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THE EXEMPT PURPOSE OF THIS FOUNDATION. SCHEDULE D, PART X, LINE 2 ASC 740 (FIN48) FOOTNOTE FROM AUDIT: THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)), AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2014 AND 2013, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. ANNUAL GALA 127910 77478 50432 2824 20899 2995 17298 0 127910 77478 50432 2824 20899 2995 17298 44016 6416 true true X true X true X true true true false true true 8534121 8534121 0.01340 158330914 98811298 59519616 0.09350 176926 90294 86632 0.00010 167041961 98901592 68140369 0.10700 69 22836 2049132 9295 2039837 0.00320 10 2742 577832 2900 574932 0.00090 3 9929 3365885 1039099 2326786 0.00370 1 1736 499248 499248 0.00080 67 6692 1986800 1986800 0.00310 150 43935 8478897 1051294 7427603 0.01170 150 43935 175520858 99952886 75567972 0.11870 1 525 525 1 534 534 2 12 33007 33007 0.00010 1 238 238 5 12 34304 34304 0.00010 false 2496421 138606558 168788896 -30182338 X true true 3 1 MEMORIAL MEDICAL CENTER 1700 COFFEE ROAD MODESTO CA 95355 www.memorialmedicalcenter.org 030000061 X X X 2 MEMORIAL HOSPITAL LOS BANOS 520 WEST I STREET LOS BANOS CA 93635 www.memoriallosbanos.org 040000177 X X X 3 SUTTER TRACY COMMUNITY HOSPITAL 1420 N TRACY BLVD TRACY CA 95376 www.suttertracy.org 030000105 X X X MEMORIAL MEDICAL CENTER 1 false false true X X X X X X X X X 13 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C true 13 true SEE PART V, SECTION C false false true X 200. 400. X X X true true X X X true X X X X X true X false X X X X true X X false false MEMORIAL HOSPITAL LOS BANOS 2 false false true X X X X X X X X X 13 true false true true X SEE PART V, SECTION C X SEE PART V, SECTION C true 13 true SEE PART V, SECTION C false false true X 200. 400. X X X true true X X X true X X X X X true X false X X X X true X X false false SUTTER TRACY COMMUNITY HOSPITAL 3 false false true X X X X X X X X X 13 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C true 13 true SEE PART V, SECTION C false false true X 200. 400. X X X true true X X X true X X X X X true X false X X X X true X X false false REPORTING FACILITY: #1, MEMORIAL MEDICAL CENTER SCHEDULE H, PART V, SECTION B, LINE 5 MEMORIAL MEDICAL CENTER (FACILITY 1): IN CONDUCTING ITS MOST RECENT CHNA, MEMORIAL MEDICAL CENTER (MMC), A FACILITY OF SUTTER CENTRAL VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. FOCUS GROUPS WERE CONDUCTED APRIL 19, 2012. HEALTH SERVICES AGENCY OF STANISLAUS, WEST MODESTO KING KENNEDY CENTER AND MEMORIAL MEDICAL CENTER COLLABORATED TO OFFER FOCUS GROUPS TO THE COMMUNITY. 15 COMMUNITY MEMBERS PARTICIPATED. DURING THESE GROUP SESSIONS, WE WERE ABLE TO PRESENT THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ASK COMMUNITY MEMBERS FOR INPUT AND IDEAS TO FOCUS OUR PRIORITIES THAT WERE IDENTIFIED. A SECOND SIMILAR FOCUS GROUP WAS CONDUCTED AT MEMORIAL MEDICAL CENTER ON APRIL 17, 2012 WITH 20 PARTICIPANTS. THOSE WHO PARTICIPATED REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED BY MMC. THE TOPICS PRESENTED INCLUDED: - IMPORTANT HEALTH ISSUES THEY, THEIR FAMILIES, AND THEIR COMMUNITIES FACED - WHAT THEY SAW AS HEALTHY AND UNHEALTHY ABOUT THEIR COMMUNITIES - WHAT THEY WOULD CHANGE TO MAKE THEIR COMMUNITIES HEALTHIER. THE RESOUNDING SUGGESTION FROM FOCUS GROUPS WAS TO IMPROVE ACCESS TO HEALTH INSURANCE AND HAVE A WIDER VARIETY OF HEALTH CARE PROVIDERS AVAILABLE WHO ACCEPTED THE HEALTH CARE PLAN. OTHER IDEAS INCLUDED BETTER ACCESS TO A SAFE ENVIRONMENT TO EXERCISE AND BE ACTIVE. INCLUDED IN THE PROCESS OF CREATING THE 2013 CHNA WERE THE FOLLOWING PERSONS AND FACILITIES WHO TOOK AN ACTIVE ROLE IN DEVELOPING THE ASSESSMENT AND WERE OUR KEY INFORMANTS. THE CHA STEERING GROUP HAS SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH. THEY WERE INVOLVED IN SELECTING TOPICS AND SCOPE OF THE CHNA, DESIGNED THE METHODOLOGY AND SELECTED QUESTIONS. A LISTING OF KEY INFORMANTS FOLLOWS: - STACEY BRONKEN, QUALITY ASSURANCE COORDINATOR FOR SIERRA VISTA CHILD AND FAMILY SERVICES. - PAULA CHIARMONTE, SENIOR RESEARCH ANALYST FOR STANISLAUS ECONOMIC DEVELOPMENT AND WORKFORCE ALLIANCE. - JENNIFER DOWNS-COLBY, ASSISTANT MANAGER FOR COMMUNITY BENEFITS AND VOLUNTEER SERVICES, MEMORIAL MEDICAL CENTER - JULIE FALKENSTEIN, MATERNAL CHILD ADOLESCENT HEALTH (MCAH)DIRECTOR FOR STANISLAUS COUNTY HEALTH SERVICES AGENCY. - ESTRELLA GARCIA, VP OF COMMUNITY IMPACT AND PROGRAM DEVELOPMENT FOR UNITED WAY OF STANISLAUS COUNTY. - LEILANI GARCIA, COORDINATOR OF EARLY CHILDHOOD PROGRAMS FOR CHILD/FAMILY SERVICES, STANISLAUS COUNTY OFFICE OF EDUCATION. - ESMERALDA GONZALEZ, CHRONIC DISEASE & INJURY PREVENTION MANAGER FOR STANISLAUS COUNTY HEALTH SERVICES AGENCY. - AMELIA GOODFELLOW, PUBLIC HEALTH ASSOCIATE FOR CENTERS FOR DISEASE CONTROL AND PREVENTION. - DEBBIE GOODWIN, CHILD CARE SPECIALIST II FOR CHILD/FAMILY SERVICES, STANISLAUS COUNTY OFFICE OF EDUCATION. - SHARON HUTCHINS, EPIDEMIOLOGIST FOR STANISLAUS COUNTY HEALTH SERVICES AGENCY. - KIRSTEN JASEK-RYSDAHL, OUTCOMES MANAGER FOR BEHAVIORAL HEALTH AND RECOVERY SERVICES. - PHOEBE LEUNG, INTERIM ASSISTANT DIRECTOR FOR STANISLAUS COUNTY HEALTH SERVICES AGENCY. - LINDA LOWE, PLANNER FOR STANISLAUS COUNTY DEPARTMENT OF AGING AND VETERAN SERVICES. - CLE MOORE-BELL, EXECUTIVE DIRECTOR FOR WEST MODESTO/KING KENNEDY NEIGHBORHOOD COLLABORATIVE. - OMER NJAJOU, RESEARCH AND OUTCOME SPECIALIST FOR BEHAVIORAL HEALTH AND RECOVERY SERVICES. - MARIE SANCHEZ, COMMUNITY BENEFIT MANAGER FOR KAISER PERMANENTE. - WERNER SCHINK, PRESIDENT OF COMMUNITY AND LOCAL NEIGHBORHOOD RESEARCH. - JOHN SIMS, EXECUTIVE DIRECTOR OF STANISLAUS COUNTY CHILDREN AND FAMILIES COMMISSION. - JEFF SLATER, GRANTS MANAGER FOR HEALTH PLAN OF SAN JOAQUIN. - OLIVIA TONG, EPIDEMIOLOGIST FOR STANISLAUS COUNTY HEALTH SERVICES AGENCY. - COLLEEN WOOLSEY, ASSOCIATE DIRECTOR OF PUBLIC HEALTH FOR STANISLAUS COUNTY HEALTH SERVICES AGENCY. IN ADDITION, A COMMUNITY SURVEY WAS CONDUCTED WITH A RESULT OF 2,056 RESPONDENTS. THE EMPLOYEE SURVEY WAS CONDUCTED WITH A TOTAL OF 215 SURVEYS RETURNED. OUTCOMES FROM THESE SURVEYS ARE AVAILABLE IN THE 2013 CHNA FOR MEMORIAL MEDICAL CENTER AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, SECTION B, LINE 6 MEMORIAL MEDICAL CENTER (FACILITY 1): MEMORIAL MEDICAL CENTER AND KAISER PERMANENTE COLLABORATED ON THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PARTV, SECTION B, LINE 7A, 7B AND 10A MEMORIAL MEDICAL CENTER (FACILITY 1): HTTP://WWW.MEMORIALMEDICALCENTER.ORG/ABOUT/COMMUNITY-BENEFIT.HTML OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PARTV, SECTION B, LINE 11 Memorial Medical Center (FACILITY 1): The following significant health needs were identified in the 2013 Community Health Needs Assessment and are needs that Memorial Medical Center intends to address through its implementation strategy: - Access to care (includes health care provider shortage); - Lack of health care insurance for low-income populations, Latinos and working age adults; - Prenatal and perinatal health education; - Chronic disease prevention and control; - Modifiable risk factors for disease, including poor diet, lack of physical activity, overweight/obesity and tobacco use; and - Behavioral risk factors for disease, including high risk sexual activity leading to sexually-transmitted infections and diseases. Descriptions of the community benefit programs that address these significant health needs can be found in Part VI. SCHEDULE H, PARTV, SECTION B, LINE 13H ELIGIBILITY CRITERIA - OTHER: MEMORIAL MEDICAL CENTER (FACILITY 1): ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. SCHEDULE H, PARTV, SECTION B, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: MEMORIAL MEDICAL CENTER (FACILITY 1): A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PARTV, SECTION B, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: MEMORIAL MEDICAL CENTER (FACILITY 1): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) PARTIAL CHARITY CARE, (3) SPECIAL CIRCUMSTANCES CHARITY CARE, (4) CATASTROPHIC CHARITY CARE, (5) HIGH COST MEDICAL CHARITY CARE, (6) UNINSURED PATIENT DISCOUNT, AND (7) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE. REPORTING FACILITY: #2, MEMORIAL HOSPITAL LOS BANOS SCHEDULE H, PART V, SECTION B, LINE 5 MEMORIAL HOSPITAL LOS BANOS (FACILITY 2): IN CONDUCTING ITS MOST RECENT CHNA, MEMORIAL HOSPITAL LOS BANOS DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. SURVEY DATA THAT WAS COLLECTED DOES NOT STEM FROM A REPRESENTATIVE SURVEY, BUT THE INFORMATION STILL PROVIDES MEANINGFUL FEEDBACK FROM LOS BANOS RESIDENTS AS IT RELATES TO ACCESS TO HEALTH CARE, CRIME AND NEIGHBORHOOD SAFETY, AVAILABILITY OF HEALTHY FOOD, PHYSICAL FITNESS AND OVERALL QUALITY OF LIFE INDICATORS. A QUESTIONNAIRE WAS DEVELOPED IN ENGLISH AND SPANISH. MEMBERS OF THE COMMUNITY (WHICH INCLUDES MEDICALLY UNDERSERVED, LOW-INCOME, AND ETHNIC MINORITIES) WERE SURVEYED AT THE LOCAL TOMATO FESTIVAL, THE LOCAL SUPERMARKET (SAVE MART), LOS BANOS UNIFIED SCHOOL DISTRICT (LBUSD), A FLU CLINIC AND A NUMBER OF SURVEYS WERE OBTAINED VIA TELEPHONE. FURTHER INPUT WAS GATHERED FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVICED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. MORE SPECIFICALLY, THE MERCED COUNTY DEPARTMENT OF PUBLIC HEALTH WAS REPRESENTED BY DR. TIM LIVERMORE (DIRECTOR OF PUBLIC HEALTH), JENNIFER ANDRADE, RN, AND LAURA ROBERTS, RN. THEIR PARTICIPATION AND INPUT CENTERED ON NEEDS ASSESSMENT PLANNING AND/OR PROJECT MEETINGS. SCHEDULE H, PART V, SECTION B, LINE 6 MEMORIAL HOSPITAL LOS BANOS (FACILITY 2): NO OTHER HOSPITALS PARTICIPATED IN THE CHNA, BUT THE ASSESSMENT WAS A COLLABORATIVE PROCESS. THE SAN JOAQUIN COMMUNITY DATA CO-OP IS A CENTRAL VALLEY BASED NONPROFIT SOCIAL RESEARCH AND EVALUATION ORGANIZATION THAT WAS CONTRACTED TO CARRY OUT THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS RESEARCH ORGANIZATION DESIGNED THE NEEDS ASSESSMENT, DEVELOPED AN INSTRUMENT FOR PRIMARY DATA COLLECTION, COLLECTED AND ANALYZED THE DATA AND PREPARED THE FINAL PRODUCT. THE RESEARCH TEAM INCLUDED CAMPBELL BULLOCK, EXECUTIVE DIRECTOR; OLGA GOLTVYANTISA, SENIOR RESEARCH ASSOCIATE, WITH EXPERTISE IN GEOGRAPHIC INFORMATION SYSTEMS (GIS) MAPPING; VANG BAO, COMMUNITY RESEARCHER; KARINA IBARRA, COMMUNITY RESEARCHER AND SPANISH TRANSLATOR; AND ZEE VANG, RESEARCH ASSISTANT; AND ADDITIONAL RESEARCH ASSISTANTS HELPED WITH THE FACILITATION OF THE COMMUNITY NEEDS ASSESSMENT SURVEY. IT IS IMPORTANT TO NOTE THAT A MAJOR CONTRIBUTING PARTNER WAS JULIE BARKER (MCHES, MPH, CLC), PROGRAM MANAGER WITH SAN JOAQUIN REGION 5- CALIFORNIA HEALTH COLLABORATIVE. ANOTHER CONTRIBUTING PARTNER WAS CARRIE J. FLOREZ, A RESEARCH SCIENTIST AT THE CENTER FOR FAMILY HEALTH- CALIFORNIA DEPARTMENT OF PUBLIC HEALTH. SCHEDULE H, PARTV, SECTION B, LINE 7A, 7B AND 10A MEMORIAL HOSPITAL LOS BANOS (FACILITY 2): HTTP://WWW.MEMORIALLOSBANOS.ORG/ABOUT/COMMUNITY-BENEFIT.HTML OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PARTV, SECTION B, LINE 11 Memorial Hospital Los Banos (FACILITY 2): The following significant health needs were identified in the 2013 Community Health Needs Assessment are needs that Memorial Hospital Los Banos intends to address through its implementation strategy: - Lack of activities for children and adults and no activities for seniors - Lack of specialists, health care availability, health services for unemployed Descriptions of the community benefit programs that address these significant health needs can be found in Part VI, along with additional efforts on behalf of Memorial Hospital Los Banos. SCHEDULE H, PARTV, SECTION B, LINE 13H ELIGIBILITY CRITERIA - OTHER: MEMORIAL HOSPITAL LOS BANOS (FACILITY 2): ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. SCHEDULE H, PARTV, SECTION B, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: MEMORIAL HOSPITAL LOS BANOS (FACILITY 2): A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PARTV, SECTION B, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: MEMORIAL HOSPITAL LOS BANOS (FACILITY 2): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) PARTIAL CHARITY CARE, (3) SPECIAL CIRCUMSTANCES CHARITY CARE, (4) CATASTROPHIC CHARITY CARE, (5) HIGH COST MEDICAL CHARITY CARE, (6) UNINSURED PATIENT DISCOUNT, AND (7) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE. REPORTING FACILITY: #3, SUTTER TRACY COMMUNITY HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 5 SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 3): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER TRACY COMMUNITY HOSPITAL DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). KEY INFORMANTS ARE HEALTH AND COMMUNITY EXPERTS FAMILIAR WITH SPECIFIC POPULATIONS AND GEOGRAPHIC AREAS WITHIN IN THE HSA. TO GAIN A DEEPER UNDERSTANDING OF THE HEALTH ISSUES PERTAINING TO CHRONIC DISEASE AND THE POPULATIONS LIVING IN THESE VULNERABLE COMMUNITIES 45 KEY INFORMANT INTERVIEWS WERE CONDUCTED USING A THEORETICALLY GROUNDED INTERVIEW GUIDE (APPENDIX D OF THE CHNA). EACH INTERVIEW WAS RECORDED AND CONTENT ANALYSIS WAS CONDUCTED TO IDENTIFY KEY THEMES AND IMPORTANT POINTS PERTAINING TO EACH GEOGRAPHIC AREA. FINDINGS FROM THESE INTERVIEWS WERE USED TO IDENTIFY COMMUNITIES IN WHICH FOCUS GROUPS SHOULD BE CONDUCTED. INTERVIEWS WERE HELD WITH THE FOLLOWING PEOPLE AND AGENCIES: - HEALTHIER SAN JOAQUIN COALITION WITH EXPERTISE IN COMMUNITY HEALTH, SOCIAL SERVICES. - CAROLINE THIBODEAU, DIRECTOR OF HEALTH SERVICES FOR MANTECA UNIFIED SCHOOL DISTRICT WITH EXPERTISE IN COMMUNITY HEALTH, CHILDREN AND FAMILIES. INTERVIEW DATE: 9/7/12. - BILL MITCHELL, DIRECTOR AND DR. KAREN FURST, HEALTH OFFICER FOR SAN JOAQUIN COUNTY PUBLIC HEALTH WITH EXPERTISE IN COMMUNITY AND PUBLIC HEALTH. INTERVIEW DATE: 9/21/12. - ANA RODRIGUEZ, IRIS RODRIGUEZ, AND PATRICIA ALVAREZ-PALMA FOR SUTTER TRACY COMMUNITY RESOURCE CENTER WITH EXPERTISE IN COMMUNITY HEALTH AND SOCIAL SERVICES. INTERVIEW DATE: 10/8/12. - BREASTFEEDING INITIATIVE, SAN JOAQUIN COUNTY PUBLIC HEALTH WITH EXPERTISE IN COMMUNITY HEALTH, SOCIAL SERVICES, AND CHILDREN AND FAMILIES. INTERVIEW DATE: 10/9/12. - DR. MARIETTA SUMAQUIAL, CLINIC MANAGER FOR LODI-WOODBRIDGE MEDICAL GROUP WITH EXPERTISE IN COMMUNITY HEALTH, PEDIATRICS. INTERVIEW DATE: 10/15/12. - CAROLYN SANDERS, COMMUNITY OUTREACH AND EDUCATION NURSE FOR DAMERON HOSPITAL WITH EXPERTISE IN COMMUNITY HEALTH. INTERVIEW DATE: 10/16/12. - CINDY EDMISTON, HEALTH SERVICES MANAGER FOR TRACY UNIFIED SCHOOL DISTRICT WITH EXPERTISE IN COMMUNITY HEALTH, CHILDREN AND FAMILIES. INTERVIEW DATE: 10/17/12. - THOMAS MAHONEY, CLINIC DIRECTOR FOR COMMUNITY MEDICAL CENTERS, INC. WITH EXPERTISE IN COMMUNITY HEALTH, SOCIAL SERVICES. INTERVIEW DATE: 10/19/12. - SAN JOAQUIN COUNTY OFFICE OF EDUCATION STAFF FOR THE EARLY CHILDHOOD EDUCATION DEPARTMENT WITH EXPERTISE IN RURAL COMMUNITIES, HEALTH EDUCATION, AND CHILDREN AND FAMILIES. INTERVIEW DATE: 10/22/12. - CLINIC STAFF FOR PLANNED PARENTHOOD, TRACY WITH EXPERTISE IN COMMUNITY HEALTH, REPRODUCTIVE HEALTH, AND HEALTH EDUCATION. INTERVIEW DATE: 10/22/12. - RAQUEL MORENO, HEALTH EDUCATION MANAGER FOR KAISER PERMANENTE WITH EXPERTISE IN COMMUNITY HEALTH. INTERVIEW DATE: 10/23/12. - PUBLIC HEALTH COMMITTEE FOR SAN JOAQUIN MEDICAL SOCIETY WITH EXPERTISE IN PUBLIC AND COMMUNITY HEALTH. INTERVIEW DATE: 10/25/12. - VIC SINGH, JEAN ANDERSON, KERRIE MELTON, AND DORIS CODY OF SAN JOAQUIN COUNTY BEHAVIORAL HEALTH WITH EXPERTISE IN BEHAVIORAL AND MENTAL HEALTH. INTERVIEW DATE: 10/30/12. - SAN JOAQUIN COMMUNITY HEALTH FORUM WITH EXPERTISE IN COMMUNITY LEADERS REPRESENTING BUSINESS, COMMUNITY HEALTH, AND EDUCATION. INTERVIEW DATE: 11/7/12. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN THE SUTTER CENTRAL VALLEY HOSPITAL FACILITIES CHNA'S ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, SECTION B, LINE 6 SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 3): MULTIPLE HOSPITALS COLLABORATED ON THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING DAMERON HOSPITAL, KAISER PERMANENTE, LODI MEMORIAL HOSPITAL, ST. JOSEPH'S MEDICAL CENTER AND SUTTER TRACY COMMUNITY HOSPITAL. SCHEDULE H, PARTV, SECTION B, LINE 7A, 7B AND 10A SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 3): HTTP://WWW.SUTTERTRACY.ORG/ABOUT/COMMUNITYBENEFIT.HTML OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PARTV, SECTION B, LINE 11 Sutter Tracy Community Hospital (FACILITY 3): The following significant health needs were identified in the 2013 Community Health Needs Assessment and are needs that Sutter Tracy Community Hospital intends to address through its implementation strategy: - Lack of access to primary and specialty care - Lack of providers, cost of care, services centralized in Stockton, long wait times for appointments. - Lack of access to health education - Limited health literacy, available classes too costly, and classes not offered on a regular basis. - Lack of access to dental care - Lack of providers, cost of care, services centralized in Stockton, long wait times for appointments, very limited services for uninsured adults - Limited cultural competence in health system - Language barriers, cultural stigmas, lack of providers. - Limited nutrition literacy/food access and security - Lack of knowledge about food preparation, cost of fresh produce, abundant and inexpensive fast food. - Limited transportation options - Cost of gas, many living in rural communities, long bus rides to Stockton. - Lack of safe and affordable places to be active - Gang related violence, poorly maintained parks, roads not safe for walking and biking. Descriptions of the community benefit programs that address these significant health needs can be found in Part VI. SCHEDULE H, PARTV, SECTION B, LINE 13H ELIGIBILITY CRITERIA - OTHER: SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 3): ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. SCHEDULE H, PARTV, SECTION B, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 3): A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PARTV, SECTION B, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 3): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) PARTIAL CHARITY CARE, (3) SPECIAL CIRCUMSTANCES CHARITY CARE, (4) CATASTROPHIC CHARITY CARE, (5) HIGH COST MEDICAL CHARITY CARE, (6) UNINSURED PATIENT DISCOUNT, AND (7) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE. 8 MHLB RURAL HEALTH CLINIC 400 WEST I STREET SUITE C LOS BANOS CA 93635 RURAL HEALTH CLINIC MMC-CARDIAC REHAB SERVICES 1800 COFFEE ROAD SUITE 41 MODESTO CA 95355 OUTPATIENT SERVICES MMC-PULMONARY REHAB SERVICES 1800 COFFEE ROAD SUITE 28 MODESTO CA 95355 OUTPATIENT SERVICES MEMORIAL SURGERY CENTER 1401 SPANOS COURT MODESTO CA 95355 OUTPATIENT SERVICES PULMONARY REHAB SERVICES 1329 SPANOS COURT B3 MODESTO CA 95355 OUTPATIENT SERVICES MMC-WOUND CLINIC 1329 SPANOS COURT B5 MODESTO CA 95355 OUTPATIENT SERVICES SUTTER TRACY HOSPITAL IMAGING CENTER 1530 BESSIE AVENUE SUITE 109 TRACY CA 95376 OUTPATIENT SERVICES SUTTER TRACY HOSPITAL RADIOLOGY SERVICES 441 W EATON AVENUE TRACY CA 95376 OUTPATIENT SERVICES SCHEDULE H, PART I, LINE 3C TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES APPLIES TO UNINSURED PATIENTS THAT WHOSE FAMILY INCOMES ARE BETWEEN 201% AND 400%. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 400% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURER HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 20% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR A 20% DISCOUNT IF 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: MEMORIAL MEDICAL CENTER: MEMORIAL MEDICAL CENTER SUPPORTED THE SAFE COMMUNITIES COMMISSION WHICH WORKS TO IMPROVE SAFETY WITHIN THEIR NEIGHBORHOODS AND DECREASE ACCIDENTS THROUGHOUT THEIR COMMUNITY. MEMORIAL MEDICAL CENTER TAKES PART IN THE ANNUAL SOROPTIMISTS COMMUNITY CHRISTMAS TREE WHICH PROVIDES UNDERSERVED CHILDREN IN THE STANISLAUS COUNTY GIFTS INCLUDING NECESSARY ITEMS FOR SURVIVAL AND TO IMPROVE QUALITY OF LIFE. MEMORIAL HOSPITAL LOS BANOS: MEMORIAL HOSPITAL LOS BANOS FUNDS A MONTHLY SENIOR CITIZENS DINNER, WHERE EMPLOYEES DONATE THEIR TIME TO HELP PREPARE AND SERVE MEALS. MEMORIAL HOSPITAL LOS BANOS IS ALSO PART OF A COMMUNITY HEALTH COALITION THAT WORKS WITH PUBLIC HEALTH, THE CITY MAYOR, PARKS & RECREATION, CHURCHES AND HOMELESS SHELTERS TO WORK ON THE HEALTH OF THEIR COMMUNITY. SUTTER TRACY COMMUNITY HOSPITAL: SUTTER TRACY COMMUNITY HOSPITAL SUPPORTS THE HEALTHIER COMMUNITY COALITION (HCC). THE HCC IS A COALITION CHARGED WITH DEVELOPING THE HEALTH IMPROVEMENT EFFORTS IN SAN JOAQUIN COUNTY. SCHEDULE H, PART III, LINE 2 METHODOLOGY FOR CALCULATING BAD DEBT (AT COST): THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE: AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. SCHEDULE H, PART III, LINE 4 THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE ESTIMATED BASED UPON AN EVALUATION OF HISTORICAL PAYMENTS, NEGOTIATED CONTRACTS AND GOVERNMENTAL REIMBURSEMENTS. SUTTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 90% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2014 AND 2013. ADJUSTMENTS AND CHANGES IN ESTIMATES ARE RECORDED IN THE PERIOD IN WHICH THEY ARE DETERMINED. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 29% AS OF 12/31/14 33% AS OF 12/31/13 MEDI-CAL 27% AS OF 12/31/14 21% AS OF 12/31/13 DURING 2014 AND 2013, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT THE ESTIMATION MAY CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SUTTER'S SELF-PAY WRITE-OFFS WERE $287 MILLION AND $375 MILLION FOR 2014 AND 2013, RESPECTIVELY. SCHEDULE H, PART III, LINE 7 MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: MEMORIAL MEDICAL CENTER: IN JUNE 2011, HEALTH SERVICES AGENCY (H.S.A.) STAFF FORMED THE 2013 COMMUNITY HEALTH ASSESSMENT (CHA) STEERING COMMITTEE, INVITING REPRESENTATIVES FROM PARTNER ORGANIZATIONS AS MEMBERS THAT FREQUENTLY GATHER OR CONSULT LOCAL DATA TO MAKE PROGRAMMATIC DECISIONS. THIS COMMITTEE WAS TASKED WITH IDENTIFYING THE KEY AREAS OF INFORMATION FOR INCLUSION IN THE CHA. AT THE FIRST MEETING, THE CHA STEERING COMMITTEE AGREED THAT THE BROAD DETERMINANTS OF HEALTH, AS DEFINED BY HEALTHY PEOPLE 2020 (U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES), WOULD BE USED FOR DEFINING THE STRUCTURE OF THE 2013 CHA. TO INCLUDE INFORMATION FROM ALL IMPORTANT BROAD DETERMINANTS OF HEALTH, THE CHA STEERING COMMITTEE AGREED THAT BOTH NEW ("PRIMARY") DATA COLLECTION (I.E. INFORMATION GATHERED FOR THE PURPOSES OF THIS REPORT) AND EXISTING ("SECONDARY") DATA WERE NECESSARY FOR A COMPLETE ASSESSMENT. THE STEERING COMMITTEE DECIDED THAT TWO TYPES OF PRIMARY DATA WOULD BE COLLECTED: 1) INFORMATION FROM INDIVIDUALS LIVING IN STANISLAUS COUNTY ("COMMUNITY SURVEY"), AND 2) INFORMATION FROM LOCAL EMPLOYERS ("EMPLOYER SURVEY"). FOR THE COMMUNITY SURVEY, STEERING COMMITTEE MEMBERS EMPHASIZED THE IMPORTANCE OF ENSURING THAT THE PEOPLE SURVEYED REFLECTED THE COUNTY'S DEMOGRAPHIC PROFILE SO THAT THE RESULTS WOULD BE A BALANCED PORTRAYAL OF THE HEALTH AND WELL-BEING OF THE ENTIRE COUNTY. DURING THE FIRST SIX MONTHS OF PLANNING, CHA STEERING COMMITTEE MEMBERS SELECTED SPECIFIC TOPIC AREAS AND DATA ELEMENTS THAT WOULD BEST REVEAL THE OVERALL QUALITY OF LIFE AND WELL-BEING OF THE COMMUNITY. BY DECEMBER 2011, TOPIC AREAS THAT WERE TO BE INCLUDED IN THE COMMUNITY SURVEY WERE SELECTED, THE INDICATORS WERE RANKED BY ORDER OF IMPORTANCE, AND THE REVIEW AND SELECTION OF MAJOR SECONDARY DATA SOURCES WAS FINALIZED. IN 2012, THE TOPICS AND SPECIFIC QUESTIONS TO INCLUDE IN THE EMPLOYER SURVEY WERE FINALIZED. IN JANUARY 2013, THE COMMUNITY SURVEY QUESTIONS WERE FINALIZED. TO UNDERSTAND THE HEALTH AND WELL-BEING OF STANISLAUS COUNTY RESIDENTS, A QUESTIONNAIRE WAS DESIGNED TO BE ADMINISTERED TO ADULTS LIVING IN THE COUNTY. PAPER VERSIONS WERE CREATED IN ENGLISH AND SPANISH. IN ADDITION, AN ELECTRONIC VERSION IN ENGLISH WAS MADE AVAILABLE THROUGH SURVEYMONKEY ON THE INTERNET. TRAINED PARTNERS AND VOLUNTEERS DISTRIBUTED AND COLLECTED SURVEYS BETWEEN APRIL AND AUGUST 2013, FOLLOWING A SURVEY PLAN DESIGNED TO CREATE A SURVEY REPRESENTATIVE OF THE COUNTY AS A WHOLE. RESPONDENTS WHO AGREED TO PARTICIPATE IN THE SURVEY WERE OFFERED THEIR CHOICE OF A SMALL DONATED INCENTIVE: A WOODEN SPOON, A MAGNETIZED NOTE PAD, SHOELACES, OR A PEDOMETER. IN 2013, THE CHA STEERING COMMITTEE AGREED THAT AN EXPERIENCED CONTRACTOR WAS NEEDED TO ANALYZE THE COMMUNITY SURVEY DATA, GIVEN LOCAL LIMITATIONS IN STAFFING AND RESOURCES, AND SELECTED THE FAMILY HEALTH OUTCOMES PROJECT (FHOP) FROM THE UNIVERSITY OF SAN FRANCISCO. TO DETERMINE WHETHER THE SURVEY PLAN WORKED AND THE SURVEY SAMPLE WAS REPRESENTATIVE OF THE COUNTY, SURVEYS THAT DID NOT INCLUDE GENDER, AGE, POVERTY STATUS, OR BOTH CITY AND ZIP CODE WERE EXCLUDED FROM THE ANALYSIS. FHOP THEN EXAMINED THE FINAL SAMPLE TO DETERMINE WHETHER IT MATCHED THE SURVEY PLAN TARGETS. THEY FOUND THAT FEMALE RESPONDENTS AND RESPONDENTS NOT LIVING IN POVERTY WERE OVER-REPRESENTED IN THE SURVEYS, WHILE SURVEYS FROM CERTAIN GEOGRAPHIC AREAS WERE UNDER-REPRESENTED, DESPITE ATTEMPTS TO ENSURE SURVEY RESPONDENTS' DEMOGRAPHICS MATCHED THAT OF THE SURVEY PLAN. TO MAKE THE SURVEY DATA MORE REPRESENTATIVE OF THE COUNTY'S POPULATION, FHOP STAFF APPLIED STATISTICAL WEIGHTING TO THE SURVEY DATA SET. ONCE WEIGHTED FREQUENCIES WERE CALCULATED, THE CONTRACTOR SENT THE FINDINGS IN THE FORM OF SAS OUTPUTS AND EXCEL FILES TO H.S.A. STAFF, WHICH IN TURN, CREATED GRAPHS AND TABLES AND REPORTED THE FINDINGS. THE CHA STEERING COMMITTEE WAS INTERESTED IN INCLUDING INFORMATION ABOUT LOCAL EMPLOYERS' CURRENT PRACTICE IN AND FUTURE PLANS FOR OFFERING HEALTH INSURANCE TO THEIR EMPLOYEES. TO THIS END, H.S.A. STAFF WORKED WITH THE STANISLAUS ECONOMIC DEVELOPMENT AND WORKFORCE ALLIANCE TO COLLECT RELEVANT DATA, CREATING THREE QUESTIONS TO BE ADDED TO THE 2013 ANNUAL EMPLOYER SURVEY CONDUCTED BY THE BUSINESS RESOURCE CENTER OF THE ALLIANCE. THE CHA EMPLOYER SURVEY QUESTIONS CONCERNED CURRENT EMPLOYER PRACTICES IN OFFERING HEALTH CARE TO THEIR EMPLOYEES, AS WELL AS THEIR PLANS FOR THE IMPLEMENTATION OF THE EMPLOYER MANDATE OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT IN 2014. THE CHA EMPLOYER SURVEY WAS ADMINISTERED ELECTRONICALLY THROUGH SURVEYMONKEY BY PROVIDING A LINK TO THE SURVEY IN THE ALLIANCE'S JANUARY 2013 NEWSLETTER. A TOTAL OF 215 EMPLOYERS PARTICIPATED. ALLIANCE PERSONNEL ANALYZED THE EMPLOYER SURVEY RESULTS USING SURVEYMONKEY AND SHARED THESE WITH H.S.A. STAFF, WHO IN TURN CREATED TABLES AND GRAPHS, AND WROTE UP THE FINDINGS. IN ORDER TO ASSESS THE HEALTH AND WELL-BEING OF THE COMMUNITY, INCLUDING UNDERLYING CAUSAL AND CONTRIBUTING FACTORS, MANY TOPICS WERE EXAMINED THROUGH SECONDARY DATA. SECONDARY DATA IS INFORMATION WHICH HAS ALREADY BEEN COLLECTED BY A SEPARATE ENTITY OR ORGANIZATION. THIS SECONDARY DATA INCLUDED INFORMATION FROM MULTIPLE SOURCES CONCERNING THE HEALTH AND WELL-BEING OF STANISLAUS COUNTY RESIDENTS. THE SECONDARY DATA WAS COMPILED, AND IN SOME CASES RE-ANALYZED, FOR THIS REPORT PRIMARILY BY H.S.A. PUBLIC HEALTH STAFF, WITH CONTRIBUTIONS BY SOME CHA STEERING COMMITTEE MEMBERS AND OUTSIDE PARTNERS. THE MOST UPDATED DATA AVAILABLE FROM EACH SOURCE WAS USED THROUGH DECEMBER 2013, WITH THE EXCEPTION OF TRENDING, WHICH REQUIRES MULTIPLE YEARS OF INFORMATION FOR COMPARISON; OR WHEN MULTIPLE YEARS NEEDED TO BE AGGREGATED TO IMPROVE STATISTICAL STABILITY. THE ANALYSIS WAS CONDUCTED BY BOTH H.S.A. PERSONNEL. ASSISTANCE WITH MAPPING FINDINGS WAS PROVIDED BY THE CENTRAL VALLEY HEALTH POLICY INSTITUTE AT THE CALIFORNIA STATE UNIVERSITY AT FRESNO. THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED IN THE 2013 CHNA: 1. ACCESS TO CARE 2. QUALITY OF CLINICAL CARE 3. MODIFIABLE RISK FACTORS FOR DISEASE 4. BEHAVIORAL RISK FACTORS FOR DISEASE 5. ENVIRONMENTAL RISK FACTORS 6. BURDEN OF DISEASE AN IN-DEPTH DESCRIPTION OF THE METHODOLOGY FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR MEMORIAL MEDICAL CENTER IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML MEMORIAL HOSPITAL LOS BANOS: MEMORIAL HOSPITAL LOS BANOS (MHLB) IS A PRIVATE, NONPROFIT COMMUNITY HOSPITAL INCORPORATED UNDER CALIFORNIA LAW TO PROVIDE HEALTH CARE SERVICES, WITHIN FINITE RESOURCES, TO CITIZENS OF LOS BANOS AND THE SURROUNDING GEOGRAPHICAL AREAS. IN ACCORDANCE WITH THE REQUIREMENTS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, MHLB CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT, TO ASSESS THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY IT SERVES. THE FINDINGS FROM THE ASSESSMENT PROVIDED THE HOSPITAL WITH THE NECESSARY INFORMATION TO DETERMINE HEALTH PRIORITIES, EMERGING GAPS, ONGOING NEEDS AND TO DEVELOP COMMUNITY HEALTH IMPROVEMENT IMPLEMENTATION PLANS. THE GOAL OF THIS REPORT IS TO HELP STIMULATE COLLABORATION AND COMMUNITY ACTION TO ADDRESS KEY HEALTH ISSUES AND DISPARITIES IN THE CITY. THE NEEDS ASSESSMENT USED A MIXED METHOD OF DATA COLLECTION APPROACH. THE PRIMARY DATA COLLECTED TO SUPPORT THE CHNA PROCESS CONSISTED OF A COMMUNITY NEEDS ASSESSMENT SURVEY AND INPUT FROM THE MERCED COUNTY DEPARTMENT OF PUBLIC HEALTH EXPERTS DURING THE VARIOUS STAGES OF THE CHNA. SECONDARY DATA INCLUDED DEMOGRAPHIC DATA, ECONOMIC DATA, CRIME DATA, CHILDHOOD OBESITY, TEEN PREGNANCY AND SENIOR HEALTH/MENTAL HEALTH AT THE CITY, COUNTY AND STATE LEVELS WITH RESPECT TO THE IDENTIFIED HEALTH NEEDS. WHILE THE SURVEY DATA THAT WAS COLLECTED DOES NOT STEM FROM A REPRESENTATIVE SURVEY, THE INFORMATION STILL PROVIDES MEANINGFUL FEEDBACK FROM LOS BANOS RESIDENTS AS IT RELATES TO ACCESS TO HEALTH CARE, CRIME AND NEIGHBORHOOD SAFETY, AVAILABILITY OF HEALTHY FOOD, PHYSICAL FITNESS AND OVERALL QUALITY OF LIFE INDICATORS. A QUESTIONNAIRE WAS DEVELOPED IN ENGLISH AND SPANISH. MEMBERS OF THE COMMUNITY (WHICH INCLUDES MEDICALLY UNDERSERVED, LOW-INCOME, AND ETHNIC MINORITIES) WERE SURVEYED AT THE LOCAL TOMATO FESTIVAL, THE LOCAL SUPERMARKET (SAVE MART), LOS BANOS UNIFIED SCHOOL DISTRICT (LBUSD), A FLU CLINIC AND A NUMBER OF SURVEYS WERE OBTAINED VIA TELEPHONE. FURTHER INPUT WAS GATHERED FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVICED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. MORE SPECIFICALLY, THE MERCED COUNTY DEPARTMENT OF PUBLIC HEALTH WAS REPRESENTED BY DR. TIM LIVERMORE (DIRECTOR OF PUBLIC HEALTH), JENNIFER ANDRADE, RN, AND LAURA ROBERTS, RN. THEIR PARTICIPATION AND INPUT CENTERED ON NEEDS ASSESSMENT PLANNING AND/OR PROJECT MEETINGS. AFTER REVIEW OF THE SECONDARY AND PRIMARY DATA, A LIST OF NEEDS AND ISSUES WAS IDENTIFIED. THE WESTSIDE NEEDS ASSESSMENT COLLABORATIVE (WNAC) HELD MEETINGS WITH COMM SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER CENTRAL VALLEY HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. FOR A MORE DETAILED LOOK AT OUR CHARITY CARE POLICIES BY REGION, PLEASE VISIT THE OFFICE OF STATEWIDE AND HEALTH PLANNING'S WEBSITE AT HTTP://SYFPHR.OSHPD.CA.GOV. COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS). B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION". 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION". B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: MEMORIAL MEDICAL CENTER: MEMORIAL MEDICAL CENTER'S HOSPITAL SERVICE AREA IS DEFINED AS STANISLAUS COUNTY. THE OTHER HOSPITALS SERVICING THIS AREA INCLUDE: - KAISER PERMANENTE, MODESTO - DOCTOR'S MEDICAL CENTER, MODESTO - EMANUEL HOSPITAL, TURLOCK LOCATION AND POPULATION SIZE - STANISLAUS COUNTY IS LOCATED IN THE SAN JOAQUIN VALLEY (THE HEART OF CALIFORNIA'S CENTRAL VALLEY), A MAJOR PRODUCER OF AGRICULTURAL PRODUCTS FOR THE US AND WORLD. - OVER 1,500 SQUARE MILES IN SIZE, STANISLAUS COUNTY INCLUDES RURAL AGRICULTURAL AREAS, SMALL AND MEDIUM-SIZED TOWNS, AND THE COUNTY SEAT OF MODESTO. - STANISLAUS COUNTY IS INCLUDED IN THE MODESTO METROPOLITAN STATISTICAL AREA, ONE OF THE NATION'S 100 LARGEST METROPOLITAN AREAS. - STANISLAUS COUNTY HAS A POPULATION OF 514,453 RESIDENTS (2010 US CENSUS). GENDER AND AGE - STANISLAUS COUNTY HAS A BALANCE BETWEEN MALES AND FEMALES (49.5% VS. 50.5%: 2010 US CENSUS). - STANISLAUS COUNTY RESIDENTS ARE YOUNGER, OVERALL, THAN CALIFORNIA RESIDENTS, WHERE THE MEDIAN AGE IS 35.2 (2010 US CENSUS). - LIKE THE NATION AS A WHOLE, STANISLAUS COUNTY IS AGING. THE AVERAGE AGE IN STANISLAUS INCREASED FROM 29.2 YEARS IN 1980 TO 32.8 YEARS OF AGE IN 2010 (US CENSUS). RACE AND ETHNICITY - THE POPULATION OF STANISLAUS IS PREDOMINANTLY WHITE (65.6%), WHILE FIVE PERCENT OF THE RESIDENTS ARE ASIANS (2010 US CENSUS). AFRICAN AMERICANS, WHO NUMBERED 3,035 IN 1980, INCREASED TO 14,721 (OR 2.9% OF RESIDENTS) IN 2010 (US CENSUS). - DURING THIS TIME PERIOD, STANISLAUS COUNTY HAS ALSO BECOME MORE ETHNICALLY DIVERSE: THE PROPORTION OF LATINOS GREW FROM 15% IN 1980 TO 41.9% IN 2010. STANISLAUS ("THE COUNTY") HAS A HIGHER PERCENTAGE OF LATINOS THAN CALIFORNIA ("THE STATE"), FOR WHICH 37.6% OF THE POPULATION IS LATINO (2010 US CENSUS). ORIGINS AND LANGUAGE - TWENTY-ONE PERCENT OF THE COUNTY'S POPULATION IS FOREIGN-BORN (2009-2011 ACS). - OF FOREIGN BORN RESIDENTS, 67% ARE FROM LATIN AMERICA, 23% FROM ASIA, 3% FROM EUROPE, 3% FROM OCEANIA AND LESS THAN 1% EACH FROM AFRICA AND NORTH AMERICA (2009-2011 ACS). - RECENT WARS AND INSTABILITY IN THE MIDDLE EAST HAVE LED TO AN INCREASING SUB-POPULATION OF ASSYRIAN REFUGEES FROM IRAQ AND IRAN, A GROUP WHICH IS NOT CATEGORIZED SEPARATELY IN US CENSUS BUREAU METHODOLOGY. - EVEN MORE RECENTLY, REFUGEES FROM BURMA HAVE BEGUN TO ARRIVE IN THE COUNTY. - STANISLAUS COUNTY RESIDENTS ARE ALSO LINGUISTICALLY DIVERSE; 41.3% OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (2011 ACS). OF THESE, 31.6% SPEAK SPANISH OR SPANISH CREOLE. SOCIOECONOMIC STATUS STANISLAUS COUNTY, LIKE OTHER SEMI-RURAL CENTRAL VALLEY COUNTIES, HAS GREATER SOCIO-ECONOMIC CHALLENGES THAN CALIFORNIA AS A WHOLE, INCLUDING LOWER INCOME, HIGHER POVERTY, GREATER USE OF PUBLIC ASSISTANCE PROGRAMS, GREATER UNEMPLOYMENT AND LESS EDUCATIONAL ATTAINMENT. LIKE ITS CENTRAL VALLEY NEIGHBORS, STANISLAUS COUNTY IS LESS WEALTHY THAN COASTAL CALIFORNIA COUNTIES. - THE MEDIAN HOUSEHOLD INCOME OF THE COUNTY IS LOWER (BY APPROXIMATELY 24%) THAN THAT OF THE STATE ($48,170 VS. $59,641, 2009-2011 ACS). - LIKEWISE, THE PER CAPITA INCOME IS 37% LOWER IN THE COUNTY ($20,793) THAN STATE ($28,504; 2009-2011 ACS). A HIGHER PERCENTAGE OF STANISLAUS COUNTY RESIDENTS (23.8%) AND FAMILIES (18.5%) LIVE BELOW THE FEDERAL POVERTY LEVEL (FPL) THAN CALIFORNIA RESIDENTS (16.6%) AND FAMILIES (12.4%; 2011 ACS). AN AGRICULTURAL BASE (USING MIGRANT LABOR) AND SEASONAL EMPLOYMENT (E.G. IN THE FOOD PROCESSING INDUSTRY) HAVE HISTORICALLY CAUSED RELATIVELY HIGH UNEMPLOYMENT, CONTRIBUTING TO STANISLAUS COUNTY'S LOWER OVERALL PROSPERITY. AS OF APRIL 2013, THE UNEMPLOYMENT RATE FOR STANISLAUS COUNTY WAS 13.4%, COMPARED TO 8.5% FOR CALIFORNIA AND 7.1% FOR THE US (RATES NOT SEASONALLY ADJUSTED; CALIFORNIA ECONOMIC DEVELOPMENT DEPARTMENT, BUREAU OF LABOR STATISTICS, 2013). MUCH RESEARCH HAS SHOWN THAT EDUCATION IS RELATED TO HEALTH; THOSE WITH A HIGHER DEGREE OF EDUCATION ARE GENERALLY HEALTHIER, ARE LESS LIKELY TO SELF-REPORT A CHRONIC DISEASE DIAGNOSIS, AND ARE MORE LIKELY TO SURVIVE INTO OLD AGE THAN THOSE WITH LESS EDUCATION (E.G. CULTER & LLERAS-MUNEY, 2007). - STANISLAUS COUNTY'S PATTERN OF EDUCATIONAL ATTAINMENT SHOWS A POPULATION AT RISK FOR POOR OVERALL HEALTH. - IN STANISLAUS, ONLY 16.5% OF THE POPULATION AGED 25 YEARS AND OLDER HAVE A BACHELOR'S OR GRADUATE DEGREE, COMPARED TO 30.1% IN CALIFORNIA (2007-2011 ACS). - ALMOST 60% OF STANISLAUS RESIDENTS (COMPARED TO 51% OF CALIFORNIANS) HAVE ONLY A HIGH SCHOOL DIPLOMA, SOME COLLEGE CREDITS OR AN ASSOCIATE'S DEGREE (US 2007-2011 ACS). - LOWER EDUCATIONAL ATTAINMENT IS ALSO A RISK FACTOR FOR POVERTY. - IN 2007-2011, AMONGST THE STANISLAUS RESIDENTS WHO WERE 25 YEARS OF AGE OR OLDER AND LIVED BELOW THE POVERTY LEVEL, 27.6% DID NOT GRADUATE FROM HIGH SCHOOL, 18.4% WERE HIGH SCHOOL GRADUATES, AND 11.2% HAD SOME COLLEGE CREDITS (2007-2011 ACS). ONLY 5.0% OF THOSE LIVING IN POVERTY HELD A BACHELOR'S DEGREE (COMPARED TO 16.5% OF THE GENERAL POPULATION). THE ECONOMIC RECESSION HAS HAD A GREATER EFFECT ON STANISLAUS COUNTY THAN ON CALIFORNIA AS A WHOLE. WHILE THERE HAS BEEN EVIDENCE OF RECOVERY, THE COUNTY IS EXPERIENCING A SLOWER RECOVERY THAN OTHER AREAS IN THE STATE AND NATION. - BETWEEN 2005-2007 AND 2009-2011, STANISLAUS' MEDIAN HOUSEHOLD INCOME DECREASED $2,205 (FROM $50,375 TO $48,170), WHILE CALIFORNIA'S INCREASED $1,280 (FROM $58,361 TO $59,641; 2005-2007 ACS AND 2009-2011 ACS). - BETWEEN 2006 AND 2011, THE PERCENTAGE OF CALIFORNIA RESIDENTS WHO PARTICIPATED IN THE SNAP (FOOD STAMP) PROGRAM ROSE FROM 4.3% TO 8.3% WHILE PARTICIPATION IN STANISLAUS COUNTY ROSE FROM 7.1% TO 14.7% (2006 & 2011 ACS). - AS OF APRIL 2013, THE COUNTY'S MONTHLY UNEMPLOYMENT RATE WAS 13.4%, COMPARED TO 8.5% FOR CALIFORNIA AND 7.1% FOR THE US. - THE MEDIAN HOME SALE PRICE IN STANISLAUS DECREASED BY 62% DURING THE RECESSION: $339,000 IN 2007 TO $130,000 IN 2011 (REALTYTRAC, 2011). AS OF MARCH, 2013, THE MEDIAN HOME PRICE HAS RISEN SLIGHTLY TO $140,000 (REALTYTRAC, 2013A), ONLY 41% OF THE MEDIAN VALUE IN 2007. - BETWEEN 2007 AND 2012, STANISLAUS COUNTY HAD ALSO CONSISTENTLY BEEN RANKED AS ONE OF THE NATION'S LEADERS IN FORECLOSURES (REALTYTRAC, 2011). AS OF 2013, STANISLAUS (AND THE MODESTO METROPOLITAN STATISTICAL AREA) WERE NO LONGER LISTED AMONG THE WORST 10 AREAS FOR FORECLOSURES IN THE COUNTRY (REALTYTRAC, 2013). AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA, WITH SOURCES, IS AVAILABLE IN THE MEMORIAL MEDICAL CENTER'S 2013 CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML MEMORIAL HOSPITAL LOS BANOS: THE HOSPITAL SERVICE AREA (HSA) IS DEFINED AS THE GEOGRAPHIC AREA THAT IS SERVED BY THE HOSPITAL. MEMORIAL HOSPITAL LOS BANOS' HSA WAS DETERMINED ON THE BASIS THAT IT IS THE ONLY FULL SERVICE HOSPITAL WITHIN 35 MILES. THE COMMUNITIES THAT FALL WITHIN THIS RANGE ARE THE CITIES OF LOS BANOS (WHICH INCLUDES SANTA NELLA) AS WELL AS DOS PALOS AND GUSTINE. THE OTHER HOSPITAL SERVICING THIS AREA IS MERCY MERCED MEDICAL CENTER. IT IS IMPORTANT TO NOTE THAT AT LEAST 75% OF HOSPITAL DISCHARGES ORIGINATED FROM THESE CITIES. IN 2010, THE POPULATION IN THESE THREE CITIES WAS 35,792; 4,950; AND 1,380 RESPECTIVELY. MEMORIAL HOSPITAL LOS BANOS AND THESE CITIES ARE SITUATED IN THE SOUTHWESTERN PART OF MERCED COUNTY, CALIFORNIA. THE RACIAL AND ETHNIC MAKEUP OF LOS BANOS INCLUDES WHITES (58%) WITH HISPANIC AND LATINO AMERICANS FORMING THE LARGEST MINORITY GROUP AND POPULATION GROUP COMPRISING 64.9% OF THE POPULATION, BLACKS (3.8%), AND ASIANS (3.2%). MORE THAN HALF (55.7%) OF THE RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME AND ABOUT ONE IN FOUR DO NOT HAVE A HIGH SCHOOL DIPLOMA. THE UNEMPLOYMENT FOR LOS BANOS IN 2012 WAS 21.0% WHICH WAS SIGNIFICANTLY HIGHER THAN THAT OF CALIFORNIA AT 11.4%. SUTTER TRACY COMMUNITY HOSPITAL: MANY HOSPITALS DEFINE THE COMMUNITY AS THE GEOGRAPHIC AREA SERVED BY THE HOSPITAL, CONSIDERED ITS PRIMARY SERVICE AREA. THIS IS BASED ON A PERCENTAGE OF HOSPITAL DISCHARGES AND IS ALSO USED IN VARIOUS OTHER DEPARTMENTS OF THE SYSTEM AND HOSPITAL, INCLUDING STRATEGY AND PLANNING. THE HSA WAS DETERMINED BY ANALYZING PATIENT DISCHARGE DATA FROM EACH OF THE PARTICIPATING HOSPITALS, AND TAKING INTO ACCOUNT THE INTEREST AMONG SEVERAL ORGANIZATIONS TO COLLABORATE ON THIS NEEDS ASSESSMENT. FURTHER ANALYSIS OF THE DATA REVEALED TEN SPECIFIC COMMUNITIES OF CONCERN, INCLUDING ZIP CODE 95376 (TRACY). ZIP CODE 95376 IS HOME TO 49,859 RESIDENTS. WITHIN THIS ZIP CODE, 62% OF THE POPULATION WAS CONSIDERED NON-WHITE OR HISPANIC. 8.2% WERE UNINSURED AND 13.8% DID NOT HAVE HEALTH INSURANCE. 17% OF INDIVIDUALS OVER THE AGE OF 25 DID NOT HAVE A HIGH SCHOOL DIPLOMA. THE COMMUNITIES OF CONCERN FOR SAN JOAQUIN HSA ARE: ZIP CODE COMMUNITY/AREA COUNTY POPULATION* 95202 STOCKTON/DOWNTOWN SAN JOAQUIN 6,934 95203 STOCKTON/DOWNTOWN SAN JOAQUIN 17,137 95204 STOCKTON/CENTRAL SAN JOAQUIN 27,786 95205 STOCKTON/SOUTHEAST SAN JOAQUIN 38,069 95206 STOCKTON/SOUTHWEST SAN JOAQUIN 65,004 95231 FR SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE 2013-2015 IMPLEMENTATION STRATEGY FOR SUTTER CENTRAL VALLEY HOSPITALS DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW. MEMORIAL MEDICAL CENTER: MEMORIAL MEDICAL CENTER HAS PARTNERED WITH OTHER HEALTHCARE FACILITIES IN STANISLAUS COUNTY TO PROVIDE A PRIMARY CARE PHYSICIAN TRAINING PROGRAM FOR PHYSICIANS THROUGH THE VALLEY CONSORTIUM FOR MEDICAL EDUCATION - FAMILY PRACTICE. MEMORIAL MEDICAL CENTER PROVIDES CONSISTENT FUNDING TO SUPPORT THIS NEEDED PROGRAM. THE PROGRAM ENHANCES THE CARE TO THE INDIGENT POPULATION AND INCREASES PROVIDERS. THE VALLEY FAMILY MEDICINE RESIDENCY OF MODESTO HAS TRAINED AND GRADUATED 58 PHYSICIANS OVER THE PAST 5 YEARS OF THE PROGRAM. OVER 50% OF THESE GRADUATES HAVE STAYED IN THE CENTRAL VALLEY, THUS INCREASING THE NUMBER OF PROVIDERS BY 29. THERE ARE APPROXIMATELY 300 PRIMARY PHYSICIAN PROVIDERS IN THE COMMUNITY AND THIS PROGRAM HAS INCREASED THE NUMBER OF PROVIDERS BY ALMOST 10%. PREGNANCY 101 AT MEMORIAL MEDICAL CENTER IS A PROGRAM THAT PROVIDES PRE-CHILD BIRTH EDUCATION. THESE CLASSES ARE OPEN TO THE PUBLIC, AND IS AVAILABLE TO ANYONE ON MEDI-CAL OR WITHOUT INSURANCE. THESE CLASSES FOCUS ON IMPROVED MANAGEMENT OF THE EARLY STAGES OF PREGNANCY ENCOMPASSING ACTIVITY, NUTRITION AND SUPPLEMENTS. MEMORIAL MEDICAL CENTER PROVIDES NURSING STAFF AND EDUCATIONAL MATERIALS TO SUPPORT THIS PROGRAM. IN 2014, PARTICIPANTS INDICATED THAT THE PROGRAM WAS "SUPER INFORMATIVE," "CONTENT WAS EASY TO FOLLOW," "I LEARNED A LOT," AND "GREAT INFORMATION HELPED WITH MY FEARS" - PROVING THAT THE PROGRAM IS BENEFICIAL FOR THE UNDERSERVED COMMUNITY. FOR SCHOOL AGE CHILDREN WHO LIVE IN UNDERSERVED OR RURAL AREAS, AFTER SCHOOL PROGRAMS FOR THE COUNTY AND THROUGH BOYS AND GIRLS CLUB (BGC) PROVIDE AN EXCELLENT ENVIRONMENT FOR TEACHING HEALTHY BEHAVIORS. YOUTH ARE GIVEN TRAINING IN GOOD NUTRITION AND IN INCREASING EXERCISE AND ACTIVITIES TO REDUCE THE INCIDENCE OF OBESITY IN CHILDREN. THE AFTERSCHOOL PROGRAM HAS 38 SCHOOL SITES IN THREE COUNTIES THAT SERVE OVER 3200 STUDENTS PER DAY. THE BOYS AND GIRLS CLUB 2014 IMPACT SURVEY REPORTED THAT 78% OF STUDENTS DEMONSTRATED IMPROVED ATTENDANCE AND 80% HAD IMPROVED ACADEMIC PERFORMANCE DUE TO THEIR PARTICIPATION IN THE BGC OVER THE PRIOR YEAR. THE STANISLAUS COUNTY OF EDUCATION (SCOE) AFTER SCHOOL PROGRAM HAD 75% OF STUDENTS MAKE APPROPRIATE FOOD CHOICES WHEN TESTED. MEMORIAL MEDICAL CENTER PROVIDES A CASH DONATION TO THE SCOE AND THE BOYS AND GIRLS CLUB TO SUPPORT THE AFTER SCHOOL PROGRAMS. THE STANISLAUS COUNTY OFFICE OF EDUCATION (SCOE) PHAST ANTI-SMOKING PROGRAM FOR YOUTH HAS PARTNERED WITH MEMORIAL MEDICAL CENTER TO PROVIDE TOBACCO PREVENTION EDUCATION (TPE) TO GRADES 6 - 12 IN STANISLAUS COUNTY. THROUGH THE PHAST YOUTH COALITION, THIS PARTNERSHIP ENCOURAGES STUDENTS WHO HAVE NOT MADE THE DECISION TO BE HEALTHY OR THOSE MOST AT RISK FOR TOBACCO USE. MEMORIAL MEDICAL CENTER IS COMMITTED TO ONGOING FUNDING OF THIS PROGRAM AS THE BENEFITS ARE NUMEROUS AND BROAD. IN 2014, 4,890 HIGH SCHOOL AND MIDDLE SCHOOL STUDENTS WERE EXPOSED TO THE TPE PROGRAMS AND THE PHAST ORGANIZATION, PLUS 80 PARENTS AND COLLEGE-AGE STUDENTS. RESULTS FROM COUNTYWIDE SURVEYS SHOW THAT REDUCTIONS IN USE OF CIGARETTES, TOBACCO AND SNUFF HAVE DECREASED DRAMATICALLY. IN ADDITION, A COUNTYWIDE SURVEY INDICATES REDUCTIONS IN USE OF THESE PRODUCTS HAVE DECREASED BY 20% - 23% IN 7TH AND 9TH GRADERS. AS THE ONLY CARDIAC REHAB, PULMONARY REHAB AND CONGESTIVE HEART FAILURE PROGRAM IN THE SERVICE AREA, MEMORIAL MEDICAL CENTER PROVIDES TRAINING AND EDUCATION FOR PATIENTS WHO HAVE EXPERIENCED A HEART EVENT OF COPD OR CHF DIAGNOSIS. CHRONIC DISEASE MANAGEMENT CONTINUES TO BE A SIGNIFICANT IDENTIFIED HEALTH NEED IN THE COMMUNITY. MEMORIAL MEDICAL CENTER PROVIDES A COMPREHENSIVE DIABETES PROGRAM OPEN TO ALL PATIENTS, INCLUDING MEDI-CAL MANAGED CARE PROGRAM, HEALTH PLAN OF SAN JOAQUIN COUNTY. THESE PROGRAMS ARE OPEN TO THE PUBLIC IF ACCOMPANIED BY A PHYSICIAN REFERRAL. ALL PROGRAMS RETRAIN PATIENTS TO IMPROVE THEIR LIFE AND HEALTH STATUS WITH BEHAVIOR MODIFICATION. MEMORIAL MEDICAL CENTER PROVIDES NURSING STAFF, AN EXERCISE PHYSIOLOGIST, DIABETES EDUCATORS, DIETICIANS AND ALL NECESSARY MATERIALS FOR THESE PROGRAMS. THE PULMONARY INDEPENDENCE PROGRAM SHOWED A 32% INCREASE IN PATIENT FUNCTION OVER PRE-PROGRAM PERFORMANCE IN 2014. THE CHF PROGRAM INDICATED THAT READMISSION RATES WERE REDUCED FROM 19% IN 2013 TO 18.3% IN 2014 (BASELINE YEAR WAS 21%). THE RATE OF SCREENING FOR TYPE 2 DM FOR DIABETES GESTATIONAL PATIENTS INCREASED FROM 9% AT THE BEGINNING OF 2014 TO 33% BY THE END OF THE YEAR. DUE TO THESE DTP INTERVENTIONS, THE NUMBER OF PATIENTS SCREENED INCREASED. THE CARDIAC REHAB PROGRAM DID A SURVEY WHERE 100% OF RESPONDENTS SURVEYED INDICATED THEY HAD AN IMPROVED QUALITY OF LIFE DUE TO PARTICIPATION IN THE PROGRAM, AND 100% INDICATED THAT THEY ARE NOW EXERCISING REGULARLY AS COMPARED TO PRE-PROGRAM. MEMORIAL MEDICAL CENTER SUPPORTS THE AMERICAN CANCER SOCIETY'S MODESTO RELAY FOR LIFE WHICH IS A TWENTY-FOUR HOUR FUNDRAISING CANCER AWARENESS EVENT. MONEY RAISED BENEFITS CANCER PATIENTS IN SERVICES PROVIDED WITH 80% OF MONEY RAISED STAYING WITHIN THE COMMUNITY AND 20% GOING TOWARDS RESEARCH. MEMORIAL MEDICAL CENTER SUPPORTS THE AMERICAN HEART ASSOCIATION BY SPONSORING THE ANNUAL HEARTWALK AS WELL AS FUNDRAISING EFFORTS TO SUPPORT THE CAMPAIGN. MEMORIAL MEDICAL CENTER HOSTS AN ASTHMA FAIR AND CONFERENCE TO INCREASE THE PROFESSIONAL COMMUNITY'S SKILLS AND KNOWLEDGE ABOUT DIAGNOSING AND TREATING ASTHMA PATIENTS. MEMORIAL MEDICAL CENTER SUPPORTS THE BOYS AND GIRLS CLUB OF STANISLAUS COUNTY TO IMPROVE EDUCATIONAL OPPORTUNITIES, PROVIDE A SAFE ENVIRONMENT, AND TEACH HELPFUL PRACTICES FOR BOYS AND GIRLS IN THEIR UNDERSERVED AREAS. MEMORIAL HOSPITAL LOS BANOS (MHLB): IN MEMORIAL HOSPITAL LOS BANOS' SERVICE AREA, THERE IS A NEED TO PROVIDE ACTIVITIES FOR CHILDREN. MHLB CONTINUES TO LOOK AT WAYS TO PARTNER WITH THE POLICE ACTIVITIES LEAGUE AND THE LOS BANOS RECREATION PROGRAM TO IMPROVE PHYSICAL ACTIVITY PROGRAMS FOR YOUTH IN THE COMMUNITY. THE FREE FAMILY HEALTH FAIR ALLOWS TARGETED COMMUNITY MEMBERS ACCESS TO HEALTH SCREENINGS AND RESOURCES. PEOPLE OF ALL AGES AND CULTURES ARE PROVIDED FITNESS AND NUTRITIONAL INFORMATION THAT HELPS ADDRESS OBESITY, CHRONIC CONDITIONS AND OVERALL GENERAL HEALTH. IN ADDITION, FOLLOW-UP ON ANY OF THE HEALTH SCREENINGS AND APPROPRIATE REFERRALS ARE GIVEN AS NEEDED. THE FAIR WAS NOT HELD IN 2014, BUT WITH THE ADDITION OF A NEW RURAL HEALTH CLINIC MANAGER, THE PLAN IS CONDUCT THIS FAIR IN 2015 AND BEYOND. MEMORIAL HOSPITAL LOS BANOS SPONSORS A TAXI VOUCHER PROGRAM, WHICH PROVIDES VOUCHERS AT DISCHARGE FOR MEDICALLY-INDIGENT PATIENTS NEEDING TRANSPORTATION ASSISTANCE. IN 2014, 146 PATIENTS WERE PROVIDED TAXI VOUCHERS. MHLB PROVIDES DIABETES EDUCATION TO SUPPORT COMMUNITY MEMBERS IN THEIR ABILITY TO TAKE CHARGE OF HEALTH CHALLENGES RELATED TO DIABETES. IN COLLABORATION WITH THE MERCED COUNTY PUBLIC HEALTH DEPARTMENT, A CHRONIC DISEASE MANAGEMENT PROGRAM WAS OFFERED TO THE COMMUNITY IN 2014. TWO STAFF MEMBERS WERE TRAINED AS CDMP INSTRUCTORS. CLASSES WERE LED IN BOTH ENGLISH AND SPANISH. MEMORIAL HOSPITAL LOS BANOS PARTNERS WITH SEVERAL NOT FOR PROFIT ORGANIZATIONS EACH YEAR SUCH AS THE AMERICAN HEART ASSOCIATION, THE AMERICAN CANCER SOCIETY AND THE MARCH OF DIMES TO SUPPORT THEIR EFFORTS THROUGHOUT THEIR COMMUNITIES. MEMORIAL HOSPITAL LOS BANOS SUPPORTS SEVERAL LOCAL ORGANIZATIONS SUCH AS SUPERIORLAND KIWANIS, THE LOS BANOS WILD CAT FOOTBALL AND THE SOROPTIMIST GIRL'S SELF-ESTEEM EVENT. SUTTER TRACY COMMUNITY HOSPITAL: THE COMMUNITY PARTNERSHIP FOR FAMILIES OF SAN JOAQUIN (CPFSJ) FAMILY RESOURCE CENTER WAS DESIGNED TO PROVIDE THE COMMUNITY WITH THE NEEDED RESOURCES RELATED TO ACCESS TO HEALTH CARE ALONG WITH OTHER HEALTH AND SOCIAL SERVICE RESOURCES AND IS FOCUSED IN IMPROVING ACCESS TO HEALTH CARE. THROUGH A STREAMLINED REFERRAL PROCESS WITH THE HOSPITAL'S EMERGENCY AND CASE MANAGEMENT DEPARTMENTS, THE FAMILY RESOURCE CENTER INTERCEPTS UNINSURED INDIVIDUALS UPON D SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: SUTTER CENTRAL VALLEY HOSPITALS ARE AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF HOSPITALS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS WHO CARE FOR PEOPLE WHO LIVE IN MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. THE HOSPITAL'S MISSION IS TO ENHANCE THE WELL-BEING OF THE PEOPLE IN OUR COMMUNITIES THROUGH COMPASSION, EXCELLENCE AND INNOVATION IN HEALTH CARE SERVICES, RESEARCH AND EDUCATION. OVER THE PAST FIVE YEARS, SUTTER HEALTH HAS COMMITTED NEARLY $4 BILLION TO CARE FOR PATIENTS WHO COULDN'T AFFORD TO PAY, AND TO SUPPORT PROGRAMS THAT IMPROVE COMMUNITY HEALTH. OUR 2014 COMMITMENT OF $767 MILLION INCLUDES UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, TRADITIONAL CHARITY CARE AND INVESTMENTS IN HEALTH EDUCATION AND PUBLIC BENEFIT PROGRAMS. FOR EXAMPLE: - TO PROVIDE CARE TO MEDI-CAL PATIENTS IN 2014, SUTTER HEALTH INVESTED $535 MILLION MORE THAN THE STATE PAID. SUTTER HEALTH HOSPITALS PROUDLY SERVE MORE MEDI-CAL PATIENTS IN OUR NORTHERN CALIFORNIA SERVICE AREA THAN ANY OTHER HEALTH CARE PROVIDER. - IN 2014, SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS WAS $91 MILLION. OUR CHARITY CARE INVESTMENT REPRESENTED AN AVERAGE OF NEARLY $1.8 MILLION PER WEEK. - THROUGHOUT OUR HEALTH CARE SYSTEM, WE PARTNER WITH AND SUPPORT COMMUNITY HEALTH CENTERS TO ENSURE THAT THOSE IN NEED HAVE ACCESS TO PRIMARY AND SPECIALTY CARE. WE ALSO SUPPORT CHILDREN'S HEALTH CENTERS, FOOD BANKS, YOUTH EDUCATION, JOB TRAINING PROGRAMS AND SERVICES THAT PROVIDE COUNSELING TO DOMESTIC VIOLENCE VICTIMS. EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESSES REAL COMMUNITY NEEDS. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: CALIFORNIA true COMMUNITY PARTNERSHIP FOR FAMILIES PO BOX 1569 STOCKTON CA 952011565 680475602 501(C)(3) 447139 GENERAL SUPPORT VALLEY CONSORTIUM FOR MEDICAL EDUCATION 1400 FLORIDA AVE STE 200 MODESTO CA 95350 270506209 501(C)(3) 386950 GENERAL SUPPORT BOYS AND GIRLS CLUB OF TRACY 753 W LOWELL AVE TRACY CA 95376 680028682 501(C)(3) 52500 GENERAL SUPPORT MARCH OF DIMES 1729 TULLY RD STE 6 MODESTO CA 95350 131846366 501(C)(3) 18000 GENERAL SUPPORT WOMENS CENTER OF SAN JOAQUIN COUNTY 620 NO SAN JOAQUIN ST STOCKTON CA 95202 942341360 501(C)(3) 15000 GENERAL SUPPORT SUTTER GOULD MEDICAL FOUNDATION 600 COFFEE RD MODESTO CA 95355 941682256 501(C)(3) 12595 GENERAL SUPPORT AMERICAN CANCER SOCIETY 1101 SYLVAN AVE STE C-105 MODESTO CA 95350 941170350 501(C)(3) 12500 GENERAL SUPPORT FILIPINO AMERICAN MED ASSN OF CTR VALLEY 7428 RIVERNINE DR MODESTO CA 95356 020740755 501(C)(3) 10000 GENERAL SUPPORT SALVATION ARMY 625 I ST PO BOX 1663 MODESTO CA 95354 941170408 501(C)(3) 7600 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 2007 O ST SACRAMENTO CA 95814 941219116 501(C)(3) 5025 GENERAL SUPPORT 10 X true true false true false false false false false true false PATRICK ANDERSON REGIONAL CIO, CENTRAL VALLEY 0 90958 0 166172 0 45133 0 17885 0 2488 0 322636 0 0 DAVID P BENN REGIONAL PRES, CENTRAL VALLEY 0 586713 0 440011 0 103888 0 305542 0 21312 0 1457466 0 98900 SUSAN C DONKER REGIONAL VP HR, CENTRAL VALLEY 0 255455 0 142054 0 15182 0 50910 0 14929 0 478530 0 14100 PATRICK FRY PRESIDENT & CEO, SUTTER HEALTH 0 1523132 0 1687050 0 416185 0 2693377 0 34953 0 6354697 0 396136 ASIT GOKLI MD REGIONAL VP & CMO, CV 0 451298 0 230349 0 47527 0 174901 0 14530 0 918605 0 36034 GARY HARRELL VP & REG COUNSEL, CNTRL VALLEY 0 258183 0 124820 0 16243 0 48207 0 11033 0 458486 0 15222 JOE HIRT CFO, CENTRAL VALLEY REGION 0 330120 0 187981 0 28888 0 71921 0 11150 0 630060 0 21100 SARAH KREVANS COO SUTTER HEALTH 0 916159 0 689878 0 156449 0 399554 0 24683 0 2186723 0 142787 DARYN KUMAR CEO, MEMORIAL MEDICAL CTR. 0 413547 0 201093 0 48237 0 92965 0 17332 0 773174 0 18198 RICHARD LISZEWSKI ADMIN, MEMORIAL HOSP LOS BANOS 0 59040 0 166257 0 34415 0 20272 0 4251 0 284235 0 0 BETTY LOPEZ PATIENT CARE SERVICE EXECUTIVE 0 275437 0 69592 0 25645 0 41672 0 13957 0 426303 0 0 THEODORE A MATSON REG VP, STRGY & BUS DEV, CV 0 178978 0 55795 0 24561 0 10600 0 9898 0 279832 0 6300 TIMOTHY NOAKES AA, FINANCE & CFO, STCH/MHLB 0 205332 0 73428 0 12102 0 50065 0 14866 0 355793 0 11639 JENNIFER A SVIHUS REGIONAL VP, PHILANTHROPY, CV 0 204990 0 78936 0 12614 0 43995 0 18401 0 358936 0 12300 DAVID M THOMPSON CEO, STCH 0 329451 0 192477 0 42703 0 86665 0 16391 0 667687 0 31807 JAMES CONFORTI PRESIDENT, SHSSR 0 594704 0 425250 0 54856 0 309954 0 22054 0 1406818 0 50081 ERIC DALTON SH VP, SHARED SERVICES 0 284740 0 72277 0 8701 0 45846 0 6488 0 418052 0 8385 JAMES STUART REGIONAL CIO, CV 271824 0 56376 0 37534 0 0 0 0 0 365734 0 0 0 SCHEDULE J, PART I, LINE 1A RELEVANT INFORMATION REGARDING COMPENSATION ITEMS: TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY. SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR EARNINGS BEYOND THE PENSION PAY CAP. THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP): THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS: SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE. A CSCDA 2003AB 680164610 130795EE3 2007-05-01 101118867 CONSTRUCTION & REFUNDING - 1/30/03 false false false B CSCDA 2004CD 680164610 130795TE7 2008-05-06 87750717 CONSTRUCTION & REFUNDING - 2/17/04 false false false C CHFFA 2007A 521643828 13033FQ37 2007-05-01 790998316 CONSTRUCTION false false false D CHFFA 2008A 521643828 13033F2L3 2008-05-14 329041638 REFUNDEDING - 2007, 2004 & 2002 false false false A 0 0 105555193 8937127 0 0 0 0 0 0 96618066 0 true false true true B 18180000 0 88924485 8608201 0 0 0 0 0 0 80316284 0 true false true true C 0 0 858694930 0 55398317 0 0 0 0 783091871 20057199 147543 2011 false false true true D 104255000 0 329041638 0 0 0 0 0 0 0 329041638 0 true false true true A false true true true true true 0.00090 0.00010 0.00100 false false false true B false true true true true true 0.00040 0.00040 false false false true C false true true true true true 0.00570 0.00570 false false false true D false true true true true true 0.01020 0.00070 0.01090 false false false true A true false false 0 false 0 false true B false true false false false false 0 false 0 false true C true false false 0 false 0 false true D false true false false false false 0 false 0 false true A true B true C true D true A CSCDA 2012A 680164610 1307956K8 2012-07-11 132681869 REFUNDING - 2002 false false false A 0 0 132681869 0 0 0 0 0 0 0 132681869 0 true false true true A 0 A false true false false false false 0 false 0 false true A true SCHEDULE K REPORTING THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO CERTAIN SUBSIDIARY ORGANIZATIONS, INCLUDING THE ORGANIZATION. THE OUTSTANDING BOND LIABILITY ALLOCATED TO THIS ORGANIZATION IS REPORTED ON FORM 990, PART X, BALANCE SHEET, AND PART VI HEREIN. WITH THE EXCEPTION OF THIS PORTION OF PART VI, THE SCHEDULE K FOR THIS ORGANIZATION IS REPORTING INFORMATION FOR THE ENTIRE BOND ISSUE. SCHEDULE K, PART I, COLUMN (E) THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNT OF: $14,262,949 FROM THE 2003AB ISSUE; $24,136,293 FROM THE 2004CD ISSUE; $21,663,823 FROM THE 2007A ISSUE, $58,581,713 FROM THE 2008A ISSUE; AND SCHEDULE K, PART I, LINE A, COLUMN (F)(CSCDA 2003AB) THE INITIAL BONDS ISSUED IN 2003 WERE "NEW MONEY" BONDS THAT WERE RETIRED AND REISSUED ON MAY 1, 2007. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE ORIGINAL "NEW MONEY" BONDS. SCHEDULE K, PART II, LINE 7 ISSUANCE COSTS FROM PROCEEDS ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. LOS BANOS ANESTHESIA ASSOCIATES SEE PART V 690667 SEE PART V false SCHEDULE L, PART IV PRATAP KURRA, MD, TRUSTEE OF SCVH IS ALSO PART OWNER OR LOS BANOS ANESTHESIA ASSOCIATES (LBAA). DURING THE YEAR LBAA PROVIDED SERVICES TO SCVH. FORM 990, PART I, LINE 1 AND PART III, LINE 1 MISSION STATEMENT: SUTTER CENTRAL VALLEY HOSPITALS PROVIDE HIGH-QUALITY, COMPASSIONATE CARE TO EACH PATIENT, WHILE EXERCISING PRUDENT FISCAL RESPONSIBILITY. SUTTER CENTRAL VALLEY HOSPITALS IS A NOT-FOR-PROFIT ORGANIZATION THAT EXISTS TO MAINTAIN AND IMPROVE THE HEALTH STATUS OF THE COMMUNITIES OF GREATER STANISLAUS COUNTY, SAN JOAQUIN AND MERCED COUNTY. WE EXTEND SELECTED SERVICES TO OTHER COMMUNITIES WHENEVER THIS WILL MEET A CRITICAL NEED AND WHEN IT WILL ENHANCE THE PRODUCTIVITY OF LOCAL RESOURCES. WE PURSUE OUR MISSION BY PROVIDING AND PROMOTING EFFECTIVE HEALTH CARE SERVICES AND BY FOSTERING AN INTEGRATED SYSTEM OF CARE IN PARTNERSHIP WITH PHYSICIANS, OTHER HEALTH CARE PROVIDERS AND PAYERS. WE PROVIDE ACCESS TO A FULL CONTINUUM OF CARE, BUILT UPON A CORE OF SOPHISTICATED HOSPITAL BASED SERVICES. FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS: SUTTER CENTRAL VALLEY HOSPITALS THE TOTAL AMOUNT FOR MODESTO MEMORIAL HOSPITAL (MMC), MEMORIAL HOSPITAL LOS BANOS (MHLB) AND SUTTER TRACY COMMUNITY HOSPITAL (STCH) FOR COMMUNITY BENEFIT SERVICES WAS $75,602,276 FOR 2014. THESE EXPENDITURES REPRESENT ACTUAL DIRECT AND INDIRECT NON-REIMBURSED COSTS OF GOODS AND SERVICES. BREAKING IT DOWN, TOTAL FINANCIAL ASSISTANCE AND MEANS-TEST INCLUDE $8,534,121 OF FINANCIAL ASSISTANCE AT COST, $59,519,616 FOR MEDICAID AND $86,632 FOR OTHER MEANS-TESTED GOVERNMENT PROGRAMS FOR A TOTAL FINANCIAL ASSISTANCE AND MEANS-TEST OF $68,140,369. THE TOTAL FOR OTHER BENEFITS WAS $7,461,907, WHICH INCLUDES $2,074,141 FOR COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND COMMUNITY BUILDING ACTIVITIES, $574,932 FOR HEALTH PROFESSIONS EDUCATION, $2,326,786 FOR SUBSIDIZED HEALTH SERVICES, $499,248 FOR RESEARCH, AND $1,986,800 FOR CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT. MEMORIAL MEDICAL HOSPITAL GENERAL DESCRIPTION: MEMORIAL MEDICAL HOSPITAL IS AN ACUTE CARE FACILITY LOCATED IN MODESTO, CALIFORNIA, 90 MILES SOUTH OF SACRAMENTO IN STANISLAUS COUNTY. CENTRALLY LOCATED TO SERVE OUR IMMEDIATE COUNTY AND OUTLYING AREAS, MEMORIAL WAS ESTABLISHED IN 1970. MEMORIAL MEDICAL CENTER IS CURRENTLY LICENSED FOR 423 ACUTE CARE BEDS AND IS A SUTTER HEALTH AFFILIATE. SERVICES AVAILABLE AT MEMORIAL MEDICAL CENTER INCLUDE: - INPATIENT AND OUT-PATIENT SURGERY - TELEMENTRY - OBSTETRICS AND PERINATAL CARE - LABORATORY - PEDIATRICS - PULMONARY REHABILITATION - ONCOLOGY - MODERN FAMILY BIRTHING CENTER - CONGESTIVE HEART FAILURE PROGRAM - MEDICAL LIBRARY ACCESS - CANCER CENTER AND CANCER/TUMOR REGISTRY - NUTRITIONAL SUPPORT SERVICES - VNA (HOME HEALTH AND IV THERAPY) - PASTORAL CARE - CARDIAC CATHETERIZATION LABORATORY - PATIENT AND COMMUNITY - CARDIAC REHABILITATION - EDUCATION RESPIRATORY THERAPY - CRITICAL CARE - DIAGNOSTIC IMAGING - 24-HOUR EMERGENCY TREATMENT - RADIATION ONCOLOGY - MAJOR TRAUMA PATIENT RECEIVING CENTER - DIABETES TREATMENT PROGRAM - BARIATRIC SURGERY - LACTATION ASSISTANCE PROGRAM - SOCIAL SERVICES THE EXPENDITURES FOR RESEARCH, EDUCATION AND TRAINING TOTALED $2,567,554. MEMORIAL PROVIDES SUPPORT TO THE COMMUNITY BY ASSISTING NON-PROFIT AGENCIES WITH CASH AND IN-KIND DONATIONS. IN 2014, MEMORIAL MEDICAL CENTER PROVIDED $1,106,081 IN CASH AND IN-KIND DONATIONS AND $2,167,257 IN SUBSIDIZED HEALTH SERVICES. COMMUNITY BUILDING AND BENEFIT ACTIVITIES TOTALED $64,099. SUMMARY OF COMMUNITY BENEFIT CONTRIBUTIONS FOR THE BROADER COMMUNITY: $5,904,991. A SAMPLING OF 2014 COMMUNITY BENEFIT PROGRAMS: COMBATING OBESITY MEMORIAL HAS JOINED WITH STANISLAUS COUNTY OFFICE OF EDUCATION "AFTER SCHOOL" PROGRAM TO SUPPORT HEALTHY NUTRITION AND TO LEARN ACTIVITIES TO COMBAT AND ULTIMATELY DECREASE THE INCIDENCE OF CHILDHOOD OBESITY. ADULT OBESITY IS ON THE RISE AS WELL. THE SUPPORT GROUP FOR WEIGHT LOSS SURGERY IS OPEN TO ALL PATIENTS REGARDLESS OF WHERE SURGERY WAS PERFORMED. MEMORIAL PROVIDES SPEAKERS INCLUDING DIETITIANS, PHYSICIANS, NURSING SUPPORT, AND FITNESS EXPERTS TO HELP PATIENTS CONTINUE ON THEIR PATH TO SUCCESS. HEART DISEASE PREVENTION AND TREATMENT PROGRAMS MEMORIAL PROVIDES THE ONLY CARDIAC REHAB PROGRAM IN THE COUNTY. A LONG STANDING HEART COALITION OF STANISLAUS COUNTY MEMBER, MEMORIAL IS ONE OF OUR COUNTY'S RESOURCES FOR HEART EDUCATION AND PREVENTING HEART DISEASE. ALONG WITH PARTNER SUTTER GOULD MEDICAL GROUP, WE PROVIDE TWICE A YEAR, FREE TO THE COMMUNITY EDUCATION HEAT (HEART EDUCATION AND TRAINING) SEMINARS TO THE PUBLIC. WITH PERIODIC HEALTH SCREENING, WHICH IS OPEN TO THE COMMUNITY, WE ARE ABLE TO DIRECT AT-RISK PATIENTS TO APPROPRIATE RESOURCES. WE ALSO SUPPORT THE MENDED HEART SUPPORT GROUP. IMPROVING CANCER AWARENESS AS CANCER IS THE SECOND LEADING CAUSE OF DEATH IN OUR COMMUNITY, MEMORIAL IS COMMITTED TO INFORMING AND ADVISING THE PEOPLE OF STANISLAUS COUNTY TO BETTER UNDERSTAND SIGNS, SYMPTOMS, TREATMENT AND PREVENTION OF CANCER. MEMORIAL ALSO OFFERS COMPLEMENTARY THERAPIES TO CANCER PATIENTS, FAMILY AND THE COMMUNITY AT LARGE. WE PROVIDE PREVENTION PROGRAMS AND ENCOURAGE EARLY SCREENING. EDUCATION AND TRAINING FOR HEALTH CAREERS AS THE COMMUNITY INCREASES IN UNEMPLOYMENT AND DECREASES IN AVAILABLE JOBS, MEMORIAL CONTINUES TO SUPPORT OUR CAREER OPPORTUNITIES IN NURSING, PHARMACY, CLINICAL LAB, RESPIRATORY THERAPY, RADIOLOGY AND RADIATION THERAPY, PHYSICAL THERAPY, EMERGENCY MEDICAL TECH, PHLEBOTOMY AND OTHER DEPARTMENTS. IN ADDITION TO SERVING AS A SITE FOR TRAINING PROGRAMS, MEMORIAL'S SUPERVISORS AND STAFF MEMBERS ARE ACTIVELY INVOLVED IN THE CREATION AND TEACHING OF LOCAL COLLEGE LEVEL PROGRAMS FOR NURSING, RESPIRATORY THERAPY, RADIOLOGY, LAB AND PHARMACOLOGY. PEOPLE SERVED THROUGH THESE PROGRAMS AND OTHERS, WE WERE ABLE TO SERVE 16,455 PEOPLE AT MEMORIAL MEDICAL CENTER. MEMORIAL HOSPITAL LOS BANOS GENERAL DESCRIPTION: MEMORIAL HOSPITAL LOS BANOS (MHLB) IS A PRIVATE, NOT-FOR-PROFIT COMMUNITY HOSPITAL INCORPORATED UNDER CALIFORNIA LAW TO PROVIDE HEALTH CARE SERVICES WITHIN FINITE RESOURCES, TO CITIZENS OF LOS BANOS AND THE SURROUNDING GEOGRAPHICAL AREAS. WE PROVIDE HIGH QUALITY COMPASSIONATE CARE AND EXERCISE PRUDENT FISCAL RESPONSIBILITY. MHLB OPENED IN 1967 AND IS PART OF THE SUTTER CENTRAL VALLEY REGION. THE ORGANIZATION AFFILIATED WITH SUTTER HEALTH IN 1996 AND IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. SERVICES AVAILABLE AT MEMORIAL HOSPITAL LOS BANOS INCLUDE: MAJOR SERVICES INCLUDE 24 HOUR EMERGENCY CARE, BONE DENSITY TESTING, CLINICAL LABORATORY, COMMUNITY EDUCATION, EICU ELECTRONIC INTENSIVE CARE UNIT, GENERAL SURGERY, MAMMOGRAPHY, MRI (MAGNETIC RESONANCE IMAGING), OBSTETRICS/GYNECOLOGY, OTOLARYNGOLOGY, PEDIATRICS, RADIOLOGY SERVICES, RURAL HEALTH CLINIC, SAME-DAY SURGERY AND ULTRASONOGRAPHY. COMMUNITY BENEFIT PROGRAMS 2014 MHLB CONTRIBUTED $591 IN COMMUNITY BUILDING ACTIVITIES FOR THE BROADER COMMUNITY, and $77,953 FOR COMMUNITY HEALTH IMPROVEMENT SERVICES. THE EXPENDITURES FOR RESEARCH, EDUCATION AND TRAINING TOTALED $21,722. MHLB PROVIDES SUPPORT TO THE COMMUNITY BY ASSISTING NON-PROFIT AGENCIES WITH CASH AND IN-KIND DONATIONS. IN 2014, MEMORIAL HOSPITAL LOS BANOS PROVIDED $150,906 IN CASH AND IN-KIND DONATIONS. SUMMARY OF COMMUNITY BENEFIT CONTRIBUTIONS FOR THE BROADER COMMUNITY: $251,172. MEMORIAL HOSPITAL LOS BANOS IS A COMMUNITY-BASED, NOT-FOR PROFIT HOSPITAL. WE ARE COMMITTED TO ENHANCING THE HEALTH OF OUR COMMUNITY IN MANY WAYS. ADDITIONALLY, HOSPITAL MANAGERS VOLUNTEER IN COMMUNITY SERVICE PROJECTS. COMMUNITY BENEFIT PROGRAMS FOR 2014 INCLUDED: - CLINICAL ROTATION SITE FOR NURSING, RESPIRATORY AND RADIOLOGY STUDENTS - CLINICAL INSTRUCTOR FOR THE MERCED NURSING PROGRAM - PROVIDED FREE USE OF EDUCATION ROOM FOR HEALTH AND WELLNESS ACTIVITIES - CAR SEAT SAFETY CLASSES AND INSPECTIONS - BREAST-FEEDING SUPPORT CLASSES AND CONSULTATIONS - CHILDBIRTH CLASSES FOR PARENTS (ENGLISH AND SPANISH) - DIABETES SUPPORT GROUP - SUPPORT OF THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AND MARCH OF DIMES WITH BOTH CORPORATE AND EMPLOYEE INVOLVEMENT - PARTNERED WITH COMMUNITY AGENCIES TO HELP IMPROVE THE HEALTH AND WELLNESS OF OUR COMMUNITIES. COMMUNITY AGENCIES SUPPORTED IN 2014 INCLUDED THE SALVATION ARMY, MANNA MINISTRIES. - PROVIDED CPR AND FIRST AIDE TRAINING CLASSES - PROVIDED FINANCIAL SUPPORT FOR LIVE YOUR DREAM, SELF-ESTEEM EVENT FOR JUNIOR HIGH SCHOOL GIRLS. THE EVENT WAS SPONSORED BY THE LOCAL SOROPTIMIST ORGANIZATION. PEOPLE SERVED: THROUGH THESE PROGRAMS AND OTHERS, WE WERE ABLE TO SERVE 943 PEOPLE AT MEMORIAL HOSPITAL LOS BANOS. FORM 990, PART III, LINE 4A (CONTINUED) SUTTER TRACY COMMUNITY HOSPITAL GENERAL DESCRIPTION: SINCE 1948, SUTTER TRACY COMMUNITY HOSPITAL (STCH) CONTINUES TO BE THE ONLY FULL-SERVICE, ACUTE CARE HOSPITAL WITHIN A 15-MILE RADIUS GEOGRAPHICALLY. LOCATED IN TRACY, CALIFORNIA, STCH STAFF HAS THE OPPORTUNITY TO DELIVER CULTURALLY COMPETENT CARE TO THE DIVERSE POPULATION WITHIN ITS SERVICE AREA. AS A STATE-OF-THE-ART FACILITY, IT FEATURES THE LATEST MEDICAL TECHNOLOGY AND DIAGNOSTIC EQUIPMENT AND OFFERS A COMPREHENSIVE ARRAY OF INPATIENT AND OUTPATIENT SERVICES ON PAR WITH MANY LARGER, URBAN HOSPITALS. ADDITIONALLY, SUTTER TRACY IS COMMITTED TO BRINGING THE BEST AND BRIGHTEST PHYSICIANS AND THE LATEST ADVANCES IN MEDICINE TO THE COMMUNITY. IT IS AFFILIATED WITH MANY REMARKABLE, LOCAL PHYSICIANS WHO ARE AT THE FOREFRONT OF THEIR FIELD. SERVICES AND MEDICAL DEPARTMENTS: - CARDIOVASCULAR SERVICES - COMMUNITY BENEFIT - CONTINENCE - DIAGNOSTIC IMAGING - DIALYSIS - EMERGENCY SERVICES - FAMILY BIRTH CENTER - LABORATORY SERVICES - OUTPATIENT LACTATION PROGRAM - PAIN MEDICINE - PHARMACY - REHABILITATION / PHYSICAL THERAPY - RESPIRATORY CARE - SOCIAL SERVICES - SPECIALTY CARE - SPIRITUAL SERVICES - SURGICAL SERVICES - WOUND OSTOMY CARE SUTTER TRACY COMMUNITY HOSPITAL COMMUNITY BENEFIT AND ECONOMIC VALUE FOR 2014 THE HOSPITAL IS FOCUSED IN DELIVERING A VARIETY OF COMMUNITY BENEFIT PROGRAMS THAT ARE IMPACTFUL TO BRING ABOUT COMMUNITY HEALTH IMPROVEMENTS AND THAT PROVIDE ESSENTIAL SERVICES TO THE POOR AND UNDERSERVED. THE PROGRAMS AND SERVICES IN 2014 WERE PART OF THE HOSPITAL'S IMPLEMENTATION PLAN TO ADDRESS COMMUNITY HEALTH NEEDS AS PRIORITIZED IN THE SAN JOAQUIN COUNTY'S COMMUNITY HEALTH NEEDS ASSESSMENT. THE EXPENDITURES FOR RESEARCH, EDUCATION AND TRAINING TOTALED $252,216. SUTTER TRACY COMMUNITY HOSPITAL (STCH) PROVIDES SUPPORT TO THE COMMUNITY BY ASSISTING NON-PROFIT AGENCIES WITH CASH AND IN-KIND DONATIONS. IN 2014, STCH PROVIDED $729,813 IN CASH AND IN-KIND DONATIONS AND $159,259 IN SUBSIDIZED HEALTH SERVICES. COMMUNITY BUILDING AND BENEFIT ACTIVITIES TOTALED $164,186. SUMMARY OF COMMUNITY BENEFIT CONTRIBUTIONS FOR THE BROADER COMMUNITY $1,305,744. BELOW IS A LIST OF ALL THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR 2014, EXCLUDING MEDI-CAL SHORTFALLS AND CHARITY CARE WHICH ARE ADDRESSED ABOVE. COMMUNITY HEALTH IMPROVEMENT SERVICES COMMUNITY HEALTH EDUCATION: - BREASTFEEDING EDUCATION CLASS - LACTATION CONSULTANTS INCREASE AWARENESS OF THE BENEFITS TO BREASTFEEDING BABIES, AND OFFER SUPPORT FOR SUCCESS. OPEN TO THE BROADER COMMUNITY. - CAR SEAT SAFETY - LOW INCOME PATIENTS NEEDING ASSISTANCE WITH A CAR SEAT FOR THEIR INFANT, ARE PROVIDED WITH ONE FOR FREE AND ARE EDUCATED ON THE PROPER INSTALLATION, USAGE AND SAFETY GUIDELINE. - COMMUNITY HEALTH FAIR - VARIOUS, FREE HEALTH SCREENINGS, EDUCATION AND REFERRALS TO LOCAL COMMUNITY RESOURCES PROVIDED. ADDITIONALLY, THOSE WITH ABNORMAL FINDINGS FROM THE EVENT WHO ARE WITHOUT INSURANCE RECEIVE A FOLLOW-UP CALL TO ENSURE THAT THEY ARE CONNECTED TO RESOURCES TO HELP THEM. - LACTATION PROGRAM - FREE CONSULTATIONS AND ONGOING SUPPORT AS NEEDED FOR NEW MOMS TO BE SUCCESSFUL IN BREASTFEEDING. OPEN TO COMMUNITY. - STROKE CLUB MEETINGS - ONGOING SUPPORT FOR STROKE SURVIVORS, THEIR FAMILY MEMBERS AND CAREGIVERS. COMMUNITY BASED CLINICAL SERVICES: - FLU CLINIC - FREE FLU SHOTS FOR ANYONE MEETING THE AGE CRITERIA FOR THE VACCINE. OPEN TO THE PUBLIC, BUT TARGETED MARKETING TO ENCOURAGE VULNERABLE UNDER-SERVED POPULATIONS TO ATTEND. HEALTH CARE SUPPORT SERVICES: - CANCER SUPPORT SERVICES - A REGISTERED NURSE TRAINED IN CANCER SUPPORT PROVIDES COMPLIMENTARY, ONGOING CASE MANAGEMENT SERVICES TO PATIENTS FOR AS LONG AS SERVICES ARE NEEDED. SERVICES INCLUDE, RESOURCE AND REFERRAL HELP IN ADDITION TO EMOTIONAL SUPPORT. - CONTINUUM OF CARE SERVICES FOR THE INDIGENT - COST OF COPAY VOUCHERS FOR INDIGENT PATIENTS TO RECEIVE A FOLLOW-UP DOCTOR'S VISIT AT THE LOCAL FEDERALLY QUALIFIED HEALTH CLINIC. - HEALTH INSURANCE ENROLLMENT ASSISTANCE PROGRAM - INSURANCE ENROLLMENT HELP FOR UNINSURED INPATIENTS. - OUTPATIENT PRESCRIPTION ASSISTANCE PROGRAM - PAYMENT OF MEDICATIONS FOR THOSE UNABLE TO PAY AND WOULD OTHERWISE GO WITHOUT TAKING THEIR NEEDED PRESCRIPTIONS. - TAXI FARES FOR PATIENTS - TRANSPORTATION ASSISTANCE FOR POOR AND HOMELESS PATIENTS NEEDING TO TRANSFER TO ANOTHER FACILITY OR DISCHARGED TO HOME. HEALTH PROFESSIONS EDUCATION SUPPORT OF FUTURE NURSES: - SJ DELTA NURSING STUDENTS - EXPENSES RELATED TO THE ONBOARDING OF STUDENTS FOR CLINICAL ROTATIONS AT THE HOSPITAL. SCHOLARSHIPS/FUNDING FOR PROFESSIONAL EDUCATION: - HEALTH OCCUPATIONS STUDENT OF AMERICA (HOSA) - SUPPORT OF HEALTH PROFESSIONS EDUCATIONS AT LOCAL HIGH SCHOOL SUBSIDIZED HEALTH SERVICES HOSPITAL OUTPATIENT SERVICES: - INDIGENT CARE - PHYSICIAN PAYMENTS TO CARE FOR UNINSURED. SUBSIDIZED CONTINUING CARE: - SUBSIDIZED DISEASE MANAGEMENT PROGRAM - SUBSIDIZED LABORATORY COSTS AND PAYMENT OF PHARMACISTS' TIME OF PROVIDING MEDICATION MANAGEMENT AND SUPPORT TO CHRONICALLY DISEASED PATIENTS. FINANCIAL AND IN KIND CONTRIBUTIONS CASH DONATIONS: - AMERICAN CANCER SOCIETY - SUPPORT OF CANCER PATIENT SERVICES AND CANCER RESEARCH. - BOYS & GIRLS CLUB - SUPPORT OF LOCAL YOUTH PROGRAMS AND ACTIVITIES. - COMMUNITY PARTNERSHIP FOR FAMILIES OF SAN JOAQUIN COUNTY (CPFSJ) -FUNDING OF RESOURCE CENTER SERVICES WHICH PROVIDE RESOURCE AND REFERRAL, CASE MANAGEMENT, INSURANCE ENROLLMENT ASSISTANCE, AND OTHER SOCIAL SERVICE SUPPORT. - ERIC'S VISION - SUPPORT OF LOCAL EVENT PROVIDING AWARENESS AND RESEARCH FUNDING FOR ALS. - HEARTS OF HARVEST FOUNDATION - CASH DONATION TO ORGANIZATION PROVIDING DIRECT SUPPORT TO FAMILIES WITH CHILDREN IN HEALTH CRISES. - HOSPITAL QUALITY ASSURANCE CHFT PLEDGE - MARCH OF DIMES - CASH DONATIONS TO SUPPORT EFFORTS OF AN ORGANIZATION PROVIDING DIRECT SERVICES TO PREMATURE INFANTS AND THEIR FAMILIES. - SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - DONATIONS TO SUPPORT "SNAP," SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM. - SURTEC ADOPT-A-FAMILY INC. - FOOD BASKETS TO INDIGENT FAMILIES FOR HOLIDAYS. - TRACY AFRICAN AMERICAN ASSOCIATION - CASH DONATION TO SUPPORT SCHOLARSHIPS FOR YOUTH. - TRACY CHAMBER OF COMMERCE - DONATION TO SUPPORT LATINO YOUTH SCHOLARSHIPS. - TRACY SUNRISE ROTARY CLUB - SUPPORT OF FUNDRAISER EVENT OF SERVICE GROUP THAT ASSISTS COMMUNITY IN MANY WAYS. - UNEED2 - SUPPORT OF AN AT RISK YOUTH TECHNOLOGY PROGRAM. - WOMEN'S CENTER OF SAN JOAQUIN - DONATIONS TO PROVIDE FURNISHINGS AT LOCAL DOMESTIC VIOLENCE SHELTER FOR WOMEN AND CHILDREN. GRANTS: - BOYS & GIRLS CLUB OF TRACY - FUNDING TO SUPPORT HEALTH AND FITNESS PROGRAMS AT EACH OF THE 6 SITES. IN KIND DONATIONS: -FOOD SERVICE/COMMUNITY SERVICE SET UP - FOOD COSTS FOR COMMUNITY BENEFIT EVENTS. - HOUSEKEEPING/COMMUNITY SERVICE SET UPS - SET-UP COSTS FOR COMMUNITY BENEFIT EVENTS. COMMUNITY BUILDING ACTIVITIES COALITION BUILDING: - COMMUNITY BENEFIT - DEDICATED STAFF COST RELATED TO MEETINGS, SEMINARS AND CONFERENCES AT BOTH A LOCAL AND COUNTY LEVEL THAT INCREASE COLLABORATIVE EFFORTS. COMMUNITY BENEFIT OPERATIONS ASSIGNED STAFF: - COMMUNITY BENEFIT PROGRAM COORDINATION & EXECUTION - SALARY COSTS FOR DEDICATED PROFESSIONALS IN THE AREA OF COMMUNITY BENEFIT WHO OVERSEE ALL HOSPITAL ACTIVITIES AND PROGRAMS. COMMUNITY NEEDS/HEALTH ASSETS ASSESSMENT: - COMMUNITY BENEFITS PROGRAM ASSESSMENT & REPORTING - SALARY COSTS FOR DEDICATED STAFF INVOLVED WITH COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND WHO COMPLETE MANDATED, REGULATORY REPORTS. OTHER RESOURCES COMMUNITY HEALTH ADVISORY COUNCIL - EXPENSES RELATED TO THE MEETINGS FOR THIS GROUP THAT REVIEW COMMUNITY GRANT APPLICATIONS AND PROVIDE ADVICE ON THE HOSPITAL'S COMMUNITY BENEFIT IMPLEMENTATION PLAN AND STRATEGY. THROUGH THESE EFFORTS IT IS ANTICIPATED THAT INDIRECTLY, THE HEALTH OF AN UNDETERMINED AMOUNT OF PEOPLE ARE POSITIVELY IMPACTED. ON OUTPUTS THAT COULD BE MEASURED, SUTTER TRACY COMMUNITY HOSPITAL WAS ABLE TO SERVE 10,094 PEOPLE. FOR 2014, SUTTER CENTRAL VALLEY HOSPITALS HAD 93,095 PATIENT DAYS. FORM 990, PART VI, LINE 1B THE AFFAIRS AND MANAGEMENT OF SUTTER CENTRAL VALLEY HOSPITALS (SCVH) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHICH HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF SCVH DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OR DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF THE SCVH'S CHAIR WHO SERVES AS CHAIR OF THE COMMITTEE, THE VICE CHAIR, THE CHAIR OF THE FINANCE AND PLANNING COMMITTEE, AN ADDITIONAL DIRECTOR AND THE PRESIDENT OF SCVH. AT LEAST ONE COMMITTEE MEMBER IS A PHYSICIAN DIRECTOR. FORM 990, PART VI, LINES 6 & 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS: THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS: SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. FORM 990, PART VI, LINE 11B DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990: SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM. FORM 990, PART VI, LINE 12 DESCRIPTION OF PROCESS TO MONITOR TRASACTIONS FOR CONFLICTS OF INTEREST: EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. FORM 990, PART VI, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN DECEMBER OF 2014. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC: THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART XI, LINE 9 OTHER CHANGES IN FUND BALANCE: K-1 RENTAL INCOME (101,201) K-1 INTEREST INCOME (38,339) EQUITY TRANSFERS (NET) (68,992,216) OTHER CHANGE IN FUND BALANCE 8,989 -------------- TOTAL $(69,122,767) ADOLESCENT TREATMENT CENTERS INC 390 40TH STREET OAKLAND CA 94609 680088443 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true BETTER HEALTH EAST BAY FOUNDATION 3012 SUMMIT STREET 3RD FLOOR OAKLAND CA 94609 510160184 FUNDRAISING CA 501(C)(3) 7 SUTTER EBH true CALIFORNIA PACIFIC MEDICAL CTR FOUND 2015 STEINER STREET 2ND FLOOR SAN FRANCISCO CA 94115 942728423 FUNDRAISING CA 501(C)(3) 7 SUTTER WBH true EAST BAY PERINATAL CENTER 3012 SUMMIT STREET 3RD FLOOR OAKLAND CA 94609 510172285 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true EDEN MEDICAL CENTER 20103 LAKE CHABOT ROAD CASTRO VALLEY CA 94546 942948100 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true MEMORIAL HOSPITAL FOUNDATION 1800 COFFEE ROAD SUITE 76 MODESTO CA 95355 942290244 FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH true MILLS-PENINSULA HEALTH SERVICES 1501 TROUSDALE DRIVE BURLINGAME CA 94010 941156265 HOSPITAL CA 501(C)(3) 3 PAMF true MILLS-PENINSULA HOSPITAL FOUNDATION 1501 TROUSDALE DRIVE BURLINGAME CA 94010 237288765 FUNDRAISING CA 501(C)(3) 7 MPHS true PALO ALTO MEDICAL FOUNDATION 2350 EL CAMINO REAL MOUNTAIN VIEW CA 94040 941156581 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SAMUEL MERRITT UNIVERSITY 450 30TH STREET 2840 OAKLAND CA 94609 942992642 UNIVERSITY CA 501(C)(3) 2 SUTTER EBH true SUTTER AUBURN FAITH HOSPITAL FOUNDATION 11815 EDUCATION ST AUBURN CA 95602 942594966 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER COAST HOSPITAL 800 E WASHINGTON BLVD CRESCENT CITY CA 95531 942988520 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER DAVIS HOSPITAL FOUNDATION PO BOX 1617 DAVIS CA 95617 680217870 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER EAST BAY HOSPITALS 3012 SUMMIT STREET 3RD FLOOR OAKLAND CA 94609 941196176 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER EAST BAY MEDICAL FOUNDATION 3687 MT DIABLO BLVD 200 LAFAYETTE CA 94549 942690415 HEALTHCARE CA 501(C)(3) 11b-II SUTTER HLTH true SUTTER GOULD MEDICAL FOUNDATION 600 COFFEE ROAD MODESTO CA 95355 941682256 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SUTTER HEALTH 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 942788907 SUPPORTING OR CA 501(C)(3) 11c III-FI NA false SUTTER HEALTH PACIFIC 91-2301 FT WEAVER RD EWA BEACH HI 96706 990298651 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER HEALTH PLAN 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 461183948 HEALTH PLAN CA PENDING PENDING SUTTER HLTH true SUTTER HEALTH SACRAMENTO SIERRA REGION PO BOX 160727 SACRAMENTO CA 95816 941156621 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER INSURANCE SERVICES CORPORATION 745 FORT STREET SUITE 800 HONOLULU HI 96813 990289310 INSURANCE SER HI 501(C)(3) 11b III-FI SUTTER HLTH true SUTTER MEDICAL CENTER FOUNDATION PO BOX 160727 SACRAMENTO CA 95816 942788906 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER MEDICAL CENTER CASTRO VALLEY 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 770146047 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER MEDICAL FOUNDATION 2800 L STREET 7TH FLOOR SACRAMENTO CA 95816 680273974 HEALTHCARE CA 501(C)(3) 11b - 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