2012-05-01T20:06:22-04:00 2011-06-30 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2010-07-01 941156295 Saint Francis Memorial Hospital SAIN 4153536600 900 Hyde Street San Francisco CA 94109 ALAN FOX 2012-05-01 4159635100 2010 2016-02-24 21:20:13Z Alan Fox 900 Hyde Street San Francisco CA 94109 250064087 false X WWW.CHWHEALTH.ORG X 1938 CA To provide compassionate, quality, cost effective medical and healthcare related services to meet the needs of the communities we serve. 19 12 1161 332 501840 0 963108 525044 188941500 216409062 4270604 6057495 1304547 1315164 195479759 224306765 95467 659485 0 0 115681638 121790325 0 0 0 82222637 100764534 197999742 223214344 -2519983 1092421 323138980 343759229 82547616 83278794 240591364 260480435 TO PROVIDE COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES FOR OUR SISTERS AND BROTHERS WHO ARE POOR AND DISENFRANCHISED; AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. false false 204981444 659485 215907222 Saint Francis Memorial Hospital's mission is to contribute to the health of the community through the provision of quality services delivered in a compassionate and cost effective manner. The hospital has 356 beds and serviced patients as follows: outpatient visits of 133,820; emergency visits of 32,950; and inpatient and outpatient operating room cases of 3,359. Inpatient services: acute medical/surgical care and rehab, intensive and burn care, adult psych, skilled nursing facility, pharmacy, cardiopulmonary, surgery and telemetry unit. Outpatient services: emergency care, sports medicine and occupational health clinics, pulmonary rehab, psych day care, outpatient burn care, spine and joint center, diagnostic imaging, radiation oncology, retail pharmacy, gastrointestinal services and physical therapy services. Support services: chaplaincy program, family support services, palliative care, parking services, nursing education services, health sciences library; as well as support, time and money to organizations and individuals throughout the community. 204981444 true true false true false false false false true true false true true true false false true false false false false false false false false true true true false true true true false false false false false false false false true false false false false false true false false false false true 227 0 true 1161 true true true false false false false false false false false false X 19 12 true false false false true true true true true false false false true true true true true false false false CA X LARA HARROW - FINANCE DEPT 9168512000 3400 DATA DRIVE 3RD FLOOR RANCHO CORDOVA CA 95670 X Jane Bachmann 3.0 X 0 0 0 Dr Mel Blaustein 3.0 X 122916 0 0 Dr Amy Bossen 3.0 X 10000 0 0 Carrie Byles 3.0 X 0 0 0 Dr Gary Chan 3.0 X 1266 0 0 Anna Cheung 3.0 X 0 518723 64965 Dr Issa Eshima 3.0 X 0 0 0 Robert Eves 3.0 X 0 0 0 William G Gaede 3.0 X 0 0 0 Dr Guido J Gores 3.0 X 0 0 0 Mary Kane RN JD 3.0 X 0 0 0 Dr Frank Malin 3.0 X 0 0 0 Dr David J Malone 3.0 X 16225 0 0 Dr Victor Prieto 3.0 X 192579 0 0 Julie Soo JD 3.0 X 0 0 0 Dr Peter Teng 3.0 X 0 0 0 Wendy Xa 3.0 X 0 0 0 Susan Campbell 8.0 X X 0 0 0 Dr Clement Jones 3.0 X X 0 0 0 Alan Fox 40.0 X 326191 0 48370 Tom Hennessy 40.0 X 0 789687 74790 Anthony Jackson 40.0 X 288881 0 39401 Helen Karow 40.0 X 200847 0 36016 Dennis Kneeppel 40.0 X 286953 0 31448 Juli Maxworthy 40.0 X 184744 0 35422 Raymond Miller 40.0 X 195541 0 27179 Barbara Morrissette 40.0 X 191544 0 26566 Dallas Ryan 40.0 X 207586 0 33725 Andrew Smith 40.0 X 281912 0 23410 Lloyd Yandell 40.0 X 158399 0 17167 Abbie Yant 40.0 X 189098 0 39082 Susanne Gardino 40.0 X 241458 0 17944 Harendra C Joshi 40.0 X 245778 0 20915 Bradford K Moy 30.0 X 261781 0 22989 John Ikona Ubi 40.0 X 270260 0 45041 Doris Y Yau 20.0 X 299556 0 48057 4173515 1308410 652487 381 false true false CITY BUILDING INC PIER 26 ANNEX NORTH SAN FRANCISCO CA 94105 Construction Service 7696575 REHABCARE GRP INC 7733 FORSYTH BLVD SUITE 2300 ST LOUIS MO 631502096 Therapy 2055580 GALEN INPATIENT PHYSICIANS 2100 POWELL ST STE 900 EMERYVILLE CA 946081803 Medical Services 1860696 CITY PARK 1234 PINE ST SAN FRANCISCO CA 94109 Parking Services 737060 DIVERSIFIED CLINICAL SERVICES 4500 SALISBURY RD SUITE 300 JACKSONVILLE FL 32216 Management Services 616507 44 237464 287580 525044 PATIENT REV/CHARITY CARE 900099 166307120 166307120 MEDICARE / MEDICAID PAYMENTS 900099 46587565 46587565 MEDICAL OFF BLDGS 532000 2376649 2376649 PHARMACY 446110 7026 3443 3583 LABORATORY 621500 524481 26224 498257 606221 606221 216409062 2544164 2544164 0 0 29227350 43303 25716243 41079 3511107 2224 3513331 3513331 0 0 0 CAFETERIA 900099 214530 214530 PARKING LOT FEES 812930 812871 812871 GIFT SHOPS 453220 47179 47179 240584 240584 1315164 224306765 215907222 501840 7372659 659485 659485 0 0 0 3154767 2978192 176575 0 93279846 87474454 5805392 6791780 6352490 439290 12360545 11561071 799474 6203387 5802154 401233 0 113715 113715 72759 72759 20511 20511 0 114435 114435 22969983 16066899 6903084 567536 18457 549079 4511478 4177505 333973 7747611 7721492 26119 0 3551394 3241832 309562 93630 55211 38419 0 117816 32777 85039 833947 833901 46 0 9326083 9020988 305095 915407 915407 BAD DEBT 14659101 14659101 MEDICAL SUPPLIES 21368015 21365576 2439 MEDI-CAL PROVIDER FEE 10173204 10173204 DUES & SUBSCRIPTIONS 239519 39478 200041 LICENSES & TAXES 447610 343669 103941 2920780 1488101 1432679 0 223214344 204981444 18232900 0 7877 7877 1877805 5964725 82502 34418 28072350 26486198 1189666 689262 2679044 2813976 5703424 9006391 259171913 158580092 99803905 100591821 93531964 105724420 68046443 74582141 22144000 17858000 323138980 343759229 19867344 19402313 4731 5456647 10000000 10000000 72664 17529 52602877 48402305 82547616 83278794 X 169771613 183124987 40309473 46841516 30510278 30513932 240591364 260480435 323138980 343759229 X 1092421 18796650 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 20511 20511 false PART II - B Lobbying expenditures paid by the Parent organization for annual membership dues where expenses are allocated to the hospital: American Hospital Association $2,382 Catholic Health Association $1,559 Hospital Association of So. Cal $16,570 ------- TOTAL $20,511 ======= 36206485 3654 5190056 5061472 36338723 33349590 6794 3252188 402087 36206485 0.16640 0.83360 true false 2094567 2094567 132800345 87694197 45106148 196844 171740 25104 93722767 70714155 23008612 30357390 30357390 100591821 UNCONSOLIDATED FOUNDATION 74582141 F 74582141 PREPAID PENSION EXPENSE 17858000 17858000 0 DUE TO RELATED PARTIES 46094699 PENSION LIABILITY 1676989 OTHER NON CURRENT LIABILITIES 534548 DEFERRED COMPENSATION 96069 48402305 Sch D, Part V, Line 4 The endowment funds are intended to be used to support the hospital's healthcare needs and other hospital program needs. true true X true X true X 500. true true true false true true 3497 3620156 0 3620156 0.01740 9859 44707650 29208687 15498963 0.07430 1872 4891636 0 4891636 0.02350 15228 53219442 29208687 24010755 0.11520 2070 1982618 43193 1939425 0.00930 806 413821 237818 176003 0.00080 33789 480148 0 480148 0.00230 0 0 0 0 0.00000 9191 782060 24850 757210 0.00360 45856 3658647 305861 3352786 0.01600 61084 56878089 29514548 27363541 0.13120 1 0 14500 0 14500 0.00010 1 0 14500 0 14500 0.00010 true 3414421 0 47218022 63455271 -16237249 X true true 1 1 Saint Francis Memorial Hospital

900 Hyde ST San Francisco CA 94109

X X X X Saint Francis Memorial Hospital 1 Schedule H, part I, Line 7, column (f) The amount of bad debt expense included on Form 990, Part IX, line 25, column (A) is $14,659,101 and has been subtracted for purposes of calculating the percentages in column (f). Schedule H, part I, Line 7 For purposes of calculating the amounts provided in the table, SFMH uses a cost accounting system that combines relative value units (RVU) and cost to charge ratios (CCR) to allocate costs to the patient level. The cost accounting system algorithm allocates total operating expenses to the procedure charge code level based upon an RVU for procedures that have been studied and assigned an RVU, or based upon a CCR for unstudied procedures that do not have an RVU assigned. When a CCR is used, the system calculates that CCR on a departmental specific basis at where the services were provided. The calculation is similar to the Worksheet 2 of Schedule H, Ratio of Patient Care Cost to Charges, except it is calculated on a departmental specific basis, not in the aggregate. The allocated procedure charge code level costs are then rolled up to the patient level based upon the billed procedure charge codes associated with those services provided to each specific patient. This is done for all patient segments including inpatient, outpatient, emergency department, private insurance, Medicaid, Medicare, uninsured and self pay. The cost accounting system is utilized to determine the unreimbursed cost of Medicaid and other means-tested government programs. The cost of charity care is calculated by applying the CCR derived from the cost accounting system on a per facility basis, to the charges incurred on patients that qualify for charity care at the respective facility. The actual cost is reported for other community benefit activities such as community health improvement services, community benefit operations, health professions education, subsidized health services, research and cash and in-kind donations. Schedule H, Part II - Community Building Activities Under work force development, we have Cristo Rey/Immaculate Conception Academy as part of our Mentoring Programs. Immaculate Conception Academy (ICA), is an all girls Catholic high school, which offers a college preparatory education in the Dominican tradition. As part of the Cristo Rey Network, ICA operates with a unique program of strong college prep curriculum partnered with a corporate work study component. Membership in the Cristo Rey Network allows ICA to open its doors to capable students desiring a faith based high school education but without adequate means to afford it. Saint Francis provides mentoring opportunities for up to 4 ICA students throughout the academic year. Schedule H, Part III, Line 4 The amount of the organization's bad debt at cost is determined by applying the CCR (see above) to patient charges that are deemed to be uncollectible. This amount represents the cost of services provided to patients who are unable or refuse to pay their bills and do not qualify for free or discounted care, government sponsored programs or other financial assistance, and are otherwise uninsured. Any portion of a patient bill remaining after applying financial, uninsured or other discounts or payments received on the account that are ultimately determined to be uncollectible are written off to bad debt. As noted in Part I, Line 3, SFMH provides free or discounted care to uninsured or under-insured individuals at or below 500% of the Federal Poverty Level. SFMH also provides patients options for prompt pay discounts, discounts for the medically indigent, and interest-free extended payment plans for patients who have demonstrated good faith and are cooperating in resolving their hospital bills. All accounts for eligible uninsured patients receive an automatic uninsured discount of 25% for patients seen. The expected patient payment amount on the patient's bill reflects this discount. SFMH makes every effort in determining if a patient qualifies for charity care upon admission. SFMH follows CHW's financial assistance policy. CHW's financial assistance policy is communicated to patients upon admission and is available in the languages primarily spoken in the community. It is also posted in various common areas of the hospital and is provided upon billing if eligibility is not previously determined. Eligibility is reevaluated as needed and amounts are classified as charity as soon as eligibility is known. CHW also utilizes a Payment Assistance Rank Ordering (PARO) scoring system to assist in determining if a patient may qualify for charity care even though they have not applied for it. PARO is a methodology that applies consistent screening and application standards to all patients utilizing historical data to develop a predictive model for healthcare financial assistance. In its development, special attention was paid to those socio-economic factors that might adversely affect those patients deserving the most attention. Other criteria are also utilized to ensure that no services that have qualified as charity are reported as bad debt. As such, SFMH does not believe that any amounts included in Part III, Line 2, are attributable to patients eligible under the organization's charity care policy. The following is an excerpt from CHW and its subordinate corporations' consolidated annual audited financial statements for the year ended June 30, 2011, related to accounts receivable and allowances for charity and doubtful accounts: Patient accounts receivable and net patient service revenue are reported at the net realizable amount from patients, third-party payors, and others for services rendered. SFMH manages its collection risk by regularly reviewing its accounts and contracts and by providing appropriate allowances. Reserves for charity and uncollectible amounts have been established and are netted against patient accounts receivable in the consolidated balance sheet. Schedule H, Part III, Line 8 SFMH prepares Medicare cost reports in a manner that comports with Provider Reimbursement Manual (PRM) 15-1, 2150ff and PRM 15-2, 1000ff. As such, the following language per the PRM 15-1 describes the computation of costs per the Medicare Cost Report: Total allowable costs of a provider are apportioned between program beneficiaries and other patients so that the share borne by the program is based upon actual services received by program beneficiaries. The ratio of covered beneficiary charges to total patient charges for the services of each ancillary department is applied to the cost of the department. Added to this amount is the cost of routine services for program beneficiaries, determined on the basis of a separate average cost per diem for all patients for general routine patient care areas. Another factor to be considered is a separate average cost per diem for intensive care unit, coronary care unit, and other special care inpatient hospital units. CHW believes that the entire Medicare shortfall of $429.3 million, as reported below in Part VI, Line 6, constitutes community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by CHW hospitals in order to continue treating the elderly in our communities. The hospitals provide care regardless of this shortfall and thereby relieve the federal government of the burden of paying the full cost for Medicare beneficiaries. This shortfall includes $16.2 million reported on Part III, Section B, Line 7, primarily for fee for service Medicare patients, as well as the unreimbursed portion of Medicare Managed Care and Medicare Capitated programs for SFMH. Schedule H, Part III, Line 9b SFMH ensures that patient accounts are processed fairly and consistently. SFMH follows CHW's collection policy. CHW's collection policy contains provisions that prohibit the collection of amounts due from patients who the organization knows qualify for charity care. Accounts with incorrect or incomplete demographic information are assigned to a collection agency if SFMH or the billing company retained by CHW is unable to obtain an updated address through skip tracing or other means. For patients who have an application pending for either government-sponsored financial assistance or for assistance under CHW's Patient Payment Assistance Policy, or where the patient is attempting in good faith to settle an outstanding bill with the facility via payment plans, SFMH will not knowingly send that patient's bill to an outside collection agency. Legal action will not be pursued to collect debts from patients who have qualified for charity or are cooperating in good faith to resolve their debt. SFMH does not impose wage garnishments or liens on primary residences. On self-pay accounts that do not meet the criteria noted above, the initial determination of assignment to a collection agency will vary depending on the nature of the account with the final decision being at the discretion of each hospital patient financial assistance department. Upon assignment of such a patient account to a collection agency, SFMH requires the agency to comply with the Fair Debt Collection Practices Act. Schedule H, Part VI, Line 2 - Needs Assessment In San Francisco since the late 1990's the Building a Healthier San Francisco Coalition (BHSF) made up of healthcare and health related organizations of which SFMH is a member, have worked together to produce the California state-mandated Community Needs Assessment for San Francisco. As a member of BHSF, Saint Francis Memorial Hospital has taken these assessment findings and through a process directed by the SFMH Board's Community Advisory Committee has set priorities for the SFMH Community Benefit Plan. In 2007, BHSF launched a new website HealthmattersinSF.org which is home to all of the data that is the basis for the San Francisco Community Needs Assessment. Following the launch of the website, a series of stakeholder meetings took place to support the process of setting citywide priorities for community benefit planning at a city level and then at the hospital level. These stakeholders coalesced to become the San Francisco Community Benefit Partnership of which SFMH is a member. Beginning in 2009, the Community Benefits Partnership defined a process for data assessment and priority setting that would create the 2010 San Francisco Community Needs Assessment. The end result of this new assessment process is Community vital Signs. Community Vital Signs The Community Benefit Partnership transformed the 4 priority areas from the 2007 assessment to 10 priority health goals for the 2010 San Francisco Community Needs Assessment. At a Community Stakeholder meeting on November 13, 2009, the Partnership hosted over 75 participants representing a cross-section of expertise in health and human services. These community stakeholders confirmed the relevance of the 10 health goals and planted the seeds for 10 affinity groups comprised of subject matter experts for each of the 10 health goals. The health goals were adopted by the San Francisco Health Commission on February 2, 2010, which now inform and guide the SFHM 2011 Community Benefit Report and the 2012 Community Benefit Plan. The 10 priority health goals are: 1. Increase Access to Quality Medical Care 2. Increase Physical Activity and Healthy Eating to Reduce Chronic Disease 3. Stop the Spread of Infectious Diseases 4. Improve Behavioral Health 5. Prevent and Detect Cancer 6. Raise Healthy Kids 7. Have a Safe and Healthy Place to Live 8. Improve Health and Health Care Access for Persons with Disabilities 9. Promote Healthy Aging 10. Eliminate Health Disparities On September 23, 2010, the San Francisco Community Benefit Partnership presented the dynamic 2010 Community Needs Assessment through the re-launch of Health Matters in San Francisco and introduction of Community Vital Signs and concept of Collaboration Centers. Community Vital Signs is the newest, most effective platform to provide current baseline for each indicator and their associated benchmarks, paving a clear and dynamic path forward in promoting the 10 priority health goals of San Francisco. It provides a central web-based location for: 1) Assessing health and health care needs; 2) Guiding health policy through collaboration; and 3) Evaluating impacts of health interventions. A.Community Needs Index Saint Francis Memorial Hospital also makes full use of the Community Needs Index (CNI), which analyzes the community needs of a specific geographic region by measuring barriers to health care including income, education, cultural, insurance, and housing. A numerical value is assigned to those areas of highest to lowest needs. These CNI scores correlate with data showing these communities also have rates of hospitalization for ambulatory care sensitive conditions. Residents in the communities with scores of "5" are more than twice likely to need inpatient care for preventable conditions than communities with a score of "1". Of the six identified zip codes in our catchment area, five of them rate as "highest needy." These zip codes include 94102 (Tenderloin), 94103 (SOMA), 94104 (Downtown), 94108 (Chinatown), and 94133 (North Beach), which allow further focus or refinement of our Community Benefit intervention for maximum and strategic impact. The CHW CNI findings are in alignment with the other health indicator data found on the Health Matters in SF website. B. Assets Assessment Following the development of the Community Vital Signs, participants in these meetings aided in identifying current assets in the form of programs and projects related to the goal and indicators. Subsequently, during this process, over 350 potential data indicators were identified to measure progress of the health goals. The Partnership then narrowed down the indicators to the 34 most relevant indicators that have current available data and benchmarks with additional research by BHSF and input during the Stakeholder Workshop on June 4, 2010. The Health Matters in SF website hosts a Collaboration Center for each health goal with the aim to continue and enhance the engagement of experts and community advocates, and health improvement process by participating in the Affinity Groups. BHSF is working with HCI to develop the web tools to enhance both individuals and organizations' ability to collaborate. C. Developing the Hospital's Implementation Plan (Community Benefit Report & Plan) At the November 2010 CAC meeting, the CAC conducted an exercise to identify existing institutional and community partner resources and categorizing them under each of the 10 health goals represented in Community Vital Signs. The exercise consisted of 3 rounds. In round 1, the CAC listed an inventory of all the programs within the scope of Saint Francis Memorial Hospital's Community Benefit program that are already being worked on to support each Community Vital Sign. In round 2, each member of the CAC voted for what they believed to be the top 3 goals to focus on by nominal group process voting. Finally in round 3, the results of the voting were announced and the Community Vital Sign indicator being used as a proxy to measure each goal was discussed in detail. As a result of the process, the CAC selected 6 of the 10 Community Vital Signs for the hospital's Community Benefit Plan focus. Community Vital Signs which Saint Francis Memorial Hospital chose not to address this year were: - Prevent and Detect Cancer: 2 votes - Raise Healthy Kids: 1 vote - Improve Health and Health Care Access for Persons with Disabilities: 0 Votes These needs were not selected because they are beyond the scope of the services offered by Saint Francis Memorial Hospital and they are already being addressed by other organizations in the community. Many of the services or programs directly address the needs of vulnerable populations in our community with Disproportionate Unmet Health Needs (DUHN). Communities with DUHN are defined as having a high prevalence or severity for a particular health concern to be addressed by a program activity, or community residents who face multiple health problems and who have limited access to timely, high quality health care. Our Community Benefit plan's services that address DUHNs include: Charity Care, Community Health Fairs, Dore Urgent Clinic, Emergency Department, Glide Health Services, Hep B Free, Homecoming Services Program, Navigator Program, Rally Visitation Services, and Recuperation Programs. Data used to validate this selection includes data from the Health Matters in SF website. At Saint Francis Memorial Hospital, some of our prominent Community Benefit programs serve to contain the growth of community health care costs. One example is the partnership with Glide Health Services, which enables timely access to health care and ensures the prevention of disease progression. D. Planning for the Uninsured/Underinsured Patient Population Saint Francis Memorial Hospital abides by the CHW Financial Assistance Policy that defines eligibility for Charity Care. Financial Counselors work directly with patients to assess whether they are eligible for government sponsored health programs. If the patient is eligible, the Financial Counselor will assist the patient with completing the application process. Patients that are making a good-faith effort to settle their bills may qualify for interest free, extended payment plans. This policy exceeds the California Hospital Association Voluntary Principles and Guidelines for Assisting Low-Income Uninsured Patients. Patient Financial Assistance notices, as required by local ordinance, are posted in four languages (Spanish, English, Russian and Chinese) in all registration areas. Financial Counselors are trained to enroll eligible patients into Healthy San Francisco. Healthy San Francisco provides a medical home and primary physician to uninsured residents of San Francisco. Although this is not an insurance program, Healthy San Francisco reinvents the health care safety net enabling the uninsured to access primary and preventative care. Through our partnership with Glide Health Services, Saint Francis Memorial Hospital provides outpa Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assistance Communication of the Financial Assistance Program to Patients and the Public: SFMH follows CHW's Financial Assistance Program. Information about patient financial assistance is available from SFMH, including a contact number for patients to call for information and assistance. The information is provided to patients at Emergency Registration, Hospital Admissions Registration and Outpatient Registration Points on the main campus and at offsite satellite clinics. Notices are posted in each of these areas as well. Written information is provided in the primary languages spoken by the populations served by the facility. At the point of registration, all patients receive brochures explaining the facility's charity care program and the availability of government sponsored programs. Uninsured patients receive copies of the charity care and Medicaid applications in addition to the brochure upon admission to the facility. It is SFMH's policy that at the time of patient billing, facilities provide to all uninsured patients the same billing information concerning services and charges provided to all other patients who receive care at SFMH facilities. If financial assistance eligibility is not determined prior to billing, initial billing statements to uninsured patients include a request to the patient to provide any insurance information that was valid for the dates of service billed, a statement informing patients without insurance coverage they may be eligible for a government sponsored program or facility funded charity care, instructions on how to apply for a government program or charity care and the provision of such applications. Any member of the SFMH staff or medical staff may make referral of patients for financial assistance. The patient or a family member, a close friend or associate of the patient may also make a request for financial assistance. Schedule H, Part VI, Line 4 - Community Information Saint Francis Memorial Hospital is the only hospital located in downtown San Francisco. Patients' accessing the hospital's services range from the city's richest to poorest residents. Our primary service area includes Downtown, Nob Hill, North Beach, the Waterfront and areas with disproportionate unmet health needs: the Tenderloin, Chinatown and South of Market Area (SOMA) communities. The City and County of San Francisco is a densely populated urban environment with a residential population of 805,235 and a daytime population over 1.2 million. The city embraces a diverse ethnic culture 48.5% Caucasian, 33.3% Asian, 6.1% African American, 15.1% Hispanic, 4.7% - two or more races, 0.4% Native Hawaiian/Pacific Islander, 0.5% American Indian/Alaska Native, 6.5% other. The population is highly educated with 85% high school graduates and 50% with a college degree. There are an estimated 73,000 persons without health insurance in San Francisco. The cost of living in San Francisco is one of the highest in the nation. The Tenderloin The Tenderloin is one of San Francisco's most densely populated and neediest neighborhoods. Approximately 28,991 residents live in the 94102 zip code. The residents of the Tenderloin speak many languages, are of many races and income levels. The neighborhood is home to many immigrant families, 27.3% of which are linguistically isolated. 43% of residents speak a language other than English at home. The Tenderloin is one of the city's most impoverished neighborhoods. It is also home to many of the city's non-profits that provide the resources and networks that individuals need to build new lives. The average median income of residents is only $22,351, with 24.5% of residents living below the federal poverty level. The Tenderloin is a very diverse community, 16.5% of residents are African American, 13.5% are Latino, 25% are Asian, and 0.4% are Native Hawaiian or Other Pacific Islander. The North of Market Community Benefit District was established in 2005 with the goal of providing consistent cleaning, beautification and safety services to the Tenderloin. These services are paid for by a tax on property owners. In 2009, the Tenderloin was deemed a National Historic District. Chinatown Established in the 1850's this neighborhood is one of the oldest Chinatowns in Northern California. Chinatown's architecture, restaurants and shopping make it one of the city's most popular tourist destinations. Chinatown is one of the city's most densely populated neighborhoods with 13,716 residents living in this small area. Since the neighborhood's birth in the 1800's it has been home to many immigrants. Today, 16% of its residents live below the poverty line. The median income of residents living in Chinatown is $31,542. A majority (58%) of residents living in this neighborhood are Asian or Pacific Islander. Only 1.3% of residents living in Chinatown are African American and 4.2% are Hispanic or Latino. 61% of residents speak a language other than English at home. South of Market Area South of Market Area (SOMA) is the fastest growing neighborhood in San Francisco with a population of 23,016 residents. Dozens of high rise condos and retail outlets are currently under development. This neighborhood exhibits high poverty rates, particularly for adults and seniors. There is a high near poverty rate among Children and in SOMA, unemployment and labor force non-participation continue to be issues for residents. 22.5% of SOMA residents live below the federal poverty line. SOMA is a very diverse neighborhood: 11.8% of residents are African American, 24.9% are Asian or Pacific Islander and 25.1% are Hispanic or Latino. 49% of SOMA residents speak a language other than English at home. The Transbay Terminal Replacement Project, along with many new residential high rises, is transforming the city's skyline and these neighborhood demographics. However, the neighborhood is still home to a number of single room occupancy hotels and poor persons. The community has been federally designated as a Medically Underserved Area/Population, given that 5 Federally Qualified Health Centers (FQHC) are located in the 94102, 94103 and 94133 zip codes. They are: Glide Health Services, Curry Senior Center, St. Anthony's Free Clinic, South of Market Health Center and North East Medical Services. Also in the community are non-FQHC clinics and Chinese Hospital. Schedule H, Part VI, Line 5 - Other Information The Hospital is governed by a Board of Trustees, the majority of whom reside within its primary service area and who are not employees, contractors or family members thereof. All surplus funds generated by SFMH are reinvested back into the organization to improve patient care and provide healthcare services to its community. SFMH has an open medical staff with privileges available to all qualified physicians in the area; In addition, SFMH furthers its exempt purpose by promoting the health of the community by exercising the following: - Operating an emergency room that is open to all persons regardless of ability to pay; - Partnering with Glide Health Clinic, an FQHC serving the underserved in the Tenderloin Neighborhood. - Engaging in the training and education of health care professionals; Schedule H, Part VI, Line 6 - Affiliated Health Care System SFMH is affiliated with CHW. Affiliates of CHW also promote the health of additional communities in Bakersfield, San Bernardino, San Francisco, San Andreas, and Grass Valley/Nevada City, California. These affiliates follow practices similar to those noted above in determining the unmet healthcare needs of their communities. Total unsponsored community benefit expense for CHW and its subordinate corporations for the year ended June 30, 2011, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 97,422 152,563,579 1.6% Unpaid Costs of Medicaid/Medi-Cal 1,035,601 444,972,896 4.7% Other Means-tested Programs 253,140 63,978,237 0.7% Community Services: Community Health Services 552,089 49,285,673 0.5% Health Professions Education 21,637 10,998,382 0.1% Subsidized Health Services 219,756 37,388,406 0.4% Donations 233,077 37,415,522 0.4% Community Building Activities 15,081 1,642,251 0.0% Community Benefit Operations 19,210 6,983,659 0.1% Total Community Services for the poor 1,060,850 143,713,893 1.5% Total Benefits for the Poor 2,447,013 805,228,605 8.5% Benefits for the Broader Community: Community Services: Community Health Services 2,004,902 23,003,029 0.2% Health Professions Education 52,255 65,128,468 0.7% Subsidized Health Services 124,290 11,026,699 0.1% Research 5,057 24,166,007 0.3% Donations 202,417 7,914,381 0.1% Community Building Activities 63,555 8,148,278 0.1% Community Benefit Operations 937 2,883,276 0.0% Total Benefits for the Broader Community 2,453,413 142,270,138 1.5% Total Community Benefits 3,562,475 571,626,794 10.0% Unpaid Costs of Medicare 1,109,062 429,356,656 4.5% Total Community Benefits including Cost of Medicare 6,009,488 1,376,855,399 14.5% Schedule H, Part I, line 7b, column (f) In January 2010, the State of California enacted legislation that provided for supplemental Medi-Cal payments to certain hospitals funded by a quality assurance fee paid by participating hospitals and matching federal funds ("the 2010 Hospital Fee Program"). The legislation covered the period of April 1, 2009 through December 31, 2010. The Centers for Medicare & Medicaid Services approved the 2010 Hospital Fee Program in its entirety in December 2010, and therefore all activity of the program was recognized during the year ended June 30, 2011. Quality assurance fees recognized during the year of $10.2 million are included in total community benefit expense related to unreimbursed Medicaid (Part I, line 7b, column b), and fee-for-service supplemental payments of $15.0 million recognized during the year are reflected under the Medicaid program as direct offsetting revenue (Part I, line 7b, column d). This net reduction in the cost of the Medicaid program is driving a large decrease in the overall cost of community benefit expense as a percent of total expenses when compared to prior years. The California Hospital Association created a private program, the California Health Foundation and Trust ("CHFT"), established for several purposes, including aggregating and distributing financial resources to support charitable activities at various hospitals and health systems in California. Upon approval of the legislation noted above in December 2010, SFMH recorded a pledge to a grant fund established by CHFT in the amount $0.5 million. The grant is reported under other benefits (Part I, line 7i, column c), as cash and in-kind contributions to community groups. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI CA, true Alisa Ann Ruch Burn Foundation 665 3rd St Ste 345 San Francisco CA 94107 237162017 501(c)(3) 7075 0 N/A N/A Quality of Life San Francisco Foundation Community Initiative 354 Pine St Ste 700 San Francisco CA 94104 943255070 501(c)(3) 8500 0 N/A N/A Social Health Glide Health Services 330 Ellis St San Francisco CA 94102 941156481 501(c)(3) 9370 0 N/A N/A Service for the Poor Hospital Council of Northern & Central California 1215 K St 800 Sacramento CA 95814 941533644 501(c)(6) 86887 0 N/A N/A Social Health ICA San Francisco Work Study 3625 24th St San Francisco CA 94110 264450576 501(c)(3) 14500 0 N/A N/A Educational Support California Health Foundation and Trust 1215 K Street Ste 800 Sacramento CA 94103 941489356 501(c)(3) 500387 0 N/A N/A Improve access to & betterment of healthcare 5 1 PART I, LINE 2 As a 501(c)(3) organization, we provide assistance to various charitable organizations to promote CHW's Mission. A designated Committee establishes and evaluates priorities and allocation of funds with emphasis on promotion of healthy communities and community collaboration. We do not monitor and report program outcomes. Spending is tracked on an ongoing basis to ensure that annual spending is within the budgeted amount. false true false false false false false false false Anna Cheung 0 311224 0 192045 0 15454 0 31950 0 33015 0 583688 0 0 Dr Victor Prieto 192579 0 0 0 0 0 0 0 0 0 192579 0 0 0 Alan Fox 234513 0 75094 0 16584 0 24996 0 23374 0 374561 0 0 0 Tom Hennessy 0 311577 0 252401 0 225709 0 36437 0 38353 0 864477 0 0 Anthony Jackson 214640 0 72531 0 1710 0 16897 0 22504 0 328282 0 0 0 Helen Karow 165012 0 35139 0 696 0 17330 0 18686 0 236863 0 0 0 Dennis Kneeppel 207137 0 70092 0 9724 0 23107 0 8341 0 318401 0 0 0 Juli Maxworthy 141866 0 34509 0 8369 0 15177 0 20245 0 220166 0 0 0 Raymond Miller 159528 0 33898 0 2115 0 10916 0 16263 0 222720 0 0 0 Barbara Morrissette 154005 0 36628 0 911 0 11046 0 15520 0 218110 0 0 0 Dallas Ryan 171053 0 35975 0 558 0 17969 0 15756 0 241311 0 0 0 Andrew Smith 211049 0 30000 0 40863 0 13748 0 9662 0 305322 0 0 0 Lloyd Yandell 134950 0 20456 0 2993 0 13572 0 3595 0 175566 0 0 0 Abbie Yant 151387 0 33908 0 3803 0 16672 0 22410 0 228180 0 0 0 Susanne Gardino 241158 0 300 0 0 0 17144 0 800 0 259402 0 0 0 Harendra C Joshi 239951 0 300 0 5527 0 13694 0 7221 0 266693 0 0 0 Bradford K Moy 226981 0 33887 0 913 0 14813 0 8176 0 284770 0 0 0 John Ikona Ubi 268635 0 1625 0 0 0 18685 0 26356 0 315301 0 0 0 Doris Y Yau 298192 0 1364 0 0 0 20309 0 27748 0 347613 0 0 0 PART I, LINE 3 Although the organization employs personnel, the Organization relied on a related organization, Catholic Healthcare West, that used one or more of the methods described in Schedule J, Part I, Line 3, to establish the Organization's Service Area Leader's compensation. See Schedule O disclosure for Form 990, Part VI, Section B, Line 15a for additional information. Schedule J, J-1 SFMH does not compensate directors, Dr. Mel Blaustein, Dr. Amy Bossen, Dr. Gary Chan, Dr. David J. Malone and Dr. Victor Prieto for their services as board members. All compensation and benefits reported represent compensation as Medical Directors of SFMH. PART I, LINE 4a The employees paid by the parent organization participate in a severance plan that provides market-standard compensation, ranging from payments of 6 months to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. The organization's non-contractual employees participate in a severance plan that provides fair compensation, ranging from payments of 2 weeks to 18 weeks of base compensation, depending on the employee's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. Severance for employees covered by collective bargaining agreements varies by agreement. PART I, LINE 4b Certain listed persons hired prior to June 30, 2006 are eligible to participate in the 2007 CHW Executive Deferred Compensation Plan, a nonqualified 457(f) plan that is subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is intended to provide a benefit approximating the difference, if any, between the benefit provided under the CHW Excess Benefit Plan and the benefit provided under the qualified benefit plan that substantially replaced the Excess Plan. No benefit will vest under the 457(f) plan before the later of the attainment of age 62 while employed or the completion of 15 years of service. Certain listed persons participate in the CHW Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the CHW retirement plan whose benefits are affected by the limitations imposed by Sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. No payments were made to any listed persons during 2010 pursuant to this plan. Certain listed persons participate in the CHW Key Employee Share Option Plan (KEYSOP), which was frozen in May 2002. The KEYSOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. No payments were made to any listed persons during 2010 pursuant to this plan. PART II, SUPPLEMENTAL DISCLOSURES The organization's executive compensation philosophy is designed to assist the organization in attracting and retaining the caliber of executives required to enable the organization to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities the organization serves, promoting employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Compensation and Benefits Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and the organization's commitment to serving the poor and disenfranchised in the communities it serves. CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITHY 521643828 13033FYE4 2005-11-10 200000000 NEW MONEY TO FINANCE CAPITAL Expen false false false 0 0 10092698 0 113606 0 0 0 0 9979093 0 0 2007 false false true true false true true true true 0.00604 0.00000 0.00604 true true true false false true false Schedule K, Part IV BOND A: CUSIP 13033FYE4 Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Saint Francis Memorial Hospital, as a separate entity, received $10 million of the $200 million of the CHFFA 2005HI pool bonds. Part III, Line 3a Although there are management or service contracts that may generate private use, we have policies and procedures in place that require such contract be in compliance with Revenue Procedure 97-13. Part III, Line 3b Although there are research agreements which may result in private use, we have policies and procedures in place that require such contract be in compliance with Revenue Procedure 2007-47. HADDAD LANZEROTTI MALIN et al Gores and Malin - BOD 80135 Payment for medical Services false HADDAD LANZEROTTI MALIN et al Gores and Malin - BOD 92160 LEASING false Form 990, PART VI - GOVERNANCE, MANAGEMENT, DISCLOSURE FORM 990, PART VI, SECTION A, LINE 2: Drs Malin and Gores are partners in a Medical Group practice. FORM 990, PART VI, SECTION A, LINE 6: The sole corporate member is Catholic Healthcare West, a 501(c)(3) exempt organization. FORM 990, PART VI, SECTION A, LINE 7a: CHW, as the sole corporate member, ratifies the selection of members and the CHW Board approves new Board members of the organization. FORM 990, PART VI, SECTION A, LINE 7b: Reserved rights of the corporate member include adoption of mission and philosophy statements, amendment or restatement of articles of incorporation and bylaws, dissolution of the corporation, acquisition of another corporation, creation of a new subsidiary, merger or consolidation with another corporation, participation as a general or limited partner in any venture, incurring long-term indebtedness in excess of normal operating requirements, ratification of board member appointments and dismissals, selection and removal of independent auditors, and transactions outside the ordinary course of business. FORM 990, PART VI, SECTION B, LINE 11A: The form 990 was reviewed by finance and accounting (regional CHW management and corporate tax department), which worked closely with an independent accounting firm engaged to review the return. The Board of Trustees has delegated the review of the Form 990 to the Finance Committee. Management provided the draft of the Form 990 to the Finance Committee before filing the return with the IRS for discussion at the committee meeting. The draft was complete except it excluded compensation information. Subsequent to its review, the Finance Committee reported back to the Board regarding its review and provided a draft to the Board of Trustees, again excluding compensation. FORM 990, PART VI, SECTION B, LINE 12c: The Organization has adopted CHW's Conflicts of Interest Policy. The Organization's Board is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the conflicts of interest policy, an annual conflict of interest disclosure statement, aimed at determining any family and business relationships and transactions, or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees and all management personnel whose responsibilities include business decisions which may give rise to conflicts of interest). Covered persons are also required to disclose real or potential conflicts at the time such conflicts arise. When an individual becomes a covered person and annually thereafter, each covered person is required to submit an updated disclosure statement and to sign a statement affirming that he/she: (1) has received a copy of the conflicts of interest policy; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflicts of interest disclosure statement. The completed questionnaires are reviewed by CHW's Legal Department and any persons with actual or potential conflicts are informed via written communication. The procedures for addressing any conflict of interest related to a proposed transaction include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the board; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the person with the conflict of interest is excluded from the discussion and approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) any conflicting issues arising during the course of a board meeting which cannot be resolved are to be referred to an independent committee of the Board of Directors; and (6) the transaction or action must be approved by a majority of disinterested persons. All conflicts of interest, whether resolved or unresolved, are reported in the Organization's Form 990. FORM 990, PART VI, SECTION B, LINE 15a: Although the organization employs personnel, the Service Area Leader is compensated by Catholic Healthcare West (CHW). For 2010, CHW's Compensation and Benefits department conducted an annual review and analysis to provide benchmarking data for the total compensation and benefits package of the Service Area Leader. Appropriate comparability data for similar jobs in peer companies (both taxable and tax-exempt) is obtained from independent third-party survey sources. FORM 990, PART VI, SECTION B, LINE 15b: For 2010, The parent organization's human resources department conducted an annual review and analysis to provide benchmarking data for the total compensation and benefits package of key executives. The compensation for these individuals was based on the qualification and experience of the candidates. Compensation is also reviewed annually as part of the merit increase process. FORM 990, PART VI, SECTION B, LINE 19: Federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection. The organization makes its financial statements available on its website and upon request. Form 990, PART XI, LINE 5 Change in unrealized gains in the amount OF $12,260,954. Interest in net assets of unconsolidated foundation in the amount of $6,535,696. Form 990, Part XII, Line 3b The organization's federal awards were included in CHW's consolidated OMB Circular A-133 audited Schedule of Federal Expenditures. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Anna Cheung TITLE:Board Member HOURS:40 Catholic Healthcare West 185 Berry Street San Francisco CA 94107 941196203 Hospital CA 501(c)(3) 3 NA false false false false false false false false false false false false false true true true false false NONE