2017-11-09T17:45:33-06:00 2016-12-31 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DR STE 500 SAN DIEGO CA 92122 990 2016-01-01 990298651 SUTTER HEALTH PACIFIC % QUIN OGAWA CFO SUTT 9162866665 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 QUIN OGAWA CFO 2017-10-27 true DEBRA HEISKALA P00649485 8585357200 2016 2022-09-23 18:48:47Z KAHI MOHALA JAMES CONFORTI 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 20275763 false X WWW.SUTTERHEALTH.ORG X 1992 CA SEE SCHEDULE O 11 8 302 0 0 47263 86256 23410491 20182422 10941 7085 0 0 23468695 20275763 0 0 0 0 16025345 15544037 0 0 25382 5372222 5401536 21397567 20945573 2071128 -669810 14241629 10285815 1893625 3904526 12348004 6381289 X SEE SCHEDULE O false false 18478964 0 20182422 SEE SCHEDULE O 18478964 true true false false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 18 0 true 302 true false false false false false false false false false false X 11 8 false false true false true true true true true false false true true true true true true true true false CA X QUIN OGAWA CFO 8086772580 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 X J KUHIO ASAM MD TRUSTEE 1.0 0.0 X 0 0 0 DIANNE BROOKINS TRUSTEE 1.0 0.0 X 0 0 0 STEVEN CHAPLIN MD MEDICAL DIRECTOR 40.0 0.0 X 486807 0 20794 JAMES E CONFORTI PRESIDENT, SH PACIFIC 1.0 40.0 X X 0 1164596 400858 PATRICK DUARTE TRUSTEE/CHAIR 1.0 0.0 X X 0 0 0 LEONARD LICINA CEO SUTTER HEALTH PACIFIC 40.0 0.0 X 0 275700 48052 DEE JAY MAILER TRUSTEE 1.0 0.0 X 0 0 0 CAMERON NEKOTA TRUSTEE 1.0 0.0 X 0 0 0 GIDGET RUSCETTA TRUSTEE 1.0 0.0 X 0 0 0 CHUCK STED TRUSTEE 1.0 0.0 X 0 0 0 DIANE STEWART TRUSTEE/VICE CHAIR OF FINANCE 1.0 0.0 X X 0 0 0 ROSE CHOY CFO SH PACIFIC (PART YEAR) 40.0 0.0 X 0 98397 2900 QUIN OGAWA CFO SH PACIFIC (PART YEAR) 40.0 0.0 X 158008 0 23019 PENNY WESTFALL SEC, VP & CHIEF COUNSEL, SVH 1.0 40.0 X 0 565926 106796 KENNETH DELANO DIRECTOR HEALING FORCES 40.0 0.0 X 193378 0 24479 CHRISTINA ENOKA DIRECTOR HUMAN RESOURCES 40.0 0.0 X 150790 0 14504 MICHELLE FERNANDEZ RN MANAGER 40.0 0.0 X 122819 0 16388 GREGORY PRIER MD CHIEF OF STAFF 40.0 0.0 X 315172 0 18211 CHARLES ST LOUIS JR DIRECTOR NURSING 40.0 0.0 X 158987 0 9624 SARAH KREVANS PRESIDENT & CEO, SUTTER HEALTH 0.0 40.0 X 0 2365948 1511150 1585961 4470567 2196775 19 true true false ELENA SHARIPOVA MD PO BOX 860868 WAHIAWA HI 96786 PSYCHIATRY SERVICES 131188 1 1957 7500 3978 72821 0 86256 PATIENT SERVICE REVENUE 623990 20182422 20182422 20182422 7085 7085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20275763 20182422 7085 0 0 0 0 892387 439863 452524 0 10272566 9589474 683092 338536 315530 23006 3136302 2647235 489067 904246 821676 82570 0 27655 27655 3981 3981 0 0 5655 5655 383251 383251 22943 22943 378130 284809 93321 76079 75722 357 0 806926 806926 42290 6859 35431 0 13799 12226 1573 240000 240000 0 626016 626016 288090 288090 PURCHASED SERVICES 1291790 1124057 142425 25308 FOOD 387232 387232 SYSTEM ALLOCATION 354847 60324 294523 MEDICAL SUPPLIES 268287 268287 184565 50789 133702 74 20945573 18478964 2441227 25382 0 0 681007 1656928 2770 0 7780012 3148229 0 0 0 0 0 0 14821 15928 528888 535695 14545354 9616319 5062332 4929035 0 0 0 0 0 0 0 0 171799 0 14241629 10285815 1263230 1337647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630395 2566879 1893625 3904526 X 12237062 6212742 110942 168547 0 0 12348004 6381289 14241629 10285815 X -669810 -1143 -5295762 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11480989 7411244 4069745 2637448 2205075 432373 426917 426917 4929035 0 INSURANCE LIABILITIES 642492 OTHER LIABILITIES 1924387 2566879 X SCHEDULE D, PART X, LINE 2 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. true true X true X 400. true true true false true true 9698 9698 0.00050 1509838 1509838 0.07210 1519536 1519536 0.07260 1 15206 15206 0.00070 8 300 153641 153641 0.00730 14 3705 102768 102578 0.00490 23 4005 271615 271425 0.01290 23 4005 1791151 1790961 0.08550 4 7 12653 12653 0.00060 1 0 2766 2766 0.00010 1 0 7379 0 7379 0.00040 7 5 34853 0 34853 0.00170 1 0 306 306 14 12 57957 0 57957 0.00280 false 0 0 9989 -9989 X true true 1 1 SUTTER HEALTH PACIFIC - KAHI MOHALA 91-2301 FORT WEAVER ROAD EWA BEACH HI 96706 www.kahimohala.org LICENSE #33-H X SUTTER HEALTH PACIFIC - KAHI MOHALA 1 false false true X X X X X X X X X 16 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 16 true SEE PART V, SECTION C false true X 400. 0. X X true true X X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X true X false false 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. 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. X true true X X X X false true false false false false false true false STEVEN CHAPLIN MD MEDICAL DIRECTOR 225442 0 257885 0 3480 0 13256 0 7538 0 507601 0 0 0 JAMES E CONFORTI PRESIDENT, SH PACIFIC 0 750788 0 340000 0 73808 0 376176 0 24682 0 1565454 0 70006 LEONARD LICINA CEO SUTTER HEALTH PACIFIC 0 208668 0 57576 0 9456 0 33358 0 14694 0 323752 0 8869 QUIN OGAWA CFO SH PACIFIC (PART YEAR) 157511 0 0 0 497 0 9262 0 13757 0 181027 0 0 0 PENNY WESTFALL SEC, VP & CHIEF COUNSEL, SVH 0 399057 0 128895 0 37974 0 94926 0 11870 0 672722 0 36337 KENNETH DELANO DIRECTOR HEALING FORCES 192031 0 1067 0 280 0 11291 0 13188 0 217857 0 0 0 CHRISTINA ENOKA DIRECTOR HUMAN RESOURCES 143537 0 6400 0 853 0 8440 0 6064 0 165294 0 0 0 GREGORY PRIER MD CHIEF OF STAFF 181499 0 132973 0 700 0 10672 0 7539 0 333383 0 0 0 CHARLES ST LOUIS JR DIRECTOR NURSING 154019 0 4268 0 700 0 9056 0 568 0 168611 0 0 0 SARAH KREVANS PRESIDENT & CEO, SUTTER HEALTH 0 1528303 0 647289 0 190356 0 1484076 0 27074 0 3877098 0 345896 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. 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) ADOLESCENT TREATMENT CENTERS INC C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680088443 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH 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 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 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 true EDEN MEDICAL CENTER C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942948100 HEALTHCARE CA 501(C)(3) 10 SUTTER HLTH 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 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 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 true SAMUEL MERRITT UNIVERSITY 450 30TH STREET STE 2840 OAKLAND CA 94609 942992642 UNIVERSITY CA 501(C)(3) 2 SUTTER EBH 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 true SUTTER BAY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 940562680 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH 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 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 true SUTTER COAST HOSPITAL C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942988520 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH 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 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 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 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 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 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 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 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 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 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 true SUTTER VALLEY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941156621 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH 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 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 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 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 true 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 Sutter Health Deferred Comp Plans Trust 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 276851989 RABBI TRUST CA NA TRUST true NORTHWOOD EUROPE TE FEEDER LP 1819 WAZEE ST 2ND FLOOR DENVER CO 90202 981272216 HOLDING COMPANY CJ NA C CORP true false false true false false false false false false false false false false false false true true true false SUTTER INSURANCE SERVICES CORPORATION p 246684 FMV