Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2018 , and ending 12-31-2018
BCheck if applicable:
CName of organization
CHINESE HOSPITAL ASSOCIATION
 
% MUKESH SANGHVI
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
845 JACKSON STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SAN FRANCISCO, CA94133
D Employer identification number

94-0382780
E Telephone number

G Gross receipts $ 109,246,848
F Name and address of principal officer:
Jian Qing Zhang
845 JACKSON STREET
SAN FRANCISCO,CA94133
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHINESEHOSPITAL-SF.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1925
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: CHINESE HOSPITAL, A COMMUNITY OWNED, NOT FOR PROFIT ORGANIZATION, EXISTS TO DELIVER QUALITY HEALTH CARE IN A COST EFFECTIVE WAY, RESPONSIVE TO THE COMMUNITY WHICH IT SERVES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 528
6 Total number of volunteers (estimate if necessary) ............. 6 48
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,670,047
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 354,502
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,819,825 1,416,388
9 Program service revenue (Part VIII, line 2g) ......... 117,180,797 101,904,624
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,739,306 1,459,212
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,123,568 4,309,832
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 123,863,496 109,090,056
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 200,000 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 57,188,692 52,285,340
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 34,447 2,500
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet323,498    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 78,279,972 78,703,224
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 135,703,111 130,991,064
19 Revenue less expenses. Subtract line 18 from line 12....... -11,839,615 -21,901,008
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 320,255,261 297,099,892
21 Total liabilities (Part X, line 26)............. 117,741,785 116,999,395
22 Net assets or fund balances. Subtract line 21 from line 20..... 202,513,476 180,100,497
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
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Signature of officer Date
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Type or print name and title
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Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: CHINESE HOSPITAL, A COMMUNITY OWNED, NOT FOR PROFIT ORGANIZATION, EXISTS PRIMARILY TO DELIVER QUALITY HEALTH CARE IN A COST EFFECTIVE WAY, RESPONSIVE TO THE COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS, PROVIDING HEALTH CARE ACCESSIBILITY TO ALL SOCIOECONOMIC LEVELS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code: 621,300 ) (Expenses $ 121,477,421 including grants of $ 0 ) (Revenue $ 100,524,998 )
INPATIENT NURSING SERVICES - CHINESE HOSPITAL IS A 65 BED, ACUTE CARE, COMMUNITY-OWNED, NON-PROFIT HOSPITAL OFFERING A WIDE RANGE OF MEDICAL, SURGICAL AND SPECIALTY PROGRAMS. PHARMACY DEPARTMENT (INPATIENT & OUTPATIENT COMBINED)- THE HOSPITAL PHARMACY PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES THAT ENSURES THAT PATIENTS' MEDICATION REQUIREMENTS ARE MET. THE PHARMACY DEPARTMENT SERVICES INCLUDE DISPENSING OF PHARMACEUTICALS IN ACCORDANCE WITH FEDERAL AND STATE OF CALIFORNIA REGULATIONS, APPROPRIATE INVENTORY MAINTENANCE FUNCTIONS, DRUG MONITORING, PATIENT DRUG ASSESSMENT FUNCTIONS, APPROPRIATE RECORD KEEPING, DRUG INFORMATION, EDUCATION SERVICES AND PERFORMANCE IMPROVEMENT FUNCTIONS. RADIOLOGY DEPARTMENTS (INPATIENT AND OUTPATIENT COMBINED)- CHINESE HOSPITAL'S RADIOLOGY/IMAGING SERVICES OFFERS QUALITY DIAGNOSTIC IMAGING TESTING FOR PATIENTS OF ALL AGES, IN ALL STAGES AND VARIATIONS OF HEALTH AND DISEASE. THESE TESTS ALLOW PHYSICIANS TO MAKE COMPREHENSIVE EVALUATIONS, AND DIAGNOSE, PLAN, AND MONITOR TREATMENTS. THE DEPARTMENT IS FULLY DIGITAL WITH ADVANCED RADIOLOGY INFORMATION SYSTEMS (RIS) AND PICTURE ARCHIVAL COMMUNICATIONS SYSTEMS (PACS). DIAGNOSTIC IMAGING SERVICES AVAILABLE INCLUDE: X-RAYS AND FLUOROSCOPY, MAGNETIC RESONANCE IMAGING SCANNER (MRI), 64-SLICE CT, COMPUTED TOMOGRAPHY, DIGITAL MAMMOGRAPHY, ULTRASOUND, DEXA BONE DENSITOMETRY, NUCLEAR MEDICINE AND INTERVENTIONAL RADIOLOGY. OTHER PROGRAM SERVICES INCLUDE COARDIOPULMONARY SERVICES, COMMUNITY CLINICS, IMMUNIZATION SERVICES, HEPATITIS B PROGRAM, OUTPATIENT MEDICAL THERAPY CENTER, SAME DAY SURGERY AND ENDOSCOPY SERVICES, AND SUPPORT HEALTH SERVICES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION FROM THE COMMUNITY BENEFIT REPORT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet121,477,421
Form 990 (2018)
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV........................Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
234
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
528
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
16
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
16
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMUKESH SANGHVI445 GRANT AVENUE SUITE 200   San Francisco,CA94108 (415) 677-2399
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) George Lew......................................................................
PRESIDENT
 5.0
.................
2.0 		X   X       0 0 0
(2) Harvey Louie......................................................................
Vice President
 5.0
.................
2.0 		X   X       0 0 0
(3) Thomas T Ng......................................................................
English Secretary
 5.0
.................
2.0 		X   X       0 0 0
(4) Kin F Yee DDS......................................................................
Assistant English Secretary
 5.0
.................
2.0 		X   X       0 0 0
(5) Jack Lee Fong......................................................................
Chinese Secretary
 5.0
.................
2.0 		X   X       0 0 0
(6) Gustin Ho MD......................................................................
Assistant Chinese Secretary
 5.0
.................
2.0 		X   X       0 0 0
(7) Robert Wong......................................................................
Treasurer
 5.0
.................
2.0 		X   X       0 0 0
(8) Yick C Tam......................................................................
Assistant Treasurer
 5.0
.................
2.0 		X   X       0 0 0
(9) Edward Chan MD......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(10) Kitman chan......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(11) Robert Chiang......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(12) Mel Lee......................................................................
Board Member
 5.0
.................
2.0 		X           0 0 0
(13) Paul M Lee......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(14) Kent Lim......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(15) Dan Quan......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(16) Dick W Wong......................................................................
Board Member
 2.0
.................
2.0 		X           0 0 0
(17) JIAN QING ZHANG......................................................................
CEO
 40.0
.................
0.0 		    X       504,539 0 101,357
Form 990 (2018)
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Amy Tsui........................................................................
CFO (Thru 08/18)
 40.0
.......................0.0 		    X       261,894 0 90,976
(19) Stephen Forney........................................................................
CFO (From 06/18)
 40.0
.......................0.0 		    X       124,231 0 48,744
(20) KEITH MINARD........................................................................
CIO
 40.0
.......................0.0 		        X   306,237 0 20,026
(21) ALSON TOY........................................................................
Medical Physician
 40.0
.......................0.0 		        X   291,553 0 61,694
(22) CHENGYU XU........................................................................
MEDICAL PHYSICIAN
 40.0
.......................0.0 		        X   309,026 0 30,847
(23) Eng Anderson........................................................................
Medical Physician
 40.0
.......................0.0 		        X   323,778 0 20,026
(24) Scott Huang........................................................................
MEDICAL PHYSICIAN
 40.0
.......................0.0 		        X   327,402 0 56,865
(25) Brenda Yee Ngou........................................................................
CEO
 0.0
.......................0.0 		          X 544,306 544,306 102,989










1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,992,966 544,306 533,524
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet147
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CHARLES PANKOW BUILDERS,
1111 BORADWAY STREET SUITE 200
OAKLAND,CA94607 		CONSTRUCTION 5,219,376
EMERGENCY MEDICINE PHYSICIANS,
4535 DRESSLER ROAD NW
CANTON,OH44718 		ED PHYSICIANS 2,391,914
QUEST DIAGNOSTICS,
P O BOX 912411
PASADENA,CA91110 		LAB WORK 562,802
CORPORATE SECURITY SERVICES,
53 STREET SUITE 314
SAN FRANCISCO,CA94103 		SECURITY COVERAGE 488,674
CURIALE WILSON LLP,
201 SPEAR ST STE 1100
SAN FRANCISCO,CA94105 		LEGAL SERVICES 276,231
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet20
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 140,465
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 1,275,923
g Noncash contributions included in lines 1a - 1f:$ 6,815
h Total. Add lines 1a-1f.......MediumBullet 1,416,388
Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621300 47,207,760 47,207,760    
b CAPITATION REVENUE 621400 35,793,579 35,793,579    
c PHARMACY REVENUE 621400 15,845,051 14,495,615 1,349,436  
d CLINIC REVENUE 623000 2,365,114 2,365,114    
e PAY FOR PERFORMANCE REVENUE 621400 103,903 103,903    
f All other program service revenue. 589,217 559,027 30,190  
g Total. Add lines 2a–2f ....MediumBullet 101,904,624
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 967,779     967,779
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   214,080
b Less: rental expenses    
c Rental income or (loss) 0 214,080
d Net rental income or (loss)......MediumBullet 214,080     214,080
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   491,433
b Less: cost or other basis and sales expenses    
c Gain or (loss)   491,433
d Net gain or (loss).....MediumBullet 491,433   55,771 435,662
8a Gross income from fundraising events (not including $ 140,465of contributions reported on line 1c). See Part IV, line 18 ....
a 479,461
b Less: direct expenses ...b 156,792
c Net income or (loss) from fundraising events..MediumBullet 322,669   322,669
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a 0
b Less: cost of goods sold ..b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a MANAGEMENT FEE 900099 2,234,650   2,234,650  
b REINSURANCE RECOVERIES 561000 914,865     914,865
c PARKING REVENUE 561000 307,651     307,651
d All other revenue .... 315,917     315,917
e Total. Add lines 11a–11d ...... MediumBullet 3,773,083
12 Total revenue. See Instructions......MediumBullet 109,090,056 100,524,998 3,670,047 3,478,623
Form 990 (2018)
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 0  
2 Grants and other assistance to domestic individuals. See Part IV, line 22 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16. 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 872,521   872,521  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 1,305,939   1,305,939  
7 Other salaries and wages 40,385,514 39,320,100 856,670 208,744
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,206,974 3,185,999 14,754 6,221
9 Other employee benefits ....... 3,792,892 3,566,593 208,050 18,249
10 Payroll taxes ........... 2,721,500 2,556,411 148,343 16,746
11 Fees for services (non-employees):        
a Management ...... 46,083 40,553 5,392 138
b Legal ......... 439,693 152,370 287,323  
c Accounting ........... 592,926 474,341 118,585  
d Lobbying ........... 6,300   6,300  
e Professional fundraising services. See Part IV, line 17 2,500 2,500
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 12,431,487 8,349,371 4,082,116  
12 Advertising and promotion .... 37,674 31,014 0 6,660
13 Office expenses ....... 909,318 766,372 125,054 17,892
14 Information technology ...... 1,424,630 1,282,167 142,463  
15 Royalties .. 0 0    
16 Occupancy ........... 4,347,112 4,206,699 130,413 10,000
17 Travel ............ 11,052 10,227 747 78
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 31,167 12,081 19,086  
20 Interest ........... 2,362,270 2,244,156 118,114  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 7,493,788 7,343,913 149,875  
23 Insurance ... 447,047 64,935 382,112  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 21,124,281 21,110,281 14,000  
b MEDICAL CLAIMS EXPENSE 20,290,163 20,290,163    
c PROVIDER FEES 3,324,756 3,324,756    
d INCOME TAX EXPENSE 185,812 0 185,812  
e All other expenses 3,197,665 3,144,919 16,476 36,270
25 Total functional expenses. Add lines 1 through 24e 130,991,064 121,477,421 9,190,145 323,498
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 0 1 0
2 Savings and temporary cash investments ......... 4,783,663 2 2,762,758
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 13,406,820 4 16,570,406
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
0 6 0
7 Notes and loans receivable, net .... 0 7 0
8 Inventories for sale or use ........ 1,195,860 8 1,369,044
9 Prepaid expenses and deferred charges ...... 2,002,745 9 1,831,836
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 309,767,254
b Less: accumulated depreciation 10b 59,866,094 252,316,431 10c 249,901,160
11 Investments—publicly traded securities . 37,882,720 11 24,193,572
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 8,667,022 15 471,116
16 Total assets. Add lines 1 through 15 (must equal line 34)... 320,255,261 16 297,099,892
Liabilities 17 Accounts payable and accrued expenses ..... 23,612,606 17 19,044,571
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 61,620,527 20 60,149,852
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 32,508,652 25 37,804,972
26 Total liabilities. Add lines 17 through 25.. 117,741,785 26 116,999,395
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 201,313,368 27 179,818,600
28 Temporarily restricted net assets ........... 1,171,589 28 253,378
29 Permanently restricted net assets 28,519 29 28,519
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 202,513,476 33 180,100,497
34 Total liabilities and net assets/fund balances ........ 320,255,261 34 297,099,892
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
109,090,056
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
130,991,064
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-21,901,008
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
202,513,476
5
Net unrealized gains (losses) on investments ...............
5
-1,398,131
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
886,160
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
180,100,497
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2018 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2018 		(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2019. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
CHINESE HOSPITAL ASSOCIATION
  		Employer identification number
94-0382780
Part I
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
CHINESE HOSPITAL ASSOCIATION
  		Employer identification number

94-0382780
Part II
Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
CHINESE HOSPITAL ASSOCIATION
  		Employer identification number

94-0382780
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................    
c Total lobbying expenditures (add lines 1a and 1b) ...................................................................    
d Other exempt purpose expenditures ........................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2018


Schedule C (Form 990 or 990-EZ) 2018
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
6,300
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
6,300
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B Line 1f The Hospital paid $6,300 over the course of 2018 to the National Group for Lobbying for Hospital related issues.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   253,330 253,330
b Buildings ....   242,986,126 28,719,794 214,266,332
c Leasehold improvements   0   0
d Equipment ....   50,184,178 31,146,300 19,037,878
e Other .....   16,343,620   16,343,620
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 249,901,160
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
ACCRUED MEDICAL CLAIMS 5,443,717
LIABILITY FOR PENSION BENEFITS 27,907,665
OTHER LONG TERM LIABILITIES 433,943
EST. THIRD-PARTY PAYOR SETTLEM 595,612
ACCRUED PAYROLL 3,424,035
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 37,804,972
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 107,848,717
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -1,398,131
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 156,792
e Add lines 2a through 2d ..................... 2e -1,241,339
3 Subtract line 2e from line 1.................. 3 109,090,056
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 109,090,056
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 130,261,696
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3 130,261,696
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 729,368
c Add lines 4a and 4b..................... 4c 729,368
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 130,991,064
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part X Line 2 Accounting Standards Codification (ASC) Topic 740, Income Taxes, provides guidance for how uncertain tax positions should be recognized, measured, presented, and disclosed in the consolidated financial statements. ASC Topic 740 requires the evaluation of tax positions taken in the course of preparing CCHPs tax returns to determine whether tax positions are more likely than not of being sustained by the applicable tax authority. Tax benefits of positions not deemed to meet the more-likely than-not threshold would be recorded as tax expense in the current year.
Reconciliation of Revenue and Expense Part XI, Line 2d Fundraising event expense to Part VIII $ 156,792 ====================================================== Total Part XI, Line 2d $ 156,792 Part XII, Line 4b Decrease in Pension Liability $ 886,160 Fundraising Event Exp to Part VIII $ (156,792) ====================================================== Total Part XII, Line 4B $ 729,368
Schedule D (Form 990) 2018


Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
CA
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2018
Schedule G (Form 990 or 990-EZ) 2018
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

Anniversary
(event type) 		(b) Event #2

Golf
(event type) 		(c) Other events

1
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
148,078
441,012
30,836
619,926

2
Less: Contributions . . . .
22,212
110,253
8,000
140,465
3 Gross income (line 1 minus
line 2) . . . . . .
125,866
330,759
22,836
479,461



VerticalDirectExpenses
4 Cash prizes . . . . . 0 0 0 0
5 Noncash prizes . . . . 261 0 0 261
6 Rent/facility costs . . . . 10,756 106,980 0 117,736
7 Food and beverages . . . 0 0 0 0
8 Entertainment . . . . 0 0 0 0
9 Other direct expenses . . . 21,745 13,852 3,198 38,795
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 156,792
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow 322,669
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1
Gross revenue . . . . .
 
 
 
 
VerticalDirectExpenses

2
Cash prizes . . . . .
 
 
 
 

3
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
 
 
 
 


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2018
Schedule G (Form 990 or 990-EZ) 2018
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2018
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    1,532,083   1,532,083 1.170 %
b Medicaid (from Worksheet 3, column a) . . . . .     5,973,475 2,405,533 3,567,942 2.720 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     48,409,647 27,425,904 20,983,743 16.000 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     55,915,205 29,831,437 26,083,768 19.890 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     350,946   350,946 0.270 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     398,576   398,576 0.300 %
h Research (from Worksheet 7) .     12,934   12,934 0.010 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     762,456   762,456 0.580 %
k Total. Add lines 7d and 7j .     56,677,661 29,831,437 26,846,224 20.470 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
957,613
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
27,425,904
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
6,442,161
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
20,983,743
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Chinese Hospital
845 Jackson Street
San Francisco,CA94133
www.chinesehospital-sf.org
220000122 		X X         X      
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Chinese Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Schedule H, Part V, Section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Chinese Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Sch H, Part V, Section C
b
See Sch H, Part V, Section C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
Chinese Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Chinese Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B, LINE 5 THE HOSPITAL'S CHNA WAS CONDUCTED IN CONJUNCTION WITH THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP) WHICH IS A COLLABORATIVE BODY WHOSE MISSION IS TO EMBRACE THE COLLECTIVE IMPACT AND TO IMPROVE COMMUNITY HEALTH AND WELLNESS IN SAN FRANCISCO. SFHIP INCLUDES THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, SAN FRANCISCO'S NON-PROFIT HOSPITALS, THE CLINICAL AND TRANSLATION SCIENCE INSTITUTE'S COMMUNITY ENGAGEMENT AND HEALTH POLICY PROGRAM AT UCSF, THE SAN FRANCISCO UNIFIED SCHOOL DISTRICT, THE OFFICE OF THE MAYOR, COMMUNITY REPRESENTATIVES FROM THE ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION, HUMAN SERVICES NETWORK, CHICANO/LATINO/INDIGENA HEALTH EQUITY COALITION, AND AFRICAN AMERICAN COMMUNITY HEALTH COUNCIL, COMMUNITY CLINIC CONSORTIUM, FAITH-BASED AND OTHER PHILANTHROPIC PARTNERS. THE TASK FORCE MEETINGS WERE CONDUCTED TO DISCUSS SPECIFIC ISSUES AFFECTING HEALTHCARE ACCESS IN SAN FRANCISCO. THE MEETINGS WERE OPEN TO THE PUBLIC AND NEIGHBORHOOD MEETINGS ALLOTTED TIME ON THE AGENDAS FOR COMMUNITY MEMBERS TO COMMENT. THE TASK FORCE CONSISTED OF PERSONS FROM VARYING SEGMENTS OF THE POPULATION INCLUDING REPRESENTATIVES FROM THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, AIDS HOUSING ALLOWANCE, CHINESE HOSPITAL, KAISER PERMANENTE, UCSF MEDICAL CENTER, SAN FRANCISCO MUNICIPAL TRANSIT AUTHORITY, CALIFORNIA NURSES ASSOCIATION, AND MANY OTHERS. PART V, SECTION B, LINE 6a THE FOLLOWING SAN FRANCISCO HOSPITALS ALSO PARTICIPATED IN THE CHNA: SAINT FRANCIS MEMORIAL HOSPITAL, ST. MARY'S MEDICAL CENTER, SUTTER HEALTH CALIFORNIA PACIFIC MEDICAL CENTER, KAISER PERMANENTE SAN FRANCISCO, AND UCSF. PART V, SECTION B, LINE 6B CHINESE HOSPITAL IS PART OF THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP), WHICH IS A COLLABORATIVE BODY WHOSE MISSION IS TO EMBRACE COLLECTIVE IMPACT AND TO IMPROVE COMMUNITY HEALTH AND WELLNESS IN SAN FRANCISCO. SFHIP INCLUDES THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, THE CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTES COMMUNITY ENGAGEMENT AND HEALTH POLICY PROGRAM AT UCSF, THE SAN FRANCISCO UNIFIED SCHOOL DISTRICT, THE OFFICE OF THE MAYOR, COMMUNITY REPRESENTATIVES FROM THE ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION, HUMAN SERVICES NETWORK, CHICANO/LATINO/INDIGENE HEALTH EQUITY COALITION, AND AFRICAN AMERICAN COMMUNITY HEALTH COUNCIL, COMMUNITY CLINIC CONSORTIUM, FAITH-BASED AND OTHER PHILANTHROPIC PARTNERS. PART V, SECTION B, LINE 7A Chinese Hospital made its CHNA report widely available on its hospital website at: http://www.chinesehospital-sf.org/community-health-needs-assessment PART V, SECTION B, LINE 10A Chinese Hospital made its Implementation Strategy report widely available on its hospital website and is included within the CHNA report at: http://www.chinesehospital-sf.org/community-health-needs-assessment PART V, SECTION B, LINE 11 THE SIGNIFICANT NEEDS IDENTIFIED AND ADDRESSED AS PART OF OUR IMPLEMENTATION STRATEGY ARE: * EXPAND PATIENT-CENTERED CULTURALLY AND LINGUISTICALLY APPROPRIATE CHRONIC DISEASE MANAGEMENT AND EDUCATION PROGRAMS - CHINESE HOSPITAL PATIENT-CENTERED PROGRAMS (DIABETES, CARDIOVASCULAR DISEASE, HYPERTENSION, HEPATITIS B, ETC) OFFER COMPREHENSIVE CARE AND EDUCATION TO THE COMMUNITY WITH A BILINGUAL MULTIDISCIPLINARY APPROACH. WE WILL EXPAND SERVICES TO ALL CHINESE HOSPITAL CLINIC SITES IN SAN FRANCISCO AND DALY CITY. * INCREASE CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH SERVICES CHINESE HOSPITAL AND CLINICS CREATE SYSTEM-WIDE MENTAL HEALTH SERVICES AND EXPAND EDUCATIONAL PROGRAMS ON MENTAL HEALTH THAT ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE FOR THIS POPULATION, SUCH AS FREE OR LOW-COST STRESS RELIEF WORKSHOPS, GENTLE FITNESS CLASSES LIKE YOGA AND TAI CHI. * EXPAND URGENT CARE ACCESS IN THE AREAS IDENTIFIED AS LACKING ACCESS TO THESE SERVICES EXPAND CLINICS OPERATION HOURS TO WEEKENDS AND AFTER HOURS, CONTRACT WITH EXISTING URGENT CARE AGENCIES IN THE IDENTIFIED AREAS, AND EXPAND TELEMEDICINE SERVICES FOR THOSE WHO CANT ACCESS OUR EXISTING SERVICES. * IMPROVE PREVENTIVE HEALTH EDUCATION AND SERVICES USE A MULTIMEDIA APPROACH AND PROVIDE EDUCATION PROGRAMS FOR OUTREACHING TO PROMOTE PUBLIC AWARENESS OF PREVENTIVE HEALTH. * PROVIDE INTEGRATIVE HEALTH SERVICES EXPAND TRADITIONAL CHINESE MEDICINAL SERVICES TO OTHER CHINESE POPULATIONS IN THE SAN FRANCISCO AND SAN MATEO COMMUNITIES. * IMPROVE CHILDRENS DENTAL HEALTH EDUCATION AND SERVICES PROVIDE AWARENESS AND EDUCATON TO THE CHINESE COMMUNITY AND ONE-ON-ONE TRAINING TO COMMUNITY PEDIATRICIANS AND PRIMARY CARE PHYSICIANS WITH YOUNG PEDIATRIC PATIENTS ON DENTAL CARE, CAVITIES, AND VARNISH APPLICATION. NEEDS IDENTIFIED THAT ARE NOT BEING ADDRESSED: 1. SMOKING IS ANOTHER HEALTH CONCERN OF THE COMMUNITY THAT IS NOT BEING ADDRESSED DUE TO AVAILABILITY OF RESOURCES. Part V, Section B, Line 16a, 16b, & 16c http://www.chinesehospital-sf.org/billing-insurance PART V, SECTION B, LINE 16J THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO OTHER ORGANIZATIONS IN SAN FRANCISCO WHO PROVIDE INFORMATION TO THE COMMUNITY, INCLUDING THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT'S (OSHPD) WEBSITE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 Excelsior Health Services
888 Paris Street
San Francisco,CA94112 		Clinic
2 Daly City Health Services
93 Skyline Plaza
Daly City,CA94015 		Clinic
3 Sunset Health Services
1800 31st Avenue
San Francisco,CA94122 		Clinic
4 Gellert Health Services
386 Gellert blvd
Daly City,CA94105 		Clinic
5 East West Clinic
445 Grant Avenue
San Francisco,CA94108 		Clinic
6
7
8
9
10
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 7 THE COST TO CHARGE RATIO WAS NOT DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE RATIO OF COSTS PER CHARGES USED FOR THE AMOUNTS ENTERED IN THE TABLE IN PART I LINE 7 WERE DERIVED FROM THE HOSPITAL'S 2018 MEDICARE COST REPORT. Part I, Line 7k, Total Community Benefit Percentage CHINESE HOSPITAL OWNS A KNOX-KEENE LICENSED, INTEGRATED, PREPAID HEALTH PLAN, CHINESE COMMUNITY HEALTH PLAN (CCHP), WHICH PROVIDES LOW-COST INSURANCE PRODUCTS TO THE COMMUNITY. WITHOUT THESE LOW-COST INSURANCE PRODUCTS, MANY OF CCHP'S MEMBERS WOULD OTHERWISE ACCESS HEALTH CARE SERVICES THROUGH CHINESE HOSPITAL'S CHARITY CARE PROGRAM. ADDITIONALLY, APPROXIMATELY 80% OF PATIENTS SEEN AT CHINESE HOSPITAL ARE SENIORS COVERED BY MEDICARE AND/OR MEDI-CAL. ONLY APPROXIMATELY 1% OF CHINESE HOSPITAL'S PATIENTS ARE UNINSURED. Part III: Line 2 THE COSTING METHODOLOGY USED IN DETERMING THE AMOUNT REPORTED ON PART III LINE 2 CONSISTS OF THE CHARGES THAT ARE DEEMED TO BE BAD DEBT MULTIPLIED BY THE RATIO OF COST-TO-CHARGES AS REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT WHEN THEY ARE NOT WRITTEN OFF YET. MAJORITY OF THE BAD DEBT FIGURE IS RELATED TO THE ACTUAL WRITTEN OFF AMOUNTS WHEN THE PATIENT WAS NOT ABLE TO PAY AFTER EXHAUSTING ALL ATTEMPTS TO COLLECT. THE DOLLAR FIGURE REPORTED AS BAD DEBT WILL BE BASED ON COST TO CHARGE RATIO AS DESCRIBED ABOVE. THE HOSPITAL TAKES EXTRAORDINARY CARE TO IDENTIFY PATIENTS ELIGIBLE FOR EITHER CHARITY CARE OR FOR DISCOUNT. IF A PATIENT COMES IN AS A SELF-PAY, THEY EITHER PAY IMMEDIATELY OR ARE ASKED TO PROVIDE THE HOSPITAL WITH THE NECESSARY SUPPORTING DOCUMENTATION THAT WOULD QUALIFY THEM FOR CHARITY CARE. DISCOUNT OPTION IS GIVEN IF THE PATIENT IS WILLING TO PAY. IF THE PATIENT DECLINES TO PROVIDE SUCH DOCUMENTATION OR OPTS TO NOT APPLY FOR CHARITY CARE, THEN THE AMOUNT OWED IS CONSIDERED AS RECEIVABLE WHEREBY WE WILL FOLLOW THE NECESSARY STEPS TO COLLECT THE BALANCE OWED. THE HOSPITAL'S EXPERIENCE IS THAT IF PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THEY ARE ENCOURAGED AND HELP THEM QUALIFY IF THEY ARE ELIGIBLE BASED ON OUR PUBLISHED CRITERIA. THIS MEANS THAT WE WILL REPORT CHARTIY CARE NUMBER SEPARATE FROM BAD DEBT NUMBER. IF A PATIENT DOES NOT QUALIFY FOR CHARITY CARE AND IS NOT WILLING TO TAKE ADVANTAGE OF PROMPT DISCOUNT BY PAYING FOR THE AMOUNT OWED, THEN WE SEND THESE ACCOUNTS TO COLLECTION AGENCY. AFTER EXHAUSTING THAT ATTEMPT, WE MAY END UP WRITING THEM OFF AS BAD DEBTS (BASED ON METHODOLOGY AS OUTLINED ABOVE). Part III: Line 3 THE HOSPITAL FOLLOWS HFMA STATEMENT 15 AND THEREFORE NO PART OF BAD DEBT, AS DEFINED BY STATEMENT 15, REPRESENTS AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE. Part III, Line 4 FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS: THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLES CONSISTS OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES, AND PRIVATE PATIENTS. THE HOSPITAL MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS.
Part III, Line 9b THE HOSPITAL POSTS THE COLLECTION POLICIES AT THE HOSPITAL'S CENTRALIZED REGISTRATION LOCATION. THE HOSPITAL'S CHARITY CARE AND DISCOUNTED PAYMENT POLICIES ARE AVAILABLE ON THE HOSPITAL'S WEB-SITE AND ALSO ON THE STATE OF CALIFORNIA'S OFFICE OF STATEWIDE HEALTH PLANNING WEB-SITE. SELF PAY PATIENTS ARE USUALLY SCREENED USING THE PATIENT'S HISTORICAL INCOME APPLIED AGAINST 350% OF THE FPL IN DETERMINING THEIR CHARITY CARE QUALIFICATIONS. HOWEVER, THERE ARE SOME PATIENTS WHO ARE UNWILLING TO PROVIDE THEIR INCOME INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE OR DISCOUNTED PAYMENT. IF THESE PATIENTS DO NOT PAY, THEY ARE SENT A DATA MAILER REQUESTING CONTACT OR PAYMENT EVERY 15 DAYS. IF THERE'S NO RESPONSE, A FINAL NOTICE IS SENT 30 DAYS AFTER THE SENDING OF THE 3RD DATA MAILER. IF THERE'S NO RESPONSE TO THE FINAL NOTICE, THE ACCOUNT IS TURNED OVER TO AN EXTERNAL COLLECTION AGENCY. DURING THIS PROCESS, SHOULD INFORMATION BECOME AVAILABLE THAT INDICATES THE PATIENT COULD BE ELIGIBLE FOR CHARITY CARE, THE ACCOUNT IS RETURNED TO THE HOSPITAL SO THAT WE MAY WORK WITH THE PATIENT TO QUALIFY THEM FOR CHARITY CARE OR OTHER FINANCIAL ASSISTANCE.
Needs Assessment THE HOSPITAL'S ASSESSMENT PROCESS INCLUDES SURVEYS OF PROGRAM PARTICIPANTS, COMMUNITY MEMBERS INCLUDING AGENCIES AND PROVIDERS, CHINESE COMMUNITY HEALTH PLAN (CCHP) MEMBERS AND PROVIDERS, CHINESE COMMUNITY HEALTH CARE ASSOCIATION (CCHCA) MEMBERS AND PROVIDERS AND THE HOSPITAL PATIENTS AND STAFF. SURVEY RESPONDENTS ARE ASKED FOR PROGRAM TOPICS OR ISSUES THAT THEY WOULD LIKE TO HAVE ADDRESSED. A REVIEW OF HEALTH TRENDS AND LOCAL COMMUNITY NEEDS BASED ON HEALTH STATISTICS IS ALSO DONE. TOPIC SUGGESTIONS ARE SENT TO CHINESE COMMUNITY HEALTH RESOURCE CENTER'S (CCHRC) ADVISORY COMMITTEE. THE COMMITTEE PRIORITIZES TOPICS FOR IMPLEMENTATION, OR NON-IMPLEMENTATION.
Patient Education of Elegibility for Assistance THE HOSPITAL SERVES A LARGE POPULATION OF LOW-INCOME PATIENTS. APPROXIMATELY 90% OF OUR MEDICARE PATIENTS MEET THE FEDERAL CRITERIA FOR "LOW-INCOME." ITS WHOLLY OWNED SUBSIDIARY CCHP OFFERS A LOW COST COMMERCIAL INSURANCE PRODUCT FOR INDIVIDUALS AND EMPLOYER GROUPS, MOST OF WHICH REPRESENT SMALL ASIAN BUSINESSES. OUR INTEGRATED HEALTHCARE DELIVERY SYSTEM ALSO SERVES MANAGED CARE MEDICAID ENROLLEES (SAN FRANCISCO HEALTH PLAN) IN THE COMMUNITY. OUR INTEGRATED HEALTHCARE DELIVERY SYSTEM BECAME THE FIRST PRIVATE SECTOR ORGANIZATION TO OFFER A MEDICAL HOME TO INDIVIDUALS PARTICIPATING IN THE HEALTHY SAN FRANCISCO PROGRAM FOR INDIVIDUALS WITH INCOMES THAT ARE LESS THAN 300% OF THE FPL. ALL THESE PROGRAMS ARE WIDELY PUBLICIZED IN BOTH ENGLISH AND CHINESE (ELECTRONICALLY AND IN HARD-COPY) TO THE COMMUNITY. THIS INFORMATION IS ON THE WEBSITES OF THE THREE ORGANIZATIONS THAT MAKE UP THE INTEGRATED DELIVERY SYSTEM, CHINESE HOSPITAL, CCHP AND CCHCA (IPA ORGANIZATION). THESE THREE ORGANIZATIONS SPONSOR THE CHINESE COMMUNITY HEALTH RESOURCE CENTER, A NONPROFIT ORGANIZATION WITH THE MISSION TO BUILD A HEALTHY COMMUNITY THROUGH CULTURALLY AND LINGUISTICALLY COMPETENT PREVENTIVE HEALTH, DISEASE MANAGEMENT, AND RESEARCH PROGRAMS. OUR FINANCIAL ASSISTANCE POLICY IS ALSO POSTED IN THE BUSINESS OFFICE, ADMITTING AND REGISTRATION AREAS AND EMERGENCY DEPARTMENT. ADDITIONALLY, PATIENT STATEMENTS MUST INCLUDE STANDARD LANGUAGE INFORMING PATIENTS THAT THEY MAY REQUEST FINANCIAL SCREENING TO DETERMINE ELIGIBILITY FOR CHARITY DISCOUNTS AND HOW THAT REQUEST MAY BE MADE. IF A PERSON ENTERS THE HOSPITAL WITHOUT INSURANCE, THEY ARE PROVIDED THE FINANCIAL ASSISTANCE/CHARITY POLICIES IN THE PRIMARY LANGUAGE OF THE PATIENT. ENGLISH, SPANISH, CANTONESE AND CHINESE LANGUAGE POLICIES ARE AVAILABLE.
Community Information THE HOSPITAL PROVIDES ACCESS AND CARE FOR A LARGE NUMBER OF UNDERSERVED, LOW INCOME PATIENTS - SERVING AS A SAN FRANCISCO SAFETY NET HOSPITAL. THE INDIGENT AND ELDERLY MONOLINGUAL ASIANS OF CHINATOWN HAVE MADE CHINESE HOSPITAL THEIR POINT OF ACCESS TO THE MEDICAL SYSTEM. THE PRIMARY SERVICE AREA IS THE GREATER CHINATOWN AND NORTH BEACH DISTRICTS OF SAN FRANCISCO. BECAUSE OF OUR UNIQUE BILINGUAL PROGRAMS AND SENSITIVITY TO CULTURAL TRADITIONS, RESIDENTS FROM OTHER SAN FRANCISCO NEIGHBORHOODS AND CITIES OF THE BAY AREA TRAVEL TO CHINESE HOSPITAL FOR THEIR HEALTH CARE NEEDS. IN 1987 CHINESE HOSPITAL AND ITS PARTNER PHYSICIAN GROUP CREATED CHINESE COMMUNITY HEALTH PLAN (CCHP)AS A MANAGED CARE HMO INSURANCE PLAN. CHINESE HOSPITAL THROUGH CCHP IS ABLE TO OFFER AFFORDABLE INSURANCE OPTIONS TO INDIVIDUALS AND MANY ASIAN SMALL BUSINESSES LOCATED IN SAN FRANCISCO. AS A RESULT, CHINESE HOSPITAL SEES VERY FEW UNINSURED PATIENTS. TO IMPROVE HEALTHCARE ACCESS TO THE EXPANDING ASIAN POPULATION IN THE WESTERN PART OF SAN FRANCISCO, THREE COMMUNITY CLINICS WERE ADDED. THESE CLINICS PROVIDE A WIDE-RANGE OF CULTURALLY COMPETENT HEALTHCARE SERVICES. GELLERT CLINICS WAS EXPANDED LAST YEAR TO INCORPORATE LAB, OPTOMETRY AND PHARMACY SERVICES. DEMOGRAPHICS OF THE COMMUNITY SERVED: 81% OF OUR IN-PATIENTS ARE ON MEDICARE. 91% OF THESE PATIENTS ARE MEDICARE/ MEDICAID ELIGIBLE AND SERVES A PROXY FOR UTILIZATION BY LOW-INCOME PATIENTS IN THE COMMUNITY. ANOTHER 9% ARE MEDICAID. THE COMMUNITY THE HOSPITAL SERVES CONTAINS MULTIPLE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS. THERE ARE SIX OTHER HOSPITALS IN SAN FRANCISCO.
State Filing of Community Benefit Report: THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT IN CALIFORNIA.
Promotion of Community Health A MAJORITY OF THE HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL PHYSICIANS IN THE COMMUNITY WHO APPLY FOR SUCH PRIVILEGES AND MEET THE REQUIRED MEDICAL QUALIFICATIONS. THE HOSPITAL'S SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH AS DETERMINED BY THE GOVERNING BODY'S FINANCE COMMITTEE. THIS COMMITTEE OVERSEES THE OPERATING AND CAPITAL BUDGETING PROCESS AND MAKES RECOMMENDATIONS TO THE FULL BOARD REGARDING RESOURCE USE. SEE THE COMMUNITY BENEFIT REPORT CONTAINED IN SCHEDULE O FOR ADDITIONAL INFORMATION.
Schedule H (Form 990) 2018
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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1JIAN QING ZHANG
CEO 		(i)

(ii)		 504,539
-------------
0 		0
-------------
0 		0
-------------
0 		79,975
-------------
0 		21,382
-------------
0 		605,896
-------------
0 		0
-------------
0
2Amy Tsui
CFO (Thru 08/18) 		(i)

(ii)		 261,894
-------------
0 		0
-------------
0 		0
-------------
0 		81,644
-------------
0 		9,332
-------------
0 		352,870
-------------
0 		0
-------------
0
3Stephen Forney
CFO (From 06/18) 		(i)

(ii)		 124,231
-------------
0 		0
-------------
0 		0
-------------
0 		39,050
-------------
0 		9,694
-------------
0 		172,975
-------------
0 		0
-------------
0
4KEITH MINARD
CIO 		(i)

(ii)		 306,237
-------------
0 		0
-------------
0 		0
-------------
0 		13,750
-------------
0 		6,276
-------------
0 		326,263
-------------
0 		0
-------------
0
5ALSON TOY
Medical Physician 		(i)

(ii)		 291,553
-------------
0 		0
-------------
0 		0
-------------
0 		54,793
-------------
0 		6,901
-------------
0 		353,247
-------------
0 		0
-------------
0
6CHENGYU XU
MEDICAL PHYSICIAN 		(i)

(ii)		 284,026
-------------
0 		25,000
-------------
0 		0
-------------
0 		30,829
-------------
0 		18
-------------
0 		339,873
-------------
0 		0
-------------
0
7Eng Anderson
Medical Physician 		(i)

(ii)		 278,778
-------------
0 		25,000
-------------
0 		20,000
-------------
0 		13,750
-------------
0 		6,276
-------------
0 		343,804
-------------
0 		0
-------------
0
8Scott Huang
MEDICAL PHYSICIAN 		(i)

(ii)		 277,402
-------------
0 		50,000
-------------
0 		0
-------------
0 		50,417
-------------
0 		6,448
-------------
0 		384,267
-------------
0 		0
-------------
0
9Brenda Yee Ngou
CEO 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		544,306
-------------
544,306 		47,222
-------------
47,222 		4,272
-------------
4,273 		595,800
-------------
595,801 		0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Question 4b Brenda Yee Ngou participates in a nonqualified deferred compensation plan to be paid out upon termination of employment at CHA. $430,640 was paid out in 2018. Schedule J, Part I, Question 4A The following individual listed on Part VII received a severance payment in 2018. Brenda Yee Ngou - $657,972
Schedule J (Form 990) 2018
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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number
94-0382780
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LJ57 11-08-2012 69,923,971 FINANCE NEW HEALTH CARE FACILITIES   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 4,040,000      
2 Amount of bonds legally defeased .............. 0      
3 Total proceeds of issue .................. 71,143,476      
4 Gross proceeds in reserve funds ............. 4,240,975      
5 Capitalized interest from proceeds ............. 9,551,013      
6 Proceeds in refunding escrows ............... 0      
7 Issuance costs from proceeds ............... 1,411,465      
8 Credit enhancement from proceeds ............. 2,607,615      
9 Working capital expenditures from proceeds ............. 0      
10 Capital expenditures from proceeds ............. 52,411,636      
11 Other spent proceeds ............. 0      
12 Other unspent proceeds ............. 29,519      
13 Year of substantial completion ............. 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? ....   X            
15 Were the bonds issued as part of an advance refunding issue? .....   X            
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
Page 2
Part Ⅲ
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 .............        
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X            
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X              
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......                
b Exception to rebate? ........                
c No rebate due? ......... X              
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider .......... 0
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider .......... 0
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ... X              
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SUPPLEMENTAL INFORMATION Schedule K, Part II, Line 2 The amount on line 2 differs from the issue price due to cumulative investment earnings. Schedule K, part iv, line 2c The arbitrage rebate calculation was last completed in January 2019.
Schedule K (Form 990) 2018

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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2018
Schedule L (Form 990 or 990-EZ) 2018
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Corporate Security Service Substantial Contributor 488,634 Security Services   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2018


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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Return Reference Explanation
PART VI, SECTION B, LINE 11B Form 990 Review Process: THE FORM 990 WAS REVIEWED BY THE FINANCE DIRECTOR AND THE CFO. THE FORM 990 WAS THEN PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE REVIEWED AND APPROVED THE FORM 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Line 12c Conflict of Interest Policy & Procedures CONFLICT OF INTEREST: THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE THROUGH AN ANNUAL CONFLICT OF INTEREST SURVEY AND DECLARATION. IN ADDITION, THE BOARD MEMBERS ARE COGNIZANT OF THE REQUIREMENTS TO REMAIN INDEPENDENT DURING DELIBERATIONS THAT IMPACT THE ORGANIZATION. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST STATEMENT THAT DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE, THERE IS VOLUNTARY DISCLOSURE OF ANY POTENTIAL CONFLICTS AS DISCUSSIONS OF PENDING TRANSACTIONS OCCUR. THE LEGAL DEPARTMENT AND CFO REVIEW THE CONFLICT OF INTEREST STATEMENTS. IF A CONFLICT ARISES, THE PERSON WITH THE CONFLICT RECUSES HIMSELF OR HERSELF FROM THE DELIBERATIONS AND DECISION MAKING PROCESS REGARDING THAT PARTICULAR MATTER. Form 990, Part VI, Line 15 Determination of Compensation FOR 2018 COMPENSATION, THE COMPENSATION AND BENEFITS PACKAGE OF THE CEO WAS EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD, WHO ARE INDEPENDENT. AS PART OF THIS PROCESS, AN INDEPENDENT CONSULTANT WAS USED TO PROVIDE COMPARABLE DATA PROVIDED FOR SIMILAR POSITIONS AT SIMILAR SIZE HOSPITALS AND HEALTH PLANS AND THE COMPENSATION PACKAGE WAS REVIEWED AND APPROVED BY THE BOARD. FOR 2018 COMPENSATION, THE COMPENSATION COMMITTEE, ALSO REVIEWED THE DATA AND APPROVED THE COMPENSATION PACKAGE FOR OTHER OFFICERS AND KEY EMPLOYEES. THE COMMITTEE'S DISCUSSIONS AND DELIBERATIONS REGARDING COMPENSATION FOR THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES WERE CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES.
Part VI Section C Line 19 Disclosure of Documents FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION, AS SUCH THESE DOCUMENTS ARE NOT AVAILABLE FOR PUBLIC INSPECTION. HOWEVER, THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST AND THEY ARE ALSO ATTACHED TO A COPY OF THIS FORM 990.
Part XI, Line 9 Decrease in pension liability $ 886,160
Community Benefit Report THE FOLLOWING IS AN EXCERPT FROM THE 2018 COMMUNITY BENEFIT REPORT General Overview Chinese Hospital is a unique healthcare provider within the City and County of San Francisco, having a long and rich history of providing access to culturally competent health care services to the Chinese Community. In 1900, the Tung Wah Dispensary opened in San Franciscos Chinatown, and by the early 1920s outgrown its space as other San Francisco providers continued to deny health care access for the local Chinese community. With visionary acumen, fifteen community organizations established a non-profit public benefit corporation in 1923 - the Chinese Hospital Association. The fifteen founding members of the Board of Trustees raised funds for construction of a new facility at 835 Jackson Street, and in October 1925 celebrated the grand opening of the first Chinese Hospital. In the mid-1970s Chinese Hospital required a brand new facility. Once again the Board of Trustees conducted extensive fund raising and received Hill Burton funding for construction of the current hospital facility that opened in September 1979 at 845 Jackson Street, next door to the original Chinese Hospital, and maintaining a licensed bed capacity of 54 beds. Chinese Hospital opened an eight-story new tower in October 2016. This will enable Chinese Hospital to better serve the needs of the community. Licensed beds increased to 65 beds. New services include an Magnetic Resonance Imaging Scanner (MRI); an expanded standby Emergency Department; 4 bed Outpatient Observation Unit; a Support Health Services clinic (which supports the community physicians and their patients by providing health educational needs); expanded and new outpatient Pharmacy; expanded Cardio-Pulmonary Unit (new body box for pulmonary functions testing, two new tread mills for stress tests); 3rd and 4th floor Medical and Surgical Units with private rooms; Surgery Department expanded from 2 Operating Rooms to 4- new and state of the art ORs; new Intensive Care Units expanded to 6-private rooms with new state of the art equipment for monitoring patients; and new state of the art Telemetry Unit, with 12 beds. An Integrated Delivery System In the mid-1980s, managed care programs surfaced in the San Francisco Bay Area. Through a collaborative program with Blue Shield of California, Chinese Hospital and its physician partner organization created Chinese Community Health Plan (CCHP). In 1987, Blue Shield transferred the health plan to the ownership of Chinese Hospital, which received its own Knox-Keene license from the State of California Department of Corporations. Chinese Community Health Plan provides low-cost commercial insurance products for individual and employer groups, most of which represent small Asian businesses. Our fully integrated healthcare delivery system also serves managed care Medicare and Medi-Cal enrollees in the community. In 2009, CCHP expanded its coverage to Northern San Mateo County. Chinese Hospital and its physician partners, Jade Healthcare Medical Group, Chinese Community Health Care Association (CCHCA), serve Medicare, Medi-Cal and commercial enrollees. Chinese Hospital Association provided without any limitations medical care to all members of the following medical insurance plans like Blue Cross, Blue Shield, Aetna, San Francisco Health Plan, Healthy Kids San Francisco, United Healthcare, HealthNet, CCHP and other providers that came for care at Chinese Hospital and its Clinics. The Jade Healthcare Medical Group is a for-profit physicians independent practice association (IPA), organized in 2016 with the mission to improve the health of our community by delivering high-quality, affordable healthcare through culturally competent and linguistically appropriate services. In 1989, the three associations Chinese Hospital, the Chinese Community Health Care Association (CCHCA), and Chinese Community Health Plan (CCHP) established of the Chinese Community Health Resource Center (CCHRC), a non-profit community center with the mission to build a healthy community through culturally and linguistically competent preventive health, disease management, and research programs. CCHRC has maintained a wide range of health education programs and a resource library (www.cchrchealth.org). Chinese Hospital continues to support CCHRC annually and providing in-kind support services to CCHRC on human resource, housekeeping, engineering, finance and IT as well as providing facility space to house CCHRCs Wellness Library and its patient navigation program. To increase healthcare access for the expanding Chinese population in the western part of San Francisco, Chinese Hospital and Chinese Community Health Care Association created the Sunset Health Services Community Clinic in 1997. The community clinic, staffed by physicians specialized in General Medicine, Internal Medicine, Women's Health, Cardiology, Podiatry, Gastroenterology and Oncology, provides a wide range of culturally competent health care services such as primary care with subspecialties: preventive care services, womens health services, health education, and laboratory services. The clinic is also staffed with nurse practitioners, acupuncturists and other clinical personnel who speak Mandarin, Cantonese, Tagalog and English. Chinese Hospital will continue to bring culturally competent healthcare to the Chinese in southern part of San Francisco and northern San Mateo County, as demonstrated by our two clinics in the area. Chinese Hospital will continue to support the community physicians and be a valued resource in the City for the Asian population. Chinese Hospital opened its Support Health Services clinic in Chinatown, in 2008. Staffed by a nurse practitioner (NP), the clinic helps manage patients, in our community, with chronic disease at no cost, with aim to promote effective chronic disease self-management. The clinic also offers management in diabetes, nutritional consult, hypertension, womens health, and anticoagulation therapy. The Support Health Services, along with the satellite clinics also provide a comprehensive immunization program to meet the need of the community, such as childhood immunizations, Hepatitis B, Tdap and Influenza & Pneumococcal vaccination. The leadership for charity care at Chinese Hospital starts with our Chief Executive Officer, Dr. Jian Zhang, serves on several non-profit boards as a member of Board of Directors and is an active member of the Chinese community Cardiac Council, American Hospital Association (she serves a voice to provide care and education for ethnic groups and their health disparities), the San Francisco Health Authority Board, NICOS Chinese Health Coalition, and the Chinese Community Health Resource Center. Many hospital staff members are also active on health coalition boards: such as, Asian Alliance against Domestics Violence, San Francisco Hepatitis B Free campaign, San Francisco Bay Area American Diabetic Association Board, and the Community Advisory Board of the UCSF Helen Diller Family Comprehensive Cancer Center and Center on Aging in Diverse Communities of UCSF, SF CAN, to name a few. The Community Benefit Plan for 2018 will summarize Chinese Hospitals objectives and the plan for community health outreach projects for 2019. A. Medical Care costs not fully compensated resulting in loss in these programs A-1. State sponsored Medi-Cal Program has very low reimbursement rates which results in providing medical care at a loss. At Chinese Hospital, we provided care to 142 patients representing total patient days of 591. Similarly, the outpatient Medi-Cal patients are provided medical care at a loss. Total of 8,827 patients were treated as Outpatients at Chinese Hospital. Chinese Hospital Clinics provided medical care to 5,282 patients. A-2. Medicare programs have reimbursement rates that are not sufficient to provide cost of medical care. At Chinese Hospital we provided care to 1,363 Inpatients, which is a total of 7,182 patient days. Total of 31,279 Medicare patients were seen as Outpatients while the clinics saw total of 21,397 patients. A-2. Traditional Charity Care: Chinese Hospital provided care to 11 patients as Inpatient with total of 266 patient days and 301 patients were taken care of at the Clinics. These individual patients have no insurance coverage and could not afford to pay the cost of care resulting in full amount written off under our charity care policy. A-3. Treatment Center Services: Chinese Hospital provided emergency room care to any patients that sought medical care irrespective to their ability to pay for the care. Once again, patients who have Medi-Cal, Medicare coverage or no coverage consume large dollars of medical care that are not fully compensated resulting in loss under these programs. See table at the end of this report.
B. Other Benefits for the Broader Community Chinese Hospital makes significant commitments in providing health education, prevention and support services for the broader Chinese community. B-1. Reduced Cost Immunization/Flu Vaccine Programs: Chinese Hospital offered the general public reduced cost immunizations and no-cost flu vaccines. These programs served over 20 people and generated nearly __ in unsponsored community benefit expenses. B-2. Chinese Community Health Resource Center: Chinese Hospital sponsors the Chinese Community Health Resource Center, a community-based organization providing bilingual health education services to the Chinese community. Programs of the Chinese Community Health Resource Center include health education classes (e.g., Allergies, Arthritis Management, Asthma, Blood Pressure, Cancer Awareness, Cholesterol, Colorectal Cancer, Coronary Artery Disease, COPD, Diabetes Management, Healthy Eating, Heart Failure, Incontinence, Injury Prevention, Insomnia, Medication Management, Memory Improvement, Osteoporosis, Pain Management, Prostate Health, Rheumatoid Arthritis, Stress Management, Stroke Prevention, Urinary Incontinence, Prenatal & Child Health), chronic disease education management, health screenings, holding health fairs, on-site classes, cancer patient services, individual nutrition counseling, smoking cessation counseling, non-clinical social services, video-viewing program, patient navigation, a Wellness Library, and bilingual health education materials. The Center also provides community presentations upon request and participate in various local and national committees. In 2018, there were over 4,611 in-person encounters and 239,750 web page views for health education through the Chinese Community Health Resource Center. In addition, Chinese Hospital donated $200,000 for operating expenses to the Chinese Community Health Resource Center plus provided in-kind support services on IT, housekeeping, engineering, finance, human resources and duties related to serving as the President of CCHRCs Board of Directors. These in-kind support was estimated as unsponsored community benefit expense of more than $70,000. Additionally, Chinese Hospital also provided facility space to house CCHRCs Wellness Library and Patient Navigation program. The square footage for the facility is 620 which estimated to $50,000 additional unsponsored community benefit expense. B-3. Anticoagulation Services: Chinese Hospitals Support Health Services provided free anticoagulation services to 28 seniors and community members. The number of total encounters was 102, and the unsponsored community benefit expense associated with these services was more than $8,000. B-4. Chinese Hospital Employees Participation in Community Programs: employees of the Chinese Hospital have participated in various community education outreach and advocacy activities such as health fairs, health talk shows, cooking competition, public health hearing, phone consultations related to social services, etc. The hours contributed for these activities estimated to be about 217 hours. C. Health Research, Education and Training Programs C-1. Student Internship: Chinese Hospital hosted clinical internships for 1 nursing student with 120 clinical rotation hours; 7 pharmacy students with 1360 rotation hours; 8 phlebotomist trainees with 600 rotation hours; 2 nurse practitioner (NP) students with 190 rotation hours and 15 medical students with 1645 rotation hours. The total staff time for onboarding time spent with the NP and medical students were 152 hours. Other incidental hours associated with this program was close to 400 hours. Total unsponsored community benefit expense of this program was around $65,000. D. Other Quantifiable and Non-Quantifiable Benefits Chinese Hospitals commitments to the community extend beyond the direct services it provides to the community. D-1. Health Fair/Street Fair: Chinese Hospital participated in various Health Fairs/Street Fairs through the volunteer efforts of hospital staff members. At the fairs, health education materials were distributed to community members and free test on blood pressure was provided. Over 2,500 individuals attended these Fairs, and the unsponsored community benefit associated with this effort was around $17,000. D-2. Chinese Hospital Monthly Community Health Day: Chinese Hospital sponsored Monthly Community Health Day in 2018 through volunteer efforts of hospital staff members. Health related educational activities and screenings were provided at the monthly health days. The health screenings offered at these health days included Blood Glucose, Blood Pressure, Body Mass Index, Cholesterol, Osteoporosis and Vision. Total health screenings performed at the health days were 2,619 among 1,174 participants. The unsponsored community benefits associated with this effort was around $23,000.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHINESE COMMUNITY HEALTH PLAN

445 GRANT AVENUE SUITE 700
SAN FRANCISCO,CA94108
94-3021419 		insurance CA CHA
  		Corporation 147,017,730 55,672,364 100.000 % Yes  
(2) CHARITABLE REMAINDER TRUST (2)

 
 
INVESTMENTS CA CHA
  		TRUST          










Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
Yes
 
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Chinese Community Health Plan

 A 55,771 Per Agreement
(2) Chinese Community Health Plan

 L 2,234,650 Per Agreement
(3) Chinese Community Health Plan

 F 100,000 Per Agreement



Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2018

Additional Data


Software ID:  
Software Version: