2025-04-23T09:18:29-05:00 2024-06-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2023-07-01 330420041 SAN GORGONIO MEMORIAL HOSPITAL SANG 9518451121 600 NORTH HIGHLAND SPRINGS AVENUE BANNING CA 92220 STEVE BARRON CEO 9518451121 2025-04-22 1 1 SOLOMON MARDAKHAEV P01806552 6105653930 2025-04-22 2023 2025-03-06 01:10:19Z STEVE BARRON 600 NORTH HIGHLAND SPRINGS AVENUE BANNING CA 92220 94398927 0 X WWW.SGMH.ORG X 1991 CA SAN GORGONIO MEMORIAL HOSPITAL IS A NONPROFIT PUBLIC BENEFIT CORPORATION FORMED FOR THE PURPOSE OF RESTORING HEALTH AND RELIEVING SUFFERING BY PROVIDING SAFE, HIGH-QUALITY, AFFORDABLE HEALTHCARE SERVICES. 9 9 785 68 0 0 3026136 1397081 92441288 95823909 0 0 334311 -2822063 95801735 94398927 0 0 0 0 54876273 56968252 0 0 129956 47408570 46117384 102284843 103085636 -6483108 -8686709 29258079 33962200 70315649 83706479 -41057570 -49744279 SAN GORGONIO MEMORIAL HOSPITAL IS A NONPROFIT PUBLIC BENEFIT CORPORATION FORMED FOR THE PURPOSE OF RESTORING HEALTH AND RELIEVING SUFFERING BY PROVIDING SAFE, HIGH-QUALITY, AFFORDABLE HEALTHCARE SERVICES. 0 0 83750687 0 95823909 THE HOSPITAL IS COMPRISED OF AN ACUTE CARE FACILITY WHICH PROVIDES HEALTHCARE SERVICES. THE HOSPITAL PROVIDED E/R VISITS (42,119), I/P DISCHARGES (2,107), O/P REGISTRATIONS (7,325), LESS E/R ADMITTED AS I/P (-2,273), AND BEHAVIORAL HEALTH VISITS (15,824) FOR A TOTAL OF 65,102 VISITS, AND PROVIDED 8,195 DAYS OF CARE DURING THE FISCAL YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT AN AMOUNT BELOW COST, AND PROVIDES CARE TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CHARITY $649,881. UNPAID MEDI-CAL PROGRAM CHARGES WERE $105,362,803. UNPAID MEDICARE PROGRAM CHARGES FOR THE FISCAL YEAR WERE $158,701,365. TOTAL QUANTIFIABLE COMMUNITY BENEFITS WERE $264,064,168. 83750687 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 182 0 785 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DANIEL HECKATHORNE CFO 9518451121 600 NORTH HIGHLAND SPRINGS AVENUE BANNING CA 92220 SUSAN DIBIASI CHAIRPERSON 5.00 X X 3200 0 0 RON RADER SECRETARY 5.00 X X 3000 0 0 STEVEN RUTHLEDGE VICE CHAIR 5.00 X X 2700 0 0 DARRELL PETERSON TREASURER 3.00 X X 1800 0 0 SHANNON MCDOUGALL BOARD MEMBER 3.00 X 1800 0 0 LANNY SWERDLOW BOARD MEMBER 3.00 X 1600 0 0 RANDAL STEVENS BOARD MEMBER 3.00 X 1400 0 0 PERRY GOLDSTEIN BOARD MEMBER 3.00 X 1200 0 0 DENNIS TANKERSLEY BOARD MEMBER 3.00 X 0 0 0 STEVE BARRON CHIEF EXECUTIVE OFFICER 40.00 X 513785 0 28495 KARAN SINGH CHIEF MEDICAL OFFICER 40.00 X 273805 0 20869 DANIEL HECKATHORNE CHIEF FINANCIAL OFFICER 40.00 X 266881 0 16029 JOHN PELEUSES COO 40.00 X 211163 0 12412 ANGELA BRADY CHIEF OF NURSING 40.00 X 261970 0 14125 TZARIMNAH KARAM VP OF HUMAN RESOURCES 40.00 X 227785 0 33542 JOSE RUIZ IMAGING TECHNICIAN 40.00 X 244515 0 7022 EMMANUEL VIRAY IMAGING TECHNICIAN 40.00 X 232518 0 11755 ANNA KAMPANARTSANYAKORN REGISTERED NURSE 40.00 X 215203 0 11822 ANA VALDEZ DIRECTOR OF RISK/PERFORMANCE IMPROVEMENT 40.00 X 213149 0 10786 JOSE LOPEZ DIRECTOR OF PHARMACY 40.00 X 195710 0 9815 PATRICIA BROWN CNO/COO 0.00 X 105683 0 5311 2978867 0 181983 160 1 1 0 ALLSCRIPTS HEALTHCARE LLC 24630 NETWORK PL CHICAGO IL 60673 EHR SOFTWARE AND SUPPORT 3951855 BEAVER MEDICAL GROUP 5957 W RAMSEY ST BANNING CA 92220 PHYSICIAN/ANESTHESIA SERVICES 2733621 CONCORDANCE 14540 INNOVATION DR RIVERSIDE OH 44101 MEDICAL AND GENERAL SUPPLIES 1652106 SAYCO BUILDERS 31566 RAILROAD CANYON RD STE 2 14 CANYON LAKE CA 92587 CONSTRUCTION SERVICES 908866 CARDINAL HEALTH 110 LLC PO BOX 56412 LOS ANGELES CA 90074 PHARMACUTICALS 777582 60 1397081 1397081 NET PATIENT SERVICE REVENUE 621110 94623909 94623909 MANAGEMENT FEE REVENUE 900099 1200000 1200000 95823909 LEGAL SETTLEMENT LOSS 900099 -2822063 -2822063 -2822063 94398927 95823909 0 -2822063 X 1970361 1970361 45328494 36561403 8677468 89623 2091090 1691521 395423 4146 4256352 3328321 919872 8159 3321955 2574847 740796 6312 1021892 1021892 49544 49544 11429560 8859052 2548792 21716 36186 36186 1916350 1628897 287453 4724190 4015561 708629 2393246 2034259 358987 22018 8807 13211 82982 24895 58087 518982 518982 721553 613320 108233 1545694 1452952 92742 BAD DEBT EXPENSE 10619147 10619147 MEDICAL SUPPLIES 6736442 6736442 REPAIRS & MAINTENANCE 1210154 1028631 181523 NON-MEDICAL SUPPLIES 1067894 854315 213579 2021550 1718317 303233 103085636 83750687 19204993 129956 11578613 18062264 9957 18338 278224 283782 13204812 9681423 1311781 2075663 271615 364122 4331263 2910196 2142620 1421067 460457 2055541 29258079 33962200 18133767 11831076 8852624 14637471 43329258 57237932 70315649 83706479 X -41057570 -49744279 -41057570 -49744279 29258079 33962200 -8686709 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 92062 14750 1083 105780 109863 -16716 1034 92113 97072 13950 1159 109863 327572 -29400 200000 1100 97072 190438 98883 40973 2723 327571 1.00000 0 1 1 4331263 2910196 1421067 1421067 BENEFICIAL INTEREST IN NET ASSETS OF SAN GORGONIO HOSPITAL FOUNDATION 855541 ACCRUED MANAGEMENT FEES 1200000 2055541 LEGAL SETTLEMENT LIABILITY 3471561 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 5384956 LEASES PAYABLE 533200 DUE TO RELATED PARTY 47076411 SUBSCRIPTION-BASED LIABILITIES 437722 HOSPITAL CP LEASE 334082 57237932 PART V, LINE 4: SAN GORGONIO MEMORIAL HOSPITAL FOUNDATION HOLDS FUNDS RESTRICTED FROM THE MORONGO TRIBE TO BE USED FOR SPECIFIC HOSPITAL PURPOSES. 1 1 X 1 X 1 X 1 1 0 1 1 15624243 2596768 13027475 0.14090 3859890 6170241 0 0.00000 51238512 106636184 0 0.00000 70722645 115403193 13027475 0.14090 31983 31983 0.00030 653732 106688 547044 0.00590 1000 1000 0.00000 686715 106688 580027 0.00620 71409360 115509881 13607502 0.14710 1 10619147 10380516 18116040 -7735524 X 1 1 1 1 SAN GORGONIO MEMORIAL HOSPITAL 600 NORTH HIGHLAND SPRINGS AVE BANNING CA 92220 WWW.SGMH.ORG 1568469997 330420041 X X X SAN GORGONIO MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 22 1 1 0 1 X SEE PART V, LINE 7D: X X 1 22 1 SEE PART V, LINE 7D: 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X X 1 X 0 X X X X 1 X 0 0 SAN GORGONIO MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: DISTRICT BOARD AND COMMUNITY LEADERS WERE CONTACTED FOR INFORMATION AND THE NEEDS ASSESSMENT WAS PRODUCED BY AND WITH OTHER HOSPITALS IN THE AREA. SAN GORGONIO MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: THE ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH LOMA LINDA UNIVERSITY HOSPITAL. SAN GORGONIO MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: HTTPS://WWW.SGMH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-STRATEGY-REPORT SAN GORGONIO MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: IT WOULD BE FISCALLY IMPOSSIBLE FOR THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS OF THE COMMUNITY, BUT THROUGH CONTINUED COLLABORATION WITH OTHER COMMUNITY AGENCIES THE HOSPITAL HOPES TO CONTINUE TO IDENTIFY PRIORITY AREAS WHERE THEY CAN MAKE THE MOST IMPACT. THE HOSPITAL HAS IDENTIFIED ACCESS TO HEALTH CARE, BEHAVIORAL HEALTH, WOMEN'S HEALTH SERVICES, AND CHRONIC DISEASE WITH A SPECIAL EMPHASIS ON HEART DISEASE AS THEIR PRIORITY AREAS. THESE WERE CHOSEN AS BROAD PRIORITIES TO ADDRESS A WIDE SPECTRUM OF INTERVENTIONS IN PARTNERSHIP WITH THE COMMUNITY. A FOCUS WILL ALLOW TRUE IMPACT VERSUS BEING FRAGMENTED AND INEFFECTIVE. A DETAILED COMMUNITY HEALTH PLAN HAS BEEN DEVELOPED WITH KEY METRICS FOR EACH OF THE PRIORITY AREAS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10,619,147. PART II, COMMUNITY BUILDING ACTIVITIES: WE SUPPLIED HEALTHY BALANCES MEALS TO OUR HOMEBOUND SENIORS THAT NEEDED ASSISTANCE AND TO OUR AUXILIARY MEMBERS WHO GRACIOUSLY DONATE THEIR TIME TO ASSIST AT THE HOSPITAL. ALSO, WE HAVE HAD MANY CLASSES FOR OUR ASSOCIATES AS WELL AS TUITION ASSISTANCE TO FURTHER THEIR CAREER. PART III, LINE 2: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. PART III, LINE 3: BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE POLICY CANNOT BE DETERMINED. THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, AND FURTHERMORE SUFFICIENT INFORMATION WAS NOT OBTAINED FROM ALL PATIENTS THAT MIGHT BE ELIGIBLE TO MAKE THIS DETERMINATION AND CALCULATION. PART III, LINE 4: THE FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. HOWEVER, THERE IS A FOOTNOTE THAT DISCUSSES CHARITY CARE AND COMMUNITY BENEFIT EXPENSE. PART III, LINE 8: ANY SHORTFALL IS DEEMED A COMMUNITY BENEFIT IN ITS ENTIRETY. PART III, LINE 9B: IT IS THE POLICY OF SAN GORGONIO MEMORIAL HOSPITAL THAT ALL PATIENTS WILL BE TREATED FAIRLY IN PRICING AND COLLECTION PRACTICES. THE HOSPITAL'S REGISTRATION AND PATIENT FINANCIAL SERVICES STAFF WILL MAKE A REASONABLE ATTEMPT TO ESTIMATE EACH PATIENT'S LIABILITY. THE HOSPITAL'S PFS STAFF, IN CONJUNCTION WITH CONTRACTED EARLY OUT AGENCIES WILL MAKE A SUBSEQUENTLY ATTEMPT TO COLLECT EACH PATIENT'S LIABILITY AND TO OFFER DISCOUNT AND CHARITY CARE APPLICATIONS. THIS IS OFFERED IN COMPLIANCE WITH CALIFORNIA ASSEMBLY BILL 774 (STATUTES OF 2006) AND SB 1276 (CHAPTER 758, STATUES OF 2014). THIS POLICY DOES NOT APPLY TO ANY PHYSICIAN SERVICES RENDERED AT SGMH. PART VI, LINE 2: THE MANAGEMENT TEAM, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF COMMUNITY MEMBERS. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY THE HOSPITAL SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS PUBLICLY AVAILABLE ON THE INTERNET AT: HTTP://WWW.SGMH.ORG. THE HOSPITAL CONDUCTED A CHNA/IMPLEMENTATION STRATEGY IN 2022 THAT IS ALSO POSTED ON THE ORGANIZATION'S WEBSITE, AND WILL BE APPLICABLE TO THE COMING FEW YEARS' FORM 990S. PART VI, LINE 3: IT IS THE HOSPITAL'S POLICY THAT WHEN IT BECOMES APPARENT THAT A PATIENT MAY HAVE DIFFICULTY IN MEETING HIS/HER FINANCIAL RESPONSIBILITY TO THE HOSPITAL, THE PATIENT WILL BE REQUESTED TO COMPLETE THE APPLICATION PROCESS FOR CALIFORNIA MEDI-CAL AND/OR OTHER AVAILABLE PROGRAMS. HOSPITAL STAFF ASSIST IN THE APPLICATION PROCESS. PATIENTS WHO DO NOT QUALIFY FOR CALFORNIA MEDI-CAL OR OTHER ASSISTANCE MAY APPLY FOR THE HOSPITAL'S ASSISTANCE PROGRAM. PART VI, LINE 4: THE HOSPITAL IS A RURAL HOSPITAL LOCATED IN THE PASS AREA OF RIVERSIDE COUNTY. IT PRIMARILY SERVES THE CITIES OF BANNING, BEAUMONT, CABAZON, AND CALIMESA, CALIFORNIA. THE POPULATION SERVED IS HIGH-RISK DUE TO POVERTY LEVEL INCOMES, LOW EDUCATION LEVELS, AND HIGH DRUG USE. THE COUNTY HAS AN UNEMPLOYMENT RATE OF 8.7%. THE HOSPITAL'S PAYOR MIX INCLUDED APPROXIMATELY 31% MEDI-CAL RECIPIENTS AND 5% UNINSURED. PART VI, LINE 5: THE HOSPITAL CONTINUES TO STRIVE TO MEET THE HEALTH NEEDS OF ITS COMMUNITY AS THESE NEEDS EVOLVE. PART VI, LINE 7, REPORTS FILED WITH STATES CA X X X X 0 0 0 0 0 0 0 0 0 STEVE BARRON CHIEF EXECUTIVE OFFICER 513785 0 0 0 0 0 25689 0 2806 0 542280 0 0 0 KARAN SINGH CHIEF MEDICAL OFFICER 273805 0 0 0 0 0 13690 0 7179 0 294674 0 0 0 DANIEL HECKATHORNE CHIEF FINANCIAL OFFICER 266881 0 0 0 0 0 13344 0 2685 0 282910 0 0 0 ANGELA BRADY CHIEF OF NURSING 261970 0 0 0 0 0 13099 0 1026 0 276095 0 0 0 TZARIMNAH KARAM VP OF HUMAN RESOURCES 227785 0 0 0 0 0 11389 0 22153 0 261327 0 0 0 JOSE RUIZ IMAGING TECHNICIAN 244515 0 0 0 0 0 0 0 7022 0 251537 0 0 0 EMMANUEL VIRAY IMAGING TECHNICIAN 232518 0 0 0 0 0 11626 0 129 0 244273 0 0 0 ANNA KAMPANARTSANYAKORN REGISTERED NURSE 215203 0 0 0 0 0 10760 0 1062 0 227025 0 0 0 ANA VALDEZ DIRECTOR OF RISK/PERFORMANCE IMPROVE 213149 0 0 0 0 0 10657 0 129 0 223935 0 0 0 JOHN PELEUSES COO 211163 0 0 0 0 0 10558 0 1854 0 223575 0 0 0 JOSE LOPEZ DIRECTOR OF PHARMACY 195710 0 0 0 0 0 9785 0 30 0 205525 0 0 0 PATRICIA BROWN CNO/COO 105683 0 0 0 0 0 5284 0 27 0 110994 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE PROVIDED ELECTRONICALLY TO ALL BOARD MEMBERS FOR AT LEAST A 10 DAY REVIEW AND COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C EXECUTIVE ASSISTANT/COMPLIANCE OFFICER MONITORS AND DOCUMENTS CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEW AND APPROVE MANAGEMENT WAGES EACH YEAR DURING THE BUDGET PROCESS. SOURCES UTILIZED BY THE BOARD WHEN REVIEWING FAIR MARKET VALUE IN COMPENSATION INCLUDE MARKET SURVEYS AND SALARY RANGES PROVIDED BY THE HR DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 PUBLISHED ON WEBSITE WWW.SGMH.ORG OR AVAILABLE BY REQUEST FROM THE CEO, CFO, CONTROLLER, OR EXECUTIVE ASSISTANT. FORM 990, PART IX, LINE 11G NURSING AND OTHER CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,574,323. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,574,323. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,602,150. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,602,150. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,682,579. MANAGEMENT AND GENERAL EXPENSES 2,548,792. FUNDRAISING EXPENSES 21,716. TOTAL EXPENSES 4,253,087. SAN GORGONIO HEALTH CARE DISTRICT 600 N HIGHLAND SPRINGS AVE BANNING CA 92220 956004149 HEALTHCARE CA GOVERNMENT N/A 0 SAN GORGONIO MEMORIAL HOSPITAL FOUNDATION 600 N HIGHLAND SPRINGS AVE BANNING CA 92220 953863230 SUPPORT SAN GORGONIO MEMORIAL HOSPITAL CA 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0