BEVERLY COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- BEVERLY COMMUNITY HOSPITAL ASSOCIATION (EIN 95-1816005)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201323199349303372
- Schema version
- 2012v2.1
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T10:10:48-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET 9TH FLOOR | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951816005 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BEVE | NameControl |
| Phone | 3237255095 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1 |
| City | MONTEBELLO | City |
| State | CA | State |
| ZIP Code | 906404308 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LARRY PUGH | Name |
| Title | VP FINANCE/CFO | Title |
| Phone | 3237255095 | Phone |
| Date Signed | 2013-11-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RENIE BURBANK | Name |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GARY V KIFF | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1 |
| City | MONTEBELLO | City |
| State | CA | State |
| ZIP Code | 906404308 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 163164588 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BEVERLY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1949 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1113 | TotalNbrEmployees |
| Total Nbr Volunteers | 131 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 545718 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 492410 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 133808533 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 159516428 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4568 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3249 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 375591 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3149691 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 134734410 | TotalRevenuePriorYear |
| Total Revenue Current Year | 163161778 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 53525032 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 56809420 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 84859875 | OtherExpensePriorYear |
| Other Expenses Current Year | 109957011 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 138384907 | TotalExpensesPriorYear |
| Total Expenses Current Year | 166766431 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3650497 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3604653 | RevenuesLessExpensesCY |
| Total Assets BOY | 85751480 | TotalAssetsBOY |
| Total Assets EOY | 97867963 | TotalAssetsEOY |
| Total Liabilities BOY | 36648818 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 52323046 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 49102662 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 45544917 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 89027116 | Expense |
| Revenue | 117602656 | Revenue |
| Description | INPATIENT AND OUTPATIENT HOSPITAL SERVICES- HOSPITAL SERVICES PROVIDED BY BEVERLY COMMUNITY HOSPITAL ASSOCIATION INCLUDED 9,107 INPATIENT ADMISSONS, 24,816 OUTPATIENT VISITS AND 34,440 EMERGENCY ROOM VISITS IN 2012. CARE IS PROVIDED WITHOUT CHARGE TO PATIENTS WHO MEET SPECIFIED CRITERIA UNDER THE CHARITY CARE POLICY. THE COST OF CHARITY CARE PROVIDED TOTALED $3,000,000 IN 2012. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 37754000 | Expense |
| Revenue | 44854040 | Revenue |
| Description | CAPITATION SERVICES - BEVERLY COMMUNITY HOSPITAL ASSOCIATION CONTRACTS WITH THE BLUE CROSS OF CALIFORNIA, MOLINA HEALTHCARE OF CALIFORNIA,HEALTH NET OF CALIFORNIA AND COMMUNITY HEALTH PLAN 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 2012 AVERAGED 108,288 MEDI-CAL BENEFICIARIES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | 135282 | Revenue |
| Description | RENT FROM RELATED ORGANIZATIONS, MONTEBELLO COMMUNITY HEALTH SERVICES, INC. AND BEVERLY HOSPITAL FOUNDATION. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 126781116 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 509 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1113 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LARRY PUGH | NamePerson |
| Telephone Number | 3237255095 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1 |
| City | MONTEBELLO | City |
| State | CA | State |
| ZIP Code | 90640 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| CARLOS MANUEL HARO PHD | |||||||||
| CHAIRPERSON | 2.00 | 3.00 | X | 0 | 0 | 0 | |||
| DENTON GUTHRIE CPA | |||||||||
| 1ST VICE CHAIRPERSON | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| LYLA EDDINGTON EDD | |||||||||
| 2ND VICE CHAIRPERSON | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| RENEE D MARTINEZ | |||||||||
| TREASURER | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| ROSEMARY OROZCO | |||||||||
| SECRETARY | 2.00 | 3.00 | X | 0 | 0 | 0 | |||
| DAVID I CHAMBERS | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| MOHAMMAD A CHAUDHRY MD | |||||||||
| BOARD MEMBER | 2.00 | 3.00 | X | 26000 | 0 | 0 | |||
| K LAWRENCE COHEN MD | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | X | 32500 | 0 | 0 | |||
| PETER J MARX ESQ | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| ALMA PEREZ | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| ANTHONY SOLANA JR ESQ | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| GARY KIFF | |||||||||
| PRESIDENT & CEO | 40.00 | 4.00 | 442369 | 0 | 11195 | X | |||
| MICHAEL ALMANZOR | |||||||||
| VP FINANCE & CFO | 40.00 | 3.00 | 162158 | 0 | 10566 | X | |||
| LARRY PUGH | |||||||||
| VP FINANCE & CFO | 40.00 | 3.00 | 41368 | 0 | 1168 | X | |||
| ALICE SHU JEN CHENG | |||||||||
| COO & SENIOR VP | 40.00 | 238711 | 0 | 0 | X | ||||
| JUNE BELLING-SULLIVAN | |||||||||
| VP NURSING & CNO | 40.00 | 212934 | 0 | 0 | X | ||||
| MARGARET MATLACK | |||||||||
| REGISTERED NURSE | 36.00 | 147228 | 0 | 3949 | X | ||||
| JOEL VELO LAZARO | |||||||||
| REGISTERED NURSE | 36.00 | 180442 | 0 | 12305 | X | ||||
| JENNIFER H YOUNG | |||||||||
| REGISTERED NURSE | 36.00 | 145701 | 0 | 4087 | X | ||||
| ALEJANDRO CASAOLA | |||||||||
| RAD NUCLEAR MED. TECH | 40.00 | 182859 | 0 | 649 | X | ||||
| ARTURO DEVERA | |||||||||
| REGISTERED NURSE | 36.00 | 172750 | 0 | 3973 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1985020 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 47892 | TotalOtherCompensation |
| Number Individuals GT100 K | 84 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CPI SOLUTIONS | |||||
| 59999 RIDGEVIEW STREET UNIT A | CAMARILLO | CA | 93012 | INFORMATION TECHNOLOGY MNGMT. | 1755539 |
| SODEXHO INC | |||||
| 309 W BEVERLY BLVD | MONTEBELLO | CA | 90640 | FOOD & DIET. SVCS. | 1647721 |
| SHIFTWISE | |||||
| CM-9705 PO BOX 70870 | ST PAUL | MN | 551709705 | TEMPORARY HELP SVCS. | 1312463 |
| LIFELINE DIALYSIS INC | |||||
| 101 W BEVERLY BLVD STE 304 | MONTEBELLO | CA | 90640 | DIALYSIS SERVICES | 730800 |
| FULCRUM GROUP | |||||
| 3998 INLAND EMPIRE BLVD STE 300 | ONTARIO | CA | 91764 | REIMBURSE. CNSLTING. | 545812 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 42 | NumberOfContractorsGT100K |
| Related Organizations | 413750 | RelatedOrganizations |
| Government Grants | 78660 | GovernmentGrants |
| Total Contributions | 492410 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 621990 | 114527106 | 114527106 |
| CAPITATION SERVICES | 621990 | 44854040 | 44854040 |
| RENT FROM AFFILIATE | 531120 | 135282 | 135282 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 159516428 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2455 | TotalRevenueColumn |
| Exclusion | $2,455 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23141 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23141 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23141 | TotalRevenueColumn |
| Exclusion | $23,141 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3604 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2810 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 794 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 794 | TotalRevenueColumn |
| Exclusion | $794 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EHR PAYMENTS | 900099 | 2800183 | 2800183 | |
| REBATES & REFUNDS | 900099 | 275367 | 275367 | |
| CAFETERIA SALES | 722210 | 51000 | $51,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3126550 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 163161778 | TotalRevenueColumn |
| Related Or Exempt Function Income | 162591978 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $77,390 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1178969 | Total |
| Management And General | 1178969 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44036619 | Total |
| Program Services | 33809994 | ProgramServices |
| Management And General | 10226625 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7907314 | Total |
| Program Services | 2811243 | ProgramServices |
| Management And General | 5096071 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3686518 | Total |
| Program Services | 2678869 | ProgramServices |
| Management And General | 1007649 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1655072 | Total |
| Program Services | 424979 | ProgramServices |
| Management And General | 1230093 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1099694 | Total |
| Management And General | 1099694 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111179 | Total |
| Management And General | 111179 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81 | Total |
| Management And General | 81 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5426202 | Total |
| Program Services | 5142526 | ProgramServices |
| Management And General | 283676 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5318896 | Total |
| Program Services | 3517263 | ProgramServices |
| Management And General | 1801633 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2276504 | Total |
| Management And General | 2276504 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1705827 | Total |
| Management And General | 1705827 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14303 | Total |
| Program Services | 335 | ProgramServices |
| Management And General | 13968 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 604766 | Total |
| Management And General | 604766 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 483241 | Total |
| Program Services | 260030 | ProgramServices |
| Management And General | 223211 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4644728 | Total |
| Program Services | 899863 | ProgramServices |
| Management And General | 3744865 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2205242 | Total |
| Program Services | 534678 | ProgramServices |
| Management And General | 1670564 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CAPITATED MEDICAL SVCS | 37753912 | 35280398 | 2473514 |
| BAD DEBT EXPENSES | 13689079 | 13689079 | |
| MEDICAL SUPPLIES | 13369181 | 13369181 | |
| HOSPITAL FEE | 10529153 | 10529153 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9069951 | Total |
| Program Services | 3833525 | ProgramServices |
| Management And General | 5236426 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166766431 | Total |
| Program Services | 126781116 | ProgramServices |
| Management And General | 39985315 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2939138 | BOY |
| EOY | 8447302 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3640031 | BOY |
| EOY | 5782476 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 127445 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16613295 | BOY |
| EOY | 18155875 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2737341 | BOY |
| EOY | 2473621 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 854164 | BOY |
| EOY | 899331 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 133199351 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 83485081 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49709476 | BOY |
| EOY | 49714270 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89853 | BOY |
| EOY | 94866 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9168182 | BOY |
| EOY | 12172777 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85751480 | BOY |
| EOY | 97867963 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15543503 | BOY |
| EOY | 24071360 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16314882 | BOY |
| EOY | 20647090 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4790433 | BOY |
| EOY | 7604596 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36648818 | BOY |
| EOY | 52323046 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48888446 | BOY |
| EOY | 45503327 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 214216 | BOY |
| EOY | 41590 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49102662 | BOY |
| EOY | 45544917 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85751480 | BOY |
| EOY | 97867963 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -3604653 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1908 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 45000 | ReconcilationDonatedServices |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $79,780 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 79780 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| 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. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1398730 | OtherCostOrOtherBasis |
| Book Value | 1398730 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 85605404 | OtherCostOrOtherBasis |
| Depreciation | 52955720 | Depreciation |
| Book Value | 32649684 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 38916086 | OtherCostOrOtherBasis |
| Depreciation | 29470754 | Depreciation |
| Book Value | 9445332 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7279131 | OtherCostOrOtherBasis |
| Depreciation | 1058607 | Depreciation |
| Book Value | 6220524 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 49714270 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATE | 5022512 |
| INVESTMENT - CHIC | 298011 |
| THIRD PARTY PAYOR RECEIVABLE | 2651879 |
| UNAMORTIZED LOAN COST | 105141 |
| MALPRACTICE INSURANCE RECEIVABLE | 2476343 |
| WORKERS' COMP INSURANCE RECEIVABLE | 1618891 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 12172777 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED SELF-INSURED LIABILITIES | $5,725,703 |
| BENEFICIAL INTEREST IN AFFILIATE | $1,878,893 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7604596 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 149474000 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 1908 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 45000 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 220000 | OtherRevenues |
| Revenue Not Rptd F990 | 266908 | RevenueNotRptdF990 |
| Revenue Subtotal | 149207092 | RevenueSubtotal |
| Investment Expenses Not Included | 81 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 13954605 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 13954686 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 163161778 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 152860000 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 152860000 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 81 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 13906350 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 13906431 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 166766431 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE ORGANIZATION 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. AS OF DECEMBER 31, 2012 THERE ARE NO UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTION 220,000. | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BENEFICIAL INTEREST IN FOUNDATION RECLASSIFIED TO EXPENSES 174,684. CONTRIBUTION RECLASSIFIED FROM TEMPORARILY RESTRICTED NET ASSETS 47,374. AUDITED FINANCIAL STATEMENT ROUNDING -386. BAD DEBT EXPENSES RECLASSIFIED TO EXPENSE SECTION 13,689,079. RECLASSIFIED REVENUE TO EXPENSE SECTION 43,854. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BENEFICIAL INTEREST IN FOUNDATION RECLASSIFIED FROM REVENUES 174,684. AUDITED FINANCIAL STATEMENT ROUNDING -1,267. RECLASSIFIED REVENUE TO EXPENSE SECTION 43,854. BAD DEBT EXPENSES RECLASSIFIED FROM REVENUE SECTION 13,689,079. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 350.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 450.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 148 | PersonsServed |
| Total Community Benefit Expense | 2704976 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2704976 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01770 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 3353 | PersonsServed |
| Total Community Benefit Expense | 59665668 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 43184984 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 16480684 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10770 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 3501 | PersonsServed |
| Total Community Benefit Expense | 62370644 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 43184984 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19185660 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12540 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 24 | NumberOfActivitiesOrPrograms |
| Persons Served | 55900 | PersonsServed |
| Total Community Benefit Expense | 2861637 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2861637 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01870 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 24 | NumberOfActivitiesOrPrograms |
| Persons Served | 55900 | PersonsServed |
| Total Community Benefit Expense | 2861637 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2861637 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01870 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 26 | NumberOfActivitiesOrPrograms |
| Persons Served | 59401 | PersonsServed |
| Total Community Benefit Expense | 65232281 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 43184984 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 22047297 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14410 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 13347 | PersonsServed |
| Total Community Building Expense | 150495 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 150495 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 1321 | PersonsServed |
| Total Community Building Expense | 758290 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 758290 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 6792 | PersonsServed |
| Total Community Building Expense | 139483 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 139483 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 21460 | PersonsServed |
| Total Community Building Expense | 1048268 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1048268 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00690 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $13,689,000 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 35497568 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 33180984 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 2316584 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1 |
| City | MONTEBELLO | City |
| State | CA | State |
| ZIP Code | 90640 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 10 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 350.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 450.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: BEVERLY HOSPITAL USES COST TO CHARGE RATIO TO DETERMINE THE COSTING METHOD | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 13689079. | ||
| PART II: COMMUNITY BUILDING ACTIVITIES: COMMUNITY HEALTH IMPROVEMENT ADVOCACY INCLUDES PROGRAMS TO PROVIDE ASSISTANCE WITH COMPLETION OF LOW-INCOME PUBLICLY SPONSORED HEALTH INSURANCE PROGRAMS AND TRANSPORTATION SERVICE. COMMUNITY SUPPORT INCLUDES COMMUNITY HEALTH CLASSES, SCREENINGS, SUPPORT GROUPS, IMMUNIZATIONS, HEALTH FAIRS, AND DONATIONS TO LOCAL NON-PROFITS.LEADERSHIP DEVELOPMENT & TRAINING COMMUNITY MEMBERS INCLUDES A CLINICAL SITE FOR NURSING STUDENTS, RESPIRATORY AND EMERGENCY MEDICAL TECHNICIANS AND CAREER FAIRS.OTHER COMMUNITY BUILDING ACTIVITIES INCLUDE TRANSPORTATION ASSISTANCE AND ASSISTANCE WITH MEDI-CAL ELIGIBILITY. | ||
| PART III, LINE 4: BAD DEBT EXPENSE: ACTUAL NET REIMBURSABLE REVENUE DEEMED TO BE UNCOLLECTIBLE BY SELF PAY WHICH ARE WRITTEN OFF TO BAD DEBT EXPENSE. BAD DEBTS ARE DETERMINED TO BE THE REMAINING AMOUNT OWED ON SELF PAY AFTER ANY APPLICABLE DISCOUNTS AND PAYMENTS. THE ORGANIZATION HAS A WRITTEN POLICY AND PROCEDURE TO IDENTIFY PATIENTS WHO QUALIFY FOR CHARITY. PATIENTS WHO QUALIFY FOR CHARITY CARE ARE SCREENED AND THEIR CLAIMS REVIEWED FOR ACCURACY. CLAIMS THAT MEET THE CONDITIONS OUTLINED IN THE HOSPITAL POLICY ARE APPROVED FOR CHARITY CARE. | ||
| 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 THAN TRANSFERRED TO A COLLECTION AGENCY. | ||
| PART V, SECTION B, LINE 3: THE 2010 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 FIFTEEN REPRESENTATIVES FROM A VARIETY COMMUNITY-SERVING ORGANIZATIONS TO IDENTIFY KEY THEMES. | BEVERLY HOSPITAL | |
| PART V, SECTION B, LINE 5C: THE REPORT IS REQUIRED TO BE FILED EACH YEAR WITH THE "OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT", AND IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | BEVERLY HOSPITAL | |
| PART V, SECTION B, LINE 16E: AT THE TIME OF ADMISSION THE HOSPITAL, DETERMINES UP FRONT WHETHER THE PATIENT WOULD QUALIFY UNDER THE HOSPITAL'S FAP. THE HOSPITAL DOES NOT ENGAGE IN ANY OF THE ACTIONS LISTED ABOVE. THE HOSPITAL OPERATES ON GOOD FAITH THAT THE PATIENT WILL QUALIFY UNDER FAP. | BEVERLY HOSPITAL | |
| PART VI, LINE 2: NEEDS ASSESSMENT: THE 2010 COMMUNITY NEEDS ASSESSMENT WAS DEVELOPED THROUGH 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 FIFTEEN 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: IN 2010, BEVERLY HOSPITAL SERVICE AREA INCLUDED AN ESTIMATED POPULATION OF 742,000 PERSONS, SHOWING A 5% GROWTH RATE OVER THE PAST 20 YEARS. IN THE SERVICE AREA, 29% ARE UNDER AGE 18 YEARS, 61% ARE BETWEEN AGES 18 AND 64 YEARS, AND 10% ARE AGE 65 YEARS AND OLDER. HISPANICS ARE THE LARGEST RACE/ETHNIC GROUP IN THE SERVICE AREA (78% OF THE POPULATION), FOLLOWED BY ASIANS OR PACIFIC ISLANDERS (15%), WHITES(6%), AND OTHERS (2%). THE MAJORITY OF THE ADULTS AGE 25 YEARS AND OLDER HAS LESS THAN A HIGH SCHOOL DIPLOMA (44%), 24% ARE HIGH SCHOOL GRADUATES AND 32% HAVE SOME COLLEGE TO A PROFESSIONAL DEGREE. AVERAGE HOUSEHOLD INCOME IN THE SERVICE AREA IS ESTIMATED AT $46,902. 19% OF FAMILIES ARE BELOW THE POVERTY LEVEL, A MUCH HIGHER POVERTY RATE THAN THE COUNTY AVERAGE OF 12%. IN 2010, 271,000 RESIDENTS IN THE AREA WERE EMPLOYED, 51% OF WORKERS HAD WHITE COLLAR JOBS, 31% BLUE COLLAR JOBS AND 18% WORKED IN SERVICE OR FARMING. THE SERVICE AREA HAS A TOTAL OF 290,858 FOREIGN BORN RESIDENTS. AS A RESULT OF THE AREAS IMMIGRATION AND ETHNIC PATTERNS, MANY RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME LIKE SPANISH (67%) AND ASIAN LANGUAGES (13%), WITH 19% WHO SPEAK ONLY ENGLISH AT HOME. FAMILIES ARE MORE THAN 80% OF ALL HOUSEHOLDS IN THE SERVICE AREA, COMPARED TO THE 67% FOR LOS ANGELES COUNTY AS A WHOLE. WHILE THE SERVICE AREA HAS A HIGHER PROPORTION OF MARRIED COUPLE FAMILIES WITH CHILDREN (33%), IT ALSO HAS A HIGHER RATE OF SINGLE PARENT FAMILIES WITH CHILDREN (18%) COMPARED TO THE COUNTY RATES. | ||
| 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. | ||
| CA | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GARY KIFF | ||||||||||||||
| PRESIDENT & CEO | 442369 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11195 | 0 | 453564 | 0 | 0 | 0 |
| MICHAEL ALMANZOR | ||||||||||||||
| VP FINANCE & CFO | 162158 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 10566 | 0 | 172724 | 0 | 0 | 0 |
| ALICE SHU JEN CHENG | ||||||||||||||
| COO & SENIOR VP | 238711 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 238711 | 0 | 0 | 0 |
| JUNE BELLING-SULLIVAN | ||||||||||||||
| VP NURSING & CNO | 212934 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 212934 | 0 | 0 | 0 |
| MARGARET MATLACK | ||||||||||||||
| REGISTERED NURSE | 147228 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3949 | 0 | 151177 | 0 | 0 | 0 |
| JOEL VELO LAZARO | ||||||||||||||
| REGISTERED NURSE | 180442 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12305 | 0 | 192747 | 0 | 0 | 0 |
| ALEJANDRO CASAOLA | ||||||||||||||
| RAD NUCLEAR MED. TECH | 182859 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 649 | 0 | 183508 | 0 | 0 | 0 |
| ARTURO DEVERA | ||||||||||||||
| REGISTERED NURSE | 172750 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3973 | 0 | 176723 | 0 | 0 | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | BROCHURE DESIGN | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 45000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | DONOR ESTIMATE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 ENTIRITY 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 2010. 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 MOHAMMAD A. CHAUDHRY, 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. | HOURS PER WEEK DEVOTED BY MEMBER OF THE BOARD |
| 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. | SUPPLEMENTAL SCHEDULES TO AUDITED FINANCIAL STATEMENTS |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. | AUDIT COMMITTEE AND OVERSIGHT |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| MONTEBELLO COMMUNITY HEALTH SERVICES INC | ||||||||||
| 309 W BEVERLY BLVD | MONTEBELLO | CA | 90604 | 953823550 | SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION | CA | 501(C)(3) | 11B | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MONTEBELLO COMMUNITY HEALTH SERVICES | ||
| J | 108066 | FAIR VALUE |
| BEVERLY HOSPITAL FOUNDATION | ||
| C | 458750 | FAIR VALUE |
| BEVERLY HOSPITAL FOUNDATION | ||
| Q | 140737 | FAIR VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES | ||
| K | 483241 | FAIR VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES | ||
| Q | 241144 | FAIR VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES | ||
| S | 383971 | FAIR VALUE |
| BEVERLY HOSPITAL FOUNDATION | ||
| D | 3193611 | FAIR VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES | ||
| D | 4292839 | FAIR VALUE |
| BEVERLY HOSPITAL FOUNDATION | ||
| A | 135282 | FAIR VALUE |