2026-08-14T19:08:37+00:00 2025-09-30 135565207 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2024-10-01 951656366 PIH HEALTH GOOD SAMARITAN HOSPITAL PIHH 2139772121 1225 WILSHIRE BLVD LOS ANGELES CA 900172395 VID SHIVARAMAN CFO 2026-08-15 true ALISON LAKRITZ P01935980 4159635100 2026-08-15 2024 2025-03-06 01:10:19Z JAMES WEST 12401 WASHINGTON BLVD WHITTIER CA 90602 373821593 false X WWW.PIHHEALTH.ORG X 1885 CA PROVIDE HIGH-QUALITY HEALTHCARE, WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING. 18 18 1768 263 156862 0 7694857 17735583 368107801 320227054 8917861 11895738 6506734 10644155 391227253 360502530 5169509 3055493 0 176197164 173236288 0 126012 230694278 253654276 412060951 429946057 -20833698 -69443527 602884520 685780667 196891669 344389192 405992851 341391475 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. false false 196376007 0 116176350 FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: FINANCIAL ASSISTANCE, ALSO KNOWN AS CHARITY CARE, IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO INDIVIDUALS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PIH HEALTH GOOD SAMARITAN HOSPITAL OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM, PROVIDING CHARITY CARE TO THOSE WITH FAMILY INCOME(S) AT OR BELOW 400% OF FEDERAL POVERTY LEVEL GUIDELINES. THE HOSPITAL HAS A POLICY TO TREAT EMERGENCY AND CERTAIN OTHER PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. UNDER THE CHARITY CARE POLICY, CHARITY CARE MAY BE PROVIDED TO PEOPLE WHO ARE UNINSURED OR UNDERINSURED AND CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN MEANS-TESTED GOVERNMENT HEALTH PROGRAMS, SUCH AS MEDI-CAL, PIH HEALTH GOOD SAMARITAN HOSPITAL REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR DUE TO THE SHORTFALL CREATED WHEN THE PAYMENTS RECEIVED FROM THESE PROGRAMS ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 41,342 178204513 3055493 193390664 PATIENT CARE: FOUNDED IN 1885, PIH HEALTH GOOD SAMARITAN HOSPITAL IS THE OLDEST HOSPITAL IN LOS ANGELES. IT BECAME PART OF PIH HEALTH IN DECEMBER 2019. AS A NONPROFIT, 408-BED ACUTE CARE HOSPITAL, THE DOWNTOWN LOS ANGELES CAMPUS INCLUDES A HOSPITAL AND A MEDICAL OFFICE BUILDING, WHICH PROVIDE COMPASSIONATE HEALTHCARE SERVICES TO MEET THE NEEDS OF OUR PATIENTS, THEIR FAMILIES, AND A GROWING AND DIVERSE COMMUNITY. PATIENT CARE IN FISCAL YEAR 2024-2025 EMPLOYEES - 1,455 VOLUNTEERS - 263 NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS - 45,793 NUMBER OF BIRTHS - 1,103 MEDICAL STAFF - 611 21565279 0 10660040 OTHER COMMUNITY BENEFIT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES: DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THIS CATEGORY INCLUDES COMMUNITY HEALTH EDUCATION, COMMUNITY SOCIAL SERVICE HELPLINE, MEDICATION-ASSISTED TREATMENT PROGRAM, MEDI-CAL ELIGIBILITY WORKERS AND TRANSPORTATION SERVICES. SNAPSHOT OF OUTCOMES: * 29,040 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES INTERNSHIP, EXTERNSHIP, PRECEPTORSHIP, AND MENTORING PROGRAMS (EMPLOYEES EXCLUDED) , SUPPORTING THE NEXT GENERATION OF HEALTHCARE PROVIDERS BY EDUCATING AND MENTORING STUDENTS IN CLINICAL, ANCILLARY, AND ADMINISTRATIVE SETTINGS. SNAPSHOT OF OUTCOMES: * 77 MEDICAL RESIDENTS, NURSING AND ANCILLARY PROFESSIONS STUDENTS WERE PROVIDED WITH MENTORSHIP, INTERNSHIP AND TRAINING OPPORTUNITIES. SUBSIDIZED HEALTH SERVICES: SUBSIDIZED SERVICES ARE CLINICAL PROGRAMS, WHICH ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO THE RESPONSIBILITY OF GOVERNMENT OR ANOTHER NONPROFIT ORGANIZATION TO PROVIDE. PIH HEALTH GOOD SAMARITAN HOSPITAL SUBSIDIZED EMERGENCY DEPARTMENT OPERATIONS. SNAPSHOT OF OUTCOMES: * $2,541,622 IN EXPENSES WERE INCURRED IN SUBSIDIZED SERVICES IN FISCAL YEAR 2024-2025 RESEARCH: RESEARCH THAT MAY BE REPORTED AS COMMUNITY BENEFIT INCLUDES CLINICAL AND COMMUNITY HEALTH RESEARCH AS WELL AS STUDIES ON HEALTHCARE DELIVERY THAT ARE GENERALIZABLE AND SHARED WITH THE PUBLIC. PIH HEALTH GOOD SAMARITAN HOSPITAL HAS BEEN OFFERING CLINICAL TRIALS AND RESEARCH STUDIES AIMED AT IMPROVING HEALTH. SNAPSHOT OF OUTCOMES: * OVER $228,061 IN EXPENSES HAVE BEEN INCURRED IN RESEARCH IN FISCAL YEAR 2024-2025 CASH & IN-KIND CONTRIBUTIONS: THIS CATEGORY INCLUDES FUNDS AND IN-KIND SERVICES DONATED BY PIH HEALTH GOOD SAMARITAN HOSPITAL TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE FOR A COMMUNITY BENEFIT PURPOSE. THESE DONATIONS INCLUDE IN-KIND HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY ORGANIZATIONS WHILE ON PIH HEALTH WORK TIME, THE COST OF OFFICE AND MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF EQUIPMENT, MEDICATIONS, SUPPLIES AND SERVICES. SNAPSHOT OF OUTCOMES: $42,450 IN EXPENSES HAVE BEEN INCURRED IN THE CASH AND IN-KIND CONTRIBUTIONS CATEGORY IN FISCAL YEAR 2024-2025. TOTAL NUMBER OF PERSONS SERVED BY OTHER COMMUNITY BENEFIT SERVICES: 75,471 FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBAANNUALREPORT 396145799 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false true false false false false true true true false false true 482 0 true 1768 true true true false false false false true true false false false false false false X 18 18 true false false false true true true true true false false false true true true true true true false false true false CA X MARK KAWAUCHI 5626980811 12401 WASHINGTON BLVD WHITTIER CA 90602 ALEX ALVAREZ DIRECTOR & VICE CHAIR 1.5 6.0 X X 0 0 0 CHARLOTTE WEAVER PHD DIRECTOR & CHAIR 1.5 6.0 X X 0 0 0 PAUL TREINEN DIRECTOR & SECRETARY 1.5 6.0 X X 0 0 0 WILLIAM ROTH DIRECTOR & TREASURER 1.5 6.0 X X 0 0 0 DEBORAH MEDRANO DIRECTOR (AS OF 12/13/2024) 1.5 6.0 X 0 0 0 JEFFREY HAMAR DIRECTOR 1.5 6.0 X 0 0 0 KENTON WOODS DIRECTOR 1.5 6.0 X 0 0 0 MARISSA GOLDBERG DIRECTOR 1.5 4.5 X 0 0 0 MELANIE BATISTE DIRECTOR 1.5 6.0 X 0 0 0 MOEZ KHORSANDI DO DIRECTOR 1.5 0 X 0 0 0 PATRICK MONROE DIRECTOR 1.5 6.0 X 0 0 0 PETER GREANEY MD DIRECTOR 1.5 6.0 X 0 0 0 REGINE LAWTON DIRECTOR (AS OF 12/13/2024) 1.5 6.0 X 0 0 0 RICHARD ATWOOD DIRECTOR 1.5 7.5 X 0 0 0 SCOTT KROG DIRECTOR (AS OF 12/13/2024) 1.5 6.0 X 0 0 0 SCOTT SOUTHRON DIRECTOR (AS OF 12/13/2024) 1.5 6.0 X 0 0 0 THURSO BARENDSE DIRECTOR 1.5 6.0 X 0 0 0 TRACEA SARALIEV DIRECTOR 1.5 6.0 X 0 0 0 WESLEY HEARTFIELD MD DIRECTOR 1.5 0 X 0 0 0 IRENA ZUANIC CNO & CO-SITE ADMIN 40.0 0.0 X 0 477595 118635 JAMES WEST SYSTEM PRESIDENT & CEO 10.0 42.2 X 0 1623596 40183 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 10.0 42.2 X 0 1481245 33880 ROSALIO LOPEZ MD SYSTEM CSO/CMO 10.0 36.0 X 0 1344833 51655 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 10.0 42.2 X 0 870104 215850 JASON FISCHER VP, OPERATONS FOR PHGSH 40.0 0.0 X 0 484256 90764 MOHAMMED GHONIM REGIONAL VP (THRU 12/06/2024) 15.0 25.0 X 0 501701 95238 IRA MEISELMAN DIRECTOR MANAGED CARE 40.0 0 X 311334 0 36568 JING CHEUNG RN 40.0 0 X 247537 0 19468 KATHLEEN YOSHIMURA DIRECTOR, LAB AND PATHOLOGY 40.0 0 X 249158 0 31996 MATILDA HERNANDEZ DEPT SUPERVISOR-12HR 40.0 0 X 291167 0 32754 TRACEY COGHLAN CLINICAL DIRECTOR 40.0 0 X 250786 0 27331 BRIAN SMOLSKIS FORMER - SYSTEM COO 0.0 0.0 X 0 1089063 16973 1349982 7872393 811295 586 true true false AYA HEALTHCARE INC 5930 CORNERSTONE CT W SUITE 300 SAN DIEGO CA 92121 NURSING REGISTRY SERVICES 15939362 SODEXO AMERICA LLC 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 DIETARY SERVICES 10096054 REHABCARE GROUP OF CALIFORNIA LLC P O BOX 502096 ST LOUIS MO 63150 REHABILITATION SERVICES 3279330 INNOVATIVE HEALTH ASSOCIATES 13886 PLUMROSE PLACE CHINO HILLS CA 91709 HEALTHCARE PROFESSIONALS 2125385 ROCKPORT HEALTHCARE SERVICES 505 N BRAND BLVD SUITE 600 GLENDALE CA 91203 HEALTHCARE SERVICES 2081450 83 2939 16632855 1099789 25676 17735583 PATIENT REVENUE 622110 254897000 254897000 HOSPITAL FEE PROGRAM 900099 61009820 61009820 LAMBERT RADIOLOGY 622110 2423323 2423323 FOOD SERVICES 722514 1848911 1848911 RENTAL INCOME FROM AFFILIATES 531120 48000 48000 0 0 0 0 320227054 9411620 9411620 0 0 15776623 26558 13319063 2457560 26558 2484118 2484118 PARKING LOT 812930 2470477 80328 2390149 VIVITY EARNING DISTRIBUTIONS 900099 629664 629664 PHYSICIAN MANAGEMENT SERVICES 621110 47100 47100 7496914 0 29434 7467480 10644155 360502530 320227054 156862 22383031 X 3055493 3055493 424149 296904 127245 130993032 126996814 3996218 5328768 5179129 149639 25639329 23850726 1788603 10851010 10751122 99888 86999 86999 177350 177350 112211651 95072507 17139144 0 335053 575 334478 2881498 2881498 21647 21647 8172497 5447185 2725312 5136387 1758344 3378043 SUPPLIES 62042632 61757937 284695 HOSPITAL FEE PROGRAM 38918191 38918191 UTILITIES 6714098 6712926 1172 OTHER EXPENSE 16956273 13444801 3385460 126012 0 0 0 0 429946057 396145799 33674246 126012 4268938 1642558 1643091 1645814 95411919 74364348 0 0 0 0 5331206 6036616 2904864 3135646 412789410 46843645 322274868 365945765 103061276 152349380 0 0 67988358 80660540 602884520 685780667 76420683 71655464 0 0 120470986 272733728 196891669 344389192 X 329457526 263835893 76535325 77555582 405992851 341391475 602884520 685780667 X -69443527 4132009 710142 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 86999 86999 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT A PORTION OF THE DUES PIH HEALTH GOOD SAMARITAN HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND TO AMERICAN HOSPITAL ASSOCIATION. PIH HEALTH GOOD SAMARITAN HOSPITAL DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 78375517 600 10485794 2645538 689752 85526621 70007051 1552 12254517 2761503 1126100 78375517 69931515 593 3371694 2575117 721634 70007051 70136969 18931 3493226 2963821 753790 69931515 68288340 35438 5607660 3656123 138346 70136969 0.1328 0.605 0.2622 false false 204149473 204149473 66410868 10253190 56157678 82151815 34207167 47944648 60077254 2383288 57693966 365945765 HOSPITAL FEE PROGRAM RECEIVABLE 75664127 SELF-INSURANCE RECEIVABLE - CURRENT PORTION 2380390 OTHER NOTES AND LOAN RECEIVABLE 2157489 RIGHT OF USE ASSETS 458534 80660540 FEDERAL INCOME TAXES CARES ACT PROVIDER RELIEF FUNDS 320006 HOSPITAL FEE PROGRAM PAYABLE 53760057 RESERVE FOR SELF-INSURED PROGRAMS -123587 PENSION PLAN 4539078 ADVANCES FROM THIRD PARTY PAYORS 5328277 OTHER ANNUITY PAYMENT LIABILITY 15155342 OTHER LONG TERM RESERVES 8843670 OTHER LIABILITIES RIGHT-OF-USE LIABILITY 467140 INTERCOMPANY PAYABLES 87368374 RESERVE FOR ASSET RETIREMENT OBLIGATION LT DEFERRED REVENUE - EAAS PROJ 97075371 272733728 X 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D, PART V, LINE 4 INTENDED USES OF ENDOWMENT FUNDS THE ORGANIZATION'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED FOR HEALTH CARE SERVICES, AS SPECIFIED BY DONORS OR THE ORGANIZATION'S BOARD OF DIRECTORS. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE PRINCIPAL OPERATIONS OF THE COMPANY ARE EXEMPT FROM INCOME TAXES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES AND, AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE COMPANY IS SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS REGULARLY CARRIED ON THAT DOES NOT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. FURTHER, THE COMPANY IS ALSO SUBJECT TO FEDERAL EXCISE TAXES PURSUANT TO THE TAX CUTS AND JOBS ACT. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS AND EXCISE TAXES. 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 GUIDANCE IS APPLICABLE TO PROFIT-ORIENTED ENTITIES, PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. MANAGEMENT BELIEVES IT HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AND, AS SUCH, NO TAX LIABILITY, BENEFITS, INTEREST OR PENALTIES WERE ACCRUED AT SEPTEMBER 30, 2025 OR 2024. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE COMPANY BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2021 FOR FEDERAL PURPOSES AND 2019 FOR CALIFORNIA PURPOSES. true true X true X true X true true true false true true 0 8318 10703351 0 10703351 0.02489 0 33024 185672656 116176350 69496306 0.16164 0 0 0 0 0 0.0 0 41342 196376007 116176350 80199657 0.18653 10 29040 6169764 101748 6068016 0.01411 3 77 2758526 733436 2025090 0.00471 1 45793 12366478 9824856 2541622 0.00591 1 510 228061 0 228061 0.00053 1 51 42450 0 42450 0.00010 16 75471 21565279 10660040 10905239 0.02536 16 116813 217941286 126836390 91104896 0.21190 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 3 3399 0 3399 0.00001 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 16 3052 0 3052 0.00001 0 0 0 0 0 0.0 2 19 6451 0 6451 0.00002 true 3219076 0 81500322 81864381 -364059 X true true 1 1 PIH HEALTH GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 900172395 WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/WELCOME-TO-PIH-HEALTH-GOOD-SAMARITAN-HOSPITAL/ 930000071 X X X X X PIH HEALTH GOOD SAMARITAN HOSPITAL 1 false false true X X X X X X X X X X 24 true true false true X https://www.pihhealth.org/about-us/community-benefit/ X X true 24 true https://www.pihhealth.org/about-us/community-benefit/ false true X 200.0 400.0 X X X X true true X X X true X https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ X https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ X https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3E SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED THROUGH A REVIEW OF CHNA SECONDARY HEALTH DATA, WHICH WERE THEN PRIORITIZED WITH COMMUNITY STAKEHOLDER INPUT THROUGH INTERVIEWS WITH COMMUNITY-BASED ORGANIZATIONS AND AGENCIES. THE PRIORITIZED NEEDS WERE THEN EXAMINED BY HOSPITAL LEADERS AND THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE TO DETERMINE WHICH SIGNIFICANT NEEDS COULD BE ADDRESSED, CONSIDERING SCOPE AND SEVERITY, EXISTING INFRASTRUCTURE, ESTABLISHED RELATIONSHIPS, AND ONGOING INVESTMENT. THE CHNA SERVED AS THE RESOURCE DOCUMENT AS IT PROVIDED DATA ON THE SCOPE AND SEVERITY OF ISSUES AND COMMUNITY INPUT. AS A RESULT, PHGSH WILL ADDRESS 1) ACCESS TO HEALTHCARE (PRIMARY CARE AND MENTAL HEALTH CARE); 2) CHRONIC DISEASES (INCLUDING OVERWEIGHT AND OBESITY, HEALTHY EATING, AND PHYSICAL ACTIVITY); 3) PREVENTIVE PRACTICES (VACCINES AND SCREENINGS); 4) SOCIAL DRIVERS OF HEALTH (FOOD INSECURITY, HOUSING AND HOMELESSNESS); AND 5) SUBSTANCE USE. SCHEDULE H, PART V, SECTION B, LINE 3 FACILITY , 1 FACILITY , 1 - PIH HEALTH GOOD SAMARITAN HOSPITAL. THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES DATA AND INFORMATION REGARDING COMMUNITY DEMOGRAPHICS, SOCIAL DRIVERS OF HEALTH, ACCESS TO HEALTHCARE, BIRTH INDICATORS, LEADING CAUSES OF DEATH, ACUTE AND CHRONIC DISEASES, HEALTH BEHAVIORS, MENTAL HEALTH, SUBSTANCE USE, PREVENTIVE PRACTICES, COMMUNITY PERSPECTIVES GATHERED FROM FOCUS GROUPS AND INTERVIEWS, AND PROGRESS ON THE IMPLEMENTATION STRATEGY. INFOGRAPHICS DEPICT KEY DATA SETS FOR THE SERVICE AREA, AND 10 HEAT MAPS FURTHER ILLUSTRATE SELECTED COMMUNITY HEALTH INDICATORS. SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 FACILITY , 1 - PIH HEALTH GOOD SAMARITAN HOSPITAL. PIH HEALTH GOOD SAMARITAN HOSPITAL CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE, AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED SIGNIFICANT HEALTH NEEDS. SEVENTEEN (17) INTERVIEWS WERE CONDUCTED BY TELEPHONE DURING FEBRUARY AND MARCH 2025. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN THE PHONE INTERVIEW. APPOINTMENTS FOR THE INTERVIEWS WERE MADE ON DATES AND TIMES CONVENIENT TO THE STAKEHOLDERS. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELL-BEING IN LOS ANGELES COUNTY SPA 4 AND SPA 6 WHO SPOKE ABOUT ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. AT THE BEGINNING OF EACH INTERVIEW, THE PURPOSE OF THE INTERVIEW IN THE CONTEXT OF THE ASSESSMENT WAS EXPLAINED, THE STAKEHOLDERS WERE ASSURED THEIR RESPONSES WOULD REMAIN CONFIDENTIAL, AND CONSENT TO PROCEED WAS GIVEN. THE INTERVIEWS WERE STRUCTURED TO OBTAIN GREATER DEPTH OF INFORMATION AND BUILD ON THE SECONDARY DATA REVIEW. DURING THE INTERVIEWS, PARTICIPANTS WERE ASKED TO IDENTIFY MAJOR HEALTH ISSUES IN THE COMMUNITY AND SOCIOECONOMIC, BEHAVIORAL, ENVIRONMENTAL, OR CLINICAL FACTORS CONTRIBUTING TO POOR HEALTH. THEY WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE ISSUES, CHALLENGES, AND BARRIERS RELATED TO THE SIGNIFICANT HEALTH NEEDS, AND IDENTIFY RESOURCES TO ADDRESS THESE HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS, AND/OR COMMUNITY EFFORTS. THE COMMUNITY AGENCIES AND ORGANIZATIONS INCLUDED PROJECT ANGEL FOOD, LOS ANGELES POLICE DEPARTMENT RAMPART COMMUNITY POLICE STATION, PEACE OVER VIOLENCE, QUEENSCARE, ANDERSON MUNGER FAMILY YMCA, HOMEBOY INDUSTRIES, LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, OLIVE CREST, THE PEOPLE CONCERN, L.A. CADA, LA TRUST FOR CHILDREN'S HEALTH, CULTIVALA, LOS ANGELES COUNTY OFFICE OF EDUCATION, PARTNERS IN CARE FOUNDATION, AND KOREATOWN YOUTH AND COMMUNITY CENTER. THE VULNERABLE POPULATIONS REPRESENTED BY THESE GROUPS INCLUDED THOSE EXPOSED TO MEDICAL OR FINANCIAL RISK BY VIRTUE OF BEING UNINSURED, UNDERINSURED, OR ELIGIBLE FOR MEDI-CAL AND/OR MEDICARE, RACIAL AND ETHNIC GROUPS EXPERIENCING POOR HEALTH OUTCOMES, THE UNHOUSED, INDIVIDUALS IDENTIFYING AS LGBTQ, PEOPLE WITH DISABILITIES, PEOPLE WITH LIMITED ENGLISH PROFICIENCY, INDIVIDUALS AND FAMILIES EXPERIENCING FOOD INSECURITY, AND SERVICE AREA COMMUNITIES WITH A CALIFORNIA HEALTHY PLACES INDEX SCORE OF 14.9% FOR CLEAN ENVIRONMENT. THE FULL COMMUNITY HEALTH NEEDS ASSESSMENT, CAN BE FOUND AT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/D723F005-D64C-43BB-A34B-67402E8FFDBE/CHNA%202025%20-%20PIH%20HEALTH%20GOOD%20SAMARITAN%20HOSPITAL%20FINAL.PDF ATTACHMENT 1 LISTS THE STAKEHOLDER INTERVIEW RESPONDENTS, THEIR TITLES, AND ORGANIZATIONS. ATTACHMENT 2 PROVIDES STAKEHOLDER RESPONSES TO THE INTERVIEW OVERVIEW QUESTIONS. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY , 1 FACILITY , 1 - PIH HEALTH GOOD SAMARITAN HOSPITAL. PIH HEALTH GOOD SAMARITAN HOSPITAL PARTICIPATED IN A COLLABORATIVE PROCESS FOR THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT WITH PIH HEALTH DOWNEY HOSPITAL AND PIH HEALTH WHITTIER HOSPITAL. GIVEN THAT THESE HOSPITALS SHARE COLLABORATIVE PARTNERS WHO SERVE THE REGION, THE COLLABORATIVE EFFORT REDUCED REDUNDANCIES AND INCREASED DATA COLLECTION EFFICIENCY. SCHEDULE H, PART V, SECTION B, LINE 7 FACILITY , 1 FACILITY , 1 - PIH HEALTH GOOD SAMARITAN HOSPITAL. THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT WAS MADE AVAILABLE TO THE PUBLIC BY POSTING ON THE HOSPITAL WEBSITE. PUBLIC COMMENT IS ENCOURAGED. A PAPER COPY OF THE REPORT IS AVAILABLE UPON REQUEST. ADDITIONALLY, THE 2025 CHNA WAS SHARED WITH PIH HEALTH'S COMMUNITY BENEFIT OVERSIGHT COMMITTEE, COMPRISED OF COMMUNITY PARTNERS, LEGISLATIVE REPRESENTATIVES, AND COMMUNITY-AT-LARGE REPRESENTATIVES, AS WELL AS LOS ANGELES DEPARTMENT OF PUBLIC HEALTH STAFF. ASSESSMENT FINDINGS WERE ALSO DISTRIBUTED TO KEY STAKEHOLDERS VIA EMAIL WITH EMPHASIS ON SUPPORTING PROGRAM PLANNING AND FUND-DEVELOPMENT ENDEAVORS, SHARING ORGANIZATIONS THE EXPENSE OF DUPLICATIVE DATA COLLECTION EFFORTS. ASSESSMENT FINDINGS ARE ALSO SHARED ON AN ON-GOING BASIS VIA PRESENTATIONS AT COMMUNITY EVENTS AND COMMUNITY COLLABORATIVE MEETINGS, THROUGH SOCIAL MEDIA CHANNELS, AND VIA PIH HEALTH'S E-NEWSLETTER AND MAILED MAGAZINE. SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 FACILITY , 1 - PIH HEALTH GOOD SAMARITAN HOSPITAL. PIH HEALTH'S IMPLEMENTATION STRATEGY ENSURES ALIGNMENT OF CHNA FINDINGS, OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PIH HEALTH'S ORGANIZATIONAL STRATEGY. PIH HEALTH GOOD SAMARITAN HOSPITAL WILL ADDRESS THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO HEALTHCARE (INCLUDING PRIMARY CARE AND MENTAL HEALTH CARE); CHRONIC DISEASE (INCLUDING OVERWEIGHT AND OBESITY, HEALTHY EATING, AND PHYSICAL ACTIVITY); PREVENTIVE PRACTICES (INCLUDING VACCINES AND SCREENINGS); SOCIAL DRIVERS OF HEALTH (INCLUDING FOOD INSECURITY AND HOUSING AND HOMELESSNESS); AND SUBSTANCE USE. PIH HEALTH GOOD SAMARITAN HOSPITAL CANNOT ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, BUT IT WILL CONCENTRATE ON THOSE PRIORITY HEALTH NEEDS THAT IT CAN MOST EFFECTIVELY ADDRESS GIVEN ITS AREAS OF FOCUS AND EXPERTISE. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, PIH HEALTH GOOD SAMARITAN HOSPITAL WILL NOT ADDRESS THE REMAINING HEALTH NEED IDENTIFIED IN THE CHNA, INCLUDING BIRTH INDICATORS, DENTAL CARE, ECONOMIC INSECURITY, EDUCATION, SEXUALLY TRANSMITTED INFECTIONS, AND VIOLENCE AND INJURY PREVENTION. TO VIEW THE 2026-2028 IMPLEMENTATION STRATEGY AND THE INITIATIVES IDENTIFIED TO ADDRESS AREAS OF FOCUS, VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/CC35C765-D97E-471A-98BE-C91DA3B5D706/COMMUNITY%20HEALTH%20IMPROVEMENT%20PLAN%202025_PHGSH%20FINAL.PDF. SCHEDULE H, PART V, SECTION B, LINE 13 FACILITY , 1 FACILITY , 1 - PIH HEALTH GOOD SAMARTIAN HOSPITAL. ASSISTANCE IS PROVIDED FREE OR DISCOUNTED FOR THOSE PATIENTS ELIGIBLE FOR FAP. THE CRITERIA FOR FAP IS IF THE PATIENT IS UNINSURED AND DOES NOT HAVE THE ABILITY TO PAY, HAS RESTRICTED MEDI-CAL BENEFITS, OR IS UNINSURED. THERE ARE ALSO CONSIDERATIONS FOR PATIENTS WHERE THE FPG IS NOT APPLICABLE AND THE PATIENT IS INSURED WITH INADEQUATE COVERAGE OR EXCESSIVE LIABILITY. 0 SCHEDULE H, PART I, LINE 6A PIH HEALTH'S COMMUNITY BENEFIT REPORT, PREPARED ANNUALLY, ACCOUNTS FOR THE ORGANIZATION'S PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITY. THE REPORT SEPARATES OUT COMMUNITY BENEFIT INVESTMENT FIGURES FOR EACH HOSPITAL. THE REPORT WAS MADE WIDELY AVAILABLE TO THE PUBLIC BY POSTING ON THE HOSPITAL WEBSITE. PUBLIC COMMENT IS ENCOURAGED. A PAPER COPY OF THE REPORT IS AVAILABLE UPON REQUEST. ADDITIONALLY, THE REPORT WAS SHARED WITH PIH HEALTH'S COMMUNITY BENEFIT OVERSIGHT COMMITTEE, COMPRISED OF COMMUNITY PARTNERS, LEGISLATIVE REPRESENTATIVES, AND COMMUNITY-AT-LARGE REPRESENTATIVES, AS WELL AS LOS ANGELES DEPARTMENT OF PUBLIC HEALTH STAFF, AND WAS ALSO SHARED THROUGH SOCIAL MEDIA CHANNELS, AND VIA PIH HEALTH'S E-NEWSLETTER AND MAILED MAGAZINE. A COMMUNITY BENEFIT REPORT FOR PIH HEALTH GOOD SAMARITAN HOSPITAL WAS ALSO SUBMITTED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION HCAI). TO VIEW THE FULL PIH HEALTH REPORT, VISIT PIHHEALTH.ORG/CBANNUALREPORT. HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/B428917B-1ABE-4FE4-8D6E-3A504E0F835F/PIH%20HEALTH%20GOOD%20SAMARITAN%20HOSPITAL%20COMMUNITY%20BENEFIT%20ANNUAL%20REPORT%20AND%20PLAN%20FY2025.PDF SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE PATIENT CARE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE FINANCIAL ASSISTANCE AND MEDI-CAL COST. ACTUAL COSTS FROM GENERAL LEDGER OR DEPARTMENTS WERE USED FOR ALL OTHER COSTS. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES PIH HEALTH WORKS WITH A VARIETY OF COMMUNITY STAKEHOLDERS TO ENHANCE THE COLLECTIVE CAPACITY FOR ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS. IN ADDITION, THROUGH CREATIVE WORKFORCE DEVELOPMENT PARTNERSHIPS WITH SCHOOLS, PIH HEALTH'S HEALTHCARE TEAMS SHARE KNOWLEDGE AND EXPERTISE TO INTRODUCE YOUNG MINDS TO THE REWARDING WORLD OF HEALTHCARE. PIH HEALTH ALSO UNDERTAKES DISASTER PREPAREDNESS TRAINING ABOVE AND BEYOND LICENSURE REQUIREMENTS TO ENSURE WE ARE EFFECTIVELY PREPARED TO SERVE THE COMMUNITY IN A DISASTER. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT BAD DEBT EXPENSE IS DETERMINED BY SUBTRACTING MEDICARE BAD DEBT REIMBURSEMENT IN THE MEDICARE COST REPORT FROM TOTAL BAD DEBT TRANSFERS NET OF RECOVERIES. THIS EXPENSE WAS NOT INCLUDED IN COMMUNITY BENEFIT EXPENSE. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS OF PIH HEALTH, INC. AND SUBSIDIARIES FOR THE YEAR ENDED SEPTEMBER 30, 2025: "IMPLICIT PRICE CONCESSIONS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE IMPLICIT PRICE CONCESSIONS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. IMPLICIT PRICE CONCESSIONS ARE INCLUDED AS A DEDUCTION FROM PATIENT SERVICES REVENUES SINCE THE COMPANY GENERALLY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY." THE BAD DEBT EXPENSE ON LINE 2 IS CALCULATED BY SUBTRACTING MEDICARE BAD DEBT REIMBURSEMENT IN THE MEDICARE COST REPORT FROM TOTAL BAD DEBT TRANSFERS NET OF RECOVERIES, AND NONE OF THE BAD DEBT EXPENSE IS INCLUDED IN COMMUNITY BENEFIT EXPENSE. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS THE AMOUNTS ON LINES 5 AND 6 ARE FROM THE FY 2025 MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THE HOSPITAL ENCOURAGES ALL SELF-PAY PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE OR OTHER PROGRAMS. 1. ALL UNINSURED PATIENTS ARE ASSUMED TO NEED FINANCIAL ASSISTANCE AND AUTOMATICALLY RECEIVE DISCOUNTED BILLS THAT REFLECT THE CONTRACT RATE OR LESS OF A MEDICARE ADVANTAGE CONTRACT. 2. ALL UNINSURED PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE AND MEDICAID APPLICATION AT THE TIME OF REGISTRATION THEREBY GIVING THEM THE OPPORTUNITY TO APPLY FOR ASSISTANCE. 3. THERE ARE SIGNS THROUGH THE FACILITY THAT EDUCATE PATIENTS AND VISITORS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. 4. THE HOSPITAL'S WEBSITE PUBLISHES THE FINANCIAL ASSISTANCE POLICY AND APPLICATIONS. 5. SELF-PAY INPATIENTS ALSO MAY BE CONTACTED BY A VENDOR TO OFFER ASSISTANCE IN APPLYING FOR MEDICAID, IF ELIGIBLE. 6. STATEMENTS (WHICH REFLECT A REDUCTION IN CHARGES TO THE RATES AT OR LOWER THAN CONTRACTED RATES FOR MEDICARE ADVANTAGE MEMBERS) PROMOTE THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. 7. ONLY PATIENTS WHO DO NOT QUALIFY FOR FURTHER FINANCIAL ASSISTANCE (AFTER DISCOUNTS) OR WHO DO NOT APPLY FOR PROGRAMS AND DO NOT PAY ARE REFERRED TO COLLECTION. IN ADDITION, IF A PATIENT IS REFERRED TO COLLECTION AND LATER APPLIES FOR CHARITY AND QUALIFIES, THE PATIENT'S ACCOUNT IS RETURNED TO THE HOSPITAL AND FINANCIAL ASSISTANCE IS EXTENDED. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE - PIH HEALTH GOOD SAMARITAN HOSPITAL: LINE 16A URL: HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE/; SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE - PIH HEALTH GOOD SAMARITAN HOSPITAL: LINE 16B URL: HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE/; SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE - PIH HEALTH GOOD SAMARITAN HOSPITAL: LINE 16C URL: HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE/; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT IN ADDITION TO THE HOSPITAL'S CHNA, PIH HEALTH UTILIZES THE FOLLOWING METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES: COMMUNITY BENEFIT OVERSIGHT COMMITTEE- IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC), WHICH IS COMPRISED OF COMMUNITY STAKEHOLDERS AND KEY PUBLIC HEALTH AND LEGISLATIVE REPRESENTATIVES. THIS COMMITTEE MEETS REGULARLY, AND ITS MEMBERS SHARE HEALTHCARE-RELATED NEEDS/CONCERNS EXPERIENCED BY THE COMMUNITY MEMBERS THEY REPRESENT AS WELL AS ASSETS OR POTENTIAL PARTNERS FOR THE HOSPITAL TO ENGAGE IN ADDRESSING THE IDENTIFIED NEEDS. FEEDBACK FROM COMMUNITY ORGANIZATIONS / COLLABORATIVE- THROUGH PARTICIPATION IN VARIOUS COMMUNITY COLLABORATIVE AND NETWORKING MEETINGS, PIH HEALTH IS ABLE TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY AND IDENTIFY PARTNERSHIP OPPORTUNITIES. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THERE ARE MANY AVENUES PIH HEALTH TAKES IN EDUCATING PATIENTS AND FAMILY MEMBERS ABOUT THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS. PATIENTS ARE ADVISED AT THE TIME OF SERVICE, DURING IN-HOUSE CARE AND POST DISCHARGES. FREE HANDOUTS OF THE FAP APPLICATION ARE PROVIDED IN BOTH ENGLISH AND SPANISH. THERE ARE POSTINGS THROUGHOUT THE HOSPITAL IN BOTH ENGLISH AND SPANISH WITH INFORMATION ABOUT OUR FAP PROGRAM. WE HAVE AN ELIGIBILITY VENDOR THAT IS CONVENIENTLY AVAILABLE TO ASSIST OUR PATIENTS IN THE EMERGENCY ROOM OR IN-HOUSE PATIENTS WITH DETERMINING ELIGIBILITY FOR VARIOUS GOVERNMENTAL PROGRAMS, AS WELL AS ADVISE AND ASSIST THE PATIENT WITH THE FAP. POST DISCHARGE, OUR BUSINESS OFFICE STAFF TAKES THE INITIATIVE TO ADVISE THE PATIENT OF OUR FAP PROGRAM. ALSO, WITH THE INITIAL STATEMENT SENT TO PATIENTS, AN APPLICATION IS INCLUDED. PIH'S FAP IS ALSO PUBLISHED ON OUR WEBSITE SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION PIH HEALTH GOOD SAMARITAN HOSPITAL (PHGSH) IS LOCATED AT 1225 WILSHIRE BLVD., LOS ANGELES, CALIFORNIA 90017. THE HOSPITAL SERVICE AREA INCLUDES 17 ZIP CODES IN THE CITY OF LOS ANGELES. THE SERVICE AREA IS SERVED BY THE LOS ANGELES COUNTY 1ST AND 2ND SUPERVISORIAL DISTRICTS AND FALLS WITHIN THE LOS ANGELES COUNTY SERVICE PLANNING AREAS (SPAS) 4 AND 6. PHGSH TRACKS ZIP CODES OF ORIGIN FOR ALL PATIENTS. THE SERVICE AREA WAS DETERMINED FROM THE ZIP CODES THAT REFLECT A MAJORITY (67%) OF HOSPITAL INPATIENT DISCHARGES FROM THE LOCAL GEOGRAPHIC AREA. BASED ON THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT, THE POPULATION FOR THE PHGSH SERVICE AREA IS 891,7856. CHILDREN AND YOUTH, AGES 0-17, MAKE UP 21% OF THE POPULATION, 68% ARE 18-64 YEARS OF AGE, AND 11% ARE SENIORS, 65 YEARS AND OLDER. IN THE SERVICE AREA, 61.1% OF THE POPULATION ARE HISPANIC/LATINO, 13.5% ARE ASIAN, 12.1% BLACK/AFRICAN AMERICAN, 10% ARE WHITE, AND THE REMAINING 3.2% ARE NATIVE AMERICAN RESIDENTS, HAWAIIAN OR PACIFIC ISLANDER, AND OTHER RACES. AMONG THE SERVICE AREA POPULATION, AGES FIVE AND OLDER, 37.8% ARE LINGUISTICALLY ISOLATED. IN THE SERVICE AREA, 24.7% OF THE POPULATION IS AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. 11.8% OF THE POPULATION HAS A DISABILITY. THE SERVICE AREA HAS A STATE RANK OF 14.9% FOR CLEAN ENVIRONMENT PER THE CALIFORNIA HEALTHY PLACES INDEX. AMONG THE RESIDENTS IN THE PRIMARY SERVICE AREA, 24.7% ARE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 49.9% ARE AT 200% OF FPL OR BELOW. THE WEIGHTED AVERAGE OF THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS $58,073. WHEN INSURANCE COVERAGE WAS EXAMINED BY SPA, 40% OF SPA 6 AND 30.3% OF SPA 4 RESIDENTS HAVE MEDI-CAL COVERAGE WHILE 9.9% OF SPA 6 AND 8.3% OF SPA 4 RESIDENTS HAVE NO INSURANCE. FOR ADDITIONAL DATA REGARDING THE SERVICE AREA, PLEASE SEE THE CHNA AT PIHHEALTH.ORG/CHNA SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH COMMUNITY BOARD: PIH HEALTH'S COMMUNITY BOARD OF DIRECTORS WORKS TO ADVANCE PIH HEALTH'S COMMITMENT TO HELPING OUR COMMUNITIES GET WELL AND STAY HEALTHY. OPEN MEDICAL STAFF: PIH HEALTH EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. USE OF SURPLUS FUNDS: PIH HEALTH APPLIES SURPLUS FUNDS TOWARD IMPROVEMENTS IN PATIENT CARE, TECHNOLOGY, AND MEDICAL EDUCATION. COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC): IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE CBOC, COMPRISED OF COMMUNITY STAKEHOLDERS AND A PUBLIC HEALTH REPRESENTATIVE. THE CBOC PROMOTES THE HEALTH OF THE COMMUNITY BY 1) REVIEWING AND VALIDATING LEGAL AND REGULATORY COMPLIANCE WITH RESPECT TO COMMUNITY BENEFIT MANDATES, 2) REVIEWING AND VALIDATING THAT PIH HEALTH'S COMMUNITY BENEFIT PROGRAMS AND SERVICES EFFECTIVELY MEET IDENTIFIED COMMUNITY HEALTH NEEDS, WITH EMPHASIS ON VULNERABLE POPULATIONS, AS AN ESSENTIAL EXPRESSION OF PIH HEALTH'S CHARITABLE MISSION AND 3) INCREASING PUBLIC AWARENESS OF COMMUNITY BENEFIT ACTIVITIES AND COMMUNITY VALUE. DONATION OF TIME: MANY PIH HEALTH PROVIDERS ARE LIVING OUT THEIR PASSION TO SERVE PEOPLE IN NEED BY DONATING THEIR TIME AND TALENTS BOTH IN PIH HEALTH COMMUNITIES AND OVERSEAS. EMPLOYEE GIVING: EACH YEAR, PIH HEALTH EMPLOYEES, PHYSICIANS, AND VOLUNTEERS GENEROUSLY SUPPORT VARIOUS CHARITABLE GIVING INITIATIVES. DURING FISCAL YEAR 2025, HOLIDAY WISH LISTS WERE FULFILLED FOR 184 FAMILIES SERVED BY THE WHOLE CHILD, 213 DUFFLE BAGS WITH ESSENTIAL ITEMS WERE DONATED TO SUPPORT THOSE AFFECTED BY SOUTHERN CALIFORNIA WILDFIRES, AND OVER 375 BACKPACKS FILLED WITH SCHOOL SUPPLIES WERE COLLECTED FOR DISTRIBUTION BY HELPLINE YOUTH COUNSELING TO STUDENTS ACROSS OUR SERVICE AREA. ENVIRONMENTAL AND SUSTAINABILITY PROJECTS: PIH HEALTH CONTINUES TO IMPLEMENT "GREEN" INITIATIVES, INCLUDING INCREASED USAGE OF LED LIGHTING TO DECREASE CONSUMPTION OF ELECTRICITY, EXPANSION OF A PROJECT WITH THE CITY OF WHITTIER TO CONVERT METHANE GAS INTO ELECTRICITY, AND PURCHASE OF REPROCESSED INSTRUMENTS THROUGH A VENDOR AGREEMENT THAT RESULTS IN NATIONAL FOREST RESTORATION. IN ADDITION, EYEGLASSES AND HEARING AIDS ARE COLLECTED FOR RECYCLING AND REDISTRIBUTION BY AREA LIONS CLUBS TO THOSE IN NEED. VOLUNTEER CONTRIBUTIONS: SOME 1,364 PIH HEALTH VOLUNTEERS COLLECTIVELY CONTRIBUTED 111,102 HOURS OF SERVICE, SUPPORTING DEPARTMENTS THROUGHOUT THE ORGANIZATION. THROUGH THE PIH HEALTH MEDICAL CAREERS PROGRAM, WHICH GIVES STUDENT VOLUNTEERS A HEAD START IN DISCOVERING PRODUCTIVE AND MEANINGFUL CAREERS IN HEALTHCARE, 40 INDIVIDUALS SPENT 756 HOURS SHADOWING MEDICAL CAREER PROFESSIONALS. PIH HEALTH'S COMMUNITY BOARD OF DIRECTORS WORKS TO ADVANCE PIH HEALTH'S COMMITMENT TO HELPING OUR COMMUNITIES GET WELL AND STAY HEALTHY. MANY BOARD MEMBERS RESIDE IN PIH HEALTH'S PRIMARY SERVICE. BOARD MEMBERS ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM HOSPITAL AFFILIATES INCLUDE: 1) PIH HEALTH, INC., PIH HEALTH'S PARENT COMPANY; 2) PIH HEALTH DOWNEY HOSPITAL; 3) PIH HEALTH GOOD SAMARITAN HOSPITAL; 4) PIH HEALTH WHITTIER HOSPITAL; 5) PIH HEALTH PHYSICIANS, A NONPROFIT MEDICAL FOUNDATION; AND 6) THE PIH HEALTH FOUNDATION, A NONPROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH HEALTH'S CHARITABLE MISSION 1) PIH HEALTH, INC. 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. 2) PIH HEALTH DOWNEY HOSPITAL OFFICIALLY BECAME PART OF PIH HEALTH IN OCTOBER 2013. AS A 501 (C)(3) NONPROFIT, 199-BED HOSPITAL, THE DOWNEY CAMPUS HAS PROVIDED QUALITY CARE IN A WELCOMING ENVIRONMENT FOR MORE THAN 105 YEARS, GIVING BACK TO THE COMMUNITY THROUGH CHARITY CARE, HEALTH PROFESSIONS EDUCATION AND MORE. 3) PIH HEALTH GOOD SAMARITAN HOSPITAL WAS FOUNDED IN 1885, PIH HEALTH GOOD SAMARITAN HOSPITAL BECAME PART OF PIH HEALTH IN DECEMBER 2019. AS A 501(C)(3) NONPROFIT, 408-BED ACUTE CARE HOSPITAL, THE DOWNTOWN LOS ANGELES CAMPUS SERVES THE HEALTHCARE NEEDS OF A GROWING AND DIVERSE COMMUNITY, GIVING BACK TO THE COMMUNITY THROUGH CHARITY CARE, MEDICAL RESEARCH, HEALTH PROFESSIONS EDUCATION AND MORE. 4) PIH HEALTH WHITTIER HOSPITAL OPENED IN 1959. AS A 501 (C)(3) NONPROFIT, 523-BED HOSPITAL, THE WHITTIER CAMPUS HAS DEVELOPED INTO A HEALTH SYSTEM OFFERING A MULTITUDE OF SERVICES, GIVING BACK TO THE COMMUNITY THROUGH CHARITY CARE, MEDICAL RESEARCH, DONATIONS, HEALTH PROFESSIONS EDUCATION AND MORE. 5) PIH HEALTH PHYSICIANS (PHP) A 501(C)(3) NONPROFIT MEDICAL GROUP THAT IS EXCLUSIVELY AFFILIATED WITH PIH HEALTH, THE GROUP IS COMPRISED OF MORE THAN 380 PRIMARY CARE PHYSICIANS, SPECIALISTS, AND ADVANCED PRACTICE PROVIDERS WHO COORDINATE CARE FROM DIAGNOSIS TO RECOVERY. PHP SUPPORTS THE LOCAL COMMUNITY THROUGH ITS FINANCIAL ASSISTANCE PROGRAM, WHITTIER FIRST DAY HEALTH & WELLNESS CENTER FOR THE HOMELESS AND THOSE AT-RISK FOR HOMELESSNESS, HEALTH PROFESSIONS EDUCATION, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES. 6) THE PIH HEALTH FOUNDATION IS A 501(C)(3) NONPROFIT ORGANIZATION WITH THE SOLE MISSION TO RAISE FUNDS THROUGH PHILANTHROPHY TO BENEFIT PIH HEALTH AND ITS AFFILIATES. DOLLARS RAISED ARE REINVESTED INTO THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTHCARE, HEALTH-BASED PROGRAMS, AND SERVICES OFFERED THROUGH PIH HEALTH. FOR DETAILED INFORMATION REGARDING THESE PIH HEALTH AFFILIATES' ADDITIONAL ACTIVITIES TO SUPPORT AND PROMOTE COMMUNITY HEALTH, PLEASE SEE EACH RESPECTIVE ORGANIZATION'S IRS FORM 990. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CA true GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954077161 501(C) (3) 210399 EXPENSES PAID BY THE ORGANIZATION PIH HEALTH PHYSICIANS 6557 GREENLEAF AVE WHITTIER CA 90601 953942828 501(C) (3) 2845094 GRANT TO RELATED ORGANIZATION 2 0 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS PIH HEALTH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS. PIH HEALTH PROVIDES FINANCIAL SUPPORT TO NONPROFIT ORGANIZATIONS IN OUR SERVICE AREA CITIES THROUGH ITS COMMUNITY SUPPORT AND SPONSORSHIPS PROGRAM, WITH EMPHASIS ON COMMUNITY HEALTH NEEDS/AREAS OF CONCERN AS IDENTIFIED BY PIH HEALTH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS. FINANCIAL SUPPORT MAY BE PROVIDED IF THE REQUESTING ORGANIZATION ADDRESSES ONE OR MORE OF THESE AREAS AND IS RESPONSIVE TO THE HEALTH AND WELLNESS NEEDS OF THE COMMUNITIES WE SERVE, ALLOWING PIH HEALTH TO BUILD UPON THE IMPACT OF EXISTING COMMUNITY HEALTH IMPROVEMENT EFFORTS. FOR CONTRIBUTIONS MADE TO CHARITABLE ORGANIZATIONS, PIH HEALTH HAS ADOPTED A POLICY WHICH GUIDES THE PROCESS TO ENSURE GOOD STEWARDSHIP OF PIH HEALTH'S CHARITABLE RESOURCES AS A FEDERALLY REGISTERED NONPROFIT ENTITY. TO ENSURE ACCURATE COMMUNITY BENEFIT REPORTING, THIS POLICY SETS FORTH THAT DIRECT FINANCIAL CONTRIBUTIONS MADE TO COMMUNITY ORGANIZATIONS MUST BE APPROPRIATELY CLASSIFIED AS EITHER A) COMMUNITY BENEFIT OR B) A SPONSORSHIP (A MARKETING COMMUNICATIONS DEPARTMENT EXPENSE NOT REPORTABLE AS COMMUNITY BENEFIT). IN COMPLIANCE WITH THIS POLICY, INFORMATION IS GATHERED FROM THE GRANTEE REGARDING THE INTENDED USE OF FUNDS AND A RESTRICTION LETTER IS SENT, NOTING THE INTENDED USE OF FUNDS. ORGANIZATIONS RECEIVING COMMUNITY SUPPORT FUNDING IN THE AMOUNT OF $2,500 OR MORE ARE REQUIRED TO SUBMIT A SUMMARY REPORT OF PROGRAM OR SERVICE IMPACT, WITHIN 90 DAYS AFTER EVENT OR RECEIPT OF PROGRAM FUNDING, UNLESS AN ALTERNATE DATE IS DESIGNATED. FOR CONTRIBUTIONS MADE TO INDIVIDUALS, PIH HEALTH 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 HEALTH DISCHARGE PLANNERS OR SOCIAL WORKERS. true true false false false false false false false BRIAN SMOLSKIS FORMER - SYSTEM COO 0 0 0 0 0 1089063 0 0 0 16973 0 1106036 0 197952 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 0 872084 0 0 0 609161 0 18300 0 15580 0 1515125 0 600326 ROSALIO LOPEZ MD SYSTEM CSO/CMO 0 987835 0 0 0 356998 0 41300 0 10355 0 1396488 0 338214 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 0 862548 0 0 0 7556 0 190785 0 25065 0 1085954 0 0 JAMES WEST SYSTEM PRESIDENT & CEO 0 1603998 0 0 0 19598 0 18300 0 21883 0 1663779 0 0 IRENA ZUANIC CNO & CO-SITE ADMIN 0 394660 0 0 0 82935 0 93721 0 24914 0 596230 0 74976 JASON FISCHER VP, OPERATONS FOR PHGSH 0 292015 0 0 0 192241 0 84709 0 6055 0 575020 0 0 MOHAMMED GHONIM REGIONAL VP (THRU 12/06/2024) 0 431232 0 0 0 70469 0 93850 0 1388 0 596939 0 62037 JING CHEUNG RN 247537 0 0 0 0 0 12395 0 7073 0 267005 0 0 0 TRACEY COGHLAN CLINICAL DIRECTOR 244899 0 0 0 5887 0 10232 0 17099 0 278117 0 0 0 MATILDA HERNANDEZ DEPT SUPERVISOR-12HR 291167 0 0 0 0 0 15655 0 17099 0 323921 0 0 0 IRA MEISELMAN DIRECTOR MANAGED CARE 306887 0 0 0 4447 0 17627 0 18941 0 347902 0 0 0 KATHLEEN YOSHIMURA DIRECTOR, LAB AND PATHOLOGY 243271 0 0 0 5887 0 14897 0 17099 0 281154 0 0 0 SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY PIH HEALTH WHITTIER HOSPITAL (PHWH), A RELATED ORGANIZATION. PHWH USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) FORM 990 OF OTHER ORGANIZATIONS; 4) COMPENSATION SURVEY OR STUDY; 5) APPROVAL BY THE BOARD. SCHEDULE J, PART I, LINE 4A SEVERANCE OR CHANGE-OF-CONTROL PAYMENT BRIAN SMOLSKIS RECEIVED A SEVERANCE PAYMENT DURING THE CALENDAR YEAR. THE PAYMENT IS INCLUDED IN PART VII, COLUMN D (E) AND SCHEDULE J, PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PIH HEALTH INC. AND ITS AFFILIATES PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK ROSALIO LOPEZ VID SHIVARAMAN IRENA ZUANIC MOHAMMED GHONIM JASON FISCHER THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2024 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): PEGGY CHULACK $600,326 IRENA ZUANIC $74,976 MOHAMMED GHONIM $62,037 ROSALIO LOPEZ $338,214 BRIAN SMOLSKIS $197,952 1 25676 MARKET VALUE 0 false true false SCHEDULE M, PART I EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS SECURITIES - PUBLICLY TRADED - NUMBER OF CONTRIBUTIONS FORM 990, PART VI, LINE 16B PIH HEALTH GOOD SAMARITAN HOSPITAL HOLDS A 2.69% INTEREST A JOINT VENTURE ARRANGEMENT THAT EXISTS TO FURTHER THE CHARITABLE AND COMMUNITY-BASED HEALTH CARE PURPOSES, MISSION, VISION, AND VALUES OF ITS CONTROLLING TAX EXEMPT MEMBERS. PIH HEALTH GOOD SAMARITAN HOSPITAL ANNUALLY EVALUATES ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS. FORM 990, PART VI, LINE 15B DURING THE TAX YEAR ENDED SEPTEMBER 30, 2025, NO OFFICERS, DIRECTORS, OR TRUSTEES RECEIVED COMPENSATION FROM THIS ORGANIZATION. THE COMPENSATION REPORTED IS PAID BY A RELATED ORGANIZATION AND IS DETERMINED BASED ON THE COMPENSATION REVIEW PRACTICES AND POLICIES OF THAT RELATED ORGANIZATION. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS PIH HEALTH, INC. IS THE SOLE MEMBER OF PIH HEALTH GOOD SAMARITAN HOSPITAL. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY PIH HEALTH, INC. HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF DIRECTORS OF PIH HEALTH GOOD SAMARITAN HOSPITAL. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS PIH HEALTH, INC. HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH HEALTH GOOD SAMARITAN HOSPITAL. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE ORGANIZATION WORKS WITH AN INDEPENDENT ACCOUNTANT, KPMG LLP, TO PREPARE THE FORM 990. ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND VP OF FINANCE. FORM 990 IS THEN REVIEWED BY THE AUDIT COMMITTEE OF PIH HEALTH, INC., WHICH IS MADE UP OF INDEPENDENT DIRECTORS. KPMG LLP MAKES ALL CHANGES NECESSARY. THE FINAL FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY 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 GENERAL COUNSEL AND CHIEF ADMINISTRATIVE OFFICER OF PIH HEALTH, INC. 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, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC PIH HEALTH GOOD SAMARITAN HOSPITAL'S ORGANIZING AND GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL INFORMATION FROM THE FINANCIAL STATEMENTS IS INCLUDED IN THE ORGANIZATION'S FORM 990, WHICH IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VIII, LINE 11D OTHER MISCELLANEOUS REVENUE ALL OTHER REVENUE - TOTAL REVENUE: 7496914, RELATED OR EXEMPT FUNCTION REVENUE: , UNRELATED BUSINESS REVENUE: 29434, REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: 7467480; FORM 990, PART IX, LINE 11G OTHER FEES PHYSICIAN FEES - TOTAL EXPENSE: 13547570, PROGRAM SERVICE EXPENSE: 13547570, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; CONSULTING AND MANAGEMENT FEES - TOTAL EXPENSE: 80013, PROGRAM SERVICE EXPENSE: 38309, MANAGEMENT AND GENERAL EXPENSES: 41704, FUNDRAISING EXPENSES: ; OTHER CONTRACTED SERVICES - TOTAL EXPENSE: 3390925, PROGRAM SERVICE EXPENSE: 3389182, MANAGEMENT AND GENERAL EXPENSES: 1743, FUNDRAISING EXPENSES: ; OTHER PROFESSIONAL SERVICES - TOTAL EXPENSE: 131, PROGRAM SERVICE EXPENSE: 131, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; MEDICAL PURCHASED SERVICES - TOTAL EXPENSE: 1637293, PROGRAM SERVICE EXPENSE: 1621493, MANAGEMENT AND GENERAL EXPENSES: 15800, FUNDRAISING EXPENSES: ; REPAIRS AND MAINTENANCE - TOTAL EXPENSE: 5142887, PROGRAM SERVICE EXPENSE: 4861569, MANAGEMENT AND GENERAL EXPENSES: 281318, FUNDRAISING EXPENSES: ; SOFTWARE MAINTENANCE - TOTAL EXPENSE: 2426449, PROGRAM SERVICE EXPENSE: 2426449, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; OTHER PURCHASED SERVICES - TOTAL EXPENSE: 44101926, PROGRAM SERVICE EXPENSE: 27303347, MANAGEMENT AND GENERAL EXPENSES: 16798579, FUNDRAISING EXPENSES: ; OUTSIDE PROVIDER COST - TOTAL EXPENSE: 28940553, PROGRAM SERVICE EXPENSE: 28940553, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; PURCHASED LABOR - TOTAL EXPENSE: 12943904, PROGRAM SERVICE EXPENSE: 12943904, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES ACCRUED MINIMUM PENSION LIABILITY - 499743; OTHER INTERCOMPANY TRANSFERS (EXPENSES PAID BY GSH) - 210399; TOTAL - 710142; FORM 990, PART VI, LINE 2 - FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS PIH HEALTH GOOD SAMARITAN HOSPITAL IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM. THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP BY VIRTUE OF THEIR POSITIONS AS OFFICER OR DIRECTORS OF RELATED ENTITIES WITHIN THE SYSTEM: JAMES WEST - BUSINESS RELATIONSHIP PEGGY CHULACK - BUSINESS RELATIONSHIP VID SHIVARAMAN - BUSINESS RELATIONSHIP ROSALIO LOPEZ - BUSINESS RELATIONSHIP ALEX ALVAREZ - BUSINESS RELATIONSHIP CHARLOTTE WEAVER - BUSINESS RELATIONSHIP JEFF HAMAR - BUSINESS RELATIONSHIP KENTON WOODS - BUSINESS RELATIONSHIP MARISSA GOLDBERG - BUSINESS RELATIONSHIP MELANIE BATISTE - BUSINESS RELATIONSHIP PATRICK MONROE - BUSINESS RELATIONSHIP PAUL TREINEN - BUSINESS RELATIONSHIP PETER GREANEY - BUSINESS RELATIONSHIP WILLIAM ROTH - BUSINESS RELATIONSHIP RICHARD ATWOOD - BUSINESS RELATIONSHIP THURSO BARENDSE - BUSINESS RELATIONSHIP TRACEA SARALIEV - BUSINESS RELATIONSHIP DEBORAH MEDRANO - BUSINESS RELATIONSHIP REGINE LAWTON - BUSINESS RELATIONSHIP SCOTT SOUTHRON - BUSINESS RELATIONSHIP GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954077161 HEART RESEARCH CA 501(C)(3) 4 PIH HEALTH GOOD SAMARITAN HOSPITAL true ORTHOPEDIC INSTITUTE OF THE GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954346048 ORTHOPEDIC RESEARCH CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL true SAMARITAN IMAGING CENTER 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954252321 OUTPATIENT IMAGING SERVICES CA 501(C)(3) 10 PIH HEALTH GOOD SAMARITAN HOSPITAL true GOOD SAMARITAN MEDICAL OFFICE BUILDING INC 1225 WILSHIRE BLVD LOS ANGELES CA 90017 953244046 PHYSICIANS MEDICAL OFFICES CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL true KATE VAN NUYS PAGE FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 956028032 GRANTS INCOME TO GOOD SAMARITAN HOSPITAL CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL true PIH HEALTH ADULT DAY HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II PIH HEALTH INC false PIH HEALTH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA 501(C)(3) 7 PIH HEALTH INC false PIH HEALTH HOME HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II PIH HEALTH INC false PIH HEALTH DOWNEY HOSPITAL 11500 BROOKSHIRE AVE DOWNEY CA 90241 951903935 HEALTHCARE CA 501(C)(3) 3 PIH HEALTH INC false PIH HEALTH WHITTIER HOSPITAL 12401 WASHINGTON BLVD WHITTIER CA 90602 951934652 HEALTHCARE CA 501(C)(3) 3 PIH HEALTH INC false PIH HEALTH MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II PIH HEALTH INC false PIH HEALTH PHYSICIANS 6557 GREENLEAF AVE WHITTIER CA 90601 953942828 HEALTHCARE CA 501(C)(3) 10 PIH HEALTH INC false PIH HEALTH INC 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II NA false AUXILIARY OF THE HOSPITAL OF THE GOOD SAMARITAN 1225 WILSHIRE BLVD LOS ANGELES CA 90017 956051253 WELFARE OF THE GOOD SAMARITAN HOSPITAL CA 501(C)(3) TYPE III-FI NA false DRMC PROPERTIES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 954769768 REAL ESTATE CA NA C CORPORATION false HEALTHMED SERVICES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 300831225 HEALTHCARE CA NA C CORPORATION false PIH HEALTH CARE SOLUTIONS 6557 GREENLEAF AVE WHITTIER CA 90601 462072342 HEALTHCARE CA NA C CORPORATION false PIH INSURANCE CO A RECIPROCAL RISK RETENTION GROUP 733 BISHOP STREET SUITE 1555 HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI NA TRUST false PIH HEALTH RE 733 BISHOP STREET STE 1555 HONOLULU HI 96813 472501390 CAPTIVE INSURANCE HI NA TRUST false PIONEER MEDICAL GROUP INC 6557 GREENLEAF AVE WHITTIER CA 90601 330927283 MEDICAL SERVICES CA NA C CORPORATION false TEXASCONNECT INC 3223 S LOOP 289 SUITE 600 6339 LUBBOCK TX 79423 335000461 MANAGEMENT SERVICES TX NA C CORPORATION false true true true false false false false false false false true false false false true false false false false GOOD SAMARITAN HOSPITAL MEDICAL OFFICE BUILDING INC A 6234997 FMV GOOD SAMARITAN HOSPITAL MEDICAL OFFICE BUILDING INC K 2881498 FMV GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION B 210399 FMV