2023 Annual Report
Addressing the diverse challenges and growing needs of the Central San Joaquin Valley.

Updated December 2023

Our Commitment to You

‘To better the lives of all those we serve isn’t just our mission, it’s our calling. We continue to grow and strengthen our health system by partnering with more physicians, helping feed the healthcare professional pipeline, and expanding our health insurance to more local employers. 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 growing healthcare needs.’


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


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



  • 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.

Serving a Diverse Region
Building a Stronger, Healthier Community. Together.

More Than 2 Million People Live in
Our Primary 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. Below is a snapshot view of the makeup of our five-county primary service area.

76% earned a high school diploma
(CA average 85%)

20% living in poverty
(CA average 12%)

55% Enrolled in Medi-Cal
(CA average 40%)

9.4% preterm births
(live births before 37 weeks gestation)
(CA average 9%)

47% speaks a language other than English
(CA average 44%)

59% considered obese
(BMI greater than 24.99)
(CA average 28%)

20% unemployment rate
(CA average 12%)

Community Health System is made up of three entities. Community Medical Centers include four hospitals, a cancer institute and several long-term care, outpatient and other healthcare facilities. This entity 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 few years, we’ve strengthened support for our affiliated physicians with our medical foundation entity, Community Health Partners, that’s now more than 450 providers strong. And our third entity is our health plan, Community Care Health, that is now one of the largest HMOs in the region, offering local businesses an affordable alternative for medical insurance for their employees. These three pillars of healthcare – hospitals, physicians and health insurance – provide comprehensive, accessible care for Valley families.

Total Employees
Affiliated Physicians
Largest private employer with a
strong medical team
Licensed beds available in:
Four Hospitals
Long Term Care Facilities
Largest healthcare provider
with access to care
Nearly 193K ER Visits
8,090+ Annual Baby Deliveries
Nearly 59K Inpatient Admissions
Caring for
the most patients
in our region
Largest provider of Medicaid (Medi-Cal) discharges in California and the 6th largest in the U.S.
Community Regional Medical Center
cares for the underserved
$1.17 billion
Spent on employee
salaries & benefits
$80 million
Spent on
facility construction & equipment
$168.7 million
Invested in
community benefit work
$2.65 billion
Spent on
operating costs and capital investments
2030 Seismic Mandate

Community Health System's top priority is patient care and safety and a big part of that is making sure all healthcare facilities meet state regulations. With the upcoming 2030 seismic mandate soon approaching, representatives from the California Hospital Association explain what that could mean for hospitals in the Central Valley, including Community Regional Medical Center in downtown Fresno.

Making Care Accessible
The Region’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 diverse region that's considered one of America's most challenging for healthcare. We also provide the only combined Level I Trauma Center and comprehensive burn center between Los Angeles and Sacramento. We’re continually striving to live out our mission to better the lives of all we serve, ensuring the highest level of care is available here, close to home.

66 Home Health Staff
Average 765 Patients Enrolled
1.1 Million Miles Traveled to Provide Care in 2023
at-home care
Providers Connected to Patients via Telehealth
Telehealth Visits Annually
Safe, secure, private
online medical visits
Average Patients Served Monthly
One of largest providers of
dialysis in the Valley
Sexual Assault Forensic Exam (SAFE) nurses
Fresno County’s only 24/7 examinations and support for
sexual assault victims
Other ways we’re working to enhance access to care
Expanded Access to Cardiac Care in the Valley
Ten Years of EPIC
Mother’s Resource Center Helps New Valley Moms
Advancing Clinical Quality
Delivering A Higher Level of Care

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.

During fiscal year 2023, we received an average of 739 requests a month from other area hospitals asking to transfer patients in need of Community’s higher level of care.

Re-accredited and awarded a Gold Seal of Approval in 2023
Community Medical Centers
Recognized by The Joint Commission
Community Health System
active research projects
The only program in the Valley accredited by both the American College of Radiology and the American College of Surgeons
Community Cancer Institute & Radin Breast Care Center nationally accredited
Among 100 best hospitals for orthopedic surgery excellence
Clovis Community recognized for
total joint replacement surgeries
1 of 3
Hospitals in CA recognized for Advanced Certification in Perinatal Care
Community Regional recognized by The Joint Commission as a
Center of Excellence for moms & babies
Among 50 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
Highest certification from The Joint Commission and American Heart Association
Community Regional recognized as
Comprehensive Stroke Center
Beacon Award for exceptional critical care nursing
Fresno Heart & Surgical is among
fewer than 200 U.S. hospitals to have achieved this accolade
Centers of Excellence for Metabolic & Bariatric Surgery
Fresno Heart & Surgical Hospital’s program is among
the busiest in California
Discharge Planning and Patient Efficiencies
Nursing Peer Review for Better Clinical Outcomes
Monarch Technology for Lung Screening Now Available
Caring for Our Workforce
The Heart & Soul of Our Health System

About one in 50 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 better the lives of all those we serve. 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.

Top 10 Employer in California
$1.17 billion

Invested on salaries and benefits for 10,219 employees in fiscal year 2023


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


Contributed to employees' retirement savings last year


Employees have advanced to higher positions or new roles/departments


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

More than 100K Hours

That student nurses trained in our hospitals at a cost of more than $5M


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


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

Here’s a look at our workforce:

People employed in the Central Valley by the largest private employer


Hawaiian/ Pacific Islander


Two or More Races










American Indian/ Alaska Native

Nursing staff
Employees work in downtown Fresno on the Community Regional Medical Center campus – nearly 60% of our workforce
Our Leadership

59% of our senior leadership are women and 43% of our leaders represent an ethnicity other than white.

Women are an essential part of our team

of our nurses identify as female


of our workforce identifies as female


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 primary care physicians and specialists, 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 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 our medical foundation Community Health Partners, now more than 450 providers strong, caring for Valley families at every life stage.

UCSF Fresno

Community’s long-standing partnership with UCSF Fresno has created a pipeline for training 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. Nearly 250 students have graduated from CHSU’s current, 4-year Doctor of Pharmacy program, but it will be discontinued after graduation of the 2024 class.

Community Benefit Investment
Creating a Healthier Valley for Us All

Our mission of bettering the lives of all those we serve requires more than just medical care. It means working beyond hospital walls to partner with community groups who are feeding the poor, educating new moms about prenatal care and helping meet the basic needs of the homeless. It means investing to attract the brightest medical minds, to expand horizons for children and to enhance support services for patients and families.

In fiscal year 2023, Community Health System provided $168.7 million in uncompensated care, medical education, outreach and patient support services to create a healthier Valley for us all. Learn more in our Community Benefit Report.

Nearly $169 Million in Community Benefit in FY 2023
$37.4M for Medication Education
$107M for Non-Reimbursed Patient Care
$17.2M for Charity Care
$5.7M for Nurse-to-Student Education
$1.4M for Investments to Address Public Health Needs
Shortfall in Medi-Cal and Medicare reimbursements

Government programs are underfunded and overextended, only covering about 88% of patient care costs while enrollment continues to boom, placing the cost of care on hospitals

In charity care to uninsured and underinsured patients

Community does not turn away anyone in need of care, regardless of their ability to pay, providing medically necessary services to patients at no cost

Invested in training physicians

Community is the largest contributor to graduate medical education in the Valley, helping train about 300 medical residents and fellows in partnership with UCSF Fresno

To support food security

to underserved communities in our region

Invested in training student nurses

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

Invested in new parent and breastfeeding support

The Mother’s Resource Center at Community Regional offers a variety of breastfeeding and parent education classes no matter where baby is delivered

More Than 1 Billion Invested in the Last 5 Years
in Community Benefit
Help Support Our Mission

As a nonprofit charity, every donation is reinvested back in to our mission of bettering the lives of all those we serve. Join us in shaping quality healthcare in the Central Valley. Together, we can make a difference.