2026-08-14T18:34:39+00:00 2025-09-30 135565207 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2024-10-01 951903935 PIH HEALTH DOWNEY HOSPITAL PIHH 5629045000 11500 BROOKSHIRE AVE DOWNEY CA 90241 VID SHIVARAMAN CFO 2026-08-15 true true ALISON LAKRITZ P01935980 4159635100 2026-08-15 2024 2025-03-06 01:10:19Z JAMES WEST 12401 WASHINGTON BLVD WHITTIER CA 90602 225585010 false X WWW.PIHHEALTH.ORG X 1956 CA TO PROVIDE QUALITY HEALTHCARE AND CONTRIBUTE TO THE COMMUNITY'S HEALTH AND WELL-BEING. 19 18 1472 324 0 32249261 7994467 221905015 213939572 6347315 0 1692265 3576181 262193856 225510220 0 0 0 119257309 135004907 0 0 0 102109447 95419146 221366756 230424053 40827100 -4913833 205809905 242369730 254381320 295854978 -48571415 -53485248 MISSION: 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 130055652 160611766 PATIENT CARE: 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 ALMOST 105 YEARS. PATIENT CARE IN FISCAL YEAR 2024-2025 EMPLOYEES: 1,361 VOLUNTEERS: 324 NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS: 62,731 MEDICAL STAFF: 487 63895604 51944966 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 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 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. TOTAL NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 32,334. 9277745 1382840 OTHER COMMUNITY BENEFIT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND CASH AND IN-KIND CONTRIBUTIONS ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS: COMMUNITY HEALTH IMPROVEMENT SERVICES IS DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THESE PROGRAMS INCLUDE: COMMUNITY EDUCATION, COMMUNITY-BASED CLINICAL SERVICES, A COMMUNITY HELPLINE, A MEDICATION-ASSISTED TREATMENT PROGRAM, HEALTH INSURANCE ENROLLMENT ASSISTANCE, AND PURCHASED SERVICES FOR AT-RISK PATIENTS. COMMUNITY BENEFIT OPERATIONS IS DEFINED AS COSTS ASSOCIATED WITH ASSIGNED STAFF AND COMMUNITY HEALTH NEEDS ASSESSMENTS, AND COMMUNITY BENEFIT STRATEGY AND OPERATIONS. SNAPSHOT OF OUTCOMES: * 11,556 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT OPERATIONS 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. PIH HEALTH PROGRAMS INCLUDE THE FAMILY MEDICINE RESIDENCY PROGRAM AND STUDENT EDUCATION. SNAPSHOT OF OUTCOMES: * 67 MEDICAL RESIDENTS, NURSING, AND ANCILLARY PROFESSIONS STUDENTS WERE PROVIDED WITH MENTORSHIP, INTERNSHIP AND TRAINING OPPORTUNITIES. SUBSIDIZED HEALTH SERVICES: SUBSIDIZED HEALTH 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 SUBSIDIZED SERVICES INCLUDE EMERGENCY DEPARTMENT ON-CALL PHYSICIANS. SNAPSHOT OF OUTCOMES: * SOME 3 INDIVIDUALS WERE SERVED BY SUBSIDIZED HEALTH SERVICES. CASH & IN-KIND CONTRIBUTIONS: THIS CATEGORY INCLUDES FUNDS AND IN-KIND SERVICES DONATED BY PIH HEALTH TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE FOR A COMMUNITY BENEFIT PURPOSE. THESE DONATIONS INCLUDE CASH DONATIONS TO COMMUNITY ORGANIZATIONS, HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY WHILE ON PIH HEALTH WORK TIME, THE COST OF MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF EQUIPMENT, MEDICATIONS, SUPPLIES, AND SERVICES. SNAPSHOT OF OUTCOMES: * 100 INDIVIDUALS BENEFITTED FROM DONATED STAFF TIME OR MEETING SPACE. TOTAL NUMBER OF PERSONS SERVED BY ALL OTHER COMMUNITY BENEFIT SERVICES CATEGORIES: 11,726 FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBANNUALREPORT 203229001 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false true false false false false true 47 0 true 1472 true false false false false false false false false false false false false X 19 18 true false false false true true true true true false false false true true true true true true false false false 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 MARK DUBIN MD DIRECTOR 3.5 0 X 13200 0 0 MARK MINKES MD DIRECTOR (UNTIL 9/26/2025) 1.5 0 X 0 0 0 MELANIE BATISTE DIRECTOR 1.5 6.0 X 0 0 0 PATRICK MONROE DIRECTOR 1.5 6.0 X 0 0 0 PAUL YOSHINO MD DIRECTOR 1.5 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 ALEXIS ZAMARRIPA CNO 40.0 0.0 X 0 314302 64163 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 MOHAMMED GHONIM REGIONAL VP (THRU 12/06/2024) 15.0 25.0 X 0 501701 95238 ELLEN MORANDO SR DIRECTOR, HR OPERATIONS 40.0 0 X 231610 0 38065 ISELA PEREZ RN CLINICAL DIRECTOR 40.0 0 X 235796 0 23489 LIBERTY ROSALES RN CHARGE NURSE 40.0 0 X 290606 0 32923 LUZ ONG RN, BSN 40.0 0 X 242177 0 24336 TUNG NGUYEN DIRECTOR, INPATIENT PHARMACY 40.0 0 X 230533 0 4490 BRIAN SMOLSKIS FORMER - SYSTEM COO 0.0 0.0 X 0 1089063 16973 MARIE-DIANNE SAUCO COO, CARE MGMT & MGMT SVC ORG 40.0 40.0 X 0 459940 146065 RAMONA PRATT FORMER CNO 40.0 40.0 X 0 541901 56681 1243922 8226685 843991 354 true true false SODEXO INC & AFFILIATES-PA PO BOX 360170 PITTSBURGH PA 152516170 DIETARY SERVICES 2384988 ALLIED UNIVERSAL SEC SERV 161 WASHINGTON ST STE 600 8 TOWER BRIDGE CONSHOHOKEN PA 19428 SECURITY SERVICES 1490570 DLS BUILDERS 1975 N BATAVIA STREET ORANGE CA 92665 CONSTRUCTION 1262978 AYA HEALTHCARE INC DRAWE 1334 POBOX 5935 TROY MI 48007 STAFFING SERVICES 1002563 EMERGENCY ASSOCIATES CORP PO BOX 9350 RANCHO SANTA FE CA 92067 PROFESSIONAL SERVICES 774831 15 55399 7939068 7994467 NET PATIENT REVENUE 622110 186722774 186722774 HOSPITAL FEE PROGRAM 900099 27216798 27216798 0 0 0 0 213939572 265428 74790 190638 0 190638 190638 0 0 PURCHASE DISCOUNTS 900099 1266008 1266008 2119535 0 0 2119535 3385543 225510220 213939572 0 3576181 X 336946 235862 101084 104796258 89705597 15090661 3418677 2926388 492289 18352655 15709873 2642782 8100371 6933918 1166453 24000 24000 59359 59359 57886 57886 31208819 28561413 2647406 0 4482979 4303612 179367 7453 6380 1073 3935312 3714563 220749 4926 3852 1074 64317 48555 15762 120664 120664 6447901 5519403 928498 2861578 2861578 MEDICAL SUPPLIES 25585600 25232849 352751 QUALITY ASSURANCE FEE (CHA HOSPITAL FEE) 14766301 14766301 EQUIPMENT R&M AND LEASE 2594412 2594412 3197639 2845359 352280 0 230424053 203229001 27195052 0 220184 248188 36470203 43705993 0 0 0 0 2783551 3121300 535781 1247540 206947093 74924144 119940116 132022949 0 0 45860070 62023760 205809905 242369730 20387836 25386394 0 0 233993484 270468584 254381320 295854978 X -48571415 -53485248 -48571415 -53485248 205809905 242369730 -4913833 0 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 57886 57886 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY EXPLANATION: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND AMERICAN HOSPITAL ASSOCIATION IS RELATED TO LOBBYING. PIH HEALTH DOWNEY 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. 11687365 11687365 103691678 14234921 89456757 25161486 17371590 7789896 53775465 42777745 10997720 12631099 539888 12091211 132022949 HOSPITAL FEE PROGRAM RECEIVABLE 46969069 OTHER RECEIVABLES 1899636 ROU ASSETS 3207690 EAAS PROJECT FUND 9947365 62023760 FEDERAL INCOME TAXES INTERCOMPANY PAYABLE 219431301 HOSPITAL FEE PAYABLE 22497011 SELF-INSURANCE RESERVES 5357823 ESTIMATED THIRD PARTY PAYOR SETTLEMENT -971786 ROU LIABILITY 2974153 EAAS DEFERRED INCOME 21180082 GOVERNMENT ADVANCES 270468584 X 0 0 0 0 0 0 0 0 0 0 0 0 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 0 114 299553 77498 222055 0.00096 0 31968 62914888 51867468 11047420 0.04794 0 252 681162 0 681162 0.00296 0 32334 63895603 51944966 11950637 0.05186 7 11556 2438011 0 2438011 0.01058 3 67 5486735 1382840 4103895 0.01781 1 3 1305963 0 1305963 0.00567 0 0 0 0 0 0.0 1 100 47036 0 47036 0.00020 12 11726 9277745 1382840 7894905 0.03426 12 44060 73173348 53327806 19845542 0.08613 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 2 2277 0 2277 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 1 383 3141 0 3141 0.00001 0 0 0 0 0 0.0 2 385 5418 0 5418 0.00002 true 18584514 42334170 32376990 9957180 X true true 1 1 PIH HEALTH DOWNEY HOSPITAL 11500 BROOKSHIRE AVE DOWNEY CA 90241 WWW.PIHHEALTH.ORG 930000048 X X X X X PIH HEALTH DOWNEY 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/CHNA X X true 24 true https://pihhealth.org/CHIS false true X 100.0 400.0 X X X X X true true X 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, PHDH 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 DOWNEY 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 DOWNEY HOSPITAL. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT: INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY PIH HEALTH DOWNEY 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. FIFTEEN (15) 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 WELLBEING IN LOS ANGELES COUNTY SPA 6 AND SPA 7 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 SOUTHEAST LOS ANGELES (SELA) COLLABORATIVE, LYNWOOD PARTNERS EDUCATIONAL FOUNDATION, LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, HUMAN SERVICES ASSOCIATION, HELPLINE YOUTH COUNSELING, INC., FOODHELP, CERRITOS COLLEGE FOUNDATION, OLIVE CREST, LYNWOOD UNIFIED SCHOOL DISTRICT, BETHEL CHURCH, CARING CONNECTIONS, TLC FAMILY RESOURCE CENTER/DOWNEY UNIFIED SCHOOL DISTRICT, KINGDOM CAUSES BELLFLOWER, LOS ANGELES COUNTY OFFICE OF EDUCATION, PARTNERS IN CARE FOUNDATION, AND DOWNEY POLICE DEPARTMENT. 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 29.2% FOR CLEAN ENVIRONMENT. THE FULL COMMUNITY HEALTH NEEDS ASSESSMENT, CAN BE FOUND AT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/C3F4D0BF-BC35-40CC-A528-05D68DE6B283/CHNA%202025%20-%20PIH%20HEALTH%20DOWNEY%20HOSPITAL%20FINAL.PDF ATTACHMENT 1 LISTS THE STAKEHOLDER INTERVIEW RESPONDENTS, THEIR TITLES, AND ORGANIZATIONS. ATTACHMENT 2 PROVIDES STAKEHOLDER RESPONSES TO THE INTERVIEW QUESTIONS. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY , 1 FACILITY , 1 - PIH HEALTH DOWNEY HOSPITAL. PIH HEALTH DOWNEY HOSPITAL PARTICIPATED IN A COLLABORATIVE PROCESS FOR THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT WITH PIH HEALTH GOOD SAMARITAN 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 DOWNEY 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 DOWNEY HOSPITAL. PIH HEALTH'S IMPLEMENTATION STRATEGY ENSURES ALIGNMENT OF CHNA FINDINGS, OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PIH HEALTH'S ORGANIZATIONAL STRATEGY. PIH HEALTH DOWNEY 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 DOWNEY 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 DOWNEY HOSPITAL WILL NOT ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING DENTAL CARE AND ECONOMIC INSECURITY. TO VIEW THE 2026-2028 IMPLEMENTATION STRATEGY AND THE INITIATIVES IDENTIFIED TO ADDRESS AREAS OF FOCUS, VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/AC65B616-8B77-4B7B-A82E-87BE23FDCB4F/COMMUNITY%20HEALTH%20IMPROVEMENT%20PLAN%202025_PHDH%20FINAL.PDF SCHEDULE H, PART V, SECTION B, LINE 13 FACILITY , 1 FACILITY , 1 - PIH HEALTH DOWNEY 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 UNDERINSURED. THIS IS ALSO CONSIDERED FOR PATIENTS WHERE THE FPG IS NOT APPLICABLE AND THE PATIENT IS INSURED WITH INADEQUATE COVERAGE OR EXCESSIVE LIABILITY. 1 OUTPATIENT REHABILITATION PIH HEALTH DOWNEY HOSPITAL 11420 BROOKSHIRE AVE DOWNEY CA 90241 OUTPATIENT THERAPY SCHEDULE H, PART I, LINE 6A PIH HEALTH'S COMMUNITY BENEFIT REPORT, PREPARED ANNUALLY, ACCOUNTS FOR THE ORGANIZATION'S PROGRAMS AND SERVICES THAT IMPROVE THE HEALTH OF THE COMMUNITY AND ENHANCE ACCESS TO CARE. THE REPORT SEPARATES OUT COMMUNITY BENEFIT INVESTMENT FIGURES FOR EACH HOSPITAL. STANDALONE COMMUNITY BENEFIT REPORTS ARE ALSO PREPARED FOR EACH PIH HEALTH HOSPITAL ENTITY. IN ADDITION, A COMMUNITY BENEFIT REPORT FOR PIH HEALTH DOWNEY HOSPITAL WAS SUBMITTED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI). SCHEDULE H, PART I, LINE 6B THE COMMUNITY BENEFIT REPORT WAS MADE WIDELY AVAILABLE TO THE PUBLIC VIA PIH HEALTH'S WEBSITE, SOCIAL MEDIA AND COMMUNITY E-NEWSLETTER. THE REPORT IS ALSO SHARED WITH CERTAIN INTERNAL AND COMMUNITY STAKEHOLDERS VIA EMAIL AND PRESENTATIONS. TO VIEW THE FULL REPORT FOR PIH HEALTH DOWNEY HOSPITAL, VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/C4363730-273E-47B0-A415-DC7B1541FC21/PIH%20HEALTH%20DOWNEY%20HOSPITAL%20FY24%20COMMUNITY%20BENEFIT%20ANNUAL%20REPORT%20AND%20PLAN.PDF SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE PATIENT CARE COST-TO-CHARGES RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE FINANCIAL ASSISTANCE. FOR ALL OTHERS, WE UTILIZED INTERNAL COSTING SYSTEM AND ACCOUNTS FOR THE VARIOUS PAYOR MIX. 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 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE THE COMPANY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. AS A RESULT OF THE ADOPTION OF ASC 606, PIH HEALTH WHITTIER HOSPITAL IS REPORTING IMPLICIT PRICE CONCESSIONS, WHICH IS ESTABLISHED BASED ON MANY FACTORS, INCLUDING PAYER MIX, AGE OF RECIEVABLES, HISTORICAL CASH COLLECTION EXPERIENCE, OTHER RELEVANT INFORMATION. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY PIH HEALTH DOWNEY HOSPITAL ACTIVELY PROVIDES ALL PATIENTS THE OPTION TO APPLY FOR FINANCIAL ASSISTANCE, THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE AS PART OF THE COMPANY'S MISSION TO SERVE THE COMMUNITY, THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED PAYMENT AMOUNTS. THE COMPANY MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY CARE UPON ADMISSION, THOUGH DETERMINATION MAY ALSO BE MADE AT A LATER TIME. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE APPLICATION OF ANY FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT, AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE COMPANY. THE COMPANY MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS, AND BY PROVIDING APPROPRIATE ALLOWANCES THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS. IMPLICIT PRICE CONCESSIONS IS 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. THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. IMPLICIT PRICE CONCESSIONS IS INCLUDED AS A DEDUCTION FROM PATIENT SERVICES REVENUES SINCE THE COMPANY GENERALLY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS THE COMPANY DOES NOT TAKE THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE STATE HAS SPECIFICALLY ASKED US TO REPORT THIS SEPARATELY FROM OUR COMMUNITY BENEFIT TOTALS. THE COMPANY USES A COST-TO-CHARGE (C2C) RATIO TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENT RECEIVED FROM MEDICARE, WHICH IS SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH HEALTH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN PIH HEALTH DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT SPECIFIC PERCENTAGE, I.E.. DEPARTMENT C2C %, IS LOADED INTO PIH HEALTH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. AS SUCH, ALL COST INFORMATION REFLECTED IN PIH HEALTH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THE ABOVE DEPARTMENT C2C METHODOLOGY. 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 DOWNEY 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 DOWNEY 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 DOWNEY 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 / COLLABORATIVES - THROUGH PARTICIPATION IN VARIOUS COMMUNITY COLLABORATIVES 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 HEALTH'S FAP IS ALSO PUBLISHED ON OUR WEBSITE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION PIH HEALTH DOWNEY HOSPITAL (PHDH) IS LOCATED AT 11500 BROOKSHIRE AVE., DOWNEY, CA 90241. THE HOSPITAL'S SERVICE AREA ENCOMPASSES 11 ZIP CODES IN 10 CITIES/COMMUNITIES, INCLUDING BELL/BELL GARDENS, BELLFLOWER, DOWNEY, HUNTINGTON PARK, LYNWOOD, MAYWOOD, NORWALK, PARAMOUNT, AND SOUTH GATE. THE SERVICE AREA IS SERVED BY THE LOS ANGELES COUNTY 4TH SUPERVISORIAL DISTRICTS AND THE MAJORITY OF THE CITIES/COMMUNITIES FALL WITHIN THE LOS ANGELES COUNTY SERVICE PLANNING AREA (SPA) 7. PHDH TRACKS ZIP CODES OF ORIGIN FOR PATIENT ADMISSIONS. THE SERVICE AREA WAS DETERMINED FROM THE ZIP CODES THAT REFLECT A MAJORITY (79%) OF HOSPITAL INPATIENT DISCHARGES FROM THE LOCAL GEOGRAPHIC AREA. THE POPULATION OF PHDH'S PRIMARY SERVICE AREA IS 687,848. CHILDREN AND YOUTH, AGES 0-17, ARE 24.3% OF THE POPULATION, 63.9% ARE ADULTS, AGES 18-64, AND 11.8% OF THE POPULATION ARE SENIORS, AGES 65 AND OLDER. THE LARGEST PORTION OF THE POPULATION IN THE SERVICE AREA ARE HISPANIC AND LATINO RESIDENTS (82.8%). WHITE RESIDENTS MAKE UP 6.5% OF THE POPULATION. ASIAN RESIDENTS COMPRISE 4.9% OF THE POPULATION, AND BLACK OR AFRICAN AMERICAN RESIDENTS ARE 4.2% OF THE POPULATION. NATIVE AMERICAN RESIDENTS, HAWAIIANS OR PACIFIC ISLANDER RESIDENTS, MULTIRACIAL AND OTHER RACE RESIDENTS COMBINED TOTAL 1.6% OF THE POPULATION. AMONG THE RESIDENTS IN THE PRIMARY SERVICE AREA, 14.4% ARE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 38.5% ARE AT 200% OF FPL OR BELOW. EDUCATIONAL ATTAINMENT IS A KEY DRIVER OF HEALTH. IN THE PRIMARY SERVICE AREA, 33.1% OF ADULTS, AGES 25 AND OLDER, LACK A HIGH SCHOOL DIPLOMA, AND 15.5% OF AREA ADULTS HAVE A BACHELOR'S DEGREE OR HIGHER. THE CALIFORNIA HEALTHY PLACES INDEX (HPI) IS A MEASURE OF SOCIOECONOMIC NEED THAT IS CORRELATED WITH POOR HEALTH OUTCOMES. FOR COMMUNITY BENEFIT PURPOSES, CALIFORNIA DEFINES VULNERABLE POPULATIONS ACCORDING TO SPECIFIC CRITERIA, INCLUDING INADEQUATE ACCESS TO CLEAN AIR AND SAFE DRINKING WATER, AS DEFINED BY AN ENVIRONMENTAL HPI SCORE OF 50 PERCENT OR LOWER. THE SERVICE AREA ZIP CODES HAVE AN HPI SCORE OF 29.2% FOR CLEAN ENVIRONMENT. AMONG RESIDENTS IN THE PRIMARY SERVICE AREA, 14.4% ARE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 38.5% ARE AT OR BELOW 200% OF FPL. THE WEIGHTED AVERAGE OF THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS $76,049. WHEN INSURANCE COVERAGE WAS EXAMINED BY SPA, 40% OF SPA 6 AND 29.8% OF SPA 7 RESIDENTS HAVE MEDI-CAL COVERAGE WHILE 9.9% OF SPA 6 AND 8.2% OF SPA 7 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. PROMOTING EARLY LITERACY: EACH YEAR OUR PEDIATRICS DEPARTMENT PARTNERS WITH REACH OUT AND READ TO DISTRIBUTE NEW BOOKS TO PATIENTS TO PROMOTE LITERACY AND SCHOOL READINESS. OVER 5,200 BOOKS WERE GIVEN TO FAMILIES DURING FISCAL YEAR 2025. IN ADDITION, OUR NICU PARTNERS WITH THE WHITTIER PUBLIC LIBRARY TO PROVIDE BOOKS TO SUPPORT BABIES AND FAMILIES AS AN IMPORTANT WAY OF CONNECTING THROUGH READING AND TALKING. 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 WHITTIER HOSPITAL; 3) PIH HEALTH GOOD SAMARITAN HOSPITAL; 4) PIH HEALTH PHYSICIANS, A NONPROFIT MEDICAL FOUNDATION; 5) PIH HEALTH POST-ACUTE CARE SERVICES 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 HEALTHCARE DELIVERY SYSTEM. 2) 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. AS A NONPROFIT HOSPITAL WITH A CHARITABLE MISSION, PIH HEALTH HOSPITAL WHITTIER IS A DEDICATED COMMUNITY HEALTH AND WELLNESS PARTNER, GIVING BACK TO THE COMMUNITY THROUGH CHARITY CARE, MEDICAL RESEARCH, DONATIONS, HEALTH PROFESSIONS EDUCATION, COMMUNITY EDUCATION, AND MORE. 3) PIH HEALTH GOOD SAMARITAN HOSPITAL WAS FOUNDED IN 1885 AND 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 PHYSICIANS (PHP) IS A 501(C)(3) NONPROFIT MEDICAL GROUP THAT IS EXCLUSIVELY AFFILIATED WITH PIH HEALTH. THE GROUP IS COMPRISED OF MORE THAN 355 PRIMARY CARE PHYSICIANS AND SPECIALISTS 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. 5) THE PIH HEALTH FOUNDATION IS A 501(C)(3) NONPROFIT ORGANIZATION WITH THE SOLE MISSION TO RAISE FUNDS THROUGH PHILANTHROPY TO BENEFIT PIH HEALTH AND ITS AFFILIATES. LED BY A VOLUNTEER BOARD OF DIRECTORS, THE PIH HEALTH FOUNDATION RAISES VITAL FUNDS TO PROVIDE THE TOOLS AND RESOURCES PIH HEALTH'S MEDICAL PROFESSIONALS REQUIRE TO DELIVER EXCEPTIONAL CARE. 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 true false false false false false false false RAMONA PRATT FORMER CNO 0 449451 0 0 0 92450 0 41300 0 15381 0 598582 0 82500 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 ALEXIS ZAMARRIPA CNO 0 280869 0 0 0 33433 0 42098 0 22065 0 378465 0 0 MARIE-DIANNE SAUCO COO, CARE MGMT & MGMT SVC ORG 0 453760 0 0 0 6180 0 120800 0 25265 0 606005 0 0 MOHAMMED GHONIM REGIONAL VP (THRU 12/06/2024) 0 431232 0 0 0 70469 0 93850 0 1388 0 596939 0 62037 ELLEN MORANDO SR DIRECTOR, HR OPERATIONS 225543 0 0 0 6067 0 13800 0 24265 0 269675 0 0 0 TUNG NGUYEN DIRECTOR, INPATIENT PHARMACY 222084 0 0 0 8449 0 4490 0 0 0 235023 0 0 0 LUZ ONG RN, BSN 242177 0 0 0 0 0 9872 0 14464 0 266513 0 0 0 ISELA PEREZ RN CLINICAL DIRECTOR 218322 0 0 0 17474 0 14253 0 9236 0 259285 0 0 0 LIBERTY ROSALES RN CHARGE NURSE 290606 0 0 0 0 0 17542 0 15381 0 323529 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 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 A RELATED ORGANIZATION, PIH HEALTH, INC., PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK VID SHIVARAMAN ROSALIO LOPEZ, MD ALEXIS ZAMARRIPA THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2024 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): MOHAMMED GHONIM: $62,037 RAMONA PRATT: $82,500 ROSALIO LOPEZ, MD: $338,214 PEGGY CHULACK: $600,326 BRIAN SMOLSKIS: $197,952 FORM 990, PART VI, LINE 15B PROCESS FOR DETERMINING COMPENSATION FOR OTHER OFFICERS OR KEY EMPLOYEES 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 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS PIH HEALTH DOWNEY 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: RICHARD ATWOOD - BUSINESS RELATIONSHIP ALEX ALVAREZ - BUSINESS RELATIONSHIP JEFF HAMAR - BUSINESS RELATIONSHIP PATRICK MONROE - BUSINESS RELATIONSHIP PAUL TREINEN - BUSINESS RELATIONSHIP CHARLOTTE WEAVER - BUSINESS RELATIONSHIP KENTON WOODS - BUSINESS RELATIONSHIP PETER GREANEY - BUSINESS RELATIONSHIP MARISSA GOLDBERG - BUSINESS RELATIONSHIP MELANIE BATISTE - BUSINESS RELATIONSHIP THURSO BARENDSE - BUSINESS RELATIONSHIP TRACEA SARALIEV - BUSINESS RELATIONSHIP WILLIAM ROTH - BUSINESS RELATIONSHIP DEBORAH MEDRANO - BUSINESS RELATIONSHIP REGINE LAWTON - BUSINESS RELATIONSHIP SCOTT KROG - BUSINESS RELATIONSHIP SCOTT SOUTHRON - BUSINESS RELATIONSHIP JAMES WEST - BUSINESS RELATIONSHIP PEGGY CHULACK - BUSINESS RELATIONSHIP VID SHIVARAMAN - BUSINESS RELATIONSHIP ROSALIO LOPEZ - BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS PIH HEALTH, INC. IS THE SOLE MEMBER OF PIH HEALTH DOWNEY 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 DOWNEY 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 DOWNEY HOSPITAL. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION, WHICH IS MADE UP OF INDEPENDENT DIRECTORS. THE FORM 990 IS THEN PROVIDED TO THE BOARD FOR ITS INFORMATION 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 CHIEF ADMINISTRATIVE OFFICER AND GENERAL COUNSEL. 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 ALL MATTERS. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 IS AVAILABLE UPON REQUEST. THE ORGANIZATION IS NOT REQUIRED TO MAKE FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS IT RECEIVED ITS TAX EXEMPTION PRIOR TO JULY 15, 1987. FORM 990, PART VII, SECTION A, LINE 1A ONE OF THE FILING ORGANIZATION'S DIRECTORS, MARK MINKES, IS AN EMPLOYEE OF PIH HEALTH MEDICAL GROUP, INC. (PMG), WHICH HAS A PROFESSIONAL SERVICE AGREEMENT WITH PIH HEALTH PHYSICIANS, AN AFFILIATE OF THE FILING ORGANIZATION, TO PROVIDE PHYSICIAN SERVICES. THE INDIVIDUALS RECEIVED COMPENSATION FROM DMG, AS FOLLOWS: MARK MINKES REPORTABLE BASE COMPENSATION - $77,071 BONUS & INCENTIVE COMPENSATION - $25,000 OTHER COMPENSATION - $0 FORM 990, PART VIII, LINE 11D OTHER MISCELLANEOUS REVENUE ALL OTHER REVENUE - TOTAL REVENUE: 2119535, RELATED OR EXEMPT FUNCTION REVENUE: , UNRELATED BUSINESS REVENUE: , REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: 2119535; FORM 990, PART IX, LINE 11G OTHER FEES PROFESSIONAL FEES - PHYSICIANS - TOTAL EXPENSE: 10308675, PROGRAM SERVICE EXPENSE: 10308675, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; PROFESSIONAL FEES - OTHERS - TOTAL EXPENSE: 18633715, PROGRAM SERVICE EXPENSE: 16860788, MANAGEMENT AND GENERAL EXPENSES: 1772927, FUNDRAISING EXPENSES: ; R&M BUILDING - TOTAL EXPENSE: 1521301, PROGRAM SERVICE EXPENSE: 1391950, MANAGEMENT AND GENERAL EXPENSES: 129351, FUNDRAISING EXPENSES: ; COLLECTION AGENCY SERVICES - TOTAL EXPENSE: 745128, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 745128, FUNDRAISING EXPENSES: ; PIH HEALTH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA 501(C)(3) 7 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 HOME HEALTH CARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 HEALTHCARE CA 501(C)(3) TYPE II 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 PIH HEALTH INC false PIH HEALTH ADULT DAY HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 HEALTHCARE 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 WHITTIER HOSPITAL 12401 WASHINGTON BLVD WHITTIER CA 90602 951934652 HEALTHCARE CA 501(C)(3) 3 PIH HEALTH INC false PIH HEALTH GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 951656366 HEALTHCARE CA 501(C)(3) 3 PIH HEALTH INC false GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954077161 RESEARCH CA 501(C)(3) 4 PIH HEALTH GOOD SAMARITAN HOSPITAL false ORTHOPEDIC INSTITUTE OF THE GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954346048 RESEARCH CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL false SAMARITAN IMAGING CENTER 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954252321 HEALTHCARE CA 501(C)(3) 10 PIH HEALTH GOOD SAMARITAN HOSPITAL false GOOD SAMARITAN MEDICAL OFFICE BUILDING INC 1225 WILSHIRE BLVD LOS ANGELES CA 90017 953244046 MEDICAL OFFICES CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL false KATE VAN NUYS PAGE FOUNDATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 956028032 GRANTS INCOME TO GOOD SAMARITAN HOSPITAL CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL 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 CARE SOLUTIONS 6557 GREENLEAF AVENUE WHITTIER CA 90601 462072342 HEALTHCARE CA NA C CORPORATION false DRMC PROPERTIES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 954769768 REAL ESTATE CA NA C CORPORATION false PIH HEALH RE 733 BISHOP STREET SUITE 1555 HONOLULU HI 96813 472501390 CAPTIVE INSURANCE HI NA TRUST false HEALTHMED SERVICES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 300831225 HEALTHCARE CA NA C CORPORATION false PIONEER MEDICAL GROUP INC 6557 GREENLEAF AVE WHITTIER CA 90601 330927283 MEDICAL SERVICES CA NA C CORPORATION false PIONEER PROVIDER NETWORK A MEDICAL GROUP INC 6557 GREENLEAF AVE WHITTIER CA 90601 330922631 MANAGEMENT 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 false false true false false false false false false false true false false false true false false false false