SRM ALLIANCE HOSPITAL SERVICES: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SRM ALLIANCE HOSPITAL SERVICES (EIN 68-0395200)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201621339349305872
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T16:47:23-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 VON KARMAN AVENUE SUITE 1700 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680395200 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SRM ALLIANCE HOSPITAL SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % NIALL FOLEY | InCareOfNm |
| Business Name Control | SRMA | BusinessNameControlTxt |
| Phone | 7075255300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MCDOWELL BLVD | AddressLine1Txt |
| City | PETALUMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95954 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TODD SALNAS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7075255300 | PhoneNum |
| Signature | 2016-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARA ADAMS | PreparerPersonNm |
| PTIN | P00023315 | PTIN |
| Phone | 9497942300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETALUMA VALLEY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TODD SALNAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MCDOWELL BLVD | AddressLine1Txt |
| City | PETALUMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95954 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $88,275,332 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STJOSEPHHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 545 | TotalEmployeeCnt |
| Total Volunteers | 172 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,240,396 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,025,191 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $78,537,609 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $87,120,719 | CYProgramServiceRevenueAmt |
| PY Investment Income | $59,685 | PYInvestmentIncomeAmt |
| CY Investment Income | $47,714 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$86,118 | PYOtherRevenueAmt |
| CY Other Revenue | -$89,431 | CYOtherRevenueAmt |
| PY Total Revenue | $79,751,572 | PYTotalRevenueAmt |
| CY Total Revenue | $88,104,193 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $383,245 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $499,600 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $43,483,699 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $44,221,164 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $431,692 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,614,027 | PYOtherExpensesAmt |
| CY Other Expenses | $39,971,343 | CYOtherExpensesAmt |
| PY Total Expenses | $76,480,971 | PYTotalExpensesAmt |
| CY Total Expenses | $84,692,107 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,270,601 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,412,086 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,975,082 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,364,472 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,983,087 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,821,015 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,991,995 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,543,457 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $79,791,814 | ExpenseAmt |
| Grant | $499,600 | GrantAmt |
| Revenue | $87,143,531 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $79,791,814 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 151 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 545 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NIALL FOLEY | PersonNm |
| Phone | 7075255300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 STONY CIRCLE SUITE 140 | AddressLine1Txt |
| City | SANTA ROSA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOSEPHINE THORNTON | |||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ANTHONY KOSINSKI | |||||||||
| CHIEF OF STAFF | 2.0 | 0.0 | Yes (X) | $27,000 | $0 | $0 | |||
| MICHAEL TOMASINI | |||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT CURRY | |||||||||
| BOARD MEMBER, VICE CHAIRPERSON | 4.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBYNN VANPATTEN | |||||||||
| BOARD SECRETARY (PART YEAR) | 2.0 | 40.0 | Yes (X) | $0 | $507,946 | $43,431 | Yes (X) | ||
| SISTER MARY BERNADETTE MCNULTY | |||||||||
| BOARD MEMBER, TREASURER | 2.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SISTER MARIAN SCHUBERT | |||||||||
| BOARD MEMBER | 2.0 | 57.0 | Yes (X) | $0 | $0 | $0 | |||
| TODD SALNAS | |||||||||
| BOARD MEMBER, PRESIDENT | 7.0 | 49.0 | Yes (X) | $0 | $534,436 | $43,431 | Yes (X) | ||
| JIM CARR | |||||||||
| VICE CHAIRPERSON (PART YEAR) | 4.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| PAMELA TUFT | |||||||||
| BOARD MEMBER, CHAIRPERSON | 5.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD INGRAM | |||||||||
| BOARD MEMBER | 5.0 | 54.0 | Yes (X) | $0 | $619,258 | $46,932 | |||
| SCOTT PRITCHARD | |||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JAMES WATSON | |||||||||
| BOARD SECRETARY | 2.0 | 52.0 | Yes (X) | $0 | $698,565 | $54,991 | Yes (X) | ||
| NANCY PRATT | |||||||||
| BOARD MEMBER (PART YEAR) | 2.0 | 48.0 | Yes (X) | $0 | $347,269 | $15,387 | |||
| MICHEL RICCIONI | |||||||||
| CHIEF FINANCIAL OFFICER | 7.0 | 43.0 | $0 | $507,769 | $46,666 | Yes (X) | |||
| KEVIN KLOCKENGA | |||||||||
| REGIONAL EVP | 7.0 | 52.0 | $0 | $879,223 | $40,946 | Yes (X) | |||
| DAVID ZIOLKOWSKI | |||||||||
| CHIEF OPERATING OFFICER | 5.0 | 45.0 | $0 | $338,684 | $35,768 | Yes (X) | |||
| RICHARD CARVOLTH | |||||||||
| CHIEF MEDICAL OFFICER | 7.0 | 43.0 | $0 | $454,028 | $20,031 | Yes (X) | |||
| JANE READ | |||||||||
| VP - OPERATIONS | 40.0 | 0.0 | $291,413 | $0 | $22,162 | Yes (X) | |||
| JAYNIE BOREN | |||||||||
| N. CAL REG VP - STRATEGIC SVCS | 5.0 | 54.0 | $0 | $387,992 | $32,906 | Yes (X) | |||
| GARY TOAVS | |||||||||
| CHIEF ENGINEER | 40.0 | 0.0 | $191,947 | $0 | $14,327 | Yes (X) | |||
| GARY MAHAN | |||||||||
| MANAGER CLINICAL & COMPLIANCE | 40.0 | 0.0 | $188,032 | $0 | $34,767 | Yes (X) | |||
| PAULA GRIFFITH | |||||||||
| STAFF NURSE IV - CNA | 32.0 | 0.0 | $165,294 | $0 | $43,394 | Yes (X) | |||
| HAI GAO | |||||||||
| STAFF NURSE II - CNA | 40.0 | 0.0 | $162,068 | $0 | $38,541 | Yes (X) | |||
| CHRIS FALLEY | |||||||||
| DIRECTOR HOSPICE SERVICES | 40.0 | 0.0 | $172,367 | $0 | $32,255 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,198,121 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,275,170 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $565,935 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 75 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL STAFFING NETWORK HEALTHCARE | |||||
| PO BOX 840292 | DALLAS | TX | 75284 | HEALTHCARE STAFFING | $548,811 |
| INTERIM PHYSICIANS LLC | |||||
| PO BOX 678004 | DALLAS | TX | 75267 | HEALTHCARE STAFFING | $501,102 |
| M ATCHISON CRNA INC | |||||
| 107 MACHINNES CT | NAPA | CA | 94558 | HEALTHCARE STAFFING | $459,250 |
| CALIFORNIA PACIFIC MEDICAL CENTER | |||||
| 2333 BUCHANAN ST | SAN FRANCISCO | CA | 94115 | MEDICAL SERVICES | $304,433 |
| CROMIN ENTERPRISES | |||||
| 8270 COLLEGE PKWY SUITE 101 | FORT MYERS | FL | 33919 | HEALTHCARE services | $264,510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $316,839 | FundraisingAmt |
| Related Organizations | $190,000 | RelatedOrganizationsAmt |
| Government Grants | $29,650 | GovernmentGrantsAmt |
| All Other Contributions | $488,702 | AllOtherContributionsAmt |
| Noncash Contributions | $7,125 | NoncashContributionsAmt |
| Total Contributions | $1,025,191 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $86,059,479 | $86,059,479 | $0 | $0 |
| ELECTRONIC HEALTH RECORDS | 622110 | $684,546 | $684,546 | $0 | $0 |
| CAFETERIA | 722514 | $84,014 | $84,014 | $0 | $0 |
| OTHER OPERATING REVENUE | 900099 | $292,680 | $292,680 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $87,120,719 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,714 | TotalRevenueColumnAmt |
| Exclusion | $47,714 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $58,896 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $316,839 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $171,139 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$112,243 | TotalRevenueColumnAmt |
| Exclusion | -$112,243 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| CASH PURCHASES & DISCOUNT | 900099 | $17,154 | $17,154 | $0 | $0 |
| REBATES & RETURNS | 900099 | $5,658 | $5,658 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $22,812 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,104,193 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $87,143,531 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$64,529 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,600 | TotalAmt |
| Program Services | $499,600 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,275 | TotalAmt |
| Program Services | $73,789 | ProgramServicesAmt |
| Management And General | $425,486 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,993,436 | TotalAmt |
| Program Services | $28,722,536 | ProgramServicesAmt |
| Management And General | $1,099,774 | ManagementAndGeneralAmt |
| Fundraising | $171,126 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,870,667 | TotalAmt |
| Program Services | $1,779,550 | ProgramServicesAmt |
| Management And General | $76,727 | ManagementAndGeneralAmt |
| Fundraising | $14,390 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,263,726 | TotalAmt |
| Program Services | $8,761,914 | ProgramServicesAmt |
| Management And General | $425,736 | ManagementAndGeneralAmt |
| Fundraising | $76,076 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,594,060 | TotalAmt |
| Program Services | $2,479,754 | ProgramServicesAmt |
| Management And General | $96,765 | ManagementAndGeneralAmt |
| Fundraising | $17,541 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,382,449 | TotalAmt |
| Program Services | $6,090,112 | ProgramServicesAmt |
| Management And General | $292,337 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $471,519 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $471,519 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,964 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $58,964 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,013 | TotalAmt |
| Program Services | $9,013 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,773,718 | TotalAmt |
| Program Services | $8,516,745 | ProgramServicesAmt |
| Management And General | $248,337 | ManagementAndGeneralAmt |
| Fundraising | $8,636 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,250 | TotalAmt |
| Program Services | $72,536 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $714 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,278,062 | TotalAmt |
| Program Services | $2,195,118 | ProgramServicesAmt |
| Management And General | $70,885 | ManagementAndGeneralAmt |
| Fundraising | $12,059 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,472,887 | TotalAmt |
| Program Services | $2,179,156 | ProgramServicesAmt |
| Management And General | $281,484 | ManagementAndGeneralAmt |
| Fundraising | $12,247 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,520,437 | TotalAmt |
| Program Services | $1,446,534 | ProgramServicesAmt |
| Management And General | $2,313 | ManagementAndGeneralAmt |
| Fundraising | $71,590 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,149 | TotalAmt |
| Program Services | $226,596 | ProgramServicesAmt |
| Management And General | $34,553 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,255 | TotalAmt |
| Program Services | $8,891 | ProgramServicesAmt |
| Management And General | $7,364 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,218 | TotalAmt |
| Program Services | $20,218 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,705,533 | TotalAmt |
| Program Services | $1,700,438 | ProgramServicesAmt |
| Management And General | $5,095 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $469,622 | TotalAmt |
| Program Services | $469,622 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $6,644,025 | $6,644,025 | $0 | $0 |
| CA HOSPITAL FEE PROGRAM | $5,453,235 | $5,453,235 | $0 | $0 |
| REPAIRS AND MAINTENANCE | $627,168 | $624,621 | $277 | $2,270 |
| LICENSES AND TAXES | $148,095 | $59,052 | $44,000 | $45,043 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,585,744 | TotalAmt |
| Program Services | $1,758,759 | ProgramServicesAmt |
| Management And General | $826,985 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,692,107 | TotalAmt |
| Program Services | $79,791,814 | ProgramServicesAmt |
| Management And General | $4,468,601 | ManagementAndGeneralAmt |
| Fundraising | $431,692 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,059 | BOYAmt |
| EOY | $2,059 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,869,504 | BOYAmt |
| EOY | $3,347,935 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,969,417 | BOYAmt |
| EOY | $10,231,167 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,133,422 | BOYAmt |
| EOY | $1,255,628 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $916,661 | BOYAmt |
| EOY | $710,412 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $52,151,022 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,562,282 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,438,922 | BOYAmt |
| EOY | $14,588,740 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,974 | BOYAmt |
| EOY | $184,886 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,412,123 | BOYAmt |
| EOY | $4,043,645 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,975,082 | BOYAmt |
| EOY | $34,364,472 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,744,610 | BOYAmt |
| EOY | $6,120,610 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,238,477 | BOYAmt |
| EOY | $18,700,405 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,983,087 | BOYAmt |
| EOY | $24,821,015 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,916,221 | BOYAmt |
| EOY | $7,168,073 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,075,774 | BOYAmt |
| EOY | $2,375,384 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,991,995 | BOYAmt |
| EOY | $9,543,457 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,975,082 | BOYAmt |
| EOY | $34,364,472 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,412,086 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,860,624 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Media Advertisements | $0 | MediaAdvertisementsAmt |
| Mailings Members | false | MailingsMembersInd |
| Mailings Members | $0 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmt |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmt |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $9,013 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,013 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS FOR LOBBYING DURING THE PAST YEAR, ST. JOSEPH HEALTH SYSTEM CONDUCTED ADVOCACY EFFORTS WHICH INCLUDED SOME LOBBYING ACTIVITIES. THESE INCLUDED MEETING WITH LOCAL, STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS, AND COMMUNICATIONS TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO PETALUMA VALLEY HOSPITAL. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,715,959 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,715,959 | DepreciationAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,194,275 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,596,038 | DepreciationAmt |
| Book Value | $2,598,237 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,927,254 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,250,285 | DepreciationAmt |
| Book Value | $9,676,969 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,313,534 | OtherCostOrOtherBasisAmt |
| Book Value | $2,313,534 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,588,740 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| HOSPITAL FEE | $1,916,499 |
| HOSPICE RESTRICTED FUNDS | $2,127,146 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,043,645 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED LIABILITIES | $2,324,595 |
| INTERCOMPANY BOND PAYABLES | $228,605 |
| DUE TO AFFILIATES | $15,582,766 |
| PAYABLE TO THIRD PARTY PAYORS | $411,354 |
| OTHER NON CURRENT LIABILITIES | $153,085 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $18,700,405 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | ASC 740 (FIN 48) FOOTNOTE 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 JUNE 30, 2015 OR 2014. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | BENEDETTI | Event1Nm |
| Gross Receipts Event1 | $248,610 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $219,710 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $28,900 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $0 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $0 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $0 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $27,378 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $6,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $70,031 | OtherDirectExpensesEvent1Amt |
| Event2 | NEXTGEN | Event2Nm |
| Gross Receipts Event2 | $13,945 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $10,445 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $3,500 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $0 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $5,000 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $750 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $1,000 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $0 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $6,400 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $113,180 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $86,684 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $26,496 | GrossRevenueOtherEventsAmt |
| Cash Prizes Other Events | $0 | CashPrizesOtherEventsAmt |
| Non Cash Prizes Other Events | $12,315 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $10,784 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $14,233 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $0 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $17,248 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $375,735 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $316,839 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $58,896 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $0 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $17,315 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $11,534 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $42,611 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $6,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $93,679 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $171,139 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$112,243 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $463,234 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $463,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,666,895 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,328,856 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,338,039 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11030 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,296 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,112 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,139,425 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,331,968 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,807,457 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11590 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $143,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,377 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $118,860 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $142,900 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $142,900 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $286,137 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,377 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $261,760 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,425,562 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,356,345 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,069,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11900 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,827 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,190 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,827 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,190 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,730,595 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $26,894,330 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,218,671 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $7,675,659 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SRM ALLIANCE HOSPITAL SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MCDOWELL BLVD | AddressLine1Txt |
| City | PETALUMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94954 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STJHS.ORG | WebsiteAddressTxt |
| State License | 110000001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SRM ALLIANCE HOSPITAL SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCHEDULE H, PART V, SECTION C | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINE 5 | THE COMMUNITY HEALTH IMPROVEMENT COMMITTEE (CHIC) SELECTED THREE TYPES OF COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH LEADERS IN THE COMMUNITY, FROM THE COUNTY DEPARTMENT OF HEALTH SERVICES AND LOCAL HEALTH, EDUCATION AND BUSINESS LEADERS; FOCUS GROUPS IN DIFFERENT COMMUNITIES THROUGHOUT THE COUNTY, BALANCED IN TERMS OF GEOGRAPHY AND CULTURE; AND A TELEPHONE SURVEY OF 1,500 PEOPLE. THESE THREE METHODS ALLOWED THE CHIC TO HEAR FROM CONTENT EXPERTS, COMMUNITY LEADERS, AND A BROAD SPECTRUM OF COMMUNITY MEMBERS. KEY INFORMANT INTERVIEWS WITH LOCAL EXPERTS CHNA PROJECT PARTNERS IDENTIFIED A PANEL OF 18 KEY INFORMANTS. KEY INFORMANTS WERE SELECTED FOR THEIR EXPERTISE IN A BROAD VARIETY OF HEALTH AND HEALTH-RELATED DISCIPLINES INCLUDING HOSPITAL AND PRIMARY CARE, PUBLIC HEALTH, MATERNAL AND CHILD HEALTH, HUMAN SERVICES, BUSINESS AND EDUCATION. PROJECT CONSULTANTS INTERVIEWED KEY INFORMANTS INDIVIDUALLY USING A STANDARDIZED SET OF QUESTIONS DESIGNED TO ELICIT INFORMATION ON THE LOCAL HEALTH ISSUES OF GREATEST CONCERN AND PERSPECTIVES ON LOCAL OPPORTUNITIES TO IMPROVE POPULATION HEALTH AND/OR THE HEALTHCARE DELIVERY SYSTEM. COMMUNITY BASED FOCUS GROUPS ST. JOSEPH HEALTH, SONOMA COUNTY (SJH-SC) CONDUCTED A SERIES OF TARGETED, COMMUNITY-BASED FOCUS GROUPS ON BEHALF OF THE PROJECT PARTNERS. THE GOAL OF THE FOCUS GROUP PROCESS WAS TO GATHER INFORMATION FROM RESIDENTS OF LOW-INCOME NEIGHBORHOODS ON THEIR HEALTH CONCERNS, THE CHALLENGES THEY FACE IN MAINTAINING HEALTH AND THEIR IDEAS ON HOW TO IMPROVE THEIR COMMUNITY'S HEALTH AND WELLBEING. FOUR FOCUS GROUPS WERE HELD, AVERAGING 8 PARTICIPANTS PER GROUP. GROUPS WERE FACILITATED IN BOTH SPANISH AND ENGLISH, BASED ON GROUP MAKE-UP. THE GROUPS WERE CONDUCTED IN THE COMMUNITIES OF SONOMA VALLEY, ROHNERT PARK, SANTA ROSA, AND CLOVERDALE AND WERE FACILITATED BY ST. JOSEPH'S STAFF USING STANDARDIZED QUESTIONS APPROVED BY THE CHNA PARTNERSHIP. BRFSS - A TELEPHONE SURVEY OF SONOMA COUNTY RESIDENTS ST. JOSEPH HEALTH, SONOMA COUNTY CONTACTED 1500 PEOPLE (839 COMPLETED THE SURVEY) USING A SURVEY TOOL INCORPORATING QUESTIONS FROM THE NATIONAL BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) SURVEY. THE SURVEY PROVIDED VALUABLE INFORMATION ON LOCAL HEALTH STATUS, HEALTH BEHAVIORS, EXPERIENCE WITH THE LOCAL HEALTH SYSTEMS AND HIGHLIGHTED THE LINKS BETWEEN SOCIAL DETERMINANTS, PREDOMINANTLY INCOME AND EDUCATIONAL ATTAINMENT, AND DISPARITIES IN HEALTH AND HEALTH CARE ACCESS. ORGANIZATIONS, PUBLIC HEALTH OR OTHER DEPARTMENTS OR AGENCIES, COMMUNITY LEADERS AND REPRESENTATIVES, OTHERS WHICH REPRESENT THE BROAD INTERESTS OF THE COMMUNITY CONSULTED DURING THE CHNA PROCESS INCLUDE: SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES SONOMA COUNTY OFFICE OF EDUCATION ECONOMIC DEVELOPMENT BOARD DRUG ABUSE ALTERNATIVE CENTER SANTA ROSA COMMUNITY HEALTH CENTERS SONOMA INDIAN HEALTH PROJECT REDWOOD COMMUNITY HEALTH COALITION KAISER PERMANENTE PARTNERSHIP HEALTHPLAN OF CALIFORNIA SONOMA COUNTY ORAL HEALTH ACCESS COALITION IN AN EFFORT TO GATHER DIVERSE POINTS OF VIEW THOSE INTERVIEWED REPRESENTED THE FOLLOWING SECTORS, SERVICES, ORGANIZATIONS AND AGENCIES: HEALTH AND HUMAN SERVICES HOSPITALS SONOMA COUNTY SCHOOLS ORAL HEALTH SERVICES COMMUNITY HEALTH CENTERS COMMUNITY BASED ORGANIZATIONS HEALTH INSURANCE PLANS ECONOMIC DEVELOPMENT |
| SCHEDULE H, PART V, LINES 6A AND 6B | THE SONOMA COUNTY COMMUNITY NEEDS ASSESSMENT (CHNA) 2013 IS A COLLABORATIVE EFFORT BY ST. JOSEPH HEALTH - SONOMA COUNTY (SANTA ROSA MEMORIAL AND PETALUMA VALLEY), SUTTER MEDICAL CENTER OF SANTA ROSA, KAISER PERMANENTE MEDICAL CENTER - SANTA ROSA AND THE SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES TO ASSESS THE HEALTH STATUS OF SONOMA COUNTY RESIDENTS AND TO IDENTIFY CRITICAL AREAS FOR HEALTH IMPROVEMENT IN SONOMA COUNTY. THE 2013 ASSESSMENT CONTINUES A SUCCESSFUL COLLABORATION BETWEEN THE HOSPITAL PARTNERS AND LOCAL HEALTH DEPARTMENT, BEGUN IN 2000, TO IDENTIFY AND JOINTLY ADDRESS SIGNIFICANT COMMUNITY HEALTH ISSUES. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | THE WEB ADDRESS IS: HTTP://WWW.STJOESONOMA.ORG/DOCUMENTS/COMMUNITY-BENEFIT/2014-PVH-COMMUNITY- HEALTH-NEEDS-ASSESSMENT-REPORT.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 10A | THE WEB ADDRESS IS: HTTP://WWW.STJOESONOMA.ORG/DOCUMENTS/COMMUNITY-BENEFIT/FY15-FY17-PVH-CB-AN D-IS-REPORT.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 11 | THE FOLLOWING HEALTH PROMOTION ACTIVITIES WERE PERFORMED IN FY15 IN RESPONSE TO NEEDS IDENTIFIED IN THE CHNA: ACCESS TO HEALTH CARE SERVICES: SRMH AND PVH'S MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN FY15, THE CLINIC SAW 870 PATIENTS OVER 2,318 ENCOUNTERS AT SEVERAL LOCATIONS COUNTYWIDE, INCLUDING THE CITIES OF SONOMA/BOYES HOT SPRINGS, SANTA ROSA, AND WINDSOR. HEALTHY EATING AND PHYSICAL FITNESS: THE PROMOTORES DE SALUD (HEALTH PROMOTERS) BRIDGE LANGUAGE AND CULTURE, PROVIDING HEALTH INFORMATION AND REFERRALS, CONDUCTING COOKING AND NUTRITION CLASSES, AND TRAINING COMMUNITY VOLUNTEER HEALTH PROMOTERS IN HEART HEALTH. IN FY15, THE PROMOTORES DE SALUD SERVED 1,369 LOW-INCOME INDIVIDUALS THROUGH 3,434 SERVICE ENCOUNTERS ACROSS SONOMA COUNTY. THE PROGRAM ENCOURAGED PARTICIPANTS TO BE MORE PHYSICALLY ACTIVE, PARTICIPATED IN HEALTH FAIRS, AND TAUGHT HEALTH EDUCATION AND HEALTHY COOKING CLASSES. HEALTHY FOR LIFE IS A SCHOOL-BASED PHYSICAL ACTIVITY AND NUTRITION PROGRAM THAT WORKS TO TEACH BEHAVIORS AT AN EARLY AGE AND ENSURE GOOD HEALTH FOR YEARS TO COME. THIS YEAR, 6 PARTNER SCHOOLS, 9 CHAMPION TEACHERS AND OVER 496 STUDENTS AND PARENTS PARTICIPATED IN FITNESS AND NUTRITION COURSES ACROSS 7,514 ENCOUNTERS. ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES: CIRCLE OF SISTERS (COS) IS A POSITIVE YOUTH DEVELOPMENT AFTER-SCHOOL PROGRAM FOR GIRLS AGES 9 TO 14 OFFERED AT NO COST. PROGRAM PARTICIPANTS ATTEND SCHOOLS WITH HIGH RATES OF ELIGIBILITY FOR THE FREE AND REDUCED LUNCH PROGRAM. IN FY15, COS SERVED 191 YOUNG WOMEN IN 6,765 ENCOUNTERS COUNTYWIDE. THE PROGRAM HELPS WITH SELF-ESTEEM AND MAKING GOOD CHOICES ABOUT THE FUTURE, AND ADDRESSES MENTAL HEALTH ISSUES SUCH AS SELF-HARM, THE RISKS OF SUBSTANCE USE, AND THE VALUE OF BUILDING STRONG AND RESILIENT RELATIONSHIPS. BARRIERS TO HEALTHY AGING: SRMH AND PVH'S HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE HOUSE CALLS TEAM, WHICH INCLUDES NURSE PRACTITIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED 5,525 PATIENT ENCOUNTERS DURING FY15, WHICH HELP TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE FOR 112 INDIVIDUALS. DISPARITIES IN ORAL HEALTH: SRMH AND PVH'S CONTINUUM OF ORAL HEALTH SERVICES INCLUDE A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA THAT SERVES CHILDREN FROM ALL OVER THE COUNTY, THE MOBILE DENTAL CLINIC, THE MIGHTY MOUTH SCHOOL-BASED DENTAL DISEASE PREVENTION PROGRAM, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. DURING FY15 3,689 INDIVIDUALS RECEIVED 7,863 SERVICE ENCOUNTERS AT THE SJH DENTAL CLINIC. SRMH AND PVH'S MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PROGRAM SAW 9,724 MOSTLY EDUCATION AND PREVENTION VISITS WITH A TOTAL OF 4,697 PATIENTS. MIGHTY MOUTH ALSO PROVIDED EDUCATION FOR AN ADDITIONAL 4,287 ENCOUNTERS. NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE SRMH'S MISSION THROUGH COMMUNITY BENEFIT PROGRAMS AND BY FUNDING OTHER NON-PROFITS THROUGH SRMH AND PVH'S CARE FOR THE PROGRAM MANAGED BY SRMH AND PVH. FURTHERMORE, SRMH AND PVH ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE SJH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES OR RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGH SJH COMMUNITIES. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE DIRECTLY ADDRESSED BY SRMH AND PVH'S COMMUNITY BENEFIT STRATEGIC PRIORITIES, THOUGH WE ARE PERFORMING THE FOLLOWING RELATED ACTIVITIES: 1. DISPARITIES IN EDUCATIONAL ATTAINMENT. SRMH AND PVH PARTICIPATE IN A NUMBER OF COUNTYWIDE EFFORTS THAT ARE WORKING TO ADDRESS THIS IMPORTANT NEED, INCLUDING SONOMA HEALTH ACTION, WHICH IS A COLLECTIVE ACTION INITIATIVE IN THE COUNTY. TODD SALNAS, PRESIDENT OF SANTA ROSA MEMORIAL HOSPITAL AND PETALUMA VALLEY HOSPITAL, SITS ON THE HEALTH ACTION COUNCIL, AND CRADLE TO CAREER IS ONE KEY INITIATIVE OF HEALTH ACTION AND IS FOCUSED ON EDUCATIONAL ATTAINMENT AND WORKFORCE DEVELOPMENT. 2. CARDIOVASCULAR DISEASE. SRMH AND PVH'S PROMOTORES DE SALUD PROGRAM FOLLOWS A PROVEN MODEL OF PEER EDUCATION, CONNECTING WITH UNDERSERVED COMMUNITIES IN A CULTURALLY APPROPRIATE MANNER. THE YOUR HEART, YOUR LIFE COURSE WE TEACH AT NO COST TO ANYONE WHO CHOOSES TO ENROLL TAKES PLACE OVER 10 WEEKS AND ALLOWS STAFF TO BUILD RELATIONSHIPS WITH PARTICIPANTS, AND LEVERAGE THOSE RELATIONSHIPS TO DRIVE REAL AND SUSTAINED BEHAVIORAL CHANGES. SRMH AND PVH'S PROGRAM IS SUPPORTED BY VOLUNTEERS, MANY OF WHOM ARE COURSE GRADUATES THEMSELVES AND WHOSE LIVES HAVE BEEN DEEPLY AFFECTED BY THE PROGRAM; THEY ARE INSPIRED TO SHARE THAT EXPERIENCE WITH OTHERS AND SHARE THE BENEFITS OF HEALTHY LIVING. 3. ADVERSE CHILDHOOD EXPERIENCES OR EXPOSURE TO STRESS (ACES). IN FY15, FOUR OF SRMH AND PVH'S STAFF BECAME CERTIFIED IN THE POSITIVE PARENTING PROGRAM, AN INTERNATIONAL EVIDENCE-BASED MODEL THAT IS WIDELY UNDERSTOOD AS AN EFFECTIVE PROGRAM TO HELP PREVENT THE OCCURRENCES OF ACES AND SPREAD POSITIVE AND SUPPORTIVE PARENTING PRACTICES. BY BECOMING CERTIFIED, SRMH'S STAFF MEMBERS WHO WORK DIRECTLY WITH PARENTS CAN OFFER INFORMATION AND BRIEF INTERVENTIONS, EDUCATING ABOUT AND SUPPORTING PARENTS IN MAKING GOOD DECISIONS. 4. TOBACCO USE. WE COLLABORATE WITH AND SUPPORT THROUGH SPONSORSHIPS SEVERAL ORGANIZATIONS THAT PERFORM SCREENING FOR TOBACCO USE AND SMOKING CESSATION, INCLUDING THE PETALUMA HEALTH CENTER, WEST COUNTY HEALTH CENTERS, AND SANTA ROSA COMMUNITY HEALTH CENTERS. SRMH AND PVH ALSO HAS A CB STAFF LIAISON ON THE BOARD, AND PROVIDES CORE FUNDING TO THE HEALTHY COMMUNITIES CONSORTIUM, WHICH IS ACTIVE IN VARIOUS TOBACCO CONTROL INITIATIVES. 5. COORDINATION AND INTEGRATION OF LOCAL HEALTH CARE SYSTEM. SRMH AND PVH PARTICIPATES IN THE HEALTH SYSTEM IMPROVEMENT INITIATIVE OF SONOMA HEALTH ACTION, AND HAVE BEEN ACTIVE IN BOTH THE MY CARE, MY PLAN: SPEAK UP SONOMA COUNTY INITIATIVE AS WELL AS THE HEARTS OF SONOMA COUNTY INITIATIVE, BOTH OF WHICH SEEK TO LEVERAGE INTEGRATION AND COORDINATION OF EFFORT. THE FORMER INITIATIVE IS FOCUSED ON ADVANCE CARE PLANNING AND THE LATTER ON CARDIOVASCULAR HEALTH. SRMH AND PVH ALSO SUPPORTED THE SANTA ROSA COMMUNITY HEALTH CENTERS WITH AN $80,000 GRANT TO SUPPORT THE COORDINATION OF CARE FOR UNDERSERVED PATIENTS, CO-LOCATING A STAFF MEMBER OF THEIRS WITHIN SRMH'S FACILITY TO ASSIST WITH TRANSITIONS AND DISCHARGE PLANNING. 6. LUNG, BREAST, AND COLORECTAL CANCER. WE OFFER CHARITY CARE SUPPORT FOR MOBILE MEDICAL PATIENTS WHO REQUIRE CANCER DIAGNOSTICS AND MAKE SIGNIFICANT EFFORTS TO CONNECT PATIENTS TO SPECIALTY CANCER CARE, COORDINATING CARE AND REFERRALS WHEN APPROPRIATE. |
| SCHEDULE H, PART V, SECTION B, LINE 13H | THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | THE WEB ADDRESS IS: http://www.stjoesonoma.org/documents/Financial-Assistance-Policy.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 16B | THE WEB ADDRESS IS:: http://www.stjoesonoma.org/documents/Sonoma-FAA-English.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 16C | HTTP://WWW.STJOESONOMA.ORG/DOCUMENTS/PRINT_SJH_SONOMACO_FINANCIALASSISTANC EBROCHURE_2016.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 16I | THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA. |
| SCHEDULE H, PART V, SECTION B, LINE 22D | FOR PATIENTS WITH A FAMILY INCOME BETWEEN 201% AND 350% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USED MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR PATIENTS WITH A FAMILY INCOME BETWEEN 351% AND 500% OF FPG, THE HOSPITAL FACILITY USED THE AVERAGE OF NEGOTIATED COMMERCIAL INSURANCE RATES TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| HOSPICE OF PETALUMA | ||||
| 416 PAYRAN STREET | PETALUMA | CA | 94954 | HOSPICE |
| HOSPICE OF SANTA ROSA | ||||
| 439 COLLEGE AVE | SANTA ROSA | CA | 95401 | HOSPICE |
| HOSPICE OF SANTA ROSA | ||||
| 447 COLLEGE AVE | SANTA ROSA | CA | 95401 | HOSPICE |
| LYNCH CREEK LABORATORY | ||||
| 151 LYNCH CREEK | PETALUMA | CA | 95954 | LAB OUTREACH |
| LYNCH CREEK IMAGING | ||||
| 151 LYNCH CREEK | PETALUMA | CA | 95954 | IMAGING/RADIOLOGY |
| HOSPICE OF NORTH COUNTY | ||||
| 205 EAST STREET | HEALDSBURG | CA | 95448 | HOSPICE |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. |
| SCHEDULE H, PART I, LINE 6A | PETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT WWW.STJOESONOMA.ORG. |
| SCHEDULE H, PART I, LINES 7A-7I | COST-TO-CHARGE RATIO USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO DETERMINE AMOUNTS ON LINE 7. |
| SCHEDULE H, PART II | SANTA ROSA MEMORIAL HOSPITAL (SRMH) AND PETALUMA VALLEY HOSPITALS (PVH) COMMUNITY BENEFIT DEPARTMENT INTEGRATES ACTIONS THAT ADDRESS THE POLITICAL, SOCIAL, BEHAVIORAL AND PHYSIOLOGICAL DETERMINANTS OF HEALTH. THE PRIMARY STRATEGIES EMPLOYED TO ADDRESS COMMUNITY NEEDS ARE COMMUNITY CAPACITY BUILDING AND IMPROVING HEALTH OUTCOMES FOR VULNERABLE POPULATIONS. PVH'S PROGRAMS FOCUS ON BUILDING COMMUNITY CAPACITY AND EMPOWERMENT TO ADDRESS QUALITY OF LIFE CONCERNS. IN ADDDITION TO COUNTYWIDE COLLABORATION AND PARTNERSHIP DEVELOPMENT TO SUPPORT THESE ACTIONS, THE NEIGHBORHOOD CARE STAFF (NCS) PROGRAM IS ESPECIALLY FOCUSED ON COMMUNITY BUILDING. THIS PROGRAM is AN INTEGRAL PART OF THE HOSPITAL'S INITIATIVE TO IMPROVE COMMUNITY AND ADDRESS SOCIAL DETERMINANTS OF HEALTH. NCS MENTOR GRASSROOTS RESIDENTS TO ADDRESS LOCAL COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES. NCS MODELS AND MENTORS COMMUNITY REPRESENTATIVES IN THESE KEY FUNCTIONS: THE IDENTIFICATION OF LOCAL ASSETS, PROVIDING FORUMS FOR DIALOGUE, SURFACING AND SUPPORTING LOCAL LEADERS, FACILITATING THE DEVELOPMENT OF SELF-SUSTAINING COMMUNITY GROUPS, FACILITATING COMMUNITY-BASED STRATEGIC PLANNING, HELPING TO BUILD LINKAGES TO AND BETWEEN COMMUNITY RESOURCES, AND ADVOCATING FOR COMMUNITY PARTICIPATION IN THE ISSUES THAT MOST AFFECT IT. IN FY15, NCS WORKED WITH 288 RESIDENTS COUNTYWIDE FROM LOW-INCOME NEIGHBORHOODS WITH DISPROPORTIONATE UNMET HEALTH NEEDS AND ENGAGED IN 4,343 SERVICE ENCOUNTERS WITH THESE INDIVIDUALS. ADDITIONALLY, SRMH AND PVH COLLABORATED WITH OR SUPPORTED THE FOLLOWING COMMUNITY BUILDING INITIATIVES: o A PORTRAIT OF SONOMA COUNTY IS AN IN-DEPTH LOOK AT HOW RESIDENTS OF SONOMA COUNTY ARE FARING IN THREE FUNDAMENTAL AREAS OF LIFE: HEALTH, ACCESS TO KNOWLEDGE, AND LIVING STANDARDS. ST. JOSEPH HEALTH STAFF SERVED ON THE PORTRAIT LEADERSHIP TEAM, INTEGRATED THE REPORT INTO THE NEW EMPLOYEE ORIENTATION FOR ALL ST. JOSEPH HEALTH INCOMING EMPLOYEES, FAMILIARIZING STAFF WITH ISSUES RELATED TO DISPARITIES, SOCIAL DETERMINANTS OF HEALTH, AND PLACE-BASED INTERVENTIONS TO IMPROVE OUTCOMES. o SONOMA HEALTH ACTION: HEALTH ACTION IS THE FRAMEWORK FOR A COMMUNITY ENGAGEMENT EFFORT TO GET PEOPLE INVOLVED IN CREATING A HEALTHIER SONOMA COUNTY. IT STARTS AT HOME WITH A PERSONAL COMMITMENT. IT CONTINUES AT WORK AND SCHOOL WITH WELLNESS-FOCUS POLICIES AND OPPORTUNITIES THAT ENCOURAGE HEALTHY LIVING. IT CULMINATES IN THE COMMUNITY WITH A SHARED VISION FOR OVERALL GOOD HEALTH. SRMH AND PVH'S PRESIDENT SERVED ON THE HEALTH ACTION COUNCIL, COMMUNITY BENEFIT STAFF PARTICIPATED IN THE ECONOMIC WELLNESS INITIATIVE AND THE HEARTS OF SONOMA COUNTY - CARDIOVASCULAR DISEASE RISK REDUCTION INITIATIVE. SUPPORTED COLLECTIVE ACTION PRINCIPLES AND PROVIDED INPUT AND LEADERSHIP IN A VARIETY OF OTHER AREAS. o THE SONOMA COUNTY FUNDERS' CIRCLE HELPS CREATE HEALTHY COMMUNITIES WITH WIDESPREAD EQUITY THROUGH COLLECTIVE INVESTING. ALL MEMBERS ARE COMMITTED TO SOCIAL INVESTMENT FOR SYSTEMIC CHANGE THAT INCLUDES LEADERSHIP IN ADVOCACY, RESEARCH, COLLABORATIVE LEARNING, CAPACITY BUILDING, AND APPLIED PRACTICE. COMMUNITY BENEFIT STAFF CHAIRED THE GOVERNANCE COMMITTEE, PARTICIPATED IN THE FORMULATION OF GOVERNANCE GUIDELINES AND HELPED TO BUILD THE CAPACITY OF THIS COLLABORATIVE WORKGROUP. o THE COMMUNITY ACTIVITY AND NUTRITION COALITION (CAN-C) OF SONOMA COUNTY IS A GROUP OF INDIVIDUALS, PROFESSIONALS AND COMMUNITY BASED ORGANIZATIONS CONCERNED ABOUT THE NUTRITIONAL HEALTH, ACTIVITY LEVEL AND WELL-BEING OF THE RESIDENTS OF SRMH AND PVH'S COMMUNITY. COMMUNITY BENEFIT STAFF SERVED ON THE STEERING COMMITTEE, MADE SEVERAL PRESENTATIONS ON RELATED PROGRAMS AND UPDATES TO CAN-C MEMBERSHIP, ATTENDED REGULAR MEETINGS AND SUBCOMMITTEE MEETINGS FOR HEALTHY STUDENTS INITIATIVE, PHYSICAL ACTIVITY SUBCOMMITTEES. o LOS CIEN: LATINO LEADERS DEDICATED TO BUILDING A BETTER FUTURE FOR SONOMA COUNTY. COMMUNITY BENEFIT STAFF PARTICIPATED IN REGULAR MONTHLY MEETINGS OF LOS CIEN AND COMMITTED ONE STAFF MEMBER AS A FORMAL LIAISON TO LOS CIEN, PROVIDING SUPPORT AND ASSISTANCE THE GROUP. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS RECEIVED A 100 PERCENT WRITE-OFF OF THE BALANCE DUE. AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT CREDIT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED PAYORS ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION REGULARLY ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING CMS STANDARD COSTING METHODS. THIS INCLUDES STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT IN ADDITION TO CONDUCTING A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, ST. JOSEPH HEALTH STAFF SERVED ON THE DEVELOPMENT OF THE PORTRAIT OF SONOMA COUNTY LEADERSHIP TEAM. A PORTRAIT OF SONOMA COUNTY IS AN IN-DEPTH LOOK AT HOW RESIDENTS OF SONOMA COUNTY ARE FARING IN THREE FUNDAMENTAL AREAS OF LIFE: HEALTH, ACCESS TO KNOWLEDGE, AND LIVING STANDARDS. ST. JOSEPH HEALTH STAFF INTEGRATED THE PORTRAIT OF SONOMA COUNTY REPORT INTO SRMH AND PVHS NEW EMPLOYEE ORIENTATION FOR ALL INCOMING EMPLOYEES, FAMILIARIZING STAFF WITH ISSUES RELATED TO DISPARITIES, SOCIAL DETERMINANTS OF HEALTH, AND PLACE-BASED INTERVENTIONS TO IMPROVE OUTCOMES. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION THE COLLABORATIVE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY. SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. THE COUNTY'S TOTAL POPULATION IS CURRENTLY ESTIMATED AT 487,011. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%). SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION OF 168,841 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. SINCE 2006, THE COUNTY POPULATION HAS GROWN AT AN OVERALL RATE OF 1.8% WITH THE CITIES OF SONOMA, SANTA ROSA AND WINDSOR EXPERIENCING THE FASTEST GROWTH RATES. SONOMA COUNTY'S UNINCORPORATED AREAS ARE HOME TO 146,739 RESIDENTS, 30.1% OF THE TOTAL POPULATION. A SIGNIFICANT NUMBER OF THESE INDIVIDUALS LIVE IN LOCATIONS THAT ARE VERY RURAL AND GEOGRAPHICALLY REMOTE. RESIDENTS OF THESE AREAS MAY EXPERIENCE SOCIAL ISOLATION AND SIGNIFICANT BARRIERS IN ACCESSING BASIC SERVICES AND SUPPORTS SUCH AS TRANSPORTATION, HEALTH CARE, NUTRITIOUS FOOD AND OPPORTUNITIES TO SOCIALIZE. LOW-INCOME AND SENIOR POPULATIONS LIVING IN REMOTE AREAS MAY FACE SPECIAL CHALLENGES IN MAINTAINING HEALTH AND QUALITY OF LIFE. OF THE COUNTY'S TOTAL SENIOR POPULATION, AGE 60 AND OLDER, 12,144 (12%) ARE CONSIDERED "GEOGRAPHICALLY ISOLATED" AS DEFINED BY THE OLDER AMERICANS ACT. (SOURCE: CALIFORNIA DEPT. OF AGING, CALIFORNIA AGING POPULATION DEMOGRAPHIC PROJECTIONS FOR INTRASTATE FUNDING FORMULA (2011)) RACE AND ETHNICITY WHITE, NON-HISPANICS CURRENTLY REPRESENT 64.2% OF THE COUNTY'S POPULATION WHILE HISPANICS ACCOUNT FOR 25.6%. OTHER ETHNIC GROUPS INCLUDE: ASIAN/PACIFIC ISLANDER (5.2%), AFRICAN AMERICANS (1.7%), AMERICAN INDIANS (1.0%), AND PERSONS REPORTING TWO OR MORE RACES (2.3%). WHILE THE COUNTY'S POPULATION IS LESS DIVERSE THAN THAT OF CALIFORNIA AS A WHOLE, THIS IS CHANGING. BY 2020, SONOMA'S HISPANIC POPULATION, CURRENTLY ESTIMATED AT 129,057, IS EXPECTED TO GROW TO 168,290 AND ACCOUNT FOR 31% OF THE TOTAL POPULATION. OTHER ETHNIC GROUPS ARE PROJECTED TO EXPERIENCE LESS DRAMATIC GROWTH. (SOURCE: CALIFORNIA DEPT. OF FINANCE, E-5 POPULATION AND HOUSING ESTIMATES FOR CITIES, COUNTIES, AND THE STATE (2011-2012) WHILE THE MAJORITY OF THE COUNTY'S ETHNIC POPULATIONS ARE ENGLISH-PROFICIENT, THE 2010 CENSUS ESTIMATES THAT 50,236 RESIDENTS, AGE 5 AND OLDER, OR 11.26% OF TOTAL POPULATION, ARE "LINGUISTICALLY ISOLATED" I.E., SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME AND SPEAKING ENGLISH LESS THAN "VERY WELL." AGE AND GENDER SONOMA COUNTY IS SLIGHTLY OLDER THAN CALIFORNIA AS A WHOLE, WITH A MEDIAN AGE OF 39.50 YEARS, AS COMPARED WITH 34.90 YEARS. SONOMA COUNTY SENIORS, AGE 60 AND OVER, REPRESENT 20.4% OF THE TOTAL POPULATION AS COMPARED WITH A STATEWIDE FIGURE OF 16.9%. OF NOTE IS THE DISPARITY IN AGE BETWEEN THE COUNTY'S OLDER WHITE POPULATION AND ITS MORE YOUTHFUL HISPANIC POPULATION. OVER 30% OF SONOMA COUNTY HISPANICS ARE AGE 12 AND UNDER, AS COMPARED TO 12% FOR WHITES. AT THE OTHER END OF THE SPECTRUM, 26.6% OF WHITES ARE SENIORS (AGE 60 AND ABOVE) AS COMPARED WITH 7.1% OF HISPANICS. SENIORS ARE THE COUNTY'S FASTEST GROWING POPULATION AGE GROUP. THIS POPULATION IS PROJECTED TO GROW FROM 102,639 IN 2012 TO 128,589 IN 2020, WITH THE GREATEST GROWTH IN THE 70-74 AGE GROUP THE BABY BOOM "AGE WAVE". THIS AGE WAVE, COMBINED WITH INCREASED LONGEVITY, WILL CONTINUE TO DRIVE GROWTH IN SENIOR POPULATIONS, ESPECIALLY IN THE 75 AND OVER AGE GROUP. SENIORS AGE 75 OVER CURRENTLY REPRESENT ABOUT 9% OF THE TOTAL POPULATION AT 44,813. FEMALES SIGNIFICANTLY OUTNUMBER MALES IN THIS AGE GROUP (62%/38%). INCOME AND WEALTH FROM 2006-2010, THE MEDIAN INCOME OF SONOMA COUNTY'S 184,000 HOUSEHOLDS WAS $63,274, SLIGHTLY HIGHER THAN THE CALIFORNIA AVERAGE. DURING THIS PERIOD, 17.7% OF SONOMA COUNTY HOUSEHOLDS HAD INCOMES OF LESS THAN $25,000. AT THE UPPER END OF THE SCALE, 28% OF HOUSEHOLDS EARNED OVER $100,000 ANNUALLY. THE IMPACT OF THE RECESSION ON INCOME AND WEALTH HAS BEEN SIGNIFICANT. WHILE LOCAL DATA ARE NOT AVAILABLE, A NATIONAL SURVEY OF CONSUMER FINANCE SHOWED THAT, BETWEEN 2007 AND 2010, THE MEDIAN NET WORTH OF AMERICAN FAMILIES PLUNGED MORE THAN 38%. (SOURCE: BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM, SURVEY OF CONSUMER FINANCES 2010). INCOME STATUS VARIES SIGNIFICANTLY BY GENDER. DURING 2006-2010, MEDIAN INCOME FOR SONOMA COUNTY MALES WAS $44,973 AS COMPARED WITH $31,960 FOR FEMALES. THIS DIFFERENTIAL EXPANDS WITH EDUCATIONAL ATTAINMENT; MEDIAN INCOME FOR MALES WITH GRADUATE DEGREES ($85,470) WAS SIGNIFICANTLY HIGHER THAN FOR FEMALES AT THE SAME EDUCATIONAL LEVEL ($55,272). SOURCE: U.S. CENSUS BUREAU, 2006-2010 ACS (REPORTED IN 2010 INFLATION ADJUSTED DOLLARS). SONOMA COUNTY HOUSEHOLD INCOMES ALSO VARY SIGNIFICANTLY BY BOTH EDUCATIONAL ATTAINMENT AND ETHNICITY. 80% OF SONOMA COUNTY HOUSEHOLDS WITH GRADUATE EDUCATION EARNED ABOVE $66,150 ANNUALLY AS COMPARED WITH ONLY 42.9% OF HOUSEHOLDS WITH HIGH SCHOOL OR LESS EDUCATION AND, WHILE 68.6% OF WHITE, NON-HISPANICS HAD ANNUAL HOUSEHOLD INCOME IN EXCESS OF $66,150 ONLY 34.5% OF HISPANICS DID. (SOURCE: U.S. CENSUS BUREAU, 2010 ACS 1-YEAR ESTIMATE) WHILE MANY SONOMA COUNTY RESIDENTS ENJOY FINANCIAL SECURITY, 10.27% OF COUNTY RESIDENTS REPORTED ANNUAL INCOMES BELOW FEDERAL POVERTY LEVEL IN 2010. THE 2010 FEDERAL POVERTY LEVEL (FPL) WAS $10,830 IN ANNUAL INCOME FOR AN INDIVIDUAL OR $22,050 FOR A FAMILY OF FOUR. THE FEDERAL POVERTY GUIDELINES ARE NOT SCALED TO REFLECT SIGNIFICANT REGIONAL VARIATIONS IN THE COST OF LIVING. GIVEN THE HIGH COST OF LIVING IN SONOMA COUNTY, IT IS GENERALLY ACCEPTED THAT AN ANNUAL INCOME UNDER 200% OF FPL ($21,660 FOR AN INDIVIDUAL) IS INADEQUATE TO MEET BASIC NEEDS FOR FOOD, CLOTHING, SHELTER, TRANSPORTATION, HEALTH CARE AND OTHER NECESSITIES. POVERTY RATES VARY SIGNIFICANTLY BY ETHNICITY. SIGNIFICANT DISPARITIES EXIST, ESPECIALLY FOR SONOMA COUNTY HISPANICS, WHO EXPERIENCE A MUCH HIGHER RATE OF POVERTY (21.8%) THAN WHITES OR ASIANS. THE COUNTY'S YOUNGEST RESIDENTS ARE MOST SIGNIFICANTLY IMPACTED BY POVERTY; WITH NEARLY 17% OF CHILDREN UNDER AGE 6 LIVING BELOW 100% FEDERAL POVERTY LEVEL. AMONG SONOMA COUNTY SENIORS AGE 75 AND OVER, OVER 2,000 LIVE IN HOUSEHOLDS WITH HOUSEHOLD INCOME BELOW 100% FPL AND AN ADDITIONAL 6,000 HAVE INCOME UNDER 200% OF FPL. POVERTY STATUS IS ALSO LINKED TO FAMILY CONFIGURATION. AMONG AN ESTIMATED 116,699 SONOMA COUNTY FAMILIES, THOSE OF MARRIED COUPLES EXPERIENCE THE LOWEST POVERTY RATES (3.8%). THE FAMILIES OF SINGLE, FEMALE HOUSEHOLDERS EXPERIENCE THE HIGHEST RATES, WITH SIGNIFICANT DISPARITY BY ETHNICITY. AMONG HISPANIC FAMILIES WITH A FEMALE SINGLE HEAD-OF-HOUSEHOLD, 29.2% ARE LIVING BELOW FPL AS COMPARED WITH 12.5% FOR WHITES IN THIS CATEGORY. AMONG SENIORS, THOSE WHO ARE MARRIED HAVE A LOWER POVERTY RATE (1.9%) THAN DO FEMALE SENIORS LIVING AS SINGLE, HEADS-OF-HOUSEHOLD (2.4%). IN SOME PARTS OF SOUTHWEST SANTA ROSA, THE RUSSIAN RIVER CORRIDOR, SONOMA VALLEY AND UNINCORPORATED AREAS IN THE NORTHWEST AND NORTHEAST, POVERTY RATES FOR CHILDREN UNDER AGE 18 EXCEED 40%. BASED ON NEIGHBORHOOD CONDITIONS, RESIDENTS IN THESE COMMUNITIES MAY HAVE LIMITED ACCESS TO SAFE PLACES TO PLAY, SAFE ROUTES TO WALK AND BIKE TO SCHOOL, GROCERY STORES THAT OFFER AFFORDABLE, FRESH FRUITS AND VEGETABLES OR PREVENTION-FOCUSED HEALTH AND DENTAL SERVICES. THE COUNTY'S LOWEST INCOME SENIOR POPULATIONS ARE CLUSTERED AROUND SANTA ROSA, THE SONOMA VALLEY AND THE RUSSIAN RIVER. SIMILARLY, LOW-INCOME SENIORS MAY FACE BARRIERS IN ACCESSING AFFORDABLE TRANSPORTATION, NUTRITIOUS FOOD, SAFE PLACES TO EXERCISE AND OPPORTUNITIES TO SOCIALIZE WITH OTHERS. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH PETALUMA HOSPITAL HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 18 YEARS. SERVING THE COMMUNITIES OF SONOMA COUNTY, THE MINISTRY'S CORE FACILITIES ARE PVH, AN 80-BED ACUTE CARE HOSPITAL, AND SRMH, A FULL SERVICE 278-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER. MAJOR PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, CRITICAL CARE, DIAGNOSTIC IMAGING, AND A WIDE RANGE OF SPECIALTY SERVICES, EMERGENCY MEDICINE AND OBSTETRICS. SRMH AND PVH ARE COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: THERE IS A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION, AN OPEN MEDICAL STAFF, AND THROUGH SRMH AND PVH'S COMMUNITY BENEFIT PROGRAMS WHICH ARE PARTLY FUNDED BY CARE FOR THE POOR DOLLARS. SRMH AND PVH ARE HEALING MINISTRIES OF ST. JOSEPH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. ST. JOSEPH HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPITAL CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE IN THE COMMUNITIES WE SERVE. LOCAL COMMUNITY BENEFIT COMMITTEE: THE ROLE OF THE SRMH AND PVH'S COMMUNITY BENEFIT COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE COMMITTEE ACTS IN ACCORDANCE WITH A BOARD-APPROVED CHARTER. THE COMMUNITY BENEFIT COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS IDENTIFIED NEEDS IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORTS, AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES. THE COMMUNITY BENEFIT COMMITTEE HAS A MINIMUM OF EIGHT MEMBERS INCLUDING THREE MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES THREE MEMBERS OF THE BOARD OF TRUSTEES AND EIGHT COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY BENEFIT COMMITTEE GENERALLY MEETS BI-MONTHLY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING KEY PROGRAMS: o PVH'S HEALTHY FOR LIFE IS A SCHOOL-BASED PHYSICAL ACTIVITY AND NUTRITION PROGRAM THAT WORKS TO TEACH BEHAVIORS AT AN EARLY AGE AND ENSURE GOOD HEALTH FOR YEARS TO COME. IN FY15 IN THE PVH SERVICE AREA, 4 PARTNER SCHOOLS (INCLUDING 3 IN THE OLD ADOBE UNION SCHOOL DISTRICT), 8 CHAMPION TEACHERS, AND OVER 557 STUDENTS AND PARENTS PARTICIPATED IN FITNESS AND NUTRITION COURSES ACROSS 4,198 ENCOUNTERS. WE HAVE BEEN WORKING WITH THE SONOMA UPSTREAM INVESTMENTS INITIATIVE TO RECERTIFY THE HEALTHY FOR LIFE PROGRAM TO ENSURE SUSTAINABILITY IN THE PROGRAM AND RECOGNIZE IT AS A BEST PRACTICE. o PVH'S MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN FY15 IN THE PVH SERVICE AREA, THE CLINIC SAW 97 PATIENTS OVER 194 ENCOUNTERS. THE CLINIC SUCCESSFULLY TRANSITIONED PATIENTS AT THE HOMELESS-SERVING COMMITTEE ON THE SHELTERLESS (COTS) MARY ISAAC CENTER TO THE PETALUMA HEALTH CENTER AT THE START OF THE FISCAL YEAR. o PVH'S HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE HOUSE CALLS TEAM, WHICH INCLUDES NURSE PRACTITIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED 236 PATIENT ENCOUNTERS DURING FY15 IN THE PVH SERVICE AREA, WHICH HELP TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE FOR 6 INDIVIDUALS IN THE PETALUMA AREA. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM SRM ALLIANCE HOSPITAL SERVICES IS A HEALING MINISTRY OF ST. JOSEPH HEALTH AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITIES IT SERVES. IN 1986, ST. JOSEPH HEALTH CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH CREATED THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND (FORMERLY KNOWN AS THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. EVERY YEAR, EACH ST. JOSEPH HEALTH HOSPITAL MINISTRY CONTRIBUTES 10 PERCENT OF ITS NET INCOME TO THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. IN FY15, PETALUMA VALLEY HOSPITAL CONTRIBUTED $464,000 TO THE SJH COMMUNITY PARTNERSHIP FUND (SJH CPF) AND THE SJH CPF RECEIVD A TOTAL OF $31M. 75% OF THE CONTRIBUTIONS ARE USED TO SUPPORT CARE FOR THE POOR PROGRAMS THAT ARE SELECTED LOCALLY BY EACH HOSPITAL. 17.5% IS USED TO SUPPORT COMMUNITY PARTNERSHIP FUND INITIATIVES, SUCH AS THE WELLNESS AND PREVENTION INITIATIVE, AND THE COMMUNITY BUILDING INITIATIVE. THE REMAINING 7.5% IS DESIGNATED TOWARD THE ENDOWMENT, WHICH HELPS ENSURE THE FUND'S ABILITY TO SUSTAIN PROGRAMS INTO THE FUTURE THAT ASSIST LOW-INCOME AND UNDERSERVED POPULATIONS. ST. JOSEPH HEALTH FURTHER RECOGNIZES THAT THE HEALTH OF ANY COMMUNITY DEPENDS ON THE MAINTENANCE AND CREATION OF STRONG STRUCTURES-BOTH PHYSICAL AND SOCIAL-THAT CONTRIBUTE TO THE LONG-TERM WELL-BEING OF PEOPLE. THAT PHILOSOPHY INSPIRED THE INITIATION OF THE COMMUNITY INVESTMENT FUND-AN EFFORT TO ENABLE NON-PROFIT 501 (C)(3) ORGANIZATIONS TO ACHIEVE THEIR FULL POTENTIAL AND PLAY A MAJOR ROLE IN THE GROWTH OF THEIR COMMUNITIES. THE COMMUNITY INVESTMENT FUND PROVIDES CAPITAL IN THE FORM OF LOANS, DEPOSITS OR OTHER SUPPORT TO NON-PROFITS TO PROMOTE SOCIAL GOOD AND THE DEVELOPMENT OF HEALTHIER COMMUNITIES. IN FY15, A TOTAL OF $9.4 MILLION WAS INVESTED INTO THE COMMUNITY THROUGH LOANS AND LINES OF CREDIT. FUNDED NON-PROFITS INCLUDE THOSE THAT SERVE THE HOMELESS, PROVIDE AFFORDABLE HOUSING, PROVIDE ACCESS TO PRIMARY MEDICAL CARE, AND ADDRESS YOUTH DEVELOPMENT. LEARN MORE ABOUT SJH COMMUNITY BENEFIT AT STJHS.ORG. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| COMMUNITY FOUNDATION 10000 DEGREES | ||||||||
| 250 D STREET STE 2015 | SANTA ROSA | CA | 95404 | 680003212 | 501(c)(3) | $7,500 | $0 | PROGRAM SUPPORT |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||||||||
| 3345 MICHELSON DR STE 100 | IRVINE | CA | 92612 | 330143024 | 501(c)(3) | $463,600 | $0 | care for the poor |
| PETALUMA PEOPLE SERVICES | ||||||||
| 1500 A PETALUMA BLVD S | PETALUMA | CA | 94952 | 942271299 | 501(c)(3) | $12,000 | $0 | program support |
| PETALUMA HEALTHY COMMUNITIES CONSORTIUM | ||||||||
| 200 DOUGLAS STREET | PETALUMA | CA | 94952 | 680475211 | 501(c)(3) | $15,000 | $0 | program support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF ORG'S PROCEDURES FOR MONITORING THE USE OF GRANTS DONATIoNS TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION OF SRM ALLIANCE HOSPITAL SERVICES. WE DO NOT MONITOR DONATIONS MADE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBYNN VANPATTEN | ||||||||||||||
| BOARD SECRETARY (PART YEAR) | $0 | $353,239 | $0 | $149,485 | $0 | $5,222 | $0 | $10,400 | $0 | $33,031 | $0 | $551,377 | $0 | $0 |
| TODD SALNAS | ||||||||||||||
| BOARD MEMBER, PRESIDENT | $0 | $360,947 | $0 | $168,643 | $0 | $4,846 | $0 | $10,400 | $0 | $33,031 | $0 | $577,867 | $0 | $0 |
| MICHEL RICCIONI | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $356,046 | $0 | $143,298 | $0 | $8,425 | $0 | $17,993 | $0 | $28,673 | $0 | $554,435 | $0 | $0 |
| KEVIN KLOCKENGA | ||||||||||||||
| REGIONAL EVP | $0 | $546,506 | $0 | $269,479 | $0 | $63,238 | $0 | $13,000 | $0 | $27,946 | $0 | $920,169 | $0 | $0 |
| DAVID ZIOLKOWSKI | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $246,329 | $0 | $89,020 | $0 | $3,335 | $0 | $7,310 | $0 | $28,458 | $0 | $374,452 | $0 | $0 |
| RICHARD CARVOLTH | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $349,551 | $0 | $95,554 | $0 | $8,923 | $0 | $0 | $0 | $20,031 | $0 | $474,059 | $0 | $0 |
| JANE READ | ||||||||||||||
| VP - OPERATIONS | $210,226 | $0 | $76,673 | $0 | $4,514 | $0 | $8,573 | $0 | $13,589 | $0 | $313,575 | $0 | $0 | $0 |
| JAYNIE BOREN | ||||||||||||||
| N. CAL REG VP - STRATEGIC SVCS | $0 | $274,761 | $0 | $107,021 | $0 | $6,210 | $0 | $10,400 | $0 | $22,506 | $0 | $420,898 | $0 | $0 |
| RICHARD INGRAM | ||||||||||||||
| BOARD MEMBER | $0 | $337,921 | $0 | $164,428 | $0 | $116,909 | $0 | $22,761 | $0 | $24,171 | $0 | $666,190 | $0 | $0 |
| JAMES WATSON | ||||||||||||||
| BOARD SECRETARY | $0 | $420,674 | $0 | $208,179 | $0 | $69,712 | $0 | $20,800 | $0 | $34,191 | $0 | $753,556 | $0 | $0 |
| GARY TOAVS | ||||||||||||||
| CHIEF ENGINEER | $191,822 | $0 | $0 | $0 | $125 | $0 | $13,428 | $0 | $899 | $0 | $206,274 | $0 | $0 | $0 |
| GARY MAHAN | ||||||||||||||
| MANAGER CLINICAL & COMPLIANCE | $176,387 | $0 | $6,459 | $0 | $5,186 | $0 | $16,448 | $0 | $18,319 | $0 | $222,799 | $0 | $0 | $0 |
| PAULA GRIFFITH | ||||||||||||||
| STAFF NURSE IV - CNA | $162,503 | $0 | $0 | $0 | $2,791 | $0 | $16,891 | $0 | $26,503 | $0 | $208,688 | $0 | $0 | $0 |
| HAI GAO | ||||||||||||||
| STAFF NURSE II - CNA | $161,881 | $0 | $0 | $0 | $187 | $0 | $8,218 | $0 | $30,323 | $0 | $200,609 | $0 | $0 | $0 |
| CHRIS FALLEY | ||||||||||||||
| DIRECTOR HOSPICE SERVICES | $142,893 | $0 | $8,047 | $0 | $21,427 | $0 | $2,833 | $0 | $29,422 | $0 | $204,622 | $0 | $0 | $0 |
| NANCY PRATT | ||||||||||||||
| BOARD MEMBER (PART YEAR) | $0 | $189,219 | $0 | $153,793 | $0 | $4,257 | $0 | $7,635 | $0 | $7,752 | $0 | $362,656 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | SUPPLEMENTAL COMPENSATION INFORMATION COMPANION TRAVEL ST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL TO CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING INDIVIDUAL RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION: JAMES WATSON: 5,075 DISCRETIONARY SPENDING ACCOUNT EXECUTIVES RECEIVE A PERCENTAGE OF BASE COMPENSATION FOR DISCRETIONARY SPENDING. THESE AMOUNTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION. |
| SCHEDULE J, PART I, LINE 3 | THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY ST. JOSEPH HEALTH SYSTEM. |
| SCHEDULE J, PART I, LINE 4B | EXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE DECEMBER 31, 2007 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF the PLAN. |
| SCHEDULE J, PART I, LINE 7 | A PORTION OF EXECUTIVES SALARIES ARE PLACED 'AT-RISK' AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATIONS MISSION STATEMENT SRM ALLIANCE HOSPITAL IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. |
| FORM 990, PART III, LINE 4A | REALIZING OUR MISSION SANTA ROSA MEMORIAL HOSPITAL (SRMH) AND PETALUMA VALLEY HOSPITAL (PVH) HAVE BEEN COLLABORATING TO MEET THE HEALTH AND QUALITY OF LIFE NEEDS OF THE PEOPLE IN THE LOCAL COMMUNITY FOR OVER 60 AND 18 YEARS, RESPECTIVELY. SERVING THE COMMUNITIES OF SONOMA COUNTY, PVH IS AN 80-BED ACUTE CARE HOSPITAL AND SRMH IS A FULL SERVICE 278-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER AREA. MAJOR PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, CRITICAL CARE, DIAGNOSTIC IMAGING, AND A WIDE RANGE OF SPECIALTY SERVICES, EMERGENCY MEDICINE AND OBSTETRICS. SRM AND PVH TOGETHER EMPLOY APPROXIMATELY 4,000 EMPLOYEES COMMITTED TO REALIZING THE MISSION, SRMH AND PVH TOGETHER COMPRISE ONE OF THE LARGEST EMPLOYERS IN SONOMA COUNTY. AS MEMBERS OF ST. JOSEPH HEALTH, SRMH AND PVH ARE COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORS" AND MINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. PATIENT FINANCIAL ASSISTANCE PROGRAM SRMH AND PVH BELIEVE THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY SRMH AND PVH HAVE A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY15, PVH PROVIDED $0.5M IN FREE AND DISCOUNTED CARE. MEDICAID PROGRAM SRMH AND PVH PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM. IN FY15, PVH PROVIDED $9.3M IN MEDICAID SHORTFALL. PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY BENEFIT INVESTMENT IS DEMONSTRATED THROUGH THE FOLLOWING KEY PROGRAMS: o PVH'S HEALTHY FOR LIFE IS A SCHOOL-BASED PHYSICAL ACTIVITY AND NUTRITION PROGRAM THAT WORKS TO TEACH BEHAVIORS AT AN EARLY AGE AND ENSURE GOOD HEALTH FOR YEARS TO COME. IN FY15 IN THE PVH SERVICE AREA, 4 PARTNER SCHOOLS (INCLUDING 3 IN THE OLD ADOBE UNION SCHOOL DISTRICT), 8 CHAMPION TEACHERS, AND OVER 557 STUDENTS AND PARENTS PARTICIPATED IN FITNESS AND NUTRITION COURSES ACROSS 4,198 ENCOUNTERS. WE HAVE BEEN WORKING WITH THE SONOMA UPSTREAM INVESTMENTS INITIATIVE TO RECERTIFY THE HEALTHY FOR LIFE PROGRAM TO ENSURE SUSTAINABILITY IN THE PROGRAM AND RECOGNIZE IT AS A BEST PRACTICE. o PVH'S MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN FY15 IN THE PVH SERVICE AREA, THE CLINIC SAW 97 PATIENTS OVER 194 ENCOUNTERS. THE CLINIC SUCCESSFULLY TRANSITIONED PATIENTS AT THE HOMELESS-SERVING COMMITTEE ON THE SHELTERLESS (COTS) MARY ISAAC CENTER TO THE PETALUMA HEALTH CENTER AT THE START OF THE FISCAL YEAR. o PVH'S HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE HOUSE CALLS TEAM, WHICH INCLUDES NURSE PRACTITIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED 236 PATIENT ENCOUNTERS DURING FY15 IN THE PVH SERVICE AREA, WHICH HELP TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE FOR 6 INDIVIDUALS IN THE PETALUMA AREA. FOR MORE INFORMATION ABOUT SRMH AND PVH, PLEASE VISIT HTTP://WWW.STJOESONOMA.ORG/. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG. |
| FORM 990, PART VI, LINE 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS SANTA ROSA MEMORIAL HOSPITAL IS THE SOLE CORPORATE MEMBER OF SRM ALLIANCE HOSPITAL SERVICES. |
| FORM 990, PART VI, LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS SRM ALLIANCE HOSPITAL SERVICES HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE SRM ALLIANCE HOSPITAL SERVICES BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE SRM ALLIANCE HOSPITAL SERVICES BOARD AS NOMINATIONS MUST BE APPROVED BY SANTA ROSA MEMORIAL HOSPITAL. |
| FORM 990, PART VI, LINE 7B | DESCR OF CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIER GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY SANTA ROSA MEMORIAL HOSPITAL, ITS SOLE CORPORATE MEMBER, FOR THE FOLLOWING: A. ESTABLISHING THE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE ORGANIZATION; B. LONG-TERM AND SHORT-TERM FINANCING; C. SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; D. ANNUAL BUDGETS; E. CAPITAL EXPENDITURES; F. ORGANIZATION'S STRATEGIC PLANS; G. MERGER OR DISSOLUTION; H. APPOINTMENT OR REMOVAL OF FISCAL AUDITORS; I. APPOINTMENT OR REMOVAL OF TRUSTEES, OFFICERS OF THE BOARD AND CHIEF EXECUTIVE OFFICER; J. AMENDMENT OR RESCISSION OF THE BYLAWS; K. EXERCISE THE POWERS WHICH ARE RESERVED TO THE ORGANIZATION IN ITS CAPACITY AS A CORPORATE MEMBER OF ANY SUBSIDIARY; AND L. EXERCISE SUCH OTHER POWERS AS MAY BE REQUIRED OR PERMITTED BY LAW AND BY THE ARTICLES OF INCORPORATION AND THE BYLAWS. |
| FORM 990, PART VI, LINE 11B | DESCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AND WAS REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD AT THE MARCH 2016 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING. |
| FORM 990, PART VI, LINE 12C | MONITORING & ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE. |
| FORM 990, PART VI, LINES 15A & 15B | PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. EXECUTIVE COMPENSATION IS APPROVED BY THE SRM ALLIANCE HOSPITAL SERVICES EXECUTIVE MANAGEMENT COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEATLH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF FOR PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2015. DURING THE YEAR, THE SRM ALLIANCE HOSPITAL SERVICES EXECUTIVE MANAGEMENT COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTNG FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING. |
| FORM 990, PART VI, LINE 19 | PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS EQUITY TRANSFERS (3,696,589) OTHER (164,035) ----------- total (3,860,624) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN FEES TOTAL FEES:4328200 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SERVICES TOTAL FEES:2190755 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:2254763 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (32 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT HEALTH NETWORK INC | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 11,III | SJHS | Yes (true) |
| COVENANT ACO | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 11,I | CHS | Yes (true) |
| COVENANT HEALTH SYSTEM | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (true) |
| COVENANT HEALTH SYSTEM FOUNDATION | ||||||||||
| 3623 22ND PLACE | LUBBOCK | TX | 79410 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| COVENANT MEDICAL GROUP | ||||||||||
| 3420 22ND PLACE | LUBBOCK | TX | 79410 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| COVENANT HEALTH PARTNERS | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 11, I | CHS | Yes (true) |
| HOAG CHARITY SPORTS | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 452982422 | SUPPORT | CA | 501(C)(3) | 7 | HHF | Yes (true) |
| HOAG HOSPITAL FOUNDATION | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 953222343 | FUNDRAISING | CA | 501(C)(3) | 7 | HMHP | Yes (true) |
| HOAG MEMORIAL HOSPITAL PRESBYTERIAN | ||||||||||
| 1 HOAG ROAD BOX 6100 | NEWPORT BEACH | CA | 92663 | 951643327 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| HOME CARE PARTNERS | ||||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 680318656 | INACTIVE | CA | 501(C)(3) | 3 | SRMH | Yes (true) |
| HOSPICE OF LUBBOCK | ||||||||||
| 3702 21ST STREET | LUBBOCK | TX | 79410 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 9 | CHS | Yes (true) |
| LUBBOCK METHODIST HOSPITAL FOUNDATION | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752220963 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| METHODIST CHILDREN'S HOSPITAL | ||||||||||
| 3610 21ST STREET | LUBBOCK | TX | 79410 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL LEVELLAND | ||||||||||
| 1900 COLLEGE AVENUE | LEVELLAND | TX | 79336 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL PLAINVIEW | ||||||||||
| 2601 DIMMITT ROAD | PLAINVIEW | TX | 79072 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | ||||||||||
| 27700 MEDICAL CENTER ROAD | MISSION VIEJO | CA | 92691 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| QUEEN OF THE VALLEY MEDICAL CENTER | ||||||||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | 941243669 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| REDWOOD MEMORIAL FOUNDATION | ||||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | RMH | Yes (true) |
| REDWOOD MEMORIAL HOSPITAL | ||||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 941384665 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SANTA ROSA MEMORIAL HOSPITAL | ||||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 941231005 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SISTERS OF ST JOSEPH OF ORANGE | ||||||||||
| 480 S BATAVIA | ORANGE | CA | 92868 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | NA | false |
| ST JOSEPH HEALTH MINISTRY | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO | false |
| ST JOSEPH HEALTH SYSTEM | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 11, I | SJHM | false |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 7 | SJHS | Yes (true) |
| ST JOSEPH HOME CARE NETWORK | ||||||||||
| 1111 SONOMA STE 308 | SANTA ROSA | CA | 95405 | 680331084 | HEALTHCARE | CA | 501(C)(3) | 9 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF EUREKA | ||||||||||
| 2700 DOLBEER STREET | EUREKA | CA | 95501 | 941156596 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF ORANGE | ||||||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST JUDE HOSPITAL YORBA LINDA | ||||||||||
| 200 WEST CENTER ST PROMENADE | ANAHEIM | CA | 92805 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JUDE HOSPITAL INC | ||||||||||
| 101 EAST VALENCIA MESA DRIVE | FULLERTON | CA | 92635 | 951643324 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY MEDICAL CENTER | ||||||||||
| 18300 HIGHWAY 18 | APPLE VALLEY | CA | 92307 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY OF THE PLAINS HOSPITAL FDN | ||||||||||
| 4000 24TH STREET | LUBBOCK | TX | 79410 | 751653181 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| TALLER SAN JOSE | ||||||||||
| 801 NORTH BROADWAY | SANTA ANA | CA | 92701 | 593816355 | WORK DEVELOPM | CA | 501(C)(3) | 2 | SSJO | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (17 entries)
| EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd |
|---|---|---|---|---|---|---|---|---|
| COVENANT LONG-TERM CARE LP | ||||||||
| 330307672 | HEALTHCARE | TX | NA | N/A | ||||
| HEALTHCARE DESIGN & CONSTRUCT | ||||||||
| 752177401 | REAL ESTATE | DE | NA | N/A | ||||
| HEALTHCARE PROPERTY ADVISORS | ||||||||
| 205033419 | REAL ESTATE | DE | NA | N/A | SEE PART VII | LUBBOCK | TX | 79410 |
| HERITAGE INVESTMENT GROUP | ||||||||
| 271000061 | INVESTMENTS | CA | NA | N/A | ||||
| HOAG ORTHOPEDIC INSTITUTE | ||||||||
| 330355575 | HEALTHCARE | CA | NA | N/A | ||||
| LUBBOCK SURGERY CENTER LTD | ||||||||
| 264591502 | HEALTHCARE | TX | NA | N/A | SEE PART VII | ORANGE | CA | 92868 |
| METHODIST DIAGNOSTIC IMAGING | ||||||||
| HEALTHCARE | TX | NA | N/A | |||||
| MISSION AMBULATORY SURGICENTER | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| NEWPORT IMAGING CENTER | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| SHA LLC | ||||||||
| INSURANCE | TX | NA | N/A | |||||
| ST JOSEPH PHYSICIAN VENTURES | ||||||||
| REAL ESTATE | CA | NA | N/A | |||||
| ST JOSEPH HLTH SYS HOME CARE | ||||||||
| HOME HEALTH | CA | NA | N/A | |||||
| ST JOSEPH HLTH SYS HOME HLTH | ||||||||
| HOME HEALTH | CA | NA | N/A | |||||
| THE INNOVATION INSTITUTE | ||||||||
| HEALTHCARE | DE | NA | N/A | |||||
| TOTAL HEALTH ENVIRONMENT | ||||||||
| HEALTHCARE | DE | NA | N/A | |||||
| ADVANCED SURGERY INSTITUTE LLC | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| NORTH BAY ENDOSCOPY CENTER | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOSEPH PROF SVCS ENTERPRISES INC | |||||||||||||
| 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 330155323 | HEALTHCARE | CA | NA | C-CORP | |||||
| AMERICAN UNITY GROUP LTD | |||||||||||||
| CAPTIVE INSURANCE | NA | C-CORP | 90 PITTS BAY ROAD | PEMBROKE | BD | HM08 | BD | ||||||
| ALLIANCE PHYSICIAN SERVICES | |||||||||||||
| INACTIVE | CA | NA | C-CORP | ||||||||||
| MISSION VIEJO MEDICAL VENTURES | |||||||||||||
| 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | HEALTHCARE | CA | NA | C-CORP | |||||
| ST JOSEPH YORBA PARK | |||||||||||||
| INACTIVE | CA | NA | C-CORP | ||||||||||
| LUBBOCK METHODIST HOSPITAL SVCS | |||||||||||||
| PO BOX 1201 | LUBBOCK | TX | 79410 | 752118585 | HEALTHCARE | TX | NA | C-CORP | |||||
| LUBBOCK METHODIST HOSP PRACTICE MGMT | |||||||||||||
| 2107 OXFORD STREET STE 300 | LUBBOCK | TX | 79410 | 752578995 | INACTIVE | TX | NA | C-CORP | |||||
| HOAG MANAGEMENT SERVICES INC | |||||||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330731587 | HEALTHCARE | CA | NA | C-CORP | |||||
| COASTAL MANAGEMENT SERVICES ORGANIZATION | |||||||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330676831 | HEALTHCARE | CA | NA | C-CORP | |||||
| HMTS INC | |||||||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 453583707 | HEALTHCARE | CA | NA | C-CORP | |||||
| ST JOSEPH HEALTH SOURCE INC | |||||||||||||
| 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 461900168 | HEALTHCARE | CA | NA | C-CORP | |||||
| DATU HEALTH INC | |||||||||||||
| 16150 MAIN CIRCLE DR SUITE 250 | CHESTERFIELD | MO | 63017 | 463070062 | IT SVCS | MO | NA | C-CORP | |||||
| ST JOSEPH HEALTH | |||||||||||||
| 3345 MICHELSON DR SUITE 100 | IRVINE | CA | 92612 | 462340232 | HOLDING COMPA | CA | NA | C-CORP | |||||
| HPA REALTY INC | |||||||||||||
| 1 CENTERPOINTE DRIVE SUITE 200 | LA PALMA | CA | 906231052 | REAL ESTATE | CA | NA | C Corp | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||
| b | $463,600 | ACCRUAL |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||
| c | $190,000 | ACCRUAL |
| SANTA ROSA MEMORIAL HOSPITAL | ||
| p | $12,390,000 | CASH |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART III | FormAndLineReferenceDesc |
| Explanation | IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HEALTHCARE DESIGN AND CONSTRUCTION EIN: 46-2611662 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 HEALTHCARE PROPERTY ADVISORS, LLC EIN: 46-5497794 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE 362, MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 100, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 200 ORANGE, CA 92868-2012 THE INNOVATION INSTITUTE EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 TOTAL HEALTH ENVIRONMENT EIN: 46-4807513 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 ADVANCED SURGERY INSTITUTE LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954 | ExplanationTxt |
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