2019-05-14T19:32:31-05:00 2018-06-30 346565596 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE SUITE 1700 IRVINE CA 92612 990 2017-07-01 201645949 CFHS HOLDINGS INC CFHS 3104487881 4650 LINCOLN BLVD MARINA DEL REY CA 90292 MARY KATHRYN HAMMACK TREASURER 3108238911 2019-05-14 1 KARA ADAMS P00023315 9497942300 192.231.86.241 2019-05-14 17:03:34 PD P 441AA63A5AD28D5142E9094244EB82DFC70B9A9D 5D66495798EA847DC80F6602DD5A7F057B72F91F 2017 2019-02-21 02:37:17Z CEDARS-SINAI MARINA DEL REY HOSPITAL JEFFREY SMITH 8700 BEVERLY BLVD LOS ANGELES CA 90048 109325916 0 X WWW.MARINAHOSPITAL.COM X 2004 CA TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE. 7 6 802 6 0 185609 1814768 2508408 93101152 106396752 8957 665 376227 420091 95301104 109325916 38000 55000 0 0 56488992 53341459 0 0 0 50104942 57927477 106631934 111323936 -11330830 -1998020 70051453 71606899 54681706 58235172 15369747 13371727 X * TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE FOR RESIDENTS IN MARINA DEL REY AND SURROUNDING BEACH COMMUNITIES AND THE WESTSIDE OF LOS ANGELES(SEE SCHEDULE O FOR CONTINUATION)(CONTINUED FROM PAGE 2)* TO BE RECOGNIZED FOR MEDICAL EXCELLENCE IN SPINE, ORTHOPEDICS, SURGICAL WEIGHT LOSS, MINIMALLY INVASIVE SURGERY, NON-INVASIVE CARDIOLOGY, AND GENERAL ACUTE MEDICAL CARE 0 0 90667574 55000 106816843 CFHS HOLDINGS, INC., DOING BUSINESS AS CEDARS-SINAI MARINA DEL REY HOSPITAL ("THE HOSPITAL"), IS A 133-BED NONPROFIT HOSPITAL AND AFFILIATE OF CEDARS-SINAI. THE HOSPITAL IS FULLY ACCREDITED WITH THE NATIONALLY RECOGNIZED JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (TJC) FOR SAFE AND EFFECTIVE QUALITY CARE. WE HAVE THE FOLLOWING INPATIENT AND OUTPATIENT SERVICES: 24-HOUR EMERGENCY CARE INCLUDING TELESTROKE SERVICES IN COLLABORATION WITH CEDARS-SINAI NEUROSURGEONS, ICU, TELEMETRY, INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES, AND THE MOST ADVANCED SURGICAL TECHNOLOGY AVAILABLE, CAREFULLY PRACTICED UNDER THE SUPERVISION AND SKILLED HANDS OF OUR WORLD-CLASS PHYSICIANS, NURSES, AND ALLIED HEALTH CARE PROFESSIONALS.(SEE SCHEDULE O FOR CONTINUATION)(CONTINUED FROM PAGE 2)HOSPITAL SERVICES:-24-HOUR EMERGENCY CARE-TELEMEDICINE STROKE PROGRAM IN THE EMERGENCY DEPARTMENT-INTENSIVE CARE UNIT-TELEMETRY/MEDICAL SURGICAL UNITS (CARDIAC MONITORED BEDS)-INPATIENT AND OUTPATIENT CARE-INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES - IMAGING, GASTROINTESTINAL, LABORATORY, AND CARDIOLOGY-OUTPATIENT BARIATRIC CLINIC-OUTPATIENT SPINE CLINIC-MINIMALLY INVASIVE SURGICAL SERVICES UTILIZING THE MAKO STRYKER ORTHOPAEDIC ROBOT AND THE DA VINCI ROBOT (FOR HERNIA, APPENDECTOMY, GALLBLADDER, COLON, ANTI-REFLUX, BARIATRIC, SPINE, TOTAL HIP, TOTAL KNEE CASES) HOSPITAL STATISTICS:EMPLOYEES 802PHYSICIANS WITH HOSPITAL PRIVILEGES 433SURGEONS WITH HOSPITAL PRIVILEGES 185NUMBER OF SURGERIES ANNUALLY 4,078NUMBER OF ER VISITS ANNUALLY 32,097PAYOR % - HMO/PPO (50%); MEDICARE (35%); MEDI-CAL (4%); COMMERCIAL/OTHER (8%); SELF-PAY/CHARITY (3%)HOSPITAL OPERATIONS:CEDARS-SINAI MARINA DEL REY HOSPITAL UPGRADED THE CLINICAL ELECTRONIC MEDICAL RECORD SYSTEM AND CONVERTED TO EPIC IN MAY OF 2017. THERE WERE CONTINUED ENHANCEMENTS TO THE REPORTING CAPABILITIES IN 2018 AND THE UPGRADED TECHNOLOGY AND REPORTING CAPABILITIES HAVE IMPROVED THE PHYSICIANS AND CLINICAL STAFF ABILITY TO VIEW PRIOR VISIT RECORDS, ENHANCE PATIENT SAFETY VIA ALERTS, INCREASE DATA ANALYSIS AND DECREASED THE AMOUNT OF LABOR FOR SCANNING OF PAPER DOCUMENTS AND ANALYSIS OF DATA. COMMUNITY SUPPORT AND ENGAGEMENT HIGHLIGHTS:- OUR TWO OUTPATIENT CLINICS ARE NATIONALLY RECOGNIZED AS LEADING SURGICAL CENTERS OF CARE. THE MARINA SPINE CENTER IS A MULTIDISCIPLINARY CENTER OFFERING COMPREHENSIVE SPINE SERVICES, FROM EVALUATION AND DIAGNOSIS TO SURGERY AND REHABILITATION. AN ADDITIONAL SPINE SURGEON WAS ADDED TO THE CLINIC STAFF IN 2018. OUR MARINA WEIGHT LOSS CENTER, WHICH HAS A TOTAL OF 12 SURGEONS, IS ACCREDITED BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP) FOR EXCELLENCE.- CEDARS-SINAI MARINA DEL REY HOSPITAL IS THE ONLY HOSPITAL LOCATED WITHIN LOS ANGELES' 11TH DISTRICT, AND WE ARE ACTIVELY INVOLVED IN COUNCILMAN MIKE BONIN'S HOMELESS INITIATIVE, VENICE FORWARD. IN ADDITION, WE HAVE JOINED FORCES WITH OUR COMMUNITY PARTNERS (VENICE FAMILY CLINIC, ST. JOSEPH CENTER, AND OPCC THE PEOPLE CONCERN) TO HELP STEM THE HOMELESS CRISIS ON THE WESTSIDE. PLANS FOR FY2019 INCLUDE IMPLEMENTING A HOMELESS FACILITATOR/NAVIGATOR IN THE EMERGENCY ROOM AT MDRH THROUGH COLLABORATION WITH "THE PEOPLE CONCERN AND CSMC TO FACILITATE AND COORDINATE THE POST-DISCHARGE HOMELESS PATIENTS' MEDICAL AND HOUSING NEEDS. - CEDARS-SINAI MARINA DEL REY HOSPITAL LEADERSHIP ENGAGES WITH THE COMMUNITY IN A VARIETY OF WAYS. FACILITY STAFF REPRESENT THE HOSPITAL AT THE FOLLOWING LOCAL COMMUNITY EVENTS AND COLLABORATIVES: *HOST COMMUNITY DANCE FITNESS CLASSES ON SITE *HOST COMMUNITY YOGA CLASSES ON SITE *HOST COMMUNITY TAI CHI CLASSES ON SITE *PARTICIPATE IN THE LOCAL ROTARY AND CHAMBER OF COMMERCE *PARTICIPATE IN L.A. COUNCIL MEMBER MIKE BONIN'S VENICE FORWARD COLLABORATIVE *VENICE FAMILY CLINIC *VENICE MARINA COUNCIL *DEL REY NEIGHBORHOOD COUNCIL AND DEL REY HEALTH FAIR *PACIFIC DIVISION BLOCK CAPTAINS MEETING *VENICE NEIGHBORHOOD COUNCIL - BOARD MEETING *MAR VISTA NEIGHBORHOOD FAIR *THE PEOPLE CONCERN (FORMERLY OPCC) *ST. JOSEPH CENTER - CES (COORDINATED ENTRY SYSTEM) *LAX COASTAL CHAMBER OF COMMERCE *4TH OF JULY COMMUNITY PARADE IN WESTCHESTERSPECIFIC HOSPITAL STAFF ATTEND MONTHLY OR QUARTERLY MEETINGS IN ADDITION TO THE SPECIAL EVENTS.- CEDARS-SINAI MARINA DEL REY HOSPITAL ADOPTS FAMILIES DURING THE HOLIDAY SEASON THROUGH SEVERAL OF THE ABOVE AGENCIES AND HOSPITAL LEADERSHIP ACTIVELY PARTICIPATES IN OTHER FUND-RAISING COMMUNITY EVENTS THROUGH BOTH MONETARY AND EMPLOYEE SUPPORT.PROGRAM ACCOMPLISHMENTS/DEVELOPMENT:- CEDARS-SINAI MARINA DEL REY HOSPITAL IN COLLABORATION WITH CEDARS-SINAI MEDICAL CENTER (CSMC) NEUROLOGY DEPARTMENT HAS BEEN UTILIZING TELEMEDICINE IN THE EMERGENCY ROOM SINCE FEBRUARY 2017 TO SUCCESSFULLY DIAGNOSE STROKE, EXPEDITE DIAGNOSIS AND TREATMENT. IN 2018, AN ADDITIONAL TELEMEDICINE ROBOT WAS ADDED TO THE FACILITY ICU TO ENHANCE NEURO SERVICES IN COLLABORATION WITH CEDARS NEUROLOGY DEPARTMENT. SINCE INCEPTION OF THE PROGRAM IN 2017 AND THROUGH 2018, 91 PATIENTS EXHIBITING ACUTE STROKE SYMPTOMS HAVE RECEIVED TELE-STROKE CONSULTATIONS VIA THE INTOUCH CAMERA. 34 OF THOSE PATIENTS WERE TRANSFERRED TO CSMC FOR HIGHER LEVEL OF CARE (15 WERE IDENTIFIED AS HAVING AN ACUTE STROKE, RECEIVED TPA, AND WERE TRANSFERRED TO CSMC). 53 REMAINED AT MDRH FOR TREATMENT. MDRH, IN COLLABORATION WITH CSMC, IS SEEKING TO OBTAIN THE AMERICAN HEART/AMERICAN STROKE ASSOCIATION AND THE JOINT COMMISSION PRIMARY STROKE CENTER CERTIFICATION WITH A TARGET GOAL FOR SUBMISSION IN 2019.-ADDITIONAL SPECIALTY PHYSICIANS ARE ROTATING THROUGH A SPECIALTY CLINIC ADJACENT TO THE HOSPITAL TO COVER SPECIALTIES NOT PREVIOUSLY OFFERED AT CEDARS-SINAI MARINA DEL REY HOSPITAL. THESE SERVICES PROVIDED BY CEDARS FOUNDATION PHYSICIANS INCLUDE ENT, GYN, CARDIOLOGY, GI, AND NEUROLOGY. THE SPECIALISTS ALTERNATE DAYS OF THE WEEK MAKING FOLLOW-UP APPOINTMENTS FOR PATIENTS SEEN AS INPATIENTS IN THE HOSPITAL EASIER WHICH ALSO HELPS REDUCE READMISSIONS AND IS CONVENIENT FOR THE PATIENTS IN OUR COMMUNITY.-THE HOSPITAL PARTICIPATED IN THE COMPREHENSIVE JOINT PROGRAM INITIATIVE WITH OUR ORTHO PHYSICIANS AND STAFF. PATIENT EDUCATION PROGRAMS WERE DEVELOPED TO IMPROVE THE PATIENT EXPERIENCE. FEEDBACK FROM THE COMMUNITY HAS BEEN POSITIVE.-THE HOSPITAL IN COLLABORATION WITH CEDARS SINAI MEDICAL FOUNDATION EAR, NOSE, AND THROAT PHYSICIANS (DR. GENE LIU) PURCHASED SPECIALIZED ENT SURGICAL EQUIPMENT TO PROVIDE THOSE SERVICES TO OUR COMMUNITY BEGINNING IN 2017 AND EXPANDED THE INSTRUMENTATION IN 2018. 90667574 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 145 0 1 802 1 1 1 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MARY KATHRYN HAMMACK 3104487881 4640 ADMIRALTY WAY SUITE 650 MARINA DEL REY CA 90292 STEVEN KREMS MD BOARD MEMBER 5.00 0.00 X 0 0 0 THOMAS M PRISELAC CHAIR 5.00 75.00 X 0 3627555 1373150 MARC H RAPAPORT BOARD MEMBER 5.00 18.00 X 0 0 0 NICKOLAS TOMASIC MD BOARD MEMBER 5.00 0.00 X 0 0 0 LESLIE VERMUT BOARD MEMBER 5.00 8.00 X 0 0 0 THOMAS J WAFER JR BOARD MEMBER 5.00 0.00 X 0 0 0 WALTER ZIFKIN BOARD MEMBER 5.00 0.00 X 0 0 0 MARK GAVENS CEO 6.00 61.00 X 0 1724078 212630 MARY KATHRYN HAMMACK CFO/TREASURER 50.00 5.00 X 247779 0 9251 PAULETTE HEITMEYER COO 50.00 1.00 X 0 448894 9583 SHARON MARTINEZ SECRETARY 50.00 1.00 X 100318 0 711 SHAWN BOND PHYSICIAN ASSISTANT 50.00 0.00 X 227831 0 7986 CATHY OHNSTAD CHIEF NURSING OFFICER 50.00 0.00 X 203060 0 9846 JEFFREY WALLACE ASSISTANT ADMINISTRATOR 50.00 0.00 X 194160 0 17559 PERCY CUPEN DIRECTOR OF QUALITY MANAGEMENT 50.00 0.00 X 201598 0 3149 KIMBERLY BOTWIN DIRECTOR PHARMACY 40.00 0.00 X 201146 0 306 1375892 5800527 1644171 123 0 1 0 PREMIER EMERGENCY PHYSICIANS OF CA MEDIC 7032 COLLECTION CTR DR CHICAGO IL 60693 EMERGENCY DEPARTMENT COVERAGE 336750 WATKINS SPINE INC 410 PROSPECT CIRCLE PASADENA CA 91030 SPINE CENTER MEDICAL DIRECTORS (2) 329473 RUBEN VILLEGAS 596 S ESPLANADE STREET ORANGE CA 92869 MATERIALS MANAGEMENT DIRECTOR/CONSULTING 172875 AMBULATORY ANESTHESIA ASSOCIATES INC 371 VAN NESS WAY SUITE 210 TORRANCE CA 90501 AMBULATORY ANESTHESIA SERVICES 106400 4 2508408 2508408 NET PATIENT REVENUE 622110 61592917 61592917 MEDICARE AND MEDICAL 622110 41031376 41031376 QAF REVENUE 622110 3772459 3772459 106396752 665 665 OTHER REVENUE 622110 420091 420091 420091 109325916 106816843 0 665 55000 55000 359011 261360 97651 37312667 27019184 10293483 448416 324711 123705 11812554 8553813 3258741 3408811 2468419 940392 5188993 4151194 1037799 1478 1478 1635 1635 9819596 8087754 1731842 325123 243842 81281 1887738 1321417 566321 98164 24541 73623 12270 6258 6012 12702 12702 295963 295963 5870045 4696036 1174009 1114333 835750 278583 PROSTHESIS/IMPLANTS 8535921 8535921 QAF EXPENSES 7503760 7503760 OTHER MEDICAL SUPPLIES 7260842 7260842 DRUGS/PHARMACEUTICALS 2551955 2551955 7446959 6469854 977105 111323936 90667574 20656362 0 4865994 7247732 291267 736853 13513907 12739866 1355955 1388178 11500292 14395625 47406359 12307714 38524038 35098645 70051453 71606899 15211037 8822603 1996743 1303244 37473926 48109325 54681706 58235172 X 15369747 13371727 15369747 13371727 70051453 71606899 -1998020 0 X X 0 1 X 1 0 X 27560638 3840204 23720434 15332824 5865647 9467177 4512897 2601863 1911034 35098645 DUE TO/FROM RELATED ORGANIZATION 35770443 MALPRACTICE RESERVES 2802000 WORKERS COMP RESERVES 3921000 CAPITAL LEASES 103408 ACCRUED PAYROLL 5512474 48109325 X PART X, LINE 2: THE FOLLOWING STATEMENT IS TAKEN FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CEDARS-SINAI HEALTH SYSTEM THAT INCLUDES CFHS HOLDINGS, INC. THE ORGANIZATION COMPLETED AN ANALYSIS OF ITS TAX POSITIONS, IN ACCORDANCE WITH ASC 740, INCOME TAXES, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN. THE ORGANIZATION HAS RECOGNIZED NO INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2015. 1 1 X 1 X 1 X 450.000000000000 1 1 1 0 1 1 167091 167091 0.00150 24241461 11410706 12830755 0.11530 24408552 11410706 12997846 0.11680 40418 40418 0.00040 50000 50000 0.00040 90418 90418 0.00080 24498970 11410706 13088264 0.11760 5000 5000 0.00000 5000 5000 0.00000 0 9092318 0 36465552 57966687 -21501135 X 1 1 1 1 MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA 90292 WWW.MARINAHOSPITAL.COM 930000096 X X X MARINA DEL REY HOSPITAL 1 0 0 1 X X X X X X X X X 17 1 0 0 1 X HTTPS://WWW.MARINAHOSPITAL.COM/COMMUNITY 1 17 1 HTTPS://WWW.MARINAHOSPITAL.COM/COMMUNITY 0 1 X 200.000000000000 450.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE X HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE X HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 MARINA DEL REY HOSPITAL PART V, SECTION B, LINE 3J: THE CHNA HELPS TO IDENTIFY THE UNMET HEALTH NEEDS OF THE COMMUNITIES SERVED BY CEDARS-SINAI MARINA DEL REY HOSPITAL AND PROVIDES A FRAMEWORK FOR PRIORITIZING HOW THE HOSPITAL WILL ADDRESS UNMET COMMUNITY NEEDS THROUGH THE PROVISION OF COMMUNITY HEALTH SERVICES.CEDARS-SINAI MARINA DEL REY'S COMMUNITY HEALTH NEEDS ASSESSMENT FOR JULY 1, 2017 THROUGH JUNE 30, 2020 WAS APPROVED BY ITS GOVERNING BODY ON MAY 23, 2018. COMMUNITY BENEFIT SERVICE AREA:CEDARS-SINAI MARINA DEL REY HOSPITAL IS LOCATED AT 4650 LINCOLN BLVD., MARINA DEL REY, CA, 90292. THE HOSPITAL'S SERVICE AREA ENCOMPASSES EIGHT ZIP CODES IN THE CITIES OF CULVER CITY, MAR VISTA, MARINA DEL REY, PLAYA DEL REY, PLAYA VISTA, SANTA MONICA, VENICE, AND WESTCHESTER. THIS AREA IS LOCATED IN LOS ANGELES COUNTY SERVICE PLANNING AREA 5 (SPA 5).COMMUNITY DEMOGRAPHICS:- THE POPULATION OF THE CEDARS-SINAI MARINA DEL REY HOSPITAL (CSMDRH) SERVICE AREA IS 230,101.- THE PERCENTAGE OF YOUTH, AGE 0-17, IN THE SERVICE AREA IS 15.5%, WHICH IS LOWER THAN THE COUNTY (23.1%) OR THE STATE (23.8%).- OVER HALF OF THE POPULATION (53.9%) IN THE HOSPITAL SERVICE AREA IS WHITE. HISPANIC OR LATINOS ACCOUNT FOR 21.8% OF THE AREA POPULATION, ASIANS 12.2% AND BLACK OR AFRICAN AMERICANS 7.1%.- TWO-THIRDS OF THE RESIDENTS IN THE SERVICE AREA SPEAK ENGLISH ONLY (66.8%), WHILE 16.9% OF THE POPULATION SPEAKS SPANISH ONLY.SOCIAL AND ECONOMIC FACTORS:- AMONG AREA RESIDENTS, 11.8% ARE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 24.7% ARE AT 200% OF FPL OR BELOW (LOW-INCOME).- THE MEDIAN HOUSEHOLD INCOME FOR THE CSMDRH SERVICE AREA IS $81,083.- IN JULY 2017, THE UNEMPLOYMENT RATE IN THE AREA RANGED FROM 3.2% IN MARINA DEL REY TO 5.5% IN LOS ANGELES.- IN THE SERVICE AREA, 63.4% OF THE POPULATION HAS A COLLEGE DEGREE, WHICH IS HIGHER THAN THE COUNTY (37.2%) AND THE STATE (39.2%).- CULVER CITY UNIFIED (93.7%) AND SANTA MONICA-MALIBU UNIFIED (90.7%) HAVE HIGH GRADUATION RATES. THESE DISTRICTS EXCEED THE HEALTHY PEOPLE 2020 OBJECTIVE FOR HIGH SCHOOL GRADUATION OF 87%.ACCESS TO HEALTH CARE:- THE HOSPITAL SERVICE AREA REPORTS 88.2% INSURANCE COVERAGE. COVERAGE RATES RANGE FROM A LOW OF 87.5% IN CULVER CITY (ZIP CODE 90230) TO A HIGH OF 94.8% IN PLAYA VISTA (ZIP CODE 90094).- 80.7% OF RESIDENTS OF SPA 5 HAVE A REGULAR SOURCE FOR CARE, COMPARED TO 84.7% FOR THE COUNTY AND 86% FOR THE STATE.- A BARRIER TO ACCESSING CARE IS THE LACK OF SPECIALTY CARE PRACTITIONERS LOCALLY AVAILABLE.- SENIORS IN SPA 5 HAVE A USUAL SOURCE OF CARE AT A HIGHER PERCENTAGE THAN FOUND IN THE COUNTY OR STATE. HOWEVER, 12.7% OF SENIORS, AGES 65-74, REPORTED A DELAY IN CARE COMPARED TO 8.9% IN THE COUNTY AND 7.7% IN THE STATE.- COMMUNITY STAKEHOLDERS NOTED THAT THE LARGE HOMELESS POPULATION IN THE NEIGHBORHOOD HAS LIMITED ACCESS TO PREVENTIVE CARE SERVICES. LEADING CAUSES OF DEATH:- HEART DISEASE AND CANCER ARE THE TOP TWO CAUSES OF DEATH IN THE SERVICE AREA, FOLLOWED BY ALZHEIMER'S DISEASE AND STROKE.CHRONIC DISEASES:- AMONG ADULTS IN SPA 5, 10.8% IDENTIFIED THEMSELVES AS EXPERIENCING FAIR OR POOR HEALTH COMPARED TO 21.9% AT THE COUNTY LEVEL.- 6.6% OF ADULTS IN SPA 5 HAVE BEEN DIAGNOSED WITH DIABETES AND 8.7% HAVE PREDIABETES.- 5.9% OF ADULTS IN SPA 5 HAVE BEEN DIAGNOSED WITH HEART DISEASE.- A CO-MORBIDITY FACTOR FOR DIABETES AND HEART DISEASE IS HYPERTENSION (HIGH BLOOD PRESSURE). IN SPA 5, 22.4% OF RESIDENTS HAVE HIGH BLOOD PRESSURE.- 14.6% OF RESIDENTS IN SPA 5 HAVE BEEN DIAGNOSED WITH ASTHMA, WHICH IS HIGHER THAN THE COUNTY RATE OF 12.8%.HOMELESSNESS:- FROM 2016 TO 2017, SPA 5 EXPERIENCED AN 18% INCREASE IN THE NUMBER OF HOMELESS INDIVIDUALS.- THE RATE OF CHRONICALLY HOMELESS ROSE TO 32.9% IN 2017, COMPARED TO 28.4% IN 2016.- ONE-THIRD OF THE HOMELESS POPULATION (33.3%) IDENTIFY AS HAVING A MENTAL ILLNESS.- THE HOSPITAL SERVICE AREA REPORTS A HIGHER LEVEL OF HOMELESS VETERANS (18.6%) WHEN COMPARED TO HOMELESS VETERANS IN LOS ANGELES COUNTY (8%).- COMMUNITY INPUT NOTED THAT THE COMPLEXITY OF HOMELESSNESS CHALLENGES LOCAL PROVIDERS: LACK OF AFFORDABLE HOUSING, THE TRANSIENT NATURE OF THE POPULATION, MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES, COMMUNITY INTOLERANCE, AND A SHORTAGE OF WRAP-AROUND AND SUPPORT SERVICES.MENTAL HEALTH:- IN THE HOSPITAL SERVICE AREA, 5.2% OF ADULTS EXPERIENCED SERIOUS PSYCHOLOGICAL DISTRESS IN THE PAST YEAR.- STIGMA AROUND MENTAL HEALTH CONTINUES TO BE A BARRIER TO ACCESSING CARE.- 8.9% OF ADULTS IN SPA 5 HAD SERIOUSLY CONSIDERED SUICIDE, WHICH IS LOWER THAN THE COUNTY (9.5%) AND STATE (9.6%) RATES.- COMMUNITY INPUT NOTED THAT BARRIERS AROUND MENTAL HEALTH INCLUDED: A LACK OF PRACTITIONERS AND PREVENTIVE PRACTICES, AS WELL AS THE COST OF CARE, WHICH IS OFTEN NOT COVERED BY INSURANCE.OVERWEIGHT AND OBESITY:- IN THE HOSPITAL SERVICE AREA, 4.4% OF CHILDREN AND 42.6% OF TEENS ARE OVERWEIGHT. 30.5% OF SENIORS IN SPA 5 ARE OVERWEIGHT.- ALMOST THREE-QUARTERS OF LATINO RESIDENTS IN SPA 5 (74.6%) ARE OVERWEIGHT OR OBESE. 46.2% OF WHITE ADULTS AND 44.2% OF AFRICAN AMERICAN ADULTS IN SPA 5 ARE OVERWEIGHT OR OBESE. AMONG ASIANS, 17.7% ARE OVERWEIGHT OR OBESE.- IN THE HOSPITAL SERVICE AREA, 15.4% OF CHILDREN AND 15% OF ADULTS CONSUME FAST FOOD THREE OR MORE TIMES A WEEK.- 57.8% OF TEENS IN SPA 5 CONSUMED TWO OR MORE SERVINGS OF FRUIT A DAY, LESS THAN THE PERCENTAGE OF TEENS IN THE COUNTY (70.9%).- 31% OF TEENS IN SPA 5 ENGAGED IN NO PHYSICAL ACTIVITY DURING THE WEEK, COMPARED TO 16.8% OF TEENS IN LA COUNTY, AND 14.8% IN THE STATE.- A BARRIER TO ENGAGING IN OUTSIDE ACTIVITY NOTED BY THE COMMUNITY IS THE LACK OF PUBLIC GREEN OR OPEN SPACES OTHER THAN THE BEACHES.PREVENTIVE PRACTICES:- CULVER CITY UNIFIED SCHOOL DISTRICT (96.4%) AND SANTA MONICA - MALIBU UNIFIED SCHOOL DISTRICT (88.8%) OF CHILDREN ENTERED KINDERGARTEN IN THE 2015-2016 YEAR WITH UP-TO-DATE IMMUNIZATIONS, COMPARED TO COUNTY (91.4%) AND STATE (92.9%).- OVERALL, 38% OF SPA 5 RESIDENTS OBTAINED A FLU VACCINATION IN 2015; THE HEALTHY PEOPLE 2020 OBJECTIVE IS FOR 70% OF THE POPULATION TO RECEIVE A FLU SHOT. AMONG SPA 5 RESIDENTS AGES 65 AND OLDER, 67.7% RECEIVED A FLU SHOT.- 61.2% OF SENIORS IN SPA 5 HAVE RECEIVED THE PNEUMONIA VACCINE. THE HEALTHY PEOPLE 2020 OBJECTIVE IS FOR 90% OF ADULTS AGES 65 AND OLDER TO BE VACCINATED.- IN SPA 5, 88.7% OF WOMEN OBTAINED A PAP SMEAR IN THE PAST THREE YEARS AND 85.3% OF WOMEN HAVE OBTAINED A MAMMOGRAM IN THE PAST TWO YEARS.SENIOR HEALTH:- FALLS ARE THE LEADING CAUSE OF INJURY AMONG OLDER ADULTS. 27.8% OF SENIORS IN SPA 5 REPORTED FALLING AT LEAST ONCE IN THE PAST YEAR.- COMMUNITY INPUT NOTED BARRIERS TO HEALTH CARE FOR SENIORS INCLUDED: HIGH RENTS, VULNERABILITY TO ISOLATION, LIMITED TRANSPORTATION RESOURCES, AND NOT ENOUGH RESOURCES FOR SUPPORTIVE LIVING.SUBSTANCE ABUSE:- 10.8% OF ADULTS IN SPA 5 ARE CURRENT SMOKERS, COMPARED TO 12.2% IN THE COUNTY AND 12.8% IN THE STATE.- AMONG TEENS IN SPA 5, 24% HAVE SMOKED AN ELECTRONIC (VAPORIZER) CIGARETTE, COMPARED TO 6.9% IN THE COUNTY AND 7.5% IN THE STATE.- 43.3% OF TEENS IN SPA 5 HAVE TRIED ALCOHOL, COMPARED TO 21.9% IN THE COUNTY AND 23% IN THE STATE.- BARRIERS TO CARE FOR SUBSTANCE ABUSE IDENTIFIED BY THE COMMUNITY INCLUDED: LIMITED DETOX OPTIONS AND WAIT LISTS FOR TREATMENT CENTERS.IDENTIFICATION OF SIGNIFICANT HEALTH NEEDS:THE ANALYSIS OF SECONDARY DATA YIELDED A PRELIMINARY LIST OF SIGNIFICANT HEALTH NEEDS WHICH THEN INFORMED PRIMARY DATA COLLECTION. THE PRIMARY DATA COLLECTION PROCESS HELPED TO VALIDATE SECONDARY DATA FINDINGS.THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS WERE DETERMINED:- ACCESS TO HEALTH CARE- CHRONIC DISEASES- HOMELESSNESS- MENTAL HEALTH- OVERWEIGHT AND OBESITY- PREVENTIVE PRACTICES- SENIOR HEALTH- SUBSTANCE ABUSETHE STAKEHOLDERS WERE ASKED TO RANK THE HEALTH NEEDS ACCORDING TO HIGHEST LEVEL OF IMPORTANCE IN THE COMMUNITY. AMONG THE INTERVIEWEES, MENTAL HEALTH, HOMELESSNESS, AND ACCESS TO HEALTH CARE WERE RANKED AS THE TOP PRIORITY NEEDS IN THE SERVICE AREA.THE SIGNIFICANT HEALTH NEEDS ARE LISTED IN PRIORITY ORDER:1. MENTAL HEALTH2. HOMELESSNESS3. ACCESS TO HEALTH CARE4. SUBSTANCE ABUSE5. CHRONIC DISEASES6. OVERWEIGHT AND OBESITY7. PREVENTIVE PRACTICES8. SENIOR HEALTHPART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. MARINA DEL REY HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING CEDARS-SINAI MARINA DEL REY'S CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH.TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. INTERVIEWS WERE COMPLETED IN OCTOBER AND NOVEMBER, 2017. COMMUNITY STAKEHOLDERS IDENTIFIED BY CSMDRH WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. INPUT WAS OBTAINED FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN A PHONE INTERVIEW. MARINA DEL REY HOSPITAL PART V, SECTION B, LINE 11: HEALTH NEEDS WERE IDENTIFIED IN THE CHNA AND SUBSEQUENTLY PRIORITIZED BY COMMUNITY STAKEHOLDERS. FROM THE PRIORITIZED HEALTH NEEDS, CEDARS-SINAI MARINA DEL REY HOSPITAL (CSMDRH) CHOSE HEALTH FOCUS AREAS TAKING ACCOUNT CSMDRH'S CAPACITY TO IMPACT COMMUNITY NEEDS, THE STRENGTH OF COMMUNITY PARTNERSHIPS AND THE ALIGNMENT WITH CEDARS-SINAI'S ORGANIZATIONAL STRATEGIC PLANNING EFFORTS.HEALTH FOCUS AREAS:ACCESS TO CARE - COMMUNITY BENEFIT EFFORTS FOCUS ON PROGRAMS, PARTNERSHIPS AND STRATEGIES THAT INCREASE ACCESS TO PRIMARY CARE, PREVENTIVE CARE AND ACCESS TO MENTAL HEALTH CARE SERVICES.HOMELESSNESS - COMMUNITY BENEFIT EFFORTS FOCUS ON PROGRAMS, PARTNERSHIPS AND STRATEGIES THAT INCREASE ACCESS TO PRIMARY CARE, MENTAL HEALTH CARE, SUBSTANCE ABUSE SERVICES AND COMMUNITY-BASED HEALTH CARE SERVICES FOR PERSONS EXPERIENCING HOMELESSNESS. ALIGNMENT WITH PUBLIC HEALTH COMMUNITY HEALTH IMPROVEMENT PLAN:CSMDRH IS COMMITTED TO ALIGNING ITS IMPLEMENTATION STRATEGY WITH THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH COMMUNITY HEALTH IMPROVEMENT PLAN. CSMDRH'S IMPLEMENTATION STRATEGY CONCENTRATES ON "PRIORITY AREA 1: INCREASE PREVENTION TO IMPROVE HEALTH" OF THE COMMUNITY HEALTH IMPROVEMENT PLAN FOR LOS ANGELES COUNTY. GOAL 1.2 FOR THIS PRIORITY AREA: INCREASE ACCESS TO CARE (MEDICAL, CLINICAL PREVENTIVE SERVICES, MENTAL HEALTH AND DENTAL) CORRESPONDS TO THE CSMDRH IMPLEMENTATION STRATEGY'S HEALTH FOCUS AREAS.EVALUATION OF IMPACT:THE HEALTH FOCUS AREAS IDENTIFIED ABOVE WERE DETERMINED THROUGH DATA COLLECTION, ANALYSIS AND A PRIORITIZATION PROCESS THAT INCORPORATED COMMUNITY INPUT. DUE TO THE QUANTITY AND SCOPE OF THE COMMUNITY'S HEALTH NEEDS IDENTIFIED, IT IS NECESSARY TO IDENTIFY FOCUS AREAS AND TO ENSURE THAT THE COMMUNITY BENEFIT INITIATIVES ARE EFFECTIVE IN IMPROVING THE HEALTH OF VULNERABLE POPULATIONS. IN SUPPORT OF OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY, CSMDRH HAS COMMITTED TO ONGOING PROGRAM EVALUATION TO ENSURE MAXIMUM IMPACT OF OUR COMMUNITY BENEFIT STRATEGIES. CSMDRH WILL INCORPORATE EVALUATION RESULTS INTO PROGRAM STRATEGY, PLANNING AND IMPLEMENTATION.HEALTH NEEDS THE HOSPITAL WILL NOT ADDRESS:THERE WERE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA THAT DID NOT MEET THE CRITERIA FOR DEVELOPING AND IMPLEMENTING A HEALTH FOCUS AREA AND, AS A RESULT, ARE NOT ADDRESSED IN THIS IMPLEMENTATION STRATEGY. THIS IS NOT INTENDED TO MINIMIZE THE IMPORTANCE OF THOSE HEALTH NEEDS; IT IS A REALITY OF HAVING A STRATEGIC FOCUS ON EFFECTIVENESS TO IMPROVE COMMUNITY HEALTH. THE HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA BUT NOT INCLUDED IN THE HEALTH FOCUS AREAS FOR THIS IMPLEMENTATION STRATEGY ARE: CHRONIC DISEASES, OVERWEIGHT AND OBESITY, AND SENIOR HEALTH. CSMDRH WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS WHERE WE CAN MAKE A MEANINGFUL CONTRIBUTION. 3 1 - MARINA DEL REY HOSPITAL 4658 LINCOLN BLVD MARINA DEL REY CA 90292 OUTPATIENT SERVICES - GEN/LAB/RADIOLOGY/MRI/CT SCANNER 2 - MARINA DEL REY HOSPITAL 4640 ADMIRALTY WAY STE 600 MARINA DEL REY CA 90292 OUTPATIENT SERVICES - SPINE CENTER 3 - MARINA DEL REY HOSPITAL 4644 LINCOLN BLVD STE 450 MARINA DEL REY CA 90292 OUTPATIENT SERVICES - BARIATRICS CENTER PART I, LINE 7: FINANCIAL ASSISTANCE AND MEDI-CAL COSTS AS A PERCENTAGE OF TOTAL HOSPITAL EXPENSES WERE DETERMINED BASED ON THE RATIO OF TOTAL FINANCIAL ASSISTANCE AND MEDI-CAL REVENUE OVER TOTAL CHARGES DURING THE FISCAL YEAR ENDING ON 6/30/2018. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL IS INVOLVED IN COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. COMMUNITY CONCERNS, SUCH AS HEALTH IMPROVEMENT, ARE ADDRESSED. THE HOSPITAL WORKS WITH OTHER TAX-EXEMPT ORGANIZATIONS TO PROMOTE HEALTH AND WELLNESS AND DISEASE PREVENTION. THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. PART III, LINE 2: PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR BAD DEBTS, AND ACCOUNTS RECEIVABLE IS REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON MANY FACTORS, INCLUDING PAYER MIX, AGE OF RECEIVABLES, HISTORICAL CASH COLLECTION EXPERIENCE, AND OTHER RELEVANT INFORMATION. A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED, AND A SIGNIFICANT PORTION OF THE HOSPITAL'S INSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR CO-PAYMENTS AND DEDUCTIBLES. THUS, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS RELATED TO THESE INSURED AND UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE HOSPITAL WRITES DOWN THE EXPECTED REIMBURSEMENT AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED. PART III, LINE 4: AUDITED FINANCIAL STATEMENTS - PAGE 13PART III, LINE 6: MEDICARE ALLOWABLE COSTS AS A PERCENTAGE OF TOTAL HOSPITAL EXPENSES WERE DETERMINED BASED ON THE RATIO OF TOTAL MEDICARE REVENUE OVER TOTAL CHARGES DURING THE FISCAL YEAR ENDING ON 6/30/2018. PART III, LINE 8: IT IS OUR BELIEF THAT ALL OF THE $21,501,135 SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS. PART III, LINE 9B: REASONABLE EFFORTS BASED ON BILLING STATEMENT NOTIFICATION AND AMOUNTS NOT ELIGIBLE:THE HOSPITAL NOTIFIES PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAMS BEFORE INITIATING ANY EXTRAORDINARY COLLECTION ACTIONS. THE HOSPITAL REFRAINS FROM INITIATING EXTRAORDINARY COLLECTION ACTIONS FOR AT LEAST 120 DAYS FROM THE DATE THE HOSPITAL BILLS FOR THE CARE IF THE PATIENT HAS NOT SUBMITTED AN APPLICATION OR THE HOSPITAL HAS DETERMINED THE PATIENT IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON THE PATIENT'S APPLICATION.AT LEAST 30 DAYS BEFORE FIRST INITIATING ANY EXTRAORDINARY COLLECTION ACTIONS, THE HOSPITAL PROVIDES THE PATIENT WITH A WRITTEN NOTICE INDICATING FINANCIAL ASSISTANCE IS AVAILABLE, IDENTIFYING THE EXTRAORDINARY COLLECTION ACTION THAT THE HOSPITAL INTENDS TO INITIATE TO OBTAIN PAYMENT, AND STATING A DEADLINE AFTER WHICH SUCH EXTRAORDINARY COLLECTION ACTIONS MAY BE INITIATED (WHICH DATE IS NOT EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED). THE NOTICE INCLUDES A PLAIN LANGUAGE SUMMARY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.IN ADDITION TO ALL WRITTEN NOTICES, PRIOR TO INITIATING ANY EXTRAORDINARY COLLECTION ACTIONS, THE HOSPITAL MAKES A REASONABLE EFFORT TO VERBALLY NOTIFY THE PATIENT ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND ABOUT HOW THE PATIENT MAY OBTAIN ASSISTANCE THROUGH THE APPLICATION PROCESS. PART VI, LINE 2: A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN FISCAL YEAR ENDED 6/30/18. SEE NARRATIVE FOR SCHEDULE H, PART V, SECTION B, LINE 3J. PART VI, LINE 3: THE HOSPITAL PROVIDES THE FOLLOWING NOTICES REGARDING FULL AND PARTIAL FINANCIAL ASSISTANCE FOR THE FINANCIALLY QUALIFIED PATIENTS:A) POSTED SIGNAGE - NOTICE OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE FOLLOWING LOCATIONS: THE EMERGENCY DEPARTMENT, THE ADMITTING DEPARTMENT, CENTRALIZED AND DECENTRALIZED REGISTRATION AREAS AND OTHER OUTPATIENT SETTINGS.B) NOTICES HAND-DELIVERED TO PATIENTS - DURING THE REGISTRATION OR ADMISSION PROCESS (OR OTHERWISE PRIOR TO DISCHARGE), PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND CEDARS-SINAI MARINA DEL REY'S FINANCIAL ASSISTANCE PROGRAMS. PATIENTS ARE ASKED TO ACKNOWLEDGE RECEIPT OF THIS VIA AN ELECTRONIC SIGNATURE.C) PATIENT STATEMENT NOTICES - ON THE PATIENT BILLING STATEMENTS, THE HOSPITAL PROVIDES A DESCRIPTION OF ITS FINANCIAL ASSISTANCE POLICY AND PROGRAMS, ALONG WITH INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: PLEASE SEE COMMUNITY SERVICE AREA AND DEMOGRAPHICS INFORMATION IN THE NARRATIVE FOR SCHEDULE H, PART V, SECTION B, LINE 3J. IN ADDITION, THERE ARE FIVE OTHER HOSPITALS THAT SERVE THE SAME COMMUNITY AS CEDARS-SINAI MARINA DEL REY HOSPITAL. PART VI, LINE 5: CEDARS-SINAI MARINA DEL REY HOSPITAL IS DRIVEN BY ITS MISSION TO STRIVE TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY BY GIVING BACK TO THE COMMUNITY IN THE FORM OF HEALTH CARE AND OTHER COMMUNITY SERVICES. THE HOSPITAL PROVIDES BOTH QUANTIFIABLE AND NON-QUANTIFIABLE CONTRIBUTIONS TO THE COMMUNITY, SUCH AS INCREASING PARTICIPATION IN LOCAL EFFORTS TO COMBAT HOMELESSNESS IN THE COMMUNITY AND INCURRING UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR THE POOR AND UNDERSERVED OF THE COMMUNITY. IN ADDITION, THE HOSPITAL DISTRIBUTED GRANTS TO ST. JOSEPH'S CENTER AND VENICE FAMILY CLINIC, BOTH SIGNIFICANT COMMUNITY PROVIDERS OF HOMELESS SERVICES IN THE MARINA DEL REY SERVICE AREA. ANY SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO FURTHER SUPPORT THE COMMUNITY. PART VI, LINE 6: THE HOSPITAL IS AN AFFILIATE OF CEDARS-SINAI HEALTH SYSTEM. THE 133-BED SURGICAL HOSPITAL IS FULLY ACCREDITED THROUGH THE JOINT COMMISSION FOR SAFE AND EFFECTIVE QUALITY CARE. BY CONCENTRATING FOUR AREAS OF EXPERTISE: SPINE, WEIGHT LOSS, ORTHOPEDICS, AND MINIMALLY INVASIVE SURGERY, THE HOSPITAL IS ABLE TO PROVIDE EXCELLENT CARE IN AN INTIMATE, PERSONAL AND CONVENIENT SETTING.THE HOSPITAL IS COMMITTED TO THE FOLLOWING:* COMMITMENT TO THE COMMUNITY: PROVIDING EXCELLENT AND PROMPT ACUTE MEDICAL SERVICES AND 24/7 EMERGENCY ROOM CARE. * TALENTED CUSTOMER SERVICE-DRIVEN TEAM: BELIEVES KINDNESS IS JUST AS IMPORTANT AS STATE-OF-THE-ART MEDICAL TECHNOLOGY. * NATIONALLY RECOGNIZED PHYSICIANS: RECOGNIZED FOR CLINICAL EXCELLENCE AND DEVOTED TO DELIVERING COMPASSIONATE, RESPONSIVE CARE.THE HOSPITAL'S MISSION:* TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE FOR RESIDENTS IN MARINA DEL REY AND SURROUNDING BEACH COMMUNITIES AND THE WESTSIDE OF LOS ANGELES * TO BE RECOGNIZED FOR MEDICAL EXCELLENCE IN SPINE, ORTHOPEDICS, SURGICAL WEIGHT LOSS, MINIMALLY INVASIVE SURGERY, NON-INVASIVE CARDIOLOGY AND GENERAL ACUTE MEDICAL CARE THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES ORGANIZATIONAL LEADERSHIP IN FOSTERING THE COMMITMENT TO COMMUNITY BENEFIT. THE BOARD OF DIRECTORS FUNCTIONS AS AN OVERSIGHT AND POLICY-MAKING BODY FOR THE HOSPITAL'S COMMUNITY BENEFIT COMMITMENTS, EFFORTS AND STRATEGIC ALIGNMENT WITH COMMUNITY NEEDS. DURING THE TAX YEAR, THE HOSPITAL'S COMMUNITY BENEFIT EXPENSE TOTALED $13,088,264 DIVIDED AMONG THE FOLLOWING CATEGORIES:* UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR THE POOR AND UNDERSERVED - $12,997,846 (CHARITY CARE - $167,091; UNREIMBURSED COST: CARING FOR MEDI-CAL PATIENTS - $12,830,755) (EXCLUDES THE UNREIMBURSED COST OF CARING FOR MEDICARE PATIENTS) COMMUNITY BENEFIT PROGRAMS, INCLUDING CHARITABLE DONATIONS - $90,418DURING THE TAX YEAR, TORRANCE MEMORIAL OFFICIALLY JOINED THE AFFILIATION. TORRANCE MEMORIAL INCLUDES THE 470-BED TORRANCE MEMORIAL MEDICAL CENTER, A MULTISPECIALTY PHYSICIAN GROUP, AN INDEPENDENT PHYSICIAN ASSOCIATION, AND AN ACCOUNTABLE CARE ORGANIZATION, WHICH COLLECTIVELY INCLUDE MORE THAN 500 PHYSICIANS. IT ALSO HAS SEVERAL OUTPATIENT CENTERS LOCATED THROUGHOUT THE SOUTH BAY REGION. THE AFFILIATION ENABLES EACH INSTITUTION TO CONTINUE THE UNIQUE RELATIONSHIPS EACH HAS WITH THE COMMUNITIES IT SERVES, WHILE PROVIDING A PLATFORM FOR A WIDE VARIETY OF COLLABORATIONS TO BETTER SERVE THE REGION. PART VI, LINE 7, REPORTS FILED WITH STATES CA 0 VENICE FAMILY CLINIC 604 ROSE AVE VENICE CA 90291 952769432 501(C)(3) 25000 GRANT FOR INTEGRATED MOBILE HEALTH TEAM ST JOSEPH CENTER 204 HAMPTON DRIVE VENICE CA 90291 953874381 501(C)(3) 25000 GRANT FOR COMMUNITY HOMELESS SERVICES GRANT FOR COMMUNITY HOMELESS SERVICES 2 0 PART I, LINE 2: THE ORGANIZATION CONTRIBUTES TO WELL ESTABLISHED EXEMPT ORGANIZATIONS AND RELIES ON THE GOVERNING BODY OF EACH OF THESE ORGANIZATIONS TO ENSURE THAT GRANT FUNDS DONATED TO EACH AND EVERY ORGANIZATION ARE USED FOR PROPER PURPOSES AND NOT OTHERWISE DIVERTED FROM THE INTENDED USE. 0 1 0 0 0 0 0 0 0 THOMAS M PRISELAC CHAIR 0 1571779 0 1248768 0 807008 0 1347100 0 26050 0 5000705 0 400000 MARK GAVENS CEO 0 974424 0 473131 0 276523 0 176135 0 36495 0 1936708 0 0 MARY KATHRYN HAMMACK CFO/TREASURER 212239 0 35540 0 0 0 6425 0 2826 0 257030 0 0 0 PAULETTE HEITMEYER COO 0 292024 0 101323 0 55547 0 8100 0 1483 0 458477 0 0 SHAWN BOND PHYSICIAN ASSISTANT 227406 0 425 0 0 0 6856 0 1130 0 235817 0 0 0 CATHY OHNSTAD CHIEF NURSING OFFICER 188097 0 14963 0 0 0 5746 0 4100 0 212906 0 0 0 JEFFREY WALLACE ASSISTANT ADMINISTRATOR 176835 0 17325 0 0 0 15785 0 1774 0 211719 0 0 0 PERCY CUPEN DIRECTOR OF QUALITY MANAGEMENT 182941 0 18657 0 0 0 830 0 2319 0 204747 0 0 0 KIMBERLY BOTWIN DIRECTOR PHARMACY 198321 0 2825 0 0 0 0 0 306 0 201452 0 0 0 PART I, LINE 3 THE CEO OF CFHS HOLDINGS, INC.(DBA CEDARS-SINAI MARINA DEL REY HOSPITAL) IS COMPENSATED BY CEDARS-SINAI MEDICAL CENTER, A RELATED TAX-EXEMPT ORGANIZATION. CEDARS-SINAI MEDICAL CENTER USED THE FOLLOWING METHODS IN ESTABLISHING THE CFHS HOLDINGS, INC. CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) WRITTEN EMPLOYMENT CONTRACT; 4) COMPENSATION SURVEY OR STUDY; AND 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THERE ARE TWO NONQUALIFIED DEFERRED COMPENSATION PLANS IN WHICH ONE OR MORE OF THE LISTED PERSONS PARTICIPATE. THE FIRST PLAN IS A DEFERRED COMPENSATION PLAN. THIS IS A "GRANDFATHERED" TRADITIONAL DEFINED BENEFIT PLAN (NO NEW PARTICIPANTS HAVE BEEN ADDED SINCE 1986). THE BENEFIT FORMULA IS A PERCENTAGE OF THE HIGHEST FIVE YEARS AVERAGE ANNUAL SALARY TIMES THE NUMBER OF YEARS OF ELIGIBLE SERVICE, WITH A MAXIMUM CREDITED SERVICE OF 30 YEARS. THE SECOND PLAN IS A SUPPLEMENTAL RETIREMENT ALLOWANCE THAT IS PAYABLE DIRECTLY TO THE PARTICIPANTS EACH QUARTER. THE BENEFIT FORMULA FOR THIS PLAN HAS ANNUAL CONTRIBUTIONS THAT ARE EITHER A PERCENTAGE OF SALARY, OR ARE DESIGNED TO FUND A PERCENTAGE OF THE ESTIMATED FINAL 5-YEAR AVERAGE SALARY. THE FOLLOWING LISTED PERSONS RECEIVED PAYMENTS DURING THE YEAR ENDED DECEMBER 31, 2017 RELATED TO ONE OR BOTH OF THE PLANS REFERENCED ABOVE. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II AND ARE NOT INCREMENTAL PAYMENTS. THOMAS M. PRISELAC 708,909 MARK GAVENS 250,973 PAULETTE HEITMEYER 53,280 FORM 990, PART VI, SECTION A, LINE 6 CEDARS-SINAI MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF CFHS HOLDINGS, INC. DOING BUSINESS AS CEDARS-SINAI MARINA DEL REY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A CEDARS-SINAI MEDICAL CENTER, AS THE SOLE CORPORATE MEMBER, ELECTS THE BOARD OF DIRECTORS OF CEDARS-SINAI MARINA DEL REY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B RESERVED RIGHTS OF CEDARS-SINAI MEDICAL CENTER, THE SOLE CORPORATE MEMBER OF CEDARS-SINAI MARINA DEL REY HOSPITAL ("THE HOSPITAL"). THE FOLLOWING ACTIONS MUST BE APPROVED OR ACTED UPON BY CEDARS-SINAI MEDICAL CENTER BEFORE BECOMING EFFECTIVE: (A) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE HOSPITAL; (B) ANY AMENDMENT TO THE HOSPITAL'S PURPOSE OR MISSION; (C) ANY CHANGE IN THE MEMBERSHIP OR MEMBERSHIP POWERS OF THE HOSPITAL OR ITS SUBSIDIARY; (D) HIRING, ELECTING, REMOVING, OR TERMINATING ANY OF THE OFFICERS OF THE HOSPITAL; (E) REMOVAL AND APPOINTMENT OF DIRECTORS OF THE HOSPITAL; (F) CHANGING THE NUMBER OF DIRECTORS ON THE BOARD OF DIRECTORS; (G) SELECTION AND APPOINTMENT OF THE AUDITORS AND LEGAL COUNSEL OF THE HOSPITAL; (H) ANY SALE OR OTHER DISPOSITION OF ALL OR A SUBSTANTIAL PORTION OF THE ASSETS OF THE HOSPITAL; (I) MERGER, CONSOLIDATION, REORGANIZATION, DIVESTITURE, AFFILIATION, LIQUIDATION, OR DISSOLUTION; (J) BORROWING MONEY AND INCURRING INDEBTEDNESS ON BEHALF OF THE HOSPITAL; (K) APPROVING THE HOSPITAL'S ANNUAL OPERATING AND CAPITAL BUDGETS; (L) DECLARING OR CONSENTING TO THE FILING OF PROCEEDINGS TO DECLARE BANKRUPTCY. FORM 990, PART VI, SECTION B, LINE 11B THE REVIEW OF THE FORM 990 INVOLVES VARIOUS MANAGEMENT PERSONNEL INCLUDING THE HOSPITAL'S TREASURER, AND A BIG FOUR ACCOUNTING FIRM. THE FORM 990 IS PRESENTED AT A BOARD OF DIRECTORS' MEETING ALLOWING THE ENTIRE BOARD THE OPPORTUNITY TO DISCUSS THE INFORMATION REPORTED. FORM 990, PART VI, SECTION B, LINE 12C THE PURPOSE OF THE CONFLICTS OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF THE HOSPITAL WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE HOSPITAL OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO THE HOSPITAL. PROCEDURES: DUTY TO DISCLOSE - IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATING THERETO TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS - AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATING THERETO, AND AFTER ANY DISCUSSION THEREOF, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTANDS THE HOSPITAL IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS: TO ENSURE THAT THE HOSPITAL OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, THE HOSPITAL SHALL CONDUCT PERIODIC REVIEWS OF THE IMPLEMENTATION OF THE POLICY. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S-LENGTH BARGAINING, B) WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS, IF ANY, CONFORM TO THE HOSPITAL'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES, AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. USE OF OUTSIDE EXPERTS: WHEN CONDUCTING PERIODIC REVIEWS, THE HOSPITAL MAY, BUT NEED NOT, USE OUTSIDE ADVISORS. IF OUTSIDE ADVISORS ARE USED, THEIR USE SHALL NOT RELIEVE THE BOARD OF ITS RESPONSIBILITY FOR ENSURING PERIODIC REVIEWS ARE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL'S CHIEF EXECUTIVE OFFICER IS COMPENSATED BY THE HOSPITAL'S SOLE CORPORATE MEMBER, CEDARS-SINAI MEDICAL CENTER. THE EXECUTIVE PERSONNEL COMMITTEE OF CEDARS-SINAI MEDICAL CENTER REVIEWS AND APPROVES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION. SINCE THE HOSPITAL DOES NOT COMPENSATE ITS CHIEF EXECUTIVE OFFICER, THE RESPONSE TO THIS QUESTION IS NO, IN ACCORDANCE WITH SPECIFIC INSTRUCTIONS FROM THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE ATTACHED TO ITS FORM 990. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C: THE HOSPITAL'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH ITS PARENT FOR FISCAL YEAR ENDED JUNE 30, 2018. THE OVERSIGHT OF THE AUDIT WAS PERFORMED BY ITS PARENT'S AUDIT COMMITTEE. 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