2024-11-15T17:05:44-06:00 2023-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2023-01-01 941201197 DAMERON HOSPITAL ASSOCIATION DAME 2099445550 525 WEST ACACIA STREET STOCKTON CA 95203 KATIE DELMORE CFO 2099445550 2024-11-15 1 1 TRACY S PAGLIA P00366884 2099556100 2024-11-15 2023 2024-10-15 13:58:12Z DANIEL LONG 525 WEST ACACIA STREET STOCKTON CA 95203 156446442 0 X WWW.DAMERONHOSPITAL.ORG X 1912 CA WE SUPPORT PHYSICIANS AND OUR EMPLOYEES IN PROVIDING QUALITY CARE IN A SAFE, CARING ENVIRONMENT. 5 5 705 8 -1723 34284 0 7844 136984238 154749622 -1015 2262 -409509 -868116 136573714 153891612 0 0 0 0 53547538 53542481 0 0 0 123978562 136507940 177526100 190050421 -40952386 -36158809 78718215 72433970 80455279 108684189 -1737064 -36250219 X WE SUPPORT PHYSICIANS AND OUR EMPLOYEES IN PROVIDING QUALITY CARE IN A SAFE, CARING ENVIRONMENT. 0 0 159693844 0 153363919 DAMERON HOSPITAL IS A FULLY ACCREDITED, 200+ BED COMMUNITY HOSPITAL PROVIDING ACUTE AND TERTIARY LEVEL CARE TO SAN JOAQUIN COUNTY RESIDENTS. NOW MANAGED BY ADVENTIST HEALTH, OUR HOSPITAL REMAINS COMMITTED TO PROVIDING THE HIGH QUALITY CARE THAT HAS EARNED VARIOUS STATE AND NATIONAL RECOGNITIONS, AS WELL AS NUMEROUS AWARDS AND ACCOLADES. THE HOSPITAL HAS ALSO BEEN DESIGNATED BY BLUE SHIELD OF CALIFORNIA AS A BLUE DISTINCTION CENTER FOR BARIATRIC SURGERY AND FOR KNEE AND HIP REPLACEMENTS AS PART OF THE BLUE DISTINCTION CENTERS FOR SPECIALTY CARE PROGRAM. IN ADDITION TO BEING A TOP-RATED JOINT REPLACEMENT CENTER IN THE STOCKTON AREA, AND THE COUNTY'S LEADING ORTHOPEDIC HOSPITAL, DAMERON HAS ALSO BEEN RECOGNIZED AS A TOP PERFORMER FOR ITS QUALITY METRICS BY THE JOINT COMMISSION.THE SAN JOAQUIN COUNTY EMERGENCY MEDICAL SERVICES AGENCY HAS ALSO NAMED DAMERON AS A DESIGNATED STEMI (HEART ATTACK) RECEIVING CENTER AND CERTIFIED STROKE CENTER. THANKS TO DAMERON'S LIFELINE TECHNOLOGY AND CARDIAC-PREPARED ER STAFF, EMERGENCY RESPONDERS HAVE A LOCAL CARE PARTNER THAT IS ALSO A CERTIFIED CARDIAC CARE HOSPITAL AND A CARDIOTHORACIC SURGERY CENTER WITH AN ACTIVE CARDIAC CATHETERIZATION LAB. DAMERON HOSPITAL CONTINUES ITS LEADING-EDGE TRADITION, AND WE ARE CONTINUALLY ENHANCING OUR FACILITIES AND SERVICES TO HELP FULFILL OUR MISSION OF DELIVERING TOP-QUALITY CARE TO THE COMMUNITY. DAMERON SERVICES INCLUDE CARDIOLOGY AND CARDIAC SURGERY, ORTHOPEDICS, BARIATRIC SURGERY, AS WELL AS GENERAL ACUTE CARE, EMERGENCY, AND INTENSIVE CARE SERVICES. DAMERON ALSO PROVIDES PHYSICAL THERAPY AND OCCUPATIONAL HEALTH SERVICES AT OUR MARCH LANE FACILITY. 159693844 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 112 0 1 705 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 CA X KATIE DELMORE 2099445550 525 WEST ACACIA STREET STOCKTON CA 95203 MARIA VILLARREAL REGISTERED NURSE 40.00 0.00 X 296948 0 27259 MEMBER AKUVA REGISTERED NURSE 40.00 0.00 X 234842 0 26385 TAMMY A SWANSON REGISTERED NURSE 40.00 0.00 X 219033 0 37239 GARY BROWN REGISTERED NURSE 40.00 0.00 X 229178 0 25147 CHRIS PETERSON CARDIAC CATH SUPERVISOR 40.00 0.00 X 211639 0 24866 TARANDEEP ARORA CHIEF OF STAFF 40.00 0.00 X 23920 0 0 WILLIAM TREZZA CHAIRMAN OF THE BOARD 10.00 0.00 X X 0 0 0 DANIEL DIXON VICE CHAIRMAN/SECRETARY 10.00 0.00 X X 0 0 0 MICHAEL HAKEEM BOARD MEMBER 10.00 0.00 X 0 0 0 KATHY LAGORIO-JANSSEN BOARD MEMBER 10.00 0.00 X 0 0 0 HON RONALD NORTHUP BOARD MEMBER 10.00 0.00 X 0 0 0 TERESA DAY CEO 40.00 0.00 X 0 0 0 KATIE DELMORE CFO 40.00 0.00 X 0 0 0 ERIC CORNWELL CMO (THRU 03/23) 40.00 0.00 X 0 0 0 DATTA GAURAV - ASSOC MEDICAL OFFICER/INTERIM CMO (AS OF 03/23) 40.00 0.00 X 0 0 0 TIMOTHY KARAGOUNIS CHIEF OPERATIONS OFFICER 40.00 0.00 X 0 0 0 DONOVAN STEWART CHIEF NURSING OFFICER 40.00 0.00 X 0 0 0 1215560 0 140896 152 0 1 1 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 60673 I.T. MANAGEMENT 4595197 CEP AMERICA ANESTHESIA PC 2100 POWELL STREET SUITE 400 EMERYVILLE CA 94608 ANESTHESIA 4220442 THOMAS MGMT 700 E FRANKLIN ROAD MERIDIAN ID 83642 FOOD SERVICE MANAGEMENT 2540895 SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 90074 PHYSICIANS 1842998 PT SOLUTIONS PO BOX 742557 ATLANTA GA 31139 P.T. MANAGEMENT 1560815 32 7844 7844 PATIENT SERVICE REV. 621110 99158596 99158596 MEDICAL/MEDICARE PYMTS 621110 35634282 35634282 HOSPITAL FEE 621110 12781698 12781698 CAFETERIA 722514 461362 461362 REBATES/REFUNDS 621110 15664 15664 6698020 6698020 154749622 2262 2262 1604482 2554830 -950348 -908677 -41671 OTHER INCOME 900099 42284 42284 INCOME FROM K-1 541900 39948 39948 82232 153891612 153363919 -1723 521572 X 23920 23920 38410182 34929415 3480767 859169 781843 77326 10885051 9826029 1059022 3364159 3043707 320452 2644939 1365049 1279890 743972 743972 342495 342495 43404233 34846265 8557968 27326321 27142412 183909 10017091 467392 9549699 2987932 2548113 439819 13565 12806 759 30749 29415 1334 2818301 2818301 4145981 4145981 1259786 1259786 BAD DEBT PROVISION 33375559 33375559 MEDI-CAL HOSPITAL FEE E 5813107 5813107 DUES & SUBSCRIPTIONS 223296 6138 217158 1360613 1360613 190050421 159693844 30356577 0 3000 3159 9843 0 9821662 8575137 4112938 3495418 2324653 794707 222307565 181091278 44957771 41216287 395890 395890 17092458 17953372 78718215 72433970 68784864 99464663 1786219 0 9884196 9219526 80455279 108684189 X -1744908 -36258063 7844 7844 -1737064 -36250219 78718215 72433970 -36158809 1645654 0 X 0 0 0 X 5182186 5182186 99494196 70746805 28747391 1560764 1513003 47761 106217757 101904367 4313390 9852662 6927103 2925559 41216287 COST REPORT SETTLEMENT RECEIVABLE 12554471 DUE FROM MEDICAL GROUP 4023272 ROU ASSETS 1375629 17953372 RISK MANAGEMENT PROGRAMS 3884146 RETIREE MEDICAL LIABILITY 2850584 ROU LEASE LIABILITY 1422357 OTHER NONCURRENT LIABILITIES 1062439 9219526 1 1 1 X 350.000000000000 1 X 150.000000000000 1 1 0 1 1 869743 869743 0.00560 43441619 33005931 10435688 0.06660 44311362 33005931 11305431 0.07220 44311362 33005931 11305431 0.07220 1 33375560 3337556 20685853 35634282 -14948429 X 1 1 1 1 DAMERON HOSPITAL ASSOCIATION 525 WEST ACACIA STREET STOCKTON CA 95203 WWW.DAMERONHOSPITAL.ORG 030000024 X X X DAMERON HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 22 1 1 0 1 X SEE SCH H PART VI - NEEDS ASSESSMENT X SEE SCH H PART VI - NEEDS ASSESSMENT 1 22 1 SEE SCH H PART VI - NEEDS ASSESSMENT 0 1 X 350.000000000000 150.000000000000 X 1 1 X X X X 1 X SCH H PART VI-PATIENT EDUC X SCH H PART VI-PATIENT EDUC X X X X 1 X 0 X X X X X 1 X 0 0 DAMERON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: A. IDENTITY OF PARTNER ORGANIZATIONS THAT COLLABORATED ON THE ASSESSMENTTHE SAN JOAQUIN COUNTY 2022 CHNA WAS AN EFFORT OF THE HEALTHIER SAN JOAQUIN COLLABORATIVE THAT INCLUDED SAN JOAQUIN PUBLIC HEALTH SERVICES, SAN JOAQUIN'S NONPROFIT HOSPITALS, AS WELL AS MANY PARTNER ORGANIZATIONS AND INDIVIDUALS THROUGHOUT THE COMMUNITY. THE CHNA WAS LED BY A CORE TEAM THAT WAS RESPONSIBLE FOR PLANNING AND KEY DECISION-MAKING, INCLUDING PROVIDING INPUT FOR DEVELOPING DATA COLLECTION INSTRUMENTS, WORKING ALONGSIDE AD LUCEM CONSULTING TO COLLECT AND ANALYZE DATA, AND REVIEWING AND COMMENTING ON THE REPORT. THE BROADLY REPRESENTATIVE CHNA STEERING COMMITTEE SUPPORTED THE PROCESS BY COLLECTING PRIMARY DATA AND PARTICIPATING IN DATA REVIEW AND HEALTH NEEDS PRIORITIZATION.I. CORE TEAM MEMBERS INCLUDED: ADVENTIST HEALTH (LODI MEMORIAL AND DAMERON HOSPITALS), COMMUNITY FOUNDATION OF SAN JOAQUIN, COMMUNITY MEDICAL CENTERS, DIGNITY HEALTH, ST. JOSEPH'S MEDICAL CENTER, BEHAVIORAL HEALTH CENTER, FIRST 5 SAN JOAQUIN, HEALTH NET, HEALTH PLAN OF SAN JOAQUIN, KAISER PERMANENTE, SAN JOAQUIN COUNTY CLINICS/SAN JOAQUIN GENERAL HOSPITAL, SAN JOAQUIN COUNTY OFFICE OF EDUCATION, SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES, SUTTER HEALTH VALLEY AREA, AND UNIVERSITY OF THE PACIFIC. II. STEERING COMMITTEE MEMBERS INCLUDED: 211 SAN JOAQUIN, ADVENTIST HEALTH, LODI MEMORIAL, DAMERON HOSPITALS, AMELIA ADAMS WHOLE LIFE CENTER, ASIAN PACIFIC SELF-DEVELOPMENT AND RESIDENTIAL ASSOCIATION (APSARA), BOYS AND GIRLS CLUB, CATHOLIC CHARITIES STOCKTON DIOCESE, CHILD ABUSE PREVENTION COUNCIL, CITY OF STOCKTON (OFFICE OF THE MAYOR, OFFICE OF VIOLENCE PREVENTION), COMMUNITY FOUNDATION OF SAN JOAQUIN, COMMUNITY MEDICAL CENTERS, DATA CO-OP (INTERIM DIRECTOR), DELTA HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES (REGION 9), DIGNITY HEALTH, ST. JOSEPH'S MEDICAL CENTER, BEHAVIORAL HEALTH CENTER, EL CONCILIO, EMERGENCY FOOD BANK, FAITH IN THE VALLEY, FIRST 5 SAN JOAQUIN, HEALTH FORCE PARTNERS, HEALTH NET, HEALTH PLAN OF SAN JOAQUIN, HISPANIC CHAMBER OF COMMERCE, KAISER PERMANENTE, LITTLE MANILA RISING, LOVE INC. MANTECA, MARY MAGDALENE COMMUNITY SERVICES PUBLIC HEALTH ADVOCATES, REINVENT SOUTH STOCKTON COALITION, SAN JOAQUIN PRIDE CENTER, SIERRA VISTA HOMES (RESIDENT'S COUNCIL), SJC BEHAVIORAL HEALTH SERVICES, SJC CHILDREN'S ALLIANCE, SJC CLINICS, SJC COUNCIL OF GOVERNMENTS, SJC OFFICE OF EDUCATION (EARLY CHILDHOOD EDUCATION AND COMPREHENSIVE HEALTH PROGRAMS), SJC HEALTH CARE SERVICES AGENCY AND WHOLE PERSON CARE PROGRAM, SJC HUMAN SERVICES AGENCY: AGING AND COMMUNITY SERVICES, SJC PUBLIC HEALTH SERVICES, ST. MARY'S DINING ROOM, STOCKTONIANS TAKING ACTION TO NEUTRALIZE DRUGS (STAND), STOCKTON NAACP, SUTTER HEALTH VALLEY AREA, THIRD CITY COALITION, UNIVERSITY OF THE PACIFIC, SCHOOL OF HEALTH SCIENCES, VISIONARY HOME BUILDERS, AND WOMEN'S CENTER AND YOUTH SERVICES AGENCY.III. SAN JOAQUIN COMMUNITY RESIDENTS: THE SAN JOAQUIN COUNTY 2022 CHNA WOULD NOT HAVE BEEN POSSIBLE WITHOUT THE SUPPORT AND ENGAGEMENT OF COUNTY RESIDENTS. MANY COMMUNITY RESIDENTS VOLUNTEERED THEIR TIME AS FOCUS GROUP PARTICIPANTS TO PROVIDE THE CRITICAL PERSPECTIVES OF RESIDENTS LIVING, WORKING, AND RAISING FAMILIES IN COUNTY COMMUNITIES. OTHERS HELPED TO SUPPORT THE PROCESS BY PROVIDING FEEDBACK/VALIDATION OF THE PRELIMINARY FINDINGS. B. IDENTITY AND QUALIFICATIONS OF CONSULTANTS USED TO CONDUCT THE ASSESSMENTTHE HEALTHIER SAN JOAQUIN COLLABORATIVE CONTRACTED WITH AD LUCEM CONSULTING, A PUBLIC HEALTH CONSULTING FIRM, TO CONDUCT THE SAN JOAQUIN COUNTY CHNA. AD LUCEM CONSULTING SPECIALIZES IN INITIATIVE DESIGN, STRATEGIC PLANNING, GRANTS MANAGEMENT, AND PROGRAM EVALUATION, TAILORING METHODS AND STRATEGIES TO EACH PROJECT AND ADAPTING TO CLIENT NEEDS AND PRIORITIES, POSITIONING CLIENTS FOR SUCCESS. AD LUCEM CONSULTING WORKS IN CLOSE COLLABORATION WITH CLIENTS, SYNTHESIZING COMPLEX INFORMATION INTO EASY-TO-UNDERSTAND, USABLE FORMATS, BRINGING A HANDS-ON, DOWN-TO-EARTH APPROACH TO EACH PROJECT. AD LUCEM CONSULTING SUPPORTS CLIENTS THROUGH A VARIETY OF SERVICES THAT CAN BE APPLIED TO A RANGE OF ISSUES. AD LUCEM CONSULTING HAS DEVELOPED CHNA REPORTS AND IMPLEMENTATION STRATEGY PLANSFOR HOSPITALS INCLUDING SYNTHESIS OF SECONDARY AND PRIMARY DATA, NEEDS PRIORITIZATION, AND IDENTIFICATION OF ASSETS AND IMPLEMENTATION STRATEGIES.TO LEARN MORE ABOUT AD LUCEM CONSULTING, VISIT WWW.ADLUCEMCONSULTING.COM. DAMERON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: ADVENTIST HEALTH LODI MEMORIAL AND DAMERON HOSPITALS, DIGNITY HEALTH, ST. JOSEPH'S MEDICAL CENTER, BEHAVIORAL HEALTH CENTER, KAISER PERMANENTE, SAN JOAQUIN GENERAL HOSPITAL, AND SUTTER HEALTH VALLEY AREA. DAMERON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: THE IMPLEMENTATION PLAN WAS DEVELOPED FOLLOWING A DISTINCT THREE STEP STRATEGIC PLANNING PROCESS. FIRST, THE HEALTH NEEDS IDENTIFIED IN THE CHNA WERE PRIORITIZED BY MEMBERS OF THE SJC2HAC. SECOND, DAMERON HOSPITAL SELECTED FOUR OF THE PRIORITIZED HEALTH NEEDS AS A PRIMARY FOCUS FOR THE PURPOSES OF MEETING THE HEALTH NEEDS OF THE COMMUNITY. THOSE CHOSEN MOST CLOSELY ALIGNED WITH THE HOSPITAL'S MISSION AND ORGANIZATIONAL CAPABILITIES. THE THIRD, AND FINAL STEP WAS THE DEVELOPMENT OF AN IMPLEMENTATION PLAN.STEP 1: PRIORITIZING HEALTH NEEDSTHE SJC2HAC PRIORITIZED AND RANKED THE IDENTIFIED COMMUNITY HEALTH NEEDS. EACH HEALTH NEED WAS RANKED ALONG TWO DIMENSIONS: 1) THE SIGNIFICANCE OR SEVERITY OF THE HEALTH NEED; AND 2) THE ABILITY OF A HOSPITAL TO MAKE A NOTABLE IMPACT ON THE IDENTIFIED HEALTH NEED.STEP 2: IDENTIFY HEALTH NEEDS FOR DAMERON HOSPITAL'S 2020 FOCUSDAMERON HOSPITAL IDENTIFIED THREE PRIMARY HEALTH NEEDS, FROM THE ELEVEN, THAT ALIGNED WITH ITS MISSION AND ORGANIZATIONAL CAPABILITIES. DAMERON HOSPITAL'S MISSION IS TO SUPPORT PHYSICIANS AND OUR EMPLOYEES IN PROVIDING QUALITY PATIENT CARE IN A SAFE AND CARING ENVIRONMENT.STEP 3: STRATEGIC PLANNINGTHIS PROCESS FOLLOWED TWO KEY STEPS. FIRST, PERSONNEL IN THE HOSPITAL WERE RECRUITED TO PARTICIPATE AND DEVELOP THE IMPLEMENTATION PLAN. SECOND, DAMERON HOSPITAL LEADERSHIP EVALUATED THE IMPLEMENTATION PLAN AND ITS ALIGNMENT TO THE COMMUNITY NEEDS ASSESSMENT. THE FINAL PLAN IS DEPICTED IN STRATEGIC PLAN (PGS. 20-22 OF THE COMMUNITY BENEFIT REPORT) THIS EVALUATION AND PRIORITIZATION RESULTS WERE USED AS THE ROADMAP FOR OUR 2020 COMMUNITY BENEFIT PLAN. DAMERON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 20E: - DOCUMENTED ITS DETERMINATION OF WHETHER INDIVIDUALS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY.- NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE INDIVIDUALS REGARDING THE INDIVIDUAL'S BILLS.- NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION.- NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 33,375,560. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL IS INVOLVED IN NUMEROUS COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITY. OVERWHELMINGLY, WE SEE DISEASES OF DESPAIR INCLUDING SUICIDE, SUBSTANCE ABUSE, MENTAL HEALTH, AND CHRONIC ILLNESSES PLAGUING THE COMMUNITIES IN WHICH WE HAVE A SIGNIFICANT PRESENCE IN. THESE COMMUNITY CONCERNS ARE ADDRESSED THROUGH HEALTH IMPROVEMENT, EDUCATION, POVERTY, WORKFORCE DEVELOPMENT, AND ACCESS TO CARE. THIS IS WHY WE HAVE FOCUSED OUR WORK AROUND ADDRESSING BEHAVIOR AND THE SYSTEMS KEEPING THE MOST VULNERABLE PEOPLE IN CYCLES OF POVERTY AND HIGH UTILIZATION. IN AN EFFORT TO HEAL THESE COMMUNITIES, WE HAVE STRATEGICALLY INVESTED IN OUR COMMUNITIES BY PARTNERING WITH HEALTHFORCE PARTNERS, AMERICAN HEART ASSOCIATION, SAN JOAQUIN MEDICAL SOCIETY DECISION MEDICAL PROGRAM, SAN JOAQUIN DELTA COLLEGE AND LOCAL BUSINESSES. WE BELIEVE THE POWER OF COMMUNITY TRANSFORMATION LIES IN THE HANDS OF THE COMMUNITY. OUR SOLUTION FOR TRANSFORMATION IS TO CREATE A SUSTAINABLE MODEL OF WELL-BEING THAT MEASURABLY IMPACTS THE WELL-BEING OF PEOPLE, WELL-BEING OF PLACE, AND EQUITY. BY PARTNERING WITH VARIOUS ORGANIZATIONS, WE WILL BE ABLE TO GAIN GROUND IN SHIFTING THE BALANCE FROM HEALTHCARE - TREATING PEOPLE ONCE THEY ARE ILL - TO TRANSFORMATIVE WELL-BEING - CHANGING THE WAY COMMUNITIES LIVE, WORK, AND PLAY. WE ALSO ENCOURAGE OUR EMPLOYEES TO SERVE ON COMMUNITY COLLABORATION BOARDS, HEALTH ADVOCACY PROGRAMS, AND PHYSICAL IMPROVEMENT PROJECTS TO PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE. IN ADDITION, WE WORK WITH NEIGHBORHOOD PROGRAMS, INCLUDING SCHOOLS, WORK SITES AND SAFETY NET PROVIDERS TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE. THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. PART III, LINE 3: THE HOSPITAL PROVIDED CARE TO ALL WHO PRESENTED THEMSELVES IN OUR EMERGENCY ROOM, WITHOUT ASKING FOR PROOF OF INSURANCE. THE HOSPITAL'S UNINSURED POPULATION CONTINUES TO INCREASE. UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING THE HOSPITAL'S CHARITY CARE POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE AND DISCOUNTED PAYMENT OPTIONS. OFTEN THE INFORMATION GATHERED IN THE MEDICAID APPLICATION WILL MAKE THIS DETERMINATION "AUTOMATIC." IF ADDITIONAL INFORMATION IS REQUIRED, THE HOSPITAL ATTEMPTS TO CONTACT THE PATIENT. THOSE THAT DO NOT RESPOND WILL BE SENT TO A COLLECTION AGENCY AFTER 120 DAYS AND FOUR STATEMENTS. THE HOSPITAL ESTIMATES 10% OF BAD DEBT EXPENSE (CALCULATED AT COST) SHOULD BE CONSIDERED CHARITY CARE. THE HOSPITAL'S BAD DEBT ACCOUNTS ARE ANALYZED BY A THIRD PARTY TO DETERMINE THIS AMOUNT. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT AMOUNTS THAT REFLECT THE CONSIDERATION TO WHICH THE ORGANIZATION EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ASSOCIATION PERFORMS A MONTHLY ANALYSIS OF HISTORIC PAID CLAIMS AND IDENTIFIES PAYMENT TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE APPROPRIATE AND SUFFICIENT IMPLICIT PRICE CONCESSIONS REFLECTED IN ACCOUNTS RECEIVABLE.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ASSOCIATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES ADDITIONAL IMPLICIT PRICE CONCESSIONS, IF NECESSARY, BASED UPON HISTORICAL COLLECTION HISTORY FOR DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAD NOT YET PAID FOR REMAINING PAYOR BALANCES.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ASSOCIATION RECORDS A SIGNIFICANT IMPLICIT PRICE CONCESSION IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS HAVE BEEN UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS REFLECTED AS A REDUCTION IN ACCOUNTS RECEIVABLE. PART III, LINE 8: THE MEDICARE COST REPORT APPORTIONS THE HOSPITAL'S COSTS ON THE BASIS OF INPATIENT DAYS AND ANCILLARY AND OUTPATIENT CHARGES TO ESTABLISH THE COSTING METHODOLOGY.HEALTHCARE DELIVERY BY HOSPITALS IS A COMPLEX, HIGHLY REGULATED BUSINESS IN THE UNITED STATES. HEALTHCARE UNIT COST INFLATION IS DRIVEN BY COMPLIANCE WITH EVER EXPANDING REGULATORY REQUIREMENTS, SHORTAGES OF HIGHLY SKILLED LABOR AND INVOLVING MEDICAL AND INFORMATION TECHNOLOGY. THE HEALTH CARE "MARKET BASKET" IS UNRELATED TO THAT OF THE AVERAGE INDIVIDUAL CONSUMER.MEDICARE ANNUAL PAYMENT UPDATES HAVE FALLEN BEHIND ACTUAL HEALTHCARE COST INFLATION TO THE POINT THAT MEDICARE PAYMENTS TO MANY U.S. HOSPITALS ARE WELL BELOW THE COST OF PROVIDING CARE. THESE UNREIMBURSED COSTS ARE A COMMUNITY BENEFIT FOR SENIORS AND OTHERS IN THE COMMUNITY AS THESE INDIVIDUALS ARE CONTINUING TO RECEIVE CARE WITHOUT WHICH MANY WOULD BECOME DEPENDENT ON OTHER GOVERNMENTAL RESOURCES SUCH AS MEDICAID. THE BENEFIT TO THE COMMUNITY FOR HEALTHIER MEDICARE RECIPIENTS IS NO DIFFERENT THAN THOSE BENEFITS THE COMMUNITY REALIZES FOR UNINSURED AND UNDERINSURED PATIENTS WHO ARE ELIGIBLE FOR PARTIAL AND FULL CHARITY CARE. MEDICARE IS A SAFETY NET FOR SENIORS AND OTHERS. WITHOUT MEDICARE COVERAGE, MANY INDIVIDUALS WOULD UNDOUBTEDLY QUALIFY FOR CHARITY CARE.IN ADDITION TO THE MISMATCH BETWEEN MEDICARE PAYMENT INCREASES AND HEALTHCARE COST INFLATION, THE HIGHLY COMPLEX MEDICARE PAYMENT SYSTEMS AND FORMULAS PRODUCE DISPARATE PAYMENT LEVELS FROM ONE HOSPITAL TO ANOTHER FOR THE SAME SERVICE. THESE DISPARATE PAYMENT LEVELS CREATE DISPARATE RESULTS WITHIN GROUPS OF HOSPITALS. FOR FURTHER INFORMATION, PLEASE REFER TO SCHEDULE H, PART III, SECTION B. PART III, LINE 9B: WHEN A PATIENT HAS REQUESTED SCREENING FOR CHARITY CARE, THE HOSPITAL MUST IMMEDIATELY CEASE COLLECTION ACTIVITY AND PLACE THE ACCOUNT IN A CHARITY PENDING STATUS. IF 100% CHARITY IS APPROVED, THE ENTIRE ACCOUNT BALANCE ISWRITTEN OFF TO CHARITY CARE. IF THE PATIENT HAS A SLIDING SCALE LIABILITY BASED ON THE FEDERAL POVERTY GUIDELINES, THEY ARE BILLED ONLY FOR THAT LIABILITY. IF THE PATIENT FAILS TO PAY THEIR AFTER-CHARITY LIABILITY, THEY ARE ASSIGNED TO A COLLECTION AGENCY WITH AN IDENTIFIER THAT INDICATES TO THE AGENCY THAT THE PATIENT IS "LOW INCOME AND THE FOLLOWING CRITERIA MUST BE FOLLOWED BY THE AGENCY:1. THEY MAY NOT REPORT THE PATIENT TO A CREDIT BUREAU2. THEY MAY NOT FILE A LAWSUIT TO RECOVER THE OUTSTANDING LIABILITY3. THEY MAY NOT CHARGE INTEREST PART VI, LINE 2: THE HOSPITAL'S 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE 2023 COMMUNITY HEALTH IMPLEMENTATION STRATEGY (CHIS) APPROVED IN FISCAL YEAR 2023, AND THE 2022 COMMUNITY HEALTH PLAN (CHP) UPDATED FOR FISCAL YEAR 2022 ARE POSTED ON THE HOSPITAL'S WEBSITE AT:WWW.DAMERONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/THE CHNA INCLUDES BOTH THE ACTIVITY AND PRODUCT OF IDENTIFYING AND PRIORITIZING A COMMUNITY'S HEALTH NEEDS, ACCOMPLISHED THROUGH THE COLLECTION AND DEVELOPMENT OF A COMMUNITY HEALTH PLAN. THE SECOND COMPONENT OF THE CHNA, THE COMMUNITY HEALTH PLAN, INCLUDES STRATEGIES AND PLANS TO ADDRESS PRIORITIZED NEEDS, WITH THE GOAL OF CONTRIBUTING TO IMPROVEMENTS IN THE COMMUNITY'S HEALTH. QUALITATIVE AND QUANTITATIVE DATA SOURCES WERE USED IN CONDUCTING THE CHNA. TO ACCOMPLISH THE MANY IMPORTANT SYSTEMIC GOALS THAT ARE UNDERWAY IN OUR COMMUNITY, OUR HOSPITAL SUPPORT LOCAL PARTNERS TO AUGMENT OUR OWN EFFORTS, AND TO PROMOTE A HEALTHIER COMMUNITY. PARTNERSHIP IS NOT USED AS A LEGAL TERM, BUT A DESCRIPTION OF THE RELATIONSHIPS OF CONNECTIVITY THAT ARE NECESSARY TO COLLECTIVELY IMPROVE THE HEALTH OF THE REGIONS WE SERVE. ONE OF OUR OBJECTIVES IS TO PARTNER WITH OTHER NONPROFIT AND FAITH-BASED ORGANIZATIONS THAT SHARE OUR VALUES AND PRIORITIES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITY WE SERVE. THIS IS AN INTENTIONAL EFFORT TO AVOID DUPLICATION AND LEVERAGE THE SUCCESSFUL WORK ALREADY IN EXISTENCE IN THE COMMUNITY. PART VI, LINE 3: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (FAP) IS POSTED ALONG WITH THE COMPLETE FAP POLICY AND FAP APPLICATION ON THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.DAMERONHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE/THESE DOCUMENTS ARE AVAILABLE IN MULTIPLE LANGUAGES.AT THE TIME OF REGISTRATION, PATIENTS WHO ARE UNINSURED AND UNDERINSURED ARE PROVIDED INFORMATION ABOUT GOVERNMENT HEALTHCARE PROGRAMS. PATIENTS ARE ALSO ORALLY INFORMED OF THEIR RIGHT TO REQUEST CHARITY ASSISTANCE. SIGNS ARE DISPLAYED IN THE PATIENT BUSINESS OFFICE, PATIENT REGISTRATION AREAS, AND THE EMERGENCY ROOM IN MULTIPLE LANGUAGES INFORMING PATIENTS OF THIS RIGHT AS WELL. THE HOSPITAL ALSO PROVIDES A BROCHURE DURING THE REGISTRATION PROCESS THAT EXPLAINS THE HOSPITAL BILLING AND COLLECTION PROCEDURES, AND HOW TO REQUEST FINANCIAL ASSISTANCE. IN ADDITION, EVERY BILLING STATEMENT SENT TO PATIENTS CONTAINS INFORMATION ON HOW TO REQUEST FINANCIAL ASSISTANCE. PART VI, LINE 4: SAN JOAQUIN COUNTY, IN THE CENTRAL VALLEY OF CALIFORNIA, IS ROUGHLY 60 MILES EAST OF SAN FRANCISCO AND 35 MILES SOUTH OF SACRAMENTO, WITH A TOTAL POPULATION OF 742,603 (2019). HISTORICALLY, AGRICULTURE HAS BEEN A STRONG DRIVER OF OUR ECONOMY AND MANY MIGRANTS AND IMMIGRANTS HAVE SETTLED HERE TO WORK IN THE FIELDS AND HELP WITH AGRICULTURAL PROCESSING OR SHIPPING. THE COUNTY IS MOSTLY RURAL, WITH ONE LARGE URBAN CORE (STOCKTON) AND SEVENSMALLER CITIES, AS WELL AS MANY RANCHING AND FARMING COMMUNITIES SCATTERED ACROSS THE COUNTY.SAN JOAQUIN COUNTY IS HOME TO A HIGH CONCENTRATION OF RESIDENTS AT ELEVATED RISK FOR COVID-19 AND WHO HAVE EXPERIENCED ENORMOUS IMPACTS FROM THE PANDEMIC. A QUARTER OF RESIDENTS ARE FOREIGN-BORN. OVERALL, 14.5% OF RESIDENTS LIVE IN POVERTY. RESIDENTS AGED 65 YEARS AND OLDER HAVE A POVERTY RATE OF 9.9%. THE EDUCATIONAL ATTAINMENT OF SAN JOAQUIN COUNTY RESIDENTS IS MUCH LOWER THAN CALIFORNIA RESIDENTS. ONLY 18.8% OF COUNTYRESIDENTS AGED 25 AND OLDER HAVE A BACHELOR'S DEGREE OR HIGHER, COMPARED TO 33.9% OF CALIFORNIANS AGED 25 AND OLDER THAT HAVE A BACHELOR'S DEGREE OR HIGHER. MANY RESIDENTS OF SAN JOAQUIN COUNTY SPEAK LANGUAGES OTHER THAN ENGLISH AT HOME. OVER ONE QUARTER OF SAN JOAQUIN COUNTY RESIDENTS COMMUNICATE AT HOME IN SPANISH, WHICH IS LESS THAN THE OVERALL RATE FOR CALIFORNIA, AND FEWER COUNTY RESIDENTS SPEAK CHINESE LANGUAGES THANCALIFORNIA AS A WHOLE. A HIGHER PERCENTAGE OF COUNTY RESIDENTS SPEAK TAGALOG, PUNJABI, AND KHMER AS COMPARED TO CALIFORNIA OVERALL. SAN JOAQUIN COUNTY HAD HIGHER (RISK ADJUSTED) RATES OF ADULT HOSPITALIZATION FOR HEART FAILURE, COPD/ASTHMA (AGES 40+), ASTHMA (AGES 18-39) AND HYPERTENSION IN 2020 THAN CALIFORNIA OVERALL. MANY OF THESE HOSPITALIZATIONS COULD POTENTIALLY BE AVOIDABLE THROUGH ACCESS TO HIGH QUALITY OUTPATIENT CARE.IN SAN JOAQUIN COUNTY, THE TOP FIVE CAUSES OF DEATH ARE HEART DISEASE, CANCER, COVID-19, STROKE, AND LUNG DISEASE. ACCORDING TO 2021 COUNTY HEALTH PROFILES, OUT OF 58 COUNTIES, SJC HAD THE 14TH HIGHEST DEATH RATE FROM DIABETES, 26TH HIGHEST CORONARY HEART DISEASE DEATH RATE, AND THE 5TH HIGHEST STROKE DEATH RATE IN THE STATE. THE TOP FIVE CAUSES OF DEATH DIFFER BY RACE/ETHNICITY. HEART DISEASE AND CANCER ARE AMONG THE TOP FIVE CAUSES OF DEATH FOR ALL RACIAL/ETHNIC GROUPS; DIABETES IS AMONG THE TOP FIVE CAUSES OF DEATH FOR ASIAN AND NATIVE HAWAIIAN/PACIFIC ISLANDER RESIDENTS, AND UNINTENTIONAL INJURIES APPEARS IN THE TOP FIVE CAUSES OF DEATH FOR BLACK/AFRICAN AMERICAN, LATINX (HISPANIC), NATIVE HAWAIIAN/PACIFIC ISLANDER AND MULTIETHNIC RESIDENTS. COVID-19 WAS THE NUMBER ONE CAUSE OF DEATH FOR ASIAN AND LATINX (HISPANIC) RESIDENTS. PART VI, LINE 5: WE INCORPORATED OUR COMMUNITY BENEFIT WORK TO BE AN INTEGRAL COMPONENT OF IMPROVING THE "TRIPLE AIM." THE "TRIPLE AIM" CONCEPT BROADLY KNOWN AND ACCEPTED WITHIN HEALTH CARE INCLUDES:1. IMPROVE THE EXPERIENCE OF CARE FOR OUR RESIDENTS.2. IMPROVE THE HEALTH OF POPULATIONS.3. REDUCE THE PER CAPITA COSTS OF HEALTH CARE.OUR STRATEGIC INVESTMENTS IN OUR COMMUNITY ARE FOCUSED ON A MORE PLANNED, PROACTIVE APPROACH TO COMMUNITY HEALTH. THE BASIC ISSUE OF GOOD STEWARDSHIP IS MAKING OPTIMAL USE OF LIMITED CHARITABLE FUNDS. DEFAULTING TO CHARITY CARE IN OUR EMERGENCY ROOMS FOR THE MOST VULNERABLE IS NOT CONSISTENT WITH OUR MISSION. AN UPSTREAM AND MORE PROACTIVE AND STRATEGIC ALLOCATION OF RESOURCES ENABLES US TO HELP LOW INCOME POPULATIONS AVOIDPREVENTABLE PAIN AND SUFFERING, IN TURN ALLOWING THE REALLOCATION OF FUNDS TO SERVE AN INCREASING NUMBER OF PEOPLE EXPERIENCING HEALTH DISPARITIES.HOSPITALS AND HEALTH SYSTEMS ARE FACING CONTINUOUS CHALLENGES DURING THIS HISTORIC SHIFT IN OUR HEALTH SYSTEM. GIVEN TODAY'S STATE OF HEALTH, WHERE COST AND HEARTACHE ARE SOARING, NOW MORE THAN EVER, WE BELIEVE WE CAN DO SOMETHING TO CHANGE THIS. THESE CHALLENGES INCLUDE A PARADIGM SHIFT IN HOW HOSPITALS AND HEALTH SYSTEMS ARE POSITIONING THEMSELVES AND THEIR STRATEGIES FOR SUCCESS IN A NEW PAYMENT ENVIRONMENT. THIS WILL IMPACT EVERYONE IN A COMMUNITY AND WILL REQUIRE SHARED RESPONSIBILITY AMONG ALL STAKEHOLDERS.AS HOSPITALS MOVE TOWARD POPULATION HEALTH MANAGEMENT, COMMUNITY HEALTH INTERVENTIONS ARE A KEY ELEMENT IN ACHIEVING THE OVERALL GOALS OF REDUCING THE OVERALL COST OF HEALTH CARE, IMPROVING THE HEALTH OF THE POPULATION, AND IMPROVING ACCESS TO AFFORDABLE HEALTH SERVICES FOR THE COMMUNITY BOTH IN OUTPATIENT AND COMMUNITY SETTINGS. THE KEY FACTOR IN IMPROVING QUALITY AND EFFICIENCY OF THE CARE HOSPITALS PROVIDE IS TO INCLUDE THE LARGER COMMUNITY THEY SERVE AS A PART OF THEIR OVERALL STRATEGY.POPULATION HEALTH IS NOT JUST THE OVERALL HEALTH OF A POPULATION, BUT ALSO INCLUDES THE DISTRIBUTION OF HEALTH. OVERALL HEALTH COULD BE QUITE HIGH IF THE MAJORITY OF THE POPULATION IS RELATIVELY HEALTHY EVEN THOUGH AMINORITY OF THE POPULATION IS MUCH LESS HEALTHY. IDEALLY SUCH DIFFERENCES WOULD BE ELIMINATED OR AT LEAST SUBSTANTIALLY REDUCED.COMMUNITY HEALTH CAN SERVE AS A STRATEGIC PLATFORM TO IMPROVE THE HEALTH OUTCOMES OF A DEFINED GROUP OF PEOPLE, CONCENTRATING ON THREE CORRELATED STAGES:1. THE DISTRIBUTION OF SPECIFIC HEALTH STATUSES AND OUTCOMES WITHIN A POPULATION;2. FACTORS THAT CAUSE THE PRESENT OUTCOMES DISTRIBUTION; AND3. INTERVENTIONS THAT MAY MODIFY THE FACTORS TO IMPROVE HEALTH OUTCOMES.IMPROVING POPULATION HEALTH REQUIRES EFFECTIVE INITIATIVES TO:1. INCREASE THE PREVALENCE OF EVIDENCE-BASED PREVENTIVE HEALTH SERVICES AND PREVENTIVE HEALTH BEHAVIORS;2. IMPROVE CARE QUALITY AND PATIENT SAFETY; AND3. ADVANCE CARE COORDINATION ACROSS THE HEALTH CARE CONTINUUM.IN ADDITION TO OUR MEDICAL SERVICES AND PROGRAMS, DAMERON HOSPITAL ALSO OFFERS THE FOLLOWING COMMUNITY BENEFIT AND OUTREACH SERVICES: 1. SPONSORSHIP OF HEALTH-RELATED COMMUNITY EVENTS AND ACTIVITIES;2. TAXI/BUS TRANSPORTATION TO AND FROM THE HOSPITAL/CLINIC, IF NEEDED MEDICAL EDUCATION FOR COMMUNITY PHYSICIANS;3. PARTICIPATION IN THE DECISION MEDICINE PROGRAM EXPOSING HIGH SCHOOL STUDENTS TO HEALTH CARE CAREERS TO ENCOURAGE YOUTH TO GIVE BACK TO THE COMMUNITY AND CONSIDER A CAREER IN MEDICINE;4. ONLINE HEALTH CENTER "FOLLOWMYHEALTH; AND5. PROVIDE A CLINICAL SETTING FOR UNDERGRADUATE/VOCATIONAL TRAINING TO STUDENTS ENROLLED IN OUTSIDE PROGRAMS. PART VI, LINE 6: THE HOSPITAL IS MANAGED BY ADVENTIST HEALTH, A HEALTH CARE SYSTEM WHICH PROVIDES HEALTHCARE SERVICES IN DIVERSE MARKETS WITHIN THE WESTERN UNITED STATES. THE CORPORATE OFFICE PROVIDES IMPORTANT SHARED ADMINISTRATIVE SUPPORT FOR DAMERON. PART VI, LINE 7, REPORTS FILED WITH STATES CA 0 0 0 0 0 0 0 1 0 MARIA VILLARREAL REGISTERED NURSE 296948 0 0 0 0 0 10195 0 17064 0 324207 0 0 0 MEMBER AKUVA REGISTERED NURSE 234842 0 0 0 0 0 8107 0 18278 0 261227 0 0 0 TAMMY A SWANSON REGISTERED NURSE 219033 0 0 0 0 0 20381 0 16858 0 256272 0 0 0 GARY BROWN REGISTERED NURSE 229178 0 0 0 0 0 8289 0 16858 0 254325 0 0 0 CHRIS PETERSON CARDIAC CATH SUPERVISOR 211639 0 0 0 0 0 7802 0 17064 0 236505 0 0 0 PART I, LINE 7 EXECUTIVE INCENTIVE COMPENSATION IS SET BASED ON MEETING A SPECIFIC SET OF METRICS ESTABLISHED ANNUALLY BY THE CEO AND EXECUTIVE TEAM AND APPROVED BY THE BOARD. METRICS GENERALLY INCLUDE QUALITY, FINANCE, PATIENT SAFETY, PATIENT EXPERIENCE, EMPLOYEE ENGAGEMENT AND MEANINGFUL USE GOALS. FORM 990, PART VII, LINE 5: ADVENTIST HEALTH COMPENSATED THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A: TERESA DAY HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $1,282,531 ERIC CORNWELL HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $594,097 KATIE DELMORE HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $549,028 TIMOTHY KARAGOUNIS HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $443,845 DONOVAN STEWART HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $438,101 DAMERON MEDICAL GROUP COMPENSATED THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A: DATTA GAURAV HAS REPORTABLE COMPENSATION IN THE AMOUNT OF $269,548 DAMERON MEDICAL GROUP ENTITY IS OWNED BY THE CMO OF THE HOSPITAL 2506918 SUPPORT FEES 0 FORM 990, PART VI, SECTION A, LINE 3 DAMERON HOSPITAL ASSOCIATION HAS ENTERED INTO AN AGREEMENT WITH ADVENTIST HEALTH SYSTEM/WEST TO PROVIDE THE FOLLOWING: - DAY-TO-DAY MANAGEMENT AND OPERATION SERVICES FOR THE HOSPITAL, INCLUDING ALL USUAL AND CUSTOMARY RESPONSIBILITIES, DUTIES, AND OBLIGATIONS IN CONNECTION WITH OPERATING AND MAINTAINING THE HOSPITAL AS A NONPROFIT HOSPITAL IN COMPLIANCE WITH REGULATIONS AND STANDARDS. THIS INCLUDES SERVICES OF SENIOR MANAGEMENT PERSONNEL TO SUPPORT PERSONNEL AS DEEMED NECESSARY. - MANAGE AND SUPERVISE ALL HOSPITAL EMPLOYED AND CONTRACTED PERSONNEL AND WILL ANALYZE THE WORKFORCE AND PROVIDE A RECOMMENDED STAFFING PLAN. - RESPONSIBLE FOR BILLING AND COLLECTION OF CHARGES FOR ALL SERVICES PROVIDED BY THE HOSPITAL, FOLLOWING THE HOSPITAL'S CURRENT CHARGE SCHEDULES AND COLLECTION POLICIES, INCLUDING THE CHARITY CARE POLICY. - TAKE OVER PAYMENT OF EXPENSES, INVOICES, ACCOUNTS PAYABLE, AND OTHER OBLIGATIONS OF THE HOSPITAL IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. THEY ARE ALLOWED ACCESS TO THE BANK ACCOUNTS, AND EXPENSES EXCEEDING $250,000 REQUIRE DAMERON BOD APPROVAL. - OVERSEE THE ACCOUNTING SYSTEM AND PREPARE MONTHLY, QUARTERLY, AND ANNUAL FINANCIAL STATEMENTS AND BOOKKEEPING. - MANAGE ALL CURRENT VENDOR AGREEMENTS AND LOOK TO RENEGOGIATE CONTRACTS WITH UNFAVORABLE TERMS. ANY CONTRACT NEGOTIATIONS OF $250,000 OR MORE REQUIRE DAMERON BOD APPROVAL. ALL CAPITAL PLAN PROJECTS MUST RECEIVE DAMERON BOARD OF DIRECTORS APPROVAL. AND ENSURE THE HOSPITAL REMAINED FULLY LICENSED AND CERTIFIED FOR PARTICIPATION IN GOVERNMENT PROGRAMS AND OTHER THIRD PARTY PAYOR PROGRAMS. - SHALL ASSESS AND RECOMMEND IMPROVEMENTS AND EFFICIENCIES TO THE HOSPITAL'S OPERATIONS INCLUDING IMPROVING FINANCIAL EFFECTIVENESS, QUALITY OF OPERATIONS, CAPITAL BUDGET, AND EXPENDITURES. THE BOD WILL ULTIMATELY MAKE DECISIONS RELATED TO THE CAPITAL BUDGET, EXPENDITURES, AND INVESTMENTS. - DEVELOP BRANDING FOR BOARD APPROVAL. - DAMERON HOSPITAL ASSOCIATION MUST OBTAIN CONSENT FROM ADVENTIST PRIOR TO TAKING THE FOLLOWING ACTIONS: AUTHORIZE OR APPROVE THE TRANSFER OR DISPOSE OF REAL OR PERSONAL PROPERTY (EXCEPT OBSOLETE ITEMS); ENTER INTO DEBT THAT CREATES LIENS ON REAL OR PERSONAL PROPERTY OF THE HOSPITAL; EXECUTE LEASES, CONTRACTS, OR AGREEMENTS; TERMINATE LICENSES, CERTIFICATIONS, OR PERMITS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO AND ACCOUNTING MANAGER. FORM 990, PART VI, SECTION B, LINE 12C EACH INDIVIDUAL FIDUCIARY MUST EXECUTE A CONFLICTS OF INTEREST DISCLOSURE STATEMENT AND QUESTIONNAIRE AT LEAST ANNUALLY AND MUST PROMPTLY REPORT ALL FACTS REGARDING ANY NEW TRANSACTION THAT MIGHT CREATE A CONFLICT OF INTEREST AS SOON AS THEY BECOME AWARE OF ANY SUCH TRANSACTION. IT IS EACH FIDUCIARY'S DUTY TO MAKE A FULL DISCLOSURE AS PROVIDED HEREIN OF ALL MATERIAL FACTS REGARDING ANY POSSIBLE CONFLICT OF INTEREST, TO DESCRIBE THE SITUATION OR TRANSACTION, AND TO DISCLOSE THE DETAILS OF THE EMPLOYEE, MEDICAL STAFF OFFICER, OR RELATED PARTY'S INTEREST IN THE SITUATION OR TRANSACTION. ALL FIDUCIARIES SHALL REPORT ALL POSSIBLE CONFLICTS OF INTEREST TO THE CHIEF EXECUTIVE OFFICER, OR HER DESIGNEE. THE CHIEF EXECUTIVE OFFICER, OR DESIGNEE, SHALL CONDUCT SUCH REVIEW AS APPROPRIATE, AND REFER SUCH INFORMATION TO THE BOARD OF DIRECTORS OF THE HOSPITAL. THE BOARD OF DIRECTORS SHALL REVIEW SUCH CONFLICTS AND DISCLOSURES. THE BOARD OF DIRECTORS MAY CONSULT WITH LEGAL COUNSEL AND SUCH OTHER AUTHORITIES AS MAY BE DESIRED, AND MAY REQUEST ANY ADDITIONAL INFORMATION DEEMED RELEVANT, INCLUDING THE SOURCE AND AMOUNT OF ANY INCOME OR FINANCIAL INTEREST OR OTHER ECONOMIC BENEFIT TO BE DERIVED BY SUCH PERSON FROM THE SITUATION OR TRANSACTION. IT IS THE POLICY OF THE BOARD OF DIRECTORS THAT THE EXISTENCE OF ANY INTEREST DESCRIBED WITHIN THE CORPORATE COMPLIANCE & REGULATORY AFFAIRS POLICY SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. EACH FIDUCIARY HAS A CONTINUING RESPONSIBILITY TO SCRUTINIZE ANY TRANSACTION IN WHICH THE FIDUCIARY OR A RELATED PARTY IS DIRECTLY OR INDIRECTLY INTERESTED FOR POTENTIAL CONFLICT OF INTEREST AND TO MAKE A FULL DISCLOSURE AS PROVIDED HEREIN. THE CHIEF EXECUTIVE OFFICER, OR THE BOARD OF DIRECTORS SHALL AS PROVIDED HEREIN THEN DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS AND SHALL TAKE THE APPROPRIATE ACTION. ALL DECISIONS REGARDING CONFLICTS OF INTEREST REST IN THE SOLE DISCRETION OF THE BOARD OF DIRECTORS IN THE EXERCISE OF ITS ULTIMATE JUDGMENT OF THE BEST INTERESTS OF THE HOSPITAL. ALL OFFICERS WHO ARE EMPLOYEES, ALONG WITH THE REST OF MANAGEMENT AND THE BOARD ARE SUBJECT TO AN ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC TO VIEW. FORM 990, PART IX, LINE 11G NURSE REGISTRY: PROGRAM SERVICE EXPENSES 12,446,825. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,446,825. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,926,379. MANAGEMENT AND GENERAL EXPENSES 346,610. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,272,989. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,035,615. MANAGEMENT AND GENERAL EXPENSES 2,229,553. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,265,168. MEDICAL RECORDS OUTSOURCING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,349,417. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,349,417. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,289,176. MANAGEMENT AND GENERAL EXPENSES 2,535,316. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,824,492. DIETARY OUTSOURCING: PROGRAM SERVICE EXPENSES 2,729,058. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,729,058. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 3,275,986. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,275,986. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 143,226. MANAGEMENT AND GENERAL EXPENSES 2,097,072. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,240,298. DAMERON HOSPITAL FOUNDATION 525 WEST ACACIA STREET STOCKTON CA 95203 942811364 SUPPORT DAMERON HOSPITAL ASSOCIATION CA 501(C)(3) LINE 7 DAMERON HOSPITAL ASSOCIATION 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0