2020-08-20T16:56:17-05:00 2019-12-31 ERNST & YOUNG US LLP 4365 EXECUTIVE DR STE 1600 SAN DIEGO CA 92121 990 2019-01-01 951683892 COMMUNITY MEMORIAL HEALTH SYSTEM % KATHRYN YAMADA COMM 8056525050 147 NORTH BRENT STREET VENTURA CA 93003 DAVID B GLYER CFO 8056525012 2020-08-17 true JOCELYNE MILLER P00634378 8585357200 2020-08-17 152.169.64.19 33577420202335000001 2020-08-20 P D82929CAA62A0C4D7060EA1070823E3249DA6E46 228D48D10834BFE8C59A0E4DF6CE68B9CD7C839B 2019 2020-09-23 17:36:50Z GARY K WILDE 147 NORTH BRENT STREET VENTURA CA 93003 565981551 false X WWW.CMHSHEALTH.ORG X 1933 CA TO HEAL, COMFORT AND PROMOTE HEALTH FOR THE COMMUNITIES WE SERVE. 18 15 3004 253 50783 1434386 1480662 420401994 492566877 14783698 5478037 2287751 3959284 438907829 503484860 469935 528727 0 0 209975064 237110948 0 0 0 195400260 275798301 405845259 513437976 33062570 -9953116 891012146 923808108 418854930 447069777 472157216 476738331 X SEE SCHEDULE O false false 448731201 0 492566877 PATIENT SERVICES TO INCLUDE 82,359 PATIENT DAYS, 181,169 OUTPATIENT VISITS, AND 326,630 VISITS TO THE CENTERS FOR FAMILY HEALTH (THE HEALTHCARE SYSTEM'S OUTPATIENT CARE CLINICS). SEE SCHEDULE O. 969509 528727 0 COMMUNITY OUTREACH PROGRAMS INCLUDE: FREE BLOOD PRESSURE CHECKS; CANCER RESOURCE CENTER AND SUPPORT GROUPS; HEART-AWARE PROGRAM THAT PROVIDES FREE RISK EVALUATION, PREVENTATIVE INFORMATION AND RESOURCES. SEE SCHEDULE O. 1055529 0 0 IT IS THE GOAL OF CMHS TO PROMOTE THE HEALTH OF THE COMMUNITY BY FOCUSING ON COMMUNITY EDUCATION OUTREACH, ACCESS TO CARE, UNCOMPENSATED AND UNDER-FUNDED CARE, AND SPONSORSHIP OF COMMUNITY RESOURCES. SEE SCHEDULE O. 450756239 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false true false false false true true true true false false true 628 0 true 3004 true true true false false false false false false false false false true false X 18 15 false false false false false false false true true false false true true true true true true true true true false CA X X KATHRYN YAMADA 8056525012 2590 EAST MAIN STREET VENTURA CA 93003 GARY K WILDE PRESIDENT & CEO 36.0 4.0 X 1211212 0 396351 ADAM THUNELL VP OPERATIONS 40.0 0.0 X 1069577 0 99382 CYNTHIA DEMOTTE VP QUALITY 40.0 0.0 X 782191 0 48869 DAVID GLYER CFO 40.0 0.0 X 610321 0 85964 CYNTHIA FAHEY CNO 40.0 0.0 X 607288 0 64455 WILFRED GARAND VP PLANNING & MANAGED CARE 40.0 0.0 X 588117 0 52589 SAMUEL SMALL CHIEF OF MEDICAL EDUCATION 40.0 0.0 X 506660 0 83844 ANTHONY RUSSELL CAO AMBULATORY MEDICINE 40.0 0.0 X 517252 0 71757 HAADY LASHKARI CHIEF ADM OFFICER OJAI/VP CMH 40.0 0.0 X 517222 0 71449 DIANY KLEIN VP HUMAN RESOURCES (thru 8/19) 40.0 0.0 X 487150 0 64279 STANLEY FROCHTZWAJG CMO, INPATIENT 40.0 0.0 X 482146 0 68649 RONALD SANDIFER CIO (Thru 6/19) 40.0 0.0 X 499535 0 0 EMILIE RAYMAN COMPLIANCE OFFICER 40.0 0.0 X 358627 0 49540 MICHAEL ELLINGSON VP MARKETING & DEVELOPMENT 36.0 4.0 X 335092 0 46001 SCOTT GOODFRIEND PHYSICIAN ADVISOR 40.0 0.0 X 309592 0 18357 KEITH MCWILLIAMS CIO 40.0 0.0 X 304026 0 7828 EUGENE DAY DIRECTOR OF PHARMACY 40.0 0.0 X 266239 0 12648 PILAR PARKER RN III 40.0 0.0 X 268324 0 6430 CARLOS LIMON JR PHARMACIST 40.0 0.0 X 247044 0 18357 MARK SCHUETTE DIR CONSTRUCTION PROJECT MGMT 40.0 0.0 X 251380 0 5702 RICHARD REISMAN VP AMBULATORY MEDICINE 36.0 0.0 X 235484 0 8353 KARI ANNE OSBORNE VP HUMAN RESOURCES 40.0 0.0 X 234036 0 6732 DEBORAH CARLSON MD BOARD MEMBER 1.0 0.0 X 163750 0 0 CARL CONSTANTINE MD BOARD MEMBER 1.0 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0 320090433 314152017 0 0 0 0 6955525 41137543 0 0 8436353 8932535 418854930 447069777 X 469204808 475350491 2952408 1387840 472157216 476738331 891012146 923808108 X -9953116 10913462 0 0 0 3620769 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false 0 false 0 false 0 false 0 false 0 false 0 true 76616 76616 false SCHEDULE C, PART II-B, LINE 1 LOBBYING ACTIVITIES THE ORGANIZATION IS A MEMBER OF THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND THE AMERICAN HOSPITAL ASSOCIATION. IN 2019, $239,667 WAS INCLUDED IN EXPENSES FOR ANNUAL MEMBERSHIP DUES, A PORTION OF WHICH IS DIRECTED BY THESE ORGANIZATIONS TO CONDUCT LOBBYING ACTIVITIES. 43529517 43529517 472180982 84611533 387569449 180205352 71646092 108559260 30741334 30741334 570399560 OPERATING LEASE ROU ASSETS 33764500 CONSTRUCTION FUNDS 31231692 DEPOSITS WITH INSURANCE CO 7079206 ASSETS LIMITED TO USE 5091822 DUE FROM THIRD PARTIES 3047358 OTHER ASSETS 1833195 82047773 0 SELF-INSURANCE LIABILITIES 6532328 OTHER LIABILITIES 2400207 8932535 X FIN 48 (ASC 740) FOOTNOTE THE FOLLOWING FOOTNOTE IS FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMUNITY MEMORIAL HEALTH SYSTEM: THE SYSTEM ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE CONSOLIDATED FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. UNDER ASC 740, THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS MAY BE RECOGNIZED ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED, BASED SOLELY ON ITS TECHNICAL MERITS, WITH THE TAXING AUTHORITY HAVING FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE SYSTEM RECORDS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS AS DISCRETE TAX ADJUSTMENTS IN THE FIRST INTERIM PERIOD THAT THE MORE-LIKELY-THAN-NOT THRESHOLD IS NOT MET. THE SYSTEM RECOGNIZES DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF ITS ASSETS AND LIABILITIES ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS FOR TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA. THE SYSTEM COMPLETED AN ANALYSIS OF ITS TAX POSITION, IN ACCORDANCE WITH ASC 740, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN. NO SIGNIFICANT TAX LIABILITY FOR UNRECOGNIZED TAX BENEFITS, INTEREST, OR PENALTIES WAS ACCRUED AS OF DECEMBER 31, 2019 OR 2018. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE SYSTEM BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2015. true true X true X true X 700. true true false false 1108185 1108185 0.00220 116196783 81746723 34450060 0.06710 117304968 81746723 35558245 0.06930 1737840 0 1737840 0.00340 11377563 2985146 8392417 0.01630 50018089 37286104 12731985 0.02480 528727 528727 0.00100 63662219 40271250 23390969 0.04550 180967187 122017973 58949214 0.11480 8800 8800 0.00000 986773 986773 0.00190 995573 995573 0.00190 false 93933593 116368217 -22434624 X true true SEE PART VI IMAGING CENTER 0.51 0.49 SEE PART VI MANAGEMENT SERVICES 0.5 0.5 SEE PART VI REAL ESTATE 0.7275 0.2725 2 1 COMMUNITY MEMORIAL HOSPITAL 147 NORTH BRENT STREET VENTURA CA 93003 WWW.CMHSHEALTH.ORG 050000026 X X X X A 2 OJAI VALLEY COMMUNITY HOSPITAL 1306 MARICOPA HWY OJAI CA 93023 WWW.CMHSHEALTH.ORG 050000045 X X X X X A A 12 false false true X X X X X X X X X 19 true true true true X See Part V, Section C X true 19 true See Part V, Section C false true X 200. 700. X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART V, SECTION B, LINE 5 COMMUNITY MEMORIAL HEALTH SYSTEM (CMHS) CONDUCTED ITS MOST RECENT CHNA THROUGH A COORDINATED EFFORT WITH ITS PARTNERS AT THE VENTURA COUNTY DEPARTMENT OF PUBLIC HEALTH, ADVENTIS HEALTH SIMI VALLEY, CAMARILLO HEALTH CARE DISTRICT, CLINICAS DEL CAMINO REAL, ST. JOHN'S REGIONAL MEDICAL CENTER, ST. JOHN'S PLEASANT VALLEY HOSPITAL, VENTURA COUNTY PUBLIC HEALTH AND THE VENTURA COUNTY HEALTH CARE AGENCY COMMUNITY HEALTH CENTER. THESE PARTNERS MAKE UP THE VENTURA COUNTY COMMUNITY NEEDS ASSESSMENT COLLABORATIVE (VCCNAC). A COMMUNITY HEALTH ASSESSMENT SURVEY (2019) WAS DESIGNED AND DISSEMINATED BY THE VENTURA COUNTY COMMUNITY NEEDS ASSESSMENT COLLABORATIVE. THE CHNA FINDINGS ARE DRAWN FROM AN ANALYSIS OF AN EXTENSIVE SET OF SECONDARY DATA (OVER 240 INDICATORS FROM NATIONAL AND STATE DATA SOURCES) AND IN-DEPTH PRIMARY DATA FROM COMMUNITY HEALTH LEADERS AND ORGANIZATIONS THAT SERVE THE COMMUNITY AT LARGE, AS WELL AS NON-HEALTH PROFESSIONALS AND COMMUNITY MEMBERS. THE MAIN SOURCE FOR THE SECONDARY DATA IS THE HEALTH MATTERS IN VENTURA COUNTY PLATFORM, A PUBLIC DATA PLATFORM MADE AVAILABLE BY VENTURA COUNTY PUBLIC HEALTH. THE PRIMARY DATA COLLECTION PROCESS INCLUDED A COMMUNITY HEALTH ASSESSMENT SURVEY. A TOTAL OF 2,722 RESPONSES WERE COLLECTED. ONE OF THE KEY OBJECTIVES OF THE ASSESSMENT WAS TO ENGAGE THE COMMUNITY, INCLUDING VULNERABLE POPULATIONS, PHYSICIANS, AND OTHER SERVICE PROVIDERS TO SHARE THEIR PERCEPTIONS ON HEALTH NEEDS FOR VENTURA COUNTY RESIDENTS. KEY INFORMATION INTERVIEWS AND FOCUS GROUP DISCUSSIONS WERE HELD TO HELP DEVELOP A DEEPER UNDERSTANDING OF THE DATA COLLECTED. ON APRIL 23, 2019, 25 STAKEHOLDERS OF THE VCCNAC CONVENED IN AN ALL-DAY EXERCISE TO REVIEW THE FINDINGS FROM THE PRIMARY DATA AND THE SECONDARY DATA COLLECTION EFFORTS TO PRIORITIZE THE SIGNIFICANT HEALTH ISSUES THAT AROSE THROUGH THIS ANALYSIS. PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES ADVENTIST HEALTH SIMI VALLEY ST. JOHN'S REGIONAL MEDICAL CENTER, DIGNITY HEALTH ST. JOHN'S PLEASANT VALLEY HOSPITAL, DIGNITY HEALTH PART V, SECTION B, LINE 6B CHNA CONDUCTED WITH OTHER ORGANIZATIONS CAMARILLO HEALTH CARE DISTRICT CLINICAS DEL CAMINO REAL, INC. VENTURA COUNTY HEALTH CARE AGENCY COMMUNITY HEALTH CENTER VENTURA COUNTY PUBLIC HEALTH PART V, SECTION B, LINE 7 CHNA WEBSITE https://www.cmhshealth.org/about/community-health-needs-assessment/ PART V, SECTION B, LINE 10 IMPLEMENTATION STRATEGY https://www.cmhshealth.org/about/community-health-needs-assessment/ PART V, SECTION B, LINE 11 THE COMMUNITY MEMORIAL HEALTH SYSTEM BOARD OF TRUSTEES ESTABLISHED A COMMUNITY BENEFIT COMMITTEE TO OVERSEE THE DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF ONGOING COMMUNITY BENEFIT ACTIVITIES AND THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE CMHS BOARD OF TRUSTEES APPROVES THE IMPLEMENTATION STRATEGY RECOMMENDED BY THE COMMITTEE. THE CHNA IDENTIFIED FIVE HEALTH PRIORITIES FOR THE COUNTY OF VENTURA: 1. IMPROVE ACCESS TO HEALTH SERVICES 2. REDUCE THE IMPACT OF BEHAVIORAL HEALTH ISSUES 3. IMPROVE HEALTH AND WELLNESS FOR OLDER ADULTS 4. REDUCE THE BURDEN OF CHRONIC DISEASE 5. ADDRESS SOCIAL NEEDS OF THE FIVE INDENTIFIED PRIORITIES, THE ORGANIZATIONS PARTICIPATING IN THE JOINT COMMUNITY HEALTH IMPLEMENTATION STRATEGY HAVE CHOSEN NOT TO ADDRESS TWO OF THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE CHNA: 1. REDUCE THE IMPACT OF BEHAVIORAL HEALTH ISSUES 2. REDUCE THE BURDEN OF CHRONIC DISEASE THE PRIORITIZED HEALTH NEEDS WERE NOT SELECTED BECAUSE VCCNAC HAS IDENTIFIED OTHER COMMUNITY STAKEHOLDERS THAT ARE CURRENTLY LEADING INTERVENTIONS TO ADDRESS THESE HEALTH NEEDS IN THE COUNTY, INCLUDING VENTURA COUNTY BEHAVIORAL HEALTH. COMMUNITY MEMORIAL HEALTH SYSTEM HAS SEPARATELY IMPLENTED ALL FIVE PRIORITIES IDENTIFIED IN THE CHNA. COMMUNITY MEMORIAL HEALTH SYSTEM ADDRESSED THE PRIORITY AREAS BY: IMPROVE ACCESS TO HEALTH SERVICES - COLLABORATING WITH CLINICAS DEL CAMINO REAL TO ENHANCE PATIENT ACCESS TO SPECIALTY CARE. INVESTMENT IN TECHNOLOGY HAS REDUCED THE NO-SHOW RATE AND THE APPOINTMENT BACKLOG. ONGOING PARTICIPATION WITH GOLD COAST HEALTH PLAN ON INITIATIVE TO IMPROVE "CHILDREN AND ADOLESCENTS' ACCESS TO PRIMARY CARE PRACTITIONERSINCREASE HEDIS SCORES FOR GCHP. - CONTINUED TO IMPROVE PHYSICIAN RESIDENT TRAINING AT THE CMHS GRADUATE MEDICAL EDUCATION PROGRAM THROUGH FACULTY RECRUITMENT AND LOCAL PARTNERSHIPS. - ENHANCING THE PHYSICIAN RESIDENT FREE CLINIC PROGRAM IN UNDERSERVED COMMUNITIES. - CONTINUED GROWTH OF THE MULTI-SPECIALTY CLINIC IN OJAI. - PARTICIPATING IN THE UNITED WAY'S BUILDING HEALTHY SMILES CAMPAIGN TO ADDRESS THE NEED FOR ACCESS TO DENTAL CARE. - RECRUITING SPECIALTY AND FAMILY PHYSICIANS. REDUCE THE IMPACT OF BEHAVIORAL HEALTH ISSUES - LAUNCHING TELEMEDICINE FOR BEHAVIORAL HEALTH. - ENHANCING ACCESS TO BEHAVIORAL HEALTH PROVIDERS BY COLLABORATING WITH CLINICAS DEL CAMINO REAL AND WORKING WITH VISTA DEL MAR FOR DEVELOPING INTEGRATED SERVICES AT CMHS' OUTPATIENT CLINICS. IMPROVE HEALTH AND WELLNESS FOR OLDER ADULTS - PROVIDING IN-KIND SUPPORT AND STAFF ENGAGEMENT TO THE EXPLORATION AND DEVELOPMENT EFFORTS OF SENIOR INDEPENDENT LIVING SUPPORT IN THE OJAI VALLEY AND WEST VENTURA. REDUCE THE BURDEN OF CHRONIC DISEASE - CMHS AMBULATORY MEDICINE RELAUNCHED INTENSIVE CASE MANAGEMENT TO IMPROVE COORDINATION OF CARE. THE CHRONIC CARE MANAGEMENT PROGRAM HAS OVER 1,000 PATIENTS ON SERVICE. - CMHS HEALTHAWARE HAS PROMOTED CARDIAC AND VASCULAR HEATLH BY PROVIDING THOUSANDS OF COMMUNITY MEMBERS WITH ONGOING HEALTH EDUCATION, SUPPORT, FREE SCREENINGS, AND HEALTH ASSESSMENTS. - PROVIDING FREE CHRONIC DISEASE DETECTION AND SCREENING SERVICES - THE HEALTH AREA OF OBESE/OVERWEIGHT YOUTH WAS NOT ADDRESSED IN 2019. CMHS HAD PLANNED TO PROVIDE PROGRAMMIC AND FINANCIAL SUPPORT TO FIT KIDS/FIT OJAI. ADDRESS SOCIAL NEEDS - IMPLEMENTED ELECTRONIC PRESCRIBING AT THE OUTPATIENT HOSPITAL CLINICS FOR CONTROLLED SUBSTANCES TO SET A GENERAL STANDARD OF PRESCRIBING OPIOID PAIN MEDICATION TO REDUCE OPIOID OVERDOSE RELATED DEATHS. - THREE PHYSICIANS OBTAINED CERTIFICATION FOR PRESCRIBING SUBOXONE FOR OPIOID DEPENDENCE TREATMENT. - CONNECTING WITH WEST VENTURA SCHOOLS TO CONTRIBUTE TO MOTIVATING STUDENTS TO GRADUATE FROM HIGH SCHOOL INCLUDING ACTIVITIES SUCH AS CAREER DAY, CPR AND FIRST AID EDUCATION, AND DISASTER PLANNING. - OFFERING EDUCATIONAL PROGRAMS - HOSTING SUPPORT GROUPS THAT ARE WIDELY AVAILABLE TO THE PUBLIC - PROVIDING RECUPERATIVE CARE TO THE HOMELESS WITH SHORT TERM CARE AND CASE MANAGEMENT. PART V, SECTION B, LINE 15E CMHS PUBLICIZES A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ON THE FACILITY'S WEBSITE. INCLUDED ON THE BACK OF EACH BILLING STATEMENT IS A DISCLAIMER REGARDING FINANCIAL ASSISTANCE BEING AVAILABLE AND A CONTACT NUMBER TO CALL IF INTERESTED. MOREOVER, CMHS HAS SIGNAGE POSTED IN THE ADMITTING AND EMERGENCY ROOM AREAS. A WRITTEN COPY OF THIS POLICY IS AVAILABLE UPON REQUEST, AS INDICATED ON THIS SIGNAGE DISPLAYED. PART V, SECTION B, LINE 16A FINANCIAL ASSISTANCE POLICY WEBSITE HTTP://WWW.CMHSHEALTH.ORG/PATIENTS-AND-VISITORS/PATIENT-INFORMATION/COMMUN ITY-MEMORIAL-HOSPITAL/FINANCIAL-SERVICES/ PART V, SECTION B, LINE 16B FINANCIAL ASSISTANCE POLICY APPLICATION WEBSITE HTTP://WWW.CMHSHEALTH.ORG/PATIENTS-AND-VISITORS/PATIENT-INFORMATION/COMMUN ITY-MEMORIAL-HOSPITAL/FINANCIAL-SERVICES/ PART V, SECTION B, LINE 16C AND 16F PLAIN LANGUAGE SUMMARY WEBSITE HTTP://WWW.CMHSHEALTH.ORG/PATIENTS-AND-VISITORS/PATIENT-INFORMATION/COMMUN ITY-MEMORIAL-HOSPITAL/FINANCIAL-SERVICES/ PART V, SECTION B, LINE 16H CMHS CREATED A BILINGUAL FINANCIAL ASSISTANCE FLYER THAT IS DISTRIBUTED TO THE COMMUNITY AT HEALTH FAIRS, FREE CLINICS, COMMUNITY EVENTS AND SUPPORT GROUPS. THIS FLYER PROVIDES DETAILS ON THE CMHS FINANCIAL ASSISTANCE PROGRAM AS WELL AS DIRECTION ON HOW TO SOLICIT SUPPORT WITH ENROLLMENT. 24 SAVIERS CENTER FOR FAMILY HEALTH 2921 S SAVIERS ROAD OXNARD CA 93033 OP CLINIC GROSSMAN IMAGING CENTER OF CMH LLC 2001 N SOLAR DRIVE SUITE 135 OXNARD CA 93030 IMAGING CENTER CAMARILLO CENTER FOR FAMILY HEALTH 422 B ARNEILL ROAD CAMARILLO CA 93010 OP CLINIC ASHWOOD CENTER FOR FAMILY HEALTH 116 ASHWOOD DRIVE VENTURA CA 93003 OP CLINIC VINEYARD CENTER FOR FAMILY HEALTH 2361 VINEYARD AVENUE OXNARD CA 93036 OP CLINIC AIRPORT MARINA CENTER FOR FAMILY HEALTH 3641 W FIFTH STREET OXNARD CA 93036 OP CLINIC SANTA PAULA CENTER FOR FAMILY HEALTH 242 E HARVARD BLVD SANTA PAULA CA 93060 OP CLINIC MSO SAN BUENAVENTURA UROLOGY CENTER 2705 LOMA VISTA ROAD SUITE 206 VENTURA CA 93003 OP CLINIC MAIN STREET CENTER FOR FAMILY HEALTH 138 W MAIN STREET VENTURA CA 93001 OP CLINIC MSO PACIFIC INPATIENT PHYSICIANS 147 NORTH BRENT STREET VENTURA CA 93003 OP CLINIC MIDTOWN MEDICAL GROUP CLINIC SPECIALTY 168 N BRENT STREET SUITE 302 VENTURA CA 93003 OP CLINIC PREMIERE HEALTH SANTA PAULA 258 262 E HARVARD BLVD SANTA PAULA CA 93060 OP CLINIC MIDTOWN MEDICAL GROUP CLINIC 2721 E MAIN STREET VENTURA CA 93003 OP CLINIC MSO SAN BUENAVENTURA UROGYNECOLOGY 2705 LOMA VISTA ROAD SUITE 206 VENTURA CA 93003 OP CLINIC FILLMORE CENTER FOR FAMILY HEALTH 852 VENTURA STREET FILLMORE CA 93015 OP CLINIC SANTA ROSA CENTER FOR FAMILY HEALTH 5800 SANTA ROSA ROAD CAMARILLO CA 93010 OP CLINIC PORT HUENEME CENTER FOR FAMILY HEALTH 321 E PORT HUENEME ROAD PORT HUENEME CA 93041 OP CLINIC MSO VENTURA COAST FAMILY CARE 124 N BRENT STREET VENTURA CA 93003 OP CLINIC OAK VIEW CENTER FOR FAMILY HEALTH 655 N VENTURA AVENUE OAK VIEW CA 93022 OP CLINIC MIDTOWN MEDICAL GROUP CLINIC - OJAI 655 N VENTURA AVENUE OAK VIEW CA 93022 OP CLINIC OJAI MULTISPECIALTY CENTER 117 PIRIE ROAD OJAI CA 93023 OP CLINIC CENTRAL COAST CENTER FOR GYNECOLOGIC ONC 2900 LOMA VISTA ROAD SUITE 205 VENTURA CA 93003 OP CLINIC MSO PREMIERE DERMATOLOGY & MOHS SURGERY 168 N BRENT STREET SUITE 403 VENTURA CA 93003 OP CLINIC PROSTATE INSTITUTE OF AMERICA 147 N BRENT STREET VENTURA CA 93003 OP CLINIC PART I, LINE 3C IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATION ALSO USED AN ALGORITHM TO DETERMINE QUALIFICATION OF CHARITY CARE FROM INFORMATION PROVIDED BY PATIENTS AT INTAKE AS WELL AS INFORMATION FROM CREDIT REPORTS. PART I, LINE 7 COSTING METHOD USED IS COST-TO-CHARGE USING WORKSHEET 2. PART I, LINE 7B UNREIMBURSED MEDICAID THE CALIFORNIA HOSPITAL FEE PROGRAM (THE PROGRAM) AND AMENDING-LEGISLATION WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA ON JANUARY 1, 2010 AND SEPTEMBER 8, 2010, RESPECTIVELY. THE PRIMARY LEGISLATION (AB 1383) AND AMENDING LEGISLATION (AB 1653) CONTAINS TWO COMPONENTS: THE QUALITY ASSURANCE FEE ACT, WHICH GOVERNS THE "HOSPITAL FEE"QUALITY ASSURANCE FEE" (QA FEE) PAID BY PARTICIPATING HOSPITALS, AND THE MEDI-CAL HOSPITAL PROVIDER STABILIZATION ACT, WHICH GOVERNS SUPPLEMENTAL MEDI-CAL PAYMENTS (SUPPLEMENTAL PAYMENTS) MADE TO PROVIDERS FROM THE FUND. HOSPITAL PARTICIPATION IS MANDATORY, WITH LIMITED EXCEPTIONS. IN JUNE 2012, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AMENDED LEGISLATION TO ALLOW FOR THE FEE-FOR-SERVICE PORTION OF THE PROGRAM TO BE ADMINISTERED SEPARATELY FROM THE MANAGED CARE COMPONENT. THERE ARE TWO PROGRAMS THAT HAD ACTIVITY IN 2018 AND 2019: A 30-MONTH HOSPITAL FEE PROGRAM COVERING THE PERIOD FROM JANUARY 1, 2017 THROUGH JUNE 30, 2019, AND A 30-MONTH HOSPITAL FEE PROGRAM COVERING THE PERIOD FROM JULY 1, 2019 THROUGH DECEMBER 31, 2021. THE SYSTEM MADE PAYMENTS TO THE DHCS FOR THE QA FEE IN THE AMOUNT OF $16,289,802 AND $12,494,991 IN 2019 AND 2018, RESPECTIVELY. THE SYSTEM MADE CALIFORNIA HEALTH FOUNDATION AND TRUST PAYMENTS IN THE AMOUNT OF $362,754 AND $340,885 IN 2019 AND 2018, RESPECTIVELY, AND THE PLEDGE PAYMENTS WERE RECORDED WITHIN THE QA FEE IN OPERATING EXPENSES WITHIN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE SYSTEM RECEIVED SUPPLEMENTAL PAYMENTS OF $33,389,043 AND $35,518,314 OVER THE COURSE OF THE PROGRAM IN 2019 AND 2018, RESPECTIVELY. THE SYSTEM RECORDED THE SUPPLEMENTAL PAYMENTS AS OPERATING REVENUE WITHIN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. PART I, LINE 7G NO AMOUNT ATTRIBUTABLE TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7G. PART I, LINE 7, COLUMN F THE ORGANIZATION INCLUDED $5,862 OF BAD DEBT EXPENSE IN PART IX. THE AMOUNT HAS BEEN SUBTRACTED FROM THE CALCULATION OF COLUMN F. PART II COMMUNITY BUILDING ACTIVITIES CMHS REGULARLY EVALUATES THE HEALTH NEEDS OF THE COMMUNITIES SURROUNDING ITS OUTPATIENT AND HOSPITAL LOCATIONS AND STRATEGICALLY RECRUITS FAMILY AND SPECIALTY PHYSICIANS TO MEET THE IDENTIFIED NEEDS. CMHS ALSO SUPPORTS ITS AFFILIATED MEDICAL GROUPS WITH PHYSICIAN RECRUITMENT WHERE A COMMUNITY NEED IS DEMONSTRATED. THE MARKET NEED IS EVALUATED BY A TARGETED STUDY OF THE NUMBER OF PHYSICIANS NEEDED PER PRACTICE AREA BASED ON POPULATION SIZE. AS A MEMBER AND ENGAGED PARTICIPANT IN THE VENTURA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE, CMHS HAS TAKEN AN ACTIVE LEADERSHIP ROLE IN THE SHARING OF VALUABLE INFORMATION ON HEALTH IMPROVEMENT INITIATIVES AND THE PLANNING OF THE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT IN 2019. THE 2019 JOINT CHNA WAS A SYNERGISTIC PROCESS INVOLVING ALL MEMBERS OF THE CHNA COLLABORATIVE WORKGROUP. A COORDINATED, CROSS-ORGANIZATIONAL STRATEGY WAS UTILIZED TO EVALUATE AND ADDRESS THE HEALTH NEEDS OF COMMUNITIES ACROSS VENTURA COUNTY. PART III, LINE 8 THE ENTIRE SHORTFALL OF MEDICARE EXPENSES OVER MEDICARE REIMBURSEMENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT EXPENSE. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE COSTS ATTRIBUTABLE TO SERVICE MEDICARE PATIENTS. THE SYSTEM IS REIMBURSED FOR SERVICES PROVIDED TO PATIENTS UNDER CERTAIN PROGRAMS ADMINISTERED BY GOVERNMENTAL AGENCIES, WHICH INCLUDES THE MEDICARE PROGRAM. THE MEDICARE PROGRAM CONSISTS OF 25.6% OF THE SYSTEMS NET REVENUE FOR 2019. HOSPITALS DO NOT DETERMINE THE LEVEL OF PAYMENT FROM THE MEDICARE PROGRAM, AND THE MEDICARE PROGRAM DOES NOT COVER THE COSTS OF TREATING THE SYSTEM'S MEDICARE PATIENTS, ALTHOUGH THE QUALITY OF CARE AND ACCESS TO CARE IS THE SAME FOR ALL PATIENTS, REGARDLESS OF PAYER SOURCE. UNREIMBURSED COST UNDER THE MEDICARE PROGRAM IS A TRUE LOSS TO THE SYSTEM AND THE LOSS IS REFLECTED IN THE SYSTEM'S FINANCIAL STATEMENTS. AS SUCH, MEDICARE LOSSES SHOULD BE CONSIDERED A COMMUNITY BENEFIT PROVIDED BY THE SYSTEM. PART III, LINE 9B THE PATIENT'S ABILITY TO PAY IS EVALUATED UPON ADMISSION. A PATIENT FINANCIAL SERVICES STAFF ASSISTS PATIENTS WITH APPLYING FOR LOCAL, STATE AND FEDERAL PROGRAMS WHEN THERE IS NO OTHER SOURCE OF PAYMENT. IN THE EVENT THAT NO THIRD-PARTY PAYMENT SOURCE IS AVAILABLE, PATIENTS ARE PROVIDED WITH INFORMATION ON THE SYSTEM'S FINANCIAL ASSISTANCE PROGRAM. FINANCIAL ASSISTANCE AND CHARITY CARE IS BASED ON A SLIDING SCALE FEE SCHEDULE UTILIZING THE CURRENT UNITED STATES FEDERAL POVERTY GUIDELINES. INFORMATION FROM THE APPLICANT'S FINANCIAL APPLICATION AND SUPPORTING DOCUMENTATION IS USED TO DETERMINE THE AMOUNT OF THE QUALIFIED FINANCIAL ASSISTANCE TO BE GRANTED. THE SYSTEM HAS A WRITTEN COLLECTION POLICY TO PROVIDE FOR AN EQUITABLE PROCESS BY WHICH A PATIENT AND/OR RESPONSIBLE PARTY CAN MAKE A PAYMENT OR PAYMENT ARRANGEMENT PRIOR TO OR AT THE TIME OF SERVICE. THE SYSTEM WILL PROACTIVELY DETERMINE THE PATIENT'S ABILITY TO PAY. A DEPOSIT, BASED UPON SELF-PAY LIABILITY IS COLLECTED PRIOR TO ADMISSION OR AT THE TIME OF SERVICE. FOR PATIENTS WHO ARE UNABLE TO PAY THEIR ESTIMATED LIABILITY AT THE TIME OF SERVICE, THE SYSTEM WILL OFFER A FINANCING OPTION. PATIENTS WHO MEET CHARITY OR INDIGENT GUIDELINES WILL BE REFERRED TO A FINANCIAL ADVOCATE FOR FINANCIAL AID. PART VI, LINE 1 MANAGEMENT COMPANIES AND JOINT VENTURES GROSSMAN IMAGING CENTER OF CMH, LLC BUENAVISTA MEDICAL PROPERTIES, LTD VENTURA CARDIOVASCULAR CO-MANAGEMENT COMPANY, LLC PART VI, LINE 2 NEEDS ASSESSMENT IN 2019, CMHS WORKED CLOSELY WITH THE VENTURA COUNTY DEPARTMENT OF PUBLIC HEALTH, ADVENTIS HEALTH SIMI VALLEY, CAMARILLO HEALTH CARE DISTRICT, CLINICAS DEL CAMINO REAL, ST. JOHN'S REGIONAL MEDICAL CENTER, ST. JOHN'S PLEASANT VALLEY HOSPITAL, AND THE VENTURA COUNTY HEALTH CARE AGENCY COMMUNITY HEALTH CENTER TO UPDATE ITS COMMUNITY NEEDS ASSESSMENT. THE AREA-WIDE SURVEY AND STUDY CONSISTED OF AN ANALYSIS OF THE SOCIO-ECONOMIC PROFILE OF VENTURA COUNTY, A COMPREHENSIVE EXAMINATION OF THE HEALTH CARE STATUS AND NEEDS OF COMMUNITIES ACROSS VENTURA COUNTY, THE STATE OF HEALTHCARE DELIVERY AND ITS ASSOCIATED SERVICES, COMMUNITY REPORTED HEALTH NEEDS, AND COMMUNITY PRIORITIZATION AND IMPLEMENTATION STRATEGIES. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL ASSISTANCE PROGRAM BROCHURES EXPLAINING THE SYSTEM'S POLICY ARE POSTED AND MADE AVAILABLE TO PATIENTS AT THE TIME OF ADMITTANCE. SIGNS ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE PROMINENTLY DISPLAYED. AN INSERT REGARDING FINANCIAL ASSISTANCE ACCOMPANIES EACH INVOICE OF HOSPITAL SERVICES SENT TO EACH PATIENT. PART VI, LINE 4 COMMUNITY INFORMATION THE HEALTH SYSTEM'S TWO HOSPITALS ARE LOCATED IN THE CITY OF VENTURA AND THE CITY OF OJAI. THE HEALTH SYSTEM PROVIDES SERVICES THROUGH ITS HOSPITALS AND CENTERS FOR FAMILY HEALTH TO ALL WESTERN VENTURA COUNTY, WHICH INCLUDES THE CITIES AND UNINCORPORATED AREAS SURROUNDING VENTURA, OJAI, SANTA PAULA, FILLMORE, OXNARD, PORT HUENEME AND CAMARILLO. THE POPULATION OF VENTURA COUNTY IS APPROXIMATELY 851,000 AND MADE OF UP 45% WHITE, 43% HISPANIC AND 12% OTHER RESIDENTS. THE POPULATION IS MADE UP OF 50.5% FEMALES AND 49.5% MALE WITH 15.6% OF THE POPULATION OVER THE AGE OF 65. THE POVERTY RATE FOR THE COUNTY IS 9.5% AND 9.3% OF THE POPULATION UNDER 65 IS UNINSURED. THE COUNTY OF VENTURA PROVIDES COMMUNITY DATA THROUGH ITS WEBSITE "HEALTH MATTERS IN VCCAN BE ACCESSED AT HTTP://WWW.HEALTHMATTERSINVC.ORG/ FOR FURTHER INFORMATION. IT HAS LONG BEEN ESTABLISHED THAT THERE ARE SIGNIFICANT VARIANCES IN PHYSICAL AND BEHAVIORAL HEALTH CONCERNS BETWEEN GROUPS BASED ON ETHNICITY, INCOME AND RESIDENCE. AS A RESULT, CMHS CAREFULLY CONSIDERS MEANINGFUL DEMOGRAPHIC VARIABLES SUCH AS AGE, RACE AND ETHNICITY WHEN PLANNING FOR BOTH INPATIENT AND OUTPATIENT CARE TO ENSURE THAT THE PATIENT CARE SERVICES IT PROVIDES ARE SENSITIVE AND RELEVANT TO THE PROGRAM PLANNING NEEDS OF THE COMMUNITIES IT SERVES. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CMHS IS GOVERNED BY A DIVERSE BOARD OF DIRECTORS WHOSE MEMBERS ARE REPRESENTATIVE OF THE COMMUNITY, HOSPITAL AND MEDICAL STAFF LEADERSHIP. CONSISTENT WITH THE IRS "COMMUNITY BENEFIT STANDARD", A MAJORITY OF THE BOARD OF DIRECTORS ARE NEITHER EMPLOYEES, CONTRACTORS, NOR FAMILY MEMBERS OF THE ORGANIZATION. CMHS HAS AN OPEN MEDICAL STAFF, EXTENDING STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS FOR ALL AREAS AND DEPARTMENTS OF ITS FACILITY. THE EMERGENCY DEPARTMENTS AT BOTH COMMUNITY MEMORIAL HOSPITAL AND OJAI VALLEY COMMUNITY HOSPITAL TREAT ALL PATIENTS, REGARDLESS OF THEIR SOCIO-ECONOMIC STATUS OR ABILITY TO PAY. THE HEALTH SYSTEM PROVIDES EMERGENCY SERVICES TO ALL PATIENTS, WITH OR WITHOUT INSURANCE, AND CONTRACTS WITH PHYSICIANS TO PROVIDE SPECIALTY EMERGENCY COVERAGE. THIS EMERGENCY TEAM INCLUDES BOARD-CERTIFIED EMERGENCY PHYSICIANS, PHYSICIAN ASSISTANTS; BOARD CERTIFIED NURSES, EMERGENCY MEDICAL TECHNICIANS, RESPIRATORY THERAPISTS AND OTHER HIGHLY TRAINED EMERGENCY CARE PROFESSIONALS. ALL ARE DEDICATED TO PROVIDING TECHNOLOGICALLY ADVANCED AND LIFESAVING MEDICAL SERVICES. CMHS OFFERS FREE, EDUCATIONAL SEMINARS ON A MONTHLY BASIS TO COMMUNITIES ACROSS VENTURA COUNTY. THESE EVENTS COVER A WIDE VARIETY OF HEALTH-RELATED TOPICS SUCH AS DIABETES, CANCER, HEART DISEASE AND VASCULAR HEALTH. CMHS ALSO OFFERS NUMEROUS CLASSES AND SUPPORT GROUPS THROUGH ITS CANCER RESOURCE CENTER, NEW PARENT RESOURCE CENTER, WELLNESS AND FITNESS CENTER, AND HEART AND VASCULAR HEALTH DEPARTMENT. THESE RESOURCES ARE DESIGNED TO PROVIDE A COMMUNITY OF SUPPORT TO THOSE NAVIGATING A SERIOUS ILLNESS, WORKING TO PREVENT OR ADDRESS A CHRONIC DISEASE, OR BUILDING A HEALTHY FUTURE FOR THEIR NEW FAMILY. PART VI, LINE 6 N/A PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA false CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941498697 501(c)(3) 362754 0 CA HOSPITAL FEE PROGRAM VENTURA FAMILY YMCA 3760 TELEGRAPH ROAD VENTURA CA 93003 951643379 501(c)(3) 10000 0 GENERAL SUPPORT VENTURA CHAMBER OF COMMERCE 505 POLI STREET 2ND FLOOR VENTURA CA 93001 951332204 501(c)(6) 7000 0 GENERAL SUPPORT NATIONAL HEALTH FOUNDATION 515 S FIGUEROA ST SUITE 1300 LOS ANGELES CA 90071 237314808 501(c)(3) 105000 0 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 212 W FIGUEROA STREET SANTA BARBARA CA 93101 135613797 501(c)(3) 7500 0 GENERAL SUPPORT 4 1 SCHEDULE I, PART I, LINE 2 DESCRIPTION OF PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE GRANTS MADE BY COMMUNITY MEMORIAL HEALTH SYSTEM (CMHS) ARE ONLY GIVEN TO 501(C)(3), 501(C)(6) AND GOVERNMENT ORGANIZATIONS. ONCE THE GRANT IS GIVEN, IT IS NOT MONITORED BY CMHS AND IS LEFT UP TO THE DISCRETION OF THE GRANTEE. X true false X X X X X false true false false false false false true false CYNTHIA FAHEY CNO 268008 0 75000 0 264280 0 63922 0 533 0 671743 0 250505 0 STANLEY FROCHTZWAJG CMO, INPATIENT 371338 0 0 0 110808 0 65798 0 2851 0 550795 0 72193 0 WILFRED GARAND VP PLANNING & MANAGED CARE 268300 0 60000 0 259817 0 52589 0 0 0 640706 0 255328 0 DAVID GLYER CFO 384649 0 110000 0 115672 0 80463 0 5501 0 696285 0 102577 0 DIANY KLEIN VP HUMAN RESOURCES (thru 8/19) 222681 0 82500 0 181969 0 64279 0 0 0 551429 0 164748 0 HAADY LASHKARI CHIEF ADM OFFICER OJAI/VP CMH 243746 0 75000 0 198476 0 59473 0 11976 0 588671 0 195908 0 EMILIE RAYMAN COMPLIANCE OFFICER 238585 0 50000 0 70042 0 46689 0 2851 0 408167 0 57840 0 RICHARD REISMAN VP AMBULATORY MEDICINE 225001 0 0 0 10483 0 0 0 8353 0 243837 0 0 0 ANTHONY RUSSELL CAO AMBULATORY MEDICINE 409512 0 50000 0 57740 0 60431 0 11326 0 589009 0 54651 0 SAMUEL SMALL CHIEF OF MEDICAL EDUCATION 417077 0 0 0 89583 0 80993 0 2851 0 590504 0 82008 0 ADAM THUNELL VP OPERATIONS 399474 0 150000 0 520103 0 92406 0 6976 0 1168959 0 517006 0 GARY K WILDE PRESIDENT & CEO 731385 0 200000 0 279827 0 392000 0 4351 0 1607563 0 266776 0 KEITH MCWILLIAMS CIO 279017 0 22957 0 2052 0 0 0 7828 0 311854 0 0 0 EUGENE DAY DIRECTOR OF PHARMACY 266239 0 0 0 0 0 0 0 12648 0 278887 0 0 0 CARLOS LIMON JR PHARMACIST 247044 0 0 0 0 0 0 0 18357 0 265401 0 0 0 KARI ANNE OSBORNE VP HUMAN RESOURCES 216694 0 15588 0 1754 0 0 0 6732 0 240768 0 0 0 MARK SCHUETTE DIR CONSTRUCTION PROJECT MGMT 251380 0 0 0 0 0 0 0 5702 0 257082 0 0 0 PILAR PARKER RN III 268324 0 0 0 0 0 0 0 6430 0 274754 0 0 0 SCOTT GOODFRIEND PHYSICIAN ADVISOR 309592 0 0 0 0 0 0 0 18357 0 327949 0 0 0 DEBORAH CARLSON MD BOARD MEMBER 163750 0 0 0 0 0 0 0 0 0 163750 0 0 0 CYNTHIA DEMOTTE VP QUALITY 216240 0 60000 0 505951 0 46336 0 2533 0 831060 0 500979 0 MICHAEL ELLINGSON VP MARKETING & DEVELOPMENT 231271 0 52500 0 51321 0 45468 0 533 0 381093 0 45866 0 RONALD SANDIFER CIO (Thru 6/19) 499535 0 0 0 0 0 0 0 0 0 499535 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 1A CERTAIN EXECUTIVES ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR W-2. FORM 990, SCHEDULE J, PART I, LINE 4B ON APRIL 1, 2002, A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE 2002 SERP) WAS ESTABLISHED TO COVER SENIOR STAFF MEMBERS OF CMHS. FOR THE 2002 SERP, THE MONTHLY BENEFIT AT NORMAL RETIREMENT DATE (AGE 65) IS EQUAL TO THE AVERAGE MONTHLY COMPENSATION FOR THE THREE-YEAR PERIOD DURING WHICH COMPENSATION WAS THE HIGHEST, INCLUDING PERIODS BEFORE APRIL 1, 2002, AT THE FOLLOWING RATES: (I) 4% FOR THE CEO AND 2% FOR OTHER PARTICIPANTS THROUGH APRIL 4, 2004, AND (II) 5% FOR THE CEO, WHICH INCLUDES A CATCH UP PROVISION FOR A SERP BENEFIT FORFEITED FROM A PRIOR EMPLOYER AS A CONDITION OF HIS EMPLOYMENT AT CMH, AND 2% FOR OTHER PARTICIPANTS AFTER APRIL 4, 2004. PARTICIPANTS VEST AFTER TEN YEARS OF SERVICE AND THE ATTAINMENT OF AGE 60, INCLUDING SERVICE PRIOR TO THE EFFECTIVE DATE, OR ATTAINMENT OF AGE 65, WHICHEVER IS EARLIER. TOGETHER, THE 1990 SERP AND THE 2002 SERP ARE REFERRED TO AS SERPS. THE SERPS WERE FUNDED BASED ON AN ANNUAL VALUATION OF THE LIABILITY. THE BOARD OF DIRECTORS HAD DESIGNATED ASSETS TO BE SEGREGATED TO FUND THE SERPS, WHICH WERE INCLUDED IN ASSETS LIMITED TO USE OR DEFERRED COMPENSATION PLANS AS OF DECEMBER 31, 2018. HOWEVER, THE ASSETS WERE NOT HELD IN TRUST OR, OTHERWISE, LEGALLY RESTRICTED TO FUND THE PLANS. THE SERP WAS TERMINATED ON SEPTEMBER 30, 2019, AND DISTRIBUTIONS OF PLAN ASSETS WERE MADE TO PARTICIPANTS. BELOW ARE THE TAXABLE DISTRIBUTIONS TO PLAN PARTICIPANTS AS REPORTED ON SCHEDULE J, PART II: CYNTHIA DEMOTTE - $500,979 MICHAEL ELLINGSON - $45,866 CYNTHIA FAHEY - $250,505 STANLEY FROCHTZWAJG - $72,193 WILFRED GARAND - $255,328 DAVID GLYER - $102,577 DIANY KLEIN - $164,748 HAADY LASHKARI - $195,908 EMILIE RAYMAN - $57,840 ANTHONY RUSSELL - $54,651 SAMUEL SMALL - $82,008 ADAM THUNELL - $517,006 GARY K. WILDE - $266,776 FORM 990, SCHEDULE J, PART I, LINE 7 BONUSES ARE AWARDED TO EXECUTIVES BASED ON THEIR CONTRIBUTION TO THE OVERALL GOALS OF THE SYSTEM, THEIR ACHIEVEMENT OF INDIVIDUAL GOALS AND WITH REGARD TO REASONABLE COMPENSATION PRACTICES FOR COMPARABLE POSITIONS IN LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS THE BONUSES AND MOVES FOR APPROVAL BY THE BOARD OF TRUSTEES. A CITY OF SAN BUENAVENTURA 956000807 797049AJ2 2011-08-17 350000000 REPLACEMENT FACILITIES false false false A 0 0 349865548 31231692 187475791 0 0 0 0 131158066 0 0 2018 false false false true A false false false false 0.05300 0.00000 0.05300 false false false false A false false false true false false 0 false 0 false false A false SCHEDULE K, PART II, LINE 3 ORIGINAL ISSUE DISCOUNT OF $134,452. SCHEDULE K, PART IV, LINE 2C THE REBATE COMPUTATION TO DETERMINE THAT NO REBATE IS DUE WAS COMPLETED ON 8/23/2017. X 1 190000 FMV false true false SCHEDULE M, PART I, COLUMN B THE NUMBER REPORTED IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 1 TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NONPROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS, CLINICS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BED AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS; AND TO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; TO PROMOTE AND CARRY ON EDUCATION ACTIVITIES RELATED TO THE CARE OF SICK, INJURED AND DISABLED, TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY OUT SCIENTIFIC AND MEDICAL RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; AND TO PROMOTE OR CARRY OUT OTHER SUCH ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED. FORM 990, PART III, LINES 4A-4C COMMUNITY BENEFIT PLAN CMHS IS DEDICATED TO ENHANCING THE HEALTH OF THE COMMUNITIES IT SERVES. IT DEMONSTRATES THIS COMMITMENT THROUGH A CONTINUED FOCUS ON THE FOLLOWING FOUR AREAS: COMMUNITY EDUCATION OUTREACH 1. CONTINUING TO PROVIDE FINANCIAL SUPPORT/SPONSORSHIPS AND PARTICIPATE IN HEALTH FAIRS, PUBLIC EXPOS, EVENTS AND OTHER COMMUNITY OUTREACH OPPORTUNITIES TO PROMOTE HEALTH SERVICES, HEALTH EDUCATION, AND PREVENTION RESOURCES THROUGHOUT THE COMMUNITY. HEALTH RELATED EDUCATION AND PREVENTION RESOURCES WILL BE FOCUSED AROUND DIABETES, OBESITY, PRENATAL CARE, HEART HEALTH, AND HEALTHY LIVING AND NUTRITION. 2. PROVIDE COMMUNITY MEMBERS AND EMPLOYEES OF LOCAL BUSINESSES WITH THE HEARTAWARE HEART DISEASE DETECTION AND SCREENING PROGRAM. 3. CONTINUE TO PARTICIPATE IN THE STATE CPSP PROGRAM TO PROVIDE EDUCATIONAL RESOURCES TO LOW INCOME CHILDREN AND PREGNANT WOMEN. 4. PROVIDE COMMUNITY FORUMS IN VENTURA AND OJAI HIGHLIGHTING THE STATUS OF OUR HEALTH SYSTEM (THE HOSPITALS AND THE CENTERS FOR FAMILY HEALTH), THE AVAILABILITY OF NEW SERVICES TO BENEFIT RESIDENTS OF THE COMMUNITY, AND OTHER COMMUNITY BENEFITS AND OUTREACH PROGRAMS PROVIDED BY THE HEALTH SYSTEM. 5. DISTRIBUTE A HEALTH INFORMATION CARD TO INDIVIDUALS IN THE COMMUNITY TO FACILITATE THE TRACKING OF PERSONAL HEALTH INFORMATION, AND EMPHASIZE THE IMPORTANCE OF THIS VITAL INFORMATION WHEN ACCESSING THE HOSPITAL, AND IN PARTICULAR, THE EMERGENCY DEPARTMENT. 6. ADD NEW DISEASE DETECTION AND SCREENING SERVICES WITH AN EMPHASIS ON DIFFERENT CONDITIONS OF IMPORTANCE, INCLUDING BUT NOT LIMITED TO, MAJOR CHRONIC DISEASES. 7. CONTINUE TO PROVIDE AT LEAST 3,000 FREE BLOOD PRESSURE CHECKS PER MONTH, AS WELL AS BLOOD PRESSURE MANAGEMENT EDUCATION AND RESOURCES, AT THE KIOSK IN THE PACIFIC VIEW MALL IN VENTURA. ACCESS TO CARE CMHS IS COMMITTED TO INCREASING ACCESS OF THE UNDERSERVED AND VULNERABLE POPULATIONS TO PRIMARY AND SECONDARY MEDICAL CARE IN VARIOUS GEOGRAPHIC LOCATIONS THROUGHOUT ITS SERVICE AREA. 1. CONTINUE TO OFFER A FREE PHYSICIAN REFERRAL SERVICE FOR MEMBERS OF THE COMMUNITY, PROVIDING AT LEAST 1,000 REFERRALS PER YEAR TO LOCAL PHYSICIANS AND OTHER HEALTH SERVICES. 2. CONTINUE EXPANSION OF EXISTING CENTERS FOR FAMILY HEALTH CLINICS AS INDICATED BY AN INCREASE IN PATIENT VISITS. 3. CONTINUE TO PROVIDE ACCESS THROUGH THE CENTERS FOR FAMILY HEALTH CLINICS TO SIGNIFICANT NUMBERS OF MEDI-CAL PATIENTS AND UNINSURED INDIVIDUALS THROUGHOUT WESTERN VENTURA COUNTY. 4. CONTINUE TO PROVIDE GENERAL MEDICAL, SURGICAL, AND SPECIALTY PROFESSIONAL COVERAGE OF ER PATIENTS THROUGH THE "ER FUND". PROVIDE STIPENDS TO PHYSICIANS, AS NECESSARY, TO INSURE COVERAGE, ESPECIALLY FOR MEDI-CAL AND UNINSURED PATIENTS, BY ALL MEDI-CAL SPECIALTIES. 5. THROUGH THE CENTERS FOR FAMILY HEALTH CLINICS, CONTINUE TO PROVIDE AN EXTENSIVE CHILDHOOD IMMUNIZATION PROGRAM. 6. ENGAGE THE SENIOR AND AGING POPULATION IN DIALOGUE SURROUNDING HEALTH CARE OBJECTIVES AND ASSIST WITH CARE COORDINATION. 7. ENHANCE OUT-OF-AREA TRANSPORTATION SERVICES TO IMPROVE ACCESS TO CARE. 8. CONTINUE TO TRAIN RESIDENT PHYSICIANS THROUGH THE SYSTEM'S GRADUATE MEDICAL EDUCATION PROGRAM WITH AN EMPHASIS ON FAMILY AND INTERNAL MEDICINE. RESIDENTS PHYSICIANS IN THE GME PROGRAM PROVIDE FREE HEALTHCARE SERVICES AND HEALTH EDUCATION OUTREACH IN MEDICALLY UNDERSERVED AREAS OF VENTURA COUNTY. UNCOMPENSATED AND UNDERFUNDED CARE 1. CONTINUE TO PROVIDE ACCESS TO A SIGNIFICANT NUMBER OF MEDI-CAL BENEFICIARIES ACROSS A BROAD RANGE OF MEDICAL SERVICES (MEASURED AS A PERCENTAGE OF GROSS REVENUE AND TOTALING AT LEAST 9%). 2. CONTINUE TO PROVIDE A SIGNIFICANT LEVEL OF SUBSIDIZED CARE THROUGH THE CENTERS FOR FAMILY HEALTH. SPONSORSHIP OF COMMUNITY RESOURCES 1. CONTINUE TO ASSIST THE VENTURA COUNTY DISTRICT ATTORNEY'S OFFICE IN SUPPORTING VICTIMS OF DOMESTIC ABUSE THROUGH THE "PROJECT SAFE HARBOR" PROGRAM. 2. PROVIDE A ROTATION FOR TRAINING OB/GYN, ORTHOPEDIC SURGERY, INTERNAL MEDICINE, AND FAMILY MEDICINE PHYSICIAN RESIDENTS. 3. CONTINUE TO PROVIDE TOURS OF THE HOSPITALS TO THE YOUTH IN THE COMMUNITY. 4. CONTINUE TO PROVIDE DATA TO A NATIONAL TUMOR REGISTRY THAT SUPPORTS A KNOWLEDGE BASE DEDICATED TO ENHANCING THE CARE OF CANCER PATIENTS IN OUR COMMUNITY. 5. CONTINUE TO PROVIDE A CANCER RESOURCE CENTER THAT OFFERS NO-COST SUPPORT GROUPS AND OTHER RESOURCES TO HELP PATIENTS AND THEIR FAMILIES NAVIGATE THEIR CANCER DIAGNOSIS, TREATMENT, AND RECOVERY. FORM 990, PART VI, LINE 11B PROCESS USED TO REVIEW FORM 990 FORM 990 WAS PREPARED BY ERNST & YOUNG AND COMMUNITY MEMORIAL HEALTH SYSTEM (CMHS) FINANCE WITH INPUT FROM THE SYSTEM'S PLANNING AND MANAGED CARE OFFICE. FORM 990 WAS REVIEWED BY THE CEO, CFO, CORPORATE COMPLIANCE OFFICER AND AUDIT COMMITTEE. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING THE FORM 990 WITH THE IRS. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY AND COLLECTED FROM DIRECTORS, OFFICERS AND KEY EMPLOYEES ON AN ANNUAL BASIS. SUCH STATEMENTS ENSURE FULL DISCLOSURE OF FINANCIAL INTERESTS AND TRANSACTIONS WHERE CONFLICT OF INTEREST IS A POSSIBILITY, AND SHALL ENSURE THE AVOIDANCE OF POTENTIAL CONFLICT OF INTEREST IN CHOOSING NEW DIRECTORS, AND OTHER MATTERS INVOLVING OFFICERS, DIRECTORS, AND KEY EMPLOYEES. IT IS THE POLICY OF CMHS THAT REQUIRES DIRECTORS TO DISQUALIFY HIMSELF/HERSELF FROM MAKING A DECISION WHERE HE/SHE HAS A CONFLICT OF INTEREST. FORM 990, PART VI, QUESTIONS 15A AND 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION USED AN INDEPENDENT CONSULTANT TO SURVEY EXECUTIVE COMPENSATION. NATIONWIDE SURVEYS WERE USED TO COMPARE THE COMPENSATION OF THE HEALTH SYSTEM'S EXECUTIVE STAFF TO THE 50TH PERCENTILE OF THOSE SURVEYED AND BY ORGANIZATIONAL SIZE AND SCOPE. THE BOARD COMPENSATION COMMITTEE IS RESPONSIBLE FOR ENGAGING THE INDEPENDENT COMPENSATION CONSULTANT AND FOR DETERMINING THE COMPENSATION OF THE CEO. THE COMPENSATION FOR ALL OTHER EXECUTIVES IS DETERMINED BY THE CEO AND SUBJECT TO THE APPROVAL BY THE BOARD COMPENSATION COMMITTEE. THE RECOMMENDATION OF THE BOARD COMPENSATION COMMITTEE IS THEN APPROVED BY THE BOARD OF DIRECTORS. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. THE PROCESS WAS LAST COMPLETED IN MAY 2019. FORM 990, PART VI, QUESTIONS 16A AND 16B JOINT VENTURES CMHS HAS MAINTAINED A LONG-STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS. FORM 990, PART VI, QUESTION 19 PUBLIC DISCLOSURE OF CERTAIN DOCUMENTS THE AUDITED FINANCIAL STATEMENTS, FORM 990 TAX RETURNS, GOVERNING AND ORGANIZATIONAL DOCUMENTS, AND CONFLICT OF INTEREST POLICY IS AVAILABLE THROUGH THE ADMINISTRATIVE OFFICES AND IS PROVIDED UPON REQUEST. FORM 990, PART VIII, LINE 1F ALL OTHER CONTRIBUTIONS, GIFTS, GRANTS, AND SIMILAR AMOUNTS THE AMOUNT SHOWN ON LINE 1F IS LESS THAN THE TOTAL AMOUNT OF CONTRIBUTIONS SHOWN ON SCHEDULE B. THIS DISCREPANCY RESULTS FROM ADJUSTMENTS MADE TO THE LINE 1F CONTRIBUTION REVENUE REMOVING AMOUNTS RECEIVED DURING THE YEAR FOR PRIOR YEAR PLEDGES. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OTHER COMPONENTS OF NET PERIODIC POST-RETIREMENT COST $ 1,779,630 CHANGE IN PENSION LIABILITY $ 1,353,625 ACAOV CONTRIBUTED CAPITAL $ 521,334 CHANGE IN PLEDGE RECEIVABLE RESERVE $ 15,891 LEASE ADJUSTMENT $( 49,711) -------------- TOTAL $ 3,620,769 ACCOUNTABLE CARE ALLIANCE OF VENTURA LLC 147 N BRENT STREET VENTURA CA 93003 462843182 MGMT SVCS CA 0 25 CMHS COMMUNITY MEMORIAL PHYSICIANS SERVICES 147 N BRENT STREET VENTURA CA 93003 463142917 MGMT SVCS CA 0 0 CMHS VENTURA ORTHOPEDIC CO-MANAGEMENT COMPANY 147 N BRENT STREET VENTURA CA 93003 453483342 MGMT SVCS CA 0 0 CMHS COMMUNITY MEMORIAL HEALTHCARE FOUNDATION 147 N BRENT STREET VENTURA CA 93003 953847251 FUNDRAISING CA 501(c)(3) 7 CMHS true GROSSMAN IMAGING CENTER OF CMH LLC 2001 N SOLAR DRIVE SUITE 135 OXNARD CA 93030 371512002 IMAGING CENTER CA NA Related -102391 -801970 false 0 false 0.51000 VENTURA CARDIOVASCULAR CO-MGMT 147 N BRENT STREET VENTURA CA 93003 273227049 MANAGEMENT SVCS CA NA Related 213400 3299 false 0 true 0.50000 BUENAVISTA MEDICAL PROPERTIES 168 N BRENT STREET VENTURA CA 93003 770275364 RENTAL CA NA Related BUENAVISTA MEDICAL PROPERTIES INC 147 N BRENT STREET VENTURA CA 93003 770298516 REAL ESTATE CA NA C Corp 267824 518548 1.00000 true CALIFORNIA HEART INSTITUTE 147 N BRENT STREET VENTURA CA 93003 770276145 BILLING SERVICES CA NA C Corp 339145 232706 1.00000 true true false true true false false false false false true false false true true true false true false true GROSSMAN IMAGING CENTER a 96226 ACCRUAL METHOD GROSSMAN IMAGING CENTER d 2878122 ACCRUAL METHOD GROSSMAN IMAGING CENTER j 168432 ACCRUAL METHOD COMMUNITY MEMORIAL HEALTHCARE FDN c 111798 ACCRUAL METHOD COMMUNITY MEMORIAL HEALTHCARE FDN q 237587 ACCRUAL METHOD FORM 990, SCHEDULE R, PART III INFORMATION FOR RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIPS ORGANIZATION NAME: GROSSMAN IMAGING CENTER OF CMH, LLC ORGANIZATION EIN: 37-1512002 U.S. ADDRESS: 2001 N. SOLAR DR., SUITE 135, OXNARD, CA 93030 ORGANIZATION NAME: VENTURA CARDIOVASCULAR CO-MANAGEMENT CO. LLC ORGANIZATION EIN: 27-3227049 U.S. ADDRESS: 147 NORTH BRENT STREET, VENTURA, CA 93003 ORGANIZATION NAME: BUENAVISTA MEDICAL PROPERTIES, LTD. ORGANIZATION EIN: 77-2753640 U.S. ADDRESS: 168 NORTH BRENT STREET, VENTURA, CA 93003