2017-08-15T11:59:28-05:00 2016-09-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2015-10-01 941502014 Southern Monterey County Memorial Hosp dba George L Mee Memorial Hospital SOUT 8313856000 300 Canal Street King City CA 93930 SUSAN M CHILDERS CEO 8313856000 2017-08-14 1 Renie Burbank P00159653 4159561500 2015 2021-01-29 14:40:06Z Mee Memorial Hospital SUSAN M CHILDERS 300 Canal Street King City CA 93930 62447900 0 X WWW.MEEMEMORIAL.COM X 1959 CA The Hospital provides comprehensive medical care to the local community and outlying areas within a 50-mile radius. 7 5 579 40 0 0 269549 320352 65319619 59848736 15752 46495 1403304 2204630 67008224 62420213 0 92038 0 0 36275641 34235313 0 0 0 27792318 32456075 64067959 66783426 2940265 -4363213 38099910 32855328 37313633 36428286 786277 -3572958 The Hospital provides comprehensive medical care to the local community and outlying areas within a 50-mile radius. 0 0 53192735 92038 59848736 The Hospital, is a 119-bed licensed facility that provides comprehensive medical care to the local community and outlying areas within a 50-mile radius. Types of care offered are acute, long-term, and rural health clinic services. Over the fiscal year, total patient days were 19,718. The Emergency service had over 13,000 visits and other Hospital services had over 30,000 other outpatient visits during the fiscal year. The clinics received over 67,000 visits in addition to the Hospital treatments. 53192735 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 224 0 1 579 1 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Stephen Omta 8313857162 300 Canal Street King City CA 93930 X Buttgereit Janet Chairman 2.00 X X 0 0 0 Nash Sarah Thru 716 Vice Chairman 2.00 X X 0 0 0 Borzini Roger Secretary/Treasurer 2.00 X X 0 0 0 Ramirez Gerry Board Member 2.00 X 0 0 0 Hovis Shirley Board Member 2.00 X 0 0 0 Ewart James Board Member 2.00 X 0 0 0 BumbaloughPaulette Thru 1215 Board Member 2.00 X 0 0 0 Schindelheim MD Roy Brd Member/Chf of Staff 40.00 X 279557 0 31523 Childers Susan CEO 40.00 X X 249665 0 34904 French Michael CFO 40.00 X 151723 0 16750 Hritz Kenneth COO 40.00 X 193243 0 31523 Salamacha Rena CIO 40.00 X 184593 0 42675 Eperjesi Jan Physician 40.00 X 355322 0 42675 Greenberg Bruce Physician 40.00 X 278250 0 31523 Montijo Sandra Physician 40.00 X 234678 0 42675 AlejandreHilda Physician 40.00 X 219203 0 15450 Mcghee James Physician 40.00 X 203101 0 42675 2349335 0 332373 59 0 1 0 Monterey Anesthesia Professionals 1522 Constitution Blvd 123 Salinas CA 93905 MEDICAL SERVICES 1393175 XTEND HEALTHCARE po box 1709 Hendersonville TN 37077 Patient AR Billing & Collections Agency 1269557 LETITIA BRADFORD MD 7485 RUSH RIVER SUITE 710-323 SACRAMENTO CA 95831 MEDICAL SERVICES 582092 CHIDI UKATU MD INC 10521 RUTHELEN STREET LOS ANGELES CA 90047 Medical Services 538023 Jacobus Consulting Inc 15375 Barranca Pkwy Suite B-202 Irvine CA 92618 Billing and Collections Services 418604 22 40195 280157 320352 Net PATIENT SERVICE REV. 621400 59848736 59848736 59848736 12457 12457 54545 27687 26858 26858 26858 34038 0 34038 34038 34038 OTHER OPERATING INCOME 900099 2039432 2039432 Cafeteria 900099 87783 87783 Rebates/Refunds 900099 50557 50557 2177772 62420213 59848736 0 2251125 X 92038 92038 1302556 354344 948212 20913163 20153282 759881 701661 666140 35521 8673677 7829587 844090 2644256 2599721 44535 212293 17953 194340 139559 139559 2997 2997 17380748 14709097 2671651 24056 24056 61123 51610 9513 623804 623804 1464879 127499 1337380 110446 80628 29818 1295739 1295739 2811781 2811781 372425 154952 217473 MEDICAL SUPPLIES 3639312 3629605 9707 Impairment Loss on Prop 1071055 1071055 0 Non-Medical Supplies 982463 956091 26372 Repairs 471656 392278 79378 1791739 306855 1484884 66783426 53192735 13590691 0 1978354 1339409 9248004 6618471 832275 809856 373963 430829 49027711 29067205 22942769 19960506 22683 26661 2701862 3669596 38099910 32855328 8014246 8055344 24016051 23446822 694765 669255 4588571 4256865 37313633 36428286 X 786277 -3572958 786277 -3572958 38099910 32855328 -4363213 3978 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2997 2997 0 Part II-B, Line 1: CA Hospital Assoc advocacy participation. Lobbying expenditure of $2,997 was based on 2016 dues. Total amount of dues was $25,486 of which 11.76% is identified for direct lobbying expenses. 512182 512182 27354220 13245424 14108796 19943072 15179571 4763501 1218237 642210 576027 19960506 OTHER RECEIVABLES 3280683 THIRD PARTY SETTLEMENTS 377963 DEPOSITS 10950 3669596 ACCRUED INTEREST PAYABLE 891559 SELF INSURED HEALTH CARE CLAIMS 1947000 LITIGATION RESERVE 1014354 PROFESSIONAL FEES 71200 INCURRED CLAIMS PAYABLE 146000 CAPITAL LEASES 186752 4256865 X 61380823 3978 3978 61376845 1043368 1043368 62420213 65740058 27687 27687 65712371 1071055 1071055 66783426 Part X, Line 2: THE HOSPITAL ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE HOSPITAL RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2016 AND 2015, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. Part XI, Line 4b - Other Adjustments: RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE -27,687. RECLASSIFICATION OF Loss on Impairment TO Expenses 1,071,055. Part XII, Line 2d - Other Adjustments: RECLASSIFICATION OF RENTAL EXPENSES TO STATEMENT OF REVENUE 27,687. Part XII, Line 4b - Other Adjustments: RECLASSIFICATION OF Loss on Impairment TO Expenses 1,071,055. 1 1 X 1 X 1 X 100.000000000000 1 1 0 1 1 410622 410622 0.00610 27 62522 36343394 26014306 10329088 0.15470 27 62522 36754016 26014306 10739710 0.16080 1 7810 92038 45518 46520 0.00070 1 7810 92038 45518 46520 0.00070 28 70332 36846054 26059824 10786230 0.16150 1 192391 192391 0.00290 1 192391 192391 0.00290 1 1749824 1161884 6525357 9363751 -2838394 X 1 1 1 1 GEORGE L MEE MEMORIAL HOSPITAL 300 CANAL STREET KING CITY CA 93930 www.MEEMEMORIAL.COM 070000047 X X X GEORGE L MEE MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X WWW.MEEMEMORIAL.COM X 1 15 1 WWW.MEEMEMORIAL.COM 0 0 1 X 100.000000000000 100.000000000000 X X X X 1 1 X X X X 1 X www.meememorial.com X www.meememorial.com X www.meememorial.com X X X X 1 X 1 X X X X X X 1 X 0 1 GEORGE L. MEE MEMORIAL HOSPITAL Part V, Section B, Line 5: The hospital conducted key informant interviews with individuals who were chosen based on their involvement within the community and potential willingness to participate. Those individuals interviewed include members of the clergy council, Chamber of Commerce members, Rotary Club members, city council members, and individuals from community focus groups. All participating individuals: (i) had special knowledge in public health, (ii) was a public health department employee, or (iii) was a member of a medically underserved, low-income, or minority population. GEORGE L. MEE MEMORIAL HOSPITAL Part V, Section B, Line 11: MMH IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AS FOLLOWS:- INVASIVE CARDIOLOGY - REFERRED TO OTHER HOSPITALS- GASTROENTEROLOGY - WORKING ON IMPLEMENTATION OF GI SERVICES- MENTAL HEALTH - WORKING WITH COUNTY BEHAVIORAL HEALTH SERVICES- KIDNEY, LIVER & HEART TRANSPLANTS - REFERRED TO OTHER HOSPITALS- CANCER/ONCOLOGY - REFERRED TO OTHER HOSPITALS GEORGE L. MEE MEMORIAL HOSPITAL Part V, Section B, Line 22d: MEANS USED TO DETERMINE THE AMOUNTS BILLED TO UNINSURED INDIVIDUALS FOR EMERGENCY CARE: Charges are based on Reasonable and Customary Charges contained in the fee schedule. FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING. GEORGE L. MEE MEMORIAL HOSPITAL Part V, Section B, Line 24: Hospital prepares a billing with gross charges as all patients would receive. Discounts are applied based on the financial assistance policy. Any gross charges would then be credited to charity when a patient was determined to be eligible. The process is consistent with HFMA statement 15. 5 1 - KING CITY CLINIC 210 CANAL STREET King City CA 93930 OUTPATIENT CLINIC 2 - SPECIALTY CLINIC 400 CANAL STREET SUITE B King City CA 93930 OUTPATIENT CLINIC 3 - FAMILY MEDICAL CENTER 400 CANAL STREET SUITE A King City CA 93930 OUTPATIENT CLINIC 4 - THE WOMEN'S CENTER 400 CANAL STREET SUITE C King City CA 93930 OUTPATIENT CLINIC 5 - GREENFIELD CLINIC 467 s EL CAMINO REAL GREENFIELD CA 93927 OUTPATIENT CLINIC Part I, Line 7: Cost to charge ratio was used to calculate the community benefit expense on Part I, Line 7b. Part II, Community Building Activities: ONLY HOSPITAL IN THE SOUTHERN PART OF THE COUNTY FOR A 50 MILE RADIUS SERVING A LARGE AGRICULTURAL AREA WITH MANY MEDICALLY INDIGENT AND UNDOCUMENTED RESIDENTS.THE HOSPITAL PROVIDES MANY SERVICES FOR THE COMMUNITY: ED, ICU, OR, OBSTETRICAL & DELIVERY, DIALYSIS, IMAGING, LAB, PHARMACY & PHYSICAL/REHAB. THE ONLY SNF TO DP/SNF IN THE AREA. PROVIDES TWO RURAL HEALTH CLINICS FOR THE PSA. MMH HAS AN OPEN MEDICAL STAFF. THE BOARD IS PRIMARILY COMPRISED ON COMMUNITY MEMBERS. MMH PROMOTES COMMUNITY HEALTH BY contracting with the County of Monterey to provide congregate meals to the eligible adults in the South Monterey County under the Monterey County Elderly Nutrition Program. In addition, community building activity of workforce development includes the promotion to the health of the community with physician recruitment. Part III, Line 2: The organization records accounts sent to collections as a bad debt and also accrues bad debt expense based on an estimate from aged accounts receivables. Part III, Line 3: METHODOLOGY USED: BASED ON COST TO CHARGE RATIO.RATIONALE: THAT PORTION OF GROSS CHARGES THAT WOULD NORMALLY BE ADJUSTED FOR CONTRACTUAL ALLOWANCES IF THIS UNINSURED OR UNDER-INSURED GROUP COULD ACCESS CONTRACTUAL DISCOUNTS & THEN APPLYING A COST TO CHARGE RATIO TO ARRIVE AT THE HOSPITAL'S COST OF PROVIDING THAT CARE. Part III, Line 4: NET PATIENT ACCOUNTS RECEIVABLE/BAD DEBTS EXPENSE FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: PATIENT ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES, AND PRIVATE PATIENTS. THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PAYMENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS DECREASED FROM 18% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2015 TO 11% GROSS PATIENT ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2016. THE HOSPITAL HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2016 OR 2015. Part III, Line 8: SHORTFALL EXPLANATION: UNFUNDED COSTS FOR DIRECT PATIENT CARE.COSTING METHODOLOGY: CALCULATED COST TO CHARGE RATIO APPLIED UNIFORMILY TO ALL PAYERS. Part III, Line 9b: COLLECTION PRACTICES FOR QUALIFIED PATIENTS:It is the policy of George L. Mee Memorial Hospital to provide excellent customer service to all patients, and assist all uninsured patients with obtaining coverage from government-sponsored programs such as Medicare, Medi-Cal, and Central Coast Alliance for Health, and Healthy Families. If such coverage is not available to the patient, the hospital will provide appropriate healthcare to the patient, and the hospital will provide financial assistance based on the current federal poverty level, and per the hospital's policy, in accordance with California state law, EMTALA, and Medicare regulations. Further, self-pay patients who do not qualify for financial assistance based on income will be provided with several options for payment of their bills. It is the hospital's policy to:- Assist all uninsured patient with obtaining coverage from government-sponsored programs such as Medicare, Medi-Cal, Central Coast Alliance for Health, and Healthy Families.- Provide all medically necessary health care services at no cost to eligible patients whose family's income is below 100% of the current federal poverty level.- Provide all medically necessary health care services at a 50% discount to eligible patients whose family's income is between 101% and 133% of the current federal poverty level. For the services provided to a patient meeting these criteria, expected payment shall not exceed the greater of the amount that would be expected from Medicare, Medi-Cal, Central Coast Alliance for Health, or Healthy Families for the same services.- Provide all medically necessary health care services at a 35% discount to eligible patients between 133% and 200% of the current federal poverty level. For the services provided to a patient meeting these criteria, expected payment shall not exceed the greater of the amount that would be expected from Medicare, Medi-Cal, Central Coast Alliance for Health, or Healthy Families for the same services.- Provide interest-free payment plans for eligible patients under this policy.- Forgo reports to credit bureaus, referral of accounts to collection agencies, liens against property or wage garnishments for eligible patients who are meeting an agreed-upon payment plan.- Provide adequate notice of this policy in all admitting and reception areas.- Offer free financial counseling to all uninsured patients for financial matters related to their hospital bills.- For all uninsured patients above 100% of the current federal poverty level, several payment options will be presented, as follows:A. Prompt Pay Discount: Offer a 25% discount if the account is paid in full at time of service.B. Payment Plan: Offer a 15% discount if the patient signs an agreement representing that he/she will meet a payment plan that will pay the balance in full within 6 months at no interest.C. CCS Early-Out: If the patient rejects each of the above options, the account will be sent to CCS for "early-out" collections for 90 days. This "early-out" process does not include reports to credit bureaus. At the end of the 90 days, the account will be returned to the hospital to be reviewed for potential Bad Debt write-off and collections reporting. Part VI, Line 2: NEEDS ASSESSMENT: MEE MEMORIAL WORKED WITH AN OUTSIDE CONSULTING FIRM, MOSS ADAMS, LLP (MOSS ADAMS) TO DEVELOP BOTH THE CHNA AND IMPLEMENTATION PLAN. MEE MEMORIAL WORKED WITH MOSS ADAMS TO COLLECT DEMOGRAPHIC AND MARKET AREA INFORMATION, INTERVIEW COMMUNITY MEMBERS AND PRIORITIZE KEY COMMUNITY HEALTH NEEDS. THE PROCESS BEGAN BY REVIEWING PRIOR MARKET ASSESSMENT REPORTS AND VARIOUS OTHER STUDIES/REPORTS PRODUCED BY OR FOR MEE MEMORIAL WITHIN THE PAST TWO YEARS. MOSS ADAMS THEN WORKED TO ANALYZE CURRENT DEMOGRAPHIC DATA FOR THE SERVICE AREA POPULATION, INCLUDING POPULATION SIZE AND GROWTH PROJECTIONS, AGE DISTRIBUTION, RACIAL AND ETHNIC DIVERSITY, SOCIOECONOMIC FACTORS AND HEALTH STATUS INDICATORS. IN CONJUNCTION WITH MOSS ADAMS, MEE MEMORIAL UTILIZED THESE KEY FINDINGS TO DEVELOP A PRIORITIZED LIST OF COMMUNITY HEALTH NEEDS AND CREATE THE CHNA AND RESPECTIVE IMPLEMENTATION PLAN. MOSS ADAMS UTILIZED THE FOLLOWING DATA SOURCES TO COMPLETE THE REPORT.- MEE MEMORIAL MARKET DATA- PREVIOUSLY CONDUCTED MEE MEMORIAL STRATEGIC PLANS- COMMUNITY MEMBER INTERVIEWS CONDUCTED BY MEE MEMORIAL HOSPITAL- THE NIELSEN COMPANY- BUREAU OF LABOR STATISTICS- CENTERS FOR DISEASE CONTROL AND PREVENTION- U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES- COUNTY HEALTH RANKINGS- OFFICE OF STATEWIDE HEALTH PLANNING (OSHPD)THE MEE MEMORIAL IMPLEMENTATION PLAN WAS DEVELOPED BASED ON IDENTIFIED NEEDS AND SHORT-TERM AND LONG-TERM STRATEGIC GOALS FOR MEE MEMORIAL. THE IMPLEMENTATION PLAN ALIGNS WITH AND EXPANDS UPON CURRENT ORGANIZATIONAL STRATEGIES AND PROGRAMS. Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UPON PRESENTATION TO OUR ADMITTING PROCESS, ONCE THE PATIENT IDENTIFIES THEY ARE WITHOUT INSURANCE, WE INFORM/EDUCATE THEM ABOUT THEIR OPTIONS WITH GOVERNMENT PROGRAMS AND PROVIDE CONTACT INFORMATION TO ACCESS THOSE PROGRAMS. ADDITIONALLY, WE PROVIDE THE PATIENT WITH OUR POLICIES RELATED TO CHARITY AND A CHARITY APPLICATION SHOULD THEY WISH TO PURSUE THAT ASSISTANCE. Part VI, Line 4: COMMUNITY INFORMATION: THE PRIMARY SERVICE AREA (PSA) IS SOUTHERN MONTEREY COUNTY AND THE SALINAS VALLEY COMPRISED OF THE FOLLOWING COMMUNITIES: KING CITY, GREENFIELD, SAN ARDO, LOCKWOOD, JOLON, SAN LUCAS & BRADLEY. THE SERVICE AREA IS SOUTH OF SALINAS, CA BY 45 MILES AND NORTH OF PASO ROBLES BY 45 MILES.THE POPULATION SIZE OF THE PSA IS ROUGHLY 40,000 WITH THE MEDIAN AGE OF 28.5 (32.5% OF 0-17 OF THE AGE GROUP, 41.6% FOR 18-44, 18.9% FOR 45-64 & 7.1% OF THE POPULATION OVER 65 YEARS OF AGE). MEDIAN HOUSEHOLD INCOME (2014) IS $51,773. RACIAL & ETHNIC DISTRIBUTION IS AS FOLLOWS: 81.2% HISPANIC OR LATINO, 14.9% WHITE & 3.9% FROM OTHER RACES. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL OWNS AND OPERATES THE FAMILY HEALTH CENTER. A GOAL OF THE CENTER IS TO PROVIDE HIGH-QUALITY, LOW-COST HEALTH CARE SERVICES TO PEOPLE WHO DO NOT OTHERWISE HAVE ACCESS WHICH MAY BE DUE TO FINANCIAL, CULTURAL, LIFESTYLE, OR PSYCHOLOGICAL BARRIERS. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States CA 0 County of Monterey 1000 SOUTH MAIN ST SUITE 211A Salinas CA 93901 946000524 92038 Cash Value nutritional program for the elderly 1 Part I, Line 2: The hospital maintains separate general ledger cost center codes to track & report all Grant activities. All activity is based on grant invoicing to the county. The county audits the hospital's book annually. The hospital provides an audited report to the county each year. X X 0 0 0 0 0 0 0 1 0 Schindelheim MD Roy Brd Member/Chf of Staff 279557 0 0 0 0 0 0 0 31523 0 311080 0 0 0 Childers Susan CEO 240665 0 9000 0 0 0 3381 0 31523 0 284569 0 0 0 French Michael CFO 151723 0 0 0 0 0 1300 0 15450 0 168473 0 0 0 Hritz Kenneth COO 193243 0 0 0 0 0 0 0 31523 0 224766 0 0 0 Salamacha Rena CIO 184593 0 0 0 0 0 0 0 42675 0 227268 0 0 0 Eperjesi Jan Physician 335322 0 20000 0 0 0 0 0 42675 0 397997 0 0 0 Greenberg Bruce Physician 278250 0 0 0 0 0 0 0 31523 0 309773 0 0 0 Montijo Sandra Physician 234678 0 0 0 0 0 0 0 42675 0 277353 0 0 0 AlejandreHilda Physician 219203 0 0 0 0 0 0 0 15450 0 234653 0 0 0 Mcghee James Physician 203101 0 0 0 0 0 0 0 42675 0 245776 0 0 0 Part I, Line 7 Mee Memorial Hospital's bonuses are based on Board criteria, review & approval of the following factors: Financial Performance Enhanced program & services Physician recruitment & retention Performance improvement/quality standards Regulatory & accreditation compliance Form 990, Part VI, Section B, line 11 INTERNAL STAFF GATHERED, REVIEWED & COMPILED INFORMATION PROVIDED TO THE TAX PREPARER. TAX PREPARER GUIDED AND ADVISED CLIENT ON ANY ISSUE IN QUESTION. TAX PREPARER SUBMITS A COMPLETED FORM 990 FOR FINAL REVIEW AND APPROVAL. MMH provided an electronic copy of the final Form 990 (including all required schedules) to each voting member of the governing body prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c MONTEREY COUNTY MEMORIAL HOSPITAL HAS A CORPORATE POLICY ON CONFLICT OF INTEREST. THIS POLICY APPLIES TO ALL INTERESTED PERSONS WHO ARE AS FOLLOWS: A. TRUSTEES B. MEMBER OF SENIOR MANAGEMENT THE BOARD OF TRUSTEES, THE CEO, AND CFO CONTINUOUSLY MONITOR AND EVALUATE ANY AND ALL TRANSACTIONS OF INTERESTED PARTIES WITH THE HOSPITAL. IF THE CURRENT OR PAST TRANSACTION POSE A POTENTIAL RISK OF BEING A CONFLICT OF INTEREST TO THE HOSPITAL, THESE ITEM(S) WILL BE BROUGHT TO THE ATTENTION OF THE CEO, BOARD CHAIRMAN, AND OR FULL BOARD OF TRUSTEES. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST TO THE BOARD, THE INTERESTED OFFICER OR BOARD MEMBER WOULD LEAVE THE BOARD MEETING WHILE THE CONFLICT OF INTEREST IS DISCUSSED AND/OR VOTED ON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROVIDED, HOWEVER, IF THE INTERESTED PERSON IS AN ADMINISTRATIVE STAFF EMPLOYEE AND THE CONTEMPLATED TRANSACTION IS AT THE ADMINISTRATIVE LEVEL, THE DECISION SHALL BE MADE BY THE HOSPITAL CEO. ANY OFFICER OR BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER MUST DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT. OFFICER OR BOARD MEMBERS SHOULD ALWAYS ABSTAIN FROM VOTING ON ANY ISSUES OF A POSSIBLE CONFLICT OF INTEREST. Form 990, Part VI, Section B, line 15 Compensation is established through comparison to regional salary survey information and performance evaluations. There is a physician compensation committee to specifically review all physician comp. Form 990, Part VI, Section C, line 19 Documents are made available upon request. Quarterly financial statements are posted to OSHPD and an annual report is filed as well. Form 990, Part VII, Section A Roy Schindelheim, MD, devotes 2 hour per week for his services as a Vice Chairman of the board of directors. He does not receive compensation or benefits as a board member. Dr. Schindelheim provides services as a physician to the hospital. He devotes 40 hours per week and the compensation and benefits are for his services as a physician. Form 990, Part IX, line 11g other services: Program service expenses 11,209,712. Management and general expenses 565,451. Fundraising expenses 0. Total expenses 11,775,163. Purchased services : Program service expenses 3,499,385. Management and general expenses 2,106,200. Fundraising expenses 0. Total expenses 5,605,585. Form 990, Part XII, line 2c Audit Committee AND OVERSIGHT: There have been no changes to this process from prior year.