2020-07-14T18:04:57-05:00 2019-06-30 910189318 MOSS ADAMS LLP 2882 PROSPECT PARK DR STE 300 RANCHO CORDOVA CA 95670 990 2018-07-01 942437106 COMMUNITY MEDICAL CENTERS INC COMM 2093732800 7210 MURRAY DRIVE STOCKTON CA 95210 JAIME ALLEN CFO 2093732800 2020-07-14 1 TRACY S PAGLIA P00366884 9165038100 2020-07-14 174.50.160.196 2020-07-14 13:52:36 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 590998BD83A1AFC8298AB8E54118062D6841B7FE 2018 2020-09-23 17:36:50Z CHRISTINE NOGUERA 7210 MURRAY DRIVE STOCKTON CA 95210 76345196 0 X WWW.COMMUNITYMEDICALCENTERS.ORG X 1978 CA THE ORGANIZATION PROVIDES PRIMARY MEDICAL, BEHAVIOR HEALTH AND DENTAL CARE TO THE POPULATION OF SAN JOAQUIN, SOLANO, AND YOLO COUNTIES WITHOUT REGARD TO PATIENT'S ABILITY TO PAY. 10 10 983 20 0 0 11555124 13681357 55344560 62579070 44425 71992 7950 12777 66952059 76345196 0 0 0 0 42908209 50422364 11093 45697 45697 19101730 23423238 62021032 73891299 4931027 2453897 41469011 48286534 21339104 25702730 20129907 22583804 TO IMPROVE THE HEALTH AND QUALITY OF LIFE FOR MEMBERS OF THE COMMUNITY. 0 0 56247029 62579070 COMMUNITY MEDICAL CENTERS IS ONE OF THE LARGEST PROVIDERS OF HEALTH CARE SERVICES IN CENTRAL CALIFORNIA. WE OPERATE 22 FULL-TIME AND 4 SATELLITE CLINICS IN 3 CALIFORNIA COUNTIES. OUR CLINICIANS COMPLETE OVER 301,000 PATIENT ENCOUNTERS ANNUALLY, AND THE NUMBER INCREASES EACH YEAR. WE HAVE FULLY IMPLEMENTED AN INTEGRATED ELECTRONIC HEALTH RECORDS (EHR) SYSTEM IN ALL PRACTICES AT ALL SITES. WE ARE ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS, AND WE STRIVE TO BE THE PATIENT-CENTERED MEDICAL HOME FOR ALL FAMILY MEMBERS. WE OFFER AN EXTENSIVE ARRAY OF SERVICES TO ALL, REGARDLESS OF THEIR CIRCUMSTANCES. WE ALSO CONTINUE TO ADD NEW MEDICAL TECHNOLOGIES, RECRUIT OUTSTANDING PHYSICIANS IN NEW SPECIALTIES. 56247029 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 112 0 1 983 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X JAIME ALLEN 2093732851 7210 MURRAY DRIVE STOCKTON CA 95210 ROBERT C SMITH PRESIDENT 2.00 X X 0 0 0 MARTHA DUKES SECRETARY 2.00 X X 0 0 0 LILY AMAN VICE PRESIDENT 2.00 X X 0 0 0 JASMINE LEEK TREASURER 2.00 X X 0 0 0 ROGER I SPEED BOARD MEMBER 2.00 X 0 0 0 PAM MAFFEI BOARD MEMBER 2.00 X 0 0 0 RUBY KING BOARD MEMBER 2.00 X 0 0 0 PETER RAGSDALE BOARD MEMBER 2.00 X 0 0 0 MARTHA ROBLES BOARD MEMBER 2.00 X 0 0 0 JAIME MORRIS BOARD MEMBER 2.00 X 0 0 0 DOLORES BLACKMAN BOARD MEMBER (THRU 05/19) 2.00 X 0 0 0 ALMUS ALDRIDGE BOARD MEMBER (THRU 08/18) 2.00 X 0 0 0 CHRISTINE NOGUERA CHIEF EXECUTIVE OFFICER 40.00 X 289578 0 14301 JAIME ALLEN CHIEF FINANCIAL OFFICER 40.00 X 166597 0 12495 BENJAMIN MORRISON CHIEF MEDICAL OFFICER 40.00 X 341625 0 18876 PREETHI RAGHU CHIEF OPERATING OFFICER 40.00 X 132464 0 7496 MICAL CAYTON CHIEF INFORMATION OFFICER 40.00 X 163533 0 5177 GINGER MANNS CHIEF NURSING OFFICER 40.00 X 180626 0 7366 ARTHUR FEAGLES CHIEF FINANCIAL OFFICER (THRU 01/19) 40.00 X 233278 0 24692 CESAR PABUSTAN PEDIATRICIAN 40.00 X 727819 0 821 EARL MCOMBER PHYSICIAN, FP 40.00 X 325048 0 12838 ANDY ZHU PHYSICIAN 40.00 X 307362 0 13857 MANDEEP DHINDSA PHYSICIAN 40.00 X 288471 0 17040 SHALINI MADUGUNDI PHYSICIAN 40.00 X 284293 0 7508 3440694 0 142467 99 0 1 0 SAN JOAQUIN GENERAL HOSPITAL PO BOX 1439 FRENCH CAMP CA 95231 PROFESSIONAL MEDICAL SERVICES 1033625 LPM HEALTHCARE INC 1001 10TH COURT PALM BEACH GARDENS FL 33410 PROFESSIONAL MEDICAL SERVICES 758096 MERINO COMPUTER CONCEPTS 1822 W KETTLEMAN LN SUITE 4 LODI CA 95242 IT CONSULTING 634905 WMB ARCHITECTS 5757 PACIFIC AVENUE SUITE 226 STOCKTON CA 95207 PROFESSIONAL MEDICAL 439865 COMPHEALTH ASSOCIATES INC PO BOX 972651 DALLAS TX 75397 PROFESSIONAL MEDICAL SERVICES 356135 6 38000 12201131 1442226 18856 13681357 NET PATIENT SERVICE REVENUE 624100 51537030 51537030 PHARMACY REVENUE 446110 7858171 7858171 INCENTIVE/QI INCOME 624100 2548332 2548332 OTHER INCOME 900099 372037 372037 EHR INCENTIVE REVENUE 624100 263500 263500 62579070 71992 71992 6451 38000 0 6451 6451 MISCELLANEOUS INCOME 900099 6326 6326 6326 76345196 62579070 0 84769 3185228 2378253 806975 37807780 30659860 7147920 53494 29672 23822 6489829 5015414 1474415 2886033 2283018 603015 60645 60645 74206 74206 45697 45697 4832109 3069173 1762936 25175 16489 8686 1787088 794910 992178 857423 153198 704225 4409743 3859377 550366 468598 232491 236107 157494 128679 28815 309266 119366 189900 2999199 1615442 1383757 287770 185316 102454 MEDICAL SUPPLIES & DRUG 5577410 4818646 758764 MINOR EQUIPMENT 522886 417877 105009 RECRUITING 462147 304262 157885 LICENSES, DUES & SUBSCR 357619 64087 293532 234460 101499 132961 73891299 56247029 17598573 45697 67113 96580 2716026 3446988 2532442 2583388 11107832 6691495 35048 57898 683864 1251239 36248067 11705771 16294381 24542296 4498907 5616932 972222 3533398 3027496 41469011 48286534 12046196 12639141 613942 537611 1336537 711788 5205973 10619628 2136456 1194562 21339104 25702730 X 20129907 22583804 20129907 22583804 41469011 48286534 2453897 0 X 0 1 X 1 1 1 X 9460708 10631547 11180498 11555124 13681357 56509234 9460708 10631547 11180498 11555124 13681357 56509234 56509234 10412 10761 16786 43875 71992 153826 2708 6451 9159 5242 6326 11568 56683787 248105518 0.99690 0.99790 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2017 AMOUNT: $ 5,242. 2018 AMOUNT: $ 6,326. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5150426 5150426 8668084 2865208 5802876 8856096 1468229 7387867 12921098 7327130 5593968 652363 45204 607159 24542296 THIRD PARTY SETTLEMENTS - STATE 3027496 3027496 THIRD PARTY SETTLEMENT PAYABLE - STATE 1194562 1194562 76358269 13073 13073 76345196 0 76345196 73904372 13073 13073 73891299 0 73891299 X X 1 JOAN KAMROWSKI 1660 ELWOOD DRIVE LOS GATOS CA 95032 GRANT WRITER 0 0 45697 -45697 45697 -45697 SPONSORSHIP & TICKET SALES 44451 38000 6451 44451 38000 6451 6451 X X X X 0 0 0 0 0 0 0 1 0 CHRISTINE NOGUERA CHIEF EXECUTIVE OFFICER 261414 0 15000 0 13164 0 7708 0 6593 0 303879 0 0 0 JAIME ALLEN CHIEF FINANCIAL OFFICER 165066 0 1531 0 0 0 2476 0 10019 0 179092 0 0 0 BENJAMIN MORRISON CHIEF MEDICAL OFFICER 309515 0 0 0 32110 0 9060 0 9816 0 360501 0 0 0 MICAL CAYTON CHIEF INFORMATION OFFICER 163533 0 0 0 0 0 64 0 5113 0 168710 0 0 0 GINGER MANNS CHIEF NURSING OFFICER 178328 0 0 0 2298 0 4577 0 2789 0 187992 0 0 0 ARTHUR FEAGLES CHIEF FINANCIAL OFFICER (THRU 01/19) 213047 0 0 0 20231 0 0 0 24692 0 257970 0 0 0 CESAR PABUSTAN PEDIATRICIAN 209327 0 474069 0 44423 0 0 0 821 0 728640 0 0 0 EARL MCOMBER PHYSICIAN, FP 254165 0 19429 0 51454 0 7624 0 5214 0 337886 0 0 0 ANDY ZHU PHYSICIAN 264999 0 10931 0 31432 0 7852 0 6005 0 321219 0 0 0 MANDEEP DHINDSA PHYSICIAN 230938 0 3379 0 54154 0 7140 0 9900 0 305511 0 0 0 SHALINI MADUGUNDI PHYSICIAN 246757 0 20378 0 17158 0 6992 0 516 0 291801 0 0 0 PART I, LINE 7 NON-FIXED PAYMENTS: COMMUNITY MEDICAL CENTERS INC. PAID INCENTIVE AWARDS TO PROVIDERS. PROVIDERS ARE ELIGIBLE TO RECEIVE TWO TYPES OF INCENTIVE AWARDS. THE FIRST IS QUALITY INCENTIVE, WHICH IS PAID FOR REACHING GOALS ESTABLISHED BY THE ORGANIZATION. THE SECOND INCENTIVE IS FOR PRODUCTIVITY, BASED ON BILLED ENCOUNTERS. THE SPECIFIC EXPECTATION IS SET BY PRACTICE SPECIALTY, ADJUSTED FOR EXPECTED SCHEDULE TIME, AND FOR TIME ALLOCATED FOR ADMINISTRATIVE DUTIES AND COMMUNITY INVOLVEMENT ON BEHALF OF THE ORGANIZATION. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033FVU1 2005-04-12 3220000 REDEEM 1994 SERIES B BONDS 0 0 0 A 3220000 2948679 63125 208196 2005 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/12/2013 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED INTERNALLY BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S LEGAL COUNSEL HAS PROVIDED ASSISTANCE TO THE BOARD TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST AND THE ORGANIZATION'S BY LAWS. WHEN CONFLICT OF INTEREST ISSUES ARISE, THE BOARD OF DIRECTORS WITH THE DIRECTOR OF THEIR LEGAL COUNSEL ADDRESSES THE ISSUES ACCORDINGLY. THE BOARD HAS BEEN MADE AWARE OF THE CONFLICT OF INTEREST REQUIREMENTS BY THEIR LEGAL COUNSEL. NO DIRECTOR, OFFICER, EMPLOYEE OR AGENT SHALL PARTICIPATE IN THE SELECTION, AWARD OR ADMINISTRATION OF ANY CONTRACT OR OTHER AFFILIATION RELATING TO OPERATIONS CONDUCTED BY THE CORPORATION OR FOR THE FURNISHING OF SERVICES OR SUPPLIES TO THE CORPORATION, IN WHICH HE OR SHE OR HIS/HER IMMEDIATE FAMILY OR BUSINESS PARTNER HAS A REAL OR POTENTIAL CONFLICT OF INTEREST OR INVOLVING AN ORGANIZATION WITH WHOM HE OR SHE IS NEGOTIATING OR HAS ANY ARRANGEMENT CONCERNING EMPLOYMENT. IF A CONTRACT OR AFFILIATION EXISTS, IT MAY BE APPROVED OR AUTHORIZED BY A MAJORITY OF THE DISINTERESTED DIRECTORS. IF THE FACTS OF ANY SUCH INTEREST BY A DIRECTOR SHALL HAVE BEEN DISCLOSED TO THE BOARD BY THE INTERESTED DIRECTOR SUCH INTERESTED DIRECTOR ABSTAINS FROM VOTING IN THAT REGARD. FORM 990, PART VI, SECTION B, LINE 15 INDUSTRY COMPENSATION SURVEYS FOR LIKE ORGANIZATIONS IN SIMILAR GEOGRAPHIC AREAS ARE REVIEWED BY THE BOARD AND THE CEO TO DETERMINE KEY EMPLOYEE COMPENSATION. THE LAST REVIEW WAS DONE IN 2019. THE BOARD OF DIRECTORS ESTABLISHED THE CEO'S SALARY. SIMILAR METHODOLOGIES WERE USED TO DETERMINE THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. THREE REVIEWS WERE DONE. ONE WAS PERFORMED BY CORPORATE COUNSEL, ONE WAS COMPLETED BY THE HUMAN RESOURCES DEPARTMENT, AND ONE WAS CONTRACTED BY THE BOARD TO BE DONE BY A HEALTH CARE CONSULTING AGENCY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST TO THE ADMINISTRATIVE OFFICES.