2018-08-15T16:15:42-05:00 2017-09-30 BDO USA LLP 600 ANTON BLVD STE 500 COSTA MESA CA 92626 990 2016-10-01 952821104 Henry Mayo Newhall Memorial Hospital % ANNA BREWER HENR 6612001191 23845 McBean Parkway Valencia CA 91355 TED D SIROTTA CFO 6612001191 2018-08-15 true CINDY J JANIKOWSKI P00165179 7149573200 2016 2022-09-23 18:48:47Z ROGER E SEAVER 23845 MCBEAN PARKWAY VALENCIA CA 91355 375604488 false X WWW.HENRYMAYO.COM X 1972 CA TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS, AND IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH COMPASSION AND EXCELLENCE. 15 11 2376 452 0 13465208 4740818 326806494 329529917 135703 1095058 4433821 5897227 344841226 341263020 4998257 6587768 0 0 148536391 156148412 0 0 0 166904495 171911685 320439143 334647865 24402083 6615155 387046616 487164798 221433815 306836451 165612801 180328347 TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS, AND IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH COMPASSION AND EXCELLENCE IN HEALTHCARE SERVICES. false false 269709135 5787368 334274494 TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF THE SANTA CLARITA VALLEY AND SURROUNDING AREAS. THE HOSPITAL HAD 58,876 PATIENT DAYS DURING THE YEAR. WE ALSO PROVIDED SERVICES FOR 71,018 EMERGENCY VISITS. 81% of total hospital inpatient admits (excluding newborns) are admitted through the emergency room. 800400 800400 TO SUPPORT GENERAL OPERATIONS OF HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION, AN AFFILIATE TO THE HOSPITAL 270509535 true true false true false false false false false false true true false false true true true false false false false false false false false false true true true true true true false false false false false false false true true true false false false false false true false false false true 321 0 true 2376 true false false false false false false false false false false X 15 11 false false false false false false false true true false false true true true true true true true true true true CA X X ANNA BREWER 6612001191 23845 MCBEAN PARKWAY VALENCIA CA 91355 X ROGER E SEAVER PRESIDENT/CEO 40.0 0.5 X X 949385 0 52032 Donald L Kimball Trustee 0.5 0.0 X 0 0 0 Judy Fish PhD Trustee 0.5 0.0 X 0 0 0 John Barstis MD Trustee 0.5 0.0 X 0 0 0 Robert Benjamin Trustee 0.5 0.5 X 0 0 0 Richard Corlin MD Trustee 0.5 0.0 X 0 0 0 Mark Liker MD Trustee 0.5 0.0 X 0 0 0 Roscoe Marter MD Trustee 0.5 0.0 X 0 0 0 Craig Peters Trustee 0.5 0.0 X 0 0 0 MARK CHAMBERLAIN Trustee 0.5 0.0 X 0 0 0 Lakhbinder Dhanda Trustee 0.5 0.0 X 0 0 0 Cheri Fleming Trustee 0.5 0.0 X 0 0 0 Chris Luechtefeld Trustee 0.5 0.0 X 0 0 0 Todd Stevens Trustee 0.5 0.0 X 0 0 0 Russell L Hanlin Trustee 0.5 0.0 X 0 0 0 CR BOB HUDSON OUTGOING SR VP/CFO 40.0 0.0 X 349090 0 36467 LARRY R KIDD VP/CCO 40.0 0.0 X 431336 0 39952 Ted D Sirotta INCOMING SR VP/CFO 40.0 0.0 X 71996 0 9590 CYNTHIA A PETERSON OUTGOING VP/CIO 40.0 0.0 X 180544 0 1196 MARK A PULEO VP/CHRO 40.0 0.0 X 240608 0 49119 JONATHAN S MILLER VP-Facility/Support 40.0 0.0 X 231367 0 47304 Kingman Ho Chief Medical Officer 40.0 0.0 X 389484 0 46703 Paige E Heaphy VP Performance Mgmt 40.0 0.0 X 249571 0 45895 Jennifer R Castaldo VP CNO 40.0 0.0 X 164346 0 21023 Ray B Moss VP CIO 40.0 0.0 X 115827 0 21822 KEITH BOYLE DIR OF SERVICE EXCELLENCE 40.0 0.0 X 197707 0 21825 HAROUTIOUN H SHAMAMIAN DIRECTOR OF PHARMACY 40.0 0.0 X 226743 0 20440 ADNAN E HAMID DIRECTOR OF IT 40.0 0.0 X 198437 0 31301 MARIA B SARTE CLINICAL RN 40.0 0.0 X 196928 0 9846 donna g ferguson director of op surgery 40.0 0.0 X 192549 0 30235 4385918 0 484750 367 false true false SODEXO INC AFFILIATES 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 OTHER PRCHD SRVCS 12015435 BERNARDS BROS INC 555 FIRST ST SAN FERNANDO CA 91340 CONSTRUCTION 22991322 CALIFORNIA REHABILITATION SERVICES 333 E GLENOAKS BLVD SUITE 204 GLENDALE CA 91207 MEDICAL PRCHD SVCS 5763037 Tower Imaging Valencia LLC 5455 Wilshire Blv Ste 1120 LOS ANGELES CA 90036 MEDICAL PRCHD SVCS 2149839 AMEC FOSTER WHEELER Environment 1105 Lakewood Parkway Ste 300 ALPHARETTA GA 30009 ENVMT ENGINEERING 1537199 76 4448452 250500 41866 4740818 HEALTHCARE SERVICES 621110 329529917 329529917 329529917 2138161 2138161 0 0 1153000 1153000 0 1153000 1153000 33298365 32982305 1359163 316060 -1359163 -1043103 0 0 0 0 0 0 0 0 0 JV INCOME 621110 732681 732681 NONPATIENT REVENUE 621110 4011546 2858896 1152650 4744227 341263020 334274494 3290811 X 800400 800400 5787368 5787368 0 0 3373556 3373556 0 0 0 117495459 117495459 3460958 3460958 22431068 22431068 9387371 9387371 5467711 5467711 1286020 1286020 525368 525368 15716 15716 0 121913 121913 59848694 44801632 15047062 259721 259721 45092519 45092519 3120275 3120275 0 8317124 8317124 434253 434253 0 0 5726131 5726131 0 15051115 15051115 3604347 3604347 REPAIR & MAINTENANCE 6441805 6441805 MISCELLANEOUS 7505502 7505502 BAD DEBT 9093471 9093471 334647865 270509535 64138330 0 42152465 34087066 2198635 18990467 1509872 0 51873513 53335450 0 0 0 0 0 0 5968258 5944383 3014519 3219582 430325935 200693601 189702815 229632334 73750620 98949891 788296 28547814 0 0 0 0 16087623 14457811 387046616 487164798 60630413 67118291 0 0 2429433 2387587 151162869 230119412 0 0 0 0 0 0 0 0 7211100 7211161 221433815 306836451 X 160073124 171669347 5539677 8659000 0 0 165612801 180328347 387046616 487164798 6615155 8100391 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true 15716 15716 false 990 SCH C POLITICAL CAMPAIGN AND LOBBYING ACTIVITIES 990 SCH C PART II-B QUESTION 1(I) FOR THE FISCAL YEAR ENDED 09/30/2017, THE ORGANIZATION PARTICIPATED WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO ADVOCATE POSITIVE HEALTHCARE POLICY FOR HOSPITALS. 3226760 3226760 199430503 94096900 105333603 123671478 94313701 29357777 103997195 12283000 91714194 229632334 DEBT SECURITIES 27521318 F JOINT VENTURE 1026496 F 28547814 0 CAPITAL LEASES 4940292 DEFERRED RENT 947169 QUALITY ASSURANCE FEE DEFERRED REVENUE 1323700 7211161 X 343576043 8100391 8100391 335475652 5787368 5787368 341263020 328860497 328860497 5787368 5787368 334647865 F990 SCH D PART XI RECONCONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH EXPENSES PER RETURN 990 SCH D PART XI QUESTION 4B CHARITY CARE 5,787,368. F990 SCH D PART XII RECONCONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH EXPENSES PER RETURN 990 SCH D PART XII QUESTION 4B CHARITY CARE 5,787,368. F990 SCH D PART X Line 2 FIN48(ASC 740) FOOTNOTE PART X LINE 2 THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). UNDER FASB ASC 740, UNCERTAINTY IN INCOME TAXES, INTEREST AND PENALTIES, IF ANY, ARE RECORDED TO INTEREST EXPENSE AND OTHER OPERATING COSTS, RESPECTIVELY. THERE WERE NO INTEREST OR PENALTIES RECORDED FOR THE YEARS, ENDED SEPTEMBER 30, 2017 AND 2016. THE TAX YEARS SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS INCLUDE THE YEARS 2013 AND FORWARD BY THE U.S. INTERNAL REVENUE SERVICE (IRS"). FOR CALIFORNIA, THE TAX YEARS SUBJECT TO EXAMINATION INCLUDE THE YEARS 2012 AND FORWARD. true true X true X true X true true false true true 5787368 5787368 0.01730 21285657 21285657 0.06360 27073025 27073025 0.08090 5862200 5862200 0.01750 5862200 5862200 0.01750 32935225 32935225 0.09840 true 9093471 0 96700204 123371182 -26670978 X true true Tower Imaging Valenc Outpatient Radiology Services 0.5 0.0 0.5 1 1 HENRY MAYO NEWHALL MEMORIAL HOSPITAL 23845 MCBEAN PKWY Valencia CA 91355 X X X 1 HENRY MAYO NEWHALL MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 16 true false false true X SEE PART V X true 16 true SEE PART V false true X 200. 400. X X X X true true X X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X X true false X X X X true X false false PART V, LINE 5 Henry Mayo Newhall Hospital completed a Community Health Needs Assessment (CHNA) in 2016 as required by state and federal law. Data Collection: This assessment incorporated components of primary data collection and secondary data analysis that focused on the health and social needs of the service area. The CHNA examined up-to-date data sources to present community demographics, social and economic factors, health care access, birth characteristics, leading causes of death, chronic disease, health behaviors, mental health and substance abuse, and preventive practices. These data are presented in the context of Los Angeles County and California State, framing the scope of an issue as it relates to the broader community. Input from Persons who Represent the Community: Targeted interviews were used to gather information and opinions from persons who represented the broad interests of the community served by the hospital. Twenty-two interviews were completed from June through September, 2016. Interviewees included individuals who are leaders and representatives of medically underserved, low-income, and minority populations, or regional, state or local health or other departments or agencies that have current data or other information relevant to the health needs of the community served by the hospital facility. PART V, LINE 7A https://www.henrymayo.com/documents/Henry-Mayo-CHNA-2016.pdf PART V, LINE 10A https://www.henrymayo.com/documents/Henry-Mayo-2017-Implementation-Strateg y-Final.pdf PART V, LINE 11 Needs the hospital will not address: Taking existing hospital and community resources into consideration, Henry Mayo will not directly address the remaining health needs identified in the CHNA including: asthma, dental care, mental health, overweight and obesity, and substance abuse. Knowing that there are not sufficient resources to address all the community health needs, Henry Mayo chose to concentrate on those health needs that can most effectively be addressed given the organizations areas of focus and available resources. Henry Mayo will continue to look for opportunities to address community needs where we can make a meaningful contribution. PART V, LINE 16A https://www.henrymayo.com/patients-visitors/patient/patient-business-servi ces/financial-policies/ https://www.henrymayo.com/patients-visitors/patient/patient-business-servi ces/financial-application-process/ https://www.henrymayo.com/patients-visitors/patient/patient-business-servi ces/financial-assistance-programs-charity-care/ https://www.henrymayo.com/documents/FAP-Policy-Physician-List.pdf ces/financial-assistance-programs-charity-care/ PART V, LINE 16B https://henrymayo.com/documents/CHARITY-CARE-APPLICATION_ENGLISH.pdf PART V, LINE 16C https://www.henrymayo.com/documents/Financial-Assistance-Summary.pdf PART III, LINES 2&4 The Hospital offers managed care-style discounts to most uninsured patients, which enables the Hospital to offer lower rates to those patients who historically have been charged standard gross charges. Under this method, the discount offered to uninsured patients is recognized as a contractual allowance instead of provision for bad debts, which reduces net patient revenues at the time the uninsured patient accounts are recorded and reduces provision for bad debts. The uninsured patient accounts, net of contractual allowances recorded, are further reduced to their net realizable value through provision for bad debts based on historical collection trends and other factors that affect the estimation process. For the years ended September 30, 2017 and 2016, provision for bad debts were approximately $9,093,000 and $9,790,000, respectively. PART III, LINE 8 COST METHODOLOGY IS COST ACCOUNTING SYSTEM. PART VI SUPPLEMENTAL INFORMATION FOR ITEMS 2-6 PAGE REFERENCES ARE TO THE COMMUNITY BENEFIT REPORT WHICH IS ATTACHED: 2. PAGE 5 - Community Health Needs Assessment 3. PAGE 7-12 - COMMUNITY BENEFIT SERVICES SUMMARY 4. PAGE 3 - Service Area 5. PAGE 7-12 - COMMUNITY BENEFIT SERVICES SUMMARY 6. PAGE 7-12 COMMUNITY BENEFIT SERVICES SUMMARY PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA true Henry Mayo Newhall Memorial Health Foundation 23845 McBean Parkway Valencia CA 91355 953849903 501(c)(3) 800400 SEE 990 SCHEDULE I 1 CHARITY CARE - HENRY MAYO NEWHALL HOSPITAL 4821 5787368 COST OF SERV MED SERVICES SCH I GENERAL INFO ON GRANTS AND ASSISTANCE 990 SCH I PART I QUESTION 2 The hospital assists individuals who are uninsured or underinsured by providYng charity care. This is applied by following the hospital's charity care policy. This policy is administered through the Business Service Department of the hospital. SCH I PART II GRANTS AND OTHER ASSITANCE TO GOVERNMENT & ORGANIZATION TO SUPPORT GENERAL OPERATIONS OF HENRY MAYO NEWHALL MEMORIAL HEALTH FOUNDATION, AN AFFILIATE TO THE HOSPITAL SCH I PART III GENERAL GRANTS AND OTHER ASSISTANCE TO INDIVIDUAL PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY MAY RECEIVE HEALTHCARE SERVICES AT NO CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. X true true X X X X true true false false false false false false false ROGER E SEAVER PRESIDENT/CEO 542227 0 251800 0 155358 0 13500 0 38532 0 1001417 0 0 0 CR BOB HUDSON OUTGOING SR VP/CFO 198901 0 144000 0 6189 0 12923 0 23544 0 385557 0 0 0 LARRY R KIDD VP/CCO 347659 0 75000 0 8677 0 13500 0 26452 0 471288 0 0 0 CYNTHIA A PETERSON OUTGOING VP/CIO 63836 0 7208 0 109500 0 0 0 1196 0 181740 0 0 0 MARK A PULEO VP/CHRO 238151 0 1154 0 1303 0 12516 0 36603 0 289727 0 0 0 JONATHAN S MILLER VP-Facility/Support 229255 0 0 0 2112 0 11663 0 35641 0 278671 0 0 0 KEITH BOYLE DIR OF SERVICE EXCELLENCE 187365 0 9281 0 1061 0 9733 0 12092 0 219532 0 0 0 Kingman Ho Chief Medical Officer 374231 0 14000 0 1253 0 4446 0 42257 0 436187 0 0 0 Paige E Heaphy VP Performance Mgmt 249451 0 0 0 120 0 8400 0 37495 0 295466 0 0 0 Jennifer R Castaldo VP CNO 148691 0 15175 0 480 0 0 0 21023 0 185369 0 0 0 Ray B Moss VP CIO 105115 0 10175 0 537 0 0 0 21822 0 137649 0 0 0 HAROUTIOUN H SHAMAMIAN DIRECTOR OF PHARMACY 208144 0 18408 0 191 0 0 0 20440 0 247183 0 0 0 ADNAN E HAMID DIRECTOR OF IT 187585 0 10445 0 407 0 3900 0 27401 0 229738 0 0 0 MARIA B SARTE CLINICAL RN 196803 0 125 0 0 0 9846 0 0 0 206774 0 0 0 donna g ferguson director of op surgery 180586 0 10680 0 1283 0 9703 0 20532 0 222784 0 0 0 SCH J, PART I, LINE 1A The hospital has a policy and procedure that provides guidelines and restrictions for travel expense reimbursement. The written policy stipulates that if an employee, for personal reasons, has his or her spouse or other members of his or her family accompany him or her while traveling on hospital business, reimbursement will be for the employees qualified expenses only. Hospital executives may have spouse or other family member travel expenses reimbursed by the hospital if such travel is deemed to have a hospital business purpose. SCH J, PART I, LINE 4A One employee that left during the year received a severance payment which is included on sch J, part II, column B(iii). the amount was paid in accordance with the agreement. Additional information is available upon request. SCH J, PART I, LINE 4B HENRY MAYO NEWHALL MEMORIAL HOSPITAL HAS A SERP (SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN) OF WHICH ONLY ONE OF ITS EMPLOYEES PARTICIPATES, ROGER SEAVER. THE AMOUNT OF BENEFIT PAID IN THE CURRENT YEAR INCLUDED ON SCHEDULE J, PART II, (B)(III) IS $133,000. A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-01 25000000 FINANCE AND REFINANCE FACILITY false false false B CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-01 35000000 FINANCE AND REFINANCE FACILITY false false false C CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-01 29550000 FINANCE AND REFINANCE FACILITY false false false D CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SCM4 2014-02-05 70000000 FINANCE AND REFINANCE FACILITY false false false A 0 41320000 25000000 0 0 0 277907 0 0 0 0 0 2016 true true true true B 0 41690000 35000000 0 0 0 361268 0 0 0 0 0 2016 true true true true C 28618000 27150000 29550000 0 0 0 332810 0 0 11986123 0 0 2016 true true true true D 0 0 70000000 0 0 0 2817884 0 0 10445674 0 0 2017 false true true true A false false false false 0 false false false false B false false false false 0 false false false false C false false false false 0 false false false false D false false false false 0 false false false false A false true false false 0 false 0 false false B false true false false 0 false 0 false false C false true false false 0 false 0 false false D false true false false 0 false 0 false false A false B false C false D false A CALIFORNIA PUBLIC FINANCE AUTHORITY 474447476 13057EAF1 2017-02-03 109625000 FINANCE AND REFINANCE FACILITY false false false A 0 0 109625000 0 0 0 1451620 0 0 0 0 0 2019 false true false true A false false false false 0 false false false false A false true false false 0 false 0 false false A false katherine dunn FAMILY MEMBER OF OFFICER 86900 WAGES false Modern Diagnostic MARK LIKER, MD, trustee 520450 INTER NEURO MONITORING false FACEY MEDICAL FOUNDATION ROSCOE MARTER MD, TRUSTEE 323013 PAY FOR HOSPITALISTS false KRYSTLE SEAVER FAMILY MEMBER OF OFFICER 60028 WAGES false F990 GOVERNANCE, MGMT AND DISCLOSURE 990 PART VI SECTION B QUESTION 11b THE BOARD OF DIRECTORS, CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEWED THE ENTIRE FORM 990 RETURN PRIOR TO FILING. F990 POLICIES 990 PART VI SECTION B QUESTION 15A The organization's CEO or top management officials' compensation are determined through the use of a compensation committee, independent consulting, and board of directors approval. Other officers/key employees of the organization receive performance reviews annually and ratings are applied that suggest the percentage of salary increase. Percentages are determined through market surveys done by Human Resources and approved each year via the budget and aprroval process. F990 DISCLOSURE 990 PART VI SECTION C QUESTION 19 THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. F990 POLICIES 990 PART VI SECTION B QUESTION 12C All board members are required to read the conflict of interest policy and complete a formal conflict of interest questionnaire annually and results of any conflict, if any, would be reported to the full board. Board members are aware and reminded of the hospital's fiduciary responsibility in reporting conflicts of interest. There have been circumstances where a conflict of interest exists and it has been disclosed to the board of directors. The conflict of interest forms are required to be updated on an annual basis. F990 GOVERNANCE, MGMT AND DISCLOSURE 990 PART VI SECTION A QUESTION 2 Dr. Mark Liker MD - Business Relationship with Modern Diagnostic Dr. Roscoe Marter MD - Business Relationship with Facey Medical Foundation Roger Seaver - Family relationship with Krystle Seaver Robert Benjamin - Family relationship with Katherine Dunn F990 Compensation of Officers, Directors, Trustees, Key Employees, Highest 990 PART VII ALL KEY AND HIGHEST PAID PERSONNEL INCLUDE ONE WAGE INCREASE AND ONE PERFORMANCE BONUS PAYMENT. However, certain executives on the list had not received wage increases and performance bonuses in prior years which were paid in the current year. FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:11707971 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:21068874 FORM 990 PART IX LINE 11G DESCRIPTION:QUALITY ASSURANCE FEE TOTAL FEES:15047062 FORM 990 PART IX LINE 11G DESCRIPTION:REGISTRY TOTAL FEES:12024787 HENRY MAYO NEWHALL MEMORIAL HEALTH FOUND 23845 MCBEAN PARKWAY VALENCIA CA 91355 953849903 RAISE FUNDS CA 501(C)(3) 7 Hospital false SANTA CLARITA HEALTHCARE ASSOCIATION 23845 MCBEAN PARKWAY VALENCIA CA 91355 953921194 HEALTHCARE ED CA 501(C)(3) 3 HOSPITAL false TOWER IMAGING VALENCIA 5455 WILSHIRE BLVD STE 1120 LOS ANGELES CA 90036 201345767 RADIOLOGY SER CA Hospital RELATED 837154 1113236 false 0 0.50000 HENRY MAYO MSO 23845 MCBEAN PARKWAY VALENCIA CA 91355 475250569 MANAGEMENT CA HOSPITAL C CORP 0 777001 1.00000 true false true true false false false false false false false false false false true true false false false false