REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 9, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Master Agreement with Q-Centrix, LLC for Oncology Cancer Registry Service Solution
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to Contract No. 4400024152, with Q-Centrix, LLC, including non-standard terms, for the addition of the oncology cancer registry service solutions, for abstracting and coding cancer cases according to standards set by American College of Surgeons and National Cancer Registrar, increasing the contract amount by $376,180, from $900,000 to a total contract amount of $1,276,180, with no change to the current term of February 14, 2024 through February 13, 2029.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The $376,180 increase includes implementation, subscription, and costs for the additional oncology cancer registry service solutions (Solutions), which is funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2025-26 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
The Amendment with Q-Centrix, LLC (Q-Centrix), will provide ARMC with access to specialized, nationally recognized solutions that enhance compliance with state and federal reporting requirements and will improve data integrity by ensuring cancer cases are abstracted and submitted with precision. The use of these Solutions will reduce the risk of costly reporting errors, accreditation deficiencies or regulatory penalties. High quality cancer registry services directly support improved patient outcomes by enabling more reliable tracking of cancer trends, treatment effectiveness, and population health needs.
ARMC currently utilizes the CNext solution for cancer registry abstraction and reporting. CNext is a widely used cancer data management system that supports case abstraction, state and federal reporting, and basic workflow management for registry operations. While CNext provides foundational tools for capturing and submitting cancer data, it relies heavily on internal staffing capacity, manual abstraction processes, and local expertise to maintain data quality and meet evolving accreditation and reporting standards. As reporting requirements grow more complex and oncology program volumes increase, the limitations of a primarily internally managed abstraction model, such as staffing shortages, training demands, and variability in abstraction accuracy, create operational and compliance risks. Transitioning from CNext to Q‑Centrix’s specialized abstraction and registry service solution, will allow ARMC to modernize its data infrastructure, reduce dependency on internal staffing, and enhance the accuracy, completeness, and reliability of cancer registry reporting.
Q-Centrix provides essential support for both oncology program growth and ongoing accreditation compliance through its specialized data abstraction and registry support, ensuring accurate, timely, and complete data submission. Additionally, Q-Centrix is accredited with the American College of Surgeons Commission on Cancer which requires strict adherence to data quality, reporting timelines, and evolving standards. Their expertise also supports accurate reporting to national benchmarks like the National Cancer Database, which is critical for performance comparison and quality improvement. Q-Centrix helps ensure compliance by delivering consistent, audit-ready data and reducing the risk of deficiencies that could jeopardize accreditation status. As oncology services expand, the volume and complexity of required clinical data increase significantly.
Through the use of these Solutions, ARMC will maintain a robust, compliant cancer program capable of supporting clinical decision making, research, and quality improvement initiatives. Strengthening cancer data operations also supports workforce stability by reducing the burden on internal staff, helping retain skilled clinical and administrative personnel, and ensuring ARMC remains a competitive and well supported healthcare employer.
On January 17, 2024, as the result of a non-competitive procurement, Purchasing executed the Master Service Agreement (Contract No. 4400024152), with Q-Centrix for data abstraction services for heart procedures (Cath Percutaneous Coronary Intervention) in the amount of $900,000, for the five-year term of February 14, 2024 through February 13, 2029.
The Master Service Agreement (Agreement) is Q-Centrix’s standard commercial contract, which includes terms that differ from the standard County contract and omits certain County standard contract terms. While the parties negotiated certain Agreement terms to County standards, Q-Centrix would not agree to all County standard terms. The non-standard and missing terms include the following:
1. The County is required to indemnify Q-Centrix for any costs incurred by Q-Centrix as a result of third-party actions against Q-Centrix resulting from the actions or omissions of any County Authorized Users or the County.
• The County standard contract does not include any indemnification or defense by the County of a contractor.
• Potential Impact: By agreeing to indemnify Q-Centrix, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time limited, or expense limited could be brought against Q-Centrix without such limitations and the County could be responsible to defend and reimburse Q-Centrix for costs, expenses, and damages, which could exceed the total Agreement amount.
2. Q-Centrix’s maximum liability to the County is limited to $1 million, excluding Q-Centrix’s indemnification obligations and claims arising from either party’s gross negligence, willful misconduct or violation of law. In addition, as it pertains to the receipt of the Solutions or the use of the Solution, and despite anything to the contrary agreed upon by the Parties, Q-Centrix will have no liability of any kind that is a result of the actions or omission of any County Authorized Users or the County.
• The County standard contract does not include a limitation of liability.
• Potential Impact: Claims could exceed the liability cap and the Agreement amount leaving the County financially liable for the excess.
3. There is no termination for convenience. The County may only terminate the Agreement due to a lack of appropriations to fund the Agreement.
• The County standard contract gives the County the right to terminate the contract, with or without cause, with a 30-day written notice of termination without any obligation other than to pay amounts for services rendered and expenses reasonably incurred prior to the effective date of termination.
• Potential Impact: The County can only terminate the Agreement during the term for an uncured breach by Q-Centrix or for loss of funding. Any attempted termination by County without cause could result in payment liability for the full Agreement amount, which could result in liability for breach of contract costs, expenses, and damages, which could exceed the total Agreement amount.
ARMC recommends the approval of this Amendment, including non-standard terms, to continue investing in modern, reliable registry services, promoting a healthy, thriving community and supporting long term sustainability to meet current and future cancer reporting and programmatic demands in a well-planned and balanced manner.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Bonnie Uphold, Supervising Deputy County Counsel, 387-5455) on May 8, 2026; Purchasing (Veronica Pedace, Buyer III, 387-2464) on May 12, 2026; Risk Management (Stephanie Pacheco, Staff Analyst II, 386-9039) on May 21, 2026; Innovation and Technology Department (Lynn Fyhrlund, Chief Information Officer, 388-5501) on May 11, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 15, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on May 18, 2026.