BEVERLY COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- BEVERLY COMMUNITY HOSPITAL ASSOCIATION (EIN 95-1816005)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201643209349313564
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T15:57:21-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Second Street Suite 900 | AddressLine1Txt |
| City | San Francisco | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951816005 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Beverly Community Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BEVE | BusinessNameControlTxt |
| Phone | 3237255095 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 West Beverly Boulevard | AddressLine1Txt |
| City | Montebello | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 906404308 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Larry Pugh | PersonNm |
| Person Title | VP FINANCE/CFO | PersonTitleTxt |
| Phone | 3237255095 | PhoneNum |
| Signature | 2016-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Renie Burbank | PreparerPersonNm |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALICE CHENG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 West Beverly Boulevard | AddressLine1Txt |
| City | Montebello | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 906404308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $182,374,641 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.beverly.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO BE A LEADING, INDEPENDENT NON-PROFIT COMMUNITY HOSPITAL IMPROVING THE QUALITY OF LIFE OF ITS CONSTITUENTS THROUGH HEALTH EDUCATION, DISEASE PREVENTION AND STATE OF THE ART ILLNESS AND INJURY TREATMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1056 | TotalEmployeeCnt |
| Total Volunteers | 164 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,168,913 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,802,201 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $170,601,263 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $176,979,426 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,167 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,755 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,874,110 | PYOtherRevenueAmt |
| CY Other Revenue | $1,584,175 | CYOtherRevenueAmt |
| PY Total Revenue | $175,650,453 | PYTotalRevenueAmt |
| CY Total Revenue | $182,374,557 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $60,824,322 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $61,162,951 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $109,641,622 | PYOtherExpensesAmt |
| CY Other Expenses | $109,199,516 | CYOtherExpensesAmt |
| PY Total Expenses | $170,465,944 | PYTotalExpensesAmt |
| CY Total Expenses | $170,362,467 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,184,509 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,012,090 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $116,088,063 | TotalAssetsBOYAmt |
| Total Assets EOY | $151,753,289 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $68,121,156 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $91,775,387 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $47,966,907 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $59,977,902 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO BE A LEADING, INDEPENDENT NON-PROFIT COMMUNITY HOSPITAL IMPROVING THE QUALITY OF LIFE OF ITS CONSTITUENTS THROUGH HEALTH EDUCATION, DISEASE PREVENTION AND STATE OF THE ART ILLNESS AND INJURY TREATMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $79,415,591 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $117,960,234 | RevenueAmt |
| Desc | INPATIENT AND OUTPATIENT HOSPITAL SERVICES - HOSPITAL SERVICES PROVIDED BY BEVERLY COMMUNITY HOSPITAL ASSOCIATION INCLUDED 8,840 INPATIENT ADMISSONS, 20,390 OUTPATIENT VISITS AND 37,502 EMERGENCY ROOM VISITS IN 2015. CARE IS PROVIDED WITHOUT CHARGE TO PATIENTS WHO MEET SPECIFIED CRITERIA UNDER THE CHARITY CARE POLICY. THE COST OF CHARITY CARE PROVIDED TOTALED $1,637,000 IN 2015. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $47,032,071 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $60,545,164 | RevenueAmt |
| Desc | CAPITATION SERVICES - BEVERLY COMMUNITY HOSPITAL ASSOCIATION CONTRACTS WITH THE BLUE CROSS OF CALIFORNIA AND HEALTH NET OF CALIFORNIA TO PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AT FULL RISK TO ENROLLED MEDI-CAL BENEFICIARIES WHO ARE CONCURRENTLY ENROLLED WITH A LOCAL MEDICAL GROUP. ENROLLMENT DURING 2015 WAS 1,122,668 MEMBER MONTHS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $126,447,662 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 677 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1056 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Larry Pugh | PersonNm |
| Phone | 3237255095 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 West Beverly Boulevard | AddressLine1Txt |
| City | Montebello | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|---|---|
| Carlos Manuel Haro PhD | |||||||||
| Chairman | 2.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Denton Guthrie CPA | |||||||||
| First Vice Chairman | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Lyla Eddington EdD | |||||||||
| Second Vice Chairman | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Gautam Ganguly MD | |||||||||
| Treasurer | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Rosemary Orozco | |||||||||
| Secretary | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| K Lawrence Cohen MD | |||||||||
| Member | 2.00 | 2.00 | Yes (X) | $30,259 | $0 | $0 | |||
| Aziz Khan MD | |||||||||
| Member | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Renee D Martinez | |||||||||
| Member | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Krishna Narayanan MD | |||||||||
| Member | 2.00 | 3.00 | Yes (X) | $51,500 | $0 | $0 | |||
| Alma Perez SPHR | |||||||||
| Member | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Kathy Schlotz | |||||||||
| Member | 2.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| Alice Shu Jen Cheng | |||||||||
| President & CEO | 40.00 | 4.00 | Yes (X) | $352,403 | $0 | $14,181 | |||
| Charles Larry Pugh | |||||||||
| VP of Finance & CFO | 40.00 | 3.00 | Yes (X) | $272,733 | $0 | $5,584 | |||
| Wendy R Beesley | |||||||||
| Senior VP & COO | 40.00 | $248,528 | $0 | $12,354 | Yes (X) | ||||
| Kathryn W Ross | |||||||||
| VP of Nursing | 40.00 | $214,494 | $0 | $4,421 | Yes (X) | ||||
| John G Barnes | |||||||||
| Administrative Director, H.R. | 40.00 | $191,639 | $0 | $9,578 | Yes (X) | ||||
| Joel Velo Lazaro | |||||||||
| Registered Nurse | 36.00 | $180,890 | $0 | $13,046 | Yes (X) | ||||
| Christina Pickering | |||||||||
| Administrative Dir., Quality Risk | 40.00 | $175,868 | $0 | $700 | Yes (X) | ||||
| Clyde Harwood | |||||||||
| VP, Comm/Gov. Relations (Thru 9/15) | 40.00 | $166,904 | $0 | $4,914 | Yes (X) | ||||
| Ismael Obordo | |||||||||
| registered Nurse | 36.00 | $165,203 | $0 | $4,213 | Yes (X) | ||||
| Jose Ignacio Morales | |||||||||
| Epidemiologist (Thru 11/15) | 40.00 | $155,637 | $0 | $13,484 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,206,058 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $82,475 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 109 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Sodexo & Affiliates | |||||
| DEPT 880328 | Los Angeles | CA | 90088 | Food & Housekeeping mngmt. | $3,314,828 |
| The Fulcrum Group | |||||
| 14269 Fern Avenue | Chino | CA | 91710 | REIMBURSE. CNSLTING. | $803,237 |
| CURA Consulting Solutions Inc | |||||
| 1036 Garrity Way | Santa Clara | CA | 95054 | information technology mngmt. | $788,459 |
| Lifeline Dialysis | |||||
| 101 W Beverly Blvd Ste 304 | Montebello | CA | 90640 | Dialysis Services | $699,840 |
| Shiftwise | |||||
| PO Box 70870 | St Paul | MN | 55170 | Temporary Help Svcs. | $581,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 104 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,802,201 | RelatedOrganizationsAmt |
| Total Contributions | $3,802,201 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Services | 621990 | $116,434,260 | $116,434,260 |
| Capitation Services | 621990 | $60,545,166 | $60,545,166 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $176,979,426 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,755 | TotalRevenueColumnAmt |
| Exclusion | $8,755 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,913 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,913 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,913 | TotalRevenueColumnAmt |
| Exclusion | $57,913 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $84 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $84 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EHR PAYMENTS | 900099 | $773,013 | $773,013 |
| Rebates & Refunds | 900099 | $479,272 | $479,272 |
| Beneficial interest in Foundation | 900099 | $273,687 | $273,687 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $290 | TotalRevenueColumnAmt |
| Exclusion | $290 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,526,262 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $182,374,557 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $178,505,398 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $66,958 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,407,675 | TotalAmt |
| Management And General | $1,407,675 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,373,345 | TotalAmt |
| Program Services | $36,096,216 | ProgramServicesAmt |
| Management And General | $9,277,129 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,599,959 | TotalAmt |
| Program Services | $3,508,946 | ProgramServicesAmt |
| Management And General | $7,091,013 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,781,972 | TotalAmt |
| Program Services | $2,909,583 | ProgramServicesAmt |
| Management And General | $872,389 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $648,729 | TotalAmt |
| Management And General | $648,729 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53 | TotalAmt |
| Management And General | $53 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,401,706 | TotalAmt |
| Program Services | $5,139,990 | ProgramServicesAmt |
| Management And General | $3,261,716 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,743,243 | TotalAmt |
| Program Services | $2,134,162 | ProgramServicesAmt |
| Management And General | $609,081 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $747,333 | TotalAmt |
| Management And General | $747,333 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,125,694 | TotalAmt |
| Program Services | $319,706 | ProgramServicesAmt |
| Management And General | $1,805,988 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,452 | TotalAmt |
| Program Services | $1,216 | ProgramServicesAmt |
| Management And General | $3,236 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $651,102 | TotalAmt |
| Management And General | $651,102 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,566 | TotalAmt |
| Management And General | $291,566 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,172,081 | TotalAmt |
| Program Services | $775,858 | ProgramServicesAmt |
| Management And General | $3,396,223 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,730,262 | TotalAmt |
| Management And General | $1,730,262 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| capitated medical Svcs | $46,775,696 | $43,163,730 | $3,611,966 |
| medical supplies | $15,214,019 | $14,758,002 | $456,017 |
| Hospital Fee | $12,839,190 | $12,839,190 | |
| OTHER PURCHASED SVCS | $8,851,745 | $2,958,613 | $5,893,132 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,002,645 | TotalAmt |
| Program Services | $1,842,450 | ProgramServicesAmt |
| Management And General | $2,160,195 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,362,467 | TotalAmt |
| Program Services | $126,447,662 | ProgramServicesAmt |
| Management And General | $43,914,805 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,491,787 | BOYAmt |
| EOY | $30,927,510 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,580,107 | BOYAmt |
| EOY | $7,442,513 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,837 | BOYAmt |
| EOY | $13,011 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,854,724 | BOYAmt |
| EOY | $16,759,673 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,754 | BOYAmt |
| EOY | $88,956 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,746,413 | BOYAmt |
| EOY | $2,942,632 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,285,110 | BOYAmt |
| EOY | $2,130,554 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $143,698,909 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $79,477,999 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,953,341 | BOYAmt |
| EOY | $64,220,910 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,911 | BOYAmt |
| EOY | $96,692 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,657,079 | BOYAmt |
| EOY | $27,130,838 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,088,063 | BOYAmt |
| EOY | $151,753,289 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,744,970 | BOYAmt |
| EOY | $42,401,947 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $40,691,424 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,549,528 | BOYAmt |
| EOY | $1,946,015 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,826,658 | BOYAmt |
| EOY | $6,736,001 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,121,156 | BOYAmt |
| EOY | $91,775,387 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,966,907 | BOYAmt |
| EOY | $59,938,594 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $39,308 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,966,907 | BOYAmt |
| EOY | $59,977,902 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,088,063 | BOYAmt |
| EOY | $151,753,289 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $12,012,090 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,095 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | 0 | FederalGrantAuditRequiredInd |
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 | $133,140 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $133,140 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | BEVERLY COMMUNITY HOSPITAL ASSOCIATION SUPPORTS CERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN THE COMMUNITY. EXPENDITURES INCURRED TO SUPPORT THESE INITIATIVES MAY BE CONSIDERED TO BE LOBBYING EXPENDITURES. AN INDIRECT EXPENDITURE OF THE HOSPITAL'S MEMBERSHIP DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) WERE USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,398,730 | OtherCostOrOtherBasisAmt |
| Book Value | $1,398,730 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $94,801,177 | OtherCostOrOtherBasisAmt |
| Depreciation | $59,992,244 | DepreciationAmt |
| Book Value | $34,808,933 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,391,518 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,308,198 | DepreciationAmt |
| Book Value | $4,083,320 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,107,484 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,177,557 | DepreciationAmt |
| Book Value | $23,929,927 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $64,220,910 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (8 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due From Affiliate | $932,261 |
| Investment - CHIC | $298,011 |
| Third Party Payor receivable | $7,130,457 |
| UNAMORTIZED LOAN COST | $2,859 |
| malpractice insurance receivable | $925,000 |
| workers' comp insurance receivable | $1,911,000 |
| Assets Limited as to use | $14,182,795 |
| Beneficial interest in Affiliate | $1,748,455 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $27,130,838 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Accrued Self-Insured Liabilities | Desc |
| Amt | $6,736,001 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,736,001 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $182,334,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,095 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$101 | OtherRevenueAmt |
| Revenue Not Reported | -$1,196 | RevenueNotReportedAmt |
| Revenue Subtotal | $182,335,196 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $53 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $39,308 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $39,361 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $182,374,557 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $170,362,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$414 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$414 | ExpensesNotReportedAmt |
| Expenses Subtotal | $170,362,414 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $53 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $53 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $170,362,467 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Corporation recognizes the tax benefit from uncertain tax positions only if it is more likely than not that the tax positions will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. |
| Part XI, Line 2d - Other Adjustments: | Audited Financial Statement Rounding -101. |
| Part XI, Line 4b - Other Adjustments: | Contribution Reclassified from Temporarily Restricted Net Assets 39,308. |
| Part XII, Line 2d - Other Adjustments: | Audited Financial Statement Rounding -414. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 350.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 450.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,483,143 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,483,143 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $73,520,528 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,809,392 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,711,136 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,003,671 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,809,392 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,194,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15960 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 35 | ActivitiesOrProgramsCnt |
| Persons Served | 56052 | PersonsServedCnt |
| Total Community Benefit Expns | $3,194,455 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,194,455 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01880 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 35 | ActivitiesOrProgramsCnt |
| Persons Served | 56052 | PersonsServedCnt |
| Total Community Benefit Expns | $3,194,455 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,194,455 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01880 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 35 | ActivitiesOrProgramsCnt |
| Persons Served | 56052 | PersonsServedCnt |
| Total Community Benefit Expns | $78,198,126 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,809,392 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $30,388,734 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17840 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 34 | ActivitiesOrProgramsCnt |
| Persons Served | 18523 | PersonsServedCnt |
| Total Community Benefit Expns | $1,063,866 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,063,866 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 34 | ActivitiesOrProgramsCnt |
| Persons Served | 18523 | PersonsServedCnt |
| Total Community Benefit Expns | $1,063,866 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,063,866 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,808,935 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $32,870,005 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,894,212 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $19,975,793 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 West Beverly Boulevard | AddressLine1Txt |
| City | Montebello | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BEVERLY.ORG | WebsiteAddressTxt |
| State License | OSHPD FACILITY NUMBER XXX-XX-XXXX | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.beverly.org | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BEVERLY.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 350.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 450.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BEVERLY HOSPITAL | Part V, Section B, Line 5: THE 2013 COMMUNITY NEEDS ASSESSMENT WAS DEVELOPED THROUGH A COMBINED QUANTITATIVE AND QUALITATIVE INFORMATION BASED ON REVIEW AND ANALYSIS OF DEMOGRAPHIC TRENDS, ECONOMIC TRENDS, HEALTH CONDITIONS, FAMILY AND COMMUNITY ISSUES, EDUCATION AND YOUTH DEVELOPMENT ISSUES, SENIOR SERVICES ISSUES AND COMMUNITY INPUT. THE HOSPITAL HELD FOCUS GROUP SESSIONS AND A SURVEY WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY-SERVING ORGANIZATIONS TO IDENTIFY KEY THEMES. |
| BEVERLY HOSPITAL | Part V, Section B, Line 11: TO ACCOMPLISH THESE OBJECTIVES, AN OUTREACH TEAM, COMPRISED OF A MANAGER OF COMMUNITY RELATIONS, AN EVENTS COORDINATOR, OUTREACH NURSE, SEVERAL HEALTH EDUCATORS, AND A PHYSICIAN PANEL AS WELL AS THE NECESSARY SUPPORT STAFF (SUCH AS SOCIAL WORKERS, RESPIRATORY CARE, NURSING SERVICES, AND INFORMATION TECHNOLOGY), WORK COLLABORATIVELY TO DEVELOP, IMPLEMENT AND/OR PARTICIPATE IN A VARIETY OF COMMUNITY ACTIVITIES. THE OUTREACH STAFF IS MULTILINGUAL TO BETTER SERVE THE NEEDS OF THE COMMUNITY. ON AN ANNUAL BASIS, BEVERLY HOSPITAL MONITORS AND REPORTS MEASURES OF PLAN PROGRESS. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | BEVERLY HOSPITAL USES COST TO CHARGE RATIO TO DETERMINE THE COSTING METHOD. |
| Part II, Community Building Activities: | THE COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY THROUGH VARIOUS PROGRAMS INCLUDING IMMUNIZATIONS, FITNESS, HEALTH SCREENINGS, TOURS, CLASSES AND LECTURES. |
| Part III, Line 4: | The Hospital carries its accounts receivable at billed amounts less uncollectible amounts. The Hospital does not accrue interest on its receivables. On a periodic basis, the Hospital evaluates its accounts receivable and establishes allowances based on contractual arrangements, history of past write offs, collections, and current credit conditions. The Hospital's policy for writing off receivables as uncollectible varies based on the payor arrangements and management's estimate of the customer's ability to pay. |
| Part III, Line 8: | MEDICARE: COST TO CHARGE RATIO IS USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE. |
| Part III, Line 9b: | ALL ACCOUNTS THAT HAVE BEEN DETERMINED NOT TO HAVE INSURANCE COVERAGE NOR QUALIFY FOR CHARITY AND REFUSE TO MAKE ARRANGEMENTS FOR SOME TYPE OF PERIODIC SCHEDULE PAYMENTS, THEY ARE REVIEWED DAILY THROUGH REMINDER QUEUE AND DAILY CONVERSATIONS WITH PATIENTS. IT IS EVENTUALLY DETERMINED WHICH ACCOUNTS THAT ARE NOT WILLING TO PAY BASED ON PRIOR CONVERSATIONS AND DUNNING HISTORY. THOSE ACCOUNTS ARE THEN TRANSFERRED TO A COLLECTION AGENCY. |
| Part VI, Line 2: | NEEDS ASSESSMENT: THE 2013 COMMUNITY NEEDS ASSESSMENT WAS DEVELOPED THROUGH A COMBINED QUANTITATIVE AND QUALITATIVE INFORMATION BASED ON REVIEW AND ANALYSIS OF DEMOGRAPHIC TRENDS, ECONOMIC TRENDS, HEALTH CONDITIONS, FAMILY AND COMMUNITY ISSUES, EDUCATION AND YOUTH DEVELOPMENT ISSUES, SENIOR SERVICES ISSUES AND COMMUNITY INPUT. THE HOSPITAL HELD FOCUS GROUP SESSIONS AND A SURVEY WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY-SERVING ORGANIZATIONS TO IDENTIFY KEY THEMES. |
| Part VI, Line 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PUBLIC NOTICES ARE POSTED OF THE FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE IN THE HIGH VOLUME INPATIENT, OUTPATIENT AND EMERGENCY SERVICE AREAS OF THE HOSPITAL. NOTICES ARE ALSO POSTED IN THE PATIENT FINANCIAL AND COLLECTION DEPARTMENTS. THESE NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT MAY OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR SUCH ASSISTANCE. |
| Part VI, Line 4: | COMMUNITY INFORMATION: ACCORDING TO THE U.S. CENSUS BUREAU 2010-2014 AMERICAN COMMUNITY SURVEY POPULATION ESTIMATES, THE BEVERLY HOSPITAL SERVICE AREA INCLUDED AN ESTIMATED POPULATION OF 710,992. IN THE SERVICE AREA, 26% OF RESIDENTS ARE CHILDREN AND TEENS, 63% ARE ADULTS BETWEEN 18-64, AND 11% ARE AGE 65 YEARS AND OLDER. THE MEDIAN AGE IN THE SERVICE AREA IS 34.1, LOWER THAN THE MEDIAN AGE IN THE COUNTY OF 35.3 HISPANICS ARE THE LARGEST RACE/ETHNIC GROUP IN THE SERVICE AREA (77% OF THE POPULATION), FOLLOWED BY ASIANS OR PACIFIC ISLANDERS (17%), WHITE NON-HISPANICS (5%) AND OTHERS (1%). AS A RESULT OF THE AREA'S IMMIGRATION AND ETHNIC PATTERNS, MANY RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME LIKE SPANISH (65%) AND ASIAN LANGUAGES (15%), BEING 19% WHO SPEAK ONLY ENGLISH AT HOME AND 1% ANOTHER LANGUAGE. ON THE EDUCATION LEVEL, 25% OF THE ADULTS AGE 25 YEARS AND OLDER HAS LESS THAN A HIGH SCHOOL DIPLOMA, 25% ARE HIGH SCHOOL GRADUATES, 22% HAVE SOME COLLEGE BUT NO DEGREE, AND 13% HAVE A PROFESSIONAL DEGREE. BEVERLY HOSPITAL SERVICE AREA HAS THE HIGHEST PERCENTAGE OF FAMILY HOUSEHOLDS, MORE THAN 80% OF ALL HOUSEHOLDS ARE FAMILIES COMPARED TO THE LOS ANGELES COUNTY OF 67%. NOT ONLY ARE RATES OF FAMILIES WITH CHILDREN (51%), BUT ALSO FAMILIES WITH NO CHILDREN (31%). IN TERMS OF INCOME, 55% OF HOUSEHOLDS ARE BELOW THE COUNTY MEDIAN INCOME. |
| Part VI, Line 5: | PROMOTION OF COMMUNITY HEALTH: BEVERLY HOSPITAL COMMUNITY BENEFITS ACTIVITIES INCLUDED: CHARITY CARE FOR PATIENTS WITHOUT THE ABILITY TO PAY FOR NECESSARY HOSPITAL TREATMENT, ABSORBING THE UNPAID COSTS OF CARE FOR PATIENTS WITH MEDI-CAL, ASSISTANCE WITH PATIENT TRANSPORTATION, ASSISTANCE PREPARING MEDI-CAL APPLICATIONS, SERVING AS CLINICAL ROTATION SITES FOR RN AND LVN STUDENTS AND EMERGENCY MEDICAL AND RESPIRATORY TECHNICIANS ATTENDING LOCAL COLLEGES; SUPPORTING LOCAL PROGRAMS LIKE KIDSFIT TO HELP OVERWEIGHT CHILDREN DEVELOP GOOD EATING AND EXERCISE HABITS AND PREGNANT MINORS PROGRAMS TO PREVENT TEEN PREGNANCY, OFFERING CHILDHOOD IMMUNIZATIONS, CPR CLASSES AND TUBERCULOSIS TESTING, WORKING IN CONJUNCTION WITH OTHER HEALTH CARE PROVIDERS TO PROVIDE HEALTH LECTURES AND SCREENINGS AT CONVENIENT COMMUNITY LOCATIONS, PROVIDING FINANCIAL SUPPORT TO A VARIETY OF LOCAL NON-PROFIT ORGANIZATIONS, PARTICIPATING IN COMMUNITY HEALTH FAIRS, OFFERING SPECIALIZED EDUCATION PROGRAMS FOR THE MANAGEMENT OF DIABETES AND PREPARED CHILDBIRTH, BREASTFEEDING AND INFANT CARE; OFFERING DEDICATED PROGRAMS FOR SENIORS SUCH AS SOCIAL ACTIVITIES, EXERCISE CLASSES, FLU IMMUNIZATIONS, SUPPORT GROUPS, AND AN ANNUAL HEALTH FAIR. |
| Part VI, Line 7, Reports Filed With States | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alice Shu Jen Cheng | ||||||||||||||
| President & CEO | $352,403 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,181 | $0 | $366,584 | $0 | $0 | $0 |
| Charles Larry Pugh | ||||||||||||||
| VP of Finance & CFO | $272,733 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,584 | $0 | $278,317 | $0 | $0 | $0 |
| Wendy R Beesley | ||||||||||||||
| Senior VP & COO | $248,528 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,354 | $0 | $260,882 | $0 | $0 | $0 |
| Kathryn W Ross | ||||||||||||||
| VP of Nursing | $214,494 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,421 | $0 | $218,915 | $0 | $0 | $0 |
| John G Barnes | ||||||||||||||
| Administrative Director, H.R. | $191,639 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,578 | $0 | $201,217 | $0 | $0 | $0 |
| Joel Velo Lazaro | ||||||||||||||
| Registered Nurse | $180,890 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,046 | $0 | $193,936 | $0 | $0 | $0 |
| Christina Pickering | ||||||||||||||
| Administrative Dir., Quality Risk | $175,868 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $700 | $0 | $176,568 | $0 | $0 | $0 |
| Clyde Harwood | ||||||||||||||
| VP, Comm/Gov. Relations (Thru 9/15) | $88,911 | $0 | $0 | $0 | $77,993 | $0 | $0 | $0 | $4,914 | $0 | $171,818 | $0 | $0 | $0 |
| Ismael Obordo | ||||||||||||||
| registered Nurse | $165,203 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,213 | $0 | $169,416 | $0 | $0 | $0 |
| Jose Ignacio Morales | ||||||||||||||
| Epidemiologist (Thru 11/15) | $155,637 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,484 | $0 | $169,121 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 4a | FormAndLineReferenceDesc |
| Explanation | CLYDE HARWOOD RECEIVED A PAYMENT OF $77,993 AND THE AMOUNT WAS INCLUDED IN HIS FORM W-2. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | California Statewide Communities Development Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 680164610 | BondIssuerEIN |
| CUSIP | 13080SLL6 | CUSIPNum |
| Bond Issued | 2015-12-02 | BondIssuedDt |
| Issue Price | $41,768,337 | IssuePriceAmt |
| Purpose | ACQUISITION, IMPROVEMENT, RENOVATION, AND EQUIPPING OF HOSPITAL | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | Yes (1) | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $41,768,337 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $768,337 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $830,549 | CapitalExpendituresAmt |
| Other Spent Proceeds | $29,097,626 | OtherSpentProceedsAmt |
| Unspent | $11,071,852 | UnspentAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | A PUBLIC ACCOUNTING FIRM PREPARED THE FORM 990. IT IS REVIEWED BY THE CFO AND CEO. THE COMPLETED FORM 990 IS REVIEWED IN ITS ENTIRETY BY ALL MEMBERS OF THE GOVERNING BOARD BEFORE IT IS FILED with the Internal Revenue Service. |
| Form 990, Part VI, Section B, line 12c | ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE A QUESTIONNAIRE ANNUALLY. QUESTIONNAIRES SUBMITTED BY OFFICERS (OTHER THAN THE PRESIDENT/CEO) AND KEY EMPLOYEES ARE REVIEWED BY THE PRESIDENT/CEO. QUESTIONNAIRES SUBMITTED BY THE PRESIDENT/CEO AND DIRECTORS ARE REVIEWED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. ALL DISCLOSED CONFLICTS ARE REPORTED TO THE BOARD OF DIRECTORS. IF A CONFLICT IS IDENTIFIED, THE CONFLICTED INDIVIDUAL WILL NOT PARTICIPATE IN DELIBERATIONS AND DECISIONS IMPACTING THE CONFLICTED MATTER. |
| Form 990, Part VI, Section B, line 15 | CURRENT COMPARATIVE COMPENSATION INFORMATION IS OBTAINED FROM AN INDEPENDENT FIRM, MOST RECENTLY IN 2015. THE PRESIDENT & CEO EVALUATION COMMITTEE OF THE BOARD OF DIRECTORS USE THIS INFORMATION AND ITS EVALUATION OF PERFORMANCE TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. DOCUMENTATION OF THIS PROCESS IS RETAINED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE PRESIDENT AND CEO EVALUATION COMMITTEE SETS THE TARGET LEVEL OF ANNUAL COMPENSATION FOR OFFICERS AND KEY EMPLOYEES NOT TO EXCEED THE 50TH PERCENTILE OF THE MARKET ANALYSIS PERFORMED BY THE INDEPENDENT COMPENSATION CONSULTANTS. THE PRESIDENT/CEO USES THE SAME PROCESS TO DETERMINE THE ANNUAL COMPENSATION ADJUSTMENTS OF OTHER OFFICERS AS WELL AS KEY EMPLOYEES. THE PRESIDENT/CEO DISCUSS THESE PROPOSED ANNUAL COMPENSATION ADJUSTMENTS WITH THE PRESIDENT AND CEO EVALUATION COMMITTEE OF THE BOARD OF DIRECTORS. DOCUMENTATION OF THIS PROCESS IS RETAINED BY THE PRESIDENT/CEO. |
| Form 990, Part VI, Section C, line 19 | REQUESTS TO VIEW THE CONFLICT OF INTEREST POLICY ARE MADE TO ADMINISTRATION. THE HOSPITAL DOES NOT MAKE EITHER THE GOVERNING/ORGANIZING DOCUMENTS OR AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VII, section A, column B | K. LAWRENCE COHEN, MD AND KRISHNA NARAYANAN, MD ARE MEMBERS OF THE BOARD. THEY DEVOTE AN AVERAGE OF TWO HOURS PER WEEK RELATING TO THEIR ACTIVITIES ASSOCIATED WITH SERVING ON THE BOARD OF DIRECTORS. THE REPORTABLE COMPENSATION IS RELATED TO PROFESSIONAL MEDICAL SERVICES PROVIDED TO THE HOSPITAL AND ARE UNRELATED TO THE AVERAGE NUMBER OF HOURS PER WEEK. |
| FORM 990, PART XII, LINE 2 & PART IV, LINE 12 | The organization's audited financial statements are prepared on a consolidated basis. However, the organization has separate financial information reported in the supplemental schedules to the consolidated audited financial statements. This separate financial information is the basis for the reconciliation at Schedule D, Parts XI AND XII. |
| FOrm 990, Part XII, Line 2c | This process has not changed from prior year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Montebello Community Health Services Inc | ||||||||||
| 309 W Beverly Blvd | Montebello | CA | 90604 | 953823550 | SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION | CA | 501(c)(3) | 11-II | BEVERLY COMMUNITY HOSPITAL ASSOCIATION | Yes (1) |
| Beverly Hospital Foundation | ||||||||||
| 309 W Beverly Blvd | Montebello | CA | 90604 | 953823550 | SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION | CA | 501(c)(3) | 7 | BEVERLY COMMUNITY HOSPITAL ASSOCIATION | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 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 | 0 | 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 (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Montebello Community Health Services | ||
| C | $3,710,893 | Fair Value |
| Beverly Hospital Foundation | ||
| C | $91,308 | Fair Value |
| montebello Community Health Services | ||
| D | $3,990,556 | fair Value |
| montebello Community Health Services | ||
| E | $3,104,858 | fair Value |
| montebello Community Health Services | ||
| K | $291,566 | fair Value |
| Montebello Community Health Services | ||
| J | $110,297 | Fair Value |