2020-11-16T15:15:45-06:00 2019-12-31 ERNST & YOUNG US LLP 18101 VON KARMAN AVE SUITE 1700 IRVINE CA 92612 990 2019-01-01 951183919 San Antonio Regional Hospital % WAH-CHUNG HSU SANA 9099852811 999 San Bernardino Road Upland CA 917864920 WAH-CHUNG HSU VICE PRESIDENT & CFO 9099852811 2020-11-13 true Kara Adams P00023315 9497942300 2020-11-16 172.88.243.146 33577420203215000033 2020-11-16 P 3B6F2444A65916AAE762AE88CFEABAFDE46687DB F991D6D3E7059131D89F76663626030BF402C6D1 2019 2021-01-29 14:40:06Z John Chapman 999 San Bernardino Road Upland CA 917864920 464642985 false X sarh.org X 1920 CA OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. 13 10 2728 520 3391012 658720 1844328 575131 343724179 378136938 15896430 6142561 7350081 7378946 368815018 392233576 208810 197106 0 0 199062994 214708470 0 0 0 177291374 179922725 376563178 394828301 -7748160 -2594725 625188103 646177281 275330603 276356195 349857500 369821086 X OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. false false 359216810 197106 380243981 SAN ANTONIO REGIONAL HOSPITAL WAS FOUNDED BY DR. WILLIAM HOWARD CRAIG IN 1907 TO MEET THE HEALTHCARE NEEDS OF LOCAL RESIDENTS. AS THE COMMUNITY SURROUNDING THE HOSPITAL GREW, IT BECAME APPARENT THAT LARGER, MORE MODERN FACILITIES WERE NEEDED. COMMUNITY LEADERS RALLIED TO RAISE THE NEEDED CAPITAL AND THE HOSPITAL MOVED TO ITS CURRENT LOCATION ON SAN BERNARDINO ROAD IN 1924. THROUGH COMMUNITY SUPPORT, THE HOSPITAL GREW - FROM ITS MODEST BEGINNING WITH 18 BEDS, 5 PHYSICIANS, AND LIMITED STAFF - TO A 363-BED REGIONAL MEDICAL FACILITY WITH OVER 2,400 EMPLOYEES AND A MEDICAL STAFF OF NEARLY 600 PHYSICIANS. ON JANUARY 6, 2017 THE HOSPITAL'S MAIN CAMPUS IN UPLAND OPENED THE LARGEST EXPANSION IN ITS HISTORY. THE 179,000 SQUARE FOOT ADDITION, WHICH INCLUDES A NEW 52-BED EMERGENCY DEPARTMENT AND 92-BED PATIENT TOWER, INCORPORATED THE LATEST HEALTHCARE ARCHITECTURAL DESIGN AND ADVANCED TECHNOLOGICAL FEATURES WITH THE GOAL OF MEETING THE NEEDS OF THE GROWING POPULATION IN THE WEST END OF CALIFORNIA'S INLAND EMPIRE. IN ADDITION TO THE MAIN CAMPUS, THE HOSPITAL HAS SATELLITE LOCATIONS IN RANCHO CUCAMONGA, FONTANA, AND EASTVALE. THESE FACILITIES PROVIDE OUTPATIENT CARE IN A CLOSE, CONVENIENT SETTING FOR THE REGION'S GROWING POPULATION. ADDITIONALLY, SAN ANTONIO OPENED A NEW 60,000 SQUARE FOOT TWO-STORY AMBULATORY CARE FACILITY DIRECTLY ACROSS THE STREET FROM THE HOSPITAL WHICH INCLUDES CITY OF HOPE'S COMPREHENSIVE CANCER CENTER. THE HOSPITAL'S WOMEN'S BREAST AND IMAGING CENTER, AS WELL AS PRE-OPERATIVE AND PRE-PROCEDURE SERVICES ARE LOCATED ON THE SECOND FLOOR. SAN ANTONIO ALSO PROVIDES SERVICES AND PROGRAMS TO COMPLEMENT CITY OF HOPE'S CANCER CENTER. LEADERSHIP - SAN ANTONIO REGIONAL HOSPITAL IS GOVERNED BY A 15-MEMBER BOARD OF TRUSTEES. THE HOSPITAL'S MEDICAL STAFF PRESIDENT-ELECT, PRESIDENT, AND IMMEDIATE PAST PRESIDENT ARE MEMBERS OF THE BOARD BY VIRTUE OF THEIR OFFICES. AT LEAST TWO ADDITIONAL PHYSICIANS ARE ELECTED FROM THE MEDICAL STAFF, AND THE REMAINING MEMBERS ARE ELECTED FROM THE COMMUNITY AT-LARGE. THE BOARD OF TRUSTEES, WITH PHYSICIAN LEADERS COMPRISING A SIGNIFICANT PORTION OF ITS MEMBERSHIP, SETS THE DIRECTION FOR THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM. THE EXECUTIVE MANAGEMENT GROUP DIRECTS THE HOSPITAL'S STRATEGIC PLANNING PROCESS AND ALLOCATES RESOURCES FOR COMMUNITY BENEFIT ACTIVITIES. THE EXECUTIVE MANAGEMENT GROUP INCLUDES THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, CHIEF NURSING OFFICER, CHIEF STRATEGY OFFICER, CHIEF HUMAN RESOURCE OFFICER, CHIEF INFORMATION OFFICER, AND PRESIDENT OF THE HOSPITAL FOUNDATION. CARING FOR OUR COMMUNITY - COMMUNITY BENEFITS ARE MORE THAN JUST NUMBERS. THEY REPRESENT PEOPLE - CHILDREN, PARENTS, GRANDPARENTS, AND THOSE WHO MAY BE BOTH DISADVANTAGED AND DISENFRANCHISED. THIS REPORT HIGHLIGHTS HOW SAN ANTONIO REGIONAL HOSPITAL GOES ABOVE AND BEYOND THE DELIVERY OF ESSENTIAL PATIENT CARE SERVICES TO PROMOTE HEALTHIER LIFESTYLES, EARLY DETECTION OF DISEASE, AND ENHANCED ACCESS TO BASIC HEALTHCARE SERVICES. AS A REGIONAL HEALTHCARE PROVIDER, SAN ANTONIO IS COMMITTED TO MAINTAINING THE HIGHEST QUALITY OF CARE FOR THOSE WE SERVE. AS A NONPROFIT HOSPITAL, ALL OF OUR RESOURCES ARE DEVOTED TO PROVIDING HEALTHCARE SERVICES. WE STRIVE TO PROVIDE OUR COMMUNITY WITH THE BEST OF CARE BY ALLOCATING A PERCENTAGE OF HOSPITAL OPERATIONS TO BE USED IN PURCHASING NEW OR UPGRADED EQUIPMENT, EXPANDING SERVICE, AND PROVIDING CARE FOR THE VULNERABLE POPULATION. WHILE THE INLAND EMPIRE IS A MATURING ECONOMIC MARKET, MANY INDIVIDUALS AND FAMILIES ARE AT SIGNIFICANT RISK DURING A MEDICAL CRISIS. OFTEN THIS IS DUE TO AN INABILITY TO ACCESS HEALTH INSURANCE OR THE RESULT OF INADEQUATE INSURANCE COVERAGE. THE HOSPITAL'S CHARITY CARE POLICY PROVIDES RELIEF TO THESE FAMILIES WHO WOULD OTHERWISE FACE MEDICAL BANKRUPTCY. DURING 2019, $2,426,165 IN CHARITY CARE WAS PROVIDED FOR PATIENTS ENTERING THE HOSPITAL'S EMERGENCY DEPARTMENT WHO WERE EITHER TREATED AND RELEASED OR REQUIRED AN INPATIENT STAY. THE HOSPITAL ABSORBED $26,562,530 IN UNREIMBURSED COSTS INCURRED IN PROVIDING CARE AND TREATMENT FOR MEDI-CAL PATIENTS, WHILE OTHER UNCOMPENSATED CARE (BAD DEBTS) TOTALED $872,882 IN ACTUAL COSTS INCURRED BY THE HOSPITAL TO TREAT THESE PATIENTS. IN ADDITION TO DIRECT MEDICAL CARE, SAN ANTONIO REGIONAL HOSPITAL REACHES OUT TO ITS COMMUNITY IN A VARIETY OF WAYS THAT GO WELL BEYOND THE TRADITIONAL CARE PROVIDED BY AN ACUTE CARE HOSPITAL. AN INVENTORY OF THESE PROGRAMS AND ACTIVITIES IS PROVIDED LATER IN THIS REPORT. IN MANY COMMUNITIES WITHIN THE HOSPITAL'S SERVICE AREA, NEEDS FAR EXCEED ACCESSIBLE RESOURCES. SAN ANTONIO UNDERSTANDS THE POWER OF COLLABORATION AND SEEKS ALLIANCES WITH OTHER HEALTH AND SOCIAL SERVICE PROVIDERS TO DEVELOP COMMUNITY-BASED PROGRAMS WITH DEFINED GOALS AND MEASURABLE OUTCOMES. THESE PARTNERSHIPS HELP TO LEVERAGE THE COMMUNITY'S RESOURCES TO ACHIEVE THE MAXIMUM BENEFIT FOR ITS RESIDENTS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) - DURING 2019, SARH JOINED OTHER HOSPITALS IN SOUTHERN CALIFORNIA'S INLAND EMPIRE TO CONDUCT A REGIONAL CHNA. THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA SERVED AS A CATALYST IN COORDINATING THE EFFORT AMONG THE 7 HOSPITALS PARTICIPATING IN THE PROJECT. SARH SERVED AN ACTIVE ROLE ON THE CHNA COMMITTEE TO DESIGN THE OVERALL STRATEGY, AS WELL AS THE COORDINATION OF PRIMARY AND SECONDARY DATA COLLECTION IN COLLABORATION WITH THE DEPARTMENTS OF PUBLIC HEALTH IN SAN BERNARDINO AND RIVERSIDE COUNTIES. THE CHNA VIEWS HEALTH WITH COLLECTIVE LENS INCLUDING HEALTH OUTCOMES AND CLINICAL CARE COMPONENTS, BUT ALSO SOCIAL DETERMINANTS AND HEALTH INDICATORS FROM THE BUILT ENVIRONMENT. THE CHNA INCORPORATED THREE DISTINCT DATA METHODOLOGIES THAT, WHEN INTERPRETED TOGETHER, PROVIDED A DEEPLY RICH PICTURE OF THE HEALTH LANDSCAPE OF THE HOSPITALS' INDIVIDUAL COMMUNITIES, AS WELL AS THE REGION AS A WHOLE. THE ASSESSMENT INCLUDED A PLETHORA OF HEALTH INDICATORS FROM MULTIPLE PRIMARY AND SECONDARY SOURCES, ALONG WITH A ROBUST QUALITY OF LIFE SURVEY AND TARGETED FOCUS GROUPS. THE DATA FROM THESE THREE SOURCES WERE AGGREGATED AND STRATIFIED ACROSS CATEGORIES AND SERVICE AREAS TO ALLOW TARGETED IDENTIFICATION OF UNIQUE CHALLENGES AND OPPORTUNITIES SURROUNDING HEALTH STATUS, QUALITY OF LIFE, AND RISK FACTORS. THE CHNA INCLUDED A LARGE GROUP OF GEOGRAPHICALLY DIVERSE HOSPITALS IN THE INLAND EMPIRE. THE COLLABORATION ACHIEVED THROUGH THIS PROCESS IS PROVIDING A SOLID BASIS FOR MORE UNIFIED AND STRATEGIC THINKING TO ADDRESS POPULATION HEALTH NEEDS ACROSS THE REGION. THE PARTICIPATING HOSPITALS, ALONG WITH ADDITIONAL HOSPITALS INTERESTED IN REGIONAL PLANNING EFFORTS, ARE USING THE CHNA AS A TOOL TO ADDRESS IDENTIFIED HEALTH NEEDS IN THE REGION. THE RESULT HAS BEEN THE DEVELOPMENT OF COLLECTIVE IMPACT INITIATIVES THAT INCORPORATE HOSPITALS ALONG WITH AN EXPANDING NETWORK OF MULTISECTORIAL PARTNERS. COMMUNITY EDUCATION - SARH OFFERS A BROAD ARRAY OF EDUCATION CLASSES, SUPPORT GROUPS, AND COMMUNITY LECTURES TO MEET THE HEALTH NEEDS OF ITS COMMUNITY. MANY PROGRAMS ARE OFFERED ON-SITE, HOWEVER SOME PROGRAMS ARE PROVIDED AT LOCATIONS THROUGHOUT THE COMMUNITY TO REACH THOSE WHO MAY HAVE SPECIAL NEEDS OR LACK TRANSPORTATION AND WOULD OTHERWISE FAIL TO ACCESS THESE IMPORTANT SERVICES. IN ADDITION TO GAINING KNOWLEDGE ABOUT IMPORTANT HEALTH TOPICS, PARTICIPANTS MAY PARTICIPATE IN FREE SCREENINGS TO IDENTIFY POTENTIAL HEALTH CONCERNS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, AND HIGH GLUCOSE. COMMUNITY BENEFIT INITIATIVES - AS PART OF ITS MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES, SARH CONDUCTS AN ONGOING ASSESSMENT PROCESS TO IDENTIFY COMMUNITY HEALTH NEEDS, WHICH INCLUDES, BUT IS NOT LIMITED TO, THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT IS CONDUCTED EVERY THREE YEARS. THE HOSPITAL'S COMMUNITY OUTREACH DEPARTMENT SUPPORTS A VARIETY OF SERVICES DESIGNED TO MEET THESE NEEDS, INCLUDING SUPPORT GROUPS, EDUCATIONAL SEMINARS, COMMUNITY HEALTH FAIRS, AND SPECIAL EVENTS. IN ADDITION, SARH ADDRESSES A NUMBER OF COMMUNITY HEALTH NEEDS THROUGH TARGETED HEALTH INITIATIVES. A FEW OF THESE PROGRAMS ARE HIGHLIGHTED HERE. HEALTHY BEGINNINGS - SARH'S MATERNAL/CHILD SERVICES, COLLECTIVELY KNOWN AS HEALTHY BEGINNINGS, IS COMMITTED TO PROVIDING EXCELLENT SERVICE AND CARE, WHICH RESULT IN THE BEST POSSIBLE OUTCOME FOR THE NEWEST MEMBERS OF ITS COMMUNITY AND THEIR FAMILIES. IN SUPPORT OF THIS GOAL, THE HOSPITAL ENGAGED IN AN EXTENSIVE PROCESS TO BECOME A "BABY FRIENDLY HOSPITAL," WHICH IS AN INTERNATIONAL DESIGNATION RECOGNIZING THE INSTITUTION'S COMPREHENSIVE PROGRAM SUPPORTING BREASTFEEDING AND INFANT/PARENT BONDING. AS PART OF THIS PROGRAM, PARENTS ARE ENCOURAGED TO TAKE ADVANTAGE OF THE MANY EDUCATIONAL OPPORTUNITIES AND SUPPORT SERVICES OFFERED BEFORE, DURING, AND AFTER DELIVERY. EXPECTANT PARENTS ATTENDING THE BREASTFEEDING CLASS RECEIVE ENCOURAGEMENT AND INSTRUCTION TO PROMOTE A SUCCESSFUL BREASTFEEDING EXPERIENCE. INTERNATIONALLY BOARD CERTIFIED LACTATION CONSULTANTS, SUPPORTED BY L 359216810 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true true false true 468 0 true 2728 true true true false false false false false false false false false false false X 13 10 false false false false false false false true true false false true true true true true true true true true true CA X WAH-CHUNG HSU 9099852811 999 SAN BERNARDINO ROAD UPLAND CA 91786 Harris Koenig 119-9 President/CEO 40.0 3.0 X X 797750 0 37721 Wah-Chung Hsu Vice President/CFO 40.0 5.0 X 428535 0 83920 John Chapman 919-12 President/CEO, Interim, COO 40.0 3.0 X X 353351 0 71811 Gudrun Moll VP/Chief Nursing Officer 40.0 0.0 X 354442 0 69118 Kamal Pandya VP/Chief Information Offier 40.0 0.0 X 245696 0 139636 La Donna Najieb Chief Human Resources officer 40.0 0.0 X 298087 0 71724 Cathy Rebman VP Busin Devel & Comm Outreach 40.0 0.0 X 217571 0 139775 Michael Tracey President-Foundation 40.0 0.0 X 261646 0 61336 Saurabh Ashier Manager Cardiovascular Serv 40.0 0.0 X 253934 0 17868 Ronald Nowosad Director/Chronic Care Program 40.0 0.0 X 193116 0 22697 Ed DiGiamarino MD Trustee 4.0 0.0 X 31500 0 0 Sohan Bassi MD Trustee/Secretary 4.0 0.0 X X 19875 0 0 Michael Chai MD Trustee 4.0 0.0 X 9000 0 0 Sarah Khan MD Trustee/Med. Staff President 4.0 0.0 X 9000 0 0 Andrea Dutton Trustee/Treasurer 4.0 0.0 X X 0 0 0 Victor Ching MD Trustee 4.0 0.0 X 0 0 0 Wes FiField Trustee 4.0 0.0 X 0 0 0 Deborah Freund Trustee 4.0 0.0 X 0 0 0 Howard Borenstein Trustee/Chairman 4.0 0.0 X X 0 0 0 Vincent Carrollo MD Trustee/Vice Chair 4.0 0.0 X X 0 0 0 Susan Leonis-Jensen Trustee 4.0 0.0 X 0 0 0 Al Arguello Trustee 4.0 0.0 X 0 0 0 3473503 0 715606 491 false true false Shiftwise Inc 1800 SW 1st Avenue Suite 510 PORTLAND OR 97201 Nursing Registry 3022814 Mayo Medical Laboratories PO Box 9146 MINNEAPOLIS MN 55480 Medical Laboratory 1068758 DVA Renal Healthcare PO Box 8500-1607 PHILADELPHIA PA 191781607 Dialysis 3988629 Emerald Textiles LLC 1725 Dornoch Ct SAN DIEGO CA 92154 Linen Services 1218939 Cerner Corporation 2800 Rockcreek Parkway KANSAS CITY MO 64117 Clinical Information 761873 56 575131 575131 NET PATIENT SERVICE REVENUE 622110 374014067 374014067 RENTAL INCOME - MOB 531120 2670083 2670083 CAPITATION REVENUE 622110 955325 955325 MEANINGFUL USE REVENUE 622110 394119 394119 OUTSIDE LAB REVENUE 621500 103344 393576 378136938 5364414 5364414 0 0 0 0 0 72986334 72208187 778147 778147 778147 0 0 0 0 0 0 272707 201222 71485 71485 PHARMACY AT CASA COLINA 446110 2814054 2702146 OTHER REVENUE 622110 2107043 2107043 CAFETERIA 722310 2091074 2091074 295290 295290 7307461 392233576 380140637 3391012 8305120 197106 197106 0 0 0 2530588 750432 1780156 0 164022581 147151022 16871559 13176232 11820909 1355323 23049156 20678292 2370864 11929913 10702788 1227125 0 1876932 1876932 392632 392632 37067 37067 0 519840 519840 28441167 28441167 1057933 1057933 6421005 5802681 618324 10102492 9063338 1039154 0 16553941 14959846 1594095 0 0 29357 26337 3020 5621147 5621147 0 17926984 16200669 1726315 2946186 2946186 MEDICAL SUPPLIES 50391808 50391808 0 MEDI-CAL FEE PROGRAM 19604055 19604055 0 DRUGS 15039594 15039594 0 TAXES AND LICENSES 1065153 1065153 0 1895432 1700466 194966 394828301 359216810 35611491 0 43214 49754 17404990 16527802 0 0 52797602 62920632 0 0 0 0 0 0 5455747 5368050 7296588 5592005 421100213 134389920 281336624 286710293 181176428 174662496 0 0 12958950 16971183 0 0 66717960 77375066 625188103 646177281 74120565 78157227 0 0 0 0 152034417 148900351 0 0 0 0 0 0 0 0 49175621 49298617 275330603 276356195 X 340727804 358162550 9129696 11658536 349857500 369821086 625188103 646177281 X -2594725 9766230 12792081 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 37067 37067 false Part II-B, Line 1i SARH IS A MEMBER OF THE CALIFORNIA ASSOCIATION OF THE AMERICAN HOSPITAL ASSOCIATION AND THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, WHICH CONDUCT LOBBYING ACTIVITIES IN SUPPORT OF MEMBER HOSPITALS AND GENERAL HEALTHCARE ISSUES. BOTH ASSOCIATIONS PROVIDE THE PERCENTAGE OF DUES THAT RELATE TO LOBBYING ACTIVITIES. 4095691 825000 169882 177910 14377 4898286 4083191 325117 301452 11165 4095691 4052191 31000 266663 243279 23384 4083191 4042191 10000 239897 217182 22715 4052191 4037191 5000 186859 166327 20532 4042191 1.00000 false true true 14867100 14867100 275731591 54025613 221705978 6263640 3922424 2341216 115915405 76441883 39473522 8322477 8322477 286710293 RECEIVABLE - HOSPITAL FEE PROG 26506634 DUE FROM AFFILIATES 1044257 BENEFICIAL INTEREST IN SAHF 49359748 DEFERRED REVENUE 464427 77375066 0 PENSION PLAN LIABILITY FAS 158 33157938 INSURANCE CLAIMS 10982733 PHYSICIAN GUARANTEE LIABILITY 5157946 49298617 X Schedule D, Part V, Line 4 PROCEEDS FROM THE ENDOWMENT FUNDS ARE RESTRICTED FOR THE PURCHASE OF PROPERTY AND EQUIPMENT FOR THE BENEFIT OF SAN ANTONIO REGIONAL HOSPITAL. Schedule D, Part X, Line 2 The principal operations of the Hospital are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and the related state provisions. Accounting Standards Codification (ASC) 740, Income Taxes, clarifies the accounting for income taxes by prescribing a minimum recognition threshold that a tax position is required to meet before being recognized in the financial statements. ASC 740 also provides guidance on derecognition, measurement, classification, interest and penalties, disclosure, and transition. The guidance is applicable to pass-through entities and tax-exempt organizations. No significant tax liability for tax benefits, interest, or penalties was accrued at December 31, 2019 or 2018. The Hospital currently files Form 990, Return of Organization Exempt From Income Tax, and Form 990-T, Exempt Organization Business Income Tax Return, in the U.S. federal jurisdiction and the state of California for each tax-exempt organization, as appropriate. The statute of limitations for the years 2016 through 2018 remains open to examination by the major U.S. taxing jurisdictions to which the Hospital is subject. true true X true X 300. true X true true false true true 2426165 2426165 0.00610 102499002 75936472 26562530 0.06730 104925167 75936472 28988695 0.07340 45 240704 3399360 973364 2425996 0.00610 2 41 152533 152533 0.00040 253778 253778 0.00060 2 9228 127161 23528 103633 0.00030 49 249973 3932832 996892 2935940 0.00740 49 249973 108857999 76933364 31924635 0.08080 1 2999 2999 1 7286 7286 1 268 28770 11229 17541 0.00010 3 268 39055 11229 27826 0.00010 false 8728819 872882 67357698 63971936 3385762 X true true SA Ambulatory Surg Outpatient surgical center 0.28471 0.71529 1 1 San Antonio Regional Hospital 999 San Bernardino Road Upland CA 91786 sarh.org 240000196 X X X San Antonio Regional Hospital 1 false false true X X X X X X X X X 19 true true true true X SEE PART V, SECTION C X true 20 false true false true X 300. 400. X X true true X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X false X false X X X X true X false false Schedule H, Part V, Section B, Line 5 SAN ANTONIO REGIONAL HOSPITAL COLLABORATED WITH THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA TO PLAN AND EXECUTE THE 2019 INLAND EMPIRE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TOGETHER WITH SEVEN OTHER HOSPITALS (DESERT REGIONAL MEDICAL CENTER, HI-DESERT MEDICAL CENTER, INLAND VALLEY MEDICAL CENTER, JFK MEMORIAL HOSPITAL, MOUNTAINS COMMUNITY HOSPITAL, RANCHO SPRINGS MEDICAL CENTER, AND REDLANDS COMMUNITY HOSPITAL), SAN ANTONIO REGIONAL HOSPITAL CONTINUED TO SHARE RESOURCES, COLLABORATE FOR COLLECTIVE IMPACT, AND BUILD UPON THE EXISTING BODY OF WORK THROUGH EXPANDED DATA COLLECTION FROM IMPORTANT VOICES IN OUR COMMUNITY. PRIMARY AND SECONDARY DATA SOURCES WERE INCLUDED IN THE CHNA. FROM NOVEMBER 12, 2018 TO JANUARY 18, 2019, MULTIPLE FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND ONLINE SURVEYS WERE ADMINISTERED. A TOTAL OF 228 PEOPLE WERE SURVEYED TO OBTAIN INPUT FROM THE COMMUNITY IN THE FORM OF 11 FOCUS GROUPS (WITH A TOTAL OF 97 FOCUS GROUP PARTICIPANTS), 32 KEY INFORMANT INTERVIEWS, AND 99 ONLINE SURVEYS (INCLUDING A SPANISH OPTION). THE MAIN OBJECTIVE IN ENGAGING THE COMMUNITY WAS TO UNDERSTAND THE GREATEST AREAS OF NEED AND TO DISCOVER STRATEGIES IN WHICH PARTICIPATING HOSPITALS COULD COLLABORATE TO BETTER SERVE COMMUNITIES AND ELEVATE THE HEALTH STATUS OF OUR REGION. PRIMARY DATA - THE HOSPITALS PARTICIPATING IN THE TWO-COUNTY ASSESSMENT WORKED TO IDENTIFY RELEVANT KEY INFORMANTS AND TOPICAL FOCUS GROUPS TO GATHER MORE INSIGHTFUL DATA AND TO AID IN DESCRIBING THE COMMUNITY. TO DETERMINE FOCUS GROUPS AND KEY INFORMANTS, MEMBERS OF THE INLAND EMPIRE REGIONAL CHNA TASKFORCE INDIVIDUALLY CREATED INTERVIEW LISTS. TASKFORCE MEMBERS CONSIDERED A VARIETY OF SECTORS TO BE REPRESENTED, INCLUDING COMMUNITY-BASED ORGANIZATIONS, LOCAL BUSINESSES, FOUNDATION/FUNDERS, SCHOOL BOARDS/DISTRICTS, CITY COUNCILS, PUBLIC HEALTH DEPARTMENTS, LAW ENFORCEMENT, LEGAL, FAITH-BASED ORGANIZATIONS, AND HOSPITAL LEADERS. IN ADDITION, THE FOLLOWING POPULATIONS WERE CONTEMPLATED FOR THE FOCUS GROUPS: THOSE DEALING WITH MENTAL HEALTH ISSUES OR SUBSTANCE ABUSE, MINORITIES, LOW INCOME, MEDICALLY UNDERSERVED/UNINSURED/UNDERINSURED, AND YOUTH. COMMUNITY VOICES - AN ONLINE SURVEY IN ENGLISH AND SPANISH WAS CREATED AND DISTRIBUTED FOR GREATER COMMUNITY INPUT. IT SHOULD BE NOTED THAT THE SURVEY RESULTS WERE NOT BASED ON A STRATIFIED RANDOM SAMPLE OF RESIDENTS THROUGHOUT RIVERSIDE AND SAN BERNARDINO COUNTIES. THE PERSPECTIVES CAPTURED IN THIS DATA SIMPLY REPRESENT THE COMMUNITY MEMBERS WHO AGREED TO PARTICIPATE AND HAVE AN INTEREST IN HEALTHCARE. IN ADDITION, THE ASSESSMENT RELIED ON SEVERAL NATIONAL AND STATE ENTITIES WITH PUBLICLY AVAILABLE DATA. ALL LIMITATIONS INHERENT IN THESE SOURCES WERE PRESENT FOR THE ASSESSMENT. PARTICIPANTS IN THE FOCUS GROUPS WERE END-USERS OF PROGRAMS AND SERVICES AS WELL AS VOLUNTEERS AND/OR AUXILIARY BOARD MEMBERS PROVIDED BY THE HOSPITALS PARTICIPATING IN THIS CHNA. POPULATIONS REPRESENTED BY FOCUS GROUP MEMBERS INCLUDED LOW-INCOME POPULATIONS, HOMELESS, SENIORS, WOMEN'S CANCER, SINGLE MOTHERS/MATERNAL HEALTH, AND SPANISH-SPEAKING PROMOTORAS. KEY INFORMANT INTERVIEWS CONSISTED OF KEY LEADERS IN OUR COMMUNITY FROM AN ARRAY OF AGENCIES, INCLUDING THOSE THAT SERVE CHILDREN, HOMELESS POPULATIONS, VETERANS, SENIORS, AND SPANISH-SPEAKING POPULATIONS. OTHER ORGANIZATIONS REPRESENTED INCLUDED PUBLIC HEALTH AGENCIES, LAW ENFORCEMENT, HEALTHCARE ORGANIZATIONS, FUNDERS, AND SCHOOL DISTRICTS. MOST OF THE KEY INFORMANTS HAD TITLES SUCH AS DIRECTOR OR EXECUTIVE DIRECTOR, PRESIDENT OR VICE PRESIDENT, OR WERE A PART OF THE MEDICAL STAFF OF THEIR ORGANIZATIONS. SEVEN RESPONDENTS MENTIONED WORKING FOR NONPROFIT ORGANIZATIONS. COMMUNITY HOSPITALS, PUBLIC AND/OR POPULATION HEALTH, WORKFORCE DEVELOPMENT, AFFORDABLE HOUSING, AND FIRE PROTECTION SERVICES WERE MOST FREQUENTLY STATED AS SERVICES PROVIDED. SECONDARY SOURCES INCLUDED PUBLICLY AVAILABLE STATE AND NATIONALLY RECOGNIZED DATA SOURCES AVAILABLE AT THE ZIP CODE, COUNTY AND STATE LEVEL. HEALTH INDICATORS FOR SOCIAL AND ECONOMIC FACTORS, HEALTH SYSTEM, PUBLIC HEALTH AND PREVENTION, AND PHYSICAL ENVIRONMENT WERE INCLUDED. THE TOP LEADING CAUSES OF DEATH AS WELL AS CONDITIONS OF MORBIDITY THAT ILLUSTRATE THE COMMUNICABLE AND CHRONIC DISEASE BURDEN ACROSS SAN BERNARDINO AND RIVERSIDE COUNTIES WERE ALSO INCLUDED. A SIGNIFICANT PORTION OF THE DATA FOR THE ASSESSMENT WAS COLLECTED THROUGH A CUSTOM REPORT GENERATED THROUGH COMMUNITY COMMON'S ENGAGEMENT NETWORK CHNA (HTTPS://ENGAGEMENTNETWORK.ORG/ASSESSMENT/). OTHER SOURCES INCLUDED CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, COUNTY HEALTH RANKINGS & ROADMAPS, AND CALIFORNIA ENVIRONMENTAL PROTECTION AGENCY'S OFFICE OF ENVIRONMENTAL HEALTH HAZARD ASSESSMENT. WHEN FEASIBLE, HEALTH METRICS WERE FURTHER COMPARED TO ESTIMATES FOR THE STATE OR NATIONAL BENCHMARKS, SUCH AS THE HEALTHY PEOPLE 2020 OBJECTIVES. INPATIENT HOSPITALIZATION DISCHARGE DATA FOR 2017 WAS DERIVED FROM THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) HOSPITAL DATASET UTILIZING THE SPEEDTRACK ANALYTICS PLATFORM. HOSPITALIZATION DISCHARGE DATA WAS STRATIFIED BY GENDER, RACE/ETHNICITY, AND AGE. DATA CONTAINING AN N-VALUE OF 10 OR LESS WERE NOT INCLUDED. THE FOCUS GROUPS, KEY INFORMANTS, AND SURVEYS CONTAINED QUESTIONS ABOUT THE MOST SIGNIFICANT HEALTH NEED IN THE COMMUNITY. BASED ON THOSE RESPONSES, PRIORITIZATION WAS GIVEN TO THE ISSUES MOST FREQUENTLY MENTIONED IN ALL THREE DATA SOURCES. FOLLOWING THE COMPLETION OF THE REGIONAL CHNA, SAN ANTONIO FINALIZED ITS 2019 CHNA AND EMBARKED ON A METHODICAL PRIORITIZATION PROCESS TO IDENTIFY THE MOST SIGNIFICANT HEALTH NEEDS TO BE ADDRESSED OVER NEXT THREE YEARS. THE RESULTS WERE SIMILAR TO THE REGIONAL PRIORITIZATION, WITH THE FOLLOWING AREAS OF NEED IDENTIFIED: MENTAL HEALTH, CHRONIC DISEASES, ACCESS TO HEALTH, AND PREVENTION AND WELLNESS. Schedule H, Part V, Section B, Line 6a OTHER HOSPITALS INCLUDED IN THE DEVELOPMENT OF THE HOSPITAL'S CHNA WERE DESERT REGIONAL MEDICAL CENTER, HI-DESERT MEDICAL CENTER, INLAND VALLEY MEDICAL CENTER, JFK MEMORIAL HOSPITAL, MOUNTAINS COMMUNITY HOSPITAL, RANCHO SPRINGS MEDICAL CENTER, AND REDLANDS COMMUNITY HOSPITAL. Schedule H, Part V, Section B, Line 6b OTHER ORGANIZATIONS INCLUDED IN THE DEVELOPMENT OF THE HOSPITAL'S CHNA WERE THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, THE HEALTH DEPARTMENT OF SAN BERNARDINO COUNTY AND THE HEALTH DEPARTMENT OF RIVERSIDE COUNTY. Schedule H, Part V, Section B, Line 7a WWW.SARH.ORG/ABOUT_US/COMMUNITY_OUTREACH/COMMUNITY_OUTREACH_PUBLICATIONS Schedule H, Part V, Section B, Line 11 The results of the CHNA guided the creation of San Antonio's Community Benefit Implementation Strategy by providing the framework for determining how we can improve the health of our community, and particularly, the most vulnerable among us. Using the CHNA as both context and the lens through which the community's needs were identified, San Antonio embarked on a formal prioritization process that included input from community stakeholders. Community health needs are complex, often difficult to define, and may affect diverse populations. Equally challenging is the task of creating interventions to address these needs in meaningful ways that are impactful and measurable. With the completion of the CHNA and the prioritization process, the next step was to develop and/or expand community benefit programs designed to improve community health status. During the strategic planning process, the community benefit team developed initiatives within each of the identified priority areas with defined goals, objectives, and evaluation metrics. Each initiative in San Antonio Regional Hospital's Implementation Strategy relates to one or more of the four priority areas, the specific needs identified in the 2019 CHNA, and input sought and provided by community stakeholders. Mental health was one of the most frequently mentioned health needs in nearly every question by the focus groups, key informants, and survey respondents. Children and the aging population were noted as populations with mental health concerns. Issues mentioned included shortage of staff, addiction, lack of available services, trauma, isolation, and social factors such as transportation, all of which lead to continued unmet needs. SARH will address these issues by supporting local and regional mental health policy and educational awareness initiatives to increase knowledge and access to mental health resources. The top three leading causes of death in San Bernardino and Riverside counties are cancer, heart disease, and chronic lower respiratory disease. Analysis of the Prevention Quality Indicators (PQI) reveal that San Bernardino County has the number of highest hospital admissions for diabetes short-term complications, diabetes long-term complications, hypertension, uncontrolled diabetes, and asthma in younger adults. SARH will be committed to improve the health status of an at-risk population by screening frequent emergency department visitors and conducting evaluations for program participation. The goal is to improve health status of enrolled CHIP members. The Know Your Numbers (KYN) program provides health education and biometric screenings in community health hubs that serve low-income, uninsured, or underinsured populations. KYN utilizes a clinical community health worker (CCHW) model to engage the population. The objective is: - To increase access to health education and preventative services by increasing number of people assed among vulnerable populations and connecting participants with a medical home. - To improve the health and well-being of community residents by promoting healthy lifestyles and activities to residents. The wHealth (adolescent wellness & workforce development) program provides a three pronged approach including curriculum on fitness, nutrition, and mental resiliency. The program is offered in partnership with local universities and school districts to improve the health and well-being of students by promoting healthy lifestyles and activities in our youth. Each year, and at the conclusion of the three-year Implementation Strategy, San Antonio Regional Hospital evaluates the effectiveness of its community benefit programs to determine the level of measurable community health impact. Taking existing hospital and community resources into consideration, San Antonio Regional Hospital will not directly address the remaining health needs identified in the CHNA including: transportation , poverty and food insecurity, and affordable housing and homelessness. The hospital cannot address all the health needs present in the community; therefore, it will concentrate on those health needs that can most effectively be addressed given the organization's areas of focus and expertise. San Antonio Regional Hospital will look for partnership opportunities that address needs not selected where it can appropriately contribute to addressing those needs, or where those needs align with current strategies and priorities. Schedule H, Part V, Section B, Line 13h THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH CHARITY CARE ASSISTANCE. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR CHARITY CARE, SARH COULD USE OUTSIDE AGENCIES IN DETERMINING ESTIMATED INCOME AMOUNTS FOR THE BASIS OF DETERMINING CHARITY CARE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. ONCE DETERMINED, DUE TO THE INHERENT NATURE OF THE PRESUMPTIVE CIRCUMSTANCES, THE ONLY DISCOUNT THAT CAN BE GRANTED IS A 100% WRITE-OFF OF THE ACCOUNT BALANCE. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. STATE-FUNDED PRESCRIPTION PROGRAMS; 2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); 4. FOOD STAMP ELIGIBILITY; 5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN); 7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND 8. PATIENT IS DECEASED WITH NO KNOWN ESTATE. Schedule H, Part V, Section B, Line 16a WWW.SARH.ORG/ABOUT_US/COMMUNITY_OUTREACH/COMMUNITY_OUTREACH_PUBLICATIONS Schedule H, Part V, Section B, Line 16b WWW.SARH.ORG/ABOUT_US/COMMUNITY_OUTREACH/COMMUNITY_OUTREACH_PUBLICATIONS Schedule H, Part V, Section B, Line 16c WWW.SARH.ORG/ABOUT_US/COMMUNITY_OUTREACH/COMMUNITY_OUTREACH_PUBLICATIONS 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. 6 SARH 685 BLDG DIAGNOSTIC CENTER 685 N 13TH AVE UPLAND CA 91786 LAB AND RADIOLOGY SERVICES IN A FREESTANDING MEDICAL OFFICE BUILDING SARH 901 BUILDING DIAGNOSTIC CENTER 999 SAN BERNARDINO ROAD UPLAND CA 91786 RADIOLOGY SERVICES IN A FREESTANDING MEDICAL OFFICE BUILDING RANCHO SAN ANTONIO MEDICAL PLAZA 7777 MILLIKEN AVE RANCHO CUCAMONGA CA 91730 LAB, X-RAY,PHYSICAL THERAPY & URGENT CARE IN A FREESTANDING MEDICAL OFFICE BUILDING SIERRA SAN ANTONIO MEDICAL PLAZA 16465 SIERRA LAKES PARKWAY FONTANA CA 92336 LAB, X-RAY, PHYSICAL THERAPY & URGENT CARE IN A FREESTANDING MEDICAL OFFICE BUILDING EASTVALE SAN ANTONIO MEDICAL PLAZA 12442 LIMONITE AVE EASTVALE CA 91752 LAB, X-RAY, PHYSICAL THERAPY & URGENT CARE IN A FREESTANDING MEDICAL OFFICE BUILDING SAN ANTONIO AMBULATORY SURGERY CENTER 901 SAN BERNARDINO ROAD UPLAND CA 91786 OUTPATIENT SURGERY CENTER Schedule H, Part VI Schedule H, Part I, Line 3c - A COMPLETED FINANCIAL ASSISTANCE APPLICATION MAY NOT BE REQUIRED IN CERTAIN CIRCUMSTANCES. THESE CIRCUMSTANCES ARE LIMITED TO SITUATION WHEN SARH DETERMINES IT HAS SUFFICIENT PATIENT FINANCIAL INFORMATION FROM WHICH TO MAKE A FINANCIAL ASSISTANCE ELIGIBILITY AND QUALIFICATION DECISION. EXAMPLES OF CIRCUMSTANCES NOT REQUIRING A FINANCIAL ASSISTANCE APPLICATION INCLUDE, BUT ARE NOT LIMITED TO: A. PATIENT IS HOMELESS B. PATIENT IS A RESIDENT AT A SHELTER INCLUDING BUT NOT LIMITED TO PROTOTYPES AND THE AMERICAN RECOVERY CENTER C. PATIENT'S ADDRESS IS THE ADDRESS FOR THE DEPARTMENT OF PUBLIC SOCIAL SERVICES D. PATIENT IS UNKNOWN E. PATIENT IS RECEIVING GENERAL RELIEF, CAL WORKS OR CAL FRESH (DOCUMENTATION REQUIRED) F. PATIENT QUALIFIED FOR MEDI-CAL WITHOUT A SHARE OF COST (SOC) DURING A PORTION OF THE CONFINEMENT OR SUBSEQUENT TO THEIR DISCHARGE/VISIT (PROOF OF ELIGIBILITY REQUIRED). G. NON-COVERED AND /OR DENIED SERVICES PROVIDED TO MEDI-CAL ELIGIBLE PATIENTS. Schedule H, Part I, Line 6a - SAN ANTONIO REGIONAL HOSPITAL PREPARED A COMMUNITY BENEFIT REPORT AS REQUIRED BY THE STATE OF CALIFORNIA. THE REPORT WAS PUBLISHED AND MADE AVAILABLE TO THE PUBLIC ONLINE AT WWW.SARH.ORG. Schdule H, Part I, Line 7 - THE COSTING METHODOLOGY USED ON 7A: CALCULATED USING WORKSHEETS 1&2 IN THE INSTRUCTIONS; THE COST TO CHARGE OPTION. THE COSTING METHODOLOGY USED ON 7B: CALCULATED USING WORKSHEET 3 IN THE INSTRUCTIONS; THE COST TO CHARGE OPTION. THE COSTING METHODOLOGY USED ON 7E TO 7I: CALCULATED USING ACTUAL COSTS FROM SARH'S GENERAL LEDGER. Line 7g - NONE OF THE COSTS ON THIS LINE WERE ATTRIBUTABLE TO A PHYSICIAN CLINIC. Sch H, Part II - SAN ANTONIO REGIONAL HOSPITAL PROVIDED SUPPORT TO LOCAL COMMUNITY ORGANIZATIONS THAT SERVE THE COMMUNITIES SURROUNDING THE HOSPITAL. THESE ORGANIZATIONS WERE RECIPIENTS OF FINANCIAL CONTRIBUTIONS THAT WERE USED TO ENHANCE THE HEALTH OF THE COMMUNITY. THESE ORGANIZATIONS INCLUDED THE AMERICAN HEART ASSOCIATION, THE AMERICAN CANCER SOCIETY, THE AMERICAN LUNG ASSOCIATION, AND THE ASSISTANCE LEAGUE OF THE FOOTHILL COMMUNITIES. OTHER ORGANIZATIONS, SUCH AS THE SCHEU YMCA, ETIWANDA SCHOOL DISTRICT MAA AND MEALS ON WHEELS, WERE SUPPORTED THROUGH IN-KIND DONATIONS. THESE ENTITIES PROVIDE THE COMMUNITY WITH OPPORTUNITIES TO PARTICIPATE IN HEALTH-RELATED ACTIVITIES OR PROGRAMS, AND PROMOTE HEALTHY EATING AND ACTIVE LIVING. IN 2019 SARH MANAGED NUMEROUS COMMUNITY PROGRAMS, INCLUDING THE FOLLOWING: . HEALTHY BEGINNINGS - SARH'S MATERNAL/CHILD SERVICES, COLLECTIVELY KNOWN AS HEALTHY BEGINNINGS, IS COMMITTED TO PROVIDING EXCELLENT SERVICE AND CARE, WHICH RESULT IN THE BEST POSSIBLE OUTCOME FOR THE NEWEST MEMBERS OF ITS COMMUNITY AND THEIR FAMILIES. IN SUPPORT OF THIS GOAL, THE HOSPITAL ENGAGED IN AN EXTENSIVE PROCESS TO BECOME A "BABY FRIENDLY HOSPITAL," WHICH IS AN INTERNATIONAL DESIGNATION RECOGNIZING THE INSTITUTION'S COMPREHENSIVE PROGRAM SUPPORTING BREASTFEEDING AND INFANT/PARENT BONDING. AS PART OF THIS PROGRAM, PARENTS ARE ENCOURAGED TO TAKE ADVANTAGE OF THE MANY EDUCATIONAL OPPORTUNITIES AND SUPPORT SERVICES OFFERED BEFORE, DURING, AND AFTER DELIVERY. EXPECTANT PARENTS ATTENDING THE BREASTFEEDING CLASS RECEIVE ENCOURAGEMENT AND INSTRUCTION TO PROMOTE A SUCCESSFUL BREASTFEEDING EXPERIENCE. INTERNATIONALLY BOARD CERTIFIED LACTATION CONSULTANTS, SUPPORTED BY LACTATION EDUCATORS, ARE AVAILABLE TO PROVIDE SUPPORT DURING THE FAMILY'S HOSPITAL STAY, AND EVERY FAMILY IS ENCOURAGED TO VISIT THE HEALTHY BEGINNINGS NEWBORN FEEDING CENTER AFTER THEY LEAVE THE HOSPITAL. IN ADDITION TO PROVIDING BREASTFEEDING EVALUATION AND SUPPORT, THE NEWBORN FEEDING CENTER ASSESSES MOTHER AND NEWBORN, PROVIDING REFERRALS TO COMMUNITY RESOURCES WHEN NEEDED. THIS EVALUATION PROCESS HAS YIELDED SIGNIFICANT OUTCOMES INCLUDING A REDUCTION IN NEWBORN READMISSION RATES, INCREASED BREASTFEEDING RATES, EARLY INTERVENTION FOR DEVELOPMENT DELAYS, AND IDENTIFICATION AND TREATMENT OF POSTNATAL ILLNESS, FROM BABY BLUES TO POSTPARTUM PSYCHOSIS. WHILE SOME FAMILIES JUST NEED REASSURANCE THAT THEIR BABY IS THRIVING, OTHERS MAY REQUIRE FURTHER EDUCATION OR SUPPORT, AND A FEW REQUIRE INTERVENTION OR TREATMENT. THE CENTER OFFERS SUPPORT TO ALL NEW FAMILIES IN THE COMMUNITY, REGARDLESS OF WHERE THEIR BABIES ARE BORN. IN FACT, MANY LOCAL PEDIATRICIANS INCLUDE A VISIT TO THE CENTER AS PART OF THE DISCHARGE INSTRUCTIONS FOR THEIR PATIENTS. . COMMUNITY LECTURES - EVERY MONTH SAN ANTONIO REGIONAL HOSPITAL HOSTS A COMMUNITY HEALTH EDUCATION LECTURE. THESE LECTURES ARE OPEN TO THE PUBLIC FOR THE PURPOSE OF ENGAGING THE COMMUNITY AND INCREASING EDUCATION RELATED TO SPECIFIC HEALTH TOPICS. LECTURES ARE LED BY THE HOSPITAL'S PHYSICIANS, CLINICAL STAFF, OR COMMUNITY ORGANIZATIONS. COMMUNITY LECTURES ARE BROADLY PUBLICIZED AND OPEN TO THE ENTIRE COMMUNITY. APPROXIMATELY, 743 COMMUNITY MEMBERS REGISTERED FOR COMMUNITY LECTURES AND THE HEART HEALTH SERIES IN 2019. COMMUNITY LECTURE TOPICS WERE AS FOLLOWS: LEGAL AND FINANCIAL WORKSHOP FOR ALZHEIMER'S DISEASE AND RELATED DEMENTIA, PROTECTING YOUR BOTTOM LINE: COLORECTAL CANCER PREVENTION AND SCREENING, PROSTATE CANCER: NEW SCREENING GUIDELINES AND EARLY DETECTION, VAPING: THE NEW PUBLIC HEALTH ISSUE, AND BREAST CANCER. DURING THE MONTH OF FEBRUARY, WE HELD A HEART HEALTH SERIES. TOPICS ARE AS FOLLOWS: SAVING YOUR HEART: THE PREVENTION AND TREATMENT OF CARDIOVASCULAR DISEASE, CONSIDERING A FAD DIET? WHAT DOES YOUR HEART SAY, WOMEN & HEART DISEASE, CONSIDERING A FAD DIET? WHAT DOES YOUR HEART SAY, WOMEN & HEART DISEASE, HAS YOUR HEART VALVE SPRUNG A LEAK, LIFE GOES ON: HEALING YOUR HEART AND MIND AFTER A CARDIAC EVENT, FREE GLUCOSE, BLOOD LIPIDS, AND BMI SCREENINGS (JANUARY). . COMMUNITY HEALTH IMPROVEMENT PROGRAM (CHIP) - IN 2019, CHIP SUCCESSFULLY RECRUITED 40 STUDENTS TO BECOME HEALTH COACHES AND A TOTAL OF 216 OVER THE PAST FOUR YEARS. CHIP ENROLLED 68 PATIENTS IN 2019 RAISING THE TOTAL NUMBER CARED FOR BY THESE HEALTH COACHES TO 306 PATIENTS. TO DATE, UNNECESSARY ER VISITS WERE REDUCED BY 36% AND HOSPITALIZATIONS BY 42% AMONG CHIP PARTICIPANTS ENROLLED FOR NINE MONTHS. THE CENTER FOR DISEASE CONTROL HAS REPORTED THAT SIX IN TEN AMERICANS LIVE WITH AT LEAST ONE CHRONIC DISEASE, LIKE HEART DISEASE, CANCER, STROKE, OR DIABETES. THESE AND OTHER CHRONIC DISEASES ARE THE LEADING CAUSES OF DEATH AND DISABILITY IN AMERICA, AND THEY ARE ALSO A LEADING DRIVER OF HEALTHCARE COSTS. IN FACT, THE CDC HAS REPORTED THAT 90% OF THE NATION'S $3.3 TRILLION IN ANNUAL HEALTHCARE EXPENDITURES RELATE TO CARING FOR PEOPLE WITH CHRONIC AND MENTAL HEALTH CONDITIONS. THE AGING POPULATION AND THE CONTINUED ESCALATION OF PATIENTS WITH CHRONIC CONDITIONS IS A PRINCIPAL REASON SAN ANTONIO REGIONAL HOSPITAL DEVELOPED AND IMPLEMENTED THE COMMUNITY HEALTH IMPROVEMENT PROGRAM (CHIP) IN JANUARY 2015. CHIP IS ONE OF THE INITIATIVES SAN ANTONIO DEVELOPED TO: 1) DIMINISH HEALTHCARE GAPS, 2) PROMOTE THE DELIVERY OF EVIDENCE-BASED CARE, AND 3) REDUCE UNNECESSARY EMERGENCY ROOM VISITS AND HOSPITALIZATIONS. COORDINATED BY A DEDICATED INTERDISCIPLINARY HEALTHCARE TEAM EMPLOYING A SERIES OF INDIVIDUALIZED CONTINUOUS CARE ALGORITHMS, THIS PROGRAM FOCUSES ON APPROPRIATE PATIENT IDENTIFICATION, PREVENTION, EVIDENCE-BASED DISEASE MANAGEMENT, AND EXEMPLARY TREATMENT OF INDIVIDUALS WITH CHRONIC CONDITIONS. EACH PARTICIPATING CHIP MEMBER IS CLOSELY MONITORED IN ACCORDANCE WITH AN INDIVIDUALIZED COMPREHENSIVE HEALTH PROFILE (CHP), QUALITY CARE PLAN (QCP), AND LONGITUDINAL PATIENT SCORECARD. A NOVEL STRATIFICATION SCALE THAT ASSESSES SOCIOECONOMIC STATUS, EDUCATION/ASSIMILATION CAPACITY, MENTAL HEALTH HISTORY, ADHERENCE POTENTIAL, PSYCHOLOGICAL STRESS FACTORS, AND SUPPORT IS UTILIZED ALONG WITH DATA MINING AND STANDARDIZED CLINICAL ASSESSMENTS TO INDIVIDUALIZE EVIDENCE-BASED CLINICAL STRATEGIES BASED UPON EACH PERSON'S RESPECTIVE NEEDS AND CAPABILITIES. A UNIQUE ASPECT OF CHIP IS THE TRAINING AND UTILIZATION OF STUDENT HEALTH COACHES. IN ADDITION TO THE CHIP INTERDISCIPLINARY CLINICAL TEAM, MEMBERS ARE MONITORED BY HEALTH COACHES TRAINED THROUGH AN INNOVATIVE CREDIT-BASED COLLABORATIVE EDUCATIONAL SEMINAR AND INTERNSHIP PROGRAM WITH CALIFORNIA STATE UNIVERSITY SAN BERNARDINO SCHOOLS OF PUBLIC HEALTH, NURSING, BIOLOGY, AND KINESIOLOGY; WESTERN UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF GRADUATE NURSING; AND CAL POLY POMONA DIETITIAN/ NUTRITION STUDENTS. AFTER APPROPRIATE SCREENING, SELECTED STUDENTS PARTICIPATE IN A SEMINAR TAUGHT BY OUR INTERDISCIPLINARY TEAM OF HEALTHCARE PROFESSIONALS INCLUDING PHYSICIANS, NURSES, NUTRITIONISTS, SOCIAL WORKERS, AND HOSPITAL ADMINISTRATORS. LICENSED PROFESSIONALS (REGISTERED NURSE AND PHYSICIAN) OVERSEE THE WORK OF THE STUDENT HEALTH COACHES, AND THEIR SCOPE OF ACTIVITIES ARE CONSISTENT WITH THEIR COMPETENCE AND THE TRAINING AND DEMONSTRATED SKILLS PROVIDED THROUGH THE PROGRAM.ONCE TRAINED, STUDENT HEALTH COACHES PROVIDE IN-HOME VISITS AND PHONE INTERACTIONS. STUDENTS ENGAGE IN THE PROCESS OF EDUCATING AND MOTIVATING AT-RI true San Antonio Hospital Foundation Inc 999 San Bernardino Road Upland CA 91786 330042666 501(C)(3) 87500 Program support American Cancer Society 6355 Riverside Avenue Riverside CA 92506 941170350 501(c)(3) 20000 Program support Meals on Wheels 4792 Falconview Court Fontana CA 92336 952799275 501(c)(3) 54686 Cost Meals provided Program support American Heart Association PO Box 50085 Prescott AZ 86304 135613797 501(c)(3) 10000 Program support 4 Supplemental Information The volunteers and medical staff of San Antonio Regional Hospital (SARH) raise funds to support the hospital. Those funds are donated annually to the San Antonio Hospital Foundation (SAHF), a related 501(c)(3) organization. SARH's CFO is also CFO for SAHF; he is responsible for monitoring all SAHF disbursements. Other organizations are selected to receive cash donations due to their commitment each offers to furthering population health. These organizations have demonstrated continuous dedication to serving residents in SARH's service area, with specific focus on the prevention of chronic disease, prevention of terminal disease and upstream approaches to health improvement. SARH has maintained ongoing, supportive relationships with each organization. X true true X X X X X false true false false false false false false false Wah-Chung Hsu Vice President/CFO 404150 0 0 0 24385 0 48069 0 35851 0 512455 0 22579 0 Harris Koenig 119-919 President/CEO 697999 0 0 0 99751 0 7000 0 30721 0 835471 0 38648 0 John Chapman 919-1219 President/CEO, Interim, COO 352385 0 0 0 966 0 35960 0 35851 0 425162 0 0 0 Gudrun Moll VP/Chief Nursing Officer 311873 0 0 0 42569 0 37896 0 31222 0 423560 0 40763 0 Cathy Rebman VP Busin Devel & Comm Outreach 211559 0 0 0 6012 0 108553 0 31222 0 357346 0 3240 0 Michael Tracey President-Foundation 250299 0 0 0 11347 0 30114 0 31222 0 322982 0 5988 0 Saurabh Ashier Manager Cardiovascular Serv 253664 0 0 0 270 0 5555 0 12313 0 271802 0 0 0 Kamal Pandya VP/Chief Information Offier 243840 0 0 0 1856 0 113642 0 25994 0 385332 0 0 0 La Donna Najieb Chief Human Resources officer 277457 0 20000 0 630 0 35873 0 35851 0 369811 0 0 0 Ronald Nowosad Director/Chronic Care Program 191933 0 0 0 1183 0 5038 0 17659 0 215813 0 0 0 Schedule J, Part I, Line 1a SARH REQUESTS BOARD MEMBERS TO ATTEND VARIOUS EDUCATIONAL SESSIONS DURING THEIR TERM. IN RECOGNITION THAT BOARD MEMBERS SERVE WITHOUT COMPENSATION AND THAT ATTENDING EDUCATIONAL SESSIONS TAKES MOST BOARD MEMBERS AWAY FROM THEIR JOBS OR BUSINESSES, SARH PROVIDES REIMBURSEMENT FOR SPOUSAL TRAVEL. SARH ALSO GROSSES UP THE SPOUSAL TRAVEL REIMBURSEMENT AND REPORTS THE GROSSED UP AMOUNT ON A 1099 GIVEN TO THE BOARD MEMBER. Schedule J, Part I, Line 4 SARH PROVIDES A 457(F) SUPPLEMENTAL NON-QUALIFIED PLAN FOR ITS EXECUTIVE MANAGEMENT TEAM. IN CONJUNCTION WITH THE 457(B) PLAN, EACH EXECUTIVE ACCRUES 10% OF THEIR BASE PAY ANNUALLY. THE CEO ACCRUED 12% OF HIS BASE PAY. HOSPITAL CONTRIBUTIONS ARE NOT VESTED UNTIL DECEMBER 31 OF THE EXECUTIVE'S THIRD CALENDAR YEAR OF EMPLOYMENT. AFTER INITIAL ELIGIBILITY, EACH YEAR'S CONTRIBUTION WILL VEST ON DECEMBER 31 OF EACH CALENDAR YEAR. FIVE MEMBERS OF THE EXECUTIVE MANAGEMENT GROUP RECEIVED PAYMENTS AND THESE AMOUNTS ARE SHOWN ON SCH J, PART II. Schedule J, Part II EMPLOYEES HIRED PRIOR TO DECEMBER 31, 2005 ARE PARTICIPANTS IN THE HOSPITAL'S DEFINED BENEFIT PENSION PLAN. THE AMOUNT IN COLUMN C INCLUDES THE ESTIMATED INCREASE IN ACTUARIAL VALUE FOR THOSE EMPLOYEES WHO ARE PLAN PARTICIPANTS. A CITY OF UPLAND 956000805 915346GB0 2017-12-21 147137583 See attached statement false false false B CITY OF UPLAND 956000805 915536FH8 2011-01-27 122414361 See attached statement false false false A 0 0 147137583 0 0 120410119 1727464 0 0 0 12547748 12452252 false true false true B 0 0 122414361 0 0 0 1865015 0 0 108139982 12409364 0 2015 true false true true A false false false false 0 false false false false B false false false false 0 false false false false A false false false true false false 0 false 0 false false B false false false true false false 0 false 0 false false A false B false Part I CITY OF UPLAND 1/27/2011 $122,414,361 - THE PROCEEDS WERE USED FOR THE CONSTRUCTION OF A 4-STORY PATIENT CARE TOWER, AN ENERGY PLANT AND RELATED SITE UTILITIES AND TO REFUND THE TAX EXEMPT BONDS ISSUED SEPTEMBER 1, 1993. CITY OF UPLAND 12/21/2017 $147,137,583 - THE PROCEEDS OF THE 2017 CERTIFICATES WILL BE APPLIED TO (A) REFINANCE A PORTION OF THE SERIES 2011 CERTIFICATES, (B) FINANCE THE ACQUISITION OF CERTAIN LAND ADJACENT TO THE HOSPITAL'S CAMPUS, (C) FINANCE, REFINANCE OR REIMBURSE A PORTION OF THE COSTS ASSOCIATED WITH THE SITE PREPARATION, CONSTRUCTION, FIT OUT, FURNISHING & EQUIPPING OF THE PROPOSED CITY OF HOPE BUILDING, (D) FINANCE, REFINANCING OR REIMBURSE A PORTION OF THE COSTS ASSOCIATED WITH THE CONSTRUCTION, RENOVATION, IMPROVEMENT, EQUIPPING AND FURNISHING OF OTHER OF THE HEALTH FACILITIES AS CONTEMPLATED IN THE FACILITIES MASTER PLAN, (E) FINANCE, REFINANCE OR REIMBURSE CERTAIN ROUTINE CAPITAL EXPENDITURES OF SARH AND (F) TO FINANCE THE COSTS OF DELIVERY ASSOCIATED WITH THE CERTIFICATES. Part V San Antonio Regional Hospital is in the process of developing post-issuance procedures. Part IV SAN ANTONIO REGIONAL HOSPITAL HAD AN INTERIM ARBITRAGE ANALYSIS PERFORMED FOR THE COMPUTATION PERIOD ENDED DECEMBER 21, 2018. Part VI, Section B, Line 11b THE FORM IS PREPARED BY THE FINANCE DEPARTMENT AND REVIEWED BY THE CFO AND EXTERNAL TAX ACCOUNTANTS. FOLLOWING THE EXTERNAL REVIEW, THE CFO REVIEWS THE FORM WITH THE CEO. THE FORM IS PROVIDED AND PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW AND APPROVAL. ONCE THE AUDIT COMMITTEE APPROVES THE FORM, A DRAFT IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. Part VI, Section B, Line 12C SARH HAS A COMPLIANCE OFFICER WHO REVIEWS THE ORGANIZATION'S COMPLIANCE POLICIES, INCLUDING ITS CONFLICT OF INTEREST STATEMENTS, AT LEAST ANNUALLY. EACH JANUARY, A CONFLICT OF INTEREST STATEMENT IS COMPLETED AND SIGNED BY EACH MEMBER OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. THE COMPLIANCE OFFICER AND CFO, WHO ATTEND ALL BOARD MEETINGS, REVIEW THE CONFLICT OF INTEREST STATEMENTS. IF A NEW POTENTIAL CONFLICT ARISES DURING THE YEAR, A NEW CONFLICT OF INTEREST STATEMENT IS SIGNED. IF A POTENTIAL CONFLICT OF INTEREST EXISTS DURING A BOARD DISCUSSION, THE BOARD MEMBER IS REQUIRED TO STATE THE CONFLICT AND ABSTAIN FROM ANY RELATED BOARD VOTE. BOARD MINUTES REFLECT THESE ABSTENTIONS. AT LEAST SEMI-ANNUALLY, SARH'S COMPLIANCE OFFICER PROVIDES A VERBAL COMPLIANCE UPDATE AT A BOARD MEETING AND REMINDS BOARD MEMBERS OF THEIR DUTY TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. Part VI, Section B, Line 15 SARH'S EXECUTIVE COMPENSATION PROGRAM IS DIRECTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. SARH HAS DEVELOPED AND APPROVED A FORMAL EXECUTIVE COMPENSATION POLICY THAT CURRENTLY COVERS SIX SENIOR MANAGEMENT EMPLOYEES, INCLUDING THE CEO AND CFO. A COMPREHENSIVE BASE PAY AND TOTAL EXECUTIVE COMPENSATION ANALYSIS IS PERFORMED BY AN OUTSIDE COMPENSATION CONSULTING FIRM EVERY TWO YEARS. IN THE INTERVENING YEARS, AN ANALYSIS OF SARH'S EXECUTIVE COMPENSATION IS REVIEWED AGAINST THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA'S COMPENSATION SURVEY. THE CONSULTANT PRESENTS THE SURVEY DATA AND ANALYSIS TO THE COMPENSATION COMMITTEE. THE EXTERNAL COMPENSATION STUDY INCLUDES AN EVALUATION FOR EXCESS BENEFIT TRANSACTIONS UNDER THE INTERMEDIATE SANCTIONS FOR TAX-EXEMPT ORGANIZATIONS AND AN ANALYSIS OF BOTH BASE AND TOTAL COMPENSATION OF ALL MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AND THEIR SALARY POSITION IN RELATION TO THE FIFTIETH AND SIXTY-FIFTH PERCENTILE OF THE MARKET. HOWEVER, THE CONSULTANT IS NOT EITHER TAX OR LEGAL COUNSEL AND THEREFORE CANNOT ASSURE COMPLIANCE WITH IRC 4958, BUT RATHER ASSURES THAT SARH'S EXECUTIVE COMPENSATION PRACTICES FALL BETWEEN THE FIFTIETH AND SIXTY-FIFTH PERCENTILE OF THE MARKET PLACE AND DO NOT EXCEED THE SEVENTY-FIFTH PERCENTILE. THE LATEST SURVEY AND ANALYSIS WERE CONDUCTED IN MARCH 2017. THE CONSULTANT USED SURVEY DATA FROM FOUR DIFFERENT PUBLISHED SURVEYS THAT INCLUDE CALIFORNIA HOSPITALS WITH COMPARABLE REVENUES, EMPLOYEES AND COMPLEXITY. THE COMPENSATION COMMITTEE REVIEWS THE CONSULTANT'S FINDINGS IN ACCORDANCE WITH THE COMPENSATION POLICY AND THEIR CHARTER AND PROVIDES DIRECTION FOR ANY NEEDED COMPENSATION POLICY OR PAY RANGE CHANGES FOR THE CEO AND APPROVES ANY SUCH RECOMMENDATIONS THAT MAY BE MADE BY THE CEO FOR OTHER EXECUTIVES. OTHER KEY EMPLOYEE COMPENSATION, VICE PRESIDENTS AND DEPARTMENT DIRECTORS ARE EVALUATED BASED ON MARKET-BASED COMPENSATION SURVEY DATA PROVIDED BY THE HOSPITAL COUNCIL OF SOUTHERN CALIFORNIA, TAKING INTO CONSIDERATION PAY RATES FOR SIMILAR MANAGEMENT POSITIONS. THE PROCEDURES DESCRIBED HERE ARE DOCUMENTED IN THE BOARD MINUTES. Part VI, Section C, Line 19 SARH HAS NOT MADE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE PART OF THE ANNUAL REPORT FILED WITH THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) AND ARE AVAILABLE ON THE OSHPD WEBSITE. THE FINANCIAL STATEMENTS ARE INCLUDED AS PART OF ITS ANNUAL MEDICARE AND MEDICAID COST REPORT FILINGS, WHICH ARE PUBLICLY AVAILABLE ON THE CMS (MEDICARE) WEBSITE. THE FINANCIAL STATEMENTS ARE ALSO PROVIDED TO ANYONE UPON A VERBAL OR WRITTEN REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 IN ACCORDANCE WITH IRS INSTRUCTIONS. Part XI, Line 9 OTHER CHANGES IN NET ASSETS INCLUDES THE CHANGE IN THE ADDITIONAL MINIMUM PENSION LIABILITY OF $3,362,943, CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF $2,528,840 AND CHANGE IN BENEFICIAL INTEREST IN SAN ANTONIO HOSPITAL FOUNDATION OF $6,900,298. Eastvale San Antonio Land Company LLC 999 San Bernardino Road Upland CA 91786 460783265 Lessor - Land CA 84953 4176815 SARH San Antonio Hospital Foundation Inc 999 San Bernardino Road Upland CA 91786 330042666 Support SARH CA 501c(3) 7 SARH true San Antonio Community Health Care Plan 999 San Bernardino Road Upland CA 91786 237391094 Health Plan CA 501(C)(9) SARH true Cucamonga Health Services Inc 999 San Bernardino Road Upland CA 91786 330010073 Holding company CA SARH C corp 49739 417105 1.00000 true FMP Holding Inc 999 San Bernardino Road Upland CA 91786 815066476 Holding company CA SARH C Corp -36522 -94565 1.00000 true false true true false false false false false true false false false true true false true true false San Antonio Hospital Foundation Inc b 87500 Cash San Antonio Community Health Care Plan r 16645145 Cash San Antonio Hospital Foundation Inc c 575131 Cash Cucamonga Health Services j 103016 Cash