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THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)), AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE COMBINED FINANCIAL STATEMENTS. WITH RESPECT TO ITS FOR-PROFIT SUBSIDIARIES AND TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE 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. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2011 AND 2010, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 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SUTTER FAIRFIELD SURGERY CENTER AUBURN AMC FAMILY PRACTICE & ORTHOPEDICS

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FAMILY PRACTICE AND ORTHOPEDICS URGENT CARELABRADIOLOGYCARDIOLOGY

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URGENT CARE, LAB, RADIOLOGY AND CARDIOLOGY MEDICAL OFFICE BLDG-AMBULATORY SURG CTR

460 PLUMAS YUBA CITY CA 95991

OUTPATIENT SERVICES AND SURGERY CENTER CARE CENTER AND CALL CENTER

2450 MARTIN ROAD FAIRFIELD CA 94533

OUTPATIENT SERVICES AND CALL CENTER AMADOR CARDIO INVASIVE AND LAB

815 COURT STREET JACKSON CA 95642

CARDIOLOGY AUBURN GASTROENTEROLOGY & NEUROLOGY

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GASTROENTEROLOGY AND NEUROLOGY CLINICAL LAB

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LAB SERVICES ROSEVILLE FAMILY PRACTICE & PHYS THERAPY

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OUTPATIENT SERVICES AND PHYSICAL THERAPY ELK GROVE - PHYSICAL THERAPY

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PHYSICAL THERAPY GRASS VLY FAMILY PRACTICE & PHYS THERAPY

10058 WOLF ROAD GRASS VALLEY CA 95949

OUTPATIENT SERVICES AND PHYSICAL THERAPY AUBURN PHYSICAL THERAPY

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PHYSICAL THERAPY DAVIS - PHYSICAL THERAPY

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PHYSICAL THERAPY LINCOLN PHYSICAL THERAPY

965 ORCHARD CREEK LANE LINCOLN CA 95648

PHYSICAL THERAPY PHYSICAL THERAPY

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PHYSICAL THERAPY AUBURN OCCUPATIONAL MEDICINE

1330 AIRPORT BLVD AUBURN CA 95602

OCCUPATIONAL MEDICINE OCCUPATIONAL HEALTH

1014 NORTH MARKET BLVD SACRAMENTO CA 95834

OCCUPATIONAL HEALTH SUTTER FAIRFIELD DIAGNOSTIC IMAGING CTR

2700 LOW COURT 1ST FLOOR FAIRFIELD CA 94534

DIAGNOSTIC IMAGING CENTER ROSEVILLE PATIENT SERVICE CENTERS

MEDICAL PLAZA DRIVE ROSEVILLE CA 95661

OUTPATIENT SERVICES DAVIS MEDICAL OFFICE BLDG ANESTHESIOLOGY

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OUTPATIENT SERVICES AND ANESTHESIOLOGY DAVIS PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES SACRAMENTO AREA PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES FORT SUTTER PATIENT SERVICE CENTERS

1020 29TH STREET SACRAMENTO CA 95816

OUTPATIENT SERVICES FOLSOM PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES SACRAMENTO AREA PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES FORT SUTTER PATIENT SERVICE CENTERS

2801 K ST SACRAMENTO CA 95816

OUTPATIENT SERVICES NORTHEAST SAC PATIENT SERVICE CENTERS

3100 DOUGLAS BLVD ROSEVILLE CA 95661

OUTPATIENT SERVICES NORTHEAST SAC PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES SACRAMENTO AREA PATIENT SERVICE CENTERS

1201 ALHAMBRA BLVD SACRAMENTO CA 95816

OUTPATIENT SERVICES SACRAMENTO AREA PATIENT SERVICE CENTERS

2725 CAPITOL AVE SACRAMENTO CA 95816

OUTPATIENT SERVICES YOLO AREA PATIENT SERVICE CENTERS

635 ANDERSON RD DAVIS CA 95616

OUTPATIENT SERVICES SACRAMENTO AREA PATIENT SERVICE CENTERS

8170 LAGUNA BLVD ELK GROVE CA 95758

OUTPATIENT SERVICES YOLO AREA PATIENT SERVICE CENTERS

2210 DEL PASO RD SACRAMENTO CA 95831

OUTPATIENT SERVICES PLACER AREA PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES PLACER AREA PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES RANCHO CORDOVA - PATIENT SERVICE CENTERS

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OUTPATIENT SERVICES WOODLAND PATIENT SERVICES CENTER

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OUTPATIENT SERVICES YOLO AREA PATIENT SERVICE CENTERS

125 N LINCOLN ST DIXON CA 95620

OUTPATIENT SERVICES PLACER AREA PATIENT SERVICE CENTERS

3288 BELL RD AUBURN CA 95603

OUTPATIENT SERVICES NORTHEAST SAC PATIENT SERVICE CENTERS

5767 GREENBACK LANE SACRAMENTO CA 95814

OUTPATIENT SERVICES YOLO AREA PATIENT SERVICE CENTERS

7420 GREENHAVEN DR SACRAMENTO CA 95831

OUTPATIENT SERVICES ROCKLIN - FAMILY PRACTICE

1160 SUNSET BLVD ROCKLIN CA 95765

OUTPATIENT SERVICES AUBURN PARKHILL FAMILY PRACTICE

404 AUBURN-FOLSOM ROAD AUBURN CA 95603

FAMILY PRACTICE VACAVILLE CARE CENTER

770 MASON STREET VACAVILLE CA 95687

OUTPATIENT SERVICES RIO VISTA CARE CENTER

690 MAIN STREET RIO VISTA CA 94571

OUTPATIENT SERVICES VALLEJO CARE CENTER

100 HOSPITAL DRIVE 2ND FLOOR VALLEJO CA 94589

OUTPATIENT SERVICES SACRAMENTO CARDIO-INVASIVE

2575 E BIDWELL ST FOLSOM CA 95630

CARDIO-INVASIVE SACRAMENTO PATIENT SERVICE CENTERS

2800 L ST SACRAMENTO CA 95816

OUTPATIENT SERVICES SMUD OCCUPATIONAL HEALTH

1708 59TH ST SACRAMENTO CA 95816

OCCUPATIONAL HEALTH WINTERS - FAMILY PRACTICE

111 EAST GRANT AVE WINTERS CA 95694

OUTPATIENT SERVICES PROCEDURE CENTER

550 B ST YUBA CITY CA 95991

PROCEDURE CENTER HOME HEALTHHOSPICE

400 PLUMAS YUBA CITY CA 95991

HOME HEALTH/HOSPICE DAVIS INTERNAL MEDICINE GASTROENTEROLOGY

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INTERNAL MEDICINE AND GASTROENTEROLOGY L STREET MEDICAL NEUROLOGY

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NEUROLOGY ROSEVILLE EXPRESS CLINIC

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OUTPATIENT SERVICES EXPRESS CLINIC - PLACERVILLE ROAD

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OUTPATIENT SERVICES EXPRESS CLINIC - GREENHAVEN

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OUTPATIENT SERVICES EXPRESS CLINIC - NATOMAS

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OUTPATIENT SERVICES OTHOPEDICS

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OTHOPEDICS OBSTETRICS

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OBSTETRICS OBSTETRICS

969 PLUMAS YUBA CITY CA 95991

OBSTETRICS AUBURN MRI

11815 EDUCATION STREET AUBURN CA 95602

MRI DAVIS ALLERGY CENTER

1970 LAKE BLVD DAVIS CA 95616

ALLERGY TESTING DERMATOLOGY

350 DEL NORTE YUBA CITY CA 95991

DERMATOLOGY PART I, QUESTION 3C TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF THE PATIENT'S FAMILY INCOME. THE ORGANIZATION WILL SUBTRACT 30% OF THE FAMILY INCOME FROM THE ALLOWABLE MEDICAL EXPENSES TO DETERMINE THE AMOUNT BY WHICH THE ALLOWABLE MEDICAL EXPENSE EXCEED THE AVAILABLE INCOME: THIS AMOUNT IS THEN ELIGIBLE FOR A CHARITY CARE WRITE-OFF. PART I, QUESTION 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. PART II COMMUNITY BUILDING ACTIVITIES SUTTER MEDICAL FOUNDATION FUNDED THE FOLLOWING PROGRAM THAT HELPED ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELPED SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. A) YUBA-SUTTER ECONOMIC DEVELOPMENT CORPORATION (YSEDC): SUTTER MEDICAL FOUNDATION PARTNERS WITH YSEDC TO SUPPORT COMMUNITY ASSETS BY OFFERING EXPERTISE AND RESOURCES. THESE RESOURCES ARE AVAILABLE TO WORK CLOSELY AND IN STRICT CONFIDENCE WITH BUSINESSES CONSIDERING LOCATIONS AND EXPANSION WITHIN THE YUBA-SUTTER REGION. ASSISTANCE WITH SITE LOCATION, ECONOMIC AND DEMOGRAPHIC INFORMATION IDENTIFICATION OF A MYRIAD OF COMMUNITY AND EMPLOYMENT TRAINING SERVICE GROUPS, COMMUNITY TOURS, INTRODUCTION TO GOVERNMENT AND BUSINESS LEADERS AND FACILITATION OF MEETINGS WITH DEVELOPERS, PLANNERS AND OTHER KEY INDIVIDUALS AS REQUIRED ARE AVAILABLE. ALL OF WHICH ASSISTS WITH THE DEVELOPMENT OF A VARIETY OF COMMUNITY REDEVELOPMENT PROGRAMS. PART III, QUESTION 4 THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE ESTIMATED BASED UPON AN EVALUATION OF HISTORICAL PAYMENTS, NEGOTIATED CONTRACTS AND GOVERNMENTAL REIMBURSEMENTS. SUTTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 90% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2011 AND 2010. ADJUSTMENTS AND CHANGES IN ESTIMATES ARE RECORDED IN THE PERIOD IN WHICH THEY ARE DETERMINED. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 25% AS OF 12/31/11 28% AS OF 12/31/10 MEDI-CAL 21% AS OF 12/31/11 20% AS OF 12/31/10 DURING 2011 AND 2010, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. SUTTER HAD NO CHANGES IN ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES IN 2011. METHODOLOGY FOR CALCULATING BAD DEBT (AT COST) THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. PART III, QUESTION 7 MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. THEREFORE THE AMOUNT REFLECTED ON THE COST REPORT WILL LIKELY DIFFER FROM ACTUAL COSTS WHICH MAY BE REFLECTED IN THE COMMUNITY BENEFIT REPORT AND ON THIS FORM. PART III, QUESTION 8 COSTING METHODOLOGY MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT OF $597,639. PART III, QUESTION 9B COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. PART V, SECTION B, QUESTION 11H BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. PART V, SECTION B, QUESTION 13G MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. PART V, SECTION B, QUESTION 19D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) PARTIAL CHARITY CARE, (3) SPECIAL CIRCUMSTANCES CHARITY CARE, (4) CATASTROPHIC CHARITY CARE, (5) HIGH COST MEDICAL CHARITY CARE, (6) UNINSURED PATIENT DISCOUNT, AND (7) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE. NEEDS ASSESSMENT PART VI, QUESTION 2 SUTTER MEDICAL FOUNDATION (SMF) UTILIZES THE SUTTER HEALTH SACRAMENTO SIERRA REGION (SHSSR) CHNA AS A TOOL TO GUIDE THEIR COMMUNITY BENEFIT EFFORTS. HOWEVER, SMF THAT SERVES SUTTER AND YUBA COUNTIES WAS NOT REQUIRED TO PARTICIPATE IN A CHNA, BUT THEY DO UTILIZE LOCAL PUBLIC HEALTH DATA AND COLLABORATE WITH OTHER ORGANIZATIONS TO ADDRESS THEIR COMMUNITIES' HEALTH NEEDS. SUTTER HEALTH SACRAMENTO SIERRA REGION (SHSSR) INCLUDES SUTTER AMADOR HOSPITAL (SAH), SUTTER AUBURN FAITH HOSPITAL (SAFH), SUTTER DAVIS HOSPITAL (SDH), SUTTER MEDICAL CENTER, SACRAMENTO (SMCS), SUTTER ROSEVILLE MEDICAL CENTER (SRMC), SUTTER SOLANO MEDICAL CENTER (SSMC), SUTTER MEDICAL FOUNDATION (SMF) AND SUTTER SURGICAL HOSPITAL NORTH VALLEY. EVERY THREE YEARS, SHSSR PARTNERS WITH KAISER PERMANENTE, UC DAVIS HEALTH SYSTEM, AND DIGNITY HEALTH TO CONDUCT A COMMUNITY NEEDS ASSESSMENT (CNA) TO HELP GUIDE OUR COMMUNITY BENEFIT PROGRAMS. WITH THIS VALUABLE INFORMATION, WE IDENTIFY PRIORITY NEEDS WE WANT TO ADDRESS IN OUR COMMUNITIES. OVER THE COURSE OF 2009, 15 FOCUS GROUPS WITH 134 COMMUNITY MEMBERS WERE CONDUCTED IN VARIOUS SETTINGS THROUGHOUT THE REGION. ANOTHER 12 COMMUNITY MEMBERS WERE INTERVIEWED VIA ONE-ON-ONE INTERVIEWS. ALL FOCUS GROUPS WITH COMMUNITY MEMBERS WERE RECORDED AND TRANSCRIBED, AND THOSE CONDUCTED IN LANGUAGES OTHER THAN ENGLISH WERE TRANSLATED. ALL TRANSCRIPTIONS WERE ANALYZED FOR COMMON THEMES AND RESULTS THAT ADDRESSED THE STUDY OBJECTIVES. A TOTAL OF 20 SERVICE PROVIDERS WERE INTERVIEWED AS WELL. THESE INCLUDED PUBLIC HEALTH EXPERTS, COUNTY PUBLIC HEALTH OFFICERS, HEALTH CARE AND SOCIAL SERVICE PRACTITIONERS, PHYSICIANS SERVING THE POOR AND UNINSURED, AND OTHER MEMBERS OF COMMUNITY-BASED ORGANIZATIONS ASSISTING THE UNINSURED. ADDITIONALLY, SECONDARY DATA FOR THE YEARS 2006, 2007 AND 2008 WERE COLLECTED AT THE ZIP CODE LEVEL. THE CNA IS AN IN-DEPTH STUDY OF THE GREATER SACRAMENTO REGION THAT IDENTIFIES HEALTH PRIORITIES, HEALTH DISPARITIES AND BARRIERS TO HEALTH CARE FOR VULNERABLE AND UNDERSERVED POPULATIONS. ALTHOUGH THE SHSSR COMMUNITY BENEFIT PRIORITY AREAS ARE DETERMINED FROM THIS PROCESS, WE ARE FOCUSED ON CREATING AND IMPROVING ACCESS TO PRIMARY AND MENTAL HEALTH CARE SERVICES MORE THAN EVER BECAUSE THE NEED IS MORE PRONOUNCED THAN EVER. WE ARE WORKING TO INCREASE ACCESS BY USING A BEST PRACTICE APPROACH, LOOKING AT 'THE WHOLE PERSON,' AND UTILIZING STRATEGIC COLLABORATIONS THAT VARY IN NATURE AND SCOPE FROM COUNTY TO COUNTY. THIS WAY, WE ARE ABLE TO USE PROGRAMS THAT MAY HAVE ORIGINATED IN ONE COUNTY, AND MODIFYING THEM TO WORK IN OTHER COUNTIES. BY INVESTING IN PROGRAMS THAT INCREASE ACCESS TO PREVENTATIVE CARE AND BY HELPING PEOPLE FIND A 'MEDICAL HOME,' WE ARE INVESTING IN THE HEALTH OF THE 'WHOLE PERSON' AND ENSURING THEIR ONGOING SUCCESS AND LONG-TERM SUSTAINABILITY OF OUR HEALTH CARE SYSTEM. SACRAMENTO SIERRA REGION'S PRIORITY NEEDS ARE: - ENSURING ACCESS TO PRIMARY CARE AND MENTAL HEALTH SERVICES - IMPROVING THE LIVES OF FAMILIES AND CHILDREN - CONNECTING WITH OUR SENIOR RESIDENTS - PREPARING OUR COMMUNITY FOR HEALTH FUTURES WE CREATED A PLATFORM AND TOOL TO MAKE THIS IMPORTANT HEALTH INFORMATION ACCESSIBLE TO OUR COMMUNITY PARTNERS AND THE GENERAL PUBLIC. LOG ON TO WWW.HEALTHYLIVINGMAP.COM AND LEARN ABOUT THE UNMET HEALTH NEEDS IN OUR REGION. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, QUESTION 3 SUTTER MEDICAL FOUNDATION FOLLOWS A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. FOR A MORE DETAILED LOOK AT OUR CHARITY CARE POLICIES BY REGION, PLEASE VISIT THE OFFICE OF STATEWIDE AND HEALTH PLANNING'S WEBSITE AT HTTP://SYFPHR.OSHPD.CA.GOV. COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS) B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION" B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS. 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. COMMUNITY INFORMATION PART VI, QUESTION 4 SUTTER MEDICAL FOUNDATION'S PRIMARY SERVICE AREA INCLUDES AMADOR COUNTY, PLACER COUNTY, SACRAMENTO COUNTY, SOLANO COUNTY, SUTTER COUNTY, YOLO COUNTY AND YUBA COUNTY. AMADOR COUNTY ACCORDING TO THE 2012 U.S. CENSUS BUREAU THE POPULATION OF AMADOR COUNTY IS 38,091 AND CONSISTED OF 54.5% MEN AND 45.5% WOMEN WITH A MEDIAN AGE OF 42.7 YEARS. THE POPULATION DENSITY WAS 63 PEOPLE PER SQUARE MILE IN 2010 WHICH IS FAR BELOW THAT OF THE CALIFORNIA STATE DENSITY OF 239.1. AMADOR'S POPULATION CONSISTS OF 87% WHITE RESIDENTS, 12.5% HISPANIC OR LATINO AND 2.5% BLACK NON-HISPANIC. THE MAJORITY OF RESIDENTS SPEAK ENGLISH AT HOME (92.4%) WHILE 5% SPEAK SPANISH. THE MEDIAN HOUSE HOLD SIZE IS 2.31 PEOPLE WITH A 2010 AVERAGE INCOME OF $54,758 AND A MEDIAN HOUSE VALUE OF $341,400. THE MAJORITY (87.4%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 19% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN AMADOR THE POVERTY LEVEL IN 2010 WAS AT 8% OF RESIDENTS, BELOW BOTH THE CALIFORNIA STATE LEVEL OF 13.7% AND THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 13.4% IN APRIL 2010 WHICH WAS ABOVE THE CALIFORNIA LEVEL OF 12.4% AS WELL AS THE FEDERAL LEVEL OF 9.9%. FOOD SUPPLIES ARE CONSISTENT WITH THE SIZE OF THE COUNTY WITH 12 GROCERY STORES AND 38 FULL SERVICE RESTAURANTS. IN 2010, HEALTH ISSUES IN THIS COUNTY INCLUDED 11.2% OF ADULTS BEING OBESE AND 5.8% OF ADULTS WITH DIABETES. IN 2007 THERE WERE 389 DEATHS AND OF THOSE THE THREE LEADING CAUSES WERE CANCER, HEART DISEASE AND ACCIDENTAL. IN 2007 THERE WERE 294 BIRTHS WITH ONLY 1 INFANT DEATH OCCURRING THAT YEAR. THE LIFE EXPECTANCY AT BIRTH IS 78.5 YEARS WHICH IS NEARLY THE SAME AS THE CALIFORNIA LIFE EXPECTANCY. IN 2009 27.9% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS ABOVE BOTH THE STATE LEVEL OF 18.5% AND FEDERAL LEVEL OF 15.5%. IN AMADOR COUNTY 51.6% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 10.5% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. PLACER COUNTY ACCORDING TO THE 2010 U.S. CENSUS BUREAU PLACER COUNTY HAD A POPULATION OF 348,342 AND CONSISTED OF 48.8% MEN AND 51.2% WOMEN WITH A MEDIAN AGE OF 38 YEARS. THE POPULATION DENSITY WAS 132.2 PEOPLE PER SQUARE MILE IN 2010 WHICH IS HALF THE CALIFORNIA STATE DENSITY OF 239.1 PEOPLE PER SQUARE MILE. PLACER'S POPULATION CONSISTS OF 83.5% WHITE RESIDENTS, 12.8% HISPANIC OR LATINO AND 5.9% ASIAN. THE MAJORITY OF RESIDENTS (89.4%) SPEAK ENGLISH AT HOME WHILE 5.9% SPEAK SPANISH AT HOME (7% OF WHICH DO NOT SPEAK ENGLISH AT ALL). THE MEDIAN HOUSE HOLD SIZE IS 2.58 PEOPLE WITH A 2010 AVERAGE INCOME OF $74,477 AND A MEDIAN HOUSE VALUE OF $427,600. NEARLY ALL (93%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 34.1% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN PLACER THE POVERTY LEVEL IN 2010 WAS AT 6.6% OF RESIDENTS, BELOW BOTH THE CALIFORNIA STATE LEVEL OF 13.7% AND THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 11.4% IN APRIL 2010 WHICH WAS BELOW THE CALIFORNIA LEVEL OF 12.4% YET ABOVE THE FEDERAL LEVEL OF 9.9%. FOOD SUPPLIES CONSIST OF 55 GROCERY STORES, 74 CONVENIENCE STORES (WITH GAS) AND 299 FULL SERVICE RESTAURANTS. IN 2010, HEALTH ISSUES IN THIS COUNTY INCLUDED 17.3% OF ADULTS BEING OBESE, 5.7% OF ADULTS WITH DIABETES AND 21.1% OF ADULTS WITH HIGH BLOOD PRESSURE. IN 2007 THERE WERE 2,502 DEATHS IN PLACER COUNTY AND OF THOSE THE THREE LEADING CAUSES WERE CANCER, HEART DISEASE AND STROKE. IN 2007 THERE WERE 4,054 BIRTHS AS WELL AS 23 INFANT DEATHS THAT SAME YEAR. IN 2008 THE LIFE EXPECTANCY AT BIRTH WAS 80.9 YEARS WHICH WAS RIGHT AT THE CALIFORNIA LIFE EXPECTANCY. IN 2010 15% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS AVERAGE WITH BOTH THE STATE LEVEL OF 18.5% AND THE FEDERAL LEVEL OF 15.5%. IN PLACER COUNTY 67.3% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 3.5% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. SACRAMENTO COUNTY ACCORDING TO THE 2010 U.S. CENSUS BUREAU SACRAMENTO COUNTY HAD A POPULATION OF 1,418,788 AND CONSISTED OF 49% MEN AND 51% WOMEN WITH A MEDIAN AGE OF 33.8 YEARS. THE POPULATION DENSITY WAS 1,470.8 PEOPLE PER SQUARE MILE IN 2010 WHICH IS NEARLY SIX TIMES THE CALIFORNIA STATE DENSITY OF 239.1 PEOPLE PER SQUARE MILE. SACRAMENTO'S POPULATION CONSISTS OF 57.5% WHITE RESIDENTS, 21.6% HISPANIC OR LATINO AND 14.3% ASIAN. THREE QUARTERS (75.6%) OF RESIDENTS SPEAK ENGLISH AT HOME AND 10% SPEAK SPANISH. THE MEDIAN HOUSE HOLD SIZE IS 2.69 PEOPLE WITH A 2010 AVERAGE INCOME OF $56,439 AND A MEDIAN HOUSE VALUE OF $324,200. A HIGH PERCENTAGE (85.1%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 27.8% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN SACRAMENTO THE POVERTY LEVEL IN 2010 WAS AT 13.9% OF RESIDENTS, RIGHT AT THE CALIFORNIA STATE LEVEL OF 13.7% AND JUST BELOW THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 12.4% IN APRIL 2010 WHICH WAS EXACTLY AT THE CALIFORNIA LEVEL OF 12.4% YET ABOVE THE FEDERAL LEVEL OF 9.9%. FOOD SUPPLIES CONSIST OF 255 GROCERY STORES, 10 SUPERCENTERS AND CLUB STORES, 233 CONVENIENCE STORES (WITH GAS) AND 922 FULL SERVICE RESTAURANTS. IN 2010, HEALTH ISSUES IN THIS COUNTY INCLUDED 20.8% OF ADULTS BEING OBESE, 6.4% OF ADULTS WITH DIABETES AND 25.3% OF ADULTS WITH HIGH BLOOD PRESSURE. IN 2007 THERE WERE 9,548 DEATHS IN SACRAMENTO COUNTY AND OF THOSE THE THREE LEADING CAUSES WERE CANCER, HEART DISEASE AND STROKE. IN 2007 THERE WERE 22,119 BIRTHS AS WELL AS 127 INFANT DEATHS THAT SAME YEAR. IN 2008 THE LIFE EXPECTANCY AT BIRTH WAS 78.4 YEARS WHICH WAS BELOW THE CALIFORNIA LIFE EXPECTANCY. IN 2010 17.6% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS BELOW THE STATE LEVEL OF 18.5% YET RIGHT ABOVE THE FEDERAL LEVEL OF 15.5%. IN SACRAMENTO COUNTY 56.7% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 17.6% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. COMMUNITY INFORMATION (CONTINUED) PART VI, QUESTION 4 SOLANO COUNTY ACCORDING TO THE 2010 U.S. CENSUS BUREAU SOLANO COUNTY HAD A POPULATION OF 413,344 AND CONSISTED OF 49.9% MEN AND 50.1% WOMEN WITH A MEDIAN AGE OF 33.9 YEARS. THE POPULATION DENSITY WAS 203 PEOPLE PER SQUARE MILE IN 2010 WHICH IS JUST UNDER THE CALIFORNIA STATE DENSITY OF 239.1 PEOPLE PER SQUARE MILE. SOLANO'S POPULATION CONSISTS OF 51% WHITE RESIDENTS, 24% HISPANIC OR LATINO, 14.6% ASIAN AND 14.7 BLACK NON-HISPANIC. THREE QUARTERS (75.4%) OF RESIDENTS SPEAK ENGLISH AT HOME WHITE 12.1% SPEAK SPANISH. THE MEDIAN HOUSE HOLD SIZE IS 2.86 PEOPLE WITH A 2010 AVERAGE INCOME OF $68,409 AND A MEDIAN HOUSE VALUE OF $389,800. A HIGH PERCENTAGE (85.8%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 24% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN SOLANO THE POVERTY LEVEL IN 2010 WAS AT 10.4% OF RESIDENTS, BELOW BOTH THE CALIFORNIA STATE LEVEL OF 13.7% AND THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 11.8% IN APRIL 2010 WHICH WAS BELOW THE CALIFORNIA LEVEL OF 12.4% YET ABOVE THE FEDERAL LEVEL OF 9.9%. FOOD SUPPLIES CONSIST OF 78 GROCERY STORES, 91 CONVENIENCE STORES (WITH GAS) AND 221 FULL SERVICE RESTAURANTS. IN 2010, HEALTH ISSUES IN THIS COUNTY INCLUDED 20.9% OF ADULTS BEING OBESE, 6.4% OF ADULTS WITH DIABETES AND 21.9% OF ADULTS WITH HIGH BLOOD PRESSURE. IN 2007 THERE WERE 2,774 DEATHS IN SOLANO COUNTY AND OF THOSE THE THREE LEADING CAUSES WERE CANCER, HEART DISEASE AND STROKE. IN 2007 THERE WERE 5,849 BIRTHS AS WELL AS 41 INFANT DEATHS THAT SAME YEAR. IN 2008 THE LIFE EXPECTANCY AT BIRTH WAS 78.5 YEARS WHICH WAS BELOW THE CALIFORNIA LIFE EXPECTANCY. IN 2010 20.3% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS ABOVE BOTH THE STATE LEVEL OF 18.5% AND THE FEDERAL LEVEL OF 15.5%. IN SOLANO COUNTY 53.9% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 15.7% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. SUTTER COUNTY ACCORDING TO THE 2010 U.S. CENSUS BUREAU SUTTER COUNTY HAD A POPULATION OF 94,737 AND CONSISTED OF 49.6% MEN AND 50.4% WOMEN WITH A MEDIAN AGE OF 34.1 YEARS. THE POPULATION DENSITY WAS 157.3 PEOPLE PER SQUARE MILE IN 2010 WHICH IS WELL BELOW THE CALIFORNIA STATE DENSITY OF 239.1 PEOPLE PER SQUARE MILE. SUTTER'S POPULATION CONSISTS OF 61% WHITE RESIDENTS, 28.8% HISPANIC OR LATINO, AND 14.4% ASIAN. A LITTLE OVER HALF (69.7%) OF RESIDENTS SPEAK ENGLISH AT HOME WHILE 17.7% SPEAK SPANISH (14% OF WHICH DO NOT SPEAK ENGLISH AT ALL) AND 10.9% SPEAK INDO-EUROPEAN. THE MEDIAN HOUSE HOLD SIZE IS 2.95 PEOPLE WITH A 2010 AVERAGE INCOME OF $50,944 AND A MEDIAN HOUSE VALUE OF $262,200. OVER THREE QUARTERS (78.4%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 18.7% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN SUTTER THE POVERTY LEVEL IN 2010 WAS AT 14.3% OF RESIDENTS, ABOVE THE CALIFORNIA STATE LEVEL OF 13.7% YET BELOW THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 21% IN APRIL 2010 WHICH WAS FAR ABOVE BOTH THE CALIFORNIA LEVEL OF 12.4% AND THE FEDERAL LEVEL OF 9.9%. FOOD SUPPLIES CONSIST OF 21 GROCERY STORES, 19 CONVENIENCE STORES (WITH GAS) AND 61 FULL SERVICE RESTAURANTS. IN 2008, HEALTH ISSUES IN THIS COUNTY INCLUDED 25.3% OF ADULTS BEING OBESE AND 7.9% OF ADULTS WITH DIABETES. IN 2007 THERE WERE 690 DEATHS IN SUTTER COUNTY AND OF THOSE THE THREE LEADING CAUSES WERE HEART DISEASE, CANCER AND STROKE. IN 2007 THERE WERE 1,497 BIRTHS AS WELL AS 9 INFANT DEATHS THAT SAME YEAR. IN 2008 THE LIFE EXPECTANCY AT BIRTH WAS 77.7 YEARS WHICH WAS RIGHT AT THE CALIFORNIA LIFE EXPECTANCY. IN 2010 22.8% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS ABOVE BOTH THE STATE LEVEL OF 18.5% AND THE FEDERAL LEVEL OF 15.5%. IN SUTTER COUNTY 47.1% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 24.4% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. YOLO COUNTY ACCORDING TO THE 2010 U.S. CENSUS BUREAU YOLO COUNTY HAD A POPULATION OF 200,849 AND CONSISTED OF 48.8% MEN AND 51.2% WOMEN WITH A MEDIAN AGE OF 29.5 YEARS. THE POPULATION DENSITY WAS 197.9 PEOPLE PER SQUARE MILE IN 2010 WHICH IS WELL BELOW THE CALIFORNIA STATE DENSITY OF 239.1 PEOPLE PER SQUARE MILE. YOLO'S POPULATION CONSISTS OF 63.2% WHITE RESIDENTS, 30.3% HISPANIC OR LATINO, AND 13% ASIAN. A LITTLE OVER HALF (67.9%) OF RESIDENTS SPEAK ENGLISH AT HOME WHILE 19.4% SPEAK SPANISH. THE MEDIAN HOUSE HOLD SIZE IS 2.7 PEOPLE WITH A 2010 AVERAGE INCOME OF $57,077 AND A MEDIAN HOUSE VALUE OF $391,300. A LARGE MAJORITY (84.3%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 37.8% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN YOLO THE POVERTY LEVEL IN 2010 WAS AT 17.1% OF RESIDENTS, ABOVE BOTH THE CALIFORNIA STATE LEVEL OF 13.7% AND THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 12.8% IN APRIL 2010 WHICH WAS ABOVE BOTH THE CALIFORNIA LEVEL OF 12.4% AND THE FEDERAL LEVEL OF 9.9%. . FOOD SUPPLIES CONSIST OF 40 GROCERY STORES, 40 CONVENIENCE STORES (WITH GAS) AND 123 FULL SERVICE RESTAURANTS. IN 2010, HEALTH ISSUES IN THIS COUNTY INCLUDED 13.9% OF ADULTS BEING OBESE AND 8.3% OF ADULTS WITH DIABETES. IN 2007 THERE WERE 1,111 DEATHS IN YOLO COUNTY AND OF THOSE THE THREE LEADING CAUSES WERE CANCER, HEART DISEASE AND STROKE. IN 2007 THERE WERE 2,522 BIRTHS AS WELL AS 12 INFANT DEATHS THAT SAME YEAR. IN 2008 THE LIFE EXPECTANCY AT BIRTH WAS 79.2 YEARS WHICH WAS RIGHT BELOW THE CALIFORNIA LIFE EXPECTANCY. IN 2010 20% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS ABOVE BOTH THE STATE LEVEL OF 18.5% AND THE FEDERAL LEVEL OF 15.5%. IN YOLO COUNTY 65.6% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 8.3% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. YUBA COUNTY ACCORDING TO THE 2011 U.S. CENSUS BUREAU YUBA COUNTY HAD A POPULATION OF 72,578 AND CONSISTED OF 50.4% MEN AND 49.6% WOMEN WITH A MEDIAN AGE OF 31 YEARS. THE POPULATION DENSITY WAS 114.2 PEOPLE PER SQUARE MILE IN 2010 WHICH IS WELL BELOW THE CALIFORNIA STATE DENSITY OF 239.1 PEOPLE PER SQUARE MILE. YUBA'S POPULATION CONSISTS OF 79.5% WHITE RESIDENTS, 25.9% HISPANIC OR LATINO, AND 7.2% ASIAN. A LITTLE OVER THREE QUARTERS (78.1%) OF RESIDENTS SPEAK ENGLISH AT HOME WHILE 13.1% SPEAK SPANISH. THE MEDIAN HOUSE HOLD SIZE IS 2.93 PEOPLE WITH A 2010 AVERAGE INCOME OF $46,807 AND A MEDIAN HOUSE VALUE OF $224,200. A LITTLE OVER THREE QUARTERS (76.9%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 12.5% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN YUBA THE POVERTY LEVEL IN 2010 WAS AT 20% OF RESIDENTS, ABOVE BOTH THE CALIFORNIA STATE LEVEL OF 13.7% AND THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 11.8% IN APRIL 2010 WHICH WAS BELOW THE CALIFORNIA LEVEL OF 12.4% YET ABOVE THE FEDERAL LEVEL OF 9.9%. . FOOD SUPPLIES CONSIST OF 13 GROCERY STORES, 15 CONVENIENCE STORES (WITH GAS) AND 29 FULL SERVICE RESTAURANTS. IN 2010, HEALTH ISSUES IN THIS COUNTY INCLUDED 27.4% OF ADULTS BEING OBESE AND 7.2% OF ADULTS WITH DIABETES. IN 2007 THERE WERE 551 DEATHS IN YUBA COUNTY AND OF THOSE THE THREE LEADING CAUSES WERE CANCER, HEART DISEASE AND STROKE. IN 2007 THERE WERE 1,351 BIRTHS OF WHICH 5 INFANT DEATHS OCCURRED. IN 2008 THE LIFE EXPECTANCY AT BIRTH WAS 75.5 YEARS WHICH WAS RIGHT BELOW THE CALIFORNIA LIFE EXPECTANCY. IN 2010 27.7% OF RESIDENTS WERE WITHOUT ANY HEALTH INSURANCE WHICH WAS ABOVE BOTH THE STATE LEVEL OF 18.5% AND THE FEDERAL LEVEL OF 15.5%. IN YUBA COUNTY 40.1% OF RESIDENTS HAVE EMPLOYMENT-BASED HEALTH INSURANCE WHILE 24.7% OF RESIDENTS ARE COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. PROMOTION OF COMMUNITY HEALTH PART VI, QUESTION 5 SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF AND IS RUN BY A COMMUNITY BOARD. A FEW HIGHLIGHTS OF SUTTER MEDICAL FOUNDATION'S (SMF) PROGRAMS IN 2011: SMF PARTNERS WITH THE SACRAMENTO PHYSICIANS' INITIATIVE TO REACH OUT, INNOVATE & TEACH (SPIRIT) PROGRAM TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY BE RECRUITING AND PLACING PHYSICIAN VOLUNTEERS THROUGHOUT OUR COMMUNITIES TO PROVIDE FREE MEDICAL SERVICES TO THE UNINSURED. SPIRIT ALSO COORDINATES SURGICAL SERVICES FOR THE UNINSURED INDIVIDUALS AT LOCAL HOSPITALS AND AMBULATORY SURGERY CENTERS. GIRLS ON THE RUN IS A LIFE CHANGING, EXPERIENTIAL LEARNING PROGRAM FOR GIRLS AGE EIGHT TO THIRTEEN YEARS OLD. THE PROGRAM COMBINES TRAINING FOR A 3.1 MILE RUNNING EVENT WITH SELF-ESTEEM ENHANCING, UPLIFTING WORKOUTS. THIS PROGRAM'S GOAL IS TO ENCOURAGE POSITIVE EMOTIONAL, SOCIAL, MENTAL, SPIRITUAL AS WELL AS PHYSICAL DEVELOPMENT. HOME CARE COMMUNITY SUPPORT ASSISTS INDIVIDUALS IN CONNECTING WITH SOCIAL SERVICES AND OTHER COMMUNITY RESOURCES TO OBTAIN ASSISTANCE WITH HEALTH RELATED OR SOCIAL ISSUES. THESE VISITS COULD INVOLVE CONNECTING THE INDIVIDUAL WITH SOCIAL SERVICES AND OTHER COMMUNITY RESOURCES RELATING TO COMMUNITY HEALTH SUCH AS MEDICAID OR NON-HEALTH RELATED ASSISTANCE SUCH AS AN AGENCY INVOLVING SOCIAL FAMILY PROBLEMS. RELAY FOR LIFE - AMERICAN CANCER SOCIETY CELEBRATES CANCER SURVIVORSHIP AND ASSISTS IN RAISING MONEY FOR RESEARCH AND PROGRAMS OF THE AMERICAN CANCER SOCIETY. THIS EVENT OFFERS PUBLIC HEALTH EDUCATION AS WELL AS HAS A DOCTOR ON SITE DURING THE EVENT. SMF PROVIDES SEVERAL SUPPORT GROUPS SUCH AS THE BREAST CANCER SUPPORT GROUP, PARKINSON'S SUPPORT GROUP AND ADULT GRIEF SUPPORT GROUP. THESE SUPPORT GROUPS ADDRESS SOCIAL, PSYCHOLOGICAL OR EMOTIONAL ISSUES RELATED TO SPECIFIC DIAGNOSES OR OCCURRENCES AND PROVIDES SUPPORT FOR PATIENTS AND THEIR FAMILIES. SMF OFFERS A CHILDHOOD OBESITY PROGRAMS TO HELP PREVENT, REDUCE AND EVENTUALLY ELIMINATE OBESITY IN CHILDREN. YUBA CITY UNIFIED SCHOOL DISTRICT WORKS WITH SMF ON THIS PROGRAM BY DISPLAYING MATERIALS AND SIGNAGE INTENDED TO ADDRESS THE PREVENTION AND REDUCTION OF CHILDHOOD OBESITY AND ALSO PARTICIPATES IN VARIOUS COMMUNITY EVENTS. THE CHILDREN'S SAFETY FAIR PRESENTS CHILDREN IN THE COMMUNITIES WITH EDUCATIONAL INFORMATION ABOUT DRUG, ALCOHOL AND TOBACCO USE AS WELL AS SAFETY TIPS ABOUT WATER, FIRE, TRAFFIC AND BICYCLES. COMMUNITY EDUCATION PROGRAMS OFFER HEALTH EXPERTISE TO THE COMMUNITY THROUGH PRESENTATIONS AND EVENTS WITH THE OBJECTIVE OF HELPING TO IMPROVE OVER-ALL HEALTH IN THE COMMUNITY. AFFILIATED HEALTH CARE SYSTEM PART VI, QUESTION 6 SUTTER MEDICAL FOUNDATION IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF 48,000 PHYSICIANS, EMPLOYEES, AND VOLUNTEERS WHO CARE FOR MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. IT'S BETTER FOR PATIENTS: WE BELIEVE THIS COMMUNITY-OWNED, NOT-FOR-PROFIT APPROACH TO HEALTH CARE BEST SERVES OUR PATIENTS AND OUR COMMUNITIES - FOR MULTIPLE REASONS. FIRST OF ALL, IT'S GOOD FOR PATIENTS. ACCORDING TO THE JOURNAL OF GENERAL INTERNAL MEDICINE (APRIL 2000), PATIENTS TREATED AT FOR-PROFIT OR GOVERNMENT-OWNED HOSPITALS WERE TWO-TO-FOUR TIMES MORE LIKELY TO SUFFER PREVENTABLE ADVERSE EVENTS THAN PATIENTS TREATED AT NOT-FOR-PROFIT INSTITUTIONS. OUR STOCKHOLDERS ARE OUR COMMUNITIES: INVESTOR-OWNED, FOR-PROFIT HEALTH SYSTEMS HAVE A FINANCIAL INCENTIVE TO AVOID CARING FOR UNINSURED AND UNDERINSURED PATIENTS. THEY ALSO HAVE A FINANCIAL INCENTIVE TO AVOID HARD-TO-SERVE POPULATIONS AND "UNDESIRABLE" GEOGRAPHIC AREAS SUCH AS RURAL AREAS. FOR MANY OF NORTHERN CALIFORNIA'S UNDERSERVED RURAL LOCALES, SUTTER HEALTH IS THE ONLY PROVIDER OF HOSPITAL AND EMERGENCY MEDICAL SERVICES IN THE COMMUNITY. PROVIDING CHARITY CARE AND SPECIAL PROGRAMS TO COMMUNITIES: OUR COMMUNITIES' SUPPORT HELPS US EXPAND SERVICES, INTRODUCE NEW PROGRAMS AND IMPROVE MEDICAL TECHNOLOGY. ACROSS OUR NETWORK, EVERY SUTTER HOSPITAL, PHYSICIAN ORGANIZATION AND CLINIC HAS A SPECIAL STORY TO TELL ABOUT FULFILLING VITAL COMMUNITY NEEDS. OUR COMMITMENT TO COMMUNITY BENEFIT: MEETING THE HEALTH CARE NEEDS OF OUR COMMUNITIES IS THE CORNERSTONE OF SUTTER HEALTH'S NOT-FOR-PROFIT MISSION. THIS INCLUDES DIRECTLY SERVING THOSE WHO CANNOT AFFORD TO PAY FOR HEALTH CARE AND SUPPORTING PROGRAMS AND SERVICES THAT HELP THOSE IN FINANCIAL NEED. SUTTER HEALTH NOW PROVIDES $2.7 MILLION IN CHARITY CARE PER WEEK. IN 2011, OUR NETWORK OF PHYSICIAN ORGANIZATIONS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS INVESTED A RECORD $756 MILLION IN BENEFITS TO THE POOR AND UNDERSERVED* AND THE BROADER COMMUNITY**. THIS INCLUDES: - THE COST OF PROVIDING CHARITY CARE - THE UNPAID COSTS OF PARTICIPATING IN MEDI-CAL - INVESTMENTS IN MEDICAL RESEARCH, HEALTH EDUCATION AND COMMUNITY-BASED PUBLIC BENEFIT PROGRAMS SUCH AS SCHOOL-BASED CLINICS AND PRENATAL CARE FOR PATIENTS. * SERVICES FOR THE POOR AND UNDERSERVED INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED, AS WELL AS THE COSTS OF PUBLIC PROGRAMS TREATING MEDI-CAL AND INDIGENT BENEFICIARIES. COSTS ARE COMPUTED BASED ON A RELATIONSHIP OF COSTS TO CHARGES. SERVICES FOR THE POOR AND UNDERSERVED ALSO INCLUDE THE COST OF OTHER SERVICES FOR INDIGENT POPULATIONS, AND CASH DONATIONS ON BEHALF OF THE POOR AND NEEDY. ** BENEFITS FOR THE BROADER COMMUNITY INCLUDE COSTS OF PROVIDING THE FOLLOWING SERVICES: HEALTH SCREENINGS AND OTHER HEALTH-RELATED SERVICES, TRAINING HEALTH PROFESSIONALS, EDUCATING THE COMMUNITY WITH VARIOUS SEMINARS AND CLASSES, THE COST OF PERFORMING MEDICAL RESEARCH AND THE COSTS ASSOCIATED WITH PROVIDING FREE CLINICS AND COMMUNITY SERVICES. BENEFITS FOR THE BROADER COMMUNITY ALSO INCLUDE CONTRIBUTIONS SUTTER HEALTH MAKES TO COMMUNITY AGENCIES TO FUND CHARITABLE ACTIVITIES. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, QUESTION 7 CALIFORNIA true SUTTER SOLANO CHARITABLE FOUNDATION 300 HOSPITAL DRIVE VALLEJO CA 94589 942668262 501(C)(3) 76228 PROGRAM SUPPORT YUBA CITY UNIFIED 750 PALORA AVE YUBA CITY CA 95991 946002768 87752 GENERAL SUPPORT CITY OF YUBA CITY 1201 CIVIC CENTER BLVD YUBA CITY CA 95993 946000460 20000 GENERAL SUPPORT MARCH OF DIMES 1755 CREEKSIDE OAKS SACRAMENTO CA 95833 131846366 501(C)(3) 10000 GENERAL SUPPORT 4 0 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS PART I, LINE 2 1. VARIOUS DEPARTMENTS OF THE HOSPITAL REQUEST FUNDING FROM THE FOUNDATION. 2. THE BOARD OF TRUSTEES AND THE EXECUTIVE DIRECTOR APPROVES THE HOSPITALS REQUEST. 3. THE APPROVAL IS SENT TO THE REQUESTING DEPARTMENT. 4. THE REQUESTING DEPARTMENT PROVIDES THE FOUNDATION A COPY OF THE INVOICE SUBSTANTIATING THE COSTS INCURRED. 5. THE FOUNDATION FORWARDS THE REQUEST FROM THE HOSPITAL, THE BOARD OF TRUSTEES MINUTES APPROVING THE FUNDING AND THE COPY OF THE INVOICE TO THE ACCOUNTANTS TO RELEASE THE FUNDS. THE SUTTER HEALTH SYSTEM HAS AN OVERLAP IN LEADERSHIP WHICH MONITORS THE USE OF GRANTS BETWEEN AFFILIATES. X X true true X X X X false true false false false false false true false CAROL APPENZELLER 0 222504 0 71467 0 691 0 26019 0 12249 0 332930 0 78126 TOM BLINN 0 1287983 0 279601 0 13376 0 289645 0 17763 0 1888368 0 279601 PAT FRY 0 1556049 0 1472283 0 16884 0 2163921 0 32168 0 5241305 0 1637694 SUSAN GOWER 0 247571 0 92298 0 4736 0 92316 0 13212 0 450133 0 100498 GLEN GROVES 0 226633 0 78467 0 3814 0 78451 0 12769 0 400134 0 87202 SARAH KREVANS 0 865473 0 633427 0 11318 0 716220 0 22510 0 2248948 0 706173 LESLIE PRATT 158326 0 18702 0 0 0 7240 0 14494 0 198762 0 0 0 ERIC RASMUSSEN 191785 0 21027 0 0 0 8704 0 19938 0 241454 0 0 0 JOHN RAY 0 378858 0 153991 0 11834 0 129637 0 14655 0 688975 0 232299 CHRIS ROGERS 0 161237 0 94217 0 210 0 27231 0 10411 0 293306 0 102942 THERESA RUIZ 0 156653 0 56528 0 142 0 57475 0 11585 0 282383 0 62951 JEFF SPRAGUE 0 444268 0 166139 0 802 0 194389 0 19747 0 825345 0 195075 PENNY WESTFALL 0 306520 0 85209 0 832 0 109405 0 10517 0 512483 0 100409 DAVID YAMAMOTO 0 275371 0 142376 0 9640 0 158559 0 18075 0 604021 0 142376 GARY ZUFELT 0 321936 0 99373 0 510 0 160593 0 18140 0 600552 0 106787 SUHEIR HADDAD 0 184270 0 20562 0 2805 0 71297 0 17959 0 296893 0 20562 KAREN GRIMMER 160822 0 18112 0 0 0 7318 0 12718 0 198970 0 0 0 ROSETTA LI 153617 0 17277 0 0 0 6990 0 19575 0 197459 0 0 0 PAMELA ADDY 153344 0 16602 0 0 0 6951 0 19050 0 195947 0 0 0 LISA BYNUM 145862 0 17464 0 0 0 6680 0 19578 0 189584 0 0 0 MICHAEL D MARINO 0 170066 0 46853 0 2528 0 62369 0 11626 0 293442 0 46853 RELEVANT INFORMATION REGARDING COMPENSATION ITEMS PART I, QUESTION 1A FIRST-CLASS TRAVEL: CERTAIN OFFICERS AND KEY EMPLOYEES OF SUTTER HEALTH MAY UPGRADE TO FIRST-CLASS TRAVEL FOR FLIGHTS GREATER THAN FOUR HOURS IN DURATION. TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY. SUPPLEMENTAL COMPENSATION INFORMATION PART I, QUESTION 3 THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. NONQUALIFIED RETIREMENT PLAN PART I, QUESTION 4B THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR EARNINGS BEYOND THE PENSION PAY CAP. THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. NON-FIXED PAYMENTS PART I, QUESTION 7 SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE. 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MISSION STATEMENT FORM 990, PART I, LINE 1 AND PART III, LINE 1 WE ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES. NEW SIGNIFICANT PROGRAM SERVICES FORM 990, PART III, LINE 2 PATIENT CENTERED MEDICAL HOME(PILOT); DERMATOLOGY: NOVEMBER 2011; ENDOCRINOLOGY: SEPTEMBER 2011. EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINE 4A SUTTER MEDICAL FOUNDATION (SMF) IS A COMMUNITY BASED, NOT-FOR-PROFIT MEDICAL ORGANIZATION SERVING NORTHERN CALIFORNIA COMMUNITIES AND SUPPORTING THE FOLLOWING CHARITABLE ORGANIZATIONS: SUTTER MEDICAL CENTER OF SACRAMENTO, SUTTER AUBURN FAITH HOSPITAL, SUTTER DAVIS HOSPITAL, SUTTER ROSEVILLE MEDICAL CENTER, SUTTER SOLANO HOSPITAL AND SUTTER AMADOR HOSPITAL. WITH CARE CENTERS LOCATED IN SACRAMENTO, YOLO, SUTTER, YUBA, SOLANO, PLACER AND AMADOR COUNTIES WE DO OUR PART TO ENSURE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES. OUR MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH NOT FOR PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE. WE VALUE EXCELLENCE AND QUALITY, CARING AND COMPASSION, HONESTY AND INTEGRITY, TEAMWORK AND COMMUNITY. SUTTER MEDICAL FOUNDATION IS ALIGNED WITH PHYSICIANS AND MID-LEVEL PROVIDERS OF SUTTER MEDICAL GROUP AND SUTTER NORTH MEDICAL GROUP OFFERING PRIMARY CARE AND SPECIALTY CARE TO OUR PATIENTS. OFFERING A FULL RANGE OF MEDICAL SERVICES, SUTTER MEDICAL FOUNDATION PROVIDES AMBULATORY SURGERY, URGENT CARE CLINICS, HOME HEALTH, HOSPICE AND STATE OF THE ART IMAGING AND CARDIOLOGY TECHNOLOGY. IN ADDITION, WE OPERATE A RURAL HEALTH CLINIC IN THE COMMUNITY OF BROWNSVILLE, YUBA COUNTY. THE FOUNDATION PROVIDED MORE THAN $41 MILLION IN UNDER AND UNREIMBURSED PATIENT CARE ALONG WITH A VARIETY OF COMMUNITY HEALTH PROGRAMS. A TOTAL OF 3,958,385 PATIENTS WERE SERVED DURING THE YEAR. FOCUS ON CHILDHOOD OBESITY SUTTER MEDICAL FOUNDATION HAS PARTNERED WITH YUBA CITY UNIFIED SCHOOL DISTRICT TO ENHANCE THE PHYSICAL EDUCATION PROGRAMS FOR STUDENTS K-5. THE PARTNERSHIP INCLUDES DEDICATED TEACHING STAFF FOR PHYSICAL EDUCATION AND FAMILY EDUCATION PROGRAMS TO ASSIST PARENTS AND GUARDIANS IN MAKING HEALTHY CHOICES FOR THEIR FAMILIES. THE SUTTER HEALTH POWER KIDS TRAVEL NORTHERN CALIFORNIA EDUCATING YOUTH ABOUT THE IMPORTANCE OF PHYSICAL FITNESS AND NUTRITION. APPEARING AT HEALTH FAIRS, PARADES AND COMMUNITY EVENTS THE POWER KIDS ARE POPULAR EDUCATORS AMONG STUDENT PRE-SCHOOL THRU THIRD GRADE. SUPPORT GROUPS SUTTER MEDICAL FOUNDATION PROVIDES A VARIETY OF FREE SUPPORT GROUPS TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. PATIENTS CAN RECEIVE SUPPORT FOR DIABETES, CHILDBIRTH EDUCATION, AUTISM AND PARKINSON'S. SCHOOL BASED HEALTH CLINIC ON A MONTHLY BASIS SUTTER NORTH PROVIDERS ALTERNATE AS VOLUNTEERS AT SCHOOL BASED HEALTH CLINICS TO PROVIDE ACUTE MEDICAL CARE TO CHILDREN AT NO COST TO THEIR FAMILIES. SUTTER MEDICAL FOUNDATION MANAGES ALL OF THE FUNDS FOR THE SCHOOL BASED HEALTH CLINICS AND ALLOWS TIME FOR EMPLOYEES TO BECOME INVOLVED AS VOLUNTEERS. PINK OCTOBER & WOMEN'S HEALTH SCREENING DAY SUTTER MEDICAL FOUNDATION HOSTS WOMEN'S HEALTH SCREENING DAY ANNUALLY AND JOINS FORCES WITH THE YUBA-SUTTER PINK OCTOBER COMMITTEE TO INCREASE AWARENESS OF EARLY DETECTION OF BREAST CANCER. WOMEN'S HEALTH SCREENING DAY PROVIDES RECTAL, CLINICAL BREAST, PAP AND BONE DENSITY SCREENINGS AT A FREE OR MINIMAL COST TO WOMEN WHO EITHER ARE UNDER OR NOT INSURED. SEVEN PROVIDERS OF SUTTER NORTH MEDICAL GROUP, IN YUBA CITY AND THE RURAL COMMUNITY OF BROWNSVILLE, DONATE THEIR TIME TO THE WOMEN'S HEALTH SCREENING DAY AND MORE THAN 120 WOMEN RECEIVED THE SERVICE. IN ADDITION, SUTTER MEDICAL FOUNDATION PROVIDED MORE THAN 200 MAMMOGRAMS FOR UNDER AND NON INSURED WOMEN. THE SCREENING FEE FOR THE WOMEN WAS A MINIMAL $30 COST PER PATIENT. PROSTATE SCREENING FOR MEN IN SEPTEMBER 2011, SUTTER NORTH MEDICAL FOUNDATION HOSTED A PROSTATE-SCREENING DAY FOR THE NON-INSURED AND UNDER-INSURED MEN. THE SCREENINGS ARE HELD AT OUR YUBA CITY CAMPUS WITH PROVIDERS DONATING THEIR TIME. THE SCREENING INCLUDED AN EDUCATIONAL CAMPAIGN AROUND THE IMPORTANCE OF REGULAR EXAMS AND SCREENINGS. MORE THAN 100 EXAMS WERE PROVIDED FOR THE LOW COST FEE OF $15. 2011 COMMUNITY SPONSORED EVENTS IN 2011, SUTTER MEDICAL FOUNDATION DONATED TO SEVERAL VARIOUS COMMUNITY EVENTS. WE MAKE IT OUR POLICY TO SUPPORT LOCAL AND NATIONAL NOT-FOR-PROFIT ORGANIZATIONS AND PUBLIC INSTITUTIONS IN NEED OF ASSISTANCE. MOREOVER, OUR EMPLOYEES MAKE EVERY EFFORT TO DONATE THEIR TIME TO LOCAL CAUSES AND YOU WILL FIND MANAGEMENT, PROVIDERS AND STAFF VOLUNTEERING WITH THE AMERICAN CANCER SOCIETY, UNITED WAY, MARCH OF DIMES, NATIONAL DIABETES SOCIETY, AMERICAN HEART ASSOCIATION, KIWANIS, ROTARY, SOROPTIMIST, GIRLS ON THE RUN, CHAMBER OF COMMERCE AND IN COMMUNITY SCHOOLS AND RELIGIOUS ORGANIZATIONS. TATTOO REMOVAL PROGRAM THE TATTOO REMOVAL PROGRAM (TATS OFF) REMOVES VISIBLE GANG TATTOOS FROM THE FACE, NECK, HANDS OR WRISTS (AND ANKLES FOR WOMEN), ELIMINATING THE STIGMA OF A PAST LIFESTYLE. IT NORMALLY TAKES FROM THREE TO TEN LASER TREATMENTS TO COMPLETE THE REMOVAL OF EACH DESIGN. THESE SESSIONS ARE SCHEDULED ONE MONTH APART TO FACILITATE PROPER HEALING BEFORE THE NEXT TREATMENT. THE OBJECTIVE IS TO MAKE IT EASIER FOR PEOPLE TO BEGIN A NEW LIFE, OBTAIN EMPLOYMENT AND ESCAPE BEING NEGATIVELY AND INACCURATELY STEREOTYPED. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTIONS 6 & 7A THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990 FORM 990, PART VI, QUESTION 11B SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12 EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, QUESTION 15 THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY LEADERS OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATION FORM 990, PART VII THE FOLLOWING BOARD MEMBERS OF THE ORGANIZATION ARE FULL-TIME EMPLOYEES (40 HOURS PER WEEK) OF SUTTER HEALTH AND THEIR SUTTER HEALTH SALARIES ARE REPORTED HEREIN. THESE INDIVIDUALS RECEIVE NO COMPENSATION FOR THEIR SERVICE AS BOARD MEMBERS OF THIS ORGANIZATION. SARAH KREVANS PAT FRY JEFF SPRAGUE PENNY WESTFALL OTHER CHANGES IN FUND BALANCE FORM 990, PART XI, LINE 5 GAIN/(LOSS) ON HEALTH CARE INVESTMENTS $ 13,875,492 K-1 ORDINARY INCOME (13,258,697) K-1 OTHER RENTAL INCOME (18) K-1 GUARANTEED PAYMENTS (130,903) K-1 INTEREST INCOME (568) K-1 LONG-TERM CAPITAL GAIN (201,258) K-1 SECTION 1231 GAIN (15,482) CHANGE IN UNREALIZED GAIN/(LOSS) (20,697) CHANGE IN SPLIT INTEREST (160) EQUITY TRANSFERS (NET) (2,100,230) STOCK PAID IN SURPLUS (666,121) OTHER CHANGES IN FUND BALANCE (2,512) ------------- (2,521,154) ============= SCHEDULE K SUPPLEMENTAL INFORMATION SCHEDULE K, PART VI GLOBAL DISCLOSURE PART I, COLUMN (E): THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO CERTAIN SUBSIDIARY ORGANIZATIONS. THE OUTSTANDING BOND LIABILITY ALLOCATED TO THIS ORGANIZATION IS REPORTED ON FORM 990, PART X, BALANCE SHEET. WITH THE EXCEPTION OF PART I(F), THE SCHEDULE K FOR THIS ORGANIZATION IS REPORTING INFORMATION FOR THE ENTIRE BOND ISSUE. PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. SMF SPECIFIC PART I, COLUMN (E): THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNTS OF: $16,846,004 FROM THE 2003AB ISSUE, $11,483,497 FROM THE 2004CD ISSUE AND $15,965,405 FROM THE 2008A ISSUE. PART I, LINE A, COLUMN (F): THE INITIAL BONDS ISSUED IN 2003 WERE NEW MONEY BONDS THAT WERE RETIRED AND REISSUED ON MAY 1, 2007. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE ORIGINAL "NEW MONEY" BONDS. PART I, LINE B, COLUMN (F): THE INITIAL BONDS ISSUED IN 2004 WERE NEW MONEY BONDS THAT WERE RETIRED AND REISSUED ON MAY 6, 2008. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE ORIGINAL "NEW MONEY" BONDS. PART I, LINE C, COLUMN (F): THE REFUNDING OCCURRED VIA THE REPAYMENT OF A DRAW ON A TAXABLE LINE OF CREDIT, DRAWN IN SEVERAL INSTALLMENTS BETWEEN APRIL 7 AND APRIL 11, 2008, USED TO REFUND THE 2004 ISSUE. THE REFUNDED BONDS ISSUED IN 2004 WERE USED FOR EXPANSION. 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