2022-11-15T13:49:11-06:00 2021-12-31 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2021-01-01 951945832 VALLEY PRESBYTERIAN HOSPITAL VALL 8187826600 15107 VANOWEN STREET VAN NUYS CA 91405 LORI CARDLE EVP & CHIEF OPERATING OFFICER 8187826600 2022-11-14 1 LORI CARDLE 999009999 MICHAEL LUMSDEN P01262236 8185771900 2022-11-14 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z GUSTAVO VALDESPINO 15107 VANOWEN STREET VAN NUYS CA 91405 588742906 0 X WWW.VALLEYPRES.ORG X 1948 CA TO IMPROVE THE QUALITY OF HEALTH IN THE SAN FERNANDO VALLEY. 19 16 2044 107 0 0 21504321 2304871 361421582 477295346 10976637 32681241 1971315 2431271 395873855 514712729 273219 272225 0 0 159460292 158969563 0 0 0 234329467 301861385 394062978 461103173 1810877 53609556 558178015 665303454 133965755 171951032 424212260 493352422 X TO IMPROVE THE QUALITY OF HEALTH IN THE SAN FERNANDO VALLEY. 0 0 421025282 272225 477295346 SEE SCHEDULE O 421025282 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 426 0 1 2044 1 0 0 0 0 0 1 1 0 0 0 0 1 0 X 19 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X LORI CARDLE 8189022902 15107 VANOWEN STREET VAN NUYS CA 91405 GUSTAVO VALDESPINO PRESIDENT & CEO 40.00 0.00 X 1760820 0 220528 LORI CARDLE EVP & CHIEF OPERATING OFFICER 40.00 0.00 X 696361 0 139977 JANICE KLOSTERMEIER SVP OF FINANCE & CFO 40.00 0.00 X 487949 0 100168 HANNAH GROSSMAN MD SVP & CHIEF MEDICAL OFFICER 40.00 0.00 X 502682 0 45619 LORI BURNELL SVP & CHIEF NURSING OFFICER 40.00 0.00 X 436085 0 97181 TAMALA CHOMA VP, GENERAL COUNSEL 40.00 0.00 X 382462 0 47766 TONY EVANS VP & CHIEF INFORMATION OFFICER 40.00 0.00 X 323866 0 21298 DIANA MILAN-FINLEY ASSOCIATE ADMINISTRATOR, OPERATIONS SUPPORT SRVCS 40.00 0.00 X 286786 0 35021 DALLAS RYAN DIRECTOR, MATERIALS MANAGEMENT 40.00 0.00 X 299861 0 15386 SOHEILA RAHMAN-ALTAR CLINICAL NURSE SUPERVISOR 40.00 0.00 X 272877 0 25294 TOM KIM CONTROLLER 40.00 0.00 X 249910 0 33437 THERESA SOLIS-BITO DIRECTOR, SERVICE AND SUPPORT 40.00 0.00 X 242689 0 35404 EDINANCE MUWONGE CLINICAL NURSE SUPERVISOR 40.00 0.00 X 239386 0 10858 JEFFREY ALLPORT VP & CIO (THROUGH 1/2021) 40.00 0.00 X 139384 0 11253 BRIAN OSTICK MD DIRECTOR / CHIEF OF STAFF 1.00 0.00 X 60000 0 0 KALPESH PATEL MD DIRECTOR 1.00 0.00 X 12000 0 0 KEVIN RICE MD DIRECTOR 1.00 0.00 X 12000 0 0 NORAMAY CADENA DIRECTOR 1.00 0.00 X 0 0 0 DANIEL CHANDLER DIRECTOR 1.00 0.00 X 0 0 0 DAVID W FLEMING DIRECTOR / CHAIR EMERITUS 1.00 0.00 X 0 0 0 LUCA JACOBELLIS SECRETARY 1.00 0.00 X X 0 0 0 GREG KAY MD CHAIR OF THE BOARD 1.00 0.00 X X 0 0 0 MERRYLL MCELWAIN TREASURER 1.00 0.00 X X 0 0 0 MATTHEW MISCHEL MD DIRECTOR 1.00 0.00 X 0 0 0 TODD MOLDAWER MD DIRECTOR 1.00 0.00 X 0 0 0 ROBERT C MYRTLE DPA DIRECTOR 1.00 0.00 X 0 0 0 GANESA PANDIAN MD DIRECTOR 1.00 0.00 X 0 0 0 ELLEN RILEY DIRECTOR 1.00 0.00 X 0 0 0 DIANA SANCHEZ DIRECTOR 1.00 0.00 X 0 0 0 STUART SOLOMON DIRECTOR 1.00 0.00 X 0 0 0 KEVEN STEINBERG DIRECTOR 1.00 0.00 X 0 0 0 MARY BETH WALKER DIRECTOR 1.00 0.00 X 0 0 0 BETH ZACHARY VICE CHAIR OF THE BOARD 1.00 0.00 X X 0 0 0 6405118 0 839190 520 0 1 0 CARDINAL HEALTH PHARMACY SERVICES LLC 21377 NETWORK PLACE CHICAGO IL 60673 HEALTHCARE MANAGEMENT 9386762 WESTWAYS STAFFING SERVICES INC PO BOX 970 SAN JOSE CA 95108 AGENCY/STAFFING 5631742 ST VINCENT ANESTHESIA MED GROUP 7032 COLLECTION CENTER DR CHICAGO IL 60693 ANESTHESIA SERVICES 3449201 KINDRED HOSPITAL REHABILITATION SERVICES PO BOX 502096 ST LOUIS MO 631502096 REHAB SERVICES 2967184 DVA RENAL HEALTHCARE INC PO BOX 781607 PHILADELPHIA PA 191781607 DIALYSIS SERVICES 2736951 85 230233 2074638 2304871 NET PATIENT SERVICE REVENUE 622110 312571475 312571475 CAPITATION PREMIUM REVENUE 622110 158673931 158673931 OTHER OPERATING REVENUE 622110 6049940 6049940 477295346 6550210 6550210 614999 0 614999 614999 614999 100093443 73962412 26131031 26131031 26131031 43847 230233 67765 -23918 -23918 PARKING REVENUE 812930 930822 930822 CAFETERIA REVENUE 722514 868096 868096 GIFT SHOP REVENUE 453220 41272 41272 1840190 514712729 477295346 0 35112512 X 272225 272225 5819206 1933595 3885611 127814052 112795600 15018452 3971761 3398669 573092 11812747 11676307 136440 9551797 8362133 1189664 717775 717775 201838 201838 273216 273216 61317557 54418933 6898624 110449 110449 10170623 8935344 1235279 6216632 5356250 860382 4189242 4189242 229877 142808 87069 76713 17070 59643 704772 704772 10886647 9379935 1506712 5566489 4796087 770402 CAPITATION EXPENSES 117739473 117739473 PROVIDER PROGRAM FEES 41193428 41193428 MEDICAL SUPPLIES 30835506 30835506 OTHER CONTROLLABLE EXP 11431148 5380839 6050309 461103173 421025282 40077891 0 9983545 12287315 38167440 23169819 904380 904380 31604488 29437758 6387256 7452016 4449878 5240439 358173965 239058104 110563804 119115861 279769320 355398684 278217 310232 878784 878784 75190903 111108166 558178015 665303454 46573260 45664194 14320961 13868472 22200000 14742742 50871534 97675624 133965755 171951032 X 422370338 491332129 1841922 2020293 424212260 493352422 558178015 665303454 53609556 15530606 0 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 96473 96473 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA HOSPITAL ASSOCIATION (CHA), HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC), AND PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS, INC. (PEACH). A PORTION OF THE DUES PAID ARE USED FOR LOBBYING ACTIVITIES BY CHA, HASC AND PEACH ON BEHALF OF THEIR MEMBERS. 1587222 1587222 203570092 114373173 89196919 2030062 2014618 15444 140125554 122670313 17455241 10861035 10861035 119115861 OTHER RECEIVABLES 5106019 WORKERS COMP RESERVE 210242 DEPOSITS 3673287 HOSPITAL FEE PROGRAM RECEIVABLE 102118618 111108166 SELF INSURANCE RESERVES 12215754 ASSET RETIREMENT OBLIGATION 4374921 MEDICAL CLAIMS PAYABLE 33066761 SPLIT-INTEREST PAYABLES 121486 DUE TO THIRD-PARTY PAYORS 4350649 HOSPITAL FEE PROGRAM PAYABLE 29207192 SHARED RISK LIABILITY PAYABLE 14338861 97675624 GOLF CLASSIC 274080 230233 43847 900 900 16876 14149 600 34340 274080 230233 43847 900 900 16876 14149 600 34340 67765 -23918 1 1 X 1 X 400.000000000000 1 X 650.000000000000 1 1 1 0 1 1 3320612 3320612 0.00720 117539540 90914440 26625100 0.05770 120860152 90914440 29945712 0.06490 1310534 1310534 0.00280 4278792 4278792 0.00930 518420 518420 0.00110 6107746 6107746 0.01320 126967898 90914440 36053458 0.07810 2785 2785 0.00000 18375 18375 0.00000 1023 1023 0.00000 22183 22183 0.00000 1 4948155 867852 69323282 83837119 -14513837 X 1 1 1 1 VALLEY PRESBYTERIAN HOSPITAL 15107 VANOWEN STREET VAN NUYS CA 91405 WWW.VALLEYPRES.ORG 930000170 X X X X VALLEY PRESBYTERIAN HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.VALLEYPRES.ORG/COMMUNITY/COMMUNITY-BENEFIT/ X 1 21 1 HTTPS://WWW.VALLEYPRES.ORG/COMMUNITY/COMMUNITY-BENEFIT/ 0 1 X 400.000000000000 650.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 5: VPH CONDUCTED INTERVIEWS AND SURVEYS WITH COMMUNITY STAKEHOLDERS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS.INTERVIEWS:SIXTEEN (16) INTERVIEWS WERE COMPLETED IN JUNE AND JULY 2021. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT INTERVIEWS. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE "CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY". THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN THE PHONE INTERVIEW. APPOINTMENTS FOR THE INTERVIEWS WERE MADE ON DATES AND TIMES CONVENIENT TO THE STAKEHOLDERS. AT THE BEGINNING OF EACH INTERVIEW, THE PURPOSE OF THE INTERVIEW IN THE CONTEXT OF THE ASSESSMENT WAS EXPLAINED, THE STAKEHOLDERS WERE ASSURED THEIR RESPONSES WOULD REMAIN CONFIDENTIAL, AND CONSENT TO PROCEED WAS GIVEN. PLEASE REFERENCE ATTACHMENT 2 OF THE COMMUNITY HEALTH NEEDS ASSESSMENT POSTED ON THE ORGANIZATION'S WEBSITE FOR A LIST OF INDIVIDUALS INTERVIEWED.SURVEY: VALLEY PRESBYTERIAN HOSPITAL CONDUCTED A COMMUNITY SURVEY. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT THROUGH A SURVEY MONKEY LINK, AND IN A PAPER COPY FORMAT. THE SURVEYS WERE AVAILABLE IN ENGLISH AND SPANISH. THE SURVEYS WERE AVAILABLE FROM JUNE 14 THROUGH AUGUST 30, 2021 AND DURING THIS TIME, 73 SURVEYS WERE COLLECTED (19 IN SPANISH AND 54 IN ENGLISH). VALLEY PRESBYTERIAN HOSPITAL DISTRIBUTED THE SURVEYS AT COMMUNITY MEETINGS AND THROUGH SOCIAL MEDIA. A WRITTEN INTRODUCTION EXPLAINED THE PURPOSE OF THE SURVEY AND ASSURED PARTICIPANTS THE SURVEY WAS VOLUNTARY, AND THEIR RESPONSES WOULD REMAIN ANONYMOUS. THE SURVEY ASKED FOR DEMOGRAPHIC INFORMATION ON THE SURVEY RESPONDENTS. THE SURVEY ASKED ABOUT COMMUNITY NEEDS AND BARRIERS, VULNERABLE POPULATIONS WHO ARE MOST IMPACTED BY THE COMMUNITY NEEDS AND ACCESSING HEALTH CARE SERVICES. FINALLY, THE SURVEY RESPONDENTS WERE ASKED TO PRIORITIZE THE MOST IMPORTANT COMMUNITY NEEDS. VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 11: IN 2021, VALLEY PRESBYTERIAN HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO COMPLY WITH FEDERAL AND STATE REGULATIONS GUIDING TAX-EXEMPT HOSPITALS. THE CHNA INCORPORATED DEMOGRAPHIC AND HEALTH DATA FOR THE COMMUNITIES SERVED BY THE HOSPITAL. SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED FROM SECONDARY DATA SOURCES AND KEY INFORMANT INTERVIEWS. HEALTH INDICATORS WERE CONSIDERED HIGH-RISK HEALTH NEEDS WHEN THEY EXCEEDED BENCHMARK DATA, SPECIFICALLY COUNTY OR STATE RATES OR HEALTHY PEOPLE 2030 OBJECTIVES. THE FOLLOWING SIGNIFICANT NEEDS WERE IDENTIFIED: ACCESS TO HEALTH CARE; ALZHEIMER'S DISEASE; BIRTH INDICATORS; CHRONIC DISEASES; COVID-19; DENTAL CARE; ECONOMIC INSECURITY; HOUSING AND HOMELESSNESS; MENTAL HEALTH; OVERWEIGHT AND OBESITY; PREVENTIVE PRACTICES; AND SUBSTANCE USE. OF THOSE SIGNIFICANT HEALTH NEEDS, VPH WILL ADDRESS THE FOLLOWING NEEDS THROUGH A COMMITMENT OF COMMUNITY BENEFIT PROGRAMS AND CHARITABLE RESOURCES: ACCESS TO CARE (INCLUDING PREVENTIVE PRACTICES AND TRANSPORTATION); HOUSING AND HOMELESSNESS; CHRONIC DISEASE (WITH AN EMPHASIS ON DIABETES); OVERWEIGHT AND OBESITY; AND MENTAL HEALTH.TO ADDRESS THE HEALTH NEED OF "ACCESS TO CARE (INCLUDING PREVENTIVE PRACTICES AND TRANSPORTATION)", VPH INTENDS TO ADDRESS THIS BY:1. PROVIDE FINANCIAL ASSISTANCE FOR HEALTH CARE SERVICES CONSISTENT WITH VPH'S FINANCIAL ASSISTANCE POLICY. IN ADDITION TO OFFERING FINANCIAL ASSISTANCE, THE HOSPITAL WILL HOST ENROLLMENT CAMPAIGNS AND ASSIST PATIENTS IN DETERMINING ELIGIBILITY AND ENROLLING IN LOW OR NO COST INSURANCE PROGRAMS, INCLUDING COVERED CA, THE STATE INSURANCE MARKETPLACE. 2. PROVIDE TRANSPORTATION TO HEALTH CARE SERVICES AT THE HOSPITAL AND LOCAL COMMUNITY HEALTH CENTERS TO SUPPORT AREA RESIDENTS WHO EXPERIENCE LACK OF TRANSPORTATION AS A BARRIER TO ACCESS HEALTH CARE SERVICES. 3. ADMINISTER THE VPH COMMUNITY GRANTS PROGRAM IN PARTNERSHIP WITH ESTABLISHED COMMUNITY ORGANIZATIONS TO IMPLEMENT PROGRAMS THAT INCREASE ACCESS TO CARE FOR UNDERSERVED POPULATIONS. 4. FACILITATE ACCESS TO FREE HEALTH SCREENINGS AND ASSIST WITH COMMUNITY RESOURCES. 5. PROVIDE OR FACILITATE ACCESS TO COVID-19 TESTING AND VACCINES, PNEUMONIA VACCINES AND FLU VACCINES TO THE MEDICALLY UNDERSERVED. 6. OFFER CULTURALLY COMPETENT PRENATAL CARE, FREE OF CHARGE TO COMMUNITY RESIDENTS. 7. HOST SEVERAL COMMUNITY HEALTH SYMPOSIUMS.THE ANTICIPATED IMPACT OF THESE ACTIONS WILL BE TO: INCREASE AVAILABILITY AND ACCESS TO HEALTH CARE AND PREVENTIVE CARE SERVICES; PROVIDE FINANCIAL ASSISTANCE TO QUALIFIED PATIENTS; REDUCE THE PERCENTAGE OF RESIDENTS WHO DELAY OBTAINING NEEDED PREVENTIVE SCREENINGS AND VACCINES; AID ACCESS TO HEALTH CARE SERVICES BY PROVIDING TRANSPORTATION ASSISTANCE; AND INCREASE KNOWLEDGE OF CHILDBIRTH AND PARENTING. VPH PLANS TO COLLABORATE WITH SEVERAL COMMUNITY HEALTH CLINICS AND NONPROFIT ORGANIZATIONS THAT SERVE RESIDENTS WITHIN VPH'S SERVICE AREA.TO ADDRESS THE HEALTH NEED OF "CHRONIC DISEASE (WITH AN EMPHASIS ON DIABETES), VPH INTENDS TO TAKE THE FOLLOWING ACTIONS:1. PROVIDE SCREENINGS FOR CHRONIC DISEASES2. PROVIDE EDUCATION ON DIABETES PREVENTION AND TREATMENT, INCLUDING A FOCUS ON HEALTH EATING AND PHYSICAL ACTIVITY.3. ESTABLISH PARTNERSHIPS AND PROGRAMS WITH LOCAL SCHOOLS AND COMMUNITY CLINICS TO FOCUS ON DIABETES PREVENTION.4. CONTINUE THE VPH COMMUNITY GRANTS PROGRAM IN PARTNERSHIP WITH ESTABLISHED COMMUNITY ORGANIZATIONS TO IMPLEMENT PROGRAMS THAT FOCUS ON CHRONIC DISEASE INTERVENTIONS.THE ANTICIPATED IMPACT OF THESE ACTIONS WILL BE TO: INCREASE THE EARLY DIAGNOSIS OF PRE-DIABETES AND DIABETES; IMPROVE LINKAGES WITH SERVICES FOR TREATMENT OF CHRONIC DISEASES; AND INCREASE PUBLIC AWARENESS OF DIABETES PREVENTION. TO ADDRESS CHRONIC DIABETES, VPH WILL COLLABORATE WITH: THE AMERICAN DIABETES ASSOCIATION, FEDERALLY QUALIFIED HEALTH CENTERS, LOCAL SCHOOLS, AND COMMUNITY-BASED ORGANIZATIONS.TO ADDRESS "HOUSING AND HOMELESSNESS", VPH INTENDS TO TAKE THE FOLLOWING ACTIONS:1. COLLABORATIVELY ADDRESS HOUSING AND HOMELESSNESS ISSUES THROUGH SHARED RESOURCES. 2. CONTINUE THE VPH COMMUNITY GRANTS PROGRAM IN PARTNERSHIP WITH ESTABLISHED COMMUNITY ORGANIZATIONS TO IMPLEMENT PROGRAMS THAT FOCUS ON HOUSING AND HOMELESSNESS INTERVENTIONS. 3. ASSIST WITH LINKING HOMELESS PATIENTS TO EXTERNAL COMMUNITY RESOURCESTHE ANTICIPATED IMPACT OF THESE ACTIONS WILL BE TO: INCREASE PARTNERSHIPS TO ADDRESS HOUSING AND HOMELESSNESS ISSUES; FACILITATE TRANSPORTATION TO LOCAL COMMUNITY HOMELESS SERVICE CENTERS; AND IMPROVE LINKAGES WITH SERVICES FOR HOUSING AND HOMELESSNESS. TO ADDRESS THIS HEALTH NEED, VPH WILL COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS, THE SAN FERNANDO VALLEY/SANTA CLARITA COALITION, TRANSITIONAL HOUSING ORGANIZATIONS, RECUPERATIVE CARE ORGANIZATIONS, AND LOCAL SHELTERS.TO ADDRESS THE HEALTH NEED OF "MENTAL HEALTH", VPH INTENDS TO TAKE THE FOLLOWING ACTIONS:1. PROVIDE COMMUNITY HEALTH EDUCATION ON MENTAL HEALTH TOPICS, INCLUDING MEDITATION AND WELLNESS. 2. CONTINUE THE VPH COMMUNITY GRANTS PROGRAM IN PARTNERSHIP WITH ESTABLISHED COMMUNITY ORGANIZATIONS TO IMPLEMENT PROGRAMS THAT INCREASE ACCESS TO MENTAL HEALTH CARE SERVICES FOR UNDERSERVED POPULATIONS. 3. PROVIDE ACCESS TO MENTAL HEALTH CARE SERVICES THROUGH TELEMEDICINE SERVICES THAT REDUCE GEOGRAPHIC BARRIERS TO CARE.THE ANTICIPATED IMPACT OF THESE ACTIONS WILL BE TO: INCREASE ACCESS TO MENTAL HEALTH RESOURCES; INCREASE PUBLIC AWARENESS OF MENTAL HEALTH RESOURCES; AND BUILD COMMUNITY CAPACITY TO ADDRESS MENTAL HEALTH ISSUES. TO ADDRESS THIS HEALTH NEED, VPH WILL COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS AND FEDERALLY QUALIFIED HEALTH CENTERS.TO ADDRESS THE NEED OF "OVERWEIGHT AND OBESITY", VPH INTENDS TO TAKE THE FOLLOWING ACTIONS:1. PROVIDE COMMUNITY EXERCISE PROGRAMS. 2. CONTINUE THE VPH COMMUNITY GRANTS PROGRAM IN PARTNERSHIP WITH ESTABLISHED COMMUNITY ORGANIZATIONS TO IMPLEMENT PROGRAMS THAT ADDRESS OVERWEIGHT AND OBESITY IN THE COMMUNITY.THE ANTICIPATED IMPACT OF THESE ACTIONS WILL BE TO: INCREASE ACCESS TO HEALTH EATING AND PHYSICAL ACTIVITY OPPORTUNITIES; AND INCREASE PUBLIC AWARENESS OF THE BENEFIT OF HEALTHY WEIGHT AND PHYSICAL ACTIVITY. TO ADDRESS THIS HEALTH NEED, VPH WILL COLLABORATE WITH YOUTH PROGRAMS, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND SENIOR CENTERS.VPH WILL MONITOR AND EVALUATE THE PROGRAMS AND ACTIVITIES OUTLINED ABOVE. THE HOSPITAL HAS IMPLEMENTED A SYSTEM THAT TRACKS THE IMPLEMENTATION OF THE STRATEGIES AND DOCUMENTS THE ANTICIPATED IMPACT. THE VPH REPORTING PROCESS INCLUDES THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES, SUCH AS THE NUMBER OF PEOPLE REACHED/SERVED, INCREASES IN KNOWLEDGE OR CHANGES IN BEHAVIOR AS A RESULT OF COMMUNITY PROGRAMS, AND COLLABORATIVE EFFORTS TO ADDRESS HEALTH NEEDS. AN EVALUATION OF THE IMPACT OF THE HOSPITAL'S ACTIONS TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS WILL BE REPORTED IN THE NEXT SCHEDULED COMMUNITY HEALTH NEEDS ASSESSMENT.TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, VPH WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: ALZHEIMER'S DISEASE; BIRTH INDICATORS; DENTAL CARE; ECONOMIC INSECURITY; AND SUBSTANCE USE. SINCE VPH CANNOT ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT IT CAN MOST EFFECTIVELY ADDRESS GIVEN AREAS OF FOCUS AND EXPERTISE. THESE OTHER HEALTH NEEDS WILL BE ADDRESSED THROUGH REFERRALS TO COMMUNITY-BASED ORGANIZATIONS. VALLEY PRESBYTERIAN HOSPITAL PART V, SECTION B, LINE 16J: OTHER MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY WITHIN THE COMMUNITY SERVED IS THROUGH FINANCIAL COUNSELING IF IDENTIFIED AS UNDERINSURED. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.VALLEYPRES.ORG/PATIENTS-VISITORS/FOR-PATIENTS/BILLING-INSURANCE-PAYMENTS-COST-OF-CARE/BILLING-PAYMENTS-COST-OF-CARE/CHARITY-CARE-FINANCIAL-ASSISTANCE/ PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.VALLEYPRES.ORG/PATIENTS-VISITORS/FOR-PATIENTS/BILLING-INSURANCE-PAYMENTS-COST-OF-CARE/BILLING-PAYMENTS-COST-OF-CARE/CHARITY-CARE-FINANCIAL-ASSISTANCE/ PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.VALLEYPRES.ORG/PATIENTS-VISITORS/FOR-PATIENTS/BILLING-INSURANCE-PAYMENTS-COST-OF-CARE/BILLING-PAYMENTS-COST-OF-CARE/CHARITY-CARE-FINANCIAL-ASSISTANCE/ 2 1 - PERINATAL CENTER 15243 VANOWEN STREET SUITE 502 VAN NUYS CA 91405 SPECIALTY CENTER 2 - WOUND & HYPERBARIC CENTER 6850 SEPULVEDA BOULEVARD SUITE 200 VAN NUYS CA 91405 SPECIALTY CENTER PART I, LINE 7: THE ORGANIZATION IS UTILIZING A COST-TO-CHARGE RATIO TO DETERMINE AMOUNTS WITHIN SCHEDULE H, PART I, LINES 7A AND 7C; AMOUNTS REPORTED ON LINE 7E, 7F, AND 7I WERE ARRIVED AT UTILIZING COST ACCOUNTING METHODOLOGY. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY SUPPORT:HOSPITAL LEADERSHIP STAFF SUPPORTED COMMUNITY ORGANIZATIONS THROUGH PARTICIPATION ON COALITIONS, COMMUNITY BOARDS, COMMITTEES AND NETWORKS OF AGENCIES ADDRESSING COMMON ISSUES. EMPLOYEES ARE ALSO SUPPORTED BY THE HOSPITAL TO ENGAGE IN PLANNING, EDUCATION PRESENTATIONS, CONSORTIA, SUMMITS, AND MEETINGS WITH COMMUNITY GROUPS.COALITION BUILDING AND ADVOCACY:HOSPITAL REPRESENTATIVES SERVED ON A NUMBER OF COMMUNITY COMMITTEES AND BOARDS THAT ADDRESS HEALTH IMPROVEMENT AND COMMUNITY DEVELOPMENT. VPH ENGAGED IN ADVOCACY EFFORTS THAT SUPPORTED ACCESS TO HEALTH CARE.WORKFORCE DEVELOPMENT:VPH KNOWS THE IMPORTANCE OF CONNECTING WITH THE WORKFORCE OF THE FUTURE. THE HOSPITAL PARTICIPATED IN A VIRTUAL CAREER DAY TO PROVIDE INFORMATION ON HEALTH CARE CAREERS. STUDENTS LISTENED TO PANEL DISCUSSIONS FROM A VARIETY OF CLINICAL AND NON-CLINICAL LEADERS DISCUSSING THEIR EDUCATIONAL BACKGROUNDS, THEIR PERSONAL JOURNEYS THROUGH HEALTH CARE AND AN ACCOUNT OF WHAT A TYPICAL DAY ON THE JOB ENTAILS. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FAP WAS ESTIMATED UTILIZING RECORD REVIEWS. THE ENTIRE AMOUNT SHOULD BE CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT CONTAIN A SEPARATE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THE FOOTNOTE THAT ADDRESSES "PATIENT ACCOUNTS RECEIVABLE" CAN BE FOUND ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY WAS BASED ON THE 2021 MEDICARE COST REPORT COST-TO-CHARGE RATIO. 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: THE HOSPITAL INITIALLY MAKES ALL REASONABLE EFFORTS TO OBTAIN FROM THE PATIENT OR HIS OR HER REPRESENTATIVE INFORMATION ABOUT WHETHER PRIVATE OR PUBLIC HEALTH INSURANCE OR SPONSORSHIP MAY FULLY OR PARTIALLY COVER THE CHARGES FOR CARE RENDERED BY THE HOSPITAL TO A PATIENT. ONCE ALL INSURERS HAVE ISSUED PAYMENT, AND THE ACCOUNT HAS BEEN REVIEWED BY A CLAIMS ADJUSTER, ANY REMAINING BALANCE IS OWED BY THE PATIENT. WHEN THE HOSPITAL IS NOT ABLE TO COLLECT OUTSTANDING PAYMENTS FROM A PATIENT OR AN INSURER THROUGH ITS OWN REASONABLE EFFORTS, IT MAY WORK WITH AN OUTSIDE COLLECTION AGENCY TO ASSIST IN OUTSTANDING PAYMENTS. FOR ANY PATIENT THAT IS UNINSURED OR HAS HIGH MEDICAL COSTS, AS DISCUSSED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE COLLECTION AGENCY OR ANY OTHER AGENT OF THE HOSPITAL SHALL NOT REPORT ADVERSE INFORMATION TO A CREDIT REPORTING AGENCY OR TAKE ANY LEGAL ACTION AGAINST THE PATIENT FOR NONPAYMENT LESS THAN 150 DAYS AFTER THE PATIENT WAS FIRST BILLED. THIS TIMELINE WILL BE EXTENDED IF THE PATIENT HAS APPEALED THE BILL AND THE APPEAL IS PENDING. THE HOSPITAL, COLLECTION AGENCY, OR ANY OTHER AFFILIATE OF THE HOSPITAL CANNOT USE WAGE GARNISHMENTS OR LIEN ON PERSONAL RESIDENCES AS A MEANS OF COLLECTIONS.ALTERNATIVELY, PATIENTS WHO ARE UNABLE TO PAY THEIR BALANCE IN FULL ARE GIVEN THE OPPORTUNITY TO MAKE MONTHLY PAYMENTS BASED ON THE BALANCE OWED WITH NO INTEREST. THE COLLECTIONS VENDOR WILL MAKE EVERY ATTEMPT TO HAVE THE ACCOUNT PAID IN FULL WITHIN THREE MONTHS FOR ACCOUNTS WITH SMALLER BALANCES, AND 12 MONTHS FOR ACCOUNTS WITH LARGER BALANCES. IF THE PATIENT AND THE COLLECTIONS VENDOR CANNOT AGREE ON A PAYMENT PLAN THE HOSPITAL SHALL CREATE A REASONABLE PAYMENT PLAN, CONSISTING OF MONTHLY PAYMENTS NOT MORE THAN 10% OF THE PATIENT'S FAMILY MONTHLY INCOME, EXCLUDING MONEY SPENT ON ESSENTIAL LIVING EXPENSES. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH ITS TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. INITIALLY, SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED THROUGH A REVIEW OF THE SECONDARY HEALTH DATA COLLECTED AND ANALYZED PRIOR TO THE INTERVIEWS AND SURVEYS. THE IDENTIFIED SIGNIFICANT HEALTH NEEDS INCLUDED: ACCESS TO HEALTH CARE; ALZHEIMER'S DISEASE; BIRTH INDICATORS; CHRONIC DISEASES; COVID-19; DENTAL CARE; ECONOMIC INSECURITY; HOUSING AND HOMELESSNESS; MENTAL HEALTH; OVERWEIGHT AND OBESITY; PREVENTIVE PRACTICES; AND SUBSTANCE ABUSE.THE IDENTIFIED SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED WITH INPUT FROM THE COMMUNITY. INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND A COMMUNITY SURVEY WERE USED TO GATHER INPUT ON THE SIGNIFICANT HEALTH NEEDS. THE FOLLOWING CRITERIA WERE USED TO PRIORITIZE THE HEALTH NEEDS: (I) THE PERCEIVED SEVERITY OF A HEALTH OR COMMUNITY ISSUE AS IT AFFECTS THE HEALTH AND LIVES OF THOSE IN THE COMMUNITY; (II) IMPROVING OR WORSENING OF AN ISSUE IN THE COMMUNITY; (III) AVAILABILITY OF RESOURCES TO ADDRESS THE NEED; AND (IV) THE LEVEL OF IMPORTANCE THE HOSPITAL SHOULD PLACE ON ADDRESSING THE ISSUE. EACH OF THE STAKEHOLDER INTERVIEWEES WAS SENT A LINK TO AN ELECTRONIC SURVEY (SURVEY MONKEY) IN ADVANCE OF THE INTERVIEW. ADDITIONALLY, THE LINK TO THE PRIORITIZATION SURVEY WAS MADE AVAILABLE TO COMMUNITY RESIDENTS. THE STAKEHOLDERS WERE ASKED TO RANK EACH IDENTIFIED HEALTH NEED. THE PERCENTAGE OF RESPONSES WERE NOTED AS THOSE THAT IDENTIFIED THE NEED AS HAVING SEVERE OR VERY SEVERE IMPACT ON THE COMMUNITY, HAD WORSENED OVER TIME, AND HAD A SHORTAGE OR ABSENCE OF RESOURCES AVAILABLE IN THE COMMUNITY. NOT ALL SURVEY RESPONDENTS ANSWERED EVERY QUESTION, THEREFORE, THE RESPONSE PERCENTAGES WERE CALCULATED BASED ON RESPONDENTS ONLY AND NOT ON THE ENTIRE SAMPLE SIZE. ACCESS TO HEALTH CARE, COVID-19, AND HOUSING AND HOMELESSNESS HAD THE HIGHEST SCORES FOR SEVERE IMPACT ON THE COMMUNITY IN THE SURVEY. HOUSING AND HOMELESSNESS, MENTAL HEALTH AND ECONOMIC INSECURITY HAD THE HIGHEST RANKINGS FOR WORSENED OVER TIME. HOUSING AND HOMELESSNESS, MENTAL HEALTH ACCESS TO HEALTH CARE AND ECONOMIC INSECURITY WERE RATED HIGHEST ON INSUFFICIENT RESOURCES AVAILABLE TO ADDRESS THE NEED.THE INTERVIEWEES AND COMMUNITY RESIDENTS WERE ALSO ASKED TO PRIORITIZE THE HEALTH NEEDS ACCORDING TO HIGHEST LEVEL OF IMPORTANCE IN THE COMMUNITY. THE TOTAL SCORE FOR EACH SIGNIFICANT HEALTH NEED (POSSIBLE SCORE OF 4) WAS DIVIDED BY THE TOTAL NUMBER OF RESPONSES FOR WHICH DATA WERE PROVIDED, RESULTING IN AN OVERALL SCORE FOR EACH HEALTH NEED. ACCESS TO HEALTH CARE, CHRONIC DISEASE AND PREVENTIVE PRACTICES WERE RANKED AS THE TOP THREE PRIORITY NEEDS IN THE SERVICE AREA. PART VI, LINE 3: THE HOSPITAL DISTRIBUTES A PLAIN LANGUAGE SUMMARY OF ITS FINANCIAL ASSISTANCE POLICIES AND OFFERS A CONFIDENTIAL APPLICATION FOR CHARITY CARE OR DISCOUNTED CARE PRIOR TO DISCHARGE. THE HOSPITAL ALSO DISTRIBUTES A WRITTEN NOTICE ABOUT THE AVAILABILITY OF THE HOSPITAL'S DISCOUNT PAYMENT AND CHARITY CARE POLICIES, ELIGIBILITY, AND CONTACT INFORMATION FOR A HOSPITAL EMPLOYEE WHO CAN PROVIDE FURTHER INFORMATION ABOUT THESE POLICIES.INFORMATION ABOUT FINANCIAL ASSISTANCE IS ALSO DISSEMINATED AND MADE WIDELY AVAILABLE THROUGH VARIOUS MEANS INCLUDING: (I) MAKING PAPER COPIES AVAILABLE IN PERSON OR BY MAIL UPON REQUEST AND WITHOUT CHARGE; (II) INFORMING AND NOTIFYING VISITORS THROUGH CONSPICUOUS PUBLIC DISPLAY, INCLUDING POSTING NOTICES IN AREAS SUCH AS THE EMERGENCY DEPARTMENT, BILLING OFFICE, ADMISSIONS OFFICE, AND OTHER OUTPATIENT SETTINGS; (III) INFORMING AND NOTIFYING THE COMMUNITY, SUCH AS BY DISTRIBUTING AN INFORMATION SHEET OR SUMMARY OF THE CHARITY CARE POLICY TO LOCAL PUBLIC AGENCIES AND NONPROFIT ORGANIZATIONS; AND (IV) MAKING AVAILABLE ON THE HOSPITAL'S WEB SITE THE CHARITY CARE POLICY AND A PLAIN LANGUAGE SUMMARY OF THE CHARITY CARE POLICY, AND THE CONFIDENTIAL APPLICATION FORM.ADDITIONALLY, FOR UNINSURED PATIENTS, THE PATIENT WILL BE PROVIDED AN ESTIMATE FOR THE PATIENT FINANCIAL RESPONSIBILITY THAT WILL BE DUE FOR THE TESTS/PROCEDURES TO BE PROVIDED OR, IN THE CASE OF AN INPATIENT ADMISSION, FOR THE ESTIMATED LENGTH OF STAY BASED UPON THEIR PRIMARY DIAGNOSIS. IF THE PATIENT IS UNABLE TO PAY THE ESTIMATE IN FULL OR MAKE PAYMENT ARRANGEMENTS, THE PATIENT WILL BE REFERRED TO FINANCIAL COUNSELING FOR A MEDI-CAL ELIGIBILITY SCREENING BASED ON THE PATIENT'S CONFIDENTIAL FINANCIAL INFORMATION. PART VI, LINE 4: THE TOTAL POPULATION OF THE VALLEY PRESBYTERIAN HOSPITAL (VPH) SERVICE AREA IS 882,305. OF THE AREA POPULATION, 49.6% ARE MALE AND 50.4% ARE FEMALE. CHILDREN AND TEENS, AGES 0-17, MAKE UP 23.0% OF THE POPULATION, 65.6% ARE ADULTS, AGES 18-64, AND 11.4% OF THE POPULATION ARE SENIORS, 65 AND OLDER. IN THE SERVICE AREA, VAN NUYS 91402 HAS THE LARGEST PERCENTAGE OF YOUTH, AGES 0-17 (25.4%). CANOGA PARK HAS THE HIGHEST PERCENTAGE OF ADULTS, AGES 65 AND OLDER (13.9%). AMONG ADULTS IN THE SERVICE AREA, 6.6% IDENTIFY AS PART OF THE LESBIAN, GAY, BISEXUAL COMMUNITY.IN THE SERVICE AREA, 61.5% OF THE POPULATION ARE HISPANIC/LATINO; WHITES MAKE UP 23.1% OF THE POPULATION; ASIANS COMPRISE 9.3% OF THE POPULATION; AFRICAN AMERICANS ARE 4.1% OF THE POPULATION; AND NATIVE AMERICANS, HAWAIIANS, AND OTHER RACES COMBINED TOTAL 3.9% OF THE POPULATION. THE SERVICE AREA HAS A LARGER PERCENTAGE OF HISPANIC/LATINO INDIVIDUALS COMPARED TO THE COUNTY (48.5%) AND STATE (39%).IN THE SERVICE AREA, SPANISH IS SPOKEN AT HOME AMONG 53.9% OF THE POPULATION. ENGLISH ONLY IS SPOKEN IN THE HOME AMONG 30.5% OF THE POPULATION. OF THE POPULATION, 7.6% SPEAK AN INDO-EUROPEAN LANGUAGE, AND 6.9% OF THE POPULATION SPEAK AN ASIAN/PACIFIC ISLANDER LANGUAGE AT HOME. THE SERVICE AREA HAS A HIGHER PERCENTAGE OF THE POPULATION THAT SPEAKS SPANISH OR AN INDO-EUROPEAN LANGUAGE IN THE HOME WHEN COMPARED TO THE COUNTY AND THE STATE. WHEN EXAMINED BY SERVICE AREA ZIP CODE, PACOIMA (78.2%) AND VAN NUYS 91402 (66.6%) HAVE THE HIGHEST PERCENTAGE OF SPANISH SPEAKERS. WINNETKA (12.5%) AND VAN NUYS 91402 (11.9%) HAVE THE HIGHEST PERCENTAGE OF ASIAN/PACIFIC ISLANDER LANGUAGE SPEAKERS IN THE SERVICE AREA. THE HIGHEST PERCENTAGE OF INDO-EUROPEAN LANGUAGES SPOKEN AT HOME IS IN NORTH HOLLYWOOD 91605 (15.2%) AND VAN NUYS 91401 (14.6%). LINGUISTIC ISOLATION IS DEFINED AS THE POPULATION, AGES 5 AND OLDER, WHO SPEAKS ENGLISH "LESS THAN VERY WELL". IN THE SERVICE AREA, 30.6% OF THE POPULATION IS LINGUISTICALLY ISOLATED.IN THE SERVICE AREA, 2.7% OF THE POPULATION, 18 YEARS AND OLDER, ARE VETERANS. THIS IS LOWER THAN THE PERCENTAGE OF VETERANS FOUND IN THE COUNTY (3.3%) AND STATE (5.2%).THE COUNTY HEALTH RANKINGS RANK ORDER COUNTIES ACCORDING TO A VARIETY OF HEALTH FACTORS. SOCIAL AND ECONOMIC INDICATORS ARE EXAMINED AS A CONTRIBUTOR TO THE HEALTH OF A COUNTY'S RESIDENTS. THIS RANKING EXAMINES: HIGH SCHOOL GRADUATION RATES, UNEMPLOYMENT, CHILDREN IN POVERTY, SOCIAL SUPPORT, AND OTHERS. CALIFORNIA'S 58 COUNTIES WERE RANKED ACCORDING TO SOCIAL AND ECONOMIC FACTORS WITH 1 BEING THE COUNTY WITH THE BEST FACTORS TO 58 FOR THE COUNTY WITH THE POOREST FACTORS. FOR SOCIAL AND ECONOMIC FACTORS, LOS ANGELES COUNTY IS RANKED 34, SHOWING A DECREASE IN RANK FROM 29 IN 2018.THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ANNUALLY UPDATES OFFICIAL POVERTY POPULATION STATISTICS. IN 2019, THE FEDERAL POVERTY LEVEL (FPL) WAS AN ANNUAL INCOME OF $12,490 FOR ONE PERSON AND $25,750 FOR A FAMILY OF FOUR. AMONG RESIDENTS IN THE SERVICE AREA, 16.8% HAD INCOMES < 200% FPL IN THE SERVICE AREA. FAMILY INCOME HAS BEEN SHOWN TO AFFECT CHILDREN'S WELLBEING. COMPARED TO THEIR PEERS, CHILDREN IN POVERTY ARE MORE LIKELY TO HAVE PHYSICAL, BEHAVIORAL AND EMOTIONAL HEALTH PROBLEMS. IN OUR SERVICE AREA, 12.6% OF CHILDREN LIVE BELOW THE POVERTY LEVEL AND 26.6% OF CHILDREN ARE CATEGORIZED AS LOW-INCOME (< 200% FPL). IN THE SERVICE AREA, 14.5% OF SENIORS LIVE IN POVERTY, WHICH IS HIGHER THAN THE COUNTY RATE (13.2%) AND THE STATE RATE (10.2%).AMONG ADULTS IN OUR SERVICE AREA, 24.3% REPORTED AVOIDING GOVERNMENT BENEFITS DUE TO CONCERNS ABOUT DISQUALIFICATION FROM OBTAINING A GREEN CARD OR US CITIZENSHIP, AS COMPARED TO LOS ANGELES COUNTY AT 18.8%. ADDITIONALLY, 37.7% OF ADULTS BELOW 200% FPL CANNOT AFFORD FOOD AND 22.2% UTILIZE FOOD STAMPS. AMONG ELIGIBLE CHILDREN IN OUR SERVICE AREA, 24.9%, ACCESS WIC BENEFITS AS COMPARED TO LOS ANGELES COUNTY AT 41.9%. AMONG LOW-INCOME OLDER AND DISABLED ADULTS, 7.3% IN OUR SERVICE AREA ARE RECEIVING SUPPLEMENTAL SECURITY INCOME AS COMPARED TO LOS ANGELES COUNTY AT 10.5%.THE NATIONAL SCHOOL LUNCH PROGRAM IS A FEDERALLY ASSISTED MEAL PROGRAM THAT PROVIDES FREE, NUTRITIONALLY BALANCED LUNCHES TO CHILDREN WHOSE FAMILIES MEET ELIGIBILITY INCOME REQUIREMENTS. AMONG CHILDREN IN THE LOS ANGELES UNIFIED SCHOOL DISTRICT, 80.3% ARE ELIGIBLE FOR THE PROGRAM. ADDITIONALLY, AMONG HOUSEHOLDS WITH INCOMES LESS THAN 300% OF FEDERAL POVERTY LEVEL, 24.4% IN OUR SERVICE AREA WERE FOOD INSECURE.UTILIZING THE MOST AVAILABLE DATA, IN 2020 THE UNEMPLOYMENT RATE IN LOS ANGELES COUNTY WAS 12.8% AND 10.1% IN CALIFORNIA. PRELIMINARY DATA FOR THE MONTH OF FEBRUARY 2021 SHOWED AN UNEMPLOYMENT RATE OF 10.6% IN LOS ANGELES COUNTY. HIGH UNEMPLOYMENT CAN BE ATTRIBUTED IN PART TO THE COVID PANDEMIC. PART VI, LINE 5: ADDITIONAL INFORMATION DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES FURTHER ITS EXEMPT PURPOSE INCLUDES: (I) THAT THE MAJORITY OF VPH'S BOARD MEMBERS ARE UNPAID COMMUNITY MEMBERS WHO RESIDE IN THE HOSPITAL SERVICE AREA; AND (II) ANY SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO FURTHER SUPPORT THE COMMUNITY. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 EISNER HEALTH 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 951690966 501(C)(3) 55000 0 CAPITAL CAMPAIGN NORTHEAST VALLEY HEALTH CORPORATION 1172 N MACLAY AVE SAN FERNANDO CA 91340 237120632 501(C)(3) 52500 0 BEHAVIORAL HEALTH COORDINATOR POSITION VALLEY COMMUNITY HEALTHCARE 6801 COLDWATER CANYON AVE NORTH HOLLYWOOD CA 91605 237050082 501(C)(3) 26000 0 MENTAL HEALTH SUPPORT SAN FERNANDO VALLEY CANCER FOUNDATION 15211 VANOWEN ST SUITE 204 VAN NUYS CA 91405 853518900 501(C)(3) 10000 0 ACCESS TO CARE SUPPORT LA FAMILY HOUSING CORP 7843 LANKERSHIM BLVD NORTH HOLLYWOOD CA 91605 953920560 501(C)(3) 10500 0 MENTAL HEALTH SUPPORT ONE GENERATION 17400 VICTORY BLVD VAN NUYS CA 91406 954066979 501(C)(3) 10375 0 SENIOR SYMPOSIUM + COVID 19 GRANT MEND - MEET EACH NEED WITH DIGNITY 10641 SAN FERNANDO ROAD PACOIMA CA 91331 237306337 501(C)(3) 10000 0 CHRONIC DISEASE, MENTAL HEALTH, AND FOOD AND SECURITY OVARIAN CANCER COALITION OF GREATER CALIFORNIA PO BOX 40035 STUDIO CITY CA 91614 954840165 501(C)(3) 10000 0 OVARIAN CANCER AWARNESS AND SUPPORT COMPREHENSIVE COMMUNITY HEALTH CENTERS INC 801 SOUTH CHEVY CHASE DR 20 GLENDALE CA 91205 421553807 501(C)(3) 8000 0 HOLIDAY TOY DISTRIBUTION YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN LOS ANGELES 6901 LENNOX AVE VAN NUYS CA 91405 951644052 501(C)(3) 6010 0 FOOD PANTRY NORTH VALLEY CARING SERVICES 15453 RAYEN ST LOS ANGELES CA 91343 954444561 501(C)(3) 5500 0 FOOD INSECURITY SUPPORT 11 0 PART I, LINE 2: THE HOSPITAL GIVES GRANTS TO NONPROFIT ORGANIZATIONS THAT ARE EITHER IN THE HEALTHCARE SPACE OR VITAL TO THEIR COMMUNITY. THE HOSPITAL PROVIDES OVERSIGHT TO ENSURE THAT ANY RESTRICTED GRANT FUNDS ARE USED ACCORDING TO THE RESTRICTIONS, IF APPLICABLE. X X X X X 0 1 0 0 0 1 0 0 0 GUSTAVO VALDESPINO PRESIDENT & CEO 777388 0 274056 0 709376 0 203395 0 17133 0 1981348 0 627481 0 LORI CARDLE EVP & CHIEF OPERATING OFFICER 559717 0 129309 0 7335 0 123364 0 16613 0 836338 0 0 0 JANICE KLOSTERMEIER SVP OF FINANCE & CFO 385747 0 94054 0 8148 0 83035 0 17133 0 588117 0 0 0 HANNAH GROSSMAN MD SVP & CHIEF MEDICAL OFFICER 433590 0 59792 0 9300 0 36202 0 9417 0 548301 0 0 0 LORI BURNELL SVP & CHIEF NURSING OFFICER 343653 0 83132 0 9300 0 80048 0 17133 0 533266 0 0 0 TAMALA CHOMA VP, GENERAL COUNSEL 335857 0 45192 0 1413 0 27085 0 20681 0 430228 0 0 0 TONY EVANS VP & CHIEF INFORMATION OFFICER 291876 0 24686 0 7304 0 4685 0 16613 0 345164 0 0 0 DIANA MILAN-FINLEY ASSOCIATE ADMINISTRATOR, OPERATIONS 255456 0 30145 0 1185 0 17888 0 17133 0 321807 0 0 0 DALLAS RYAN DIRECTOR, MATERIALS MANAGEMENT 231763 0 25650 0 42448 0 8448 0 6938 0 315247 0 41848 0 SOHEILA RAHMAN-ALTAR CLINICAL NURSE SUPERVISOR 272538 0 0 0 339 0 8261 0 17033 0 298171 0 0 0 TOM KIM CONTROLLER 224468 0 24842 0 600 0 8223 0 25214 0 283347 0 0 0 THERESA SOLIS-BITO DIRECTOR, SERVICE AND SUPPORT 227099 0 0 0 15590 0 10190 0 25214 0 278093 0 0 0 EDINANCE MUWONGE CLINICAL NURSE SUPERVISOR 200929 0 22325 0 16132 0 10039 0 819 0 250244 0 0 0 JEFFREY ALLPORT VP & CIO (THROUGH 1/2021) 11541 0 58000 0 69843 0 9975 0 1278 0 150637 0 0 0 PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: THE ORGANIZATION MAINTAINS A 457(F) PLAN AVAILABLE TO CERTAIN EXECUTIVES OF THE ORGANIZATION. DURING THE 2021 CALENDAR YEAR, THE ORGANIZATION MADE THE FOLLOWING CONTRIBUTIONS TO THE PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS, WHICH IS REPORTED AS "RETIREMENT AND OTHER DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): GUSTAVO VALDESPINO - $191,995 LORI CARDLE - $113,389 JANICE KLOSTERMEIER - $73,060 HANNAH GROSSMAN - $36,202 LORI BURNELL - $70,073 TAMALA CHOMA - $27,085 TONY EVANS - $4,685 DIANA MILAN-FINLEY - $17,888 IN ADDITION, DUE TO VESTING OF THE 457(F) PLAN IN 2021, THE FOLLOWING INDIVIDUALS RECOGNIZED THE FOLLOWING AMOUNTS AS TAXABLE COMPENSATION, WHICH HAS BEEN REPORTED AS "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III) AS WELL AS ON SCHEDULE J, PART II, COLUMN (F), AS THESE AMOUNTS (EXCLUDING EARNINGS WITHIN THE PLAN, WHICH MAY HAVE BEEN INCLUDED IN THE VESTED AMOUNT BUT WERE UNABLE TO BE SEPARATED OUT) WERE REPORTED AS DEFERRED COMPENSATION IN A PRIOR YEAR: GUSTAVO VALDESPINO - $627,481 DALLAS RYAN - $41,848 PART I, LINE 6 VALLEY PRESBYTERIAN HOSPITAL HAS AN INCENTIVE (BONUS) PLAN AVAILABLE FOR EXECUTIVE TEAM MEMBERS AND HOSPITAL DEPARTMENT DIRECTORS. PAYMENT OF ANY BONUS IS CONTINGENT ON SEVERAL CRITERIA, INCLUDING: EARNINGS BEFORE INTEREST, DEPRECIATION, AND AMORTIZATION (EBIDA); QUALITY; AND PATIENT SATISFACTION SCORES, WHICH ARE BENCHMARKED BY ACHIEVING SPECIFIC MEASURES ON AN ANNUAL BASIS. FORM 990, PART III, LINE 4A: VALLEY PRESBYTERIAN HOSPITAL IS ONE OF THE LARGEST AND MOST PRESTIGIOUS FULL-SERVICE, ACUTE CARE FACILITIES IN THE SAN FERNANDO VALLEY. THE 350-BED HOSPITAL SERVES THOUSANDS OF FAMILIES EACH YEAR, WITH ACCESS TO A WIDE RANGE OF MEDICAL EXPERTISE AND LEADING-EDGE TECHNOLOGY ACROSS ALL ELEMENTS OF CARE. KEY HOSPITAL MEDICAL SERVICES AND PROGRAM SERVICE ACCOMPLISHMENTS IN 2021 INCLUDE: EMERGENCY SERVICES - THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT PLAYS AN IMPORTANT ROLE IN SERVING THE COMMUNITY AND HAS SEVERAL DESIGNATIONS THAT DEMONSTRATE COMMITMENT TO EXCELLENT CARE. AS A CERTIFIED CARDIAC RECEIVING CENTER FOR HEART ATTACK PATIENTS, HEART SPECIALISTS COLLABORATE TO PROVIDE CRITICAL CARE WITHIN THE FIRST 90 MINUTES OF CHEST PAIN. IN ADDITION, THE HOSPITAL IS A CERTIFIED STROKE CENTER BASED ON ITS RESPONSE TO CRITICAL PATIENT CONDITIONS. THE HOSPITAL HAS A DEDICATED STROKE-FOCUSED PROGRAM STAFFED BY MEDICAL PROFESSIONALS WHO ARE SPECIALLY TRAINED IN STROKE CARE AND WHO USE ADVANCED TECHNIQUES TO ACT QUICKLY. VALLEY PRESBYTERIAN HOSPITAL IS DESIGNATED AS A PEDIATRIC MEDICAL CENTER (PMC), RECOGNIZED BY THE COUNTY OF LOS ANGELES. THIS DESIGNATION ALLOWS OUR TEAM OF PEDIATRIC SPECIALISTS TO TREAT AND HANDLE A HIGHER LEVEL OF CARE NEEDED FOR PEDIATRIC PATIENTS IN OUR PEDIATRIC INTENSIVE CARE UNIT (PICU). WE ARE ONE OF ONLY THREE HOSPITALS THAT HOLD THE PMC DESIGNATION IN THE SAN FERNANDO VALLEY. DURING 2021, 46,576 PATIENTS VISITED THE EMERGENCY SERVICES DEPARTMENT DURING THE COVID-19 PANDEMIC. REHABILITATION SERVICES - VALLEY PRESBYTERIAN HOSPITAL OFFERS A FULL RANGE OF REHABILITATION SERVICES. OUR PHYSICIANS, NURSES, THERAPISTS AND SPECIALISTS WORK TOGETHER TO PROVIDE PERSONALIZED TREATMENT PLANS. WE OFFER PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND REHABILITATION SERVICES IN OUR WELL-EQUIPPED REHABILITATION CENTER. CHILDREN'S SERVICES - THE HOSPITAL PROVIDES COMPASSIONATE AND SPECIALIZED PEDIATRIC CARE FOR SICK OR INJURED CHILDREN. VPH HAS A 25-BED PEDIATRIC CARE CENTER FOR CHILDREN WITH SERIOUS CONDITIONS. ADDITIONALLY, THE HOSPITAL HAS A 10-BED PEDIATRIC INTENSIVE CARE UNIT (PICU) AND A 32-BED, LEVEL III NEONATAL INTENSIVE CARE UNIT (NICU) FOR CRITICALLY ILL NEWBORNS. VPH MAINTAINS THE PEDIATRIC MEDICAL CENTER DESIGNATION. MATERNITY SERVICES - THE BRANDED "LITTLE TREASURES" MATERNITY PROGRAM IS WELL KNOWN AMONG FAMILIES IN THE REGION. DURING 2021, 2,359 BABIES WERE BORN AT VPH. SHOULD A NEED ARISE, A PHYSICIAN IS AVAILABLE 24/7 TO HANDLE PATIENT EMERGENCIES. THE HOSPITAL'S PERINATAL CENTER SERVES WOMEN WITH HIGH-RISK PREGNANCIES AND OFFERS "NON-STRESS" ULTRASOUNDS, FETAL ECHOCARDIOGRAM SERVICES AS WELL AS HIGH-RISK INFANT FOLLOW UP SERVICES. SURGERY SERVICES - THE HOSPITAL PROVIDES A BROAD RANGE OF SURGICAL SERVICES REPRESENTING A WIDE RANGE OF SPECIALTY AREAS. IN 2021, 6,990 SURGERIES WERE PERFORMED. PHYSICIANS AND SURGICAL STAFF HAVE THE TOOLS AND ADVANCED TECHNOLOGY NEEDED TO PERFORM A FULL RANGE OF SURGICAL PROCEDURES AND TO DELIVER THE HIGHEST QUALITY OF CARE. MANY PROCEDURES INVOLVE MINIMALLY INVASIVE TECHNIQUES, WHICH CAN MINIMIZE PAIN AND SPEED RECOVERY TIME. HEART & VASCULAR SERVICES - VALLEY PRESBYTERIAN HOSPITAL OFFERS A FULL RANGE OF CARDIAC SERVICES TO DIAGNOSE AND TREAT PATIENTS SUFFERING FROM CRITICAL HEART AND VASCULAR CONDITIONS QUICKLY AND ACCURATELY. THE EXPERT MULTIDISCIPLINARY MEDICAL TEAM IS DEDICATED TO ACTING QUICKLY AND SAVING PATIENTS' LIVES. THE FRITZ B. BURNS VALLEY CARDIAC CATHETERIZATION LAB IS ONE OF THE AREA'S MOST TECHNOLOGICALLY ADVANCED AND BEST EQUIPPED FACILITIES. VALLEY PRESBYTERIAN HOSPITAL IS RECOGNIZED BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE SILVER QUALITY ACHIEVEMENT AWARD FOR OUR COMMITMENT TO ENSURE STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED, RESEARCH-BASED GUIDELINES BASED ON THE LATEST SCIENTIFIC EVIDENCE. OUTPATIENT SERVICES - THE HOSPITAL'S OUTPATIENT SERVICES DEPARTMENTS INCLUDE OUTPATIENT GENERAL AND GASTROINTESTINAL LABORATORIES; RADIOLOGY/IMAGING DEPARTMENT; AND THERAPY PROGRAMS, INCLUDING OCCUPATIONAL, PHYSICAL, RESPIRATORY, AND NUCLEAR MEDICINE. CENTER FOR WOUND HEALING - THE CENTER FOR WOUND HEALING IS AMONG A FEW FACILITIES NATIONWIDE THAT BRINGS TOGETHER THE INTERDISCIPLINARY EXPERTISE OF VASCULAR AND PODIATRIC SURGEONS, LIMB SALVAGE, AND WOUND MANAGEMENT SPECIALISTS. PATIENTS WITH "AT-RISK" LIMBS RECEIVE INTEGRATED CARE UTILIZING THE LATEST EQUIPMENT AND INSTRUMENTS TO PERFORM LIMB-SAVING PROCEDURES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS COMPLETED BY AN OUTSIDE ACCOUNTING FIRM IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE STAFF. THE CONTROLLER AND THE EVP & CHIEF OPERATING OFFICER THEN REVIEW THE DRAFT FORM 990, AND APPROPRIATE REVISIONS ARE MADE. THEREAFTER, THE FORM 990 IS REVIEWED WITH THE CEO AND THE BOARD FINANCE COMMITTEE, AND THEN IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C VPH'S BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE OF VPH IS REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE ATTESTATION. VPH'S COMPLIANCE OFFICER AND CEO REVIEW THESE ATTESTATIONS TO IDENTIFY ANY/ALL CONFLICTS THAT THE ORGANIZATION MUST BE AWARE OF SO THE APPROPRIATE MITIGATIONS CAN BE PUT IN PLACE. SHOULD A BOARD MEMBER, OFFICER, DIRECTOR, AND/OR KEY EMPLOYEE HAVE A CONFLICT WITH ANY ISSUES BEING DISCUSSED OR VOTED ON AT A MEETING OF THE BOARD OF DIRECTORS, THEY WOULD BE ASKED TO RECUSE THEMSELVES FROM THE DISCUSSION AND/OR VOTE ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION IS REVIEWED AND PAY ACTIONS ARE RECOMMENDED BY THE COMPENSATION COMMITTEE (WHICH CONSISTS OF BOARD AND NON-BOARD MEMBERS WITH COMPENSATION EXPERIENCE), AND THEN APPROVED BY THE VPH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTING FIRM AND MAINTAINS AN OBJECTIVE DECISION-MAKING PROCESS, ENSURING CONSISTENCY OF VPH'S EXECUTIVE PROGRAMS WITH THE ORGANIZATION'S EXECUTIVE PAY PHILOSOPHY AND OVERALL MISSION AND VALUES. VPH'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO FULFILL ITS MISSION OF IMPROVING THE QUALITY OF HEALTH IN THE SAN FERNANDO VALLEY AND TO ENSURE ITS FINANCIAL STABILITY. TOTAL COMPENSATION OFFERED TO OUR EXECUTIVES INCLUDES BASE SALARY, INCENTIVE BONUS, AND BENEFITS. THE INCENTIVE BONUS IS BASED ON KEY MEASURABLE SUCCESS INDICATORS APPROVED IN ADVANCE BY THE COMPENSATION COMMITTEE. THESE INDICATORS INCLUDE QUALITY, FINANCIAL, AND PATIENT SATISFACTION GOALS. IN ORDER TO RETAIN OUR KEY EMPLOYEES, WE OFFER A DEFERRED COMPENSATION PLAN WHICH PROVIDES AN ANNUAL BENEFIT (BASED ON A PERCENTAGE OF COMPENSATION) TO BE PAID ON A FUTURE DATE UPON VESTING IN THE PLAN. IN DETERMINING EACH INDIVIDUAL'S COMPENSATION, THE COMMITTEE RELIES ON COMPARABILITY DATA PROVIDED BY OUR INDEPENDENT CONSULTANT AND OBTAINED FROM SEVERAL DATA SOURCES INCLUDING: FORMS 990 OF SELECT COMPARATOR ORGANIZATIONS (28 CALIFORNIA-BASED, SIMILARLY-SIZED NONPROFIT HOSPITALS) AND A NUMBER OF WELL-REGARDED NATIONAL HEALTHCARE SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE HOSPITAL LOCATION. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 28,230,031. MANAGEMENT AND GENERAL EXPENSES 4,608,879. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,838,910. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 13,089,838. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,089,838. CONSULTING FEES: PROGRAM SERVICE EXPENSES 13,099,064. MANAGEMENT AND GENERAL EXPENSES 2,289,745. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,388,809. CHARITABLE REMAINDER TRUSTS (4) CHARITABLE GIVING CA VPH 1 VALLEY PRESBYTERIAN SERVICES CORPORATION 15107 VANOWEN STREET VAN NUYS CA 91405 823927685 MANAGEMENT SERVICE ORGANIZATION CA VPH C 1383336 1751956 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 VALLEY PRESBYTERIAN SERVICES CORPORATION D 4221544 BOOK VALUE