2022 Annual Report
Addressing the diverse challenges and growing needs of the Central San Joaquin Valley.

Revised January 2023

Our Commitment to You

‘As part of our mission to deliver high-quality care for every stage of life, we’re growing and strengthening our health system by partnering with more physicians, expanding our health insurance to more local employers and creating comfortable, high-tech, patient-centered facilities. We believe that when hospitals, health plans and physicians work together, the result is a stronger, truly integrated healthcare delivery system to better serve our region’s healthcare needs.’

Mission
mission

WHY WE EXIST
Community Health System exists to better the lives of all those we serve.

Mission
vision

WHAT WE ASPIRE TO
We will be the trusted health leader opening new doors to educate, innovate and expand our care and services across the Valley.

Mission
values

WHAT WE STAND FOR

  • Humanity: to do right by all people.
  • Duty: to care, teach and serve is our calling.
  • Excellence: to reach beyond expectations in all we do.
  • Ingenuity: to fearlessly forge new paths forward.

A Diverse Region’s Needs
Building a Stronger, Healthier Community. Together.

Addressing the diverse, challenging and growing needs of California’s Central San Joaquin Valley.

More than 1.7 million people live in Community’s five-county service area

Fresno, Madera, Merced, Kings and Tulare counties have some of the greatest health needs and challenges in the state, making the need for accessible, affordable healthcare even more vital.

3 in 10 Adults lack a high school diploma

Fresno County 7th Unhealthiest county in California

49% Receive Medi-Cal, compared to 33% statewide

3rd Highest diabetes-related amputations in Fresno County

15% Don't speak English

Top 5 Metro area for food insecurity in U.S.

9.9% Unemployed in Tulare County is among the state's highest

Community Health System is made up of three entities. Community Medical Centers includes four hospitals, a cancer institute and several long-term care, outpatient and other healthcare facilities. This network is known for its Level I Trauma Center, comprehensive burn care, long-standing medical education partnership with UCSF Fresno, and as the place to deliver babies. Over the past year, we’ve strengthened support for our affiliated physicians with the Community Provider Network. And finally, our Community Care Health plan is now one of the largest HMOs in the region, offering local businesses medical insurance for their employees. These three pillars of healthcare – hospitals, physicians and health insurance – provide comprehensive, collaborative care for Valley families.

9,750
Total Employees
2,500+
Affiliated Physicians
Largest private employer creating a
strong medical team
1,273
Licensed beds available in:
Four Hospitals
Cancer Institute
Long Term Care
Outpatient Facilities
Largest healthcare provider
with access to care
176,000+ ER Visits
8,884+ Annual Baby Deliveries
Nearly 60,000 Inpatient Admissions
Caring for
the most patients
10th
Largest provider of Medicaid services in the U.S. and second largest in the state (Medi-Cal)
Community Regional Medical Center
cares for the underserved
$1.16 billion
Spent on employee
salaries & benefits
$160 million
Spent on
facility construction and equipment
$268 million
Invested in
community benefit work*
$2.4 billion
Spent on
operating costs, capital and community investments

*Data from fiscal year 2022 (September 1, 2021 – August 31, 2022)

COVID-19 Response
A global pandemic

Making sure people in our community have access to the healthcare they need has always been our priority. During the pandemic, Community quickly formed a crisis command center, calling on experts from across our system to mobilize to fight this new disease. Employee teams, healthcare partners and community organizations collaborated and shared resources in new ways to expand COVID-19 testing, staffing, PPE supplies and bed capacity – and then later to vaccinate staff and the public.

‘Our success with remdesivir started raising our name within a lot of medical research institutions and they started reaching out to us. Because of that, we had 15 ongoing clinical trials … giving patients here early access to treatments that might not be available anywhere else.’

– Dr. Eyad Almasri, Medical Director of Critical Care at Community Regional Medical Center and a Clinical Professor of Medicine with UCSF Fresno

11,265

total COVID-19 patients as of March 3, 2022 – more than all of San Francisco County’s hospitals combined

$219 million
Added COVID-19 expenses
COVID-19 public education efforts

Community was also instrumental in keeping the public up-to-date on COVID-19 developments and local efforts with articles, regular videos and easy-to-understand infographics.

Frontline staff shares COVID-19 stories and plea for public safety December 24, 2020
State of COVID-19 Crisis: One Year Later March 23, 2021
Making Care Accessible
The area’s main 'safety net'

Community serves as the area’s main "safety net" provider, caring for a large share of the uninsured and underinsured in Central California – a region that's considered one of America's most challenging for healthcare. We also provide the only Level I Trauma Center and comprehensive burn center between Los Angeles and Sacramento. We’re continually striving to ensure the highest level of care is available here, close to home, by focusing on the needs of our Valley patients.

44 Home health nurses
Average 935 patients enrolled
1.2 Million miles traveled to provide care in 2022
Providing
at-home care
310
Providers connected to patients via telehealth
83,916
Telehealth visits annually
Safe, secure, private
online medical visits
952
Average patients served monthly
One of largest providers of
dialysis in the Valley
12
Sexual Assault Forensic Exam (SAFE) nurses
Fresno County’s only 24/7 examinations and support for
sexual assault victims
Growing to serve more Valley residents

‘When we started this expansion, Clovis was one of the fastest-growing cities in California. The Clovis Community expansion is part of a decade-long strategy to meet the Valley’s growing need for different kinds of inpatient and outpatient care settings — all of which must work together seamlessly. The challenges of the COVID-19 pandemic have demonstrated the critical need for increased healthcare access and how important it was to continue this project to care for Valley families.’

Craig Wagoner, Executive Vice President & Chief Operating Officer of Community Health System

Other ways we’re working to enhance access to care
What it's like to be a home health nurse
Region’s first chaplain residency program starts during pandemic
Community nurses and therapist bring top care into patients’ homes
Advancing Clinical Quality
Delivering measurable quality

We strive to rank among the nation’s top hospital systems in delivering measurable quality care and investing in best practices and innovative technology. Community Regional Medical Center is among the top 15 busiest emergency departments in the country and is the second busiest in California.

On average we receive about 650 requests a month for patients from other Valley hospitals to be transferred to Community’s higher level of care.

33
Centers of Excellence designations
Recognized by
12 organizations
300+
Community Health System
active research projects
9 years
In a row People’s Choice Award (Fresno Bee)
Clovis Community was voted
best hospital in the region
100
Among 100 best hospitals for orthopedic surgery excellence
Clovis Community recognized for
total joint replacement surgeries
100
Among 100 best hospitals for vascular surgery
Community Regional recognized for superior outcomes in
vascular surgeries
Level I
Highest distinction Level I Trauma Center
Community Regional recognized by the
American College of Surgeons
Stroke
Gold Plus Quality from the American Heart Association
Community Regional recognized for
neuroscience & stroke care
3x
Beacon Award for exceptional critical care nursing
Fresno Heart & Surgical is among
fewer than 200 U.S. hospitals to have achieved this accolade
6
Centers of Excellence for Metabolic & Bariatric Surgery
Fresno Heart & Surgical Hospital’s program is among
the busiest in California
Neurosurgical team gets young equestrian back in the saddle September 8, 2021
Pediatric whipple procedure September 8, 2021
Life-saving colonoscopy April 8, 2021
Caring for Our Workforce
Preparing tomorrow’s healthcare workforce, today

Nearly one out of every 62 people in Fresno County wears a Community Health System ID badge – as an employee, volunteer, student, contract worker or affiliated medical provider such as a dentist, doctor or paramedic. It takes the strength of all of us working together to create a healthier community. Community is committed to growing and managing a workforce that meets the Valley’s expanding health needs, including creating opportunities to encourage those with special expertise to relocate or stay here to provide more people in our community with access to medical care.

Here’s how we’re doing that while striving to be the Valley’s employer of first choice:
$1.16 billion

Invested on salaries and benefits for 9,750 employees in fiscal year 2022

63%

Of fulltime employees earn more than Fresno County’s median household income of $57K

$28.4M

Contributed to employees' retirement savings last year

1,149

Employees have advanced to higher positions or new roles/departments

$32.5M

Invested last year in reimbursements for employees' college tuition, professional certifications, seminars & training

114K

Hours that student nurses trained in our hospitals at a cost of $5.4 million

Support

Online therapy, mental health and wellness resources, and on-site and online group well-being chats for employees and their families

FREE

Full-service gym with personal training on our downtown campus, open to all employees and physicians

Becker’s Top 150 Great Places to Work in Healthcare

We’ve been named to Becker’s Top 150 Great Places to Work in Healthcare list. Our commitment to diversity and inclusion is a cornerstone of our patient care and our work culture, with mandatory education for all employees on respectful LBGTQ+ interactions and California laws against workplace bullying and discrimination. More than 700 employees have invested 20 or more years at Community, finding an encouraging environment to grow their careers.

Here’s a look at our workforce:
3,200+
Nursing staff
5,100
Employees work in downtown Fresno on the Community Regional Medical Center campus – nearly 60% of our workforce
9,750+

People employed in the Central Valley by the largest private employer

1%

Hawaiian/ Pacific Islander

4%

Two or More Races

23%

Asian

37%

Latinx

30%

White

4%

Black

1%

American Indian/ Alaska Native

Our Leadership

43% of our senior leadership are women and 26% of our leaders represent an ethnicity other than white.

Did You Know?

In August 2022 Forbes ranked Community Health System #30 as a best healthcare employer in California.

Women are an essential part of our team
83%

of our nurses identify as female

75%

of our workforce identifies as female

41%

of our female workforce is under the age of 35

Investing in Physicians
The place to practice medicine

In a region that’s chronically short of physicians of all specialties, we’re striving to support and encourage more doctors to choose the Valley as the place to practice medicine. More than 30% of our local physicians are over the age of 60 and nearing retirement, which could worsen doctor-to-patient ratios and create hardships for those seeking care in the future. Currently, there are 133 active physicians per 100,000 residents in the San Joaquin Valley compared with 222 active physicians per 100,000 people statewide.

Community Provider Network and Community Health Partners

Community Provider Network focuses on supporting physicians so they can focus on caring for patients. This new division of Community Health System provides an extensive continuum of healthcare services, optimizing resources for our provider partners and most importantly the patients we serve. Community Provider Network includes Community Health Partners, a fast-growing network of affiliated healthcare providers caring for Valley families at every life stage. 

UCSF Fresno

Community’s long-standing partnership with UCSF Fresno has created a pipeline for training of medical residents and fellows to help ensure high-quality, affordable care is available to our underserved populations. While the federal government pays a portion of graduate medical education (GME) costs through Medicare and Medicaid payments, it only pays for a limited number of residency positions, falling 80% short of the current UCSF Fresno training costs.

California Health Sciences University

Agreements with the California Health Sciences University (CHSU), a private institution offering doctoral degrees through its College of Osteopathic Medicine and College of Pharmacy, allow CHSU’s medical and pharmacy students to rotate through our facilities as part of their training. Pharmacy students began rotating in 2017. Medical students began rotating in 2019 and also will soon train in our CHP specialty clinics under the supervision of 30 CHSU faculty physicians and other local physicians.

Community Benefit Investment

Fiscal year 2022 data

Creating a healthier Valley for us all

Caring for Central Valley families requires more than just medical care. It means working beyond hospital walls to partner with community groups who are feeding the poor and educating immigrants about diabetes, COVID-19 and vaccinations. It means investing to attract the brightest medical minds, to expand horizons for children and to enhance support for patients.

Community Health System provided $268 million, about 11% of its operating budget, last year in uncompensated care, medical education, outreach and patient support services to create a healthier Valley for us all. California requires hospitals to invest in the people and communities they serve as part of their nonprofit designation and report it publicly in an annual Community Benefit Report.

$268 million in community benefits in FY 2022
$37M

Unreimbursed costs of training medical residents and fellows

$15M

Charity care

$1.1M

Nursing students training

$670K

Direct investments in community partners addressing community health needs

$366K

Continuing physician education & allied health professionals medical training

$213M

Patient care not covered by Medi-Cal or Medicare

$17,500
In education support

to underserved and farmworkers’ children pursuing medical careers in fiscal year 2021

9,200
Safe discharges for 4,200 homeless patients

During fiscal year 2021, employees helped provide clothing and new shoes to homeless patients

183K+
Hours of training to student nurses

Community is the regional leader in providing clinical experiences through partnerships with 20 universities and colleges

450K lbs
Of waste saved from landfills

Community recycles needles, paper, lead wires, electronics and surgical towels

$1M
In medical support

provided to Armenia over the past six years

830
Employees & 740 units of blood

donated during hospital blood drives in fiscal year 2021

$1.8 billion invested over the past decade in community benefit
Chaplain Juan Gutiérrez ministers in the fields to farmworkers, often answers their late-night calls and teaches many how to wire money home to Mexico. Read More >
Trusted community leaders can act as a bridge for recent immigrants, helping increase healthcare access, understanding and trust. Read More >
“In one of the richest food production areas in the world and we recently ranked as the third-highest food insecure metro area in the U.S.” Read More >
Armando Alvarez went from gun-toting drug dealer to a husband, father of four, Fresno middle school counselor, a part-time minister – and a gang intervention specialist. Read More >
Legger Thompson, was one of 1,600 patients helped by Community’s Diabetes Education Center last year, lowering his blood sugar enough to stop taking diabetes medication. Read More >
In Fresno County, African-American women are 55% more likely to have a premature baby than white mothers and Black babies die twice as often as white babies. Read More >
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