2015-11-16T18:36:58-06:00 2014-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192367 990 2014-01-01 941044474 LODI MEMORIAL HOSPITAL ASSOCIATION INC LODI 2093343411 975 S FAIRMONT AVENUE LODI CA 95240 TERRY DEAK CFO & VICE PRESIDENT 2093343411 2015-11-12 1 TRACY S PAGLIA P00366884 2099556100 2014 2016-03-07 17:11:31Z LODI MEMORIAL HOSPITAL & LODI HEALTH DANIEL WOLCOTT 975 S FAIRMONT AVENUE LODI CA 95240 196766345 0 X WWW.LODIHEALTH.ORG X 1945 CA PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY 16 13 1536 191 53186 -334 479674 246454 203455454 175780911 1276688 1907152 158468 80506 205370284 178015023 259063 125917 0 0 94731082 96376902 0 0 121583 122576161 87296131 217566306 183798950 -12196022 -5783927 264618252 263936164 168836580 173860474 95781672 90075690 X AS A NOT-FOR-PROFIT, HEALTH-CARE DELIVERY SYSTEM, LODI MEMORIAL HOSPITAL IS DEDICATED TO:- IMPROVING COMMUNITY HEALTH;- PROVIDING QUALITY AND TIMELY HEALTH-CARE SERVICES, RANGING FROM HEALTH PROMOTION AND EDUCATION TO DIAGNOSTICS, ACUTE-INPATIENT CARE, REHABILITATION SERVICES AND HOME CARE;- EXPANDING COMMUNITY ACCESS TO CARE. 0 0 127240790 125917 169634198 LODI MEMORIAL HOSPITAL IS A NON-PROFIT, ACUTE CARE HOSPITAL PROVIDING HIGH QUALITY SERVICES THAT PROMOTE HEALTH AND REHABILITATION, PREVENT DISEASE, AND TREAT AND CARE FOR THE SICK AND INJURED. HOSPITAL STAFF, MEDICAL STAFF AND THE GOVERNING BOARD ARE DEDICATED TO TREATING ALL PATIENTS AND VISITORS AS INDIVIDUALS WITH EQUAL DIGNITY, RESPECT AND QUALITY OF CARE.LODI MEMORIAL HOSPITAL TREATS AND PROVIDES CARE TO ITS PATIENTS THROUGH INPATIENT AND OUTPATIENT SERVICES. INPATIENTS RECEIVE CARE THROUGH MEDICAL-SURGICAL, PERI-OPERATIVE, PERI-NATAL, PEDIATRIC, INTENSIVE CARE, AND ACUTE-PHYSICAL REHABILITATION SERVICES.OUTPATIENT CARE INCLUDES 24-HOUR EMERGENCY, DIAGNOSTIC SERVICES, SURGERY, REHABILITATION AND EDUCATION.LODI MEMORIAL HOSPITAL IDENTIFIES THE HEALTH-CARE AND HEALTH MAINTENANCE NEEDS AND PREFERENCES OF THE COMMUNITY IT SERVES. DIAGNOSTIC, REHABILITATIVE, EDUCATIONAL, TREATMENT AND PREVENTATIVE SERVICES ARE DEVELOPED AS APPROPRIATE FOR A HOSPITAL OF THIS SIZE AND ROLE.LODI MEMORIAL HOSPITAL, CONSISTENT WITH ITS NON-PROFIT STATUS, DEVELOPS FINANCIAL RESOURCES TO ADEQUATELY SUPPORT HEALTH MAINTENANCE AND PATIENT-CARE SERVICES; CHARITY CARE FOR THOSE UNABLE TO PAY, WORKING CAPITAL NEEDS; AND CAPITAL REQUIREMENTS OF PLANT, EQUIPMENT AND EVOLVING TECHNOLOGY. EVERY EFFORT IS MADE TO KEEP COSTS AFFORDABLE FOR PATIENTS WHILE CONTINUOUSLY STRIVING TO IMPROVE THE QUALITY OF SERVICE. 9553833 0 6173151 LODI MEMORIAL COMMUNITY CLINICS ARE LICENSED UNDER THE DEPARTMENT OF PUBLIC HEALTH SERVICES REGULATIONS, AND ARE OWNED AND OPERATED BY THE LODI MEMORIAL HOSPITAL ASSOCIATION, INC., A NOT-FOR-PROFIT ENTITY AND WILL PROVIDE MEDICAL CARE TO ANY AGE. A COMMUNITY CLINIC UNIT OFFERS SERVICES DURING POSTED HOURS OF BUSINESS, WITH AT LEAST ONE PHYSICIAN EXPERIENCED IN THE COMMUNITY CLINIC PRACTICE. SPECIALTY CONSULTATION WILL BE AVAILABLE BY PHONE OR REFERRAL TO MEMBERS OF THE MEDICAL STAFF. IN 2014, FOUR (4) COMMUNITY CLINICS WERE LICENSED AND OPERATIONAL. 136794623 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 474 0 1 1536 1 1 1 0 0 0 0 0 0 0 0 0 X 16 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X TERRY DEAK CFO & VICE PRESIDENT 2093343411 975 S FAIRMONT AVE LODI CA 95240 X ADDINGTON RON BOARD MEMBER 2.00 X 0 0 0 AGUIRE ELIZABETH BOARD MEMBER 2.00 X 0 0 0 CRABTREE STEVE BOARD MEMBER, CHAIR 5.00 X X 0 0 0 CUMMINS WILLIAM LEE BOARD MEMBER 2.00 X 0 0 0 DILLON CECIL BOARD MEMBER, CHAIR (THRU 04/2014) 5.00 X X 0 0 0 FERREE CHRISTEEN BOARD MEMBER 2.00 X 0 0 0 GILL PARAMPAL MD BOARD MEMBER 2.00 X 303119 0 0 HALEY PAUL BOARD MEMBER/SEC&TREASURER 2.00 X X 0 0 0 KIRST JEFF BOARD MEMBER 2.00 X 0 0 0 KHAN TAJ BOARD MEMBER 2.00 X 0 0 0 FETZER STEVE BOARD MEMBER 2.00 X 0 0 0 MC LAOUGHLIN TRAVERS MD BOARD MEMBER & CMS (2014) 5.00 X 16222 0 0 SHULMAN MONA BOARD MEMBER 2.00 X 0 0 0 OLSON DEBBIE BOARD MEMBER 2.00 X 0 0 0 PHELPS DAN BOARD MEMBER/VICE CHAIR 2.00 X X 0 0 0 SORBERA THOMAS MD BOARD MEMBER & LMCC PHYSICIAN 40.00 X 67300 0 0 PATRICK ROBERT PAT BOARD MEMBER 2.00 X 0 0 0 HARRINGTON JOSEPH P CEO & PRESIDENT 50.00 X 350053 0 14416 DEAK TERRANCE A CFO & VICE PRESIDENT 50.00 X 227802 0 12666 MORENO DEBBE JOYCE CHIEF NURSING OFFICER 50.00 X 203513 0 14160 SEY MARK CHIEF ADMINISTRATIVE OFFICER 50.00 X 202783 0 13006 SCHNEIDER PAMELA EXECUTIVE DIRECTOR-O/P SVCS 50.00 X 154352 0 11863 LAVIOLA STEVEN MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 459578 0 5815 FAHEY GORDON MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 352687 0 2970 FREUNDEDMUND A MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 380064 0 8298 SOROUR NAGUI MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 605809 0 0 LINGAMURTHY RAVI MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 360691 0 0 3683973 0 83194 199 0 1 0 QUANTUM HEALTHCARE MEDICAL ASSOCIATES I 5000 HOPYARD RD STE 100 PLEASANTON CA 94588 PHYSICIAN PROFESSIONAL SERVICES - HOSPIT 2752589 PREMIER ANESTHESIA 2655 NORTHWINDS PARKWAY ALPHAETA GA 30009 PHYSICIAN PROFESSIONAL SERVICES - ANESTH 1382455 GE HEALTHCARE 3000 N GRANDVIEW BLVD WAUKESHA WI 53188 BIOMEDICAL MAINTENACE SERVICE 1132693 MORPHEUS ANESTHESIA 999 S FAIRMONT AVE SUITE 110 LODI CA 95240 PHYSICIAN PROFESSIONAL SERVICES - ANESTH 700106 MEDITECH MEDITECH CIRCLE WESTWOOD MA 02090 IT SERVICES AND SUPPORT 535713 45 9705 86366 150383 246454 PATIENT SVC REVENUE 621400 171875817 171875817 CAPITATION FEES 621990 2798177 2798177 LOSS FROM LODI OUTPATIENT SURGICA 621400 -78291 -78291 LOSS FROM ADVANCED IMAGING CENTER 621400 -121132 -121132 LOSS FR TRINITY PLAZA SURGERY CEN 621400 -824275 -824275 2130615 2130615 175780911 1078725 1078725 170803 170803 199066 172962 26104 26104 26438 -334 19161284 74700 18469541 108819 691743 -34119 657624 657624 MANAGEMENT FEES 541610 53520 53520 OTHER REVENUE 900099 882 882 54402 178015023 175807349 53186 1908034 112917 112917 13000 13000 1591255 1146624 444631 336755 242658 94097 82488509 59393810 23031410 63289 1255284 903937 350524 823 4689817 3374501 1308546 6770 6015282 4331406 1679609 4267 226963 226963 942904 18628 924276 64085 64085 106692 106692 115832 115832 17130406 12335122 4783247 12037 164352 158684 5668 22455080 16178506 6273613 2961 2053325 1479581 573744 10678219 7682824 2979204 16191 143514 103413 40101 161312 115708 44869 735 12046126 8680175 3365951 1007108 725700 281408 BAD DEBTS 10388496 10388496 HOSP MEDI-CAL QLTY ASSU 8658648 8658648 DUES, SUBSCRIPTIONS, BO 338438 238560 92507 7371 BUSINESS TAXES & LICENS 278571 200732 77839 336060 242714 91875 1471 183798950 136794623 46882744 121583 181436 191950 9536469 11231216 2297624 615279 36512423 43310371 3325440 3466667 4670820 4536701 259356849 106648028 160547228 152708821 32431079 33277233 3769407 9606599 11346326 4991327 264618252 263936164 28003568 36119003 140030000 136905000 803012 836471 168836580 173860474 X 94959340 89476178 822332 599512 95781672 90075690 264618252 263936164 X -5783927 21976 55969 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 106692 106692 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO CALIFORNIA HOSPITAL ASSOCIATION & THE HOSPITAL COUNCIL OF NORTHERN CALIFORNIA ARE CONSIDERED TO BE FOR LOBBYING ACTIVITIES. 822332 94945 317765 599512 736801 363885 278354 822332 928619 275442 467260 736801 1293178 647989 1012548 928619 4870578 1178278 4755678 1293178 0.00000 0.00000 1.00000 0 0 3655763 3655763 614559 132470650 41517449 91567760 5099191 2176969 2922222 112242823 61211189 51031634 5273863 1742421 3531442 152708821 CONDITIONAL ASSET RETIREMENT 836471 836471 X PART X, LINE 2: EFFECTIVE JANUARY 1, 2009, WE FOLLOW ASC 74010 GUIDANCE RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THESE GUIDELINES PRESCRIBE A COMPREHENSIVE MODEL FOR RECOGNIZING, MEASURING, PRESENTING, AND DISCLOSING IN THE CONSOLIDATED FINANCIAL STATEMENTS, TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THEY ALSO PROVIDE ACCOUNTING GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. AS OF DECEMBER 31, 2014, WE ARE NOT AWARE OF ANY UNCERTAIN TAX POSITIONS FOR ANY YEARS OPEN UNDER FEDERAL OR STATE OF CALIFORNIA STATUTES OF LIMITATIONS. 1 1 X 1 X 1 X 500.000000000000 1 1 1 0 1 1 1 3051 672778 0 672778 0.00390 15 50054 48605328 37494462 11110866 0.06410 16 53105 49278106 37494462 11783644 0.06800 12 20032 3697021 20553 3676468 0.02120 175285 37188 138097 0.00080 4 11399 6504771 5432960 1071811 0.00620 201187 0 201187 0.00120 16 31431 10578264 5490701 5087563 0.02940 32 84536 59856370 42985163 16871207 0.09740 280458 280458 0.00160 280458 280458 0.00160 1 10388496 3635974 45223636 47374605 -2150969 X 1 1 1 TRINITY PLAZA SURGERY CENTER LLC AMBULATORY SURGERY CENTER - OPERATIONS CEASED, DISSOLVED EFF 12/31/14 0.94000 0.00000 0.06000 2 ADVANCED IMAGING CENTER AT LODI MEMORIAL HOSPITAL LLC DIAGNOSTIC IMAGING CENTER (WITH MRI) 0.51000 0.00000 0.49000 3 LODI OUTPATIENT SURGERY CENTER AMBULATORY SURGERY CENTER 0.31000 0.00000 0.40100 4 ENDOSCOPY CENTER OF LODI LLC AMBULATORY SURGERY CENTER 0.31000 0.00000 0.40100 2 1 LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE LODI CA 95240 LODIHEALTH.ORG 030000056 X X X GENERAL ACUTE CARE BEDS = 190 A 2 LODI MEMORIAL HOSPITAL - WEST 800 LOWER SACRAMENTO ROAD ACUTE PHYS LODI CA 95242 LODIHEALTH.ORG 030000056 X X ACUTE PHY REHAB = 24 BEDS (NOTE BEDS IN SUSPENSE / NOT OCCUPIED IN 2014) A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.LODIHEALTH.ORG X X 1 14 1 WWW.LODIHEALTH.ORG 0 0 1 X 100.000000000000 500.000000000000 X X X 1 1 X X X X 1 X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: LODI MEMORIAL HOSPITAL, - FACILITY 2: LODI MEMORIAL HOSPITAL - WEST FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: LODI MEMORIAL HOSPITAL ASSOCIATION, INC (ALSO KNOWN AS LODI HEALTH) CONDUCTED ITS FIRST COMMUNITY-HEALTH NEEDS ASSESSMENT IN 1995 AND, SINCE THEN, HAS DONE SO EVERY THREE YEARS. TO DETERMINE COMMUNITY-HEALTH NEEDS, THE NEEDS ASSESSMENT INCLUDES THE GATHERING AND REVIEW OF THE FOLLOWING DATA: CENSUS DATA, SOCIOECONOMIC AND GEOGRAPHIC INDICATORS; STATEWIDE HEALTH-INDICATOR DATA; COUNTYWIDE HEALTH INDICATORS; EXISTING REGIONAL PROGRAMS AND SERVICES MEETING THE COMMUNITY'S HEALTH NEEDS (ASSET MAPPING); AND SYSTEM-SPECIFIC UTILIZATION DATA. RESULTS FROM THE MOST RECENT 2013 ASSESSMENT, INCLUDING RELEVANT SOCIO-DEMOGRAPHIC DATA, ARE REVIEWED BY YEAR'S END BY SEVERAL INTERNAL AND EXTERNAL STAKEHOLDER GROUPS, INCLUDING NGOS, AND A LIST OF HEALTH PRIORITIES IS DEVELOPED FOR CONSIDERATION. THE LIST IS REVIEWED AND EVALUATED TO DETERMINE WHERE LODI HEALTH MAY BE ABLE TO DEDICATE ADDITIONAL RESOURCES TO IMPROVE COMMUNITY HEALTH. THE 2014 COMMUNITY BENEFIT PLAN WAS DEVELOPED IN THE LATTER PART OF 2013 IN COLLABORATION WITH COMMUNITY GROUPS, NGOS AND HEALTH PROVIDERS. STAKEHOLDER INVOLVEMENT: THOSE INVOLVED IN THE REVIEW, PRIORITIZATION AND PLANNING PROCESS INCLUDE THE SYSTEM'S COMMUNITY-ADVISORY BOARD, REPRESENTING A BROAD CROSS-SECTION OF THE SYSTEM'S COMMUNITY; MEMBERS OF THE SAN JOAQUIN COUNTY HEALTHIER COMMUNITIES COALITION, A COUNTYWIDE GROUP OF HEALTH, EDUCATION AND HUMAN-SERVICE PROVIDERS; SYSTEM STAFF; MEDICAL STAFF; AND SYSTEM BOARD MEMBERS. AS COMMUNITY NEEDS ARE REVIEWED, THE ABILITY OF THE SYSTEM TO MEET THOSE NEEDS WITHIN THE REALM OF ITS RESOURCES AND, WHEN POSSIBLE, IN COLLABORATION WITH COMMUNITY PARTNERSHIPS IS DISCUSSED. DISCUSSION AND RECOMMENDATION PROCESS IS AGENDIZED AT REGULARLY SCHEDULED MEETINGS OF THE COMMUNITY-ADVISORY BOARD AND THE SYSTEM'S STRATEGIC-PLANNING COMMITTEE. RECOMMENDATIONS FROM THOSE REVIEW GROUPS ARE DIRECTED TO THE SYSTEM'S STRATEGIC-PLANNING COMMITTEE SO THEY MAY MAKE RECOMMENDATIONS TO THE SYSTEM'S FULL BOARD OF DIRECTORS FOR DISCUSSION AND APPROVAL. CURRENTLY, THE REVIEW GROUPS' MAJOR FOCUS HAS BEEN TO ASSESS AND RECOMMEND HOW LODI HEALTH AND ITS RELATED BUSINESSES MAY BEST MEET THE COMMUNITY'S NEED RELATIVE TO THE CURRENT ECONOMY AND IN RESPONSE TO THE AFFORDABLE CARE ACT. KEY AREAS OF ASSESSMENT INCLUDE HOW TO BETTER ENGAGE COMMUNITY MEMBERS RELATIVE TO WELLNESS AND PREVENTION; ALIGNING PHYSICIAN AND SYSTEM INCENTIVES IN ORDER TO BEST MEET THE COMMUNITY'S NEED; AND STRENGTHENING COMMUNITY COLLABORATION TO IMPROVE COMMUNITY HEALTH.HOW THE LODI HEALTH STRATEGIC PLAN IS DEVELOPED: LODI HEALTH IS A 190-BED, TWO-CAMPUS, ACUTE-CARE HOSPITAL WITH 59 SEPARATE INPATIENT AND OUTPATIENT PROGRAMS AND SERVICES. SERVICES BEGAN IN 1952. SINCE ITS OPENING, LODI HEALTH HAS EXPANDED AND GROWN TO ITS CURRENT SIZE, WHICH INCLUDES TWO INPATIENT FACILITIES, LODI MEMORIAL HOSPITAL, LOCATED AT 975 SOUTH FAIRMONT AVE., AND LODI HEALTH WEST, LOCATED AT 800 SOUTH LOWER SACRAMENTO RD. LODI HEALTH WEST WAS ACQUIRED IN 1990. LODI HEALTH ALSO OPERATES FIVE PRIMARY-CARE MEDICAL PRACTICES; TWO PRENATAL PRACTICES; A PEDIATRIC PRACTICE; A PULMONARY PRACTICE; TWO CARDIOLOGY PRACTICES; AN OCCUPATIONAL-MEDICINE PRACTICE; A WOUND-CARE AND HYPERBARIC PRACTICE; A FREE OUTREACH PRACTICE; A GENERAL SURGERY PRACTICE; AN ORTHOPEDIC PRACTICE; AND A NEUROLOGY AND ENDOCRINOLOGY PRACTICE. IN ADDITION TO ITS INPATIENT ACUTE-CARE SERVICES AND MEDICAL PRACTICES, LODI HEALTH OPERATES A HOME HEALTH AGENCY, A DURABLE-MEDICAL-EQUIPMENT COMPANY, AN ADULT-DAY-CARE PROGRAM, A CHILD-CARE PROGRAM, A MEDICAL-SERVICES ORGANIZATION FOR PHYSICIANS AND A FULL ARRAY OF CLINICAL-OUTPATIENT SERVICES, INCLUDING LABORATORY, PHYSICAL THERAPY AND DIAGNOSTIC SERVICES.THE LODI MEMORIAL HOSPITAL ASSOCIATION IS THE SOLE CORPORATE MEMBER AND WAS INCORPORATED IN 1945. LODI MEMORIAL HOSPITAL ASSOCIATION IS A CALIFORNIA PUBLIC-BENEFIT, NON-PROFIT CORPORATION WITH APPROXIMATELY 1,500 MEMBERS. MEMBERSHIP IS OPEN TO ANY INTERESTED MEMBER FOR A LIFETIME FEE OF $100. THE MEMBERS ANNUALLY ELECT DIRECTORS TO THE BOARD, WHICH IS THE GOVERNING BODY FOR THE SYSTEM. THE ASSOCIATION AND THE SYSTEM HAVE BEEN SUCCESSFUL OVER THE PAST DECADES BECAUSE OF THEIR COMMITMENT AND ABILITY TO FULFILL THEIR ORIGINAL MISSION OF PROVIDING QUALITY HEALTH CARE TO RESIDENTS, WHILE CONTINUING TO ADAPT TO THE CHANGING HEALTH-CARE NEEDS OF THE COMMUNITY.THIS STRATEGIC PLAN IS A CONTINUING EFFORT OF THAT COMMITMENT AND EMPHASIZES THE LINK BETWEEN THE COMMUNITY AND THE SYSTEM. THE PLAN IS A COLLABORATIVE WORK OF COMMUNITY MEMBERS, BOARD MEMBERS, MEDICAL STAFF, MANAGEMENT AND STAFF EMPLOYEES. IT REPRESENTS LODI HEALTH'S BEST EFFORT TO ORGANIZE ITS VISION, MISSION, GOALS AND VALUES INTO A COHESIVE AND COMPREHENSIVE BLUEPRINT FOR THE SUCCESSFUL DELIVERY OF A WIDE CONTINUUM OF HEALTH SERVICES TO THE COMMUNITY, WITH THE ULTIMATE GOAL OF IMPROVING THE QUALITY OF LIFE IN AND BEYOND THE HOSPITAL WALLS.THE PLAN IS AN ONGOING, DYNAMIC DOCUMENT, WHICH REPRESENTS A CONTINUATION OF PREVIOUS AND CURRENT PLANS. THE PLAN IS OPEN TO REVISION, REFINEMENT AND CHANGE AS NEW INFORMATION IS ADDED TO OUR PLANNING PROFILE AND AS THE INTERNAL/EXTERNAL ENVIRONMENT DICTATE CHANGES. LODI HEALTH IS COMMITTED TO REMAINING A COMMUNITY-BASED ORGANIZATION AND, ALL THE WHILE, WILLING TO COOPERATE AND/OR COLLABORATE WITH ALL ENTITIES FOR THE BENEFIT OF THE LODI HEALTH SYSTEM, ITS PHYSICIANS, EMPLOYEES, VOLUNTEERS, ADVISORY BOARDS AND THE COMMUNITY AT LARGE. THAT SAID, LODI HEALTH WILL CONTINUE TO EXPLORE PARTNERSHIPS WITH OTHER HEALTH SYSTEMS AND PROVIDERS IN ORDER TO BEST SERVE THE NEEDS OF RESIDENTS IN ITS SERVICE AREA.THE ELEMENTS OF THE PLAN ARE INTENTIONALLY TIED TOGETHER TO ESTABLISH AND MAINTAIN THE ALIGNMENT BETWEEN THE VISION, MISSION, VALUES, GOALS AND PROJECTS. IT IS THE SYSTEM'S SINCERE COMMITMENT TO KEEP THE FOCUS ON THIS ALIGNMENT BETWEEN THE PLAN ELEMENTS TO INCREASE THE CHANCES FOR SUCCESSFUL IMPLEMENTATION. MAJOR GOALS HAVE BEEN DEVELOPED ALONG WITH STRATEGIES THAT ARE DESIGNED TO ACHIEVE THOSE GOALS. FINAL RESPONSIBILITY FOR IMPLEMENTATION OF THIS PLAN LIES WITH THE SYSTEM PRESIDENT AND CHIEF EXECUTIVE OFFICER. METRICS HAVE BEEN ESTABLISHED TO MONITOR PROGRESS OF PROJECTS. THIS PROCESS WILL SERVE TO COMMUNICATE TO ALL OF THE SYSTEM INTERNAL STAKEHOLDERS THE PRIORITIES AND DIRECTION OF THE SYSTEM. STANDING COMMITTEES OF THE SYSTEM BOARD WILL REVIEW AND MONITOR CHANGES TO THE PLAN.PUBLIC REVIEW: EVERY THREE YEARS THE SYSTEM CONDUCTS A COMMUNITY-HEALTH-NEEDS ASSESSMENT TO INCLUDE A REVIEW AND ASSESSMENT OF HEALTH STATUS AND COMMUNITY NEED. AFTER ITS COMMUNITY-NEEDS ASSESSMENT AND DATA-GATHERING ACTIVITIES ARE COMPLETED, FINDINGS ARE REPORTED TO ALL SYSTEM PLANNING PARTICIPANTS AND THE GENERAL PUBLIC, SUMMARIZING COMMENTS, SUGGESTIONS AND ISSUES ROSE.THE SYSTEM THEN MAKES FORMAL PRESENTATIONS TO ITS INTERNAL AND EXTERNAL-PLANNING PARTNERS, INCLUDING THE COMMUNITY-ADVISORY BOARD, MEDICAL STAFF, SYSTEM MANAGEMENT, STRATEGIC-PLANNING COMMITTEE, NGOS AND OTHER COMMUNITY STAKEHOLDERS. INPUT IS SOLICITED AT ALL MEETINGS TO BETTER MEET COMMUNITY NEED, AND AN IMPLEMENTATION PLAN IS DEVELOPED.THIS PAST YEAR IN DECEMBER 2013, THE BOARD OF DIRECTORS ADOPTED THE 2014 COMMUNITY BENEFIT IMPLEMENTATION PLAN.(SEE CONTINUATION FOR PROCESS DESCRIPTION) FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: YES, HOWEVER, THE PROCESS WAS NOT IN CONJUNCTION WITH OTHER REGIONAL HOSPITALS, BUT DONE CONSULTATIVELY AND DATA WAS SHARED. AS THE MOST NORTHERNLY HOSPITAL IN OUR COUNTY, AND ONLY HOSPITAL IN OUR CITY, OUR SERVICE AREA DIFFERS SIGNIFICANTLY FROM OTHER AREA HOSPITALS WHICH FOCUS PRIMARILY ON ONE COUNTY, WHILE LODI HEALTH FOCUSES ON ITS FIVE COUNTY SERVICE AREA. ADDITIONALLY, THE TIMING REQUIREMENTS FOR OTHER AREA HOSPITALS TO COMPLETE THEIR NEEDS ASSESSMENTS PRECEDES LODI HEALTH BY ONE YEAR.HOSPITALS IN SAN JOAQUIN COUNTY INCLUDE:- DAMERON HOSPITAL- ST. JOSEPH'S BEHAVORIAL HEALTH CENTER- ST. JOSEPH'S MEDICAL CENTER- SUTTER TRACY COMMUNITY HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: DISTRIBUTED ELECTRONICALLY TO STAFF, MEDICAL STAFF, MEDIA AND COMMUNITY ORGANIZATIONS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: AFTER PRIORITIZING THE HEALTH NEEDS, THE HOSPITAL AND ITS COMMUNITY PLANNING GROUP DETERMINED THAT RESOURCES WERE NOT AVAILABLE TO ADDRESS ALL EIGHT HEALTH PRIORITIES IDENTIFIED IN THE CHNA. IT PRIORITIZED ITS FOCUS TO THE TOP FIVE THAT WERE MOST ALIGNED WITH THE HEALTH SYSTEM'S CORE MISSION, CAPABILITIES AND RESOURCES. THOSE SELECTED TO BE ADDRESSED WERE ACCESS TO CARE, CULTURALLY APPROPRIATE CARE, HEALTH LITERACY AND HEALTH EDUCATION, ACCESS TO MENTAL HEALTH SERVICES AND SAFE AND AFFORDABLE PLACES TO EXERCISE. THOSE THAT WILL NOT BE DIRECTLY ADDRESSED ARE RELIABLE TRANSPORTATION, AFFORDABLE DENTAL SERVICES AND ACCESS TO HEALTHY FOOD.FACILITY REPORTING GROUP ASCH H, PART V, SECTION B, LINE 5, CONTINUATION:THE PROCESS:THE LODI HEALTH BOARD OF DIRECTORS' STRATEGICPLANNING COMMITTEE IS CHARGED WITH DEVELOPING AND MONITORING THE SYSTEM'S STRATEGIC PLAN. THEIR PROCESS IS:* ANNUALLY REVIEW THE EXTERNAL HEALTHCARE ENVIRONMENT, INCLUDING NEW AND UPDATED INFORMATION FROM THE: CALIFORNIA HEALTHCARE ASSOCIATION (CHA) "VIEW OF THE FUTURE" LATEST RELEASE; AMERICAN HOSPITAL ASSOCIATION (AHA) "VISION OF THE FUTURE" LATEST RELEASE; AND MAJOR NATIONAL, STATE AND LOCAL EVENTS THAT HAVE OR MAY AFFECT OUR LOCAL MARKET.* ANNUALLY REVIEW THE INTERNAL ENVIRONMENTS, INCLUDING: AUDITED FINANCIALS FOR THE LAST THREE YEARS FOR TRENDS; MARKETSHARE INFORMATION, FOR SYSTEM AND ALL BUSINESS LINES, I.E. INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, HOMEHEALTH AGENCY, ACUTEPHYSICAL REHABILITATION AND CLINICS; PAYER MIX BY SERVICE AND ZIP CODE; UTILIZATION DATA; LIST OF MAJOR EMPLOYEE, BOARD AND MEDICAL STAFF ISSUES CURRENTLY OPEN/IN PROGRESS; COMMUNITYNEEDS ASSESSMENT AND BENEFIT PLAN; QUALITY PERFORMANCE, CLINICAL AND PATIENT SATISFACTION; EMPLOYEE SATISFACTION; PHYSICIAN SATISFACTION; AND INFORMATIONTECHNOLOGY CAPABILITIES.* REVIEW THE FINDINGS AND RECOMMENDATIONS OF THE COMMUNITYNEEDS ASSESSMENT, CONDUCTED EVERY THREE YEARS, TO DETERMINE THE COMMUNITY'S HEALTH STATUS AND NEED FOR HEALTH SERVICES AND INTEGRATE THOSE INTO THE SYSTEM'S STRATEGIC PLAN. ANNUALLY, THE NEEDSASSESSMENT FINDINGS SHALLBE REVISITED PRIOR TO EACH APRIL MEETING TO ASSESS WHETHER LODI HEALTH, WITHIN THE REALM OF ITS RESOURCES, CAN OR SHOULD DEVELOP PROGRAMS AND SERVICES TO MEET COMMUNITY NEED AND/OR WORK WITH OTHER LOCAL HEALTH PROVIDERS, SCHOOLS AND ORGANIZATIONS TO MEET COMMUNITYHEALTH NEEDS FOR WELLNESS, PREVENTION AND TREATMENT.* ANNUALLY REVIEW THE SYSTEM MISSION, VISION AND VALUES FOR BOARD APPROVAL AT ITS MAY MEETING.* ANNUALLY DEVELOP LONG AND SHORTTERM GOALS AND OBJECTIVES FOR SUBMISSION TO THE BOARD FOR APPROVAL. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16A WEBSITE: WWW.LODIHEALTH.ORG FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16C WEBSITE: WWW.LODIHEALTH.ORG 9 LODI MEMORIAL HOSP HOME HEALTH AGENCY 800 S LOWER SACRAMENTO RD LODI CA 95242 HOME HEALTH AGENCY LODI MEMORIAL COMM CLINIC - MILLSBRIDGE 1901 KETTLEMAN LANE SUITE 200 LODI CA 95242 COMMUNITY CLINIC LODI OUTPATIENT SURGERY CENTER 521 S HAM LANE LODI CA 95242 AMBULATORY SURGICAL CENTERS ENDOSCOPY CENTER OF LODI LLC 840 S FAIRMONT AVE SUITE 1 LODI CA 95240 AMBULATORY SURGERY CENTER LODI MEMORIAL COMMUNITY CLINIC - VINE 1235 W VINE ST SUITE 22 LODI CA 95240 COMMUNITY CLINIC ADV IMAGING CENTER AT LODI MEM HOSP LLC 999 S FAIRMONT AVENUE SUITE 110 LODI CA 95240 DIAGNOSTIC IMAGING OUTPATIENT CENTER LODI MEMORIAL SURGICAL GROUP 999 S FAIRMONT AVENUE SUITE 100 LODI CA 95240 COMMUNITY CLINC LODI MEMORIAL COMMUNITY CLINIC - TRINITY 10200 TRINITY PARKWAY SUITE 102 STOCKTON CA 95219 COMMUNITY CLINIC TRINITY PLAZA SURGICAL CENTER LLC 10200 TRINITY PARKWAY SUITE 101 STOCKTON CA 95209 AMBULATORY SURGERY CENTER (DISSOLVED 12/31/14) PART I, LINE 7: COST IS ASSIGNED UTILIZING OUR INTERNAL COST ACCOUNTING SYSTEM (EPSI). COST IS ESTIMATED BY UTILIZING RELATIVE VALUE UNITS ASSIGNED TO EACH PRODUCT (I.E. CHARGEABLE TEST, SUPPLY, OR PROCEDURE). EACH PRODUCT'S RELATIVE VALUE IS ESTIMATED BY EACH DEPARTMENT DIRECTOR BASED ON RESOURCES EXPENDED FOR EACH DEPARTMENT PRODUCT. DEPARTMENT COSTS ARE ALLOCATED TO EACH PRODUCT BASED ON ACCUMULATED RELATIVE VALUES. EACH PATIENT ACCUMULATES PRODUCTS DURING THEIR VISIT. THE TOTAL COST FOR EACH PATIENT REPRESENTS THE SUM OF ALL THE PRODUCTS PROVIDED TO THEM DURING THEIR VISIT OR INPATIENT STAY. THE ABOVE METHOD IS THE CALCULATION FOR HOSPITAL CHARGES. FOR COMMUNITY CLINICS, HOSPITAL BASED CLINICS, HOSPITAL BASED HOME HEALTH AGENCY AND TWO SURGERY CENTER JOINT VENTURES A COST TO CHARGE RATIO WAS CALCULATED BASED ON THE DIRECT COSTS OF THESE LINES OF BUSINESS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10,388,496. PART II, COMMUNITY BUILDING ACTIVITIES: SAN JOAQUIN COUNTY IS AMONG THE MOST DIFFICULT COUNTIES IN THE STATE WHEN IT COMES TO RECRUITING PHYSICIANS TO PRACTICE MEDICINE, AND THE HOSPITAL DEVOTES SIGNIFICANT FINANCIAL AND HUMAN RESOURCES TO THAT EFFORT. CURRENTLY THE HOSPITAL IS ATTEMPTING TO ESTABLISH A RESIDENCY PROGRAM IN CONJUNCTION WITH THE LOCAL COUNTY HOSPITAL, A TEACHING FACILITY, IN HOPES THAT ONCE PHYSICIANS COME TO PRACTICE HERE THEY WILL APPRECIATE THE REGION AND STAY AND ESTABLISH MEDICAL PRACTICE OR AFFILIATE WITH AN EXISTING PRACTICE. TOTAL PHYSICIAN RECRUITMENT COSTS = $251,493; OTHER HARD TO FILL RECRUITMENT COSTS = $28,965 PART III, LINE 4: COSTING METHODOLOGY:UTILIZING THE PREVIOUS COSTING METHODOLOGY AS OUTLINED IN RESPONSE TO PART I LINE 7, ALL PATIENTS ARE ASSIGNED A PAYOR CLASS (I.E. CHARITY, SELF PAY, MEDICARE, MEDI-CAL, MANAGED CARE). THE COST BY PAYOR IS A SUMMATION OF ALL PATIENTS IN THE ASSIGNED PAYOR CLASS. THE AMOUNTS WRITTEN OFF AS BAD DEBT (ASSIGNED TO A COLLECTION AGENCY) ARE NET OF ANY APPLICABLE PAYMENTS OR DISCOUNTS. ANY PAYMENTS RECEIVED AFTER AN ACCOUNT IS ASSIGNED TO A COLLECTION AGENCY REDUCE THE BAD DEBT EXPENSE IN THE PERIOD RECEIVED.OF THE TOTAL UNINSURED PATIENTS SEEN IN 2014: 17% QUALIFIED FOR CHARITY CARE AND 54% WERE WRITTEN OFF TO BAD DEBTS. IT IS DIFFICULT TO ASCERTAIN HOW MANY UNINSURED WRITTEN OFF TO BAD DEBTS WOULD QUALIFY FOR CHARITY CARE. ALL BAD DEBT WRITE OFFS ARE SENT TO A COLLECTION AGENCY. IF AN ACCOUNT QUALIFIES FOR CHARITY CARE AFTER BEING SENT TO AN AGENCY, NO FURTHER COLLECTION ACTIVITY IS PURSUED AND THE "BAD DEBT" ACCOUNT IS WRITTEN OFF IN FULL - WE HAVE NOT TRACKED THESE IN THE PAST AS PART OF OUR CHARITY CARE EXPENSE BUT ESTIMATE AT LEAST 35% OF OUR BAD DEBT COSTS REPRESENTS CHARITY CARE. WE NOTICED A SIGNIFICANT DECLINE IN BAD DEBTS AND CHARITY CARE IN 2014 DUE TO THE ACA AND THE EXPANSION OF THE MEDICAID PROGRAM IN CALIFORNIA WHICH REDUCED OUR UNINSURED POPULATION FROMOVER 6% TO LESS THAN 2%.COMMUNITY BENEFIT RATIONALE: UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE. OFTEN THE INFORMATION GATHERED IN THE MEDICAID APPLICATION WILL MAKE THIS DETERMINATION "AUTOMATIC". IF ADDITIONAL INFORMATION IS REQUIRED WE ATTEMPT TO CONTACT THE PATIENT.BAD DEBT EXPENSE CAN BE FOUND ON PAGE 5 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AS THE "PROVISION FOR UNCOLLECTIBLE ACCOUNTS" (NOTE 17 ON PAGE 35 DISCUSSES UNCOMPENSATED CARE AND COMMUNITY BENEFIT COSTS).SEE FOOTNOTE 2 ON THE FINANCIAL STATEMENT THAT DISCUSSES "PATIENT ACCOUNTS RECEIVABLE". PART III, LINE 8: THE COSTS OF PROVIDING CARE TO MEDICARE RECIPIENTS OFTEN EXCEED THE GOVERNMENT'S REIMBURSEMENT FOR THESE SERVICES. FOR COSTS ASSIGNED TO MEDICARE PATIENTS, PLEASE SEE RESPONSE IN PART III, LINE 4.FEE REIMBURSED CHARGES FOR LABORATORY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY WITH INCIDENTAL CHARGES FOR SUPPLIES AND DRUGS WERE OBTAINED FROM THE MEDICARE PS&R. COST TO CHARGE RATIOS (CCR) FROM THE FILED COST REPORT WERE UTILIZED TO CALCULATE MEDICARE COSTS. MEDICARE REVENUES FOR THESE SERVICES WERE $45,223,636; COSTS WERE $47,374,605.THE COST ACCOUNTING SYSTEM IS USED FOR HOSPITAL CHARGES - ALL INPATIENT, OUTPATIENT, EMERGENCY AND URGENT CARE - FOR ALL PAYORS. A COST-TO-CHARGE RATIO WAS USED FOR SEGMENTS THAT ARE NOT YET INCLUDED IN THE COST ACCOUNTING SYSTEM: PRIMARILY HOSPITAL BASED CLINICS, COMMUNITY CLINICS, HOME HEALTH AND OUR RURAL HEALTHCARE CLINIC. 95.5% OF OUR CONSOLIDATED GROSS REVENUES ARE CAPTURED IN THE COST ACCOUNTING SYSTEM. PART III, LINE 9B: UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE (FINANCIAL ASSISTANCE) POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE (FINANCIAL ASSISTANCE). PART VI, LINE 2: EVERY THREE YEARS LODI MEMORIAL HOSPITAL ASSESSES COMMUNITY HEALTH NEEDS BY 1)CONSULTING WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY GROUPS TO REVIEW THE NEEDS OF EACH CONSTITUENCY; 2)REVIEWING SERVICE-AREA MORBIDITY AND MORTALITY HEALTH DATA PROVIDED BY THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES; 3)COMPILING SOCIO-ECONOMIC DATA TO DETERMINE WHERE THE GREATEST NEEDS EXIST WITHIN THE HOSPITAL-SERVICE AREA; AND 4)ASKING AREA RESIDENTS TO COMPLETE A HEALTH SURVEY REGARDING THEIR PERSONAL HEALTH AND NOTIONS ABOUT GOOD HEALTH. ONCE THE DATA IS COLLECTED, IT IS REVIEWED AND ASSESSED BY THE HOSPITAL'S COMMUNITY ADVISORY BOARD, BOARD OF DIRECTORS AND HOSPITAL MANAGERS TO DETERMINE WHAT SERVICES AND GAP AREAS MAY NEED ENHANCING OR ADDRESSING TO IMPROVE HEALTH WITHIN THE REALM OF THE HOSPITAL'S RESOURCES TO DO SO. PART VI, LINE 3: SIGNS ARE PROMINENTLY POSTED IN THE ADMISSIONS, EMERGENCY AND BILLING DEPARTMENTS OF THE HOSPITAL, IN ADDITION TO ALL THE HOSPITAL CLINICS, TO ADVISE PATIENTS AND VISITORS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND HOW TO WORK WITH HOSPITAL STAFF TO OBTAIN IT. THE SAME INFORMATION IS INCLUDED IN PATIENT-ADMISSION PACKETS AND POSTED ON THE HOSPITAL WEBSITE. HOSPITAL CASE MANAGERS ARE VIGILANT OF PATIENTS NEEDING FINANCIAL ASSISTANCE AND FOLLOW UP WITH THOSE IN NEED. FINANCIAL ASSISTANCE INCLUDES APPLYING FOR MEDICAID AS WELL AS CHARITY CARE. PART VI, LINE 4: NEARLY ALL OF THE INDIVIDUALS SEEKING CARE FROM LODI MEMORIAL HOSPITAL RESIDE IN ONE OF FIVE COUNTIES: SAN JOAQUIN, SACRAMENTO, SOLANO, AMADOR, AND CALAVERAS. ABOUT HALF OF THE HOSPITAL'S PATIENTS RESIDES WITHIN A FIVE-MILE RADIUS OF THE HOSPITAL IN SAN JOAQUIN COUNTY. GEOGRAPHICALLY, THE HOSPITAL SITS AT THE NORTHERN END OF THE SAN JOAQUIN VALLEY WHERE THE RESIDENTS ARE AMONG THE POOREST AND LEAST EDUCATED OF ALL THE STATE'S COUNTIES. IN ADDITION, SAN JOAQUIN COUNTY HAS AMONG THE WORST UNEMPLOYMENT RATES IN THE STATE'S COUNTIES; NEARLY TWO IN 10 RESIDENTS ARE UNEMPLOYED. ALSO SAN JOAQUIN COUNTY IS GROUND-ZERO FOR THE MORTGAGE CRISIS IN THIS COUNTRY. THE COUNTY IS ALSO AMONG THE MOST VIOLENT COUNTIES IN WHICH TO LIVE IN THE COUNTRY DUE TO SIGNIFICANT GANG ACTIVITY, LOW LEVELS OF EDUCATION, AND POVERTY. HOSPITAL PATIENTS REPRESENT DIVERSITY: ABOUT 40 PERCENT ARE HISPANIC, WITH MANY OF THOSE PATIENTS BEING MONOLINGUAL SPANISH SPEAKERS. ANOTHER THREE PERCENT ARE PAKISTANI, MANY OF WHOM SPEAK ONLY URDU OR PASHTU. ADDITIONALLY THERE IS A SIGNIFICANT POPULATION OF HOSPITAL PATIENTS WHO ARE GREATER THAN 80 YEARS OF AGE. THE MAJOR HEALTH ISSUES OF PATIENTS ARE HEART DISEASE, STROKE, CANCER, DIABETES AND OBESITY. PART VI, LINE 5: THE HOSPITAL CONDUCTS A MYRIAD OF ACTIVITIES TO PROMOTE COMMUNITY HEALTH. THOSE ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO: HEALTH FAIRS WITH FREE MEDICAL SCREENINGS FOR HIGH CHOLESTEROL, HIGH-BLOOD PRESSURE, DIABETES AND LOW-OXYGEN SATURATION LEVELS; REFERRALS TO FREE CLINICS OR LOCAL PHYSICIANS FOR THOSE WITH HIGH VALUES; A VARIETY OF LINKED VIDEOS TO THE HOSPITAL WEB PAGE, FACEBOOK PAGE, YOUTUBE PAGE, AND TWITTER RELATED TO HEALTH EDUCATION AND PREVENTION; A WELLNESS PROGRAM FOR HOSPITAL EMPLOYEES THAT IS ROOTED IN EXERCISE AND NUTRITION SO THAT EMPLOYEES MAY LEAD BY EXAMPLE; A MONTHLY NUTRITION COLUMN IN THE LOCAL NEWSPAPER; HOSPITAL STAFF SERVING ON THE BOARDS OF REGIONAL NGOS; DONATIONS OF MATERIALS AND EQUIPMENT TO NGOS; EMPLOYEE DONATIONS OF FOOD AND CLOTHING TO THE NEEDY. THE HOSPITAL IS ALSO THE SECOND LARGEST YEAR-ROUND EMPLOYER IN LODI, WITH EMPLOYEES REINVESTING THEIR EARNINGS IN THE LOCAL ECONOMY. THE HOSPITAL HAS ALSO ADOPTED THE MOST IMPOVERISHED, LARGEST AND MOST DIVERSE SCHOOL IN THE LOCAL SCHOOL DISTRICT TO HELP EDUCATE STUDENTS, PARENTS AND TEACHERS IN PREVENTION. IN THAT EFFORT, THE HOSPITAL HOSTS AT THE SCHOOL HEALTH AND EDUCATION FAIRS; PARTICIPATES IN CLASSROOM TEACHING AND HEALTH DEMONSTRATIONS; AND PARTICIPATES IN CAREERS FAIRS AT THE SCHOOL. DUE TO HAND-WASHING EDUCATION ALONE, THE SCHOOLS ABSENTEE RATES HAVE DECLINED DRAMATICALLY. FOR STUDENTS TO LEARN, THEY MUST BE IN SCHOOL; AND FOR SCHOOLS TO RECEIVE STATE FUNDING, THEY MUST MAINTAIN THEIR ATTENDANCE. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K ST STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 102698 ACCESS TO HEALTH SERVICES FOR UNINSURED/ UNDERINSURED PATIENTS 1 0 STIPENDS AND SCHOLARSHIPS 13 13000 PART I, LINE 2: THROUGH THE USE OF TEMPORARILY RESTRICTED ACCOUNTS, WE TRACK AND MONITOR THE INCOMING RECEIPTS FROM GRANTS AND THE UTILIZATION OF GRANT FUNDS. EACH GRANT IS TRACKED SEPARATELY. SHOULD THE GRANTOR AGENCY REQUIRE SPECIFIC REPORTS, WE COMPLY WITH THEIR REPORTING REQUIREMENTS. THE GRANTS WE MONITOR ARE SPECIFIC TO THE GRANTOR'S NEEDS AND REQUESTS. IN 2014 WE RECEIVED GRANT FUNDS TO USE AS STIPENDS OR SCHOLARSHIPS FOR MEDICAL ASSISTANT STUDENTS THAT INTERN AT OUR CLINICS. THE MAXIMUM GIVEN TO ANY ONE STUDENT IS $1,000 AFTER THEY COMPLETE THE INTERNSHIP PROGRAM. 1099'S ARE ISSUED ON THESE SCHOLARSHIPS. X X X X 0 1 0 0 0 0 0 0 0 GILL PARAMPAL MD BOARD MEMBER 303119 0 0 0 0 0 0 0 0 0 303119 0 0 0 HARRINGTON JOSEPH P CEO & PRESIDENT 343395 0 0 0 6658 0 6500 0 7916 0 364469 0 0 0 DEAK TERRANCE A CFO & VICE PRESIDENT 223602 0 0 0 4200 0 1583 0 11083 0 240468 0 0 0 MORENO DEBBE JOYCE CHIEF NURSING OFFICER 199313 0 0 0 4200 0 3077 0 11083 0 217673 0 0 0 SEY MARK CHIEF ADMINISTRATIVE OFFICER 197147 0 0 0 5636 0 5090 0 7916 0 215789 0 0 0 SCHNEIDER PAMELA EXECUTIVE DIRECTOR-O/P SVCS 153016 0 0 0 1336 0 3947 0 7916 0 166215 0 0 0 LAVIOLA STEVEN MD PHYSICIAN, COMMUNITY CLINICS 357750 0 31953 0 69875 0 0 0 5815 0 465393 0 0 0 FAHEY GORDON MD PHYSICIAN, COMMUNITY CLINICS 230377 0 17470 0 104840 0 0 0 2970 0 355657 0 0 0 FREUNDEDMUND A MD PHYSICIAN, COMMUNITY CLINICS 353511 0 26353 0 200 0 0 0 8298 0 388362 0 0 0 SOROUR NAGUI MD PHYSICIAN, COMMUNITY CLINICS 459020 0 38275 0 108514 0 0 0 0 0 605809 0 0 0 LINGAMURTHY RAVI MD PHYSICIAN, COMMUNITY CLINICS 338437 0 22254 0 0 0 0 0 0 0 360691 0 0 0 PART I, LINE 4B LINE 4B - LMH HAS A 457(F) SERP WHICH IS LIMITED TO SELECT MEMBERS OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. PARTICIPANTS ARE SELECTED BY THE BOARD OF DIRECTORS OR AN AUTHORIZED OFFICER. THE AMOUNT OF THE DEFERRED COMPENSATION UNDER THE PLAN FOR A PARTICIPANT FOR A PLAN YEAR SHALL BE SPECIFIED IN THE PARTICIPANT'S PARTICIPATION AGREEMENT OR, IF NOT SO SPECIFIED, THE AMOUNT DETERMINED BY THE EMPLOYER FOR SUCH PLAN YEAR IN THE EMPLOYER'S SOLE AND ABSOLUTE DISCRETION. A PARTICIPANT BECOMES FULLY VESTED IN THE PARTICIPANT'S ACCOUNT UPON THE EARLIEST OF NORMAL RETIREMENT, DATE OF DEATH OR DATE OF DISABILITY WHILE STILL AN EMPLOYEE, DATE OF TERMINATION OR DEMOTION BY THE EMPLOYER IF THE EVENT OCCURS WITHIN THE TWELVE MONTH PERIOD FOLLOWING A CHANGE IN CONTROL, THE EMPLOYER'S INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE. IF THE PARTICIPANT CEASES TO BE AN EMPLOYEE PRIOR TO BECOMING FULLY VESTED, THE EMPLOYEE SHALL NOT BE ENTITLED TO ANY BENEFIT UNDER THIS PLAN. ANY AMOUNTS CREDITED TO A PARTICIPANT'S ACCOUNT THAT ARE NOT VESTED AT THAT TIME SHALL BE FORFEITED. DISTRIBUTIONS UNDER THE PLAN COMMENCE WITHIN 90 DAYS FOLLOWING VESTING AND NOT LATER THAN MARCH 15 OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR OF VESTING. JOSEPH P HARRINGTON HAS A SERP INVESTMENT ACCOUNT, NO CONTRIUTIONS TO THIS PLAN WERE MADE IN 2014. A CALIFORNIA STATEWIDE COMMUNITES DEVELOPMENT AUTHORITY 680164610 2007-12-01 150629537 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 13095000 155434444 11445998 18234618 1547800 5651669 118554358 2012 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 0 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA STATEWIDE COMMUNITES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/26/2014 SCHEDULE K SUPPLENTAL INFORMATION THE DIFFERENCE OF $4,804,907 BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN PART II, LINE 3 IS DUE TO THE CUMULATIVE INVESTMENT EARNINGS (2007-2014) ON PROJECT FUNDS AND RESERVE FUNDS. PART I; COLUMN F: TO CONSTRUCT AND EQUIP: GENERAL ACUTE CARE ADDITION & NEW EMERGENCY DEPT. TO ALSO REMODEL WITH NEW EQUIPMENT: KITCHEN AND CAFETERIA. P GILL OBSTETRICS AND GYNECOLOGY >5% OWNED PARTNERSHIP BY PARAMPAL GILL, CURRENT BOARD MEMBER 336755 PHYSICIAN PROFESSIONAL SERVICE-OB CLINIC,PHYSICIAN RECUITMENT 0 FORM 990, PART VI, SECTION A, LINE 6 ASSOCIATION MEMBERSHIP IS OPEN TO ANYONE FOR A ONE-TIME, LIFETIME FEE OF $100. MEMBERS PARTICIPATE IN THE ANNUAL ELECTION OF BOARD MEMBERS WHO DIRECT THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS PARTICIPATE IN THE ANNUAL ELECTION OF BOARD MEMBERS WHO DIRECT THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS CANNOT SELL OR DISSOLVE THE CORPORATION - A 2/3RDS VOTE OF THE ASSOCIATION MEMBERS WOULD BE REQUIRED. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS SHARED WITH MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS BY ELECTRONIC COMMUNICATION FOR THEIR REVIEW. A SPECIAL BOARD MEETING IS SCHEDULED TO ANSWER QUESTIONS AND RECEIVE INPUT FROM THE BOARD. AFTER REVIEWS ARE COMPLETED AND CHANGES ARE MADE, THE BOARD IS ELECTRONICALLY PROVIDED WITH A COPY OF THE FINAL RETURN PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD, COMMITTEES, OFFICERS AND MANAGEMENT ARE REQUIRED TO REVIEW, ATTEST AND DISCLOSE ANY POTENTIAL CONFLICT OF INTERESTS ON AN ANNUAL BASIS. IN ADDITION, IT IS VERBALLY REQUESTED AT EVERY BOARD MEETING FOR ALL MEMBERS TO DECLARE IF THEY HAVE A CONFLICT OF INTEREST ON ANY AGENDA ITEM AND TO ABSTAIN FROM VOTING ON SAID ITEM. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS A CEO COMPENSATION COMMITTEE, WHO REVIEWS THE CEO'S PERFORMANCE AND COMPENSATION AT LEAST ANNUALLY WHOSE SPECIFIC RESPONSIBILITIES INCLUDE: SCHEDULING AND COMPLETING AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE, REVIEWING AND ESTABLISHING PERFORMANCE CRITERIA FOR THE CEO, AN ANNUAL REVIEW OF THE CEO'S JOB DESCRIPTION, SOLICITING INPUT FROM OTHER SOURCES ON CEO PERFORMANCE, ANNUALLY REVIEWING MARKET AREA COMPENSATION AND BENEFITS FOR HOSPITAL CEO TO DETERMINE FAIR MARKET VALUE COMPENSATION, ANNUALLY PROVIDE VERBAL AND WRITTEN FEEDBACK TO CEO ON PERFORMANCE. THE BOARD OF DIRECTORS HAS A CEO COMPENSATION COMMITTEE THAT ALSO ESTABLISHES A COMPENSATION PHILOSOPHY FOR CEO AND SENIOR MANAGEMENT, REVIEWS AND APPROVES THE CEO RECOMMENDATION FOR CAO, CNO, CFO AND VP COMPENSATION AND REVIEWS AND APPROVES MANAGEMENT COMMITTEE INCENTIVE COMPENSATION. IN ADDITION, LODI MEMORIAL HOSPITAL (LMH) PARTICIPATES IN AN ANNUAL COMPENSATION SURVEY SPONSORED BY THE CALIFORNIA HOSPITAL ASSOCIATION, THE HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA AND THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA. LMH SUBMITS THEIR WAGE AND SALARY DATA TO AN INDENDENDENT THIRD PARTY WHICH PRODUCES A REPORT BY JOB TITLE AND JOB DESCRIPTION THAT COMPARES SALARIES BY REGION WITHIN CALIFORNIA FOR ALL HOSPITALS WHO PARTICIPATE IN THE SURVEY. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. PART VII, SECTION A, LINE 1A LODI MEMORIAL HOSPITAL OPERATES COMMUNITY CLINICS AS DEFINED BY THE CALIFORNIA HEALTH AND SAFETY CODE SECTION 1204(A). THE HOSPITAL ENTERS INTO EMPLOYMENT AGREEMENTS WITH PHYSICIANS FOR THE PROFESSIONAL SERVICES PROVIDED IN THE COMMUNITY CLINICS TO THE UNINSURED AND UNDERINSURED POPULATIONS IN THE COMMUNITY. FORM 990, PART XI, LINE 9: INCOME OF SUBSIDIARY - VITAL -31,811. INCOME OF SUBSIDIARY - LRHS -44,508. BOOK/TAX K-1 DIFFERENCES 906,954. MINORITY INTEREST TRANSFER -774,666. ADVANCED IMAGING CENTER AT LODI MEMORIAL HOSPITAL LLC (AIC) 1001 S FAIRMONT AVE LODI CA 95240 943407786 DIAGNOSTIC IMAGING / MRI OUTPATIENT TREATMENT CENTER CA N/A RELATED -121132 451427 0 0 0.51000 LODI SURGICAL VENTURES LLC (LSV) 975 S FAIRMONT AVE LODI CA 95240 454239289 MAJ. OWNER OF LLC OPERATING AMBULATORY SURGERY CENTERS CA N/A RELATED -78291 1693868 0 1 0.60780 ARTEL LLC 521 S HAM LANE LODI CA 95240 263513966 AMBULATORY SURGICAL CENTERS CA LODI SURGICAL VENTURES LLC RELATED 0 0 0.31000 TRINITY PLAZA SURGERY CENTER LLC 10200 TRINITY PARKWAY SUITE 101 STOCKTON CA 95219 260358326 AMBULATORY SURGICAL CENTERS CA N/A RELATED -824275 0 1 0.94000 VITAL ENTERPRISES DBA MEMORIAL HOME MED-EQUIP 1115 S FAIRMONT AVE SUITE 1 LODI CA 95240 680021729 DURABLE MEDICAL EQUIPMENT COMPANY CA N/A C 344121 715340 1.00000 1 LODI REGIONAL HEALTH SYSTEMS INC 975 S FAIRMONT AVE LODI CA 95240 680398894 PHYSICIAN MANAGEMENT AND MEDICAL OFFICE BUILDING DEVELOPMENT & MANAGEMENT CA N/A C 1731952 14302146 1.00000 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 LODI REGIONAL HEALTH SYSTEMS INC O 428948 FMV VITAL ENTERPRISES O 241690 FMV VITAL ENTERPRISES Q 298859 FMV LODI REGIONAL HEALTH SYSTEMS INC K 102844 FMV ARTEL LLC D 71190 FMV ARTEL LLC A 131705 FMV TRINITY PLAZA SURGERY CENTER LLC B 6007513 FMV LODI REGIONAL HEALTH SYSTEMS INC B 797414 FMV VITAL ENTERPRISES P 60269 FMV ARTEL LLC P 368466 FMV ARTEL LLC D 2487188 FMV