2024-11-12T19:17:55-06:00 2023-12-31 952302617 SINGERLEWAK LLP 2010 MAIN ST STE 300 IRVINE CA 92614 990 2023-01-01 952413054 EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL EMAN 6269638411 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 LEON CHOINIERE CFO 6269387595 2024-11-08 1 1 JONATHAN P SCHUBERT CPA P00103314 9496230540 2024-11-08 2023 2024-10-15 13:58:12Z RAJESH K SHARMA 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 198773450 0 X EMANATEHEALTH.ORG X 1965 CA OPERATION OF ACUTE CARE HOSPITAL. 17 16 744 44 11710 9266 0 4060458 120315266 122075370 3985295 2028159 1238853 2407973 125539414 130571960 0 0 0 0 56883969 58944326 0 0 0 61782683 67188862 118666652 126133188 6872762 4438772 149861579 166225851 23834446 28936447 126027133 137289404 OUR MISSION IS TO HELP PEOPLE KEEP WELL IN BODY, MIND AND SPIRIT BY PROVIDING QUALITY HEALTH CARE SERVICES IN A SAFE, COMPASSIONATE ENVIRONMENT. 0 0 110290735 123018296 EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL (FPH) IS AN ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE TO THE SURROUNDING COMMUNITY. FPH PROVIDES FOR, ON AVERAGE, 69 PATIENTS PER DAY. TOTAL ADJUSTED INPATIENT DAYS WERE 47,537. OUTPATIENT AND EMERGENCY VISITS TOTALED 54,087. FPH PROVIDED TRADITIONAL CHARITY CARE AT COST TOTALING $2,074,909, UNREIMBURSED MEDI-CAL PROGRAM COST TOTALING $11,242,390 AND OTHER COMMUNITY BENEFIT COST TOTALING $467,374. DURING 2023, FPH RECORDED A NET SUPPLEMENTAL PAYMENTS OF $4,290,645 FROM THE CALIFORNIA HOSPITAL FEE PROGRAM FOR THE HOSPITAL SERVICES TO MEDI-CAL FEE-FOR-SERVICE AND MEDI-CAL MANAGED CARE PATIENTS COVERED FOR THE PERIOD FROM JANUARY 1, 2023 TO DECEMBER 31, 2023. 110290735 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 X 128 0 1 744 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X LEON CHOINIERE CFO 6269387595 140 WEST COLLEGE ST PO BOX 6108 COVINA CA 917225108 X RAJESH SHARMA SEE SCH O PRESIDENT & CEO 4.00 36.00 X X 0 2411826 163047 LEON CHOINERE SEE SCH O CFO 4.00 36.00 X 0 498019 13626 CHANDRA REDDY RSO/NUCLEAR MED TECH 40.00 X 246338 0 25472 STANLEY KOZAKA PHARMACIST 40.00 X 233840 0 32531 JOANNE WEIGH DIRECTOR PERIOPERATIVE SVC 40.00 X 244992 0 9980 ALMIRA DUQUE CLINICAL LAB SPECIALIST 40.00 X 207668 0 17894 RESTITUTO ESPADERO PHARMACIST 40.00 X 216520 0 72 CLIFFORD CHRIST CHAIR 3.00 X X 0 0 0 PATSY GORRELL VICE CHAIR, BOD 3.00 X X 0 0 0 GARY MATHEWSON SECRETARY, BOD 3.00 X X 0 0 0 BERNARD BOLLINGER JR ESQ TREASURER 3.00 X X 0 0 0 RAFFAELE CORBISIERO MD COS EHMC BOARD OF DIRECTORS 3.00 X 0 0 0 GEORGE FERENCZI MD BOARD OF DIRECTORS 3.00 X 0 0 0 LISA FUERST BOARD OF DIRECTORS 3.00 X 0 0 0 ROBERT GONZALES BOARD OF DIRECTORS 3.00 X 0 0 0 BRENDA HAYAKAWA MD COS EHFPH BOARD OF DIRECTORS 3.00 X 0 0 0 SANJAY KHEDIA MD BOARD OF DIRECTORS 3.00 X 0 0 0 MARY KIRCHEN IHM BOARD OF DIRECTORS 3.00 X 0 0 0 ANNA LEUNG MD BOARD OF DIRECTORS 3.00 X 0 0 0 ARTHUR LUDWICK BOARD OF DIRECTORS 3.00 X 0 0 0 PHILIP MALDONADO DDS BOARD OF DIRECTORS 3.00 X 0 0 0 LUCRECIA MONTES PHARMD IHM BOARD OF DIRECTORS 3.00 X 0 0 0 SHARON YEE MD BOARD OF DIRECTORS 3.00 X 0 0 0 1149358 2909845 262622 192 0 1 0 MEDLINE INDUSTRIES DEPT LA 21558 PASADENA CA 91185 CONTRACTORS 5385902 MCKESSON CORP FILE 57256 LOS ANGELES CA 90074 CONTRACTORS 4642023 EMANATE HEALTH MEDICAL CENTER 210 W SAN BERNARDINO RD COVINA CA 91722 CONTRACTORS 3000000 SIEMENS MEDICAL SOLUTIONS PO BOX 120001 DEPT 0733 DALLAS TX 75312 CONTRACTORS 1375132 BOSTON SCIENTIFIC CORP PO BOX 951653 DALLAS TX 753951653 CONTRACTORS 1174210 82 1228 4059230 4060458 PATIENT REV/MEDICARE/MEDICAID PAY 900099 107657099 107657099 HOSPITAL FEE PROGRAM REVENUE 900099 14418271 14418271 122075370 2117863 2117863 170335 0 170335 170335 14839 155496 65438002 2673784 65527706 2673784 -89704 0 -89704 -89704 OTHER OPERATING REVENUE 900099 896025 896025 PREMIUM REVENUE 900099 728094 728094 REBATES & REFUNDS 900099 290882 290882 322637 46901 -3129 278865 2237638 130571960 123018296 11710 3481496 X 290985 83286 207699 43814062 43650193 163869 12545390 12477541 67849 2293889 2281483 12406 204042 204042 2142015 2142015 15650509 15650226 283 89908 89908 3617624 3612621 5003 916416 916416 PURCHASED SERVICES 19911624 5699100 14212524 HOSPITAL FEE PROGRAM 10127626 10127626 BAD DEBT EXPENSE 7761913 7761913 CONTRACT LABOR 4279741 4279741 2487444 2435082 52362 126133188 110290735 15842453 0 1830154 1582834 17166562 15985590 661287 1923418 892469 960411 114635668 79082574 32428505 35553094 65504886 68284854 145244 145244 31232472 41790406 149861579 166225851 18972527 23525126 4861919 5411321 23834446 28936447 X 124211346 130467384 1815787 6822020 126027133 137289404 149861579 166225851 X 4438772 747833 -817392 6893058 X X 0 1 X 1 0 X 1552493 5002533 6555026 1536154 16339 1552493 1524031 12123 1536154 1498549 25482 1524031 1492855 5694 1498549 1.00000 0 1 1 3608616 3608616 62537429 40322091 22215338 1550325 1550325 0 44884279 37090594 7793685 2055019 119564 1935455 35553094 BENEFICIAL INTEREST IN FOUNDATION 6921117 HOSPITAL FEE PROGRAM 22009179 HOSPITAL/PROF. EXCESS INS RECOVERIES-CURRENT 535000 HOSPITAL/PROF. EXCESS INS RECOVERIES-L/T 2423000 OTHER RECEIVABLES 9276217 OPERATING LEASE - RIGHT OF USE 625893 41790406 OTHER CURRENT LIABILITIES 1293402 MALPRACTICE RESERVE LONG TERM 2957000 DEFERRED RENT 422344 CAPITAL LEASE 738575 5411321 X 125240663 747833 747833 124492830 6079130 6079130 130571960 118167233 0 118167233 7965955 7965955 126133188 PART V, LINE 4: PERMANENTLY RESTRICTED ASSETS ARE RESTRICTED INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES. PART X, LINE 2: ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT DECEMBER 31, 2023 OR 2022. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES INCLUDED IN INCOME 204,042. TRANSFER FROM FOUNDATION 1,228. PASSTHROUGH INCOME DIFFERENCE 7,733. CHANGE IN BENEFICIAL INTEREST FOUNDATION -1,895,786. PROVISION FOR BAD DEBTS 7,761,913. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 7,761,913. INVESTMENT FEES INCLUDED IN INCOME 204,042. 1 1 X 1 X 350.000000000000 1 X 500.000000000000 1 1 1 0 1 1 2074909 2074909 0.01650 43336917 36385170 6951747 0.05510 45411826 36385170 9026656 0.07160 184778 184778 0.00150 282596 282596 0.00220 467374 467374 0.00370 45879200 36385170 9494030 0.07530 1 7761913 0 23112805 21199391 1913414 X 1 1 1 1 FPH 250 SOUTH GRAND AVENUE GLENDORA CA 91741 WWW.EMANATEHEALTH.ORG 106190298 X X X X EMANATE HEALTH FOOTHILL PRESBYTERIAN HOS 1 1 0 1 X X X X X X X X X 19 1 1 0 1 X SEE FOOTNOTE AT PART V PAGE 8 1 19 1 SEE FOOTNOTE AT PART V PAGE 8 0 1 X 350.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X SEE FOOTNOTE AT PART V PAGE 8 X SEE FOOTNOTE AT PART V PAGE 8 X SEE NOTE AT PART V PAGE 8 X X X X X X 1 X 0 X X X 1 X 0 0 EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS THROUGH THE USE OF KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND/OR SURVEYS. INDIVIDUALS WITH KNOWLEDGE, INFORMATION, AND/OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED, INCLUDING REPRESENTATIVES FROM STATE, LOCAL OR OTHER REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENTS (OR EQUIVALENT DEPARTMENT OR AGENCY) AS WELL AS LEADERS; REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS; AND REPRESENTATIVES FROM LOCAL SCHOOLS, PUBLIC SERVICE ORGANIZATIONS AND BUSINESSES AS WELL AS SOCIAL AND HEALTH SERVICE PROVIDERS. FOCUS GROUPS WERE CONDUCTED IN ENGLISH AND SPANISH AS NEEDED. FOR A COMPLETE LIST OF INDIVIDUALS WHO PROVIDED INPUT DURING THE CHNA PROCESS, SEE APPENDIX C OF THE CHNA REPORT. PRIMARY DATA WERE COLLECTED AS DESCRIBED ABOVE FROM A VARIETY OF STAKEHOLDERS THROUGH PHONE INTERVIEWS AND FOCUS GROUPS TO IDENTIFY THE MOST SEVERE HEALTH NEEDS AND DRIVERS IN THE EMANATE HEALTH (EH) SERVICE AREA AS WELL AS GEOGRAPHIC DISPARITIES, SUB-POPULATION DISPARITIES AND COMMUNITY ASSETS AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS AND DRIVERS. IN ALL, 42 INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED. ADDITIONALLY, AS PART OF THE SAN GABRIEL VALLEY HOSPITAL COLLABORATIVE, HOSPITALS WITHIN SERVICE PLANNING AREA 3 COLLECTIVELY SHARED OTHER INTERVIEWS AND FOCUS GROUPS INPUT, AS WELL AS A COMMUNITY SURVEY, CONDUCTED IN THE REGION AS PART OF THEIR CHNA. THIS INFORMATION WAS ALSO INCORPORATED INTO EMANATE HEALTH ANALYTICAL FRAMEWORK. PRIMARY DATA WERE INPUTTED INTO MICROSOFT EXCEL DATABASE TO ASSIST IN ORGANIZING THE DATA, CODING AND IDENTIFYING MAJOR THEMES, AND COLLECTING QUOTES. METHODOLOGY FOR INTERPRETATION AND ANALYSIS OF PRIMARY DATA:THE CENTER FOR NONPROFIT MANAGEMENT (CNM) USED A THREE-STEP PROCESS FOR ANALYZING AND INTERPRETING PRIMARY DATA: 1) ALL INFORMATION GATHERED DURING FOCUS GROUPS AND INTERVIEWS WERE ENTERED INTO MICROSOFT EXCEL, 2) SPREADSHEET DATA WERE REVIEWED MULTIPLE TIMES USING CONTENT ANALYSIS TO BEGIN SORTING AND CODING THE DATA, AND 3) THROUGH THE CODING PROCESS, THEMES, CATEGORIES AND QUOTES WERE IDENTIFIED. STEPS TWO AND THREE ARE REPEATED AS OFTEN AS NECESSARY TO RECOGNIZE AS MANY CONNECTIONS AND PATTERNS WITHIN THE DATA AS POSSIBLE. THIS APPROACH PROVIDES A SYSTEMATIC WAY TO IDENTIFY BROAD THEMES WITHIN A LARGE SET OF QUALITATIVE DATA AND BEGIN CODING AND CATEGORIZING DATA AROUND THOSE THEMES (E.G., ACCESS TO CARE, POVERTY, CULTURAL BARRIERS). RESPONSES WERE REVIEWED AND CODED SO THAT COMMON THEMES PULLED FROM THE DATA CAN BE COMBINED WITH QUANTITATIVE DATA TO FORM CONCLUSIONS. EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 6A: THE 2022 CHNA WAS COMPLETED THROUGH COLLABORATION BETWEEN EMANATE HEALTH (WHICH INCLUDES EMANATE HEALTH MEDICAL CENTER AND EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL). EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 11: EMANATE HEALTH'S CHNA 2022-2025 IMPLEMENTATION PLAN'S AREAS OF FOCUS ARE CHRONIC DISEASES/HEALTHY BEHAVIORS; MENTAL HEALTH; HOMELESSNESS; AND ACCESS TO CARE. DUE TO THE 2020-2021 COVID-19 PANDEMIC, SEVERAL OF THE STRATEGIES AND ACTIVITIES WERE PUT ON HOLD DURING THE STAY-AT-HOME MANDATE AND THE CHALLENGES UNDERWENT BY THE HOSPITALS. HOWEVER, EMANATE HEALTH AND ITS COMMUNITY PARTNERS WORKED DILIGENTLY TO IMPLEMENT PART OF THE GOALS AND ACTIVITIES OUTLINED IN THE IMPLEMENTATION PLAN.CHRONIC DISEASES/HEALTH BEHAVIORSSTROKE DISEASE THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION REPORTS THAT FOOTHILL PRESBYTERIAN HOSPITAL AND QUEEN OF THE VALLEY HOSPITAL RECEIVED THE GOLD PLUS QUALITY ACHIEVEMENT AWARD, AND THE GOLD PLUS TARGET STROKE HONOR ROLL ELITE WAS AWARDED TO QUEEN OF THE VALLEY HOSPITAL, AND TYPE 2 DIABETES HONOR ROLL. WITHIN MINUTES OF A STROKE PATIENT'S ARRIVAL IN THE EMERGENCY DEPARTMENT, EMANATE HEALTH'S TEAM IS ABLE TO QUICKLY ASSESS STROKE SYMPTOMS AND PROVIDE TREATMENT. EMANATE HEALTH OFFERS FREE SUPPORT STROUPS FOR STROKE SURVIVORS IN ENGLISH AND SPANISH. QUEEN OF THE VALLEY HOSPITAL RECEIVED THE GOLD PLUS QUALITY AWARD WITH THE HONOR ELITE DISTINCTION, AS WELL AS THE TARGET: TYPE 2 DIABETES HONOR ROLL. CONGRATULATIONS TO THE DOCTORS, NURSES AND OTHER STAFF ON EMANATE HEALTH'S STROKE TEAM FOR YOUR HARD WORK IN ACHIEVING THIS RECOGNITION.MENTAL HEALTH & HOMELESSNESSIN 2023 THE PARTNERSHIP CONTINUED WITH (LAHSA) LOS ANGELES HOMELESS SERVICE AUTHORITY AND UNITED WAY FOR A DEDICATED HOMELESS PATIENT NAVIGATOR WHO VISITS HOMELESS OR AT-RISK FOR HOMELESS PATIENTS PRIOR TO DISCHARGE. AS A DEDICATED POINT OF CONTACT, THE PATIENT NAVIGATOR BUILDS GREATER CONNECTION AND TRUST WITH THE HOMELESS PATIENT. THE ROLE OF THE NAVIGATOR IS TO CONDUCT AN ASSESSMENT OF THE PATIENT'S HEALTH AND PSYCHOSOCIAL NEEDS TO CONNECT THEM WITH THE NEEDED SERVICES; I.E. IDENTIFY SHELTER OR HOUSING RESOURCES FOR THE PATIENT BEING DISCHARGED; FOOD ATTAINMENT; FOLLOW-UP MEDICAL APPOINTMENTS AND PRESCRIPTIONS; EMPLOYMENT, ETC. THE NAVIGATOR HAS BEEN GRANTED SPECIAL ACCESS TO THE LA COUNTY RESOURCE SYSTEM AND WORKS UNDER THE HOSPITAL SOCIAL SERVICES LEADERSHIP. -IN PARTNERSHIP WITH FIRST 5 LA'S WELCOME BABY PROGRAM, 1,329 PREGNANT AND POST-PARTUM WOMEN RECEIVED DEPRESSION AND RISK-SCREENING ASSESSMENTS. IT WAS IDENTIFIED THAT 307 DISCLOSED POSSIBLE SIGNS AND SYMPTOMS FOR DEPRESSION. HOSPITAL LIAISONS CONDUCTED 1,089 BRIDGES FOR NEWBORN ASSESSMENTS WHICH INCLUDE INFORMATION ON DETERMINANTS OF HEALTH FOR THE FAMILY. OF THOSE, 115 WOMEN WERE REFERRED FOR MENTAL HEALTH SERVICES. THE NEW GAD-7 GENERALIZED ANXIETY DISORDER ASSESSMENT WAS ADMINISTERED TO 100% OF WELCOME BABY WOMEN WHO RECEIVED THE GAD-7. -IN PARTNERSHIP WITH THE HEALTH CONSORTIUM OF THE SAN GABRIEL VALLEY'S INTEGRATION COMMITTEE, WEBINARS WERE PROVIDED TO THE COMMUNITY BY EXPERT PRESENTERS.1. PRESENTATION AND DISCUSSION ON SUICIDE: RISK FACTORS; PROTECTIVE FACTORS; WARNING SIGNS, ETC. 2. ASIAN AMERICAN AND NATIVE HAWAIIAN/PACIFIC ISLANDER COMMUNITIES IN THE SAN GABRIEL VALLEY. CURRENT TRENDS, VISION AND RESOURCES.3. PALS FOR HEALTH: PROVIDING SUPPORTIVE SERVICES FOR VICTIMS AND ADVOCATING FOR LIMITED ENGLISH-SPEAKING COMMUNITIES.4. FOLLOW-UP 2022 BEHAVIORAL CONFERENCE: 94% OF ATTENDEES REPORTED THAT CONFERENCE CONTENT WILL IMPROVE THE QUALITY OF THEIR PATIENT/CLIENT CARE.5. RELEASE OF THE 2022 STATE OF HATE CRIME REPORT IN LA COUNTY, WITH DATA FOR THE SAN GABRIEL VALLEY. PART V, SECTION B, LINE 7A CHNA REPORT: THE 2022 CHNA REPORT IS AVAILABLE ON THE HOSPITAL'S WEBSITE HTTPS://WWW.EMANATEHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS/ PLEASE NOTE THAT THE ABOVE LINK IS CASE SENSITIVE. PLEASE USE LOWER CASE LETTERS. PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY: THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HOSPITAL'S WEBSITE THE HOSPITAL FACILITIES 2022-2025 IMPLEMENTATION STRATEGY REPORT IS POSTED ON THE EMANATE HEALTH WEBSITE.HTTPS://WWW.EMANATEHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS/PLEASE NOTE THAT THE ABOVE LINK IS CASE SENSITIVE. PLEASE USE LOWER CASE LETTERS. PART V, SECTION B, LINE 11: FOR THE 2022-2025 CHNA CYCLE, A COLLABORATIVE OF NONPROFIT HOSPITALS LOCATED IN THE SAN GABRIEL VALLEY OF LOS ANGELES COUNTY, CALIFORNIA (THE SPA 3 HOSPITAL COLLABORATIVE) COMMITTED TO PARTICIPATE IN A JOINT CHNA DATA COLLECTION PROCESS. THE INTENT IS TO FACILITATE THE DEVELOPMENT OF A COORDINATED EFFORT TO COLLABORATIVELY ADDRESS PRIORITY HEALTH NEEDS THROUGH THEIR JOINT IMPLEMENTATION STRATEGIES MOVING FORWARD. THE SPA 3 HOSPITAL COLLABORATIVE AGREED TO SHARE AMONG ALL PARTICIPATING HOSPITALS THE PRIMARY DATA COLLECTED THROUGH THE CHNA CYCLE. ADDITIONALLY, THE HOSPITALS IDENTIFIED A LIMITED LIST OF SUBPOPULATIONS THEY WANTED TO TARGET THROUGH QUALITATIVE DATA COLLECTION EFFORTS (BOTH INDIVIDUAL INTERVIEWS AND FOCUS GROUPS). TOGETHER, THE SPA 3 HOSPITAL COLLABORATIVE AGREED ON A CORE SET OF QUESTIONS TO BE ASKED ACROSS ALL INTERVIEWS AND FOCUS GROUPS, AND DEVELOPED A LIST OF TOPICS OF INTEREST SPECIFIC TO EACH INTERVIEW OR FOCUS GROUP THAT WOULD LEAD TO A MORE DETAILED UNDERSTANDING OF THE SPECIFIC HEALTH NEEDS OF THE TARGET GROUP REPRESENTED IN THE ENGAGEMENT. THE NEW FEDERAL CHNA REQUIREMENTS HAVE PROVIDED AN OPPORTUNITY TO REVISIT THE NEEDS ASSESSMENT AND STRATEGIC PLANNING PROCESSES WITH AN EYE TOWARD ENHANCED COMPLIANCE AND TRANSPARENCY AND LEVERAGING EMERGING TECHNOLOGIES. THE INTENTION IS TO DEVELOP AND IMPLEMENT A TRANSPARENT, RIGOROUS, AND WHENEVER POSSIBLE, COLLABORATIVE APPROACH TO UNDERSTANDING THE NEEDS AND ASSETS IN OUR COMMUNITIES. FROM DATA COLLECTION AND ANALYSIS TO THE IDENTIFICATION OF PRIORITIZED NEEDS AND THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY, THE INTENT OF DEVELOPING AN IMPLEMENTATION STRATEGY IS TO CREATE A RIGOROUS PROCESS THAT WOULD YIELD TO MEANINGFUL RESULTS. REVIEW AND COMPILATION OF SECONDARY DATA WAS CONDUCTED THROUGH MULTIPLE SOURCES THAT PROVIDE ACCESS TO PUBLICLY AVAILABLE INDICATORS INCLUDING SOCIAL AND ECONOMIC FACTORS, HEALTH BEHAVIORS, PHYSICAL ENVIRONMENT, CLINICAL CARE, AND HEALTH OUTCOMES. THE PRIMARY DATA WAS COLLECTED THROUGH KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND SURVEYS. THIS CONSISTED OF REACHING OUT TO LOCAL PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS AND RESIDENTS TO IDENTIFY ISSUES THAT MOST IMPACTED THE HEALTH OF THE COMMUNITY. THE CHNA PROCESS ALSO INCLUDED AN IDENTIFICATION OF EXISTING COMMUNITY ASSETS AND RESOURCES TO ADDRESS THE HEALTH NEEDS. IN CONJUNCTION WITH THIS REPORT, EMANATE HEALTH HAS DEVELOPED AN IMPLEMENTATION STRATEGY FOR THE PRIORITY HEALTH NEEDS THE HOSPITAL WOULD ADDRESS. THESE STRATEGIES ARE BUILD ON EMANATE HEALTH'S ASSETS AND RESOURCES, AS WELL AS EVIDENCE-BASED STRATEGIES, WHEREVER POSSIBLE. PART V, LINE 16A, CHARITY CARE/FAP: HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/EMANATE-HEALTH-SITE-360/MEDIA/2AC37B678368498FABA8EE354EDA2BD9/CHARITY-CARE-A009-APPROVED-82022.PDFHOW AMOUNTS GENERALLY BILLED (AGB) IS CALCULATED HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/EMANATE-HEALTH-SITE-360/MEDIA/1366/EMANATE-HEALTH-AMOUNTS-GENERALLY-BILLED-AGB-2019-ENGLISH.PDFPLEASE NOTE THAT THE ABOVE LINKS ARE CASE SENSITIVE. PLEASE USE LOWER CASE LETTERS. PART V, LINE 16B FINANCIAL ASSISTANCE APPLICATION FORM URL: HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/EMANATE-HEALTH-SITE-360/MEDIA/1380/EMANATE-HEALTH-FINANCIAL-ASSISTANCE-APPLICATION-ENGLISH.PDFPLEASE NOTE THAT THE ABOVE LINK IS CASE SENSITIVE. PLEASE USE LOWER CASE LETTERS. PART V, LINE 16C FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY PAGE: HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/EMANATE-HEALTH-SITE-360/MEDIA/1365/EMANATE-HEALTH-FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SUMMARY-2019-ENGLISH.PDFPLEASE NOTE THAT THE ABOVE LINK IS CASE SENSITIVE. PLEASE USE LOWER CASE LETTERS. PART I, LINE 3C: ELIGIBILITY CRITERIA AND AMOUNTS CHARGED TO PATIENTS.SERVICES ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) WILL BE MADE AVAILABLE TO THE PATIENT ON A SLIDING FEE SCALE, IN ACCORDANCE WITH FINANCIAL NEED, AS DETERMINED IN REFERENCE TO FEDERAL POVERTY LEVELS (FPL) IN EFFECT AT THE TIME OF DETERMINATION.-PATIENTS WITH MONETARY ASSETS OR INCOME LEVEL AT 400% OR LESS OF THE FPL, WILL HAVE THE ENTIRE HOSPITAL BILL WRITTEN OFF REGARDLESS OF NET WORTH OR SIZE OF BILL;-PATIENTS WITH MONETARY ASSETS OR INCOME LEVEL BETWEEN 400% AND 550% OF THE FPL, WILL HAVE A PORTION OF THE HOSPITAL BILL WRITTEN OFF, BASED UPON THE SLIDING SCALE SET FORTH BELOW REGARDLESS OF NET WORTH OR SIZE OF BILL:401% - 450% = 75% WRITE-OFF451% - 500% = 50% WRITE-OFF501% - 550% = 25% WRITE OFF-PATIENTS WITH HOSPITAL BILL THAT EXCEEDS THE PATIENT'S MONETARY ASSETS OR NET WORTH MAY QUALIFY AND BE COVERED UNDER THIS POLICY USING THE GUIDELINES BELOW:- PATIENTS WITH MONETARY ASSETS OR NET INCOME LEVELS BETWEEN 401% AND 550% OF THE FPL, THE AMOUNT OF THE HOSPITAL BILL THAT EXCEEDS THE PATIENT'S NET WORTH WILL BE WRITTEN-OFF; - PATIENTS WITH MONETARY ASSETS OR INCOME IS OVER THE 550% OF THE FPL, PORTION OF THE HOSPITAL BILL THAT EXCEEDS THE PATIENT'S NET WORTH MAY BE: - WRITTEN-OFF UPON APPROVAL OF THE VP OF REVENUE CYCLE OR HIS/HER DESIGNEE; OR - ARRANGED FOR PAYMENT WITH THE PATIENT THROUGH MONTHLY PAYMENT PLAN. FOR PURPOSES OF DETERMINING MONETARY ASSETS OR INCOME, THE REVIEW SHALL NOT INCLUDE THE:A. RETIREMENT OR DEFERRED COMPENSATION PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE, OR NON-QUALIFIED DEFERRED COMPENSATION PLANS;B. FIRST TEN THOUSAND DOLLARS ($10,000) OF A PATIENT'S MONETARY ASSETS;C. FIFTY PERCENT (50%) OF A PATIENT'S MONETARY ASSETS OVER THE FIRST $10,000. PART I, LINE 6A: THE SOLE MEMBER OF EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL (FPH) IS EMANATE HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. EMANATE HEALTH PREPARED AN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT THAT DESCRIBES THE HOSPITAL'S PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY THE HOSPITAL. PART I, LINE 7: MANY GOVERNMENT PROGRAMS (MEDI-CAL, COVERED CALIFORNIA, AND MEDICARE) AND OTHER THIRD PARTY COVERAGE PROGRAMS HAVE BEEN ESTABLISHED TO PROVIDE FOR OR DEFRAY THE HEALTHCARE COSTS FOR THE INDIVIDUALS WHO MAY BE CONSIDERED NEEDY. IN THE CASE WHERE ARRANGEMENTS FOR PAYMENT TO THE HOSPITAL REQUIRE THE HOSPITAL TO ACCEPT THE PAYMENT AMOUNT AS PAYMENT IN FULL, THE BALANCES OF THESE ACCOUNTS WRITTEN OFF ARE ATTRIBUTABLE TO CONTRACTUAL ADJUSTMENTS AND WILL NOT BE CONSIDERED CHARITY CARE. IN CASES WHERE THESE PROGRAMS REQUIRE THE PATIENTS TO PAY CO-PAYMENTS OR DEDUCTIBLES AND THE PATIENTS DO NOT HAVE THE ABILITY TO PAY; THESE AMOUNTS WILL BE CONSIDERED CHARITY CARE.CHARITY DETERMINATION WILL BE GRANTED ON "ALL, PARTIAL, OR NOTHING BASIS". THERE IS A CATEGORY OF PATIENTS WHO QUALIFY FOR MEDI-CAL, BUT DO NOT RECEIVE PAYMENT FOR THEIR ENTIRE STAY. UNDER THE CHARITY POLICY DEFINITION, THESE PATIENTS ARE ELIGIBLE FOR CHARITY CARE WRITE-OFFS. IN ADDITION, THE HOSPITAL SPECIFICALLY INCLUDES AS CHARITY THE CHARGES RELATED TO DENIED STAYS, DENIED DAYS OF CARE, AND NON-COVERED SERVICES. THESE "TREATMENT AUTHORIZATION REQUEST" DENIALS AND ANY LACK OF PAYMENT FOR NON-COVERED SERVICES PROVIDED TO MEDI-CAL PATIENTS ARE TO BE CLASSIFIED AS CHARITY. THESE PATIENTS ARE RECEIVING THE SERVICES AND THEY DO NOT HAVE THE ABILITY TO PAY FOR IT. IN ADDITION, MEDICARE PATIENTS WHO HAVE MEDI-CAL COVERAGE FOR THEIR CO-INSURANCE/DEDUCTIBLES, FOR WHICH MEDI-CAL DOES NOT MAKE PAYMENT AND MEDICARE DOES NOT ULTIMATELY PROVIDE BAD DEBT REIMBURSEMENT WILL ALSO BE INCLUDED AS CHARITY. THESE INDIGENT PATIENTS ARE RECEIVING A SERVICE FOR WHICH A PORTION OF THE RESULTING BILL IS NOT BEING REIMBURSED.THE ABOVE CHARITY WRITE-OFFS ARE CONVERTED INTO CHARITY COST USING THE COST TO CHARGE RATIO WHICH WAS DERIVED FROM WORKSHEET 2 OF THE INSTRUCTIONS TO THE IRS SCHEDULE H, "RATIO OF PATIENT CARE COST-TO-CHARGES."INCLUDED IN PART 1, LINE 7B ARE NET SUPPLEMENTAL MEDI-CAL PAYMENTS OF $4,290,645 FROM THE CALIFORNIA HOSPITAL FEE PROGRAM ("PROGRAM"). CALIFORNIA LEGISLATION ESTABLISHED THE PROGRAM TO IMPOSE A QUALITY ASSURANCE FEE ON CERTAIN GENERAL ACUTE CARE HOSPITALS IN ORDER TO MAKE SUPPLEMENTAL AND GRANT PAYMENTS AND INCREASED CAPITATION PAYMENTS (SUPPLEMENTAL PAYMENTS) TO HOSPITALS UP TO THE AGGREGATE UPPER PAYMENT LIMIT FOR VARIOUS PERIODS. SEVERAL PIECES OF LEGISLATION HAVE BEEN ENACTED TO CREATE THE PROGRAM FOR VARIOUS PERIODS OF TIME.THE PROGRAM IS DESIGNED TO MAKE SUPPLEMENTAL INPATIENT AND OUTPATIENT MEDI-CAL PAYMENTS TO PRIVATE HOSPITALS, INCLUDING ADDITIONAL PAYMENTS FOR CERTAIN FACILITIES THAT PROVIDE HIGH-ACUITY CARE AND TRAUMA SERVICES TO THE MEDI-CAL POPULATION. THE PROGRAM PROVIDES A MECHANISM FOR INCREASING PAYMENTS TO HOSPITAL THAT SERVE MEDI-CAL PATIENTS, WITH NO IMPACT ON THE STATE'S GENERAL FUND. SOME OF THESE PAYMENTS ARE BE MADE DIRECTLY BY THE STATE, WHILE OTHERS ARE BE MADE BY MEDI-CAL MANAGED CARE PLANS, WHICH WILL RECEIVE INCREASED CAPITATION RATES FROM THE STATE IN AMOUNTS EQUAL TO THE SUPPLEMENTAL PAYMENTS. OUTSIDE OF THE LEGISLATION, THE CALIFORNIA HOSPITAL ASSOCIATION (CHA) HAS CREATED A PRIVATE PROGRAM, OPERATED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT), WHICH WAS ESTABLISHED TO ALLEVIATE DISPARITIES POTENTIALLY RESULTING FROM THE IMPLEMENTATION OF THE PROGRAMS.THERE ARE TWO PROGRAMS THAT HAD ACTIVITY IN 2023: HQAF 7, A 12-MONTH HOSPITAL FEE PROGRAM COVERING THE PERIOD FROM JANUARY 1, 2022 THROUGH DECEMBER 31, 2022, AND HQAF 8, A 24-MONTH HOSPITAL FEE PROGRAM COVERING THE PERIOD FROM JANUARY 1, 2023 THROUGH DECEMBER 31, 2024. FPH PROVIDED APPROXIMATELY 7,000 DAYS OF QUALITY HEALTH CARE SERVICES TO MEDI-CAL BENEFICIARIES ANNUALLY.DUE TO DEEP FUNDING CUTS TO MEDI-CAL PROGRAM, AS WELL AS HISTORICAL LOW LEVELS OF REIMBURSEMENT AND HIGH RATE OF DENIALS, THE HOSPITAL FEE PROGRAM HAS BEEN CRITICAL IN HELPING FPH TO CONTINUE PROVIDING QUALITY HEALTH CARE SERVICES TO THE POOREST AND MOST VULNERABLE POPULATION IN THE COMMUNITY. THE PROGRAM REMAINS CRUCIAL IN MAINTAINING MEDI-CAL SERVICES AND CHARITY PROVIDED BY OUR HOSPITAL TO THE COMMUNITY'S LOW INCOME POPULATION, AND IT IS VITAL TO FPH THAT FUTURE SIMILAR PROGRAMS BE APPROVED AND IMPLEMENTED.PART I, LINE 7F:HEALTH PROFESSION EDUCATION - IN AN EFFORT TO CREATE A HEALTHY COMMUNITY IN THE EAST SAN GABRIEL VALLEY AREA, EMANATE HEALTH HAS OFFERED A NUMBER OF SPECIAL EVENTS, LECTURES AND CLASSES TO HELP EDUCATE THE COMMUNITY TO IMPROVE THEIR HEALTH, SCHOLARSHIPS FOR NURSING STUDENTS AND OTHER HEALTH RELATED PROGRAMS THAT EDUCATE HEALTH PROFESSIONALS IN THE BROADER COMMUNITY. IN NOVEMBER 2016, THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) OFFICIALLY ANNOUNCED ITS APPROVAL TO ACCREDIT A FAMILY MEDICINE RESIDENCY PROGRAM AT EMANATE HEALTH. IN ADDITION, EMANATE HEALTH OFFICIALLY ENTERED INTO AN AFFILIATION WITH USC'S KECK SCHOOL OF MEDICINE AND ITS DEPARTMENT OF FAMILY MEDICINE. THIS AFFILIATION PROVIDES OPPORTUNITIES FOR MEDICAL RESEARCH AND EDUCATIONAL OPPORTUNITIES FOR THE SCHOOL'S STUDENTS, WHILE ALSO ALLOWING EMANATE HEALTH PHYSICIANS WHO FUNCTION AS VOLUNTARY FACULTY TO OUR RESIDENTS TO ALSO BECOME VOLUNTARY FACULTY FOR USC'S DEPARTMENT OF FAMILY MEDICINE. THE TEN FIRST-YEAR RESIDENT POSITIONS IN OUR CHARTER CLASS STARTED TRAINING AT OUR HOSPITALS AND AT EAST VALLEY COMMUNITY HEALTH CENTER IN JULY - 2017, AND THE NUMBER OF RESIDENTS REMAINED AT 30 POSITIONS IN 2023. PART III, LINE 2: STATEMENT REGARDING COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III - REGARDING CARE OF THE POOR AND COMMUNITY BENEFIT REPORT:EMANATE HEALTH HAS A POLICY TO TREAT EMERGENCY PATIENTS REGARDLESS OF ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT IN ACCORDANCE WITH CERTAIN ESTABLISHED POLICIES OF THE CORPORATION. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED BECAUSE OF INABILITY TO PAY. EMANATE HEALTH PROVIDES PROGRAMS AND ACTIVITIES THAT CONTRIBUTE TO CHARITY CARE, CARE OF THE POOR, AND COMMUNITY BENEFIT. THESE PROGRAMS AND ACTIVITIES SERVE A MAJORITY OF PERSONS WHO ARE BENEFICIARIES OF MEDI-CAL AND COUNTY/STATE PROGRAMS FOR THE MEDICALLY INDIGENT. ALSO INCLUDED ARE ACTIVITIES THAT IMPROVE THE COMMUNITY'S HEALTH STATUS, AND EDUCATE OR PROVIDE SOCIAL SERVICES TO THE ELDERLY AND CHILDREN. EMANATE HEALTH USES 3 CATEGORIES TO CLASSIFY CARE OF THE POOR AND COMMUNITY BENEFIT: CATEGORY 1: TRADITIONAL CHARITY CARE - CARE OF THE POOR INCLUDES SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED. THIS WRITE-OFF IS ARRANGED BEFORE THE CARE IS GIVEN WHEN POSSIBLE. IF THERE IS ANY SUBSIDY DONATED FOR THESE SERVICES, THAT AMOUNT IS DEDUCTED FROM THE GROSS AMOUNT. CATEGORY 2: UNPAID COST OF PUBLIC PROGRAMS - THIS AMOUNT REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PATIENTS IN THE MEDI-CAL PROGRAM AND ENROLLED IN HMO AND PPO PLANS UNDER CONTRACT WITH THE MEDI-CAL PROGRAM. CATEGORY 3: COMMUNITY BENEFIT - SERVICES THAT ARE BENEFICIAL TO THE BROADER COMMUNITY, IE., OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT THAT NEED SPECIAL SERVICES AND SUPPORT. EXAMPLES INCLUDE THE ELDERLY, SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH AIDS. THEY ALSO INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION, AND HEALTH CLINICS AND SCREENINGS. ALL CHARITY AMOUNT IS INCLUDED IN PART I, LINE 7.STATEMENT REGARDING BAD DEBT EXPENSE:THE POLICY OF EMANATE HEALTH IS TO PROVIDE OUR UNINSURED AND UNDERINSURED PATIENTS THE SAME ALLOWANCES PROVIDED TO ITS MANAGED CARE CONTRACTORS. THAT IS, THOSE PATIENTS SHALL HAVE APPLIED TO THEIR ACCOUNTS APPROPRIATE ALLOWANCES AND PER DIEM RATES. EMANATE HEALTH IS TO FOLLOW UP ON AND COLLECT ALL SELF PAY ACCOUNT BALANCES, AS WELL AS, WHERE THIRD PARTY BENEFITS EXIST, ALL PATIENT CO-PAYS AND DEDUCTIBLES, EITHER AT THE TIME OF SERVICE, OR WHEN THEY BECOME DUE. THIS SHALL BE ACCOMPLISHED IN A FAIR, CARING AND COMPASSIONATE MANNER. THE RESULTING NET REALIZABLE BALANCE ON THESE ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER ALL COLLECTION EFFORTS AND FOLLOW UP ATTEMPTS HAVE BEEN MADE. EMANATE HEALTH RECOGNIZES BAD DEBT EXPENSE BASED UPON ITS HISTORICAL EXPERIENCE. PART III, LINE 4: TEXT OF THE FOOTNOTE TO THE CONSOLIDATED FINANCIAL STATEMENTS REGARDING BAD DEBT EXPENSE:PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION EMANATE EXPECTS TO BE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS IN EXCHANGE FOR PROVIDING PATIENT CARE. PROVIDING PATIENT CARE SERVICES IS CONSIDERED A SINGLE PERFORMANCE OBLIGATION, SATISFIED OVER TIME, IN BOTH THE INPATIENT AND OUTPATIENT SETTING. GENERALLY, EMANATE BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER SERVICES ARE PERFORMED AND/OR WHEN THE PATIENT IS DISCHARGED FROM THE FACILITY. REVENUE FOR INPATIENT ACUTE CARE SERVICES IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED, OR ACTUAL, CHARGES. EMANATE MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE. AS ALL EMANATE'S PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, EMANATE ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN ACCOUNTING STANDARDS CODIFICATION (ASC) 606, REVENUE FROM CONTRACTS WITH CUSTOMERS, AND, THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY SATISFIED AT THE END OF THE REPORTING PERIOD, WHICH ARE PRIMARILY RELATED TO INPATIENT ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN THE PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD. FOR PATIENTS COVERED BY THIRD-PARTY PAYORS, EMANATE DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR GOODS AND SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THOSE THIRD-PARTY PAYORS. EMANATE DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE.LAWS AND REGULATIONS CONCERNING GOVERNMENT PROGRAMS, INCLUDING MEDICARE AND MEDICAID, ARE COMPLEX AND SUBJECT TO VARYING INTERPRETATIONS. EMANATE IS SUBJECT TO RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. IN ADDITION, THE CONTRACTS EMANATE HAS WITH COMMERCIAL PAYORS ALSO PROVIDE FOR A RETROACTIVE AUDIT AND REVIEW OF CLAIMS. SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE WITH THE PAYOR, AND EMANATE'S HISTORICAL SETTLEMENT ACTIVITY, ATTEMPTING TO ENSURE THAT A SIGNIFICANT REVENUE REVERSAL WILL NOT OCCUR WHEN THE FINAL AMOUNTS ARE SUBSEQUENTLY DETERMINED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS NEW INFORMATION BECOMES AVAILABLE, OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, PATIENTS COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH IS REFERRED TO AS THE PATIENT PORTION. EMANATE ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT FROM STANDARD CHARGES IN ACCORDANCE WITH ITS POLICIES. CONSISTENT WITH EMANATE'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, EMANATE HAS DETERMINED THAT IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES, SUCH AS COPAY AND DEDUCTIBLES. THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS EXPECTED TO BE COLLECTED BASED ON EMANATE'S COLLECTION HISTORY WITH THOSE PATIENTS IS RECORDED AS IMPLICIT PRICE CONCESSIONS, OR AS A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE. SUBSEQUENT ADJUSTMENTS THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT OR PAYOR'S ABILITY TO PAY ARE RECOGNIZED AS BAD DEBT EXPENSE. WITH THE ADOPTION OF ASC 606, BAD DEBT EXPENSE IS INCLUDED WITHIN OTHER EXPENSE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS, RATHER THAN AS A DEDUCTION TO ARRIVE AT REVENUE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2023 WAS NOT MATERIAL FOR EMANATE. EMANATE ESTIMATES THE TRANSACTION PRICE FOR THE PATIENT PORTION AND UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. PART III, LINE 8: MEDICARE COST REPORT WAS USED TO REPORT THE MEDICARE REVENUE AND MEDICARE ALLOWABLE COSTS. THE MEDICARE RAC (RECOVERY AUDIT CONTRACTORS) AMOUNT RETRACTED BY MEDICARE IN THE CURRENT YEAR FOR THE SERVICES PROVIDED TO THE MEDICARE PATIENTS IN THE PRIOR YEARS WAS NOT OFFSET AGAINST THE MEDICARE REVENUE IN THE CURRENT YEAR. MEDICARE ALLOWABLE COSTS TEND TO UNDERSTATE THE ACTUAL COSTS WHICH INCLUDED CERTAIN COST DISALLOWANCES AND NON-REIMBURSABLE COST CENTERS SUCH AS NON-ALLOWABLE PHYSICIAN FEES, CAFETERIA COSTS, MANAGED CARE OUTSIDE MEDICAL CLAIMS, HOME OFFICE'S MANAGEMENT FEES ADJUSTMENT, NON-ALLOWABLE MEALS, HOME OFFICE BUILDING COSTS, AND OTHER NON-ALLOWABLE EXPENSES. IF THE ESTIMATED ADDITIONAL ALLOCATED DISALLOWABLE MEDICARE COSTS OF $1,034,000 WERE INCLUDED IN LINE 5 AND LINE 6 RESPECTIVELY, THE (SHORTFALL) ON LINE 7 WOULD BE ($879,426). PART III, LINE 9B: EMANATE HEALTH OFFERS THE FOLLOWING COVERAGE OPTIONS WHICH ARE ALWAYS EXPLORED IN ASSESSING PATIENTS' ABILITY TO PAY:A) LINKAGE TO AVAILABLE STATE AID SUCH AS: (I) MEDI-CAL, (II) CALIFORNIA CHILDREN SERVICES, (III) COVERED CALIFORNIA, (IV) OTHERB) PATIENTS UNDER AGE TWENTY ONE YEARS, WHO ARE SELF PAY, SHALL BE REFERRED TO THE ONSITE MEDI-CAL ELIGIBILITY WORKER OR TO EITHER OF OUR CONTRACTED VENDORS FOR COMPLETION OF A MEDI-CAL APPLICATION AND/OR THE ON SITE GEM (GET ELIGIBILITY MOVING) PROGRAM.C) ALL OBSTETRICAL PATIENTS WHO ARE SELF PAY AND UNABLE TO MEET THEIR FINANCIAL OBLIGATION SHALL BE REFERRED TO THE ONSITE MEDI-CAL ELIGIBILITY WORKER OR TO EITHER OF OUR CONTRACTED VENDORS FOR COMPLETION OF A MEDI-CAL APPLICATION AND/OR THE ON SITE GEM PROGRAM.FOR THOSE PATIENTS WHO QUALIFY FOR CHARITY CARE ACCORDING TO EMANATE HEALTH'S CHARITY CARE POLICY, THE PATIENT ACCOUNTS WOULD BE WRITTEN OFF TO CHARITY AND THE PATIENTS WOULD NOT BE BILLED. PART VI, LINE 2: 2022 COMMUNITY HEALTH NEEDS ASSESSMENT:THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) ENACTED ON MARCH 23, 2010, INCLUDED NEW REQUIREMENTS FOR NONPROFIT HOSPITALS IN ORDER TO MAINTAIN TAX EXEMPT STATUS. THE PROVISION WAS THE SUBJECT OF FINAL REGULATIONS PROVIDING GUIDANCE ON THE REQUIREMENTS OF SECTION 501(R) OF THE INTERNAL REVENUE CODE. INCLUDED IN THE NEW REGULATIONS IS A REQUIREMENT THAT ALL NONPROFIT HOSPITALS MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND DEVELOP AN IMPLEMENTATION STRATEGY (IS) EVERY THREE YEARS. WHILE EMANATE HEALTH HAS CONDUCTED CHNAS FOR MANY YEARS TO IDENTIFY NEEDS AND RESOURCES IN OUR COMMUNITIES AND TO GUIDE OUR COMMUNITY BENEFIT PLANS, THESE NEW REQUIREMENTS HAVE PROVIDED AN OPPORTUNITY TO REVISIT OUR NEEDS ASSESSMENT AND STRATEGIC PLANNING PROCESSES WITH AN EYE TOWARD ENHANCING COMPLIANCE AND TRANSPARENCY AND LEVERAGING EMERGING TECHNOLOGIES. THE CHNA PROCESS UNDERTAKEN IN 2022 AND DESCRIBED IN THIS REPORT WAS CONDUCTED IN COMPLIANCE WITH CURRENT FEDERAL REQUIREMENTS. SUMMARY OF COMMUNITY IDENTIFIED NEEDS HEALTH OUTCOMES AND DRIVERS ALSO KNOWN AS SOCIAL DETERMINANTS OF HEALTH ARE INTERCONNECTED AND CAN NEGATIVELY OR POSITIVELY IMPACT INDIVIDUAL HEALTH. THEY INCLUDE SOCIAL AND ECONOMIC FACTORS THAT OFTEN CONTRIBUTE TO THE ABILITY OR INABILITY OF CERTAIN POPULATIONS OR GROUPS TO ACCESS THE NECESSARY CARE NEEDED TO DIAGNOSE, TREAT AND PREVENT POOR HEALTH. THEREFORE, IT IS IMPORTANT THAT THESE FACTORS BE TAKEN INTO CONSIDERATION WHEN DEVELOPING HEALTH STRATEGIES AND PROGRAMS TO ADDRESS HEALTH NEEDS. THE FOLLOWING IS A LIST OF 10 IDENTIFIED COMMUNITY NEEDS (HEALTH OUTCOMES AND SOCIAL DETERMINANTS OF HEALTH) THAT RESULTED FROM THE ANALYSIS OF PRIMARY AND SECONDARY DATA, OBSERVATIONS OF DISPARITIES, AND REVIEW OF THE PREVIOUS EMANATE HEALTH CHNA FINDINGS. ACCESS TO PREVENTATIVE CARE AND HEALTH CARE BIAS IN SYSTEMS CANCER CHRONIC DISEASE COVID-19 ECONOMIC INSECURITY FOOD INSECURITY HOUSING INSECURITY AND HOMELESSNESS MENTAL HEALTH OVERWEIGHT AND OBESITYSUMMARY OF NEEDS ASSESSMENT METHODOLOGY AND PROCESS IDENTIFICATION THE 2022 CHNA NEEDS ASSESSMENT METHODOLOGY AND PROCESS INVOLVED A MIXED-METHODS APPROACH THAT INCLUDED THE COLLECTION OF BOTH SECONDARY DATA AND PRIMARY DATA. SECONDARY DATA INDICATORS ON A VARIETY OF HEALTH, SOCIAL, ECONOMIC, AND ENVIRONMENTAL TOPICS WERE COLLECTED BY ZIP CODE, SERVICE PLANNING AREA (SPA)1, COUNTY, AND STATE LEVELS (AS AVAILABLE). IN MOST CASES, VALUES PRESENTED FOR THE EMANATE HEALTH SERVICE AREA WERE CALCULATED BY AGGREGATING VALUES OF SMALLER GEOGRAPHIC UNITS (E.G., ZIP CODES) WHICH FALL WITHIN THE SERVICE AREA BOUNDARY. WHEN ONE OR MORE GEOGRAPHIC UNITS ARE NOT ENTIRELY ENCOMPASSED BY A SERVICE AREA, THE MEASURE IS AGGREGATED PROPORTIONALLY. THE OPTIONS FOR WEIGHING "SMALL AREA ESTIMATIONS" ARE BASED ON TOTAL AREA, TOTAL POPULATION, AND DEMOGRAPHIC GROUP POPULATION. PRIMARY DATA COLLECTION CONSISTED OF REACHING OUT TO LOCAL PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND RESIDENTS TO IDENTIFY ISSUES THAT MOST AFFECTED THE HEALTH OF THE COMMUNITY. THE CHNA PROCESS ALSO INCLUDED AN IDENTIFICATION OF EXISTING COMMUNITY ASSETS AND RESOURCES TO ADDRESS THE IDENTIFIED HEALTH NEEDS. IN ORDER TO BE INCLUDED IN THE LIST OF IDENTIFIED HEALTH NEEDS, A HEALTH OUTCOME OR DRIVER HAD TO MEET TWO REQUIREMENTS: IT HAD TO BE MENTIONED IN THE PRIMARY DATA COLLECTION MORE THAN ONCE AND A SECONDARY DATA INDICATOR ASSOCIATED WITH THE HEALTH OUTCOME AND/OR DRIVER NEEDED TO PERFORM POORLY AGAINST A DESIGNATED BENCHMARK (COUNTY AVERAGE, STATE AVERAGE, OR HEALTHY PEOPLE 2030). PRIORITIZATION ON FEBRUARY OF 2023, TEN KEY COMMUNITY AND EMANATE HEALTH STAKEHOLDERS CAME TOGETHER TO REVIEW AND DISCUSS THE SIGNIFICANT COMMUNITY HEALTH NEEDS AND SOCIAL DETERMINANTS OF HEALTH THAT EMERGED OF THE CHNA. STAKEHOLDERS PARTICIPATED IN A PRIORITIZATION PROCESS TO PRODUCE A RECOMMENDATION AROUND THE SIGNIFICANT HEALTH NEEDS TO BE CONSIDERED BY EMANATE HEALTH OVER THE NEXT THREE YEARS (2023-2025). BY COMBINING THE COMMUNITY NEEDS GENERAL TRENDS, COMMUNITY INPUT, AND AVAILABLE ASSETS, THE COMMUNITY NEEDS THAT EMANATE HEALTH WILL ADDRESS IN THE NEXT THREE YEARS ARE: MENTAL HEALTH INEQUITY OF CARE - GET PEOPLE GET HEALTH INSURANCE AND ACCESS TO PREVENTATIVE CARE AND HEALTHCARE CREATING AND CULTIVATING COMMUNITY PARTNERSHIPS TO ADDRESS HOMELESSNESS, FOOD INSECURITY AND COVID-19 EFFECTS MATERNAL HEALTH AND INFANT MORTALITY DIABETES AND OBESITY COMMUNITY ASSETS AND RESOURCES COMMUNITY ASSETS AND RESOURCES TO ADDRESS THE EMERGING HEALTH NEEDS WERE IDENTIFIED THROUGH FOCUS GROUPS AND INTERVIEWS IN THE IDENTIFICATION PHASE OF THE PROCESS. STAKEHOLDERS WERE ASKED TO SHARE NAMES OF COMMUNITY ORGANIZATIONS, PROGRAMS, AND OTHER RESOURCES THEY KNEW OF AND/OR HAD EXPERIENCE WITH TO ADDRESS THE SPECIFIC HEALTH NEEDS. THESE INCLUDED HOSPITALS, CLINICS, HEALTH CENTERS, ASSOCIATIONS, COMMUNITY-BASED ORGANIZATIONS, FAITH-BASED ORGANIZATIONS, UNIVERSITIES, PUBLIC INITIATIVES AND HOTLINES. FOLLOWING THE IDENTIFICATION OF ASSETS, INTERNET RESEARCH WAS CONDUCTED TO VALIDATE EACH ASSET AND RESOURCE AND COLLECT UP-TO-DATE INFORMATION FOR EACH. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY ASSISTANCE:THE HOSPITAL EMPLOYS A VARIETY OF METHODS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY POSTING ITS CHARITY CARE POLICIES IN PUBLIC PLACES AND PROVIDING PATIENTS WITH WRITTEN NOTICE ABOUT THEIR FINANCIAL OPTIONS, INCLUDING THE AVAILABILITY OF DISCOUNTS, PAYMENT PLANS AND PUBLIC INSURANCE PROGRAMS SUCH AS MEDI-CAL, COVERED CALIFORNIA, ACCESS FOR INFANTS AND MOTHERS PROGRAM AND OTHER OPTIONS. SINCE 1991, EMANATE HEALTH'S GEM (GET ENROLLMENT MOVING PROJECT) HAS BEEN A LEADER IN THE SAN GABRIEL VALLEY IN CONNECTING FAMILIES AND INDIVIDUALS WITH ACCESS TO FREE OR LOW-COST HEALTH INSURANCE, AS WELL AS REFERRALS TO OTHER HEALTH ACCESS PROGRAMS FOR THE UNINSURED. THE GEM PROJECT PARTNERS, SCHOOLS, CHILD-CARE AGENCIES, CHURCHES, FAMILY RESOURCE CENTERS, CLINICS, COMMUNITY BASED ORGANIZATION, ETC. TO IDENTIFY UNINSURED CHILDREN AND ADULTS, AND PROVIDE INSURANCE ENROLLMENT SERVICES IN THE GEM OFFICE AND AT THE OFF-SITE COMMUNITY LOCATIONS. IN ADDITION, THE HOSPITAL HAS OUTREACH PROGRAMS TO LOW INCOME VULNERABLE POPULATIONS. EMANATE HEALTH ALSO SUPPORTS ECHO (EVERY CHILD'S HEALTH OPTION) PROGRAM WHICH PROVIDES URGENT AND SPECIALTY CARE TO UNINSURED CHILDREN. PART VI, LINE 4: COMMUNITY INFORMATION:EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL (FPH) TOGETHER WITH ITS AFFILIATE EMANATE HEALTH MEDICAL CENTER (EHMC) SERVES AN URBAN COMMUNITY OF NEARLY ONE MILLION PEOPLE IN THE SAN GABRIEL VALLEY. EHMC HAS TWO HOSPITALS: INTER-COMMUNITY HOSPITAL (ICH) IN COVINA AND QUEEN OF THE VALLEY HOSPITAL (QVH) IN WEST COVINA. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL (FPH), A FULLY ACCREDITED 105 BED NONPROFIT HOSPITAL, HAS PROUDLY SERVED THE COMMUNITIES OF GLENDORA, AZUSA, LA VERNE AND SAN DIMAS SINCE 1973. KEY SERVICES: FULL RANGE OF GENERAL ACUTE CARE SERVICES. EMANATE HEALTH OUTPATIENT DIABETES EDUCATION PROGRAM - RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION AS A CENTER OF EXCELLENCE FOR DIABETES EDUCATION. 37-BED DIABETES CARE UNIT. 13-BED CARL E. WYNN NEWBORN INN - STATE-OF-THE-ART, PRIVATE-ROOM MATERNITY CARE. 9-BED CORONARY CARE UNIT. 9-BED INTENSIVE CARE UNIT. 37-BED MEDICAL/SURGICAL CARE SERVICES. THE ARTHUR AND SARAH LUDWICK EMERGENCY CARE PAVILLION - 24-HOUR EMERGENCY SERVICES, FEATURING THE ONLY FAA-APPROVED HELIPORT BETWEEN SAN BERNARDINO AND ARCADIA WITH APPROXIMATELY 39,325 ER VISITS IN 2023.LITHOTRIPSY SERVICES. EMANATE HEALTH CENTERS FOR REHABILITATION SERVICES - OFFERING SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY SERVICES FOR CHILDREN AND ADULTS. THE HOSPITAL IS GOVERNED BY A 20-MEMBER BOARD OF DIRECTORS COMPRISED OF PHYSICIANS, BUSINESS AND COMMUNITY LEADERS. THE BOARD HAS THE OVERALL RESPONSIBILITY FOR THE MANAGEMENT OF THE HOSPITAL. TO CARRY OUT THIS RESPONSIBILITY, THE GOVERNING BODY PROVIDES FOR THE EFFECTIVE FUNCTIONING OF ACTIVITIES RELATED TO: DELIVERY OF PATIENT CARE, PERFORMANCE IMPROVEMENT, PATIENT SAFETY, RISK MANAGEMENT, MEDICAL STAFF CREDENTIALING, FINANCIAL MANAGEMENT, STRATEGIC PLANNING AND COMMUNITY BENEFIT.FPH'S MEDICAL STAFF CONSISTED OF 424 PHYSICIANS, OF WHICH 114 ARE MEMBERS OF ITS ACTIVE STAFF (DEFINED AS ADMITTING MORE THAN TWELVE PATIENTS PER YEAR). 85.5% OF THE TOTAL MEDICAL STAFF MEMBERS AND 94.7% OF THE ACTIVE MEDICAL MEMBERS WERE BOARD-CERTIFIED IN THEIR RESPECTIVE SPECIALTIES.THE SURPLUS FUNDS HELD BY THE HOSPITAL ARE USED TO FULFILL ITS MISSION AS AN INTEGRATED HEALTH CARE ORGANIZATION COMMITTED TO PROVIDING QUALITY HEALTH CARE SERVICES IN A COMPASSIONATE ENVIRONMENT FOR THE PEOPLE IN THE SURROUNDING COMMUNITIES BY OFFERING OUTREACH EDUCATION AND CHARITY CARE, INVESTING IN ADVANCED MEDICAL TECHNOLOGY AND MODERNIZING HOSPITAL FACILITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: EMANATE HEALTH, THE SOLE CORPORATE MEMBER OF EMANATE HEALTH MEDICAL CENTER (EHMC), EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL (FPH), EMANATE HEALTH HOSPICE (HOSPICE), AND EMANATE HEALTH FOUNDATION (FOUNDATION), PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT DESCRIBES SPECIFIC OUTREACH PROGRAMS AND SERVICES THAT SUPPORT AND PROVIDE CHARITY CARE AND EDUCATION AND PROMOTE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES SERVED BY FPH AND ITS AFFILIATE ORGANIZATIONS.EHMC OPERATES ACUTE CARE HOSPITALS WITH A TOTAL OF 516 LICENSED BEDS AND PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR THE COMMUNITIES SURROUNDING ITS TWO MEDICAL CENTER CAMPUSES: QUEEN OF THE VALLEY HOSPITAL (QVH) LOCATED IN WEST COVINA WITH 325 LICENSED BEDS, AND INTER-COMMUNITY HOSPITAL (ICH) LOCATED IN COVINA WITH 191 LICENSED BEDS. HOSPICE, LOCATED IN WEST COVINA, CALIFORNIA, OPERATES A 10 LICENSED BED SKILLED NURSING FACILITY AND IN HOME SERVICES FOR TERMINALLY ILL PATIENTS AND A HOME HEALTH AGENCY DOING BUSINESS AS EMANTE HEALTH HOME CARE. FOUNDATION PERFORMS THE FUND-RAISING AND TRUST ADMINISTRATION ACTIVITIES RELATED TO EMANATE HEALTH AND ITS AFFILIATES.COMMUNITY OUTREACH:EMANATE HEALTH IS AN ORGANIZATION RECOGNIZED FOR ITS OUTSTANDING COMMUNITY OUTREACH EFFORTS AND ACCOMPLISHMENTS. AN ORGANIZATION DEDICATED TO CREATING INNOVATIVE PARTNERSHIPS AMONG THE NUMEROUS HEALTH AND SOCIAL SERVICE ORGANIZATIONS IN OUR VALLEY, WITH MANY PARTICIPATING AGENCIES IN DIVERSE COLLABORATIVE RELATIONSHIP DEVOTED TO PROMOTING COMMUNITY HEALTH AND WELL-BEING.SOME HIGHLIGHTS INCLUDE EMANATE HEALTH'S GET ENROLLMENT MOVING PROGRAM (GEM). VOLUNTEERS AND EMANATE HEALTH STAFF MEMBERS WORK TOGETHER TO RECRUIT ELIGIBLE FAMILIES AND ENROLL THEM IN MEDI-CAL, COVERED CALIFORNIA, AND OTHER HEALTH ACCESS PROGRAMS. GEM ALSO CALLS ENROLLED INDIVIDUALS THREE SEPARATE TIMES TO CONFIRM ENROLLMENT, ENSURE UTILIZATION OF SERVICES AND TROUBLE SHOOT, AND TO PROVIDE ASSISTANCE AT RENEWAL TIME. GEM IS A PROJECT OF EMANATE HEALTH MANAGED BY COMMUNITY BENEFITS DEPARTMENT AND IT IS SUPPORTED BY FUNDING FROM THE L.A. COUNTY OF PUBLIC HEALTH DEPARTMENT. EMANATE HEALTH'S DIABETES PROGRAM PROVIDES FREE DIABETIC FOOT SCREENINGS FOR PATIENTS AND RESIDENTS EVERY MONTH. FREE SUPPORT GROUPS ARE OFFERED AT FOOTHILL EDUCATION CENTER IN GLENDORA AND EMANATE HEALTH DIABETES CENTER IN COVINA TO HELP RESIDENTS WITH THEIR CONCERNS, ACHIEVEMENTS AND CHALLENGES IN MANAGING THEIR DIABETES. THE LATINO COMMUNITY HAS ACCESS TO SPANISH LANGUAGE GROUPS LED BY A REGISTERED NURSE AND CERTIFIED DIABETES EDUCATOR. EMANATE HEALTH HAS BEEN PROACTIVE IN OFFERING OUTREACH AND EDUCATION THROUGHOUT THE COMMUNITY IN THE AFFORDABLE CARE ACT/MEDI-CAL EXPANSION AND MARKET PLACE. SINCE CONCEPTION, EVERY CHILD'S HEALTHY OPTION (ECHO) IS A COLLABORATIVE EFFORT INVOLVING EMANATE HEALTH, COORDINATED AND LEAD BY LOCAL SCHOOL DISTRICTS. THE ECHO PROGRAM HAS IN PLACE A CADRE OF VOLUNTEER HEALTH PROVIDERS WHO OFFER FREE URGENT CARE SERVICES IN VARIOUS SPECIALTIES; IT ENSURES THAT EVERY CHILD, REGARDLESS OF INCOME LEVEL, HAVE ACCESS TO URGENT QUALITY HEALTH CARE AND PROVIDES ENROLLMENT FOR THE CHILD IN HEALTH INSURANCE. OTHER IMPORTANT PROGRAMS THAT RECEIVE SUPPORT FROM EMANATE HEALTH ARE THE SAN GABRIEL VALLEY CONSORTIUM ON HOMELESSNESS AND FOOD FOR ALL COLLABORATIVE PROGRAM, SAN GABRIEL VALLEY HEALTH CONSORTIUM, AMONG OTHERS.AS A TEAM OF THE FOUR FINEST HEALTH CARE INSTITUTIONS IN THE REGION, OUR COLLECTIVE STRENGTHS ENABLE US TO CONTINUE THE COMMITMENT TO EXCELLENCE THE SAN GABRIEL VALLEY HAS COME TO KNOW AND TRUST. PART VI, LINE 7, REPORTS FILED WITH STATES CA 0 0 0 0 0 0 0 0 0 RAJESH SHARMA SEE SCH O PRESIDENT & CEO 0 983299 0 871600 0 556927 0 148824 0 14223 0 2574873 0 0 LEON CHOINERE SEE SCH O CFO 0 359812 0 114987 0 23220 0 5186 0 8440 0 511645 0 0 CHANDRA REDDY RSO/NUCLEAR MED TECH 244586 0 1000 0 752 0 11754 0 13718 0 271810 0 0 0 STANLEY KOZAKA PHARMACIST 231274 0 1500 0 1066 0 11180 0 21351 0 266371 0 0 0 JOANNE WEIGH DIRECTOR PERIOPERATIVE SVC 222656 0 15000 0 7336 0 8798 0 1182 0 254972 0 0 0 ALMIRA DUQUE CLINICAL LAB SPECIALIST 206088 0 1201 0 379 0 10222 0 7672 0 225562 0 0 0 RESTITUTO ESPADERO PHARMACIST 212398 0 1000 0 3122 0 0 0 72 0 216592 0 0 0 PART I, LINE 3 ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO - EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL IS AN AFFILIATE OF EMANATE HEALTH. ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO - EMANATE HEALTH USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO. PLEASE SEE ADDITIONAL EXPLANATION AT SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. 990 PART V LINE 7H THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES. CONSEQUENTLY THERE WERE NO FORMS 1098C FILED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS EMANATE HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THIS ORGANIZATION IS EMANATE HEALTH. THE MEMBER THROUGH THE BOARD OF DIRECTORS HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE ORGANIZATION'S SOLE MEMBER, EMANATE HEALTH. FORM 990, PART VI, SECTION B, LINE 11B STAFF ACCOUNTANTS, DIRECTOR OF FINANCE AND VICE PRESIDENT OF CORPORATE FINANCE REVIEW FORM 990 FOR ACCURACY AND COMPLETENESS UPON RECEIVING IT FROM THE CPA TAX PREPARER. FORM 990 IS FORWARDED TO LEON CHOINIERE, CFO, FOR THE FINAL REVIEW. TAX PREPARER PRESENTS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE FOR APPROVAL. BOARD DELEGATED REVIEW AND APPROVAL TO THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, KEY EMPLOYEES, AND MANAGEMENT ARE COVERED BY THE CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICT AND REVIEW OF CONFLICT ARE PERFORMED AT THESE VARIOUS LEVELS OF THE ORGANIZATION. APPROPRIATE ACTION DEPENDING ON THE CONFLICT IS TAKEN BY MANAGEMENT, KEY EMPLOYEES, AND THE BOARD. DISCLOSURE FORMS ARE REQUIRED ANNUALLY BY EACH MEMBER OF THE BOARD OF DIRECTORS, KEY EMPLOYEES, AND MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE PAY AT EMANATE HEALTH FOLLOWS MARKET-BASED PAY PRACTICES FOR HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND TYPE IN THE SOUTHERN CALIFORNIA AREA. SALARY RANGES FOR EXECUTIVES WORKING AT EMANATE HEALTH FACILITIES FALL WITHIN THE MIDDLE OF THE MARKET, JUST AS THEY DO FOR ALL EMPLOYEES OF OUR ORGANIZATION. EVERY POSITION IN THE ORGANIZATION HAS A SALARY RANGE ATTACHED TO IT THAT REPRESENTS WHAT OTHERS DOING A SIMILAR JOB IN OTHER ORGANIZATIONS ARE LIKELY TO BE PAID. THE LONG-STANDING PAY PHILOSOPHY FOR EMANATE HEALTH HAS BEEN TO POSITION OUR SALARY RANGES IN THE MIDDLE OF OUR LOCAL LABOR MARKET; WE DON'T WANT TO LAG THE LOCAL MARKET, NOR DO WE WANT TO LEAD THE MARKET, SINCE THAT IS NOT A STRATEGY WE CAN AFFORD TO SUSTAIN OVER TIME. WE RELY ON MARKET STUDIES TO DETERMINE WHERE OUR PAY PRACTICES ARE RELATIVE TO OTHER HOSPITALS IN SOUTHERN CALIFORNIA. FOR EXECUTIVE PAY, WE USE THE NATIONALLY-RECOGNIZED AND RESPECTED FIRM, HEWITT ASSOCIATES LLC, AN AON HEWITT COMPANY (AON), TO ANALYZE OUR EXECUTIVE PAY PROGRAM AND DETERMINE WHERE IT FALLS IN OUR MARKET. THIS STUDY IS PERFORMED EVERY OTHER YEAR. THE MOST RECENT EXECUTIVE COMPENSATION DATA IS DATED APRIL 18, 2023. AS PART OF THEIR EXECUTIVE COMPENSATION REVIEW, AON ALSO ISSUES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE PAY PROGRAM FOR A NOT-FOR-PROFIT ORGANIZATION LIKE OURS THAT IS SUBJECT TO THE REQUIREMENTS OF SECTION 4958 OF THE INTERNAL REVENUE CODE AND UNITED STATES TREASURY DEPARTMENT REGULATIONS. IN THEIR APRIL 18, 2023, OPINION LETTER, AON WROTE, "THIS LETTER IS TO INDICATE THAT WE HAVE REVIEWED THE CURRENT COMPENSATION LEVELS, STRUCTURE, AND ADMINISTRATION OF THE EXECUTIVE COMPENSATION PROGRAM AT EMANATE HEALTH. THE FOLLOWING REVIEW IS BASED UPON OUR COMPREHENSIVE REPORT ENTITLED: EMANATE EXECUTIVE COMPENSATION ASSESSMENT. THIS REPORT WAS PRESENTED TO THE COMPENSATION COMMITTEE ON APRIL 18TH AND DISCUSSED IN DETAIL. BASED UPON THIS REVIEW, WE FIND THEM IN SUBSTANTIAL COMPLIANCE WITH ALL CURRENT RULES, REGULATIONS, AND GUIDELINES GOVERNING EXECUTIVE COMPENSATION IN NOT-FOR-PROFIT (501.C) CORPORATIONS. FURTHER, THE LEVELS OF COMPENSATION AWARDED TO THE VARIOUS EXECUTIVES, BOTH IN TERMS OF OPPORTUNITY AND ACTUAL AMOUNTS, ARE CONSISTENT AND REASONABLE WITH PREVAILING MARKET TRENDS AND PRACTICES. LASTLY, THE GOVERNING PRACTICES OF THE COMPENSATION COMMITTEE ARE CONSISTENT WITH SARBANES-OXLEY GUIDELINES AND SECTION 4958 (INTERMEDIATE SANCTIONS) GUIDELINES FOR INDEPENDENCE." THE EXECUTIVE POSITIONS THAT ARE INCLUDED IN THE EXECUTIVE COMPENSATION REVIEW INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSE & CLINICAL EXECUTIVE (FPH/ICH), CHIEF NURSE & CLINICAL EXECUTIVE (QVH), AND CHIEF PEOPLE OFFICER. EMANATE HEALTH EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST EMANATE HEALTH IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVE REQUIRED TO ENABLE EMANATE HEALTH TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES EMANATE HEALTH SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND EMANATE HEALTH'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE AND REVENUE. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST AN AUDIT REPORT IS AVAILABLE AS REQUIRED. NO OTHER DOCUMENTS ARE AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS THE OFFICERS REPORTED ON PART VII OF FORM 990 AND SCHEDULE J RECEIVE THEIR ENTIRE COMPENSATION FROM EMANATE HEALTH. THE IRS INSTRUCTIONS TO FORM 990 REQUIRE THAT ALL COMPENSATION PAID BY A RELATED ORGANIZATION MUST BE DISCLOSED IN THE 990 RETURN FOR EACH AFFILIATED ENTITY. THEREFORE, THE OFFICER COMPENSATION REPORTED IN THE 990 RETURNS FOR EMANATE HEALTH MEDICAL CENTER, EMANATE HEALTH HOSPICE, EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL AND EMANATE HEALTH FOUNDATION, ALL ORGANIZATIONS RELATED TO EMANATE HEALTH, CONSTITUTE THE COMPENSATION PAID BY EMANATE HEALTH AND DOES NOT REPRESENT ADDITIONAL COMPENSATION TO SUCH OFFICERS. PART VII, SECTION A THE OFFICERS SERVE AS CORPORATE OFFICERS FOR EMANATE HEALTH, EMANATE HEALTH MEDICAL CENTER, (EHMC), EMANATE HEALTH HOSPICE (HOSPICE), EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL (FPH) AND EMANATE HEALTH FOUNDATION (FOUNDATION), ALL AFFILIATES OF THE TAXPAYER. THE NUMBER OF HOURS DEVOTED BY THE CORPORATE OFFICERS TO THE AFFILIATES ARE AS FOLLOWS. RAJESH SHARMA DEVOTED 14, 2, 2, AND 18 HOURS TO EHMC, HOSPICE, FOUNDATION, AND EMANATE HEALTH, RESPECTIVELY. LEON CHOINERE DEVOTED 14, 2, 2, AND 18 HOURS TO EHMC, HOSPICE, FOUNDATION, AND EMANATE HEALTH, RESPECTIVELY. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 2,142,015. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,142,015. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF RESTRICTED FUNDS 5,006,233. PASSTHROUGH INCOME DIFFERENCE -7,733. CHANGE IN BENEFICIAL INTEREST 1,895,786. TRANSFER FROM FOUNDATION -1,228. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS HAS CONSTITUTED AN AUDIT AND COMPLIANCE COMMITTEE AND DELEGATED TO THAT COMMITTEE THE RESPONSIBILITY FOR ENGAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. THIS STRUCTURE HAS BEEN IN EFFECT IN PRIOR YEARS AND WAS NOT CHANGED IN 2023. PART XII LINES 2B: THE FINANCIAL STATEMENTS OF EMANATE HEALTH AND ITS AFFILIATES, EMANATE HEALTH MEDICAL CENTER, EMANATE HEALTH HOSPICE, EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL, EMANATE HEALTH FOUNDATION, GLENDORA SURGERY CENTER, AND EMANATE HEALTH MSO WERE AUDITED ON A CONSOLIDATED BASIS. EMANATE HEALTH 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 953885523 EXEMPT ORGANIZATION SUPPORT & MANAGEMENT CA 501(C)(3) LINE 12B, II N/A 0 EMANATE HEALTH MEDICAL CENTER 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 956006469 ACUTE CARE HOSPITAL CA 501(C)(3) LINE 3 N/A 0 EMANATE HEALTH FOUNDATION 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 952534063 EXEMPT ORGANIZATION PUBLIC SUPPORT CA 501(C)(3) LINE 7 N/A 0 EMANATE HEALTH HOSPICE 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 953493611 HOME HEALTH & HOSPICE CARE CA 501(C)(3) LINE 10 N/A 0 GLENDORA SURGERY CENTER 315 E ROUTE 66 101 GLENDORA CA 91740 510492499 OUTPATIENT SURGERY CENTER CA N/A S 0 EMANATE HEALTH MSO 210 W SAN BERNARDINO ROAD COVINA CA 91723 812647150 MANAGEMENT SERVICES CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 EMANATE HEALTH MEDICAL CENTER O 875605 FAIR MARKET VALUE FORM 990, SCHEDULE R, PART V, NUMBER 2, CODE O: THE EXECUTIVE SALARIES ARE PROCESSED THROUGH EMANATE HEALTH. THE SALARIES REPORTED ON FORM 990 ARE PROCESSED THROUGH EMANATE HEALTH. EMANATE HEALTH ACTS AS A COMMON PAYMASTER FOR AFFILIATED ENTITIES, EMANATE HEALTH MEDICAL CENTER, EMANATE HEALTH FOUNDATION AND EMANATE HEALTH HOSPICE. EMANATE HEALTH FILED ONE FORM W-3 WHICH SHOWS A COMBINED NUMBER OF 3,808 EMPLOYEES. THE NUMBER OF EMPLOYEES FOR EACH ENTITY IS REPORTED SEPARATELY ON ITS OWN FORM 990 PART I LINE 5. EMANATE HEALTH MEDICAL CENTER'S FORM 990 REPORTED A TOTAL OF 3,011 EMPLOYEES, EMANATE HEALTH HOSPICE'S FORM 990 REPORTED 88 EMPLOYEES, EMANATE HEALTH FOUNDATION'S FORM 990 REPORTED 5 EMPLOYEES AND EMANATE HEALTH'S FORM 990 REPORTED 394 EMPLOYEES. THE FILING ORGANIZATION FILES ITS OWN FORM W-3, HOWEVER AMOUNTS REPORTED ON SCHEDULE R, PART V, NUMBER 2, CODE O REPRESENT SHARED EMPLOYEE EXPENSES THAT OCCUR BETWEEN THE AFFILIATES.