2019-08-02T13:16:50-05:00 2018-09-30 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2017-10-01 951934652 PIH HEALTH HOSPITAL - WHITTIER PIHH 5626980811 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 RICHARD WANG VP OF FINANCE 5626980811 2019-08-01 1 REBEKUH ELEY P01247672 3126343400 66.98.98.130 2019-08-01 13:57:40 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 64E34636FEC2DFD844E3D394C3B342543AC68841 2017 2019-02-21 02:37:17Z RICHARD WANG 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 724192052 0 X WWW.PIHHEALTH.ORG X 1954 CA TO PROVIDE QUALITY HEALTHCARE AND CONTRIBUTE TO THE COMMUNITY'S HEALTH AND WELL-BEING. 15 12 3785 772 25991 33855 3620107 1040754 560571584 586124611 12774082 18731184 2718833 3009976 579684606 608906525 219630 197851 0 0 266966788 272384404 0 0 0 270505103 274860898 537691521 547443153 41993085 61463372 1282135553 1297737709 664673317 583090156 617462236 714647553 X MISSION: WHY WE ARE HERE: WE PROVIDE HIGH QUALITY HEALTHCARE WITHOUTDISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OURCOMMUNITIES IN AN ETHICAL, SAFE, AND FISCALLY PRUDENT MANNER INRECOGNITION OF OUR CHARITABLE PURPOSE.VISION: WHERE WE WANT TO BE: WE WILL ACHIEVE EXCELLENCE IN EVERYTHINGWE DO.VALUES: OUR PROMISE: OUR PATIENTS' SAFETY, WELL-BEING, AND MEDICALCONDITION WILL BE OUR PRIMARY CONCERN AT ALL TIMES. WE WILLCONSISTENTLY DEMONSTRATE RESPECT AND COMPASSION FOR THE BELIEFS,SITUATION, AND NEEDS OF OUR PATIENTS AND CO-WORKERS. WE WILL STRIVE TOANTICIPATE NEEDS AND RESPOND IN A TIMELY WAY TO MEET OR EXCEED THEEXPECTATIONS OF OTHERS. OUR ATTITUDE AND ACTIONS WILL REFLECT THEHIGHEST ETHICAL AND MORAL STANDARDS. WE WILL WORK TOGETHER - WITHIN ANDOUTSIDE THE ORGANIZATION - TO SOLVE PROBLEMS AND PURSUE OPPORTUNITIESIN CREATIVE WAYS. WE WILL SERVE THE COMMUNITY WISELY THROUGH THEEFFICIENT AND PRUDENT USE OF OUR FINANCIAL RESOURCES. 0 0 370511395 197851 519083994 PATIENT CARE: PIH HEALTH HOSPITAL - WHITTIER BEGAN AS A COMMUNITY HOSPITAL IN 1959. AS A 501 (C)(3) NONPROFIT, 523-BED HOSPITAL, THE WHITTIER CAMPUS HAS DEVELOPED INTO A HEALTH SYSTEM OFFERING A MULTITUDE OF SERVICES.PATIENT CARE IN FISCAL YEAR 2017-2018EMPLOYEES 3,373VOLUNTEERS 886NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS 82,206NUMBER OF BIRTHS 1,752MEDICAL STAFF 490 97143518 66701037 FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: FINANCIAL ASSISTANCE, ALSO KNOWN AS CHARITY CARE, IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO INDIVIDUALS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PIH HEALTH OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM, PROVIDING CHARITY CARE TO THOSE WITH FAMILY INCOME(S) AT OR BELOW 400% OF FEDERAL POVERTY LEVEL GUIDELINES.IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN MEANS-TESTED GOVERNMENT HEALTH PROGRAMS, SUCH AS MEDI-CAL, PIH HEALTH REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR DUE TO THE SHORTFALL CREATED WHEN THE PAYMENTS RECEIVED FROM THESE PROGRAMS ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 42,281 12236164 2461859 OTHER COMMUNITY BENEFIT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH AND IN-KIND CONTRIBUTIONS AND COMMUNITY BUILDING FOR COMMUNITY BENEFIT ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES: DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THESE PROGRAMS INCLUDE: COMMUNITY COLLABORATIVE SUPPORT AND PARTICIPATION, COMMUNITY EDUCATION, COMMUNITY INFORMATION AND REFERRAL SUPPORT, ENROLLMENT ASSISTANCE, HEALTH AND WELLNESS CENTER AT WHITTIER FIRST DAY, PREVENTATIVE HEALTH PROGRAMS AND SCREENINGS, SUPPORT GROUPS, AND TRANSPORTATION RESOURCES.SNAPSHOT OF OUTCOMES:MORE THAN 20,618 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES.HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, NURSES, STUDENTS AND OTHER HEALTH PROFESSIONALS WHEN EDUCATION IS NECESSARY OR REQUIRED BY STATE LAW, ACCREDITING BODY OR HEALTH PROFESSION SOCIETY. PIH HEALTH PROGRAMS INCLUDE THE FAMILY MEDICINE RESIDENCY PROGRAM, PARAMEDIC BASE STATION TRAINING AND STUDENT EDUCATION (INTERNSHIP, EXTERNSHIP, PRECEPTORSHIP AND MENTORING PROGRAMS).SNAPSHOT OF OUTCOMES:MORE THAN 1,112 STUDENT NURSES, PHYSICIAN RESIDENTS, AND OTHER INDIVIDUALS STUDYING TO BECOME HEALTHCARE PROFESSIONALS WERE PROVIDED WITH MENTORSHIP, PRECEPTORSHIP AND TRAINING OPPORTUNITIES.SUBSIDIZED HEALTH SERVICES: SUBSIDIZED SERVICES ARE CLINICAL PROGRAMS, WHICH ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO THE RESPONSIBILITY OF GOVERNMENT OR ANOTHER NONPROFIT ORGANIZATION TO PROVIDE. PIH HEALTH SERVICES PROVIDED INCLUDE DIABETES EDUCATION CENTER, EMERGENCY DEPARTMENT ON-CALL PHYSICIANS, HIGH-RISK INFANT FOLLOW-UP CLINIC, HOSPICE HOMES, PALLIATIVE CARE PROGRAM, AND PARAMEDIC BASE STATION.SNAPSHOT OF OUTCOMES:THE HIGH RISK INFANT FOLLOW-UP CLINIC ENSURES FAMILIES HAVE ACCESS TO SPECIALIZED CARE TO MEET THEIR CHILDREN'S DEVELOPMENTAL NEEDS, WITH APPROXIMATELY 80-100 CHILDREN SERVED EACH YEAR.THE HOSPICE HOMES ENSURE ACCESS TO QUALITY, COMPASSIONATE END-OF-LIFE CARE, REGARDLESS OF ABILITY TO PAY, WITH APPROXIMATELY 200 PATIENTS SERVED EACH YEAR.TOTAL INDIVIDUALS SERVED BY SUBSIDIZED HEALTH SERVICES= 12,757RESEARCH: RESEARCH THAT MAY BE REPORTED AS COMMUNITY BENEFIT INCLUDES CLINICAL AND COMMUNITY HEALTH RESEARCH AS WELL AS STUDIES ON HEALTHCARE DELIVERY THAT ARE GENERALIZABLE AND SHARED WITH THE PUBLIC. PIH HEALTH HAS BEEN OFFERING CLINICAL TRIALS AND RESEARCH STUDIES AIMED AT IMPROVING HEALTH AND CANCER CARE SINCE 2001. SNAPSHOT OF OUTCOMES:13 CLINICAL TRIALS WERE OFFERED WITH 35 PARTICIPATING.CASH & IN-KIND CONTRIBUTIONS: THIS CATEGORY INCLUDES FUNDS AND IN-KIND SERVICES DONATED BY PIH HEALTH TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE FOR A COMMUNITY BENEFIT PURPOSE. THESE DONATIONS INCLUDE CASH DONATIONS TO COMMUNITY ORGANIZATIONS, HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY WHILE ON PIH HEALTH WORK TIME, THE COST OF MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF EQUIPMENT, MEDICATIONS, AND SUPPLIES. SNAPSHOT OF OUTCOMES:89 AT-RISK INDIVIDUALS WERE PROVIDED WITH IN-KIND DURABLE MEDICAL EQUIPMENT OR SERVICES, SUCH AS SKILLED NURSING OR MENTAL HEALTHCARE.$118,000 IN CASH DONATIONS WAS GIVEN TO 29 ORGANIZATIONS TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IN OUR SERVICE AREA COMMUNITIES.TOTAL NUMBER OF PERSONS SERVED BY ALL CATEGORIES: 35,484FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBANNUALREPORT 479891077 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 175 0 1 3785 1 1 1 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X RICHARD WANG 5626980811 12401 WASHINGTON BLVD WHITTIER CA 90602 ALEX ALVAREZ DIRECTOR (AS OF 10/9/17) 1.50 4.50 X 0 0 0 RICHARD ATWOOD DIRECTOR & CHAIR 1.50 6.00 X X 0 0 0 ROBERT BOHR MD DIRECTOR 7.00 40.00 X 72000 414879 17540 PAULA COWAN DIRECTOR & SECRETARY 1.50 4.50 X X 0 0 0 BLAYNE CUTLER MD PHD DIRECTOR (AS OF 10/9/17) 1.50 4.50 X 0 0 0 JANE DICUS DIRECTOR 1.50 4.50 X 0 0 0 ED DUNLAP DIRECTOR & VICE CHAIR 1.50 4.50 X X 0 0 0 JEFF HAMAR DIRECTOR & TREASUER 1.50 4.50 X X 0 0 0 PATRICK MONROE DIRECTOR 1.50 4.50 X 0 0 0 SUDHAKER NAYAK MD DIRECTOR 8.50 40.00 X 119070 1627624 37121 ROBERT PETRINA DIRECTOR 1.50 4.50 X 0 0 0 NEAL SHINDEL MD DIRECTOR 1.50 40.00 X 0 1128326 36373 CHARLOTTE WEAVER PHD DIRECTOR 1.50 4.50 X 0 0 0 KENTON WOODS DIRECTOR 1.50 4.50 X 0 0 0 HUEY-MIN YU DIRECTOR 1.50 4.50 X 0 0 0 JAMES WEST PRESIDENT/CEO 30.00 16.20 X 1373355 0 269389 PEGGY CHULACK CAO & ASST. SECRETARY 30.00 16.20 X 668472 0 124860 GREG WILLIAMS CFO & ASST. TREASURER 30.00 16.20 X 658252 0 177226 ROSALIO LOPEZ MD CMO/CSO 40.00 4.50 X 820505 0 138561 REANNA THOMPSON COO/CNO 40.00 X 484637 0 122605 DAVID KLINGER VP FACILITIES 40.00 X 506307 0 34237 DAVIS LEE CHIEF MED INFO OFFICER 40.00 X 501206 0 103642 DEBRA LEGAN VP MKTG & PLANNING 40.00 X 403951 0 83520 RONALD YOSHIHARA VP FINANCE & ANALYTICS 40.00 X 323277 0 58627 PERRY EBELTOFT VP ANCILLARY SVS 40.00 X 297012 0 67487 ANUP PATEL VP ENT RSK MGMT & CORP COM 40.00 X 267017 0 60014 NICHOLAS CHRISTIANSON VP REV CYC & MGD CRE 40.00 X 259712 0 62171 SHELLY NECKE VP POST ACUTE CR SVS 40.00 X 257110 0 43584 CHICO MANNING VP SUPPLY CHAIN 40.00 X 227398 0 39398 JUNG HO MEDICAL PHYSICIST 40.00 X 262095 0 24610 DIANE MCCOWAN DIR PHARMACY 40.00 X 241974 0 14428 SCOTT BREMER DIR COMP, BENEF & HRIS 40.00 X 232723 0 34526 REBECCA WEYANT RN ADM DIR 40.00 X 212214 0 27884 CESAR ROSAS RN CHARGE NURSE 40.00 X 202768 0 12203 SHERREL HOLLINGSWORTH CHIEF HR OFFICER TERM 2/17/17 0.00 X 566068 0 42923 8957123 3170829 1632929 498 1 1 0 ALLSCRIPTS - CHICAGO 24630 NETWORK PLACE CHICAGO IL 60673 IT SERVICES 18297950 LAMBERT RADIOL MED GRP INC 11721 WHITTIER BLVD SUITE 509 WHITTIER CA 90601 MEDICAL SERVICES 11921907 INTERCOMMUNITY ANESTH SVCS INC PO BOX 511509 LOS ANGELES CA 90051 MEDICAL SERVICES 11634983 WHITTIER PULM AND CRITC CARE 6905 ALTA VISTA DRIVE RANCHO PALOS VERDES CA 90275 MEDICAL SERVICES 7656224 DOWNEY MEDICAL GROUP 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 MEDICAL SERVICES 3173185 66 1040754 1040754 NET PATIENT REVENUE 621610 472722217 472722217 OTHER PATIENT REVENUE 621610 69844389 69844389 HOSPITAL FEE PROGRAM 900099 33532814 33532814 FOOD SERVICES 900099 2902796 2902796 ARRA INCENTIVE PAYMENT 900099 44502 44502 7077893 7077893 586124611 11015246 11015246 120656543 2344922 113078505 2207022 7578038 137900 7715938 7715938 COMMUNITY PHARMACY 624110 2122279 2122279 PURCHASE DISCOUNTS 900099 861706 861706 25991 25991 3009976 608906525 588246890 25991 19592890 X 72851 72851 125000 125000 7424544 4914168 2510376 188500604 165880532 22620072 12670941 11150428 1520513 48155928 42377217 5778711 15632387 13756501 1875886 2157010 2157010 1765885 1765885 38563 38563 35340 35340 60202984 54374463 5828521 8520271 5004111 3516160 32073042 28224277 3848765 10154971 7727037 2427934 469549 419717 49832 69304 32092 37212 7600114 5516500 2083614 24357350 21434468 2922882 5360313 5360313 MEDICAL SUPPLIES 72720046 71765532 954514 QUALITY ASSURANCE FEE ( 23508485 23508485 BAD DEBT EXPENSE 10503133 10503133 EQUIPMENT R&M 4743457 4724272 19185 10581081 8380293 2200788 547443153 479891077 67552076 0 271662 268902 67651252 71041882 5568606 5421268 8554562 6103446 598189306 249636017 367452391 348553289 457811734 473856017 374825346 392492905 1282135553 1297737709 54167762 51381052 364725100 354833542 48000000 28000000 197780455 148875562 664673317 583090156 X 617462236 714647553 617462236 714647553 1282135553 1297737709 X 61463372 4847408 -150154 31024691 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 35340 35340 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND AMERICAN HOSPITAL ASSOCIATION ARE RELATED TO LOBBYING. 214611 214611 324762931 76815258 247947673 75485821 28520490 46965331 188111472 136818264 51293208 9614471 7482005 2132466 348553289 INTERCOMPANY RECEIVABLE 357860450 HOSPITAL FEE PROGRAM RECEIVABLE 25180306 OTHER RECEIVABLES 3707507 DEFERRED FINANCING COSTS 3389609 INVESTMENT IN AFFILIATES 1555033 OTHER DEPOSITS 800000 392492905 PENSION LIABILITY 49218144 INTEREST RATE SWAP 25961432 NOTE PAYABLE 19500000 HOSPITAL FEE PAYABLE 18597013 DEFERRED COMPENSATION 16441177 SELF INSURANCE RESERVES 15167800 BOND INTEREST PAYABLE 2240973 OTHER LIABILITIES 1749023 148875562 X PART X, LINE 2: THE COMPANY HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES, AND AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE COMPANY IS SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, WHICH DOES NOT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS. THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE GUIDANCE IS APPLICABLE TO PROFIT-ORIENTED ENTITIES, PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. MANAGEMENT BELIEVES IT HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS, AND AS SUCH NO TAX LIABILITY, BENEFITS, INTEREST OR PENALTIES WERE ACCRUED AT SEPTEMBER 30, 2018 OR 2017. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE COMPANY BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2014 FOR FEDERAL PURPOSES AND 2012 FOR CALIFORNIA PURPOSES. 1 1 X 1 X 1 X 1 1 1 0 1 1 926 4132048 1415172 2716876 0.00510 40888 90656078 66384985 24271093 0.04520 467 2355392 830070 1525322 0.00280 42281 97143518 68630227 28513291 0.05310 18 20693 1998028 33881 1964147 0.00370 5 1112 4015445 995210 3020235 0.00560 6 12757 5603019 1220753 4382266 0.00820 1 35 153302 4536 148766 0.00030 4 997 466370 1700 464670 0.00090 34 35594 12236164 2256080 9980084 0.01870 34 77875 109379682 70886307 38493375 0.07180 1 2 32168 32168 0.00010 1 15 15703 15703 0.00000 2 6 20810 20810 0.00000 1 2 535 535 0.00000 5 25 69216 69216 0.00010 1 10503133 74309129 90430350 -16121221 X 1 1 1 ANGEL CARE HEALTH NETWORK LLC (VIVITY) SEE PART VI 0.12500 0.00000 0.00000 1 1 PIH HEALTH HOSPITAL - WHITTIER 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 WWW.PIHHEALTH.ORG LICENSE #930000129 X X X X SKILLED NURSING FACILITY PIH HEALTH HOSPITAL - WHITTIER 1 0 0 1 X X X X X X X X X X 15 1 1 0 1 X PIHHEALTH.ORG/WELLNESS/COMMUNITY-BENEFIT/ X HEALTHACTIONLAB.SHUTTERFLY.COM X X 1 15 1 PIHHEALTH.ORG/CHIP 0 1 X 100.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE X PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE X WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/3985/FINANCIAL-APPLICATION-PLAIN X X X X X X 1 X 0 X X X X 1 X 0 0 PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES DATA AND INFORMATION REGARDING DEMOGRAPHIC PROFILE, SOCIAL DETERMINANTS OF HEALTH, GENERAL HEALTHCARE ACCESS, MATERNAL AND INFANT HEALTH, ORAL HEALTH, MENTAL HEALTH, HEALTH BEHAVIORS, WEIGHT STATUS, NUTRITION AND PHYSICAL ACTIVITY, CHRONIC DISEASES, LEADING CAUSES OF DEATH AND COMMUNITY PERSPECTIVES GATHERED FROM FOCUS GROUPS AND INTERVIEWS. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 5: PRIMARY DATA COLLECTION CONSISTED OF 21 KEY STAKEHOLDER INTERVIEWS AND SIX COMMUNITY FOCUS GROUPS (50 PARTICIPANTS) REGARDING PERCEPTIONS AND OPINIONS OF THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA.INTERVIEW PARTICIPANTS INCLUDED AGENCIES REPRESENTING A BROAD RANGE OF HEALTH AND SOCIAL SERVICES, INCLUDING LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AS WELL THE LOCAL HEALTH DEPARTMENT THAT HAVE CURRENT INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE. KEY STAKEHOLDER INTERVIEWEES1. EVELYN CASTRO-GUILLEN, CHIEF OPERATING OFFICER, THE WHOLE CHILD2. JOANN EROS-DELGADO, FACILITY DIRECTOR, LA COUNTY COMMUNITY RESOURCE CENTER3. RICHARD ESPINOSA, HEALTH DEPUTY, OFFICE OF LA COUNTY SUPERVISOR DON KNABE4. JEFF FARBER, EXECUTIVE DIRECTOR, HELPLINE YOUTH COUNSELING5. ALEXANDRIA GUEVARA, TEEN PROGRAM DIRECTOR, WHITTIER BOYS & GIRLS CLUB6. MICHEL HESIA, PROMOTORA, ACTIVATE WHITTIER COMMUNITY COLLABORATIVE7. SCOTT LEE MD, FAMILY MEDICINE PHYSICIAN, PIH HEALTH8. PENNY LOPEZ, PROGRAM DIRECTOR, ACTIVATE WHITTIER COMMUNITY COLLABORATIVE9. EDITH MARCEL, PROMOTORA PRESIDENT, HEALTHY LOS NIETOS COMMUNITY COLLABORATIVE10. CLARE MCCLAFFERTY, SOCIAL WORKER, PIH HEALTH11. RICARDO MENDOZA, DEPUTY DISTRICT DIRECTOR, OFFICE OF CONGRESSWOMAN LINDA SANCHEZ12. SID MENZIES, CHIEF OPERATING OFFICER, BOYS & GIRLS CLUB OF WHITTIER13. USAMA MITRY MD, FAMILY MEDICINE PHYSICIAN, PIH HEALTH14. MARIA OCHOA RN BSN PHN, SPA 7 COMMUNITY LIAISON PUBLIC HEALTH NURSE LA COUNTY DEPARTMENT OF PUBLIC HEALTH15. LIZET OLMOS, RECREATION COORDINATOR, PICO RIVERA SENIOR CENTER16. JIM ROBERTS, PATIENT ADVISOR/AMBASSADOR, PIH HEALTH17. DENNA SANCHEZ PHD, PSYCHOLOGIST COORDINATOR, PSYCHOLOGICAL SERVICES RIO HONDO COLLEGE18. ANA SUAREZ, DISTRICT CHIEF, LA COUNTY DEPARTMENT OF MENTAL HEALTH SPA 719. JOHN VELASCO, DIRECTOR AND VICE PRESIDENT, HEART OF COMPASSION20. MARTHA VELASQUEZ, PROGRAM DIRECTOR, SPIRITT FAMILY SERVICES21. GUYLENE VELEZ, SOCIAL WORKER, PIH HEALTHFOCUS GROUPS PARTICIPANTS INCLUDED MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, INDIVIDUALS OR ORGANIZATIONS SERVING THE INTERESTS OF THESE POPULATIONS, AND PERSONS REPRESENTING THE BROAD INTEREST OF THE COMMUNITY. FOCUS GROUPS WERE CONDUCTED IN BOTH ENGLISH AND SPANISH.COMMUNITY FOCUS GROUPS1. PARTNERSHIP FOR HEALTHIER COMMUNITIES COLLABORATIVE, SIX COMMUNITY-BASED ORGANIZATIONS2. STEINMETZ SENIOR CENTER- HACIENDA HEIGHTS, 10 OLDER ADULTS3. PLAZA DE LA RAZA, FIVE PARENTS OF PRESCHOOL-AGED CHILDREN4. INTERFAITH FOOD CENTER, 10 FOOD PANTRY CLIENTS5. MY FRIEND'S HOUSE, 12 FAITH-BASED GROUP PASTORS, LAY PASTORS AND CONGREGANTS6. FRIENDS OF FAMILY HEALTH CENTER - LA HABRA, SEVEN COMMUNITY CLINIC CLIENTS PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 6A: PIH HEALTH HOSPITAL - WHITTIER'S CHNA WAS CONDUCTED WITH PIH HEALTH HOSPITAL - DOWNEY AND KAISER FOUNDATION HOSPITAL - DOWNEY MEDICAL CENTER. SHARED SERVICE AREAS AND COMMUNITY PARTNERS ALLOWED FOR COORDINATED INTERVIEWS AND FOCUS GROUPS AND SHARING OF DATA/RESULTS. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 7D: ASSESSMENT FINDINGS WERE ALSO DISTRIBUTED TO KEY STAKEHOLDERS VIA EMAIL WITH EMPHASIS ON SUPPORTING PROGRAM PLANNING AND FUND-DEVELOPMENT ENDEAVORS, AND SPARING ORGANIZATIONS THE EXPENSE OF DUPLICATIVE DATA COLLECTION EFFORTS. ASSESSMENT FINDINGS ARE ALSO SHARED ON AN ON-GOING BASIS VIA PRESENTATIONS AT COMMUNITY EVENTS AND COMMUNITY COLLABORATIVE MEETINGS AND THROUGH SOCIAL MEDIA CHANNELS. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 11: PIH HEALTH'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) ENSURES ALIGNMENT OF CHNA FINDINGS, OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PIH HEALTH'S ORGANIZATIONAL STRATEGY. TO VIEW THE 2017-2019 CHIP AND THE INITIATIVES IDENTIFIED TO ADDRESS AREAS OF FOCUS (DIABETES, HEART DISEASE, OVERWEIGHT/OBESITY, PREVENTATIVE SCREENINGS AND IMMUNIZATIONS, FOOD INSECURITY, HOMELESSNESS AND EDUCATION), VISIT PIHHEALTH.ORG/CHIP. FOR THE HEALTH NEEDS THAT WERE NOT PRIORITIZED AS AREAS OF FOCUS (ASTHMA, CANCER DEATHS, DENTAL CARE ACCESS, HEALTH INSURANCE COVERAGE/AFFORDABILITY, LUNG DISEASE DEATHS, MENTAL HEALTHCARE, AND SUBSTANCE ABUSE), PIH HEALTH HAS NEITHER THE EXPERTISE NOR THE INFRASTRUCTURE TO SERVE AS LEAD IN THESE AREAS. AS THESE HEALTH NEEDS ARE STILL VERY IMPORTANT TO PIH HEALTH AND THE COMMUNITIES WE SERVE, WORK WILL CONTINUE IN THESE AREAS WHERE APPLICABLE, AND REFERRAL AND FUNDING RELATIONSHIPS WITH COMMUNITY-BASED AGENCIES ALREADY WORKING IN THESE AREAS MAY BE STRENGTHENED. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 13B: ASSISTANCE IS PROVIDED FREE OR DISCOUNTED FOR THOSE PATIENTS ELIGIBLE FOR FAP. THE CRITERIA FOR FAP IS IF THE PATIENT IS UNINSURED AND DOES NOT HAVE THE ABILITY TO PAY, HAS RESTRICTED MEDI-CAL BENEFITS, OR IS UNDERINSURED. THIS IS ALSO CONSIDERATIONS FOR PATIENTS WHERE THE FPG IS NOT APPLICABLE AND THE PATIENT IS INSURED WITH INADEQUATE COVERAGE OR EXCESSIVE LIABILITY. 12 1 - SAME DAY SURGERY 12415 WASHINGTON BLVD WHITTIER CA 90602 OUTPATIENT SURGICAL SERVICES 2 - INTERCOMMUNITY MAGNETIC RESONANCE IMAGNG 12455 WASHINGTON BLVD WHITTIER CA 90602 MRI SERVICES 3 - ERNEST D WELLS MEDICAL OFFICE BUILDING 12462 PUTNAM ST WHITTIER CA 90602 OUTPATIENT SERVICES 4 - PATRICIA L SHCEIFLY BREAST HEALTH CTR 12393 WASHINGTON BLVD WHITTIER CA 90602 BREAST HEALTH SVCS 5 - PRESBYTERIAN HEALTH MEDICAL PLAZA 12291 WASHINGTON BLVD WHITTIER CA 90602 WOUND HEALING, LAB DRAW STATION 6 - ARCADIA HOME HEALTH NURSING 351 E FOOTHILL BLVD SUITE 100 ARCADIA CA 91006 VISITING NURSES ASSOCIATION 7 - HOSPICE HOMES - DOVE 10736 VALLEY VIEW AVE WHITTIER CA 90604 HOSPICE CARE 8 - HOSPICE HOMES - ROSE 10742 VALLEY VIEW AVE WHITTIER CA 90604 HOSPICE CARE 9 - PIH HOME HEALTH 15050 IMPERIAL HWY LA MIRADA CA 90638 HOME HEALTH AGENCY 10 - PRESBYTERIAN HEALTH MEDICAL PLAZA 15088 IMPERIAL HWY SUITE 219 LA MIRADA CA 90638 OUTPATIENT THERAPY 11 - BHP - LA MIRADA 12675 S LA MIRADA BLVD SUITE 219 LA MIRADA CA 90638 RADIOLOGY 12 - HACIENDA HEIGHTS MEDICAL OFFICE BUILDING 1850 AZUSA AVE HACIENDA HEIGHTS CA 91745 MAMMOGRAPHY PART I, LINE 6A: PIH HEALTH'S COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2017-2018 COUNTS FOR BOTH PIH HEALTH HOSPITAL - WHITTIER AND PIH HEALTH - HOSPITAL DOWNEY'S PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITY. THE REPORT SEPARATES OUT COMMUNITY BENEFIT INVESTMENT FIGURES FOR EACH HOSPITAL.TO VIEW THE FULL REPORT, VISIT PIHHEALTH.ORG/CBANNUALREPORT PART I, LINE 7: PATIENT CARE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE FINANCIAL ASSISTANCE. FOR ALL OTHERS, WE UTILIZED INTERNAL COSTING SYSTEM AND ACCOUNTS FOR THE VARIOUS PAYER MIX. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10,503,133. PART II, COMMUNITY BUILDING ACTIVITIES: PIH HEALTH WORKS WITH A VARIETY OF COMMUNITY STAKEHOLDERS TO ENHANCE THE COLLECTIVE CAPACITY FOR ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS. PIH HEALTH MOBILIZES ASSETS AND INVESTS RESOURCES THROUGH A VARIETY OF COMMUNITY-BUILDING ACTIVITIES DESIGNED TO ADDRESS IDENTIFIED NEEDS, INCLUDING PARTICIPATION IN EDUCATION AND WORKFORCE INITIATIVES AIMED AT HEALTHCARE WORKFORCE DEVELOPMENT, AS WELL AS PARTICIPATION ON LOCAL CHAMBER OF COMMERCE BOARDS AIMED AT IMPROVING THE ECONOMIC, CIVIC AND CULTURAL WELLBEING OF THE COMMUNITY. PIH HEALTH ALSO UNDERTAKES DISASTER PREPAREDNESS TRAINING ABOVE AND BEYOND LICENSURE REQUIREMENTS TO ENSURE WE ARE EFFECTIVELY PREPARED TO SERVE THE COMMUNITY IN A DISASTER. IN ADDITION, PIH HEALTH HAS ADVOCATED TO CONGRESSIONAL LEADER FOR MORE SUPPORT FOR MENTAL HEALTH AND THE ORGANIZATION'S PRESIDENT AND CEO HAS SUPPORTED LOCAL, STATE AND FEDERAL HEALTH-RELATED ADVOCACY THROUGH PARTICIPATION AND LEADERSHIP IN VARIOUS HEALTHCARE ASSOCIATIONS. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE THE COMPANY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. PART III, LINE 4: THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED AMOUNTS. THE COMPANY MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS.AS PART OF THE COMPANY'S MISSION TO SERVE THE COMMUNITY, THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED PAYMENT AMOUNTS. THE COMPANY MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY CARE UPON ADMISSION, THOUGH DETERMINATION MAY ALSO BE MADE AT A LATER TIME. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE APPLICATION OF ANY FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT, AND REASONABLE EFFORTS TO COLLECT FROM PATIENT HAVE BEEN EXHAUSTED, THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE COMPANY.THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE THE COMPANY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. PART III, LINE 8: THE COMPANY DOES NOT TAKE THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE STATE HAS SPECIFICALLY ASKED US TO REPORT THIS SEPARATELY FROM OUR COMMUNITY BENEFIT TOTALS. THE COMPANY USES A COST-TO-CHARGE (C2C) RATIO TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENT RECEIVED FROM MEDICARE, WHICH IS SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH HEALTH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN PIH HEALTH DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT SPECIFIC PERCENTAGE, IE. DEPARTMENT C2C %, IS LOADED INTO PIH HEALTH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. AS SUCH, ALL COST INFORMATION REFLECTED IN PIH HEALTH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THE ABOVE DEPARTMENT C2C METHODOLOGY. PART III, LINE 9B: THE HOSPITAL ENCOURAGES ALL SELF-PAY PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE OR OTHER PROGRAMS. 1. ALL UNINSURED PATIENTS ARE ASSUMED TO NEED FINANCIAL ASSISTANCE AND AUTOMATICALLY RECEIVE DISCOUNTED BILLS THAT REFLECT THE CONTRACT RATE OR LESS OF A MEDICARE ADVANTAGE CONTRACT.2. ALL UNINSURED PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE AND MEDICAID APPLICATION AT THE TIME OF REGISTRATION THEREBY GIVING THEM THE OPPORTUNITY TO APPLY FOR ASSISTANCE. 3. THERE ARE SIGNS THROUGH THE FACILITY THAT EDUCATE PATIENTS AND VISITORS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. 4. THE HOSPITAL'S WEBSITE PUBLISHES THE FINANCIAL ASSISTANCE POLICY AND APPLICATIONS.5. SELF-PAY INPATIENTS ALSO MAY BE CONTACTED BY A VENDOR TO OFFER ASSISTANCE IN APPLYING FOR MEDICAID, IF ELIGIBLE. 6. STATEMENTS (WHICH REFLECT A REDUCTION IN CHARGES TO THE RATES AT OR LOWER THAN CONTRACTED RATES FOR MEDICARE ADVANTAGE MEMBERS) PROMOTE THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM7. ONLY PATIENTS WHO DO NOT QUALIFY FOR FURTHER FINANCIAL ASSISTANCE (AFTER DISCOUNTS) OR WHO DO NOT APPLY FOR PROGRAMS AND DO NOT PAY ARE REFERRED TO COLLECTION. IN ADDITION, IF A PATIENT IS REFERRED TO COLLECTION AND LATER APPLIES FOR CHARITY AND QUALIFIES, THE PATIENT'S ACCOUNT IS RETURNED TO THE HOSPITAL AND FINANCIAL ASSISTANCE IS EXTENDED. PART IV, LINE 1, COLUMN (B): VIVITY WAS FORMED TO CREATE A LARGE SOUTHERN CALIFORNIA HEALTH CARE NETWORK THAT COULD EFFECTIVELY COMPETE WITH KAISER PERMANENTE. THE MEMBERS COLLABORATED TO DEVELOP A NEW BLUE CROSS HMO BENEFIT PLAN FOR SALE IN LOS ANGELES AND ORANGE COUNTIES. THE COMBINED INFRASTRUCTURE OF THE MEMBERS AND A MORE HOLISTIC APPROACH TO HEALTH CARE RESULTS IN REDUCED SPECIALTY CARE OR REDUNDANT MEDICAL PROCEDURES. THE COST-SAVINGS ARE PASSED ON TO THE PATIENTS. LONGER TERM VALUE OF THE INNOVATIVE VENTURE WILL COME FROM FUTURE IMPROVEMENTS IN EFFICIENCY AND EFFECTIVENESS ENABLED BY SUCH THINGS AS COMMON EMR, SHARED CARE MANAGEMENT, JOINT WELLNESS RESOURCES, ETC. PART VI, LINE 2: IN ADDITION TO THE HOSPITAL'S CHNA, PIH HEALTH UTILIZES THE FOLLOWING METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES: COMMUNITY BENEFIT OVERSIGHT COMMITTEE- IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC), WHICH IS COMPRISED OF COMMUNITY STAKEHOLDERS AND KEY PUBLIC HEALTH AND LEGISLATIVE REPRESENTATIVES. THIS COMMITTEE MEETS REGULARLY AND ITS MEMBERS SHARE HEALTHCARE-RELATED NEEDS/CONCERNS EXPERIENCED BY THE COMMUNITY MEMBERS THEY REPRESENT AS WELL AS ASSETS OR POTENTIAL PARTNERS FOR THE HOSPITAL TO ENGAGE IN ADDRESSING THE IDENTIFIED NEEDS.COMMUNITY HEALTH IMPROVEMENT TEAM- THIS INTERNAL WORK GROUP OF HOSPITAL STAFF THAT MANAGES THE HOSPITAL'S VARIOUS COMMUNITY-BASED PROGRAMS MEETS ANNUALLY TO SHARE RESOURCES THAT BENEFIT COMMUNITY MEMBERS AND TO DISCUSS ANY CHALLENGES / NEEDS AS A WAY TO ENHANCE THE PROVISION OF SERVICES.FEEDBACK FROM COMMUNITY ORGANIZATIONS / COLLABORATIVES- THROUGH PARTICIPATION IN VARIOUS COMMUNITY COLLABORATIVES AND NETWORKING MEETINGS, PIH HEALTH IS ABLE TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY AND IDENTIFY PARTNERSHIP OPPORTUNITIES. PART VI, LINE 3: THERE ARE MANY AVENUES PIH HEALTH TAKES IN EDUCATING PATIENTS AND FAMILY MEMBERS ABOUT THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS. PATIENT ARE ADVISED AT THE TIME OF SERVICE, DURING IN-HOUSE CARE AND POST DISCHARGES. FREE HANDOUTS OF THE FAP APPLICATION ARE PROVIDED IN BOTH ENGLISH AND SPANISH. THERE AE POSTINGS THROUGHOUT THE HOSPITAL IN BOTH ENGLISH AND SPANISH WITH INFORMATION ABOUT OUR FAP PROGRAM. WE HAVE AN ELIGIBILITY VENDOR THAT IS CONVENIENTLY AVAILABLE TO ASSIST OUR PATIENTS IN THE EMERGENCY ROOM OR IN-HOUSE PATIENTS WITH DETERMINING ELIGIBILITY FOR VARIOUS GOVERNMENTAL PROGRAMS, AS WELL AS, ADVISE AND ASSIST THE PATIENT WITH THE FAP. POST DISCHARGE, OUR BUSINESS OFFICE STAFF TAKES THE INITIATIVE TO ADVISE THE PATIENT OF OUR FAP PROGRAM. ALSO, WITH EACH PATIENT STATEMENT THAT IS SENT OUT, THE FAP PROGRAM IS PRINTED ON THE BACK OF THE STATEMENT. PIH HEALTH'S FAP IS ALSO PUBLISHED ON OUR WEBSITE. PART VI, LINE 4: PIH HEALTH HOSPITAL - WHITTIER SERVES AN URBAN GEOGRAPHY IN THE SOUTHEAST PORTION OF LOS ANGELES COUNTY, CALIFORNIA, WITHIN SERVICE PLANNING AREA 7 (SPA 7). PRIMARY SERVICE AREA CITIES INCLUDE:DOWNEY 90241HACIENDA HEIGHTS 91745LA HABRA 90631LA HABRA HEIGHTS 90631LA MIRADA 90638LA PUENTE 91744MONTEBELLO 90640NORWALK 90650PICO RIVERA 90660ROWLAND HEIGHTS 91748SANTA FE SPRINGS 90670WALNUT 91789WHITTIER 90601-90606PRIMARY SERVICE AREA PROFILETHE POPULATION FOR PIH HEALTH HOSPITAL - WHITTIER'S PRIMARY SERVICE AREA IS 822,408. POPULATION DEMOGRAPHICS: CHILDREN AND YOUTH (AGES 0-19) MAKE UP 27.9% OF THE POPULATION; OLDER ADULTS (AGES 65+) MAKE UP 12.2% OF THE POPULATION. THE LARGEST POPULATION BY RACE AND ETHNICITY IN THE SERVICE AREA IS HISPANIC OR LATINO (65.1%). WHITE/CAUCASIANS MAKE UP 16.1% OF THE POPULATION. ASIANS COMPRISE 15.5% OF THE POPULATION, AND AFRICAN AMERICANS, NATIVE AMERICANS, HAWAIIANS, AND OTHER RACES COMBINED TOTAL 3.3% OF THE POPULATION. INCOME & POVERTY: THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA RANGES FROM $47,438 IN MONTEBELLO TO $91,623 IN WALNUT. SOME 11.6% OF THE SERVICE AREA POPULATION LIVES BELOW 100% OF THE FEDERAL POVERTY LEVEL AND 33.5% LIVE BELOW 200%. HEALTH INSURANCE: 79.1% OF THE SERVICE AREA IS INSURED, 90.9% OF CHILDREN UNDER 18 ARE INSURED AND 71% OF ADULTS AGES 18-64 ARE INSURED. IN SPA 7, 30.7% ARE MEDI-CAL RECIPIENTS.THERE ARE SEVEN OTHER HOSPITALS PROVIDING CARE IN THE SERVICE AREA POPULATION AND NO FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE SERVICE AREA. FOR ADDITIONAL DATA REGARDING THE SERVICE AREA, PLEASE SEE THE COMMUNITY HEALTH NEEDS ASSESSMENT AT PIHHEALTH.ORG/CHNA PART VI, LINE 5: COMMUNITY BOARDPIH HEALTH'S COMMUNITY BOARD OF DIRECTORS WORKS TO ADVANCE PIH HEALTH'S COMMITMENT TO HELPING OUR COMMUNITIES GET WELL AND STAY HEALTHY.OPEN MEDICAL STAFFPIH HEALTH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES.USE OF SURPLUS FUNDSPIH HEALTH APPLIES SURPLUS FUNDS TOWARD IMPROVEMENTS IN PATIENT CARE, TECHNOLOGY, AND MEDICAL EDUCATION.COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC)IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE CBOC, COMPRISED OF COMMUNITY STAKEHOLDERS AND A PUBLIC HEALTH REPRESENTATIVE. THE CBOC PROMOTES THE HEALTH OF THE COMMUNITY BY 1) REVIEWING AND VALIDATING LEGAL AND REGULATORY COMPLIANCE WITH RESPECT TO COMMUNITY BENEFIT MANDATES, 2) REVIEWING AND VALIDATING THAT PIH HEALTH'S COMMUNITY BENEFIT PROGRAMS AND SERVICES EFFECTIVELY MEET IDENTIFIED COMMUNITY HEALTH NEEDS, WITH EMPHASIS ON VULNERABLE POPULATIONS, AS AN ESSENTIAL EXPRESSION OF PIH HEALTH'S CHARITABLE MISSION AND 3) INCREASING PUBLIC AWARENESS OF COMMUNITY BENEFIT ACTIVITIES AND COMMUNITY VALUE.DONATION OF TIMEMANY PIH HEALTH PROVIDERS ARE LIVING OUT THEIR PASSION TO SERVE PEOPLE IN NEED BY DONATING THEIR TIME AND TALENTS BOTH IN OUR COMMUNITY AND OVERSEAS. EMERGENCY AND DISASTER PREPAREDNESS/DISASTER RESOURCE CENTER (DRC) PIH HEALTH HOSPITAL - WHITTIER IS ONE OF 13 LOS ANGELES COUNTY DESIGNATED DRC'S THAT ENSURE THE COMMUNITY HAS ACCESS TO RESOURCES AND THE HIGHLY SKILLED STAFF NEEDED TO RESPOND TO A LARGE-SCALE DISASTER OR OTHER PUBLIC HEALTH EMERGENCIES.ENVIRONMENTAL AND RECYCLING PROJECTSPIH HEALTH CONTINUES TO IMPLEMENT "GREEN" INITIATIVES, INCLUDING INCREASED USAGE OF LED LIGHTING TO DECREASE CONSUMPTION OF ELECTRICITY AND, EXPANDING A METHANE GAS PROJECT WITH THE CITY OF WHITTIER TO CONVERT METHANE GAS INTO ELECTRICITY. EYEGLASSES AND HEARING AIDS ARE ALSO COLLECTED AND RECYCLED FOR THE EAST WHITTIER LIONS CLUB.VOLUNTEER CONTRIBUTIONS SOME 980 PIH HEALTH VOLUNTEERS COLLECTIVELY CONTRIBUTED 95,273 HOURS OF SERVICE, SUPPORTING DEPARTMENTS THROUGHOUT THE ORGANIZATION.REACH OUT AND READ PROGRAM OUR PEDIATRICS DEPARTMENT PARTNERS WITH REACH OUT AND READ TO PROMOTE EARLY LITERACY AND SCHOOL READINESS. PHYSICIANS PROVIDE PATIENTS WITH A CHILDREN'S BOOK AND DISCUSS WITH PARENTS THE IMPORTANCE OF READING ALOUD. EACH YEAR, OVER 6,000 NEW BOOKS ARE DISTRIBUTED. PART VI, LINE 6: HOSPITAL AFFILIATES INCLUDE: 1) PIH HEALTH, INC., PIH HEALTH'S PARENT COMPANY; 2) PIH HEALTH HOSPITAL - DOWNEY; 3) PIH HEALTH PHYSICIANS, A NONPROFIT MEDICAL FOUNDATION; AND 4) THE PIH HEALTH FOUNDATION, A NONPROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH'S CHARITABLE MISSION PIH HEALTH, INC. PROVIDES TECHNICAL, FACILITY AND SUPPORT SERVICES FOR TAX-EXEMPT AFFILIATES WHOSE CHARITABLE PURPOSE IS TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO THEIR COMMUNITY BY WAY OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.PIH HEALTH HOSPITAL - DOWNEY OFFICIALLY BECAME PART OF PIH HEALTH IN OCTOBER 2013. AS A 501 (C)(3) NONPROFIT, 199-BED HOSPITAL, THE DOWNEY CAMPUS HAS PROVIDED QUALITY CARE IN A WELCOMING ENVIRONMENT FOR NEARLY 100 YEARS. AS A NONNPROFIT HOSPITAL WITH A CHARITABLE MISSION, PIH HEALTH HOSPITAL DOWNEY IS A DEDICATED COMMUNITY HEALTH AND WELLNESS PARTNER. THIS COMMITMENT AND LEADERSHIP GIVES BACK TO THE COMMUNITY THROUGH CHARITY CARE, HEALTH PROFESSIONS EDUCATION AND MORE.PIH HEALTH PHYSICIANS SUPPORTS THE LOCAL COMMUNITY THROUGH ITS FINANCIAL ASSISTANCE PROGRAM, WHITTIER FIRST DAY HEALTH & WELLNESS CENTER FOR THE HOMELESS AND THOSE AT-RISK FOR HOMELESSNESS, HEALTH PROFESSIONS EDUCATION, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES. THE PIH HEALTH FOUNDATION RAISES FUNDS IN SUPPORT OF PIH HEALTH TO ENSURE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES FOR YEARS TO COME THROUGH SUPPORTING PROGRAMS THAT DIRECTLY IMPACT THE COMMUNITY, INCLUDING PIH HEALTH'S COMMUNITY BENEFIT PROGRAMS. GIFTS BIG, SMALL AND ALL WILL SUPPORT PIH HEALTH'S WORK TO PROVIDE ACCESS TO QUALITY HEALTHCARE, SCREENINGS, PREVENTATIVE CARE, PREVENTION-FOCUSED EDUCATION AND OTHER IMPORTANT INITIATIVES.FOR DETAILED INFORMATION REGARDING THESE PIH HEALTH AFFILIATES' ADDITIONAL ACTIVITIES TO SUPPORT AND PROMOTE COMMUNITY HEALTH, PLEASE SEE EACH RESPECTIVE ORGANIZATION'S IRS FORM 990. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 INTERFAITH FOOD CENTER 11819 BURKE STREET SANTA FE SPRINGS CA 90670 953889152 501(C)(3) 12000 FOOD FOR LOW-INCOME FAMILIES FIRST CHRISTIAN CHURCH OF DOWNEY 10909 NEW STREET DOWNEY CA 90241 951803687 501(C)(3) 9500 TRUCK FOR FOOD DELIVERY FOR INDIGENTS HELPLINE YOUTH COUNSELING INC 14181 TELEGRAPH ROAD WHITTIER CA 90604 237113824 501(C)(3) 7901 SUPPORT YOUTH COUNSELING BOYS GIRLS CLUB OF WHITTIER 7905 GREENLEAF AVENUE WHITTIER CA 90602 956151763 501(C)(3) 7450 HEALTHY NUTRITION AND LIFESTYLES FOR KIDS TLC FAMILY RESOURCE CENTER 13220 BELLFLOWER BLVD DOWNEY CA 90242 956006586 501(C)(3) 6000 PROVIDE FOOD AND SERVICES FOR INDIGENTS WHITTIER ROTARY CLUB PO BOX 753 WHITTIER CA 90608 951371765 501(C)(3) 5000 DENTAL CARE FOR INDIGENTS WHITTIER AREA FIRST DAY COALITION 12426 WHITTIER BLVD WHITTIER CA 90602 931141844 501(C)(3) 5000 SUPPORT HOMELESS VISTA COMMUNITY CLINIC 1000 VALE TERRACE DRIVE VISTA CA 92084 952815615 501(C)(3) 5000 FOOD FOR LOW-INCOME FAMILIES THE WHOLE CHILD 10155 COLIMA ROAD WHITTIER CA 90603 952031148 501(C)(3) 5000 SUPPORT HOMELESS CHILDREN AND FAMILIES SOROPTIMIST INTERNATIONAL PO BOX 468 WHITTIER CA 90608 956096575 501(C)(3) 5000 EDUCATION FOR NEEDY LYNWOOD PARTNERS EDUCATION FOUNDATION 11321 BULLS ROAD LYNWOOD CA 90262 473028270 501(C)(3) 5000 SUPPORT HOMELESS STUDENTS AND FAMILIES 11 0 SCHOLARSHIPS 49 125000 PART I, LINE 2: PIH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS. PIH HEALTH PROVIDES FINANCIAL SUPPORT TO TAX-EXEMPT, NONPROFIT ORGANIZATIONS IN OUR SERVICE AREA CITIES THROUGH ITS COMMUNITY SUPPORT AND SPONSORSHIPS PROGRAM, WITH EMPHASIS ON COMMUNITY HEALTH NEEDS/AREAS OF CONCERN AS IDENTIFIED BY PIH HEALTH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS. FINANCIAL SUPPORT MAY BE PROVIDED IF THE REQUESTING ORGANIZATION ADDRESSES ONE OR MORE OF THESE AREAS AND IS RESPONSIVE TO THE HEALTH AND WELLNESS NEEDS OF THE COMMUNITIES WE SERVE, ALLOWING PIH HEALTH TO BUILD UPON THE IMPACT OF EXISTING COMMUNITY HEALTH IMPROVEMENT EFFORTS. FOR CONTRIBUTIONS MADE TO CHARITABLE ORGANIZATIONS, PIH HEALTH HAS ADOPTED A POLICY WHICH GUIDES THE PROCESS TO ENSURE GOOD STEWARDSHIP OF PIH HEALTH'S CHARITABLE RESOURCES AS A FEDERALLY REGISTERED NONPROFIT ENTITY. TO ENSURE ACCURATE COMMUNITY BENEFIT REPORTING, THIS POLICY SETS FORTH THAT DIRECT FINANCIAL CONTRIBUTIONS MADE TO COMMUNITY ORGANIZATIONS MUST BE APPROPRIATELY CLASSIFIED AS EITHER A) COMMUNITY BENEFIT OR B) A SPONSORSHIP (A MARKETING COMMUNICATIONS DEPARTMENT EXPENSE NOT REPORTABLE AS COMMUNITY BENEFIT). IN COMPLIANCE WITH THIS POLICY, INFORMATION IS GATHERED FROM THE GRANTEE REGARDING THE INTENDED USE OF FUNDS AND A RESTRICTION LETTER IS SENT, NOTING THE INTENDED USE OF FUNDS. ORGANIZATIONS RECEIVING COMMUNITY SUPPORT FUNDING IN THE AMOUNT OF $2,500 OR MORE ARE REQUIRED TO SUBMIT A SUMMARY REPORT OF PROGRAM OR SERVICE IMPACT, WITHIN 90 DAYS AFTER EVENT OR RECEIPT OF PROGRAM FUNDING, UNLESS AN ALTERNATE DATE IS DESIGNATED. FOR CONTRIBUTIONS MADE TO INDIVIDUALS, PIH HEALTH HAS ESTABLISHED A DEDICATED BUDGET WHICH SUBSIDIZES VITAL ASSISTANCE SUCH AS PURCHASE OF DURABLE MEDICAL EQUIPMENT OR NON-ACUTE CARE NOT COVERED BY INSURANCE UPON HOSPITAL DISCHARGE, INCLUDING PAID PLACEMENT IN SKILLED NURSING OR MENTAL HEALTH FACILITIES. IN THESE INSTANCES, A SPECIFIC SERVICE IS BEING PURCHASED AND RECEIPT OF PROPER SERVICE IS ENSURED THROUGH FOLLOW-UP BY PIH DISCHARGE PLANNERS OR SOCIAL WORKERS. X X X X X 1 1 0 0 0 0 0 0 0 ROBERT BOHR MD DIRECTOR 72000 414879 0 0 0 0 0 10736 0 6804 72000 432419 0 0 SUDHAKER NAYAK MD DIRECTOR 119070 1627624 0 0 0 0 0 10736 0 26385 119070 1664745 0 0 NEAL SHINDEL MD DIRECTOR 0 1128326 0 0 0 0 0 10736 0 25637 0 1164699 0 0 JAMES WEST PRESIDENT/CEO 1137303 0 47927 0 188125 0 247002 0 22387 0 1642744 0 172284 0 PEGGY CHULACK CAO & ASST. SECRETARY 537083 0 39460 0 91929 0 115228 0 9632 0 793332 0 64439 0 GREG WILLIAMS CFO & ASST. TREASURER 585710 0 38202 0 34340 0 156339 0 20887 0 835478 0 0 0 ROSALIO LOPEZ MD CMO/CSO 666564 0 30938 0 123003 0 123371 0 15190 0 959066 0 109510 0 REANNA THOMPSON COO/CNO 462680 0 13784 0 8173 0 122568 0 37 0 607242 0 0 0 DAVID KLINGER VP FACILITIES 352597 0 24545 0 129165 0 34200 0 37 0 540544 0 120879 0 DAVIS LEE CHIEF MED INFO OFFICER 398325 0 21948 0 80933 0 82849 0 20793 0 604848 0 58213 0 DEBRA LEGAN VP MKTG & PLANNING 319897 0 16686 0 67368 0 76346 0 7174 0 487471 0 60594 0 RONALD YOSHIHARA VP FINANCE & ANALYTICS 266649 0 6329 0 50299 0 50069 0 8558 0 381904 0 28825 0 PERRY EBELTOFT VP ANCILLARY SVS 269717 0 0 0 27295 0 43918 0 23569 0 364499 0 20100 0 ANUP PATEL VP ENT RSK MGMT & CORP COM 238471 0 0 0 28546 0 59977 0 37 0 327031 0 22054 0 NICHOLAS CHRISTIANSON VP REV CYC & MGD CRE 242318 0 11250 0 6144 0 47110 0 15061 0 321883 0 0 0 SHELLY NECKE VP POST ACUTE CR SVS 219909 0 23482 0 13719 0 28383 0 15201 0 300694 0 6659 0 CHICO MANNING VP SUPPLY CHAIN 212376 0 8800 0 6222 0 39361 0 37 0 266796 0 0 0 JUNG HO MEDICAL PHYSICIST 262095 0 0 0 0 0 15602 0 9008 0 286705 0 0 0 DIANE MCCOWAN DIR PHARMACY 232398 0 0 0 9576 0 14391 0 37 0 256402 0 0 0 SCOTT BREMER DIR COMP, BENEF & HRIS 223211 0 0 0 9512 0 9407 0 25119 0 267249 0 0 0 REBECCA WEYANT RN ADM DIR 206074 0 0 0 6140 0 12743 0 15141 0 240098 0 0 0 CESAR ROSAS RN CHARGE NURSE 202768 0 0 0 0 0 12166 0 37 0 214971 0 0 0 SHERREL HOLLINGSWORTH CHIEF HR OFFICER TERM 2/17/17 105375 0 28855 0 431838 0 25769 0 17154 0 608991 0 109217 0 PART I, LINES 4A-B PART I, LINE 4A: IN 2017, A SEVERANCE PAYMENT OF $290,826 WAS MADE TO SHERREL HOLLINGSWORTH. PART I, LINE 4B: PIH HEALTH INC. AND ITS AFFILIATES PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK GREGORY WILLIAMS PERRY EBELTOFT SHERREL HOLLINGSWORTH DAVIS LEE ROSALIO LOPEZ ANUP PATEL REANNA THOMPSON RON YOSHIHARA DAVID KLINGER NICHOLAS CHRISTIANSON CHICO MANNING SHELLY NECKE DEBRA LEGAN THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2017 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): JAMES WEST $172,284 PEGGY CHULACK $64,439 ROSALIO LOPEZ $109,510 DAVID KLINGER $120,879 DAVIS LEE $58,213 DEBRA LEGAN $60,594 SHERREL HOLLINGSWORTH $109,217 RON YOSHIHARA $28,825 PERRY EBELTOFT $20,100 ANUP PATEL $22,054 SHELLY NECKE $6,659 A CITY OF WHITTIER 956000812 966769DA6 2009-05-14 280328878 PURCHASE OF LAND AND TO REFUND BONDS ISSUED 1/31/2007 0 0 0 B CITY OF WHITTIER 956000812 966769DH1 2011-03-31 40828054 CONSTRUCTION OF FACILITIES 0 0 0 C CITY OF WHITTIER 956000812 2012-12-31 148000000 REFUND BONDS ISSUED 5/14/2009 0 0 0 D CITY OF WHITTIER 956000812 966769DK4 2014-08-07 106612491 HOSPITAL FACILITIES CONSTRUCTION AND TO REFUND BONDS ISSUED 10/1/2013 0 0 0 A 209025000 280328878 2416738 1087414 1337383 275487443 2013 1 0 1 1 B 5375000 40828054 816561 40011493 2013 0 0 1 1 C 6050000 148000000 148000000 1 0 1 1 D 106612491 1880505 6854015 97877971 2014 1 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 0 1 1 0 0 0 1 A 0 0 0 1 1 1 GOLDMAN SACHS BANK 29.500000000000 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 1 GOLDMAN SACHS BANK 23.400000000000 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART IV, LINE 2C ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR BONDS A AND B IN FY13, LISTED BELOW ARE THE ANALYSIS OPINION LETTER DATES. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY16. BOND A ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON FEBRUARY 11, 2013 FOR BOND A. BOND B ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON FEBRUARY 11, 2013 FOR BOND B. MARY WARGO SISTER OF OFFICER 91179 PEGGY CHULACK'S SISTER, MARY WARGO, IS EMPLOYED BY PIH. 0 FORM 990, PART VI, SECTION A, LINE 6 PIH HEALTH, INC. IS THE SOLE MEMBER OF PIH HEALTH HOSPITAL - WHITTIER. FORM 990, PART VI, SECTION A, LINE 7A PIH HEALTH, INC. HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF DIRECTORS OF PIH HEALTH HOSPITAL - WHITTIER. FORM 990, PART VI, SECTION A, LINE 7B PIH HEALTH, INC. HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH HEALTH HOSPITAL - WHITTIER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION, WHICH IS MADE UP OF INDEPENDENT DIRECTORS. THE FORM 990 IS THEN PROVIDED TO THE BOARD FOR ITS INFORMATION. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL MANAGEMENT AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL POSITIVE RESPONSES ARE REVIEWED BY THE CHIEF ADMINISTRATIVE OFFICER AND GENERAL COUNSEL. EACH POSITIVE RESPONSE IS CONSIDERED IN LIGHT OF MAGNITUDE OF OWNERSHIP INTEREST, FINANCIAL TRANSACTION(S), ETC. IF DEEMED NECESSARY, CONFLICTS OF INTEREST COULD BE RESOLVED BY INSISTING THAT THE INCUMBENT EITHER DIVEST THEIR OWNERSHIP INTEREST, THAT THE ORGANIZATION TERMINATE THE BUSINESS RELATIONSHIP, OR EVEN THAT THE DIRECTOR RESIGN. DIRECTORS WITH POTENTIAL CONFLICTS OF INTEREST MAY RECUSE THEMSELVES FROM VOTING ON CERTAIN MATTERS AND/OR MAY EXCUSE THEMSELVES FROM MEETINGS DURING THE DISCUSSION, DELIBERATION, AND VOTING ON OF MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT, THIRD-PARTY, EXPERT COMPENSATION CONSULTANT TO REVIEW ITS EXECUTIVE SALARIES. THE CONSULTANT OBTAINS SPECIFIC ORGANIZATIONAL DATA FROM WHICH TO BASE ITS ANALYSIS (REVENUES, EXPENSES, EMPLOYEES, SERVICE AREA, JOB DESCRIPTIONS, ETC.). THE CONSULTANT'S ANALYSIS INCLUDES A REVIEW OF COMPENSATION TRENDS, REGULATORY ISSUES, THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, THE METHODOLOGY USED FOR THE ASSESSMENT, THE BASE SALARY ANALYSIS, THE INCENTIVE COMPENSATION ANALYSIS, THE TOTAL CASH COMPENSATION ANALYSIS, AND THE TOTAL COMPENSATION ANALYSIS. SALARY MOVEMENT, INCENTIVE COMPENSATION, MARKET BENEFIT, AND RECRUITMENT AND RETENTION TRENDS ARE REVIEWED. THIS ANALYSIS IS PROVIDED TO THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS. THE EXECUTIVE COMPENSATION COMMITTEE HAS APPROVED A REGIONAL PEER GROUP THAT INCLUDES HIGH-PERFORMING, COMPARABLY-SIZED CALIFORNIA HOSPITALS AND HEALTH SYSTEMS. THE CONSULTANT COMPILES COMPARABILITY DATA FROM NATIONAL AND REGIONAL PEERS; COMPARES THE ORGANIZATION'S EXECUTIVE COMPENSATION WITH PEER GROUP COMPENSATION LEVELS; AND PREPARES A REPORT THAT INCLUDES ALL OF THE BACK-UP DATA ON COMPARABILITY, PEER GROUPS, AND JOB MATCHES. THE METHODOLOGY USED BY THE CONSULTANT INCLUDES TWO PEER GROUPS: A NATIONAL PEER GROUP OF COMPARABLY-SIZED HOSPITALS AND SINGLE HOSPITAL SYSTEMS AND A REGIONAL PEER GROUP OF HOSPITALS AND SYSTEMS IN SOUTHERN CALIFORNIA, THE DATA OF WHICH IS PROVIDED TO THE COMMITTEE IN ITS REPORT. THE NATIONAL DATA IS USED AS THE PRIMARY COMPARATOR FOR THE ANALYSIS. THE COMMITTEE IS PRESENTED WITH CHARTS THAT COMPARE ORGANIZATION SALARIES TO THE LEVEL TARGETED IN THE COMPENSATION PHILOSOPHY. NEITHER PERFORMANCE NOR QUALIFICATIONS OF THE INCUMBENT IS CONSIDERED WHEN PROVIDING THE MARKET DATA. THE COMMITTEE IS PROVIDED WITH A REVIEW OF THE BASE SALARY ANALYSIS, A REVIEW OF THE INCENTIVE COMPENSATION ANALYSIS, A REVIEW OF THE TOTAL CASH COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE), AND A REVIEW OF THE TOTAL COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE PLUS BENEFITS/PERQUISITES). BASED UPON ALL OF THE ABOVE INFORMATION, THE CONSULTANT PROVIDES THE COMMITTEE WITH RECOMMENDED SALARY RANGES FOR THE PERIOD ASSESSED. THE EXECUTIVE COMPENSATION COMMITTEE DELIBERATES ON THE COMPARABILITY DATA TO ENSURE THAT IT IS APPROPRIATE IN REPRESENTING LIKE ORGANIZATIONS, LIKE POSITIONS, AND LIKE CIRCUMSTANCES, AND THAT IT COULD REALISTICALLY RELY ON THE COMPARABILITY DATA IN REACHING ITS DECISION THAT THE COMPENSATION IS REASONABLE AND REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED. THE EXECUTIVE COMPENSATION COMMITTEE AFFIRMS THIS PROCESS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 AND FORM 990-T ARE AVAILABLE UPON REQUEST. THE ORGANIZATION IS NOT REQUIRED TO MAKE FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS IT RECEIVED ITS TAX EXEMPTION PRIOR TO JULY 15, 1987. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 29,227,309. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,227,309. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 22,971,318. MANAGEMENT AND GENERAL EXPENSES 3,963,555. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,934,873. R&M BUILDING: PROGRAM SERVICE EXPENSES 2,175,836. MANAGEMENT AND GENERAL EXPENSES 25,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,201,411. COLLECTION AGENCY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,839,391. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,839,391. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 8,080,084. PENSION ADJUSTMENTS 22,944,607. PIH HEALTH COMMUNITY PHARMACY LLC 12401 WASHINGTON BLVD WHITTIER CA 90602 264390142 PHARMACY CA 6128318 525721 PIH HEALTH HOSPITAL - WHITTIER PIH HEALTH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA 501(C)(3) LINE 7 PIH HEALTH INC 1 PIH HEALTH MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) LINE 12B, II PIH HEALTH INC 1 PIH HEALTH HOME HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 1 PIH HEALTH INC 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) LINE 12B, II N/A 0 PIH HEALTH ADULT DAY HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 1 PIH HEALTH PHYSICIANS 12401 WASHINGTON BLVD WHITTIER CA 90602 953942828 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 1 PIH HEALTH HOSPITAL - DOWNEY 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 951903935 HEALTHCARE CA 501(C)(3) LINE 3 PIH HEALTH INC 1 PIH INSURANCE CO A RECIPROCAL RISK RETENTION GROUP 1003 BISHOP STREET HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI PIH HEALTH INC T 1 PIH HEALTH CARE SOLUTIONS 6557 GREENLEAF AVENUE WHITTIER CA 90601 462072342 HEALTHCARE CA PIH HEALTH INC C 1 DRMC PROPERTIES 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 954769768 REAL ESTATE CA DRMC INC C 1 PIH HEALTH RE 1003 BISHOP STREET HONOLULU HI 96813 472501390 CAPTIVE INSURANCE HI PIH HEALTH INC T 1 HEALTHMED SERVICES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 300831225 HEALTHCARE CA PIH HEALTH INC C 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 0 1 0 PIH HEALTH PHYSICIANS L 4571384 FMV PIH HEALTH FOUNDATION C 1040754 FMV PIH HEALTH MANAGEMENT CORP M 833298 FMV PART IV, COLUMN (E): PIH HEALTH CARE SOLUTIONS IS A NONPROFIT MUTUAL BENEFIT CORPORATION. PART IV, COLUMN (E): PIH INSURANCE COMPANY IS AN UNINCORPORATED RISK RETENTION GROUP.