FURP.ORG / PUBLIC DATA EXPLORER

SUTTER VALLEY MEDICAL FOUNDATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SUTTER VALLEY MEDICAL FOUNDATION (EIN 68-0273974)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202203189349320225
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-14T22:36:55-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1560 MISSION ST STE 1600AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN680273974EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SUTTER VALLEY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JONATHAN ZACHRESONInCareOfNm
Business Name ControlSUTTBusinessNameControlTxt
Phone9162866665PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O SH TAX 2200 RIVER PLAZA DRAddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95833ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUE HADDADPersonNm
Person TitleCFOPersonTitleTxt
Phone9162866665PhoneNum
Signature2022-11-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSUEPersonFirstNm
Person LastHADDADPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEVA NITTAPreparerPersonNm
PTINP01286320PTIN
Phone4158948000PhoneNum
Preparation2022-11-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHERESA FREIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O SH TAX 2200 RIVER PLAZA DRAddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95833ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,811,066,868GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SUTTERHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee5628TotalEmployeeCnt
Total Volunteers24TotalVolunteersCnt
Total Gross UBI$43,394TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$79,672,596PYContributionsGrantsAmt
CY Contributions Grants$23,585,249CYContributionsGrantsAmt
PY Program Service Revenue$1,576,304,649PYProgramServiceRevenueAmt
CY Program Service Revenue$1,780,807,669CYProgramServiceRevenueAmt
PY Investment Income$1,288,801PYInvestmentIncomeAmt
CY Investment Income$2,624,471CYInvestmentIncomeAmt
PY Other Revenue$101,703PYOtherRevenueAmt
CY Other Revenue$104,710CYOtherRevenueAmt
PY Total Revenue$1,657,367,749PYTotalRevenueAmt
CY Total Revenue$1,807,122,099CYTotalRevenueAmt
PY Grants And Similar Paid$125,279PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$42,140CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$463,256,543PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$458,470,465CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$210,869CYTotalFundraisingExpenseAmt
PY Other Expenses$1,193,379,167PYOtherExpensesAmt
CY Other Expenses$1,267,625,352CYOtherExpensesAmt
PY Total Expenses$1,656,760,989PYTotalExpensesAmt
CY Total Expenses$1,726,137,957CYTotalExpensesAmt
PY Revenues Less Expenses$606,760PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$80,984,142CYRevenuesLessExpensesAmt
Total Assets BOY$896,771,770TotalAssetsBOYAmt
Total Assets EOY$666,026,093TotalAssetsEOYAmt
Total Liabilities BOY$456,390,268TotalLiabilitiesBOYAmt
Total Liabilities EOY$414,838,314TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$440,381,502NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$251,187,779NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,605,118,527ExpenseAmt
Grant$42,140GrantAmt
Revenue$1,780,807,669RevenueAmt
DescSEE SCHEDULE ODesc
Total Program Service Expenses$1,605,118,527TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1166IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee5628EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJONATHAN ZACHRESONPersonNm
Phone9162866665PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19100 FOOTHILLS BOULEVARDAddressLine1Txt
CityROSEVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP95747ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Sarah Krevans
DIR/PRES & CEO, SH2.040.0Yes (X)$0$9,160,299$379,211
James Conforti
DIRECTOR/SH SVP & COO4.040.0Yes (X)$0$2,036,409$557,262Yes (X)
Theresa Frei
CEO, SVMF2.040.0$0$1,101,993$135,550Yes (X)
Gary Zufelt
FOUNDATION AREA CEO, N. Valley0.040.0$0$803,099$98,352Yes (X)
Patrina White
CEO, SSCD/SWC0.040.0$0$765,679$90,904Yes (X)
Jeff Szczesny
SH VP, HR Ops0.040.0$0$712,117$91,945Yes (X)
Penny Westfall
SH VP, CLO, SEC2.040.0$0$778,774$1,812Yes (X)
Todd Smith MD
FND Area CEO, South Valley0.040.0$0$674,755$105,476Yes (X)
Sue Haddad
CFO FOUNDATION, SVMF2.040.0$0$566,944$83,101Yes (X)
Peter Hull MD
CME, SRMC2.040.0Yes (X)$0$476,502$73,655
Michael D Marino
VP, HR, SVMF & North Valley0.040.0$0$395,736$61,039Yes (X)
Jonathan K Bareng
Dir, Radiation Physics40.00.0$334,001$0$38,017Yes (X)
Benjamin Kirk
DEPUTY GEN COUNS, SEC2.040.0$0$268,591$46,746Yes (X)
Chuan Wu
Lead Physicist40.00.0$270,982$0$41,505Yes (X)
Fangyan Z Sy
SVMF Sr. Director Quality40.00.0$248,542$0$40,908Yes (X)
Jennifer S Glass
Staff Radiation Physicist40.00.0$243,508$0$39,793Yes (X)
Sandra L Adams
Dir, Service Area40.00.0$245,245$0$33,090Yes (X)
Paige Terra
CFO, SHVA0.00.0$0$232,494$0Yes (X)
Douglas Brosnan MD
Director/Chief of Staff/Inform2.036.0Yes (X)$0$133,613$0
Thomas Blinn
Former CEO, VAF0.00.0$0$109,889$0Yes (X)
I-Mei Hsiu MD
Director/SH Board2.09.0Yes (X)$0$27,500$0
David Adkins MD
Director2.02.0Yes (X)$0$0$0
Timothy Byrd
Director2.02.0Yes (X)$0$0$0
Viva Ettin MD
Director2.02.0Yes (X)$0$0$0
Bronwyn Fields RN
Director2.02.0Yes (X)$0$0$0
Dan Flores
Chair Finance & Planning4.04.0Yes (X)$0$0$0Yes (X)
Maria Pallavicini
Director2.02.0Yes (X)$0$0$0
Pat Pathipati
Director2.02.0Yes (X)$0$0$0
Fatima Seward
Chair4.04.0Yes (X)$0$0$0Yes (X)
Kurt Shuler MD
Director2.03.0Yes (X)$0$0$0
Jerry Tokunaga
Director2.02.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,342,278TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$18,244,394TotReportableCompRltdOrgAmt
Total Other Compensation$1,918,366TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K743IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DEACON CONSTRUCTION LLC
7745 GREENBACK LN STE 250CITRUS HEIGHTSCA956105865CONSTRUCTION SVCS$3,178,608
ADVANCED BUILDING MAINTENANCE
1804 TRIBUTE RD STE KSACRAMENTOCA958154313Janitorial Services$2,471,969
WFC BUILDERS INC
6050 WAREHOUSE WYSACRAMENTOCA958264922CONSTRUCTION SVCS$2,382,291
QUEST DIAGNOSTICS NICHOLS
PO BOX 912501PASADENACA911102501Lab Services$2,305,260
HSS INC
900 SO BROADWAY STE 100DENVERCO802094269Security Services$2,027,853
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K79CntrctRcvdGreaterThan100KCnt
Federated Campaigns$450FederatedCampaignsAmt
Fundraising$17,232FundraisingAmt
Related Organizations$94,029RelatedOrganizationsAmt
Government Grants$22,741,055GovernmentGrantsAmt
All Other Contributions$732,483AllOtherContributionsAmt
Noncash Contributions$15,186NoncashContributionsAmt
Total Contributions$23,585,249TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621110$1,772,697,233$1,772,697,233
HEALTHCARE RELATED JV INCOME621110$5,613,929$5,613,929
RENTAL TO AFFILIATES621110$1,383,747$1,383,747
GUARANTEED PAYMENT JV INCOME621110$1,112,760$1,112,760
FieldValueIRS element (for citing)
Total Program Service Revenue$1,780,807,669TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$473,639TotalRevenueColumnAmt
Exclusion$473,639ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$73,441RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$5,834RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$67,607RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$67,607TotalRevenueColumnAmt
Exclusion$67,607ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$39,439SecuritiesAmt
Other$6,038,549OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$3,927,156OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$39,439SecuritiesAmt
Other$2,111,393OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,150,832TotalRevenueColumnAmt
Exclusion$2,150,832ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$5,488FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$17,232ContriRptFundraisingEventAmt
Fundraising Direct Expenses$11,779FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,291TotalRevenueColumnAmt
Exclusion-$6,291ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescSFSC ADMIN FEEDesc
Business541610BusinessCd
Total Revenue Column$43,394TotalRevenueColumnAmt
Unrelated Business Revenue$43,394UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$43,394OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,807,122,099TotalRevenueColumnAmt
Related Or Exempt Func Income$1,780,807,669RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$43,394UnrelatedBusinessRevenueAmt
Exclusion$2,685,787ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$34,140TotalAmt
Program Services$34,140ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$8,000TotalAmt
Program Services$8,000ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$273,461,010TotalAmt
Program Services$256,042,558ProgramServicesAmt
Management And General$17,362,564ManagementAndGeneralAmt
Fundraising$55,888FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$22,823,604TotalAmt
Program Services$21,374,193ProgramServicesAmt
Management And General$1,449,411ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$138,726,727TotalAmt
Program Services$129,851,635ProgramServicesAmt
Management And General$8,805,401ManagementAndGeneralAmt
Fundraising$69,691FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$23,459,124TotalAmt
Program Services$21,969,355ProgramServicesAmt
Management And General$1,489,769ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$901,443TotalAmt
Program Services$82,202ProgramServicesAmt
Management And General$819,241ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$952,437TotalAmt
Program Services$952,437ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Management And General$1,000ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$667,794TotalAmt
Management And General$667,794ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$694,619,877TotalAmt
Program Services$678,767,531ProgramServicesAmt
Management And General$15,852,346ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$121,028TotalAmt
Management And General$121,028ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$12,431,075TotalAmt
Program Services$1,874,160ProgramServicesAmt
Management And General$10,554,088ManagementAndGeneralAmt
Fundraising$2,827FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$37,829,151TotalAmt
Program Services$24,736,002ProgramServicesAmt
Management And General$13,093,149ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$52,111,593TotalAmt
Program Services$49,525,421ProgramServicesAmt
Management And General$2,586,172ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,077,531TotalAmt
Program Services$1,000,157ProgramServicesAmt
Management And General$76,777ManagementAndGeneralAmt
Fundraising$597FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$96,580TotalAmt
Program Services$89,184ProgramServicesAmt
Management And General$7,396ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,455,991TotalAmt
Program Services$6,455,991ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$40,444,060TotalAmt
Program Services$36,622,016ProgramServicesAmt
Management And General$3,822,044ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,890,865TotalAmt
Program Services$1,255,351ProgramServicesAmt
Management And General$1,635,514ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
CAPITATED SERVICES$145,361,157$145,361,157
SYSTEM ALLOCATIONS$106,597,778$71,299,701$35,245,715$52,362
MEDICAL SUPPLIES$104,467,274$104,467,274
PURCHASED SERVICES$50,069,105$44,435,420$5,630,498$3,187

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,529,613TotalAmt
Program Services$8,914,642ProgramServicesAmt
Management And General$1,588,654ManagementAndGeneralAmt
Fundraising$26,317FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,726,137,957TotalAmt
Program Services$1,605,118,527ProgramServicesAmt
Management And General$120,808,561ManagementAndGeneralAmt
Fundraising$210,869FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$396,169,403BOYAmt
EOY$181,527,424EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$109,027BOYAmt
EOY$95,566EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$81,891,329BOYAmt
EOY$93,365,511EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$9,830,238BOYAmt
EOY$618,605EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$776,316BOYAmt
EOY$496,448EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$789,995,393LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$520,796,303LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$293,160,106BOYAmt
EOY$269,199,090EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$897,351BOYAmt
EOY$511,874EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$16,394,730BOYAmt
EOY$24,647,530EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$24,283,299BOYAmt
EOY$21,687,245EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$73,259,971BOYAmt
EOY$73,876,800EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$896,771,770BOYAmt
EOY$666,026,093EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$189,638,627BOYAmt
EOY$193,316,258EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$149,256,914BOYAmt
EOY$147,446,550EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$117,494,727BOYAmt
EOY$74,075,506EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$456,390,268BOYAmt
EOY$414,838,314EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$438,480,953BOYAmt
EOY$248,816,337EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,900,549BOYAmt
EOY$2,371,442EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$440,381,502BOYAmt
EOY$251,187,779EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$896,771,770BOYAmt
EOY$666,026,093EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$80,984,142ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$425,209NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$269,752,656OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$223,522BeginningYearBalanceAmt
Contributions-$13,123ContributionsAmt
Investment Earnings Or Losses-$100InvestmentEarningsOrLossesAmt
Other Expenditures$3,000OtherExpendituresAmt
End Year Balance$207,299EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$217,076BeginningYearBalanceAmt
Contributions$5,796ContributionsAmt
Investment Earnings Or Losses$4,650InvestmentEarningsOrLossesAmt
Other Expenditures$4,000OtherExpendituresAmt
End Year Balance$223,522EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$144,711BeginningYearBalanceAmt
Contributions$67,800ContributionsAmt
Investment Earnings Or Losses$5,460InvestmentEarningsOrLossesAmt
Grants Or Scholarships$895GrantsOrScholarshipsAmt
End Year Balance$217,076EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$113,025BeginningYearBalanceAmt
Contributions$29,320ContributionsAmt
Investment Earnings Or Losses$2,366InvestmentEarningsOrLossesAmt
End Year Balance$144,711EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$100,600BeginningYearBalanceAmt
Contributions$12,425ContributionsAmt
End Year Balance$113,025EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.97840PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.02160TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,677,545OtherCostOrOtherBasisAmt
Book Value$38,677,545BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$348,104,585OtherCostOrOtherBasisAmt
Depreciation$180,227,579DepreciationAmt
Book Value$167,877,006BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,060,810OtherCostOrOtherBasisAmt
Depreciation$74,155,183DepreciationAmt
Book Value$19,905,627BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$285,863,860OtherCostOrOtherBasisAmt
Depreciation$249,510,294DepreciationAmt
Book Value$36,353,566BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,288,593OtherCostOrOtherBasisAmt
Depreciation$16,903,247DepreciationAmt
Book Value$6,385,346BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$269,199,090TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY RECEIVABLES$1,835,499
NOTES RECEIVABLE$1,850,278
OTHER RECEIVABLES$6,574,303
OTHER ASSETS$63,616,720
FieldValueIRS element (for citing)
Total Book Value Other Assets$73,876,800TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
INSURANCE LIABILITIES$1,172,294
THIRD PARTY SETTLEMENTS$27,056,527
CAPITAL LEASES$139,582
OTHER LIABILITIES$45,707,103
FieldValueIRS element (for citing)
Total Liability$74,075,506TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4THE INTENTIONS FOR THE ENDOWMENT FUNDS ARE AS FOLLOWS: DR. HUDLIN MEDICAL SCHOLARSHIP ENDOWMENT - THE EARNINGS OF THE ENDOWMENT ARE TO BE SPENT FOR THE PURPOSE OF PROVIDING SCHOLARSHIP SUPPORT FOR DISADVANTAGED HIGH SCHOOL STUDENTS PURSUING MEDICAL CAREERS. CHILDRENS BRAIN HEALTH ENDOWMENT - TO SUPPORT THE GENERAL NEEDS RELATED TO THE PSYCHOLOGICAL ASSESSMENT OF CHILDREN.
SCHEDULE D, PART X, LINE 2ASC 740 AUDIT FOOTNOTE THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH AND MANY AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS, ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE STATUTE OF LIMITATIONS FOR TAX YEARS 2018 THROUGH 2020 REMAINS OPEN IN U.S. TAX JURISDICTIONS IN WHICH SUTTER AND ITS AFFILIATES ARE SUBJECT TO TAXATION. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO SUCH UNCERTAIN TAX POSITIONS RECOGNIZED FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Generosity GalaEvent1Nm
Gross Receipts Event1$22,720GrossReceiptsEvent1Amt
Charitable Contri Event1$17,232CharitableContriEvent1Amt
Gross Revenue Event1$5,488GrossRevenueEvent1Amt
Non Cash Prizes Event1$936NonCashPrizesEvent1Amt
Food And Beverage Event1$836FoodAndBeverageEvent1Amt
Entertainment Event1$2,500EntertainmentEvent1Amt
Other Direct Expenses Event1$7,507OtherDirectExpensesEvent1Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$22,720GrossReceiptsTotalAmt
Charitable Contributions Tot$17,232CharitableContributionsTotAmt
Gross Revenue Total Events$5,488GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$936NonCashPrizesTotalEventsAmt
Food And Beverage Total Events$836FoodAndBeverageTotalEventsAmt
Entertainment Total Events$2,500EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$7,507OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$11,779DirectExpenseSummaryEventsAmt
Net Income Summary-$6,291NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
Indiv Hospital Tailored PolicyYes (X)IndivHospitalTailoredPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other400.FreeCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,461,433TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,461,433NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$109,236,468TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,787,771DirectOffsettingRevenueAmt
Net Community Benefit Expns$39,448,697NetCommunityBenefitExpnsAmt
Total Expense0.02290TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,756,040TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$872,175DirectOffsettingRevenueAmt
Net Community Benefit Expns$883,865NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$115,453,941TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$70,659,946DirectOffsettingRevenueAmt
Net Community Benefit Expns$44,793,995NetCommunityBenefitExpnsAmt
Total Expense0.02600TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served3498PersonsServedCnt
Total Community Benefit Expns$246,923TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$246,923NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$2,168,960TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,051,905DirectOffsettingRevenueAmt
Net Community Benefit Expns$117,055NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$3,315,159TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,586,298DirectOffsettingRevenueAmt
Net Community Benefit Expns$728,861NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$479,938TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$217,792DirectOffsettingRevenueAmt
Net Community Benefit Expns$262,146NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Total Community Benefit Expns$2,218,823TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,218,823NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served3498PersonsServedCnt
Total Community Benefit Expns$8,429,803TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,855,995DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,573,808NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served3498PersonsServedCnt
Total Community Benefit Expns$123,883,744TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$75,515,941DirectOffsettingRevenueAmt
Net Community Benefit Expns$48,367,803NetCommunityBenefitExpnsAmt
Total Expense0.02810TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Reimbursed By Medicare$13,213,000ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$19,758,703CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,545,703MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1STANISLAUS SURG HOSPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMEDICAL SERVICESPrimaryActivitiesTxt
Org Profit Or Ownership0.31OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.4567PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndOtherOtherDesc
TWIN CITIES SURGICAL HOSPITAL
1455 PLUMAS BLVDYUBA CITYCA959915074https://www.sutterhealth.org/sshnvLICENSE #550000989Yes (X)Yes (X)OUTPATIENT SERVICES
STANISLAUS SURGICAL HOSPITAL
21421 OAKDALE ROADMODESTOCA953553356WWW.STANISLAUSSURGICAL.COM/LICENSE #030000695Yes (X)Yes (X)OUTPATIENT SERVICES

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndPrior CHNA ImpactPriorCHNAImpactIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtOther WebsiteOtherWebsiteIndOther Website URLOtherWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndProvided Nonprofit ContactProvidedNonprofitContactIndOther MethodOtherMethodIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndNotified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP TranslatedFAPTranslatedIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndProvided Written NoticeProvidedWrittenNoticeIndMade Effort Orally NotifyMadeEffortOrallyNotifyIndProcessed FAP ApplicationProcessedFAPApplicationIndMade Presumptive Elig DetermMadePresumptiveEligDetermIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndProspective Medicare MedicaidProspectiveMedicareMedicaidIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesIndAsset Level CriteriaAssetLevelCriteriaIndNo Emergency CareNoEmergencyCareInd
TWIN CITIES SURGICAL HOSPITAL
1falsefalseYes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)19Yes (true)Yes (true)falseYes (true)Yes (X)SEE PART V, SECTION CYes (X)SEE PART V, SECTION CYes (X)Yes (true)19Yes (true)SEE PART V, SECTION CfalseYes (true)Yes (X)400.0.Yes (X)Yes (X)Yes (true)Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)SEE PART V, SECTION CYes (X)SEE PART V, SECTION CYes (X)SEE PART V, SECTION CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)falseYes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)falsefalse
STANISLAUS SURGICAL HOSPITAL
2falsefalseYes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)19Yes (true)Yes (true)falseYes (true)Yes (X)SEE PART V, SECTION CYes (X)SEE PART V, SECTION CYes (X)Yes (true)19Yes (true)SEE PART V, SECTION CfalseYes (true)Yes (X)100350.Yes (X)Yes (X)Yes (true)Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)SEE PART V, SECTION CYes (X)SEE PART V, SECTION CYes (X)SEE PART V, SECTION CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)falseYes (X)Yes (X)Yes (X)Yes (X)falseYes (X)falsefalseYes (X)Yes (X)

Supplemental Information SupplementalInformationGrp (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3ETWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
SCHEDULE H, PART V, SECTION B, LINE 5TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: INPUT FROM THE COMMUNITY SERVED WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WAS COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. TWIN CITIES SURGICAL HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN MARCH 7, 2019, AND APRIL 5, 2019. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN TWIN CITIES SURGICAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ABOUT-US/COMMUNITY-NEEDS- ASSESSMENT.HTML
SCHEDULE H, PART V, SECTION B, LINES 6ATWIN CITIES SURGICAL HOSPITAL (FACILITY 1): CHNA HOSPITAL COLLABORATORS: WORKING COLLABORATIVELY, RIDEOUT MEMORIAL HOSPITAL (RMH), DBA ADVENTIST HEALTH AND RIDEOUT, AND TWIN CITIES SURGICAL HOSPITAL, DBA SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV) CONTRACTED WITH COMMUNITY HEALTH INSIGHTS TO CONDUCT A CHNA FOR THEIR MUTUAL SERVICE AREAS.
SCHEDULE H, PART V, SECTION B, LINE 7A, 7B, AND 10ATWIN CITIES SURGICAL HOSPITAL (FACILITY 1): HOSPITAL FACILITY WEBSITE: HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ABOUT-US/COMMUNITY-NEEDS- ASSESSMENT.HTML OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 11TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT TWIN CITIES SURGICAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES 2. PREVENTION OF DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION, AND ACCESS TO RESOURCES 3. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 4. ACCESS TO QUALITY PRIMARY HEALTH SERVICES 5. ACCESS TO SPECIALTY AND EXTENDED CARE 6. ACTIVE LIVING AND HEALTH EATING 7. SAFE AND VIOLENCE-FREE ENVIRONMENT DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH ADDITIONAL CRITICAL EFFORTS ON BEHALF OF TWIN CITIES SURGICAL HOSPITAL. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. TWIN CITIES SURGICAL HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS AND FUNCTIONAL NEEDS: WHILE THIS IS AN IMPORTANT ISSUE, TWIN CITIES SURGICAL HOSPITAL IS CURRENTLY FOCUSING ITS RESOURCES IN OTHER AREAS; HOWEVER, WE'LL CONTINUE TO LOOK FOR OPPORTUNITIES TO INCREASE ACCESS TO TRANSPORTATION.
SCHEDULE H, PART V, SECTION B, LINE 15ETWIN CITIES SURGICAL HOSPITAL (FACILITY 1): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16CTWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE
SCHEDULE H, PART V, SECTION B, LINE 16JTWIN CITIES SURGICAL HOSPITAL (FACILITY 1): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART V, SECTION B, LINE 22DTWIN CITIES SURGICAL HOSPITAL (FACILITY 1): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.
SCHEDULE H, PART V, SECTION B, LINE 3ESTANISLAUS SURGICAL HOSPITAL (FACILITY 2): THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
SCHEDULE H, PART V, SECTION B, LINE 5STANISLAUS SURGICAL HOSPITAL (FACILITY 2): IN CONDUCTING ITS MOST RECENT CHNA, STANISLAUS SURGICAL HOSPITAL (SSH) A FACILITY OF SUTTER VALLEY MEDICAL FOUNDATION, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS THROUGH KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. DATA COLLECTED AND ANALYZED INCLUDED BOTH PRIMARY OR QUALITATIVE DATA AND SECONDARY OR QUANTITATIVE DATA. PRIMARY DATA INCLUDED 11 INTERVIEWS WITH 16 COMMUNITY HEALTH EXPERTS AS WELL AS 9 FOCUS GROUPS CONDUCTED WITH A TOTAL OF 75 COMMUNITY RESIDENTS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WERE COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. STANISLAUS SURGICAL HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN DECEMBER 5, 2018, AND MARCH 12, 2019. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN STANISLAUS SURGICAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 6STANISLAUS SURGICAL HOSPITAL (FACILITY 2): COMMUNITY HEALTH INSIGHTS CONDUCTED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ON BEHALF OF MEMORIAL MEDICAL CENTER OF MODESTO AND STANISLAUS SURGICAL HOSPITAL.
SCHEDULE H, PART V, SECTION B, LINE 7A, 7B, AND 10ASTANISLAUS SURGICAL HOSPITAL (FACILITY 2): HOSPITAL FACILITY WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/MMC-SSH-2019-CHNA.PDF
SCHEDULE H, PART V, SECTION B, LINE 11STANISLAUS SURGICAL HOSPITAL (FACILITY 2): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT STANISLAUS SURGICAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO BASIC NEEDS, SUCH AS HOUSING, JOBS, AND FOOD 2. ACCESS TO MENTAL, BEHAVIORAL, AND SUBSTANCE-ABUSE SERVICES 3. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 4. SAFE AND VIOLENCE-FREE ENVIRONMENT 5. INJURY AND DISEASE PREVENTION AND MANAGEMENT 6. ACTIVE LIVING AND HEALTHY EATING DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL THE HEATH NEEDS IN THE COMMUNITY. STANISLAUS SURGICAL HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS AND FUNCTIONAL NEEDS - TRANSPORTATION AND PHYSICAL DISABILITY - WHILE OUR IMPLEMENTATION PLAN DOES NOT DIRECTLY ADDRESS ISSUES OF TRANSPORTATION AND PHYSICAL DISABILITY, MANY OF OUR PROGRAMS WILL OFFER CLIENTS REFERRALS TO TRANSPORTATION SERVICES SO THAT THEY CAN ACCESS MEDICAL APPOINTMENTS. 2. ACCESS TO SPECIALTY AND EXTENDED CARE - OUR FOCUS IN STANISLAUS COUNTY IS PRIMARILY ON EXPANDING ACCESS TO PRIMARY CARE THROUGH PARTNERSHIPS WITH OUR FQHC AND COMMUNITY PARTNERS. HOWEVER, SEVERAL OF THESE PROGRAMS WHICH INCREASE ACCESS TO PRIMARY CARE WILL ALSO HELP PATIENTS BECOME CONNECTED TO SPECIALTY CARE ONCE THEY ARE ESTABLISHED WITH A PCP. 3. POLLUTION-FREE LIVING ENVIRONMENT - DUE TO LIMITED RESOURCES AND ABILITY TO IMPACT ENVIRONMENTAL POLICIES, THE HOSPITAL DOES NOT INTEND TO DIRECTLY ADDRESS THIS HEALTH ISSUE AT THIS TIME.
SCHEDULE H, PART V, SECTION B, LINE 15ESTANISLAUS SURGICAL HOSPITAL (FACILITY 2): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY SUBMIT CHARITY CARE APPLICATION TO THE COLLECTIONS SUPERVISOR.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B AND 16CSTANISLAUS SURGICAL HOSPITAL (FACILITY 2): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY WERE PREVIOUSLY AVAILABLE ON THE SANISLAUS SURGICAL HOSPITAL WEBSITE AT: HTTPS://STANISLAUSSURGICAL.COM/FINANCIAL-ASSISTANCE AS OF 6/1/2022 SUTTER HEALTH NO LONGER OWNS OR OPERATES STANISLAUS SURGICAL HOSPITAL. THESE DOCUMENTS WERE REMOVED FROM THE WEBSITE AFTER THIS DATE.
SCHEDULE H, PART V, SECTION B, LINE 16JSTANISLAUS SURGICAL HOSPITAL (FACILITY 2): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA (ENGLISH & SPANISH). DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED THE FINANCIAL ASSISTANCE POLICY IS POSTED IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL, INCLUDING, BUT NOT LIMITED TO THE BILLING OFFICE, ADMISSIONS OFFICE, AND PATIENT WAITING AREA. HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A COPY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST.
FieldValueIRS element (for citing)
Facility74FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (74 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
SUTTER MED CARE CT & AMBULATORY SURG CT
460 PlumasYuba CityCA95991Outpatient Services/Surgery Center
Modesto Urgent Care
600 Coffee RoadModestoCA95355Urgent Care
Stockton Medical Plaza I
2545 West Hammer LaneStocktonCA95209Urgent Care/Surgery Center/ Outpatient Services
Stockton Medical Plaza II
2505 West Hammer LaneStocktonCA95209Urgent Care/Surgery Center/ Outpatient Services
Stockton Surgery Center
8011 Don AvenueStocktonCA95209Surgery Center
Patterson Care Center
801 E StreetPattersonCA95363Lab/Outpatient Services
Turlock Care Center
3100 W Christoffersen ParkwayTurlockCA95382Urgent Care/Radiology/ Laboratory
Briggsmore Specialty Center
1409 E BriggsmoreModestoCA95355Outpatient Services
Sutter Imaging Sacramento
3161 L StreetSacramentoCA95816Imaging
Sutter Roseville Cancer Center
8 Medical Plaza DriveROSEVILLECA95661Outpatient Services
3 Medical Plaza Care Center
3 MEDICAL PLAZA DRIVEROSEVILLECA95661Outpatient Services
Sutter Imaging Roseville Parkway
1640 East Roseville ParkwayROSEVILLECA95661Imaging
Sutter Imaging Roseville II
2 Medical Plaza DriveROSEVILLECA95661Imaging
Sutter Medical Plaza - Sutter Place
2020 SUTTER PLACEDavisCA95616Outpatient Services
Sutter Urgent Care Fairfield
2702 Low CourtFairfieldCA94534Outpatient Services
Sutter Yuba City Medical Center
480 PlumasYuba CityCA95991Outpatient Services
Sutter Medical Plaza Vacaville
770 Mason StreetVacavilleCA95687Outpatient Services
Sutter Medical Plaza Vallejo
100 Hospital DriveVallejoCA94589Outpatient Services
Sutter Amador Surgery Center
223 Clinton RoadJacksonCA95642Outpatient Services
Sutter Fairfield Surgery Center
2700 Low CourtFairfieldCA94534Surgery Center
Urgent CareLabRadiologyCardiology
440 PlumasYuba CityCA95991Urgent Care/Lab/Radiology/ Cardiology
Auburn Gastroenterology & Neurology
11795 Education StreetAuburnCA95602Gastroenterology and Neurology PHYSICAL THERAPY
ROSEVILLE - FAMILY PRACTICE AND PHY TH
568 N SUNRISE AVEROSEVILLECA95661Outpatient Services and Physical Therapy
GRASS VALLEY FAMILY PRACTICE & PHY TH
10058 WOLF ROADGRASS VALLEYCA95949Outpatient Services and PHYSICAL THERAPY
Sutter Medical Foundation PHY TH
420 B StYuba CityCA95991Physical Therapy
Sutter Fairfield Diagnostic Imaging CTR
2700 Low CourtFairfieldCA94534Diagnostic Imaging Center
Sutter Medical Plaza Folsom
2575 E BIDWELL STFOLSOMCA95630Outpatient Services
Fort Sutter Surgery Center
2801 K STSACRAMENTOCA95816Outpatient Services
Sutter Medical Plaza Roseville
3100 DOUGLAS BLVDROSEVILLECA95661Outpatient Services
Alhambra Medical Office & Urgent Care
1201 ALHAMBRA BLVDSACRAMENTOCA95816Outpatient Services
635 Anderson Road Care Center
635 ANDERSON RDDavisCA95616Outpatient Services
West Sacramento Walk-In Care
2055 Town Center PlazaWest SacramentoCA95691Outpatient Services
Natomas Walk-In Care
2860 Del Paso RoadSacramentoCA95834Outpatient Services
West Roseville Care Center
2050 Blue Oaks BoulevardRosevilleCA95747Outpatient Services
Davis Walk-In Care
4647 2nd StreetDavisCA95618Outpatient Services
Sutter Medical Plaza Elk Grove
8170 LAGUNA BLVDELK GROVECA95758Outpatient Services
SMF Surgery Center
8200 LAGUNA BLVDELK GROVECA95758Ambulatory Surgery Center
Sutter Imaging RosevillePET
2241 Douglas BoulevardRosevilleCA95661Imaging
Sutter Medical Plaza Natomas
2210 DEL PASO RDSACRAMENTOCA95831Outpatient Services
Sutter Medical Plaza Lincoln
685 TWELVE BRIDGES DRLINCOLNCA95648Outpatient Services
Sutter Imaging Folsom I
1655 Creekside DriveFOLSOMCA95630Diagnostic Imaging Center
Sutter Imaging Folsom II
1661 Creekside DriveFOLSOMCA95630Diagnostic Imaging Center
Sutter Medical Plaza Woodland
475 PIONEER AVEWOODLANDCA95776Outpatient Services
Sutter Medical Plaza Dixon
125 N LINCOLN STDIXONCA95620Outpatient Services
Bell Road Medical Offices
3288 BELL RDAUBURNCA95603Outpatient Services
Sutter Medical Plaza Greenback Lab
5767 GREENBACK LANESACRAMENTOCA95825Laboratory
Sutter Medical Plaza Greenhaven Lab
7420 GREENHAVEN DRSACRAMENTOCA95831Laboratory
Sutter Imaging Auburn
3123 Professional DriveAuburnCA95603Diagnostic Imaging Center
Sutter Imaging Carmichael
6620 Coyle AvenueCarmichaelCA95608Diagnostic Imaging Center
Procedure Center
550 B StYuba CityCA95991Procedure Center
400 Plumas Care Center
400 PlumasYuba CityCA95991Outpatient Services
Davis Internal MED AND GASTROENTEROLOGY
2068 John Jones RoadDavisCA95616Internal Medicine and GASTROENTEROLOGY
L STREET MEDICAL NEUROLOGY
2800 L StreetSACRAMENTOCA95819Neurology
470 Plumas Care Center
470 PlumasYuba CityCA95991Orthopedics & Podiatry
Sutter Obstetrics and Gynecology
969 PlumasYuba CityCA95991Obstetrics
Sutter Advanced Dermatology & LASER CTR
350 Del NorteYuba CityCA95991Dermatology
Sacramento - Midtown Walk-In Care
1360 16th StreetSacramentoCA95814Outpatient Services
Sacramento - Loehmanns PL WALK-IN CARE
2537 Fair Oaks BoulevardSacramentoCA95825Outpatient Services
Roseville - Foothills Walk-In Care
4010 Foothills BoulevardROSEVILLECA95747Outpatient Services
El Dorado Hills Walk-In Care
3919 Park DriveEl Dorado HillsCA95762Outpatient Services
Elk Grove Walk-In Care
4810 Elk Grove BoulevardELK GROVECA95758Outpatient Services
Citrus Heights Walk-In Care
5406 Sunrise BoulevardCitrus HeightsCA95610Outpatient Services
Roseville Walk-In Care
781 Pleasant Grove BoulevardRosevilleCA95678Outpatient Services
Folsom Walk-In Care
2766 East Bidwell StreetFOLSOMCA95630Outpatient Services
Vacaville Walk-in Care
2060 Harbison DriveVacavilleCA95687Outpatient Services
Sutter Gould CARD STOCKTON CARE CTR
1801 East March LaneStocktonCA95210Cardiology
Radiation Oncology Services-Vacaville
200 Bella Vista RoadVacavilleCA95687Outpatient Services
Ceres Care Center Lab
2516 Whitmore AvenueCeresCA95307Outpatient Services
Tracy Care Center
445 W Eaton AveTracyCA95376Outpatient Services
Laboratory
100 Mission BlvdJacksonCA95642Laboratory
Sutter Medical Plaza Brownsville
16911 Willow Glen RoadBrownsvilleCA95919Outpatient Services
Fairmont Specialty Center
918 South Fairmont AveLodiCA95240Outpatient Surgery
Palmer Drive Care Center
3581 Palmer DriveCameron ParkCA95682Cancer Services
Eye Care Center
1011 Sylvan AvenueModestoCA95350Outpatient Services

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINES 3A & 3CFINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: SUTTER VALLEY MEDICAL FOUNDATION OWNS 100% OF TWIN CITIES SURGICAL HOSPITAL, WHICH PROVIDES PREDOMINANTLY ELECTIVE SURGERIES AND DOES NOT PROVIDE EMERGENCY CARE. FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THIS FACILITY USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION TWIN CITIES SURGICAL HOSPITAL HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENT'S FAMILY INCOME. SUTTER VALLEY MEDICAL FOUNDATION ACQUIRED A 31% OWNERSHIP INTEREST STANISLAUS SURGICAL HOSPITAL IN 2016. THIS HOSPITAL PROVIDES PREDOMINANTLY ELECTIVE SURGERIES AND DOES NOT PROVIDE EMERGENCY CARE. STANISLAUS SURGICAL HOSPITAL PROVIDES FREE CHARITY CARE FOR MEDICALLY NECESSARY PROCEDURES FOR UNINSURED PATIENTS FOR FAMILY INCOMES THAT ARE AT OR BELOW 100% OF FPG.
SCHEDULE H, PART I, LINE 3BSUTTER VALLEY MEDICAL FOUNDATION IS COMMITTED TO PROVIDING CHARITY CARE. TWIN CITIES SURGICAL HOSPITAL PROVIDES FREE CARE AT HIGH PERCENTAGE OF FPG, SO IT DOES NOT PROVIDE DISCOUNTED CARE. STANISLAUS SURGICAL HOSPITAL PROVIDES DISCOUNTED CHARITY CARE BASED ON A SLIDING SCALE UP TO 350% OF FPG.
SCHEDULE H, PART I, LINE 7COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.
SCHEDULE H, PART I, SECTION 7GFINANCIAL ASSISTANCE/OTHER COMMUNITY BENEFITS AT COST RELATED TO SUBSIDIZED HEALTH SERVICES: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $728,861.
SCHEDULE H, PART IISUTTER VALLEY MEDICAL FOUNDATION (SVMF) DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT FOR 2021.
SCHEDULE H, PART III, LINE 4 - BAD DEBTAUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. EFFECTIVE JANUARY 1, 2018, SUTTER ENTITIES IMPLEMENTED THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS UPDATE (ASU), REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE ACCOUNTING CHANGE MODIFIED BAD DEBT REPORTING, AND AS A RESULT, BAD DEBT IS ONLY REPORTED IN LIMITED SITUATIONS.
SCHEDULE H, PART III, LINE 7MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS.
SCHEDULE H, PART III, LINE 8COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.
SCHEDULE H, PART III, LINE 9BDEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL AND CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.
SCHEDULE H, PART VI, LINE 2THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. LANGUAGES: THE POLICY SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA. IN ADDITION, ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. INFORMATION PROVIDED TO PATIENTS DURING THE PROVISION OF HOSPITAL SERVICES: A. DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND IDENTIFY THE DEPARTMENT THAT PATIENTS CAN VISIT TO RECEIVE INFORMATION ABOUT, AND ASSISTANCE WITH APPLYING FOR, FINANCIAL ASSISTANCE. B. FINANCIAL ASSISTANCE COUNSELORS: PATIENTS WHO MAY BE UNINSURED PATIENTS SHALL BE ASSIGNED FINANCIAL COUNSELORS, WHO SHALL VISIT WITH THE PATIENTS IN PERSON AT THE HOSPITAL, PROVIDE PATIENTS A FINANCIAL ASSISTANCE APPLICATION, ASSIST WITH THE APPLICATION PROCESS, AND PROVIDE A CONTACT INFORMATION FOR THE PATIENT TO CALL FOR QUESTIONS. C. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITALS SHALL PROVIDE ALL PATIENTS A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. D. APPLICATIONS PROVIDED AT DISCHARGE: AT THE TIME OF DISCHARGE, HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. E. INFORMATION PROVIDE TO PATIENTS AT OTHER TIMES: 1. CONTACT INFORMATION WHICH INCLUDES A PHONE NUMBER AND HOSPITAL DEPARTMENT TO OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE APPLICATION PROCESS. 2. BILLING STATEMENTS: BILLING STATEMENTS PROVIDED TO PATIENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, A PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS ABOUT FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE PATIENTS CAN OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE INCLUDING THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY OF THE POLICY, AND THE APPLICATION FOR FINANCIAL ASSISTANCE. 3. UPON REQUEST: HOSPITALS SHALL PROVIDE PATIENTS WITH PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST AND WITHOUT CHARGE. F. PUBLICITY OF FINANCIAL ASSISTANCE INFORMATION 1. PUBLIC POSTING: HOSPITALS SHALL POST COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IN A PROMINENT LOCATION IN THE EMERGENCY ROOM, ADMISSIONS AREA, AND ANY OTHER LOCATION IN THE HOSPITAL WHERE THERE IS A HIGH VOLUME OF PATIENT TRAFFIC, INCLUDING BUT NOT LIMITED TO THE WAITING ROOMS, BILLING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS. THESE PUBLIC NOTICES SHALL INCLUDE INFORMATION ABOUT THE RIGHT TO REQUEST AN ESTIMATE OF FINANCIAL RESPONSIBILITY FOR SERVICES. 2. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY SHALL BE AVAILABLE IN A PROMINENT PLACE ON THE SUTTER HEALTH WEBSITE (WWW.SUTTERHEALTH.ORG) AND ON EACH INDIVIDUAL HOSPITAL'S WEBSITE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. 3. MAIL: PATIENTS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY BE SENT BY MAIL, AT NO COST TO THE PATIENT. 4. ADVERTISEMENTS/PRESS RELEASES: AS NECESSARY AND ON AT LEAST AN ANNUAL BASIS, SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT HOSPITALS IN THE PRINCIPAL NEWSPAPER(S) IN THE COMMUNITIES SERVED BY SUTTER HEALTH, OR WHEN DOING SO IS NOT PRACTICAL, SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THIS INFORMATION, OR USE OTHER MEANS THAT SUTTER HEALTH CONCLUDES WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY TO AFFECTED PATIENTS IN OUR COMMUNITIES. 5. COMMUNITY AWARENESS: SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI, LINE 4REPORTING FACILITY: #1 TWIN CITIES SURGICAL HOSPITAL THE DEFINITION OF THE COMMUNITY SERVED WAS THE PRIMARY SERVICE AREA JOINTLY SHARED BY RIDEOUT MEMORIAL HOSPITAL (RMH) AND TWIN CITIES SURGICAL HOSPITAL, DBA SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV). THIS AREA WAS DEFINED BY FIVE ZIP CODES: 95901, 95953, 95961, 95991, AND 95993. THIS SERVICE AREA WAS DESIGNATED BECAUSE THE MAJORITY OF PATIENTS SERVED BY BOTH RMH AND SSHNV RESIDED IN THESE ZIP CODES. RMH IS LOCATED IN MARYSVILLE, CA, AND SSHNV IS LOCATED IN YUBA CITY, CA. SEPARATED BY THE FEATHER RIVER, THESE CITIES ARE LOCATED ADJACENT TO ONE ANOTHER AND ARE PART OF THE YUBA CITY METROPOLITAN STATISTICAL AREA AS DESIGNATED BY THE US OFFICE OF MANAGEMENT AND BUDGET, WHICH IS LOCATED APPROXIMATELY 40 MILES DUE NORTH OF CALIFORNIA'S CAPITAL-SACRAMENTO. THE SERVICE AREA IS HOME TO OVER 147,000 COMMUNITY RESIDENTS AND ENCOMPASSES PORTIONS OF BOTH SUTTER AND YUBA COUNTIES. THERE ARE FOUR HOSPITALS THAT SERVE THE COMMUNITY. COMMUNITIES OF CONCERN ARE GEOGRAPHIC AREAS WITHIN THE SERVICE AREA THAT HAVE THE GREATEST CONCENTRATION OF POOR HEALTH OUTCOMES AND ARE HOME TO MORE MEDICALLY UNDERSERVED, LOW-INCOME, AND DIVERSE POPULATIONS AT GREATER RISK FOR POORER HEALTH. COMMUNITIES OF CONCERN ARE IMPORTANT TO THE OVERALL CHNA METHODOLOGY BECAUSE, AFTER THE SERVICE AREA IS ASSESSED MORE BROADLY, THEY ALLOW FOR A FOCUS ON THOSE PORTIONS OF THE REGION LIKELY EXPERIENCING THE GREATEST HEALTH DISPARITIES. GEOGRAPHIC COMMUNITIES OF CONCERN WERE IDENTIFIED USING A COMBINATION OF PRIMARY AND SECONDARY DATA SOURCES. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR ZIP CODES THAT MET THE CRITERIA TO BE CLASSIFIED AS A COMMUNITY OF CONCERN. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR COMMUNITIES THAT MET THE CRITERIA FOR CLASSIFICATION AS A COMMUNITY OF CONCERN. THESE COMMUNITIES ARE MARYSVILLE, LIVE OAK, OLIVEHURST AND SOUTH YUBA CITY. REPORTING FACILITY: #2 STANISLAUS SURGICAL HOSPITAL THE DEFINITION OF THE COMMUNITY SERVED WAS STANISLAUS COUNTY. THIS IS THE DESIGNATED SERVICE AREA BECAUSE THE MAJORITY OF PATIENTS SERVED BY STANISLAUS SURGICAL HOSPITAL RESIDED IN THIS AREA. THERE ARE EIGHT HOSPITALS THAT SERVE THE COMMUNITY. LOCATED IN CALIFORNIA'S CENTRAL VALLEY, THE COUNTY COVERS APPROXIMATELY 1,500 SQUARE MILES AND IS HOME TO OVER 530,000 RESIDENTS. IT IS THE 16TH MOST POPULOUS AMONG CALIFORNIA'S 58 COUNTIES. THERE ARE NINE INCORPORATED CITIES IN THE COUNTY INCLUDING CERES, HUGHSON, MODESTO, NEWMAN, OAKDALE, PATTERSON, RIVERBANK, TURLOCK, AND WATERFORD. OF THESE, MODESTO, THE COUNTY SEAT, IS THE MOST POPULOUS ACCOUNTING FOR APPROXIMATELY 40% OF THE COUNTY'S POPULATION; TURLOCK IS THE SECOND, FOLLOWED BY CERES. THE TWO LARGEST RACE/ETHNIC GROUPS IN THE COUNTY ARE THOSE OF HISPANIC OR LATINO ORIGIN (44.8%), FOLLOWED BY CAUCASIANS (43.5%). AGRICULTURE PLAYS A SIGNIFICANT ROLE IN THE COUNTY, THUS THE COUNTY'S LARGEST EMPLOYERS ARE IN THE AGRICULTURE AND FOOD RELATED INDUSTRIES. THE ROBERT WOOD JOHNSON'S COUNTY HEALTH RANKINGS RANKED STANISLAUS COUNTY THE 41ST MOST HEALTHY AMONG CALIFORNIA'S 58 COUNTIES. COMMUNITIES OF CONCERN ARE GEOGRAPHIC AREAS WITHIN THE SERVICE AREA THAT HAVE THE GREATEST CONCENTRATION OF POOR HEALTH OUTCOMES AND ARE HOME TO MORE MEDICALLY UNDERSERVED, LOW-INCOME, AND DIVERSE POPULATIONS AT GREATER RISK FOR POORER HEALTH. COMMUNITIES OF CONCERN ARE IMPORTANT TO THE OVERALL CHNA METHODOLOGY BECAUSE, AFTER THE SERVICE AREA HAS BEEN ASSESSED MORE BROADLY, THEY ALLOW FOR A FOCUS ON THOSE PORTIONS OF THE REGION LIKELY EXPERIENCING THE GREATEST HEALTH DISPARITIES. GEOGRAPHIC COMMUNITIES OF CONCERN WERE IDENTIFIED USING A COMBINATION OF PRIMARY AND SECONDARY DATA SOURCES FOR STANISLAUS COUNTY. 10 ZIP CODES MET THE CRITERIA TO BE CLASSIFIED AS COMMUNITIES OF CONCERN. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR COMMUNITIES THAT MET THE CRITERIA FOR CLASSIFICATION AS A COMMUNITY OF CONCERN. THESE COMMUNITIES ARE CERES, EMPIRE, WEST MODESTO, AIRPORT DISTRICT, OAKDALE, PATTERSON, RIVERBANK AND TURLOCK. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA, WITH SOURCES, IS AVAILABLE IN THE STANISLAUS SURGICAL HOSPITAL 2019 CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. REPORTING FACILITY: #1 TWIN CITIES SURGICAL HOSPITAL THE 2019-2021 IMPLEMENTATION STRATEGY FOR TWIN CITIES SURGICAL HOSPITAL (SSHNV) DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW. PROGRAMS ADDRESSING: ACCESS TO MENTAL/BEHAVORIAL/SUBSTANCE ABUSE SERVICES FIT QUEST PROGRAM THE FIT QUEST PROGRAM IS A COMPREHENSIVE CHILDREN'S WELLNESS PROGRAM FOCUSING ON IMPROVING NUTRITION, FITNESS, AND MENTAL WELLNESS. THE ON-SITE SCHOOL PROGRAM, GEARED TOWARD 5TH AND 6TH GRADE STUDENTS, TEACHES STUDENTS EASY WAYS TO INCORPORATE HEALTHY CHOICES INTO DAILY LIVING. THE CURRICULUM IS DESIGNED TO IMPROVE OVERALL HEALTH IN A FUN AND MEANINGFUL WAY. THE FIT QUEST PROGRAM IS INCREDIBLY IMPACTFUL, REACHING OVER 40 SCHOOLS IN YUBA AND SUTTER COUNTY, PROVIDING SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS. THE EXPANDED CURRICULUM AND ROLE MODELING OF AND INTERACTIONS WITH THE NATURALISTS IN CHOOSING TO DRINK WATER, AND STAYING ACTIVE HAVE IMPACTED OVER 2,400 STUDENTS. SPECIALISTS HAVE BEEN ENGAGED THROUGHOUT THE PROCESS ATTENDING ASSEMBLIES AND PROVIDING GUIDANCE AND SUGGESTIONS AT PLANNING MEETINGS FOR CONTINUED ENHANCEMENTS IN THE FIT QUEST PROGRAM. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES; AND ACTIVE LIVING AND HEALTHY EATING. THE GOAL OF FIT QUEST IS TO TEACH CHILDREN HEALTHY LESSONS ABOUT THE IMPORTANCE OF PHYSICAL FITNESS, MENTAL WELLNESS AND NUTRITIOUS EATING. IN 2021, THERE WERE 882 STUDENTS SERVED. COUNSELING FOR PEOPLE EXPERIENCING OR AT-RISK FOR HOMELESSNESS FUNDING WILL ALLOW CLIENTS EXPERIENCING OR AT-RISK FOR HOMELESSNESS, WHOM DO NOT HAVE CALIFORNIA HEALTH AND WELLNESS AND BLUE SHIELD TO HAVE ACCESS TO COUNSELING WITH LICENSED MENTAL HEALTH PROFESSIONALS. COUNSELING IS OFFERED AT TWO LOCATIONS IN A PRIVATE OFFICE ALLOWING CLIENTS TO WORK ONE ON ONE WITH A COUNSELOR. COUNSELORS DETERMINE THE FREQUENCY OF COUNSELING SERVICES WITH EACH CLIENT AND HELP TO CONNECT THEM WITH ANY NEEDED OUTSIDE RESOURCES THE COUNSELOR DETERMINES IS NEEDED. THE GOAL IS TO PROVIDE COUNSELING SERVICES TO ALL CLIENTS REQUESTING ASSISTANCE WHO ARE EXPERIENCING OR AT-RISK FOR HOMELESSNESS. BY PROVIDING COUNSELING WITH LICENSED MENTAL HEALTH PROFESSIONALS, CLIENTS CAN OVERCOME PERSONAL CONCERNS AND BETTER THEIR QUALITY OF LIFE, WITH THE GOAL OF REINTEGRATING INTO THE COMMUNITY. IN 2021, THERE WERE 25 INDIVIDUALS SERVED WHO RECEIVED 49 SERVICES. PROGRAMS ADDRESSING: PREVENTION OF DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES WOMEN'S HEALTH SCREENINGS AND MAMMOGRAMS IN HONOR OF BREAST CANCER AWARENESS MONTH, SUTTER MEDICAL FOUNDATION - NORTH OFFERS NO-COST MAMMOGRAMS AND WOMEN'S HEALTH SCREENINGS. THIS PROGRAM REMAINS A KEY INITIATIVE FOR SSHNV AND A CORNERSTONE EVENT FOR THE ENTIRE YUBA/SUTTER COMMUNITY. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE; AND ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES. THE GOAL OF THE SCREENING EVENT IS TO PROVIDE NO-COST MAMMOGRAMS AND HEALTH SCREENINGS FOR WOMEN WHO OTHERWISE WOULDN'T HAVE ACCESS TO ONE, DUE TO NO INSURANCE OR A HIGH, UNAFFORDABLE DEDUCTIBLES. IN 2021, 51 MAMMOGRAMS AND 63 OF WOMEN'S HEALTH SCREENINGS WERE PROVIDED. FIT QUEST PROGRAM THE FIT QUEST PROGRAM IS A COMPREHENSIVE CHILDREN'S WELLNESS PROGRAM FOCUSING ON IMPROVING NUTRITION, FITNESS, AND MENTAL WELLNESS. THE ON-SITE SCHOOL PROGRAM, GEARED TOWARD 5TH AND 6TH GRADE STUDENTS, TEACHES STUDENTS EASY WAYS TO INCORPORATE HEALTHY CHOICES INTO DAILY LIVING. THE CURRICULUM IS DESIGNED TO IMPROVE OVERALL HEALTH IN A FUN AND MEANINGFUL WAY. THE FIT QUEST PROGRAM IS INCREDIBLY IMPACTFUL, REACHING OVER 40 SCHOOLS IN YUBA AND SUTTER COUNTY, PROVIDING SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS. THE EXPANDED CURRICULUM AND ROLE MODELING OF AND INTERACTIONS WITH THE NATURALISTS IN CHOOSING TO DRINK WATER, AND STAYING ACTIVE HAVE IMPACTED OVER 2,400 STUDENTS. SPECIALISTS HAVE BEEN ENGAGED THROUGHOUT THE PROCESS ATTENDING ASSEMBLIES AND PROVIDING GUIDANCE AND SUGGESTIONS AT PLANNING MEETINGS FOR CONTINUED ENHANCEMENTS IN THE FIT QUEST PROGRAM. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES; AND ACTIVE LIVING AND HEALTHY EATING. THE GOAL OF FIT QUEST IS TO TEACH CHILDREN HEALTHY LESSONS ABOUT THE IMPORTANCE OF PHYSICAL FITNESS, MENTAL WELLNESS AND NUTRITIOUS EATING. IN 2021, THERE WERE 882 STUDENTS SERVED. FOOD RESCUE PROGRAM IN PARTNERSHIP WITH SUTTER HEALTH, YUBA SUTTER FOOD BANK WILL EXPAND THE FOOD RESCUE PROGRAM THROUGH REPLACEMENT OF A DECOMMISSIONED TRUCK. DISTRIBUTION TARGETS PARTS OF COUNTIES VAPID OF FRESH FRUIT, VEGETABLES, AND OTHER HEALTHFUL WHOLE FOODS, USUALLY FOUND IN IMPOVERISHED AREAS. FOOD IS ALSO DISTRIBUTED TO OVER 30 PARTNER AGENCIES WHO SUPPORT FOOD ACCESS IN YUBA AND SUTTER COUNTY THROUGH A VARIETY OF PROGRAMS, INCLUDING FOOD PANTRIES AND HOT MEALS. THE GOAL OF THE PROGRAM IS TO RECOVER AN ESTIMAED 83,000 POUNDS OF SURPLUS FOOD FOR DISTRIBUTION TO NEARLY 8,000 PEOPLE WHO HAVE LIMITED ACCESS TO HEALTHY FOODS WILL IMPROVE THEIR OVERALL HEALTH AND WELL BEING. IN 2021, THERE WERE 13,781 INDIVIDUALS SERVED AND 2,222,844 POUNDS OF FOOD DISTRIBUTED. PROGRAMS ADDRESSING: ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD FOOD RESCUE PROGRAM IN PARTNERSHIP WITH SUTTER HEALTH, YUBA SUTTER FOOD BANK WILL EXPAND THE FOOD RESCUE PROGRAM THROUGH REPLACEMENT OF A DECOMMISSIONED TRUCK. DISTRIBUTION TARGETS PARTS OF COUNTIES VAPID OF FRESH FRUIT, VEGETABLES, AND OTHER HEALTHFUL WHOLE FOODS, USUALLY FOUND IN IMPOVERISHED AREAS. FOOD IS ALSO DISTRIBUTED TO OVER 30 PARTNER AGENCIES WHO SUPPORT FOOD ACCESS IN YUBA AND SUTTER COUNTY THROUGH A VARIETY OF PROGRAMS, INCLUDING FOOD PANTRIES AND HOT MEALS. THE GOAL OF THE PROGRAM IS TO RECOVER AN ESTIMAED 83,000 POUNDS OF SURPLUS FOOD FOR DISTRIBUTION TO NEARLY 8,000 PEOPLE WHO HAVE LIMITED ACCESS TO HEALTHY FOODS WILL IMPROVE THEIR OVERALL HEALTH AND WELL BEING. IN 2021, THERE WERE 13,781 INDIVIDUALS SERVED AND 2,222,844 POUNDS OF FOOD DISTRIBUTED. PROGRAMS ADDRESSING: ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES WOMEN'S HEALTH SCREENINGS AND MAMMOGRAMS IN HONOR OF BREAST CANCER AWARENESS MONTH, SUTTER MEDICAL FOUNDATION - NORTH OFFERS NO-COST MAMMOGRAMS AND WOMEN'S HEALTH SCREENINGS. THIS PROGRAM REMAINS A KEY INITIATIVE FOR SSHNV AND A CORNERSTONE EVENT FOR THE ENTIRE YUBA/SUTTER COMMUNITY. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE; AND ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES. THE GOAL OF THE SCREENING EVENT IS TO PROVIDE NO-COST MAMMOGRAMS AND HEALTH SCREENINGS FOR WOMEN WHO OTHERWISE WOULDN'T HAVE ACCESS TO ONE, DUE TO NO INSURANCE OR A HIGH, UNAFFORDABLE DEDUCTIBLES. IN 2021, 51 MAMMOGRAMS AND 63 WOMEN'S HEALTH SCREENINGS WERE PROVIDED. PROGRAMS ADDRESSING: ACCESS TO SPECIALTY AND EXTENDED CARE YOLO CARES NEWLY FUNDED PROGRAM IN 2020. YOLOCARES PROGRAM IS COMPREHENSIVE, 24/7, 360-DEGREE, COMMUNITY-BASED PALLIATIVE CARE (INCLUDING BEHAVIORAL HEALTH SERVICES, DISEASE MANAGEMENT AND IMPROVED ACCESS TO CARE) TO PATIENTS THROUGHOUT YOLO COUNTY. YOLOCARES SERVES AS THE PRIMARY CARE PHYSICIAN FOR YOLOCARE PATIENTS IN NEED AND WILL WORK WITH PARTNERS TO COORDINATE CARE. PEER-TO-PEER EDUCATION WILL BE OFFERED TO AREA PHYSICIANS ABOUT THE YOLOCARES PROGRAM TO HELP CREATE A STREAMLINED CONTINUUM OF CARE AND REFERRAL PROCESS BETWEEN YOLOCARES, YOLO ADULT DAY HEALTH CENTER, COMMUNICARE, AND FOURTH & HOPE THROUGH EDUCATIONAL WORKSHOPS. THE PROGRAM WILL WORK TO EXPAND THE KNOWLEDGE OF PALLIATIVE CARE, YOLOCARES SERVICES, AND ADVANCE CARE PLANNING THROUGH YOLO
SCHEDULE H, PART VI, LINE 6SUTTER HEALTH IS THE NOT-FOR-PROFIT PARENT OF NOT-FOR-PROFIT AND FOR-PROFIT COMPANIES THAT TOGETHER FORM AN INTEGRATED HEALTHCARE SYSTEM LOCATED IN NORTHERN CALIFORNIA. THE SYSTEM IS COMMITTED TO HEALTH EQUITY, COMMUNITY PARTNERSHIPS AND INNOVATIVE, HIGH-QUALITY PATIENT CARE. OUR OVER 65,000 EMPLOYEES AND ASSOCIATED CLINICIANS SERVE MORE THAN 3 MILLION PATIENTS THROUGH OUR HOSPITALS, CLINICS AND HOME HEALTH SERVICES. LEARN MORE ABOUT HOW WE'RE TRANSFORMING HEALTHCARE AT SUTTERHEALTH.ORG AND VITALS.SUTTERHEALTH.ORG SUTTER HEALTH'S TOTAL INVESTMENT IN COMMUNITY BENEFIT IN 2021 WAS $872 MILLION. THIS AMOUNT INCLUDES TRADITIONAL CHARITY CARE AND UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS. THIS AMOUNT ALSO INCLUDES INVESTMENTS IN COMMUNITY HEALTH PROGRAMS TO ADDRESS PRIORITIZED HEALTH NEEDS AS IDENTIFIED BY REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENTS. AS PART OF SUTTER HEALTH'S COMMITMENT TO FULFILL ITS NOT-FOR-PROFIT MISSION AND HELP SERVE SOME OF THE MOST VULNERABLE IN ITS COMMUNITIES, THE SUTTER HEALTH NETWORK HAS IMPLEMENTED CHARITY CARE POLICIES TO HELP PROVIDE ACCESS TO MEDICALLY NECESSARY CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2021, SUTTER HEALTH INVESTED $91 MILLION IN CHARITY CARE. OVERALL, SINCE THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT, GREATER NUMBERS OF PREVIOUSLY UNINSURED PEOPLE NOW HAVE MORE ACCESS TO HEALTHCARE COVERAGE THROUGH THE MEDI-CAL AND MEDICARE PROGRAMS. THE PAYMENTS FOR PATIENTS WHO ARE COVERED BY MEDI-CAL AND MEDICARE DO NOT COVER THE FULL COSTS OF PROVIDING CARE. IN 2021, SUTTER HEALTH INVESTED $557 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS. THROUGH COMMUNITY BENEFIT INVESTMENTS, SUTTER HELPED LOCAL COMMUNITIES ACCESS PRIMARY, MENTAL HEALTH AND ADDICTION CARE, AND BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD. SEE MORE ABOUT HOW SUTTER HEALTH REINVESTS INTO THE COMMUNITY BY VISITING SUTTERPARTNERS.ORG.
SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT: N/A

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
SUTTER VALLEY HOSPITALS
2200 RIVER PLAZA DR SACRAMENTOCASACRAMENTOCA95833941156621501(C)3$20,934PROGRAM SUPPORT
WELLSPACE HEALTH
777 12TH ST STE 250SACRAMENTOCA95814941713704501(C)3$10,000PROGRAM SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPGrantTypeTxt
Recipient8RecipientCnt
Cash Grant$8,000CashGrantAmt
Valuation Method UsedFMVValuationMethodUsedDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationIN ORDER TO CLOSELY MONITOR EFFICIENCY AND EFFECTIVENESS, THE COMMUNITY BENEFIT FUNCTION OUTLINES MEASURABLE REPORTING (QUARTERLY, SIX-MONTH AND/OR YEAR-END), PROGRAM AND FUNDING REQUIREMENTS IN A MEMORANDUM OF UNDERSTANDING (MOU), BUSINESS SERVICES AGREEMENT (BSA), OR JOINT VENTURE AGREEMENT FOR EACH INVESTMENT MADE WITH A COMMUNITY PARTNER. WHERE IT IS DETERMINED NECESSARY, ADDITIONAL EFFORTS ARE MADE TO MONITO EFFECTIVENESS AND EFFICIENCY OF INVESTMENTS, WHICH COULD INCLUDE: -QUARTERLY MEETINGS WITH COMMUNITY PARTNERS -E-MAIL AND TELEPHONIC COMMUNICATIONS WITH COMMUNITY PARTNERS -CONTINUED DIALOGUE WITH INVOLVED HOSPITAL STAFF AND COMMUNITY PARTNERS THROUGHOUT DURATION OF PROGRAM -SITE VISITS WITH COMMUNITY PARTNERS -BI-ANNUAL "OUTCOMES" SURVEY (6-MONTH AND/OR YEAR-END OUTCOMES) -REVIEW OF HOSPITAL USAGE AND PATIENT LEVEL DATA -COLLECTION OF PATIENT STORIES AND NARRATIVES -COLLABORATIVE DISCUSSIONS AROUND AD-HOC SUCCESS AND CHALLENGES THAT ARISE -REPORTING TO INCLUDE YEAR-END FINANCIAL SUMMARY THAT COMPARES ACTUAL EXPENDITURES TO THE FUNDED PROJECT'S BUDGET, INDICATING ANY UNUSED AMOUNT OF GRANT FUNDS. AT THE END OF EACH YEAR/REPORTING PERIOD, COMMUNITY BENEFIT ANALYZES FULL-YEAR DATA TO ENSURE COMMUNITY PARTNERS MET THE OBJECTIVES OUTLINED IN THE MOU OR BSA. IF THE COMMUNITY PARTNERS DID NOT REACH THE ANTICIPATED OUTCOMES, COMMUNITY BENEFIT WORKS TO UNDERSTAND THAT CIRCUMSTANCES PREVENTED THE ORGANIZATION FROM MEETING THE GOALS TO HELP IDENTIFY WAYS TO IMPROVE OR PERHAPS RE-EVALUATE WHAT SUCCESS OF THIS PROGRAM LOOKS LIKE, AND MAKES THE DETERMINATION TO CONTINUE OR TERMINATE FUNDING.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Sarah Krevans
DIR/PRES & CEO, SH$0$1,935,922$0$0$0$7,224,377$0$344,838$0$34,373$0$9,539,510$0$4,135,265
James Conforti
DIRECTOR/SH SVP & COO$0$1,119,575$0$709,247$0$207,587$0$526,438$0$30,824$0$2,593,671$0$306,460
Theresa Frei
CEO, SVMF$0$650,506$0$344,024$0$107,463$0$108,438$0$27,112$0$1,237,543$0$147,740
Gary Zufelt
FOUNDATION AREA CEO, N. Valley$0$501,448$0$237,689$0$63,962$0$70,038$0$28,314$0$901,451$0$90,454
Patrina White
CEO, SSCD/SWC$0$509,407$0$190,388$0$65,884$0$65,938$0$24,966$0$856,583$0$81,279
Jeff Szczesny
SH VP, HR Ops$0$512,098$0$133,154$0$66,865$0$64,538$0$27,407$0$804,062$0$68,550
Penny Westfall
SH VP, CLO, SEC$0$9,958$0$138,902$0$629,914$0$606$0$1,206$0$780,586$0$0
Todd Smith MD
FND Area CEO, South Valley$0$475,314$0$182,490$0$16,951$0$70,638$0$34,838$0$780,231$0$36,250
Sue Haddad
CFO FOUNDATION, SVMF$0$409,228$0$111,600$0$46,116$0$56,038$0$27,063$0$650,045$0$50,208
Peter Hull MD
CME, SRMC$0$379,005$0$56,154$0$41,343$0$46,738$0$26,917$0$550,157$0$33,231
Michael D Marino
VP, HR, SVMF & North Valley$0$319,245$0$46,020$0$30,471$0$42,738$0$18,301$0$456,775$0$24,832
Jonathan K Bareng
Dir, Radiation Physics$307,453$0$23,139$0$3,409$0$17,638$0$20,379$0$372,018$0$0$0
Benjamin Kirk
DEPUTY GEN COUNS, SEC$0$249,489$0$18,626$0$476$0$15,169$0$31,577$0$315,337$0$0
Chuan Wu
Lead Physicist$270,502$0$0$0$480$0$16,447$0$25,058$0$312,487$0$0$0
Fangyan Z Sy
SVMF Sr. Director Quality$230,095$0$17,086$0$1,361$0$13,990$0$26,918$0$289,450$0$0$0
Jennifer S Glass
Staff Radiation Physicist$242,359$0$0$0$1,149$0$14,735$0$25,058$0$283,301$0$0$0
Sandra L Adams
Dir, Service Area$221,399$0$16,645$0$7,201$0$13,461$0$19,629$0$278,335$0$0$0
Paige Terra
CFO, SHVA$0$0$0$0$0$232,494$0$0$0$0$0$232,494$0$0
Thomas Blinn
Former CEO, VAF$0$0$0$0$0$109,889$0$0$0$0$0$109,889$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THIS ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS'S LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH.
SCHEDULE J, PART I, LINE 4ATHE FOLLOWING INDIVIDUALS RECEIVED Severance PAYMENTS DURING THE YEAR: Penny Westfall: $ 500,140 SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PENSION PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA PROVIDES 6% TO 12% OF BASE SALARY PLUS ANNUAL INCENTIVE PLAN AWARD (COMMENSURATE WITH MANAGEMENT LEVEL). CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTH'S QUALIFIED PENSION PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. THE FOLLOWING INDIVIDUALS RECEIVED 457(F) NON-QUALIFIED PAYMENTS DURING THE YEAR: Sarah Krevans: $6,833,449 Penny Westfall: $ 117,086
SCHEDULE J, PART I, LINE 7NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 15% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP): THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, OPERATING UNIT AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. LONG TERM PERFORMANCE PLANS: SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTERS LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL LONG TERM PERFORMANCE PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT. AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CHFFA 2016B
A52164382813032UDW52016-08-17$901,627,093Refund 2005BC, 2003AB, 2007AYes (true)falsefalse
CHFFA 2017A
B52164382813032UNY02017-07-06$496,319,743Refund 2004CD, 2008A (pt), 2008BCYes (true)falsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$0$0$902,923,938$0$0$0$0$0$0$0$902,923,938$02016falseYes (true)Yes (true)Yes (true)
B$0$0$496,319,743$0$0$0$0$0$0$0$496,319,743$02017falseYes (true)Yes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndEngage Bond Counsel ResearchEngageBondCounselResearchIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalseYes (true)Yes (true)Yes (true)Yes (true)Yes (true)0.009200.000100.00930falsefalsefalseYes (true)
BfalseYes (true)Yes (true)Yes (true)Yes (true)Yes (true)0.015200.000200.01540falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
AfalseYes (true)falsefalsefalsefalsefalse0falseYes (true)
0
BfalseYes (true)falsefalsefalsefalsefalse0falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K:The organization's sole corporate member is a conduit borrower of tax-exempt bond issues that allocates portions of each issue to certain subsidiaries, including the organization. The outstanding bond liability allocated to this organization is reported on Form 990, Part X, Balance Sheet, and Part VI herein. With the exception of this portion of Part VI, the Schedule K for this organization is reporting information for the entire bond issue.
SCHEDULE K, PART I, COLUMN ETHE ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNT OF: $53,216,412 FROM THE 2016B ISSUE AND; $117,119,861 FROM THE 2017A. THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED IN PART I, COLUMN (E) AND THE PROCEEDS OF ISSUE IN PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 7ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1 & PART III, LINE 1MISSION STATEMENT: WE ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES.
FORM 990, PART III, LINE 4APROGRAM SERVICE ACCOMPLISHMENTS: Sutter Valley Medical Foundation (SVMF) is a community based, not-for-profit medical organization serving Central and Northern California communities and supporting the Sutter Health-affiliated hospitals. SVMF has care centers located in Amador, Placer, Sacramento, San Joaquin, Solano, Stanislaus, Sutter, Yolo and Yuba Counties. Our mission is to enhance the health and well-being of people in the communities we serve through not for profit commitment to compassion and excellence in health care. We value excellence and quality, caring and compassion, honesty and integrity, teamwork and community. Sutter Valley Medical Foundation is aligned with physician and mid-level providers of Gould Medical Group, Sutter Medical Group and Sutter North Medical Group. We offer a full range of primary care and specialty care medical services, including ambulatory surgery, urgent and walk-in care clinics and state of the art imaging, lab and cardiology technology. In addition, we operate the Twin Cities Surgical Hospital in Yuba County, as well as Rural Health Clinics in Amador and Yuba Counties and the Maino Community Health Library in Stanislaus County. In 2015, Sutter Medical Foundation changed its name to Sutter Valley Medical Foundation and in 2016, Sutter Gould Medical Foundation merged into Sutter Valley Medical Foundation. In 2021, the Foundation provided more than $46 million in charity care and community benefits and provided patient services of 6.5 million patient visits. The Foundation also provides community support through donations and participation in various not-for profit community programs including, but not limited to, the following: . American Cancer Society . American Heart Association . Fitquest program supporting student wellness thought schools in Sutter, Yuba, Sacramento and Placer Counties . Girls on The Run . Health Careers Academy program for high school students . Kiwanis . Look Good Feel Better program supporting women receiving cancer treatment . March of Dimes . National Diabetes Society . Rotary . Salvation Army . Soroptimist . Sponsor of support groups for disease related education including but not limited to diabetes, childbirth education, autism and Parkinson's . Tats Off, tattoo removal program . United Way
FORM 990, PART VI, LINE 1ATHE AFFAIRS AND MANAGEMENT OF SUTTER VALLEY MEDICAL FOUNDATION (SVMF) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SVMF DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTOR. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CORPORATION'S CHAIR WHO SHALL SERVE AS CHAIR OF THE COMMITTEE, THE CHAIR OF THE FINANCE AND PLANNING COMMITTEE, THE CHIEF OPERATING OFFICER OF THE GENERAL MEMBER (IF THIS POSITION IS OCCUPIED) AND TWO ADDITIONAL DIRECTORS. IF THE POSITION OF THE CHIEF OPERATING OFFICER OF THE GENERAL MEMBER IS NOT OCCUPIED, THEN THE PRESIDENT AND CEO OF THE GENERAL MEMBER MAY APPOINT EITHER A DESIGNATED DIRECTOR OR AN APPOINTED DIRECTOR AS A MEMBER. AT LEAST ONE EXECUTIVE COMMITTEE MEMBER SHALL BE A PHYSICIAN DIRECTOR.
FORM 990, PART VI, LINE 4IN 2021, SUTTER VALLEY MEDICAL FOUNDATION UPDATED ITS BYLAWS TO CHANGE THE NUMBER OF BOARD OF DIRECTORS. THE FORMER BYLAWS NOTED BETWEEN SEVENTEEN (17) TO TWENTY-FIVE (25) BOARD MEMBERS. THE AMENDED BYLAWS STATE THERE CAN BE BETWEEN NINE (9) AND NINETEEN (19) BOARD MEMBERS.
FORM 990, PART VI, LINE 6 & 7ACLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS: THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 7BCLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS: SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL.
FORM 990, PART VI, LINE 11BPROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW FORM 990: SUTTER HEALTH HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED.
FORM 990, PART VI, LINE 12PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST: EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. THE BOARD MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR (OR COMMITTEE CHAIR AS APPLICABLE) MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL LEAVE THE ROOM PRIOR TO THE BOARD'S FINAL DISCUSSION AND VOTE.
FORM 990, PART VI, LINES 15A & 15BPROCESS FOR DETERMINING COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE), (C) TOTAL DIRECT CASH (BASE SALARY + ANNUAL INCENTIVE + LONG TERM INCENTIVE) AND (D) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY ADJUSTMENTS MAY BE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL ANNUALLY, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE 2021 EXECUTIVE COMPENSATION APPROVAL WAS COMPLETED IN FEBRUARY 2021.
FORM 990, PART VI, LINE 19AVAILABILITY OF GOVERNING DOCUMENTS, COI POLICY & FINANCIAL STATEMENTS: THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART VII, SECTION A COMPENSATION OF BOARD MEMBERS: THE FOLLOWING BOARD MEMBERS OF THE ORGANIZATION ARE FULL-TIME EMPLOYEES (40 HOURS PER WEEK) OF SUTTER HEALTH AND THEIR SUTTER HEALTH SALARIES ARE REPORTED HEREIN. THESE INDIVIDUALS RECEIVE NO COMPENSATION FOR THEIR SERVICE AS BOARD MEMBERS OF THIS ORGANIZATION. - SARAH KREVANS - JAMES CONFORTI - PETER HULL INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID FULL-TIME BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF SUTTER HEALTH, A SEPARATE LEGAL ENTITY. IT IS THE INTENTION OF SUTTER HEALTH AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE SUTTER HEALTH EMPLOYEES WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION.
FORM 990, PART XI, LINE 9OTHER CHANGES IN FUND BALANCE: GAIN/(LOSS) ON HEALTH CARE INVESTMENTS $ 13,042,631 HEALTHCARE RELATED JV INCOME (5,613,929) GUARANTEED PAYMENT JV INCOME (1,112,760) EQUITY TRANSFERS (NET) (278,571,053) STOCK AND OTHER ITEMS (846,694) CHANGE IN SPLIT INTEREST 3,061 OTHER CHANGES 3,346,088 -------------- TOTAL: $ (269,752,656)
FORM 990 PART IX LINE 11GDESCRIPTION:MEDICAL GROUP COMPENSATION TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11GDESCRIPTION:PROF FEE - PHYSICIAN TOTAL FEES:4195863
FORM 990 PART IX LINE 11GDESCRIPTION:NON-PHYSICIAN MEDICAL TOTAL FEES:934
FORM 990 PART IX LINE 11GDESCRIPTION:THERAPISTS/OTHER MEDICAL TOTAL FEES:629845
FORM 990 PART IX LINE 11GDESCRIPTION:NURSE REGISTRY FEES TOTAL FEES:2021367

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1TWIN CITIES SURGICAL HOSPITAL LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 RIVER PLAZA DRIVEAddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95833ZIPCd
FieldValueIRS element (for citing)
EIN352182617EIN
Primary ActivitiesSURGERYPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Total Income$34,234,589TotalIncomeAmt
End Of Year Assets$18,971,657EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SUTTER VMFBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (19 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CALIFORNIA PACIFIC MEDICAL CTR FOUND
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833942728423FUNDRAISINGCA501(C)(3)7SUTTER BHYes (true)
EAST BAY PERINATAL CENTER
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833510172285HEALTHCARECA501(C)(3)3SUTTER BHYes (true)
MEMORIAL HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833942290244FUNDRAISINGCA501(C)(3)12A - ISUTTER VHYes (true)
MILLS-PENINSULA HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833237288765FUNDRAISINGCA501(C)(3)7SUTTER BHYes (true)
SAMUEL MERRITT UNIVERSITY
450 30TH STREET STE 2840OAKLANDCA94609942992642UNIVERSITYCA501(C)(3)2SUTTER BHYes (true)
SUTTER AUBURN FAITH HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833942594966FUNDRAISINGCA501(C)(3)7SUTTER VHYes (true)
SUTTER BAY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833940562680HOSPITALCA501(C)(3)3SUTTER HLTHYes (true)
SUTTER BAY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833941156581HEALTHCARECA501(C)(3)3SUTTER HLTHYes (true)
SUTTER COAST HOSPITAL
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833942988520HOSPITALCA501(C)(3)3SUTTER HLTHYes (true)
SUTTER DAVIS HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833680217870FUNDRAISINGCA501(C)(3)7SUTTER VHYes (true)
SUTTER HEALTH
2200 RIVER PLAZA DRIVESACRAMENTOCA95833942788907SUPPORTING ORCA501(C)(3)12C III-FINAfalse
SUTTER HEALTH PACIFIC
91-2301 FT WEAVER RDEWA BEACHHI96706990298651HOSPITALCA501(C)(3)3SUTTER HLTHYes (true)
SUTTER HEALTH PLAN
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833461183948HEALTH PLANCA501(C)(4)N/ASUTTER HLTHYes (true)
SUTTER MEDICAL CENTER FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833942788906FUNDRAISINGCA501(C)(3)7SUTTER VHYes (true)
SUTTER ROSEVILLE MEDICAL CTR FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833680040113FUNDRAISINGCA501(C)(3)7SUTTER VHYes (true)
SUTTER VALLEY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833941156621HOSPITALCA501(C)(3)3SUTTER HLTHYes (true)
SUTTER VISITING NURSE ASSOC AND HOSPICE
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833946068843HEALTHCARECA501(C)(3)10SUTTER HLTHYes (true)
TRACY HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DRSACRAMENTOCA95833680318845FUNDRAISINGCA501(C)(3)12A - ISUTTER VHYes (true)
SUTTER INSURANCE SERVICES CORPORATION
745 FORT STREET SUITE 1100HONOLULUHI96813990289310INSURANCE SERHI501(C)(3)12C III-FISUTTER HLTHYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctDirect Controlling NADirectControllingNACd
SURG CTR OF ABSMC
3875 TELEGRPHOAKLNDCA94609470946086PATIENT CARECANA
CA PACIFIC ADV IMAG
PO BOX 6102NOVATODE94598562311840PATIENT CAREDENA
SF ENDOSCOPY CENTER
2200 RIVER PLZSACRAMENTOCA95833912160588PATIENT CARECANA
PRESIDIO SURG CNTR
1635 DIVISADEROSFCA94115320144060PATIENT CARECANA
SUT FAIRFIELD SURG
2200 RIVER PLZSACRAMENTOCA95833300233892PATIENT CARECASUTTER VMFRELATED$3,383,564$4,701,192false$0Yes (true)0.79500
SUT AMADOR SURG CTR
2200 RIVER PLZSACRAMENTOCA95833461398093PATIENT CARECANARELATED-$284,220$450,241falsefalse0.38000
ROSEVILLE ENDOSCOPY
2200 RIVER PLZSACRAMENTOCA95833870710513PATIENT CARECANARELATED$3,061,060$1,620,075Yes (true)false0.40000
STANISLAUS SRG HOSP
1421 OAKDALE ROADMODESTOCA95355911754157PATIENT CARECANA-$301,456$5,177,502false0.31000
MEMORIAL MED BLDG 1
1800 COFFEE RD 76MODESTOCA95355770234236OFFICE RENTALCANA
MAGNETIC IMAGING AF
2125 OAK GROVEWLN CKCA94598473696091PATIENT CARECANA
ASC OPTRS-SNTA ROSA
2200 RIVER PLZSACRAMENTOCA95833263386169CARE MNGMTCANA
ASC OPTRS-SLO LLC
2200 RIVER PLZSACRAMENTOCA95833272673776CARE MNGMTCANA
ICG CREDIT OPP FUND
11111 SANTA MONICALOS ANGELESCA90025814220441INVESTMENTSCANA
CARLSBAD SURG CTR
6121 PASEO DEL NORTECARLSBADCA92011201413484PATIENT CARECANA
COAST CTR FOR ORTH
3444 KEARNY VILLA RDSAN DIEGOCA92123330839637PATIENT CARECANA
OTAY LAKES SURG CTR
955 LANE AVECHULA VISTACA91914200794766PATIENT CARECANA
MADISON INTL GLOBAL
410 PARK AVENEW YORKNY10022981310251INVESTMENTSNYNA
DIVISADERO HLDS LLC
1635 DIVISADEROSAN FRANCISCOCA94115320621050Outpatient suCANA
Auburn Surgery Center LP
2200 River Plaza DriveSacramentoCA95833364123623Surgery CenterCA$152,900$402,5230.17570N/A
ASC OPERATORS LLC
2200 RIVER PLAZA DRIVESACRAMENTOCA95833208970704care managementCANARelated$7,044,488$11,953,199falseYes (true)0.45000
PENINSULA ENDOSCOPY
2200 RIVER PLAZASACRAMENTOCA95833271905059PATIENT CARENA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCdAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCd
SUTTER HEALTH DEFERRED COMP PLANS' TRUST
2200 RIVER PLAZA DRIVESACRAMENTOCA95833276851989RABBI TRUSTCANATRUSTYes (true)
NORTHWOOD EUROPE TE FEEDER LP
1819 WAZEE ST 2ND FLOORDENVERCO90202981272216HOLDING COMPANAC CORPYes (true)CJ
LYXSOP SEGREGATED PORTFOLIO 1
INVESTMENTNAC CORPYes (true)CJPO BOX 10008 WILLOW HOUSECRICKET SQUAREGRAND CAYMANCJ
LYXSOP SEGREGATED PORTFOLIO 2
INVESTMENTNAC CORPYes (true)CJPO BOX 10008 WILLOW HOUSECRICKET SQUAREGRAND CAYMANCJ
AQR REAL RETURN OFFSHORE FUND LP
980700570INVESTMENTNAc corpYes (true)CJ89 NEXUS WAYCAMANA BAYGRAND CAYMANCJKY1-9009
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Sutter Health Plan
S$104,823,050FMV
Sutter Insurance Services Corporation
P$4,351,557FMV
Sutter Bay Hospitals
R$261,929FMV
Sutter Bay Medical Foundation
R$188,171FMV
Sutter Valley Hospitals
P$2,278,511FMV
Sutter Valley Hospitals
R$48,815,944FMV
Sutter Visiting Nurse Association and Hospice
R$578,502FMV
Sutter Fairfield Surgery Center LLC
P$53,994FMV
Sutter Valley Hospitals
J$572,374FMV
Sutter Fairfield Surgery Center LLC
J$803,122FMV
Sutter Valley Hospitals
K$9,586,860FMV