SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL (EIN 94-1502014)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-15
- IRS object ID
- 201622289349306162
- 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 H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-15T16:00:41-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941502014 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN MONTEREY COUNTY MEMORIAL HOSP | BusinessNameLine1Txt |
| Business Name Line2 | DBA GEORGE L MEE MEMORIAL HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 8313856000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN M CHILDERS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8313856000 | PhoneNum |
| Signature | 2016-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RENIE BURBANK | PreparerPersonNm |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN M CHILDERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $67,036,410 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MEEMEMORIAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1964 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 579 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $219,008 | PYContributionsGrantsAmt |
| CY Contributions Grants | $269,549 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $61,990,404 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $65,319,619 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,881 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,752 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,613,957 | PYOtherRevenueAmt |
| CY Other Revenue | $1,403,304 | CYOtherRevenueAmt |
| PY Total Revenue | $64,832,250 | PYTotalRevenueAmt |
| CY Total Revenue | $67,008,224 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $84,450 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $36,661,266 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,275,641 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,322,514 | PYOtherExpensesAmt |
| CY Other Expenses | $27,792,318 | CYOtherExpensesAmt |
| PY Total Expenses | $68,068,230 | PYTotalExpensesAmt |
| CY Total Expenses | $64,067,959 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,235,980 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,940,265 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,354,947 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,099,910 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $39,508,949 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $37,313,633 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,154,002 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $786,277 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $55,627,964 | ExpenseAmt |
| Desc | THE HOSPITAL, IS A 119-BED LICENSED FACILITY THAT PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. TYPES OF CARE OFFERED ARE ACUTE, LONG-TERM, AND RURAL HEALTH CLINIC SERVICES. OVER THE FISCAL YEAR, TOTAL PATIENT DAYS WERE 22,036. THE EMERGENCY SERVICE HAD OVER 13,000 VISITS AND OTHER SERVICES HAD OVER 30,000 OTHER OUTPATIENT VISITS DURING THE FISCAL YEAR. | Desc |
| Total Program Service Expenses | $55,627,964 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 224 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 579 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | 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 | STEPHEN OMTA | PersonNm |
| Phone | 8313857162 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BUTTGEREIT JANET | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SCHINDELHEIM MD ROY | ||||||||
| VICE-CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $251,992 | $0 | $43,494 | ||
| BORZINI ROGER | ||||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BUMBALOUGH PAULETTE | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| EDDINGTON ROBERT | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| NASH SARAH | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| UKATU MD CHIDI | ||||||||
| CHIEF OF STAFF | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SMITH LEX THRU 2014 | ||||||||
| CHIEF EXECUTIVE OFFICER | 50.00 | Yes (X) | Yes (X) | $306,426 | $0 | $35,319 | ||
| CHILDERS SUSAN | ||||||||
| CHIEF EXECUTIVE OFFICER | 50.00 | Yes (X) | Yes (X) | $226,886 | $0 | $34,633 | ||
| HRITZ KEN | ||||||||
| CHIEF OPERATING OFFICER | 50.00 | $189,796 | $0 | $31,494 | Yes (X) | |||
| WONG KAREN | ||||||||
| CHF HUMAN RESOURSE OFF'R | 50.00 | $165,637 | $0 | $14,358 | Yes (X) | |||
| SALAMACHA RENA | ||||||||
| CHIEF INFORMATION OFFICER | 50.00 | $157,696 | $0 | $42,997 | Yes (X) | |||
| SILVA NANCY | ||||||||
| STAFF NURSE II OB | 40.00 | $151,586 | $0 | $928 | Yes (X) | |||
| GRASSO LAURIE | ||||||||
| STAFF NURSE II ER | 40.00 | $150,117 | $0 | $1,435 | Yes (X) | |||
| FARRELL IAN | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | $149,593 | $0 | $16,126 | Yes (X) | |||
| MCKINNEY SHERRIE | ||||||||
| CHIEF NURSING OFFICER | 40.00 | $147,857 | $0 | $1,542 | Yes (X) | |||
| ROBEY LAURA | ||||||||
| NURSE PRACTITIONER | 40.00 | $141,842 | $0 | $31,494 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,039,428 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $253,820 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 74 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| XTEND HEALTHCARE | |||||
| PO BOX 1709 | HENDERSONVILLE | TN | 37077 | PATIENT AR BILLING & COLLECTIONS AGENCY | $1,547,157 |
| MONTEREY ANESTHESIA PROFESSIONALS | |||||
| 1522 CONSTITUTION BLVD 123 | SALINAS | CA | 93905 | MEDICAL SERVICES | $1,350,529 |
| CHIDI UKATU MD INC | |||||
| 10521 RUTHELEN STREET | LOS ANGELES | CA | 90047 | MEDICAL SERVICES | $815,165 |
| LETITIA BRADFORD MD | |||||
| 7485 RUSH RIVER SUITE 710-323 | SACRAMENTO | CA | 95831 | MEDICAL SERVICES | $546,805 |
| JOHN FEJES MD | |||||
| 25685 MORSE DR | CARMEL | CA | 93923 | MEDICAL SERVICES | $418,604 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 39 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $161,356 | RelatedOrganizationsAmt |
| Government Grants | $71,062 | GovernmentGrantsAmt |
| All Other Contributions | $37,131 | AllOtherContributionsAmt |
| Total Contributions | $269,549 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REV. | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $65,319,619 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,319,619 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $65,319,619 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,752 | TotalRevenueColumnAmt |
| Exclusion | $15,752 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $49,834 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,186 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,648 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,648 | TotalRevenueColumnAmt |
| Exclusion | $21,648 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER OPERATING INCOME | 900099 | $1,322,016 | $1,322,016 |
| REBATES/REFUNDS | 900099 | $59,640 | $59,640 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,381,656 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $67,008,224 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,319,619 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,419,056 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,269,622 | TotalAmt |
| Program Services | $41,319 | ProgramServicesAmt |
| Management And General | $1,228,303 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,135,580 | TotalAmt |
| Program Services | $21,309,041 | ProgramServicesAmt |
| Management And General | $826,539 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,549 | TotalAmt |
| Program Services | $241,323 | ProgramServicesAmt |
| Management And General | $23,226 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,120,693 | TotalAmt |
| Program Services | $9,232,155 | ProgramServicesAmt |
| Management And General | $888,538 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,485,197 | TotalAmt |
| Program Services | $2,267,011 | ProgramServicesAmt |
| Management And General | $218,186 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,891 | TotalAmt |
| Management And General | $50,891 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,812 | TotalAmt |
| Management And General | $157,812 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,237 | TotalAmt |
| Management And General | $92,237 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,280 | TotalAmt |
| Management And General | $3,280 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,791,602 | TotalAmt |
| Program Services | $11,963,608 | ProgramServicesAmt |
| Management And General | $1,827,994 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,349 | TotalAmt |
| Management And General | $25,349 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,577 | TotalAmt |
| Program Services | $72,918 | ProgramServicesAmt |
| Management And General | $11,659 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,554 | TotalAmt |
| Management And General | $604,554 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,080,891 | TotalAmt |
| Program Services | $1,036,644 | ProgramServicesAmt |
| Management And General | $44,247 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,277 | TotalAmt |
| Program Services | $103,220 | ProgramServicesAmt |
| Management And General | $6,057 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,854 | TotalAmt |
| Program Services | $133,797 | ProgramServicesAmt |
| Management And General | $6,057 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,345,736 | TotalAmt |
| Management And General | $1,345,736 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,086,868 | TotalAmt |
| Program Services | $2,086,868 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $515,511 | TotalAmt |
| Program Services | $515,511 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,873,411 | $3,869,966 | $3,445 |
| OTHER EXPENSES | $3,830,468 | $2,754,583 | $1,075,885 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,067,959 | TotalAmt |
| Program Services | $55,627,964 | ProgramServicesAmt |
| Management And General | $8,439,995 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,927 | BOYAmt |
| EOY | $1,978,354 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,696,863 | BOYAmt |
| EOY | $9,248,004 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $938,779 | BOYAmt |
| EOY | $832,275 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,409 | BOYAmt |
| EOY | $373,963 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,246,299 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,303,530 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,725,298 | BOYAmt |
| EOY | $22,942,769 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,669 | BOYAmt |
| EOY | $22,683 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,335,002 | BOYAmt |
| EOY | $2,701,862 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,354,947 | BOYAmt |
| EOY | $38,099,910 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,688,291 | BOYAmt |
| EOY | $8,014,246 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $389,297 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,523,500 | BOYAmt |
| EOY | $9,152,661 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,095,899 | BOYAmt |
| EOY | $14,863,390 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $751,616 | BOYAmt |
| EOY | $694,765 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,060,346 | BOYAmt |
| EOY | $4,588,571 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,508,949 | BOYAmt |
| EOY | $37,313,633 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,154,002 | BOYAmt |
| EOY | $786,277 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,154,002 | BOYAmt |
| EOY | $786,277 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,354,947 | BOYAmt |
| EOY | $38,099,910 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,940,265 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $14 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,280 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,280 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | CA HOSPITAL ASSOC ADVOCACY PARTICIPATION. LOBBYING EXPENDITURE OF $3,280 WAS BASED ON 2015 DUES. TOTAL AMOUNT OF DUES WAS $23,246 OF WHICH 14.11% IS IDENTIFIED FOR DIRECT LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $512,182 | OtherCostOrOtherBasisAmt |
| Book Value | $512,182 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,288,382 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,491,382 | DepreciationAmt |
| Book Value | $14,797,000 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,943,878 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,172,955 | DepreciationAmt |
| Book Value | $2,770,923 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,501,857 | OtherCostOrOtherBasisAmt |
| Depreciation | $639,193 | DepreciationAmt |
| Book Value | $4,862,664 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,942,769 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $1,643,918 |
| ASSETS LIMITED AS TO USE | $365 |
| OTHER ASSETS | $30,955 |
| THIRD PARTY SETTLEMENTS | $922,494 |
| DEPOSITS | $104,130 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,701,862 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED INTEREST PAYABLE | $367,572 |
| SELF INSURED HEALTH CARE CLAIMS | $452,368 |
| LITIGATION RESERVE | $1,014,354 |
| ASSEMBLY BILL 97 CLAWBACK LIAB | $2,185,539 |
| PROFESSIONAL FEES | $57,700 |
| INCURRED CLAIMS PAYABLE | $243,200 |
| CAPITAL LEASES | $267,838 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,588,571 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $67,036,424 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $14 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $14 | RevenueNotReportedAmt |
| Revenue Subtotal | $67,036,410 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$28,186 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$28,186 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $67,008,224 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $64,096,145 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $28,186 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $28,186 | ExpensesNotReportedAmt |
| Expenses Subtotal | $64,067,959 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $64,067,959 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ACCOUNTING STANDARD CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE HOSPITAL RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE THAN LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2015 AND 2014, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE -28,186. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RECLASSIFICATION OF RENTAL EXPENSES TO STATEMENT OF REVENUE 28,186. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 100.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,228,135 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,228,135 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01920 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 13579 | PersonsServedCnt |
| Total Community Benefit Expns | $7,385,172 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,315,574 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $69,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,675,542 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,244,109 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,431,433 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10040 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 13579 | PersonsServedCnt |
| Total Community Benefit Expns | $34,288,849 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,559,683 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,729,166 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12070 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 9467 | PersonsServedCnt |
| Total Community Benefit Expns | $118,211 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $79,394 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,817 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 9467 | PersonsServedCnt |
| Total Community Benefit Expns | $118,211 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $79,394 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,817 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 28 | ActivitiesOrProgramsCnt |
| Persons Served | 23046 | PersonsServedCnt |
| Total Community Benefit Expns | $34,407,060 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,639,077 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,767,983 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12130 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $137,688 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $137,688 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $137,688 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $137,688 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,810,827 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,950,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,038,193 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,652,535 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$614,342 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | GEORGE L MEE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://MEEMEMORIAL.COM/ | WebsiteAddressTxt |
| State License | 070000047 | 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 | GEORGE L MEE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | Yes (1) | OrganizationIncurExciseTaxInd |
| Form4720 Filed | 0 | Form4720FiledInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 100.000000000000 | 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 |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MEEMEMORIAL.COM | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| 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 (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GEORGE L. MEE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: SURVEY QUESTIONNAIRES & DIRECT INTERVIEWS WITH CLERGY COUNCIL, CHAMBER OF COMMERCE, ROTARY CLUB, CITY COUNCIL AND COMMUNITY FOCUS GROUPS. |
| GEORGE L. MEE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: MMH IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AS FOLLOWS:- INVASIVE CARDIOLOGY - REFERRED TO OTHER HOSPITALS- GASTROENTEROLOGY - WORKING ON IMPLEMENTATION OF GI SERVICES- MENTAL HEALTH - WORKING WITH COUNTY BEHAVIORAL HEALTH SERVICES- KIDNEY, LIVER & HEART TRANSPLANTS - REFERRED TO OTHER HOSPITALS- CANCER/ONCOLOGY - REFERRED TO OTHER HOSPITALS |
| GEORGE L. MEE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 22D: MEANS USED TO DETERMINE THE AMOUNTS BILLED TO UNINSURED INDIVIDUALS FOR EMERGENCY CARE:FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING. |
| GEORGE L. MEE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 24: HOSPITAL PREPARED A BILLING WITH GROSS CHARGES AS ALL PATIENTS WOULD RECEIVE. ANY GROSS CHARGES WOULD THEN BE CREDITED TO CHARITY WHEN A PATIENT WAS DETERMINED TO BE ELIGIBLE. THAT PROCESS IS CONSISTENT WITH HFMA STATEMENT 15 |
| PART V, SECTION B, LINE 12A | MEE MEMORIAL HOSPITAL (MMH) CONDUCTED CHNA DURING 2012 WHICH IS REFLECTED IN ANNUAL REPORT, COMMUNITY BENEFIT REPORT, AND MARKET UPDATE/STRATEGY CONNECTIONS REPORT. THE DATA INCLUDES THE COMMUNITY SERVED, DEMOGRAPHICS, INTERVIEWS THE VARIOUS ORGANIZATION AND FOCUS GROUPS, ETC. MMH HAS FAILED TO ADOPT A CHNA REPORT THAT CONTAINS ALL OF THE ELEMENTS REQUIRED BY 1.501(R)-3. THEY HAVE ENGAGED A FIRM TO CORRECT THE FAILURE BY PREPARING AND ADOPTING A CHNA REPORT CONTAINING ALL OF THE REQUIRED ELEMENTS AND MAKING THE CORRECTED CHNA REPORT MADE WIDELY AVAILABLE TO THE PUBLIC (I.E., POSTED A WRITTEN REPORT OF THE CHNA AT THE FACILITY AND ON THEIR WEBSITE) WITHIN THE MEANING OF 1.501(R)-1(C)(4). MMH HAS FAILED TO ADOPT AND IMPLEMENT A CHNA WAS NEITHER WILLFUL NOR EGREGIOUS AND HAVE TAKEN MEASURES TO MEET THE REQUIREMENTS BEFORE THE END OF THEIR FISCAL YEAR 2016. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| GEORGE L. MEE MEMORIAL HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | WWW.MEEMEMORIAL.COM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| KING CITY CLINIC | ||||
| 210 CANAL STREET | KING CITY | CA | 93930 | OUTPATIENT CLINIC |
| SPECIALTY CLINIC | ||||
| 400 CANAL STREET SUITE B | KING CITY | CA | 93930 | OUTPATIENT CLINIC |
| FAMILY MEDICAL CENTER | ||||
| 400 CANAL STREET SUITE A | KING CITY | CA | 93930 | OUTPATIENT CLINIC |
| THE WOMEN'S CENTER | ||||
| 400 CANAL STREET SUITE C | KING CITY | CA | 93930 | OUTPATIENT CLINIC |
| GREENFIELD CLINIC | ||||
| 467 S EL CAMINO REAL | GREENFIELD | CA | 93927 | OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COST TO CHARGE RATIO WAS USED TO CALCULATE THE COMMUNITY BENEFIT EXPENSE ON PART I, LINE 7B. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | ONLY HOSPITAL IN THE SOUTHERN PART OF THE COUNTY FOR A 50 MILE RADIUS SERVING A LARGE AGRICULTURAL AREA WITH MANY MEDICALLY INDIGENT AND UNDOCUMENTED RESIDENTS.THE HOSPITAL PROVIDES MANY SERVICES FOR THE COMMUNITY: ED, ICU, OR, OBSTETRICAL & DELIVERY, DIALYSIS, IMAGING, LAB, PHARMACY & PHYSICAL/REHAB. THE ONLY SNF TO DP/SNF IN THE AREA. PROVIDES TWO RURAL HEALTH CLINICS FOR THE PSA. MMH HAS AN OPEN MEDICAL STAFF. THE BOARD IS PRIMARILY COMPRISED ON COMMUNITY MEMBERS. MMH PROMOTES COMMUNITY HEALTH BY CONTRACTING WITH THE COUNTY OF MONTEREY TO PROVIDE CONGREGATE MEALS TO THE ELIGIBLE ADULTS IN THE SOUTH MONTEREY COUNTY UNDER THE MONTEREY COUNTY ELDERLY NUTRITION PROGRAM. |
| WORKFORCE DEVELOPMENT | COMMUNITY BUILDING ACTIVITY OF WORKFORCE DEVELOPMENT PROMOTED THE HEALTH OF THE COMMUNITY WITH PHYSICIAN RECRUITMENT. |
| PART III, LINE 4: | METHODOLOGY USED: BASED ON COST TO CHARGE RATIO.RATIONALE: THAT PORTION OF GROSS CHARGES THAT WOULD NORMALLY BE ADJUSTED FOR CONTRACTUAL ALLOWANCES IF THIS UNINSURED OR UNDER-INSURED GROUP COULD ACCESS CONTRACTUAL DISCOUNTS & THEN APPLYING A COST TO CHARGE RATIO TO ARRIVE AT THE HOSPITAL'S COST OF PROVIDING THAT CARE.NET PATIENT ACCOUNTS RECEIVABLE/BAD DEBTS EXPENSE FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: PATIENT ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES, AND PRIVATE PATIENTS. THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PAYMENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS DECREASED FROM 6.8 MILLION DOLLARS AT SEPTEMBER 30, 2014 TO 5.3 MILLION DOLLARS AT SEPTEMBER 30, 2015. THE HOSPITAL HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2015 OR 2014. |
| PART III, LINE 8: | SHORTFALL EXPLANATION: UNFUNDED COSTS FOR DIRECT PATIENT CARE.COSTING METHODOLOGY: CALCULATED COST TO CHARGE RATIO APPLIED UNIFORMILY TO ALL PAYERS. |
| PART III, LINE 9B: | COLLECTION PRACTICES FOR QUALIFIED PATIENTS:IT IS THE POLICY OF GEORGE L. MEE MEMORIAL HOSPITAL TO PROVIDE EXCELLENT CUSTOMER SERVICE TO ALL PATIENTS, AND ASSIST ALL UNINSURED PATIENTS WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, AND CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES. IF SUCH COVERAGE IS NOT AVAILABLE TO THE PATIENT, THE HOSPITAL WILL PROVIDE APPROPRIATE HEALTHCARE TO THE PATIENT, AND THE HOSPITAL WILL PROVIDE FINANCIAL ASSISTANCE BASED ON THE CURRENT FEDERAL POVERTY LEVEL, AND PER THE HOSPITAL'S POLICY, IN ACCORDANCE WITH CALIFORNIA STATE LAW, EMTALA, AND MEDICARE REGULATIONS. FURTHER, SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON INCOME WILL BE PROVIDED WITH SEVERAL OPTIONS FOR PAYMENT OF THEIR BILLS. IT IS THE HOSPITAL'S POLICY TO:- ASSIST ALL UNINSURED PATIENT WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT NO COST TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BELOW 100% OF THE CURRENT FEDERAL POVERTY LEVEL.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 50% DISCOUNT TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BETWEEN 101% AND 133% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 35% DISCOUNT TO ELIGIBLE PATIENTS BETWEEN 133% AND 200% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE INTEREST-FREE PAYMENT PLANS FOR ELIGIBLE PATIENTS UNDER THIS POLICY.- FORGO REPORTS TO CREDIT BUREAUS, REFERRAL OF ACCOUNTS TO COLLECTION AGENCIES, LIENS AGAINST PROPERTY OR WAGE GARNISHMENTS FOR ELIGIBLE PATIENTS WHO ARE MEETING AN AGREED-UPON PAYMENT PLAN.- PROVIDE ADEQUATE NOTICE OF THIS POLICY IN ALL ADMITTING AND RECEPTION AREAS.- OFFER FREE FINANCIAL COUNSELING TO ALL UNINSURED PATIENTS FOR FINANCIAL MATTERS RELATED TO THEIR HOSPITAL BILLS.- FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING. |
| PART VI, LINE 2: | NEEDS ASSESSMENT: MEE MEMORIAL WORKED WITH AN OUTSIDE CONSULTING FIRM, MOSS ADAMS, LLP (MOSS ADAMS) TO DEVELOP BOTH THE CHNA AND IMPLEMENTATION PLAN. MEE MEMORIAL WORKED WITH MOSS ADAMS TO COLLECT DEMOGRAPHIC AND MARKET AREA INFORMATION, INTERVIEW COMMUNITY MEMBERS AND PRIORITIZE KEY COMMUNITY HEALTH NEEDS. THE PROCESS BEGAN BY REVIEWING PRIOR MARKET ASSESSMENT REPORTS AND VARIOUS OTHER STUDIES/REPORTS PRODUCED BY OR FOR MEE MEMORIAL WITHIN THE PAST TWO YEARS. MOSS ADAMS THEN WORKED TO ANALYZE CURRENT DEMOGRAPHIC DATA FOR THE SERVICE AREA POPULATION, INCLUDING POPULATION SIZE AND GROWTH PROJECTIONS, AGE DISTRIBUTION, RACIAL AND ETHNIC DIVERSITY, SOCIOECONOMIC FACTORS AND HEALTH STATUS INDICATORS. IN CONJUNCTION WITH MOSS ADAMS, MEE MEMORIAL UTILIZED THESE KEY FINDINGS TO DEVELOP A PRIORITIZED LIST OF COMMUNITY HEALTH NEEDS AND CREATE THE CHNA AND RESPECTIVE IMPLEMENTATION PLAN. MOSS ADAMS UTILIZED THE FOLLOWING DATA SOURCES TO COMPLETE THE REPORT.MEE MEMORIAL MARKET DATAPREVIOUSLY CONDUCTED MEE MEMORIAL STRATEGIC PLANSCOMMUNITY MEMBER INTERVIEWS CONDUCTED BY MEE MEMORIAL HOSPITALTHE NIELSEN COMPANYBUREAU OF LABOR STATISTICSCENTERS FOR DISEASE CONTROL AND PREVENTIONU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESCOUNTY HEALTH RANKINGSOFFICE OF STATEWIDE HEALTH PLANNING (OSHPD)THE MEE MEMORIAL IMPLEMENTATION PLAN WAS DEVELOPED BASED ON IDENTIFIED NEEDS AND SHORT-TERM AND LONG-TERM STRATEGIC GOALS FOR MEE MEMORIAL. THE IMPLEMENTATION PLAN ALIGNS WITH AND EXPANDS UPON CURRENT ORGANIZATIONAL STRATEGIES AND PROGRAMS. THE IMPLEMENTATION PLAN WILL BE FILED WITH THE INTERNAL REVENUE SERVICE USING FORM 990 SCHEDULE H. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UPON PRESENTATION TO OUR ADMITTING PROCESS, ONCE THE PATIENT IDENTIFIES THEY ARE WITHOUT INSURANCE, WE INFORM/EDUCATE THEM ABOUT THEIR OPTIONS WITH GOVERNMENT PROGRAMS AND PROVIDE CONTACT INFORMATION TO ACCESS THOSE PROGRAMS. ADDITIONALLY, WE PROVIDE THE PATIENT WITH OUR POLICIES RELATED TO CHARITY AND A CHARITY APPLICATION SHOULD THEY WISH TO PURSUE THAT ASSISTANCE. |
| PART VI, LINE 4: | COMMUNITY INFORMATION: THE PRIMARY SERVICE AREA (PSA) IS SOUTHERN MONTEREY COUNTY AND THE SALINAS VALLEY COMPRISED OF THE FOLLOWING COMMUNITIES: KING CITY, GREENFIELD, SAN ARDO, LOCKWOOD, JOLON, SAN LUCAS & BRADLEY. THE SERVICE AREA IS SOUTH OF SALINAS, CA BY 45 MILES AND NORTH OF PASO ROBLES BY 45 MILES.THE POPULATION SIZE OF THE PSA IS ROUGHLY 40,000 WITH THE MEDIAN AGE OF 28.5 (32.5% OF 0-17 OF THE AGE GROUP, 41.6% FOR 18-44, 18.9% FOR 45-64 & 7.1% OF THE POPULATION OVER 65 YEARS OF AGE). MEDIAN HOUSEHOLD INCOME (2014) IS $51,773. RACIAL & ETHNIC DISTRIBUTION IS AS FOLLOWS: 81.2% HISPANIC OR LATINO, 14.9% WHITE & 3.9% FROM OTHER RACES. |
| PART VI, LINE 5: | PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL OWNS AND OPERATES THE FAMILY HEALTH CENTER. A GOAL OF THE CENTER IS TO PROVIDE HIGH-QUALITY, LOW-COST HEALTH CARE SERVICES TO PEOPLE WHO DO NOT OTHERWISE HAVE ACCESS WHICH MAY BE DUE TO FINANCIAL, CULTURAL, LIFESTYLE, OR PSYCHOLOGICAL BARRIERS. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCHINDELHEIM MD ROY | ||||||||||||||
| VICE-CHAIRMAN | $226,992 | $0 | $25,000 | $0 | $0 | $0 | $0 | $0 | $43,494 | $0 | $295,486 | $0 | $0 | $0 |
| SMITH LEX THRU 2014 | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $149,260 | $0 | $13,987 | $0 | $143,179 | $0 | $3,825 | $0 | $31,494 | $0 | $341,745 | $0 | $0 | $0 |
| CHILDERS SUSAN | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $215,963 | $0 | $10,923 | $0 | $0 | $0 | $3,139 | $0 | $31,494 | $0 | $261,519 | $0 | $0 | $0 |
| HRITZ KEN | ||||||||||||||
| CHIEF OPERATING OFFICER | $189,796 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $31,494 | $0 | $221,290 | $0 | $0 | $0 |
| WONG KAREN | ||||||||||||||
| CHF HUMAN RESOURSE OFF'R | $165,637 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,358 | $0 | $179,995 | $0 | $0 | $0 |
| SALAMACHA RENA | ||||||||||||||
| CHIEF INFORMATION OFFICER | $157,696 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $42,997 | $0 | $200,693 | $0 | $0 | $0 |
| SILVA NANCY | ||||||||||||||
| STAFF NURSE II OB | $151,586 | $0 | $0 | $0 | $0 | $0 | $928 | $0 | $0 | $0 | $152,514 | $0 | $0 | $0 |
| GRASSO LAURIE | ||||||||||||||
| STAFF NURSE II ER | $150,117 | $0 | $0 | $0 | $0 | $0 | $1,435 | $0 | $0 | $0 | $151,552 | $0 | $0 | $0 |
| FARRELL IAN | ||||||||||||||
| PHYSICIAN ASSISTANT | $149,593 | $0 | $0 | $0 | $0 | $0 | $1,768 | $0 | $14,358 | $0 | $165,719 | $0 | $0 | $0 |
| ROBEY LAURA | ||||||||||||||
| NURSE PRACTITIONER | $141,842 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $31,494 | $0 | $173,336 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4A | LEX SMITH RECEIVED A PAYMENT OF $143,179 AND THE AMOUNT WAS INCLUDED IN HIS FORM W-2. |
| PART I, LINE 7 | MEE MEMORIAL HOSPITAL'S BONUSES ARE BASED ON BOARD CRITERIA, REVIEW & APPROVAL OF THE FOLLOWING FACTORS: FINANCIAL PERFORMANCE ENHANCED PROGRAM & SERVICES PHYSICIAN RECRUITMENT & RETENTION PERFORMANCE IMPROVEMENT/QUALITY STANDARDS REGULATORY & ACCREDITATION COMPLIANCE |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHIDI UKATU MD INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CHIEF OF STAFF | RelationshipDescriptionTxt |
| Transaction | $620,602 | TransactionAmt |
| Transaction | MEDICAL SERVICES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | INTERNAL STAFF GATHERED, REVIEWED & COMPILED INFORMATION PROVIDED TO THE TAX PREPARER. TAX PREPARER GUIDED AND ADVISED CLIENT ON ANY ISSUE IN QUESTION. TAX PREPARER SUBMITS A COMPLETED FORM 990 FOR FINAL REVIEW AND APPROVAL. MMH PROVIDED AN ELECTRONIC COPY OF THE FINAL FORM 990 (INCLUDING ALL REQUIRED SCHEDULES) TO EACH VOTING MEMBER OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONTEREY COUNTY MEMORIAL HOSPITAL HAS A CORPORATE POLICY ON CONFLICT OF INTEREST. THIS POLICY APPLIES TO ALL INTERESTED PERSONS WHO ARE AS FOLLOWS: A. TRUSTEES B. MEMBER OF SENIOR MANAGEMENT THE BOARD OF TRUSTEES, THE CEO, AND CFO CONTINUOUSLY MONITOR AND EVALUATE ANY AND ALL TRANSACTIONS OF INTERESTED PARTIES WITH THE HOSPITAL. IF THE CURRENT OR PAST TRANSACTION POSE A POTENTIAL RISK OF BEING A CONFLICT OF INTEREST TO THE HOSPITAL, THESE ITEM(S) WILL BE BROUGHT TO THE ATTENTION OF THE CEO, BOARD CHAIRMAN, AND OR FULL BOARD OF TRUSTEES. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST TO THE BOARD, THE INTERESTED OFFICER OR BOARD MEMBER WOULD LEAVE THE BOARD MEETING WHILE THE CONFLICT OF INTEREST IS DISCUSSED AND/OR VOTED ON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROVIDED, HOWEVER, IF THE INTERESTED PERSON IS AN ADMINISTRATIVE STAFF EMPLOYEE AND THE CONTEMPLATED TRANSACTION IS AT THE ADMINISTRATIVE LEVEL, THE DECISION SHALL BE MADE BY THE HOSPITAL CEO. ANY OFFICER OR BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER MUST DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT. OFFICER OR BOARD MEMBERS SHOULD ALWAYS ABSTAIN FROM VOTING ON ANY ISSUES OF A POSSIBLE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS ESTABLISHED THROUGH COMPARISON TO REGIONAL SALARY SURVEY INFORMATION AND PERFORMANCE EVALUATIONS. THERE IS A PHYSICIAN COMPENSATION COMMITTEE TO SPECIFICALLY REVIEW ALL PHYSICIAN COMP. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII, SECTION A | ROY SCHINDELHEIM, MD, DEVOTES 2 HOUR PER WEEK FOR HIS SERVICES AS A VICE CHAIRMAN OF THE BOARD OF DIRECTORS. HE DOES NOT RECEIVE COMPENSATION OR BENEFITS AS A BOARD MEMBER. DR. SCHINDELHEIM PROVIDES SERVICES AS A PHYSICIAN TO THE HOSPITAL. HE DEVOTES 40 HOURS PER WEEK AND THE COMPENSATION AND BENEFITS ARE FOR HIS SERVICES AS A PHYSICIAN. |
| FORM 990, PART IX, LINE 11G | OTHER SERVICES: PROGRAM SERVICE EXPENSES 11,963,608. MANAGEMENT AND GENERAL EXPENSES 1,827,994. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,791,602. |
| FORM 990, PART XII, LINE 2C | AUDIT COMMITTEE AND OVERSIGHT: THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. |
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