2016-11-15T16:47:26-06:00 2015-12-31 330155525 HBLA CERTIFIED PUBLIC ACCOUNTANTS INC 19600 FAIRCHILD STE 320 IRVINE CA 92612 990 2015-01-01 956006469 CITRUS VALLEY MEDICAL CENTER INC CITR 6263317331 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 RAJESH K SHARMA EVP/CFO 6269387595 2016-11-14 1 EDWARD E BENOE P00032866 9498332815 2015 2017-02-10 21:41:12Z ROBERT H CURRY 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 455210006 0 X CVHP.ORG X 1959 CA OPERATION OF ACUTE CARE FACILITY. 22 20 2654 390 76447 75447 92495 131024 408610349 408396719 3745122 5858509 2297937 2833221 414745903 417219473 0 0 0 0 173073824 180514861 0 0 0 211746214 215413448 384820038 395928309 29925865 21291164 345428296 330009463 155997194 124133846 189431102 205875617 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 348040159 409056468 CVMC OPERATES TWO ACUTE CARE HOSPITALS, QUEEN OF THE VALLEY CAMPUS (QVC) AND INTER-COMMUNITY CAMPUS (ICC), IN THE EAST SAN GABRIEL VALLEY OF LOS ANGELES COUNTY. CVMC PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE FOR THE COMMUNITIES SURROUNDING THE TWO MEDICAL CAMPUSES. QVC & ICC PROVIDE CARE FOR AN AVERAGE OF 284 PATIENTS PER DAY. COMBINED ADJUSTED PATIENT DAYS WAS 151,309. EMERGENCY ROOM & OUTPATIENT VISITS TOTALED 163,393. CVMC PROVIDED CHARITY CARE AT COST TOTALING $1,671,000, UNREIMBURSED MEDI-CAL COST TOTALING $43,064,000, AND OTHER COMMUNITY BENEFIT COST TOTALING $4,870,000. DURING 2015, CVMC RECORDED A NET SUPPLEMENTAL MEDI-CAL PAYMENTS OF $26,615,000 FROM THE CALIFORNIA HOSPITAL FEE PROGRAM FOR THE HOSPITAL SERVICES TO MEDI-CAL FEE-FOR-SERVICES PATIENTS COVERED FOR THE PERIOD FROM JANUARY 1, 2015 TO DECEMBER 31, 2015 AND NON-EXPANSION MEDI-CAL MANAGED CARE PATIENTS FOR THE FIRST 6 MONTHS FROM JANUARY 1, 2014 TO JUNE 30, 2014 UNDER A 3-YEAR PROGRAM WHICH STARTED FROM JANUARY 2014 TO DECEMBER 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 ORGANIZATIONS 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. 348040159 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 330 0 1 2654 1 1 1 0 0 0 0 0 0 0 0 0 X 22 20 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 STREET PO BOX 6108 COVINA CA 917225108 ARTHUR LUDWICK BOARD OF DIRECTORS 3.00 X 0 0 0 CLIFFORD CHRIST CHAIR 3.00 X 0 0 0 DONALD BOSS ESQ BOARD OF DIRECTORS 3.00 X 0 0 0 EARL WASHINGTON BOARD OF DIRECTORS 3.00 X 0 0 0 GORDON SHIPP BOARD OF DIRECTORS 3.00 X 0 0 0 GURJEET KALKAT MD BOARD OF DIRECTORS 3.00 X 34500 23940 0 HAROLD BORAK SR BOARD OF DIRECTORS 3.00 X 0 0 0 J PAUL HOLLAND MD BOARD OF DIRECTORS 3.00 X 0 3600 0 JACQUELINE BRACY MD BOARD OF DIRECTORS 3.00 X 0 22718 0 JEFFREY SHAPIRO MD BOARD OF DIRECTORS 3.00 X 0 12000 0 LANCE WILCHER DNP FNP-BC BOARD OF DIRECTORS 3.00 X 0 0 0 MARY KIRCHEN IHM BOARD OF DIRECTORS 3.00 X 0 0 0 OJ RODRIGUEZ BOARD OF DIRECTORS 3.00 X 0 0 0 PATRICIA HANES PHD BOARD OF DIRECTORS 3.00 X 0 0 0 PATSY GORRELL TREASURER 3.00 X 0 0 0 PHILIP MALDONADO DDS BOARD OF DIRECTORS 3.00 X 0 0 0 RAYMOND MATTES IHM BOARD OF DIRECTORS 3.00 X 0 0 0 ROBERT DUNCAN SECRETARY 3.00 X 0 0 0 ROBERT H CURRY PARENT PRESIDENT, CEO, BOD 14.00 26.00 X X 0 1294402 25281 ROBINSON BARON MD BOARD OF DIRECTORS 3.00 X 0 38548 0 THOMAS BRYAN MD BOARD OF DIRECTORS 3.00 X 0 0 0 WALTER ALLEN III VICE CHAIR 3.00 X 0 0 0 GARY MATHEWSON BOARD OF DIRECTORS 3.00 X 0 0 0 RAJESH SHARMA EXECUTIVE VP/CFO 14.00 26.00 X 0 665987 22150 CECILIA AGUDO MICN CHARGE R.N. 36.00 X 0 219297 20651 EDWARD JAI CORP DIR. PHARMACY SVC. 40.00 X 0 240663 20601 ERLINDA PARRENO R.N. II 12HR SHIFT 36.00 X 0 223491 9624 GENARO BADILLA MICN CHARGE R.N. 36.00 X 0 219503 19925 JOHN RAMIREZ VICE PRES FAC/ SUP SVCS 40.00 X 0 221551 13403 34500 3185700 131635 424 0 1 0 CITRUS VALLEY ANESTHESIA MEDICAL 457 W ALLEN AVE STE 118 SAN DIMAS CA 91773 PURCHASED SERVICE MEDICAL 1145917 ANESTHESIA PRACTICE ASSOCIATES 5 HOLLAND ST STE 101 IRVINE CA 92618 PURCHASED SERVICE MEDICAL 789193 SOUTHERN CALIFORNIA HOSPITALIST PO BOX 8206 ANAHEIM CA 92812 PURCHASED SERVICE MEDICAL 559901 INLAND NEUROSURGERY INSTITUTE 255 E BONITA AVE BLDG 9 POMONA CA 91767 PURCHASED SERVICE MEDICAL 516205 UNITED SURGEONS OF CITRUS VALLEY 222 N SUNSET AVE F WEST COVINA CA 91790 PURCHASED SERVICE MEDICAL 495370 29 131024 131024 PATIENT REV/MEDICARE/MEDICAID PAY 900099 332842272 332842272 HOSPITAL FEE PROGRAM REVENUE 900099 66241106 66241106 PREMIUM REVENUE 900099 8747975 8747975 ELECTRONIC HEALTH RECORDS PROGRAM 900099 565366 565366 408396719 2339299 2339299 84783 8336 76447 76447 76447 41488327 13080 37982197 0 3506130 13080 3519210 13080 3506130 CAFETERIA SALES 722210 1253910 1253910 REBATES & REFUNDS 900099 747328 747328 MISCELLANEOUS 900099 463570 463570 291966 269814 22152 2756774 417219473 409143183 76447 7868819 737237 737230 7 130506228 130504889 1339 4217333 4217333 34268864 34268864 10785199 10785019 180 279184 260330 18854 546323 546323 7802744 7275806 526938 54382796 54345543 37253 331149 327648 3501 2162852 2162852 11451557 11451557 2535971 2311068 224903 UNRELATED BUSINESS INCO 2317 2317 PURCHASED SERVICES 66656433 20177202 46479231 HOSPITAL FEE - PROG EXP 39625909 39625909 PROVISION FOR BAD DEBT 14122052 14122052 15514161 14920534 593627 395928309 348040159 47888150 0 4520 4520 11508200 32069811 45717710 42507540 77882839 23966461 5034945 5596476 2054842 2076951 356196131 269383455 78169267 86812676 111765572 120730493 13290401 16244535 345428296 330009463 89916386 62384457 60197808 55164389 5883000 6585000 155997194 124133846 X 185601202 201618217 3829900 4257400 189431102 205875617 345428296 330009463 X 21291164 -5344943 498295 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 144576457 100161412 44415045 200301931 169222043 31079888 11317743 11317743 86812676 FIXED INCOME - RESTRICTED ASSETS - WORKERS COMP FUND 184777 F FIXED INCOME INVESTMENTS - LIMITED TO USE 10070605 F FIXED INCOME - WORKERS COMP FUNDS - TRAVELERS 2709884 F FIXED INCOME - BOND INVESTMENT FUND 11478683 F EQUITIES - INVESTMENTS - LIMITED TO USE 96286544 F 120730493 WORKERS COMP RESERVES 6585000 6585000 X 397068000 -5344943 46749 -5298194 402366194 14853279 14853279 417219473 381213000 0 381213000 14715309 14715309 395928309 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, 2015 OR 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: BENEFICIAL INTEREST IN CVHF'S OPERATING INCOME 46,749. PART XI, LINE 4B - OTHER ADJUSTMENTS: BANK CHARGES 56,434. INVESTMENT FEES 546,323. TEMPORARILY RESTRICTED NET INCOME -14,144. BAD DEBT 14,122,052. TRANSFER FROM CITRUS VALLEY HEALTH FOUNDATION 131,024. PASSTHROUGH INCOME DIFFERENCE 19,855. RENTAL EXPENSES -8,336. ROUNDING 71. PART XII, LINE 4B - OTHER ADJUSTMENTS: BANK CHARGES 56,434. INVESTMENT FEES 546,323. BAD DEBT 14,122,052. ROUNDING DIFFERENCE -1,164. RENTAL EXPENSES -8,336. 1 1 X 1 X 350.000000000000 1 X 500.000000000000 1 1 0 1 1 1671310 1671310 0.00420 162191646 145742459 16449187 0.04150 163862956 145742459 18120497 0.04570 4649295 4649295 0.01170 191921 191921 0.00050 28000 17934 10066 0.00000 18000 18000 0.00000 4887216 17934 4869282 0.01220 168750172 145760393 22989779 0.05790 1 14122052 0 83299594 75794011 7505583 X 1 1 1 1 CVMC - QVC AND ICC 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 WWW.CVHP.ORG 930000131 X X X IP REHAB UNIT, IP MENTAL HEALTH UNIT, SNF UNIT CVMC - QVC AND ICC 1 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.CVHP.ORG/DOCUMENTS/CVHP_CHNA_REPORT_2013.PDF 1 14 1 WWW.CVHP.ORG/DOCUMENTS/CVHP-2014COMMUNITY.PDF 1 0 1 X 350.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X WWW.CVHP.ORG X WWW.CVHP.ORG X WWW.CVHP.ORG X X X X X 1 0 1 X 0 0 PART V, SECTION A: CVMC OPERATES TWO ACUTE CARE HOSPITALS, QUEEN OF THE VALLEY CAMPUS (QVC) AND INTER-COMMUNITY CAMPUS (ICC). QVC IS LOCATED AT 1115 SOUTH SUNSET AVENUE, WEST COVINA, CA 91790. ICC IS LOCATED AT 210 W. SAN BERNARDINO ROAD, COVINA, CA 91723. CVMC - QVC AND ICC PART V, SECTION B, LINE 5: DURING THE INITIAL PHASE OF THE CHNA PROCESS, COMMUNITY INPUT WAS COLLECTED IN THE SAN GABRIEL VALLEY DURING FIVE FOCUS GROUPS AND 19 INTERVIEWS WITH KEY STAKEHOLDERS SELECTED WITH THE ASSISTANCE OF THE CITRUS VALLEY HEALTH PARTNERS AND KAISER FOUNDATION HOSPITAL - BALDWIN PARK COMMUNITY BENEFIT MANAGERS AND RECOMMENDATIONS FROM OTHER KEY INFORMANTS, AND INCLUDED HEALTH CARE PROFESSIONALS, GOVERNMENT OFFICIALS, SOCIAL SERVICE PROVIDERS, COMMUNITY RESIDENTS, LEADERS AND OTHER RELEVANT COMMUNITY REPRESENTATIVES WITH KNOWLEDGE OF THE CITRUS VALLEY HEALTH PARTNERS SERVICE AREA. THE INTERVIEWS WERE CONDUCTED PRIMARILY VIA TELEPHONE FOR APPROXIMATELY 30 TO 45 MINUTES EACH; THE CONVERSATIONS WERE CONFIDENTIAL AND INTERVIEWERS ADHERED TO STANDARD ETHICAL RESEARCH GUIDELINES. FOCUS GROUP SESSIONS WERE 60 TO 90 MINUTES EACH. AS WITH THE INTERVIEWS, THE FOCUS GROUP TOPICS ALSO WERE DESIGNED TO COLLECT REPRESENTATIVE INFORMATION ABOUT HEALTH CARE UTILIZATION, PREVENTIVE AND PRIMARY CARE, HEALTH INSURANCE, ACCESS AND BARRIERS TO CARE, EMERGENCY ROOM USE, CHRONIC DISEASE MANAGEMENT AND OTHER COMMUNITY ISSUES. CONCURRENTLY, SECONDARY DATA WERE COLLECTED AND COMPARED TO RELEVANT BENCHMARKS INCLUDING HEALTHY PEOPLE 2020, LOS ANGELES COUNTY OR CALIFORNIA WHEN POSSIBLE. THE DATA WERE ALSO COLLECTED AT SMALLER GEOGRAPHIES, WHEN POSSIBLE, TO ALLOW FOR MORE IN-DEPTH ANALYSIS AND IDENTIFICATION OF COMMUNITY HEALTH ISSUES. IN ADDITION, PREVIOUS CHNAS WERE REVIEWED TO IDENTIFY TRENDS AND ENSURE THAT PREVIOUSLY IDENTIFIED NEEDS WERE NOT OVERLOOKED. PRIMARY AND SECONDARY DATA WERE COMPILED INTO A SCORECARD PRESENTING HEALTH NEEDS AND HEALTH DRIVERS WITH HIGHLIGHTED COMPARISONS TO THE AVAILABLE DATA BENCHMARKS. THE SCORECARD WAS DESIGNED TO ALLOW FOR A COMPREHENSIVE ANALYSIS ACROSS ALL DATA SOURCES AND FOR USE DURING THE PRIORITIZATION PHASE OF THE CHNA PROCESS. CVMC - QVC AND ICC PART V, SECTION B, LINE 6A: COMMUNITY HEALTH NEEDS ASSESSMENT - THE HOSPITAL FACILITY'S NEEDS ASSESSMENT WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: - FOOTHILL PRESBYTERIAN HOSPITAL - MORRIS L. JOHNSTON MEMORIAL - GLENDORA, CA - KAISER FOUNDATION HOSPITAL - BALDWIN PARK, CA CVMC - QVC AND ICC PART V, SECTION B, LINE 22D: 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: ELIGIBILITY CRITERIA AND AMOUNTS CHARGED TO PATIENTS.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 OFF -PATIENTS 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 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, LINES 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 AND MEDICARE) AND OTHER THIRD PARTY COVERAGE PROGRAMS HAVE BEEN ESTABLISHED TO PROVIDE FOR OR DEFRAY THE HEALTHCARE COSTS FOR THE INDIVIDUALS WHO ALSO 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 I, LINE 7B ARE NET SUPPLEMENTAL MEDI-CAL PAYMENTS OF $26,615,000 FROM THE CALIFORNIA HOSPITAL FEE PROGRAM ("PROGRAM") FOR THE SERVICES PROVIDED TO MEDI-CAL FEE-FOR-SERVICE PATIENTS COVERED FOR THE PERIOD FROM JANUARY 1, 2015 TO DECEMBER 31, 2015 AND NON-EXPANSION MEDI-CAL MANAGED CARE PATIENTS FOR THE FIRST 6 MONTHS FROM JANUARY 1, 2014 TO JUNE 30, 2014 UNDER A 3-YEAR PROGRAM WHICH STARTED FROM JANUARY 2014 TO DECEMBER 2016.THE PROGRAM WAS SIGNED INTO LAW AND WAS APPROVED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) IN DECEMBER 2014. UNDER THE PROGRAM, CALIFORNIA HOSPITALS WERE ASSESSED A FEE BASED ON THE NUMBER OF MEDI-CAL PATIENT DAYS EACH FACILITY PROVIDES. THE STATE WOULD USE THESE MONIES TO DRAW DOWN MATCHING FEDERAL FUNDS. THE FEES PAID BY HOSPITALS, COMBINED WITH THE FEDERAL MATCHING FUNDS, WERE DISTRIBUTED BACK TO THE HOSPITALS IN THE FORM OF SUPPLEMENTAL MEDI-CAL PAYMENTS. THE ACTUAL AMOUNT EACH HOSPITAL RECEIVED WAS BASED ON THE FACILITY'S VOLUME OF MEDI-CAL PATIENTS. CVMC PROVIDED APPROXIMATELY 43,000 DAYS OF QUALITY HEALTH CARE SERVICES TO MEDI-CAL BENEFICIARIES ANNUALLY.CVMC IS ONE OF THE LARGEST PROVIDERS OF CARE TO MEDI-CAL ENROLLEES IN SOUTHERN CALIFORNIA. DUE TO DEEP FUNDING CUTS TO THE 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 CVMC TO CONTINUE PROVIDING QUALITY HEALTH CARE SERVICES TO THE POOREST AND MOST VULNERABLE POPULATION IN THE COMMUNITY. WITHOUT THE PROGRAM, A NUMBER OF HOSPITALS MAY BE FORCED TO RESTRICT OR END SERVICES TO MEDI-CAL PATIENTS AND OUR HOSPITAL MAY FACE SIMILAR DILEMMA.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 CVMC THAT FUTURE SIMILAR PROGRAMS BE APPROVED AND IMPLEMENTED. PART I, LINE 7G: THE AMOUNT INCLUDED IN THIS LINE IS THE NET COST OF THE SUBSIDIZED HEALTH SERVICES PROGRAM CALLED "NEONATAL SLEEP APNEA" WHICH TREATMENT INCORPORATES STUDIES THAT FURTHER SCIENCE'S UNDERSTANDING OF THE APNEA ILLNESS IN NEWBORNS. 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 91% AND 98% OF SELF-PAY PATIENT ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2015 AND 2014, RESPECTIVELY. THE CORPORATION HAS UPDATED ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES DURING CALENDAR YEAR 2015 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 OUT-OF-AREA MEDICAL CLAIMS, HOME OFFICE'S MANAGEMENT FEES ADJUSTMENT, MAMMOGRAPHY CLINIC, NON-ALLOWABLE MEALS, HOME OFFICE BUILDING COSTS, AND OTHER NON-ALLOWABLE EXPENSES. IF THE MEDICARE RAC AUDIT TAKEBACKS OF $1,090,906 AND THE ESTIMATED ADDITIONAL ALLOCATED DISALLOWABLE MEDICARE COSTS OF $6,402,000 WERE INCLUDED IN LINE 5 AND LINE 6 RESPECTIVELY, THE SURPLUS ON LINE 7 WOULD BE $12,677. 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: NEEDS ASSESSMENT: THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA), ENACTED ON MARCH 23, 2010, INCLUDED THE REQUIREMENT, UNDER SECTION 501(R), THAT NONPROFIT HOSPITAL ORGANIZATIONS MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AT LEAST ONCE EVERY THREE YEARS TO MAINTAIN TAX EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE SERVICE CODE. AS PART OF THE CHNA, EACH HOSPITAL IS REQUIRED TO COLLECT INPUT FROM DESIGNATED INDIVIDUALS IN THE COMMUNITY, INCLUDING PUBLIC HEALTH EXPERTS AS WELL AS MEMBERS, REPRESENTATIVES OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS AND INDIVIDUALS WITH CHRONIC CONDITIONS. THOUGH THE CHNA PROCESS IS A NEW NATIONAL MANDATE WITHIN THE ACA, NONPROFIT HOSPITALS IN CALIFORNIA HAVE BEEN REQUIRED TO CONDUCT A CHNA EVERY THREE YEARS FOLLOWING PASSAGE OF CALIFORNIA SENATE BILL 697 (SB697) IN 1994.CITRUS VALLEY HEALTH PARTNERS HAS CONDUCTED CHNAS FOR MANY YEARS TO IDENTIFY NEEDS AND RESOURCES IN ITS COMMUNITIES AND TO GUIDE THE DEVELOPMENT OF COMMUNITY BENEFIT PLANS. THE ADOPTION OF ACA LEGISLATION HAS 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 CHNA PROCESS UNDERTAKEN IN 2013 AND DESCRIBED IN THIS REPORT WAS CONDUCTED IN COMPLIANCE WITH THESE NEW FEDERAL REQUIREMENTS.THE NEW LEGISLATION GUIDING THE CHNA FOR NONPROFIT HOSPITALS REQUIRES A GREATER EMPHASIS ON STRUCTURED AND STANDARDIZED METHODOLOGIES IN TERMS OF HOW COMMUNITY NEEDS ARE IDENTIFIED AND PRIORITIZED. THE ASSESSMENT HAD TO BALANCE A STRICT FOCUS ON METHODOLOGY WITH THE INDIVIDUAL NEEDS OF LOCAL HOSPITALS AND THE DESIRE TO HAVE AN INCLUSIVE PROCESS, ENGAGING A RANGE OF STAKEHOLDERS AND CONSIDERATION OF THE DIVERSE NEEDS OF THE COMMUNITIES SERVED.FOR THE 2013 CHNA, THREE KAISER FOUNDATION HOSPITALS AND ONE NON-KAISER FOUNDATION HOSPITAL, CITRUS VALLEY HEALTH PARTNERS, IN LOS ANGELES, WEST LOS ANGELES AND THE SAN GABRIEL VALLEY FORMED A COLLABORATIVE TO WORK WITH THE CENTER FOR NONPROFIT MANAGEMENT EVALUATION CONSULTING TEAM IN CONDUCTING THE CHNA. THIS CHNA REPORT WAS PRODUCED FOR AND IN COLLABORATION WITH CITRUS VALLEY HEALTH PARTNERS AND KAISER FOUNDATION HOSPITAL-BALDWIN PARK.AFTER PRIMARY AND SECONDARY DATA WERE ANALYZED (SEE PART V LINE 3 ABOVE), A PROCESS WAS CREATED WITH THE ASSISTANCE OF THE COLLABORATIVE PARTNERS, WHICH THE IDENTIFIED NEEDS, BASED ON THE AMOUNT OF DATA INDICATING A NEED. THE FIRST STEP INVOLVED DESIGNING A METHOD FOR SORTING THE EXTENSIVE LIST OF HEALTH ISSUES AND DRIVERS IDENTIFIED THROUGH THE PRIMARY AND SECONDARY SOURCES DESCRIBED ABOVE. THE METHOD DEVELOPED BY THE TEAM SORTED THE IDENTIFIED NEEDS INTO THREE LEVELS OR TIERS, BASED ON THE AMOUNT OF DATA INDICATING A NEED. THE FIRST AND MOST INCLUSIVE TIER INCLUDED ANY NEED OR DRIVER IDENTIFIED AS PERFORMING POORLY AGAINST A SET BENCHMARK IN SECONDARY DATA OR MENTIONED AT LEAST ONCE IN PRIMARY DATA COLLECTION. THE SECOND TIER INCLUDED THOSE ISSUES IDENTIFIED AS POORLY PERFORMING AGAINST A SET BENCHMARK OR MENTIONED MULTIPLE TIMES IN PRIMARY DATA COLLECTION. THE THIRD AND MOST EXCLUSIVE TIER INCLUDED THOSE ISSUES IDENTIFIED AS POORLY PERFORMING AGAINST A SET BENCHMARK THAT ALSO RECEIVED MULTIPLE MENTIONS IN PRIMARY DATA COLLECTION.AFTER APPLICATION OF THE RATING METHOD, TIER TWO WAS DEEMED AS THE MOST APPROPRIATE IDENTIFIER OF A POTENTIAL PRIORITIZED HEALTH NEED (AND/OR DRIVER) AS THESE CRITERIA PROVIDED A STRINGENT YET INCLUSIVE APPROACH THAT WOULD ALLOW FOR A COMPREHENSIVE LIST OF 22 HEALTH NEEDS TO BE BROUGHTFORTH FOR COMMUNITY INPUT IN THE PRIORITIZATION PROCESS. A SUMMARY OF THE DATA RELATED TO THESE IDENTIFIED HEALTH NEEDS IS INCLUDED IN APPENDIX B: CITRUS VALLEY HEALTH PARTNERS HEALTH NEEDS PROFILES.A MODIFIED SIMPLEX METHOD WAS USED TO IMPLEMENT THE PRIORITIZATION PROCESS, CONSISTING OF TWO FACILITATED GROUP SESSIONS ENGAGING PARTICIPANTS IN THE FIRST PHASE OF COMMUNITY INPUT AND NEW PARTICIPANTS IN A DISCUSSION OF THE DATA (AS PRESENTED IN THE SCORECARDS AND ACCOMPANYING HEALTH NEED NARRATIVES) AND THE PRIORITIZATION PROCESS. AT THE SESSIONS, PARTICIPANTS WERE PROVIDED WITH A BRIEF OVERVIEW OF THE CHNA PROCESS, A LIST OF IDENTIFIED NEEDS IN THE SCORECARD FORMAT AND THEBRIEF NARRATIVE SUMMARY DESCRIPTIONS OF THE IDENTIFIED HEALTH NEEDS DESCRIBED ABOVE. THEN, IN SMALLER BREAK-OUT GROUPS, PARTICIPANTS CONSIDERED THE SCORECARDS AND HEALTH NEEDS SUMMARIES IN COMPLETING A PRIORITIZATION GRID EXERCISE WHICH WAS THEN SHARED WITH THE LARGER GROUP. (THESE PRIORITIZATION GRIDS WILL ALSO SERVE AS SUPPLEMENTAL INFORMATION FOR THE IMPLEMENTATION STRATEGY PHASE.) FOLLOWING THIS SERIES OF DISCUSSIONS, PARTICIPANTS COMPLETED A BRIEF QUESTIONNAIRE ABOUTHEALTH NEEDS, DRIVERS AND RESOURCES AND RANKED EACH HEALTH NEED ACCORDING TO SEVERAL CRITERIA INCLUDING SEVERITY, CHANGE OVER TIME, RESOURCES AVAILABLE TO ADDRESS THE NEED OR DRIVER AND COMMUNITY READINESS TO SUPPORT ACTION ON BEHALF OF ANY HEALTH NEED OR DRIVER. AFTER COMPLETINGTHE QUESTIONNAIRES, PARTICIPANTS WERE EACH GIVEN TEN (10) STICKER DOTS AND INVITED TO PLACE FIVE DOTS ON ANY HEALTH NEEDS AND FIVE DOTS ON ANY HEALTH DRIVERS THAT WERE LISTED IN ALPHABETICAL ORDER ON LARGE FLIP CHART PAPER POSTED AROUND THE MEETING SPACE. PARTICIPANTS COULD PLACE THE FIVE DOTS IN EACH SECTION (HEALTH NEEDS AND HEALTH DRIVERS) IN ANY MANNER THEY WISHED, AND EACH DOT COUNTED AS ONE VOTE. DATA GATHERED THROUGH THE SURVEY WERE ANALYZED AND GIVEN AN OVERALL SCORE, RANGING FROM 1 FOR LEAST NEED TO 12 FOR HIGHEST NEED. HEALTH NEEDS WERE ALSO RANKED BY THECRITERIA INCLUDING SEVERITY, CHANGE OVER TIME AND AVAILABLE RESOURCES TO ADDRESS THE NEED.SERVICE AREA: CITRUS VALLEY HEALTH PARTNERS COMPRISES FOUR CAMPUSES: INTER-COMMUNITY IN COVINA, QUEEN OF THE VALLEY IN WEST COVINA, FOOTHILL PRESBYTERIAN IN GLENDORA, AND CITRUS VALLEY HOSPICE IN WEST COVINA. THE COMMUNITY SERVED BY A HOSPITAL IS DEFINED AS THOSE INDIVIDUALS RESIDING WITHIN ITS HOSPITALSERVICE AREA. A HOSPITAL SERVICE AREA INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS.THE CITRUS VALLEY HEALTH PARTNERS (CVHP) SERVICE AREA INCLUDES THE FOLLOWING CITIES AND SERVICE PLANNING AREAS (SPA):AZUSA, BALDWIN PARK (INCLUDING IRWINDALE), COVINA, DIAMOND BAR, EL MONTE, GLENDORA, HACIENDA HEIGHTS, LA PUENTE, LA VERNE, ROWLAND HEIGHTS, SAN DIMAS, SOUTH EL MONTE, WALNUT, WEST COVINA, SAN GABRIEL (SPA) AND POMONA VALLEYS (SPA).SERVICE AREA DESCRIPTION:A DESCRIPTION OF THE COMMUNITY SERVED BY CVHP IS PROVIDED IN THE DATA TABLES AND NARRATIVE. DEPENDING UPON THE AVAILABLE DATA SOURCES FOR EACH VARIABLE, CVHP INFORMATION IS PRESENTED AS REPRESENTING THE ENTIRETY OF THE CITY/COMMUNITY WHEN POSSIBLE. DATA ARE ORGANIZED IN SECTIONS: DEMOGRAPHIC PROFILE, ACCESS TO HEALTH CARE AND CHRONIC DISEASE PREVALENCE AND INCIDENCE. 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, HEALTHY FAMILIES, 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: CITRUS VALLEY MEDICAL CENTER (CVMC) SERVES AN URBAN COMMUNITY OF NEARLY ONE MILLION PEOPLE IN THE SAN GABRIEL VALLEY AND HAS TWO HOSPITALS: CVMC - INTER-COMMUNITY CAMPUS IN COVINA AND CVMC - QUEEN OF THE VALLEY CAMPUS IN WEST COVINA. FOLLOWING IS A SUMMARY OF THE MAJOR DEMOGRAPHICS OF THE HOSPITAL'S SERVICE AREA -- POPULATION BY AGE: 6.3% AGE 0-4, 19.2% AGE 5-17, 63.2% AGE 18-64 AND 11.3% AGE 65+; MEDIAN HOUSEHOLD INCOME $66,422; POVERTY LEVEL: 33.7% 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 CVMC'S INPATIENT DAYS SERVED: MEDI-CAL AND MEDI-CAL MANAGED CARE 41.7%, MEDICARE AND MEDICARE MANAGED CARE 42.7%, MANAGED CARE 13.9%, AND SELF-PAY 1.7%. APPROXIMATELY 12 OTHER HOSPITALS ARE SERVICING THE AREAS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL PROVIDES A WIDE RANGE OF PATIENT CARE SERVICES THROUGH ITS TWO CAMPUSES AS FOLLOWS:CVMC - QUEEN OF THE VALLEY CAMPUS LOCATED IN WEST COVINA IS A 325-BED FULLY ACCREDITED NONPROFIT, CATHOLIC HEALTH CARE FACILITY FOUNDED IN 1962 BY THE IMMACULATE HEART COMMUNITY.KEY SERVICES: -FAMILY BIRTH & NEWBORN CENTER (A 40-BED PERINATAL SERVICES AND A 40-BED NICU) - MORE DELIVERIES ARE MADE AT THIS CAMPUS THAN ANY HEALTH CARE FACILITY IN THE EAST SAN GABRIEL VALLEY WITH APPROXIMATELY 4,200 DELIVERIES ANNUALLY AND APPROXIMATELY 500 BABIES HAVE BEEN CARED FOR IN THE LEVEL IIIB NEWBORN INTENSIVE CARE UNIT EACH YEAR. -THE GELERIS FAMILY CANCER CENTER - OFFERING COMPLETE EDUCATION, DIAGNOSIS, TREATMENT AND SUPPORT SERVICES. PATIENTS ARE KEPT APPRISED OF ONGOING CLINICAL CANCER TRIALS AND MAY PARTICIPATE, WHEN ELIGIBLE.-QUEEN'S MAMMOGRAPHY CENTER - PROVIDING LOW-COST MAMMOGRAPHY SCREENING AND BREAST HEALTH EDUCATION.-STATE-OF-THE-ART MRI, CAT SCAN AND LITHOTRIPSY SERVICES-12-BED INTENSIVE CARE UNIT.-6-BED CARDIAC CARE UNIT.-37-BED DEFINITIVE OBSERVATION UNIT.-12-BED REHABILITATION UNIT.-160-BED MEDICAL/SURGICAL SERVICES.-18-BED PEDIATRICS UNIT - A CERTIFIED CHILD LIFE SPECIALIST IS ON STAFF TO PROVIDE EDUCATION, SUPPORT AND THERAPEUTIC INTERVENTIONS THAT ADDRESS THE PSYCHOSOCIAL AND EMOTIONAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES.-CITRUS VALLEY CENTERS FOR REHABILITATION SERVICES - OFFERING SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY SERVICES FOR CHILDREN AND ADULTS-EMERGENCY DEPARTMENT IS ONE OF THE BUSIEST IN SOUTHERN CALIFORNIA, WITH NEARLY 62,000 VISITS ANNUALLY-ROBOTIC SURGERY PROGRAM FEATURING THE DA VINCI SI SURGICAL SYSTEM.CVMC - INTER-COMMUNITY CAMPUS HAS BEEN PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY SINCE 1922. THE NONPROFIT 193-BED FACILITY IN COVINA PROVIDES HIGH-QUALITY HEALTH CARE TO THE EAST SAN GABRIEL VALLEY WITH A WIDE RANGE OF MEDICAL, SURGICAL AND SPECIALTY SERVICES. KEY SERVICES: -CITRUS VALLEY HEART CENTER - OFFERING THE ONLY OPEN HEART SURGERY PROGRAM IN THE EAST SAN GABRIEL VALLEY -CARDIAC CATH LAB - PROVIDING THE LATEST TREATMENTS AND ADVANCEMENTS FOR PATIENTS SUFFERING FROM CARDIAC DISEASE -DIAGNOSTIC CARDIOLOGY AND NUCLEAR MEDICINE DEPARTMENTS -CARDIAC REHABILITATION PROGRAM -14-BED CARDIAC CARE UNIT. -8-BED INTENSIVE CARE UNIT. -54-BED DEFINITIVE OBSERVATION UNIT. -24-BED ORTHO/SURG UNIT. -38-BED MEDICAL/SURGICAL SERVICES. -30-BED MENTAL HEALTH UNIT. -25-BED TRANSITIONAL CARE UNIT. -RADIATION ONCOLOGY AND INPATIENT CANCER UNIT. -MAMMOGRAPHY SCREENING CENTER WITH 3D MAMMOGRAPHY TECHNOLOGY. -WOUND CARE - COMPREHENSIVE CARE FOR PATIENTS WITH WOUNDS THAT WON'T HEAL, INCLUDING A STATE-OF-THE-ART HYPERBARIC CHAMBER -EMERGENCY DEPARTMENT WITH NEARLY 27,000 VISITS ANNUALLY.-CHEST PAIN EMERGENCY UNIT -CITRUS VALLEY CENTERS FOR REHABILITATION SERVICES - OFFERING SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY SERVICES FOR CHILDREN AND ADULTS -INFORMATION CENTER FOR PHYSICIAN, HOSPITAL AND COMMUNITY OUTREACH REFERRALS -CANCER RESOURCE CENTER 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. THE HOSPITAL'S MEDICAL STAFF CONSISTED OF 661 PHYSICIANS, OF WHICH 426 ARE MEMBERS OF ITS ACTIVE STAFF (DEFINED AS ADMITTING MORE THAN TWELVE PATIENTS PER YEAR). THE TEN MOST ACTIVE ADMITTING PHYSICIANS ACCOUNTED FOR APPROXIMATELY 31.9% OF TOTAL ADMISSIONS. THESE PHYSICIANS HAD SPECIALTIES IN INTERNAL MEDICINE, PSYCHIATRY, OBSTETRIC/GYNECOLOGY AND CARDIOLOGY - 87% OF THE TOTAL MEDICAL STAFF MEMBERS AND 97.2% OF THE ACTIVE MEDICAL 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.CITRUS VALLEY HEALTH PARTNERS IS EMBARKING ON A VERY EXCITING PROJECT TO MODERNIZE AND IMPROVE ITS OLDEST HOSPITAL, CITRUS VALLEY MEDICAL CENTER INTER-COMMUNITY CAMPUS (ICC). THIS DRAMATIC PROJECT WILL NEARLY DOUBLE THE SIZE OF THE EMERGENCY DEPARTMENT AND HELP US CONTINUE TO BRING STATE OF THE ART CLINICAL TECHNOLOGY TO OUR COMMUNITY. IT CONSISTS OF THREE PROJECTS:EMERGENCY DEPARTMENT - ICC'S EMERGENCY DEPARTMENT SEES NEARLY 27,000 VISITS PER YEAR IN JUST 12 BEDS. IT IS FREQUENTLY CROWDED, CRAMPED AND CAN BE DIFFICULT TO NAVIGATE FOR PATIENTS. THIS $10 MILLION NEW PROJECT WILL EXPAND THE EMERGENCY DEPARTMENT TO 21 BEDS BY TAKING OVER THE EXISTING MEDICAL RECORDS DEPARTMENT AND THE EXISTING PUBLIC CORRIDOR, AS WELL AS ADDING A NEW WAITING AREA AND PUBLIC ENTRANCE. THE BRAND NEW EMERGENCY DEPARTMENT AT INTER-COMMUNITY IS SCHEDULED TO OPEN IN THE SPRING OF 2016 -- JUST UNDER TWO YEARS TO COMPLETE. HYBRID OPERATING ROOM - CVHP IS MAKING A SIGNIFICANT INVESTMENT IN ITS HEART AND VASCULAR CENTER BY BUILDING THE FIRST HYBRID OPERATING ROOM IN THE AREA. THIS EXCITING TECHNOLOGY INTEGRATES ADVANCED IMAGING TECHNOLOGY AND SURGICAL CAPABILITIES TO PERFORM THE NEWEST GENERATION OF SURGICAL AND INTERVENTIONAL PROCEDURES. THESE INCLUDE MINIMALLY INVASIVE HEART AND VASCULAR PROCEDURES, AS WELL AS THOSE THAT COMBINE CATHETER-BASED AND OPEN PROCEDURES. INTER-COMMUNITY'S FIRST PROCEDURE IN ITS HYBRID OR WAS AN ENDOVASCULAR AORTIC ANEURYSM REPAIR (EVAR) PERFORMED IN EARLY DECEMBER 2015. THE PROCEDURE WAS A SUCCESS AND THE PATIENT WENT HOME WITHIN A FEW DAYS.ADVANCED MRI - IN MARCH 2015, A NEW 3T MRI WAS INSTALLED AT INTER-COMMUNITY HOSPITAL AND IS OPERATIONAL AND WE HAVE ALREADY BEGUN PROVIDING FULL MRI SERVICE TO BOTH OUR INPATIENTS AND OUTPATIENTS. THIS NEW 3T MRI ALLOWS US TO PROVIDE OUR COMMUNITY WITH ADVANCED TECHNOLOGY AND A MORE COMFORTABLE PATIENT EXPERIENCE. IT CAN COMFORTABLY ACCOMMODATE PATIENTS OF DIFFERENT SHAPES AND SIZES AND THAT CAN HELP ALLEVIATE ANXIETY AND CLAUSTROPHOBIA. IN ADDITION, EXCLUSIVE TOTAL IMAGING MATRIX (TIM) TECHNOLOGY MAKES IT POSSIBLE TO SCAN MULTIPLE AREAS OF A PERSON'S BODY AT ONE TIME WITH NO NEED FOR REPOSITIONING. NATIVE SYNGO TIM SOFTWARE- PROTOCOLS FOR NON-CONTRAST ENHANCED 3D MRA ENABLES IMAGING OF THE ABDOMINAL AND PERIPHERAL VESSELS AS AN ALTERNATIVE TO MR ANGIOGRAPHY WITH CONTRAST MEDIUM, ESPECIALLY FOR THE PATIENTS WITH SEVERE RENAL INSUFFICIENCY.CVHP IS EXCITED ABOUT THE OPPORTUNITY TO MODERNIZE THE ICC CAMPUS AND EXPAND SERVICES TO CONTINUE TO CARE FOR THE NEEDS OF OUR PATIENTS AND COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: CITRUS VALLEY HEALTH PARTNERS (CVHP), THE SOLE CORPORATE MEMBER OF 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 CVMC AND ITS AFFILIATE ORGANIZATIONS.FPH OPERATES A GENERAL ACUTE CARE HOSPITAL WITH 105 LICENSED BEDS, LOCATED IN GLENDORA, CALIFORNIA, AND PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR THE SURROUNDING COMMUNITIES.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.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 ENSURE THAT 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 CONNECT 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. FREE 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 ANDCHALLENGES IN MANAGING THEIR DIABETES, AND THE LATINO COMMUNITY HAVE 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 ADIABETES 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 WHICH 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 0 0 0 0 0 0 0 0 0 ROBERT H CURRY PARENT PRESIDENT, CEO, BOD 0 795174 0 447709 0 51519 0 11386 0 13895 0 1319683 0 0 RAJESH SHARMA EXECUTIVE VP/CFO 0 467055 0 174349 0 24583 0 8721 0 13429 0 688137 0 0 CECILIA AGUDO MICN CHARGE R.N. 0 219086 0 103 0 108 0 7961 0 12690 0 239948 0 0 EDWARD JAI CORP DIR. PHARMACY SVC. 0 225848 0 7602 0 7213 0 7042 0 13559 0 261264 0 0 ERLINDA PARRENO R.N. II 12HR SHIFT 0 221598 0 1103 0 790 0 9047 0 577 0 233115 0 0 GENARO BADILLA MICN CHARGE R.N. 0 219275 0 128 0 100 0 7235 0 12690 0 239428 0 0 JOHN RAMIREZ VICE PRES FAC/ SUP SVCS 0 204241 0 10000 0 7310 0 0 0 13403 0 234954 0 0 PART I, LINE 3 ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR - CITRUS VALLEY MEDICAL CENTER, INC. IS AN AFFILIATE OF CITRUS VALLEY HEALTH PARTNERS, INC. (CVHP). 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 CEO/EXECUTIVE DIRECTOR. PLEASE SEE ADDITIONAL EXPLANATION AT SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 2010-03-31 3700000 MEDICAL EQUIPMENT 0 0 1 A 3700000 3700000 2011 0 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 0 ROBERT H CURRY OFFICER OF CVHP, INC. AND BOARD MEMBER OF OPTIMA 187287 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 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 11 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 THE ORGANIZATION UTILIZES THE FOLLOWING TO ESTABLISH REASONABLE COMPENSATION: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANT; WRITTEN EMPLOYMENT CONTRACT; COMPENSATION SURVEY/STUDIES; APPROVAL BY BOARD OR COMPENSATION COMMITTEE, WHICH APPROVAL IS DOCUMENTED IN CONTEMPORANEOUS WRITTEN MINUTES. 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, HAYGROUP, 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 OCTOBER 2014. AS PART OF THEIR EXECUTIVE COMPENSATION REVIEW, HAYGROUP 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 OCTOBER 16, 2014, OPINION LETTER, HAYGROUP WROTE, WE BELIEVE WE HAVE COMPARED THE EXECUTIVE COMPENSATION TO COMPENSATION AND BENEFITS PAID TO EXECUTIVES OF ORGANIZATIONS WITH LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES, AND AS A RESULT, WE BELIEVE THAT COMPENSATION AND BENEFITS PAID TO THE EXECUTIVES ARE REASONABLE WITHIN THE MEANING OF SECTION 53.4958-4(B)(1)(II)(A) OF THE TREASURY REGULATIONS. 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 XI, LINE 9: CHANGE IN BENEFICIAL INTEREST 518,150. PASSTHROUGH INCOME DIFFERENCE -19,855. PART XII LINES 2B: AUDITED FINANCIAL STATEMENTS 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., AND GLENDORA SURGERY CENTER, WERE AUDITED ON A CONSOLIDATED BASIS. FORM 990, PART XII, LINE 2C AUDIT AND COMPLIANCE COMMITTEE THE BOARD OF DIRECTORS HAS CONSTITUTED AN AUDIT AND COMPLIANCE COMMITTEE AND DELEGATED TO THAT COMMITTEE THE RESPONSIBLITY FOR ENAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. THIS STRUCTURE HAS BEEN IN EFFECT IN PRIOR YEARS AND WAS NOT CHANGED IN 2015. 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 ARE COMPENSATED BY AN AFFILIATED ENTITY, CITRUS VALLEY HEALTH PARTNERS (CVHP). THE COMPENSATION AMOUNTS DISCLOSED IN PART VII OF FORM 990 AND SCHEDULE J REPRESENT 100% OF THE COMPENSATION PAID BY CVHP TO THE OFFICERS. THE OFFICERS ALSO SERVE AS CORPORATE OFFICERS FOR CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, INC., FOOTHILL PRESBYTERIAN HOSPITAL AND CITRUS VALLEY HEALTH FOUNDATION, INC., ALL AFFILIATES OF THE TAXPAYER. CONSEQUENTLY, IN ACCORDANCE WITH OUR UNDERSTANDING OF THE FORM 990 INSTRUCTIONS, SIMILAR DISCLOSURES OF THE TOTAL COMPENSATION OF EACH OF THE OFFICERS ARE MADE IN PART VII AND SCHEDULE J IN EACH OF THE AFOREMENTIONED AFFILIATES 990 RETURNS. PART VII, SECTION A REPORTABLE HOURS FOR RELATED ORGANIZATIONS 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 4, 2, 2, AND 18 HOURS TO FPH, CVH, CVHF, AND CVHP, RESPECTIVELY. RAJESH SHARMA DEVOTED 4, 2, 2, AND 18 HOURS TO FPH, CVH, CVHF, AND CVHP, RESPECTIVELY. 990 PART V LINE 7H FILING OF FORM 1098C THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF AUTOMOBILES, BOATS, AIRPLANES OR OTHER VEHICLES. CONSEQUENTLY NO FORMS 1098C WERE FILED. SCHEDULE H PART V, LINE 7A THE CHNA REPORT IS AVAILABLE ON THE HOSPITAL FACILITY'S WEBSITE: WWW.CVHP.ORG/DOCUMENTS/CVHP_CHNA_REPORT_2013.PDF CITRUS VALLEY HEALTH PARTNERS INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 953885523 EXEMPT ORGANIZATION SUPPORT & MANAGEMENT CA 501 (C) (3) 11 TYPE II N/A 0 CITRUS VALLEY HEALTH FOUNDATION INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 952534063 EXEMPT ORGANIZATION SUPPORT CA 501 (C) (3) 11 TYPE I N/A 0 FOOTHILL PRESBYTERIAN HOSPITAL INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 952413054 ACUTE CARE HOSPITAL CA 501 (C) (3) 3 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) 9 N/A 0 GLENDORA SURGERY CENTER 315 E ROUTE 66 101 GLENDORA CA 91740 510492499 OUTPATIENT SURGERY CENTER CA N/A S 0 0 0 1 1 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 CITRUS VALLEY HEALTH FOUNDATION C 131024 FAIR MARKET VALUE FOOTHILL PRESBYTERIAN HOSPITAL O -953084 FAIR MARKET VALUE CITRUS VALLEY HOSPICE O -44791 FAIR MARKET VALUE FOOTHILL PRESBYTERIAN HOSPITAL O 555731 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 3,135 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 2,654 EMPLOYEES, CITRUS VALLEY HOSPICE'S FORM 990 REPORTED 87 EMPLOYEES, CITRUS VALLEY HEALTH FOUNDATION'S FORM 990 REPORTED 7 EMPLOYEES AND CITRUS VALLEY HEALTH PARTNER'S FORM 990 REPORTED 387 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.