SAN ANTONIO REGIONAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SAN ANTONIO REGIONAL HOSPITAL (EIN 95-1183919)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201323199349300007
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T00:07:20-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18111 VON KARMAN AVENUE SUITE 1000 | AddressLine1 |
| City | IRVINE | City |
| State | CA | State |
| ZIP Code | 92612 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951183919 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | San Antonio Community Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % WAH-CHUNG HSU | InCareOfName |
| Name Control | SANA | NameControl |
| Phone | 9099206103 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 San Bernardino Road | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Upland | City |
| State | CA | State |
| ZIP Code | 917864920 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WAH-CHUNG HSU | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Date Signed | 2013-11-14 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KARA ADAMS | Name |
| Phone | 9497942300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Harris Koenig | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 San Bernardino Road | AddressLine1 |
| City | Upland | City |
| State | CA | State |
| ZIP Code | 91786 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 537255441 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | sach.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1920 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | To improve the overall health of our regional community by offering services that both comfort and cure in a manner that earns the trust of our patients, our physicians and our employees. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2239 | TotalNbrEmployees |
| Total Nbr Volunteers | 288 | TotalNbrVolunteers |
| Total Gross UBI | 1266648 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 607263 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 265809104 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 272784272 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9240346 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13411227 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4368214 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3162374 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 279417664 | TotalRevenuePriorYear |
| Total Revenue Current Year | 289357873 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 126470 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 119452 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 144665971 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 151514743 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 113032068 | OtherExpensePriorYear |
| Other Expenses Current Year | 124299371 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 257824509 | TotalExpensesPriorYear |
| Total Expenses Current Year | 275933566 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 21593155 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 13424307 | RevenuesLessExpensesCY |
| Total Assets BOY | 551683168 | TotalAssetsBOY |
| Total Assets EOY | 573640761 | TotalAssetsEOY |
| Total Liabilities BOY | 237789264 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 222506049 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 313893904 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 351134712 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The mission of San Antonio Community Hospital is to improve the overall health of our regional community by offering healthcare services that both comfort and cure in settings that inspire confidence and in a manner that earns the trust of our patients our physicians and our employees. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 261815245 | Expense |
| Grants | 119452 | Grants |
| Revenue | 274143223 | Revenue |
| Description | See Schedule O. | Description |
| Total Program Service Expense | 261815245 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 384 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 2239 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | WAH-CHUNG HSU | NamePerson |
| Telephone Number | 9099206103 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 SAN BERNARDINO ROAD | AddressLine1 |
| City | UPLAND | City |
| State | CA | State |
| ZIP Code | 91786 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Donald Alpiner DO | |||||||||
| Trustee | 4.0 | 0.0 | X | 2404 | 0 | 0 | |||
| Dora Barilla | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Mark Bertone | |||||||||
| Trustee/Vice Chairman | 4.0 | 0.0 | X | 0 | 0 | 0 | X | ||
| Dann Bowman | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Andrea Dutton | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Thomas Easter MD | |||||||||
| Trustee | 4.0 | 0.0 | X | 5094 | 0 | 0 | |||
| Richard Gilbert | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Stanley Kim MD | |||||||||
| Trustee | 4.0 | 0.0 | X | 1503 | 0 | 0 | |||
| Harris Koenig | |||||||||
| President/CEO | 40.0 | 3.0 | X | 651763 | 0 | 52359 | X | ||
| James Milhiser | |||||||||
| Trustee Chairman | 4.0 | 1.0 | X | 0 | 0 | 0 | X | ||
| Thomas Ritchie | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Al Ronco | |||||||||
| Trustee/Treasurer | 4.0 | 0.0 | X | 0 | 0 | 0 | X | ||
| Tejinder Singh MD | |||||||||
| Trustee | 4.0 | 0.0 | X | 31500 | 0 | 0 | |||
| Carl Schultz MD | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Steven Spears | |||||||||
| Trustee | 4.0 | 0.0 | X | 0 | 0 | 0 | |||
| Roger Parsons | |||||||||
| CFO/Secretary Outgoing | 40.0 | 5.0 | 430621 | 0 | 135924 | X | |||
| Wah-Chung Hsu | |||||||||
| CFO/Secretary Incoming | 40.0 | 5.0 | 83161 | 0 | 4609 | X | |||
| Liz Aragon | |||||||||
| Vice President | 40.0 | 0.0 | 276021 | 0 | 172031 | X | |||
| Lynn Kelly | |||||||||
| Vice President | 40.0 | 0.0 | 253405 | 0 | 104996 | X | |||
| Peter Aprato | |||||||||
| Vice President | 40.0 | 0.0 | 226680 | 0 | 40553 | X | |||
| Kenneth Saltgaver | |||||||||
| Director Pharmacy | 40.0 | 0.0 | 179096 | 0 | 149142 | X | |||
| Ae Cha Ko | |||||||||
| Registered Nurse | 40.0 | 0.0 | 173492 | 0 | 9515 | X | |||
| Carola Drascich | |||||||||
| Registered Nurse | 40.0 | 0.0 | 164598 | 0 | 56839 | X | |||
| Sharon Simmons | |||||||||
| Director of Finance | 40.0 | 0.0 | 157797 | 0 | 141145 | X | |||
| Khoa Phan | |||||||||
| Pharmacist | 40.0 | 0.0 | 160088 | 0 | 51028 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2797223 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 918141 | TotalOtherCompensation |
| Number Individuals GT100 K | 205 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Comforce | |||||
| 17682 Mitchell No Ste 100 | IRVINE | CA | 92614 | Temporary Labor | 1655682 |
| Softscript | |||||
| 2444 Wilshire Blvd Se 280 | SANTA MONICA | CA | 90403 | Transcription | 1023305 |
| Synergy Cardiothoracic Surgery Medi | |||||
| 901 San Bernardino Road Ste C | UPLAND | CA | 91786 | Cardiology prof svcs | 777360 |
| Mayo Medical Laboratories | |||||
| 200 1st Street SW | ROCHESTER | MN | 55480 | Medical Laboratory | 757325 |
| Angelica Textile Services | |||||
| 925 South 8th Street | COLTON | CA | 92324 | Linen Services | 635967 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 36 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT REVENUE | 622000 | 267094622 | 267094622 | |
| RENTAL INCOME MOB | 531120 | 2704265 | 2704265 | |
| LAB REVENUE UBI | 621500 | 615486 | 615486 | |
| CAPITATION REVENUE | 622000 | 764688 | 764688 | |
| ELECTRONIC HEALTH RECORD MEANINGFUL USE REVENUE | 900099 | 1605211 | 1605211 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 272784272 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7820916 | TotalRevenueColumn |
| Exclusion | $7,820,916 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 252139148 | Securities |
| Other | 1223691 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 246252678 | Securities |
| Other | 1519850 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5886470 | Securities |
| Other | -296159 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5590311 | TotalRevenueColumn |
| Exclusion | $5,590,311 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 194820 | GrossSalesOfInventory |
| Cost Of Goods Sold | 125040 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69780 | TotalRevenueColumn |
| Exclusion | $69,780 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| DEF REVENUE -CONSTRUCTION FOR OTHER | 622000 | 622666 | 622666 | ||
| CAFETERIA REVENUE | 722100 | 1082481 | $1,082,481 | ||
| SURGERY CENTER UBI | 621990 | 651162 | 651162 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 736285 | TotalRevenueColumn |
| Related Or Exempt Function Income | 736285 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3092594 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 289357873 | TotalRevenueColumn |
| Related Or Exempt Function Income | 273527737 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1266648 | UnrelatedBusinessRevenue |
| Exclusion | $14,563,488 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119452 | Total |
| Program Services | 119452 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2431987 | Total |
| Program Services | 238889 | ProgramServices |
| Management And General | 2193098 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112388227 | Total |
| Program Services | 106854623 | ProgramServices |
| Management And General | 5533604 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11169402 | Total |
| Program Services | 10627694 | ProgramServices |
| Management And General | 541708 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17200010 | Total |
| Program Services | 16365822 | ProgramServices |
| Management And General | 834188 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8325117 | Total |
| Program Services | 7921355 | ProgramServices |
| Management And General | 403762 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 212355 | Total |
| Management And General | 212355 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262452 | Total |
| Management And General | 262452 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262365 | Total |
| Management And General | 262365 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33831 | Total |
| Program Services | 33831 | ProgramServices |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 598344 | Total |
| Management And General | 598344 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19494492 | Total |
| Program Services | 18549023 | ProgramServices |
| Management And General | 945469 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1616887 | Total |
| Program Services | 1538469 | ProgramServices |
| Management And General | 78418 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9794282 | Total |
| Program Services | 9319266 | ProgramServices |
| Management And General | 475016 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9619323 | Total |
| Program Services | 9152793 | ProgramServices |
| Management And General | 466530 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5628101 | Total |
| Program Services | 5355142 | ProgramServices |
| Management And General | 272959 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 386804 | Total |
| Program Services | 368044 | ProgramServices |
| Management And General | 18760 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 178185 | Total |
| Program Services | 169543 | ProgramServices |
| Management And General | 8642 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 809268 | Total |
| Program Services | 760278 | ProgramServices |
| Management And General | 48990 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12203638 | Total |
| Program Services | 11464879 | ProgramServices |
| Management And General | 738759 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2480650 | Total |
| Program Services | 2360340 | ProgramServices |
| Management And General | 120310 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 45900755 | 45900755 | |
| MEDI-CAL FEE PROGRAM | 12702311 | 12702311 | |
| DUES, SUBSCRIP & OTHER | 985260 | 937475 | 47785 |
| TAXES & LICENSES | 643643 | 612427 | 31216 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 486425 | Total |
| Program Services | 462834 | ProgramServices |
| Management And General | 23591 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 275933566 | Total |
| Program Services | 261815245 | ProgramServices |
| Management And General | 14118321 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9425 | BOY |
| EOY | 167269 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7638883 | BOY |
| EOY | 11789297 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51672022 | BOY |
| EOY | 70303009 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4255401 | BOY |
| EOY | 4436150 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5917207 | BOY |
| EOY | 4750684 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 397902146 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 214047302 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124845505 | BOY |
| EOY | 183854844 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315894241 | BOY |
| EOY | 256427550 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4647890 | BOY |
| EOY | 4691366 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36802594 | BOY |
| EOY | 37220592 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 551683168 | BOY |
| EOY | 573640761 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43650135 | BOY |
| EOY | 46529173 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122369162 | BOY |
| EOY | 120720830 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71769967 | BOY |
| EOY | 55256046 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237789264 | BOY |
| EOY | 222506049 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 297475145 | BOY |
| EOY | 334769165 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12391568 | BOY |
| EOY | 12338356 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4027191 | BOY |
| EOY | 4027191 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 313893904 | BOY |
| EOY | 351134712 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 551683168 | BOY |
| EOY | 573640761 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 13424307 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 6492284 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 17324217 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $33,831 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 33831 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i | Identifier |
| Explanation | San Antonio Community Hospital is a member of the California Association of the American Hospital Association and the American Hospital Association which conducts lobbying activities in support of member hospitals and general healthcare issues. Both associations provide the percentage of dues that relate to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4027191 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 787050 | InvestmentEarningsOrLosses |
| Other Expenditures | 746597 | OtherExpenditures |
| Administrative Expenses | 40453 | AdministrativeExpenses |
| End Of Year Balance | 4027191 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4017691 | BeginningOfYearBalance |
| Contributions | 9500 | Contributions |
| Investment Earnings Or Losses | 32936 | InvestmentEarningsOrLosses |
| Other Expenditures | -5194 | OtherExpenditures |
| Administrative Expenses | 38130 | AdministrativeExpenses |
| End Of Year Balance | 4027191 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4017691 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 764343 | InvestmentEarningsOrLosses |
| Other Expenditures | 743754 | OtherExpenditures |
| Administrative Expenses | 20589 | AdministrativeExpenses |
| End Of Year Balance | 4017691 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4017691 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 614286 | InvestmentEarningsOrLosses |
| Other Expenditures | 601219 | OtherExpenditures |
| Administrative Expenses | 13067 | AdministrativeExpenses |
| End Of Year Balance | 4017691 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4002691 | BeginningOfYearBalance |
| Contributions | 15000 | Contributions |
| Investment Earnings Or Losses | -766842 | InvestmentEarningsOrLosses |
| Other Expenditures | -780189 | OtherExpenditures |
| Administrative Expenses | 13347 | AdministrativeExpenses |
| End Of Year Balance | 4017691 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14864344 | OtherCostOrOtherBasis |
| Book Value | 14864344 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 132726912 | OtherCostOrOtherBasis |
| Depreciation | 102535586 | Depreciation |
| Book Value | 30191326 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2242115 | OtherCostOrOtherBasis |
| Depreciation | 1180248 | Depreciation |
| Book Value | 1061867 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 147612993 | OtherCostOrOtherBasis |
| Depreciation | 110331468 | Depreciation |
| Book Value | 37281525 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 100455782 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 100455782 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 183854844 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BENEFICIAL INTEREST IN SAHF | 30908493 |
| MALPRACTICE LT CLAIMS REC | 4056750 |
| DEF FINANCING COSTS 2011 BOND | 1598875 |
| DEF COMP PLAN | 397089 |
| PHYSICIAN RECRUITMENT REC | 174867 |
| DUE FROM AFFILIATES | 84518 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 37220592 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION PLAN LIABILITY FAS 158 | $43,910,768 |
| LONG TERM INSURANCE CLAIMS | $10,622,612 |
| DEF GAIN CONSTR FOR OTHER - CURRENT | $622,666 |
| PHYSICIAN GUARANTEE LIABILITY | $100,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 55256046 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule D, Part V, Line 4 | Identifier |
| Explanation | San Antonio Community Hospital is the sole corporate member of San Antonio Hospital Foundation Inc., SAHF, and is required to consolidate SAHF assets and liabilities onto its balance sheet. Proceeds from the endowment funds are intended for the purchase of property and equipment for the benefit of San Antonio Community Hospital. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1988958 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1988958 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00710 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24633720 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18980664 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5653056 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02030 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26622678 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18980664 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7642014 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02740 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 43 | NumberOfActivitiesOrPrograms |
| Persons Served | 79352 | PersonsServed |
| Total Community Benefit Expense | 777229 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 88009 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 689220 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 191296 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 191296 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 596560 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 596560 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 39 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 39 | NetCommunityBenefitExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 44902 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21351 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 23551 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 51 | NumberOfActivitiesOrPrograms |
| Persons Served | 79352 | PersonsServed |
| Total Community Benefit Expense | 1610026 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 109360 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1500666 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00540 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 51 | NumberOfActivitiesOrPrograms |
| Persons Served | 79352 | PersonsServed |
| Total Community Benefit Expense | 28232704 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19090024 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9142680 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03280 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 3550 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3550 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1496 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1496 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 5046 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5046 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $38,220,621 | BadDebtExpenseAmount |
| Amount Attributable To | 3800000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 52349623 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 57825514 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -5475891 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SA Amb Surgery Ctr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Outpatient surgical center | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.29000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.67000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | San Antonio Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 San Bernardino Road | AddressLine1 |
| City | Upland | City |
| State | CA | State |
| ZIP Code | 91786 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | San Antonio Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 300. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 350. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| SACH 685 Building Diagnostic Center | ||||
| 685 N 13th Street | Upland | CA | 91786 | Lab and Radiology services in a freestanding medical office building |
| SACH 901 Building Diagnostic Center | ||||
| 999 San Bernardino Road | Upland | CA | 91786 | Radiology services in a freestanding medical office building |
| SACH RSA Building Diagnostic Center | ||||
| 7777 Milliken Avenue | Rancho Cucamonga | CA | 91730 | Lab and Radiology services in a freestanding medical office building |
| SACH Sierra San Antonio Diagnostic Ctr | ||||
| 16465 Sierra Lakes Pkwy | Fontana | CA | 92336 | Lab and Radiology services in a freestanding medical office building |
| San Antonio Ambulatory Surgery Center | ||||
| 901 San Bernardino Road | Upland | CA | 91786 | Outpatient surgery center |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Schedule H, Part I | Part I, Line 7 | The costing methodology used on 7a: Calculated using worksheets 1&2 in the instructions; the cost to charge option. The costing methodology used on 7b: Calculated using Worksheet 3 in the instructions; the cost to charge option. The costing methodology used on 7e to 7i: Calculated using actual costs from SACH's general ledger. |
| Schedule H, Part I | Part I, line 7b | The California Hospital fee program resulted in a net loss to SACH of $2,050,451. |
| Schedule H, Part I | Part I, line 7g | None of the costs on this line were attributable to a physician clinic. |
| Schedule H, Part II | Part II | San Antonio Community Hospital provided support to two local community organizations that serve the communities surrounding the hospital. These organizations were recipients of financial contributions that were used to enhance the health of the community. These organizations included Assistance League of the Foothill Communities and the Scheu Family YMCA. Both entities provide the community with opportunities to participate in health-related activities or programs, and promote healthy eating and active living. The Coalition Building activity represents time spent by the SACH Community Health Specialist who works directly with community groups to provide health education and technical assistance to support efforts that compliment the objectives identified in the community health needs assessment. Through these partnerships, San Antonio is able to work collaboratively to improve the health status of the communities they serve. In 2012, the hospital developed a partnership to expand an existing community benefit activity, Healthy Eating Lifestyle Program (HELP), into a neighborhood identified as a high area of need through a recent community needs assessment. The program has been successful in providing education to families about healthy eating and exercising. As a result, graduates of the program become lay health educators within their respective communities and continue to increase the reach of HELP. Please also see Part VI, line 5 for information related to coalition building. Schedule H, Part III Schedule H, Part III, Section A, Line 3 Management estimates that approximately 10% of patient debts would have been eligible for financial assistance if appropriate information had been made available by applicable patients. From a different perspective, SACH estimates that approximately 80% of all patients eligible for financial assistance were identified. The majority of SACH's bad debts result from medically indigent patients in the Emergency Department. SACH provides this emergency care and related inpatient care without compensation improving the overall health and well being of the community. |
| Schedule H, Part III | Part III, Section A, line 4 | The footnote for Allowance for Uncollectible Accounts appears in the audited financial statements on pages 12-13. |
| Schedule H, Part III | Part III, Section C Line 9b | When a patient qualifies for financial assistance, including but not limited to charity care, the hospital may waive some or all of its collection efforts. For a patient that qualifies for charity care, the entire bill is written off to charity allowance and the hospital makes no collection efforts. The hospital follows debt collection policy and procedures for any portion of the bill not eligible for write-off. |
| Schedule H, Part V | Part V, Section B, Line 14g | The hospital posts signs and notices regarding the charity care policy in the emergency department, admitting areas, and in the business office. These postings contain contact information for the financial counseling representatives who will assist patients in determining what types of financial assistance are available. |
| Schedule H, Part VI | Part VI, Line 2 | Although California's Community Benefit Legislation (SB697) only requires a triennial community assessment, San Antonio Community Hospital (SACH) reviews and updates the secondary data each year and conducts primary research no less than every three years. In addition to the annual assessment of secondary data detailed below, the triennial assessment includes primary research that includes written surveys, key informant interviews, and focus groups. The hospital has engaged independent consulting firms and university research centers to conduct the primary research. The annual assessment looks at the hospital's community from a wide perspective in terms of population, demographics, and key health indicators. Most of the data is focused on the hospital's primary service area, since this is where over 80% of the hospital's patients reside, and is also the area most often targeted for its community outreach efforts. During the assessment, primary service area population and demographics are evaluated based on the following statistics: current year population's estimates, five-year population segments (children, seniors, women of child bearing age), median age, marital status, household/families, ethnicity, language, education, employment, income, and hospitalization rates. Although the assessment focuses on demographic and health information for SACH's service area, there are benefits in examining county data, since many health indicators are only available at the county level. In addition, given the transient nature of the population in San Bernardino County, it makes sense for hospitals to work together and with other healthcare agencies to address issues that affect all county residents. With this in mind, population and demographic data are updated and reviewed for San Bernardino County, and general health indicators are compared to other California counties, state averages, and national goals. |
| Schedule H, Part VI | Part VI, Line 3 | Patients who may qualify for charity care under the hospital's Charity Care Policy are provided with information and an application form for Charity Care during the admitting or outpatient process. The hospital's charity care policy is posted in patient registration areas. The hospital's charity care policy provides relief to families who have no means for making payment. |
| Schedule H, Part VI | Part VI, Line 4 | SACH defines its community terms of its "service area", which is the geographic area from which it receives the majority of its hospital admissions. For purposes of analysis, the service area is divided into "primary" and "secondary" areas, with the primary service area accounting for approximately 80% of the admissions and the majority of SACH's planning efforts. SACH's primary service area is compromised of the cities of Chino, Claremont, Fontana, Montclair, Ontario, Rancho Cucamonga, and Upland with a total estimated population of 816,038, a median age of 32.9, and a median household income of $69,801. In the population 25 years of age and older, 11.9% have not graduated high school, 22.6% have a high school diploma, 24.3% have some education beyond high school, and 21.3% have a bachelor's degree or higher. The population is predominately Hispanic at 52.2%, followed by Caucasians at 35.2%, Asian-Americans at 7.6%, African-Americans at 5.6%, and all others at 2.8%. The secondary service area, which represents approximately 10% of SACH's admissions, includes Pomona on the west, Rialto to the east, Norco, and Eastvale to the southeast with an estimated total population of 458,270, a median age of 30.8, and a median household income of $66,984. In the population 25 years of age and older, 25.7% have not graduated high school, 24.5% have a high school diploma, 21.6% have some education beyond high school, and 14.6% have a bachelor's degree or higher. The population is predominately Hispanic at 56.4%, followed by Caucasians at 20.4%, Asian-Americans at 12.6%, African-Americans at 8.2%, and all others at 2.4%. |
| Schedule H, Part VI | Part VI, Line 5 | SACH has a community board and open medical staff privileges. As in most communities, health and service needs are great, but the resources limited. SACH understands the power of collaboration and seeks alliances with other health and social services providers to develop community based programs with defined goals and measurable outcomes. These partnerships help to leverage the community's scarce resources and achieve the maximum benefit for its residents, which results in demonstrated improvement in their health. The hospital has been proactive in responding to the specific health needs of special populations within our community this includes non-English speakers, persons who live in poverty, have mental or physical disabilities, or in other ways are disenfranchised. SACH is an integral part of San Bernardino County's Healthy Communities initiative which promotes physical, social, and economic environments that support the wellbeing of its members and embraces the belief that health is more than merely the absence of disease. Healthy Communities contain elements that enable people to maintain a high quality of life and productivity. Finally, healthy communities offer access to healthcare services that focus on both treatment prevention and treatment of disease for all members of the community. SACH has provided leadership and professional expertise to support the Healthy Cities in its service area including Healthy Chino, Healthy Fontana, Montclair Community Collaborative, Healthy Ontario, Healthy Rancho Cucamonga, and Upland Partnership. SACH staff serve on executive committees, planning committees, and various workgroups within these Healthy cities programs, providing insight and advice to support strategic planning, implementation and evaluation of health and wellness initiatives. SACH has served on planning and task forces, such as Ontario's Planning, Health Access, and Prevention and Wellness Initiatives, Montclair's WE CARE (West End Children's Activity Resource Coalition) committee, and Rancho Cucamonga Executive, Steering, Sub-committees. These efforts have reaped substantial rewards, not only in community building, but also in improved health and wellness. For example, SACH has been in discussion with the City of Upland as they update their General Plan. The hospital is an integral part of the community for residents and others beyond the city limits. The value of the Coalition Building activities are reported in Part II Line 6. In addition to these collaborative efforts, SACH continues to provide monetary and in-kind support to health-related nonprofit community organizations such as the American Cancer Society, which provides educational outreach and support programs for cancer patients and their families, and the San Antonio Community Hospital Dental Center which provides child dental health for at risk children who are unable to receive services otherwise. |
| Schedule H, Part VI | Part VI, Line 6 | Not applicable. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|---|---|
| San Antonio Hospital Foundation | ||||||||||
| 999 San Bernardino Road | Upland | CA | 91786 | 330042666 | 501(C)(3) | 70000 | ||||
| Meals on Wheels | ||||||||||
| 4792 Falconview Court | Fontana | CA | 92336 | 952799275 | 501(c)(3) | 44902 | Cost of goods | meals | Donate meals to Meals on Wheels to deliver to seniors | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | The Volunteers and Medical Staff of San Antonio Community Hospital raise funds to support the hospital. Those funds are donated annually to San Antonio Hospital Foundation, a related 501(c)(3) organization. The Hospital's CFO is also SFO for the Foundation. The Hospital CFO is responsible for monitoring all Foundation disbursements, including disbursements related to grant funding. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Harris Koenig | ||||||||||||||
| President/CEO | 376395 | 0 | 86527 | 0 | 188841 | 0 | 28875 | 0 | 23484 | 0 | 704122 | 0 | 0 | 0 |
| Roger Parsons | ||||||||||||||
| CFO/Secretary Outgoing | 264294 | 0 | 86117 | 0 | 80210 | 0 | 126646 | 0 | 9278 | 0 | 566545 | 0 | 11417 | 0 |
| Liz Aragon | ||||||||||||||
| Vice President | 224451 | 0 | 38764 | 0 | 12806 | 0 | 155673 | 0 | 16358 | 0 | 448052 | 0 | 5243 | 0 |
| Lynn Kelly | ||||||||||||||
| Vice President | 208975 | 0 | 32706 | 0 | 11724 | 0 | 94927 | 0 | 10069 | 0 | 358401 | 0 | 4084 | 0 |
| Peter Aprato | ||||||||||||||
| Vice President | 212549 | 0 | 0 | 0 | 14131 | 0 | 24195 | 0 | 16358 | 0 | 267233 | 0 | 0 | 0 |
| Kenneth Saltgaver | ||||||||||||||
| Director Pharmacy | 174458 | 0 | 3625 | 0 | 1013 | 0 | 134779 | 0 | 14363 | 0 | 328238 | 0 | 0 | 0 |
| Ae Cha Ko | ||||||||||||||
| Registered Nurse | 158216 | 0 | 15047 | 0 | 229 | 0 | 1738 | 0 | 7777 | 0 | 183007 | 0 | 0 | 0 |
| Carola Drascich | ||||||||||||||
| Registered Nurse | 153140 | 0 | 10678 | 0 | 780 | 0 | 42749 | 0 | 14090 | 0 | 221437 | 0 | 0 | 0 |
| Sharon Simmons | ||||||||||||||
| Director of Finance | 154007 | 0 | 3491 | 0 | 299 | 0 | 132837 | 0 | 8308 | 0 | 298942 | 0 | 0 | 0 |
| Khoa Phan | ||||||||||||||
| Pharmacist | 159919 | 0 | 0 | 0 | 169 | 0 | 50521 | 0 | 507 | 0 | 211116 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Schedule J, Part I | Part I, Line 1a | The hospital requests board members to attend various educational sessions during their term. In recognition that board members serve without compensation and that attending educational sessions takes most board members away from their jobs or businesses, the hospital provides reimbursement for spousal travel. The hospital also grosses up the spousal travel reimbursement and reports the grossed up amount on a 1099 given to the board member. |
| Schedule J, Part I | Part I, Line 4 | San Antonio Community Hospital provides a 457(f) supplemental non-qualified plan for seven members of its executive management team. The plan provides an accrued (but not paid) benefit up to a maximum of 10% of each of the executive's base pay. The plan accrues earnings at the 10-year Treasury note rate on the last banking day of each year. The plan participants are not eligible to receive the funds in this plan until retirement or termination. In 2012, three members of the executive management group received payments. Roger Parsons, CFO, received $11,417, Liz Aragon, VP Nursing received $5,243 and Lynn Kelly, VP Human Resources received $4,084. |
| Schedule J, Part I, Line 7 | The hospital's compensation policy includes an incentive payment structure for quality and patient satisfaction measures, included in the structure is a portion that is discretionary and subject to Board approval. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF UPLAND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 956000805 | IssuerEIN |
| CUSIP Number | 915346FH8 | CUSIPNumber |
| Date Issued | 2011-01-27 | DateIssued |
| Issue Price | 122414361 | IssuePrice |
| Description Of Purpose | SEE ATTACHED STATEMENT | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 0 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 126537058 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 14667046 | RefundingEscrow |
| Issuance Costs From Proceeds | 1865015 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 0 | CapitalExpenditures |
| Other Spent Proceeds | 110004997 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | false | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | false | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedProp |
| Prcntge Bond Financed Prop | 0.00000 | PrcntgeBondFinancedProp |
| Remedial Action Taken | false | RemedialActionTaken |
| Non Qualified Bond Remed Procdrs | true | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | true | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1 |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | false | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SCHEDULE K, PART I, COLUMN A | 0 | THE CERTIFICATES OF PARTICIPATION WERE ISSUED BY THE CITY OF UPLAND, CALIFORNIA EVIDENCING INDIVIDUAL OWNERSHIP INTERESTS OF THE HOLDERS THERE OF IN INSTALLMENT PAYMENTS TO BE MADE BY THE CITY OF UPLAND FROM PURCHASE PAYMENTS TO BE RECEIVED FROM SAN ANTONIO COMMUNITY HOSPITAL. |
| SCHEDULE K, PART I, COLUMN C | 0 | CUSIP NUMBERS ARE 915346EW6, 915346EX4, 915346EY2, 915346EY2, 915346EZ9, 915346FA3, 915346FB1, 915346FC9, 915346FD7, 915346FE5, 915346FF2, 915346FG0, 915346FJ4 AND 915346FH8 |
| SCHEDULE K, PART I, COLUMN F | 0 | BORROWING PROCEEDS TO BE USED FOR THE CONSTRUCTION OF A FOUR STORY PATIENT CARE TOWER, AN ENERGY PLANT, AND RELATED SITE UTILITIES FOR $110,004,997 AND TO REFUND EXISTING LONG TERM DEBT DATED SEPTEMBER 1, 1993 OF $14,667,046. |
| SCHEDULE K, PART V | 0 | SAN ANTONIO COMMUNITY HOSPITAL IS IN THE PROCESS OF DEVELOPING POST-ISSUANCE PROCEDURES TO BE IN PLACE PRIOR TO DEBT FINANCED ADDITION BEING PLACED INTO SERVICE. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | San Antonio Radiological Group | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Trustee, Carl L. Schultz | Relationship |
| Amount Of Transaction | 316113 | AmountOfTransaction |
| Description Of Transaction | Compensation for services | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Schedule O, Part III | Part III, Line 4a | "Overview" -San Antonio Community Hospital (SACH) was founded by Dr. William Howard Craig in 1907, just a year after the City of Upland was incorporated. As the community surrounding the hospital grew, it became apparent that larger, more modern facilities were needed. Frances Mary Paul, the widow of a local banker, spearheaded the effort to raise funds to build a new hospital by personally donating $75,000. The community rallied and sufficient funds were raised. The hospital moved on July 30, 1924, from its original location on the corner of San Antonio Avenue and Arrow Highway, to its present location on San Bernardino Road. SACH has grown from its modest beginning as an eighteen-bed hospital with five physicians and limited staff to a 279-bed regional medical facility with 1,622 full time equivalent employees and a medical staff of nearly 500 physicians. In 2012, the Hospital had approximately 15,073 inpatient admissions, 137,000 outpatient visits, and 73,800 emergency room visits. SACH is currently constructing the largest expansion in its 100-year history to replace its emergency department and add a patient tower to meet the needs of the growing population in the west end of California's Inland Empire. "Leadership"-SACH is governed by a 15-member Board of Trustees. The hospital's President and Chief Executive Officer, and the medical staff's President-Elect, President, and Immediate Past President are members of the board by virtue of their offices. Two additional physicians are elected from the medical staff, and the remaining members are elected from the community at-large. The Board of Trustees, with physician leaders comprising 33 percent of its membership, sets the direction for the hospital and its Community Benefits Program. The Executive Management Group directs the hospital's strategic planning process and allocates resources for community benefit activities. The Executive Management Group is comprised of the Chief Executive Officer, Chief Financial Officer, Chief Nursing Officer, Vice President of Human Resources, Vice President of Administrative Services, Director of Business Development and Community Outreach and President of the Hospital Foundation. Department directors are responsible for the operation and management of the individual departments. The directors encourage employee participation in community benefit activities, and it is this support that ensures the ultimate success of the SACH's community outreach program. "Our commitment" -The leadership at SACH has an unwavering commitment to the hospital's mission, vision, values, and strategic plan, which focus on improving the region's overall health by providing quality patient care in a compassionate and caring environment. Our mission is to improve the overall health of our regional community by offering healthcare services that both comfort and cure, in settings that inspire confidence, and in a manner that earns the trust of our patients, our physicians, and our employees. Our vision is to use our strengths to enhance our reputation for excellence in quality care, patient experience, and an exceptional working and practice environment. Our values articulate the principles that help us to fulfill our mission and vision, and our strategic plan specifically addresses the development of programs and services in response to regional community needs. SACH's commitment to providing quality care for all members of our community has received national recognition. In its 2009 National Benchmarks study, Thomson Reuters recognized SACH as a "Top 100 Hospital" in the United States. SACH was the only large community hospital in California and the first California hospital in four years to receive an award. This recognition is based on performance achievements in nine areas: mortality, medical complications, patient safety, average length of stay, expenses, profitability, cash-to-debt ratio, patient satisfaction, and adherence to clinical standards of care. In addition to the Top 100 Hospital award, Thomas Reuters selected SACH as one of 23 hospitals nationally to receive its inaugural "Everest" award for sustained operational performance and rapid increase in performance improvement rates over the previous five years. In addition, HealthGrades has recognized SACH for quality excellence in Emergency Medicine, Stroke Care, and Maternity Care. In 2008, SACH became the 65th hospital in the United States to receive the Baby Friendly designation which measures infant health, breast feeding, and infant-parent attachment based on global criteria developed by the World Health organization and UNICEF. SACH has also been honored by the California Hospital Assessment Reporting Task Force (CHART) for excellence in clinical and safety measures. "Caring for our Community" - Community benefits are more than just numbers. They represent people-moms and dads, children and grandparents, and the homeless, helpless, and hopeless. San Antonio Community Hospital goes above and beyond the delivery of essential patient care services to ensure healthier children, early detection of disease, and enhanced access to basic healthcare services. It captures the essence of our purpose: to improve health and make the community a better place to work, grow, and play. As a regional healthcare provider, SACH is committed to maintaining the highest quality of care for those we serve. As a nonprofit hospital, all of our resources are devoted to providing healthcare services. Any surpluses generated from hospital operations are used to purchase new or upgraded equipment, expand services, and provide care for vulnerable populations. While the Inland Empire is a maturing economic market, as a whole, many individuals and families are at significant risk during a medical crisis due to their inability to access health insurance or as the result of inadequate insurance coverage. The hospital's charity care policy provides relief to these families who would otherwise face medical bankruptcy. During 2012, $1,988,958 (at cost) in charity care was provided for qualifying patients. In addition to this direct medical care, SACH reaches out to its community in a variety of ways that go well beyond the traditional care provided by an acute care hospital. "Planning"-SACH conducts a formal strategic planning process involving senior management, the board, the medical staff leadership every three years with annual reviews and updates. In 2008, the executive management team worked closely with SACH's Board of Trustees and Medical Staff to develop a three-year strategic plan for 2009 to 2011, which includes details of strategic, operational, quality and community benefit initiatives. In addition to programmatic and service enhancement projects, the strategic plan includes a Facilities Master Plan, which calls for the renovation and expansion of the hospital's main campus. "Facility Expansion" - The expansion, expected to open in late 2014, will include new medical/surgical and intensive care inpatient beds and a new Emergency Department, which are essential to accommodate the growing needs of SACH's service area and to offset the expected reduction in the number of medical/surgical beds as a result of current State seismic compliance requirements. The tremendous growth experienced in SACH's Emergency Department services is key driver of the planned expansion. The hospital's 29-bed Emergency Department, which was built in 1975, was designed to accommodate 30,000 patient visits per year. In fiscal year 2012, SACH's Emergency Department had 73,800 visits. With the high unemployment in the hospital's service area, the number of uninsured patients treated in the Emergency Department continues to rise, adding additional stress to the already overburdened existing facilities. "Four-Story Patient Tower" - The primary structure in the planned addition to SACH's facilities will be a four-story patient care tower to be constructed on the east side of the hospital campus immediately adjacent to the existing patient tower and ancillary service departments. The four-story tower designed to include a 52-bed replacement Emergency Department, including computerized tomography ("CT") scanning and other radiology capabilities, 80 medical/surgical and telemetry rooms, 12 intensive care rooms, a new main lobby, 33,470 square feet of shelled space on the first floor, and site improvements including parking and landscaping. |
| Schedule O, Part III | Part III, Line 4a | Continuation of explanation on line 4A: "Energy Plant and Site Utilities" - The addition of the new four-story patient care tower will require construction of a conventional energy plant to supplement existing co-generation capacity. The new energy plant will be built near the existing energy plant in a location consistent with appropriate environmental standards. The site utilities project will connect the new energy plant with the new four-story patient care tower. "Hospital Services" - SACH provides a full spectrum of preventive acute, primary, and specialty care to the communities it services. These services include inpatient medical and surgical service, emergency and intensive care services, palliative care and a community wellness and health promotion program. Areas of special expertise include cardiovascular services provided at SACH's Heart Center, specialized infant care provided at the Level II neonatal intensive care unit (NICU), and the diagnostic and treatment services available at its Cancer Center and Gamma Knife Center, "The Heart Center" - SACH's heart program coordinates the comprehensive cardiac service line, including non-invasive cardiology, diagnostic and interventional cardiac catheterization, cardiac nuclear scanning, cardiovascular surgery, and cardiac rehabilitation. SACH has been designated as "STEMI" (ST-elevation myocardial infarction)-receiving hospital by San Bernardino, Los Angeles and Riverside counties, meaning that the hospital has the equipment, expertise and facilities to administer percutaneous coronary intervention, the preferred method of treating severe heart attack patients. SACH is the only hospital in the Inland Empire with a three-county designation. "Cancer Center" - SACH's cancer program has been fully accredited by the American College of Surgeon's Commission on Cancer Since 1980. The hospital treats more than 800 new cancer cases per year. The cancer program treatment modalities include surgery, chemotherapy, hormone therapy, and immunotherapy. Outpatient radiation oncology services include 3D conformal, external beam, electron beam and intensity modulated therapy ("IMRT"). The Cancer Resource Center provides education and support services for cancer patients and their families. Nurse navigators are part of the cancer team and meet with every hospitalized patient with cancer. The navigators also work closely with the physicians on an outpatient basis to ensure that patients have a positive experience as they move between the inpatient and outpatient status during different stages of their treatment. "Gamma Knife Center" - SACH offers the only Gamma Knife radiosurgery system in its primary service area. The Gamma Knife enables the hospital's Radiation Oncology and Neurosurgery Department to conduct noninvasive, outpatient brain surgery, using low-dose radiation beams to target tumors and abnormal cells with precision. The less invasive method is performed on an outpatient basis, allowing patients to receive treatment and return home the same day. "Women's Breast and Imaging Center" - The Women's Breast and Imaging Center is located immediately adjacent to the main hospital facility and offers patients the latest advancements in screening and diagnostic procedures for early detection of breast cancer. The Center's technology includes digital mammography, ultrasound and stereotactic breast biopsy procedures. A dedicated nurse navigator coordinates the breast cancer patient's care throughout diagnosis, treatment, and recovery. Additional screening services for women's health offered at the Center include general ultrasound for diagnosing gynecological disorders and osteoporosis screening for assessing bone health. A focus of the Women's Center is to assure that the patient's experience is as positive as their medical outcome. "Maternal Child Services" - coordinates care with obstetricians and pediatricians to provide comprehensive prenatal, delivery and postpartum care. The Maternal Child Department includes 32 maternity beds, four labor, delivery and recovery rooms, 10 labor, delivery, recovery and postpartum rooms, a cesarean section surgical suite and recovery room, and a 20-bed NICU. A postpartum follow-up center is located near the main hospital to provide screening and support services for infants and their parents. The services provided at the center are offered to all families regardless of where they delivered their baby, and the nominal fee is waived for any family that cannot afford to pay the services provided by SACH's Internationally Board Certified Lactation Consultant. SACH is designated a Baby Friendly hospital by the World Health Organization. This designation is an important part of SACH's Healthy Beginnings program, which reinforces the benefits of breastfeeding. "Surgical Services" - The Surgery Department operates nine surgical suites and two additional surgical suites dedicated to cardiovascular surgeries. The Surgery Department performs approximately 350 inpatient and 350 outpatient surgeries per month, including general surgery and surgeries in the specialties of orthopedics, cardiology, gynecology, urology, otolaryngology, and ophthalmology. "Imaging and Radiation Oncology Services" -The Radiology Department provides imaging services to support the SACH's Emergency, Surgery, and other departments. The imaging services offered to both inpatients and outpatients include diagnostic radiology and fluoroscopy, 64-slice CT scan, 3-T magnetic resonance imaging (MRI), interventional radiology, ultrasound, mammography, and special procedures. The Radiation Oncology Department provides external beam radiation for the treatment of various cancer conditions and brachytherapy for the treatment of prostate cancer. "Community Education"- SACH offers a broad array of education classes, support groups and community lectures to meet the health needs of its community. Some of the programs are offered on-site, but many are provided at locations throughout the community to reach those who may have special needs or lack transportation and would otherwise fail to access these important services. In addition to gaining knowledge about important health topics, participants may participate in free screenings to identify potential health concerns such as high blood pressure, high cholesterol, high glucose, skin cancer, and prostate cancer. "Community Benefit Initiatives" - As part of its mission to improve the health of the community it serves, SACH conducts an ongoing assessment process to identify community health needs. The hospital's Community Outreach Department supports a variety of services designed to meet these needs, including support groups, educational seminars and community health fairs, as well as several targeted health initiatives. A few if these programs are highlighted here. "Healthy Beginnings" - SACH's maternal/child services, collectively known as Healthy Beginnings, is committed to providing excellent service and care, which result in the best possible outcome for the newest members of its community and their families. In support of this goal, the hospital engaged in an extensive process to become a "Baby Friendly Hospital," which is an international designation recognizing the institution's comprehensive program supporting breastfeeding and infant/parent bonding. As part of this program, parents are encouraged to take advantage of the many educational opportunities and support services offered before, during, and after delivery. Expectant parents attending the breastfeeding class receive encouragement and instruction to promote a successful breastfeeding experience. Internationally Board Certified Lactation Consultants, supported by lactation educators, are available to provide support during the family's hospital stay, and every family is encouraged to visit the Healthy Beginnings Newborn Feeding Center after they leave the hospital. In addition to providing breastfeeding evaluation and support, the Newborn Feeding Center assesses mother and newborn, providing referrals to community resources when needed. This thorough evaluation process has yielded significant outcomes including a reduction in newborn readmission rates, increased breastfeeding rates, early intervention for development delays and identification and treatment of postnatal illness, from baby blues to postpartum psychosis. While some families just need reassurance that their baby is thriving, others may require further education or support, and a few require intervention or treatment. The Center offers support to all new families in the community, regardless of where their babies are born. In fact, many local pediatricians include a visit to the Center as part of the discharge instructions for their patients. |
| Schedule O, Part III | Part III, Line 4a | Continuation of explanation provided on line 4A. "Dental Center" - The San Antonio Community Hospital Dental Center has been operating for over 75 years with the mission to provide dental care to low-income, uninsured children in Western San Bernardino County. The Dental Center operates during the school year, with clinics held from October through May. In addition to direct patient care, the Dental Center provides in-school screening to identify children in need of dental care. The Dental Center's goal is to educate children about the importance of dental hygiene and to provide prophylactic and therapeutic dental and orthodontic services to this vulnerable population. Some of the children treated have been unable to eat properly or to function in school due to the pain being experienced. Once located on the hospital's campus, the Dental Center is now housed in a dedicated building in Rancho Cucamonga owned and operated by the Assistance League of the Foothill Communities. SACH paid the remodeling cost for the Dental Center building in 1985 and continues to provide financial assistance and other services to support the program. The Dental Center is a prime example of the benefits that can be provided to families in need through collaborative efforts. SACH, the Assistance League of the Foothill Communities, volunteer dentists, hygienists and other health and dental professionals, along with a variety of funding agencies are devoted to improving the health and well-being of elementary and junior high school children throughout the regional community. "Safe Surrender" -SACH's Safe Surrender program and DVD entitled "Safe Surrender. No Shame. No Blame. No Names." is a wonderful example of how the hospital and its employees recognize and take ownership in community health issues where they can make a difference. Officially called the "Safe Haven" law, the Safe Surrender program ensures that a baby can be surrendered anonymously to any hospital, fire department, or police department without criminal repercussions. While many healthcare workers were aware of the law, few junior high, high school and college students knew about this safe and secure option for both infant and parents. Produced in partnership with college film students, Safe Surrender. No Shame. No Blame. No Names. contains powerful imagery and interviews with teenage girls who relate to young women at their own level. The DVD is available free of charge to anyone willing to help raise awareness of the Safe Surrender alternative to infant abandonment. From the moment of its release, there has been an overwhelming response that has garnered statewide attention due to its poignant and highly effective portrayal of the unfortunate consequences of infant abandonment, as well as offering life-saving alternatives. To date more than 2,300 copies of the DVD have been distributed to over 750 different community organizations, school districts, nurse educators and teachers. The San Bernardino County Superintendent of Schools, through its School Linked Health Programs and Partnerships, has incorporated the hospital's Safe Surrender DVD into its Positive Prevention Plus sex education curriculum. San Bernardino County has rolled the program out to all 34 of its school districts, educating nurses and teachers and targeting thousands of middle school and high school students. After serving as a pilot project and seeing the program's impact on its students, San Bernardino County is printing the curriculum for distribution to school districts throughout California who request it. It is also available through the Department of Education's Healthy Kids Resource Center. With the additional exposure through the school curriculum, the number of young people touched by the DVD's message will continue to grow. "Sports Injury Clinic" - SACH launched the Sports Injury Screening Clinic at its Rancho San Antonio satellite facility in late 2009. The program was introduced to provide free screenings for community members who have sustained sports-related injuries. Through discussions with various school health advisory councils, SACH soon realized that in addition to the program for the general community, there was strong support for a free sports screening program targeted to local school districts, city community centers, youth league programs, senior citizen programs and adult intramural leagues. Using this targeted approach has enabled the clinic to help several uninsured high school athletes who were screened and educated about their injuries. The students not only learned how to manage their current injury to speed recovery, but also learned methods to avoid additional injuries in the future. These free services have allowed the students to get back to a healthy lifestyle and to return to their sport. One young athlete who suffered a head injury while playing soccer arrived at the clinic with an undiagnosed brain injury. The family had heard about the screenings and brought their athlete in to undergo a special test designed to diagnose patients with head injuries. When the serious nature of the injury was identified through the screening, the young woman was referred for an MRI and follow-up consultation with a neurologist. If this young athlete had failed to access treatment, this injury could have been debilitating, if not life-threatening, particularly if she were to sustain further injury. Through this program, SACH has been able to diagnose, educate, and immediately activate treatment plans for these athletes, and at no cost to the families. In these fragile economic times when many families have lost health insurance coverage, this community service takes on even greater importance. The walk-in screening clinic takes place every Monday from 4 pm to 6 pm at the Rancho San Antonio Rehabilitation Center in the City of Rancho Cucamonga. Each patient that comes into the clinic with a sports injury receives a free medical screening by a board-certified physician in addition to a free assessment by a physical therapist and/or athletic trainer. Plans for the program include increasing community awareness via local newspapers, school districts, and adult and youth sports leagues. Given the enthusiastic response of the people who have been served by the clinic, it is anticipated that demand will continue to grow which could lead to further expansion of the program. |
| Schedule O, Part III | Part III, Line 4a | Continuation of explanation provided on line 4A. "HAPPY Children's Health Initiative" - SACH is an active participant in Healthy Ontario's prevention and wellness and healthcare access workgroups. These initiatives are closely aligned with the hospital's goal to improve the health status of the communities we serve and provide a tangible means for the hospital to respond to identified community needs. Healthcare access in the City of Ontario is particularly challenging given that 22% of the population is uninsured and 16% do not have a regular medical home. As a result, access for this particular population is primarily through the 911 system and hospital emergency departments. One of the key objectives established by the healthcare access workgroup was to encourage appropriate utilization of high-cost services and systems, and to properly channel resources to increase access to preventive and primary care. It is out of this objective that HAPPY (Health Access Partnership Project for Youth) was born. HAPPY's goals are to increase health plan enrollment for qualified children, conduct health screenings for children without access to healthcare through collaboration and coordination of care among public and private entities, and to demonstrate cost savings through new models of health care for children within targeted groups. Children are enrolled in the HAPPY Club through Kids Come First Community Clinic and are given an identification card. All services provided through the program are monitored and evaluated to measure health outcomes. Since the program is currently designed as a pilot project, it is limited to children who reside in the City of Ontario and are not currently covered in the health system. The HAPPY project is designed to increase access to children's preventative health services such as regular medical check-ups, preventative & wellness care, screening and assessment, immunizations, health education and specialty care referrals. The program began in the summer of 2009, but enrollment did not begin in earnest until school was in session. During its first year, the HAPPY Club enrolled 530 children, which put the program well on its way to achieving its goal to enroll 1,500 children over an 18-month period. Given its rapid growth in membership, it is likely that HAPPY will reach its enrollment goal during the 2011-2012 school year. Since its inception, the HAPPY Club has made a tremendous difference in the lives of many children and their families by filling the gap in the safety net. Each child enrolled in the Happy Club receives a medical screening, and in many cases these screenings lead to early intervention and referrals to critically needed medical care. This is where SACH steps in to help by facilitating referrals to physicians who can provide the specialized medical care needed. In addition to arranging for referrals to pediatric specialists on its medical staff, SACH provides laboratory, radiology, cardiology and various other diagnostic procedures for HAPPY children who need further medical follow-up. In addition to the expense incurred by the hospital, physician specialists including radiologists and cardiologists donate their time and resources to interpret the diagnostic exams and report their findings to the medical director at the Kids Come First clinic. Access to diagnostic testing has enabled the medical providers at the clinic to identify and treat health problems that had gone undiagnosed due to the family's inability to access medical care for their child. Without treatment, many of these children are at risk for more serious health problems that can develop into lifelong chronic diseases such as diabetes. Healthy Ontario's experience has demonstrated that new ways of thinking about health can lead to innovative models of care like the HAPPY Club, which is effectively filling some of the holes in the healthcare safety net. The hope for the future is that the success achieved by Healthy Ontario's pilot project will become a model that other cities can replicate to mirror the HAPPY Club's success in their own communities. |
| Schedule O, Part VI | Part VI, Section B, Line 10a | The hospital has a Medical Staff activity whose activities are separate from the hospital's but the hospital's governing board has ultimate authority over certain medical staff actions. |
| Schedule O, Part VI | Part VI, Section B, Line 11B | The Form is prepared internally by the organization's Accounting Department and reviewed by the organization's CFO. The Form is then reviewed by the organization's external financial and tax audit firm. Following the external review, the CFO reviews the Form with the organization's CEO. The Form is then sent to members of the organization's Board Audit Committee for review and approval. The Form is then sent to the entire organization Board prior to final signatures and filing. |
| Schedule O, Part VI | Part VI, Section B, Line 12c | The organization has a Compliance Officer who reviews the organization's compliance policies, including its conflict of interest statements, at least annually. The organization's Board has an organization meeting every January. At the annual organization meeting conflict of interest statements are distributed to all Board members and Officers and subsequently collected by the organization's Compliance Officer. The CFO, who attends all Board meetings, also reviews the Board conflict of interest statements. If a new potential conflict of interest arises during the year, a new conflict of interest statement is signed. If a potential conflict of interest exists during a Board discussion, the Board member is required to state the conflict and abstain from any related Board votes. Board minutes reflect these abstentions. At least semi-annually, the organization's Compliance Officer provides a verbal compliance update at a Board meeting and reminds Board members of their duty to disclose potential conflicts of interest. The organization follows a similar annual procedure for members of its executive management and department directors, including at least annual compliance education sessions. |
| Schedule O, Part VI | Part VI, Section B, Line 15 | The organization's executive compensation program is directed by the Compensation Committee of the Board. The organization has developed and approved a formal executive compensation policy that currently covers six senior management employees, including the CEO and the CFO. A comprehensive base pay and total executive compensation analysis is performed by an outside compensation consulting firm every two years. The consultant presents the survey data and analysis to the Board Compensation Committee. The external compensation study includes an evaluation for excess benefit transactions under the Intermediate Sanctions for Tax-Exempt Organizations as described in Section 4958 of the Internal Revenue Code. The latest survey and analysis were conducted in 2012. A request for proposal process was conducted prior to the selection of the compensation consultant. The consultant used survey data from all of California, with subsets of data from Southern California, and a further subset of data from the organization's local market area. The Compensation Committee reviews the external consultant's findings and provides direction for any needed compensation policy or pay range changes. The organization's Board Audit Committee also conducts an annual review of the reasonableness of the CEO's and CFO's total compensation. Other key employee compensation, Vice Presidents and Department Directors, is evaluated based on market based compensation survey data provided by the Hospital Council of Southern California taking into consideration pay rates for similar management positions at SACH. The procedures described here are documented in the board minutes. |
| Schedule O, Part VI | Part VI, Section C, Line 19 | The organization has not made its governing documents or conflict of interest statements available to the public. The organization's financial statements are part of the Organization's annual report filed with the California Office of Statewide Health Planning and Development (OSHPD) and are available on the OSHPD Web site. The organization's financial statements are also included as part of its annual Medicare and Medicaid cost report filings which are publically available on the CMS (Medicare) Web site. The organization's financial statements are also provided to anyone upon a verbal or written request. The audited Financial Statements are attached to the Form 990 in accordance with the IRS Instructions. |
| Supplemental Information to Form 990 or 990-EZ | Part XI, Line 9 | "Other Changes in net assets" - Change in additional minimum persion liability 16,815,477, less decrease in SAHF - temporarily restricted net assets for SAHF of 53,210 and increase of interest of subsidiary SAHF - earnings of $482,877, book-tax difference in ASC income of $79,073 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| San Antonio Hospital Foundation Inc | ||||||||||
| 999 San Bernardino Road | Upland | CA | 91786 | 330042666 | Support SACH | CA | 501c(3) | 7 | SACH | true |
| San Antonio Community Health Care Plan | ||||||||||
| 999 San Bernardino Road | Upland | CA | 91786 | 237391094 | Health Plan S | CA | 501(C)(9) | SACH | true | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cucamonga Health Services | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 San Bernardino Road | AddressLine1 |
| City | Upland | City |
| State | CA | State |
| ZIP Code | 91786 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330010073 | EIN |
| Primary Activity | Holding company | PrimaryActivity |
| Legal Domicile State | CA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SACH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 12379 | ShareOfTotalIncome |
| Share Of EOY Assets | 336085 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Controlled Org | true | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| San Antonio Hospital Foundation Inc | ||
| p | 747015 | Market Value |
| San Antonio Community Health Care Plan | ||
| q | 11206137 | Market Value |
| San Antonio Hospital Foundation Inc | ||
| b | 70000 | Market Value |