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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 COMBINED 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, 2013 AND 2012, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 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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 350% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURE HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAT 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 10% 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. PART I, LINE 7 COSTING METHODOLOGY COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. PART II COMMUNITY BUILDING ACTIVITIES SUTTER MEDICAL CENTER CASTRO VALLEY (SMCCV) FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. THE INJURY PREVENTION COALITIONS ADDRESSED ISSUES IN SURROUNDING COMMUNITIES, INCLUDING CHILD PASSENGER SAFETY, SAFE MEDICATION DISPOSAL AND FALL PREVENTION FOR SENIORS. THE SENIOR INJURY PREVENTION PARTNERSHIP WORKS UNDER THE ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT AND IS RESPONSIBLE FOR THE ANNUAL S.I.P.P. FALL PREVENTION CONFERENCE. THE ASHLAND CHERRYLAND TOGETHER COLLABORATIVE IS THE RECIPIENTS OF A NATIONAL DRUG FREE COMMUNITIES GRANT AND FOCUSES EFFORTS ON ENVIRONMENTAL PREVENTION STRATEGIES. SAFEKIDS AND THE CHILD INJURY PREVENTION NETWORK FOCUSED EFFORTS ON CHILD PASSENGER SAFETY AND MANY OTHER EMERGING SAFETY ISSUES. THE MEDS COALITION ADOPTED THE FIRST OF ITS KIND COUNTY ORDINANCE THAT HOLDS PRODUCERS OF MEDICATIONS RESPONSIBLE FOR THE DEVELOPMENT AND FUNDING OF MEDICATION DISPOSAL PROGRAMS IN 2013. 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. 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. PART III, LINE 4 BAD DEBT AUDIT FOOTNOTE 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% AND 89% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2013 AND 2012 RESPECTIVELY. 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 33% AS OF 12/31/13 29% AS OF 12/31/12 MEDI-CAL 21% AS OF 12/31/13 23% AS OF 12/31/12 DURING 2013 AND 2012, 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 CHANGES 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 $375 MILLION AND $370 MILLION FOR 2013 AND 2012, RESPECTIVELY. PART III, LINE 7 MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. PART III, LINE 8 MEDICARE SHORTFALL COMMUNITY BENEFIT AND COSTING METHODOLOGY 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. PART III, LINE 9B COLLECTION POLICY FOR PATIENTS ELLIGIBLE FOR FINANCIAL ASSISTANCE 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. PART VI, LINE 2 NEEDS ASSESSMENT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS A COLLABORATIVE REPORT COMMISSIONED BY FIVE LOCAL NON-PROFIT HOSPITALS IN THE EAST BAY-SUTTER MEDICAL CENTER CASTRO VALLEY, ALTA BATES SUMMIT MEDICAL CENTER, ST. ROSE HOSPITAL, WASHINGTON HOSPITAL HEALTHCARE SYSTEM AND CHILDREN'S HOSPITAL & RESEARCH CENTER. THE CHNA CORE GROUP, A GROUP REPRESENTING THE COLLABORATING HOSPITALS, MEMBERS FROM ALAMEDA COUNTY PUBLIC HEALTH AND THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA WORKED IN PARTNERSHIP TO DEFINE SPECIFIC DEMOGRAPHIC AND HEALTH STATUS MEASURES FOR REVIEW AND ANALYSIS AND JOINTLY REVIEWED AND DISCUSSED THE RESULTS. THE HOSPITALS RETAINED VALLEY VISION, INC. TO CONDUCT THE TEN-MONTH ASSESSMENT PROCESS. VALLEY VISION, INC. IS A NON-PROFIT 501(C)(3) CONSULTING FIRM WITH OVER SEVEN YEARS EXPERIENCE IN CONDUCTING CHNAS. THE ASSESSMENT USED A MIXED METHOD DATA COLLECTION APPROACH THAT INCLUDED PRIMARY DATA SUCH AS KEY INFORMANT INTERVIEWS, COMMUNITY FOCUS GROUPS, AND A COMMUNITY ASSETS ASSESSMENT. SECONDARY DATA INCLUDED HEALTH OUTCOMES, DEMOGRAPHIC DATA, BEHAVIORAL DATA, AND ENVIRONMENTAL DATA. THE HEALTH NEEDS IDENTIFIED THROUGH ANALYSIS OF BOTH QUANTITATIVE AND QUALITATIVE DATA ARE AS FOLLOWS: - MENTAL HEALTH: ISSUES ARISING FROM LIVING IN A STATE OF STRESS, LIVING IN A STRESSFUL ENVIRONMENT DUE TO LIMITED ECONOMIC RESOURCES, SAFETY CONCERNS FOR SELF AND FAMILY - ACCESS TO HEALTH RESOURCES: INABILITY TO ADDRESS BASIC HEALTHCARE NEEDS DUE TO A LACK OF ACCESS TO RESOURCES TO MAINTAIN AND/OR IMPROVE ONE'S HEALTH, INCLUDING PRIMARY, SPECIALTY, AND PREVENTATIVE CARE - NUTRITION: POOR DIETING HABITS RESULTING FROM LIVING IN AN UNHEALTHY FOOD ENVIRONMENT WITH LIMITED ACCESS TO FRESH AND HEALTHIER FOODS - DENTAL CARE: ISSUES RESULTING FROM A LACK OF ACCESS TO DENTAL SERVICES - HEALTH LITERACY: INABILITY TO IMPROVE ONE'S HEALTH DUE TO LIMITED HEALTH LITERACY AND EDUCATION, INCLUDING HOW TO MAINTAIN AND IMPROVE ONE'S HEALTH THROUGH HEALTHY BEHAVIORS SUCH AS DIET AND PHYSICAL ACTIVITY - POLLUTION: RESPIRATORY AND RELATED ISSUES RESULTING FROM LIVING IN COMMUNITIES WITH POOR AIR QUALITY DUE TO HOUSING CONDITIONS AND ADJACENCY TO HIGH POLLUTION AREAS SUCH AS MAJOR INTERSTATE HIGHWAYS THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR SUTTER MEDICAL CENTER CASTRO VALLEY IS AVAILABLE AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SUTTER MEDICAL CENTER CASTRO VALLEY FOLLOWS 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: - 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) - 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. PART VI, LINE 4 COMMUNITY INFORMATION SUTTER MEDICAL CENTER CASTRO VALLEY'S PRIMARY HOSPITAL SERVICE AREA, OR HSA, IS BASED UPON COMMUNITIES WHERE A SIGNIFICANT PERCENTAGE OF DISCHARGES ORIGINATE, BASED UPON THE PATIENT'S HOME ZIP CODE. THESE ZIP CODES INCLUDED 94541, 94542, 94544, 94545, 94546, 94552, 94577, 94578, 94579, AND 94580. THE HSA INCLUDES A RICHLY DIVERSE POPULATION OF JUST OVER 362,000 RESIDENTS. WHITES, HISPANICS, ASIANS AND BLACKS MAKE UP THE LARGEST MAJORITY OF RESIDENTS WITH WHITES PREDOMINATELY RESIDING IN 94542, 94546, 94552, AND 94577 ZIP CODES; HISPANICS PREDOMINATELY RESIDING IN THE 94541, 94544, 94578 AND 94580 ZIP CODES; AND ASIANS PREDOMINATELY RESIDE IN 94545 AND 94579 ZIP CODES. THE ECONOMIC DIVERSITY OF THE HSA ALSO VARIES FROM ZIP CODE TO ZIP CODE. FOR EXAMPLE, THE MEDIAN INCOME OF RESIDENTS OF 94552 IS $134,256 WHILE THE MEDIAN INCOME OF RESIDENTS IN 94578 IS $52,512. TO IDENTIFY COMMUNITIES OF CONCERN, INPUT FROM THE CHNA TEAM, PRIMARY DATA FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, ALONG WITH DETAILED ANALYSIS OF SECONDARY DATA, HEALTH OUTCOME INDICATORS, AND SOCIO-DEMOGRAPHICS WERE EXAMINED. ZIP CODES WITH RATES THAT CONSISTENTLY EXCEEDED COUNTY, STATE, AND/OR HEALTHY PEOPLE 2020 BENCHMARKS FOR ED UTILIZATION, HOSPITALIZATION, AND MORTALITY WERE CONSIDERED. ZIP CODES WITH RATES THAT CONSISTENTLY FELL IN THE TOP 20% WERE NOTED AND TRIANGULATED WITH PRIMARY AND SOCIO-DEMOGRAPHIC DATA TO IDENTIFY PRELIMINARY COMMUNITIES OF CONCERN. THESE ZIP CODES WERE THEN CONFIRMED WITH EACH CORRESPONDING HOSPITAL CHNA WORKGROUP FOR MODIFICATION, AND IN SOME INSTANCES ADDITIONAL ZIP CODES WERE ADDED. THE COMMUNITIES OF CONCERN ARE HOME TO MORE THAN 250,000 COMMUNITY RESIDENTS. THE AREAS CONSIST OF SIX ZIP CODES, ALL LOCATED IN ALAMEDA COUNTY. ZIP CODE 94541 IS HOME TO THE ALL OR PORTIONS OF HAYWARD, FAIRVIEW, CHERRYLAND, AND ASHLAND, AND IS HOME TO OVER 60,000 RESIDENTS. ZIP CODE 94544 IS THE MOST HEAVILY POPULATED OF ALL THE COMMUNITIES OF CONCERN, AND IS HOME TO PORTIONS OF THE CITIES OF HAYWARD AND UNION CITY. ZIP CODE 94545 SITS TO THE WEST OF 94544, AND IS HOME TO PORTIONS OF THE CITY OF HAYWARD. NORTH OF THE CENTRAL HAYWARD AREA IS SAN LEANDRO ZIP CODE 94578, HOME TO OVER 38,000 RESIDENTS. ADJACENT AND TO THE WEST OF THIS ZIP CODE IS 94579, THE LEAST POPULATED AMONG ALL COMMUNITIES OF CONCERN WITH JUST OVER 20,000 RESIDENTS. TO THE SOUTH OF THIS ZIP CODE IS 94580, THE SAN LORENZO AREA, HOME TO OVER 27,000 RESIDENTS. THERE ARE FIVE HOSPITALS SERVING THE COMMUNITY. THE COMMUNITIES OF CONCERN SIT ADJACENT THE SAN FRANCISCO BAY AND ARE SITUATED ALONG THE INTERSTATE 880, 580, AND HIGHWAY 238 CORRIDORS, WHICH RUN NORTH AND SOUTH THROUGH THE EAST BAY AREA. HIGHWAY 92 AND THE SAN MATEO BRIDGE RUN EAST AND WEST THROUGH THE AREA, AND CONNECT THE EAST BAY WITH SOUTH BAY AREA. FROM AN ECONOMIC PERSPECTIVE, ZIP CODES 94541 AND 94578 EXCEEDED BENCHMARKS FOR THE PERCENT OF FAMILIES WITH CHILDREN LIVING IN POVERTY. IN 94578, 22.4% OF ALL FAMILIES WITH CHILDREN, OR JUST OVER ONE IN FIVE, LIVED IN POVERTY. FURTHER, WELL OVER ONE-THIRD OF ALL SINGLE-FEMALE HEADED HOUSEHOLDS LIVED IN POVERTY IN THE ZIP CODE COMMUNITIES OF 94544, 94578, AND 94587. ALSO, EACH OF THE SIX COMMUNITIES OF CONCERN EXCEEDED BENCHMARKS FOR HIGH UNEMPLOYMENT RATES. LAST, NEARLY SIX IN TEN RESIDENTS OF 94578 RENTED THEIR RESIDENCE, AN INDICATOR OF ECONOMIC MEANS. ALL COMMUNITIES OF CONCERN WERE HOME TO DIVERSE POPULATIONS, WITH PEOPLES OF COLOR ACCOUNTING FOR THE MAJORITY OF COMMUNITY RESIDENTS. FOR EXAMPLE, NEARLY 9 OF 10 RESIDENTS OF ZIP CODES 94545 AND 94587 WERE NON-WHITE. FURTHER, EACH ZIP CODE EXCEEDED BENCHMARKS FOR THE PERCENT OF THE POPULATION OVER THE AGE OF FIVE THAT SPOKE LIMITED ENGLISH AT HOME, WITH 16.1% OF ALL RESIDENTS OVER THE AGE OF FIVE IN 94544 SPEAKING LIMITED ENGLISH AT HOME. FROM AN EDUCATIONAL PERSPECTIVE, ALL ZIP CODES EXCEEDED BENCHMARKS FOR THE PERCENT OF THE TOTAL POPULATION OVER THE AGE OF 25 WITHOUT A HIGH SCHOOL DIPLOMA. LAST, TWO OF THE ZIP CODE COMMUNITIES OF CONCERN EXCEEDED BENCHMARKS FOR THE PERCENT OF POPULATION THAT HAD NO HEALTH INSURANCE. ZIP CODES 94541 AND 94578 HAD 18.6% AND 18.8%, RESPECTIVELY, OF RESIDENTS WITHOUT HEALTH INSURANCE. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE SUTTER MEDICAL CENTER CASTRO VALLEY CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. 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. ALL SUTTER MEDICAL CENTER CASTRO VALLEY COMMUNITY BENEFIT INITIATIVES ALIGN WITH THE FOLLOWING PILLARS: 1. CONNECT PATIENTS TO THE RIGHT CARE, PLACE AND TIME THROUGH ACCESS TO PRIMARY CARE AND MENTAL HEALTH SERVICES. 2. INVEST IN VULNERABLE AREAS TO ENSURE CAPACITY OF CARE MEETS DEMANDS OF VULNERABLE POPULATIONS. 3. COLLABORATE TO INFLUENCE BEHAVIOR TO UTILIZE PREVENTIVE CARE, CHRONIC DISEASE MANAGEMENT AND COMMUNITY SERVICES. 4. BUILD COMMUNITY CAPACITY AND IMPROVE HEALTH. THE 2013-2015 IMPLEMENTATION STRATEGY FOR SUTTER MEDICAL CENTER CASTRO VALLEY 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: THE LACK OF ACCESS TO HEALTH RESOURCES IS A PRIORITY HEALTH NEED FOR SUTTER MEDICAL CENTER CASTRO VALLEY. THE EMERGENCY DEPARTMENT UTILIZATION AND CARE INITIATIVE WILL FUNCTION TO ESTABLISH STRONGER WORKING RELATIONSHIPS WITH WINTON WELLNESS CENTER AND TIBURCIO HEALTH CENTER. THE GOALS OF THE INITIATIVE ARE TO IMPROVE CARE TRANSITIONS OF TARGETED PATIENTS BETWEEN SMCCV AND THESE HEALTH CENTERS, DECREASE LEVEL 1 AND LEVEL 2 EMERGENCY DEPARTMENT VISITS, DECREASE READMISSION OF PATIENTS FROM THESE CLINICS AND PROVIDE ACCESS FOR UNINSURED AND UNDERINSURED PATIENTS. ACCESS TO FLU SHOTS CAN BE A BARRIER TO PEOPLE WITH NO INSURANCE OR LIMITED FINANCIAL RESOURCES. UNVACCINATED PEOPLE ARE AT GREATER RISK OF INCOME LOSS DUE TO ILLNESS OR CARING FOR FAMILY MEMBERS WHO ARE ILL. THE SPREAD OF INFECTION THROUGH THE COMMUNITY CAN LEAD TO OVERBURDENING OF CLINICS, ERS, AND HOSPITALIZATIONS DUE TO COMPLICATIONS. BY IMPROVING ACCESS TO VACCINES TO THE INDIGENT PEOPLE WE PROTECT AND INCREASE THE OVERALL HEALTH OF OUR COMMUNITY. THE COMMUNITY FLU SHOT CLINIC WILL PRIMARILY HELP THE UNINSURED/UNDERINSURED IN THE ASHLAND AND CHERRYLAND AREA. THIS POPULATION EXPERIENCES HIGH LEVELS OF POVERTY, CHRONIC DISEASE, AND LACK OF INSURANCE. VACCINES WILL BE ALLOCATED FOR THE PROVISION OF THIS SERVICE AND WILL BE SUPPORTED BY SMCCV NURSE VOLUNTEERS AS PART OF THEIR TRAINING EXPERIENCE AND NURSING STUDENTS MAY ALSO ASSIST WITH IMMUNIZATIONS. SMCCV PLANS TO PARTNER WITH LOCAL COMMUNITY ORGANIZATIONS AND CLINICS SUCH AS TIBURCIO VASQUEZ HEALTH CENTER, EDEN UNITED CHURCH IN CHRIST, HAWYARD AREA PARKS AND RECREATION DEPARTMENT. TRANSPORTATION CAN BE A CHALLENGE FOR THOSE WHO ARE DISCHARGED FROM THE HOSPITAL AND HAVE NO MEANS OF RETURNING HOME. SMCCV PLANS TO ALLOCATE FUNDING TO SUPPORT THE TAXI VOUCHER PROGRAM. THIS PROGRAM BRIDGES THE TRANSPORTATION GAP FOR THE INDIGENT AND ALLOWS PATIENTS THE ABILITY TO RETURN HOME SAFELY. ACCESS TO MEDICAL TREATMENT FOR INDIGENT POPULATIONS CAN BE A CHALLENGE. EVEN MORE CHALLENGING IS THE COST OF MEDICATIONS TO ENSURE THEIR RECOVERY. WITHOUT PRESCRIBED MEDICATIONS, PATIENTS MAY EXPERIENCE SLOW RECOVERY TIME, RELAPSE, COMPLICATIONS, AND POSSIBLE READMISSION. IMPROVING ACCESS TO NEEDED MEDICATIONS IMPROVES PATIENT OUTCOMES. THROUGH AN AGREEMENT WITH WALGREENS AND SAFEWAY, SMCCV PROVIDES FUNDING FOR PRESCRIPTION DRUGS FOR UP TO THE FIRST THREE DAYS OF A PATIENT'S DISCHARGE FOR PEOPLE WHO WOULD OTHERWISE BE UNABLE TO PAY FOR THEIR PRESCRIPTIONS. SMCCV CONTINUES TO SUPPORT PROFESSIONAL EDUCATION TO ENSURE HEALTH CARE WORKERS RECEIVE THE SKILLS, TRAINING AND EXPERIENCE THEY NEED TO BUILD A SUSTAINABLE WORKFORCE AND IMPROVE ACCESS TO HEALTH CARE. WORKING WITH PROFESSIONAL EDUCATION INSTITUTIONS SUCH AS SAMUEL MERRITT NURSING SCHOOL AND TOURO UNIVERSITY, THE PRECEPTORSHIP AND INTERNSHIP PROGRAMS ALLOW STUDENTS THE ABILITY TO WORK ALONGSIDE STAFF AND GAIN VALUABLE CLINIC EXPERIENCE IN A MULTI-DISCIPLINARY ENVIRONMENT. SMCCV CONTINUES TO WORK TO IMPROVE HEALTH DRIVERS THAT IMPACT MENTAL HEALTH (SAFETY). THE VIOLENCE/INJURY PREVENTION EDUCATION AND REDUCTION PROGRAMS AT SUTTER MEDICAL CENTER CASTRO VALLEY IS COORDINATED BY THE TRAUMA DEPARTMENT STAFF IN COLLABORATION WITH LOCAL FIRST RESPONDERS, SMCCV STAFF, CITY AND GOVERNMENT AGENCIES TO REDUCE UNINTENTIONAL INJURY, REDUCE INJURY FROM MOTOR VEHICLE ACCIDENTS AND REDUCE VIOLENCE IN YOUTH TO IMPROVE SAFETY IN THE COMMUNITY. THESE THREE PROGRAMS INCLUDE INJURY PREVENTION EDUCATION, "EVERY 15 MINUTES" PROGRAM FOR JUNIOR AND SENIOR HIGH SCHOOL STUDENTS, AND CAUGHT IN THE CROSSFIRE PROGRAM, A GANG DIVERSION PROGRAM. THROUGH CONTINUED EDUCATION AND AWARENESS ACTIVITIES, FAMILY MEMBERS AND SENIORS WILL BEGIN TO HAVE A GREATER SENSE OF AWARENESS ON HOW TO REDUCE FALLS, STUDENTS WILL HAVE A BETTER UNDERSTANDING OF THE RAMIFICATIONS OF DRUNK DRIVING AND POOR DECISIONS, AND YOUTH INVOLVED IN VIOLENCE WILL HAVE THE OPPORTUNITY TO TURN AWAY FROM VIOLENCE. THESE ACTIONS INCREASE SAFETY AND REDUCE STRESS NOT ONLY WITHIN FAMILIES, BUT IN THE COMMUNITIES WHERE WE LIVE. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM SUTTER MEDICAL CENTER CASTRO VALLEY IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF ALMOST 50,000 PHYSICIANS, EMPLOYEES, AND VOLUNTEERS WHO CARE FOR MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. IT'S BETTER FOR PATIENTS: WE BELIEVE THIS COMMUNITY-OWNED, NOT-FOR-PROFIT APPROACH TO HEALTH CARE BEST SERVES OUR PATIENTS AND OUR COMMUNITIES - FOR MULTIPLE REASONS. FIRST OF ALL, IT'S GOOD FOR PATIENTS. ACCORDING TO THE JOURNAL OF GENERAL INTERNAL MEDICINE (APRIL 2000), PATIENTS TREATED AT FOR-PROFIT OR GOVERNMENT-OWNED HOSPITALS WERE TWO-TO-FOUR TIMES MORE LIKELY TO SUFFER PREVENTABLE ADVERSE EVENTS THAN PATIENTS TREATED AT NOT-FOR-PROFIT INSTITUTIONS. OUR STOCKHOLDERS ARE OUR COMMUNITIES: INVESTOR-OWNED, FOR-PROFIT HEALTH SYSTEMS HAVE A FINANCIAL INCENTIVE TO AVOID CARING FOR UNINSURED AND UNDERINSURED PATIENTS. THEY ALSO HAVE A FINANCIAL INCENTIVE TO AVOID HARD-TO-SERVE POPULATIONS AND "UNDESIRABLE" GEOGRAPHIC AREAS SUCH AS RURAL AREAS. FOR MANY NORTHERN CALIFORNIA'S UNDERSERVED RURAL LOCALES, SUTTER HEALTH IS THE ONLY PROVIDER OF HOSPITAL AND EMERGENCY MEDICAL SERVICES IN THE COMMUNITY. PROVIDING CHARITY CARE AND SPECIAL PROGRAMS TO COMMUNITIES: OUR COMMUNITIES' SUPPORT HELPS US EXPAND SERVICES, INTRODUCE NEW PROGRAMS AND IMPROVE MEDICAL TECHNOLOGY. ACROSS OUR NETWORK, EVERY SUTTER HOSPITAL, PHYSICIAN ORGANIZATION AND CLINIC HAS A SPECIAL STORY TO TELL ABOUT FULFILLING VITAL COMMUNITY NEEDS. OUR COMMITMENT TO COMMUNITY BENEFIT: MEETING THE HEALTH CARE NEEDS OF OUR COMMUNITIES IS THE CORNERSTONE OF SUTTER HEALTH'S NOT-FOR-PROFIT MISSION. THIS INCLUDES DIRECTLY SERVING THOSE WHO CANNOT AFFORD TO PAY FOR HEALTH CARE AND SUPPORTING PROGRAMS AND SERVICES THAT HELP THOSE IN FINANCIAL NEED. SUTTER HEALTH NOW PROVIDES AN AVERAGE OF MORE THAN $3 MILLION IN CHARITY CARE PER WEEK. IN 2013, OUR NETWORK OF PHYSICIAN ORGANIZATIONS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS INVESTED $901 MILLION IN HEALTH CARE PROGRAMS, SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED. THIS INCLUDES: - THE COST OF PROVIDING CHARITY CARE; - THE UNPAID COSTS OF PARTICIPATING IN MEDI-CAL; AND - INVESTMENTS IN MEDICAL RESEARCH, HEALTH EDUCATION AND COMMUNITY-BASED PUBLIC BENEFIT PROGRAMS SUCH AS SCHOOL-BASED CLINICS AND PRENATAL CARE FOR PATIENTS. SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS CONTINUED TO GROW, REACHING ANOTHER ALL-TIME HIGH OF $166 MILLION IN 2013. PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA false MARCH OF DIMES FULFILLMENT CENTER PO BOX 1657 WILKESBARRES PA 187021657 131846366 501(C)(3) 8108 GENERAL SUPPORT 1 X true true false true false false false false false true false RAMIRO AMALGUER NURSE, STAFF II 218010 0 2000 0 14428 0 10550 0 29671 0 274659 0 0 0 DAVID BENN REGIONAL PRES, CENTRAL VALLEY 0 584151 0 489688 0 149659 0 269631 0 20677 0 1513806 0 593223 ED BERDICK SVP SUTTER SHARED SVCS 0 793936 0 765256 0 153438 0 336916 0 19135 0 2068681 0 718832 DAVID BRADLEY REGIONAL PRES, East Bay 0 675355 0 418602 0 84234 0 214816 0 15397 0 1408404 0 488302 GREGORY BROWN VP & REG COUNSEL, EB (PT YEAR) 0 106981 0 50105 0 26905 0 18378 0 8267 0 210636 0 0 AMY CELLA VP & REG COUNSEL, EB (PT YEAR) 0 4374 0 125434 0 80894 0 18921 0 2534 0 232157 0 158934 JANICE FERGUSON ASST.VP PATIENT CARE SERVICES 200456 0 14804 0 14744 0 10350 0 17143 0 257497 0 0 0 PAT FRY PRESIDENT & CEO, SUTTER HEALTH 0 1568936 0 1958195 0 462231 0 1986744 0 34082 0 6010188 0 2310942 JOHN GATES REGIONAL VP FINANCE EAST/WEST 0 602582 0 196871 0 291162 0 84396 0 18710 0 1193721 0 191359 JOE HIRT CFO, CENTRAL VALLEY 0 341126 0 119377 0 36784 0 58786 0 13658 0 569731 0 140877 BRIAN HUNTER SH VP, REVENUE CYCLE 0 459691 0 170600 0 54591 0 103780 0 19010 0 807672 0 195964 SARAH KREVANS COO, SUTTER HEALTH 0 909010 0 875587 0 479602 0 348316 0 24557 0 2637072 0 1312940 JACK LUNSFORD RAD LEAD 229171 0 750 0 2948 0 10479 0 17761 0 261109 0 0 0 KAREN MANNERING CHARGE-NURSE 255481 0 7776 0 25284 0 11467 0 11220 0 311228 0 0 0 STEVEN MITCHELL COO, MEMORIAL MEDICAL CENTER 0 108250 0 122328 0 318997 0 24435 0 2098 0 576108 0 148643 RANJIT SINGH NURSE, STAFF II 182883 0 8117 0 39149 0 10357 0 16888 0 257394 0 0 0 GEORGE BISCHALANEY CEO 429221 243602 73079 110480 17526 873908 293502 ROSE CORCORAN RN VP PATIENT CARE SERVICES 237459 73990 9211 30173 12707 363540 73990 BRYAN DAYLOR VP ANCILLARY SUPPORT SVCS 239542 86072 22242 34151 18739 400746 97554 DEBORA HENDRICKSON REGIONAL ADMIN DIR. QUALITY 182399 12839 19559 9088 18537 242422 CATHERINE MESSMAN ADMIN DIRECTOR FINANCE 219677 72817 9475 29970 43674 375613 81535 SIDNEY WANETICK VP MEDICAL AFFAIRS 336485 110216 16857 48225 55766 567549 125616 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. 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. PLEASE SEE SCHEDULE O'S PART VI, LINE 15 DISCLOSURE FOR FURTHER DETAILS ON COMPENSATION PROCEDURES. 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. 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 CHFFA 2011B 521643828 13033LKW6 2011-02-10 470318145 CONSTRUCT NEW FACILITIES false false false A 0 0 472888501 0 0 0 0 0 0 472888501 0 0 2012 false false true true A false false true true true true 0.00000 0.00000 0.00000 false false 0.00000 false true A false true false false 0 false 0 false true A true GLOBAL DISCLOSURES PART I, COLUMN (E): 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 FILING 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. PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. SMCCV SPECIFIC PART I, COLUMN (E): THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNTS OF: $287,141,586 FROM THE 2011B ISSUE. ALAMEDA ANESTHESIA ASSOCIATES SEE PART IV 2827712 SEE PART IV false PACIFIC BRAIN SPINE MEDICAL GROUP SEE PART IV 1467262 SEE PART IV false PART IV DESCRIPTION OF BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS DAVID BLACK, MD, TRUSTEE AND OFFICER OF SUTTER MEDICAL CENTER CASTRO VALLEY (SMCCV), IS ALSO A SHAREHOLDER OF ALAMEDA ANESTHESIA ASSOCIATES (AAA). DURING THE YEAR AAA PROVIDED SERVICES TO SMCCV VIA AN ARMS-LENGTH AGREEMENT. JEFFREY RANDALL, MD, TRUSTEE OF SMCCV IS ALSO A SHAREHOLDER OF PACIFIC BRAIN & SPINE MEDICAL GROUP (PBSMG). DURING THE YEAR, PBSMG PROVIDED SERVICES TO SMCCV VIA AN ARMS-LENGTH AGREEMENT. FORM 990, PART I, LINE 1 AND PART III, LINE 1 MISSION STATEMENT WE ENHANCE THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES. THE MISSION OF SUTTER MEDICAL CENTER CASTRO VALLEY IS CARRIED OUT BY OUR BOARD OF DIRECTORS, EMPLOYEES, PHYSICIANS AND VOLUNTEERS WHO ARE COMMITTED TO: - PROVIDING OUR PATIENTS AND THEIR FAMILIES WITH THE HIGHEST QUALITY MEDICAL CARE AND CUSTOMER SERVICE; - CREATING STANDARDS OF EXCELLENCE TO ENSURE QUALITY AND VALUE FOR OUR PATIENTS; - MAINTAINING A FINANCIALLY SOUND ORGANIZATION THROUGH EFFECTIVE CLINICAL AND ADMINISTRATIVE controls; - ENCOURAGING A CULTURE THAT SUPPORTS EMPLOYEES AND PHYSICIANS IN DEVELOPING THEIR SKILLS AND TALENTS. THE PEOPLE OF SUTTER MEDICAL CENTER CASTRO VALLEY ARE COMMITTED TO THESE CORE VALUES: - EXCELLENCE: WE EXCEED CUSTOMER EXPECTATIONS BY DELIVERING PREMIER CLINICAL QUALITY AND MAINTAINING THE HIGHEST LEVELS OF SAFETY; - COMPASSION AND CARING: WE TREAT THOSE WE SERVE AND ONE ANOTHER WITH CONCERN, KINDNESS AND RESPECT; - HONESTY AND INTEGRITY: WE ACT OPENLY AND TRUTHFULLY IN EVERYTHING WE DO; - TEAMWORK: WE RECOGNIZE THAT THE POWER OF OUR COMBINED EFFORTS EXCEEDS WHAT WE CAN ACCOMPLISH INDIVIDUALLY, AND WE ARE ACCOUNTABLE TO EACH OTHER AND OUR CUSTOMERS; - COMMUNITY: WE WORK TO UNDERSTAND AND BEST SERVE THE DIVERSE NEEDS OF OUR COMMUNITIES; - AFFORDABILITY: WE DELIVER HEALTHCARE EFFICIENTLY BY USING RESOURCES RESPONSIBLY; - INNOVATION: WE CONTINUALLY CREATE, SEEK OUT AND ADOPT NEW WAYS OF PROVIDING VALUE TO OUR CUSTOMERS RAPIDLY MOVING FROM IDEA TO EXECUTION. FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS SUTTER MEDICAL CENTER CASTRO VALLEY (SMCCV) IS A NOT-FOR-PROFIT, COMMUNITY -BASED MEDICAL CENTER. PHYSICIANS, VOLUNTEERS AND EMPLOYEES OF SMCCV WORK TOGETHER TO ENSURE THAT THE COMMUNITY HAS ACCESS TO EXCEPTIONAL HEALTH CARE. THE MEDICAL CENTER IS THE REGIONAL TRAUMA CENTER FOR SOUTHERN ALAMEDA COUNTY, IS DESIGNATED A COMMUNITY CANCER CENTER BY THE AMERICAN COLLEGE OF SURGEONS AND IS FULLY ACCREDITED BY THE JOINT COMMISSION. AS AN AFFILIATE OF SUTTER HEALTH, IT IS PART OF A NETWORK OF NON-PROFIT HOSPITALS, MEDICAL RESEARCH FACILITIES, HOME HEALTH, HOSPICE AND LONG TERM CARE CENTERS, WORKING TOGETHER TO SHARE EXPERTISE AND RESOURCES TO ADVANCE HEALTH CARE QUALITY. THE MEDICAL CENTER HAD 37,139 PATIENT DAYS THIS YEAR. IT IS RECOGNIZED AS A LEADER IN EMERGENCY AND TRAUMA CARE, ELEVATING THE LEVEL OF CARE IN EVERY SERVICE OFFERED. IN ADDITION, THE MEDICAL CENTER'S HEALTH EDUCATION CLASSES, SUPPORT GROUPS AND OUTREACH PROGRAMS ARE DESIGNED TO HELP RESIDENTS OF THE COMMUNITY LIVE HEALTHY, ACTIVE LIVES. AS ONE OF THE LARGEST EMPLOYERS IN THE REGION, SMCCV'S LEADERSHIP AND EMPLOYEES RECOGNIZE THEIR RESPONSIBILITY TO BE A RESOURCE TO THE COMMUNITY, TO IMPROVE THE QUALITY OF LIFE AND HELP RESIDENTS AVOID INJURY AND ILLNESS. THE OUTREACH PROGRAMS OFFERED BY THE MEDICAL CENTER SUPPORT SEVERAL CENTERS OF EXCELLENCE: - THE SUTTER EAST BAY NEUROSCIENCE CENTER PROVIDES THE MOST ADVANCED MEDICAL AND SURGICAL CARE USING MINIMALLY INVASIVE SURGICAL TECHNIQUES FOR THE TREATMENT OF BRAIN TUMORS, VASCULAR DISORDERS, MOVEMENT DISORDERS, AND SPINAL AND PERIPHERAL NERVE PROBLEMS. - AS THE EAST BAY'S ONLY ADULT PSYCHIATRIC PROGRAM BASED IN AN ACUTE CARE HOSPITAL, SMCCV'S PSYCHIATRIC SERVICES PROVIDE VOLUNTARY PSYCHIATRIC CARE THAT IS INDIVIDUALIZED, COMPASSIONATE, THERAPEUTIC AND COMMUNITY-BASED. SERVICES INCLUDE MENTAL HEALTH ASSESSMENTS, DIAGNOSIS AND BOTH INPATIENT AND OUTPATIENT TREATMENT FOR ADULTS EXPERIENCING ACUTE BEHAVIORAL AND EMOTIONAL CHALLENGES. - ADVANCED RADIOLOGY AND IMAGING SERVICES ARE AVAILABLE. DESIGNATED AS A BREAST IMAGING CENTER OF EXCELLENCE, THE IMAGING CENTER BRINGS MANY OF OUR IMAGING SERVICES TOGETHER IN ONE CONVENIENT LOCATION, IMPROVING ACCESS, SPEED, COMFORT AND PRIVACY FOR PATIENTS. THESE SERVICES INCLUDE MRI, MAMMOGRAPHY, DOPPLER ULTRASOUND, BONE DENSITOMETRY, NUCLEAR MEDICINE WITH PET CAPABILITIES AND STEREOTACTIC BREAST BIOPSY, COMPLEMENTING THE RANGE OF RADIOLOGY AND FLUOROSCOPY PROCEDURES. SMCCV IS ALSO HOME TO ADVANCED NEUROINTERVENTIONAL RADIOLOGY, FOR THE DIAGNOSIS AND NON-SURGICAL TREATMENT OF ANEURYSMS, VASCULAR STENOSIS, STROKE AND OTHER MAJOR NEUROLOGICAL DISEASES. AS PART OF ITS MISSION AS A NOT-FOR-PROFIT HOSPITAL, SMCCV PROVIDES BENEFIT TO ITS COMMUNITIES IN MANY WAYS, INCLUDING CHARITY CARE, SUBSIDIZED SERVICES, FINANCIAL DONATIONS TO LOCAL ORGANIZATIONS, COMMUNITY HEALTH EDUCATION ABOUT PREVENTION AND TREATMENT OF ACUTE AND CHRONIC DISEASES, AND TRAINING OF COMMUNITY MEMBERS FOR HEALTH PROFESSIONS. THIS YEAR SMCCV RECEIVED THE FOLLOWING AWARDS AND RECOGNITION FOR ITS SERVICES: - SMCCV EARNED 'TOP PERFORMER' ON A KEY QUALITY MEASURE - RECOGNITION FROM THE JOINT COMMISSION. SMCCV HAS BEEN NAMED A TOP PERFORMER ON KEY QUALITY MEASURES FOR EXEMPLARY PERFORMANCE IN IMPROVING CARE FOR PATIENTS WHO EXPERIENCE HEART ATTACKS, HEART FAILURE, PNEUMONIA AND SURGERY. THE AWARD WAS MADE BY THE JOINT COMMISSION, THE U.S. LEADER IN ACCREDITING HEALTH CARE ORGANIZATIONS. SMCCV IS ONE OF 1,099 HOSPITALS IN THE NATION THAT EARNED THIS DISTINCTION. THE LIST OF TOP PERFORMER ORGANIZATIONS REPRESENTS THE TOP 33 PERCENT OF ALL JOINT COMMISSION-ACCREDITED HOSPITALS REPORTING ACCOUNTABILITY MEASURE PERFORMANCE DATA FOR 2012. TO RECEIVE THIS RECOGNITION, SMCCV SCORED AT LEAST 95 PERCENT ACROSS ALL REPORTED ACCOUNTABILITY MEASURES, AS WELL AS WITHIN A NUMBER OF OTHER METRICS. A 95 PERCENT SCORE MEANS A HOSPITAL PROVIDED AN EVIDENCE-BASED PRACTICE 95 TIMES OUT OF 100 OPPORTUNITIES TO PROVIDE THE PRACTICE. EACH ACCOUNTABILITY MEASURE REPRESENTS AN EVIDENCE-BASED PRACTICE - FOR EXAMPLE, GIVING ASPIRIN AT ARRIVAL FOR HEART ATTACK PATIENTS OR GIVING ANTIBIOTICS ONE HOUR BEFORE SURGERY. - SMCCV EARNS LEAPFROG'S "A" RATING FOR PATIENT SAFETY SMCCV EARNED AN "A" GRADE IN THE LEAPFROG GROUP'S FALL 2013 HOSPITAL SAFETY SCORE INITIATIVE. AN "A" RATING IS A DESERVED RECOGNITION OF THE MEDICAL CENTER'S EFFORTS IN PROMOTING PATIENT SAFETY. THE HOSPITAL SAFETY SCORE WAS CREATED WITH THE ADVICE OF A BLUE RIBBON EXPERT PANEL OF FOREMOST PATIENT SAFETY EXPERTS FROM HARVARD, JOHNS HOPKINS, STANFORD AND OTHER LEADING ACADEMIC CENTERS, AND IS THE ONLY PEER-REVIEWED HOSPITAL GRADING SYSTEM IN THE UNITED STATES. THE HOSPITAL SAFETY SCORE ASSIGNS LETTER GRADES TO LOCAL HOSPITALS BASED ON SAFETY IN PREVENTING ERRORS, INFECTIONS, INJURIES AND MEDICATION MIX-UPS THE EMPLOYER-DRIVEN HOSPITAL QUALITY WATCHDOG, THE LEAPFROG GROUP, RELEASED ITS UPDATED HOSPITAL SAFETY SCORES ON WEDNESDAY, OCTOBER 23, 2013. - SMCCV EMERGENCY DEPARTMENT NAMED "TOP" IN BAY AREA CHECKBOOK SURVEYED AREA PHYSICIANS FOR THEIR ASSESSMENTS OF EMERGENCY DEPARTMENTS WITH WHICH THEY WERE FAMILIAR, COLLECTED REPORTS FROM PEOPLE WHO HAD USED EMERGENCY DEPARTMENTS, AND COLLECTED DETAILED INFORMATION ON EMERGENCY DEPARTMENT STAFFING AND ON THE QUALITY OF INPATIENT CARE IN CASE THE PATIENT IS ADMITTED. - SMCCV EARNS VASCULAR TESTING ACCREDITATION SMCCV IN CASTRO VALLEY, CALIF., HAS BEEN GRANTED A THREE-YEAR TERM OF ACCREDITATION IN VASCULAR TESTING IN THE AREAS OF EXTRA CRANIAL CEREBROVASCULAR TESTING AND PERIPHERAL VENOUS TESTING BY THE INTERSOCIETAL ACCREDITATION COMMISSION (IAC). ACCREDITATION BY THE IAC MEANS THAT SMCCV HAS UNDERGONE A THOROUGH REVIEW OF ITS OPERATIONAL AND TECHNICAL COMPONENTS BY A PANEL OF EXPERTS. THE IAC GRANTS ACCREDITATION ONLY TO THOSE FACILITIES THAT ARE FOUND TO BE PROVIDING QUALITY PATIENT CARE, IN COMPLIANCE WITH NATIONAL STANDARDS THROUGH A COMPREHENSIVE APPLICATION. CARDIOVASCULAR DISEASES ARE THE NUMBER ONE CAUSE OF DEATH IN THE UNITED STATES. EARLY DETECTION OF LIFE-THREATENING HEART DISORDERS, STROKE AND OTHER DISEASES IS POSSIBLE THROUGH THE USE OF VASCULAR TESTING PROCEDURES. WHILE THESE TESTS ARE HELPFUL, THERE ARE MANY FACETS THAT CONTRIBUTE TO AN ACCURATE DIAGNOSIS, SUCH AS THE SKILL OF THE TECHNOLOGIST PERFORMING THE EXAMINATION, THE TYPE OF EQUIPMENT USED, THE BACKGROUND AND KNOWLEDGE OF THE INTERPRETING PHYSICIAN AND QUALITY ASSURANCE MEASURES. IAC ACCREDITATION IS A "SEAL OF APPROVAL" THAT PATIENTS CAN RELY ON AS AN INDICATION THAT SMCCV HAS BEEN CAREFULLY CRITIQUED ON ALL ASPECTS OF ITS OPERATIONS CONSIDERED RELEVANT BY MEDICAL EXPERTS IN THE FIELD OF VASCULAR TESTING. - SMCCV EXCELS AT KEEPING PATIENTS HEALTHY, STATE REPORT FINDS SMCCV WAS RECOGNIZED AMONG THE TOP BAY AREA HOSPITALS FOR HAVING SIGNIFICANTLY BETTER RATES FOR KEEPING PATIENTS ALIVE AND HEALTHY, ACCORDING TO A RECENT STUDY BY THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. THE STUDY FOUND THAT MORE THAN HALF OF BAY AREA HOSPITALS HAD WORSE-THAN-AVERAGE DEATH RATES FOR AT LEAST ONE MEDICAL PROCEDURE OR PATIENT CONDITION IN 2010 OR 2011. RESEARCHERS EXAMINED MORTALITY RATES FOR 12 CONDITIONS AND PROCEDURES AT 331 CALIFORNIA HEALTH CARE INSTITUTIONS, AFTER TAKING INTO ACCOUNT RISK FACTORS SUCH AS AGE. FROM THIS EXAMINATION, THEY IDENTIFIED WHICH HOSPITALS HAD DEATH RATES SIGNIFICANTLY BETTER OR WORSE THAN STATE AVERAGES. ACCORDING TO THE STUDY, SMCCV HAD RATES SIGNIFICANTLY BETTER THAN THE STATE AVERAGE IN 2010 OR 2011 FOR BRAIN SURGERY AND ACUTE STROKE. - SMCCV STROKE PROGRAM EARNS GOLD PLUS AWARD THE AMERICAN HEART ASSOCIATION/ AMERICAN STROKE ASSOCIATION PRESENTED TO SMCCV WITH THE GET WITH THE GUIDELINES- STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD. THE AWARD RECOGNIZES SMCCV'S COMMITMENT AND SUCCESS IN IMPLEMENTING EXCELLENT CARE FOR STROKE PATIENTS. TO RECEIVE THE AWARD, SMCCV ACHIEVED 85 PERCENT OR HIGHER ADHERENCE TO ALL GET WITH THE GUIDELINES STROKE QUALITY ACHIEVEMENT INDICATORS FOR TWO OR MORE CONSECUTIVE 12-MONTHS INTERVAL AND ACHIEVED 75 PERCENT OR HIGHER COMPLIANCE WITH SIX OF 10 GET WITH THE GUIDELINES-STROKE QUALITY MEASURE, WHICH ARE REPORTING INITIATIVES TO MEASURE QUALITY OF CARE. IN ADDITION, SMCCV HAS ALSO BEEN RECOGNIZED AS A RECIPIENT OF THE ASSOCIATION'S TARGET: STROKE HONOR ROLL, FOR IMPROVING STROKE CARE. OVER THE PAST QUARTER, AT LEAST 50 PERCENT OF THE HOSPITAL'S ELIGIBLE ISCHEMIC STROKE PATIENTS HAVE RECEIVED TISSUE PLASMINOGEN ACTIVATOR OR TPA WITHIN 60 MINUTES OF ARRIVING AT THE HOSPITAL. FORM 990, PART VI, LINE 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. FORM 990, PART VI, LINE 12 DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS 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. 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 EQUITY TRANSFERS (NET) 44,283,843 PARTNERSHIP INCOME ON BOOKS 139,566 CHANGE IN INTEREST/AUDIT ADJUSTMENT 4,667,125 K-1 INTEREST INCOME (2) K-1 ORDINARY INCOME (16,402) K-1 1231 GAIN (217,380) ----------- TOTAL 48,856,750 =========== ADOLESCENT TREATMENT CENTERS INC 390 40TH STREET OAKLAND CA 94609 680088443 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true ALTA BATES SUMMIT 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 DELTA MEMORIAL HOSPITAL FOUNDATION 3901 LONE TREE WAY ANTIOCH CA 94509 942417022 FUNDRAISING CA 501(C)(3) 11a - I SUTTER EBH 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) 7 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 CENTRAL VALLEY HOSPITALS 1800 COFFEE ROAD SUITE 76 MODESTO CA 95355 941080917 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH 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) 3 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 - II 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 FOUNDATION 2800 L STREET 7TH FLOOR SACRAMENTO CA 95816 680273974 HEALTHCARE CA 501(C)(3) 11b - II SUTTER HLTH true SUTTER ROSEVILLE MEDICAL CTR FOUNDATION ONE MEDICAL PLAZA ROSEVILLE CA 95661 680040113 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER SOLANO CHARITABLE FOUNDATION 300 HOSPITAL DRIVE VALLEJO CA 94589 942668262 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER VISITING NURSE ASSOC AND HOSPICE 1900 POWELL ST 300 EMERYVILLE CA 94608 946068843 HEALTHCARE CA 501(C)(3) 9 SUTTER HLTH true SUTTER WEST BAY HOSPITALS 2333 BUCHANAN STREET SAN FRANCISCO CA 94115 940562680 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER WEST BAY MEDICAL FOUNDATION 2015 STEINER STREET 1ST FLOOR SAN FRANCISCO CA 94115 942948131 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true TRACY HOSPITAL FOUNDATION 1420 N TRACY BLVD TRACY CA 95376 680318845 FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH true MAGNETIC IMAGING AF 175 LENNON WLN CK CA 94598 942953833 PATIENT CARE CA NA SURG CTR OF ABSMC 3875 TELEGRAPH OAKLAND CA 94609 470946086 OUTPATIENT SURG CA NA ALTA CT SERVICES LP 175 LENNON WLN CK CA 94598 943083464 PATIENT CARE CA NA CALIFORNIA PACIFIC ADV IMAGING LLC PO BOX 6102 NOVATO CA 94948 562311840 MRI JOINT VENTURE CA NA SAN FRANCISCO ENDOSCOPY CENTER LLC 3000 RIVERCHASE BIRMINGHAM AL 35244 912160588 ENDOSCOPY JV CA NA PRESIDIO SURGERY CENTER LLC 1635 DIVISADERO SF CA 94115 320144060 AMBULATORY SURG CA NA SUTTER FAIRFIELD SURGERY CTR 2700 LOW CT FAIRFIELD CA 94533 300233892 SURGERY CA NA TWIN CITIES SURGICAL HOSPITAL LLC 250 S WACKER CHICAGO IL 60606 352182617 SURGERY CA NA SUTTER AMADOR SURGERY CENTER LLC 2200 RIVER PLAZA SACRAMENTO CA 95833 461398093 SURGERY CA NA ROSEVILLE ENDOSCOPY CENTER LLC 4 MEDICAL PLAZA SUITE 210 ROSEVILLE CA 95661 870710513 ENDOSCOPY JV CA NA MEMORIAL MEDICAL OFFICE BUILDING PRTNR I 1800 COFFEE RD SUITE 76 MODESTO CA 95355 770287288 OFFICE RENTAL CA NA MEMORIAL MEDICAL OFFICE BUILDING PRTNR I 1800 COFFEE RD SUITE 76 MODESTO CA 95355 770287288 OFFICE RENTAL CA NA HEALTH VENTURES INC 350 HAWTHORNE ST OAKLAND CA 94609 942918780 HEALTH SERVICES CA NA C CORP true false false true false false false false true true false true false false false true false true true SUTTER VISITING NURSE ASSOCIATION AND HOSPICE L 110190 FMV EDEN MEDICAL CENTER FOUNDATION C 542421 FMV SUTTER WEST BAY HOSPITAL L 1318167 FMV SUTTER INSURANCE SERVICES CORPORATION P 1952004 FMV