2016-08-11T11:22:49-05:00 2015-09-30 BDO USA LLP 600 ANTON BLVD STE 500 COSTA MESA CA 92626 990 2014-10-01 952821104 Henry Mayo Newhall Memorial Hospital % ANNA BREWER HENR 6612001191 23845 McBean Parkway Valencia CA 91355 CR HUDSON CFO 6612001191 2016-08-04 true CINDY J JANIKOWSKI P00165179 7149573200 2014 2016-12-15 16:53:06Z ROGER E SEAVER 23845 MCBEAN PARKWAY VALENCIA CA 91355 392047241 false X WWW.HENRYMAYO.COM X 1972 CA TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS, AND IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH COMPASSION AND EXCELLENCE. 15 9 2136 402 0 3525507 11273043 272722140 318459723 1027840 1264666 4351921 3913070 281627408 334910502 10172239 6193229 0 0 122153870 132312648 0 0 0 155989152 169724035 288315261 308229912 -6687853 26680590 319434158 357925667 209516770 221444365 109917388 136481302 TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS, AND IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH COMPASSION AND EXCELLENCE IN HEALTHCARE SERVICES. false false 230331672 6193229 320050054 TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS. THE HOSPITAL HAD 59,820 PATIENT DAYS DURING THE YEAR. WE ALSO PROVIDED SERVICES FOR 64,236 EMERGENCY VISITS. 76% OF TOTAL HOSPITAL INPATIENT ADMITS (EXCLUDING NEWBORNS) ARE ADMITTED THROUGH THE EMERGENCY ROOM. 230331672 true true false true false false false false false false true false false false true true true false false false false false false false false false true true false true true true false false false false false false false true true true false false false false false true false false false true 263 0 true 2136 true false false false false false false false false false false X 15 9 false false false false false false false true true false false true true true true true true true true true true CA X X X ANNA BREWER 6612001191 23845 MCBEAN PARKWAY VALENCIA CA 91355 ROGER E SEAVER PRESIDENT/CEO 40.0 0.5 X X 610400 0 51772 Don Kimball Chair 0.5 0.0 X 0 0 0 Judy Fish PhD Vice Chair 0.5 0.0 X 0 0 0 John Barstis MD Trustee 0.5 0.0 X 0 0 0 Robert Benjamin Trustee 0.5 0.5 X 0 0 0 Richard Corlin MD Trustee 0.5 0.0 X 0 0 0 Dale Donohoe Trustee 0.5 0.0 X 0 0 0 James D Hicken Trustee 0.5 0.0 X 0 0 0 Cheri Fleming Trustee 0.5 0.0 X 0 0 0 Lakhbinder Dhanda MD Trustee 0.5 0.0 X 0 0 0 Mark Chamberlain Trustee 0.5 0.0 X 0 0 0 Richard Corlin MD Trustee 0.5 0.0 X 0 0 0 Chris Luechtefeld Trustee 0.5 0.5 X 0 0 0 Mark Liker MD Trustee 0.5 0.0 X 0 0 0 Roscoe Marter MD Trustee 0.5 0.0 X 0 0 0 Craig Peters Trustee 0.5 0.0 X 0 0 0 JOHN V SCHLEIF SR VP/COO 40.0 0.0 X 333301 0 39696 CR BOB HUDSON SR VP/CFO 40.0 0.0 X 334104 0 51772 LARRY R KIDD VP/CNO 40.0 0.0 X 292067 0 31846 CYNTHIA A PETERSON VP/CIO 40.0 0.0 X 279284 0 43725 MARK A PULEO VP/CHIEF HR 40.0 0.0 X 221149 0 46969 JONATHAN S MILLER VP OF ANCILLARY AND SUPPORT 40.0 0.0 X 219699 0 46197 JEAN MARIE STEWART SR DIR OF CATH LAB 40.0 0.0 X 328173 0 13000 GERALD A SUBAR DIR OF PHARMACY 40.0 0.0 X 211191 0 22816 DONNA G FERGUSON DIR OF SURGERY 40.0 0.0 X 209976 0 31093 ELIZABETH A DAHL CLINICAL COORDINATOR 40.0 0.0 X 196674 0 9834 DELE AKAO PHARMACY MANAGER 40.0 0.0 X 189624 0 37032 3425642 0 425752 301 false true false SODEXO INC AFFILIATES 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 OTHER PRCHD SRVCS 7430226 BERNARDS BROS INC 555 FIRST ST SAN FERNANDO CA 91340 CONSTRUCTION 11963000 CALIFORNIA REHABILITATION SERVICES 333 E GLENOAKS BLVD SUITE 204 GLENDALE CA 91207 MEDICAL PRCHD SVCS 3864518 MCCARTHY BUILDING COMPANIES 20401 SW BIRCH ST SUITE 300 NEWPORT BEACH CA 92660 CONSTRUCTION 8978848 NTI WESTLAB INC 801 N PARKCENTER DR SUITE 202 SANTA ANA CA 92705 MEDICAL PRCHD SVCS 1978931 76 1951682 1257664 8063697 11273043 HEALTHCARE SERVICES 621110 318459723 318459723 318459723 400365 400365 0 0 918000 918000 0 918000 918000 58001040 57136739 864301 864301 864301 0 0 0 JV INCOME 621110 672331 672331 NONPATIENT REVENUE 621110 2322739 1337620 985119 2995070 334910502 321387674 2249785 X 0 6193229 6193229 0 0 2601980 2601980 0 0 0 100136209 100136209 2948335 2948335 18764172 18764172 7861952 7861952 5131268 5131268 1486578 1486578 471112 471112 17326 17326 0 0 63456784 35419863 28036921 1864008 1864008 42689118 42689118 1715522 1715522 0 6673583 6673583 319781 319781 0 0 7969937 7969937 0 15842735 15842735 1749634 1749634 REPAIR AND MAINTENANCE 5327709 5327709 MISCELLANEOUS 6386514 6386514 BAD DEBT EXPENSE 8622426 8622426 308229912 230331672 77898240 0 35306715 54171507 77154879 8725105 0 1849671 39503719 48044915 0 0 0 0 0 0 4680197 5171106 3033872 3618076 324614903 171770724 134945439 152844179 12196660 69020924 0 0 0 0 0 0 12612677 14480184 319434158 357925667 37638571 55357829 0 0 2511265 2470656 160305200 155741486 0 0 0 0 0 0 0 0 9061734 7874394 209516770 221444365 X 106360329 133347935 3557059 3133367 0 0 109917388 136481302 319434158 357925667 26680590 -116676 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true 17326 17326 false 990 SCH C POLITICAL CAMPAIGN AND LOBBYING ACTIVITIES 990 SCH C PART II-B QUESTION 1(I) FOR THE FISCAL YEAR ENDED 09/30/2015, THE ORGANIZATION PARTICIPATED WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO ADVOCATE POSITIVE HEALTHCARE POLICY FOR HOSPITALS. THE ORGANIZATION ALSO ENGAGED A WASHINGTON LOBBYIST, TO ASSIST IN OBTAINING A FEDERAL HEALTHCARE RELATED GRANT. 3226760 3226760 174314503 80383155 93931348 97899979 80038569 17861410 49173661 11349000 37824661 152844179 0 CAPITAL LEASES 7874394 7874394 X 328600597 -116676 -116676 328717273 6193229 6193229 334910502 302036683 302036683 6193229 6193229 308229912 F990 SCH D PART XI RECON OF REVENUE PER AFS WITH REVENUE PER RETURN 990 SCH D PART XI QUESTION 4B CHARITY CARE 6,193,229. F990 SCH D PART XII RECONC. OF EXPENSES PER AFS WITH EXPENSES PER RETURN 990 SCH D PART XII QUESTION 4B CHARITY CARE 6,193,229. F990 SCH D PART X Line 2 FIN48(ASC 740) FOOTNOTE PART X LINE 2 THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). UNDER FASB ASC 740, UNCERTAINTY IN INCOME TAXES, INTEREST AND PENALTIES, IF ANY, ARE RECORDED TO INTEREST EXPENSE AND OTHER OPERATING COSTS, RESPECTIVELY. THERE WERE NO INTEREST OR PENALTIES RECORDED FOR THE YEARS, ENDED SEPTEMBER 30, 2015 AND 2014. THE TAX YEARS SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS INCLUDE THE YEARS 2011 AND FORWARD BY THE U.S. INTERNAL REVENUE SERVICE (IRS"). FOR CALIFORNIA, THE TAX YEARS SUBJECT TO EXAMINATION INCLUDE THE YEARS 2010 AND FORWARD. true true X true X true X true true true false true true 6193229 6193229 0.02010 19192761 19192761 0.06230 0 0 0.00000 25385990 25385990 0.08240 4076556 4076556 0.01320 0 0 0 0.00000 0 0 0 0.00000 4076556 0 4076556 0.01320 29462546 0 29462546 0.09560 true 8622426 0 99925278 120912207 -20986929 X true true Tower Imaging Valenc Outpatient Radiology Services 0.50000 0.00000 0.50000 1 1 HENRY MAYO NEWHALL MEMORIAL HOSPITAL 23845 MCBEAN PKWY Valencia CA 91355 X X X 1 HENRY MAYO NEWHALL MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 13 true false false true X SEE PART V X true 13 true SEE PART V false false true X 200. 400. X X X X true true X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X true false X X X X true X false false PART V, LINE 5 The study used both primary and secondary research to complete its assessment. Primary research involved 24 interviews with community stakeholders who are leaders and representatives of medically underserved, low-income, minority and chronic disease populations or regional, State or local health or other departments or agencies that have "current data or other information relevant to the health needs of the community served by the hospital facility." Secondary data was collected from a variety of local, county and state sources to present the hospital service area demographics, social and economic factors. Healthcare statistics included birth characteristics including number of births, teen birth rate, prenatal care, low birth rate, infant mortality, breastfeeding; mortality/leading causes of death, chronic diseases. PART V, LINE 7A http://www.henrymayo.com/media/file/HenryMayo_community-health-needs-asses sment-and-plan-fy-14-16.pdf PART V, LINE 10A http://www.henrymayo.com/media/file/HenryMayo_community-health-needs-asses sment-and-plan-fy-14-16.pdf PART V, LINE 11 Addressing Other Health Needs: Though they were not individually highlighted in the plan, Henry Mayo Newhall Memorial Hospital will continue to address many of the other healthcare needs that were identified in the Community Health Needs Assessment. To address the community's needs in asthma, alcohol and drugs, and violence, Henry Mayo will provide charity care and services in the hospital's Emergency Department to those who qualify. The Behavioral Health Unit will provide charity care and services to uninsured and underinsured patients in need of mental health services. And Henry Mayo will provide inpatient consultations to smokers. At this time, the hospital will not highlight dental health or obesity as these are not an area of expertise. PART V, LINE 16A http://www.henrymayo.com/media/file/AB%20774_%20effective%200107_2007_%20c harity_discount%20pmt_updated%20010115.pdf PARTV, LINE 16B http://www.henrymayo.com/media/file/Charity%20Application_English(2).pdf PART V, LINE 16C http://www.henrymayo.com/patients-and-visitors/patient-business-services/d iscount-payment-ab774 PART III, LINES 2&4 The Hospital offers managed care-style discounts to most uninsured patients, which enables the Hospital to offer lower rates to those patients who historically have been charged standard gross charges. Under this method, the discount offered to uninsured patients is recognized as a contractual allowance instead of provision for bad debts, which reduces net patient revenues at the time the uninsured patient accounts are recorded and reduces provision for bad debts. The uninsured patient accounts, net of contractual allowances recorded, are further reduced to their net realizable value through provision for bad debts based on historical collection trends and other factors that affect the estimation process. For the years ended September 30, 2015 and 2014, provision for bad debts were approximately $8,622,426 and $17,009,000, respectively. PART III, LINE 8 COST METHODOLOGY IS COST ACCOUNTING SYSTEM. PART VI SUPPLEMENTAL INFORMATION FOR ITEMS 2-6 PAGE REFERENCES ARE TO THE COMMUNITY BENEFIT REPORT WHICH IS ATTACHED: 2. PAGE 3 - ASSESSING OUR COMMUNITY'S NEEDS 3. PAGE 4-12 - SUMMARY OF COMMUNITY BENEFIT ACTIVITIES 4. PAGE 3 - ASSESSING OUR COMMUNITY'S NEEDS 5. PAGE 4-12 - SUMMARY OF COMMUNITY BENEFIT ACTIVITIES 6. PAGE 7-14 SUMMARY OF COMMUNITY BENEFIT ACTIVITIES PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA true CHARITY CARE - HENRY MAYO NEWHALL HOSPITAL 3692 6193229 COST OF SERV MED SERVICES SCH I GENERAL INFO ON GRANTS AND ASSISTANCE 990 SCH I PART I QUESTION 2 The hospital assists individuals who are uninsured or underinsured by providing charity care. This is applied by following the hospitals charity care policy. This policy is administered through the Business Service Department of the hospital. SCH I GENERAL GRANTS AND OTHER ASSISTANCE TO INDIVIDUAL 990 SCH I PART III PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY MAY RECEIVE HEALTHCARE SERVICES AT NO CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES X X X true false false false false false false false false ROGER E SEAVER PRESIDENT/CEO 590722 0 0 0 19678 0 13250 0 38522 0 662172 0 JOHN V SCHLEIF SR VP/COO 320931 0 0 0 12370 0 13250 0 26446 0 372997 0 CR BOB HUDSON SR VP/CFO 322253 0 0 0 11851 0 13250 0 38522 0 385876 0 LARRY R KIDD VP/CNO 266986 0 23788 0 1293 0 13250 0 18596 0 323913 0 CYNTHIA A PETERSON VP/CIO 252739 0 24728 0 1817 0 13250 0 30475 0 323009 0 MARK A PULEO VP/CHIEF HR 201837 0 18649 0 663 0 11462 0 35507 0 268118 0 JONATHAN S MILLER VP OF ANCILLARY AND SUPPORT 202953 0 15751 0 995 0 11135 0 35062 0 265896 0 JEAN MARIE STEWART SR DIR OF CATH LAB 296750 0 29893 0 1530 0 13000 0 0 0 341173 0 GERALD A SUBAR DIR OF PHARMACY 102844 0 0 0 108347 0 0 0 22816 0 234007 0 DONNA G FERGUSON DIR OF SURGERY 189912 0 18731 0 1333 0 10571 0 20522 0 241069 0 ELIZABETH A DAHL CLINICAL COORDINATOR 196524 0 150 0 0 0 9834 0 0 0 206508 0 DELE AKAO PHARMACY MANAGER 182130 0 7140 0 354 0 9649 0 27383 0 226656 0 A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-01 25000000 FINANCE AND REFINANCE FACILITY false false false B CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-01 35000000 FINANCE AND REFINANCE FACILITY false false false C CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-01 29550000 FINANCE AND REFINANCE FACILITY false false false D CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SCM4 2014-02-05 70000000 FINANCE AND REFINANCE FACILITY false false false A 0 41320000 25000000 0 0 0 277907 0 0 1113 0 0 2020 true true false true B 0 41690000 35000000 0 0 0 362268 0 0 2320 0 0 2020 true true false true C 0 27150000 29550000 0 0 0 332810 0 0 18921046 0 0 2020 true true false true D 0 0 70000000 0 0 0 2817884 0 0 22861228 0 0 2020 false true false true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false false B false false false false 0.00000 0.00000 0.00000 false false 0.00000 false false C false false false false 0.00000 0.00000 0.00000 false false 0.00000 false false D false false false false 0.00000 0.00000 0.00000 false false 0.00000 false false A false true false false 0 false 0 false false B false true false false 0 false 0 false false C false true false false 0 false 0 false false D false true false false 0 false 0 false false A false B false C false D false Intertex General DALE DONOHOE, trustee 598373 CONSTRUCTION false Modern Diagnostic MARK LIKER, MD, trustee 225175 INTER NEURO MONITORING false FACEY MEDICAL FOUNDATION ROSCOE MARTER MD, TRUSTEE 1686855 PAY FOR HOSPITALISTS false KRYSTLE SEAVER FAMILY MEMBER OF OFFICER 42323 WAGES false KATHERINE DUNN FAMILY MEMBER OF TRUSTEE 78925 WAGES false F990 GOVERNANCE, MGMT AND DISCLOSURE 990 PART VI SECTION B QUESTION 11b THE CHAIRMAN OF THE FINANCE COMMITTEE, CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE, THE BOARD OF DIRECTORS, CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND THE HOSPITAL'S FINANCE DEPARTMENT REVIEWED THE ENTIRE FORM 990 RETURN PRIOR TO FILING. F990 POLICIES 990 PART VI SECTION B QUESTION 15A The organization's CEO, executive director, or top management officials' compensation are determined through the use of a compensation committee, independent consulting, and board of directors approval. Other officers/key employees of the organization receive performance reviews annually and ratings are applied that suggest the percentage of salary increase. Percentages are determined through market surveys done by Human Resources and approved each year via the budget and aprroval process. F990 DISCLOSURE 990 PART VI SECTION C QUESTION 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. F990 POLICIES 990 PART VI SECTION B QUESTION 12C All board members are required to read the conflict of interest policy and complete a formal conflict of interest questionnaire annually and results of any conflict, if any, would be reported to the full board. Board members are aware and reminded of the hospital's fiduciary responsibility in reporting conflicts of interest. There have been circumstances where a conflict of interest exists and it has been disclosed to the board of directors. The conflict of interest forms are required to be updated on an annual basis. F990 GOVERNANCE, MGMT AND DISCLOSURE 990 PART VI SECTION A QUESTION 2 Dr. Dale Donohoe - Business Relationship with Intertex Dr. Mark Liker MD - Business Relationship with Modern Diagnostic Dr. Roscoe Marter - Business Relationship with Facey Medical Foundation Roger Seaver - Family relationship with Krystle Seaver F990 Compensation of Officers, Directors, Trustees, Key Employees, Highest 990 PART VII ALL KEY AND HIGHEST PAID PERSONNEL INCLUDE ONE WAGE INCREASE AND ONE PERFORMANCE BONUS PAYMENT. HOWEVER, CERTAIN EXECUTIVES ON THE LIST HAVE NOT RECEIVED THE WAGE INCREASE AND PERFORMANCE BONUS, WHICH MAY BE DUE IN FUTURE YEARS. FORM 990 PART IX LINE 11G DESCRIPTION:REGISTRY TOTAL FEES:9011686 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:8178112 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:18230065 FORM 990 PART IX LINE 11G DESCRIPTION:QUALITY ASSURANCE FEE TOTAL FEES:28036921 HENRY MAYO NEWHALL MEMORIAL HEALTH FOUND 23845 MCBEAN PARKWAY VALENCIA CA 91355 953849903 RAISE FUNDS CA 501(C)(3) 7 Hospital false TOWER IMAGING VALENCIA 5455 WILSHIRE BLVD STE 1120 LOS ANGELES CA 90036 201345767 RADIOLOGY SERIVCE CA Hospital RELATED 495973 1126642 false 0 false 0.50000 false true true false false false false false false false false false false false true false false false false