2012-07-30T10:22:12-05:00 2011-09-30 DELOITTE TAX LLP 655 WEST BROADWAY SUITE 700 SAN DIEGO CA 921018590 990 2010-10-01 951934652 PRESBYTERIAN INTERCOMMUNITY HOSPITAL INC PRES 5626980811 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 MITCHELL THOMAS 5626980811 2012-07-27 1 DIANA J MCCUTCHEN 6192326500 2010 2016-02-24 21:20:13Z MITCHELL THOMAS 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 535072562 0 X N/A X 1954 CA TO PROVIDE QUALITY HEALTHCARE AND CONTRIBUTE TO THE COMMUNITY'S HEALTH AND WELL-BEING. 15 12 3082 830 139234 52047 1595087 2204568 392575409 444974620 13580533 15084659 2138979 3235462 409890008 465499309 739812 852252 0 0 193119748 212682689 0 0 0 181162804 202598224 375022364 416133165 34867644 49366144 848581314 905350088 409434369 493712181 439146945 411637907 X MISSION: WHY WE ARE HERE: WE PROVIDE HIGH QUALITY HEALTHCARE WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITIES IN AN ETHICAL, SAFE, AND FISCALLY PRUDENT MANNER IN RECOGNITION OF OUR CHARITABLE PURPOSE. VISION: WHERE WE WANT TO BE: WE WILL ACHIEVE EXCELLENCE IN EVERYTHING WE DO. VALUES: OUR PROMISE: OUR PATIENT'S SAFETY, WELL-BEING, AND MEDICAL CONDITION WILL BE OUR PRIMARY CONCERN AT ALL TIMES. WE WILL CONSISTENTLY DEMONSTRATE RESPECT AND COMPASSION FOR THE BELIEFS, SITUATION, AND NEEDS OF OUR PATIENTS AND CO-WORKERS. WE WILL STRIVE TO ANTICIPATE NEEDS AND RESPOND IN A TIMELY WAY TO MEET OR EXCEED THE EXPECTATIONS OF OTHERS. OUR ATTITUDE AND ACTIONS WILL REFLECT THE HIGHEST ETHICAL AND MORAL STANDARDS. WE WILL WORK TOGETHER WITHIN AND OUTSIDE THE ORGANIZATION TO SOLVE PROBLEMS AND PURSUE OPPORTUNITIES IN CREATIVE WAYS. WE WILL SERVE THE COMMUNITY WISELY THROUGH THE EFFICIENT AND PRUDENT USE OF OUR FINANCIAL RESOURCES. 0 0 257888806 376715 385268841 PATIENT CARE: PRESBYTERIAN INTERCOMMUNITY HOSPITAL (PIH) IS A 444-BED MEDICAL CENTER AND INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH SERVES MORE THAN 1.5 MILLION RESIDENTS IN LOS ANGELES, SAN BERNARDINO, AND ORANGE COUNTIES, AND INCLUDES A NETWORK OF PRIMARY CARE CLINICS, MOBILE HEALTH SERVICES, A RESIDENTIAL HOSPICE PROGRAM, AS WELL AS AN ADULT DAY HEALTH CARE CENTER. PIH IS SITUATED IN THE SOUTHEAST PORTION OF LOS ANGELES COUNTY WITHIN AN AREA REFERRED TO AS SERVICE PLANNING AREA 7 (SPA 7). APPROXIMATELY 73% OF ADMISSIONS CAME FROM NINE CITIES, WHICH COMPRISE PIH'S PRIMARY SERVICE AREA. PIH'S SECONDARY SERVICE AREAS INCLUDE ADDITIONAL CITIES IN SAN GABRIEL VALLEY AND NORTH ORANGE COUNTY. THE FOLLOWING IS A LIST OF PROGRAMS OFFERED THROUGH PIH DURING THE YEAR:A DAY AWAY ADULT DAY HEALTH CARE CENTERBLOOD DONOR CENTERCOMPREHENSIVE CANCER PROGRAMCAR SEAT PROGRAM (LOW-COST CAR SEATS)CARE FORCE ONE MOBILE HEALTH SERVICESCHAPLAINCY PROGRAMCOMMUNITY-BUILDING BY SENIOR LEADERSHIP & MANAGEMENTCOMMUNITY EDUCATION OUTREACH (BREAST HEALTH/CHILDBIRTH/DIABETES/HEART HEALTH)COMMUNITY HELPLINES (CANCER HELPLINE, COMMUNITY ADVICE NURSE, SOCIAL SERVICES HELPLINE) DISASTER READINESSDONATIONS TO COMMUNITY ORGANIZATIONS (FINANCIAL & IN-KIND)ED PHYSICIAN ON-CALL PROGRAM (EA PROGRAM)ENROLLMENT ASSISTANCE (MEDI-CAL ELIGIBILITY WORKERS & ENROLLMENT COORDINATORS)EXERCISE CLASSES / FALL PREVENTION PROGRAMFAMILY PRACTICE RESIDENCY PROGRAMFLU AND PNEUMONIA VACCINATION CLINICSHEALTH SCREENINGSHIGH-RISK INFANT FOLLOW-UP CLINICHOSPICE AND HOME HEALTHHOSPITALISTS / INTENSIVISTS (24/7)NOTARY SERVICESPARAMEDIC BASE STATION (INCLUDING STAFF TRAINING)PHYSICIAN/MEDICAL PROFESSIONAL EDUCATIONPURCHASED SERVICES & TRANSPORTATION FOR UNDERSERVED PATIENTS/FAMILIESRESEARCHSENIOR SERVICESSEXUAL ASSUALT RESPONSE TEAM (SART)STUDENT TRAINING (NURSING & ANCILLARY)SUPPORT GROUPSWHITTIER FIRST DAY CLINIC (LOCAL HOMELESS SHELTER)CHARITY CARE REFERS TO DOLLARS EXPENDED FOR THE PROVISION OF FREE OR DISCOUNTED CARE PROVIDED TO BOTH THE UNINSURED AND THE INSURED WHO LACK FINANCIAL RESOURCES AND MEET THE UNCOMPENSATED CARE PROGRAMS CRITERIA TO PAY FOR NEEDED HEALTHCARE SERVICES. RECOGNIZING ITS CHARITABLE MISSION, PIH OFFERS A GENEROUS UNCOMPENSATED CARE PROGRAM THAT EXCEEDS RECOMMENDED STANDARDS, PROVIDING CHARITY CARE TO ALL PATIENTS WHO APPLY AND QUALIFY WITH FAMILY INCOME(S) WITHIN 400% OF THE FEDERAL POVERTY GUIDELINES. ADDITIONALLY, UNDER THE PIH SELF-PAY PAYMENT PROGRAM, ALL CASH-PAY PATIENTS AND THOSE THAT HAVE LIMITED BENEFIT PLANS (ALL PATIENTS LACKING HEALTH INSURANCE) ARE AUTOMATICALLY GIVEN A BILL REDUCTION COMMENSURATE WITH OR LESS THAN THE NEGOTIATED REIMBURSEMENT RATES WITH A CONTRACTED HEALTHY FAMILIES PROGRAM PLAN; NO PRE-QUALIFICATION IS NECESSARY. EACH FISCAL YEAR, PIH REALIZES A NET LOSS DUE TO OFFERING CASH DISCOUNTS OFF OF ACTUAL HOSPITAL COSTS OF PROVIDING THIS CARE. THE DISCOUNTS PROVIDED BY THE SELF-PAY PAYMENT PROGRAM ARE ESPECIALLY OF BENEFIT TO THOSE IN THE PROCESS OF APPLYING FOR PIHS CHARITY CARE OR OTHER GOVERNMENT MEANS-TESTED PROGRAMS AND AWAITING ELIGIBILITY DETERMINATION. PIH ALSO REALIZES A NET LOSS EACH FISCAL YEAR IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN GOVERNMENT-SPONSORED MEANS-TESTED HEALTH PROGRAMS, SUCH AS MEDI-CAL, MEDI-CAL HMO, CCS, AND HEALTHY WAY LA. NUMBER OF PERSONS SERVED THROUGH CHARITY CARE & MEANS-TESTED PROGRAMS: 35,529.NUMBER OF PERSONS SERVED THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH & IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS: 53,229. FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH'S ANNUAL REPORT & PLAN FOR COMMUNITY BENEFIT REPORT AT WWW.PIH.NET. 91808996 58282832 CHARITY CARE REFERS TO DOLLARS EXPENDED TO THE PROVISION OF FREE OR DISCOUNTED CARE PROVIDED TO THOSE LACKING INSURANCE OR FINANCIAL RESOURCES TO PAY FOR NEEDED HEALTHCARE SERVICES. RECOGNIZING OUR CHARITABLE MISSION, PIH OFFERS A GENEROUS UNCOMPENSATED CARE PROGRAM PROVIDING CHARITY CARE TO ALL PATIENTS WITH FAMILY INCOME(S) WITHIN 400% OF THE FEDERAL POVERTY GUIDELINES. ADDITIONALLY, UNDER THE PIH CASH DISCOUNT PROGRAM, ALL CASH-PAY PATIENTS (ALL PATIENTS LACKING HEALTH INSURANCE) ARE OFFERED A BILL REDUCTION COMMENSURATE WITH THE DISCOUNTED REIMBURSEMENT RATE EXTENDED THROUGH THE GOVERNMENT-SPONSORED MEANS-TESTED HEALTHY FAMILIES PROGRAM; NO PRE-QUALIFICATION IS NECESSARY. EACH FISCAL YEAR, PIH REALIZES A NET LOSS DUE TO OFFERING CASH DISCOUNTS OFF OF ACTUAL HOSPITAL COSTS OF PROVIDING THIS CARE. THE DISCOUNTS PROVIDED BY THE CASH PAYMENT PROGRAM ARE ESPECIALLY OF BENEFIT TO THOSE IN THE PROCESS OF APPLYING FOR PIH'S CHARITY CARE OR OTHER GOVERNMENT MEANS-TESTED PROGRAM AND AWAITING ELIGIBILITY DETERMINATION. NUMBER OF PERSONS SERVED: 35,529. 20057068 475537 3999883 SUBSIDIZED HEALTH SERVICES, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, CONTRIBUTIONS TO COMMUNITY GROUPS, RESEARCH: IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN GOVERNMENT-SPONSORED MEANS-TESTED HEALTH PROGRAMS, SUCH AS MEDI-CAL, MEDI-CAL HMO AND HEALTHY FAMILIES, PIH REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR. NUMBER OF PERSONS SERVED: 53,229.FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH'S COMMUNITY BENEFIT REPORT AT WWW.PIH.NET. 369754870 1 1 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 244 0 1 3082 1 1 1 0 0 0 0 0 0 0 0 0 X 15 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X RONALD YOSHIHARA 5626980811 12102 WASHINGTON BLVD WHITTIER CA 90606 X EFRAIN ACEVES 1.50 X 0 0 0 DONALD ALVARADO 1.50 X X 0 0 0 RICHARD ATWOOD 1.50 X 0 0 0 PAULA COWAN 1.50 X 0 0 0 JANE DICUS 1.50 X X 0 0 0 LEON MN GARCIA 1.50 X 0 0 0 THOMAS KING 1.50 X 0 0 0 ANGEL MUNOZ 1.50 X 0 0 0 SUDHAKER NAYAK MD 1.50 X 191106 0 0 NORMA PROVENCIO 1.50 X 0 0 0 WILLIAM SHANAHAN MD 1.50 X 55000 0 0 NEAL SHINDEL MD 1.50 X 42012 24194 0 DREW SONES 1.50 X X 0 0 0 KENTON WOODS 1.50 X X 0 0 0 HUEY-MIN YU 1.50 X 0 0 0 JAMES WEST 40.00 X 885023 0 184410 MITCHELL THOMAS 40.00 X 520452 0 112615 PEGGY CHULACK 40.00 X 440143 0 66885 ROSALIO LOPEZ MD 40.00 X 530978 0 95031 REANNA THOMPSON 40.00 X 394473 0 59756 DAVE KLINGER 40.00 X 366152 0 59920 JOAN ROLLAND 40.00 X 170885 0 48212 JUDY PUGACH 40.00 X 183151 0 35497 LON OREY 40.00 X 348567 0 44720 PATRICIA BRAY 40.00 X 184012 0 32815 PERRY EBELTOFT 40.00 X 197719 0 42062 RAMONA PRATT 40.00 X 220667 0 39345 RONALD YOSHIHARA 40.00 X 266127 0 63988 ROWENA STAJER 40.00 X 217114 0 31094 SUSANNE CARLSON 40.00 X 253613 0 43481 MARVIN RICE 40.00 X 440960 0 99994 JUNG HO 40.00 X 225439 0 2430 CARMEN A CHANG 40.00 X 187710 0 1561 PHILIP B CHON 40.00 X 184110 0 2010 ALAN Y ENDO 40.00 X 182580 0 3011 ANNA KRUGER 40.00 X 173075 0 561 6861068 24194 1069398 267 0 1 0 MILLIE AND SEVERSON INC PO BOX 3601 LOS ALAMITOS CA 90720 CONSTRUCTION 24728560 ALLSCRIPTS (FORMERLY ECLIPSYS) 3 RAVINIA DRIVE SUITE B-150 ATLANTA GA 30346 IT SERVICES 10762498 WHITTIER PULM AND CRITC CARE 6905 ALTA VISTA DRIVE RANCHO PALOS VERDES CA 90275 MEDICAL SERVICES 5311065 LAMBERT RADIOL MED GRP INC 11721 WHITTIER BLVD 509 WHITTIER CA 90601 MEDICAL SERVICES 4635071 FAMILY PRACTICE RESIDENCY PROGRAM 12291 WASHINGTON BLVD WHITTIER CA 90606 MEDICAL SERVICES 3164360 75 2204568 2204568 NET PATIENT SERVICE RE 621610 405297234 405297234 HOSPITAL FEE PROGRAM 900099 27601129 27601129 OTHER PATIENT REVENUE 621610 12076257 12076257 444974620 9004803 9004803 75635109 18000 69555870 17383 6079239 617 6079856 6079856 COMMUNITY PHARMACY 624110 2586771 2576936 9835 PURCHASE DISCOUNTS 900099 537291 537291 NON-PATIENT LAB 621500 125323 125323 -13923 4076 -17999 3235462 465499309 447551556 139234 15603951 601102 601102 251150 251150 5427058 3934941 1492117 144966239 129681194 15285045 11796843 10026637 1770206 38750932 36389574 2361358 11741617 10432372 1309245 370219 370219 1502114 4287 1497827 53850 53850 50318 50318 48997600 42779593 6218007 5219496 3387479 1832017 19673508 15967976 3705532 7783111 6476465 1306646 475004 349350 125654 187623 30295 157328 10664380 8885149 1779231 16502054 13750287 2751767 3780695 998994 2781701 MEDICAL SUPPLIES 47358556 47036965 321591 0 HOSPITAL FEE PROGRAM 18574513 18574513 0 0 BAD DEBT 14195019 14195019 0 0 EQUIPMENT R&M 3966211 3792882 173329 0 EQUIPMENT LEASES 728967 720282 8685 0 2514986 1488364 1026622 416133165 369754870 46378295 0 2269947 8522455 6521483 6038 69675419 63298558 3431697 3307679 10649826 8710475 405509298 116205653 256432376 289303645 351404186 352866582 594192 594192 147602188 178740464 848581314 905350088 34496454 38628321 273946465 308097102 100991450 146986758 409434369 493712181 X 439146945 411637907 439146945 411637907 848581314 905350088 X 49366144 -76875182 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 50318 50318 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND AMERICAN HOSPITAL ASSOCIATION ARE RELATED TO LOBBYING. 214611 214611 187032997 44555746 142477251 98134089 66760589 31373500 120127601 4889318 115238283 289303645 DEFERRED FINANCING COSTS 3544563 DUE FROM AFFILIATES 164049712 OTHER RECEIVABLES 3729110 INVESTMENTS IN AFFILIATES 1113445 OTHER ASSET-HOSPITAL FEE PROGRAM 6303634 178740464 DEFERRED COMPENSATION 14047633 SELF INSURANCE TRUST 19697205 ACCRUED BOND INTEREST PAYABLE 1496675 DEFERRED INCOME-HOSP FEE PROGRAM 10011739 INTEREST RATE SWAP 49557301 INTERCO PAYABLE 840002 PENSION LIABILITY 51336203 146986758 465499309 416133165 49366144 -20815448 -56059734 -76875182 -27509038 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT, AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE COMPANY HAS NOT RECORDED A LIABILITY FOR UNRECOGNIZED TAX UNCERTAINTIES IN 2011 OR 2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION ADJUSTMENTS -16,444,669. NET UNREALIZED LOSSES ON INTEREST RATE SWAP -9,925,385. LOSS ON INSURANCE LITIGATION SETTLEMENT -650,000. EQUITY TRANSFER TO IHMC -29,039,680. 1 1 X 1 X 1 X 1 1 1 0 1 1 8107 23198308 7008980 16189328 0.04030 27159 66704942 50753201 15951741 0.03970 263 954672 520651 434021 0.00110 35529 90857922 58282832 32575090 0.08110 21 39459 4569321 66008 4503313 0.01120 5 624 3519378 816145 2703233 0.00670 5 11766 10857432 2977663 7879769 0.01960 1 20 86332 86332 0.00020 6 1360 1024605 140067 884538 0.00220 38 53229 20057068 3999883 16057185 0.03990 38 88758 110914990 62282715 48632275 0.12100 1 8532 8532 0.00000 1 15 36000 36000 0.00010 1 15 48781 48781 0.00010 3 30 93313 93313 0.00020 0 14195019 66236883 76706202 -10469319 X 1 1 1 1 PRESBYTERIAN INTERCOMMUNITY HOSPITAL

12401 WASHINGTON BLVD WHITTER CA 90602

X X X X SKILLED NURSING FACILITY NOT REQUIRED 1 11 SAME DAY SURGERY

12415 WASHINGTON BLVD WHITTER CA 90602

OUTPATIENT SURGICAL SERVICES INTERCOMMUNITY MAGNETIC RESONANCE IMAGIN

12455 WASHINGTON BLVD WHITTER CA 90602

MRI SERVICES ERNEST D WELLS MEDICAL OFFICE BUILDING

12462 PUTNAM ST WHITTER CA 90602

OUTPATIENT SERVICES PATRICIA L SCHEIFLY BREAST HEALTH CTR

12393 WASHINGTON BLVD WHITTER CA 90602

SVCS PRESBYTERIAN HEALTH MEDICAL PLAZA

12291 WASHINGTON BLVD WHITTER CA 90602

WOUND HEALING, LAB DRAW STATION ARCADIA HOME HEALTH NURSING

351 E FOOTHILL BLVD SUITE 100 ARCADIA CA 91006

VISITING NURSES ASSOCIATION HOSPICE HOMES - DOVE

10736 VALLEY VIEW AVE WHITTER CA 90604

HOSPICE CARE HOSPICE HOMES - ROSE

10742 VALLEY VIEW AVE WHITTER CA 90604

HOSPICE CARE PIH HOME HEALTH

15050 IMPERIAL HWY LA MIRADA CA 90638

HOME HEALTH AGENCY PRESBYTERIAN HEALTH MEDICAL PLAZA

15088 IMPERIAL HWY LA MIRADA CA 90638

OUTPATIENT THERAPY BHP - LA MIRADA

12675 S LA MIRADA BLVD SUITE 219 LA MIRADA CA 90638

RADIOLOGY PART I, LINE 6A: PIH FILES ITS COMMUNITY BENEFIT REPORT WITH THE STATE OF CALIFORNIA IN FULFILLMENT OF ITS MANDATED REPORTING REQUIREMENT, AS STIPULATED BY CALIFORNIA SENATE BILL 697 (SB 697). THIS ANNUAL REPORT & PLAN FOR COMMUNITY BENEFIT IS SUBMITTED TO OFFICE OF STATEWIDE HEALTH PLANNING & DEVELOPMENT (OSHPD), HEALTHCARE INFORMATION DIVISION, AND IS ALSO WIDELY DISTRIBUTED THROUGHOUT THE COMMUNITY, AS WELL AS BEING POSTED TO PIH'S WEBSITE: WWW.PIH.NET. PART I, LINE 7: THE COST SYSTEM IS BASED ON THE COST-TO-CHARGE ("C2C") METHODOLOGY, SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTEMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT-SPECIFIC PERCENTAGE, E.G. DEPARTMENT C2C%, IS LOADED INTO PIH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. ALL COST INFORMATION REFLECTED IN PIH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THIS DEPARTMENT-LEVEL C2C METHODOLOGY. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 14195019. PART II: PIH WORKS WITH A VARIETY OF COMMUNITY STAKEHOLDERS TO ENHANCE OUR COLLECTIVE CAPACITY TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. MEMBERS OF PIH'S MANAGEMENT TEAM, IN ADDITION TO DESIGNATED COMMUNITY BENEFIT STAFF, ACTIVELY ENGAGE KEY COMMUNITY STAKEHOLDERS THROUGH SERVICE ON THE HOSPITAL'S COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC). THE CBOC IS ACCOUNTABLE TO THE HOSPITAL'S BOARD OF DIRECTORS AND IS RESPONSIBLE FOR COMMUNITY BENEFIT OVERSIGHT, IMPLEMENTATION AND EVALUATION.TO FURTHER SUPPORT COMMUNITY-BUILDING, MANY HOSPITAL STAFF MEMBERS SERVE ON BOARDS OF COMMUNITY-BASED ORGANIZATIONS THAT SERVE THE HEALTH AND SOCIAL SERVICE NEEDS OF LOCAL COMMUNITIES, SUCH AS THE WHOLE CHILD, A LOCAL AGENCY WITH A MISSION TO STRENGTHEN VITAL PARENT-CHILD RELATIONSHIPS. PIH'S DIRECTOR OF MARKETING & PLANNING DEPARTMENT SERVED ON A COMMUNITY COALITION, ADVOCATING FOR BRINGING VITAL PUBLIC TRANSPORTATION SERVICES TO WHITTIER. OTHER MEMBERS OF THIS COALITION INCLUDE WHITTIER CITY COUNCIL MEMBERS, A CITY OF WHITTIER PLANNING COMMISSIONER, WHITTIER COLLEGE PROFESSORS, THE EXECUTIVE DIRECTOR OF THE WHITTIER CHAMBER OF COMMERCE, AS WELL AS WHITTIER RESIDENTS. FURTHERMORE, PIH OFFERS A FREE SHUTTLE SERVICE FROM A LOCAL TRAIN STATION DURING MORNING AND AFTERNOON HOURS TO PROVIDE EMPLOYEES LIVING A SIGNIFICANT DISTANCE FROM THE HOSPITAL WITH AN INCENTIVE TO COMMUTE VIA TRAIN RATHER THAN BY CAR. LAUNCHED INITIALLY AS A PILOT IN FY 2005-2006, THE SHUTTLE SERVICE NOW HAS MANY PARTICIPANTS USING PUBLIC TRANSPORTATION ON A REGULAR BASIS, SUPPORTING PIH'S EFFORTS TO IMPROVE THE ENVIRONMENT.ADDITIONALLY, PIH MOBILIZES ASSETS AND INVESTS RESOURCES THROUGH OTHER CAREFULLY PRIORITIZED COMMUNITY-BUILDING ACTIVITIES. EXAMPLES OF THESE ACTIVITIES INCLUDE:ACTIVATE WHITTIER - A COLLABORATIVE COMMUNITY INITIATIVE WITH A VISION FOR A HEALTHY ACTIVE WHITTIER, WHICH IS COMMITTED TO MOTIVATING AND SUPPORTING A HEALTHY COMMUNITY THROUGH WELLNESS EDUCATION, ADVOCACY AND POLICY-RELATED EFFORTS, AND PROMOTION OF HEALTHY EATING AND PHYSICAL ACTIVITY. ACTIVATE WHITTIER SUPPORTS THE GRANT-FUNDED ACHIEVE INITIATIVE, DESIGNED TO FACILITATE ENVIRONMENTAL CHANGE. PIH IS AN ACTIVE MEMBER AND JOINS THE CITY OF WHITTIER, YMCA OF GREATER WHITTIER, LA COUNTY PUBLIC HEALTH DEPARTMENT, WHITTIER COLLEGE, WHITTIER FIRST DAY, AND THE BOYS AND GIRLS CLUB OF WHITTIER, ALL OF WHICH ARE SERVING AS ACTIVE PARTNERS IN THIS COLLABORATION.LA MIRADA ACHIEVE - A 3-YEAR INITIATIVE LED BY THE CITY OF LA MIRADA, WITH FY 2010-2011 BEING THE PROJECTS FINAL YEAR. THIS ACHIEVE INITIATIVE ENGAGED KEY STAKEHOLDERS IN ALL COMMUNITY SECTORS TO IDENTIFY AND IMPLEMENT POLICIES AND ENVIRONMENTAL STRATEGIES WHICH SOUGHT TO 1) FACILITATE AN INCREASE IN PHYSICAL ACTIVITY IN AFTER-SCHOOL PROGRAMS; 2) FACILITATE DEVELOPMENT AND IMPLEMENTATION OF WORKSITE WELLNESS POLICIES; AND 3) TO ESTABLISH LA MIRADA PARKS AS SMOKE-FREE ENVIRONMENTS. PIH SERVED AS A PARTNER IN IMPLEMENTATION OF THIS INITIATIVE.WHITTIER CITY SCHOOL DISTRICT - PIH HAS CONTRIBUTED TO THE INCREASED EFFECTIVENESS AND IMPROVED CAPACITY OF A LOCAL SCHOOL DISTRICT THROUGH THE REACH FOR THE STARS CHILDHOOD OBESITY PREVENTION PROGRAM. AS A KEY PROGRAM PARTNER, PIH HAS CONTRIBUTED STAFF TIME, IN-KIND RESOURCES, DIRECT PRIMARY CARE FOR SCHOOL CHILDREN THROUGH ITS CARE FORCE ONE MOBILE HEALTH SERVICES, AND A VARIETY OF HEALTH PROMOTION EDUCATION EFFORTS. EFFECTIVE FY 2010-2011, PIH IS FACILITATING EXPANSION OF THIS PROGRAM INTO A DISTRICT-WIDE EFFORT THAT INCLUDES THE IMPLEMENTATION OF CATCH (COORDINATED APPROACH TO CHILDRENS HEALTH) - AN EVIDENCE-BASED CURRICULUM. IN ADDITION, PIH PLAYED A KEY ROLE, THROUGH ITS PARTICIPATION IN ACTIVATE WHITTIER, IN FACILITATING THE FIRST-EVER SALAD BAR IN THE DISTRICT SPECIFICALLY AT AN ELEMENTARY SCHOOL LOCATED IN A LOW-INCOME AREA WITH HIGH NEED FOR ACCESS TO HEALTHY FOOD OPTIONS. WHITTIER AREA FIRST DAY COALITION - PIH PROVIDES DIRECT SUPPORT FOR WHITTIER FIRST DAY, AN AGENCY THAT OFFERS SHORT-TERM TRANSITIONAL HOUSING AND SUPPORTIVE SOCIAL SERVICES FOR HOMELESS ADULTS. A PIH BOARD MEMBER ALSO SERVES ON THE BOARD OF FIRST DAY. IN ADDITION, PIH AND FIRST DAY ACTIVELY COLLABORATE IN MANY WAYS TO ASSIST HOMELESS RESIDENTS AND, ULTIMATELY, BENEFIT THE ENTIRE COMMUNITY THROUGH MANY POSITIVE OUTCOMES. FOR EXAMPLE, PIH PROVIDES A LICENSED NURSE PRACTITIONER TO STAFF AN ON-SITE HEALTH AND WELLNESS CLINIC AT FIRST DAY, AS WELL AS DONATING MEDICATIONS AND MEDICAL SUPPLIES. THROUGH THIS PROVISION OF PREVENTIVE PRIMARY CARE SERVICES TO FIRST DAY RESIDENTS, THE RESIDENTS EXPERIENCED A MEASURABLE REDUCTION IN SICK VISITS TO LOCAL CLINICS AND THE EMERGENCY ROOM. THE PIH AND FIRST DAY COLLABORATIVE HAS BEEN RECOGNIZED BY THE LOS ANGELES HOMELESS SERVICES AUTHORITY AND THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AS A MODEL FOR EFFECTIVE COMMUNITY ENGAGEMENT TO MEET THE NEEDS OF THOSE MOST AT-RISK. DURING FY 2009-2010, PIH WAS RECOGNIZED BY VHA, INC. WITH ITS NATIONAL 2010 COMMUNITY BENEFIT EXCELLENCE LEADERSHIP AWARD, WITH SPECIAL EMPHASIS ON THIS PARTNERSHIP BETWEEN PIH AND FIRST DAY. PART III, LINE 4: THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED AMOUNTS. THE COMPANY MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES. RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS HAVE BEEN ESTABLISHED AND ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEET. PART III, LINE 8: THE COMPANY DOES NOT TAKE THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE STATE HAS SPECIFICALLY ASKED US TO REPORT THIS SEPARATELY FROM OUR COMMUNITY BENEFIT TOTALS. THE COMPANY USES A COST-TO-CHARGE (C2C) RATIO TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENT RECEIVED FROM MEDICARE, WHICH IS SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN PIH DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT SPECIFIC PERCENTAGE, IE. DEPARTMENT C2C %, IS LOADED INTO PIH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. AS SUCH, ALL COST INFORMATION REFLECTED IN PIH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THE ABOVE DEPARTMENT C2C METHODOLOGY. PART III, LINE 9B: UNINSURED PATIENTS WILL BE ENCOURAGED TO APPLY FOR GOVERNMENT PROGRAMS OR UNCOMPENSATED CARE. IF PIH'S COLLECTION AGENCY IDENTIFIES A PATIENT THAT QUALIFIES FOR PIH'S UNCOMPENSATED CARE PROGRAM BUT THAT FAILED TO APPLY, IT WILL RETURN THE ACCOUNT TO PIH AND RECOMMEND AN UNCOMPENSATED CARE WRITE-OFF. IN ADDITION IT WILL REMOVE DELINQUENCIES FROM THE PATIENT'S CREDIT REPORT. PART I, LINE 7B:IN OCTOBER 2010, CMS APPROVED LEGISLATION ENACTED BY THE STATE OF CALIFORNIA THAT PROVIDED FOR SUPPLEMENTAL MEDI-CAL PAYMENTS TO BE PAID TO CERTAIN HOSPITALS FROM FUNDS COLLECTED FROM PARTICIPATING HOSPITALS UNDER THE STATE'S QUALITY ASSURANCE FEE PROGRAM. SUCH AMOUNTS WERE ALLOCATED AND PAID TO PRESBYTERIAN INTERCOMMUNITY HOSPITAL BASED ON PRIOR YEAR PATIENT DATA, WHICH INCLUDES MEDI-CAL PATIENTS. THE INCLUSION OF OUT-OF-PERIOD REVENUE IN FISCAL YEAR 2011 FINANCIAL RESULTS REDUCED THE NET UNREIMBURSED MEDICAID. IF THESE AMOUNTS HAD NOT BEEN INCLUDED, THE HOSPITAL WOULD HAVE REPORTED A TOTAL CHARITY CARE PERCENTAGE OF 14.23% INSTEAD OF THE 12.10% CURRENTLY BEING REPORTED. PART VI, LINE 2: TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE, PIH CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, IN ACCORDANCE WITH CALIFORNIA STATE LAW AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA). THE FINDINGS OF THESE ASSESSMENTS SERVES AS A PRIMARY TOOL FOR THE HOSPITAL TO DETERMINE ITS COMMUNITY BENEFIT PLAN, WHICH OUTLINES HOW THE HOSPITAL WILL ADDRESS UNMET COMMUNITY HEALTH NEEDS, AND ULTIMATELY, STRIVE TO IMPROVE THE OVERALL HEALTH AND QUALITY OF LIFE IN OUR LOCAL COMMUNITIES. 2010 COMMUNITY HEALTH NEEDS ASSESSMENTDRIVEN BY A NEW AND SIGNIFICANTLY INNOVATIVE APPROACH TO ASSESSING COMMUNITY HEALTH NEEDS, THE PIH 2010 COMMUNITY HEALTH NEEDS ASSESSMENT TOOK A FOCUSED APPROACH THAT INCLUDED ENHANCED PRIMARY DATA COLLECTION IN ORDER TO GAIN A DEEPER UNDERSTANDING OF THE HEALTH ACCESS EXPERIENCE OF OUR COMMUNITY'S MOST VULNERABLE. AS A RESULT, PRIMARY DATA COLLECTION INCLUDED 27 STAKEHOLDER INTERVIEWS HELD WITH COMMUNITY STAKEHOLDERS, REPRESENTING LOCAL GOVERNMENT, AND HEALTH AND SOCIAL SERVICES IN PRIMARY SERVICE AREA COMMUNITIES. IN ADDITION, TEN FOCUS GROUPS WERE CONDUCTED TO GATHER INFORMATION AND PERCEPTIONS FROM PIH PRIMARY SERVICE AREA RESIDENTS; GROUPS WERE CONDUCTED IN BOTH ENGLISH AND SPANISH.SECONDARY DATA WERE COLLECTED BY OBTAINING AND ANALYZING A VARIETY OF OBJECTIVE DATA FROM LOCAL, COUNTY, AND STATE SOURCES TO PRESENT A COMMUNITY PROFILE, BIRTH AND DEATH CHARACTERISTICS, ACCESS TO HEALTH CARE, CHRONIC DISEASES, SOCIAL ISSUES, AND SCHOOL AND STUDENT CHARACTERISTICS. WHEN PERTINENT, THESE DATA SETS WERE PRESENTED IN THE CONTEXT OF LOS ANGELES COUNTY AND THE STATE, WHICH SERVED TO FRAME THE SCOPE OF AN ISSUE AS IT RELATED TO THE BROADER COMMUNITY. ADDITIONALLY, FINDINGS WERE COMPARED TO ACCEPTED BENCHMARKS THAT REFERENCE RECOGNIZABLE STATE AND NATIONAL RESOURCES (E.G., HEALTHY PEOPLE 2020 OBJECTIVES). ENHANCED GIS MAPPING RELATED TO PRIORITY HEALTH AREAS WAS INCLUDED, AS WELL. IN ADDITION TO BEING AVAILABLE ON PIH'S WEBSITE, THE 2010 COMMUNITY HEALTH NEEDS ASSESSMENT HAS BEEN WIDELY SHARED WITH CIVIC, BUSINESS AND COMMUNITY LEADERS, LOCAL COMMUNITY-BASED ORGANIZATIONS, AND KEY STAKEHOLDERS, AS WELL AS THE COMMUNITY AT-LARGE. EMPHASIS IS MADE ON SHARING ASSESSMENT RESULTS WITH AREA AGENCIES TO ASSIST THEM WITH THEIR PROGRAM PLANNING AND FUND-DEVELOPMENT ENDEAVORS, WHILE SPARING THE EXPENSE OF DUPLICATIVE DATA COLLECTION EFFORTS. PART VI, LINE 3: CHARITY CARE REFERS TO DOLLARS EXPENDED FOR THE PROVISION OF FREE OR DISCOUNTED CARE PROVIDED TO BOTH THE INSURED AND UNINSURED WHO LACK FINANCIAL RESOURCES AND MEET THE UNCOMPENSATED CARE PROGRAMS CRITERIA TO PAY FOR NEEDED HEALTHCARE SERVICES. DURING FY 2010-2011, PIH INCURRED UN-REIMBURSED COSTS FOR THIS PROVISION OF CHARITY CARE TO THE UNDER-SERVED IN THE AMOUNT OF $16,189,328.PIH'S CHARITY CARE POLICY INCLUDES THE FOLLOWING TWO PROGRAMS: UNCOMPENSATED CARE PROGRAM PIH OFFERS A GENEROUS UNCOMPENSATED CARE PROGRAM THAT EXCEEDS RECOMMENDED STANDARDS, PROVIDING CHARITY CARE TO ALL PATIENTS WHO APPLY AND QUALIFY WITH FAMILY INCOME(S) WITHIN 400% OF THE FEDERAL POVERTY GUIDELINES. PATIENTS WHO WOULD QUALIFY UNDER THIS PROGRAM ARE:UNINSURED PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY AS DETERMINED BY THE FINANCIAL GUIDELINES IN THIS POLICY;PATIENTS WHO HAVE RESTRICTED MEDI-CAL EMERGENCY AND PREGNANCY SERVICES COVERAGE (AND NO SHARE OF COST) AND WHOSE SERVICES ARE NOT COVERED FOR A PARTICULAR EPISODE OR PARTIAL EPISODE OF CARE. (AN UNCOMPENSATED CARE APPLICATION IS NOT REQUIRED SINCE THE PATIENT IS PRESUMED TO MEET THE CHARITY CARE ELIGIBILITY REQUIREMENTS);THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE, BUT ARE NOT LIMITED TO: STATE-FUNDED PRESCRIPTION PROGRAMS; HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC OR SHELTER PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); FOOD STAMP ELIGIBILITY; SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND PATIENT IS DECEASED WITH NO KNOWN ESTATE; AND PATIENTS WHO ARE CURRENTLY ELIGIBLE FOR MEDI-CAL, BUT WERE NOT ELIGIBLE IN ONE TO THREE MONTHS PRIOR TO ELIGIBILITY ARE PRESUMED TO BE ELIGIBLE FOR CHARITY AND DO NOT NEED TO FILL OUT THE APPLICATION.INSURED PATIENTS WHOSE COVERAGE IS INADEQUATE TO COVER A CATASTROPHIC SITUATION;PERSONS WHOSE INCOME IS SUFFICIENT TO PAY FOR BASIC LIVING COSTS BUT NOT MEDICAL CARE, AND ALSO THOSE PERSONS WITH GENERALLY ADEQUATE INCOMES WHO ARE SUDDENLY FACED WITH CATASTROPHICALLY LARGE MEDICAL BILLS;PATIENTS WHO DEMONSTRATE ABILITY TO PAY PART BUT NOT ALL OF THEIR LIABILITY. FOR EXAMPLE, THOSE WHO HAVE AN OUT OF POCKET THAT EXCEEDS 10% OF THEIR ANNUAL NET FAMILY INCOME IN THE PRIOR TWELVE MONTHS.SELF-PAY PAYMENT PROGRAMADDITIONALLY, UNDER THE PIH SELF-PAY PAYMENT PROGRAM, ALL CASH-PAY PATIENTS AND THOSE THAT HAVE LIMITED BENEFIT PLANS (ALL PATIENTS LACKING HEALTH INSURANCE) ARE AUTOMATICALLY GIVEN A BILL REDUCTION COMMENSURATE WITH OR LESS THAN THE NEGOTIATED REIMBURSEMENT RATES WITH A CONTRACTED HEALTHY FAMILIES PROGRAM PLAN; NO PRE-QUALIFICATION IS NECESSARY. IF A PATIENT CANNOT PAY THE ENTIRE DISCOUNTED OBLIGATION AND DOES NOT QUALIFY FOR GOVERNMENT OR HOSPITAL PROGRAMS, PIH WILL EXTEND REASONABLE NO-INTEREST PAYMENTS. THE DISCOUNTS PROVIDED BY THE SELF-PAY PAYMENT PROGRAM ARE ESPECIALLY OF BENEFIT TO THOSE IN THE PROCESS OF APPLYING FOR PIH'S CHARITY CARE OR OTHER GOVERNMENT MEANS-TESTED PROGRAMS AND AWAITING ELIGIBILITY DETERMINATION. UNINSURED PATIENTS ARE EDUCATED ABOUT THE SELF-PAY PAYMENT PROGRAM PRIOR TO OR AT REGISTRATION/ADMISSION (OR AFTER AN EMERGENCY DEPARTMENT PATIENT HAS BEEN MEDICALLY SCREENED AND STABILIZED).ADDITIONAL PATIENT EDUCATION REGARDING PIH'S CHARITY CAREIT IS IMPORTANT TO NOTE THAT, REGARDLESS OF ABILITY TO PAY, APPROPRIATE CLINICAL STAFF ESTABLISH A PLAN OF CARE, ORDER MEDICALLY NECESSARY TREATMENT, SERVICES AND MEDICATIONS, IN ORDER TO STABILIZE ALL PATIENTS. ONCE STABILIZED, BILINGUAL (ENGLISH & SPANISH) FINANCIAL COUNSELORS OR OTHER APPROPRIATE STAFF WORK WITH ELIGIBLE PATIENTS IN APPLYING FOR PIH'S CHARITY CARE OR OTHER GOVERNMENT MEANS-TESTED PROGRAMS. IN ACCORDANCE WITH CALIFORNIA'S FAIR PRICING LAW FOR LOW-INCOME, UNINSURED INDIVIDUALS, PIH POSTS NOTICES IN BOTH ENGLISH AND SPANISH WITH INFORMATION REGARDING ITS UNCOMPENSATED CARE AND SELF-PAY PAYMENT POLICIES IN SETTINGS THAT ARE HIGHLY VISIBLE TO THE PUBLIC, SUCH AS THE EMERGENCY DEPARTMENT, BILLING/CASHIER OFFICE, PATIENT REGISTRATION, AS WELL AS VARIOUS ANCILLARY DEPARTMENTS AND OUTPATIENT FACILITIES. UN-INSURED PATIENTS ALSO RECEIVE A LETTER IN ENGLISH AND/OR SPANISH, WHICH DETAILS THE VARIOUS PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. IN ADDITION, THE BELOW STATEMENT APPEARS ON ALL PATIENT BILLING STATEMENTS IN ENGLISH AND SPANISH:"PLEASE PAY THE BALANCE DUE. IF YOU CANNOT PAY THE ENTIRE BALANCE, PLEASE CALL TO SET UP INSTALLMENT PAYMENTS. IF YOU ARE UNABLE TO PAY ALL OR PART OF YOUR BALANCE AND YOUR FAMILY INCOME IS WITHIN 400% OF FEDERAL POVERTY LIMITS, PLEASE CALL AND REQUEST AN UNCOMPENSATED CARE APPLICATION." PART VI, LINE 4: PRESBYTERIAN INTERCOMMUNITY HOSPITAL (PIH) IS SITUATED IN THE SOUTHEAST PORTION OF LOS ANGELES COUNTY, CALIFORNIA WITHIN AN AREA REFERRED TO AS SERVICE PLANNING AREA 7 (SPA 7). APPROXIMATELY 73% OF ADMISSIONS COME FROM NINE CITIES, WHICH COMPRISE ITS PRIMARY SERVICE AREA. PIH'S SECONDARY SERVICE AREA INCLUDES ADDITIONAL CITIES IN SAN GABRIEL VALLEY AND NORTH ORANGE COUNTY. IN ADDITION, THROUGH PIH HOME HEALTH, ARCADIA HOME NURSING & HEALTH SERVICES, HOSPICE OF PRESBYTERIAN AND HOSPICE OF PASADENA, PIH'S REACH EXTENDS UP THE 605 FREEWAY CORRIDOR INTO ARCADIA-PASADENA, BRINGING THE TOTAL ESTIMATED HOSPITAL SERVICE AREA WELL BEYOND 1.5 MILLION RESIDENTS. BELOW ARE PIH'S PRIMARY AND SECONDARY SERVICE AREAS, BASED UPON OSHPD DISCHARGE DATA (2009):PRIMARY SERVICE AREA(ENCOMPASSES 9 CITIES/13 ZIP CODES)HACIENDA HEIGHTS 91745LA HABRA 90631LA HABRA HEIGHTS 90631LA MIRADA 90638MONTEBELLO 90640NORWALK 90650PICO RIVERA 90660SANTA FE SPRINGS 90670WHITTIER 90601-90606SECONDARY SERVICE AREA - WESTBELL 90201BELLFLOWER 90706DOWNEY 90240-90242LOS ANGELES 90022LOS ANGELES 90040SOUTH GATE 90280SECONDARY SERVICE AREA - EASTCHINO HILLS 91709DIAMOND BAR 91765LA PUENTE 91744LA PUENTE 91746ROWLAND HEIGHTS 91748WALNUT 91789WEST COVINA 91792PRIMARY SERVICE AREA PROFILETHE POPULATION FOR THE PIH PRIMARY SERVICE AREA IS APPROXIMATELY 600,000. CHILDREN AND YOUTH, AGES 0-17 MAKE UP 29.4% OF THE POPULATION; 32.9% ARE 18-39 YEARS OF AGE; 26.6% ARE 40-64; AND 11.2% OF THE POPULATION ARE SENIORS, 65 YEARS OF AGE AND OLDER. THE AREA HAS SLIGHTLY HIGHER PERCENTAGES OF CHILDREN AGES 5-17 AND SENIORS THAN FOUND IN LOS ANGELES COUNTY AND THE STATE. THE PRIMARY SERVICE AREA CONSISTS PRIMARILY OF LATINOS (60.7%) AND WHITES (25.6%). ASIAN/PACIFIC ISLANDERS COMPRISE 9.7% OF THE POPULATION, AND AFRICAN AMERICANS, NATIVE AMERICANS, AND OTHER RACES COMBINED TOTAL ONLY 4.0% OF THE POPULATION. THE AREA HAS A NOTABLY LARGER PERCENTAGE OF LATINOS, AND A SMALLER PERCENTAGE OF ALL OTHER RACES AND ETHNICITIES WHEN COMPARED TO LOS ANGELES COUNTY. POVERTY RATES PAINT AN IMPORTANT PICTURE OF THE POPULATION WITHIN THE PIH PRIMARY SERVICE AREA. AT THE TIME OF THE 2000 CENSUS, FROM 5.5% TO 16.6% OF THE POPULATION LIVED AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. IT CAN BE ASSUMED WITH THE INCREASE IN UNEMPLOYMENT IN THE AREA, THAT POVERTY RATES HAVE ALSO INCREASED. IMPORTANTLY, THE DATA INDICATE THAT WITHIN THE PIH SERVICE AREA POVERTY INCREASES MARKEDLY FOR THE POPULATION AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL). IN THE PIH SERVICE AREA ALMOST ONE-THIRD (31.3%) OF THE RESIDENTS EXIST AT 200% OF FPL. IN THE OVERALL PIH SERVICE AREA, SPANISH IS SPOKEN IN 44.3% OF THE HOMES; THIS IS HIGHER THAN THE NUMBER OF SPANISH SPEAKING HOUSEHOLDS IN THE COUNTY (37.9%) AND THE STATE (25.8%). COMPARATIVELY, THE SERVICE AREA HAS NOTICEABLY FEWER HOUSEHOLDS THAT SPEAK OTHER INDO-EUROPEAN (2.6%) OR ASIAN/PACIFIC ISLAND LANGUAGES (8.0%). OF THE POPULATION AGE 25 AND OVER, 30.0% HAVE LESS THAN A HIGH SCHOOL DIPLOMA; THIS IS CONSISTENT WITH COUNTY COMPLETION RATES. BY COMPARISON, THE AREA HAS HIGHER HIGH SCHOOL GRADUATION RATES THAN THE COUNTY OR STATE, WITH ALMOST ONE-QUARTER OF THE POPULATION (24.8%) HAVING A HIGH SCHOOL DIPLOMA. IN COMPARISON, THE RESIDENTS SHOW EQUIVALENT ASSOCIATE DEGREE COLLEGE ATTAINMENT, BUT LOWER RATES OF RESIDENTS WITH BACHELORS DEGREES, GRADUATE OR PROFESSIONAL DEGREES THAN IN THE COUNTY OR STATE.THE POPULATION SERVED BY PIH EXPERIENCES HIGH RATES OF OVERWEIGHT AND OBESITY, CHRONIC DISEASES AND POOR BIRTH OUTCOMES. THE CONCERNS AND BARRIERS FACED BY VULNERABLE POPULATIONS IN WHITTIER AND THE SURROUNDING ENVIRONS INCLUDE A LACK OF AFFORDABLE HOUSING, RESOURCES THAT ARE OUTSTRIPPED BY NEEDS, DIFFICULTY ACCESSING SERVICES, AND A GENERAL LACK OF AWARENESS OF THE SERVICES THAT ARE AVAILABLE. PART VI, LINE 6: SINCE OPENING IN 1959, PRESBYTERIAN INTERCOMMUNITY HOSPITAL (PIH) HAS GROWN FROM A 188-BED FACILITY TO A 444-BED MEDICAL CENTER AND INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT TODAY SERVES MORE THAN 1.5 MILLION RESIDENTS, AND INCLUDES A NETWORK OF PRIMARY CARE CLINICS, MOBILE HEALTH SERVICES, A RESIDENTIAL HOSPICE PROGRAM, AS WELL AS AN ADULT DAY HEALTH CARE CENTER. PIH'S MISSION IS TO PROVIDE HIGH-QUALITY HEALTHCARE WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITIES IN AN ETHICAL, SAFE, AND FISCALLY PRUDENT MANNER IN RECOGNITION OF OUR CHARITABLE PURPOSE. WE ARE GUIDED BY OUR BELIEF THAT HEALTH CARE IS A RIGHT AND NOT A PRIVILEGE. TODAY, AS A NOT-FOR-PROFIT HOSPITAL, COMMUNITY BENEFIT CONTINUES TO BE AN INTEGRAL PART OF PIH'S MISSION. WE DEDICATE ASSETS TO CHARITABLE PURPOSES, SUCH AS CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS, AS WELL AS A MULTITUDE OF COMMUNITY-BASED INITIATIVES TO IMPROVE AND PROMOTE OVERALL HEALTH AND WELL-BEING, REGARDLESS OF HEALTH OR ECONOMIC STATUS. IN ADDITION, PIH HAS A STRONG NETWORK OF COMMUNITY PARTNERSHIPS AND COLLABORATIONS, DEMONSTRATING OUR ACTIVE LEADERSHIP ROLE IN THE COMMUNITY.CAREFUL STEWARDSHIP OF PIH'S CHARITABLE RESOURCES IS OF HIGH PRIORITY FOR PIH'S BOARD OF DIRECTORS. AS SUCH, IN 2006, THE BOARD ESTABLISHED A COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC), COMPRISED OF COMMUNITY STAKEHOLDERS AND HOSPITAL SENIOR MANAGEMENT, WHICH IS DEDICATED TO PROVIDING THE STRATEGIC DIRECTION, OVERSIGHT, AND EVALUATION OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS AND INITIATIVES. MEASUREMENT OF OUTCOMES FOR EACH OF PIH'S FLAGSHIP COMMUNITY BENEFIT PROGRAMS VIA DEVELOPMENT OF AIMS AND MEASURABLE OBJECTIVES, HAS RESULTED IN A MORE SOPHISTICATED LEVEL OF EVALUATION AND OVERSIGHT BY PIH'S CBOC AT ITS ANNUAL MEETINGS. EXAMPLES OF PIH'S COMMITMENT TO IMPROVEMENT OF OVERALL COMMUNITY HEALTH AND HEALTHCARE ACCESS ARE BELOW:ENROLLMENT ASSISTANCE PIH, THROUGH ITS BRIGHT HEALTH PHYSICIANS AFFILIATE, ESTABLISHED A TEAM OF BI-LINGUAL ENROLLMENT COORDINATORS TO ASSIST THE UN-INSURED IN APPLYING FOR HEALTH INSURANCE COVERAGE FOR CHILDREN AND TO ASSIST ELIGIBLE PIH PATIENTS IN APPLYING FOR PIH'S CHARITY CARE PROGRAM. THE ENROLLMENT COORDINATORS ALSO PROVIDE REFERRALS TO OTHER SOURCES OF HEALTH CARE AND SOCIAL SERVICES. THEY WORK IN CONJUNCTION WITH LOCAL SCHOOLS AND PIH'S BUSINESS OFFICE, EMERGENCY, MOBILE HEALTH SERVICES, SOCIAL WORK AND INFORMATION TECHNOLOGY DEPARTMENTS TO LOCATE FAMILIES IN NEED. THE RESULTS OF THEIR EFFORTS ARE ALSO REFLECTED IN PIH'S CHARITY CARE REPORTING. IN ADDITION, PIH CONTRACTS WITH AGENCIES SPECIALIZING IN MEDI-CAL AND HEALTHY FAMILIES ENROLLMENT, IN AN EFFORT TO ENSURE THAT ALL THOSE ELIGIBLE OBTAIN HEALTH INSURANCE COVERAGE AND, ULTIMATELY, HAVE ACCESS TO CARE. COMMUNITY-BASED HEALTH CAREPIH AND WHITTIER FIRST DAY, A LOCAL TRANSITIONAL HOMELESS SHELTER, COLLABORATE IN MANY WAYS TO ASSIST SHELTER RESIDENTS AND, ULTIMATELY, TO BENEFIT THE ENTIRE COMMUNITY THROUGH MANY POSITIVE OUTCOMES. AS SUCH, PIH PROVIDES A NURSE PRACTITIONER (AND SUPERVISING PHYSICIAN) TO STAFF A HEALTH AND WELLNESS CLINIC ON-SITE AT WHITTIER FIRST DAY TO ENSURE THAT HOMELESS INDIVIDUALS HAVE DIRECT ACCESS TO BASIC AND PREVENTIVE HEALTH CARE SERVICES; DURING FY 2011, 87% OF CLINIC PATIENTS EXPERIENCED IMPROVED HEALTH STATUS; PIH WAS RECOGNIZED BY VHA, INC. WITH ITS NATIONAL 2010 COMMUNITY BENEFIT EXCELLENCE LEADERSHIP AWARD, WITH SPECIAL EMPHASIS ON THE PARTNERSHIP BETWEEN PIH AND FIRST DAY. IN ADDITION, PIH'S CARE FORCE ONE MOBILE HEALTH SERVICES PROVIDES FREE AND LOW-COST PRIMARY HEALTHCARE SERVICES DIRECTLY TO THOSE IN THE COMMUNITY WHO HAVE DIFFICULTY ACCESSING CARE FOR A VARIETY OF REASONS, WITH OVER 9,100 PATIENT ENCOUNTERS DURING FY 2011.FAMILY PRACTICE RESIDENCY PROGRAMPIH IS COMMITTED TO EDUCATING THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS VIA ITS FAMILY PRACTICE RESIDENCY PROGRAM, WHICH PLACES SPECIAL EMPHASIS ON TRAINING RESIDENT PHYSICIANS TO WORK WITH MEDICALLY AT-RISK COMMUNITY MEMBERS OF ALL AGES WHO RESIDE IN LOW-INCOME, UNDER-SERVED AREAS. RESIDENT PHYSICIANS PROVIDE COMMUNITY HEALTH SERVICES VIA PIH'S HOME-BASED PALLIATIVE CARE PROGRAM, AT HOSPITAL-SUPPORTED CLINICS AT WHITTIER COLLEGE AND A LOCAL HOMELESS SHELTER, AS WELL AS THROUGH COMMUNITY PARTNERSHIPS, SUCH AS WITH THE LOS NIETOS SCHOOL DISTRICT, IN WHICH RESIDENTS SUPPORT THIS LOW-INCOME COMMUNITY IN ITS EFFORTS TO ADDRESS THEIR SIGNIFICANT OBESITY RATES. IN ADDITION, THE PIH RESIDENCY PROGRAM OFFERS A TROPICAL MEDICINE TRACK, WHICH PROVIDES OPPORTUNITIES FOR RESIDENTS TO PROVIDE MUCH NEEDED CARE IN COUNTRIES AS FAR AWAY AS CAMEROON AND ZAMBIA.R. C. BAKER FOUNDATION REGIONAL EMERGENCY DEPARTMENTDURING FY 2010-2011, PIH'S EMERGENCY DEPARTMENT (ED) EXPERIENCED AN ESTIMATED 70,000 VISITS. PIH COMPLETED EXPANSION OF THE ED IN 2009, MAKING IT ONE OF THE LARGEST EMERGENCY ROOMS IN LOS ANGELES COUNTY WITH AN INCREASE FROM 43 TO 61 BEDS, ALLOWING FOR DECREASED WAIT TIMES, MORE TRIAGE ROOMS, AND AN AREA DESIGNED SPECIFICALLY FOR PEDIATRIC CARE. ADDITIONALLY, THE ED FEATURES THE LOCAL AREAS PARAMEDIC BASE STATION, PROVIDING BOTH THE EQUIPMENT AND RESOURCES FOR QUALIFIED STAFFING OF THE BASE STATION SO THAT WHEN AN AMBULANCE IS DISPATCHED TO A LOCAL HOME, PARAMEDICS HAVE CRITICAL ACCESS TO LOCAL HOSPITAL-BASED EMERGENCY SERVICES. FURTHERMORE, PIH SUSTAINS A CONTRACT WITH AN ON-CALL PHYSICIAN PANEL SO THAT ALL ELIGIBLE PATIENTS, REGARDLESS OF HEALTH INSURANCE STATUS, ARE ASSURED ACCESS TO SPECIALTY CARE APPROPRIATE TO THEIR NEEDS. RUBY L. GOLLEHER COMPREHENSIVE CANCER PROGRAMPIH'S AWARD-WINNING COMPREHENSIVE CANCER PROGRAM PARTICIPATES IN CLINICAL RESEARCH TRIALS THROUGH AFFILIATIONS WITH TWO ACADEMIC TEACHING CENTERS: (1) SOUTHWEST ONCOLOGY GROUP [SWOG] IN AFFILIATION WITH THE UNIVERSITY OF CALIFORNIA AT IRVINE; AND (2) RADIATION THERAPY ONCOLOGY GROUP (RTOG) IN AFFILIATION WITH THE UNIVERSITY OF CALIFORNIA AT DAVIS. THE PROGRAM HAS BEEN ENHANCED IN RECENT YEARS TO INCLUDE: A CANCER SURVIVORSHIP PROGRAM; LYMPHEDEMA WORKSHOPS; AND TWO NEW CLINICAL TRIALS FOR METASTATIC PROSTATE CANCER AND STAGE III COLON CANCER; AND COMPLEMENTARY MEDICINE OFFERINGS OPEN TO THE COMMUNITY, INCLUDING YOGA FOR HEALING AND REIKI HEALING HANDS THERAPY.VOLUNTEER CONTRIBUTIONSAPPROXIMATELY 800 PIH VOLUNTEERS COLLECTIVELY CONTRIBUTED 125,696 HOURS, TRANSLATING INTO MORE THAN $2,620,753 IN SAVINGS FOR THE HOSPITAL. PART VI, LINE 7: WHILE PIH IS NOT PART OF A HOSPITAL SYSTEM, THE HOSPITAL IS AFFILIATED WITH: 1) INTERHEALTH CORP, PIH'S PARENT COMPANY; 2) BRIGHT HEALTH PHYSICIANS (BHP), A NOT-FOR-PROFIT MEDICAL FOUNDATION; 3) THE PIH FOUNDATION, A NOT-FOR-PROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH'S CHARITABLE MISSION; AND 4) MEDSITE, WHICH SUBSIDIZES THE S. MARK TAPER FOUNDATION A DAY AWAY ADULT DAY HEALTH CARE CENTER. INTERHEALTH CORP. PROVIDES TECHNICAL, FACILITY AND SUPPORT SERVICES FOR TAX-EXEMPT AFFILIATES WHOSE CHARITABLE PURPOSE IS TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO THEIR COMMUNITY BY WAY OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.BHP SUPPORTS THE LOCAL COMMUNITY THROUGH A NETWORK OF COMMUNITY-BASED HEALTH CLINICS, AND HEALTH PROMOTION AND HEALTH INSURANCE ENROLLMENT EFFORTS. DURING FY 2010-2011, PIH & BRIGHT HEALTH PHYSICIANS (BHP) WERE THE RECIPIENTS OF THE WHITTIER BEAUTIFUL AWARD, PRESENTED BY THE WHITTIER CHAMBER OF COMMERCE FOR ITS CORPORATE OFFICE IN UPTOWN WHITTIER, WHICH OPENED IN 2010, AFTER THE PURCHASE AND REFURBISHMENT OF THE VACANT FISHER BUILDING. THE NEW, 40,000 SQUARE FOOT OFFICE BUILDING HOUSES OVER 165 EMPLOYEES, WHO IN TURN SUPPORT AREA BUSINESSES. THE CITY OF WHITTIER'S ECONOMIC DEVELOPMENT NEWSLETTER "GROWING WHITTIER," (SPRING/SUMMER 2010, ISSUE 11), STATES THAT PROJECTS SUCH AS THIS UNDERSCORE PIH AS A "RESOURCE THAT PROTECTS THE HEALTH AND SAFETY OF THE COMMUNITY WHILE PROVIDING JOBS TO OUR CITY'S RESIDENTS." THE PIH FOUNDATION RAISES FUNDS IN SUPPORT OF PIH, AS WELL AS PROVIDING IN-KIND FUNDRAISING CONSULTATION TO LOCAL COMMUNITY-BASED ORGANIZATIONS. THE PIH FOUNDATIONS GALA, WHICH IS HELD ANNUALLY, BENEFITS A HOSPITAL PROGRAM, INITIATIVE, OR DEPARTMENT EACH YEAR. DURING FY 2010-2011, THE GALA DREW MORE THAN 700 PEOPLE AND RAISED A RECORD $642,740 IN SUPPORT OF THE CRITICAL CARE CENTER THAT WILL BE IN PIH'S NEW PLAZA TOWER; THE CRITICAL CARE CENTER RECENTLY CELEBRATED 50 YEARS OF SERVICE TO THE COMMUNITY. ALSO DURING FY 2010-2011, PIH FOUNDATION GOLF TOURNAMENT GENERATED OVER $205,000 IN SUPPORT OF PIH'S NURSING EDUCATION PROGRAM, WHICH PROVIDES FOR NURSING SCHOLARSHIPS SO THAT PIH NURSES ARE ABLE TO ADVANCE THEIR EDUCATION, AS WELL AS THE HOSPITALS CAPITAL CAMPAIGN FOR THE NEW PLAZA TOWER. MEDSITE'S S. MARK TAPER FOUNDATION A DAY AWAY ADULT DAY HEALTH CARE CENTER HAS, SINCE 1999, PROVIDED HIGH QUALITY CARE FOR INDIVIDUALS REQUIRING CONTINUOUS SUPERVISION AND CARE AND WHOSE CAREGIVERS MAY NEED TO WORK, CARE FOR OTHERS, OR ARE IN DESPERATE NEED OF RESPITE. THE CENTER OFFERS BOTH SOCIAL & MEDICAL PROGRAMS DEPENDING UPON INDIVIDUAL NEED. FAMILY MEMBERS INVOLVED IN THEIR LOVED ONES TREATMENT HAVE THE OPPORTUNITY TO PARTICIPATE IN ON-GOING EDUCATION AND CAREGIVER SUPPORT GROUPS - ALL DESIGNED TO EMPOWER FAMILIES TO BE MORE SKILLED AND EFFECTIVE IN THEIR CAREGIVING ROLES. DURING FY 2010-2011, SOME 90 INDIVIDUALS WERE CARED FOR AT A DAY AWAY. FOR DETAILED INFORMATION REGARDING THESE PIH AFFILIATES' ADDITIONAL ACTIVITIES TO SUPPORT AND PROMOTE COMMUNITY HEALTH, PLEASE SEE EACH RESPECTIVE ORGANIZATION'S IRS FORM 990. REPORTS FILED WITH STATES PART VI, LINE 7 CA 1 AMERICAN CANCER SOCIETY 13230 PENN STREET WHITTIER CA 90602 941170350 501(C)(3) 7900 GENERAL SUPPORT PARTNERS IN CARE FOUNDATION 732 MOTT STREET STE 150 SAN FERNANDO CA 91340 953954057 501(C)(3) 5625 GENERAL SUPPORT RANCHO LOS AMIGOS FOUNDATION 7601 E IMPERIAL HWY DOWNEY CA 90242 953849600 501(C)(3) 6800 GENERAL SUPPORT YMCA OF GREATER WHITTIER 12510 E HADLEY ST STE 201 WHITTIER CA 90601 951684795 501(C)(3) 8500 GENERAL SUPPORT SANTA FE SPRINGS CHAMBERS 12016 E TELEGRAPH RD STE 100 SANTA FE SPRINGS CA 90670 952912042 501(C)(3) 6000 GENERAL SUPPORT WHITTIER COMMUNITY FOUNDATION 13230 PENN STREET WHITTIER CA 90602 951918226 501(C)(3) 7500 GENERAL SUPPORT CALIFORNIA HEALTH FOUNDATION AND TRUST 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941498687 501(C)(3) 475537 SUPPORT CHARITABLE ACTIVITIES AT HOSPITALS & HEALTH SYSTEMS IN CALIFORNIA 7 SCHOLARSHIPS AND MEDICAL EDUCATION 51 142000 PSYCHIATRIC CARE AT INDEPENDENT FACILITY FOR UNINSURED 59 109150 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: PIH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS BASED ON 1) CHARITABLE MISSION OR PURPOSE OF THE CHARITABLE ORGANIZATION AND ITS ALIGNMENT WITH PIH'S MISSION, VALUES AND OBJECTIVES AND/OR 2) IDENTIFIED INDIVIDUAL NEED FOR HEALTH-RELATED SERVICES. FOR CONTRIBUTIONS MADE TO CHARITABLE ORGANIZATIONS, PIH ADOPTED A POLICY WHICH GUIDES THE PROCESS BY WHICH FUNDS ARE GRANTED TO ENSURE THAT PIH IS A GOOD STEWARD OF ITS RESOURCES AS A FEDERALLY REGISTERED 501(C)(3) NOT-FOR-PROFIT ENTITY. TO ENSURE ACCURATE COMMUNITY BENEFIT REPORTING, THIS POLICY ALSO SETS FORTH THAT DIRECT CONTRIBUTIONS MADE TO COMMUNITY ORGANIZATIONS MUST BE APPROPRIATELY CLASSIFIED AS EITHER A) COMMUNITY BENEFIT OR B) COMMUNITY RELATIONS/MARKETING CONTRIBUTIONS. IN COMPLIANCE WITH THIS POLICY, INFORMATION IS GATHERED FROM THE GRANTEE REGARDING THE INTENDED USE OF FUNDS AND THE PERCENT OF GRANTED FUNDS THAT WILL GO TOWARDS SUPPORTING THE ORGANIZATION'S MISSION. FOR CONTRIBUTIONS MADE TO INDIVIDUALS, PIH HAS ESTABLISHED A DEDICATED BUDGET WHICH SUBSIDIZES VITAL ASSISTANCE SUCH AS PURCHASE OF DURABLE MEDICAL EQUIPMENT OR NON-ACUTE CARE NOT COVERED BY INSURANCE UPON HOSPITAL DISCHARGE, INCLUDING PAID PLACEMENT IN SKILLED NURSING OR MENTAL HEALTH FACILITIES. IN THESE INSTANCES, A SPECIFIC SERVICE IS BEING PURCHASED AND RECEIPT OF PROPER SERVICE IS ENSURED THROUGH FOLLOW-UP BY PIH DISCHARGE PLANNERS OR SOCIAL WORKERS. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 SUDHAKER NAYAK MD 191106 0 0 0 0 0 0 0 0 0 191106 0 0 0 JAMES WEST 769831 0 63000 0 52192 0 8012 0 176398 0 1069433 0 63000 0 MITCHELL THOMAS 389758 0 32753 0 97941 0 8012 0 104603 0 633067 0 32753 0 PEGGY CHULACK 365436 0 68310 0 6397 0 8012 0 58873 0 507028 0 68310 0 ROSALIO LOPEZ MD 481810 0 40013 0 9155 0 8012 0 87019 0 626009 0 40013 0 REANNA THOMPSON 288993 0 69300 0 36180 0 8012 0 51744 0 454229 0 69300 0 DAVE KLINGER 291800 0 39520 0 34832 0 8012 0 51908 0 426072 0 39520 0 JOAN ROLLAND 160215 0 3755 0 6915 0 21769 0 26443 0 219097 0 0 0 JUDY PUGACH 163356 0 12880 0 6915 0 5423 0 30074 0 218648 0 0 0 LON OREY 238982 0 13680 0 95905 0 7679 0 37041 0 393287 0 0 0 PATRICIA BRAY 177056 0 0 0 6956 0 5821 0 26994 0 216827 0 0 0 PERRY EBELTOFT 190217 0 0 0 7502 0 5614 0 36448 0 239781 0 0 0 RAMONA PRATT 184667 0 29266 0 6734 0 6130 0 33215 0 260012 0 0 0 RONALD YOSHIHARA 215339 0 18366 0 32422 0 23236 0 40752 0 330115 0 0 0 ROWENA STAJER 161680 0 25567 0 29867 0 17187 0 13907 0 248208 0 0 0 SUSANNE CARLSON 196219 0 32088 0 25306 0 6433 0 37048 0 297094 0 0 0 MARVIN RICE 338925 0 29621 0 72414 0 30012 0 69982 0 540954 0 0 0 JUNG HO 225439 0 0 0 0 0 0 0 2430 0 227869 0 0 0 CARMEN A CHANG 187710 0 0 0 0 0 0 0 1561 0 189271 0 0 0 PHILIP B CHON 184110 0 0 0 0 0 0 0 2010 0 186120 0 0 0 ALAN Y ENDO 182580 0 0 0 0 0 0 0 3011 0 185591 0 0 0 ANNA KRUGER 173075 0 0 0 0 0 0 0 561 0 173636 0 0 0 PART I, LINE 1A ALL EMPLOYEES ARE ELIGIBLE FOR HEALTH CLUB REIMBURSEMENT AND ANY SUCH REIMBURSEMENTS WERE INCLUDED IN TAXABLE COMPENSATION, PER 2011 PLAN YEAR BENEFITS SUMMARY. PART I, LINE 4B PART I, LINE 4B: IHC AND ITS AFFILIATES SPONSOR A 457(F) PLAN. THE PLAN PARTICIPANTS AND AMOUNTS RECEIVED (IF APPLICABLE) WERE: PATRICIA BRAY, SUSANNE CARLSON ($18,892), PEGGY CHULACK, DAVID KLINGER ($28,418), PERRY EBELTOFT, ROSALIO LOPEZ MD, LON OREY ($89,053), RAMONA PRATT, JUDY PUGACH, JOAN ROLLAND, ROWENA STAJER ($23,867), MARVIN RICE ($65,226), MITCHELL THOMAS ($75,441), REANNA THOMPSON ($29,394), JAMES WEST, AND RONALD YOSHIHARA ($25,368). SUPPLEMENTAL INFORMATION PART III PART II, COLUMN F: THE ORGANIZATION INADVERTENTLY USED THE INCORRECT CALENDAR YEAR BONUS INFORMATION ON THE 2009 FORM 990. THE BONUS IS REPORTED CORRECTLY ON THE 2010 FORM 990 IN PART II, COLUMN B(II). BECAUSE THE BONUS AMOUNTS WERE PREVIOUSLY REPORTED IN THE PRIOR YEAR FORM 990, THE AMOUNTS ALSO APPEAR IN COLUMN F OF THE CURRENT YEAR FORM 990. ALL OTHER COMPENSATION INFORMATION REPORTED ON THE 2009 FORM 990 IS CORRECT. CITY OF WHITTIER - SERIES 2009 956000812 966769DA6 2009-05-14 280328878 HOSPITAL FACILITIES REFUND 2007 BONDS 0 0 0 CITY OF WHITTIER - SERIES 2011 956000812 966769DH1 2011-03-31 40828054 CONSTRUCTION OF FACILITIES 0 0 0 280328878 5800000 2416738 1087414 1337283 2012 1 0 1 1 40828054 939373 40011493 2012 0 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 1 1 GOLDMAN SACHS BANK USA 29.500000000000 0 0 0 0 1 0 0 0 0 0 1 SEE PART V 4635071 0 SCHEDULE L, PART IV: A: LAMBERT RADIOLOGY MEDICAL GROUP, INC.B: SHAREHOLDER, WILLIAM SHANAHAN IS A DIRECTOR OF PIHC: $4,635,071D: RADIOLOGY SERVICES PROVIDED TO PIHE: NO FORM 990, PART VI, SECTION A, LINE 2 1)DREW SONES HAS A BUSINESS RELATIONSHIP WITH LEON M.N. GARCIA. 2)JANE DICUS HAS A BUSINESS RELATIONSHIP WITH DREW SONES. FORM 990, PART VI, SECTION A, LINE 6 INTERHEALTH CORP. ("IHC") IS THE SOLE MEMBER OF PIH. FORM 990, PART VI, SECTION A, LINE 7A IHC HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF PIH. FORM 990, PART VI, SECTION A, LINE 7B IHC HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION, WHICH IS MADE UP OF INDEPENDENT DIRECTORS. THE FORM 990S ARE THEN PROVIDED TO THE BOARD FOR ITS INFORMATION. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL MANAGEMENT AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL POSITIVE RESPONSES ARE REVIEWED BY THE COMPLIANCE OFFICER. EACH POSITIVE RESPONSE IS CONSIDERED IN LIGHT OF MAGNITUDE OF OWNERSHIP INTEREST, FINANCIAL TRANSACTION(S), ETC. IF DEEMED NECESSARY, CONFLICTS OF INTEREST COULD BE RESOLVED BY INSISTING THAT THE INCUMBENT EITHER DIVEST THEIR OWNERSHIP INTEREST, THAT THE ORGANIZATION TERMINATE THE BUSINESS RELATIONSHIP, OR EVEN THAT THE DIRECTOR RESIGN. DIRECTORS WITH POTENTIAL CONFLICTS OF INTEREST MAY RECUSE THEMSELVES FROM VOTING ON CERTAIN MATTERS AND/OR MAY EXCUSE THEMSELVES FROM MEETINGS DURING THE DISCUSSION, DELIBERATION, AND VOTING ON OF MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT, THIRD-PARTY, EXPERT COMPENSATION CONSULTANT TO REVIEW ITS EXECUTIVE SALARIES. THE CONSULTANT OBTAINS SPECIFIC ORGANIZATIONAL DATA FROM WHICH TO BASE ITS ANALYSIS (REVENUES, EXPENSES, EMPLOYEES, SERVICE AREA, JOB DESCRIPTIONS, ETC.). THE CONSULTANT'S ANALYSIS INCLUDES A REVIEW OF COMPENSATION TRENDS, REGULATORY ISSUES, THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, THE METHODOLOGY USED FOR THE ASSESSMENT, THE BASE SALARY ANALYSIS, THE INCENTIVE COMPENSATION ANALYSIS, THE TOTAL CASH COMPENSATION ANALYSIS, AND THE TOTAL COMPENSATION ANALYSIS. SALARY MOVEMENT, INCENTIVE COMPENSATION, MARKET BENEFIT, AND RECRUITMENT AND RETENTION TRENDS ARE REVIEWED. THIS ANALYSIS IS PROVIDED TO THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS. THE EXECUTIVE COMPENSATION COMMITTEE HAS APPROVED A REGIONAL PEER GROUP THAT INCLUDES HIGH-PERFORMING, COMPARABLY-SIZED CALIFORNIA HOSPITALS AND INTEGRATED DELIVERY SYSTEMS. THE CONSULTANT COMPILES COMPARABILITY DATA FROM NATIONAL AND REGIONAL PEERS; COMPARES THE ORGANIZATION'S EXECUTIVE COMPENSATION WITH PEER GROUP COMPENSATION LEVELS; AND PREPARES A REPORT THAT INCLUDES ALL OF THE BACK-UP DATA ON COMPARABILITY, PEER GROUPS, AND JOB MATCHES. THE METHODOLOGY USED BY THE CONSULTANT HAS TWO PEER GROUPS-A NATIONAL PEER GROUP OF COMPARABLY-SIZED HOSPITALS AND INTEGRATED DELIVERY SYSTEMS AND A REGIONAL PEER GROUP OF HOSPITALS AND SYSTEMS IN SOUTHERN CALIFORNIA, THE DATA OF WHICH IS PROVIDED TO THE COMMITTEE IN ITS REPORT. THE NATIONAL DATA IS USED AS THE PRIMARY COMPARATOR FOR THE ANALYSIS. THE COMMITTEE IS PRESENTED WITH CHARTS THAT COMPARE ORGANIZATION SALARIES TO THE LEVEL TARGETED IN THE COMPENSATION PHILOSOPHY. NEITHER PERFORMANCE NOR QUALIFICATIONS OF THE INCUMBENT IS CONSIDERED WHEN PROVIDING THE MARKET DATA. THE COMMITTEE IS PROVIDED WITH A REVIEW OF THE BASE SALARY ANALYSIS, A REVIEW OF THE INCENTIVE COMPENSATION ANALYSIS, A REVIEW OF THE TOTAL CASH COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE), AND A REVIEW OF THE TOTAL COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE PLUS BENEFITS/PERQUISITES). BASED UPON ALL OF THE ABOVE INFORMATION, THE CONSULTANT PROVIDES THE COMMITTEE WITH RECOMMENDED SALARY RANGES FOR THE PERIOD ASSESSED. THE EXECUTIVE COMPENSATION COMMITTEE DELIBERATES ON THE COMPARABILITY DATA TO ENSURE THAT IT IS APPROPRIATE IN REPRESENTING LIKE ORGANIZATIONS, LIKE POSITIONS, AND LIKE CIRCUMSTANCES, AND THAT IT COULD REALISTICALLY RELY ON THE COMPARABILITY DATA IN REACHING ITS DECISION THAT THE COMPENSATION IS REASONABLE AND REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED. THE EXECUTIVE COMPENSATION COMMITTEE AFFIRMS THIS PROCESS TO THE BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE SPECIFIC SALARY OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE SENIOR VICE PRESIDENT OF FINANCE AND CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 AND FORM 990-T ARE AVAILABLE UPON REQUEST. THE ORGANIZATION IS NOT REQUIRED TO MAKE FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS IT RECEIVED ITS TAX EXEMPTION PRIOR TO JULY 15, 1987. FORM 990, PART VII, SECTION A: BOARD MEMBERS ARE NOT COMPENSATED FOR SERVICE AS A MEMBER OF THE BOARD. WILLIAM SHANAHAN MD RECEIVED $55,000 DURING CALENDAR YEAR 2010 FOR PROFESSIONAL SERVICES AS A MEDICAL DIRECTOR. NEAL SHINDEL MD RECEIVED $42,012 DURING CALENDAR YEAR 2010 FOR GI BONUS PAYMENTS. SUDHAKER NAYAK MD RECEIVED $191,106 DURING CALENDAR YEAR 2010 FOR PROFESSIONAL SERVICES AS ED ON CALL FOR PIH. THE HOURS REPORTED ON PART VII ONLY REFLECT TIME SPENT AS AN UNCOMPENSATED BOARD MEMBER AND DOES NOT INCLUDE TIME SPENT ON OTHER DUTIES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -20,815,448. PENSION ADJUSTMENTS -16,444,669. NET UNREALIZED LOSSES ON INTEREST RATE SWAP -9,925,385. LOSS ON INSURANCE LITIGATION SETTLEMENT -650,000. EQUITY TRANSFER TO IHMC -29,039,680. TOTAL TO FORM 990, PART XI, LINE 5: -76,875,182. SCHEDULE R, PART IV, COLUMN (E): PIH INSURANCE COMPANY IS AN UNINCORPORATED RISK RETENTION GROUP. PIH COMMUNITY PHARMACY LLC 12401 WASHINGTON BLVD WHITTIER CA 90602 264390142 PHARMACY CA 2586771 522845 PRESBYTERIAN INTERCOMMUNITY HOSPITAL INC PIH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA SECTION 501(C)(3) 7 INTERHEALTH CORP 1 IHC MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA SECTION 501(C)(3) 11, TYPE 1 INTERHEALTH CORP 1 INTERHEALTH HOME HEALTH CARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 HEALTHCARE CA SECTION 501(C)(3) 9 INTERHEALTH CORP 1 INTERHEALTH CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA SECTION 501(C)(3) 11, TYPE 1 INTERHEALTH CORP 0 MED SITE - HACIENDA HEIGHTS 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 HEALTHCARE CA SECTION 501(C)(3) 9 INTERHEALTH CORP 1 BRIGHT HEALTH PHYSICIANS OF PIH 12401 WASHINGTON BLVD WHITTIER CA 90602 953942828 HEALTHCARE CA SECTION 501(C)(3) 9 INTERHEALTH CORP 1 PIH INSURANCE COMPANY A RECIPROCAL RISK RETENTION GROUP 1003 BISHOP STREET HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI INTERHEALTH CORP T 0 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 IHC MANAGEMENT CORP L 370219 FV BASED ON INTERCOMPANY BALANCE PIH FOUNDATION C 2204568 FV BASED ON INTERCOMPANY BALANCE BRIGHT HEALTH PYSICIANS OF PIH O 3712695 FV BASED ON INTERCOMPANY BALANCE PIH INSURANCE COMPANY A RECIPROCAL RISKRETENTION GROUP Q 1879198 FV BASED ON INTERCOMPANY BALANCE PIH FOUNDATION B 147500 FV BASED ON INTERCOMPANY BALANCE IHC MANAGEMENT CORP Q 29039680 SETTLEMENT OF INTERCO BAL AT FV