2023-11-11T02:16:19-06:00 2022-12-31 ERNST & YOUNG US LLP 18101 VON KARMAN AVE SUITE 1700 IRVINE CA 92612 990 2022-01-01 951183919 San Antonio Regional Hospital % WAH-CHUNG HSU SANA 9099852811 999 San Bernardino Road Upland CA 917864920 Wah-chung Hsu VICE PRESIDENT/CFO 9099852811 2023-11-10 true Wah-chung Hsu 999009999 Kara Adams P00023315 9497942300 2023-11-09 3 2022 2023-04-26 12:10:37Z John Chapman 999 San Bernardino Road Upland CA 917864920 548396214 false X sarh.org X 1920 CA OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. 13 11 2864 245 3950809 212878 3251741 2331863 425519992 451232220 5410157 1933659 11790166 11591494 445972056 467089236 112034 340430 0 0 202967547 218129268 0 0 0 199241504 217215005 402321085 435684703 43650971 31404533 729626898 744326867 248852148 262623661 480774750 481703206 X OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. false false 391913662 340430 458917667 SAN ANTONIO REGIONAL HOSPITAL WAS FOUNDED BY DR. WILLIAM HOWARD CRAIG IN 1907 TO MEET THE HEALTHCARE NEEDS OF LOCAL RESIDENTS. AS THE COMMUNITY SURROUNDING THE HOSPITAL GREW, IT BECAME APPARENT THAT LARGER, MORE MODERN FACILITIES WERE NEEDED. COMMUNITY LEADERS RALLIED TO RAISE THE NEEDED CAPITAL AND THE HOSPITAL MOVED TO ITS CURRENT LOCATION ON SAN BERNARDINO ROAD IN 1924. THROUGH COMMUNITY SUPPORT, THE HOSPITAL GREW - FROM ITS MODEST BEGINNING WITH 18 BEDS, 5 PHYSICIANS, AND LIMITED STAFF - TO A 363-BED REGIONAL MEDICAL FACILITY WITH 2,200 EMPLOYEES, OVER 400 VOLUNTEERS, AND A MEDICAL STAFF OF NEARLY 600 PHYSICIANS REPRESENTING A WIDE SPECTRUM OF MEDICAL AND SURGICAL SPECIALTIES. ON JANUARY 6, 2017 THE HOSPITAL'S MAIN CAMPUS IN UPLAND OPENED THE LARGEST EXPANSION IN ITS HISTORY. THE 179,000 SQUARE FOOT ADDITION, WHICH INCLUDES A NEW 52-BED EMERGENCY DEPARTMENT AND 92-BED PATIENT TOWER, INCORPORATED THE LATEST HEALTHCARE ARCHITECTURAL DESIGN AND ADVANCED TECHNOLOGICAL FEATURES TO MEET THE NEEDS OF THE GROWING POPULATION IN THE WEST END OF CALIFORNIA'S INLAND EMPIRE. IN ADDITION TO THE MAIN CAMPUS, THE HOSPITAL HAS SATELLITE LOCATIONS IN RANCHO CUCAMONGA, FONTANA, AND EASTVALE, AND RECENTLY OPENED A FOURTH URGENT CARE IN THE CITY OF ONTARIO IN THE FALL OF 2022. THESE FACILITIES PROVIDE OUTPATIENT CARE IN A CLOSE, CONVENIENT SETTING FOR THE REGION'S GROWING POPULATION. ADDITIONALLY, SAN ANTONIO OPENED A NEW 60,000-SQUARE-FOOT TWO-STORY AMBULATORY CARE FACILITY DIRECTLY ACROSS THE STREET FROM THE HOSPITAL IN 2019. THE SCHEU BUILDING HOUSES CITY OF HOPE'S COMPREHENSIVE CANCER CENTER ON THE FIRST FLOOR AND THE HOSPITAL'S OUTPATIENT SERVICES AND PROGRAMS ON THE SECOND FLOOR. THE WOMEN'S BREAST AND IMAGING CENTER, PRE-OPERATIVE AND PRE-PROCEDURE SERVICES, AND TARGETED PROGRAMS TO COMPLEMENT CITY OF HOPE'S CANCER CENTER ARE AMONG THE HOSPITAL'S OFFERINGS IN THIS LOCATION. LEADERSHIP - SAN ANTONIO REGIONAL HOSPITAL IS GOVERNED BY A 13-MEMBER BOARD OF TRUSTEES. THE HOSPITAL'S MEDICAL STAFF PRESIDENT-ELECT, PRESIDENT, AND IMMEDIATE PAST PRESIDENT ARE MEMBERS OF THE BOARD BY VIRTUE OF THEIR OFFICES. AT LEAST TWO ADDITIONAL PHYSICIANS ARE ELECTED FROM THE MEDICAL STAFF, AND THE REMAINING MEMBERS ARE ELECTED FROM THE COMMUNITY AT-LARGE. THE BOARD OF TRUSTEES, WITH PHYSICIAN LEADERS COMPRISING A SIGNIFICANT PORTION OF ITS MEMBERSHIP, SETS THE DIRECTION FOR THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM. THE EXECUTIVE MANAGEMENT GROUP DIRECTS THE HOSPITAL'S STRATEGIC PLANNING PROCESS AND ALLOCATES RESOURCES FOR COMMUNITY BENEFIT ACTIVITIES. THE EXECUTIVE MANAGEMENT GROUP INCLUDES THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, CHIEF NURSING OFFICER, CHIEF STRATEGY OFFICER, CHIEF HUMAN RESOURCE OFFICER, CHIEF INFORMATION OFFICER, AND PRESIDENT OF THE HOSPITAL FOUNDATION. DEPARTMENT DIRECTORS ARE RESPONSIBLE FOR THE OPERATION AND MANAGEMENT OF THE INDIVIDUAL DEPARTMENTS. THE DIRECTORS ENCOURAGE EMPLOYEE PARTICIPATION IN COMMUNITY BENEFIT ACTIVITIES, AND IT IS THIS SUPPORT THAT ENSURES THE ULTIMATE SUCCESS OF THE SARH'S COMMUNITY OUTREACH PROGRAM. OUR COMMITMENT- THE LEADERSHIP AT SAN ANTONIO REGIONAL HOSPITAL HAS AN UNWAVERING COMMITMENT TO THE HOSPITAL'S MISSION, VISION, VALUES, AND STRATEGIC PLAN, WHICH FOCUS ON IMPROVING THE REGION'S OVERALL HEALTH BY PROVIDING QUALITY PATIENT CARE IN A COMPASSIONATE AND CARING ENVIRONMENT. OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. OUR VISION IS TO BE A LEADER IN CREATING HEALTHY FUTURES THROUGH EXCELLENCE AND COMPASSION. OUR VALUES ARTICULATE THE PRINCIPLES THAT HELP US TO FULFILL OUR MISSION AND VISION, AND OUR STRATEGIC PLAN SPECIFICALLY ADDRESSES THE DEVELOPMENT OF PROGRAMS AND SERVICES IN RESPONSE TO THE REGIONAL COMMUNITY NEEDS. SAN ANTONIO'S COMMITMENT TO PROVIDING QUALITY CARE FOR ALL MEMBERS OF OUR COMMUNITY HAS RECEIVED NATIONAL RECOGNITION. IN 2022, SARH WAS NAMED AMONG IBM/WATSON HEALTH'S 50 TOP CARDIOVASCULAR HOSPITALS, HEALTHGRADES 50 BEST HOSPITALS FOR CARDIAC SURGERY, AND U.S. NEWS & WORLD REPORT HIGH PERFORMING HOSPITAL FOR STROKE. ADDITIONALLY, SARH WAS AWARDED THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES GOLD PLUS STROKE AWARD AND RECEIVED WOMEN'S CHOICE AWARDS FOR ORHTOPEDICS, HEART CARE, STROKE CARE, CANCER CARE, PATIENT SAFETY, AND MAMMOGRAMS. CARING FOR OUR COMMUNITY - SAN ANTONIO REGIONAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF THE RESIDENTS THAT IT SERVES. AS SUCH, WE DO OUR BEST TO BUILD PARTNERSHIPS WITH OTHER ORGANIZATIONS THAT SHARE OUR VALUES AND MISSION. WE UNDERSTAND THAT COMMUNITY BENEFITS ARE MORE THAN JUST NUMBERS. THEY REPRESENT PEOPLE - CHILDREN, PARENTS, GRANDPARENTS, AND THOSE WHO MAY BE MARGINALIZED, DISADVANTAGED, AND DISENFRANCHISED. SAN ANTONIO REGIONAL HOSPITAL UNDERSTANDS THAT EACH COMMUNITY IT SERVES ALSO HAS ITS DISTINCTIVE CHALLENGES, BUT ALSO OPPORTUNITIES BY DELIVERING ESSENTIAL PATIENT CARE SERVICES TO PROMOTE HEALTHIER LIFESTYLES, EARLY DETECTION OF DISEASE, AND ENHANCED ACCESS TO BASIC HEALTHCARE SERVICES. AS A REGIONAL HEALTHCARE PROVIDER, SAN ANTONIO REGIONAL HOSPITAL IS COMMITTED TO MAINTAINING THE HIGHEST QUALITY OF CARE FOR THOSE WE SERVE. AS A NONPROFIT HOSPITAL, ALL OF OUR RESOURCES ARE DEVOTED TO PROVIDING HEALTHCARE SERVICES. WE STRIVE TO PROVIDE OUR COMMUNITY WITH THE BEST OF CARE BY ALLOCATING A PERCENTAGE OF HOSPITAL OPERATIONS BY PURCHASING NEW OR UPGRADED EQUIPMENT, EXPANDING SERVICES, AND PROVIDING CARE FOR THE VULNERABLE POPULATION WITH FREE OR LOW-COST SCREENINGS, SERVICES, AND HEALTH EDUCATION TO PREVENT CHRONIC DISEASES AND IMPROVE HEALTH OUTCOMES. WHILE THE INLAND EMPIRE IS A MATURING ECONOMIC MARKET, MANY INDIVIDUALS AND FAMILIES ARE AT SIGNIFICANT RISK DURING A MEDICAL CRISIS. OFTEN THIS IS DUE TO AN INABILITY TO ACCESS HEALTH INSURANCE OR THE RESULT OF INADEQUATE INSURANCE COVERAGE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES RELIEF TO THE FAMILIES WHO WOULD OTHERWISE FACE MEDICAL BANKRUPTCY. IN 2022, $1,084,052 IN FINANCIAL ASSISTANCE WAS PROVIDED FOR PATIENTS ENTERING THE HOSPITAL'S EMERGENCY DEPARTMENT WHO WERE EITHER TREATED AND RELEASED OR REQUIRED AN INPATIENT STAY. THE HOSPITAL ABSORBED $45,885,317 IN UNREIMBURSED COSTS INCURRED IN PROVIDING CARE AND TREATMENT FOR MEDI-CAL PATIENTS, WHILE OTHER UNCOMPENSATED CARE (BAD DEBTS) TOTALED $16,345,089 IN ACTUAL COSTS INCURRED BY THE HOSPITAL TO TREAT THESE PATIENTS. IN ADDITION TO DIRECT MEDICAL CARE, SAN ANTONIO REGIONAL HOSPITAL REACHES OUT TO ITS COMMUNITY IN A VARIETY OF WAYS THAT GO WELL BEYOND THE TRADITIONAL CARE PROVIDED BY AN ACUTE CARE HOSPITAL. AN INVENTORY OF THESE PROGRAMS AND ACTIVITIES IS PROVIDED LATER IN THIS REPORT. IN MANY COMMUNITIES WITHIN THE HOSPITAL'S SERVICE AREA, NEEDS FAR EXCEED ACCESSIBLE RESOURCES. SAN ANTONIO REGIONAL HOSPITAL UNDERSTANDS THE POWER OF COLLABORATION AND SEEKS ALLIANCES WITH OTHER HEALTH AND SOCIAL SERVICE PROVIDERS TO DEVELOP COMMUNITY-BASED PROGRAMS WITH DEFINED GOALS AND MEASURABLE OUTCOMES. THESE PARTNERSHIPS HELP TO LEVERAGE THE COMMUNITY'S RESOURCES TO ACHIEVE THE MAXIMUM BENEFIT FOR ITS RESIDENTS. PLANNING - SARH CONDUCTS A FORMAL STRATEGIC PLANNING PROCESS INVOLVING SENIOR MANAGEMENT, THE BOARD, THE MEDICAL STAFF LEADERSHIP EVERY THREE YEARS WITH ANNUAL REVIEWS AND UPDATES. THE EXECUTIVE MANAGEMENT TEAM WORKED CLOSELY WITH SARH'S BOARD OF TRUSTEES AND MEDICAL STAFF TO DEVELOP A THREE- STRATEGIC PLAN, WHICH INCLUDES DETAILS OF STRATEGIC, OPERATIONAL, QUALITY AND COMMUNITY BENEFIT INITIATIVES. IN ADDITION TO PROGRAMMATIC AND SERVICE ENHANCEMENT PROJECTS, THE STRATEGIC PLAN INCLUDING THE EXPANSION OF COMMUNITY HEALTH IMPROVEMENT. HOSPITAL SERVICES - SARH PROVIDES A FULL SPECTRUM OF PREVENTATIVE ACUTE, PRIMARY, AND SPECIALTY CARE TO THE COMMUNITIES IT SERVICES. THESE SERVICES INCLUDE INPATIENT MEDICAL AND SURGICAL SERVICES, EMERGENCY AND INTENSIVE CARE SERVICES, PALLIATIVE CARE, AND A COMMUNITY WELLNESS AND HEALTH PROMOTION PROGRAM. AREAS OF SPECIAL EXPERTISE INCLUDE CARDIOVASCULAR SERVICES PROVIDED AT SARH'S HEART CENTER, SPECIALIZED INFANT CARE PROVIDED AT THE LEVEL II NEONATAL INTENSIVE CARE UNIT (NICU), AND THE DIAGNOSTIC AND TREATMENT SERVICES AVAILABLE AT ITS CANCER CENTER AND GAMMA KNIFE CENTER. AT SAN ANTONIO REGIONAL HOSPITAL, WE ARE DEDICATED TO PROVIDING THE BEST URGENT CARE FACILITIES AND WALK-IN CLINICS IN EASTVALE, FONTANA, RANCHO CUCAMONGA, AND ONTARIO - WITH THE EXPERTS AND TECHNOLOGY TO TREAT LIFE'S UNEXPECTED INTERRUPTIONS. THE HEART CENTER - SARH'S HEART PROGRAM COORDINATES THE COMPREHENSIVE CARDIAC SERVICES WHICH INCLUDES NON-INVASIVE CARDIOLOGY, DIAGNOSTIC AND INTERVENTIONAL CARDIAC CATHETERIZATION, ELECTROPHYSIOLOGY STUDIES, CARDIAC NUCLEAR SCANNING, CARDIOVASCULAR SURGERY, AND CARDIAC REHABILITATIION. SARH HAS BEEN DESIGNATED AS "STEMI" (ST-ELEVATION MYOCARDIAL INFRACTION) RECEIVING CENTER. A STEMI RECEIVING CENTER IS A HOSPITAL WITH INFRASTRUCTURE, PERSONNEL, AND EXPERTISE TO DIAGNOSE AND TREAT PATIENTS WHO REQUIR 391913662 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true true false true 345 0 true 2864 true true true false false false false false false false false false false false X 13 11 false false false false false false false true true false false true true true true true true true true true true CA X WAH-CHUNG HSU 9099852811 999 SAN BERNARDINO ROAD UPLAND CA 91786 John Chapman President/CEO 40.0 3.0 X X 968165 0 87596 Kamal Pandya VP/Chief Information Officer 40.0 0.0 X 429824 0 60626 Debora Turner 11-112022 Chief Operating Officer 40.0 0.0 X 393370 0 85905 Sandra Wier Chief Human Resources Officer 40.0 0.0 X 381714 0 73242 Gurjeet Dhillon VP/Chief Nursing Officer 40.0 0.0 X 338965 0 78561 Maurice Jackson Surgical Technician 40.0 0.0 X 284313 0 7414 Cathy Rebman 11-62022 VP Busin Dev & Comm Outreach 40.0 0.0 X 257994 0 27817 Saurabh Ashier Manager Cardiovascular Service 40.0 0.0 X 247867 0 19053 Melissa Wood Director Finance 40.0 0.0 X 237225 0 6290 Sohan Bassi MD Trustee/Vice Chair 4.0 1.0 X X 19875 0 0 David Dang MD Trustee 4.0 2.0 X 5250 0 0 Dennis Trigueros MD Trustee/Med. Staff President 4.0 0.0 X 5069 0 0 Steven Barag MD Trustee 4.0 0.0 X 1500 0 0 Wes Fifield Trustee/Chairman 4.0 1.0 X X 0 0 0 Victor Ching MD Trustee/Treasurer 4.0 0.0 X X 0 0 0 Dora Barilla Trustee/Secretary 4.0 0.0 X X 0 0 0 Al Arguello Trustee 4.0 0.0 X 0 0 0 Deborah Freund Trustee 4.0 0.0 X 0 0 0 Mary Lopez Trustee 4.0 0.0 X 0 0 0 Robert Mendez Trustee 4.0 0.0 X 0 0 0 3571131 0 446504 626 false true false Shiftwise Inc 1800 SW 1st Avenue Suite 510 PORTLAND OR 97201 Nursing Registry 16009504 DVA Renal Healthcare PO Box 8500-1607 PHILADELPHIA PA 191781607 Dialysis 3877656 Synergy CT Surgery Partnership 901 San Bernardino Road 102 UPLAND CA 91786 Medical Services 1321888 Emerald Textiles LLC 1725 Dornoch Ct SAN DIEGO CA 92154 Linen Services 1266940 Parallon Revenue Cycle Services 39687 Treasury Center CHICAGO IL 606949800 Collection Services 973603 48 2331863 2331863 NET PATIENT SERVICE REVENUE 622110 398801698 398801698 PROVIDER FEE REVENUE 622110 48439478 48439478 RENTAL INCOME - MOB 531120 3443467 3443467 CAPITATION REVENUE 622110 456025 456025 OUTSIDE LAB REVENUE 621500 91552 91552 451232220 6239399 6239399 0 0 0 0 0 76826507 81132247 -4305740 -4305740 -4305740 0 0 0 0 0 0 221521 174731 46790 46790 PHARMACY AT CASA COLINA 446110 3635876 3635876 OTHER REVENUE 622110 1433254 1433254 INSURANCE INCENTIVE PAYMENT 622110 4769111 4769111 1706463 1483082 223381 11544704 467089236 458826115 3950809 1980449 X 340430 340430 0 0 0 3039619 919649 2119970 0 172929351 154206188 18723163 9364749 8350822 1013927 20114714 17936882 2177832 12680835 11307873 1372962 0 6923955 6923955 437177 437177 60860 60860 0 621678 621678 45777162 45777162 820908 820908 6530167 5901331 628836 10580340 9434800 1145540 0 18164686 16415481 1749205 0 0 52444 46766 5678 5154915 5154915 0 19388191 17521166 1867025 3759615 3759615 MEDICAL SUPPLIES 52412815 52412815 PROVIDER FEE 24076331 24076331 DRUGS 18141601 18141601 DUES AND SUBSCRIPTIONS 1146852 1146852 3165308 2822598 342710 435684703 391913662 43771041 0 57414 57062 24641530 13047456 0 0 67020263 64869549 0 0 0 0 0 0 6749888 6450773 9105565 12637052 456358069 187898190 273945016 268459879 236678737 254366226 0 0 6154773 6105362 0 0 105273712 118333508 729626898 744326867 69158945 89936769 0 0 0 0 142109204 138615419 0 0 0 0 0 0 0 0 37583999 34071473 248852148 262623661 X 468684228 471129648 12090522 10573558 480774750 481703206 729626898 744326867 X 31404533 -29017488 -1458589 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 60860 60860 false Part II-B, Line 1i SARH IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, WHICH CONDUCT LOBBYING ACTIVITIES IN SUPPORT OF MEMBER HOSPITALS AND GENERAL HEALTHCARE ISSUES. BOTH ASSOCIATIONS PROVIDE THE PERCENTAGE OF DUES THAT RELATE TO LOBBYING ACTIVITIES. 4945691 253250 410648 385936 29712 5193941 4945691 0 634274 605765 28509 4945691 4898286 25000 388504 339657 26442 4945691 4095691 825000 169882 177910 14377 4898286 4083191 325117 301452 11165 4095691 1.00000 false true true 14864344 14864344 288885551 79952117 208933434 8018664 5681843 2336821 133951178 102264230 31686948 10638332 10638332 268459879 RECEIVABLE - PROVIDER FEE PROG 52788332 BENEFICIAL INTEREST IN SAHF 46673864 MALPRACTICE CLAIMS RECEIVABLE 6675750 DUE FROM RELATED ENTITIES 6353874 CAPITAL LEASE 4481158 DEFERRED REVENUE 1149419 PHYSICIAN GUARANTEE ASSET 111111 PURCHASE OPTION 100000 118333508 0 PENSION PLAN LIABILITY FAS 158 17347998 INSURANCE CLAIMS 13243874 RIGHT OF USE LIABILITY 3060223 PHYSICIAN GUARANTEE LIABILITY 419378 34071473 X Schedule D, Part V, Line 4 PROCEEDS FROM THE ENDOWMENT FUNDS ARE RESTRICTED FOR THE PURCHASE OF PROPERTY AND EQUIPMENT FOR THE BENEFIT OF SAN ANTONIO REGIONAL HOSPITAL. Schedule D, Part X, Line 2 The principal operations of the Hospital are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and the provisions of the state in which the Hospital operates. Accounting Standards Codification (ASC) 740, Income Taxes, clarifies the accounting for income taxes by prescribing a minimum recognition threshold that a tax position is required to meet before being recognized in the financial statements. ASC 740 also provides guidance on derecognition, measurement, classification, interest and penalties, disclosure, and transition. The guidance is applicable to pass-through entities and tax-exempt organizations. No significant tax expense or liability for tax benefits, interest, or penalties was accrued at or for the years ended December 31, 2022 or 2021. The Hospital currently files Form 990, Return of Organization Exempt From Income Tax, and Form 990-T, Exempt Organization Business Income Tax Return, in the U.S. federal jurisdiction and the state of California for each tax-exempt organization, as appropriate. The statute of limitations for the years 2019 through 2021 remains open to examination by the major U.S. taxing jurisdictions to which the Hospital is subject. true true X true X 300. true X true true false true true 1084052 1085052 0.00250 122140991 102080189 20060802 0.04610 123225043 102080189 21145854 0.04860 21 12628 1817882 75880 1742002 0.00400 1 122176 122176 0.00030 1 303714 303714 0.00070 2 14190 128743 38313 90430 0.00200 25 26818 2372515 114193 2258322 0.00700 25 26818 125597558 102194382 23404176 0.05560 1 50 5400 5400 1 4451 959 959 2 4501 6359 6359 false 60402385 63657121 -3254736 X true true SA Ambulatory Surg OUTPATIENT SURGICAL CENTER 0.28404 0.0 0.61697 1 1 San Antonio Regional Hospital 999 San Bernardino Road Upland CA 91786 sarh.org 240000196 X X X San Antonio Regional Hospital 1 false false true X X X X X X X X X 22 true true true true X SEE PART V, SECTION C X true 23 true www.SARH.ORG false true X 300. 400. X X true true X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X false X false X X X X true X false false Schedule H, Part V, Section B, Line 5 THE HOSPITAL CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022 FOR THE CALENDAR YEARS OF 2023, 2024, AND 2025. SAN ANTONIO REGIONAL HOSPITAL (SARH) WELCOMED THE PARTICIPATION OF AND INPUT FROM OUR COMMUNITY MEMBERS. TO SUCCESSFULLY GATHER ROBUST PRIMARY DATA, NUMEROUS DEMOGRAPHIC GROUPS WERE PROVIDED AN ONLINE SURVEY AND DIVERSE SETS OF FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED. SEVEN FOCUS GROUPS WERE CONDUCTED IN UNDER-RESOURCED AREAS TO TALK WITH RESIDENTS AND WORKERS WHO DO NOT TYPICALLY ENGAGE IN TRADITIONAL REGIONAL NEEDS ASSESSMENTS, INCLUDING IMMIGRANTS, YOUTH, WORKING-CLASS INDIVIDUALS AND THOSE IDENTIFYING AS BIPOC (BLACK, INDIGENOUS AND PEOPLE OF COLOR). FOCAL POINTS OF OUR COMMUNITY-PARTICIPATORY PROCESS INCLUDED HEALTH CARE ACCESS AND USAGE, HUMANE HOUSING, MENTAL HEALTH NEEDS, SUBSTANCE USE, AND CHRONIC DISEASE. SARH'S TEAM ENDEAVORED TO GAIN A BETTER UNDERSTANDING OF THE CURRENT CONCERNS AND INTERESTS AMONG HIGHER NEED SEGMENTS OF THE HOSPITAL'S PRIMARY SERVICE AREA. SAN ANTONIO REGIONAL HOSPITAL COLLABORATED WITH THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, INLAND EMPIRE HEALTH PLAN, SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH AND RIVERSIDE COUNTY DEPARTMENT OF PUBLIC HEALTH TO PLAN AND EXECUTE THE 2022 INLAND EMPIRE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TOGETHER WITH THREE OTHER HOSPITALS (MONTCLAIR HOSPITAL MEDICAL CENTER, REDLANDS COMMUNITY HOSPITAL, AND SAN GORGONIO MEMORIAL HOSPITAL), SAN ANTONIO REGIONAL HOSPITAL CONTINUED TO SHARE RESOURCES, COLLABORATE FOR COLLECTIVE IMPACT, AND BUILD UPON THE EXISTING BODY OF WORK THROUGH EXPANDED DATA COLLECTION FROM IMPORTANT VOICES IN OUR COMMUNITY. PRIMARY AND SECONDARY DATA SOURCES WERE INCLUDED IN THE CHNA. PRIMARY DATA WAS COLLECTED FOR THE INLAND EMPIRE REGIONAL CHNA FROM TWO SOURCES: KEY INFORMANT INTERVIEWS AND COMMUNITY LISTENING SESSIONS. HOSPITAL SECONDARY DATA IN THIS NEEDS ASSESSMENT FOCUS ON HOSPITAL INPATIENT AND EMERGENCY DEPARTMENT (ED) UTILIZATION DATA, THE TOP CAUSES OF DEATH, MORBIDITIES (HEALTH CONDITIONS), CHRONIC CONDITIONS AND THE SOCIAL DETERMINANTS AFFECTING HOSPITAL USE. THE MAIN OBJECTIVE IN ENGAGING THE COMMUNITY WAS TO UNDERSTAND THE GREATEST AREAS OF NEED AND TO DISCOVER STRATEGIES IN WHICH PARTICIPATING HOSPITALS COULD COLLABORATE TO BETTER SERVE COMMUNITIES AND ELEVATE THE HEALTH STATUS OF OUR REGION. PRIMARY DATA - THE CHNA STAKEHOLDERS IDENTIFIED NINE KEY INFORMANTS WHO WERE INTERVIEWED INDIVIDUALLY IN PERSON OR BY TELEPHONE IN MARCH, APRIL AND MAY 2022. THE INFORMANTS REPRESENTED COMMUNITY, CIVIC AND GOVERNMENT LEADERS IN THE INLAND EMPIRE. QUESTIONS FOCUSED ON KEY HEALTH NEEDS, SOCIAL FACTORS AND COMMUNITY CONDITIONS THAT AFFECT HEALTH AS WELL AS COMMUNITY ASSETS THAT COULD BE USED TO ADDRESS THESE ISSUES. KEY THEMES THAT EMERGED FROM THESE INTERVIEWS INCLUDED MENTAL HEALTH, SUBSTANCE USE DISORDER, EDUCATION, FINANCIAL STRAIN, AS WELL AS UNEMPLOYMENT AND LACK OF APPROPRIATE JOB SKILLS TRAINING. LISTENING SESSIONS - A TOTAL OF EIGHT LISTENING SESSIONS WERE CONDUCTED AT MULTIPLE LOCATIONS, IN ENGLISH AND SPANISH, THROUGHOUT THE INLAND EMPIRE TO GAIN INSIGHTS FROM DIVERSE COMMUNITIES ON REGIONAL HEALTH PRIORITIES. EFFORTS WERE TAKEN TO INCLUDE INTERVIEWEES IDENTIFYING WITH POPULATIONS WHOSE VOICES CHNA STAKEHOLDERS WANTED TO ELEVATE IN THE PRIORITIZATION OF REGIONAL HEALTH ISSUES: IMMIGRANTS, YOUTH, WORKING-CLASS COMMUNITY MEMBERS AND INDIVIDUALS WHO IDENTIFIED AS BIPOC (BLACK, INDIGENOUS AND PEOPLE OF COLOR). EFFORTS TO RECRUIT PARTICIPANTS INCLUDED PHONE CALLS, EMAILS, SOCIAL MEDIA POSTS AND DIRECT OUTREACH IN COMMUNITY LOCATIONS (HEALTH FAIRS, HOSPITALS, PHARMACIES, LAUNDROMATS, AND LIBRARIES). RECRUITMENT FOR LISTENING SESSIONS WAS ALSO PURSUED VIA DOOR-TO-DOOR VISITS TO HOMES AND BUSINESSES. THE MOST COMMON HEALTH THEMES THAT EMERGED IN THE LISTENING SESSIONS WERE MENTAL HEALTH (DEPRESSION, ANXIETY, AND SUBSTANCE USE), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), DIABETES, HYPERTENSION, HEARTH DISEASE, CANCER, AND OBESITY. ENVIRONMENTAL AND OTHER COMMUNITY THEMES WERE ALSO DISCUSSED. THE MOST COMMON THEMES OF THIS CATEGORY INCLUDED AIR QUALITY, AFFORDABLE HOUSING, MORE GREEN SPACES, CRIME AND VIOLENCE, AS WELL AS LACK OF COMMUNITY ACTIVITIES AND CELEBRATIONS. HOSPITAL SECONDARY DATA IN THIS NEEDS ASSESSMENT FOCUS ON HOSPITAL INPATIENT AND EMERGENCY DEPARTMENT (ED) UTILIZATION DATA, THE TOP CAUSES OF DEATH, MORBIDITIES (HEALTH CONDITIONS), CHRONIC CONDITIONS AND THE SOCIAL DETERMINANTS AFFECTING HOSPITAL USE. THE 2016-2020 HOSPITAL DATA WERE DERIVED FROM CALIFORNIA'S DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AND INTEGRATED WITH DATA FROM THE FEDERAL AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ), CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), THE AMERICAN MEDICAL ASSOCIATION (AMA) AND THE U.S. CENSUS BUREAU. THE HOSPITAL DATA WERE STRATIFIED BY THE INLAND EMPIRE AS A WHOLE AND BY SAN BERNARDINO AND RIVERSIDE COUNTIES. IN ADDITION, DATA SPECIFIC TO EACH HOSPITAL SERVICE AREA. THE CALIFORNIA HOSPITAL DATA FOR INPATIENT ADMISSIONS - FLAGGED FOR PREVENTION QUALITY INDICATORS (PQIS) AND "Z" TYPE DIAGNOSIS ARE IMPORTANT BECAUSE THEY HIGHLIGHT THE MOST COMMON CHRONIC CONDITIONS AND SOCIAL DRIVERS OF HEALTH IN THE DESIGNATED REGIONS. ADDITIONAL SECONDARY DATA FOR THIS ASSESSMENT WERE DERIVED FROM THE IP3 ASSESS PLATFORM DEVELOPED BY THE INSTITUTE FOR PEOPLE, PLACE, AND POSSIBILITY (IP3). IP3 ASSESS USES TWO FRAMEWORKS: BURDEN OF DISEASE AND VITAL CONDITIONS FOR WELL-BEING. THE DOMAINS IN THE BURDEN OF DISEASE FRAMEWORK CONSIST OF COMMON HEALTH CONDITIONS, AND THE DOMAINS IN THE VITAL CONDITIONS FRAMEWORK COMPRISE SEVEN COMMUNITY CONDITIONS THAT AFFECT HEALTH AND WELL-BEING. THE IP3 ASSESS DATA WERE REVIEWED SYSTEMATICALLY BY REGIONAL CHNA STAKEHOLDERS IN PRIORITIZING KEY HEALTH AND ENVIRONMENTAL ISSUES TO SUPPORT HEALTH IN THE INLAND EMPIRE. FOLLOWING THE COMPLETION OF THE REGIONAL CHNA, SAN ANTONIO FINALIZED ITS 2022 CHNA AND EMBARKED ON A METHODICAL PRIORITIZATION PROCESS TO IDENTIFY THE MOST SIGNIFICANT HEALTH NEEDS TO BE ADDRESSED OVER NEXT THREE YEARS. THE RESULTS WERE SIMILAR TO THE REGIONAL PRIORITIZATION, WITH THE FOLLOWING AREAS OF NEED IDENTIFIED: MENTAL AND BEHAVIORAL HEALTH, INFANT AND MATERNAL HEALTH, AS WELL AS CARDIOVASCULAR DISEASE AND DIABETES. Schedule H, Part V, Section B, Line 6a OTHER HOSPITALS INCLUDED IN THE DEVELOPMENT OF THE HOSPITAL'S CHNA WERE MONTCLAIR HOSPITAL MEDICAL CENTER, REDLANDS COMMUNITY HOSPITAL, AND SAN GORGONIO MEMORIAL HOSPITAL. Schedule H, Part V, Section B, Line 6b OTHER ORGANIZATIONS INCLUDED IN THE DEVELOPMENT OF THE HOSPITAL'S CHNA WERE THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, INLAND EMPIRE HEALTH PLAN, THE PUBLIC HEALTH DEPARTMENT OF SAN BERNARDINO COUNTY AND THE PUBLIC HEALTH DEPARTMENT OF RIVERSIDE COUNTY. Schedule H, Part V, Section B, Line 7a WWW.SARH.ORG/ABOUT-US/COMMUNITY-CONNECTION/COMMUNITY-BENEFIT/ Schedule H, Part V, Section B, Line 11 THE RESULTS OF THE CHNA GUIDED THE CREATION OF SAN ANTONIO'S COMMUNITY BENEFIT IMPLEMENTATION STRATEGY BY PROVIDING THE FRAMEWORK FOR DETERMINING HOW WE CAN IMPROVE THE HEALTH OF OUR COMMUNITY, AND PARTICULARLY, THE MOST VULNERABLE AMONG US. USING THE CHNA AS BOTH CONTEXT AND THE LENS THROUGH WHICH THE COMMUNITY'S NEEDS WERE IDENTIFIED, SAN ANTONIO EMBARKED ON A FORMAL PRIORITIZATION PROCESS THAT INCLUDED INPUT FROM COMMUNITY STAKEHOLDERS. COMMUNITY HEALTH NEEDS ARE COMPLEX, OFTEN DIFFICULT TO DEFINE, AND MAY AFFECT DIVERSE POPULATIONS. EQUALLY CHALLENGING IS THE TASK OF CREATING INTERVENTIONS TO ADDRESS THESE NEEDS IN MEANINGFUL WAYS THAT ARE IMPACTFUL AND MEASURABLE. WITH THE COMPLETION OF THE CHNA AND THE PRIORITIZATION PROCESS, THE NEXT STEP WAS TO DEVELOP AND/OR EXPAND COMMUNITY BENEFIT PROGRAMS DESIGNED TO IMPROVE COMMUNITY HEALTH STATUS. DURING THE STRATEGIC PLANNING PROCESS, THE COMMUNITY BENEFIT TEAM DEVELOPED INITIATIVES WITHIN EACH OF THE IDENTIFIED PRIORITY AREAS WITH DEFINED GOALS, OBJECTIVES, AND EVALUATION METRICS. EACH INITIATIVE IN SAN ANTONIO REGIONAL HOSPITAL'S IMPLEMENTATION STRATEGY RELATES TO ONE OR MORE OF THE THREE PRIORITY AREAS, THE SPECIFIC NEEDS IDENTIFIED IN THE 2022 CHNA, AND INPUT SOUGHT AND PROVIDED BY COMMUNITY STAKEHOLDERS. MATERNAL AND CHILD HEALTH - KEY INFORMANTS REVEALED THAT THE REGION IS SEEING HIGH INFANT DEATH RATE, HIGH RATE OF PRE-TERM BIRTHS, HIGH RATE OF TOBACCO USE DURING PREGNANCY AND BELOW BENCHMARK IN EARLY PRENATAL CARE, PARTICULARLY IN POPULATIONS THAT IDENTIFY AS BLACK/AFRICAN AMERICAN. OVER THE NEXT THREE YEARS, THE HOSPITAL AIMS TO INCREASE SUPPORT TO PARENTS AND CAREGIVERS, SOCIALLY AND EMOTIONALLY WITH FAMILY-FOCUSED ACTIVITIES, EDUCATION AND SERVICES. MENTAL AND BEHAVIORAL HEALTH - THE CHNA REVEALED THAT COMMUNITY MEMBERS ARE UNABLE TO IDENTIFY RESOURCES OR ACCESS TO PREVENTATIVE CARE AND MENTAL HEALTH SERVICES. IN ORDER TO ADDRESS THIS NEED, SAN ANTONIO WILL STRIVE TO INCREASE ACCESS TO PREVENTATIVE CARE AS WELL AS INCREASED AWARENESS OF MENTAL HEALTH CARE RESOURCES, SERVICES AND EDUCATION. CARDIOVASCULAR DISEASE & DIABETES - PRIMARY DATA COLLECTION REVEALED THAT COMMUNITY MEMBERS FEEL MANAGEMENT OF HEALTH IS THE MOST PRESSING ISSUE AS IT ENABLES ONE TO STAY HEALTH AND INCREASES LONGEVITY. CHRONIC ILLNESSES ASSOCIATED WITH CARDIOVASCULAR DISEASE AND DIABETES CONTINUE TO BE AN INCREASING HEALTH RISK ACROSS THE NATION AND IN OUR COMMUNITY, FOR BOTH ADULTS AND CHILDREN. SAN ANTONIO WILL REDUCE THE IMPACT OF CARDIOVASCULAR DISEASE AND DIABETES AND INCREASE THE FOCUS ON CARDIOVASCULAR DISEASE AND DIABETES PREVENTION AND TREATMENT EDUCATION. EACH YEAR, AND AT THE CONCLUSION OF THE THREE-YEAR IMPLEMENTATION STRATEGY, SAN ANTONIO REGIONAL HOSPITAL EVALUATES THE EFFECTIVENESS OF ITS COMMUNITY BENEFIT PROGRAMS TO DETERMINE THE LEVEL OF MEASURABLE COMMUNITY HEALTH IMPACT. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, SAN ANTONIO REGIONAL HOSPITAL WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: BASIC NEEDS FOR HEATLH AND SAFETY, HUMANE HOUSING, AND MEANINGFUL WORK AND WEALTH. THE HOSPITAL CANNOT ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY; THEREFORE, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. SAN ANTONIO REGIONAL HOSPITAL WILL LOOK FOR PARTNERSHIP OPPORTUNITIES THAT ADDRESS NEEDS NOT SELECTED WHERE IT CAN APPROPRIATELY CONTRIBUTE TO ADDRESSING THOSE NEEDS, OR WHERE THOSE NEEDS ALIGN WITH CURRENT STRATEGIES AND PRIORITIES. Schedule H, Part V, Section B, Line 13h SARH understands that certain patients may be non-responsive to the financial assistance application process. Under these circumstances, SARH may utilize other sources of information to make an individual assessment of financial need. The information will enable SARH to make an informed decision on the financial need of non-responsive patients utilizing the best estimates available in the absence of information provided directly by the patient. SARH may utilize a State approved third-party to conduct an electronic review of patient information to assess financial need. This review utilizes a healthcare industry recognized model that is based on public record databases. This predictive model is designed to assess each patient to the same standards and the traditional application process. The electronic technology will be deployed prior to bad debt assignment after in-house collection efforts and all other eligibility and payment sources have been exhausted. This process allows SARH to screen all patients for financial assistance prior to exploring any extraordinary collection actions. The data returned from this electronic eligibility review will constitute adequate documentation of financial need under this policy. A completed financial assistance application may not be required in certain circumstances. These circumstances are limited to situation when SARH determines it has sufficient patient financial information from which to make a financial assistance eligibility and qualification decision. Examples of circumstances not requiring a financial assistance application include, but are not limited to: 1. Patient is homeless; 2. Patient is a resident at a shelter including but not limited to prototypes and the American Recovery Center; 3. Patient's address is the address for the Department of Public Social Services; 4. Patient is unknown; 5. Patient is receiving General Relief, Cal WORKS or Cal Fresh (documentation required); 6. Patient qualified for Medi-Cal without a share of cost (SOC) during a portion of the confinement or subsequent to their discharge/visit (proof of eligibility required); 7. Non-covered and /or denied services provided to Medi-Cal eligible patients. Schedule H, Part V, Section B, Line 16a www.sarh.org/patients-and-visitors/billing/ Schedule H, Part V, Section B, Line 16b www.sarh.org/patients-and-visitors/billing/ Schedule H, Part V, Section B, Line 16c www.sarh.org/patients-and-visitors/billing/ Schedule H, Part V, Section B, Line 3e THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. 8 Scheu Family OP Services 1100 San Bernardino Road Upland CA 91786 LAB AND RADIOLOGY SERVICES IN A FREESTANDING MEDICAL OFFICE BUILDING 901 Building 901 San Bernardino Road Upland CA 91786 PHYSICAL THERAPY SERVICES IN A FREESTANDING MEDICAL OFFICE BUILDING Rancho San Antonio Medical PLaza 7777 MILLIKEN AVE RANCHO CUCAMONGA CA 91730 LAB, X-RAY, PHYSICAL THERAPY & URGENT CARE IN A FREESTANDING MEDICAL OFFICE BUILDING Sierra San Antonio Medical Plaza 16465 SIERRA LAKES PARKWAY FONTANA CA 92336 LAB, X-RAY, PHYSICAL THERAPY & URGENT CARE IN A FREESTANDING MEDICAL OFFICE BUILDING Eastvale San Antonio Medical Plaza 12442 LIMONITE AVE EASTVALE CA 91752 LAB, X-RAY & URGENT CARE IN A FREESTANDING MEDICAL OFFICE BUILDING 685 Building 685 N 13TH AVENUE UPLAND CA 91786 CARDIAC REHAB SERVICES IN A FREESTANDING MEDICAL OFFICE BUILDING San Antonio Ambulatory Surgery Center 901 SAN BERNARDINO ROAD UPLAND CA 91786 OUTPATIENT SURGERY CENTER San Antonio Urgent Care Ontario 970 North Mountain Ave Ontario CA 91762 Urgent Care in a freestanding building ________________________________________________________________________ Schedule H, Part I, Line 3c - SARH understands that certain patients may be non-responsive to the financial assistance application process. Under these circumstances, SARH may utilize other sources of information to make an individual assessment of financial need. The information will enable SARH to make an informed decision on the financial need of non-responsive patients utilizing the best estimates available in the absence of information provided directly by the patient. SARH may utilize a State approved third-party to conduct an electronic review of patient information to assess financial need. This review utilizes a healthcare industry recognized model that is based on public record databases. This predictive model is designed to assess each patient to the same standards and the traditional application process. The electronic technology will be deployed prior to bad debt assignment after in-house collection efforts and all other eligibility and payment sources have been exhausted. This process allows SARH to screen all patients for financial assistance prior to exploring any extraordinary collection actions. The data returned from this electronic eligibility review will constitute adequate documentation of financial need under this policy. A completed financial assistance application may not be required in certain circumstances. These circumstances are limited to situation when SARH determines it has sufficient patient financial information from which to make a financial assistance eligibility and qualification decision. Examples of circumstances not requiring a financial assistance application include, but are not limited to: 1. Patient is homeless; 2. Patient is a resident at a shelter including but not limited to prototypes and the American Recovery Center; 3. Patient's address is the address for the Department of Public Social Services; 4. Patient is unknown; 5. Patient is receiving General Relief, Cal WORKS or Cal Fresh (documentation required); 6. Patient qualified for Medi-Cal without a share of cost (SOC) during a portion of the confinement or subsequent to their discharge/visit (proof of eligibility required); 7. Non-covered and /or denied services provided to Medi-Cal eligible patients. Schedule H, Part I, Line 6a - SAN ANTONIO REGIONAL HOSPITAL PREPARED A COMMUNITY BENEFIT REPORT AS REQUIRED BY THE STATE OF CALIFORNIA. THE REPORT WAS PUBLISHED AND MADE AVAILABLE TO THE PUBLIC ONLINE AT WWW.SARH.ORG. Schedule H, Part I, Line 7 - THE COSTING METHODOLOGY USED ON 7A: CALCULATED USING WORKSHEETS 1&2 IN THE INSTRUCTIONS; THE COST TO CHARGE OPTION. THE COSTING METHODOLOGY USED ON 7B: CALCULATED USING WORKSHEET 3 IN THE INSTRUCTIONS; THE COST TO CHARGE OPTION. THE COSTING METHODOLOGY USED ON 7E TO 7I: CALCULATED USING ACTUAL COSTS FROM SARH'S GENERAL LEDGER. Schedule H, Part I, Line 7g - San Antonio Regional Hospital provides subsidized health services by providing reimbursement for on-call physician services provided to uninsured, indigent patients who present through the Emergency Room. Schedule H, Part II - THE LEWIS-SAN ANTONIO HEALTHY COMMUNITIES INSTITUTE (HCI) WAS ESTABLISHED IN APRIL 2016 TO IDENTIFY OPPORTUNITIES, SOLUTIONS, AND PARTNERS TO POSITIVELY IMPACT THE HEALTH OF OUR REGION. HCI SEEKS TO ADDRESS THE HEALTHCARE WORKFORCE SHORTAGE AS WELL AS ELEMENTS OF THE EDUCATIONAL ATTAINMENT GAP THROUGH ITS WELLNESS STARTS WITH YOU! (FORMERLY WHEALTH) PROGRAM. THE MISSION IS TO CREATE A PIPELINE OF STUDENTS, ESPECIALLY UNDERREPRESENTED POPULATIONS, WHO ARE INTERESTED IN, ENGAGED, AND PREPARED FOR COLLEGE AND HEALTH RELATED FIELDS. HCI IS CURRENTLY FOCUSING ON THREE PROGRAM AREAS: HEALTHCARE WORKFORCE, HEALTH POLICY EDUCATION, AND NON-CLINICAL HEALTHCARE INTERNSHIPS. HEALTH CARE WORKFORCE - SOUTHERN CALIFORNIA'S INLAND EMPIRE REGION INCLUDES SAN BERNARDINO, THE LARGEST US GEOGRAPHICAL COUNTY, AND RIVERSIDE COUNTIES. THIS REGION HAS POORER HEALTH STATUS AND A GREATER SHORTAGE OF HEALTHCARE PROFESSIONALS THAN SURROUNDING COMMUNITIES. HCI IMPLEMENTED A SCHOOL-BASED ADOLESCENT PROGRAM CALLED "WELLNESS STARTS WITH YOU!" (WSWY) TO ADDRESS THESE TWO MAJOR NEEDS IN ORDER TO BUILD HEALTHIER OUTCOMES FOR THE FUTURE OF THE INLAND EMPIRE. WSWY SUPPORTS STUDENTS IN THEIR HEALTH CAREER JOURNEY BY: 1) CREATING LEARNING OPPORTUNITIES AROUND CHRONIC DISEASE PREVENTION; 2) HELPING TO ESTABLISH LIFELONG HEALTHY HABITS; AND 3) SUPPORTING AN INTEREST IN HEALTHCARE CAREERS. THIS PROGRAM AIMS TO INCREASE KNOWLEDGE ON WELLNESS TOPICS AND HEALTHCARE PROFESSIONAL DEVELOPMENT TRAINING. THE WELLNESS STARTS WITH YOU! CURRICULUM IS ADAPTED FROM HEALTHCORPS INC., A NATIONAL NONPROFIT, AND ALIGNS WITH THE NATIONAL HEALTH EDUCATION STANDARDS FOCUSING ON NUTRITION, FITNESS, AND MENTAL RESILIENCE. WSWY PROGRAM GOALS INCLUDE: 1) INCREASING KNOWLEDGE IN NUTRITION, PHYSICAL ACTIVITY, AND MENTAL RESILIENCE AMONG JUNIOR HIGH AND HIGH SCHOOL PARTICIPANTS USING HEALTH CORPS CURRICULUM; AND 2) INCREASING PROFESSIONAL DEVELOPMENT TRAINING FOR HEALTHCARE CAREER PREPAREDNESS AMONG HIGH SCHOOL PARTICIPANTS. THE CURRICULUM UTILIZES UNIVERSITY STUDENTS FROM ACROSS THE REGION TO INSTRUCT HIGH SCHOOL WELLNESS IN EIGHT CLASSROOM SESSIONS. PROFESSIONAL DEVELOPMENT IS INTEGRATED THROUGHOUT THE PROGRAM ALONG WITH INSTRUCTION AND MENTORSHIP AMONG VARIOUS EDUCATIONAL LEVELS. WSWY WAS IMPLEMENTED AT CHAFFEY, MONTCLAIR, ONTARIO, AND UPLAND HIGH SCHOOLS AND SERVED A TOTAL OF 574 STUDENTS. THE YOUNG HEALTHCARE PROFESSIONALS (YHP) PROGRAM SUPPORTS STUDENTS IN THEIR HEALTH CAREER JOURNEY BY: 1) SUPPORTING AN INTEREST IN ALLIED HEALTHCARE CAREERS; 2) TRAINING STUDENTS FOR ENTRY-LEVEL HEALTHCARE POSITIONS IN THE REGION; 3) HELPING TO ESTABLISH LIFELONG HEALTHY HABITS; AND 4) MENTORING YOUTH AS THEY TRANSITION TO ADULTHOOD. THIS PROGRAM AIMS TO INCREASE KNOWLEDGE AND SKILLS FOR ALLIED HEALTHCARE PROFESSIONS, AS WELL AS INCREASE KNOWLEDGE OF HEALTHY LIVING STRATEGIES. THE YHP PROGRAM GOALS INCLUDE: 1) INCREASING THE NUMBER OF ADOLESCENTS PURSUING THE FIELD OF HEALTHCARE AS A CAREER; AND INCREASING KNOWLEDGE OF WELLNESS LIFESTYLE HABITS USING THE 8 DIMENSIONS OF WELLNESS BY THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA). THE CURRICULUM UTILIZES UNIVERSITY STUDENTS FROM ACROSS THE INLAND EMPIRE TO INSTRUCT HIGH SCHOOL STUDENTS OVER 5 SATURDAY SESSIONS. THE YOUNG HEALTHCARE PROFESSIONALS PROGRAM WAS PILOTED AS A HYBRID PROGRAM DURING SUMMER 2021. IN 2022, 8 STUDENTS FROM CHAFFEY HIGH SCHOOL COMPLETED THE PROGRAM IN PERSON. ALL STUDENTS IN THE PROGRAM RECEIVED A MATERIALS BASKET WITH ITEMS NEEDED FOR EACH OF THE SESSIONS. SOME ITEMS CONTAINED IN THE MATERIALS BASKET INCLUDE; A STOCKPOT, MEASURING CUPS/SPOONS, A PERSONAL BLENDER, PLAY-DOH, AND MINDFULNESS CARDS. THE STUDENTS EXPLORED VARIOUS ALLIED HEALTHCARE CAREERS THROUGH MINI-PRESENTATIONS, RECORDED INTERVIEWS WITH HEALTH PROFESSIONALS FROM SAN ANTONIO REGIONAL HOSPITAL, AND ONLINE VIRTUAL LABS USING THE LABSTER PLATFORM. ALONGSIDE, THE STUDENTS HAD THE OPPORTUNITY TO EARN THEIR FOOD HANDLER'S CARD AND THE BASIC LIFE SUPPORT CERTIFICATION WITH KEY MEDICAL RESOURCES; BOTH ARE PROFESSIONAL CERTIFICATIONS THAT ENABLE THEM TO OBTAIN THEIR FIRST JOB AND/OR AN ENTRY-LEVEL POSITION IN THE HEALTHCARE FIELD. IN REGARD TO WELLNESS, STUDENTS RECEIVED COOKING SUPPLIES AND A $25 SPROUTS GIFT CARD FOR A COOKING ASSIGNMENT TO MAKE A NUTRITIOUS RECIPE. STUDENTS FURTHER EXPLORED WELLNESS WITH THE EIGHT DIMENSIONS OF WELLNESS SESSION THAT INTRODUCED THE VARIOUS TYPES OF WELLNESS. LASTLY, THE EMOTIONAL LIFE SKILLS TRAINING WHERE STUDENTS LEARNED EARLY IDENTIFICATION SIGNS FOR EMOTIONAL SUFFERING, WAYS TO IMPLEMENT SELF-CARE, AND TIPS TO DEVELOP A SUPPORTIVE COMMUNITY. OVERALL, THE YOUNG HEALTHCARE PROFESSIONALS PROGRAM WAS SUCCESSFUL AND WELL-RECEIVED BY STUDENTS AND PARTNER TEACHER AT CHAFFEY HIGH SCHOOL. HCI AND SELECT SCHOOL DISTRICTS COLLABORATED TO PROVIDE STUDENTS ENROLLED IN THE PEER COUNSELING CLASS SUPPLEMENTAL INFORMATION ON TOPICS RELATED TO SOCIAL EMOTIONAL LEARNING. STUDENTS IN THE POSITIVE MINDS, HEALTHY ACTIONS: SOCIAL EMOTIONAL TRAINING (PMHA) PROGRAM WILL RECEIVE ADDITIONAL KNOWLEDGE AND SKILLS NECESSARY TO ENHANCE THEIR CAPABILITIES AS PEER COUNSELORS. THE GOAL OF PMHA WAS TO PROMOTE AWARENESS AND INCREASE KNOWLEDGE ON TOPICS RELATED TO SOCIAL EMOTIONAL LEARNING AND TO PROVIDE STUDENTS WITH KNOWLEDGE AND SKILLS TO IMPROVE THEIR ROLES AS PEER COUNSELORS. IN THE FALL OF 2022, THIS PROGRAM WAS IMPLEMENTED FOR THE FIRST TIME. A TOTAL OF 69 STUDENTS FROM CHAFFEY, MONTCLAIR, AND ONTARIO HIGH SCHOOLS PARTICIPATED IN THE PROGRAM. SINCE 2016, HCI HAS OVERSEEN SARH'S COMMUNITY-BASED, NON-CLINICAL INTERNSHIP PROGRAM. UNDERGRADUATE, GRADUATE AND DOCTORAL STUDENTS FROM LOCAL UNIVERSITIES IN VARIOUS HEALTH DISCIPLINES, SUCH AS PUBLIC HEALTH, SOCIAL WORK, HEALTHCARE ADMINISTRATION, NUTRITION, AND BUSINESS ADMINISTRATION ARE BROUGHT TOGETHER TO COMPLETE THEIR FIELD EXPERIENCES ON-SITE AND IN THE COMMUNITY. STUDENTS ARE CONNECTE true San Antonio Hospital Foundation Inc 999 San Bernardino Road Upland CA 91786 330042666 501(C)(3) 250000 Program support Meals on Wheels Inland Valley Inc 4792 Falconview Court Fontana CA 92336 952799275 501(c)(3) 76626 Cost Meals provided Program support 2 Supplemental Information THE VOLUNTEERS OF SAN ANTONIO REGIONAL HOSPITAL (SARH) RAISE FUNDS TO SUPPORT THE HOSPITAL. THOSE FUNDS ARE DONATED ANNUALLY TO THE SAN ANTONIO HOSPITAL FOUNDATION (SAHF), A RELATED 501(C)(3) ORGANIZATION. SARH'S CFO IS ALSO CFO FOR SAHF; HE IS RESPONSIBLE FOR MONITORING ALL SAHF DISBURSEMENTS. Other Organizations are selected to receive cash and in-kind donations due to their commitment each offers to furthering population health. These organizations have demonstrated continuous dedication to serving residents in SARH's service area, with specific focus on the prevention of chronic disease, prevention of terminal disease and upstream approaches to health improvement. SARH has maintained ongoing, supportive relationships with each organization. X true true X X X X X false true false false false false false false false John Chapman President/CEO 582422 0 271190 0 114553 0 51324 0 36272 0 1055761 0 90055 0 Kamal Pandya VP/Chief Information Officer 320281 0 71981 0 37562 0 34711 0 25915 0 490450 0 34255 0 Debora Turner 11-112022 Chief Operating Officer 277958 0 68978 0 46434 0 56766 0 29139 0 479275 0 0 0 Sandra Wier Chief Human Resources Officer 306409 0 67906 0 7399 0 41675 0 31567 0 454956 0 0 0 Gurjeet Dhillon VP/Chief Nursing Officer 277308 0 46044 0 15613 0 39656 0 38905 0 417526 0 0 0 Maurice Jackson Surgical Technician 276877 0 0 0 7436 0 2784 0 4630 0 291727 0 0 0 Cathy Rebman 11-62022 VP Busin Dev & Comm Outreach 129813 0 64443 0 63738 0 12033 0 15784 0 285811 0 7070 0 Saurabh Ashier Manager Cardiovascular Service 247216 0 0 0 651 0 6345 0 12708 0 266920 0 0 0 Melissa Wood Director Finance 231956 0 5000 0 269 0 5585 0 705 0 243515 0 0 0 Schedule J, Part I, Line 1a SARH REQUESTS BOARD MEMBERS TO ATTEND VARIOUS EDUCATIONAL SESSIONS DURING THEIR TERM. IN RECOGNITION THAT BOARD MEMBERS SERVE WITHOUT COMPENSATION AND THAT ATTENDING EDUCATIONAL SESSIONS TAKES MOST BOARD MEMBERS AWAY FROM THEIR JOBS OR BUSINESSES, SARH PROVIDES REIMBURSEMENT FOR SPOUSAL TRAVEL. SARH ALSO GROSSES UP THE SPOUSAL TRAVEL REIMBURSEMENT AND REPORTS THE GROSSED UP AMOUNT ON A 1099 GIVEN TO THE BOARD MEMBER. Schedule J, Part I, Line 4 SARH PROVIDES A 457(F) SUPPLEMENTAL NON-QUALIFIED PLAN FOR ITS EXECUTIVE MANAGEMENT TEAM. IN CONJUNCTION WITH THE 457(B) PLAN, EACH EXECUTIVE ACCRUES 10% OF THEIR BASE PAY ANNUALLY. HOSPITAL CONTRIBUTIONS ARE NOT VESTED UNTIL DECEMBER 31 OF THE EXECUTIVE'S THIRD CALENDAR YEAR OF EMPLOYMENT. AFTER INITIAL ELIGIBILITY, EACH YEAR'S CONTRIBUTION WILL VEST ON DECEMBER 31 OF EACH CALENDAR YEAR. FOUR MEMBERS OF THE EXECUTIVE MANAGEMENT GROUP RECEIVED PAYMENTS AND THESE AMOUNTS ARE SHOWN ON SCH J, PART II. Schedule J, Part II EMPLOYEES HIRED PRIOR TO DECEMBER 31, 2005 ARE PARTICIPANTS IN THE HOSPITAL'S DEFINED BENEFIT PENSION PLAN. THE AMOUNT IN COLUMN C INCLUDES THE ESTIMATED INCREASE IN ACTUARIAL VALUE FOR THOSE EMPLOYEES WHO ARE PLAN PARTICIPANTS. A CITY OF UPLAND 956000805 915346GBO 2017-12-21 147137583 See attached statement false false false A 0 147137583 0 0 0 120410119 1727464 0 0 0 12347370 12652630 false true false true A false false false false 0 false false false false A false false false true false false 0 false 0 false false A false Part I CITY OF UPLAND 12/21/2017 $147,137,583 - THE PROCEEDS OF THE 2017 CERTIFICATES WILL BE APPLIED TO (A) REFINANCE A PORTION OF THE SERIES 2011 CERTIFICATES ISSUED 1/27/2011, (B) FINANCE, REFINANCE OR REIMBURSE A PORTION OF THE COSTS ASSOCIATED WITH THE SITE PREPARATION, CONSTRUCTION, FIT OUT, FURNISHING & EQUIPPING OF THE PROPOSED CITY OF HOPE BUILDING, (C) FINANCE, REFINANCING OR REIMBURSE A PORTION OF THE COSTS ASSOCIATED WITH THE CONSTRUCTION, RENOVATION, IMPROVEMENT, EQUIPPING AND FURNISHING OF OTHER OF THE HEALTH FACILITIES AS CONTEMPLATED IN THE FACILITIES MASTER PLAN, (D) FINANCE, REFINANCE OR REIMBURSE CERTAIN ROUTINE CAPITAL EXPENDITURES OF SARH AND (E) TO FINANCE THE COSTS OF DELIVERY ASSOCIATED WITH THE CERTIFICATES. Part V San Antonio Regional Hospital is in the process of developing post-issuance procedures. Part IV SAN ANTONIO REGIONAL HOSPITAL HAD AN INTERIM ARBITRAGE ANALYSIS PERFORMED FOR THE COMPUTATION PERIOD ENDED DECEMBER 31, 2022. Part VI, Section B, Line 11b THE FORM IS PREPARED BY THE FINANCE DEPARTMENT AND REVIEWED BY THE CFO AND EXTERNAL TAX ACCOUNTANTS. FOLLOWING THE EXTERNAL REVIEW, THE CFO REVIEWS THE FORM WITH THE CEO. THE FORM IS PROVIDED AND PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW AND APPROVAL. ONCE THE AUDIT COMMITTEE APPROVES THE FORM, A DRAFT IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. Part VI, Section B, Line 12C SARH HAS A COMPLIANCE OFFICER WHO REVIEWS THE ORGANIZATION'S COMPLIANCE POLICIES, INCLUDING ITS CONFLICT OF INTEREST STATEMENTS, AT LEAST ANNUALLY. EACH JANUARY, A CONFLICT OF INTEREST STATEMENT IS COMPLETED AND SIGNED BY EACH MEMBER OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. THE COMPLIANCE OFFICER AND CFO, WHO ATTEND ALL BOARD MEETINGS, REVIEW THE CONFLICT OF INTEREST STATEMENTS. IF A NEW POTENTIAL CONFLICT ARISES DURING THE YEAR, A NEW CONFLICT OF INTEREST STATEMENT IS SIGNED. IF A POTENTIAL CONFLICT OF INTEREST EXISTS DURING A BOARD DISCUSSION, THE BOARD MEMBER IS REQUIRED TO STATE THE CONFLICT AND ABSTAIN FROM ANY RELATED BOARD VOTE. BOARD MINUTES REFLECT THESE ABSTENTIONS. AT LEAST SEMI-ANNUALLY, SARH'S COMPLIANCE OFFICER PROVIDES A VERBAL COMPLIANCE UPDATE AT A BOARD MEETING AND REMINDS BOARD MEMBERS OF THEIR DUTY TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. Part VI, Section B, Line 15 SARH'S EXECUTIVE COMPENSATION PROGRAM IS DIRECTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. SARH HAS DEVELOPED AND APPROVED A FORMAL EXECUTIVE COMPENSATION POLICY THAT CURRENTLY COVERS EIGHT SENIOR MANAGEMENT EMPLOYEES, INCLUDING THE CEO AND CFO. A COMPREHENSIVE BASE PAY AND TOTAL EXECUTIVE COMPENSATION ANALYSIS IS PERFORMED BY AN OUTSIDE COMPENSATION CONSULTING FIRM EVERY TWO YEARS. IN THE INTERVENING YEARS, AN ANALYSIS OF SARH'S EXECUTIVE COMPENSATION IS REVIEWED AGAINST THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA'S COMPENSATION SURVEY. THE CONSULTANT PRESENTS THE SURVEY DATA AND ANALYSIS TO THE COMPENSATION COMMITTEE. THE EXTERNAL COMPENSATION STUDY INCLUDES AN EVALUATION FOR EXCESS BENEFIT TRANSACTIONS UNDER THE INTERMEDIATE SANCTIONS FOR TAX-EXEMPT ORGANIZATIONS AND AN ANALYSIS OF BOTH BASE AND TOTAL COMPENSATION OF ALL MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AND THEIR SALARY POSITION IN RELATION TO THE FIFTIETH AND SIXTY-FIFTH PERCENTILE OF THE MARKET. HOWEVER, THE CONSULTANT IS NOT EITHER TAX OR LEGAL COUNSEL AND THEREFORE CANNOT ASSURE COMPLIANCE WITH IRC 4958, BUT RATHER ASSURES THAT SARH'S EXECUTIVE COMPENSATION PRACTICES FALL BETWEEN THE FIFTIETH AND SIXTY-FIFTH PERCENTILE OF THE MARKET PLACE AND DO NOT EXCEED THE SEVENTY-FIFTH PERCENTILE. THE LATEST SURVEY AND ANALYSIS WERE CONDUCTED IN APRIL 2023. THE CONSULTANT USED SURVEY DATA FROM FOUR DIFFERENT PUBLISHED SURVEYS THAT INCLUDE CALIFORNIA HOSPITALS WITH COMPARABLE REVENUES, EMPLOYEES AND COMPLEXITY. THE COMPENSATION COMMITTEE REVIEWS THE CONSULTANT'S FINDINGS IN ACCORDANCE WITH THE COMPENSATION POLICY AND THEIR CHARTER AND PROVIDES DIRECTION FOR ANY NEEDED COMPENSATION POLICY OR PAY RANGE CHANGES FOR THE CEO AND APPROVES ANY SUCH RECOMMENDATIONS THAT MAY BE MADE BY THE CEO FOR OTHER EXECUTIVES. OTHER KEY EMPLOYEE COMPENSATION, VICE PRESIDENTS AND DEPARTMENT DIRECTORS ARE EVALUATED BASED ON MARKET-BASED COMPENSATION SURVEY DATA PROVIDED BY THE HOSPITA COUNCIL OF SOUTHERN CALIFORNIA, TAKING INTO CONSIDERATION PAY RATES FOR SIMILAR MANAGEMENT POSITIONS. THE LATEST SURVEY AND ANALYSIS WERE CONDUCTED IN APRIL 2023. THE PROCEDURES DESCRIBED HERE ARE DOCUMENTED IN THE BOARD MINUTES. Part VI, Section C, Line 19 SARH HAS NOT MADE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE PART OF THE ANNUAL REPORT FILED WITH THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) AND ARE AVAILABLE ON THE OSHPD WEBSITE. THE FINANCIAL STATEMENTS ARE INCLUDED AS PART OF ITS ANNUAL MEDICARE AND MEDICAID COST REPORT FILINGS, WHICH ARE PUBLICLY AVAILABLE ON THE CMS (MEDICARE) WEBSITE. THE FINANCIAL STATEMENTS ARE ALSO PROVIDED TO ANYONE UPON A VERBAL OR WRITTEN REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 IN ACCORDANCE WITH IRS INSTRUCTIONS. Part XI, Line 9 OTHER CHANGES IN NET ASSETS INCLUDES THE CHANGE IN THE ADDITIONAL MINIMUM PENSION LIABILITY OF $3,962,087, CHANGE IN NET ASSETS WITH DONOR RESTRICTIONS OF -$1,516,964 AND CHANGE IN BENEFICIAL INTEREST IN SAN ANTONIO HOSPITAL FOUNDATION OF -$3,903,712. FORM 990 PART IX LINE 11G DESCRIPTION:PRO FEES OTHER TOTAL FEES:26923989 FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY LABOR TOTAL FEES:18853173 Eastvale San Antonio Land Company LLC 999 San Bernardino Road Upland CA 91786 460783265 Lessor - Land CA 82358 490258 SARH San Antonio Hospital Foundation Inc 999 San Bernardino Road Upland CA 91786 330042666 Support SARH CA 501c(3) 7 SARH true San Antonio Community Health Care Plan 999 San Bernardino Road Upland CA 91786 237391094 Health Plan CA 501(C)(9) SARH true Cucamonga Health Services Inc 999 San Bernardino Road Upland CA 91786 330010073 Holding Company CA SARH C corp 1358799 13804548 1.00000 true FMP Holding Inc 999 San Bernardino Road Upland CA 91786 815066476 Holding Company CA SARH C Corp 90432 1765603 1.00000 true SAR Medical Group 999 San Bernardino Road Upland CA 91786 863578927 Holding Company CA SARH C Corp 0 385243 1.00000 true false false true false false false false false false true false false false true false false true true true San Antonio Community Health Care Plan r 15743285 Cash San Antonio Hospital Foundation Inc c 2331863 Cash San Antonio Hospital Foundation Inc q 1000902 Cash Cucamonga Health Services Inc j 117057 cash