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THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: DEFERRED INCOME TAX ASSETS, WHICH AS OF DECEMBER 31, 2010 AND 2009 WERE FULLY RESERVED, REFLECT THE NET TAX EFFECT OF TEMPORARY DIFFERENCES BETWEEN THE CARRYING AMOUNTS OF ASSETS AND THE LIABILITIES FOR FINANCIAL REPORTING AND THE AMOUNTS USED FOR INCOME TAX PURPOSES. AS OF DECEMBER 31, 2010 AND 2009, SUTTER HAD DEFERRED TAX ASSETS OF $13 (MILLION) RELATING PRINCIPALLY TO NET OPERATING LOSS CARRYOVERS. AS OF DECEMBER 31, 2010 AND 2009, SUCH DEFERRED TAX ASSETS WERE OFFSET BY A VALUATION ALLOWANCE OF $13 (MILLION). THE VALUATION ALLOWANCE DID NOT CHANGE IN 2010 OR 2009. FEDERAL NET OPERATING LOSS CARRYOVERS TOTALED $32 (MILLION) AT DECEMBER 31, 2010 AND WILL EXPIRE BETWEEN 2015 AND 2030. 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X X OUTPATIENT SERVICES SUTTER SURGICAL HOSPITAL NORTH VALLEY 1 65 AMADOR CARDIO-INVASIVE & LAB

815 COURT STREET JACKSON CA 95642

CARDIOLOGY AUBURN-AMC FAMILY PRACTICE & ORTHOPEDICS

3133 PROFESSIONAL DRIVE AUBURN CA 95603

FAMILY PRACTICE AND ORTHOPEDICS AUBURN-GASTROENTEROLOGY & NEUROLOGY

11795 EDUCATION STREET AUBURN CA 95602

GASTREOENTEROLOGY AND NEUROLOGY AUBURN-MRI

11815 EDUCATION STREET AUBURN CA 95602

MRI AUBURN-OCCUPATIONAL MEDICINE

13300 AIRPORT BOULEVARD AUBURN CA 95602

OCCUPATIONAL MEDICINE AUBURN-PARKHILL FAMILY PRACTICE

404 AUBURN-FOLSOM ROAD AUBURN CA 95603

FAMILY PRACTICE AUBURN-PHYSICAL THERAPY

11930 HERITAGE OAKS PLACE AUBURN CA 95603

PHYSICAL THERAPY CLINICAL LAB

2715 K STREET SACRAMENTO CA 95816

LABORATORY SERVICES DAVIS-ALLERGY CENTER

1970 LAKE BOULEVARD DAVIS CA 95616

ALLERGY TESTING DAVIS INTERNAL MEDICINE&GASTROENTEROLOGY

2068 JOHN JONES WAY DAVIS CA 95616

INTERNAL MEDICINE AND GASTROENTEROLOGY DAVIS-PHYSICAL THERAPY

1340 LAKE BOULEVARD DAVIS CA 95616

PHYSICAL THERAPY DAVIS MED OFFICE BLDG & ANESTHESIOLOGY

1801 HANOVER DRIVE DAVIS CA 95616

MEDICAL OFFICE BUILDING AND ANESTHESIOLOGY DAVIS PATIENT SERVICE CENTERS

2020 SUTTER PLACE DAVIS CA 95616

PATIENT SERVICE CENTERS ELK GROVE PHYSICAL THERAPY

9280 W STOCKTON BOULEVARD ELK GROVE CA 95758

PHYSICAL THERAPY EXPRESS CLINIC-PLACERVILLE ROAD

10470 OLD PLACERVILLE ROAD SACRAMENTO CA 95827

EXPRESS CLINIC EXPRESS CLINIC-GREENHAVEN

980 FLORIN ROAD SACRAMENTO CA 95831

EXPRESS CLINIC EXPRESS CLINIC-NATOMAS

2751 DEL PASO ROAD SACRAMENTO CA 95835

EXPRESS CLINIC FOLSOM PATIENT SERVICE CENTERS

2575 E BIDWELL STREET FOLSOM CA 95630

PATIENT SERVICE CENTERS FORT SUTTER PATIENT SERVICE CENTERS

1020 29TH STREET SACRAMENTO CA 95816

PATIENT SERVICE CENTERS FORT SUTTER PATIENT SERVICE CENTERS

2801 K STREET SACRAMENTO CA 95816

PATIENT SERVICE CENTERS GRASS VLY FAMILY PRACTICE & PHYS THERAPY

10058 WOLF ROAD GRASS VALLEY CA 95949

FAMILY PRACTICE AND PHYSICAL THERAPY L STREET-MEDICAL NEUROLOGY

5275 F STREET SACRAMENTO CA 95819

NEUROLOGY LINCOLN PHYSICAL THERAPY

965 ORCHARD CREEK LANE LINCOLN CA 95648

PHYSICAL THERAPY NORTHEAST SACRAMENTO PATIENT SVC CENTERS

3100 DOUGLAS BOULEVARD ROSEVILLE CA 95661

PATIENT SERVICE CENTERS NORTHEAST SACRAMENTO PATIENT SVC CENTERS

5767 GREENBACK LANE SACRAMENTO CA 95841

PATIENT SERVICE CENTERS NORTHEAST SACRAMENTO PATIENT SVC CENTERS

83 SCRIPPS DRIVE SACRAMENTO CA 95825

PATIENT SERVICE CENTERS OCCUPATIONAL HEALTH

1014 NORTH MARKET BOULEVARD SACRAMENTO CA 95834

OCCUPATIONAL HEALTH PLACER AREA PATIENT SERVICE CENTERS

1160 SUNSET BOULEVARD ROCKLIN CA 95765

PATIENT SERVICE CENTERS PLACER AREA PATIENT SERVICE CENTERS

3288 BELL ROAD AUBURN CA 95603

PATIENT SERVICE CENTERS PLACER AREA PATIENT SERVICE CENTERS

685 TWELVE BRIDGES DRIVE LINCOLN CA 95648

PATIENT SERVICE CENTERS RANCHO CORDOVA PATIENT SERVICE CENTERS

11121 SUN CENTER DRIVE RANCHO CORDOVA CA 95670

PATIENT SERVICE CENTERS ROCKLIN FAMILY PRACTICE

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FAMILY PRACTICE ROSEVILLE FAMILY PRACTICE & PHYS THERAPY

568 N SUNRISE AVENUE ROSEVILLE CA 95661

FAMILY PRACTICE AND PHYSICAL THERAPY ROSEVILLE EXPRESS CLINIC

4004 FOOTHILLS BOULEVARD ROSEVILLE CA 95747

EXPRESS CLINIC ROSEVILLE PATIENT SERVICE CENTERS

MEDICAL PLAZA DRIVE ROSEVILLE CA 95661

PATIENT SERVICE CENTERS SACRAMENTO AREA PATIENT SERVICE CENTERS

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PATIENT SERVICE CENTERS SACRAMENTO AREA PATIENT SERVICE CENTERS

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PATIENT SERVICE CENTERS SACRAMENTO AREA PATIENT SERVICE CENTERS

5301 F STREET SACRAMENTO CA 95819

PATIENT SERVICE CENTERS SACRAMENTO AREA PATIENT SERVICE CENTERS

8170 LAGUNA BOULEVARD ELK GROVE CA 95758

PATIENT SERVICE CENTERS SACRAMENTO CARDIO-INVASIVE

2575 E BIDWELL STREET FOLSOM CA 95630

CARDIOLOGY SACRAMENTO PATIENT SERVICE CENTERS

2800 L STREET SACRAMENTO CA 95816

PATIENT SERVICE CENTERS SMUD OCCUPATIONAL HEALTH

1708 59TH STREET SACRAMENTO CA 95819

OCCUPATIONAL HEALTH WINTERS FAMILY PRACTICE

111 EAST GRANT AVENUE WINTERS CA 95694

FAMILY PRACTICE WOODLAND PATIENT SERVICES CENTER

475 PIONEER AVENUE WOODLAND CA 95776

PATIENT SERVICES CENTER YOLO AREA PATIENT SERVICES CENTER

125 N LINCOLN STREET DIXON CA 95620

PATIENT SERVICES CENTER YOLO AREA PATIENT SERVICES CENTER

2210 DEL PASO ROAD SACRAMENTO CA 95831

PATIENT SERVICES CENTER YOLO AREA PATIENT SERVICES CENTER

635 ANDERSON ROAD DAVIS CA 95616

PATIENT SERVICES CENTER YOLO AREA PATIENT SERVICES CENTER

7420 GREENHAVEN DRIVE SACRAMENTO CA 95831

PATIENT SERVICES CENTER MED OFFICE BLDG AMBULATORY SURGERY CTR

460 PLUMAS YUBA CITY CA 95991

OUTPATIENT SERVICES URGENT CARELABRADIOLOGYCARDIOLOGY

440 PLUMAS YUBA CITY CA 95991

URGENT CARE/LAB/RADIOLOGY/ CARDIOLOGY MEDICAL OFFICE BUILDING

480 PLUMAS YUBA CITY CA 95991

OUTPATIENT SERVICES OBSTETRICS

969 PLUMAS YUBA CITY CA 95991

OBSTETRICS HOME HEALTHHOSPICE

400 PLUMAS YUBA CITY CA 95991

HOME HEALTH/HOSPICE DERMATOLOGY

350 DEL NORTE YUBA CITY CA 95991

DERMATOLOGY ORTHOPEDICS

470 PLUMAS YUBA CITY CA 95991

ORTHOPEDICS PHYSICAL THERAPY

420 B STREET YUBA CITY CA 95991

PHYSICAL THERAPY PROCEDURE CENTER

550 B STREET YUBA CITY CA 95991

PROCEDURE CENTER OBSTETRICS

924 CHESTNUT YUBA CITY CA 95991

OBSTETRICS SUTTER FAIRFIELD DIAGNOSTIC IMAGING CTR

2700 LOW COURT 1ST FLR FAIRFIELD CA 94534

DIAGNOSTIC IMAGING CENTER MEDICAL OFFICE BUILDING

2702 LOW COURT FAIRFIELD CA 94534

OUTPATIENT SERVICES CARE CENTER AND CALL CENTER

2450 MARTIN ROAD FAIRFIELD CA 94533

OUTPATIENT SERVICES SUTTER FAIRFIELD SURGERY CENTER

2700 LOW COURT 2ND FLOOR FAIRFIELD CA 94534

SURGERY CENTER VACAVILLE CARE CENTER

770 MASON STREET VACAVILLE CA 95687

OUTPATIENT SERVICES RIO VISTA CARE CENTER

690 MAIN STREET RIO VISTA CA 94571

OUTPATIENT SERVICES VALLEJO CARE CENTER

100 HOSPITAL DRIVE 2ND FLOOR VALLEJO CA 94589

OUTPATIENT SERVICES PART I, QUESTION 3C TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 350% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURER HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR A 20% DISCOUNT IF 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE. PART I, QUESTION 7 COSTING METHODOLOGY USED: COST TO CHARGE RATION UTILIZING WORKSHEET 2 METHODOLOGY. PART II COMMUNITY BUILDING ACTIVITIES N/A PART III, QUESTION 4 THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. 1. AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 28% AS OF 12/31/10 27% AS OF 12/31/09 MEDI-CAL 20% AS OF 12/31/10 20% AS OF 12/31/09 DURING 2010 AND 2009, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYORS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. 2. METHODOLOGY FOR CALCULATING BAD DEBT (AT COST) THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. 3. METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. PART III, QUESTION 7 MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. THEREFORE THE AMOUNT REFLECTED ON THE COST REPORT WILL LIKELY DIFFER FROM ACTUAL COSTS WHICH MAY BE REFLECTED IN THE COMMUNITY BENEFIT REPORT AND ON THIS FORM. PART III, QUESTION 8 COSTING METHODOLOGY MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT OF $150,320. PART III, QUESTION 9B COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. NEEDS ASSESSMENT: SUTTER MEDICAL FOUNDATION RESIDES WITHIN THE SUTTER HEALTH SACRAMENTO SIERRA REGION, WHICH (SHSSR) PARTICIPATES IN A COLLABORATIVE COMMUNITY NEEDS ASSESSMENT (CNA) - KAISER PERMANENTE, MERCY, UC DAVIS HEALTH SYSTEM - PROCESS EVERY THREE YEARS TO HELP TARGET AREAS OF NEED WITHIN THE COMMUNITIES SERVED. RESULTS FROM THE CNA ASSIST SHSSR WITH IDENTIFYING AREAS OF FOCUS AND ARE UTILIZED TO DRAFT A THREE-YEAR PLAN TO ADDRESS IDENTIFIED NEEDS. THE INTERACTIVE CNA WEB SITE CAN BE SEEN AT WWW.HEALTHYLIVINGMAP.COM PATIENT EDUCATION FOR ELIGIBILITY FOR ASSISTANCE: SUTTER MEDICAL FOUNDATION FOLLOWS A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW PATIENT EDUCATION FOR ELIGIBILITY ASSISTANCE. COMMUNICATION OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS) B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION" B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATION TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. COMMUNITY INFORMATION: THE AFFILIATES IN THE SUTTER HEALTH SACRAMENTO SIERRA REGION SERVE PLACER, SACRAMENTO, YOLO, SOLANO, YUBA, SUTTER AND AMADOR COUNTIES. THE COUNTIES INCLUDE BOTH RURAL AND URBAN COMMUNITIES THAT ARE VERY DIVERSE - FROM COMMUNITIES SERVING A HIGH PERCENTAGE OF MIGRANT FARM WORKERS (YOLO), AN URBAN CITY THAT WAS NAMED THE MOST DIVERSE CITY IN THE UNITED STATES (SACRAMENTO), TO A COUNTY WITH THE HIGHEST PER CAPITA INCOME IN THE STATE (PLACER COUNTY). THE PERCENT ELIGIBLE FOR MEDI-CAL DEMONSTRATES THE VAST DIFFERENCE OF THESE COUNTIES. IN 2006, CALIFORNIA HAD 17.8% ELIGIBLE FOR MEDI-CAL. DURING THE SAME YEAR, PLACER HAD 8%, YOLO HAD 13% AND SACRAMENTO HAD 19% ELIGIBLE. MAJORITY OF THE HEALTH INDICATORS AND DEMOGRAPHIC DATA FOR THESE THREE COUNTIES FOLLOWS THIS TREND. PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION READS: WE ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES. SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR CARE FACILITIES. OUR AFFILIATES FURTHER THEIR TAX EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST THROUGH WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS SUTTER MEDICAL FOUNDATION SPECIFIC ACTIVITIES INCLUDE: - WORKING COLLABORATIVELY WITH COMMUNITY SAFETY NET CLINICS TO HELP ENSURE UNDER AND UNINSURED HAVE ACCESS TO PRIMARY CARE SERVICE - BUILDING RELATIONSHIPS WITH COUNTY AND CITY HEALTH DEPARTMENTS TO MOVE COMMUNITY HEALTH INITIATIVES BEYOND THE TRADITIONAL PUBLIC HEALTH TACTICS AFFILIATED HEALTH CARE SYSTEM: SUTTER MEDICAL FOUNDATION, WHICH IS PART OF SUTTER HEALTH, A NOT-FOR-PROFIT SYSTEM OF PHYSICIANS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS. SERVING PATIENTS AND THEIR FAMILIES IN MORE THAN 100 NORTHERN CALIFORNIA CITIES AND TOWNS, SUTTER HEALTH AFFILIATES JOIN RESOURCES AND SHARE EXPERTISE TO ADVANCE HEALTH CARE QUALITY AND ACCESS. SUTTER-AFFILIATED HOSPITALS ARE REGIONAL LEADERS IN CARDIAC CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, ORTHOPEDICS, AND ADVANCED PATIENT SAFETY TECHNOLOGY. SUTTER HEALTH HOSPITALS PLAN AND DELIVER COMMUNITY BENEFIT SERVICES LOCALLY WITH A FOCUS ON COLLABORATING WITHIN THEIR COMMUNITY TO MEET IDENTIFIED NEEDS. IN 2010, SUTTER HEALTH AFFILIATES PROVIDED $751 MILLION IN SERVICES TO THE POOR* AND BROADER COMMUNITY**. SUTTER HEALTH FOLLOWS THE NATIONAL STANDARDS FOR COMMUNITY BENEFIT REPORTING AS OUTLINED IN CHA'S A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT 2008. * SERVICES FOR THE POOR AND UNDERSERVED INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED, AS WELL AS THE COSTS OF PUBLIC PROGRAMS TREATING MEDI-CAL AND INDIGENT BENEFICIARIES. COSTS ARE COMPUTED BASED ON A RELATIONSHIP OF COSTS TO CHARGES. SERVICES FOR THE POOR AND UNDERSERVED ALSO INCLUDE THE COST OF OTHER SERVICES FOR INDIGENT POPULATIONS, AND CASH DONATIONS ON BEHALF OF THE POOR AND NEEDY. ** BENEFITS FOR THE BROADER COMMUNITY INCLUDE COSTS OF PROVIDING THE FOLLOWING SERVICES: HEALTH SCREENINGS AND OTHER HEALTH-RELATED SERVICES, TRAINING HEALTH PROFESSIONALS, EDUCATING THE COMMUNITY WITH VARIOUS SEMINARS AND CLASSES, THE COST OF PERFORMING MEDICAL RESEARCH AND THE COSTS ASSOCIATED WITH PROVIDING FREE CLINICS AND COMMUNITY SERVICES. BENEFITS FOR THE BROADER COMMUNITY ALSO INCLUDE CONTRIBUTIONS SUTTER HEALTH MAKES TO COMMUNITY AGENCIES TO FUND CHARITABLE ACTIVITIES. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI CA, true SUTTER DAVIS FOUNDATION 2000 SUTTER PLACE DAVIS CA 95616 680217870 501(C)(3) 16000 GENERAL DONATION SUTTER SOLANO CHARITABLE FOUNDATION 300 HOSPITAL DRIVE VALLEJO CA 94589 942668262 501(C)(3) 17851 PROGRAM SUPPORT YUBA CITY UNIFIED 750 PALORA AVE YUBA CITY CA 95991 946002768 126681 PROGRAM SUPPORT SHADY CREEK OUTDOOR EDUCATION 970 KLAMATH LANE YUBA CITY CA 95993 680239809 501(C)(3) 15000 GENERAL DONATION MARYSVILLE JOINT UNIFIED SCHOOL DISTRICT 1919 B ST MARYSVILLE CA 95901 9500 PROGRAM SUPPORT 3 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS PART I, LINE 2 1. VARIOUS DEPARTMENTS OF THE HOSPITAL REQUEST FUNDING FROM THE FOUNDATION. 2. THE BOARD OF TRUSTEES AND THE EXECUTIVE DIRECTOR APPROVES THE HOSPITALS REQUEST. 3. THE APPROVAL IS SENT TO THE REQUESTING DEPARTMENT. 4. THE REQUESTING DEPARTMENT PROVIDES THE FOUNDATION A COPY OF THE INVOICE SUBSTANTIATING THE COSTS INCURRED. 5. THE FOUNDATION FORWARDS THE REQUEST FROM THE HOSPITAL, THE BOARD OF TRUSTEES MINUTES APPROVING THE FUNDING AND THE COPY OF THE INVOICE TO THE ACCOUNTANTS TO RELEASE THE FUNDS. THE SUTTER HEALTH SYSTEM HAS AN OVERLAP IN LEADERSHIP WHICH MONITORS THE USE OF GRANTS BETWEEN AFFILIATES. X X X true true X X X X false true false false false false false true false CAROL APPENZELLER 0 220223 0 35600 0 631 0 69386 0 11052 0 336892 0 42323 TOM BLINN 0 494089 0 273662 0 10746 0 459728 0 15029 0 1253254 0 202089 PAT FRY 0 1450576 0 1233950 0 15110 0 2058620 0 30292 0 4788548 0 973771 SUSAN GOWER 0 232017 0 50300 0 4131 0 86490 0 11991 0 384929 0 46050 GLEN GROVES 0 226464 0 36300 0 3236 0 71896 0 6378 0 344274 0 43995 SARAH KREVANS 0 813872 0 602072 0 12439 0 645775 0 20775 0 2094933 0 533801 LESLIE PRATT 154299 0 17412 0 0 0 7710 0 13141 0 192562 0 0 0 ERIC RASMUSSEN 178806 0 17412 0 0 0 8810 0 18235 0 223263 0 0 0 JOHN RAY 0 335423 0 176013 0 8374 0 181097 0 13466 0 714373 0 168630 CHRIS ROGERS 0 221673 0 53800 0 343 0 74188 0 16428 0 366432 0 39140 THERESA RUIZ 0 148334 0 30800 0 120 0 52951 0 10534 0 242739 0 25539 JEFF SPRAGUE 0 428571 0 156805 0 722 0 195028 0 17254 0 798380 0 142002 PENNY WESTFALL 0 266619 0 76293 0 0 0 101595 0 7861 0 452368 0 0 DAVID YAMAMOTO 0 269563 0 153628 0 8390 0 145915 0 16463 0 593959 0 111820 GARY ZUFELT 0 272279 0 154974 0 412 0 131133 0 16484 0 575282 0 102291 TERESA WILSON 153223 0 25300 0 27 0 8017 0 17645 0 204212 0 0 0 MICHAEL MARINO 159705 0 16400 0 2115 0 54625 0 10581 0 243426 0 0 0 KAREN GRIMMER 153103 0 15055 0 0 0 7550 0 13121 0 188829 0 0 0 KEVIN ENGLE 155092 0 9200 0 806 0 7413 0 3523 0 176034 0 0 0 LISA BYNUM 143919 0 14505 0 0 0 7113 0 17942 0 183479 0 0 0 RELEVANT INFORMATION REGARDING COMPENSATION ITEMS PART I, QUESTION 1A FIRST-CLASS TRAVEL: OFFICERS PAID BY SUTTER HEALTH MAY UPGRADE TO FIRST-CLASS TRAVEL FOR FLIGHTS GREATER THAN FOUR HOURS IN DURATION. TRAVEL FOR COMPANIONS: OFFICERS AND KEY EMPLOYEES PAID BY SUTTER HEALTH ARE ELIGIBLE TO BRING A COMPANION ON ONE BUSINESS TRIP PER CALENDAR YEAR AND HAVE THE COST OF THE AIRFARE AND MEALS PAID FOR BY SUTTER HEALTH. THE COST IS ADDED TO EMPLOYEE'S WAGES. TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES. SUPPLEMENTAL COMPENSATION INFORMATION PART I, QUESTION 3 THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. NONQUALIFIED RETIREMENT PLAN PART I, QUESTION 4B THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE ADDITIONAL DEFERRED COMPENSATION BENEFITS TO THE PARTICIPANTS, WHO ARE MEMBERS OF A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, BY PROVIDING FOR THE PAYMENT OF DEFERRED COMPENSATION AFTER THE COMPLETION OF THE SPECIFIED NUMBER OF YEARS OF SERVICE. ANNUALLY, SUTTER HEALTH MAKES A CONTRIBUTION TO EACH PARTICIPANT'S ACCOUNT BASED ON 4% OF BASE PAY. THERE IS AN ADDITIONAL CONTRIBUTION FOR EXECUTIVES WHOSE PENSION ELIGIBLE EARNINGS WERE GREATER THAN THE PENSION PAY CAP IN THE PREVIOUS YEAR. THE CALCULATION IS AS FOLLOWS: - PENSION ELIGIBLE EARNINGS - LESS PENSION PAYCAP AMOUNT - TIMES A SPECIFIC % BASED ON YEARS OF SERVICE THE PENSION RESTORATION PLAN IS DESIGNED TO HELP MAXIMIZE EACH PARTICIPANT'S RETIREMENT POTENTIAL BY PROVIDING A TARGETED BENEFIT THAT, ALONG WITH EACH PARTICIPANT'S OTHER RETIREMENT INCOME, PROVIDES: - 65% OF FINAL 4-YEAR AVERAGE SALARY IF PARTICIPANT RETIRES AT AGE 65 WITH 22.5 YEARS OF SERVICE. - 50% OF FINAL 4-YEAR AVERAGE SALARY IF PARTICIPANT RETIRES AT AGE 65 WITH 15 YEARS OF SERVICE. SINCE IT IS A TARGETED BENEFIT, ANNUAL CONTRIBUTION AMOUNTS VARY BASED ON ASSUMPTIONS MADE TAKING INTO ACCOUNT EACH PARTICIPANTS' AGE, YEARS OF SERVICE, AND OTHER RETIREMENT ACCOUNT BALANCES. NAME AND AMOUNT FOR 2010: JEFF SPRAGUE $36,700 PAT FRY $1,127,856 SARAH KREVANS $149,800 PENNY WESTFALL $15,200 TOM BLINN $224,700 SUSAN GOWER $8,200 GARY ZUFELT $12,300 CHRIS ROGERS $8,300 JOHN RAY $23,900 CAROL APPENZELLER $7,600 THERESA RUIZ $5,400 DAVID YAMAMOTO $15,500 GLEN GROVES $7,800 MICHAEL MARINO $6,100 NON-FIXED PAYMENTS PART I, QUESTION 7 SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLAN (LTPP) Sutter Health also employs long term performance plans which are designed to focus on longer term strategic objectives of the organization. Sutters long term performance plan approach is a combination of both longer term measures of organization success and key organization strategies which require the combined effort of all leadership to achieve success. Sutter uses a common fate approach in that all plan participants are measured against the same, organization wide criteria vs. individual efforts. This fosters a common purpose across leadership and a shared sense of accountability for the overall success of Sutter Health. To ensure that extraordinary efforts by individuals can be recognized and that actions of leadership are consistent with supporting Sutter Healths overall Mission, Vision, and Values, Sutters long term incentive plan approach also incorporates a CEO discretionary component. This unique feature allows the President & CEO the ability to modify individual awards within limits that have been pre-approved by the Sutter Health Compensation Committee. This includes both the reduction and increase of award amounts. Such modifications generally do not exceed +/- 20% and are employed judiciously and are reviewed by the Compensation Committee. CSCDA 2003AB 521598225 130911NE6 2007-05-01 16278513 RENOVATION & EXPANSION OF FACILITY false false false CSCDA 2004CD 680164610 130795TE7 2008-05-06 11403068 REFUNDING - 2/17/2004 false false false CHFFA 2008A 521643828 13033F2L3 2008-05-14 15965405 REFUNDING - 2/17/2004 false false false 16846004 1354095 true false true true 949923 11483497 1011293 true false true true 2414644 15965405 false false true true false false true false true 0.00000 0.00000 0.00000 true false true true false true 0.00139 0.00000 0.00139 true false true true false true 0.00057 0.00000 0.00057 true false false false false false false false false false false true false false false false false false false SEE SCHEDULE O MARION LEFF MD TRUSTEE 108521145 SEE PART V false THERESA RUIZ KEY EMPLOYEE 30982 SEE PART V false DESCRIPTION OF BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV MARION LEFF, MD. - TRUSTEE OF SUTTER MEDICAL FOUNDATION, IS ALSO A MEMBER AND A SHAREHOLDER OF SUTTER MEDICAL GROUP (SMG). DURING THE YEAR, SMG PROVIDED MEDICAL SERVICES TO SMF VIA A PHYSICIAN SERVICES AGREEMENT. THERESA RUIZ - KEY EMPLOYEE, HAS A FAMILY MEMBER WHO WORKS AS A MEDICAL ASSISTANT FOR SMF-NORTH. MISSION STATEMENT FORM 990, PART I, LINE 1 AND PART III, LINE 1 WE ENHANCE THE HEALTH AND WELL BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES. EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINE 4A SUTTER MEDICAL FOUNDATION (SMF) IS A COMMUNITY BASED, NOT-FOR-PROFIT MEDICAL ORGANIZATION SERVING NORTHERN CALIFORNIA COMMUNITIES AND SUPPORTING THE FOLLOWING CHARITABLE ORGANIZATIONS: SUTTER MEDICAL CENTER OF SACRAMENTO, SUTTER AUBURN FAITH HOSPITAL, SUTTER DAVIS HOSPITAL, SUTTER ROSEVILLE MEDICAL CENTER, SUTTER SOLANO HOSPITAL AND SUTTER AMADOR HOSPITAL. WITH CARE CENTERS LOCATED IN SACRAMENTO, YOLO, SUTTER, YUBA, SOLANO, PLACER AND AMADOR COUNTIES WE DO OUR PART TO ENSURE THE HEALTH AND WELL BEING OF OUR COMMUNITIES. OUR MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH NOT FOR PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE. WE VALUE EXCELLENCE AND QUALITY, CARING AND COMPASSION, HONESTY AND INTEGRITY, TEAMWORK AND COMMUNITY. SUTTER MEDICAL FOUNDATION IS ALIGNED WITH PHYSICIANS AND MID-LEVEL PROVIDERS OF SUTTER MEDICAL GROUP AND SUTTER NORTH MEDICAL GROUP OFFERING PRIMARY CARE AND SPECIALTY CARE TO OUR PATIENTS. OFFERING A FULL RANGE OF MEDICAL SERVICES, SUTTER MEDICAL FOUNDATION PROVIDES AMBULATORY SURGERY, URGENT CARE CLINICS, HOME HEALTH, HOSPICE AND STATE OF THE ART IMAGING AND CARDIOLOGY TECHNOLOGY. IN ADDITION, WE OPERATE A RURAL HEALTH CLINIC IN THE COMMUNITY OF BROWNSVILLE, YUBA COUNTY. THE FOUNDATION PROVIDED MORE THAN $35 MILLION IN UNDER AND UNREIMBURSED PATIENT CARE ALONG WITH A VARIETY OF COMMUNITY HEALTH PROGRAMS. FOCUS ON CHILDHOOD OBESITY SUTTER MEDICAL FOUNDATION HAS PARTNERED WITH YUBA CITY UNIFIED SCHOOL DISTRICT TO ENHANCE THE PHYSICAL EDUCATION PROGRAMS FOR STUDENTS K-5. THE PARTNERSHIP INCLUDES DEDICATED TEACHING STAFF FOR PHYSICAL EDUCATION AND PARENT EDUCATION SEMINARS TO ASSIST PARENTS AND GUARDIANS IN MAKING HEALTHY CHOICES FOR THEIR FAMILIES. THE SUTTER HEALTH POWER KIDS TRAVEL NORTHERN CALIFORNIA EDUCATING YOUTH ABOUT THE IMPORTANCE OF PHYSICAL FITNESS AND NUTRITION. APPEARING AT HEALTH FAIRS, PARADES AND COMMUNITY EVENTS THE POWER KIDS ARE POPULAR EDUCATORS AMONG STUDENT PRE-SCHOOL THRU THIRD GRADE. SUPPORT GROUPS SUTTER MEDICAL FOUNDATION PROVIDES A VARIETY OF FREE SUPPORT GROUPS TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. PATIENTS CAN RECEIVE SUPPORT FOR BREAST CANCER, DIABETES, AUTISM AND PARKINSON'S. SCHOOL BASED HEALTH CLINIC ON A MONTHLY BASIS SUTTER NORTH PROVIDERS ALTERNATE AS VOLUNTEERS AT SCHOOL BASED HEALTH CLINICS TO PROVIDE ACUTE MEDICAL CARE TO CHILDREN AT NO COST TO THEIR FAMILIES. SUTTER NORTH MEDICAL FOUNDATION MANAGES ALL OF THE FUNDS FOR THE SCHOOL BASED HEALTH CLINICS AND ALLOWS TIME FOR EMPLOYEES TO BECOME INVOLVED AS VOLUNTEERS. PINK OCTOBER & WOMEN'S HEALTH SCREENING DAY SUTTER MEDICAL FOUNDATION HOSTS WOMEN'S HEALTH SCREENING DAY ANNUALLY AND JOINS FORCES WITH THE YUBA-SUTTER PINK OCTOBER COMMITTEE TO INCREASE AWARENESS OF EARLY DETECTION OF BREAST CANCER. WOMEN'S HEALTH SCREENING DAY PROVIDES RECTAL, CLINICAL BREAST, PAP AND BONE DENSITY SCREENINGS AT A FREE OR MINIMAL COST TO WOMEN WHO EITHER ARE UNDER OR NOT INSURED. SEVEN PROVIDERS OF SUTTER NORTH MEDICAL GROUP, IN YUBA CITY AND THE RURAL COMMUNITY OF BROWNSVILLE, DONATE THEIR TIME TO THE WOMEN'S HEALTH SCREENING DAY AND MORE THAN 185 WOMEN RECEIVED THE SERVICE. IN ADDITION, SUTTER MEDICAL FOUNDATION PROVIDED MORE 300 MAMMOGRAMS FOR UNDER AND NON INSURED WOMEN. THE SCREENING FEE FOR THE WOMEN WAS A MINIMAL $30 COST PER PATIENT. PROSTATE SCREENING FOR MEN IN SEPTEMBER 2008, SUTTER NORTH MEDICAL FOUNDATION HOSTED A PROSTATE-SCREENING DAY FOR THE NON-INSURED AND UNDER-INSURED MEN. THE SCREENINGS ARE HELD AT OUR YUBA CITY CAMPUS WITH PROVIDERS DONATING THEIR TIME. THE SCREENING INCLUDES AN EDUCATIONAL CAMPAIGN AROUND THE IMPORTANCE OF REGULAR EXAMS AND SCREENINGS. MORE THAN 90 EXAMS WERE PROVIDED FOR THE LOW COST FEE OF $15. 2010 COMMUNITY SPONSORED EVENTS IN 2010, SUTTER MEDICAL FOUNDATION DONATED TO SEVERAL VARIOUS COMMUNITY EVENTS. WE MAKE IT OUR POLICY TO SUPPORT LOCAL AND NATIONAL NOT-FOR-PROFIT ORGANIZATIONS AND PUBLIC INSTITUTIONS IN NEED OF ASSISTANCE. MOREOVER, OUR EMPLOYEES MAKE EVERY EFFORT TO DONATE THEIR TIME TO LOCAL CAUSES AND YOU WILL FIND MANAGEMENT, PROVIDERS AND STAFF VOLUNTEERING WITH THE AMERICAN CANCER SOCIETY, UNITED WAY, MARCH OF DIMES, NATIONAL DIABETES SOCIETY, AMERICAN HEART ASSOCIATION, KIWANIS, ROTARY, SOROPTIMIST, GIRLS ON THE RUN, CHAMBER OF COMMERCE AND IN COMMUNITY SCHOOLS AND RELIGIOUS ORGANIZATIONS. TATTOO REMOVAL PROGRAM THE TATTOO REMOVAL PROGRAM (TATS OFF) REMOVES VISIBLE GANG TATTOOS FROM THE FACE, NECK, HANDS OR WRISTS (AND ANKLES FOR WOMEN), ELIMINATING THE STIGMA OF A PAST LIFESTYLE. IT NORMALLY TAKES FROM THREE TO TEN LASER TREATMENTS TO COMPLETE THE REMOVAL OF EACH DESIGN. THESE SESSIONS ARE SCHEDULED ONE MONTH APART TO FACILITATE PROPER HEALING BEFORE THE NEXT TREATMENT. THE OBJECTIVE IS TO MAKE IT EASIER FOR PEOPLE TO BEGIN A NEW LIFE, OBTAIN EMPLOYMENT AND ESCAPE BEING NEGATIVELY AND INACCURATELY STEREOTYPED. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTIONS 6 & 7A THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS, IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990 FORM 990, PART VI, QUESTION 11A SUTTER HEALTH HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, OFFICE OF THE GENERAL COUNSEL, AND HUMAN RESOURCES. ADDITIONALLY, THE CHIEF FINANCIAL OFFICER SIGNS OFF ON THIS DATA BEFORE THE RETURN GOES TO THE PREPARATION STAGE. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT AND THE AFFILIATE WITH THE CHIEF FINANCIAL OFFICER GIVING HIS/HER APPROVAL BEFORE THE RETURN IS FILED. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12 EACH INDIVIDUAL BOARD MEMBER AND OFFICER HAS TO SIGN AN ACKNOWLEDGEMENT FORM THAT THEY HAVE READ THE POLICY. ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL OFFICERS AND BOARD MEMBERS. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED TRUSTEE MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE TRUSTEE TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED TRUSTEE SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, QUESTION 15 THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. ALL OFFICERS OF THE ORGANIZATION (I.E., CEO, CFO, COO) UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL ANNUALLY. KEY EMPLOYEES AND OTHER EXECUTIVES OF SUTTER HEALTH WHO ARE CONSIDERED DISQUALIFIED PERSONS FOR FORM 990 REPORTING PURPOSES ARE HANDLED IN THE SAME MANNER. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATION FORM 990, PART VII THE FOLLOWING BOARD MEMBERS/OFFICERS OF THE ORGANIZATION ARE FULL-TIME (40 HOURS PER WEEK) EMPLOYEES OF SUTTER HEALTH AND THEIR SUTTER HEALTH SALARIES ARE REPORTED HEREIN. THESE INDIVIDUALS RECEIVE NO COMPENSATION FOR THEIR SERVICE AS BOARD MEMBERS/OFFICERS OF THIS ORGANIZATION. SARAH KREVANS PAT FRY OTHER CHANGES IN FUND BALANCE FORM 990, PART XI, LINE 5 CHANGE IN UNREALIZED GAIN/(LOSS) ON INVESTMENTS $ 13,299,884 K-1 ORDINARY INCOME (6,446,297) K-1 GUARANTEED PAYMENTS (477,519) K-1 INTEREST INCOME (836) K-1 SECTION 1231 LOSS 6,077 NORTH BAY ASSET TRANSFER TO SWBMF (13,222,217) CHANGE IN UNREALIZED GAIN/(LOSS) 30,721 CHANGE IN SPLIT INTEREST 4.469 EQUITY TRANSFERS (NET) 39,319,940 PRIOR PERIOD ADJUSTMENTS 1,353,163 ------------- $ 33,867,385 ============ COMPILATION, REVIEW AND AUDIT OF INDEPENDENT ACCOUNTANT FORM 990, PART XII, QUESTION 2 ANNUALLY THE SUTTER HEALTH SYSTEM HAS AN AUDIT OF COMBINED BALANCE SHEETS AND STATEMENTS OF OPERATIONS PERFORMED BY INDEPENDENT AUDITORS. AN AUDIT COMMITTEE SELECTS THE AUDITORS AND REVIEWS RESULTS. SCHEDULE K SUPPLEMENTAL INFORMATION SCHEDULE K GLOBAL DISCLOSURE PART I, COLUMN (E): THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO SUBSIDIARY ORGANIZATIONS. THE ORGANIZATION IS ONLY REPORTING THE AMOUNT IT HAS BEEN ALLOCATED. PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH AN EQUITY CONTRIBUTION. SMF SPECIFIC PART I, LINE A, COLUMN (F): THE INITIAL BONDS ISSUED IN 2003 WERE NEW MONEY BONDS THAT WERE RETIRED AND REISSUED ON MAY 1, 2007. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE "NEW MONEY" BONDS. PART I, LINE B, COLUMN (F): THE INITIAL BONDS ISSUED IN 2004 WERE NEW MONEY BONDS THAT WERE RETIRED AND REISSUED ON MAY 6, 2008. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE "NEW MONEY" BONDS. PART I, LINE C, COLUMN (F): THE REFUNDING OCCURRED VIA THE REPAYMENT OF A DRAW ON A TAXABLE LINE OF CREDIT, DRAWN IN SEVERAL INSTALLMENTS BETWEEN APRIL 7 AND APRIL 11, 2008, USED TO REFUND THE 2004 ISSUE. PART IV, LINE 5, COLUMN (B): INVESTMENTS OF UNEXPENDED PROCEEDS CONTINUE TO BE MONITORED BY THE CORPORATE MEMBER OF THE ORGANIZATION AND ITS ARBITRAGE CONSULTANTS (THE BANK OF NEW YORK MELLON TRUST COMPANY, N.A. AND BLX GROUP) FOR COMPLIANCE WITH YIELD RESTRICTIONS. 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