2024-09-05T10:06:57-05:00 2023-10-31 410746749 CLIFTONLARSONALLEN LLP 925 HIGHLAND POINTE DRIVE SUITE 450 ROSEVILLE CA 95678 990 2022-11-01 941450151 MARSHALL MEDICAL CENTER MARS 5306221441 1100 MARSHALL WAY PLACERVILLE CA 95667 LAURIE ELDRIDGE CFO 5306221441 2024-09-03 1 1 KURT BENNION CPA P01469618 9167847800 2024-08-21 2022 2024-08-08 14:25:15Z SIRI NELSON 1100 MARSHALL WAY PLACERVILLE CA 95667 332658391 0 X WWW.MARSHALLMEDICAL.ORG X 1959 CA TO IMPROVE THE HEALTH OF OUR COMMUNITY AND OFFER HEALTH SERVICES OF SUPERIOR VALUE AND QUALITY. 15 14 1899 120 0 0 7820920 3454804 291710916 325634558 1470576 -1279738 4425957 3215971 305428369 331025595 326821 15000 0 0 144675199 156832089 0 0 0 163367694 165344031 308369714 322191120 -2941345 8834475 328063834 339775718 158671049 149067796 169392785 190707922 X MARSHALL MEDICAL CENTER PROUDLY SERVES THE WESTERN SLOPE OF EL DORADO COUNTY. OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITY AND OFFER HEALTH SERVICES OF SUPERIOR VALUE AND QUALITY, CENTERED ON THE GOALS AND NEEDS OF OUR PATIENTS. WE STRIVE (CONTINUED IN SCHEDULE O)TO DELIVER SERVICE THAT EXCEEDS OUR PATIENTS' EXPECTATIONS. 0 0 246362831 15000 325634558 IN KEEPING WITH THE COMMITMENT TO IMPROVE THE HEALTH OF OUR COMMUNITY AND OFFER HEALTH SERVICES OF SUPERIOR VALUE AND QUALITY, THE FOLLOWING WILL BE CONSIDERED WHEN INDIVIDUALS WHO NEED HEALTH CARE CANNOT PAY:- PROVIDING FREE CARE AND/OR SUBSIDIZED CARE;- PROVIDING CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND- PROVIDING HEALTH/WELLNESS ACTIVITIES AND COMMUNITY EDUCATION PROGRAMS.(CONTINUED ON SCHEDULE O)NOT ONLY DOES MARSHALL MEDICAL CENTER PROVIDE LOW-COST CARE TO INDIVIDUALS COVERED BY GOVERNMENT PROGRAMS AND THOSE UNABLE TO AFFORD HEALTH CARE, BUT IT ALSO HELPS PATIENTS FIND AND ACCESS PRIVATE AND GOVERNMENTAL RESOURCES FOR HEALTH CARE BENEFITS. MARSHALL MEDICAL CENTER RECOGNIZES BELOW-COST REIMBURSEMENTS AS CHARITY AND UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. INPATIENT SERVICES IN TAX YEAR 2022 WERE PROVIDED TO 4,418 PATIENTS. SOME EXAMPLES OF INPATIENT SERVICES INCLUDED:- 347 BABIES DELIVERED- 22 SPECIAL PROCEDURES PERFORMED- 155 CARDIAC CATHETERIZATIONS- 159,087 LABORATORY TESTS PERFORMED- 4,703 CT SCANS- 8,482 RADIOLOGY PROCEDURES PERFORMEDOUTPATIENT SERVICES IN TAX YEAR 2022 WERE PROVIDED TO 189,916 PATIENTS. SOME EXAMPLES FOR OUTPATIENT SERVICES INCLUDED:- 28,018 EMERGENCY ROOM VISITS- 2,048 OUTPATIENT SPECIAL PROCEDURES PERFORMED- 45,491 RADIOLOGY PROCEDURES PERFORMED- 501 CARDIAC CATHETERIZATIONS- 444,021 LABORATORY TESTS PERFORMED- 11,518 CT SCANS- 1,711 RURAL HEALTH CLINIC VISITS- 20,824 CARDIOLOGY CLINIC VISITS- 1,493 PULMONOLOGY CLINIC VISITS- 6,087 ONCOLOGY CLINIC VISITS- 7,452 OP INFUSION CLINIC VISITS- 2,129 RHEUMATOLOGY CLINIC VISITS- 13,634 PEDIATRIC CLINIC VISITS- 11,643 OB CLINICS VISITS- 6,913 CANCER PROGRAM CASES- 67,311 FAMILY PRACTICE CLINICS VISITS- 7,737 GASTROENTEROLOGY CLINIC VISITS- 2,496 ENT CLINIC VISITS- 3,148 HEARING CLINIC VISITS- 17,392 ORTHOPEDIC CLINIC VISITS- 7,764 SURGERY CLINIC VISITS- 5,232 UROLOGY CLINIC VISITS- 4,201 PSYCHIATRY CLINIC VISITS- 2,416 PODIATRY CLINIC VISITS- 4,298 HBO & WOUND CARE CLINIC VISITS- 23,195 HOSPITALISTS VISITS- 4,779 CARES CLINIC VISTS- 1,213 NEUROLOGY CLINIC VISITS- 1,923 SPECIALTY SERVICES VISITSMARSHALL MEDICAL CENTER RECOGNIZES IT HAS AN OBLIGATION TO PROVIDE SERVICES ABOVE AND BEYOND ITS ROLE AS A HEALING FACILITY. THE FOLLOWING COMMUNITY BENEFITS DEMONSTRATE THE TANGIBLE WAYS IN WHICH THE ORGANIZATION IS FULFILLING ITS MISSION:- BLOOD PRESSURE CLINICS;- FLU CLINICS;- VOLUNTEER PROGRAM;- FOR YOUR HEALTH (A COMMUNITY MAGAZINE);- CANCER RESOURCE CENTER;- PALLIATIVE CARE PROGRAM;- HOLIDAY FOOD DRIVE FOR VARIOUS FOOD BANKS;- SEXUAL ASSAULT RESPONSE TEAM PROGRAM;- COMMUNITY HEALTH LIBRARY;- CHILDBIRTH CLASSES;- CONGESTIVE HEART ACTIVE TELEPHONE TREATMENT PROGRAM;- SCHOLARSHIPS;- PHARMACEUTICAL TRIALS;- USE OF HOSPITAL CONFERENCE ROOMS FOR COMMUNITY-BASED ORGANIZATIONS;- SEMINARS AND SUPPORT GROUPS;- FREE TRAINING FOR PHARMACY STUDENTS, NURSING STUDENTS, LVN STUDENTS, AND OTHER HEALTHCARE PROFESSIONALS;- SMOKING CESSATION PROGRAM;- CONTRIBUTED TO THE COMMUNITY THROUGH VOLUNTEER SERVICE TO ORGANIZATIONS, INCLUDING CHAMBERS OF COMMERCE;- LOW-COST MAMMOGRAPHY PROGRAM;- HELD NUMEROUS COMMUNITY HEALTH EDUCATION CLASSES;- MARSHALL MEDICAL CENTER'S CHAPLAIN PROVIDED 1,674 PATIENT VISITS, 235 PATIENT COUNSELING VISITS, AND CONDUCTED 1 MEMORIAL SERVICE;- ACCEL PROGRAM (LOCAL PROJECT TO COORDINATE THE SAFETY NETWORK FOR EL DORADO COUNTY);- ELECTRONIC HEALTH INFORMATION EXCHANGE;- PROVIDED FREE TRANSPORTATION TO PATIENTS UNABLE TO AFFORD TRANSPORTATION;- PROVIDED MEETING LOCATION FOR NUMEROUS SUPPORT GROUPS (MENTAL HEALTH FIRST AID, STROKE EDUCATION AND SUPPORT AND MORE) AT NO CHARGE;- COMMUNITY SPONSORSHIPS INCLUDING BUT NOT LIMITED TO, CENTER FOR VIOLENCE-FREE RELATIONSHIPS, SOROPTIMIST INTERNATIONAL, HANDS4HOPE, AND ROTARY CLUB OF EL DORADO HILLS; AND- ENCOURAGED EMPLOYEES TO PARTICIPATE IN VARIOUS COMMUNITY-BUILDING ORGANIZATIONS INCLUDING, BUT NOT LIMITED TO EL DORADO COUNTY ECONOMIC DEVELOPMENT CORP, LEADERSHIP EL DORADO, EL DORADO UNION HIGH SCHOOL DISTRICT CAREER EDUCATION ADVISORY COMMITTEE, AND VARIOUS HEALTH ORGANIZATION BOARDS. 246362831 1 1 0 1 0 0 1 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 129 0 1 1899 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X LAURIE ELDRIDGE 5306262780 1100 MARSHALL WAY PLACERVILLE CA 95667 SIRI NELSON PRESIDENT/CEO 39.00 1.00 X X 654913 0 5187 BRIAN GOLDSMITH MD CHIEF MEDICAL OFFICER 40.00 0.00 X 384395 0 790 LAURIE ELDRIDGE CHIEF FINANCIAL OFFICER 39.00 1.00 X 369309 0 5920 MARTIN ENTWISTLE ASSOC CHIEF MEDICAL OFFICER, VP POP. HEALTH 40.00 0.00 X 312579 0 1281 BRETT APPLEBERG CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 301797 0 4374 CYNTHIA RICE CHIEF NURSING OFFICER 40.00 0.00 X 301025 0 781 JONATHAN RUSSELL CHIEF AMBULATORY OFFICER 40.00 0.00 X 280025 0 6081 MINDY DANOVARO EXECUTIVE DIRECTOR OF PHILANTHROPY 39.00 1.00 X 268183 0 2983 MARTIN DALY VP OF INFORMATION TECHNOLOGY 40.00 0.00 X 246980 0 781 JANICE RANGER EXECUTIVE DIRECTOR OF FINANCE 40.00 0.00 X 243606 0 3778 ROBIN MCATEE OPERATING ROOM RN 40.00 0.00 X 240614 0 5170 STEPHANIE GODON DIRECTOR OF PHARMACY 40.00 0.00 X 232018 0 946 JON HAUGAARD CHAIR 2.00 0.00 X X 0 0 0 TOM CUMPSTON VICE CHAIR 2.00 1.00 X X 0 0 0 JOHN KNIGHT SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 JIM ABERCROMBIE DIRECTOR (THROUGH MARCH 2023) 2.00 0.00 X 0 0 0 SEAN ANDERSON MD CHIEF OF STAFF 2.00 0.00 X 0 0 0 ANNA BLAIR RN DIRECTOR 2.00 0.00 X 0 0 0 GERARDO GALANG MD DIRECTOR 2.00 0.00 X 0 0 0 ANDREA HOWARD DIRECTOR 2.00 1.00 X 0 0 0 ALEXIS LONG MD DIRECTOR 2.00 0.00 X 0 0 0 ED MANANSALA EDD DIRECTOR 2.00 0.00 X 0 0 0 GEORGE NIELSEN PAST CHAIR 2.00 0.00 X 0 0 0 MIKE PERVIS DIRECTOR 2.00 0.00 X 0 0 0 CHRISTEEN REEG DIRECTOR 2.00 0.00 X 0 0 0 KIM STOLL DIRECTOR 2.00 1.00 X 0 0 0 BRIAN VEERKAMP DIRECTOR 2.00 0.00 X 0 0 0 SCOTT YODER MD CHIEF OF STAFF (THROUGH DEC 2022) 2.00 0.00 X 0 0 0 3835444 0 38072 379 0 1 0 EL DORADO MULTISPECIALTY MED GROUP 1095 MARSHALL WAY PLACERVILLE CA 95667 MULTISPECIALTY CARE SERVICES 28941476 MARSHALL PRIMARY CARE MED ASSOCIATES 2882 PROSPECT PARK DR RANCHO CORDOVA CA 95670 PHYSICIAN PRIMARY CARE SERVICES 13338459 EL DORADO ANESTHESIA MED GROUP 113 MIRAMONT CT EL DORADO HILLS CA 95762 ANESTHESIA SERVICES 5102122 CARTERKELLY INC PO BOX 1477 PLACERVILLE CA 95667 CONSTRUCTION & ENGINEERING SERVICES 4571085 AYA HEALTHCARE INC PO BOX 123519 DALLAS TX 75312 HEALTHCARE STAFFING 4211052 48 7757 3447047 3454804 PATIENT REVENUE, NET 621110 321594020 321594020 EL DORADO SURGERY CENT 621400 4040538 4040538 325634558 164492 164492 346993 188566 158427 158427 158427 1397209 47021 -1397209 -47021 -1444230 -1444230 MISCELLANEOUS REVENUE 900099 3057544 3057544 3057544 331025595 325634558 0 1936233 X 10000 10000 5000 5000 2628456 919960 1708496 101760014 82769015 18990999 5192752 3915159 1277593 38390420 29986834 8403586 8860447 7124565 1735882 440053 30758 409295 762226 762226 327329 327329 15967 15967 8704 8704 75573547 62225971 13347576 529008 118 528890 1426644 609604 817040 6954384 1734630 5219754 217992 137613 80379 117210 66920 50290 2584980 2584980 13412967 13412967 885940 476780 409160 MEDICAL SUPPLIES 44879387 44147639 731748 BAD DEBT EXPENSE 5750174 5750174 REGISTRY 3312268 2984816 327452 MISCELLANEOUS EXPENSES 3307410 177995 3129415 4837841 3289280 1548561 322191120 246362831 75828289 0 20233594 30983920 12448463 23793490 65456451 78825784 1555701 1180566 4716546 5024348 2470246 4664463 322366427 201818398 122855228 120548029 67180397 31840356 904055 4752442 13973 0 30229180 38162320 328063834 339775718 54881830 48740036 79990616 77061096 23798603 23266664 158671049 149067796 X 169050878 190707922 341907 0 169392785 190707922 328063834 339775718 X 8834475 6342487 6138175 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 15967 15967 322175153 322191120 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 19129 24137 60250 15967 119483 250000 250000 250000 250000 1000000 1500000 7175 7789 14964 X 1 0.10 0 0 0 1 0 0.00 0 5527627 5527627 157812646 88939605 68873041 30215110 21468559 8746551 121202067 91410234 29791833 7608977 7608977 120548029 UNAMORTIZED LOAN COSTS 2683561 PREPAID PENSION COSTS 30235077 RIGHT-OF-USE LEASE ASSET 4395324 OTHER ASSETS 848358 38162320 X 319930871 1288442 1288442 318642429 8704 12374462 12383166 331025595 316479263 47021 47021 316432242 8704 5750174 5758878 322191120 PART II, LINE 9: MARSHALL MEDICAL CENTER HAS ONE CONSERVATION EASEMENT FOR THE PROTECTION OF NATURAL HABITAT, WHICH WAS OBTAINED ON APRIL 16, 2003. THE CONSERVATION EASEMENT IS INCLUDED AS PART OF LAND THAT IS INCLUDED IN PROPERTY & EQUIPMENT ON THE BALANCE SHEET. NO REVENUE OR MATERIAL EXPENSES ARE ASSOCIATED WITH THE EASEMENT. PART X, LINE 2: THE MEDICAL CENTER IS A TAX EXEMPT ORGANIZATION AND IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES, EXCEPT FOR UNRELATED BUSINESS INCOME. IN ACCORDANCE WITH SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IN ADDITION, THE MEDICAL CENTER QUALIFIED FOR THE CHARITABLE DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THERE WAS NO INCOME TAX DUE FOR THE TAX YEARS ENDED OCTOBER 31, 2023 AND 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF FIXED ASSETS 47,021. INVESTMENT LOSS 1,241,421. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 5,750,174. CONTRIBUTIONS WITH DONOR RESTRICTIONS 2,425,323. OTHER NONOPERATING INCOME 4,198,965. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF FIXED ASSETS 47,021. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 5,750,174. 1 1 X 1 X 149.000000000000 1 X 450.000000000000 1 1 0 1 1 10 505 5856952 3678107 2178845 0.00690 2 15205 60148809 39968618 20180191 0.06380 12 15710 66005761 43646725 22359036 0.07070 10 3846 2426035 2426035 0.00770 12 125 341174 341174 0.00110 7 1016 295743 295743 0.00090 29 4987 3062952 3062952 0.00970 41 20697 69068713 43646725 25421988 0.08040 1 150000 17694 17694 0.00010 2 45 64687 64687 0.00020 3 150045 82381 82381 0.00030 1 5750174 1148310 62967583 107816900 -44849317 X 1 1 1 EL DORADO SURGERY CENTER LLC OUTPATIENT SURGERY CENTER 0.87000 0.00000 0.13000 1 1 MARSHALL MEDICAL CENTER 1100 MARSHALL WAY PLACERVILLE CA 95667 WWW.MARSHALLMEDICAL.ORG 30000059 X X X MARSHALL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE LINE 7D X X 1 21 1 SEE LINE 7D 0 1 X 149.000000000000 450.000000000000 X X X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X X 1 X 0 X X X X 1 X 0 0 MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 5: SEVENTEEN (17) PHONE INTERVIEWS WERE CONDUCTED DURING JUNE 2022. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT INTERVIEWS. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN EL DORADO COUNTY, WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL.MARSHALL ALSO CONDUCTED SURVEYS WITH COMMUNITY RESIDENTS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THE SURVEYS WERE AVAILABLE IN AN ELECTRONIC FORMAT THROUGH A SURVEYMONKEY LINK. THE SURVEYS WERE COLLECTED FROM JUNE 6 TO JULY 11, 2022. DURING THIS TIME, 62 COMMUNITY MEMBERS COMPLETED THE SURVEY. MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT WWW.MARSHALLMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT/. MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 11: IN FY22, MARSHALL MEDICAL CENTER ENGAGED IN ACTIVITIES AND PROGRAMS THAT ADDRESSED THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE FY20-FY22 IMPLEMENTATION STRATEGY. MARSHALL MEDICAL CENTER COMMITTED TO COMMUNITY BENEFIT EFFORTS THAT ADDRESSED: BEHAVIORAL HEALTH (INCLUDED MENTAL HEALTH AND SUBSTANCE USE), CHRONIC DISEASE PREVENTION, MANAGEMENT, AND TREATMENT, AND SUPPORT FOR THE HEALTH AND WELFARE OF THE COMMUNITY. SELECTED ACTIVITIES AND PROGRAMS THAT HIGHLIGHT THE HOSPITAL'S COMMITMENT TO THE COMMUNITY ARE DETAILED BELOW.ACCESS TO BEHAVIORAL HEALTH SERVICES (MENTAL HEALTH AND SUBSTANCE USE)1. MARSHALL CARES (CLINICALLY ASSISTED RECOVERY & EDUCATION SERVICES) - CARES WAS CREATED TO TREAT OPIATE USE DISORDER, BUT IT HAS GROWN INTO A CLINIC FOCUSED ON SUPPORT TREATMENT FOR PERSONS WITH ANY SUBSTANCE DEPENDENCY, INCLUDING ALCOHOL, TOBACCO, STIMULANTS, OPIOIDS, BENZODIAZEPINES, AND OTHER SEDATIVE HYPNOTICS. CLINIC SERVICES INCLUDE COMPREHENSIVE MEDICATION ASSISTED TREATMENT WITH A PHYSICIAN, COUNSELING, CASE MANAGEMENT AND BEHAVIORAL HEALTH SUPPORT SERVICES.2. MEDICATION ASSISTED TREATMENT (MAT) - SINCE DECEMBER 2016, MARSHALL HAS PARTICIPATED IN A JOINT EFFORT WITH THE EL DORADO COMMUNITY HEALTH CENTER (EDCHC) AND THE CALIFORNIA HEALTHCARE FOUNDATION TO PROVIDE MEDICATION ASSISTED TREATMENT (MAT) FOR OPIOID ADDICTION. WHEN PEOPLE PRESENT IN MARSHALL'S EMERGENCY DEPARTMENT IN WITHDRAWAL, THEY ARE OFFERED PARTICIPATION IN THE MAT/ED BRIDGE PROGRAM, WHICH INCLUDES BUPRENORPHINE TO ALLEVIATE WITHDRAWAL SYMPTOMS. THROUGH THE EDCHC AND MARSHALL CARES, THEY ARE ALSO REFERRED TO OUTPATIENT THERAPY, WHERE THEY MEET WITH A DOCTOR WITHIN 48 HOURS. THE PROGRAM INCLUDES GROUP SESSIONS, COUNSELING, AND SOCIAL SERVICES.3. COLLABORATION - STAFF MEMBERS PARTICIPATE IN ASSEMBLYMAN KEVIN KILEY'S HEALTH COUNCIL ON HOMELESSNESS AND MENTAL HEALTH TO PROMOTE AWARENESS AND PROVIDE RESOURCES FOR PERSONS EXPERIENCING HOMELESSNESS AND INDIVIDUALS SUFFERING FROM MENTAL HEALTH ISSUES IN EL DORADO COUNTY.CHRONIC DISEASE PREVENTION, MANAGEMENT AND TREATMENT1. POPULATION HEALTH - THE MARSHALL POPULATION HEALTH TEAM COORDINATED THE COMMUNITY CASE SERVICES THAT MARSHALL DELIVERED, WITH THE OBJECTIVE OF STRENGTHENING THE CONTINUUM OF CARE PROVIDED TO OUR PATIENTS AND THE COMMUNITY. DRIVEN BY PRIMARY CARE PROVIDERS, AND WITH ENGAGEMENT OF CLINIC STAFF AND SPECIALISTS, MARSHALL PLACED PARTICULAR FOCUS ON SCREENINGS FOR BREAST CANCER, COLON CANCER AND DIABETES AND MET OR EXCEEDED ITS PERFORMANCE TARGETS IN ALL THREE AREAS.2. COMMUNITY CARE NETWORK (CCN) - THE CCN FOCUSES ON IMPROVING THE EFFECTIVENESS AND QUALITY OF CARE FOR HIGH-RISK PATIENTS. MARSHALL'S CCN ASSISTS CHRONICALLY ILL PATIENTS WITH HEALTH CARE COORDINATION AND MANAGEMENT, IN-HOME CARE, MEDICAL SUPPLIES, AND VOLUNTEER HEALTH COACHES, AT NO COST TO THE PATIENT. CCN REMOVES OBSTACLES THAT OFTEN PREVENT PATIENTS FROM RECEIVING ROUTINE AND PREVENTIVE CARE AS WELL AS TO PREVENT THE POTENTIAL NEED FOR REHOSPITALIZATION. THIS PROGRAM REDUCES READMISSIONS AND UNNECESSARY EMERGENCY ROOM VISITS. FOR PERSONS WITH MORE COMPLEX NEEDS, A TEAM OF SOCIAL WORKERS, LVNS, RN CASE MANAGERS, PHARMACISTS, DIABETES EDUCATORS, DIETITIANS, AND PHYSICAL THERAPISTS WORK WITH THEM IN THEIR HOMES TO HELP NAVIGATE THEIR PATHS TO IMPROVED HEALTH AND OVERCOME COMMUNITY BARRIERS. IN FY23, 5,543 PERSONS WERE REACHED THROUGH CCN.3. CONGESTIVE HEART ACTIVE TELEPHONE TREATMENT (CHATT) - THE CHATT PROGRAM HELPED PEOPLE MANAGE CONGESTIVE HEART FAILURE. CHATT IMPROVED QUALITY OF LIFE, REDUCED CHF COMPLICATIONS AND HELPED KEEP PEOPLE WITH CHF OUT OF THE HOSPITAL. THIS SERVICE INCLUDED FREQUENT TELEPHONE CALLS FROM A REGISTERED NURSE, WHO SPECIALIZES IN CARDIOVASCULAR CARE. IN FY22, CHATT SERVED 335 INDIVIDUALS.4. CANCER RESOURCE CENTER - MARSHALL'S CANCER RESOURCE CENTER PROVIDED CLASSES, SUPPORT GROUPS AND SERVICES. SERVICES WERE AVAILABLE TO ANYONE IMPACTED BY CANCER IN EL DORADO COUNTY. IN FY23, THE CANCER RESOURCE CENTER AIDED 400 INDIVIDUALS:- COMPLETED 185 NUTRITION CONSULTS/SERVICES AND 122 PSYCHOSOCIAL DISTRESS AND NUTRITION SCREENINGS.- PROVIDED 370 NAVIGATION CONSULTATIONS AND 235 SOCIAL WORK CONSULTATIONS.- TRANSPORTATION IS A WELL-KNOWN BARRIER TO HEALTH CARE, ESPECIALLY IN RURAL AREAS. THE CANCER RESOURCE CENTER PROVIDED 23 ROUND TRIP RIDES AS WELL AS PROVIDED 78 PERSONS WITH GAS CARDS.- THE WIG BANK SERVED 44 PERSONS.- PROVIDED 53 NO-COST MAMMOGRAMS.- PROVIDED 195 PSYCHOSOCIAL DISTRESS AND NUTRITION SCREENINGS.- 266 INDIVIDUALS RECEIVED SOCIAL WORK CONSULTS OR SERVICES.5. HEALTH EDUCATION - IN FY23, MARSHALL REACHED 496 COMMUNITY MEMBERS WITH THE FOLLOWING COMMUNITY HEALTH EDUCATION SESSIONS:- JOINT REPLACEMENT EDUCATION- SMOKING CESSATION EDUCATION- MENTAL HEALTH FIRST AID- ALZHEIMER'S AND DEMENTIA EDUCATION- BARIATRIC SURGERY EDUCATION- FALL PREVENTION AWARENESS- MATTER OF BALANCE CLASSES6. DIABETES AND NUTRITION EDUCATION - HEALTHY LIVING CLASSES WERE PROVIDED MONTHLY. THESE FREE VIRTUAL CLASSES, LED BY A NURSE, PROVIDED INFORMATION ON THE BASICS OF DIABETES SELF-MANAGEMENT. CLASSES INCLUDED: UNDERSTANDING DIABETES AND PLANNING FOR SUCCESS AND HEALTHY EATING FOR DIABETES. IN ADDITION, MARSHALL PROVIDED TELE-VISITS FOR THE DIABETES IN PREGNANCY PROGRAM, A GESTATIONAL DIABETES PROGRAM. PARTICIPANTS LEARNED ABOUT NUTRITION AND MEAL PLANNING, CONTROLLING BLOOD SUGAR, EXERCISE AND EMOTIONAL SUPPORT RESOURCES.7. SUPPORT GROUPS - SUPPORT GROUPS WERE OFFERED TO COMMUNITY MEMBERS THROUGH ONLINE OPTIONS, INCLUDING ZOOM. THE SUPPORT GROUPS INCLUDED:BREAST CANCER, OSTOMY, AND PROSTATE CANCER.SUPPORT FOR THE HEALTH AND WELFARE OF THE COMMUNITY1. FINANCIAL AID AND HEALTH INSURANCE ASSISTANCE - PROVIDED FINANCIAL ASSISTANCE THROUGH FREE AND DISCOUNTED CARE FOR HEALTH CARE SERVICES, CONSISTENT WITH MARSHALL MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. OFFERED ASSISTANCE TO ENROLL IN PUBLIC HEALTH INSURANCE PROGRAMS.2. TRANSPORTATION AND OTHER MEDICAL NEEDS - PROVIDED TRANSPORTATION TO PERSONS WHO COULD NOT AFFORD TRANSPORTATION TO OR FROM MEDICAL SERVICES AND APPOINTMENTS. FOR PERSONS LIVING IN POVERTY, THE HOSPITAL PROVIDED MEDICATIONS AND ASSISTED LIVING SERVICES.3. COMMUNITY HEALTH LIBRARY - MARSHALL'S COMMUNITY HEALTH LIBRARY CONTAINS OVER 5,000 RESOURCES, WHICH WERE MADE AVAILABLE AT NO CHARGE FOR USE BY COMMUNITY RESIDENTS. STAFF LIBRARIANS ALSO CONDUCTED MEDICAL TOPIC SEARCHES FOR COMMUNITY MEMBERS. IN FY23, 276 COMMUNITY MEMBERS ACCESSED THESE SERVICES.4. STOP THE BLEED - MARSHALL TRAINED STAFF MEMBERS AS INSTRUCTORS TO EDUCATE COMMUNITY MEMBERS TO TREAT INJURIES CAUSED BY HOME ACCIDENTS, MOTOR VEHICLE ACCIDENTS, ACTIVE SHOOTERS, BOMBINGS, AND WORK-RELATED INJURIES. IN FY23, MARSHALL STAFF INSTRUCTORS TRAINED 120 EL DORADO COUNTY RESIDENTS, INCLUDING STUDENTS AND TEACHERS AT LOCAL SCHOOLS ON WOUND PACKING AND TOURNIQUET APPLICATION.5. FALL PREVENTION - PROVIDED COMMUNITY PRESENTATIONS AND SCREENINGS IN AREAS OF PHYSICAL THERAPY, VESTIBULAR REHAB, MEDICATION REVIEW, BLOOD PRESSURE SCREENINGS, AND A HOME SAFETY REVIEW. IN FY23, 5 COMMUNITY MEMBERS WERE SERVED.6. CASE MANAGEMENT AND SOCIAL SERVICES - MARSHALL CASE MANAGEMENT AND SOCIAL SERVICES WORKED ON BEHALF OF PERSONS EXPERIENCING HOMELESSNESS AND ASSISTED THEM WITH FINDING SHELTER, TRANSPORTATION, CLOTHING AND REHABILITATION. ADDITIONALLY, THE TEAM ASSISTED THEM TO ENROLL IN HEALTH INSURANCE AND FREE MEDICATION PROGRAMS AND OBTAIN NEEDED MEDICAL EQUIPMENT. IN FY23, MARSHALL ASSISTED 484 INDIVIDUALS EXPERIENCING HOMELESSNESS.7. MOBILE MEDICINE/RURAL OUTREACH - MARSHALL MOBILE MEDICINE/RURAL OUTREACH'S PROGRAM PROVIDED PRIMARY CARE, WOUND CARE, AND WOMEN'S HEALTH SERVICES IN PARTNERSHIP WITH LOCAL ORGANIZATIONS. PROGRAMS INCLUDED:- MOBILE SERVICES REACHED HOMELESS CAMPS, CABINS IN THE WOODS AND THE ELDERLY IN THE COMFORT OF THEIR HOMES WHO WERE INHIBITED BY A LACK OF TRANSPORTATION OR OTHER MEANS AND WERE CHALLENGED TO MEET THE EXPECTATIONS OF A TRADITIONAL OFFICE VISIT.- MULTI-VISIT PATIENTS (MVP) IDENTIFIED THE HIGHEST UTILIZERS OF THE EMERGENCY DEPARTMENT THAT COULD HAVE BEEN PROACTIVELY MANAGED AT AN OUTPATIENT/ COMMUNITY OUTREACH CAPACITY.- CLINICAL SERVICES WERE PROVIDED ON LIBRARY CAMPUSES THROUGHOUT THE COUNTY.- WORKING WITH UPPER ROOM, A LOCAL ORGANIZATION THAT SUPPORTS THE ELDERLY, LOW INCOME AND UNSHELTERED INDIVIDUALS, THE OUTREACH PROGRAM PROVIDED WOUND CARE, SUPPORTED MEDICATION ADHERENCE, TOOK VITAL SIGNS, PROVIDED REFERRALS AND HEALTH EDUCATION, CALLED PROVIDERS WITH CLIENTS, ESTABLISHED PRIMARY CARE APPOINTMENTS, SCRIBING FOR HEALTH INSURANCE COVERAGE DOCUMENTS, AND OFFERED PSYCHIATRIC SUPPORT.(CONTINUED AT THE END OF PART V, SECTION C) MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 13B: WHEN ANY PATIENT'S SINGLE VISIT RESPONSIBILITY EXCEEDS $50,000 THE BALANCE ABOVE $50,000 WILL BE DISCOUNTED BY 50% AS CATASTROPHIC ADJUSTMENT AUTOMATICALLY UPON FINAL BILLING. PATIENTS ARE NOT REQUIRED TO APPLY FOR THIS PRGORAM TO BE ENTITLED TO THIS 50% OVER $50,000 DISCOUNT. IF THE PATIENT APPLIES AND QUALIFIES FOR THE FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL RECEIVE THE APPROPRIATE REDUCTION IN ADDITION TO THE CATASTROPHIC ADJUSTMENT.A PATIENT WHOSE FAMILY INCOME DOES NOT EXCEED 450 PERCENT OF THE FEDERAL POVERTY LEVEL MAY QUALIFY FOR CHARITY CARE ON THE BASIS OF HIGH MEDICAL COSTS, WHICH IS DEFINED TO MEAN ANY OF THE FOLLOWING: 1. ANNUAL OUT-OF-POCKET COSTS PAID AT THIS FACILITY EXCEED 10% OF SUCH PATIENTS' FAMILY GROSS INCOME AND ESSENTIAL LIVING EXPENSES IN THE PRIOR 12 MONTHS; OR2. ANNUAL OUT-OF-POCKET EXPENSES THAT EXCEED 10% OF SUCH PATIENT'S FAMILY GROSS INCOME AND ESSENTIAL LIVING EXPENSES, IF THE PATIENT PROVIDES DOCUMENTATION OF THE PATIENT'S MEDICAL EXPENSES PAID BY THE PATIENT OR THE PATIENT'S FAMILY IN THE PRIOR 12 MONTHS.THIS SHALL NOT INCLUDE OUT-OF-POCKET EXPENSES FOR INSURANCE PREMIUMS. MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION ARE AVAILABLE ONLINE AT HTTPS://WWW.MARSHALLMEDICAL.ORG/PATIENTS-VISITORS/PATIENT-INFORMATION/INSURANCE-BILLING-INFORMATION/BUSINESS-OFFICE/HELP-PAYING-YOUR-BILL/MARSHALL MEDICAL CENTER'S HOSPITAL BILLING DEPARTMENT ALSO ATTEMPTS TO MAKE CONTACT WITH PATIENTS TO INFORM THEM THAT THEY SHOULD APPLY FOR FINANCIAL ASSISTANCE. PART V, SECTION B, LINE 11 (CONTINUED): 8. CARE COORDINATION FOR VULNERABLE POPULATIONS (CCVP) - CARE COORDINATION FOR VULNERABLE POPULATIONS (CCVP) SERVED THE UNSHELTERED HOMELESS, THE ELDERLY, WOMEN AND LATINO COMMUNITIES. PROGRAMS INCLUDED A NAVIGATION PROGRAM CENTERED ON LIFE SKILLS TO DECREASE AVOIDABLE ED VISITS, DECREASING MISSED MEDICAL APPOINTMENTS, AND INFECTION CONTROL. THIS WORK INCLUDED THE ESTABLISHMENT OF A COMMUNITY HEALTH WORKER PROGRAM. THIS PROGRAM FOCUSED ON WORKING WITH VOLUNTEERS WHO WERE ALREADY ENGAGED WITH PERSONS EXPERIENCING HOMELESSNESS AND SUPPORTED THEM TO PROVIDE MORE SERVICES.9. COMMUNITY HEALTH MAGAZINE - FOR YOUR HEALTH IS MARSHALL'S QUARTERLY MAGAZINE, WHICH WAS WIDELY DISTRIBUTED THROUGHOUT EL DORADO COUNTY AND AVAILABLE IN DIGITAL FORMAT ON THE HOSPITAL'S WEBSITE. TOPICS IN FY23 INCLUDED: GENERAL WELLNESS, VACCINATIONS, AND DISEASE PREVENTION.10. CHILDBIRTH CLASSES - PROVIDED FREE OR LOW-COST EDUCATIONAL CLASSES TO THE COMMUNITY, INCLUDING CHILDBIRTH CLASSES. CLASSES WERE SELF-PACED AND VIRTUAL AND WERE PAIRED WITH LIVESTREAM Q & A SESSIONS. CLASS TOPICS INCLUDED: HEALTHY PREGNANCY, BREASTFEEDING, NEWBORN BABY AND BEHAVIOR, SOOTHING TECHNIQUES, BATHING, HEALTH AND SAFETY SKILLS, AND NUTRITION. 226 COMMUNITY MEMBERS PARTICIPATED. 2 1 - CARES 1045 MARSHALL WAY PLACERVILLE CA 95667 OTHER OUTPATIENT CLINIC - CLINICALLY ASSISTED RECOVERY AND EDUCATION SERVICE 2 - PSYCHIATRY & NEUROLOGY 3581 PALMER DRIVE SUITE 202 CAMERON PARK CA 95682 OTHER OUTPATIENT CLINIC PART I, LINE 3C: MARSHALL MEDICAL CENTER IS COMMITTED TO SERVING THE MEMBERS OF OUR COMMUNITY. WE WANT TO MAKE SURE THAT YOU ARE GIVEN EVERY OPPORTUNITY TO APPLY FOR ANY FINANCIAL ASSISTANCE, INCLUDING CHARITY CARE, FOR WHICH YOU MAY BE ELIGIBLE. YOU MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE IF YOU SUBMIT THE NECESSARY DOCUMENTATION AND EITHER: (1) YOUR FAMILY INCOME IS BELOW 450% OF THE CURRENT FEDERAL POVERTY GUIDELINES; OR (2) YOU INDIVIDUALLY OR YOUR FAMILY HAS HIGH MEDICAL COSTS. YOU WOULD HAVE HIGH MEDICAL COSTS IF YOUR INDIVIDUAL OR YOUR FAMILY ANNUAL OUT-OF-POCKET COSTS EXCEED 10% OF YOUR OR YOUR FAMILY GROSS INCOME AND ESSENTIAL LIVING EXPENSES IN THE PRIOR 12 MONTHS. THE SPECIFIC LEVEL OF ASSISTANCE YOU MAY BE ELIGIBLE FOR WILL DEPEND ON YOUR PARTICULAR FAMILY INCOME LEVEL. PART I, LINE 7: BEGINNING WITH TAX YEAR 2014, MARSHALL MEDICAL CENTER IMPLEMENTED A COST ACCOUNTING SYSTEM TO ESTIMATE DIRECT AND INDIRECT COSTS OF PROVIDING PATIENT CARE. THE RESULTING COST-TO-CHARGE RATIO WAS APPLIED TO GROSS REVENUES ASSOCIATED WITH FINANCIAL ASSISTANCE AND MEANS-TESTED PROGRAMS IN ORDER TO CALCULATE FINANCIAL ASSISTANCE AT COST. 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 $ 5,750,174. PART II, COMMUNITY BUILDING ACTIVITIES: WORKFORCE DEVELOPMENT - MARSHALL LEADERSHIP PARTICIPATED IN THE EL DORADO UNION HIGH SCHOOL DISTRICT CAREER TECHNICAL EDUCATION ADVISORY COMMITTEE, A GROUP OF PRIVATE ENTITIES THAT ASSIST THE HIGH SCHOOL DISTRICT PLAN AND PREPARE FOR TECHNICAL CAREERS AND EDUCATION OFFERINGS. 53 STUDENTS PARTICIPATED IN THE HEALTH CAREER EXPLORATION DAY.ADVOCACY - HOSPITAL REPRESENTATIVES ENGAGED IN ADVOCACY EFFORTS THAT SUPPORTED THE COMMUNITY.ECONOMIC DEVELOPMENT - HOSPITAL LEADERS SUPPORTED LOCAL CHAMBERS OF COMMERCE AND FOCUSED ON ISSUES RELATED TO COMMUNITY HEALTH AND SAFETY. PART III, LINE 2: MARSHALL MEDICAL CENTER MAKES A BEST EFFORT TO APPLY ALL KNOWN DISCOUNTS AND PAYMENTS POSTED TO THE PATIENT ACCOUNT PRIOR TO DETERMINATION OF BAD DEBT WRITE-OFF. NON-COMPLIANT PATIENTS MAY RESULT IN THE DELAY OF PROPERLY APPLIED DISCOUNTS.IN ACCORDANCE WITH CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 127400 ET SEQ., MARSHALL MEDICAL CENTER DISCOUNTS PAYMENTS AND PROVIDES CHARITY CARE TO FINANCIALLY QUALIFIED PATIENTS. PATIENTS WHO QUALIFY FOR THESE DISCOUNTS OR CHARITY CARE UNDER OUR POLICIES INCLUDE PATIENTS WHO MEET BOTH OF THE FOLLOWING QUALIFICATIONS:1. THE PATIENT EITHER IS SELF-PAY OR HAS HIGH MEDICAL COSTS, AS DEFINED IN OUR DISCOUNT PAYMENT AND CHARITY CARE POLICIES; AND2. THE PATIENT HAS A FAMILY INCOME (AS DEFINED IN THE POLICIES) THAT DOES NOT EXCEED 350% OF THE FEDERAL POVERTY LEVEL. PART III, LINE 3: MARSHALL MEDICAL CENTER ESTIMATES THAT APPROXIMATELY 19.97% OF ALL PATIENT ACCOUNTS ASSIGNED TO BAD DEBT MIGHT BE ATTRIBUTABLE TO PATIENTS WHO MIGHT HAVE QUALIFIED FOR FINANCIAL ASSISTANCE HAD THOSE PATIENTS PROVIDED SUFFICIENT INFORMATION TO BECOME QUALIFIED. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE" SECTION IN NOTE 1, PAGE 11, IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DISCUSSION OF THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: MARSHALL MEDICAL CENTER USES A COST ACCOUNTING SYSTEM, MAKING A BEST EFFORT TO APPLY ALL KNOWN DISCOUNTS AND PAYMENTS POSTED TO THE PATIENT ACCOUNT PRIOR TO DETERMINATION OF BAD DEBT WRITE-OFFS. NON-COMPLIANT PATIENTS MAY RESULT IN THE DELAY OF PROPERLY APPLIED DISCOUNTS.THE SHORTFALL INCURRED ON MEDICARE PATIENTS CAN BE CONSIDERED A COMMUNITY BENEFIT BECAUSE MARSHALL MEDICAL CENTER IS THE ONLY HOSPITAL FACILITY WITHIN APPROXIMATELY 25 MILES. THEREFORE, PATIENTS WOULD HAVE TO TRAVEL OUTSIDE OF THE COMMUNITY TO OBTAIN HEALTHCARE SERVICES. THE ONLY OTHER HOSPITAL FACILITY IN EL DORADO COUNTY IS APPROXIMATELY 50 MILES FROM PLACERVILLE AND PATIENTS WOULD HAVE TO TRAVERSE A 7,000+ FOOT ELEVATION MOUNTAIN PASS TO OBTAIN HEALTHCARE SERVICES FROM THAT FACILITY. OUR PATIENT POPULATION IS HEAVILY MEDICARE-WEIGHTED AND MARSHALL PROVIDES A VAST AMOUNT OF CARE TO THIS MEDICARE POPULATION, WHICH TEND TOWARDS MORE ACUTE ILLNESSES THAT MAKE TRAVEL DIFFICULT. BECAUSE WE ARE A COMMUNITY-BASED HOSPITAL, WE HAVE TO PROVIDE A BROAD RANGE OF SERVICES TO MEET THE NEEDS OF THE COMMUNITY, WHICH IMPACTS OUR ABILITY TO SPECIALIZE IN MORE FOCUSED SERVICES. PART III, LINE 9B: AT THE TIME OF REGISTRATION AND IN THE FIRST BILLING STATEMENT, PATIENTS ARE PRESENTED WITH ALL DISCOUNT AND PROGRAM OPTIONS AVAILABLE. BILLING STATEMENTS 2 THROUGH 5 REMIND THE PATIENT OF DISCOUNTS AVAILABLE. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED COVERAGE OR FOR MARSHALL MEDICAL CENTER'S OWN FINANCIAL ASSISTANCE PROGRAM, MARSHALL MEDICAL CENTER SHALL NOT KNOWINGLY SEND OR ASSIGN SUCH PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY PRIOR TO 180 DAYS FROM THE DATE OF MARSHALL MEDICAL CENTER'S INITIAL BILLING OF THAT ACCOUNT. PRIOR TO FILING ANY LEGAL ACTION AGAINST A PATIENT, THE DEBT COLLECTION AGENCY WILL (A) PERFORM AN ANALYSIS OF THE PATIENT'S ASSETS AND INCOME TO DETERMINE WHETHER THE PATIENT HAS ASSETS AND INCOME SUFFICIENT TO JUSTIFY FILING THE LEGAL ACTION, (B) PRESENT THE ANALYSIS TO MARSHALL MEDICAL CENTER'S DIRECTOR OF HOSPITAL PATIENT BILLING, IN SUCH FORMAT AS MARSHALL MEDICAL CENTER MAY REQUEST, AND (C) OBTAIN THE DIRECTOR'S APPROVAL FOR FILING THE LEGAL ACTION AGAINST THE PATIENT. PART VI, LINE 2: THE COMMUNITY'S HEALTHCARE NEEDS ARE DETERMINED BASED ON MANY FACTORS INCLUDING BUT NOT LIMITED TO MARKET STUDIES, PHYSICIAN FEEDBACK BASED ON THE NEEDS OF THEIR PATIENTS, HEALTH MANPOWER STUDIES, SURVEYS, AND A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS. PART VI, LINE 3: AT THE TIME OF REGISTRATION, EVERY UNINSURED PATIENT IS PRESENTED WITH A DOCUMENT THAT OUTLINES ALL THE FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS, AS WELL AS THE ORGANIZATIONAL CHARITY CARE POLICY THAT THEY MAY BE ABLE TO QUALIFY FOR. MARSHALL MEDICAL CENTER PROVIDES, AT ITS EXPENSE, PRIVATE CONSULTANTS AND COUNTY MEDI-CAL EMPLOYEES WHO WORK WITH PATIENTS DURING AND AFTER SERVICES TO ASSIST THEM IN COMPLETING THE NECESSARY FORMS, TO FILE ALL THE NECESSARY DOCUMENTS, AND TO ATTEND ANY REQUISITE APPOINTMENTS WITH PROVIDING AGENCIES. FINANCIAL COUNSELORS ARE ALSO PROVIDED TO ASSIST PATIENTS IN UNDERSTANDING ELIGIBILITY REQUIREMENTS RELATED TO QUALIFYING FOR CHARITY CARE. PART VI, LINE 4: MARSHALL MEDICAL CENTER SERVES APPROXIMATELY 158,730 RESIDENTS ON THE WESTERN SLOPE OF THE SIERRAS IN EL DORADO COUNTY. OTHER PERTINENT DEMOGRAPHICS ABOUT OUR HOSPITAL SERVICE AREA FOR TAX YEAR 2022 INCLUDE:- 20.6% IS UNDER AGE 18; 57.9% IS AGE 18-64 AND 21.5% IS AGE 65 AND OVER- PERCENTAGE LIVING IN POVERTY IS 7.9%- PERCENTAGE LACKING HIGH SCHOOL DIPLOMA IS 6.0% (EL DORADO COUNTY)- PERCENTAGE UNINSURED IS 3.6%- ETHNIC PERCENTAGES ARE: WHITE 80.1%, HISPANIC 10.6%, ASIAN 4.3%, AFRICAN AMERICAN 0.8%, NATIVE AMERICAN, PACIFIC ISLANDER OR OTHER RACE 4.2% PART VI, LINE 5: MARSHALL MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY THROUGH A LARGE AND VARIED ARRAY OF HEALTHCARE SERVICES INCLUDING BUT NOT LIMITED TO INPATIENT SERVICES (OBSTETRICS, SURGERIES, RADIOLOGY, DIAGNOSTIC CARDIAC CATHETERIZATIONS) AND OUTPATIENT SERVICES (EMERGENCY ROOM, OUTPATIENT SURGERIES, RADIOLOGY, LABORATORY, DIAGNOSTIC CARDIAC CATHETERIZATIONS, NUMEROUS FAMILY AND SPECIALTY CLINICS, RURAL HEALTH CLINIC, CANCER PROGRAMS, AND HOME HEALTH VISITS). WE RECOGNIZE THAT WE HAVE AN OBLIGATION TO PROVIDE SERVICES ABOVE AND BEYOND OUR ROLE AS A HEALING FACILITY. - OPEN MEDICAL STAFF: WE OFFER AN "OPEN MEDICAL STAFF" MODEL EXCEPT FOR A FEW SELECT SPECIALTIES, WHICH ARE "EXCLUSIVE CONTRACTS".- COMMUNITY BOARD: OUR BOARD OF DIRECTORS IS COMPRISED OF 14 VOLUNTEER COMMUNITY MEMBERS. THEY DEDICATE NUMEROUS HOURS OF THEIR OWN TIME TO CONTRIBUTE TO A POSITIVE HEALTH ENVIRONMENT THROUGH MARSHALL MEDICAL CENTER.- USE OF SURPLUS FUNDS: EXCESS REVENUE (SURPLUS FUNDS) ARE RETAINED FOR FUTURE COMMUNITY NEEDS INCLUDING BUT NOT LIMITED TO CAPITAL IMPROVEMENTS, EXPANSION OF NEW SERVICES AND TECHNOLOGICAL IMPROVEMENTS. THE COMMUNITY-BASED BOARD OF DIRECTORS CONTROLS THE DIRECTION OF THE USE OF SURPLUS FUNDS. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 EL DORADO COUNTY CHAMBER OF COMMERCE 542 MAIN STREET PLACERVILLE CA 95667 941328508 501(C)(3) 10000 0 GENERAL OPERATING SUPPORT 1 0 PART I, LINE 2: MARSHALL MEDICAL CENTER'S ASSISTANCE TO EITHER AN ORGANIZATION OR AN INDIVIDUAL IS LIMITED. THE PROCEDURES FOR MONITORING THE GRANTS ARE DIFFERENT FOR EACH TYPE OF ASSISTANCE. MARKETING SPONSORSHIP ASSISTANCE - THE AMOUNTS TO EACH ORGANIZATION ARE NOMINAL AND USUALLY GIVEN TO NONPROFIT ORGANIZATIONS. NO MONITORING IS NEEDED ON THESE DONATED MONIES BASED ON MATERIALITY AND CRITERIA FOR SELECTION. PROGRAM SUPPORT RELATED TO PAYROLL FUNDING - MONITORING IS CONDUCTED AS THE FUNDS ARE ISSUED TO COVER THE PAYROLL AND BENEFIT EXPENSES OF A RELATED NONPROFIT ORGANIZATION. ADDITIONALLY, THE GRANT RECIPIENT SHARES A BOARD MEMBER WITH MARSHALL MEDICAL CENTER AND RECIPIENT MANAGEMENT REPORTS TO MARSHALL MEDICAL CENTER'S BOARD OF DIRECTORS ON AN ANNUAL BASIS. PROGRAM SUPPORT RELATED TO COMMUNITY HEALTH ISSUES - THIS FINANCIAL ASSISTANCE IS GIVEN TO A HEALTHCARE NONPROFIT FOR COMMUNITY HEALTH NEEDS. THE CARE MANAGER FOR THE RECEIVING ORGANIZATION ATTENDS CASE MANAGEMENT MEETINGS HERE AT MARSHALL AND GIVES PERIODIC VERBAL REPORTS ON PROGRESS MADE WITH THE GRANTED MONEY. THE ORGANIZATION ALSO PROVIDES COMPREHENSIVE WRITTEN REPORTS REGARDING PROGRESS ON AN ANNUAL BASIS TO MANAGEMENT. ASSISTANCE TO INDIVIDUALS IN THE FORM OF EDUCATIONAL SCHOLARSHIPS - THESE ASSISTANCE AWARDS ARE NOMINAL AND ARE GIVEN TO RECIPIENTS FOR EDUCATIONAL NEEDS WITHOUT FOLLOW-UP MONITORING. RECIPIENTS MUST MEET SELECTION CRITERIA BEFORE SUPPORT IS PROVIDED. X 1 1 X X X X X 1 0 0 0 0 1 0 1 0 SIRI NELSON PRESIDENT/CEO 547091 0 107822 0 0 0 0 0 5187 0 660100 0 0 0 BRIAN GOLDSMITH MD CHIEF MEDICAL OFFICER 360407 0 23988 0 0 0 0 0 790 0 385185 0 0 0 LAURIE ELDRIDGE CHIEF FINANCIAL OFFICER 324812 0 44497 0 0 0 0 0 5920 0 375229 0 0 0 MARTIN ENTWISTLE ASSOC CHIEF MEDICAL OFFICER, VP POP. HEALTH 284834 0 27745 0 0 0 0 0 1281 0 313860 0 0 0 BRETT APPLEBERG CHIEF HUMAN RESOURCES OFFICER 276797 0 25000 0 0 0 0 0 4374 0 306171 0 0 0 CYNTHIA RICE CHIEF NURSING OFFICER 274775 0 26250 0 0 0 0 0 781 0 301806 0 0 0 JONATHAN RUSSELL CHIEF AMBULATORY OFFICER 255947 0 24078 0 0 0 0 0 6081 0 286106 0 0 0 MINDY DANOVARO EXECUTIVE DIRECTOR OF PHILANTHROPY 267183 0 1000 0 0 0 0 0 2983 0 271166 0 0 0 MARTIN DALY VP OF INFORMATION TECHNOLOGY 227455 0 19525 0 0 0 0 0 781 0 247761 0 0 0 JANICE RANGER EXECUTIVE DIRECTOR OF FINANCE 140632 0 102974 0 0 0 0 0 3778 0 247384 0 0 0 ROBIN MCATEE OPERATING ROOM RN 233161 0 7453 0 0 0 0 0 5170 0 245784 0 0 0 STEPHANIE GODON DIRECTOR OF PHARMACY 223355 0 8663 0 0 0 0 0 946 0 232964 0 0 0 PART I, LINE 1A ANY EMPLOYEE WHO MEETS A 20+ YEAR LONGEVITY THRESHOLD RECEIVES A BONUS OF $1,000 - $3,000 THAT IS GROSSED UP TO COVER INCOME TAXES AND PAYROLL TAXES. PART I, LINE 4A IN CALENDAR YEAR 2023, JANICE RANGER RECEIVED A SEVERANCE PAYMENT OF $95,532. PART I, LINE 6 THERE ARE FOUR LEM LEADERSHIP INCENTIVE COMPENSATION POLICIES THAT INCLUDE LEM LEADERSHIP INCENTIVE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, LEADERSHIP INCENTIVE COMPENSATION FOR CHIEF EXECUTIVE LEADERSHIP POSITIONS, LEADERSHIP EVALUATION COMPENSATION FOR EXECUTIVE DIRECTOR & DEPARTMENT DIRECTOR POSITIONS, AND LEADERSHIP EVALUATION COMPENSATION FOR VICE PRESIDENT POSITIONS. ALL OF THESE COMPENSATION POLICIES ARE WEIGHTED UNDER FOUR PILLARS INCLUDING PEOPLE, FINANCE, QUALITY AND COMMUNITY. THE FINANCE PILLAR IS BASED ON AUDITED OPERATING MARGIN RESULTS FOR THE FISCAL YEAR ENDING OCTOBER 31ST. IN ADDITION, THERE IS ALSO A REWARD PROGRAM FOR MARSHALL MEDICAL CENTER STAFF THAT IS WEIGHTED ON THE SAME FOUR PILLARS. PART I, LINE 7 BONUSES ARE CALCULATED USING A PRE-DETERMINED FORMULA, BUT THE BOARD HAS THE ABILITY TO TAKE INTO ACCOUNT OTHER FACTORS AND ADJUST THE FORMULA AT THEIR DISCRETION. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UVPO 2020-04-27 54734815 SEE PART VI 0 0 0 B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033L6R3 2015-04-09 30423048 SEE PART VI 0 0 0 A 55436535 2911731 636674 2289428 17219302 19459114 13609496 1 0 0 1 B 4485000 30423055 3849054 498389 791050 29133616 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 A 1 B 1 - ENTRY A - ISSUED 04/27/2020: PART I, COLUMN F - THE BONDS CURRENTLY REFUNDED THE BORROWER'S SERIES 2004B BONDS (ORIGINALLY ISSUED ON MARCH 25, 2004) AS WELL AS FOR THE FINANCING AND RENOVATIONS TO CERTAIN HEALTH FACILITIES, TO FUND A DEBT SERVICE RESERVE, TO PAY RELATED CAPITALIZED INTEREST AND TO PAY COSTS OF ISSUANCE RELATED TO THE BONDS. PART II, LINE 3 - THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, COLUMN E DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. PART III, LINE 7 - AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2B - THE PORTION OF THE BOND PROCEEDS USED FOR CURRENT REFUNDING HAS MET THE 6-MONTH EXPENDITURE EXCEPTION. - ENTRY B - ISSUED 04/09/2015: PART 1, COLUMN F - THE BONDS CURRENTLY REFUNDED THE BORROWER'S SERIES 2004A BONDS (ORIGINALLY ISSUED ON MARCH 25, 2004). PART II, LINE 4 - THE SERIES 2015 BOND RESERVE ACCOUNT WAS FUNDED BY BOND PROCEEDS OF THE SERIES 2004A AND SERIES 2012A BONDS. PART II, LINE 13 - PROCEEDS OF THE BONDS WERE ISSUED FOR THE PURPOSE OF CURRENT REFUNDING; THEREFORE, THE PROJECT PERIOD IS NOT APPLICABLE FOR THIS BOND ISSUE. PART III, LINE 7 - AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2C - THE REBATE COMPUTATION WAS PERFORMED AS OF APRIL 9, 2020 AND SHOWED NO REBATE DUE. FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD, THE PAST CHAIR, THE PRESIDENT/CEO, THE CHIEF OF THE MEDICAL STAFF, AND THE LONGEST-TENURED MEDICAL GROUP DIRECTOR. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, PROVIDED THAT ANY ACTION IT TAKES CANNOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 SIRI NELSON, JONATHAN RUSSELL, AND MARTIN ENTWISTLE WERE BOARD MEMBERS OF EL DORADO SURGERY CENTER DURING THE FISCAL YEAR ENDED OCTOBER 31, 2023. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990, MANAGEMENT (CFO AND EXECUTIVE DIRECTOR OF FINANCE) REVIEWED THE FORM 990 IN DETAIL. ANY APPROPRIATE CHANGES WERE MADE. THE FULL GOVERNING BOARD OF DIRECTORS (BOD) HAS DELEGATED THE RESPONSIBILITY OF REVIEWING THE FORM 990 PRIOR TO FILING WITH THE IRS TO THE BOD AUDIT COMMITTEE, A SUBCOMMITTEE OF THE FULL GOVERNING BOD, SO THE FORM 990 WAS THEN SUBMITTED TO THE GOVERNING BOD AUDIT COMMITTEE. THE AUDIT COMMITTEE PERFORMED A HIGH-LEVEL REVIEW OF THE FORM 990 AND REQUESTED MANAGEMENT TO MAKE ANY CHANGES THE COMMITTEE DEEMED NECESSARY. PRIOR TO FILING THE FORM 990 WITH THE IRS, THE AUDIT COMMITTEE PROVIDED A SUMMARY TO THE FULL GOVERNING BOD OF THE BOD AUDIT COMMITTEE'S REVIEW OF THE FORM 990. AT ANY TIME, BOTH BEFORE OR AFTER FILING, THE COMPLETE FORM 990 WAS AVAILABLE UPON REQUEST TO ANY MEMBER OF THE GOVERNING BOD. FORM 990, PART VI, SECTION B, LINE 12C OUR POLICY IS TO OBTAIN ON AN ANNUAL BASIS FROM CHIEF ADMINISTRATIVE OFFICERS, VICE PRESIDENTS, DIRECTORS, ASSISTANT DIRECTORS, PURCHASING STAFF, LEGAL STAFF, AND COMPLIANCE STAFF A DISCLOSURE STATEMENT NAMING ANY ORGANIZATIONS, INCLUDING THOSE AFFILIATED WITH MARSHALL MEDICAL CENTER, IN WHICH THE EMPLOYEE AND/OR A MEMBER OF HIS/HER IMMEDIATE FAMILY MAY HAVE ANY INTEREST, WHETHER THROUGH EMPLOYMENT, STOCK OR SHARES OWNERSHIP, CONTRACTUAL AGREEMENT, BOARD MEMBERSHIP, OR DIRECT COMPENSATION. THERE IS NO MINIMUM AMOUNT OF VALUE OF AN ITEM, SERVICE, OR ARRANGEMENT THAT WILL TRIGGER A CONFLICT OF INTEREST. IMMEDIATE FAMILY INCLUDES ANY SPOUSE, PARENT, CHILD/STEP-CHILD, AND/OR SIBLING THAT LIVES IN THE SAME HOUSEHOLD AS THE EMPLOYEE. DISCLOSURE STATEMENTS ARE REVIEWED BY THE CEO FOR ANY ACTUAL OR POTENTIAL CONFLICTS. THE CEO'S DISCLOSURE STATEMENT IS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEES OF THE BOARD OF DIRECTORS. ADDITIONALLY, UPON CONSIDERATION OF ANY NEW CONTRACT AGREEMENT, POTENTIAL PARTIES MUST IDENTIFY ANY POTENTIAL INTERESTED PARTIES IN COMMON. SHOULD ANY TRANSACITON INVOLVING POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARISE, THE CEO APPOINTS A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE ARRANGEMENT IN QUESTION. DUE DILIGENCE IS EXERCISED TO DETERMINE WHETHER MARSHALL MEDICAL CENTER CAN, WITH REASONABLE EFFORTS, OBTAIN A MORE ADVANTAGEOUS TRANSACTION FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE CEO MAKES THE DETERMINATION WHETHER THE TRANSACTION IS IN MARSHALL MEDICAL CENTER'S BEST INTEREST, BENEFIT, AND IS FAIR AND REASONABLE. IN THE EVENT THAT ANY OF THE AFOREMENTIONED EMPLOYEES OR IMMEDIATE FAMILY MEMBERS HAS AN OUTSIDE INTEREST THAT CONFLICTS OR SUGGESTS A POSSIBLE CONFLICT WITH MARSHALL MEDICAL CENTER'S BUSINESS INTERESTS, SAID EMPLOYEES ARE RECUSED FROM PARTICIPATING IN DELIBERATIONS AND/OR DECISIONS ABOUT A BUSINESS TRANSACTION. OUR POLICY IS TO OBTAIN ON AN ANNUAL BASIS FROM MEMBERS OF THE GOVERNING BOARD A DISCLOSURE STATEMENT NAMING ANY ORGANIZATIONS, INCLUDING THOSE AFFILIATED WITH MARSHALL MEDICAL CENTER, IN WHICH THE BOARD MEMBER OR AN IMMEDIATE FAMILY MEMBER HAS ANY INTEREST, WHETHER THROUGH EMPLOYMENT, OWNERSHIP, CONTRACTUAL AGREEMENT, BOARD MEMBERSHIP, OR COMPENSATION. THERE IS NO MINIMUM AMOUNT OF VALUE OF AN ITEM, SERVICE, OR ARRANGEMENT THAT WILL TRIGGER A CONFLICT OF INTEREST. DISCLOSURE STATEMENTS ARE REVIEWED BY ADMINISTRATIVE OFFICE PERSONNEL FOR ANY ACTUAL OR POTENTIAL CONFLICTS AND ARE AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW. ANY MATERIAL FINDINGS ARE FORWARDED TO ADMINISTRATION FOR RESOLUTION. ADDITIONALLY, UPON CONSIDERATION OF ANY NEW CONTRACT AGREEMENT, VENDORS ARE REVIEWED FOR POTENTIAL CONFLICTS OF INTEREST TO IDENTIFY ANY POTENTIAL INTERESTED PARTIES IN COMMON. SHOULD ANY TRANSACTION INVOLVING POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARISE, THE TRANSACTION MAY BE ENTERED INTO ONLY AFTER THE FOLLOWING STEPS ARE TAKEN BY THE BOARD: A. CONCLUDE THAT THE TRANSACTION WILL BENEFIT THE HOSPITAL AND THAT THE HOSPITAL IS ENTERING INTO THE TRANSACTION FOR ITS OWN BENEFIT (THE MINUTES SHOULD DELINEATE THE BENEFIT); B. CONCLUDE THAT THE TRANSACTION IS FAIR AND REASONABLE TO THE HOSPITAL AT THE TIME IT IS ENTERED; C. AUTHORIZE OR APPROVE IT IN GOOD FAITH BY A VOTE OF THE DIRECTORS, WITHOUT COUNTING THE VOTE OF THE INTERESTED PERSON(S) AND WITH KNOWLEDGE OF THE MATERIAL FACTS CONCERNING THE TRANSACTION AND THE DIRECTOR(S)' INTEREST IN THE TRANSACTION; AND D. PRIOR TO AUTHORIZING OR APPROVING THE TRANSACTION, THE BOARD DETERMINES AFTER REASONABLE INVESTIGATION AND IN GOOD FAITH THAT THE HOSPITAL COULD NOT OBTAIN THROUGH REASONABLE EFFORT A MORE ADVANTAGEOUS ARRANGEMENT UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DECIDES THE CEO'S COMPENSATION WITH INPUT FROM THE AUDIT AND COMPLIANCE COMMITTEES USING DATA COMPILED FROM THE CALIFORNIA HEALTHCARE ASSOCIATION'S ALLIED FOR HEALTH EXECUTIVE COMPENSATION SURVEY, WILLIS TOWERS WATSON EXECUTIVE COMPENSATION SURVEY AND OTHER SOURCES SUCH AS AN INDEPENDENT COMPENSATION CONSULTANT, AND FOLLOWING THE EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT. THE DATA INCLUDES HOSPITALS FROM NORTHERN AND SOUTHERN CALIFORNIA, AS WELL AS RURAL AND URBAN HOSPITALS. THE DATA DIFFERENTIATES BY BED SIZE, OPERATING EXPENSES, AND FULL-TIME EQUIVALENTS (FTES). ALL INFORMATION UTILIZES AGGREGATE, HISTORICAL INFORMATION. THE AUDIT AND COMPLIANCE COMMITTEES MEET QUARTERLY BUT INCORPORATES COMPENSATION REVIEW ANNUALLY WHEN A REVIEW OF THE CEO'S COMPENSATION IS IN ORDER. THE CEO (ADMINISTRATOR) DECIDES THE COMPENSATION FOR THE COO (ASSISTANT ADMINISTRATOR), CNO (CHIEF NURSING OFFICER), CFO (CHIEF FINANCIAL OFFICER), CAO (CHIEF AMBULATORY OFFICER) AND CMO (CHIEF MEDICAL OFFICER); REVIEWING THEM ANNUALLY. THE CHIEF EXECUTIVE TEAM DECIDES COMPENSATION FOR ALL DIVISION/INTERNAL LEADERSHIP VICE PRESIDENTS. THE ABOVE COMPENSATION WAS DETERMINED USING A STATEMENT OF EXECUTIVE COMPENSATION PHILOSOPHY CREATED WITH INPUT FROM AN INDEPENDENT COMPENSATION CONSULTANT WHICH USED DATA COMPILED FROM THE CALIFORNIA HEALTHCARE ASSOCIATION'S ALLIED FOR HEALTH EXECUTIVE COMPENSATION SURVEY, AS WELL AS OTHER SURVEYS. THE DATA INCLUDES HOSPITALS FROM NORTHERN AND SOUTHERN CALIFORNIA, AS WELL AS RURAL AND URBAN HOSPITALS. THE DATA DIFFERENTIATES BY BED SIZE, OPERATING EXPENSES, AND FULL-TIME EQUIVALENTS (FTES). ALL INFORMATION UTILIZES AGGREGATE, HISTORICAL INFORMATION. IF NECESSARY, TEMPORARY PAY CUTS MAY ALSO BE APPROVED FOR OFFICERS TO MEET OPERATIONAL NEEDS. FORM 990, PART VI, SECTION C, LINE 19 - MARSHALL MEDICAL CENTER'S GOVERNING DOCUMENTS ARE MADE AVAILABLE ACCORDING TO THE CALIFORNIA CORPORATIONS CODE REQUIREMENTS. - OUR CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. - SELECTED FINANCIAL INFORMATION IS PUBLISHED ANNUALLY IN OUR PERIODIC PUBLICATION, "REPORT TO THE COMMUNITY". THIS PUBLICATION IS INCLUDED IN TWO LOCAL NEWSPAPERS WITH A CIRCULATION OF APPROXIMATELY 35,000 HOMES. THE PUBLICATION IS ALSO PLACED IN VARIOUS PUBLIC AREAS INCLUDING DOCTORS' OFFICES, LIBRARIES, THE CHAMBER OF COMMERCE, REAL ESTATE OFFICES, AND ALL OF OUR LOCATION WAITING ROOMS. MONTHLY SELECTED FINANCIAL INFORMATION IS POSTED ON THE "KAIZEN" BULLETIN BOARD IN THE HOSPITAL FOR PURPOSES OF OPERATIONAL TRANSPARENCY TO THE COMMUNITY. ALSO, AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR REVIEW UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 62,225,971. MANAGEMENT AND GENERAL EXPENSES 13,347,576. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,573,547. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES 6,138,175. FORM 990, PART XII, LINE 2C: THE RESPONSIBILITY FOR SELECTING THE FINANCIAL STATEMENT AUDITOR AND FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE YEAR. MARSHALL FOUNDATION FOR COMMUNITY HEALTH PO BOX 1996 PLACERVILLE CA 95667 237419011 SUPPORT MARSHALL MEDICAL CENTER & COMMUNITY HEALTH CA 501(C)(3) LINE 7 MARSHALL MEDICAL CENTER 1 EL DORADO SURGERY CENTER LLC 4300 GOLDEN CENTER DRIVE SUITE E PLACERVILLE CA 95667 450586784 SURGICAL SERVICES CA MARSHALL MEDICAL CENTER RELATED 129473 1148669 0 1 0.87000 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 EL DORADO SURGERY CENTER LLC S 256886 CASH MARSHALL FOUNDATION FOR COMMUNITY HEALTH L 197809 COST