2013-05-14T15:14:41-05:00 2012-06-30 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DRIVE STE 500 SAN DIEGO CA 92122 990 2011-07-01 956130458 EISENHOWER MEDICAL CENTER % G AUBREY SERFLING EISE 7607731888 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 G AUBREY SERFLING 2013-05-14 8585357200 2011 2016-02-24 21:20:13Z G AUBREY SERFLING 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 451836311 false X WWW.EMC.ORG X 1966 CA EISENHOWER MEDICAL CENTER, A NOT-FOR-PROFIT ORGANIZATION, EXISTS TO SERVE THE CHANGING HEALTHCARE NEEDS OF OUR REGION BY PROVIDING EXCELLENCE IN PATIENT CARE WITH SUPPORTIVE EDUCATION AND RESEARCH. 35 32 2909 822 391416 36217095 26023308 402139490 403829317 4411848 -2407868 4311965 5936492 447080398 433381249 0 0 0 0 193161382 189526928 0 0 3240760 282296938 286831702 475458320 476358630 -28377922 -42977381 1025919556 997676029 534839818 576201694 491079738 421474335 X EISENHOWER MEDICAL CENTER, A NOT-FOR-PROFIT ORGANIZATION, EXISTS TO SERVE THE CHANGING HEALTHCARE NEEDS OF OUR REGION BY PROVIDING EXCELLENCE IN PATIENT CARE WITH SUPPORTIVE EDUCATION AND RESEARCH. false false 366134955 411447565 PATIENT CARE SERVICES AT ACUTE CARE HOSPITAL - SEE SCHEDULE O 75717856 0 CHARITY AND COMMUNITY SERVICES - SEE SCHEDULE O 441852811 true true false true false false false false false true true false false false true true false true false false false false false false false false true true false false true true false false false false false false false false false true true false false false true true true true false false true 532 0 true 2909 true true true false false false false false false false false false X 35 32 true false false false true true true true true false false false true true true true true true true true true CA X G AUBREY SERFLING 7603403911 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 RICHARD G BENNETT 1.0 X 0 0 0 CHARLES L BIGGS 1.0 X 0 0 0 GARY P BRINSON 1.0 X 0 0 0 WILLIAM D CALKINS 1.0 X 0 0 0 JAMES G CULLEN 2.0 X X 0 0 0 SHAHIN ETEBAR MD 1.0 X 101600 0 0 HELENE V GALEN 1.0 X 0 0 0 SAMUEL L GINN 1.0 X 0 0 0 HARRY M GOLDSTEIN 1.0 X 0 0 0 ADRIAN GRAFF-RADFORD MD 1.0 X 0 0 0 ALAN I GREENE 1.0 X 0 0 0 JOHN F GRUNDHOFFER 1.0 X 0 0 0 BARRY T HACKSHAW MD 1.0 X 0 0 0 LARRY G HATFIELD 1.0 X 0 0 0 ROBERT C HAWK 1.0 X 0 0 0 JOHN H HERRELL 1.0 X 0 0 0 LOIS U HORVITZ 1.0 X 0 0 0 EUTHYM KONTAXIS MD 1.0 X 120275 0 0 JOHN M LANE 1.0 X 0 0 0 JOHN MARION 1.0 X 0 0 0 JOANN MCGRATH 1.0 X 0 0 0 KENNETH MELKUS 1.0 X 0 0 0 HAROLD M MESSMER JR 1.0 X 0 0 0 KENNETH M NOVACK 1.0 X 0 0 0 WILLIAM N OSTERMAN 1.0 X 0 0 0 CAROL SWANSON PRICE 1.0 X 0 0 0 GREG P RENKER 2.0 X X 0 0 0 HARRY S RINKER 1.0 X 0 0 0 ROBERT J RISHWAIN 1.0 X 0 0 0 KATHRYN B SAMPLE 1.0 X 0 0 0 STEVEN SAMPLE 1.0 X 0 0 0 SANDRA SCHULZ 1.0 X 0 0 0 JOHN SCHWARZLOSE 1.0 X 0 0 0 MICHAEL S SHANNON 1.0 X 0 0 0 ALVIN V SHOEMAKER 2.0 X X 0 0 0 QUINTEN VANDERWERF MD 1.0 X 57800 0 0 LISSA NOEL WAGNER 1.0 X 0 0 0 MARY WATTENBARGER 1.0 X 0 0 0 G AUBREY SERFLING 50.0 X X 894952 0 233182 KIMBERLY A OSBORNE 50.0 X 298858 0 38637 MARY KROLL 40.0 X 63903 0 11681 MICHAEL P APPLEHANS 50.0 X 364346 0 43920 STEVEN ARENDT 50.0 X 254306 0 31525 MARY ELLEN FONTANA 50.0 X 331404 0 35915 ELIZABETH M GUIGNIER 50.0 X 218079 0 52814 LYNN A HART 50.0 X 213671 0 28703 MICHAEL D LANDES 50.0 X 353996 0 67226 MARTIN J MASSIELLO 50.0 X 402806 0 56174 MARY ANN MCLAUGHLIN 50.0 X 190466 0 25308 ANN M MOSTOFI 50.0 X 321684 0 39083 DAVID PEREZ 50.0 X 246315 0 52706 JOSEPH SCHERGER MD 50.0 X 376344 0 52405 ALI A TOURKAMAN 50.0 X 302949 0 38445 LOUISE A WHITE 50.0 X 247082 0 32937 ALAN WILLIAMSON 50.0 X 258666 0 21653 ROY T YOUNG MD 50.0 X 278859 0 37413 MAUREEN STROHM MD 50.0 X 260898 0 33281 FREDERICK L WESTERGARD 50.0 X 251144 0 33635 MIGUEL A PADILLA 50.0 X 217891 0 27799 THOMAS M POTTS 50.0 X 204135 0 26291 6832429 0 1020733 295 false true false EISENHOWER MEDICAL ASSOCIATES INC 39000 BOB HOPE DRIVE LCCC- 2ND FLO RANCHO MIRAGE CA 92270 MEDICAL SERVICES 19394156 HOSPITAL HOUSEKEEPING SYSTEMS P O BOX 826 SAN ANTONIO TX 782930826 ENVIRONMENTAL SVCS 1469706 DESERT ORTHOPEDIC CENTER P O BOX 1730 RANCHO MIRAGE CA 92270 MED ADMIN/CONSULTING 830794 LINC LIGHTING ELECTRICAL 152 TECHNOLOGY IRVINE CA 92618 CONSTRUCTION 427237 DESERT CARDIOLOGY CONSULTANTS 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 MED ADMIN/CONSULTING 416830 24 10377368 15645940 882627 26023308 Patient Revenue 541610 391437996 391437996 Medical Office Bldg Rental 523000 4746991 4368452 378539 ELECTRONIC HEALTH RECORDS MEANINGFUL USE 541610 3935000 3935000 PHARMACY 446110 3657549 3657549 MEDICAL RECORDS 900099 51781 51781 403829317 3635550 2060295 12877 1562378 0 0 12411644 11534109 6920953 877535 -6920953 -6043418 -6043418 0 0 0 MEMBERSHIP FEES 900099 2214879 2214879 HOSPITAL SUITES FEES 900099 930883 930883 ALL OTHER REVENUE 900099 2790730 2790730 5936492 433381249 411447565 391416 -4481040 0 0 0 0 4696674 3428572 986302 281800 0 126363800 118658113 6307865 1397822 9001299 8444703 457412 99184 38544661 35639075 2414355 491231 10920494 10340309 480584 99601 3299764 2821067 464326 14371 718174 718174 238608 238608 25354 25354 0 89634 89634 63950736 61659802 1884606 406328 1240501 511511 684789 44201 18142993 16189034 1722273 231686 7311689 5483771 1827918 0 0 18436388 15560843 2851742 23803 252743 200547 27764 24432 0 308222 291538 14836 1848 21491347 19121206 2370141 0 60043134 53421367 6565138 56629 4409928 4262092 147836 MEDICAL SUPPLIES 66224320 66163820 60084 416 CA QUALITY ASSURANCE FEE 17320930 17320930 RECRUITMENT EXPENSE 1386195 1266936 118884 375 SETTLEMENT EXPENSE 449341 224671 179736 44934 1491701 842904 626698 22099 476358630 441852811 31265059 3240760 12519 14673 58037131 87092598 40149661 34373259 48652629 60054756 0 0 0 0 3289263 2660754 6293834 6337421 16105072 12638593 1063610483 410400523 703533920 653209960 115992991 106355715 0 0 5168703 4492501 0 0 28683833 30445799 1025919556 997676029 51813301 70820623 0 0 13312868 6074055 399068055 399118399 0 0 0 0 18904320 18578532 0 0 51741274 81610085 534839818 576201694 X 407597346 356250212 67933721 49580465 15548671 15643658 491079738 421474335 1025919556 997676029 X -42977381 -26628022 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 25354 false false 25354 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B EISENHOWER MEDICAL CENTER PAID HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA CONSOLIDATED DUES TO COVER MEMBERSHIP IN THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC), CALIFORNIA HOSPITAL ASSOCIATION (CHA), AND CALIFORNIA HOSPITAL ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS). THESE DUES INCLUDE STATE AND FEDERAL REPRESENTATION AND ADVOCACY, LOCAL AND REGIONAL ADVOCACY, STATEWIDE PUBLIC ADVOCACY PROGRAM AND DUES-BASED PROGRAMS AND SERVICES. 13.82% OF THESE DUES IS FOR DIRECT LOBBYING EXPENSES OR $25,354. 19160580 32934 672698 631642 19234570 16450538 45421 3306231 641610 19160580 15559365 108837 1403024 620688 16450538 16385406 34514 -777584 82971 15559365 0.18670 0.81330 0.00000 false false 35111087 35111087 728010534 200163976 527846558 25054890 8836826 16218064 271762512 201399721 70362791 3671460 0 3671460 653209960 0 PENSION PLAN LONG TERM PAYABLE 53332698 LIAB. TO ANNUITANTS/BENEFICIARY 13089936 WORKERS COMP PAYABLE 8417000 HPL & General Liability Insurance 4776140 Due to Affiliates 1591291 Miscellaneous Other 403020 81610085 433381249 476358630 -42977381 -336588 -28756594 -29093182 -72070563 411119383 -336588 -28756597 -29093185 440212568 89634 -6920953 -6831319 433381249 483189946 6920950 6920950 476268996 89634 89634 476358630 ENDOWMENT FUNDS Schedule D, Part V, LINE 4 THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO MAINTAIN THE PRINCIPLE DONATED AND USE THE EARNINGS FROM EACH DONATION FOR THE PURPOSE DESIGNATED IN THE ORIGINAL ENDOWMENT. FIN 48 FOOTNOTE Schedule D, Part X, Line 2 ASC 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2012 OR 2011. SCHEDULE D, PART XI, LINE 8 PENSION RELATED CHANGES ($24,262,108) CHANGE IN NPV OF PLEDGES ($ 1,031,546) CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS ($ 3,462,943) ROUNDING $ 3 ------------- TOTAL ($28,756,594) SCHEDULE D, PART XII, LINE 2D PENSION RELATED CHANGES ($24,262,108) CHANGE IN NPV OF PLEDGES ($ 1,031,546) CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS ($ 3,462,943) ------------- TOTAL ($28,756,597) SCHEDULE D, PART XII, LINE 4B LOSS ON DISPOSAL OF CIP ($ 6,920,953) SCHEDULE D, PART XIII, LINE 2D LOSS ON DISPOSAL OF CIP ($ 6,920,953) ROUNDING $ 3 ------------ TOTAL ($ 6,920,950) true true X true X true X true false true true 3377779 0 3377779 0.00700 37420764 18384153 19036611 0.03930 955010 0 955010 0.00200 41753553 18384153 23369400 0.04830 4082076 109140 3972936 0.00820 4103880 995572 3108308 0.00640 1070960 354500 716460 0.00150 467310 0 467310 0.00100 700013 0 700013 0.00140 10424239 1459212 8965027 0.01850 52177792 19843365 32334427 0.06680 7722 7722 0.00000 24626 24626 0.00010 32348 32348 0.00010 false 21812750 0 160625271 215379473 -54754202 X true true EISENHOWER IMAGING MEDICAL IMAGING 0.50800 0.49200 CENTER LLC MIRAGE ENDOSCOPY ENDOSCOPY SERVICES 0.39200 0.60800 CENTER LLC 1 1 EISENHOWER MEDICAL CENTER

39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270

X X X X EISENHOWER MEDICAL CENTER 1 true true 200. true 350. true X X X X X X X true true X X true false true X false false 18 EISENHOWER URGENT CARE AND PRIMARY CARE

45280 SEELEY DRIVE LA QUINTA CA 92253

OUTPATIENT CLINIC EISENHOWER INDUSTRIAL REHABILITATION

78822 HWY 11 LA QUINTA CA 92253

REHABILITATION EISENHOWER INDUSTRIAL REHABILITATION

4771-F EAST PALM CANYON DRIVE PALM SPRINGS CA 92262

REHABILITATION EISENHOWER PRIMARY CARE

4791 EAST PALM CANYON DRIVE PALM SPRINGS CA 92262

OUTPATIENT CLINIC EISENHOWER PRIMARY CARE

72780 COUNTRY CLUB DRIVE SUITE B-2 RANCHO MIRAGE CA 92270

OUTPATIENT CLINIC EISENHOWER PRIMARY CARE AT ARGYROS

45280 SEELEY DRIVE LA QUINTA CA 92253

OUTPATIENT CLINIC EISENHOWER URGENT CARE

151 SOUTH SUNRISE WAY PALM SPRINGS CA 92262

OUTPATIENT CLINIC EISENHOWER URGENT CARE

72780 COUNTRY CLUB DRIVE SUITE B-2 RANCHO MIRAGE CA 92270

OUTPATIENT CLINIC EISENHOWER DESERT ORTHO CENTER- ARGYROS

45280 SEELEY DRIVE 2ND FLOOR LA QUINTA CA 92253

OUTPATIENT CLINIC EISENHOWER NEUROSCIENCE INSTITUTE

72780 COUNTRY CLUB DRIVE SUITE 104 RANCHO MIRAGE CA 92270

OUTPATIENT CLINIC EISENHOWER SCHNITZERNOVAK BREAST CENTER

151 SOUTH SUNRISE WAY PALM SPRINGS CA 92262

DIAGNOSTIC CLINIC EISENHOWER LAB SERVICES

72780 COUNTRY CLUB DRIVE SUITE B-2 RANCHO MIRAGE CA 92270

DIAGNOSTIC CLINIC EMC OUTPATIENT SERVICES LABTECHNIQUES

4791 EAST PALM CANYON DRIVE PALM SPRINGS CA 92262

DIAGNOSTIC CLINIC EMC OUTPATIENT SERVICES LABTECHNIQUES

151 SOUTH SUNRISE WAY PALM SPRIGNS CA 92262

DIAGNOSTIC CLINIC EISENHOWER PRIMARY CARE

72780 COUNTRY CLUB DRIVE SUITE 305 RANCHO MIRAGE CA 92270

OUTPATIENT CLINIC EISENHOWER PRIMARY CARE

78120 WILDCAT DRIVE PALM DESERT CA 92210

OUTPATIENT CLINIC BREAST CENTER

72780 COUNTRY CLUB DRIVE SUITE A-1 RANCHO MIRAGE CA 92270

DIAGNOSTIC CLINIC EISENHOWER LABRADIOLOGY AT DEL WEBB

78120 WILDCAT DRIVE PALM DESERT CA 92210

DIAGNOSTIC CLINIC SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE AND MEDICAID IS THE ALLOWABLE COST-TO-CHARGE RATIO PER THE COST REPORT. THE COST OF THE COMMUNITY BENEFITS WAS CALCULATED USING SALARIES OF EMPLOYEES, DIRECT AND INDIRECT EXPENSES. WORKSHEET 2 WAS NOT USED. SCHEDULE H, PART I, LINE 7G THERE WAS AN IMMATERIAL AMOUNT OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS INCLUDED ON THIS LINE. SCHEDULE H, PART II THE COMMUNITY BUILDING ACTIVITIES, AS REPORTED IN PART II, INCLUDE ACTIVITIES SUCH AS CAREER DAYS AT LOCAL HIGH SCHOOLS AND "SHADOWING" PROGRAMS, WHEREBY STUDENTS CAN SHADOW A HEALTH CARE PROFESSIONAL TO GET A FIRST HAND VIEW OF WHAT A HEALTH CARE PROFESSIONAL DOES ON A DAILY BASIS. THE MORE EXPOSURE STUDENTS HAVE TO HEALTH CARE CAREERS, THE GREATER THE CHANCE TO RECRUIT FROM WITHIN THE COMMUNITY TO SERVICE THE COMMUNITY. SCHEDULE H, PART III, LINE 4 WE DO NOT INCLUDE OTHER BAD DEBT AMOUNTS IN COMMUNITY BENEFITS. SCHEDULE H, PART III, LINE 8 100% OF THE COST OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. MEDICARE IS A SUBSTANTIAL PROPORTION OF EMC'S PATIENT POPULATION. WHILE THE LEVEL OF CARE IS REGARDLESS OF SOURCE OF PAYER, THE LEVEL OF PAYMENT FOR MEDICARE IS DETERMINED BY GOVERNMENT REIMBURSEMENT POLICY. THE MEDICARE SHORTFALL IS AN UNREIMBURSED AMOUNT THAT MUST BE ACCOUNTED FOR IN EMC'S FINANCIAL STATEMENTS. SINCE GENERALLY ACCEPTED ACCOUNTING STANDARDS IDENTIFY THIS SHORTFALL IT SHOULD BE ACCEPTED AS A SHORTFALL IN IRS REPORTING STANDARDS. THE COSTING METHODOLOGY FOR THE AMOUNT REPORTED ON LINE 6 IS THE ALLOWABLE COST-TO-CHARGE RATIO PER THE COST REPORT. SCHEDULE H, PART III, LINE 9B FOR PATIENTS WHO QUALIFY FOR PARTIAL CHARITY CARE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED BILLS, EMC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS. EMC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS; LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 13 A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS ATTACHED TO BILLING INVOICES. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 EMC UTILIZES THE FINDINGS OF THE HEALTH ASSESSMENT RESOURCE CENTER AND THE DESERT HEALTHCARE DISTRICT TO DETERMINE THE NEEDS OF THE COMMUNITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 EMC EDUCATES PATIENTS ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER ITS CHARITY CARE POLICY THROUGH VERBAL COMMUNICATION DURING COLLECTION FOLLOW UP AND THROUGH INFORMATIONAL FLYERS INCLUDED WITH BILLING STATEMENTS. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 COMMUNITY IS DEFINED TO INCLUDE THE FOLLOWING CITIES/AREAS IN THE COACHELLA VALLEY: RANCHO MIRAGE, INDIAN WELLS, PALM DESERT, THOUSAND PALMS, LA QUINTA, CATHEDRAL CITY, PALM SPRINGS, INDIO AND DESERT HOT SPRINGS. THE COMMUNITY CAN BE FURTHER DEFINED AS URBAN. BASED ON 2010 HEALTH ASSESSMENT RESOURCE CENTER (HARC) SURVEY ESTIMATES, APPROXIMATELY 40.6% OF THE COMMUNITY'S ADULT POPULATION (18 AND OLDER) ARE AGE 65 YEARS AND OLDER. BASED ON FINDINGS FROM THE HARC NEEDS ASSESSMENTS, APPROXIMATELY 6.2% OF SENIORS (55+) REQUIRE ASSISTANCE FOR INDEPENDENT ACTIVITIES OF DAILY LIVING. ADDITIONAL SURVEY RESULTS IDENTIFIED THE ESTIMATED TOTAL NUMBER OF PEOPLE ENROLLED IN MEDICARE, MEDI-CAL OR VETERANS ASSISTANCE PROGRAMS IN THE COMMUNITY IS 149,400 OR 47% OF THE POPULATION. ABOUT 36,300 SENIORS (65+) IN THE SURVEY AREA DO NOT HAVE MEDICARE SUPPLEMENTAL INSURANCE. BASED UPON THE SAME REPORT, AN ESTIMATED 19.2% OF SENIOR SURVEY RESPONDENTS, OR 18,600 SENIOR RESIDENTS, IN THE EISENHOWER MEDICAL CENTER SERVICE AREA HAVE ANNUAL INCOMES THAT PLACE THEM AT OR BELOW 250% OF THE POVERTY GUIDELINE. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE MAJORITY OF EMC BOARD OF TRUSTEES IS MADE UP OF PROMINENT MEMBERS OF THE COMMUNITY WHO ARE NEITHER EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION. EMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. WHEN EMC ENDS THE YEAR WITH AN EXCESS OF OPERATING RECEIPTS OVER OPERATING DISBURSEMENTS, THESE EXCESS FUNDS ARE USED TO EXPAND AND REPLACE EXISTING FACILITIES AND MEDICAL EQUIPMENT TO IMPROVE PATIENT CARE AND FOR MEDICAL TRAINING AND EDUCATION. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 CALIFORNIA X X X X X false true false false false false false false false G AUBREY SERFLING 599997 0 0 0 294955 0 189224 0 43958 0 1128134 0 147681 0 KIMBERLY A OSBORNE 298858 0 0 0 0 0 30525 0 8112 0 337495 0 0 0 MICHAEL P APPLEHANS 310003 0 0 0 54343 0 26743 0 17177 0 408266 0 43920 0 STEVEN ARENDT 254306 0 0 0 0 0 24172 0 7353 0 285831 0 0 0 MARY ELLEN FONTANA 155143 0 0 0 176261 0 27915 0 8000 0 367319 0 176963 0 ELIZABETH M GUIGNIER 214420 0 0 0 3659 0 32975 0 19839 0 270893 0 0 0 LYNN A HART 207135 0 0 0 6536 0 15889 0 12814 0 242374 0 0 0 MICHAEL D LANDES 326526 0 0 0 27470 0 41767 0 25459 0 421222 0 0 0 MARTIN J MASSIELLO 400005 0 0 0 2801 0 47450 0 8724 0 458980 0 0 0 MARY ANN MCLAUGHLIN 182957 0 0 0 7509 0 14042 0 11266 0 215774 0 0 0 ANN M MOSTOFI 252362 0 0 0 69322 0 24041 0 15042 0 360767 0 0 0 DAVID PEREZ 239067 0 0 0 7248 0 22747 0 29959 0 299021 0 0 0 JOSEPH SCHERGER MD 349981 0 0 0 26363 0 35649 0 16756 0 428749 0 0 0 ALI A TOURKAMAN 239990 0 0 0 62959 0 18419 0 20026 0 341394 0 60808 0 LOUISE A WHITE 240845 0 0 0 6237 0 17912 0 15025 0 280019 0 0 0 ALAN WILLIAMSON 200004 0 0 0 58662 0 9350 0 12303 0 280319 0 51495 0 ROY T YOUNG MD 240131 0 0 0 38728 0 25175 0 12238 0 316272 0 0 0 MAUREEN STROHM MD 239990 0 0 0 20908 0 21273 0 12008 0 294179 0 0 0 FREDERICK L WESTERGARD 251144 0 0 0 0 0 19545 0 14090 284779 0 0 0 MIGUEL A PADILLA 217891 0 0 0 0 0 17014 0 10785 0 245690 0 0 0 THOMAS M POTTS 204135 0 0 0 0 0 16036 0 10255 0 230426 0 0 0 TERMS AND CONDITIONS OF SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN Schedule J, Part I, LINE 4B EMC HAS A 457(F) PLAN OFFERED TO PROVIDE AN OPPORTUNITY TO DEFER CURRENT SALARY AND/OR BONUS AS PART OF THE EXECUTIVE FLEXIBLE BENEFIT PLAN. EXECUTIVES MUST MAKE ELECTION PRIOR TO JULY 1 EACH YEAR. ELECTION MAY NOT REDUCE THE PARTICIPANTS ANNUAL INCOME BELOW THE SOCIAL SECURITY WAGE BASE. DEFERRALS WILL BE CREDITED MID-PLAN YEAR. PARTICIPANT ELECTS THE VESTING DATE FOR EACH YEAR'S DEFERRALS. THE FOLLOWING INDIVIDUALS RECEIVED A DISTRIBUTION FROM THE NONQUALIFIED DEFERRED COMPENSATION PLAN DURING THE YEAR: G. AUBREY SERFLING - $147,681 ALI TOURKAMAN - $60,808 ANN MOSTOFI - $51,633 ALAN WILLIAMSON - $51,495 MARY ELLEN FONTANA - $176,963 CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TGP2 2010-08-11 110101868 SEE PART VI false false false CITY OF RANCHO MIRAGE JOINT POWERS FIN AUTH 330471341 75212YAF8 2007-08-14 261211954 SEE PART VI false false false 0 0 110109763 8026438 0 0 2075430 0 0 76913110 23094785 0 2011 true false true true 0 0 263865443 0 0 78601931 3254935 0 0 148640854 37178243 0 2010 true true true true false true false false 0.00000 0.00000 0.00000 true false true false false 0.01600 0.00000 0.01600 true false false false 0 false 0 false false false false false 0 false 0 false false X SEE SCHEDULE O FOR SCHEDULE K INFORMATION 0 EISENHOWER MEDICAL ASSOCIATION OWNER/KEY EMPL WILLIAMSON 20006416 VENDOR FOR PHYSICIAN SVCS false X 1 14000 opinions of experts X 14 868627 cost/selling price 0 false true false SCHEDULE M, PART I EISENHOWER MEDICAL CENTER IS REPORTING THE NUMBER OF ITEMS CONTRIBUTED. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A KEY ACHIEVEMENTS (FISCAL YEAR 2012) ON JULY 1, 2011, THE EISENHOWER INPATIENT REHABILITATION CENTER OPENS, OFFERING INTENSIVE THERAPY FOR STROKE PATIENTS, ORTHOPEDICS PATIENTS AND OTHERS WITH DEBILITATING MEDICAL CONDITIONS REQUIRING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. IN JULY 2011, EISENHOWER MEDICAL CENTER IS RANKED #4 IN GYNECOLOGY IN U.S. NEWS MEDIA & WORLD REPORT'S 2011-12 BEST HOSPITALS RANKINGS. IN OCTOBER 2011, EISENHOWER RECEIVES A FULL, THREE-YEAR ACCREDITATION BY THE ACCREDITATION COUNCIL OF GRADUATE MEDICAL EDUCATION, MAKING EISENHOWER THE FIRST IN THE VALLEY TO BECOME A TEACHING HOSPITAL. IN FALL 2011, EISENHOWER OPENS A 10,000-SQUARE-FOOT GASTROINTESTINAL LABORATORY IN THE DOLORES HOPE OUTPATIENT CARE CENTER. IN JANUARY 2012, EISENHOWER EMPLOYEES SUPPORT THE HUMANA CHALLENGE WALK-IT PROGRAM BY COLLECTIVELY WALKING NEARLY 40 MILLION STEPS IN 10 DAYS TO SUPPORT THE MESSAGE OF FITNESS AND GOOD HEALTH. ON JANUARY 10, 2012, EISENHOWER CELEBRATES THE NAMING OF THE JOEL M. HIRSCHBERG CENTER FOR INTERNAL MEDICINE AT THE UIHLEIN BUILDING ON THE MAIN HOSPITAL CAMPUS. IN FEBRUARY 2012, EISENHOWER MEDICAL CENTER HOSTS THE 9TH ANNUAL COMMUNITY HEART CONFERENCE AT THE ANNENBERG CENTER FOR HEALTH SCIENCES. ON MARCH 10, 2012, EISENHOWER HOSTS THE SECOND ANNUAL HIV CONFERENCE WITH THE HIV PROVIDER NETWORK AT THE ANNENBERG CENTER FOR HEALTH SCIENCES AT EISENHOWER. ON MARCH 17, 2012, EISENHOWER HOSTS THE 17TH ANNUAL JIM COOK DAY OF HOPE FOR DIABETES, THE LARGEST EDUCATIONAL AND INSPIRATIONAL EVENT OF ITS KIND IN THE 11 WESTERN UNITED STATES, AT THE ANNENBERG CENTER FOR HEALTH SCIENCES AT EISENHOWER. IN JUNE 2012, EISENHOWER MEDICAL CENTER'S HEALTHY LIVING MAGAZINE RECEIVES THE GOLD AWARD IN THE CATEGORY OF PUBLICATIONS/EXTERNAL MAGAZINE BY THE HEALTHCARE PUBLICATIONS & MARKETING ASSOCIATION (HPRMA) AT ITS ANNUAL GOLDEN ADVOCATE AWARD CEREMONY. THE GOLDEN ADVOCATE AWARDS MEASURE HEALTH CARE MARKETING AND PUBLIC RELATIONS COMMUNICATIONS EXCELLENCE AMONG SOUTHERN CALIFORNIA HEALTH CARE PROFESSIONALS. IN JUNE 2012, EISENHOWER INPATIENT REHABILITATION CENTER EARNS A THREE-YEAR ACCREDITATION FROM THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). EISENHOWER MEDICAL CENTER IS FIRST HOSPITAL IN RIVERSIDE COUNTY WITH THE PRESTIGIOUS CARF ACCREDITATION, WHICH IS EARNED LESS THAN ONE YEAR AFTER OPENING THE CENTER. ON JUNE 27, 2012, EISENHOWER MARKS WORLD SPIROMETRY DAY WITH FREE LUNG CAPACITY TESTS FOR MEMBERS OF THE COMMUNITY. DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, QUESTION 2 KATHRYN B. SAMPLE AND STEVEN B. SAMPLE, BOTH ON THE BOARD TRUSTEES, ARE MARRIED. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 THE BOARD OF TRUSTEES ARE MEMBERS OF EISENHOWER MEDICAL CENTER. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A TRUSTEES HAVE THE RIGHT TO ELECT THE GOVERNING BODY MEMBERS OF THE EISENHOWER MEDICAL CENTER BOARD OF DIRECTORS. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B MEMBERS HAVE THE RIGHT TO VOTE ON THE FOLLOWING MAJOR DECISIONS: ANY MATERIAL CHANGE IN THE MISSION OF EMC; THE MERGER OF EMC WITH ANY OTHER BUSINESS ENTITY; THE DISSOLUTION OF EMC; THE SALE OF ALL OR SUBSTANTIALLY ALL OF EMC'S ASSETS; AND ANY MATTER ON WHICH A MEMBER OF A CALIFORNIA NON-PROFIT CORPORATION IS REQUIRED TO BE PERMITTED TO VOTE ON UNDER APPLICABLE LAW. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND SUBSEQUENTLY REVIEWED BY MANAGEMENT. AFTER MANAGEMENT REVIEW, THE FORM 990 IS PRESENTED TO THE BOARD AFTER FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C ANNUALLY RELATED PARTIES, INCLUDING OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE SURVEYED FOR TRANSACTIONS THAT COULD GIVE RISE TO CONFLICTS. WRITTEN QUESTIONAIRES ARE REVIEWED BY LEGAL AND FINANCE TO DETERMINE IF ADDITIONAL QUESTIONS OR INFORMATION SHOULD BE DOCUMENTED REGARDING SPECIFIC TRANSACTIONS. ALL NEW CONTRACTS ARE REVIEWED BY EXECUTIVE MANAGEMENT FOR CONFLICT CONSIDERATIONS. GENERAL COUNSEL REVIEWS ALL STATEMENTS SUBMITTED BY BOARD MEMBERS WHO INDICATE A POTENTIAL CONFLICT. GENERAL COUNSEL ADVISES THE CEO AND CHAIRMAN OF THE BOARD OF ANY MATERIAL CONFLICTS SO THAT THE INDIVIDUAL CAN BE RECUSED FROM ANY DISCUSSION OR DELIBERATION PERTAINING TO THE CONFLICT. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTIONS 15A AND 15B EISENHOWER MEDICAL CENTER ENGAGES AN INDEPENDENT CONSULTING FIRM TO PROVIDE THE BOARD'S COMPENSATION COMMITTEE TO PROVIDE BENCHMARKED SURVEY DATA FOR THE EXECUTIVE LEADERSHIP TEAM IN THE ORGANIZATION. THE CONSULTANT PROVIDES ANALYSIS OF SALARIES, INCENTIVE PLANS AND BENEFITS AS COMPARED TO PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS. THIS REVIEW WAS COMPLETED AND PRESENTED TO THE COMPENSATION COMMITTEE IN JANUARY 2012. THIS PROCESS WAS CONTEMPORANEOUSLY SUBSTANTIATED IN THE MEETING MINUTES OF THE COMPENSATION COMMITTEE. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 EISENHOWER MEDICAL CENTER RELEASES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. THAT REQUEST MAY BE EITHER VERBAL OR WRITTEN. HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII G. AUBREY SERFLING, PRESIDENT AND CEO OF EMC, IS ALSO THE BOARD DIRECTOR (EX-OFFICIO) OF EISENHOWER HEALTH SERVICES (EHS). HE DEVOTES 1 HOUR PER WEEK TO EHS. HE ALSO DEVOTES 1 HOUR PER WEEK TO ANNENBERG CENTER FOR HEALTH SCIENCES AND THE BARBARA SINATRA CHILDREN'S CENTER, IN ADDITION TO THE 50 HOURS PER WEEK HE DEVOTES TO EMC. KIMBERLY OSBORNE, CHIEF FINANCIAL OFFICER OF EMC, IS ALSO THE BOARD DIRECTOR AND TREASURER AT EHS. SHE DEVOTES 50 HOURS PER WEEK TO THE POSITION AT EMC AND 1 HOUR PER WEEK AT EHS. MARY KROLL IS THE CORPORATE SECRETARY OF EMC, ACHS, BSCC AND EHS. SHE DEVOTES 40 HOURS PER WEEK TO HER POSITION AT EMC, 2 HOURS PER WEEK AT BSCC AND 1 HOUR PER WEEK TO ACHS AND EHS. MARTIN MASSIELLO, CHIEF OPERATING OFFICER OF EMC, IS ALSO THE BOARD DIRECTOR AND PRESIDENT OF EHS. HE DEVOTES 50 HOURS PER WEEK TO HIS POSITION AT EMC AND 1 HOUR PER WEEK AT EHS. HELENE V. GALEN, BOARD TRUSTEE/DIRECTOR OF EISENHOWER MEDICAL CENTER, DEVOTES 2 HOUR PER WEEK TO THE BARBARA SINATRA CHILDREN'S CENTER AS THE PRESIDENT. WILLIAM N. OSTERMAN, BOARD TRUSTEE/DIRECTOR OF EISENHOWER MEDICAL CENTER, DEVOTES 2 HOUR PER WEEK TO THE BARBARA SINATRA CHILDREN'S CENTER AS THE SECRETARY. PAYMENT FOR SERVICES OTHER THAN BOARD SERVICES FORM 990, PART VII SHAHIN ETEBAR, MD RECEIVED A TOTAL OF $101,600 AS A STIPEND FOR NEUROLOGY SERVICES. EUTHYM KONTAXIS, MD RECEIVED A TOTAL OF $120,275 AS A STIPEND FOR EMERGENCY ROOM ADMINISTRATIVE SERVICES. QUINTEN VANDERWERF, MD RECEIVED A TOTAL OF $57,800 AS A STIPEND FOR EMERGENCY ROOM ON-CALL SERVICES. CHANGES IN NET ASSETS/FUND BALANCES FORM 990, PART XI, LINE 5 PENSION RELATED CHANGES ($24,262,108) CHANGE IN NPV OF PLEDGES ($ 1,031,546) CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS ($ 3,462,943) TRANSFER FROM ACHS $ 2,465,160 UNREALIZED LOSS ON INVESTMENTS ($ 336,588) ROUNDING $ 3 ------------- TOTAL ($26,628,022) TAX EXEMPT BONDS DESCRIPTION OF PURPOSE SCHEDULE K, PART I, COLUMN F A - CONSTRUCTION OF HOSPITAL AND REFUND A PORTION OF TAXABLE LOAN B - CONSTRUCTION OF HOSPITAL AND REFUNDING BOND ISSUES DATED 2/19/1997 and 5/27/2004. TOTAL PROCEEDS OF ISSUE SCHEDULE K, PART II, COLUMN A & B, LINE 3 THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS AND ISSUE PRICE IS INVESTMENT INCOME OF 7,895 FOR THE 2010 BONDS AND 2,653,488 FOR THE 2007 BONDS. OTHER SPENT PROCEEDS SCHEDULE K, PART II, LINE 11 THE AMOUNT OF OTHER SPENT PROCEEDS RELATES TO CURRENT REFUNDING PROCEEDS OF THE ISSUES: A: REPAYMENT OF TAXABLE LOC B: REFUNDED 1997 ISSUE EISENHOWER PROPERTIES LLC 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 201971850 PROP. RENTAL CA 2362831 23729774 EMC EISENHOWER HEALTH SERVICES 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 330617193 SUPPORT SVCS CA 501(C)(3) 11, I EMC true ANNENBERG CENTER FOR HEALTH SERVICES 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 953382683 HEALTH CARE CA 501(C)(3) 11, I EMC true BARBARA SINATRA CHILDREN'S CENTER 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 330136550 CHILD SVCS CA 501(C)(3) 7 EMC true EISENHOWER IMAGING CENTER MEDICAL IMAGING CA EMC RELATED 1695781 2219651 false 0 true 0.50800 CHARITABLE REMAINDER TRUST (21) HOSPITAL SUPPORT CA NA TRUST true false false false false false false false false true false false false false false true true true ANNENBERG CENTER FOR HEALTH SCIENCES P 12964453 ACCRUAL METHOD ANNENBERG CENTER FOR HEALTH SCIENCES J 297817 ACCRUAL METHOD ANNENBERG CENTER FOR HEALTH SCIENCES Q 2069841 ACCRUAL METHOD ANNENBERG CENTER FOR HEALTH SCIENCES R 2465160 ACCRUAL METHOD BARBARA SINATRA CHILDREN'S CENTER P 872969 ACCRUAL METHOD BARBARA SINATRA CHILDREN'S CENTER R 1665677 ACCRUAL METHOD EISENHOWER IMAGING CENTER P 818856 ACCRUAL METHOD EISENHOWER IMAGING CENTER A-IV 280679 ACCRUAL METHOD IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP SCHEDULE R, PART III EISENHOWER IMAGING CENTER EIN: 68-0554124 ADDRESS: 39000 BOB HOPE DRIVE RANCHO MIRAGE, CA 92270