DAMERON HOSPITAL ASSOCIATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DAMERON HOSPITAL ASSOCIATION (EIN 94-1201197)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2023-03-16
- IRS object ID
- 202320759349301417
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-03-16T15:09:15-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3121 W MARCH LN STE 200 | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952192367 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941201197 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAMERON HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DAME | BusinessNameControlTxt |
| Phone | 2099445550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 WEST ACACIA STREET | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATIE DELMORE | PersonNm |
| Person Title | FINANCE OFFICER | PersonTitleTxt |
| Phone | 2099445550 | PhoneNum |
| Signature | 2023-03-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KATIE | PersonFirstNm |
| Person Last | DELMORE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TRACY S PAGLIA | PreparerPersonNm |
| PTIN | P00366884 | PTIN |
| Phone | 2099556100 | PhoneNum |
| Preparation | 2023-03-16 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERRI DAY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 WEST ACACIA STREET | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $165,619,967 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DAMERONHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1912 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | WE SUPPORT PHYSICIANS AND OUR EMPLOYEES IN PROVIDING QUALITY CARE IN A SAFE, CARING ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 696 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $81,800 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $51,402 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,708,790 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,331,117 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $136,381,259 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $159,159,873 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,231,050 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,454 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$241,700 | PYOtherRevenueAmt |
| CY Other Revenue | -$225,087 | CYOtherRevenueAmt |
| PY Total Revenue | $142,079,399 | PYTotalRevenueAmt |
| CY Total Revenue | $163,276,357 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $54,101,656 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,203,790 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $106,774,195 | PYOtherExpensesAmt |
| CY Other Expenses | $119,279,528 | CYOtherExpensesAmt |
| PY Total Expenses | $160,875,851 | PYTotalExpensesAmt |
| CY Total Expenses | $174,483,318 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$18,796,452 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$11,206,961 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $97,253,994 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,194,904 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $43,408,842 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $53,576,475 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,845,152 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $42,618,429 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE SUPPORT PHYSICIANS AND OUR EMPLOYEES IN PROVIDING QUALITY CARE IN A SAFE, CARING ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $150,362,626 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $158,758,693 | RevenueAmt |
| Desc | DAMERON HOSPITAL IS A JOINT COMMISSION ACCREDITED, 202-BED, NOT-FOR-PROFIT COMMUNITY HOSPITAL DELIVERING EXCELLENT HEALTHCARE TO GENERATIONS OF SAN JOAQUIN COUNTY RESIDENTS FOR OVER 100 YEARS AND IS A NATIONALLY RECOGNIZED AS A LEADER IN QUALITY AND SAFETY. DAMERON HOSPITAL STRIVES TO PROMOTE HEALING AND WELLNESS THROUGH COMPASSIONATE, QUALITY AND COST-EFFECTIVE CARE TO MEET THE IDENTIFIED NEEDS OF THE COMMUNITY WE SERVE. DAMERON HOSPITAL IS PROUD OF ITS PAST AND IS DEDICATED TO ITS FUTURE IN PROVIDING SERVICES TO THE COMMUNITY TO MEET THEIR HEALTHCARE NEEDS. IN KEEPING WITH A HEALTHIER COMMUNITY, DAMERON HOSPITAL IS A SMOKE-FREE, TOBACCO-FREE ENVIRONMENT.DAMERON HOSPITAL EXISTS SOLELY TO SERVE THE HEALTHCARE NEEDS OF THE GREATER STOCKTON AREA AND SAN JOAQUIN COUNTY, PROVIDING THE COMMUNITY WITH ADVANCED TECHNOLOGY AND STATE-OF-THE-ART DIAGNOSTIC AND THERAPEUTIC EQUIPMENT, AS WELL AS FACILITIES FOR INPATIENT, OUTPATIENT, OCCUPATIONAL SERVICES AND AMBULATORY CARE CENTER. DAMERON HOSPITAL OFFERS A BROAD ARRAY OF SERVICES FOR THE HEALTH MAINTENANCE FOR ALL AGE GROUPS.COMPREHENSIVE PATIENT SERVICES INCLUDE BARIATRIC, CARDIOLOGY, ORTHOPEDICS, EMERGENCY/URGENT CARE, AND IMAGING SPECIALTIES. | Desc |
| Total Program Service Expenses | $150,362,626 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 67 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 696 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KATIE DELMORE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2099445550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 W ACACIA ST | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| LARRY BEDNARZ | |||||||
| REGISTERED NURSE | 40.00 | Yes (X) | $250,863 | $0 | $22,498 | ||
| MARIA VILLARREAL | |||||||
| REGISTERED NURSE | 40.00 | Yes (X) | $242,202 | $0 | $29,643 | ||
| SHAUN FILLON | |||||||
| REGISTERED NURSE | 40.00 | Yes (X) | $233,583 | $0 | $28,981 | ||
| CECILIA JAVIER | |||||||
| SR. DIRECTOR, LABORATORY | 40.00 | Yes (X) | $222,701 | $0 | $28,387 | ||
| MELISSA DAY | |||||||
| SENIOR DIRECTOR NURSING | 40.00 | Yes (X) | $214,720 | $0 | $27,305 | ||
| WILLIAM TREZZA | |||||||
| CHAIRMAN OF THE BOARD | 10.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| DANIEL DIXON | |||||||
| VICE CHAIRMAN | 10.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| BRIAN MARTUCCI | |||||||
| SECRETARY | 10.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MICHAEL HAKEEM | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| KATHY LAGORIO-JANSSEN | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| HON RONALD NORTHUP | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| ERIC CORNWELL | |||||||
| CMO | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| TERRI DAY | |||||||
| PRESIDENT/CEO/INTERIM CFO | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| SANJEEV GOSWAMI | |||||||
| CHIEF OF STAFF | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| JASON WHITNEY | |||||||
| CFO (EFF. 1/21) | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,164,069 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $136,814 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 161 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL SOLUTIONS LLC | |||||
| PO BOX 310737 | DES MOINES | IA | 50331 | REGISTERED NURSING SERVICES | $5,172,878 |
| CEP AMERICA ANESTHESIA PC | |||||
| 2100 POWELL STREET SUITE 400 | EMERYVILLE | CA | 94608 | ANESTHESIOLOGIST SERVICES | $4,556,111 |
| PACIFIC HEART & VASCULAR MEDICAL | |||||
| 1801 E MARCH LANE STE D400 | STOCKTON | CA | 95210 | CARDIAC IMAGING PHYSICIAN SERVICES | $3,466,816 |
| ADVENTIST HEALTH SYSTEMWEST | |||||
| 1 ADVENTIST HEALTH WAY | ROSEVILLE | CA | 95661 | MANAGEMENT SERVICES | $2,982,014 |
| SOUND PHYSICIANS OF CALIF | |||||
| P O BOX 742936 | LOS ANGELES | CA | 90074 | HOSPITALIST PHYSICIAN SERVICES | $2,700,181 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,331,110 | GovernmentGrantsAmt |
| All Other Contributions | $7 | AllOtherContributionsAmt |
| Total Contributions | $4,331,117 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REV. | 621110 | $81,341,394 | $81,341,394 |
| MEDICAL/MEDICARE PYMTS | 621110 | $48,601,749 | $48,601,749 |
| HOSPITAL FEE | 621110 | $23,107,040 | $23,107,040 |
| CAFETERIA | 722210 | $369,971 | $369,971 |
| REBATES/REFUNDS | 621110 | $124,892 | $124,892 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,614,827 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,614,827 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $159,159,873 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,953 | TotalRevenueColumnAmt |
| Exclusion | $9,953 | ExclusionAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,204 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$2,204 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,204 | TotalRevenueColumnAmt |
| Exclusion | -$2,204 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $379,525 | SecuritiesAmt |
| Other | $500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $379,524 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1 | SecuritiesAmt |
| Other | $500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $501 | TotalRevenueColumnAmt |
| Exclusion | $501 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,588,860 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $1,961,882 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$373,022 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$401,180 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $28,158 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OTHER INCOME | 900099 | $96,497 | $96,497 | |
| INCOME FROM K-1 | 541900 | $53,642 | $53,642 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $150,139 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,276,357 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $158,758,693 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $81,800 | UnrelatedBusinessRevenueAmt |
| Exclusion | $104,747 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,620,735 | TotalAmt |
| Program Services | $33,373,776 | ProgramServicesAmt |
| Management And General | $3,246,959 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,031,609 | TotalAmt |
| Program Services | $955,801 | ProgramServicesAmt |
| Management And General | $75,808 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,268,542 | TotalAmt |
| Program Services | $12,435,873 | ProgramServicesAmt |
| Management And General | $1,832,669 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,282,904 | TotalAmt |
| Program Services | $2,979,003 | ProgramServicesAmt |
| Management And General | $303,901 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,982,014 | TotalAmt |
| Program Services | $1,377,981 | ProgramServicesAmt |
| Management And General | $1,604,033 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $484,720 | TotalAmt |
| Management And General | $484,720 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,803 | TotalAmt |
| Management And General | $294,803 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,937,121 | TotalAmt |
| Program Services | $36,276,890 | ProgramServicesAmt |
| Management And General | $6,660,231 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,266,899 | TotalAmt |
| Program Services | $29,980,531 | ProgramServicesAmt |
| Management And General | $286,368 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,171,238 | TotalAmt |
| Program Services | $522,677 | ProgramServicesAmt |
| Management And General | $7,648,561 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,544,257 | TotalAmt |
| Program Services | $2,300,688 | ProgramServicesAmt |
| Management And General | $243,569 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,269 | TotalAmt |
| Program Services | $9,911 | ProgramServicesAmt |
| Management And General | $15,358 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,229 | TotalAmt |
| Program Services | $50,975 | ProgramServicesAmt |
| Management And General | $2,254 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,474 | TotalAmt |
| Management And General | $27,474 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,971,633 | TotalAmt |
| Program Services | $5,971,633 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,275,912 | TotalAmt |
| Management And General | $1,275,912 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS PROVISION | $14,346,472 | $14,346,472 | |
| MEDI-CAL HOSPITAL FEE E | $9,769,118 | $9,769,118 | |
| DUES & SUBSCRIPTIONS | $127,747 | $11,297 | $116,450 |
| FOUNDATION | $1,622 | $1,622 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,483,318 | TotalAmt |
| Program Services | $150,362,626 | ProgramServicesAmt |
| Management And General | $24,120,692 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,534 | BOYAmt |
| EOY | $3,000 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,897,759 | BOYAmt |
| EOY | $1,460,851 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,258,494 | BOYAmt |
| EOY | $18,778,925 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,712,247 | BOYAmt |
| EOY | $3,763,062 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,932,225 | BOYAmt |
| EOY | $2,200,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $218,809,527 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $171,718,236 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,821,459 | BOYAmt |
| EOY | $47,091,291 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,761 | BOYAmt |
| EOY | $7,881 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,914 | BOYAmt |
| EOY | $395,890 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,944,601 | BOYAmt |
| EOY | $22,493,337 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,253,994 | BOYAmt |
| EOY | $96,194,904 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,140,265 | BOYAmt |
| EOY | $43,165,877 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,268,577 | BOYAmt |
| EOY | $10,410,598 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,408,842 | BOYAmt |
| EOY | $53,576,475 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,837,309 | BOYAmt |
| EOY | $42,610,586 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,843 | BOYAmt |
| EOY | $7,843 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,845,152 | BOYAmt |
| EOY | $42,618,429 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,253,994 | BOYAmt |
| EOY | $96,194,904 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$11,206,961 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$19,762 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,182,186 | OtherCostOrOtherBasisAmt |
| Book Value | $5,182,186 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $98,392,137 | OtherCostOrOtherBasisAmt |
| Depreciation | $65,299,634 | DepreciationAmt |
| Book Value | $33,092,503 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,560,764 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,450,451 | DepreciationAmt |
| Book Value | $110,313 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $105,010,233 | OtherCostOrOtherBasisAmt |
| Depreciation | $98,117,564 | DepreciationAmt |
| Book Value | $6,892,669 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,664,207 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,850,587 | DepreciationAmt |
| Book Value | $1,813,620 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $47,091,291 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| COST REPORT SETTLEMENT RECEIVABLE | $18,469,973 |
| DUE FROM MEDICAL GROUP | $4,023,364 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $22,493,337 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| RISK MANAGEMENT PROGRAMS | $4,940,047 |
| RETIREE MEDICAL LIABILITY | $4,669,551 |
| OTHER NONCURRENT LIABILITIES | $801,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,410,598 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 350.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 150.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $681,549 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $681,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,727,309 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,185,738 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,541,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15950 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,408,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,185,738 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,223,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,408,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,185,738 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,223,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16380 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $14,346,472 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $4,309,356 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,860,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $37,932,062 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,072,062 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAMERON HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 WEST ACACIA STREET | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DAMERONHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 030000024 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAMERON HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCH H PART VI - NEEDS ASSESSMENT | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SCH H PART VI - NEEDS ASSESSMENT | OtherWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | Yes (1) | OrganizationIncurExciseTaxInd |
| Form4720 Filed | Yes (1) | Form4720FiledInd |
| Excise Report Form4720 For All | $50,000 | ExciseReportForm4720ForAllAmt |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 350.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 150.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SCH H PART VI-PATIENT EDUC | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SCH H PART VI-PATIENT EDUC | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DAMERON HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 5: THE CHNA WAS A COLLABORATIVE EXAMINATION OF HEALTH IN SAN JOAQUIN COUNTY, UPDATING AND BUILDING ON WORK DONE IN PRIOR YEARS, INCLUDING MANY OF THE THEMES IDENTIFIED IN PREVIOUS CHNA CYCLES. THE 2019 CHNA PROCESS APPLIED A SOCIAL DETERMINANTS OF HEALTH FRAMEWORK AND EXAMINED SAN JOAQUIN COUNTY'S SOCIAL, ENVIRONMENTAL, AND ECONOMIC CONDITIONS THAT IMPACT HEALTH IN ADDITION TO EXPLORING FACTORS RELATED TO DISEASES, CLINICAL CARE, AND PHYSICAL HEALTH. 6 ANALYSIS OF THIS BROAD RANGE OF CONTRIBUTING FACTORS RESULTED IN IDENTIFICATION OF THE TOP HEALTH NEEDS FOR THE COUNTY. THE 2019 CHNA ASSESSED THE HEALTH ISSUES AND CONTRIBUTING FACTORS WITH GREATEST IMPACT AMONG VULNERABLE POPULATIONS THAT DISPROPORTIONATELY HAVE POORER HEALTH OUTCOMES ACROSS MULTIPLE HEALTH NEEDS. THE CHNA EXPLORED DISPARITIES FOR POPULATIONS RESIDING IN SPECIFIC GEOGRAPHIC AREAS REFERRED TO HERE AS "PRIORITY NEIGHBORHOODS", AS WELL AS DISPARITIES AMONG THE COUNTY'S DIVERSE ETHNIC POPULATIONS. THESE ANALYSES WILL INFORM INTERVENTION STRATEGIES TO PROMOTE HEALTH EQUITY. THE 2019 CHNA UTILIZED A MIXED-METHODS APPROACH. THE CORE TEAM, THE PUBLIC HEALTH SERVICES EPIDEMIOLOGISTS, AND AD LUCEM CONSULTING REVIEWED SECONDARY DATA AVAILABLE THROUGH KAISER PERMANENTE'S CHNA DATA PLATFORM AND COMPILED ADDITIONAL DATA FROM NATIONAL, STATEWIDE, AND LOCAL SOURCES TO PROVIDE A MORE COMPLETE PICTURE OF HEALTH IN SAN JOAQUIN COUNTY. THESE DATA WERE COMPARED TO BENCHMARK DATA AND ANALYZED TO IDENTIFY POTENTIAL AREAS OF NEED. IN ADDITION, AD LUCEM CONSULTING, IN CONCERT WITH THE CORE TEAM, COLLECTED PRIMARY DATA VIA KEY INFORMANT INTERVIEWS AND FOCUS GROUPS THAT OFFERED A WIDE RANGE OF OPINIONS ABOUT ISSUES THAT MOST IMPACT THE HEALTH OF THE COMMUNITY, AS WELL AS EXAMPLES OF EXISTING RESOURCES THAT WORK TO ADDRESS THOSE NEEDS, AND SUGGESTIONS FOR CONTINUED PROGRESS IN IMPROVING THESE ISSUES. THE ANALYZED QUANTITATIVE AND QUALITATIVE DATA WERE TRIANGULATED TO IDENTIFY THE TOP HEALTH NEEDS IN THE COUNTY. A SUMMARY HEALTH NEED PROFILE WAS THEN CREATED FOR EACH OF THESE. A MULTI-STEP PROCESS WAS CONDUCTED TO RANK THE HEALTH NEEDS INTO HIGHEST, MEDIUM AND LOWER PRIORITY. FIRST, PRIORITIES WERE COLLECTED FROM THE COMMUNITY-BASED ON: 1) RESPONSES TO A SURVEY WITH OLDER ADULTS DESIGNED TO CAPTURE THEIR PERSPECTIVES ON PRIORITY HEALTH NEEDS FACING THEIR COMMUNITIES; 2) A MEETING HELD WITH TRACY COMMUNITY RESIDENTS TO PRESENT THE SECONDARY AND PRIMARY DATA AND COLLECT THEIR INPUT ON PRIORITY HEALTH NEEDS; 3) THE RESULTS OF THE OLDER ADULT SURVEY AND TRACY COMMUNITY MEETING WERE SHARED WITH THE CHNA STEERING COMMITTEE, ALONG WITH THE HEALTH NEED PROFILES. FINAL HEALTH NEED PRIORITIZATION TOOK PLACE AT THIS MEETING, WHERE THE STEERING COMMITTEE REACHED CONSENSUS AS TO WHICH OF THE HEALTH NEEDS SHOULD BE A PRIORITY FOR ACTION. THIS PRIORITIZATION WAS BASED ON CRITERIA IDENTIFIED BY THE CORE TEAM. THESE METHODS, THE DATA COLLECTED AND THE RESULTING PRIORITIZED COMMUNITY HEALTH NEEDS ARE PRESENTED IN THIS REPORT AND IN THE APPENDICES. |
| DAMERON HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 6A: ADVENTIST HEALTH LODI MEMORIAL, COMMUNITY MEDICAL CENTERS, DIGNITY HEALTH ST. JOSEPH'S MEDICAL CENTER, FIRST 5 SAN JOAQUIN, HEALTH NET, HEALTH PLAN OF SAN JOAQUIN, KAISER PERMANENTE, SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES, AND SUTTER HEALTH |
| 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 V, SECTION B, LINE 10 | THE HOSPITAL FACILITY'S 2020 IMPLEMENTATION STRATEGY IS CURRENTLY POSTED AT THE URL PROVIDED, AND HAS BEEN ATTACHED TO THIS FILING AS THE STRATEGY MAY NOT HAVE BEEN POSTED FOR THE ENTIRE YEAR ON THE WEBSITE. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
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| 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 $ 14,346,472. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | * COMMUNITY SUPPORT- FREE INTERPRETER SERVICES FOR PATIENTS AND THEIR DESIGNATED SUPPORT PERSON.- TAXI/BUS TRANSPORTATION TO AND FROM THE HOSPITAL/CLINIC, IF NEEDED.* LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERSLEADERSHIP STOCKTON IS A PROGRAM DESIGNED TO INSPIRE A NEW GENERATION OF MEN AND WOMEN TO ASSUME LEADERSHIP ROLES IN THE COMMUNITY. THE NINE-MONTH PROGRAM CHALLENGES AND PREPARES INDIVIDUALS FROM DIVERSE BACKGROUNDS TO BECOME INFLUENTIAL IN THE REGION'S FUTURE. TO DEVELOP EDUCATED AND MOTIVATED COMMUNITY LEADER PARTICIPANTS ARE EXPOSED TO CIVIC, CIVIL, EDUCATION, HEALTHCARE AND NON-PROFIT ENTITIES. PARTICIPANTS HEARD FROM AREA HEALTHCARE LEADERS ABOUT THE CURRENT AND FUTURE STATE OF HEALTHCARE. DIANE VIGIL, DIRECTOR OF COMMUNITY BENEFITS PRESENTED ON BEHALF OF DAMERON HOSPITAL. THE ROUNDTABLE DISCUSSION ENABLED PARTICIPANTS TO LEARN ABOUT HOSPITAL AND HEALTHCARE FACILITIES LOCATED THROUGHOUT GREATER STOCKTON COMMUNITY. A QUESTION AND ANSWER PERIOD CONCLUDED THE FORUM.* HEALTHIER COMMUNITY COALITION:DAMERON HOSPITAL IS AN ACTIVE PARTICIPANT IN THE SAN JOAQUIN COUNTY HEALTHIER COMMUNITY COALITION. THE PURPOSES OF THE COALITION ARE: A) TO PROVIDE LEADERSHIP IN THE DEVELOPMENT AND COORDINATION OF HEALTH STATUS IMPROVEMENT EFFORTS IN SAN JOAQUIN COUNTY; B) TO PROVIDE A FORUM FOR HEALTH SERVICES STAKEHOLDERS TO SHARE IDEAS AND INFORMATION ABOUT PROJECTS AND SEEK COLLABORATIVE PARTNERS; AND C) TO WORK COLLABORATIVELY AND ENCOURAGE THE EFFORTS OF OTHER COLLABORATIVE ATTEMPTING TO RESPOND TO COMMUNITY HEALTH ISSUES AND PROBLEMS. DAMERON HOSPITAL COLLABORATED ON CREATING AN ALL-INCLUSIVE FREE AND CONFIDENTIAL SERVICE HELPLINE FOR LOCAL RESOURCES. THE 211 HELPLINE, LAUNCHED IN 2015, IS AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK. DAMERON STAFF HAS CO-CHAIRED THIS COALITION AND PARTICIPATED IN KEY LEADERSHIP ROLES SINCE 2011. ITS PURPOSE IS TO MAKE IT EASY FOR PEOPLE TO FIND THE HELP THEY NEED, WHEN THEY NEED IT. (HTTP://WWW.211.ORG)DAMERON HOSPITAL PARTICIPATED IN THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), WHICH IS PUBLICLY AVAILABLE AT HTTP://HEALTHTHIERSANJOAQUIN.ORG. ADDITIONAL DETAIL ABOUT IDENTIFIED NEEDS, DATA COLLECTED, COMMUNITY INPUT OBTAINED, AND PRIORITIZATION METHODS USED CAN BE FOUND IN THE CHNA REPORT. THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED ARE:1. OBESITY/DIABETES2. EDUCATION3. YOUTH DEVELOPMENT4. ECONOMIC SECURITY5. VIOLENCE AND INJURY6. SUBSTANCE USE7. ACCESS TO HOUSING8. ACCESS TO CARE9. MENTAL HEALTH10. ORAL HEALTH11. ASTHMA/AIR QUALLITYCOMMUNITY HEALTH IMPROVEMENT PLAN:DAMERON HOSPITAL'S COMMUNITY BENEFIT DIRECTOR PARTICIPATED IN CREATING THE SAN JOAQUIN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE CHIP PROCESS WAS GUIDED BY THE CHNA CORE PLANNING GROUP MADE UP OF NOT-FOR-PROFIT HOSPITALS, TWO MEDICAID MANAGED CARE PLANS, COMMUNITY MEDICAL CENTERS (FEDERALLY QUALIFIED HEALTH CENTERS), PUBLIC HEALTH SERVICES, FIRST 5 SAN JOAQUIN, AND COMMUNITY PARTNERSHIPS FOR FAMILIES. THE CHIP PROCESS ALSO ENGAGED ITS BROADLY REPRESENTATIVE CHNA STEERING COMMITTEE AS WELL AS ADDITIONAL SUBJECT MATTER EXPERTS, WHICH ALTOGETHER INCLUDED HEALTH AND SOCIAL SERVICE PROVIDERS, EDUCATORS, BEHAVIORAL HEALTH AND AFFORDABLE HOUSING ADVOCATES, LAW ENFORCEMENT OFFICERS, LAND USE AND TRANSPORTATION PLANNERS, AND POLICYMAKERS. THE PROCESS IDENTIFIED THREE PRIORITY ISSUES: HEALTHY EATING/ACTIVE LIVING, HIGH-QUALITY EDUCATION COMMUNITY SAFETY AND SOCIAL SUPPORTS.WITH THESE ISSUES SERVING AS THE FOUNDATION FOR THE CHIP, THE CORE PLANNING GROUP AND STEERING COMMITTEE DEVELOPED GOALS, OBJECTIVES, STRATEGIES, AND ACTION ITEMS FOR EACH PRIORITY. CHIP IS A RESOURCE FOR MULTIPLE PARTNERS AND COLLABORATORS IN OUR WORK TO SET PRIORITIES AND COORDINATE AND TARGET RESOURCES.*COMMUNITY HEALTH IMPROVEMENT ADVOCACY:1. DAMERON HAS OFFERED FLU SHOT CLINICS IN THE COMMUNITY.2. DAMERON'S LINACIA PHARMACY HAS PROVIDED PHARMACEUTICALS AT NO COST TO A NUMBER OF INDIGENT PATIENTS.3. DAMERON PROVIDES COMPLIMENTARY USE OF CLASROOMS FOR VARIOUS COMMUNITY EDUCATION AND SUPPORT GROUPS.4. DAMERON HAS A VOLUNTEER PROGRAM FOR COMMUNITY MEMBERS WILLING TO DONATE THEIR TIME IN A HEALTH CAREENVIRONMENT.5. DAMERON DONATES MATERIALS, EQUIPMENT AND SUPPLIES TO COMMUNITY GROUPS.6. DAMERON SPONSORS HEALTH-RELATED COMMUNITY EVENTS AND ACTIVITIES*WORKFORCE DEVELOPMENT:DECISION MEDICINE:THIS TWO-WEEK PROGRAM, SPONSORED BY SAN JOAQUIN MEDICAL SOCIETY, IS DESIGNED TO INTRODUCE HIGH SCHOOL STUDENTS TO THE FIELD OF MEDICINE THROUGH PERSONAL MENTORING OPPORTUNITIES AND SITE VISITS WITH BEHIND-THE-SCENES ACCESS TO SOME OF OUR REGIONAL HOSPITALS, CLINICS AND PUBLIC HEALTH CENTERS. DECISION MEDICINE 2018 TOOK PLACE AT VARIOUS LOCATIONS IN NORTHERN CALIFORNIA, INCLUDING HOSPITALS, VARIOUS CLINICS AND INSIDE ACTUAL PRIVATE OFFICES OF PARTICIPATING PHYSICIANS IN SAN JOAQUIN COUNTY. DAMERON HOSPITAL PROVIDED A FULL EIGHT-HOUR DAY OF STUDENT INTERACTIVE TOURS INTO THE CORE LABORATORY, THE PATHOLOGY LABORATORY, AND TOUR OF THE HOSPITAL DATA CENTER; DIDACTIC LECTURES ON BASIC HEMATOLOGY & COMPARATIVE CELLULAR MORPHOLOGY AND FORENSIC PATHOLOGY; LECTURE FROM STANFORD/DAMERON HEART PROGRAM SURGEON, DR. MARIA CURRIE; HANDS-ON LABORATORY EXERCISES FOR PHLEBOTOMY, BLOOD SPECIMEN PREPARATION, BLOOD SMEAR TECHNIQUE, DIFFERENTIAL STAINING TECHNIQUE, BLOOD SMEAR EXAMINATION BY LIGHT MICROSCOPY, AND BLOOD TYPING. IN ADDITION, STUDENTS WERE PROVIDED AN INDIVIDUAL COMPLETE BLOOD ANALYSIS (CBC), A PRELIMINARY ABO BLOOD GROUP DETERMINATION, HISTORICAL INFORMATION ABOUT DAMERON HOSPITAL AND CAREER INFORMATION IN PATHOLOGY AND LABORATORY MEDICINE. DAMERON HOSPITAL HOSTED TWENTY-FOUR STUDENTS (TWENTY-TWO GIRLS AND 2 BOYS) THAT INCLUDED LUNCH AND REFRESHMENTS THROUGHOUT THE DAY. THE COMMUNITY BENEFIT DIRECTOR COORDINATES THIS PROGRAM FOR DAMERON HOSPITAL. VOLUNTEERS INCLUDE A BOARD MEMBER, CHIEF INFORMATION OFFICER, TELEMETRY DIRECTOR, HOSPITAL EXECUTIVE LEADERSHIP TEAM MEMBER, LABORATORY MEDICAL DIRECTOR, LABORATORY MANAGER, SEVERAL CLINICAL LABORATORY SCIENTISTS, PATIENT RELATIONS COORDINATOR, AND HEALTH EDUCATOR. SAN JOAQUIN MEDICAL SOCIETY TRACKING OF DECISION MEDICINE GRADUATES HAS YIELDED ONE PRACTICING PHYSICIAN; ONE IN RESIDENCY, SEVENTEEN IN MED SCHOOL; TWO BS/MD PROGRAM; 90 PRE-MED MAJORS IN UNDERGRAD; TWO NURSING; TWO PHYSICIAN ASSISTANTS; AND TWO DENTIST.HEALTH CAREERS ACADEMY:THE HEALTH CAREERS ACADEMY (HCA) WAS ESTABLISHED IN 2011 BY THE STOCKTON UNIFIED SCHOOL DISTRICT TO MEET THE GROWING COMMUNITY NEED FOR HEALTHCARE CLINICIANS IN STOCKTON AND THE GREATER SAN JOAQUIN COUNTY. HCA HAS A STUDENT POPULATION OF 497 STUDENTS WITH A SENIOR CLASS OF 121. THE GOAL OF HCA IS TO PRODUCE STUDENTS WHO HAVE BEEN CHALLENGED WITH A RIGOROUS COLLEGE PREP CURRICULUM, AS WELL AS TEACHING THEM HEALTH CAREER TECHNICAL SKILLS. STUDENTS ARE PROVIDED WITH COMMUNITY SERVICE OPPORTUNITIES TO GAIN BETTER SENSE OF COMMUNITY AWARENESS AND ARE EXPOSED TO VARIOUS MEDICAL PROFESSIONS DURING THEIR PRN ROUNDS. UPON GRADUATION, THEY LEAVE PREPARED TO JOIN THE WORKFORCE; PURSUE FURTHER HEALTH RELATED VOCATIONAL TRAINING; OR ATTEND A FOUR-YEAR COLLEGE. DAMERON HOSPITAL STAFF IS COMMITTED TO OFFERING SPEAKERS, MENTORS AND PARTICIPATE IN MOCK INTERVIEW AT THE REQUEST OF THE HCA. OUR COMMUNITY BENEFIT DIRECTOR SERVES ON THE HCA COMMUNITY COMMITTEE TO ENHANCE THE LEARNING EXPERIENCES OF OUR FUTURE HEALTH CARE PROFESSIONS. 2019 MARKS THE FIRST GRADUATING CLASS YIELDING A MED SCHOOL GRADUATE.ASSOCIATION OF CALIFORNIA NURSE LEADERS (ACNL):THIS ASSOCIATION WAS CREATED AND IS EMBRACED BY NURSE LEADERS THROUGHOUT CALIFORNIA. ITS MISSION IS TO DEVELOP NURSE LEADERS; ADVANCE PROFESSIONAL PRACTICE; INFLUENCE HEALTH POLICY; AND PROMOTE QUALITY AND PATIENT SAFETY. WITH HEALTH CARE REFORM, IMPLEMENTATION OF THE IOM FUTURE OF NURSING INITIATIVES, PROFESSIONAL PRACTICE ISSUES AND REGULATORY MANDATES, CHALLENGES AND OPPORTUNITIES FOR NURSE LEADERS HAVE NEVER BEEN GREATER. ACNL HELPS NURSE LEADERS ADDRESS THESE ISSUES TOGETHER. ACNL PROVIDES ESSENTIAL INFORMATION, STATEWIDE NETWORKING WITH PEERS, PROGRESSIVE LEADERSHIP DEVELOPMENT PROGRAMS AND TIMELY EDUCATIONAL ACTIVITIES. DAMERON HOSPITAL'S NURSING DIRECTORS ARE MEMBERS OF THE NORTH CENTRAL CHAPTER THAT INCLUDES MONTHLY CHAPTER MEETINGS, PARTICIPATION IN ACNL PROJECTS AND SPONSORING ANNUAL ACNL CONFERENCES. DAMERON HOSPITAL CONTINUED ITS ACNL MEMBERSHIP AND ACTIVE PARTICIPATION THROUGH 2018. |
| PART III, LINE 4: | THE ORGANIZATION DETERMINES THE AMOUNT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BASED UPON A QUERY OF THE COLLECTIONS SYSTEM (GOLDEN STATE COLLECTIONS) - 10% OF ESTIMATED BAD DEBT EXPENSE.ANY DISCOUNTS AND/OR PAYMENTS APPLIED TO A PATIENT'S ACCOUNT ARE NOT REVERSED BEFORE WRITING THE ACCOUNT OFF TO BAD DEBT. IN OTHER WORDS, THE NET BALANCE OF THE ACCOUNT IS WHAT'S WRITTEN OFF.BAD DEBT EXPENSE IS NOT INCLUDED AS A COMMUNITY BENEFIT IN THE HOSPITAL'S COMMUNITY BENEFIT REPORT.BAD DEBT EXPENSE FOOTNOTE - SEE AUDITED FINANCIAL STATEMENTS, PAGE 7 AND 8, FOOTNOTE 1, PATIENT ACCOUNTS RECEIVABLE SECTION. |
| PART III, LINE 8: | IF MEDICARE DOES NOT REIMBURSE OUR COSTS FOR PATIENT CARE, THE EXCESS OF COST OVER REIMBURSEMENT SHOULD BE CONSIDERED A BENEFIT TO THE COMMUNITY WE SERVE.MEDICARE USES THE MEDICARE COST REPORT PROGRAM IN COMPUTING THE COST IN PROVIDING MEDICAL CARE SERVICES FOR MEDICARE BENEFICIARIES. THE MEDICARE COST REPORT CALCULATES ROUTINE COSTS USING PER DIEM METHODOLGY AND THE ANCILLARY COST IS CALCULATED USING COST TO CHARGE RATIOS. |
| PART III, LINE 9B: | IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE AND DISCOUNTED PAYMENT POLICY, PATIENTS WILL BE MADE AWARE OF THE AVAILABILITY OF CHARITY CARE AND DISCOUNTED PAYMENT OPTIONS ON THE HOSPITAL'S WEBSITE, AT ALL POINTS OF REGISTRATION IN THE HOSPITAL, AS WELL AS IN CONNECTION WITH BILLING STATEMENTS ISSUED BY THE HOSPITAL.THE PATIENT ACCOUNTING DEPARTMENT SENDS THE RESPONSIBLE PARTY A FINAL BILL AT LEAST 90 DAYS FROM THE DATE THE HOSPITAL PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT, INFORMING THE RESPONSIBLE PARTY OF THE HOSPITAL'S CHARITY CARE AND DISCOUNTED PAYMENT POLICY, A PLAIN LANGUAGE SUMMARY OF THAT POLICY AND THE PATIENT'S RIGHTS, AS REQUIRED UNDER CALIFORNIA HEALTH AND SAFETY CODE SECTION 127430(A), THE PHONE NUMBER THE RESPONSIBLE PARTY CAN CALL FOR MORE INFORMATION IF INTERESTED IN APPLYING, THE COLLECTIONS ACTIONS THAT MAY BE PURSUED IN THE EVENT OF NONPAYMENT, AND THE DEADLINE FOR WHEN THOSE ACTIONS MAY BE COMMENCED (SUCH DEADLINE TO BE AT LEAST 30 DAYS FROM THE DATE OF THE FINAL BILL IS SENT). THE PATIENT ACCOUNTING DEPARTMENT WILL ALSO ATTEMPT TO CALL OR OTHERWISE ORALLY INFORM THE RESPONSIBLE PARTY OF THE HOSPITAL'S CHARITY CARE AND DISCOUNTED PAYMENT POLICY AND HOW THE RESPONSIBLE PARTY MAY OBTAIN ASSISTANCE WITH THE APPLICATION PROCESS. THE RESPONSIBLE PARTY IS REQUESTED TO FORWARD ANY INSURANCE INFORMATION OR TO MAKE PAYMENT OR SUBMIT AN APPLICATION UNDER THE CHARITY CARE AND DISCOUNTED PAYMENT POLICY WITHIN THE STATED DEADLINE OR THE ACCOUNT MAY BE REFERRED TO COLLECTIONS. COLLECTIONS ACTIONS MAY INCLUDE ENGAGING A COLLECTION AGENCY TO ASSIST WITH OBTAINING PAYMENT, REPORTING THE PATIENT'S ACCOUNT TO A CONSUMER CREDIT REPORTING AGENCY, DEFERRING, DENYING OR REQUIRING A PAYMENT BEFORE PROVIDING ELECTIVE, NON-MEDICALLY NECESSARY SERVICES BECAUSE OF THE PATIENT'S NONPAYMENT OF ONE OR MORE BILLS FOR PREVIOUSLY PROVIDED CARE, COMMENCING A CIVIL ACTION AGAINST THE PATIENT FOR NONPAYMENT, WAGE GARNISHMENT, BANK GARNISHMENT AND ABSTRACT LIENS ON REAL PROPERTY AS WELL AS BUSINESS GARNISHMENT IF RESPONSIBLE PARTY IS THE BUSINESS OWNER. HOWEVER, FOR A PATIENT THAT LACKS COVERAGE, THE HOSPITAL, ANY ASSIGNEE OF THE HOSPITAL, OR OTHER OWNER OF THE PATIENT DEBT, INCLUDING A COLLECTION AGENCY, WILL NOT REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY OR COMMENCE CIVIL ACTION AGAINST THE PATIENT FOR NONPAYMENT AT ANY TIME PRIOR TO 150 DAYS AFTER THE INITIAL BILLING. THIS PERIOD SHALL BE EXTENDED IF THE PATIENT HAS A PENDING APPEAL FOR COVERAGE OF THE SERVICES UNTIL A FINAL DETERMINATION OF THE APPEAL IS MADE.IF THE RESPONSIBLE PARTY REQUESTS FINANCIAL ASSISTANCE, THE REQUEST IS FORWARDED TO THE CREDIT AND COLLECTIONS DEPARTMENT AND THE PATIENT IS SENT AN APPLICATION UNDER THE CHARITY CARE AND DISCOUNTED PAYMENT POLICY IDENTIFYING THE CHARITY PROCESS AND THE DOCUMENTATION REQUIRED FOR PROCESSING. THE RESPONSIBLE PARTY IS GIVEN 30 DAYS TO COMPLETE AND RETURN THE APPLICATION AND SUPPORTING DOCUMENTS. IF THE COLLECTIONS PROCESS HAS ALREADY BEGUN, IT SHALL BE SUSPENDED DURING THIS TIME. IF AN INCOMPLETE APPLICATION IS RECEIVED, THE HOSPITAL WILL PROVIDE WRITTEN NOTICE DESCRIBING ADDITIONAL INFORMATION NEEDED AND WILL PROVIDE THE CONTACT INFORMATION, INCLUDING THE TELEPHONE NUMBER AND OFFICE LOCATION, OF A PERSON WHO CAN PROVIDE INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE AND DISCOUNTED PAYMENT POLICY AND ASSISTANCE WITH COMPLETING THE APPLICATION.COLLECTIONS SHALL REMAIN SUSPENDED UNTIL A DETERMINATION OF ELIGIBILITY IS MADE OR THE HOSPITAL HAS DETERMINED, AFTER A REASONABLE PERIOD OF TIME, THE PATIENT HAS FAILED TO RESPOND TO REQUESTS FOR ADDITIONAL INFORMATION TO COMPLETE THE APPLICATION. IF A COMPLETE APPLICATION IS RECEIVED, THE HOSPITAL WILL DETERMINE THE PATIENT'S ELIGIBILITY AND WILL NOTIFY THE PATIENT IN WRITING OF THE DETERMINATION AND THE BASIS FOR THE DETERMINATION. IF THE PATIENT IS DETERMINED TO BE ELIGIBLE FOR ASSISTANCE UNDER THE CHARITY CARE AND DISCOUNTED PAYMENT POLICY, (1) IF SUCH ASSISTANCE IS IN THE FORM OF A DISCOUNT, THE PATIENT WILL RECEIVE A BILLING STATEMENT THAT INDICATES THE AMOUNT OWED, HOW THAT AMOUNT WAS DETERMINED, AND STATES OR DESCRIBES HOW THE PATIENT CAN OBTAIN INFORMATION REGARDING THE AMOUNT GENERALLY BILLED ("AGB") FOR THE CARE PROVIDED, AND (2) THE PATIENT WILL BE REFUNDED ANY AMOUNTS PAID OVER THE AMOUNT FOR WHICH THE PATIENT HAS BEEN DETERMINED UNDER THE CHARITY CARE AND DISCOUNTED PAYMENT POLICY TO BE RESPONSIBLE. THE HOSPITAL SHALL FURTHER TAKE ALL REASONABLY AVAILABLE MEASURES TO ADDRESS ANY ADVERSE INFORMATION REPORTED TO CREDIT REPORTING AGENCIES. THE HOSPITAL WILL ACCEPT APPLICATIONS UNDER THE CHARITY CARE AND DISCOUNTED PAYMENT POLICY UNTIL 240 DAYS FROM THE DATE THE HOSPITAL PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT.EXTENDED PAYMENT PLANS FOR THE AMOUNT OWED MAY BE ARRANGED FOR THOSE UNABLE TO PAY THEIR ACCOUNT IN FULL PURSUANT TO THE HOSPITAL'S CHARITY CARE AND DISCOUNTED PAYMENT POLICY. REQUESTS FOR PAYMENT PLANS EXCEEDING THE HOSPITAL'S SCHEDULE MAY BE REFERRED TO THE HOSPITAL'S DESIGNEE FOR HANDLING. IF THE ACCOUNT IS NOT PAID OR SATISFACTORY PAYMENT ARRANGEMENTS MADE, THE ACCOUNT IS SENT FOR PRE-COLLECTION TO THE CREDIT AND COLLECTIONS DEPARTMENT OR ITS DESIGNEE, AS DESCRIBED IN THE CHARITY CARE AND DISCOUNTED PAYMENT POLICY. THE HOSPITAL MAY DECLARE AN EXTENDED PAYMENT PLAN (INCLUDING A REASONABLE PAYMENT PLAN) INOPERATIVE IF THE PATIENT FAILS TO MAKE ALL CONSECUTIVE PAYMENTS DURING A 90-DAY PERIOD. BEFORE DECLARING AN EXTENDED PAYMENT PLAN INOPERATIVE, THE HOSPITAL, COLLECTION AGENCY OR ASSIGNEE SHALL MAKE A REASONABLE ATTEMPT TO CONTACT THE PATIENT BY TELEPHONE, GIVE WRITTEN NOTICE THAT THE EXTENDED PAYMENT PLAN MAY BECOME INOPERATIVE, AND INFORM THE PATIENT THAT S/HE MAY RENEGOTIATE THE TERMS OF THE PAYMENT PLAN. |
| PART VI, LINE 2: | THE HOSPITAL'S CHNA AND 2020 IMPLEMENTATION STRATEGY ARE POSTED ON THE HOSPITAL'S WEBSITE AT:WWW.DAMERONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/DAMERON HOSPITAL IS A MEMBER OF THE SAN JOAQUIN COUNTY COMMUNITY HEALTH ASSESSMENT COLLABORATIVE (SJC2HAC), WHICH IS RESPONSIBLE FOR PRODUCING AND RELEASING, EVERY THREE YEARS, THE HEALTHIER SAN JOAQUIN COUNTY COMMUNITY ASSEMENT. THE SAN JOAQUIN COUNTY 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PRESENTS A COMPREHENSIVE PICTURE OF COMMUNITY HEALTH THAT ENCOMPASSES THE CONDITIONS THAT IMPACT HEALTH IN OUR COUNTY. THE OVERALL GOAL IS TO INFORM AND ENGAGE LOCAL DECISION-MAKERS, KEY STAKEHOLDERS, AND THE COMMUNITY-AT-LARGE IN EFFORTS TO IMPROVE THE HEALTH AND WELL-BEING OF ALL SAN JOAQUIN COUNTY RESIDENTS.THE SAN JOAQUIN COUNTY COMMUNITY HAS A LONG TRADITION OF WORKING COLLABORATIVELY AND HAS CONDUCTED A JOINT TRIENNIAL CHNA FOR MANY YEARS. THIS COLLABORATIVE EFFORT STEMS FROM A DESIRE TO ADDRESS LOCAL NEEDS AND A DEDICATION TO IMPROVING THE HEALTH OF EVERYONE IN THE COMMUNITY.SAN JOAQUIN COUNTY WILL USE THE RESULTS OF THIS CHNA TO DRIVE THE DEVELOPMENT OF A JOINT COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), WHICH WILL IDENTIFY LONG-TERM, SYSTEMATIC STRATEGIES AND ACTIONS TO ADDRESS HEALTH NEEDS. COMMUNITY PARTNERS ACROSS THE COUNTY WILL WORK TOGETHER TO SET PRIORITIES AND COORDINATE AND TARGET RESOURCES. THE 2019 CHNA REPORT WILL BE AVAILABLE AT: WWW.HEALTHIERSANJOAQUIN.ORG.ADDITIONALLY, THE HOSPITALS INVOLVED IN THE CHNA WILL EACH DEVELOP AN IMPLEMENTATION PLAN TO OUTLINE HOW THEY WILL BE ADDRESSING PRIORITY HEALTH NEEDS. THESE STRATEGIES WILL BUILD ON A HOSPITAL'S OWN ASSETS AND RESOURCES, AS WELL AS ON EVIDENCE-BASED STRATEGIES AND BEST PRACTICES, WHEREVER POSSIBLE. THEIR IMPLEMENTATION STRATEGIES (IS) WILL BE FILED WITH THE INTERNAL REVENUE SERVICE. BOTH THE CHNA AND THE IMPLEMENTATION STRATEGIES, ONCE FINALIZED, WILL BE POSTED PUBLICLY ON EACH OF THE HOSPITALS' WEBSITES. |
| 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/THE HOSPITAL SHALL OFFER A PAPER COPY OF A PLAIN LANGUAGE SUMMARY OF THIS POLICY TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS, INCLUDING FOR INDIVIDUALS WHO RECEIVED EMERGENCY OR OUTPATIENT CARE AND WERE NEVER ADMITTED AS INPATIENTS. A CONSPICUOUS WRITTEN NOTICE ON BILLING STATEMENTS WILL NOTIFY AND INFORM RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THIS POLICY. SUCH NOTICE SHALL PROVIDE THE TELEPHONE NUMBER OF THE HOSPITAL'S DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE POLICY AND THE APPLICATION PROCESS AND THE DIRECT WEBSITE ADDRESS WHERE COPIES OF THE FAP, FINANCIAL ASSISTANCE APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY MAY BE OBTAINED. SIGNAGE REGARDING THE POLICY, HOW TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND HOW TO OBTAIN COPIES OF THE POLICY, THE FINANCIAL ASSISTANCE APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY, IS POSTED AT ALL POINTS OF REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT, THE BILLING OFFICE, THE ADMISSIONS OFFICE AND OTHER OUTPATIENT SETTINGS. PRIOR TO COMMENCING COLLECTION ACTIVITIES, THE HOSPITAL OR ITS DESIGNEE SHALL PROVIDE THE PATIENT WITH WRITTEN NOTICE CONTAINING A PLAIN LANGUAGE SUMMARY OF THE PATIENT'S RIGHTS PURSUANT TO CALIFORNIA HEALTH AND SAFETY CODE SECTION 127430(A), AND A STATEMENT THAT NONPROFIT CREDIT COUNSELING SERVICES MAY BE AVAILABLE IN THE AREA.THE HOSPITAL WILL, IN ADDITION TO INFORMING PATIENTS ABOUT THIS POLICY, NOTIFY AND INFORM MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THIS POLICY AS WELL AS HOW OR WHERE TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS AND TO OBTAIN COPIES OF THE FAP, FINANCIAL ASSISTANCE APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY. THE HOSPITAL WILL MAKE THIS POLICY, THE FINANCIAL ASSISTANCE APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE THAT THE HOSPITAL DETERMINES IS SPOKEN BY POPULATIONS IN THE COMMUNITY WITH LIMITED ENGLISH PROFICIENCY CONSTITUTING THE LESSER OF 1,000 INDIVIDUALS OR 5 PERCENT OF THE COMMUNITY SERVED BY THE HOSPITAL. HOSPITAL FINANCIAL COUNSELORS WILL ATTEMPT TO CONTACT REGISTERED INPATIENTS DURING THEIR HOSPITAL STAY TO ASSESS PATIENTS' NEEDS AND IDENTIFY THOSE PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL MAY UTILIZE INTERNAL STAFF OR THIRD PARTY AGENTS TO ASSIST PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE PROGRAMS FUNDED BY CITY, COUNTY, STATE OR FEDERAL PROGRAMS. |
| PART VI, LINE 4: | I. GEOGRAPHIC DESCRIPTION OF THE COMMUNITY SERVEDSAN JOAQUIN COUNTY CONTAINS BOTH RURAL AND URBAN AREAS. COMMUNITIES AND CITIES MAINTAIN THEIR UNIQUE GEOGRAPHIC IDENTITIES, SEPARATED BY AGRICULTURE AND OPEN SPACE LANDS. THE COUNTY INCLUDES SEVEN INCORPORATED CITIES STOCKTON, TRACY, MANTECA, LODI, LATHROP, RIPON AND ESCALON AS WELL AS MANY SMALL WELL-ESTABLISHED RURAL COMMUNITIES IN THE UNINCORPORATED AREAS.II. DEMOGRAPHIC PROFILE OF THE COMMUNITY SERVEDTABLE 1. DEMOGRAPHIC PROFILE - SAN JOAQUIN COUNTYRACE/ETHNICITY SOCIOECONOMIC DATATOTAL POPULATION 779,233 LIVING IN POVERTY (<100% FEDERALPOVERTY LEVEL)13.6%ASIAN 18.5% BLACK 8.3% HISPANIC/LATINO1 43% NATIVE AMERICAN/ALASKA NATIVE 2.1% PACIFIC ISLANDER/NATIVE HAWAIIAN 0.9%MULTIPLE RACES 5.6%WHITE ALONE 64.5%UNEMPLOYMENT 9.6%UNINSURED POPULATION 6% |
| PART VI, LINE 5: | IN ADDITION TO OUR MEDICAL SERVICES AND PROGRAMS, DAMERON HOSPITAL ALSO OFFERS THE FOLLOWING COMMUNITY BENEFIT AND OUTREACH SERVICES: - VOLUNTEER PROGRAM FOR COMMUNITY MEMBERS WILLING TO DONATE THEIR TIME IN A HEALTH CARE ENVIRONMENT - SPONSORSHIP OF HEALTH-RELATED COMMUNITY EVENTS AND ACTIVITIES- EMPLOYEE VOLUNTEER TIME - TAXI/BUS TR OF MATERIALS, EQUIPMENT AND SUPPLIES TO COMMUNITY GROUPSANSPORTATION TO AND FROM THE HOSPITAL/CLINIC, IF NEEDED MEDICAL EDUCATION FOR COMMUNITY PHYSICIANS - REFERRAL SERVICE TO COMMUNITY SUB-SPECIALTIES AT TERTIARY CENTERS, FOR POPULATION AGE 21 OF UNDER - 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 - ON-SITE FREE WIRELESS INTERNET ACCESS AND NOTARY SERVICES - WORKFORCE DEVELOPMENT - HEALTH PROFESSIONAL EDUCATION - ONLINE HEALTH CENTER "FOLLOWMYHEALTH" - STAFF PARTICIPATION IN CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS - PROVIDE A CLINICAL SETTING FOR UNDERGRADUATE/VOCATIONAL TRAINING TO STUDENTS ENROLLED IN OUTSIDE PROGRAMS - UNREIMBURSED MEDI-CAL, MEDICARE, CHARITY CARE, AND UNINSURED PATIENT DISCOUNTS- FREE INTERPRETER SERVICES FOR PATIENTS AND THEIR DESIGNATED SUPPORT PERSON. |
| PART VI, LINE 6: | (NOT PART OF AFFILIATED HEALTHCARE SYSTEM) |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LARRY BEDNARZ | ||||||||||||||
| REGISTERED NURSE | $130,807 | $0 | $0 | $0 | $120,056 | $0 | $8,222 | $0 | $14,276 | $0 | $273,361 | $0 | $0 | $0 |
| MARIA VILLARREAL | ||||||||||||||
| REGISTERED NURSE | $147,014 | $0 | $1,051 | $0 | $94,137 | $0 | $9,049 | $0 | $20,594 | $0 | $271,845 | $0 | $0 | $0 |
| SHAUN FILLON | ||||||||||||||
| REGISTERED NURSE | $130,560 | $0 | $0 | $0 | $103,023 | $0 | $8,015 | $0 | $20,966 | $0 | $262,564 | $0 | $0 | $0 |
| CECILIA JAVIER | ||||||||||||||
| SR. DIRECTOR, LABORATORY | $217,701 | $0 | $5,000 | $0 | $0 | $0 | $13,062 | $0 | $15,325 | $0 | $251,088 | $0 | $0 | $0 |
| MELISSA DAY | ||||||||||||||
| SENIOR DIRECTOR NURSING | $209,720 | $0 | $5,000 | $0 | $0 | $0 | $12,583 | $0 | $14,722 | $0 | $242,025 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: ERIC CORNWELL HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $432,761 AND OTHER COMPENSATION IN THE AMOUNT OF $45,404. TERRI DAY HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $493,094. SANJEEV GOSWAMI HAD REPORTABLE COMPENSATION IN THE AMOUNT OF $34,200. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAMERON MEDICAL GROUP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | ENTITY IS OWNED BY THE CMO OF THE HOSPITAL | RelationshipDescriptionTxt |
| Transaction | $264,000 | TransactionAmt |
| Transaction | SUPPORT FEES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 MANAGMENT PERSONNEL AS DEEMED NECESSARY 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 BOD 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 DOB 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: AUTHROIZE OR APPROVE THE TRANSFER OR DISPOSE OF REAL OR PERSONAL PROPERTY (EXCEPT OBSELETE 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 | FORM 990 IS REVIEWED BY THE CFO AND ACCOUNTING MANAGER. THE RETURN IS PROVIDED TO THE BOARD FOR REVIEW PRIOR TO FILING. |
| 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 B, LINE 15 | EXECUTIVE INCENTIVE COMPENSATION IS SET BASED ON MEETING A SPECIFIC SET OF THE BOARD. METRICS GENERALLY INCLUDE QUALITY, FINANCE, PATIENT SAFETY, YEAR, THE BOARD APPOINTS AN EXECUTIVE COMPENSATION COMMITTEE TO 1) REVIEW PERFORMANCE AGAINST ESTABLISHED GOALS AS WELL AS OVERALL EXECUTIVE METRICS ESTABLISHED ANNUALLY BY THE CEO AND EXECUTIVE TEAM AND APPROVED BY PATIENT EXPERIENCE, EMPLOYEE ENGAGEMENT AND MEANINGFUL USE GOALS. EACH AND APPROVE AN ANNUAL EXECUTIVE COMPENSATION PLAN; 2) TO EVALUATE EXECUTIVE PERFORMANCE; AND 3) TO SET THE OVERALL EXECUTIVE COMPENSATION PLAN FOR THE FOLLOWING YEAR. THE CEO PROVIDES RECOMMENDATIONS CONCERNING THE PERFORMANCE AND COMPENSATION OF THE EXECUTIVES FOR BOARD APPROVAL. THE EXECUTIVE COMPENSATION COMMITTEE AND CHAIRMAN OF THE BOARD EVALUATE THE CEO AND APPROVE THE CEO'S COMPENSATION. THE ANNUAL EXECUTIVE COMPENSATION PLAN IS DEVELOPED AND PRESENTED TO THE BOARD BY AN INDEPENDENT HEALTHCARE COMPENSATION EXPERT WHO ALSO ADVISES AND GUIDES THE BOARD AS TO MARKET AND OTHER FACTORS AFFECTING EXECUTIVE AND CEO COMPENSATION. THIS INCLUDES BUT IS NOT LIMITED TO BASE COMPENSATION, THE EXECUTIVE INCENTIVE PROGRAM AND RECOMMENDED PERFORMANCE AND MARKET COMPENSATION ADJUSTMENTS. |
| 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 12,067,298. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,067,298. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 600,495. MANAGEMENT AND GENERAL EXPENSES 515,342. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,115,837. PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 3,222,610. MANAGEMENT AND GENERAL EXPENSES 2,926,985. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,149,595. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,230,987. MANAGEMENT AND GENERAL EXPENSES 1,678,903. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,909,890. PHARMACY AND LABORATORY OUTSOURCING: PROGRAM SERVICE EXPENSES 2,931,906. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,931,906. MAINTENANCE: PROGRAM SERVICE EXPENSES 2,762,110. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,762,110. MEDICAL RECORDS OUTSOURCING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,453,881. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,453,881. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,461,484. MANAGEMENT AND GENERAL EXPENSES 85,120. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,546,604. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAMERON HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 WEST ACACIA STREET | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942811364 | EIN |
| Primary Activities | SUPPORT DAMERON HOSPITAL ASSOCIATION | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAMERON HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |