2016-11-15T00:00:00-06:00 2015-12-31 450250958 EIDE BAILLY LLP 800 NICOLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2015-01-01 952082686 Ridgecrest Regional Hospital RIDG 7604463551 1081 N China Lake Blvd Ridgecrest CA 93555 James Suver CEO 7604463551 2016-11-16 1 Kim C Hunwardsen P00484560 6122536500 2016-11-15 2015 2017-02-10 21:41:12Z James Suver 1081 N China Lake Blvd Ridgecrest CA 93555 107035408 0 X www.rrh.org X 1965 CA Community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 11 8 862 65 0 0 31532 68352 86086330 111495311 357710 127245 425585 -5315526 86901157 106375382 0 0 0 0 38860483 45158559 0 0 0 46401261 53232458 85261744 98391017 1639413 7984365 133996608 145632853 76793140 80494869 57203468 65137984 To be a community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 0 0 88275299 111451212 Ridgecrest Regional Hospital provides inpatient and outpatient care. Charity care is provided to qualified patients with minimum or no charge. Care accomplishments for the year are as follows: Number of Visits 57,023Number of Patient Days 5,966Home Health Visits 6,149Hospice Routine Care Days 2,811SNF Resident Days 32,082Rural Health Visits 47,152Community Care Clinic Visits 28,876 88275299 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 0 0 0 1 185 0 1 862 1 0 0 0 0 0 1 1 0 0 0 0 X 11 8 0 0 1 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X James Suver 7604993040 1081 North China Lake Blvd Ridgecrest CA 93555 Dana Lyons Chairperson 1.00 1.00 X X 0 0 0 Patricia Mullis Vice Chair 1.00 0.00 X X 0 0 0 Chris Ellis Secretary 1.00 0.00 X X 0 0 0 Michael Mower Treasurer 1.00 0.00 X X 0 0 0 Bud Biery Director 1.00 1.00 X 0 0 0 Earl Ferguson MD Director/Physician 3.00 0.00 X 78694 0 0 Harriet Luzinas-Smith Director 1.00 1.00 X 0 0 0 Lawrence Cosner MD Director/Physician 48.00 0.00 X 235259 0 34863 Don Zdeba Director 1.00 0.00 X 0 0 0 Gerald Baker Director 1.00 0.00 X 0 0 0 Martin Walter Director 1.00 0.00 X 0 0 0 James Suver CEO 50.00 2.00 X 362891 0 22211 Lois Johnson CFO 50.00 0.00 X 156599 0 41333 Sandra Gilliam Admin Patient Care 50.00 0.00 X 180635 0 29148 Healthy Desai Orthopedic Surgeon 40.00 0.00 X 658662 0 44841 Hope Zissos MD Family Practice Physician 40.00 0.00 X 251854 0 48383 Aisha Rollins Pediatrician 40.00 0.00 X 279544 0 18348 Gul Anwar Family Practice Physician 40.00 0.00 X 243874 0 43263 James Antes Physician Assistant 40.00 0.00 X 221743 0 40001 2669755 0 322391 88 0 1 0 Comphealth Medical Staffing PO Box 972670 Dallas TX 75397 Staffing 749731 Maurice Dusol Jr MD PO Box 1297 Ridgecrest CA 93556 Medical 559008 William P Cannata MD 9187 Altura Lane Whittier CA 90603 Medical 508529 Rene Salinas 919 N Heritage Drive 7 Ridgecrest CA 93555 Medical 464100 Rose Stone MD Inc 120 W Franklin Ridgecrest CA 93555 Medical 435164 58 16431 51921 68352 Net Patient Service Rev 622000 111066332 111066332 Skilled Nursing Management Fees 900099 61741 61741 367238 367238 111495311 108693 108693 447979 302215 145764 145764 145764 21420 0 2868 21420 -2868 18552 18552 4146 16431 8957 -4811 -4811 301887 345986 -44099 -44099 Loss Defeasance Long Term Debt 900099 -5412380 -5412380 -5412380 106375382 111451212 0 -5144182 X 1139059 348663 790396 173009 173009 34033335 30720553 3312782 664804 604368 60436 6683025 6195322 487703 2465327 2199970 265357 289299 289299 126014 126014 20656118 19029400 1626718 4329512 4036189 293323 1481020 1481020 332598 279062 53536 212068 173845 38223 2921188 2921188 7266869 6422299 844570 1646640 1646640 Medical Supplies 7017021 7017021 Repair and Maintenance 2798961 1501579 1297382 Provision for Bad Debts 497557 497557 Equipment Lease and Ren 422610 369301 53309 3234983 2658313 576670 98391017 88275299 10115718 0 7810674 11588752 17454067 12248908 15444578 37919 26308 279550 1900823 2010002 2957544 3025334 146750193 57808268 83572409 88941925 17371889 13879579 1079200 133996608 145632853 10266253 9310892 15304 65115000 13047 8726 65779069 1398840 5380878 76793140 80494869 X 57203468 65137984 57203468 65137984 133996608 145632853 7984365 18253 -68102 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 4053349 4053349 107798182 33537110 74261072 558442 385124 173318 30978261 23886034 7092227 3361959 3361959 88941925 Estimated Third Party Payor Settlements 4523878 Malpractice Insurance Payable 857000 5380878 X 106556104 18253 -497557 -479304 107035408 -660026 -660026 106375382 98553486 660026 660026 97893460 497557 497557 98391017 Part IV, Line 2b: Skilled nursing facility residents private monies maintained as a drawing account as required by Title 22 of the California Code of Regulations. Part X, Line 2: The Hospital is a nonprofit California corporation as defined in Section 501(c)(3) of the Internal Revenue Code and is generally exempt from both federal and state income taxes on related income pursuant to Section 501(a) of the same code. The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. Further, management believes that none of the current activities of the Hospital qualify for unrelated business income taxes. As a result, no provision for income taxes has been made in the accompanying financial statements. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Included in Expenses for Tax Reporting -497,557. Part XI, Line 4b - Other Adjustments: Loss on Sale of Property Included in Expenses for Financials -2,868. Retail Pharmacy Expenses Included in Expenses for Financials -345,986. Fundraising Expenses Included in Expenses for Financials -8,957. Rental Expenses Included in Expenses for Financials -302,215. Part XII, Line 2d - Other Adjustments: Loss on Sale of Property Included in Revenues for Tax Reporting 2,868. Retail Pharmacy Expenses Included in Revenues for Tax Reporting 345,986. Fundraising Expenses Included in Revenue for Tax Reporting 8,957. Rental Expenses Included in Revenue for Tax Reporting 302,215. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Included in Revenue in Financials 497,557. Hospice Auction 16252 12106 4146 760 4146 2821 16252 12106 4146 760 4146 2821 7727 -3581 1 1 X 1 X 300.000000000000 1 X 1 1 0 0 386243 386243 0.00390 25572024 16454110 9117914 0.09310 25958267 16454110 9504157 0.09700 50492 27975 22517 0.00020 124361 124361 0.00130 14800 14800 0.00020 189653 27975 161678 0.00170 26147920 16482085 9665835 0.09870 1368 1368 0.00000 8469 8469 0.00010 337952 337952 0.00350 347789 347789 0.00360 1 497557 25830744 27075137 -1244393 X 1 1 1 1 Ridgecrest Regional Hospital 1081 N China Lake Blvd Ridgecrest CA 93555 www.rrh.org 120000186 X X X X Ridgecrest Regional Hospital 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X see Section C X X 1 13 1 http://rrh.org/images/IS2013.pdf 0 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X See Section C X see Section C X See Section C X X X X X 1 X 0 X X 1 X 0 0 Ridgecrest Regional Hospital Part V, Section B, Line 5: Input from community was gathered through in-person and telephone interviews. Individuals consulted consisted of 2 physicians; a psychologist; other medical professionals; and larger employers of the community. Ridgecrest Regional Hospital Part V, Section B, Line 7d: Distributed results by direct mail in quarterly mailer "Outlook". Ridgecrest Regional Hospital Part V, Section B, Line 11: Due to the great number of needs in the community, not all significant needs have been resolved but all have been addressed. It will take time to resolve all of the health needs, or at least as many as are feasible.The needs addressed were as follows:1) Substance Abuse: RRH is opening a new Crisis Stabalization Unit in collaboration with the County.2) Heart Disease and Stroke: RRH conducts health fairs and continues to dedicate articles in the community newsletter specifically to addres these issues. They also have ongoing recruitment efforts for a cardiologist.3) Cancer: RRH continues with their programs and is looking at collaborating with other area health care organizations to improve their program.4) Obesity/Nutrition/Diabetes: RRH conducts health fairs to address these issues, as well as the nutrition class in the schools and community. They are currently working on implenting an employee STEP challenge as well.5) Smoking/Tobacco Use: RRH conducted Smoking Cessation classes for the community.6) Access to Specialists/Medical Provider Recruitment: RRH has ongoing recruitment efforts for more speciality areas and has budgeted to add some more specialty physicians in 2016.7) Services for Low Income/MediCal: RRH implemented a Mobile Health Unit to reach this group of individuals8) Senior Health Services Including Dementia: RRH is working on implementing a new Department of Senior Wellness, in which they have set a goal to have implemented in 2016.9) Womens Health Services: RRH has continued recruiting efforts for more OB specialty physicians. They have budgeted for this in 2016. Ridgecrest Regional Hospital Part V, Section B, Line 13h: Uninsured patients with incomes at or below federal poverty level are offered full charity care. Patients who are insured and have high medical costs (annual expenses exceed 10% of income) are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Ridgecrest Regional Hospital Part V, Section B, Line 16i: Financial packets are sent to each self pay patient, in addition to: a website reference to the policy; an onsite financial counselor made available to patients; and posting of the policy in all patient access areas. Form 990, Schedule H, Part V, Section B, Line 7a: www.rrh.org/community-services-health-needs-assessment-survey-results/ Form 990, Schedule H, Part V, Section B, Line 16a/16b/16c: http://rrh.org/administration-services/billing/ 14 1 - Ridgecrest Regional Hospital Rural Healt 1111 N China Lake Blvd Ridgecrest CA 93555 Rural Health Clinic 2 - China Lake Community Care Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Community Care Clinic 3 - Ridgecrest Regional Hospital Sleep Study 1081 N China Lake Blvd Ridgecrest CA 93555 Sleep Study Lab 4 - Ridgecrest Regional Hospital Urgent Care 1111 N China Lake Blvd Ridgecrest CA 93555 Urgent Care 5 - Ridgecrest Regional Hospital Home Health 1653 N Triangle Dr Ridgecrest CA 93555 Home Health 6 - Ridgecrest Regional Hospital Orthopedic 1041 N China Lake Blvd Ridgecrest CA 93555 Orthopedic Clinic 7 - China Lake Gastroenterology 1011 N China Lake Blvd Ridgecrest CA 93555 Gastroenterology Clinic 8 - China Lake Surgical Clinic 1011 N China Lake Blvd Ridgecrest CA 93555 Surgical Clinic 9 - Ridgecrest Regional Hospital Hospice 1653 N Triangle Dr Ridgecrest CA 93555 Hospice 10 - China Lake Specialty Clinics-OB Clinic 1011 N China Lake Blvd Ridgecrest CA 93555 OB Clinic 12 - China Lake Surgical Clinic 1011 N China Lake Blvd Ridgecrest CA 93555 Dermatology Clinic 13 - Trona Rural Health Clinic 82824 Trona Rd Suite A Trona CA 93562 Rural Health Clinic 14 - Ridgecrest Regional Hosp Living Assist 1653 N Triangle Dr Ridgecrest CA 93555 Living Assistance Program 15 - Bella Serra Skilled Nursing Facility 1131 N China Lake Blvd Ridgecrest CA 935553131 Skilled Nursing Facility Part I, Line 3c: Uninsured patients with incomes at or below federal poverty level are offered full charity care. Patients who are insured and have high medical costs (annual expenses exceed 10% of income) are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Part I, Line 7: Lines 7a and 7b were converted to cost based on an average ratio of costs to gross charges. Lines 7e, 7f, and 7i were based on actual expenses. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 497,557. Part II, Community Building Activities: Activities include: Community Collaboration through Community Health Improvement Advocacy, physician recruitment to ensure basic care is available locally, sponsor annual health fair with free and low cost health screening, collaborate with other emergency services on disaster and emergency preparedness. Provide wellness fairs for the Navy Base and Water District. Part III, Line 2: Patient A/R consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages its receivables by regularly reviewing the accounts, inquiring with respective payors as to collectability and providing for allowances on their accounting records for estimated contractual adjustments and uncollectible accounts. Bad debt is reported at charges per the audited financials. Part III, Line 3: Patient A/R consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages its receivables by regularly reviewing the accounts, inquiring with respective payors as to collectability and providing for allowances on their accounting records for estimated contractual adjustments and uncollectible accounts. Line 2 and 3 are calculated by applying Medicare cost to charge ratio to the expenses on the financial statement. No other bad debt amounts included in the community benefits. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in Foornote 1 on page 12 of the attached financial statements. Part III, Line 8: One hundred percent of any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole. Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: Prior to discharge, patients who fall under the collection practices receive a financial application packet to complete with a staff member's business card attached. They are instructed to call if they need assistance in completing the financial application, which will determine their eligibility for assistance. If eligible, they may qualify for possible charity care allowance.RRH does not send patients to collections until 120 days after the date of the invoice. If the patient begins the financial assistance process they bring the account back from collections. Part VI, Line 2: In addition to the community health needs assessment Ridgecrest uses patient satisfaction surveys to assess the health care needs of the community, along with conducting blood draws at health fairs. The HR administrator serves on the local Rotary as well to network with other community leaders. Part VI, Line 3: Signs are posted in registration areas informing them of assistance with their bills and includes citing a phone number to call for assistance in this area. Self pay patients are sent a packet of information regarding financial assistance programs. Part VI, Line 4: Rural California Desert Community located in Kern County; more than 50 miles from next nearest hospital. The population is approximately 38,000: and approximately 6.8% of that population is uninsured. Part VI, Line 5: The Hospital provides classes on controlling disease, low cost mammography screening, and help to patients to apply for Medicaid (if eligible). The Hospital distributes, via US Mail, a community newsletter that includes health tips and information and a medical directory that contains listings of the medical professionals in the community. In addition, the Hospital provides life lesson seminars monthly and has a community wellness resource center where the community can check out books and videos and pick up brochures on health-related topics, all free of charge. It also distributes mental health and health improvement guide brochures and a resource directory (for low-income individuals) to businesses within the community. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States CA X X X 0 0 0 0 0 0 0 0 0 Lawrence Cosner MD Director/Physician 235048 0 0 0 211 0 0 0 34922 0 270181 0 0 0 James Suver CEO 274216 0 77250 0 11425 0 10600 0 13105 0 386596 0 0 0 Lois Johnson CFO 152746 0 2889 0 964 0 6470 0 35623 0 198692 0 0 0 Sandra Gilliam Admin Patient Care 179770 0 0 0 865 0 7222 0 22639 0 210496 0 0 0 Healthy Desai Orthopedic Surgeon 658574 0 0 0 88 0 10600 0 34753 0 704015 0 0 0 Hope Zissos MD Family Practice Physician 247788 0 3920 0 146 0 10400 0 39310 0 301564 0 0 0 Aisha Rollins Pediatrician 279483 0 0 0 61 0 7220 0 11660 0 298424 0 0 0 Gul Anwar Family Practice Physician 200907 0 42895 0 72 0 8400 0 36093 0 288367 0 0 0 James Antes Physician Assistant 220723 0 1000 0 20 0 3073 0 37083 0 261899 0 0 0 Gul Anwar Highly Compensated Employee Personal X 40000 26308 0 0 1 26308 Mark Mower Family of Treasurer Michael Mower 117449 Wages 0 James Gilliam Family of Key Employee Sandy Gilliam 41626 Wages 0 Kathryn Garcia Family of Board Member Lawrence Cosner 13934 Wages 0 Form 990, Part VI, Section A, line 4 The Hospital's bylaws were changed during the year. Changes were made to the number of corporate members, and election of those members among other insignificant changes. Form 990, Part VI, Section A, line 6 There is one class of members, Corporate Members and an honorary nonvoting group of individuals called Emeritus Members who are appointed by the Board of Directors and have limited rights. Corporate Membership is limited to thirty (30) persons, who must reside in the Hospital service area (as such service area is determined by the Board of Directors) who are elected to membership by a vote of the Corporate Members present or represented at a meeting of Corporate Members. Form 990, Part VI, Section A, line 7a The Corporate Members have the right to elect the members of the Board of Directors. Form 990, Part VI, Section A, line 7b Under the bylaws, the Corporate Members have the right to: elect the members of the Board of Directors; fill a vacancy on the Board of Directors; and ratify the bylaws that have been approved by the Board of Directors. In addition, members have certain rights granted pursuant to the California Nonprofit Public Benefit Corporation Act including the right to: remove a director; approve most amendments to the Articles of Incorporation; approve a sale of assets not in the usual and regular course of its business; merge with another entity; and dissolve. Form 990, Part VI, Section A, line 8b The organization does not have any committee with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11 The Form 990 is provided to the Board of Directors via electronic distribution prior to filing with the IRS. Form 990, Part VI, Section B, line 12c There is annual disclosure on conflict of interest policy for directors, officers, medical staff officers, and administrative employees, and corporate members. Compliance with conflict of interest policy is monitored by the CEO. Any noted conflicts are reviewed and discussed by the Board of Directors. The individual with the potential conflict must abstain from the discussion and vote on the potential conflict. Form 990, Part VI, Section B, line 15 Compensation for the CEO was determined by a compensation committee of the Board of Directors using compensation comparison provided by HASC. For other officers, the HASC salary survey is used to comply with prohibition from direct solicitation of salary information due to anti-trust regulations. Form 990, Part VI, Section C, line 19 All public documents are made available upon request. Form 990, Part IX, line 11g Other Purchased Services: Program service expenses 7,541,057. Management and general expenses 828,579. Fundraising expenses 0. Total expenses 8,369,636. Professional Fees: Program service expenses 10,919,332. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,919,332. Other Fees: Program service expenses 569,011. Management and general expenses 798,139. Fundraising expenses 0. Total expenses 1,367,150. RRH Development Foundation 1081 N China Lake Blvd Ridgecrest CA 93555 464181603 Raising Hospital Capital Equipment Funds CA 501(c)(3) Line 9 Ridgecrest Regional Hospital 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0