2025-07-11T15:02:37-05:00 2024-08-31 390859910 BAKER TILLY ADVISORY GROUP LP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2023-09-01 941156276 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER FRES 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 CHRISTOPHER NEUMAN SVP, CHIEF FINANCIAL OFFICER 5594596000 2025-07-10 1 1 WENDY CAMPOS P00448102 2099556100 2025-07-10 2023 2025-03-06 01:10:19Z SEE SCHEDULE O CRAIG WAGONER 1560 E SHAW AVENUE FRESNO CA 93710 4038992448 0 X WWW.COMMUNITYMEDICAL.ORG X 1947 CA FCH&MC MEETS THE MEDICAL NEEDS OF ITS COMMUNITY THROUGH ITS ACUTE-CARE HOSPITALS AND FACILITIES. 14 12 8642 807 27693948 458338 11613093 11416708 2454632760 2643561356 19276196 78456282 8425039 9031628 2493947088 2742465974 575595 492306 0 0 1124875000 1092237000 0 0 0 1223682565 1331002891 2349133160 2423732197 144813928 318733777 2778693696 3113716823 1138297550 1156851315 1640396146 1956865508 X FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER'S (FCH&MC'S) EXISTS TO BETTER THE LIVES OF ALL THOSE WE SERVE 0 0 2219680049 492306 2643561356 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER OPERATES TWO ACUTE-CARE HOSPITALS AND NUMEROUS OUTPATIENT CENTERS, CLINICS AND OTHER SERVICES WHICH MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL DETAILS.- COMMUNITY REGIONAL MEDICAL CENTER. CRMC IS A TERTIARY ACUTE CARE FACILITY THAT PROVIDES THE PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA WITH THE FOLLOWING SERVICES: (I) THE CENTRAL VALLEY'S ONLY LEVEL I TRAUMA CENTER, (II) THE COMMUNITY REGIONAL BURN CENTER, (III) A LEVEL III NEONATAL INTENSIVE CARE UNIT, (IV) COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES, INCLUDING TECHNOLOGICALLY ADVANCED MEDICAL/SURGICAL SPECIALTIES SUCH AS CARDIOVASCULAR, NEUROSCIENCE, ORTHOPEDICS AND WOMEN'S AND CHILDREN'S SERVICES, (V) THE COMMUNITY FAMILY BIRTH CENTER, (VI) GENERAL AND SPECIALTY INTENSIVE CARE UNITS, (VII) THE LEON S. PETERS REHABILITATION CENTER, (VIII) INPATIENT AND OUTPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) DIALYSIS TREATMENT FACILITIES, (XI) DIAGNOSTIC RADIOLOGY SERVICES, (XII) SHORT STAY SURGERY SERVICES, (XIII) A CARDIOVASCULAR CARE UNIT, AND (XIV) 24 HOUR EMERGENCY SERVICES. CRMC IS ALSO A TEACHING HOSPITAL THAT IS AFFILIATED WITH UCSF. THE MAIN CAMPUS OF CRMC CONSISTS OF A HOSPITAL BUILDING WITH FIVE AND 10-STORY WINGS, CONNECTED TO A FIVE STORY TRAUMA AND CRITICAL CARE BUILDING. CRMC ALSO PROVIDES (I) BEHAVIORAL HEALTH SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC"), (II) SUBACUTE AND SKILLED NURSING SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER ("CSTCC"), AND (III) HIV AND OMFS SERVICES ARE OFFERED AT THE DERAN KOLIGIAN AMBULATORY CARE CENTER LOCATED ON THE CRMC MAIN CAMPUS (THE "FRESNO CAMPUS"). - CLOVIS COMMUNITY MEDICAL CENTER. CCMC IS LOCATED IN THE CITY OF CLOVIS (WHICH IS CONTIGUOUS TO THE CITY OF FRESNO), WHERE IT SERVES THE PRIMARY SERVICE AREA AND, TO A LESSER DEGREE, THE SECONDARY SERVICE AREA. THE CHS CAMPUS IN CLOVIS (THE "CLOVIS CAMPUS") INCLUDES THE MAIN FACILITY, WHICH CONSISTS OF AN ACUTE CARE HOSPITAL WITH TWO FIVE-STORY TOWER AND A THREE-STORY TOWER CONNECTED TO AN OUTPATIENT SURGERY/ENDOSCOPY/DIAGNOSTIC CENTER. THE FACILITY HAS ALL PRIVATE ROOMS. THE FACILITY PROVIDES: (I) COMPREHENSIVE MEDICAL AND SURGICAL CAPABILITIES, (II) 24-HOUR EMERGENCY CARE, (III) AN INTENSIVE CARE UNIT, (IV) THE COMMUNITY FAMILY BIRTH CENTER, (V) THE MARJORIE E. RADIN BREAST CARE CENTER (VI) SHORT STAY AND INPATIENT SURGICAL SERVICES, INCLUDING ROBOTICS AND ADVANCED MINIMALLY INVASIVE SURGERY, (VII) A LEVEL II NEONATAL INTENSIVE CARE UNIT, (VIII) INPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) ADVANCED DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, AND (XI) INVASIVE AND NON-INVASIVE CARDIAC SERVICES. OTHER FACILITIES AND SERVICES PROVIDED ON THE CLOVIS CAMPUS INCLUDE: (I) AN OUTPATIENT WOUND CARE CLINIC WITH TWO HYPERBARIC OXYGEN CHAMBERS, (II) AN OUTPATIENT PHYSICAL REHABILITATION CLINIC, INCLUDING LYMPHEDEMA THERAPY, (III) COMMUNITY CANCER INSTITUTE (CCI), A THREE-STORY BUILDING WHICH IS CENTRAL CALIFORNIA'S PREMIER COMPREHENSIVE CANCER CARE CENTER - AND THE ONLY ONE IN THE AREA WITH MANY OUTPATIENT SERVICES IN A SINGLE LOCATION, AND (IV) THE H. MARCUS RADIN CONFERENCE CENTER, WHICH OPENED IN 2012 AND PROVIDES A 214- SEAT AUDITORIUM THAT IS FULLY INTEGRATED FOR TRAINING IN CHS'S OPERATING ROOMS AND FOR BROADCASTING OTHER EVENTS, AND TWO STATE-OF-THE-ART COMPUTER TRAINING LABS.- FRESNO HEART AND SURGICAL HOSPITAL. HEART HOSPITAL IS AN ACUTE CARE FACILITY WITH ALL PRIVATE ROOMS LOCATED IN THE CITY OF FRESNO OVERLOOKING WOODWARD PARK IN NORTHEAST FRESNO. THE FACILITY OPENED IN OCTOBER 2003 AND PROVIDES THE PRIMARY AND SECONDARY SERVICE AREAS WITH (I) CARDIOLOGY AND CARDIAC SURGERY SERVICES, (II) VASCULAR SURGERY SERVICES, AND (III) BARIATRIC AND OTHER MINIMALLY INVASIVE SURGERY SERVICES. THE ORGANIZATION IS THE PRINCIPAL TEACHING HOSPITAL IN THE CENTRAL VALLEY THROUGH A GRADUATE MEDICAL EDUCATION PROGRAM AFFILIATED WITH THE UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO MEDICAL EDUCATION PROGRAM. CHS SUPPORTS A FULLY ACCREDITED EDUCATIONAL PROGRAM WITH CALIFORNIA STATE UNIVERSITY, FRESNO, BY PROVIDING CLINICAL EXPERIENCE TO ITS NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND DIETETIC STUDENTS. ADDITIONALLY, THE ORGANIZATION PROVIDES CLINICAL EXPERIENCE TO FRESNO CITY COLLEGE'S NURSING, SURGERY AND RADIOLOGY TECHNOLOGY STUDENTS. CHS ALSO PROVIDES CLINICAL EXPERIENCE TO STUDENTS IN THE SAN JOAQUIN VALLEY COLLEGE LVN TO RN PROGRAM, FRESNO ADULT SCHOOL AND CLOVIS ADULT SCHOOL LICENSED VOCATIONAL NURSE PROGRAMS, AS WELL AS STUDENTS IN MANY OTHER PROGRAMS AT AREA COMMUNITY COLLEGES. EACH OF THE THREE ACUTE HOSPITALS CONDUCTS EDUCATIONAL PROGRAMS FOR THE BENEFIT OF PHYSICIANS, NURSES, TECHNICIANS, MANAGEMENT PERSONNEL, EMPLOYEES, AND THE PUBLIC. IN ADDITION, CHS SPONSORS NUMEROUS HEALTH PROMOTION AND EDUCATION PROGRAMS FOR ITS EMPLOYEES AND MEMBERS OF THE COMMUNITY IN MANY AREAS, INCLUDING ASTHMA, DIABETES, NUTRITION AND WEIGHT CONTROL, STRESS MANAGEMENT, HEALTH AND WELLNESS, AND SMOKING CESSATION. THE ORGANIZATION IS AN ACTIVE PARTNER IN SEVERAL COMMUNITY SERVICE PROJECTS SUPPORTING EDUCATION IN HEALTH CAREERS FOR HIGH SCHOOLS AND OTHER COMMUNITY GROUPS. TO ADDRESS THE NATION-WIDE NURSING SHORTAGE, THE ORGANIZATION HAS IMPLEMENTED SEVERAL SYSTEM-WIDE INITIATIVES TO INCREASE RECRUITMENT AND RETENTION INCLUDING THE IMPLEMENTATION OF A NURSE RESIDENCY PROGRAM AND CLINICAL LADDER, BOTH DESIGNED TO EXPAND THE EDUCATION OF NEW NURSES AND PROMOTE RETENTION OF A HIGHER PERCENTAGE OF THESE NURSES. 2219680049 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 X 391 0 1 8642 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X DEBORAH MOFFETT 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 ROGER STURDEVANT CHAIR 1.40 0.50 X X 0 0 0 GREG ESTEP CHAIR-ELECT 1.40 2.40 X X 0 0 0 KAREN MCCAFFREY SECRETARY 1.40 0.50 X X 0 0 0 SUSAN ABUNDIS BOARD MEMBER 1.40 0.50 X 0 0 0 LORI BENNETT EDD BOARD MEMBER 1.40 0.50 X 0 0 0 RONALD BIERMA MD BOARD MEMBER 1.40 0.50 X 0 0 0 KEITH BOONE MD BOARD MEMBER 1.40 0.50 X 0 0 0 MARK COELHO BOARD MEMBER 1.40 0.50 X 0 0 0 GERARDO HERNANDEZ BOARD MEMBER 1.40 0.50 X 0 0 0 WAGIH IBRAHIM MD BOARD MEMBER 1.40 0.50 X 0 0 0 LELAND PARNAGIAN BOARD MEMBER 1.40 0.50 X 0 0 0 JOSHUA PETERSON BOARD MEMBER 1.40 0.50 X 0 0 0 RUTHIE QUINTO BOARD MEMBER 1.40 0.50 X 0 0 0 CHANDRASEKAR VENUGOPAL MD BOARD MEMBER 1.40 0.50 X 0 0 0 CRAIG S CASTRO PRESIDENT, CHIEF EXECUTIVE OFFICER 55.00 5.00 X 0 2203578 784941 CHRISTOPHER NEUMAN SVP, CHIEF FINANCIAL OFFICER 55.00 5.00 X 0 1305393 34720 DEBORAH MOFFETT VICE FINANCIAL OFFICER/VP FINANCE 50.00 5.00 X 0 507812 34106 ISABEL MARTINEZ - FIRST VS DIRECTOR CORP GOVERNANCE 40.00 5.00 X 0 140955 24989 KATHY MELENDEZ - SECOND VS BOARD GOVERNANCE SPECIALIST 35.00 5.00 X 0 89916 2843 CRAIG WAGONER EVP, CHIEF OPERATING OFFICER 50.00 6.90 X 0 1622090 36219 BRIANNE L MARRIOTT SVP, CHIEF LEGAL OFFICER 50.00 5.00 X 0 910143 36725 ALDO DE LA TORRE - SVP NETWORK DEVELOPMENT AND INSURANCE SVC 50.00 6.90 X 0 870280 38708 CARLA MILTON - SVP CHIEF HUMAN RESOURCES OFFICER 50.00 6.90 X 0 781246 39715 THOMAS UTECHT SVP, CHIEF MEDICAL OFFICER 50.00 5.00 X 1167686 0 49150 JEFFREY THOMAS - VP CHIEF MEDICAL AND QUALITY OFFICER - CRMC 50.00 5.00 X 695531 0 24932 TRACY KIRITANI VP, HOSPITAL FINANCIAL OPERATIONS 50.00 5.00 X 690333 0 34478 DANIEL DAVIS - SVP CHIEF CLINICAL AND OPERATIONS OFFICER 50.00 5.00 X 598989 0 22621 ROBYN GONZALES VP, CHIEF OPERATING OFFICER CRMC 50.00 5.00 X 521157 0 41751 ROGER LARSEN - FORMER SVP CHIEF FINANCIAL OFFICER THRU 08/22 0.00 0.00 X 0 667956 12984 JUANITA HERNANDEZ - FRMR FIRST VS/SECOND VS/DIR CORP GOV THRU 02/22 0.00 0.00 X 0 170795 0 3673696 9270164 1218882 2553 1 1 0 CARDINAL HEALTH PO BOX 56412 LOS ANGELES CA 90074 MEDICAL 141724291 CCFMG 2625 EAST DIVISADERO FRESNO CA 93721 MEDICAL 65744944 MEDLINE INDUSTRIES INC DEPT LA 21588 PASADENA CA 91185 MEDICAL 61529446 AMN HEALTHCARE INC BANK OF AMERICA 450 B STREET SUITE SAN DIEGO CA 92101 MEDICAL 52743108 THOMAS CUISINE MANAGEMENT 700 E FRANKLIN ROAD MERIDIAN ID 83642 FOOD SERVICES 29471981 475 10820053 596655 11416708 MEDICAL SERVICE 622110 2416304182 2416304182 GRANTS AND CONTRACTS 622110 199620080 199620080 PHARMACY SALES 456110 27637094 682269 26954825 2643561356 30415305 30415305 1344553450 14001 1296519293 7181 48034157 6820 48040977 48040977 HOSPITAL CAFETERIA REV 722514 8292505 8292505 INCOME FR PARTNERSHIPS 900099 445713 445713 PARKING AND SECURITY 812930 293410 293410 9031628 2742465974 2616606531 27693948 86748787 X 492306 492306 7650260 7650260 566649 307522 259127 907308105 789358051 117950054 29093548 25311387 3782161 83854715 72953602 10901113 63763723 55474439 8289284 111267 111267 43329 43329 929168 929168 414326828 402241392 12085436 1795548 1795548 4467215 4467215 36678571 30809999 5868572 502104 421767 80337 407281 407281 28661000 24075240 4585760 84997000 71397480 13599520 15317000 12866280 2450720 MEDICAL SUPPLIES 455550778 455550778 MEDI-CAL PROVIDER FEE 185916598 185916598 MINOR EQUIPMENT 41250510 41250510 UBI TAX 145000 145000 59903694 50657088 9246606 2423732197 2219680049 204052148 0 45856065 18503625 502843001 478041745 18421888 10905455 5557012 20163088 26940115 28475827 14723284 13117644 2052720256 894569721 1177239500 1158150535 490608734 816513553 37269926 40213006 6129920 5435968 453104251 524196377 2778693696 3113716823 213603158 250102719 379493 544290 710995618 698663634 137639250 131249362 75680031 76291310 1138297550 1156851315 X 1640396146 1956865508 1640396146 1956865508 2778693696 3113716823 X 318733777 3833581 -5386886 -711110 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 43329 43329 0 PART II-B, LINE 1: FCH&MC ENGAGED CALIFORNIA HOSPITALS COMMITTEE ON ISSUES (CHCI) SPONSORED BY CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) THROUGH INTERMEDIARY CALIFORNIA HOSPITAL ASSOCIATION TO ASSIST THE CALIFORNIA GENERAL PURPOSE COMMITTEE IN SUPPORT OF CANDIDATES AND BALLOT MEASURES AS IT RELATES TO HEALTHCARE ISSUES. 15908426 16148551 32056977 1409032276 454269741 954762535 6218953 6140280 78673 558867041 434159700 124707341 46545009 46545009 1158150535 RECEIVABLE FROM AFFILIATES 489241320 SUPPLEMENTAL FUNDING 12472969 ROU ASSETS 22482088 524196377 ASSET RETIREMENT OBLIGATION 5340218 GROUP HEALTH 2631492 MALPRACTICE - IBNR 5814000 WORKERS COMPENSATION RESERVE 38378981 PHYSICIAN GUARANTEE PAYABLE 1101850 LEASE LIABILITY 20244735 CLAIM ACTIVITY 1995833 OTHER LIABILITIES 784201 76291310 FORM 990, SCHEDULE D, PART X, LINE 2: THERE IS NO FOOTNOTE FOR FIN 48 IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DUE TO IMMATERIALITY. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 46948494 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES CAPTIVE INSURANCE 8568631 0 0 0 0 0 0 55517125 0 55517125 1 0 1 0 0 0 PART I, LINE 3: ACCRUAL METHOD 1 1 X 1 X 400.000000000000 1 X 450.000000000000 1 1 1 0 1 1 17080000 17080000 0.00700 424389000 270902000 153487000 0.06340 441469000 270902000 170567000 0.07040 9 1765 625375 54703 570672 0.00020 2 30 53997908 8733484 45264424 0.01870 1 329010 329010 0.00010 12 1795 54952293 8788187 46164106 0.01900 12 1795 496421293 279690187 216731106 0.08940 2 96 6894 6894 0.00000 2 96 6894 6894 0.00000 1 1013216 0 359977814 417460408 -57482594 X 1 1 1 CA IMAGING INSTITUTE LLC MEDICAL IMAGING 0.50000 0.00000 0.50000 2 1 COMMUNITY REGIONAL MEDICAL CENTER 2823 FRESNO ST FRESNO CA 93721 WWW.COMMUNITYMEDICAL.ORG 040000096 X X X X X A 2 CLOVIS COMMUNITY MEDICAL CENTER 2755 HERNDON CLOVIS CA 93612 WWW.COMMUNITYMEDICAL.ORG 040000004 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V X 1 23 1 SEE PART V 0 1 X 400.000000000000 450.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X X 1 X X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: COMMUNITY REGIONAL MEDICAL CENTER, - FACILITY 2: CLOVIS COMMUNITY MEDICAL CENTER FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONSISTS OF PRIMARY DATA FROM OVER 4,800 INDIVIDUAL INTERVIEWS AND 59 MULTI-LINGUAL FOCUS GROUPS. PARTICIPANTS IN PRIMARY DATA COLLECTION EFFORTS INCLUDED RESIDENTS THROUGHOUT FRESNO, KINGS, MADERA, AND TULARE COUNTIES AND REPRESENTATIVES FROM AND USERS OF HEALTH IMPROVEMENT PROGRAMS SERVING LOW-INCOME AND VULNERABLE POPULATIONS, CHILDREN AND FAMILIES, HOMELESS, LGBTQ+, SENIORS, TRIBAL COMMUNITIES, AS WELL AS BLACK/AFRICAN AMERICAN, HMONG, LATINO AND SPANISH-SPEAKING POPULATIONS. SECONDARY DATA WAS COLLECTED USING GOVERNMENT AND OTHER PUBLIC HEALTH RESOURCES INCLUDING THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, U.S. CENTER FOR DISEASE CONTROL, HEALTHY COMMUNITIES INSTITUTE AND U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: SEVERAL HOSPITALS COLLABORATED ON THIS REPORT. THE PARTICIPATING HOSPITALS WERE: COMMUNITY REGIONAL MEDICAL CENTER, CLOVIS COMMUNITY MEDICAL CENTER, FRESNO HEART AND SURGICAL HOSPITAL, KAWEAH HEALTH MEDICAL CENTER, SAINT AGNES MEDICAL CENTER, SIERRA VIEW MEDICAL CENTER, AND VALLEY CHILDREN'S HEALTHCARE. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: - BINATIONAL OF CENTRAL CALIFORNIA - CALIFORNIA STATE UNIVERSITY, FRESNO STUDENT VOLUNTEERS - CENTRAL VALLEY HEALTH POLICY INSTITUTE - CULTIVA LA SALUD - EVERY NEIGHBORHOOD PARTNERSHIP - FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH - FRESNO INTERDENOMINATIONAL REFUGEE MINISTRIES - HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA - KINGS COUNTY COMMISSION ON AGING - KINGS PARTNERSHIP FOR PROSPERITY, PROGRESS, AND PREVENTION - MADERA COALITION FOR COMMUNITY JUSTICE - MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH - MOXLEY PUBLIC HEALTH - THE FRESNO CENTER - TULARE COUNTY DEPARTMENT OF PUBLIC HEALTH - TULE RIVER TRIBE PUBLIC HEALTH AUTHORITY - UNITED WAY FRESNO AND MADERA COUNTIES - UNITED WAY OF TULARE COUNTY FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: COMMUNITY REGIONAL MEDICAL CENTER ("CRMC") AND CLOVIS COMMUNITY MEDICAL CENTER ("CCMC") COMPLETED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IN FY22 AS REQUIRED BY STATE AND FEDERAL LAW. THE CHNA IS THE PRIMARY TOOL USED BY THE HOSPITAL FACILITIES TO DETERMINE THEIR COMMUNITY BENEFIT PLANS, WHICH OUTLINE HOW THEY WILL GIVE BACK TO THE COMMUNITY IN THE FORM OF HEALTHCARE AND OTHER COMMUNITY SERVICES TO ADDRESS UNMET COMMUNITY HEALTH NEEDS. THE ASSESSMENT INCORPORATED COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUSED ON THE HEALTH AND SOCIAL NEEDS OF THE SERVICE AREA.TARGETED INTERVIEWS AND FOCUS GROUPS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITALS. FIFTY (50) KEY INFORMANT INTERVIEWS WERE COMPLETED DURING OCTOBER AND NOVEMBER 2021. INTERVIEWEES INCLUDED LEADERS AND/OR REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. IN ADDITION, 59 FOCUS GROUPS WERE HELD IN THE REGION, LED BY EIGHT ORGANIZATIONS. THE FOCUS GROUPS INCLUDED 473 COMMUNITY MEMBERS AND WERE HELD IN-PERSON OR VIRTUALLY. FOCUS GROUPS WERE HELD IN FIVE LANGUAGES TO MEET THE NEEDS OF THE PARTICIPANTS. FINALLY, COMMUNITY-BASED ORGANIZATIONS AND OTHER GROUPS DISTRIBUTED A COMMUNITY SURVEY IN ONLINE AND PAPER FORMATS TO AREA RESIDENTS; 4,856 USABLE SURVEYS WERE RECEIVED. INPUT WAS ALSO OBTAINED FROM COUNTY DEPARTMENTS OF PUBLIC HEALTH AND DEPARTMENTS OF BEHAVIORAL HEALTH.SIGNIFICANT HEALTH NEEDS SECONDARY DATA COLLECTION RESULTED IN IDENTIFYING COMMUNITY HEALTH NEEDS THAT WERE FURTHER ASSESSED IN THE PRIMARY DATA COLLECTION KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND A COMMUNITY-WIDE SURVEY. THE IDENTIFIED SIGNIFICANT NEEDS INCLUDED (IN ALPHABETICAL ORDER):- ACCESS TO CHILD CARE - ACCESS TO HEALTHCARE (INCLUDES DENTAL AND MENTAL HEALTHCARE) - ADVERSE CHILDHOOD EXPERIENCES - CHRONIC DISEASES - COVID-19 - CRIME AND VIOLENCE - ECONOMIC STABILITY - EDUCATION - ENVIRONMENTAL CONDITIONS (INCLUDES WATER AND AIR) - FOOD INSECURITY- INTERNET ACCESS - HIV/AIDS AND STIS - HOUSING AND HOMELESSNESS - MATERNAL AND CHILD HEALTH - MENTAL HEALTH - NUTRITION AND PHYSICAL HEALTH (INCLUDES OVERWEIGHT AND OBESITY) - PREVENTIVE CARE AND PRACTICES (INCLUDES SCREENINGS, IMMUNIZATIONS/VACCINES) - SUBSTANCE USE (ALCOHOL AND DRUGS) - TOBACCO AND NICOTINE - TRANSPORTATIONCOMMUNITY RESPONDENTS WERE ASKED TO RANK THE HEALTH OUTCOMES AND SOCIAL DETERMINANTS OF HEALTH THAT CONTRIBUTE TO DISEASE IN THE REGION. THE RESULTS OF THE RESPONSES FROM THE PRIORITY RANKING WERE COMPARED TO THE SECONDARY DATA COLLECTED FOR EACH HEALTH NEED AND THE PRIMARY DATA COLLECTED FROM A COMMUNITY SURVEY, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. AS A RESULT, THE TOP FIVE PRIORITIZED HEALTH NEEDS WERE IDENTIFIED: - MENTAL HEALTH - MATERNAL AND CHILD HEALTH - ACCESS TO CARE (INCLUDING DENTAL CARE AND MENTAL HEALTH CARE) - CHRONIC DISEASES - NUTRITIONAL AND PHYSICAL HEALTH (INCLUDING OVERWEIGHT AND OBESITY) PART V, SECTION B, LINE 7A: THE HOSPITAL FACILITY'S WEBSITE WHERE THE CHNA REPORT IS AVAILABLE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT PART V, SECTION B, LINE 10: THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT PART V, SECTION B, LINE 11: COMMUNITY HEALTH SYSTEM ("CHS") INTENDS TO TAKE ACTIONS TO ADDRESS THE FOLLOWING HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2022 CHNA: (1) ACCESS TO HEALTHCARE, (2) CHRONIC DISEASE, (3) ECONOMIC STABILITY, (4) MATERNAL AND CHILD HEALTH, AND (5) MENTAL HEALTH. CHS SELECTED HEALTH NEEDS TO PRIMARILY FOCUS EFFORTS ON BASED UPON THE SYSTEM'S CAPACITY TO ADDRESS THE NEEDS, THE STRENGTH OF COMMUNITY PARTNERSHIPS AND THOSE NEEDS THAT CORRESPOND WITH THE HEALTH SYSTEM'S PRIORITIES. CHS WILL ADDRESS THESE HEALTH NEEDS THOUGH A MULTI-FACETED APPROACH INCLUDING, DIRECT PROGRAMS/SERVICES, LEADERSHIP, AND PARTICIPATION IN BROAD MULTI-STAKEHOLDER COALITIONS/COLLABORATIVES AND CONTINUOUS COLLABORATION BETWEEN CHS AND COMMUNITY PARTNERS. ADDRESSING PRIORITY HEALTH NEEDS - COMMUNITY REGIONAL MEDICAL CENTER ("CRMC")IN FY24, CRMC ENGAGED IN ACTIVITIES AND PROGRAMS THAT ADDRESSED THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2023-2025 IMPLEMENTATION STRATEGY. CRMC COMMITTED TO COMMUNITY BENEFIT EFFORTS THAT ADDRESSED ACCESS TO HEALTHCARE, CHRONIC DISEASES, ECONOMIC STABILITY, MATERNAL AND CHILD HEALTH AND MENTAL HEALTH. ACTIVITIES AND PROGRAMS THAT HIGHLIGHT CRMC'S COMMITMENT TO THE COMMUNITY ARE DETAILED BELOW.ACCESS TO HEALTHCARE RESPONSE TO NEED FINANCIAL ASSISTANCE THE HOSPITAL PROVIDED FINANCIAL ASSISTANCE THROUGH FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES, CONSISTENT WITH CHS'S FINANCIAL ASSISTANCE POLICY.ASSISTANCE WITH INSURANCE COVERAGE IN PARTNERSHIP WITH FRESNO'S COUNTY DEPARTMENT OF SOCIAL SERVICES, CRMC PROVIDED ENROLLMENT FOR 344 UNINSURED PERSONS WHO PRESUMPTIVELY QUALIFIED FOR MEDI-CAL.RYAN WHITE HIV/AIDS PROGRAM CHS PARTNERS WITH FAMILY HEALTH CARE NETWORK'S SPECIAL SERVICES CLINIC TO PROVIDE VITAL AND TIMELY HEALTHCARE AND CASE MANAGEMENT FOR PATIENTS WITH HIV/AIDS AND THEIR FAMILIES. IN FY24, THE CLINIC PROVIDED CARE TO PATIENTS THROUGH OVER 7,700 CLINICAL VISITS UNDER THE FEDERAL RYAN WHITE GRANT.SEXUAL ASSAULT FORENSIC EXAM PROGRAM (SAFE) CRMC'S EMERGENCY DEPARTMENT PROVIDED FRESNO COUNTY'S ONLY IN-HOSPITAL TESTING AND EXAMINATION FOR SEXUAL ASSAULT AND RAPE VICTIMS. SPECIALLY TRAINED NURSES COLLECTED, PRESERVED AND SECURELY STORED EVIDENCE COLLECTED FROM ADULT AND CHILD VICTIMS, AND FROM SUSPECTS UNDER POLICE CUSTODY. SEXUAL ASSAULT FORENSIC EXAM PROGRAM NURSES HELPED GATHER EVIDENCE OF SEXUAL VIOLENCE AND ENSURED PATIENTS WERE SAFELY DISCHARGED. NURSES ALSO PROVIDED FOLLOW-UP EVALUATIONS FOR CHILD VICTIMS OF SEXUAL ABUSE AND HELPED CONNECT VICTIMS AND THEIR FAMILIES TO COUNSELING SERVICES. IN FY24, 135 PEOPLE WERE SERVED.TRAUMA PREVENTION PROGRAM CRMC PROVIDES THE ONLY LEVEL I TRAUMA CENTER AND COMPREHENSIVE BURN CENTER IN THE AREA. AN INJURY PREVENTION SPECIALIST PROVIDED EXTENSIVE INJURY PREVENTION OUTREACH IN SCHOOLS AND OTHER COMMUNITY-BASED VENUES, INCLUDING CAR SEAT SAFETY CHECKS AND EDUCATION ON TOPICS LIKE GUN SAFETY, FALL PREVENTION, BICYCLE AND PEDESTRIAN SAFETY, THE DANGERS OF DISTRACTED DRIVING FOR TEENS AND SMARTER DRIVING TIPS FOR OLDER ADULTS.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO INCREASE ACCESS TO HEALTHCARE AND PROVIDE PREVENTIVE CARE SERVICES. - READING & BEYOND PROVIDES SERVICES FOR LOW-INCOME CHILDREN AND FAMILIES IN FRESNO. THE HOSPITAL SUPPORTED THEIR HEALTH INITIATIVES. - THE HOSPITAL SUPPORTED EVERY NEIGHBORHOOD PARTNERSHIP'S BACK TO SCHOOL HEALTH SCREENING AND RESOURCE FAIR HOSTED BY ASSEMBLY MEMBER ESMERALDA SORIA. - FUNDING WAS PROVIDED TO THE MARJAREE MASON CENTER TO SUPPORT HEALTHCARE SERVICES FOR SURVIVORS OF DOMESTIC VIOLENCE IN FRESNO COUNTY.CHRONIC DISEASES RESPONSE TO NEED COMMUNITY DIABETES EDUCATION COMMUNITY DIABETES EDUCATION PROVIDED CARE TO PERSONS WHO WERE OTHERWISE UNABLE TO RECEIVE DIABETES SELF-MANAGEMENT EDUCATION, INCLUDING BILINGUAL SERVICES TO A HIGH CONCENTRATION OF SPANISH-SPEAKING PATIENTS. AS AN ACCREDITED SWEET SUCCESS PROGRAM AFFILIATE, THE DIABETES EDUCATION CENTER PROVIDED EDUCATION TARGETED TO WOMEN DIAGNOSED WITH DIABETES DURING PREGNANCY. COMMUNITY MEMBERS RECEIVED EDUCATION ON HEALTHY EATING HABITS AND CONTROLLING DIABETES DURING PREGNANCY. DIALYSIS CRMC HAS AN OUTPATIENT DIALYSIS UNIT WITH 41 DIALYSIS STATIONS FOR THREE SHIFTS OF PATIENTS, SIX DAYS A WEEK - CARING FOR ADULTS NEEDING DIALYSIS. CRMC ALSO OFFERS A PERITONEAL DIALYSIS HOME TRAINING PROGRAM FOR PATIENTS WHO CAN DO HOME TREATMENT. THE OUTPATIENT DIALYSIS UNIT HAS ON-SITE DIETITIANS AND SOCIAL WORKERS.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO IDENTIFY AND TREAT CHRONIC DISEASES. - FUNDING WAS PROVIDED TO THE FRESNO CENTER FOR COMMUNITY-BASED CHRONIC DISEASE OUTREACH EVENTS. - THE HOSPITAL SUPPORTED THE AMERICAN HEART ASSOCIATION TO PURCHASE AND DISTRIBUTE SELF-MONITORED BLOOD PRESSURE KITS.ECONOMIC STABILITY RESPONSE TO NEED TRANSPORTATION SUPPORT TRANSPORTATION VOUCHERS WERE MADE AVAILABLE TO PATIENTS AND FAMILIES HAVING DIFFICULTY ACCESSING CARE AND SERVICES BECAUSE OF TRANSPORTATION BARRIERS. COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO SUPPORT ECONOMIC STABILITY. - THE HOSPITAL SUPPORTED POVERELLO HOUSE'S PAPA MIKE'S CAFE, WHICH IS A NO-COST, FULL-SERVICE RESTAURANT SERVING MADE-TO-ORDER MEALS FOR ANYONE IN NEED. - FUNDING WAS PROVIDED TO THE FRESNO MISSION TO SUPPORT FOOD SERVICES FOR THE COMMUNITY CARE AND FAMILY CENTER. - CRMC PARTNERED WITH THE CENTRAL CALIFORNIA FOOD BANK TO SUPPORT YOKOMI ELEMENTARY SCHOOL'S BACKPACK PROGRAM, THAT SENDS WEEKEND FOOD HOME FOR STUDENTS AND THEIR FAMILIES, IN DOWNTOWN FRESNO FOR THE 2024/25 SCHOOL YEAR. - FUNDING WAS PROVIDED TO THE CENTRAL CALIFORNIA WOMEN'S CONFERENCE FOOD INSECURITY GRANTS INITIATIVE. - THE AMERICAN RED CROSS SOUND THE ALARM OUTREACH INSTALLED FREE SMOKE ALARMS IN COMMUNITY RESIDENCES WITH SUPPORT FROM CRMC. - CRMC INVESTED IN BIRNEY ELEMENTARY SCHOOL'S TECHNOLOGY AND READING PROGRAM, WHICH IS IN A LOW SOCIOECONOMIC AREA OF CENTRAL FRESNO. THE FUNDS WERE USED IN THE TITLE 1 SCHOOL TO PURCHASE SCIENCE, TECHNOLOGY, ENGINEERING AND MATHEMATICS (STEM) LEARNING MATERIALS. - FUNDS WERE PROVIDED TO THE MARJAREE MASON CENTER'S DOMESTIC VIOLENCE VICTIM SAFE HOUSE. THIS COMMUNITY REFUGE PROVIDES SAFE LODGING FOR ADULTS AND CHILDREN FLEEING DOMESTIC VIOLENCE. - THE HOSPITAL SPONSORED FRESNO CITY COUNCILMAN NELSON ESPARZA'S BEAT THE HEAT COMMUNITY EVENT.MATERNAL AND CHILD HEALTH RESPONSE TO NEED MOTHER'S RESOURCE CENTERTHE MOTHER'S RESOURCE CENTER OFFERED A VARIETY OF BREASTFEEDING AND PARENT EDUCATION CLASSES TO NEW PARENTS, REGARDLESS OF WHERE THEY DELIVERED THEIR BABIES. CLASSES INCLUDED PREPARATION FOR CHILDBIRTH, BREASTFEEDING SUPPORT, MOMMIES MAKING MILK AND MAMA'S CAFE CLUB, A POSTPARTUM RESOURCE AND SUPPORT NETWORK FOR ALL BREASTFEEDING MOMS. CLASSES WERE OFFERED IN ENGLISH AND SPANISH. IN FY24, THE MOTHER'S RESOURCE CENTER HAD 688 OUTPATIENT AND 9,083 INPATIENT CONSULTS.DOULA TRAINING PARTNERSHIPCRMC HAS PARTNERED WITH THE BLACK WELLNESS AND PROSPERITY CENTER (BWPC) FOR A FIRST-OF-ITS-KIND IN THE STATE COLLABORATION TO TRAIN BLACK, INDIGENOUS AND PEOPLE OF COLOR (BIPOC) DOULAS WITHIN OUR FACILITY. IN FY24, EIGHT DOULAS COMPLETED 162 HOURS OF TRAINING OBSERVATIONS AT CRMC.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO SUPPORT MATERNAL AND CHILD HEALTH. - SUPPORT WAS PROVIDED TO THE BLACK WELLNESS AND PROSPERITY CENTER TO SUPPORT MATERNAL AND CHILD HEALTH EDUCATION. FUNDS ALSO SUPPORTED THE DOULA TRAINING PROGRAM, WHICH SEEKS TO IMPROVE MATERNAL OUTCOMES FOR BLACK AND MINORITY MOTHERS AND THEIR BABIES BY EXPANDING THE INTEGRATION OF DOULAS IN THE HOSPITAL SETTING. - FUNDS WERE PROVIDED TO THE FRESNO COUNCIL ON CHILD ABUSE PREVENTION, SUBSTANCE USE DISORDER COMMUNITY OUTREACH EVENT.MENTAL HEALTH RESPONSE TO NEED BRIDGE PROGRAM CRMC PROVIDED 198 INDIVIDUALS WITH BUPRENORPHINE MEDICATION ENCOUNTERS TO SUPPRESS CRAVINGS AND WITHDRAWAL SYMPTOMS FROM OPIOID USE. THE TREATMENT PROVIDED PATIENTS WITH IMMEDIATE ATTENTION IN THE HOSPITAL SETTING, RATHER THAN BEING REFERRED TO A REHABILITATION CENTER, WHICH MAY TAKE WEEKS OR MONTHS. ADDITIONALLY, THE BRIDGE PROGRAM PROVIDED EDUCATIONAL INFORMATION TO THE GREATER COMMUNITY ABOUT SUBSTANCE ABUSE. COMMUNITY BEHAVIORAL HEALTH CENTER THE CBHC IS A 73-BED ACUTE PSYCHIATRIC HOSPITAL, WHICH IS LICENSED UNDER CRMC. CBHC IS THE LARGEST PSYCHIATRIC CARE FACILITY IN FRESNO COUNTY PROVIDING 24-HOUR ADULT, INPATIENT PSYCHIATRIC CARE. THERE ARE FOUR SEPARATE UNITS WITH LEVELS OF CARE APPROPRIATE TO THE FUNCTIONAL LEVELS OF THE PATIENTS. THE SERVICES PROVIDED INCLUDE PSYCHIATRIC ASSESSMENTS, FORENSIC (CUSTODY) SERVICES, RECREATION THERAPY, GROUP AND INDIVIDUAL THERAPY, ADULT CARE, MEDICATION MANAGEMENT, MILIEU MANAGEMENT AND OTHER TREATMENT MODALITIES. PART V, SECTION B, LINE 11 (CONTINUED): COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO SUPPORT MENTAL HEALTH CARE SERVICES. - READING & BEYOND WAS PROVIDED FUNDING FOR THEIR FAMILY ADVOCACY PROGRAM, PROVIDING SUPPORT TO THOSE WHO HAVE LOVED ONES WITH A MENTAL HEALTH DIAGNOSIS. - EVERY NEIGHBORHOOD PARTNERSHIP WOMEN'S ALLIANCE RECEIVED FUNDS FOR TRAUMA RESILIENCE EDUCATION. - FUNDS WERE PROVIDED FOR THE FRESNO CHAFFEE ZOO ART IN THE WILD MENTAL HEALTH SUPPORT PROGRAM. - THE FOUNDATION FOR FRESNO UNIFIED SCHOOLS WAS PROVIDED WITH A DONATION TO SUPPORT PEER-LED SUPPORT GROUPS.OTHER COMMUNITY BENEFIT SERVICES - COMMUNITY REGIONAL MEDICAL CENTER ("CRMC"):CRMC PROVIDED COMMUNITY BENEFIT SERVICES IN ADDITION TO THOSE PROGRAMS THAT FOCUSED ON ADDRESSING PRIORITY HEALTH NEEDS. HEALTH PROFESSIONAL EDUCATION DEFINITION: EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, NURSING STUDENTS AND OTHER HEALTH PROFESSIONALS. GRADUATE MEDICAL EDUCATION CRMC TRAINED 262 RESIDENTS AND 47 FELLOWS IN PARTNERSHIP WITH UCSF FRESNO. IN ADDITION, THIRD-AND FOURTH-YEAR MEDICAL STUDENTS ARE TRAINED ON A ROTATING BASIS. ROTATING MEDICAL STUDENTS INCLUDE THOSE IN UCSF'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION (SJV PRIME). SJV PRIME TRAINED LOCAL STUDENTS TO PROVIDE CULTURALLY COMPETENT, ACCESSIBLE CARE IN THE SAN JOAQUIN VALLEY. MORE THAN ONE-THIRD OF GRADUATING RESIDENTS STAY IN THE CENTRAL VALLEY TO PRACTICE MEDICINE, MAKING THIS PROGRAM CRITICAL TO ADDRESSING THE REGION'S ACCESS TO CARE ISSUES. THROUGH AN AGREEMENT WITH THE CALIFORNIA HEALTH SCIENCES UNIVERSITY (CHSU), A PRIVATE INSTITUTION OFFERING DOCTORAL DEGREES THROUGH ITS COLLEGE OF OSTEOPATHIC MEDICINE, CHSU MEDICAL STUDENTS ROTATED THROUGH THE HOSPITAL AS PART OF THEIR TRAINING. FHSH SUPPORTS IN THE TRAINING OF THE ADVANCED GI MIS/BARIATRICS FELLOWSHIP PROGRAM, IN PARTNERSHIP WITH ADVANCED LAPAROSCOPIC SURGICAL ASSOCIATES. THIS PROGRAM INCLUDED FOUR FELLOWS IN FY24.NURSING CRMC HAD 1,364 NURSING STUDENTS PARTICIPATE IN PRECEPTED HOSPITAL CLINICAL ROTATIONS. SONOGRAPHY PROGRAMS COMMUNITY OFFERS TWO SONOGRAPHY PROGRAMS AT CRMC TO HELP ADDRESS THE HEALTHCARE PROVIDER SHORTAGE THROUGHOUT THE REGION: THE DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM AND THE ADVANCED CARDIAC SONOGRAPHY PROGRAM. THE 18-MONTH DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM IS ONE OF CALIFORNIA'S FEW HOSPITAL-BASED SONOGRAPHY PROGRAMS AND IS THE CENTRAL VALLEY'S ONLY MULTIDISCIPLINARY COMMISSION ON ACCREDITATION OF ALLIED HEALTH EDUCATION PROGRAMS ("CAAHEP") ACCREDITED SONOGRAPHY PROGRAM. THE ADVANCED CARDIAC SONOGRAPHY PROGRAM IS AN 18-MONTH HYBRID PROGRAM DESIGNED TO CREATE A CAREER TRACK FOR SONOGRAPHERS PRACTICING AT AN ADVANCED LEVEL IN THE ECHOCARDIOGRAPHY LABORATORY BY PROVIDING A CAAHEP-ACCREDITED EDUCATIONAL PATHWAY FOR CLINICAL AND ADMINISTRATIVE ADVANCEMENT.OTHER HEALTH PROFESSIONAL EDUCATION THIRTY STUDENTS FROM CALIFORNIA STATE UNIVERSITY, FRESNO'S PHYSICAL THERAPY DOCTORATE PROGRAM PARTICIPATED IN A HANDS-ON SPINAL CORD INJURY MOBILIZATION LAB AT THE LEON S. PETERS REHABILITATION CENTER. CRMC SUPPORTED THE CENTRAL VALLEY BIOETHICS CONFERENCE HOSTED BY UCSF FRESNO.PHARMACY RESIDENCY PROGRAMTHE POST GRADUATE YEAR 1 (PGY1) PHARMACY RESIDENCY PROGRAM WAS ESTABLISHED IN 2002 AT CRMC. THE PROGRAM IS ACCREDITED THROUGH THE AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS (ASHP). IN FY24, CRMC FILLED THREE PHARMACY RESIDENCY POSITIONS. CLINICAL PASTORAL EDUCATION OF COMMUNITY HEALTH SYSTEM THE CLINICAL PASTORAL EDUCATION (CPE) PROGRAM AT CRMC PROVIDED PROFESSIONAL TRAINING FOR SPIRITUAL CARE PROVIDERS TO IMPROVE THEIR PROFESSIONAL MINISTRY SKILLS. THE CPE PROGRAM IS A MULTI-FAITH AND INTER-FAITH ENVIRONMENT THAT RESPECTS DIVERSITY. THE PROGRAM IS FULLY ACCREDITED TO OFFER ASSOCIATION OF CLINICAL PASTORAL EDUCATION'S (ACPE) CERTIFIED CPE PROGRAMS OF LEVEL I/II AND CERTIFIED EDUCATOR CPE. THE PROGRAM TRAINED 5 CHAPLAINS TO WORK WITH UNDERSERVED, RURAL POPULATIONS LIKE FARMWORKERS, PROVIDING SPIRITUAL AND EMOTIONAL SUPPORT. CASH DONATIONS DEFINITION: FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. FUNDS WERE DONATED TO NONPROFIT COMMUNITY GROUPS AND LOCAL ORGANIZATIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA INCLUDING, BUT NOT LIMITED TO: - FRESNO GRIZZLIES' "WILD ABOUT READING" LITERACY PROGRAM, WHICH PROVIDED OVER 100,000 STUDENTS WHO READ 10 BOOKS IN FIVE WEEKS WITH FREE TICKETS TO A GRIZZLIES GAME. - NATIONAL ALLIANCE ON MENTAL HEALTH ILLNESS' (NAMI) "I AM NAMI" WALK AND COMMUNITY OUTREACH EVENT - FRESNO RAINBOW PRIDE PARADE AND FESTIVAL COMMUNITY BENEFIT OPERATIONS DEFINITION: DIRECT AND INDIRECT COSTS ASSOCIATED WITH ASSIGNED STAFF, COMMUNITY HEALTH NEEDS ASSESSMENTS, COMMUNITY BENEFIT PLANNING, TRACKING, REPORTING, EVALUATING AND OPERATIONS.COMMUNITY BENEFIT OPERATIONS INCLUDED COMMUNITY BENEFIT STAFF SALARY, BENEFITS AND EXPENSES, ADMINISTRATIVE SUPPORT FOR COMMUNITY BENEFIT, COMMUNITY BENEFIT CONSULTANTS AND CBISA SOFTWARE SUBSCRIPTION FEES.COMMUNITY BUILDING ACTIVITIES DEFINITION: ACTIVITIES THAT SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HOSPITAL ORGANIZATION. THESE ACTIVITIES MAY ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS OR THE DETERMINANTS OF HEALTH, SUCH AS EDUCATION, HOMELESSNESS, POVERTY AND THE ENVIRONMENT. MEDWATCH TODAYOUR TELEVISION SHOW MEDWATCH TODAY, IN PARTNERSHIP WITH NEXSTAR MEDIA GROUP, PROVIDES 22 MINUTES OF WEEKLY BROADCAST QUALITY, CONSUMER-HEALTH FOCUSED VIDEO CONTENT TO ADULTS 45+ EACH WEEK ON LOCAL KGPE AND NBC CHANNELS. IN FY24, SOME TOPICS INCLUDED PREDIABETES PREVENTION, CARDIAC CARE, CANCER PREVENTION AND PARENTING TIPS.WORKFORCE DEVELOPMENT PROJECT SEARCH IS A DEDICATED PROGRAM FOCUSED ON PROVIDING EDUCATION AND TRAINING TO YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. SINCE 2017, CRMC HAS SERVED AS A VOCATIONAL TRAINING SITE FOR DISABLED ADULTS THROUGH PROJECT SEARCH. PARTICIPANTS RECEIVE EXPERIENCE NECESSARY TO FIND AND MAINTAIN EMPLOYMENT. IN FY24, 36 STUDENTS WORKED ALONGSIDE HOSPITAL STAFF IN CLINICAL AND NONCLINICAL AREAS INCLUDING NICU, ANTEPARTUM, POSTPARTUM, ENVIRONMENTAL SERVICES, MATERIALS MANAGEMENT, KITCHEN AND PLANT OPERATIONS AT CRMC AND CCMC.HOSPITAL TOURS WERE PROVIDED FOR 60 LOW-INCOME HIGH SCHOOL STUDENTS IN THE MEDICAL PATHWAYS PROGRAM.ADDRESSING PRIORITY HEALTH NEEDS - CLOVIS COMMUNITY MEDICAL CENTERIN FY24, CCMC ENGAGED IN ACTIVITIES AND PROGRAMS THAT ADDRESSED THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE FY23-FY25 IMPLEMENTATION STRATEGY. CCMC COMMITTED TO COMMUNITY BENEFIT EFFORTS THAT ADDRESSED ACCESS TO HEALTHCARE, CHRONIC DISEASES, ECONOMIC STABILITY, MATERNAL AND CHILD HEALTH AND MENTAL HEALTH. SOME OF THE ACTIVITIES AND PROGRAMS THAT HIGHLIGHT CCMC'S COMMITMENT TO THE COMMUNITY ARE DETAILED BELOW. ACCESS TO CARE RESPONSE TO NEED FINANCIAL ASSISTANCE THE HOSPITAL PROVIDED FINANCIAL ASSISTANCE THROUGH FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES, CONSISTENT WITH CHS'S FINANCIAL ASSISTANCE POLICY. COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO INCREASE ACCESS TO HEALTHCARE AND PROVIDE PREVENTIVE CARE SERVICES. - A CASH DONATION WAS PROVIDED TO EVERY NEIGHBORHOOD PARTNERSHIP'S BEAT THE HEAT EVENT TO SUPPORT ACCESS TO HEALTH INFORMATION AND RESOURCES, HOSTED BY FRESNO CITY COUNCILMEMBER TYLER MAXWELL. - FUNDING WAS PROVIDED TO THE MARJAREE MASON CENTER TO SUPPORT HEALTHCARE SERVICES FOR SURVIVORS OF DOMESTIC VIOLENCE IN FRESNO COUNTY.CHRONIC DISEASE RESPONSE TO NEED SUPPORT GROUPS AND EDUCATION CLASSES COMMUNITY CANCER INSTITUTE (CCI) HOSTED SUPPORT GROUPS AND CLASSES FOR 438 CANCER SURVIVORS AND THEIR FAMILIES. THE SUPPORT GROUPS, HELD IN ENGLISH AND SPANISH, WERE OPEN TO ALL PERSONS TOUCHED BY CANCER, REGARDLESS OF WHERE THEY RECEIVED CANCER CARE. THE SUPPORT GROUPS INCLUDED: PROSTATE, NECK AND HEAD, BRAIN, BREAST, NUTRITION AND WELLNESS CLASSES, STRESS MANAGEMENT AND MEDITATION.HEALTHQUEST SEMINARS LIVE ON-CAMPUS AND ONLINE HEALTH EDUCATION FEATURED HEALTH PROFESSIONALS DISCUSSING TOPICS RELATED TO IDENTIFIED HEALTH NEEDS INCLUDING HEART DISEASE, STROKE PREVENTION, CANCER DETECTION, PREVENTION AND TREATMENT, CAREGIVER SUPPORT AND LIVER DISEASE. THESE SEMINARS REACHED 599 COMMUNITY MEMBERS.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO PREVENT AND MANAGE CHRONIC DISEASES. - SUPPORT WAS PROVIDED FOR THE BOYS & GIRLS CLUBS OF FRESNO COUNTY HEALTHY HABITS PROGRAM IN REEDLEY. - THE HOSPITAL SUPPORTED THE AMERICAN HEART ASSOCIATION TO PURCHASE AND DISTRIBUTE SELF- MONITORED BLOOD PRESSURE KITS.ECONOMIC STABILITY RESPONSE TO NEED TRANSPORTATION SERVICES TRANSPORTATION VOUCHERS WERE MADE AVAILABLE TO PATIENTS AND FAMILIES HAVING DIFFICULTY ACCESSING CARE BECAUSE OF TRANSPORTATION CHALLENGES. PART V, SECTION B, LINE 11 (CONTINUED): COMMUNITY SUPPORTCASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS DEDICATED TO IMPROVING ECONOMIC STABILITY: - VISION Y COMPROMISO'S PROMOTORA-LED BROADBAND TRAINING - CATHOLIC CHARITIES FOOD DRIVE - THE KINGS COMMUNITY ACTION ORGANIZATION FOOD BANK - CENTRAL CALIFORNIA WOMEN'S CONFERENCE FOOD INSECURITY GRANTS INITIATIVEMATERNAL AND INFANT HEALTH RESPONSE TO NEED COMMUNITY SUPPORT A CASH DONATION WAS PROVIDED TO CASA FRESNO AND MADERA COUNTIES FOR AGES AND STAGES SCREENINGS IN FRESNO COUNTY.MENTAL HEALTH RESPONSE TO NEED BRIDGE PROGRAM CCMC PROVIDED 198 INDIVIDUALS WITH BUPRENORPHINE MEDICATION ENCOUNTERS TO SUPPRESS CRAVINGS AND WITHDRAWAL SYMPTOMS FROM OPIOID USE. THE TREATMENT PROVIDED PATIENTS WITH IMMEDIATE ATTENTION IN THE HOSPITAL SETTING, RATHER THAN BEING REFERRED TO A REHABILITATION CENTER, WHICH MAY TAKE WEEKS OR MONTHS. ADDITIONALLY, THE BRIDGE PROGRAM PROVIDED EDUCATIONAL INFORMATION TO THE GREATER COMMUNITY ABOUT SUBSTANCE ABUSE.COMMUNITY SUPPORT CASH DONATIONS WERE PROVIDED TO COMMUNITY ORGANIZATIONS DEDICATED TO ADDRESSING MENTAL HEALTH. - A CASH DONATION WAS PROVIDED TO CLOVIS UNIFIED SCHOOL DISTRICT TO SUPPORT ACCESS TO MENTAL HEALTH AND SUICIDE PREVENTION SERVICES. - FIRST 5 TULARE COUNTY RECEIVED FUNDING FOR ACES (ADVERSE CHILDHOOD EXPERIENCES) TRAINING.OTHER COMMUNITY BENEFIT SERVICES - CCMC:CCMC PROVIDED COMMUNITY BENEFIT SERVICES IN ADDITION TO THOSE PROGRAMS THAT FOCUSED ON ADDRESSING PRIORITY HEALTH NEEDS. HEALTH PROFESSIONAL EDUCATION DEFINITION: EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, NURSING STUDENTS AND OTHER HEALTH PROFESSIONALS. GRADUATE MEDICAL EDUCATION THROUGH AN AGREEMENT WITH THE CALIFORNIA HEALTH SCIENCES UNIVERSITY (CHSU), A PRIVATE INSTITUTION OFFERING DOCTORAL DEGREES THROUGH ITS COLLEGE OF OSTEOPATHIC MEDICINE, CHSU MEDICAL STUDENTS ROTATED THROUGH THE HOSPITAL AS PART OF THEIR TRAINING. NURSING CCMC HAD 668 NURSING STUDENTS PARTICIPATE IN PRECEPTED HOSPITAL CLINICAL ROTATIONS. OTHER HEALTH PROFESSIONAL EDUCATION OUR POST GRADUATE YEAR 1 (PGY1) PHARMACY RESIDENCY PROGRAM WAS ESTABLISHED IN 2016 AT CCMC. THE PROGRAM IS ACCREDITED THROUGH THE AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS (ASHP). IN FY24, CCMC FILLED TWO PHARMACY RESIDENCY POSITIONS.CASH DONATIONS DEFINITION: FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. FUNDS WERE DONATED TO NONPROFIT COMMUNITY GROUPS AND LOCAL ORGANIZATIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA INCLUDING, BUT NOT LIMITED TO: - CLOVIS COMMUNITY FOUNDATION'S DEVELOPMENT OF A CHILDREN'S BOOK BASED ON THE HISTORY OF CLOVIS. - CALIFORNIA HEALTH SCIENCES UNIVERSITY'S "IGNITE THE FUTURE" SCHOLARSHIP GALACOMMUNITY BENEFIT OPERATIONS DEFINITION: DIRECT AND INDIRECT COSTS ASSOCIATED WITH ASSIGNED STAFF, COMMUNITY HEALTH NEEDS ASSESSMENTS, COMMUNITY BENEFIT PLANNING, TRACKING, REPORTING, EVALUATING AND OPERATIONS.COMMUNITY BENEFIT OPERATIONS INCLUDED COMMUNITY BENEFIT STAFF SALARY, BENEFITS AND EXPENSES, ADMINISTRATIVE SUPPORT FOR COMMUNITY BENEFIT, COMMUNITY BENEFIT CONSULTANTS AND CBISA SOFTWARE SUBSCRIPTION FEES.COMMUNITY BUILDING ACTIVITIES DEFINITION: ACTIVITIES THAT SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HOSPITAL ORGANIZATION. THESE ACTIVITIES MAY ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS OR THE DETERMINANTS OF HEALTH, SUCH AS EDUCATION, HOMELESSNESS, POVERTY AND THE ENVIRONMENT. WORKFORCE DEVELOPMENT PROJECT SEARCH IS A DEDICATED PROGRAM FOCUSED ON PROVIDING EDUCATION AND TRAINING TO YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. SINCE 2017, CCMC HAS SERVED AS A VOCATIONAL TRAINING SITE FOR DISABLED ADULTS THROUGH PROJECT SEARCH. PARTICIPANTS RECEIVE EXPERIENCE NECESSARY TO FIND AND MAINTAIN EMPLOYMENT. IN FY24, 36 STUDENTS WORKED ALONGSIDE HOSPITAL STAFF IN CLINICAL AND NONCLINICAL AREAS INCLUDING NICU, ANTEPARTUM, POSTPARTUM, ENVIRONMENTAL SERVICES, MATERIALS MANAGEMENT, KITCHEN AND PLANT OPERATIONS AT CRMC AND CCMC.DELTA SIGMA THETA AFRICAN AMERICAN HIGH SCHOOL RECOGNITION SCHOLARSHIPS WERE SUPPORTED.CENTRAL CA ASIAN PACIFIC WOMEN HIGH SCHOOL SCHOLARSHIPS WERE SUPPORTED. PART V, SECTION B, LINE 13B: THE PATIENT'S, OR THE PATIENT'S FAMILY'S MEDICAL EXPENSES FOR COVERED SERVICES (INCURRED AT CHS OR OTHER PROVIDERS IN THE PAST TWELVE (12) MONTHS) EXCEEDS 10% OF THE PATIENT'S FAMILY INCOME. SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP A: PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CARE PART V, SECTION B, LINE 16J: OSHPD HAS CREATED A WEB-BASED SYSTEM THAT WILL ALLOW USERS TO SEARCH, COMPARE, AND VIEW EACH HOSPITAL'S SUBMITTED CHARITY CARE POLICY, DISCOUNT PAYMENT POLICY, ELIGIBILITY PROCEDURES, REVIEW PROCESS, AND APPLICATION FORM. ACCESS OSHPD'S HOSPITAL FAIR PRICING SEARCH SYSTEM AT: HTTPS://SYFPHR.HCAI.CA.GOV/#FRESNO-COUNTY PART V, SECTION B, LINE 22D: UNDER CALIFORNIA LAW (AB 774), THE MAXIMUM THAT A FAP-ELIGIBLE PATIENT MAY BE CHARGED IS THE REIMBURSEMENT RATE OF ANY GOVERNMENT-SPONSORED HEALTH PROGRAMS IN WHICH THE HOSPITAL PARTICIPATES. 5 1 - COMMUNITY CANCER INSTITUTE 785 NORTH MEDICAL CENTER DR W CLOVIS CA 93611 OUTPATIENT CANCER CENTER INCLUDED IN CCMC HOSPITAL LICENSE 2 - DERAN KOLIGIAN AMBULATORY CARE CENTER 290 N WAYTE LANE FRESNO CA 93701 CLINICS: OMFS SURGERY, HIV/AIDS INCLUDED IN CRMC HOSPITAL LICENSE 3 - COMMUNITY BEHAVIORAL HEALTH CENTER 7171 N CEDAR AVE FRESNO CA 93720 PSYCHIATRIC CARE FACILITY INCLUDED IN CRMC HOSPITAL LICENSE 4 - COMMUNITY SUBACUTE TRANSITIONAL CARE CEN 3003 N MARIPOSA ST FRESNO CA 93703 TRANSITIONAL CARE INCLUDED IN CRMC HOSPITAL LICENSE 5 - FRESNO HEART AND SURGICAL HOSPITAL 15 E AUDUBON FRESNO CA 93720 SPECIALTY SURGERY SERVICES INCLUDED IN CRMC HOSPITAL LICENSE PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS ISSUED BY COMMUNITY HEALTH SYSTEM (CHS), A DBA USED BY THE TWO HOSPITALS THAT COMPRISE THE ORGANIZATION. PART I, LINE 7: COSTING METHODOLOGY: CHARITY CARE IS ESTIMATED BY CALCULATING THE RATIO OF COST PER ADJUSTED PATIENT DAY (EXCLUDING BAD DEBTS) AND THEN MULTIPLYING THAT RATIO BY THE ADJUSTED PATIENT DAYS ASSOCIATED WITH CHARITY CARE PATIENTS. CHS DOES NOT UTILIZE A COST ACCOUNTING SYSTEM TO ESTIMATE THE COST OF CHARITY CARE. 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 $ 1,013,216. PART II, COMMUNITY BUILDING ACTIVITIES: SEE PART V, SECTION B, LINE 11 FOR COMMUNITY BUILDING ACTIVITIES DESCRIPTIONS FOR WORKFORCE DEVELOPMENT. PART III, LINE 2: ADJUSTMENT DUE TO THE PATIENT'S ABILITY TO PAY DUE TO A BANKRUPTCY ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 3: CHS DOES NOT RECOGNIZE ANY PORTION OF ITS BAD DEBT EXPENSE AS A COMMUNITY BENEFIT. PART III, LINE 4: FOOTNOTE FOR BAD DEBT EXPENSE: SEE AUDITED FINANCIAL STATEMENTS NOTE 3, PAGE 17.FOOTNOTE FOR ACCOUNTS RECEIVABLE: SEE AUDITED FINANCIAL STATEMENTS NOTE 2, PAGE 12. PART III, LINE 8: MEDICARE SHORTFALL: THE MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFIT BECAUSE: (1) NONNEGOTIABLE MEDICARE RATES ARE SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; AND (2) BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES.COSTING METHODOLOGY: INPATIENT CARE SERVICES, SKILLED NURSING SERVICES, REHABILITATION SERVICES, AND CERTAIN OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DIAGNOSIS. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. CERTAIN INPATIENT NONACUTE SERVICES AND MEDICAL EDUCATION COSTS RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST-BASED REIMBURSEMENT METHODOLOGY. PROFESSIONAL SERVICES ARE REIMBURSED BASED ON A FEE SCHEDULE. PART III, LINE 9B: THOSE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE GENERALLY SUBJECT TO THE NORMAL COLLECTION PROCEDURES FOR ALL PATIENTS. COMMUNITY HEALTH SYSTEM (CHS) MAY EMPLOY REASONABLE COLLECTION EFFORTS TO OBTAIN PAYMENT FROM PATIENTS. GENERAL COLLECTION ACTIVITIES MAY INCLUDE ISSUING PATIENT STATEMENTS, PHONE CALLS, AND FOLLOW UP LETTERS SENT TO THE PATIENT OR GUARANTOR. CHS SHALL NOT PURSUE COLLECTIONS AND EXTRAORDINARY COLLECTION ACTIONS WHEN: THE PATIENT IS A RYAN WHITE PATIENT, THE PATIENT IS HOMELESS, THE PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AND/OR GOVERNMENT SPONSORED COVERAGE AND THE APPLICATION IS PENDING, CHS IS AWARE THAT THE PATIENT IS ALREADY APPROVED FOR FINANCIAL ASSISTANCE, AND THE PATIENT IS REASONABLY COOPERATING WITH CHS IN AN EFFORT TO SETTLE AN OUTSTANDING BILL.CHS WILL MAKE REASONABLE EFFORTS TO NOTIFY THE PATIENT PRIOR TO ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTIONS. THESE ACTIONS WILL ONLY TAKE PLACE AFTER 150 DAYS FROM THE INITIAL PATIENT STATEMENT. ALL PATIENT STATEMENTS SHALL INCLUDE THE NOTICE OF RIGHTS, WHICH INCLUDES A SUMMARY OF FINANCIAL ASSISTANCE THAT IS AVAILABLE TO ELIGIBLE PATIENTS. ALL PATIENTS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNT AT ANY TIME. PART VI, LINE 2: AS PART OF THE AFFORDABLE CARE ACT, COMMUNITY HEALTH SYSTEM PARTNERED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA AND MANY OTHER VALLEY HOSPITALS AS WELL AS LOCAL ORGANIZATIONS TO PUBLISH A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022. ADDITIONALLY, EACH OF CHS' THREE HOSPITALS DEVELOPED IMPLEMENTATION PLANS TO ADDRESS SOME OF THE KEY NEEDS IDENTIFIED IN THE REPORT. PART VI, LINE 3: COMMUNITY HEALTH SYSTEM ("CHS") SHALL WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IN A MANNER THAT IS REASONABLY CALCULATED TO REACH, NOTIFY AND INFORM THOSE PATIENTS IN OUR COMMUNITIES WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE, INCLUDING AT A MINIMUM, THE FOLLOWING WAYS: PUBLIC DISPLAYS: COMMUNITY HEALTH SYSTEM SHALL CLEARLY AND CONSPICUOUSLY POST PUBLIC DISPLAYS (OR OTHER MEASURES REASONABLY CALCULATED TO ATTRACT PATIENTS' ATTENTION) THAT NOTIFY AND INFORM PATIENTS ABOUT THIS POLICY IN PUBLIC LOCATIONS AT CHS INCLUDING, AT A MINIMUM, THE EMERGENCY DEPARTMENT, BILLING OFFICE, ADMISSIONS OFFICE, AND OUTPATIENT SETTINGS, INCLUDING OBSERVATION UNITS. THESE SHALL BE POSTED IN ENGLISH, SPANISH, AND HMONG. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE, AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY SHALL BE AVAILABLE ON THE HOME PAGE AND MAIN BILLING PAGE, AS WELL AS OTHER PROMINENT PLACES ON CHS' WEBSITE, HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. MAIL: PATIENTS MAY REQUEST A FREE COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY BE SENT BY MAIL.OTHER EFFORTS: CHS WILL PROVIDE A DIGITAL KIT TO RELEVANT COMMUNITY ORGANIZATIONS WHO WILL WIDELY PUBLICIZE THE AVAILABILITY OF THIS POLICY TO AFFECTED PATIENTS IN THE COMMUNITY. CHS OR AN AUTHORIZED REPRESENTATIVE SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WHICH ADVISES THE PATIENT OF THE MAXIMUM GROSS MONTHLY HOUSEHOLD INCOME PER FAMILY SIZE TO QUALIFY FOR FINANCIAL ASSISTANCE AS FOLLOWS: - AT REGISTRATION: DURING REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE). - EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. - OUTPATIENT SERVICES: AT THE OUTPATIENT APPOINTMENT BEFORE THE PROCEDURE TAKES PLACE. - AT DISCHARGE: AT THE TIME OF DISCHARGE, WHEN CHS OR AN AUTHORIZED REPRESENTATIVE OF CHS SHALL ALSO PROVIDE OR OFFER TO PROVIDE ALL UNINSURED PATIENTS APPLICATIONS FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM. FOR NOTICES PROVIDED PURSUANT TO SECTION IV.G.2.A.2 AND A.3, THE PLAIN LANGUAGE SUMMARY WILL BE PROVIDED TO PATIENTS WHO ARE CONSCIOUS. IF THE PATIENT IS UNCONSCIOUS OR NOT ABLE TO RECEIVE THE PLAIN LANGUAGE SUMMARY, THEN THE NOTICE MUST BE PROVIDED AT DISCHARGE. FOR PATIENTS NOT ADMITTED TO CHS, THE PLAIN LANGUAGE SUMMARY WILL BE PROVIDED WHEN THE PATIENT IS LEAVING THE FACILITY. IF A PATIENT LEAVES CHS WITHOUT RECEIVING THE PLAIN LANGUAGE SUMMARY, CHS WILL MAIL THE NOTICE TO THE PATIENT WITHIN SEVENTY-TWO (72) HOURS OF PROVIDING THE SERVICES. PART VI, LINE 4: COMMUNITY HEALTH SYSTEM ("CHS") IS A LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE SYSTEM BASED IN FRESNO, CALIFORNIA. ESTABLISHED IN 1897, CHS IS THE REGION'S LARGEST HEALTHCARE PROVIDER AND PRIVATE EMPLOYER. WITH APPROXIMATELY 11,000 EMPLOYEES, ALMOST 800 VOLUNTEERS, AND 2,500 AFFILIATED PHYSICIANS, CHS SERVES A 15,000 SQUARE-MILE AREA THAT INCLUDES FRESNO, KINGS, MADERA AND TULARE COUNTIES IN CALIFORNIA'S CENTRAL VALLEY, A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). CHS IS MADE UP OF COMMUNITY MEDICAL CENTERS (HOSPITALS AND OUTPATIENT CENTERS), COMMUNITY PROVIDER NETWORK (OUR AFFILIATED PHYSICIANS) AND COMMUNITY CARE HEALTH (OUR HEALTH PLAN). FOR OVER 125 YEARS, COMMUNITY HEALTH SYSTEM HAS BEEN INVESTING IN THIS REGION GROWING A SUCCESSFUL HEALTHCARE SYSTEM THAT SUPPORTS OUR COMMUNITY AND SERVES VALLEY RESIDENTS. CHS ALSO OPERATES THE ONLY COMBINED BURN AND LEVEL 1 TRAUMA UNITS BETWEEN LOS ANGELES AND SACRAMENTO, PROVIDING CRITICAL CARE AND OTHER SPECIALTY SERVICES TO PATIENTS FROM WELL OUTSIDE THE PRIMARY SERVICE REGION. THOSE UNITS ARE LOCATED AT COMMUNITY REGIONAL MEDICAL CENTER ("CRMC"), WHICH ALSO OPERATES ONE OF THE BUSIEST HOSPITAL EMERGENCY DEPARTMENTS IN THE NATION.COMMITMENT TO THE COMMUNITYWE RECOGNIZE OUR OBLIGATION TO PROVIDE SERVICE ABOVE AND BEYOND OUR ROLE AS A SYSTEM OF HEALING FACILITIES. COMMUNITY'S HOSPITALS PROVIDE FINANCIAL ASSISTANCE TO THOSE IN THE COMMUNITY WHO CANNOT AFFORD SERVICES, OR WHOSE HEALTH INSURANCE DOES NOT COVER ALL SERVICES PROVIDED, AND WE INVEST IN THE COMMUNITY TO INCREASE ACCESS TO HEALTHCARE SERVICES AND IMPROVE HEALTH. THIS REPORT DEMONSTRATES TANGIBLE WAYS WE FULFILL OUR MISSION TO BETTER THE LIVES OF ALL THOSE WE SERVE THROUGH HUMANITY AND INGENUITY.SERVICE AREA THE HOSPITAL FACILITIES ARE IN THE HEART OF CALIFORNIA'S SAN JOAQUIN VALLEY NEAR MAJOR INTERSTATE HIGHWAYS AND THREE POPULAR NATIONAL PARKS. THE HOSPITALS SHARE A PRIMARY SERVICE AREA OF FRESNO, KINGS, MADERA AND TULARE COUNTIES. - COMMUNITY REGIONAL MEDICAL CENTER IS LOCATED AT 2823 FRESNO ST., FRESNO, CA 93721 - CLOVIS COMMUNITY MEDICAL CENTER IS LOCATED AT 2755 HERNDON AVE., CLOVIS, CA 93611 - FRESNO HEART & SURGICAL HOSPITAL IS LOCATED AT 15 E. AUDUBON DR., FRESNO, CA 93720 - COMMUNITY BEHAVIORAL HEALTH CENTER IS LOCATED AT 7171 N. CEDAR AVE., FRESNO, CA 93720COMMUNITY HEALTH SYSTEM'S SERVICE AREA SNAPSHOTPOPULATION - THE POPULATION IS 1,761,174. - CHILDREN AND YOUTH, AGES 0-17, MAKE UP 28.8% OF THE POPULATION, 59.2% ARE ADULTS AND 12% ARE SENIORS, AGES 65 AND OLDER.RACE AND ETHNICITY - MORE THAN HALF OF THE POPULATION (57.0%) IDENTIFY AS HISPANIC OR LATINO. - 29.1% OF THE SERVICE AREA POPULATION ARE WHITE RESIDENTS. - ASIAN RESIDENTS COMPRISE 7.2% OF THE POPULATION AND 3.6% OF THE POPULATION ARE BLACK OR AFRICAN AMERICAN RESIDENTS. LANGUAGES - SPANISH IS SPOKEN IN 38.5% OF THE HOMES, 54.1% OF THE RESIDENTS SPEAK ENGLISH ONLY AND 4.3% SPEAK AN ASIAN OR PACIFIC ISLANDER LANGUAGE IN THE HOME. POVERTY - AMONG AREA RESIDENTS, 20.5% LIVE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL), WHICH IS HIGHER THAN THE STATE RATE (12.6%). - 44.2% OF THE POPULATION LIVE AT 200% OF FPL (LOW INCOME) PART VI, LINE 5: COMMUNITY HEALTH SYSTEM'S ("CHS") COMMITMENT TO OUR COMMUNITY IS DEMONSTRATED AT EVERY LEVEL OF THE ORGANIZATION. EVIDENCE OF OUR MISSION IS THE CONTINUAL INVESTMENT IN IMPROVING THE HEALTH OF THOSE WE SERVE AND IN OUR WORKFORCE OF MORE THAN 14,000 EMPLOYEES, PHYSICIANS, AND VOLUNTEERS. AN INTEGRAL PART OF OUR MISSION IS OUR PATIENT POPULATION THAT INCLUDES MORE THAN 62,000 ADMISSIONS, ALMOST 214,000 OUTPATIENT VISITS AND MORE THAN 203,000 EMERGENCY DEPARTMENT VISITS EQUALING MORE THAN 465,000 PATIENTS TO WHOM WE PROVIDED QUALITY MEDICAL CARE.CHS STRIVES TO BRING PEOPLE AND ORGANIZATIONS TOGETHER TO IMPROVE COMMUNITY WELLNESS. THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") PROCESS IS ONE WAY WE CAN LIVE OUT OUR MISSION. TO FULFILL THIS MISSION, WE MUST BE INTENTIONAL ABOUT UNDERSTANDING THE HEALTH ISSUES THAT IMPACT RESIDENTS AND WORK TOGETHER TO CREATE A HEALTHY COMMUNITY.A PRIMARY COMPONENT OF CREATING A HEALTHY COMMUNITY IS ASSESSING THE NEEDS AND PRIORITIZING THOSE NEEDS FOR IMPACT. IN 2021 AND 2022, CHS CONDUCTED A COMPREHENSIVE CHNA TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS AND OTHER HEALTH NEEDS. THE RESULTS FROM THE ASSESSMENT PROVIDE CRITICAL INFORMATION TO GUIDE US IN MAKING A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ALSO ENABLE CHS TO MEASURE IMPACT AND STRATEGICALLY ESTABLISH PRIORITIES TO DEVELOP INTERVENTIONS AND ALIGN RESOURCES.A CHNA IS A TOOL THAT IS USED TO GUIDE COMMUNITY BENEFIT ACTIVITIES AND SEVERAL OTHER PURPOSES. FOR HOSPITALS, IT IS USED TO IDENTIFY AND ADDRESS KEY HEALTH NEEDS AND SUPPORTS THE DEVELOPMENT OF COMMUNITY BENEFIT PLANS MANDATED BY THE STATE OF CALIFORNIA AND THE FEDERAL GOVERNMENT. THE DATA FROM A CHNA IS FURTHERMORE USED TO INFORM COMMUNITY DECISION-MAKING, THE PRIORITIZATION OF HEALTH NEEDS AND THE DEVELOPMENT, IMPLEMENTATION AND EVALUATION OF AN IMPLEMENTATION PLAN OR COMMUNITY HEALTH IMPROVEMENT PLAN ("CHIP").THE CHNA IS AN IMPORTANT PIECE IN THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY/CHIP BECAUSE IT HELPS THE COMMUNITY TO UNDERSTAND THE HEALTH-RELATED ISSUES THAT NEED TO BE ADDRESSED. TO IDENTIFY AND ADDRESS THE CRITICAL HEALTH NEEDS OF THE REGION, CHS UTILIZED THE MOST CURRENT AND RELIABLE INFORMATION FROM EXISTING SOURCES AND THEN COLLECTED NEW DATA THROUGH INTERVIEWS, FOCUS GROUPS AND SURVEYS WITH COMMUNITY RESIDENTS AND LEADERS.CHS IS GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES COMPRISED OF CIVIC LEADERS AND PHYSICIANS. THE TRUSTEES SET THE VISION AND POLICY DIRECTION FOR THE ORGANIZATION AND APPROVE THE ORGANIZATION'S STRATEGIC, BUSINESS AND FINANCIAL PLANS. THE BOARD OF TRUSTEES REVIEWS AND ADOPTS THE CHNAS, THE ANNUAL COMMUNITY BENEFIT REPORTS AND OUR IMPACT ON THE AREAS OF GREATEST NEED.SENIOR MANAGEMENT ENCOURAGES INITIATIVES TO EXPAND ACCESS TO HEALTHCARE SERVICES IN OUR COMMUNITY AND IS COMMITTED TO INVESTING IN AND PARTNERING WITH LOCAL, NONPROFIT ORGANIZATIONS WORKING IN SOCIO-ECONOMICALLY DISADVANTAGED NEIGHBORHOODS AND RURAL POPULATIONS. A MULTISTAKEHOLDER COMMITTEE ENSURES BOARD AND SENIOR MANAGEMENT DIRECTIVES ARE FULFILLED AND APPROVES FINANCIAL ALLOCATIONS TO COMMUNITY BENEFIT PROGRAMS, OUTREACH AND EDUCATION.COMMUNITY BENEFIT AND COMMUNITY SERVICE ARE AT THE HEART OF OUR HEALTHCARE SYSTEM. PART VI, LINE 6: COMMUNITY MEDICAL CENTERS (CMC) OPERATES ITS FACILITIES UNDER TWO HOSPITAL LICENSES: COMMUNITY REGIONAL MEDICAL CENTER (CRMC) AND CLOVIS COMMUNITY MEDICAL CENTER (CCMC). FRESNO HEART & SURGICAL HOSPITAL (FHSH), COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC) AND COMMUNITY SUBACUTE &TRANSITIONAL CARE CENTER (CSTCC) OPERATE UNDER THE CRMC LICENSE. CMC ALSO OPERATES A CANCER INSTITUTE AND SEVERAL OUTPATIENT AND OTHER HEALTHCARE FACILITIES.WHILE CHS' SYSTEM OF CARE WORKS COLLABORATIVELY TO ADDRESS THE REGION'S HEALTHCARE NEEDS, CRMC AND CCMC ACTIVITIES AND FINANCIAL CONTRIBUTIONS FOR COMMUNITY BENEFIT ARE REPORTED SEPARATELY IN THIS REPORT.CRMC HAS 685 LICENSED BEDS AND OFFERS CENTRAL CALIFORNIA'S HIGHEST LEVEL OF MEDICAL CARE. CRMC IS A LEADER IN COMPREHENSIVE NEUROSCIENCE SERVICES, HAS A LEVEL 3 NICU (NEONATAL INTENSIVE CARE UNIT) AND A FULL-SERVICE 58,000 SQUARE-FOOT EMERGENCY DEPARTMENT (ED). CRMC IS HOME TO THE ONLY LEVEL I TRAUMA CENTER AND COMPREHENSIVE BURN CENTER BETWEEN LOS ANGELES AND SACRAMENTO. WE SERVE AS THE AREA'S "SAFETY NET" PROVIDER, CARING FOR OUR REGION'S MOST VULNERABLE POPULATIONS.FHSH IS A SPECIALTY HOSPITAL IN CENTRAL CALIFORNIA WITH 57-LICENSED BEDS. FHSH IS KNOWN FOR ITS EXCELLENT PATIENT EXPERIENCE AND EXEMPLARY BARIATRIC, CARDIAC, ENDOCRINE, NEURO AND VASCULAR SURGERY SERVICES. FHSH OPERATES UNDER THE CRMC LICENSE.CBHC OPERATES 73 BEDS UNDER THE CRMC LICENSE AND IS THE LARGEST INPATIENT MENTAL HEALTH FACILITY IN FRESNO COUNTY FOR THOSE IN NEED OF ACUTE PSYCHIATRIC CARE. CBHC PROVIDES 24-HOUR CARE TO PATIENTS BASED ON THEIR LEVEL OF NEED.CSTCC IS A 106-BED FACILITY PROVIDING INPATIENT CARE FOR CHRONIC, SUBACUTE CONDITIONS AND COMPLEX ILLNESSES THAT REQUIRE 24-HOUR MEDICAL SUPERVISION. CSTCC PROVIDES PATIENTS WITH TREATMENT THAT IS CONSISTENT WITH AN ACUTE CARE CENTER'S EFFECTIVENESS WHILE IN A COMFORTABLE LONG-TERM SETTING.CCMC HAS 352 LICENSED BEDS. IT INCLUDES AN EMERGENCY DEPARTMENT (ED) AND PROVIDES SPECIALTY CARE FOR PATIENTS, INCLUDING COMPREHENSIVE HEART AND LUNG CARE, WOMEN'S SERVICES AND LABOR AND DELIVERY. CCMC IS HOME TO THE COMMUNITY CANCER INSTITUTE (CCI) AND THE MARJORIE E. RADIN BREAST CARE CENTER, PART OF CENTRAL CALIFORNIA'S PREMIER COMPREHENSIVE CANCER CARE PROGRAM, WHICH OFFERS MULTIDISCIPLINARY CARE TEAMS, A CLINIC, SCREENINGS AND DIAGNOSTICS, AS WELL AS CANCER TREATMENTS USING THE MOST ADVANCED TECHNOLOGY. PART VI, LINE 7, REPORTS FILED WITH STATES CA 0 FOUNDATION FOR FRESNO SCHOOLS 906 N STREET FRESNO CA 93721 871626646 501(C)(3) 25000 0 TO SUPPORT INITIATIVE FOR MENTAL HEALTH FOUNDATION FOR CLOVIS SCHOOLS 1450 HERNDON AVENUE CLOVIS CA 93611 770140576 501(C)(3) 40000 0 SPECIALIZED SUICIDE PREVENTION AND INTERVENTION PROGRAMS MARJAREE MASON CENTER 1600 M STREET FRESNO CA 93721 941156639 501(C)(3) 105000 0 TO SUPPORT DOMESTIC VIOLENCE INTERVENTION AND PREVENTION CALIFORNIA HOSPITALS COMMITTEE ON ISSUES 1215 K STREET SUITE 800 SACRAMENTO CA 95814 680148902 501(C)(6) 43329 0 LOBBYING EXPENDITURES ADVANCED ARMENIA FOUNDATION 2753 QUINCY AVENUE CLOVIS CA 93619 843093464 501(C)(3) 100000 0 SUPPORT MEDICAL MISSION TO ARMENIA CENTRAL CALIFORNIA FOOD BANK 4010 E AMENDOLA DRIVE FRESNO CA 93725 946024540 501(C)(3) 16960 0 SCHOOL BACKPACK PROGRAM AT YOKOMI ELEMENTARY SCHOOL CENTRAL CALIFORNIA WOMEN'S CONFERENCE PO BOX 25611 FRESNO CA 93729 770178140 501(C)(3) 10000 0 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 2007 O STREET SACRAMENTO CA 95811 135613797 501(C)(3) 25000 0 TO SUPPORT BLOOD PRESSURE EDUCATION EFFORTS, INCLUDING THE DISTRIBUTION OF SELF-MONITORED BLOOD PRESSURE KITS TO NEW MOMS IN THE CENTRAL VALLEY VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 942797447 501(C)(3) 0 12589 FMV PEDIATRIC TECHOTHERM DEVICE TO SUPPORT CARE OF NEONATES BLACK WELLNESS AND PROSPERITY CENTER 1133 S STREET FRESNO CA 93721 843848144 501(C)(3) 10000 0 TO SUPPORT IMPROVING BLACK MATERNAL AND INFANT HEALTH OUTCOMES THROUGH THE DOULA TRAINING PROGRAM FRESNO RESCUE MISSION PO BOX 1422 FRESNO CA 93716 941279785 501(C)(3) 61840 0 TO SUPPORT FOOD SERVICE FOR THE COMMUNITY CARE AND FAMILY CENTER READING AND BEYOND 4670 E BUTHER AVENUE FRESNO CA 93702 770508471 501(C)(3) 10000 0 TO SUPPORT HEALTH SERVICES OPEN HOUSE AND WELLNESS WEDNESDAYS AND FAMILY ADVOCACY PROGRAM 11 1 PART I, LINE 2: THE ORGANIZATION DOES NOT HAVE A GRANT PROCEDURE FOR MONITORING THE USE OF FUNDS. X 1 1 X X X X 1 1 0 0 0 0 0 1 0 CRAIG S CASTRO PRESIDENT, CHIEF EXECUTIVE OFFICER 0 1847656 0 125000 0 230922 0 767121 0 17820 0 2988519 0 0 CRAIG WAGONER EVP, CHIEF OPERATING OFFICER 0 1064611 0 435598 0 121881 0 23100 0 13119 0 1658309 0 0 CHRISTOPHER NEUMAN SVP, CHIEF FINANCIAL OFFICER 0 778610 0 517863 0 8920 0 19800 0 14920 0 1340113 0 0 THOMAS UTECHT SVP, CHIEF MEDICAL OFFICER 773707 0 326906 0 67073 0 26400 0 22750 0 1216836 0 0 0 BRIANNE L MARRIOTT SVP, CHIEF LEGAL OFFICER 0 642911 0 238163 0 29069 0 19800 0 16925 0 946868 0 0 ALDO DE LA TORRE - SVP NETWORK DEVELOPMENT AND INSURANCE SVC 0 584493 0 230556 0 55231 0 16500 0 22208 0 908988 0 0 CARLA MILTON - SVP CHIEF HUMAN RESOURCES OFFICER 0 539365 0 208960 0 32921 0 23100 0 16615 0 820961 0 0 TRACY KIRITANI VP, HOSPITAL FINANCIAL OPERATIONS 517440 0 121098 0 51795 0 26400 0 8078 0 724811 0 0 0 JEFFREY THOMAS - VP CHIEF MEDICAL AND QUALITY OFFICER - CRMC 521043 0 118348 0 56140 0 16500 0 8432 0 720463 0 0 0 ROGER LARSEN - FORMER SVP CHIEF FINANCIAL OFFICER THRU 08/22 0 0 0 0 0 667956 0 0 0 12984 0 680940 0 0 DANIEL DAVIS - SVP CHIEF CLINICAL AND OPERATIONS OFFICER 479945 0 114281 0 4763 0 16500 0 6121 0 621610 0 0 0 ROBYN GONZALES VP, CHIEF OPERATING OFFICER CRMC 414474 0 91483 0 15200 0 26400 0 15351 0 562908 0 0 0 DEBORAH MOFFETT VICE FINANCIAL OFFICER/VP FINANCE 0 397367 0 104584 0 5861 0 26400 0 7706 0 541918 0 0 JUANITA HERNANDEZ - FRMR FIRST VS/SECOND VS/DIR CORP GOV THRU 02/22 0 0 0 0 0 170795 0 0 0 0 0 170795 0 0 ISABEL MARTINEZ - FIRST VS DIRECTOR CORP GOVERNANCE 0 104881 0 27413 0 8661 0 9697 0 15292 0 165944 0 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR THOMAS UTECHT. THIS IS INCLUDED IN TAXABLE COMPENSATION. PART I, LINES 4A-B LINE 4A: SEVERANCE AGREEMENTS WERE MADE BETWEEN THE ORGANIZATION AND TWO EMPLOYEES: ROGER LARSEN AND JUANITA HERNANDEZ. UNDER THESE AGREEMENTS, PAYMENTS WERE MADE DURING 2023 FOR BOTH EMPLOYEES. DETAILS OF THE TERMS AND CONDITIONS OF THE SEVERANCE AGREEMENTS ARE AVAILABLE TO THE IRS UPON REQUEST. LINE 4B: DURING THE YEAR, CRAIG S. CASTRO PARTICIPATED IN A SERP PLAN. A CONTRIBUTION OF $740,721 WAS MADE IN 2023. SELECT INDIVIDUALS AGREED TO PARTICIPATE IN A CAP-EX PLAN. SEE SCHEDULE L, PART V FOR A BROADER DESCRIPTION. PART I, LINE 7 IF FUNDING IS AVAILABLE, THE CHS BOARD WILL PROVIDE THE CHS PRESIDENT & CHIEF EXECUTIVE OFFICER WITH A DISCRETIONARY BONUS POOL TO RECOGNIZE CHS SENIOR LEADERS WHO HAVE DEMONSTRATED EXCEPTIONAL PERFORMANCE. DURING THE YEAR, THOMAS UTECHT AND DANIEL DAVIS RECEIVED A DISCRETIONARY BONUS. A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TS20 2017-02-01 429863267 CONSTRUCTION & REFUNDING 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048VZJ0 2021-12-16 350004938 NEW CONSTRUCTION 0 0 0 A 71386139 430205457 2780950 50342190 377082317 2018 1 1 1 1 B 5769557 350004938 350000000 4938 2022 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, COLUMN F: ROW A: SERIES 2017 REFUNDED THE FOLLOWING: REFUNDED A PORTION OF THE SERIES 2007 BONDS OUTSTANDING WITH A PAR AMOUNT OF $213,100,000; SERIES BONDS 2009 PAR AMOUNT $182,365,000. SCHEDULE K, PART II, LINE 3: COLUMN A: TOTAL PROCEEDS OF ISSUE = ISSUE PRICE + PROJECT FUND EARNINGS OF $342,190. SCHEDULE K COMBINED SUPPLEMENTAL INFORMATION: THE ORGANIZATION AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HAVE ESTABLISHED AN OBLIGATED GROUP TO ACCESS CAPITAL MARKETS. THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY LIABLE FOR LONG-TERM DEBT OUTSTANDING UNDER THE OBLIGATED GROUPS MASTER TRUST INDENTURE. THE ORGANIZATION IS THE PRIMARY BENEFICIARY OF THE TAX-EXEMPT BOND PROCEEDS AND FILES SCHEDULE K FOR THE BENEFIT OF ALL MEMBERS OF THE OBLIGATED GROUP. CRAIG CASTRO OFFICER SPLIT INTEREST INSURANCE X 2630651 2875673 0 1 1 CHRISTOPHER NEUMAN OFFICER SPLIT INTEREST INSURANCE X 1895110 1990894 0 1 1 CRAIG WAGONER KEY EMPLOYEE SPLIT INTEREST INSURANCE X 986225 1078083 0 1 1 ALDO DE LA TORRE KEY EMPLOYEE SPLIT INTEREST INSURANCE X 1795318 1940503 0 1 1 CARLA MILTON KEY EMPLOYEE SPLIT INTEREST INSURANCE X 706907 772749 0 1 1 BRIANNE L MARRIOTT KEY EMPLOYEE SPLIT INTEREST INSURANCE X 823753 858981 0 1 1 ROGER LARSEN FORMER OFFICER SPLIT INTEREST INSURANCE X 1321766 1388572 0 1 1 10905455 GWR PPMG 35% CONTROLLED ENTITY OF A MEMBER OF FCH&MC'S BOARD OF TRUSTEES 123306 PHYSICIAN SERVICES 0 CHRIS-ANN VENUGOPAL FAMILY MEMBER OF A MEMBER OF FCH&MC'S BOARD OF TRUSTEES 184216 SALARIES AND WAGES 0 PART II: (C) PURPOSE OF LOAN:THE ORGANIZATION HAS ENTERED INTO COLLATERAL ASSIGNMENT SPLIT DOLLAR AGREEMENTS WITH THE PERSONS LISTED ON SCHEDULE L, PART II UNDER TREAS. REG. SECTION 1.7872-15(E)(5)(II). THE ORGANIZATION HAS INVESTED AMOUNTS LISTED IN COLUMN (E) INTO THE PLANS AND IS ENTITLED TO RECEIVE A RETURN OF THESE FUNDS, PLUS AN INTEREST RATE UPON THE DEATH OF THE NAMED PERSON. HEADING, BOX C: OTHER DBAS USED: BOB SMITTCAMP FAMILY NEUROSCIENCE INSTITUTE CENTRAL CALIFORNIA HEART INSTITUTE CLOVIS COMMUNITY CENTER FOR WOUND HEALING CLOVIS COMMUNITY MEDICAL CENTER COMMUNITY BEHAVIORAL HEALTH CENTER COMMUNITY CANCER INSTITUTE COMMUNITY DIALYSIS CENTER - CLOVIS COMMUNITY DIALYSIS CENTER - FRESNO COMMUNITY HEALTH SYSTEM COMMUNITY HOME CARE COMMUNITY MEDICAL CENTERS COMMUNITY PROVIDER NETWORK COMMUNITY REGIONAL MEDICAL CENTER COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER DERAN KOLIGIAN AMBULATORY CARE CENTER DIABETES CARE CENTER OF FRESNO FRESNO HEART AND SURGICAL HOSPITAL UNIVERSITY MEDICAL CENTER PHARMACY FORM 990, PART V, LINES 1 & 2: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA IS THE CENTRAL PAYOR FOR ITSELF, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION, COMMUNITY HEALTH PARTNERS, AND FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 4 DURING FY 2024, THE BOARD OF TRUSTEES AMENDED ITS BYLAWS TO REVISE ITS PROCESS FOR APPOINTING MEDICAL STAFF TRUSTEES AND TO ADDRESS THE EFFECT OF SHORT BOARD TERMS ON INCOMING TRUSTEES WHO ARE APPOINTED TO FILL UNEXPIRED TERMS OF THEIR PREDECESSORS IN OFFICE. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA (CHCC) IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE SOLE AND EXCLUSIVE RIGHT TO APPOINT ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310-5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE MOST RECENT AMENDED ARTICLES OF INCORPORATION PROVIDES THAT UPON DISSOLUTION ALL REMAINING ASSETS WILL BE DISTRIBUTED TO CHCC OR ITS SUCCESSOR. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE FORM IS REVIEWED BY THE BOARD OF TRUSTEES. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER COMMITTEE WITH BOARD DELEGATED POWERS ALSO COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT PRIOR TO THE ASSIGNMENT OF THEIR DUTIES AND THEREAFTER ON AN ANNUAL BASIS. THE STATEMENT ASKS SPECIFIC QUESTIONS THAT WOULD DETERMINE IF THERE ARE CONFLICTS OF INTERESTS. CHS'S CHIEF ETHICS & COMPLIANCE OFFICER, AND CHIEF LEGAL OFFICER REVIEW THE RESPONSES AND DETERMINE WHETHER THERE IS A CONFLICT BASED ON POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DIRECTOR, PRINCIPAL OFFICER, OR MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL BE REMOVED FROM DECISION MAKING AS IT PERTAINS TO THAT CONFLICT. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS-LENGTH BARGAINING; 2) WHETHER ARRANGEMENTS FOR PHYSICIAN AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15A: CHCC, THE SOLE MEMBER OF FCH&MC, ESTABLISHES COMPENSATION FOR THE CEO. FORM 990, PART VI, SECTION B, LINE 15 RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION RESTS WITH THE BOARD'S EXECUTIVE COMPENSATION SUBCOMMITTEE. THE COMMITTEE WILL "CONSIDER ALL MATTERS INVOLVING COMPENSATION AND BENEFITS OF (I) CORPORATE OFFICERS WHO ARE CLASSIFIED AS "DISQUALIFIED PERSONS" PURSUANT TO INTERNAL REVENUE CODE SECTION 4958; (II) ALL OTHER CORPORATE OFFICERS WHO ARE SENIOR VICE PRESIDENTS AND EXECUTIVE VICE PRESIDENTS AND (III) THE PRESIDENT/CHIEF EXECUTIVE OFFICER." THROUGH THE EXECUTIVE COMPENSATION SUBCOMMITTEE, THE BOARD HAS ENGAGED SULLIVAN, COTTER AND ASSOCIATES, INC. TO CONDUCT A TOTAL COMPENSATION REVIEW FOR THOSE INDIVIDUALS IDENTIFIED IN THEIR SCOPE OF RESPONSIBILITY WHICH INCLUDED THE USE OF COMPARABILITY DATA AND DOCUMENTATION OF THE FINDINGS REPORTED TO THE COMMITTEE. FOR TAX YEAR 2023, THIS PROCESS WAS COMPLETED OCTOBER/NOVEMBER, 2023. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL TAX LAWS DO NOT REQUIRE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES RELATED TO CONFLICTS OF INTEREST BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THIS FORM 990 AND ARE PUBLICLY AVAILABLE. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 289,114,921. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 289,114,921. MD SUPERVISORY FEES: PROGRAM SERVICE EXPENSES 14,149,037. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,149,037. MEDICAL PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 20,530,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,530,750. LINEN SERVICES: PROGRAM SERVICE EXPENSES 7,505,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,505,895. AMBULANCE SERVICE: PROGRAM SERVICE EXPENSES 7,492,254. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,492,254. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 63,448,535. MANAGEMENT AND GENERAL EXPENSES 12,085,436. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,533,971. FORM 990, PART XI, LINE 9: UBI FROM PASSTHROUGH INVESTMENTS -711,110. 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