SUTTER HEALTH PACIFIC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: SUTTER HEALTH PACIFIC (EIN 99-0298651)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-14
IRS object ID: 202113189349301166
Schema version: 2020v4.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-14T16:38:18-06:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	560 MISSION ST STE 1600	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	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	990298651	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SUTTER HEALTH PACIFIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% QUIN OGAWA CFO	InCareOfNm
Business Name Control	SUTT	BusinessNameControlTxt
Phone	9162866665	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 OLD FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	QUIN OGAWA	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8086772580	PhoneNum
Signature	2021-11-05	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	QUIN	PersonFirstNm
Person Last	OGAWA	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Eva Nitta	PreparerPersonNm
PTIN	P01286320	PTIN
Phone	4158948000	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd

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	KAHI MOHALA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	JAMES CONFORTI	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 OLD FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$24,045,552	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SUTTERHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1992	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	296	TotalEmployeeCnt
Total Volunteers	9	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$87,313	PYContributionsGrantsAmt
CY Contributions Grants	$2,135,010	CYContributionsGrantsAmt
PY Program Service Revenue	$23,533,113	PYProgramServiceRevenueAmt
CY Program Service Revenue	$21,901,819	CYProgramServiceRevenueAmt
PY Investment Income	$11,448	PYInvestmentIncomeAmt
CY Investment Income	$8,723	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$23,631,874	PYTotalRevenueAmt
CY Total Revenue	$24,045,552	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	$18,814,781	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$19,243,581	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$169,818	CYTotalFundraisingExpenseAmt
PY Other Expenses	$7,202,058	PYOtherExpensesAmt
CY Other Expenses	$7,182,748	CYOtherExpensesAmt
PY Total Expenses	$26,016,839	PYTotalExpensesAmt
CY Total Expenses	$26,426,329	CYTotalExpensesAmt
PY Revenues Less Expenses	-$2,384,965	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$2,380,777	CYRevenuesLessExpensesAmt
Total Assets BOY	$11,094,080	TotalAssetsBOYAmt
Total Assets EOY	$17,279,695	TotalAssetsEOYAmt
Total Liabilities BOY	$7,605,240	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,190,633	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$3,488,840	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$13,089,062	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$22,781,181	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$21,901,819	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$22,781,181	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	32	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	296	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	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	QUIN OGAWA CFO	PersonNm
Phone	8086772580	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 OLD FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Key EmployeeKeyEmployeeInd
JAMES E CONFORTI
President, SH PACIFIC	2.0	40.0	Yes (X)	Yes (X)	$0	$1,967,179	$495,099
RISHI SIKKA MD
DIRECTOR, PRESIDENT, SHS ENT.	1.0	40.0	Yes (X)		$0	$1,545,041	$217,152
PENNY WESTFALL
Sec, SH VP, CLO, Bay & Valley	1.0	40.0		Yes (X)	$0	$820,028	$74,390
KEVIN W KUICH
Chief Medical Officer	40.0	0.0			$489,684	$0	$26,845	Yes (X)
CLAUDIA CRIST
CEO, Kahi	2.0	40.0	Yes (X)	Yes (X)	$0	$428,267	$59,955
Elena Sharipova
Psychiatrist	40.0	0.0			$334,135	$0	$31,932	Yes (X)
STEVEN CHAPLIN MD
DIRECTOR/PSYCHIATRIST	40.0	0.0	Yes (X)		$315,198	$0	$22,544
Ben Kirk
Sec, Deputy Gen Counsel - Sac	1.0	40.0		Yes (X)	$0	$290,432	$41,160
Linda Pitman
Chief Operating Officer(PT YR)	40.0	0.0			$255,059	$0	$13,090		Yes (X)
QUIN OGAWA
CFO SHP	40.0	0.0		Yes (X)	$228,341	$0	$12,119
Maureen Kumar
Director - Human Resources	40.0	0.0			$172,746	$0	$15,671	Yes (X)
MICHELLE M FERNANDEZ
Director, Patient Care	40.0	0.0			$164,772	$0	$8,855	Yes (X)
Angela D Castro
Manager - Nursing Float	40.0	0.0			$139,238	$0	$13,917	Yes (X)
RUTH ANN BECKER
Director	1.0	0.0	Yes (X)		$0	$0	$0
KATHERINE W BENNETT
Director	1.0	0.0	Yes (X)		$0	$0	$0
PATRICK DUARTE
Director	1.0	0.0	Yes (X)		$0	$0	$0
DEE JAY MAILER
Director	1.0	0.0	Yes (X)		$0	$0	$0
CAMERON NEKOTA
DIRECTOR/CHAIR	2.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
GIDGET D G RUSCETTA
Director	1.0	0.0	Yes (X)		$0	$0	$0
PAUL SINGER
Director	1.0	0.0	Yes (X)		$0	$0	$0
CHARLES STED
Director	1.0	1.0	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,099,173	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,050,947	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,032,729	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	42	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Locumtenenscom LLC
PO Box 405547	ATLANTA	GA	30384	PSYCHIATRY SERVICES	$871,709
Jackson and Coker Holdings LLC
PO Box 277638	ATLANTA	GA	30384	PSYCHIATRY SERVICES	$434,641
CHG Companies Inc Comp Health In
PO Box 972651	DALLAS	TX	753972651	PSYCHIATRY SERVICES	$299,374
L Siracusa and Assoc Inc
286 Kalhi Street	HONOLULU	HI	96819	Security Services	$111,813

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$1,718	FederatedCampaignsAmt
Government Grants	$2,024,895	GovernmentGrantsAmt
All Other Contributions	$108,397	AllOtherContributionsAmt
Total Contributions	$2,135,010	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT SERVICE REVENUE	Desc
Business	623990	BusinessCd
Total Revenue Column	$21,901,819	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,901,819	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$21,901,819	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,723	TotalRevenueColumnAmt
Exclusion	$8,723	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$24,045,552	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,901,819	RelatedOrExemptFuncIncomeAmt
Exclusion	$8,723	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,053,478	TotalAmt
Program Services	$426,593	ProgramServicesAmt
Management And General	$626,885	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$12,194,295	TotalAmt
Program Services	$11,351,890	ProgramServicesAmt
Management And General	$732,420	ManagementAndGeneralAmt
Fundraising	$109,985	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$387,623	TotalAmt
Program Services	$360,845	ProgramServicesAmt
Management And General	$23,282	ManagementAndGeneralAmt
Fundraising	$3,496	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,531,924	TotalAmt
Program Services	$3,908,413	ProgramServicesAmt
Management And General	$603,534	ManagementAndGeneralAmt
Fundraising	$19,977	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,076,261	TotalAmt
Program Services	$969,131	ProgramServicesAmt
Management And General	$97,785	ManagementAndGeneralAmt
Fundraising	$9,345	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$19,326	TotalAmt
Program Services	$19,326	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$8,089	TotalAmt
Management And General	$8,089	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,506,688	TotalAmt
Program Services	$1,506,688	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$59,707	TotalAmt
Program Services	$13,238	ProgramServicesAmt
Management And General	$46,469	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$659,421	TotalAmt
Program Services	$455,055	ProgramServicesAmt
Management And General	$189,861	ManagementAndGeneralAmt
Fundraising	$14,505	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$215,075	TotalAmt
Program Services	$773	ProgramServicesAmt
Management And General	$214,302	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$864,023	TotalAmt
Program Services	$827,416	ProgramServicesAmt
Management And General	$36,607	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$113,044	TotalAmt
Program Services	$84,784	ProgramServicesAmt
Management And General	$28,009	ManagementAndGeneralAmt
Fundraising	$251	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$12,499	TotalAmt
Program Services	$11,715	ProgramServicesAmt
Management And General	$784	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$120,000	TotalAmt
Program Services	$120,000	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$630,021	TotalAmt
Program Services	$630,021	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$284,869	TotalAmt
Program Services	$284,869	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
PURCHASED SERVICES	$971,215	$829,769	$138,816	$2,630
SYSTEM ALLOCATION	$879,404	$188,688	$683,774	$6,942
FOOD	$430,413	$430,413
MEDICAL SUPPLIES	$310,809	$310,809

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$98,145	TotalAmt
Program Services	$50,745	ProgramServicesAmt
Management And General	$44,713	ManagementAndGeneralAmt
Fundraising	$2,687	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$26,426,329	TotalAmt
Program Services	$22,781,181	ProgramServicesAmt
Management And General	$3,475,330	ManagementAndGeneralAmt
Fundraising	$169,818	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$883,281	BOYAmt
EOY	$1,042,790	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$769	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,076,741	BOYAmt
EOY	$4,035,899	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,492	BOYAmt
EOY	$4,855	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$111,342	BOYAmt
EOY	$270,411	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$22,403,426	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$10,630,005	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$4,018,078	BOYAmt
EOY	$11,773,421	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,998,377	BOYAmt
EOY	$152,319	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,094,080	BOYAmt
EOY	$17,279,695	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,081,111	BOYAmt
EOY	$1,306,483	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,524,129	BOYAmt
EOY	$2,884,150	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,605,240	BOYAmt
EOY	$4,190,633	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	$3,284,682	BOYAmt
EOY	$13,010,487	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$204,158	BOYAmt
EOY	$78,575	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,488,840	BOYAmt
EOY	$13,089,062	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$11,094,080	BOYAmt
EOY	$17,279,695	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$2,380,777	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$5,255	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$11,986,254	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	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 D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$8,115,975	OtherCostOrOtherBasisAmt
Book Value	$8,115,975	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$12,310,342	OtherCostOrOtherBasisAmt
Depreciation	$9,211,937	DepreciationAmt
Book Value	$3,098,405	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$1,433,531	OtherCostOrOtherBasisAmt
Depreciation	$1,114,849	DepreciationAmt
Book Value	$318,682	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$543,578	OtherCostOrOtherBasisAmt
Depreciation	$303,219	DepreciationAmt
Book Value	$240,359	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$11,773,421	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
INSURANCE LIABILITIES	$1,163,842
OTHER LIABILITIES	$1,720,308

Field	Value	IRS element (for citing)
Total Liability	$2,884,150	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PART X, LINE 2	FormAndLineReferenceDesc
Explanation	THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MANY AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER 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 STATUTE OF LIMITATIONS FOR TAX YEARS 2017 THROUGH 2019 REMAIN OPEN IN U.S. TAX JURISDICTIONS IN WHICH SUTTER AND ITS AFFILIATES ARE SUBJECT TO TAXATION. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO SUCH UNCERTAIN TAX POSITIONS RECOGNIZED AT DECEMBER 31, 2020 AND 2019.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	400.	FreeCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	false	FinancialAssistanceBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	5	PersonsServedCnt
Total Community Benefit Expns	$10,053	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,053	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	101	PersonsServedCnt
Total Community Benefit Expns	$2,801	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,801	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	547	PersonsServedCnt
Total Community Benefit Expns	$17,954	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,954	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	653	PersonsServedCnt
Total Community Benefit Expns	$30,808	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$30,808	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	653	PersonsServedCnt
Total Community Benefit Expns	$30,808	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$30,808	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$155	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$155	NetCommunityBenefitExpnsAmt

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$10,977	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,977	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	65	PersonsServedCnt
Total Community Benefit Expns	$1,598	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,598	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	12	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$52,087	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$52,087	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	65	PersonsServedCnt
Total Community Benefit Expns	$64,817	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$64,817	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Reimbursed By Medicare	$0	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$1,756,982	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,756,982	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	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	SUTTER HEALTH PACIFIC - KAHI MOHALA	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 OLD FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Field	Value	IRS element (for citing)
Website Address	https://www.sutterhealth.org/kahi	WebsiteAddressTxt
State License	LICENSE #33-H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SUTTER HEALTH PACIFIC - KAHI MOHALA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE PART V, SECTION C	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	400.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	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 (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3E	THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
SCHEDULE H, PART V, SECTION B, LINE 5	IN CONDUCTING ITS MOST RECENT CHNA, SUTTER HEALTH PACIFIC - KAHI MOHALA DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. DEDICATED TO SERVING AND ENHANCING HAWAII'S NONPROFIT AND PUBLIC SECTORS, ISLANDER INSTITUTE ASSISTED WITH COLLECTING COMMUNITY INPUT IN THE FORM OF MEETINGS WHICH INDICATED COMMUNITY NEEDS AND THE DEGREE OF COMMUNITY READINESS TO JOIN IN FORMING SOLUTIONS AND KEY INFORMANT INTERVIEWS WHICH PROVIDED EXPERT OPINIONS ON VARIOUS COMMUNITY NEEDS, POSSIBLE SOLUTIONS, SYSTEMIC FACTORS AND/OR EVALUATION OF ORGANIZATIONAL READINESS FOR PARTNERSHIPS. ISLANDER INSTITUTE CONVENED 21 COMMUNITY MEETINGS IN TOTAL TO ENGAGE EVERYDAY PEOPLE IN DISCUSSIONS AROUND HEALTH IN THEIR COMMUNITIES. A SPECIFIC EFFORT WAS MADE TO LEARN ABOUT THE EXPERIENCE OF HEALTH IN VULNERABLE COMMUNITIES, INCLUDING DISADVANTAGED MINORITIES, RURAL RESIDENTS, YOUTH, SENIORS, PLACES THAT ARE MEDICALLY UNDERSERVED, AND PEOPLE WITH LOW INCOMES. THE MEETINGS WERE NOT LIMITED TO THESE POPULATIONS AND INCLUDED A DIVERSE SAMPLE OF GEOGRAPHIES, AGES, ETHNICITIES, AND SOCIOECONOMIC BACKGROUNDS. SPECIAL ATTENTION WAS GIVEN TO ENSURE THE MEETINGS WERE NOT MERELY EXTRACTING INFORMATION FROM PEOPLE AND COMMUNITIES. RATHER, THE PURPOSE OF THE MEETINGS WAS TO BUILD RELATIONSHIPS BY LISTENING, ENGAGING, UNDERSTANDING VALUES, AND BUILDING RECIPROCITY. ISLANDER INSTITUTE PARTNERED WITH ORGANIZATIONS AND INDIVIDUALS WITH STRONG CONNECTIONS WITHIN THEIR COMMUNITIES TO ORGANIZE AND HOST THESE MEETINGS. ALL THE HOSTS WORK IN COMMUNITY HEALTH, COMMUNITY SERVICE AND/OR COMMUNITY BUILDING AND ENGAGE ON ISSUES AFFECTING HEALTH AND WELLBEING. AS HOSTS, THEY PLAYED A CRITICAL ROLE IN CREATING A SAFE SPACE AND INVITING THE RIGHT PEOPLE INTO THE SPACE, INCLUDING PATIENTS, STAFF, OR COMMUNITY MEMBERS WHO HAD IMPORTANT STORIES AND COULD FEEL COMFORTABLE SHARING THEM. THE MEETINGS WERE KEPT RELATIVELY SMALL-BETWEEN FIVE TO 25 PEOPLE-AND DESIGNED TO MAXIMIZE EVERYONE'S COMFORT LEVEL, WHICH WOULD ALLOW ALL TO MEANINGFULLY PARTICIPATE AND FOR THE CONVERSATION TO GO DEEPER. PARTICIPANTS WERE TOLD THAT THEY WOULD NOT BE PERSONALLY IDENTIFIED IN THE REPORT. IN THIS CHNA, THEY ARE IDENTIFIED BASED ON ATTRIBUTES THAT MIGHT BE HELPFUL TO GIVE CONTEXT TO THEIR INPUT, SUCH AS THEIR AREA OF RESIDENCE OR BACKGROUND. ISLANDER INSTITUTE CREATED AN INITIAL LIST OF PEOPLE WHO COULD SHED LIGHT ON QUESTIONS OF HEALTH, SOCIAL DETERMINANTS, AND THE CIRCUMSTANCES IN VARIOUS COMMUNITIES. THE INITIAL LIST INCLUDED EXPERTS AND AUTHORITIES WITH WHOM ISLANDER INSTITUTE HAD EXISTING RELATIONSHIPS BASED ON ITS MANY YEARS OF WORKING IN HAWAII. THROUGHOUT THE MONTHS OF CONVERSATIONS, PEOPLE SUGGESTED OTHERS TO TALK TO AND HELPED MAKE CONNECTIONS. IN TOTAL, ISLANDER INSTITUTE SPOKE WITH ROUGHLY 200 PEOPLE FROM SIX ISLANDS IN PERSON OR OVER THE PHONE, IN A ONE-ON-ONE FORMAT OR IN SMALL GROUPS, AND IN FORMAL OR INFORMAL SETTINGS. AMONG THE KEY INFORMANTS, ISLANDER INSTITUTE ALSO MET WITH REPRESENTATIVES OF EACH OF THE 19 PARTICIPATING HOSPITAL FACILITIES TO BEST UNDERSTAND THEIR ENGAGEMENT WITH THE CHNA AND THE COMMUNITIES THEY SERVE. THESE CONVERSATIONS HELPED ILLUMINATE INTERESTS, CAPACITIES, AND MISSIONS OF EACH FACILITY AND SHED LIGHT ON LIMITATIONS AND USES OF PREVIOUS CHNAS AND THE POTENTIAL FOR THIS CHNA. THE FINDINGS FROM KEY INFORMANT INTERVIEWS IN KAHI MOHALA'S CHNA ARE AVAILABLE AT https://www.sutterhealth.org/pdf/for-patients/chna/ kahi-mohala-2019-chna.pdf
SCHEDULE H, PART V, SECTION B, LINES 6A AND 6B	THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) LED THIS COLLABORATION TO CONDUCT STATE- AND COUNTY-WIDE ASSESSMENTS FOR ITS MEMBERS. NINETEEN MEMBER HOSPITALS IN HAWAII PARTICIPATED IN THE CHNA PROJECT: . ADVENTIST HEALTH CASTLE . KAHI MOHALA . KAHUKU MEDICAL CENTER . KAISER FOUNDATION HOSPITAL - HONOLULU . KAPI'OLANI MEDICAL CENTER . KUAKINI MEDICAL CENTER . KULA HOSPITAL . LANA'I COMMUNITY HOSPITAL . MAUI MEMORIAL MEDICAL CENTER . MOLOKAI GENERAL HOSPITAL . NORTH HAWAI'I COMMUNITY HOSPITAL . PALI MOMI MEDICAL CENTER . THE QUEEN'S MEDICAL CENTER . THE QUEEN'S MEDICAL CENTER - WEST O'AHU . REHABILITATION HOSPITAL OF THE PACIFIC . SHRINERS HOSPITALS FOR CHILDREN - HONOLULU . STRAUB MEDICAL CENTER . WAHIAWA GENERAL HOSPITAL . WILCOX MEDICAL CENTER HAH AIMS TO BE THE UNIFYING VOICE OF HAWAII'S HEALTHCARE PROVIDERS AND AN AUTHORITATIVE AND RESPECTED LEADER IN SHAPING HAWAII'S HEALTHCARE POLICY. FOUNDED IN 1939, HAH REPRESENTS THE STATE'S HOSPITALS, NURSING FACILITIES, ASSISTED LIVING FACILITIES, HOME HEALTH AGENCIES, HOSPICES, AND OTHER HEALTHCARE PROVIDERS. HAH WORKS WITH COMMITTED PARTNERS AND STAKEHOLDERS TO ESTABLISH A MORE EQUITABLE, SUSTAINABLE HEALTHCARE SYSTEM DRIVEN TO IMPROVE QUALITY, EFFICIENCY, AND EFFECTIVENESS FOR PATIENTS AND COMMUNITIES.
SCHEDULE H, PART V, SECTION B, LINE 7A	HOSPITAL FACILITY WEBSITE: https://www.sutterhealth.org/pdf/for-patients/chna/ kahi-mohala-2019-chna.pdf SCHEDULE H, PART V, SECTION B, LINE 7B: OTHER WEBSITE: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment SCHEDULE H, PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY: https://www.sutterhealth.org/pdf/for-patients/chna/ kahi-mohala-2019-2021-implementation-strategy.pdf
SCHEDULE H, PART V, SECTION B, LINE 11	THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT KAHI MOHALA INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: . PROVIDE ACCESSIBLE, PROACTIVE SUPPORT FOR THOSE WITH HIGH NEEDS. IDENTIFY, DEVELOP, AND STRENGTHEN OUTREACH, EARLY INTERVENTION, FREE HEALTHCARE SERVICES, MENTAL HEALTH, AND ORAL HEALTH FOR THOSE WHO ARE STRUGGLING WITH HOUSELESSNESS, MENTAL ILLNESS, AND ADDICTION. . STRENGTHEN FAMILIES. CREATE THE CONDITIONS AND OPPORTUNITIES FOR FAMILIES TO BE HEALING FORCES FOR ITS OWN MEMBERS, INCLUDING ADDRESSING FINANCIAL STRESS THAT WILL ENABLE MORE HEALTHY TIME TOGETHER. . INVEST IN TEENAGERS AND HEALTHY STARTS. INVEST IN HEALTH AND EDUCATION AT THE EARLIEST STAGES OF LIFE. SUPPORT SCHOOL-BASED STRUCTURES, COMMUNITY-BASED ACTIVITIES, AND YOUTH EMPOWERMENT FOR PRE-TEENS AND TEENS. DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. KAHI MOHALA IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: . ADDRESS FINANCIAL INSECURITY . WORK TOGETHER FOR EQUALITY AND JUSTICE . PREPARE FOR EMERGENCIES . BUILD GOOD FOOD SYSTEMS . RESTORE ENVIRONMENT AND SENSE OF PLACE . NURTURE COMMUNITY IDENTITY AND COHESIVENESS . SHIFT KUPUNA CARE AWAY FROM "SICK CARE" . STRENGTHEN TRUST IN HEALTHCARE AS A MENTAL AND BEHAVIORAL HEALTH FACILITY KAHI MOHALA DOES NOT HAVE THE RESOURCES AND/OR EXPERTISE TO RESPOND TO THESE COMMUNITY NEEDS AT THIS TIME.
SCHEDULE H, PART V, SECTION B, LINE 15E	METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C	THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE
SCHEDULE H, PART V, SECTION B, LINE 22D	AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

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SCHEDULE H, PART I, LINES 3A AND 3C	FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENT'S FAMILY INCOME.
SCHEDULE H, PART I, LINE 3B	SUTTER HEALTH PACIFIC - KAHI MOHALA IS COMMITTED TO PROVIDING CHARITY CARE AND THEREFORE, PROVIDES FREE CARE AT HIGH PERCENTAGE OF FEDERAL POVERTY GUIDELINES (FPG). THE ORGANIZATION DOES NOT PROVIDE DISCOUNTED CARE.
SCHEDULE H, PART I, LINE 6A	SUTTER HEALTH (94-2788907), A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES: KAHI MOHALA FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. KAHI MOHALA WAS PART OF THE PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE FOCUSED ON DEVELOPING EFFECTIVE BEHAVIORAL HEALTH PREVENTION STRATEGIES. KAHI MOHALA FOCUSED ON ENVIRONMENTAL IMPROVEMENTS THROUGH ITS KAHI MOHALA NEIGHBORHOOD LITTER/GRAFFITI REMOVAL PROGRAM. KAHI MOHALA SUPPORTED COMMUNITY HEALTH IMPROVEMENT ADVOCACY WITH SUPPORT OF LOCAL ORGANIZATIONS SUCH AS THE HEALTH CARE ASSOCIATION OF HAWAII, HAWAII PUBLIC HEALTH ASSOCIATION, AND THE STATE HEALTH PLANNING DEPARTMENT. KAHI MOHALA SUPPORTED THE PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE AND THE ARMY ONESOURCE PROGRAM WHICH HAS CREATED STATE-LEVEL ALLIANCES TO RAISE AWARENESS, IMPROVE SERVICE DELIVERY AND GENERATE COMMUNITY SUPPORT FOR SERVICE MEMBERS AND THEIR FAMILIES. THE PROGRAM EDUCATES THE BEHAVIORAL HEALTH COMMUNITY ON MILITARY CULTURE AND BEST PRACTICES FOR ASSESSING AND TREATING BEHAVIORAL HEALTH ISSUES RESULTING FROM TRAUMAS OF WAR.
SCHEDULE H, PART III, LINE 4 - BAD DEBT	AUDIT FOOTNOTE: THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. EFFECTIVE JANUARY 1, 2019, SUTTER ENTITIES IMPLEMENTED THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS UPDATE (ASU), REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE ACCOUNTING CHANGE MODIFIED BAD DEBT REPORTING, AND AS A RESULT, BAD DEBT IS ONLY REPORTED IN LIMITED SITUATIONS.
SCHEDULE H, PART III, LINE 7	MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. 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 FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.
SCHEDULE H, PART III, LINE 9B	DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL AND CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.
SCHEDULE H, PART VI, LINE 2	THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. LANGUAGES: THE POLICY SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S)OF HOSPITAL'S SERVICE AREA. IN ADDITION, ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN PRIMARY LANGUAGE(S)OF HOSPITAL'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. INFORMATION PROVIDED TO PATIENTS DURING THE PROVISION OF HOSPITAL SERVICES: A. DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND IDENTIFY THE DEPARTMENT THAT PATIENTS CAN VISIT TO RECEIVE INFORMATION ABOUT, AND ASSISTANCE WITH APPLYING FOR, FINANCIAL ASSISTANCE. B. FINANCIAL ASSISTANCE COUNSELORS: PATIENTS WHO MAY BE UNINSURED PATIENTS SHALL BE ASSIGNED FINANCIAL COUNSELORS, WHO SHALL VISIT WITH THE PATIENTS IN PERSON AT THE HOSPITAL, PROVIDE PATIENTS A FINANCIAL ASSISTANCE APPLICATION, ASSIST WITH THE APPLICATION PROCESS, AND PROVIDE A CONTACT INFORMATION FOR THE PATIENT TO CALL FOR QUESTIONS. C. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITALS SHALL PROVIDE ALL PATIENTS A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. D. APPLICATIONS PROVIDED AT DISCHARGE: AT THE TIME OF DISCHARGE, HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. E. INFORMATION PROVIDED TO PATIENTS AT OTHER TIMES: 1. CONTACT INFORMATION WHICH INCLUDES A PHONE NUMBER AND HOSPITAL DEPARTMENT TO OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE APPLICATION PROCESS. 2. BILLING STATEMENTS: BILLING STATEMENTS PROVIDED TO PATIENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, A PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS ABOUT FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE PATIENTS CAN OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE INCLUDING THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY OF THE POLICY, AND THE APPLICATION FOR FINANCIAL ASSISTANCE. 3. UPON REQUEST: HOSPITALS SHALL PROVIDE PATIENTS WITH PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST AND WITHOUT CHARGE. F. PUBLICITY OF FINANCIAL ASSISTANCE INFORMATION 1. PUBLIC POSTING: HOSPITALS SHALL POST COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IN A PROMINENT LOCATION IN THE EMERGENCY ROOM, ADMISSIONS AREA, AND ANY OTHER LOCATION IN THE HOSPITAL WHERE THERE IS A HIGH VOLUME OF PATIENT TRAFFIC, INCLUDING BUT NOT LIMITED TO THE WAITING ROOMS, BILLING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS. THESE PUBLIC NOTICES SHALL INCLUDE INFORMATION ABOUT THE RIGHT TO REQUEST AN ESTIMATE OF FINANCIAL RESPONSIBILITY FOR SERVICES. 2. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY SHALL BE AVAILABLE IN A PROMINENT PLACE ON THE SUTTER HEALTH WEBSITE (WWW.SUTTERHEALTH.ORG) AND ON EACH INDIVIDUAL HOSPITAL'S WEBSITE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. 3. MAIL: PATIENTS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY BE SENT BY MAIL, AT NO COST TO THE PATIENT. 4. COMMUNITY AWARENESS: SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI, LINE 4	NINETEEN HAWAII HOSPITALS, LOCATED ACROSS THE STATE, PARTICIPATED IN THE CHNA PROJECT. THE HOSPITAL SERVICE AREA IS THE WHOLE STATE OF HAWAII AND ASIA PACIFIC BUT IS PREDOMINANTLY DEFINED BY A GEOGRAPHICAL BOUNDARY OF THE HONOLULU COUNTY AS THE MAJORITY OF OUR PATIENTS SERVED COME FROM THE ISLAND OF OAHU. IN THE PAST, HAH PRODUCED FIVE SEPARATE, THOUGH SIMILAR, REPORTS: ONE STATEWIDE REPORT AND ONE PER COUNTY JURISDICTION. FOR THIS CHNA, HAH AGREED THAT ISLANDER INSTITUTE WOULD PROVIDE ONE COMPREHENSIVE REPORT TO SERVE ALL 19 FACILITIES. THE REASON FOR THIS DECISION MAY BE UNIQUE TO HAWAII. ALTHOUGH SOME FACILITIES SERVE RELATIVELY SMALL COMMUNITIES, AS ISLAND PEOPLE WHO SHARE A UNIQUE HISTORICAL, CULTURAL, SOCIAL, AND ECONOMIC CONTEXT, THE STORY OF HAWAII'S ENTIRE ARCHIPELAGO FORMS THE BACKDROP FOR EVERYONE'S COMMUNITY WORK. COMMON THEMES, CHALLENGES, AND ISSUES CUT ACROSS COMMUNITIES, AND THERE IS MUCH TO BE LEARNED FROM OUR SHARED EXPERIENCES AS PEOPLE OF HAWAII. AS SUCH, THE MAJORITY OF THIS CHNA IS WRITTEN FOR THE BENEFIT OF EVERY PARTICIPATING FACILITY, WITH THEMES AND FINDINGS RELEVANT TO ANY WORK IN HAWAII. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN KAHI MOHALA'S CHNA AT: https://www.sutterhealth.org/pdf/for-patients/chna/ kahi-mohala-2019-chna.pdf
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE 2019 - 2021 IMPLEMENTATION STRATEGY FOR KAHI MOHALA DEFINES PROGRAMS THAT WILL ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. KAHI SUPPORTED THE PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE. ARMY ONESOURCE HAS CREATED THE STATE-LEVEL ALLIANCES TO RAISE AWARENESS, IMPROVE SERVICE DELIVERY AND GENERATE COMMUNITY SUPPORT FOR OUR SERVICE MEMBERS AND FAMILIES. THEY ALSO FOCUS ON EDUCATING THE BEHAVIORAL HEALTH COMMUNITY ON MILITARY CULTURE AND BEST PRACTICES FOR ASSESSING AND TREATING BEHAVIORAL HEALTH ISSUES RESULTING FROM THE TRAUMA OF WAR. KAHI ALSO SUPPORTED THE HAWAII LGBT LEGACY FOUNDATION BY PROVIDING A COMMUNITY BENEFIT SPONSORSHIP OF HONOLULU PRIDE AS WELL AS PARTICIPATING IN THE PRIDE EVENT. THE HAWAII LGBT LEGACY FOUNDATION IS COMMITTED TO A LEGACY OF HOPE, EQUALITY AND UNITY. THE MISSION IS TO SUPPORT, EMPOWER, EDUCATE, UNIFY, AND FACILITATE LGBT ORGANIZATIONS AND INDIVIDUALS THROUGHOUT HAWAII. KAHI SUPPORTED THE MENTAL HEALTH AMERICA OF HAWAII ORGANIZATION THROUGH A COMMUNITY BENEFIT SPONSORSHIP AS WELL AS PARTNERING WITH MENTAL HEALTH AMERICA FOR THE 2020 MENTAL HEALTH AWARENESS DAY. DUE TO COVID-19 THEY WERE UNABLE TO HOST THE DAY IN PERSON AS THEY HAVE IN YEARS PAST. THE CEO OF KAHI MOHALA WAS ABLE TO REACH OUT TO LEGISLATORS TO HIGHLIGHT MENTAL HEALTH AS AN IMPORTANT PUBLIC HEALTH ISSUE, RAISE AWARENESS OF CURRENT PREVENTION AND TREATMENT OPPORTUNITIES, THE ORGANIZATIONS DOING THE WORK AND HOW ELECTED OFFICIALS CAN PROMOTE MENTAL HEALTH IN HAWAII. KAHI HOSTED AND CO-SPONSORED WITH MENTAL HEALTH KOKUA COMMUNITY EDUCATION TRAININGS ON CAMPUS AND TROUGHOUT THE SERVICE AREA. TOPICS PROVIDED WERE SAFE TALK TRAINING, C-SSRS TRAINING, YOUTH MENTAL HEALTH FIRST AID, CBCT FOR PTSD. KAHI PROVIDED THE USE OF THEIR ROOMS/FACILITIES FOR SEVERAL COMMUNITY PROGRAMS INCLUDING THE 12-STEP RECOVERY PROGRAM THROUGH ALANON, NARCOTICS ANONYMOUS, AND CHILD & FAMILY SERVICES FOR DOMESTIC VIOLENCE PROGRAMS.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: SUTTER HEALTH IS A NOT-FOR-PROFIT, INTEGRATED HEALTHCARE SYSTEM LOCATED IN NORTHERN CALIFORNIA AND COMMITTED TO HEALTH EQUITY, COMMUNITY PARTNERSHIPS AND INNOVATIVE, HIGH-QUALITY PATIENT CARE. OUR OVER 60,000 EMPLOYEES AND AFFILIATED CLINICIANS SERVE MORE THAN 3 MILLION PATIENTS THROUGH OUR HOSPITALS, CLINICS AND HOME HEALTH SERVICES. LEARN MORE ABOUT HOW WE'RE TRANSFORMING HEALTHCARE AT HTTPS://www.sutterhealth.org AND HTTPS://vitals.sutterhealth.org SUTTER HEALTH'S TOTAL INVESTMENT IN COMMUNITY BENEFIT IN 2020 WAS $1.03 BILLION, AN INCREASE OF ABOUT $200 MILLION OVER 2019. THIS AMOUNT INCLUDES TRADITIONAL CHARITY CARE AND UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, AS WELL AS INVESTMENTS IN COMMUNITY HEALTH PROGRAMS TO ADDRESS PRIORITIZED HEALTH NEEDS AS IDENTIFIED BY REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENTS. . AS PART OF SUTTER HEALTH'S COMMITMENT TO FULFILL ITS NOT-FOR-PROFIT STATUS AND SERVE THE MOST VULNERABLE IN ITS COMMUNITIES, SUTTER HEALTH'S HOSPITALS AND MEDICAL FOUNDATIONS ALONG WITH OTHER ALIGNED HEALTHCARE PROVIDERS, OFFER CHARITY CARE TO ENSURE THAT PATIENTS CAN ACCESS NEEDED MEDICAL CARE REGARDLESS OF THEIR ABILITY TO PAY. SUTTER'S CHARITY CARE POLICIES, WHICH HAVE BEEN IN PLACE FOR MANY YEARS, OFFER FINANCIAL ASSISTANCE TO UNINSURED AND UNDERINSURED INDIVIDUALS EARNING LESS THAN $51,520 A YEAR OR $106,000 FOR A FAMILY OF FOUR. IN 2020, SUTTER HEALTH INVESTED $109 MILLION IN CHARITY CARE. . OVERALL, SINCE THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT, GREATER NUMBERS OF PREVIOUSLY UNINSURED PEOPLE NOW HAVE MORE ACCESS TO HEALTHCARE COVERAGE THROUGH THE MEDI-CAL AND MEDICARE PROGRAMS. THE PAYMENTS FOR PATIENTS WHO ARE COVERED BY MEDI-CAL AND MEDICARE DO NOT COVER THE FULL COSTS OF PROVIDING CARE. IN 2020, SUTTER HEALTH INVESTED $698 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS, AN INCREASE OF ALMOST $200 MILLION OVER 2019. . THROUGH COMMUNITY BENEFIT INVESTMENTS, SUTTER HELPED LOCAL COMMUNITIES ACCESS PRIMARY, MENTAL HEALTH AND ADDICTION CARE, AND BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD. SEE MORE ABOUT HOW SUTTER HEALTH REINVESTS INTO THE COMMUNITY BY VISITING https://www.sutterpartners.org IN ADDITION, EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESS REAL COMMUNITY NEEDS. FOR MORE FACTS AND INFORMATION VISIT htttps://www.sutterpartners.org
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT: N/A

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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
JAMES E CONFORTI
President, SH PACIFIC	$0	$1,058,033	$0	$514,101	$0	$395,045	$0	$464,926	$0	$30,173	$0	$2,462,278	$0	$198,797
RISHI SIKKA MD
DIRECTOR, PRESIDENT, SHS ENT.	$0	$754,775	$0	$379,595	$0	$410,671	$0	$183,426	$0	$33,726	$0	$1,762,193	$0	$298,244
PENNY WESTFALL
Sec, SH VP, CLO, Bay & Valley	$0	$518,608	$0	$178,117	$0	$123,303	$0	$63,126	$0	$11,264	$0	$894,418	$0	$49,982
KEVIN W KUICH
Chief Medical Officer	$464,551	$0	$25,000	$0	$133	$0	$15,426	$0	$11,419	$0	$516,529	$0	$0	$0
CLAUDIA CRIST
CEO, Kahi	$0	$319,883	$0	$34,458	$0	$73,926	$0	$45,526	$0	$14,429	$0	$488,222	$0	$0
Elena Sharipova
Psychiatrist	$324,002	$0	$10,000	$0	$133	$0	$15,426	$0	$16,506	$0	$366,067	$0	$0	$0
STEVEN CHAPLIN MD
DIRECTOR/PSYCHIATRIST	$282,312	$0	$32,674	$0	$212	$0	$15,273	$0	$7,271	$0	$337,742	$0	$0	$0
Ben Kirk
Sec, Deputy Gen Counsel - Sac	$0	$254,097	$0	$35,898	$0	$437	$0	$13,747	$0	$27,413	$0	$331,592	$0	$0
Linda Pitman
Chief Operating Officer(PT YR)	$159,318	$0	$4,000	$0	$91,741	$0	$8,619	$0	$4,471	$0	$268,149	$0	$0	$0
QUIN OGAWA
CFO SHP	$221,808	$0	$6,400	$0	$133	$0	$12,000	$0	$119	$0	$240,460	$0	$0	$0
Maureen Kumar
Director - Human Resources	$169,981	$0	$2,707	$0	$58	$0	$9,196	$0	$6,475	$0	$188,417	$0	$0	$0
MICHELLE M FERNANDEZ
Director, Patient Care	$160,639	$0	$4,000	$0	$133	$0	$8,691	$0	$164	$0	$173,627	$0	$0	$0
Angela D Castro
Manager - Nursing Float	$137,878	$0	$1,302	$0	$58	$0	$7,459	$0	$6,458	$0	$153,155	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	TRAVEL FOR COMPANIONS: FOR APPROPRIATE OCCASIONS AS APPROVED BY THE BOARD CHAIR, BOARD MEMBERS MAY HAVE THEIR SPOUSE ACCOMPANY THEM TO A BOARD FUNCTION. REASONABLE TRAVEL EXPENSES WILL BE REIMBURSED AND BE REPORTED AS INCOME ON A FORM 1099 TO THE BOARD MEMBER AS APPROPRIATE. THREE BOARD MEMBERS RECEIVED THIS BENEFIT.
SCHEDULE J, PART I, LINE 3	SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THIS ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARM'S LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH.
SCHEDULE J, PART I, LINE 4A	SEVERANCE PAYMENTS: LINDA PITMAN RECEIVED SEVERANCE PAYMENTS OF $91,506.
SCHEDULE J, PART I, LINE 4B	NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PENSION PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA PROVIDES 6% TO 12% OF BASE SALARY PLUS ANNUAL INCENTIVE PLAN AWARD (COMMENSURATE WITH MANAGEMENT LEVEL). CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTH'S QUALIFIED PENSION PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT.
SCHEDULE J, PART I, LINE 7	NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 15% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP): THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, OPERATING UNIT AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. LONG TERM PERFORMANCE PLANS: SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL LONG TERM PERFORMANCE PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1 AND PART III, LINE 1	MISSION STATEMENT: SUTTER HEALTH PACIFIC (DBA KAHI MOHALA) IS DEDICATED TO IMPROVING THE QUALITY OF LIFE AND RESTORING HOPE FOR INDIVIDUALS AND FAMILIES AFFECTED BY MENTAL ILLNESS.
FORM 990, PART III, LINE 4A	PROGRAM SERVICE ACCOMPLISHMENTS: SUTTER HEALTH PACIFIC, A CALIFORNIA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION, WAS ORGANIZED TO OPERATE AS KAHI MOHALA, AN 88 BED, FREESTANDING NOT-FOR-PROFIT PSYCHIATRIC HOSPITAL. KAHI MOHALA HAS BEEN OPERATIONAL SINCE 1983 AND IS SITUATED ON A 14.5-ACRE CAMPUS. THE HOSPITAL IS LICENSED BY THE STATE OF HAWAII AND IS ACCREDITED BY THE JOINT COMMISSION. THERE WERE 24,828 PATIENT DAYS IN 2020. KAHI MOHALA'S MISSION IS: "KAHI MOHALA IS DEDICATED TO IMPROVING THE QUALITY OF LIFE AND RESTORING HOPE FOR INDIVIDUALS AND FAMILIES AFFECTED BY MENTAL ILLNESS." TREATMENT PROGRAMS KAHI MOHALA IS DEDICATED NOT ONLY TO PSYCHIATRIC, EMOTIONAL AND BEHAVIORAL STABILIZATION, BUT ALSO TO RECOVERY THROUGH EMPOWERMENT. TEACHING INDIVIDUALS THE SKILLS TO SELF-MANAGE AND SELF-REGULATE TO THE FULLEST POSSIBLE EXTENT IS A FUNDAMENTAL GOAL WITHIN THE TREATMENT AND RECOVERY PROCESS. LEVELS OF CARE - ACUTE CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - RESIDENTIAL CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - ADOLESCENT PARTIAL HOSPITALIZATION PROGRAM (PHP) INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) SPECIALIZED TREATMENT SERVICES - PSYCHIATRIC EVALUATION/TREATMENT AND MEDICATION MANAGEMENT - NURSING ASSESSMENT - PSYCHOLOGICAL TESTING - SUBSTANCE ABUSE/DUAL DIAGNOSIS SERVICES - EATING DISORDER SERVICES THERAPEUTIC SERVICES AVAILABLE - INDIVIDUAL, FAMILY AND GROUP THERAPY - EDUCATIONAL SERVICES - OCCUPATIONAL THERAPY - RECREATIONAL THERAPY - ART THERAPY - REALITY-ORIENTED PHYSICAL EXPERIENTIAL SERVICES (ROPES) THIS CORPORATION WAS FORMED FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION: A. TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NOT-FOR-PROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BEDS AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTSTO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; B. TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED, OR TO THE PROMOTION OF HEALTH; C. TO PROMOTE AND CARRY OUT SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; D. TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITY SERVED; AND E. TO CONTRIBUTE TO THE GROWTH, DEVELOPMENT AND FINANCIAL STRENGTH OF SUTTER HEALTH SYSTEM. KAHI MOHALA - LIST OF COMMUNITY BENEFITS 2020: - TWELVE-STEP PROGRAMS (ALCOHOLICS ANONYMOUS, ALANON, NARCOTICS ANONYMOUS) PURPOSE: PEER-LED, SELF-HELP GROUPS OF PERSONS RECOVERING FORM ADDICTIONS, OR FAMILY MEMBERS OF PERSONS RECOVERING FROM ADDICTIONS. GOALS AND OBJECTIVES: TO GAIN SUPPORT AND EDUCATION IN A GROUP SETTING. - INTERNSHIP, RESIDENCY AND PRACTICUM PROGRAMS PURPOSE: TO PROVIDE A SUPERVISED CLINICAL PRACTICE SETTING FOR MEDICAL STUDENTS, SOCIAL WORKERS, NURSES, PSYCHOLOGISTS, SUBSTANCE ABUSE COUNSELORS AND OCCUPATIONAL THERAPISTS. GOALS AND OBJECTIVES: TO OBTAIN DIRECT PRACTICE EXPERIENCE IN THE STUDENT'S FIELD. - INFORMATION AND REFERRAL PURPOSE: TO PROVIDE TELEPHONE INFORMATION AND REFERRAL TO THE PUBLIC REGARDING MENTAL HEALTH AND CHEMICAL DEPENDENCY RESOURCES. GOAL: TO PROVIDE A FREE COMMUNITY RESOURCE. - MEMBERSHIPS ON COMMUNITY BOARDS AND COMMITTEES: GOODWILL INDUSTRIES, ROTARY, HEALTHCARE ASSOCIATION OF HAWAII (HAH), HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA), CHAMBER OF COMMERCE, MENTAL HEALTH AMERICA OF HAWAII (MHA), NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), HAWAII YOUTH SERVICES NETWORK (HYSN), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE PURPOSE: TO VOLUNTEER EXPERTISE ON VARIOUS COMMUNITY BOARDS AND COMMITTEES. GOALS AND OBJECTIVES: TO SUPPORT OUR COMMUNITY BY HELPING OTHERS MEET THE GOALS AND OBJECTIVES OF THE VARIOUS ORGANIZATIONS AND COMMITTEES. - COMMUNITY ROPES GROUPS PURPOSE: PROVIDE PROBLEM SOLVING, TEAM BUILDING, AND LEADERSHIP AWARENESS THROUGH THE USE OF GAMES AND ELEMENTS ON THE ROPES COURSE. GOALS AND OBJECTIVES: PROVIDE THE YOUTH/AT RISK YOUTH THE OPPORTUNITY TO EXPERIENCE TEAM BUILDING/PROBLEM SOLVING EXERCISES THROUGH THE USE OF OUR ROPES COURSE. - COMMUNITY EDUCATION SERIES - APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST) PURPOSE: PROVIDE TWO DAY WORKSHOP IN SUICIDE FIRST AID. GOALS AND OBJECTIVES: PROVIDES MEMBERS OF THE COMMUNITY A COURSE TO IDENTIFY THOSE WHO MAY BE AT RISK OF SUICIDE AND HOW TO CREATE A PLAN FOR THEIR IMMEDIATE SAFETY. - CHILD & FAMILY SERVICE PURPOSE: USE OF ROOM/FACILITIES. GOALS AND OBJECTIVES: TO PROVIDE A MEETING PLACE FOR THE DOMESTIC VIOLENCE PROGRAM. - CPR TRAINING PURPOSE: TO PROVIDE CPR TRAINING TO COMMUNITY. GOAL: TRAIN EWA BEACH COMMUNITY HOW TO PERFORM CPR. - HAWAII FOOD BANK CASH DONATION AND CANNED FOOD DRIVE PURPOSE: CASH DONATION & CANNED FOOD COLLECTION. GOALS AND OBJECTIVES: PROVIDE ASSISTANCE TO THE HUNGRY AND HOMELESS IN THE COMMUNITY. - NATIONAL ASSOCIATION ON MENTAL ILLNESS (NAMI) WALK PURPOSE: PARTICIPATION IN ANNUAL NAMI WALK. GOALS AND OBJECTIVES: TO RAISE MONEY AND AWARENESS OF MENTAL ILLNESS. - LITTER & GRAFFITI REMOVAL PURPOSE: TO REMOVE BLIGHT FROM NEIGHBORHOOD. GOAL: MAINTAIN LITTER AND TAG FREE ENVIRONMENT FOR AREA SURROUNDING KAHI MOHALA.
FORM 990, PART VI, LINE 1A	GOVERNING BODY: THE AFFAIRS AND MANAGEMENT OF SUTTER HEALTH PACIFIC (SHP) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHO HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SHP DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR OF THE BOARD WHO SERVES AS CHAIR OF THE COMMITTEE, THE ADMINISTRATOR/CEO, AND AT LEAST ONE ADDITIONAL DIRECTOR.
FORM 990, PART VI, LINES 6 & 7A	CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS: THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 7B	CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL AND THE NATURE OF THEIR TYPE OF VOTING RIGHTS: SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR; N. ANY SELF-DEALING TRANSACTION BETWEEN A DIRECTOR OF THE CORPORATION AND THE CORPORATION OR A SUBSIDIARY OF THE CORPORATION; OR O. REHIRING, CONTRACTING WITH, OR OTHERWISE COMPENSATING A SUTTER HEALTH EXECUTIVE, OR ANY OFFICER OR MEMBER OF MANAGEMENT OF THE CORPORATION OR ANY AFFILIATED ENTITY AFTER THEIR EMPLOYMENT HAS ENDED. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL.
FORM 990, PART VI, LINE 11B	PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW FORM 990: SUTTER HEALTH HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED.
FORM 990, PART VI, LINE 12	PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST: EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. THE BOARD MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR (OR COMMITTEE CHAIR AS APPLICABLE) MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL LEAVE THE ROOM PRIOR TO THE BOARD'S FINAL DISCUSSION AND VOTE.
FORM 990, PART VI, LINE 15	PROCESS FOR DETERMINING COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE), (C) TOTAL DIRECT CASH (BASE SALARY + ANNUAL INCENTIVE + LONG TERM INCENTIVE) AND (D) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY ADJUSTMENTS MAY BE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL ANNUALLY, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE 2020 EXECUTIVE COMPENSATION APPROVAL WAS COMPLETED IN FEBRUARY 2020.
FORM 990, PART VI, LINE 19	AVAILABILITY OF GOVERNING DOCUMENTS, COI POLICY & FINANCIAL STATEMENTS: THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
FORM 990, PART VII, SECTION A	COMPENSATION OF BOARD MEMBERS: THE FOLLOWING BOARD MEMBERS OF THE ORGANIZATION ARE FULL-TIME EMPLOYEES (40 HOURS PER WEEK) OF SUTTER HEALTH AND THEIR SUTTER HEALTH SALARIES ARE REPORTED HEREIN. THESE INDIVIDUALS RECEIVE NO COMPENSATION FOR THEIR SERVICE AS BOARD MEMBERS OF THIS ORGANIZATION. - JAMES E. CONFORTI - CLAUDIA CRIST - RISHI SIKKA, MD INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID FULL-TIME BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF SUTTER HEALTH, A SEPARATE LEGAL ENTITY. IT IS THE INTENTION OF SUTTER HEALTH AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE SUTTER HEALTH EMPLOYEES WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: EQUITY TRANSFERS (NET): $ 11,986,254 -------------------- TOTAL $ 11,986,254

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CALIFORNIA PACIFIC MEDICAL CTR FOUND
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942728423	FUNDRAISING	CA	501(C)(3)	7	SUTTER BH	Yes (true)
EAST BAY PERINATAL CENTER
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	510172285	HEALTHCARE	CA	501(C)(3)	3	SUTTER BH	Yes (true)
MEMORIAL HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942290244	FUNDRAISING	CA	501(C)(3)	12A - I	SUTTER VH	Yes (true)
MILLS-PENINSULA HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	237288765	FUNDRAISING	CA	501(C)(3)	7	SUTTER BH	Yes (true)
SAMUEL MERRITT UNIVERSITY
450 30TH STREET STE 2840	OAKLAND	CA	94609	942992642	UNIVERSITY	CA	501(C)(3)	2	SUTTER BH	Yes (true)
SUTTER AUBURN FAITH HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942594966	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER BAY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	940562680	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER BAY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941156581	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER COAST HOSPITAL
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942988520	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER DAVIS HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680217870	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER HEALTH
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	942788907	SUPPORTING OR	CA	501(C)(3)	12C III-FI	NA	false
SUTTER HEALTH PLAN
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	461183948	HEALTH PLAN	CA	501(C)(4)	N/A	SUTTER HLTH	Yes (true)
SUTTER INSURANCE SERVICES CORPORATION
745 FORT STREET SUITE 1100	HONOLULU	HI	96813	990289310	INSURANCE SER	HI	501(C)(3)	12C III-FI	SUTTER HLTH	Yes (true)
SUTTER MEDICAL CENTER FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942788906	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER ROSEVILLE MEDICAL CTR FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680040113	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER SOLANO CHARITABLE FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942668262	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER VALLEY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941156621	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER VALLEY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680273974	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
TRACY HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680318845	FUNDRAISING	CA	501(C)(3)	12A - I	SUTTER VH	Yes (true)
SUTTER VISITING NURSE ASSOC AND HOSPICE
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	946068843	HEALTHCARE	CA	501(C)(3)	10	SUTTER HLTH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
CALIFORNIA PACIFIC ADV IMAGING LLC
PO BOX 6102	NOVATO	CA	94598	562311840	PATIENT CARE	DE	NA	N/A
SAN FRANCISCO ENDOSCOPY CENTER
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	912160588	PATIENT CARE	CA	NA	N/A
PRESIDIO SURGERY CENTER LLC
1635 DIVISADERO	SAN FRANCISCO	CA	94115	320144060	PATIENT CARE	CA	NA	N/A
SUTTER FAIRFIELD SURGERY CENTER LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	300233892	PATIENT CARE	CA	NA	N/A
SUTTER AMADOR SURGERY CENTER LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	461398093	PATIENT CARE	CA	NA	N/A
ROSEVILLE ENDOSCOPY CENTER
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	870710513	PATIENT CARE	CA	NA	N/A
STANISLAUS SURGICAL HOSPITAL LLC
1421 OAKDALE ROAD	MODESTO	CA	95355	911754157	PATIENT CARE	CA	NA	N/A
MEMORIAL MEDICAL BUILDING 1
1800 COFFEE RD 76	MODESTO	CA	95355	770234236	OFFICE RENTAL	CA	NA	N/A
MAGNETIC IMAGING AFFILIATES LLC
2125 OAK GROVE ROAD	WALNUT CREEK	CA	94598	473696091	PATIENT CARE	CA	NA	N/A
ASC OPERATORS - SANTA ROSA LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	263386169	CARE MANAGEMENT	CA	NA	N/A
ASC OPERATORS - SAN LUIS OBISPO LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	272673776	CARE MANAGEMENT	CA	NA	N/A
ICG CREDIT OPPORTUNITIES FUND LP
11111 SANTA MONICA BLVD SUITE 2100	LOS ANGELES	CA	90025	814220441	INVESTMENTS	CA	NA	N/A
CARLSBAD SURGERY CENTER LLC
6121 PASEO DEL NORTE STE 100	CARLSBAD	CA	92011	201413484	PATIENT CARE	CA	NA	N/A
COAST CTR FOR ORTHOPEDIC & ARTHROSCOPIC
3444 KEARNY VILLA ROAD	SAN DIEGO	CA	92123	330839637	PATIENT CARE	CA	NA	N/A
OTAY LAKES SURGERY CENTER LLC
955 LANE AVE SUITE 100	CHULA VISTA	CA	91914	200794766	PATIENT CARE	CA	NA	N/A
MADISON INTERNATIONAL GLOBAL
410 PARK AVENUE	NEW YORK	NY	10022	981310251	INVESTMENTS	NY	NA	N/A
SURG CTR OF ABSMC
3875 TELEGRAPH	OAKLAND	CA	94609	470946086	Patient Care	CA	NA	N/A
DIVISADERO HOLD LLC
1635 DIVISADERO	SAN FRANCISCO	CA	94115	320621050	Outpatient surg	CA	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd
SUTTER HEALTH DEFERRED COMP PLANS' TRUST
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	276851989	RABBI TRUST	CA	NA	TRUST	Yes (true)
NORTHWOOD EUROPE TE FEEDER LP
1819 WAZEE ST 2ND FLOOR	DENVER	CO	90202	981272216	HOLDING COMPANY		NA	C CORP	Yes (true)	CJ
LYXSOP SEGREGATED PORTFOLIO 1
					INVESTMENT		NA	C CORP	Yes (true)	CJ	PO BOX 10008 WILLOW HOUSE	CRICKET SQUARE	GRAND CAYMAN	CJ
LYXSOP SEGREGATED PORTFOLIO 2
					INVESTMENT		NA	C CORP	Yes (true)	CJ	PO BOX 10008 WILLOW HOUSE	CRICKET SQUARE	GRAND CAYMAN	CJ
AQR REAL RETURN OFFSHORE FUND LP
				980700570	INVESTMENT		NA	c corp	Yes (true)	CJ	89 NEXUS WAY	CAMANA BAY	GRAND CAYMAN	CJ	KY1-9009

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	SUTTER INSURANCE SERVICES CORPORATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	P	TransactionTypeTxt
Involved	$242,046	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt