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DIAGNOSTIC LAB SERVICES SCHEDULE H, PART I, LINE 7 PART I, LINES 7 (A) AND 7(B) - MEDICAL CARE SERVICES PROVIDED TO CHARITY AND MEDI-CAL BENEFICIARIES RESULT IN SHORTFALLS FOR THE HOSPITAL. THESE SHORTFALL COSTS ARE NET OF ANY APPLICABLE PAYMENTS RECEIVED FROM CHARITY OR MEDI-CAL. THE METHOD FOR DETERMINING THESE SHORTFALLS IS BASED ON ACTUAL COSTS AS CALCULATED BY A COST ACCOUNTING SYSTEM. THIS ROBUST COST ACCOUNTING SYSTEM PRIMARILY UTILIZES A RELATIVE VALUE UNIT (RVU) COSTING APPROACH WHICH IS CALCULATED USING A SIMULTANEOUS EQUATIONS METHODOLOGY. THE COST ACCOUNTING SYSTEM INCLUDES ALL THE PATIENT TYPES (INPATIENT, OUTPATIENT & EMERGENCY) AND PAYORS (MEDICARE, MEDI-CAL, COMMERCIAL HMO, SENIOR HMO AND ALL OTHERS) SEEKING SERVICES AT THE HOSPITAL. THE UNREIMBURSED MEDICAID PERCENTAGE OF TOTAL EXPENSE IS INDICATING A MARKED DECLINE OVER THE PREVIOUS YEAR OF TY2011 (3.63% IN TY2011 COMPARED TO 2.80% IN TY2012). THE PRIMARY CONTRIBUTOR TO THIS IS RELATED TO THE CALIFORNIA DEPARTMENT OF HEALTHCARE SERVICES HOSPITAL FEE PROGRAM; THIS PROGRAM BEGAN IN TY2010. THIS SUPPLEMENTAL MEDI-CAL (CALIFORNIA MEDICAID) PROGRAM AIMS TO HELP CALIFORNIA HOSPITALS REGAIN SOME OF THE BILLIONS THEY LOST YEAR OVER YEAR DUE TO LOW MEDI-CAL REIMBURSEMENT RATES. FOR TY2012, THIS PROGRAM COVERED 12 MONTHS (JANUARY 1, 2012 THROUGH DECEMBER 31, 2012) AND RESULTED IN HUNTINGTON MEMORIAL HOSPITAL MITIGATING THE MEDI-CAL LOSSES INCURRED BY ABOUT $2.4 MILLION. WHERE THE $2.4 MILLION WILL BE RECORDED OVER A TWO YEAR PERIOD, AND THAT FOR 2012, $10M IS INCLUDED IN LINE 7B ON PART I OF SCHEDULE H. PART I, LINES 7 (E) THRU 7(H) - THESE PROGRAMS AND OCCURRENCES DETERMINED THE NET COMMUNITY BENEFITS EXPENSES BY COMPILING THE TOTAL COMMUNITY EXPENSES LESS THE DIRECT OFFSETTING REVENUES, ASSOCIATED WITH THESE ACTIVITIES. IN ADDITION TO THE DIRECT EXPENSES, INDIRECT EXPENSES WERE INCLUDED TO ACCOUNT FOR OVERHEAD COSTS TO CONDUCT THE PROGRAMS. THE METHOD USED IS THE "OTHER METHOD" BY CALCULATING DIRECT EXPENSES (WAGE AND NONWAGE EXPENSES) ATTRIBUTABLE TO THE RESPECTIVE PROGRAMS. PART I, LINES 7 (I) - THESE REPORTED TRANSACTIONS INCLUDES ACTUAL AMOUNT OF FUNDS DONATED TO CALIFORNIA HEALTH FOUNDATION & TRUST (CHFT) FOR A COMMUNITY BENEFIT PURPOSE. PART I, LINE 7(G) - HMH SUBSIDIZED SOME CLINICS AND PROGRAMS RELATED TO LOW-INCOME TRAUMA, SENIOR AND PERINATAL POPULATIONS. THESE INCLUDED A TRAUMA INTERAGENCY COMMUNICATION PROGRAM /TRAINING, LOW-INCOME SENIOR CARE CLINICS, LOW-INCOME MEDICARE/MEDI-CAL CLINICS, LOW-INCOME PERINATAL CLINICS THAT EXPERIENCE SHORTFALLS FROM STATE FUNDED CARE COORDINATION ASSOCIATED WITH THE MULTIPURPOSE SENIOR SERVICES PROGRAM (MSSP) FOR LOW INCOME MEDICARE/MEDI-CAL POPULATIONS. NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS ARE INCLUDED. SCHEDULE H, PART I, LINE 7G HMH SUBSIDIZED SOME CLINICS AND PROGRAMS RELATED TO LOW-INCOME TRAUMA, SENIOR AND PERINATAL POPULATIONS. THESE INCLUDED A TRAUMA INTERAGENCY COMMUNICATION PROGRAM/TRAINING, LOW-INCOME SENIOR CARE CLINICS, LOW-INCOME MEDICARE/MEDI-CAL CLINICS, LOW-INCOME PERINATAL CLINICS THAT EXPERIENCE SHORTFALLS FROM STATE FUNDED CARE COORDINATION ASSOCIATED WITH THE MULTIPURPOSE SENIOR SERVICES PROGRAM (MSSP) FOR LOW INCOME MEDICARE/MEDI-CAL POPULATIONS. NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS ARE INCLUDED. SCHEDULE H, PART II HMH PLAYS AN ACTIVE ROLE IN COMMUNITY COALITION BUILDING IN COLLABORATION WITH A BROAD RANGE OF COMMUNITY AND PUBLIC ORGANIZATIONS ENCOMPASSING THE PUBLIC SECTOR, FAITH COMMUNITY, AND PRIVATE BUSINESS. BEYOND HEALTH CARE, HMH PARTICIPATES IN DEVELOPMENT OF SOCIAL AND ECONOMIC PROGRAMS TO ENCOURAGE IMPROVEMENTS IN SAFETY AND LEADERSHIP TRAINING, RECREATIONAL ACTIVITIES, "NEIGHBORHOOD CLUBS" OFFERING ASSISTANCE TO SINGLE PARENTS AND ELDERLY RESIDENTS, INCREASED INVOLVEMENT OF PARENTS IN SCHOOL POLICIES, ETC. SPECIFICALLY TO HEALTH CARE RELATED COMMUNITY BUILDING OBJECTIVES, HMH ENGAGES IN ACTIVITIES THAT INCLUDE OFFERING AN AMBULATORY CARE CENTER TO UNDER-INSURED AND UNINSURED PERSONS, PROVIDING SPECIALIZED PROGRAMS AND SERVICES FOR SENIORS AND DISABLED PERSONS (SENIOR CARE NETWORK), PROVIDING DEDICATED, MULTI-SESSION COMMUNITY HEALTH EDUCATION PROGRAMS ON TOPICS SUCH AS OBESITY PREVENTION, DIABETES AND ASTHMA FOR CHILDREN AND THEIR FAMILIES AS WELL AS ADULTS; PROVIDING COMMUNITY HEALTH EDUCATION AND SUPPORT PROGRAMS FOR A VARIETY OF HEALTH CONDITIONS AND DISEASES, HOSTING FLU CLINICS, OFFERING A HEALTH SCIENCE LIBRARY AND PARTNERING WITH COMMUNITY ORGANIZATIONS. THESE ACTIVITIES ILLUSTRATE HUNTINGTON MEMORIAL HOSPITAL COMMITMENT TO SUPPORTING AND BUILDING THE COMMUNITY. SCHEDULE H, PART III, LINE 3 WITH REGARDS TO AN ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS POSSIBLY ELIGIBLE FOR FINANCIAL ASSISTANCE: HMH CONDUCTED THIS ESTIMATE BY USING THE BAD DEBT WRITE-OFFS POSTED TO THE RESPECTIVE TRENDED YEARS AND IDENTIFIED THE BAD DEBT SUBSEQUENTLY RECLASSIFIED TO CHARITY. THE AVERAGE OF THE AMOUNTS FOR THE PREVIOUS FOUR YEARS YIELDED APPROXIMATELY 1.00% PERCENT. THIS PERCENTAGE WAS APPLIED TO THE 2012 TOTAL NET BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 TO ESTIMATE THE PORTION OF BAD DEBT THAT POTENTIALLY COULD QUALIFY FOR CHARITY IN FUTURE YEARS. SCHEDULE H, PART III, LINE 4 BAD DEBT: THE FOOTNOTES TO THE HUNTINGTON MEMORIAL HOSPITAL (HMH) FINANCIAL STATEMENTS INCLUDE A BAD DEBT FOOTNOTE THAT CAN BE FOUND ON PAGES 10 AND 11 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 THE MEDICARE SHORTFALL INCURRED BY HMH IS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL PROVIDES NEEDED ACUTE, REHABILITATIVE, PSYCHIATRIC, OUTPATIENT AND TRAUMA CARE TO ASSIST ELDERLY AND DISABLED ADULTS RETURN TO GOOD HEALTH, ALL WHILE BEING PAID REIMBURSEMENT RATES FROM MEDICARE THAT COVER ONLY A FRACTION OF THE COST OF PROVIDING SUCH CARE. THE REPORTED MEDICARE SHORTFALL AMOUNT IS CONSISTENT WITH THE FILED COST REPORT AND IS NET OF DIRECT GME REVENUES AND COSTS REFLECTED IN PART I. THE MEDICARE COST REPORT CALCULATES MEDICARE COSTS FOR ACUTE CARE HOSPITALS USING RATIOS OF COST-TO-CHARGES AND CALCULATED PER DIEM AVERAGE. THE MEDICARE SHORTFALL INCURRED BY HUNTINGTON MEMORIAL HOSPITAL IS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL PROVIDES NEEDED ACUTE, REHABILITATIVE, PSYCHIATRIC, OUTPATIENT AND TRAUMA CARE TO ASSIST ELDERLY AND DISABLED ADULTS RETURN TO GOOD HEALTH, ALL WHILE BEING PAID REIMBURSEMENT RATES FROM MEDICARE THAT COVER ONLY A FRACTION OF THE COST OF PROVIDING SUCH CARE. THE REPORTED MEDICARE SHORTFALL AMOUNT IS CONSISTENT WITH THE FILED COST REPORT AND IS NET OF DIRECT GME REVENUES AND COSTS REFLECTED IN PART I. THE MEDICARE COST REPORT CALCULATES MEDICARE COSTS FOR ACUTE CARE HOSPITALS USING RATIOS OF COST-TO-CHARGES AND CALCULATED PER DIEM AVERAGE. SCHEDULE H, PART III, LINE 9B HMH DOES NOT PURSUE COLLECTION OF AMOUNTS FOR CARE WITHOUT CHARGE TO PATIENTS WHO MEET CERTAIN CRITERIA AND ARE KNOWN TO QUALIFY FOR CHARITY CARE. UNINSURED PATIENTS ARE AUTOMATICALLY EXTENDED COURTESY DISCOUNTS ON ALL INPATIENT AND EMERGENCY SERVICES TO PATIENTS WHO MEET CERTAIN LOW-INCOME GUIDELINES BUT ARE NOT ELIGIBLE FOR CHARITY CARE. THE CHARITY POLICY AND PROCEDURE SEEKS TO DIFFERENTIATE BETWEEN PATIENTS WHO DEMONSTRATE AN IN ABILITY TO PAY, VERSUS BAD DEBT, WHICH IS THE UNWILLINGNESS OF THE PATIENT TO PAY. THE COURTESY DISCOUNT AVERAGES APPROXIMATELY 70% OF GROSS CHARGES. THE BALANCE (APPROXIMATELY 30% OF GROSS CHARGE) IS BILLED TO THE PATIENT. SCHEDULE H, PART IV, LINE 2 HMH OWNERSHIP OF HOSC IS INDIRECT THROUGH A WHOLLY OWNED SUBSIDIARY, CONGRESS SERVICES CORPORATION. THE INFORMATION REGARDING THE OWNERSHIP PERCENTAGES OF THE OTHER HOSC PARTNERS IS UNAVAILABLE. BASED ON THE INFORMATION AVAILABLE TO HMH, WE CONCLUDED THAT ONE OR MORE OF THE PHYSICIAN'S ON STAFF AT HMH COLLECTIVE OWNERSHIP (SHARE OF PROFITS IN HOSC) EXCEEDS THE 10% THRESHOLD. GIVEN THE LACK OF DATA AVAILABLE, HMH IS UNABLE TO DETERMINE THE APPROPRIATE PERCENTAGE TO ENTER IN THE "PHYSICIAN'S PROFIT % OR STOCK OWNERSHIP %" ON LINE 2 OF THE PART IV TABLE. SCHEDULE H, PART V, SECTION B, LINE 14G HMH PROVIDES A CONSIDERABLE AMOUNT OF ITS SERVICES WITHOUT CHARGE TO FINANCIALLY ELIGIBLE PATIENTS WHO CANNOT AFFORD TO PAY FOR CARE. ALL MEDICALLY NECESSARY SERVICES ARE AVAILABLE AS UNCOMPENSATED SERVICES, BASED ON NEED. HMH PUBLICIZES THE FINANCIAL ASSISTANCE POLICY ON THE FACILITY'S WEBSITE. MOREOVER INCLUDED ON THE BACK OF EACH BILLING STATEMENT IS A DISCLAIMER REGARDING FINANCIAL ASSISTANCE BEING AVAILABLE AND A CONTACT NUMBER TO CALL, IF INTERESTED. MOREOVER, HMH HAS SIGNAGE POSTED IN THE ADMITTING AND EMERGENCY ROOM AREAS. A WRITTEN COPY OF THIS POLICY IS AVAILABLE UPON REQUEST, AS INDICATED ON THIS SIGNAGE DISPLAYED. SCHEDULE H, PART V, SECTION B, LINE 20D AT HMH EMERGENCY PATIENTS WILL BE CONSIDERED IN NEED OF FINANCIAL ASSISTANCE UNTIL THE HOSPITAL HAS HAD THE OPPORTUNITY TO ASSESS THE PATIENT'S FINANCIAL CONDITION, WHICH WILL BE THE DETERMINING FACTORS FOR SUCH ASSISTANCE. HMH PROVIDES MEANS-TESTED FINANCIAL ASSISTANCE THAT IS PRIMARILY CATEGORIZED INTO FULL AND PARTIAL ASSISTANCE. TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, A PATIENT'S OR RESPONSIBLE FAMILY MEMBER'S INCOME MUST BE AT OR BELOW 350% OF THE FEDERAL POVERTY LEVEL. THE PATIENT OR RESPONSIBLE FAMILY MEMBER MUST COMPLETE THE FINANCIAL ASSISTANCE FORM AND INCLUDE THE NECESSARY DOCUMENTATION. PATIENTS WHOSE INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL WILL RECEIVE FINANCIAL ASSISTANCE EQUAL TO 100% OF THE UNINSURED/UNDERINSURED PRICE. PATIENTS WHOSE INCOME IS BETWEEN 200% AND 350% OF THE FEDERAL POVERTY LEVEL WILL RECEIVE A CHARITY DISCOUNT EQUAL TO 50% OF THE UNINSURED/UNDERINSURED PRICE. IN THE EVENT FINANCIAL ASSISTANCE IS NOT A VIABLE OPTION, THE PATIENT WITH NO INSURANCE WILL BE BILLED IN ACCORDANCE WITH THE HMH PRICING OUTLINED BELOW. UNINSURED/UNDERINSURED PRICING: INPATIENTS GENERALLY ARE EXTENDED A PRICE SIMILAR TO THAT OF DRG PRICING AND OUTPATIENTS ARE BILLED AT 35% OF ACTUAL (GROSS) CHARGES. WITH REGARDS TO GROSS CHARGES, HMH ENDEAVORS TO MAINTAIN PRICING (GROSS CHARGES) COMPARABLE TO THE MARKET. LOOKING BACK AT PRIOR YEAR CLAIMS IN TERMS OF PERCENTAGE OF CHARGES, AMOUNTS CHARGED THE UNINSURED POPULATION NET OF THE HOSPITAL'S AUTOMATIC COURTESY DISCOUNT WAS IN LINE WITH THE AVERAGE NET REVENUE FROM THE AVERAGE OF MEDICARE AND COMMERCIAL PAYERS. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 HMH PERFORMS A COMMUNITY NEEDS ASSESSMENT EVERY 3 YEARS, IN ACCORDANCE WITH CALIFORNIA COMMUNITY BENEFITS LEGISLATION FOR NOT-FOR-PROFIT HOSPITALS. REVIEW AND ANALYSIS OF HEALTH RELATED DATA, COMPARED WITH NATIONAL BENCHMARKS AND REGIONAL EXPERIENCES, COMBINED WITH CONSULTATION WITH COMMUNITY LEADERS AND REPRESENTATIVES OF LOCAL AGENCIES, ARE CONSIDERED IN IDENTIFYING THE TOP HEALTH ISSUES AND OPPORTUNITIES FOR IMPROVEMENT TO ARRIVE AT THE COMMUNITY NEEDS USED IN DETERMINING THE COMMUNITY BENEFITS PLAN. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 THE ORGANIZATION PROVIDES EDUCATION TO PATIENTS ABOUT ELIGIBILITY FOR ASSISTANCE IN SEVERAL WAYS. FINANCIAL COUNSELORS ARE ON HAND TO EVALUATE PATIENTS FOR THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR THE HOSPITAL'S CHARITY CARE AND DISCOUNT POLICIES, AND FACILITATE APPLICATION FOR ASSISTANCE. PATIENTS WHO ARE UNINSURED ARE GIVEN A NOTICE AT THE TIME OF ADMISSION/REGISTRATION, AND THE HOSPITAL POSTS NOTICES INFORMING PATIENTS OF ITS CHARITY CARE POLICY. ADDITIONALLY, THE HOSPITAL'S WEBSITE POSTS PAYMENT OPTIONS AND ALTERNATIVES AVAILABLE TO PATIENTS WITHOUT HEALTHCARE COVERAGE. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 HMH, LOCATED IN PASADENA, DEFINES THE "COMMUNITY" IT SERVES FOR PURPOSES OF NEEDS ASSESSMENT TO INCLUDE THE SERVICE AREA OF PASADENA, ALTA DENA, SAN MARINO, AND SOUTH PASADENA. THE SERVICE AREA POPULATION IS ESTIMATED AT 231,274 AS OF 2013. IN COMPARISON TO LOS ANGELES COUNTY, THE SERVICE AREA HAS A HIGHER PROPORTION OF: PERSONS AGE 18-64 YEAR, AND 65 YRS AND OLDER, PERSONS OF WHITE, ASIAN AND BLACK RACES, PERSONS SPEAKING ENGLISH AT HOME, ADULTS WITH SOME COLLEGE TO A COLLEGE DEGREE, AND EMPLOYED PERSONS. THE HOSPITAL HAD 24.0% OF THE PATIENT DISCHARGES HAVING MEDICAID OR WERE UNINSURED FOR THE FY 2012; DESPITE HAVING A LOWER PROPORTION OF FAMILIES WITH INCOMES BELOW THE POVERTY LEVEL AT 8.3% WITHIN THE GREATER PASADENA, WHEN COMPARED TO LOS ANGELES COUNTY. HEART DISEASE AND CANCER WERE THE TOP TWO LEADING CAUSES OF DEATH IN THE SERVICE AREA. HUNTINGTON MEMORIAL HOSPITAL IS ONE OF 16 ACUTE CARE HOSPITALS WITHIN THE SAN GABRIEL VALLEY AND THE ONLY TRAUMA FACILITY WITHIN IN THIS SAME AREA. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 HUNTINGTON MEMORIAL HOSPITAL HAS AN OPEN MEDICAL STAFF, AND A COMMUNITY BOARD (BOARD OF DIRECTORS COMPOSED OF COMMUNITY MEMBERS). THE HOSPITAL CONDUCTS NUMEROUS ACTIVITIES THAT CONTRIBUTE TO PROMOTING THE HEALTH OF THE COMMUNITY. IN ADDITION TO PROVIDING CHARITY CARE FOR PATIENTS WITHOUT THE ABILITY TO PAY FOR NECESSARY TREATMENT, ABSORBING UNPAID COSTS OF CARE FOR PATIENTS WITH MEDI-CAL AND MEDICARE, OPERATING AN EMERGENCY ROOM ON A 24-HOUR BASIS, AND OFFERING AN AMBULATORY CARE CLINIC TO SERVE UNDER-INSURED AND UNINSURED PERSONS, THE HOSPITAL IS DEDICATED TO PROVIDING SPECIALIZED PROGRAMS AND SERVICES FOR SENIORS AND DISABLED PERSONS, PROVIDING COMMUNITY HEALTH EDUCATION, PREVENTION, AND SUPPORT PROGRAMS FOR A VARIETY OF HEALTH CONDITIONS AND DISEASES, HOSTING FLU CLINICS, OFFERING A HEALTH SCIENCES LIBRARY AND GRADUATE MEDICAL EDUCATION, AND PARTNERING WITH COMMUNITY ORGANIZATIONS. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 IN ACCORDANCE WITH CALIFORNIA SENATE BILL 697, COMMUNITY BENEFITS LEGISLATION, HUNTINGTON MEMORIAL HOSPITAL, A PRIVATE NOT-FOR-PROFIT HOSPITAL, HAS SUBMITTED A COMMUNITY BENEFITS PLAN FOR FISCAL YEAR 2012 (JANUARY 1 TO DECEMBER 31). SENATE BILL 697 REQUIRES A NOT-FOR PROFIT HOSPITAL IN CALIFORNIA TO COMPLETE THE FOLLOWING ACTIVITIES: - REVIEW AND REAFFIRM ITS MISSION STATEMENT TO ENSURE THAT ITS POLICIES INTEGRATE AND REFLECT THE PUBLIC INTEREST IN MEETING ITS RESPONSIBILITIES AS A NOT-FOR-PROFIT ORGANIZATION. - COMPLETE AND UPDATE A NEEDS ASSESSMENT EVERY THREE YEARS, EVALUATING THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. - ADOPT AND FILE A COMMUNITY BENEFITS PLAN ANNUALLY, DOCUMENTING ACTIVITIES THAT THE HOSPITAL HAS UNDERTAKEN TO ADDRESS COMMUNITY NEEDS WITHIN ITS MISSION AND FINANCIAL CAPACITY; AND TO THE EXTENT PRACTICABLE, ASSIGN AND REPORT THE ECONOMIC VALUE OF COMMUNITY BENEFITS PROVIDED IN FURTHERANCE OF ITS PLAN. true HUNTINGTON MEDICAL FOUNDATION 133 N ALTADENA DRIVE PASADENA CA 91107 954434428 501(C)(3) 650000 TO SUPPORT THE OPERATION OF THE URGENT CARE CENTER MANAGED BY HMF CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K ST STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 38995 CA HOSPITAL FEE PROGRAM 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 THE USAGE OF THE GRANT IS MONITORED BY THE HOSPITAL'S EXTERNAL AFFAIRS AND THE PROGRESS OF THE OPERATION OF THE COMMUNITY URGENT CARE CENTER IS PERIODICALLY REPORTED TO THE BOARD. X X X true true X X X X X false true false false false false false false false JAMES S NOBLE 412927 0 112000 0 14495 0 19950 0 23656 0 583028 0 0 0 STEPHEN A RALPH 597693 0 200000 0 40919 0 308795 0 17095 0 1164502 0 0 0 JANE HADERLEIN 351787 0 98000 0 10810 0 19950 0 23549 0 504096 0 0 0 BERNADETTE L MERLINO 236042 0 57000 0 82172 0 22483 0 14009 0 411706 0 58801 0 BONNIE L KASS 265907 0 64000 0 40481 0 25430 0 24596 0 420414 0 0 0 DEBRA L TAFOYA 230919 0 57000 0 72638 0 26200 0 20771 0 407528 0 53998 0 PAULA VERRETTE 346959 0 82000 0 21829 0 123773 0 14600 0 589161 0 0 0 DEBRA A ORTEGA 259375 0 82000 0 18599 0 22450 0 16996 0 399420 0 0 0 EUGENE E GUTIERREZ IV 144312 0 0 0 17835 0 0 0 14113 0 176260 0 0 0 JEFFREY P WEIGAND 203942 0 30856 0 25840 0 5967 0 24860 0 291465 0 0 0 SAMUEL I BRENEISER 196531 0 29958 0 16500 0 23049 0 10277 0 276315 0 0 0 JAMES C LIU 234239 0 6035 0 0 0 22424 0 21354 0 284052 0 0 0 REBECCA ARMATO 192470 0 26439 0 7600 0 16040 0 10307 0 252856 0 0 0 JOHN F GOEDERS 187099 0 27738 0 3783 0 17780 0 25464 0 261864 0 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 1A PASADENA HOSPITAL ASSOCIATION (PHA) ALLOWS FOR COMPANION TRAVEL TO CERTAIN PRE-APPROVED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO PHA. THE FOLLOWING OFFICER RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE TAXABLE COMPENSATION: STEPHEN A. RALPH - $996 STEPHEN A. RALPH, CEO, HAS MEMBERSHIPS IN THE ATHENAEUM AND THE VALLEY HUNT CLUB, WHICH ARE SOCIAL CLUBS IN PASADENA. THE USAGE OF THE CLUBS WERE PRIMARY FOR BUSINESS PURPOSE. AUTO ALLOWANCES WERE ADVANCED TO CERTAIN EXECUTIVES AND WERE REPORTED IN THEIR W-2. SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4B PASADENA HOSPITAL ASSOCIATION (PHA) ADOPTED A 457(F) DEFINED BENEFIT RETIREMENT PLAN, EFFECTIVE DECEMBER 31, 2005. THE PLAN COVERS MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM OF PHA. THE NORMAL RETIREMENT DATE OF THE PLAN IS AGE 65. EACH PARTICIPANT OF THE PLAN IS FULLY VESTED AFTER 20 YEARS OF SERVICE, AND BENEFITS ARE PRORATED FOR PARTICIPANTS WITH LESS THAN 20 YEARS OF SERVICE. AS MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM OF PHA, CERTAIN PERSONS LISTED ON PART VII OF THE 990 PARTCIPATE IN THE PLAN. PARTICIPANTS RECEIVED DISTRIBUTION FROM 457F RETIREMENT PLAN IN 2012: BERNADETTE MERLINO - $58,801 DEBRA TOFOYA - $53,998 A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 130911J92 2005-05-18 236905804 SEE PART VI false false false A 0 0 254060207 16002082 14917982 0 1999157 0 0 163114000 56901875 3011 2008 false true false true A false true true true false 0.00003 0.00000 0.00003 false false 0.00000 false true A false false false true false false 0 true GEFC 27. true false true A true DESCRIPTION OF PURPOSE 0 SCHEDULE K, PART I, COLUMN(F) THE PURPOSE OF THE BONDS WERE TO CONSTRUCT NEW FACILITIES, EQUIP EXISTING AND NEW FACILITIES, AND TO REFUND BONDS ISSUED 8/13/1996. JAMES S NOBLE CURRENT OFFICER HOME LOAN X 400000 335181 false true true 335181 SHERRY KIRCHHEIMER WIFE OF BOARD OF DIRECTOR EMPLOYMENT X 21 1796769 COST/SELLING PRICE 0 false true false NON CASH CONTRIBUTIONS SCHEDULE M, PART I, COLUMN B THE AMOUNT IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A PASADENA HOSPITAL ASSOCIATION, DBA HUNTINGTON MEMORIAL HOSPITAL IS A 625-BED, NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN PASADENA, CALIFORNIA. FOUNDED IN 1892, HUNTINGTON HOSPITAL IS COMMITTED TO PROVIDING EXCELLENT PATIENT CARE DELIVERED WITH COMPASSION AND RESPECT. THE HOSPITAL OFFERS A FULL COMPLEMENT OF ACUTE MEDICAL CARE AND COMMUNITY SERVICES, RANGING FROM GENERAL MEDICINE TO THE FOREMOST SPECIALIZED PROGRAMS IN CARDIOVASCULAR SERVICES, ONCOLOGY, AND THE NEUROSCIENCES. THE HOSPITAL HAS THE ONLY TRAUMA CENTER IN THE REGION. IN ADDITION, HUNTINGTON OFFERS WOMEN'S AND CHILDREN'S SERVICES, STATE OF-THE ART ORTHOPEDIC SURGERY, IN- AND OUTPATIENT PSYCHIATRIC SERVICES, HUNTINGTON HOSPITAL SENIOR CARE NETWORK, AND HUNTINGTON AMBULATORY CARE CENTER. AS A TEACHING FACILITY AFFILIATED WITH THE UNIVERSITY OF SOUTHERN CALIFORNIA'S KECK SCHOOL OF MEDICINE, HUNTINGTON SUPPORTS 39 RESIDENTS EACH YEAR, SPECIALIZING IN INTERNAL MEDICINE OR GENERAL SURGERY. APPROXIMATELY ONE-THIRD OF HUNTINGTON'S RESIDENTS REMAIN IN THE AREA TO PRACTICE, PROVIDING A SEAMLESS TRANSITION THROUGH GENERATIONS OF CARE. RECENTLY, HUNTINGTON HOSPITAL RECEIVED NUMEROUS AWARDS, RECOGNITIONS, AND CERTIFICATIONS: - FULL HOSPITAL-WIDE ACCREDITATION FROM THE JOINT COMMISSION FOR ACHIEVING NATIONAL STANDARDS FOR HEALTH CARE QUALITY AND SAFETY - GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION FOR THE STROKE CARE AND TOTAL KNEE AND HIP REPLACEMENT - DESIGNATION AS A PRIMARY STROKE CENTER FROM THE JOINT COMMISSION, ONE OF THE FIRST HOSPITALS IN LOS ANGELES COUNTY TO EARN THIS DESIGNATION - MAGNET RECOGNITION BY AMERICAN NURSES CREDENTIALING CENTER - RANKED AS A U.S. NEWS AND WORLD REPORT TOP HOSPITAL (METRO) IN TEN SPECIALTIES, INCLUDING: ORTHOPEDICS, NEUROLOGY AND NEUROSURGERY, UROLOGY, GASTROENTEROLOGY, GERIATRICS, DIABETES AND ENDOCRINOLOGY, PULMONOLOGY, GYNECOLOGY, NEPHROLOGY, AND EAR, NOSE AND THROAT - HUNTINGTON HOSPITAL TRAUMA CENTER HAS BEEN VERIFIED AS A LEVEL II TRAUMA CENTER BY THE VERIFICATION REVIEW COMMITTEE (VRC), AN AD HOC COMMITTEE OF THE COMMITTEE ON TRAUMA (COT) OF THE AMERICAN COLLEGE OF SURGEONS (ACS)- NAMED TO TARGET: STROKE HONOR ROLL BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION AND ALSO RECEIVED THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES - STROKE GOLD PLUS PERFORMANCE ACHIEVEMENT AWARD IN RECOGNITION OF THE HOSPITAL'S HIGH QUALITY, BEST PRACTICE STROKE CARE - HUNTINGTON HOSPITAL CANCER CENTER RECEIVED ACCREDITATION WITH COMMENDATION FROM THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER - HUNTINGTON-HILL BREAST CENTER RECEIVED ACCREDITATION BY THE AMERICAN COLLEGE OF SURGEONS' NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS - ONE OF ONLY THREE HOSPITALS IN LOS ANGELES COUNTY TO HAVE ACHIEVED THIS HONOR - THE BREAST IMAGING CENTER IS DESIGNATED A CENTER OF EXCELLENCE BY THE AMERICAN COLLEGE OF RADIOLOGY - THE AMERICAN COLLEGE OF RADIOLOGY COMMISSION ON QUALITY AND SAFETY HAS ACCREDITED HUNTINGTON HOSPITAL'S TOSHIBA AQUILION ONE 320 FOR COMPUTER TOMOGRAPHY AND TOSHIBA 2005 VANTAGE FOR MAGNETIC RESONANCE IMAGING SERVICES - MAXIMUM FIVE-YEAR ACCREDITATION FROM THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION - BARIATRIC SURGERY CENTER OF EXCELLENCE BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY - THE CHEERS AWARD - BESTOWED BY THE INSTITUTE FOR SAFE MEDICATION PRACTICES - HONORS ORGANIZATIONS THAT HAVE SET A "SUPERLATIVE STANDARD OF EXCELLENCE" IN THE PREVENTION OF MEDICATION ERRORS - OUTSTANDING LEADERSHIP AWARD FROM THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR ELIMINATING VENTILATOR-ASSOCIATED PNEUMONIA - ONE OF ONLY 37 HOSPITALS NATIONWIDE TO BE RECOGNIZED - LAB ACCREDITATION BOARD OF ABRET GRANTED THE HOSPITAL ACCREDITATION FOR OUR NEUROPHYSIOLOGY INTRAOPERATIVE MONITORING LABORATORIES - CENTERS OF DISTINCTION FOR BARIATRIC SURGERY, SPINE SURGERY, KNEE AND HIP JOINT REPLACEMENT, AND HEART AND VASCULAR SERVICES BY THE BLUE CROSS BLUE SHIELD ASSOCIATION - DESIGNATION AS A STEMI (ST SEGMENT ELEVATION MYOCARDIAL INFARCTION) RECEIVING CENTER WHERE EMERGENCY MEDICAL SERVICE PERSONNEL GIVE PATIENTS HAVING POSSIBLE MYOCARDIAL INFARCTIONS A 12-LEAD EKG IN THE FIELD AND A HOSPITAL TEAM IS READY WHEN A PATIENT ARRIVES IN THE EMERGENCY DEPARTMENT - GOLD MEDAL FOR EXCELLENCE IN SUPPORTING ORGAN DONATION FROM THE U.S. DEPARTMENT OF HEALTH SERVICES - HIGH RELIABILITY TEAM AWARD FROM THE VOLUNTEER HOSPITAL ASSOCIATION - ACCREDITATION BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF VASCULAR LABORATORIES (ICAVL) HUNTINGTON HOSPITAL ALSO OFFERS CONTINUING EDUCATION AND LEARNING FOR THE PUBLIC, EMPLOYEES, MEDICAL STAFF, AND OTHER HEALTH CARE PROFESSIONALS, THROUGH THE AVAILABILITY OF HEALTH SCIENCE AND COMMUNITY LIBRARIES. WITH SOCIAL MEDIA TRANSFORMING THE WAY THAT PEOPLE COMMUNICATE, HUNTINGTON HOSPITAL HAS EXTENDED ITS REACH INTO THE WEB COMMUNITY USING FAMILIAR SITES LIKE FACEBOOK, YOUTUBE, AND TWITTER. DESC CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7A THE TRUSTEES OF THE COLLIS P. AND HOWARD HUNTINGTON MEMORIAL HOSPITAL TRUST HAVE THE POWER OF ELECTING REPLACEMENT TRUSTEES OF THE TRUST'S BOARD IN THEIR CAPACITY AS TRUSTEES. ALL TRUSTEES ALSO SERVE ON THE BOARD OF DIRECTORS OF PASADENA HOSPITAL ASSOCIATION, DBA HUNTINGTON MEMORIAL HOSPITAL. DESC THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B FINANCIAL DATA IS GATHERED FROM AND VERIFIED BY VARIOUS DIRECTORS. THE DATA USED IN PREPARATION OF THE RETURN BY THE OUTSIDE TAX PREPARER IS REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING. A COPY OF THE FILED RETURN IS SENT TO EACH MEMBER OF THE BOARD. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C THE PROCESS OF DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS IS GOVERNED BY THE ORGANIZATION'S POLICIES, WHEREBY INDIVIDUALS IN POSITIONS OF LEADERSHIP (OFFICERS, DIRECTORS, AND MANAGEMENT PERSONNEL) ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS. ONCE DISCLOSED, A REVIEW OF ANY POTENTIAL CONFLICTS IS CONDUCTED AT THE LEVEL OF CHIEF EXECUTIVE OFFICER IN CONJUNCTION WITH THE COMPLIANCE OFFICER. BASED ON THIS EVALUATION, IT MAY BE NECESSARY TO FOLLOW-UP WITH THE INDIVIDUAL AND REQUEST ANY ADDITIONAL INFORMATION DEEMED RELEVANT, OR DISCUSS WAYS TO MITIGATE OR ELIMINATE THE RISK OF CONFLICT. ANY CONCERNS OF CONFLICTS OF INTEREST ARE ADDRESSED BY THE AUDIT & COMPLIANCE COMMITTEE AND THE FINDINGS AND RECOMMENDATIONS ARE REPORTED TO THE BOARD OF DIRECTORS. AFTER DISCUSSION WITH THE INTERESTED PERSON, HE/SHE WILL LEAVE THE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS REGARDING THE TRANSACTION OR ARRANGEMENT WITH THE HOSPITAL. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN Form 990, Part VI, LINES 15A & 15B EXECUTIVE COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD, AND THE COMMITTEES DELIBERATIONS AND DECISIONS ARE DOCUMENTED CONTEMPORANEOUSLY IN THE MINUTES OF THE MEETING IN WHICH COMPENSATION ARRANGEMENTS WERE DETERMINED. REVIEW & APPROVAL OF COMPENSATION FOR ALL TOP MANAGEMENT OFFICIALS, INCLUDING THE CEO, CFO & VP POSITIONS IS CONDUCTED BY THE COMPENSATION COMMITTEE ANNUALLY, AND THE PERSONS WHO SERVE IN THOSE POSITIONS ARE NOT PRESENT DURING DISCUSSIONS RELATED TO THEIR COMPENSATION. COMPARABLE DATA FOR SIMILAR POSITIONS AND ORGANIZATIONS, PREPARED BY INDEPENDENT CONSULTANTS, IS USED TO ESTABLISH COMPENSATION. REVIEW & APPROVAL FOR THE CEO & VPS WAS LAST PERFORMED BY THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING HELD IN MARCH 2012. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. RESTATEMENT OF BEGINNING BALANCES FORM 990, PART X, LINE 2 AND LINE 27 THE BEGINNING BALANCES REPORTED ON LINE 2, SAVINGS AND TEMPORARY CASH INVESTMENTS AND LINE 27, UNRESTRICTED NET ASSETS, HAVE BEEN RESTATED FROM THE AMOUNTS REPORTED ON THE PRIOR YEAR FORM 990. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 ACCRUED PENSION $(29,572,260) GAIN (LOSS) ON SUBSIDIARY $( 712,960) RATE LOCK TERMINATION BOND 2005 $ 158,342 ------------- TOTAL OTHER CHANGES IN NET ASSETS $(30,126,878) COLLIS P HOWARD HUNTINGTON MEM HOSP TRST 100 W CALIFORNIA BLVD PASADENA CA 91109 956027688 SUPPORT PHA CA 501(C)(3) 11, III-FI NA false HUNTINGTON MEDICAL FOUNDATION 133 N ALTADENA DRIVE 2ND FLR PASADENA CA 91107 954434428 HLTHCARE SVCS CA 501(C)(3) 3 PHA true HMH FLINTRIDGE LA CANADA GUILD PO BOX 563 LA CANADA CA 91012 956016968 FUNDRAISING CA 501(C)(3) 11, III-FI NA false WOMEN'S AUXILIARY HUNTINGTON MEM HOSP 930 S EL MOLINO AVE PASADENA CA 91106 956195080 FUNDRAISING CA 501(c)(3) 11, III-FI NA false HUNTINGTON AMBULATORY SURGERY CENTER 625 S FAIR OAKS AVE SUITE 380 PASADENA CA 91105 273922007 SURGERY CENTER CA CSC RELATED 0 0 false 0 false 0.00000 HUNTINGTON OUTPATIENT SURGERY CENTER 797 S FAIR OAKS AVE PASADENA CA 91105 954043257 SURGERY CENTER CA CSC RELATED 0 0 false 0 false 0.00000 CONGRESS SERVICES CORPORATION 804 SOUTH FAIR OAKS AVENUE PASADENA CA 91105 953978299 MANAGEMENT SVCS CA NA C CORP 1447874 11304729 1.00000 false CHARITABLE REMAINDER TRUSTS (2) SUPPORT CA NA TRUST false true true true true false false false false true true true true false true false true false true HUNTINGTON MEDICAL FOUNDATION B 650000 COST HUNTINGTON MEDICAL FOUNDATION D 1124994 COST HUNTINGTON MEDICAL FOUNDATION M 176683 COST CONGRESS SERVICES CORPORATION D 12508805 COST HUNTINGTON AMBULATORY SURGERY CENTER J 1519204 COST HUNTINGTON AMBULATORY SURGERY CENTER L 378490 COST RELATED ORG TAXABLE AS PARTNERSHIP SCHEDULE R, PART III LINE 1: HUNTINGTON AMBULATORY SURGERY CENTER 27-3922007 625 S FAIR OAKS AVE, SUITE 380 PASADENA, CA 91105 LINE 2: HUNTINGTON OUTPATIENT SURGERY CENTER 95-4043257 797 S FAIR OAKS AVE PASADENA, CA 91105