2016-09-12T21:10:57-05:00 2015-10-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2014-11-01 951945832 VALLEY PRESBYTERIAN HOSPITAL VALL 8187826600 15107 VANOWEN STREET VAN NUYS CA 91405 LORI CARDLE SVP FIN/CFO 8187826600 2016-09-12 1 RENIE BURBANK P00159653 4159561500 2014 2017-02-10 21:41:12Z LORI CARDLE 15107 VANOWEN STREET VAN NUYS CA 91405 403492210 0 X WWW.VALLEYPRES.ORG X 1948 CA VALLEY PRESBYTERIAN HOSPITAL EXISTS TO IMPROVE THE QUALITY OF HEALTH IN OUR COMMUNITY. 21 13 1926 734 0 0 2324825 2787759 254586124 379393965 4687974 3110398 9490053 7472529 271088976 392764651 327353 1716942 0 0 131784158 138148669 0 0 0 141678286 200001959 273789797 339867570 -2700821 52897081 228216894 285456877 95841034 101152022 132375860 184304855 X VALLEY PRESBYTERIAN HOSPITAL EXISTS TO IMPROVE THE QUALITY OF HEALTH IN OUR COMMUNITY. 0 0 257907721 1716942 381781834 SEE SCHEDULE O NONE NONE 257907721 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 369 0 1 1926 1 0 0 0 0 0 1 1 0 0 0 0 X 21 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X LORI CARDLE 8187826600 15107 VANOWEN ST VAN NUYS CA 91405 X GREG KAY MD CHAIRMAN 1.25 X X 0 0 0 WILLIAM C ALLEN SECRETARY 0.40 X X 0 0 0 JAMES PORTER TREASURER (THRU 12/2014) 0.40 X X 0 0 0 DAVID ADELMAN DIRECTOR 0.50 X 0 0 0 DANIEL CHANDLER DIRECTOR 0.40 X 0 0 0 DAVID FLEMING CHAIRMAN EMERITUS 0.40 X 0 0 0 RUTH GARCIA-CORRALES DIRECTOR 0.40 X 0 0 0 ALEX GUERRERO DIRECTOR 0.58 X 0 0 0 DIANNE F HARRISON DIRECTOR 0.50 X 0 0 0 RICHARD KATZ DIRECTOR 0.40 X 0 0 0 PETER KOETTERS MD DIRECTOR 0.77 X 0 0 0 DIEGO A MECHOSO MD DIRECTOR (THRU 12/2014) 0.40 X 0 0 0 MATTHEW MISCHEL MD DIRECTOR 0.40 X 0 0 0 TODD MOLDAWER MD DIRECTOR 0.40 X 0 0 0 GANESA PANDIAN MD DIRECTOR 0.40 X 21840 0 0 TRACY RAFTER DIRECTOR 0.40 X 0 0 0 JOSHUA ROKAW MD DIRECTOR 0.40 X 44835 0 0 BARBARA ROMERO DIRECTOR 0.40 X 0 0 0 STUART SOLOMON DIRECTOR (THRU 12/2014) 0.40 X 0 0 0 SUKSHMA SREEPATHI MD CHIEF OF STAFF 0.77 X 42210 0 0 TONY TARTAGLIA DIRECTOR 0.40 X 0 0 0 FRANCISCO URIBE DIRECTOR 0.40 X 0 0 0 VLADIMIR VICTORIO DIRECTOR 0.40 X 0 0 0 GUSTAVO VALDESPINO PRESIDENT/CHIEF EXECUTIVE OFFICER 40.00 X 694392 0 165448 LORI CARDLE SR. VP-FINANCE & OPERATIONS/CFO 40.00 X 369644 0 83011 JEAN O'KEEFE RICO SR. VP-CHIEF QUALITY OFFICER 40.00 X 354050 0 86744 GAYATHRI JITH SR. VP-STRATEGY/AMBULATORY SERVICES 40.00 X 313613 0 78192 LORI BURNELL SR. VP-CHIEF NURSING OFFICER 40.00 X 216401 0 45261 JONATHAN WU VP-HUMAN RESOURCES 40.00 X 233136 0 32639 PEGI MATSUDA PRESIDENT-FOUNDATION 40.00 X 274011 0 54752 JEFFREY ALLPORT VP-CHIEF INFORMATION OFFICER 40.00 X 238109 0 50759 SOMASUNDARAM DEVADASON PHARMACIST 40.00 X 239582 0 15332 JEREMY REDIN ASSISTANT CHIEF FINANCIAL OFFICER 40.00 X 220840 0 16500 STARR WILLIAMS III PHARMACIST 40.00 X 214193 0 12110 SOHEILA RAHMAN-ATAR REGISTERED NURSE 40.00 X 193713 0 8879 DOMINADOR CRUZ REGISTERED NURSE 40.00 X 191280 0 23447 3861849 0 673074 329 0 1 0 PREFERRED IPA 1025 N BRAND BLVD 100 GLENDALE CA 91202 MEDICAL SERVICES 4602763 SHANGRI-LA CONSTRUCTION 36 DISCOVERY SUITE 240 IRVINE CA 92618 CONSTRUCTION 3422016 REHABCARE GROUP PO BOX 502096 ST LOUIS MO 63150 HEALTHCARE MANAGEMENT 2475987 ST VINCENT ANESTHESIA MEDICAL PO BOX 50045 PASADENA CA 91115 ANESTHESIA SERVICES 1666667 COMMUNITY FAMILY CARE MEDICAL GROUP 19210 S VERMONT AVE GARDENA CA 90048 MEDICAL SERVICES 1623913 72 380865 1538207 868687 2787759 PATIENT SERVICE REV. 541900 378696406 378696406 EXEMPT ORG. REVENUE 541900 697559 697559 379393965 2718368 2718368 285566 5488 280078 280078 280078 10947231 10555201 392030 392030 392030 131060 380865 166870 -35810 -35810 ANCILLARY & OTHER REV 900099 6031492 2387869 3643623 FOOD SALES 811000 1006655 1006655 GIFT SHOP REVENUE 453220 190114 190114 7228261 392764651 381781834 0 8195058 1716942 1716942 5409262 5409262 107972039 90988970 16983069 3491941 3491941 13130821 161836 12968985 8144606 6637004 1507602 5445756 3947118 1498638 801176 801176 202427 202427 205953 205953 30196773 18505905 11690868 445485 445485 7570672 6179245 1391427 2896560 2896560 4459099 553045 3906054 423444 53922 369522 71270 14595 56675 1740840 1740840 8319099 8319099 3092842 3092842 PROVIDER PROGRAM FEES 52072597 52072597 CAPITATION EXPENSES 43036206 43036206 MEDICAL SUPPLIES 30897250 30878839 18411 OTHER CONTROLLABLE EXP 8124510 3161497 4963013 339867570 257907721 81959849 0 3048740 3371697 3722421 34784763 835140 868380 29360403 33219315 3674252 3837499 3360229 2760757 269946944 180633981 86095246 89312963 87762989 99186497 10357474 18115006 228216894 285456877 46845477 63754216 2003618 31534811 18965060 15457128 18432746 95841034 101152022 X 126583970 178984669 5791890 5320186 132375860 184304855 228216894 285456877 X 52897081 -672331 -295755 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 205953 205953 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA HOSPITAL ASSOCIATION (CHA), HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC), AND PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS, INC. (PEACH). A PORTION OF THE DUES PAID ARE USED FOR LOBBYING ACTIVITIES BY CHA, HASC AND PEACH ON BEHALF OF THEIR MEMBERS. 1587222 1587222 149589659 94670792 54918867 107181385 85963189 21218196 11588678 11588678 89312963 SELF INSURANCE RESERVE 362092 OTHER RECEIVABLES 1634142 DUE TO THIRD-PARTY PAYORS 4999923 HOSPITAL PROVIDER FEE 11118849 18115006 SELF INSURANCE RESERVES 16931835 ANNUITY AND TRUST PAYABLE 1500911 18432746 X 392770139 0 392770139 -5488 -5488 392764651 339873058 5488 5488 339867570 0 339867570 PART X, LINE 2: THE HOSPITAL RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF OCTOBER 31, 2015 OR 2014. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION RENTAL EXPENSES FOR NET RENTAL INCOME -5,488. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION RENTAL EXPENSES FOR NET RENTAL INCOME 5,488. GOLF TOURNAMENT 253550 205040 48510 20678 1000 15000 17439 24622 DINNER 258375 175825 82550 545 4060 46299 4600 32627 511925 380865 131060 20678 1545 19060 63738 4600 57249 166870 -35810 1 1 1 X 350.000000000000 1 X 1 1 0 1 1 356187 70 356117 0.00100 178321464 197516067 -19194603 0.00000 3100229 249760 2850469 0.00840 181777880 197765897 -15988017 0.00940 527207 527207 0.00160 1279546 1279546 0.00380 308842 308842 0.00090 2115595 2115595 0.00630 183893475 197765897 -13872422 0.01570 1 5405920 2247836 67317624 80352718 -13035094 X 1 1 1 1 VALLEY PRESBYTERIAN HOSPITAL 15107 VANOWEN STREET VAN NUYS CA 91405 WWW.VALLEYPRES.ORG X X X VALLEY PRESBYTERIAN HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X WWW.VALLEYPRES.ORG X 1 14 1 HTTP://WWW.VALLEYPRES.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT.ASPX 0 0 1 X 350.000000000000 350.000000000000 X X X X 1 1 X X X X 1 X X X X X 1 X X 1 X X X X X X 1 X 0 0 VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY INPUT: VALLEY PRESBYTERIAN HOSPITAL CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2013. VALLEY PRESBYTERIAN HOSPITAL CONTRACTED WITH VALLEY CARE COMMUNITY CONSORTIUM (VCCC) TO CONDUCT A CHNA THAT WAS COMPLIANT WITH STATE AND FEDERAL REGULATIONS. TO BETTER UNDERSTAND THE HEALTH NEEDS IN THE HOSPITAL SERVICE AREA, VCCC REVIEWED NUMEROUS STATE AND COUNTY SOURCES, COLLECTED PRIMARY DATA, CONDUCTED A LOCAL LITERATURE REVIEW, AND DOCUMENTED COMMUNITY ASSETS AND RESOURCES. THE CHNA MAY BE ACCESSED AT WWW.VALLEYPRES.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT.ASPX.THE MEMBERS OF THE COMMUNITY PARTICIPANTS CONSISTED OF:LACDHS-OLIVE VIEW UCLA MEDICAL CENTER AMBULATORY CARE NETWORK (OLIVE VIEW MID VALLEY COMPREHENSIVE HEALTH CENTER) ANTELOPE VALLEY COMMUNITY CLINIC ANTELOPE VALLEY PARTNERS FOR HEALTH CALIFORNIA STATE UNIVERSITY, NORTHRIDGEJEWISH FAMILY SERVICES OF LOS ANGELES KIDS' COMMUNITY DENTAL CLINIC LA COUNTY DEPARTMENT OF MENTAL HEALTH LAUSD WALKING GROUPSLOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH MID VALLEY COMPREHENSIVE CENTER NORTHEAST VALLEY HEALTH CORPORATION PROVIDENCE ACCESS TO CARE-HEALTH EDUCATION OUTREACH TARZANA TREATMENT CENTER THE CHURCH ON THE WAY VALLEY PRESBYTERIAN HOSPITAL FIELD REPRESENTATIVE OF CALIFORNIA STATE ASSEMBLYMAN, FELIPE FUENTES EXPERT LEADERS REPRESENTING CITY AND COUNTY GOVERNMENT, CLINICS, HOSPITALS, HOUSING PROVIDERS, MENTAL HEALTH AGENCIES, AND COMMUNITY ORGANIZATION LEADERS VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 11: VPH PLANS TO MEET THE IDENTIFIED PRIORITY HEALTH NEEDS THROUGH A COMMITMENT OF RESOURCES WITH THE FOLLOWING PROGRAMS AND SERVICES. CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH EDUCATION, ONE OF THE TEN COMMUNITY NEEDS IDENTIFIED FROM THE CHNA, WILL BE ADDRESSED BROADLY THROUGHOUT ALL OF VPH'S COMMUNITY EDUCATION EFFORTS. THE REMAINING NINE IDENTIFIED PRIORITY HEALTH NEEDS WILL BE INTERWOVEN INTO THE FOLLOWING COMMUNITY EDUCATION PROGRAM THEMES: DIABETES AWARENESS AND SCREENING (BLOOD GLUCOSE, ETC.); PREVENTIVE HEALTH SCREENINGS (BLOOD PRESSURE, CAROTID ARTERY, CHOLESTEROL, BMI, FOOT SCREENINGS, ETC.); CHRONIC DISEASE CARE MANAGEMENT; MENTAL HEALTH; NUTRITION; STROKE AWARENESS AND EDUCATION; CHILDHOOD OBESITY AWARENESS AND EDUCATION; WOMEN'S SERVICES AND PRENATAL AWARENESS AND EDUCATION; HEALTHY AGING. VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 16I: OTHER MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY WITHIN THE COMMUNITY SERVED IS THROUGH FINANCIAL COUNSELING IF IDENTIFIED AS UNDERINSURED. VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY BILLED 110% OF MEDICARE RATE TO INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PART I, LINE 7B IN DECEMBER 2014, CMS APPROVED THE CURRENT FEEFORSERVICE SUPPLEMENTAL PAYMENT COMPONENT OF THE CALIFORNIA PROVIDER FEE PROGRAM FOR THE THREE YEAR PERIOD JANUARY 1, 2014 THROUGH DECEMBER 31, 2016. AS A RESULT OF THE CMS APPROVAL, REVENUE AND EXPENSES FROM JANUARY 1, 2014 THROUGH OCTOBER 31, 2015 (22 MONTHS) WERE RECORDED IN FISCAL YEAR 2015. FURTHERMORE, IN JUNE 2015, CMS APPROVED THE NONEXPANSION MANAGED CARE SUPPLEMENTAL PAYMENT COMPONENT FOR THE FIRST SIX MONTH PERIOD OF THE JANUARY 1, 2014 THROUGH DECEMBER 31, 2016 CALIFORNIA PROVIDER FEE PROGRAM. NET IMPACT OF THE PROVIDER FEE PROGRAM WAS $50,063,590 WHICH DECREASED THE MEDICAID COMMUNITY BENEFIT EXPENSE VERSUS FISCAL YEAR 2014. PART II, COMMUNITY BUILDING ACTIVITIES: SEE FORM 990, PART III, LINE 4A AND SCHEDULE O. PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. THE FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENT THAT ADDRESSES ALLOWANCE FOR DOUBTFUL ACCOUNTS IS AS FOLLOWS:PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRDPARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS AND NONCONTRACTED INSURANCE (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELFPAY PATIENTS WAS 90.0 PERCENT OF SELFPAY ACCOUNTS RECEIVABLE AT BOTH OCTOBER 31, 2015 AND 2014. IN ADDITION, THE HOSPITAL'S WRITEOFFS TOTALED APPROXIMATELY $2,554,000 AND $9,561,000 FOR THE YEARS ENDED OCTOBER 31, 2015 AND 2014, RESPECTIVELY. DECREASED WRITEOFFS WERE THE RESULT OF A LOWER NUMBER OF SELFPAY ACCOUNTS PRIMARILY RELATED TO THE AFFORDABLE CARE ACT (ACA) AND MEDICAID EXPANSION RESULTING IN LESS UNINSURED PATIENTS. THE HOSPITAL HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING THE YEARS FOR THE YEARS ENDED OCTOBER 31, 2015 AND 2014. THE HOSPITAL MAINTAINED ALLOWANCES FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS OF APPROXIMATELY $4,719,000 AND $4,484,000 AS OF OCTOBER 31, 2015 AND 2014, RESPECTIVELY. PART III, LINE 8: THE COSTING METHODOLOGY WAS BASED ON THE 2015 MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: PAYMENT PLANS - BALANCES ARE DUE UPON DISCHARGE FROM THE HOSPITAL. IF THE PATIENT DOES NOT QUALIFY FOR STATE ASSISTANCE OR VALLEY PRESBYTERIAN HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM, PAYMENT ARRANGEMENTS MAY BE ESTABLISHED WITH VALLEY PRESBYTERIAN HOSPITAL'S FINANCIAL COUNSELOR. PAYMENT ARRANGEMENTS MAY BE MADE WITH NO INTEREST PENALTIES. DEFAULTING ON A PAYMENT PLAN WILL RESULT IN DISQUALIFICATION OF THIS OPTION. PART VI, LINE 2: COMMUNITY NEEDS ASSESSMENT AND PLANNING PROCESS:AS AN INDEPENDENT, NONPROFIT COMMUNITY HOSPITAL, VALLEY PRESBYTERIAN HOSPITAL IS DEDICATED TO IMPROVING THE QUALITY OF HEALTH IN THE SAN FERNANDO VALLEY. WE ARE A VALUES-BASED ORGANIZATION THAT STRIVES TO UPHOLD OUR CORE VALUES OF DIGNITY, RESPECT, COMPASSION, TRANSPARENCY AND COLLABORATION. WE ARE COMMITTED TO SUPPORTING ACTIVITIES AND PROGRAMS THAT ADDRESS THE IDENTIFIED UNMET HEALTH NEEDS IN OUR SERVICE AREA.VPH FOLLOWS A FOUR-STEP PROCESS TO DEVELOP THE COMMUNITY PLAN. THE FOUR STEPS INCLUDE:1. REVIEW THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND OTHER INFORMATION FROM COMMUNITY-BASED ORGANIZATIONS, PUBLIC SOURCES, ETC.2. CREATE NEW PROGRAMS BASED ON INFORMATION FROM THE NEEDS ASSESSMENT, DISCUSSIONS WITH OTHER HEALTH CARE PROFESSIONALS, AND REVIEWING AND ASSESSING COMMUNITY PROGRAM INFORMATION FROM OTHER LOCAL HOSPITALS.3. REFERENCE THE VPH STRATEGIC PLAN TO ALIGN COMMUNITY BENEFIT PROGRAMS WITH OVERALL VPH GOALS, OBJECTIVES AND STRATEGIES.4. ANALYZE EXISTING COMMUNITY BENEFIT PROGRAM RESULTS TO ENHANCE AND OR MODIFY ACTIVITIES AND PROGRAMS TO BE IMPLEMENTED OR CONTINUED IN FISCAL YEAR 2015. PART VI, LINE 3: PATIENT EDUCTION: A PACKET IS GIVEN TO ANY PATIENT IDENTIFIED AS SELF PAY OR UNDER INSURED.FINANCIAL ASSISTANCE PROGRAM - UNINSURED OR UNDERINSURED PATIENTS WHO ARE UNABLE TO PAY THEIR BILL MAY BE ELIGIBLE FOR 100% FINANCIAL ASSISTANCE, LEAVING NO FINANCIAL OBLIGATION TO THE HOSPITAL FOR THE BILL. QUALIFICATIONS ARE BASED UPON VERIFIABLE INCOME, FAMILY SIZE AND CURRENT FEDERAL POVERTY GUIDELINES. TO QUALIFY FOR VALLEY PRESBYTERIAN HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM, REQUIRED DOCUMENTATION MUST BE SUBMITTED WITHIN 15 DAYS OF DISCHARGE FROM THE HOSPITAL.UNINSURED DISCOUNT RATE - VALLEY PRESBYTERIAN HOSPITAL OFFERS DAILY RATES FOR INPATIENT SERVICES AND A SIGNIFICANTLY REDUCED CHARGE RATE FOR OUTPATIENT SERVICES. THE DISCOUNT IS SIMILAR TO RATES PAID BY MEDICARE AND IS OFFERED UNDER THE UNINSURED DISCOUNT PROGRAM.PAYMENT PLANS - BALANCES ARE DUE UPON DISCHARGE FROM THE HOSPITAL. IF THE PATIENT DOES NOT QUALIFY FOR STATE ASSISTANCE OR VALLEY PRESBYTERIAN HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM, PAYMENT ARRANGEMENTS MAY BE ESTABLISHED WITH VALLEY PRESBYTERIAN HOSPITAL'S FINANCIAL COUNSELOR. PAYMENT ARRANGEMENTS MAY BE MADE WITH NO INTEREST PENALTIES. DEFAULTING ON A PAYMENT PLAN WILL RESULT IN DISQUALIFICATION OF THIS OPTION. MEDI-CAL AND GOVERNMENT PROGRAMS - PATIENTS MAY QUALIFY FOR GOVERNMENT PROGRAMS TO ASSIST WITH ALL OR PART OF THE HOSPITAL EXPENSES. VALLEY PRESBYTERIAN HOSPITAL HAS AN INTERNAL MEDI-CAL ELIGIBILITY UNIT TO ASSIST PATIENTS WITH THE MEDI-CAL APPLICATION PROCESS. (PATIENTS MAY RECEIVE BILLS FROM OTHER BILLING COMPANIES FOR ITEMS SUCH AS PHYSICIAN CHARGES, RADIOLOGY, AND AMBULANCE.) PART VI, LINE 4: COMMUNITY INFORMATION: THE CATCHMENT AREA SERVED BY VALLEY PRESBYTERIAN HOSPITAL IS BORDERED TO THE NORTH BY THE SANTA SUSANA MOUNTAINS, THE SANTA CLARITA VALLEY, AND THE CITY OF LANCASTER AND PALMDALE AND RURAL COMMUNITIES IN THE ANTELOPE VALLEY; TO THE EAST BY THE COMMUNITIES OF SYLMAR, SUN VALLEY, AND STUDIO CITY; TO THE SOUTH BY THE COMMUNITIES OF VAN NUYS, SHERMAN OAKS, ENCINO, TARZANA, AND THE SANTA MONICA MOUNTAINS; AND TO THE WEST BY THE COMMUNITIES OF WOODLAND HILLS, CALABASAS, CANOGA PARK, IN LOS ANGELES COUNTY AND SIMI VALLEY OF VENTURA COUNTY. THE HOSPITAL SERVICE AREA INCLUDES HIGHER INCOME AND MIDDLE-CLASS HOUSEHOLDS ADJACENT TO POCKETS OF EXTREME POVERTY AND ETHNIC DIVERSITY.VALLEY PRESBYTERIAN HOSPITAL'S SERVICE AREA INCLUDES THE TOWNS OF CALABASAS, CANOGA PARK, CANYON COUNTRY, CASTAIC, CHATSWORTH, ENCINO, GRANADA HILLS, LANCASTER, MISSION HILLS, NEWHALL, NORTH HILLS, NORTH HOLLYWOOD, NORTHRIDGE, PACOIMA, PALMDALE, PANORAMA CITY, RESEDA, SAN FERNANDO, SANTA CLARITA, SHERMAN OAKS, STUDIO CITY, SUN VALLEY, SUNLAND, SYLMAR, TARZANA, TUJUNGA, VALENCIA, VALLEY VILLAGE, VAN NUYS, WEST HILLS, WINNETKA, AND WOODLAND HILLS IN LOS ANGELES COUNTY, AND A PORTION OF SIMI VALLEY IN VENTURA COUNTY. THE COMMUNITIES THAT VALLEY PRESBYTERIAN HOSPITAL SERVES HAVE DIVERSE GEOGRAPHY AND TOPOGRAPHY, VARY ACROSS LEVELS OF SOCIO-ECONOMIC STATUS AND EDUCATIONAL ATTAINMENT LEVELS, AND EXPERIENCE DIFFERENCES IN PHYSICAL ENVIRONMENT AND OVERALL ACCESS TO REQUIRED HEALTH SERVICES.IN THE VPH SERVICE AREA, RACIAL/ETHNIC DIVERSITY HAS INCREASED SUBSTANTIALLY DUE TO IMMIGRATION FROM COUNTRIES INCLUDING MEXICO, EL SALVADOR, IRAN, ISRAEL, ARMENIA, VIETNAM, KOREA, INDIA, AND CHINA. A NEARLY EQUAL PERCENTAGE OF THE REGION'S RESIDENTS ARE LATINO AND NON-HISPANIC WHITE AT CLOSE TO 40% EACH, WITH A SIGNIFICANT YET SMALLER PERCENTAGE OF ASIAN/PACIFIC ISLANDERS AND AFRICAN AMERICANS/BLACKS. ALTHOUGH THE COUNTY AND THE STATE HAVE BEGUN TO EXPERIENCE A SLIGHT INCREASE IN EMPLOYMENT, THE RECOVERY HAS BEEN SLOW FOLLOWING THE GLOBAL RECESSION OF 2009. WHILE AREA RESIDENTS ARE MORE EDUCATED, AND HIGHER PROPORTIONS HOLD OF GRADUATE AND PROFESSIONAL DEGREES COMPARED TO THE REST OF THE COUNTY, POVERTY REMAINS A SIGNIFICANT BARRIER FOR FAMILIES IN SEVERAL COMMUNITIES. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 AMERICAN DIABETES ASSOCIATION PO BOX 930850 ATLANTA GA 311930850 131623888 501(C)(3) 10000 LATINO DIABETES AWARENESS PROGRAM CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K STREET STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 1485746 CA HOSPITAL PROVIDER PROGRAM EL NIDO FAMILY CENTERS 10200 SEPULVEDA BLVD 350 MISSION HILLS CA 91345 953186429 501(C)(3) 30000 SUPPORT FOR FAMILIES IN LOW INCOME COMMUNITIES INTERNATIONAL CONFERENCE MANAGEMENT PO BOX 1007 WOODBURY CT 06798 720846838 N/A 13171 DIABETIC FOOT CONFERENCE MARCH OF DIMES 3699 WILSHIRE BLVD 520 LOS ANGELES CA 90010 131846366 501(C)(3) 5000 MARCH FOR BABIES SPONSORSHIP NORTHEAST VALLEY HEALTH CORPORATION 1172 N MCLAY AVE SAN FERNANDO CA 91340 237120632 501(C)(3) 30000 PROVISION OF MEDICAL SERVICES TO THE INDIGENT AND UNDERSERVED ONE GENERATION 17400 VICTORY BLVD VAN NUYS CA 91406 954066979 501(C)(3) 7000 PROGRAM SUPPORT TO ENRICH THE LIVES OF SENIORS, CHILDREN AND THEIR FAMILIES. OVARIAN CANCER COALITION OF GREATER CALIFORNIA 12517 HORTENSE ST STUDIO CITY CA 91614 954840165 501(C)(3) 7500 EDUCATION AND RESEARCH OF OVARIAN CANCER SAN FERNANDO VALLEY COMMUNITY FOUNDATION 23679 CALABASAS RD 507 CALABASAS CA 91302 200391706 501(C)(3) 5000 PROMOTING PARTICIPATION IN COMMUNITY ORGANIZATIONS AND PHILANTHROPIC CAUSES SOCIAL AND ENVIRONMENTAL ENTREPRENEURS 23532 CALABASAS RD STE A CALABASAS CA 91303 954116679 501(C)(3) 25000 UNDERWRITE 150 FREE BREAST CANCER SCREENING TIERRA DEL SOL FOUNDATION 9919 SUNLAND BLVD SUNLAND CA 91040 952671260 501(C)(3) 8769 EMPOWERING PEOPLE WITH DISABILITIES TO FULFILL THEIR POTENTIAL VALLEY COMMUNITY HEALTHCARE 6801 COLDWATER CANYON AVE NORTH HOLLYWOOD CA 91605 237050082 501(C)(3) 25000 PROVIDING PRIMARY CARE AND INTEGRATED HEALTH SERVICES TO THOSE IN NEED SAN FERNANDO VALLEY INTERFAITH COUNCIL 10824 TOPANGA CANYON BLVD CHATSWORTH CA 91311 952653387 501(C)(3) 300 CREATE POSITIVE CHANGE WITHIN SAN FERNANDO VALLEY THROUGH UNITY AND FAITH NATIONAL HEALTH FOUNDATION 515 S FIGUEROA ST STE 1300 LOS ANGELES CA 90071 237314808 501(C)(3) 500 TAKING ACTION ON SOCIAL DETERMINANTS OF HEALTH AND GAPS IN HEALTH CARE THE UCLA FOUNDATION 10920 WILSHIRE BLVD 14TH FL LOS ANGELES CA 90024 956006143 501(C)(3) 1000 SUPPORT UNIVERSITY'S COMMITMENT TO TEACHING, RESEARCH, AND SERVICE VALLEY VILLAGE 20830 SHERMAN WAY WINNETKA CA 91306 237314159 501(C)(3) 1000 SERVE MEN AND WOMEN WITH DEVELOPMENTAL DISABILITIES PACOIMA BEAUTIFUL 13520 VAN NUYS BLVD STE 200 PACOIMA CA 91331 954770745 501(C)(3) 1000 ENVIRONMENTAL JUSTICE ORGANIZATION PLANTING GRASSROOTS IN PACOIMA REGIONAL BLACK CHAMBER OF COMMERCE 16161 VENTURA BLVD 661 ENCINO CA 91436 141918416 501(C)(6) 1500 PROVIDE REGIONAL STRATEGIC ASSISTANCE OF EMPOWERMENT TO MINORITY BUSINESSES EAST VALLEY PALS 11640 BURBANK BLVD N HOLLYWOOD CA 91601 237183528 501(C)(3) 1500 RAISES FUNDS AND PROVIDES FINANCIAL SUPPORT FOR MEN AND WOMEN OF THE LAPD COMMUNITY FAMILY CARE MEDICAL GROUP 19210 S VERMONT AVE BLDG D STE 400 GARDENA CA 90048 911806072 N/A 2000 IPA SERVING THE CITY OF HAWTHORNE FERNANDO AWARD FOUNDATION INC 12520 MAGNOLIA BLVD STE 212 N HOLLYWOOD CA 91607 954576012 501(C)(3) 2500 GENERAL SUPPORT TO AWARD FOR VOLUNTEERISM IN THE SAN FERNANDO VALLEY LOS ANGELES MISSION 303 E 5TH ST LOS ANGELES CA 90013 953134049 501(C)(3) 2500 PROVIDING HELP, HOPE AND OPPORTUNITY TO MEN, WOMEN AND CHILDREN IN NEED VALLEY CARE COMMUNITY CONSORTIUM 7515 VAN NUYS BLVD 5TH FL VAN NUYS CA 91405 205569606 501(C)(3) 2500 LEADS PARTNERS TO IMPROVE HEALTH OF RESIDENTS IN SAN FERNANDO VALLEY THE WEST COAST SPORTS MEDICINE FND 1200 ROSECRANS AVE 206 MANHATTAN BEACH CA CA 90266 954497009 501(C)(3) 2900 ATHLETIC TRAINING AND FITNESS PROGRAM FOR AT RISK HIGH SCHOOL STUDENTS LOS ANGELES VALLEY COLLEGE 5800 FULTON AVE VALLEY GLEN CA 91401 952587353 501(C)(3) 1500 EDUCATES COMMUNITY, DEVELOPING CRITICAL AND CREATIVE THINKERS WOODBURY UNIVERSITY 7500 N GLENOAKS BLVD BURBANK CA 91510 952786163 501(C)(3) 2500 SUPPORT TO UNIVERSITY IN MEETING THE EDUCATIONAL NEEDS OF SO CALIFORNIA SHERMAN OAKS CHAMBER OF COMMERCE 14827 VENTURA BLVD STE 207 SHERMAN OAKS CA 91403 954169290 501(C)(6) 700 BUILD BETTER SHERMAN OAKS THROUGH BUSINESS DEVELOPMENT ACTIVITIES ENCINO CHAMBER OF COMMERCE 4933 BALBOA BLVD ENCINO CA 91316 950715553 501(C)(6) 1000 GENERAL SUPPORT TO IMPROVE BUSINESS AND COMMUNITY OF ENCINO UNITED CHAMBERS OF COMMERCE 5121 VAN NUYS BLVD STE 203 SHERMAN OAKS CA 91403 953217120 501(C)(6) 1245 ADVOCATE ON BUSINESSES BEHALF FOR THE SAN FERNANDO VALLEY NORTHRIDGE CHAMBER OF COMMERCE 9401 RESEDA BLVD NORTHRIDGE CA 91324 952751561 501(C)(6) 4000 PROVIDING PROGRAMS AND SERVICES TO SUPPORT BUSINESS IN NORTHRIDGE GREATER SAN FERNANDO VALLEY CHAMBER OF COMMERCE 7120 HAYVENHURST AVE STE 114 VAN NUYS CA 91406 951329756 501(C)(6) 4945 GENERAL SUPPORT FOR PROMOTING ECONOMIC VITALITY IN THE SAN FERNANDO VALLEY THE VALLEY ECONOMIC ALLIANCE 5121 VAN NUYS BLVD STE 200 SHERMAN OAKS CA 91403 954524503 501(C)(3) 9166 TO ELEVATE ECONOMIC VITALITY AND STABILITY OF SAN FERNANDO VALLEY INDUSTRY COMMERCE ASSOCIATION 16600 SHERMAN WAY 170 VAN NUYS CA 91406 237182039 501(C)(6) 10000 GENERAL SUPPORT TO REPRESENT SAN FERNANDO VALLEY BUSINESS TO GOVERNMENT VALLEY ECONOMIC DEVELOPMENT CENTER 5121 VAN NUYS BLVD STE 300 SHERMAN OAKS CA 91403 953139419 501(C)(3) 10500 SUPPORT TO CREATE AND SUSTAIN JOBS AND BUSINESSES IN OUR COMMUNITIES 20 8 PART I, LINE 2: 1) ONCE A GRANT IS RECEIVED, GRANT COVENANTS ARE IDENTIFIED, REVIEWED AND COMMUNICATED AS APPROPRIATE, 2) COVENANTS ARE CALENDARED BY MONTH TO ENSURE TIMELY RESPONSE AND COMPLETION, 3A) IF A GRANT IS FOR CAPITAL EQUIPMENT, THE BENEFITTING VALLEY PRESBYTERIAN HOSPITAL DEPARTMENT NOTIFIES THE DEVELOPMENT DEPARTMENT THAT A PROJECT HAS BEEN COMPLETED AND/OR EQUIPMENT HAS BEEN PURCHASED; A PURCHASE ORDER IS COMPLETED; THE DEVELOPMENT DEPARTMENT NOTIFIES ACCOUNTING THAT FUNDS MAY BE RELEASED, 3B) IF THE GRANT IS FOR TRAINING, ALL STEPS IN 3A APPLY, BUT INSTEAD OF COMPLETING A PURCHASE ORDER, DOCUMENTATION OF TRAINING DETAILS IS ATTACHED INCLUDING WHO ATTENDED TRAINING, HOW MANY HOURS AND HOURLY RATES, 4) ONCE THE GRANT IS EXPENDED, THE GRANTOR IS NOTIFIED. X X X X X 0 1 0 0 0 1 0 0 0 GUSTAVO VALDESPINO PRESIDENT/CHIEF EXECUTIVE OFFICER 665475 0 0 0 28917 0 148948 0 16500 0 859840 0 0 0 LORI CARDLE SR. VP-FINANCE & OPERATIONS/CFO 361243 0 0 0 8401 0 72261 0 10750 0 452655 0 0 0 JEAN O'KEEFE RICO SR. VP-CHIEF QUALITY OFFICER 341333 0 0 0 12717 0 70244 0 16500 0 440794 0 0 0 GAYATHRI JITH SR. VP-STRATEGY/AMBULATORY SERVICES 305404 0 0 0 8209 0 63192 0 15000 0 391805 0 0 0 LORI BURNELL SR. VP-CHIEF NURSING OFFICER 207519 0 0 0 8882 0 37162 0 8099 0 261662 0 0 0 JONATHAN WU VP-HUMAN RESOURCES 225287 0 0 0 7849 0 32639 0 0 0 265775 0 0 0 PEGI MATSUDA PRESIDENT-FOUNDATION 262875 0 0 0 11136 0 49872 0 4880 0 328763 0 0 0 JEFFREY ALLPORT VP-CHIEF INFORMATION OFFICER 227057 0 0 0 11052 0 34259 0 16500 0 288868 0 0 0 SOMASUNDARAM DEVADASON PHARMACIST 239582 0 0 0 0 0 10832 0 4500 0 254914 0 0 0 JEREMY REDIN ASSISTANT CHIEF FINANCIAL OFFICER 219759 0 0 0 1081 0 0 0 16500 0 237340 0 0 0 STARR WILLIAMS III PHARMACIST 214193 0 0 0 0 0 7230 0 4880 0 226303 0 0 0 SOHEILA RAHMAN-ATAR REGISTERED NURSE 193713 0 0 0 0 0 8879 0 0 0 202592 0 0 0 DOMINADOR CRUZ REGISTERED NURSE 191280 0 0 0 0 0 6947 0 16500 0 214727 0 0 0 PART I, LINE 4B DURING CALENDAR YEAR 2014, VALLEY PRESBYTERIAN HOSPITAL HAD A 457(F) PLAN. THE FOLLOWING ARE OFFICERS AND KEY EMPLOYEES THAT PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: GUSTAVO VALDESPINO - $140,198 JEAN O'KEEFE RICO - $61,494 LORI CARDLE - $63,511 GAYATHRI JITH - $54,442 PEGI MATSUDA - $46,759 JONATHON WU - $32,639 JEFFREY ALLPORT - $34,259 LORI BURNELL - $37,162 PART I, LINE 6 VALLEY PRESBYTERIAN HOSPITAL HAS AN INCENTIVE (BONUS) PLAN FOR EXECUTIVE TEAM MEMBERS AND HOSPITAL DEPARTMENT DIRECTORS. PAYMENT OF ANY BONUS IS CONTINGENT ON SEVERAL CRITERIA, EBIDA, QUALITY, AND PATIENT SATISFACTION OF WHICH ARE BENCHMARKED BY ACHIEVING SPECIFIC METRICS ON AN ANNUAL BASIS. GANESHA PANDIAN MD DIRECTOR 21840 MEDICAL SERVICES 0 JOSHUA ROKAW MD DIRECTOR 44835 MEDICAL SERVICES 0 SUKSHMA SREEPATHI MD DIRECTOR 42210 MEDICAL SERVICES 0 FORM 990, PART III, LINE 4A IN FY15, VPH PROVIDED COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS WITHIN ITS SERVICE AREA. A SUMMARY OF THESE ACTIVITIES FOLLOWS. COMMUNITY HEALTH IMPROVEMENT SERVICES: THE HOSPITAL'S COMMUNITY EDUCATION PROGRAMS ARE DESIGNED TO MEET THE SIGNIFICANT COMMUNITY HEALTH NEEDS. DURING THE FISCAL YEAR, 5109 PEOPLE PARTICIPATED IN ONE OR MORE OF THE HOSPITAL'S FREE COMMUNITY EDUCATION PROGRAMS. COMMUNITY HEALTH EDUCATION/COMMUNITY-BASED CLINICAL SERVICES: WOMEN'S SERVICES - VPH OFFERED A NUMBER OF FREE COMMUNITY EDUCATION PROGRAMS TO WOMEN AND TO THEIR FAMILIES TO HELP THEM EXPERIENCE A SAFE PREGNANCY AND CHILDBIRTH. DURING THE PAST YEAR, MORE THAN 2,415 WOMEN AND THEIR FAMILIES ATTENDED COMMUNITY CLASSES ON: 1) CHILDBIRTH PREPARATION, 2) CARING FOR A NEW BABY, AND 3) BREASTFEEDING SUPPORT. A MAJORITY OF WOMEN'S SERVICES CLASSES ARE HELD IN ENGLISH AND IN SPANISH. CHRONIC DISEASE EDUCATION - VPH HELD WORKSHOPS ON DIABETES MANAGEMENT, STROKE MANAGEMENT, AND HEART HEALTH IN ENGLISH AND SPANISH. NURSE EDUCATORS AND PHYSICIANS SPOKE TO WORKSHOP ATTENDEES ABOUT LIFESTYLE, HEALTHY EATING AND EXERCISE. HEARTSAVER CPR CLASSES WERE ALSO OFFERED. MORE THAN 35 COMMUNITY RESIDENTS ATTENDED THESE FREE COMMUNITY WORKSHOPS DURING THE FISCAL YEAR. HEALTHY AGING - THE HOSPITAL OFFERED LOW-IMPACT EXERCISE CLASSES FOR SENIORS LIVING WITH CHRONIC PAIN. THE SENIOR EXERCISE CLASSES WERE HELD TWICE A WEEK AND HAD 1,743 CLASS VISITORS. AS A RESULT OF THE HEALTHY MATURITY CLASSES, PARTICIPANTS IDENTIFIED CHANGES THEY WOULD MAKE TO THEIR LIVES TO INCLUDE, INCREASING THEIR PHYSICAL ACTIVITY, AND STRETCHING AND REDUCING THEIR STRESS LEVELS. COMMUNITY HEALTH FAIRS - THE HOSPITAL HOSTED ITS ANNUAL COMMUNITY HEALTH FAIR, WHICH WAS ATTENDED BY 645 RESIDENTS. OVER 1,690 BLOOD PRESSURE, BMI CAROTID ARTERY, CHOLESTEROL, FOOT EXAMS, AND GLUCOSE, AND OVER 360 FLU SHOTS ADMINISTERED. OVER 960 PIECES OF FRESH PRODUCE, INCLUDING APPLES, BANANAS, CARROTS AND POTATOES, WERE DISTRIBUTED TO ATTENDEES PLUS EACH ATTENDEE WAS OFFERED A HEALTHY LUNCHEON MEAL. DURING THE COMMUNITY HEALTH FAIR, THERE WAS A HEALTH COOKING DEMONSTRATION FROM THE HOSPITAL'S DIETARY DIRECTOR. TWO VPH PHYSICIANS CONDUCTED PRESENTATIONS ON DIABETES PREVENTION AND MANAGEMENT AND THE SIGNS AND PREVENTION OF STROKE. VPH ALSO PARTICIPATED IN THE SHERMAN OAKS CHAMBER HEALTH & WELLNESS EXPO, LA DAILY NEWS AGING EXPO, NORTHRIDGE CHAMBER SENIOR EXPO AND THE LA VALLEY COLLEGE/VALLEY ECONOMIC ALLIANCE HEALTH EXPO. AT THESE COMMUNITY EVENTS, MORE THAN 1,300 FREE BLOOD PRESSURE, BMI, GLUCOSE, SCREENINGS WERE CONDUCTED. VPH CARES - THIS COMMUNITY MAGAZINE WAS DISTRIBUTED THREE (3) TIMES DURING THE FISCAL YEAR AND INCLUDED STORIES AND EDUCATIONAL INFORMATION ON LIVING A HEALTHY LIFESTYLE, HEALTHY COOKING AND EATING, SMOKING CESSATION, PHYSICAL ACTIVITY AND OTHER IMPORTANT HEALTH EDUCATION TOPICS. THE MAGAZINE WAS MAILED TO MORE THAN 30,600 HOMES WITHIN A FIVE MILE RADIUS OF THE HOSPITAL. HEALTH CARE SUPPORT SERVICES: PATIENT TRANSPORTATION - TRANSPORTATION ASSISTANCE (BUS TOKENS AND TAXI VOUCHERS) WAS PROVIDED TO OVER 1,441 PATIENTS AND FAMILIES WITH LIMITED RESOURCES TO SUPPORT ACCESS TO CARE. INSURANCE ENROLLMENT - THESE SERVICES WERE PROVIDED TO ASSIST PATIENTS WITH GOVERNMENT SPONSORED HEALTH INSURANCE COVERAGE PROGRAMS. THE HOSPITAL EMPLOYED ENROLLER ASSISTED PATIENTS PRIMARILY WITH MEDI-CAL COVERAGE. DURING THE FISCAL YEAR, THE HOSPITAL ENROLLED MORE THAN 2,544 PERSONS IN ONE OR MORE GOVERNMENT-SPONSORED INSURANCE COVERAGE PROGRAMS. HEALTH PROFESSIONS EDUCATION: EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, NURSING STUDENTS, AND OTHER HEALTH PROFESSIONALS WERE OFFERED BY THE HOSPITAL THROUGHOUT THE FISCAL YEAR. CONTINUING EDUCATION FOR PHYSICIANS AND OTHER HEALTH PROVIDERS - VALLEY PRESBYTERIAN HOSPITAL HOSTED WEEKLY MEDICAL EDUCATION EVENTS MADE AVAILABLE TO PHYSICIANS AND HEALTH PROVIDERS AMONG THE HOSPITAL STAFF AND THE PROVIDER COMMUNITY. MORE THAN 1,080 HEALTH CARE PROVIDERS ATTENDED MEDICAL EDUCATION EVENTS HOSTED BY THE HOSPITAL. VPH PROVIDED SPONSORSHIP OF AN INTERDISCIPLINARY DIABETIC FOOT, AMPUTATION PREVENTION, PAD, AND WOUND CARE CONFERENCE FOR SPECIALISTS IN THE FIELD. NURSING EDUCATION - THE HOSPITAL PROVIDED PRECEPTORS FOR NURSING STUDENTS THIS PAST YEAR. ONE NURSE PRACTITIONER STUDENT FROM UCLA PARTICIPATED IN A CLINICAL ROTATION. SEVEN STUDENT NURSES IN THE LEADERSHIP AND MANAGEMENT TRACKS FROM CALIFORNIA STATE UNIVERSITY, DOMINGUEZ HILLS AND CALIFORNIA STATE UNIVERSITY, NORTHRIDGE WORKED WITH HOSPITAL PRECEPTORS. VALLEY SIMULATION LABORATORY - THE VALLEY SIMULATION LABORATORY AT VALLEY PRESBYTERIAN HOSPITAL PROVIDES HIGH-FIDELITY MANNEQUINS THAT ARE DESIGNED TO SIMULATE PATIENT SITUATIONS AND RESPONSES. THE LABORATORY IS DESIGNED TO MODEL LABOR & DELIVERY AND THE INTENSIVE CARE UNIT. VPH PARTNERED WITH LOCAL NURSING PROGRAMS TO PROVIDE NURSING STUDENTS WITH A LINK FROM CLASSROOM LEARNING TO HANDS-ON MEDICAL APPLICATIONS IN A NO-RISK ENVIRONMENT. THE SIMULATION LABORATORY WAS USED 57 TIMES IN THE PAST YEAR. OTHER HEALTH PROFESSIONS EDUCATION - THE HOSPITAL ALSO PROVIDED PRECEPTORS FOR 111 STUDENTS IN VARIOUS HEALTH CARE DISCIPLINES: - 21 RESPIRATORY THERAPY STUDENTS FROM CONCORDE CAREER COLLEGE AND LOS ANGELES VALLEY COLLEGE COMPLETED CLINICAL INTERNSHIPS. - ONE STUDENT DIETICIAN FROM CALIFORNIA STATE UNIVERSITY NORTHRIDGE COMPLETED A CLINICAL INTERNSHIP. - ONE PUBLIC HEALTH STUDENT FROM CALIFORNIA STATE UNIVERSITY NORTHRIDGE PARTICIPATED IN A PRECEPTED CLINICAL ROTATION. - 23 PODIATRIC MEDICAL STUDENTS FROM WESTERN UNIVERSITY OF HEALTH SCIENCES - COLLEGE OF PODIATRIC MEDICINE, PARTICIPATED IN CLINICAL ROTATIONS. - 36 RADIOLOGY TECHNICIAN STUDENTS FROM CASA LOMA COLLEGE, CALIFORNIA STATE UNIVERSITY NORTHRIDGE, AND KAPLAN COLLEGE COMPLETED CLINICAL INTERNSHIPS. - 4 PHYSICIAN ASSISTANT STUDENTS FROM USC COMPLETED CLINICAL INTERNSHIPS. - 16 HEALTH ADMINISTRATION STUDENTS FROM CALIFORNIA STATE UNIVERSITY NORTHRIDGE AND USC COMPLETED INTERNSHIPS. - 2 MEDICAL LABORATORY TECHNICIAN STUDENTS FROM COLLEGE OF THE CANYONS COMPLETED A CLINICAL ROTATION. - 5 SURGICAL TECHNICIAN STUDENTS FROM CONCORDE CAREER COLLEGE AND SIMI VALLEY SURGICAL TECHNICIANS SCHOOL COMPLETED A CLINICAL ROTATION. - 2 HEALTH INFORMATION MANAGEMENT STUDENTS FROM SANTA BARBARA COMMUNITY COLLEGE OBTAINED PRECEPTED TRAINING. CASH AND IN-KIND CONTRIBUTIONS: FUNDS AND IN-KIND SERVICES WERE DONATED TO COMMUNITY GROUPS AND NOT FOR PROFIT ORGANIZATIONS. THE SUPPORT OF THESE ORGANIZATIONS FURTHERED THE HOSPITAL'S MISSION AND/OR ALIGNED WITH THE TEN COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT. DONATED SPACE - THE HOSPITAL DONATED MEETING SPACE WITHIN ITS FACILITY FOR 25 NOT PROFIT ORGANIZATIONS AND/OR COMMUNITY FORUMS DURING THE FISCAL YEAR. CASH DONATIONS - MORE THAN 46 COMMUNITY ORGANIZATIONS WERE SUPPORTED BY THE HOSPITAL. THESE COMMUNITY ORGANIZATIONS WERE PARTNERS WITH THE HOSPITAL IN THE FURTHERANCE OF ITS MISSION AND/OR ALIGNMENT WITH NEEDS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY BUILDING ACTIVITIES: THESE ARE ACTIVITIES THAT SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HOSPITAL. THESE ACTIVITIES MAY ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND ENVIRONMENTAL CONCERNS. ECONOMIC DEVELOPMENT: IN 2015, THE HOSPITAL PROVIDED SUPPORT TO THE WOMEN'S ENTREPRENEUR CENTER AND THE FUTURE YOUNG ADULT ENTREPRENEUR CENTER THROUGH A PARTNERSHIP WITH THE VALLEY ECONOMIC DEVELOPMENT CENTER (VEDC). THE VEDC HAS ASSISTED MORE THAN 104,000 BUSINESSES IN CREATING AND RETAINING OVER 19,400 JOBS. OVER 3,100 INDIVIDUALS HAVE GRADUATED FROM THE ENTREPRENEURIAL TRAINING PROGRAM AT THE WOMEN'S BUSINESS CENTER AND ENTERED THE LOS ANGELES WORKFORCE. COMMUNITY SUPPORT: A NUMBER OF HOSPITAL LEADERSHIP STAFF SUPPORT COMMUNITY ORGANIZATIONS THROUGH PARTICIPATION ON COALITIONS, COMMITTEES AND NETWORKS OF AGENCIES ADDRESSING COMMON ISSUES. EMPLOYEES ARE ALSO SUPPORTED BY THE HOSPITALS TO ENGAGE IN PLANNING, EDUCATION PRESENTATIONS, CONSORTIA, SUMMITS, AND MEETINGS WITH COMMUNITY GROUPS. COALITION BUILDING AND ADVOCACY: HOSPITAL REPRESENTATIVES SERVE ON A NUMBER OF ORGANIZATIONS AND COMMITTEES THAT ADDRESS HEALTH IMPROVEMENT AND COMMUNITY DEVELOPMENT. VPH ENGAGES IN ADVOCACY EFFORTS THAT SUPPORT ACCESS TO HEALTH CARE. WORKFORCE DEVELOPMENT: FIFTY STUDENTS FROM BIRMINGHAM HIGH SCHOOL PARTICIPATED IN VPH-SPONSORED HEALTH CARE CAREER DAYS. TWENTY-ONE (21) ADVANCED DEGREE INTERNATIONAL STUDENTS FROM USC AND 35 STUDENTS FROM JAPAN PARTICIPATED IN A DISCUSSION OF HEALTH CARE WORKFORCE ISSUES. FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND ASSISTANT CFO REVIEW THE DRAFT 990. ONCE THE 990 IS COMPLETED, IT IS REVIEWED WITH THE CEO, THE BOARD FINANCE COMMITTEE AND BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C VALLEY PRESBYTERIAN HOSPITAL'S BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. EACH OFFICER, DIRECTOR AND KEY EMPLOYEE OF VPH IS REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE ATTESTATION. VPH'S COMPLIANCE OFFICER AND CEO REVIEW THESE ATTESTATIONS TO IDENTIFY ANY/ALL CONFLICTS THAT THE ORGANIZATION MUST BE AWARE OF SO THE APPROPRIATE MITIGATIONS CAN BE PUT IN PLACE. SHOULD A BOARD MEMBER, OFFICER, DIRECTOR, AND/OR KEY EMPLOYEE HAVE A CONFLICT WITH ANY ISSUES BEING DISCUSSED OR VOTED ON AT THE BOARD OF DIRECTORS THEY WOULD BE ASKED TO RECUSE THEMSELVES FROM THE DISCUSSION AND/OR VOTE ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION IS REVIEWED AND PAY ACTIONS ARE RECOMMENDED BY THE COMPENSATION COMMITTEE, WHICH CONSISTS OF BOARD AND NON-BOARD MEMBERS WITH COMPENSATION EXPERIENCE, AND APPROVED BY THE VALLEY PRESBYTERIAN HOSPITAL BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTING FIRM AND MAINTAINS AN OBJECTIVE DECISION-MAKING PROCESS, ENSURING CONSISTENCY OF VPH'S EXECUTIVE PROGRAMS WITH THE ORGANIZATION'S EXECUTIVE PAY PHILOSOPHY AND OVERALL MISSION AND VALUES. VPH'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO FULFILL ITS MISSION OF IMPROVING THE QUALITY OF HEALTH IN THE SAN FERNANDO VALLEY AND TO ENSURE ITS FINANCIAL STABILITY. TOTAL COMPENSATION OFFERED TO OUR EXECUTIVES INCLUDES BASE SALARY, INCENTIVE BONUS, AND BENEFITS. THE INCENTIVE BONUS IS BASED ON KEY MEASURABLE SUCCESS INDICATORS APPROVED IN ADVANCE BY THE COMPENSATION COMMITTEE. THESE INDICATORS INCLUDE QUALITY, FINANCIAL, AND PATIENT SATISFACTION GOALS. IN ORDER TO RETAIN OUR KEY EMPLOYEES, WE OFFER A DEFERRED COMPENSATION PLAN WHICH PROVIDES AN ANNUAL BENEFIT (BASED ON A PERCENTAGE OF COMPENSATION) TO BE PAID ON A FUTURE DATE UPON VESTING IN THE PLAN. IN DETERMINING EACH INDIVIDUAL'S COMPENSATION, THE COMMITTEE RELIES ON COMPARABILITY DATA PROVIDED BY OUR INDEPENDENT CONSULTANT AND OBTAINED FROM SEVERAL DATA SOURCES INCLUDING: FORMS 990 OF SELECT COMPARATOR ORGANIZATIONS (28 CALIFORNIA-BASED, SIMILARLY-SIZED NONPROFIT HOSPITALS) AND A NUMBER OF WELL-REGARDED NATIONAL HEALTHCARE SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST AT THE HOSPITAL LOCATION. FORM 990, PART VII, SECTION A AND SCHEDULE L, PART IV BUSINESS TRANSACTIONS WITH INTERESTED PERSONS: GANESHA PANDIAN, MD, JOSHUA ROKAW, MD, AND SUKSHMA SREEPATHI, MD ARE MEMBERS OF THE BOARD. THEY DEVOTE AN AVERAGE OF 0.40 TO 0.50 HOURS PER WEEK RELATING TO THEIR ACTIVITIES ASSOCIATED WITH SERVING ON THE BOARD OF DIRECTORS. THE REPORTABLE COMPENSATION RELATED TO PROFESSIONAL MEDICAL ADMINISTRATIVE SERVICES PROVIDED TO THE HOSPITAL IS REPORTED ON SCHEDULE L, PART IV AND ARE UNRELATED TO THE AVERAGE NUMBER OF HOURS PER WEEK. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -295,755. VALLEY PRESBYTERIAN HOSPITAL FOUNDATION 15107 VANOWEN STREET VAN NUYS CA 91405 NEWLY FORMED CHARITABLE FOUNDATION CA 501(C)(7) LINE 3 VALLEY PRESBYTERIAN HOSPITAL 0 CHARITABLE REMAINDER TRUST (4) HOLDING COMPANY CA VALLEY PRESBYTERIAN HOSPITAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0