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      <PersonNm>Colleen Duncan</PersonNm>
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        <Desc>Inpatient Care: In 2023 Oroville Hospital provided 39,419 acute and 1,378 observation days of care for 11,977 patients. There were 1,720 surgeries, 583,022 lab tests, and 31,914 medical images performed. 283 babies were delivered to the people of Oroville and the surrounding foothill communities.</Desc>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Seng Yang</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Edward R Gilbert</PersonNm>
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      <ContractorCompensationGrp>
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        <Desc>Op Leases: Right Of Use Asset</Desc>
        <BookValueAmt>24383997</BookValueAmt>
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        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>FASB ASC 740, Income Taxes,clarifies the accounting for uncertainty in income taxes recognized in the Hospitals financial statements and prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. In addition, FASB ASC 740 provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, disclosure, and transition. The Hospital presently recognizes income tax positions based on managements estimate of whether it is reasonably possible that a liability has been incurred for unrecognized income tax effects by applying FASB ASC 450, Contingencies.</ExplanationTxt>
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        <OwnWebsiteURLTxt>www.orovillehospital.com</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
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        <StrategyWebsiteURLTxt>www.orovillehospital.com</StrategyWebsiteURLTxt>
        <StrategyAttachedInd>false</StrategyAttachedInd>
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        <FPGFamilyIncmLmtFreeCarePct>200.0000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.0000</FPGFamilyIncmLmtDscntCarePct>
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        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
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        <OtherActionsTakenInd>X</OtherActionsTakenInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: Oroville Hospital - Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Oroville Hospital broadly disseminated the community needs assessment to residents throughout its primary service area. Employees of Oroville Hospital were also invited to contribute to the Community Health Needs Assessment (CHNA), and in a few instances, responses are compared and contrasted between employees and residents. For some reported findings, subgroup analysis is included concerning difference in respondent groups by demographic characteristics.The CHNA process, including the collection of primary and secondary data, provides a fresh opportunity to be forward thinking and to look at the needs of the community for the next three years and beyond. Overall, Oroville Hospital has made progress to address the health concerns and needs within the greater community. The impact of actions is tangible and reflects increased services and resources in response to unmet needs. The hospital will continue to prioritize activities within its Action Plan that correspond with this CHNA as it strives to provide the best quality patient care for anyone that walks through its doors. The health concerns identified in this CHNA for 2022 build on prior years assessments and responses. Many of the top health concerns are unchanged from 2019 due to the interruption in activities resulting from COVID19, although the Action Plan has been updated to note progress being made. Overall, since there are similar concerns between the 2019 and 2022 CHNAs, the Action Plan items proposed in 2019 continue to be needed by the community.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: Oroville Hospital - Part V, Section B, Line 16j</FormAndLineReferenceDesc>
        <ExplanationTxt>Office of Statewide Health Planning and Development Website</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: Oroville Hospital - Part V, Section B, Line 20e</FormAndLineReferenceDesc>
        <ExplanationTxt>Our hospital does not pursue collection of amounts from patients determined to qualify for charity care.</ExplanationTxt>
      </SupplementalInformationGrp>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Oroville Hospital Post Acute Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 Executive Parkway</AddressLine1Txt>
            <CityNm>Oroville</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95966</ZIPCd>
          </USAddress>
          <FacilityTxt>Skilled Nursing Facility</FacilityTxt>
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      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7 - Explanation of Costing Methodology</FormAndLineReferenceDesc>
        <ExplanationTxt>The costs were determined using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the audited financial statements. The formula used for the computation equals financial statement data as follows: Total Operating Expense less the sum of Non Patient Care Activities, Mcal Provider Taxes and Total Community Benefit &amp; Building Expense. This amount is then divided by the Gross Patient Care Charges reduced by charges for Community Benefit Programs. The ratio for 2023 equaled 31.01%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense</FormAndLineReferenceDesc>
        <ExplanationTxt>Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and the specific circumstances of the account. Ratios are determined from those actual historical collection experiences and applied to outstanding receivables. Payments on patients accounts reduce the outstanding receivables. Discounts on patients accounts are recorded as an adjustment to revenue, not bad debt expense.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3 - Methodology of Estimated Amount &amp; Rationale for Including in Community Benefit</FormAndLineReferenceDesc>
        <ExplanationTxt>It is our belief that $1,733,522 amount of bad debt should be included as community benefit. As a tax-exempt hospital we must provide necessary services regardless of the patient's ability to pay for the service provided. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit. We applied a percentage based on our historical experiences to our total amount of bad debt for self-pay patients to estimate the portion of self-pay bad debt that is likely attributable to individuals eligible for the hospital's financial assistance policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4 - Bad Debt Expense</FormAndLineReferenceDesc>
        <ExplanationTxt>Patient Accounts Receivable The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payors, patients, and others. The Hospital provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. As a service to the patient, the Hospital bills third-party payors directly and bills the patient when the patient's liablility is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. No interest is charged to patients for delinquent accounts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8 - Explanation Of Shortfall As Community Benefit</FormAndLineReferenceDesc>
        <ExplanationTxt>Medicare Cost Reports that the hospital is required to file does not include all of the costs required to treat Medicare patients. Therefore the amount reflected on the Cost report will likely differ from actual costs. The hospital's DSH payments and Uncompensated Care Payments are $4,959,343. The excess is used to subsidize charity and bad debt, and to improve patient care through programs, training, and acquired capital.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</FormAndLineReferenceDesc>
        <ExplanationTxt>Any self-pay, uninsured patient who indicates an inability to pay is screened for a charity discount. Additionally, "high cost" patients as defined are also screened for a charity discount when the patient requests such screening. Screening for discounts will occur only after all other potential resources have been exhausted. The screening process will optimally occur at the time of service but may occur anytime during the collection process including post assignment to an outside collection agency.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2 - Needs Assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>As part of the 2010 Patient Protection and Affordable Care Act, Oroville Hospital has developed an ongoing, community-based assessment that has become part of the strategic plan on a long-term, continuing basis. This 2022 Community Health Needs Assessment (CHNA) includes the communitys perspective regarding health care needs and available services. Special consideration has been taken to ensure input was received from community representatives that possess broad interests of the community served by Oroville Hospital, including those who have particular knowledge or expertise in public healthPoor health status can result from a variety of factors including: genetic, environmental, behavioral, and socioeconomic. The best way to address this is by identifying the causes of these diseases, conditions and challenges and developing interventions in order to decrease the incidence or prevalence of these conditions. Oroville Hospital is working to better identify, strategize and implement action plans regarding these issues. Primary Data was collected from the following sources and methods:Two versions of the 2022 Community Health Needs Survey were developed using the framework of the 2013, 2016 and 2019 Community Health Needs Surveys. The first version was targeted to residents of Oroville Hospitals Primary Medical Service Area, and the second version was targeted to employees of Oroville Hospital. Adjustments were made to the previous Community Health Needs Surveys to ensure the content and feedback that we received was applicable to current times.Three focus groups were conducted throughout the Oroville community, targeting the medically underserved, low-income and minority populations.In addition to the focus groups that of which targeted a specific population, Oroville Hospital also hosted a Community Meeting that was open to the general public to collect input from the community. Invitations were sent out to all residents living within Oroville Hospitals primary medical service area.The purpose of the focus groups and meeting was to seek out and utilize the input of groups that represent medically underserved, low-income and minority populations. Input that was received was used to help identify and prioritize the health needs facing our community, resources available or new resources that could help mitigate these needs and how past action plans provided by Oroville Hospital have assisted the community in addressing the identified health needs.Questionnaires were sent to community leaders to obtain their vision was for the community, and how Oroville Hospital can assist in achieving that vision and how our past action plans have been received. Respondents included members of Butte County Public Health, the University of California Agriculture and Natural Resources and Prestige Assisted Living at Oroville.Secondary data was retrieved and compiled from local, state, national and other data resources. The sources include: United States Census Bureau Center for Disease and Prevention (CDC) United States Department of Health and Human Services United States Department of Agriculture (USDA) Substance Abuse and Mental Health Services Administration (SAMHSA) World Health Organization National Coalition for the Homeless Healthy People 2020 UCLA Center for Health Policy Research California Department of Public Health California Center for Public Health Advocacy Butte County Department of Public Health Butte County Coroners Office Butte County-wide Homeless Continuum of Care Butte County Health RankingsIdentified Primary Health Concerns of the CommunityPrimary and secondary data collection and analysis identified the follow as the most significant health needs for residents of the Oroville Hospital primary medical service area:*Heart Health*Mental Health Services*Substance Abuse*Affordable Health Care*Obesity*PovertyHospital Action Plans:The health concerns identified in the 2019 CHNA have been adapted and added to meet the needs of the 2022 health concerns. After identifying the communitys top health concerns, Oroville Hospital has new and existing action plans in place. Since there are many similar prioritized health concerns between the previous and current Community Health Needs Assessments, many of the Action Plan items have either remained the same since the services are still needed in the community.Oroville Hospital strategized with Public Health and the other hospitals within the county to determine the best way to reassess the health need of the community for 2022. Covid-19 and the Camp Fire Disaster drastically changed the population and health needs of the county. Oroville Hospital is and will continue to evaluate the effects of these disasters and will continue to work with its recent Health Needs Assessment. We anticipate our action plan will be flexible to meet ongoing community health needs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3 - Patient Education of Eligibility for Assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>Oroville Hospital's Financial Assistance Policy is available on the hospital's website, and signs are posted in the business office, the admitting and registration areas and the emergency department informing patients about our financial assistance policies and the availability of charity discounts. The plain language summary includes instructions on how an individual can obtain a copy of the Financial Assistance Policy and FAP Application by mail.Additionally, patient statements include standard language informing patients that they may request financial screening to determine eligibility for charity discounts and how that request may be made. All statements sent to patients contain a plain language summary of the patient's rights pursuant to AB 774 and the Rosenthal Fair Debt Collection Practices Act. Once a charity determination has been made, the outcome is communicated to the patient by a letter and/or phone call and is documented in the patient's account notes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4 - Community Information</FormAndLineReferenceDesc>
        <ExplanationTxt>Oroville Hospital is in a rural setting, predominately agricultural based and located in Butte County. Butte County encompasses 1636.46 square miles. The highest point is Humboldt Peak (7,870 feet) and the lowest point is 90 feet above sea level. The primary medical service area population for Oroville Hospital is approximately 85,103. which is comprised of approximately 62.6% Caucasian, 17.3% Hispanic, 6.5% Asian and 1.6% African American, 1.5% Native American. Approximately 43% of the population is 55 years of age or older. The total population of the secondary medical service area is 417,818. 37% of the residents in the primary medical service area live on an annual income of less than $30,000 per year. 15% of the hospital's revenue was derived from Medi-Cal. The hospital's primary medical service area includes Bangor, Berry Creek, Biggs, Gridley, Oroville, and Palermo. There is one other hospital, Orchard Hospital in Gridley, serving the community. Rural, isolated adults, seniors (many living alone) and families and special populations who are at risk for poor health outcomes and behavior are the targeted populations for the Community Benefit Plan. The challenges involved in meeting the ongoing needs of a rural population are many. The majority of adults do not identify with a particular faith community. Many adults and seniors lack a social support system and have limited knowledge on how to effectively access healthcare services and resources. Frequent visits to emergency services and ongoing chronic health conditions are common among the rural adult population.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4 - Community Building Activities</FormAndLineReferenceDesc>
        <ExplanationTxt>While Oroville Hospital provides vital health care services to a ruralcommunity, it is also the second largest employer in Oroville, offeringmany economic benefits to the area. As a large organization, the hospital employed 2,646 individuals in various service areas for a total of 2,988,000 hours worked during 2023. This results in a workforce that stimulates the local economy by spending a portion of its income in Oroville and the surrounding areas. Being located in a rural area, it is essential to have organizations that employ many people in order to drive economic growth in industries such as real estate, energy and social services. Oroville Hospital is proud to be a mainstay in this community that draws skilled individuals from all economic and educational backgrounds to the city. By offering employment for many, skilled professionals are encouraged to settle in Oroville and nearby towns and cities. In addition, Oroville Hospital strives to purchase goods and services from local suppliers whenever possible, creating ripple effects that provide additional economic value in the form of income and job creation for businesses in the community. For the multi-year hospital expansion project, the hospital has hired many local contractors and, when possible, will purchase supplies and furniture from businesses in the north state to outfit the 159,000-square-foot building. Because the hospital has the ability to provide jobs for many in order to offer quality health care, it is also an organization that presents job stability for its employees. The hospital offers full health care benefits for eligible staff members, making it a desirable employer for the citizens of Oroville and Butte County.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5 - Promotion of Community Health</FormAndLineReferenceDesc>
        <ExplanationTxt>IMPROVING ACCESSThrough the development of hospital-based community clinics, Oroville Hospital has improved and increased access to health services throughout the Oroville community. The majority of our outpatient services accept all insurance plans including the State of Californias Medi-Cal program. Our community has a disproportionate share of low/no income families. Access to health care services would be extremely difficult for this group were it not for hospital-based clinics. The State of Californias Medi-Cal program reimbursement payments to physicians are set at a rate that makes it difficult for an independent physician to accept Medi-Cal patients. As a result many health care providers throughout the state and our community have eliminated Medi-Cal patients from their roster. EXPANDING COMMUNITY MEDICAL SERVICESAccess to a wide variety of medical services is necessary when it comes to delivering comprehensive medical care to patients. As a health system providing care to a large region of the North State, Oroville Hospital has priortized the recruitment of specialty and primary care providers to deliver quality and timely health care to patients. Since primary care providers are the foundation for excellent health, Oroville Hospital's addition of six primare care medical staff and a new walk-in clinic enables patients to receive the medical attention needed to live a healthy life. The continued growth of outpatient services further illustrates the hospital's commitment to delivering comprehensive medical services, including advanced procedures and state-of-the-art technology, to patients here at home.HELPING BUTTE COUNTY AND OUR COMMUNITYOne of the biggest set-backs from the COVID-19 pandemic was job security. Oroville Hospital is proud to remain one of the largest employers in Butte County, providing nearly 2,600 individuals with a steady career that they, and their families, can rely on. Not only do hospital employees reap the benefits of Oroville Hospital, but local businesses also see a great influx of income due to the demands of having such a large establishment in town. In the future to come, Oroville Hospital plans on expanding its already plentiful employment opportunities. With the construction of the new 5-story tower, over time it is estimated that the hospital will be able to offer 700 additional community members a high quality career, with excellent benefitsA COMMITMENT TO EDUCATIONPsychiatric Residency ProgramMental health services have been identified as a need to the Oroville and surrounding communities, due to the lack of available providers and services available. Oroville Hospital recognizes the significance of having accessible mental health services available and has continued to proactively work towards a solution.In June of 2023, Oroville Hospital announced its accreditation as a sponsoring institution by the American Council of Graduate Medical Education and underwent its first site visit in December 2023. Oroville Hospital Psychiatry Residency program is scheduled to launch July 2025 with 6 PGY-1 residents, and 6 new residents added per year for a total of 24 residents by 2027.With the residency program, this means physicians will be able to complete their residency program here locally, where they can then build their practice and bring the much needed services and programs to Butte County and the surrounding communities. This ensures that our community will continue to receive top-quality health care for years to come.Certified Nurse Assistant ProgramCertified Nurse Assistants (CNAs) play a crucial role in the care that patients receive. In order to ensure adequate and consistent staffing, Oroville Hospital offers a paid program that helps make it easier to transition to a career in health care.COMMUNITY EDUCATIONOroville Hospital believes that as an evolving community, we should all be Growing Healthy Together. That is why the hospital has put together a series of videos in hopes of motivating our community members to stay healthy and active. These videos showcase some of Oroville Hospitals very own providers, and their contributions in helping the community grow healthy together. These videos also bring awareness, teach preventative measures, and offer information about services that are available at Oroville Hospital that patients may not have known about before.Cardiologists recommend that children should get at least 60 minutes of moderately intense physical activity per day, and adults at least 150 minutes of exercise per week. That is why Oroville Hospital has also compiled a list of recreational videos to show the people of Butte County the many fun, family friendly things there are to do here in our very own community that can help you stay active. Even with COVID-19, it is still extremely important to keep moving, even if outside, not only for your physical health, but for your mental health as well.New Hospital Expansion Oroville Hospital has plans underway for a new five-story medical tower located adjacent to the existing hospital. Upgrades will also be made to the emergency services, dietary and pharmacy departments. Expanded services are ambulatory care, labor and delivery, intensive care unit and medical surgical floors. In addition, a new parking lot will provide ample parking for guests and patients. The tower will have state-of-the-art equipment, private patient rooms and will connect with the original facility via enclosed passageways on the first and second floors. The total investment for the entire project will cost in excess of $200 million. ADDITIONAL SERVICESDue to the COVID-19 pandemic, patients have been required to cook most of their meals exclusively at home. For those who were not used to this lifestyle, it was challenging to abruptly have to learn how to prepare healthy and nutritious meals independently on an ongoing basis. Luckily, Oroville Hospitals Registered Dieticians were ready to teach patients healthy habits and tricks to ensure they were receiving all of the right nutrients, whether they were accommodating for a specific medical condition, or just wished to be generally healthier. Due to mandated COVID-19 precautions, all counseling sessions were safely conducted virtually over video and audio calls.Oroville Hospital pediatric providers are proud to continue to supply their patients with a free, age appropriate book to take home with them at the end of each well-child visit. By introducing and encouraging reading at a young age, a childs brain is better equipped to develop properly and expand their vocabulary comprehension. In addition to free books, bookmarks are also given to children. These bookmarks not only help the child mark their place in the book, it also gives parents helpful examples of activities they can do with their children that encourage talking, reading, and singing. Oroville Hospital remains dedicated to improving reading competency in children, and will continue to develop this program</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7 - States Filing of Community Benefit Report</FormAndLineReferenceDesc>
        <ExplanationTxt>CA</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI - Additional Information</FormAndLineReferenceDesc>
        <ExplanationTxt>Part II, Ln 8: Oroville Hospital recruits physicians and other healthcare professionals needed in our traditionally underserved community, the cost of which was $380,034 in this tax year. In order to promote the health of the community we serve, Oroville Hospital participates in extensive community building activities which are not included elsewhere on Schedule H.</ExplanationTxt>
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        <ExplanationTxt>OTHER PROGRAM SERVICES 4: Oroville Hospital also provides a variety of outpatient Medical Imaging services, including a Women's Imaging Center and a Radiation Oncology Center. It has Outreach Laboratory Services, Home Health Services, Ambulatory Services, and Outpatient Surgery. Oroville Hospital had 188,707 outpatient visits and performed 2,681 outpatient surgeries in 2023. OTHER PROGRAM SERVICES 5: Oroville Hospital Post-Acute Center: In 2023 Oroville Hospital provided 41,066 post-acute days of care for 865 patients.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO compensation is established after reviewing market studies and comparable hospitals. A compensation committee made up of members of the Board of Trustees reviews the data and establishes the salary. Other officers and key employees salaries are established after reviewing market studies and comparable hospitals, with the CEO and COO making any final decisions.</ExplanationTxt>
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