2013-08-06T13:00:07-05:00 2012-09-30 861065772 DELOITTE TAX LLP 655 WEST BROADWAY SUITE 700 SAN DIEGO CA 921018590 990 2011-10-01 951934652 PRESBYTERIAN INTERCOMMUNITY HOSPITAL INC PRES 5626980811 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 MITCHELL THOMAS 5626980811 2013-08-05 1 DIANA J MCCUTCHEN P00545657 6192326500 2011 2016-02-24 21:20:13Z MITCHELL THOMAS 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 526533163 0 X N/A X 1954 CA TO PROVIDE QUALITY HEALTHCARE AND CONTRIBUTE TO THE COMMUNITY'S HEALTH AND WELL-BEING. 15 12 3160 1133 161325 65848 2204568 954865 444974620 470131844 15084659 11480664 3235462 4804357 465499309 487371730 852252 485251 0 0 212682689 223540380 0 0 0 202598224 223810513 416133165 447836144 49366144 39535586 905350088 984432289 493712181 521987119 411637907 462445170 X MISSION: WHY WE ARE HERE: WE PROVIDE HIGH QUALITY HEALTHCARE WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITIES IN AN ETHICAL, SAFE, AND FISCALLY PRUDENT MANNER IN RECOGNITION OF OUR CHARITABLE PURPOSE. VISION: WHERE WE WANT TO BE: WE WILL ACHIEVE EXCELLENCE IN EVERYTHING WE DO. VALUES: OUR PROMISE: OUR PATIENT'S SAFETY, WELL-BEING, AND MEDICAL CONDITION WILL BE OUR PRIMARY CONCERN AT ALL TIMES. WE WILL CONSISTENTLY DEMONSTRATE RESPECT AND COMPASSION FOR THE BELIEFS, SITUATION, AND NEEDS OF OUR PATIENTS AND CO-WORKERS. WE WILL STRIVE TO ANTICIPATE NEEDS AND RESPOND IN A TIMELY WAY TO MEET OR EXCEED THE EXPECTATIONS OF OTHERS. OUR ATTITUDE AND ACTIONS WILL REFLECT THE HIGHEST ETHICAL AND MORAL STANDARDS. WE WILL WORK TOGETHER - WITHIN AND OUTSIDE THE ORGANIZATION - TO SOLVE PROBLEMS AND PURSUE OPPORTUNITIES IN CREATIVE WAYS. WE WILL SERVE THE COMMUNITY WISELY THROUGH THE EFFICIENT AND PRUDENT USE OF OUR FINANCIAL RESOURCES. 0 0 275615787 427005 413319014 PATIENT CARE: PRESBYTERIAN INTERCOMMUNITY HOSPITAL (PIH) IS A NONPROFIT 501(C)(3) 444-BED MEDICAL CENTER AND INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT WAS FOUNDED IN 1959 BY VOLUNTEERS WHO WENT DOOR-TO-DOOR WITH COFFEE CANS TO RAISE FUNDS TO BUILD A LOCAL HEALTHCARE FACILITY. OVER 50 YEARS LATER, PIH HEALTH HAS MAINTAINED THAT SAME SENSE OF COMMUNITY AND FAMILY-LIKE CULTURE WHERE PATIENTS ARE THE TOP PRIORITY, AND EMPLOYEES AND VOLUNTEERS ARE PROUD TO BE AFFILIATED WITH SUCH AN ORGANIZATION. PIH SERVES MORE THAN 1.5 MILLION RESIDENTS IN LOS ANGELES, SAN BERNARDINO, AND ORANGE COUNTIES AND OFFERS A WIDE RANGE OF SERVICES INCLUDING UTILIZATION OF PRIMARY CARE TEAMS TO PROVIDE GENERAL MEDICINE AND PREVENTATIVE CARE; ACCESS TO EMERGENCY AND URGENT CARE, AND HOME HEALTH SERVICES AND HOSPICE. PIH IS SITUATED IN THE SOUTHEAST PORTION OF LOS ANGELES COUNTY, CALIFORNIA, WITHIN AN AREA REFERRED TO AS SERVICE PLANNING AREA 7 (SPA 7). APPROXIMATELY 73% OF DISCHARGES COME FROM NINE CITIES/COMMUNITIES, WHICH COMPRISE ITS PRIMARY SERVICE AREA. PIH HEALTH'S SECONDARY SERVICE AREA INCLUDES ADDITIONAL CITIES IN THE SAN GABRIEL VALLEY AND NORTH ORANGE COUNTY. PIH IS COMMITTED TO REMAINING AT THE FOREFRONT OF HEALTHCARE ADVANCES INCLUDING TECHNOLOGY, EQUIPMENT AND TOP-NOTCH FACILITIES AND AMENITIES TO BENEFIT PATIENTS AND STAFF ALIKE. ITS HIGHLY TRAINED AND COMPASSIONATE PHYSICIANS, NURSES, CLINICIANS, STAFF AND VOLUNTEERS WORK TIRELESSLY AND COLLABORATIVELY EVERY DAY TO BE THE COMMUNITIES' HEALTH AND WELLNESS PARTNER.PIH PROUDLY FEATURES THE FOLLOWING CENTERS OF EXCELLENCE: THE HEART & LUNG CENTERCRITICAL CARE SERVICESMATERNAL-CHILD HEALTH SERVICESTHE R.C. BAKER FOUNDATION EMERGENCY CENTERTHE RUBY L. GOLLEHER COMPREHENSIVE CANCER PROGRAMTHE PATRICIA L. SCHEIFLY BREAST HEALTH CENTERREHABILITATION SERVICESHOSPICE AND HOME HEALTH SERVICESPIH PROVIDES THE FOLLOWING PROGRAMS IN CONNECTION WITH ITS CHARITABLE MISSION:A DAY AWAY ADULT DAY HEALTH CARE CENTERCOMPREHENSIVE CANCER PROGRAMCAR SEAT PROGRAM (LOW-COST CAR SEATS)CHAPLAINCY PROGRAMCOMMUNITY-BUILDING BY SENIOR LEADERSHIP & MANAGEMENTCOMMUNITY-BASED HEALTHCARE (FAMILY PRACTICE RESIDENCY/CARE FORCE ONE MOBILE HEALTH SERVICES)COMMUNITY EDUCATION OUTREACH (BREAST HEALTH/CHILDBIRTH/DIABETES/HEART HEALTH)COMMUNITY HELPLINES (CANCER HELPLINE, COMMUNITY ADVICE NURSE, SOCIAL SERVICES HELPLINE) DISASTER READINESSDONATIONS TO COMMUNITY ORGANIZATIONS (FINANCIAL & IN-KIND)ED PHYSICIAN ON-CALL PROGRAM (EA PROGRAM)ENROLLMENT ASSISTANCE (MEDI-CAL ELIGIBILITY WORKERS & ENROLLMENT COORDINATORS)EXERCISE CLASSES / FALL PREVENTION PROGRAMFAMILY PRACTICE RESIDENCY PROGRAMFLU AND PNEUMONIA VACCINATION CLINICSHEALTH SCREENINGSHIGH-RISK INFANT FOLLOW-UP CLINICHOSPICE AND HOME HEALTHHOSPITALISTS / INTENSIVISTS (24/7)PARAMEDIC BASE STATION (INCLUDING STAFF TRAINING)PHYSICIAN/MEDICAL PROFESSIONAL EDUCATIONPURCHASED SERVICES & TRANSPORTATION FOR UNDERSERVED PATIENTS/FAMILIESRESEARCHSENIOR SERVICESSEXUAL ASSAULT RESPONSE TEAM (SART)STUDENT TRAINING (NURSING & ANCILLARY)SUPPORT GROUPSWHITTIER FIRST DAY HEALTH & WELLNESS CENTER (LOCAL HOMELESS SHELTER) 102576230 58246 56511017 FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: FINANCIAL ASSISTANCE, OR CHARITY CARE, REFERS TO DOLLARS EXPENDED FOR THE PROVISION OF FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. RECOGNIZING OUR CHARITABLE MISSION, PIH OFFERS A GENEROUS UNCOMPENSATED CARE PROGRAM PROVIDING CHARITY CARE TO ALL PATIENTS WITH FAMILY INCOME(S) WITHIN 400% OF THE FEDERAL POVERTY GUIDELINES. ADDITIONALLY UNDER THE SELF-PAY PAYMENT PROGRAM, PATIENTS WHO ARE UNINSURED OR HAVE VERY LIMITED BENEFITS ARE AUTOMATICALLY GIVEN A BILL REDUCTION REFLECTIVE OF OR LESS THAN THE HEALTHY FAMILIES RATE WITH A CONTRACTED PLAN; NO PRE-QUALIFICATION IS NECESSARY. EACH FISCAL YEAR, PIH REALIZES A NET LOSS DUE TO OFFERING CASH DISCOUNTS OFF OF ACTUAL HOSPITAL COSTS OF PROVIDING THIS CARE.THE DISCOUNTS PROVIDED BY THE SELF-PAY PAYMENT PROGRAM ARE ESPECIALLY OF BENEFIT TO THOSE IN THE PROCESS OF APPLYING FOR PIH'S CHARITY CARE OR OTHER GOVERNMENT MEANS-TESTED PROGRAM AND AWAITING ELIGIBILITY DETERMINATION. NUMBER OF PERSONS SERVED THROUGH FINANCIAL ASSISTANCE, OR CHARITY CARE: 8,434IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN MEANS-TESTED GOVERNMENT HEALTH PROGRAMS, SUCH AS MEDI-CAL, MEDI-CAL HMO AND HEALTHY FAMILIES, PIH REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR DUE TO THE SHORTFALL CREATED WHEN THE PAYMENTS RECEIVED FROM THESE PROGRAMS ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. THIS PAYMENT SHORTFALL IS NOT THE SAME AS A CONTRACTUAL ALLOWANCE, WHICH IS THE FULL DIFFERENCE BETWEEN CHARGES AND PAYMENTS BY GOVERNMENT PROGRAMS. NUMBER OF PERSONS SERVED BY MEANS-TESTED GOVERNMENT PROGRAMS: 27,683.FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH'S COMMUNITY BENEFIT REPORT AT WWW.PIHHEALTH.ORG/CBANNUALREPORT.PDF. 21116432 3765652 SUBSIDIZED HEALTH SERVICES, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, CONTRIBUTIONS TO COMMUNITY GROUPS, RESEARCH ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES: THESE ACTIVITIES ARE CARRIED OUT TO IMPROVE COMMUNITY HEALTH, EXTEND BEYOND PATIENT CARE ACTIVITIES, AND ARE SUBSIDIZED BY PIH. SUCH SERVICES DO NOT GENERATE PATIENT CARE BILLS, ALTHOUGH THEY MAY INVOLVE A NOMINAL FEE. THESE PROGRAMS INCLUDE: ACTIVATE WHITTIER COMMUNITY COLLABORATIVE, CARE FORCE ONE MOBILE HEALTH SERVICES, COMMUNITY HEALTH EDUCATION AND SUPPORT, ENROLLMENT COORDINATORS, FALL PREVENTION PROGRAM, SCHOOL-BASED WELLNESS PROGRAMS, SENIOR SERVICES, AND WHITTIER FIRST DAY HEALTH & WELLNESS CENTER.HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, INTERNS AND RESIDENTS, NURSES AND NURSING STUDENTS, PASTORAL CARE TRAINEES, AND OTHER HEALTH PROFESSIONALS WHEN EDUCATION IS NECESSARY FOR A DEGREE, CERTIFICATE OR TRAINING REQUIRED BY STATE LAW, ACCREDITING BODY OR HEALTH PROFESSION SOCIETY. LEVERAGING ITS UNIQUE POSITION AS A COMMUNITY-ORIENTED HEALTHCARE LEADER, PIH SUPPORTS HEALTHCARE-RELATED EDUCATION AND MENTORING TO ENSURE OPPORTUNITIES EXIST FOR THE NEXT GENERATION OF HEALTHCARE PROVIDERS. PIH PROGRAMS INCLUDE THE FAMILY PRACTICE RESIDENCY PROGRAM, PARAMEDIC BASE STATION TRAINING AND STUDENT EDUCATION (INTERNSHIP, EXTERNSHIP, PRECEPTORSHIP AND MENTORING PROGRAMS).SUBSIDIZED HEALTH SERVICES: THESE SERVICES ARE CLINICAL PROGRAMS PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, BAD DEBT, AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO THE RESPONSIBILITY OF GOVERNMENT OR ANOTHER NONPROFIT ORGANIZATION TO PROVIDE. PIH SERVICES PROVIDED INCLUDE HIGH-RISK INFANT FOLLOW-UP CLINIC AND HOSPICE HOMES.RESEARCH: PIH PROVIDES THE RUBY L. GOLLEHER COMPREHENSIVE CANCER PROGRAM, WHICH CONSISTS OF CLINICAL TRIALS THROUGH AFFILIATIONS WITH SOUTHWEST ONCOLOGY GROUP AND RADIATION THERAPY ONCOLOGY GROUP AND FREE WORKSHOPS OFFICERED FOR THE COMMUNITY, INCLUDING A SURVIVORSHIP PROGRAM, ART AND WRITING WORKSHOPS, LYMPHEDEMA WORKSHOPS, AND COMPLEMENTARY MEDICINE OFFERINGS.CASH & IN-KIND CONTRIBUTIONS: THESE DONATIONS INCLUDE CASH DONATIONS TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE, HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY WHILE ON PIH WORK TIME, THE COST OF MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF FOOD, EQUIPMENT, MEDICATIONS, AND SUPPLIES. SUBSIDIZED HEALTH SERVICES, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, CONTRIBUTIONS TO COMMUNITY GROUPS, RESEARCH: NUMBER OF PERSONS SERVED: 57,239FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH'S COMMUNITY BENEFIT REPORT AT WWW.PIHHEALTH.ORG/CBANNUALREPORT.PDF. 399308449 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 263 0 1 3160 1 1 1 0 0 0 0 0 0 0 0 0 X 15 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X RONALD YOSHIHARA 5626980811 12102 WASHINGTON BLVD WHITTIER CA 90606 X EFRAIN ACEVES 1.50 X 0 0 0 DONALD ALVARADO 1.50 X X 0 0 0 RICHARD ATWOOD 1.50 X X 0 0 0 PAULA COWAN 1.50 X 0 0 0 JANE DICUS 1.50 X X 0 0 0 LEON MN GARCIA 1.50 X 0 0 0 THOMAS KING 1.50 X 0 0 0 ANGEL MUNOZ 1.50 X 0 0 0 SUDHAKER NAYAK MD 1.50 X 231926 0 0 NORMA PROVENCIO 1.50 X 0 0 0 WILLIAM SHANAHAN MD 1.50 X 65000 0 0 NEAL SHINDEL MD 1.50 X 60351 25129 0 DREW SONES 1.50 X 0 0 0 KENTON WOODS 1.50 X X 0 0 0 HUEY-MIN YU 1.50 X 0 0 0 JAMES WEST 40.00 X 795751 0 181310 MITCHELL THOMAS 40.00 X 551622 0 187584 PEGGY CHULACK 40.00 X 442364 0 126110 REANNA THOMPSON 40.00 X 339171 0 98633 ROSALIO LOPEZ MD 40.00 X 498575 0 196814 DAVE KLINGER 40.00 X 338013 0 124624 JOAN ROLLAND 40.00 X 167349 0 37656 JUDY PUGACH 40.00 X 170970 0 40864 JULIA MCCONAGHY 40.00 X 245859 0 38382 LON OREY 40.00 X 275165 0 51949 MARVIN RICE 40.00 X 411310 0 89355 PATRICIA BRAY 40.00 X 185358 0 50956 PERRY EBELTOFT 40.00 X 198606 0 62208 RAMONA PRATT 40.00 X 191677 0 18243 RONALD YOSHIHARA 40.00 X 234260 0 50346 ROWENA STAJER 40.00 X 164954 0 28116 SUSANNE CARLSON 40.00 X 232282 0 33816 JUNG HO 40.00 X 230294 0 2068 PHILIP CHON 40.00 X 190309 0 416 ALAN ENDO 40.00 X 187626 0 2593 ANNA KRUGER 40.00 X 181765 0 416 KERRIE WON 40.00 X 172294 0 4216 6762851 25129 1426675 323 0 1 0 MILLIE AND SEVERSON PO BOX 3601 LOS ALAMITOS CA 90720 CONSTRUCTION 40944325 ALLSCRIPTS 3 RAVINIA DRIVE SUITE B-150 ATLANTA GA 30346 IT SERVICES 14438030 WHITTIER PULM AND CRITC CARE 6905 ALRA VISTA DRIVE RANCHO PALOS VERDES CA 90275 MEDICAL SERVICES 5084181 LAMBERT RADIOLOGY MED GRP INC 11721 WHITTIER BLVD 509 WHITTIER CA 90601 MEDICAL SERVICES 4777301 FAMILY PRACTICE RESIDENCY PROGRAM 12291 WASHINGTON BLVD WHITTIER CA 90606 MEDICAL SERVICES 2788656 90 954865 954865 NET PATIENT REVENUE 621610 400141310 400141310 HOSPITAL FEE PROGRAM - 900099 28622748 28622748 OTHER PATIENT REVENUE 621610 26660865 26660865 CAREMORE BONUS 900099 6522454 6522454 ARRA INCENTIVE PAYMENT 900099 3382934 3382934 4801533 4801533 470131844 9591790 9591790 41042407 7900 39095841 65592 1946566 -57692 1888874 1888874 COMMUNITY PHARMACY 624110 3469946 3463839 6107 PURCHASE DISCOUNTS 900099 1179193 1179193 NON-PATIENT LAB 621500 125838 125838 29380 29380 4804357 487371730 473595683 161325 12659857 263351 263351 221900 221900 7246531 5199888 2046643 150894980 136400204 14494776 14035169 11929895 2105274 38933346 36955295 1978051 12430354 11236047 1194307 470686 470686 942888 2243 940645 103835 103835 40022 40022 55638190 48762762 6875428 5762302 3928229 1834073 20943871 17173974 3769897 7940666 6567495 1373171 604303 438057 166246 218367 58908 159459 10357638 8327929 2029709 16210743 13035641 3175102 4749811 1060564 3689247 MEDICAL SUPPLIES 50012736 49717187 295549 HOSPITAL FEE PROGRAM 28256378 28256378 BAD DEBT 12537667 12537667 EQUIPMENT R&M 4302592 4135324 167268 4717818 3099511 1618307 447836144 399308449 48527695 0 8522455 195072 6038 6039 63298558 57989576 3307679 3637391 8710475 9407691 476609050 123414854 289303645 353194196 352866582 394655194 594192 594192 178740464 164752938 905350088 984432289 38628321 41805592 308097102 300692022 146986758 179489505 493712181 521987119 X 411637907 462445170 411637907 462445170 905350088 984432289 X 39535586 11271677 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 40022 40022 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND AMERICAN HOSPITAL ASSOCIATION ARE RELATED TO LOBBYING. 0 0 214611 214611 188160430 49795213 138365217 91124763 66230427 24894336 197109246 7389214 189720032 353194196 DEFERRED FINANCING COSTS 3398608 DUE FROM AFFILIATES 144987212 OTHER RECEIVABLES 4712748 INVESTMENTS IN AFFILIATES 1105610 OTHER ASSET-HOSPITAL FEE PROGRAM 10548760 164752938 DEFERRED COMPENSATION 14186344 SELF INSURANCE TRUST 18652141 ACCRUED BOND INTEREST PAYABLE 1382214 DEFERRED INCOME-HOSP FEE PROGRAM 14019353 INTEREST RATE SWAP 53053913 INTERCO PAYABLE 1125046 PENSION LIABILITY 75646415 THIRD PARTY LIABILITY: COST REPORT PAYABLE 1424079 179489505 487371730 447836144 39535586 32870396 -21598719 11271677 50807263 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT, AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE COMPANY HAS NOT RECORDED A LIABILITY FOR UNRECOGNIZED TAX UNCERTAINTIES IN 2012 OR 2011. PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION ADJUSTMENTS -18,521,095. NET UNREALIZED LOSSES ON INTEREST RATE SWAP -3,496,612. INSURANCE LITIGATION SETTLEMENT 418,988. TOTAL TO SCHEDULE D, PART XI, LINE 8: -21,598,719. 1 1 X 1 X 1 X 1 1 1 0 1 1 8434 28832482 8265907 20566575 0.04720 26695 70952553 47330664 23621889 0.05430 988 2791195 914446 1876749 0.00430 36117 102576230 56511017 46065213 0.10580 36 35929 4845752 65612 4780140 0.01100 5 852 3366867 749945 2616922 0.00600 5 19032 12054786 2941823 9112963 0.02090 1 21 113295 113295 0.00030 6 1405 735732 8272 727460 0.00170 53 57239 21116432 3765652 17350780 0.03990 53 93356 123692662 60276669 63415993 0.14570 1 8164 8164 0.00000 1 11 37634 37634 0.00010 1 19 26352 26352 0.00010 3 30 72150 72150 0.00020 0 12537667 57698654 69663711 -11965057 X 1 1 1 1 PRESBYTERIAN INTERCOMMUNITY HOSPITAL

12401 WASHINGTON BLVD WHITTIER CA 90602

X X X X SKILLED NURSING FACILITY PRESBYTERIAN INTERCOMMUNITY HOSPITAL 1 1 1 100.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X X X X 1 0 1 X 0 0 11 SAME DAY SURGERY

12415 WASHINGTON BLVD WHITTIER CA 90602

OUTPATIENT SURGICAL SERVICES INTERCOMMUNITY MAGNETIC RESONANCE IMAGIN

12455 WASHINGTON BLVD WHITTIER CA 90602

MRI SERVICES ERNEST D WELLS MEDICAL OFFICE BUILDING

12462 PUTNAM ST WHITTIER CA 90602

OUTPATIENT SERVICES PATRICIA L SHCEIFLY BREAST HEALTH CTR

12393 WASHINGTON BLVD WHITTIER CA 90602

SVCS PRESBYTERIAN HEALTH MEDICAL PLAZA

12291 WASHINGTON BLVD WHITTIER CA 90602

WOUND HEALING, LAB DRAW STATION ARCADIA HOME HEALTH NURSING

351 E FOOTHILL BLVD SUITE 100 ARCADIA CA 91006

VISITING NURSES ASSOCIATION HOSPICE HOMES - DOVE

10736 VALLEY VIEW AVE WHITTIER CA 90604

HOSPICE CARE HOSPICE HOMES - ROSE

10742 VALLEY VIEW AVE WHITTIER CA 90604

HOSPICE CARE PIH HOME HEALTH

15050 IMPERIAL HWY LA MIRADA CA 90638

HOME HEALTH AGENCY PRESBYTERIAN HEALTH MEDICAL PLAZA

15088 IMPERIAL HWY LA MIRADA CA 90638

OUTPATIENT THERAPY BHP - LA MIRADA

12675 S LA MIRADA BLVD SUITE 219 LA MIRADA CA 90638

RADIOLOGY PART I, LINE 6A: PIH FILES ITS COMMUNITY BENEFIT REPORT WITH THE STATE OF CALIFORNIA IN ACCORDANCE WITH CALIFORNIA SENATE BILL 697 (SB 697), WHICH REQUIRES ANNUAL DOCUMENTATION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS ANNUAL COMMUNITY BENEFIT REPORT IS SUBMITTED TO OFFICE OF STATEWIDE HEALTH PLANNING & DEVELOPMENT (OSHPD), HEALTHCARE INFORMATION DIVISION, AND IS ALSO DISTRIBUTED WIDELY THROUGHOUT THE COMMUNITY, AS WELL AS BEING POSTED TO PIH HEALTH'S WEBSITE:WWW.PIHHEALTH.ORG/CBANNUALREPORT.PDF. PART I, LINE 7: THE COST SYSTEM IS BASED ON THE COST-TO-CHARGE ("C2C") METHODOLOGY, SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTEMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT-SPECIFIC PERCENTAGE, E.G. DEPARTMENT C2C%, IS LOADED INTO PIH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. ALL COST INFORMATION REFLECTED IN PIH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THIS DEPARTMENT-LEVEL C2C METHODOLOGY. PART I, L7 COL(F): BAD DEBT EXPENSE OF $12,537,667 WAS REPORTED ON FORM 990, PART IX, LINE 24C AND THEN SUBTRACTED FROM THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 FOR PURPOSES OF CALCULATING THE AMOUNT BEING REPORTED ON LINE 7F. PART II: PIH WORKS WITH A VARIETY OF COMMUNITY STAKEHOLDERS TO ENHANCE THE COLLECTIVE CAPACITY FOR IMPROVING THE HEALTH AND SAFETY OF THE COMMUNITIES WE SERVE. MEMBERS OF PIH'S MANAGEMENT TEAM, IN ADDITION TO DESIGNATED COMMUNITY BENEFIT STAFF, ACTIVELY ENGAGE KEY COMMUNITY STAKEHOLDERS THROUGH SERVICE ON PIH'S COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC). THE CBOC IS ACCOUNTABLE TO THE HOSPITAL'S BOARD OF DIRECTORS AND IS RESPONSIBLE FOR COMMUNITY BENEFIT OVERSIGHT AND EVALUATION.TO FURTHER SUPPORT COMMUNITY BUILDING, PIH OFFERS EXPERTISE, MOBILIZES ASSETS, AND INVESTS RESOURCES IN COMMUNITY-BASED ORGANIZATIONS THAT SERVE THE IDENTIFIED HEALTH AND SOCIAL SERVICE NEEDS OF LOCAL COMMUNITIES AND ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS. FOR EXAMPLE, DESIGNATED PIH STAFF MEMBERS SERVE ON BOARDS OF AREA COMMUNITY-BASED ORGANIZATIONS SUCH AS THE WHOLE CHILD, A LOCAL AGENCY WITH A MISSION TO STRENGTHEN VITAL PARENT-CHILD RELATIONSHIPS. PIH ALSO PROVIDES DISASTER PREPAREDNESS TRAINING TO ENSURE THE COMMUNITY HAS KNOWLEDGE OF CRITICAL INFORMATION AND STRATEGIES TO EFFECTIVELY PREPARE FOR A DISASTER.IN ADDITION, PIH PARTNERED WITH THE WHITTIER CONNECTIONS COMMUNITY COLLABORATIVE, WHICH IN NOVEMBER 2011 LED COMMUNITY VOLUNTEER TEAMS IN SURVEYING WHITTIER'S HOMELESS POPULATION USING AN EVIDENCE-BASED VULNERABILITY ASSESSMENT. THE ASSESSMENT RESULTED IN THE CREATION OF A BY-NAME LIST, INCLUDING PHOTOS OF HOMELESS INDIVIDUALS AS WELL AS DATA ON HEALTH STATUS, INSTITUTIONAL HISTORY, LENGTH OF HOMELESSNESS, PATTERNS OF SHELTER USE, AND PREVIOUS HOUSING SITUATIONS. FINDINGS WERE ANALYZED TO IDENTIFY THOSE WHO HAD BEEN HOMELESS THE LONGEST AND THOSE LIVING WITH SPECIFIC HEALTH CONDITIONS ASSOCIATED WITH A HIGH MORTALITY RISK. FURTHERMORE, PIH OFFERS A FREE SHUTTLE SERVICE FROM A LOCAL TRAIN STATION DURING MORNING AND AFTERNOON HOURS TO PROVIDE EMPLOYEES LIVING A SIGNIFICANT DISTANCE FROM THE HOSPITAL WITH AN INCENTIVE TO COMMUTE VIA TRAIN RATHER THAN BY CAR. LAUNCHED INITIALLY AS A PILOT IN FY 2005-2006, THE SHUTTLE SERVICE NOW HAS MANY PARTICIPANTS USING PUBLIC TRANSPORTATION ON A REGULAR BASIS, SUPPORTING PIH'S EFFORTS TO IMPROVE THE ENVIRONMENT. PART III, LINE 4: THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED AMOUNTS. THE COMPANY MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES. BAD DEBT AMOUNTS ARE NOT CONSIDERED TO BE COMMUNITY BENEFIT COSTS. PART III, LINE 8: THE COMPANY DOES NOT TAKE THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE STATE HAS SPECIFICALLY ASKED US TO REPORT THIS SEPARATELY FROM OUR COMMUNITY BENEFIT TOTALS. THE COMPANY USES A COST-TO-CHARGE (C2C) RATIO TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENT RECEIVED FROM MEDICARE, WHICH IS SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN PIH DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT SPECIFIC PERCENTAGE, IE. DEPARTMENT C2C %, IS LOADED INTO PIH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. AS SUCH, ALL COST INFORMATION REFLECTED IN PIH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THE ABOVE DEPARTMENT C2C METHODOLOGY. PART III, LINE 9B: UNINSURED PATIENTS ARE ENCOURAGED TO APPLY FOR GOVERNMENT PROGRAMS OR UNCOMPENSATED CARE. ALL UNINSURED PATIENTS ARE PROVIDED WITH A CHARITY CARE AND MEDICAID APPLICATION AT THE TIME OF REGISTATION, THEREBY GIVING THEM THE OPPORTUNITY TO APPLY FOR ASSISTANCE. ALL SELF-PAY INPATIENTS ARE ALSO CONTACTED BY A VENDOR OFFERING ASSISTANCE IN APPLYING FOR MEDICAID, IF ELIGIBLE. STATEMENTS (WHICH REFLECT A REDUCTION IN CHARGES TO RATES AT OR LOWER THAN CONTRACTED RATES FOR SCHIP MEMBERS OF A HEALTHPLAN) PROMOTE THE HOSPITAL'S CHARITY CARE PROGRAM. ONLY PATIENTS WHO DO NOT QUALIFY FOR FURTHER FINANCIAL ASSISTANCE (AFTER DISCOUNTS) OR WHO DO NOT APPLY FOR PROGRAMS AND DO NOT PAY ARE REFERRED TO COLLECTIONS. IN ADDITION, IF A PATIENT IS REFERRED TO COLLECTION AND LATER APPLIES FOR CHARITY CARE AND QUALIFIES, THE PATIENT'S ACCOUNT IS RETURNED TO THE HOSPITAL AND CHARITY CARE IS EXTENDED. IF PIH'S COLLECTION AGENCY IDENTIFIES A PATIENT WHO QUALIFIES FOR PIH'S UNCOMPENSATED CARE PROGRAM BUT WHO FAILED TO APPLY, IT WILL RETURN THE ACCOUNT TO PIH AND RECOMMEND AN UNCOMPENSATED CARE WRITE-OFF. IN ADDITION, IT WILL REMOVE DELINQUENCIES FROM THE PATIENT'S CREDIT REPORT. PRESBYTERIAN INTERCOMMUNITY HOSPITAL PART V, SECTION B, LINE 19D: PIH USED THE RATES OF ITS HEALTHY FAMILY (SCHIP) NEGOTIATED RATES WITH BLUE SHIELD OR LOWER. PART VI, LINE 2: AS A NONPROFIT HOSPITAL, PIH CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS IN ACCORDANCE WITH CALIFORNIA SENATE BILL 697 (SB 697) AND, MORE RECENTLY, THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA), A FEDERAL STATUTE THAT WAS SIGNED INTO LAW IN MARCH 2010. AS A RESULT, TAX-EXEMPT HOSPITALS ARE REQUIRED TO CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS AND DEVELOP IMPLEMENTATION STRATEGIES OUTLINING HOW THE HOSPITAL WILL ADDRESS UNMET COMMUNITY HEALTH NEEDS, AND ULTIMATELY, STRIVE TO IMPROVE THE OVERALL HEALTH AND QUALITY OF LIFE IN THEIR LOCAL COMMUNITIES. EACH ASSESSMENT PRESENTS DATA REGARDING PIH'S PRIMARY SERVICE AREA CITIES, WHICH ARE DETERMINED BY HOSPITAL DISCHARGE DATA OBTAINED THROUGH THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. THE INTENT OF THIS ASSESSMENT IS TO PRESENT AN OVERALL DEPICTION OF HEALTH-RELATED DATA FINDINGS SPECIFIC TO THE COMMUNITIES IN PIH'S SERVICE AREA. THE DATA FINDINGS AND COMMUNITY INPUT GAINED THROUGH THIS ASSESSMENT HIGHLIGHT KEY NEEDS AND OPPORTUNITIES FOR ACTION. THIS INFORMATION GREATLY ASSISTS PIH WITH THE FOLLOWING: DETERMINING PRIORITY HEALTH AREAS AND HEALTH NEEDS BASED UPON CONSISTENT CRITERIA. DEVELOPING PIH'S IMPLEMENTATION STRATEGY, WHICH WILL IDENTIFY PRIORITY HEALTH AREAS AND PROVIDE THE FRAMEWORK FOR PIH'S THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN. DESIGNING MEANINGFUL INITIATIVES THAT WILL PROVE TO BE AN EFFECTIVE USE OF PIH'S CHARITABLE RESOURCES.PRIMARY DATA COLLECTIONPRIMARY DATA COLLECTION FOR THE 2013 CHNA CONSISTED OF TARGETED INTERVIEWS, FOCUS GROUPS, A COMMUNITY SURVEY, AND A PHOTOVOICE PROJECT, WHICH WERE USED TO GATHER INFORMATION REGARDING PERCEPTIONS AND OPINIONS FROM THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA.A TOTAL OF 16 KEY COMMUNITY STAKEHOLDERS TELEPHONE INTERVIEWS WERE CONDUCTED, REPRESENTING A CROSS-SECTION OF AGENCIES PROVIDING A BROAD CONTINUUM OF HEALTH AND SOCIAL SERVICES, INCLUDING PUBLIC HEALTH EXPERTISE. NINE FOCUS GROUPS WERE CONDUCTED, WITH ONE HELD IN SPANISH AND EIGHT IN ENGLISH. ADDITIONALLY, A WEB-BASED COMMUNITY SURVEY WAS USED TO COLLECT PRIMARY DATA FROM AREA RESIDENTS. PAPER COPIES OF THE SURVEY WERE MADE AVAILABLE THROUGH PARTNER AGENCIES FOR USE BY INDIVIDUALS WHO MAY NOT HAVE ACCESS TO A COMPUTER. A TOTAL OF 391 PEOPLE RESPONDED.FINALLY, THROUGH THE ACTIVATE WHITTIER COMMUNITY COLLABORATIVE FOR WHICH PIH IS A FOUNDING PARTNER, TWO PHOTOVOICE PROJECTS WERE FACILITATED, WITH 29 RESIDENTS PARTICIPATING. THE PHOTOVOICE PROJECTS, WHICH WERE CONDUCTED BY PIH AND LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, ENCOURAGED RESIDENTS TO TELL THEIR STORIES ABOUT HEALTHY EATING AND ACTIVE LIVING IN WHITTIER VIA PHOTOGRAPHS AND BRIEF CAPTIONS. SECONDARY DATA COLLECTIONSECONDARY DATA WERE COLLECTED FROM A VARIETY OF LOCAL, COUNTY, AND STATE SOURCES IN ORDER TO PROFILE PIH'S PRIMARY SERVICE AREA. DATA INCLUDES PRIMARY SERVICE AREA DEMOGRAPHICS, AS WELL AS SOCIAL DETERMINANTS OF HEALTH; DEATH CHARACTERISTICS; MATERNAL, CHILD AND INFANT HEALTH; ACCESS TO HEALTHCARE; ORAL HEALTH; MENTAL HEALTH; CLINICAL CARE; NUTRITION, PHYSICAL ACTIVITY AND WEIGHT STATUS; CHRONIC DISEASE; AND HEALTH BEHAVIORS. WHEN APPLICABLE, THESE DATA SETS ARE PRESENTED IN THE CONTEXT OF LOS ANGELES COUNTY AND THE STATE IN ORDER TO FRAME THE SCOPE OF AN ISSUE AS IT RELATES TO THE BROADER COMMUNITY. ANALYSES WERE CONDUCTED AT THE MOST LOCAL LEVEL POSSIBLE, BASED ON THE AVAILABILITY OF THE DATA. ADDITIONALLY, FINDINGS ARE COMPARED TO ACCEPTED BENCHMARKS THAT REFERENCE RECOGNIZABLE STATE AND NATIONAL RESOURCES (E.G., HEALTHY PEOPLE 2020 OBJECTIVES).IN ADDITION TO BEING AVAILABLE ON PIH'S WEBSITE, THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT IS WIDELY SHARED WITH CIVIC, BUSINESS AND COMMUNITY LEADERS, LOCAL COMMUNITY-BASED ORGANIZATIONS, AND KEY STAKEHOLDERS, AS WELL AS THE COMMUNITY AT-LARGE. EMPHASIS IS MADE ON SHARING ASSESSMENT RESULTS WITH AREA AGENCIES TO ASSIST THEM WITH THEIR PROGRAM PLANNING AND FUND-DEVELOPMENT ENDEAVORS, WHILE SPARING THE EXPENSE OF DUPLICATIVE DATA COLLECTION EFFORTS. PART VI, LINE 3: FINANCIAL ASSISTANCE, OR CHARITY CARE, REFERS TO DOLLARS EXPENDED FOR THE PROVISION OF FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. FINANCIAL ASSISTANCE IS REPORTED IN TERMS OF COSTS, NOT CHARGES, AND DOES NOT INCLUDE BAD DEBT. DURING FY 2011-12, PIH INCURRED UN-REIMBURSED COSTS FOR THIS PROVISION OF CHARITY CARE TO THE UNDER-SERVED IN THE AMOUNT OF $20,566,575. PIH'S FINANCIAL ASSISTANCE ENCOMPASSES THE FOLLOWING TWO PROGRAMS: UNCOMPENSATED CARE PROGRAM PIH OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM, PROVIDING CHARITY CARE TO THOSE WITH FAMILY INCOME(S) WITHIN 400% OF THE 2012 FEDERAL POVERTY LEVEL GUIDELINES. PER PIH'S CHARITY CARE POLICY, THOSE WHO WOULD QUALIFY UNDER THIS PROGRAM INCLUDE:UNINSURED PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY AS DETERMINED BY THE FINANCIAL GUIDELINES STATED IN THE CHARITY CARE POLICY;PATIENTS WHO HAVE RESTRICTED MEDI-CAL EMERGENCY AND PREGNANCY SERVICES COVERAGE (AND NO SHARE OF COST) AND WHOSE SERVICES ARE NOT COVERED FOR A PARTICULAR EPISODE OR PARTIAL EPISODE OF CARE. (AN UNCOMPENSATED CARE APPLICATION IS NOT REQUIRED SINCE THE PATIENT IS PRESUMED TO MEET THE CHARITY CARE ELIGIBILITY REQUIREMENTS);THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE, BUT ARE NOT LIMITED TO: STATE-FUNDED PRESCRIPTION PROGRAMS; HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC OR SHELTER PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); FOOD STAMP ELIGIBILITY; SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND PATIENT IS DECEASED WITH NO KNOWN ESTATE; AND PATIENTS WHO ARE CURRENTLY ELIGIBLE FOR MEDI-CAL, BUT WERE NOT ELIGIBLE IN ONE TO THREE MONTHS PRIOR TO ELIGIBILITY ARE PRESUMED TO BE ELIGIBLE FOR CHARITY AND DO NOT NEED TO FILL OUT THE APPLICATION.INSURED PATIENTS WHOSE COVERAGE IS INADEQUATE TO COVER A CATASTROPHIC SITUATION;PERSONS WHOSE INCOME IS SUFFICIENT TO PAY FOR BASIC LIVING COSTS BUT NOT MEDICAL CARE, AND ALSO THOSE PERSONS WITH GENERALLY ADEQUATE INCOMES WHO ARE SUDDENLY FACED WITH CATASTROPHICALLY LARGE MEDICAL BILLS;PATIENTS WHO DEMONSTRATE ABILITY TO PAY PART BUT NOT ALL OF THEIR LIABILITY. FOR EXAMPLE, THOSE WHO HAVE AN OUT OF POCKET THAT EXCEEDS 10% OF THEIR ANNUAL NET FAMILY INCOME IN THE PRIOR TWELVE MONTHS.SELF-PAY PAYMENT PROGRAMADDITIONALLY, UNDER THE PIH SELF-PAY PAYMENT PROGRAM, PATIENTS WHO ARE UNINSURED OR HAVE VERY LIMITED BENEFITS ARE AUTOMATICALLY GIVEN A BILL REDUCTION REFLECTIVE OF OR LESS THAN THE HEALTHY FAMILIES RATE WITH A CONTRACTED PLAN; NO PRE-QUALIFICATION IS NECESSARY. IF A PATIENT CANNOT PAY THE ENTIRE DISCOUNTED OBLIGATION AND DOES NOT QUALIFY FOR GOVERNMENT OR HOSPITAL PROGRAMS, PIH WILL EXTEND REASONABLE NO-INTEREST PAYMENTS. THIS PROGRAM IS ESPECIALLY OF BENEFIT TO THOSE APPLYING FOR PIH'S CHARITY CARE OR OTHER PUBLIC MEANS-TESTED HEALTHCARE PROGRAMS AND AWAITING ELIGIBILITY DETERMINATION. UNINSURED PATIENTS ARE EDUCATED ABOUT THE SELF-PAY PAYMENT PROGRAM PRIOR TO OR AT REGISTRATION/ADMISSION (OR AFTER AN EMERGENCY DEPARTMENT PATIENT HAS BEEN MEDICALLY SCREENED AND STABILIZED).ADDITIONAL PATIENT EDUCATION REGARDING PIH'S FINANCIAL ASSISTANCEIT IS IMPORTANT TO NOTE THAT, REGARDLESS OF ABILITY TO PAY, APPROPRIATE CLINICAL STAFF ESTABLISH A PLAN OF CARE, ORDER MEDICALLY NECESSARY TREATMENT, SERVICES AND MEDICATIONS, IN ORDER TO STABILIZE ALL PATIENTS. ONCE STABILIZED, BILINGUAL (ENGLISH & SPANISH) FINANCIAL COUNSELORS OR OTHER APPROPRIATE STAFF WORK WITH ELIGIBLE PATIENTS IN APPLYING FOR PIH'S CHARITY CARE OR OTHER GOVERNMENT MEANS-TESTED PROGRAMS. IN ACCORDANCE WITH CALIFORNIA'S FAIR PRICING LAW FOR LOW-INCOME, UNINSURED INDIVIDUALS, PIH POSTS NOTICES IN BOTH ENGLISH AND SPANISH WITH INFORMATION REGARDING ITS UNCOMPENSATED CARE AND SELF-PAY PAYMENT POLICIES IN SETTINGS THAT ARE HIGHLY VISIBLE TO THE PUBLIC, SUCH AS THE EMERGENCY DEPARTMENT, BILLING/CASHIER OFFICE, PATIENT REGISTRATION, AS WELL AS VARIOUS ANCILLARY DEPARTMENTS AND OUTPATIENT FACILITIES. UNINSURED PATIENTS ALSO RECEIVE A LETTER IN ENGLISH AND/OR SPANISH, WHICH DETAILS THE VARIOUS PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. THE UNCOMPENSATED CARE APPLICATION IS ALSO AVAILABLE ON THE PIH WEBSITE. IN ADDITION, THE BELOW STATEMENT APPEARS ON ALL PATIENT BILLING STATEMENTS IN ENGLISH AND SPANISH:"PLEASE PAY THE BALANCE DUE. IF YOU CANNOT PAY THE ENTIRE BALANCE, PLEASE CALL TO SET UP INSTALLMENT PAYMENTS. IF YOU ARE UNABLE TO PAY ALL OR PART OF YOUR BALANCE AND YOUR FAMILY INCOME IS WITHIN 400% OF FEDERAL POVERTY LIMITS, PLEASE CALL AND REQUEST AN UNCOMPENSATED CARE APPLICATION." PART VI, LINE 4: PIH IS SITUATED IN THE SOUTHEAST PORTION OF LOS ANGELES COUNTY, CALIFORNIA, WITHIN AN AREA REFERRED TO AS SERVICE PLANNING AREA 7 (SPA 7). APPROXIMATELY 73% OF DISCHARGES COME FROM NINE CITIES/COMMUNITIES, WHICH COMPRISE ITS PRIMARY SERVICE AREA. PIH'S SECONDARY SERVICE AREA INCLUDES ADDITIONAL CITIES IN THE SAN GABRIEL VALLEY AND NORTH ORANGE COUNTY. BELOW ARE PIH'S PRIMARY AND SECONDARY SERVICE AREAS, BASED UPON OSHPD DISCHARGE DATA (2011):PRIMARY SERVICE AREA(ENCOMPASSES 9 CITIES/13 ZIP CODES)HACIENDA HEIGHTS 91745LA HABRA 90631LA HABRA HEIGHTS 90631LA MIRADA 90638-90639MONTEBELLO 90640NORWALK 90650PICO RIVERA 90660SANTA FE SPRINGS 90670WHITTIER 90601-90606SECONDARY SERVICE AREA - WESTBELL 90201BELLFLOWER 90706DOWNEY 90240-90242LOS ANGELES 90022LOS ANGELES 90040SOUTH GATE 90280SECONDARY SERVICE AREA - EASTCHINO HILLS 91709DIAMOND BAR 91765LA PUENTE 91744LA PUENTE 91746ROWLAND HEIGHTS 91748WALNUT 91789WEST COVINA 91792PRIMARY SERVICE AREA PROFILETHE POPULATION FOR THE PIH PRIMARY SERVICE AREA IS 606,484. CHILDREN AND YOUTH (AGES 0-17) MAKE UP 25.7% OF THE POPULATION; OLDER ADULTS (AGES 65+) MAKE UP 12.1% OF THE POPULATION. THE AREA HAS HIGHER PERCENTAGES OF CHILDREN AGES 5-17 AND OLDER ADULTS 65+ THAN FOUND IN LOS ANGELES COUNTY AND THE STATE. IN THE PIH SERVICE AREA, 6.1% OF THE POPULATION 18 YEARS AND OLDER ARE VETERANS, HIGHER THAN LA COUNTY. IN THE SERVICE AREA, 8% OF SENIORS LIVE ALONE. THE LARGEST POPULATION BY RACE AND ETHNICITY IN THE SERVICE AREA IS HISPANIC OR LATINO (67.7%). WHITE/CAUCASIANS MAKE UP 18.8% OF THE POPULATION. ASIANS COMPRISE 10.4% OF THE POPULATION, AND AFRICAN AMERICANS, NATIVE AMERICANS, HAWAIIANS, AND OTHER RACES COMBINED TOTAL 3.1% OF THE POPULATION. WHEN COMPARED TO L.A. COUNTY, THE SERVICE AREA HAS A LARGER PERCENTAGE OF LATINOS, AND A SMALLER PERCENTAGE OF OTHER RACES/ETHNICITIES. 79.3% OF THE TOTAL POPULATION HAS HEALTH INSURANCE, WITH 90.4% OF CHILDREN UNDER AGE 18 HAVING COVERAGE. AMONG SPA 7, OVER 90% OF CHILDREN AND YOUTH HAVE A USUAL SOURCE OF CARE. IN THE SERVICE AREA, SPANISH IS SPOKEN IN 48% OF THE HOMES, HIGHER THAN THE NUMBER OF SPANISH SPEAKING HOUSEHOLDS IN THE COUNTY AND THE STATE. LINGUISTIC ISOLATION DATA REPRESENTS THE POPULATION OVER AGE FIVE WHO SPEAK ENGLISH LESS THAN VERY WELL. IN THE PIH PRIMARY SERVICE AREA, 24.3% OF THE POPULATION IS LINGUISTICALLY ISOLATED. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA RANGES FROM $50,881 IN MONTEBELLO TO $121,380 IN LA HABRA HEIGHTS. THE AVERAGE FAMILY SIZE RANGES FROM 3.40 INDIVIDUALS IN WHITTIER (90603) TO 4.25 INDIVIDUALS IN PICO RIVERA.EDUCATIONAL ATTAINMENT IS CONSIDERED A KEY DRIVER OF HEALTH STATUS, WITH LOW LEVELS OF EDUCATION LINKED TO POVERTY AND POOR HEALTH. IN THE PIH SERVICE AREA, 75.4% OF THE ADULT POPULATION, 25 YEARS AND OLDER, HAVE OBTAINED A HIGH SCHOOL DIPLOMA OR HIGHER EDUCATION. THIS IS LOWER THAN THE COUNTY RATE OF 75.9% AND THE STATE RATE OF 80.7%.ON AVERAGE, THE SERVICE AREA HAS A LOWER UNEMPLOYMENT RATE (10.8%) THAN WHEN COMPARED TO THE COUNTY AND THE STATE. COMPARED OVER THREE YEARS, UNEMPLOYMENT RATES WERE LOWER IN 2009, ROSE IN 2010, AND DECREASED IN 2011. POVERTY RATES PAINT AN IMPORTANT PICTURE OF THE POPULATION WITHIN THE PIH SERVICE AREA. IN THE SERVICE AREA, 10.2% OF THE POPULATION IS AT POVERTY LEVEL, LESS THAN THE COUNTY AND STATE RATES. IN SPA 7, 35.8% OF RESIDENTS ARE NOT ABLE TO AFFORD FOOD AND 9.9% UTILIZE FOOD STAMPS. THIS INDICATES THAT A CONSIDERABLE PERCENTAGE OF RESIDENTS MAY QUALIFY FOR FOOD STAMPS BUT DO NOT ACCESS THIS RESOURCE. EVERY TWO YEARS, THE LOS ANGELES HOMELESS SERVICES AUTHORITY (LAHSA) CONDUCTS THE GREATER LOS ANGELES HOMELESS COUNT AS A SNAPSHOT TO DETERMINE HOW MANY INDIVIDUALS ARE HOMELESS ON A GIVEN DAY. ACCORDING TO THE 2011 LAHSA COUNT, SPA 7 HAD AN ANNUALIZED ESTIMATE OF 4,759 HOMELESS INDIVIDUALS. IN SPA 7, 81% OF THE HOMELESS ARE INDIVIDUALS, AND 19% ARE HOMELESS FAMILIES, WHICH IS AN INCREASE FROM 8% IN 2009. HEART DISEASE, CANCER AND STROKE ARE THE THREE LEADING CAUSES OF DEATH. WHEN COMPARED TO STATE DEATH RATES, THE AREA HAS HIGHER DEATH RATES FOR HEART DISEASE, CANCER, DIABETES, AND INFLUENZA/PNEUMONIA. IN SPA 7, THE RATES OF OVERWEIGHT EXCEED THE COUNTY AND STATE RATES. THE CONCERNS AND BARRIERS FACED BY VULNERABLE POPULATIONS IN WHITTIER AND THE SURROUNDING COMMUNITIES INCLUDE DIFFICULTY ACCESSING SERVICES SUCH AS MENTAL HEALTH, DENTAL HEALTH, VISION AND SPECIALTY CARE SERVICES, GENERAL LACK OF AWARENESS OF THE SERVICES THAT ARE AVAILABLE, AND A CONTINUED NEED FOR HEALTH EDUCATION ON A VARIETY OF TOPICS. PART VI, LINE 5: PIH IS A NONPROFIT 501(C)(3) REGIONAL HEALTHCARE DELIVERY NETWORK THAT WAS FOUNDED IN 1959 BY VOLUNTEERS WHO WENT DOOR-TO-DOOR TO RAISE FUNDS TO BUILD A LOCAL HEALTHCARE FACILITY. OVER 50 YEARS LATER, PIH HAS MAINTAINED THAT SAME SENSE OF COMMUNITY AND FAMILY-LIKE CULTURE WHERE PATIENTS ARE THE TOP PRIORITY, AND EMPLOYEES AND VOLUNTEERS ARE PROUD TO BE AFFILIATED WITH SUCH AN ORGANIZATION. OUR MISSION IS TO PROVIDE HIGH-QUALITY HEALTHCARE WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITIES IN AN ETHICAL, SAFE, AND FISCALLY PRUDENT MANNER IN RECOGNITION OF OUR CHARITABLE PURPOSE. WE ARE GUIDED BY OUR BELIEF THAT HEALTH CARE IS A RIGHT AND NOT A PRIVILEGE. PIH OFFERS A WIDE RANGE OF SERVICES INCLUDING UTILIZATION OF PRIMARY CARE TEAMS TO PROVIDE GENERAL MEDICINE AND PREVENTATIVE CARE; ACCESS TO EMERGENCY AND URGENT CARE, HOME HEALTH SERVICES AND HOSPICE; AND A NETWORK OF PIH PHYSICIANS AND ADVANCED PRACTICE PROFESSIONALS. ITS HIGHLY TRAINED AND COMPASSIONATE PHYSICIANS, NURSES, CLINICIANS, STAFF AND VOLUNTEERS WORK TIRELESSLY AND COLLABORATIVELY EVERY DAY TO BE THE COMMUNITIES' HEALTH AND WELLNESS PARTNER.COMMUNITY BENEFIT CONTINUES TO BE AN INTEGRAL PART OF PIH'S MISSION WITH ASSETS DEDICATED TO CHARITABLE PURPOSES SUCH AS FINANCIAL ASSISTANCE PROGRAMS AND COMMUNITY-BASED INITIATIVES TO IMPROVE AND PROMOTE OVERALL HEALTH AND WELL-BEING REGARDLESS OF HEALTH OR ECONOMIC STATUS. PIH HAS A STRONG NETWORK OF PARTNERSHIPS AND COLLABORATIONS THAT DEMONSTRATE OUR LEADERSHIP IN THE COMMUNITY. CAREFUL STEWARDSHIP OF PIH'S CHARITABLE RESOURCES IS OF HIGH PRIORITY FOR PIH'S BOARD OF DIRECTORS. IN 2006, THE BOARD ESTABLISHED THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC) COMPRISED OF COMMUNITY STAKEHOLDERS AND HOSPITAL LEADERSHIP. THE CBOC IS DEDICATED TO PROVIDING STRATEGIC DIRECTION, OVERSIGHT, AND EVALUATION OF OUR COMMUNITY BENEFIT INITIATIVES. THE SELECTION OF PIH COMMUNITY BENEFIT PRIORITY HEALTH AREAS AND DEVELOPMENT OF ITS IMPLEMENTATION STRATEGY ARE INTEGRAL TO ENSURING PIH'S INITIATIVES THAT ARE RESPONSIVE TO COMMUNITY NEEDS. UPON COMPLETION OF EACH COMMUNITY HEALTH NEEDS ASSESSMENT, THE CBOC ENGAGES IN A THOUGHTFUL PRIORITIZATION PROCESS BASED ON DATA FINDINGS AND COMMUNITY INPUT GATHERED THROUGH CONVERSATIONS, FOCUS GROUPS, INTERVIEWS, AND SURVEYS. EXAMPLES OF PIH'S COMMITMENT TO IMPROVING THE HEALTH OF OUR COMMUNITIES ARE BELOW:COMMUNITY-BASED HEALTHCARE PIH AND WHITTIER FIRST DAY, A LOCAL TRANSITIONAL HOMELESS SHELTER, COLLABORATE IN MANY WAYS TO ASSIST SHELTER RESIDENTS AND, ULTIMATELY, TO BENEFIT THE ENTIRE COMMUNITY THROUGH MANY POSITIVE OUTCOMES. AS SUCH, PIH PROVIDES A NURSE PRACTITIONER AND SUPERVISING PHYSICIAN TO STAFF A HEALTH AND WELLNESS CLINIC ON-SITE AT WHITTIER FIRST DAY TO ENSURE THAT HOMELESS INDIVIDUALS HAVE DIRECT ACCESS TO BASIC AND PREVENTIVE HEALTH CARE SERVICES. DURING FY 2011-12, 86% OF PATIENTS EXPERIENCED IMPROVED HEALTH STATUS. PIH WAS RECOGNIZED BY VHA, INC. WITH ITS NATIONAL 2010 COMMUNITY BENEFIT EXCELLENCE LEADERSHIP AWARD, WITH SPECIAL EMPHASIS ON THE PARTNERSHIP BETWEEN PIH AND FIRST DAY. PIH'S CARE FORCE ONE MOBILE HEALTH, COMMUNITY HEALTH EDUCATION, AND FAMILY PRACTICE DEPARTMENTS PROVIDE FLU AND PNEUMONIA IMMUNIZATIONS TO LOW-INCOME, UNINSURED AND UNDERINSURED INDIVIDUALS. CLINICS ARE HOSTED AT LOCAL CHURCHES, SCHOOLS, COMMUNITY AND SENIOR CENTERS, AND COMMUNITY-BASED HEALTH FAIRS. IN ADDITION, PIH'S CARE FORCE ONE MOBILE HEALTH SERVICES PROVIDES FREE AND LOW-COST PRIMARY HEALTHCARE SERVICES DIRECTLY TO THOSE IN THE COMMUNITY WHO HAVE DIFFICULTY ACCESSING CARE FOR A VARIETY OF REASONS, WITH OVER 3,741 PATIENT ENCOUNTERS DURING FY 2011-12.THE PIH PATRICIA L. SCHEIFLY BREAST HEALTH CENTER, DESIGNATED AS A BREAST IMAGING CENTER OF EXCELLENCE, PROVIDES FREE AND LOW-COST MAMMOGRAMS TO UNINSURED OR UNDER-SERVED WOMEN IN THE COMMUNITY. A PIH FOUNDATION FUND IS SPECIFICALLY DESIGNATED TO PROVIDE THE FREE MAMMOGRAMS. COMMUNITY COLLABORATIVES TO IMPROVE HEALTH AND WELLNESSPIH ACTIVELY SUPPORTS AND PARTICIPATES IN TWO COMMUNITY-BASED COLLABORATIVES: ACTIVATE WHITTIER AND HEALTHY LOS NIETOS."ACTIVATE WHITTIER'S" MISSION IS TO CHAMPION "A HEALTHY ACTIVE WHITTIER" THROUGH NEIGHBORHOOD AND COMMUNITY ENGAGEMENT, COLLABORATIVE PARTNERSHIPS, AND POLICY/ENVIRONMENTAL CHANGE, WITH A FOCUS ON SUSTAINABLE EFFORTS TO IMPROVE THE HEALTH AND WELLNESS OF THOSE LIVING, WORKING, LEARNING, AND PLAYING IN OUR COMMUNITY. ACTIVATE WHITTIER IS A PARTNERSHIP BETWEEN PIH, YMCA OF GREATER WHITTIER, CITY OF WHITTIER, LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, BOYS & GIRLS CLUB OF WHITTIER, KAISER PERMANENTE DOWNEY MEDICAL CENTER, AND WHITTIER COLLEGE. ACTIVATE WHITTIER'S COMMUNITY ACTION PLAN FEATURES STRATEGIES TO IMPROVE HEALTH IN DESIGNATED NEIGHBORHOODS, SCHOOLS, AND WORKSITES.HEALTHY LOS NIETOS' AIM IS TO INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY AS A METHOD TO REDUCE THE INCIDENCE OF OVERWEIGHT AND OBESITY AMONG SCHOOL-AGE CHILDREN. HEALTHY LOS NIETOS BEGAN WHEN SCHOOL AND CITY OFFICIALS - SEEING INCREASING RATES OF DIABETES AND OBESITY BEGAN WORKING COLLABORATIVELY TO IDENTIFY SOLUTIONS. IN 2011, HEALTHY LOS NIETOS WAS DEVELOPED IN PARTNERSHIP WITH PIH AND TARGETS 6TH, 7TH AND 8TH GRADE STUDENTS, SCHOOL STAFF AND PARENTS, WITH PIH RESIDENT PHYSICIANS PROVIDING PREVENTION-FOCUSED EDUCATION. CATCH'S PHYSICAL ACTIVITY AND NUTRITION CURRICULUM IS BEING IMPLEMENTED DURING THE 2012-13 SCHOOL YEAR FOR GRADES K-8, INCLUDING PARENTS AND STAFF.ENROLLMENT ASSISTANCE: ENROLLMENT COORDINATORS & MEDI-CAL ELIGIBILITY WORKERSPIH EMPLOYS TWO ENROLLMENT COORDINATORS TO ASSIST THE UN-INSURED IN APPLYING FOR HEALTH INSURANCE COVERAGE AND TO ASSIST ELIGIBLE PATIENTS IN APPLYING FOR PIH'S FINANCIAL ASSISTANCE PROGRAM. THE ENROLLMENT COORDINATORS ALSO PROVIDE REFERRALS TO OTHER SOURCES OF HEALTHCARE AND SOCIAL SERVICE RESOURCES. THEY WORK IN CONJUNCTION WITH LOCAL SCHOOLS AND PIH'S BUSINESS OFFICE, EMERGENCY, MOBILE HEALTH SERVICES, SOCIAL WORK AND INFORMATION TECHNOLOGY DEPARTMENTS TO LOCATE FAMILIES IN NEED. PIH ALSO CONTRACTS WITH AGENCIES SPECIALIZING IN MEDI-CAL AND HEALTHY FAMILIES ENROLLMENT IN AN EFFORT TO ENSURE THAT ALL THOSE ELIGIBLE OBTAIN HEALTH INSURANCE COVERAGE AND, ULTIMATELY, HAVE ACCESS TO CARE. FAMILY PRACTICE RESIDENCY PROGRAMPIH IS COMMITTED TO EDUCATING THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS VIA ITS FAMILY PRACTICE RESIDENCY PROGRAM, WHICH PLACES EMPHASIS ON TRAINING RESIDENT PHYSICIANS TO WORK IN LOW-INCOME, UNDER-SERVED AREAS. RESIDENT PHYSICIANS PROVIDE COMMUNITY HEALTH SERVICES VIA PIH'S HOME-BASED PALLIATIVE CARE PROGRAM, AT HOSPITAL-SUPPORTED CLINICS AT WHITTIER COLLEGE AND A LOCAL HOMELESS SHELTER, AS WELL AS THROUGH COMMUNITY PARTNERSHIPS, SUCH AS WITH THE LOS NIETOS SCHOOL DISTRICT, AIMED AT REDUCING CHILDHOOD OBESITY. IN ADDITION, THE PIH RESIDENCY PROGRAM OFFERS A TROPICAL MEDICINE TRACK, WHICH PROVIDES OPPORTUNITIES FOR RESIDENTS TO PROVIDE MUCH NEEDED CARE IN COUNTRIES AS FAR AWAY AS CAMEROON AND ZAMBIA.R. C. BAKER FOUNDATION REGIONAL EMERGENCY DEPARTMENTPIH'S EMERGENCY DEPARTMENT (ED) - ONE OF THE LARGEST IN LOS ANGELES COUNTY EXPERIENCED 69,641 VISITS DURING FY 2011-12. THE ED FEATURES THE AREA'S PARAMEDIC BASE STATION, PROVIDING BOTH THE EQUIPMENT AND RESOURCES FOR QUALIFIED STAFFING SO THAT WHEN AN AMBULANCE IS DISPATCHED TO A LOCAL HOME, PARAMEDICS HAVE CRITICAL ACCESS TO LOCAL HOSPITAL-BASED EMERGENCY SERVICES. PIH ALSO SUSTAINS A CONTRACT WITH AN ON-CALL PHYSICIAN PANEL SO THAT ELIGIBLE PATIENTS, REGARDLESS OF HEALTH INSURANCE STATUS, ARE ASSURED ACCESS TO SPECIALTY CARE APPROPRIATE TO THEIR NEEDS. RUBY L. GOLLEHER COMPREHENSIVE CANCER PROGRAMPIH'S CANCER PROGRAM EARNED THE HIGHEST ACCREDITATION POSSIBLE FOR A NONACADEMIC MEDICAL CENTERS THE DESIGNATION OF COMPREHENSIVE COMMUNITY CANCER PROGRAM BY THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER AS WELL AS RECOGNITION WITH ITS OUTSTANDING ACHIEVEMENT AWARD FOR 2010-2013. THE PROGRAM FEATURES CLINICAL TRIALS THROUGH AFFILIATIONS WITH SOUTHWEST ONCOLOGY GROUP AND RADIATION THERAPY ONCOLOGY GROUP AND FREE WORKSHOPS OFFERED FOR THE COMMUNITY, INCLUDING A SURVIVORSHIP PROGRAM, ART AND WRITING WORKSHOPS, LYMPHEDEMA WORKSHOPS, AND COMPLEMENTARY MEDICINE.VOLUNTEER CONTRIBUTIONSA TOTAL OF 1,029 PIH VOLUNTEERS COLLECTIVELY CONTRIBUTED 133,000 HOURS, TRANSLATING INTO MORE THAN $2,898,078 IN SAVINGS FOR THE HOSPITAL. PART VI, LINE 6: WHILE PIH IS NOT PART OF A HOSPITAL SYSTEM, THE HOSPITAL IS AFFILIATED WITH: 1) INTERHEALTH CORP, PIH'S PARENT COMPANY; 2) BRIGHT HEALTH PHYSICIANS OF PIH (BHP) A NONPROFIT MEDICAL FOUNDATION; 3) THE PIH FOUNDATION, A NONPROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH'S CHARITABLE MISSION; AND 4) MED SITE - HACIENDA HEIGHTS, WHICH SUBSIDIZES THE PIH S. MARK TAPER FOUNDATION A DAY AWAY ADULT DAY HEALTH CARE CENTER. INTERHEALTH CORP. PROVIDES TECHNICAL, FACILITY AND SUPPORT SERVICES FOR TAX-EXEMPT AFFILIATES WHOSE CHARITABLE PURPOSE IS TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO THEIR COMMUNITY BY WAY OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.BHP SUPPORTS THE LOCAL COMMUNITY THROUGH A NETWORK OF COMMUNITY-BASED HEALTH CLINICS, AND HEALTH PROMOTION AND HEALTH INSURANCE ENROLLMENT EFFORTS. PHP'S DEPARTMENT OF PEDIATRICS HAS PARTNERED WITH REACH OUT AND READ, TO PROMOTE EARLY LITERACY AND SCHOOL READINESS WITH THE GOAL OF ADVOCATING FOR EARLY LITERACY FOR EVERY CHILD IN THE COMMUNITY. ADDITIONALLY, PHP PHYSICIANS ALSO DEDICATE TIME TO ENSURE THOSE MOST IN NEED HAVE ACCESS TO BASIC HEALTHCARE, INCLUDING THE INDIGENT LIVING IN REMOTE AREAS OF COUNTRIES SUCH AS LATIN AMERICA, HAITI, NEPAL, AND THE PHILIPPINES THROUGH MEDICAL MISSIONS. THE PIH FOUNDATION RAISES FUNDS IN SUPPORT OF PIH AND ALSO PROVIDES IN-KIND FUNDRAISING CONSULTATION TO LOCAL COMMUNITY-BASED ORGANIZATIONS. PIH FOUNDATION'S HEALTHY LIVING - HEALTHY GIVING PHILANTHROPIC EFFORT RAISES FUNDS IN SUPPORT OF PIH TO ENSURE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES FOR YEARS TO COME THROUGH SUPPORTING PROGRAMS THAT DIRECTLY IMPACT THE COMMUNITY, INCLUDING PIH'S COMMUNITY BENEFIT PROGRAMS. HEALTHY LIVING - HEALTHY GIVING IS AN OPPORTUNITY FOR EVERYONE TO PLAY A ROLE IN THE OVERALL HEALTH OF THEIR FRIENDS, FAMILY, NEIGHBORS AND EVERYONE WHO LIVES, WORKS, LEARNS, AND PLAYS IN OUR COMMUNITY. GIFTS' BIG, SMALL AND ALL WILL SUPPORT PIH'S WORK TO PROVIDE ACCESS TO QUALITY HEALTHCARE, SCREENINGS AND PREVENTATIVE CARE, AND PREVENTION-FOCUSED EDUCATION. MEDSITE'S PIH S. MARK TAPER FOUNDATION A DAY AWAY ADULT DAY HEALTH CARE CENTER HAS, SINCE 1999, PROVIDED HIGH QUALITY CARE FOR INDIVIDUALS AGES 18 AND OLDER WHO REQUIRE CONTINUOUS SUPERVISION AND CARE AND WHOSE CAREGIVERS MAY NEED TO WORK, CARE FOR OTHERS, OR ARE IN DESPERATE NEED OF RESPITE. THE CENTER OFFERS BOTH SOCIAL AND MEDICAL PROGRAMS DEPENDING UPON INDIVIDUAL NEED. FAMILY MEMBERS INVOLVED IN THEIR LOVED ONE'S TREATMENT HAVE THE OPPORTUNITY TO PARTICIPATE IN ON-GOING EDUCATION AND CAREGIVER SUPPORT GROUPS ALL DESIGNED TO EMPOWER FAMILIES TO BE MORE SKILLED AND EFFECTIVE IN THEIR CAREGIVING ROLES. DURING FY 2011-12, SOME 80 INDIVIDUALS WERE CARED FOR AT A DAY AWAY, WITH 99 PERCENT OF FAMILIES REPORTING THAT THEY WERE ABLE TO DELAY CONSIDERATION OF NURSING HOME OR OTHER PLACEMENT FOR THEIR LOVED ONES DUE TO A DAY AWAY'S SERVICES. REPORTS FILED WITH STATES PART VI, LINE 7 CA 1 CALIFORNIA HEALTH FOUNDATION AND TRUST 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941498687 501(C)(3) 58246 SUPPORT CHARITABLE ACTIVITIES AT HOSPITALS & HEALTH SYSTEMS IN CALIFORNIA AMERICAN CANCER SOCIETY 13230 PENN STREET WHITTIER CA 90602 941170350 501(C)(3) 5081 GENERAL SUPPORT BOYS & GIRLS CLUB OF WHITTIER 7905 GREENLEAF AVENUE WHITTIER CA 90602 956151763 501(C)(3) 5270 GENERAL SUPPORT RIO HONDO COLLEGE FOUNDATION 3600 WORKMAN MILL RD WHITTIER CA 90601 954367487 501(C)(3) 100000 GENERAL SUPPORT THE WHOLE CHILD 10155 COLIMA ROAD WHITTIER CA 90603 952031148 501(C)(3) 5700 GENERAL SUPPORT WHITTIER COMMUNITY FOUNDATION 13230 PENN STREET WHITTIER CA 90602 951918226 501(C)(3) 8750 0 GENERAL SUPPORT WHITTIER HOST LIONS CLUB PO BOX 245 WHITTIER CA 90608 956094500 501(C)(3) 9875 0 GENERAL SUPPORT 7 0 SCHOLARSHIPS AND MEDICAL EDUCATION 49 111000 PSYCHIATRIC CARE AT INDEPENDENT FACILITY FOR UNINSURED 67 110900 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: PIH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS BASED ON 1) CHARITABLE MISSION OR PURPOSE OF THE CHARITABLE ORGANIZATION AND ITS ALIGNMENT WITH PIH'S MISSION, VALUES AND OBJECTIVES AND/OR 2) IDENTIFIED INDIVIDUAL NEED FOR HEALTH-RELATED SERVICES. FOR CONTRIBUTIONS MADE TO CHARITABLE ORGANIZATIONS, PIH ADOPTED A POLICY WHICH GUIDES THE PROCESS BY WHICH FUNDS ARE GRANTED TO ENSURE THAT PIH IS A GOOD STEWARD OF ITS RESOURCES AS A FEDERALLY REGISTERED 501(C)(3) NOT-FOR-PROFIT ENTITY. TO ENSURE ACCURATE COMMUNITY BENEFIT REPORTING, THIS POLICY ALSO SETS FORTH THAT DIRECT CONTRIBUTIONS MADE TO COMMUNITY ORGANIZATIONS MUST BE APPROPRIATELY CLASSIFIED AS EITHER A) COMMUNITY BENEFIT OR B) COMMUNITY RELATIONS/MARKETING CONTRIBUTIONS. IN COMPLIANCE WITH THIS POLICY, INFORMATION IS GATHERED FROM THE GRANTEE REGARDING THE INTENDED USE OF FUNDS AND THE PERCENT OF GRANTED FUNDS THAT WILL GO TOWARDS SUPPORTING THE ORGANIZATION'S MISSION. FOR CONTRIBUTIONS MADE TO INDIVIDUALS, PIH HAS ESTABLISHED A DEDICATED BUDGET WHICH SUBSIDIZES VITAL ASSISTANCE SUCH AS PURCHASE OF DURABLE MEDICAL EQUIPMENT OR NON-ACUTE CARE NOT COVERED BY INSURANCE UPON HOSPITAL DISCHARGE, INCLUDING PAID PLACEMENT IN SKILLED NURSING OR MENTAL HEALTH FACILITIES. IN THESE INSTANCES, A SPECIFIC SERVICE IS BEING PURCHASED AND RECEIPT OF PROPER SERVICE IS ENSURED THROUGH FOLLOW-UP BY PIH DISCHARGE PLANNERS OR SOCIAL WORKERS. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 SUDHAKER NAYAK MD 231926 0 0 0 0 0 0 0 0 0 231926 0 0 0 JAMES WEST 781585 0 0 0 14166 0 0 0 181310 0 977061 0 0 0 MITCHELL THOMAS 401996 0 0 0 149626 0 16500 0 171084 0 739206 0 143626 0 PEGGY CHULACK 375575 0 0 0 66789 0 0 0 126110 0 568474 0 60379 0 REANNA THOMPSON 288725 0 0 0 50446 0 0 0 98633 0 437804 0 43626 0 ROSALIO LOPEZ MD 489251 0 0 0 9324 0 0 0 196814 0 695389 0 0 0 DAVE KLINGER 330999 0 0 0 7014 0 8012 0 116612 0 462637 0 0 0 JOAN ROLLAND 160370 0 0 0 6979 0 16500 0 21156 0 205005 0 0 0 JUDY PUGACH 164707 0 0 0 6263 0 0 0 40864 0 211834 0 0 0 JULIA MCCONAGHY 210243 0 0 0 35616 0 6817 0 31565 0 284241 0 29016 0 LON OREY 234636 0 0 0 40529 0 7679 0 44270 0 327114 0 33537 0 MARVIN RICE 339279 0 0 0 72031 0 24512 0 64843 0 500665 0 64843 0 PATRICIA BRAY 178390 0 0 0 6968 0 0 0 50956 0 236314 0 0 0 PERRY EBELTOFT 191993 0 0 0 6613 0 6175 0 56033 0 260814 0 0 0 RAMONA PRATT 184853 0 0 0 6824 0 0 0 18243 0 209920 0 0 0 RONALD YOSHIHARA 227139 0 0 0 7121 0 16500 0 33846 0 284606 0 0 0 ROWENA STAJER 158954 0 0 0 6000 0 0 0 28116 0 193070 0 0 0 SUSANNE CARLSON 196316 0 0 0 35966 0 0 0 33816 0 266098 0 29552 0 JUNG HO 230294 0 0 0 0 0 0 0 2068 0 232362 0 0 0 PHILIP CHON 189206 0 1103 0 0 0 0 0 416 0 190725 0 0 0 ALAN ENDO 184639 0 2987 0 0 0 0 0 2593 0 190219 0 0 0 ANNA KRUGER 181765 0 0 0 0 0 0 0 416 0 182181 0 0 0 KERRIE WON 161881 0 10413 0 0 0 0 0 4216 0 176510 0 0 0 PART I, LINE 1A ALL EMPLOYEES ARE ELIGIBLE FOR HEALTH CLUB REIMBURSEMENT AND ANY SUCH REIMBURSEMENTS WERE INCLUDED IN TAXABLE COMPENSATION, PER 2012 PLAN YEAR BENEFITS SUMMARY. PART I, LINE 4B IHC AND ITS AFFILIATES SPONSOR A 457(F) PLAN. THE PLAN PARTICIPANTS AND AMOUNTS RECEIVED (IF APPLICABLE) WERE: PATRICIA BRAY, SUSANNE CARLSON ($29,552), PEGGY CHULACK ($60,379), PERRY EBELTOFT, DAVID KLINGER, ROSALIO LOPEZ, MD., JULIA MCCONAGHY ($29,016), LON OREY ($33,537), RAMONA PRATT, JUDY PUGACH, MARVIN RICE ($64,843), JOAN ROLLAND, ROWENA STAJER, MITCHELL THOMAS ($143,626), REANNA THOMPSON ($43,626), JAMES WEST, AND RONALD YOSHIHARA. CITY OF WHITTIER - SERIES 2009 956000812 966769DA6 2009-05-14 280328878 HOSPITAL FACILITIES REFUND 2007 BONDS 0 0 0 CITY OF WHITTIER - SERIES 2011 956000812 966769DH1 2011-03-31 40828054 CONSTRUCTION OF FACILITIES 0 0 0 280328878 5800000 2416738 1087414 1337283 2013 1 0 1 1 40828054 939373 40011493 2013 0 0 1 1 0 0 0 0 1 0 0 0 0 1 0 1 1 GOLDMAN SACHS BANK USA 29.500000000000 0 0 0 0 1 0 0 0 0 0 1 X SEE PART V 4797026 0 SCHEDULE L, PART IV:A: JILL PANGB: DAUGHTER OF KEY EMPLOYEE JULIA MCCONAGHYC: $19,725D: INDEPENDENT CONTRACTORE: NOA: LAMBERT RADIOLOGY MEDICAL GROUPB: SHAREHOLDER, WILLIAM SHANAHAN IS A DIRECTOR OF PIHC: $4,777,301D: RADIOLOGY SERVICES PROVIDED TO PIHE: NO FORM 990, PART VI, SECTION A, LINE 2 1) THOMAS KING HAS A BUSINESS RELATIONSHIP WITH LEON M.N. GARCIA. 2) JANE DICUS AND DREW SONES HAVE A BUSINESS RELATIONSHIP. 3) WILLIAM SHANAHAN, MD HAS A BUSINESS RELATIONSHIP WITH ROSALIO LOPEZ, MD., SUDHAKER NAYAK, MD. AND NEAL SHINDEL, MD. FORM 990, PART VI, SECTION A, LINE 6 INTERHEALTH CORP. ("IHC") IS THE SOLE MEMBER OF PIH. FORM 990, PART VI, SECTION A, LINE 7A IHC HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF PIH. FORM 990, PART VI, SECTION A, LINE 7B IHC HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION, WHICH IS MADE UP OF INDEPENDENT DIRECTORS. THE FORM 990S ARE THEN PROVIDED TO THE BOARD FOR ITS INFORMATION. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL MANAGEMENT AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL POSITIVE RESPONSES ARE REVIEWED BY THE COMPLIANCE OFFICER. EACH POSITIVE RESPONSE IS CONSIDERED IN LIGHT OF MAGNITUDE OF OWNERSHIP INTEREST, FINANCIAL TRANSACTION(S), ETC. IF DEEMED NECESSARY, CONFLICTS OF INTEREST COULD BE RESOLVED BY INSISTING THAT THE INCUMBENT EITHER DIVEST THEIR OWNERSHIP INTEREST, THAT THE ORGANIZATION TERMINATE THE BUSINESS RELATIONSHIP, OR EVEN THAT THE DIRECTOR RESIGN. DIRECTORS WITH POTENTIAL CONFLICTS OF INTEREST MAY RECUSE THEMSELVES FROM VOTING ON CERTAIN MATTERS AND/OR MAY EXCUSE THEMSELVES FROM MEETINGS DURING THE DISCUSSION, DELIBERATION, AND VOTING ON OF MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT, THIRD-PARTY, EXPERT COMPENSATION CONSULTANT TO REVIEW ITS EXECUTIVE SALARIES. THE CONSULTANT OBTAINS SPECIFIC ORGANIZATIONAL DATA FROM WHICH TO BASE ITS ANALYSIS (REVENUES, EXPENSES, EMPLOYEES, SERVICE AREA, JOB DESCRIPTIONS, ETC.). THE CONSULTANT'S ANALYSIS INCLUDES A REVIEW OF COMPENSATION TRENDS, REGULATORY ISSUES, THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, THE METHODOLOGY USED FOR THE ASSESSMENT, THE BASE SALARY ANALYSIS, THE INCENTIVE COMPENSATION ANALYSIS, THE TOTAL CASH COMPENSATION ANALYSIS, AND THE TOTAL COMPENSATION ANALYSIS. SALARY MOVEMENT, INCENTIVE COMPENSATION, MARKET BENEFIT, AND RECRUITMENT AND RETENTION TRENDS ARE REVIEWED. THIS ANALYSIS IS PROVIDED TO THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS. THE EXECUTIVE COMPENSATION COMMITTEE HAS APPROVED A REGIONAL PEER GROUP THAT INCLUDES HIGH-PERFORMING, COMPARABLY-SIZED CALIFORNIA HOSPITALS AND HEALTH SYSTEMS. THE CONSULTANT COMPILES COMPARABILITY DATA FROM NATIONAL AND REGIONAL PEERS; COMPARES THE ORGANIZATION'S EXECUTIVE COMPENSATION WITH PEER GROUP COMPENSATION LEVELS; AND PREPARES A REPORT THAT INCLUDES ALL OF THE BACK-UP DATA ON COMPARABILITY, PEER GROUPS, AND JOB MATCHES. THE METHODOLOGY USED BY THE CONSULTANT WAS TWO PEER GROUPS: A NATIONAL PEER GROUP OF COMPARABLY-SIZED HOSPITALS AND SINGLE HOSPITAL SYSTEMS AND A REGIONAL PEER GROUP OF HOSPITALS AND SYSTEMS IN SOUTHERN CALIFORNIA, THE DATA OF WHICH IS PROVIDED TO THE COMMITTEE IN ITS REPORT. THE NATIONAL DATA IS USED AS THE PRIMARY COMPARATOR FOR THE ANALYSIS. THE COMMITTEE IS PRESENTED WITH CHARTS THAT COMPARE ORGANIZATION SALARIES TO THE LEVEL TARGETED IN THE COMPENSATION PHILOSOPHY. NEITHER PERFORMANCE NOR QUALIFICATIONS OF THE INCUMBENT IS CONSIDERED WHEN PROVIDING THE MARKET DATA. THE COMMITTEE IS PROVIDED WITH A REVIEW OF THE BASE SALARY ANALYSIS, A REVIEW OF THE INCENTIVE COMPENSATION ANALYSIS, A REVIEW OF THE TOTAL CASH COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE), AND A REVIEW OF THE TOTAL COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE PLUS BENEFITS/PERQUISITES). BASED UPON ALL OF THE ABOVE INFORMATION, THE CONSULTANT PROVIDES THE COMMITTEE WITH RECOMMENDED SALARY RANGES FOR THE PERIOD ASSESSED. THE EXECUTIVE COMPENSATION COMMITTEE DELIBERATES ON THE COMPARABILITY DATA TO ENSURE THAT IT IS APPROPRIATE IN REPRESENTING LIKE ORGANIZATIONS, LIKE POSITIONS, AND LIKE CIRCUMSTANCES, AND THAT IT COULD REALISTICALLY RELY ON THE COMPARABILITY DATA IN REACHING ITS DECISION THAT THE COMPENSATION IS REASONABLE AND REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED. THE EXECUTIVE COMPENSATION COMMITTEE AFFIRMS THIS PROCESS TO THE BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE SPECIFIC SALARY OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE SENIOR VICE PRESIDENT OF FINANCE AND CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 AND FORM 990-T ARE AVAILABLE UPON REQUEST. THE ORGANIZATION IS NOT REQUIRED TO MAKE FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS IT RECEIVED ITS TAX EXEMPTION PRIOR TO JULY 15, 1987. FORM 990, PART VII, SECTION A: BOARD MEMBERS ARE NOT COMPENSATED FOR SERVICE AS A MEMBER OF THE BOARD. NEAL SHINDEL, MD RECEIVED $60,351 DURING CALENDAR YEAR 2011 FOR GI BONUS PAYMENTS. SUDHAKER NAYAK, MD RECEIVED $231,926 DURING CALENDAR YEAR 2011 FOR PROFESSIONAL SERVICES AS AN EMERGENCY DOCTOR ON CALL FOR PIH. WILLIAM SHANAHAN, MD RECEIVED $65,000 DURING CALENDAR YEAR 2011 FOR PROFESSIONAL SERVICES AS A MEDICAL DIRECTOR PIH. THE HOURS REPORTED ON PART VII ONLY REFLECT TIME SPENT AS AN UNCOMPENSATED BOARD MEMBER AND DOES NOT INCLUDE THE TIME SPENT ON OTHER DUTIES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 32,870,396. PENSION ADJUSTMENTS -18,521,095. NET UNREALIZED LOSSES ON INTEREST RATE SWAP -3,496,612. INSURANCE LITIGATION SETTLEMENT 418,988. TOTAL TO FORM 990, PART XI, LINE 5: 11,271,677. PIH COMMUNITY PHARMACY LLC 12401 WASHINGTON BLVD WHITTIER CA 90602 264390142 PHARMACY CA 3469947 634480 PRESBYTERIAN INTERCOMMUNITY HOSPITAL INC PIH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA SECTION 501(C)(3) 7 INTERHEALTH CORP 1 IHC MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA SECTION 501(C)(3) 11, TYPE 1 INTERHEALTH CORP 1 INTERHEALTH HOME HEALTH CARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 HEALTHCARE CA SECTION 501(C)(3) 9 INTERHEALTH CORP 1 INTERHEALTH CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA SECTION 501(C)(3) 11, TYPE 1 INTERHEALTH CORP 0 MED SITE - HACIENDA HEIGHTS 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 HEALTHCARE CA SECTION 501(C)(3) 9 INTERHEALTH CORP 1 BRIGHT HEALTH PHYSICIANS OF PIH 12401 WASHINGTON BLVD WHITTIER CA 90602 953942828 HEALTHCARE CA SECTION 501(C)(3) 9 INTERHEALTH CORP 1 PIH INSURANCE CO A RECIPROCAL RISK RETENTION GROUP 1003 BISHOP STREET HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI INTERHEALTH CORP T 0 1 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 PIH FOUNDATION B 275625 FMV BASED ON INTERCOMPANY BALANCE PIH FOUNDATION C 954865 FMV BASED ON INTERCOMPANY BALANCE INTERHEALTH CORP J 2792394 FMV BASED ON INTERCOMPANY BALANCE IHC MANAGEMENT CORP L 470686 FMV BASED ON INTERCOMPANY BALANCE BRIGHT HEALTH PHYSICIANS OF PIH N 512785 FMV BASED ON INTERCOMPANY BALANCE BRIGHT HEALTH PHYSICIANS OF PIH O 6096014 FMV BASED ON INTERCOMPANY BALANCE BRIGHT HEALTH PHYSICIANS OF PIH Q 152348 FMV BASED ON INTERCOMPANY BALANCE PIH INSURANCE COMPANY A RECIPROCAL RISK RETENTION GROUP Q 2724738 FMV BASED ON INTERCOMPANY BALANCE SCHEDULE R, PART IV, COLUMN (E): PIH INSURANCE COMPANY IS AN UNINCORPORATED RISK RETENTION GROUP.