2013-08-15T17:27:06-05:00 2012-09-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2011-10-01 941502014 SOUTHERN MONTEREY COUNTY MEMORIAL HOSP DBA GEORGE L MEE MEMORIAL HOSPITAL SOUT 8313856000 300 CANAL STREET KING CITY CA 93930 SUSAN M CHILDERS 8313856000 2013-08-14 1 RENIE BURBANK P00159653 4159561500 2011 2016-02-24 21:20:13Z SUSAN M CHILDERS 300 CANAL STREET KING CITY CA 93930 77949441 0 X WWW.MEEMEMORIAL.COM X 1964 CA THE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. 8 5 615 43 0 0 119031 380220 68451371 72904784 447 -897657 835504 4660125 69406353 77047472 0 0 0 0 36596136 38449203 0 0 0 31125605 35808345 67721741 74257548 1684612 2789924 35888773 38184501 48918360 48424164 -13029587 -10239663 THE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. 0 0 62518635 75027872 THE HOSPITAL, IS A 119-BED LICENSED FACILITY THAT PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. TYPES OF CARE OFFERED ARE ACUTE, LONG-TERM, AND RURAL HEALTH CLINIC SERVICES. OVER THE FISCAL YEAR, TOTAL PATIENT DAYS WERE 28,733, AND TOTAL PATIENTS TREATED WERE 41,232. 62518635 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 160 0 1 615 1 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 X MICHAEL FRENCH 8313857162 300 CANAL STREET KING CITY CA 93930 BUTTGEREIT JANET 2.00 X X 0 0 0 BORZINI ROGER 2.00 X X 0 0 0 BUMBALOUGH PAULETTE 2.00 X 0 0 0 NASH SARAH 2.00 X 0 0 0 MYER JOHN 2.00 X 0 0 0 SCHINDELHEIM ROY 40.00 X X 221888 0 23623 GRAUPERA LEOPOLD 40.00 X 346506 0 10777 SMITH LEX 40.00 X X 271253 0 32850 CHILDERS SUSAN 40.00 X 222372 0 31247 KIEPEK ARLENE 40.00 X 127418 0 23790 RHYNE CATHERINE 40.00 X 0 0 0 EGU OBILOH 40.00 X 370396 0 19983 FEJES JOHN 40.00 X 300824 0 32259 MONTIJO SANDRA 40.00 X 234553 0 32259 GREENBERG BRUCE 40.00 X 223388 0 23623 VISCARRA ANTONIO 40.00 X 209315 0 32259 2527913 0 262670 69 0 1 0 XTEND HEALTHCARE PO BOX 1709 HENDERSONVILLE TN 37077 PATIENT AR BILLING & COLLECTIONS AGENCY 2507798 MONTEREY ANESTHESIA PROFESSIONALS 1522 CONSTITUTION BLVD 123 SALINAS CA 93905 MEDICAL SERVICES 1244799 UKATU CHIDI MD 10521 RUTHELEN STREET LOS ANGELES CA 90047 MEDICAL SERVICES 700469 BRADFORD LETITIA MD 7485 RUSH RIVER SUITE 710-323 SACRAMENTO CA 95831 MEDICAL SERVICES 424944 TRAN DAN MD 17212 MARINA VIEW PLACE HUNTINGTON BEACH CA 92649 MEDICAL SERVICES 370060 21 380220 380220 PATIENT SERVICE REV. 621400 72904784 72904784 72904784 2343 2343 48057 1969 46088 46088 46088 900000 -900000 -900000 -900000 WRITE-OFF LIABILITY 900099 2490949 2490949 OTHER OPERATING INCOME 900099 1973585 1973585 REBATES/REFUNDS 900099 46342 46342 103161 103161 4614037 77047472 75027872 0 1639380 1674230 868574 805656 23964166 20908523 3055643 539767 464085 75682 10339560 8874384 1465176 1931480 1632012 299468 51075 17290 33785 369748 369748 115800 115800 6627784 6627784 1214120 841874 372246 761457 664906 96551 1822935 1549360 273575 1459533 1240603 218930 893137 635280 257857 BAD DEBT EXPENSE 12993784 12993784 OTHER PURCHASED SERVICE 3728178 689526 3038652 MEDICAL SUPPLIES 3244760 3244760 2526034 1265890 1260144 74257548 62518635 11738913 0 1361287 173163 10438266 11212843 599424 790563 477192 496807 43719322 20703911 22715080 23015411 12518 12518 285006 2483196 35888773 38184501 13701932 16647346 958973 0 10467393 10140139 13440063 15967823 1597449 1253442 8752550 4415414 48918360 48424164 X -13029587 -10239663 -13029587 -10239663 35888773 38184501 2789924 0 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 512182 512182 27437083 10213307 17223776 13585468 9878829 3706639 2184589 611775 1572814 23015411 OTHER RECEIVABLES 2430866 ASSETS LIMITED AS TO USE 5785 OTHER ASSETS 46545 2483196 ACCRUED INTEREST PAYABLE 1157528 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 854532 SELF INSURED HEALTH CARE CLAIMS 1389000 LITIGATION RESERVE 1014354 4415414 77047472 74257548 2789924 2789924 78160635 211194 211194 77949441 -901969 -901969 77047472 75227619 970071 970071 74257548 0 74257548 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ACCOUNTING STANDARD CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE HOSPITAL RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE THAN LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. PART XII, LINE 2D - OTHER ADJUSTMENTS: SERVICE LEAGUE REVENUE 211,194. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF LOSS ON DISPOSAL TO REVENUE -900,000. RECLASS OF RENTAL EXPENSES TO REVENUE -1,969. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RECLASS OF LOSS ON DISPOSAL TO REVENUE 900,000. SERVICE LEAGUE EXPENSES 68,102. RECLASS OF RENTAL EXPENSES TO REVENUE 1,969. 1 1 X 1 X 350.000000000000 1 X 1 0 0 924741 924741 0.01510 67104 28829195 23010681 5818514 0.09500 67104 29753936 23010681 6743255 0.11010 67104 29753936 23010681 6743255 0.11010 400 4000 4000 0.00010 400 4000 4000 0.00010 1 4467262 7781971 13814567 -6032596 X 1 1 1 1 GEORGE L MEE MEMORIAL HOSPITAL

300 CANAL STREET KING CITY CA 93930

X X X GEORGE L MEE MEMORIAL HOSPITAL 1 0 1 1 350.000000000000 1 350.000000000000 1 X X X X X X X 1 1 X X X X 1 X X 1 X X X X X 1 X 0 0 5 KING CITY CLINIC

210 CANAL STREET KING CITY CA 93930

RURAL HEALTH CLINIC SPECIALTY CLINIC

400 CANAL STREET SUITE B KING CITY CA 93930

HEALTH CLINIC FAMILY MEDICAL CENTER

400 CANAL STREET SUITE A KING CITY CA 93930

HEALTH CLINIC WOMENS CENTER

400 CANAL STREET SUITE C KING CITY CA 93930

HEALTH CLINIC GREENFIELD CLINIC

467 EL CAMINO REAL GREENFIELD CA 93927

RURAL HEALTH CLINIC PART I, LINE 7: COST TO CHARGE RATIO WAS USED TO CALCULATE THE COMMUNITY BENEFIT EXPENSE ON PART I, LINE 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LINE 7 FINANCIAL ASSISTANCE AT COST: THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUES. SERVICES PROVIDED ARE RECORDED AS GROSS PATIENT SERVICE REVENUES AND THEN WRITTEN OFF ENTIRELY AS AN ADJUSTMENT TO NET PATIENT SERVICE REVENUES.THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE: THE AMOUNT OF CHARGES FOREGONE, (BASED ON ESTABLISHED RATES), FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE AND COMMUNITY SERVICE POLICIES, THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES, AND STATISTICS QUANTIFYING THE LEVEL OF CHARITY CARE AS A PERCENTAGE OF EXPENSES OF THE HOSPITAL AS A WHOLE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 12993784. PART II: COMMUNITY HEALTH IMPROVEMENT ADVOCACY ACTIVITIES: A HEALTH FAIR AND AN EDUCATIONAL PROGRAM PROVIDED INFORMATION ON AVAILABLE HEALTH SERVICES AND TREATMENT TO INDIVIDUALS AT NO CHARGE. PART III, LINE 4: BAD DEBT EXPENSES IS RECORDED BASED ON GROSS CHARGES FOR PATIENTS WHO HAVE NEITHER PAID FOR SERVICES OR APPLIED AND QUALIFIED FOR CHARITY CARE. THE HOSPITAL ENCOURAGES AND ASSISTS PATIENTS WITH APPLICATIONS FOR CHARITY CARE IF THEY DO NOT HAVE OTHER COVERAGE. AMOUNTS ARE ONLY RECORDED AS CHARITY CARE FOR PATIENTS WHO HAVE COMPLETED APPLICATIONS AND MET QUALIFYING CRITERIA. HEALTH CARE IS A COMMUNITY BENEFIT FOR WHICH THE HOSPITAL IS NOT COMPENSATED IF THE ACCOUNT RESULTS IN A BAD DEBT.BAD DEBT EXPENSE FOOTNOTE: FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PAYMENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS DECREASED FROM 28% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2011 TO 27% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2012. THE HOSPITAL HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2012 OR 2011. NET PATIENT ACCOUNTS RECEIVABLE FOOTNOTE: PATIENT ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES, AND PRIVATE PATIENTS. THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). PART III, LINE 8: MEDICARE COST REPORTS WERE USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE. THE HOSPITAL IS THE SOLE PROVIDER WITHIN OUR LARGE GEOGRAPHIC AREA AND THE SHORTFALL SHOULD BE TREATED AS SUCH. THE ENTIRE SHORTFALL IS CONSIDERED TO BE A COMMUNITY BENEFIT. PART III, LINE 9B: COLLECTION PRACTICES FOR QUALIFIED PATIENTS:IT IS THE POLICY OF GEORGE L. MEE MEMORIAL HOSPITAL TO PROVIDE EXCELLENT CUSTOMER SERVICE TO ALL PATIENTS, AND ASSIST ALL UNINSURED PATIENTS WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, AND CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES. IF SUCH COVERAGE IS NOT AVAILABLE TO THE PATIENT, THE HOSPITAL WILL PROVIDE APPROPRIATE HEALTHCARE TO THE PATIENT, AND THE HOSPITAL WILL PROVIDE FINANCIAL ASSISTANCE BASED ON THE CURRENT FEDERAL POVERTY LEVEL, AND PER THE HOSPITAL'S POLICY, IN ACCORDANCE WITH CALIFORNIA STATE LAW, EMTALA, AND MEDICARE REGULATIONS. FURTHER, SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON INCOME WILL BE PROVIDED WITH SEVERAL OPTIONS FOR PAYMENT OF THEIR BILLS. IT IS THE HOSPITAL'S POLICY TO:- ASSIST ALL UNINSURED PATIENT WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT NO COST TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BELOW 100% OF THE CURRENT FEDERAL POVERTY LEVEL.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 50% DISCOUNT TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BETWEEN 101% AND 133% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 35% DISCOUNT TO ELIGIBLE PATIENTS BETWEEN 133% AND 200% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE INTEREST-FREE PAYMENT PLANS FOR ELIGIBLE PATIENTS UNDER THIS POLICY.- FORGO REPORTS TO CREDIT BUREAUS, REFERRAL OF ACCOUNTS TO COLLECTION AGENCIES, LIENS AGAINST PROPERTY OR WAGE GARNISHMENTS FOR ELIGIBLE PATIENTS WHO ARE MEETING AN AGREED-UPON PAYMENT PLAN.- PROVIDE ADEQUATE NOTICE OF THIS POLICY IN ALL ADMITTING AND RECEPTION AREAS.- OFFER FREE FINANCIAL COUNSELING TO ALL UNINSURED PATIENTS FOR FINANCIAL MATTERS RELATED TO THEIR HOSPITAL BILLS.- FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING. GEORGE L. MEE MEMORIAL HOSPITAL PART V, SECTION B, LINE 19D: MEANS USED TO DETERMINE THE AMOUNTS BILLED TO UNINSURED INDIVIDUALS FOR EMERGENCY CARE:FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING. PART VI, LINE 2: NEEDS ASSESSMENT: THE HOSPITAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY THROUGH COLLABORATION WITH OTHER FACILITIES AND HEALTH RELATED ORGANIZATIONS INVOLVED IN COMMUNITY NEEDS ASSESSMENTS, HEALTH SURVEYS, COMMUNITY AWARENESS PROGRAMS, COMMUNITY FEEDBACK AND OTHER INFORMATIONAL OUTREACHES. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: BUSINESS OFFICE STAFF SCREENS PATIENTS INDIVIDUALLY, AND EXPLAIN THE NEED TO APPLY FOR STATE AID FIRST. IF APPROVED THEY WILL BE TREATED UNDER THAT PROGRAM, IF NOT THEY WILL APPLY FOR CHARITY CARE. THEY ARE GIVEN A FINANCIAL APPLICATION SO THE HOSPITAL WILL BE ABLE TO DETERMINE WHETHER OR NOT THEY QUALIFY FOR CHARITY CARE. PART VI, LINE 4: COMMUNITY INFORMATION: GEORGE L. MEE MEMORIAL HOSPITAL (THE HOSPITAL) IS LOCATED IN KING CITY, CALIFORNIA. THE HOSPITAL, ORGANIZED IN MARCH, 1959, IS A 119-BED LICENSED FACILITY PROVIDING ACUTE, LONG-TERM CARE AND RURAL HEALTH CLINIC SERVICES TO RESIDENTS OF THE SOUTHERN MONTEREY COUNTY AREA. REPORTS FILED WITH STATES PART VI, LINE 7 CA X X X 0 0 0 0 0 0 0 0 0 SCHINDELHEIM ROY 191888 0 30000 0 0 0 0 0 23623 0 245511 0 0 0 GRAUPERA LEOPOLD 316506 0 30000 0 0 0 0 0 10777 0 357283 0 0 0 SMITH LEX 236061 0 35192 0 0 0 8650 0 24200 0 304103 0 0 0 CHILDERS SUSAN 199389 0 22983 0 0 0 7103 0 24144 0 253619 0 0 0 KIEPEK ARLENE 127418 0 0 0 0 0 0 0 23790 0 151208 0 0 0 EGU OBILOH 370396 0 0 0 0 0 0 0 19983 0 390379 0 0 0 FEJES JOHN 275824 0 25000 0 0 0 0 0 32259 0 333083 0 0 0 MONTIJO SANDRA 204553 0 30000 0 0 0 0 0 32259 0 266812 0 0 0 GREENBERG BRUCE 193388 0 30000 0 0 0 0 0 23623 0 247011 0 0 0 VISCARRA ANTONIO 209315 0 0 0 0 0 0 0 32259 0 241574 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE CFO AND SHARED WITH THE CEO FOR FINAL APPROVAL. THE FORM MAY BE REVIEWED BY THE CEO AND CFO IN EITHER HARD COPY OR COMPUTER FILE VERSION. THE BOARD WILL REVIEW THE FINAL VERSION IN HARD COPY FORMAT. THE REVIEW AND BOARD APPROVAL OF THE 990 WILL BE CONDUCTED PRIOR TO SUBMISSION TO INTERNAL REVENUE SERVICE. THE FORM 990 IS PRESENTED BY AN INDEPENDENT AUDITOR/TAX PROVIDER AT THE MONTHLY MEETING OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C MONTEREY COUNTY MEMORIAL HOSPITAL HAS A CORPORATE POLICY ON CONFLICT OF INTEREST. THIS POLICY APPLIES TO ALL INTERESTED PERSONS WHO ARE AS FOLLOWS: A. TRUSTEES B. MEMBER OF SENIOR MANAGEMENT THE BOARD OF TRUSTEES, THE CEO, AND CFO WILL CONTINUOUSLY MONITOR AND EVALUATE ANY AND ALL TRANSACTIONS OF INTERESTED PARTIES WITH THE HOSPITAL. IF THE CURRENT OR PAST TRANSACTION POSE A POTENTIAL RISK OF BEING A CONFLICT OF INTEREST TO THE HOSPITAL, THESE ITEM(S) WILL BE BROUGHT TO THE ATTENTION OF THE CEO, BOARD CHAIRMAN, AND OR FULL BOARD OF TRUSTEES. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST TO THE BOARD, THE INTERESTED BOARD MEMBER WOULD LEAVE THE BOARD MEETING WHILE THE CONFLICT OF INTEREST IS DISCUSSED AND/OR VOTED ON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROVIDED, HOWEVER, IF THE INTERESTED PERSON IS AN ADMINISTRATIVE STAFF EMPLOYEE AND THE CONTEMPLATED TRANSACTION IS AT THE ADMINISTRATIVE LEVEL, THE DECISION SHALL BE MADE BY THE HOSPITAL CEO. ANY BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER MUST DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT. BOARD MEMBERS SHOULD ALWAYS ABSTAIN FROM VOTING ON ANY ISSUES OF A POSSIBLE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS ESTABLISHED THROUGH COMPARISON TO REGIONAL SALARY SURVEY INFORMATION AND PERFORMANCE USE EVALUATIONS. THE BOARD APPROVES ALL COMPENSATION AGREEMENTS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR.