SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL (EIN 94-1502014)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-04
- IRS object ID
- 202232169349300833
- Schema version
- 2020v4.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-04T10:45:56-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | 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 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941502014 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN MONTEREY COUNTY MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 8313856000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK WOOLERY | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 8313857160 | PhoneNum |
| Signature | 2022-08-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARK | PersonFirstNm |
| Person Last | WOOLERY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL LUMSDEN | PreparerPersonNm |
| PTIN | P01262236 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Preparation | 2022-08-02 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEE MEMORIAL HEALTHCARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RENA SALAMACHA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $93,008,012 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MEEMEMORIAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 422 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,101,319 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,913,192 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,468,705 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,907,437 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$28,942 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,572 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,003,883 | PYOtherRevenueAmt |
| CY Other Revenue | $155,450 | CYOtherRevenueAmt |
| PY Total Revenue | $53,544,965 | PYTotalRevenueAmt |
| CY Total Revenue | $92,991,651 | 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 | $27,745,711 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,971,694 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $35,041,227 | PYOtherExpensesAmt |
| CY Other Expenses | $31,706,213 | CYOtherExpensesAmt |
| PY Total Expenses | $62,786,938 | PYTotalExpensesAmt |
| CY Total Expenses | $60,677,907 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,241,973 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $32,313,744 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,570,085 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,837,019 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $41,596,349 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,547,101 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,026,264 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $28,289,918 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MEE MEMORIAL HEALTHCARE SYSTEM IS COMMITTED TO PROVIDING CULTURALLY SENSITIVE AND PATIENT-CENTERED HEALTHCARE, DELIVERED WITH THE HIGHEST QUALITY OF SERVICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $46,484,582 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $82,907,437 | RevenueAmt |
| Desc | MEE MEMORIAL OPERATES A 25 ACUTE CARE BED AND 48 SKILLED NURSING BED LICENSED FACILITY THAT PROVIDES COMPREHENSIVE MEDICAL CARE TO THE LOCAL COMMUNITY AND OUTLYING AREAS WITHIN A 50-MILE RADIUS, AND SERVES AS A CRITICAL ACCESS HOSPITAL FOR THE REGION. IN ADDITION, MEE MEMORIAL HAS A NETWORK OF FOUR CLINICS TO SERVE ITS CLIENTELE, THREE IN KING CITY AND ONE IN GREENFIELD. TYPES OF CARE OFFERED INCLUDE ACUTE, LONG-TERM, AND RURAL HEALTH CLINIC SERVICES. OVER THE SEPTEMBER 30, 2021 FISCAL YEAR, TOTAL PATIENT DAYS WERE 13,392. THE EMERGENCY SERVICE DEPARTMENT HAD 12,900 VISITS AND OTHER HOSPITAL SERVICES HAD 30,709 OTHER OUTPATIENT VISITS DURING THE FISCAL YEAR. THE CLINICS RECEIVED 51,551 VISITS IN ADDITION TO HOSPITAL SERVICES. | Desc |
| Total Program Service Expenses | $46,484,582 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 167 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 422 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK WOOLERY | PersonNm |
| Phone | 8313857160 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT D VALLADARES MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $545,325 | $0 | $0 | |||
| MONEESHA PINTO MD | ||||||||
| TRUSTEE THRU 7/2021 / CHIEF OF STAFF | 40.00 | $332,402 | $0 | $60,884 | Yes (X) | |||
| SANDRA MONTIJO MD | ||||||||
| PHYSICIAN | 40.00 | $283,831 | $0 | $70,283 | Yes (X) | |||
| MARYANNE BALINO | ||||||||
| INT LAB MGR / CLINICAL LAB SCIENTIST | 40.00 | $251,028 | $0 | $97,489 | Yes (X) | |||
| RENA SALAMACHA BS MS | ||||||||
| CEO / TRUSTEE | 40.00 | $247,772 | $0 | $71,989 | Yes (X) | Yes (X) | ||
| LEAH DAHLFRED MD | ||||||||
| PHYSICIAN | 40.00 | $295,958 | $0 | $0 | Yes (X) | |||
| JORGE FERIA MD | ||||||||
| PHYSICIAN | 40.00 | $263,050 | $0 | $22,993 | Yes (X) | |||
| LISA MOYLAN | ||||||||
| CHIEF NURSING OFFICER | 40.00 | Yes (X) | $192,927 | $0 | $34,065 | |||
| DENISE MILLER | ||||||||
| QUALITY ASSURANCE DIR THROUGH 7/2021 | 40.00 | Yes (X) | $156,300 | $0 | $63,628 | |||
| MARK WOOLERY | ||||||||
| CFO | 40.00 | $187,189 | $0 | $26,215 | Yes (X) | |||
| BRUCE GREENBERG MD | ||||||||
| PHYSICIAN | 23.00 | $189,806 | $0 | $2,696 | Yes (X) | |||
| ROY SCHINDELHEIM MD | ||||||||
| TRUSTEE THROUGH 11/2020 / PHYSICIAN | 40.00 | $134,035 | $0 | $4,679 | Yes (X) | |||
| MICHAEL HOWARD | ||||||||
| CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| JAMES EWART | ||||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| ROGER BORZINI | ||||||||
| SECRETARY-TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| NOAH HAWTHORNE MD | ||||||||
| TRUSTEE EFFECTIVE 2/2021 | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| AMISH SHAH MD | ||||||||
| TRUSTEE THROUGH 12/2020 | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,079,623 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $454,921 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 72 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SODEXO INC & AFFILIATES | |||||
| 9801 WASHINGTONIAN BLVD | GAITHERSBURG | MD | 20878 | DIETARY AND ENVIROMENTAL SERVICES | $2,699,393 |
| VITUITY | |||||
| 210 POWELL ST SUITE 400 | EMERYVILLE | CA | 94608 | MEDICAL SERVICES | $2,537,128 |
| MONTEREY ANESTHESIA PROFESSIONALS | |||||
| 1522 CONSTITUTION BLVD 123 | SALINAS | CA | 93905 | MEDICAL SERVICES | $1,337,147 |
| RURAL PHYSICIANS MANAGEMENT COMPANY LLC | |||||
| 10624 S EASTERN AVE A-263 | HENDERSON | NV | 89052 | MEDICAL SERVICES | $1,054,616 |
| PACIFIC REHABILITATION & PAIN | |||||
| 32692 COAST RIDGE DR | CARMEL | CA | 93923 | MEDICAL SERVICES | $709,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 45 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,915,388 | GovernmentGrantsAmt |
| All Other Contributions | $2,997,804 | AllOtherContributionsAmt |
| Total Contributions | $9,913,192 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | $81,343,089 | $81,343,089 |
| OTHER OPERATING REVENUE | 622110 | $1,504,594 | $1,504,594 |
| REBATES AND REFUNDS | 622110 | $59,754 | $59,754 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,907,437 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,572 | TotalRevenueColumnAmt |
| Exclusion | $15,572 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,974 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,361 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $53,613 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,613 | TotalRevenueColumnAmt |
| Exclusion | $53,613 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722514 | $72,143 | $72,143 |
| MISCELLANEOUS REVENUE | 900099 | $29,694 | $29,694 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $101,837 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $92,991,651 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,907,437 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $171,022 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,820,081 | TotalAmt |
| Program Services | $1,245,855 | ProgramServicesAmt |
| Management And General | $574,226 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,927,993 | TotalAmt |
| Program Services | $16,124,822 | ProgramServicesAmt |
| Management And General | $3,803,171 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,720 | TotalAmt |
| Program Services | $141,534 | ProgramServicesAmt |
| Management And General | $261,186 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,026,346 | TotalAmt |
| Program Services | $1,729,929 | ProgramServicesAmt |
| Management And General | $3,296,417 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,794,554 | TotalAmt |
| Program Services | $630,686 | ProgramServicesAmt |
| Management And General | $1,163,868 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,963 | TotalAmt |
| Management And General | $163,963 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,500 | TotalAmt |
| Management And General | $119,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,499,793 | TotalAmt |
| Program Services | $15,834,318 | ProgramServicesAmt |
| Management And General | $2,665,475 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,738 | TotalAmt |
| Program Services | $179,492 | ProgramServicesAmt |
| Management And General | $52,246 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $272,532 | TotalAmt |
| Program Services | $151,322 | ProgramServicesAmt |
| Management And General | $121,210 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,506 | TotalAmt |
| Management And General | $110,506 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,089,409 | TotalAmt |
| Program Services | $2,024,130 | ProgramServicesAmt |
| Management And General | $65,279 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,112 | TotalAmt |
| Program Services | $23,323 | ProgramServicesAmt |
| Management And General | $6,789 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,447 | TotalAmt |
| Program Services | $22,034 | ProgramServicesAmt |
| Management And General | $6,413 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,770 | TotalAmt |
| Management And General | $532,770 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,418,407 | TotalAmt |
| Program Services | $2,418,407 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $598,888 | TotalAmt |
| Program Services | $177,416 | ProgramServicesAmt |
| Management And General | $421,472 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,310,840 | $3,310,840 | |
| REPAIRS & MAINTENANCE | $2,512,628 | $1,946,146 | $566,482 |
| LICENSES & TAXES | $234,183 | $68,463 | $165,720 |
| DUES & SUBSCRIPTIONS | $128,437 | $99,480 | $28,957 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $424,060 | TotalAmt |
| Program Services | $356,385 | ProgramServicesAmt |
| Management And General | $67,675 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,677,907 | TotalAmt |
| Program Services | $46,484,582 | ProgramServicesAmt |
| Management And General | $14,193,325 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $254,397 | BOYAmt |
| EOY | $2,161,569 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,140,280 | BOYAmt |
| EOY | $6,343,885 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,210,896 | BOYAmt |
| EOY | $4,502,735 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,138,460 | BOYAmt |
| EOY | $962,774 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,312 | BOYAmt |
| EOY | $229,390 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,308,156 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,518,972 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,949,474 | BOYAmt |
| EOY | $21,789,184 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,629 | BOYAmt |
| EOY | $28,067 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,590,637 | BOYAmt |
| EOY | $11,819,415 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,570,085 | BOYAmt |
| EOY | $47,837,019 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,354,948 | BOYAmt |
| EOY | $5,619,294 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,643,105 | BOYAmt |
| EOY | $357,096 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,858,724 | BOYAmt |
| EOY | $12,304,079 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,750,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $989,572 | BOYAmt |
| EOY | $1,266,632 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,596,349 | BOYAmt |
| EOY | $19,547,101 | 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 | -$4,026,264 | BOYAmt |
| EOY | $28,289,918 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,026,264 | BOYAmt |
| EOY | $28,289,918 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,570,085 | BOYAmt |
| EOY | $47,837,019 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $32,313,744 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,438 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,225 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,225 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA HOSPITAL ASSOCIATION/HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA, A LEADER REPRESENTING THE INTERESTS OF CALIFORNIA HOSPITALS AND HEALTH SYSTEMS WITH THE LEGISLATURE, ADMINISTRATION AND REGULATORY AGENCIES. OF THE $27,009 OF DUES PAID DURING THE SEPTEMBER 30, 2021 FISCAL YEAR, 11.94% ($3,225) WERE ALLOCATED TO LOBBYING EXPENDITURES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $659,201 | OtherCostOrOtherBasisAmt |
| Book Value | $659,201 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,120,923 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,243,967 | DepreciationAmt |
| Book Value | $15,876,956 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,130,319 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,494,558 | DepreciationAmt |
| Book Value | $2,635,761 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,397,713 | OtherCostOrOtherBasisAmt |
| Depreciation | $780,447 | DepreciationAmt |
| Book Value | $2,617,266 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,789,184 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSITS | $455,432 |
| HOSPITAL PROVIDER FEE RECEIVABLE | $11,115,632 |
| OTHER RECEIVABLES | $248,351 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,819,415 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED SELF-INSURED HEALTHCARE CLAIMS | $638,000 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENT PAYABLE | $628,632 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,266,632 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $93,010,450 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,438 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $2,438 | RevenueNotReportedAmt |
| Revenue Subtotal | $93,008,012 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$16,361 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$16,361 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $92,991,651 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $60,694,268 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $16,361 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $16,361 | ExpensesNotReportedAmt |
| Expenses Subtotal | $60,677,907 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $60,677,907 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE HOSPITAL RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2021 AND 2020, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RECLASSIFICATION OF RENTAL EXPENSES TO STATEMENT OF REVENUE -16,361. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RECLASSIFICATION OF RENTAL EXPENSES TO STATEMENT OF REVENUE 16,361. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| 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 | $145,973 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $145,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,432,368 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,031,371 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,400,997 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.30330 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,578,341 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,031,371 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,546,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.30570 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $593,873 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $408,680 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $185,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $593,873 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $408,680 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $185,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,172,214 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,440,051 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,732,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.30880 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | -$42,302 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,247,645 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $19,104,351 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,341,423 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,762,928 | 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 | GEORGE L MEE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 CANAL STREET | AddressLine1Txt |
| City | KING CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MEEMEMORIAL.COM | WebsiteAddressTxt |
| State License | 070000047 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GEORGE L MEE MEMORIAL HOSPITAL | 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 | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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 | HTTPS://WWW.MEEMEMORIAL.COM/ABOUT-MEE/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.MEEMEMORIAL.COM/ABOUT-MEE/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | HTTPS://WWW.MEEMEMORIAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MEEMEMORIAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MEEMEMORIAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GEORGE L. MEE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE HOSPITAL CONDUCTED PRIMARY DATA GATHERING REGARDING THE HEALTH NEEDS OF THE COMMUNITY VIA AN INTERNET SURVEY OF APPROXIMATELY 50 COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES. ONLINE SURVEY INVITATIONS WERE EXTENDED PARTICIPANTS, WITH TWO REMINDERS SENT THEREAFTER. OF THE APPROXIMATELY 50 COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES IDENTIFIED, THERE WERE 39 SURVEY RESPONDENTS DURING THE 14-DAY SURVEY PERIOD. |
| GEORGE L. MEE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: BASED ON STAKEHOLDER SURVEY FINDINGS, HEALTH INDICATOR DATA, AND INPUT FROM MEDICAL STAFF AND COMMUNITY LEADERS, NINE COMMUNITY HEALTH NEEDS EMERGED: (I) ACCESS TO PRIMARY CARE; (II) ACCESS TO SPECIALTY CARE; (III) AVAILABILITY OF URGENT/AFTER-HOURS CARE; (IV) ACCESS TO MENTAL HEALTH SERVICES; (V) AVAILABILITY OF SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES; (VI) AVAILABILITY OF PRESCRIPTION DRUGS; (VII) TRANSPORTATION TO/FROM MEDICAL SERVICES; (VIII) SERVICES AND OUTREACH TO VULNERABLE POPULATIONS (E.G. SENIORS, DISABLED, HOMELESS, LGBTQ; AND (IX) PATIENT EDUCATION/COUNSELING RELATED TO MEDICAL CONDITIONS.THE IRS REQUIRES THAT HOSPITAL LEADERS DEVELOP CRITERIA FOR PRIORITIZING THE ISSUES THAT ARE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL ESTABLISHED THE FOLLOWING CRITERIA FOR EVALUATING NEEDS: DOES THE ISSUE ALIGN WITH MMH'S MISSION AND EXPERTISE; DOES THE ISSUE IMPACT A LARGE NUMBER OF PEOPLE; ARE THERE COLLABORATORS THAT WOULD COMMIT TO WORKING WITH MMH TO ADDRESS THE ISSUE; DOES THE ISSUE PROVIDE AN OPPORTUNITY TO REDUCE HEALTH DISPARITIES AMONG SUBGROUPS OF THE POPULATION; ARE THERE GAPS IN CURRENT SERVICES AND PROGRAMS RELATED TO THE ISSUE; WOULD SOLVING THIS PARTICULAR ISSUE HELP TO ADDRESS OTHER HEALTH NEEDS; DO KEY STAKEHOLDERS PERCEIVE THIS TO BE AN IMPORTANT HEALTH ISSUE; AND WOULD THERE BE NEGATIVE CONSEQUENCES IF MMMH DOES NOT WORK TO ADDRESS THE ISSUE? EACH OF THE ABOVE-MENTIONED CRITERIA WAS SCORED BY HOSPITAL LEADERS. BASED OFF THAT SCORING, THE HOSPITAL DETERMINED IT WILL HELP TO ADDRESS THREE HIGH PRIORITY COMMUNITY HEALTH NEEDS: ACCESS TO PRIMARY CARE; PATIENT EDUCATION/COUNSELING RELATED TO MEDICAL CONDITIONS OR HEALTH BEHAVIORS; AND ACCESS TO SPECIALTY CARE.SPECIFIC TACTICS AND RESOURCES IDENTIFIED TO ADDRESS THE HEALTH NEED OF "ACCESS TO PRIMARY CARE" INCLUDES: (I) RECRUITMENT OF NEW PRIMARY CARE PHYSICIANS; (II) IMPLEMENT TELEMEDICINE AND VIRTUAL PROGRAMS; AND (III) RETAIN PROVIDERS BY (A) MAINTAINING A CULTURE THAT ASSURES MMH IS SUPPORTIVE, ACCOUNTABLE, COLLABORATIVE, AND ACCESSIBLE, (B) PROVIDING THE INFRASTRUCTURE AND CONTINUE TO IMPLEMENT LEAN CULTURE TO MITIGATE BARRIERS THAT IMPACT PHYSICIANS' PRODUCTIVITY AND PATIENT ACCESS, AND (C) EVALUATE RECRUITMENT AND COMPENSATION PRACTICES CONTINUOUSLY TO ENSURE MMH REMAINS A COMPETITIVE EMPLOYER. OUTCOMES WILL BE EVALUATED BY THE NUMBER OF NET ADDITIONAL PRIMARY CARE PROVIDERS, THE PERCENTAGE OF PATIENTS WHO SAW THEIR PRIMARY CARE PROVIDER IN THE LAST YEAR, WAIT TIMES FOR NEW APPOINTMENTS, AND PROVIDER SATISFACTION AND PROVIDER PRODUCTIVITY.SPECIFIC TACTICS AND RESOURCES IDENTIFIED TO ADDRESS THE HEALTH NEED OF "ACCESS TO SPECIALTY CARE" INCLUDE: (I) RECRUITMENT OF NEW SPECIALTY CARE PROVIDERS; (II) IMPROVEMENT OF THE AVAILABILITY OF SPECIALTY CARE; (III) IMPLEMENTATION OF THE TELEMEDICINE AND VIRTUAL PROGRAMS; AND (IV) IMPROVING ACCESS TO CARE. OUTCOMES WILL BE EVALUATED BY THE NUMBER OF NET ADDITIONAL SPECIALTY CARE PROVIDERS, REFERRAL WAIT TIMES FOR APPOINTMENTS (IN ALL PAYER CLASSES), THE IMPLEMENTATION OF A GI PROGRAM, THE IMPLEMENTATION OF AN ORTHOPEDIC PROGRAM, THE IMPLEMENTATION OF AN OPHTHALMOLOGY / OPTOMETRY / OPTICAL PROGRAM, THE IMPLEMENTATION OF A TELEMEDICINE-DERMATOLOGY PROGRAM, AND THE EXPANSION OF OBSTETRIC SERVICES.SPECIFIC TACTICS AND RESOURCES IDENTIFIED TO ADDRESS THE HEALTH NEED OF "ACCESS TO MENTAL HEALTH SERVICES" (WHICH WASN'T SPECIFICALLY IDENTIFIED AS PRIORITIZED HEALTH NEED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, BUT IS STILL BEING ADDRESSED) INCLUDE: (I) INTEGRATION OF MENTAL HEALTH SERVICES INTO CLINICS AND COMMUNITY SERVICES; (II) INCREASE AWARENESS AND EDUCATION ABOUT THE DAY TO DAY MENTAL HEALTH CHALLENGES SUCH AS STRESS, ANXIETY, DEPRESSION, ETC.; (III) RECRUIT MORE PROVIDERS TO INCREASE ACCESS; (IV) RESEARCH EXISTING MENTAL HEALTH CRISIS LINES AND FORM PARTNERSHIPS TO PROMOTE TO THE COMMUNITY; AND (V) IMPROVE EARLY INTERVENTION. OUTCOMES WILL BE EVALUATED BY THE ESTABLISHMENT OF MENTAL HEALTH IN PRIMARY CARE AND/OR OTHER SERVICE LINES TO HELP IDENTIFY MENTAL HEALTH ISSUES AT AN EARLY STAGE, WAIT TIMES FOR FIRST APPOINTMENT TARGETS (5 BUSINESS DAYS FOR URGENT NEED AND 30 DAYS FOR A ROUTINE NEED), IMPLEMENTATION OF A PEDIATRIC BEHAVIORAL DEVELOPMENT SPECIALTY PROGRAM, IMPLEMENTATION OF PSYCHOLOGY SERVICES, AND PATIENT SATISFACTION.SPECIFIC TACTICS AND RESOURCES IDENTIFIED TO ADDRESS THE HEALTH NEED OF "PATIENT EDUCATION / COUNSELING RELATED TO MEDICAL CONDITIONS OR HEALTH BEHAVIORS" INCLUDE: (I) EXPAND HOSPITAL AND CLINIC PREVENTION CLASSES; (II) ESTABLISH A DIABETES PREVENTION PROGRAM, WHICH FOLLOWS PATIENTS OVER TIME; (III) CONDUCT REVIEWS OF AGRICULTURAL SITE CLINICS; AND (IV) ENGAGE IN REVIEWING TOPICS WITH REGISTERED DIETICIANS, RESPIRATORY THERAPISTS, AND PHARMACISTS. OUTCOMES WILL BE EVALUATED BY THE LIST OF CURRICULA PROVIDED ON THESE VARIOUS TOPICS, THE NUMBER OF ATTENDEES AND COMPLETED REVIEWS OF AGRICULTURAL SITE CLINICS, THE NUMBER OF EVENTS HOSTED AND COMMUNITY RESIDENTS REACHED, THE NUMBER OF PEOPLE ENROLLED IN THE DIABETES PREVENTION PROGRAM, AND THE NUMBER OF PEOPLE WHO COMPLETED THE DIABETES PREVENTION PROGRAM.THE FOLLOWING SEVEN ADDITIONAL HEALTH NEEDS IDENTIFIED BY COMMUNITY PARTICIPANTS DURING THE CHNA PROCESS WILL NOT BE ACTIVELY ADDRESSED BY MMH DUE TO RESOURCE CONSTRAINTS AND/OR LACK OF EXPERTISE: (I) ALTERNATIVE MEDICINE; (II) CHIROPRACTIC CARE; (III) ASSISTED LIVING; (IV) ALZHEIMER'S/DEMENTIA CARE: (V) TEEN PREGNANCY PREVENTION; (VI) CHRONIC PAIN CARE (OTHER THAN INCREASING AWARENESS OF CURRENT SERVICES; AND (VII) CANCER CARE (OTHER THAN FACILITATING PATIENT REFERRALS TO AND COORDINATING CARE WITH CANCER TREATMENT PROVIDERS). |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - KING CITY CLINIC | ||||
| 210 CANAL STREET | KING CITY | CA | 93930 | OUTPATIENT HEALTH CLINIC |
| 2 - ADULT MEDICINE CLINIC | ||||
| 400 CANAL STREET SUITE C | KING CITY | CA | 93930 | OUTPATIENT HEALTH CLINIC |
| 3 - ALBERT AND DONNA OLIVEIRA CLINIC | ||||
| 467 S EL CAMINO REAL | GREENFIELD | CA | 93927 | OUTPATIENT HEALTH CLINIC |
| 4 - SPECIALTY CLINICOCCUPATIONAL HEALTH | ||||
| 400 CANAL STREET SUITE B | KING CITY | CA | 93930 | OUTPATIENT HEALTH CLINIC |
| 5 - MEE MEMORIAL DIALYSIS CENTER | ||||
| 809 BROADWAY STREET | KING CITY | CA | 93930 | OUTPATIENT DIALYSIS CENTER |
| 6 - REHABILITATIVEPHYSICAL THERAPY SERVICES | ||||
| 809 BROADWAY STREET | KING CITY | CA | 93930 | OUTPATIENT REHAB CENTER |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST TO CHARGE RATIO WAS USED TO CALCULATE THE COMMUNITY BENEFIT EXPENSE ON PART I, LINE 7B. |
| PART III, LINE 2: | BAD DEBT EXPENSE REFLECTS A CREDIT BALANCE ON SCHEDULE H, PART III, LINE 2, AS THE ORGANIZATION MADE A CORRECTION TO BAD DEBT EXPENSE DURING THE 9/30/2021 TAX YEAR. TRUE BAD DEBT EXPENSE (WITHOUT THE CORRECTION) EQUALS $1,537,802.THE ORGANIZATION RECORDS ACCOUNTS SENT TO COLLECTIONS AS A BAD DEBT AND ALSO ACCRUES BAD DEBT EXPENSE BASED ON AN ESTIMATE FROM AGED ACCOUNTS RECEIVABLE. |
| PART III, LINE 3: | THE ORGANIZATION HAS IDENTIFIED ACCOUNTS RECEIVABLE ATTRIBUTABLE TO SELF-PAY PATIENTS; REDUCTIONS ARE MADE TO THE ACCOUNTS RECEIVABLE FOR SELF-PAY PATIENTS BASED-OFF HISTORICAL TRENDS AND PATTERNS, WHICH IS REFLECTED ON SCHEDULE H, PART III, LINE 3. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES "BAD DEBT EXPENSE", "ACCOUNTS RECEIVABLE", AND "ALLOWANCE FOR DOUBTFUL ACCOUNTS" CAN BE FOUND ON PAGE 7 OF THE AUDITED FINANCIAL STATEMENTS ATTACHED TO THIS FORM 990. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED TO CALCULATE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS IS A RATIO OF PATIENT COSTS TO CHARGES. |
| PART III, LINE 9B: | COLLECTION PRACTICES FOR QUALIFIED PATIENTS:IT IS THE POLICY OF MEE MEMORIAL HEALTHCARE SYSTEM TO PROVIDE EXCELLENT CUSTOMER SERVICE TO ALL PATIENTS, AND ASSIST ALL UNINSURED PATIENTS WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, AND CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES. IF SUCH COVERAGE IS NOT AVAILABLE TO THE PATIENT, THE HOSPITAL WILL PROVIDE APPROPRIATE HEALTHCARE TO THE PATIENT, AND THE HOSPITAL WILL PROVIDE FINANCIAL ASSISTANCE BASED ON THE CURRENT FEDERAL POVERTY LEVEL, AND PER THE HOSPITAL'S POLICY, IN ACCORDANCE WITH CALIFORNIA STATE LAW, EMTALA, AND MEDICARE REGULATIONS. FURTHER, SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON INCOME WILL BE PROVIDED WITH SEVERAL OPTIONS FOR PAYMENT OF THEIR BILLS. IT IS THE HOSPITAL'S POLICY TO:- ASSIST ALL UNINSURED PATIENT WITH OBTAINING COVERAGE FROM GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, AND HEALTHY FAMILIES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT NO COST TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BELOW 100% OF THE CURRENT FEDERAL POVERTY LEVEL.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 50% DISCOUNT TO ELIGIBLE PATIENTS WHOSE FAMILY'S INCOME IS BETWEEN 101% AND 133% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE ALL MEDICALLY NECESSARY HEALTH CARE SERVICES AT A 35% DISCOUNT TO ELIGIBLE PATIENTS BETWEEN 133% AND 200% OF THE CURRENT FEDERAL POVERTY LEVEL. FOR THE SERVICES PROVIDED TO A PATIENT MEETING THESE CRITERIA, EXPECTED PAYMENT SHALL NOT EXCEED THE GREATER OF THE AMOUNT THAT WOULD BE EXPECTED FROM MEDICARE, MEDI-CAL, CENTRAL COAST ALLIANCE FOR HEALTH, OR HEALTHY FAMILIES FOR THE SAME SERVICES.- PROVIDE INTEREST-FREE PAYMENT PLANS FOR ELIGIBLE PATIENTS UNDER THIS POLICY.- FORGO REPORTS TO CREDIT BUREAUS, REFERRAL OF ACCOUNTS TO COLLECTION AGENCIES, LIENS AGAINST PROPERTY OR WAGE GARNISHMENTS FOR ELIGIBLE PATIENTS WHO ARE MEETING AN AGREED-UPON PAYMENT PLAN.- PROVIDE ADEQUATE NOTICE OF THIS POLICY IN ALL ADMITTING AND RECEPTION AREAS.- OFFER FREE FINANCIAL COUNSELING TO ALL UNINSURED PATIENTS FOR FINANCIAL MATTERS RELATED TO THEIR HOSPITAL BILLS.- FOR ALL UNINSURED PATIENTS ABOVE 100% OF THE CURRENT FEDERAL POVERTY LEVEL, SEVERAL PAYMENT OPTIONS WILL BE PRESENTED, AS FOLLOWS:A. PROMPT PAY DISCOUNT: OFFER A 25% DISCOUNT IF THE ACCOUNT IS PAID IN FULL AT TIME OF SERVICE.B. PAYMENT PLAN: OFFER A 15% DISCOUNT IF THE PATIENT SIGNS AN AGREEMENT REPRESENTING THAT HE/SHE WILL MEET A PAYMENT PLAN THAT WILL PAY THE BALANCE IN FULL WITHIN 6 MONTHS AT NO INTEREST.C. CCS EARLY-OUT: IF THE PATIENT REJECTS EACH OF THE ABOVE OPTIONS, THE ACCOUNT WILL BE SENT TO CCS FOR "EARLY-OUT" COLLECTIONS FOR 90 DAYS. THIS "EARLY-OUT" PROCESS DOES NOT INCLUDE REPORTS TO CREDIT BUREAUS. AT THE END OF THE 90 DAYS, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR POTENTIAL BAD DEBT WRITE-OFF AND COLLECTIONS REPORTING. |
| PART VI, LINE 2: | MMH ENGAGED CAROL DAVIS, OWNER AND PRINCIPAL CONSULTANT WITH STRATEGY CONNECTIONS, A HEALTHCARE CONSULTANCY, TO FACILITATE THE THREE-YEAR CHNA UPDATE. TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY THROUGHOUT THE CHNA PROCESS, MMH CONDUCTED ONLINE SURVEYS WITH COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES, REFERENCED HEALTH INDICATOR DATA, AND RECEIVED INPUT FROM MMH MEDICAL STAFF.IN ADDITION, MMH ANNUALLY UNDERTAKES A "WEEK OF WELLNESS", WHICH PROVIDES FREE HEALTH SCREENINGS AND PROMOTES HEALTHY CHOICES AND GENERAL WELLNESS. THIS EVENT ALLOWS MMH TO ASSESS WHAT HEALTH NEEDS MIGHT BE PERTINENT TO THE INDIVIDUALS WITHIN ITS SERVICE AREA. |
| PART VI, LINE 3: | UPON PRESENTATION TO OUR ADMITTING PROCESS, ONCE THE PATIENT IDENTIFIES THEY ARE WITHOUT INSURANCE, WE INFORM/EDUCATE THEM ABOUT THEIR OPTIONS WITH GOVERNMENT PROGRAMS AND PROVIDE CONTACT INFORMATION TO ACCESS THOSE PROGRAMS. ADDITIONALLY, WE PROVIDE THE PATIENT WITH OUR POLICIES RELATED TO CHARITY AND A CHARITY APPLICATION SHOULD THEY WISH TO PURSUE THAT ASSISTANCE.ADDITIONALLY, PATIENTS ARE INFORMED OF MEE MEMORIAL HEALTHCARE SYSTEM'S FINANCIAL ASSISTANCE PROGRAM IN SEVERAL WAYS, WHICH INCLUDE:1. NOTIFICATIONS POSTED IN ALL PATIENT ACCESS AND EMERGENCY AREAS.2. INCLUDED WITHIN MEE MEMORIAL HEALTHCARE SYSTEM'S CONDITIONS OF ADMISSIONS FORM3. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED ON ALL PATIENT STATEMENTS, IN PLAIN LANGUAGE, WITH PHONE NUMBERS TO CALL FOR FURTHER INFORMATION.4. ALL FINANCIAL ASSISTANCE PROGRAM INFORMATION IS ADVERTISED ON MEE MEMORIAL HEALTHCARE SYSTEM'S WEBSITE. |
| PART VI, LINE 4: | FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL HAS IDENTIFIED THE FOLLOWING EIGHT ZIP CODES AS THE TARGET COMMUNITY: 93960 (SOLEDAD); 93927 (GREENFIELD); 93930 (KING CITY); 93426 (BRADLEY); 93450 (SAN ARDO); 93932 (LOCKWOOD); 93928 (JOLON); AND 93954 (SAN LUCAS). THE ESTIMATED CURRENT POPULATION IN THE SERVICE AREA IS 66,535, WHICH REPRESENTS 3.9% OVERALL GROWTH SINCE THE 20210 CENSUS. NINETY-FOUR PERCENT OF THE POPULATION LIVES IN THE SOLEDAD, GREENFIELD, OR KING CITY ZIP CODES.COMPARED TO THE STATE OF CALIFORNIA, THE OVERALL PROFILE OF THE CHNA SERVICE POPULATION INDICATES THAT RESIDENTS: (I) ARE YOUNGER, (II) HAVE LESS FORMAL EDUCATION, (III) HAVE LESS HOUSEHOLD INCOME, (IV) ARE MORE LIKELY TO BE FOREIGN-BORN, (V) ARE MORE LIKELY TO LIVE IN POVERTY, (VI) ARE MORE LIKELY TO BE HISPANIC OR LATINO, AND (VII) ARE LESS LIKELY TO BE MILITARY VETERANS. THE MEDIAN AGE IN THE HOSPITAL SERVICE AREA IS 31.7, COMPARED 36.4 WITHIN CALIFORNIA AND 38.0 WITHIN THE UNITED STATES. THE PERCENTAGE OF INDIVIDUALS WITH A HIGH SCHOOL DEGREE OR HIGHER WITHIN THE HOSPITAL SERVICE AREA IS 51.3%, COMPARED TO 82.5% WITHIN CALIFORNIA AND 87.3% WITHIN THE UNITED STATES. THE MEDIAN HOUSE INCOME WITHIN THE HOSPITAL SERVICE AREA IS $51,174, COMPARED TO $67,169 WITHIN CALIFORNIA AND $57,652 WITHIN THE UNITED STATES. THE PERCENTAGE OF INDIVIDUALS WHO ARE FOREIGN-BORN WITHIN THE HOSPITAL SERVICE AREA IS 37.1%, COMPARED TO 27.0% WITHIN CALIFORNIA AND 13.4% WITHIN THE UNITED STATES. THE PERCENTAGE OF INDIVIDUALS THAT ARE BELOW POVERTY WITHIN THE HOSPITAL SERVICE AREA IS 18.5%, COMPARED TO 13.3% WITHIN CALIFORNIA AND 12.3% WITHIN THE UNITED STATES. THE PERCENTAGE OF INDIVIDUALS WHO ARE HISPANIC OR LATINO WITHIN THE HOSPITAL SERVICE AREA IS 78.3%, COMPARED TO 39.1% WITHIN CALIFORNIA AND 18.1% WITHIN THE UNITED STATES. THE PERCENTAGE OF INDIVIDUALS WHO ARE MILITARY VETERANS WITHIN THE HOSPITAL SERVICE AREA IS 2.0%, COMPARED TO 4.2% WITHIN CALIFORNIA AND 5.8% WITHIN THE UNITED STATES. |
| PART VI, LINE 5: | THE HOSPITAL UNDERTAKES MANY ACTIVITIES WHICH HELPS PROMOTE THE HEALTH OF THE COMMUNITY. ONE SUCH EXAMPLE WOULD BE THE OPERATION OF FOUR HEALTH CLINICS; A GOAL OF THE CLINICS IS TO PROVIDE HIGH-QUALITY, LOW-COST HEALTH CARE SERVICES TO PEOPLE WHO DO NOT OTHERWISE HAVE ACCESS WHICH MAY BE DUE TO FINANCIAL, CULTURAL, LIFESTYLE, OR PSYCHOLOGICAL BARRIERS. THE HOSPITAL ALSO CONTRACTS WITH THE COUNTY OF MONTEREY TO PROVIDE CONGREGATE MEALS TO ELIGIBLE ADULTS UNDER THE MONTEREY COUNTY ELDERLY NUTRITION PROGRAM. THE HOSPITAL HAS AN OPEN MEDICAL STAFF, AND THE BOARD IS PRIMARILY COMPRISED OF COMMUNITY MEMBERS. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT D VALLADARES MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $545,325 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $545,325 | $0 | $0 | $0 |
| MONEESHA PINTO MD | ||||||||||||||
| TRUSTEE THRU 7/2021 / CHIEF OF STAFF | $300,602 | $0 | $0 | $0 | $31,800 | $0 | $0 | $0 | $60,884 | $0 | $393,286 | $0 | $0 | $0 |
| SANDRA MONTIJO MD | ||||||||||||||
| PHYSICIAN | $283,831 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $70,283 | $0 | $354,114 | $0 | $0 | $0 |
| MARYANNE BALINO | ||||||||||||||
| INT LAB MGR / CLINICAL LAB SCIENTIST | $246,036 | $0 | $0 | $0 | $4,992 | $0 | $0 | $0 | $97,489 | $0 | $348,517 | $0 | $0 | $0 |
| RENA SALAMACHA BS MS | ||||||||||||||
| CEO / TRUSTEE | $247,772 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $71,989 | $0 | $319,761 | $0 | $0 | $0 |
| LEAH DAHLFRED MD | ||||||||||||||
| PHYSICIAN | $295,958 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $295,958 | $0 | $0 | $0 |
| JORGE FERIA MD | ||||||||||||||
| PHYSICIAN | $214,622 | $0 | $30,000 | $0 | $18,428 | $0 | $0 | $0 | $22,993 | $0 | $286,043 | $0 | $0 | $0 |
| LISA MOYLAN | ||||||||||||||
| CHIEF NURSING OFFICER | $192,927 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $34,065 | $0 | $226,992 | $0 | $0 | $0 |
| DENISE MILLER | ||||||||||||||
| QUALITY ASSURANCE DIR THROUGH 7/2021 | $156,300 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $63,628 | $0 | $219,928 | $0 | $0 | $0 |
| MARK WOOLERY | ||||||||||||||
| CFO | $187,189 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,215 | $0 | $213,404 | $0 | $0 | $0 |
| BRUCE GREENBERG MD | ||||||||||||||
| PHYSICIAN | $178,806 | $0 | $0 | $0 | $11,000 | $0 | $0 | $0 | $2,696 | $0 | $192,502 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S BONUSES ARE BASED ON BOARD CRITERIA, REVIEW, AND APPROVAL OF THE FOLLOWING FACTORS, SOME OF WHICH INVOLVE THE USE OF DISCRETION OR JUDGMENT BY INDIVIDUALS: FINANCIAL PERFORMANCE; ENHANCED PROGRAM & SERVICES; PHYSICIAN RECRUITMENT & RETENTION; PERFORMANCE IMPROVEMENT/QUALITY STANDARDS; REGULATORY & ACCREDITATION COMPLIANCE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING STAFF. A DRAFT FORM 990 IS THEN REVIEWED BY THE ORGANIZATION'S CFO; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS THEN PROVIDED TO ALL MEMBERS OF BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | MEE MEMORIAL HEALTHCARE SYSTEM HAS A CORPORATE POLICY ON CONFLICTS OF INTEREST; THIS POLICY APPLIES TO ALL INTERESTED PERSONS, DEFINED AS: (A) TRUSTEES, AND (B) SENIOR MANAGEMENT, WHICH INCLUDES OFFICERS AND KEY EMPLOYEES. THE BOARD OF TRUSTEES, CEO, AND CFO CONTINUOUSLY MONITOR AND EVALUATE ANY AND ALL TRANSACTIONS OF INTERESTED PARTIES WITH THE HOSPITAL. IF A CURRENT OR PAST TRANSACTION POSE A POTENTIAL RISK OF BEING A CONFLICT OF INTEREST TO THE HOSPITAL, THESE ITEM(S) WILL BE BROUGHT TO THE ATTENTION OF THE CEO, BOARD CHAIRMAN, AND/OR FULL BOARD OF TRUSTEES. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST TO THE BOARD, THE INTERESTED OFFICER OR BOARD MEMBER LEAVES THE BOARD MEETING WHILE THE CONFLICT OF INTEREST IS DISCUSSED AND/OR VOTED ON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROVIDED, HOWEVER, IF THE INTERESTED PERSON IS AN ADMINISTRATIVE STAFF EMPLOYEE AND THE CONTEMPLATED TRANSACTION IS AT THE ADMINISTRATIVE LEVEL, THE DECISION SHALL BE MADE BY THE HOSPITAL CEO. ANY OFFICER OR BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER MUST DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT. OFFICER OR BOARD MEMBERS ALWAYS ABSTAIN FROM VOTING ON ANY ISSUES OF A POSSIBLE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION FOR THE ORGANIZATION'S CEO IS SET BY THE BOARD OF DIRECTORS; THE CEO, WHO IS A MEMBER OF THE BOARD, DOES NOT PARTICIPATE IN THIS PROCESS. THE BOARD UTILIZES SALARY INFORMATION COMPILED BY THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, AND TAKES INTO ACCOUNT OTHER FACTORS (SUCH AS PERFORMANCE) IN MAKING THEIR DETERMINATION. THIS PROCESS IS DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE CEO, WHO TAKES INTO ACCOUNT COMPARABILITY DATA PROVIDED BY THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AS WELL AS OTHER FACTORS, SUCH AS PERFORMANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST; ADDITIONALLY, QUARTERLY FINANCIAL STATEMENTS AND AN ANNUAL REPORT ARE FILED WITH OSHPD AND ARE AVAILABLE ON THE OSHPD WEBSITE. |
| FORM 990, PART VII, SECTION A | MONEESHA PINTO, MD, RENA SALAMACHA, AND ROY SCHINDELHEIM, MD DEVOTE 2 HOUR PER WEEK FOR THEIR SERVICES AS MEMBERS OF THE BOARD OF TRUSTEES IN ADDITION TO OTHER DUTIES THROUGH EMPLOYMENT AT THE HOSPITAL. EACH DOES NOT RECEIVE COMPENSATION OR BENEFITS AS A BOARD MEMBER, BUT RATHER AS SERVICES THROUGH EMPLOYMENT TO THE HOSPITAL. |
| FORM 990, PART IX, LINE 11G | MEDICAL-PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 9,513,018. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,513,018. REGISTRY/TRAVELER STAFF FEES: PROGRAM SERVICE EXPENSES 1,929,016. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,929,016. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,955,388. MANAGEMENT AND GENERAL EXPENSES 1,889,594. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,844,982. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 436,896. MANAGEMENT AND GENERAL EXPENSES 775,881. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,212,777. |