2016-11-15T15:57:21-06:00 2015-12-31 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2015-01-01 951816005 Beverly Community Hospital Association BEVE 3237255095 309 West Beverly Boulevard Montebello CA 906404308 Larry Pugh VP FINANCE/CFO 3237255095 2016-11-11 1 Renie Burbank P00159653 4159561500 2015 2017-02-10 21:41:12Z ALICE CHENG 309 West Beverly Boulevard Montebello CA 906404308 182374641 0 X www.beverly.org X 1949 CA 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. 11 9 1056 164 0 0 3168913 3802201 170601263 176979426 6167 8755 1874110 1584175 175650453 182374557 0 0 0 0 60824322 61162951 0 0 0 109641622 109199516 170465944 170362467 5184509 12012090 116088063 151753289 68121156 91775387 47966907 59977902 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. 0 0 79415591 0 117960234 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. 47032071 0 60545164 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. 126447662 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 677 0 1 1056 1 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Larry Pugh 3237255095 309 West Beverly Boulevard Montebello CA 90640 X Carlos Manuel Haro PhD Chairman 2.00 3.00 X X 0 0 0 Denton Guthrie CPA First Vice Chairman 2.00 2.00 X X 0 0 0 Lyla Eddington EdD Second Vice Chairman 2.00 2.00 X X 0 0 0 Gautam Ganguly MD Treasurer 2.00 2.00 X X 0 0 0 Rosemary Orozco Secretary 2.00 2.00 X X 0 0 0 K Lawrence Cohen MD Member 2.00 2.00 X 30259 0 0 Aziz Khan MD Member 2.00 2.00 X 0 0 0 Renee D Martinez Member 2.00 2.00 X 0 0 0 Krishna Narayanan MD Member 2.00 3.00 X 51500 0 0 Alma Perez SPHR Member 2.00 2.00 X 0 0 0 Kathy Schlotz Member 2.00 3.00 X 0 0 0 Alice Shu Jen Cheng President & CEO 40.00 4.00 X 352403 0 14181 Charles Larry Pugh VP of Finance & CFO 40.00 3.00 X 272733 0 5584 Wendy R Beesley Senior VP & COO 40.00 X 248528 0 12354 Kathryn W Ross VP of Nursing 40.00 X 214494 0 4421 John G Barnes Administrative Director, H.R. 40.00 X 191639 0 9578 Joel Velo Lazaro Registered Nurse 36.00 X 180890 0 13046 Christina Pickering Administrative Dir., Quality Risk 40.00 X 175868 0 700 Clyde Harwood VP, Comm/Gov. Relations (Thru 9/15) 40.00 X 166904 0 4914 Ismael Obordo registered Nurse 36.00 X 165203 0 4213 Jose Ignacio Morales Epidemiologist (Thru 11/15) 40.00 X 155637 0 13484 2206058 0 82475 109 0 1 0 Sodexo & Affiliates DEPT 880328 Los Angeles CA 90088 Food & Housekeeping mngmt. 3314828 The Fulcrum Group 14269 Fern Avenue Chino CA 91710 REIMBURSE. CNSLTING. 803237 CURA Consulting Solutions Inc 1036 Garrity Way Santa Clara CA 95054 information technology mngmt. 788459 Lifeline Dialysis 101 W Beverly Blvd Ste 304 Montebello CA 90640 Dialysis Services 699840 Shiftwise PO Box 70870 St Paul MN 55170 Temporary Help Svcs. 581250 104 3802201 3802201 Patient Services 621990 116434260 116434260 Capitation Services 621990 60545166 60545166 176979426 8755 8755 57913 0 57913 57913 57913 84 84 0 EHR PAYMENTS 900099 773013 773013 Rebates & Refunds 900099 479272 479272 Beneficial interest in Foundation 900099 273687 273687 290 290 1526262 182374557 178505398 0 66958 1407675 1407675 45373345 36096216 9277129 10599959 3508946 7091013 3781972 2909583 872389 648729 648729 53 53 8401706 5139990 3261716 2743243 2134162 609081 747333 747333 2125694 319706 1805988 4452 1216 3236 651102 651102 291566 291566 4172081 775858 3396223 1730262 1730262 capitated medical Svcs 46775696 43163730 3611966 medical supplies 15214019 14758002 456017 Hospital Fee 12839190 12839190 OTHER PURCHASED SVCS 8851745 2958613 5893132 4002645 1842450 2160195 170362467 126447662 43914805 0 10491787 30927510 3580107 7442513 17837 13011 17854724 16759673 405754 88956 2746413 2942632 3285110 2130554 143698909 79477999 55953341 64220910 95911 96692 21657079 27130838 116088063 151753289 31744970 42401947 0 40691424 26549528 1946015 9826658 6736001 68121156 91775387 X 47966907 59938594 0 39308 47966907 59977902 116088063 151753289 12012090 -1095 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 133140 133140 0 Part II-B, Line 1: 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. 1398730 1398730 94801177 59992244 34808933 17391518 13308198 4083320 30107484 6177557 23929927 64220910 Due From Affiliate 932261 Investment - CHIC 298011 Third Party Payor receivable 7130457 UNAMORTIZED LOAN COST 2859 malpractice insurance receivable 925000 workers' comp insurance receivable 1911000 Assets Limited as to use 14182795 Beneficial interest in Affiliate 1748455 27130838 Accrued Self-Insured Liabilities 6736001 6736001 X 182334000 -1095 -101 -1196 182335196 53 39308 39361 182374557 170362000 -414 -414 170362414 53 53 170362467 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. 1 1 1 X 350.000000000000 1 X 450.000000000000 1 1 1 0 1 1 1483143 0 1483143 0.00870 73520528 47809392 25711136 0.15090 75003671 47809392 27194279 0.15960 35 56052 3194455 3194455 0.01880 35 56052 3194455 3194455 0.01880 35 56052 78198126 47809392 30388734 0.17840 34 18523 1063866 0 1063866 0.00620 34 18523 1063866 1063866 0.00620 1 9808935 0 32870005 12894212 19975793 X 1 1 1 1 BEVERLY HOSPITAL 309 West Beverly Boulevard Montebello CA 90640 WWW.BEVERLY.ORG OSHPD FACILITY NUMBER XXX-XX-XXXX X X X BEVERLY HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X www.beverly.org 1 14 1 WWW.BEVERLY.ORG 0 0 1 X 350.000000000000 450.000000000000 X X X X X 1 1 X X X X 1 X X 1 X 0 X X X X 1 X 0 0 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. 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 X X X 1 0 0 0 0 0 0 0 0 Alice Shu Jen Cheng President & CEO 352403 0 0 0 0 0 0 0 14181 0 366584 0 0 0 Charles Larry Pugh VP of Finance & CFO 272733 0 0 0 0 0 0 0 5584 0 278317 0 0 0 Wendy R Beesley Senior VP & COO 248528 0 0 0 0 0 0 0 12354 0 260882 0 0 0 Kathryn W Ross VP of Nursing 214494 0 0 0 0 0 0 0 4421 0 218915 0 0 0 John G Barnes Administrative Director, H.R. 191639 0 0 0 0 0 0 0 9578 0 201217 0 0 0 Joel Velo Lazaro Registered Nurse 180890 0 0 0 0 0 0 0 13046 0 193936 0 0 0 Christina Pickering Administrative Dir., Quality Risk 175868 0 0 0 0 0 0 0 700 0 176568 0 0 0 Clyde Harwood VP, Comm/Gov. Relations (Thru 9/15) 88911 0 0 0 77993 0 0 0 4914 0 171818 0 0 0 Ismael Obordo registered Nurse 165203 0 0 0 0 0 0 0 4213 0 169416 0 0 0 Jose Ignacio Morales Epidemiologist (Thru 11/15) 155637 0 0 0 0 0 0 0 13484 0 169121 0 0 0 Part I, Line 4a CLYDE HARWOOD RECEIVED A PAYMENT OF $77,993 AND THE AMOUNT WAS INCLUDED IN HIS FORM W-2. A California Statewide Communities Development Authority 680164610 13080SLL6 2015-12-02 41768337 ACQUISITION, IMPROVEMENT, RENOVATION, AND EQUIPPING OF HOSPITAL 0 1 0 A 41768337 768337 830549 29097626 11071852 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 0 A 1 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. 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 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 1 0 0 1 1 1 0 0 0 0 1 1 1 1 1 1 0 1 1 1 Montebello Community Health Services C 3710893 Fair Value Beverly Hospital Foundation C 91308 Fair Value montebello Community Health Services D 3990556 fair Value montebello Community Health Services E 3104858 fair Value montebello Community Health Services K 291566 fair Value Montebello Community Health Services J 110297 Fair Value