2014-11-17T18:14:14-06:00 2013-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2013-01-01 942823538 MARIN GENERAL HOSPITAL MARI 4159257000 250 BON AIR ROAD GREENBRAE CA 94904 LEE DOMANICO CEO 4159257000 2014-11-17 1 RENIE BURBANK P00159653 4159561500 2013 2015-11-30 17:44:51Z LEE DOMANICO 250 BON AIR ROAD GREENBRAE CA 94904 325515054 0 X WWW.MARINGENERAL.ORG X 1991 CA TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. 10 10 1823 281 45045 -3411 3609682 4750424 296953669 314837387 528 9130 30038503 3682675 330602382 323279616 761272 9048701 0 0 172256312 176921525 0 0 0 122355439 128172123 295373023 314142349 35229359 9137267 198885071 198919079 133360851 124723149 65524220 74195930 TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. 0 0 290798376 9048701 314837387 SEE SCHEDULE O 290798376 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 286 0 1 1823 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X RONALD SPERLING 4154642090 100 B DRAKES LANDING SUITE 250 GREENBRAE CA 94904 PAUL KIRINCIC CHAIRMAN 2.00 X X 0 0 0 STEVEN A SCHROEDER MD VICE CHAIRMAN 2.00 X X 0 0 0 JEREMY FAIR TREASURER 2.00 X X 0 0 0 MARA PEREZ PHD MGH BOARD MEMBER/SECRETARY 2.00 X X 0 0 0 DAVID HILL MGH BOARD MEMBER 2.00 X 0 0 0 ANN KAO MD MGH BOARD MEMBER 2.00 X 0 0 0 GENE MARIE O'CONNELL MGH BOARD MEMBER 2.00 X 0 0 0 DEREK PARKER MGH BOARD MEMBER 2.00 X 0 0 0 ROBERT PEIRCE MGH BOARD MEMBER 2.00 X 0 0 0 TIMOTHY SOWERBY MD MGH BOARD MEMBER 2.00 X 0 0 0 LEE DOMANICO CEO/MGH BOARD EX-OFFICIO 36.00 4.00 X 1182835 0 16187 DAVID W COX CHIEF FINANCIAL OFFICER 38.00 2.00 X 530249 0 29267 JON D FRIEDENBERG CHF ADMINISTRATIVE OFFICER 32.00 8.00 X 437035 0 43553 MARK A ZIELAZINSKI CHIEF INFO & TECH OFFICER 40.00 X 341719 0 34873 JOEL SKLAR CHIEF MEDICAL OFFICER 28.00 X 323141 0 34691 THERESA E GIANFORTUNE CHF HUMAN RESOURCES OFFICER 40.00 X 205444 0 22393 LINDA LANG CHF HUMAN RESOURCES OFFICER 40.00 X 107484 0 2523 RICHARD S REID VP/CONTROLLER 40.00 X 317352 0 67313 SUSAN S CUMMING MEDICAL DIRECTOR MGH 32.00 X 305855 0 29916 CHUN LI CHIEF CLIN PHYSICIST 32.00 X 305258 0 57332 GOONASAGRIE NAIDOO VP OF NURSING 40.00 X 245822 0 61305 GREGORY LEE CARD CATH TECH IV 40.00 X 429654 0 35027 MARGARET M ROBERTS CLINICAL RN III 36.00 X 327726 0 54402 SANDY D AUGUSTUS CLINICAL RN III 28.00 X 325014 0 49024 JAMES I WHITLOCK RAD TECH IV 40.00 X 263864 0 47130 WESTERBERG JEFFREY W RAD TECH IV 40.00 X 259377 0 48580 5907829 0 633516 515 0 1 0 PRIMA MEDICAL FOUNDATION 4 HAMILTON LANDING STE 100 NOVATO CA 94949 PHYSICIAN SERVICES 3169740 MARIN HOSPITALIST MEDICAL GROUP PO BOX 708 NOVATO CA 94948 PHYSICIAN SERVICES 2342219 QUEST DIAGNOSTICS INC 3924 COLLECTION CTR DR CHICAGO IL 60693 LABORATORY/TESTING SERVICES 1541234 ANESTHESIOLOGY CONSULTANTS OF 540 SAN PEDRO COVE SAN RAFAEL CA 94901 PHYSICIAN SERVICES 1534724 TRUENORTH AR LLC 3050 FITE CIRCLE STE 170 SACRAMENTO CA 95827 COLLECTION SERVICES 1044574 50 2595329 2155095 4750424 PATIENT SERVICE REV. 621100 314837387 314837387 314837387 9130 9130 2080355 2235438 -155083 -155083 -155083 ALL OTHER REVENUES 900099 2835708 45045 2790663 INVESTMENT IN PARTNERSHIP 900099 1002050 1002050 3837758 323279616 314837387 45045 3646760 8991068 8991068 57633 57633 4701548 4701548 132508423 126090546 6417877 8858471 8392960 465511 20750301 19056286 1694015 10102782 9282697 820085 1190363 1071573 118790 252835 252835 653086 653086 3089427 3017577 71850 8876846 7958092 918754 13771176 12459318 1311858 108907 108907 1611276 1611276 13072177 13072177 1800506 1620455 180051 MEDICAL SUPPLIES 40066721 40066721 PURCHASED SERVICES 25260817 19337150 5923667 PRO. FEES - PHYSICIANS 12238668 12238668 6179318 5712186 467132 314142349 290798376 23343973 0 23634897 48172713 370989 372553 47046797 49559372 4757248 4860164 4841856 4533877 210275833 146905941 62946809 63369892 5292156 8637971 49994319 19412537 198885071 198919079 49145877 46366876 59138129 51734801 25076845 26621472 133360851 124723149 X 65524220 74195930 65524220 74195930 198885071 198919079 X 9137267 -4217 -461340 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 22387 22387 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO HOSPITAL COUNCIL NORTHERN CENTRAL CALIFORNIA (HCNCC). A PORTION OF THE DUES PAID WERE USED FOR LOBBYING PURPOSES. 214643 214643 214643 214643 214643 214643 214643 214643 214643 214643 1.00000 0 1 1 26968343 26514181 454162 59976111 47986394 11989717 106524816 72157027 34367789 16806563 248339 16558224 63369892 OTHER RECEIVABLES 5397438 ASSETS LIMITED TO USE 5089323 DEPOSITS 618400 INTERCOMPANY RECEIVABLES 4090227 THIRD PARTY SETTLEMENTS 4217149 19412537 INSURANCE LIABILITIES 4989011 POST-RETIREMENT HEALTH OBLIGATION 7704243 INTERCOMPANY PAYABLES 1997178 ACCRUED PENSION LIABILITIES 11931040 26621472 X 321353000 -4217 -4157837 -4162054 325515054 -2235438 -2235438 323279616 309143000 2235390 2235390 306907610 7234739 7234739 314142349 PART V, LINE 4: ENDOWMENT FUNDS ARE NOW ADMINISTERED BY FOUNDATION OF WHICH THE ORGANIZATION IS THE SOLE CORPORATE PARENT. EARNINGS FROM GENERAL ENDOWMENT FUND ARE AVAILABLE TO BE DESIGNATED BY FOUNDATION BOARD. THE EARNINGS FROM THE OTHER ENDOWMENT FUNDS ARE TRANSFERRED TO RELATED TEMPORARILY RESTRICTED FUNDS. PART X, LINE 2: MGH IS ORGANIZED AS A NOT-FOR-PROFIT ENTITY UNDER THE GENERAL NONPROFIT CORPORATION LAWS OF THE STATE OF CALIFORNIA. EXEMPTIONS FROM FEDERAL INCOME TAXATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA FRANCHISE TAXATION HAVE BEEN OBTAINED. CERTAIN ACTIVITIES AND SUBSIDIARIES MAY BE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION 42,000. CHANGE IN BENEFIT PLAN 3,033,548. EQUITY TRANSFER TO FOUNDATION RECLASSIFIED TO GRANT EXPENSE -540,000. EQUITY TRANSFER TO PRIMA RECLASSIFIED TO GRANT EXPENSE -2,840,739. RECLASSIFICATION OF SUPPORT TO RELATED ORGANIZATIONS -3,854,000. AUDITED FINANCIAL STATEMENT ROUNDING 1,354. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF RENTAL EXPENSES FROM EXPENSES -2,235,438. PART XII, LINE 2D - OTHER ADJUSTMENTS: AUDITED FINANCIAL STATEMENT ROUNDING -48. RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE 2,235,438. PART XII, LINE 4B - OTHER ADJUSTMENTS: EQUITY TRANSFER TO FOUNDATION RECLASSIFIED FROM REVENUES 540,000. RECLASSIFICATION OF SUPPORT TO RELATED ORGANIZATIONS 3,854,000. EQUITY TRANSFER TO PRIMA RECLASSIFIED TO GRANT EXPENSE 2,840,739. PARTS XI, XII, & XIII - RECONCILIATIONS: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS; HOWEVER, SEPARATE FINANCIAL INFORMATION IS MAINTAINED FOR EACH ORGANIZATION. THE SEPARATE FINANCIAL INFORMATION FOR THIS ORGANIZATION IS THE BASIS FOR THE RECONCILIATIONS AT SCHEDULE D, PARTS XI, XII, & XIII. 1 1 X 1 X 400.000000000000 1 X 1 1 0 1 1 2787633 2787633 0.00890 23711680 1315277 22396403 0.07130 10463668 10463668 0.03330 36962981 1315277 35647704 0.11350 6851 434189 575 433614 0.00140 479462 3400 476062 0.00150 12678 12678 0.00000 8064471 8064471 0.02570 6851 8990800 3975 8986825 0.02860 6851 45953781 1319252 44634529 0.14210 0 16786264 82909883 128375695 -45465812 X 1 1 1 MGHSCA LLC OUTPATIENT SURGERY CENTER 0.51000 0.00000 0.00000 2 MARIN MAGNETIC RESONANCE IMAGING CENTER OUTPATIENT IMAGING/MRI CENTER 0.51000 0.00000 0.00000 1 1 MARIN GENERAL HOSPITAL 250 BON AIR ROAD GREENBRAE CA 94904 110000361 X X X MARIN GENERAL HOSPITAL 1 1 X X X X X X X X X 13 1 1 1 X WWW.MARINGENERAL.ORG X X X X X X 1 0 1 1 400.000000000000 1 400.000000000000 0 1 1 X X X X X X 1 X 1 X X X 1 X 0 0 MARIN GENERAL HOSPITAL PART V, SECTION B, LINE 3: FOCUS GROUPS, LED BY MARIN HEALTH AND HUMAN SERVICES, WERE HELD IN MARIN CITY, NOVATO, CANAL, SAN GERONIMO, WEST MARIN, WHISTLESTOP AND AT THE YOUTH LEADERSHIP INSTITUTE. THE SURVEY ASKED FOCUS GROUP PARTICIPANTS ABOUT: IMPORTANT HEALTH ISSUES THEY FACE, THEIR FAMILIES, AND THEIR COMMUNITIES FACED; WHAT THEY SAW AS HEALTHY AND UNHEALTHY ABOUT THEIR COMMUNITIES; AND WHAT THEY'D CHANGE IN THEIR COMMUNITIES TO MAKE THEM HEALTHIER. A TOTAL OF 103 ENGLISH, AND 50 SPANISH RESPONSES WERE OBTAINED. MARIN GENERAL HOSPITAL PART V, SECTION B, LINE 4: KAISER PERMANENTE, NOVATO COMMUNITY HOSPITAL 10 IMAGING CENTER 1350 S ELISEO DRIVE 105 205 GREENBRAE CA 94904 OUTPATIENT IMAGING ONCOLOGY SERVICES 1350 S ELISEO DRIVE 100 140 GREENBRAE CA 94904 OUTPATIENT ONCOLOGY OUTPATIENT LAB 655 REDWOOD HWY 100 MILL VALLEY CA 94941 OUTPATIENT LAB OUTPATIENT LAB 5 BON AIR ROAD 119 LARKSPUR CA 94939 OUTPATIENT LAB OUTPATIENT LAB 900 S ELISEO DRIVE 104 GREENBRAE CA 94904 OUTPATIENT LAB PHYSICAL THERAPY 1350 S ELISEO DRIVE 250 GREENBRAE CA 94904 PHYSICAL THERAPY OUTPATIENT SURGERY CENTER 505 SIR FRANCIS DRAKE BLVD GREENBRAE CA 94904 OUTPATIENT SURGERY PRIMA MEDICAL FOUNDATION 100 A DRAKES LANDING GREENBRAE CA 94904 PHYSICIAN'S MEDICAL GROUP OUTPATIENT LAB 100 A DRAKES LANDING GREENBRAE CA 94904 OUTPATIENT LAB MARIN MAGNETIC IMAGING 1260 S ELISEO GREENBRAE CA 94904 OUTPATIENT IMAGING PART I, LINE 3C: TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINE (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: 1) SPECIAL CIRCUMSTANCES CHARITY CARE: A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, INELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING MGH'S CHARITY CARE ELIGIBILITY CRITERIA. 2) CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR INCOME. 3) UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. 4) PROMPT PAYMENT DISCOUNT: ADDITIONAL DISCOUNT FOR PATIENTS RECEIVING THE UNINSURED DISCOUNT OF AT LEAST 10% WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR 20% IF THE 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE. PART I, LINE 6: AVAILABILITY OF COMMUNITY BENEFIT REPORT MGH POSTS THEIR COMMUNITY BENEFIT REPORT ON THEIR WEBSITE AND SUBMITS THE REPORT TO CALIFORNIA AGENCIES. ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE AT THE MARIN GENERAL HOSPITAL BOARD MEETING AND THE MARIN HEALTHCARE DISTRICT BOARD MEETING. MARIN GENERAL HOSPITAL ALSO PROVIDES RELEASES TO THE MEDIA ON SPECIFIC ACTIVITIES. PART I, LINE 7E: COMMUNITY HEALTH IMPROVEMENT SERVICES COMMUNITY HEALTH IMPROVEMENT SERVICES - CHARITY CARE, MEDI-CAL AND GOVERNMENT MEANS-TESTED PROGRAMS ARE NOT LISTED BELOW BUT ARE INCLUDED IN THE TOTAL QUANTIFIABLE COMMUNITY BENEFIT.- COMMUNITY HEALTH EDUCATION- AARP DRIVER SAFETY PROGRAM: DRIVER SAFETY PROGRAM FOR OLDER ADULTS- ASTHMA FOR DUMMIES: ASTHMA EDUCATION CLASS FOR THE COMMUNITY- BASIC STREET SKILLS CLASS: EDUCATIONAL CLASS ON STREET SKILLS FOR BICYCLISTS- BEGINNING YOGA AND STRETCH CLASS: OFFERED TO THE COMMUNITY- BEHAVIORAL HEALTH PARTIAL HOSPITALIZATION NUTRITION COUNSELING- BEREAVEMENT SUPPORT GROUP- BREAST HEALTH FORUM: SEMINAR HELD TO PROMOTE BREAST CANCER AWARENESS- BREAST SURGERY EDUCATION CLASS: CLASS HELD PRIOR TO BREAST CANCER SURGERY- BREASTFEEDING TELEPHONE LINE: FREE ADVICE LINE OPEN TO THE COMMUNITY- CANCER RESOURCE & RECOVERY CENTER: A RESOURCE CENTER AVAILABLE FOR PATIENTS, THEIR FAMILIES AND COMMUNITY MEMBERS INTERESTED IN CANCER INFORMATION- CAREGIVER'S SUPPORT GROUP- COMMUNITY PRE DIABETES CLASS- COMMUNITY REGISTERED DIETITIAN PHONE LINE: FREE ADVICE LINE OPEN TO THE COMMUNITY FOR NUTRITION INFORMATION- CONSIDER THE CONVERSATION - ADVANCE CARE PLANNING: CLASS ON ADVANCE HEALTH CARE DIRECTIVES- COUPLES GROUP: LIVING WITH LIFE THREATENING DISEASE- EVERY 15 MINUTES: A COMMUNITY COLLABORATION TO EDUCATE HIGH SCHOOL STUDENTS ON DRINKING AND DRIVING- HANDS ON CPR AND AED TRAINING: FREE COMMUNITY-WIDE CPR AND AED TRAINING- HOME IS WHERE THE HEART CARE IS: HEART HEALTH FORUM WITH LECTURES FROM CARDIOVASCULAR EXPERTS- HORSES AS HEALERS: A POST TREATMENT RECOVERY ACTIVITY FOR COMMUNITY MEMBERS WITH CANCER- HR COMMUNITY LECTURES ON WORK/HEALTH CARE: LECTURES TO HIGH SCHOOLS BY HUMAN RESOURCES ON WORKING IN A HEALTH CARE ENVIRONMENT- INTEGRATIVE HEALTH SPEAKERS SERIES: LECTURE SERIES ON MIND-BODY MEDICINE AND INTEGRATIVE THERAPIES- KNITTING CIRCLE: FOR CANCER SURVIVORS AND FAMILIES- LYMPHEDEMA CLASSES AND SUPPORT GROUP- MARIN COUNTY SENIOR FAIR: BOOTH AT ONE DAY FAIR EVENT FOR SENIORS- MEDICAL LIBRARY: HEALTH REFERENCE LIBRARY OPEN TO STAFF, PHYSICIANS AND COMMUNITY- MINDFUL MOTHERHOOD STRESS REDUCTION CLASS: FOR WOMEN IN THE POSTPARTUM PERIOD- OUTPATIENT LACTATION CENTER: FREE EDUCATION, COUNSELING AND BREASTFEEDING SUPPORT AVAILABLE TO THE COMMUNITY- PRENATAL BREASTFEEDING CLASS- THE MOM'S GROUP: FREE SUPPORT GROUP TO THE COMMUNITY THAT DISCUSSES NEWBORN CARE, BREASTFEEDING, PARENTING, ETC.- THE NEW FATHER CLASS: FREE CLASS FOR NEW FATHERS ON HAVING A NEWBORN- WOMEN'S SUPPORT GROUP: LIVING WELL WITH METASTASIS- COMMUNITY BASED CLINICAL SERVICES- LOW COST MAMMO DAY: MAMMOGRAMS OFFERED TO UNDERSERVED WOMEN- PROSTATE CANCER SCREENING: FREE SCREENING OFFERED TO THE COMMUNITY- HEALTH CARE SUPPORT SERVICES- INDIGENT FUNDED SERVICES FOR BEHAVIORAL HEALTH: INCLUDING TRANSPORTATION, LODGING, MEALS AND OTHER NEEDS- INDIGENT FUNDED SERVICES FOR CASE MANAGEMENT: INCLUDING TRANSPORTATION, LODGING, AND PHYSICAL THERAPY- SHUTTLE PROGRAM FOR SENIOR PARTIAL ADULT DAY CARE PROGRAM: FREE SHUTTLE SERVICE FOR BEHAVIORAL HEALTH PROGRAM PART I, LINE 7F: HEALTH PROFESSIONS EDUCATION - PHYSICIANS/MEDICAL STUDENTS- GRAND ROUNDS: EDUCATION PROGRAMS OPEN TO COMMUNITY DOCTORS AND NURSE PRACTITIONERS- NURSES/NURSING STUDENTS- CASE MANAGEMENT STUDENT NURSES: TRAINING OF CASE MANAGEMENT STUDENTS- NURSING STUDENT PLACEMENT: TIME SPENT FROM EDUCATION PLACING STUDENT NURSES- TRAUMA NURSE CORE COURSE (TNCC): NURSING EDUCATION FOCUSED ON TRAUMA- OTHER HEALTH PROFESSIONAL EDUCATION- CHAPLAIN RESIDENT PROGRAM: TRAINING HOURS PROVIDED BY OUR STAFF- CITY COLLEGE OF SF RADIATION THERAPY PROGRAM: HOURS SPENT BY OUR STAFF AS PART OF TRAINING PROGRAM- PRECEPTORSHIP FOR CASE MANAGEMENT STUDENTS: TRAINING HOURS PROVIDED BY OUR STAFF- PRECEPTORSHIP FOR NUTRITION STUDENTS: TRAINING HOURS PROVIDED BY OUR STAFF- TRAUMA: THE MARIN SERIES: EDUCATION CLASSES FOR PARAMEDICS, EMTS, FIRE 10 DEPARTMENT AND OTHER HEALTH CARE WORKERS- SCHOLARSHIPS/FUNDING FOR PROFESSIONAL EDUCATION- FUNDING FOR STAFF EDUCATION - NUTRITION RESEARCH- CLINICAL RESEARCH- EASTERN COOPERATIVE ONCOLOGY GROUP (ECOG): INVOLVEMENT WITH ECOG WHO CONDUCTS CLINICAL TRIALS IN ALL TYPES OF ADULT CANCERS PART I, LINE 7H: RESEARCH PROGRAMS THE MARIN CANCER INSTITUTE AT MGH HAS PARTICIPATED IN CANCER RESEARCH TRIALS FOR MORE THAN 25 YEARS, MANY OF WHICH ARE IN THE AREA OF BREAST CANCER. PART I, LINE 7I: FINANCIAL AND IN-KIND CONTRIBUTIONS - CASH DONATIONS- COASTAL HEALTH ALLIANCE: PROVIDES CARE FOR THE UNINSURED- ESURANCE HARBOR POINT TENNIS CLASSIC: HALF OF THE DONATION WENT TO THE CALIFORNIA PROSTATE COALITION AND THE OTHER HALF TO TO CELEBRATE LIFE BREAST CANCER FOUNDATION- HEALTHY AGING SYMPOSIUM: CONTRIBUTIONS FOR MARIN HEALTH & HUMAN SERVICES TO CONTINUE PROVIDING VITAL OUTREACH SERVICES FOR OLDER ADULTS IN MARIN COUNTY- HONOR THY HEALER: TO THE ZERO BREAST CANCER FOUNDATION FOR RESEARCH, EDUCATION AND ADVOCACY PROGRAMS- HOSPICE BY THE BAY: TO HOSPICE BY THE BAY FOR THEIR OPERATIONS- MARIN CITY HEALTH & WELLNESS: PROVIDES CARE FOR THE UNINSURED- MARIN COMMUNITY CLINICS: MEDICAL CARE PROVIDED TO THE UNDERSERVED- MARIN COMMUNITY FOUNDATION - HEALTHY KIDS FUND: SUPPORTS THE PROVISION OF HEALTH INSURANCE FOR CHILDREN IN MARIN COUNTY- MARIN LINK: FUNDS FOR PRINTING STROKE RESOURCE DIRECTORIES FOR THE COMMUNITY- MARIN SENIOR FAIR: EDUCATIONAL EVENT FOR SENIORS IN THE COMMUNITY- MARIN SONOMA CONCOURS D'ELEGANCE: FUNDS GO TO HOSPICE BY THE BAY TO SUPPORT HOSPICE SERVICES IN MARIN COUNTY- MHD 1206(B) CLINICS: OPERATION OF THE CLINICS- NAMI WALK: EDUCATIONAL EVENT AND WALK SUPPORTING AWARENESS OF MENTAL ILLNESS- PRIMA MEDICAL FOUNDATION: SUPPORTING AND SUSTAINING PRIMARY CARE IN MARIN- RALLY FOR HEALTH & HOPE: PROVIDES SERVICES FOR BREAST CANCER PATIENTS- REDWOODS CRABFEST: CONTRIBUTIONS TO THE REDWOODS AND THE OPERATION OF A FREE SHUTTLE FOR SENIORS IN THE COMMUNITY- ROTACARE SAN RAFAEL: PROVIDES CARE FOR UNDERSERVED THROUGH THE ROTACARE PROGRAM- STEPPING OUT TO CELEBRATE LIFE: BENEFITS THE TO CELEBRATE LIFE BREAST CANCER FOUNDATION- SUMMER SOLSTICE EVENT: DONATION SUPPORTS MEDICAL CARE FOR UNDERSERVED CHILDREN- WOMEN HEALTH CARE EXECUTIVES: PROVIDES SCHOLARSHIPS FOR HIGH SCHOOL STUDENTS IN HEALTH CARE FIELDS- IN-KIND DONATIONS- COMMUNITY MENTAL HEALTH UNIT B - FACILITIES: FACILITIES FREE SERVICES- COMPASSIONATE DISCHARGE PRESCRIPTIONS: DISCOUNTED PRESCRIPTION PROGRAM- FOOD DONATION: FOOD DONATED BY NUTRITION SERVICES TO COMMUNITY ORGANIZATIONS- MARIN COMMUNITY CLINIC FACILITIES: FACILITIES FREE SERVICES- MEDSHARE: DONATION OF SUPPLIES- MEETING ROOM SPACE: MEETING ROOMS PROVIDED TO COMMUNITY GROUPS- VIDA (VOLUNTEERS FOR INTER-AMERICAN DEVELOPMENT ASSISTANCE): DONATION OF SUPPLIES PART II, COMMUNITY BUILDING ACTIVITIES: ECONOMIC DEVELOPMENT: MARIN GENERAL HOSPITAL IS A MEMBER OF THE SAN RAFAEL CHAMBER OF COMMERCE. THE SAN RAFAEL CHAMBER OF COMMERCE IS ONE OF MARIN COUNTY'S LEADING BUSINESS ADVOCATES. THEY ARE STRONG CHAMPIONS FOR LOCAL BUSINESS INTERESTS AND WORK VIGOROUSLY TO MAINTAIN A HEALTHY ECONOMY.COALITION BUILDING: MARIN GENERAL HOSPITAL WORKS WITH THE AGRICULTURAL INSTITUTE OF MARIN AND HEALTH COUNCIL OF MARIN TO PROMOTE HEALTHY INITIATIVES IN THE COMMUNITY.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: MARIN GENERAL HOSPITAL PARTICIPATES ON A COMMUNITY COMMITTEE THROUGH THE MARIN MOBILITY CONSORTIUM FOUNDATION THAT IS WORKING TO DEVELOP A PROGRAM TO COORDINATE RIDES FOR SENIORS, DISABLED AND PARATRANSIT PERSONS. MARIN GENERAL ALSO PARTICIPATES IN MEETINGS AND FUNDRAISING FOR THE ROTARY OF CENTRAL MARIN FOUNDATION. PART III, LINE 4: 1. 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 2.2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.3. ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS - MGH'S NET PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, MGH 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, MGH 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), MGH 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.MGH'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 5% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT DECEMBER 31, 2013 AND 2012. IN ADDITION, MGH'S WRITE-OFFS WERE APPROXIMATELY $16,786 AND $18,179 FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. MGH HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2013 OR 2012.SIGNIFICANT CONCENTRATIONS OF NET PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS:COMMERCIAL - 62%MEDICARE - 19%MEDI-CAL - 8%PRIVATE PAY AND OTHER - 11%MGH PROVIDES FOR ESTIMATED LOSSES ON PATIENT ACCOUNTS RECEIVABLE BASED ON PRIOR BAD DEBT EXPERIENCE AND GENERALLY DOES NOT CHARGE INTEREST ON PAST DUE BALANCES. PAST DUE STATUS IS BASED UPON THE DATE OF SERVICES PROVIDED. UNCOLLECTIBLE RECEIVABLES ARE CHARGED OFF WHEN DEEMED UNCOLLECTIBLE. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PART III, LINE 8: THE ORGANIZATION DID NOT COUNT THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. ALL MEDICARE REVENUE AND COST WAS INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. PART III, LINE 9B: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING 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: MARIN GENERAL HOSPITAL IS A MEMBER OF THE HEALTHY MARIN PARTNERSHIP, A COLLABORATION OF DIVERSE MARIN COUNTY ORGANIZATIONS THAT WAS FORMED TO ADDRESS HEALTH ISSUES IN MARIN COUNTY. MEMBERS INCLUDE HEALTH CARE INSTITUTIONS, COUNTY GOVERNMENT, EDUCATIONAL ORGANIZATIONS, BUSINESS ORGANIZATIONS AND OTHER ORGANIZATIONS SUCH AS FOUNDATIONS, THE MARIN INTERFAITH COUNCIL AND THE UNITED WAY. EVERY THREE YEARS, SINCE 1996, THE HEALTHY MARIN PARTNERSHIP CONDUCTS A COMMUNITY NEEDS ASSESSMENT THAT IDENTIFIES HEALTH ISSUES IN MARIN. THIS ASSESSMENT SERVES AS A BASIS FOR PLANNING ON BEHALF OF BOTH THE INDIVIDUAL ORGANIZATIONS AS WELL AS THE PARTNERSHIP AS A WHOLE, WHICH PLANS AND IMPLEMENTS SPECIFIC COMMUNITY PROGRAMS. THE 2011 NEEDS ASSESSMENT WAS BASED ON A REVIEW OF A VARIETY OF DATA SOURCES AND CAN BE FOUND AT WWW.HEALTHYMARINPARTNERSHIP.ORG. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: MGH'S CHARITY CARE POLICY INCLUDES THE FOLLOWING DETAILS RELATED TO PATIENT EDUCATION FOR ELIGIBIITY ASSISTANCE. COMMUNICATION OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILTY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS). B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE MARIN GENERAL HOSPITAL STANDARIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION".2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL 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 SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, MGH 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 MGH WEBSITE. 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 THIRD-PARTY LIENS, AND DISPUTE INITIATION POLICY. C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVENRMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGES OF MGH'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATION 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 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 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: MARIN GENERAL HOSPITAL PRIMARILY SERVES RESIDENTS OF MARIN COUNTY. CERTAIN SPECIALTY PROGRAMS SERVICE A BROADER POPULATION, INCLUDING PATIENTS FROM SONOMA COUNTY, THE BROADER SF BAY AREA AND BEYOND. THE UNITED STATES CENSUS BUREAU REPORTS THAT THE MEDIAN HOUSEHOLD INCOME FROM 2006-2010 IS $89,268. THE COUNTY'S POPULATION INCREASED SLIGHTLY - FROM 259,880 IN 2009 TO 261,837 IN 2010, ACCORDING TO THE STATE OF CALIFORNIA, DEPARTMENT OF FINANCE. THE POPULATION HAS AGED SINCE 1990 WHEN THE MEDIAN AGE WAS 38 YEARS, ACCORDING TO A 2007 REPORT BY THE MARIN ECONOMIC COMMISSION. BY 2000 THE MEDIAN AGE WAS 41.3 YEARS. SENIOR CITIZENS (65 AND OLDER) HAVE INCREASED SIGNIFICANTLY, FROM 9.7 PERCENT OF THE POPULATION IN 1980 TO 15.8 PERCENT IN 2008. ACCORDING TO THE UNITED STATES CENSUS BUREAU, 86 PERCENT OF THE POPULATION IS CAUCASIAN, FOLLOWED BY PERSONS OF HISPANIC ORIGIN AT 16 PERCENT. WHILE THE MARIN POPULATION IS BECOMING MORE ETHNICALLY DIVERSE, IT IS DOING SO AT A SLOWER RATE THAN OTHER CALIFORNIA COUNTIES. ALTHOUGH MARIN COUNTY WAS RECENTLY NAMED "THE HEALTHIEST COUNTY IN CALIFORNIA," IT CONTINUES TO HAVE ONE OF THE HIGHEST RATES OF BREAST CANCER AND PROSTATE CANCER IN CALIFORNIA. CANCER, HEART DISEASE AND STROKE REMAIN THE PRIMARY CAUSES OF DEATH FOR BOTH MEN AND WOMEN. AMONG NON-WHITES, THERE ARE HIGHER RATES OF POVERTY AND ADOLESCENT PREGNANCIES, LOWER LEVELS OF ADEQUATE PRENATAL CARE, HIGHER RATES OF LOW BIRTH RATE INFANTS, AND CULTURAL/LINGUISTIC BARRIERS TO ACCESSING HEALTH CARE. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: AS PART OF ITS COMMITMENT TO INCREASING HEALTH CARE FOR THE UNDER- AND UNINSURED, MGH PROVIDES ONGOING FINANCIAL SUPPORT TO KEY HEALTH CARE SAFETY NET ORGANIZATIONS, INCLUDING THE MARIN COMMUNITY CLINICS, ROTACARE, AND THE MARIN COMMUNITY FOUNDATION TO SUPPORT THE PROVISION OF HEALTH INSURANCE FOR CHILDREN IN MARIN COUNTY. MGH ALSO PROVIDES FUNDING FOR ACCESS TO CARE THROUGH THE PRIMA MEDICAL FOUNDATION AND THE MARIN HEALTHCARE DISTRICT 1206(B) CLINICS. OTHER ORGANIZATIONS THAT MGH SUPPORTS FINANCIALLY INCLUDE MARIN CITY HEALTH & WELLNESS, HOSPICE BY THE BAY, AND THE ZERO BREAST CANCER FOUNDATION. PROGRAMMATICALLY, MGH PHYSICIANS AND STAFF DIRECTLY PARTICIPATE IN A VARIETY OF ADDITIONAL COMMUNITY BUILDING ACTIVITIES, INCLUDING PROVIDING SPACE FOR FREE SURGERIES THROUGH OPERATION ACCESS AND PROVIDING ONE OR MORE FREE HEALTH CARE SCREENINGS TO THE COMMUNITY ON AN ANNUAL BASIS. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 MARIN COMMUNITY CLINIC 300 PROF CTR PARKWAY SAN RAFAEL CA 94903 942237120 501(C)(3) 220762 GENERAL SUPPORT MARIN GENERAL HOSPITAL VOLUNTEERS 250 BON AIR RD GREENBRAE CA 94904 942823538 501(C)(3) 76800 GENERAL SUPPORT MARIN ECONOMIC FORUM 3501 CIVIC CENTER DRIVE SAN RAFAEL CA 94903 680101012 501(C)(3) 10000 GENERAL SUPPORT SAN RAFAEL CHAMBER OF COMMERCE 817 MISSION AVE SAN RAFAEL CA 94901 940839470 501(C)(6) 18944 GENERAL SUPPORT MARIN GENERAL HOSPITAL FOUNDATION 100B DRAKES LANDING 255 GREENBRAE CA 94904 946127213 501(C)(3) 540000 GENERAL SUPPORT PRIMA MEDICAL FOUNDATION 4 HAMILTON LANDING SUITE 100 NOVATO CA 94949 271376321 501(C)(3) 8117463 GENERAL SUPPORT 5 1 PATIENT ASSISTANCE 290 57633 PART I, LINE 2: THE HOSPITAL DOES NOT REQUIRE ACCOUNTING OF THE USE OF GRANT FUNDS PROVIDED. IN THE CASES OF GENERAL PURPOSE GRANTS, THE GRANTEE'S CHARITABLE PURPOSE IS REVIEWED PRIOR TO THE ISSUANCE OF THE GRANT. A GRANT WAS AWARDED TO THE MARIN COMMUNITY CLINIC, AN ORGANIZATION WITH LOCATIONS BOTH ON AND OFF-SITE FROM THE HOSPITAL, WHICH THE HOSPITAL INTERACTS WITH ON A DAILY BASIS. X X X X 0 0 0 0 0 1 0 0 0 LEE DOMANICO CEO/MGH BOARD EX-OFFICIO 709150 0 279123 0 194562 0 16187 0 0 0 1199022 0 0 0 DAVID W COX CHIEF FINANCIAL OFFICER 384818 0 145431 0 0 0 8029 0 21238 0 559516 0 0 0 JON D FRIEDENBERG CHF ADMINISTRATIVE OFFICER 316312 0 120723 0 0 0 13637 0 29916 0 480588 0 0 0 MARK A ZIELAZINSKI CHIEF INFO & TECH OFFICER 302088 0 39631 0 0 0 12750 0 22123 0 376592 0 0 0 JOEL SKLAR CHIEF MEDICAL OFFICER 259751 0 63390 0 0 0 13453 0 21238 0 357832 0 0 0 THERESA E GIANFORTUNE CHF HUMAN RESOURCES OFFICER 146105 0 59339 0 0 0 10004 0 12389 0 227837 0 0 0 RICHARD S REID VP/CONTROLLER 266112 0 51240 0 0 0 37397 0 29916 0 384665 0 0 0 SUSAN S CUMMING MEDICAL DIRECTOR MGH 305855 0 0 0 0 0 0 0 29916 0 335771 0 0 0 CHUN LI CHIEF CLIN PHYSICIST 274570 0 30688 0 0 0 36094 0 21238 0 362590 0 0 0 GOONASAGRIE NAIDOO VP OF NURSING 245822 0 0 0 0 0 30142 0 31163 0 307127 0 0 0 GREGORY LEE CARD CATH TECH IV 429654 0 0 0 0 0 24933 0 10094 0 464681 0 0 0 MARGARET M ROBERTS CLINICAL RN III 327726 0 0 0 0 0 33164 0 21238 0 382128 0 0 0 SANDY D AUGUSTUS CLINICAL RN III 325014 0 0 0 0 0 19108 0 29916 0 374038 0 0 0 JAMES I WHITLOCK RAD TECH IV 263864 0 0 0 0 0 17214 0 29916 0 310994 0 0 0 WESTERBERG JEFFREY W RAD TECH IV 259377 0 0 0 0 0 18664 0 29916 0 307957 0 0 0 PART I, LINE 6 THE CALCULATION OF BONUSES IS DEPENDENT ON MANY FACTORS THAT ARE ASSIGNED VARIOUS WEIGHTINGS. THOSE FACTORS ARE: - PATIENT SATISFACTION SURVEY SCORES - EMPLOYEE SATISFACTION SURVEY SCORES - PHYSICIAN SATISFACTION SURVEY SCORES - EXCESS OF REVENUE OVER EXPENSES - REVENUE GROWTH - COMMUNITY BENEFIT PROGRAMS - QUALITY AND SAFETY RESULTS PART I, LINE 3: OTHER REPORTABLE COMPENSATION THE TAXABLE COMPENSATION RECEIVED BY THE EXECUTIVE TEAM WAS FOR HEALTH AND WELFARE BENEFITS, DEFINED BENEFIT RETIREMENT PENSION PLAN, DISBILITY, LONG-TERM CARE INSURANCE, LIFE INSURANCE AND ACCIDENTIAL DEATH AND DISMEMBERMENT INSURANCE. THE TAXABLE COMPENSATION RECEIVED BY THE KEY EMPLOYEES AND FIVE HIGHEST COMPENSATED EMPLOYEES WAS FOR GROUP TERM LIFE INSURANCE. THE OTHER REPORTABLE COMPENSATION WAS INCLUDED IN THEIR FORM W-2. FORM 990, PART VI, SECTION A, LINE 6 MARIN HEALTHCARE DISTRICT IS THE SOLE CORPORATE MEMBER OF MARIN GENERAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF THE GENERAL MEMBER MAY, BY RESOLUTION, AUTHORIZE A PERSON OR COMMITTEE OF PERSONS TO EXERCISE ITS VOTE ON ANY MATTER TO COME BEFORE THE MEMBERSHIP OF THIS CORPORATION. IN ADDITION, THE GENERAL MEMBER MAY EXERCISE ITS MEMBERSHIP RIGHTS AT ANY REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS OF THE GENERAL MEMBER. THE FUNCTIONS REQUIRED BY LAW OR BY THE BYLAWS TO BE PERFORMED AT THE ANNUAL MEMBERSHIP MEETING OR ANY REGULAR OR SPECIAL MEETING OF THE MEMBERS OF THIS CORPORATION MAY BE PERFORMED AT ANY REGULAR OR SPECIAL MEETING OF THE GENERAL MEMBER'S OWN BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 7B OTHER RESERVED RIGHTS INCLUDE: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. DISPOSITION OF A SIGNIFICANT PORTION OF THE ASSETS OF THE ORGANIZATION; C. ISSUANCE OF LONG TERM DEBT EXCEEDING A CERTAIN PORTION OF THE ORGNIZATIONS ASSETS. FORM 990, PART VI, SECTION B, LINE 11 OUR TAX ADVISOR PROVIDES AND PREPARES THE RETURN IN CONSULTATION WITH OUR ACCOUNTING DEPARTMENT. THE INFORMATION IS THEN REVIEWED BY OUR CHIEF FINANCIAL OFFICER PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH INDIVIDUAL BOARD MEMBER AND OFFICER HAS TO SIGN AN ACKNOWLEDGEMENT FORM THAT THEY HAVE READ THE POLICY. A DISCLOSURE STATEMENT IS COMPLETED BY ALL OFFICERS AND BOARD MEMBERS. 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 LEGAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED TRUSTEE 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 TRUSTEE TO LEAVE THE ROOM OR NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED TRUSTEE SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE MGH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE EXECUTIVE COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF MGH'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 AND REGIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS MGH ARE MOST APPROPRIATE. ALL OFFICERS OF THE ORGANIZATION UNDERGO A REVIEW ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 MARIN GENERAL HOSPITAL WILL MAKE THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION 42,000. CHANGE IN BENEFIT PLAN 3,033,548. AUDITED FINANCIAL STATEMENT ROUNDING 360. CHANGE IN INVESTMENT - MGHF -3,537,248. FORM 990, PART XII, LINE 2C : AUDIT COMMITTEE AND OVERSIGHT MARIN GENERAL HOSPITAL HAD AN AUDIT OF ITS BALANCE SHEET AND STATEMENT OF OPERATIONS PERFORMED BY INDEPENDENT AUDITORS. AN AUDIT COMMITTEE SELECTS THE AUDITORS AND REVIEWS RESULTS. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. FORM 990, PART III, LINE 4A : EXEMPT PURPOSE ACHIEVEMENTS MARIN GENERAL HOSPITAL (MGH) IS A NOT-FOR-PROFIT HOSPITAL LOCATED IN GREENBRAE, CALIFORNIA, WITH 235 LICENSED ACUTE CARE BEDS, IT IS THE LARGEST ACUTE CARE HOSPITAL IN MARIN COUNTY AND PROVIDES BOTH PRIMARY AND SECONDARY CARE AND GENERAL SERVICES SUCH AS THE MARIN CANCER INSTITUTE AND THE MARIN HEART INSTITUTE. OTHER SERVICES INCLUDE A LEVEL III TRAUMA CENTER AND FULL COMPLEMENT OF ACUTE CARE AND ANCILLARY SERVICES SUCH AS NEONATAL INTENSIVE CARE, PEDIATRICS, A FAMILY BIRTHING CENTER, SHARED CARE, HOME CARE, ADULT BEHAVIORAL HEALTH SERVICES, AN ELECTROPHYSIOLOGY LABORATORY, A STROKE PROGRAM AND CARDIAC CATHETERIZATION LABORATORY. MGH IS ACCREDITED BY THE JOINT COMMISSION. MISSION AND VALUES: THE MISSION OF MGH IS AS FOLLOWS: TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. MGH'S VALUES ARE: MARIN GENERAL HOSPITAL WILL BE THE INDISPENSABLE PROVIDER OF HEALTH CARE IN MARIN, RECOGNIZING AND VALUED BY OUR COMMUNITY, PATIENTS, PHYSICIANS, AND EMPLOYEES FOR DELIVERING SUPERIOR CLINICAL OUTCOMES IN A SUSTAINABLE STATE-OF-THE-ART FACILITY. GOVERNANCE: MGH IS AN INDEPENDENT 501(C)(3) NOT FOR PROFIT HOSPITAL. ITS SOLE CORPORATE MEMBER IS THE MARIN HEALTHCARE DISTRICT, A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA, WHICH RETAINS CERTAIN RESERVE POWERS OVER THE ORGANIZATION. MGH IS GOVERNED BY ITS OWN BOARD OF DIRECTORS. PROGRAMS, FACILITIES, AND SERVICES: OPENED IN MAY 1952, MGH HAS CONTINUED TO EXPAND ITS PROGRAMS, SERVICES AND FACILITIES. SERVICES INCLUDE A BASIC EMERGENCY DEPARTMENT AND LEVEL III TRAUMA CENTER, MEDICAL AND SURGICAL SERVICES, MATERNITY SERVICES, PEDIATRICS, NEONATAL INTENSIVE CARE, AN ADULT PSYCHIATRIC UNIT, A COMPREHENSIVE CANCER CENTER, PARTIAL HOSPITALIZATION FOR ADULT PSYCHIATRIC PATIENTS, A HEARING AND SPEECH CENTER, OUTPATIENT LABORATORIES, AND RADIOLOGY SERVICES. SPECIFIC SERVICES ARE AS FOLLOWS: -ANGIOPLASTY: FULL SERVICES TO ASSIST CLEARING OF ARTERY BLOCKAGES. -AMBULATORY SURGERY CENTER: THE SURGERY CENTER PROVIDES ELECTIVE OUTPATIENT SURGERIES AND DIAGNOSTIC PROCEDURES. -CARDIAC SPECIALTY UNIT: PROVIDES CARE TO COMPLEX MULTI-SYSTEM NEEDS AND CARDIAC MONITORING. -CARDIAC CATHETERIZATION LABORATORY: 24-HOUR PROGRAM CONDUCTS PROCEDURES TO DIAGNOSE AND TREAT CORONARY ARTERY HEART VALVES AND FUNCTIONS. -DESIGNATED CHEST PAIN CENTER WITH PERCUTANEOUS CORONARY INTERVENTION (PCI): -SPIRITUAL CARE PROGRAM: PROVIDES EMOTIONAL AND SPIRITUAL SUPPORT SERVICES FOR PATIENTS AND THEIR FAMILIES AND FRIENDS. -ELECTROPHYSIOLOGY LAB: USES STATE-OF-THE-ART TECHNOLOGY TO DIAGNOSE AND TREAT PATIENTS WITH IRREGULAR HEARTBEATS (ARRHYTHMIA). -EMERGENCY SERVICES: AN EMERGENCY DEPARTMENT AND MARIN COUNTY'S ONLY DESIGNATED TRAUMA CENTER (LEVEL III), WITH A PARAMEDIC BASE STATION AND 24-HOUR SERVICE. -FAMILY BIRTHING CENTER: OFFERS PRIVATE ROOMS AND A VARIETY OF BIRTHING OPTIONS IN A FAMILY ENVIRONMENT, INCLUDING THE ABILITY TO MEET SPECIAL MEDICAL NEEDS. -GENERAL SURGICAL UNIT -HEARING AND SPEECH PROGRAM: AN OUTPATIENT PROGRAM OFFERING COMPREHENSIVE DIAGNOSTIC AND REHABILITATIVE SPEECH, LANGUAGE AND HEARING SERVICES. -CENTER FOR INTEGRATIVE HEALTH & WELLNESS: PROVIDES INPATIENT AND OUTPATIENT PROGRAMS WHICH COMPLEMENT MEDICAL CARE, INCLUDING MASSAGE THERAPY, SUPPORT GROUPS, GUIDED IMAGERY, ART THERAPY, ETC. -INTENSIVE CARE UNIT -LABORATORY: COMPREHENSIVE DIAGNOSTIC TESTING SERVICES ON-SITE ALONG WITH SATELLITE LOCATIONS OFF-SITE. -LACTATION CENTER: COMPREHENSIVE EDUCATIONAL AND RETAIL SERVICES FOR BREASTFEEDING MOTHERS, INCLUDING THE BABYNOOK STORE. -LITHOTRIPSY: REMOVAL OF KIDNEY STONES. -MAGNETIC RESONANCE IMAGING CENTER (MRI): OPERATES A MOBILE UNIT THAT PROVIDES DEFINITIVE IMAGING OF INTERNAL BODY STRUCTURES -MARIN CANCER INSTITUTE: PROVIDES COMPREHENSIVE CANCER CARE SERVICES FROM DIAGNOSIS THROUGH TREATMENT. -HAYNES CARDIOVASCULAR INSTITUTE: PROVIDES COMPREHENSIVE HEART & VASCULAR SERVICES INCLUDING: ANEURYSMS, CORONARY ARTERY DISEASE, CORONARY REVERSAL, DISORDERS OF CARDIAC RHYTHM, HEART ATTACKS, HEART FAILURE, PERIPHERAL VASCULAR DISEASE, VASCULAR HEART DISEASE. -HOSPITALIST PROGRAM: INTERNAL MEDICINE PHYSICIANS WHO CARE FOR HOSPITALIZED PATIENTS. HOSPITALISTS ARE PHYSICIANS WHO ARE EXPERTS IN TREATING ACUTE ILLNESSES AND THEIR ENTIRE ATTENTION IS DIRECTED TOWARD PATIENTS WHILE THEY ARE IN THE HOSPITAL. -MARIN MAMMOGRAPHY AND BREAST HEALTH CENTER: OFFERS BREAST HEALTH SERVICES AND EDUCATION. -MEDICAL UNITS -NEONATAL INTENSIVE CARE UNIT: THE ONLY LEVEL II UNIT IN MARIN COUNTY. -NUCLEAR MEDICINE: INPATIENT AND EMERGENCY SERVICES AVAILABLE 24/7. ROUTINE OUTPATIENT SERVICES AVAILABLE ON WEEKDAYS AND SATURDAYS. -PEDIATRICS PHARMACY: 24-HOUR SERVICES FOR INPATIENTS. -PHYSICAL THERAPY: PROVIDES SERVICES FOR INPATIENTS AND OUTPATIENTS, SPECIALIZING IN LYMPHEDEMA AND URINARY INCONTINENCE. -BEHAVIORAL HEALTH UNIT: CONTAINS INPATIENT UNIT, PARTIAL DAY CARE AND PARTIAL HOSPITALIZATION. -RADIOLOGY: PROVIDES X-RAYS, CT SCANNING, ULTRASOUND AND DIGITAL SUBTRACTION ANGIOGRAPHY. -RESPIRATORY CARE: PROVIDES 24 HOUR INPATIENT CARE, AS WELL AS OUTPATIENT CARE, BEDSIDE SPIROMETRY AND HOME CARE. -SHARED CARE UNIT: INCORPORATES FAMILY INTO THE PATIENT CARE ENVIRONMENT AND PROVIDES FAMILY TEACHING. -SURGERY -ORTHOPEDIC SURGERY PROGRAM: TOTAL JOINT REPLACEMENT, SPINE SURGERY -ELECTIVE NEUROSURGERY PROGRAM: IN COLLABORATION WITH UCSF -PALLIATIVE CARE -DIABETES CARE PROGRAM: INPATIENT DIABETES "KEYS TO CONTROL" EDUCATION PROGRAM SINCE 1952, THE HOSPITAL HAS UNDERGONE MAJOR EXPANSIONS. IN 1989, THE "HOSPITAL OF THE FUTURE" - A $36 MILLION NEW WEST WING, WAS OPENED AND HOUSES CARDIAC SURGERY, INTENSIVE CARE, EMERGENCY AND GENERAL SURGERY. IN 1992, THE CANCER INSTITUTE WAS EXPANDED. LATER, A STATE OF THE ART FAMILY BIRTHING CENTER WAS ADDED (1999), AND IN 2006, THE CARDIAC CATHETERIZATION LABORATORY WAS COMPLETELY RENOVATED. IN 2001, THE $3.4 MILLION JOHNSON FAMILY FOUNDATION ELECTROPHYSIOLOGY LAB WAS OPENED WITH A $3.9 MILLION RENOVATION AND EQUIPMENT REPLACEMENT COMPLETED IN 2011. IN 2005, THE HOSPITAL PURCHASED TWO STATE-OF-THE-ART DIGITAL MAMMOGRAPHY MACHINES, WITH A THIRD MACHINE BEING ADDED IN 2008. QUALITY IMPROVEMENT: QUALITY PATIENT CARE IS THE TOP PRIORITY AT MGH. THE GOAL OF OUR PATIENT CARE TEAMS IS TO TREAT THE WHOLE PERSON WITH PERSONAL, COMPASSIONATE, AND EXPERT CARE. PHYSICIANS HAVE PRIMARY RESPONSIBILITY FOR ASSURING DELIVERY OF HIGH QUALITY CARE. A NUMBER OF SPECIFIC FORMAL STRUCTURES AND PROCESSES ARE IN PLACE TO MONITOR AND EVALUATE QUALITY AND TO FACILITATE CONTINUOUS QUALITY IMPROVEMENT. THESE INCLUDE A QUALITY COMMITTEE OF THE BOARD OF DIRECTORS, PARTICIPATION IN ACCREDITATION SURVEYS AND AN INTERNAL "QUALITY DASHBOARD" IN WHICH SPECIFIC OUTCOME INDICATORS ARE REVIEWED ON A ROUTINE BASIS AND COMPARED TO REGIONAL AND NATIONAL STANDARDS. ON A QUALITY BASIS, AN INDEPENDENT SURVEY (PRESS-GANEY) IS CONDUCTED TO ASSESS PATIENT SATISFACTION WITH THEIR CARE AT MGH. CONSISTENTLY, 88% OR MORE OF RESPONDING PATIENTS SURVEYED RATED THE CARE THEY RECEIVED AS "GOOD" OR "VERY GOOD" (THE HIGHEST RATING). FORM 990, PART III, LINE 4A : EXEMPT PURPOSE ACHIEVEMENTS CONTINUED AWARDS AND ACCREDITATIONS: JOINT COMMISSION ACCREDITATIONS - ACCREDITED PROGRAMS & CERTIFICATIONS (2010): MARIN GENERAL HOSPITAL HAS EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ACCREDITATION BY DEMONSTRATING COMPLIANCE WITH THE JOINT COMMISSION'S NATIONAL STANDARDS FOR HEALTH CARE QUALITY AND SAFETY IN HOSPITALS AND IN BEHAVIORAL HEALTH CARE. MARIN GENERAL HOSPITAL ALSO EARNED PRIMARY STROKE CENTER CERTIFICATION FROM THE JOINT COMMISSION ON MAY 13, 2010. ACCREDITATION FROM THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (2010): OUR BREAST HEALTH CENTER HAS OUTSTANDING EARLY DETECTION RATES AND IS ONE OF A FEW BAY AREA BREAST HEALTH CENTERS TO BE ACCREDITED BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC). THE NAPBC IS A CONSORTIUM OF NATIONAL, PROFESSIONAL ORGANIZATIONS FOCUSED ON BREAST HEALTH AND DEDICATED TO THE IMPROVEMENT OF QUALITY CARE AND OUTCOMES OF PATIENTS WITH DISEASES OF THE BREAST THROUGH EVIDENCE-BASED STANDARDS AND PATIENT AND PROFESSIONAL EDUCATION. -SOCIETY OF CHEST PAIN CENTERS (SCPC) - CHEST PAIN CENTER ACCREDITATION WITH PCI (PERCUTANEOUS CORONARY INTERVENTION) (2011): THE DESIGNATION DENOTES FACILITIES THAT UTILIZE STANDARDIZED DIAGNOSTIC AND TREATMENT PROGRAMS TO IMPROVE EVALUATION AND SPEED UP THE EFFECTIVE ADMINISTRATION OF TREATMENT TO CHEST PAIN PATIENTS. -NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS - ACCREDITED PROGRAM (2011): THE BREAST DIAGNOSTIC CENTER IS ACCREDITED AS A BREAST IMAGING CENTER OF EXCELLENCE DEMONSTRATING EXCELLENCE IN MAMMOGRAPHY, STEREOTACTIC BREAST BIOPSY, BREAST ULTRASOUND AND ULTRASOUND-GUIDED BREAST BIOPSY. -COMMISSION ON CANCER - THREE YEAR ACCREDITATION WITH COMMENDATION (2011): IN 2011, THE COMMISSION ON CANCER (COC) OF THE AMERICAN COLLEGE OF SURGEONS AWARDED THREE-YEAR APPROVAL STATUS AND EIGHT OUT OF EIGHT POSSIBLE COMMENDATIONS TO THE MARIN CANCER INSTITUTE (MCI). -AMERICAN STROKE ASSOCIATION - GOLD PLUS STROKE PERFORMANCE AWARD (2012): THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION RECOGNIZE THE HOSPITALS FOR THEIR SUCCESS IN USING GET WITH THE GUIDELINES TO IMPROVE QUALITY OF CARE FOR HEART DISEASE AND STROKE PATIENTS. -CALIFORNIA MEDICAL ASSOCIATION INSTITUTE FOR MEDICAL QUALITY - ACCREDITATION FOR CONTINUING MEDICAL EDUCATION (2012): PHYSICIANS WHO ATTEND CME COURSES OFFERED BY IMQ/CMA ACCREDITED PROVIDERS MEET THE MEDICAL BOARD OF CALIFORNIA'S DIVISION OF LICENSURE REQUIREMENTS FOR PHYSICIAN LICENSURE AND THE CALIFORNIA MEDICAL ASSOCIATION'S CERTIFICATION IN CONTINUING MEDICAL EDUCATION. LEVEL III TRAUMA PROGRAM REVERIFICATION (2012): AMERICAN COLLEGE OF SURGEONS THE AMERICAN COLLEGE OF SURGEONS DOES NOT DESIGNATE TRAUMA CENTERS; INSTEAD, IT VERIFIES THE PRESENCE OF THE RESOURCES LISTED IN RESOURCES FOR OPTIMAL CARE OF THE INJURED PATIENT. THIS IS A VOLUNTARY PROCESS AND ONLY THOSE TRAUMA CENTERS THAT HAVE SUCCESSFULLY COMPLETED A VERIFICATION VISIT ARE INCLUDED. BREAST IMAGING CENTER OF EXCELLENCE (2012): AMERICAN COLLEGE OF RADIOLOGY MARIN GENERAL HOSPITAL HAS BEEN DESIGNATED A BREAST IMAGING CENTER OF EXCELLENCE BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR). THE ACR AWARD RECOGNIZES BREAST IMAGING CENTERS THAT HAVE EARNED ACCREDITATION IN ALL OF THE COLLEGE'S VOLUNTARY BREAST-IMAGING ACCREDITATION PROGRAMS AND MODULES, IN ADDITION TO THE MANDATORY MAMMOGRAPHY ACCREDITATION PROGRAM. RECOGNIZED CENTERS HAVE UNDERGONE PEER-REVIEW EVALUATIONS EVERY THREE YEARS TO CONFIRM THAT THEY ADHERE TO HIGH PRACTICE STANDARDS IN IMAGE QUALITY, PERSONNEL QUALIFICATIONS, FACILITY EQUIPMENT, AND QUALITY CONTROL AND ASSURANCE PROCEDURES. TO MAINTAIN THEIR DESIGNATION, FACILITIES MUST UNDERGO AN ON-SITE REVIEW EVERY THREE YEARS. COMMUNITY BENEFIT PROGRAMS: MGH PLACES STRONG EMPHASIS ON PROGRAMS AND ACTIVITIES THAT BENEFIT THE COMMUNITY OUTSIDE THE HOSPITAL'S WALLS. THESE INCLUDE PREVENTION, DETECTION, EDUCATION, AND PROFESSIONAL EDUCATION PROGRAMS AS WELL AS PARTICIPATION AS A FOUNDING AGENCY IN THE HEALTHY MARIN PARTNERSHIP. MGH PROGRAMS AND ACTIVITIES RANGE FROM PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS, PROVIDING FUNDING TO COMMUNITY PROGRAMS, DIRECT SERVICE IN THE COMMUNITY, AND PROVIDING CHARITY MEDICAL CARE. EXAMPLES INCLUDE: CONTRIBUTING TO THE MARIN COMMUNITY CLINIC (A NON-PROFIT MEDICAL CLINIC LOCATED ON THE MGH CAMPUS WHICH PROVIDES SERVICES TO THE UNDERINSURED AND UNINSURED); FREE PROSTATE & SKIN CANCER SCREENINGS; LOW COST MAMMOGRAM SCREENINGS; MARIN GENERAL HOSPITAL CONTRIBUTED $55 MILLION IN SUPPORT OF COMMUNITY BENEFIT PROGRAMS IN 2012. THE MAJORITY OF THIS SPENDING WAS FOR CHARITY CARE AND UN-REIMBURSED CARE TOTALING MORE THAN $46 MILLION. THE UNPAID COST OF MEDI-CARE WAS $40.5 MILLION. MARIN HEALTHCARE DISTRICT 100 B DRAKES LANDING RD STE 250 GREENBRAE CA 94904 911886269 CORPORATE PARENT CA N/A 0 MARIN GENERAL HOSPITAL FOUNDATION 100 B DRAKES LANDING RD STE 250 GREENBRAE CA 94904 946127213 FUNDRAISING FOUNDATION CA 501(C)(3) 11-I MARIN GENERAL HOSPITAL 1 PRIMA MEDICAL FOUNDATION 4 HAMILTON LANDING STE 100 NOVATO CA 94949 271376321 PHYSICIAN MEDICAL FOUNDATION CA 501(C)(3) 9 0 MGHSCA LLC 100B DRAKES LANDING RD STE 190 GREENBRAE CA 94904 383861395 OUTPATIENT SURGERY CENTER CA N/A MARIN MAGNETIC RESONANCE IMAGING CENTER 1260 SOUTH ELISEO GREENBRAE CA 94904 680055977 OUTPATIENT IMAGING CA N/A 0 1 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 MARIN GENERAL HOSPITAL FOUNDATION B 540000 BOOK VALUE MARIN GENERAL HOSPITAL FOUNDATION C 2349753 BOOK VALUE MARIN GENERAL HOSPITAL FOUNDATION M 250145 BOOK VALUE MARIN GENERAL HOSPITAL FOUNDATION O 492840 BOOK VALUE MARIN GENERAL HOSPITAL FOUNDATION Q 475882 BOOK VALUE PRIMA MEDICAL FOUNDATION B 8117463 BOOK VALUE MARIN MAGNETIC RESONANCE IMAGING CENTER S 191250 BOOK VALUE MGHSCA LLC S 817754 BOOK VALUE