2014-08-15T11:23:43-05:00 2013-09-30 BDO USA LLP 3200 BRISTOL ST 4TH FLOOR COSTA MESA CA 92626 990 2012-10-01 952821104 Henry Mayo Newhall Memorial Hospital % ANNA BREWER HENR 6612001191 23845 McBean Parkway Suite Valencia CA 91355 CR Bob Hudson 6612001191 2014-08-14 true CINDY J JANIKOWSKI 7149573200 2012 2015-11-30 17:44:51Z ROGER E SEAVER 23845 MCBEAN PARKWAY VALENCIA CA 91355 306276856 false X WWW.HENRYMAYO.COM X 1972 CA TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS, AND IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH COMPASSION AND EXCELLENCE IN HEALTHCARE SERVICES. 14 9 1695 346 0 0 11420874 9392393 252011310 282993187 431707 416722 3043815 3391781 266907706 296194083 12565976 14575005 0 0 100121200 109633686 0 0 0 139816055 145235327 252503231 269444018 14404475 26750065 258811680 280918309 168324505 163681069 90487175 117237240 TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS, AND IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH COMPASSION AND EXCELLENCE IN HEALTHCARE SERVICES. false false 198698671 14575005 284629294 TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS. THE HOSPITAL HAD 54,447 PATIENT DAYS DURING THE YEAR. WE ALSO PROVIDED SERVICES FOR 51,996 EMERGENCY VISITS. 74% of total hospital inpatient admits (excluding newborns) are admitted through the emergency room. 198698671 true true false true false false false false false false true false false true true true true false false false false false false false false false true true false true true true false false false false false false false true false true false false false false false true false false false true 272 0 true 1695 true false false false false false false false false false false X 14 9 true false false false false false false true true false false true true true true true true true true true true CA X X X ANNA BREWER 6612001191 23845 MCBEAN PARKWAY VALENCIA CA 91355 X Craig Peters 2.0 X 0 0 0 Dale Donohoe 2.0 X 0 0 0 Don Kimball 2.0 X 0 0 0 Douglas R Sink 2.0 X 0 0 0 Elizabeth Hopp 2.0 X 0 0 0 James D Hicken 2.0 X 0 0 0 Judge Graciela Freixes 2.0 X 0 0 0 Mark Liker MD 2.0 X 0 0 0 Richard Corlin MD 2.0 X 0 0 0 ROGER E SEAVER 40.0 X X 540321 0 55790 Roscoe Marter MD 2.0 X 0 0 0 Vinod Assomull MD 2.0 X 0 0 0 John Barstis MD 2.0 X 0 0 0 Robert Benjamin 2.0 X 0 0 0 Judy Fish PhD 2.0 X 0 0 0 Marlee Lauffer 2.0 X 0 0 0 Richard Frankenstein MD 2.0 X 0 0 0 Gregory Jenkins 2.0 X 0 0 0 CR BOB HUDSON 40.0 X 355747 0 45409 JOHN V SCHLEIF 40.0 X 364468 0 37207 CYNTHIA A PETERSON 40.0 X 262714 0 27273 JONATHAN S MILLER 40.0 X 197938 0 30067 LARRY R KIDD 40.0 X 276609 0 19707 MARK A PULEO 40.0 X 211916 0 32520 DONNA G FERGUSON 40.0 X 190788 0 24566 Elizabeth Cravitz 40.0 X 181928 0 25577 EVA A NOWLIN 40.0 X 182980 0 15665 GERALD A SUBAR 40.0 X 214509 0 22469 JEAN MARIE STEWART 40.0 X 300485 0 0 3280403 0 336250 81 false true false SODEXO INC AFFILIATES 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 OTHER PRCHD SRVCS 8539025 NTI Westlab Inc 801 N PARKCENTER DR SUITE 202 SANTA ANA CA 92705 MEDICAL PRCHS SRVCS 1899210 TOWER IMAGING VALENCIA LLC 5455 WILSHIRE BLVD STE 1120 LOS ANGELES CA 90036 MEDICAL PRCHS SRVCS 1572075 PACIFIC NATIONAL GROUP 2392 SBATEMAN AVE IRWINDALE CA 91010 Construction 1347219 CALIFORNIA REHABILITATION SERVICES 333 E GLENOAKS BLVD SUITE 204 GLENDALE CA 91207 MEDICAL PRCHS SRVCS 3050727 81 1723530 698694 6970169 9392393 HEALTHCARE SERVICES 621110 282993187 282993187 282993187 439427 439427 0 0 921000 921000 0 921000 921000 10050068 10000 10082773 -32705 10000 -22705 -22705 0 0 0 JV INCOME 621110 715107 715107 NONPATIENT REVENUE 621110 1755674 1755674 2470781 296194083 284629294 2172396 X 0 14575005 14575005 0 0 2457686 2457686 0 0 0 82571267 82571267 1811849 1811849 16096222 16096222 6696662 6696662 4699523 4699523 1543833 1543833 459976 459976 62056 62056 0 0 46673767 29134878 17538889 1168381 1168381 33805042 33805042 2170574 2170574 0 4896489 4896489 258649 258649 0 0 7277720 7277720 0 15303008 15303008 1427474 1427474 REPAIR AND MAINTENANCE 4482997 4482997 MISCELLANEOUS 4489812 4489812 BAD DEBT EXPENSE 16516026 16516026 269444018 198698671 70745347 0 30960621 53679357 9872243 10091020 0 1093415 38074467 46051087 0 0 0 0 0 0 4123933 4312020 8825890 2733757 276240383 149569524 133216338 126670859 13618683 13830973 3055500 3055500 0 0 0 0 17064005 19400321 258811680 280918309 30317349 37418935 0 0 2590680 2551270 116655199 113623046 0 0 0 0 10969267 0 0 0 7792010 10087818 168324505 163681069 X 89252136 114428071 1235039 2809169 0 0 90487175 117237240 258811680 280918309 26750065 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true 62056 62056 false 990 SCH C POLITICAL CAMPAIGN AND LOBBYING ACTIVITIES 990 SCH C PART II-B QUESTION 1(I) FOR THE FISCAL YEAR ENDED 09/30/2013, THE ORGANIZATION PARTICIPATED WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO ADVOCATE POSITIVE HEALTHCARE POLICY FOR HOSPITALS. THE ORGANIZATION ALSO ENGAGED A WASHINGTON LOBBYIST, TO ASSIST IN OBTAINING A FEDERAL HEALTHCARE RELATED GRANT. 3226760 3226760 156976138 66983027 89993111 92112311 72171505 19940806 23925174 10414992 13510182 126670859 UNAMORTIZED FINANCING COST 6788663 OTHER RECEIVABLES 1661643 OTHER ASSETS 1791959 RECEIVABLE FROM AFFILIATE 2733471 PLEDGED LEASE 2551270 QUALITY ASSURANCE FEE 3873315 19400321 0 CAPITAL LEASES 10087818 ACCRUED INTEREST 0 ACCRUED MALPRACTICE LIABILITY 0 10087818 X 281619078 281619078 14575005 14575005 296194083 254869013 254869013 14575005 14575005 269444018 F990 SCH D PART XIII RECONC. OF EXPENSES PER AFS WITH EXPENSES PER RETURN 990 SCH D PART XIII QUESTION 4B CHARITY CARE 14,575,005. F990 SCH D PART XII RECON OF REVENUE PER AFS WITH REVENUE PER RETURN 990 SCH D PART XII QUESTION 4B CHARITY CARE 14,575,005. F990 SCH D PART X Line 2 FIN48(ASC 740) FOOTNOTE PART X LINE 2 THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). UNDER FASB ASC 740, UNCERTAINTY IN INCOME TAXES, INTEREST AND PENALTIES, IF ANY, ARE RECORDED TO INTEREST EXPENSE AND OTHER OPERATING COSTS, RESPECTIVELY. THERE WERE NO INTEREST OR PENALTIES RECORDED FOR THE YEARS, ENDED SEPTEMBER 30, 2013 AND 2012. THE TAX YEARS SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS INCLUDE THE YEARS 2009 AND FORWARD BY THE U.S. INTERNAL REVENUE SERVICE (IRS"). FOR CALIFORNIA, THE TAX YEARS SUBJECT TO EXAMINATION INCLUDE THE YEARS 2008 AND FORWARD. true true X true X true X true true false true true 14575005 14575005 0.05410 8817892 8817892 0.03270 0 0 0.00000 23392897 23392897 0.08680 2260343 2260343 0.00840 0 0 0 0.00000 0 0 0 0.00000 2260343 0 2260343 0.00840 25653240 0 25653240 0.09520 true 16516026 0 93946363 112528654 -18582291 X true true Tower Imaging Valenc Imaging Service 0.50000 0.00000 0.00000 1 1 HENRY MAYO NEWHALL MEMORIAL HOSPITAL

23845 MCBEAN PKWY Valencia CA 91355

X X X 1 HENRY MAYO NEWHALL MEMORIAL HOSPITAL 1 true X X X X X X X X X 13 true false true X X X X X X X X X X false false true true 200. true 400. true X X X X X true true X X X X X X true true X X X X true X false false PART III, LINE 4: The Hospital offers managed care-style discounts to most uninsured patients, which enables the Hospital to offer lower rates to those patients who historically have been charged standard gross charges. Under this method, the discount offered to uninsured patients is recognized as a contractual allowance instead of provision for bad debts, which reduces net patient revenues at the time the uninsured patient accounts are recorded and reduces provision for bad debts. The uninsured patient accounts, net of contractual allowances recorded, are further reduced to their net realizable value through provision for bad debts based on historical collection trends and other factors that affect the estimation process. For the years ended September 30, 2013 and 2012, provision for bad debts were approximately $16,516,000 and $15,879,000, respectively. PART VI SUPPLEMENTAL INFORMATION FOR ITEMS 2-6 PAGE REFERENCES ARE TO THE COMMUNITY BENEFIT REPORT WHICH IS ATTACHED: 2. PAGE 5 - ASSESSING OUR COMMUNITY'S NEEDS 3. PAGE 8-13 - SUMMARY OF COMMUNITY BENEFIT ACTIVITIES 4. PAGE 5 - ASSESSING OUR COMMUNITY'S NEEDS 5. PAGE 8-13 - SUMMARY OF COMMUNITY BENEFIT ACTIVITIES 6. PAGE 10-18 SUMMARY OF COMMUNITY BENEFIT ACTIVITIES PART V, LINE 14 FAP is available at the patient's inquiry. PART V, LINE 3 The study used both primary and secondary research to complete its assessment. Primary research involved 24 interviews with community stakeholders who are leaders and representatives of medically underserved, low-income, minority and chronic disease populations or regional, State or local health or other departments or agencies that have current data or other information relevant to the health needs of the community served by the hospital facility. Secondary data were collected from a variety of local, country and state sources to present the hospital service area demographics, social and economic factors. Healthcare statistics included birth characteristics including number of births, teen birth rate, prenatal care, low birth rate, infant mortality, breastfeeding; mortality/leading causes of death, chronic diseases. Part v, Line 7 Addressing Other Health Needs: Though they were not individually highlighted in the plan, Henry Mayo Newhall Memorial Hospital will continue to address many of the other healthcare needs that were identified in the Community Health Needs Assessment. To address the community's needs in asthma, alcohol and drugs, and violence, Henry Mayo will provide charity care and services in the hospital's Emergency Department to those who qualify. The Behavioral Health Unit will provide charity care and services to uninsured and underinsured patients in need of mental health services. And Henry Mayo will provide inpatient consultations to smokers. At this time, the hospital will not highlight dental health or obesity as these are not an area of expertise. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI CA, true CHARITY CARE - HENRY MAYO NEWHALL HOSPITAL 3903 14575005 COST OF SERV MED SERVICES SCH I GENERAL INFO ON GRANTS AND ASSISTANCE 990 SCH I PART I QUESTION 2 The hospital assists individuals who are uninsured or underinsured by providYng charity care. This is applied by following the hospitals charity care policy. This policy is administered through the Business Service Department of the hospital. SCH I GENERAL GRANTS AND OTHER ASSISTANCE TO INDIV 990 SCH I PART III PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY MAY RECEIVE HEALTHCARE SERVICES AT NO CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES X true true X X X false false false false false false false false false CR BOB HUDSON 290513 0 57445 0 7789 0 12750 0 32659 0 401156 0 CYNTHIA A PETERSON 236891 0 24037 0 1786 0 10403 0 16870 0 289987 0 DONNA G FERGUSON 173684 0 15836 0 1268 0 7696 0 16870 0 215354 0 Elizabeth Cravitz 163685 0 17913 0 330 0 8707 0 16870 0 207505 0 EVA A NOWLIN 165725 0 15289 0 1966 0 8708 0 6957 0 198645 0 GERALD A SUBAR 207605 0 6068 0 836 0 0 0 22469 0 236978 0 JOHN V SCHLEIF 297701 0 54211 0 12556 0 12750 0 24457 0 401675 0 JONATHAN S MILLER 181541 0 15765 0 632 0 7598 0 22469 0 228005 0 LARRY R KIDD 254501 0 20836 0 1272 0 12750 0 6957 0 296316 0 MARK A PULEO 190711 0 20691 0 514 0 10051 0 22469 0 244436 0 JEAN MARIE STEWART 273949 0 25269 0 1267 0 0 0 0 0 300485 0 ROGER E SEAVER 442513 0 83600 0 14208 0 12750 0 43040 0 596111 0 SCH J COMPENSATION INFORMATION 990 SCH J PART I Q1 Roger Seaver does not golf at all but is allowed to host community leaders, Foundation and Hospital Board members or other leaders of the community and their guests periodically, and on a limited basis. C.R. Bob Hudson pays any cost over and above the membership dues for his personal golf, which is very limited (under 18 rounds per year). Both memberships are used as donations to other charities' auction items on a limited basis. A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 130795JG3 2007-08-01 45000000 FINANCE AND REFINANCE FACILITY false true false B CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 130795ux3 2008-06-13 30000000 FINANCE AND REFINANCE FACILITY false true false A 0 0 45177952 3533097 0 0 3272502 0 0 34312891 0 0 2010 false false false B 0 0 29840700 2299888 0 0 2363378 0 0 23674621 0 0 2010 false false false A false false false false false true 0.00000 0.00000 0.00000 false false 0.00000 false true B false false false false 0.00000 0.00000 0.00000 true false 0.00000 false true A false false false false false false 0 false false true TRANSAMERICA OCCIDEN 30. true true false B false false false false false false 0 false false false 0 false A true B true Part IV, Line 2c 0 08/30/2012 Intertex General DALE DONOHOE, trustee 681419 CONSTRUCTION false Modern Diagnostic MARK LIKER, MD, trustee 107040 INTER NEURO MONITORING false Katy Brown Family Member of 141504 wages false CA Kidney Care vinod assomull, trustee 1006559 inpatient renal dialysis false F990 GOVERNANCE, MGMT AND DISCLOSURE 990 PART VI SECTION B QUESTION 11b THE CHAIRMAN OF THE FINANCE COMMITTEE, CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE, THE BOARD OF DIRECTORS, CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND THE HOSPITAL'S FINANCE DEPARTMENT REVIEWED THE ENTIRE FORM 990 RETURN PRIOR TO FILING. F990 POLICIES 990 PART VI SECTION B QUESTION 15A The organization's CEO, executive director, or top management officials' compensation are determined through the use of a compensation committee, independent consulting, and board of directors approval. Other officers/key employees of the organization receive performance reviews annually and ratings are applied that suggest the percentage of salary increase. Percentages are determined through market surveys done by Human Resources and approved each year via the budget and aprroval process. F990 DISCLOSURE 990 PART VI SECTION C QUESTION 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. F990 POLICIES 990 PART VI SECTION B QUESTION 12C All board members are required to read the conflict of interest policy and complete a formal conflict of interest questionnaire annually and results of any conflict, if any, would be reported to the full board. Board members are aware and reminded of the hospital's fiduciary responsibility in reporting conflicts of interest. There have been circumstances where a conflict of interest exists and it has been disclosed to the board of directors. The conflict of interest forms are required to be updated on an annual basis. F990 GOVERNANCE, MGMT AND DISCLOSURE 990 PART VI SECTION A QUESTION 2 Dr. Dale Donohoe - Business Relationship Dr. Mark Liker MD - Business Relationship Dr. Vinod Assomu - Business Relationship Bob Benjamin - Family relationship F990 Compensation of Officers, Directors, Trustees, Key Employees, Highest 990 PART VII the salaries in the FY 2013 990's for management include one wage increase and one performance bonus. OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:REGISTRY TOTAL FEES:8240296 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:6184744 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:14709838 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:QUALITY ASSURANCE FEES TOTAL FEES:17538889 HENRY MAYO NEWHALL MEMORIAL HEALTH FOUND 23845 MCBEAN PARKWAY VALENCIA CA 91355 953849903 RAISE FUNDS CA 501(C)(3) 7 Hospital false TOWER IMAGING VALENCIA 23929 MCBEAN PARKWAY BLDG F STE 1 VALENCIA CA 91355 201345767 RADIOLOGY SERvice CA Hospital Related 763067 1824333 false 0 false 0.50000 false true true false false false false false false false false false false false false false false false