2023-11-14T13:01:10-06:00 2022-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-01-01 941458282 NORTHBAY HEALTHCARE GROUP NORT 7076465000 1200 B GALE WILSON BOULEVARD FAIRFIELD CA 94533 JOSEPH D'ANGINA VICE PRESIDENT AND CFO 7076463111 2023-11-14 1 JOSEPH DANGINA 999009999 0 MICHAEL LUMSDEN P01262236 4159561500 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z B KONARD JONES 4500 BUSINESS CTR DR FAIRFIELD CA 94534 713289955 0 X WWW.NORTHBAY.ORG X 1954 CA HEALTH CARE SERVICES (INCLUDING HOSPITAL AND PHYSICIAN SERVICES) WITHIN SOLANO COUNTY. 9 8 0 1 0 0 2564723 2500454 675399468 691645258 6360551 17456051 1218838 1688192 685543580 713289955 50000 27500 0 0 290784512 299597999 0 0 0 401645470 432429333 692479982 732054832 -6936402 -18764877 886687386 800719097 461156410 468715995 425530976 332003102 X COMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME. 0 0 692968234 27500 691645258 NORTHBAY HEALTHCARE GROUP OPERATES TWO NON-PROFIT HOSPITALS WITHIN SOLANO COUNTY: NORTHBAY MEDICAL CENTER AND VACAVALLEY HOSPITAL. NORTHBAY MEDICAL CENTER, A 132-BED ACUTE-CARE HOSPITAL, IS COMMITTED TO MEETING THE CHANGING HEALTH NEEDS OF LOCAL RESIDENTS, MAKING STATE-OF-THE-ART SERVICES AVAILABLE CLOSE TO HOME. THESE SERVICES INCLUDE: A 24-HOUR EMERGENCY DEPARTMENT AND STEMI RECEIVING CENTER, A LEVEL II TRAUMA CENTER, AN ACCREDITED CHEST PAIN CENTER WITH PCI, A PRIMARY STROKE CENTER, A MODERN MATERNITY UNIT WITH PRIVATE BIRTHING SUITES, A NEWBORN INTENSIVE CARE UNIT FOR PREMATURE AND CRITICALLY ILL NEWBORNS, STATE-OF-THE-ART CRITICAL CARE UNITS, COMPREHENSIVE DIAGNOSTIC IMAGING SERVICES, SURGICAL SERVICES, A CARDIAC CATHETERIZATION LAB, THE NORTHBAY HEART & VASCULAR CENTER, AND A CANCER CENTER ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS.VACAVALLEY HOSPITAL IS A 50-BED, NON-PROFIT HOSPITAL PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF VACAVILLE AND SURROUNDING COMMUNITIES OF NORTHERN SOLANO COUNTY. VACAVALLEY HOSPITAL PROVIDES A 24-HOUR EMERGENCY DEPARTMENT, 44 MEDICAL-SURGICAL BEDS, A SIX-BED CRITICAL CARE UNIT FOR HIGH-LEVEL INTENSIVE CARE, TWO SURGERY SUITES, A FULL-SERVICE LABORATORY, AND DIAGNOSTIC IMAGING SERVICES WITH A FULLY EQUIPPED RADIOLOGY DEPARTMENT INCLUDING CT SCANNER. 692968234 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 585 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JOSEPH D'ANGINA 7076463111 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 ARCHIE HUMPHREY CHAIR 1.00 1.00 X X 17095 0 0 WAYNE SENALIK VICE CHAIR 1.00 0.00 X X 16755 0 0 DENISE SUIHKONEN SECRETARY - TREASURER 1.00 0.00 X X 16774 0 0 DONALD DOYLE MD DIRECTOR 1.00 0.00 X 16774 0 0 THERESA HITE DIRECTOR 1.00 0.00 X 1080 0 0 B KONARD JONES DIRECTOR / PRESIDENT & CEO 13.00 37.00 X X 0 1241415 422171 JAMES LONG MD DIRECTOR 1.00 0.00 X 24940 0 0 GWENDOLYN RUNNELS DIRECTOR 1.00 0.00 X 0 0 0 MARK SIEVERS DIRECTOR 1.00 1.00 X 16898 0 0 MICHELE BOUIT VP FINANCE & CFO THRU 11/2022 35.00 15.00 X 0 519394 83794 TIMOTHY MAURICE INT VP, FINANCE & CFO START 11/2022 35.00 15.00 X 0 145386 10 SCOTT DAVIS VP CHIEF STRAT OFFICER THRU 8/2022 35.00 15.00 X 0 803881 94351 CHRISTOPHER TIMBERS VP CHIEF INFORMATION OFFICER 40.00 10.00 X 0 515565 139297 SETH KAUFMAN CHIEF MED OFFICER & CHIEF QUAL OFFICER 50.00 0.00 X 0 496437 114544 JIM ANDERSEN VP HUMAN RESOURCES 45.00 5.00 X 0 412618 103723 WAYNE GIETZ PRESIDENT NBHG THRU 4/2022 45.00 5.00 X 0 469159 44405 SHENIECE SMITH ESQ FACHE VP CAO & GENERAL COUNSEL 45.00 5.00 X 0 419888 78989 TRACY GEDDIS VP OPERATIONS 45.00 5.00 X 0 361596 64588 STEVE HUDDLESTON VP PUBLIC AFAIRS THRU 12/2022 45.00 5.00 X 0 314860 75449 HEATHER RESSEGER VP CHIEF NURSING OFFICER START 6/2022 50.00 0.00 X 0 338792 42110 TRACI DUNCAN VP CHIEF NURSING OFFICER THRU 6/2022 50.00 0.00 X 0 173755 52756 AROLD NELSON CLINICAL NURSE SUPERVISOR 40.00 0.00 X 0 416879 56013 JUAN ORIAS CLINICAL NURSE II 40.00 0.00 X 0 438582 31760 THERESA BARTOLI CLINICAL COORDINATOR 40.00 0.00 X 0 367533 54523 PETER DHALIWAL CLINICAL NURSE II 40.00 0.00 X 0 369465 38799 JOANNE JACOB CLINICAL NURSE II 40.00 0.00 X 0 348346 0 110316 8153551 1497282 0 0 1 0 RIGHTSOURCING INC PO BOX 515743 LOS ANGELES CA 900515118 PROFESSIONAL RECRUITING SERVICES 7520345 SACSOLANO ANESTHESIA EXCHANGE 3315 WATT AVE SACRAMENTO CA 95821 ANESTHESIA SERVICES 7399019 PACIFIC RADIATION ONCOLOGY 133 RANCHO BONITA WAY SONOMA CA 95476 ONCOLOGY SERVICES 2788081 SNAPNURSE 675 PONCE DE LEON AVE STE 8500 ATLANTA GA 30308 CONTRACTED LABOR 2017554 DPR CONSTRUCTION INC 1801 J STREET SUITE 200 SACRAMENTO CA 95811 GENERAL CONSTRUCTION 1984785 199 2496500 3954 2500454 NET PATIENT SERVICE REVENUE 621400 569795786 569795786 CAPITATION REVENUE 621400 106799181 106799181 PHARMACY REVENUE 621400 9403576 9403576 REINSURANCE RECOVERIES 621400 4053771 4053771 RENTAL REVENUE - RELATED ORGS 621400 1006620 1006620 586324 586324 691645258 6515312 6515312 453545 453545 268226 0 268226 268226 268226 9980316 506878 0 0 9980316 506878 10487194 10487194 CAFETERIA 722514 852210 852210 MISCELLANEOUS REVENUE 900099 551003 551003 VENDING MACHINES 722515 16753 16753 1419966 713289955 691645258 0 19144243 X 27500 27500 722214 610981 111233 239237220 232532400 6704820 8964596 8690359 274237 33614728 32787190 827538 17059241 16615439 443802 159723 49408 110315 265627622 263512548 2115074 4009 3846 163 8032911 7825075 207836 339951 339691 260 8217832 8161869 55963 203502 197166 6336 79277 75695 3582 14294772 14266243 28529 27422648 26632053 790595 3536514 3535898 616 MEDICAL SUPPLIES 67880979 66898146 982833 QUALITY ASSURANCE FEE 22811094 22811094 TAXES & LICENSES 990226 556249 433977 DUES & SUBSCRIPTIONS 468628 297986 170642 12359645 9352492 3007153 732054832 692968234 39086598 0 8196984 24119050 53722570 48030007 154045083 121241831 657 656 5455059 5468532 12026622 2875537 542583978 266846880 293080935 275737098 285144234 250545598 5252996 3971861 69762246 68728927 886687386 800719097 37714385 25307326 39807820 6530537 258042910 253861930 44186740 41635845 81404555 141380357 461156410 468715995 X 425381974 331850575 149002 152527 425530976 332003102 886687386 800719097 X -18764877 -45192465 -29570532 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 50804 50804 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA; A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO LOBBYING, WHICH SUPPORTS CERTAIN INITIATIVES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE WITHIN ITS COMMUNITY. 9867153 9867153 194944877 63250117 131694760 29724161 17915154 11809007 282212931 174178541 108034390 25834856 11503068 14331788 275737098 OTHER RECEIVABLES 24731770 HOSPITAL QUALITY ASSURANCE FEE RECEIVABLE 3539125 OPERATING LEASE RIGHT-OF-USE ASSETS 40379372 DUE FROM RELATED ORGANIZATIONS 78660 68728927 MALPRACTICE LIABILITY 6051296 REFUNDS DUE TO PATIENTS & INS CO. 4907514 OPERATING LEASE LIABILITY 45744865 AMOUNTS DUE TO 3RD PARTY PAYORS 11029829 LOAN PAYABLE TO NBHA 8496895 DUE TO RELATED ORGANIZATIONS 54921113 REFERRAL CLAIMS IBNR 8712682 OTHER LIABILITIES 1516163 141380357 1 1 X 1 X 138.000000000000 1 X 1 1 1 0 1 1 30004377 0 30004377 0.04100 258364911 209683118 48681793 0.06650 288369288 209683118 78686170 0.10750 7455603 4963334 2492269 0.00340 187105 0 187105 0.00030 7642708 4963334 2679374 0.00370 296011996 214646452 81365544 0.11120 45578 45578 0.00010 7000 7000 0.00000 52578 52578 0.00010 1 22147250 0 129099522 174438231 -45338709 X 1 1 2 1 NORTHBAY MEDICAL CENTER 1200 B GALE WILSON BLVD FAIRFIELD CA 94533 WWW.NORTHBAY.ORG 110000093 X X X OUTPATIENT CLINICS A 2 NORTHBAY VACAVALLEY HOSPITAL 1000 NUT TREE ROAD VACAVILLE CA 95687 WWW.NORTHBAY.ORG 110000093 X X X OUTPATIENT CLINICS A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 22 1 0 0 1 X HTTPS://WWW.NORTHBAY.ORG/COMMUNITY/PUBLIC-REPORTS.CFM X 1 22 1 HTTPS://WWW.NORTHBAY.ORG/COMMUNITY/PUBLIC-REPORTS.CFM 0 1 X 138.000000000000 350.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.NORTHBAY.ORG/PATIENTS-VISITORS/FORMS-DOCUMENTS.CFM X HTTPS://WWW.NORTHBAY.ORG/PATIENTS-VISITORS/FORMS-DOCUMENTS.CFM X HTTPS://WWW.NORTHBAY.ORG/PATIENTS-VISITORS/FORMS-DOCUMENTS.CFM X X X X X X X 1 X 0 X X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: NORTHBAY MEDICAL CENTER, - FACILITY 2: NORTHBAY VACAVALLEY HOSPITAL GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 5: A BROAD RANGE OF COMMUNITY MEMBERS, TOTALING TO 125 TOTAL PARTICIPANTS, PROVIDED INPUT THROUGH KEY INFORMANT INTERVIEWS (EIGHT IN TOTAL) AND GROUP INTERVIEWS/FOCUS GROUPS (3 IN TOTAL). WE CONSULTED INDIVIDUALS WITH KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY.THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM HEALTH DEPARTMENTS, SCHOOL DISTRICTS, LOCAL NONPROFITS, AND OTHER REGIONAL PUBLIC AND PRIVATE ORGANIZATIONS. IN ADDITION, WE GATHERED INPUT FROM COMMUNITY LEADERS, CLIENTS OF LOCAL SERVICE PROVIDERS, AND OTHER INDIVIDUALS REPRESENTING PEOPLE WHO ARE MEDICALLY UNDERSERVED, LOW INCOME OR WHO FACE UNIQUE BARRIERS TO HEALTH (E.G., RACE/ETHNIC MINORITIES AND INDIVIDUALS EXPERIENCING HOMELESSNESS). KEY INFORMANT AND GROUP INTERVIEWS WERE HELD WITH INDIVIDUALS WHO REPRESENT ALDEA CHILDREN & FAMILY SERVICES (8/11/2021), CAMINAR (8/30/2021), COMMUNITY MEDICAL CENTERS (8/17/2021), NAPA COMMUNITY HEALTH INITIATIVE (8/12/2021), NAPA/SOLANO AREA AGENCY ON AGING (8/11/2021), OLE HEALTH (8/24/2021), RIO VISTA CARE (8/18/2021), SOLANO COUNTY OFFICE OF EDUCATION (8/2/2021), SOLANO COUNTY PUBLIC HEALTH (8/12/2021 AND 9/1/2021), SOLANO FAMILY JUSTICE CENTER (8/18/2021), AND THE LEAVEN (8/13/2021). GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 11: THE FOLLOWING HEALTH NEEDS WERE DETERMINED TO BE SIGNIFICANT (IN PRIORITIZED ORDER) IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS TO CARE2. HOUSING3. INCOME & EMPLOYMENT4. MENTAL & BEHAVIORAL HEALTH5. COMMUNITY SAFETY6. TRANSPORTATIONTO ADDRESS THE HEALTH NEED OF ACCESS TO CARE, NORTHBAY HEALTH HAS UNDERTAKEN THE FOLLOWING INITIATIVES: 1. COVID-19 VACCINE CLINICS: NORTHBAY DONATED VACCINES AND PROVIDED STAFFING AND ADMINISTRATIVE SUPPORT TO LARGE-SCALE AND NEIGHBORHOOD VACCINE CLINICS ACROSS THE COUNTY TO PREVENT THE SPREAD OF THE CORONAVIRUS. IN 2022, NORTHBAY SHIFTED ITS FOCUS FROM COMMUNITY CLINICS TO OFFERING VACCINATIONS TO THE PUBLIC AT LARGE THROUGH REGISTRATION AT MYTURN.CA.GOV, A STATE-WIDE ACCESS SITE. IN ADDITION, NORTHBAY HEALTH CONTINUED OFFERING VACCINATIONS AND BOOSTER SHOTS TO ITS PATIENTS AT PRIMARY CARE FACILITIES.2. OLE HEALTH PARTNERSHIP: NORTHBAY HEALTH AND OLE HEALTH, A FEDERALLY QUALIFIED HEALTH CENTER, HAVE PARTNERED TO WORK TOGETHER TO INCREASE ACCESS TO CARE TO THE MOST VULNERABLE POPULATION OF UNDERINSURED AND NON-INSURED RESIDENTS OF FAIRFIELD. THROUGH A COMMUNITY BENEFIT GRANT PROGRAM, NORTHBAY HEALTH PROVIDES 2,700 SQUARE FEET OF CLINIC SPACE TO OLE HEALTH ON THE CAMPUS OF NORTHBAY MEDICAL CENTER, A CENTRAL LOCATION IN PROXIMITY TO THE AT-RISK POPULATION. IN 2022, UTILIZATION OF THE CENTER NEARLY DOUBLED YEAR OVER YEAR, WITH 10,776 PATIENT VISITS RECORDED, COMPARED TO 5,530 VISITS IN 2021. ADDITIONALLY, NORTHBAY ASSISTED OLE HEALTH WITH LOCATING ADDITIONAL SPACE TO INCREASE ITS ABILITY TO REACH MORE PATIENTS IN NEED OF PREVENTIVE AND PRIMARY CARE SERVICES. THE VALUE OF CLINIC SPACE PROVIDED BY NORTHBAY WAS $70,587, AND DOES NOT INCLUDE CLINICAL CONSULTATIONS AND COLLABORATION WITH OUR NORTHBAY MEDICAL STAFF.3. CHARITY CARE: IN 2022, NORTHBAY HEALTH PROVIDED FREE CARE TO 4,588 PATIENTS WHO RECEIVED THE BENEFIT OF NORTHBAY'S FINANCIAL ASSISTANCE PROGRAM; THE UNREIMBURSED COST OF CHARITY CARE PROVIDED TO THESE PATIENTS WAS $7,447,172.4. HOSPICE & BEREAVEMENT SERVICES: NORTHBAY'S HOSPICE AND BEREAVEMENT SERVICES ARE OFFERED TO ANYONE, REGARDLESS OF INSURANCE OR ABILITY TO PAY, WHETHER IN THE HOME, HOSPITAL, NURSING HOME OR BOARD-AND-CARE FACILITY. THE MULTIDISCIPLINARY STAFF INCLUDES A MEDICAL DIRECTOR, SPECIALLY TRAINED NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS, VOLUNTEERS, AND A BEREAVEMENT COORDINATOR. IN 2022, THE VOLUME OF HOSPICE IN THE NORTHBAY HEALTH PROGRAM GREW AND THE PROGRAM SUSTAINED ITS 91% SATISFACTION RATING AMONG FAMILIES SERVED.TO ADDRESS THE HEALTH NEED OF HOUSING, NORTHBAY HEALTH HAS UNDERTAKEN THE FOLLOWING INITIATIVES:1. NOMADIC SHELTERING PROGRAM: NORTHBAY HEALTH CONTINUED TO SUPPORT THE SOLANO DREAM CENTER (WHICH IS A NOMADIC SHELTERING PROGRAM TAKING IN HOMELESS INDIVIDUALS AND PROVIDING SHELTER, FOOD AND PERSONAL HYGIENE SERVICES) UNTIL JUNE 2022, WHEN THE MOU WAS TERMINATED TO CONCERNS FOR PATIENT SAFETY.2. OPPORTUNITY HOUSE: IN 2022, NORTHBAY HEALTH PROVIDED A $30,000 GRANT TO OPPORTUNITY HOUSE, WHICH PROVIDES TEMPORARY HOUSING AND SOBER WORK-TO-HOUSING PROGRAM. IN ADDITION, NORTHBAY HEALTH ALSO SUPPORTED THE DAILY OPERATION OF THE ADULT SHELTER BY PROVIDING DRUG SCREENING KITS TO TEST NEW ARRIVALS, A CONDITION OF THE SOBER WORK-TO-HOUSING PROGRAM. TOTAL COST OF THE 500 DONATED KITS WAS $3,067.3. VALLEJO NAVIGATION CENTER: THIS SHELTER IS A PROVIDER OF HOMELESS WRAP-AROUND SERVICES. NORTHBAY WILL PROVIDE A $50,000 GRANT FOR FUNDING, WHICH WAS WITHHELD FOR THE PROGRAM AFTER THE CITY OF VALLEJO ENCOUNTERED HURDLES IN ACQUIRING THE SELECTED SITE. NORTHBAY REMAINS COMMITTED TO MAKING ITS FINAL $50,000 DONATION TO OPERATE THE CENTER ONCE IT IS CONSTRUCTED AND OPEN. IT WOULD BE THE FINAL INSTALLMENT OF A $200,000 GRANT TO ADDRESS HOMELESSNESS IN SOUTH SOLANO COUNTY.TO ADDRESS THE HEALTH NEED OF INCOME & EMPLOYMENT, NORTHBAY HEALTH HAS UNDERTAKEN THE FOLLOWING INITIATIVES:1. SUPPORT OF THE SOLANO ECONOMIC DEVELOPMENT CORP.: NORTHBAY HEALTH IS A LEADING FINANCIAL SUPPORTER OF THIS ORGANIZATION, AND PARTICIPATES ON THE BOARD OF DIRECTORS AND SOLANO EDC ADVOCACY COUNCIL (VP OF PUBLIC AFFAIRS STEVE HUDDLESTON SERVED OF THE BOARD OF DIRECTORS AND EXECUTIVE COMMITTEE UNTIL HIS RETIREMENT IN JULY 2022). THE AIM OF THIS ORGANIZATION IS TO INCREASE THE EMPLOYMENT BASE FOR ALL SECTORS OF THE COMMUNITY, ASSIST EXISTING EMPLOYERS TO REMAIN IN THE COMMUNITY AND INCREASE THE NUMBER OF JOBS AVAILABLE TO LOCAL RESIDENTS, AND CREATE PARTNERSHIPS THAT LINK EDUCATIONAL INSTITUTIONS TO WORKFORCE DEVELOPMENT. DURING 2022, NORTHBAY HEALTH'S MEMBERSHIP INVESTMENT OF $25,000 MADE IT ONE OF THE LEADING PRIVATE-SECTOR SUPPORTERS.2. SUPPORT OF CHAMBERS OF COMMERCE: AS A FINANCIAL SUPPORTER AND THROUGH PARTICIPATION ON THE BOARDS OF DIRECTORS OF MOST OF THE 10 CHAMBERS OF COMMERCE IN SOLANO COUNTY, NORTHBAY HEALTH HELPS THE LOCAL BUSINESS COMMUNITY FLOURISH AND RETAIN EXISTING JOBS. NORTHBAY INVESTED A TOTAL OF $22,000 IN THE 10 LOCAL CHAMBERS OF COMMERCE IN ITS SERVICE AREA.3. BACK TO SCHOOL RESOURCE FAIR: NORTHBAY HEALTH STAFF DISTRIBUTED AND FITTED 500 BICYCLE SAFETY HELMETS TO YOUTH AND EDUCATED PARENTS ON PREVENTING HARMFUL ACCIDENTS IN THE HOME. THE FAIR HAS AN INTENDED OUTCOME OF PROVIDING FAMILIES WITH HEALTH CARE EDUCATION, LINKS TO COMMUNITY HEALTH RESOURCES, BICYCLE SAFETY HELMETS, AND INFANT CAR SEAT INSTRUCTIONS.4. SUPPORT OF SALVATION ARMY KROC CENTER OF SUISUN CITY: THE KROC CENTER SUPPORTS LOW-INCOME NEIGHBORHOODS OF SUISUN CITY OPERATED BY THE SALVATION ARMY, AND PROVIDES FAMILIES WITH RECREATION OPPORTUNITIES, HEALTH EDUCATION, FOOD DISTRIBUTION AND SUPPORT THE CHRISTMAS RED KETTLE PROGRAM. NORTHBAY HEALTH PROVIDED THE KROC CENTER WITH A $1,000 DONATION IN 2022.TO ADDRESS THE HEALTH NEED OF MENTAL & BEHAVIORAL HEALTH, NORTHBAY HEALTH HAS UNDERTAKEN THE FOLLOWING INITIATIVES:1. NORTHBAY HEALTH IS WORKING WITH SOLANO COUNTY HEALTH & SOCIAL SERVICES AS IT CONSTRUCTS A NEW MENTAL HEALTH SERVICES UNIT ON BECK AVENUE IN FAIRFIELD. THE UNIT WILL PROVIDE A SEAMLESS TRANSITION OF HOMELESS PATIENTS IN NEED OF MENTAL HEALTH SERVICES UPON DISCHARGE FROM NORTHBAY HEALTH'S TWO HOSPITALS. REPRESENTATIVES OF NORTHBAY HEALTH SERVED ON AN ADVISORY GROUP DESIGNING A RESIDENTIAL TREATMENT FACILITY, WHICH IS PROJECTED TO OPEN IN JANUARY 2023.2. SUPPORT OF VACAVILLE NEIGHBORHOOD BOYS & GIRLS CLUB: DURING 2022, NORTHBAY HEALTH PROVIDED $1,000 TO HELP WITH PROGRAMS THAT ASSIST LOW-INCOME FAMILIES BY PROVIDING AN OUT-OF-SCHOOL PLACE THAT OFFERS LIFE-ENHANCING EXPERIENCES, INCLUDING HEALTHY MEALS AND ACTIVITIES.3. NORTHBAY HEALTH BEHAVIORAL HEALTH TEAM: THE NORTHBAY HEALTH BEHAVIORAL HEALTH TEAM ADDRESSES THE BEHAVIORAL HEALTH NEEDS OF PATIENTS SEEN IN THE EMERGENCY DEPARTMENTS, AND THOSE ADMITTED TO THE TWO HOSPITALS. AMID THE PANDEMIC, DUE TO STAFFING SHORTAGES AND THE RESIGNATION OF THE DIRECTOR OF BEHAVIORAL HEALTH, SOME INITIATIVES WERE DELAYED IN 2022. HOWEVER, A BEHAVIORAL HEALTH TASK FORCE COMMITTEE WAS CONVENED TO ENSURE VARIOUS PROJECTS DID NOT CEASE. THEY INCLUDED IMPLEMENTING THE COLUMBIA SUICIDE SEVERITY RATING SCALE AND THE INITIATIVE THE VAC (VIOLENCE ASSESSMENT CHECKLIST IN THE EMERGENCY DEPARTMENT), ALL EFFORTS TO IMPROVE SERVICES AND THE SAFETY OF OUR BEHAVIORAL HEALTH PATIENTS. SOCIAL WORKERS PROVIDED SUPPORT FOR 1,363 PATIENTS IN THE TWO HOSPITALS IN 2022, MOST IN THE EMERGENCY DEPARTMENT (1,257). IT REPRESENTED AN 18% INCREASE OVER 2021. THE TEAM ALSO SUPPORTED 1,682 PATIENTS IN 2022, PROVIDING CONNECTIONS TO COMMUNITY RESOURCES. OF THEM, 163 WERE PROVIDED SHELTER THROUGH A COMMUNITY NOMADIC SHELTER PROGRAM FINANCIALLY SUPPORTED BY NORTHBAY HEALTH.TO ADDRESS THE HEALTH NEED OF COMMUNITY SAFETY, NORTHBAY HEALTH CONTINUES TO SUPPORT OF THE LEAVEN, A NONPROFIT ORGANIZATION WHICH WORKS WITH MEMBERS OF THE LOCAL COMMUNITY TO BRING AFTER-SCHOOL MENTORING AND TUTORING PROGRAMS AS A REVITALIZATION TOOL TO STRUGGLING NEIGHBORHOODS, WHERE DROP-OUT RATES ARE OUT OF CONTROL AND GANGS THREATEN THE PEACE OF THE COMMUNITY. THE LEAVEN OPERATES CENTERS IN TROUBLED NEIGHBORHOODS IN FAIRFIELD. IN 2022, THE LEAVEN OPERATED THE YOUTH CENTER ON DANA DRIVE IN FAIRFIELD, ADJACENT TO THE CAMPUS OF NORTHBAY MEDICAL CENTER. NORTHBAY'S TOTAL CONTRIBUTION TO THE LEAVEN WAS $25,000 IN 2022, IN ADDITION TO THE IN-KIND DONATION OF FREE RENT IN A NORTHBAY OWNED DUPLEX ON DANA DRIVE.TRANSPORTATION HAS NOT BEEN ADDRESSED IN THE MOST RECENTLY COMPLETED IMPLEMENTATION STRATEGY, BUT WILL BE ADDRESSED IN FUTURE IMPLEMENTATION STRATEGY'S AND/OR COMMUNITY BENEFIT REPORTS. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 13B: BANKRUPTCY AND DECEASED PATIENTS WITH NO ESTATE. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 16J: THE POLICY IS POSTED ON THE CALIFORNIA OSHPD WEBSITE. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 20E: INFORMATION FROM THE PREDICTIVE MODEL MAY BE USED TO GRANT PRESUMPTIVE ELIGIBILITY OR TO SATISFY THE DOCUMENTATION REQUIREMENTS FOR PATIENTS IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED BY THE PATIENT AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 21C: AGB (AMOUNTS GENERALLY BILLED) DISCOUNTS ARE CALCULATED BASED ON HISTORICAL PAYMENT RATES USING A BLENDED AVERAGE FOR MEDICARE AND COMMERCIAL PAYERS. 49 1 - PRIMARY CARE AMERICAN CANYON 416 NAPA JUNCTION AMERICAN CANYON CA 94503 OUTPATIENT PRIMARY CARE 2 - PRIMARY CARE FAIRFIELD 2458 HILBORN ROAD FAIRFIELD CA 94534 OUTPATIENT PRIMARY CARE 3 - PRIMARY CARE GREEN VALLEY 4520 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 OUTPATIENT PRIMARY CARE 4 - PRIMARY CARE VACAVILLE 421 NUT TREE ROAD VACAVILLE CA 95687 OUTPATIENT PRIMARY CARE 5 - BREAST CANCER PROGRAM 1020 NUT TREE ROAD VACAVILLE CA 95687 CANCER HEALTH CENTER 6 - CANCER CENTER MEDICAL ONCOLOGY 1020 NUT TREE ROAD SUITE 390 VACAVILLE CA 95687 CANCER HEALTH CENTER 7 - CANCER CENTER RADIATION ONCOLOGY 1020 NUT TREE ROAD SUITE 190 VACAVILLE CA 95687 CANCER HEALTH CENTER 8 - CARDIAC & PULMONARY REHABILITATION 1020 NUT TREE ROAD SUITE 250 VACAVILLE CA 95687 CARDIAC & PULMONARY CARE HEALTH CENTER 9 - DIAGNOSTIC IMAGING FAIRFIELD 1101 B GALE WILSON BLVD FAIRFIELD CA 94533 DIAGNOSTIC IMAGING HEALTH CENTER 10 - DIAGNOSTIC IMAGING VACAVILLE 1020 NUT TREE ROAD SUITE 150 VACAVILLE CA 95687 DIAGNOSTIC IMAGING HEALTH CENTER 11 - EAR NOSE & THROAT 1860 PENNSYLVANIA AVE SUITE 305 FAIRFIELD CA 94533 EAR, NOSE & THROAT HEALTH CENTER 12 - GASTROENTEROLOGY FAIRFIELD 4520 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 GASTROENTEROLOGY HEALTH CENTER 13 - GASTROENTEROLOGY VACAVILLE 1010 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 GASTROENTEROLOGY HEALTH CENTER 14 - HEALTHSPRING FITNESS 1020 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 FITNESS CENTER 15 - HEART & VASCULAR CENTER FAIRFIELD 1860 PENNSYLVANIA AVE SUITE 120 FAIRFIELD CA 94533 HEART & VASCULAR HEALTH CENTER 16 - HEART & VASCULAR CENTER GREEN VALLEY 4520 BUSINESS CENTER DRIVE SUITE 200 FAIRFIELD CA 94534 HEART & VASCULAR HEALTH CENTER 17 - HEART & VASCULAR CENTER VACAVILLE 1020 NUT TREE ROAD SUITE 290 VACAVILLE CA 95687 HEART & VASCULAR HEALTH CENTER 18 - HOSPICE & BEREAVEMENT 2470 HILBORN ROAD SUITE 240 FAIRFIELD CA 94534 HOSPICE HEALTH CENTER 19 - INFECTIOUS DISEASE 1010 NUT TREE ROAD SUITE 100B VACAVILLE CA 95687 INFECTIOUS DISEASE HEALTH CENTER 20 - LACTATION SUPPORT 1860 PENNSYLVANIA AVENUE SUITE 310 FAIRFIELD CA 94533 LACTATION SUPPORT HEALTH CENTER 21 - NEUROSCIENCE & SPINE 1010 NUT TREE ROAD SUITE 100-B VACAVILLE CA 95687 NEUROSCIENCE & SPINE HEALTH CENTER 22 - OCCUPATIONAL MEDICINE FAIRFIELD 2470 HILBORN ROAD SUITE 100 FAIRFIELD CA 94534 OCCUPATIONAL MEDICINE HALTH CENTER 23 - OCCUPATIONAL MEDICINE VACAVILLE 1679 E MONTE VISTA AVENUE SUITE 104 VACAVILLE CA 95688 OCCUPATIONAL MEDICINE HALTH CENTER 24 - ORTHOPEDICS FAIRFIELD 2500 HILBORN ROAD VACAVILLE CA 94534 ORTHOPEDICS HEALTH CENTER 25 - ORTHOPEDICS & REHABILITATION 2500 HILBORN ROAD VACAVILLE CA 94534 ORTHOPEDICS HEALTH CENTER 26 - ORTHOPEDICS VACAVILLE 1010 NUT TREE ROAD SUITE 200 VACAVILLE CA 95687 ORTHOPEDICS HEALTH CENTER 27 - PAIN MANAGEMENT FAIRFIELD 1860 PENNSYLVANIA AVENUE SUITE 310 FAIRFIELD CA 94533 PAIN MANAGEMENT HEALTH CENTER 28 - PAIN MANAGEMENT VACAVILLE 1020 NUT TREE ROAD SUITE 270 VACAVILLE CA 95687 PAIN MANAGEMENT HEALTH CENTER 29 - PODIATRY FAIRFIELD 2500 HILBORN ROAD FAIRFIELD CA 94534 PODIATRY HEALTH CENTER 30 - PODIATRY VACAVILLE 1010 NUT TREE ROAD VACAVILLE CA 95687 PODIATRY HEALTH CENTER 31 - PULMONOLOGY FAIRFIELD 1860 PENNSYLVANIA AVENUE SUITE 200 FAIRFIELD CA 94533 PULMONOLOGY HEALTH CENTER 32 - PULMONOLOGY SLEEP MEDICINE CLINIC 2458 HILBORN ROAD FAIRFIELD CA 94534 PULMONOLOGY HEALTH CENTER 33 - PULMONOLOGY VACAVILLE 1010 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 REHABILITATION SERVICES HEALTH CENTER 34 - REHABILITATION SERVICES FAIRFIELD 2500 HILBORN ROAD FAIRFIELD CA 94534 REHABILITATION SERVICES HEALTH CENTER 35 - REHABILITATION SERVICES VACAVILLE 1020 NUT TREE ROAD SUITE 260 VACAVILLE CA 95687 REHABILITATION SERVICES HEALTH CENTER 36 - RHEUMATOLOGY 1010 NUT TREE ROAD SUITE 200 VACAVILLE CA 95687 RHEUMATOLOGY HEALTH CENTER 37 - SPECIALTY PHARMACY 1020 NUT TREE ROAD VACAVILLE CA 95687 SPECIALTY PHARMACY 38 - SPECIALTY PRACTICES FAIRFIELD 1860 PENNSYLVANIA AVENUE FAIRFIELD CA 94533 SPECIALTY PRACTICES HEALTH CENTER 39 - SPECIALTY PRACTICES VACAVILLE 1010 NUT TREE ROAD VACAVILLE CA 95687 SPECIALTY PRACTICES HEALTH CENTER 40 - SURGERY CENTER AT VACAVALLEY 1006 NUT TREE ROAD VACAVILLE CA 95687 SURGERY CENTER 41 - URGENT CARE FAIRFIELD 1320 TRAVIS BLVD SUITE C FAIRFIELD CA 94533 URGENT CARE 42 - URGENT CARE VACAVILLE 1679 E MONTE VISTA AVE SUITE 104 VACAVILLE CA 95688 URGENT CARE 43 - UROLOGY FAIRFIELD 1860 PENNSYLVANIA AVENUE SUITE 200 FAIRFIELD CA 94533 UROLOGY HEALTH CENTER 44 - UROLOGY NAPA 3250 BEARD ROAD NAPA CA 94558 UROLOGY HEALTH CENTER 45 - VACAVALLEY HEALTH PLAZA 1010 NUT TREE ROAD VACAVILLE CA 95687 HEALTH PLAZA 46 - WOMEN'S DIAGNOSTIC IMAGING FAIRFIELD 1101 B GALE WILSON BLVD FAIRFIELD CA 94533 WOMEN'S DIAGNOSTIC IMAGING HEALTH CENTER 47 - WOMEN'S DIAGNOSTIC IMAGING VACAVILLE 1020 NUT TREE ROAD SUITE 150 VACAVILLE CA 95687 WOMEN'S DIAGNOSTIC IMAGING HEALTH CENTER 48 - WOMEN'S SERVICES 1860 PENNSYLVANIA AVENUE SUITE 300 FAIRFIELD CA 94533 WOMEN'S SERVICES HEALTH CENTER 49 - WOUND CARE 1010 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 WOUND CARE HEALTH CENTER PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS ON SCHEDULE H, PART I, LINES 7A AND 7B. THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED TO DETERMINE AMOUNTS ON LINE 7E. PART II, COMMUNITY BUILDING ACTIVITIES: ECONOMIC DEVELOPMENT - THE ORGANIZATION PROVIDES SUPPORT TO SEVEN LOCAL CHAMBERS OF COMMERCE (AMERICAN CANYON, BENICIA, DIXON, FAIRFIELD-SUISUN, RIO VISTA, VACAVILLE, AND VALLEJO), ALONG WITH PROVIDING SUPPORT TO THE SOLANO ECONOMIC DEVELOPMENT CORPORATION. TOGETHER, NORTHBAY AND THESE ORGANIZATIONS WORK TO ENHANCE THE LOCAL ECONOMY, EMPLOYMENT, QUALITY OF LIFE, AND EDUCATIONAL PROGRAMS.COMMUNITY SUPPORT - THE ORGANIZATION PROVIDES SUPPORT TO VARIOUS ORGANIZATIONS, INCLUDING ADOPT-A-SCHOOL AND SALVATION ARMY KROC CENTER, BOTH OF WHICH COMPRISE A NETWORK OF SUPPORT FOR VULNERABLE POPULATIONS IN OUR COMMUNITY. SERVICES MADE POSSIBLE BY NORTHBAY'S SUPPORT INCLUDE A HAVEN FOR ABUSED AND ABANDONED CHILDREN, EARLY CHILDHOOD EDUCATION, AND AN AFTER-SCHOOL MENTORING PROGRAM FOR CHILDREN LIVING IN UNDERSERVED NEIGHBORHOODS AND SHELTER. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS ON A CONSOLIDATED BASIS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WITH THIRD-PARTY INSURANCE COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTABLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (THOSE WITHOUT THIRD-PARTY INSURANCE COVERAGE) AND RECEIVABLES REPRESENTING DEDUCTIBLES AND COPAYMENTS REQUIRED FROM PATIENTS BY THEIR INSURANCE PLANS, THE SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS HISTORICALLY COLLECTED AFTER ALL REASONABLE COLLECTIONS HAVE BEEN EXHAUSTED IS THE ESTIMATED UNCOLLECTABLE RATE. THIS RATE IS APPLIED TO EXISTING ACCOUNTS TO RECORD AN ESTIMATE FOR UNCOLLECTABLE ACCOUNTS. PART III, LINE 3: A COST-TO-CHARGE RATIO (WHICH IS UTILIZED FOR CALCULATING CHARITY CARE COSTS ON SCHEDULE H, PART I, LINE 7A) WAS APPLIED TO TOTAL BAD DEBT EXPENSE TO ARRIVE AT THE ESTIMATED AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT CONTAIN A SEPARATE FOOTNOTE ADDRESSING "BAD DEBT EXPENSE". HOWEVER, THE FOOTNOTE THAT ADDRESSES "PATIENTS ACCOUNTS RECEIVABLE" CAN BE FOUND ON PAGES 10 AND 27-30 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE, EXPENSES ARE DISALLOWED BASED ON PRIOR YEARS' COST REPORTS AUDITS AND STANDARD MEDICARE NON-REIMBURSABLE EXPENSES, AS DIRECTED BY THE MEDICARE PROGRAM. THE MEDICARE COST REPORT AND ITS RULES OF ALLOWABLE COSTS TO WERE USED AS THE COSTING METHODOLOGY TO DETERMINE THE AMOUNT ON SCHEDULE H, PART III, LINE 6.IT IS THE HOSPITAL'S BELIEF THAT THE SHORTFALL REFLECTED ON PART III, LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN THE HOSPITAL'S COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS. PART III, LINE 9B: NORTHBAY HEALTHCARE'S COLLECTION POLICIES OUTLINE THE TYPES OF COLLECTION EFFORTS THAT CONTRACTED COLLECTION AGENCIES MAY OR MAY NOT TAKE TO COLLECT ON PAST-DUE ACCOUNTS. IT IS RECOGNIZED THAT AS PART OF THE FINANCIAL ASSISTANCE PROCESS, PATIENTS MAY FROM TIME TO TIME BREAK THEIR PROMISE TO PAY MADE ON THE FINANCIAL ASSISTANCE APPLICATION. IN THESE INSTANCES, PATIENTS WITH PAST-DUE FINANCIAL ASSISTANCE OBLIGATIONS MAY BE REFERRED TO COLLECTION IN THE SAME MANNER AS ANY OTHER PATIENT WITH AN UNPAID PAST-DUE ACCOUNT. HOWEVER, IN NO INSTANCE WILL ANY PATIENT RECEIVING FINANCIAL ASSISTANCE UNDER THIS POLICY BE SUBJECT TO ABUSIVE TELEPHONE COLLECTION PRACTICES, LIENS BEING PLACED ON THEIR PRIMARY RESIDENCE, WAGE GARNISHMENTS, OR INVOLUNTARY COURT HOLD ORDERS. PART VI, LINE 2: HEALTH NEEDS WERE IDENTIFIED THROUGH TWO PATHWAYS. FIRST, A HEALTH NEED COULD BE IDENTIFIED THROUGH PRIMARY OR SECONDARY (QUANTITATIVE) INDICATORS IF THERE WAS AT LEAST ONE RELATED INDICATOR THAT WAS WORSE THAN ESTABLISHED BENCHMARKS, SHOWED SIGNIFICANT EVIDENCE OF RACIAL/ETHNIC DISPARITIES, OR PERFORMED WORSE THAN A STATED EXTERNAL GOAL. SECOND, A HEALTH NEED COULD BE IDENTIFIED THROUGH PRIMARY OR SECONDARY (QUALITATIVE) DATA IF IT WAS A THEME IN KEY INFORMANT INTERVIEWS, GROUP INTERVIEWS, AND FOCUS GROUPS. FOLLOWING IDENTIFICATION, HEALTH NEEDS WERE PRIORITIZED VIA TWO ROUNDS OF IN-PERSON RANKING BY RESIDENTS, HEALTH OFFICIALS, AND COMMUNITY ORGANIZATIONAL LEADERS FROM THE VACAVILLE AND VALLEJO KAISER FOUNDATION HOSPITAL SERVICE AREAS AND ONE ROUND OF ONLINE RANKING EXCLUSIVELY BY SOLANO COUNTY STAKEHOLDERS. IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, NORTHBAY OPERATES MANY SEMINARS, SUPPORT GROUPS, AND COMMUNITY EVENTS WHICH ALLOWS IT TO FURTHER ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. PART VI, LINE 3: NORTHBAY HEALTHCARE POSTS NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL PATIENT REGISTRATION AREAS IN ALL PATIENT AREAS, IN PATIENT HANDBOOKS, AT ITS PATIENT BUSINESS SERVICES DEPARTMENT, AND ON ITS WEBSITE. NOTICES ARE POSTED IN ENGLISH AND SPANISH. PATIENTS ARE ALSO PROVIDED WITH INFORMATION REGARDING THE CHARITY CARE AND DISCOUNT POLICY AT THE POINT OF ACCESS. IF A PATIENT FEELS THAT THEY MAY BE ELIGIBLE UNDER THE POLICY, HE/SHE IS REFERRED TO NORTHBAY FINANCIAL COUNSELING FOR FURTHER ASSISTANCE. A FINAL DETERMINATION IS MADE WITHIN 30 DAYS OF A COMPLETE APPLICATION AND ALL REQUESTED DOCUMENTATION BEING SUBMITTED. ONCE A DECISION IS MADE FOR THE APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE, A LETTER IS SENT TO THE PATIENT AS NOTIFICATION OF THE DECISION. PART VI, LINE 4: NORTHBAY'S SERVICE AREA ENCOMPASSES SOLANO COUNTY, WHICH IS LOCATED APPROXIMATELY 45 MILES SOUTHWEST OF SACRAMENTO AND 45 MILES NORTHEAST OF SAN FRANCISCO. THE COUNTY'S MAIN CITIES AND TOWNS ARE BENICIA, BIRDS LANDING, DIXON, FAIRFIELD, ELMIRA, RIO VISTA, VACAVILLE, AND VALLEJO. ALL WALKS OF LIFE ARE REPRESENTED AND MORE THAN ONE-THIRD OF THE COUNTY'S RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIS COMPARES TO A RATE OF JUST 21 PERCENT FOR THE UNITED STATES POPULATION.THE KAISER PERMANENTE COMMUNITY HEALTH DATA PLATFORM ESTIMATES A POPULATION OF ABOUT 445,432 IN SOLANO COUNTY, AND NEARLY 15.3% OF THE POPULATION INCLUDES PEOPLE AGE 65 YEARS AND OVER. THE COMMUNITY IS HIGHLY DIVERSE IN SOCIOECONOMIC STATUS AND ETHNICITY. WITHIN NORTHBAY'S SERVICE AREA, 48.8% OF THE POPULATION IDENTIFIES AS WHITE, 27.1% AS HISPANIC, 15.7% ASIAN, 14.5% AS AFRICAN-AMERICAN, 8.2% AS MULTI-RACE, .8% AS HAWAIIAN/PACIFIC ISLANDER, .8% AS AMERICAN INDIAN/ALASKA NATIVE, AND 11.3% AS AN OTHER RACE. WITHIN THE SERVICE AREA, 7.9% OF THE POPULATION LIVES IN POVERTY (ALTHOUGH A SUB-SET OF 10.5% OF CHILDREN LIVE IN POVERTY), 14.7% ARE UNEMPLOYED, 4.6% ARE UNINSURED, AND 12.3% ARE ADULTS WITH NO HIGH SCHOOL DIPLOMA. PART VI, LINE 5: NORTHBAY CONTINUALLY PROMOTES PUBLIC HEALTH THROUGH DOZENS OF PROGRAMS, FROM FREE PRENATAL CARE TO LOW-INCOME PREGNANT WOMEN, TO FREE HOSPICE AND BEREAVEMENT SERVICES. A SUBSIDIZED DEMENTIA DAY CARE FACILITY AND A TRANSITIONAL CARE FACILITY FOR THE HOMELESS WHO REQUIRE POST-DISCHARGE CONTINUITY OF CARE ARE ALSO PROVIDED. MANY PUBLIC EDUCATION PROGRAMS -- HEALTH FAIRS, FREE SCREENINGS, DRIVE-THROUGH FLU VACCINATIONS, INJURY PREVENTION DEMONSTRATIONS, DRUNKEN DRIVING PREVENTION PROGRAMS AT LOCAL SCHOOLS AND DIABETES AWARENESS -- ARE CONDUCTED EVERY YEAR IN COMMUNITY FACILITIES CLOSE TO THOSE WHO CAN BENEFIT FROM THEM. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 SOLANO DREAM CENTER INC 743 E TABOR AVENUE FAIRFIELD CA 94533 832407160 501(C)(3) 27500 0 GENERAL SUPPORT FOR HOMELESS COMMUNITY BENEFIT 1 0 PART I, LINE 2: MONITORING PROPER USE OF THE AMOUNTS GRANTED TO SOLANO DREAM CENTER, INC. IS ACHIEVED BY WITNESSING THE WORK PERFORMED AND IMPACT ACHIEVED IN COMBATTING HOMELESSNESS WITHIN THE SOLANO COUNTY COMMUNITY. ADDITIONALLY, ACCESS TO SAFE, SECURE, AND AFFORDABLE HOUSING WAS OUTLINED AS A HEALTH NEED IN THE 2022 NORTHBAY HEALTHCARE GROUP COMMUNITY HEALTH NEEDS ASSESSMENT. 1 1 0 0 0 0 0 0 0 B KONARD JONES DIRECTOR / PRESIDENT & CEO 0 955902 0 0 0 285513 0 380198 0 41973 0 1663586 0 0 SCOTT DAVIS VP CHIEF STRAT OFFICER THRU 8/2022 0 286192 0 0 0 517689 0 50656 0 43695 0 898232 0 0 CHRISTOPHER TIMBERS VP CHIEF INFORMATION OFFICER 0 416138 0 0 0 99427 0 64757 0 74540 0 654862 0 0 SETH KAUFMAN CHIEF MED OFFICER & CHIEF QUAL OFFIC 0 441650 0 0 0 54787 0 50571 0 63973 0 610981 0 0 MICHELE BOUIT VP FINANCE & CFO THRU 11/2022 0 451818 0 0 0 67576 0 66506 0 17288 0 603188 0 0 JIM ANDERSEN VP HUMAN RESOURCES 0 360924 0 0 0 51694 0 56888 0 46835 0 516341 0 0 WAYNE GIETZ PRESIDENT NBHG THRU 4/2022 0 192692 0 0 0 276467 0 29416 0 14989 0 513564 0 0 SHENIECE SMITH ESQ FACHE VP CAO & GENERAL COUNSEL 0 401851 0 0 0 18037 0 55153 0 23836 0 498877 0 0 AROLD NELSON CLINICAL NURSE SUPERVISOR 0 398079 0 0 0 18800 0 12514 0 43499 0 472892 0 0 JUAN ORIAS CLINICAL NURSE II 0 419782 0 0 0 18800 0 1025 0 30735 0 470342 0 0 TRACY GEDDIS VP OPERATIONS 0 339641 0 0 0 21955 0 29769 0 34819 0 426184 0 0 THERESA BARTOLI CLINICAL COORDINATOR 0 360460 0 0 0 7073 0 16676 0 37847 0 422056 0 0 PETER DHALIWAL CLINICAL NURSE II 0 364239 0 0 0 5226 0 8310 0 30489 0 408264 0 0 STEVE HUDDLESTON VP PUBLIC AFAIRS THRU 12/2022 0 198788 0 0 0 116072 0 46700 0 28749 0 390309 0 25267 HEATHER RESSEGER VP CHIEF NURSING OFFICER START 6/202 0 307100 0 0 0 31692 0 10373 0 31737 0 380902 0 0 JOANNE JACOB CLINICAL NURSE II 0 348346 0 0 0 0 0 0 0 0 0 348346 0 0 TRACI DUNCAN VP CHIEF NURSING OFFICER THRU 6/2022 0 109801 0 12000 0 51954 0 21841 0 30915 0 226511 0 14997 PART I, LINE 3 THE PRESIDENT OF NORTHBAY HOSPITAL GROUP IS A PAID EMPLOYEE OF NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION. NORTHBAY HEALTHCARE CORPORATION UTILIZES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION OF THE PRESIDENT: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B DURING THE 2022 CALENDAR YEAR, SCOTT DAVIS RECEIVED A $433,000 SEVERANCE PAYMENT FROM A RELATED ORGANIZATION AND WAYNE GIETZE RECEIVED A $149,600 SEVERANCE PAYMENT FROM A RELATED ORGANIZATION. BOTH PAYMENTS WERE TAXABLE COMPENSATION TO THE INDIVIDUALS, AND REPORTED WITHIN SCHEDULE J, PART II, COLUMN (B)(III). THE FOLLOWING INDIVIDUALS PARTICIPATED IN A RELATED ORGANIZATION'S SUPPLEMENTAL 457(F) RETIREMENT PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN DURING THE 2022 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): B. KONARD JONES - $367,998 SCOTT DAVIS - $41,991 CHRISTOPHER TIMBERS - $54,573 SETH KAUFMAN, MD - $39,755 MICHELE BOUIT - $60,406 JIM ANDERSEN - $47,032 WAYNE GIETZ - $17,216 SHENIECE SMITH, ESQ., FACHE - $52,001 TRACY GEDDIS - $26,399 STEVE HUDDLESTON - $27,116 TRACI DUNCAN - $16,524 ADDITIONALLY, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, THE FOLLOWING INDIVIDUALS RECOGNIZED TAXABLE COMPENSATION IN THE FOLLOWING AMOUNTS, WHICH HAS BEEN REPORTED AS "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III) AND "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" IN SCHEDULE J, PART II, COLUMN (F): STEVE HUDDLESTON - $25,267 TRACI DUNCAN - $14,997 A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TVG5 2015-04-30 34809259 CONSTRUCTION COSTS FOR EXPANSION OF NORTHBAY MEDICAL CENTER 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TZY2 2016-08-04 39829633 PARTIALLY REFUND BOND DATED 10/23/2013 0 0 0 C CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TP49 2017-01-11 210294259 CONSTRUCTION COSTS FOR EXPANSION OF NORTHBAY MEDICAL CENTER 0 0 0 A 4080000 35106625 2185336 696185 32225104 2016 0 0 1 1 B 15540000 40773481 3637994 796405 36338468 614 1 0 1 1 C 300000 216694521 15026139 3561472 178386054 19720856 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA MUNICIPAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/30/2020 ISSUER NAME: CALIFORNIA MUNICIPAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/31/2021 ISSUER NAME: CALIFORNIA MUNICIPAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2021 PART I, COLUMN (E) AND PART II, LINE 3: THE DIFFERENCE BETWEEN THE TOTAL ISSUE PRICE REPORTED IN SCHEDULE K, PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN SCHEDULE K, PART II, LINE 3 REPRESENTS INVESTMENT EARNINGS ON UNSPENT BOND PROCEEDS. FORM 990, PART V, LINE 2A: ALL FORM W-2S FOR NORTHBAY HEALTH SYSTEM WERE FILED BY NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION OF NORTHBAY HEALTHCARE GROUP, WHICH IS THE BASIS FOR THE REPORTING OF "ZERO" AS THE NUMBER OF EMPLOYEES REPORTED ON FORM 990, PART V, LINE 2A. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE SOLE MEMBER, NORTHBAY HEALTHCARE CORPORATION, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A NORTHBAY HEALTHCARE CORPORATION, THE ORGANIZATION'S SOLE MEMBER, HAS THE POWER TO ELECT ALL DIRECTORS FROM A PANEL OF QUALIFIED INDIVIDUALS NOMINATED BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS OF NORTHBAY HEALTHCARE GROUP. FORM 990, PART VI, SECTION A, LINE 7B NORTHBAY HEALTHCARE CORPORATION, THE ORGANIZATION'S SOLE MEMBER, HAS THE RIGHT TO REMOVE ANY DIRECTOR. IN ADDITION, THE FOLLOWING POWERS ARE RESERVED TO THE MEMBER, MAY BE EXERCISED ONLY BY THE MEMBER, AND MAY BE EXERCISED WITHOUT ANY ACTION OR APPROVAL BY THE BOARD OF NORTHBAY HEALTHCARE GROUP: (I) ELECTION OF DIRECTORS FROM A PANEL OF QUALIFIED NOMINEES; AND (II) DISSOLUTION OF THE CORPORATION. THE FOLLOWING ACTIONS MAY BE TAKEN BY NORTHBAY HEALTHCARE GROUP ONLY IF ADOPTED BY THE BOARD AND APPROVED BY THE MEMBER: (I) ADOPT OR IMPLEMENT THE ANNUAL OPERATING AND CAPITAL BUDGET; (II) EFFECTUATE ANY PURCHASES OR FINANCING, HOWEVER STRUCTURED, IN AN AMOUNT EQUAL TO OR EXCEEDING ONE MILLION DOLLARS; (III) AMEND THE ARTICLES OF INCORPORATION OR THE BYLAWS; (IV) IMPLEMENT ANY MERGER, CONSOLIDATION, AFFILIATION, JOINT VENTURE ACTIVITY, OR ALLIANCE BETWEEN THE CORPORATION AND ANY OTHER ENTITY; (V) ESTABLISH OR PROMULGATE CORPORATE POLICY AND GOALS; (VI) ESTABLISH OR PROMULGATE LONG-RANGE AND STRATEGIC PLANS; (VII) ESTABLISH GENERAL POLICY WITH RESPECT TO EMPLOYEE BENEFIT PLANS; (VIII) UNDERTAKE OR MANAGE ANY FINANCING ACTIVITIES THAT ARE IN EXCESS OF ONE YEAR; (IX) DETERMINE ANY COMPENSATION OR REIMBURSEMENT TO BE PAID TO DIRECTORS; (X) ADJUST THE TERM OF ANY DIRECTOR; AND (XI) FORMATION BY THE CORPORATION OF ANY NEW CORPORATION, OR TAKING ANY OWNERSHIP OF ANY CORPORATION OR ENTITY AS A SHAREHOLDER, MEMBER, PARTNER, OR JOINT VENTURER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT AND CFO AND PRESENTED TO THE BOARD OF DIRECTORS OF THE PARENT COMPANY, NORTHBAY HEALTHCARE CORPORATION. A COPY OF THE FORM 990 IS ALSO DISTRIBUTED TO ALL VOTING MEMBERS GOVERNING BODY OF NORTHBAY HEALTHCARE GROUP FOR THEIR REVIEW AND COMMENTS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUESTS ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND MEMBERS COMMITTEES APPOINTED BY THE BOARD OF DIRECTORS TO SELF-MONITOR COMPLIANCE; IN ADDITION, EACH OFFICER AND BOARD MEMBERS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND ALL RESPONSES FILED. IF A POTENTIAL CONFLICT ARISES, BOARD MEMBERS, EMPLOYEES, AND MEDICAL STAFF ARE REQUIRED TO SELF-DISCLOSE THE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER OR MEDICAL CHIEF OF STAFF. PROCESSES AND PROCEDURES ARE IN PLACE TO EVALUATE AND DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS. IF CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WILL PRESENT RELEVANT INFORMATION TO THE BOARD. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DID NOT DIRECTLY COMPENSATE ANY OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES; THESE INDIVIDUALS ARE COMPENSATED BY NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION. AS SUCH, FORM 990, PART VI, SECTION A, LINES 15A AND 15B HAVE BEEN MARKED "NO", AS MANDATED BY THE FORM 990 INSTRUCTIONS. HOWEVER, IN DETERMINING COMPENSATION FOR ALL OFFICERS AND KEY EMPLOYEES OF NORTHBAY HEALTHCARE GROUP: AN AD HOC COMPENSATION COMMITTEE OF THE NORTHBAY HEALTHCARE CORPORATION BOARD REVIEWS COMPENSATION. THEY ARE ASSISTED BY INDEPENDENT CONSULTANTS, AND INDEPENDENT LOCAL SURVEYS AS A MEANS TO SUBSTANTIATE COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE DIGITAL ASSURANCE CORPORATION WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENT ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 94,431,525. MANAGEMENT AND GENERAL EXPENSES 500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 94,432,025. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 28,065,353. MANAGEMENT AND GENERAL EXPENSES 1,049,958. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,115,311. CORPORATE MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 94,912,147. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 94,912,147. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 46,103,523. MANAGEMENT AND GENERAL EXPENSES 1,064,616. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,168,139. FORM 990, PART XI, LINE 9: RELIEF OF INTERCOMPANY RECEIVABLES -29,570,532. NORTHBAYPHYSICIAN SURGERY CENTER LLC 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 203502901 AMBULATORY SURGERY CENTER CA 7082510 8996306 NORTHBAY HEALTHCARE GROUP NORTHBAY HEALTHCARE CORPORATION 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 680046750 TO SUPPORT THE OPERATION OF NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II N/A 0 NORTHBAY HEALTHCARE FOUNDATION 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 942995085 PROVIDES FUNDRAISING FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II NORTHBAY HEALTHCARE CORPORATION 0 NORTHBAY HEALTH ADVANTAGE 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 942495998 MANAGES REAL ESTATE FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II NORTHBAY HEALTHCARE CORPORATION 0 SOLANO DIAGNOSTIC PARTNERS 1101 B GALE WILSON BLVD FAIRFIELD CA 94533 931013774 DIAGNOSTIC IMAGING CENTER CA N/A 0 0 0 0 0 1 1 0 0 0 0 1 1 0 1 1 1 1 1 0 0