2024-08-06T13:53:39-05:00 2023-09-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2022-10-01 951934652 PIH HEALTH WHITTIER HOSPITAL PIHH 5626980811 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 VID SHIVARAMAN CFO 5626980811 2024-07-31 1 0 BRITTANY ELLISER P01284594 2253444000 2024-07-22 2022 2024-08-08 14:25:15Z JAMES WEST 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 1107404007 0 X WWW.PIHHEALTH.ORG X 1954 CA TO PROVIDE QUALITY HEALTHCARE AND CONTRIBUTE TO THE COMMUNITY'S HEALTH AND WELL-BEING. 19 16 4818 901 6439 4895 2605263 1184872 799429040 832507712 46874630 22174084 13062269 18204368 861971202 874071036 155788 126850 0 0 379216449 415157708 0 0 0 405307408 460754036 784679645 876038594 77291557 -1967558 1750782539 1866079653 927328918 982123064 823453621 883956589 X 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. 0 0 577045856 758980961 PATIENT CARE: PIH HEALTH WHITTIER HOSPITAL BEGAN AS A COMMUNITY HOSPITAL 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.PATIENT CARE IN FISCAL YEAR 2022-2023EMPLOYEES 4,029VOLUNTEERS 901NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS 80,936NUMBER OF BIRTHS 2,041MEDICAL STAFF 696 146567712 81894609 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.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. NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 42,345 16281984 126850 3415695 COMMUNITY HEALTH IMPROVEMENT SERVICES: DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THESE PROGRAMS INCLUDE: COMMUNITY EDUCATION, COMMUNITY INFORMATION AND REFERRAL SUPPORT, ENROLLMENT ASSISTANCE, HEALTH AND WELLNESS CENTER AT WHITTIER FIRST DAY SUPPORT, COMMUNITY HEALTH MESSAGING, SUPPORT GROUPS, COVID-19 VACCINATION CLINICS AND TRANSPORTATION RESOURCES.SNAPSHOT OF OUTCOMES:MORE THAN 17,654 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES.HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, NURSES, STUDENTS AND OTHER HEALTH PROFESSIONALS WHEN EDUCATION IS NECESSARY OR REQUIRED BY STATE LAW, ACCREDITING BODY OR HEALTH PROFESSION SOCIETY. PIH HEALTH PROGRAMS INCLUDE THE FAMILY MEDICINE RESIDENCY PROGRAM AND STUDENT EDUCATION (INTERNSHIP, EXTERNSHIP, PRECEPTORSHIP AND MENTORING PROGRAMS).SNAPSHOT OF OUTCOMES:MORE THAN 223 STUDENT NURSES, PHYSICIAN RESIDENTS, AND OTHER INDIVIDUALS STUDYING TO BECOME HEALTHCARE PROFESSIONALS WERE PROVIDED WITH MENTORSHIP, PRECEPTORSHIP 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 SERVICES PROVIDED INCLUDE DIABETES EDUCATION CENTER, EMERGENCY DEPARTMENT ON-CALL PHYSICIANS, HOSPICE HOMES AND HOME HEALTH, AND PARAMEDIC BASE STATION.SNAPSHOT OF OUTCOMES:THE HOSPICE HOMES ENSURE ACCESS TO QUALITY, COMPASSIONATE END-OF-LIFE CARE, REGARDLESS OF ABILITY TO PAY; 90 SERVED.1,466 INDIVIDUALS PROVIDED WITH SERVICES AND EDUCATIONAL CLASSES VIA THE DIABETES EDUCATION CENTERTOTAL INDIVIDUALS SERVED BY SUBSIDIZED HEALTH SERVICES= 17,635RESEARCH: 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 HAS BEEN OFFERING CLINICAL TRIALS AND RESEARCH STUDIES AIMED AT IMPROVING HEALTH AND CANCER CARE SINCE 2001.SNAPSHOT OF OUTCOMES:MORE THAN 64 CLINICAL TRIALS IN VARIOUS STAGES, ENTERPRISE-WIDE IN ONCOLOGY, STROKE, CARDIOVASCULAR, NEONATAL, PODIATRY, ENDOVASCULAR AND OTHER THERAPEUTIC AREAS. WITH A TOTAL OF 620 ENROLLED PATIENTS IN OUR CLINICAL / REGISTRY STUDIES.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:200 AT-RISK INDIVIDUALS WERE PROVIDED WITH IN-KIND DURABLE MEDICAL EQUIPMENT OR SERVICES, SUCH AS SKILLED NURSING OR MENTAL HEALTHCARE AND TRANSPORTATION.FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBANNUALREPORT 739895552 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 144 0 1 4818 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 19 16 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARK KAWAUCHI 5626980811 12102 WASHINGTON BOULEVARD WHITTIER CA 90606 X ADRIAN CRISAN MD DIRECTOR 1.50 0.00 X 0 0 0 ALEX ALVAREZ DIRECTOR & TREASURER 1.50 6.00 X X 0 0 0 BLAYNE CUTLER MD PHD DIRECTOR 1.50 6.00 X 0 0 0 BRENT GRAY MD DIRECTOR 12.50 1.50 X 103480 0 0 CHARLOTTE WEAVER PHD DIRECTOR & VICE CHAIR 1.50 6.00 X X 0 0 0 EDUARDO TOVAR MD DIRECTOR 9.50 0.00 X 83138 0 0 JANE DICUS DIRECTOR 1.50 6.00 X 0 0 0 JAY BROWN AS OF 3123 DIRECTOR 1.50 6.00 X 0 0 0 JEFF HAMAR DIRECTOR 1.50 6.00 X 0 0 0 KENTON WOODS DIRECTOR 1.50 6.00 X 0 0 0 MARISSA GOLDBERG DIRECTOR 1.50 6.00 X 0 0 0 MELANIE BATISTE DIRECTOR 1.50 6.00 X 0 0 0 PATRICK MONROE DIRECTOR & CHAIR 1.50 6.00 X X 0 0 0 PAUL TREINEN DIRECTOR 1.50 6.00 X 0 0 0 PAULA COWAN UNTIL 9222023 DIRECTOR 1.50 6.00 X 0 0 0 PETER GREANEY MD DIRECTOR & SECRETARY 1.50 6.00 X X 0 0 0 RICHARD ATWOOD DIRECTOR 1.50 7.50 X 0 0 0 ROBERT MALONEY MD DIRECTOR 1.50 6.00 X 0 0 0 SUDHAKER NAYAK MD DIRECTOR 9.50 0.00 X 77603 2400 0 WILLIAM ROTH AS OF 3123 DIRECTOR 1.50 6.00 X 0 0 0 JAMES WEST SYSTEM PRESIDENT & CEO 20.00 32.20 X 2046653 0 355723 ROSALIO LOPEZ MD SYSTEM CSO/CMO 20.00 26.20 X 1114134 0 46447 BRIAN SMOLSKIS UNTIL 9282023 SYSTEM COO 20.00 27.70 X 1034811 0 219042 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 20.00 32.20 X 995412 0 192712 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 20.00 32.20 X 749812 0 150468 RAMONA PRATT CNO 40.00 0.00 X 411459 0 119587 DAVIS LEE CMIO & CIO 40.00 0.00 X 781918 0 118242 JUDY PUGACH VP REGULATORY AFFAIRS 40.00 0.00 X 627953 0 91608 CAROL SALAS SYSTEM CHIEF HR OFFICER 40.00 0.00 X 531311 0 132850 ROLAND FARGO REGIONAL VP 15.00 25.00 X 461515 0 97325 CHICO MANNING VP, SUPPLY CHAIN 40.00 0.00 X 437827 0 88953 SHELLY NECKE VP POST ACUTE CR SVS 40.00 0.00 X 432147 0 105454 DEBRA LEGAN VP MKTG & PLANNING 40.00 0.00 X 411234 0 93808 MARK KAWAUCHI VP OF FINANCE 40.00 0.00 X 369296 0 103622 MOHAMMED GHONIM REGIONAL VP 10.00 30.00 X 365787 0 71068 NOEL COPPINGER VP, REVENUE CYCLE 40.00 0.00 X 342691 0 66437 BRENT MELTON VP SUPPORT SERVICES 40.00 0.00 X 339331 0 56107 ANUP PATEL VP ENT RSK MGMT & CORP COMP 40.00 0.00 X 335835 0 92555 LUCINDA PLACE VP OF QUALITY MGMT 40.00 0.00 X 327621 0 87444 RON EICKHOFF VP, RESPIRATORY 40.00 0.00 X 262382 0 66500 STACY JOHNSON VP, RADIOLOGY & IMAGING 40.00 0.00 X 262246 0 58560 KEVIN BROWN UNTIL 542023 VP, CARDIOLOGY SERVICES 5.00 35.00 X 262193 0 44695 SCOTT BREMER SYS DIR COMPENSATION, BENEFITS 40.00 0.00 X 280482 0 33783 CESAR ROSAS RN CHARGE NURSE 40.00 0.00 X 278146 0 0 REBECCA WEYANT ADMIN DIR SURGICAL SVCS 40.00 0.00 X 277244 0 31797 VICTORIA NGUYEN RN DIALYSIS 40.00 0.00 X 276246 0 15461 DIANE MCCOWAN DIR PHARMACY 40.00 0.00 X 272187 0 17389 ANITA CHOU FORMER CFO & ASST TREASURER 0.00 0.00 X 119014 0 14 14671108 2400 2557651 1103 1 1 0 ALLSCRIPTS HEALTHCARE LLC ECLIPSYS CORPORATION LOCKBOX 07713 PHILADELPHIA PA 191710133 IT SERVICES 29836041 LAMBERT RADIOL MED GROUP INC 11721 WHITTIER BLVD SUITE 509 WHITTIER CA 90601 MEDICAL SERVICES 20197155 INTERCOMMUNITY ANESTH SVCS INC PO BOX 511509 LOS ANGELES CA 900518064 MEDICAL SERVICES 13545107 WHITTIER PULM AND CRITICAL CARE 6905 ALTA VISTA DRIVE RANCHO PALOS VERDES CA 90275 MEDICAL SERVICES 7178211 SODEXO INC & AFFILIATES-PA PO BOX 360170 PITTSBURGH PA 152516170 NUTRITION SERVICES 5364418 57 1184872 1184872 NET PATIENT REVENUE 622110 591843272 591843272 OTHER PATIENT REVENUE 622110 178067561 178067561 HOSPITAL FEE PROGRAM 900099 35151645 35151645 RELATED CAPITATION 561110 11661856 11661856 FOOD SERVICES 722514 4006153 4006153 11777225 11777225 832507712 17745342 17745342 237752273 3000 233326531 0 4425742 3000 4428742 4428742 12879 6440 6439 6439 COMMUNITY PHARMACY 456110 11783553 11783553 PURCHASE DISCOUNTS 900099 2637674 2637674 VIVITY EARNINGS DISTRI 900099 1666528 1666528 2110174 2110174 18197929 874071036 844291265 6439 28588460 X 126850 126850 12615626 7518806 5096820 384490 330661 53829 282607842 243042744 39565098 13510773 11619265 1891508 81303995 69921436 11382559 24734982 21272085 3462897 5078698 5078698 4208126 4208126 200225 200225 2345365 2345365 71919809 62421162 9498647 1373851 1373851 13814641 8102010 5712631 46430111 39929895 6500216 13212313 9820393 3391920 734827 631988 102839 325431 94506 230925 22550696 8135588 14415108 26119498 22462768 3656730 14129257 14129257 MEDICAL SUPPLIES 123843418 123722401 121017 CLAIMS EXPENSE 39048696 39048696 BAD DEBT EXPENSE 27104766 27104766 QUALITY ASSURANCE FEE 22999422 22999422 25314886 20216259 5098627 876038594 739895552 136143042 0 382171 958151 136029181 160372798 13250000 13250000 7696289 8658525 9056099 9360532 673432824 369190272 318785536 304242552 682896131 699024967 3105646 3267552 579581486 666944576 1750782539 1866079653 98659040 90576349 484878506 478394199 39480000 34040000 183000000 254500000 121311372 124612516 927328918 982123064 X 823453621 883956589 823453621 883956589 1750782539 1866079653 X -1967558 51314160 11156366 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 200225 200225 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, CALIFORNIA HOSPITALS COMMITTEE ON ISSUES, 340B HEALTH, AND AMERICAN HOSPITAL ASSOCIATION ARE RELATED TO LOBBYING. PIH HEALTH WHITTIER 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. 214611 214611 329563317 120573055 208990262 79988671 44038272 35950399 241268473 191960366 49308107 22397752 12618579 9779173 304242552 INTERCOMPANY RECEIVABLE 598388913 HOSPITAL FEE PROGRAM RECEIVABLE 49253227 OTHER RECEIVABLES 9686403 DEFERRED FINANCING COSTS 4215364 RIGHT-OF-USE ASSETS 4664393 COST REPORT RECEIVABLE 736276 666944576 HOSPITAL FEE PAYABLE 31590469 PENSION LIABILITY 26695356 DEFERRED COMPENSATION 16751589 SELF INSURANCE RESERVES 15779619 LITIGATION RESERVE 15500000 BOND INTEREST PAYABLE 6053245 INTEREST RATE SWAP 4005964 ROU LIABILITY 3916033 AFFILIATE PAYABLE 3235465 GOVERNMENT ADVANCES 1084776 124612516 X PART X, LINE 2: 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, 2023 OR 2022. 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 2019 FOR FEDERAL PURPOSES AND 2017 FOR CALIFORNIA PURPOSES. 1 1 X 1 X 1 X 1 1 1 0 1 1 0 623 5309097 1624780 3684317 0.00430 0 41406 144907526 78313145 66594381 0.07840 0 316 3517676 1956684 1560992 0.00180 42345 153734299 81894609 71839690 0.08450 16 17580 2410958 475 2410483 0.00280 3 223 6476050 1465324 5010726 0.00590 4 17635 6105820 1483160 4622660 0.00540 1 620 1021368 466736 554632 0.00070 3 200 140938 0 140938 0.00020 27 36258 16155134 3415695 12739439 0.01500 27 78603 169889433 85310304 84579129 0.09950 1 2 6343 0 6343 0.00000 1 4 250425 211700 38725 0.00000 1 1 4358 0 4358 0.00000 1 4 28471 0 28471 0.00000 1 1314 2537 0 2537 0.00000 5 1325 292134 211700 80434 0.00000 1 27104766 85195503 92763755 -7568252 X 1 1 1 1 PIH HEALTH HOSPITAL - WHITTIER 12401 WASHINGTON BLVD WHTTIER CA 90602 WWW.PIHHEALTH.ORG 930000129 X X X X SKILLED NURSING FACILITY PIH HEALTH WHITTIER HOSPITAL 1 0 0 1 X X X X X X X X X X 22 1 1 0 1 X HTTPS://WWW.PIHHEALTH.ORG/CHNA X X 1 22 1 HTTPS://PIHHEALTH.ORG/CHIS 0 1 X 100.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE X HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE X HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 PIH HEALTH WHITTIER HOSPITAL PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES DATA, MAPS AND INFORMATION REGARDING SOCIAL DETERMINANTS OF HEALTH, HEALTH STATUS AND LIFE EXPECTANCY, ACCESS TO HEALTHCARE, MENTAL HEALTH, ALCOHOL, SUBSTANCE AND TOBACCO USE, PHYSICAL ACTIVITY, NUTRITION AND WEIGHT STATUS, REPRODUCTIVE HEALTH, ACUTE AND CHRONIC DISEASE, LEADING CAUSES OF DEATH, COMMUNITY PERSPECTIVES GATHERED FROM FOCUS GROUPS AND INTERVIEWS, AND PROGRESS ON THE IMPLEMENTATION STRATEGY. PIH HEALTH WHITTIER HOSPITAL PART V, SECTION B, LINE 5: PRIMARY DATA-COMMUNITY INPUTPIH HEALTH WHITTIER HOSPITAL CONDUCTED TARGETED INTERVIEWS TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. EIGHTEEN (18) TELEPHONE INTERVIEWS WERE CONDUCTED DURING MARCH AND APRIL 2022. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN THE LOS ANGELES SERVICE AREA WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. 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. 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. INTERVIEW PARTICIPANTS INCLUDED AGENCIES REPRESENTING A BROAD RANGE OF HEALTH AND SOCIAL SERVICES, INCLUDING LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AS WELL THE LOCAL HEALTH DEPARTMENT THAT HAVE CURRENT INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE. THE FULL LISTING OF INTERVIEW AND FOCUS GROUPS CAN BE FOUND IN ATTACHMENT 2 OF THE ASSESSMENT FOUND HERE: HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/73C98380-25D9-458F-ABDA-09C966B4FA25/FINAL_CHNA%20REPORT%202022-WHITTIER.9.23.22.PDF PIH HEALTH WHITTIER HOSPITAL PART V, SECTION B, LINE 6A: PIH HEALTH WHITTIER HOSPITAL PARTICIPATED IN A COLLABORATIVE PROCESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT WITH PIH HEALTH DOWNEY HOSPITAL. PIH HEALTH WHITTIER HOSPITAL PART V, SECTION B, LINE 7D: 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 OUR ORGANIZATION'S E-NEWSLETTER AND MAILED MAGAZINE. PIH HEALTH WHITTIER HOSPITAL PART V, SECTION B, LINE 11: PIH HEALTH'S COMMUNITY HEALTH IMPLEMENTATION STRATEGY (CHIS) ENSURES ALIGNMENT OF CHNA FINDINGS, OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PIH HEALTH'S ORGANIZATIONAL STRATEGY. TO VIEW THE 2023-2025 CHIS AND THE INITIATIVES IDENTIFIED TO ADDRESS AREAS OF FOCUS (ACCESS TO HEALTH CARE - PRIMARY CARE, DENTAL CARE AND MENTAL HEALTH, CANCER INCIDENCE/MORTALITY, DIABETES INCIDENCE/MORTALITY, HEART DISEASE/STROKE INCIDENCE/MORTALITY, OVERWEIGHT/OBESITY, SUBSTANCE USE AND MISUSE, PREVENTATIVE SCREENINGS AND IMMUNIZATIONS WITH EMPHASIS ON FLU AND PNEUMONIA VACCINES AND CANCER SCREENINGS, FOOD INSECURITY, HOUSING/HOMELESSNESS), VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/8C2F0B48-FAB8-4A2D-A03D-4B875D0A931A/COMMUNITY%20HEALTH%20IMPROVEMENT%20PLAN%202022_PHWH.PDFSINCE PIH HEALTH WHITTIER HOSPITAL CANNOT DIRECTLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, WE WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN OUR AREAS OF FOCUS AND EXPERTISE. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, PIH HEALTH WHITTIER HOSPITAL WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING: BIRTH INDICATORS, COVID-19, ECONOMIC INSECURITY, EDUCATION, AND VIOLENCE AND INJURY PREVENTION. WHILE THE HOSPITAL DOES NOT INTEND TO EMPHASIZE COMMUNITY COVID-19 INTERVENTIONS AT THIS POINT IN THE PANDEMIC, PIH HEALTH WHITTIER HOSPITAL WILL CONTINUE TO DELIVER VACCINES, TESTING AND ACUTE MEDICAL CARE TO ADDRESS COVID-19. PIH HEALTH WHITTIER HOSPITAL PART V, SECTION B, LINE 13B: 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 CONSIDERATIONS FOR PATIENTS WHERE THE FPG IS NOT APPLICABLE AND THE PATIENT IS INSURED WITH INADEQUATE COVERAGE OR EXCESSIVE LIABILITY. 13 1 - SAME DAY SURGERY 12415 WASHINGTON BLVD WHITTIER CA 90602 OUTPATIENT SURGICAL SERVICES 2 - PATRICIA L SCHEIFLY BREAST HEALTH CTR 12393 WASHINGTON BLVD WHITTIER CA 90602 BREAST HEALTH SVCS 3 - ERNEST D WELLS MEDICAL OFFICE BUILDING 12462 PUTNAM ST WHITTIER CA 90602 OUTPATIENT SERVICES 4 - WASHINGTON MEDICAL OFFICE BUILDING 12291 WASHINGTON BLVD WHITTIER CA 90602 WOUND HEALING, LAB DRAW STATION 5 - BLOOMFIELD MEDICAL OFFICE BUILDING 12400 BLOOMFIELD SANTE FE SPRINGS CA 90670 OUTPATIENT SERVICES 6 - WHITTWOOD MEDICAL OFFICE BUILDING 15725 E WHITTIER BLVD HACIENDA HEIGHTS CA 90603 OUTPATIENT SERVICES 7 - LA MIRADA MEDICAL OFFICE BUILDING 12675 S LA MIRADA BLVD SUITE 219 LA MIRADA CA 90638 OUTPATIENT SERVICES 8 - HACIENDA HEIGHTS MEDICAL OFFICE BUILDING 1850 AZUSA AVE HACIENDA HEIGHTS CA 91745 OUTPATIENT SERVICES 9 - PIH HEALTH THERAPY SERVICES 15088 IMPERIAL HWY LA MIRADA CA 90638 OUTPATIENT SERVICES 10 - PIH HOME HEALTH SERVICES 15050 IMPERIAL HWY LA MIRADA CA 90638 HOME HEALTH AGENCY 11 - ARCADIA HOME HEALTH SERVICES 351 E FOOTHILL BLVD SUITE 100 ARCADIA CA 91006 VISITING NURSES ASSOCIATION 12 - HOSPICE HOMES - DOVE 10736 VALLEY VIEW AVE WHITTIER CA 90604 HOSPICE CARE 13 - HOSPICE HOMES - ROSE 10742 VALLEY VIEW AVE WHITTIER CA 90604 HOSPICE CARE 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 VIA SOCIAL MEDIA, OUR ORGANIZATION'S WEBSITE AND A COMMUNITY E-NEWSLETTER. IT WILL ALSO BE SHARED WITH CERTAIN INTERNAL AND COMMUNITY STAKEHOLDERS VIA PRESENTATION.TO VIEW THE FULL REPORT, VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/FADD2708-EF33-4817-9801-C298556711D5/PIH_HEALTH_WHITTIER_HOSPITAL_FY23_COMMUNITY_BENEFIT_ANNUAL_REPORT_AND_PLAN.PDF PART I, LINE 7: PATIENT CARE COST-TO-CHARGES RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID. FOR ALL OTHERS, WE UTILIZED INTERNAL COSTING SYSTEM AND ACCOUNTS FOR THE VARIOUS PAYER MIX. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $27,104,766. 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. PIH HEALTH MOBILIZES ASSETS AND INVESTS RESOURCES THROUGH A VARIETY OF COMMUNITY-BUILDING ACTIVITIES DESIGNED TO ADDRESS IDENTIFIED NEEDS, INCLUDING PARTICIPATION ON LOCAL CHAMBER OF COMMERCE BOARDS AIMED AT IMPROVING THE ECONOMIC, CIVIC AND CULTURAL WELLBEING OF THE COMMUNITY. 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. IN ADDITION, PIH HEALTH HAS ADVOCATED FOR IMPROVED PUBLIC TRANSPORTATION SOLUTIONS VIA EXTENDED LIGHT RAIL SERVICE IN THE COMMUNITY TO IMPROVE FUNDING AND RESOURCES TO ADDRESS THIS NEED. ALSO, THE ORGANIZATION'S PRESIDENT AND CEO HAS SUPPORTED LOCAL, STATE AND FEDERAL HEALTH-RELATED ADVOCACY THROUGH PARTICIPATION AND LEADERSHIP IN VARIOUS HEALTHCARE ASSOCIATIONS. LASTLY, PIH HEALTH ACCOUNTS FOR STAFF PARTICIPATION IN AND/OR SUPPORT OF WORKFORCE DEVELOPMENT PROGRAMS, WORKFORCE DEVELOPMENT BOARDS, ETC. PART III, LINE 2: 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. PART III, LINE 3: PIH HEALTH WHITTIER 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. PART III, LINE 4: 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. PART III, LINE 8: THE COMPANY DOES NOT TAKE THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE STATE HAS SPECIFICALLY ASKED US TO REPORT THIS SEPARATELY FROM OUR COMMUNITY BENEFIT TOTALS. THE COMPANY USES A COST-TO-CHARGE (C2C) RATIO TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENT RECEIVED FROM MEDICARE, WHICH IS SIMILAR TO THE IRS FORM 990 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. PART III, LINE 9B: 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. PART VI, LINE 2: 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. PART VI, LINE 3: THERE ARE MANY AVENUES PIH HEALTH TAKES IN EDUCATING PATIENTS AND FAMILY MEMBERS ABOUT THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS. PATIENT 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 AE 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. PART VI, LINE 4: PIH HEALTH WHITTIER HOSPITAL IS LOCATED AT 12401 WASHINGTON BLVD., WHITTIER, CA 90602. THE HOSPITAL'S SERVICE AREA ENCOMPASSES 13 ZIP CODES IN 9 CITIES/COMMUNITIES. THE SERVICE AREA IS SERVED BY THE LOS ANGELES COUNTY 4TH SUPERVISORIAL DISTRICT AND THE MAJORITY OF THE CITIES/COMMUNITIES FALL WITHIN THE LOS ANGELES COUNTY SERVICE PLANNING AREA (SPA) 7. A SECTION OF LA HABRA ZIP CODE 90631 IS IN ORANGE COUNTY. PIH HEALTH WHITTIER HOSPITAL TRACKS ZIP CODES OF ORIGIN FOR PATIENT ADMISSIONS. THE SERVICE AREA WAS DETERMINED FROM THE ZIP CODES THAT REFLECT A MAJORITY OF PATIENT ADMISSIONS FROM THE LOCAL GEOGRAPHIC AREA.BASED ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, THE POPULATION FOR PIH HEALTH WHITTIER HOSPITAL'S SERVICE AREA IS 616,536. CHILDREN AND YOUTH, AGES 0-17, ARE 22.8% OF THE POPULATION, 67.6% ARE ADULTS, AGES 18-64, AND 9.6% OF THE POPULATION ARE ADULTS, AGES 65 AND OLDER. IN THE SERVICE AREA, 68.0% OF THE POPULATION IS HISPANIC/LATINO, 16.1% ARE WHITE, 12.3% ARE ASIAN, 1.7% ARE BLACK/AFRICAN AMERICAN, 1.5% ARE OTHER/MULTIPLE RACES, 0.3% ARE NATIVE AMERICAN/ALASKAN NATIVE, AND 0.2% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER. AMONG THE SERVICE AREA POPULATION, AGES FIVE AND OLDER, 45.7% SPEAK SPANISH IN THE HOME, 42.5% SPEAK ONLY ENGLISH IN THE HOME, 9.7% SPEAK AN ASIAN OR PACIFIC ISLANDER LANGUAGE, 1.7% SPEAK OTHER INDO-EUROPEAN LANGUAGES, AND 0.3% SPEAK OTHER LANGUAGES IN THEIR HOME. IN THE SERVICE AREA, 10.3% OF THE POPULATION IS AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. AMONG SERVICE AREA ADULTS, AGES 25 AND OLDER, 19.2% HAVE LESS THAN A HIGH SCHOOL DIPLOMA, 49.6% ARE HIGH SCHOOL GRADUATES, AND 31.1% HAVE AN ASSOCIATE, BACHELOR'S, OR GRADUATE/PROFESSIONAL DEGREE. THERE ARE FIVE OTHER HOSPITALS PROVIDING CARE IN THE SERVICE AREA POPULATION AND NO FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE SERVICE AREA. FOR ADDITIONAL DATA REGARDING THE SERVICE AREA, PLEASE SEE THE CHNA AT PIHHEALTH.ORG/CHNA PART VI, LINE 5: COMMUNITY BOARDPIH HEALTH'S COMMUNITY BOARD OF DIRECTORS WORKS TO ADVANCE PIH HEALTH'S COMMITMENT TO HELPING OUR COMMUNITIES GET WELL AND STAY HEALTHY.OPEN MEDICAL STAFFPIH HEALTH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES.USE OF SURPLUS FUNDSPIH 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 TIMEMANY PIH HEALTH PROVIDERS ARE LIVING OUT THEIR PASSION TO SERVE PEOPLE IN NEED BY DONATING THEIR TIME AND TALENTS BOTH IN OUR COMMUNITY AND OVERSEAS. EMERGENCY AND DISASTER PREPAREDNESS/DISASTER RESOURCE CENTER (DRC) PIH HEALTH WHITTIER HOSPITAL IS ONE OF 13 LOS ANGELES COUNTY DESIGNATED DRC'S THAT ENSURE THE COMMUNITY HAS ACCESS TO RESOURCES AND THE HIGHLY SKILLED STAFF NEEDED TO RESPOND TO A LARGE-SCALE DISASTER OR OTHER PUBLIC HEALTH EMERGENCIES.ENVIRONMENTAL AND RECYCLING PROJECTSPIH HEALTH CONTINUES TO IMPLEMENT "GREEN" INITIATIVES, INCLUDING INCREASED USAGE OF LED LIGHTING TO DECREASE CONSUMPTION OF ELECTRICITY AND, EXPANDING A METHANE GAS PROJECT WITH THE CITY OF WHITTIER TO CONVERT METHANE GAS INTO ELECTRICITY. EYEGLASSES AND HEARING AIDS ARE ALSO COLLECTED AND RECYCLED FOR REDISTRIBUTION BY THE EAST WHITTIER LIONS CLUB TO THOSE IN NEED.VOLUNTEER CONTRIBUTIONS SOME 1,355 PIH HEALTH VOLUNTEERS COLLECTIVELY CONTRIBUTED 112,001 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, 30 INDIVIDUALS SPENT 184 HOURS SHADOWING MEDICAL CAREER PROFESSIONALS AND ATTENDING SIMULATION LABS. SOME 15 VOLUNTEERS AND COMMUNITY MEMBERS ATTENDED A 'MEET THE PROS' EDUCATIONAL CLASS, WHERE A HEALTHCARE PROFESSIONAL GAVE A PRESENTATION ON HIS CAREER PATH.REACH OUT AND READ PROGRAM OUR PEDIATRICS DEPARTMENT PARTNERS WITH REACH OUT AND READ TO PROMOTE EARLY LITERACY AND SCHOOL READINESS. PHYSICIANS PROVIDE PATIENTS WITH A CHILDREN'S BOOK AND DISCUSS WITH PARENTS THE IMPORTANCE OF READING ALOUD. EACH YEAR, OVER 4,912 NEW BOOKS ARE DISTRIBUTED. PART VI, LINE 6: 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 PHYSICIANS, A NONPROFIT MEDICAL FOUNDATION; 5) PIH HEALTH HOME HEALTHCARE AND 6) THE PIH HEALTH FOUNDATION, A NONPROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH'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 100 YEARS. AS A NONNPROFIT HOSPITAL WITH A CHARITABLE MISSION, PIH HEALTH HOSPITAL DOWNEY IS A DEDICATED COMMUNITY HEALTH AND WELLNESS PARTNER. THIS COMMITMENT AND LEADERSHIP GIVES BACK TO THE COMMUNITY THROUGH CHARITY CARE, HEALTH PROFESSIONS EDUCATION AND MORE.3) PIH HEALTH GOOD SAMARITAN HOSPITAL FOUNDED IN 1885, 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. AS A NONNPROFIT HOSPITAL WITH A CHARITABLE MISSION, PIH HEALTH GOOD SAMARITAN HOSPITAL IS A DEDICATED COMMUNITY HEALTH AND WELLNESS PARTNER. THIS COMMITMENT AND LEADERSHIP GIVES BACK TO THE COMMUNITY THROUGH CHARITY CARE, MEDICAL RESEARCH, DONATIONS, 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 270 PRIMARY CARE PHYSICIANS AND SPECIALIST 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) PIH HEALTH HOME HEALTHCARE PROVIDES AROUND-THE-CLOCK, QUALITY CARE FOR PATIENTS IN THEIR OWN HOME. PIH HEALTH HOME HEALTHCARE IS CERTIFIED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.6) THE PIH HEALTH FOUNDATION IS A 501(C)(3) NONPROFIT ORGANIZATION WITH THE SOLE MISSION TO RAISE FUNDS THROUGH PHILANTROPHY 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. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 BOYS GIRLS CLUB OF WHITTIER 7905 GREENLEAF AVE WHITTIER CA 90602 956151763 501(C)(3) 10000 0 FUNDS ARE INTENDED TO SUPPORT HEALTHY LIFESTYLES PROGRAMMING, WHICH HELPS FILL GAPS FOR LOWER-INCOME FAMILIES WITH PHYSICAL ACTIVITY, ORGANIZED SPORTS, AND NUTRITION EDUCATION FOR YOUTH. INTERFAITH FOOD CENTER 11819 BURKE STREET SANTA FE SPRINGS CA 90670 953889152 501(C)(3) 10000 0 FUNDS WILL SUPPORT INTERFAITH FOOD CENTERS FOOD PANTRY PROGRAM KINGDOM CAUSES BELLFLOWER 16429 BELLFLOWER BLVD SANTA FE SPRINGS CA 90706 954849998 501(C)(3) 10000 0 FUNDS ARE INTENDED TO SUPPORT MARGARETS HOUSE, A TRANSITIONAL HOME PROVIDING SHORT-TERM HOUSING AND SERVICES FOR FAMILIES WITH MINOR DEPENDENT CHILDREN. PROJECT ANGEL FOOD 922 VINE STREET LOS ANGELES CA 90038 954115863 501(C)(3) 10000 0 FUNDS SHOULD BE RESTRICTED TO SUPPORTING LITTLE LAKE SCHOOL DISTRICTS MINDFUL STUDENTS PROGRAM TO INCREASE STUDENT ENGAGEMENT AND MENTAL HEALTH THROUGH PRACTICING MINDFULNESS STRATEGIES. COMMUNITY FAMILY GUIDANCE CENTER 10929 SOUTH STREET STE208B CERRITOS CA 90703 953083776 501(C)(3) 8000 0 FUNDING WILL SUPPORT THE WELLBEING OF CHILDREN AND FAMILIES BY PROVIDING NON-INTENSIVE AND INTENSIVE MENTAL HEALTH SERVICES, WHICH CONSIST OF SHORT-TERM PREVENTION AND EARLY INTERVENTIONS, PARENT EDUCATION, CASE MANAGEMENT SERVICES. HELPLINE YOUTH COUNSELING INC 14181 TELEGRAPH ROAD WHITTIER CA 90604 237113824 501(C)(3) 7500 0 FUNDS SHOULD BE RESTRICTED TO HELPLINE YOUTH COUNSELINGS PROVISION OF ACCESSIBLE MENTAL HEALTH SERVICES FOR LOW-INCOME CHILDREN, INDIVIDUALS AND FAMILIES. LA CADA 12070 TELEGRAPH ROAD STE207 SANTA FE SPRINGS CA 90670 237110152 501(C)(3) 7500 0 FUNDS WILL SUPPORT LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE'S SUBSTANCE USE PROGRAMS/DIRECT SERVICES FOR HOMELESS SUBSTANCE USERS. 7 PART I, LINE 2: PIH HEALTH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS. PIH HEALTH PROVIDES FINANCIAL SUPPORT TO TAX-EXEMPT, 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. X X X X X 1 1 0 0 0 0 0 0 0 JAMES WEST SYSTEM PRESIDENT & CEO 1506821 0 0 0 539832 0 335520 0 20325 0 2402498 0 517243 0 BRIAN SMOLSKIS UNTIL 9282023 SYSTEM COO 838304 0 0 0 196507 0 196657 0 22507 0 1253975 0 188312 0 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 826709 0 0 0 168703 0 178274 0 14760 0 1188446 0 120897 0 ROSALIO LOPEZ MD SYSTEM CSO/CMO 907438 0 0 0 206696 0 36700 0 9869 0 1160703 0 0 0 DAVIS LEE CMIO & CIO 532268 0 0 0 249650 0 103309 0 20056 0 905283 0 247135 0 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 681460 0 0 0 68352 0 141186 0 9404 0 900402 0 61131 0 JUDY PUGACH VP REGULATORY AFFAIRS 329056 0 75000 0 223897 0 85077 0 6654 0 719684 0 37477 0 CAROL SALAS SYSTEM CHIEF HR OFFICER 461805 0 0 0 69506 0 109715 0 23257 0 664283 0 53155 0 ROLAND FARGO REGIONAL VP 389307 0 0 0 72208 0 76941 0 20507 0 558963 0 65794 0 SHELLY NECKE VP POST ACUTE CR SVS 376010 0 0 0 56137 0 89692 0 15884 0 537723 0 47881 0 RAMONA PRATT CNO 401796 0 0 0 9663 0 100536 0 19174 0 531169 0 0 0 CHICO MANNING VP, SUPPLY CHAIN 359243 0 0 0 78584 0 88953 0 118 0 526898 0 69549 0 DEBRA LEGAN VP MKTG & PLANNING 402846 0 0 0 8388 0 93748 0 182 0 505164 0 0 0 MARK KAWAUCHI VP OF FINANCE 362522 0 0 0 6774 0 81020 0 22724 0 473040 0 0 0 MOHAMMED GHONIM REGIONAL VP 357516 0 0 0 8271 0 69038 0 2151 0 436976 0 0 0 ANUP PATEL VP ENT RSK MGMT & CORP COMP 307879 0 0 0 27956 0 68953 0 24724 0 429512 0 20971 0 LUCINDA PLACE VP OF QUALITY MGMT 319988 0 0 0 7633 0 67059 0 20507 0 415187 0 0 0 NOEL COPPINGER VP, REVENUE CYCLE 280661 0 0 0 62030 0 59921 0 6638 0 409250 0 55256 0 BRENT MELTON VP SUPPORT SERVICES 302672 0 0 0 36659 0 33574 0 22655 0 395560 0 29480 0 RON EICKHOFF VP, RESPIRATORY 255608 0 0 0 6774 0 51611 0 15010 0 329003 0 0 0 STACY JOHNSON VP, RADIOLOGY & IMAGING 255832 0 0 0 6414 0 50233 0 8449 0 320928 0 0 0 SCOTT BREMER SYS DIR COMPENSATION, BENEFITS 279294 0 0 0 1188 0 13747 0 20158 0 314387 0 0 0 REBECCA WEYANT ADMIN DIR SURGICAL SVCS 274958 0 0 0 2286 0 16035 0 15884 0 309163 0 0 0 KEVIN BROWN UNTIL 542023 VP, CARDIOLOGY SERVICES 255779 0 0 0 6414 0 36142 0 8675 0 307010 0 0 0 VICTORIA NGUYEN RN DIALYSIS 263139 0 0 0 13107 0 9349 0 6131 0 291726 0 0 0 DIANE MCCOWAN DIR PHARMACY 269799 0 0 0 2388 0 16200 0 1311 0 289698 0 0 0 CESAR ROSAS RN CHARGE NURSE 267897 0 0 0 10249 0 0 0 0 0 278146 0 0 0 ANITA CHOU FORMER CFO & ASST TREASURER -14 0 0 0 119028 0 0 0 14 0 119028 0 0 0 PART I, LINES 4A-B PART I, LINE 4A: THE FOLLOWING 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. ANITA CHOU JOHN JOYCE MARK ST. JULIEN PART I, LINE 4B: 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 VID SHIVARAMAN BRIAN SMOLSKIS RAMONA PRATT DAVIS LEE ANUP PAEL CHICO MANNING SHELLY NECKE DEBRA LEGAN JUDY PUGACH CAROL SALAS BRENT MELTON MARK KAWAUCHI LUCINDA PLACE NOEL COPPINGER MOHAMMED GHONIM RON EICKHOFF STACY JOHNSON ROLAND FARGO KEVIN BROWN ANITA CHOU MARK ST. JULIEN JOHN JOYCE THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2022 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): JAMES WEST $517,243 PEGGY CHULACK $120,897 VID SHIVARAMAN $61,131 BRIAN SMOLSKIS $188,312 DAVIS LEE $247,135 ANUP PATEL $20,971 CHICO MANNING $69,549 SHELLY NECKE $47,881 JUDY PUGACH $37,477 CAROL SALAS $53,155 BRENT MELTON $29,480 NOEL COPPINGER $55,256 ROLAND FARGO $65,794 A CITY OF WHITTIER 956000812 966769DK4 2014-08-07 106612491 ACQUIRE AND EQUIP HOSPITAL 0 0 0 B CITY OF WHITTIER 956000812 996769DL2 2018-11-29 48500000 REFUND SERIES 2012 B BONDS 0 0 0 C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UWP9 2020-10-08 197721474 CONSTRUCTION AND EQUIPMENT & REFUND BONDS 2009 AND 2012C 0 0 0 D CITY OF WHITTIER - SERIES 2022A 956000812 NONEAVAIL 2022-04-06 40135000 REFUND BOND 2012A 0 0 0 A 106612491 1880505 6854015 97877971 2014 0 0 1 1 B 11195000 48500000 457075 48042925 1 0 1 1 C 2365000 197721474 2170191 54446263 108924588 32180432 1 0 0 1 D 4285000 40135000 40135000 1 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 0 1 1 0 0 0 1 A 0 1 0 0 0 0 0 1 1 B 0 1 0 0 0 1 BARCLAY 7.000000000000 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART IV, LINE 4A: BOND 2012 SERIES ALSO ENTERED INTO HEDGE WITH UNION BANK, N.A JAMES WEST PRESIDENT AND CEO SPLIT DOLLAR LIFE AGREEMENT BENEFIT PLAN X 13250000 13250000 0 1 1 13250000 MARY WARGO SISTER OF OFFICER 97684 SEE PART V 0 ANDREW PRATT SON OF OFFICER 119130 SEE PART V 0 SEE PART V SEE PART V 167676 SEE PART V 0 SCH L, PART II, LOANS TO AND FROM INTERESTED PERSONS: (A) NAME OF PERSON: JAMES WEST(B) RELATIONSHIP WITH ORGANIZATION: PRESIDENT & CEO(C) PURPOSE OF LOAN: SPLIT DOLLAR LIFE AGREEMENT BENEFIT PLAN SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: MARY WARGO, SISTER OF PEGGY CHULACK, IS EMPLOYED BY PIH HEALTH WHITTIER HOSPITAL. SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: ANDREW PRATT, SON OF RAMONA PRATT, IS EMPLOYED BY PIH HEALTH WHITTIER HOSPITAL. SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: ELIZABETH BROGAN-SHIVARAMAN, FAMILY MEMBER OF OFFICER VID SHIVARAMAN, IS EMPLOYED BY PIH HEALTH PHYSICIANS. FORM 990, PART VI, SECTION A, LINE 2 PIH HEALTH WHITTIER 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, JEFF HAMAR, PAULA COWAN, ALEX ALVAREZ, BLAYNE CUTLER, JANE DICUS, PATRICK MONROE, PAUL TREINEN, CHARLOTTE WEAVER, KENTON WOODS, PETER GREANEY, MARISSA GOLDBERG, MELANIE BATISTE, ROBERT MALONEY, JAMES WEST, PEGGY CHULACK, VID SHIVARAMAN, ROSALIO LOPEZ, AND BRIAN SMOLSKIS. FORM 990, PART VI, SECTION A, LINE 6 PIH HEALTH, INC. IS THE SOLE MEMBER OF PIH HEALTH WHITTIER HOSPITAL FORM 990, PART VI, SECTION A, LINE 7A PIH HEALTH, INC. HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF DIRECTORS OF PIH HEALTH WHITTIER HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B PIH HEALTH, INC. HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH HEALTH WHITTIER HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B 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. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL MANAGEMENT AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL POSITIVE RESPONSES ARE REVIEWED BY THE 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 OF MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT, THIRD-PARTY, EXPERT COMPENSATION CONSULTANT TO REVIEW ITS EXECUTIVE SALARIES. THE CONSULTANT OBTAINS SPECIFIC ORGANIZATIONAL DATA FROM WHICH TO BASE ITS ANALYSIS (REVENUES, EXPENSES, EMPLOYEES, SERVICE AREA, JOB DESCRIPTIONS, ETC.). THE CONSULTANT'S ANALYSIS INCLUDES A REVIEW OF COMPENSATION TRENDS, REGULATORY ISSUES, THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, THE METHODOLOGY USED FOR THE ASSESSMENT, THE BASE SALARY ANALYSIS, THE INCENTIVE COMPENSATION ANALYSIS, THE TOTAL CASH COMPENSATION ANALYSIS, AND THE TOTAL COMPENSATION ANALYSIS. SALARY MOVEMENT, INCENTIVE COMPENSATION, MARKET BENEFIT, AND RECRUITMENT AND RETENTION TRENDS ARE REVIEWED. THIS ANALYSIS IS PROVIDED TO THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS. THE EXECUTIVE COMPENSATION COMMITTEE HAS APPROVED A REGIONAL PEER GROUP THAT INCLUDES HIGH-PERFORMING, COMPARABLY-SIZED CALIFORNIA HOSPITALS AND HEALTH SYSTEMS. THE CONSULTANT COMPILES COMPARABILITY DATA FROM NATIONAL AND REGIONAL PEERS; COMPARES THE ORGANIZATION'S EXECUTIVE COMPENSATION WITH PEER GROUP COMPENSATION LEVELS; AND PREPARES A REPORT THAT INCLUDES ALL OF THE BACK-UP DATA ON COMPARABILITY, PEER GROUPS, AND JOB MATCHES. THE METHODOLOGY USED BY THE CONSULTANT INCLUDES TWO PEER GROUPS: A NATIONAL PEER GROUP OF COMPARABLY-SIZED HOSPITALS AND SINGLE HOSPITAL SYSTEMS AND A REGIONAL PEER GROUP OF HOSPITALS AND SYSTEMS IN SOUTHERN CALIFORNIA, THE DATA OF WHICH IS PROVIDED TO THE COMMITTEE IN ITS REPORT. THE NATIONAL DATA IS USED AS THE PRIMARY COMPARATOR FOR THE ANALYSIS. THE COMMITTEE IS PRESENTED WITH CHARTS THAT COMPARE ORGANIZATION SALARIES TO THE LEVEL TARGETED IN THE COMPENSATION PHILOSOPHY. NEITHER PERFORMANCE NOR QUALIFICATIONS OF THE INCUMBENT IS CONSIDERED WHEN PROVIDING THE MARKET DATA. THE COMMITTEE IS PROVIDED WITH A REVIEW OF THE BASE SALARY ANALYSIS, A REVIEW OF THE INCENTIVE COMPENSATION ANALYSIS, A REVIEW OF THE TOTAL CASH COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE), AND A REVIEW OF THE TOTAL COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE PLUS BENEFITS/PERQUISITES). BASED UPON ALL OF THE ABOVE INFORMATION, THE CONSULTANT PROVIDES THE COMMITTEE WITH RECOMMENDED SALARY RANGES FOR THE PERIOD ASSESSED. THE EXECUTIVE COMPENSATION COMMITTEE DELIBERATES ON THE COMPARABILITY DATA TO ENSURE THAT IT IS APPROPRIATE IN REPRESENTING LIKE ORGANIZATIONS, LIKE POSITIONS, AND LIKE CIRCUMSTANCES, AND THAT IT COULD REALISTICALLY RELY ON THE COMPARABILITY DATA IN REACHING ITS DECISION THAT THE COMPENSATION IS REASONABLE AND REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED. THE EXECUTIVE COMPENSATION COMMITTEE AFFIRMS THIS PROCESS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 AND FORM 990-T ARE AVAILABLE UPON REQUEST. THE ORGANIZATION IS NOT REQUIRED TO MAKE FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS IT RECEIVED ITS TAX EXEMPTION PRIOR TO JULY 15, 1987. FORM 990, PART VII, SECTION A, LINE 1: THREE OF THE FILING ORGANIZATION'S DIRECTORS ARE EMPLOYEES OF PIONEER MEDICAL GROUP (PMG) WHICH HAS A PROFESSIONAL SERVICE AGREEMENT WITH PIH HEALTH PHYSICIANS, AN AFFILIATE OF THE FILING ORGNAIZATION, TO PROVIDE PHYSICIAN SERVICES. THE INDIVIDUALS RECEIVED COMPENSATION FROM PMG AS FOLLOWS: SUDHAKER MAYAK: REPORTABLE BASE COMPENSATION - $1,801,100 OTHER COMPENSATION - $54,518 EDUARDO TOVAR: REPORTABLE BASE COMPENSATION - $1,279,771 OTHER COMPENSATION - $57,363 BRENT GRAY: REPORTABLE BASE COMPENSATION - $694,853 OTHER COMPENSATION - $39,301 ONE OF THE FILING ORGANIZATION'S OFFICERS, ROSALIO LOPEZ, IS AN EMPLOYEE OF PIH HEALTH DOWNEY MEDICAL GROUP, INC. (DMG), 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: ROSALIO LOPEZ: REPORTABLE BASE COMPENSATION - $70,464 OTHER COMPENSATION - $0 FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - PHYSICIANS:: PROGRAM SERVICE EXPENSES 24,010,731. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,010,731. PROFESSIONAL FEES - OTHER:: PROGRAM SERVICE EXPENSES 35,884,729. MANAGEMENT AND GENERAL EXPENSES 6,646,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,531,669. R&M BUILDING: PROGRAM SERVICE EXPENSES 2,525,702. MANAGEMENT AND GENERAL EXPENSES 84,058. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,609,760. : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,767,649. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,767,649. FORM 990, PART XI, LINE 9: SWAP MARKET VALUE ADJ 3,506,353. PENSION ADJ 7,650,013. PIH HEALTH COMMUNITY PHARMACY LLC 12401 WASHINGTON BLVD WHITTIER CA 90602 264390142 PHARMACY CA 11783553 715887 PIH HEALTH WHITTIER HOSPITAL PIH HEALTH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA 501(C)(3) LINE 7 PIH HEALTH INC 1 PIH HEALTH MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) LINE 12B, II PIH HEALTH INC 1 PIH HEALTH HOME HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 1 PIH HEALTH INC 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) LINE 12B, II N/A 0 PIH HEALTH ADULT DAY HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 1 PIH HEALTH PHYSICIANS 6557 GREENLEAF AVENUE WHITTIER CA 90601 953942828 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 1 PIH HEALTH DOWNEY HOSPITAL 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 951903935 HEALTHCARE CA 501(C)(3) LINE 3 PIH HEALTH INC 1 GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 951656366 HEALTHCARE CA 501(C)(3) LINE 3 PIH HEALTH INC 1 GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954077161 RESEARCH CA 501(C)(3) LINE 4 GOOD SAMARITAN HOSPITAL 1 ORTHOPEDIC INSTITUTE OF THE GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954346048 RESEARCH CA 501(C)(3) LINE 12A, I GOOD SAMARITAN HOSPITAL 1 SAMARITAN IMAGING CENTER 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954252321 HEALTHCARE CA 501(C)(3) LINE 10 GOOD SAMARITAN HOSPITAL 1 GOOD SAMARITAN MEDICAL OFFICE BUILDING INC 1225 WILSHIRE BLVD LOS ANGELES CA 90017 953244046 MEDICAL OFFICES CA 501(C)(3) LINE 12A, I GOOD SAMARITAN HOSPITAL 1 KATE VAN NUYS PAGE FOUNDATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 956028032 GRANTS INCOME TO GOOD SAMARITAN HOSPITAL CA 501(C)(3) LINE 12A, I GOOD SAMARITAN HOSPITAL 1 PIH HEALTH INSURANCE COMPANY 733 BISHOP STREET STE 1555 HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI N/A T 1 PIH HEALTH CARE SOLUTIONS 6557 GREENLEAF AVENUE WHITTIER CA 90601 462072342 HEALTHCARE CA N/A C 1 DRMC PROPERTIES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 954769768 REAL ESTATE CA N/A C 1 PIH HEALTH RE 733 BISHOP STREET STE 1555 HONOLULU HI 96813 472501390 CAPTIVE INSURANCE HI N/A T 1 HEALTHMED SERVICES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 300831225 HEALTHCARE CA N/A C 1 PIONEER MEDICAL GROUP INC 12401 WASHINGTON BLVD WHITTIER CA 90602 330927283 MEDICAL SERVICES CA N/A C 1 PIONEER PROVIDER NETWORK A MEDICAL GROUP INC 12401 WASHINGTON BLVD WHITTIER CA 90602 330922631 MANAGEMENT SERVICES CA N/A C 1 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 PIH HEALTH FOUNDATION C 1184872 FMV PIH HEALTH PHYSICIANS L 11394345 FMV PIH HEALTH MANAGEMENT CORP M 1551459 FMV PART IV, COLUMN (E): PIH INSURANCE COMPANY IS AN UNINCORPORATED RISK RETENTION GROUP. PART IV, COLUMN (E): PIH HEALTH CARE SOLUTIONS IS A NONPROFIT MUTUAL BENEFIT CORPORATION.