2025-11-14T17:24:00-06:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2024-01-01 330586911 CHG FOUNDATION CHGF 6194220422 2420 FENTON STREET 100 CHULA VISTA CA 91914 SCOTT CARROLL CHIEF FINANCIAL OFFICER 6194220422 2025-11-13 1 1 LAUREN A HAVERLOCK P00545829 8185771900 2025-11-13 2024 2025-03-06 01:10:19Z COMMUNITY HEALTH GROUP PARTNERSHIP PLAN SCOTT CARROLL 2420 FENTON STREET 100 CHULA VISTA CA 91914 1837429828 0 X WWW.CHGSD.COM X 1994 CA CHG FOUNDATION 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 8 569 0 0 0 0 0 1500555965 1790894136 29313041 46535692 493515 0 1530362521 1837429828 592022 849392 0 0 29344361 32999806 0 0 0 1221691374 1594327133 1251627757 1628176331 278734764 209253497 1446221312 1718361471 603890653 679646954 842330659 1038714517 CHG FOUNDATION 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 1554986772 849392 1790894136 TO ARRANGE FOR, MAKE AVAILABLE, AND ASSUME FINANCIAL RISK FOR THE PROVISION OF HEALTH CARE SERVICES TO ENROLLED MEMBERS ELIGIBLE FOR MEDI-CAL IN SAN DIEGO COUNTY UNDER THE CALIFORNIA MEDI-CAL PREPAID HEALTH PLAN PROGRAM. 1554986772 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 1 2622 0 1 569 1 0 0 0 0 0 0 0 0 0 0 1 0 X 8 8 1 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 CA X SCOTT CARROLL 6194986591 2420 FENTON STREET SUITE 100 CHULA VISTA CA 91914 ALBERT VITELA CHAIRMAN OF THE BOARD OF DIRECTORS 3.00 1.00 X X 0 53079 0 CARLOS CESENA VICE CHAIRMAN OF THE BOARD OF DIRECTORS 3.00 1.00 X X 0 40550 0 CARLOTA SALAS SECRETARY OF THE BOARD OF DIRECTORS 3.00 1.00 X X 0 37945 0 JONATHAN BALL BOARD MEMBER 3.00 1.00 X 0 30921 0 TITO CALSADA BOARD MEMBER 3.00 1.00 X 0 33175 0 DOMENIC D'ALESSIO BOARD MEMBER 3.00 1.00 X 0 35341 0 JOSE LUIS VALDIVIA BOARD MEMBER 3.00 1.00 X 0 38094 0 RENEE L RAMOS BOARD MEMBER 3.00 1.00 X 0 33979 0 NORMA DIAZ CHIEF EXECUTIVE OFFICER 38.00 2.00 X 0 1114503 56354 SCOTT CARROLL CHIEF FINANCIAL OFFICER 37.00 3.00 X 0 425892 31124 JOSEPH GARCIA CHIEF OPERATING OFFICER 38.00 2.00 X 0 827200 0 ALAN CONRAD CHIEF MEDICAL OFFICER 20.00 20.00 X 0 497267 20448 ANN WARREN ASSOCIATE CHIEF EXECUTIVE OFFICER 16.00 24.00 X 0 460248 32419 ALLAN SOMBILLO CHIEF INFORMATION OFFICER 20.00 20.00 X 0 336997 31291 ALEJANDRO HINOJOSA-VALENCIA IHA PHYSICIAN 20.00 20.00 X 0 416660 58520 YOUSAF FAROOK SENIOR DIRECTOR OF HEALTH CARE SERVICES 20.00 20.00 X 0 230530 55915 FRANCISCA CHAVEZ SENIOR DIRECTOR OF OPERATIONS 38.00 2.00 X 0 223704 53964 NOREEN KOIZUMI DIRECTOR OF CORPORATE QUALITY 20.00 20.00 X 0 245862 43709 HEIDI ARNDT SENIOR COMPLIANCE OFFICER 16.00 24.00 X 0 322703 43721 0 5404650 427465 0 0 1 0 UCSD MEDICAL CENTER 9300 CAMPUS POINT DR LA JOLLA CA 920378275 PHARMACY SERVICES 177707150 GREEN HOSPITAL OF SCRIPPS CLINIC PO BOX 2469 LA JOLLA CA 920382469 MEDICAL/HEALTHCARE SERVICES 89014924 GROSSMONT HOSPITAL CORPORATION FILE 55484 LOS ANGELES CA 900745484 MEDICAL/HEALTHCARE SERVICES 73838888 SHARP CHULA VISTA MEDICAL CENTER PO BOX 556630 LOS ANGELES CA 900746630 MEDICAL/HEALTHCARE SERVICES 64904154 PALOMAR HEALTH PO BOX 748698 LOS ANGELES CA 900748698 MEDICAL/HEALTHCARE SERVICES 61093024 649 MEDI-CAL PREMIUMS 524114 1790894136 1790894136 1790894136 46535692 46535692 1837429828 1790894136 0 46535692 X 658392 658392 191000 191000 3201309 877755 2323554 22376660 6135372 16241288 1090599 299027 791572 4415880 1210774 3205106 1915358 525165 1390193 17174116 17174116 352312 352312 789057 789057 1538818009 1533945398 4872611 230634 230634 6413919 6413919 7397830 7397830 1959848 1959848 1624944 1624944 138957 138957 2954761 2954761 1487793 1487793 REINSURANCE 11143889 11143889 TAXES, LICENSES, & FEES 1316665 1316665 EMPLOYEE TRAINING AND P 792715 792715 DUES & SUBSCRIPTIONS 440914 440914 1290770 1290770 1628176331 1554986772 73189559 0 9568133 2468119 914894641 1294258329 492988242 393128121 7649660 2762855 21780938 8992415 11964133 12788523 9156503 12955524 1446221312 1718361471 172375475 156498599 431515178 523148355 603890653 679646954 X 842330659 1038714517 842330659 1038714517 1446221312 1718361471 X 209253497 -12869639 X 0 1 X 1 0 X 5000 5000 974217788 1195859294 1226812699 1500555965 1790894136 6688339882 974222788 1195859294 1226812699 1500555965 1790894136 6688344882 0 0 0 6688344882 3199838 1255304 7004224 29313041 46535692 87308099 3199838 1255304 7004224 29313041 46535692 87308099 856173 3022623 13882146 493515 18254457 978278799 1200137221 1247699069 1530362521 1837429828 6793907438 0.98450 0.98780 0.01290 0.00890 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 856,173. 2021 AMOUNT: $ 3,022,623. 2022 AMOUNT: $ 13,882,146. 2023 AMOUNT: $ 493,515. 2024 AMOUNT: $ 0. 2256951 111168 2368119 2165153 91798 2256951 2173843 7800 16490 2165153 2176530 100081 4584 67791 39561 2173843 2119104 206540 4986 154100 2176530 1.00000 0.00000 0.00000 0 0 3500000 3500000 18044358 8797934 9246424 130907 130907 0 105673 63574 42099 12788523 ACCRUED MEDICAL LOSS RATIO (MLR) RISK CORRIDOR LIABILITIES 21576200 HOSPITAL DIRECTED PAYMENTS PAYABLE 111534411 MANAGED CARE ORGANIZATION TAX PAYABLE 377093750 ACCRUED PROVIDER INCENTIVES 12943994 523148355 X 1837429828 0 1837429828 0 1837429828 1641045970 12910183 12910183 1628135787 40544 40544 1628176331 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION, 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 AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. THE ORGANIZATION IS 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 THE ORGANIZATION 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 THE ORGANIZATION'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION 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, 2024 AND 2023. THE ORGANIZATION FILES INFORMATION RETURNS IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. PART XII, LINE 2D - OTHER ADJUSTMENTS: ACCRUED COMMUNITY REINVESTMENT OBLIGATION 12,910,183. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS RECORDED ON CHG BOOKS BUT REPORTED ON CHG FOUNDATION FORM 990 40,544. 1 LIFELINE COMMUNITY SERVICES 200 MICHIGAN AVENUE VISTA CA 92084 952794253 501(C)(3) 79300 0 COMMUNITY REINVESTMENT, VIVA LA VIDA! RAISE THE PADDLE - 10/2/24, VIVA LA VIDA! - 09/27/24 CHULA VISTA POLICE FOUNDATION 315 FOURTH AVENUE CHULA VISTA CA 91910 300281686 501(C)(3) 65000 0 COMMUNITY REINVESTMENT CHICANO FEDERATION 3180 UNIVERSITY AVENUE SAN DIEGO CA 92104 237085960 501(C)(3) 55000 0 COMMUNITY REINVESTMENT YWCA 1012 C STREET SAN DIEGO CA 92101 951661119 501(C)(3) 53500 0 COMMUNITY REINVESTMENT MANA DE SAN DIEGO 2515 CAMINO DEL RIO SOUTH 228 SAN DIEGO CA 92108 330821060 501(C)(3) 52500 0 2024 ENDOWMENT SCHOLARSHIP FUND, LEGACY LUNCHEON/WOMEN'S HISTORY MONTH - MAR 22 2024 MAAC 1355 3RD AVENUE CHULA VISTA CA 91911 952457354 501(C)(3) 50000 0 COMMUNITY REINVESTMENT SAN YSIDRO HEALTH CENTER 1275 30TH STREET SAN DIEGO CA 92154 952801772 501(C)(3) 28000 0 EMERALD BALL GIFT 2024 LA REVISTA BINACIONAL INC 345 15TH STREET SAN DIEGO CA 92101 922812453 25000 0 ADVERTISEMENT COMMUNITY PUBLICATION, SD SPRING MAGAZINE LAUNCH PARTY - MARCH 6 2024 LA MAESTRA COMMUNITY HEALTH CENTER 4060 FAIRMONT AVENUE SAN DIEGO CA 92105 330473171 501(C)(3) 18000 0 OSCAR NIGHT, CASINO NIGHT AND GAMES GALA DINNER 09/20/24, 32ND ANNUAL TOY DRIVE & GIFT DRIVE, LA MAESTRA'S ANNUAL GOLF TOURNAMENT LUNCH 04/26/24 ISMAEL CALA FOUNDATION 601 BRICKELL KEY DRIVE MIAMI FL 33131 473009429 501(C)(3) 15000 0 THE LEGACY OF LIGHT GALA - 09/07/24 NEIGHBORHOOD HEALTHCARE 425 N DATE STREET ESCONDIDO CA 920253413 952796316 501(C)(3) 12050 0 FUN UNDER THE SUN - 8/31/24 TRUECARE 150 VALPREDA ROAD SAN MARCOS CA 920692973 952847102 501(C)(3) 12000 0 2024 ILLUMINATION THE TRUECARE GALA - 04/06/24 GROSSMONT HOSPITAL FOUNDATION PO BOX 158 SAN DIEGO CA 919440158 330124488 501(C)(3) 10000 0 21ST ANNUAL SHARP HOSPICECARE BENEFIT DINNER AUG 23-24, 2024 SOUNDSKILZ INC PO BOX 891720 TEMECULA CA 92589 208145549 10000 0 STARLIGHT PARADE AND FESTIVAL - 12/14/24 ASSOCIATION FOR COMMUNITY AFFILIATED 1155 15TH STREET NW WASHINGTON DC 20005 050509791 501(C)(6) 10000 0 ACAP SDOH INOVATION CENTER FOUNDER'S CIRCLE 2024 INVOICE COMSPORTS WORLD 63 VIA VENETO CHULA VISTA CA 91910 830683157 501(C)(3) 8050 0 RICKY DURAN 5V5 VILLA CUP SPONSORSHIP, VILLA BOWL 27 IN 2024 T-SHIRTS YMCA 151 YMCA WAY SAN DIEGO CA 92102 952039198 501(C)(3) 7500 0 YMCA OF SAN DIEGO COUNTY DONATION SCRIPPS HEALTH FOUNDATION 10140 CAMPUS POINT DRIVE SAN DIEGO CA 92121 951684089 501(C)(3) 7500 0 SCRIPPS HEALTH FOUNDATION SAN DIEGO DONATION, 50TH ANNUAL SCRIPPS MERCY BALL APRIL 20 2024 SPONSORSHIP KIM CENTER FOR SOCIAL BALANCE 5173 WARING ROAD SAN DIEGO CA 92120 814518651 501(C)(3) 7500 0 LEAPS ALLIANCE 2024 CHAMPIONS FOR HEALTH 4699 MURPHY CANYON ROAD SAN DIEGO CA 92123 952568714 501(C)(3) 7000 0 UNITED IN WELLNESS GALA - JUNE 1 2024 AT THE PRADO MENTAL HEALTH AMERICA OF SAN DIEGO COUNTY 4069 30TH STREET SAN DIEGO CA 92104 951948185 501(C)(3) 5500 0 MEETING OF THE MINDS BEHAVIORAL HEALTH CONFERENCE 10/10/2024 SHARP HEALTHCARE FOUNDATION 8695 SPECTRUM CENTER BLVD SAN DIEGO CA 92123 953492461 501(C)(3) 5500 0 50TH ANNIVERSARY SHARP CHULA VISTA MEDICAL CENTER GALA VISTA COMMUNITY CLINIC 1000 VALE TERRACE DRIVE VISTA CA 920845218 952815615 501(C)(3) 5500 0 SATURDAY NIGHT FEVER VCC GALA - 09/07/24 20 3 SCHOLARSHIPS 155 191000 PART I, LINE 2: CHG FOUNDATION AWARDS GRANTS AND SCHOLARSHIPS FOR HEALTH AND EDUCATIONAL RELATED PURPOSES TO ORGANIZATIONS AND INDIVIDUALS RESIDING IN SAN DIEGO COUNTY WHO ARE NOT RELATED TO THE ORGANIZATION. 0 0 0 0 0 0 0 0 0 NORMA DIAZ CHIEF EXECUTIVE OFFICER 0 902393 0 28683 0 183427 0 17250 0 39104 0 1170857 0 0 JOSEPH GARCIA CHIEF OPERATING OFFICER 0 827200 0 0 0 0 0 0 0 0 0 827200 0 0 ALAN CONRAD CHIEF MEDICAL OFFICER 0 496814 0 453 0 0 0 17250 0 3198 0 517715 0 0 ANN WARREN ASSOCIATE CHIEF EXECUTIVE OFFICER 0 334438 0 12909 0 112901 0 17250 0 15169 0 492667 0 0 ALEJANDRO HINOJOSA-VALENCIA IHA PHYSICIAN 0 155997 0 251453 0 9210 0 17250 0 41270 0 475180 0 0 SCOTT CARROLL CHIEF FINANCIAL OFFICER 0 374773 0 3309 0 47810 0 17250 0 13874 0 457016 0 0 ALLAN SOMBILLO CHIEF INFORMATION OFFICER 0 331858 0 849 0 4290 0 16917 0 14374 0 368288 0 0 HEIDI ARNDT SENIOR COMPLIANCE OFFICER 0 268652 0 1537 0 52514 0 16377 0 27344 0 366424 0 0 NOREEN KOIZUMI DIRECTOR OF CORPORATE QUALITY 0 207684 0 2449 0 35729 0 12560 0 31149 0 289571 0 0 YOUSAF FAROOK SENIOR DIRECTOR OF HEALTH CARE SERVI 0 224831 0 2649 0 3050 0 11800 0 44115 0 286445 0 0 FRANCISCA CHAVEZ SENIOR DIRECTOR OF OPERATIONS 0 219875 0 1649 0 2180 0 11502 0 42462 0 277668 0 0 PART I, LINE 3 CHG FOUNDATION RELIES ON COMMUNITY HEALTH GROUP (PARENT), A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S CEO. CHG FOUNDATION'S CEO IS ALSO THE CEO OF COMMUNITY HEALTH GROUP; CHG FOUNDATION'S CEO RECEIVES ONE HUNDRED PERCENT OF HER COMPENSATION FROM COMMUNITY HEALTH GROUP. COMMUNITY HEALTH GROUP UTILIZES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION OF THE CEO: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY AND/OR STUDY; AND 4) APPROVAL BY THE BOARD OF DIRECTORS. JOSEPH GARCIA FAMILY MEMBER OF OFFICER 827200 COMPENSATION 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: JOSEPH GARCIA IS COMPENSATED THROUGH COMMUNITY HEALTH GROUP, A RELATED ORGANIZATION, THAT PROVIDES ADMINISTRATIVE SERVICES AND SUPPORT TO CHG FOUNDATION AND ACTS AS THE COMMON PAYMASTER. 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'S PARENT (COMMUNITY HEALTH GROUP, OR "CHG") 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 FOR CHG. COMPENSATION PAID TO J.A.G. CONSULTING, LLC BY CHG IN 2024 IN RELATION TO THESE DUTIES WAS $827,200. FORM 990, PART VI, SECTION A, LINE 6 CHG FOUNDATION HAS ONE SOLE MEMBER, COMMUNITY HEALTH GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, COMMUNITY HEALTH GROUP, HAS THE POWER TO APPOINT ALL OF THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER OF CHG FOUNDATION, COMMUNITY HEALTH GROUP HAS THE POWER TO APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF CHG FOUNDATION. ADDITIONALLY, COMMUNITY HEALTH GROUP HAS THE POWER OR AUTHORITY GIVEN TO MEMBERS BY THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW BY ITS WRITTEN CONSENT. FORM 990, PART VI, SECTION B, LINE 11B BAKER TILLY ADVISORY GROUP, LP IS ENGAGED TO PREPARE AND COMPLETE THE FORM 990 ON BEHALF OF CHG FOUNDATION. THE FORM 990 IS PREPARED UNDER THE DIRECTION, REVIEW, AND OVERSIGHT OF COMMUNITY HEALTH GROUP'S (CHG FOUNDATION'S PARENT) FINANCE DEPARTMENT, AND EXECUTIVE MANAGEMENT TEAM. THE FORM 990 IS REVIEWED IN DETAIL BY THE CHIEF FINANCIAL OFFICER OF CHG FOUNDATION WHO APPROVES THE FINAL VERSION FOR FILING WITH BAKER TILLY ADVISORY GROUP, LP. CHG FOUNDATION'S BOARD OF DIRECTORS RELIES ON THE EXPERTISE OF INTERNAL MANAGEMENT AND BAKER TILLY ADVISORY GROUP, LP FOR THE ACCURATE AND TIMELY FILING OF FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CHG FOUNDATION 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 CHG FOUNDATION AND COMMUNITY HEALTH GROUP. ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE REPORTED TO COMMUNITY HEALTH GROUP'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 CHG FOUNDATION ANSWERED EACH OF THESE QUESTIONS AS "NO" BECAUSE ALL COMPENSATION PAID TO THOSE PERSONS REPORTED IN PART VII OR SCHEDULE J IS PAID BY COMMUNITY HEALTH GROUP (CHG FOUNDATION'S PARENT). SEE THE COMMUNITY HEALTH GROUP FORM 990 SCHEDULE O FOR A DESCRIPTION OF THE PROCESSES BY WHICH IT DETERMINES EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS, AS WELL AS THE AUDITED CONSOLIDATED 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 CONSULTING EXPENSES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,872,611. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,872,611. HEALTH CARE EXPENSES: PROGRAM SERVICE EXPENSES 1,533,945,398. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,533,945,398. FORM 990, PART IX, LINES 5 THROUGH 10: CHG FOUNDATION HAS NO EMPLOYEES. FOR A FEE, COMMUNITY HEALTH GROUP (PARENT) PROVIDES ADMINISTRATIVE SERVICES AND SUPPORT TO CHG FOUNDATION UNDER THE TERMS AND CONDITIONS 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, A RELATED ORGANIZATION (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. FORM 990, PART IX, LINES 11B THROUGH 11D; AND LINES 12 THROUGH 24E: A MAJORITY OF THE EXPENSES REPORTED IN THESE LINES REPRESENT AMOUNTS ALLOCATED TO CHG FOUNDATION FROM COMMUNITY HEALTH GROUP IN ACCORDANCE WITH THE TERMS OF THE ADMINISTRATIVE SERVICES AGREEMENT IN PLACE BETWEEN THE TWO ENTITIES. SUCH ALLOCATED EXPENSES ARE REPORTED AT THE FUNCTIONAL LEVEL ON CHG FOUNDATION'S FORM 990 PART IX. FORM 990, PART XI, LINE 9: GRANTS RECORDED ON CHG BOOKS BUT REPORTED ON CHG FOUNDATION FORM 990 40,544. ACCRUED COMMUNITY REINVESTMENT OBLIGATION -12,910,183. 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. COMMUNITY HEALTH GROUP 2420 FENTON STREET SUITE 100 CHULA VISTA CA 91914 953766170 HEALTH CARE SERVICES CA 501(C)(4) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 COMMUNITY HEALTH GROUP O 32999807 BOOK VALUE COMMUNITY HEALTH GROUP P 1641045970 BOOK VALUE COMMUNITY HEALTH GROUP S 6294138 BOOK VALUE COMMUNITY HEALTH GROUP M 17174116 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 $6,294,138 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.