2024-11-15T11:29:03-06:00 2023-12-31 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2023-01-01 953766170 COMMUNITY HEALTH GROUP COMM 6194220422 2420 FENTON STREET 100 CHULA VISTA CA 91914 SCOTT CARROLL CHIEF FINANCIAL OFFICER 6194220422 2024-11-15 1 0 LAUREN A HAVERLOCK P00545829 8185771900 2024-11-14 2023 2024-10-15 13:58:12Z NORMA DIAZ 2420 FENTON STREET 100 CHULA VISTA CA 91914 162552714 0 X WWW.CHGSD.COM X 1982 CA COMMUNITY HEALTH GROUP IS DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF OUR MEMBERS BY PROVIDING ACCESS TO QUALITY CARE AND OFFERING EXCEPTIONAL SERVICE TO DIVERSE POPULATIONS. 8 8 521 0 0 0 0 0 133734810 145128764 239459 1111726 13987742 15262756 147962011 161503246 0 0 0 0 10415962 12478445 0 0 0 124138159 147533046 134554121 160011491 13407890 1491755 104636790 110029532 32624800 36527455 72011990 73502077 COMMUNITY HEALTH GROUP IS DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF OUR MEMBERS BY PROVIDING ACCESS TO QUALITY CARE AND OFFERING EXCEPTIONAL SERVICE TO DIVERSE POPULATIONS. 0 0 145829334 0 145128764 TO ARRANGE FOR, MAKE AVAILABLE, AND ASSUME FINANCIAL RISK FOR THE PROVISION OF HEALTH CARE SERVICES TO ENROLLED MEMBERS ELIGIBLE FOR MEDICARE AND MEDI-CAL IN SAN DIEGO COUNTY UNDER THE DUAL DEMONSTRATION CAL MEDICONNECT PROGRAM. 145829334 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 1 2388 0 1 521 1 0 0 0 0 0 0 0 0 X 8 8 1 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X SCOTT CARROLL 6194986591 2420 FENTON STREET SUITE 100 CHULA VISTA CA 91914 ALBERT VITELA CHAIRMAN OF THE BOARD OF DIRECTORS 1.00 3.00 X X 45035 0 0 CARLOS CESENA VICE CHAIRMAN OF THE BOARD OF DIRECTORS 1.00 3.00 X X 33850 0 0 CARLOTA SALAS SECRETARY OF THE BOARD OF DIRECTORS 1.00 3.00 X X 29600 0 0 JONATHAN BALL BOARD MEMBER 1.00 3.00 X 29550 0 0 TITO CALSADA BOARD MEMBER 1.00 3.00 X 30950 0 0 DOMENIC D'ALESSIO BOARD MEMBER 1.00 3.00 X 32075 0 0 JOSE LUIS VALDIVIA BOARD MEMBER 1.00 3.00 X 34350 0 0 RENEE L RAMOS BOARD MEMBER 1.00 3.00 X 27850 0 0 NORMA DIAZ CHIEF EXECUTIVE OFFICER 2.00 38.00 X 985802 0 49254 SCOTT CARROLL CHIEF FINANCIAL OFFICER 3.00 37.00 X 428410 0 31757 JOSEPH GARCIA CHIEF OPERATING OFFICER 2.00 38.00 X 828700 0 0 PATRICK TELLEZ CHIEF MEDICAL OFFICER 20.00 20.00 X 396835 0 1085 ANN WARREN ASSOCIATE CHIEF EXECUTIVE OFFICER 24.00 16.00 X 456476 0 38701 ALLAN SOMBILLO CHIEF INFORMATION OFFICER 20.00 20.00 X 339711 0 22110 ALAN CONRAD CHIEF MEDICAL OFFICER 20.00 20.00 X 355802 0 40592 ALEJANDRO HINOJOSA-VALENCIA IHA PHYSICIAN 20.00 20.00 X 496239 0 30483 YOUSAF FAROOK SENIOR DIRECTOR OF HEALTH CARE SERVICES 20.00 20.00 X 246247 0 35988 FRANCISCA CHAVEZ SENIOR DIRECTOR OF OPERATIONS 2.00 38.00 X 242924 0 18993 NOREEN KOIZUMI DIRECTOR OF CORPORATE QUALITY 20.00 20.00 X 242567 0 49836 HEIDI ARNDT SENIOR COMPLIANCE OFFICER 24.00 16.00 X 286074 0 34135 5569047 0 352934 93 0 1 0 MEDIMPACT HEALTHCARE SYSTEMS INC 10680 TREENA STREET SAN DIEGO CA 92131 PHARMACY SERVICES 52521467 UCSD MEDICAL CENTER 9300 CAMPUS POINT DR LA JOLLA CA 92037 MEDICAL/HEALTHCARE SERVICES 13759788 GREEN HOSPITAL OF SCRIPPS CLINIC PO BOX 2469 LA JOLLA CA 92038 MEDICAL/HEALTHCARE SERVICES 7364301 GROSSMONT HOSPITAL CORPORATION FILE 55484 LOS ANGELES CA 90074 MEDICAL/HEALTHCARE SERVICES 6568356 SHARP CHULA VISTA MEDICAL CENTER FILE 55453 LOS ANGELES CA 90074 MEDICAL/HEALTHCARE SERVICES 5629834 175 CAL MEDICONNECT REVENU 524114 145128764 145128764 145128764 1111194 1111194 1050000 1049468 532 532 532 ADMINISTRATIVE FEE FRO 561000 15262756 15262756 15262756 161503246 145128764 0 16374482 X 1192229 607677 584552 9017652 4596280 4421372 310613 158319 152294 1214760 666770 547990 743191 378803 364388 22266 22266 91144 91144 137982027 135770190 2211837 28940 28940 1776613 1776613 3202465 3202465 28077 28077 187343 187343 6802 6802 24366 24366 111936 111936 REINSURANCE 3651295 3651295 EMPLOYEE TRAINING AND P 55969 55969 DUES & SUBSCRIPTIONS 44844 44844 TAXES, LICENSES, & FEES 40927 40927 278032 278032 160011491 145829334 14182157 0 8723467 1875958 39592286 27632728 44096301 45783541 1699966 2035426 15152141 11552396 1427207 3599745 1040820 28540880 8056743 561254 104636790 110029532 24489117 29548055 7770194 6605984 365489 373416 32624800 36527455 X 72011990 73502077 72011990 73502077 104636790 110029532 X 1491755 224084 -71756 -153996 X 0 1 X 1 0 0 1 X 8129983 6191148 1938835 7022158 5361248 1660910 3599745 PAYABLE TO THE STATE OF CALIFORNIA 354286 OTHER MISCELLANEOUS LIABILITIES 19130 373416 X PART IV, LINE 2B: AT 12/31/23 COMMUNITY HEALTH GROUP IS HOLDING $6,605,984 OF FUNDS ON BEHALF OF CHG FOUNDATION. SUCH FUNDS ARE HELD AS DEPOSITS/ADVANCE FUNDING FOR CLAIMS PAYMENTS TO BE MADE BY COMMUNITY HEALTH GROUP ON BEHALF OF CHG FOUNDATION. PART X, LINE 2: CHG AND CHG FOUNDATION ARE NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATIONS, ORGANIZED UNDER THE NOT-FOR-PROFIT PUBLIC BENEFIT LAWS OF CALIFORNIA, AND EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE (THE "CODE") SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTIONS 501(C)(4) AND 501(C)(3), RESPECTIVELY, OF THE CODE. BOTH ORGANIZATIONS ARE EXEMPT FROM STATE TAXES UNDER THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D). ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. MANAGEMENT HAS EVALUATED THE TAX POSITIONS OF CHG AND CHG FOUNDATION AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED ARE RELATED TO CHG'S AND CHG FOUNDATION'S CONTINUED QUALIFICATION AS TAX-EXEMPT ORGANIZATIONS AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED THAT WOULD BE TAXABLE. MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT ALL INCOME TAX POSITIONS WILL BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION. THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2023 AND 2022. CHG AND CHG FOUNDATION FILE INFORMATION RETURNS IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 NORMA DIAZ CHIEF EXECUTIVE OFFICER 855733 0 75874 0 54195 0 8400 0 40854 0 1035056 0 0 0 JOSEPH GARCIA CHIEF OPERATING OFFICER 828700 0 0 0 0 0 0 0 0 0 828700 0 0 0 ALEJANDRO HINOJOSA-VALENCIA IHA PHYSICIAN 486548 0 3129 0 6562 0 5252 0 25231 0 526722 0 0 0 ANN WARREN ASSOCIATE CHIEF EXECUTIVE OFFICER 383408 0 29139 0 43929 0 8400 0 30301 0 495177 0 0 0 SCOTT CARROLL CHIEF FINANCIAL OFFICER 349765 0 21828 0 56817 0 8400 0 23357 0 460167 0 0 0 PATRICK TELLEZ CHIEF MEDICAL OFFICER 322801 0 20002 0 54032 0 0 0 1085 0 397920 0 0 0 ALAN CONRAD CHIEF MEDICAL OFFICER 354538 0 1264 0 0 0 0 0 40592 0 396394 0 0 0 ALLAN SOMBILLO CHIEF INFORMATION OFFICER 314321 0 21100 0 4290 0 7716 0 14394 0 361821 0 0 0 HEIDI ARNDT SENIOR COMPLIANCE OFFICER 272698 0 12686 0 690 0 7605 0 26530 0 320209 0 0 0 NOREEN KOIZUMI DIRECTOR OF CORPORATE QUALITY 207584 0 25192 0 9791 0 6006 0 43830 0 292403 0 0 0 YOUSAF FAROOK SENIOR DIRECTOR OF HEALTH CARE SERVI 223205 0 22592 0 450 0 5480 0 30508 0 282235 0 0 0 FRANCISCA CHAVEZ SENIOR DIRECTOR OF OPERATIONS 219452 0 21492 0 1980 0 0 0 18993 0 261917 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDED TAXABLE GYM REIMBURSEMENTS TO NORMA DIAZ AND NOREEN KOIZUMI. PART I, LINE 7 THE ORGANIZATION PROVIDED THE FOLLOWING TYPES OF NON-FIXED PAYMENTS IN 2023: VACATION CASHOUT PAYMENTS, DISCRETIONARY BONUSES, TAXABLE GYM REIMBURSEMENTS AND GIFT CARDS. JOSEPH GARCIA FAMILY MEMBER OF OFFICER 828700 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 2 NORMA DIAZ AND JOSEPH A. GARCIA HAVE A FAMILY RELATIONSHIP (SPOUSES). FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENGAGED WITH JOSEPH A. GARCIA, A CONSULTANT WITH J.A.G CONSULTING, LLC (SINGLE-MEMBER LLC, WHERE JOSEPH A. GARCIA IS THE SOLE MANAGER) TO FULFILL THE DUTIES OF CHIEF OPERATING OFFICER. COMPENSATION PAID TO J.A.G CONSULTING, LLC IN 2023 IN RELATION TO THESE DUTIES WAS $828,700. FORM 990, PART VI, SECTION B, LINE 11B MOSS ADAMS, LLP IS ENGAGED TO PREPARE AND COMPLETE THE FORM 990 ON BEHALF OF COMMUNITY HEALTH GROUP. THE FORM 990 IS PREPARED UNDER THE DIRECTION, REVIEW, AND OVERSIGHT OF COMMUNITY HEALTH GROUP'S FINANCE DEPARTMENT, AND EXECUTIVE MANAGEMENT TEAM. THE FORM 990 IS REVIEWED IN DETAIL BY THE CHIEF FINANCIAL OFFICER OF COMMUNITY HEALTH GROUP WHO APPROVES THE FINAL VERSION FOR FILING WITH MOSS ADAMS, LLP. COMMUNITY HEALTH GROUP'S BOARD OF DIRECTORS RELIES ON THE EXPERTISE OF INTERNAL MANAGEMENT AND MOSS ADAMS, LLP FOR THE ACCURATE AND TIMELY FILING OF FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE COMMUNITY HEALTH GROUP BOARD OF DIRECTORS AND EXECUTIVE MANAGEMENT TEAM RECEIVE A REFRESHER TRAINING (CONDUCTED BY OUTSIDE LEGAL COUNSEL) ON THE IMPORTANCE OF IDENTIFYING ANY CONFLICTS OF INTEREST; THE DISCLOSURE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST IS AN INTEGRAL PART OF THE CULTURE AT COMMUNITY HEALTH GROUP. ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE REPORTED TO THE COMPANY'S COMPLIANCE OFFICER FOR INVESTIGATION AND FOLLOW-UP. IN THE EVENT OF ANY CONFLICTS OF INTEREST, THE BOARD OF DIRECTORS WILL DETERMINE WHAT RESTRICTIONS, IF ANY, WILL BE IMPOSED ON THE PERSON(S) WITH THE CONFLICT; AND SUCH PERSON(S) WILL RECUSE THEMSELVES FROM PARTICIPATING IN ANY DELIBERATIONS AND DECISIONS OF THE BOARD OF DIRECTORS REGARDING MATTERS INVOLVING THE POTENTIAL CONFLICT OF INTEREST, UNLESS OTHERWISE PERMITTED OR AUTHORIZED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 A SALARY ANALYSIS IS PREPARED BY AN UNRELATED THIRD-PARTY COMPENSATION CONSULTANT. AN EVALUATION COMMITTEE, CONSISTING OF THE CHAIRMAN OF THE BOARD OF DIRECTORS AND FOUR ADDITIONAL BOARD MEMBERS REVIEWS THIS ANALYSIS AND MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS REGARDING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION. THE BOARD OF DIRECTORS MAKES THE FINAL DECISIONS REGARDING COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. THIS ANALYSIS IS PERFORMED ANNUALLY IN DECEMBER. SALARY ANALYSES FOR ALL POSITIONS ON THE COMPANY'S EXECUTIVE MANAGEMENT TEAM (EXCEPT FOR THE CHIEF EXECUTIVE OFFICER POSITION, FOR WHICH THE PROCESS OF DETERMINING COMPENSATION IS PREVIOUSLY DESCRIBED HEREIN), AND CERTAIN OTHER MANAGERIAL POSITIONS ARE PREPARED BY AN UNRELATED THIRD-PARTY COMPENSATION CONSULTANT. RESULTS OF THESE ANALYSES ARE PRESENTED TO THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT, WHO THEN MAKES SALARY RECOMMENDATIONS TO THE CHIEF EXECUTIVE OFFICER FOR FINAL APPROVAL. THE CHIEF EXECUTIVE OFFICER MAKES THE FINAL DECISIONS REGARDING COMPENSATION OF THE PERSONS FILLING THESE POSITIONS. THE CHIEF EXECUTIVE OFFICER DOES NOT PARTICIPATE IN NOR HAVE DECISION MAKING AUTHORITY REGARDING THE COMPENSATION ARRANGEMENT BETWEEN THE ORGANIZATION AND J.A.G. CONSULTING, LLC (SINGLE-MEMBER LLC, WHERE JOSEPH A. GARCIA IS THE SOLE MANAGER), DUE TO THE FAMILY RELATIONSHIP THAT EXISTS BETWEEN THE CHIEF EXECUTIVE OFFICER (NORMA DIAZ) AND JOSEPH A. GARCIA, AS PREVIOUSLY DESCRIBED IN SCHEDULE O. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDE THE CONSOLIDATED RESULTS OF COMMUNITY HEALTH GROUP AND CHG FOUNDATION ARE AVAILABLE TO THE GENERAL PUBLIC ON THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE WEBSITE (DMHC.CA.GOV). THE ORGANIZATION'S GOVERNING DOCUMENTS ARE ON FILE WITH THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE AND CAN BE OBTAINED VIA REQUEST UNDER THE CALIFORNIA PUBLIC RECORDS ACT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART IX, LINE 11G HEALTH CARE EXPENSES: PROGRAM SERVICE EXPENSES 120,387,344. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120,387,344. PHARMACY EXPENSES: PROGRAM SERVICE EXPENSES 15,382,846. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,382,846. CONSULTING AND TEMP SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,211,837. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,211,837. FORM 990, PART XI, LINE 9: GRANTS RECORDED ON CHG BOOKS BUT REPORTED ON CHG FOUNDATION FORM 990 -153,996. PART V, LINE 1A & 2A: COMMUNITY HEALTH GROUP AND CHG FOUNDATION SHARE JOINT COSTS FOR EMPLOYEES AND INDEPENDENT CONTRACTORS. AS SUCH, THE NUMBER OF EMPLOYEES AND INDEPENDENT CONTRACTORS REPORTED IS THE SAME FOR BOTH ORGANIZATIONS. CHG FOUNDATION 2420 FENTON STREET SUITE 100 CHULA VISTA CA 91914 330586911 HEALTH CARE SERVICES CA 501(C)(3) LINE 10 COMMUNITY HEALTH GROUP 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 CHG FOUNDATION O 29344361 BOOK VALUE CHG FOUNDATION Q 1251473761 BOOK VALUE CHG FOUNDATION R 1164210 BOOK VALUE CHG FOUNDATION L 15262756 BOOK VALUE PART V, SECTION 2, LINES 1 TO 4: FOR A FEE, COMMUNITY HEALTH GROUP PROVIDES ADMINISTRATIVE SERVICES AND SUPPORT TO CHG FOUNDATION UNDER THE TERMS OF AN ADMINISTRATIVE SERVICES AGREEMENT. THE SERVICES PROVIDED INCLUDE, BUT ARE NOT LIMITED TO: MEDICAL MANAGEMENT, CLAIMS PROCESSING AND PAYMENT, INFORMATION SYSTEMS, LEGAL, PLANNING, INSURANCE, ACCOUNTING SERVICES, AND OTHER SERVICES AS DEFINED IN THE AGREEMENT. ALL EMPLOYEES PERFORMING WORK ON BEHALF OF CHG FOUNDATION IN ACCORDANCE WITH THE ADMINISTRATIVE SERVICES AGREEMENT ARE COMPENSATED AND PAID BY COMMUNITY HEALTH GROUP (PARENT), WHO ALSO ACTS AS THE COMMON PAYMASTER. COMPENSATION IS ALLOCATED TO CHG FOUNDATION FROM COMMUNITY HEALTH GROUP, AND THIS ALLOCATED COMPENSATION IS REPORTED ON CHG FOUNDATION'S FORM 990, PART IX, LINES 5-10. SUCH AMOUNTS ARE REPORTED ON LINE 1 OF THIS SCHEDULE R, PART V, SECTION 2. LINE 2 OF THIS SCHEDULE R, PART V, SECTION 2 IS PRIMARILY COMPRISED OF REIMBURSEMENTS OF HEALTH CARE EXPENSES AND PHARMACY EXPENSES (CLAIMS PAYMENTS), PAID BY COMMUNITY HEALTH GROUP ON BEHALF OF CHG FOUNDATION, AS WELL AS REIMBURSEMENT OF COMPENSATION AND OTHER ADMINISTRATIVE EXPENSES ALLOCATED TO CHG FOUNDATION IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE AFOREMENTIONED ADMINISTRATIVE SERVICES AGREEMENT. LINE 3 OF THIS SCHEDULE R, PART V, SECTION 2 REFLECTS THE NET AMOUNT OF 1,164,210 THAT WAS TRANSFERRED TO CHG FOUNDATION FROM COMMUNITY HEALTH GROUP AS A RETURN OF FUNDS TO CHG FOUNDATION THAT COMMUNITY HEALTH GROUP WAS HOLDING ON BEHALF OF CHG FOUNDATION. IN THE NORMAL COURSE OF BUSINESS, FUNDS ARE BEING HELD BY COMMUNITY HEALTH GROUP ON BEHALF OF CHG FOUNDATION ON A SHORT-TERM BASIS SO THAT SUCH FUNDS ARE AVAILABLE FOR FUNDING CERTAIN OBLIGATIONS OF CHG FOUNDATION THAT WILL BE PAID BY COMMUNITY HEALTH GROUP IN ACCORDANCE WITH THE ADMINISTRATIVE SERVICES AGREEMENT. COMMUNITY HEALTH GROUP HOLDS THESE FUNDS IN CUSTODY OF CHG FOUNDATION AND MAINTAINS A SEPARATE ACCOUNTING OF THESE FUNDS (AS WELL AS ALL INTEREST EARNED ON SUCH FUNDS) WHILE THEY ARE IN POSSESSION OF COMMUNITY HEALTH GROUP. LINE 4 OF THIS SCHEDULE R, PART V, SECTION 2 REPRESENTS FEES FOR THE ADMINISTRATIVE SERVICES AND SUPPORT THAT COMMUNITY HEALTH GROUP PROVIDES TO CHG FOUNDATION IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE ADMINISTRATIVE SERVICES AGREEMENT IN EFFECT BETWEEN THE TWO ORGANIZATIONS.