HENRY MAYO NEWHALL MEMORIAL HOSPITAL: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HENRY MAYO NEWHALL MEMORIAL HOSPITAL (EIN 95-2821104)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-08
- IRS object ID
- 202202209349300605
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-08T06:40:09-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S 6TH ST 2300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952821104 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY MAYO NEWHALL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HENR | BusinessNameControlTxt |
| Phone | 6612002000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 23845 MCBEAN PARKWAY | AddressLine1Txt |
| City | VALENCIA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TED D SIROTTA | PersonNm |
| Person Title | SENIOR VP/CFO | PersonTitleTxt |
| Phone | 6612002000 | PhoneNum |
| Signature | 2022-08-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TED | PersonFirstNm |
| Person Last | SIROTTA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAWRENCE H MOHR CPA | PreparerPersonNm |
| PTIN | P00447603 | PTIN |
| Phone | 6128764500 | PhoneNum |
| Preparation | 2022-08-03 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROGER E SEAVER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 23845 MCBEAN PARKWAY | AddressLine1Txt |
| City | VALENCIA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $442,063,868 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HENRYMAYO.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | BE THE TRUSTED REGIONAL LEADER TO INSPIRE AND DELIVER OPTIMAL HEALTH AND WELLNESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 2149 | TotalEmployeeCnt |
| Total Volunteers | 151 | TotalVolunteersCnt |
| Total Gross UBI | $308,303 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,016,098 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,775,437 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $359,809,714 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $405,891,441 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,800,082 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,644,069 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,376,443 | PYOtherRevenueAmt |
| CY Other Revenue | $4,415,795 | CYOtherRevenueAmt |
| PY Total Revenue | $382,002,337 | PYTotalRevenueAmt |
| CY Total Revenue | $419,726,742 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,234,300 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,193,451 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $157,621,849 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $163,819,648 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $217,975,009 | PYOtherExpensesAmt |
| CY Other Expenses | $238,027,282 | CYOtherExpensesAmt |
| PY Total Expenses | $380,831,158 | PYTotalExpensesAmt |
| CY Total Expenses | $408,040,381 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,171,179 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,686,361 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $558,511,458 | TotalAssetsBOYAmt |
| Total Assets EOY | $625,737,572 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $351,466,463 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $406,757,573 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $207,044,995 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $218,979,999 | NetAssetsOrFundBalancesEOYAmt |
| Mission | BE THE TRUSTED REGIONAL LEADER TO INSPIRE AND DELIVER OPTIMAL HEALTH AND WELLNESS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $369,020,611 | ExpenseAmt |
| Grant | $5,551,691 | GrantAmt |
| Revenue | $407,056,341 | RevenueAmt |
| Desc | TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF SANTA CLARITA VALLEY AND SURROUNDING AREAS. THE HOSPITAL HAD 59,042 PATIENT DAYS DURING THE YEAR. WE ALSO PROVIDED SERVICES FOR 57,472 EMERGENCY VISITS. 78% OF TOTAL HOSPITAL INPATIENT ADMITS (EXCLUDING NEWBORNS) ARE ADMITTED THROUGH THE EMERGENCY ROOM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $641,760 | ExpenseAmt |
| Grant | $641,760 | GrantAmt |
| Desc | TO SUPPORT GENERAL OPERATIONS OF HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION, AN AFFILIATE TO THE HOSPITAL. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $369,662,371 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 249 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2149 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICHARD KIM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6612002000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 23845 MCBEAN PARKWAY | AddressLine1Txt |
| City | VALENCIA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ROGER E SEAVER | ||||||||||
| PRESIDENT/CEO | 40.00 | 0.50 | Yes (X) | Yes (X) | $827,852 | $0 | $76,966 | |||
| KINGMAN HO MD | ||||||||||
| CHIEF MEDICAL OFFICER (THROUGH 01/2021) | 40.00 | Yes (X) | $587,440 | $0 | $57,283 | |||||
| TED D SIROTTA | ||||||||||
| SR VP/CFO | 40.00 | Yes (X) | $445,451 | $0 | $61,804 | |||||
| LARRY R KIDD | ||||||||||
| SR VP/CCO | 40.00 | Yes (X) | $451,750 | $0 | $45,922 | |||||
| RAY B MOSS | ||||||||||
| VP/CIO | 40.00 | $321,405 | $0 | $57,705 | Yes (X) | |||||
| MARK A PULEO | ||||||||||
| VP/CHRO | 40.00 | $286,058 | $0 | $62,674 | Yes (X) | |||||
| JONATHAN S MILLER | ||||||||||
| VP-FACILTY/SUPPORT (THROUGH 05/2020) | 40.00 | $311,611 | $0 | $14,851 | Yes (X) | |||||
| MARIA SARTE | ||||||||||
| CLINCAL RN | 40.00 | $230,372 | $0 | $11,519 | Yes (X) | |||||
| CARISSA BORTUGNO | ||||||||||
| DIRECTOR PHARMACY | 40.00 | $193,972 | $0 | $36,528 | Yes (X) | |||||
| LISA BARRETT | ||||||||||
| CLINCAL RN | 40.00 | $195,458 | $0 | $21,307 | Yes (X) | |||||
| KIMBERLY CLARK | ||||||||||
| CLINCAL RN | 40.00 | $191,205 | $0 | $23,983 | Yes (X) | |||||
| JOSEPHINE KAPLAN | ||||||||||
| DIRECTOR CASE MANAGEMENT | 40.00 | $191,142 | $0 | $16,402 | Yes (X) | |||||
| JENNIFER R CASTALDO | ||||||||||
| VP/CNO (THROUGH 05/2020) | 40.00 | $177,603 | $0 | $16,315 | Yes (X) | |||||
| JOHN BARSTIS MD | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| ROBERT BENJAMIN | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| MARK CHAMBERLAIN | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| LAKHBINDER DHANDA MD | ||||||||||
| TRUSTEE | 3.60 | Yes (X) | $0 | $0 | $0 | |||||
| DALE R DONOHOE | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| SONYA ENGLE | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| JUDY FISH | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| CHERI FLEMING | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| RUSSELL HANLIN | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| DONALD KIMBALL | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| CHRIS LUECHTEFELD | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| ROSCOE MARTER MD | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| DON NISHIGUCHI MD | ||||||||||
| TRUSTEE | 9.00 | Yes (X) | $0 | $0 | $0 | |||||
| HOLLY SCHROEDER | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| TODD STEVENS | ||||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,411,319 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $503,259 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 462 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SODEXO INC & AFFILIATES | |||||
| 9801 WASHINGTON BLVD | GAITHERSBURG | MD | 20878 | OTHER PURCHASED SERVICES | $12,422,537 |
| INTERSTATE REHABILITATION LLC | |||||
| 333 E GLENOAKS BLVD SUITE 204 | GLENDALE | CA | 61207 | MEDICAL PURCHASED SERVICES | $6,764,732 |
| FACEY MEDICAL FOUNDATION | |||||
| 15451 SAN FERNANDO MISSION BLVD S | MISSION HILLS | CA | 91345 | PROFESSIONAL SERVICES | $3,894,567 |
| MEDEFIS INC | |||||
| 12400 HIGH BLUFF DRIVE SUITE 100 | SAN DIEGO | CA | 92130 | PROFESSIONAL SERVICES | $2,693,417 |
| SCCT MEDICAL GROUP | |||||
| 11333 N SEPULVEDA BLVD | MISSION HILLS | CA | 91345 | PROFESSIONAL SERVICES | $2,148,850 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 228 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $844,707 | RelatedOrganizationsAmt |
| Government Grants | $4,930,730 | GovernmentGrantsAmt |
| Total Contributions | $5,775,437 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTHCARE SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $405,891,441 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $405,891,441 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $405,891,441 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,545,724 | TotalRevenueColumnAmt |
| Exclusion | $2,545,724 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $455 | TotalRevenueColumnAmt |
| Exclusion | $455 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $973,992 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $650,170 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $323,822 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $323,822 | TotalRevenueColumnAmt |
| Exclusion | $323,822 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $22,784,846 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $21,651,108 | SecuritiesAmt |
| Other | $35,848 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,133,738 | SecuritiesAmt |
| Other | -$35,848 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,097,890 | TotalRevenueColumnAmt |
| Exclusion | $1,097,890 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| FITNESS CENTER REVENUE | 621110 | $687,764 | $687,764 | |
| INCOME FROM CARE NETWO | 621110 | $477,136 | $477,136 | |
| SUPPORT SERVICES | 621110 | $308,303 | $308,303 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,618,770 | TotalRevenueColumnAmt |
| Exclusion | $2,618,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,091,973 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $419,726,742 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $407,056,341 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $308,303 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,586,661 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $854,494 | TotalAmt |
| Program Services | $854,494 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,338,957 | TotalAmt |
| Program Services | $5,338,957 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,087,985 | TotalAmt |
| Program Services | $2,721,814 | ProgramServicesAmt |
| Management And General | $366,171 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,537,271 | TotalAmt |
| Program Services | $106,188,404 | ProgramServicesAmt |
| Management And General | $12,348,867 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,240,744 | TotalAmt |
| Program Services | $3,797,405 | ProgramServicesAmt |
| Management And General | $443,339 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,019,569 | TotalAmt |
| Program Services | $24,742,557 | ProgramServicesAmt |
| Management And General | $3,277,012 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,934,079 | TotalAmt |
| Program Services | $9,057,861 | ProgramServicesAmt |
| Management And General | $876,218 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,771,238 | TotalAmt |
| Program Services | $8,957 | ProgramServicesAmt |
| Management And General | $1,762,281 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $356,476 | TotalAmt |
| Management And General | $356,476 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,457 | TotalAmt |
| Management And General | $16,457 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,518 | TotalAmt |
| Management And General | $147,518 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,748,280 | TotalAmt |
| Program Services | $53,964,992 | ProgramServicesAmt |
| Management And General | $6,783,288 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,404 | TotalAmt |
| Program Services | $3,847 | ProgramServicesAmt |
| Management And General | $117,557 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,301,525 | TotalAmt |
| Program Services | $2,201,639 | ProgramServicesAmt |
| Management And General | $99,886 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,303,427 | TotalAmt |
| Program Services | $6,600,867 | ProgramServicesAmt |
| Management And General | $702,560 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,967,033 | TotalAmt |
| Program Services | $4,307,653 | ProgramServicesAmt |
| Management And General | $4,659,380 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,077 | TotalAmt |
| Program Services | $79,358 | ProgramServicesAmt |
| Management And General | $8,719 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,312 | TotalAmt |
| Program Services | $41,954 | ProgramServicesAmt |
| Management And General | $11,358 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,917,157 | TotalAmt |
| Program Services | $7,679,251 | ProgramServicesAmt |
| Management And General | $2,237,906 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,838,302 | TotalAmt |
| Program Services | $22,838,302 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,873,566 | TotalAmt |
| Program Services | $1,873,566 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $57,186,710 | $56,712,401 | $474,309 |
| BAD DEBT | $34,461,458 | $34,461,458 | |
| QUALITY ASSURANCE FEES | $21,909,386 | $21,909,386 | |
| REPAIR & MAINTENANCE | $2,139,192 | $1,905,917 | $233,275 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,826,764 | TotalAmt |
| Program Services | $2,371,331 | ProgramServicesAmt |
| Management And General | $3,455,433 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,040,381 | TotalAmt |
| Program Services | $369,662,371 | ProgramServicesAmt |
| Management And General | $38,378,010 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,625,820 | BOYAmt |
| EOY | $66,762,900 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,467,277 | BOYAmt |
| EOY | $21,269,535 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,774,860 | BOYAmt |
| EOY | $54,237,213 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,768,080 | BOYAmt |
| EOY | $7,557,468 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,007,320 | BOYAmt |
| EOY | $5,797,981 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $513,271,844 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $233,870,215 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,294,775 | BOYAmt |
| EOY | $279,401,629 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,642,756 | BOYAmt |
| EOY | $103,089,886 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,638,005 | BOYAmt |
| EOY | $3,658,870 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,292,565 | BOYAmt |
| EOY | $83,962,090 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,511,458 | BOYAmt |
| EOY | $625,737,572 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,404,769 | BOYAmt |
| EOY | $81,546,657 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,530,229 | BOYAmt |
| EOY | $3,666,047 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $215,959,112 | BOYAmt |
| EOY | $232,857,418 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,479,084 | BOYAmt |
| EOY | $6,720,053 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,093,269 | BOYAmt |
| EOY | $81,967,398 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $351,466,463 | BOYAmt |
| EOY | $406,757,573 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $199,290,075 | BOYAmt |
| EOY | $209,927,480 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,754,920 | BOYAmt |
| EOY | $9,052,519 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,044,995 | BOYAmt |
| EOY | $218,979,999 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,511,458 | BOYAmt |
| EOY | $625,737,572 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $11,686,361 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $10,679,303 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$10,430,660 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $16,754 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $16,754 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FOR THE FISCAL YEAR ENDED 9/30/21, THE ORGANIZATION PARTICIPATED WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO ADVOCATE POSITIVE HEALTHCARE POLICIES FOR HOSPITALS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,302,340 | OtherCostOrOtherBasisAmt |
| Book Value | $6,302,340 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $369,800,100 | OtherCostOrOtherBasisAmt |
| Depreciation | $130,550,665 | DepreciationAmt |
| Book Value | $239,249,435 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,983,115 | OtherCostOrOtherBasisAmt |
| Depreciation | $103,319,550 | DepreciationAmt |
| Book Value | $26,663,565 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,186,289 | OtherCostOrOtherBasisAmt |
| Book Value | $7,186,289 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $279,401,629 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RECEIVABLE FROM HENRY MAYO NEWHALL FOUNDATION | $9,222,358 |
| RECEIVABLE FROM HENRY MAYO MSO | $612,317 |
| PLEDGED LEASE | $2,213,789 |
| OTHER RECEIVABLES | $20,528,108 |
| RECEIVABLE FOR HENRY MAYO CIN | $61,004 |
| OTHER CURRENT ASSETS | $29,640 |
| RIGHT-OF-USE ASSET | $51,294,874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $83,962,090 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY LIABILITIES | $5,977,924 |
| ADVANCE PAYMENTS | $20,585,559 |
| PAYABLE TO AFFILIATE | $223,629 |
| OTHER LIABILITIES | $8,087,023 |
| LEASE OBLIGATIONS | $47,093,263 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $81,967,398 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $380,869,571 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $10,679,303 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $44,431 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$50,231,075 | OtherRevenueAmt |
| Revenue Not Reported | -$39,507,341 | RevenueNotReportedAmt |
| Revenue Subtotal | $420,376,912 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$650,170 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$650,170 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $419,726,742 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $368,934,567 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $44,431 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $650,170 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $694,601 | ExpensesNotReportedAmt |
| Expenses Subtotal | $368,239,966 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $39,800,415 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $39,800,415 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $408,040,381 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION IS EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE ("IRC") AND A SIMILAR PROVISION OF STATE LAW. ACCORDINGLY, NO PROVISION FOR INCOME TAXES FOR THIS ENTITY HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2021 AND 2020. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -34,461,458. CHARITY CARE (GROSS CHARGES) -5,338,957. NET ASSET TRANSFER FROM HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION 1,720,497. LOSS ON BOND DEFEASANCE -12,151,157. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -650,170. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 650,170. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 34,461,458. CHARITY CARE (GROSS CHARGES) 5,338,957. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,345,701 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,345,701 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,594,771 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,302,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,292,768 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03750 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,940,472 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,302,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,638,469 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04080 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $765,114 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $765,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,662,852 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,662,852 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $703,351 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $703,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,131,317 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,131,317 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,071,789 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,302,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,769,786 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $34,461,457 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $58,860,202 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $76,604,617 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$17,744,415 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 TOWER IMAGING VALENCIA | |||
| OUTPATIENT RADIOLOGY SERVICE | 0.50000 | 0.00000 | 0.50000 |
| 2 HENRY MAYO NEWHALL URGENT CARE CLINICS LLC | |||
| URGENT CARE OPERATION | 0.51000 | 0.49000 | |
| 3 KECK MEDICINE OF USC AND HENRY MAYO NEWHALL MEMORIAL HOSPITAL LLC | |||
| CANCER SERVICE LINE | 0.50000 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY MAYO NEWHALL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 23845 MCBEAN PKWY | AddressLine1Txt |
| City | VALENCIA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.HENRYMAYO.COM | WebsiteAddressTxt |
| State License | 930000206 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | TRAUMA CENTER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY MAYO NEWHALL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.HENRYMAYO.COM/COMMUNITY/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HENRY MAYO NEWHALL MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: HENRY MAYO NEWHALL HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN TAX YEAR 2018 (FISCAL YEAR 2019) AS REQUIRED BY STATE AND FEDERAL LAW. THE ASSESSMENT INCORPORATED COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUSED ON THE HEALTH AND SOCIAL NEEDS OF THE SERVICE AREA. THE CHNA EXAMINED UP-TO-DATE DATA SOURCES FOR THE SERVICE AREA TO PRESENT COMMUNITY DEMOGRAPHICS, SOCIAL DETERMINANTS OF HEALTH, HEALTH CARE ACCESS, MATERNAL AND INFANT HEALTH, LEADING CAUSES OF DEATH, DISABILITY AND DISEASE, HEALTH BEHAVIORS, MENTAL HEALTH, SUBSTANCE USE AND MISUSE, AND PREVENTIVE PRACTICES. WHEN APPLICABLE, THESE DATA SETS WERE PRESENTED IN THE CONTEXT OF CALIFORNIA AND COMPARED TO THE HEALTHY PEOPLE 2021 OBJECTIVES. TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. TWENTY-ONE (21) INTERVIEWS WERE COMPLETED IN JUNE 2019. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND/OR REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. INPUT WAS OBTAINED FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. |
| HENRY MAYO NEWHALL MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: ACCESS TO HEALTH CARE, CANCER, DIABETES, HEART DISEASE AND MENTAL HEALTH WERE RANKED AS THE TOP FIVE PRIORITY NEEDS IN THE SERVICE AREA. THE CALCULATIONS OF THE COMMUNITY INPUT RESULTED IN THE FOLLOWING PRIORITY ORDERING OF THE SIGNIFICANT HEALTH NEEDS:1. ACCESS TO HEALTH CARE2. CANCER3. DIABETES4. HEART DISEASE5. MENTAL HEALTH6. SUBSTANCE USE AND MISUSE7. PREMATURE BIRTHS8. ALZHEIMER'S DISEASE9. PREVENTIVE PRACTICES (SCREENINGS AND IMMUNIZATIONS)10. OVERWEIGHT AND OBESITY11. HOUSING AND HOMELESSNESS12. ASTHMA13. LIVER DISEASEFOR SPECIFIC PLAN AND OTHER NEEDS NOT ADDRESSED, PLEASE REFER TO THE ATTACHED COMMUNITY BENEFIT REPORT, PAGES 8-10. |
| SCHEDULE H, PART V, LINE 7A CHNA REPORT DIRECT LINK: | HTTPS://WWW.HENRYMAYO.COM/APP/FILES/PUBLIC/EA9348AC-AE05-48BD-ADA8-7218E89F6B2A/COMMUNITY%20BENEFIT/HENRY-MAYO-2019-CHNA-1.PDF |
| SCHEDULE H, PART V, LINE 16A FINANCIAL ASSISTANCE POLICY (FAP): | HTTPS://WWW.HENRYMAYO.COM/APP/FILES/PUBLIC/5627EA95-5D2E-4289-8708-D8D58C1BABC4/FINANCIAL%20ASSISSTANCE%20PROGRAM.PDF |
| SCHEDULE H, PART V, LINE 16B FAP APPLICATION FORM: | HTTPS://WWW.HENRYMAYO.COM/APP/FILES/PUBLIC/D851BA5C-3632-4C9C-85ED-058F2A7AA327/V2-FAP%20APPLICATION%202022.PDF |
| SCHEDULE H, PART V, LINE 16C FAP PLAIN LANGUAGE SUMMARY: | HTTPS://WWW.HENRYMAYO.COM/APP/FILES/PUBLIC/0995F2AD-7A89-48F2-8F45-C5B237B3C5C2/MR242D-%20FINAL%20COPY.PDF |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | INDIVIDUAL OR HOUSEHOLD UNIT INCOME - UP TO 350% OF THE FPL. EMPLOYMENT STATUS SHALL BE CONSIDERED WHEN DETERMINING INCOME LEVELS. PRIOR INCOME LEVELS MAY NOT MEET THE ESTABLISHED POVERTY LEVEL GUIDELINES; HOWEVER, RECENT UNEMPLOYMENT SHOULD BE CONSIDERED AS THE CURRENT SOURCE OF INCOME. INDIVIDUAL OR HOUSEHOLD UNIT NET WORTH - UP TO $250,000 (EXCLUDING NET WORTH IN PRIMARY HOMES OF UP TO $500,000 AND RETIREMENT OR DEFERRED COMPENSATION PLANS). WHEN REVIEWING NET WORTH, OTHER FINANCIAL OBLIGATIONS SUCH AS HIGH MEDICAL BILLS SHOULD BE CONSIDERED. PATIENTS WITH HIGH NET WORTH THAT WOULD OTHERWISE DISQUALIFY THEM FOR FINANCIAL ASSISTANCE MAY BE CONSIDERED FOR ELIGIBILITY IF THEY HAVE, FOR EXAMPLE, UNINSURED CATASTROPHIC HEALTH CARE COSTS THAT WOULD SIGNIFICANTLY REDUCE THEIR NET WORTH. HIGH MEDICAL COSTS SHALL MEAN:1. ANNUAL OUT-OF-POCKET COSTS INCURRED BY A PATIENT AT HMNH THAT EXCEED 10% OF THE PATIENT'S FAMILY INCOME IN THE PRIOR 12 MONTHS;2. ANNUAL OUT-OF-POCKET MEDICAL EXPENSES THAT EXCEED 10% OF THE PATIENT'S FAMILY INCOME, 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;SELF-PAY PATIENTS ADMITTED THROUGH THE EMERGENCY DEPARTMENT, PER EMTALA GUIDELINES,WITH INSUFFICIENT INFORMATION PROVIDED BY THE PATIENT TO FULLY EVALUATE ELIGIBILITY TESTS, AND THE ABILITY TO PAY WHICH CANNOT BE RELIABLY DETERMINED, WILL BE CLASSIFIED AS CHARITY. IF INFORMATION BECOMES AVAILABLE LATER THAT WOULD DISQUALIFY THE PATIENT FROM MEETING THE FINANCIAL ASSISTANCE CRITERIA, THEN THE PATIENT ACCOUNT WILL BE RECLASSIFIED TO THE APPROPRIATE PAYER CLASS.PATIENTS WHO QUALIFY FOR MEDI-CAL, BUT WHERE HMNH DOES NOT RECEIVE PAYMENT FOR THEIR ENTIRE STAY ARE ELIGIBLE FOR CHARITY CARE FOR DENIED STAYS, DENIED DAYS OF CARE, AND NONCOVERED SERVICES. THESE DENIALS AND ANY LACK OF PAYMENT FOR NON-COVERED SERVICES PROVIDED TO MEDI-CAL PATIENTS ARE TO BE CLASSIFIED AS CHARITY. THESE PATIENTS ARE RECEIVING THE SERVICE, AND THEY DO NOT HAVE THE ABILITY TO PAY FOR IT. IN ADDITION, MEDICARE PATIENTS WHO HAVE MEDI-CAL COVERAGE FOR THEIR CO-INSURANCE/DEDUCTIBLES, FOR WHICH MEDI-CAL DOES NOT MAKE PAYMENT, AND MEDICARE DOES NOT ULTIMATELY PROVIDE BAD DEBT REIMBURSEMENT WILL ALSO BE INCLUDED AS CHARITY. THESE PATIENTS ARE RECEIVING A SERVICE FOR WHICH A PORTION OF THE RESULTING BILL IS NOT BEING REIMBURSED.TRAUMA SERVICES RENDERED TO PATIENT MEDICAL CONDITIONS MEETING THE DEFINITION OF BILLABLE TRAUMA CARE, PER OUR TRAUMA CARE AGREEMENTS WITH THE LOS ANGELES COUNTY AND THE STATE OF CALIFORNIA, WILL BE CLASSIFIED AS CHARITY CARE. THESE PATIENTS WILL NOT BE BILLED FOR THEIR SERVICES.HMNH DEEMS PATIENTS WHO ARE ELIGIBLE FOR GOVERNMENT SPONSORED, LOW-INCOME ASSISTANCE PROGRAMS (I.E., MEDI-CAL, OUT OF STATE MEDICAID, CALIFORNIA CHILDREN'S SERVICES AND ANY OTHER APPLICABLE FEDERAL, STATE OR LOCAL LOW-INCOME PROGRAM) TO BE INDIGENT. THEREFORE, SUCH PATIENTS MAY BE CONSIDERED AS ELIGIBLE PRESUMPTIVELY UNDER THE FAP WHEN PAYMENT IS NOT MADE BY THE GOVERNMENTAL PROGRAM. RATIONALE FOR SUCH PRESUMPTIVE DETERMINATION SHALL BE DOCUMENTED IN THE PATIENT ACCOUNT. |
| PART III, LINE 2: | THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CARRYING AMOUNT OF PATIENT ACCOUNTS RECEIVABLE IS REDUCED BY BAD DEBT ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. |
| PART III, LINE 4: | FROM PAGE 17 OF THE AUDITED FINANCIAL STATEMENTS, ATTACHED:GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED OR UNDERINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGES, BY ANY CONTRACTUAL ADJUSTMENT, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENT TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. CONSISTENT WITH THE HOSPITAL'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE HOSPITAL HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND OTHER PATIENT BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE HOSPITAL EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. |
| PART III, LINE 8: | 100% INCLUDED IN THE COMMUNITY BENEFIT PACKAGE. COST METHODOLOGY IS COST ACCOUNTING SYSTEM. |
| PART VI, LINE 2: | HENRY MAYO COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN TAX YEAR 2018 (FISCAL YEAR 2019), AS REQUIRED BY STATE AND FEDERAL LAW. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS A PRIMARY TOOL USED BY HENRY MAYO TO DETERMINE ITS COMMUNITY BENEFIT PLAN, WHICH OUTLINES HOW IT WILL GIVE BACK TO THE COMMUNITY, IN THE FORM OF HEALTH CARE AND OTHER COMMUNITY SERVICES, TO ADDRESS UNMET COMMUNITY NEEDS. THE ASSESSMENT INCORPORATED COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUS ON THE HEALTH AND SOCIAL NEEDS OF THE SERVICE AREA. |
| PART VI, LINE 3: | PAGE 9- 11 OF THE COMMUNITY BENEFIT PACKAGE WHICH IS ATTACHED. |
| PART VI, LINE 4: | PAGE 4 - 6 OF THE COMMUNITY BENEFIT PACKAGE WHICH IS ATTACHED. |
| PART VI, LINE 5: | PAGE 9-17 OF THE COMMUNITY BENEFIT PACKAGE WHICH IS ATTACHED. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION | ||||||||
| 23845 MCBEAN PKWY | VALENCIA | CA | 91355 | 953849903 | 501(C)(3) | $641,760 | TO SUPPORT GENERAL OPERATIONS OF THE FOUNDATION, AN AFFILIATE OF THE HOSPITAL. | |
| WILLIAM S HART UNION HIGH SCHOOL DISTRICT | ||||||||
| 21380 CENTRE POINTE PARKWAY | SANTA CLARITA | CA | 91350 | 611454418 | 501(C)(3) | $154,778 | TO PROVIDE ATHLETIC TRAINERS AT HIGH SCHOOLS IN THE COMMUNITY TO HELP REDUCE INJURIES AND KEEP STUDENT ATHLETES SAFE | |
| SANTA CLARITA VALLEY ECONOMIC | ||||||||
| 26455 ROCKWELL CANYON ROAD | VALENCIA | CA | 91355 | 954133918 | 501(C)(3) | $26,800 | TO SUPPORT LOCAL ECONOMIC DEVELOPMENT | UNIVERSITY CENTER 263 |
| ID ME PROMOTIONS | ||||||||
| 18401 BURBANK BLVD SUITE 116 | TARZANA | CA | 91356 | 470941148 | 501(C)(3) | $13,390 | TO SUPPORT COMMUNITY HEALTH EDUCATION | |
| UNITED STATES POSTAL SERVICE | ||||||||
| 28201 FRANKLIN PARKWAY | SANTA CLARITA | CA | 91383 | 410760000 | GOVERNMENT | $10,265 | TO PROVIDE COMMUNITY HEALTH EDUCATION THROUGH YOUR HEALTH MAGAZINE 2021 | |
| AMERICAN CANCER SOCIETY | ||||||||
| 25020 W AVENUE STANFORD SUITE170 | VALENCIA | CA | 91355 | 131788491 | 501(C)(3) | $7,500 | COMMUNITY CANCER EDUCATION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CHARITY CARE (GROSS CHARGES) - HENRY MAYO NEWHALL HOSPITAL | GrantTypeTxt |
| Recipient | 1141 | RecipientCnt |
| Cash Grant | $5,338,957 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2: | THE HOSPITAL ASSISTS INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED BY PROVIDING CHARITY CARE. THIS IS APPLIED BY FOLLOWING THE HOSPITAL'S CHARITY CARE POLICY. THIS POLICY IS ADMINISTERED THROUGH THE PATIENT FINANCIAL SERVICE AND PATIENT ACCESS DEPARTMENTS OF THE HOSPITAL. |
| PART II: | THE HOSPITAL SUPPORTS (PROVIDES GRANTS TO) ORGANIZATIONS THAT EITHER DO WORK IN AREAS RELATED TO THE HEALTH NEEDS IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT, AND TO ORGANIZATIONS THAT SUPPORT ECONOMIC DEVELOPMENT. FOR THE HEALTH-RELATED ACTIVITIES WE TRACK HOW MANY PEOPLE WE REACH AT PARTICULAR EVENTS, CLASSES OR SEMINARS. FOR ECONOMIC ACTIVITIES WE SUPPORT ORGANIZATIONS THAT HAVE BROAD COMMUNITY PARTICIPATION. GRANTS ARE ALSO PROVIDED TO SUPPORT GENERAL OPERATIONS OF HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION, AN AFFILIATE TO THE HOSPITAL. |
| PART III: | PATIENTS MEETING CERTAIN CRITERIA UNDER THE CHARITY CARE POLICY MAY RECEIVE HEALTHCARE SERVICES AT NO CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROGER E SEAVER | ||||||||||||||
| PRESIDENT/CEO | $508,472 | $0 | $223,000 | $0 | $96,380 | $0 | $33,750 | $0 | $43,216 | $0 | $904,818 | $0 | $159,000 | $0 |
| KINGMAN HO MD | ||||||||||||||
| CHIEF MEDICAL OFFICER (THROUGH 01/20 | $403,908 | $0 | $58,732 | $0 | $124,800 | $0 | $33,750 | $0 | $23,533 | $0 | $644,723 | $0 | $0 | $0 |
| TED D SIROTTA | ||||||||||||||
| SR VP/CFO | $340,548 | $0 | $59,051 | $0 | $45,852 | $0 | $33,750 | $0 | $28,054 | $0 | $507,255 | $0 | $0 | $0 |
| LARRY R KIDD | ||||||||||||||
| SR VP/CCO | $349,366 | $0 | $55,356 | $0 | $47,028 | $0 | $33,750 | $0 | $12,172 | $0 | $497,672 | $0 | $0 | $0 |
| RAY B MOSS | ||||||||||||||
| VP/CIO | $256,121 | $0 | $31,084 | $0 | $34,200 | $0 | $33,750 | $0 | $23,955 | $0 | $379,110 | $0 | $0 | $0 |
| MARK A PULEO | ||||||||||||||
| VP/CHRO | $227,603 | $0 | $30,409 | $0 | $28,046 | $0 | $33,750 | $0 | $28,924 | $0 | $348,732 | $0 | $0 | $0 |
| JONATHAN S MILLER | ||||||||||||||
| VP-FACILTY/SUPPORT (THROUGH 05/2020) | $91,173 | $0 | $34,049 | $0 | $186,389 | $0 | $8,125 | $0 | $6,726 | $0 | $326,462 | $0 | $0 | $0 |
| MARIA SARTE | ||||||||||||||
| CLINCAL RN | $230,372 | $0 | $0 | $0 | $0 | $0 | $11,519 | $0 | $0 | $0 | $241,891 | $0 | $0 | $0 |
| CARISSA BORTUGNO | ||||||||||||||
| DIRECTOR PHARMACY | $173,795 | $0 | $0 | $0 | $20,177 | $0 | $10,103 | $0 | $26,425 | $0 | $230,500 | $0 | $0 | $0 |
| LISA BARRETT | ||||||||||||||
| CLINCAL RN | $191,798 | $0 | $0 | $0 | $3,660 | $0 | $9,923 | $0 | $11,384 | $0 | $216,765 | $0 | $0 | $0 |
| KIMBERLY CLARK | ||||||||||||||
| CLINCAL RN | $181,731 | $0 | $0 | $0 | $9,474 | $0 | $2,700 | $0 | $21,283 | $0 | $215,188 | $0 | $0 | $0 |
| JOSEPHINE KAPLAN | ||||||||||||||
| DIRECTOR CASE MANAGEMENT | $166,578 | $0 | $5,000 | $0 | $19,564 | $0 | $0 | $0 | $16,402 | $0 | $207,544 | $0 | $0 | $0 |
| JENNIFER R CASTALDO | ||||||||||||||
| VP/CNO (THROUGH 05/2020) | $99,446 | $0 | $26,311 | $0 | $51,846 | $0 | $8,125 | $0 | $8,190 | $0 | $193,918 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | SOME EMPLOYEES RECEIVED A SEVERANCE PAYMENT DURING THE CALENDER YEAR. THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. HENRY MAYO NEWHALL MEMORIAL HOSPITAL HAS A SERP (SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN) OF WHICH ONLY ONE OF ITS EMPLOYEES PARTICIPATES, ROGER SEAVER. THE AMOUNT OF BENEFIT PAID IN THE CURRENT YEAR INCLUDED ON SCHEDULE J, PART II, (B)(II) IS $164,000. |
| PART I, LINE 7 | BONUSES ARE TIED TO QUANTITATIVE AND QUALITATIVE CRITERIA. ONE OF THE CRITERIA FOR THE BONUSES IS TIED TO FINANCIAL METRICS SUCH AS EBITDA MARGIN AND ACHIEVING COST PER UNIT OF SERVICE. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY | ||||||||
| A | 680164610 | 13080SCJ1 | 2014-02-05 | $70,780,579 | FINANCE AND REFINANCE FACILITY | Yes (1) | 0 | 0 |
| CALIFORNIA PUBLIC FINANCE AUTHORITY | ||||||||
| B | 474447476 | 13057EAL8 | 2017-02-03 | $115,072,912 | FINANCE AND REFINANCE FACILITY | 0 | 0 | 0 |
| CALIFORNIA PUBLIC FINANCE AUTHORITY | ||||||||
| C | 474447476 | 13057EDN1 | 2021-03-10 | $33,921,350 | REFINANCE SERIES 2013A AND 2013B BONDS | 0 | 0 | 0 |
| CALIFORNIA PUBLIC FINANCE AUTHORITY | ||||||||
| D | 474447476 | 13057EDW1 | 2021-03-10 | $6,539,029 | FINANCE AND REFINANCE FACILITY | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $4,475,000 | $59,665,000 | $70,780,579 | $1,141,054 | $1,692,946 | $29,092,467 | $38,854,112 | 2017 | 0 | Yes (1) | Yes (1) | Yes (1) | |
| B | $780,000 | $115,072,912 | $1,455,316 | $85,000,000 | $28,194,396 | 2019 | Yes (1) | 0 | Yes (1) | Yes (1) | |||
| C | $33,921,350 | $221,771 | $33,699,579 | 2021 | Yes (1) | 0 | Yes (1) | Yes (1) | |||||
| D | $6,539,029 | $39,029 | 0 | 0 | 0 | Yes (1) | $6,500,000 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| D | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| D | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | DATE REBATE COMPUTATION PERFORMED | FormAndLineReferenceDesc |
| Explanation | ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/28/2019 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| DON NISHIGUCHI | |||
| DON NISHIGUCHI, MD - TRUSTEE | $61,920 | PROFESSIONAL FEES AS DETERMINED AT ARMS-LENGTH AMOUNT | 0 |
| LAKHBINDER DHANDA | |||
| LAKHBINDER DHANDA, MD - TRUSTEE | $28,088 | PROFESSIONAL FEES AS DETERMINED AT ARMS-LENGTH AMOUNT | 0 |
| KATHERINE DUNN | |||
| FAMILY MEMBER OF TRUSTEE | $101,598 | WAGES | 0 |
| PARTIKSHA DHANDA | |||
| FAMILY MEMBER OF TRUSTEE | $98,565 | WAGES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS, CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEWED THE ENTIRE FORM 990 RETURN BEFORE DISTRIBUTION TO THE BOARD AND PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE REQUIRED TO READ THE CONFLICT OF INTEREST POLICY AND COMPLETE A FORMAL CONFLICT OF INTEREST QUESTIONNAIRE AND RESULTS OF ANY CONFLICT, IF ANY, WOULD BE REPORTED TO THE FULL BOARD. BOARD MEMBERS ARE AWARE AND REMINDED OF THE HOSPITAL'S FIDUCIARY RESPONSIBILITY IN REPORTING CONFLICTS OF INTEREST. THERE HAVE BEEN CIRCUMSTANCES WHERE A CONFLICT OF INTEREST EXISTS AND IT HAS BEEN DISCLOSED TO THE BOARD OF DIRECTORS. THE CONFLICT OF INTEREST FORMS ARE REQUIRED TO BE UPDATED ON AN ANNUAL BASIS. IF A CONFLICT IS IDENTIFIED, THE BOARD MEMBER WOULD BE EXCUSED FROM VOTING ON ANY APPLICABLE MATTERS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATIONS'S CEO AND EXECUTIVE MANAGEMENT COMPENSATION ARE DETERMINED THROUGH THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT CONSULTANT, AND BOARD OF DIRECTOR APPROVAL. OTHER KEY EMPLOYEES AND MANAGEMENT OF THE ORGANIZATION RECEIVE PERFORMANCE REVIEWS ANNUALLY AND RATINGS ARE APPLIED THAT SUGGEST THE PERCENTAGE OF SALARY INCREASE. PERCENTAGES ARE DETERMINED THROUGH MARKET SURVEYS DONE BY HUMAN RESOURCES AND APPROVED EACH YEAR VIA THE BUDGET AND APPROVAL PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 41,520,091. MANAGEMENT AND GENERAL EXPENSES 5,778,514. TOTAL EXPENSES 47,298,605. CONSULTING AND MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 72,500. TOTAL EXPENSES 72,500. REGISTRY: PROGRAM SERVICE EXPENSES 12,372,401. MANAGEMENT AND GENERAL EXPENSES 198,244. TOTAL EXPENSES 12,570,645. OTHER PURCHASED SERVICES - CIN: MANAGEMENT AND GENERAL EXPENSES 762,430. TOTAL EXPENSES 762,430. OTHER SERVICES- CLINICS: MANAGEMENT AND GENERAL EXPENSES 44,100. TOTAL EXPENSES 44,100. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER FROM HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION 1,720,497. LOSS ON BOND DEFEASANCE -12,151,157. |
| FORM 990, PART XII, LINE 2C: | NEITHER THE OVERSIGHT PROCESS FOR THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| HENRY MAYO CARE NETWORK LLC | |||||||||
| 23845 MCBEAN PKWY | VALENCIA | CA | 91355 | 824876499 | HEALTHCARE NETWORK | CA | $477,136 | $23,088 | HENRY MAYO NEWHALL MEMORIAL HOSPITAL |
| HENRY MAYO NEWHALL CLINICS LLC | |||||||||
| 23845 MCBEAN PKWY | VALENCIA | CA | 91355 | 833940984 | HEALTHCARE CLINICS | CA | $0 | $48,234 | HENRY MAYO NEWHALL MEMORIAL HOSPITAL |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION | ||||||||||
| 23845 MCBEAN PKWY | VALENCIA | CA | 91355 | 953849903 | RAISE FUNDS | CA | 501(C)(3) | LINE 7 | HOSPITAL | Yes (1) |
| SANTA CLARITA HEALTHCARE ASSOCIATION | ||||||||||
| 23845 MCBEAN PKWY | VALENCIA | CA | 91355 | 953921194 | INACTIVE | CA | 501(C)(3) | LINE 3 | HOSPITAL | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TOWER IMAGING VALENCIA | |||||||||||||
| 13400 RIVERSIDE DR STE 102 | SHERMAN OAKS | CA | 91423 | 201345767 | RADIOLOGY SERVICES | CA | HOSPITAL | RELATED | $298,433 | $1,031,984 | 0 | 0 | 0.50000 |
| HENRY MAYO NEWHALL URGENT CARE CLINICS LLC | |||||||||||||
| 23929 MCBEAN PARKWAY STE 102 | VALENCIA | CA | 91355 | 843120192 | HEALTHCARE CLINICS | CA | HOSPITAL | RELATED | -$282,078 | $935,042 | 0 | 0 | 0.51000 |
| KECK MEDICINE OF USC AND HENRY MAYO NEWHALL | |||||||||||||
| 1441 EASTLAKE AVE | LOS ANGELAS | CA | 90033 | 853779519 | MEDICAL CENTER | CA | HOSPITAL | RELATED | -$400 | $1,121,956 | 0 | 0 | 0.50000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY MAYO MANAGEMENT SERVICE ORGANIZATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 23845 MCBEAN PKWY | AddressLine1Txt |
| City | VALENCIA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 475250569 | EIN |
| Primary Activities | MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $1,035,848 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,300,329 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION | ||
| B | $641,760 | ACTUAL AMOUNT |
| HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION | ||
| C | $732,637 | AMOUNT GUARANTEED |
| HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION | ||
| D | $11,352,655 | ACTUAL AMOUNT |
| HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION | ||
| K | $849,738 | ACTUAL AMOUNT |
| HENRY MAYO MSO | ||
| D | $600,000 | ACTUAL AMOUNT |
| KECK MEDICINE OF USC AND HENRY MAYO NEWHALL | ||
| B | $1,000,000 | ACTUAL AMOUNT |
| TOWER IMAGING VALENCIA LLC | ||
| J | $570,235 | ACTUAL AMOUNT |
Comments