2022-11-15T17:19:48-06:00 2021-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2021-01-01 941458282 NORTHBAY HEALTHCARE GROUP NORT 7076465000 1200 B GALE WILSON BOULEVARD FAIRFIELD CA 94533 MICHELE BOUIT VP, FINANCE/CFO 7076463400 2022-11-14 1 MICHELE BOUIT 999009999 MICHAEL LUMSDEN P01262236 4159561500 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z B KONARD JONES 4500 BUSINESS CTR DR FAIRFIELD CA 94534 734746255 0 X WWW.NORTHBAY.ORG X 1954 CA HEALTH CARE SERVICES (INCLUDING HOSPITAL AND PHYSICIAN SERVICES) WITHIN SOLANO COUNTY. 9 8 0 0 0 0 40052915 2564723 599933947 675399468 5115543 6360551 3203625 1218838 648306030 685543580 45500 50000 0 0 282883798 290784512 0 0 0 355621953 401645470 638551251 692479982 9754779 -6936402 927133322 886687386 524750674 461156410 402382648 425530976 X COMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME. 0 0 658492074 50000 675399468 NORTHBAY HEALTHCARE GROUP OPERATES TWO NON-PROFIT HOSPITALS WITHIN SOLANO COUNTY: NORTHBAY MEDICAL CENTER AND VACAVALLEY HOSPITAL. NORTHBAY MEDICAL CENTER, A 132-BED ACUTE-CARE HOSPITAL, IS COMMITTED TO MEETING THE CHANGING HEALTH NEEDS OF LOCAL RESIDENTS, MAKING STATE-OF-THE-ART SERVICES AVAILABLE CLOSE TO HOME. THESE SERVICES INCLUDE: A 24-HOUR EMERGENCY DEPARTMENT AND STEMI RECEIVING CENTER, A LEVEL II TRAUMA CENTER, AN ACCREDITED CHEST PAIN CENTER WITH PCI, A PRIMARY STROKE CENTER, A MODERN MATERNITY UNIT WITH PRIVATE BIRTHING SUITES, A NEWBORN INTENSIVE CARE UNIT FOR PREMATURE AND CRITICALLY ILL NEWBORNS, STATE-OF-THE-ART CRITICAL CARE UNITS, COMPREHENSIVE DIAGNOSTIC IMAGING SERVICES, SURGICAL SERVICES, A CARDIAC CATHERIZATION LAB, THE NORTHBAY HEART & VASCULAR CENTER, AND A CANCER CENTER ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS.VACAVALLEY HOSPITAL IS A 50-BED, NON-PROFIT HOSPITAL PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF VACAVILLE AND SURROUNDING COMMUNITIES OF NORTHERN SOLANO COUNTY. VACAVALLEY HOSPITAL PROVIDES A 24-HOUR EMERGENCY DEPARTMENT, 44 MEDICAL-SURGICAL BEDS, A SIX-BED CRITICAL CARE UNIT FOR HIGH-LEVEL INTENSIVE CARE, TWO SURGERY SUITES, A FULL SERVICE LABORATORY, AND DIAGNOSTIC IMAGING SERVICES WITH A FULLY EQUIPPED RADIOLOGY DEPARTMENT INCLUDING CT SCANNER. 658492074 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 667 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MICHELE BOUIT 7076463400 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 ARCHIE HUMPHREY CHAIR 1.00 1.00 X X 16887 0 0 WAYNE SENALIK VICE CHAIR 1.00 0.00 X X 16699 0 0 DENISE SUIHKONEN SECRETARY - TREASURER 1.00 0.00 X X 16718 0 0 DONALD DOYLE MD DIRECTOR 1.00 0.00 X 16718 0 0 THERESA HITE DIRECTOR 1.00 0.00 X 1045 0 0 B KONARD JONES DIRECTOR / PRES. & CEO OF NBHC 13.00 37.00 X 0 1712261 408955 JAMES LONG MD DIRECTOR 1.00 0.00 X 24853 0 0 GWENDOLYN RUNNELS DIRECTOR 1.00 0.00 X 0 0 0 MARK SIEVERS DIRECTOR 1.00 1.00 X 16850 0 0 AIMEE BREWER PRESIDENT, NBHG (THROUGH 9/2021) 45.00 5.00 X 0 684178 109617 WAYNE GIETZ PRESIDENT, NBHG (START 9/2021) 45.00 5.00 X 0 623438 82421 MICHELE BOUIT VICE PRESIDENT & CFO 35.00 15.00 X 0 512144 88016 CHRISTOPHER TIMBERS VP, CHIEF INFORMATION OFFICER 40.00 10.00 X 0 484597 126816 STEVE HUDDLESTON VP, PUBLIC AFFAIRS 45.00 5.00 X 0 418468 50130 SCOTT DAVIS VP, CHIEF STRATEGY OFFICER 35.00 15.00 X 0 509139 75631 JIM ANDERSEN VP, HUMAN RESOURCES 45.00 5.00 X 0 558805 72262 SETH KAUFMAN MD CHIEF MEDICAL OFFICER 50.00 0.00 X 0 456289 64713 TRACI DUNCAN VP, CHIEF NURSING OFFICER 50.00 0.00 X 0 477669 35931 ROBERT COSCIONE VP, PAYER STRATEGY (THRU 8/2021) 50.00 0.00 X 0 418462 57077 NICOLE BROCATO VP, OPERATIONS / CQO (THRU 8/2021) 50.00 0.00 X 0 308498 75687 THERESA BARTOLI CLINICAL COORDINATOR 40.00 0.00 X 0 336318 65987 AROLD NELSON CLINICAL NURSE SUPERVISOR 40.00 0.00 X 0 339281 56680 THEO RALLIS ASSISTANT VP, FINANCE / CONTROLLER 35.00 15.00 X 0 336033 49391 DUSTIN DATOC REGISTERED NURSE FIRST ASSISTANT 40.00 0.00 X 0 315833 56957 JOANNE JACOB CLINICAL COORDINATOR 40.00 0.00 X 0 321492 14784 109770 8812905 1491055 0 0 1 0 SACSOLANO ANESTHESIA EXCHANGE 3315 WATT AVE SACRAMENTO CA 95821 ANESTHESIA SERVICES 6024088 RIGHTSOURCING INC PO BOX 515743 LOS ANGELES CA 900515118 PROFESSIONAL RECRUITING SERVICES 4203573 SOUND INPATIENT PHYSICIANS 1709 DOCK STREET TACOMA WA 98402 PHYSICIAN SERVICES 4156435 TOTAL RENAL CARE PO BOX 781607 PHILADELPHIA PA 191781607 DIALYSIS SERVICES 3190533 MEDIC AMBULANCE SERVICE INC 1001 TEXAS ST SUITE C FAIRFIELD CA 94533 MEDICAL TRANSPORTATION SRVCS 2502894 192 281949 2084480 198294 2564723 NET PATIENT SERVICE REVENUE 622110 554422305 554422305 CAPITATION REVENUE 622110 105845511 105845511 PHARMACY REVENUE 622110 10441473 10441473 REINSURANCE RECOVERIES 622110 3548888 3548888 RENTAL REVENUE - RELATED ORGS 622110 1006620 1006620 134671 134671 675399468 5073661 5073661 385717 385717 267473 11 267462 267462 267462 50103837 49184291 18373 919546 -18373 901173 901173 CAFETERIA 722514 848811 848811 AMORT OF GAIN ON MOB SALE 525990 100516 100516 VENDING MACHINES 722515 1037 1037 1012 1012 951376 685543580 675399468 0 7579389 X 50000 50000 631629 521003 110626 231955343 231501429 453914 8756250 8743855 12395 33232453 33145815 86638 16208837 16186407 22430 40707 36791 3916 146832 146832 142527614 142043165 484449 7685 7685 6817867 6804521 13346 635547 635508 39 12929389 12332981 596408 201958 201891 67 81876 73581 8295 14550052 14549515 537 27524855 27460489 64366 4119326 4119326 CORPORATE MGMT FEES 90031470 90031470 MEDICAL SUPPLIES 73532382 67914764 5617618 QUALITY ASSURANCE FEE 25720066 25720066 TAXES & LICENSES 733863 368610 365253 2043981 1770953 273028 692479982 658492074 33987908 0 8581357 8196984 180378784 53722570 25023297 0 66694712 154045083 2206 657 4376263 5455059 13552658 12026622 531543109 238462174 316850696 293080935 237661103 285144234 6620056 5252996 67392190 69762246 927133322 886687386 38222152 37714385 91183502 39807820 262155019 258042910 50025233 44186740 83164768 81404555 524750674 461156410 X 402359264 425381974 23384 149002 402382648 425530976 927133322 886687386 X -6936402 11362700 18722030 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 12020 12020 0 PART II-B, LINE 1: NORTHBAY HEALTHCARE GROUP SUPPORTS CERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN ITS COMMUNITY. THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA; A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO LOBBYING. 23384 127768 1483 666 149003 27615 12169 16400 23384 51077 31504 37942 17024 27615 59131 24328 25199 7183 51077 41400 42250 19888 4331 300 59131 0.00000 0.00000 1.00000 0 0 9867153 9867153 235188013 63480074 171707939 27601472 15581659 12019813 236485072 148410055 88075017 22401399 10990386 11411013 293080935 OTHER RECEIVABLES 12108866 HOSPITAL QUALITY ASSURANCE FEE RECEIVABLE 13185155 OPERATING LEASE RIGHT-OF-USE ASSETS 44468225 69762246 MALPRACTICE INSURANCE LIABILITY 3483040 REFUNDS DUE TO PATIENTS & INS CO. 3069002 OPERATING LEASE LIABILITY 49117871 AMOUNTS PAYABLE TO THIRD PARTY PAYORS 8609917 DEFERRED SOCIAL SECURITY TAXES 8627830 DUE TO NORTHBAY HEALTH ADVANTAGE 8496895 81404555 PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO FINANCIALLY ASSIST PATIENTS AND EMPLOYEES IN NEED WITH HOUSING, UTILITIES, MEDICATIONS, FOOD, MEDICAL EQUIPMENT, TRANSPORTATION, PERSONAL ITEMS, AND REGULAR LIFE EXPENSES. 1 1 X 1 X 138.000000000000 1 X 1 1 1 0 1 1 32471743 32471743 0.04690 252511768 181368636 71143132 0.10270 284983511 181368636 103614875 0.14960 6511314 5530962 980352 0.00140 6511314 5530962 980352 0.00140 291494825 186899598 104595227 0.15100 91785 91785 0.00010 62079 62079 0.00010 32140 32140 0.00000 27000 27000 0.00000 213004 213004 0.00020 1 53073586 7987574 117935793 178750551 -60814758 X 1 1 2 1 NORTHBAY MEDICAL CENTER 1200 B GALE WILSON BLVD FAIRFIELD CA 94533 WWW.NORTHBAY.ORG 110000093 X X X OUTPATIENT CLINICS A 2 NORTHBAY VACAVALLEY HOSPITAL 1000 NUT TREE ROAD VACAVILLE CA 95687 WWW.NORTHBAY.ORG 110000093 X X X OUTPATIENT CLINICS A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 19 1 1 1 1 X WWW.NORTHBAY.ORG X X 1 20 1 WWW.NORTHBAY.ORG 0 1 X 138.000000000000 350.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.NORTHBAY.ORG/PATIENTS-VISITORS/FORMS-DOCUMENTS.CFM X HTTPS://WWW.NORTHBAY.ORG/PATIENTS-VISITORS/FORMS-DOCUMENTS.CFM X HTTPS://WWW.NORTHBAY.ORG/PATIENTS-VISITORS/FORMS-DOCUMENTS.CFM X X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: NORTHBAY MEDICAL CENTER, - FACILITY 2: NORTHBAY VACAVALLEY HOSPITAL GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 5: A BROAD RANGE OF COMMUNITY MEMBERS PROVIDED INPUT THROUGH KEY INFORMANT INTERVIEWS, GROUP INTERVIEWS, AND FOCUS GROUPS. WE CONSULTED INDIVIDUALS WITH KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM HEALTH DEPARTMENTS, SCHOOL DISTRICTS, LOCAL NON-PROFITS, AND OTHER REGIONAL PUBLIC AND PRIVATE ORGANIZATIONS. IN ADDITION, WE GATHERED INPUT FROM COMMUNITY LEADERS, CLIENTS OF LOCAL SERVICE PROVIDERS, AND OTHER INDIVIDUALS REPRESENTING PEOPLE WHO ARE MEDICALLY UNDERSERVED, LOW INCOME, OR WHO FACE UNIQUE BARRIERS TO HEALTH (E.G., RACE/ETHNIC MINORITIES AND INDIVIDUALS EXPERIENCING HOMELESSNESS).THERE WERE A TOTAL OF EIGHT KEY INFORMANT INTERVIEWS OCCURRING BETWEEN 8/8/2018 AND 9/7/2018 WITH REPRESENTATIVES FROM VACAVILLE FAMILY RESOURCE CENTER, WINTERS HEALTHCARE, SOLANO COUNTY BOARD OF SUPERVISORS, CAMINAR, SOLANO COUNTY DEPARTMENT OF HEALTH AND SOCIAL SERVICES, SOLANO COUNTY PUBLIC HEALTH DEPARTMENT, PARTNERSHIP HEALTHPLAN, AND SOLANO COUNTY DEPARTMENT OF HEALTH AND SOCIAL SERVICES. IN ADDITION, THERE WERE FOUR GROUP INTERVIEWS: (1) A GROUP-INTERVIEW ON 8/30/2018 WITH SEVEN INDIVIDUALS REPRESENTING FIRST 5 SOLANO PARTNER ORGANIZATIONS, INCLUDING RIO VISTA CARE, CHILD START INC., SOLANO FAMILY AND CHILDREN'S SERVICES, COUNTY OF SOLANO MENTAL HEALTH SERVICES, AND THE SOLANO COUNTY OFFICE OF EDUCATION; (2) A GROUP-INTERVIEW ON 9/20/2018 WITH TWELVE INDIVIDUALS FROM THE WORKFORCE DEVELOPMENT BOARD; (3) A GROUP INTERVIEW ON 9/20/2018 WITH FOUR INDIVIDUALS FROM THE LEAVEN; AND (4) A GROUP INTERVIEW ON 9/28/2018 WITH FIVE INDIVIDUALS FROM SENIOR SERVICE PROVIDERS OLDER AND DISABLED ADULT SERVICES, FOOD BANK OF CONTRA COSTA AND SOLANO COUNTY, NORTH BAY REGIONAL CENTER, AND BORN TO AGE. ALL FOCUS GROUPS TARGETED INDIVIDUALS WHICH WORKED WITH THE MEDICALLY-UNDERSERVED, LOW-INCOME, AND MINORITY TARGET GROUPS.LASTLY, THERE WERE SEVEN SEPARATE FOCUS GROUPS HELD (IN BOTH ENGLISH AND SPANISH) IN WHICH 63 INDIVIDUALS PARTICIPATED ON THE FOLLOWING DATES: 9/26/2018, 10/1/2018, 10/5/2018, 10/5/2018, 10/5/2018, 10/8/2018, AND 10/8/2018. ALL FOCUS GROUPS INCLUDED INDIVIDUALS FROM THE MEDICAL-UNDERSERVED, LOW-INCOME, AND MINORITY TARGET GROUPS. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 6A: THE ORGANIZATION CONDUCTED ITS CHNA IN CONJUNCTION WITH THE SOLANO COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE (SOLANO CHNA COLLABORATIVE) WHICH INCLUDED THE FOLLOWING HOSPITAL FACILITIES (OTHER THAN THE ORGANIZATION ITSELF): (I) KAISER FOUNDATION AND (II) SUTTER HEALTH. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 6B: THE OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES WHICH PARTNERED WITH THE ORGANIZATION TO COMPLETE THE CHNA INCLUDE: (I) SOLANO COUNTY HEALTH AND SOCIAL SERVICES AND (II) COMMUNITY HEALTH INSIGHTS. ADDITIONALLY, THE ORGANIZATION CONSULTED WITH HARDER+COMPANY COMMUNITY RESEARCH, A SOCIAL RESEARCH AND PLANNING FIRM WHICH ASSISTS IN PLANNING, EVALUATING, AND IMPROVING SERVICES FOR VULNERABLE POPULATIONS. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 7D: THE REPORT IS ALSO AVAILABLE ON THE WEBSITES OF SOLANO COUNTY HEALTH AND SOCIAL SERVICES AS WELL AS THE SOLANO COALITION FOR BETTER HEALTH, AND CAN BE REQUESTED IN HARD COPY FROM THOSE AGENCIES. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 11: FOR THE PURPOSES OF THE CHNA, NORTHBAY HEALTHCARE DEFINES A "HEALTH NEED" AS A HEALTH OUTCOME AND/OR THE RELATED CONDITIONS THAT CONTRIBUTE TO A DEFINED HEALTH NEED. HEALTH NEEDS ARE IDENTIFIED BY THE COMPREHENSIVE IDENTIFICATION, INTERPRETATION, AND ANALYSIS OF A ROBUST SET OF PRIMARY AND SECONDARY DATA.THE FOLLOWING SEVEN HEALTH NEEDS WERE DETERMINED TO BE SIGNIFICANT (IN PRIORITIZED ORDER):1. ECONOMIC SECURITY: ECONOMIC SECURITY MEANS HAVING THE FINANCIAL RESOURCES, PUBLIC SUPPORTS, CAREER AND EDUCATIONAL OPPORTUNITIES, AND HOUSING NECESSARY TO BE ABLE TO LIVE YOUR FULLEST LIFE. 2. BEHAVIORAL HEALTH: BEHAVIORAL HEALTH IS THE FOUNDATION FOR HEALTHY LIVING AND ENCOMPASSES MENTAL ILLNESS, SUBSTANCE USE AND OVERDOSES, AND ACCESS TO SERVICE PROVIDERS FOR PREVENTIVE CARE AND TREATMENT. 3. ACCESS TO CARE: ACCESS TO QUALITY HEALTH CARE INCLUDES AFFORDABLE HEALTH INSURANCE, USE OF PREVENTIVE CARE, AND ULTIMATELY REDUCED RISK OF UNNECESSARY DISABILITY AND PREMATURE DEATH. 4. HEAL: HEALTHY EATING AND ACTIVE LIVING (HEAL) RELATES TO FAIRFIELD/VACAVILLE SERVICE AREA RESIDENTS' ABILITY TO SHAPE THEIR HEALTH OUTCOMES THROUGH NUTRITION AND PHYSICAL ACTIVITY. 5. VIOLENCE AND INJURY PREVENTION: DIRECT AND INDIRECT EXPOSURE TO VIOLENCE AND INJURY, SUCH AS DOMESTIC AND COMMUNITY VIOLENCE, HAVE SIGNIFICANT EFFECTS ON WELL-BEING AND HEALTH. 6. HOUSING: ACCESS TO SAFE, SECURE, AND AFFORDABLE HOUSING IS AN IMPORTANT SOCIAL DETERMINANT OF HEALTH. FAMILIES WITH FEWER FINANCIAL RESOURCES ARE MORE LIKELY TO EXPERIENCE SUBSTANDARD HOUSING CONDITIONS AND THE ASSOCIATED RISKS. 7. MATERNAL & INFANT HEALTH: MOTHERS IN THE FAIRFIELD/VACAVILLE SERVICE AREA FACE MANY BARRIERS RELATED TO THEIR OWN WELL-BEING AND THAT OF THEIR CHILDREN.TO COMBAT THE HEALTH NEED OF ECONOMIC SECURITY, NORTHBAY HEALTHCARE INTENDS ON: (I) FURTHERING THE GOALS OF MOVING SOLANO FORWARD, A PROGRAM OPERATED BY THE SOLANO ECONOMIC DEVELOPMENT CORP., WHICH SEEKS BUSINESS ATTRACTION AND JOB CREATION, BY BEING A LEADING FINANCIAL SUPPORTER AND BY PARTICIPATING ON THE BOARD OF DIRECTORS OF THE SOLANO EDC ADVOCACY COUNCIL; (II) HELP THE LOCAL BUSINESS COMMUNITY FLOURISH AND RETAIN EXISTING JOBS BY BEING A FINANCIAL SUPPORTER AND PARTICIPATE ON THE BOARD OF DIRECTORS OF MOST OF THE NINE CHAMBERS OF COMMERCE'S IN SOLANO COUNTY AND BY CONDUCTING JOB AND RECRUITMENT FAIRS TO CONNECT THE UNEMPLOYED TO BUSINESSES THAT ARE HIRING; (III) CONDUCT A WEEKEND HEALTH AND RESOURCE FAIR FOR FAMILIES IN DISADVANTAGED NEIGHBORHOODS; (IV) FINANCIALLY SUPPORT THE PROGRAMS OF THE RAY KROC CENTER IN THE LOW-INCOME NEIGHBORHOODS OF SUISUN CITY OPERATED BY THE SALVATION ARMY; AND (V) THROUGH A COMMUNITY BENEFIT GRANT, ASSIST THE VACAVILLE NEIGHBORHOOD BOYS & GIRLS CLUB WITH PROGRAMS TO ASSIST LOW-INCOME FAMILIES BY PROVIDING AN OUT-OF-SCHOOL PLACE THAT OFFERS LIFE-ENHANCING EXPERIENCES, INCLUDING HEALTH MEALS AND ACTIVITIES.TO COMBAT THE HEALTH NEED OF BEHAVIORAL HEALTH, NORTHBAY HEALTHCARE INTENDS ON: (I) WORKING WITH SOLANO COUNTY HEALTH & SOCIAL SERVICES AS IT CONSTRUCTS A NEW MENTAL HEALTH SERVICES UNIT ON BECK AVENUE IN FAIRFIELD; (II) INCREASE THE PATIENT CONTACTS FOR BEHAVIORAL HEALTH SERVICES IN BOTH THE INPATIENT AND OUTPATIENT SETTINGS, CONNECTING THEM DIRECTLY TO COUNTY AND COMMUNITY RESOURCES; AND (III) PROVIDE A GRANT TO HORSEPLAY THERAPEUTIC RIDING CENTER, WHICH OFFERS A YEAR-ROUND RECREATIONAL RIDING PROGRAM FOR SPECIAL NEEDS CHILDREN AND ADULTS.TO COMBAT THE HEALTH NEED OF ACCESS TO CARE, NORTHBAY HEALTHCARE INTENDS ON: (I) PARTNERING WITH OLE HEALTH, A FEDERAL QUALIFIED HEALTH CENTER, BY PROVIDING 2,000 SQUARE FEET OF CLINIC SPACE TO OLE HEALTH ON THE CAMPUS OF NORTHBAY MEDICAL CENTER, WHICH WILL REDUCE UTILIZATION OF EMERGENCY ROOM RESOURCES AND RESULT IN BETTER OUTCOMES FOR PATIENTS OF OLE HEALTH WHO REQUIRE HOSPITALIZATION; (II) PROVIDE ACCESS TO CARE FOR AS MANY OF THOSE WHO CANNOT AFFORD THE COST AS POSSIBLE VIA THE ORGANIZATION'S CHARITY CARE PROGRAM; (III) INCREASE THE ADMISSION OF HOSPICE PATIENTS BY 5% IN 2020, EXTENDING THE PROGRAM'S REACH IN SOLANO COUNTY, WHILE EXPANDING THE POOL OF STAFF AND VOLUNTEERS TO ENSURE CAPACITY; AND (IV) CONTINUING TO OPERATE THE NORTHBAY ADULT DAY CENTER, WHICH OFFERS CLIENTS WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIAS THE OPPORTUNITY TO SOCIALIZE AND PARTICIPATE IN STIMULATING ACTIVITIES.TO COMBAT THE HEALTH NEED OF HEALTHY EATING AND ACTIVE LIVING, NORTHBAY HEALTHCARE INTENDS ON: (I) CONDUCTING COMMUNITY OUTREACH INITIATIVES TO AFFECT THE PUBLIC'S BEHAVIOR IN ORDER TO REDUCE THE INCIDENCE AND PREVALENCE OF CARDIOVASCULAR DISEASES, AS WELL AS OFFERING HANDS-ONLY CPR AND AUTOMATED DEFIBRILLATION EDUCATION TO A LOCAL BUSINESS AND LOCAL SCHOOL; (II) PROVIDE FINANCIAL ASSISTANCE TO MEALS ON WHEELS, WHICH SUPPORTS SENIOR INDEPENDENCE, HEALTH, AND WELL-BEING BY REGULARLY PROVIDING NUTRITIOUS MEALS AND HUMAN CONNECTION; (III) PROVIDE GRANT FUNDING FOR THE FAIRFIELD CERTIFIED FARMERS' MARKET, WHICH WILL HELP FUND A 2-FOR-1 MATCHING PROGRAM THAT PROVIDES NEEDY FAMILIES AN ADDITIONAL $10 PER MONTH, WHICH INCREASES ACCESS TO HEALTH FOODS; AND (IV) PROVIDE A GRANT TO SOLANO LAND TRUST, WHICH WILL CONDUCT OUTDOOR EDUCATION PROGRAMS, DOCENT-LED TOURS AND COMMUNITY EVENTS TO CONNECT SCHOOL CHILDREN AND THEIR FAMILIES TO NATURE.TO COMBAT THE HEALTH NEED OF VIOLENCE AND INJURY PREVENTION, NORTHBAY HEALTHCARE INTENDS ON: (I) PROVIDING A BUILDING FACILITY FOR THE PROGRAMS OF THE LEAVEN (A NON-PROFIT ORGANIZATION WHICH BRINGS AFTER-SCHOOL MENTORING AND TUTORING PROGRAMS AS A REVITALIZATION TOOL TO STRUGGLING NEIGHBORHOODS), AS WELL AS BY COVERING ALL OPERATIONAL COSTS; (II) SUPPORTING AND PARTNERING WITH THE ROBBY POBLETE FOUNDATION, WHICH OPERATES A FIREARMS BUYBACK EVENT, WITH THE GOAL OF GETTING AT LEAST 150 WEAPONS OFF THE STREET AS WELL AS OFFERING SCHOLARSHIPS TO INDIVIDUALS SEEKING A CAREER PATHWAY AWAY FROM A LIFE OF CRIME; AND (III) PROVIDE FINANCIAL ASSISTANCE TO THE JIM CAPOOT "CHARGE ON" FOUNDATION, WHICH BRINGS YOUTH UNDER THE SUPERVISION AND POSITIVE INFLUENCE OF A LAW ENFORCEMENT AGENCY AND EXPANDS PUBLIC AWARENESS ABOUT THE ROLE OF A POLICE OFFICER AND REINFORCEMENT OF THE RESPONSIBLE VALUES AND ATTITUDES INSTILLED IN YOUNG PEOPLE BY THEIR PARENTS.TO COMBAT THE HEALTH NEED OF HOUSING, NORTHBAY HEALTHCARE INTENDS ON: (I) PROVIDING FINANCIAL SUPPORT TO SOLANO DREAM CENTER, WHICH PROVIDES HOMELESS INDIVIDUALS WITH EMERGENCY SHELTER AND CONNECTIONS TO EMPLOYMENT ASSISTANCE AND OTHER SERVICES; (II) PROVIDE COMMUNITY BENEFIT GRANT FUNDING TO SUSTAIN A PROGRAM PROVIDING A SAFE ENVIRONMENT FOR HOMELESS OR NEAR-HOMELESS PATIENTS WHO ARE READY FOR DISCHARGE, CONNECTING THEM WITH PRIMARY CARE, LONG-TERM HOUSING, AND OTHER RESOURCES; (III) PROVIDE $150,000 IN START-UP FUNDING FOR THE VALLEJO NAVIGATION CENTER, WHICH WILL PROVIDE ACCESS TO TEMPORARY HOUSING AND WRAP-AROUND SERVICES TO SUPPORT MEN AND WOMEN LIVING UNSHELTERED IN THE CITY OF VALLEJO; AND (IV) THROUGH A COMMUNITY BENEFIT GRANT, ASSIST IN THE FUNDING OF A GROUP HOUSING PROJECT IN THE CITY OF RIO VISTA FOR HOMELESS VETERANS, WHICH WILL SERVE SIX TO EIGHT HOMELESS VETERANS, CONNECTING THEM TO VA SERVICES, EMPLOYMENT ASSISTANCE, AND HEALTH CARE SERVICES.TO COMBAT THE HEALTH NEED OF MATERNAL & INFANT HEALTH, NORTHBAY HEALTHCARE WILL PARTICIPATE IN CALIFORNIA PERINATAL QUALITY CARE COLLABORATIVE (CPQCC) AND CALIFORNIA MATERNAL QUALITY CARE COLLABORATIVE (CMQCC) TO HELP ADDRESS THE OPIOID USE EPIDEMIC AS IT HAS IMPACTED FAMILIES IN SOLANO COUNTY. NORTHBAY WOMEN AND CHILDREN'S SERVICES PROVIDERS WILL ENCOURAGE NON-PHARMACOLOGIC TREATMENT FOR NEONATAL ABSTINENCE SYNDROME (NAS) WHERE APPROPRIATE BASED ON EVIDENCE DEMONSTRATING ITS SUPERIORITY.NORTHBAY HEALTHCARE, IN ITS 2020 IMPLEMENTATION STRATEGY, ADDRESSES EACH OF THE SEVEN PRIORITIZED NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 13B: BANKRUPTCY AND DECEASED PATIENTS WITH NO ESTATE. GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 16J: THE POLICY IS POSTED ON THE CALIFORNIA OSHPD WEBSITE. 53 1 - CENTER FOR PRIMARY CARE FAIRFIELD 2458 HILLBORN ROAD FAIRFIELD CA 94534 PRIMARY CARE CLINIC 2 - CENTER FOR PRIMARY CARE GREEN VALLEY 4520 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 PRIMARY CARE CLINIC 3 - CENTER FOR PRIMARY CARE VACAVILLE 421 NUT TREE ROAD VACAVILLE CA 95687 PRIMARY CARE CLINIC 4 - BREAST CANCER PROGRAM 1020 NUT TREE ROAD VACAVILLE CA 95687 BREAST CANCER CENTER 5 - CANCER CENTER MEDICAL ONCOLOGY 1020 NUT TREE ROAD SUITE 390 VACAVILLE CA 95687 CANCER CENTER 6 - CANCER CENTER RADIATION ONCOLOGY 1020 NUT TREE ROAD SUITE 190 VACAVILLE CA 95687 CANCER CENTER 7 - CARDIAC & PULMONARY REHABILITATION 1020 NUT TREE ROAD SUITE 250 VACAVILLE CA 95687 CARDIAC REHAB CENTER 8 - CENTER FOR WOMEN'S HEALTH 1860 PENNSYLVANIA AVENUE SUITE 300 FAIRFIELD CA 94533 WOMEN'S HEALTH 9 - DIAGNOSTIC IMAGING FAIRFIELD 1101 B GALE WILSON BOULEVARD FAIRFIELD CA 94533 DIAGNOSTIC IMAGING 10 - DIAGNOSTIC IMAGING VACAVILLE 1020 NUT TREE ROAD SUITE 150 VACAVILLE CA 95687 DIAGNOSTIC IMAGING 11 - EAR NOSE AND THROAT 1860 PENNSYLVANIA AVE SUITE 305 FAIRFIELD CA 94533 OUTPATIENT CLINIC 12 - GASTROENTEROLOGY FAIRFIELD 4520 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 OUTPATIENT CLINIC 13 - GASTROENTEROLOGY VACAVILLE 1010 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 OUTPATIENT CLINIC 14 - HEALTHSPRING FITNESS 1020 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 OUTPATIENT FITNESS CENTER 15 - HEART AND VASCULAR CENTER FAIRFIELD 1860 PENNSYLVANIA AVE SUITE 120 FAIRFIELD CA 94533 OUTPATIENT CLINIC 16 - HEART AND VASCULAR CENTER GREEN VALLEY 4520 BUSINESS CENTER DRIVE SUITE 200 FAIRFIELD CA 94534 OUTPATIENT CLINIC 17 - HEART AND VASCULAR CENTER VACAVILLE 1020 NUT TREE ROAD SUITE 290 VACAVILLE CA 95687 OUTPATIENT CLINIC 18 - HOME HEALTH 2470 HILBORN ROAD SUITE 240 FAIRFIELD CA 94534 HOME HEALTH CLINIC 19 - HOSPICE & BEREAVEMENT 2470 HILBORN ROAD SUITE 240 FAIRFIELD CA 94534 HOSPICE & BEREAVEMENT 20 - INFECTIOUS DISEASE 1010 NUT TREE ROAD SUITE 100B VACAVILLE CA 95687 INFECTIOUS DISEASE CLINIC 21 - LACTATION SUPPORT 1860 PENNSYLVANIA AVENUE SUITE 310 FAIRFIELD CA 94533 OUTPATIENT MATERNITY CLINIC 22 - NEUROSCIENCE FAIRFIELD 1860 PENNSYLVANIA AVENUE FAIRFIELD CA 94533 NEUROSCIENCE CLINIC 23 - NEUROSCIENCE VACAVILLE 1010 NUT TREE ROAD SUITE 100-B VACAVILLE CA 95687 NEUROSCIENCE CLINIC 24 - NEUROSCIENCE VACAVILLE (SPINE PROGRAM) 1020 NUT TREE ROAD 2ND FLOOR VACAVILLE CA 95687 NEUROSCIENCE CLINIC 25 - OCCUPATIONAL HEALTH FAIRFIELD 2470 HILLBORN ROAD SUITE 100 FAIRFIELD CA 94534 OCCUPATIONAL HEALTH CLINIC 26 - OCCUPATIONAL HEALTH VACAVILLE 1679 E MONTE VISTA AVE SUITE 104 VACAVILLE CA 95688 OCCUPATIONAL HEALTH CLINIC 27 - ORTHOPEDICS FAIRFIELD 2500 HILLBORN ROAD FAIRFIELD CA 94534 OUTPATIENT ORTHOPEDIC CLINIC 28 - ORTHOPEDICS VACAVILLE 1010 NUT TREE ROAD SUITE 200 VACAVILLE CA 95687 OUTPATIENT ORTHOPEDIC CLINIC 29 - OSTEOPATHIC MANIPULATIVE MEDICINE 1020 NUT TREE ROAD SUITE 290 VACAVILLE CA 95687 OSTEOPATHIC MEDICINE CLINIC 30 - PAIN MANAGEMENT FAIRFIELD 1860 PENNSYLVANIA AVENUE SUITE 310 FAIRFIELD CA 94533 PAIN MANAGEMENT CLINIC 31 - PAIN MANAGEMENT VACAVILLE 1020 NUT TREE ROAD SUITE 270 VACAVILLE CA 95687 PAIN MANAGEMENT CLINIC 32 - PHYSICALOCCUPATIONAL THERAPY FAIRFIELD 2500 HILLBORN ROAD FAIRFIELD CA 94534 PHYSICAL/OCCUPATIOAL THERAPY CLINIC 33 - PHYSICALOCCUPATIONAL THERAPY VACAVILLE 1020 NUT TREE ROAD SUITE 260 VACAVILLE CA 95687 PHYSICAL/OCCUPATIOAL THERAPY CLINIC 34 - PODIATRY FAIRFIELD 2500 HILLBORN ROAD FAIRFIELD CA 94534 OUTPATIENT PODIATRY CLINIC 35 - PODIATRY VACAVILLE 1010 NUT TREE ROAD VACAVILLE CA 95687 OUTPATIENT PODIATRY CLINIC 36 - PULMONARY MEDICINE FAIRFIELD 1860 PENNSYLVANIA AVENUE SUITE 200 FAIRFIELD CA 94533 PULMONARY MEDICINE CLINIC 37 - PULMONARY MEDICINE SLEEP MEDICINE CLINIC 2458 HILLBORN ROAD FAIRFIELD CA 94534 PULMONARY MEDICINE CLINIC 38 - PULMONARY MEDICINE VACAVILLE 1010 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 PULMONARY MEDICINE CLINIC 39 - RHEUMATOLOGY 1010 NUT TREE ROAD SUITE 200 VACAVILLE CA 95687 RHEUMATOLOGY CLINIC 40 - SPECIALTY PHARMACY 1020 NUT TREE ROAD VACAVILLE CA 95687 SPECIALTY PHARMACY 41 - SPECIALTY PRACTICES FAIRFIELD 1860 PENNSYLVANIA AVENUE FAIRFIELD CA 94533 SPECIALTY OUTPATIENT CLINIC 42 - SPECIALTY PRACTICES VACAVILLE 1010 NUT TREE ROAD VACAVILLE CA 95687 SPECIALTY OUTPATIENT CLINIC 43 - SPEECH THERAPY 2500 HILBORN ROAD FAIRFIELD CA 94534 SPEECH THERAPY CLINIC 44 - SPINE PROGRAM 1020 NUT TREE ROAD SUITE 270 VACAVILLE CA 95687 OUTPATIENT SPINE CLINIC 45 - SURGERY CENTER AT VACAVALLEY 1006 NUT TREE ROAD VACAVILLE CA 95687 OUTPATIENT SURGERY CENTER 46 - VACAVALLEY HEALTH PLAZA 1010 NUT TREE ROAD VACAVILLE CA 95687 HEALTH PLAZA 47 - URGENT CARE FAIRFIELD 1320 TRAVIS BLVD SUITE C FAIRFIELD CA 94533 URGENT CARE CLINIC 48 - URGENT CARE VACAVILLE 1679 E MONTE VISTA AVE SUITE 104 VACAVILLE CA 95688 URGENT CARE CLINIC 49 - UROLOGY FAIRFIELD 1860 PENNSYLVANIA AVENUE SUITE 200 FAIRFIELD CA 94533 UROLOGY CLINIC 50 - UROLOGY NAPA 3520 BEAR ROAD NAPA CA 94558 UROLOGY CLINIC 51 - WOMEN'S DIAGNOSTIC IMAGING FAIRFIELD 1101 B GALE WILSON BOULEVARD SUITE 100 FAIRFIELD CA 94533 WOMEN'S DIAGNOSTIC IMAGING CLINIC 52 - WOMEN'S DIAGNOSTIC IMAGING VACAVILLE 1020 NUT TREE ROAD SUITE 150 VACAVILLE CA 95687 WOMEN'S DIAGNOSTIC IMAGING CLINIC 53 - WOUND CARE 1010 NUT TREE ROAD SUITE 100 VACAVILLE CA 95687 WOUND CARE CLINIC PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS ON SCHEDULE H, PART I, LINES 7A AND 7B. THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED TO DETERMINE AMOUNTS ON LINE 7E. PART II, COMMUNITY BUILDING ACTIVITIES: PHYSICAL IMPROVEMENTS AND HOUSING - NORTHBAY DONATED FUNDS TO PROVIDE OR REHABILITATE HOUSING FOR VULNERABLE POPULATIONS WHICH WILL BE USED FOR NEW INITIATIVES THAT RELATE TO HOMELESSNESS. THIS INCLUDES FUNDING TO THE SOLANO DREAM CENTER, WHOSE MISSION IS TO TRANSFORM OTHERS SUFFERING FROM ADDITION, DOMESTIC, VIOLENCE, HOMELESSNESS AND TRAUMA.ECONOMIC DEVELOPMENT - SUPPORT FOR CHILD HAVEN, CHILDREN'S NETWORK, THE LEAVEN, MISSION SOLANO, WE CARE FOR CHILDREN SOLANO, AND MEALS ON WHEELS, WHICH COMPRISE A NETWORK OF SUPPORT FOR VULNERABLE POPULATIONS IN OUR COMMUNITY. SERVICES INCLUDE A HAVEN FOR ABUSED AND ABANDONED CHILDREN, EARLY CHILDHOOD EDUCATION, AN AFTER-SCHOOL MENTORING PROGRAM FOR CHILDREN LIVING IN UNDERSERVED NEIGHBORHOODS AND SHELTER AND WRAP-AROUND SERVICES FOR THE HOMELESS.COMMUNITY SUPPORT - FINANCIAL SUPPORT INCLUDES FOR ADOPT-A-SCHOOL, SALVATION ARMY KROC CENTER, VACAVILLE BOYS AND GIRLS CLUB, VACAVILLE CHRISTMAS WISH, AND THE WELLNESS CHALLENGE AT MARKHAM ELEMENTARY.COALITION BUILDING - SOLANO COALITION FOR BETTER HEALTH IS A CONSORTIUM OF LOCAL HEALTH CARE SYSTEMS, THE COUNTY, NON-PROFIT SOCIAL SERVICE AGENCIES AND COMMUNITY CLINIC NETWORKS THAT WORK TOGETHER TO ASSESS THE COMMUNITY HEALTH NEEDS AND COLLABORATE TO MEET THEM. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS ON A CONSOLIDATED BASIS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WITH THIRD-PARTY INSURANCE COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTABLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (THOSE WITHOUT THIRD-PARTY INSURANCE COVERAGE) AND RECEIVABLES REPRESENTING DEDUCTIBLES AND COPAYMENTS REQUIRED FROM PATIENTS BY THEIR INSURANCE PLANS, THE SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS HISTORICALLY COLLECTED AFTER ALL REASONABLE COLLECTIONS HAVE BEEN EXHAUSTED IS THE ESTIMATED UNCOLLECTABLE RATE. THIS RATE IS APPLIED TO EXISTING ACCOUNTS TO RECORD AN ESTIMATE FOR UNCOLLECTABLE ACCOUNTS. PART III, LINE 3: A COST-TO-CHARGE RATIO (WHICH IS UTILIZED FOR CALCULATING CHARITY CARE COSTS ON SCHEDULE H, PART I, LINE 7A) WAS APPLIED TO TOTAL BAD DEBT EXPENSE TO ARRIVE AT THE ESTIMATED AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT CONTAIN A SEPARATE FOOTNOTE ADDRESSING "BAD DEBT EXPENSE". HOWEVER, THE FOOTNOTE THAT ADDRESSES "PATIENTS ACCOUNTS RECEIVABLE" CAN BE FOUND ON PAGES 9 AND 27-30 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE, EXPENSES ARE DISALLOWED BASED ON PRIOR YEARS' COST REPORTS AUDITS AND STANDARD MEDICARE NON-REIMBURSABLE EXPENSES, AS DIRECTED BY THE MEDICARE PROGRAM. THE MEDICARE COST REPORT AND ITS RULES OF ALLOWABLE COSTS TO WERE USED AS THE COSTING METHODOLOGY TO DETERMINE THE AMOUNT ON SCHEDULE H, PART III, LINE 6.IT IS THE HOSPITAL'S BELIEF THAT THE SHORTFALL REFLECTED ON PART III, LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN THE HOSPITAL'S COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS. PART III, LINE 9B: NORTHBAY HEALTHCARE'S COLLECTION POLICIES OUTLINE THE TYPES OF COLLECTION EFFORTS THAT CONTRACTED COLLECTION AGENCIES MAY OR MAY NOT TAKE TO COLLECT ON PAST-DUE ACCOUNTS. IT IS RECOGNIZED THAT AS PART OF THE FINANCIAL ASSISTANCE PROCESS, PATIENTS MAY FROM TIME TO TIME BREAK THEIR PROMISE TO PAY MADE ON THE FINANCIAL ASSISTANCE APPLICATION. IN THESE INSTANCES, PATIENTS WITH PAST-DUE FINANCIAL ASSISTANCE OBLIGATIONS MAY BE REFERRED TO COLLECTION IN THE SAME MANNER AS ANY OTHER PATIENT WITH AN UNPAID PAST-DUE ACCOUNT. HOWEVER, IN NO INSTANCE WILL ANY PATIENT RECEIVING FINANCIAL ASSISTANCE UNDER THIS POLICY BE SUBJECT TO ABUSIVE TELEPHONE COLLECTION PRACTICES, LIENS BEING PLACED ON THEIR PRIMARY RESIDENCE, WAGE GARNISHMENTS, OR INVOLUNTARY COURT HOLD ORDERS. PART VI, LINE 2: IN PARTNERSHIP WITH THE SOLANO COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE, A NEEDS ASSESSMENT WAS CONDUCTED IN 2019. IT RESULTED IN A DETAILED LIST OF PRIORITY HEALTH NEEDS, INCLUDING A DESCRIPTION OF UNWANTED HEALTH OUTCOMES AND ASSOCIATED DRIVERS. THE NEEDS ASSESSMENT IS AVAILABLE ON THE WEBSITE, WWW.NORTHBAY.ORG. IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, NORTHBAY OPERATES MANY SEMINARS, SUPPORT GROUPS, AND COMMUNITY EVENTS WHICH ALLOWS IT TO FURTHER ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. PART VI, LINE 3: NORTHBAY HEALTHCARE POSTS NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL PATIENT REGISTRATION AREAS IN ALL PATIENT AREAS, IN PATIENT HANDBOOKS, AT ITS PATIENT BUSINESS SERVICES DEPARTMENT, AND ON ITS WEBSITE. NOTICES ARE POSTED IN ENGLISH AND SPANISH. PATIENTS ARE ALSO PROVIDED WITH INFORMATION REGARDING THE CHARITY CARE AND DISCOUNT POLICY AT THE POINT OF ACCESS. IF A PATIENT FEELS THAT THEY MAY BE ELIGIBLE UNDER THE POLICY, HE/SHE IS REFERRED TO NORTHBAY FINANCIAL COUNSELING FOR FURTHER ASSISTANCE. A FINAL DETERMINATION IS MADE WITHIN 30 DAYS OF A COMPLETE APPLICATION AND ALL REQUESTED DOCUMENTATION BEING SUBMITTED. ONCE A DECISION IS MADE FOR THE APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE, A LETTER IS SENT TO THE PATIENT AS NOTIFICATION OF THE DECISION. PART VI, LINE 4: THE NORTHBAY HEALTHCARE SERVICE AREA INCLUDES ALL OF SOLANO COUNTY COMMUNITIES WITH A CONCENTRATION OF RESIDENTS IN THE CENTRAL SOLANO COMMUNITIES OF FAIRFIELD, SUISUN CITY, AND VACAVILLE. NORTHBAY HEALTHCARE IS CENTRALLY LOCATED ALONG THE INTERSTATE 80 CORRIDOR IN SOLANO COUNTY.THE TOTAL POPULATION IN THE SERVICE AREA IS ESTIMATED AT 287,540; OF THIS POPULATION 43.7% IDENTIFIES AS NON-HISPANIC WHITE, 27.52% IDENTIFIES AS HISPANIC OR LATINO, 11.4% IDENTIFIES AS ASIAN, 11.1% IDENTIFIES AS BLACK OR AFRICAN AMERICAN, 5.3% IDENTIFIES WITH MULTIPLES RACES, .3% IDENTIFIES AS NATIVE AMERICAN/ALASKAN NATIVE, .8% IDENTIFIES AS HAWAIIAN/PACIFIC ISLANDER, AND .2% IDENTIFIES AS SOME OTHER RACE.WITHIN THE SERVICE AREA, 11.3% OF THE TOTAL POPULATION IS LIVING IN POVERTY (<100% FEDERAL POVERTY LEVEL), WITH 16.6% OF THE CHILDREN IN THE SERVICE AREA LIVING IN POVERTY. THE UNEMPLOYMENT RATE IS 3.9%, WITH 8.5% OF THE POPULATION UNINSURED. ADULTS WITH NO HIGH SCHOOL DIPLOMA MAKE UP 13.5% OF THE POPULATION. PART VI, LINE 5: NORTHBAY CONTINUALLY PROMOTES PUBLIC HEALTH THROUGH DOZENS OF PROGRAMS, FROM FREE PRENATAL CARE TO LOW-INCOME PREGNANT WOMEN, TO FREE HOSPICE AND BEREAVEMENT SERVICES. A SUBSIDIZED DEMENTIA DAY CARE FACILITY AND A TRANSITIONAL CARE FACILITY FOR THE HOMELESS WHO REQUIRE POST-DISCHARGE CONTINUITY OF CARE ARE ALSO PROVIDED. UP TO 30 PUBLIC EDUCATION PROGRAMS -- HEALTH FAIRS, FREE SCREENINGS, DRIVE-THROUGH FLU VACCINATIONS, INJURY PREVENTION DEMONSTRATIONS, DRUNKEN DRIVING PREVENTION PROGRAMS AT LOCAL SCHOOLS AND DIABETES AWARENESS -- ARE CONDUCTED EVERY YEAR IN COMMUNITY FACILITIES CLOSE TO THOSE WHO CAN BENEFIT FROM THEM. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 SOLANO DREAM CENTER INC 743 E TABOR AVENUE FAIRFIELD CA 94533 832407160 501(C)(3) 50000 0 GENERAL SUPPORT FOR HOMELESS COMMUNITY BENEFIT 1 0 PART I, LINE 2: MONITORING PROPER USE OF THE AMOUNTS GRANTED TO SOLANO DREAM CENTER, INC. IS ACHIEVED BY WITNESSING THE WORK PERFORMED AND IMPACT ACHIEVED IN COMBATTING HOMELESSNESS WITHIN THE SOLANO COUNTY COMMUNITY. ADDITIONALLY, ACCESS TO SAFE, SECURE, AND AFFORDABLE HOUSING WAS OUTLINED AS A HEALTH NEED IN THE 2019 NORTHBAY HEALTHCARE GROUP COMMUNITY HEALTH NEEDS ASSESSMENT. 0 1 0 0 0 0 0 0 0 B KONARD JONES DIRECTOR / PRES. & CEO OF NBHC 0 721606 0 946747 0 43908 0 372149 0 36806 0 2121216 0 0 AIMEE BREWER PRESIDENT, NBHG (THROUGH 9/2021) 0 418381 0 156975 0 108822 0 68598 0 41019 0 793795 0 0 WAYNE GIETZ PRESIDENT, NBHG (START 9/2021) 0 391227 0 222897 0 9314 0 56396 0 26025 0 705859 0 0 JIM ANDERSEN VP, HUMAN RESOURCES 0 452158 0 86112 0 20535 0 58091 0 14171 0 631067 0 0 CHRISTOPHER TIMBERS VP, CHIEF INFORMATION OFFICER 0 390355 0 80499 0 13743 0 65082 0 61734 0 611413 0 0 MICHELE BOUIT VICE PRESIDENT & CFO 0 449101 0 43126 0 19917 0 80770 0 7246 0 600160 0 0 SCOTT DAVIS VP, CHIEF STRATEGY OFFICER 0 414897 0 80499 0 13743 0 24669 0 50962 0 584770 0 0 SETH KAUFMAN MD CHIEF MEDICAL OFFICER 0 403348 0 45989 0 6952 0 5811 0 58902 0 521002 0 0 TRACI DUNCAN VP, CHIEF NURSING OFFICER 0 348150 0 80075 0 49444 0 19191 0 16740 0 513600 0 27852 ROBERT COSCIONE VP, PAYER STRATEGY (THRU 8/2021) 0 230179 0 80500 0 107783 0 49035 0 8042 0 475539 0 0 STEVE HUDDLESTON VP, PUBLIC AFFAIRS 0 173117 0 73913 0 171438 0 28150 0 21980 0 468598 0 24331 THERESA BARTOLI CLINICAL COORDINATOR 0 334520 0 1798 0 0 0 15032 0 50955 0 402305 0 0 AROLD NELSON CLINICAL NURSE SUPERVISOR 0 329495 0 2478 0 7308 0 7289 0 49391 0 395961 0 0 THEO RALLIS ASSISTANT VP, FINANCE / CONTROLLER 0 236133 0 98670 0 1230 0 17395 0 31996 0 385424 0 0 NICOLE BROCATO VP, OPERATIONS / CQO (THRU 8/2021) 0 214768 0 79333 0 14397 0 27865 0 47822 0 384185 0 0 DUSTIN DATOC REGISTERED NURSE FIRST ASSISTANT 0 315596 0 237 0 0 0 5647 0 51310 0 372790 0 0 JOANNE JACOB CLINICAL COORDINATOR 0 319385 0 2107 0 0 0 14356 0 428 0 336276 0 0 PART I, LINE 3 THE PRESIDENT OF NORTHBAY HOSPITAL GROUP IS A PAID EMPLOYEE OF NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION. NORTHBAY HEALTHCARE CORPORATION UTILIZES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION OF THE PRESIDENT: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A RELATED ORGANIZATION'S SUPPLEMENTAL 457(F) RETIREMENT PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN DURING THE 2021 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): B. KONARD JONES - $361,640 AIMEE BREWER - $57,838 WAYNE GIETZ - $45,292 JIM ANDERSEN - $48,777 CHRISTOPHER TIMBERS - $54,058 MICHELE BOUIT - $78,001 SCOTT DAVIS - $19,500 TRACI DUNCAN - $8,127 ROBERT COSCIONE - $43,495 STEVE HUDDLESTON - $7,277 NICOLE BROCATO - $19,413 ADDITIONALLY, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, THE FOLLOWING INDIVIDUALS RECEOGNIZED TAXABLE COMPENSATION IN THE FOLLOWING AMOUNTS, WHICH HAS BEEN REPORTED AS "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III) AND "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" IN SCHEDULE J, PART II, COLUMN (F): TRACI DUNCAN - $27,852 STEVE HUDDLESTON - $24,331 A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TVG5 2015-04-30 34809259 CONSTRUCTION COSTS FOR EXPANSION OF NORTHBAY MEDICAL CENTER 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TZY2 2016-08-04 39829633 PARTIALLY REFUND BOND DATED 10/23/2013 0 0 0 C CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TP49 2017-01-11 210294259 CONSTRUCTION COSTS FOR EXPANSION OF NORTHBAY MEDICAL CENTER 0 0 0 A 3395000 35074656 2243032 696185 32135439 2016 0 0 1 1 B 12780000 40703644 3749641 796405 35230319 927279 1 0 1 1 C 200000 216342782 15474608 3561472 172968172 24338530 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA MUNICIPAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/30/2020 ISSUER NAME: CALIFORNIA MUNICIPAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/01/2019 ISSUER NAME: CALIFORNIA MUNICIPAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2019 PART I, COLUMN (E) AND PART II, LINE 3: THE DIFFERENCE BETWEEN THE TOTAL ISSUE PRICE REPORTED IN SCHEDULE K, PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN SCHEDULE K, PART II, LINE 3 REPRESENTS INVESTMENT EARNINGS ON PROCEEDS (FOR EACH BOND) AS WELL AS UNSPENT PROCEEDS FROM PREVIOUSLY DEFEASED BONDS FOR THE 2016 BOND. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE SOLE MEMBER, NORTHBAY HEALTHCARE CORPORATION, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A NORTHBAY HEALTHCARE CORPORATION, THE ORGANIZATION'S SOLE MEMBER, HAS THE POWER TO ELECT ALL DIRECTORS FROM A PANEL OF QUALIFIED INDIVIDUALS NOMINATED BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS OF NORTHBAY HEALTHCARE GROUP. FORM 990, PART VI, SECTION A, LINE 7B NORTHBAY HEALTHCARE CORPORATION, THE ORGANIZATION'S SOLE MEMBER, HAS THE RIGHT TO REMOVE ANY DIRECTOR. IN ADDITION, THE FOLLOWING POWERS ARE RESERVED TO THE MEMBER, MAY BE EXERCISED ONLY BY THE MEMBER, AND MAY BE EXERCISED WITHOUT ANY ACTION OR APPROVAL BY THE BOARD OF NORTHBAY HEALTHCARE GROUP: (I) ELECTION OF DIRECTORS FROM A PANEL OF QUALIFIED NOMINEES; AND (II) DISSOLUTION OF THE CORPORATION. THE FOLLOWING ACTIONS MAY BE TAKEN BY NORTHBAY HEALTHCARE GROUP ONLY IF ADOPTED BY THE BOARD AND APPROVED BY THE MEMBER: (I) ADOPT OR IMPLEMENT THE ANNUAL OPERATING AND CAPITAL BUDGET; (II) EFFECTUATE ANY PURCHASES OR FINANCING, HOWEVER STRUCTURED, IN AN AMOUNT EQUAL TO OR EXCEEDING ONE MILLION DOLLARS; (III) AMEND THE ARTICLES OF INCORPORATION OR THE BYLAWS; (IV) IMPLEMENT ANY MERGER, CONSOLIDATION, AFFILIATION, JOINT VENTURE ACTIVITY, OR ALLIANCE BETWEEN THE CORPORATION AND ANY OTHER ENTITY; (V) ESTABLISH OR PROMULGATE CORPORATE POLICY AND GOALS; (VI) ESTABLISH OR PROMULGATE LONG-RANGE AND STRATEGIC PLANS; (VII) ESTABLISH GENERAL POLICY WITH RESPECT TO EMPLOYEE BENEFIT PLANS; (VIII) UNDERTAKE OR MANAGE ANY FINANCING ACTIVITIES THAT ARE IN EXCESS OF ONE YEAR; (IX) DETERMINE ANY COMPENSATION OR REIMBURSEMENT TO BE PAID TO DIRECTORS; (X) ADJUST THE TERM OF ANY DIRECTOR; AND (XI) FORMATION BY THE CORPORATION OF ANY NEW CORPORATION, OR TAKING ANY OWNERSHIP OF ANY CORPORATION OR ENTITY AS A SHAREHOLDER, MEMBER, PARTNER, OR JOINT VENTURER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT/CFO AND PRESENTED TO THE BOARD OF DIRECTORS OF THE PARENT COMPANY, NORTHBAY HEALTHCARE CORPORATION. A COPY OF THE FORM 990 IS ALSO DISTRIBUTED TO ALL VOTING MEMBERS GOVERNING BODY OF NORTHBAY HEALTHCARE GROUP FOR THEIR REVIEW AND COMMENTS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUESTS ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND MEMBERS COMMITTEES APPOINTED BY THE BOARD OF DIRECTORS TO SELF-MONITOR COMPLIANCE; IN ADDITION, EACH OFFICER AND BOARD MEMBERS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND ALL RESPONSES FILED. IF A POTENTIAL CONFLICT ARISES, BOARD MEMBERS, EMPLOYEES, AND MEDICAL STAFF ARE REQUIRED TO SELF-DISCLOSE THE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER OR MEDICAL CHIEF OF STAFF. PROCESSES AND PROCEDURES ARE IN PLACE TO EVALUATE AND DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS. IF CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WILL PRESENT RELEVANT INFORMATION TO THE BOARD. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DID NOT DIRECTLY COMPENSATE ANY OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES; THESE INDIVIDUALS ARE COMPENSATED BY NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION. AS SUCH, FORM 990, PART VI, SECTION A, LINES 15A AND 15B HAVE BEEN MARKED "NO", AS MANDATED BY THE FORM 990 INSTRUCTIONS. HOWEVER, IN DETERMINING COMPENSATION FOR ALL OFFICERS AND KEY EMPLOYEES OF NORTHBAY HEALTHCARE GROUP: AN AD HOC COMPENSATION COMMITTEE OF THE NORTHBAY HEALTHCARE CORPORATION BOARD REVIEWS COMPENSATION. THEY ARE ASSISTED BY INDEPENDENT CONSULTANTS, AND INDEPENDENT LOCAL SURVEYS AS A MEANS TO SUBSTANTIATE COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE DIGITAL ASSURANCE CORPORATION WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENT ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 81,586,202. MANAGEMENT AND GENERAL EXPENSES 75,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,661,202. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 27,756,421. MANAGEMENT AND GENERAL EXPENSES 396,619. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,153,040. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 32,700,542. MANAGEMENT AND GENERAL EXPENSES 12,830. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,713,372. FORM 990, PART XI, LINE 9: RELIEF OF INTERCOMPANY RECEIVABLES 18,873,362. REVERSAL OF PRIOR YEAR CONTRIBUTION REVENUE -151,332. FORM 990, PART V, LINE 2A: ALL FORM W-2S FOR NORTHBAY HEALTHCARE SYSTEM WERE FILED BY NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION OF NORTHBAY HEALTHCARE CORPORATION, WHICH IS THE BASIS FOR THE REPORTING OF "ZERO" AS THE NUMBER OF EMPLOYEES REPORTED ON FORM 990, PART V, LINE 2A. 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