FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER (EIN 94-1156276)
Tax period: 2023-09-01 to 2024-08-31
Filed: 2025-07-11
IRS object ID: 202541929349301049
Schema version: 2023v6.0
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 F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2025-07-11T15:02:37-05:00	ReturnTs
Tax Period End	2024-08-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390859910	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BAKER TILLY ADVISORY GROUP LP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	3121 W MARCH LN STE 200	AddressLine1Txt
City	STOCKTON	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	952192367	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-09-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	941156276	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FRESNO COMMUNITY HOSPITAL	BusinessNameLine1Txt
Business Name Line2	AND MEDICAL CENTER	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	FRES	BusinessNameControlTxt
Phone	5594596000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1560 E SHAW AVENUE	AddressLine1Txt
City	FRESNO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93710	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CHRISTOPHER NEUMAN	PersonNm
Person Title	SVP, CHIEF FINANCIAL OFFICER	PersonTitleTxt
Phone	5594596000	PhoneNum
Signature	2025-07-10	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	WENDY CAMPOS	PreparerPersonNm
PTIN	P00448102	PTIN
Phone	2099556100	PhoneNum
Preparation	2025-07-10	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	SEE SCHEDULE O	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	CRAIG WAGONER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1560 E SHAW AVENUE	AddressLine1Txt
City	FRESNO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93710	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$4,038,992,448	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.COMMUNITYMEDICAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1947	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	FCH&MC MEETS THE MEDICAL NEEDS OF ITS COMMUNITY THROUGH ITS ACUTE-CARE HOSPITALS AND FACILITIES.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	8642	TotalEmployeeCnt
Total Volunteers	807	TotalVolunteersCnt
Total Gross UBI	$27,693,948	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$458,338	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$11,613,093	PYContributionsGrantsAmt
CY Contributions Grants	$11,416,708	CYContributionsGrantsAmt
PY Program Service Revenue	$2,454,632,760	PYProgramServiceRevenueAmt
CY Program Service Revenue	$2,643,561,356	CYProgramServiceRevenueAmt
PY Investment Income	$19,276,196	PYInvestmentIncomeAmt
CY Investment Income	$78,456,282	CYInvestmentIncomeAmt
PY Other Revenue	$8,425,039	PYOtherRevenueAmt
CY Other Revenue	$9,031,628	CYOtherRevenueAmt
PY Total Revenue	$2,493,947,088	PYTotalRevenueAmt
CY Total Revenue	$2,742,465,974	CYTotalRevenueAmt
PY Grants And Similar Paid	$575,595	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$492,306	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,124,875,000	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,092,237,000	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,223,682,565	PYOtherExpensesAmt
CY Other Expenses	$1,331,002,891	CYOtherExpensesAmt
PY Total Expenses	$2,349,133,160	PYTotalExpensesAmt
CY Total Expenses	$2,423,732,197	CYTotalExpensesAmt
PY Revenues Less Expenses	$144,813,928	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$318,733,777	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,778,693,696	TotalAssetsBOYAmt
Total Assets EOY	$3,113,716,823	TotalAssetsEOYAmt
Total Liabilities BOY	$1,138,297,550	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,156,851,315	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,640,396,146	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,956,865,508	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER'S (FCH&MC'S) EXISTS TO BETTER THE LIVES OF ALL THOSE WE SERVE	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$2,219,680,049	ExpenseAmt
Grant	$492,306	GrantAmt
Revenue	$2,643,561,356	RevenueAmt
Desc	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER OPERATES TWO ACUTE-CARE HOSPITALS AND NUMEROUS OUTPATIENT CENTERS, CLINICS AND OTHER SERVICES WHICH MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL DETAILS.- COMMUNITY REGIONAL MEDICAL CENTER. CRMC IS A TERTIARY ACUTE CARE FACILITY THAT PROVIDES THE PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA WITH THE FOLLOWING SERVICES: (I) THE CENTRAL VALLEY'S ONLY LEVEL I TRAUMA CENTER, (II) THE COMMUNITY REGIONAL BURN CENTER, (III) A LEVEL III NEONATAL INTENSIVE CARE UNIT, (IV) COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES, INCLUDING TECHNOLOGICALLY ADVANCED MEDICAL/SURGICAL SPECIALTIES SUCH AS CARDIOVASCULAR, NEUROSCIENCE, ORTHOPEDICS AND WOMEN'S AND CHILDREN'S SERVICES, (V) THE COMMUNITY FAMILY BIRTH CENTER, (VI) GENERAL AND SPECIALTY INTENSIVE CARE UNITS, (VII) THE LEON S. PETERS REHABILITATION CENTER, (VIII) INPATIENT AND OUTPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) DIALYSIS TREATMENT FACILITIES, (XI) DIAGNOSTIC RADIOLOGY SERVICES, (XII) SHORT STAY SURGERY SERVICES, (XIII) A CARDIOVASCULAR CARE UNIT, AND (XIV) 24 HOUR EMERGENCY SERVICES. CRMC IS ALSO A TEACHING HOSPITAL THAT IS AFFILIATED WITH UCSF. THE MAIN CAMPUS OF CRMC CONSISTS OF A HOSPITAL BUILDING WITH FIVE AND 10-STORY WINGS, CONNECTED TO A FIVE STORY TRAUMA AND CRITICAL CARE BUILDING. CRMC ALSO PROVIDES (I) BEHAVIORAL HEALTH SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC"), (II) SUBACUTE AND SKILLED NURSING SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER ("CSTCC"), AND (III) HIV AND OMFS SERVICES ARE OFFERED AT THE DERAN KOLIGIAN AMBULATORY CARE CENTER LOCATED ON THE CRMC MAIN CAMPUS (THE "FRESNO CAMPUS"). - CLOVIS COMMUNITY MEDICAL CENTER. CCMC IS LOCATED IN THE CITY OF CLOVIS (WHICH IS CONTIGUOUS TO THE CITY OF FRESNO), WHERE IT SERVES THE PRIMARY SERVICE AREA AND, TO A LESSER DEGREE, THE SECONDARY SERVICE AREA. THE CHS CAMPUS IN CLOVIS (THE "CLOVIS CAMPUS") INCLUDES THE MAIN FACILITY, WHICH CONSISTS OF AN ACUTE CARE HOSPITAL WITH TWO FIVE-STORY TOWER AND A THREE-STORY TOWER CONNECTED TO AN OUTPATIENT SURGERY/ENDOSCOPY/DIAGNOSTIC CENTER. THE FACILITY HAS ALL PRIVATE ROOMS. THE FACILITY PROVIDES: (I) COMPREHENSIVE MEDICAL AND SURGICAL CAPABILITIES, (II) 24-HOUR EMERGENCY CARE, (III) AN INTENSIVE CARE UNIT, (IV) THE COMMUNITY FAMILY BIRTH CENTER, (V) THE MARJORIE E. RADIN BREAST CARE CENTER (VI) SHORT STAY AND INPATIENT SURGICAL SERVICES, INCLUDING ROBOTICS AND ADVANCED MINIMALLY INVASIVE SURGERY, (VII) A LEVEL II NEONATAL INTENSIVE CARE UNIT, (VIII) INPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) ADVANCED DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, AND (XI) INVASIVE AND NON-INVASIVE CARDIAC SERVICES. OTHER FACILITIES AND SERVICES PROVIDED ON THE CLOVIS CAMPUS INCLUDE: (I) AN OUTPATIENT WOUND CARE CLINIC WITH TWO HYPERBARIC OXYGEN CHAMBERS, (II) AN OUTPATIENT PHYSICAL REHABILITATION CLINIC, INCLUDING LYMPHEDEMA THERAPY, (III) COMMUNITY CANCER INSTITUTE (CCI), A THREE-STORY BUILDING WHICH IS CENTRAL CALIFORNIA'S PREMIER COMPREHENSIVE CANCER CARE CENTER - AND THE ONLY ONE IN THE AREA WITH MANY OUTPATIENT SERVICES IN A SINGLE LOCATION, AND (IV) THE H. MARCUS RADIN CONFERENCE CENTER, WHICH OPENED IN 2012 AND PROVIDES A 214- SEAT AUDITORIUM THAT IS FULLY INTEGRATED FOR TRAINING IN CHS'S OPERATING ROOMS AND FOR BROADCASTING OTHER EVENTS, AND TWO STATE-OF-THE-ART COMPUTER TRAINING LABS.- FRESNO HEART AND SURGICAL HOSPITAL. HEART HOSPITAL IS AN ACUTE CARE FACILITY WITH ALL PRIVATE ROOMS LOCATED IN THE CITY OF FRESNO OVERLOOKING WOODWARD PARK IN NORTHEAST FRESNO. THE FACILITY OPENED IN OCTOBER 2003 AND PROVIDES THE PRIMARY AND SECONDARY SERVICE AREAS WITH (I) CARDIOLOGY AND CARDIAC SURGERY SERVICES, (II) VASCULAR SURGERY SERVICES, AND (III) BARIATRIC AND OTHER MINIMALLY INVASIVE SURGERY SERVICES. THE ORGANIZATION IS THE PRINCIPAL TEACHING HOSPITAL IN THE CENTRAL VALLEY THROUGH A GRADUATE MEDICAL EDUCATION PROGRAM AFFILIATED WITH THE UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO MEDICAL EDUCATION PROGRAM. CHS SUPPORTS A FULLY ACCREDITED EDUCATIONAL PROGRAM WITH CALIFORNIA STATE UNIVERSITY, FRESNO, BY PROVIDING CLINICAL EXPERIENCE TO ITS NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND DIETETIC STUDENTS. ADDITIONALLY, THE ORGANIZATION PROVIDES CLINICAL EXPERIENCE TO FRESNO CITY COLLEGE'S NURSING, SURGERY AND RADIOLOGY TECHNOLOGY STUDENTS. CHS ALSO PROVIDES CLINICAL EXPERIENCE TO STUDENTS IN THE SAN JOAQUIN VALLEY COLLEGE LVN TO RN PROGRAM, FRESNO ADULT SCHOOL AND CLOVIS ADULT SCHOOL LICENSED VOCATIONAL NURSE PROGRAMS, AS WELL AS STUDENTS IN MANY OTHER PROGRAMS AT AREA COMMUNITY COLLEGES. EACH OF THE THREE ACUTE HOSPITALS CONDUCTS EDUCATIONAL PROGRAMS FOR THE BENEFIT OF PHYSICIANS, NURSES, TECHNICIANS, MANAGEMENT PERSONNEL, EMPLOYEES, AND THE PUBLIC. IN ADDITION, CHS SPONSORS NUMEROUS HEALTH PROMOTION AND EDUCATION PROGRAMS FOR ITS EMPLOYEES AND MEMBERS OF THE COMMUNITY IN MANY AREAS, INCLUDING ASTHMA, DIABETES, NUTRITION AND WEIGHT CONTROL, STRESS MANAGEMENT, HEALTH AND WELLNESS, AND SMOKING CESSATION. THE ORGANIZATION IS AN ACTIVE PARTNER IN SEVERAL COMMUNITY SERVICE PROJECTS SUPPORTING EDUCATION IN HEALTH CAREERS FOR HIGH SCHOOLS AND OTHER COMMUNITY GROUPS. TO ADDRESS THE NATION-WIDE NURSING SHORTAGE, THE ORGANIZATION HAS IMPLEMENTED SEVERAL SYSTEM-WIDE INITIATIVES TO INCREASE RECRUITMENT AND RETENTION INCLUDING THE IMPLEMENTATION OF A NURSE RESIDENCY PROGRAM AND CLINICAL LADDER, BOTH DESIGNED TO EXPAND THE EDUCATION OF NEW NURSES AND PROMOTE RETENTION OF A HIGHER PERCENTAGE OF THESE NURSES.	Desc
Total Program Service Expenses	$2,219,680,049	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	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	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	Yes (1)	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	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	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
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	391	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	8642	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
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	14	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (1)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	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	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DEBORAH MOFFETT	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5594596000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1560 E SHAW AVENUE	AddressLine1Txt
City	FRESNO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93710	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ROGER STURDEVANT
CHAIR	1.40	0.50	Yes (X)	Yes (X)	$0	$0	$0
GREG ESTEP
CHAIR-ELECT	1.40	2.40	Yes (X)	Yes (X)	$0	$0	$0
KAREN MCCAFFREY
SECRETARY	1.40	0.50	Yes (X)	Yes (X)	$0	$0	$0
SUSAN ABUNDIS
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
LORI BENNETT EDD
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
RONALD BIERMA MD
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
KEITH BOONE MD
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
MARK COELHO
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
GERARDO HERNANDEZ
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
WAGIH IBRAHIM MD
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
LELAND PARNAGIAN
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
JOSHUA PETERSON
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
RUTHIE QUINTO
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
CHANDRASEKAR VENUGOPAL MD
BOARD MEMBER	1.40	0.50	Yes (X)		$0	$0	$0
CRAIG S CASTRO
PRESIDENT, CHIEF EXECUTIVE OFFICER	55.00	5.00		Yes (X)	$0	$2,203,578	$784,941
CHRISTOPHER NEUMAN
SVP, CHIEF FINANCIAL OFFICER	55.00	5.00		Yes (X)	$0	$1,305,393	$34,720
DEBORAH MOFFETT
VICE FINANCIAL OFFICER/VP FINANCE	50.00	5.00		Yes (X)	$0	$507,812	$34,106
ISABEL MARTINEZ - FIRST VS
DIRECTOR CORP GOVERNANCE	40.00	5.00		Yes (X)	$0	$140,955	$24,989
KATHY MELENDEZ - SECOND VS
BOARD GOVERNANCE SPECIALIST	35.00	5.00		Yes (X)	$0	$89,916	$2,843
CRAIG WAGONER
EVP, CHIEF OPERATING OFFICER	50.00	6.90			$0	$1,622,090	$36,219	Yes (X)
BRIANNE L MARRIOTT
SVP, CHIEF LEGAL OFFICER	50.00	5.00			$0	$910,143	$36,725	Yes (X)
ALDO DE LA TORRE - SVP NETWORK
DEVELOPMENT AND INSURANCE SVC	50.00	6.90			$0	$870,280	$38,708	Yes (X)
CARLA MILTON - SVP
CHIEF HUMAN RESOURCES OFFICER	50.00	6.90			$0	$781,246	$39,715	Yes (X)
THOMAS UTECHT
SVP, CHIEF MEDICAL OFFICER	50.00	5.00			$1,167,686	$0	$49,150		Yes (X)
JEFFREY THOMAS - VP CHIEF
MEDICAL AND QUALITY OFFICER - CRMC	50.00	5.00			$695,531	$0	$24,932		Yes (X)
TRACY KIRITANI
VP, HOSPITAL FINANCIAL OPERATIONS	50.00	5.00			$690,333	$0	$34,478		Yes (X)
DANIEL DAVIS - SVP CHIEF
CLINICAL AND OPERATIONS OFFICER	50.00	5.00			$598,989	$0	$22,621		Yes (X)
ROBYN GONZALES
VP, CHIEF OPERATING OFFICER CRMC	50.00	5.00			$521,157	$0	$41,751		Yes (X)
ROGER LARSEN - FORMER SVP
CHIEF FINANCIAL OFFICER THRU 08/22	0.00	0.00			$0	$667,956	$12,984			Yes (X)
JUANITA HERNANDEZ - FRMR FIRST
VS/SECOND VS/DIR CORP GOV THRU 02/22	0.00	0.00			$0	$170,795	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,673,696	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$9,270,164	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,218,882	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2553	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	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
CARDINAL HEALTH
PO BOX 56412	LOS ANGELES	CA	90074	MEDICAL	$141,724,291
CCFMG
2625 EAST DIVISADERO	FRESNO	CA	93721	MEDICAL	$65,744,944
MEDLINE INDUSTRIES INC
DEPT LA 21588	PASADENA	CA	91185	MEDICAL	$61,529,446
AMN HEALTHCARE INC
BANK OF AMERICA 450 B STREET SUITE	SAN DIEGO	CA	92101	MEDICAL	$52,743,108
THOMAS CUISINE MANAGEMENT
700 E FRANKLIN ROAD	MERIDIAN	ID	83642	FOOD SERVICES	$29,471,981

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	475	CntrctRcvdGreaterThan100KCnt
Related Organizations	$10,820,053	RelatedOrganizationsAmt
Government Grants	$596,655	GovernmentGrantsAmt
Total Contributions	$11,416,708	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
MEDICAL SERVICE	622110	$2,416,304,182	$2,416,304,182
GRANTS AND CONTRACTS	622110	$199,620,080	$199,620,080
PHARMACY SALES	456110	$27,637,094	$682,269	$26,954,825

Field	Value	IRS element (for citing)
Total Program Service Revenue	$2,643,561,356	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,415,305	TotalRevenueColumnAmt
Exclusion	$30,415,305	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,344,553,450	SecuritiesAmt
Other	$14,001	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,296,519,293	SecuritiesAmt
Other	$7,181	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$48,034,157	SecuritiesAmt
Other	$6,820	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$48,040,977	TotalRevenueColumnAmt
Exclusion	$48,040,977	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
HOSPITAL CAFETERIA REV	722514	$8,292,505	$8,292,505
INCOME FR PARTNERSHIPS	900099	$445,713		$445,713
PARKING AND SECURITY	812930	$293,410		$293,410

Field	Value	IRS element (for citing)
Other Revenue Total	$9,031,628	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,742,465,974	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,616,606,531	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$27,693,948	UnrelatedBusinessRevenueAmt
Exclusion	$86,748,787	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$492,306	TotalAmt
Program Services	$492,306	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$7,650,260	TotalAmt
Management And General	$7,650,260	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$566,649	TotalAmt
Program Services	$307,522	ProgramServicesAmt
Management And General	$259,127	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$907,308,105	TotalAmt
Program Services	$789,358,051	ProgramServicesAmt
Management And General	$117,950,054	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$29,093,548	TotalAmt
Program Services	$25,311,387	ProgramServicesAmt
Management And General	$3,782,161	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$83,854,715	TotalAmt
Program Services	$72,953,602	ProgramServicesAmt
Management And General	$10,901,113	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$63,763,723	TotalAmt
Program Services	$55,474,439	ProgramServicesAmt
Management And General	$8,289,284	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$111,267	TotalAmt
Management And General	$111,267	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$43,329	TotalAmt
Program Services	$43,329	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$929,168	TotalAmt
Management And General	$929,168	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$414,326,828	TotalAmt
Program Services	$402,241,392	ProgramServicesAmt
Management And General	$12,085,436	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,795,548	TotalAmt
Management And General	$1,795,548	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,467,215	TotalAmt
Management And General	$4,467,215	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$36,678,571	TotalAmt
Program Services	$30,809,999	ProgramServicesAmt
Management And General	$5,868,572	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$502,104	TotalAmt
Program Services	$421,767	ProgramServicesAmt
Management And General	$80,337	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$407,281	TotalAmt
Program Services	$407,281	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$28,661,000	TotalAmt
Program Services	$24,075,240	ProgramServicesAmt
Management And General	$4,585,760	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$84,997,000	TotalAmt
Program Services	$71,397,480	ProgramServicesAmt
Management And General	$13,599,520	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$15,317,000	TotalAmt
Program Services	$12,866,280	ProgramServicesAmt
Management And General	$2,450,720	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
MEDICAL SUPPLIES	$455,550,778	$455,550,778
MEDI-CAL PROVIDER FEE	$185,916,598	$185,916,598
MINOR EQUIPMENT	$41,250,510	$41,250,510
UBI TAX	$145,000	$145,000

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$59,903,694	TotalAmt
Program Services	$50,657,088	ProgramServicesAmt
Management And General	$9,246,606	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,423,732,197	TotalAmt
Program Services	$2,219,680,049	ProgramServicesAmt
Management And General	$204,052,148	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$45,856,065	BOYAmt
EOY	$18,503,625	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$502,843,001	BOYAmt
EOY	$478,041,745	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$18,421,888	BOYAmt
EOY	$10,905,455	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$5,557,012	BOYAmt
EOY	$20,163,088	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$26,940,115	BOYAmt
EOY	$28,475,827	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$14,723,284	BOYAmt
EOY	$13,117,644	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$2,052,720,256	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$894,569,721	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,177,239,500	BOYAmt
EOY	$1,158,150,535	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$490,608,734	BOYAmt
EOY	$816,513,553	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$37,269,926	BOYAmt
EOY	$40,213,006	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,129,920	BOYAmt
EOY	$5,435,968	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$453,104,251	BOYAmt
EOY	$524,196,377	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,778,693,696	BOYAmt
EOY	$3,113,716,823	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$213,603,158	BOYAmt
EOY	$250,102,719	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$379,493	BOYAmt
EOY	$544,290	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$710,995,618	BOYAmt
EOY	$698,663,634	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$137,639,250	BOYAmt
EOY	$131,249,362	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$75,680,031	BOYAmt
EOY	$76,291,310	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,138,297,550	BOYAmt
EOY	$1,156,851,315	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	$1,640,396,146	BOYAmt
EOY	$1,956,865,508	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,640,396,146	BOYAmt
EOY	$1,956,865,508	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,778,693,696	BOYAmt
EOY	$3,113,716,823	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$318,733,777	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$3,833,581	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	-$5,386,886	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$711,110	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	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$43,329	OtherActivitiesAmt
Total Lobbying Expenditures	$43,329	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	FCH&MC ENGAGED CALIFORNIA HOSPITALS COMMITTEE ON ISSUES (CHCI) SPONSORED BY CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) THROUGH INTERMEDIARY CALIFORNIA HOSPITAL ASSOCIATION TO ASSIST THE CALIFORNIA GENERAL PURPOSE COMMITTEE IN SUPPORT OF CANDIDATES AND BALLOT MEASURES AS IT RELATES TO HEALTHCARE ISSUES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$15,908,426	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$16,148,551	OtherCostOrOtherBasisAmt
Book Value	$32,056,977	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,409,032,276	OtherCostOrOtherBasisAmt
Depreciation	$454,269,741	DepreciationAmt
Book Value	$954,762,535	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,218,953	OtherCostOrOtherBasisAmt
Depreciation	$6,140,280	DepreciationAmt
Book Value	$78,673	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$558,867,041	OtherCostOrOtherBasisAmt
Depreciation	$434,159,700	DepreciationAmt
Book Value	$124,707,341	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$46,545,009	OtherCostOrOtherBasisAmt
Book Value	$46,545,009	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,158,150,535	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
RECEIVABLE FROM AFFILIATES	$489,241,320
SUPPLEMENTAL FUNDING	$12,472,969
ROU ASSETS	$22,482,088

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$524,196,377	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDesc	AmtAmt
ASSET RETIREMENT OBLIGATION	$5,340,218
GROUP HEALTH	$2,631,492
MALPRACTICE - IBNR	$5,814,000
WORKERS COMPENSATION RESERVE	$38,378,981
PHYSICIAN GUARANTEE PAYABLE	$1,101,850
LEASE LIABILITY	$20,244,735
CLAIM ACTIVITY	$1,995,833
OTHER LIABILITIES	$784,201

Field	Value	IRS element (for citing)
Total Liability	$76,291,310	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE D, PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THERE IS NO FOOTNOTE FOR FIN 48 IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DUE TO IMMATERIALITY.	ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxt	OfficesOfficesCnt	EmployeeEmployeeCnt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt	Specific Services ProvidedSpecificServicesProvidedTxt
CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS	$46,948,494
CENTRAL AMERICA AND THE CARIBBEAN	0	0	PROGRAM SERVICES	$8,568,631	CAPTIVE INSURANCE

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$55,517,125	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$55,517,125	TotalSpentAmt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 3:	FormAndLineReferenceDesc
Explanation	ACCRUAL METHOD	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	400.000000000000	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	$17,080,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,080,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00700	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$424,389,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$270,902,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$153,487,000	NetCommunityBenefitExpnsAmt
Total Expense	0.06340	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$441,469,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$270,902,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$170,567,000	NetCommunityBenefitExpnsAmt
Total Expense	0.07040	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	1765	PersonsServedCnt
Total Community Benefit Expns	$625,375	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$54,703	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$570,672	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	30	PersonsServedCnt
Total Community Benefit Expns	$53,997,908	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,733,484	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$45,264,424	NetCommunityBenefitExpnsAmt
Total Expense	0.01870	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$329,010	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$329,010	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	12	ActivitiesOrProgramsCnt
Persons Served	1795	PersonsServedCnt
Total Community Benefit Expns	$54,952,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,788,187	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,164,106	NetCommunityBenefitExpnsAmt
Total Expense	0.01900	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	12	ActivitiesOrProgramsCnt
Persons Served	1795	PersonsServedCnt
Total Community Benefit Expns	$496,421,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$279,690,187	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$216,731,106	NetCommunityBenefitExpnsAmt
Total Expense	0.08940	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	96	PersonsServedCnt
Total Community Benefit Expns	$6,894	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,894	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	96	PersonsServedCnt
Total Community Benefit Expns	$6,894	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,894	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,013,216	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$359,977,814	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$417,460,408	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$57,482,594	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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 CA IMAGING INSTITUTE LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	MEDICAL IMAGING	PrimaryActivitiesTxt
Org Profit Or Ownership	0.50000	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.00000	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.50000	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
COMMUNITY REGIONAL MEDICAL CENTER
1	2823 FRESNO ST	FRESNO	CA	93721	WWW.COMMUNITYMEDICAL.ORG	040000096	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
CLOVIS COMMUNITY MEDICAL CENTER
2	2755 HERNDON	CLOVIS	CA	93612	WWW.COMMUNITYMEDICAL.ORG	040000004	Yes (X)	Yes (X)			Yes (X)	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	FACILITY REPORTING GROUP - A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
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	22	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	23	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V	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	400.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	450.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
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
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V	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
Other Publicity	Yes (X)	OtherPublicityInd
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
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: COMMUNITY REGIONAL MEDICAL CENTER, - FACILITY 2: CLOVIS COMMUNITY MEDICAL CENTER
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:	THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONSISTS OF PRIMARY DATA FROM OVER 4,800 INDIVIDUAL INTERVIEWS AND 59 MULTI-LINGUAL FOCUS GROUPS. PARTICIPANTS IN PRIMARY DATA COLLECTION EFFORTS INCLUDED RESIDENTS THROUGHOUT FRESNO, KINGS, MADERA, AND TULARE COUNTIES AND REPRESENTATIVES FROM AND USERS OF HEALTH IMPROVEMENT PROGRAMS SERVING LOW-INCOME AND VULNERABLE POPULATIONS, CHILDREN AND FAMILIES, HOMELESS, LGBTQ+, SENIORS, TRIBAL COMMUNITIES, AS WELL AS BLACK/AFRICAN AMERICAN, HMONG, LATINO AND SPANISH-SPEAKING POPULATIONS. SECONDARY DATA WAS COLLECTED USING GOVERNMENT AND OTHER PUBLIC HEALTH RESOURCES INCLUDING THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, U.S. CENTER FOR DISEASE CONTROL, HEALTHY COMMUNITIES INSTITUTE AND U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	SEVERAL HOSPITALS COLLABORATED ON THIS REPORT. THE PARTICIPATING HOSPITALS WERE: COMMUNITY REGIONAL MEDICAL CENTER, CLOVIS COMMUNITY MEDICAL CENTER, FRESNO HEART AND SURGICAL HOSPITAL, KAWEAH HEALTH MEDICAL CENTER, SAINT AGNES MEDICAL CENTER, SIERRA VIEW MEDICAL CENTER, AND VALLEY CHILDREN'S HEALTHCARE.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	- BINATIONAL OF CENTRAL CALIFORNIA - CALIFORNIA STATE UNIVERSITY, FRESNO STUDENT VOLUNTEERS - CENTRAL VALLEY HEALTH POLICY INSTITUTE - CULTIVA LA SALUD - EVERY NEIGHBORHOOD PARTNERSHIP - FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH - FRESNO INTERDENOMINATIONAL REFUGEE MINISTRIES - HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA - KINGS COUNTY COMMISSION ON AGING - KINGS PARTNERSHIP FOR PROSPERITY, PROGRESS, AND PREVENTION - MADERA COALITION FOR COMMUNITY JUSTICE - MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH - MOXLEY PUBLIC HEALTH - THE FRESNO CENTER - TULARE COUNTY DEPARTMENT OF PUBLIC HEALTH - TULE RIVER TRIBE PUBLIC HEALTH AUTHORITY - UNITED WAY FRESNO AND MADERA COUNTIES - UNITED WAY OF TULARE COUNTY
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11:	COMMUNITY REGIONAL MEDICAL CENTER ("CRMC") AND CLOVIS COMMUNITY MEDICAL CENTER ("CCMC") COMPLETED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IN FY22 AS REQUIRED BY STATE AND FEDERAL LAW. THE CHNA IS THE PRIMARY TOOL USED BY THE HOSPITAL FACILITIES TO DETERMINE THEIR COMMUNITY BENEFIT PLANS, WHICH OUTLINE HOW THEY WILL GIVE BACK TO THE COMMUNITY IN THE FORM OF HEALTHCARE AND OTHER COMMUNITY SERVICES TO ADDRESS UNMET COMMUNITY HEALTH NEEDS. THE ASSESSMENT INCORPORATED COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUSED ON THE HEALTH AND SOCIAL NEEDS OF THE SERVICE AREA.TARGETED INTERVIEWS AND FOCUS GROUPS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITALS. FIFTY (50) KEY INFORMANT INTERVIEWS WERE COMPLETED DURING OCTOBER AND NOVEMBER 2021. INTERVIEWEES INCLUDED 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. IN ADDITION, 59 FOCUS GROUPS WERE HELD IN THE REGION, LED BY EIGHT ORGANIZATIONS. THE FOCUS GROUPS INCLUDED 473 COMMUNITY MEMBERS AND WERE HELD IN-PERSON OR VIRTUALLY. FOCUS GROUPS WERE HELD IN FIVE LANGUAGES TO MEET THE NEEDS OF THE PARTICIPANTS. FINALLY, COMMUNITY-BASED ORGANIZATIONS AND OTHER GROUPS DISTRIBUTED A COMMUNITY SURVEY IN ONLINE AND PAPER FORMATS TO AREA RESIDENTS; 4,856 USABLE SURVEYS WERE RECEIVED. INPUT WAS ALSO OBTAINED FROM COUNTY DEPARTMENTS OF PUBLIC HEALTH AND DEPARTMENTS OF BEHAVIORAL HEALTH.SIGNIFICANT HEALTH NEEDS SECONDARY DATA COLLECTION RESULTED IN IDENTIFYING COMMUNITY HEALTH NEEDS THAT WERE FURTHER ASSESSED IN THE PRIMARY DATA COLLECTION KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND A COMMUNITY-WIDE SURVEY. THE IDENTIFIED SIGNIFICANT NEEDS INCLUDED (IN ALPHABETICAL ORDER):- ACCESS TO CHILD CARE - ACCESS TO HEALTHCARE (INCLUDES DENTAL AND MENTAL HEALTHCARE) - ADVERSE CHILDHOOD EXPERIENCES - CHRONIC DISEASES - COVID-19 - CRIME AND VIOLENCE - ECONOMIC STABILITY - EDUCATION - ENVIRONMENTAL CONDITIONS (INCLUDES WATER AND AIR) - FOOD INSECURITY- INTERNET ACCESS - HIV/AIDS AND STIS - HOUSING AND HOMELESSNESS - MATERNAL AND CHILD HEALTH - MENTAL HEALTH - NUTRITION AND PHYSICAL HEALTH (INCLUDES OVERWEIGHT AND OBESITY) - PREVENTIVE CARE AND PRACTICES (INCLUDES SCREENINGS, IMMUNIZATIONS/VACCINES) - SUBSTANCE USE (ALCOHOL AND DRUGS) - TOBACCO AND NICOTINE - TRANSPORTATIONCOMMUNITY RESPONDENTS WERE ASKED TO RANK THE HEALTH OUTCOMES AND SOCIAL DETERMINANTS OF HEALTH THAT CONTRIBUTE TO DISEASE IN THE REGION. THE RESULTS OF THE RESPONSES FROM THE PRIORITY RANKING WERE COMPARED TO THE SECONDARY DATA COLLECTED FOR EACH HEALTH NEED AND THE PRIMARY DATA COLLECTED FROM A COMMUNITY SURVEY, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. AS A RESULT, THE TOP FIVE PRIORITIZED HEALTH NEEDS WERE IDENTIFIED: - MENTAL HEALTH - MATERNAL AND CHILD HEALTH - ACCESS TO CARE (INCLUDING DENTAL CARE AND MENTAL HEALTH CARE) - CHRONIC DISEASES - NUTRITIONAL AND PHYSICAL HEALTH (INCLUDING OVERWEIGHT AND OBESITY)
PART V, SECTION B, LINE 7A:	THE HOSPITAL FACILITY'S WEBSITE WHERE THE CHNA REPORT IS AVAILABLE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT
PART V, SECTION B, LINE 10:	THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT
PART V, SECTION B, LINE 11:	COMMUNITY HEALTH SYSTEM ("CHS") INTENDS TO TAKE ACTIONS TO ADDRESS THE FOLLOWING HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2022 CHNA: (1) ACCESS TO HEALTHCARE, (2) CHRONIC DISEASE, (3) ECONOMIC STABILITY, (4) MATERNAL AND CHILD HEALTH, AND (5) MENTAL HEALTH. CHS SELECTED HEALTH NEEDS TO PRIMARILY FOCUS EFFORTS ON BASED UPON THE SYSTEM'S CAPACITY TO ADDRESS THE NEEDS, THE STRENGTH OF COMMUNITY PARTNERSHIPS AND THOSE NEEDS THAT CORRESPOND WITH THE HEALTH SYSTEM'S PRIORITIES. CHS WILL ADDRESS THESE HEALTH NEEDS THOUGH A MULTI-FACETED APPROACH INCLUDING, DIRECT PROGRAMS/SERVICES, LEADERSHIP, AND PARTICIPATION IN BROAD MULTI-STAKEHOLDER COALITIONS/COLLABORATIVES AND CONTINUOUS COLLABORATION BETWEEN CHS AND COMMUNITY PARTNERS. ADDRESSING PRIORITY HEALTH NEEDS - COMMUNITY REGIONAL MEDICAL CENTER ("CRMC")IN FY24, CRMC ENGAGED IN ACTIVITIES AND PROGRAMS THAT ADDRESSED THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2023-2025 IMPLEMENTATION STRATEGY. CRMC COMMITTED TO COMMUNITY BENEFIT EFFORTS THAT ADDRESSED ACCESS TO HEALTHCARE, CHRONIC DISEASES, ECONOMIC STABILITY, MATERNAL AND CHILD HEALTH AND MENTAL HEALTH. ACTIVITIES AND PROGRAMS THAT HIGHLIGHT CRMC'S COMMITMENT TO THE COMMUNITY ARE DETAILED BELOW.ACCESS TO HEALTHCARE RESPONSE TO NEED FINANCIAL ASSISTANCE THE HOSPITAL PROVIDED FINANCIAL ASSISTANCE THROUGH FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES, CONSISTENT WITH CHS'S FINANCIAL ASSISTANCE POLICY.ASSISTANCE WITH INSURANCE COVERAGE IN PARTNERSHIP WITH FRESNO'S COUNTY DEPARTMENT OF SOCIAL SERVICES, CRMC PROVIDED ENROLLMENT FOR 344 UNINSURED PERSONS WHO PRESUMPTIVELY QUALIFIED FOR MEDI-CAL.RYAN WHITE HIV/AIDS PROGRAM CHS PARTNERS WITH FAMILY HEALTH CARE NETWORK'S SPECIAL SERVICES CLINIC TO PROVIDE VITAL AND TIMELY HEALTHCARE AND CASE MANAGEMENT FOR PATIENTS WITH HIV/AIDS AND THEIR FAMILIES. IN FY24, THE CLINIC PROVIDED CARE TO PATIENTS THROUGH OVER 7,700 CLINICAL VISITS UNDER THE FEDERAL RYAN WHITE GRANT.SEXUAL ASSAULT FORENSIC EXAM PROGRAM (SAFE) CRMC'S EMERGENCY DEPARTMENT PROVIDED FRESNO COUNTY'S ONLY IN-HOSPITAL TESTING AND EXAMINATION FOR SEXUAL ASSAULT AND RAPE VICTIMS. SPECIALLY TRAINED NURSES COLLECTED, PRESERVED AND SECURELY STORED EVIDENCE COLLECTED FROM ADULT AND CHILD VICTIMS, AND FROM SUSPECTS UNDER POLICE CUSTODY. SEXUAL ASSAULT FORENSIC EXAM PROGRAM NURSES HELPED GATHER EVIDENCE OF SEXUAL VIOLENCE AND ENSURED PATIENTS WERE SAFELY DISCHARGED. NURSES ALSO PROVIDED FOLLOW-UP EVALUATIONS FOR CHILD VICTIMS OF SEXUAL ABUSE AND HELPED CONNECT VICTIMS AND THEIR FAMILIES TO COUNSELING SERVICES. IN FY24, 135 PEOPLE WERE SERVED.TRAUMA PREVENTION PROGRAM CRMC PROVIDES THE ONLY LEVEL I TRAUMA CENTER AND COMPREHENSIVE BURN CENTER IN THE AREA. AN INJURY PREVENTION SPECIALIST PROVIDED EXTENSIVE INJURY PREVENTION OUTREACH IN SCHOOLS AND OTHER COMMUNITY-BASED VENUES, INCLUDING CAR SEAT SAFETY CHECKS AND EDUCATION ON TOPICS LIKE GUN SAFETY, FALL PREVENTION, BICYCLE AND PEDESTRIAN SAFETY, THE DANGERS OF DISTRACTED DRIVING FOR TEENS AND SMARTER DRIVING TIPS FOR OLDER ADULTS.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO INCREASE ACCESS TO HEALTHCARE AND PROVIDE PREVENTIVE CARE SERVICES. - READING & BEYOND PROVIDES SERVICES FOR LOW-INCOME CHILDREN AND FAMILIES IN FRESNO. THE HOSPITAL SUPPORTED THEIR HEALTH INITIATIVES. - THE HOSPITAL SUPPORTED EVERY NEIGHBORHOOD PARTNERSHIP'S BACK TO SCHOOL HEALTH SCREENING AND RESOURCE FAIR HOSTED BY ASSEMBLY MEMBER ESMERALDA SORIA. - FUNDING WAS PROVIDED TO THE MARJAREE MASON CENTER TO SUPPORT HEALTHCARE SERVICES FOR SURVIVORS OF DOMESTIC VIOLENCE IN FRESNO COUNTY.CHRONIC DISEASES RESPONSE TO NEED COMMUNITY DIABETES EDUCATION COMMUNITY DIABETES EDUCATION PROVIDED CARE TO PERSONS WHO WERE OTHERWISE UNABLE TO RECEIVE DIABETES SELF-MANAGEMENT EDUCATION, INCLUDING BILINGUAL SERVICES TO A HIGH CONCENTRATION OF SPANISH-SPEAKING PATIENTS. AS AN ACCREDITED SWEET SUCCESS PROGRAM AFFILIATE, THE DIABETES EDUCATION CENTER PROVIDED EDUCATION TARGETED TO WOMEN DIAGNOSED WITH DIABETES DURING PREGNANCY. COMMUNITY MEMBERS RECEIVED EDUCATION ON HEALTHY EATING HABITS AND CONTROLLING DIABETES DURING PREGNANCY. DIALYSIS CRMC HAS AN OUTPATIENT DIALYSIS UNIT WITH 41 DIALYSIS STATIONS FOR THREE SHIFTS OF PATIENTS, SIX DAYS A WEEK - CARING FOR ADULTS NEEDING DIALYSIS. CRMC ALSO OFFERS A PERITONEAL DIALYSIS HOME TRAINING PROGRAM FOR PATIENTS WHO CAN DO HOME TREATMENT. THE OUTPATIENT DIALYSIS UNIT HAS ON-SITE DIETITIANS AND SOCIAL WORKERS.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO IDENTIFY AND TREAT CHRONIC DISEASES. - FUNDING WAS PROVIDED TO THE FRESNO CENTER FOR COMMUNITY-BASED CHRONIC DISEASE OUTREACH EVENTS. - THE HOSPITAL SUPPORTED THE AMERICAN HEART ASSOCIATION TO PURCHASE AND DISTRIBUTE SELF-MONITORED BLOOD PRESSURE KITS.ECONOMIC STABILITY RESPONSE TO NEED TRANSPORTATION SUPPORT TRANSPORTATION VOUCHERS WERE MADE AVAILABLE TO PATIENTS AND FAMILIES HAVING DIFFICULTY ACCESSING CARE AND SERVICES BECAUSE OF TRANSPORTATION BARRIERS. COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO SUPPORT ECONOMIC STABILITY. - THE HOSPITAL SUPPORTED POVERELLO HOUSE'S PAPA MIKE'S CAFE, WHICH IS A NO-COST, FULL-SERVICE RESTAURANT SERVING MADE-TO-ORDER MEALS FOR ANYONE IN NEED. - FUNDING WAS PROVIDED TO THE FRESNO MISSION TO SUPPORT FOOD SERVICES FOR THE COMMUNITY CARE AND FAMILY CENTER. - CRMC PARTNERED WITH THE CENTRAL CALIFORNIA FOOD BANK TO SUPPORT YOKOMI ELEMENTARY SCHOOL'S BACKPACK PROGRAM, THAT SENDS WEEKEND FOOD HOME FOR STUDENTS AND THEIR FAMILIES, IN DOWNTOWN FRESNO FOR THE 2024/25 SCHOOL YEAR. - FUNDING WAS PROVIDED TO THE CENTRAL CALIFORNIA WOMEN'S CONFERENCE FOOD INSECURITY GRANTS INITIATIVE. - THE AMERICAN RED CROSS SOUND THE ALARM OUTREACH INSTALLED FREE SMOKE ALARMS IN COMMUNITY RESIDENCES WITH SUPPORT FROM CRMC. - CRMC INVESTED IN BIRNEY ELEMENTARY SCHOOL'S TECHNOLOGY AND READING PROGRAM, WHICH IS IN A LOW SOCIOECONOMIC AREA OF CENTRAL FRESNO. THE FUNDS WERE USED IN THE TITLE 1 SCHOOL TO PURCHASE SCIENCE, TECHNOLOGY, ENGINEERING AND MATHEMATICS (STEM) LEARNING MATERIALS. - FUNDS WERE PROVIDED TO THE MARJAREE MASON CENTER'S DOMESTIC VIOLENCE VICTIM SAFE HOUSE. THIS COMMUNITY REFUGE PROVIDES SAFE LODGING FOR ADULTS AND CHILDREN FLEEING DOMESTIC VIOLENCE. - THE HOSPITAL SPONSORED FRESNO CITY COUNCILMAN NELSON ESPARZA'S BEAT THE HEAT COMMUNITY EVENT.MATERNAL AND CHILD HEALTH RESPONSE TO NEED MOTHER'S RESOURCE CENTERTHE MOTHER'S RESOURCE CENTER OFFERED A VARIETY OF BREASTFEEDING AND PARENT EDUCATION CLASSES TO NEW PARENTS, REGARDLESS OF WHERE THEY DELIVERED THEIR BABIES. CLASSES INCLUDED PREPARATION FOR CHILDBIRTH, BREASTFEEDING SUPPORT, MOMMIES MAKING MILK AND MAMA'S CAFE CLUB, A POSTPARTUM RESOURCE AND SUPPORT NETWORK FOR ALL BREASTFEEDING MOMS. CLASSES WERE OFFERED IN ENGLISH AND SPANISH. IN FY24, THE MOTHER'S RESOURCE CENTER HAD 688 OUTPATIENT AND 9,083 INPATIENT CONSULTS.DOULA TRAINING PARTNERSHIPCRMC HAS PARTNERED WITH THE BLACK WELLNESS AND PROSPERITY CENTER (BWPC) FOR A FIRST-OF-ITS-KIND IN THE STATE COLLABORATION TO TRAIN BLACK, INDIGENOUS AND PEOPLE OF COLOR (BIPOC) DOULAS WITHIN OUR FACILITY. IN FY24, EIGHT DOULAS COMPLETED 162 HOURS OF TRAINING OBSERVATIONS AT CRMC.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO SUPPORT MATERNAL AND CHILD HEALTH. - SUPPORT WAS PROVIDED TO THE BLACK WELLNESS AND PROSPERITY CENTER TO SUPPORT MATERNAL AND CHILD HEALTH EDUCATION. FUNDS ALSO SUPPORTED THE DOULA TRAINING PROGRAM, WHICH SEEKS TO IMPROVE MATERNAL OUTCOMES FOR BLACK AND MINORITY MOTHERS AND THEIR BABIES BY EXPANDING THE INTEGRATION OF DOULAS IN THE HOSPITAL SETTING. - FUNDS WERE PROVIDED TO THE FRESNO COUNCIL ON CHILD ABUSE PREVENTION, SUBSTANCE USE DISORDER COMMUNITY OUTREACH EVENT.MENTAL HEALTH RESPONSE TO NEED BRIDGE PROGRAM CRMC PROVIDED 198 INDIVIDUALS WITH BUPRENORPHINE MEDICATION ENCOUNTERS TO SUPPRESS CRAVINGS AND WITHDRAWAL SYMPTOMS FROM OPIOID USE. THE TREATMENT PROVIDED PATIENTS WITH IMMEDIATE ATTENTION IN THE HOSPITAL SETTING, RATHER THAN BEING REFERRED TO A REHABILITATION CENTER, WHICH MAY TAKE WEEKS OR MONTHS. ADDITIONALLY, THE BRIDGE PROGRAM PROVIDED EDUCATIONAL INFORMATION TO THE GREATER COMMUNITY ABOUT SUBSTANCE ABUSE. COMMUNITY BEHAVIORAL HEALTH CENTER THE CBHC IS A 73-BED ACUTE PSYCHIATRIC HOSPITAL, WHICH IS LICENSED UNDER CRMC. CBHC IS THE LARGEST PSYCHIATRIC CARE FACILITY IN FRESNO COUNTY PROVIDING 24-HOUR ADULT, INPATIENT PSYCHIATRIC CARE. THERE ARE FOUR SEPARATE UNITS WITH LEVELS OF CARE APPROPRIATE TO THE FUNCTIONAL LEVELS OF THE PATIENTS. THE SERVICES PROVIDED INCLUDE PSYCHIATRIC ASSESSMENTS, FORENSIC (CUSTODY) SERVICES, RECREATION THERAPY, GROUP AND INDIVIDUAL THERAPY, ADULT CARE, MEDICATION MANAGEMENT, MILIEU MANAGEMENT AND OTHER TREATMENT MODALITIES.
PART V, SECTION B, LINE 11 (CONTINUED):	COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO SUPPORT MENTAL HEALTH CARE SERVICES. - READING & BEYOND WAS PROVIDED FUNDING FOR THEIR FAMILY ADVOCACY PROGRAM, PROVIDING SUPPORT TO THOSE WHO HAVE LOVED ONES WITH A MENTAL HEALTH DIAGNOSIS. - EVERY NEIGHBORHOOD PARTNERSHIP WOMEN'S ALLIANCE RECEIVED FUNDS FOR TRAUMA RESILIENCE EDUCATION. - FUNDS WERE PROVIDED FOR THE FRESNO CHAFFEE ZOO ART IN THE WILD MENTAL HEALTH SUPPORT PROGRAM. - THE FOUNDATION FOR FRESNO UNIFIED SCHOOLS WAS PROVIDED WITH A DONATION TO SUPPORT PEER-LED SUPPORT GROUPS.OTHER COMMUNITY BENEFIT SERVICES - COMMUNITY REGIONAL MEDICAL CENTER ("CRMC"):CRMC PROVIDED COMMUNITY BENEFIT SERVICES IN ADDITION TO THOSE PROGRAMS THAT FOCUSED ON ADDRESSING PRIORITY HEALTH NEEDS. HEALTH PROFESSIONAL EDUCATION DEFINITION: EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, NURSING STUDENTS AND OTHER HEALTH PROFESSIONALS. GRADUATE MEDICAL EDUCATION CRMC TRAINED 262 RESIDENTS AND 47 FELLOWS IN PARTNERSHIP WITH UCSF FRESNO. IN ADDITION, THIRD-AND FOURTH-YEAR MEDICAL STUDENTS ARE TRAINED ON A ROTATING BASIS. ROTATING MEDICAL STUDENTS INCLUDE THOSE IN UCSF'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION (SJV PRIME). SJV PRIME TRAINED LOCAL STUDENTS TO PROVIDE CULTURALLY COMPETENT, ACCESSIBLE CARE IN THE SAN JOAQUIN VALLEY. MORE THAN ONE-THIRD OF GRADUATING RESIDENTS STAY IN THE CENTRAL VALLEY TO PRACTICE MEDICINE, MAKING THIS PROGRAM CRITICAL TO ADDRESSING THE REGION'S ACCESS TO CARE ISSUES. THROUGH AN AGREEMENT WITH THE CALIFORNIA HEALTH SCIENCES UNIVERSITY (CHSU), A PRIVATE INSTITUTION OFFERING DOCTORAL DEGREES THROUGH ITS COLLEGE OF OSTEOPATHIC MEDICINE, CHSU MEDICAL STUDENTS ROTATED THROUGH THE HOSPITAL AS PART OF THEIR TRAINING. FHSH SUPPORTS IN THE TRAINING OF THE ADVANCED GI MIS/BARIATRICS FELLOWSHIP PROGRAM, IN PARTNERSHIP WITH ADVANCED LAPAROSCOPIC SURGICAL ASSOCIATES. THIS PROGRAM INCLUDED FOUR FELLOWS IN FY24.NURSING CRMC HAD 1,364 NURSING STUDENTS PARTICIPATE IN PRECEPTED HOSPITAL CLINICAL ROTATIONS. SONOGRAPHY PROGRAMS COMMUNITY OFFERS TWO SONOGRAPHY PROGRAMS AT CRMC TO HELP ADDRESS THE HEALTHCARE PROVIDER SHORTAGE THROUGHOUT THE REGION: THE DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM AND THE ADVANCED CARDIAC SONOGRAPHY PROGRAM. THE 18-MONTH DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM IS ONE OF CALIFORNIA'S FEW HOSPITAL-BASED SONOGRAPHY PROGRAMS AND IS THE CENTRAL VALLEY'S ONLY MULTIDISCIPLINARY COMMISSION ON ACCREDITATION OF ALLIED HEALTH EDUCATION PROGRAMS ("CAAHEP") ACCREDITED SONOGRAPHY PROGRAM. THE ADVANCED CARDIAC SONOGRAPHY PROGRAM IS AN 18-MONTH HYBRID PROGRAM DESIGNED TO CREATE A CAREER TRACK FOR SONOGRAPHERS PRACTICING AT AN ADVANCED LEVEL IN THE ECHOCARDIOGRAPHY LABORATORY BY PROVIDING A CAAHEP-ACCREDITED EDUCATIONAL PATHWAY FOR CLINICAL AND ADMINISTRATIVE ADVANCEMENT.OTHER HEALTH PROFESSIONAL EDUCATION THIRTY STUDENTS FROM CALIFORNIA STATE UNIVERSITY, FRESNO'S PHYSICAL THERAPY DOCTORATE PROGRAM PARTICIPATED IN A HANDS-ON SPINAL CORD INJURY MOBILIZATION LAB AT THE LEON S. PETERS REHABILITATION CENTER. CRMC SUPPORTED THE CENTRAL VALLEY BIOETHICS CONFERENCE HOSTED BY UCSF FRESNO.PHARMACY RESIDENCY PROGRAMTHE POST GRADUATE YEAR 1 (PGY1) PHARMACY RESIDENCY PROGRAM WAS ESTABLISHED IN 2002 AT CRMC. THE PROGRAM IS ACCREDITED THROUGH THE AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS (ASHP). IN FY24, CRMC FILLED THREE PHARMACY RESIDENCY POSITIONS. CLINICAL PASTORAL EDUCATION OF COMMUNITY HEALTH SYSTEM THE CLINICAL PASTORAL EDUCATION (CPE) PROGRAM AT CRMC PROVIDED PROFESSIONAL TRAINING FOR SPIRITUAL CARE PROVIDERS TO IMPROVE THEIR PROFESSIONAL MINISTRY SKILLS. THE CPE PROGRAM IS A MULTI-FAITH AND INTER-FAITH ENVIRONMENT THAT RESPECTS DIVERSITY. THE PROGRAM IS FULLY ACCREDITED TO OFFER ASSOCIATION OF CLINICAL PASTORAL EDUCATION'S (ACPE) CERTIFIED CPE PROGRAMS OF LEVEL I/II AND CERTIFIED EDUCATOR CPE. THE PROGRAM TRAINED 5 CHAPLAINS TO WORK WITH UNDERSERVED, RURAL POPULATIONS LIKE FARMWORKERS, PROVIDING SPIRITUAL AND EMOTIONAL SUPPORT. CASH DONATIONS DEFINITION: FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. FUNDS WERE DONATED TO NONPROFIT COMMUNITY GROUPS AND LOCAL ORGANIZATIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA INCLUDING, BUT NOT LIMITED TO: - FRESNO GRIZZLIES' "WILD ABOUT READING" LITERACY PROGRAM, WHICH PROVIDED OVER 100,000 STUDENTS WHO READ 10 BOOKS IN FIVE WEEKS WITH FREE TICKETS TO A GRIZZLIES GAME. - NATIONAL ALLIANCE ON MENTAL HEALTH ILLNESS' (NAMI) "I AM NAMI" WALK AND COMMUNITY OUTREACH EVENT - FRESNO RAINBOW PRIDE PARADE AND FESTIVAL COMMUNITY BENEFIT OPERATIONS DEFINITION: DIRECT AND INDIRECT COSTS ASSOCIATED WITH ASSIGNED STAFF, COMMUNITY HEALTH NEEDS ASSESSMENTS, COMMUNITY BENEFIT PLANNING, TRACKING, REPORTING, EVALUATING AND OPERATIONS.COMMUNITY BENEFIT OPERATIONS INCLUDED COMMUNITY BENEFIT STAFF SALARY, BENEFITS AND EXPENSES, ADMINISTRATIVE SUPPORT FOR COMMUNITY BENEFIT, COMMUNITY BENEFIT CONSULTANTS AND CBISA SOFTWARE SUBSCRIPTION FEES.COMMUNITY BUILDING ACTIVITIES DEFINITION: ACTIVITIES THAT SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HOSPITAL ORGANIZATION. THESE ACTIVITIES MAY ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS OR THE DETERMINANTS OF HEALTH, SUCH AS EDUCATION, HOMELESSNESS, POVERTY AND THE ENVIRONMENT. MEDWATCH TODAYOUR TELEVISION SHOW MEDWATCH TODAY, IN PARTNERSHIP WITH NEXSTAR MEDIA GROUP, PROVIDES 22 MINUTES OF WEEKLY BROADCAST QUALITY, CONSUMER-HEALTH FOCUSED VIDEO CONTENT TO ADULTS 45+ EACH WEEK ON LOCAL KGPE AND NBC CHANNELS. IN FY24, SOME TOPICS INCLUDED PREDIABETES PREVENTION, CARDIAC CARE, CANCER PREVENTION AND PARENTING TIPS.WORKFORCE DEVELOPMENT PROJECT SEARCH IS A DEDICATED PROGRAM FOCUSED ON PROVIDING EDUCATION AND TRAINING TO YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. SINCE 2017, CRMC HAS SERVED AS A VOCATIONAL TRAINING SITE FOR DISABLED ADULTS THROUGH PROJECT SEARCH. PARTICIPANTS RECEIVE EXPERIENCE NECESSARY TO FIND AND MAINTAIN EMPLOYMENT. IN FY24, 36 STUDENTS WORKED ALONGSIDE HOSPITAL STAFF IN CLINICAL AND NONCLINICAL AREAS INCLUDING NICU, ANTEPARTUM, POSTPARTUM, ENVIRONMENTAL SERVICES, MATERIALS MANAGEMENT, KITCHEN AND PLANT OPERATIONS AT CRMC AND CCMC.HOSPITAL TOURS WERE PROVIDED FOR 60 LOW-INCOME HIGH SCHOOL STUDENTS IN THE MEDICAL PATHWAYS PROGRAM.ADDRESSING PRIORITY HEALTH NEEDS - CLOVIS COMMUNITY MEDICAL CENTERIN FY24, CCMC ENGAGED IN ACTIVITIES AND PROGRAMS THAT ADDRESSED THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE FY23-FY25 IMPLEMENTATION STRATEGY. CCMC COMMITTED TO COMMUNITY BENEFIT EFFORTS THAT ADDRESSED ACCESS TO HEALTHCARE, CHRONIC DISEASES, ECONOMIC STABILITY, MATERNAL AND CHILD HEALTH AND MENTAL HEALTH. SOME OF THE ACTIVITIES AND PROGRAMS THAT HIGHLIGHT CCMC'S COMMITMENT TO THE COMMUNITY ARE DETAILED BELOW. ACCESS TO CARE RESPONSE TO NEED FINANCIAL ASSISTANCE THE HOSPITAL PROVIDED FINANCIAL ASSISTANCE THROUGH FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES, CONSISTENT WITH CHS'S FINANCIAL ASSISTANCE POLICY. COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO INCREASE ACCESS TO HEALTHCARE AND PROVIDE PREVENTIVE CARE SERVICES. - A CASH DONATION WAS PROVIDED TO EVERY NEIGHBORHOOD PARTNERSHIP'S BEAT THE HEAT EVENT TO SUPPORT ACCESS TO HEALTH INFORMATION AND RESOURCES, HOSTED BY FRESNO CITY COUNCILMEMBER TYLER MAXWELL. - FUNDING WAS PROVIDED TO THE MARJAREE MASON CENTER TO SUPPORT HEALTHCARE SERVICES FOR SURVIVORS OF DOMESTIC VIOLENCE IN FRESNO COUNTY.CHRONIC DISEASE RESPONSE TO NEED SUPPORT GROUPS AND EDUCATION CLASSES COMMUNITY CANCER INSTITUTE (CCI) HOSTED SUPPORT GROUPS AND CLASSES FOR 438 CANCER SURVIVORS AND THEIR FAMILIES. THE SUPPORT GROUPS, HELD IN ENGLISH AND SPANISH, WERE OPEN TO ALL PERSONS TOUCHED BY CANCER, REGARDLESS OF WHERE THEY RECEIVED CANCER CARE. THE SUPPORT GROUPS INCLUDED: PROSTATE, NECK AND HEAD, BRAIN, BREAST, NUTRITION AND WELLNESS CLASSES, STRESS MANAGEMENT AND MEDITATION.HEALTHQUEST SEMINARS LIVE ON-CAMPUS AND ONLINE HEALTH EDUCATION FEATURED HEALTH PROFESSIONALS DISCUSSING TOPICS RELATED TO IDENTIFIED HEALTH NEEDS INCLUDING HEART DISEASE, STROKE PREVENTION, CANCER DETECTION, PREVENTION AND TREATMENT, CAREGIVER SUPPORT AND LIVER DISEASE. THESE SEMINARS REACHED 599 COMMUNITY MEMBERS.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO PREVENT AND MANAGE CHRONIC DISEASES. - SUPPORT WAS PROVIDED FOR THE BOYS & GIRLS CLUBS OF FRESNO COUNTY HEALTHY HABITS PROGRAM IN REEDLEY. - THE HOSPITAL SUPPORTED THE AMERICAN HEART ASSOCIATION TO PURCHASE AND DISTRIBUTE SELF- MONITORED BLOOD PRESSURE KITS.ECONOMIC STABILITY RESPONSE TO NEED TRANSPORTATION SERVICES TRANSPORTATION VOUCHERS WERE MADE AVAILABLE TO PATIENTS AND FAMILIES HAVING DIFFICULTY ACCESSING CARE BECAUSE OF TRANSPORTATION CHALLENGES.
PART V, SECTION B, LINE 11 (CONTINUED):	COMMUNITY SUPPORTCASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS DEDICATED TO IMPROVING ECONOMIC STABILITY: - VISION Y COMPROMISO'S PROMOTORA-LED BROADBAND TRAINING - CATHOLIC CHARITIES FOOD DRIVE - THE KINGS COMMUNITY ACTION ORGANIZATION FOOD BANK - CENTRAL CALIFORNIA WOMEN'S CONFERENCE FOOD INSECURITY GRANTS INITIATIVEMATERNAL AND INFANT HEALTH RESPONSE TO NEED COMMUNITY SUPPORT A CASH DONATION WAS PROVIDED TO CASA FRESNO AND MADERA COUNTIES FOR AGES AND STAGES SCREENINGS IN FRESNO COUNTY.MENTAL HEALTH RESPONSE TO NEED BRIDGE PROGRAM CCMC PROVIDED 198 INDIVIDUALS WITH BUPRENORPHINE MEDICATION ENCOUNTERS TO SUPPRESS CRAVINGS AND WITHDRAWAL SYMPTOMS FROM OPIOID USE. THE TREATMENT PROVIDED PATIENTS WITH IMMEDIATE ATTENTION IN THE HOSPITAL SETTING, RATHER THAN BEING REFERRED TO A REHABILITATION CENTER, WHICH MAY TAKE WEEKS OR MONTHS. ADDITIONALLY, THE BRIDGE PROGRAM PROVIDED EDUCATIONAL INFORMATION TO THE GREATER COMMUNITY ABOUT SUBSTANCE ABUSE.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS DEDICATED TO ADDRESSING MENTAL HEALTH. - A CASH DONATION WAS PROVIDED TO CLOVIS UNIFIED SCHOOL DISTRICT TO SUPPORT ACCESS TO MENTAL HEALTH AND SUICIDE PREVENTION SERVICES. - FIRST 5 TULARE COUNTY RECEIVED FUNDING FOR ACES (ADVERSE CHILDHOOD EXPERIENCES) TRAINING.OTHER COMMUNITY BENEFIT SERVICES - CCMC:CCMC PROVIDED COMMUNITY BENEFIT SERVICES IN ADDITION TO THOSE PROGRAMS THAT FOCUSED ON ADDRESSING PRIORITY HEALTH NEEDS. HEALTH PROFESSIONAL EDUCATION DEFINITION: EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, NURSING STUDENTS AND OTHER HEALTH PROFESSIONALS. GRADUATE MEDICAL EDUCATION THROUGH AN AGREEMENT WITH THE CALIFORNIA HEALTH SCIENCES UNIVERSITY (CHSU), A PRIVATE INSTITUTION OFFERING DOCTORAL DEGREES THROUGH ITS COLLEGE OF OSTEOPATHIC MEDICINE, CHSU MEDICAL STUDENTS ROTATED THROUGH THE HOSPITAL AS PART OF THEIR TRAINING. NURSING CCMC HAD 668 NURSING STUDENTS PARTICIPATE IN PRECEPTED HOSPITAL CLINICAL ROTATIONS. OTHER HEALTH PROFESSIONAL EDUCATION OUR POST GRADUATE YEAR 1 (PGY1) PHARMACY RESIDENCY PROGRAM WAS ESTABLISHED IN 2016 AT CCMC. THE PROGRAM IS ACCREDITED THROUGH THE AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS (ASHP). IN FY24, CCMC FILLED TWO PHARMACY RESIDENCY POSITIONS.CASH DONATIONS DEFINITION: FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. FUNDS WERE DONATED TO NONPROFIT COMMUNITY GROUPS AND LOCAL ORGANIZATIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA INCLUDING, BUT NOT LIMITED TO: - CLOVIS COMMUNITY FOUNDATION'S DEVELOPMENT OF A CHILDREN'S BOOK BASED ON THE HISTORY OF CLOVIS. - CALIFORNIA HEALTH SCIENCES UNIVERSITY'S "IGNITE THE FUTURE" SCHOLARSHIP GALACOMMUNITY BENEFIT OPERATIONS DEFINITION: DIRECT AND INDIRECT COSTS ASSOCIATED WITH ASSIGNED STAFF, COMMUNITY HEALTH NEEDS ASSESSMENTS, COMMUNITY BENEFIT PLANNING, TRACKING, REPORTING, EVALUATING AND OPERATIONS.COMMUNITY BENEFIT OPERATIONS INCLUDED COMMUNITY BENEFIT STAFF SALARY, BENEFITS AND EXPENSES, ADMINISTRATIVE SUPPORT FOR COMMUNITY BENEFIT, COMMUNITY BENEFIT CONSULTANTS AND CBISA SOFTWARE SUBSCRIPTION FEES.COMMUNITY BUILDING ACTIVITIES DEFINITION: ACTIVITIES THAT SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HOSPITAL ORGANIZATION. THESE ACTIVITIES MAY ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS OR THE DETERMINANTS OF HEALTH, SUCH AS EDUCATION, HOMELESSNESS, POVERTY AND THE ENVIRONMENT. WORKFORCE DEVELOPMENT PROJECT SEARCH IS A DEDICATED PROGRAM FOCUSED ON PROVIDING EDUCATION AND TRAINING TO YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. SINCE 2017, CCMC HAS SERVED AS A VOCATIONAL TRAINING SITE FOR DISABLED ADULTS THROUGH PROJECT SEARCH. PARTICIPANTS RECEIVE EXPERIENCE NECESSARY TO FIND AND MAINTAIN EMPLOYMENT. IN FY24, 36 STUDENTS WORKED ALONGSIDE HOSPITAL STAFF IN CLINICAL AND NONCLINICAL AREAS INCLUDING NICU, ANTEPARTUM, POSTPARTUM, ENVIRONMENTAL SERVICES, MATERIALS MANAGEMENT, KITCHEN AND PLANT OPERATIONS AT CRMC AND CCMC.DELTA SIGMA THETA AFRICAN AMERICAN HIGH SCHOOL RECOGNITION SCHOLARSHIPS WERE SUPPORTED.CENTRAL CA ASIAN PACIFIC WOMEN HIGH SCHOOL SCHOLARSHIPS WERE SUPPORTED.
PART V, SECTION B, LINE 13B:	THE PATIENT'S, OR THE PATIENT'S FAMILY'S MEDICAL EXPENSES FOR COVERED SERVICES (INCURRED AT CHS OR OTHER PROVIDERS IN THE PAST TWELVE (12) MONTHS) EXCEEDS 10% OF THE PATIENT'S FAMILY INCOME.
SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP A:	PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CARE
PART V, SECTION B, LINE 16J:	OSHPD HAS CREATED A WEB-BASED SYSTEM THAT WILL ALLOW USERS TO SEARCH, COMPARE, AND VIEW EACH HOSPITAL'S SUBMITTED CHARITY CARE POLICY, DISCOUNT PAYMENT POLICY, ELIGIBILITY PROCEDURES, REVIEW PROCESS, AND APPLICATION FORM. ACCESS OSHPD'S HOSPITAL FAIR PRICING SEARCH SYSTEM AT: HTTPS://SYFPHR.HCAI.CA.GOV/#FRESNO-COUNTY
PART V, SECTION B, LINE 22D:	UNDER CALIFORNIA LAW (AB 774), THE MAXIMUM THAT A FAP-ELIGIBLE PATIENT MAY BE CHARGED IS THE REIMBURSEMENT RATE OF ANY GOVERNMENT-SPONSORED HEALTH PROGRAMS IN WHICH THE HOSPITAL PARTICIPATES.

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - COMMUNITY CANCER INSTITUTE
785 NORTH MEDICAL CENTER DR W	CLOVIS	CA	93611	OUTPATIENT CANCER CENTER INCLUDED IN CCMC HOSPITAL LICENSE
2 - DERAN KOLIGIAN AMBULATORY CARE CENTER
290 N WAYTE LANE	FRESNO	CA	93701	CLINICS: OMFS SURGERY, HIV/AIDS INCLUDED IN CRMC HOSPITAL LICENSE
3 - COMMUNITY BEHAVIORAL HEALTH CENTER
7171 N CEDAR AVE	FRESNO	CA	93720	PSYCHIATRIC CARE FACILITY INCLUDED IN CRMC HOSPITAL LICENSE
4 - COMMUNITY SUBACUTE TRANSITIONAL CARE CEN
3003 N MARIPOSA ST	FRESNO	CA	93703	TRANSITIONAL CARE INCLUDED IN CRMC HOSPITAL LICENSE
5 - FRESNO HEART AND SURGICAL HOSPITAL
15 E AUDUBON	FRESNO	CA	93720	SPECIALTY SURGERY SERVICES INCLUDED IN CRMC HOSPITAL LICENSE

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	THE COMMUNITY BENEFIT REPORT IS ISSUED BY COMMUNITY HEALTH SYSTEM (CHS), A DBA USED BY THE TWO HOSPITALS THAT COMPRISE THE ORGANIZATION.
PART I, LINE 7:	COSTING METHODOLOGY: CHARITY CARE IS ESTIMATED BY CALCULATING THE RATIO OF COST PER ADJUSTED PATIENT DAY (EXCLUDING BAD DEBTS) AND THEN MULTIPLYING THAT RATIO BY THE ADJUSTED PATIENT DAYS ASSOCIATED WITH CHARITY CARE PATIENTS. CHS DOES NOT UTILIZE A COST ACCOUNTING SYSTEM TO ESTIMATE THE COST OF CHARITY CARE.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,013,216.
PART II, COMMUNITY BUILDING ACTIVITIES:	SEE PART V, SECTION B, LINE 11 FOR COMMUNITY BUILDING ACTIVITIES DESCRIPTIONS FOR WORKFORCE DEVELOPMENT.
PART III, LINE 2:	ADJUSTMENT DUE TO THE PATIENT'S ABILITY TO PAY DUE TO A BANKRUPTCY ARE RECORDED AS BAD DEBT EXPENSE.
PART III, LINE 3:	CHS DOES NOT RECOGNIZE ANY PORTION OF ITS BAD DEBT EXPENSE AS A COMMUNITY BENEFIT.
PART III, LINE 4:	FOOTNOTE FOR BAD DEBT EXPENSE: SEE AUDITED FINANCIAL STATEMENTS NOTE 3, PAGE 17.FOOTNOTE FOR ACCOUNTS RECEIVABLE: SEE AUDITED FINANCIAL STATEMENTS NOTE 2, PAGE 12.
PART III, LINE 8:	MEDICARE SHORTFALL: THE MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFIT BECAUSE: (1) NONNEGOTIABLE MEDICARE RATES ARE SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; AND (2) BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES.COSTING METHODOLOGY: INPATIENT CARE SERVICES, SKILLED NURSING SERVICES, REHABILITATION SERVICES, AND CERTAIN OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DIAGNOSIS. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. CERTAIN INPATIENT NONACUTE SERVICES AND MEDICAL EDUCATION COSTS RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST-BASED REIMBURSEMENT METHODOLOGY. PROFESSIONAL SERVICES ARE REIMBURSED BASED ON A FEE SCHEDULE.
PART III, LINE 9B:	THOSE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE GENERALLY SUBJECT TO THE NORMAL COLLECTION PROCEDURES FOR ALL PATIENTS. COMMUNITY HEALTH SYSTEM (CHS) MAY EMPLOY REASONABLE COLLECTION EFFORTS TO OBTAIN PAYMENT FROM PATIENTS. GENERAL COLLECTION ACTIVITIES MAY INCLUDE ISSUING PATIENT STATEMENTS, PHONE CALLS, AND FOLLOW UP LETTERS SENT TO THE PATIENT OR GUARANTOR. CHS SHALL NOT PURSUE COLLECTIONS AND EXTRAORDINARY COLLECTION ACTIONS WHEN: THE PATIENT IS A RYAN WHITE PATIENT, THE PATIENT IS HOMELESS, THE PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AND/OR GOVERNMENT SPONSORED COVERAGE AND THE APPLICATION IS PENDING, CHS IS AWARE THAT THE PATIENT IS ALREADY APPROVED FOR FINANCIAL ASSISTANCE, AND THE PATIENT IS REASONABLY COOPERATING WITH CHS IN AN EFFORT TO SETTLE AN OUTSTANDING BILL.CHS WILL MAKE REASONABLE EFFORTS TO NOTIFY THE PATIENT PRIOR TO ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTIONS. THESE ACTIONS WILL ONLY TAKE PLACE AFTER 150 DAYS FROM THE INITIAL PATIENT STATEMENT. ALL PATIENT STATEMENTS SHALL INCLUDE THE NOTICE OF RIGHTS, WHICH INCLUDES A SUMMARY OF FINANCIAL ASSISTANCE THAT IS AVAILABLE TO ELIGIBLE PATIENTS. ALL PATIENTS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNT AT ANY TIME.
PART VI, LINE 2:	AS PART OF THE AFFORDABLE CARE ACT, COMMUNITY HEALTH SYSTEM PARTNERED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA AND MANY OTHER VALLEY HOSPITALS AS WELL AS LOCAL ORGANIZATIONS TO PUBLISH A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022. ADDITIONALLY, EACH OF CHS' THREE HOSPITALS DEVELOPED IMPLEMENTATION PLANS TO ADDRESS SOME OF THE KEY NEEDS IDENTIFIED IN THE REPORT.
PART VI, LINE 3:	COMMUNITY HEALTH SYSTEM ("CHS") SHALL WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IN A MANNER THAT IS REASONABLY CALCULATED TO REACH, NOTIFY AND INFORM THOSE PATIENTS IN OUR COMMUNITIES WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE, INCLUDING AT A MINIMUM, THE FOLLOWING WAYS: PUBLIC DISPLAYS: COMMUNITY HEALTH SYSTEM SHALL CLEARLY AND CONSPICUOUSLY POST PUBLIC DISPLAYS (OR OTHER MEASURES REASONABLY CALCULATED TO ATTRACT PATIENTS' ATTENTION) THAT NOTIFY AND INFORM PATIENTS ABOUT THIS POLICY IN PUBLIC LOCATIONS AT CHS INCLUDING, AT A MINIMUM, THE EMERGENCY DEPARTMENT, BILLING OFFICE, ADMISSIONS OFFICE, AND OUTPATIENT SETTINGS, INCLUDING OBSERVATION UNITS. THESE SHALL BE POSTED IN ENGLISH, SPANISH, AND HMONG. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE, AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY SHALL BE AVAILABLE ON THE HOME PAGE AND MAIN BILLING PAGE, AS WELL AS OTHER PROMINENT PLACES ON CHS' WEBSITE, HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. MAIL: PATIENTS MAY REQUEST A FREE COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY BE SENT BY MAIL.OTHER EFFORTS: CHS WILL PROVIDE A DIGITAL KIT TO RELEVANT COMMUNITY ORGANIZATIONS WHO WILL WIDELY PUBLICIZE THE AVAILABILITY OF THIS POLICY TO AFFECTED PATIENTS IN THE COMMUNITY. CHS OR AN AUTHORIZED REPRESENTATIVE SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WHICH ADVISES THE PATIENT OF THE MAXIMUM GROSS MONTHLY HOUSEHOLD INCOME PER FAMILY SIZE TO QUALIFY FOR FINANCIAL ASSISTANCE AS FOLLOWS: - AT REGISTRATION: DURING REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE). - EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. - OUTPATIENT SERVICES: AT THE OUTPATIENT APPOINTMENT BEFORE THE PROCEDURE TAKES PLACE. - AT DISCHARGE: AT THE TIME OF DISCHARGE, WHEN CHS OR AN AUTHORIZED REPRESENTATIVE OF CHS SHALL ALSO PROVIDE OR OFFER TO PROVIDE ALL UNINSURED PATIENTS APPLICATIONS FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM. FOR NOTICES PROVIDED PURSUANT TO SECTION IV.G.2.A.2 AND A.3, THE PLAIN LANGUAGE SUMMARY WILL BE PROVIDED TO PATIENTS WHO ARE CONSCIOUS. IF THE PATIENT IS UNCONSCIOUS OR NOT ABLE TO RECEIVE THE PLAIN LANGUAGE SUMMARY, THEN THE NOTICE MUST BE PROVIDED AT DISCHARGE. FOR PATIENTS NOT ADMITTED TO CHS, THE PLAIN LANGUAGE SUMMARY WILL BE PROVIDED WHEN THE PATIENT IS LEAVING THE FACILITY. IF A PATIENT LEAVES CHS WITHOUT RECEIVING THE PLAIN LANGUAGE SUMMARY, CHS WILL MAIL THE NOTICE TO THE PATIENT WITHIN SEVENTY-TWO (72) HOURS OF PROVIDING THE SERVICES.
PART VI, LINE 4:	COMMUNITY HEALTH SYSTEM ("CHS") IS A LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE SYSTEM BASED IN FRESNO, CALIFORNIA. ESTABLISHED IN 1897, CHS IS THE REGION'S LARGEST HEALTHCARE PROVIDER AND PRIVATE EMPLOYER. WITH APPROXIMATELY 11,000 EMPLOYEES, ALMOST 800 VOLUNTEERS, AND 2,500 AFFILIATED PHYSICIANS, CHS SERVES A 15,000 SQUARE-MILE AREA THAT INCLUDES FRESNO, KINGS, MADERA AND TULARE COUNTIES IN CALIFORNIA'S CENTRAL VALLEY, A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). CHS IS MADE UP OF COMMUNITY MEDICAL CENTERS (HOSPITALS AND OUTPATIENT CENTERS), COMMUNITY PROVIDER NETWORK (OUR AFFILIATED PHYSICIANS) AND COMMUNITY CARE HEALTH (OUR HEALTH PLAN). FOR OVER 125 YEARS, COMMUNITY HEALTH SYSTEM HAS BEEN INVESTING IN THIS REGION GROWING A SUCCESSFUL HEALTHCARE SYSTEM THAT SUPPORTS OUR COMMUNITY AND SERVES VALLEY RESIDENTS. CHS ALSO OPERATES THE ONLY COMBINED BURN AND LEVEL 1 TRAUMA UNITS BETWEEN LOS ANGELES AND SACRAMENTO, PROVIDING CRITICAL CARE AND OTHER SPECIALTY SERVICES TO PATIENTS FROM WELL OUTSIDE THE PRIMARY SERVICE REGION. THOSE UNITS ARE LOCATED AT COMMUNITY REGIONAL MEDICAL CENTER ("CRMC"), WHICH ALSO OPERATES ONE OF THE BUSIEST HOSPITAL EMERGENCY DEPARTMENTS IN THE NATION.COMMITMENT TO THE COMMUNITYWE RECOGNIZE OUR OBLIGATION TO PROVIDE SERVICE ABOVE AND BEYOND OUR ROLE AS A SYSTEM OF HEALING FACILITIES. COMMUNITY'S HOSPITALS PROVIDE FINANCIAL ASSISTANCE TO THOSE IN THE COMMUNITY WHO CANNOT AFFORD SERVICES, OR WHOSE HEALTH INSURANCE DOES NOT COVER ALL SERVICES PROVIDED, AND WE INVEST IN THE COMMUNITY TO INCREASE ACCESS TO HEALTHCARE SERVICES AND IMPROVE HEALTH. THIS REPORT DEMONSTRATES TANGIBLE WAYS WE FULFILL OUR MISSION TO BETTER THE LIVES OF ALL THOSE WE SERVE THROUGH HUMANITY AND INGENUITY.SERVICE AREA THE HOSPITAL FACILITIES ARE IN THE HEART OF CALIFORNIA'S SAN JOAQUIN VALLEY NEAR MAJOR INTERSTATE HIGHWAYS AND THREE POPULAR NATIONAL PARKS. THE HOSPITALS SHARE A PRIMARY SERVICE AREA OF FRESNO, KINGS, MADERA AND TULARE COUNTIES. - COMMUNITY REGIONAL MEDICAL CENTER IS LOCATED AT 2823 FRESNO ST., FRESNO, CA 93721 - CLOVIS COMMUNITY MEDICAL CENTER IS LOCATED AT 2755 HERNDON AVE., CLOVIS, CA 93611 - FRESNO HEART & SURGICAL HOSPITAL IS LOCATED AT 15 E. AUDUBON DR., FRESNO, CA 93720 - COMMUNITY BEHAVIORAL HEALTH CENTER IS LOCATED AT 7171 N. CEDAR AVE., FRESNO, CA 93720COMMUNITY HEALTH SYSTEM'S SERVICE AREA SNAPSHOTPOPULATION - THE POPULATION IS 1,761,174. - CHILDREN AND YOUTH, AGES 0-17, MAKE UP 28.8% OF THE POPULATION, 59.2% ARE ADULTS AND 12% ARE SENIORS, AGES 65 AND OLDER.RACE AND ETHNICITY - MORE THAN HALF OF THE POPULATION (57.0%) IDENTIFY AS HISPANIC OR LATINO. - 29.1% OF THE SERVICE AREA POPULATION ARE WHITE RESIDENTS. - ASIAN RESIDENTS COMPRISE 7.2% OF THE POPULATION AND 3.6% OF THE POPULATION ARE BLACK OR AFRICAN AMERICAN RESIDENTS. LANGUAGES - SPANISH IS SPOKEN IN 38.5% OF THE HOMES, 54.1% OF THE RESIDENTS SPEAK ENGLISH ONLY AND 4.3% SPEAK AN ASIAN OR PACIFIC ISLANDER LANGUAGE IN THE HOME. POVERTY - AMONG AREA RESIDENTS, 20.5% LIVE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL), WHICH IS HIGHER THAN THE STATE RATE (12.6%). - 44.2% OF THE POPULATION LIVE AT 200% OF FPL (LOW INCOME)
PART VI, LINE 5:	COMMUNITY HEALTH SYSTEM'S ("CHS") COMMITMENT TO OUR COMMUNITY IS DEMONSTRATED AT EVERY LEVEL OF THE ORGANIZATION. EVIDENCE OF OUR MISSION IS THE CONTINUAL INVESTMENT IN IMPROVING THE HEALTH OF THOSE WE SERVE AND IN OUR WORKFORCE OF MORE THAN 14,000 EMPLOYEES, PHYSICIANS, AND VOLUNTEERS. AN INTEGRAL PART OF OUR MISSION IS OUR PATIENT POPULATION THAT INCLUDES MORE THAN 62,000 ADMISSIONS, ALMOST 214,000 OUTPATIENT VISITS AND MORE THAN 203,000 EMERGENCY DEPARTMENT VISITS EQUALING MORE THAN 465,000 PATIENTS TO WHOM WE PROVIDED QUALITY MEDICAL CARE.CHS STRIVES TO BRING PEOPLE AND ORGANIZATIONS TOGETHER TO IMPROVE COMMUNITY WELLNESS. THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") PROCESS IS ONE WAY WE CAN LIVE OUT OUR MISSION. TO FULFILL THIS MISSION, WE MUST BE INTENTIONAL ABOUT UNDERSTANDING THE HEALTH ISSUES THAT IMPACT RESIDENTS AND WORK TOGETHER TO CREATE A HEALTHY COMMUNITY.A PRIMARY COMPONENT OF CREATING A HEALTHY COMMUNITY IS ASSESSING THE NEEDS AND PRIORITIZING THOSE NEEDS FOR IMPACT. IN 2021 AND 2022, CHS CONDUCTED A COMPREHENSIVE CHNA TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS AND OTHER HEALTH NEEDS. THE RESULTS FROM THE ASSESSMENT PROVIDE CRITICAL INFORMATION TO GUIDE US IN MAKING A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ALSO ENABLE CHS TO MEASURE IMPACT AND STRATEGICALLY ESTABLISH PRIORITIES TO DEVELOP INTERVENTIONS AND ALIGN RESOURCES.A CHNA IS A TOOL THAT IS USED TO GUIDE COMMUNITY BENEFIT ACTIVITIES AND SEVERAL OTHER PURPOSES. FOR HOSPITALS, IT IS USED TO IDENTIFY AND ADDRESS KEY HEALTH NEEDS AND SUPPORTS THE DEVELOPMENT OF COMMUNITY BENEFIT PLANS MANDATED BY THE STATE OF CALIFORNIA AND THE FEDERAL GOVERNMENT. THE DATA FROM A CHNA IS FURTHERMORE USED TO INFORM COMMUNITY DECISION-MAKING, THE PRIORITIZATION OF HEALTH NEEDS AND THE DEVELOPMENT, IMPLEMENTATION AND EVALUATION OF AN IMPLEMENTATION PLAN OR COMMUNITY HEALTH IMPROVEMENT PLAN ("CHIP").THE CHNA IS AN IMPORTANT PIECE IN THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY/CHIP BECAUSE IT HELPS THE COMMUNITY TO UNDERSTAND THE HEALTH-RELATED ISSUES THAT NEED TO BE ADDRESSED. TO IDENTIFY AND ADDRESS THE CRITICAL HEALTH NEEDS OF THE REGION, CHS UTILIZED THE MOST CURRENT AND RELIABLE INFORMATION FROM EXISTING SOURCES AND THEN COLLECTED NEW DATA THROUGH INTERVIEWS, FOCUS GROUPS AND SURVEYS WITH COMMUNITY RESIDENTS AND LEADERS.CHS IS GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES COMPRISED OF CIVIC LEADERS AND PHYSICIANS. THE TRUSTEES SET THE VISION AND POLICY DIRECTION FOR THE ORGANIZATION AND APPROVE THE ORGANIZATION'S STRATEGIC, BUSINESS AND FINANCIAL PLANS. THE BOARD OF TRUSTEES REVIEWS AND ADOPTS THE CHNAS, THE ANNUAL COMMUNITY BENEFIT REPORTS AND OUR IMPACT ON THE AREAS OF GREATEST NEED.SENIOR MANAGEMENT ENCOURAGES INITIATIVES TO EXPAND ACCESS TO HEALTHCARE SERVICES IN OUR COMMUNITY AND IS COMMITTED TO INVESTING IN AND PARTNERING WITH LOCAL, NONPROFIT ORGANIZATIONS WORKING IN SOCIO-ECONOMICALLY DISADVANTAGED NEIGHBORHOODS AND RURAL POPULATIONS. A MULTISTAKEHOLDER COMMITTEE ENSURES BOARD AND SENIOR MANAGEMENT DIRECTIVES ARE FULFILLED AND APPROVES FINANCIAL ALLOCATIONS TO COMMUNITY BENEFIT PROGRAMS, OUTREACH AND EDUCATION.COMMUNITY BENEFIT AND COMMUNITY SERVICE ARE AT THE HEART OF OUR HEALTHCARE SYSTEM.
PART VI, LINE 6:	COMMUNITY MEDICAL CENTERS (CMC) OPERATES ITS FACILITIES UNDER TWO HOSPITAL LICENSES: COMMUNITY REGIONAL MEDICAL CENTER (CRMC) AND CLOVIS COMMUNITY MEDICAL CENTER (CCMC). FRESNO HEART & SURGICAL HOSPITAL (FHSH), COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC) AND COMMUNITY SUBACUTE &TRANSITIONAL CARE CENTER (CSTCC) OPERATE UNDER THE CRMC LICENSE. CMC ALSO OPERATES A CANCER INSTITUTE AND SEVERAL OUTPATIENT AND OTHER HEALTHCARE FACILITIES.WHILE CHS' SYSTEM OF CARE WORKS COLLABORATIVELY TO ADDRESS THE REGION'S HEALTHCARE NEEDS, CRMC AND CCMC ACTIVITIES AND FINANCIAL CONTRIBUTIONS FOR COMMUNITY BENEFIT ARE REPORTED SEPARATELY IN THIS REPORT.CRMC HAS 685 LICENSED BEDS AND OFFERS CENTRAL CALIFORNIA'S HIGHEST LEVEL OF MEDICAL CARE. CRMC IS A LEADER IN COMPREHENSIVE NEUROSCIENCE SERVICES, HAS A LEVEL 3 NICU (NEONATAL INTENSIVE CARE UNIT) AND A FULL-SERVICE 58,000 SQUARE-FOOT EMERGENCY DEPARTMENT (ED). CRMC IS HOME TO THE ONLY LEVEL I TRAUMA CENTER AND COMPREHENSIVE BURN CENTER BETWEEN LOS ANGELES AND SACRAMENTO. WE SERVE AS THE AREA'S "SAFETY NET" PROVIDER, CARING FOR OUR REGION'S MOST VULNERABLE POPULATIONS.FHSH IS A SPECIALTY HOSPITAL IN CENTRAL CALIFORNIA WITH 57-LICENSED BEDS. FHSH IS KNOWN FOR ITS EXCELLENT PATIENT EXPERIENCE AND EXEMPLARY BARIATRIC, CARDIAC, ENDOCRINE, NEURO AND VASCULAR SURGERY SERVICES. FHSH OPERATES UNDER THE CRMC LICENSE.CBHC OPERATES 73 BEDS UNDER THE CRMC LICENSE AND IS THE LARGEST INPATIENT MENTAL HEALTH FACILITY IN FRESNO COUNTY FOR THOSE IN NEED OF ACUTE PSYCHIATRIC CARE. CBHC PROVIDES 24-HOUR CARE TO PATIENTS BASED ON THEIR LEVEL OF NEED.CSTCC IS A 106-BED FACILITY PROVIDING INPATIENT CARE FOR CHRONIC, SUBACUTE CONDITIONS AND COMPLEX ILLNESSES THAT REQUIRE 24-HOUR MEDICAL SUPERVISION. CSTCC PROVIDES PATIENTS WITH TREATMENT THAT IS CONSISTENT WITH AN ACUTE CARE CENTER'S EFFECTIVENESS WHILE IN A COMFORTABLE LONG-TERM SETTING.CCMC HAS 352 LICENSED BEDS. IT INCLUDES AN EMERGENCY DEPARTMENT (ED) AND PROVIDES SPECIALTY CARE FOR PATIENTS, INCLUDING COMPREHENSIVE HEART AND LUNG CARE, WOMEN'S SERVICES AND LABOR AND DELIVERY. CCMC IS HOME TO THE COMMUNITY CANCER INSTITUTE (CCI) AND THE MARJORIE E. RADIN BREAST CARE CENTER, PART OF CENTRAL CALIFORNIA'S PREMIER COMPREHENSIVE CANCER CARE PROGRAM, WHICH OFFERS MULTIDISCIPLINARY CARE TEAMS, A CLINIC, SCREENINGS AND DIAGNOSTICS, AS WELL AS CANCER TREATMENTS USING THE MOST ADVANCED TECHNOLOGY.
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	0	GrantRecordsMaintainedInd

Recipient Table RecipientTable (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
FOUNDATION FOR FRESNO SCHOOLS
906 N STREET	FRESNO	CA	93721	871626646	501(C)(3)	$25,000	$0	TO SUPPORT INITIATIVE FOR MENTAL HEALTH
FOUNDATION FOR CLOVIS SCHOOLS
1450 HERNDON AVENUE	CLOVIS	CA	93611	770140576	501(C)(3)	$40,000	$0	SPECIALIZED SUICIDE PREVENTION AND INTERVENTION PROGRAMS
MARJAREE MASON CENTER
1600 M STREET	FRESNO	CA	93721	941156639	501(C)(3)	$105,000	$0	TO SUPPORT DOMESTIC VIOLENCE INTERVENTION AND PREVENTION
CALIFORNIA HOSPITALS COMMITTEE ON ISSUES
1215 K STREET SUITE 800	SACRAMENTO	CA	95814	680148902	501(C)(6)	$43,329	$0	LOBBYING EXPENDITURES
ADVANCED ARMENIA FOUNDATION
2753 QUINCY AVENUE	CLOVIS	CA	93619	843093464	501(C)(3)	$100,000	$0	SUPPORT MEDICAL MISSION TO ARMENIA
CENTRAL CALIFORNIA FOOD BANK
4010 E AMENDOLA DRIVE	FRESNO	CA	93725	946024540	501(C)(3)	$16,960	$0	SCHOOL BACKPACK PROGRAM AT YOKOMI ELEMENTARY SCHOOL
CENTRAL CALIFORNIA WOMEN'S CONFERENCE
PO BOX 25611	FRESNO	CA	93729	770178140	501(C)(3)	$10,000	$0	GENERAL SUPPORT
AMERICAN HEART ASSOCIATION
2007 O STREET	SACRAMENTO	CA	95811	135613797	501(C)(3)	$25,000	$0	TO SUPPORT BLOOD PRESSURE EDUCATION EFFORTS, INCLUDING THE DISTRIBUTION OF SELF-MONITORED BLOOD PRESSURE KITS TO NEW MOMS IN THE CENTRAL VALLEY
VALLEY CHILDREN'S HOSPITAL
9300 VALLEY CHILDRENS PLACE	MADERA	CA	93636	942797447	501(C)(3)	$0	$12,589	TO SUPPORT CARE OF NEONATES	FMV	PEDIATRIC TECHOTHERM DEVICE
BLACK WELLNESS AND PROSPERITY CENTER
1133 S STREET	FRESNO	CA	93721	843848144	501(C)(3)	$10,000	$0	TO SUPPORT IMPROVING BLACK MATERNAL AND INFANT HEALTH OUTCOMES THROUGH THE DOULA TRAINING PROGRAM
FRESNO RESCUE MISSION
PO BOX 1422	FRESNO	CA	93716	941279785	501(C)(3)	$61,840	$0	TO SUPPORT FOOD SERVICE FOR THE COMMUNITY CARE AND FAMILY CENTER
READING AND BEYOND
4670 E BUTHER AVENUE	FRESNO	CA	93702	770508471	501(C)(3)	$10,000	$0	TO SUPPORT HEALTH SERVICES OPEN HOUSE AND WELLNESS WEDNESDAYS AND FAMILY ADVOCACY PROGRAM

Field	Value	IRS element (for citing)
Total501c3 Org	11	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION DOES NOT HAVE A GRANT PROCEDURE FOR MONITORING THE USE OF FUNDS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	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	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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
CRAIG S CASTRO
PRESIDENT, CHIEF EXECUTIVE OFFICER	$0	$1,847,656	$0	$125,000	$0	$230,922	$0	$767,121	$0	$17,820	$0	$2,988,519	$0	$0
CRAIG WAGONER
EVP, CHIEF OPERATING OFFICER	$0	$1,064,611	$0	$435,598	$0	$121,881	$0	$23,100	$0	$13,119	$0	$1,658,309	$0	$0
CHRISTOPHER NEUMAN
SVP, CHIEF FINANCIAL OFFICER	$0	$778,610	$0	$517,863	$0	$8,920	$0	$19,800	$0	$14,920	$0	$1,340,113	$0	$0
THOMAS UTECHT
SVP, CHIEF MEDICAL OFFICER	$773,707	$0	$326,906	$0	$67,073	$0	$26,400	$0	$22,750	$0	$1,216,836	$0	$0	$0
BRIANNE L MARRIOTT
SVP, CHIEF LEGAL OFFICER	$0	$642,911	$0	$238,163	$0	$29,069	$0	$19,800	$0	$16,925	$0	$946,868	$0	$0
ALDO DE LA TORRE - SVP NETWORK
DEVELOPMENT AND INSURANCE SVC	$0	$584,493	$0	$230,556	$0	$55,231	$0	$16,500	$0	$22,208	$0	$908,988	$0	$0
CARLA MILTON - SVP
CHIEF HUMAN RESOURCES OFFICER	$0	$539,365	$0	$208,960	$0	$32,921	$0	$23,100	$0	$16,615	$0	$820,961	$0	$0
TRACY KIRITANI
VP, HOSPITAL FINANCIAL OPERATIONS	$517,440	$0	$121,098	$0	$51,795	$0	$26,400	$0	$8,078	$0	$724,811	$0	$0	$0
JEFFREY THOMAS - VP CHIEF
MEDICAL AND QUALITY OFFICER - CRMC	$521,043	$0	$118,348	$0	$56,140	$0	$16,500	$0	$8,432	$0	$720,463	$0	$0	$0
ROGER LARSEN - FORMER SVP
CHIEF FINANCIAL OFFICER THRU 08/22	$0	$0	$0	$0	$0	$667,956	$0	$0	$0	$12,984	$0	$680,940	$0	$0
DANIEL DAVIS - SVP CHIEF
CLINICAL AND OPERATIONS OFFICER	$479,945	$0	$114,281	$0	$4,763	$0	$16,500	$0	$6,121	$0	$621,610	$0	$0	$0
ROBYN GONZALES
VP, CHIEF OPERATING OFFICER CRMC	$414,474	$0	$91,483	$0	$15,200	$0	$26,400	$0	$15,351	$0	$562,908	$0	$0	$0
DEBORAH MOFFETT
VICE FINANCIAL OFFICER/VP FINANCE	$0	$397,367	$0	$104,584	$0	$5,861	$0	$26,400	$0	$7,706	$0	$541,918	$0	$0
JUANITA HERNANDEZ - FRMR FIRST
VS/SECOND VS/DIR CORP GOV THRU 02/22	$0	$0	$0	$0	$0	$170,795	$0	$0	$0	$0	$0	$170,795	$0	$0
ISABEL MARTINEZ - FIRST VS
DIRECTOR CORP GOVERNANCE	$0	$104,881	$0	$27,413	$0	$8,661	$0	$9,697	$0	$15,292	$0	$165,944	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	SOCIAL CLUB DUES ARE PAID FOR THOMAS UTECHT. THIS IS INCLUDED IN TAXABLE COMPENSATION.
PART I, LINES 4A-B	LINE 4A: SEVERANCE AGREEMENTS WERE MADE BETWEEN THE ORGANIZATION AND TWO EMPLOYEES: ROGER LARSEN AND JUANITA HERNANDEZ. UNDER THESE AGREEMENTS, PAYMENTS WERE MADE DURING 2023 FOR BOTH EMPLOYEES. DETAILS OF THE TERMS AND CONDITIONS OF THE SEVERANCE AGREEMENTS ARE AVAILABLE TO THE IRS UPON REQUEST. LINE 4B: DURING THE YEAR, CRAIG S. CASTRO PARTICIPATED IN A SERP PLAN. A CONTRIBUTION OF $740,721 WAS MADE IN 2023. SELECT INDIVIDUALS AGREED TO PARTICIPATE IN A CAP-EX PLAN. SEE SCHEDULE L, PART V FOR A BROADER DESCRIPTION.
PART I, LINE 7	IF FUNDING IS AVAILABLE, THE CHS BOARD WILL PROVIDE THE CHS PRESIDENT & CHIEF EXECUTIVE OFFICER WITH A DISCRETIONARY BONUS POOL TO RECOGNIZE CHS SENIOR LEADERS WHO HAVE DEMONSTRATED EXCEPTIONAL PERFORMANCE. DURING THE YEAR, THOMAS UTECHT AND DANIEL DAVIS RECEIVED A DISCRETIONARY BONUS.

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 MUNICIPAL FINANCE AUTHORITY
A	201563466	13048TS20	2017-02-01	$429,863,267	CONSTRUCTION & REFUNDING	0	0	0
CALIFORNIA MUNICIPAL FINANCE AUTHORITY
B	201563466	13048VZJ0	2021-12-16	$350,004,938	NEW CONSTRUCTION	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
A	$71,386,139	$430,205,457	$2,780,950	$50,342,190	$377,082,317	2018	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	$5,769,557	$350,004,938		$350,000,000	$4,938	2022	0	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	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	0	0	0.00000	0.00000	0.00000	0	0	Yes (1)
B	0	0	0	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	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	0	Yes (1)	0	0	0	0	Yes (1)
B	0	0	Yes (1)	0	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K, PART I, COLUMN F:	ROW A: SERIES 2017 REFUNDED THE FOLLOWING: REFUNDED A PORTION OF THE SERIES 2007 BONDS OUTSTANDING WITH A PAR AMOUNT OF $213,100,000; SERIES BONDS 2009 PAR AMOUNT $182,365,000.
SCHEDULE K, PART II, LINE 3:	COLUMN A: TOTAL PROCEEDS OF ISSUE = ISSUE PRICE + PROJECT FUND EARNINGS OF $342,190.
SCHEDULE K COMBINED SUPPLEMENTAL INFORMATION:	THE ORGANIZATION AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HAVE ESTABLISHED AN OBLIGATED GROUP TO ACCESS CAPITAL MARKETS. THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY LIABLE FOR LONG-TERM DEBT OUTSTANDING UNDER THE OBLIGATED GROUPS MASTER TRUST INDENTURE. THE ORGANIZATION IS THE PRIMARY BENEFICIARY OF THE TAX-EXEMPT BOND PROCEEDS AND FILES SCHEDULE K FOR THE BENEFIT OF ALL MEMBERS OF THE OBLIGATED GROUP.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (7 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
CRAIG CASTRO
OFFICER	SPLIT INTEREST INSURANCE	Yes (X)	$2,630,651	$2,875,673	0	Yes (1)	Yes (1)
CHRISTOPHER NEUMAN
OFFICER	SPLIT INTEREST INSURANCE	Yes (X)	$1,895,110	$1,990,894	0	Yes (1)	Yes (1)
CRAIG WAGONER
KEY EMPLOYEE	SPLIT INTEREST INSURANCE	Yes (X)	$986,225	$1,078,083	0	Yes (1)	Yes (1)
ALDO DE LA TORRE
KEY EMPLOYEE	SPLIT INTEREST INSURANCE	Yes (X)	$1,795,318	$1,940,503	0	Yes (1)	Yes (1)
CARLA MILTON
KEY EMPLOYEE	SPLIT INTEREST INSURANCE	Yes (X)	$706,907	$772,749	0	Yes (1)	Yes (1)
BRIANNE L MARRIOTT
KEY EMPLOYEE	SPLIT INTEREST INSURANCE	Yes (X)	$823,753	$858,981	0	Yes (1)	Yes (1)
ROGER LARSEN
FORMER OFFICER	SPLIT INTEREST INSURANCE	Yes (X)	$1,321,766	$1,388,572	0	Yes (1)	Yes (1)

Field	Value	IRS element (for citing)
Total Balance Due	$10,905,455	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
GWR PPMG
35% CONTROLLED ENTITY OF A MEMBER OF FCH&MC'S BOARD OF TRUSTEES	$123,306	PHYSICIAN SERVICES	0
CHRIS-ANN VENUGOPAL
FAMILY MEMBER OF A MEMBER OF FCH&MC'S BOARD OF TRUSTEES	$184,216	SALARIES AND WAGES	0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II:	FormAndLineReferenceDesc
Explanation	(C) PURPOSE OF LOAN:THE ORGANIZATION HAS ENTERED INTO COLLATERAL ASSIGNMENT SPLIT DOLLAR AGREEMENTS WITH THE PERSONS LISTED ON SCHEDULE L, PART II UNDER TREAS. REG. SECTION 1.7872-15(E)(5)(II). THE ORGANIZATION HAS INVESTED AMOUNTS LISTED IN COLUMN (E) INTO THE PLANS AND IS ENTITLED TO RECEIVE A RETURN OF THESE FUNDS, PLUS AN INTEREST RATE UPON THE DEATH OF THE NAMED PERSON.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
HEADING, BOX C:	OTHER DBAS USED: BOB SMITTCAMP FAMILY NEUROSCIENCE INSTITUTE CENTRAL CALIFORNIA HEART INSTITUTE CLOVIS COMMUNITY CENTER FOR WOUND HEALING CLOVIS COMMUNITY MEDICAL CENTER COMMUNITY BEHAVIORAL HEALTH CENTER COMMUNITY CANCER INSTITUTE COMMUNITY DIALYSIS CENTER - CLOVIS COMMUNITY DIALYSIS CENTER - FRESNO COMMUNITY HEALTH SYSTEM COMMUNITY HOME CARE COMMUNITY MEDICAL CENTERS COMMUNITY PROVIDER NETWORK COMMUNITY REGIONAL MEDICAL CENTER COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER DERAN KOLIGIAN AMBULATORY CARE CENTER DIABETES CARE CENTER OF FRESNO FRESNO HEART AND SURGICAL HOSPITAL UNIVERSITY MEDICAL CENTER PHARMACY
FORM 990, PART V, LINES 1 & 2:	COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA IS THE CENTRAL PAYOR FOR ITSELF, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION, COMMUNITY HEALTH PARTNERS, AND FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 4	DURING FY 2024, THE BOARD OF TRUSTEES AMENDED ITS BYLAWS TO REVISE ITS PROCESS FOR APPOINTING MEDICAL STAFF TRUSTEES AND TO ADDRESS THE EFFECT OF SHORT BOARD TERMS ON INCOMING TRUSTEES WHO ARE APPOINTED TO FILL UNEXPIRED TERMS OF THEIR PREDECESSORS IN OFFICE.
FORM 990, PART VI, SECTION A, LINE 6	COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA (CHCC) IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER HAS THE SOLE AND EXCLUSIVE RIGHT TO APPOINT ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310-5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE MOST RECENT AMENDED ARTICLES OF INCORPORATION PROVIDES THAT UPON DISSOLUTION ALL REMAINING ASSETS WILL BE DISTRIBUTED TO CHCC OR ITS SUCCESSOR.
FORM 990, PART VI, SECTION B, LINE 11B	UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE FORM IS REVIEWED BY THE BOARD OF TRUSTEES. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER COMMITTEE WITH BOARD DELEGATED POWERS ALSO COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT PRIOR TO THE ASSIGNMENT OF THEIR DUTIES AND THEREAFTER ON AN ANNUAL BASIS. THE STATEMENT ASKS SPECIFIC QUESTIONS THAT WOULD DETERMINE IF THERE ARE CONFLICTS OF INTERESTS. CHS'S CHIEF ETHICS & COMPLIANCE OFFICER, AND CHIEF LEGAL OFFICER REVIEW THE RESPONSES AND DETERMINE WHETHER THERE IS A CONFLICT BASED ON POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DIRECTOR, PRINCIPAL OFFICER, OR MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL BE REMOVED FROM DECISION MAKING AS IT PERTAINS TO THAT CONFLICT. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS-LENGTH BARGAINING; 2) WHETHER ARRANGEMENTS FOR PHYSICIAN AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15A: CHCC, THE SOLE MEMBER OF FCH&MC, ESTABLISHES COMPENSATION FOR THE CEO.
FORM 990, PART VI, SECTION B, LINE 15	RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION RESTS WITH THE BOARD'S EXECUTIVE COMPENSATION SUBCOMMITTEE. THE COMMITTEE WILL "CONSIDER ALL MATTERS INVOLVING COMPENSATION AND BENEFITS OF (I) CORPORATE OFFICERS WHO ARE CLASSIFIED AS "DISQUALIFIED PERSONS" PURSUANT TO INTERNAL REVENUE CODE SECTION 4958; (II) ALL OTHER CORPORATE OFFICERS WHO ARE SENIOR VICE PRESIDENTS AND EXECUTIVE VICE PRESIDENTS AND (III) THE PRESIDENT/CHIEF EXECUTIVE OFFICER." THROUGH THE EXECUTIVE COMPENSATION SUBCOMMITTEE, THE BOARD HAS ENGAGED SULLIVAN, COTTER AND ASSOCIATES, INC. TO CONDUCT A TOTAL COMPENSATION REVIEW FOR THOSE INDIVIDUALS IDENTIFIED IN THEIR SCOPE OF RESPONSIBILITY WHICH INCLUDED THE USE OF COMPARABILITY DATA AND DOCUMENTATION OF THE FINDINGS REPORTED TO THE COMMITTEE. FOR TAX YEAR 2023, THIS PROCESS WAS COMPLETED OCTOBER/NOVEMBER, 2023.
FORM 990, PART VI, SECTION C, LINE 19	FEDERAL TAX LAWS DO NOT REQUIRE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES RELATED TO CONFLICTS OF INTEREST BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THIS FORM 990 AND ARE PUBLICLY AVAILABLE.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 289,114,921. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 289,114,921. MD SUPERVISORY FEES: PROGRAM SERVICE EXPENSES 14,149,037. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,149,037. MEDICAL PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 20,530,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,530,750. LINEN SERVICES: PROGRAM SERVICE EXPENSES 7,505,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,505,895. AMBULANCE SERVICE: PROGRAM SERVICE EXPENSES 7,492,254. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,492,254. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 63,448,535. MANAGEMENT AND GENERAL EXPENSES 12,085,436. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,533,971.
FORM 990, PART XI, LINE 9:	UBI FROM PASSTHROUGH INVESTMENTS -711,110.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
AMI REALTY PARTNERS LP
1560 E SHAW AVENUE	FRESNO	CA	93710	203709876	INACTIVE	CA	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
COMMUNITY SURGICAL CENTER HOLDINGS LLC
789 MEDICAL CENTER DRIVE E SUITE 10	CLOVIS	CA	93611		INACTIVE	CA	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
COMMUNITY SURGICAL CENTER LLC
789 MEDICAL CENTER DRIVE E SUITE 10	CLOVIS	CA	93611		INACTIVE	CA	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA
1560 E SHAW AVENUE	FRESNO	CA	93710	942864615	SUPPORTING ORGANIZATION	CA	501(C)(3)	LINE 12B, II	N/A	Yes (1)
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION
1560 E SHAW AVENUE	FRESNO	CA	93710	770191730	SUPPORTING ORGANIZATION	CA	501(C)(3)	LINE 7		Yes (1)	COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA
COMMUNITY HEALTH PARTNERS
45 RIVER PARK PLACE WEST SUITE 507	FRESNO	CA	93720	852103299	HEALTHCARE	CA	501(C)(3)	LINE 3		Yes (1)	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	AMSURG CMC ASC VENTURES LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1A BURTON HILLS BOULEVARD SUITE 300	AddressLine1Txt
City	NASHVILLE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	37215	ZIPCd

Field	Value	IRS element (for citing)
EIN	883433826	EIN
Primary Activities	HOLDING COMPANY	PrimaryActivitiesTxt
Legal Domicile State	TN	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	EXCLUDED	PredominantIncomeTypeTxt
Share Of EOY Assets	$2,400,969	ShareOfEOYAssetsAmt
Disproportionate Allocations	0	DisproportionateAllocationsInd
General Or Managing Partner	Yes (1)	GeneralOrManagingPartnerInd
Ownership	0.51000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd
COMMUNITY INSURANCE SERVICES COMPANY
789 N MEDICAL CENTER DRIVE EAST	CLOVIS	CA	93611	980674776	INSURANCE	CJ	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER	C	$12,318,330	$46,948,494	1.00000	Yes (1)
COMMUNITY CARE HEALTH PLAN INC
789 N MEDICAL CENTER DRIVE EAST	CLOVIS	CA	93611	273353543	HEALTH CARE PLAN		FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER	C	$76,199,199	$17,678,321	1.00000	Yes (1)	CA
COMMUNITY HEALTH ENTERPRISES INC
789 N MEDICAL CENTER DRIVE EAST	CLOVIS	CA	93611	770175659	PHARMACY SALES			C				0	CA	N/A
COMMUNITY COLLABORATIVE CARE NETWORK
45 RIVER PARK PLACE WEST SUITE 507	FRESNO	CA	93720	332243552	HEALTH CARE		COMMUNITY HEALTH PARTNERS	C		$153,850	1.00000	Yes (1)	CA

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	0	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	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION
C	$10,820,053	CASH
COMMUNITY INSURANCE SERVICES COMPANY
R	$14,790,170	CASH
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA
P	$326,583,796	COST
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION
S	$10,776,014	CASH