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BEVERLY COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BEVERLY COMMUNITY HOSPITAL ASSOCIATION (EIN 95-1816005)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201133199349310253
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-15T18:54:04-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE CALIFORNIA STREET 4TH FLOORAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94111ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN951816005EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BEVERLY COMMUNITY HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBEVENameControl
Phone3237255095Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1309 WEST BEVERLY BOULEVARDAddressLine1
CityMONTEBELLOCity
StateCAState
ZIP Code906404308ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL A ALMANZORName
TitleVP FINANCE/CFOTitle
Phone3237255095Phone
Date Signed2011-11-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRENIE BURBANKName
Phone4159561500Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHAEL A ALMANZORNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1309 WEST BEVERLY BOULEVARDAddressLine1
CityMONTEBELLOCity
StateCAState
ZIP Code906404308ZIPCode
FieldValueIRS element (for citing)
Gross Receipts152039950GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BEVERLY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1949YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO 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 Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees1005TotalNbrEmployees
Total Nbr Volunteers169TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year24056551ContributionsGrantsPriorYear
Contributions Grants Current Year2666601ContributionsGrantsCurrentYear
Program Service Revenue Prior Year126350469ProgramServiceRevenuePriorYear
Program Service Revenue CY148905292ProgramServiceRevenueCY
Investment Income Prior Year2941InvestmentIncomePriorYear
Investment Income Current Year2899InvestmentIncomeCurrentYear
Other Revenue Prior Year516265OtherRevenuePriorYear
Other Revenue Current Year465080OtherRevenueCurrentYear
Total Revenue Prior Year150926226TotalRevenuePriorYear
Total Revenue Current Year152039872TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2065GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year52123464SalariesEtcPriorYear
Salaries Etc Current Year51867303SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year75103162OtherExpensePriorYear
Other Expenses Current Year93949141OtherExpensesCurrentYear
Total Expenses Prior Year127228691TotalExpensesPriorYear
Total Expenses Current Year145816444TotalExpensesCurrentYear
Revenues Less Expenses Prior Year23697535RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6223428RevenuesLessExpensesCY
Total Assets BOY84189616TotalAssetsBOY
Total Assets EOY87297341TotalAssetsEOY
Total Liabilities BOY37663503TotalLiabilitiesBOY
Total Liabilities EOY34547187TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY46526113NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY52750154NetAssetsOrFundBalancesEOY
Mission DescriptionTO 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense62047997Expense
Revenue119476140Revenue
DescriptionINPATIENT AND OUTPATIENT HOSPITAL SERVICES - HOSPITAL SERVICES PROVIDED BY BEVERLY COMMUNITY HOSPITAL ASSOCIATION INCLUDED 8,858 INPATIENT ADMISSIONS, 25,147 OUTPATIENT VISITS AND 31,008 EMERGENCY ROOM VISITS IN 2010. CARE IS PROVIDED WITHOUT CHARGE TO PATIENTS WHO MEET SPECIFIED CRITERIA UNDER THE CHARITY CARE POLICY. CHARITY CARE PROVIDED BASED ON ESTABLISHED RATES, TOTALED $7,687,603 IN 2010.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense25924000Expense
Revenue29577580Revenue
DescriptionCAPITATION SERVICES - BEVERLY COMMUNITY HOSPITAL ASSOCIATION CONTRACTS WITH THE BLUE CROSS OF CALIFORNIA, MOLINA HEALTHCARE OF CALIFORNIA AND CALIFORNIA HEALTH SERVICES 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 2010 AVERAGED 108,362 MEDI-CAL BENEFICIARIES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Revenue101400Revenue
DescriptionRENT FROM AFFILIATE, MONTEBELLO COMMUNITY HEALTH SERVICES, INC.Description
FieldValueIRS element (for citing)
Total Program Service Expense87971997TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096311NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1005NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL ALMANZORNamePerson
Telephone Number3237255095TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1309 WEST BEVERLY BOULEVARDAddressLine1
CityMONTEBELLOCity
StateCAState
ZIP Code90640ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MICHAEL D FELS PHD
CHAIRPERSON2.00X000
LYLA EDDINGTON EDD
2ND VICE CHAIPERSON2.00X000
RENEE D MARTINEZ
MEMBER OF BOARD2.00X000
K LAWRENCE COHEN MD
MEMBER OF BOARD2.00X3000000
CARLOS MANUEL HARO PHD
TREASURER2.00X000
DENTON GUTHRIE CPA
1ST VICE CHAIRPERSON2.00X000
AZIZ KHAN MD
MEMBER OF BOARD2.00X1300000
CHARLES LAWRENCE
MEMBER OF BOARD2.00X000
PETER J MARX ESQ
MEMBER OF BOARD2.00X000
ROSEMARIE OROZCO
SECRETARY2.00X000
ANTHONY SOLANA JR ESQ
MEMBER OF BOARD2.00X000
DAVID I CHAMBERS
MEMBER OF BOARD2.00X000
ALMA PEREZ
MEMBER OF BOARD2.00X000
GARY KIFF
PRESIDENT/CEO34.00400756010270X
MICHAEL ALMANZOR
VP FINANCE/CFO37.00128945011680X
WENDY BEESLEY
SENIOR VP/COO40.0023834401120X
JUNE BELLING-SULLIVAN
VP NURSING/CNO40.0017064501093X
ALEJANDRO CASASOLA
RAD-NUC MED TECH40.001887340793X
DISMUS IRUNGU
REGISTERED NURSE36.0016499603981X
ARTURO DEVERA
REGISTERED NURSE36.0016399303556X
CHARLENE CHU
REGISTERED NURSE36.00151800010773X
LOIS LONG
REGISTERED NURSE36.0015406103531X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1805274TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation46797TotalOtherCompensation
Number Individuals GT100 K91NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HAMILTON CONSTRUCTION
202 MERCURY CIRCLEPOMONACA91768CONSTRUCTION1920681
FULCRUM GROUP THE
3998 INLAND EMPIRE BLVD SUITE 300ONTARIOCA91764CONSULTING735565
CODING SOURCE
3415 S SEPULVEDA BLVD 9TH FLOORLOS ANGELESCA90064CODING493969
KEENAN AND ASSOCIATES
P O BOX 4328TORRANCECA90510CONSULTING493157
PARADIGM MEDICAL MANAGEMENT
1515 W 190TH ST STE 410GARDENACA90248MANAGEMENT381290
FieldValueIRS element (for citing)
Number Of Contractors GT100 K30NumberOfContractorsGT100K
Related Organizations2613928RelatedOrganizations
Government Grants52673GovernmentGrants
Total Contributions2666601TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
HOSPITAL SERVICES621990119226312119226312
CAPITATION SERVICES6219902957758029577580
RENT FROM AFFILIATE531120101400101400
FieldValueIRS element (for citing)
Total Program Service Revenue148905292TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1556TotalRevenueColumn
Exclusion$1,556ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real17025Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real17025Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column17025TotalRevenueColumn
Exclusion$17,025ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1421Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities78Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1343Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1343TotalRevenueColumn
Exclusion$1,343ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
REBATES & REFUNDS900099249828249828
OTHER REVENUE900099154875$154,875
CAFETERIA SALES72221043352$43,352
FieldValueIRS element (for citing)
Total Other Revenue448055TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column152039872TotalRevenueColumn
Related Or Exempt Function Income149155120RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$218,151ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1005854Total
Management And General1005854ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38776713Total
Program Services28876093ProgramServices
Management And General9900620ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8728307Total
Program Services3880690ProgramServices
Management And General4847617ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3356429Total
Program Services2333515ProgramServices
Management And General1022914ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4821833Total
Program Services2985639ProgramServices
Management And General1836194ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total606542Total
Management And General606542ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total130020Total
Management And General130020ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1074736Total
Program Services1074736ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total16734939Total
Program Services15622460ProgramServices
Management And General1112479ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total971245Total
Management And General971245ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1915772Total
Program Services260029ProgramServices
Management And General1655743ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total27938Total
Program Services605ProgramServices
Management And General27333ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total24517Total
Program Services24517ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total1124453Total
Management And General1124453ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5226897Total
Program Services2400533ProgramServices
Management And General2826364ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1962588Total
Management And General1962588ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICE CAP.29142569275522801590289
HOSPITAL FEE1293970512939705
PROVISION FOR BAD DEBT98024859802485
OTHER PURCHASED SERVICE483914016612763177864
REPAIRS AND MAINTENANCE12996241299624

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1304138Total
Management And General1304138ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total145816444Total
Program Services87971997ProgramServices
Management And General57844447ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8773573BOY
EOY7612043EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY291522BOY
EOY440700EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY17169498BOY
EOY15024683EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2462695BOY
EOY2864002EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY436186BOY
EOY837614EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis124261164LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec74592803LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY48865314BOY
EOY49668361EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY84996BOY
EOY88597EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6105832BOY
EOY10761341EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY84189616BOY
EOY87297341EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY26842974BOY
EOY19800504EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6589675BOY
EOY10352622EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4230854BOY
EOY4394061EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY37663503BOY
EOY34547187EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY46184189BOY
EOY52430985EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY341924BOY
EOY319169EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY46526113BOY
EOY52750154EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY84189616BOY
EOY87297341EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6223428ReconcilationRevenueExpenses
Reconcilation Other Changes613ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$22,248OtherActivitiesAmount
Total Lobbying Expenditures IIB22248TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationBEVERLY COMMUNITY HOSPITAL ASSOCIATION SUPPORTS CERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN ITS 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 EXPENDITURES.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1398730OtherCostOrOtherBasis
Book Value1398730BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis82028405OtherCostOrOtherBasis
Depreciation47215865Depreciation
Book Value34812540BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis33153295OtherCostOrOtherBasis
Depreciation26877048Depreciation
Book Value6276247BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7680734OtherCostOrOtherBasis
Depreciation499890Depreciation
Book Value7180844BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings49668361TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATE5570075
INVESTMENT - CHIC298011
THIRD PARTY PAYOR RECEIVABLE4893255
FieldValueIRS element (for citing)
Total Book Value Other Assets10761341TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED SELF-INSURED LIABILITIES$2,843,113
BENEFICIAL INTEREST IN AFFILIATE$1,550,948
FieldValueIRS element (for citing)
Total Of Amounts4394061TotalOfAmounts
Total Revenue152039872TotalRevenue
Total Expenses145816444TotalExpenses
Excess Or Deficit For Year6223428ExcessOrDeficitForYear
Net Unrealized GL On Investments705NetUnrealizedGLOnInvestments
Other-$92OtherAmount
Total Adjustments613TotalAdjustments
Excess Or Deficit Per FS6224041ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt151872922TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments705NetUnrealizedGainsInvestments
Other Revenues98380OtherRevenues
Revenue Not Rptd F99099085RevenueNotRptdF990
Revenue Subtotal151773837RevenueSubtotal
Other Revenues Not Included266035OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt266035RevenueNotRptdOnFinStmt
Total Revenue Per Form990152039872TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt145626071TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal145626071ExpensesSubtotal
Other Expenses Not Included190373OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt190373ExpensesNotRptdOnFinStmt
Total Expenses Per Form990145816444TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE ORGANIZATION ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION (ASC) 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON JANUARY 1, 2009, WHICH HAD NO FINANCIAL STATEMENT IMPACT TO THE ORGANIZATION. 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.
PART XI, LINE 8 - OTHER ADJUSTMENTS:NET ASSET ADJUSTMENT - VARIANCE ON NET ASSET ROLLFORWARD -55. REVENUE ROUNDING ADJUSTMENT -37.
PART XII, LINE 2D - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTION 98,380.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BENEFICIAL INTEREST IN FOUNDATION RECLASSIFIED TO EXPENSES 190,373. CONTRIBUTION RECLASSIFIED FROM TEMPORARILY RESTRICTED NET ASSETS 75,625. REVENUE ROUNDING ADJUSTMENT 37.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:BENEFICIAL INTEREST IN FOUNDATION RECLASSIFIED FROM REVENUES 190,373.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage350.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent350XPcent350
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served177PersonsServed
Total Community Benefit Expense4076587TotalCommunityBenefitExpense
Net Community Benefit Expense4076587NetCommunityBenefitExpense
Percent Of Total Expense0.03000PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served999PersonsServed
Total Community Benefit Expense54594510TotalCommunityBenefitExpense
Direct Offsetting Revenue41646260DirectOffsettingRevenue
Net Community Benefit Expense12948250NetCommunityBenefitExpense
Percent Of Total Expense0.09520PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served1176PersonsServed
Total Community Benefit Expense58671097TotalCommunityBenefitExpense
Direct Offsetting Revenue41646260DirectOffsettingRevenue
Net Community Benefit Expense17024837NetCommunityBenefitExpense
Percent Of Total Expense0.12520PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs24NumberOfActivitiesOrPrograms
Persons Served20998PersonsServed
Total Community Benefit Expense2637794TotalCommunityBenefitExpense
Net Community Benefit Expense2637794NetCommunityBenefitExpense
Percent Of Total Expense0.01940PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs24NumberOfActivitiesOrPrograms
Persons Served20998PersonsServed
Total Community Benefit Expense2637794TotalCommunityBenefitExpense
Net Community Benefit Expense2637794NetCommunityBenefitExpense
Percent Of Total Expense0.01940PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs26NumberOfActivitiesOrPrograms
Persons Served22174PersonsServed
Total Community Benefit Expense61308891TotalCommunityBenefitExpense
Direct Offsetting Revenue41646260DirectOffsettingRevenue
Net Community Benefit Expense19662631NetCommunityBenefitExpense
Percent Of Total Expense0.14460PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs270NumberOfActivitiesOrPrograms
Persons Served4365PersonsServed
Total Community Building Expense183136TotalCommunityBuildingExpense
Net Community Building Expense183136NetCommunityBuildingExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served1186PersonsServed
Total Community Building Expense871705TotalCommunityBuildingExpense
Net Community Building Expense871705NetCommunityBuildingExpense
Percent Of Total Expense0.00640PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served3250PersonsServed
Total Community Building Expense117165TotalCommunityBuildingExpense
Net Community Building Expense117165NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs276NumberOfActivitiesOrPrograms
Persons Served8801PersonsServed
Total Community Building Expense1172006TotalCommunityBuildingExpense
Net Community Building Expense1172006NetCommunityBuildingExpense
Percent Of Total Expense0.00860PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$9,802,485BadDebtExpenseAmount
Amount Reimbursed By Medicare36618287AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare26609242CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall10009045MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1BEVERLY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1309 WEST BEVERLY BOULEVARDAddressLine1
CityMONTEBELLOCity
StateCAState
ZIP Code90640ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1BEVERLY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
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 $ 9802485.
PART II: 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: COLLECTION PRACTICES: 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 VI, LINE 2: BEVERLY HOSPITAL REVIEWS AND REAFFIRMS ITS MISSION STATEMENT TO ENSURE THAT ITS POLICIES INTEGRATE AND REFLECT THE PUBLIC INTEREST IN MEETING ITS RESPONSIBILITIES AS A NOT-FOR-PROFIT ORGANIZATION. THE HOSPITAL WILL COMPLETE AND UPDATE A NEEDS ASSESSMENT EVERY THREE YEARS BY EVALUATING THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. THE HOSPITAL ADOPTS AND FILES A COMMUNITY BENEFITS PLAN ANNUALLY, DOCUMENTING ACTIVITIES THAT THE HOSPITAL HAS UNDERTAKEN TO ADDRESS COMMUNITY NEEDS WITHIN ITS MISSION AND FINANCIAL CAPACITY; AND TO THE EXTENT PRACTICABLE, ASSIGN AND REPORT THE ECONOMIC VALUE OF COMMUNITY BENEFITS PROVIDED IN FURTHERANCE OF ITS PLAN.
PART VI, LINE 3: 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: 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 AREA'S 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 6: 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.
CAREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
GARY KIFF
29576000010499600010270041102601049960
WENDY BEESLEY
2159830002236100011200239464000
JUNE BELLING-SULLIVAN
170645000000010930171738000
ALEJANDRO CASASOLA
18873400000007930189527000
DISMUS IRUNGU
164996000000039810168977000
ARTURO DEVERA
163993000000035560167549000
CHARLENE CHU
1518000000000107730162573000
LOIS LONG
154061000000035310157592000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2BUSINESS RELATIONSHIP BETWEEN MICHAEL FELS AND PETER MARX.
FORM 990, PART VI, SECTION B, LINE 11A PUBLIC ACCOUNTING FIRM PREPARED THE FORM 990. IT IS REVIEWED AND APPROVED BY THE HOSPITAL CEO AND CFO. THE COMPLETED PAPER COPY OF FORM 990 IS REVIEWED BY ALL MEMBERS OF THE GOVERNING BOARD CONSISTING OF THE OFFICERS, BOARD COMMITTEE MEMBERS AND AGAIN BY HOSPITAL CEO AND CFO BEFORE IT IS FILED. THE COMPLETED FORM 990 IS REVIEWED IN ITS ENTIRETY.
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 12C
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 B, LINE 15
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 VI, SECTION C, LINE 19
HOURS PER WEEK DEVOTED BY MEMBER OF THE BOARDK. LAWRENCE COHEN, MD AND AZIZ KHAN, 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 VII, SECTION A, COLUMN B
HOURS PER WEEK DEVOTED BY INDIVIDUALSGARY V. KIFF, PRESIDENT & CEO DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 34 HRS BEVERLY HOSPITAL FOUNDATION 3 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 3 HRS AVERAGE HOURS PER WEEK 40 HRS MICHAEL ALMANZOR, VP FINANCE & CFO DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 37 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 3 HRS AVERAGE HOURS PER WEEK 40 HRS MICHAEL D. FELS, PH.D, CHAIRPERSON DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS BEVERLY HOSPITAL FOUNDATION 1 HR MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 5 HRS LYLA EDDINGTON, ED.D, 2ND VICE CHAIRPERSON DIVIDES HER TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS RENEE D. MARTINEZ, BOARD MEMBER DIVIDES HER TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS K. LAWRENCE COHEN, MD, BOARD MEMBER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS CARLOS MANUEL HARO, PH.D, TREASURER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS DENTON GUTHRIE, CPA, 1ST VICE CHAIRPERSON DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS AZIZ KHAN, MD, BOARD MEMBER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS BEVERLY HOSPITAL FOUNDATION 1 HR MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 5 HRS CHARLES LAWRENCE, BOARD MEMBER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS PETER J. MARX, ESQ, BOARD MEMBER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS ROSEMARIE OROZCO, SECRETARY DIVIDES HER TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS ANTHONY SOLANA, JR., ESQ., BOARD MEMBER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS ALMA PEREZ, BOARD MEMBER, DIVIDES HER TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRS DAVID I. CHAMBERS, BOARD MEMBER DIVIDES HIS TIME AS FOLLOWS: BEVERLY COMMUNITY HOSPITAL ASSOCIATION 2 HRS MONTEBELLO COMMUNITY HEALTH SERVICES, INC. 2 HRS AVERAGE HOURS PER WEEK 4 HRSFORM 990, PART VII, SECTION A, COLUMN B
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 705. NET ASSET ADJUSTMENT - VARIANCE ON NET ASSET ROLLFORWARD -55. REVENUE ROUNDING ADJUSTMENT -37. TOTAL TO FORM 990, PART XI, LINE 5: 613.FORM 990, PART XI, LINE 5:
SUPPLEMENTAL SCHEDULES TO AUDITED FINANCIAL STATEMENTSTHE 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, XII, & XIII.FORM 990, PART XII, LINE 2 & PART IV, LINE 12
AUDIT COMMITTEE AND OVERSIGHTTHIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.FORM 990, PART XII, LINE 2C
EXCESS OR (DEFICIT) FOR THE YEAR PER AUDITED FINANCIAL STATEMENTS AUDITED FINANCIAL STATEMENTS INCLUDE ONLY ROUNDED AMOUNTS (ROUNDED TO THE NEAREST HUNDRED DOLLARS). THIS RETURN HAS BEEN PREPARED USING THE ORGANIZATION'S TRIAL BALANCE, WHICH INCLUDES WHOLE DOLLAR AMOUNTS. THEREFORE, SCHEDULE D, PART XI, LINE 10 DOES NOT TIE TO THE EXCESS OR (DEFICIT) FOR THE YEAR PER THE AUDITED FINANCIAL STATEMENTS.SCHEDULE D, PART XI, LINE 10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
MONTEBELLO COMMUNITY HEALTH SERVICES INC
309 W BEVERLY BLVDMONTEBELLOCA90604953823550SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATIONCA501(C)(3)11BN/A0
BEVERLY HOSPITAL FOUNDATION
309 W BEVERLY BLVDMONTEBELLOCA90604237429685SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATIONCA501(C)(3)7N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MONTEBELLO COMMUNITY HEALTH SERVICES
D2706136FAIR VALUE
MONTEBELLO COMMUNITY HEALTH SERVICES
C2402000FAIR VALUE
BEVERLY HOSPITAL FOUNDATION
C211927FAIR VALUE
BEVERLY HOSPITAL FOUNDATION
D2863939FAIR VALUE