SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL (EIN 94-1502014)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201422279349305077
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-15T19:27:28-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 SECOND STREET 9TH FLOORAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941502014EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN MONTEREY COUNTY MEMORIAL HOSPBusinessNameLine1
Business Name Line2DBA GEORGE L MEE MEMORIAL HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone8313856000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 CANAL STREETAddressLine1
CityKING CITYCity
StateCAState
ZIP Code93930ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSUSAN M CHILDERSName
TitleCFOTitle
Phone8313856000Phone
Date Signed2014-08-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRENIE BURBANKName
PTINP00159653PTIN
Phone4159561500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSUSAN M CHILDERSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1300 CANAL STREETAddressLine1
CityKING CITYCity
StateCAState
ZIP Code93930ZIPCode
FieldValueIRS element (for citing)
Gross Receipts85398964GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MEEMEMORIAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTHE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees573TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year380220ContributionsGrantsPriorYear
Contributions Grants Current Year137746ContributionsGrantsCurrentYear
Program Service Revenue Prior Year72904784ProgramServiceRevenuePriorYear
Program Service Revenue CY77968534ProgramServiceRevenueCY
Investment Income Prior Year-897657InvestmentIncomePriorYear
Investment Income Current Year-494935InvestmentIncomeCurrentYear
Other Revenue Prior Year4660125OtherRevenuePriorYear
Other Revenue Current Year7257324OtherRevenueCurrentYear
Total Revenue Prior Year77047472TotalRevenuePriorYear
Total Revenue Current Year84868669TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year69261GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY82672GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year38449203SalariesEtcPriorYear
Salaries Etc Current Year36042245SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year35739084OtherExpensePriorYear
Other Expenses Current Year37432262OtherExpensesCurrentYear
Total Expenses Prior Year74257548TotalExpensesPriorYear
Total Expenses Current Year73557179TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2789924RevenuesLessExpensesPriorYear
Revenues Less Expenses CY11311490RevenuesLessExpensesCY
Total Assets BOY38184501TotalAssetsBOY
Total Assets EOY41786045TotalAssetsEOY
Total Liabilities BOY48424164TotalLiabilitiesBOY
Total Liabilities EOY40714218TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-10239663NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1071827NetAssetsOrFundBalancesEOY
Mission DescriptionTHE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense55793026Expense
Grants82672Grants
Revenue77968534Revenue
DescriptionTHE HOSPITAL, IS A 119-BED LICENSED FACILITY THAT PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. TYPES OF CARE OFFERED ARE ACUTE, LONG-TERM, AND RURAL HEALTH CLINIC SERVICES. OVER THE FISCAL YEAR, TOTAL PATIENT DAYS WERE 25,455, AND TOTAL PATIENTS TREATED WERE 45,000.Description
Total Program Service Expense55793026TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096180NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees573NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL FRENCHNamePerson
Telephone Number8313857162TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1300 CANAL STREETAddressLine1
CityKING CITYCity
StateCAState
ZIP Code93930ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BUTTGEREIT JANET
CHAIRMAN2.00XX000
BORZINI ROGER
SECRETARY/TREASURER2.00XX000
BUMBALOUGH PAULETTE
TRUSTEE2.00X000
EDDINGTON ROBERT
TRUSTEE2.00X000
NASH SARAH
TRUSTEE2.00X000
ZARO MD CHRISTINA
CHIEF OF STAFF2.00X109400012000
SCHINDELHEIM MD ROY
VICE-CHAIRMAN2.00XX210641043494
SMITH LEX
CEO50.00XX295209031494
CHILDERS SUSAN
CFO50.00X230374031494
SALAMACHA RENA
CIO50.00X129988042997
WONG KAREN
CHRO50.00156540014358X
SILVA NANCY
STAFF NURSE II OB40.0016419800X
LAI JOY
PHARMACY MANAGER40.00146545014358X
ROBEY LAURA
NURSE PRACTITIONER40.00143082031494X
FARRELL IAN
PHYSICIAN ASSISTANT40.00139656014358X
DIESH VIJAY
PHARMACIST40.00120596014358X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1846229TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation250405TotalOtherCompensation
Number Individuals GT100 K52NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
XTEND HEALTHCARE
PO BOX 1709HENDERSONVILLETN37077PATIENT AR BILLING & COLLECTIONS AGENCY1797444
MONTEREY ANESTHESIA PROFESSIONALS
1522 CONSTITUTION BLVD 123SALINASCA93905MEDICAL SERVICES1306945
UKATU CHIDI MD
10521 RUTHELEN STREETLOS ANGELESCA90047MEDICAL SERVICES709147
BRADFORD LETITIA MD
7485 RUSH RIVER SUITE 710-323SACRAMENTOCA95831MEDICAL SERVICES567231
TRAN DAN MD
17212 MARINA VIEW PLACEHUNTINGTON BEACHCA92649MEDICAL SERVICES410950
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
All Other Contributions137746AllOtherContributions
Total Contributions137746TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REV.Description
Business Code621400BusinessCode
Total Revenue Column77968534TotalRevenueColumn
Related Or Exempt Function Income77968534RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue77968534TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6544TotalRevenueColumn
Exclusion$6,544ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real47125Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real22316Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real24809Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column24809TotalRevenueColumn
Exclusion$24,809ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other6500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other507979Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-501479Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-501479TotalRevenueColumn
Exclusion-$501,479ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
WRITE-OFF LIABILITY9000995880568$5,880,568
OTHER OPERATING INCOME9000991153295$1,153,2950
REBATES/REFUNDS90009971730$71,7300

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column126922TotalRevenueColumn
Exclusion$126,922ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue7232515TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column84868669TotalRevenueColumn
Related Or Exempt Function Income77968534RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$6,762,389ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total82672Total
Program Services82672ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1423665Total
Program Services410319ProgramServices
Management And General1013346ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21849928Total
Program Services21132284ProgramServices
Management And General717644ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total291067Total
Program Services262239ProgramServices
Management And General28828ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10470882Total
Program Services9868551ProgramServices
Management And General602331ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2006703Total
Program Services1890128ProgramServices
Management And General116575ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total203769Total
Program Services32549ProgramServices
Management And General171220ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total407965Total
Program Services41054ProgramServices
Management And General366911ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total127200Total
Program Services10000ProgramServices
Management And General117200ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13973575Total
Program Services11289439ProgramServices
Management And General2684136ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5111989Total
Program Services5084309ProgramServices
Management And General27680ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1444972Total
Program Services1412905ProgramServices
Management And General32067ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total242274Total
Program Services219106ProgramServices
Management And General23168ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total70210Total
Program Services59313ProgramServices
Management And General10897ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1337610Total
Program Services1337610ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2004683Total
Program Services1703981ProgramServices
Management And General300702ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total829396Total
Program Services788633ProgramServices
Management And General40763ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionBAD DEBT EXPENSEDescription
Total10952215Total
Management And General10952215ManagementAndGeneral

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total726404Total
Program Services167934ProgramServices
Management And General558470ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total73557179Total
Program Services55793026ProgramServices
Management And General17764153ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY173163BOY
EOY972570EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11212843BOY
EOY11566094EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY790563BOY
EOY787837EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY496807BOY
EOY725106EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis45167709LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec22538161LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY23015411BOY
EOY22629548EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY12518BOY
EOY12518EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2483196BOY
EOY5092372EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY38184501BOY
EOY41786045EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY16647346BOY
EOY9027500EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY10140139BOY
EOY9878302EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY15967823BOY
EOY15618715EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY1253442BOY
EOY922031EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4415414BOY
EOY5267670EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY48424164BOY
EOY40714218EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-10239663BOY
EOY1071827EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-10239663BOY
EOY1071827EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY38184501BOY
EOY41786045EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses11311490ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis512182OtherCostOrOtherBasis
Book Value512182BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis26844198OtherCostOrOtherBasis
Depreciation10883096Depreciation
Book Value15961102BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis14833153OtherCostOrOtherBasis
Depreciation11023068Depreciation
Book Value3810085BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2978176OtherCostOrOtherBasis
Depreciation631997Depreciation
Book Value2346179BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings22629548TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES4361975
ASSETS LIMITED AS TO USE5785
OTHER ASSETS32596
THIRD PARTY SETTLEMENTS692016
FieldValueIRS element (for citing)
Total Book Value Other Assets5092372TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ACCRUED INTEREST PAYABLE$276,601
SELF INSURED HEALTH CARE CLAIMS$1,380,876
LITIGATION RESERVE$1,014,354
ASSEMBLY BILL 97 CLAWBACK LIAB$2,185,539
PROFESSIONAL FEES$42,000
INCURRED CLAIMS PAYABLE$368,300
FieldValueIRS element (for citing)
Total Of Amounts5267670TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt74474418TotRevenueEtcAuditedFinclStmt
Other Revenues-10918046OtherRevenues
Revenue Not Rptd F990-10918046RevenueNotRptdF990
Revenue Subtotal85392464RevenueSubtotal
Other Revenues Not Included-523795OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-523795RevenueNotRptdOnFinStmt
Total Revenue Per Form99084868669TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt63187954TotExpensesEtcAuditedFinclStmt
Other Expenses Included582990OtherExpensesIncluded
Expenses Not Rptd F990582990ExpensesNotRptdF990
Expenses Subtotal62604964ExpensesSubtotal
Other Expenses Not Included10952215OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt10952215ExpensesNotRptdOnFinStmt
Total Expenses Per Form99073557179TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE HOSPITAL ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ACCOUNTING STANDARD CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE HOSPITAL RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE THAN LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2013 AND 2012, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RECLASSIFICATION OF SERVICE LEAGUE REVENUE 34,169. RECLASSIFICATION OF BAD DEBT EXPENSE FROM NET PATIENT REVENUE -10,952,215.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RECLASSIFICATION OF LOSS ON DISPOSAL OF ASSETS -501,479. RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE -22,316.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RECLASSIFICATION OF LOSS ON DISPOSAL OF ASSETS 501,479. RECLASSIFICATION OF SERVICE LEAGUE EXPENSES 59,195. RECLASSIFICATION OF RENTAL EXPENSES TO STATEMENT OF REVENUE 22,316.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RECLASSIFICATION OF BAD DEBT EXPENSE FROM NET PATIENT REVENUE 10,952,215.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3016290TotalCommunityBenefitExpense
Net Community Benefit Expense3016290NetCommunityBenefitExpense
Percent Of Total Expense0.04100PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs27NumberOfActivitiesOrPrograms
Persons Served66550PersonsServed
Total Community Benefit Expense27864711TotalCommunityBenefitExpense
Direct Offsetting Revenue27020694DirectOffsettingRevenue
Net Community Benefit Expense844017NetCommunityBenefitExpense
Percent Of Total Expense0.01150PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs27NumberOfActivitiesOrPrograms
Persons Served66550PersonsServed
Total Community Benefit Expense30881001TotalCommunityBenefitExpense
Direct Offsetting Revenue27020694DirectOffsettingRevenue
Net Community Benefit Expense3860307NetCommunityBenefitExpense
Percent Of Total Expense0.05250PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served8767PersonsServed
Total Community Benefit Expense98765TotalCommunityBenefitExpense
Direct Offsetting Revenue59873DirectOffsettingRevenue
Net Community Benefit Expense38892NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served8767PersonsServed
Total Community Benefit Expense98765TotalCommunityBenefitExpense
Direct Offsetting Revenue59873DirectOffsettingRevenue
Net Community Benefit Expense38892NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs34NumberOfActivitiesOrPrograms
Persons Served75317PersonsServed
Total Community Benefit Expense30979766TotalCommunityBenefitExpense
Direct Offsetting Revenue27080567DirectOffsettingRevenue
Net Community Benefit Expense3899199NetCommunityBenefitExpense
Percent Of Total Expense0.05300PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served8767PersonsServed
Total Community Building Expense82672TotalCommunityBuildingExpense
Direct Offsetting Revenue59873DirectOffsettingRevenue
Net Community Building Expense22799NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Total Community Building Expense12803TotalCommunityBuildingExpense
Net Community Building Expense12803NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense3290TotalCommunityBuildingExpense
Net Community Building Expense3290NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served8767PersonsServed
Total Community Building Expense98765TotalCommunityBuildingExpense
Direct Offsetting Revenue59873DirectOffsettingRevenue
Net Community Building Expense38892NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$10,952,215BadDebtExpenseAmount
Amount Attributable To6855909AmountAttributableTo
Amount Reimbursed By Medicare8399419AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15761658CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-7362239MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1GEORGE L MEE MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1300 CANAL STREETAddressLine1
CityKING CITYCity
StateCAState
ZIP Code93930ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GEORGE L MEE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
On RequestXOnRequest
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
KING CITY CLINIC
210 CANAL STREETKING CITYCA93930OUTPATIENT CLINIC
SPECIALTY CLINIC
400 CANAL STREET SUITE BKING CITYCA93930OUTPATIENT CLINIC
FAMILY MEDICAL CENTER
400 CANAL STREET SUITE AKING CITYCA93930OUTPATIENT CLINIC
THE WOMEN'S CENTER
400 CANAL STREET SUITE CKING CITYCA93930OUTPATIENT CLINIC
GREENFIELD CLINIC
467 S EL CAMINO REALGREENFIELDCA93927OUTPATIENT CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: COST TO CHARGE RATIO WAS USED TO CALCULATE THE COMMUNITY BENEFIT EXPENSE ON PART I, LINE 7B.
PART II: ONLY HOSPITAL IN THE SOUTHERN PART OF THE COUNTY FOR A 50 MILE RADIUS SERVING A LARGE AGRICULTURAL AREA WITH MANY MEDICALLY INDIGENT AND UNDOCUMENTED RESIDENTS.PROVIDES MANY SERVICES FOR THE COMMUNITY: ED, ICU, OR, OBSTETRICAL & DELIVERY, DIALYSIS, IMAGING, LAB, PHARMACY & PHYSICAL/REHAB. THE ONLY SNF TO DP/SNF IN THE AREA. PROVIDES TWO RURAL HEALTH CLINICS FOR THE PSA. MMH HAS AN OPEN MEDICAL STAFF. THE BOARD IS PRIMARILY COMPRISED ON COMMUNITY MEMBERS. MMH PROMOTES COMMUNITY HEALTH BY OFFERING MULTIPLE HEALTH FAIRS AND PROVIDES MEALS TO ELIGIBLE ADULTS THROUGH THE COUNTY SENIOR NUTRITION PROGRAM.
PART III, LINE 4: METHODOLOGY USED: BASED ON INFLATED MEDICARE RATES APPLIED TO GROSS CHARGES.RATIONALE: THAT PORTION OF GROSS CHARGES THAT WOULD NORMALLY BE ADJUSTED FOR CONTRACTUAL ALLOWANCES IF THIS UNINSURED OR UNDER-INSURED GROUP COULD ACCESS CONTRACTUAL DISCOUNTS & THEN APPLYING A COST TO CHARGE RATIO TO ARRIVE AT THE HOSPITAL'S COST OF PROVIDING THAT CARE.NET PATIENT ACCOUNTS RECEIVABLE/BAD DEBTS EXPENSE FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: PATIENT ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES, AND PRIVATE PATIENTS. THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PAYMENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS INCREASED FROM 27% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2012, TO 31% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2013. THE HOSPITAL HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2013 OR 2012.
PART III, LINE 8: SHORTFALL EXPLANATION: UNFUNDED COSTS FOR DIRECT PATIENT CARE.COSTING METHODOLOGY: CALCULATED COST TO CHARGE RATIO APPLIED UNIFORMILY TO ALL PAYERS.
PART III, LINE 9B: COLLECTION PRACTICES FOR QUALIFIED PATIENTS:IT IS THE POLICY OF GEORGE L. MEE MEMORIAL HOSPITAL TO PROVIDE EXCELLENT CUSTOMER SERVICE TO ALL PATIENTS, AND ASSIST ALL UNINSURED PATIENTS WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, AND CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES. IF SUCH COVERAGE IS NOT AVAILABLE TO THE PATIENT, THE HOSPITAL WILL PROVIDE APPROPRIATE HEALTHCARE TO THE PATIENT, AND THE HOSPITAL WILL PROVIDE FINANCIAL ASSISTANCE BASED ON THE CURRENT FEDERAL POVERTY LEVEL, AND PER THE HOSPITAL'S POLICY, IN ACCORDANCE WITH CALIFORNIA STATE LAW, EMTALA, AND MEDICARE REGULATIONS. FURTHER, SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON INCOME WILL BE PROVIDED WITH SEVERAL OPTIONS FOR PAYMENT OF THEIR BILLS. IT IS THE HOSPITAL'S POLICY TO:- ASSIST ALL UNINSURED PATIENT WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT NO COST TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BELOW 100% OF THE CURRENT FEDERAL POVERTY LEVEL.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 50% DISCOUNT TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BETWEEN 101% AND 133% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 35% DISCOUNT TO ELIGIBLE PATIENTS BETWEEN 133% AND 200% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE INTEREST-FREE PAYMENT PLANS FOR ELIGIBLE PATIENTS UNDER THIS POLICY.- FORGO REPORTS TO CREDIT BUREAUS, REFERRAL OF ACCOUNTS TO COLLECTION AGENCIES, LIENS AGAINST PROPERTY OR WAGE GARNISHMENTS FOR ELIGIBLE PATIENTS WHO ARE MEETING AN AGREED-UPON PAYMENT PLAN.- PROVIDE ADEQUATE NOTICE OF THIS POLICY IN ALL ADMITTING AND RECEPTION AREAS.- OFFER FREE FINANCIAL COUNSELING TO ALL UNINSURED PATIENTS FOR FINANCIAL MATTERS RELATED TO THEIR HOSPITAL BILLS.- FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING.
PART V, SECTION B, LINE 3: DIRECT INTERVIEWS WITH CLERGY COUNCIL, CHAMBER OF COMMERCE, ROTARY CLUB, CITY COUNCIL AND COMMUNITY FOCUS GROUPS.GEORGE L. MEE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 7: - INVASIVE CARDIOLOGY - REFERRED TO OTHER HOSPITALS- GASTROENTEROLOGY - WORKING ON IMPLEMENTATION OF GI SERVICES- MENTAL HEALTH - WORKING WITH COUNTY BEHAVIORAL HEALTH SERVICES- KIDNEY, LIVER & HEART TRANSPLANTS - REFERRED TO OTHER HOSPITALS- CANCER/ONCOLOGY - REFERRED TO OTHER HOSPITALSGEORGE L. MEE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 20D: MEANS USED TO DETERMINE THE AMOUNTS BILLED TO UNINSURED INDIVIDUALS FOR EMERGENCY CARE:FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING.GEORGE L. MEE MEMORIAL HOSPITAL
PART VI, LINE 2: NEEDS ASSESSMENT: THE ORGANIZATION ENGAGED CAROL DAVIS WITH STRATEGY CONNECTIONS TO CONDUCT A THOROUGH COMMUNITY NEEDS ASSESSMENT THAT HAS ALSO PROVIDED ANNUAL MARKET & BUSINESS PLAN UPDATES FOR OUR STRATEGIC PLANS.CAROL CONDUCTED IN-DEPTH INTERVIEWS WITH CARE PROVIDERS, COMMUNITY STAKEHOLDERS AND REVIEW/ANALYSIS OF MARKET DEMOGRAPHICS ALONG WITH HISTORIC SERVICES PROVIDED. MMH ALSO REVIEWS SERVICES PROVIDED BY OTHER FACILITIES OUTSIDE OF THE IMMEDIATE MARKET SERVICE AREA.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UPON PRESENTATION TO OUR ADMITTING PROCESS, ONCE THE PATIENT IDENTIFIES THEY ARE WITHOUT INSURANCE, WE INFORM/EDUCATE THEM ABOUT THEIR OPTIONS WITH GOVERNMENT PROGRAMS AND PROVIDE CONTACT INFORMATION TO ACCESS THOSE PROGRAMS. ADDITIONALLY, WE PROVIDE THE PATIENT WITH OUR POLICIES RELATED TO CHARITY AND A CHARITY APPLICATION SHOULD THEY WISH TO PURSUE THAT ASSISTANCE. WE ALSO MAKE THESE AVAILABLE TO THE GENERAL PUBLIC THROUGH OUR WEBSITE: HTTP://MEEMEMORIAL.COM/FOR-OUR-PATIENTS/PATIENT-RIGHTS
PART VI, LINE 4: COMMUNITY INFORMATION: THE PRIMARY SERVICE AREA (PSA) IS SOUTHERN MONTEREY COUNTY AND THE SALINAS VALLEY COMPRISED OF THE FOLLOWING COMMUNITIES: KING CITY, GREENFIELD, SAN ARDO, LOCKWOOD, JOLON, SAN LUCAS & BRADLEY. THE SERVICE AREA IS SOUTH OF SALINAS, CA BY 45 MILES AND NORTH OF PASO ROBLES BY 45 MILES.THE POPULATION SIZE OF THE PSA IS ROUGHLY 40,000 WITH THE MEDIAN AGE OF 28.5 (32.5% OF 0-17 OF THE AGE GROUP, 41.6% FOR 18-44, 18.9% FOR 45-64 & 7.1% OF THE POPULATION OVER 65 YEARS OF AGE). MEDIAN HOUSEHOLD INCOME (2014) IS $51,773. RACIAL & ETHNIC DISTRIBUTION IS AS FOLLOWS: 81.2% HISPANIC OR LATINO, 14.9% WHITE & 3.9% FROM OTHER RACES.
CAREPORTS FILED WITH STATESPART VI, LINE 7
COST-TO-CHARGE RATIO.LINE I

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF MONTEREYBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 SOUTH MAIN ST SUITE 301AddressLine1
CitySALINASCity
StateCAState
ZIP Code93901ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient946000524EINOfRecipient
Amount Of Cash Grant82672AmountOfCashGrant
Method Of ValuationCASH VALUEMethodOfValuation
Purpose Of GrantNUTRITIONAL PROGRAM FOR THE ELDERLYPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SCHINDELHEIM MD ROY
VICE-CHAIRMAN2106410000000434940254135000
SMITH LEX
CEO25497804023100000314940326703000
CHILDERS SUSAN
CFO20917402120000000314940261868000
SALAMACHA RENA
CIO1299880000000429970172985000
WONG KAREN
CHRO1565400000000143580170898000
SILVA NANCY
STAFF NURSE II OB164198000000000164198000
LAI JOY
PHARMACY MANAGER1465450000000143580160903000
ROBEY LAURA
NURSE PRACTITIONER1430820000000314940174576000
FARRELL IAN
PHYSICIAN ASSISTANT1396560000000143580154014000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11INTERNAL STAFF GATHERS, REVIEWS & COMPILES INFORMATION PROVIDED TO THE TAX PREPARER. TAX PREPARER GUIDES AND ADVISES CLIENT ON ANY ISSUE IN QUESTION. TAX PREPARER COMPLETES THE TAX DOCUMENTS AND SUBMITS TO CLIENT FOR FINAL APPROVAL/SIGNATURE. THE BOARD & EXECUTIVE TEAM REVIEW WITH THE TAX PREPARER AT A REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12CMONTEREY COUNTY MEMORIAL HOSPITAL HAS A CORPORATE POLICY ON CONFLICT OF INTEREST. THIS POLICY APPLIES TO ALL INTERESTED PERSONS WHO ARE AS FOLLOWS: A. TRUSTEES B. MEMBER OF SENIOR MANAGEMENT THE BOARD OF TRUSTEES, THE CEO, AND CFO WILL CONTINUOUSLY MONITOR AND EVALUATE ANY AND ALL TRANSACTIONS OF INTERESTED PARTIES WITH THE HOSPITAL. IF THE CURRENT OR PAST TRANSACTION POSE A POTENTIAL RISK OF BEING A CONFLICT OF INTEREST TO THE HOSPITAL, THESE ITEM(S) WILL BE BROUGHT TO THE ATTENTION OF THE CEO, BOARD CHAIRMAN, AND OR FULL BOARD OF TRUSTEES. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST TO THE BOARD, THE INTERESTED BOARD MEMBER WOULD LEAVE THE BOARD MEETING WHILE THE CONFLICT OF INTEREST IS DISCUSSED AND/OR VOTED ON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROVIDED, HOWEVER, IF THE INTERESTED PERSON IS AN ADMINISTRATIVE STAFF EMPLOYEE AND THE CONTEMPLATED TRANSACTION IS AT THE ADMINISTRATIVE LEVEL, THE DECISION SHALL BE MADE BY THE HOSPITAL CEO. ANY BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER MUST DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT. BOARD MEMBERS SHOULD ALWAYS ABSTAIN FROM VOTING ON ANY ISSUES OF A POSSIBLE CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION IS ESTABLISHED THROUGH COMPARISON TO REGIONAL SALARY SURVEY INFORMATION AND PERFORMANCE USE EVALUATIONS. THE BOARD APPROVES ALL COMPENSATION AGREEMENTS.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART VII, SECTION AROY SCHINDELHEIM, MD, DEVOTES 2 HOUR PER WEEK FOR HIS SERVICES AS A VICE CHAIRMAN OF THE BOARD OF DIRECTORS. HE DOES NOT RECEIVE COMPENSATION OR BENEFITS AS A BOARD MEMBER. DR. SCHINDELHEIM PROVIDES SERVICES AS A PHYSICIAN TO THE HOSPITAL. HE DEVOTES 40 HOURS PER WEEK AND THE COMPENSATION AND BENEFITS ARE FOR HIS SERVICES AS A PHYSICIAN. CHRISTINA ZARO, MD, CHIEF OF STAFF, DEVOTES 2 HOUR PER WEEK FOR HER SERVICES AS A MEMBER OF THE BOARD OF DIRECTORS. SHE DOES NOT RECEIVE COMPENSATION OR BENEFITS AS A BOARD MEMBER. DR. ZARO, PROVIDES SERVICES AS A PHYSICIAN TO THE HOSPITAL. SHE DEVOTES 20 HOURS PER WEEK AND THE COMPENSATION AND BENEFITS ARE FOR HER SERVICES AS A PHYSICIAN.
FORM 990, PART IX, LINE 11GOTHER SERVICES: PROGRAM SERVICE EXPENSES 11,289,439. MANAGEMENT AND GENERAL EXPENSES 2,684,136. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,973,575.OTHER FEES
FORM 990, PART XII, LINE 2CTHERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR.AUDIT COMMITTEE AND OVERSIGHT
FORM 990, PART IX, LINE 11GOTHER FEES FOR SERVICES INCLUDES: PROFESSIONAL FEES - MEDICAL THERAPIST & OTHER : $6,910,829 PURCHASED SERVICES - MEDICAL : $ 278,079 PURCHASED SERVICES - MGMT SRVCS, COLLECTION & OTHER: $4,137,871 CONTRACT LABOR - MEDICAL THERAPIST & OTHER : $1,623,392 CONTRACT LABOR - REGISTRY NURSING PERSONNEL : $ 405,896 REPAIR & MAINTENANCE SERVICES : $ 617,508

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