SUTTER HEALTH PACIFIC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: SUTTER HEALTH PACIFIC (EIN 99-0298651)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-09
IRS object ID: 201743139349303834
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-09T17:45:33-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4370 LA JOLLA VILLAGE DR STE 500	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92122	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	990298651	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	QUIN OGAWA	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2017-10-27	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DEBRA HEISKALA	PreparerPersonNm
PTIN	P00649485	PTIN
Phone	8585357200	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	KAHI MOHALA	BusinessNameLine1Txt

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$20,275,763	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SUTTERHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1992	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	302	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$47,263	PYContributionsGrantsAmt
CY Contributions Grants	$86,256	CYContributionsGrantsAmt
PY Program Service Revenue	$23,410,491	PYProgramServiceRevenueAmt
CY Program Service Revenue	$20,182,422	CYProgramServiceRevenueAmt
PY Investment Income	$10,941	PYInvestmentIncomeAmt
CY Investment Income	$7,085	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$23,468,695	PYTotalRevenueAmt
CY Total Revenue	$20,275,763	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$16,025,345	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$15,544,037	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$25,382	CYTotalFundraisingExpenseAmt
PY Other Expenses	$5,372,222	PYOtherExpensesAmt
CY Other Expenses	$5,401,536	CYOtherExpensesAmt
PY Total Expenses	$21,397,567	PYTotalExpensesAmt
CY Total Expenses	$20,945,573	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,071,128	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$669,810	CYRevenuesLessExpensesAmt
Total Assets BOY	$14,241,629	TotalAssetsBOYAmt
Total Assets EOY	$10,285,815	TotalAssetsEOYAmt
Total Liabilities BOY	$1,893,625	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$3,904,526	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$12,348,004	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$6,381,289	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$18,478,964	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$20,182,422	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$18,478,964	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	18	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	302	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	QUIN OGAWA CFO	PersonNm
Phone	8086772580	PhoneNum

US Address USAddress

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

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

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
J KUHIO ASAM MD
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
DIANNE BROOKINS
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
STEVEN CHAPLIN MD
MEDICAL DIRECTOR	40.0	0.0	Yes (X)	$486,807	$0	$20,794
JAMES E CONFORTI
PRESIDENT, SH PACIFIC	1.0	40.0	Yes (X)	$0	$1,164,596	$400,858	Yes (X)
PATRICK DUARTE
TRUSTEE/CHAIR	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
LEONARD LICINA
CEO SUTTER HEALTH PACIFIC	40.0	0.0	Yes (X)	$0	$275,700	$48,052
DEE JAY MAILER
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
CAMERON NEKOTA
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
GIDGET RUSCETTA
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
CHUCK STED
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
DIANE STEWART
TRUSTEE/VICE CHAIR OF FINANCE	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
ROSE CHOY
CFO SH PACIFIC (PART YEAR)	40.0	0.0		$0	$98,397	$2,900	Yes (X)
QUIN OGAWA
CFO SH PACIFIC (PART YEAR)	40.0	0.0		$158,008	$0	$23,019	Yes (X)
PENNY WESTFALL
SEC, VP & CHIEF COUNSEL, SVH	1.0	40.0		$0	$565,926	$106,796	Yes (X)
KENNETH DELANO
DIRECTOR HEALING FORCES	40.0	0.0		$193,378	$0	$24,479		Yes (X)
CHRISTINA ENOKA
DIRECTOR HUMAN RESOURCES	40.0	0.0		$150,790	$0	$14,504		Yes (X)
MICHELLE FERNANDEZ
RN MANAGER	40.0	0.0		$122,819	$0	$16,388		Yes (X)
GREGORY PRIER MD
CHIEF OF STAFF	40.0	0.0		$315,172	$0	$18,211		Yes (X)
CHARLES ST LOUIS JR
DIRECTOR NURSING	40.0	0.0		$158,987	$0	$9,624		Yes (X)
SARAH KREVANS
PRESIDENT & CEO, SUTTER HEALTH	0.0	40.0		$0	$2,365,948	$1,511,150			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,585,961	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,470,567	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,196,775	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	19	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Field	Value	IRS element (for citing)
Person	ELENA SHARIPOVA MD	PersonNm

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 860868	AddressLine1Txt
City	WAHIAWA	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96786	ZIPCd

Field	Value	IRS element (for citing)
Services	PSYCHIATRY SERVICES	ServicesDesc
Compensation	$131,188	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$1,957	FederatedCampaignsAmt
Related Organizations	$7,500	RelatedOrganizationsAmt
Government Grants	$3,978	GovernmentGrantsAmt
All Other Contributions	$72,821	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$86,256	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT SERVICE REVENUE	Desc
Business	623990	BusinessCd
Total Revenue Column	$20,182,422	TotalRevenueColumnAmt
Related Or Exempt Func Income	$20,182,422	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$20,182,422	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,085	TotalRevenueColumnAmt
Exclusion	$7,085	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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

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

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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

Net Income Or Loss NetIncomeOrLossGrp

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

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

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$20,275,763	TotalRevenueColumnAmt
Related Or Exempt Func Income	$20,182,422	RelatedOrExemptFuncIncomeAmt
Exclusion	$7,085	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

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

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$892,387	TotalAmt
Program Services	$439,863	ProgramServicesAmt
Management And General	$452,524	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,272,566	TotalAmt
Program Services	$9,589,474	ProgramServicesAmt
Management And General	$683,092	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$338,536	TotalAmt
Program Services	$315,530	ProgramServicesAmt
Management And General	$23,006	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,136,302	TotalAmt
Program Services	$2,647,235	ProgramServicesAmt
Management And General	$489,067	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$904,246	TotalAmt
Program Services	$821,676	ProgramServicesAmt
Management And General	$82,570	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$27,655	TotalAmt
Program Services	$27,655	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$3,981	TotalAmt
Management And General	$3,981	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$5,655	TotalAmt
Management And General	$5,655	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$383,251	TotalAmt
Program Services	$383,251	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$22,943	TotalAmt
Program Services	$22,943	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$378,130	TotalAmt
Program Services	$284,809	ProgramServicesAmt
Management And General	$93,321	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$76,079	TotalAmt
Program Services	$75,722	ProgramServicesAmt
Management And General	$357	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$806,926	TotalAmt
Program Services	$806,926	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$42,290	TotalAmt
Program Services	$6,859	ProgramServicesAmt
Management And General	$35,431	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$13,799	TotalAmt
Program Services	$12,226	ProgramServicesAmt
Management And General	$1,573	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$240,000	TotalAmt
Program Services	$240,000	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$626,016	TotalAmt
Program Services	$626,016	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$288,090	TotalAmt
Program Services	$288,090	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
PURCHASED SERVICES	$1,291,790	$1,124,057	$142,425	$25,308
FOOD	$387,232	$387,232
SYSTEM ALLOCATION	$354,847	$60,324	$294,523
MEDICAL SUPPLIES	$268,287	$268,287

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$184,565	TotalAmt
Program Services	$50,789	ProgramServicesAmt
Management And General	$133,702	ManagementAndGeneralAmt
Fundraising	$74	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,945,573	TotalAmt
Program Services	$18,478,964	ProgramServicesAmt
Management And General	$2,441,227	ManagementAndGeneralAmt
Fundraising	$25,382	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$681,007	BOYAmt
EOY	$1,656,928	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,770	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$7,780,012	BOYAmt
EOY	$3,148,229	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$14,821	BOYAmt
EOY	$15,928	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$528,888	BOYAmt
EOY	$535,695	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$14,545,354	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$9,616,319	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$5,062,332	BOYAmt
EOY	$4,929,035	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$171,799	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,241,629	BOYAmt
EOY	$10,285,815	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,263,230	BOYAmt
EOY	$1,337,647	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$630,395	BOYAmt
EOY	$2,566,879	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,893,625	BOYAmt
EOY	$3,904,526	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,237,062	BOYAmt
EOY	$6,212,742	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$110,942	BOYAmt
EOY	$168,547	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$12,348,004	BOYAmt
EOY	$6,381,289	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$14,241,629	BOYAmt
EOY	$10,285,815	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$669,810	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$1,143	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$5,295,762	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,480,989	OtherCostOrOtherBasisAmt
Depreciation	$7,411,244	DepreciationAmt
Book Value	$4,069,745	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,637,448	OtherCostOrOtherBasisAmt
Depreciation	$2,205,075	DepreciationAmt
Book Value	$432,373	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$426,917	OtherCostOrOtherBasisAmt
Book Value	$426,917	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,929,035	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
INSURANCE LIABILITIES	$642,492
OTHER LIABILITIES	$1,924,387

Field	Value	IRS element (for citing)
Total Liability	$2,566,879	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PART X, LINE 2	FormAndLineReferenceDesc
Explanation	ASC 740 (FIN 48) FOOTNOTE FROM AUDIT: THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE STATUTE OF LIMITATIONS FOR TAX YEARS 2013 THROUGH 2015 REMAIN OPEN IN U.S. TAX JURISDICTIONS IN WHICH SUTTER AND ITS AFFILIATES ARE SUBJECT TO TAXATION. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2016 AND 2015, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS.	ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,698	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,698	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,509,838	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,509,838	NetCommunityBenefitExpnsAmt
Total Expense	0.07210	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,519,536	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,519,536	NetCommunityBenefitExpnsAmt
Total Expense	0.07260	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$15,206	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,206	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	300	PersonsServedCnt
Total Community Benefit Expns	$153,641	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$153,641	NetCommunityBenefitExpnsAmt
Total Expense	0.00730	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	14	ActivitiesOrProgramsCnt
Persons Served	3705	PersonsServedCnt
Total Community Benefit Expns	$102,768	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$102,578	NetCommunityBenefitExpnsAmt
Total Expense	0.00490	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	4005	PersonsServedCnt
Total Community Benefit Expns	$271,615	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$271,425	NetCommunityBenefitExpnsAmt
Total Expense	0.01290	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	4005	PersonsServedCnt
Total Community Benefit Expns	$1,791,151	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,790,961	NetCommunityBenefitExpnsAmt
Total Expense	0.08550	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	7	PersonsServedCnt
Total Community Benefit Expns	$12,653	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,653	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,766	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,766	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$7,379	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,379	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	5	PersonsServedCnt
Total Community Benefit Expns	$34,853	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$34,853	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$306	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$306	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	14	ActivitiesOrProgramsCnt
Persons Served	12	PersonsServedCnt
Total Community Benefit Expns	$57,957	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$57,957	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$0	BadDebtExpenseAmt
Reimbursed By Medicare	$0	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,989	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$9,989	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

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

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE PART V, SECTION C	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	400.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	IN CONDUCTING ITS MOST RECENT CHNA, SUTTER HEALTH PACIFIC KAHI MOHALA DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. DEDICATED TO SERVING AND ENHANCING HAWAIIS NONPROFIT AND PUBLIC SECTORS, STORYLINE CONSULTING ASSISTED WITH COLLECTING COMMUNITY INPUT IN THE FORM OF KEY INFORMANT INTERVIEWS. STORYLINE IS BASED IN HAWAII AND PROVIDES PLANNING, RESEARCH, EVALUATION, GRANT WRITING, AND OTHER ORGANIZATIONAL DEVELOPMENT SUPPORT AND GUIDANCE. BY GATHERING AND PRESENTING DATA AND TESTIMONIES IN A CLEAR AND EFFECTIVE WAY, STORYLINE HELPS ORGANIZATIONS TO IMPROVE DECISION-MAKING, ILLUSTRATE IMPACT, AND INCREASE RESOURCES. THE QUALITATIVE DATA USED IN THIS ASSESSMENT CONSIST OF KEY INFORMANT INTERVIEWS COLLECTED BY STORYLINE CONSULTING. KEY INFORMANTS ARE INDIVIDUALS RECOGNIZED FOR THEIR KNOWLEDGE OF COMMUNITY HEALTH IN ONE OR MORE HEALTH AREAS, AND WERE NOMINATED AND SELECTED BY THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) ADVISORY COMMITTEE IN SEPTEMBER 2014. FIFTEEN KEY INFORMANTS WERE INTERVIEWED FOR THEIR KNOWLEDGE ABOUT COMMUNITY HEALTH NEEDS, BARRIERS, STRENGTHS, AND OPPORTUNITIES (INCLUDING THE NEEDS FOR VULNERABLE AND UNDERSERVED POPULATIONS AS REQUIRED BY IRS REGULATIONS). IN MANY CASES, THE VULNERABLE POPULATIONS ARE DEFINED BY RACE/ETHNIC GROUPS, AND THIS ASSESSMENT WILL PLACE A SPECIAL EMPHASIS ON THESE FINDINGS. INTERVIEW TOPICS WERE NOT RESTRICTED TO THE HEALTH AREA FOR WHICH A KEY INFORMANT WAS NOMINATED. EXCERPTS FROM THE INTERVIEW TRANSCRIPTS WERE CODED BY RELEVANT TOPIC AREAS AND OTHER KEY TERMS USING THE QUALITATIVE ANALYTIC TOOL DEDOOSE. THE FREQUENCY WITH WHICH A TOPIC AREA WAS DISCUSSED IN KEY INFORMANT INTERVIEWS WAS ONE FACTOR USED TO ASSESS THE RELATIVE URGENCY OF THAT TOPIC AREAS HEALTH AND SOCIAL NEEDS. THE FINDINGS FROM KEY INFORMANT INTERVIEWS IN KAHI MOHALA'S CHNA ARE AVAILABLE AT HTTP://WWW.KAHIMOHALA.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML
SCHEDULE H, PART V, SECTION B, LINE 6A & 6B	THE STATE OF HAWAII IS UNIQUE IN THAT ALL OF ITS COMMUNITY HOSPITALS AND HOSPITAL SYSTEMS JOINED EFFORTS TO FULFILL NEW REQUIREMENTS UNDER THE AFFORDABLE CARE ACT, WHICH THE IRS DEVELOPED GUIDELINES TO IMPLEMENT. THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) LED THIS COLLABORATION TO CONDUCT STATE- AND COUNTY-WIDE ASSESSMENTS FOR ITS MEMBERS. FIFTEEN MEMBER HOSPITALS IN HAWAII PARTICIPATED IN THE CHNA PROJECT: - CASTLE MEDICAL CENTER - SUTTER HEALTH PACIFIC, KAHI MOHALA - KAISER PERMANENTE MEDICAL CENTER - KAPI`OLANI MEDICAL CENTER FOR WOMEN & CHILDREN - KUAKINI MEDICAL CENTER - PALI MOMI MEDICAL CENTER - REHABILITATION HOSPITAL OF THE PACIFIC - SHRINERS HOSPITALS FOR CHILDREN - HONOLULU - STRAUB CLINIC & HOSPITAL - THE QUEEN'S MEDICAL CENTER - THE QUEENS MEDICAL CENTER WEST OAHU - WAHIAWA GENERAL HOSPITAL HAH IS THE UNIFYING VOICE OF HAWAIIS HEALTHCARE PROVIDERS AND AN AUTHORITATIVE AND RESPECTED LEADER IN SHAPING HAWAIIS HEALTHCARE POLICY. FOUNDED IN 1939, HAH REPRESENTS THE STATES HOSPITALS, NURSING FACILITIES, HOME HEALTH AGENCIES, HOSPICES, DURABLE MEDICAL EQUIPMENT SUPPLIERS, AND OTHER HEALTHCARE PROVIDERS WHO EMPLOY ABOUT 20,000 PEOPLE IN HAWAII. HAH WORKS WITH COMMITTED PARTNERS AND STAKEHOLDERS TO ESTABLISH A MORE EQUITABLE, SUSTAINABLE HEALTHCARE SYSTEM DRIVEN TO IMPROVE QUALITY, EFFICIENCY, AND EFFECTIVENESS FOR PATIENTS AND COMMUNITIES.
SCHEDULE H, PART V, SECTION B, LINE 7A, 7B AND 10A	FILING ORG WEBSITE: HTTP://WWW.KAHIMOHALA.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS-ASSESSMEN T
SCHEDULE H, PART V, SECTION B, LINE 11	THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT KAHI MOHALA INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: - ACCESS TO MENTAL HEALTH SERVICES - MENTAL HEALTH & MENTAL DISORDERS - SUBSTANCE ABUSE DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. KAHI MOHALA IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT: - CANCER - DIABETES - ECONOMY - ENVIRONMENT - EXERCISE, NUTRITION & WEIGHT - FAMILY PLANNING - HEART DISEASE & STROKE - IMMUNIZATIONS & INFECTIOUS DISEASES - MATERNAL, FETAL, & REPRODUCTIVE HEALTH - ORAL HEALTH - OTHER CHRONIC DISEASES - PREVENTION & SAFETY - RESPIRATORY DISEASES - WELLNESS & LIFESTYLE - WOMENS HEALTH AS A MENTAL AND BEHAVIORAL HEALTH FACILITY KAHI MOHALA DOES NOT HAVE THE RESOURCES AND/OR EXPERTISE TO RESPOND TO THESE COMMUNITY NEEDS AT THIS TIME. KAHI MOHALA IS A COLLABORATIVE PARTNER TO NUMEROUS COMMUNITY ORGANIZATIONS AND ON OCCASION WILL SPONSOR PROGRAMS AND INITIATIVES THAT ADDRESS THE NEEDS LISTED ABOVE. HOWEVER, THESE NEEDS WILL NOT BE THE AREA OF FOCUS FOR 2016-2018.
SCHEDULE H, PART V, SECTION B, LINE 15E	METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE - OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: https://www.sutterhealth.org/for-patients/financial-assistance
SCHEDULE H, PART V, SECTION B, LINE 16J	MEASURES USED TO PUBLICIZE THE FACILITYS FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITALS SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. ON AN ANNUAL BASIS SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART V, SECTION B, LINE 22D	AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

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SCHEDULE H, PART I, LINE 3A & 3C	FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENT'S FAMILY INCOME. SCHEDULE H, PART I, LINE 3B SUTTER HEALTH PACIFIC-KAHI MOHALA IS COMMITTED TO PROVIDING CHARITY CARE AND THEREFORE, PROVIDES FREE CARE AT A HIGH PERCENTAGE OF FPG. IT DOES NOT PROVIDE DISCOUNTED CARE.
SCHEDULE H, PART I, LINE 6A	SUTTER HEALTH, A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES: KAHI MOHALA FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. KAHI MOHALA EMPLOYEES SERVE ON THE BOARD FOR ORGANIZATIONS SUCH AS THE AMERICAN HOSPITAL ASSOCIATION AND THE GOODWILL INDUSTRIES OF HAWAII. KAHI MOHALA PROVIDES USE OF ROOM/FACILITIES FOR COURT HEARINGS. KAHI MOHALA IS INVOLVED WITH THE QUEENS LEADER COLLABORATIVE TO PROVIDE BEHAVIORAL HEALTH SUPPORT WHICH INCLUDES INPATIENT CONSULTS, STAFF EDUCATION AND TRAINING. KAHI MOHALA IS PART OF THE PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE FOCUSED ON DEVELOPING EFFECTIVE BEHAVIORAL HEALTH PREVENTION STRATEGIES. KAHI MOHALA FOCUSED ON ENVIRONMENTAL IMPROVEMENTS THROUGH ITS KAHI MOHALA CLEAN UP PROGRAM. KAHI MOHALA SUPPORTS TALK STORY TIME, A COMMUNITY SUPPORT NETWORK MEETING FOR MILITARY SPOUSES AND SIGNIFICANT OTHERS WHO HAVE EXPERIENCED TRAUMATIC EVENTS IN OR OUTSIDE OF MILITARY COMBAT.
SCHEDULE H, PART III, LINE 2	METHODOLOGY FOR CALCULATING BAD DEBT (AT COST): THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE: AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. SCHEDULE H, PART III, LINE 4 AUDIT FOOTNOTE: THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE A FOOTNOTE FOR PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS. PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS AND THIRD-PARTY PAYERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SUTTER'S SELF-PAY WRITE-OFFS WERE $204 MILLION AND $192 MILLION FOR 2016 AND 2015, RESPECTIVELY.
SCHEUDLE H, PART III, LINE 7	MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS.
SCHEDULE H, PART III, LINE 8	COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.
SCHEDULE H, PART III, LINE 9B	DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2016 2018 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. LANGUAGES: THE POLICY SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA. IN ADDITION, ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. INFORMATION PROVIDED TO PATIENTS DURING THE PROVISION OF HOSPITAL SERVICES: A. DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND IDENTIFY THE DEPARTMENT THAT PATIENTS CAN VISIT TO RECEIVE INFORMATION ABOUT, AND ASSISTANCE WITH APPLYING FOR, FINANCIAL ASSISTANCE. B. FINANCIAL ASSISTANCE COUNSELORS: PATIENTS WHO MAY BE UNINSURED PATIENTS SHALL BE ASSIGNED FINANCIAL COUNSELORS, WHO SHALL VISIT WITH THE PATIENTS IN PERSON AT THE HOSPITAL, PROVIDE PATIENTS A FINANCIAL ASSISTANCE APPLICATION, ASSIST WITH THE APPLICATION PROCESS, AND PROVIDE A CONTACT INFORMATION FOR THE PATIENT TO CALL FOR QUESTIONS. C. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITALS SHALL PROVIDE ALL PATIENTS A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. D. APPLICATIONS PROVIDED AT DISCHARGE: AT THE TIME OF DISCHARGE, HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. E. INFORMATION PROVIDE TO PATIENTS AT OTHER TIMES: 1. CONTACT INFORMATION WHICH INCLUDES A PHONE NUMBER AND HOSPITAL DEPARTMENT TO OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE APPLICATION PROCESS. 2. BILLING STATEMENTS: BILLING STATEMENTS PROVIDED TO PATIENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, A PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS ABOUT FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE PATIENTS CAN OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE INCLUDING THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY OF THE POLICY, AND THE APPLICATION FOR FINANCIAL ASSISTANCE. 3. UPON REQUEST: HOSPITALS SHALL PROVIDE PATIENTS WITH PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST AND WITHOUT CHARGE. F. PUBLICITY OF FINANCIAL ASSISTANCE INFORMATION 1. PUBLIC POSTING: HOSPITALS SHALL POST COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IN A PROMINENT LOCATION IN THE EMERGENCY ROOM, ADMISSIONS AREA, AND ANY OTHER LOCATION IN THE HOSPITAL WHERE THERE IS A HIGH VOLUME OF PATIENT TRAFFIC, INCLUDING BUT NOT LIMITED TO THE WAITING ROOMS, BILLING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS. THESE PUBLIC NOTICES SHALL INCLUDE INFORMATION ABOUT THE RIGHT TO REQUEST AN ESTIMATE OF FINANCIAL RESPONSIBILITY FOR SERVICES. 2. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY SHALL BE AVAILABLE IN A PROMINENT PLACE ON THE SUTTER HEALTH WEBSITE (WWW.SUTTERHEALTH.ORG) AND ON EACH INDIVIDUAL HOSPITAL'S WEBSITE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. 3. MAIL: PATIENTS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY BE SENT BY MAIL, AT NO COST TO THE PATIENT. 4. ADVERTISEMENTS/PRESS RELEASES: AS NECESSARY AND ON AT LEAST AN ANNUAL BASIS, SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT HOSPITALS IN THE PRINCIPAL NEWSPAPER(S) IN THE COMMUNITIES SERVED BY SUTTER HEALTH, OR WHEN DOING SO IS NOT PRACTICAL, SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THIS INFORMATION, OR USE OTHER MEANS THAT SUTTER HEALTH CONCLUDES WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY TO AFFECTED PATIENTS IN OUR COMMUNITIES. 5. COMMUNITY AWARENESS: SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI, LINE 4	THERE ARE 15 HOSPITALS LOCATED ACROSS THE STATE SERVING THE HAWAII POPULATION. THE HOSPITAL SERVICE AREA IS DEFINED BY A GEOGRAPHICAL BOUNDARY OF HONOLULU COUNTY. THE COUNTY WILL SERVE AS THE UNIT OF ANALYSIS FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT. HENCE, THE HEALTH NEEDS DISCUSSED IN THIS ASSESSMENT WILL PERTAIN TO INDIVIDUALS LIVING WITHIN THIS GEOGRAPHIC BOUNDARY. WHEN POSSIBLE, HIGHLIGHTS FOR SUB-GEOGRAPHIES WITHIN HONOLULU COUNTY ARE PROVIDED. IN 2013, HONOLULU COUNTY HAD A POPULATION OF 983,429. AS MEASURED BY THE DECENNIAL CENSUS, THE POPULATION DENSITY IN THE COUNTY IS MUCH HIGHER THAN BOTH HAWAII AND THE U.S. OVERALL. BETWEEN 2010 AND 2013, HONOLULU COUNTYS POPULATION GREW MORE QUICKLY THAN THE NATIONAL AVERAGE. HONOLULU COUNTYS POPULATION IS SLIGHTLY YOUNGER THAN THE REST OF THE STATE AND THE COUNTRY, WITH A MEDIAN AGE OF 37.0 IN 2013, COMPARED TO 38.1 AND 37.5, RESPECTIVELY. CHILDREN UNDER 18 MADE UP ONLY 21.7% OF THE COUNTYS POPULATION (COMPARED TO 22.0% IN THE STATE AND 23.3% IN THE U.S.), AND ADULTS OVER 65 MADE UP 15.6% OF THE POPULATION (COMPARED TO 15.7% IN HAWAII AND 14.2% IN THE U.S.). A HIGHER PERCENTAGE OF THE COUNTYS POPULATION IS FOREIGN-BORN COMPARED TO THE STATE OVERALL; THE DIFFERENCE IS EVEN GREATER WHEN COMPARING TO THE NATION. IN 2009-2013, 19.6% OF HONOLULU COUNTY WAS FOREIGN-BORN, COMPARED TO 17.9% OF THE STATE AND 12.9% OF THE U.S. IN ADDITION, MORE RESIDENTS IN THE COUNTY SPEAK A FOREIGN LANGUAGE: IN 2009-2013, 27.8% OF HONOLULU COUNTYS POPULATION AGED 5 AND OLDER SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME, COMPARED TO 25.4% OF HAWAII RESIDENTS AND 20.7% OF U.S. RESIDENTS. THE RACE/ETHNICITY BREAKDOWN OF HONOLULU COUNTY IS SIGNIFICANTLY DIFFERENT FROM THE REST OF THE COUNTRY. IN FIGURE 5.2 OF THE CHNA, RACIAL IDENTITY IS DISPLAYED TO THE LEFT OF THE LINE, WHILE HISPANIC/LATINO ETHNICITY (OF ANY RACE) IS SHOWN TO THE RIGHT. ONLY 21.7% OF COUNTY RESIDENTS IDENTIFIED AS WHITE ONLY, COMPARED TO 25.6% OF THE STATE AND 73.7% OF THE NATION. SIMILAR TO HAWAII OVERALL, BLACK/AFRICAN AMERICAN, HISPANIC/LATINO, AND OTHER RACE/ETHNICITY GROUPS ARE MUCH SMALLER THAN IN THE REST OF THE U.S. ALMOST ONE IN FOUR RESIDENTS IDENTIFIES AS TWO OR MORE RACES, A PROPORTION SIMILAR TO HAWAII OVERALL BUT MUCH HIGHER THAN IN THE REST OF THE U.S. A CLOSER EXAMINATION OF THE MULTIRACIAL POPULATION, IN ADDITION TO THE SINGLE-RACE POPULATIONS, SHEDS MORE LIGHT ON THE DIVERSITY OF THE COUNTY. WITHIN HONOLULU COUNTY IN 2013, 23.5% OF THE POPULATION IDENTIFIED AS ANY PART NATIVE HAWAIIAN OR PACIFIC ISLANDER, 60.0% AS ANY PART ASIAN, AND 37.8% AS ANY PART WHITE. THE OVERALL INCOME IN HONOLULU COUNTY IS HIGH RELATIVE TO BOTH THE STATE AND NATION. THE COUNTYS MEDIAN HOUSEHOLD INCOME IN 2009-2013 WAS $72,764, COMPARED TO $67,402 IN THE STATE AND $53,046 IN THE NATION. AT $30,361, PER CAPITA INCOME WAS ALSO HIGHER IN HONOLULU COUNTY THAN IN HAWAII ($29,305) AND THE U.S. ($28,155) OVERALL. CERTAIN RACE/ETHNIC GROUPS ARE MORE AFFECTED BY POVERTY. IT IS IMPORTANT TO NOTE, HOWEVER, THAT FEDERAL DEFINITIONS OF POVERTY ARE NOT GEOGRAPHICALLY ADJUSTED, SO THE DATA MAY NOT ADEQUATELY REFLECT THE PROPORTION OF HONOLULU COUNTY RESIDENTS WHO STRUGGLE TO PROVIDE FOR THEMSELVES, DUE TO THE HIGH COST OF LIVING THROUGHOUT THE STATE OF HAWAII. FOR INSTANCE, THE 2013 MEDIAN GROSS MONTHLY RENT WAS $905 IN THE U.S. BUT $1,414 IN THE STATE OF HAWAII. HONOLULU COUNTY RESIDENTS HAVE HIGHER LEVELS OF EDUCATIONAL ATTAINMENT THAN THE REST OF THE NATION. IN 2009-2013, 90.3% OF THE COUNTYS RESIDENTS AGED 25 AND OLDER HAD AT LEAST A HIGH SCHOOL DEGREE, COMPARED TO 90.4% IN HAWAII AND 86.0% IN THE U.S. IN THE SAME PERIOD, 32.1% OF HONOLULU COUNTY RESIDENTS AGED 25 AND OLDER HAD AT LEAST A BACHELORS DEGREE, COMPARED TO 30.1% IN THE STATE AND 28.8% IN THE NATION. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN KAHI MOHALA'S CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS-ASSESSMEN T
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE 2016 - 2018 IMPLEMENTATION STRATEGY FOR KAHI MOHALA DEFINES PROGRAMS THAT WILL ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. KAHI SUPPORTS THE ALOHA UNITED WAY PROGRAM WHICH WORKS TO ENCOURAGE INDIVIDUALS OF ALL WALKS OF LIFE TO JOIN TOGETHER TO CREATE HOPE AND CHANGE THE LANDSCAPE OF OUR COMMUNITY FOR THE BETTER. ALOHA UNITED WAY IS WORKING TO REDUCE HOMELESSNESS, PROVIDE MORE OPPORTUNITIES FOR OUR KUPUNA TO AGE GRACEFULLY, AND BETTER PREPARE OUR KEIKI FOR KINDERGARTEN. BY FOCUSING ON 3 IMPACT AREAS--EDUCATION, POVERTY PREVENTION AND SAFETY NET--WE ARE ABLE TO DRIVE AND SUPPORT SIGNIFICANT SOCIAL CHANGE, FUNDING COLLECTIVE IMPACT, PREVENTING PROBLEMS BEFORE THEY BEGIN, AND HELPING THE VULNERABLE IN OUR COMMUNITY WHO NEED ASSISTANCE. KAHI SUPPORTS THE PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE. ARMY ONE SOURCE HAS CREATED THE STATE-LEVEL ALLIANCES TO RAISE AWARENESS, IMPROVE SERVICE DELIVERY AND GENERATE COMMUNITY SUPPORT FOR OUR SERVICE MEMBERS AND FAMILIES. THEY ALSO FOCUS ON EDUCATING THE BEHAVIORAL HEALTH COMMUNITY ON MILITARY CULTURE AND BEST PRACTICES FOR ASSESSING AND TREATING BEHAVIORAL HEALTH ISSUES RESULTING FROM THE TRAUMA OF WAR. IN ADDITION TO THESE INITIATIVES, KAHI IMPLEMENTS SEVERAL OTHER COMMUNITY BENEFIT PROGRAMS INCLUDING: - KAHI PROVIDES THE USE OF THEIR ROOMS/FACILITIES FOR SEVERAL COMMUNITY PROGRAMS INCLUDING THE 12-STEP RECOVERY PROGRAM FOR ADDICTION-AFFECTED FAMILY MEMBERS, ALCOHOLICS ANONYMOUS, NARCOTICS ANONYMOUS, AND CHILD & FAMILY SERVICES FOR THOSE AFFECTED BY DOMESTIC VIOLENCE. - KAHI SPONSORS THE ANNUAL INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA CONFERENCE, WHICH WORKS ON PREVENTING, ASSESSING AND TREATING CHILDHOOD, ADOLESCENT AND ADULT TRAUMA. - KAHI SPONSORS THE ANNUAL NATIONAL ASSOCIATION ON MENTAL ILLNESS WALK, WHICH RAISES MONEY AND AWARENESS OF MENTAL ILLNESS. IN ADDITION TO REGISTERED WALKERS, KAHI HELD AN ON CAMPUS WALK FOR STAFF AND ITS RESIDENTIAL PATIENTS. - KAHI SUPPORTS THE HAWAII HOSPITAL EDUCATION AND RESEARCH FOUNDATION WHICH IS A NONPROFIT THAT PROMOTES, SPONSORS AND CONDUCTS HEALTH FIELD RESEARCH THROUGH EDUCATIONAL PROGRAMS AND THE ACCUMULATION/DISSEMINATION OF HEALTH INFORMATION, AND CONDUCTS HOSPITAL PREPAREDNESS EXERCISES FOR PUBLIC HEALTH EMERGENCIES.
SCHEDULE H, PART VI, LINE 6	THE ORGANIZATION IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF HOSPITALS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS WHO CARE FOR MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WERE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. THE HOSPITALS MISSION IS TO ENHANCE THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WHERE WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTHCARE SERVICES. AT SUTTER HEALTH, WE BELIEVE THERE SHOULD BE NO BARRIERS TO RECEIVING TOP-QUALITY MEDICAL CARE. WE STRIVE TO PROVIDE ACCESS TO EXCELLENT HEALTHCARE SERVICES FOR NORTHERN CALIFORNIANS, REGARDLESS OF ABILITY TO PAY. AS PART OF OUR NOT-FOR-PROFIT MISSION, SUTTER HEALTH INVESTS MILLIONS OF DOLLARS BACK INTO THE COMMUNITIES WE SERVE AND BEYOND. THROUGH THESE INVESTMENTS AND COMMUNITY PARTNERSHIPS, WERE PROVIDING AND PRESERVING VITAL PROGRAMS AND SERVICES, THEREBY IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. OVER THE PAST FIVE YEARS, SUTTER HEALTH HAS COMMITTED MORE THAN $4 BILLION TO CARE FOR PATIENTS WHO COULDNT AFFORD TO PAY, AND TO SUPPORT PROGRAMS THAT IMPROVE COMMUNITY HEALTH. OUR 2016 COMMITMENT OF $669 MILLION INCLUDES UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, TRADITIONAL CHARITY CARE AND INVESTMENTS IN HEALTH EDUCATION AND PUBLIC BENEFIT PROGRAMS. FOR EXAMPLE: - IN 2016, SUTTER HEALTH INVESTED $388 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS. MEDI-CAL ACCOUNTED FOR 19 PERCENT OF SUTTER HEALTHS GROSS PATIENT SERVICE REVENUES IN 2016. SUTTER HEALTH HOSPITALS PROUDLY SERVE MORE MEDI-CAL PATIENTS IN OUR NORTHERN CALIFORNIA SERVICE AREA THAN ANY OTHER HEALTHCARE PROVIDER. - THROUGHOUT OUR HEALTHCARE SYSTEM, WE PARTNER WITH AND SUPPORT COMMUNITY HEALTH CENTERS TO ENSURE THAT THOSE IN NEED HAVE ACCESS TO PRIMARY AND SPECIALTY CARE. WE ALSO SUPPORT CHILDRENS HEALTH CENTERS, FOOD BANKS, YOUTH EDUCATION, JOB TRAINING PROGRAMS AND SERVICES THAT PROVIDE COUNSELING TO DOMESTIC VIOLENCE VICTIMS. EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESS REAL COMMUNITY NEEDS. FOR MORE FACTS AND INFORMATION VISIT WWW.SUTTERHEALTH.ORG.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
STEVEN CHAPLIN MD
MEDICAL DIRECTOR	$225,442	$0	$257,885	$0	$3,480	$0	$13,256	$0	$7,538	$0	$507,601	$0	$0	$0
JAMES E CONFORTI
PRESIDENT, SH PACIFIC	$0	$750,788	$0	$340,000	$0	$73,808	$0	$376,176	$0	$24,682	$0	$1,565,454	$0	$70,006
LEONARD LICINA
CEO SUTTER HEALTH PACIFIC	$0	$208,668	$0	$57,576	$0	$9,456	$0	$33,358	$0	$14,694	$0	$323,752	$0	$8,869
QUIN OGAWA
CFO SH PACIFIC (PART YEAR)	$157,511	$0	$0	$0	$497	$0	$9,262	$0	$13,757	$0	$181,027	$0	$0	$0
PENNY WESTFALL
SEC, VP & CHIEF COUNSEL, SVH	$0	$399,057	$0	$128,895	$0	$37,974	$0	$94,926	$0	$11,870	$0	$672,722	$0	$36,337
KENNETH DELANO
DIRECTOR HEALING FORCES	$192,031	$0	$1,067	$0	$280	$0	$11,291	$0	$13,188	$0	$217,857	$0	$0	$0
CHRISTINA ENOKA
DIRECTOR HUMAN RESOURCES	$143,537	$0	$6,400	$0	$853	$0	$8,440	$0	$6,064	$0	$165,294	$0	$0	$0
GREGORY PRIER MD
CHIEF OF STAFF	$181,499	$0	$132,973	$0	$700	$0	$10,672	$0	$7,539	$0	$333,383	$0	$0	$0
CHARLES ST LOUIS JR
DIRECTOR NURSING	$154,019	$0	$4,268	$0	$700	$0	$9,056	$0	$568	$0	$168,611	$0	$0	$0
SARAH KREVANS
PRESIDENT & CEO, SUTTER HEALTH	$0	$1,528,303	$0	$647,289	$0	$190,356	$0	$1,484,076	$0	$27,074	$0	$3,877,098	$0	$345,896

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEES WAGES AND TAXED ACCORDINGLY.
SCHEDULE J, PART I, LINE 3	SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THIS ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARM'S LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTERS EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATIONS OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH.
SCHEDULE J, PART I, LINE 4B	NONQUALIFIED RETIREMENT PLAN THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTHS OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN AND SOCIAL SECURITY BENEFITS. SUTTERS PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PENSION PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PENSION PLAN AND SOCIAL SECURITY BENEFIT CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR ELIGIBLE EARNINGS BEYOND THE IRS DEFINITION OF INCLUDIBLE COMPENSATION ("PENSION PAY CAP"). THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PENSION PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F)) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTHS QUALIFIED PENSION PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTERS NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. THE FOLLOWING INDIVIDUAL RECEIVED 457(F) NON-QUALIFIED PAYMENTS DURING THE YEAR: ROSE CHOY - $5,454
SCHEDULE J, PART I, LINE 7	NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 10% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, OPERATING UNIT AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD UP TO 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS A LONG TERM PERFORMANCE PLAN WHICH IS DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTERS LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTHS OVERALL MISSION, VISION, AND VALUES, SUTTERS LONG TERM PERFORMANCE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1 AND PART III, LINE 1	SUTTER HEALTH PACIFIC (DBA KAHI MOHALA) IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES.
FORM 990, PART III, LINE 4A	SUTTER HEALTH PACIFIC, A CALIFORNIA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION WAS ORGANIZED TO OPERATE KAHI MOHALA, AN 88 BED, FREESTANDING PSYCHIATRIC HOSPITAL. KAHI MOHALA HAS BEEN OPERATIONAL SINCE 1983 AND IS SITUATED ON A 14.5-ACRE CAMPUS. THE HOSPITAL IS LICENSED BY THE STATE OF HAWAII AND IS ACCREDITED BY THE JOINT COMMISSION UNDER THE ACCREDITATION MANUAL OF HOSPITALS, WITH THE EXCEPTION OF THE LONGER TERM PROGRAMS FOR CHILDREN AND ADOLESCENTS, WHICH ARE ACCREDITED UNDER THE CONSOLIDATED STANDARDS. THERE WERE 26,184 PATIENT DAYS IN 2016. KAHI MOHALAS MISSION IS: "KAHI MOHALA IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES." TREATMENT PROGRAMS KAHI MOHALA IS DEDICATED NOT ONLY TO PSYCHIATRIC, EMOTIONAL AND BEHAVIORAL STABILIZATION, BUT ALSO TO RECOVERY THROUGH EMPOWERMENT. TEACHING INDIVIDUALS THE SKILLS TO SELF-MANAGE AND SELF-REGULATE TO THE FULLEST POSSIBLE EXTENT IS A FUNDAMENTAL GOAL WITHIN THE TREATMENT AND RECOVERY PROCESS. LEVELS OF CARE - ACUTE CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - RESIDENTIAL CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - ADOLESCENT PARTIAL HOSPITALIZATION PROGRAM (PHP) INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - HEALING FORCES WOMENS TRAUMA RECOVERY - ELECTROCONVULSIVE THERAPY (ECT) SPECIALIZED TREATMENT SERVICES - PSYCHIATRIC EVALUATION/TREATMENT AND MEDICATION MANAGEMENT - NURSING ASSESSMENT - PSYCHOLOGICAL TESTING - SUBSTANCE ABUSE/DUAL DIAGNOSIS SERVICES - EATING DISORDER SERVICES THERAPEUTIC SERVICES AVAILABLE - INDIVIDUAL, FAMILY AND GROUP THERAPY - EDUCATIONAL SERVICES - OCCUPATIONAL THERAPY - RECREATIONAL THERAPY - ART THERAPY - REALITY-ORIENTED PHYSICAL EXPERIENTIAL SERVICES (ROPES) THIS CORPORATION WAS FORMED FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION: A. TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NOT-FOR-PROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BEDS AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS AND TO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; B. TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED, OR TO THE PROMOTION OF HEALTH; C. TO PROMOTE AND CARRY OUT SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; D. TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITY SERVED; AND E. TO CONTRIBUTE TO THE GROWTH, DEVELOPMENT AND FINANCIAL STRENGTH OF SUTTER HEALTH SYSTEM. KAHI MOHALA - LIST OF COMMUNITY BENEFITS - TWELVE-STEP PROGRAMS (ALCOHOLICS ANONYMOUS, ALANON, NARCOTICS ANONYMOUS) PURPOSE: PEER-LED, SELF-HELP GROUPS OF PERSONS RECOVERING FROM ADDICTIONS, OR FAMILY MEMBERS OF PERSONS RECOVERING FROM ADDICTIONS. GOALS AND OBJECTIVES: TO GAIN SUPPORT AND EDUCATION IN A GROUP SETTING. - INTERNSHIP, RESIDENCY AND PRACTICUM PROGRAMS PURPOSE: TO PROVIDE A SUPERVISED CLINICAL PRACTICE SETTING FOR MEDICAL STUDENTS, SOCIAL WORKERS, NURSES, PSYCHOLOGISTS, SUBSTANCE ABUSE COUNSELORS AND OCCUPATIONAL THERAPISTS. GOALS AND OBJECTIVES: TO OBTAIN DIRECT PRACTICE EXPERIENCE IN THE STUDENTS FIELD. - INFORMATION AND REFERRAL PURPOSE: TO PROVIDE TELEPHONE INFORMATION AND REFERRAL TO THE PUBLIC REGARDING MENTAL HEALTH AND CHEMICAL DEPENDENCY RESOURCES. GOAL: TO PROVIDE A FREE COMMUNITY RESOURCE. - MEMBERSHIPS ON COMMUNITY BOARDS AND COMMITTEES: GOODWILL INDUSTRIES, KAPOLEI ROTARY, HEALTHCARE ASSOCIATION OF HAWAII, HFMA, CHAMBER OF COMMERCE, MENTAL HEALTH AMERICA OF HAWAII (MHA), NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), HAWAII YOUTH SERVICES NETWORK (HYSN), COMMUNITY CHILDRENS COUNCIL (CCCS), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE PURPOSE: TO VOLUNTEER EXPERTISE ON VARIOUS COMMUNITY BOARDS AND COMMITTEES. GOALS AND OBJECTIVES: TO SUPPORT OUR COMMUNITY BY HELPING OTHERS MEET THE GOALS AND OBJECTIVES OF THE VARIOUS ORGANIZATIONS AND COMMITTEES. - COMMUNITY ROPES GROUPS PURPOSE: PROVIDE PROBLEM SOLVING, TEAM BUILDING, AND LEADERSHIP AWARENESS THROUGH THE USE OF GAMES AND ELEMENTS ON THE ROPES COURSE. GOALS AND OBJECTIVES: PROVIDE THE YOUTH/AT RISK YOUTH THE OPPORTUNITY TO EXPERIENCE TEAM BUILDING/PROBLEM SOLVING EXERCISES THROUGH THE USE OF OUR ROPES COURSE. - HAWAII FOOD BANK CASH DONATION AND CANNED FOOD DRIVE PURPOSE: CASH DONATION & CANNED FOOD COLLECTION GOALS AND OBJECTIVES: PROVIDE ASSISTANCE TO THE HUNGRY AND HOMELESS IN THE COMMUNITY - CHILD & FAMILY SERVICE PURPOSE: USE OF ROOM/FACILITIES GOALS AND OBJECTIVES: TO PROVIDE A MEETING PLACE FOR THE DOMESTIC VIOLENCE PROGRAM - MILITARY SPOUSES SUPPORT NETWORK PURPOSE: PROVIDE COMMUNITY SUPPORT NETWORK FOR MILITARY SPOUSES/SIGNIFICANT OTHERS WHOSE PARTNERS HAVE EXPERIENCED TRAUMATIC EVENTS IN OR OUTSIDE OF MILITARY COMBAT. GOALS AND OBJECTIVES: TO PROVIDE SUPPORT TIME IN A SAFE ENVIRONMENT WHERE SPOUSES OF ALL BRANCHES OF SERVICE AND VETERANS CAN SHARE THEIR FEELINGS, LEARN COPING SKILLS AND CONNECT WITH OTHERS. TO PROVIDE A PLACE WHERE SPOUSES AND SIGNIFICANT OTHERS CAN ATTEND WORKSHOPS, GROUP OUTINGS AND INSPIRATIONAL EXPERIENCES. - CPR TRAINING PURPOSE: TO PROVIDE CPR TRAINING TO COMMUNITY GOAL: TRAIN EWA BEACH COMMUNITY HOW TO PERFORM CPR - NATIONAL ASSOCIATION ON MENTAL ILLNESS (NAMI) WALK PURPOSE: PARTICIPATION IN ANNUAL NAMI WALK GOALS AND OBJECTIVES: TO RAISE MONEY AND AWARENESS OF MENTAL ILLNESS - PRINCE KUHIO TOASTMASTERS PURPOSE: TO PROVIDE PROFESSIONAL DEVELOPMENT TRAINING TO COMMUNITY GOAL: ENCOURAGE PROFESSIONAL DEVELOPMENT ACTIVITY IN COMMUNITY - LITTER & GRAFFITI REMOVAL PURPOSE: TO REMOVE BLIGHT FROM NEIGHBORHOOD GOAL: MAINTAIN LITTER AND TAG FREE ENVIRONMENT FOR AREA SURROUNDING KAHI MOHALA
FORM 990, PART VI, LINE 1A	THE AFFAIRS AND MANAGEMENT OF SUTTER HEALTH PACIFIC (SHP) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHO HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SHP DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR OF THE BOARD WHO SERVES AS CHAIR OF THE COMMITTEE, THE ADMINISTRATOR/CEO, AND AT LEAST ONE ADDITIONAL DIRECTOR. FORM 990, PART VI, LINE 4 SIGNIFICANT BYLAW CHANGES REMOVED VICE CHAIR AND VICE CHAIR OF FINANCE AS OFFICER POSITIONS AND ADDED ASSISTANT SECRETARY AS AN OFFICER POSITION. FORM 990, PART VI, LINES 6 & 7A THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 7B	SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL.
FORM 990, PART VI, LINE 11B	SUTTER HEALTH HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED.
FORM 990, PART VI, LINE 12C	EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION.
FORM 990, PART VI, LINES 15A & 15B	THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTERS EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATIONS OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE), (C) TOTAL DIRECT CASH (BASE SALARY + ANNUAL INCENTIVE + LONG TERM INCENTIVE) AND (D) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH. THIS METHOD IS MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION UNDERGO AN ANNUAL REVIEW BY THE COMPENSATION COMMITTEE OR A DELEGATED SUB-COMMITTEE. APPROVAL IS RECORDED IN THE MINUTES. EXECUTIVE COMPENSATION REVIEW WAS LAST COMPLETED IN DECEMBER 2016.
FORM 990, PART VI, LINE 19	THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
FORM 990, PART VII, SECTION A	THE FOLLOWING BOARD MEMBER OF SUTTER HEALTH PACIFIC IS A FULL-TIME EMPLOYEE (40 HOURS PER WEEK) OF SUTTER HEALTH AND HIS SUTTER HEALTH SALARY IS REPORTED HEREIN. THE FOLLOWING INDIVIDUAL RECEIVED NO COMPENSATION FOR HIS SERVICE AS A BOARD MEMBER OF THIS ORGANIZATION. - JAMES CONFORTI
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: EQUITY TRANSFERS (NET): $(5,295,762)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ADOLESCENT TREATMENT CENTERS INC
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680088443	HEALTHCARE	CA	501(C)(3)	3	SUTTER EBH	Yes (true)
BETTER HEALTH EAST BAY FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	510160184	FUNDRAISING	CA	501(C)(3)	7	SUTTER EBH	Yes (true)
CALIFORNIA PACIFIC MEDICAL CTR FOUND
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942728423	FUNDRAISING	CA	501(C)(3)	7	SUTTER BH	Yes (true)
EAST BAY PERINATAL CENTER
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	510172285	HEALTHCARE	CA	501(C)(3)	3	SUTTER EBH	Yes (true)
EDEN MEDICAL CENTER
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942948100	HEALTHCARE	CA	501(C)(3)	10	SUTTER HLTH	Yes (true)
MEMORIAL HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942290244	FUNDRAISING	CA	501(C)(3)	12A - I	SUTTER CVH	Yes (true)
MILLS-PENINSULA HEALTH SERVICES
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941156265	HOSPITAL	CA	501(C)(3)	3	SUTTER BMF	Yes (true)
MILLS-PENINSULA HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	237288765	FUNDRAISING	CA	501(C)(3)	7	SUTTER BH	Yes (true)
SAMUEL MERRITT UNIVERSITY
450 30TH STREET STE 2840	OAKLAND	CA	94609	942992642	UNIVERSITY	CA	501(C)(3)	2	SUTTER EBH	Yes (true)
SUTTER AUBURN FAITH HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942594966	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER BAY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	940562680	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER BAY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941156581	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER CENTRAL VALLEY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941080917	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER COAST HOSPITAL
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942988520	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER DAVIS HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680217870	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER EAST BAY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941196176	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER EAST BAY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942690415	HEALTHCARE	CA	501(C)(3)	12B - II	SUTTER HLTH	Yes (true)
SUTTER GOULD MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941682256	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER HEALTH
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	942788907	SUPPORTING OR	CA	501(C)(3)	12C III-FI	NA	false
SUTTER HEALTH PLAN
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	461183948	HEALTH PLAN	CA	501(C)(4)	N/A	SUTTER HLTH	Yes (true)
SUTTER INSURANCE SERVICES CORPORATION
745 FORT STREET SUITE 1100	HONOLULU	HI	96813	990289310	INSURANCE SER	HI	501(C)(3)	12C III-FI	SUTTER HLTH	Yes (true)
SUTTER MEDICAL CENTER FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942788906	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER MEDICAL CENTER CASTRO VALLEY
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	770146047	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER ROSEVILLE MEDICAL CTR FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680040113	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER SOLANO CHARITABLE FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942668262	FUNDRAISING	CA	501(C)(3)	7	SUTTER VH	Yes (true)
SUTTER VALLEY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	941156621	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER VALLEY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680273974	HEALTHCARE	CA	501(C)(3)	12B - II	SUTTER HLTH	Yes (true)
SUTTER VISITING NURSE ASSOC AND HOSPICE
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	946068843	HEALTHCARE	CA	501(C)(3)	10	SUTTER HLTH	Yes (true)
SUTTER WEST BAY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	942948131	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
TRACY HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR	SACRAMENTO	CA	95833	680318845	FUNDRAISING	CA	501(C)(3)	12A - I	SUTTER CVH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MAGNETIC IMAGING AFFILIATES LLC
175 LENNON	WALNUT CREEK	CA	94598	942953833	PATIENT CARE	CA	NA
SURGERY CENTER OF ALTA BATES SMC
3875 TELEGRAPH	OAKLAND	CA	94609	470946086	OUTPATIENT SURG	CA	NA
ALTA CT SERVICES LP
175 LENNON	WALNUT CREEK	CA	94598	943083464	PATIENT CARE	CA	NA
CALIFORNIA PACIFIC ADV IMAGING LLC
PO BOX 6102	NOVATO	CA	94598	562311840	MRI JOINT VENTURE	DE	NA
SAN FRANCISCO ENDOSCOPY CENTER
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	912160588	ENDOSCOPY JV	CA	NA
PRESIDIO SURGERY CENTER LLC
1635 DIVISADERO	SAN FRANCISCO	CA	94115	320144060	AMBULATORY SURG	CA	NA
SUTTER FAIRFIELD SURGERY CENTER LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	300233892	SURGERY	CA	NA
TWIN CITIES SURGICAL HOSPITAL LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	352182617	SURGERY	CA	NA
SUTTER AMADOR SURGERY CENTER LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	461398093	SURGERY	CA	NA
ROSEVILLE ENDOSCOPY CENTER
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	870710513	ENDOSCOPY JV	CA	NA
STANISLAUS SURGICAL HOSPITAL LLC
1421 OAKDALE ROAD	MODESTO	CA	95355	911754157	SURGERY	CA	NA
MEMORIAL MEDICAL BUILDING 1
1800 COFFEE RD 76	MODESTO	CA	95355	770287288	OFFICE RENTAL	CA	NA
MEMORIAL MEDICAL BUILDING 2
1800 COFFEE RD 76	MODESTO	CA	95355	770287288	OFFICE RENTAL	CA	NA
MAGNETIC IMAGING AFFILIATES LLC
2125 OAK GROVE ROAD	WALNUT CREEK	CA	94598	473696091	PATIENT CARE	CA	NA
ASC OPERATORS - SANTA ROSA LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	263386169	PATIENT CARE	CA	NA
ASC OPERATORS - SAN LUIS OBISPO LLC
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	272673776	PATIENT CARE	CA	NA
DRZ EMERGING MARKETS LP
250 PARK AVE SOUTH SUITE 250	WINTER PARK	FL	32789	611729868	INVESTMENTS	FL	NA
STRATEGIC COMMODITIES FUND LLC
257 PARK AVE SOUTH SUITE 700	NEW YORK	NY	10010	562493292	INVESTMENTS	NY	NA
ICG CREDIT OPPORTUNITIES FUND LP
11111 SANTA MONICA BLVD SUITE 2100	LOS ANGELES	CA	90025	814220441	INVESTMENTS	CA	NA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
Sutter Health Deferred Comp Plans Trust
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	276851989	RABBI TRUST	CA	NA	TRUST	Yes (true)
NORTHWOOD EUROPE TE FEEDER LP
1819 WAZEE ST 2ND FLOOR	DENVER	CO	90202	981272216	HOLDING COMPANY		NA	C CORP	Yes (true)	CJ

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

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

Field	Value	IRS element (for citing)
Transaction Type	p	TransactionTypeTxt
Involved	$246,684	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt