LODI MEMORIAL HOSPITAL ASSOCIATION INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: LODI MEMORIAL HOSPITAL ASSOCIATION INC (EIN 94-1044474)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-15
IRS object ID: 201743199349308884
Schema version: 2016v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-15T12:45:46-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	910189318	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Moss Adams LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	3121 W March Ln Ste 200	AddressLine1Txt
City	Stockton	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	952192367	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	941044474	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LODI MEMORIAL HOSPITAL ASSOCIATION INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	LODI	BusinessNameControlTxt
Phone	2093343411	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	975 S Fairmont Avenue	AddressLine1Txt
City	Lodi	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	952405118	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Paul Ziegele	PersonNm
Person Title	VP/CFO	PersonTitleTxt
Phone	2093343411	PhoneNum
Signature	2017-11-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Tracy S Paglia	PreparerPersonNm
PTIN	P00366884	PTIN
Phone	2099556100	PhoneNum
Preparation	2017-11-15	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	73.90.207.82	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2017-11-15	IPDt
IP Tm	02:22:46	IPTm
IP Timezone	PS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	189799C539B232A8D1FA5D0851A612580EB85C47	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	LODI HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DANIEL WOLCOTT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	975 S Fairmont Avenue	AddressLine1Txt
City	Lodi	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	952405118	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$253,059,370	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	https://www.adventisthealth.org/lodimemorial/page	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1945	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	Living God's love by inspiring health, wholeness and hope.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	1616	TotalEmployeeCnt
Total Volunteers	123	TotalVolunteersCnt
Total Gross UBI	$53,503	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$17	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,224,792	PYContributionsGrantsAmt
CY Contributions Grants	$215,942	CYContributionsGrantsAmt
PY Program Service Revenue	$204,432,429	PYProgramServiceRevenueAmt
CY Program Service Revenue	$231,546,547	CYProgramServiceRevenueAmt
PY Investment Income	$4,925,344	PYInvestmentIncomeAmt
CY Investment Income	$681,473	CYInvestmentIncomeAmt
PY Other Revenue	$87,377	PYOtherRevenueAmt
CY Other Revenue	$225,087	CYOtherRevenueAmt
PY Total Revenue	$211,669,942	PYTotalRevenueAmt
CY Total Revenue	$232,669,049	CYTotalRevenueAmt
PY Grants And Similar Paid	$126,021	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$75,833	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$105,013,818	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$109,753,743	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$356,051	CYTotalFundraisingExpenseAmt
PY Other Expenses	$103,321,076	PYOtherExpensesAmt
CY Other Expenses	$140,211,372	CYOtherExpensesAmt
PY Total Expenses	$208,460,915	PYTotalExpensesAmt
CY Total Expenses	$250,040,948	CYTotalExpensesAmt
PY Revenues Less Expenses	$3,209,027	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$17,371,899	CYRevenuesLessExpensesAmt
Total Assets BOY	$253,223,534	TotalAssetsBOYAmt
Total Assets EOY	$233,497,008	TotalAssetsEOYAmt
Total Liabilities BOY	$160,987,673	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$158,334,613	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$92,235,861	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$75,162,395	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Living God's love by inspiring health, wholeness and hope.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$172,167,873	ExpenseAmt
Grant	$75,833	GrantAmt
Revenue	$225,686,559	RevenueAmt
Desc	LODI MEMORIAL HOSPITAL IS A NON-PROFIT, ACUTE CARE HOSPITAL PROVIDING HIGH QUALITY SERVICES THAT PROMOTE HEALTH AND REHABILITATION, PREVENT DISEASE, AND TREAT AND CARE FOR THE SICK AND INJURED. HOSPITAL STAFF, MEDICAL STAFF AND THE GOVERNING BOARD ARE DEDICATED TO TREATING ALL PATIENTS AND VISITORS AS INDIVIDUALS WITH EQUAL DIGNITY, RESPECT AND QUALITY OF CARE.LODI MEMORIAL HOSPITAL TREATS AND PROVIDES CARE TO ITS PATIENTS THROUGH INPATIENT AND OUTPATIENT SERVICES. INPATIENTS RECEIVE CARE THROUGH MEDICAL-SURGICAL, PERI-OPERATIVE, PERI-NATAL, PEDIATRIC, INTENSIVE CARE, AND ACUTE-PHYSICAL REHABILITATION SERVICES.OUTPATIENT CARE INCLUDES 24-HOUR EMERGENCY, DIAGNOSTIC SERVICES, SURGERY, REHABILITATION AND EDUCATION.LODI MEMORIAL HOSPITAL IDENTIFIES THE HEALTH-CARE AND HEALTH MAINTENANCE NEEDS AND PREFERENCES OF THE COMMUNITY IT SERVES. DIAGNOSTIC, REHABILITATIVE, EDUCATIONAL, TREATMENT AND PREVENTATIVE SERVICES ARE DEVELOPED AS APPROPRIATE FOR A HOSPITAL OF THIS SIZE AND ROLE.LODI MEMORIAL HOSPITAL, CONSISTENT WITH ITS NON-PROFIT STATUS, DEVELOPS FINANCIAL RESOURCES TO ADEQUATELY SUPPORT HEALTH MAINTENANCE AND PATIENT-CARE SERVICES; CHARITY CARE FOR THOSE UNABLE TO PAY, WORKING CAPITAL NEEDS; AND CAPITAL REQUIREMENTS OF PLANT, EQUIPMENT AND EVOLVING TECHNOLOGY. EVERY EFFORT IS MADE TO KEEP COSTS AFFORDABLE FOR PATIENTS WHILE CONTINUOUSLY STRIVING TO IMPROVE THE QUALITY OF SERVICE.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$21,985,851	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$5,859,988	RevenueAmt
Desc	LODI MEMORIAL COMMUNITY CLINICS ARE LICENSED UNDER THE DEPARTMENT OF PUBLIC HEALTH SERVICES REGULATIONS, AND ARE OWNED AND OPERATED BY THE LODI MEMORIAL HOSPITAL ASSOCIATION, INC., A NOT-FOR-PROFIT ENTITY AND WILL PROVIDE MEDICAL CARE TO ANY AGE. A COMMUNITY CLINIC UNIT OFFERS SERVICES DURING POSTED HOURS OF BUSINESS, WITH AT LEAST ONE PHYSICIAN EXPERIENCED IN THE COMMUNITY CLINIC PRACTICE. SPECIALTY CONSULTATION WILL BE AVAILABLE BY PHONE OR REFERRAL TO MEMBERS OF THE MEDICAL STAFF. IN 2016, FOUR (4) COMMUNITY CLINICS WERE LICENSED AND OPERATIONAL.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$194,153,724	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	517	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1616	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PAUL ZIEGELE CFO & VICE PRESIDENT	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	2093343411	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	975 S FAIRMONT AVE	AddressLine1Txt
City	LODI	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95240	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DICKINSON CHARLES
AHSW Director	0.00	4.00	Yes (X)	$0	$217,464	$0
FREEDMAN JOHN
AHSW Director	0.00	4.00	Yes (X)	$0	$300	$0
FRIESTAD CHRISTINE
AHSW Director	0.00	4.00	Yes (X)	$0	$968	$0
GABRIEL MELODY
AHSW Director	0.00	4.00	Yes (X)	$0	$2,269	$0
GRAHAM RICARDO
AHSW Director	0.00	4.00	Yes (X)	$0	$4,246	$0
HEINRICH KERRY
AHSW Director	0.00	4.00	Yes (X)	$0	$683	$0
INNOCENT LARRY
AHSW Director	0.00	4.00	Yes (X)	$0	$1,503	$0
REIMCHE ALLAN
AHSW Director	0.00	4.00	Yes (X)	$0	$4,407	$0
RIPPEY WESLEY
AHSW Director	0.00	4.00	Yes (X)	$0	$129,770	$0
SALAZAR VELINO
AHSW Director	0.00	4.00	Yes (X)	$0	$3,915	$0
TORKELSEN MAX
AHSW Director	0.00	4.00	Yes (X)	$0	$4,102	$0
REINER SCOTT
AHSW Director/Chair	0.00	50.00	Yes (X)	$0	$1,711,534	$286,273	Yes (X)
WING BILL
AHSW Director/Vchair/Asst Sec	0.00	50.00	Yes (X)	$0	$1,319,055	$238,355	Yes (X)
JOBE MEREDITH
AHSW Secretary	0.00	50.00		$0	$552,085	$99,823	Yes (X)
WAGNER JACK
AHSW Asst Sec	0.00	50.00		$0	$1,117,705	$41,826	Yes (X)
WOLCOTT DANIEL
AHSW President/CEO	0.00	50.00		$0	$510,936	$53,717	Yes (X)
DEAK TERRENCE Thru 93016
AHSW VP/CFO/Asst Sec	0.00	50.00		$0	$245,251	$32,971	Yes (X)
ZIEGELE PAUL
AHSW VP/CFO	0.00	50.00		$0	$141,245	$21,206	Yes (X)
MORENO DEBBE
AHSW VP/CNO	0.00	50.00		$0	$260,947	$37,622		Yes (X)
WHITNEY JASON
VP Ops/AVP Bus Dev Integration	50.00	0.00		$176,314	$0	$29,765		Yes (X)
BROWN MARY
RN Supervisor/Nursing Admin	51.00	0.00		$208,761	$0	$38,610			Yes (X)
BECK ATWATER SANDRA
Director Hospital Pharmacy	45.00	0.00		$194,079	$0	$27,800			Yes (X)
LOEHRER HEIDI
RN Manager/Surgery	44.50	0.00		$170,381	$0	$36,913			Yes (X)
WALLACE MARK
Director Human Resources	45.00	0.00		$169,202	$0	$36,330			Yes (X)
WALLACE KENT
Director Perioperative Services	45.00	0.00		$166,225	$0	$33,799			Yes (X)
GILL PARAMPAL MD
Former Board Member	0.00	0.00		$308,445	$0	$0				Yes (X)
McLOUGHLIN TRAVERS MD
Former Board Member	0.00	0.00		$16,320	$0	$0				Yes (X)
SORBERA THOMAS MD
Former Board Member	0.00	0.00		$84,690	$0	$0				Yes (X)
HARRINGTON JOSEPH
AHSW Former President/CEO	0.00	0.00		$0	$421,892	$20,279				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,494,417	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$6,650,277	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,035,289	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	278	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ADVENTIST HEALTH PHYSICIANS NETWORK
2100 DOUGLAS BLVD	ROSEVILLE	CA	95661	PHYSICIAN PROFESSIONAL SERVICES - CLINIC	$9,744,107
THE REGENTS OF THE UC-DAVIS
1200 DUTTON HALL - ONE SHIELDS AVE	DAVIS	CA	95616	PHYSICIAN PROFESSIONAL SERVICES - HOSPIT	$7,037,635
CEP AMERICA - ANESTHESIA PC
2100 POWELL ST SUITE 900	EMERYVILLE	CA	94608	PHYSICIAN PROFESSIONAL SERVICES - ANESTH	$1,316,473
MORPHEUS ANESTHESIA INC
999 S FAIRMONT AVE SUITE 110	LODI	CA	95240	PHYSICIAN PROFESSIONAL SERVICES - ANESTH	$687,251
SATELLITE HEALTHCARE INC
300 SANTANA ROW SUITE 300	SAN JOSE	CA	95128	MANAGEMENT FEES-DIALYSIS UNIT	$624,824

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	44	CntrctRcvdGreaterThan100KCnt
Government Grants	$80,622	GovernmentGrantsAmt
All Other Contributions	$135,320	AllOtherContributionsAmt
Total Contributions	$215,942	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SVC REVENUE	621400	$227,417,940	$227,417,940
CAPITATION FEES	621990	$3,651,546	$3,651,546
Loss from Advanced Imaging Center	621400	-$80,445	-$80,445
LOSS FROM Artel LLC	621400	-$474,349	-$474,349
loss From AHPN Clinics	621400	-$660,736	-$660,736

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,692,591	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,692,591	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$231,546,547	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$736,800	TotalRevenueColumnAmt
Exclusion	$736,800	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$76,650	TotalRevenueColumnAmt
Exclusion	$76,650	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$188,616	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$182,176	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$6,440	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,440	TotalRevenueColumnAmt
Unrelated Business Revenue	-$17	UnrelatedBusinessRevenueAmt
Exclusion	$6,457	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$20,074,363	SecuritiesAmt
Other	$1,805	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$20,190,340	SecuritiesAmt
Other	$17,805	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$115,977	SecuritiesAmt
Other	-$16,000	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$131,977	TotalRevenueColumnAmt
Exclusion	-$131,977	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MANAGEMENT FEES	Desc
Business	541610	BusinessCd
Total Revenue Column	$64,520	TotalRevenueColumnAmt
Unrelated Business Revenue	$53,520	UnrelatedBusinessRevenueAmt
Exclusion	$11,000	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$154,127	TotalRevenueColumnAmt
Exclusion	$154,127	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$218,647	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$232,669,049	TotalRevenueColumnAmt
Related Or Exempt Func Income	$231,546,547	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$53,503	UnrelatedBusinessRevenueAmt
Exclusion	$853,057	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$75,833	TotalAmt
Program Services	$75,833	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$206,079	TotalAmt
Program Services	$149,968	ProgramServicesAmt
Management And General	$56,111	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$615,922	TotalAmt
Program Services	$448,218	ProgramServicesAmt
Management And General	$167,704	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$86,622,306	TotalAmt
Program Services	$62,877,095	ProgramServicesAmt
Management And General	$23,525,931	ManagementAndGeneralAmt
Fundraising	$219,280	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$3,761,821	TotalAmt
Program Services	$2,737,547	ProgramServicesAmt
Management And General	$1,024,274	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$12,285,273	TotalAmt
Program Services	$8,915,418	ProgramServicesAmt
Management And General	$3,335,770	ManagementAndGeneralAmt
Fundraising	$34,085	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$6,262,342	TotalAmt
Program Services	$4,557,223	ProgramServicesAmt
Management And General	$1,685,382	ManagementAndGeneralAmt
Fundraising	$19,737	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$289,872	TotalAmt
Program Services	$289,872	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$378,982	TotalAmt
Program Services	$18,628	ProgramServicesAmt
Management And General	$360,354	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$18,500	TotalAmt
Management And General	$10,000	ManagementAndGeneralAmt
Fundraising	$8,500	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$15,561	TotalAmt
Management And General	$15,561	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$38,624,323	TotalAmt
Program Services	$27,968,372	ProgramServicesAmt
Management And General	$10,630,134	ManagementAndGeneralAmt
Fundraising	$25,817	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$185,256	TotalAmt
Program Services	$134,814	ProgramServicesAmt
Management And General	$41,721	ManagementAndGeneralAmt
Fundraising	$8,721	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$27,175,518	TotalAmt
Program Services	$19,776,132	ProgramServicesAmt
Management And General	$7,397,387	ManagementAndGeneralAmt
Fundraising	$1,999	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$3,813,772	TotalAmt
Program Services	$2,775,353	ProgramServicesAmt
Management And General	$1,038,419	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$9,085,810	TotalAmt
Program Services	$6,611,914	ProgramServicesAmt
Management And General	$2,448,488	ManagementAndGeneralAmt
Fundraising	$25,408	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$209,765	TotalAmt
Program Services	$152,650	ProgramServicesAmt
Management And General	$56,000	ManagementAndGeneralAmt
Fundraising	$1,115	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$127,281	TotalAmt
Program Services	$92,625	ProgramServicesAmt
Management And General	$33,072	ManagementAndGeneralAmt
Fundraising	$1,584	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$11,991,289	TotalAmt
Program Services	$8,726,285	ProgramServicesAmt
Management And General	$3,265,004	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$566,965	TotalAmt
Program Services	$412,591	ProgramServicesAmt
Management And General	$154,374	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Bad Debts	$20,855,114	$20,855,114
Hosp Medi-cal Qlty Assu	$14,668,476	$14,668,476
Loss on Bond Debt Refin	$11,120,377	$11,120,377
Dues, Subscriptions, Bo	$338,400	$246,260	$82,335	$9,805

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$746,111	TotalAmt
Program Services	$542,959	ProgramServicesAmt
Management And General	$203,152	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$250,040,948	TotalAmt
Program Services	$194,153,724	ProgramServicesAmt
Management And General	$55,531,173	ManagementAndGeneralAmt
Fundraising	$356,051	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$210,421	BOYAmt
EOY	$237,066	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$38,009,386	BOYAmt
EOY	$21,357,581	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$372,079	BOYAmt
EOY	$974,714	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$31,657,599	BOYAmt
EOY	$49,640,461	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$244,156	BOYAmt
EOY	$176,025	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,291,288	BOYAmt
EOY	$3,713,633	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,676,736	BOYAmt
EOY	$1,377,919	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$264,900,631	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$121,659,010	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$152,132,296	BOYAmt
EOY	$143,241,621	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$10,650,055	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$9,444,962	BOYAmt
EOY	$11,349,737	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$5,534,556	BOYAmt
EOY	$1,428,251	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$253,223,534	BOYAmt
EOY	$233,497,008	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$22,197,349	BOYAmt
EOY	$24,464,570	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$133,625,000	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,165,324	BOYAmt
EOY	$133,870,043	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$160,987,673	BOYAmt
EOY	$158,334,613	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$91,688,521	BOYAmt
EOY	$74,600,052	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$547,340	BOYAmt
EOY	$562,343	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$92,235,861	BOYAmt
EOY	$75,162,395	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$253,223,534	BOYAmt
EOY	$233,497,008	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$17,371,899	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$240,566	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$57,867	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$15,561	OtherActivitiesAmt
Total Lobbying Expenditures	$15,561	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	A portion of dues paid to california hospital association & the hospital council of northern california are considered to be for lobbying activities.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,811,038	OtherCostOrOtherBasisAmt
Book Value	$9,811,038	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$614,559	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$127,143,507	OtherCostOrOtherBasisAmt
Depreciation	$49,402,764	DepreciationAmt
Book Value	$78,355,302	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,243,781	OtherCostOrOtherBasisAmt
Depreciation	$2,369,059	DepreciationAmt
Book Value	$874,722	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$116,383,063	OtherCostOrOtherBasisAmt
Depreciation	$67,641,370	DepreciationAmt
Book Value	$48,741,693	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,704,683	OtherCostOrOtherBasisAmt
Depreciation	$2,245,817	DepreciationAmt
Book Value	$5,458,866	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$143,241,621	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Conditional Asset retirement	$907,629
Workers Compensation	$4,109,882
Malpractice Liability	$459,684
Note Payable to Parent	$128,392,848

Field	Value	IRS element (for citing)
Total Liability	$133,870,043	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$492,109	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$492,109	NetCommunityBenefitExpnsAmt
Total Expense	0.00210	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$68,820,469	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$55,560,337	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,260,132	NetCommunityBenefitExpnsAmt
Total Expense	0.05790	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$69,312,578	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$55,560,337	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,752,241	NetCommunityBenefitExpnsAmt
Total Expense	0.06000	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$10,088,193	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,865,562	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,222,631	NetCommunityBenefitExpnsAmt
Total Expense	0.02720	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$112,693	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$29,864	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$82,829	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$7,838,992	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,864,475	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,974,517	NetCommunityBenefitExpnsAmt
Total Expense	0.00860	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$449,081	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$150,011	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$299,070	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,488,959	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,909,912	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,579,047	NetCommunityBenefitExpnsAmt
Total Expense	0.03750	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$87,801,537	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$65,470,249	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,331,288	NetCommunityBenefitExpnsAmt
Total Expense	0.09750	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$364,923	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$364,923	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$364,923	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$364,923	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$18,930,611	BadDebtExpenseAmt
Bad Debt Expense Attributable	$5,679,183	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$49,743,048	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$52,524,640	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,781,592	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 ADVANCED IMAGING CENTER AT LODI MEMORIAL HOSPITAL LLC
DIAGNOSTIC IMAGING CENTER (WITH MRI)	0.51000	0.00000	0.49000
2 Lodi Outpatient Surgery Center
Ambulatory Surgery Center	0.78000	0.00000	0.22000
3 Endoscopy Center of Lodi LLC
Ambulatory Surgery Center	0.78000	0.00000	0.22000

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Facility Reporting GroupFacilityReportingGroupCd	Address Line2USAddress/AddressLine2Txt
LODI MEMORIAL HOSPITAL
1	975 S Fairmont Ave	Lodi	CA	95240	adventisthealth.org	030000056	Yes (X)	Yes (X)	Yes (X)	GENERAL ACUTE CARE BEDS = 190	A
LODI MEMORIAL HOSPITAL - WEST
2	800 LOWER SACRAMENTO ROAD ACUTE	lodi	CA	95242	adventisthealth.org	030000056	Yes (X)	Yes (X)		Outpatient Departments at this Campus	A	PHYS

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Facility Reporting Group - A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	adventisthealth.org/lodimemorial/pages/mission/community-benefits.aspx	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	adventisthealth.org/Documents/Community%20Benefits/CHP%202017/Final_2017_CH	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.adventisthealth.org/pages/financial-assistance.aspx	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://www.adventisthealth.org/pages/financial-assistance.aspx	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.adventisthealth.org/pages/financial-assistance.aspx	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: LODI MEMORIAL HOSPITAL, - Facility 2: LODI MEMORIAL HOSPITAL - WEST
Facility Reporting Group - A Part V, Section B, line 5:	Lodi Health began the health needs assessment process by partnering with Harder+Company Community Research along with a full consortium of partners in the San Joaquin County area. This collaboration allowed for a more comprehensive assessment, along with the opportunity for synergy between health systems to more fully address key issues impacting the shared community.Harder+Company Community Research is known for excellence in conducting and facilitating community health needs assessments. By facilitating the process, clients are aided in the gathering of information that provides necessary information to enable the creation and implementation of plans designed to make positive change in their community. Through collaboration, the consortium was informed of common themes throughout the global area service area as well as disparities existing within local communities. Using this data enables the collaborative to work together to achieve social impact through meaningful program evaluation and strategic planning efforts.While Harder+Company Community Research led the process, the Core Planning Group included representatives from:- Dameron Hospital Association- Community Medical Centers- Community Partnerships for Families- First 5 San Joaquin- Health Net- Health Plan of San Joaquin- Kaiser Permanente- Lodi Health- San Joaquin County Public Health Services- St. Joseph's Medical Center- Sutter Tracy Community HospitalWorking in collaboration with other health systems, insurance companies, non-hospital health providers broadened the perspective and provided a more informed process for the work group. Interviews and secondary data collection was completed by the Harder+Company Community Research team. To evalutate both the global and local findings related to the Lodi Health PSA and SSA, two committees were formed and utilized at the hospital level, the: Hospital Health Needs Assessment Committee (HHNAC) an internal team of employees at Lodi Health; and the Community Health Needs Assessment Committee (CHNAC) External stakeholders with some HHNAC representation. The CHNAC consists of key public health and community leaders representing needs of the ommunity at large as well as minority and other at risk segments.The Community Health Needs Assessment Committee consisted of community leaders with demonstrated connections within the community. These leaders also brought the ability to identify opportunities for change based on population health data, and an intimate working knowledge of the market. The CHNAC met twice and provided additional input via e-survey on this CHNA.(SEE CONTINUATION FOR PROCESS DESCRIPTION)
Facility Reporting Group - A Part V, Section B, line 6a:	Members of the committee included: - Daniel Wolcott, CEO of Lodi Health - Jason Whitney, AVP of Business Development - Valerie Cronin, Director of Case Management - Chris Hagen, Spiritual Care Services - Desiree Magnant, Lodi Health Community Health Needs Assessment Coordinator - Barbara Alberson, Chief, State/Local Injury Control Section at CA Dept of Public Health - Jeff Hood, City of Lodi Parks and Recreation Director - Taj Khan, California Islamic Center President - Sally Snyde, WOW Science Museum - John Gordon, Galt School Board Member - Inez Kiriu, City of Galt - Joseph Woelfel, Director of Patient Care Clinic, University of the Pacific
Facility Reporting Group - A Part V, Section B, line 11:	AFTER PRIORITIZING THE HEALTH NEEDS, THE HOSPITAL AND ITS COMMUNITY PLANNING GROUP DETERMINED THAT RESOURCES WERE NOT AVAILABLE TO ADDRESS ALL EIGHT HEALTH PRIORITIES IDENTIFIED IN THE CHNA. IT PRIORITIZED ITS FOCUS TO THE TOP FIVE THAT WERE MOST ALIGNED WITH THE HEALTH SYSTEM'S CORE MISSION, CAPABILITIES AND RESOURCES. THOSE SELECTED TO BE ADDRESSED WERE ACCESS TO CARE, CULTURALLY APPROPRIATE CARE, HEALTH LITERACY AND HEALTH EDUCATION, ACCESS TO MENTAL HEALTH SERVICES AND SAFE AND AFFORDABLE PLACES TO EXERCISE. THOSE THAT WILL NOT BE DIRECTLY ADDRESSED ARE RELIABLE TRANSPORTATION, AFFORDABLE DENTAL SERVICES AND ACCESS TO HEALTHY FOOD.FACILITY REPORTING GROUP ASCH H, PART V, SECTION B, LINE 5, CONTINUATION:THE PROCESS:THE LODI HEALTH BOARD OF DIRECTORS' STRATEGICPLANNING COMMITTEE IS CHARGED WITH DEVELOPING AND MONITORING THE SYSTEM'S STRATEGIC PLAN. THEIR PROCESS IS:* ANNUALLY REVIEW THE EXTERNAL HEALTHCARE ENVIRONMENT, INCLUDING NEW AND UPDATED INFORMATION FROM THE: CALIFORNIA HEALTHCARE ASSOCIATION (CHA) "VIEW OF THE FUTURE" LATEST RELEASE; AMERICAN HOSPITAL ASSOCIATION (AHA) "VISION OF THE FUTURE" LATEST RELEASE; AND MAJOR NATIONAL, STATE AND LOCAL EVENTS THAT HAVE OR MAY AFFECT OUR LOCAL MARKET.* ANNUALLY REVIEW THE INTERNAL ENVIRONMENTS, INCLUDING: AUDITED FINANCIALS FOR THE LAST THREE YEARS FOR TRENDS; MARKETSHARE INFORMATION, FOR SYSTEM AND ALL BUSINESS LINES, I.E. INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, HOMEHEALTH AGENCY, ACUTEPHYSICAL REHABILITATION AND CLINICS; PAYER MIX BY SERVICE AND ZIP CODE; UTILIZATION DATA; LIST OF MAJOR EMPLOYEE, BOARD AND MEDICAL STAFF ISSUES CURRENTLY OPEN/IN PROGRESS; COMMUNITYNEEDS ASSESSMENT AND BENEFIT PLAN; QUALITY PERFORMANCE, CLINICAL AND PATIENT SATISFACTION; EMPLOYEE SATISFACTION; PHYSICIAN SATISFACTION; AND INFORMATIONTECHNOLOGY CAPABILITIES.* REVIEW THE FINDINGS AND RECOMMENDATIONS OF THE COMMUNITYNEEDS ASSESSMENT, CONDUCTED EVERY THREE YEARS, TO DETERMINE THE COMMUNITY'S HEALTH STATUS AND NEED FOR HEALTH SERVICES AND INTEGRATE THOSE INTO THE SYSTEM'S STRATEGIC PLAN. ANNUALLY, THE NEEDSASSESSMENT FINDINGS SHALLBE REVISITED PRIOR TO EACH APRIL MEETING TO ASSESS WHETHER LODI HEALTH, WITHIN THE REALM OF ITS RESOURCES, CAN OR SHOULD DEVELOP PROGRAMS AND SERVICES TO MEET COMMUNITY NEED AND/OR WORK WITH OTHER LOCAL HEALTH PROVIDERS, SCHOOLS AND ORGANIZATIONS TO MEET COMMUNITYHEALTH NEEDS FOR WELLNESS, PREVENTION AND TREATMENT.* ANNUALLY REVIEW THE SYSTEM MISSION, VISION AND VALUES FOR BOARD APPROVAL AT ITS MAY MEETING.* ANNUALLY DEVELOP LONG AND SHORTTERM GOALS AND OBJECTIVES FOR SUBMISSION TO THE BOARD FOR APPROVAL.

Field	Value	IRS element (for citing)
Facility	8	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - LODI MEMORIAL HOSP HOME HEALTH AGENCY
800 S LOWER SACRAMENTO RD	lodi	CA	95242	HOME HEALTH AGENCY
2 - LODI MEMORIAL COMM CLINIC - MILLSBRIDGE
1901 KETTLEMAN LANE SUITE 200	lodi	CA	95242	COMMUNITY CLINiC
3 - LODI OUTPATIENT SURGERY CENTER
521 S HAM LANE	LODI	CA	95242	Ambulatory Surgical Centers
4 - Endoscopy Center of Lodi LLC
840 S FAIRMONT AVE SUITE 1	LODI	CA	95240	AMBULATORY SURGERY CENTER
5 - LODI MEMORIAL COMMUNITY CLINIC - VINE
1235 W VINE ST SUITE 22	lodi	CA	95240	COMMUNITY CLINiC
6 - ADV IMAGING CENTER AT LODI MEM HOSP LLC
1031 S FAIRMONT AVENUE	lodi	CA	95240	DIAGNOSTIC IMAGING OUTPATIENT CENTER
7 - LODI MEMORIAL SURGICAL GROUP
999 S FAIRMONT AVENUE SUITE 100	LODI	CA	95240	COMMUNITY CLINC
8 - LODI MEMORIAL COMMUNITY CLINIC - TRINITY
10200 TRINITY PARKWAY SUITE 102	Stockton	CA	95219	COMMUNITY CLINiC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 7:	COST IS ASSIGNED UTILIZING OUR INTERNAL COST ACCOUNTING SYSTEM (EPSI). COST IS ESTIMATED BY UTILIZING RELATIVE VALUE UNITS ASSIGNED TO EACH PRODUCT (I.E. CHARGEABLE TEST, SUPPLY, OR PROCEDURE). EACH PRODUCT'S RELATIVE VALUE IS ESTIMATED BY EACH DEPARTMENT DIRECTOR BASED ON RESOURCES EXPENDED FOR EACH DEPARTMENT PRODUCT. DEPARTMENT COSTS ARE ALLOCATED TO EACH PRODUCT BASED ON ACCUMULATED RELATIVE VALUES. EACH PATIENT ACCUMULATES PRODUCTS DURING THEIR VISIT. THE TOTAL COST FOR EACH PATIENT REPRESENTS THE SUM OF ALL THE PRODUCTS PROVIDED TO THEM DURING THEIR VISIT OR INPATIENT STAY. THE ABOVE method IS THE CALCULATION FOR HOSPITAL CHARGES. FOR COMMUNITY CLINICS, HOSPITAL BASED CLINICS, HOSPITAL BASED HOME HEALTH AGENCY AND TWO SURGERY CENTER JOINT VENTURES A COST TO CHARGE RATIO WAS CALCULATED BASED ON THE DIRECT COSTS OF THESE LINES OF BUSINESS.
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 $ 20,855,114.
Part II, Community Building Activities:	SAN JOAQUIN COUNTY IS AMONG THE MOST DIFFICULT COUNTIES IN THE STATE WHEN IT COMES TO RECRUITING PHYSICIANS TO PRACTICE MEDICINE, AND THE HOSPITAL DEVOTES SIGNIFICANT FINANCIAL AND HUMAN RESOURCES TO THAT EFFORT. CURRENTLY THE HOSPITAL IS ATTEMPTING TO ESTABLISH A RESIDENCY PROGRAM IN CONJUNCTION WITH THE LOCAL COUNTY HOSPITAL, A TEACHING FACILITY, IN HOPES THAT ONCE PHYSICIANS COME TO PRACTICE HERE THEY WILL APPRECIATE THE REGION AND STAY AND ESTABLISH MEDICAL PRACTICE OR AFFILIATE WITH AN EXISTING PRACTICE. TOTAL PHYSICIAN RECRUITMENT COSTS = $334,606; OTHER HARD TO FILL RECRUITMENT COSTS = $30,317
Part III, Line 3:	WE PROVIDED CARE TO ALL WHO PRESENT THEMSELVES IN OUR EMERGENCY ROOM, WITHOUT ASKING FOR PROOF OF INSURANCE. IN THE THIRD YEAR OF THE ACA OUR UNINSURED POPULATION HAS INCREASED. UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE. OFTEN THE INFORMATION GATHERED IN THE MEDICAID APPLICATION WILL MAKE THIS DETERMINATION "AUTOMATIC". IF ADDITIONAL INFORMATION IS REQUIRED WE ATTEMPT TO CONTACT THE PATIENT. THOSE THAT DO NOT RESPOND WILL BE SENT TO A COLLECTION AGENCY AFTER 120 DAYS AND 4 STATEMENTS. WE ESTIMATE 30% OF OUR BAD DEBT EXPENSE SHOULD BE CONSIDERED CHARITY CARE.
Part III, Line 4:	COSTING METHODOLOGY:UTILIZING THE PREVIOUS COSTING METHODOLOGY AS OUTLINED IN RESPONSE TO PART I LINE 7, ALL PATIENTS ARE ASSIGNED A PAYOR CLASS (I.E. CHARITY, SELF PAY, MEDICARE, MEDI-CAL, MANAGED CARE). THE COST BY PAYOR IS A SUMMATION OF ALL PATIENTS IN THE ASSIGNED PAYOR CLASS. THE AMOUNTS WRITTEN OFF AS BAD DEBT (ASSIGNED TO A COLLECTION AGENCY) ARE NET OF ANY APPLICABLE PAYMENTS OR DISCOUNTS. ANY PAYMENTS RECEIVED AFTER AN ACCOUNT IS ASSIGNED TO A COLLECTION AGENCY REDUCE THE BAD DEBT EXPENSE IN THE PERIOD RECEIVED.OF THE TOTAL UNINSURED PATIENTS SEEN THIS YEAR: 25% QUALIFIED FOR CHARITY CARE AND 75% WERE WRITTEN OFF TO BAD DEBTS. IT IS DIFFICULT TO ASCERTAIN HOW MANY UNINSURED WRITTEN OFF TO BAD DEBTS WOULD QUALIFY FOR CHARITY CARE. ALL BAD DEBT WRITE OFFS ARE SENT TO A COLLECTION AGENCY. IF AN ACCOUNT QUALIFIES FOR CHARITY CARE AFTER BEING SENT TO AN AGENCY, NO FURTHER COLLECTION ACTIVITY IS PURSUED AND THE "BAD DEBT" ACCOUNT IS WRITTEN OFF IN FULL - WE HAVE NOT TRACKED THESE IN THE PAST AS PART OF OUR CHARITY CARE EXPENSE BUT ESTIMATE AT LEAST 30% OF OUR BAD DEBT COSTS REPRESENTS CHARITY CARE. UNCOMPENSATED CARE AND COMMUNITY BENEFIT COSTS:OUR POLICY IS TO PROVIDE SERVICE TO ALL WHO REQUIRE IT, REGARDLESS OF THEIR ABILITY TO PAY. AS SUCH, WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE. WHEN THIS CARE IS PROVIDED TO PATIENTS WHO LACK FINANCIAL RESOURCES AND THEREFORE ARE DEEMED MEDICALLY INDIGENT, IT IS CLASSIFIED AS CHARITY CARE. WHEN IT IS PROVIDED TO PATIENTS WHO HAVE THE MEANS TO PAY, BUT DECLINE TO DO SO, IT IS CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS. SOME UNDETERMINED PORTION OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS REPRESENTS CARE TO INDIGENT PATIENTS WHO WE HAVE BEEN UNABLE TO IDENTITY AS CHARITY. CHARITY CARE CHARGES ARE NOT REFLECTED IN NET PATIENT SERVICE REVENUES. IN ADDITION, WE PROVIDE SERVICES TO POOR AND UNDERSERVED PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED, INCLUDING PATIENTS INSURED UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS THAT ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND FREQUENTLY THE PAYMENTS ARE LESS THAN THE COSTS OF RENDERING THE SERVICES.PATIENT ACCOUNTS RECEIVABLE:PATIENT ACCOUNTS RECEIVABLE FOR SERVICES PROVIDED TO PATIENTS COVERED UNDER THE MEDICARE AND MEDICAID (MEDI-CAL IN CALIFORNIA) PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS (INCLUDING SELF-PAY) ARE RECORDED AT THEIR ESTIMATED REALIZABLE VALUE BASED ON CONTRACTUAL BILLING RATES OR OUR STANDARD BILLING RATES FOR OUR NON CONTRACTED PAYORS. WE REGULARLY REVIEW ACCOUNTS AND CONTRACTS AND PROVIDE APPROPRIATE ESTIMATES OF CONTRACTUAL ALLOWANCES THAT ARE THEN NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE. WE ALSO PROVIDE AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON OUR EVALUATION OF THE AGING OF OUR PATIENT ACCOUNTS RECEIVABLE, OUR HISTORICAL COLLECTION EXPERIENCE FOR EACH TYPE OF PAYOR AND OTHER RELEVANT FACTORS.OUR PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSISTS OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. WE GRANT CREDIT WITHOUT COLLATERAL TO OUR PATIENTS AND THIRD PARTY PAYORS.
Part III, Line 8:	THE COSTS OF PROVIDING CARE TO MEDICARE RECIPIENTS OFTEN EXCEED THE GOVERNMENT'S REIMBURSEMENT FOR THESE SERVICES. FOR COSTS ASSIGNED TO MEDICARE PATIENTS, PLEASE SEE RESPONSE IN PART III, LINE 4.COST TO CHARGE RATIOS (CCR) FROM THE FILED COST REPORT WERE UTILIZED TO CALCULATE MEDICARE COSTS. MEDICARE REVENUES FOR THESE SERVICES WERE $49,743,048; COSTS WERE $52,524,640.THE ALLOWABLE COSTS WERE CALCULATED ON THE COST REPORT BASED ON COST TO CHARGE RATIOS BY DEPARTMENT.
Part III, Line 9b:	UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE (FINANCIAL ASSISTANCE) POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE (FINANCIAL ASSISTANCE).
Part VI, Line 2:	EVERY THREE YEARS LODI MEMORIAL HOSPITAL ASSESSES COMMUNITY HEALTH NEEDS BY 1)CONSULTING WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY GROUPS TO REVIEW THE NEEDS OF EACH CONSTITUENCY; 2)REVIEWING SERVICE-AREA MORBIDITY AND MORTALITY HEALTH DATA PROVIDED BY THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES; 3)COMPILING SOCIO-ECONOMIC DATA TO DETERMINE WHERE THE GREATEST NEEDS EXIST WITHIN THE HOSPITAL-SERVICE AREA; AND 4)ASKING AREA RESIDENTS TO COMPLETE A HEALTH SURVEY REGARDING THEIR PERSONAL HEALTH AND NOTIONS ABOUT GOOD HEALTH. ONCE THE DATA IS COLLECTED, IT IS REVIEWED AND ASSESSED BY THE HOSPITAL'S COMMUNITY ADVISORY BOARD, BOARD OF DIRECTORS AND HOSPITAL MANAGERS TO DETERMINE WHAT SERVICES AND GAP AREAS MAY NEED ENHANCING OR ADDRESSING TO IMPROVE HEALTH WITHIN THE REALM OF THE HOSPITAL'S RESOURCES TO DO SO.
Part VI, Line 3:	SIGNS ARE PROMINENTLY POSTED IN THE ADMISSIONS, EMERGENCY AND BILLING DEPARTMENTS OF THE HOSPITAL, IN ADDITION TO ALL THE HOSPITAL CLINICS, TO ADVISE PATIENTS AND VISITORS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND HOW TO WORK WITH HOSPITAL STAFF TO OBTAIN IT. THE SAME INFORMATION IS INCLUDED IN PATIENT-ADMISSION PACKETS AND POSTED ON THE HOSPITAL WEBSITE. HOSPITAL CASE MANAGERS ARE VIGILANT OF PATIENTS NEEDING FINANCIAL ASSISTANCE AND FOLLOW UP WITH THOSE IN NEED. FINANCIAL ASSISTANCE INCLUDES APPLYING FOR MEDICAID AS WELL AS CHARITY CARE.
Part VI, Line 4:	NEARLY ALL OF THE INDIVIDUALS SEEKING CARE FROM LODI MEMORIAL HOSPITAL RESIDE IN ONE OF FIVE COUNTIES: SAN JOAQUIN, SACRAMENTO, SOLANO, AMADOR, AND CALAVERAS. ABOUT HALF OF THE HOSPITAL'S PATIENTS RESIDES WITHIN A FIVE-MILE RADIUS OF THE HOSPITAL IN SAN JOAQUIN COUNTY. GEOGRAPHICALLY, THE HOSPITAL SITS AT THE NORTHERN END OF THE SAN JOAQUIN VALLEY WHERE THE RESIDENTS ARE AMONG THE POOREST AND LEAST EDUCATED OF ALL THE STATE'S COUNTIES. IN ADDITION, SAN JOAQUIN COUNTY HAS AMONG THE WORST UNEMPLOYMENT RATES IN THE STATE'S COUNTIES; NEARLY TWO IN 10 RESIDENTS ARE UNEMPLOYED. ALSO SAN JOAQUIN COUNTY IS GROUND-ZERO FOR THE MORTGAGE CRISIS IN THIS COUNTRY. THE COUNTY IS ALSO AMONG THE MOST VIOLENT COUNTIES IN WHICH TO LIVE IN THE COUNTRY DUE TO SIGNIFICANT GANG ACTIVITY, LOW LEVELS OF EDUCATION, AND POVERTY. HOSPITAL PATIENTS REPRESENT DIVERSITY: ABOUT 40 PERCENT ARE HISPANIC, WITH MANY OF THOSE PATIENTS BEING MONOLINGUAL SPANISH SPEAKERS. ANOTHER THREE PERCENT ARE PAKISTANI, MANY OF WHOM SPEAK ONLY URDU OR PASHTU. ADDITIONALLY THERE IS A SIGNIFICANT POPULATION OF HOSPITAL PATIENTS WHO ARE GREATER THAN 80 YEARS OF AGE. THE MAJOR HEALTH ISSUES OF PATIENTS ARE HEART DISEASE, STROKE, CANCER, DIABETES AND OBESITY.
Part VI, Line 5:	THE HOSPITAL CONDUCTS A MYRIAD OF ACTIVITIES TO PROMOTE COMMUNITY HEALTH. THOSE ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO: HEALTH FAIRS WITH FREE MEDICAL SCREENINGS FOR HIGH CHOLESTEROL, HIGH-BLOOD PRESSURE, DIABETES AND LOW-OXYGEN SATURATION LEVELS; REFERRALS TO FREE CLINICS OR LOCAL PHYSICIANS FOR THOSE WITH HIGH VALUES; A VARIETY OF LINKED VIDEOS TO THE HOSPITAL WEB PAGE, FACEBOOK PAGE, YOUTUBE PAGE, AND TWITTER RELATED TO HEALTH EDUCATION AND PREVENTION; A WELLNESS PROGRAM FOR HOSPITAL EMPLOYEES THAT IS ROOTED IN EXERCISE AND NUTRITION SO THAT EMPLOYEES MAY LEAD BY EXAMPLE; A MONTHLY NUTRITION COLUMN IN THE LOCAL NEWSPAPER; HOSPITAL STAFF SERVING ON THE BOARDS OF REGIONAL NGOS; DONATIONS OF MATERIALS AND EQUIPMENT TO NGOS; EMPLOYEE DONATIONS OF FOOD AND CLOTHING TO THE NEEDY. THE HOSPITAL IS ALSO THE SECOND LARGEST YEAR-ROUND EMPLOYER IN LODI, WITH EMPLOYEES REINVESTING THEIR EARNINGS IN THE LOCAL ECONOMY. THE HOSPITAL HAS ALSO ADOPTED THE MOST IMPOVERISHED, LARGEST AND MOST DIVERSE SCHOOL IN THE LOCAL SCHOOL DISTRICT TO HELP EDUCATE STUDENTS, PARENTS AND TEACHERS IN PREVENTION. IN THAT EFFORT, THE HOSPITAL HOSTS AT THE SCHOOL HEALTH AND EDUCATION FAIRS; PARTICIPATES IN CLASSROOM TEACHING AND HEALTH DEMONSTRATIONS; AND PARTICIPATES IN CAREERS FAIRS AT THE SCHOOL. DUE TO HAND-WASHING EDUCATION ALONE, THE SCHOOLS ABSENTEE RATES HAVE DECLINED DRAMATICALLY. FOR STUDENTS TO LEARN, THEY MUST BE IN SCHOOL; AND FOR SCHOOLS TO RECEIVE STATE FUNDING, THEY MUST MAINTAIN THEIR ATTENDANCE.
Part VI, Line 6:	THE HOSPITAL IS A MEMBER OF ADVENTIST HEALTH, A HEALTH CARE SYSTEM WHICH PROVIDES HEALTHCARE SERVICES IN DIVERSE MARKETS WITHIN THE WESTERN UNITED STATES. A MEMBER HOSPITAL MAY SHARE SOME SERVICES WITH OTHER MEMBER HOSPITALS IN ITS GEOGRAPHIC AREA, SUCH AS CLINICAL, MANAGEMENT AND SUPPORT SERVICES. USING TODAY'S TECHNOLOGY, HOSPITALS OUTSIDE THE GEOGRAPHIC AREA ARE ABLE TO PROVIDE SUPPORT THROUGH REMOTE SERVICES SUCH AS TELEPHARMACY AND ROBOTICS SURGERY. THE CORPORATE OFFICE PROVIDES IMPORTANT SHARED ADMINISTRATIVE SUPPORT FOR MEMBER HOSPITALS' RURAL HEALTH CLINICS AND HOME CARE AGENCIES, QUALITY OF CARE, OTHER CLINICAL NEEDS, FINANCING AND RISK MANAGEMENT, AND SHARED CLINICAL AND FINANCIAL INFORMATION TECHNOLOGY. AS MANY EXPERIENCED AND NEW PHYSICIANS SEARCH FOR ALTERNATIVES TO INDEPENDENT PRACTICE, THERE IS ALSO CORPORATE ADMINISTRATIVE SUPPORT FOR HOSPITAL AFFILIATED MEDICAL GROUPS THAT ENGAGE PHYSICIANS THROUGH EMPLOYMENT OR OTHER CONTRACTS. THIS PROVIDES STABILITY AND GROWTH OF QUALIFIED PHYSICIANS ACROSS MANY SPECIALTIES, WHICH IS VERY IMPORTANT TO MAKE HEALTHCARE SERVICES AVAILABLE AND TO MAINTAIN AND IMPROVE HEALTH WITHIN THE COMMUNITIES SERVED.
Part VI, Line 7, Reports Filed With States	CA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CALIFORNIA HEALTH FOUNDATION & TRUST	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1215 K St ste 800	AddressLine1Txt
City	sacramento	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95814	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	941498697	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$42,704	CashGrantAmt
Purpose Of Grant	HOSPITAL QA FEE PROGRAM PLEDGES	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	Through the use of temporarily restricted accounts, we track and monitor the incoming receipts from grants and the utilization of grant funds. Each grant is tracked separately. Should the grantor agency require specific reports, we comply with their reporting requirements. THE GRANTS WE MONITOR ARE SPECIFIC TO THE GRANTOR'S NEEDS AND REQUESTS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DICKINSON CHARLES
AHSW Director	$0	$184,932	$0	$0	$0	$32,532	$0	$0	$0	$0	$0	$217,464	$0	$0
REINER SCOTT
AHSW Director/Chair	$0	$1,018,912	$0	$299,575	$0	$393,047	$0	$249,575	$0	$36,698	$0	$1,997,807	$0	$326,648
WING BILL
AHSW Director/Vchair/Asst Sec	$0	$855,884	$0	$253,689	$0	$209,482	$0	$203,961	$0	$34,394	$0	$1,557,410	$0	$155,912
JOBE MEREDITH
AHSW Secretary	$0	$364,469	$0	$95,028	$0	$92,588	$0	$74,172	$0	$25,651	$0	$651,908	$0	$56,774
WAGNER JACK
AHSW Asst Sec	$0	$698,200	$0	$200,386	$0	$219,119	$0	$16,384	$0	$25,442	$0	$1,159,531	$0	$0
WOLCOTT DANIEL
AHSW President/CEO	$0	$370,180	$0	$115,875	$0	$24,881	$0	$16,180	$0	$37,537	$0	$564,653	$0	$0
DEAK TERRENCE Thru 93016
AHSW VP/CFO/Asst Sec	$0	$169,332	$0	$50,321	$0	$25,598	$0	$14,627	$0	$18,344	$0	$278,222	$0	$0
ZIEGELE PAUL
AHSW VP/CFO	$0	$121,225	$0	$5,000	$0	$15,020	$0	$6,811	$0	$14,395	$0	$162,451	$0	$0
MORENO DEBBE
AHSW VP/CNO	$0	$206,307	$0	$43,890	$0	$10,750	$0	$15,880	$0	$21,742	$0	$298,569	$0	$0
WHITNEY JASON
VP Ops/AVP Bus Dev Integration	$151,271	$0	$24,578	$0	$465	$0	$4,005	$0	$25,760	$0	$206,079	$0	$0	$0
BROWN MARY
RN Supervisor/Nursing Admin	$208,761	$0	$0	$0	$0	$0	$10,703	$0	$27,907	$0	$247,371	$0	$0	$0
BECK ATWATER SANDRA
Director Hospital Pharmacy	$186,075	$0	$7,500	$0	$504	$0	$9,421	$0	$18,379	$0	$221,879	$0	$0	$0
LOEHRER HEIDI
RN Manager/Surgery	$170,168	$0	$0	$0	$213	$0	$9,006	$0	$27,907	$0	$207,294	$0	$0	$0
WALLACE MARK
Director Human Resources	$161,198	$0	$7,500	$0	$504	$0	$8,423	$0	$27,907	$0	$205,532	$0	$0	$0
WALLACE KENT
Director Perioperative Services	$165,760	$0	$0	$0	$465	$0	$8,039	$0	$25,760	$0	$200,024	$0	$0	$0
GILL PARAMPAL MD
Former Board Member	$308,445	$0	$0	$0	$0	$0	$0	$0	$0	$0	$308,445	$0	$0	$0
McLOUGHLIN TRAVERS MD
Former Board Member	$16,320	$0	$0	$0	$0	$0	$0	$0	$0	$0	$16,320	$0	$0	$0
SORBERA THOMAS MD
Former Board Member	$84,690	$0	$0	$0	$0	$0	$0	$0	$0	$0	$84,690	$0	$0	$0
HARRINGTON JOSEPH
AHSW Former President/CEO	$0	$106,708	$0	$255,520	$0	$59,664	$0	$16,180	$0	$4,099	$0	$442,171	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 4b	FormAndLineReferenceDesc
Explanation	PRIOR TO AFFILIATION WITH ADVENTIST HEALTH, LMH HAD A 457(F) SERP WHICH IS LIMITED TO SELECT MEMBERS OF THE BOARD OF DIRECTORS OR AN AUTHORIZED OFFICER. THE AMOUNT OF THE DEFERRED SPECIFIED IN THE PARTICIPANT'S PARTICIPATION AGREEMENT OR, IF NOT SO MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. PARTICIPANTS ARE SELECTED BY COMPENSATION UNDER THE PLAN FOR A PARTICIPANT FOR A PLAN YEAR SHALL BE SPECIFIED, THE AMOUNT DETERMINED BY THE EMPLOYER FOR SUCH PLAN YEAR IN THE EMPLOYER'S SOLE AND ABSOLUTE DISCRETION. A PARTICIPANT BECOMES FULLY VESTED IN THE PARTICIPANT'S ACCOUNT UPON THE EARLIEST OF NORMAL RETIREMENT, DATE OF DEATH OR DATE OF DISABILITY WHILE STILL AN EMPLOYEE, DATE OF TERMINATION OR DEMOTION BY THE EMPLOYER IF THE EVENT OCCURS WITHIN THE TWELVE MONTH PERIOD FOLLOWING A CHANGE IN CONTROL, THE EMPLOYER'S INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE. IF THE PARTICIPANT CEASES TO BE AN EMPLOYEE PRIOR TO BECOMING FULLY VESTED, THE EMPLOYEE SHALL NOT BE ENTITLED TO ANY BENEFIT UNDER THIS PLAN. ANY AMOUNTS CREDITED TO A PARTICIPANT'S ACCOUNT THAT ARE NOT VESTED AT THAT TIME SHALL BE FORFEITED. DISTRIBUTIONS UNDER THE PLAN COMMENCE WITHIN 90 DAYS FOLLOWING VESTING AND NOT LATER THAN MARCH 15 OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR OF VESTING. JOSEPH P HARRINGTON, RETIRING CEO, SERP PAID OUT = $244,480 A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. REINER, SCOTT - $326,648 WING, BILL - $155,912 JOBE, MEREDITH - $56,774 Additional Information: The directors serve on the Board without compensation. Amounts reported generally are for taxable benefits. Further explanation for those directors who receive compensation for services rendered in their professional capacity is discussed for each individual as applicable. Mr. Dickinson was on the Board until June 1, 2016 at which time he tendered his resignation to accept a full-time position at Adventist Health System/West as the VP, Business Solutions. Wesley Rippey, MD is the Chief Medical Officer for Portland Adventist Medical Center. The hospital paid Dr. Rippey $66,000 for his CMO services. Additionally, Dr. Rippey provides vascular study interpretations and on call coverage for patients of the hospital. The hospital paid $61,909 for these professional services. These services were provided under contracts approved by the Board Compliance Committee.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	P GILL OBSTETRICS AND GYNECOLOGY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	>35% owned partnership by Parampal Gill, Current Board Member	RelationshipDescriptionTxt
Transaction	$206,467	TransactionAmt
Transaction	PHYSICIAN PROFESSIONAL SERVICE-OB CLINIC, PHYSICIAN RECUITMENT	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 6	The hospital is organized as a not-for-profit public benefit corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West.
Form 990, Part VI, Section A, line 7a	The hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital.
Form 990, Part VI, Section A, line 7b	The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws.
Form 990, Part VI, Section B, line 11b	The completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board after their review but prior to filing.
Form 990, Part VI, Section B, line 12c	During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process.
Form 990, Part VI, Section B, line 15	THE BOARD OF DIRECTORS HAS A CEO COMPENSATION COMMITTEE, WHO REVIEWS THE CEO'S PERFORMANCE AND COMPENSATION AT LEAST ANNUALLY WHOSE SPECIFIC RESPONSIBILITIES INCLUDE: SCHEDULING AND COMPLETING AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE, REVIEWING AND ESTABLISHING PERFORMANCE CRITERIA FOR THE CEO, AN ANNUAL REVIEW OF THE CEO'S JOB DESCRIPTION, SOLICITING INPUT FROM OTHER SOURCES ON CEO PERFORMANCE, ANNUALLY REVIEWING MARKET AREA COMPENSATION AND BENEFITS FOR HOSPITAL CEO TO DETERMINE FAIR MARKET VALUE COMPENSATION, ANNUALLY PROVIDE VERBAL AND WRITTEN FEEDBACK TO CEO ON PERFORMANCE. THE BOARD OF DIRECTORS HAS A CEO COMPENSATION COMMITTEE THAT ALSO ESTABLISHES A COMPENSATION PHILOSOPHY FOR CEO AND SENIOR MANAGEMENT, REVIEWS AND APPROVES THE CEO RECOMMENDATION FOR CAO, CNO, CFO AND VP COMPENSATION AND REVIEWS AND APPROVES MANAGEMENT COMMITTEE INCENTIVE COMPENSATION. IN ADDITION, LODI MEMORIAL HOSPITAL (LMH) PARTICIPATES IN AN ANNUAL COMPENSATION SURVEY SPONSORED BY THE CALIFORNIA HOSPITAL ASSOCIATION, THE HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA AND THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA. LMH SUBMITS THEIR WAGE AND SALARY DATA TO AN INDENDENDENT THIRD PARTY WHICH PRODUCES A REPORT BY JOB TITLE AND JOB DESCRIPTION THAT COMPARES SALARIES BY REGION WITHIN CALIFORNIA FOR ALL HOSPITALS WHO PARTICIPATE IN THE SURVEY.
Form 990, Part VI, Section C, line 19	AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST.
PART VII, SECTION A, LINE 1A	Lodi Memorial Hospital operates community clinics as defined by the California Health and Safety Code Section 1204(a). The Hospital enters into employment agreements with physicians for the professional services provided in the community clinics to the uninsured and underinsured populations in the community.
Form 990, Part IX, line 11g	Physician fees: Program service expenses 14,791,301. Management and general expenses 5,520,622. Fundraising expenses 0. Total expenses 20,311,923. Repairs & maintenance: Program service expenses 2,782,524. Management and general expenses 1,038,534. Fundraising expenses 0. Total expenses 3,821,058. Professional management fees: Program service expenses 4,244,315. Management and general expenses 1,584,123. Fundraising expenses 0. Total expenses 5,828,438. Other professional fees: Program service expenses 6,150,232. Management and general expenses 2,486,855. Fundraising expenses 25,817. Total expenses 8,662,904.
Form 990, Part XI, line 9:	INCOME OF SUBSIDIARY - VITAL -245,860. INCOME OF SUBSIDIARY - LRHS -93,924. BOOK/TAX K-1 DIFFERENCES 397,651.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (22 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
Adventist Health Clearlake Hospital Inc
15630 18th Ave	Clearlake	CA	95422	680395149	Hospital	CA	501(c)(3)	Line 3	Adventist Health System West	0
Castle Medical Center
640 Ulukahiki St	Kailua	HI	96734	990107330	Hospital	HI	501(c)(3)	Line 1	Adventist Health System West	0
Central Valley General Hospital
1025 N Douty St	Hanford	CA	93230	770324630	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Feather River Hospital
5974 Pentz Rd	Paradise	CA	95969	941101228	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Glendale Adventist Medical Center
1509 Wilson Ter	Glendale	CA	91206	951816017	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Hanford Community Hospital
115 Mall Dr	Hanford	CA	93230	940535360	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Northwest Med Fnd of Tillamook
1000 Third St	Tillamook	OR	97141	930622075	Hospital	OR	501(c)(3)	Line 1	Adventist Health System West	0
Paradise Valley Hospital
2100 Douglas Blvd	Roseville	CA	95661	951816034	Discontinued Operations	CA	501(c)(3)	Line 1	Adventist Health System West	0
Portland Adventist Medical Center
10123 SE Market St	Portland	OR	97216	930429015	Hospital	OR	501(c)(3)	Line 1	Adventist Health System West	0
St Helena Hospital
10 Woodland Rd	St Helena	CA	94574	941279779	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Simi Valley Hospital & Health Care Serv
2975 N Sycamore Dr	Simi Valley	CA	93065	956064971	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Sonora Community Hospital
1000 Greenley Rd	Sonora	CA	95370	941415069	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Ukiah Adventist Hospital
275 Hospital Dr	Ukiah	CA	95482	941639901	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Walla Walla General Hospital
1025 S Second Ave	Walla Walla	WA	99362	910617726	Hospital	WA	501(c)(3)	Line 1	Adventist Health System West	0
White Memorial Medical Center
1720 Cesar E Chavez Ave	Los Angeles	CA	90033	952282647	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Willits Hospital Inc
1 Marcela Drive	Willits	CA	95490	680108919	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Adventist Health Physicians Network
2100 Douglas Blvd	Roseville	CA	95661	680357690	Medical Foundation	CA	501(c)(3)	Line 12b, II	Adventist Health System West	0
Adv Hlth So California Med Fnd
2100 Douglas Blvd	Roseville	CA	95661	954424391	Discontinued Operations	CA	501(c)(3)	Line 12c, III-FI	Adventist Health System West	0
San Joaquin Community Hospital
2615 Chester Avenue	Bakersfield	CA	93301	952294234	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Reedley Community Hospital
372 W Cypress Ave	Reedley	CA	93654	453220509	Hospital	CA	501(c)(3)	Line 1	Adventist Health System West	0
Western Health Resources
2100 Douglas Blvd	Roseville	CA	95661	953867863	Home Care	CA	501(c)(3)	Line 1	Adventist Health System West	0
Adventist Health System West
2100 Douglas Blvd	roseville	CA	95661	953484589	Integrated Health System	CA	501(c)(3)	Line 1		0	N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ADVANCED IMAGING CENTER AT LODI MEMORIAL HOSPITAL LLC (AIC)
1001 S FAIRMONT AVE	lodi	CA	95240	943407786	Diagnostic Imaging / MRI Outpatient Treatment Center	CA	N/A	related	-$80,445	$421,139	0	0	0.51000
LODI SURGICAL VENTURES LLC (LSV)
975 S FAIRMONT AVE	LODI	CA	95240	454239289	Maj. owner of LLC operating Ambulatory Surgery Centers	CA	N/A	related	-$19,682		0	Yes (1)
ARTEL LLC
521 S HAM LANE	LODI	CA	95240	263513966	Ambulatory Surgical Centers	CA		related	-$474,349	$1,757,215	0	0	0.78000	Lodi Memorial Hospital Association Inc

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
VITAL ENTERPRISES DBA MEMORIAL HOME MED-EQUIP
1115 S Fairmont Ave Suite 1	lodi	CA	95240	680021729	Durable Medical Equipment Company	CA	N/A	C	$165,424	$373,713	1.00000	Yes (1)
LODI REGIONAL HEALTH SYSTEMS INC
975 S Fairmont Ave	lodi	CA	95240	680398894	Physician Management and Medical Office Building development & Management	CA	N/A	C	$1,532,410	$13,596,505	1.00000	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
LODI REGIONAL HEALTH SYSTEMS INC
O	$301,946	fMV
VITAL ENTERPRISES
O	$255,293	fMV
VITAL ENTERPRISES
Q	$320,430	FMV
LODI REGIONAL HEALTH SYSTEMS INC
K	$108,705	FMV
LODI REGIONAL HEALTH SYSTEMS INC
D	$3,616,342	Outstanding Loan Balance
LODI REGIONAL HEALTH SYSTEMS INC
P	$395,454	FMV
Artel LLC
B	$2,293,884	FMV
VITAL ENTERPRISES
A	$31,104	FMV