2014-12-15T13:55:39-06:00 2014-01-31 420714325 MCGLADREY LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2013-02-01 942281314 Emanuel Medical Center Inc EMAN 2096674200 825 Delbon Avenue Turlock CA 95382 Linda Stuhmer CEO 2096645011 2014-12-15 1 Wayne Harder P00294296 3126343400 2013 2015-11-30 17:44:51Z John Sigsbury 825 Delbon Avenue Turlock CA 95382 237473456 0 X www.emanuelmed.org X 1974 CA Operating on the foundation of Christian values to create a healthier community. 13 12 1548 885 0 0 1114713 419333 209372564 226976360 2820328 7754916 20813061 1072844 234120666 236223453 0 0 0 0 99778097 92640848 0 0 433661 138402234 138777990 238180331 231418838 -4059665 4804615 238432748 237166985 127261192 120280435 111171556 116886550 X Emanuel Medical Center ("EMC") is a non-profit public benefit corporation. EMC's mission is to create a healthier community through operating on the foundation of Christian values; focusing on health promotion and prevention of disease; providing safe, high quality and comprehensive health services for patients and their families; maintaining fiscal responsibility to all for maintenance; growth and development; and creating a collaborative partnership among community health resources. 0 1 206345380 227000194 Emanuel Medical Center ("EMC") is owned and operated by the Evangelical Covenant Church, which founded the hospital in 1917. Today, our 403-bed multi-level medical campus includes a 209-bed acute care hospital, a 145-bed skilled nursing facility and a 49-bed assisted living facility. Our broad range of services include emergency, critical care, imaging, medical and radiation oncology, pediatric, medical, surgical, birth center, neonatal intensive care, primary care, women's health, cardiology, laboratory, community education, and spiritual support. As the only hospital in its primary service area, during fiscal year (FY) 2014 ending January 31st, EMC: provided 40,273 days of acute care; served residents with 47,829 days of long-term care; treated 59,954 patients in our emergency room; performed 5,502 surgical procedures, delivered 1,343 babies; supported residents with 7,871 days of assisted living. 206345380 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0 1 159 0 1 1548 1 0 0 0 0 0 1 1 0 0 0 0 X 13 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X Linda Stuhmer 2096645011 825 Delbon Avenue Turlock CA 95382 John Sigsbury Director/President 1.00 40.00 X X 0 560806 70691 Arlon Waterson Director 1.00 X 0 0 0 Art DeRooy Director/Treasurer 1.00 X 0 0 0 Bill Gibbs Director 1.00 X 0 0 0 Kulmeet Dang DO Director 1.00 X 0 0 0 Jennifer Larson Director 1.00 X 0 0 0 Jim Pallios Director 1.00 X 0 0 0 Reza Nazari MD Director 1.00 X 0 0 0 David Dwight Director/President CMB 1.00 X 0 0 0 Ronald Arakelian Director 1.00 X 0 0 0 Marlene Stante Director/Secretary 1.00 X 0 0 0 Wade Fulmer Director 1.00 X 0 0 0 Tom Wilson MD Director 1.00 X 0 0 0 David Neapolitan CFO 40.00 X 285237 0 7272 Constance Fairchilds VP Patient Care 40.00 X 266504 0 4604 David Canton MD VP Medical Affairs 40.00 X 169082 0 0 Linda Hanks VP General Counsel 40.00 X 239766 0 4176 Ronald Evangelista Dir. Surgical Service 40.00 X 192773 0 1092 Michael Iltis ED Cancer Center 40.00 X 189917 0 4443 Terrance Gray VP Human Resources 40.00 X 197892 0 1707 Mathew Salsig RN Charge 40.00 X 157512 0 6676 1698683 560806 100661 83 0 1 0 Arnold & Porter LLP Three Embarcadero Center 10th Fl San Francisco CA 94111 Legal Services 2030554 Valley Emergency Physicians 1990 N California Blvd Walnut Creek CA 94596 Medical Services 1859584 Focus One Solutions LLC 13609 California Street Omaha NE 68154 Contract Labor 1748675 Softscript Inc 2444 Wilshire Blvd Suite 280 Santa Monica CA 90403 Transcript Services 1340504 Hooper Lundy & Bookman PC 5750 Market St Ste 2300 San Francisco CA 94105 Legal Services 1184710 48 41085 378248 42057 419333 Patient Service Revenue 621300 226976360 226976360 226976360 2191656 2191656 211480 0 211480 211480 211480 6681372 1118112 5563260 5563260 5563260 282539 41085 131891 150648 150648 Cafeteria Sales 722210 686882 686882 Minimum Volume Agreement 900099 23834 23834 710716 236223453 227000194 0 8803926 2295525 1290824 875519 129182 67325860 62873403 4253955 198502 2177777 2017874 159903 15325774 14453336 872438 5515912 5201636 286526 27750 1942121 1942121 4187506 22979 4164527 304309 304309 72703 72703 13554882 12158303 1396444 135 1118194 764637 351385 2172 2429348 2429348 2082793 1812107 270686 118717 50419 67818 480 96615 18065 78367 183 4797961 4797961 10065312 6918079 3145510 1723 754456 754456 Bad Debt 31909692 31909692 Medical Supplies 29446464 29443802 2662 Hospital Quality Assura 15255666 14443630 799270 12766 Purchase Services 12147415 10882596 1209607 55212 8493836 7213334 1277608 2894 231418838 206345380 24639797 433661 6206998 5613538 1474486 274661 85378 31073388 39394773 1936256 275081 3120572 3385389 1173950 1231748 201670117 106279246 96381649 95390871 62679436 70074833 34111352 21715374 238432748 237166985 20030767 21060470 564999 90251561 87057834 4222281 5268065 12756583 6329067 127261192 120280435 X 105256033 110779518 1673154 1835589 4242369 4271443 111171556 116886550 238432748 237166985 4804615 910379 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 72703 0 0 0 72703 0 Part II-B, Line 1: Emanuel Medical Center contributed $72,703 to California Hospitals Committee on Issues (CHCI) sponsored by California Association of Hospitals and Health Systems (CAHHS) in 2013 to support lobbying activities. 5044106 29074 262914 9750 1699 5324645 4680286 55163 320958 12301 5044106 4659235 -9971 52522 21500 4680286 4306565 -18254 290699 10750 -90975 4659235 2385000 1921884 29195 29514 4306565 1.00000 0 0 141650 1367081 1508731 68775365 27081732 41693633 3214477 1658983 1555494 81481506 58402380 23079126 46690038 19136151 27553887 95390871 Scholarship Funds 6019951 Trustee Held Funds 8986315 Other Assets 169894 Bond Issue Costs 724722 Medical Oncology Acquisition Assets 2286650 Partnership Investments 3527842 21715374 EMC Workers Compensation 5457196 Other Current Liabilities 871871 6329067 X 205244140 910379 20000 930379 204313761 31909692 31909692 236223453 199529146 20000 20000 199509146 31909692 31909692 231418838 Part V, Line 4: Income from permanently restricted funds is restricted primarily for cancer research and nursing scholarships. Part X, Line 2: The Center qualifies as a not-for-profit entity under the laws of California and as a tax-exempt organization under Section 501(a) as an organization described in Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for federal or state income taxes has been provided. Certain activities are subject to income taxes; however, such income tax activities are not significant to the financial statements. Management has reviewed the Center's tax positions for all open tax years and has concluded that no material liabilities exist as of January 31, 2014 and 2013. Management files the Center's tax returns in the U.S. federal jurisdiction. The Center is no longer subject to U.S. federal examinations by tax authorities for years before 2011. Part XI, Line 4b - Other Adjustments: Bad Debt Expense 31,909,692. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 31,909,692. Festival of Trees 323624 41085 282539 8136 30870 92885 323624 41085 282539 8136 30870 92885 131891 150648 1 1 X 1 X 1 X 1 1 1 0 1 1 0 3418 9670719 0 9670719 0.04850 0 43138 55302345 14717855 40584490 0.20340 0 0 0 0.00000 46556 64973064 14717855 50255209 0.25190 0 0 0 0 0.00000 0 0 0 0 0.00000 0 14158 9466735 6312103 3154632 0.01580 0 0 0 0 0.00000 0 0 0 0 0.00000 14158 9466735 6312103 3154632 0.01580 60714 74439799 21029958 53409841 0.26770 0 0 0.00000 0 0 0.00000 0 0 0.00000 0 0 0.00000 0 0 0.00000 0 0 0.00000 5483000 0 5483000 0.02750 967000 0 967000 0.00480 0 0 0.00000 6450000 6450000 0.03230 1 31909692 0 63417074 56506152 6910922 X 1 1 1 1 Emanuel Medical Center 825 Delbon Avenue Turlock IL 95382 X X X Outpatient Services Emanuel Medical Center 1 1 X X X X X X X X X 13 1 0 1 X X X X 0 0 1 1 200.000000000000 1 350.000000000000 1 X 1 1 X X X X X 0 0 X X X X 1 X 0 0 Emanuel Medical Center Part V, Section B, Line 3: The Center and Crescendo Consulting Group, LLC, worked with local stakeholders to obtain community-representative information.This included interviews with key stakeholders to identify provider perspectives and observations of the community as a whole.- Vito Chiesa, Stanislaus County Supervisor- John Walker, MD, Stanislaus County Public Health Director- Roy Wasden, Turlock City Manager- Keith Boggs, Stanislaus County, Assistant Executive DirectorDiscussion groups with Leadership Team members included healthcare consumers, service providers, and other community opinion leaders were designed to represent a span of healthcare consumers in the area.- Emanuel Medical Center- Jessica's House- Monte Vista Chapel- Turlock Chamber of Commerce- Turlock City Manager- Turlock Gospel Mission- Turlock Police Department- Turlock United School District- United Samaritans FoundationOnline surveys were made available at the Center and several online locations to poll local healthcare consumers. Emanuel Medical Center Part V, Section B, Line 5d: The CHNA will be made available on the Center's website. It is currently available upon request and was previously available in a shortened form as a means of surveying the community healthcare consumers and determining local input. Emanuel Medical Center Part V, Section B, Line 7: The Center has prioritized certain needs above others dependent on the ability to address such needs and the community input and ranking of such identified needs. Those needs not directly addressed shall be indirectly impacted in future implementation strategy executions in accordance with perceived public need as demonstrated by community surveys. Part I, Line 3c: EMC uses FPG and has a charity care policy to determine eligibility for charity or discounted care. Part I, Line 7: EMC operated outpatient 1206(d) clinics that provide primary care and health services to low income families and communities. Part II, Community Building Activities: Leadership development and training:Emanuel Medical Center provided the opportunity for students in the health care fields to learn in our facility free of charge. The education department coordinated clinical rotations and provided orientations for nursing students and high school Regional Occupational Program (ROP) students. Staff that work with these students provide one-on-one attention and teaching throughout the students' experience here. In the 2013 school year, a total of approximately 25 ROP high school students from Turlock and Hilmar were each provided 100 - 150 hours of experience in patient care or administrative areas. In the spring and fall semesters of 2013, approximately 125 total nursing students each completed an average of 100 hours of clinical rotations at our facility. Aside from the large amount of time that staff members spend with students, the education department itself provided approximately 200 hours of time devoted to coordination and orientation for these students.Physician availability and work force development:Completed in 2011, Emanuel Medical Center's latest community physician need study documents significant growth in the number of physicians required in the primary services area of the medical center. However, the community continues to have fewer than half the number of physicians per 100,000 population at the most conservative benchmarks for physician need.During the year ending January 31, 2014, Emanuel Medical Center recruited one new general surgeon who is also boarded in colorectal surgery, the first in the region and in Emanuel's service area. Additionally, a new nurse practitioner was hired to provide services in the new Patterson Primary Health Center operated by Emanuel.In FY 2014, Emanuel continued to provide a medical education program specifically designed to increase the number of physicians in the community. In the fourth year of this program, a total of 25 students from two medical schools - Midwestern and Touro Medical School Universities - began their year-long clinical rotation studies under the direction of Emanuel medical staff. Part III, Line 2: Bad debt expense of $31,909,692 was subtracted from total expenses for purposes of calculating the percentages in Part I, Line 7. EMC separates charity care expenses from bad debt expenses on the financial statements and does not include bad debt expense in charity care. Bad debt expenses are recorded for self-pay patient accounts that are not qualified for charity care and are not collectible for services provided by EMC. The cost methodology for bad debt expense is based on cost-to-charge ratio. Part III, Line 3: The Center maintains separate records of bad debt expenses and charity care expenses. The charity discounts and charity care provided during the year totaled $58,327,412, separate from the true bad debts totaling $31,909,692. The charity discounts and care conform to the Financial Assistance Policy guidelines. Part III, Line 4: Patient accounts receivable: The Center reports patient accounts receivable for services rendered at net realizable amounts from third-party payors, patients and others. As a service to the patient, the Center bills third-party payors directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts receivable are reduced by both an allowance for contractual adjustments and an allowance for doubtful accounts. Patient accounts are written off when collection efforts have been exhausted. Part III, Line 8: The Center uses a cost to charge ratio methodology to determine the allowable costs of care related to Medicare costs. This involves using prospectively determined prices for each patient service and subsequent application given the cost of such service. Part III, Line 9b: EMC has a charity care policy to provide patient care for all patients regardless of ability to pay. Financial assistance is extended in accordance with AB774 and the mission and values of the hospital. Part VI, Line 2: To assess health care needs in EMC's service area, we rely on the "Stanislaus County Community Health Assessment" prepared and published regularly by the Stanislaus County Health Services Agency.In preparing the most recent assessment, the Stanislaus County Community Health Assessment Steering Committee developed more than 70 quality-of-life indicators; indicators that are understandable to the general user and the public, that respond quickly and noticeably to real changes, that are relevant for policy decisions, and that are available annually.In preparing its assessment, the assessment steering committee gathered primary data from a face-to-face survey of more than 2,800 Stanislaus County residents and used a number of secondary data sources including the U.S. Census Bureau's American Community Survey; the Centers for Disease Control and Prevention's behavioral risk factor surveillance system; the California health interview surveys for 2007, 2009, and 2011-2012; the California healthy kids survey; and the healthy people 2020 objectives. Part VI, Line 3: EMC's charity care policy is communicated to every patient through procedures spelled out in the policy itself. Those requirements include the following:1. Every patient is presented, at time of service, with notice (in appropriate language) regarding the AB774 discount/charity care program. Patients will be asked to sign an acknowledgement attesting that notice of program and offer of applications has transpired.2. A follow-up notice regarding the AB774 discount/charity care program is included with first billing for services. A plain language summary of patients' rights pursuant to SB 350 is included in this notice. Part VI, Line 4: EMC serves the City of Turlock and a number of smaller communities surrounding it in southern Stanislaus and northern Merced counties. This area is located in the heart of California's central valley and is generally more rural, agricultural, ethnically diverse and economically disadvantaged than California as a whole. Our primary service communities are: Turlock, Ceres, Delhi, Denair, Hilmar, Keyes, Livingston, Atwater, Winton, Stevenson, and Patterson.Below are key demographics from the U.S. Census Bureau's quickfacts for Stanislaus County, Merced County and the City of Turlock:People Quickfacts - Stanislaus County - CaliforniaPopulation, 2013 Estimate - 525,491 - 38,332,521Pop. % change, 4/1/10-7/1/13 - 2.1% - 2.9%Persons <5 years old, %, 2013 - 7.4% - 6.5%Persons <18 years old, %, 2013 - 27.6% - 23.9%Persons >65 years old, %, 2013 - 11.7% - 12.5%Female person, %, 2013 - 50.5% - 50.3%White persons, %, 2013 - 84.3% - 73.5%Black persons, %, 2013 - 3.2% - 6.6%American Indian & Alaska native, %, 2013 1.9% - 1.7%Asian persons, %, 2013 - 5.8% - 14.1%Native Hawaiian & Pacific Islander, %, 2013 0.9% - 0.5%Persons reporting two or more races, %, 2013 3.8% - 3.7%Persons of Hispanic or Latino origin, %, 2013 43.5% - 38.4%White persons not Hispanic, %, 2013 45.1% - 39.0%Living in same house >1 year, %, 2008-2012 81.0% - 84.2%Foreign born persons, %, 2008-2012 20.4% - 27.1%Other than English spoken at home, % >5, 2008-2012 40.6% - 43.5%High school graduates, % >25, 2008-2012 76.0% - 81.0%Bachelor's degree or higher, % >25, 2008-2012 16.3% - 30.5%Persons with a disability, age >5, 2013 n/a - n/aHomeownership rate, 2008-2012 59.1% - 56.0%Housing units in multi-unit structures, %, 2008-2012 16.8% - 30.9%Median value of owner-occupied housing units, 2008-2012 $192,200 - $383,900Households, 2008-2012 165,999 - 12,466,331Persons per household, 2008-2012 3.06 - 2.93Median household income, 2008-2012 $49,866 - $61,400Per capita money income, 2008-2012 $21,785 - $29,551Persons below poverty level, %, 2012 19.2% - 15.3%People Quickfacts Merced County - CaliforniaPopulation, 2013 Estimate - 263,228 - 38,332,521 Pop. % change, 4/1/10-07/1/13 - 2.9% - 2.9% Persons <5 years old, %, 2013 - 8.2% - 6.5% Persons <18 years old, %, 2013 - 30.4% - 23.9% Persons >65 years old, %, 2013 - 10.2% - 12.5% Female person, %, 2013 - 49.4% - 50.3% White persons, %, 2013 - 81.9% - 73.5% Black persons, %, 2013 - 4.2% - 6.6% American Indian and Alaska native, %, 2013 2.5% - 1.7% Asian persons, %, 2013 - 8.1% - 14.1% Native Hawaiian & Pacific Islander, %, 2013 0.4% - 0.5% Persons reporting two or more races, %, 2013 3.0% - 3.7% Persons of Hispanic or Latino origin, %, 2013 56.8% - 38.4% White persons not Hispanic, %, 2013 30.2% - 39.0% Living in same house >1 year, %, 2008-2012, 82.0% - 84.2% Foreign born persons, &, 2008-2012 25.2% - 27.1% Other than English spoken at home, % >5, 2008-2012 52.0% - 43.5% High school graduates, % >25, 2008-2012 66.6% - 81.0% Bachelor's degree or higher, % >25, 2008-2012 12.5% - 30.5% Persons with a disability, age >5, 2013 n/a - n/a Homeownership rate, 2008-2012 54.2% - 56.0% Housing units in multi-unit structures, %, 2008-2012 17.8% - 30.9% Median value of owner-occupied housing units, 2008-2012 $161,600 - $383,900 Households, 2008-2012 74,496 - 12,466,331 Persons per household, 2008-2012 3.38 - 2.93 Median household income, 2008-2012 $43,565 - $61,400 Per capita money income, 2008-2012 $18,343 - $29,551 Persons below poverty level, %, 2012 24.6% - 15.3% People Quickfacts - Turlock City - California Population 2013 estimate - 70,365 - 38,332,521 Pop. % change, 4/1/10-7/1/2013 - 2.6% - 2.9% Persons <5 years old, %, 2010 - 7.5% - 6.8% Persons <18 years old, %, 2010 - 27.5% - 25.0% Persons >65 years old, %, 2010 - 11.7% - 11.4% Female person, %, 2010 - 51.3% - 50.3% White persons, %, 2010 - 69.8% - 57.6% Black persons, %, 2010 - 1.7% - 6.2% American Indian and Alaska persons, %, 2010 0.9% - 1.0% Asian persons, %, 2010 - 5.6% - 13.0% Native Hawaiian & Pacific Islander, %, 2010 0.5% - 0.4% Persons reporting two or more Races, %, 2010 5.0% - 4.9% Persons of Hispanic or Latino origin, %, 2010 36.4% - 37.6% White persons not Hispanic, %, 2010 52.8% - 40.1% Living in same house >1 year, %, 2008-2012 79.5% - 84.2% Foreign born persons, %, 2008-2012 25.6% - 27.1% Other than English spoken at home, % >5, 2008-2012 44.4% - 43.5% High school graduates, % >25, 2008-2012 79.7% - 81.0% Bachelor's degree or higher, % >25, 2008-2012 23.3% - 30.5% Persons with a disability, age >5, 2013 n/a - n/a Homeownership rate, 2008-2012 54.8% - 56.0% Housing units in multi-unit structures, %, 2008-2012 22.5% - 30.9% Median value of owner-occupied housing units, 2008-2012 $214,600 - $383,900 Households, 2008-2012 23,114 - 12,466,331 Persons per household, 2008-2012 2.91 - 2.93 Median household income, 2008-2012 $52,974 - $61,400 Per capita money income, 2008-2012 $23,118 - $29,551 Persons below poverty level, %, 2012 15.7% - 15.3% Part VI, Line 5: As the only hospital in its primary service area, during fiscal year (FY) ending January 31, 2014 EMC:-provided 40,273 days of acute care-served residents with 47,829 days of long-term care-treated 59,954 patients in our emergency room-performed 5,502 surgical procedures-delivered 1,343 babies-supported residents with 7,871 days of assisted livingEMC is religiously affiliated and one of two Covenant Ministries of Benevolence (CMB) wholly owned acute care hospitals.We have a 16-member community board. EMC's mission is to create a healthier community through:-operating on the foundation of Christian values-focusing on health promotion and prevention of disease-providing safe, high quality and comprehensive health services for our patients and their families-maintaining fiscal responsibility to allow for maintenance, growth and development-creating a collaborative partnership among community health resourcesTo achieve this mission, EMC extends medical staff privileges to all qualified physicians in the communities we serve. The following summarizes other community benefit accomplishments in the fiscal year ended January 31, 2014:Community Health Education:Community health education is provided by both Emanuel Regional Cancer Services and EMC's education department.Emanuel Cancer Center:During FY 2014, Emanuel Cancer Center provided regular educational opportunities and support groups which were free to the community.Cancer Education:Throughout the year, we performed breast cancer screening for the indigent population of women in the area. For the third consecutive year, Emanuel Cancer Center conducted a lung cancer awareness and "quitters" campaign that offered free quit kits to smokers.Support Groups:In March 2009, we launched a new support group called "monkey business." This support group was specifically designed to help children who have a loved one with cancer cope with the emotional aspects of what they are experiencing. We invited both the children and their loved ones to the group which meets weekly for eight weeks. EMC also hosts a bi-monthly cancer support group called "cancer in your life" which is open to adult cancer patients.Education Department:The Emanuel Medical Center education department provided or coordinated free educational services to the community throughout FY 2014. Life support class were offered free of charge to area physicians, physician assistants, paramedics, and EMC volunteers. These classes include basic, advanced, neonatal and pediatric life support. EMC also provided childbirth education classes to English and Spanish speaking attendees in our community. Classes were free for patients referred by Turlock and Livingston medical offices. Part VI, Line 6: EMC is not part of an affiliated health care system. Part VI, Line 7, Reports Filed With States CA X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 John Sigsbury Director/President 0 401636 0 85696 0 73474 0 59987 0 10704 0 631497 0 0 David Neapolitan CFO 223729 0 50609 0 10899 0 0 0 7272 0 292509 0 0 0 Constance Fairchilds VP Patient Care 224105 0 31500 0 10899 0 1329 0 3275 0 271108 0 0 0 David Canton MD VP Medical Affairs 0 0 0 0 169082 0 0 0 0 0 169082 0 56025 0 Linda Hanks VP General Counsel 183588 0 45279 0 10899 0 0 0 4176 0 243942 0 0 0 Ronald Evangelista Dir. Surgical Service 156394 0 36379 0 0 0 0 0 1092 0 193865 0 0 0 Michael Iltis ED Cancer Center 148540 0 40119 0 1258 0 0 0 4443 0 194360 0 0 0 Terrance Gray VP Human Resources 161993 0 25000 0 10899 0 0 0 1707 0 199599 0 0 0 Mathew Salsig RN Charge 156512 0 1000 0 0 0 0 0 6676 0 164188 0 0 0 Part I, Line 1a John Sigsbury, President/CEO of EMC, utilizes the Country Club membership. Housing allowances are occasionally provided on a temporary basis to new hires recruited from out of town. Part I, Lines 4a-b David Canton received $113,057 in severance pay. EMC and related organizations provide certain supplemental retirement benefits to their officers and key employees. These benefits are provided through a nonqualified deferred compensation plan, under which a portion of the benefits being earned are structured to provide a retention incentive that has been determined by the compensation committee of CMB's Board (CMB is EMC's parent) to be of a substantial value to the organization. The committee approves all retirement benefits, together with all other forms of compensation and benefits for these and other executives, in a manner intended to qualify for the rebuttable presumption of reasonableness under the intermediate sanctions rules of federal income tax law. A City of Turlock California 946000445 900173BA2 2004-12-17 43281164 Capital Additions 0 0 0 B City of Turlock California 946000445 900173BA2 2007-09-18 58750652 Refunded Bonds Issued 12/17/2004 and Capital Additions 0 0 0 A 7549227 45416870 3688877 3839982 856951 37799063 2007 0 0 1 1 B 6333710 59815854 5297439 3501278 982568 30653046 20504721 2011 1 0 1 1 A 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 1 0 B 0 0 1 0 0 0 0 1 0 A 1 B 1 Kirk Larson Family member to Jennifer Larson (Director) 113668 Independent contractor providing construction services 0 X 14850 FMV X 1 5000 FMV X Decor 1 11207 FMV X Jewelry 1 11000 FMV 0 0 0 Part I, Column (b): Column (b) indicates the number of contributions received. Form 990, Part III, line 3 Hospice Services were discontinued in December 2013 Form 990, Part VI, Section A, line 2 Jennifer Larson, a Member of the EMC Board of Directors, is married to Kirk Larson. Kirk Larson is a general contractor who performs construction work for EMC. Form 990, Part VI, Section A, line 6 Members are elected and ex-officio are Members of the Board of Benevolence of the Evangelical Covenant Church (ECC). A Member is any person who, pursuant to a provision of the organization's governing documents of applicable state law, has the right to participate in the organization's governance or to receive distributions of income or assets from the organization (regardless of what a person is called in the governing documents). Form 990, Part VI, Section A, line 7a The Members elect the Board of Directors. Form 990, Part VI, Section A, line 7b The Members vote to: - appoint the President and Chief Executive Officer of the corporation; - determine compensation of the President and Chief Executive Officer of the corporation; - approve the strategic plan, mission statement, and major changes of policy of the corporation; - approve major borrowing of the corporation; - approve the disposition, buying, leasing, selling or encumbering of real property belonging to the corporation that is used by its ministry; - approve mergers or dissolution of the corporation; - approve creation of new subordinate corporations, subsidiaries and other related entities; - approve amendments to the articles of incorporation and bylaws of the corporation; - approve a plan for distribution of assets upon dissolution of the corporation; - approve the fiscal year end of the corporation; and, - designate auditors. Form 990, Part VI, Section B, line 11 The return is reviewed by the CFO and also presented to the Board of Directors Finance Committee Chairman for review. A copy of the return is also distributed to all Board Members prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c Emanuel Medical Center, Inc. has an administrative policy of conflict of interest identifying the parameters of a conflict of interest and the requirement to disclose any such conflict of interest each January. The EMC policy is distributed to EMC Board Members and senior Vice Presidents who are asked to sign acknowledging receipt of the policy and to disclose if they have any conflict of interests. If someone is absent from the meeting or fails to return the acknowledgement, there is a follow-up with the individual until the signed acknowledgement is provided. Form 990, Part VI, Section B, line 15 EMC uses a third party consultant and industry compensation survey information to determine appropriate compensation for its leadership annually. The consultant reviews salaries, incentive bonuses and benefits to assure compensation is reasonable and within market practice for our industry. Guidelines for acceptable compensation ranges are determined by the EMC Board of Directors Compensation Committee. Form 990, Part VI, Section C, line 19 Emanuel Medical Center's Form 990 can be found on Guidestar. In addition, financial statements are filed with The Office of Statewide Health Planning and Development. The governing documents and financial statements are available upon request for the same period of disclosure as set forth in IRC Section 6104(d). Covenant Ministries of Benevolence 5145 N California Avenue Chicago IL 60625 363486813 Management and Support Services IL 501(c)(3) Line 11a, I Evangelical Covenant Church 0 Evangelical Covenant Church 5101 N Francisco Avenue Chicago IL 60625 362167730 Church IL 501(c)(3) Line 1 N/A 0 Swedish Covenant Faculty Group 5145 N California Avenue Chicago IL 60625 363686216 Patient Treatment and Education IL 501(c)(3) Line 11a, I Swedish Covenant Hospital 0 Swedish Covenant Hospital 5145 N California Avenue Chicago IL 60625 362179813 Hospital IL 501(c)(3) Line 3 Covenant Ministries of Benevolence 0 SC Insurance Company 6970 E Chauncey Lane Ste 100 Phoenix AZ 85054 273312053 Insurance IL 501(c)(3) Line 7 Swedish Covenant Hospital 0 Coast Asset Management LLC 2450 Colorado Ave Suite 100 Santa Monica CA 90404 954763400 Hedge Fund Investment CA N/A N/A 0 0 Covenant Village of Portland LP 420 NE Mason Street Portland OR 97211 364356838 Assisted Living Community OR N/A N/A 0 0 Lifeconnect LLC 5700 Old Orchard Rooad Skokie IL 60077 272827919 Wellness Software Development IL N/A N/A 0 0 Management Services Organization LLC 5700 Old Orchard Rooad Skokie IL 60077 272827998 Management & Consulting Services IL N/A N/A 0 0 Covenant International Insurance Company LTD Crawford House 50 Cedar Ave Hamilton BD Insurance BD N/A 0 Covenant Trust Company 5215 Old Orchard Road Suite 725 Skokie IL 60077 363583163 Financial Services IL N/A C 0 Swedish Covenant Management Services Inc 5145 North California Avenue Chicago IL 60625 364073303 Physician Practice Management IL N/A C 0 Swedish Covenant Managed Health Care Alliance 2740 West Foster Avenue Suite 409 Chicago IL 60625 364118659 Physician - Hospital Organization IL N/A C 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0