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)
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OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
CHINESE HOSPITAL ASSOCIATION
 
 
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 $ 111,090,912
F Name and address of principal officer:
DR JIAN 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: COST EFFECTIVE HEALTH CARE WHICH IS RESPONSIVE TO THE COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 533
6 Total number of volunteers (estimate if necessary) ............. 6 29
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,232,616
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 362,528
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,182,762 5,454,002
9 Program service revenue (Part VIII, line 2g) ......... 115,644,749 101,560,978
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,790,523 1,693,250
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,966,873 2,370,558
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 122,584,907 111,078,788
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 860,000 110,000
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) 47,941,526 49,381,860
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet488,252    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 79,756,742 77,601,931
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 128,558,268 127,093,791
19 Revenue less expenses. Subtract line 18 from line 12....... -5,973,361 -16,015,003
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 313,420,456 312,675,526
21 Total liabilities (Part X, line 26)............. 144,471,546 160,510,360
22 Net assets or fund balances. Subtract line 21 from line 20..... 168,948,910 152,165,166
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.
Sign Here
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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 (2020)
Form 990 (2020)
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 ACCESS TO HEALTH CARE AND ACCEPTABILITY 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:   ) (Expenses $ 74,368,309 including grants of $ 110,000 ) (Revenue $ 101,560,978 )
CHINESE HOSPITAL IS AN 88-BED NON-PROFIT COMMUNITY HOSPITAL AND AFFILIATED COMMUNITY CLINICS OFFERING A WIDE RANGE OF MEDICAL, SURGICAL, AND SPECIALTY CARE TO A MULTICULTURAL COMMUNITY. CHINESE HOSPITAL AIMS TO DELIVER QUALITY HEALTH CARE IN A COST EFFECTIVE WAY, RESPOND TO OUR COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS, AND OFFER ACCESS TO HEALTH CARE TO ALL SOCIOECONOMIC LEVELS. SERVICES OFFERED AT CHINESE HOSPITAL INCLUDE ACUPUNCTURE, CARDIOPULMONARY, EMERGENCY CARE, HEALTH PROGRAMS (INCLUDING IMMUNIZATIONS, HEPATITIS B SERVICES, A DIABETES CENTER, AND PALLIATIVE CARE), LABORATORY, NURSING CARE, OPTOMETRY, PHARMACY, RADIOLOGY/IMAGING, AND SURGERY.
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 expensesMediumBullet74,368,309
Form 990 (2020)
Form 990 (2020)
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 V......
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
 
No
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) ....
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............
18
 
No
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...................
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 attachment
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.....Click to see attachment
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
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........Click to see attachment
22
 
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 ....
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.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
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, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
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
211
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 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
533
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
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
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
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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
 
No
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 (2020)
Form 990 (2020)
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
14
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
14
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
Yes
 
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
Yes
 
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
Yes
 
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:
MediumBulletMICHAEL (CHI-KUO) CHUNG445 GRANT AVENUE SUITE 200   SAN FRANCISCO,CA94108 (415) 677-2494
Form 990 (2020)
Form 990 (2020)
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.

See instructions for the order in which to list the persons above.
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) DR JIAN ZHANG......................................................................
CHIEF EXECUTIVE OFFICER
40.00
.................
0.00
    X       521,637 80,000 77,235
(2) ANTONIA LENDARIS......................................................................
CHIEF NUSRING OPERATIONS OFFICER
40.00
.................
0.00
      X     306,924 0 21,507
(3) ANDERSON ENG MD......................................................................
MEDICAL PHYSICIAN
40.00
.................
0.00
        X   299,620 0 21,215
(4) KEITH MINARD......................................................................
CHIEF INFO OFFICER THROUGH 7/2020
40.00
.................
0.00
      X     289,120 0 4,266
(5) ALSON TOY......................................................................
RN SURGERY
40.00
.................
0.00
        X   288,686 0 45,381
(6) JIAYUN CHEN......................................................................
RN SURGERY
40.00
.................
0.00
        X   277,527 0 79,486
(7) FRANK CHEN MD......................................................................
MEDICAL PHYSICIAN - SUNSET CLINIC
40.00
.................
0.00
        X   268,357 0 20,637
(8) AUNG KYAW MAUNG MD......................................................................
MEDICAL PHYSICIAN
40.00
.................
0.00
        X   268,302 0 34,671
(9) LYDIA MAHR-CHAN......................................................................
DIRECTOR OF HUMAN RESOURCES
40.00
.................
0.00
      X     267,764 0 15,416
(10) CHI-KUO CHUNG......................................................................
CFO START 6/2020
40.00
.................
0.00
    X       144,618 0 10,278
(11) PAUL ZIEGELE......................................................................
CFO THROUGH 6/2020
40.00
.................
0.00
    X       0 0 0
(12) MEL LEE......................................................................
CHAIR THROUGH 4/2020
2.00
.................
0.00
X   X       0 0 0
(13) KITMAN CHAN......................................................................
BOARD MEMBER / CHAIR AS OF 5/2020
5.00
.................
0.00
X   X       0 0 0
(14) HARVEY LOUIE......................................................................
VICE CHAIR
5.00
.................
0.00
X   X       0 0 0
(15) THOMAS T NG......................................................................
SECRETARY
5.00
.................
0.00
X   X       0 0 0
(16) JACK SIT......................................................................
ASSISTANT SECRETARY
5.00
.................
0.00
X   X       0 0 0
(17) ROBERT K WONG......................................................................
TREASURER
5.00
.................
0.00
X   X       0 0 0
Form 990 (2020)
Form 990 (2020)
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) ROBERT CHIANG........................................................................
ASSISTANT TREASURER
5.00
.......................0.00
X   X       0 0 0
(19) JACK LEE FONG........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(20) GUSTIN HO MD........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(21) PAUL M LEE........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(22) CLIFTON LEUNG........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(23) DAN T QUAN........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(24) JACK SIT........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(25) YICK C TAM........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0
(26) DICK W WONG........................................................................
BOARD MEMBER
2.00
.......................0.00
X           0 0 0








1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,932,555 80,000 330,092
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 MediumBullet124
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
 
No
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
CALIFORNIA EMERGENCY ASSOCIATES

PO BOX 677979
DALLAS,TX75267
ER PHYSICIAN SERVICES 1,534,909
CHARLES PANKOW BUILDERS LTD

1111 BROADWAY SUITE 200
OAKLAND,CA94607
CONSTRUCTION SERVICES 716,718
QUEST DIAGNOSTICS

PO BOX 912411
PASADENA,CA91110
LABORATORY SERVICES 582,425
CORPORATE SECURITY SERVICE INC

5 3RD ST STE 314
SAN FRANCISCO,CA94103
SECURITY SERVICES 500,478
WHITMAN PARTNERS

3030 SW 1ST AVE
PORTLAND,OR97201
RECRUITMENT SERVICES 384,245
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet82
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 2,038,092
f All other contributions, gifts, grants, and similar amounts not included above1f 3,415,910
g Noncash contributions included in lines 1a - 1f:$ 1g 331,621
h Total. Add lines 1a-1f.......MediumBullet 5,454,002
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 621300 44,935,264 44,935,264    
b CAPITATION REVENUE 621400 38,407,589 38,407,589    
c PHARMACY REVENUE 621400 13,639,654 12,444,534 1,195,120  
d CLINIC REVENUE 623000 2,123,506 2,123,506    
e PAY FOR PERFORMANCE 621400 529,755 529,755    
f All other program service revenue. 1,925,210 1,903,871 21,339  
g Total. Add lines 2a–2f .....MediumBullet 101,560,978
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 901,926     901,926
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   174,390 6a
b Less: rental expenses   12,124 6b
c Rental income or (loss)   162,266 6c
d Net rental income or (loss).......MediumBullet 162,266   16,157 146,109
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   791,324 7a
b Less: cost or other basis and sales expenses   0 7b
c Gain or (loss)   791,324 7c
d Net gain or (loss).........MediumBullet 791,324     791,324
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a SHARED SERVICE AGREEMENT 900099 1,900,874     1,900,874
b PARKING REVENUE 561000 279,608     279,608
c CAFETERIA 722514 27,810     27,810
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 2,208,292
12 Total revenue. See instructions.....MediumBullet 111,078,788 100,344,519 1,232,616 4,047,651
Form 990 (2020)
Form 990 (2020)
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 .... 110,000 110,000
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 1,658,765 621,817 1,036,948  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 37,317,667 20,865,198 16,048,495 403,974
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,382,844 1,970,459 1,387,984 24,401
9 Other employee benefits ....... 4,327,277 2,482,876 1,813,733 30,668
10 Payroll taxes ........... 2,695,307 1,540,100 1,136,272 18,935
11 Fees for services (non-employees):        
a Management ...... 1,259,519   1,259,519  
b Legal ......... 409,500 11,922 397,578  
c Accounting ........... 228,847   228,847  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 26,311   26,311  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 18,225,980 8,386,627 9,829,079 10,274
12 Advertising and promotion .... 10,131   10,131  
13 Office expenses ....... 881,348   881,348  
14 Information technology ...... 1,371,950 793,571 578,379  
15 Royalties ..        
16 Occupancy ........... 2,851,204 734,118 2,117,086  
17 Travel ............ 1,258   1,258  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 24,483   24,483  
20 Interest ........... 4,243,399   4,243,399  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 9,450,010 488,080 8,961,930  
23 Insurance ... 617,332   617,332  
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 18,629,552 18,629,552    
b MEDICAL CLAIMS EXPENSE 17,733,989 17,733,989    
c QUALITY ASSURANCE FEE 1,421,605   1,421,605  
d INCOME TAX EXPENSE 110,809   110,809  
e All other expenses 104,704   104,704  
25 Total functional expenses. Add lines 1 through 24e 127,093,791 74,368,309 52,237,230 488,252
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 (2020)
Form 990 (2020)
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 ........ 3,200 1 3,200
2 Savings and temporary cash investments ......... 3,320,530 2 6,360,749
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 25,631,367 4 15,243,976
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 1,592,020 8 1,778,554
9 Prepaid expenses and deferred charges ...... 4,782,073 9 2,862,484
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 318,623,882
b Less: accumulated depreciation 10b 80,833,271 244,471,425 10c 237,790,611
11 Investments—publicly traded securities . 28,111,913 11 45,113,395
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .. 400,000 13 400,000
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 5,107,928 15 3,122,557
16 Total assets. Add lines 1 through 15 (must equal line 33)... 313,420,456 16 312,675,526
Liabilities 17 Accounts payable and accrued expenses ..... 15,882,778 17 12,066,189
18 Grants payable ...   18  
19 Deferred revenue .........   19 8,462,081
20 Tax-exempt bond liabilities ......... 58,624,758 20 57,044,490
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 34,937,191 23 35,122,916
24 Unsecured notes and loans payable to unrelated third parties ..   24 7,585,992
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 35,026,819 25 40,228,692
26 Total liabilities. Add lines 17 through 25.. 144,471,546 26 160,510,360
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 168,667,013 27 151,408,176
28 Net assets with donor restrictions ........... 281,897 28 756,990
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 168,948,910 32 152,165,166
33 Total liabilities and net assets/fund balances ........ 313,420,456 33 312,675,526
Form 990 (2020)
Form 990 (2020)
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
111,078,788
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
127,093,791
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-16,015,003
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
168,948,910
5
Net unrealized gains (losses) on investments ...............
5
1,133,272
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
-1,902,013
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
152,165,166
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 (2020)
Form 990 (2020)
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 instructions and the latest information.
OMB No. 1545-0047
2020
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) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed 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) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (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) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (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 5 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) 2020

Schedule A (Form 990 or 990-EZ) 2020
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) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (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) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (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) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in 11a above?
11b
 
 
c
A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 0.015 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 0.035 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) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2020 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2020
(iii)
Distributable
Amount for 2020
1 Distributable amount for 2020 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2020:
a From 2015.......  
b From 2016.......  
c From 2017.......  
d From 2018.......  
e From 2019.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2020 distributable amount  
i Carryover from 2015 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2020 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2020 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2020, 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 2020. 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 2021. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2016.....  
b Excess from 2017.....  
c Excess from 2018.....  
d Excess from 2019.....  
e Excess from 2020.....  
Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020
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) 2020


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
2020
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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
Name of organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number
94-0382780
Part I
Contributors
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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
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) (2020)
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
2020
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) 2020

Schedule C (Form 990 or 990-EZ) 2020
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) 2017 (b) 2018 (c) 2019 (d) 2020 (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) 2020


Schedule C (Form 990 or 990-EZ) 2020
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)
Yes|No
(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? ..........................................................
 
No
 
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? ...................................................................................................................
Yes
 
6,806
j
Total. Add lines 1c through 1i ....................................................................................................
6,806
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 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA HOSPITAL ASSOCIATION AND HOSPITAL COUNCIL - NORTHERN AND CENTRAL CALIFORNIA, ORGANIZATIONS WHICH ADVOCATE FOR CALIFORNIA'S HOSPITALS AND HEALTH SYSTEMS; A PORTION ($6,806) OF THOSE MEMBERSHIP DUES HAVE BEEN INDICATED AS USED FOR LOBBYING PURPOSES.
Schedule C (Form 990 or 990EZ) 2020


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 instructions and the latest information.
OMB No. 1545-0047
2020
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 FASB 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 FASB 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 FASB 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) 2020

Schedule D (Form 990) 2020
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
Term 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 .....   3,604,093 3,604,093
b Buildings ....   267,022,082 45,900,045 221,122,037
c Leasehold improvements        
d Equipment ....   40,284,808 30,259,066 10,025,742
e Other .....   7,712,899 4,674,160 3,038,739
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 237,790,611
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 40,228,692
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) 2020

Schedule D (Form 990) 2020
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
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  
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  
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  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
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
Schedule D (Form 990) 2020


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
2020
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
Yes
 
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
 
No
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) . . .
    899,248   899,248 0.710 %
b Medicaid (from Worksheet 3, column a) . . . . .            
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     4,080,158 865,446 3,214,712 2.530 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     4,979,406 865,446 4,113,960 3.240 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).            
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     3,254,886 2,458,243 796,643 0.630 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     3,254,886 2,458,243 796,643 0.630 %
k Total. Add lines 7d and 7j .     8,234,292 3,323,689 4,910,603 3.870 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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 Healthcare 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
5,983,920
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
225,978
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
14,710,191
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
38,708,581
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-23,998,390
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) 2020
Schedule H (Form 990) 2020
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 ASSOCIATION
845 JACKSON STREET
SAN FRANCISCO,CA94133
WWW.CHINESEHOSPITAL-SF.ORG
220000122
X X         X      
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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 ASSOCIATION
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):
 
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 19
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 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
CHINESE HOSPITAL ASSOCIATION
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
HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE
b
HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
CHINESE HOSPITAL ASSOCIATION
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) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
CHINESE HOSPITAL ASSOCIATION
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) 2020
Schedule H (Form 990) 2020
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, 20a, 20b, 20c, 20d, 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
CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: THE SFHIP COMMUNITY HEALTH NEEDS ASSESSMENT TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY VIA FOCUS GROUPS.SFHIP KEY INFORMANT GROUP INTERVIEW: ONE FOCUS GROUP WAS COMPRISED OF SFHIP MEMBERS WHO ARE ALL SUBJECT MATTER EXPERTS. TWO SERIES OF QUESTIONS WERE ASKED: (I) "WHAT ARE THE HEALTHIEST CHARACTERISTICS OF THIS COMMUNITY? WHAT SUPPORTS PEOPLE TO LIVE HEALTHIER LIVES? AND (II) "WHAT ARE THE BIGGEST HEALTH ISSUES AND/OR CONDITIONS YOUR COMMUNITY STRUGGLES WITH? WHAT DO YOU THINK CREATES THOSE ISSUES?".EQUITY COALITION FOCUS GROUPS: THREE FOCUS GROUPS WERE CONDUCTED WITH EACH OF THE THREE HEALTH EQUITY COALITIONS IN SAN FRANCISCO: (I) THE CHICANO / LATINO / INDIGENA HEALTH EQUITY COALITION (II) THE ASIAN PACIFIC ISLANDER HEALTHY PARITY COALITION, AND (III) THE AFRICAN AMERICAN HEALTH EQUITY COALITION. USING THE TECHNOLOGY OF PARTICIPATION (TOP) CONSENSUS METHOD, THE QUESTION POSED TO EACH FOCUS GROUP WAS, "WHAT ACTIONS CAN WE TAKE TO IMPROVE HEALTH?".FOOD INSECURE PREGNANT WOMEN FOCUS GROUPS: THE HOMELESS PRENATAL PROGRAM HELD FOUR FOCUS GROUPS WITH WOMEN WHO EXPERIENCED FOOD INSECURITY WHILE PREGNANT. EACH FOCUS GROUP FOCUSED ON A DIFFERENT GROUP OF WOMEN: SPANISH, CHINESE, MULTI-ETHNIC ENGLISH SPEAKERS, AND AFRICAN AMERICAN. THE QUESTION TO RESPOND TO WAS, "WHAT ACTIONS CAN WE TAKE TO IMPROVE YOUR FOOD NEEDS?".KAISER LED FOCUS GROUPS: KAISER CONDUCTED FOUR FOCUS GROUPS, ONE EACH WITH KAISER PERMANENTE LEADERSHIP, KAISER PERMANENTE STAFF, SPANISH-SPEAKING PARENTS ON YOUTH HEALTHY EATING AND ACTIVE LIVING, AND HOMELESS AND/OR HIV POSITIVE YOUTH.IN ADDITION, THE CHINESE HOSPITAL SUPPLEMENTAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED THROUGH FOCUS GROUPS DESIGNED TO ASSESS THE HEALTH STATUS, CONCERNS AND ACCESS AMONG THE CHINESE POPULATION THAT CHINESE HOSPITAL SERVES IN THE CITY AND COUNTY OF SAN FRANCISCO. THE RECRUITMENT OF THESE FOCUS GROUPS WAS CONDUCTED THROUGH ETHNIC MEDIA PRESS RELEASE, FLYER DISTRIBUTION AT LOCAL COMMUNITY ORGANIZATIONS, AS WELL AS THROUGH POPULAR CHINESE SOCIAL MEDIA APP, WECHAT. THE FOCUS GROUP PARTICIPANTS WERE RECRUITED FROM OVER 15 DIFFERENT ZIP CODE NEIGHBORHOODS.A SERIES OF FOUR (4) FOCUS GROUPS WERE CONDUCTED TO ASSESS AND IDENTIFY THE PREDOMINANT HEALTH CONCERNS OF THE CHINESE-SPEAKING POPULATION THAT CHINESE HOSPITAL.THE FOCUS GROUPS WERE CONDUCTED BETWEEN SEPTEMBER 7TH- 11TH, 2019 AT CHINESE HOSPITAL WITH AN AVERAGE OF 10 PARTICIPANTS PER GROUP. THE FACILITATOR OF THE FOCUS GROUP IS A BILINGUAL, TRAINED HEALTH EDUCATOR WITH MORE THAN 10 YEARS OF EXPERIENCE IN CONDUCTING QUALITATIVE INTERVIEW SESSIONS. ALL FOUR (4) FOCUS GROUPS WERE CONDUCTED IN CANTONESE-CHINESE, THE PREFERRED CHINESE DIALECT OF THE PARTICIPANTS. ALL PARTICIPANTS COMPLETED A DEMOGRAPHIC SURVEY AND THE FOCUS GROUP SESSIONS WERE AUDIO RECORDED WITH PARTICIPANTS' CONSENT. THE FACILITATOR UTILIZED A QUESTION GUIDE AND THE STICKY NOTE TECHNIQUE (PETERSON AND BARRON, 2007) TO SOLICIT FEEDBACK FROM PARTICIPANTS. A BILINGUAL, BICULTURAL PATIENT NAVIGATOR/HEALTH INFORMATION SPECIALIST HAND RECORDED THE MEETING NOTES. PARTICIPANTS WERE ASKED TO RANK THEIR HEALTH NEEDS FROM 1-5, WITH 1 BEING THE MOST IMPORTANT, AND THEIR RESPONSES POSTED WITH STICKY NOTES ON A BOARD FOR OTHER PARTICIPANTS TO SEE. STICKY NOTES SERVED AS BASES FOR FURTHER DISCUSSION TO ASSESS COMMUNITY NEEDS.
CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: CHA'S 2019 CHNA WAS CONDUCTED IN CONJUNCTION WITH THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP), A COLLABORATIVE BODY WHOSE MISSION IS TO EMBRACE COLLECTIVE IMPACT AND TO IMPROVE COMMUNITY HEALTH AND WELLNESS IN SAN FRANCISCO. SFHIP INCLUDES THE FOLLOWING SAN FRANCISCO NON-PROFIT HOSPITALS (OTHER THAN CHA): SUTTER HEALTH CALIFORNIA PACIFIC MEDICAL CENTER, SAINT FRANCIS MEMORIAL HOSPITAL, KAISER PERMANENTE SAN FRANCISCO, UCSF, AND ST. MARY'S MEDICAL CENTER.
CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: THE 2019 CHNA WAS CONDUCTED IN CONJUNCTION WITH SFHIP, WHICH INCLUDES THE FOLLOWING REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: ASIAN AND PACIFIC ISLANDER HEALTH PARTY COALITION, SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM, CHICANO / LATINO/ INDIGENA HEALTH EQUITY COALITION, SF INTERFAITH COUNCIL, SAN FRANCISCO HEALTH SERVICES NETWORK, AFRICAN AMERICAN COMMUNITY HEALTH EQUITY COUNCIL, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, METTA FUND, SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, UNIVERSITY OF SAN FRANCISCO, HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA, VIETNAMESE YOUTH DEVELOPMENT CENTER, HOMELESS PRENATAL PROGRAM, FACENTE CONSULTING, SAN FRANCISCO HUMAN SERVICES NETWORK, SAN FRANCISCO OFFICE OF THE CHIEF MEDICAL EXAMINER, RAFIKI COALITION FOR HEALTH AND WELLNESS, CENTER FOR OPEN RECOVERY.
CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: AMONG ALL THE COMMUNITY HEALTH NEEDS IDENTIFIED BY 2019 SFHIP CHNA AND CHINESE HOSPITAL 2019 SUPPLEMENTAL CHNA, BASED ON THE RESOURCES AVAILABLE, CHINESE HOSPITAL SELECTS THE FOLLOWING 3 MAIN AREAS AS OUR PRIORITIES TO ADDRESS IN THE NEXT THREE YEARS: (I) CHRONIC DISEASES AND LOW SCREENING RATES; (II) PALLIATIVE CARE; (III) DEMENTIA/CAREGIVER BURDEN. ADDITIONALLY, CHINESE HOSPITAL WILL CONTINUE TO ADDRESS HEALTH CONCERNS REGARDING MENTAL HEALTH IDENTIFIED BY THE FOCUS GROUP PARTICIPANTS UNDER THE CATEGORY OF OTHER HEALTH CONCERNS THOUGH THEY ARE NOT AMONG THE TOP 3 HEALTH CONCERNS. BASED ON THE FINDINGS FROM THIS QUALITATIVE HEALTH NEEDS ASSESSMENT, CHRONIC DISEASE AND ITS SCREENINGS ARE AMONG THE TOP CONCERNS. THE NEED FOR ACCESSIBLE, CULTURALLY AND LINGUISTICALLY APPROPRIATE CHRONIC DISEASE MANAGEMENT PROGRAMS IN COMMUNITIES CHINESE HOSPITAL SERVES REMAINED HIGH. TO MEET THESE DEMANDS, WE WILL CONTINUE TO EXPAND THE CHINESE HOSPITAL'S PROGRAMS AND SERVICES AS FOLLOWS:1) EXPAND THE EXISTING CHRONIC DISEASE MANAGEMENT PROGRAMS TO ADDRESS CHRONIC CONDITIONS THAT ARE CONCERNING THE CHINESE POPULATION: CHINESE HOSPITAL'S PATIENT-CENTERED DIABETES PROGRAMS CONTINUES TO OFFER COMPREHENSIVE DIABETES CARE TO THE COMMUNITY WITH A MULTIDISCIPLINARY APPROACH. OUR MULTIDISCIPLINARY TEAM CONSISTS BILINGUAL PRIMARY CARE DOCTORS, AN ENDOCRINOLOGIST, NURSE PRACTITIONERS, CERTIFIED DIABETES EDUCATORS, REGISTERED DIETITIANS, CARE COORDINATORS, MEDICAL ASSISTANTS, A PODIATRIST, AND OTHER PROVIDERS AND STAFF. WE ALSO PROVIDE AMERICAN DIABETES ASSOCIATION CERTIFIED DIABETES SELF-MANAGEMENT EDUCATION (DSME) TO DIABETIC PATIENTS AND FAMILIES. THE COURSES ARE PROVIDED IN CANTONESE, MANDARIN, AND ENGLISH, AND EDUCATION MATERIALS ARE BILINGUAL IN CHINESE AND ENGLISH. THE CENTER IS ALSO EXPANDING ITS PROGRAM TO SERVE THE PRE-DIABETIC POPULATION BY ADDING THE BILINGUAL CDC RECOGNIZED DIABETES PREVENTION PROGRAM.CHINESE HOSPITAL SUPPORT HEALTH SERVICES ALSO CONTINUES TO PROVIDE CHRONIC DISEASE MANAGEMENT FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CONGESTIVE HEALTH DISEASE, HEPATITIS B AND OTHER CHRONIC DISEASES. AS LOW HEALTH SCREENING RATES WAS AMONG THE TOP CONCERNS IDENTIFIED BY THE FOCUS GROUP, CHINESE HOSPITAL WILL CONTINUE THE EFFORTS IN IMPROVING PREVENTIVE HEALTH EDUCATION AND SERVICES. CHINESE HOSPITAL WILL CONTINUE TO HOLD PROMOTIONAL EVENTS TARGETING THE CHINESE POPULATION, E.G. COMMUNITY HEALTH FAIRS WILL CONTINUE TO BE HELD ON A REGULAR BASIS. THESE FAIRS HAVE AND WILL CONTINUE TO PROVIDE FREE HEALTH SCREENINGS AND BILINGUAL HEALTH EDUCATION MATERIALS FOR THOSE WHO PARTICIPATE. FREE OR LOW-COST FITNESS CLASSES WILL BE PROVIDED TO THE COMMUNITY AT A CONVENIENT LOCATION AND TIME. CHINESE HOSPITAL WILL ALSO CONTINUE TO USE A MULTIMEDIA APPROACH, SUCH AS CHINESE TV OR RADIO CHANNELS, NEWSPAPERS, AND HEALTH PLAN NEWSLETTERS TARGETING THE CHINESE COMMUNITY, FOR OUTREACH AND PUBLIC AWARENESS OF PREVENTIVE HEALTH. IN ADDITION, CHINESE HOSPITAL AND CCHRC ARE DEVELOPING AND EXPANDING ITS HEALTH EDUCATION PROGRAMS ON PREVENTIVE SCREENINGS, HEALTH BEHAVIOR AND HEALTHY LIFESTYLE TO ADDRESS THE IDENTIFIED BEHAVIORAL HEALTH CONCERNS, E.G. SMOKING. BILINGUAL HEALTH EDUCATION RESOURCES NEED TO BE MADE AVAILABLE TO THE PUBLIC ONLINE, AS WELL AS BY PRINTED COPIES TO CERTAIN POPULATION HAVE LITTLE OR NO ACCESS TO THE INTERNET.2) PROMOTE PATIENT USAGE OF THE TECHNOLOGY-BASED PATIENT DASHBOARD SYSTEM IN CHINESE HOSPITAL PATIENT ROOMS TO INCREASE PATIENTS' ACCESS TO EDUCATIONAL VIDEOS ON THE PREVENTION AND MANAGEMENT CHRONIC DISEASES: CHINESE HOSPITAL IMPLEMENTED AN INTERACTIVE PATIENT DASHBOARD IN ALL PATIENT ROOMS IN AUGUST 2019. THIS DASHBOARD SYSTEM ENABLES PATIENTS TO ACCESS HEALTH EDUCATION MATERIALS, INPATIENT SERVICES, AND ENTERTAINMENT DURING THEIR STAY AT CHINESE HOSPITAL. WE AIM TO INCREASE PATIENTS' USAGES OF THIS DASHBOARD TO SYSTEM ACCESS BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL VIDEOS ON THE PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. TO PROVIDE PATIENT-CENTERED CARE, EACH PATIENT WILL RECEIVE A TAILORED LIST OF EDUCATIONAL VIDEOS SPECIFIC TO THEIR NEEDS, WHICH WILL BE SELECTED BY THEIR HEALTH CARE TEAM.3) CONTINUE TO WORK WITH OUR PARTNER, CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC) TO EXPAND THE BILINGUAL (CHINESE & ENGLISH) HEALTH EDUCATION MATERIALS ON CHRONIC DISEASES AND HEALTH TOPICS OF COMMUNITY'S CONCERN: CHINESE HOSPITAL, TOGETHER WITH CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC), WILL EXPAND THE FREE BILINGUAL (CHINESE & ENGLISH) HEALTH EDUCATION MATERIALS TO INCLUDE THE HEALTH CONCERNS IDENTIFIED BY THE FOCUS GROUP ON CHRONIC CONDITIONS SUCH AS ORAL DISORDERS, EYE HEALTH, AND CHRONIC PAIN.4) WORK WITH OUR PARTNER, CCHRC TO DELIVER HEALTH EDUCATION MATERIALS AND PROGRAMS INCLUDING THROUGH WEBSITE AND SOCIAL MEDIA: BASED ON THE RECOMMENDATIONS OF USING TECHNOLOGY TO DELIVER HEALTH INFORMATION, CHINESE HOSPITAL WILL WORK WITH CCHRC AND CONTINUE TO MAKE BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL WEBSITES (WWW.CHINESEHOSPITAL-SF.ORG AND WWW.CCHRHCHEALTH.ORG). ADDITIONALLY, CHINESE HOSPITAL AND CCHRC WILL EXPLORE THE USE CULTURAL APPROPRIATE SOCIAL MEDIA TO DELIVER HEALTH INFORMATION. SPECIFICALLY, WE WILL EXPLORE THE INCORPORATION WECHAT, A FREE MOBILE APPLICATION, IN THE DISTRIBUTION OF HEALTH EDUCATION MATERIALS AND PROGRAMS. WECHAT IS ONE OF THE MOST WIDELY USED SOCIAL MEDIA PLATFORM IN CHINA AND CHINESE INDIVIDUALS GLOBALLY, INCLUDING CHINESE IMMIGRANTS IN THE UNITED STATES (TENCENT, 2017). GIVEN THE FEEDBACK RECEIVED FROM THE CONDUCTED FOCUS GROUPS, WECHAT IS REGULARLY USED WITHIN THE CHINESE COMMUNITY OF SAN FRANCISCO. WHEN ABLE TO, WE WILL INCORPORATE WECHAT AS A TOOL TO INFORM AND ENGAGE PATIENTS IN PROGRAMS OFFERED BY THE HOSPITAL.5) CONTINUE TO WORK WITH NICOS, AND THE CHINATOWN CHILDREN'S ORAL HEALTH TASKFORCE TO ADDRESS THE NEED FOR IMPROVED CHILDREN'S DENTAL HEALTH EDUCATION AND SERVICES: CHINESE HOSPITAL WILL CONTINUE WORKING WITH NICOS, A COALITION OF COMMUNITY BASED ORGANIZATIONS, AND THE CHINATOWN CHILDREN'S ORAL HEALTH TASKFORCE, TO ADDRESS THE NEED FOR IMPROVED CHILDREN'S DENTAL HEALTH EDUCATION AND SERVICES. CHINESE HOSPITAL PLANS TO WORK WITH ITS COMMUNITY PARTNER, THE CHINESE COMMUNITY HEALTH RESOURCE CENTER, TO PRODUCE FURTHER HEALTH EDUCATION MATERIAL ON ORAL HEALTH.FOCUS GROUP PARTICIPANTS IDENTIFIED THE NEED FOR MORE PALLIATIVE CARE EDUCATIONAL MATERIALS AND SERVICES AS ONE OF THE TOP CONCERNS. TO ADDRESS THESE CONCERNS, CHINESE HOSPITAL WILL:1) ESTABLISH, IMPLEMENT AND EVALUATE AN OUTPATIENT PALLIATIVE CARE PROGRAM AT CHINESE HOSPITAL: UTILIZING FUNDS AWARDED TO CHINESE HOSPITAL BY THE STUPSKI FOUNDATION (2019-2022), CURRENT INPATIENT PALLIATIVE CARE SERVICES IS BEING EXPANDED TO OUTPATIENT SERVICES AS WELL. THIS OUTPATIENT PALLIATIVE CARE PROJECT WILL INCLUDE THE RECRUITMENT AND ONBOARDING OF A CERTIFIED PALLIATIVE CARE SPECIALIST/GERIATRICIAN, THE DEVELOPMENT OF POLICIES AND PROTOCOLS, THE IMPLEMENTATION AND MONITORING OF A DATA TRACKING SYSTEM, AND ITS EVALUATION AND IMPROVEMENT. 2) EXPAND BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL MATERIALS ON PALLIATIVE CARE: CHINESE HOSPITAL WILL WORK WITH OUR PARTNER CCHRC TO DEVELOP BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL MATERIALS ON PALLIATIVE CARE/COMFORT CARE AND AN EDUCATIONAL VIDEO ON PAIN MANAGEMENT. 3) CONTINUE TO COLLABORATE WITH CCHRC TO PROVIDE EDUCATION PROGRAMS AND SERVICES ON ADVANCE HEALTH CARE DIRECTIVES AS WELL AS PROVIDE ASSISTANCE IN FORM COMPLETION: CHINESE HOSPITAL WILL WORK WITH CCHRC WILL CONTINUE TO PROVIDE EDUCATION SEMINARS, COUNSELING SESSIONS ON THE TOPIC OF ADVANCE HEALTH CARE DIRECTIVES, AS WELL AS CONTINUE TO PROVIDE SERVICE TO ASSIST WITH ADVANCE HEALTH CARE DIRECTIVE FORM COMPLETIONS.THE FOCUS GROUP PARTICIPANTS ALSO IDENTIFIED AS ONE OF THE TOP CONCERNS AWARENESS OF DEMENTIA AND THE BURDEN OF CAREGIVERS PROVIDING CARE FOR INDIVIDUALS LIVING WITH DEMENTIA. TO ADDRESS THESE CONCERNS, CHINESE HOSPITAL WILL WORK WITH CCHRC TO DEVELOP BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL MATERIALS AND TRAINING TO RAISE THE AWARENESS OF CAREGIVER BURDEN AND TO PROVIDE PRACTICAL INFORMATION ON SYMPTOM RECOGNITION AND CARE MANAGEMENT FOR CAREGIVERS OF INDIVIDUALS LIVING WITH DEMENTIA.TO ADDRESS THE HEALTH NEED OF MENTAL HEALTH, CHINESE HOSPITAL WILL CONTINUE TO PROMOTE THE SYSTEM-WIDE MENTAL/BEHAVIORAL HEALTH SERVICES THROUGH COMMUNICATIONS SUCH AS FLYERS, NEWSLETTERS, WEBSITES, ETC. TO THE COMMUNITY ON A REGULAR BASIS. ADDITIONALLY, IT WILL CONTINUE TO EXPAND CULTURALLY AND LINGUISTICALLY APPROPRIATE EDUCATIONAL PROGRAMS ON MENTAL HEALTH, INCLUDING VIDEO CONFERENCE FOR SUPPORT (VIA WEBEX), WHICH WILL INCREASE ACCESS TO MENTAL HEALTH PROVIDERS AND CONNECT PATIENTS WITH THEIR CARE TEAM REMOTELY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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 1 - CHINESE HOSPITAL OUTPATIENT CENTER
386 GELLERT BOULEVARD
DALY CITY,CA94015
OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC
2 2 - SUNSET HEALTH SERVICES
1800 31ST AVENUE
SAN FRANCISCO,CA94122
OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC
3 3 - EXCELSIOR HEALTH SERVICES
888 PARIS STREET SUITE 202
SAN FRANCISCO,CA94112
OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC
4 4 - SUPPORT HEALTH SERVICES
845 JACKSON STREET B1
SAN FRANCISCO,CA94133
OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC
5 5 - EAST WEST HEALTH SERVICES
445 GRANT AVENUE GROUND FLOOR
SAN FRANCISCO,CA94108
ACCUPUNCTURE & HERBAL MEDICINE SPECIALTY
6
7
8
9
10
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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: A COST-TO-CHARGE RATIO WAS UTILIZED TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART I, LINE 7.
PART III, LINE 3: THE HOSPITAL RUNS A CREDIT SCORE AND COLLECTS TAX RETURNS FOR PATIENTS APPLYING FOR FINANCIAL ASSISTANCE; BASED OFF THIS INFORMATION, AN ESTIMATE IS MADE TO DETERMINE HOW MUCH OF THE BAD DEBT EXPENSE ON PART III, LINE 3 WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. IN ADDITION, SOME OF THE BAD DEBT EXPENSE IS RELATED TO HOMELESS PATIENTS, WHICH WOULD BE ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND CO-INSURANCE FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGES BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY AND DEEMED UNCOLLECTIBLE ARE RECORDED AS BAD DEBT EXPENSE.
PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT HAVE A SEPARATE FOOTNOTE ADDRESSING BAD DEBT EXPENSE; HOWEVER, THE FOOTNOTE WHICH ADDRESSES PATIENT ACCOUNTS RECEIVABLE CAN BE FOUND ON PAGE PATIENT ACCOUNTS RECEIVABLE CAN BE FOUND ON PAGES 7 AND 15 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AS MEDICARE RATES ARE NON-NEGOTIABLE AND SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS. BY CONTINUING TO TREAT PATIENTS ELIGIBLE TO MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. ADDITIONALLY, IRS REV. RUL. 69-545 STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.A COST-TO-CHARGE IS UTILIZED TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART III, LINES 6.
PART III, LINE 9B: AT LEAST 30 DAYS PRIOR TO INITIATING ECAS, CHINESE HOSPITAL OR ITS AUTHORIZED VENDOR WILL PROVIDE THE PATIENT WITH A WRITTEN NOTICE ("ECA NOTICE") THAT WILL: (A) INDICATE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS; (B) IDENTIFY THE ECA(S) THAT THE HOSPITAL FACILITY OR AUTHORIZED VENDOR INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE; (C) STATE A DEADLINE AFTER WHICH SUCH ECA(S) MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN ECA NOTICE IS PROVIDED; (D) INCLUDE THE FOLLOWING STATEMENT OR ANY FURTHER STATEMENT REQUIRED BY AN AMENDMENT TO CALIFORNIA HEALTH & SAFETY CODE 127430: "STATE AND FEDERAL LAW REQUIRE DEBT COLLECTORS TO TREAT YOU FAIRLY AND PROHIBIT DEBT COLLECTORS FROM MAKING FALSE STATEMENTS OR THREATS OF VIOLENCE, USING OBSCENE OR PROFANE LANGUAGE, AND MAKING IMPROPER COMMUNICATIONS WITH THIRD PARTIES, INCLUDING YOUR EMPLOYER. EXCEPT UNDER UNUSUAL CIRCUMSTANCES, DEBT COLLECTORS MAY NOT CONTACT YOU BEFORE 8:00 A.M. OR AFTER 9:00 P.M. IN GENERAL, A DEBT COLLECTOR MAY NOT GIVE INFORMATION ABOUT YOUR DEBT TO ANOTHER PERSON, OTHER THAN YOUR ATTORNEY OR SPOUSE. A DEBT COLLECTOR MAY CONTACT ANOTHER PERSON TO CONFIRM YOUR LOCATION OR TO ENFORCE A JUDGMENT. FOR MORE INFORMATION ABOUT DEBT COLLECTION ACTIVITIES, YOU MAY CONTACT THE FEDERAL TRADE COMMISSION BY TELEPHONE AT 1- 877-FTC-HELP (382-4357) OR ONLINE AT WWW.FTC.GOV.; CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS MAY EMPLOY THE FOLLOWING ECAS, SUBJECT TO ANY RESTRICTIONS DESCRIBED BELOW: 1. CREDIT REPORTING(A) FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, NEITHER CHINESE HOSPITAL NOR ANY OF ITS AUTHORIZED VENDORS WILL REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY FOR NON-PAYMENTS AT ANY TIME PRIOR TO 150 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. 2. CIVIL ACTIONS (E.G., LITIGATION, DEBTOR'S EXAMS)(A) FOR UNINSURED PATIENTS OR PATIENTS WITH HIGH MEDICAL COSTS (AS DEFINED IN CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY), NEITHER CHINESE HOSPITAL NOR ANY OF ITS AUTHORIZED VENDORS WILL COMMENCE CIVIL ACTION FOR NON-PAYMENTS AT ANY TIME PRIOR TO 150 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. (B) THIS RESTRICTION DOES NOT PRECLUDE CHINESE HOSPITAL FACILITIES FROM PURSUING REIMBURSEMENT FROM THIRD-PARTY LIABILITY SETTLEMENTS, TORTFEASORS, OR OTHER LEGALLY RESPONSIBLE PARTIES. (C) THE COSTS, INCLUDING ATTORNEY FEES, ASSOCIATED WITH ANY LEGAL ACTION THAT CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS IS REQUIRED TO TAKE MAY ALSO BE THE RESPONSIBILITY OF THE PATIENT. 3. RENEWAL OF EXISTING JUDGMENTS4. PROPERTY LIENS(A) CHINESE HOSPITAL AND ITS AUTHORIZED VENDORS THAT ARE AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT PLACE LIENS ON THE PRIMARY RESIDENCE OF A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. (B) AUTHORIZED VENDORS THAT ARE NOT AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT NOTICE OR CONDUCT A SALE OF THE PRIMARY RESIDENCE OF A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. 5. WAGE GARNISHMENTS (A) CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS THAT ARE AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT FILE A WRIT OF GARNISHMENT AGAINST A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. (B) CHINESE HOSPITAL'S AUTHORIZED VENDORS THAT ARE NOT AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT FILE A WRIT OF GARNISHMENT AGAINST A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY, UNLESS SUCH WRIT IS BY ORDER OF THE COURT UPON NOTICED MOTION, SUPPORTED BY A DECLARATION FILED BY THE MOVANT IDENTIFYING THE BASIS FOR WHICH IT BELIEVES THE PATIENT HAS THE ABILITY TO MAKE PAYMENTS ON THE JUDGMENT UNDER THE WAGE GARNISHMENT. (C) WAGE GARNISHMENT AMOUNTS WILL NOT EXCEED LIMITS PERMITTED UNDER STATE LAWS.
PART VI, LINE 2: THE CHINESE HOSPITAL SUPPLEMENTAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED THROUGH FOCUS GROUPS DESIGNED TO ASSESS THE HEALTH STATUS, CONCERNS, AND ACCESS AMONG THE CHINESE POPULATION THAT CHINESE HOSPITAL SERVES IN THE CITY AND COUNTY OF SAN FRANCISCO. PARTICIPANTS WERE ASKED TO RANK THEIR HEALTH NEEDS FROM 1-5, WITH 1 BEING THE MOST IMPORTANT, AND THEIR RESPONSES POSTED WITH STICKY NOTES ON A BOARD FOR OTHER PARTICIPANTS TO SEE. STICKY NOTES SERVE AS BASES FOR FURTHER DISCUSSION TO ASSESS COMMUNITY NEEDS. THE FOCUS GROUP RESPONDENTS THEN RECOMMEND HEALTH NEEDS, WHICH BECOME THE BASIS FOR CHINESE HOSPITAL'S CHNA AND IMPLEMENTATION STRATEGY.IN ADDITION, CHINESE HOSPITAL HOLDS VARIOUS COMMUNITY EVENTS AND SCREENINGS, WHICH ALLOWS IT TO FURTHER ASSESS THE HEALTH NEEDS OF THE COMMUNITY.
PART VI, LINE 3: THE HOSPITAL POSTS ITS FINANCIAL ASSISTANCE POLICY WITHIN ADMITTING AND REGISTRATION AREAS, THE EMERGENCY DEPARTMENT, AND THE BUSINESS OFFICE. ALL ADMITS TO THE HOSPITAL ARE ALSO PROVIDED THE FINANCIAL ASSISTANCE/CHARITY CARE POLICIES IN THE PRIMARY LANGUAGE OF THE PATIENT.CHINESE HOSPITAL ALSO MAKES REASONABLE EFFORTS TO PROVIDE ALL PATIENTS WHO RECEIVE CARE (WHETHER EMERGENCY, INPATIENT, OR OUTPATIENT) FROM A CHINESE HOSPITAL FACILITY, AND MAY BE BILLED FOR THAT CARE, WITH A CONSPICUOUS WRITTEN NOTICE ON EACH BILLING STATEMENT THAT INCLUDES THE FOLLOWING: (I) INFORMATION ABOUT THE AVAILABILITY OF CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND OTHER DISCOUNTS AVAILABLE FROM CHINESE HOSPITAL; (II) INFORMATION ABOUT ELIGIBILITY FOR FINANCIAL ASSISTANCE AND OTHER DISCOUNTS; (III) CONTACT INFORMATION FOR A HOSPITAL EMPLOYEE OR OFFICE FROM WHICH THE PERSON MAY OBTAIN FURTHER INFORMATION ABOUT CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND OTHER DISCOUNTS; AND (IV) THE DIRECT WEBSITE WHERE COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE OBTAINED.IF A PATIENT HAS NOT PROVIDED PROOF OF HEALTH COVERAGE BY A THIRD PARTY AT THE TIME CARE IS PROVIDED OR BY THE TIME THE PATIENT IS DISCHARGED, CHINESE HOSPITAL'S FIRST POST-DISCHARGE BILL WILL PROVIDE THE PATIENT WITH A BILL THAT CONTAINS A CLEAR AND CONSPICUOUS STATEMENT THAT, IF THE PATIENT DOES NOT HAVE HEALTH INSURANCE COVERAGE FOR THE CHARGES, THE PATIENT MAY BE ELIGIBLE FOR (I) A GOVERNMENT-SPONSORED HEALTHCARE PROGRAM, SUCH AS MEDICARE, MEDICAID, OR CHIP, (II) COVERAGE OFFERED THROUGH A HEALTH BENEFITS EXCHANGE; (III) COVERAGE THROUGH OTHER STATE-OR COUNTY-FUNDED HEALTH PROGRAMS (E.G. CALIFORNIA CHILDREN'S SERVICES PROGRAM), OR (IV) FINANCIAL ASSISTANCE FROM CHINESE HOSPITAL UNDER ITS FINANCIAL ASSISTANCE POLICY. A STATEMENT IS ALSO INCLUDING INDICATING HOW PATIENTS MAY OBTAIN APPLICATIONS FOR THE AFOREMENTIONED PROGRAMS AND THAT THE HOSPITAL WILL PROVIDE THE APPLICATIONS. THE HOSPITAL SERVES A LARGE POPULATION OF LOW-INCOME. 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, WHICH 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 ASSOCIATION, CCHP, AND JADE HEALTH CARE MEDICAL GROUP.
PART VI, LINE 4: THE COMMUNITY CHINESE HOSPITAL SERVES HAS A MAJORITY OF LOW-INCOME, MONOLINGUAL OR LINGUISTICALLY ISOLATED SENIOR POPULATION. OF THE INPATIENT POPULATION AT CHINESE HOSPITAL, 98% ARE CHINESE ANCESTRY, 88% ARE OVER THE AGE OF 60, AND 91% ARE MEDICARE/MEDI-CAL BENEFICIARIES. THE PRIMARY SERVICE AREA IS THE GREATER CHINATOWN AND NORTH BEACH DISTRICTS OF SAN FRANCISCO. THE POPULATION OF THE CHINATOWN/NORTH BEACH DISTRICTS IS 26,492, WITH OVER HALF (50.2%) IDENTIFYING AS ASIAN; MORE SPECIFICALLY, 43.7% IDENTIFY AS CHINESE. THE PER CAPITA INCOME IS $58,461, WHILE THE MEDIAN HOUSEHOLD INCOME IS $66,442. THE PERCENTAGE OF PERSONS 65 YEARS AND OVER IS 22.4%, AND IT IS ESTIMATED 16.0% OF THE POPULATIONS IS BELOW THE POVERTY LEVEL. 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. ADDITIONAL INFORMATION REGARDING THESE SERVICE AREAS CAN BE FOUND IN THE ORGANIZATION'S CHNA REPORT POSTED TO ITS WEBSITE AT WWW.CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.
PART VI, LINE 5: 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.
PART VI, LINE 6: THE CHINESE HOSPITAL HEALTH SYSTEM IS AN INTEGRATIVE HEALTH SYSTEM CONSISTING OF CHINESE HOSPITAL AND CLINICS, CHINESE COMMUNITY HEALTH PLAN (CCHP), AND JADE HEALTH CARE MEDICAL GROUP. EACH ENTITY PERFORMS AN IMPORTANT ROLE IN ACHIEVING THE COMMON GOAL OF PROVIDING THE COMMUNITY WITH QUALITY AFFORDABLE CARE THAT IS CULTURALLY COMPETENT AND LINGUISTICALLY APPROPRIATE. CCHP IS LICENSED WITH THE CALIFORNIA DEPARTMENT OF MANAGED CARE TO OFFER COMMERCIAL HEALTH PLANS AND MAINTAIN A CONTRACT WITH CENTERS FOR MEDICARE AND MEDICAID TO OFFER MEDICARE ADVANTAGE PLANS; CCHP OFFERS A HIGH QUALITY, RIGHT-SIZED ALTERNATIVE FOR HEALTH COVERAGE. JADE HEALTH CARE MEDICAL GROUP IS A MEDICAL GROUP DELIVERING CULTURALLY SENSITIVE, BILINGUAL MANAGED HEALTH CARE IN THE SAN FRANCISCO BAY AREA.
PART VI, LINE 7, REPORTS FILED WITH STATES CA
Schedule H (Form 990) 2020
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number
94-0382780
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) CHINESE COMMUNITY HEALTH RESOURCE CENTER INC
818 JACKSON STREET
SAN FRANCISCO,CA94133
20-4251913 501(C)(3) 110,000       TO SUPPORT BILINGUAL HEALTH EDUCATION SERVICES TO THE CHINESE COMMUNITY
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: PROPER USE OF GRANT FUNDS AWARDED TO CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC) IS MONITORED VIA WITNESSING THE WORK OF CCHRC IN THE CHINESE COMMUNITY SURROUNDING THE HOSPITAL, AS WELL AS VIA A CLOSE, CONTINUOUS, WORKING RELATIONSHIP BETWEEN THE TWO ORGANIZATIONS.
Schedule I (Form 990) 2020



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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
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
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 on 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 on 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) 2020

Schedule J (Form 990) 2020
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
1DR JIAN ZHANG
CHIEF EXECUTIVE OFFICER
(i)

(ii)
521,637
-------------
80,000
0
-------------
0
0
-------------
0
55,979
-------------
0
21,256
-------------
0
598,872
-------------
80,000
0
-------------
0
2ANTONIA LENDARIS
CHIEF NUSRING OPERATIONS OFFICER
(i)

(ii)
306,924
-------------
0
0
-------------
0
0
-------------
0
14,250
-------------
0
7,257
-------------
0
328,431
-------------
0
0
-------------
0
3ANDERSON ENG MD
MEDICAL PHYSICIAN
(i)

(ii)
299,620
-------------
0
0
-------------
0
0
-------------
0
13,902
-------------
0
7,313
-------------
0
320,835
-------------
0
0
-------------
0
4KEITH MINARD
CHIEF INFO OFFICER THROUGH 7/2020
(i)

(ii)
219,237
-------------
0
0
-------------
0
69,883
-------------
0
0
-------------
0
4,266
-------------
0
293,386
-------------
0
0
-------------
0
5ALSON TOY
RN SURGERY
(i)

(ii)
288,686
-------------
0
0
-------------
0
0
-------------
0
37,429
-------------
0
7,952
-------------
0
334,067
-------------
0
0
-------------
0
6JIAYUN CHEN
RN SURGERY
(i)

(ii)
277,527
-------------
0
0
-------------
0
0
-------------
0
64,885
-------------
0
14,601
-------------
0
357,013
-------------
0
0
-------------
0
7FRANK CHEN MD
MEDICAL PHYSICIAN - SUNSET CLINIC
(i)

(ii)
268,357
-------------
0
0
-------------
0
0
-------------
0
13,324
-------------
0
7,313
-------------
0
288,994
-------------
0
0
-------------
0
8AUNG KYAW MAUNG MD
MEDICAL PHYSICIAN
(i)

(ii)
268,302
-------------
0
0
-------------
0
0
-------------
0
13,415
-------------
0
21,256
-------------
0
302,973
-------------
0
0
-------------
0
9LYDIA MAHR-CHAN
DIRECTOR OF HUMAN RESOURCES
(i)

(ii)
267,764
-------------
0
0
-------------
0
0
-------------
0
13,107
-------------
0
2,309
-------------
0
283,180
-------------
0
0
-------------
0
10CHI-KUO CHUNG
CFO START 6/2020
(i)

(ii)
144,618
-------------
0
0
-------------
0
0
-------------
0
7,231
-------------
0
3,047
-------------
0
154,896
-------------
0
0
-------------
0
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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
PART I, LINES 4A-B KEITH MINARD RECEIVED A TAXABLE SEVERANCE OF $69,883, WHICH HAS BEEN REPORTED IN "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III). DR. JIAN ZHANG PARTICIPATED IN THE ORGANIZATION'S SUPPLEMENTAL 457(F) DEFERRED COMPENSATION PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN TOTALED $7,825 IN 2020, WHICH HAS BEEN REPORTED IN "DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C).
Schedule J (Form 990) 2020

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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 , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number
94-0382780
Part
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
Proceeds
A B C D
1 Amount of bonds retired .................. 7,105,000      
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 70,301,569      
4 Gross proceeds in reserve funds ............. 4,114,101      
5 Capitalized interest from proceeds ............. 9,551,013      
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,411,465      
8 Credit enhancement from proceeds ............. 2,607,615      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 52,617,375      
11 Other spent proceeds .............        
12 Other unspent proceeds .............        
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 of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X            
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, 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              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
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            
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? X              
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 0 %      
6 Total of lines 4 and 5 ............. 0 %      
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? .............                
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
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? .......   X            
b Exception to rebate? ........   X            
c No rebate due? ......... X              
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
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
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
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/01/2019
SCHEDULE K, PART I, COLUMN (E) AND SCHEDULE K, PART II, LINE 3: THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED ON SCHEDULE K, PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE REPORTED ON SCHEDULE K, PART II, LINE 3 IS DUE TO CUMULATIVE INVESTMENT EARNINGS ON BOND FUNDS.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  

SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 20 268,801  
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( FOOD/MEALS FOR STAFF ) X 4 62,820  
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2020)
Schedule M (Form 990) (2020)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED ON SCHEDULE M, PART I, COLUMN (B).
Schedule M (Form 990) (2020)

Additional Data


Software ID:  
Software Version:  
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
2020
Open to Public
Inspection
Name of the organization
CHINESE HOSPITAL ASSOCIATION
 
Employer identification number

94-0382780
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 3 THE ROLE OF INTERIM CHIEF FINANCIAL OFFICER WAS FULFILLED BY PAUL ZIEGELE, A CONSULTANT WITH TATUM (AN ORGANIZATION PROVIDING INTERIM EXECUTIVE SERVICES). TOTAL PAYMENTS MADE TO TATUM IN EXCHANGE FOR PAUL ZIEGELE'S SERVICES TOTALED $280,787 DURING THE 2020 CALENDAR YEAR.
FORM 990, PART VI, SECTION A, LINE 6 CHA DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS. HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE "MEMBERS" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WITH THE POWER TO ELECT MEMBER OF THE GOVERNING BODY. ACCORDINGLY, CHA HAS SIXTEEN (16) MEMBERS: (1) CHINESE CONSOLIDATED BENEVOLENT ASSOCIATION; (2) NING YUNG BENEVOLENT ASSOCIATION; (3) SUE HING BENEVOLENT ASSOCIATION; (4) HOP WO BENEVOLENT ASSOCIATION; (5) KONG CHOW BENEVOLENT ASSOCIATION; (6) YEONG WO BENEVOLENT ASSOCIATION; (7) SAM YUP BENEVOLENT ASSOCIATION; (8) YAN WO BENEVOLENT ASSOCIATION; (9) CHINESE CHAMBER OF COMMERCE; (10) CHINESE AMERICAN CITIZENS ALLIANCE; (11) KUOMINTANG OF CHINA; (12) CHEE KUNG TONG; (13) CHINESE DEMOCRATIC CONSTITUTIONALIST PARTY; (14) CHINATOWN Y.M.C.A; (15) CHINESE CHRISTIAN UNION OF SAN FRANCISCO; AND (16) CHINESE HOSPITAL MEDICAL STAFF.
FORM 990, PART VI, SECTION A, LINE 7A EACH OF THE ORGANIZATION'S MEMBERS HAS THE POWER TO DESIGNATE ONE MEMBER OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT, IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING DEPARTMENT. THE FORM 990 IS THEN REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER; ADJUSTMENTS ARE MADE, AS NECESSARY. THE FORM 990 IS THEN MADE AVAILABLE TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL CONFLICT OF INTEREST SURVEY AND DECLARATION. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST STATEMENT THAT DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE, VOLUNTARY DISCLOSURE OF ANY POTENTIAL CONFLICTS AS DISCUSSIONS OF PENDING TRANSACTIONS OCCUR IS REQUIRED. THE LEGAL DEPARTMENT AND CFO REVIEW THE CONFLICT OF INTEREST STATEMENTS. IF A CONFLICT OF INTEREST ARISES, THE PERSON WITH THE CONFLICT RECUSES HIM/HERSELF FROM THE DELIBERATIONS AND DECISION-MAKING PROCESS REGARDING THAT PARTICULAR MATTER.
FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS PACKAGE OF THE CEO IS EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD. AS A PART OF THIS PROCESS, AN INDEPENDENT CONSULTANT WAS USED TO PROVIDE COMPARABLE DATA OF EQUIVALENT EMPLOYEES AT SIMILARLY SIZED HOSPITALS AND HEALTH PLANS; THE OVERALL COMPENSATION PACKAGE FOR THE CEO WAS THEN REVIEWED AND APPROVED BY INDEPENDENT MEMBERS OF THE BOARD. THE COMPENSATION AND BENEFITS PACKAGE FOR OTHER OFFICERS AND KEY EMPLOYEES IS ALSO EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD, WHICH UTILIZED COMPARABLE DATA FOR SIMILAR EMPLOYEES AT SIMILARLY SIZED HOSPITALS AND HEALTH PLANS.
FORM 990, PART VI, SECTION C, LINE 19 FEDERAL LAW DOES NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION; ACCORDINGLY, THESE DOCUMENTS ARE CURRENTLY NOT MADE AVAILABLE TO THE PUBLIC. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST, AND ARE ALSO ATTACHED TO A COPY OF THIS FORM 990.
FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,315,556. MANAGEMENT AND GENERAL EXPENSES 6,034,706. FUNDRAISING EXPENSES 10,274. TOTAL EXPENSES 9,360,536. TPA FEES - CCHP: PROGRAM SERVICE EXPENSES 5,071,071. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,071,071. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,794,373. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,794,373.
FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY -2,039,759. RETIREMENT PLAN BENEFIT GAIN 137,746.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


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
2020
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) 2020
Schedule R (Form 990) 2020
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
 
C 8,174,942 67,772,594 100.000 % Yes  
(2) CHARITABLE REMAINEDER TRUST (2)

 
 
CHARITABLE GIVING CA CHA
 
        Yes  










Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
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
Yes
 
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
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
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 26,281 BOOK VALUE
(2) CHINESE COMMUNITY HEALTH PLAN

D 1,296,343 BOOK VALUE
(3) CHINESE COMMUNITY HEALTH PLAN

K 172,005 BOOK VALUE
(4) CHINESE COMMUNITY HEALTH PLAN

L 1,935,206 BOOK VALUE
(5) CHINESE COMMUNITY HEALTH PLAN

M 4,234,365 BOOK VALUE
(6) CHINESE COMMUNITY HEALTH PLAN

O 4,266,000 BOOK VALUE
(7) CHINESE COMMUNITY HEALTH PLAN

P 272,096 BOOK VALUE
(8) CHINESE COMMUNITY HEALTH PLAN

Q 3,517,726 BOOK VALUE
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020
Schedule R (Form 990) 2020
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) 2020

Additional Data


Software ID:  
Software Version: