SUTTER VALLEY MEDICAL FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- SUTTER VALLEY MEDICAL FOUNDATION (EIN 68-0273974)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-14
- IRS object ID
- 202133189349301573
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-14T22:11:01-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 560 MISSION ST STE 1600 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680273974 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER VALLEY MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JONATHAN ZACHRESON | InCareOfNm |
| Business Name Control | SUTT | BusinessNameControlTxt |
| Phone | 9162866665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O SH TAX 2200 RIVER PLAZA DR | AddressLine1Txt |
| City | SACRAMENTO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95833 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUE HADDAD | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9162866665 | PhoneNum |
| Signature | 2021-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SUE | PersonFirstNm |
| Person Last | HADDAD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EVA NITTA | PreparerPersonNm |
| PTIN | P01286320 | PTIN |
| Phone | 4158948000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | THERESA FREI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O SH TAX 2200 RIVER PLAZA DR | AddressLine1Txt |
| City | SACRAMENTO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95833 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,657,374,068 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SUTTERHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 5437 | TotalEmployeeCnt |
| Total Volunteers | 36 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,683,097 | PYContributionsGrantsAmt |
| CY Contributions Grants | $79,672,596 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,637,548,736 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,576,304,649 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,635,357 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,288,801 | CYInvestmentIncomeAmt |
| PY Other Revenue | $93,652 | PYOtherRevenueAmt |
| CY Other Revenue | $101,703 | CYOtherRevenueAmt |
| PY Total Revenue | $1,640,960,842 | PYTotalRevenueAmt |
| CY Total Revenue | $1,657,367,749 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $480,055 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $125,279 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $442,336,119 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $463,256,543 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $290,647 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,189,818,944 | PYOtherExpensesAmt |
| CY Other Expenses | $1,193,379,167 | CYOtherExpensesAmt |
| PY Total Expenses | $1,632,635,118 | PYTotalExpensesAmt |
| CY Total Expenses | $1,656,760,989 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,325,724 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $606,760 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $657,737,276 | TotalAssetsBOYAmt |
| Total Assets EOY | $896,771,770 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $459,714,510 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $456,390,268 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $198,022,766 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $440,381,502 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,520,864,029 | ExpenseAmt |
| Grant | $125,279 | GrantAmt |
| Revenue | $1,576,304,649 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $1,520,864,029 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1262 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 5437 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JONATHAN ZACHRESON | PersonNm |
| Phone | 9162866665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9100 FOOTHILLS BOULEVARD | AddressLine1Txt |
| City | ROSEVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95747 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Sarah Krevans | ||||||||||
| DIRECTOR/PRESIDENT & CEO, SH | 2.0 | 40.0 | Yes (X) | $0 | $3,159,516 | $403,159 | ||||
| James Conforti | ||||||||||
| DIRECTOR/SH SVP & COO | 4.0 | 40.0 | Yes (X) | $0 | $1,967,179 | $495,099 | Yes (X) | |||
| Theresa Frei | ||||||||||
| CEO, SVMF | 2.0 | 40.0 | $0 | $1,096,965 | $117,063 | Yes (X) | ||||
| Paige Terra | ||||||||||
| CFO, SH Valley Area (pt-yr) | 2.0 | 40.0 | $0 | $960,662 | $99,027 | Yes (X) | ||||
| Gary Zufelt | ||||||||||
| FNDTN AREA CEO, NORTH VALLEY | 0.0 | 40.0 | $0 | $810,823 | $95,020 | Yes (X) | ||||
| Penny Westfall | ||||||||||
| SH VP, CLO, SH BAY & VALLEY | 2.0 | 40.0 | $0 | $820,028 | $74,390 | Yes (X) | ||||
| Jeff Szczesny | ||||||||||
| SH VP, HR Operations | 0.0 | 40.0 | $0 | $804,856 | $88,593 | Yes (X) | ||||
| Patrina White | ||||||||||
| FNDTN AREA CEO, CENTRAL VALLEY | 0.0 | 40.0 | $0 | $769,386 | $85,992 | Yes (X) | ||||
| Sue Haddad | ||||||||||
| CFO, SH Valley Area Fndtn | 2.0 | 40.0 | $0 | $663,672 | $80,330 | Yes (X) | ||||
| Todd Smith MD | ||||||||||
| Foundation Area CEO, SV | 0.0 | 40.0 | $0 | $599,387 | $103,638 | Yes (X) | ||||
| Peter Hull MD | ||||||||||
| Director/CME SRMC | 2.0 | 40.0 | Yes (X) | $0 | $606,558 | $71,265 | ||||
| Michael D Marino | ||||||||||
| VP, HR, SVMF & North Valley | 0.0 | 40.0 | $0 | $516,215 | $55,556 | Yes (X) | ||||
| Jonathan K Bareng | ||||||||||
| Dir, Radiation Physics | 40.0 | 0.0 | $394,233 | $0 | $34,287 | Yes (X) | ||||
| Chuan Wu | ||||||||||
| Lead Physicist | 40.0 | 0.0 | $273,937 | $0 | $38,372 | Yes (X) | ||||
| Sandra L Adams | ||||||||||
| Dir, Service Area | 40.0 | 0.0 | $274,796 | $0 | $31,073 | Yes (X) | ||||
| Fangyan Z Sy | ||||||||||
| SVMF Sr. Director Quality | 40.0 | 0.0 | $260,936 | $0 | $37,565 | Yes (X) | ||||
| Jennifer S Glass | ||||||||||
| Staff Radiation Physicist | 40.0 | 0.0 | $253,307 | $0 | $37,239 | Yes (X) | ||||
| Helen Thomson | ||||||||||
| Director/SH Board | 2.0 | 9.0 | Yes (X) | $0 | $11,458 | $0 | ||||
| I-Mei Hsiu MD | ||||||||||
| Director/SH Board | 2.0 | 9.0 | Yes (X) | $0 | $4,583 | $0 | ||||
| Kurt Shuler MD | ||||||||||
| Director | 2.0 | 3.0 | Yes (X) | $0 | $0 | $0 | ||||
| David Adkins MD | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Timothy Byrd | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Viva Ettin MD | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Bronwyn Fields RN | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Dan Flores | ||||||||||
| Chair Finance & Planning | 4.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Megan Gross MD | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Gary Hooper | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Maria Pallavicini | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Pat Pathipati | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Fatima Seward | ||||||||||
| Chair | 4.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Jerry Tokunaga | ||||||||||
| Director | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,457,209 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,791,288 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,947,668 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 786 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DEACON CONSTRUCTION LLC | |||||
| 7745 GREENBACK LN STE 250 | CITRUS HEIGHTS | CA | 956105865 | CONSTRUCTION SVCS | $4,230,809 |
| HSS INC | |||||
| 900 S BROADWAY STE 100 | DENVER | CO | 802094269 | SECURITY SERVICES | $2,240,871 |
| ADVANCED BUILDING MAINTENANCE | |||||
| 1804 TRIBUTE RD STE K | SACRAMENTO | CA | 958134313 | JANITORIAL SERVICES | $2,149,623 |
| QUEST DIAGNOSTICS NICHOLS | |||||
| PO BOX 912501 | PASADENA | CA | 911102501 | SECURITY SERVICES | $1,893,637 |
| MEDICINE PHYSICIANS INC | |||||
| 8849 AHMED AVE | ELK GROVE | CA | 95624 | STAFFING SERVICES | $1,662,304 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 84 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $300 | FederatedCampaignsAmt |
| Related Organizations | $282,321 | RelatedOrganizationsAmt |
| Government Grants | $78,929,443 | GovernmentGrantsAmt |
| All Other Contributions | $460,532 | AllOtherContributionsAmt |
| Noncash Contributions | $10,076 | NoncashContributionsAmt |
| Total Contributions | $79,672,596 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $1,567,633,123 | $1,567,633,123 |
| HEALTHCARE RELATED JV INCOME | 621110 | $6,874,134 | $6,874,134 |
| RENTAL TO AFFILIATES | 621110 | $1,166,856 | $1,166,856 |
| GUARANTEED PAYMENT JV INCOME | 621110 | $630,536 | $630,536 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,576,304,649 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,172,801 | TotalRevenueColumnAmt |
| Exclusion | $1,172,801 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $70,011 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,319 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,692 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,692 | TotalRevenueColumnAmt |
| Exclusion | $63,692 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $116,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $116,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $116,000 | TotalRevenueColumnAmt |
| Exclusion | $116,000 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SFSC ADMIN FEE | Desc |
| Business | 541610 | BusinessCd |
| Total Revenue Column | $38,011 | TotalRevenueColumnAmt |
| Exclusion | $38,011 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $38,011 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,657,367,749 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,576,304,649 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,390,504 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,279 | TotalAmt |
| Program Services | $121,279 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,144,785 | TotalAmt |
| Program Services | $252,479,704 | ProgramServicesAmt |
| Management And General | $20,577,141 | ManagementAndGeneralAmt |
| Fundraising | $87,940 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,176,636 | TotalAmt |
| Program Services | $21,430,081 | ProgramServicesAmt |
| Management And General | $1,746,555 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,644,728 | TotalAmt |
| Program Services | $131,794,424 | ProgramServicesAmt |
| Management And General | $10,741,269 | ManagementAndGeneralAmt |
| Fundraising | $109,035 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,290,394 | TotalAmt |
| Program Services | $22,459,908 | ProgramServicesAmt |
| Management And General | $1,830,486 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,086,906 | TotalAmt |
| Program Services | $70,458 | ProgramServicesAmt |
| Management And General | $1,016,448 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,827 | TotalAmt |
| Program Services | $179,827 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $482,034 | TotalAmt |
| Management And General | $482,034 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630,494,537 | TotalAmt |
| Program Services | $614,874,117 | ProgramServicesAmt |
| Management And General | $15,620,420 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,083 | TotalAmt |
| Management And General | $76,083 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,955,271 | TotalAmt |
| Program Services | $2,841,992 | ProgramServicesAmt |
| Management And General | $10,112,356 | ManagementAndGeneralAmt |
| Fundraising | $923 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,318,340 | TotalAmt |
| Program Services | $26,462,142 | ProgramServicesAmt |
| Management And General | $15,856,198 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,289,925 | TotalAmt |
| Program Services | $49,938,786 | ProgramServicesAmt |
| Management And General | $2,351,139 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,154,344 | TotalAmt |
| Program Services | $1,024,150 | ProgramServicesAmt |
| Management And General | $130,194 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,663 | TotalAmt |
| Program Services | $87,330 | ProgramServicesAmt |
| Management And General | $95,333 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,760,417 | TotalAmt |
| Program Services | $6,760,417 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,336,586 | TotalAmt |
| Program Services | $36,763,300 | ProgramServicesAmt |
| Management And General | $3,573,286 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,467,632 | TotalAmt |
| Program Services | $1,118,596 | ProgramServicesAmt |
| Management And General | $1,349,036 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CAPITATED SERVICES | $134,234,501 | $134,234,501 | ||
| SYSTEM ALLOCATIONS | $113,406,486 | $78,422,164 | $34,925,083 | $59,239 |
| MEDICAL SUPPLIES | $92,923,535 | $92,923,535 | ||
| PURCHASED SERVICES | $50,638,415 | $37,194,073 | $13,442,747 | $1,595 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,390,665 | TotalAmt |
| Program Services | $9,679,245 | ProgramServicesAmt |
| Management And General | $1,679,505 | ManagementAndGeneralAmt |
| Fundraising | $31,915 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,656,760,989 | TotalAmt |
| Program Services | $1,520,864,029 | ProgramServicesAmt |
| Management And General | $135,606,313 | ManagementAndGeneralAmt |
| Fundraising | $290,647 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,256,760 | BOYAmt |
| EOY | $396,169,403 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,026,674 | BOYAmt |
| EOY | $109,027 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,923,954 | BOYAmt |
| EOY | $81,891,329 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,078,287 | BOYAmt |
| EOY | $9,830,238 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $408,812 | BOYAmt |
| EOY | $776,316 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $783,960,922 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $490,800,816 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $307,624,847 | BOYAmt |
| EOY | $293,160,106 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $967,540 | BOYAmt |
| EOY | $897,351 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,056,473 | BOYAmt |
| EOY | $16,394,730 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,283,299 | BOYAmt |
| EOY | $24,283,299 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,110,630 | BOYAmt |
| EOY | $73,259,971 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $657,737,276 | BOYAmt |
| EOY | $896,771,770 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,818,174 | BOYAmt |
| EOY | $189,638,627 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,242,968 | BOYAmt |
| EOY | $149,256,914 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,653,368 | BOYAmt |
| EOY | $117,494,727 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,714,510 | BOYAmt |
| EOY | $456,390,268 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,213,906 | BOYAmt |
| EOY | $438,480,953 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,808,860 | BOYAmt |
| EOY | $1,900,549 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,022,766 | BOYAmt |
| EOY | $440,381,502 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $657,737,276 | BOYAmt |
| EOY | $896,771,770 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $606,760 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$104,105 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$988,000 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $242,844,081 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $217,076 | BeginningYearBalanceAmt |
| Contributions | $5,796 | ContributionsAmt |
| Investment Earnings Or Losses | $4,650 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,000 | OtherExpendituresAmt |
| End Year Balance | $223,522 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $144,711 | BeginningYearBalanceAmt |
| Contributions | $67,800 | ContributionsAmt |
| Investment Earnings Or Losses | $5,460 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $895 | GrantsOrScholarshipsAmt |
| End Year Balance | $217,076 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $113,025 | BeginningYearBalanceAmt |
| Contributions | $29,320 | ContributionsAmt |
| Investment Earnings Or Losses | $2,366 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $144,711 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,600 | BeginningYearBalanceAmt |
| Contributions | $12,425 | ContributionsAmt |
| End Year Balance | $113,025 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $100,600 | ContributionsAmt |
| End Year Balance | $100,600 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.96610 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03390 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,804,700 | OtherCostOrOtherBasisAmt |
| Book Value | $43,804,700 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $348,356,303 | OtherCostOrOtherBasisAmt |
| Depreciation | $169,528,457 | DepreciationAmt |
| Book Value | $178,827,846 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,294,204 | OtherCostOrOtherBasisAmt |
| Depreciation | $68,799,434 | DepreciationAmt |
| Book Value | $18,494,770 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $273,758,549 | OtherCostOrOtherBasisAmt |
| Depreciation | $236,025,868 | DepreciationAmt |
| Book Value | $37,732,681 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,747,166 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,447,057 | DepreciationAmt |
| Book Value | $14,300,109 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $293,160,106 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERCOMPANY RECEIVABLES | $4,222,225 |
| NOTES RECEIVABLE | $873,214 |
| OTHER RECEIVABLES | $4,567,820 |
| OTHER ASSETS | $63,596,712 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $73,259,971 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INSURANCE LIABILITIES | $1,169,162 |
| THIRD PARTY SETTLEMENTS | $59,075,074 |
| CAPITAL LEASES | $205,830 |
| OTHER LIABILITIES | $57,044,661 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $117,494,727 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | THE 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 2 | ASC 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, THE LEGAL ENTITY, 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 2017 THROUGH 2019 REMAIN 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. AT DECEMBER 31, 2020 AND 2019, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| Indiv Hospital Tailored Policy | Yes (X) | IndivHospitalTailoredPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 400. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,881,593 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,881,593 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $117,726,194 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $58,941,236 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $58,784,958 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03550 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,566,272 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,566,678 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,999,594 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $125,174,059 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $60,507,914 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $64,666,145 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03900 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 3258 | PersonsServedCnt |
| Total Community Benefit Expns | $233,785 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $233,785 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $2,109,624 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,863,369 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $246,255 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $3,375,345 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,307,958 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,067,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $399,008 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $191,079 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $207,929 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 35 | PersonsServedCnt |
| Total Community Benefit Expns | $2,119,671 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,119,671 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 19 | ActivitiesOrProgramsCnt |
| Persons Served | 3293 | PersonsServedCnt |
| Total Community Benefit Expns | $8,237,433 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,362,406 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,875,027 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 19 | ActivitiesOrProgramsCnt |
| Persons Served | 3293 | PersonsServedCnt |
| Total Community Benefit Expns | $133,411,492 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $64,870,320 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $68,541,172 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04120 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $12,378,058 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $26,210,696 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,832,638 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STANISLAUS SURG HOSP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MEDICAL SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.31 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.4567 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|---|
| TWIN CITIES SURGICAL HOSPITAL | |||||||||
| 1 | 455 PLUMAS BLVD | YUBA CITY | CA | 959915074 | https://www.sutterhealth.org/sshnv | LICENSE #550000989 | Yes (X) | Yes (X) | OUTPATIENT SERVICES |
| STANISLAUS SURGICAL HOSPITAL | |||||||||
| 2 | 1421 OAKDALE ROAD | MODESTO | CA | 953553356 | WWW.STANISLAUSSURGICAL.COM/ | LICENSE #030000695 | Yes (X) | Yes (X) | OUTPATIENT SERVICES |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Prior CHNA ImpactPriorCHNAImpactInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Other WebsiteOtherWebsiteInd | Other Website URLOtherWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Provided Nonprofit ContactProvidedNonprofitContactInd | Other MethodOtherMethodInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP TranslatedFAPTranslatedInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | Provided Written NoticeProvidedWrittenNoticeInd | Made Effort Orally NotifyMadeEffortOrallyNotifyInd | Processed FAP ApplicationProcessedFAPApplicationInd | Made Presumptive Elig DetermMadePresumptiveEligDetermInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Prospective Medicare MedicaidProspectiveMedicareMedicaidInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd | Asset Level CriteriaAssetLevelCriteriaInd | No Emergency CareNoEmergencyCareInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TWIN CITIES SURGICAL HOSPITAL | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 19 | Yes (true) | Yes (true) | Yes (true) | Yes (true) | Yes (X) | SEE PART V, SECTION C | Yes (X) | SEE PART V, SECTION C | Yes (X) | Yes (true) | 19 | Yes (true) | SEE PART V, SECTION C | false | Yes (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 C | Yes (X) | SEE PART V, SECTION C | Yes (X) | SEE PART V, SECTION C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | false | ||
| STANISLAUS SURGICAL HOSPITAL | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 19 | Yes (true) | Yes (true) | Yes (true) | Yes (true) | Yes (X) | SEE PART V, SECTION C | Yes (X) | SEE PART V, SECTION C | Yes (X) | Yes (true) | 19 | Yes (true) | SEE PART V, SECTION C | false | Yes (true) | Yes (X) | 100 | 350. | 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 C | Yes (X) | SEE PART V, SECTION C | Yes (X) | SEE PART V, SECTION C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | false | Yes (X) | false | false | Yes (X) | Yes (X) |
Supplemental Information SupplementalInformationGrp (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3E | TWIN 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 5 | TWIN 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 HTTPS://WWW.SUTTERHEALTH.ORG/SSHNV/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS-ASS ESSMENT |
| SCHEDULE H, PART V, SECTION B, LINES 6A AND 6B | TWIN 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 | HOSPITAL FACILITY WEBSITES: TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): https://www.sutterhealth.org/PDF/FOR-PATIENTS/CHNA/SSHNV-2019-CHNA.PDF SCHEDULE H, PART V, SECTION B, LINE 7B OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/SSHNV/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY: TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): https://www.sutterhealth.org/PDF/FOR-PATIENTS/CHNA/ SSHNV-2019-2021-IMPLEMENTATION-STRATEGY.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 11 | TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT 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 15E | TWIN 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, & 16C | TWIN 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 16J | TWIN 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 22D | TWIN 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 3E | STANISLAUS 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 5 | STANISLAUS 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-ASSESSMEN T |
| SCHEDULE H, PART V, SECTION B, LINE 6 | STANISLAUS 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 | HOSPITAL FACILITY WEBSITES: STANISLAUS SURGICAL HOSPITAL (FACILITY 12): HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/MMC-SSH-2019-CHNA.PDF SCHEDULE H, PART V, SECTION B, LINE 7B OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY: STANISLAUS SURGICAL HOSPITAL (FACILITY 12): HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/ SSH-2019-IMPLEMENTATION-STRATEGY.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 11 | STANISLAUS 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 federally qualified health centers (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 primary care physician (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 15E | STANISLAUS 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 16C | STANISLAUS SURGICAL HOSPITAL (FACILITY 2): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTPS://STANISLAUSSURGICAL.COM/FINANCIAL-ASSISTANCE |
| SCHEDULE H, PART V, SECTION B, LINE 16J | STANISLAUS 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 82 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (82 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Sutter Med Care Ct & Ambulatory Surg Ct | ||||
| 460 Plumas | Yuba City | CA | 95991 | Outpatient Services/Surgery Center |
| Modesto Urgent Care | ||||
| 600 Coffee Road | Modesto | CA | 95355 | Urgent Care |
| Stockton Medical Plaza I | ||||
| 2545 West Hammer Lane | Stockton | CA | 95209 | Urgent Care/Surgery Center/ Outpatient Services |
| Stockton Medical Plaza II | ||||
| 2505 West Hammer Lane | Stockton | CA | 95209 | Urgent Care/Surgery Center/ Outpatient Services |
| Stockton Surgery Center | ||||
| 8011 Don Avenue | Stockton | CA | 95209 | Surgery Center |
| Patterson Care Center | ||||
| 801 E Street | Patterson | CA | 95363 | Lab/Outpatient Services |
| Turlock Care Center | ||||
| 3100 W Christoffersen Parkway | Turlock | CA | 95382 | Urgent Care/Radiology/ Laboratory |
| Briggsmore Specialty Center | ||||
| 1409 E Briggsmore | Modesto | CA | 95355 | Outpatient Services |
| Sutter Imaging Sacramento | ||||
| 3161 L Street | Sacramento | CA | 95816 | Imaging |
| Sutter Roseville Cancer Center | ||||
| 8 Medical Plaza Drive | ROSEVILLE | CA | 95661 | Outpatient Services |
| 3 Medical Plaza Care Center | ||||
| 3 MEDICAL PLAZA DRIVE | ROSEVILLE | CA | 95661 | Outpatient Services |
| Sutter Imaging Roseville Parkway | ||||
| 1640 East Roseville Parkway | ROSEVILLE | CA | 95661 | Imaging |
| Sutter Imaging Roseville II | ||||
| 2 Medical Plaza Drive | ROSEVILLE | CA | 95661 | Imaging |
| Sutter Medical Plaza - Sutter Place | ||||
| 2020 SUTTER PLACE | Davis | CA | 95616 | Outpatient Services |
| Sutter Urgent Care Fairfield | ||||
| 2702 Low Court | Fairfield | CA | 94534 | Outpatient Services |
| Sutter Yuba City Medical Center | ||||
| 480 Plumas | Yuba City | CA | 95991 | Outpatient Services |
| Sutter Medical Plaza Vacaville | ||||
| 770 Mason Street | Vacaville | CA | 95687 | Outpatient Services |
| Sutter Medical Plaza Vallejo | ||||
| 100 Hospital Drive | Vallejo | CA | 94589 | Outpatient Services |
| Sutter Amador Surgery Center | ||||
| 223 Clinton Road | Jackson | CA | 95642 | Outpatient Services |
| Sutter Fairfield Surgery Center | ||||
| 2700 Low Court | Fairfield | CA | 94534 | Surgery Center |
| Urgent CareLabRadiologyCardiology | ||||
| 440 Plumas | Yuba City | CA | 95991 | Urgent Care/Lab/Radiology/ Cardiology |
| Auburn Gastroenterology & Neurology | ||||
| 11795 Education Street | Auburn | CA | 95602 | Gastroenterology and Neurology PHYSICAL THERAPY |
| ROSEVILLE - FAMILY PRACTICE AND PHY TH | ||||
| 568 N SUNRISE AVE | ROSEVILLE | CA | 95661 | Outpatient Services and Physical Therapy |
| Sutter Physical & Hand Th Elk Grove | ||||
| 9280 W STOCKTON BLVD | ELK GROVE | CA | 95758 | PHYSICAL THERAPY |
| GRASS VALLEY FAMILY PRACTICE & PHY TH | ||||
| 10058 WOLF ROAD | GRASS VALLEY | CA | 95949 | Outpatient Services and Physical Therapy |
| Sutter Physical & Hand Th Auburn | ||||
| 11930 Heritage Oak Place | Auburn | CA | 95603 | PHYSICAL THERAPY |
| Sutter Medical Foundation PHY TH | ||||
| 420 B St | Yuba City | CA | 95991 | Physical Therapy |
| Sutter Fairfield Diagnostic Imaging Ctr | ||||
| 2700 Low Court | Fairfield | CA | 94534 | Diagnostic Imaging Center |
| Sutter Imaging Campus Commons | ||||
| 2 Scripps Drive | Sacramento | CA | 95825 | Diagnostic Imaging Center |
| Sutter Imaging South | ||||
| 8118 Timberlake Way | Sacramento | CA | 95823 | Diagnostic Imaging Center |
| Sutter Medical Plaza Folsom | ||||
| 2575 E BIDWELL ST | FOLSOM | CA | 95630 | Outpatient Svcs/Urgent Care |
| Fort Sutter Surgery Center | ||||
| 2801 K ST | SACRAMENTO | CA | 95816 | Outpatient Services |
| Sutter Medical Plaza Roseville | ||||
| 3100 DOUGLAS BLVD | ROSEVILLE | CA | 95661 | Outpatient Services |
| Alhambra Medical Office & Urgent Ctr | ||||
| 1201 ALHAMBRA BLVD | SACRAMENTO | CA | 95816 | Outpatient Services |
| Sutter Capitol Pavilion | ||||
| 2725 CAPITOL AVE | SACRAMENTO | CA | 95816 | Outpatient Services |
| 635 Anderson Road Care Center | ||||
| 635 ANDERSON RD | Davis | CA | 95616 | Outpatient Services |
| West Sacramento Walk-In Care | ||||
| 2055 Town Center Plaza | West Sacramento | CA | 95691 | Outpatient Services |
| Natomas Walk-In Care | ||||
| 2860 Del Paso Road | Sacramento | CA | 95834 | Outpatient Services |
| West Roseville Care Center | ||||
| 2050 Blue Oaks Boulevard | Roseville | CA | 95747 | Outpatient Services |
| Davis Walk-In Care | ||||
| 4647 Second Street | Sacramento | CA | 95618 | Outpatient Services |
| Sutter Medical Plaza Elk Grove | ||||
| 8170 LAGUNA BLVD | ELK GROVE | CA | 95758 | Outpatient Services |
| SMF Surgery Center | ||||
| 8200 LAGUNA BLVD | ELK GROVE | CA | 95758 | Amblulatory Surgery Center |
| Sutter Imaging RosevillePET | ||||
| 2241 Douglas Boulevard | Roseville | CA | 95661 | Imaging |
| Sutter Medical Plaza Natomas | ||||
| 2210 DEL PASO RD | SACRAMENTO | CA | 95831 | Outpatient Services |
| Sutter Medical Plaza Lincoln | ||||
| 685 TWELVE BRIDGES DR | LINCOLN | CA | 95648 | Outpatient Services |
| Sutter Imaging Folsom I | ||||
| 1655 Creekside Drive | FOLSOM | CA | 95630 | Diagnostic Imaging Center |
| Sutter Imaging Folsom II | ||||
| 1661 Creekside Drive | FOLSOM | CA | 95630 | Diagnostic Imaging Center |
| Sutter Medical Plaza Woodland | ||||
| 475 PIONEER AVE | WOODLAND | CA | 95776 | Outpatient Services |
| Sutter Medical Plaza Dixon | ||||
| 125 N LINCOLN ST | DIXON | CA | 95620 | Outpatient Services |
| Bell Road Medical Offices | ||||
| 3288 BELL RD | AUBURN | CA | 95603 | Outpatient Services |
| Sutter Medical Plaza Greenback Lab | ||||
| 5767 GREENBACK LANE | SACRAMENTO | CA | 95825 | Laboratory |
| Sutter Medical Plaza Greenhaven Lab | ||||
| 7420 GREENHAVEN DR | SACRAMENTO | CA | 95831 | Laboratory |
| Sutter Imaging Auburn | ||||
| 3123 Professional Drive | Auburn | CA | 95603 | Diagnostic Imaging Center Gastroenterology |
| Sutter Imaging Carmichael | ||||
| 6620 Coyle Avenue | Carmichael | CA | 95608 | Diagnostic Imaging Center |
| Behavorial Health Center | ||||
| 3425 Coffee Road | Modesto | CA | 95355 | Behavioral Healthcare |
| Procedure Center | ||||
| 550 B St | Yuba City | CA | 95991 | Procedure Center |
| 400 Plumas Care Center | ||||
| 400 Plumas | Yuba City | CA | 95991 | Outpatient Services |
| Davis Internal Med and Gastroenterology | ||||
| 2068 John Jones Road | Davis | CA | 95616 | Internal Medicine and Gastroenterology |
| L STREET MEDICAL NEUROLOGY | ||||
| 2800 L Street | SACRAMENTO | CA | 95819 | Neurology |
| 470 Plumas Care Center | ||||
| 470 Plumas | Yuba City | CA | 95991 | Orthopedics & Podiatry |
| Sutter Obstetrics and Gynecology | ||||
| 969 Plumas | Yuba City | CA | 95991 | Obstetrics |
| Sutter Advanced Dermatology & Laser Ctr | ||||
| 350 Del Norte | Yuba City | CA | 95991 | Dermatology |
| Sacramento - Midtown Walk-In Care | ||||
| 1360 16th Street | Sacramento | CA | 95814 | Outpatient Services |
| Sacramento - Loehmanns Pl W-I Care | ||||
| 2537 Fair Oaks Boulevard | Sacramento | CA | 95825 | Outpatient Services |
| Roseville - Foothills Walk-In | ||||
| 4010 Foothills Boulevard | ROSEVILLE | CA | 95747 | Outpatient Services |
| El Dorado Hills Walk-In Care | ||||
| 3919 Park Drive | El Dorado Hills | CA | 95762 | Outpatient Services |
| Elk Grove Walk-In Care | ||||
| 4810 Elk Grove Boulevard | ELK GROVE | CA | 95758 | Outpatient Services |
| Citrus Heights Walk-In Care | ||||
| 5406 Sunrise Boulevard | Citrus Heights | CA | 95610 | Outpatient Services |
| Rancho Cordova Walk-In Care | ||||
| 4040 Sunrise Boulevard | Rancho Cordova | CA | 95742 | Outpatient Services |
| Roseville Walk-In Care | ||||
| 781 Pleasant Grove Boulevard | Roseville | CA | 95678 | Outpatient Services |
| Folsom Walk-In Care | ||||
| 2766 East Bidwell Street | FOLSOM | CA | 95630 | Outpatient Services |
| SUTTER GOULD CARD STOCKTON CARE Ctr | ||||
| 1801 East March Lane | Stockton | CA | 95210 | Cardiology |
| Radiation Oncology Services-Vacaville | ||||
| 200 Bella Vista Road | Vacaville | CA | 95687 | Outpatient Services |
| Oakdale Road Care Center | ||||
| 1501 Oakdale Road Suite 218 | Modesto | CA | 95355 | Surgery Center |
| Ceres Care Center Lab | ||||
| 2516 Whitmore Avenue | Ceres | CA | 95307 | Outpatient Services |
| Tracy Care Center | ||||
| 445 W Eaton Ave | Tracy | CA | 95376 | Outpatient Services |
| Laboratory | ||||
| 100 Mission Blvd | Jackson | CA | 95642 | Laboratory |
| Sutter Medical Plaza Brownsville | ||||
| 16911 Willow Glen Road | Brownsville | CA | 95919 | Outpatient Services |
| Fairmont Specialty Center | ||||
| 918 South Fairmont Ave | Lodi | CA | 95240 | Outpatient Surgery |
| Palmer Drive Care Center | ||||
| 3581 Palmer Drive | Cameron Park | CA | 95682 | Cancer Services |
| Vacaville Walk-in Care | ||||
| 2060 Harbison Drive | Vacaville | CA | 95687 | Outpatient Services |
| Eye Care Center | ||||
| 1011 Sylvan Avenue | Modesto | CA | 95350 | Outpatient Services |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINES 3A & 3C | FINANCIAL 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 3B | SUTTER 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 7 | COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. |
| SCHEDULE H, PART I, SECTION 7G | FINANCIAL ASSISTANCE/OTHER COMMUNITY BENEFITS AT COST RELATED TO SUBSIDIZED HEALTH SERVICES: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $1,067,387 |
| SCHEDULE H, PART II | SUTTER VALLEY MEDICAL FOUNDATION (SVMF) DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT FOR 2020. |
| SCHEDULE H, PART III, LINE 4 - BAD DEBT | AUDIT 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 7 | MEDICARE 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 8 | COSTING 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 VI, LINE 9B | DEBT 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 2 | THE 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 3 | PATIENT 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 4 | REPORTING 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,8 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-ASSESSMEN T |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION 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 SHADY CREEK'S FIT QUEST PROGRAM HAS STUDENTS PARTICIPATE IN 3 ASSEMBLIES AT EACH SCHOOL SITE, LEAD BY NATURALISTS, WITH A FOCUS ON HEALTH, WELLNESS, AND FITNESS EDUCATION, AS WELL AS A WEEK-LONG IMMERSION AT THE OUTDOOR SCHOOL. THE GOAL OF FITQUEST IS TO TEACH CHILDREN AND THEIR FAMILIES HEALTHY LESSONS ABOUT FITNESS, PHYSICAL ACTIVITY AND THE IMPORTANCE OF NUTRITIOUS EATING. IN 2020, A TOTAL OF 1,186 COMMUNITY MEMBERS BENEFITED FROM THIS PROGRAM. The Salvation Army's Hope Vista is a transitional housing program with the capacity to house up to 8 households at a time. Each household is provided case management for the duration of their program. The program is intended to provide temporary housing while overcoming barriers to employment and permanent housing ultimately achieving self-sufficiency. IN 2020, 43 INDIVIDUALS WERE SERVED WITH 1,213 BEDNIGHTS BEING PROVIDED AND EACH INDIVIDUAL BEING CONNECTED TO BASIC NEEDS SUCH AS MEALS AND CLOTHING. 34 OF THE INDIVIDUALS SERVED WERE ABLE TO OBTAIN PERMANENT HOUSING. SUTTER SURGICAL HOSPITAL NORTH VALLEY (DBA TWIN CITIES SURGICAL HOSPITAL) SUPPORTS THE YUBA-SUTTER FOOD BANK MOBILE FRESH FOOD PROGRAM. THE GOAL OF THE PROGRAM IS TO DELIVER fresh fruits and vegetables to seniors with specific needs who may also be highly vulnerable or homebound due to health conditions and otherwise may have not been reached by the emergency food system. IN 2020, THEY provided 45,309 pounds of fresh produce to 3,825 seniors. REPORTING FACILITY: #2 STANISLAUS SURGICAL HOSPITAL THE MOBILE FRESH PROGRAM PROVIDES YEAR ROUND FOOD ASSISTANCE TO LOW-INCOME INDIVIDUALS, FAMILIES, AND CHILDREN IN HIGH NEED AREAS IN STANISLAUSE COUNTY. THE PROGRAM IS DESIGNED TO BRING THE FOOD OUT TO MEET THE PEOPLE WHERE THEY LIVE, ADDRESSING SOME OF THE BARRIERS OF THE LOW INCOME POPULATION. THIS PROGRAM IS SUPPORTED IN PARTNERSHIP WITH MEMORIAL MEDICAL CENTER AND IN 2020 726 INDIVIDUALS WERE REACHED WITH OVER 52,587 POUNDS OF FOOD DISTRIBUTED. STANISLAUS SURGICAL HOSPITAL IN PARTNERSHIP WITH MEMORIAL MEDICAL CENTER SUPPORT THE STREET MEDICINE TEAM. THIS PROGRAM DEPLOYS A TEAM OF MEDICAL PROFESSIONALS WHO CAN PROVIDE ACUTE MEDICAL SERVICES AND ACCESS TO EDUCATION THROUGH REFERRALS TO INDIVIDUALS WHO ARE EXPERIENCING HOMELESSNESS. A LICENSED VOCATIONAL NURSE (LVN) AND A COMMUNITY HEALTH WORKER (CHW) CONNECTS WITH THE HOMELESS POPULATION BY BRINGING MEDICAL SERVICES TO THEM WITH THE USE OF A MEDICAL VAN EQUIPPED WITH MEDICAL SUPPLIES TO PERFORM BASIC MEDICAL SERVICES SUCH AS WOUND CARE, BLOOD PRESSURE CHECKS, AND GLUCOSE CHECKS. FOR MANY MONTHS AFTER THE PANDEMIC BEGAN, THE GVHC STREET MEDICINE TEAM WAS THE ONLY CONSISTENT OUTREACH TEAM AVAILABLE TO THE HOMELESS COMMUNITY. THEY REACHED 2,208 INDIVIDUALS, MANY OF WHOM WERE HOMELESS FOR THE FIRST TIME AS THE RESULT OF THE FINANCIAL IMPACTS OF THE PANDEMIC. OF THOSE REACHED, 22,230 REFERRALS WERE MADE TO SERVICES SUCH AS PRIMARY HEALTH CARE, BEHAVIORAL HEALTH, HEALTH INSURANCE, INCOME ASSISTANCE, HOUSING, CRISIS SERVICES AND OTHER BASIC NEEDS. THEY PARTNERED WITH A BROADER EFFORT IN STANISLAUS COUNTY CALLED THE 100 DAY CHALLENGE THAT HAD AS ITS GOAL HOUSING 100 PEOPLE EXPERIENCING HOMELESSNESS IN 100 DAYS. THEY ASSISTED WITH THE HEALTH ASSESSMENTS NEEDED AS PART OF THEIR HOUSING APPLICATION. ADDITIONALLY, THEY BROUGHT THEIR STAFF CASE MANAGER ALONG WITH THE TEAM TO HELP LINK PATIENTS TO THEIR SERVICES. STANISLAUS SURGICAL HOSPITAL SUPPORTS THE STANISLAUS COUNTY OFFICE OF EDUCATION'S SOCCER FOR SUCCESS PROGRAM. THIS PROGRAM FOCUSES ON HELPING CHILDREN/YOUTH TO ESTABLISH HEALTHY HABITS AND DEVELOP CRITICAL LIFE SKILLS THROUGH CARING COACH-MENTORS. DUE TO THE RESTRICTIONS OF COVID-19, THE EVER CHANGING ENVIRONMENT AND THE FACT THAT MANY DISTRICTS REMAINED DISTANCE LEARNING ONLY, THEY WERE UNABLE TO HOST THE EVENT AND CONDUCT THE SOCCER FOR SUCCESS AT ANY OF THE PROGRAMS. PART VI, LINE 6 SUTTER HEALTH IS A NOT-FOR-PROFIT, INTEGRATED HEALTHCARE SYSTEM LOCATED IN NORTHERN CALIFORNIA AND COMMITTED TO HEALTH EQUITY, COMMUNITY PARTNERSHIPS AND INNOVATIVE, HIGH-QUALITY PATIENT CARE. OUR OVER 60,000 EMPLOYEES AND AFFILIATED 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 2020 WAS $1.03 BILLION, AN INCREASE OF ABOUT $200 MILLION OVER 2019. THIS AMOUNT INCLUDES TRADITIONAL CHARITY CARE AND UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, AS WELL AS 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 STATUS AND SERVE THE MOST VULNERABLE IN ITS COMMUNITIES, SUTTER HEALTH'S HOSPITALS AND MEDICAL FOUNDATIONS ALONG WITH OTHER ALIGNED HEALTHCARE PROVIDERS, OFFER CHARITY CARE TO ENSURE THAT PATIENTS CAN ACCESS NEEDED MEDICAL CARE REGARDLESS OF THEIR ABILITY TO PAY. SUTTER'S CHARITY CARE POLICIES, WHICH HAVE BEEN IN PLACE FOR MANY YEARS, OFFER FINANCIAL ASSISTANCE TO UNINSURED AND UNDERINSURED INDIVIDUALS EARNING LESS THAN $51,520 A YEAR OR $106,000 FOR A FAMILY OF FOUR. IN 2020, SUTTER HEALTH INVESTED $109 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 2020, SUTTER HEALTH INVESTED $698 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS, AN INCREASE OF ALMOST $200 MILLION OVER 2019. -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. IN ADDITION, EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESS REAL COMMUNITY NEEDS. FOR MORE FACTS AND INFORMATION VISIT WWW.SUTTERHEALTH.ORG. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT: N/A |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Sutter Health | |||||||
| 2200 River Plaza Drive | SACRAMENTO | CA | 95833 | 942788907 | 501(C)(3) | $89,043 | Program Support |
| Sutter Valley Hospitals | |||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 941156621 | 501(C)(3) | $27,186 | Program Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | IN 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 MONITOR 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 SUCCESSES 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 WHAT 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sarah Krevans | ||||||||||||||
| DIRECTOR/PRESIDENT & CEO, SH | $0 | $1,824,667 | $0 | $909,152 | $0 | $425,697 | $0 | $368,826 | $0 | $34,333 | $0 | $3,562,675 | $0 | $354,278 |
| James Conforti | ||||||||||||||
| DIRECTOR/SH SVP & COO | $0 | $1,058,033 | $0 | $514,101 | $0 | $395,045 | $0 | $464,926 | $0 | $30,173 | $0 | $2,462,278 | $0 | $198,797 |
| Theresa Frei | ||||||||||||||
| CEO, SVMF | $0 | $630,412 | $0 | $282,461 | $0 | $184,092 | $0 | $89,926 | $0 | $27,137 | $0 | $1,214,028 | $0 | $58,874 |
| Paige Terra | ||||||||||||||
| CFO, SH Valley Area (pt-yr) | $0 | $409,230 | $0 | $223,942 | $0 | $327,490 | $0 | $77,726 | $0 | $21,301 | $0 | $1,059,689 | $0 | $124,665 |
| Gary Zufelt | ||||||||||||||
| FNDTN AREA CEO, NORTH VALLEY | $0 | $495,169 | $0 | $170,061 | $0 | $145,593 | $0 | $64,026 | $0 | $30,994 | $0 | $905,843 | $0 | $46,468 |
| Penny Westfall | ||||||||||||||
| SH VP, CLO, SH BAY & VALLEY | $0 | $518,608 | $0 | $178,117 | $0 | $123,303 | $0 | $63,126 | $0 | $11,264 | $0 | $894,418 | $0 | $49,982 |
| Jeff Szczesny | ||||||||||||||
| SH VP, HR Operations | $0 | $504,715 | $0 | $176,003 | $0 | $124,138 | $0 | $61,126 | $0 | $27,467 | $0 | $893,449 | $0 | $45,875 |
| Patrina White | ||||||||||||||
| FNDTN AREA CEO, CENTRAL VALLEY | $0 | $462,573 | $0 | $154,003 | $0 | $152,810 | $0 | $61,126 | $0 | $24,866 | $0 | $855,378 | $0 | $66,098 |
| Sue Haddad | ||||||||||||||
| CFO, SH Valley Area Fndtn | $0 | $402,993 | $0 | $154,514 | $0 | $106,165 | $0 | $53,226 | $0 | $27,104 | $0 | $744,002 | $0 | $61,223 |
| Todd Smith MD | ||||||||||||||
| Foundation Area CEO, SV | $0 | $472,169 | $0 | $65,043 | $0 | $62,175 | $0 | $68,926 | $0 | $34,712 | $0 | $703,025 | $0 | $0 |
| Peter Hull MD | ||||||||||||||
| Director/CME SRMC | $0 | $374,186 | $0 | $109,110 | $0 | $123,262 | $0 | $44,226 | $0 | $27,039 | $0 | $677,823 | $0 | $53,458 |
| Michael D Marino | ||||||||||||||
| VP, HR, SVMF & North Valley | $0 | $313,887 | $0 | $110,332 | $0 | $91,996 | $0 | $37,226 | $0 | $18,330 | $0 | $571,771 | $0 | $29,744 |
| Jonathan K Bareng | ||||||||||||||
| Dir, Radiation Physics | $343,653 | $0 | $47,388 | $0 | $3,192 | $0 | $15,426 | $0 | $18,861 | $0 | $428,520 | $0 | $0 | $0 |
| Chuan Wu | ||||||||||||||
| Lead Physicist | $273,459 | $0 | $0 | $0 | $478 | $0 | $14,794 | $0 | $23,578 | $0 | $312,309 | $0 | $0 | $0 |
| Sandra L Adams | ||||||||||||||
| Dir, Service Area | $237,046 | $0 | $33,525 | $0 | $4,225 | $0 | $12,824 | $0 | $18,249 | $0 | $305,869 | $0 | $0 | $0 |
| Fangyan Z Sy | ||||||||||||||
| SVMF Sr. Director Quality | $229,180 | $0 | $31,339 | $0 | $417 | $0 | $12,399 | $0 | $25,166 | $0 | $298,501 | $0 | $0 | $0 |
| Jennifer S Glass | ||||||||||||||
| Staff Radiation Physicist | $252,510 | $0 | $0 | $0 | $797 | $0 | $13,661 | $0 | $23,578 | $0 | $290,546 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | SUPPLEMENTAL 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 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: Peter Hull, MD: $22,709 |
| SCHEDULE J, PART I, LINE 7 | NON-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 ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CHFFA 2016B | ||||||||
| A | 521643828 | 13032UDW5 | 2016-08-17 | $901,627,093 | Refund 2005BC, 2003AB, 2007A | Yes (true) | false | false |
| CHFFA 2017A | ||||||||
| B | 521643828 | 13032UNY0 | 2017-07-06 | $496,319,743 | Refund 2004CD, 2008A (pt), 2008BC | Yes (true) | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $0 | $0 | $902,923,938 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $902,923,938 | $0 | 2016 | false | Yes (true) | Yes (true) | Yes (true) |
| B | $0 | $0 | $496,319,743 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $496,319,743 | $0 | 2017 | false | Yes (true) | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Engage Bond Counsel ResearchEngageBondCounselResearchInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | Yes (true) | Yes (true) | Yes (true) | Yes (true) | Yes (true) | 0.01020 | 0.00020 | 0.01040 | false | false | false | Yes (true) |
| B | false | Yes (true) | Yes (true) | Yes (true) | Yes (true) | Yes (true) | 0.01450 | 0.00030 | 0.01480 | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| B | false | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 E THE 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 7 | ISSUANCE COSTS FROM PROCEEDS: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. |
Schedule L IRS990ScheduleL
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $0 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUBSTANTIAL CONTRIBUTOR | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SUBSTANTIAL CONTRIBUTOR | RelationshipDescriptionTxt |
| Transaction | $41,218,923 | TransactionAmt |
| Transaction | SERVICE VENDOR: MEDICAL SVCS | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 & PART III, LINE 1 | MISSION 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 4A | PROGRAM 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 2020, THE FOUNDATION PROVIDED MORE THAN $66 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS AND PROVIDED PATIENT SERVICES OF 5.6 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 1A | THE 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 6 & 7A | CLASSES 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 7B | CLASSES 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 11B | PROCESS 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 12 | PROCESS 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 BOARDS FINAL DISCUSSION AND VOTE. |
| FORM 990, PART VI, LINES 15A & 15B | PROCESS 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 2020 EXECUTIVE COMPENSATION APPROVAL WAS COMPLETED IN FEBRUARY 2020. |
| FORM 990, PART VI, LINE 19 | AVAILABILITY 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 9 | OTHER CHANGES IN FUND BALANCE: GAIN/(LOSS) ON HEALTH CARE INVESTMENTS $ 6,606,782 HEALTHCARE RELATED JV INCOME (6,874,134) GUARANTEED PAYMENT JV INCOME (630,536) EQUITY TRANSFERS (NET) 243,654,218 STOCK AND OTHER ITEMS 80,153 CHANGE IN SPLIT INTEREST 7,598 -------------- TOTAL: $ 242,844,081 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL GROUP COMPENSATION TOTAL FEES:XXX-XX-XXXX |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEE - PHYSICAN TOTAL FEES:5359531 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:THERAPISTS/OTHER MEDICAL TOTAL FEES:249309 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:NURSE REGISTRY FEES TOTAL FEES:547067 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TWIN CITIES SURGICAL HOSPITAL LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 RIVER PLAZA DRIVE | AddressLine1Txt |
| City | SACRAMENTO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95833 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352182617 | EIN |
| Primary Activities | SURGERY | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Total Income | $32,057,311 | TotalIncomeAmt |
| End Of Year Assets | $21,610,826 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER VMF | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CALIFORNIA PACIFIC MEDICAL CTR FOUND | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 942728423 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER BH | Yes (true) |
| EAST BAY PERINATAL CENTER | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 510172285 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER BH | Yes (true) |
| MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 942290244 | FUNDRAISING | CA | 501(C)(3) | 12A - I | SUTTER VH | Yes (true) |
| MILLS-PENINSULA HOSPITAL FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 237288765 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER BH | Yes (true) |
| SAMUEL MERRITT UNIVERSITY | ||||||||||
| 450 30TH STREET STE 2840 | OAKLAND | CA | 94609 | 942992642 | UNIVERSITY | CA | 501(C)(3) | 2 | SUTTER BH | Yes (true) |
| SUTTER AUBURN FAITH HOSPITAL FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 942594966 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER VH | Yes (true) |
| SUTTER BAY HOSPITALS | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 940562680 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER BAY MEDICAL FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 941156581 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER COAST HOSPITAL | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 942988520 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER DAVIS HOSPITAL FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 680217870 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER VH | Yes (true) |
| SUTTER HEALTH | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 942788907 | SUPPORTING OR | CA | 501(C)(3) | 12C III-FI | NA | false |
| SUTTER HEALTH PACIFIC | ||||||||||
| 91-2301 FT WEAVER RD | EWA BEACH | HI | 96706 | 990298651 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER HEALTH PLAN | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 461183948 | HEALTH PLAN | CA | 501(C)(4) | N/A | SUTTER HLTH | Yes (true) |
| SUTTER MEDICAL CENTER FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 942788906 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER VH | Yes (true) |
| SUTTER ROSEVILLE MEDICAL CTR FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 680040113 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER VH | Yes (true) |
| SUTTER SOLANO CHARITABLE FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 942668262 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER VH | Yes (true) |
| SUTTER VALLEY HOSPITALS | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 941156621 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER VISITING NURSE ASSOC AND HOSPICE | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 946068843 | HEALTHCARE | CA | 501(C)(3) | 10 | SUTTER HLTH | Yes (true) |
| TRACY HOSPITAL FOUNDATION | ||||||||||
| C/O SH TAX 2200 RIVER PLAZA DR | SACRAMENTO | CA | 95833 | 680318845 | FUNDRAISING | CA | 501(C)(3) | 12A - I | SUTTER VH | Yes (true) |
| SUTTER INSURANCE SERVICES CORPORATION | ||||||||||
| 745 FORT STREET SUITE 1100 | HONOLULU | HI | 96813 | 990289310 | INSURANCE SER | HI | 501(C)(3) | 12C III-FI | SUTTER HLTH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SURG CTR OF ABSMC | ||||||||||||||
| 3875 TELEGRPH | OAKLND | CA | 94609 | 470946086 | PATIENT CARE | CA | NA | |||||||
| CA PACIFIC ADV IMAG | ||||||||||||||
| PO BOX 6102 | NOVATO | DE | 94598 | 562311840 | PATIENT CARE | DE | NA | |||||||
| SF ENDOSCOPY CENTER | ||||||||||||||
| 2200 RIVER PLZ | SACRAMENTO | CA | 95833 | 912160588 | PATIENT CARE | CA | NA | |||||||
| PRESIDIO SURG CNTR | ||||||||||||||
| 1635 DIVISADERO | SF | CA | 94115 | 320144060 | PATIENT CARE | CA | NA | |||||||
| SUT FAIRFIELD SURG | ||||||||||||||
| 2200 RIVER PLZ | SACRAMENTO | CA | 95833 | 300233892 | PATIENT CARE | CA | SUTTER VMF | RELATED | $370,685 | $3,395,175 | false | $0 | Yes (true) | 0.79500 |
| SUT AMADOR SURG CTR | ||||||||||||||
| 2200 RIVER PLZ | SACRAMENTO | CA | 95833 | 461398093 | PATIENT CARE | CA | NA | RELATED | -$215,867 | $489,537 | false | false | 0.38000 | |
| ROSEVILLE ENDOSCOPY | ||||||||||||||
| 2200 RIVER PLZ | SACRAMENTO | CA | 95833 | 870710513 | PATIENT CARE | CA | NA | RELATED | $1,751,297 | $1,169,150 | Yes (true) | false | 0.40000 | |
| STANISLAUS SRG HOSP | ||||||||||||||
| 1421 OAKDALE ROAD | MODESTO | CA | 95355 | 911754157 | PATIENT CARE | CA | NA | RELATED | -$633,233 | $5,398,220 | false | false | 0.30998 | |
| MEMORIAL MED BLDG 1 | ||||||||||||||
| 1800 COFFEE RD 76 | MODESTO | CA | 95355 | 770234236 | OFFICE RENTAL | CA | NA | |||||||
| MAGNETIC IMAGING AF | ||||||||||||||
| 2125 OAK GROVE | WLN CK | CA | 94598 | 473696091 | PATIENT CARE | CA | NA | |||||||
| ASC OPTRS-SNTA ROSA | ||||||||||||||
| 2200 RIVER PLZ | SACRAMENTO | CA | 95833 | 263386169 | CARE MNGMT | CA | NA | |||||||
| ASC OPTRS-SLO LLC | ||||||||||||||
| 2200 RIVER PLZ | SACRAMENTO | CA | 95833 | 272673776 | CARE MNGMT | CA | NA | |||||||
| ICG CREDIT OPP FUND | ||||||||||||||
| 11111 SANTA MONICA | LOS ANGELES | CA | 90025 | 814220441 | INVESTMENTS | CA | NA | |||||||
| CARLSBAD SURG CTR | ||||||||||||||
| 6121 PASEO DEL NORTE | CARLSBAD | CA | 92011 | 201413484 | PATIENT CARE | CA | NA | |||||||
| COAST CTR FOR ORTH | ||||||||||||||
| 3444 KEARNY VILLA RD | SAN DIEGO | CA | 92123 | 330839637 | PATIENT CARE | CA | NA | |||||||
| OTAY LAKES SURG CTR | ||||||||||||||
| 955 LANE AVE | CHULA VISTA | CA | 91914 | 200794766 | PATIENT CARE | CA | NA | |||||||
| MADISON INTL GLOBAL | ||||||||||||||
| 410 PARK AVE | NEW YORK | NY | 10022 | 981310251 | INVESTMENTS | NY | NA | |||||||
| DIVISADERO HOLDINGS LLC | ||||||||||||||
| 1635 DIVISADERO | SAN FRANCISCO | CA | 94115 | 320621050 | Outpatient surg | CA | NA | |||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUTTER HEALTH DEFERRED COMP PLANS' TRUST | |||||||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 276851989 | RABBI TRUST | CA | NA | TRUST | Yes (true) | ||||||
| NORTHWOOD EUROPE TE FEEDER LP | |||||||||||||||
| 1819 WAZEE ST 2ND FLOOR | DENVER | CO | 90202 | 981272216 | HOLDING COMPA | NA | C CORP | Yes (true) | CJ | ||||||
| LYXSOP SEGREGATED PORTFOLIO 1 | |||||||||||||||
| INVESTMENT | NA | C CORP | Yes (true) | CJ | PO BOX 10008 WILLOW HOUSE | CRICKET SQUARE | GRAND CAYMAN | CJ | |||||||
| LYXSOP SEGREGATED PORTFOLIO 2 | |||||||||||||||
| INVESTMENT | NA | C CORP | Yes (true) | CJ | PO BOX 10008 WILLOW HOUSE | CRICKET SQUARE | GRAND CAYMAN | CJ | |||||||
| AQR REAL RETURN OFFSHORE FUND LP | |||||||||||||||
| 980700570 | INVESTMENT | NA | c corp | Yes (true) | CJ | 89 NEXUS WAY | CAMANA BAY | GRAND CAYMAN | CJ | KY1-9009 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (13 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Sutter Health Plan | ||
| Q | $96,753,591 | FMV |
| Sutter Insurance Services Corporation | ||
| P | $4,173,557 | FMV |
| Sutter Bay Hospitals | ||
| R | $105,725 | FMV |
| Sutter Bay Medical Foundation | ||
| S | $669,861 | FMV |
| Sutter Valley Hospitals | ||
| P | $1,664,692 | FMV |
| Sutter Valley Hospitals | ||
| R | $41,535,206 | FMV |
| Sutter Valley Hospitals | ||
| K | $9,890,911 | FMV |
| SUTTER VISITING NURSE ASSOCIATION & HOSPICE | ||
| P | $124,791 | FMV |
| SUTTER VISITING NURSE ASSOCIATION & HOSPICE | ||
| R | $82,415 | FMV |
| Sutter Medical Center Foundation | ||
| C | $176,180 | FMV |
| Sutter Valley Hospitals | ||
| J | $359,779 | FMV |
| Sutter Fairfield Surgery Center LLC | ||
| J | $794,927 | FMV |
| Sutter Roseville Medical Center Foundation | ||
| C | $61,446 | FMV |