2018-11-13T16:11:06-06:00 2017-12-31 450250958 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2017-01-01 952082686 Ridgecrest Regional Hospital RIDG 7604463551 1081 N China Lake Blvd Ridgecrest CA 93555 James Suver CEO 7604463551 2018-11-13 1 Kim C Hunwardsen P00484560 6122536500 2018-11-13 216.147.170.229 2018-11-13 08:31:09 CS P 66CC91E6B7F11C4783FFFA5645E675327CB67316 B602D594AFD2B0B327E07A06F36CA6A7E42546D0 2017 2019-02-21 02:37:17Z James Suver 1081 N China Lake Blvd Ridgecrest CA 93555 123527404 0 X www.rrh.org X 1965 CA Community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 11 8 990 74 81883 -239494 89651 346765 117700944 122564950 227286 335574 321096 252140 118338977 123499429 0 0 0 0 49051954 52816684 0 0 0 57823322 67492815 106875276 120309499 11463701 3189930 154543765 157317640 77978378 77600139 76565387 79717501 X To be a community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 1 0 105414203 121317332 Ridgecrest Regional Hospital provides inpatient and outpatient care. Charity care is provided to qualified patients with minimum or no charge. Care accomplishments for the year are as follows: Number of Visits 65,172 Number of Patient Days 6,390 Home Health Visits 4,483 Hospice Routine Care Days 2,180SNF Resident Days 27,175Rural Health Visits 58,699Community Care Clinic Visits 36,524 105414203 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 1 1 0 1 0 0 0 0 1 1 0 0 0 1 207 0 1 990 1 1 1 0 0 0 0 1 1 0 0 0 0 X 11 8 0 0 1 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X James Suver 7604993040 1081 North China Lake Blvd Ridgecrest CA 93555 Dana Lyons Chairperson (Jan-May) 2.00 0.10 X X 0 0 0 George Haslam - Director (Jan-May)/Chairperson (Jun-Dec) 2.00 0.00 X X 0 0 0 Patricia Mullis Vice Chair 2.00 0.00 X X 0 0 0 Chris Ellis Secretary 2.00 0.00 X X 0 0 0 Michael Mower Treasurer (Jan-May) 2.00 0.00 X X 0 0 0 Don Zbeda - Director (Jan-May)/Treasurer (Jun-Dec) 2.00 0.00 X X 0 0 0 Harriet Luzinas-Smith Director 2.00 0.10 X 751 0 0 Lawrence Cosner MD Director/Physician 48.00 0.00 X 230493 0 36739 Gerald Baker Director (Jan-May) 2.00 0.00 X 0 0 0 Walter Martin Director 2.00 0.00 X 0 0 0 Cornelis Vanderhoek MD Director/Physician 8.00 0.00 X 45600 0 0 Margie Hannon Director (Jun-Dec) 2.00 0.00 X 0 0 0 Rita Read Director (Jun-Dec) 2.00 0.10 X 0 0 0 Paige Sorbo-Netzer Director (Jun-Dec) 2.00 0.00 X 0 0 0 James Suver CEO 50.00 0.10 X 448221 0 23324 John Chivers CFO 50.00 0.10 X 140381 0 8791 Healthy Desai Orthopedic Surgeon 40.00 0.00 X 659981 0 46933 Hope Zissos MD Family Practice Physician 40.00 0.00 X 261021 0 50089 Aisha Rollins Pediatrician 40.00 0.00 X 293898 0 19623 Christian Schwartz Physician Assistant 44.30 0.00 X 219372 0 20466 Luigi Cendana Pediatrician 40.00 0.00 X 248486 0 629 2548204 0 206594 81 0 1 0 Comphealth Medical Staffing PO Box 972670 Dallas TX 75397 Staffing 657366 Ali R Lashgari MD 4741 Keswick CT San Diego CA 92130 Medical 632004 Ghassan A Mohsen 212 Washington Way Ridgecrest CA 93555 Medical 617479 Eric D Frey 1325 Princeton St Santa Monica CA 90404 Medical 564149 Maurice Dusol Jr MD PO Box 1297 Ridgecrest CA 93555 Medical 559008 67 14087 332678 219990 346765 Net Patient Service Rev 622000 120488701 120488701 Net Pharmacy Rev 446110 1145449 1063566 81883 EHR Revenue 622000 440013 440013 490787 490787 122564950 343922 343922 269192 17052 252140 252140 252140 2575 10923 -8348 -8348 -8348 123499429 122483067 81883 587714 X 920761 303991 616770 205508 205508 41305043 36659387 4645656 817554 705998 111556 6554487 5907536 646951 3013331 2644779 368552 477546 477546 128770 128770 27809457 25172640 2636817 4827823 4454075 373748 1591910 315338 1276572 558758 359901 198857 229914 158262 71652 2456132 2456132 7650639 6944678 705961 2018899 2018899 Medical Supplies 8338761 8304419 34342 Repair and Maintenance 3606067 1884458 1721609 Provision for Bad Debts 2696490 2696490 Pharmacy Expenses 1269621 1269621 3832028 2952091 879937 120309499 105414203 14895296 0 16956112 12167733 16432495 20772256 15640 3150 15536 10696 2706359 2316090 3231597 4540505 156763308 71829250 86526724 84934058 28158532 32493947 325770 175000 79205 154543765 157317640 10836746 13212847 23425 21167 49325 12600 62843882 60099411 4225000 4254114 77978378 77600139 X 76565387 79717501 76565387 79717501 154543765 157317640 3189930 -37816 0 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 5149 5149 0 Part II-B, Line 1: Lobbying portion of Hospital Association dues. 0 1 X 3212289 3212289 112867634 42790679 70076955 36837673 28585667 8252006 3845712 452904 3392808 84934058 Estimated Third Party Payor Settlements 4174909 Malpractice Insurance Payable 79205 4254114 X 119534557 -37816 -3944108 -3981924 123516481 -17052 -17052 123499429 116382443 17052 17052 116365391 3944108 3944108 120309499 Part IV, Line 2b: Skilled nursing facility resident private monies maintained as a drawing account as required by Title 22 of the California Code of Regulations. Part X, Line 2: The Hospital is organized as a California nonprofit corporation and has been recognized by the Interal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital will file an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS for its retail pharmacy. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Included in Expenses on Form 990 -2,696,490. Pharmacy Expenses Reported in Expenses on Form 990 -1,247,618. Part XI, Line 4b - Other Adjustments: Rental Expenses Included in Expenses for Financials -17,052. Part XII, Line 2d - Other Adjustments: Rental Expenses Included in Revenue on Form 990 17,052. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Included in Revenue in Financials 2,696,490. Pharmacy Expenses Reported in Revenue for Financials 1,247,618. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 295000 295000 0.00250 5746729 4651155 1095574 0.00930 6041729 4651155 1390574 0.01180 204087 128241 75846 0.00060 6272 6272 0.00010 18000 18000 0.00020 228359 128241 100118 0.00090 6270088 4779396 1490692 0.01270 13372 13372 0.00010 28155 28155 0.00020 13108 13108 0.00010 2314 2314 0.00000 21187 21187 0.00020 297143 297143 0.00250 1500 1500 0.00000 376779 376779 0.00310 1 2696490 0 26477654 27274294 -796640 X 1 1 1 1 Ridgecrest Regional Hospital 1081 N China Lake Blvd Ridgecrest CA 93555 www.rrh.org 120000186 X X X X Sleep study lab Ridgecrest Regional Hospital 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X http://rrh.org/info-resources X 1 16 1 http://rrh.org/cnastrategy2016/ 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X http://rrh.org/info-resources/ X http://rrh.org/info-resources/ X http://rrh.org/info-resources/ X X X X X 1 X 0 X X X X 1 X 0 0 Ridgecrest Regional Hospital Part V, Section B, Line 5: Input from the community was gathered through online and telephone interviews in March 2016. Individuals consulted consisted of 2 physicians, a psychologist, a public health nurse, other healthcare professionals, and a director of community outreach Ridgecrest Regional Hospital Part V, Section B, Line 11: Due to the timing of the approval for the 2016 CHNA and Implementation Strategy, the Hospital addressed needs identified in the 2016 CHNA in 2016 and 2017. The following needs have been identified and will be addressed as follows:1) Substance & Alcohol Abuse: provided assistance with opening a Mental Health Crisis Stabilization Unit in October 2017, which has the capability to take patients in crisis for a 23 hour period with onsite psychiatric nurses and a telepsychiatrist2) Cancer: Affiliation with UC Davis Cancer Center; New oncology, including chemotherapy, services in Outpatient Pavilion and cancer clinic opened November 2017; Recruitment of onsite oncologist3) Mental Health: provided assistance with opening a Mental Health Crisis Stabilization Unit in October 2017, which has the capability to take patients in crisis for a 23 hour period with onsite psychiatric nurses and a telepsychiatrist; Continued Recruitment of onsite psychiatrist including pediatric psychiatry4) Heart Disease: Onsite non-invasive cardiologist - started in 20165) Obesity & Nutrition: Senior exercise classes; Silver Sneakers; Chair Yoga; Diabetes classes; Healthy Eating classes6) Senior Health Services Including Dementia - expanded senior services in 2016 and 2017 with additional off-site location7) Women's Health Services - added two OB/GYN physicians (one in 2016 and one in 2017)8) Access to Specialists: Continued recruitment efforts in the areas of mental health, dentistry, podiatry, and pediatrics, including the additions of a podiatrist and a dentist in 20179) Medical Provider Recruitment: Recruited four physicians in 2016 and four physicians in 2017, encompassing the fields of pediatrics, OB/GYN, cardiology, family practice, dentistry, and podiatry10) Services for Low Income/Medi-Cal: Expanded pediatric, OB/GYN, and dental services offered to low-income and Medi-Cal patients, including the addition of one pediatrician and one dentist in 201711) Asthma/Respiratory Disease: RRH offers a Better Breathers Club that provides support and information for those with lung disease, including COPD, asthma, lung cancer, and fibrosis12) Smoking/Tobacco Use: RRH offers the Freedom From Smoking program, an 8-week smoking cessation class for adults to overcome tobacco addiction Ridgecrest Regional Hospital Part V, Section B, Line 13h: Uninsured, self pay patients with incomes at or below 300% of federal poverty level are offered free care. Insured patients with high medical costs (annual expenses exceed 10% of income) and incomes at or below 300% of the federal poverty level are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Ridgecrest Regional Hospital Part V, Section B, Line 16j: Financial packets are provided to each self-pay patient, in addition to: a website reference to the policy; an onsite financial counselor made available to patients; and posting of the policy in all patient access areas. 18 1 - Bella Serra Skilled Nursing Facility 1131 N China Lake Blvd Ridgecrest CA 935553131 Skilled Nursing Facility 2 - Ridgecrest Regional Hospital Rural Healt 1111 N China Lake Blvd Ridgecrest CA 93555 Rural Health Clinic 3 - China Lake Community Care Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Community Care Clinic 4 - Ridgecrest Regional Hospital Urgent Care 1111 N China Lake Blvd Ridgecrest CA 93555 Urgent Care 5 - Center Professional Pharmacy 1109 N China Lake Blvd Ridgecrest CA 93555 Center Professional Pharmacy 6 - Ridgecrest Regional Hospital Orthopedic 1041 N China Lake Blvd Ridgecrest CA 93555 Orthopedic Clinic 7 - Ridgecrest Regional Hospital Home Health 1653 N Triangle Dr Ridgecrest CA 93555 Home Health 8 - China Lake Dermatology 1011 N China Lake Blvd Ridgecrest CA 93555 Dermatology Clinic 9 - China Lake Specialty Clinics-OB Clinic 1011 N China Lake Blvd Ridgecrest CA 93555 OB Clinic 10 - China Lake Gastroenterology 1011 N China Lake Blvd Ridgecrest CA 93555 Gastroenterology Clinic 11 - Ridgecrest Regional Hospital Hospice 1653 N Triangle Dr Ridgecrest CA 93555 Hospice 12 - China Lake Surgical Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Surgical Clinic 13 - Ridgecrest Regional Hosp Living Assist 1653 N Triangle Dr Ridgecrest CA 93555 Living Assistance Program 14 - Ridgecrest Regionl Hosp Internist Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Internist Clinic 15 - Ridgecrest Regional Hosp Senior Services 417 Drummond Ave Ridgecrest CA 93555 Senior Services 16 - Ridgecrest Regional Hosp Occup Health 409 Drummond Ave Ridgecrest CA 93555 Occupational Health 17 - RRH Cancer Center 1011 N China Lake Blvd Ridgecrest CA 93555 Cancer Center 18 - Trona Rural Health Clinic 82820 Trona Rd Trona CA 93562 Rural Health Clinic Part I, Line 3c: Uninsured, self pay patients with incomes at or below 300% of federal poverty level are offered free care. Insured patients with high medical costs (annual expenses exceed 10% of income) and incomes at or below 300% of the federal poverty level are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Part I, Line 7: Lines 7a and 7b were converted to cost based on an average ratio of costs to gross charges. Lines 7e, 7f, and 7i were based on actual expenses. 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 $ 2,696,490. Part II, Community Building Activities: Activities include: Provide free office space for health and economic-development organizations within the community, community collaboration through community health improvement advocacy, physician recruitment to ensure basic care is available locally, sponsor annual health fair with free and low cost health screening, collaborate with other emergency services on disaster and emergency preparedness, provide wellness fairs for the Navy Base and Water District, assist with planning for an aquatic center, and donate funds to aid hurricane victims, a local women's shelter in obtaining transportation, and exercise equipment for a local park. Part III, Line 2: Patient A/R consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages its receivables by regularly reviewing the accounts, inquiring with respective payors as to collectability and providing for allowances on their accounting records for estimated contractual adjustments and uncollectible accounts. Bad debt is reported at charges per the audited financials. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in footnote 1 on page 8 and 9 of the attached financial statements. Part III, Line 8: One hundred percent of any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole. Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: RRH will make reasonable efforts to provide patients with information about its financial assistance policy before it or its agency representatives take extraordinary actions to collect a patient's bill. RRH shall not knowingly assign an account to a collection agency if the patient has a pending application for a County, State, or Federal health assistance program. For a patient who lacks insurance coverage or a patient who provides information that he or she may be a patient with High Medical Costs, neither RRH, nor any assignee of the hospital or other owner of the patient debt, including a collection agency, shall report adverse information to a credit reporting bureau or engage in extraordinary debt collection activities at any time prior to 150 days after the first billing, and only after providing a thirty day notice of the extraordinary debt collection activities that will be commenced. Part VI, Line 2: In addition to the community health needs assessment Ridgecrest uses patient satisfaction surveys to assess the health care needs of the community, along with conducting blood draws at health fairs. The HR administrator serves on the local Rotary as well to network with other community leaders. Part VI, Line 3: Signs are posted in registration areas informing patients of assistance with their bills and includes citing a phone number to call for assistance in this area. Self pay patients are sent a packet of information regarding financial assistance programs. Part VI, Line 4: Rural California Desert Community located in Kern County; more than 50 miles from next nearest hospital. The population is approximately 38,000 and approximately 6.8% of that population is uninsured. Part VI, Line 5: Ridgecrest Regional Hospital's governing body is comprised of persons who reside in the Organization's primary service area. The Hospital applies any surplus funds to improve the Facility and equipment to improve patient care. The Hospital also extends medical staff privileges to other qualified physicians in the community.Ridgecrest Regional Hospital holds an annual health fair for the community, wherein vendors offer information and services related to health and wellness, along with free and reduced-priced blood screenings. A health fair at China Lake Naval Base is also held, wherein information on health and nutrition are provided. Ridgecrest Regional Hospital offers free blood pressure checks and veteran benefit information for Veteran's Standdown, an event held to provide benefits and services to veterans. Ridgecrest Regional Hospital offers 16 weekly classes to seniors within the community, free of charge, that promote exercise, as well as senior group services catered to finding joy and happiness in life while socializing and building support systems. The following support groups are offered free of charge to the community: Grief, Caregiver, Alzheimer's Caregiver, Better Breathers, and Diabetes. The Wellness Resource Center provides free access to information on health and nutrition, including videos and books. In addition, the Wellness Resource Center provides nutrition programs, cooking classes, and presentations to schools, churches, businesses, parents, and other organizations. Hospital tours are provided to students and other groups within the community. An annual publication, mailed to all homes within the community and available at Ridgecrest Regional Hospital, lists all services and providers at Ridgecrest Regional Hospital. A brochure provides information for local mental health services. Connected, a quarterly publication, focuses on Ridgecrest Regional Hospital's services, along with health tips and information. Part VI, Line 6: N/A X X X 0 0 0 0 0 0 0 0 0 Lawrence Cosner MD Director/Physician 229944 0 0 0 549 0 0 0 36799 0 267292 0 0 0 James Suver CEO 302437 0 132723 0 13061 0 10800 0 12584 0 471605 0 0 0 Healthy Desai Orthopedic Surgeon 659893 0 0 0 88 0 10338 0 36654 0 706973 0 0 0 Hope Zissos MD Family Practice Physician 260797 0 0 0 224 0 10800 0 39349 0 311170 0 0 0 Aisha Rollins Pediatrician 293810 0 0 0 88 0 7581 0 12102 0 313581 0 0 0 Christian Schwartz Physician Assistant 214806 0 4500 0 66 0 8424 0 12102 0 239898 0 0 0 Luigi Cendana Pediatrician 248443 0 0 0 43 0 0 0 689 0 249175 0 0 0 Gul Anwar Former Highly Compensated Employee Personal X 40000 3150 0 0 1 3150 Kathryn Garcia Family of Board Member Lawrence Cosner 62047 Wages 0 Mark Mower Family of Treasurer Michael Mower 97566 Wages 0 Mary Rusher Family of Treasurer Michael Mower 45895 Wages 0 X 1 219990 FMV from Appraisal 0 0 0 Form 990, Part III, line 2 A cancer center was established and related services began 11/09/17. An additional surgery center was established and related services began 03/01/17. The retail pharmacy began operations in 2017. Form 990, Part VI, Section A, line 4 In 2017, RRH revised its bylaws. Any Directors elected to fill a vacancy in the Board shall hold office for the remainder of that vacancy's original term. The Chair shall now be ex-officio a voting member of all standing committees. The Chief of Medical Staff is now required to attend the open sessions of regular and special meetings. The Administrator of Patient Care Services is now the Chief Operating Officer, who is to attend open sessions of meetings. The CFO shall also attend all open session meetings. The bylaws shall be reviewed every two years, or as deemed necessary by the Board. Form 990, Part VI, Section A, line 6 There is one class of members, Corporate Members and an honorary nonvoting group of individuals called Emeritus Members who are appointed by the Board of Directors and have limited rights. Corporate Membership is limited to thirty (30) persons, who must reside in the Hospital service area (as such service area is determined by the Board of Directors) who are elected to membership by a vote of the Corporate Members present or represented at a meeting of Corporate Members. Form 990, Part VI, Section A, line 7a The Corporate Members have the right to elect the members of the Board of Directors. Form 990, Part VI, Section A, line 7b Under the bylaws, the Corporate Members have the right to: elect the members of the Board of Directors; fill a vacancy on the Board of Directors; and ratify the bylaws that have been approved by the Board of Directors. In addition, members have certain rights granted pursuant to the California Nonprofit Public Benefit Corporation Act including the right to: remove a director; approve most amendments to the Articles of Incorporation; approve a sale of assets not in the usual and regular course of its business; merge with another entity; and dissolve. Form 990, Part VI, Section A, line 8b The organization does not have any committee with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the Board of Directors via electronic distribution prior to filing with the IRS. Form 990, Part VI, Section B, line 12c There is annual disclosure on conflict of interest policy for directors, officers, medical staff officers, and administrative employees, and corporate members. Compliance with conflict of interest policy is monitored by the CEO. Any noted conflicts are reviewed and discussed by the Board of Directors. The individual with the potential conflict must abstain from the discussion and vote on the potential conflict. Form 990, Part VI, Section B, line 15 Compensation for the CEO was determined by a compensation committee of the Board of Directors using compensation comparison provided by HASC. For other officers, the HASC salary survey is used to comply with prohibition from direct solicitation of salary information due to anti-trust regulations. Form 990, Part VI, Section C, line 19 All public documents are made available upon request. Form 990, Part IX, line 11g Other Purchased Services: Program service expenses 9,211,840. Management and general expenses 1,834,492. Fundraising expenses 0. Total expenses 11,046,332. Professional Fees: Program service expenses 14,938,625. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,938,625. Other Fees: Program service expenses 1,022,175. Management and general expenses 802,325. Fundraising expenses 0. Total expenses 1,824,500. RRH Development Foundation 1081 N China Lake Blvd Ridgecrest CA 93555 464181603 Raising Hospital Capital Equipment Funds CA 501(c)(3) Line 7 Ridgecrest Regional Hospital 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0