2019-11-11T07:02:51-06:00 2018-12-31 450250958 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2018-01-01 952082686 Ridgecrest Regional Hospital RIDG 7604463551 1081 N China Lake Blvd Ridgecrest CA 93555 James Suver CEO 7604463551 2019-11-08 1 Kim C Hunwardsen P00484560 6122536500 2019-11-08 216.147.181.48 2019-11-08 10:11:38 MS P 51153E6FE133A46BE9F60C7A8748BC609ADBB28A A9F393D044C6B02927C29CDABEE7CBE310A8D2B0 2018 2020-04-17 16:48:07Z James Suver 1081 N China Lake Blvd Ridgecrest CA 93555 126478037 0 X www.rrh.org X 1965 CA Community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 11 8 919 60 233036 -4058 346765 346852 122564950 125384690 335574 449923 252140 263094 123499429 126444559 0 7115 0 0 52816684 53879355 0 0 0 67492815 68639559 120309499 122526029 3189930 3918530 157317640 166917629 77600139 77838557 79717501 89079072 X To be a community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 1 0 99707926 7115 125384690 Ridgecrest Regional Hospital provides inpatient and outpatient care. Charity care is provided to qualified patients with minimum or no charge. Care accomplishments for the year are as follows:Number of Visits 62,671Number of Patient Days 6,052Home Health Visits 4,446Hospice Routine Care Days 2,963SNF Resident Days 23,717Rural Health Visits 62,440Community Care Clinic Visits 34,585 99707926 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 212 0 1 919 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 11 8 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X Kanner Tillman 7604993040 1081 North China Lake Blvd Ridgecrest CA 93555 George Haslam Chairperson 1.20 0.00 X X 0 0 0 Patricia Mullis Vice Chair 1.20 0.00 X X 0 0 0 Chris Ellis Secretary 1.20 0.00 X X 0 0 0 Don Zdeba Treasurer 1.20 0.00 X X 0 0 0 Dana Lyons Director (Jun-Dec) 1.20 0.00 X 0 0 0 Chris Ellis Director (Jan-May) 1.20 0.00 X 0 0 0 Harriet Luzinas-Smith Director (Jan-May) 1.20 0.10 X 25446 0 596 Lawrence Cosner MD Director/Physician 40.00 0.00 X 220900 0 31465 Walter Martin Director 1.20 0.00 X 0 0 0 Cornelis Vanderhoek MD Director/Physician 40.00 0.00 X 45600 0 0 Margaret Hannon Director 1.20 0.00 X 0 0 0 Anita Read Director 1.20 0.10 X 0 0 0 Paige Sorbo-Netzer Director 1.20 0.00 X 0 0 0 Dave Goppelt Director (Jun-Dec) 1.20 0.00 X 0 0 0 James Suver CEO 50.00 2.00 X 506346 0 23491 John Chivers CFO 50.00 0.00 X 272494 0 27794 Healthy Desai Physician 40.00 0.00 X 651521 0 47984 Luigi Cendana Physician 40.00 0.00 X 357263 0 17189 Hope Zissos Physician 40.00 0.00 X 260972 0 50004 Aisha Rollins Physician 40.00 0.00 X 258060 0 19590 Brenda Diel Administrator of Quality 50.00 0.00 X 205595 0 34418 2804197 0 252531 88 0 1 0 James E Thompson dba JTS Construction PO Box 41765 Bakersfield CA 93384 Construction 2578708 CHG Companies Inc PO Box 972651 Dallas TX 75397 Medical 1368244 Medical Referral Network International d 72-877 Dinah Shore Dr Ste 103 2 Rancho Mirage CA 92270 Medical 728330 Ghassan A Mohsen 400 Montefino Dr Ridgecrest CA 93555 Medical 724384 Ali R Lashgari MD A Prof Med Corp 4741 Keswick Ct San Diego CA 92130 Medical 632004 64 56619 290233 346852 Net Patient Service Rev 622000 122827278 122827278 Pharmacy Revenue 446110 1400245 1167209 233036 EHR Revenue 622000 655280 655280 501887 501887 125384690 454816 454816 291479 28385 263094 263094 263094 200 5093 -4893 -4893 -4893 126444559 125151654 233036 713017 X 7115 7115 1145212 324126 821086 59483 59483 41149187 33117347 8031840 923825 726699 197126 6214550 4887357 1327193 4387098 3435605 951493 553565 33755 519810 109742 109742 29780570 26121930 3658640 4218270 3746752 471518 2066063 1753455 312608 450176 276207 173969 242765 101121 141644 2343031 2142586 200445 7241283 5983592 1257691 2137641 760807 1376834 Medical Supplies 8526670 8526670 Repair and Maintenance 4056629 2156988 1899641 Provision for Bad Debts 2237007 2237007 Pharmacy Expenses 991377 991377 3684770 2317947 1366823 122526029 99707926 22818103 0 12167733 20465260 20772256 20285913 3150 10696 9087 2316090 2159842 4540505 4302715 162289764 78395495 84934058 83894269 32493947 33339486 79205 2461057 157317640 166917629 13212847 15768721 21167 22567 12600 30208 60099411 57184397 4254114 4832664 77600139 77838557 X 79717501 89079072 79717501 89079072 157317640 166917629 X 3918530 8637 5434404 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5865 5865 0 Part II-B, Line 1: Lobbying portion of Hospital Association dues. 0 1 X 3212289 3212289 112867634 47400164 65467470 39024777 30465983 8558794 7185064 529348 6655716 83894269 Estimated Third Party Payor Settlements 4393303 Malpractice Insurance Payable 439361 4832664 X 123246082 8637 -3235499 -3226862 126472944 -28385 -28385 126444559 119318915 28385 28385 119290530 3235499 3235499 122526029 Part IV, Line 2b: Skilled nursing facility resident private monies maintained as a drawing account as required by Title 22 of the California Code of Regulations. Part X, Line 2: The Hospital is organized as a California nonprofit corporation and has been recognized by the Interal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital will file an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS for its retail pharmacy. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Included in Expenses on Form 990 -2,237,007. Pharmacy Expenses Reported in Expenses on Form 990 -991,377. Grant Expense Reported in Expense on Form 990 -7,115. Part XI, Line 4b - Other Adjustments: Rental Expenses Included in Expenses for Financials -28,385. Part XII, Line 2d - Other Adjustments: Rental Expenses Included in Revenue on Form 990 28,385. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Included in Revenue in Financials 2,237,007. Pharmacy Expenses Reported in Revenue for Financials 991,377. Grant Expense Reported in Revenue for Financials 7,115. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 91000 91000 0.00080 6215053 5209140 1005913 0.00840 6306053 5209140 1096913 0.00920 221309 70281 151028 0.00130 4715 4715 0.00000 2328797 1006160 1322637 0.01100 19000 19000 0.00020 2573821 1076441 1497380 0.01250 8879874 6285581 2594293 0.02170 5500 5500 0.00000 46141 46141 0.00040 16324 16324 0.00010 86 86 0.00000 1896 1896 0.00000 14497 14497 0.00010 231462 231462 0.00190 7649 7649 0.00010 323555 323555 0.00260 1 2237007 0 26159342 26721562 -562220 X 1 1 1 1 Ridgecrest Regional Hospital 1081 N China Lake Blvd Ridgecrest CA 93555 www.rrh.org 120000186 X X X X Ridgecrest Regional Hospital 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X See Section C, Line 7d X X 1 16 1 See Section C, Line 7d 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X 1 X 0 X X X X 1 X 0 0 Ridgecrest Regional Hospital Part V, Section B, Line 5: Input from the community was gathered through online and telephone interviews in March 2016. Individuals consulted consisted of 2 physicians, a psychologist, a public health nurse, other healthcare professionals, and a director of community outreach Ridgecrest Regional Hospital Part V, Section B, Line 7d: CHNA and Implementation Strategy:https://www.rrh.org/about-us/community-benefit/community-health-needs-assessment-survey/ Ridgecrest Regional Hospital Part V, Section B, Line 11: The Hospital addressed needs identified in the 2016 CHNA in 2016, 2017, and 2018. The following needs have been identified and will be addressed as follows:1) Substance & Alcohol Abuse: provided assistance with opening a Mental Health Crisis Stabilization Unit in October 2017, which has the capability to take patients in crisis for a 23 hour period with onsite psychiatric nurses and a telepsychiatrist2) Cancer: Affiliation with UC Davis Cancer Center; New oncology, including chemotherapy, services in Outpatient Pavilion and cancer clinic opened November 2017; Recruitment of onsite oncologist3) Mental Health: provided assistance with opening a Mental Health Crisis Stabilization Unit in October 2017, which has the capability to take patients in crisis for a 23 hour period with onsite psychiatric nurses and a telepsychiatrist; Continued Recruitment of onsite psychiatrist including pediatric psychiatry4) Heart Disease: Onsite non-invasive cardiologist - started in 20165) Obesity & Nutrition: Senior exercise classes; Silver Sneakers; Chair Yoga; Diabetes classes; Healthy Eating classes6) Senior Health Services Including Dementia - expanded senior services in 2016 and 2017 with additional off-site location7) Women's Health Services - added three OB/GYN physicians (one in 2016, one in 2017, and one in 2018)8) Access to Specialists: Continued recruitment efforts in the areas of mental health, dentistry, podiatry, and pediatrics, including the additions of a podiatrist and a dentist in 2017 and a pediatrician in 20189) Medical Provider Recruitment: Recruited four physicians in 2016, four physicians in 2017, and three physicians in 2018 - encompassing the fields of pediatrics, OB/GYN, cardiology, family practice, dentistry, and podiatry10) Services for Low Income/Medi-Cal: Expanded pediatric, OB/GYN, and dental services offered to low-income and Medi-Cal patients, including the addition of one pediatrician and one dentist in 2017 and one pediatrician and one OB/GYN physician in 201811) Asthma/Respiratory Disease: RRH offers a Better Breathers Club that provides support and information for those with lung disease, including COPD, asthma, lung cancer, and fibrosis12) Smoking/Tobacco Use: RRH offers the Freedom From Smoking program, an 8-week smoking cessation class for adults to overcome tobacco addiction Ridgecrest Regional Hospital Part V, Section B, Line 13h: Uninsured, self-pay patients with incomes at or below 300% of the federal poverty level are offered free care. Insured patients with high medical costs (annual expenses exceed 10% of income) and incomes at or below 300% of the federal poverty level are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Ridgecrest Regional Hospital Part V, Section B, Line 16j: In addition to financial packets being provided to each self-pay patient in is also provided in the following methods: a website reference to the policy, an onsite financial counselor made available to patients, and posting of the policy in all patient access areas. Schedule H, Part V, Line 16a-c: Financial assistance policy:https://www.rrh.org/documents/Financial-Assistance-Program-Policy-V7.12865_1).pdfFinancial assistance application:https://www.rrh.org/documents/Financial-Assistance-Application.pdfPlain language summary:https://www.rrh.org/documents/Financial-Assistance-Plain-Language-Summary.pdf 18 1 - Bella Serra Skilled Nursing Facility 1131 N China Lake Blvd Ridgecrest CA 935553131 Skilled Nursing Facility 2 - Ridgecrest Regional Hospital Rural Healt 1111 N China Lake Blvd Ridgecrest CA 93555 Rural Health Clinic 3 - China Lake Community Care Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Community Care Clinic 4 - Ridgecrest Regional Hospital Urgent Care 1111 N China Lake Blvd Ridgecrest CA 93555 Urgent Care 5 - Center Professional Pharmacy 1109 N China Lake Blvd Ridgecrest CA 93555 Center Professional Pharmacy 6 - RRH Cancer Center 1011 N China Lake Blvd Ridgecrest CA 93555 Cancer Center 7 - Stemmer Clinic 900 Heritage Dr Suite A Ridgecrest CA 93555 Stemmer Clinic 8 - Ridgecrest Regional Hospital Home Health 1653 N Triangle Dr Ridgecrest CA 93555 Home Health 9 - China Lake Surgical Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Surgical Clinic 10 - Ridgecrest Regional Hospital Orthopedic 1041 N China Lake Blvd Ridgecrest CA 93555 Orthopedic Clinic 11 - China Lake Dermatology 1011 N China Lake Blvd Ridgecrest CA 93555 Dermatology Clinic 12 - Ridgecrest Regional Hospital Hospice 1653 N Triangle Dr Ridgecrest CA 93555 Hospice 13 - Ridgecrest Regionl Hosp Internist Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Internist Clinic 14 - China Lake Gastroenterology 1011 N China Lake Blvd Ridgecrest CA 93555 Gastroenterology Clinic 15 - Ridgecrest Regional Hosp Living Assist 1653 N Triangle Dr Ridgecrest CA 93555 Living Assistance Program 16 - Ridgecrest Regional Hosp Occup Health 409 Drummond Ave Ridgecrest CA 93555 Occupational Health 17 - Ridgecrest Regional Hosp Senior Services 417 Drummond Ave Ridgecrest CA 93555 Senior Services 18 - Trona Rural Health Clinic 82820 Trona Rd Trona CA 93562 Rural Health Clinic Part I, Line 3c: Uninsured, self-pay patients with incomes at or below 300% of federal poverty level are offered free care. Insured patients with high medical costs (annual expenses exceed 10% of income) and incomes at or below 300% of the federal poverty level are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Part I, Line 7: Lines 7a, 7b, 7g were converted to cost based on an average ratio of costs to gross charges according to costs allocated to the relevant costs centers on the Medicare Cost Report.Lines 7e, 7f, and 7i were based on actual expenses. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 2,237,007. Part II, Community Building Activities: Activities include: Provide free office space for health and economic-development organizations within the community, community collaboration through community health improvement advocacy, physician recruitment to ensure basic care is available locally, sponsor annual health fair with free and low cost health screening, collaborate with other emergency services on disaster and emergency preparedness, provide wellness fairs for the Navy Base and Water District, and donate funds to reopen the aquatic center, as well as helmets for the local police department. Part III, Line 2: Patient A/R consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages its receivables by regularly reviewing the accounts, inquiring with respective payors as to collectability and providing for allowances on their accounting records for estimated contractual adjustments and uncollectible accounts. Bad debt is reported at charges per the audited financials. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in footnote 1 on page 8 and 9 of the attached financial statements. Part III, Line 8: One hundred percent of any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole.Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increase their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: RRH will make reasonable efforts to provide patients with information about its financial assistance policy before it or its agency representatives take extraordinary actions to collect a patient's bill. RRH shall not knowingly assign an account to a collection agency if the patient has a pending application for a County, State, or Federal health assistance program. For a patient who lacks insurance coverage or a patient who provides information that he or she may be a patient with high medical costs, neither RRH, nor any assignee of the hospital or other owner of the patient debt, including a collection agency, shall report adverse information to a credit reporting bureau or engage in extraordinary debt collection activities at any time prior to 150 days after the first billing, and only after providing a thirty-day notice of the extraordinary debt collection activities that will be commenced. Part VI, Line 2: In addition to the community health needs assessment Ridgecrest uses patient satisfaction surveys to assess the health care needs of the community, along with conducting blood draws at health fairs. The HR administrator serves on the local Rotary as well to network with other community leaders. Part VI, Line 3: Signs are posted in registration areas informing patients of assistance with their bills and includes citing a phone number to call for assistance in this area. Self pay patients are sent a packet of information regarding financial assistance programs. Part VI, Line 4: Rural California Desert Community located in Kern County; more than 50 miles from next nearest hospital. The population is approximately 38,000 and approximately 6.8% of that population is uninsured. Part VI, Line 5: Ridgecrest Regional Hospital's governing body is comprised of persons who reside in the Organization's primary service area. The Hospital applies any surplus funds to improve the Facility and equipment to improve patient care. The Hospital also extends medical staff privileges to other qualified physicians in the community.Ridgecrest Regional Hospital holds an annual health fair for the community, wherein vendors offer information and services related to health and wellness, along with free and reduced-priced blood screenings. A health fair at China Lake Naval Base is also held, wherein information on health and nutrition are provided. Ridgecrest Regional Hospital offers veteran benefit information for Veteran's Standdown, an event held to provide benefits and services to veterans. Ridgecrest Regional Hospital offers 16 weekly classes to seniors within the community, free of charge, that promote exercise, as well as senior group services catered to finding joy and happiness in life while socializing and building support systems. Ridgecrest Regional Hospital also offers 6 Rock Steady Boxing exercise classes per week for those with Parkinson's Disease, free of charge. Ridgecrest Regional Hospital offers the Diabetes Education Empowerment Program TM workshops four times a year. The following support groups are offered free of charge to the community: Grief, Caregiver, Alzheimer's Caregiver, Better Breathers, and Diabetes. The Wellness Resource Center provides free access to information on health and nutrition, including videos and books. In addition, the Wellness Resource Center provides nutrition programs, cooking classes and presentations to schools, churches, businesses, parents, and other organizations. Hospital tours are provided to students and other groups within the community. An annual publication, mailed to all homes within the community and available at Ridgecrest Regional Hospital, lists all services and providers at Ridgecrest Regional Hospital. A brochure provides information for local mental health services. Connected, a quarterly publication, focuses on Ridgecrest Regional Hospital's services, along with health tips and information. Part VI, Line 6: N/A 1 RRH Development Foundation 1081 N China Lake Blvd Ridgecrest CA 93555 464181603 501(c)(3) 7115 General Operating 1 0 Part I, Line 2: Ridgecrest Regional Hospital has two board members that overlap with the RRH Development Foundation board, a related organization. The RRH Development Foundation is formed to support Ridgecrest Regional Hospital. X X X 0 0 0 0 0 0 0 0 0 Lawrence Cosner MD Director/Physician 219019 0 1300 0 581 0 0 0 31525 0 252425 0 0 0 James Suver CEO 315771 0 176949 0 13626 0 11000 0 12551 0 529897 0 0 0 John Chivers CFO 224558 0 38000 0 9936 0 2168 0 25686 0 300348 0 0 0 Healthy Desai Physician 651429 0 0 0 92 0 11000 0 37044 0 699565 0 0 0 Luigi Cendana Physician 306911 0 50275 0 77 0 7280 0 9970 0 374513 0 0 0 Hope Zissos Physician 260748 0 0 0 224 0 10920 0 39144 0 311036 0 0 0 Aisha Rollins Physician 257970 0 0 0 90 0 7581 0 12069 0 277710 0 0 0 Brenda Diel Administrator of Quality 177535 0 9843 0 18217 0 0 0 34478 0 240073 0 0 0 Kathryn Cosner Family of Board Member Lawrence Cosner 59483 Wages 0 Form 990, Part III, line 2 A mobile rural health clinic was established and related services began on 08/07/18. The OB clinic began providing services as a rural health OB clinic in 2018. Form 990, Part VI, Section A, line 6 There is one class of members, Corporate Members and an honorary nonvoting group of individuals called Emeritus Members who are appointed by the Board of Directors and have limited rights. Corporate Membership is limited to thirty (30) persons, who must reside in the Hospital service area (as such service area is determined by the Board of Directors) who are elected to membership by a vote of the Corporate Members present or represented at a meeting of Corporate Members. Form 990, Part VI, Section A, line 7a The Corporate Members have the right to elect the members of the Board of Directors. Form 990, Part VI, Section A, line 7b Under the bylaws, the Corporate Members have the right to: elect the members of the Board of Directors; fill a vacancy on the Board of Directors; and ratify the bylaws that have been approved by the Board of Directors. In addition, members have certain rights granted pursuant to the California Nonprofit Public Benefit Corporation Act including the right to: remove a director; approve most amendments to the Articles of Incorporation; approve a sale of assets not in the usual and regular course of its business; merge with another entity; and dissolve. Form 990, Part VI, Section A, line 8b The organization does not have any committee with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the Board of Directors via electronic distribution prior to filing with the IRS. Form 990, Part VI, Section B, line 12c There is annual disclosure on conflict of interest policy for directors, officers, medical staff officers, and administrative employees, and corporate members. Compliance with conflict of interest policy is monitored by the CEO. Any noted conflicts are reviewed and discussed by the Board of Directors. The individual with the potential conflict must abstain from the discussion and vote on the potential conflict. Form 990, Part VI, Section B, line 15 Compensation for the CEO was determined by a compensation committee of the Board of Directors using compensation comparison provided by HASC. For other officers, the HASC salary survey is used to comply with prohibition from direct solicitation of salary information due to anti-trust regulations. Form 990, Part VI, Section C, line 19 All public documents are made available upon request. Form 990, Part IX, line 11g Other Purchased Services: Program service expenses 9,613,033. Management and general expenses 3,161,964. Fundraising expenses 0. Total expenses 12,774,997. Professional Fees: Program service expenses 15,816,119. Management and general expenses 3,600. Fundraising expenses 0. Total expenses 15,819,719. Other Fees: Program service expenses 692,778. Management and general expenses 493,076. Fundraising expenses 0. Total expenses 1,185,854. Form 990, Part XI, line 9: Restatement of 2017 Net Assets due to supplemental Hospital Quality Assurance Fees recorded in 2018 that were related to 2017 5,434,404. RRH Development Foundation 1081 N China Lake Blvd Ridgecrest CA 93555 464181603 Raising Hospital Capital Equipment Funds CA 501(c)(3) Line 7 Ridgecrest Regional Hospital 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0