2020-11-12T17:11:27-06:00 2019-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2019-01-01 940382780 CHINESE HOSPITAL ASSOCIATION CHIN 4156772440 845 JACKSON STREET SAN FRANCISCO CA 94133 CHI-KUO CHUNG CHIEF FINANCIAL OFFICER 4156772440 2020-11-11 1 MICHAEL LUMSDEN P01262236 4159561500 2020-11-11 76.14.38.113 2020-11-11 15:46:49 PS P 00C4359F54289D19625D58AABAD73364CEA05A5F 00C4359F54289D19625D58AABAD73364CEA05A5F 2019 2021-01-29 14:40:06Z DR JIAN ZHANG 845 JACKSON STREET SAN FRANCISCO CA 94133 123019303 0 X WWW.CHINESEHOSPITAL-SF.ORG X 1925 CA COST EFFECTIVE HEALTH CARE WHICH IS RESPONSIVE TO THE COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS. 16 16 539 185 1557994 383612 1416388 2182762 101904624 115644749 1459212 1790523 4309832 2966873 109090056 122584907 0 860000 0 0 52285340 47941526 2500 0 214663 78703224 79756742 130991064 128558268 -21901008 -5973361 297099892 313420456 116999395 144471546 180100497 168948910 X CHINESE HOSPITAL, A COMMUNITY-OWNED, NOT-FOR-PROFIT ORGANIZATION, EXISTS PRIMARILY TO DELIVER QUALITY HEALTH CARE IN A COST EFFECTIVE WAY, RESPONSIVE TO THE COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS, PROVIDING ACCESS TO HEALTH CARE AND ACCEPTABILITY TO ALL SOCIOECONOMIC LEVELS. 0 0 95465621 860000 115644749 CHINESE HOSPITAL IS AN 88-BED NON-PROFIT COMMUNITY HOSPITAL AND AFFILIATED COMMUNITY CLINICS OFFERING A WIDE RANGE OF MEDICAL, SURGICAL, AND SPECIALTY CARE TO A MULTICULTURAL COMMUNITY. CHINESE HOSPITAL AIMS TO DELIVER QUALITY HEALTH CARE IN A COST EFFECTIVE WAY, RESPOND TO OUR COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS, AND OFFER ACCESS TO HEALTH CARE TO ALL SOCIOECONOMIC LEVELS. SERVICES OFFERED AT CHINESE HOSPITAL INCLUDE ACUPUNCTURE, CARDIOPULMONARY, EMERGENCY CARE, HEALTH PROGRAMS (INCLUDING IMMUNIZATIONS, HEPATITIS B SERVICES, A DIABETES CENTER, AND PALLIATIVE CARE), LABORATORY, NURSING CARE, OPTOMETRY, PHARMACY, RADIOLOGY/IMAGING, AND SURGERY. 95465621 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 244 0 1 539 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 16 16 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MUKESH SANGHVI 4156772399 445 GRANT AVENUE SUITE 200 SAN FRANCISCO CA 94108 GEORGE LEW PRESIDENT 5.00 2.00 X X 0 0 0 HARVEY LOUIE VICE PRESIDENT 5.00 2.00 X X 0 0 0 THOMAS T NG ENGLISH SECRETARY 5.00 2.00 X X 0 0 0 KIN F YEE DDS ASSISTANT ENGLISH SECRETARY 5.00 2.00 X X 0 0 0 JACK LEE FONG CHINESE SECRETARY 5.00 2.00 X X 0 0 0 GUSTIN HO MD ASSISTANT CHINESE SECRETARY 5.00 2.00 X X 0 0 0 ROBERT WONG TREASURER 5.00 2.00 X X 0 0 0 YICK C TAM ASSISTANT TREASURER 5.00 2.00 X X 0 0 0 KITMAN CHAN BOARD MEMBER 2.00 2.00 X 0 0 0 EDWARD Y C CHANG MD BOARD MEMBER 2.00 2.00 X 0 0 0 ROBERT CHIANG BOARD MEMBER 2.00 2.00 X 0 0 0 MEL LEE BOARD MEMBER 2.00 2.00 X 0 0 0 PAUL M LEE BOARD MEMBER 2.00 2.00 X 0 0 0 KENT LIM BOARD MEMBER 2.00 2.00 X 0 0 0 DAN QUAN BOARD MEMBER 2.00 2.00 X 0 0 0 DICK W WONG BOARD MEMBER 2.00 2.00 X 0 0 0 DR JIAN ZHANG CHIEF EXECUTIVE OFFICER 40.00 0.00 X 546376 0 26551 STEPHEN FORNEY CFO THROUGH 9/2019 40.00 0.00 X 282579 0 14178 PAUL ZIEGELE INTERIM CFO EFFECTIVE 9/2019 40.00 0.00 X 0 0 0 KEITH MINARD CHIEF INFORMATION OFFICER 40.00 0.00 X 302827 0 20234 LYDIA MAHR-CHAN CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 282228 0 18827 ANDERSON ENG MD MEDICAL PHYSICIAN 40.00 0.00 X 297332 0 20234 ALSON TOY RN SURGERY 40.00 0.00 X 294974 0 7144 AUNG KYAW MAUNG MD MEDICAL PHYSICIAN 40.00 0.00 X 283997 0 18904 JUDI WONG MD MEDICAL PHYSICIAN - GELLERT CLINIC 40.00 0.00 X 283356 0 17756 FRANK CHEN MD MEDICAL PHYSICIAN - SUNSET CLINIC 40.00 0.00 X 278068 0 19497 BRENDA YEE FORMER CHIEF EXECUTIVE OFFICER 0.00 0.00 X 556658 0 0 SCOTT GOODIN FORMER CHIEF FINANCIAL OFFICER 0.00 0.00 X 306131 0 6484 3714526 0 169809 138 1 1 0 CHARLES PANKOW BUILDERS LTD 1111 BROADWAY STREET SUITE 200 OAKLAND CA 94607 CONSTRUCTION SERVICES 4708178 EMERGENCY MEDICINE PHYSICIANS 4535 DRESSLER RD NW CANTON OH 44718 EMERGENCY PHYSICIANS GROUP 1110676 GE PRECISION HEALTHCARE LLC PO BOX 96483 CHICAGO IL 60693 IMAGING SERVICES 994534 THE STINNETT GROUP LLP 550 MONTGOMERY STREET SUITE 500 SAN FRANCISCO CA 94111 CONSTRUCTION SERVICES 799072 QUEST DIAGNOSTICS PO BOX 912411 PASADENA CA 91110 LABORATORY SERVICES 777419 100 774619 1408143 2182762 NET PATIENT SERVICE REVENUE 621300 55944786 55944786 CAPITATION REVENUE 621400 38625420 38625420 PHARMACY REVENUE 621400 16650617 15082037 1568580 CLINIC REVENUE 623000 2068259 2068259 PAY FOR PERFORMANCE 621400 432314 432314 1923353 1902975 20378 115644749 791441 791441 210677 234623 -23946 -23946 -30964 7018 999082 0 999082 999082 999082 671532 774619 199773 471759 471759 MANAGEMENT FEE 900099 2187644 2187644 PARKING REVENUE 561000 298198 298198 CAFETERIA 722514 33218 33218 2519060 122584907 114055791 1557994 4788360 X 860000 860000 1493800 323061 1170739 869273 869273 35807454 22373998 13262930 170526 3998242 2387046 1593142 18054 3058290 1845820 1198541 13929 2714467 1616298 1086015 12154 249900 249900 249346 99738 149608 283000 283000 84049 84049 15265411 13939131 1326280 34681 34681 930033 930033 1280851 1088723 192128 3186312 2892109 294203 9337 9337 46651 46651 2489065 2489065 9160718 9009798 150920 526969 526969 MEDICAL SUPPLIES 22129509 22129509 MEDICAL CLAIMS EXPENSE 16024087 16024087 QUALITY ASSURANCE FEE 3786512 3786512 INCOME TAX EXPENSE 146251 146251 3874060 876303 2997757 128558268 95465621 32877984 214663 3090 3200 2759668 3320530 15208219 25631367 1369044 1592020 1831836 4782073 316053474 71582049 249901160 244471425 24193572 28111913 400000 400000 1433303 5107928 297099892 313420456 22625851 15882778 60149852 58624758 34937191 34223692 35026819 116999395 144471546 X 179818600 168667013 281897 281897 180100497 168948910 297099892 313420456 X -5973361 294892 -5473118 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10656 10656 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA HOSPITAL ASSOCIATION, AN ORGANIZATION WHICH ADVOCATES FOR CALIFORNIA'S HOSPITALS AND HEALTH SYSTEMS; A PORTION ($10,656) OF THOSE MEMBERSHIP DUES HAVE BEEN INDICATED AS USED FOR LOBBYING PURPOSES. 5904093 5904093 253788075 37247950 216540125 47872689 34334099 13538590 8488617 8488617 244471425 ACCRUED MEDICAL CLAIMS 2158166 PENSION LIABILITY 31629319 OPERATING LEASE LIABILITIES 1239334 35026819 GOLF 869428 260829 608599 150 320 54476 49125 19887 ANNIVERSARY 189263 126330 62933 14329 5924 1175 51278 1 387460 387460 630 2479 1446151 774619 671532 150 320 68805 55679 1175 73644 199773 471759 1 1 X 1 X 1 X 1 1 1 0 1 1 2454291 2454291 0.01910 3571495 2313759 1257736 0.00980 6025786 2313759 3712027 0.02890 903553 903553 0.00700 11641 11641 0.00010 915194 915194 0.00710 6940980 2313759 4627221 0.03600 1 3827499 1869340 34021129 55249782 -21228653 X 1 1 1 1 CHINESE HOSPITAL ASSOCIATION 845 JACKSON STREET SAN FRANCISCO CA 94133 WWW.CHINESEHOSPITAL-SF.ORG 220000122 X X X CHINESE HOSPITAL ASSOCIATION 0 0 1 X X X X X X X X X 19 1 1 1 1 X HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 19 1 HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: THE SFHIP COMMUNITY HEALTH NEEDS ASSESSMENT TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY VIA FOCUS GROUPS.SFHIP KEY INFORMANT GROUP INTERVIEW: ONE FOCUS GROUP WAS COMPRISED OF SFHIP MEMBERS WHO ARE ALL SUBJECT MATTER EXPERTS. TWO SERIES OF QUESTIONS WERE ASKED: (I) "WHAT ARE THE HEALTHIEST CHARACTERISTICS OF THIS COMMUNITY? WHAT SUPPORTS PEOPLE TO LIVE HEALTHIER LIVES? AND (II) "WHAT ARE THE BIGGEST HEALTH ISSUES AND/OR CONDITIONS YOUR COMMUNITY STRUGGLES WITH? WHAT DO YOU THINK CREATES THOSE ISSUES?".EQUITY COALITION FOCUS GROUPS: THREE FOCUS GROUPS WERE CONDUCTED WITH EACH OF THE THREE HEALTH EQUITY COALITIONS IN SAN FRANCISCO: (I) THE CHICANO / LATINO / INDIGENA HEALTH EQUITY COALITION (II) THE ASIAN PACIFIC ISLANDER HEALTHY PARITY COALITION, AND (III) THE AFRICAN AMERICAN HEALTH EQUITY COALITION. USING THE TECHNOLOGY OF PARTICIPATION (TOP) CONSENSUS METHOD, THE QUESTION POSED TO EACH FOCUS GROUP WAS, "WHAT ACTIONS CAN WE TAKE TO IMPROVE HEALTH?".FOOD INSECURE PREGNANT WOMEN FOCUS GROUPS: THE HOMELESS PRENATAL PROGRAM HELD FOUR FOCUS GROUPS WITH WOMEN WHO EXPERIENCED FOOD INSECURITY WHILE PREGNANT. EACH FOCUS GROUP FOCUSED ON A DIFFERENT GROUP OF WOMEN: SPANISH, CHINESE, MULTI-ETHNIC ENGLISH SPEAKERS, AND AFRICAN AMERICAN. THE QUESTION TO RESPOND TO WAS, "WHAT ACTIONS CAN WE TAKE TO IMPROVE YOUR FOOD NEEDS?".KAISER LED FOCUS GROUPS: KAISER CONDUCTED FOUR FOCUS GROUPS, ONE EACH WITH KAISER PERMANENTE LEADERSHIP, KAISER PERMANENTE STAFF, SPANISH-SPEAKING PARENTS ON YOUTH HEALTHY EATING AND ACTIVE LIVING, AND HOMELESS AND/OR HIV POSITIVE YOUTH.IN ADDITION, THE CHINESE HOSPITAL SUPPLEMENTAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED THROUGH FOCUS GROUPS DESIGNED TO ASSESS THE HEALTH STATUS, CONCERNS AND ACCESS AMONG THE CHINESE POPULATION THAT CHINESE HOSPITAL SERVES IN THE CITY AND COUNTY OF SAN FRANCISCO. THE RECRUITMENT OF THESE FOCUS GROUPS WAS CONDUCTED THROUGH ETHNIC MEDIA PRESS RELEASE, FLYER DISTRIBUTION AT LOCAL COMMUNITY ORGANIZATIONS, AS WELL AS THROUGH POPULAR CHINESE SOCIAL MEDIA APP, WECHAT. THE FOCUS GROUP PARTICIPANTS WERE RECRUITED FROM OVER 15 DIFFERENT ZIP CODE NEIGHBORHOODS.A SERIES OF FOUR (4) FOCUS GROUPS WERE CONDUCTED TO ASSESS AND IDENTIFY THE PREDOMINANT HEALTH CONCERNS OF THE CHINESE-SPEAKING POPULATION THAT CHINESE HOSPITAL.THE FOCUS GROUPS WERE CONDUCTED BETWEEN SEPTEMBER 7TH- 11TH, 2019 AT CHINESE HOSPITAL WITH AN AVERAGE OF 10 PARTICIPANTS PER GROUP. THE FACILITATOR OF THE FOCUS GROUP IS A BILINGUAL, TRAINED HEALTH EDUCATOR WITH MORE THAN 10 YEARS OF EXPERIENCE IN CONDUCTING QUALITATIVE INTERVIEW SESSIONS. ALL FOUR (4) FOCUS GROUPS WERE CONDUCTED IN CANTONESE-CHINESE, THE PREFERRED CHINESE DIALECT OF THE PARTICIPANTS. ALL PARTICIPANTS COMPLETED A DEMOGRAPHIC SURVEY AND THE FOCUS GROUP SESSIONS WERE AUDIO RECORDED WITH PARTICIPANTS' CONSENT. THE FACILITATOR UTILIZED A QUESTION GUIDE AND THE STICKY NOTE TECHNIQUE (PETERSON AND BARRON, 2007) TO SOLICIT FEEDBACK FROM PARTICIPANTS. A BILINGUAL, BICULTURAL PATIENT NAVIGATOR/HEALTH INFORMATION SPECIALIST HAND RECORDED THE MEETING NOTES. PARTICIPANTS WERE ASKED TO RANK THEIR HEALTH NEEDS FROM 1-5, WITH 1 BEING THE MOST IMPORTANT, AND THEIR RESPONSES POSTED WITH STICKY NOTES ON A BOARD FOR OTHER PARTICIPANTS TO SEE. STICKY NOTES SERVED AS BASES FOR FURTHER DISCUSSION TO ASSESS COMMUNITY NEEDS. CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: CHA'S 2019 CHNA WAS CONDUCTED IN CONJUNCTION WITH THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP), A COLLABORATIVE BODY WHOSE MISSION IS TO EMBRACE COLLECTIVE IMPACT AND TO IMPROVE COMMUNITY HEALTH AND WELLNESS IN SAN FRANCISCO. SFHIP INCLUDES THE FOLLOWING SAN FRANCISCO NON-PROFIT HOSPITALS (OTHER THAN CHA): SUTTER HEALTH CALIFORNIA PACIFIC MEDICAL CENTER, SAINT FRANCIS MEMORIAL HOSPITAL, KAISER PERMANENTE SAN FRANCISCO, UCSF, AND ST. MARY'S MEDICAL CENTER. CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: THE 2019 CHNA WAS CONDUCTED IN CONJUNCTION WITH SFHIP, WHICH INCLUDES THE FOLLOWING REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: ASIAN AND PACIFIC ISLANDER HEALTH PARTY COALITION, SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM, CHICANO / LATINO/ INDIGENA HEALTH EQUITY COALITION, SF INTERFAITH COUNCIL, SAN FRANCISCO HEALTH SERVICES NETWORK, AFRICAN AMERICAN COMMUNITY HEALTH EQUITY COUNCIL, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, METTA FUND, SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, UNIVERSITY OF SAN FRANCISCO, HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA, VIETNAMESE YOUTH DEVELOPMENT CENTER, HOMELESS PRENATAL PROGRAM, FACENTE CONSULTING, SAN FRANCISCO HUMAN SERVICES NETWORK, SAN FRANCISCO OFFICE OF THE CHIEF MEDICAL EXAMINER, RAFIKI COALITION FOR HEALTH AND WELLNESS, CENTER FOR OPEN RECOVERY. CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: AMONG ALL THE COMMUNITY HEALTH NEEDS IDENTIFIED BY 2019 SFHIP CHNA AND CHINESE HOSPITAL 2019 SUPPLEMENTAL CHNA, BASED ON THE RESOURCES AVAILABLE, CHINESE HOSPITAL SELECTS THE FOLLOWING 3 MAIN AREAS AS OUR PRIORITIES TO ADDRESS IN THE NEXT THREE YEARS: (I) CHRONIC DISEASES AND LOW SCREENING RATES; (II) PALLIATIVE CARE; (III) DEMENTIA/CAREGIVER BURDEN. ADDITIONALLY, CHINESE HOSPITAL WILL CONTINUE TO ADDRESS HEALTH CONCERNS REGARDING MENTAL HEALTH IDENTIFIED BY THE FOCUS GROUP PARTICIPANTS UNDER THE CATEGORY OF OTHER HEALTH CONCERNS THOUGH THEY ARE NOT AMONG THE TOP 3 HEALTH CONCERNS. BASED ON THE FINDINGS FROM THIS QUALITATIVE HEALTH NEEDS ASSESSMENT, CHRONIC DISEASE AND ITS SCREENINGS ARE AMONG THE TOP CONCERNS. THE NEED FOR ACCESSIBLE, CULTURALLY AND LINGUISTICALLY APPROPRIATE CHRONIC DISEASE MANAGEMENT PROGRAMS IN COMMUNITIES CHINESE HOSPITAL SERVES REMAINED HIGH. TO MEET THESE DEMANDS, WE WILL CONTINUE TO EXPAND THE CHINESE HOSPITAL'S PROGRAMS AND SERVICES AS FOLLOWS:1) EXPAND THE EXISTING CHRONIC DISEASE MANAGEMENT PROGRAMS TO ADDRESS CHRONIC CONDITIONS THAT ARE CONCERNING THE CHINESE POPULATION: CHINESE HOSPITAL'S PATIENT-CENTERED DIABETES PROGRAMS CONTINUES TO OFFER COMPREHENSIVE DIABETES CARE TO THE COMMUNITY WITH A MULTIDISCIPLINARY APPROACH. OUR MULTIDISCIPLINARY TEAM CONSISTS BILINGUAL PRIMARY CARE DOCTORS, AN ENDOCRINOLOGIST, NURSE PRACTITIONERS, CERTIFIED DIABETES EDUCATORS, REGISTERED DIETITIANS, CARE COORDINATORS, MEDICAL ASSISTANTS, A PODIATRIST, AND OTHER PROVIDERS AND STAFF. WE ALSO PROVIDE AMERICAN DIABETES ASSOCIATION CERTIFIED DIABETES SELF-MANAGEMENT EDUCATION (DSME) TO DIABETIC PATIENTS AND FAMILIES. THE COURSES ARE PROVIDED IN CANTONESE, MANDARIN, AND ENGLISH, AND EDUCATION MATERIALS ARE BILINGUAL IN CHINESE AND ENGLISH. THE CENTER IS ALSO EXPANDING ITS PROGRAM TO SERVE THE PRE-DIABETIC POPULATION BY ADDING THE BILINGUAL CDC RECOGNIZED DIABETES PREVENTION PROGRAM.CHINESE HOSPITAL SUPPORT HEALTH SERVICES ALSO CONTINUES TO PROVIDE CHRONIC DISEASE MANAGEMENT FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CONGESTIVE HEALTH DISEASE, HEPATITIS B AND OTHER CHRONIC DISEASES. AS LOW HEALTH SCREENING RATES WAS AMONG THE TOP CONCERNS IDENTIFIED BY THE FOCUS GROUP, CHINESE HOSPITAL WILL CONTINUE THE EFFORTS IN IMPROVING PREVENTIVE HEALTH EDUCATION AND SERVICES. CHINESE HOSPITAL WILL CONTINUE TO HOLD PROMOTIONAL EVENTS TARGETING THE CHINESE POPULATION, E.G. COMMUNITY HEALTH FAIRS WILL CONTINUE TO BE HELD ON A REGULAR BASIS. THESE FAIRS HAVE AND WILL CONTINUE TO PROVIDE FREE HEALTH SCREENINGS AND BILINGUAL HEALTH EDUCATION MATERIALS FOR THOSE WHO PARTICIPATE. FREE OR LOW-COST FITNESS CLASSES WILL BE PROVIDED TO THE COMMUNITY AT A CONVENIENT LOCATION AND TIME. CHINESE HOSPITAL WILL ALSO CONTINUE TO USE A MULTIMEDIA APPROACH, SUCH AS CHINESE TV OR RADIO CHANNELS, NEWSPAPERS, AND HEALTH PLAN NEWSLETTERS TARGETING THE CHINESE COMMUNITY, FOR OUTREACH AND PUBLIC AWARENESS OF PREVENTIVE HEALTH. IN ADDITION, CHINESE HOSPITAL AND CCHRC ARE DEVELOPING AND EXPANDING ITS HEALTH EDUCATION PROGRAMS ON PREVENTIVE SCREENINGS, HEALTH BEHAVIOR AND HEALTHY LIFESTYLE TO ADDRESS THE IDENTIFIED BEHAVIORAL HEALTH CONCERNS, E.G. SMOKING. BILINGUAL HEALTH EDUCATION RESOURCES NEED TO BE MADE AVAILABLE TO THE PUBLIC ONLINE, AS WELL AS BY PRINTED COPIES TO CERTAIN POPULATION HAVE LITTLE OR NO ACCESS TO THE INTERNET.2) PROMOTE PATIENT USAGE OF THE TECHNOLOGY-BASED PATIENT DASHBOARD SYSTEM IN CHINESE HOSPITAL PATIENT ROOMS TO INCREASE PATIENTS' ACCESS TO EDUCATIONAL VIDEOS ON THE PREVENTION AND MANAGEMENT CHRONIC DISEASES: CHINESE HOSPITAL IMPLEMENTED AN INTERACTIVE PATIENT DASHBOARD IN ALL PATIENT ROOMS IN AUGUST 2019. THIS DASHBOARD SYSTEM ENABLES PATIENTS TO ACCESS HEALTH EDUCATION MATERIALS, INPATIENT SERVICES, AND ENTERTAINMENT DURING THEIR STAY AT CHINESE HOSPITAL. WE AIM TO INCREASE PATIENTS' USAGES OF THIS DASHBOARD TO SYSTEM ACCESS BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL VIDEOS ON THE PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. TO PROVIDE PATIENT-CENTERED CARE, EACH PATIENT WILL RECEIVE A TAILORED LIST OF EDUCATIONAL VIDEOS SPECIFIC TO THEIR NEEDS, WHICH WILL BE SELECTED BY THEIR HEALTH CARE TEAM.3) CONTINUE TO WORK WITH OUR PARTNER, CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC) TO EXPAND THE BILINGUAL (CHINESE & ENGLISH) HEALTH EDUCATION MATERIALS ON CHRONIC DISEASES AND HEALTH TOPICS OF COMMUNITY'S CONCERN: CHINESE HOSPITAL, TOGETHER WITH CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC), WILL EXPAND THE FREE BILINGUAL (CHINESE & ENGLISH) HEALTH EDUCATION MATERIALS TO INCLUDE THE HEALTH CONCERNS IDENTIFIED BY THE FOCUS GROUP ON CHRONIC CONDITIONS SUCH AS ORAL DISORDERS, EYE HEALTH, AND CHRONIC PAIN.4) WORK WITH OUR PARTNER, CCHRC TO DELIVER HEALTH EDUCATION MATERIALS AND PROGRAMS INCLUDING THROUGH WEBSITE AND SOCIAL MEDIA: BASED ON THE RECOMMENDATIONS OF USING TECHNOLOGY TO DELIVER HEALTH INFORMATION, CHINESE HOSPITAL WILL WORK WITH CCHRC AND CONTINUE TO MAKE BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL WEBSITES (WWW.CHINESEHOSPITAL-SF.ORG AND WWW.CCHRHCHEALTH.ORG). ADDITIONALLY, CHINESE HOSPITAL AND CCHRC WILL EXPLORE THE USE CULTURAL APPROPRIATE SOCIAL MEDIA TO DELIVER HEALTH INFORMATION. SPECIFICALLY, WE WILL EXPLORE THE INCORPORATION WECHAT, A FREE MOBILE APPLICATION, IN THE DISTRIBUTION OF HEALTH EDUCATION MATERIALS AND PROGRAMS. WECHAT IS ONE OF THE MOST WIDELY USED SOCIAL MEDIA PLATFORM IN CHINA AND CHINESE INDIVIDUALS GLOBALLY, INCLUDING CHINESE IMMIGRANTS IN THE UNITED STATES (TENCENT, 2017). GIVEN THE FEEDBACK RECEIVED FROM THE CONDUCTED FOCUS GROUPS, WECHAT IS REGULARLY USED WITHIN THE CHINESE COMMUNITY OF SAN FRANCISCO. WHEN ABLE TO, WE WILL INCORPORATE WECHAT AS A TOOL TO INFORM AND ENGAGE PATIENTS IN PROGRAMS OFFERED BY THE HOSPITAL.5) CONTINUE TO WORK WITH NICOS, AND THE CHINATOWN CHILDREN'S ORAL HEALTH TASKFORCE TO ADDRESS THE NEED FOR IMPROVED CHILDREN'S DENTAL HEALTH EDUCATION AND SERVICES: CHINESE HOSPITAL WILL CONTINUE WORKING WITH NICOS, A COALITION OF COMMUNITY BASED ORGANIZATIONS, AND THE CHINATOWN CHILDREN'S ORAL HEALTH TASKFORCE, TO ADDRESS THE NEED FOR IMPROVED CHILDREN'S DENTAL HEALTH EDUCATION AND SERVICES. CHINESE HOSPITAL PLANS TO WORK WITH ITS COMMUNITY PARTNER, THE CHINESE COMMUNITY HEALTH RESOURCE CENTER, TO PRODUCE FURTHER HEALTH EDUCATION MATERIAL ON ORAL HEALTH.FOCUS GROUP PARTICIPANTS IDENTIFIED THE NEED FOR MORE PALLIATIVE CARE EDUCATIONAL MATERIALS AND SERVICES AS ONE OF THE TOP CONCERNS. TO ADDRESS THESE CONCERNS, CHINESE HOSPITAL WILL:1) ESTABLISH, IMPLEMENT AND EVALUATE AN OUTPATIENT PALLIATIVE CARE PROGRAM AT CHINESE HOSPITAL: UTILIZING FUNDS AWARDED TO CHINESE HOSPITAL BY THE STUPSKI FOUNDATION (2019-2022), CURRENT INPATIENT PALLIATIVE CARE SERVICES IS BEING EXPANDED TO OUTPATIENT SERVICES AS WELL. THIS OUTPATIENT PALLIATIVE CARE PROJECT WILL INCLUDE THE RECRUITMENT AND ONBOARDING OF A CERTIFIED PALLIATIVE CARE SPECIALIST/GERIATRICIAN, THE DEVELOPMENT OF POLICIES AND PROTOCOLS, THE IMPLEMENTATION AND MONITORING OF A DATA TRACKING SYSTEM, AND ITS EVALUATION AND IMPROVEMENT. 2) EXPAND BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL MATERIALS ON PALLIATIVE CARE: CHINESE HOSPITAL WILL WORK WITH OUR PARTNER CCHRC TO DEVELOP BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL MATERIALS ON PALLIATIVE CARE/COMFORT CARE AND AN EDUCATIONAL VIDEO ON PAIN MANAGEMENT. 3) CONTINUE TO COLLABORATE WITH CCHRC TO PROVIDE EDUCATION PROGRAMS AND SERVICES ON ADVANCE HEALTH CARE DIRECTIVES AS WELL AS PROVIDE ASSISTANCE IN FORM COMPLETION: CHINESE HOSPITAL WILL WORK WITH CCHRC WILL CONTINUE TO PROVIDE EDUCATION SEMINARS, COUNSELING SESSIONS ON THE TOPIC OF ADVANCE HEALTH CARE DIRECTIVES, AS WELL AS CONTINUE TO PROVIDE SERVICE TO ASSIST WITH ADVANCE HEALTH CARE DIRECTIVE FORM COMPLETIONS.THE FOCUS GROUP PARTICIPANTS ALSO IDENTIFIED AS ONE OF THE TOP CONCERNS AWARENESS OF DEMENTIA AND THE BURDEN OF CAREGIVERS PROVIDING CARE FOR INDIVIDUALS LIVING WITH DEMENTIA. TO ADDRESS THESE CONCERNS, CHINESE HOSPITAL WILL WORK WITH CCHRC TO DEVELOP BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL MATERIALS AND TRAINING TO RAISE THE AWARENESS OF CAREGIVER BURDEN AND TO PROVIDE PRACTICAL INFORMATION ON SYMPTOM RECOGNITION AND CARE MANAGEMENT FOR CAREGIVERS OF INDIVIDUALS LIVING WITH DEMENTIA.TO ADDRESS THE HEALTH NEED OF MENTAL HEALTH, CHINESE HOSPITAL WILL CONTINUE TO PROMOTE THE SYSTEM-WIDE MENTAL/BEHAVIORAL HEALTH SERVICES THROUGH COMMUNICATIONS SUCH AS FLYERS, NEWSLETTERS, WEBSITES, ETC. TO THE COMMUNITY ON A REGULAR BASIS. ADDITIONALLY, IT WILL CONTINUE TO EXPAND CULTURALLY AND LINGUISTICALLY APPROPRIATE EDUCATIONAL PROGRAMS ON MENTAL HEALTH, INCLUDING VIDEO CONFERENCE FOR SUPPORT (VIA WEBEX), WHICH WILL INCREASE ACCESS TO MENTAL HEALTH PROVIDERS AND CONNECT PATIENTS WITH THEIR CARE TEAM REMOTELY. 5 1 - CHINESE HOSPITAL OUTPATIENT CENTER 386 GELLERT BOULEVARD DALY CITY CA 94015 OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC 2 - SUNSET HEALTH SERVICES 1800 31ST AVENUE SAN FRANCISCO CA 94122 OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC 3 - EXCELSIOR HEALTH SERVICES 888 PARIS STREET SUITE 202 SAN FRANCISCO CA 94112 OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC 4 - SUPPORT HEALTH SERVICES 845 JACKSON STREET B1 SAN FRANCISCO CA 94133 OUTPATIENT HEALTH SERVICES/MEDICAL CLINIC 5 - EAST WEST HEALTH SERVICES 445 GRANT AVENUE GROUND FLOOR SAN FRANCISCO CA 94108 ACCUPUNCTURE & HERBAL MEDICINE SPECIALTY PART I, LINE 7: A COST-TO-CHARGE RATIO WAS UTILIZED TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART I, LINE 7. PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON PART III, LINE 2 CONSISTS OF THE CHARGES THAT ARE DEEMED TO BE BAD DEBT, MULTIPLIED BY THE RATIO OF COST-TO-CHARGES AS REPORTED ON CHA'S MEDICARE COST REPORT WHEN THEY ARE NOT WRITTEN-OFF YET. THE MAJORITY OF THE BAD DEBT FIGURE IS RELATED TO THE ACTUAL WRITTEN-OFF AMOUNTS WHEN THE PATIENT WAS NOT ABLE TO PAY AFTER EXHAUSTING ALL ATTEMPTS TO COLLECT. PART III, LINE 3: THE HOSPITAL RUNS A CREDIT SCORE AND COLLECTS TAX RETURNS FOR PATIENTS APPLYING FOR FINANCIAL ASSISTANCE; BASED OFF THIS INFORMATION, AN ESTIMATE IS MADE TO DETERMINE HOW MUCH OF THE BAD DEBT EXPENSE ON PART III, LINE 3 WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. IN ADDITION, SOME OF THE BAD DEBT EXPENSE IS RELATED TO HOMELESS PATIENTS, WHICH WOULD BE ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND CO-INSURANCE FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGES BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY AND DEEMED UNCOLLECTIBLE ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT HAVE A SEPARATE FOOTNOTE ADDRESSING BAD DEBT EXPENSE; HOWEVER, THE FOOTNOTE WHICH ADDRESSES PATIENT ACCOUNTS RECEIVABLE CAN BE FOUND ON PAGE PATIENT ACCOUNTS RECEIVABLE CAN BE FOUND ON PAGES 7 AND 15 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AS MEDICARE RATES ARE NON-NEGOTIABLE AND SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS. BY CONTINUING TO TREAT PATIENTS ELIGIBLE TO MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. ADDITIONALLY, IRS REV. RUL. 69-545 STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.A COST-TO-CHARGE IS UTILIZED TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART III, LINES 6. PART III, LINE 9B: AT LEAST 30 DAYS PRIOR TO INITIATING ECAS, CHINESE HOSPITAL OR ITS AUTHORIZED VENDOR WILL PROVIDE THE PATIENT WITH A WRITTEN NOTICE ("ECA NOTICE") THAT WILL: (A) INDICATE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS; (B) IDENTIFY THE ECA(S) THAT THE HOSPITAL FACILITY OR AUTHORIZED VENDOR INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE; (C) STATE A DEADLINE AFTER WHICH SUCH ECA(S) MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN ECA NOTICE IS PROVIDED; (D) INCLUDE THE FOLLOWING STATEMENT OR ANY FURTHER STATEMENT REQUIRED BY AN AMENDMENT TO CALIFORNIA HEALTH & SAFETY CODE 127430: "STATE AND FEDERAL LAW REQUIRE DEBT COLLECTORS TO TREAT YOU FAIRLY AND PROHIBIT DEBT COLLECTORS FROM MAKING FALSE STATEMENTS OR THREATS OF VIOLENCE, USING OBSCENE OR PROFANE LANGUAGE, AND MAKING IMPROPER COMMUNICATIONS WITH THIRD PARTIES, INCLUDING YOUR EMPLOYER. EXCEPT UNDER UNUSUAL CIRCUMSTANCES, DEBT COLLECTORS MAY NOT CONTACT YOU BEFORE 8:00 A.M. OR AFTER 9:00 P.M. IN GENERAL, A DEBT COLLECTOR MAY NOT GIVE INFORMATION ABOUT YOUR DEBT TO ANOTHER PERSON, OTHER THAN YOUR ATTORNEY OR SPOUSE. A DEBT COLLECTOR MAY CONTACT ANOTHER PERSON TO CONFIRM YOUR LOCATION OR TO ENFORCE A JUDGMENT. FOR MORE INFORMATION ABOUT DEBT COLLECTION ACTIVITIES, YOU MAY CONTACT THE FEDERAL TRADE COMMISSION BY TELEPHONE AT 1- 877-FTC-HELP (382-4357) OR ONLINE AT WWW.FTC.GOV.; CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS MAY EMPLOY THE FOLLOWING ECAS, SUBJECT TO ANY RESTRICTIONS DESCRIBED BELOW: 1. CREDIT REPORTING(A) FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, NEITHER CHINESE HOSPITAL NOR ANY OF ITS AUTHORIZED VENDORS WILL REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY FOR NON-PAYMENTS AT ANY TIME PRIOR TO 150 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. 2. CIVIL ACTIONS (E.G., LITIGATION, DEBTOR'S EXAMS)(A) FOR UNINSURED PATIENTS OR PATIENTS WITH HIGH MEDICAL COSTS (AS DEFINED IN CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY), NEITHER CHINESE HOSPITAL NOR ANY OF ITS AUTHORIZED VENDORS WILL COMMENCE CIVIL ACTION FOR NON-PAYMENTS AT ANY TIME PRIOR TO 150 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. (B) THIS RESTRICTION DOES NOT PRECLUDE CHINESE HOSPITAL FACILITIES FROM PURSUING REIMBURSEMENT FROM THIRD-PARTY LIABILITY SETTLEMENTS, TORTFEASORS, OR OTHER LEGALLY RESPONSIBLE PARTIES. (C) THE COSTS, INCLUDING ATTORNEY FEES, ASSOCIATED WITH ANY LEGAL ACTION THAT CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS IS REQUIRED TO TAKE MAY ALSO BE THE RESPONSIBILITY OF THE PATIENT. 3. RENEWAL OF EXISTING JUDGMENTS4. PROPERTY LIENS(A) CHINESE HOSPITAL AND ITS AUTHORIZED VENDORS THAT ARE AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT PLACE LIENS ON THE PRIMARY RESIDENCE OF A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. (B) AUTHORIZED VENDORS THAT ARE NOT AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT NOTICE OR CONDUCT A SALE OF THE PRIMARY RESIDENCE OF A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. 5. WAGE GARNISHMENTS (A) CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS THAT ARE AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT FILE A WRIT OF GARNISHMENT AGAINST A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. (B) CHINESE HOSPITAL'S AUTHORIZED VENDORS THAT ARE NOT AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT FILE A WRIT OF GARNISHMENT AGAINST A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY, UNLESS SUCH WRIT IS BY ORDER OF THE COURT UPON NOTICED MOTION, SUPPORTED BY A DECLARATION FILED BY THE MOVANT IDENTIFYING THE BASIS FOR WHICH IT BELIEVES THE PATIENT HAS THE ABILITY TO MAKE PAYMENTS ON THE JUDGMENT UNDER THE WAGE GARNISHMENT. (C) WAGE GARNISHMENT AMOUNTS WILL NOT EXCEED LIMITS PERMITTED UNDER STATE LAWS. PART VI, LINE 2: THE CHINESE HOSPITAL SUPPLEMENTAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED THROUGH FOCUS GROUPS DESIGNED TO ASSESS THE HEALTH STATUS, CONCERNS, AND ACCESS AMONG THE CHINESE POPULATION THAT CHINESE HOSPITAL SERVES IN THE CITY AND COUNTY OF SAN FRANCISCO. PARTICIPANTS WERE ASKED TO RANK THEIR HEALTH NEEDS FROM 1-5, WITH 1 BEING THE MOST IMPORTANT, AND THEIR RESPONSES POSTED WITH STICKY NOTES ON A BOARD FOR OTHER PARTICIPANTS TO SEE. STICKY NOTES SERVE AS BASES FOR FURTHER DISCUSSION TO ASSESS COMMUNITY NEEDS. THE FOCUS GROUP RESPONDENTS THEN RECOMMEND HEALTH NEEDS, WHICH BECOME THE BASIS FOR CHINESE HOSPITAL'S CHNA AND IMPLEMENTATION STRATEGY.IN ADDITION, CHINESE HOSPITAL HOLDS VARIOUS COMMUNITY EVENTS AND SCREENINGS, WHICH ALLOWS IT TO FURTHER ASSESS THE HEALTH NEEDS OF THE COMMUNITY. PART VI, LINE 3: THE HOSPITAL POSTS ITS FINANCIAL ASSISTANCE POLICY WITHIN ADMITTING AND REGISTRATION AREAS, THE EMERGENCY DEPARTMENT, AND THE BUSINESS OFFICE. ALL ADMITS TO THE HOSPITAL ARE ALSO PROVIDED THE FINANCIAL ASSISTANCE/CHARITY CARE POLICIES IN THE PRIMARY LANGUAGE OF THE PATIENT.CHINESE HOSPITAL ALSO MAKES REASONABLE EFFORTS TO PROVIDE ALL PATIENTS WHO RECEIVE CARE (WHETHER EMERGENCY, INPATIENT, OR OUTPATIENT) FROM A CHINESE HOSPITAL FACILITY, AND MAY BE BILLED FOR THAT CARE, WITH A CONSPICUOUS WRITTEN NOTICE ON EACH BILLING STATEMENT THAT INCLUDES THE FOLLOWING: (I) INFORMATION ABOUT THE AVAILABILITY OF CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND OTHER DISCOUNTS AVAILABLE FROM CHINESE HOSPITAL; (II) INFORMATION ABOUT ELIGIBILITY FOR FINANCIAL ASSISTANCE AND OTHER DISCOUNTS; (III) CONTACT INFORMATION FOR A HOSPITAL EMPLOYEE OR OFFICE FROM WHICH THE PERSON MAY OBTAIN FURTHER INFORMATION ABOUT CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND OTHER DISCOUNTS; AND (IV) THE DIRECT WEBSITE WHERE COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE OBTAINED.IF A PATIENT HAS NOT PROVIDED PROOF OF HEALTH COVERAGE BY A THIRD PARTY AT THE TIME CARE IS PROVIDED OR BY THE TIME THE PATIENT IS DISCHARGED, CHINESE HOSPITAL'S FIRST POST-DISCHARGE BILL WILL PROVIDE THE PATIENT WITH A BILL THAT CONTAINS A CLEAR AND CONSPICUOUS STATEMENT THAT, IF THE PATIENT DOES NOT HAVE HEALTH INSURANCE COVERAGE FOR THE CHARGES, THE PATIENT MAY BE ELIGIBLE FOR (I) A GOVERNMENT-SPONSORED HEALTHCARE PROGRAM, SUCH AS MEDICARE, MEDICAID, OR CHIP, (II) COVERAGE OFFERED THROUGH A HEALTH BENEFITS EXCHANGE; (III) COVERAGE THROUGH OTHER STATE-OR COUNTY-FUNDED HEALTH PROGRAMS (E.G. CALIFORNIA CHILDREN'S SERVICES PROGRAM), OR (IV) FINANCIAL ASSISTANCE FROM CHINESE HOSPITAL UNDER ITS FINANCIAL ASSISTANCE POLICY. A STATEMENT IS ALSO INCLUDING INDICATING HOW PATIENTS MAY OBTAIN APPLICATIONS FOR THE AFOREMENTIONED PROGRAMS AND THAT THE HOSPITAL WILL PROVIDE THE APPLICATIONS. THE HOSPITAL SERVES A LARGE POPULATION OF LOW-INCOME. APPROXIMATELY 90% OF OUR MEDICARE PATIENTS MEET THE FEDERAL CRITERIA FOR "LOW-INCOME". ITS WHOLLY OWNED SUBSIDIARY, CCHP, OFFERS A LOW-COST COMMERCIAL INSURANCE PRODUCT FOR INDIVIDUALS AND EMPLOYER GROUPS, MOST OF WHICH REPRESENT SMALL ASIAN BUSINESSES. OUR INTEGRATED HEALTHCARE DELIVERY SYSTEM ALSO SERVES MANAGED CARE MEDICAID ENROLLEES (SAN FRANCISCO HEALTH PLAN) IN THE COMMUNITY, WHICH BECAME THE FIRST PRIVATE SECTOR ORGANIZATION TO OFFER A MEDICAL HOME TO INDIVIDUALS PARTICIPATING IN THE HEALTHY SAN FRANCISCO PROGRAM FOR INDIVIDUALS WITH INCOMES THAT ARE LESS THAN 300% OF THE FPL. ALL THESE PROGRAMS ARE WIDELY PUBLICIZED IN BOTH ENGLISH AND CHINESE (ELECTRONICALLY AND IN HARD-COPY) TO THE COMMUNITY. THIS INFORMATION IS ON THE WEBSITES OF THE THREE ORGANIZATIONS THAT MAKE UP THE INTEGRATED DELIVERY SYSTEM, CHINESE HOSPITAL ASSOCIATION, CCHP, AND JADE HEALTH CARE MEDICAL GROUP. PART VI, LINE 4: THE COMMUNITY CHINESE HOSPITAL SERVES HAS A MAJORITY OF LOW-INCOME, MONOLINGUAL OR LINGUISTICALLY ISOLATED SENIOR POPULATION. OF THE INPATIENT POPULATION AT CHINESE HOSPITAL, 98% ARE CHINESE ANCESTRY, 88% ARE OVER THE AGE OF 60, AND 91% ARE MEDICARE/MEDI-CAL BENEFICIARIES. THE PRIMARY SERVICE AREA IS THE GREATER CHINATOWN AND NORTH BEACH DISTRICTS OF SAN FRANCISCO. THE POPULATION OF THE CHINATOWN/NORTH BEACH DISTRICTS IS 26,492, WITH OVER HALF (50.2%) IDENTIFYING AS ASIAN; MORE SPECIFICALLY, 43.7% IDENTIFY AS CHINESE. THE PER CAPITA INCOME IS $58,461, WHILE THE MEDIAN HOUSEHOLD INCOME IS $66,442. THE PERCENTAGE OF PERSONS 65 YEARS AND OVER IS 22.4%, AND IT IS ESTIMATED 16.0% OF THE POPULATIONS IS BELOW THE POVERTY LEVEL. BECAUSE OF OUR UNIQUE BILINGUAL PROGRAMS AND SENSITIVITY TO CULTURAL TRADITIONS, RESIDENTS FROM OTHER SAN FRANCISCO NEIGHBORHOODS AND CITIES OF THE BAY AREA TRAVEL TO CHINESE HOSPITAL. ADDITIONAL INFORMATION REGARDING THESE SERVICE AREAS CAN BE FOUND IN THE ORGANIZATION'S CHNA REPORT POSTED TO ITS WEBSITE AT WWW.CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PART VI, LINE 5: A MAJORITY OF THE HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL PHYSICIANS IN THE COMMUNITY WHO APPLY FOR SUCH PRIVILEGES AND MEET THE REQUIRED MEDICAL QUALIFICATIONS. THE HOSPITAL'S SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH, AS DETERMINED BY THE GOVERNING BODY'S FINANCE COMMITTEE. PART VI, LINE 6: THE CHINESE HOSPITAL HEALTH SYSTEM IS AN INTEGRATIVE HEALTH SYSTEM CONSISTING OF CHINESE HOSPITAL AND CLINICS, CHINESE COMMUNITY HEALTH PLAN (CCHP), AND JADE HEALTH CARE MEDICAL GROUP. EACH ENTITY PERFORMS AN IMPORTANT ROLE IN ACHIEVING THE COMMON GOAL OF PROVIDING THE COMMUNITY WITH QUALITY AFFORDABLE CARE THAT IS CULTURALLY COMPETENT AND LINGUISTICALLY APPROPRIATE. CCHP IS LICENSED WITH THE CALIFORNIA DEPARTMENT OF MANAGED CARE TO OFFER COMMERCIAL HEALTH PLANS AND MAINTAIN A CONTRACT WITH CENTERS FOR MEDICARE AND MEDICAID TO OFFER MEDICARE ADVANTAGE PLANS; CCHP OFFERS A HIGH QUALITY, RIGHT-SIZED ALTERNATIVE FOR HEALTH COVERAGE. JADE HEALTH CARE MEDICAL GROUP IS A MEDICAL GROUP DELIVERING CULTURALLY SENSITIVE, BILINGUAL MANAGED HEALTH CARE IN THE SAN FRANCISCO BAY AREA. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 CHINESE COMMUNITY HEALTH PLAN 445 GRANT AVENUE SUITE 700 SAN FRANCISCO CA 94108 943021419 860000 EQUITY TRANSFER 1 PART I, LINE 2: AN EQUITY TRANSFER OF $860,000 WAS PROVIDED TO CHINESE COMMUNITY HEALTH PLAN, A WHOLLY-OWNED SUBSIDIARY OF CHINESE HOSPTIAL ASSOCIATION. USE OF FUNDS TRANSFERRED WAS MONITORED VIA OVERLAPPING GOVERNANCE OF THE TWO ORGANIZATIONS. X X X X 1 1 0 0 0 0 0 0 0 DR JIAN ZHANG CHIEF EXECUTIVE OFFICER 505586 0 40790 0 0 0 7647 0 18904 0 572927 0 0 0 STEPHEN FORNEY CFO THROUGH 9/2019 256890 0 25689 0 0 0 0 0 14178 0 296757 0 0 0 KEITH MINARD CHIEF INFORMATION OFFICER 302827 0 0 0 0 0 13750 0 6484 0 323061 0 0 0 LYDIA MAHR-CHAN CHIEF HUMAN RESOURCES OFFICER 261730 0 20498 0 0 0 12343 0 6484 0 301055 0 0 0 ANDERSON ENG MD MEDICAL PHYSICIAN 272173 0 25159 0 0 0 13750 0 6484 0 317566 0 0 0 ALSON TOY RN SURGERY 294974 0 0 0 0 0 0 0 7144 0 302118 0 0 0 AUNG KYAW MAUNG MD MEDICAL PHYSICIAN 259751 0 24246 0 0 0 0 0 18904 0 302901 0 0 0 JUDI WONG MD MEDICAL PHYSICIAN - GELLERT CLINIC 258874 0 24482 0 0 0 11272 0 6484 0 301112 0 0 0 FRANK CHEN MD MEDICAL PHYSICIAN - SUNSET CLINIC 256188 0 21880 0 0 0 13013 0 6484 0 297565 0 0 0 BRENDA YEE FORMER CHIEF EXECUTIVE OFFICER 0 0 0 0 556658 0 0 0 0 0 556658 0 0 0 SCOTT GOODIN FORMER CHIEF FINANCIAL OFFICER 0 0 0 0 306131 0 0 0 6484 0 312615 0 0 0 PART I, LINES 4A-B FORMER CEO BRENDA YEE RECEIVED A SEVERANCE OF $556,658 IN 2019, WHICH WAS TAXABLE COMPENSATION AND REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III). IN ADDITION, FORMER CFO SCOTT GOODIN RECEIVED $312,615 OF TOTAL SEVERANCE IN 2019, $306,131 OF WHICH WAS TAXABLE AND REPORTED ON SCHEDULE J, PART II, COLUMN (B)(III) AND $6,484 OF WHICH WAS NON-TAXABLE (AS THE INDIVIDUAL WAS ELIGIBLE FOR CONTINUATION OF BENEFITS AS A PART OF THE SEVERANCE ARRANGEMENT) AND REPORTED AS "NONTAXABLE BENEFITS" IN SCHEDULE J, PART II, COLUMN (D). DR. JIAN ZHANG PARTICIPATED IN THE ORGANIZATION'S SUPPLEMENTAL 457(F) DEFERRED COMPENSATION PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN TOTALED $7,647 IN 2019, WHICH HAS BEEN REPORTED IN "DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C). A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033LJ57 2012-11-08 69923971 FINANCE NEW HEALTH CARE FACILITIES 0 0 0 A 5510000 70286003 4274755 9551013 1411465 2607615 52441155 2016 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/01/2019 SCHEDULE K, PART I, COLUMN (E) AND SCHEDULE K, PART II, LINE 3: THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED ON SCHEDULE K, PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE REPORTED ON SCHEDULE K, PART II, LINE 3 IS DUE TO CUMULATIVE INVESTMENT EARNINGS ON BOND FUNDS. SCHEDULE K, PART IV, LINE 2C THE ARBITRAGE REBATE CALCULATION WAS LAST COMPLETED IN JANUARY 2019. FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE SEPTEMBER 2019, THE ROLE OF INTERIM CHIEF FINANCIAL OFFICER WAS FULFILLED BY PAUL ZIEGELE, A CONSULTANT WITH TATUM (AN ORGANIZATION PROVIDING INTERIM EXECUTIVE SERVICES). TOTAL PAYMENTS MADE TO TATUM IN EXCHANGE FOR PAUL ZIEGELE'S SERVICES TOTALED $249,900 DURING THE 2019 CALENDAR YEAR. FORM 990, PART VI, SECTION A, LINE 6 CHA DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS. HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE "MEMBERS" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WITH THE POWER TO ELECT MEMBER OF THE GOVERNING BODY. ACCORDINGLY, CHA HAS SIXTEEN (16) MEMBERS: (1) CHINESE CONSOLIDATED BENEVOLENT ASSOCIATION; (2) NING YUNG BENEVOLENT ASSOCIATION; (3) SUE HING BENEVOLENT ASSOCIATION; (4) HOP WO BENEVOLENT ASSOCIATION; (5) KONG CHOW BENEVOLENT ASSOCIATION; (6) YEONG WO BENEVOLENT ASSOCIATION; (7) SAM YUP BENEVOLENT ASSOCIATION; (8) YAN WO BENEVOLENT ASSOCIATION; (9) CHINESE CHAMBER OF COMMERCE; (10) CHINESE AMERICAN CITIZENS ALLIANCE; (11) KUOMINTANG OF CHINA; (12) CHEE KUNG TONG; (13) CHINESE DEMOCRATIC CONSTITUTIONALIST PARTY; (14) CHINATOWN Y.M.C.A; (15) CHINESE CHRISTIAN UNION OF SAN FRANCISCO; AND (16) CHINESE HOSPITAL MEDICAL STAFF. FORM 990, PART VI, SECTION A, LINE 7A EACH OF THE FOLLOWING MEMBERS HAS THE POWER TO DESIGNATE ONE MEMBER OF THE BOARD OF TRUSTEES: (1) CHINESE CONSOLIDATED BENEVOLENT ASSOCIATION; (2) NING YUNG BENEVOLENT ASSOCIATION; (3) SUE HING BENEVOLENT ASSOCIATION; (4) HOP WO BENEVOLENT ASSOCIATION; (5) KONG CHOW BENEVOLENT ASSOCIATION; (6) YEONG WO BENEVOLENT ASSOCIATION; (7) SAM YUP BENEVOLENT ASSOCIATION; (8) YAN WO BENEVOLENT ASSOCIATION; (9) CHINESE CHAMBER OF COMMERCE; (10) CHINESE AMERICAN CITIZENS ALLIANCE; (11) KUOMINTANG OF CHINA; (12) CHEE KUNG TONG; (13) CHINESE DEMOCRATIC CONSTITUTIONALIST PARTY; (14) CHINATOWN Y.M.C.A; (15) CHINESE CHRISTIAN UNION OF SAN FRANCISCO; AND (16) CHINESE HOSPITAL MEDICAL STAFF. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT, IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING DEPARTMENT. THE FORM 990 IS THEN REVIEWED BY THE ORGANIZATION'S CONTROLLER AND CHIEF FINANCIAL OFFICER; ADJUSTMENTS ARE MADE, AS NECESSARY. THE FORM 990 IS THEN MADE AVAILABLE TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL CONFLICT OF INTEREST SURVEY AND DECLARATION. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST STATEMENT THAT DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE, VOLUNTARY DISCLOSURE OF ANY POTENTIAL CONFLICTS AS DISCUSSIONS OF PENDING TRANSACTIONS OCCUR IS REQUIRED. THE LEGAL DEPARTMENT AND CFO REVIEW THE CONFLICT OF INTEREST STATEMENTS. IF A CONFLICT OF INTEREST ARISES, THE PERSON WITH THE CONFLICT RECUSES HIM/HERSELF FROM THE DELIBERATIONS AND DECISION-MAKING PROCESS REGARDING THAT PARTICULAR MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS PACKAGE OF THE CEO IS EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD. AS A PART OF THIS PROCESS, AN INDEPENDENT CONSULTANT WAS USED TO PROVIDE COMPARABLE DATA OF EQUIVALENT EMPLOYEES AT SIMILARLY SIZED HOSPITALS AND HEALTH PLANS; THE OVERALL COMPENSATION PACKAGE FOR THE CEO WAS THEN REVIEWED AND APPROVED BY INDEPENDENT MEMBERS OF THE BOARD. THE COMPENSATION AND BENEFITS PACKAGE FOR OTHER OFFICERS AND KEY EMPLOYEES IS ALSO EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD, WHICH UTILIZED COMPARABLE DATA FOR SIMILAR EMPLOYEES AT SIMILARLY SIZED HOSPITALS AND HEALTH PLANS. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL LAW DOES NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION; ACCORDINGLY, THESE DOCUMENTS ARE CURRENTLY NOT MADE AVAILABLE TO THE PUBLIC. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST, AND ARE ALSO ATTACHED TO A COPY OF THIS FORM 990. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,681,596. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,681,596. TPA FEES - CCHP: PROGRAM SERVICE EXPENSES 4,257,535. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,257,535. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,326,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,326,280. FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY -4,687,739. RETIREMENT BENEFIT LOSS -785,379. CHINESE COMMUNITY HEALTH PLAN 445 GRANT AVENUE SUITE 700 SAN FRANCISCO CA 94108 943021419 INSURANCE CA CHA C 144403895 54588792 1.00000 1 CHARITABLE REMAINEDER TRUST (2) CHARITABLE GIVING CA CHA 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 CHINESE COMMUNITY HEALTH PLAN A 41828 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN B 860000 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN D 3425883 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN L 1702196 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN O 5570000 BOOK VALUE