2025-08-13T16:29:24+00:00 2024-09-30 135565207 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2023-10-01 951903935 PIH Health Downey Hospital PIHH 5629045000 11500 Brookshire Ave Downey CA 90241 Vid Shivaraman CFO 2025-08-13 true true BRITTANY ELLISER P01284594 2253444000 2025-08-13 2023 2025-03-06 01:10:19Z James West 12401 Washington Blvd Whittier CA 90602 262266686 false X www.pihhealth.org X 1956 CA To provide quality healthcare and contribute to the community's health and well-being. 16 15 1485 289 0 0 54190 32249261 195932591 221905015 5000 6347315 1280425 1692265 197272206 262193856 0 0 0 0 112525853 119257309 0 0 0 92310998 102109447 204836851 221366756 -7564645 40827100 194522798 205809905 283921313 254381320 -89398515 -48571415 Mission: We provide high quality healthcare without discrimination and contribute to the health and well-being of our communities in an ethical, safe, and fiscally prudent manner in recognition of our charitable purpose. false false 120689960 0 157868008 Patient Care: PIH Health Downey Hospital officially became part of PIH Health in October 2013. As a 501 (c)(3) nonprofit, 199-bed hospital, the Downey campus has provided quality care in a welcoming environment for almost 100 years. Patient Care in Fiscal Year 2023-2024 Employees: 1,250 Volunteers: 289 Number of Emergency Department (ED) visits: 62,413 Medical Staff: 478 69808686 0 62772647 Financial Assistance and Means-Tested Government Programs: Financial Assistance, also known as charity care, is defined as free or discounted health services provided to individuals who cannot afford to pay and who meet the eligibility criteria of the organization's financial assistance policy. PIH Health offers a generous Financial Assistance Program, providing charity care to those with family income(s) at or below 400% of Federal Poverty Level guidelines. In providing services to those patients participating in means-tested government health programs, such as Medi-Cal, PIH Health realizes a collective net loss each fiscal year due to the shortfall created when the payments received from these programs are less than the cost of caring for public program beneficiaries. Number of persons served by financial assistance and means-tested government programs: 42,911 7555685 0 1264360 Other Community Benefit Services: Community health improvement services, Health professions education, Subsidized health services, Cash and in-kind contributions and Community Building are comprised of the following: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS: Community Health Improvement Services is defined as community health improvement activities, which extend beyond patient care activities. These programs include: community education, a community helpline, a medication-assisted treatment program, health insurance enrollment assistance, and purchased services for at-risk patients. Community Benefit Operations is defined as costs associated with assigned staff and community health needs assessments, and community benefit strategy and operations. Snapshot of Outcomes: * 9,337 community members were reached through a variety of community health improvement activities. HEALTH PROFESSIONS EDUCATION: This category includes educational programs for physicians, nurses, students and other health professionals when education is necessary or required by state law, accrediting body or health profession society. PIH Health programs include the Family Medicine Residency Program, and Student Education (internship, externship, preceptorship and mentoring programs). Snapshot of Outcomes: * 61 student nurses, physician residents and other individuals studying to become healthcare professionals were provided with mentorship, preceptorship and training opportunities. SUBSIDIZED HEALTH SERVICES: Subsidized services are clinical programs, which are provided despite a financial loss so significant that negative margins remain after removing the effects of financial assistance, bad debt and Medi-Cal shortfalls. Nevertheless, the service is provided because it meets an identified community need and, if no longer offered, would either be unavailable in the area or fall to the responsibility of government or another nonprofit organization to provide. PIH Health services provided include Emergency Department On-Call Physicians. Snapshot of Outcomes: * Some 14 individuals were served by subsidized health services. CASH & IN-KIND CONTRIBUTIONS: This category includes funds and in-kind services donated by PIH Health to community organizations or to the community-at-large for a community benefit purpose. These donations include cash donations to community organizations, hours contributed by staff to the community while on PIH Health work time, the cost of meeting space provided to community groups, and the donations of equipment, medications, supplies and services. Snapshot of Outcomes: * 103 individuals benefitted from donated staff time or meeting space. Total number of persons served by all Other Community Benefit Services categories: 9,515 For additional information, please refer to PIH Health's community benefit report at: PIHHealth.org/CBAnnualReport 198054331 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 39 0 true 1485 true false false false false false false false false false false false false X 16 15 true false false false true true true true true false false true true true true true true false false false CA X Mark Kawauchi 5626980811 12401 Washington Blvd Whittier CA 90602 ALEX ALVAREZ DIRECTOR & TREASURER 1.5 6.0 X X 0 0 0 CHARLOTTE WEAVER PhD DIRECTOR & CHAIR 1.5 6.0 X X 0 0 0 PATRICK MONROE DIRECTOR & VICE CHAIR 1.5 6.0 X X 0 0 0 PAUL TREINEN DIRECTOR & SECRETARY 1.5 6.0 X X 0 0 0 BLAYNE CUTLER MD PhD THRU 92724 DIRECTOR 1.5 6.0 X 0 0 0 JANE DICUS THRU 92724 DIRECTOR 1.5 6.0 X 0 0 0 JAY BROWN THRU 92724 DIRECTOR 1.5 6.0 X 0 0 0 JEFF HAMAR DIRECTOR 1.5 6.0 X 0 0 0 KENTON WOODS DIRECTOR 1.5 6.0 X 0 0 0 MARISSA GOLDBERG DIRECTOR 1.5 6.0 X 0 0 0 MARK DUBIN MD DIRECTOR 2.5 0 X 10475 0 0 MARK MINKES MD DIRECTOR 1.5 0 X 0 0 0 MELANIE BATISTE DIRECTOR 1.5 6.0 X 0 0 0 PAUL YOSHINO MD START 32224 DIRECTOR 1.5 0 X 0 0 0 PETER GREANEY MD DIRECTOR 1.5 6.0 X 0 0 0 RICHARD ATWOOD DIRECTOR 1.5 7.5 X 0 0 0 ROBERT MALONEY MD THRU 111623 DIRECTOR 1.5 6.0 X 0 0 0 SUSHIL OJHA MD THRU 32424 DIRECTOR 1.5 0 X 0 0 0 THURSO BARENDSE START 2824 DIRECTOR 1.5 6.0 X 0 0 0 TRACEA SARALIEV START 2824 DIRECTOR 1.5 6.0 X 0 0 0 WILLIAM ROTH DIRECTOR 1.5 6.0 X 0 0 0 ALEXIS ZAMARRIPA START 41124 CNO 40.0 0.0 X 0 175101 28339 JAMES WEST SYSTEM PRESIDENT & CEO 10.0 42.2 X 0 2523533 38737 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 10.0 42.2 X 0 1619441 32543 ROSALIO LOPEZ MD SYSTEM CSO/CMO 10.0 36.2 X 0 1366325 48338 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 10.0 42.2 X 0 884098 197076 MOHAMMED GHONIM REGIONAL VP 15.0 25.0 X 0 480593 78065 ROLAND FARGO THRU 12312023 REGIONAL VP 15.0 25.0 X 0 576709 102284 CYNTHIA APODACA RN, BSN 40.0 0 X 215449 0 27002 LIBERTY ROSALES RN CHARGE NURSE 40.0 0 X 279202 0 31407 LUZ ONG RN, BSN 40.0 0 X 225982 0 22922 MARY RODRIGUEZ RN CHARGE NURSE 40.0 0 X 236363 0 16940 ROSALIE MADDEN RN CHARGE NURSE 40.0 0 X 228145 0 36927 BRIAN SMOLSKIS FORMER- SYSTEM COO 0.0 0 X 0 1928328 264451 KEVIN BROWN FORMER -VP, CARDIOLOGY SERVICES (THRU 5/23) 0.0 0 X 0 434841 61389 MARIE-DIANNE SAUCO FORMER CNO 0.0 40.0 X 0 457280 124147 RAMONA PRATT FORMER CNO 0.0 40.0 X 0 561902 76388 1195616 11008151 1186955 313 true true false SODEXO INC & AFFILIATES-PA PO BOX 360170 PITTSBURGH PA 152516170 Dietary Services 2867184 DLS BUILDERS 1975 N BATAVIA STREET ORANGE CA 92665 Construction 2580278 AYA HEALTHCARE INC DRAWE 1334 POBOX 5935 TROY MI 48007 Staffing Services 1420660 ALLIED UNIVERSAL SEC SERV 161 WASHINGTON ST STE 600 EIGHT TOWER BRIDGE CONSHOHOKEN PA 19428 Security Services 1301647 EMERGENCY ASSOCIATES CORP PO BOX 9350 RANCHO SANTA FE CA 92067 Professional Services 924934 18 31059719 1189542 32249261 Net Patient Revenue 622110 187969025 187969025 Hospital Fee Program 900099 33799501 33799501 Food Services 722514 136489 136489 0 0 0 0 221905015 259877 72830 187047 0 187047 187047 6347315 0 0 6347315 6347315 6347315 Purchase Discounts 900099 1316705 1316705 188513 0 0 188513 1505218 262193856 221905015 0 8039580 X 573130 401191 171939 90616869 78836676 11780193 2726817 2372331 354486 18225858 15856496 2369362 7114635 6189732 924903 24000 24000 6668 6668 42811 42811 27521022 24864021 2657001 0 4253516 3884213 369303 2628 2628 3574945 3482581 92364 7502 7502 46028 38864 7164 5071241 5071241 7232890 6292614 940276 2314541 2314541 Medical Supplies 22971366 22351731 619635 Quality Assurance Fee (CHA Hospital Fee) 18366990 18366990 Bad Debt Expense 5639214 5639214 Equipment R&M and Lease 3182722 2893585 289137 1851363 1505349 346014 0 221366756 198054331 23312425 0 34779 220184 35947031 36470203 0 0 3024418 2783551 465042 535781 188821312 68881196 124015720 119940116 0 0 31035808 45860070 194522798 205809905 18747403 20387836 0 265173910 233993484 283921313 254381320 X -89398515 -48571415 -89398515 -48571415 194522798 205809905 40827100 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 42811 42811 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY EXPLANATION: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND AMERICAN HOSPITAL ASSOCIATION IS RELATED TO LOBBYING. PIH HEALTH DOWNEY HOSPITAL DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS), ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE 11687365 11687365 96626006 12520627 84105379 25161486 15866390 9295096 51961350 39984579 11976771 3385105 509600 2875505 119940116 Hospital Fee Program Receivable 42886783 Other Receivables 1554789 ROU Assets 1418498 45860070 Intercompany Payable 203098994 Hospital Fee Payable 22387467 Self-Insurance Reserves 6549512 Government Advances 789176 Estimated Third Party Payor Settlement -62917 ROU Liability 1231252 233993484 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE PRINCIPAL OPERATIONS OF THE COMPANY ARE EXEMPT FROM INCOME TAXES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES AND, AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE COMPANY IS SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS REGULARLY CARRIED ON THAT DOES NOT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. FURTHER, THE COMPANY IS ALSO SUBJECT TO FEDERAL EXCISE TAXES PURSUANT TO THE TAX CUTS AND JOBS ACT. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS AND EXCISE TAXES. THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE GUIDANCE IS APPLICABLE TO PROFIT-ORIENTED ENTITIES, PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. MANAGEMENT BELIEVES IT HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AND, AS SUCH, NO TAX LIABILITY, BENEFITS, INTEREST OR PENALTIES WERE ACCRUED AT SEPTEMBER 30, 2024 OR 2023. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE COMPANY BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2020 FOR FEDERAL PURPOSES AND 2018 FOR CALIFORNIA PURPOSES. true true X true X true X true true true false true true 0 261 422467 114014 308453 0.0014 0 42450 69386220 62658633 6727587 0.0312 0 200 0 0 0 0.0 0 42911 69808687 62772647 7036040 0.0326 7 9337 1483584 15000 1468584 0.0068 3 61 4781270 1249360 3531910 0.0164 1 14 1265325 0 1265325 0.0059 0 0 0 0 0 0.0 1 103 25506 0 25506 0.0001 12 9515 7555685 1264360 6291325 0.0292 12 52426 77364372 64037007 13327365 0.0618 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 4 2575 0 2575 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 34 1602 0 1602 0.0000 0 0 0 0 0 0.0 2 38 4177 0 4177 0.0000 true 5639214 0 37693355 26753661 10939694 X true true 1 1 PIH Health Downey Hospital 11500 Brookshire Ave Downey CA 90241 WWW.PIHHEALTH.ORG 930000048 X X X X X PIH Health Downey Hospital 1 false false true X X X X X X X X X X 22 true true false true X https://www.pihhealth.org/CHNA X X true 22 true https://pihhealth.org/CHIS false true X 100.0 400.0 X X X X X true true X X X X true X https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ X https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ X https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - PIH Health Downey Hospital. The 2022 Community Health Needs Assessment includes data and information regarding social determinants of health, health status and life expectancy, access to healthcare, mental health, alcohol, substance and tobacco use, physical activity, nutrition and weight status, reproductive health, acute and chronic disease, leading causes of death, community perspectives gathered from focus groups and interviews, and progress on the implementation strategy. Infographics depict key data sets for the service area, and 10 heat maps further illustrate selected community health indicators. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - PIH HEALTH DOWNEY HOSPITAL. 2022 Community Health Needs Assessment: Primary Data Collection (Community Input) PIH Health Downey Hospital conducted targeted interviews to gather information and opinions from persons who represent the broad interests of the community served by the hospital. Eighteen (18) telephone interviews were conducted during March and April 2022. Interview participants included a broad range of stakeholders concerned with health and wellbeing in the service area who spoke to issues and needs in the communities served by the hospital. The identified stakeholders were invited by email to participate in the phone interview. Appointments for the interviews were made on dates and times convenient to the stakeholders. At the beginning of each interview, the purpose of the interview in the context of the assessment was explained, the stakeholders were assured their responses would remain confidential, and consent to proceed was given. Interview questions focused on the following topics: * Biggest health issues in the community * Groups most impacted by community issues * Where people access routine healthcare services * Reasons for not having health coverage/insurance * Reasons for delaying needed healthcare * COVID-19 pandemic impact and the vaccine * Priority ranking of community needs * Whether they have received any cancer screenings and reasons for delaying * Barriers experienced while receiving cancer treatment * Additional comments and concerns Interview participants included agencies representing a broad range of health and social services, including leaders and representatives of medically underserved, low-income and minority populations, as well the local health department, to gather information relevant to the health needs of the communities we serve. The full listing of interviews and focus groups can be found in Attachment 2 of the assessment found here: https://www.pihhealth.org/app/files/public/cbe4c661-a9c5-476d-bc89-de447879855f/FINAL_CHNA%20Report%202022-Downey.9.23.22.pdf Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - PIH HEALTH DOWNEY HOSPITAL. PIH Health Downey Hospital participated in a collaborative process for the Community Health Needs Assessment with PIH Health Whittier Hospital. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - PIH HEALTH DOWNEY HOSPITAL. The 2022 Community Health Needs Assessment was shared with PIH Health's Community Benefit Oversight Committee, comprised of community partners, legislative representatives, and community-at-large representatives, as well as Los Angeles Department of Public Health staff. Assessment findings were also distributed to key stakeholders via email with emphasis on supporting program planning and fund-development endeavors, sharing organizations the expense of duplicative data collection efforts. Assessment findings are also shared on an on-going basis via presentations at community events and community collaborative meetings, through social media channels, and via PIH Health's e-newsletter and mailed magazine. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - PIH HEALTH DOWNEY HOSPITAL. PIH Health's Implementation Strategy ensures alignment of CHNA findings, our community health improvement programs and PIH Health's organizational strategy. To view the 2023-2025 Implementation Strategy and the initiatives identified to address areas of focus (access to health care - primary care, dental care and mental health, cancer incidence/mortality, diabetes incidence/mortality, heart disease/stroke incidence/mortality, overweight/obesity, substance use and misuse, preventative screenings and immunizations with emphasis on flu and pneumonia vaccines and cancer screenings, food insecurity, housing/homelessness), visit https://www.pihhealth.org/app/files/public/72cfb81b-4833-4bbd-90a1-bb00ea6c44f7/Community%20Health%20Improvement%20Plan%202022_PHDH.pdf Since PIH Health Downey Hospital cannot directly address all the health needs present in the community, we will concentrate on those health needs that can most effectively be addressed given our areas of focus and expertise. Taking existing hospital and community resources into consideration, PIH Health Downey Hospital will not directly address the remaining health needs identified in the CHNA, including: birth indicators, COVID-19, economic insecurity, education, and violence and injury prevention. While the hospital does not intend to emphasize community COVID-19 interventions at this point in the pandemic, PIH Health Downey Hospital will continue to deliver vaccines, testing and acute medical care to address COVID-19. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - PIH HEALTH DOWNEY HOSPITAL. Assistance is provided free or discounted for those patients eligible for FAP. The criteria for FAP is if the patient is uninsured and does not have the ability to pay, has restricted Medi-Cal benefits, or is underinsured. This is also considerations for patients where the FPG is not applicable and the patient is insured with inadequate coverage or excessive liability. 1 OUTPATIENT REHABILITATION PIH HEALTH DOWNEY HOSPITAL 11420 BROOKSHIRE AVE DOWNEY CA 90241 OUTPATIENT THERAPY Schedule H, Part I, Line 6a PIH Health's Community Benefit Report, prepared annually, accounts for the organization's programs and services that promote the health of the community. The report separates out community benefit investment figures for each hospital. Standalone Community Benefit Reports are also prepared for each PIH Health hospital entity. Schedule H, Part I, Line 6b The Community Benefit Report was made widely available to the public via PIH Health's website, social media and community e-newsletter. The report is also shared with certain internal and community stakeholders via email and presentations. To view the full report for PIH Health Downey Hospital, visit https://www.pihhealth.org/app/files/public/c4363730-273e-47b0-a415-dc7b1541fc21/PIH%20Health%20Downey%20Hospital%20FY24%20Community%20Benefit%20Annual%20Report%20and%20Plan.pdf Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 5639214 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Patient care cost-to-charges ratio derived from worksheet 2 was used to calculate the financial assistance. For all others, we utilized internal costing system and accounts for the various payer mix. Schedule H, Part II Community Building Activities PIH Health works with a variety of community stakeholders to enhance the collective capacity for addressing the root causes of health problems. PIH Health staff supported a local community service club by participating in their meetings/activities. Civic clubs improve the civic and cultural wellbeing of the community. PIH Health also undertakes disaster preparedness training above and beyond licensure requirements to ensure we are effectively prepared to serve the community in a disaster. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE THE COMPANY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. AS A RESULT OF THE ADOPTION OF ASC 606, PIH HEALTH WHITTIER HOSPITAL IS REPORTING IMPLICIT PRICE CONCESSIONS, WHICH IS ESTABLISHED BASED ON MANY FACTORS, INCLUDING PAYER MIX, AGE OF RECIEVABLES, HISTORICAL CASH COLLECTION EXPERIENCE, OTHER RELEVANT INFORMATION. Schedule H, Part III, Line 3 Bad Debt Expense Methodology PIH Health Downey Hospital actively provides all patients the option to apply for financial assistance, therefore, no estimate is made for bad debt attributable to patients eligible under the financial assistance policy. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote As part of the Company's mission to serve the community, the Company provides care to patients even though they may lack adequate insurance or may participate in programs with negotiated or regulated payment amounts. The Company makes every effort to determine if a patient qualifies for charity care upon admission, though determination may also be made at a later time. After satisfaction of amounts due from insurance, the application of any financial, uninsured or other discounts or payments received on the account, and reasonable efforts to collect from the patient have been exhausted, the Company follows established guidelines for placing certain past-due patient balances with collection agencies, subject to certain restrictions on collection efforts as determined by the Company. The Company manages its collection risk by regularly reviewing its accounts and contracts, and by providing appropriate allowances that are netted against patient accounts receivable in the consolidated balance sheets. Implicit price concessions are based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in healthcare coverage and other collection indicators. Management routinely assesses the adequacy of the implicit price concessions based upon historical write-off experience by payor category. The Company follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. Implicit price concessions are included as a deduction from patient services revenues since the Company generally accepts and treats all patients without regard to the ability to pay. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The Company does not take the position that Medicare shortfall should be treated as community benefit. The State has specifically asked us to report this separately from our community benefit totals. The Company uses a cost-to-charge (C2C) ratio to determine Medicare allowable costs of care relating to payment received from Medicare, which is similar to the IRS Schedule H method. However, the PIH Health system is more refined and exacting, since it is generated at the department level and includes both direct costs and allocated company-wide indirect costs. All period indirect costs are allocated between PIH Health departments based on their relative gross charges. The sum of the direct and allocated indirect costs of each department are divided by the total department gross procedure charges. The resulting department specific percentage, i.e.. department C2C %, is loaded into PIH Health's ERP software each quarter. The cost system applies the department's C2C% to all procedure charges originating within the department in order to compute the related procedure costs. As such, all cost information reflected in PIH Health's regulatory reporting and financial analysis is based on the above department C2C methodology. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The hospital encourages all self-pay patients to apply for financial assistance or other programs. 1. All uninsured patients are assumed to need financial assistance and automatically receive discounted bills that reflect the contract rate or less of a Medicare Advantage contract. 2. All uninsured patients are provided with a financial assistance and Medicaid application at the time of registration thereby giving them the opportunity to apply for assistance. 3. There are signs through the facility that educate patients and visitors about the availability of financial assistance. 4. The hospital's website publishes the financial assistance policy and applications. 5. Self-pay inpatients also may be contacted by a vendor to offer assistance in applying for Medicaid, if eligible. 6. Statements (which reflect a reduction in charges to the rates at or lower than contracted rates for Medicare Advantage members) promote the hospital's financial assistance program. 7. Only patients who do not qualify for further financial assistance (after discounts) or who do not apply for programs and do not pay are referred to collection. In addition, if a patient is referred to collection and later applies for charity and qualifies, the patient's account is returned to the hospital and financial assistance is extended. Schedule H, Part V, Section B, Line 16a FAP website - PIH Health Downey Hospital: Line 16a URL: https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - PIH Health Downey Hospital: Line 16b URL: https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - PIH Health Downey Hospital: Line 16c URL: https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment In addition to the hospital's CHNA, PIH Health utilizes the following methods to assess the health care needs of the communities it serves: Community Benefit Oversight Committee- In 2006, PIH Health's Board of Directors established the Community Benefit Oversight Committee (CBOC), which is comprised of community stakeholders and key public health and legislative representatives. This committee meets regularly and its members share healthcare-related needs/concerns experienced by the community members they represent as well as assets or potential partners for the hospital to engage in addressing the identified needs. Feedback from Community Organizations / Collaborative- Through participation in various community collaborative and networking meetings, PIH Health is able to assess the healthcare needs of the community and identify partnership opportunities. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance There are many avenues PIH Health takes in educating patients and family members about the various financial assistance programs. Patients are advised at the time of service, during in-house care and post discharges. Free handouts of the FAP application are provided in both English and Spanish. There are ae postings throughout the hospital in both English and Spanish with information about our FAP program. We have an eligibility vendor that is conveniently available to assist our patients in the emergency room or in-house patients with determining eligibility for various governmental programs, as well as advise and assist the patient with the FAP. Post discharge, our Business Office staff takes the initiative to advise the patient of our FAP program. Also, with the initial statement sent to patients, an application is included. PIH Health's FAP is also published on our website. Schedule H, Part VI, Line 4 Community information PIH Health Downey Hospital is located at 11500 Brookshire Ave., Downey, CA 90241. The hospital's service area encompasses 10 ZIP codes in the cities of Bellflower, Bell Gardens, Downey, Huntington Park, Lynwood, Norwalk, Paramount, and South Gate. The service area is served by the Los Angeles County 1st, 2nd, and 4th Supervisorial Districts and the majority of the cities/communities fall within the Los Angeles County Service Planning Area (SPA) 7. PIH Health Downey Hospital tracks ZIP codes of origin for patient admissions. The service area was determined from the ZIP codes that reflect a majority of patient admissions from the local geographic area. The population for PIH Health Downey Hospital's service area is 691,496. Children and youth (ages 0-17) make up 26.5% of the population, 63.4% are adults, ages 18 to 64, and 10.1% are adults, ages 65 and older. In the service area, 81.9% of the population is Hispanic/Latino, 7.4% are White, 5.0% are Asian, 4.5% are Black/African American, 0.9% are Other/Multiple Races, 0.3% are Native Hawaiian/Pacific Islander, and 0.1% are Native American/Alaskan Native. Among the service area population, ages five and older, 72.3% speak Spanish in the home, 22.2% speak only English in the home, 3.9% speak an Asian or Pacific Islander language, 1.0% speak other Indo-European languages, and 0.6% speak other languages in their home. In the service area, 16.4% of the population is at or below 100% of the federal poverty level. Among service area adults, ages 25 and older, 35.0% have less than a high school diploma, 45% are high school graduates, and 19.9% have an associate, bachelor's, or graduate/professional degree. For additional data regarding the service area, please see the CHNA at PIHHealth.org/CHNA Schedule H, Part VI, Line 5 Promotion of community health Community Board: PIH Health's community Board of Directors works to advance PIH Health's commitment to helping our communities get well and stay healthy. Open Medical Staff: PIH Health extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. Use of Surplus Funds: PIH Health applies surplus funds toward improvements in patient care, technology, and medical education. Community Benefit Oversight Committee (CBOC): In 2006, PIH Health's Board of Directors established the CBOC, comprised of community stakeholders and a public health representative. The CBOC promotes the health of the community by 1) reviewing and validating legal and regulatory compliance with respect to community benefit mandates, 2) reviewing and validating that PIH Health's community benefit programs and services effectively meet identified community health needs, with emphasis on vulnerable populations, as an essential expression of PIH Health's charitable mission and 3) increasing public awareness of community benefit activities and community value. Donation of Time: Many PIH Health providers are living out their passion to serve people in need by donating their time and talents both in our community and overseas. Employee Giving: Each year, PIH Health employees, physicians, and volunteers generously support various charitable giving initiatives. During Fiscal Year 2024, holiday wish lists were fulfilled for 175 families served by The Whole Child, over 250 duffle bags with essential items were donated for youth in the foster care system through a partnership with Foster Love, and over 300 backpacks filled with school supplies were collected for distribution by Helpline Youth Counseling to low-income students across our service area. Environmental and Recycling Projects: PIH Health continues to implement "green" initiatives, including increased usage of LED lighting to decrease consumption of electricity, expansion of a project with the City of Whittier to convert methane gas into electricity, and purchase of reprocessed instruments through a vendor agreement that results in national forest restoration. In addition, eyeglasses and hearing aids are collected for recycling and redistribution by the East Whittier Lions Club to those in need. Reach Out and Read Program: Our Pediatrics Department partners with Reach Out and Read to promote early literacy and school readiness. Physicians provide patients with a children's book and discuss with parents the importance of reading aloud. Each year, approximately 5,000 new books are distributed. Volunteer Contributions: Some 1,380 PIH Health volunteers collectively contributed 108,326 hours of service, supporting departments throughout the organization. Through the PIH Health Medical Careers Program, which gives student volunteers a head start in discovering productive and meaningful careers in healthcare, 42 individuals spent 828 hours shadowing medical career professionals. Schedule H, Part VI, Line 6 Affiliated health care system Hospital affiliates include: 1) PIH Health, Inc., PIH Health's parent company; 2) PIH Health Whittier Hospital; 3) PIH Health Good Samaritan Hospital; 4) PIH Health Physicians, a nonprofit medical foundation; 5) PIH Health Home Healthcare and 6) the PIH Health Foundation, a nonprofit organization that exists to raise philanthropic funds in support of PIH Health's charitable mission 1) PIH Health, Inc. provides technical, facility, and support services for tax-exempt affiliates whose charitable purpose is to provide a broad range of healthcare services to their community by way of an integrated healthcare delivery system. 2) PIH Health Whittier Hospital opened in 1959. As a 501 (c)(3) nonprofit, 523-bed hospital, the Whittier campus has developed into a health system offering a multitude of services. As a non-profit hospital with a charitable mission, PIH Health Hospital Whittier is a dedicated community health and wellness partner. This commitment and leadership gives back to the community through charity care, medical research, donations, health professions education and more. 3) PIH Health Good Samaritan Hospital was founded in 1885, PIH Health Good Samaritan Hospital became part of PIH Health in December 2019. As a 501(c)(3) nonprofit, 408-bed acute care hospital, the downtown Los Angeles campus serves the healthcare needs of a growing and diverse community, giving back to the community through charity care, health professions education and more. 4) PIH Health Physicians (PHP) is a 501(c)(3) nonprofit medical group that is exclusively affiliated with PIH Health, the group is comprised of more than 270 primary care physicians and specialist who coordinate care from diagnosis to recovery. PHP supports the local community through its financial assistance program, Whittier First Day Health & Wellness Center for the homeless and those at-risk for homelessness, health professions education, and other community health improvement services. 5) PIH Health Home Healthcare provides around-the-clock, quality care for patients in their own home. PIH Health Home Healthcare is certified by the Centers for Medicare and Medicaid Services. 6) The PIH Health Foundation is a 501(c)(3) nonprofit organization with the sole mission to raise funds through philantrophy to benefit PIH Health and its affiliates. Dollars raised are reinvested into the communities we serve through quality healthcare, health-based programs and services offered through PIH Health. For detailed information regarding these PIH Health affiliates' additional activities to support and promote community health, please see each respective organization's IRS Form 990. Schedule H, Part VI, Line 7 State filing of community benefit report CA true true false false false false false false false RAMONA PRATT FORMER CNO 0 425868 0 40657 0 95377 0 61835 0 14553 0 638290 0 85580 MARIE-DIANNE SAUCO FORMER CNO 0 374600 0 76500 0 6180 0 100199 0 23948 0 581427 0 0 BRIAN SMOLSKIS FORMER- SYSTEM COO 0 833329 0 160594 0 934405 0 241053 0 23398 0 2192779 0 721922 JAMES WEST SYSTEM PRESIDENT & CEO 0 1565657 0 383472 0 574404 0 18000 0 20737 0 2562270 0 552201 ROSALIO LOPEZ MD SYSTEM CSO/CMO 0 1028860 0 104954 0 232511 0 40500 0 7838 0 1414663 0 215904 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 0 909522 0 151215 0 558704 0 18000 0 14543 0 1651984 0 545719 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 0 782967 0 93639 0 7492 0 176607 0 20469 0 1081174 0 0 ALEXIS ZAMARRIPA START 41124 CNO 0 174101 0 1000 0 0 0 7442 0 20897 0 203440 0 0 KEVIN BROWN FORMER -VP, CARDIOLOGY SERVICES (THRU 5/23) 0 144836 0 20600 0 269405 0 53308 0 8081 0 496230 0 132205 ROLAND FARGO THRU 12312023 REGIONAL VP 0 459050 0 42778 0 74881 0 80538 0 21746 0 678993 0 68451 MOHAMMED GHONIM REGIONAL VP 0 361193 0 47607 0 71793 0 76020 0 2045 0 558658 0 63416 LIBERTY ROSALES RN CHARGE NURSE 277811 0 1000 0 391 0 16855 0 14552 0 310609 0 0 0 MARY RODRIGUEZ RN CHARGE NURSE 231476 0 2080 0 2807 0 15055 0 1885 0 253303 0 0 0 ROSALIE MADDEN RN CHARGE NURSE 218876 0 1500 0 7769 0 14114 0 22813 0 265072 0 0 0 LUZ ONG RN, BSN 216914 0 1500 0 7568 0 9218 0 13704 0 248904 0 0 0 CYNTHIA APODACA RN, BSN 212249 0 3200 0 0 0 13122 0 13880 0 242451 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY PIH HEALTH WHITTIER HOSPITAL (PHWH), A RELATED ORGANIZATION. PHWH USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) FORM 990 OF OTHER ORGANIZATIONS; 4) COMPENSATION SURVEY OR STUDY; 5) APPROVAL BY THE BOARD. Schedule J, Part I, Line 4a Severance or change-of-control payment BRIAN SMOLSKIS AND KEVIN BROWN RECEIVED A SEVERANCE PAYMENT DURING THE CALENDAR YEAR. THE PAYMENT IS INCLUDED IN PART VII, COLUMN D AND SCHEDULE J PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan A RELATED ORGANIZATION, PIH HEALTH, INC., PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK VID SHIVARAMAN ROSALIO LOPEZ, MD BRIAN SMOLSKIS ROLAND FARGO KEVIN BROWN RAMONA PRATT THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2023 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): MOHAMMED GHONIM: $63,416 ROLAND FARGO: $68,451 RAMONA PRATT: $85,580 KEVIN BROWN: $132,205 ROSALIO LOPEZ, MD: $215,904 JAMES WEST: $552,201 PEGGY CHULACK: $545,719 BRIAN SMOLSKIS: $721,922 Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Richard Atwood - Business relationship, Alex Alvarez - Business relationship, Jeff Hamar - Business relationship, Patrick Monroe - Business relationship, Paul Treinen - Business relationship, Charlotte Weaver - Business relationship, Kenton Woods - Business relationship, Peter Greaney - Business relationship, Marissa Goldberg - Business relationship, Melanie Batiste - Business relationship, Thurso Barendse - Business relationship, Tracea Saraliev - Business relationship, William Roth - Business relationship, James West - Business relationship, Peggy Chulack - Business relationship, Vid Shivaraman - Business relationship, Rosalio Lopez - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders PIH Health, Inc. is the sole member of PIH Health Downey Hospital. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PIH Health, Inc. has authority to elect all the members of the board of directors of PIH Health Downey Hospital. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PIH Health, Inc. has all voting rights and the power to elect the board of directors of PIH Health Downey Hospital. Form 990, Part VI, Line 11b Review of form 990 by governing body Form 990 is reviewed by the Audit Committee of the parent organization, which is made up of independent directors. The Form 990 is then provided to the Board for its information. Form 990, Part VI, Line 12c Conflict of interest policy Each year, all management and board of directors members are required to complete a conflict of interest disclosure form. All positive responses are reviewed by the Chief Administrative Officer and General Counsel. Each positive response is considered in light of magnitude of ownership interest, financial transaction(s), etc. If deemed necessary, conflicts of interest could be resolved by insisting that the incumbent either divest their ownership interest, that the organization terminate the business relationship, or even that the director resign. Directors with potential conflicts of interest may recuse themselves from voting on certain matters and/or may excuse themselves from meetings during the discussion, deliberation, and voting on of matters. Form 990, Part VI, Line 19 Required documents available to the public The Organization does not make its governing documents, conflicts of interest policy, and financial statements available to the public. Form 990 is available upon request. The organization is not required to make form 1023 available for public inspection as it received its tax exemption prior to July 15, 1987. Form 990, Part VII, Section A, Line 1a Two of the filing organization's Directors, Rosalio Lopez and Mark Minkes, is an employee of PIH Health Medical Group, Inc. (PMG), which has a professional service agreement with PIH Health Physicians, an affiliate of the filing organization, to provide physician services. The individuals received compensation from DMG, as follows: Rosalio Lopez: Reportable Base Compensation - $5,376 Other Compensation - $0 Mark Minkes Reportable Base Compensation - $76,526 Bonus & Incentive Compensation - $37,500 Other Compensation - $22,437 Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 188513, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 188513; Form 990, Part IX, Line 11g Other Fees Professional Fees - Physicians - Total Expense: 9443659, Program Service Expense: 9443659, Management and General Expenses: , Fundraising Expenses: ; PROFESSIONAL FEES - OTHERS - Total Expense: 16436338, Program Service Expense: 14303575, Management and General Expenses: 2132763, Fundraising Expenses: ; R&M BUILDING - Total Expense: 1228518, Program Service Expense: 1116787, Management and General Expenses: 111731, Fundraising Expenses: ; COLLECTION AGENCY SERVICES - Total Expense: 412507, Program Service Expense: , Management and General Expenses: 412507, Fundraising Expenses: ; PIH Health Foundation 12401 Washington Blvd Whittier CA 90602 953761274 Fundraising CA 501(c)(3) 7 PIH Health Inc false PIH Health Management Corp 12401 Washington Blvd Whittier CA 90602 954016278 Support of tax-exempt affiliates CA 501(c)(3) Type II PIH Health Inc false PIH Health Home Health Care 12401 Washington Blvd Whittier CA 90602 953036281 Healthcare CA 501(c)(3) Type II PIH Health Inc false PIH Health Inc 12401 Washington Blvd Whittier CA 90602 953619388 Support of tax-exempt affiliates CA 501(c)(3) Type II PIH Health Inc false PIH Health Adult Day Healthcare 12401 Washington Blvd Whittier CA 90602 953643829 Healthcare CA 501(c)(3) Type II PIH Health Inc false PIH Health Physicians 6557 Greenleaf Ave Whittier CA 90601 953942828 Healthcare CA 501(c)(3) 10 PIH Health Inc false PIH Health Whittier Hospital 12401 Washington Blvd Whittier CA 90602 951934652 Healthcare CA 501(c)(3) 3 PIH Health Inc false PIH Health Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 951656366 Healthcare CA 501(c)(3) 3 PIH Health Inc false Good Samaritan Institute for Research and Education 1225 Wilshire Blvd Los Angeles CA 90017 954077161 Research CA 501(c)(3) 4 PIH Health Good Samaritan Hospital false Orthopedic Institute of the Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 954346048 Research CA 501(c)(3) Type I PIH Health Good Samaritan Hospital false Samaritan Imaging Center 1225 Wilshire Blvd Los Angeles CA 90017 954252321 Healthcare CA 501(c)(3) 10 PIH Health Good Samaritan Hospital false Good Samaritan Medical Office Building Inc 1225 Wilshire Blvd Los Angeles CA 90017 953244046 Medical Offices CA 501(c)(3) Type I PIH Health Good Samaritan Hospital false Kate Van Nuys Page Foundation 1225 Wilshire Blvd Los Angeles CA 90017 956028032 Grants income to Good Samaritan Hospital CA 501(c)(3) Type I PIH Health Good Samaritan Hospital false PIH Insurance Co A Reciprocal Risk Retention Group 733 BISHOP STREET SUITE 1555 Honolulu HI 96813 263760243 Captive Insurance HI NA Trust false PIH Health Care Solutions 6557 Greenleaf Avenue Whittier CA 90601 462072342 Healthcare CA NA C Corporation false DRMC Properties Inc 12401 Washington Blvd Whittier CA 90602 954769768 Real Estate CA NA C Corporation false PIH Healh RE 733 BISHOP STREET SUITE 1555 Honolulu HI 96813 472501390 Captive Insurance HI NA Trust false Healthmed Services Inc 12401 Washington Blvd Whittier CA 90602 300831225 Healthcare CA NA C Corporation false Pioneer Medical Group Inc 6557 Greenleaf Ave Whittier CA 90601 330927283 Medical Services CA NA C Corporation false Pioneer Provider Network A Medical Group Inc 6557 Greenleaf Ave Whittier CA 90601 330922631 Management Services CA NA C Corporation false false false true false false false false false false false true false false false true false false false false