2017-11-15T13:01:55-06:00 2016-12-31 330155525 HBLA CERTIFIED PUBLIC ACCOUNTANTS INC 19600 FAIRCHILD STE 320 IRVINE CA 92612 990 2016-01-01 952413054 FOOTHILL PRESBYTERIAN HOSPITAL - MORRIS L JOHNSTON MEMORIAL FOOT 6269638411 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 RAJESH SHARMA EVP/CFO 6269387577 2017-11-14 1 EDWARD E BENOE P00032866 9498332815 64.88.174.3 2017-11-14 09:06:15 PS P BE8C1585C77E85D8C5B6C00A25D6EE10CA7DCD6F 013B549FA91C60EF164FD041BDC10933EE2EE962 2016 2021-01-29 14:40:06Z FOOTHILL PRESBYTERIAN HOSPITAL ROBERT H CURRY 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 117208610 0 X CVHP.ORG X 1965 CA OPERATION OF ACUTE CARE HOSPITAL. 21 19 666 199 11676 7712 297 413900 94467670 98037842 300488 -496749 894174 1174281 95662629 99129274 0 0 0 0 44313804 45725596 0 0 0 44126141 47241751 88439945 92967347 7222684 6161927 76483292 88551122 13365532 17612630 63117760 70938492 X OUR MISSION IS TO HELP PEOPLE KEEP WELL IN BODY, MIND AND SPIRIT BY PROVIDING QUALITY HEALTH CARE SERVICES IN A SAFE, COMPASSIONATE ENVIRONMENT. 0 0 81414554 98555839 FOOTHILL PRESBYTERIAN HOSPITAL IS AN ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE TO THE SURROUNDING COMMUNITY. FPH PROVIDES FOR, ON AVERAGE, 55 PATIENTS PER DAY. TOTAL ADJUSTED INPATIENT DAYS WERE 35,705. OUTPATIENT AND EMERGENCY VISITS TOTALED 57,111. FPH PROVIDED TRADITIONAL CHARITY CARE AT COST TOTALING $434,000, UNREIMBURSED MEDI-CAL PROGRAM COST TOTALING $10,562,000 AND OTHER COMMUNITY BENEFIT COST TOTALING $480,000. DURING 2016, FPH RECORDED A NET SUPPLEMENTAL PAYMENTS OF $2,268,000 FROM THE CALIFORNIA HOSPITAL FEE PROGRAM (PROGRAM) FOR THE HOSPITAL SERVICES TO MEDI-CAL FEE-FOR-SERVICE PATIENTS COVERED FOR THE PERIOD FROM JANUARY 1, 2016 TO DECEMBER 31, 2016, AND FOR THE 12 MONTHS OF THE MANAGED CARE EXPANSION AND NON-EXPANSION COMPONENTS OF THE PROGRAM THAT WERE APPROVED IN 2016.COMMUNITY WELLNESS SERVICES IS COMMITTED TO IMPROVING THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL HEALTH STATUS OF OUR COMMUNITIES AND TO CONSERVE AND ENHANCE THE ORGANIZATION'S RESOURCES. THIS IS ACCOMPLISHED THROUGH A VARIETY OF CLASSES, COMMUNITY PROGRAMS, SUPPORT GROUPS, HEALTH FAIRS, SCREENINGS, EDUCATIONAL PROGRAMS WITHIN OUR SCHOOLS, CHURCHES, LIBRARIES, SENIOR CENTERS AS WELL AS THE USE OF TELEPHONE REFERRALS. MOST PROGRAMS ARE OFFERED AT NO CHARGE. ALL PROGRAMMING IS OPEN TO EVERY MEMBER OF OUR COMMUNITY AND SURROUNDING COMMUNITIES. 81414554 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 X 127 0 1 666 1 1 1 0 0 0 0 0 0 0 0 0 X 21 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X RAJESH K SHARMA EXECUTIVE VPCFO 6269387595 140 W COLLEGE PO BOX 6108 COVINA CA 917225108 X WALTER ALLEN III CHAIR 3.00 X 0 0 0 ROBERT DUNCAN VICE CHAIR 3.00 X 0 0 0 RAYMOND MATTES IHM BOARD OF DIRECTORS 3.00 X 0 0 0 PATRICIA HANES PHD SECRETARY 3.00 X 0 0 0 CLIFFORD CHRIST TREASURER 3.00 X 0 0 0 ARTHUR LUDWICK BOARD OF DIRECTORS 3.00 X 0 0 0 ROBERT H CURRY PARENT PRESIDENT, CEO, BOD 4.00 36.00 X X 0 1288100 24888 HAROLD BORAK SR BOARD OF DIRECTORS 3.00 X 0 0 0 OJ RODRIGUEZ BOARD OF DIRECTORS 3.00 X 0 0 0 MARY KIRCHEN IHM BOARD OF DIRECTORS 3.00 X 0 0 0 PHILIP MALDONADO DDS BOARD OF DIRECTORS 3.00 X 0 0 0 DONALD BOSS ESQ BOARD OF DIRECTORS 3.00 X 0 0 0 THOMAS BRYAN MD BOARD OF DIRECTORS 3.00 X 0 0 0 GARY MATHEWSON BOARD OF DIRECTORS 3.00 X 0 0 0 SUBHASH DHAND MD BOARD OF DIRECTORS 3.00 X 0 0 0 NAJI KANDALAFT MD CHIEF OF STAFF 3.00 X 25520 35189 0 MARY JANE BETTFREUND BOARD OF DIRECTORS 3.00 X 0 0 0 BERNARD BOLLINGER JR ESQ BOARD OF DIRECTORS 3.00 X 0 0 0 GEORGE FERENCZI MD BOARD OF DIRECTORS 3.00 X 0 0 0 ANNA LEUNG MD BOARD OF DIRECTORS 3.00 X 0 0 0 SHARON YEE MD BOARD OF DIRECTORS 3.00 X 0 0 0 PATSY GORRELL BOARD OF DIRECTORS 3.00 X 0 0 0 ROBINSON BARON BOARD OF DIRECTORS 3.00 X 0 0 0 JAQUELINE BRACY MD BOARD OF DIRECTORS 3.00 X 0 0 0 J PAUL HOLLAND MD BOARD OF DIRECTORS 3.00 X 0 0 0 GURJEET KALKAT MD BOARD OF DIRECTORS 3.00 X 0 0 0 JEFFREY SHAPIRO MD BOARD OF DIRECTORS 3.00 X 0 0 0 GORDON SHIPP BOARD OF DIRECTORS 3.00 X 0 0 0 EARL WASHINGTON BOARD OF DIRECTORS 3.00 X 0 0 0 LANCE WILCHNER DNP BOARD OF DIRECTORS 3.00 X 0 0 0 RAJESH SHARMA EXECUTIVE VP/CFO 4.00 36.00 X 0 726109 19197 STANLEY KOZAKA PHARMACIST 40.00 X 201677 0 23717 JOHN CASSARA PHARMACY DIRECTOR 40.00 X 207005 0 9367 CHANDRA REDDY RSO/NUCLEAR MED 40.00 X 230854 0 24715 MELISSA HOWARD CHIEF NURSE EXEC 40.00 X 0 181180 22746 KATHLEEN HAANGE CORP DIR, NURS ADM. 40.00 X 0 178119 17224 665056 2408697 141854 112 0 1 0 MEDLINE INDUSTRIES DEPT LA 21558 PASADENA CA 91185 CONTRACTORS 1407317 ACOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS TX 75373 REGISTRY STAFFING 400824 MEDICLEAN INC 4500 DUNHAM ST COMMERCE CA 90040 LAUNDRY SERVICES 300590 JTS MANAGEMENTINC 1906 ORANGE TREE LANE STE 220 REDLANDS CA 92374 CONTRACTORS 248126 RCSN INC 10221 SLATE AVE STE 214 FOUNTAIN VALLEY CA 92708 REGISTRY STAFFING 141369 43 413900 413900 PATIENT REV/MEDICARE/MEDICAID PAY 900099 88442652 88442652 HOSPITAL FEE PROGRAM REVENUE 900099 9595190 9595190 98037842 658478 658478 152180 0 152180 152180 11676 140504 16924109 18079336 -1155227 -1155227 -1155227 ELECTRONIC HEALTH RECORDS PROGRAM 900099 401941 401941 REBATES & REFUNDS 900099 296426 296426 CAFETERIA 900099 207044 207044 116690 116056 634 1022101 99129274 98555839 11676 147859 X 231350 55907 175443 33287689 33246053 41636 1088796 1088796 8417391 8415017 2374 2700370 2693229 7141 1965 1965 300 300 111161 111161 1200211 670824 529387 11333515 11331940 1575 871601 871601 84929 84929 129941 129941 4105341 4092102 13239 872940 872940 UNRELATED BUS INC TAX 14182 14182 PURCHASED SERVICES 14055645 3396620 10659025 HOSPITAL FEE PROGRAM 7326818 7326818 BAD DEBT EXPENSE 3793698 3793698 3339504 3341874 -2370 92967347 81414554 11552793 0 5858287 4407220 11104359 10322886 457855 519129 381223 285987 98300156 63055992 33815850 35244164 21320464 32461761 393234 191170 3152020 5118805 76483292 88551122 8791785 13109159 2379480 2238075 2194267 2265396 13365532 17612630 X 60934525 68468064 661513 934800 1521722 1535628 63117760 70938492 76483292 88551122 X 6161927 1435989 222816 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1521722 13906 1535628 1075512 446210 1521722 1059972 15540 1075512 1050271 9701 1059972 1035028 15243 1050271 1.00000 0 1 1 1173257 1173257 53243339 29318059 23925280 43666098 33737933 9928165 217462 217462 35244164 BENEFICIAL INTEREST IN CVHF 1173440 HOSPITAL FEE PROGRAM 3808365 HOSPITAL/PROF. EXCESS INS RECOVERIES-CURRENT 8000 HOSPITAL/PROF. EXCESS INS RECOVERIES-L/T 129000 5118805 OTHER CURRENT LIABILITIES 1312923 MALPRACTICE RESERVE LONG TERM 475000 CAPITAL LEASE PAYABLE 477473 2265396 X 95997000 1435989 1435989 94561011 4568263 4568263 99129274 88877000 0 88877000 4090347 4090347 92967347 PART V, LINE 4: PERMANENTLY RESTRICTED ASSETS ARE RESTRICTED INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES. PART X, LINE 2: ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT DECEMBER 31, 2016 OR 2015. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED INCOME ACTIVITY -6,792. INVESTMENT FEES INCLUDED IN INCOME 111,161. PASSTHROUGH INCOME DIFFERENCE 3,712. ROUNDING DIFFERENCE -100. DECREASE IN BENEFICIAL INTEREST CVHF 252,659. PROVISION FOR BAD DEBTS 3,793,698. BANK CHARGES 25. TRANSFER FROM CVHF 413,900. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED INCOME ACTIVITY 185,201. INVESTMENT FEES INCLUDED IN INCOME 111,161. BAD DEBT EXPENSE 3,793,698. BANK CHARGES 25. ROUNDING DIFFERENCE 262. 1 1 X 1 X 350.000000000000 1 X 500.000000000000 1 1 0 1 1 434429 434429 0.00470 27518190 19224902 8293288 0.08920 27952619 19224902 8727717 0.09390 432555 432555 0.00470 47222 47222 0.00050 479777 479777 0.00520 28432396 19224902 9207494 0.09910 1 3793698 0 17892353 18970349 -1077996 X 1 1 1 1 FOOTHILL PRESBYTERIAN HOSPITAL 250 SOUTH GRAND AVENUE GLENDORA CA 91741 WWW.CVHP.ORG 106190298 X X X FOOTHILL PRESBYTERIAN HOSPITAL 1 1 0 1 X X X X X X X X X 16 1 1 0 1 X SEE FOOTNOTE AT PART V PAGE 8 1 16 1 SEE FOOTNOTE AT PART V PAGE 8 0 1 X 350.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X SEE FOOTNOTE AT PART V PAGE 8 X SEE FOOTNOTE AT PART V PAGE 8 X SEE NOTE AT PART V PAGE 8 X X X X X X 1 X 0 X X X 1 X 0 0 FOOTHILL PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY INPUT:THE 2016 CHNA NEEDS ASSESSMENT METHODOLOGY AND PROCESS INVOLVED A MIXED-METHODS APPROACH THAT INCLUDED THE COLLECTION OF BOTH SECONDARY DATA AND PRIMARY DATA. OVER 400 SECONDARY DATA INDICATORS ON A VARIETY OF HEALTH, SOCIAL, ECONOMIC, AND ENVIRONMENTAL TOPICS WERE COLLECTED BY ZIP CODE, SERVICE PLANNING AREA (SPA)1, COUNTY, AND STATE LEVELS (AS AVAILABLE). THE CONSULTANT TEAM QUERIED DATA ON INDICATORS THROUGH THE KAISER PERMANENTE CHNA DATA PLATFORM AND OBTAINED THE DATA RATES FOR THE CITRUS VALLEY HEALTH PARTNERS AREA THROUGH ACCESSING VARIOUS ADDITIONAL DATA SOURCES. IN MOST CASES THE SERVICE AREA VALUES REPRESENT THE AGGREGATE OF DATA OF SMALLER GEOGRAPHIC UNITS (E.G., ZIP CODES, CENSUS TRACTS) WHICH FALL WITHIN THE SERVICE AREA BOUNDARY. WHEN ONE OR MORE GEOGRAPHIC UNITS ARE NOT ENTIRELY ENCOMPASSED BY A SERVICE AREA, THE MEASURE IS AGGREGATED PROPORTIONALLY. THE OPTIONS FOR WEIGHING "SMALL AREA ESTIMATIONS" ARE BASED ON TOTAL AREA, TOTAL POPULATION, AND DEMOGRAPHIC GROUP POPULATION. PRIMARY DATA COLLECTION CONSISTED OF REACHING OUT TO LOCAL PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND RESIDENTS TO IDENTIFY ISSUES THAT MOST AFFECTED THE HEALTH OF THE COMMUNITY. THE CHNA PROCESS ALSO INCLUDED AN IDENTIFICATION OF EXISTING COMMUNITY ASSETS AND RESOURCES TO ADDRESS THE IDENTIFIED HEALTH NEEDS.FOR THE CITRUS VALLEY HEALTH PARTNERS' CHNA, PRIMARY DATA WERE COLLECTED THROUGH SIX FOCUS GROUPS AND TEN PHONE INTERVIEWS WITH A TOTAL 69 STAKEHOLDERS, INCLUDING COMMUNITY REPRESENTATIVES, HEALTH EXPERTS, LOCAL GOVERNMENT REPRESENTATIVES, LOCAL BUSINESS OWNERS, AND SOCIAL AND HEALTH SERVICE PROVIDERS. THESE INFORMANTS ASSISTED IN IDENTIFYING THE MOST SEVERE HEALTH OUTCOMES AND ASSOCIATED DRIVERS, HEALTH DISPARITIES, AND COMMUNITY ASSETS AND RESOURCES AVAILABLE IN THE CITRUS VALLEY HEALTH PARTNERS SERVICE AREA TO ADDRESS THE IDENTIFIED HEALTH OUTCOMES AND DRIVERS IDENTIFIED THROUGH SECONDARY DATA ANALYSIS. IN ORDER TO BE INCLUDED IN THE LIST OF IDENTIFIED HEALTH NEEDS, A HEALTH OUTCOME OR DRIVER HAD TO MEET TWO REQUIREMENTS: IT HAD TO BE MENTIONED IN THE PRIMARY DATA COLLECTION MORE THAN ONCE AND A SECONDARY DATA INDICATOR ASSOCIATED WITH THE HEALTH OUTCOME AND/OR DRIVER NEEDED TO PERFORM POORLY AGAINST A DESIGNATED BENCHMARK (COUNTY AVERAGE, STATE AVERAGE, OR HEALTHY PEOPLE 2020 GOAL).PRIORITIZATION OF THE IDENTIFIED NEEDS IS ESSENTIAL TO THE COMMUNITY BENEFIT PLANNING PROCESS. THE CENTER FOR NONPROFIT MANAGEMENT (CNM) ENGAGED A TOTAL OF 41 COMMUNITY STAKEHOLDERS THROUGH A COMMUNITY FORUM HELD IN DECEMBER 2015 TO ASSIST WITH THE PRIORITIZATION OF 19 HEALTH NEEDS. DURING THE COMMUNITY FORUM, ATTENDEES REVIEWED A SUMMARY OF THE SECONDARY DATA INDICATORS AND RESPONSES FROM STAKEHOLDERS AND PARTICIPATED IN A GUIDED GROUP ACTIVITY TO SHARE INSIGHTS AND PERSPECTIVES WITH THEIR COLLEAGUES. AT THE END OF THE COMMUNITY FORUM, ATTENDEES WERE ASKED TO COMPLETE A SURVEY IN WHICH THEY RANKED EACH HEALTH OUTCOME AND HEALTH DRIVER ACCORDING TO FIVE CRITERIA:- MAGNITUDE: HOW MANY COMMUNITY MEMBERS WERE AFFECTED- SEVERITY: HOW MUCH COMMUNITY MEMBERS WERE IMPACTED- CHANGE OVER TIME: WHETHER AN ISSUE HAS IMPROVED OR GOTTEN WORSE OVER TIME- RESOURCES: AMOUNT OF RESOURCES AVAILABLE IN THE COMMUNITY TO ADDRESS AN ISSUE- DISPARITIES: THE LEVEL OF IMPACT ON A SPECIFIC VULNERABLE POPULATION GROUPTHOSE WHO WERE NOT ABLE TO ATTEND THE COMMUNITY FORUM COULD PARTICIPATE IN THE PROCESS BY COMPLETING AN ONLINE VERSION OF THE PRIORITIZATION SURVEY DISSEMINATED AT THE COMMUNITY FORUMS. IN ADDITION, ATTENDEES HAD AN OPPORTUNITY TO VOTE TO INDICATE WHICH HEALTH OUTCOMES AND HEALTH DRIVERS THEY BELIEVED MOST SEVERELY AFFECTED THE COMMUNITIES WITHIN THE CITRUS VALLEY HEALTH PARTNERS' SERVICE AREA.A LINK TO THE ONLINE SURVEY AND SUPPLEMENTAL MATERIALS SHARED AT THE FORUMS WERE EMAILED TO STAKEHOLDERS; A TOTAL OF SIX PEOPLE COMPLETED THE ONLINE SURVEY. OVERALL COMPOSITE SCORES WERE CALCULATED FOR BOTH IN-PERSON AND ONLINE SURVEYS BY AVERAGING THE RESPONSES TO THE CRITERIA QUESTIONS.THE RESULTING SCORES WERE PUT INTO A MATRIX WHERE OTHER FACTORS (OR CONSIDERATIONS) WERE TAKEN INTO ACCOUNT, INCLUDING OBSERVED POPULATION DISPARITIES BY ETHNICITY, AGE, GENDER, AND GEOGRAPHY THROUGHSECONDARY OR PRIMARY DATA; NOTED TRENDS FROM A REVIEW OF THE 2013 CITRUS VALLEY HEALTH PARTNERS CHNA (WORSENING OR IMPROVING); AND ORDER IN PRIORITY RANKING. THE MATRIX SERVED AS A WAY TO CENTRALIZE ALL COMPOSITE SCORES AND CONSIDERATIONS, FURTHER DEMONSTRATING THE SEVERITY OF EACH HEALTH OUTCOME AND DRIVER. FOOTHILL PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 6A: COMMUNITY HEALTH NEEDS ASSESSMENT - THE HOSPITAL FACILITY'S NEEDS ASSESSMENT WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:- CITRUS VALLEY MEDICAL CENTER - COVINA, CA- KAISER FOUNDATION HOSPITAL - BALDWIN PARK, CA PART V, LINE 7A CHNA REPORT: THE CHNA REPORT IS AVAILABLE ON THE HOSPITAL'S WEBSITE WWW.CVHP.ORG/DOCUMENTS/COMMUNITY_NEEDS/2016-CITRUS-VALLEY-CHNA-REPORT-FINAL.PDF PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY: THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HOSPITAL'S WEBSITEWWW.CVHP.ORG/DOCUMENTS/COMMUNITY_NEEDS/2016_CHNA_CVHP_IMP_PLAN.PDF PART V, SECTION B, LINE 11: CITRUS VALLEY HEALTH PARTNERS CHIEF COMMUNICATIONS AND ADVOCACY OFFICER AND THE DIRECTOR OF COMMUNITY BENEFIT ENGAGED IN AN EXAMINATION AND ANALYSIS PROCESS OF THE BROADER LIST OF COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA. THE COMPREHENSIVE REVIEW PROCESS WAS DESIGNED WITH THE PURPOSE OF IDENTIFYING THE COMMUNITY NEEDS THAT CAN BEST BE ADDRESSED BY THE HOSPITAL ORGANIZATION TAKING IN CONSIDERATION ASSETS AND EXPERTISE AND COMMUNITY PARTNERSHIPS. THE CORE FACTORS THAT DROVE THE PROCESS WERE: 1) HIGH COMMUNITY NEED AND 2) FEASIBILITY TO CREATE AN IMPACT. THE METHODOLOGY USED FOR THE SELECTION INCLUDED A SCALE OF 1 TO 5 FROM LEAST TO MOST FOR EACH OF THE HEALTH NEEDS LISTED IN SECTION VI. THE RESULTING SCORES WERE TRANSLATED TO A FOUR SECTION GRID (VERTICAL AND HORIZONTAL AXES FROM LOW TO HIGH) ACCORDING TO HIGH NEED AND FEASIBILITY FOR REVIEW BY THE IMPLEMENTATION STRATEGY TEAM. THE HEALTH NEEDS RECEIVING THE HIGHEST SCORES FOR NEED AND FEASIBILITY WERE SELECTED AS NEEDS THAT CITRUS VALLEY HEALTH PARTNERS WILL ADDRESS AS OUTLINED AND DESCRIBED IN THE PRIORITY AREAS LISTED BELOW. FOLLOWING IS THE CONCEPTUAL CRITERIA UTILIZED FOR THIS PROCESS:HIGH NEED:- MAGNITUDE/SCALE OF THE PROBLEM: THE HEALTH NEED AFFECTS A LARGE NUMBER OF PEOPLE WITHIN THE COMMUNITY- SEVERITY OF PROBLEM: THE HEALTH NEED HAS SERIOUS CONSEQUENCES (MORBIDITY, MORTALITY, AND/OR ECONOMIC BURDEN) FOR THOSE AFFECTED- DISPARITIES: THE HEALTH NEED DISPROPORTIONATELY IMPACTS THE HEALTH STATUS OF ONE OR MORE VULNERABLE POPULATION GROUPSFEASIBILITY:- CONSIDER CVHP'S RELEVANT CAPACITIES AND INITIATIVES WITHIN THE INTEGRATED HEALTH SYSTEM.- ABILITY TO LEVERAGE: OPPORTUNITIES TO COLLABORATE WITH EXISTING AND NEW COMMUNITY PARTNERS WORKING TO ADDRESS THE NEED, TO BUILD ON CURRENT PROGRAMS AND EFFORTS, IDENTIFY AND SUPPORT EMERGING INNOVATIVE OPPORTUNITIES, AND OTHER ASSETS.CVHP HAS IDENTIFIED THE FOLLOWING PRIORITY HEALTH FOCUS AREAS TO BE ADDRESSED IN YEARS 2017-2019:AREA OF FOCUS I: INCREASE DIABETES PREVENTION STRATEGIES AND DISEASE MANAGEMENT BEST PRACTICES.AREA OF FOCUS II: INCREASE ACCESS TO MENTAL HEALTH AND BEHAVIORAL HEALTH SERVICES AND ENHANCE SERVICE CAPACITY THROUGH PROVIDER COLLABORATION.AREA OF FOCUS III: INCREASE AWARENESS AND IMPROVE ACCESS TO HEALTH EDUCATION AND RESOURCES FOCUSING ON THE REDUCTION OF OBESITY AND OVERWEIGHT.AREA OF FOCUS IV: IMPROVE ACCESS TO HEALTH CARE. PART V, LINE 16A FAP WEBSITE: WWW.CVHP.ORG/DOCUMENTS/FINANCIAL-ASSISTANCE/A009-CHARITY-CARE.PDF PART V, LINE 16B APPLICATION FORM URL: HTTP://WWW.CVHP.ORG/DOCUMENTS/FINANCIAL-ASSISTANCE/FINANCIAL_ASSISTANCE_FORMS_ENGLISH.PDF PART V, LINE 16C PLAIN LANGUAGE SUMMARY PAGE: HTTP://WWW.CVHP.ORG/PATIENT_RESOURCES/FINANCIAL_ASSISTANCE.ASPX PART V, SECTION B, LINE 22B: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE-THE HOSPITAL DETERMINED, DURING THE TAX YEAR, THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO (FINANCIAL ASSISTANCE POLICY) FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE AS FOLLOWS: - THE PREVAILING MANAGED CARE PER DIEM RATE SHALL BE APPLIED FOR ALL INPATIENT STAYS. ANY IMPLANTS AND OR PROSTHETIC DEVICES AND HIGH COST DRUGS ARE EXCLUDED FROM THE PER DIEM RATES AND ARE PAYABLE AT INVOICE PLUS A 5% PROCESSING FEE. - ALL NON-SURGICAL OUTPATIENT SERVICES SHALL BE REDUCED BY SIXTY FIVE PERCENT (65%) OF CHARGES AT THE TIME OF SERVICE. THIS DISCOUNT WILL BE CHANGED IN FUTURE YEARS TO APPROXIMATE THE AMOUNT EXPECTED TO BE RECEIVED FROM MANAGED CARE PLANS. - ALL OUTPATIENT SURGICAL PROCEDURE SHALL BE CHARGED AT BENCHMARK MANAGED CARE CASE RATES. IMPLANTS AND/OR PROSTHETIC DEVICES ARE EXCLUDED FROM THE CASE RATE AND ARE PAYABLE AT INVOICE PLUS A 5% PROCESSING FEE. PART I, LINE 3C: SERVICES ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) WILL BE MADE AVAILABLE TO THE PATIENT ON A SLIDING FEE SCALE, IN ACCORDANCE WITH FINANCIAL NEED, AS DETERMINED IN REFERENCE TO FEDERAL POVERTY LEVELS IN EFFECT AT THE TIME OF DETERMINATION.PATIENTS WITH MONETARY ASSETS OR INCOME LEVEL AT 350% OR LESS OF THE FPL, WILL HAVE THE ENTIRE HOSPITAL BILL WRITTEN OFF REGARDLESS OF NET WORTH OR SIZE OF BILL;PATIENTS WITH MONETARY ASSETS OR INCOME LEVEL BETWEEN 350% AND 500% OF THE FPL, WILL HAVE A PORTION OF THE HOSPITAL BILL WRITTEN OFF, BASED UPON THE SLIDING SCALE SET FORTH BELOW REGARDLESS OF NET WORTH OR SIZE OF BILL: 351% - 400% = 75% WRITE-OFF 401% - 450% = 50% WRITE-OFF 451% - 500% = 25% WRITE OFFPATIENTS WITH HOSPITAL BILL THAT EXCEEDS THE PATIENT'S MONETARY ASSETS OR NET WORTH MAY QUALIFY AND BE COVERED UNDER THIS POLICY USING THE GUIDELINES BELOW:- PATIENTS WITH MONETARY ASSETS OR NET INCOME LEVELS BETWEEN 351% AND 400% OF THE FPL, THE AMOUNT OF THE HOSPITAL BILL THAT EXCEEDS THE PATIENT'S NET WORTH WILL BE WRITTEN-OFF;- PATIENTS WITH MONETARY ASSETS OR INCOME IS OVER THE 401% OF THE FPL, PORTION OF THE HOSPITAL BILL THAT EXCEEDS THE PATIENT'S NET WORTH MAY BE WRITTEN-OFF UPON APPROVAL OF THE VP OF REVENUE CYCLE OR HIS/HER DESIGNEE; OR ARRANGED FOR PAYMENT WITH THE PATIENT THROUGH MONTHLY PAYMENT PLAN. FOR PURPOSES OF DETERMINING MONETARY ASSETS OR INCOME, THE REVIEW SHALL NOT INCLUDE THE:A. RETIREMENT OR DEFERRED COMPENSATION PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE, OR NON-QUALIFIED DEFERRED COMPENSATION PLANS;B. FIRST TEN THOUSAND DOLLARS ($10,000) OF A PATIENT'S MONETARY ASSETS;C. FIFTY PERCENT (50%) OF A PATIENT'S MONETARY ASSETS OVER THE FIRST $10,000. PART I, LINE 6A: THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC., A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. CITRUS VALLEY HEALTH PARTNERS, INC. (CVHP), PREPARED AN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT THAT DESCRIBES THE HOSPITAL'S PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY THE HOSPITAL. PART I, LINE 7: MANY GOVERNMENT PROGRAMS (MEDI-CAL, COVERED CALIFORNIA, AND MEDICARE) AND OTHER THIRD PARTY COVERAGE PROGRAMS HAVE BEEN ESTABLISHED TO PROVIDE FOR OR DEFRAY THE HEALTHCARE COSTS FOR THE INDIVIDUALS WHO MAY BE CONSIDERED NEEDY. IN THE CASE WHERE ARRANGEMENTS FOR PAYMENT TO THE HOSPITAL REQUIRE THE HOSPITAL TO ACCEPT THE PAYMENT AMOUNT AS PAYMENT IN FULL, THE BALANCES OF THESE ACCOUNTS WRITTEN OFF ARE ATTRIBUTABLE TO CONTRACTUAL ADJUSTMENTS AND WILL NOT BE CONSIDERED CHARITY CARE. IN CASES WHERE THESE PROGRAMS REQUIRE THE PATIENTS TO PAY CO-PAYMENTS OR DEDUCTIBLES AND THE PATIENTS DO NOT HAVE THE ABILITY TO PAY; THESE AMOUNTS WILL BE CONSIDERED CHARITY CARE.CHARITY DETERMINATION WILL BE GRANTED ON "ALL, PARTIAL, OR NOTHING BASIS". THERE IS A CATEGORY OF PATIENTS WHO QUALIFY FOR MEDI-CAL, BUT DO NOT RECEIVE PAYMENT FOR THEIR ENTIRE STAY. UNDER THE CHARITY POLICY DEFINITION, THESE PATIENTS ARE ELIGIBLE FOR CHARITY CARE WRITE-OFFS. IN ADDITION, THE HOSPITAL SPECIFICALLY INCLUDES AS CHARITY THE CHARGES RELATED TO DENIED STAYS, DENIED DAYS OF CARE, AND NON-COVERED SERVICES. THESE "TREATMENT AUTHORIZATION REQUEST" DENIALS AND ANY LACK OF PAYMENT FOR NON-COVERED SERVICES PROVIDED TO MEDI-CAL PATIENTS ARE TO BE CLASSIFIED AS CHARITY. THESE PATIENTS ARE RECEIVING THE SERVICES AND THEY DO NOT HAVE THE ABILITY TO PAY FOR IT. IN ADDITION, MEDICARE PATIENTS WHO HAVE MEDI-CAL COVERAGE FOR THEIR CO-INSURANCE/DEDUCTIBLES, FOR WHICH MEDI-CAL DOES NOT MAKE PAYMENT AND MEDICARE DOES NOT ULTIMATELY PROVIDE BAD DEBT REIMBURSEMENT WILL ALSO BE INCLUDED AS CHARITY. THESE INDIGENT PATIENTS ARE RECEIVING A SERVICE FOR WHICH A PORTION OF THE RESULTING BILL IS NOT BEING REIMBURSED.THE ABOVE CHARITY WRITE-OFFS ARE CONVERTED INTO CHARITY COST USING THE COST TO CHARGE RATIO WHICH WAS DERIVED FROM WORKSHEET 2 OF THE INSTRUCTIONS TO THE IRS SCHEDULE H, "RATIO OF PATIENT CARE COST-TO-CHARGES."INCLUDED IN PART 1, LINE 7B ARE NET SUPPLEMENTAL MEDI-CAL PAYMENTS OF $2,268,372 FROM THE CALIFORNIA HOSPITAL FEE PROGRAM ("PROGRAM"). CALIFORNIA LEGISLATION ESTABLISHED THE PROGRAM TO IMPOSE A QUALITY ASSURANCE FEE (QA FEE) ON CERTAIN GENERAL ACUTE CARE HOSPITALS IN ORDER TO MAKE SUPPLEMENTAL AND GRANT PAYMENTS AND INCREASED CAPITATION PAYMENTS (SUPPLEMENTAL PAYMENTS) TO HOSPITALS UP TO THE AGGREGATE UPPER PAYMENT LIMIT FOR VARIOUS PERIODS. SEVERAL PIECES OF LEGISLATION HAVE BEEN ENACTED TO CREATE THE PROGRAM FOR VARIOUS PERIODS OF TIME.THE PROGRAM IS DESIGNED TO MAKE SUPPLEMENTAL INPATIENT AND OUTPATIENT MEDI-CAL PAYMENTS TO PRIVATE HOSPITALS, INCLUDING ADDITIONAL PAYMENTS FOR CERTAIN FACILITIES THAT PROVIDE HIGH-ACUITY CARE AND TRAUMA SERVICES TO THE MEDI-CAL POPULATION. THE PROGRAM PROVIDES A MECHANISM FOR INCREASING PAYMENTS TO HOSPITAL THAT SERVE MEDI-CAL PATIENTS, WITH NO IMPACT ON THE STATE'S GENERAL FUND. SOME OF THESE PAYMENTS WILL BE MADE DIRECTLY BY THE STATE, WHILE OTHERS WILL BE MADE BY MEDI-CAL MANAGED CARE PLANS, WHICH WILL RECEIVE INCREASED CAPITATION RATES FROM THE STATE IN AMOUNTS EQUAL TO THE SUPPLEMENTAL PAYMENTS. OUTSIDE OF THE LEGISLATION, THE CALIFORNIA HOSPITAL ASSOCIATION (CHA) HAS CREATED A PRIVATE PROGRAM, OPERATED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT), WHICH WAS ESTABLISHED TO ALLEVIATE DISPARITIES POTENTIALLY RESULTING FROM THE IMPLEMENTATION OF THE PROGRAMS.IN OCTOBER 2013, A 36-MONTH HOSPITAL FEE PROGRAM WAS ESTABLISHED FOR THE PERIOD FROM JANUARY 1, 2014 THROUGH DECEMBER 31, 2016. THE FEE-FOR-SERVICE COMPONENT WAS APPROVED IN 2014, SIX MONTHS OF THE MANAGED CARE NON-EXPANSION COMPONENT WAS APPROVED IN 2015 AND 12 MONTHS OF THE MANAGED CARE EXPANSION AND NON-EXPANSION COMPONENTS WERE APPROVED IN 2016. FPH PROVIDED APPROXIMATELY 4,700 DAYS OF QUALITY HEALTH CARE SERVICES TO MEDI-CAL BENEFICIARIES ANNUALLY.DUE TO DEEP FUNDING CUTS TO MEDI-CAL PROGRAM, AS WELL AS HISTORICAL LOW LEVELS OF REIMBURSEMENT AND HIGH RATE OF DENIALS, THE HOSPITAL FEE PROGRAM HAS BEEN CRITICAL IN HELPING FPH TO CONTINUE PROVIDING QUALITY HEALTH CARE SERVICES TO THE POOREST AND MOST VULNERABLE POPULATION IN THE COMMUNITY. THE PROGRAM REMAINS CRUCIAL IN MAINTAINING MEDI-CAL SERVICES AND CHARITY PROVIDED BY OUR HOSPITAL TO THE COMMUNITY'S LOW INCOME POPULATION, AND IT IS VITAL TO FPH THAT FUTURE SIMILAR PROGRAMS BE APPROVED AND IMPLEMENTED. PART III, LINE 4: TEXT OF THE FOOTNOTE TO THE CONSOLIDATED FINANCIAL STATEMENTS REGARDING BAD DEBT EXPENSE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS:PATIENT SERVICE REVENUE IS REDUCED BY THE PROVISION FOR BAD DEBTS AND ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE CORPORATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO SELF-PAY PATIENTS, INCLUDING BOTH UNINSURED PATIENTS AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THEIR BALANCE. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. THE CORPORATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERED APPROXIMATELY 92% AND 91% OF SELF-PAY PATIENT ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2016 AND DECEMBER 31, 2015, RESPECTIVELY. THE CORPORATION HAS UPDATED ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES DURING CALENDAR YEAR 2016 TO COMPLY WITH NEW FEDERAL AND STATE GUIDELINES.STATEMENT REGARDING COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III - REGARDING CARE OF THE POOR AND COMMUNITY BENEFIT REPORT:CVHP HAS A POLICY TO TREAT EMERGENCY PATIENTS REGARDLESS OF ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT IN ACCORDANCE WITH CERTAIN ESTABLISHED POLICIES OF THE CORPORATION. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED BECAUSE OF INABILITY TO PAY. CVHP PROVIDES PROGRAMS AND ACTIVITIES THAT CONTRIBUTE TO CHARITY CARE, CARE OF THE POOR, AND COMMUNITY BENEFIT. THESE PROGRAMS AND ACTIVITIES SERVE A MAJORITY OF PERSONS WHO ARE BENEFICIARIES OF MEDI-CAL AND COUNTY/STATE PROGRAMS FOR THE MEDICALLY INDIGENT. ALSO INCLUDED ARE ACTIVITIES THAT IMPROVE THE COMMUNITY'S HEALTH STATUS, AND EDUCATE OR PROVIDE SOCIAL SERVICES TO THE ELDERLY AND CHILDREN. THE CORPORATION USES 3 CATEGORIES TO CLASSIFY CARE OF THE POOR AND COMMUNITY BENEFIT: CATEGORY 1: TRADITIONAL CHARITY CARE - CARE OF THE POOR INCLUDES SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED. THIS WRITE-OFF IS ARRANGED BEFORE THE CARE IS GIVEN WHEN POSSIBLE. IF THERE IS ANY SUBSIDY DONATED FOR THESE SERVICES, THAT AMOUNT IS DEDUCTED FROM THE GROSS AMOUNT. CATEGORY 2: UNPAID COST OF PUBLIC PROGRAMS - THIS AMOUNT REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PATIENTS IN THE MEDI-CAL PROGRAM AND ENROLLED IN HMO AND PPO PLANS UNDER CONTRACT WITH THE MEDI-CAL PROGRAM. CATEGORY 3: COMMUNITY BENEFIT - SERVICES THAT ARE BENEFICIAL TO THE BROADER COMMUNITY, IE., OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT THAT NEED SPECIAL SERVICES AND SUPPORT. EXAMPLES INCLUDE THE ELDERLY, SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH AIDS. THEY ALSO INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION, AND HEALTH CLINICS AND SCREENINGS.STATEMENT REGARDING BAD DEBT EXPENSE:THE POLICY OF THE ORGANIZATION IS TO PROVIDE OUR UNINSURED AND UNDERINSURED PATIENTS THE SAME ALLOWANCES PROVIDED TO ITS MANAGED CARE CONTRACTORS. THAT IS, THOSE PATIENTS SHALL HAVE APPLIED TO THEIR ACCOUNTS APPROPRIATE ALLOWANCES AND PER DIEM RATES. THE ORGANIZATION IS TO FOLLOW UP ON AND COLLECT ALL SELF PAY ACCOUNT BALANCES, AS WELL AS, WHERE THIRD PARTY BENEFITS EXIST, ALL PATIENT CO-PAYS AND DEDUCTIBLES, EITHER AT THE TIME OF SERVICE, OR WHEN THEY BECOME DUE. THIS SHALL BE ACCOMPLISHED IN A FAIR, CARING AND COMPASSIONATE MANNER. THE RESULTING NET REALIZABLE BALANCE ON THESE ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER ALL COLLECTION EFFORTS AND FOLLOW UP ATTEMPTS HAVE BEEN MADE. THE ORGANIZATION RECOGNIZES BAD DEBT EXPENSE BASED UPON ITS HISTORICAL EXPERIENCE. PART III, LINE 8: MEDICARE COST REPORT WAS USED TO REPORT THE MEDICARE REVENUE AND MEDICARE ALLOWABLE COSTS. THE MEDICARE RAC (RECOVERY AUDIT CONTRACTORS) AMOUNT RETRACTED BY MEDICARE IN THE CURRENT YEAR FOR THE SERVICES PROVIDED TO THE MEDICARE PATIENTS IN THE PRIOR YEARS WAS NOT OFFSET AGAINST THE MEDICARE REVENUE IN THE CURRENT YEAR. MEDICARE ALLOWABLE COSTS TEND TO UNDERSTATE THE ACTUAL COSTS WHICH INCLUDED CERTAIN COST DISALLOWANCES AND NON-REIMBURSABLE COST CENTERS SUCH AS NON-ALLOWABLE PHYSICIAN FEES, CAFETERIA COSTS, MANAGED CARE OUTSIDE MEDICAL CLAIMS, HOME OFFICE'S MANAGEMENT FEES ADJUSTMENT, NON-ALLOWABLE MEALS, HOME OFFICE BUILDING COSTS, AND OTHER NON-ALLOWABLE EXPENSES. IF THE ESTIMATED ADDITIONAL ALLOCATED DISALLOWABLE MEDICARE COSTS OF $1,232,834 WERE INCLUDED IN LINE 5 AND LINE 6 RESPECTIVELY, THE (SHORTFALL) ON LINE 7 WOULD BE ($2,310,830). PART III, LINE 9B: THE CORPORATION OFFERS THE FOLLOWING COVERAGE OPTIONS WHICH ARE ALWAYS EXPLORED IN ASSESSING PATIENTS' ABILITY TO PAY:A) LINKAGE TO AVAILABLE STATE AID SUCH AS: (I) MEDI-CAL, (II) CALIFORNIA CHILDREN SERVICES, (III) COVERED CALIFORNIA, (IV) OTHERB) PATIENTS UNDER AGE TWENTY ONE YEARS, WHO ARE SELF PAY, SHALL BE REFERRED TO THE ONSITE MEDI-CAL ELIGIBILITY WORKER OR TO EITHER OF OUR CONTRACTED VENDORS FOR COMPLETION OF A MEDI-CAL APPLICATION AND/OR THE ON SITE GEM (GET ELIGIBILITY MOVING) PROGRAM.C) ALL OBSTETRICAL PATIENTS WHO ARE SELF PAY AND UNABLE TO MEET THEIR FINANCIAL OBLIGATION SHALL BE REFERRED TO THE ONSITE MEDI-CAL ELIGIBILITY WORKER OR TO EITHER OF OUR CONTRACTED VENDORS FOR COMPLETION OF A MEDI-CAL APPLICATION AND/OR THE ON SITE GEM PROGRAM.FOR THOSE PATIENTS WHO QUALIFY FOR CHARITY CARE ACCORDING TO THE ORGANIZATION'S CHARITY CARE POLICY, THE PATIENT ACCOUNTS WOULD BE WRITTEN OFF TO CHARITY AND THE PATIENTS WOULD NOT BE BILLED. PART VI, LINE 2: 2016 NEEDS ASSESSMENT:THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) ENACTED ON MARCH 23, 2010, INCLUDED NEW REQUIREMENTS FOR NONPROFIT HOSPITALS IN ORDER TO MAINTAIN TAX EXEMPT STATUS. THE PROVISION WAS THE SUBJECT OF FINAL REGULATIONS PROVIDING GUIDANCE ON THE REQUIREMENTS OF SECTION 501(R) OF THE INTERNAL REVENUE CODE. INCLUDED IN THE NEW REGULATIONS IS A REQUIREMENT THAT ALL NONPROFIT HOSPITALS MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND DEVELOP AN IMPLEMENTATION STRATEGY (IS)EVERY THREE YEARS.CITRUS VALLEY HEALTH PARTNERS HAS CONDUCTED CHNAS FOR MANY YEARS, OFTEN AS PART OF LONG STANDING COMMUNITY COLLABORATIVE WITH KAISER FOUNDATION HOSPITAL-BALDWIN PARK (KFH-BALDWIN PARK). CITRUS VALLEY HEALTH PARTNERS AND KFH-BALDWIN PARK HAVE SIMILAR GEOGRAPHIC SERVICE AREAS, SPECIFICALLY AN OVERLAP OF 14 CITIES WITHIN THE LARGER AREA OF KFH-BALDWIN PARK. THIS CURRENT CHNA WAS COMPLETED THROUGH A COLLABORATION BETWEEN CITRUS VALLEY HEALTH PARTNERS AND KFH-BALDWIN PARK.THE NEW FEDERAL CHNA REQUIREMENTS HAVE PROVIDED AN OPPORTUNITY TO REVISIT THE NEEDS ASSESSMENT AND STRATEGIC PLANNING PROCESSES WITH AN EYE TOWARD ENHANCED COMPLIANCE AND TRANSPARENCY AND LEVERAGING EMERGING TECHNOLOGIES. THE INTENTION IS TO DEVELOP AND IMPLEMENT A TRANSPARENT, RIGOROUS, AND WHENEVER POSSIBLE, COLLABORATIVE APPROACH TO UNDERSTANDING THE NEEDS AND ASSETS IN OUR COMMUNITIES. FROM DATA COLLECTION AND ANALYSIS TO THE IDENTIFICATION OF PRIORITIZED NEEDS AND THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY, THE INTENT WAS TO DEVELOP A RIGOROUS PROCESS THAT WOULD YIELD MEANINGFUL RESULTS.REVIEW OF SECONDARY DATA WAS CONDUCTED THROUGH MULTIPLE SOURCES THAT PROVIDE ACCESS TO PUBLICLY AVAILABLE INDICATORS INCLUDING SOCIAL AND ECONOMIC FACTORS, HEALTH BEHAVIORS, PHYSICAL ENVIRONMENT, CLINICAL CARE, AND HEALTH OUTCOMES. PRIMARY DATA WERE COLLECTED THROUGH KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND SURVEYS. THIS CONSISTED OF REACHING OUT TO LOCAL PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS AND RESIDENTS TO IDENTIFY ISSUES THAT MOST IMPACTED THE HEALTH OF THE COMMUNITY. THE CHNA PROCESSALSO INCLUDED AN IDENTIFICATION OF EXISTING COMMUNITY ASSETS AND RESOURCES TO ADDRESS THE HEALTH NEEDS. IN CONJUNCTION WITH THIS REPORT, CITRUS VALLEY HEALTH PARTNERS WILL DEVELOP AN IMPLEMENTATION STRATEGY FOR THE PRIORITY HEALTH NEEDS THE HOSPITAL WILL ADDRESS. THESE STRATEGIES WILL BUILD ON CITRUS VALLEY HEALTHPARTNERS' ASSETS AND RESOURCES, AS WELL AS EVIDENCE-BASED STRATEGIES, WHEREVER POSSIBLE. SERVICE AREATHE CITRUS VALLEY HEALTH PARTNERS HOSPITAL GENERALLY SERVES RESIDENTS SURROUNDING THE HOSPITAL IN THE EAST SAN GABRIEL VALLEY REGION AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS. THE SERVICE AREA INCLUDES THE FOLLOWING CITIES/COMMUNITIES AND SERVICE PLANNING AREA (SPA):AZUSA, BALDWIN PARK, CITY OF INDUSTRY, COVINA, DIAMOND BAR, EL MONTE, GLENDORA, HACIENDA HEIGHTS, IRWINDALE, LA PUENTE (INCLUDING BASSETT AND VALINDA), LA VERNE, ROWLAND HEIGHTS, SAN DIMAS, SOUTH EL MONTE, WALNUT, WEST COVINA, AND SAN GABRIEL VALLEY (SPA).METHODS TO IDENTIFY COMMUNITY HEALTH NEEDS:A MIXED METHODS APPROACH INVOLVING PRIMARY AND SECONDARY DATA WAS EMPLOYED TO IDENTIFY HEALTH OUTCOMES AND DRIVERS. DATA-GATHERING EFFORTS ARE DESCRIBED IN THE SECTIONS THAT FOLLOW.SECONDARY DATATHE CNM TEAM UTILIZED THE KAISER PERMANENTE (KP) CHNA DATA PLATFORM (WWW.CHNA.ORG/KP) TO REVIEW OVER 135 INDICATORS FROM PUBLICALLY AVAILABLE DATA SOURCES. FURTHER, DATA ON OVER 300 INDICATORS FROM A WIDE RANGE OF LOCAL, COUNTY, STATE AND NATIONAL SOURCES WERE COLLECTED TO SUPPLEMENT THE 135 INDICATORS COLLECTED ON THE KP PLATFORM. FOR DETAILS ON SPECIFIC SOURCES AND DATES OF THE DATA USED, PLEASE SEE APPENDIX A.FOR THE PURPOSES OF THE CHNA, CITRUS VALLEY HEALTH PARTNERS DEFINES A "HEALTH NEED" AS A HEALTH OUTCOME AND/OR THE RELATED CONDITIONS, OR HEALTH DRIVERS THAT CONTRIBUTE TO A DEFINED HEALTH OUTCOME.HEALTH NEEDS ARE IDENTIFIED BY THE COMPREHENSIVE IDENTIFICATION, INTERPRETATION, AND ANALYSIS OF A ROBUST SET OF PRIMARY AND SECONDARY DATA.THE DATA WERE CATEGORIZED BY HEALTH OUTCOMES (MORTALITY AND MORBIDITY) AND HEALTH DRIVERS (HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS, AND PHYSICAL ENVIRONMENT). TOGETHER HEALTH OUTCOMES AND HEALTH DRIVERS REPRESENT THE HEALTH NEEDS OF A COMMUNITY. THESE CATEGORIES ARE BASED ON THE MOBILIZING ACTION TOWARD COMMUNITY HEALTH (MATCH) FRAMEWORK, WHICH ILLUSTRATES THE INTERRELATIONSHIPS AMONG THE ELEMENTS OF HEALTH AND THEIR RELATIONSHIP TO EACH OTHER: SOCIAL AND ECONOMIC FACTORS, HEALTH BEHAVIORS, CLINICAL CARE, PHYSICAL ENVIRONMENTAL, AND HEALTH OUTCOMES. THEMATCH FRAMEWORK CATEGORIES WERE ALSO USED TO PRESENT THE DATA IN THE FOLLOWING SECTIONS OF THE REPORT. ONCE THE DATA INDICATORS WERE CATEGORIZED BY HEALTH OUTCOMES AND HEALTH DRIVERS, ADDITIONAL PIECES OF INFORMATION WERE GATHERED: HEALTH NEEDS WITH DATA INDICATORS THAT PERFORMED POORLY AGAINST A SET BENCHMARK GOALS (I.E., COMPARISON TO LA COUNTY OR CALIFORNIA RATES OR HEALTHY PEOPLE 2020) WERE IDENTIFIED; A TALLY OF THE NUMBER OF TIMES A HEALTH NEED WAS MENTIONED IN THE PRIMARY DATA COLLECTION WAS RECORDED; AND, HEALTH NEEDS IDENTIFIED IN THE 2013 CHNA REPORT WERE IDENTIFIED.A LITERATURE REVIEW WAS ALSO CONDUCTED AS A WAY TO COLLECT CONTEXTUAL INFORMATION FOR THE HEALTH OUTCOMES AND DRIVERS AND PROVIDE CVHP AND CHNA READERS A MORE HOLISTIC PERSPECTIVE OF THE ISSUES IDENTIFIED THROUGH THE NEEDS ASSESSMENT PROCESSMETHODOLOGY FOR INTERPRETATION AND ANALYSIS OF PRIMARY DATACNM USED A THREE-STEP PROCESS FOR ANALYZING AND INTERPRETING PRIMARY DATA: 1) ALL INFORMATION GATHERED DURING FOCUS GROUPS AND INTERVIEWS WERE ENTERED INTO MICROSOFT EXCEL, 2) SPREADSHEET DATA WERE REVIEWED MULTIPLE TIMES USING CONTENT ANALYSIS TO BEGIN SORTING AND CODING THE DATA, AND 3) THROUGH THE CODING PROCESS, THEMES, CATEGORIES AND QUOTES WERE IDENTIFIED. STEPS TWO AND THREE ARE REPEATED AS OFTEN AS NECESSARY TO RECOGNIZE AS MANY CONNECTIONS AND PATTERNS WITHIN THE DATA AS POSSIBLE.THIS APPROACH PROVIDES A SYSTEMATIC WAY TO IDENTIFY BROAD THEMES WITHIN A LARGE SET OF QUALITATIVE DATA AND BEGIN CODING AND CATEGORIZING DATA AROUND THOSE THEMES (E.G., ACCESS TO CARE, POVERTY, CULTURAL BARRIERS). RESPONSES WERE REVIEWED AND CODED SO THAT COMMON THEMES PULLED FROM THE DATA CAN BE COMBINED WITH QUANTITATIVE DATA TO FORM CONCLUSIONS. THROUGH THIS PROCESS, 10 HEALTH OUTCOMES AND NINE DRIVERS WERE IDENTIFIED. THE TABLE BELOW PROVIDES A COMBINED LIST OF HEALTH OUTCOMES AND DRIVERS IN ORDER OF PRIORITY. FOR PLANNING PURPOSES, THE ABOVE LISTS OF HEALTH OUTCOMES AND DRIVERS WERE COMBINED AND PRIORITIZATION SCORES CALCULATED FOR THE COMBINED LIST.PRIORITIZED HEALTH NEEDS1. DIABETES - OUTCOME2. OVERWEIGHT AND OBESITY - OUTCOME3. ECONOMIC SECURITY - DRIVER4. MENTAL HEALTH - OUTCOME5. ACCESS TO HEALTH CARE - DRIVER6. HEALTHY BEHAVIORS - DRIVER7. CULTURAL AND LINGUISTIC BARRIERS - DRIVER8. HOUSING - DRIVER9. ALCOHOL ABUSE, SUBSTANCE ABUSE, AND TOBACCO USE - OUTCOME10. PREVENTIVE HEALTH CARE - DRIVER11. CANCER - OUTCOME12. CARDIOVASCULAR DISEASE - OUTCOME13. PHYSICAL ENVIRONMENT - DRIVER14. VIOLENCE AND INJURY PREVENTION - DRIVER15. ORAL HEALTH - OUTCOME16. RESPIRATORY DISEASE - OUTCOME17. HYPERTENSION - OUTCOME18. ALZHEIMER'S DISEASE - OUTCOME19. ACCESS TO HEALTHY FOODS - DRIVER PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY ASSISTANCE:THE HOSPITAL EMPLOYS A VARIETY OF METHODS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY POSTING ITS CHARITY CARE POLICIES IN PUBLIC PLACES AND PROVIDING PATIENTS WITH WRITTEN NOTICE ABOUT THEIR FINANCIAL OPTIONS, INCLUDING THE AVAILABILITY OF DISCOUNTS, PAYMENT PLANS AND PUBLIC INSURANCE PROGRAMS SUCH AS MEDI-CAL, HEALTHY KIDS, COVERED CALIFORNIA, ACCESS FOR INFANTS AND MOTHERS PROGRAM AND OTHER OPTIONS. SINCE 1991, CVHP'S GEM (GET ENROLLMENT MOVING PROJECT) HAS BEEN A LEADER IN THE SAN GABRIEL VALLEY IN CONNECTING FAMILIES AND INDIVIDUALS WITH ACCESS TO FREE OR LOW-COST HEALTH INSURANCE, AS WELL AS REFERRALS TO OTHER HEALTH ACCESS PROGRAMS FOR THE UNINSURED. THE GEM PROJECT PARTNERS WITH PROMOTORAS (BILINGUAL HEALTH PROMOTERS), SCHOOLS, CHILD-CARE AGENCIES, CHURCHES, FAMILY RESOURCE CENTERS, CLINICS, COMMUNITY BASED ORGANIZATION, ETC. TO IDENTIFY UNINSURED CHILDREN AND ADULTS, AND PROVIDE INSURANCE ENROLLMENT SERVICES IN THE GEM OFFICE AND AT THE OFF-SITE COMMUNITY LOCATIONS. IN ADDITION, THE HOSPITAL HAS OUTREACH PROGRAMS TO LOW INCOME VULNERABLE POPULATIONS VIA DOOR-TO-DOOR, COMMUNITY SITES AND EVENTS. CVHP ALSO SUPPORTS ECHO (EVERY CHILD'S HEALTH OPTION) PROGRAM WHICH PROVIDES URGENT AND SPECIALTY CARE TO UNINSURED CHILDREN. PART VI, LINE 4: COMMUNITY INFORMATION:FOOTHILL PRESBYTERIAN HOSPITAL (FPH) TOGETHER WITH ITS AFFILIATE CITRUS VALLEY MEDICAL CENTER (CVMC) SERVES AN URBAN COMMUNITY OF NEARLY ONE MILLION PEOPLE IN THE SAN GABRIEL VALLEY. CVMC HAS TWO HOSPITALS: INTER-COMMUNITY CAMPUS IN COVINA AND QUEEN OF THE VALLEY CAMPUS IN WEST COVINA. FOLLOWING IS A SUMMARY OF THE MAJOR DEMOGRAPHICS OF THE HOSPITAL AND ITS AFFILIATES' SERVICE AREA -- POPULATION BY AGE: 6.1% AGE 0-4, 16.9% AGE 5-17, 63.8% AGE 18-64 AND 11.2% AGE 65+; MEDIAN HOUSEHOLD INCOME $66,422; POVERTY LEVEL: 47.2% OF THE RESIDENTS IN THE HOSPITAL SERVICE AREA LIVE UNDER 200% OF THE FEDERAL POVERTY LEVEL AND ARE CLASSIFIED AS LOW-INCOME; PAYER MIX BASED ON FPH'S INPATIENT DAYS SERVED: MEDI-CAL AND MEDI-CAL MANAGED CARE 22.3%, MEDICARE AND MEDICARE MANAGED CARE, 52.5%, MANAGED CARE 20.6%, AND SELF-PAY 3.6%. APPROXIMATELY 12 OTHER HOSPITALS ARE SERVICING THE AREAS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:FOOTHILL PRESBYTERIAN HOSPITAL, A FULLY ACCREDITED 105 BED NONPROFIT HOSPITAL, HAS PROUDLY SERVED THE COMMUNITIES OF GLENDORA, AZUSA, LA VERNE AND SAN DIMAS SINCE 1973. KEY SERVICES: FULL RANGE OF GENERAL ACUTE CARE SERVICES. CITRUS VALLEY HEALTH PARTNERS OUTPATIENT DIABETES EDUCATION PROGRAM - RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION AS A CENTER OF EXCELLENCE FOR DIABETES EDUCATION. 37-BED DIABETES CARE UNIT. 13-BED CARL E. WYNN NEWBORN INN - STATE-OF-THE-ART, PRIVATE-ROOM MATERNITY CARE. 9-BED CORONARY CARE UNIT. 9-BED INTENSIVE CARE UNIT. 37-BED MEDICAL/SURGICAL CARE SERVICES. THE ARTHUR AND SARAH LUDWICK EMERGENCY CARE PAVILLION - 24-HOUR EMERGENCY SERVICES, FEATURING THE ONLY FAA-APPROVED HELIPORT BETWEEN SAN BERNARDINO AND ARCADIA WITH APPROXIMATELY 37,000 ER VISITS ANNUALLY.LITHOTRIPSY SERVICES. CITRUS VALLEY CENTERS FOR REHABILITATION SERVICES - OFFERING SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY SERVICES FOR CHILDREN AND ADULTS. THE HOSPITAL IS GOVERNED BY A 22-MEMBER BOARD OF DIRECTORS COMPRISED OF PHYSICIANS, BUSINESS AND COMMUNITY LEADERS. THE BOARD HAS THE OVERALL RESPONSIBILITY FOR THE MANAGEMENT OF THE HOSPITAL. TO CARRY OUT THIS RESPONSIBILITY, THE GOVERNING BODY PROVIDES FOR THE EFFECTIVE FUNCTIONING OF ACTIVITIES RELATED TO: DELIVERY OF PATIENT CARE, PERFORMANCE IMPROVEMENT, PATIENT SAFETY, RISK MANAGEMENT, MEDICAL STAFF CREDENTIALING, FINANCIAL MANAGEMENT, STRATEGIC PLANNING AND COMMUNITY BENEFIT.THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITIES. AS OF DECEMBER 31, 2016, THE HOSPITAL'S MEDICAL STAFF CONSISTED OF 427 PHYSICIANS, OF WHICH 159 ARE MEMBERS OF ITS ACTIVE STAFF (DEFINED AS ADMITTING MORE THAN TWELVE PATIENTS PER YEAR). THE TEN MOST ACTIVE ADMITTING PHYSICIANS ACCOUNTED FOR APPROXIMATELY 67.4% OF TOTAL ADMISSIONS TO FPH. THESE PHYSICIANS HAD SPECIALTIES OF INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY AND PULMONARY MEDICINE. AS OF DECEMBER 31, 2016, 81.5% OF THE TOTAL MEDICAL STAFF MEMBERS AND 82.4% OF THE ACTIVE MEDICAL STAFF MEMBERS WERE BOARD-CERTIFIED IN THEIR RESPECTIVE SPECIALTIES.THE SURPLUS FUNDS HELD BY THE HOSPITAL ARE USED TO FULFILL ITS MISSION AS AN INTEGRATED HEALTH CARE ORGANIZATION COMMITTED TO PROVIDING QUALITY HEALTH CARE SERVICES IN A COMPASSIONATE ENVIRONMENT FOR THE PEOPLE IN THE SURROUNDING COMMUNITIES BY OFFERING OUTREACH EDUCATION AND CHARITY CARE, INVESTING IN ADVANCED MEDICAL TECHNOLOGY AND MODERNIZING HOSPITAL FACILITIES.IN DECEMBER 2015, A NEW SIEMENS MAGNETOM ESPREE 1.5 MRI SCANNER WAS INSTALLED AT FPH AND IS FULLY OPERATIONAL AND READY FOR BOTH INPATIENTS AND OUTPATIENTS. THIS IS A STATE-OF-THE-ART SYSTEM THAT HAS ADVANCED TECHNOLOGY AND IS FULLY EQUIPPED WITH A BROAD RANGE OF MRI APPLICATIONS THAT WILL HAVE A GREAT IMPACT ON DIAGNOSIS, PATIENT MANAGEMENT AND CLINICAL OUTCOMES. ONE MAIN FEATURE OF THE NEW MRI IS A WIDE BORE SCANNER THAT PROVIDES HIGHER QUALITY IMAGING FOR CLAUSTROPHOBIC PATIENTS OR CAN ACCOMMODATE PATIENTS WEIGHING UP TO 550 POUNDS. THESE MRI TECHNOLOGIES WILL HAVE A GREAT IMPACT FOR DIAGNOSIS, PATIENT MANAGEMENT AND CLINICAL OUTCOMES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: CVHP, THE SOLE CORPORATE MEMBER OF CITRUS VALLEY MEDICAL CENTER (CVMC), FOOTHILL PRESBYTERIAN HOSPITAL (FPH), CITRUS VALLEY HOSPICE (HOSPICE), AND CITRUS VALLEY HEALTH FOUNDATION (CVHF), PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT DESCRIBES SPECIFIC OUTREACH PROGRAMS AND SERVICES THAT SUPPORT AND PROVIDE CHARITY CARE AND EDUCATION AND PROMOTE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES SERVED BY FPH AND ITS AFFILIATE ORGANIZATIONS.CVMC OPERATES ACUTE CARE HOSPITALS WITH A TOTAL OF 518 LICENSED BEDS AND PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR THE COMMUNITIES SURROUNDING ITS TWO MEDICAL CENTER CAMPUSES: QUEEN OF THE VALLEY CAMPUS LOCATED IN WEST COVINA WITH 325 LICENSED BEDS, AND INTER-COMMUNITY CAMPUS LOCATED IN COVINA WITH 193 LICENSED BEDS. HOSPICE, LOCATED IN WEST COVINA, CALIFORNIA, OPERATES A 10 LICENSED BED SKILLED NURSING FACILITY AND IN HOME SERVICES FOR TERMINALLY ILL PATIENTS AND A HOME HEALTH CARE AGENCY DOING BUSINESS AS CITRUS VALLEY HOME HEALTH. CVHF PERFORMS THE FUND-RAISING AND TRUST ADMINISTRATION ACTIVITIES RELATED TO CVHP AND ITS AFFILIATES.COMMUNITY OUTREACH:CVHP IS AN ORGANIZATION RECOGNIZED FOR ITS OUTSTANDING COMMUNITY OUTREACH EFFORTS AND ACCOMPLISHMENTS. AN ORGANIZATION DEDICATED TO CREATING INNOVATIVE PARTNERSHIPS AMONG THE NUMEROUS HEALTH AND SOCIAL SERVICE ORGANIZATIONS IN OUR VALLEY, WITH CLOSE TO 100 PARTICIPATING AGENCIES IN DIVERSE COLLABORATIVE RELATIONSHIP DEVOTED TO PROMOTING COMMUNITY HEALTH AND WELL-BEING.SOME HIGHLIGHTS INCLUDE CVHP'S PARTNERSHIP NURSING PROGRAM, WHICH IS BASED ON THE CONCEPT THAT THROUGH WORKING PARTNERSHIPS BETWEEN FAITH COMMUNITIES, COMMUNITY ORGANIZATIONS AND MEDICAL PROFESSIONALS, HEALTH AND WELLNESS ISSUES CAN BE SIGNIFICANTLY IMPROVED. GET ENROLLMENT MOVING PROGRAM (GEM), VOLUNTEERS AND CVHP STAFF MEMBERS WORK TOGETHER TO RECRUIT ELIGIBLE FAMILIES AND ENROLL THEM IN MEDI-CAL, HEALTHY KIDS, COVERED CALIFORNIA, AND OTHER HEALTH ACCESS PROGRAMS. GEM ALSO CALLS ENROLLED INDIVIDUALS THREE SEPARATE TIMES TO CONFIRM ENROLLMENT, ENSURE UTILIZATION OF SERVICES AND TROUBLE SHOOT, AND TO PROVIDE ASSISTANCE AT RENEWAL TIME. GEM IS A PROJECT OF CVHP AND IT IS SUPPORTED BY FUNDING FROM THE L.A. COUNTY OF PUBLIC HEALTH DEPARTMENT AND FIRST 5 LA. GEM PROMOTORAS DE SALUD/HEALTH PROMOTERS IS A PEER OUTREACH AND EDUCATION NEIGHBORHOOD-BASED INITIATIVE WITH THE PURPOSE OF TEACHING AND CONNECTING COMMUNITY RESIDENTS WITH HEALTH INSURANCE OPTIONS. AS LEADERS IN THEIR COMMUNITY, THEY VISIT HOMES DOOR-TO-DOOR TO IDENTIFY NEEDS FOR INFORMATION AND SERVICES. CVHP'S DIABETES PROGRAM PROVIDES FREE DIABETIC FOOT SCREENINGS FOR PATIENTS AND RESIDENTS EVERY MONTH. DIABETES TEST STRIPS ARE PROVIDED FREE OF CHARGE TO PATIENTS THROUGH A PARTNERSHIP WITH A LOCAL COMMUNITY CLINIC; THIS PRACTICE HAD ALREADY SHOWN POSITIVE RESULTS IN RESIDENTS BETTER MANAGING THEIR DIABETES. FREE SUPPORT GROUPS ARE OFFERED AT FOOTHILL EDUCATION CENTER IN GLENDORA AND CVHP RESOURCE CENTER IN COVINA TO HELP RESIDENTS WITH THEIR CONCERNS, ACHIEVEMENTS AND CHALLENGES IN MANAGING THEIR DIABETES. THE LATINO COMMUNITY HAS ACCESS TO SPANISH LANGUAGE GROUPS LED BY A REGISTERED NURSE AND CERTIFIED DIABETES EDUCATOR. CVHP'S VISION IS TO BE AN INTEGRAL PARTNER IN ELEVATING COMMUNITIES' HEALTH THROUGH PARTNERSHIPS. CVHP HAS FORMED A DIABETES PREVENTION AND MANAGEMENT MULTIDISCIPLINARY GROUP MADE UP OF 18 PUBLIC AND PRIVATE AGENCIES WHO JOIN MINDS TO RESPOND TO THE NEEDS OF THE DIABETIC POPULATION AND DECREASE THE DEVASTATING EFFECTS THAT COME WITH IT. CVHP'S BEST BABIES COLLABORATIVE PROGRAM OFFERS FREE HOME VISITATION SERVICES FOR HIGH RISK TEENS AND WOMEN IN PARTNERSHIP WITH SIX COMMUNITY PARTNERS. THIS PROGRAM IS MADE POSSIBLE THROUGH FUNDING AND PARTNERSHIP WITH FIRST 5 LA. CVHP HAS BEEN PROACTIVE IN OFFERING OUTREACH AND EDUCATION THROUGHOUT THE COMMUNITY IN THE AFFORDABLE CARE ACT/MEDI-CAL EXPANSION AND MARKET PLACE. SINCE CONCEPTION, EVERY CHILD'S HEALTHY OPTION (ECHO) IS A COLLABORATIVE EFFORT INVOLVING CVHP, COORDINATED AND LEAD BY LOCAL SCHOOL DISTRICTS. THE ECHO PROGRAM HAS IN PLACE A CADRE OF VOLUNTEER HEALTH PROVIDERS WHO OFFER FREE URGENT CARE SERVICES IN VARIOUS SPECIALTIES; IT ENSURES THAT EVERY CHILD, REGARDLESS OF INCOME LEVEL, HAVE ACCESS TO URGENT QUALITY HEALTH CARE AND PROVIDES ENROLLMENT FOR THE CHILD IN HEALTH INSURANCE. OTHER IMPORTANT PROGRAMS THAT RECEIVE SUPPORT FROM CVHP ARE THE SAN GABRIEL VALLEY COALITION ON HOMELESSNESS AND THE SAN GABRIEL VALLEY DISABILITIES COLLABORATIVE.FOR CVHP'S ACCOMPLISHMENTS AND OUTSTANDING EFFORTS TO IMPROVE THE COMMUNITY'S HEALTH AND WELL-BEING, WE WERE NAMED WINNER OF A 1999 VHA LEADERSHIP AWARD IN COMMUNITY HEALTH IMPROVEMENT. CVHP WAS ONE OF ONLY EIGHT HONOREES NATIONWIDE TO RECEIVE A VOLUNTARY HOSPITALS OF AMERICA, INC. (VHA) AWARD IN 1999 AND WAS THE ONLY CALIFORNIA-BASED ORGANIZATION TO BE RECOGNIZED. AS A TEAM OF THE FOUR FINEST HEALTH CARE INSTITUTIONS IN THE REGION, OUR COLLECTIVE STRENGTHS ENABLE US TO CONTINUE THE COMMITMENT TO EXCELLENCE THE SAN GABRIEL VALLEY HAS COME TO KNOW AND TRUST. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 0 0 0 0 0 0 0 0 ROBERT H CURRY PARENT PRESIDENT, CEO, BOD 0 868458 0 398352 0 21290 0 10600 0 14288 0 1312988 0 0 RAJESH SHARMA EXECUTIVE VP/CFO 0 549461 0 163534 0 13114 0 9600 0 9597 0 745306 0 0 STANLEY KOZAKA PHARMACIST 201162 0 101 0 414 0 9924 0 13793 0 225394 0 0 0 JOHN CASSARA PHARMACY DIRECTOR 186657 0 5000 0 15348 0 3822 0 5545 0 216372 0 0 0 CHANDRA REDDY RSO/NUCLEAR MED 230510 0 102 0 242 0 11505 0 13210 0 255569 0 0 0 MELISSA HOWARD CHIEF NURSE EXEC 0 166284 0 10000 0 4896 0 8638 0 14108 0 203926 0 0 KATHLEEN HAANGE CORP DIR, NURS ADM. 0 165765 0 5103 0 7251 0 8325 0 8899 0 195343 0 0 PART I, LINE 3 ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO - FOOTHILL PRESBYTERIAN HOSPITAL IS AN AFFILIATE OF CITRUS VALLEY HEALTH PARTNERS, INC. (CVHP). ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO - CVHP USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO. PLEASE SEE ADDITIONAL EXPLANATION AT SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. PART I, LINE 4A JOHN CASSARA RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $13,341. ROBERT CURRY OFFICER OF CVHP, INC. AND BOARD MEMBER OF OPTIMA 1983203 CITRUS VALLEY HEALTH PARTNERS, INC. PURCHASES INSURANCE FROM OPTIMA. OPTIMA IS A FULL-SERVICE BROKERAGE COMPANY WHICH IS A WHOLLY OWNED SUBSIDIARY OF THE CALIFORNIA HEALTHCARE INSURANCE COMPANY, INC. 0 990 PART V LINE 7H THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES. CONSEQUENTLY THERE WERE NO FORMS 1098C FILED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC., A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC. THE MEMBER THROUGH THE BOARD OF DIRECTORS HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE ORGANIZATION'S SOLE MEMBER, CITRUS VALLEY HEALTH PARTNERS. FORM 990, PART VI, SECTION B, LINE 11B STAFF ACCOUNTANTS, ACCOUNTING MANAGER AND VICE PRESIDENT OF CORPORATE FINANCE REVIEW FORM 990 FOR ACCURACY AND COMPLETENESS UPON RECEIVING IT FROM THE CPA TAX PREPARER. FORM 990 IS FORWARDED TO RAJESH SHARMA, EVP & CFO, FOR THE FINAL REVIEW. TAX PREPARER PRESENTS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE FOR APPROVAL. BOARD DELEGATED REVIEW AND APPROVAL TO THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, KEY EMPLOYEES, AND MANAGEMENT ARE COVERED BY THE CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICT AND REVIEW OF CONFLICT ARE PERFORMED AT THESE VARIOUS LEVELS OF THE ORGANIZATION. APPROPRIATE ACTION DEPENDING ON THE CONFLICT IS TAKEN BY MANAGEMENT, KEY EMPLOYEES, AND THE BOARD. DISCLOSURE FORMS ARE REQUIRED ANNUALLY BY EACH MEMBER OF THE BOARD OF DIRECTORS, KEY EMPLOYEES, AND MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE PAY AT CITRUS VALLEY HEALTH PARTNERS FOLLOWS MARKET-BASED PAY PRACTICES FOR HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND TYPE IN THE SOUTHERN CALIFORNIA AREA. SALARY RANGES FOR EXECUTIVES WORKING AT CVHP FACILITIES FALL WITHIN THE MIDDLE OF THE MARKET, JUST AS THEY DO FOR ALL EMPLOYEES OF OUR ORGANIZATION. EVERY POSITION IN THE ORGANIZATION HAS A SALARY RANGE ATTACHED TO IT THAT REPRESENTS WHAT OTHERS DOING A SIMILAR JOB IN OTHER ORGANIZATIONS ARE LIKELY TO BE PAID. THE LONG-STANDING PAY PHILOSOPHY FOR CVHP HAS BEEN TO POSITION OUR SALARY RANGES IN THE MIDDLE OF OUR LOCAL LABOR MARKET; WE DON'T WANT TO LAG THE LOCAL MARKET, NOR DO WE WANT TO LEAD THE MARKET, SINCE THAT IS NOT A STRATEGY WE CAN AFFORD TO SUSTAIN OVER TIME. WE RELY ON MARKET STUDIES TO DETERMINE WHERE OUR PAY PRACTICES ARE RELATIVE TO OTHER HOSPITALS IN SOUTHERN CALIFORNIA. FOR EXECUTIVE PAY, WE USE THE NATIONALLY-RECOGNIZED AND RESPECTED FIRM, HEWITT ASSOCIATES LLC, AN AON HEWITT COMPANY (AON), TO ANALYZE OUR EXECUTIVE PAY PROGRAM AND DETERMINE WHERE IT FALLS IN OUR MARKET. THIS STUDY IS PERFORMED EVERY OTHER YEAR. THE MOST RECENT EXECUTIVE COMPENSATION DATA IS DATED APRIL 2016. AS PART OF THEIR EXECUTIVE COMPENSATION REVIEW, AON ALSO ISSUES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE PAY PROGRAM FOR A NOT-FOR-PROFIT ORGANIZATION LIKE OURS THAT IS SUBJECT TO THE REQUIREMENTS OF SECTION 4958 OF THE INTERNAL REVENUE CODE AND UNITED STATES TREASURY DEPARTMENT REGULATIONS. IN THEIR APRIL 20, 2016, OPINION LETTER, AON WROTE, "THIS LETTER IS TO INDICATE THAT WE HAVE REVIEWED THE CURRENT COMPENSATION LEVELS, STRUCTURE, AND ADMINISTRATION OF THE EXECUTIVE COMPENSATION PROGRAM AT THE CITRUS VALLEY HEALTH PARTNERS. THE FOLLOWING REVIEW IS BASED UPON OUR COMPREHENSIVE REPORT ENTITLED: ALIGNING EXECUTIVE COMPENSATION AND STRATEGY. THIS REPORT WAS PRESENTED TO THE COMPENSATION COMMITTEE ON APRIL 20TH AND DISCUSSED IN DETAIL. BASED UPON THIS REVIEW, WE FIND THEM IN SUBSTANTIAL COMPLIANCE WITH ALL CURRENT RULES, REGULATIONS, AND GUIDELINES GOVERNING EXECUTIVE COMPENSATION IN NOT-FOR-PROFIT (501.C) CORPORATIONS. FURTHER, THE LEVELS OF COMPENSATION AWARDED TO THE VARIOUS EXECUTIVES, BOTH IN TERMS OF OPPORTUNITY AND ACTUAL AMOUNTS, ARE CONSISTENT AND REASONABLE WITH PREVAILING MARKET TRENDS AND PRACTICES. LASTLY, THE GOVERNING PRACTICES OF THE COMPENSATION COMMITTEE ARE CONSISTENT WITH SARBANES-OXLEY GUIDELINES AND SECTION 4958 (INTERMEDIATE SANCTIONS) GUIDELINES FOR INDEPENDENCE." THE EXECUTIVE POSITIONS THAT ARE INCLUDED IN THE BIENNIAL EXECUTIVE COMPENSATION REVIEW INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER/CHIEF INFORMATION OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER, CHIEF HUMAN RESOURCES OFFICER, CHIEF CLINICAL SERVICES OFFICER, CHIEF STRATEGY OFFICER, CHIEF COMPLIANCE OFFICER, CHIEF TRANSFORMATION OFFICER, CHIEF COMMUNICATIONS & ADVOCACY OFFICER, AND CEO (CITRUS VALLEY HEALTH FOUNDATION). CITRUS VALLEY HEALTH PARTNERS' (CVHP) EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST CVHP IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVE REQUIRED TO ENABLE CVHP TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES CVHP SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND CVHP'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE AND REVENUE. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST AN AUDIT REPORT IS AVAILABLE AS REQUIRED. NO OTHER DOCUMENTS ARE AVAILABLE. FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS THE OFFICERS REPORTED ON PART VII OF FORM 990 AND SCHEDULE J RECEIVE THEIR ENTIRE COMPENSATION FROM CITRUS VALLEY HEALTH PARTNERS (CVHP). THE IRS INSTRUCTIONS TO FORM 990 REQUIRE THAT ALL COMPENSATION PAID BY A RELATED ORGANIZATION MUST BE DISCLOSED IN THE 990 RETURN FOR EACH AFFILIATED ENTITY. THEREFORE, THE OFFICER COMPENSATION REPORTED IN THE 990 RETURNS FOR CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, INC., FOOTHILL PRESBYTERIAN HOSPITAL AND CITRUS VALLEY HEALTH FOUNDATION, INC., ALL ORGANIZATIONS RELATED TO CVHP, CONSTITUTE THE COMPENSATION PAID BY CVHP AND DOES NOT REPRESENT ADDITIONAL COMPENSATION TO SUCH OFFICERS. PART VII, SECTION A THE OFFICERS SERVE AS CORPORATE OFFICERS FOR CITRUS VALLEY HEALTH PARTNERS (CVHP), CITRUS VALLEY MEDICAL CENTER, INC. (CVMC), CITRUS VALLEY HOSPICE (CVH), INC., FOOTHILL PRESBYTERIAN HOSPITAL (FPH) AND CITRUS VALLEY HEALTH FOUNDATION, INC. (CVHF), ALL AFFILIATES OF THE TAXPAYER. THE NUMBER OF HOURS DEVOTED BY THE CORPORATE OFFICERS TO THE AFFILIATES ARE AS FOLLOWS. ROBERT CURRY DEVOTED 14, 2, 2, AND 18 HOURS TO CVMC, CVH, CVHF, AND CVHP, RESPECTIVELY. RAJESH SHARMA DEVOTED 14, 2, 2, AND 18 HOURS TO CVMC, CVH, CVHF, AND CVHP, RESPECTIVELY. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 670,824. MANAGEMENT AND GENERAL EXPENSES 529,387. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,200,211. FORM 990, PART IX, LINE 24E CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,973,309. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,973,309. EQUIPMENT RENTAL AND MAINTENANCE: PROGRAM SERVICE EXPENSES 799,879. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 799,879. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 546,909. MANAGEMENT AND GENERAL EXPENSES -2,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 544,539. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 21,777. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,777. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF RESTRICTED FUNDS 479,187. PASSTHROUGH INCOME DIFFERENCE -3,712. DECREASE IN BENEFICIAL INTEREST CVHF -252,659. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS HAS CONSTITUTED AN AUDIT AND COMPLIANCE COMMITTEE AND DELEGATED TO THAT COMMITTEE THE RESPONSIBILITY FOR ENGAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. THIS STRUCTURE HAS BEEN IN EFFECT IN PRIOR YEARS AND WAS NOT CHANGED IN 2016. PART XII LINES 2B: THE FINANCIAL STATEMENTS OF CITRUS VALLEY HEALTH PARTNERS, INC. AND ITS AFFILIATES, CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, FOOTHILL PRESBYTERIAN HOSPITAL, CITRUS VALLEY HEALTH FOUNDATION, INC., GLENDORA SURGERY CENTER, AND COVINA VALLEY MANAGEMENT, INC. WERE AUDITED ON A CONSOLIDATED BASIS. CITRUS VALLEY HEALTH PARTNERS INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 953885523 EXEMPT ORGANIZATION SUPPORT & MANAGEMENT CA 501(C)(3) LINE 12B, II N/A 0 CITRUS VALLEY MEDICAL CENTER INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 956006469 ACUTE CARE HOSPITAL CA 501(C)(3) LINE 3 N/A 0 CITRUS VALLEY HEALTH FOUNDATION INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 952534063 EXEMPT ORGANIZATION PUBLIC SUPPORT CA 501(C)(3) LINE 7 N/A 0 CITRUS VALLEY HOSPICE INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 953493611 HOME HEALTH & HOSPICE CARE CA 501(C)(3) LINE 10 N/A 0 GLENDORA SURGERY CENTER 315 E ROUTE 66 101 GLENDORA CA 91740 510492499 OUTPATIENT SURGERY CENTER CA N/A S 0 COVINA VALLEY MANAGEMENT INC 210 W SAN BERNARDINO ROAD COVINA CA 91723 812647150 MANAGEMENT SERVICES CA N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 CITRUS VALLEY MEDICAL CENTER O 990855 FAIR MARKET VALUE CITRUS VALLEY MEDICAL CENTER O -599335 FAIR MARKET VALUE CITRUS VALLEY HEALTH FOUNDATION C 413900 FAIR MARKET VALUE FORM 990, SCHEDULE R, PART V, NUMBER 2, CODE O: THE EXECUTIVE SALARIES ARE PROCESSED THROUGH CITRUS VALLEY HEALTH PARTNERS. THE SALARIES REPORTED ON FORM 990 ARE PROCESSED THROUGH CITRUS VALLEY HEALTH PARTNERS. CITRUS VALLEY HEALTH PARTNERS ACTS AS A COMMON PAYMASTER FOR AFFILIATED ENTITIES, CITRUS VALLEY MEDICAL CENTER, CITRUS VALLEY HEALTH FOUNDATION AND CITRUS VALLEY HOSPICE. CITRUS VALLEY HEALTH PARTNERS FILED ONE FORM W-3 WHICH SHOWS A COMBINED NUMBER OF 3,243 EMPLOYEES. THE NUMBER OF EMPLOYEES FOR EACH ENTITY IS REPORTED SEPARATELY ON ITS OWN FORM 990 PART I LINE 5. CITRUS VALLEY MEDICAL CENTER'S FORM 990 REPORTED A TOTAL OF 2,787 EMPLOYEES, CITRUS VALLEY HOSPICE'S FORM 990 REPORTED 93 EMPLOYEES, CITRUS VALLEY HEALTH FOUNDATION'S FORM 990 REPORTED 7 EMPLOYEES AND CITRUS VALLEY HEALTH PARTNER'S FORM 990 REPORTED 356 EMPLOYEES. THE FILING ORGANIZATION FILES ITS OWN FORM W-3, HOWEVER AMOUNTS REPORTED ON SCHEDULE R, PART V, NUMBER 2, CODE O REPRESENT SHARED EMPLOYEE EXPENSES THAT OCCUR BETWEEN THE AFFILIATES.