2018-08-15T13:09:01-05:00 2017-09-30 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2016-10-01 951934652 PIH HEALTH HOSPITAL - WHITTIER PIHH 5626980811 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 GREG WILLIAMS CFO 5626980811 2018-08-13 1 WAYNE HARDER P00294296 3126343400 2016 2022-09-23 18:48:47Z GREG WILLIAMS 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 671025810 0 X WWW.PIHHEALTH.ORG X 1954 CA TO PROVIDE QUALITY HEALTHCARE AND CONTRIBUTE TO THE COMMUNITY'S HEALTH AND WELL-BEING. 17 14 3772 831 30778 5167 1880468 3620107 573514042 560571584 26648320 12774082 4490857 2718833 606533687 579684606 194770 219630 0 0 261563778 266966788 0 0 0 275350407 270505103 537108955 537691521 69424732 41993085 1250290757 1282135553 696010407 664673317 554280350 617462236 X MISSION: WHY WE ARE HERE: WE PROVIDE HIGH QUALITY HEALTHCARE WITHOUTDISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OURCOMMUNITIES IN AN ETHICAL, SAFE, AND FISCALLY PRUDENT MANNER INRECOGNITION OF OUR CHARITABLE PURPOSE.VISION: WHERE WE WANT TO BE: WE WILL ACHIEVE EXCELLENCE IN EVERYTHINGWE DO.VALUES: OUR PROMISE: OUR PATIENTS' SAFETY, WELL-BEING, AND MEDICALCONDITION WILL BE OUR PRIMARY CONCERN AT ALL TIMES. WE WILLCONSISTENTLY DEMONSTRATE RESPECT AND COMPASSION FOR THE BELIEFS,SITUATION, AND NEEDS OF OUR PATIENTS AND CO-WORKERS. WE WILL STRIVE TOANTICIPATE NEEDS AND RESPOND IN A TIMELY WAY TO MEET OR EXCEED THEEXPECTATIONS OF OTHERS. OUR ATTITUDE AND ACTIONS WILL REFLECT THEHIGHEST ETHICAL AND MORAL STANDARDS. WE WILL WORK TOGETHER - WITHIN ANDOUTSIDE THE ORGANIZATION - TO SOLVE PROBLEMS AND PURSUE OPPORTUNITIESIN CREATIVE WAYS. WE WILL SERVE THE COMMUNITY WISELY THROUGH THEEFFICIENT AND PRUDENT USE OF OUR FINANCIAL RESOURCES. 0 0 343633600 219630 493167664 PATIENT CARE: PIH HEALTH HOSPITAL - WHITTIER PROVIDES THE HIGH-QUALITY HEALTHCARE OUR COMMUNITIES HAVE COME TO EXPECT. FOUNDED IN 1959 AS PRESBYTERIAN INTERCOMMUNITY HOSPITAL, THE HOSPITAL WAS BUILT TO ADDRESS THE NEED FOR CARE AFTER A POST-WORLD WAR II POPULATION BOOM. PIH HEALTH HOSPITAL-WHITTIER PROVIDES OUTSTANDING AND COMPASSIONATE CARE TO PATIENTS, EVERY DAY.TODAY, THE CAMPUS IS THE AREA'S ACKNOWLEDGED LEADING HEALTHCARE CENTER. THE 547-BED, TOP-NOTCH FACILITY SERVES NEARLY 2.1 MILLION RESIDENTS IN LOS ANGELES AND ORANGE COUNTIES AND THE SAN GABRIEL VALLEY AREA. THE WHITTIER CAMPUS IS A PART OF PIH HEALTH, A COMPREHENSIVE HEALTH SYSTEM CONSISTING OF TWO HOSPITALS, 22 MEDICAL OFFICE LOCATIONS AND A HOST OF SPECIALTY SERVICES INCLUDING ACUTE CARE HOSPITAL SERVICES, ACUTE REHABILITATION CENTER, CANCER/ONCOLOGY CARE, CORONARY INTENSIVE CARE, MEDICAL-SURGICAL ACUTE CARE, MEDICAL-SURGICAL INTENSIVE CARE, NEONATAL INTENSIVE CARE, NEWBORN NURSERY CARE, OBSERVATION UNIT, PEDIATRIC ACUTE CARE, OBSTETRICS CARE/LABOR AND DELIVERY, TELEMETRY UNIT, TRANSITIONAL CARE UNIT, EMERGENCY AND HOME CARE SERVICES, AND A WIDE RANGE OF ANCILLARY AND OUTPATIENT SERVICES.PATIENT CARE IN FISCAL YEAR 2016-2017EMPLOYEES 3,302VOLUNTEERS 826NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS 80,279NUMBER OF BIRTHS 1,749MEDICAL STAFF 503 98181295 66701038 FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: FINANCIAL ASSISTANCE, ALSO KNOWN AS CHARITY CARE, IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO INDIVIDUALS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PIH HEALTH OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM, PROVIDING CHARITY CARE TO THOSE WITH FAMILY INCOME(S) AT OR BELOW 400% OF FEDERAL POVERTY LEVEL GUIDELINES.IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN MEANS-TESTED GOVERNMENT HEALTH PROGRAMS, SUCH AS MEDI-CAL, PIH HEALTH REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR DUE TO THE SHORTFALL CREATED WHEN THE PAYMENTS RECEIVED FROM THESE PROGRAMS ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 41,088 13058857 2461859 OTHER COMMUNITY BENEFIT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES: DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THESE PROGRAMS INCLUDE: COMMUNITY COLLABORATIVE SUPPORT AND PARTICIPATION, COMMUNITY EDUCATION, COMMUNITY INFORMATION AND REFERRAL SUPPORT, ENROLLMENT ASSISTANCE, HEALTH AND WELLNESS CENTER AT WHITTIER FIRST DAY, PREVENTATIVE HEALTH PROGRAMS AND SCREENINGS, SUPPORT GROUPS, AND TRANSPORTATION RESOURCES.SNAPSHOT OF OUTCOMES:MORE THAN 22,524 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES.HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, NURSES, STUDENTS AND OTHER HEALTH PROFESSIONALS WHEN EDUCATION IS NECESSARY OR REQUIRED BY STATE LAW, ACCREDITING BODY OR HEALTH PROFESSION SOCIETY. PIH HEALTH PROGRAMS INCLUDE THE FAMILY MEDICINE RESIDENCY PROGRAM, PARAMEDIC BASE STATION TRAINING AND STUDENT EDUCATION (INTERNSHIP, EXTERNSHIP, PRECEPTORSHIP AND MENTORING PROGRAMS).SNAPSHOT OF OUTCOMES:MORE THAN 971 STUDENT NURSES, PHYSICIAN RESIDENTS, AND OTHER INDIVIDUALS STUDYING TO BECOME HEALTHCARE PROFESSIONALS WERE PROVIDED WITH MENTORSHIP, PRECEPTORSHIP AND TRAINING OPPORTUNITIES.SUBSIDIZED HEALTH SERVICES: SUBSIDIZED SERVICES ARE CLINICAL PROGRAMS, WHICH ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO THE RESPONSIBILITY OF GOVERNMENT OR ANOTHER NONPROFIT ORGANIZATION TO PROVIDE. PIH HEALTH SERVICES PROVIDED INCLUDE DIABETES EDUCATION CENTER, EMERGENCY DEPARTMENT ON-CALL PHYSICIANS, HIGH-RISK INFANT FOLLOW-UP CLINIC, HOSPICE HOMES, PALLIATIVE CARE PROGRAM, AND PARAMEDIC BASE STATION.SNAPSHOT OF OUTCOMES:THE HIGH RISK INFANT FOLLOW-UP CLINIC ENSURES FAMILIES HAVE ACCESS TO SPECIALIZED CARE TO MEET THEIR CHILDREN'S DEVELOPMENTAL NEEDS, WITH APPROXIMATELY 80-100 CHILDREN SERVED EACH YEAR. THE HOSPICE HOMES ENSURE ACCESS TO QUALITY, COMPASSIONATE END-OF-LIFE CARE, REGARDLESS OF ABILITY TO PAY, WITH APPROXIMATELY 200 PATIENTS SERVED EACH YEAR. TOTAL INDIVIDUALS SERVED BY SUBSIDIZED HEALTH SERVICES = 12,532RESEARCH: RESEARCH THAT MAY BE REPORTED AS COMMUNITY BENEFIT INCLUDES CLINICAL AND COMMUNITY HEALTH RESEARCH AS WELL AS STUDIES ON HEALTHCARE DELIVERY THAT ARE GENERALIZABLE AND SHARED WITH THE PUBLIC. PIH HEALTH HAS BEEN OFFERING CLINICAL TRIALS AND RESEARCH STUDIES AIMED AT IMPROVING HEALTH AND CANCER CARE SINCE 2001. SNAPSHOT OF OUTCOMES:15 CLINICAL TRIALS WERE OFFERED WITH 57 PARTICIPATING.CASH & IN-KIND CONTRIBUTIONS: THIS CATEGORY INCLUDES FUNDS AND IN-KIND SERVICES DONATED BY PIH HEALTH TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE FOR A COMMUNITY BENEFIT PURPOSE. THESE DONATIONS INCLUDE CASH DONATIONS TO COMMUNITY ORGANIZATIONS, HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY WHILE ON PIH HEALTH WORK TIME, THE COST OF MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF EQUIPMENT, MEDICATIONS, AND SUPPLIES. SNAPSHOT OF OUTCOMES:68 AT-RISK INDIVIDUALS WERE PROVIDED WITH IN-KIND DURABLE MEDICAL EQUIPMENT OR SERVICES, SUCH AS SKILLED NURSING OR MENTAL HEALTHCARE. MORE THAN $93,000 IN CASH DONATIONS WAS GIVEN TO 31 ORGANIZATIONS TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IN OUR SERVICE AREA COMMUNITIES.TOTAL NUMBER OF PERSONS SERVED BY ALL CATEGORIES: 37,225FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBANNUALREPORT 454873752 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 178 0 1 3772 1 1 1 0 0 0 0 0 0 0 0 0 X 17 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X GREG WILLIAMS 5626980811 12401 WASHINGTON BLVD WHITTIER CA 90602 EFRAIN ACEVES DIRECTOR & VICE CHAIR 1.50 4.50 X X 0 0 0 RICHARD ATWOOD DIRECTOR 1.50 6.00 X 0 0 0 JAMES BALL DIRECTOR 1.50 4.50 X 0 0 0 PAULA COWAN DIRECTOR 1.50 4.50 X 0 0 0 JANE DICUS DIRECTOR & CHAIR 1.50 4.50 X X 0 0 0 ED DUNLAP DIRECTOR 1.50 4.50 X 0 0 0 FRANK GOMEZ PHD DIRECTOR 1.50 4.50 X 0 0 0 THOMAS KING DIRECTOR & SECRETARY 1.50 4.50 X X 0 0 0 SUDHAKER NAYAK MD DIRECTOR 9.00 40.00 X 154550 1701371 34335 ROBERT PETRINA DIRECTOR 1.50 4.50 X 0 0 0 C WAYNE RAY MD DIRECTOR(UNTIL 1/9/17) 10.00 X 72000 0 0 NEAL SHINDEL MD DIRECTOR 1.50 40.00 X 0 1261543 34688 KENTON WOODS DIRECTOR & TREASURER 1.50 4.50 X X 0 0 0 HUEY-MIN YU DIRECTOR 1.50 4.50 X 0 0 0 CHARLOTTE WEAVER DIRECTOR(AS OF 10/10/16) 1.50 4.50 X 0 0 0 PATRICK MONROE DIRECTOR(AS OF 10/10/16) 1.50 4.50 X 0 0 0 JEFF HAMAR DIRECTOR(AS OF 10/10/16) 1.50 4.50 X 0 0 0 ROBERT BOHR MD DIRECTOR(AS OF 1/9/17) 1.50 0.00 X 0 529531 9210 JAMES WEST PRESIDENT/CEO 30.00 16.20 X 1311324 0 234548 PEGGY CHULACK CHIEF ADMIN OFFICER 30.00 16.20 X 709623 0 109060 GREG WILLIAMS CFO 30.00 14.70 X 572298 0 175957 ROSALIO LOPEZ MD SR VP & CMO/CSO 40.00 4.50 X 1054869 0 110446 REANNA THOMPSON COO/CNO 40.00 X 532804 0 112103 DAVID KLINGER SR VP FAC & REAL ESTATE 40.00 X 575584 0 33937 DAVIS LEE CHIEF MED INFO OFFICER 40.00 X 513054 0 93847 SHERREL HOLLINGSWORTH CHIEF HR OFFICER 40.00 X 473600 0 103957 DEBRA LEGAN VP MKTG & PLANNING 40.00 X 359751 0 60409 RONALD YOSHIHARA VP FINANCE & ANALYTICS 40.00 1.70 X 341979 0 78550 PERRY EBELTOFT VP ANCILLARY SVS 40.00 X 323883 0 60679 JOAN ROLLAND ADM ED/DISASTER SV 40.00 X 290089 0 66408 ANUP PATEL VP ENT RSK MGMT & CORP COM 40.00 X 244948 0 55217 CHICO MANNING VP SUPPLY CHAIN 40.00 X 190823 0 43478 SUSANNE CARLSON VP REV CYC & MGD CARE 40.00 X 160966 0 14948 JUNG HO MEDICAL PHYSICIST 40.00 X 261919 0 29263 JACQUELINE NGUYEN PHARMACIST CLIN 40.00 X 246790 0 23898 SCOTT BREMER DIR COMP, BENEF & HRIS 40.00 X 226333 0 31109 SHELLY NECKE VP POST ACUTE CR SVS 40.00 X 219639 0 56780 JACQUELYN CITUK EXEC DIR PHARM 40.00 X 217632 0 9240 MITCHELL THOMAS CFO - FORMER 0.00 X 165452 0 19754 PATRICIA BRAY VP POST ACUTE CR SVS 0.00 X 207792 0 0 9427702 3492445 1601821 492 1 1 0 ALLSCRIPTS - CHICAGO 24630 NETWORK PLACE CHICAGO IL 60673 IT SERVICES 16721626 INTERCOMMUNITY ANESTH SVCS INC PO BOX 511509 LOS ANGELES CA 90051 MEDICAL SERVICES 11666674 LAMBERT RADIOL MED GRP INC 11721 WHITTIER BLVD SUITE 509 WHITTIER CA 90601 MEDICAL SERVICES 8894906 WHITTIER PULM AND CRITC CARE 6905 ALTA VISTA DRIVE RANCHO PALOS VERDES CA 90275 MEDICAL SERVICES 6986352 RIGHTSOURCING INC 999 STEWART AVENUE SUITE 100 BETHPAGE NY 11714 PROFESSIONAL SERVICES 2347076 73 3620107 3620107 NET PATIENT REVENUE 621610 450843094 450843094 OTHER PATIENT REVENUE 621610 67045122 67045122 HOSPITAL FEE PROGRAM 900099 32700748 32700748 FOOD SERVICES 900099 2936894 2936894 ARRA INCENTIVE PAYMENT 900099 151007 151007 6894719 6894719 560571584 9498518 9498518 94284988 331780 90891002 450202 3393986 -118422 3275564 3275564 COMMUNITY PHARMACY 624110 1758977 1758977 PURCHASE DISCOUNTS 900099 929078 929078 30778 30778 2718833 579684606 562330561 30778 13703160 X 98630 98630 121000 121000 7593650 5255423 2338227 179261791 147117099 32144692 16608981 14117634 2491347 48532845 41252918 7279927 14969521 12730336 2239185 2031167 2031167 1598079 21239 1576840 67927 67927 117720 117720 61564871 55509020 6055851 7748157 4054130 3694027 32671221 26790401 5880820 10523428 7226247 3297181 480933 403055 77878 6628415 5115408 1513007 24989953 21242875 3747078 5534170 5534170 MEDICAL SUPPLIES 68064894 67663663 401231 QUALITY ASSURANCE FEE ( 24179384 24179384 BAD DEBT EXPENSE 8617821 8617821 EQUIPMENT R&M 4574889 4570937 3952 11112074 8786532 2325542 537691521 454873752 82817769 0 532477 271662 74142187 67651252 4884813 5568606 8799320 8554562 595691603 228239212 378720227 367452391 429580252 457811734 353631481 374825346 1250290757 1282135553 50476693 54167762 374109701 364725100 53000000 48000000 218424013 197780455 696010407 664673317 X 554280350 617462236 554280350 617462236 1250290757 1282135553 X 41993085 29167986 -295214 -7683971 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 117720 117720 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: A PORTION OF DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND AMERICAN HOSPITAL ASSOCIATION ARE RELATED TO LOBBYING. 214611 214611 323050127 68163118 254887009 73397213 25479820 47917393 182088441 127826532 54261909 16941211 6769742 10171469 367452391 DEFERRED FINANCING COSTS 3573685 INTERCOMPANY RECEIVABLE 315689137 OTHER RECEIVABLES 7086437 INVESTMENT IN AFFILIATES 1555033 HOSPITAL FEE PROGRAM RECEIVABLE 46105739 OTHER DEPOSITS 815315 374825346 BOND INTEREST PAYABLE 2175564 HOSPITAL FEE PAYABLE 26002593 DEFERRED COMPENSATION 15511404 INTEREST RATE SWAP 38751086 PENSION LIABILITY 77434909 SELF INSURANCE RESERVES 16430706 OTHER LIABILITIES 1974193 NOTE PAYABLE 19500000 197780455 X PART X, LINE 2: THE COMPANY HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES, AND AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE COMPANY IS SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, WHICH DOES NOT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS. THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT, AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE COMPANY HAS NOT RECORDED A LIABILITY FOR UNRECOGNIZED TAX UNCERTAINTIES IN 2017 OR 2016. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE COMPANY BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2013 FOR FEDERAL PURPOSES AND 2011 FOR CALIFORNIA PURPOSES. 1 1 X 1 X 1 X 1 1 1 0 1 1 1202 5220875 1923794 3297081 0.00610 39364 90571101 63759303 26811798 0.04990 522 2389319 1017941 1371378 0.00260 41088 98181295 66701038 31480257 0.05860 21 22584 2156215 84095 2072120 0.00390 4 971 4412542 840496 3572046 0.00660 6 12532 5771388 1386921 4384467 0.00820 1 57 173857 149027 24830 0.00000 4 1061 544855 1320 543535 0.00100 36 37205 13058857 2461859 10596998 0.01970 36 78293 111240152 69162897 42077255 0.07830 1 2 22543 22543 0.00000 1 10 15579 15579 0.00000 2 6 30316 30316 0.00010 1 2 522 522 0.00000 5 20 68960 68960 0.00010 1 8617821 71268014 87906199 -16638185 X 1 1 1 1 PIH HEALTH HOSPITAL - WHITTIER 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 WWW.PIHHEALTH.ORG 930000129 X X X X SKILLED NURSING FACILITY PIH HEALTH HOSPITAL - WHITTIER 1 0 0 1 X X X X X X X X X X 15 1 1 0 1 X PIHHEALTH.ORG/CHNA X HEALTHACTIONLAB.SHUTTERFLY.COM X X 1 15 1 PIHHEALTH.ORG/CHIP 0 1 X 100.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES DATA AND INFORMATION REGARDING DEMOGRAPHIC PROFILE, SOCIAL DETERMINANTS OF HEALTH, GENERAL HEALTHCARE ACCESS, MATERNAL AND INFANT HEALTH, ORAL HEALTH, MENTAL HEALTH, HEALTH BEHAVIORS, WEIGHT STATUS, NUTRITION AND PHYSICAL ACTIVITY, CHRONIC DISEASES, LEADING CAUSES OF DEATH AND COMMUNITY PERSPECTIVES GATHERED FROM FOCUS GROUPS AND INTERVIEWS. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 5: PRIMARY DATA COLLECTION CONSISTED OF 21 KEY STAKEHOLDER INTERVIEWS AND SIX COMMUNITY FOCUS GROUPS (50 PARTICIPANTS) REGARDING PERCEPTIONS AND OPINIONS OF THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA.INTERVIEW PARTICIPANTS INCLUDED AGENCIES REPRESENTING A BROAD RANGE OF HEALTH AND SOCIAL SERVICES, INCLUDING LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AS WELL THE LOCAL HEALTH DEPARTMENT THAT HAVE CURRENT INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE. KEY STAKEHOLDER INTERVIEWEES1. EVELYN CASTRO-GUILLEN, CHIEF OPERATING OFFICER, THE WHOLE CHILD2. JOANN EROS-DELGADO, FACILITY DIRECTOR, LA COUNTY COMMUNITY RESOURCE CENTER3. RICHARD ESPINOSA, HEALTH DEPUTY, OFFICE OF LA COUNTY SUPERVISOR DON KNABE4. JEFF FARBER, EXECUTIVE DIRECTOR, HELPLINE YOUTH COUNSELING5. ALEXANDRIA GUEVARA, TEEN PROGRAM DIRECTOR, WHITTIER BOYS & GIRLS CLUB6. MICHEL HESIA, PROMOTORA, ACTIVATE WHITTIER COMMUNITY COLLABORATIVE7. SCOTT LEE MD, FAMILY MEDICINE PHYSICIAN, PIH HEALTH8. PENNY LOPEZ, PROGRAM DIRECTOR, ACTIVATE WHITTIER COMMUNITY COLLABORATIVE9. EDITH MARCEL, PROMOTORA PRESIDENT, HEALTHY LOS NIETOS COMMUNITY COLLABORATIVE10. CLARE MCCLAFFERTY, SOCIAL WORKER, PIH HEALTH11. RICARDO MENDOZA, DEPUTY DISTRICT DIRECTOR, OFFICE OF CONGRESSWOMAN LINDA SANCHEZ12. SID MENZIES, CHIEF OPERATING OFFICER, BOYS & GIRLS CLUB OF WHITTIER13. USAMA MITRY MD, FAMILY MEDICINE PHYSICIAN, PIH HEALTH14. MARIA OCHOA RN BSN PHN, SPA 7 COMMUNITY LIAISON PUBLIC HEALTH NURSE LA COUNTY DEPARTMENT OF PUBLIC HEALTH15. LIZET OLMOS, RECREATION COORDINATOR, PICO RIVERA SENIOR CENTER16. JIM ROBERTS, PATIENT ADVISOR/AMBASSADOR, PIH HEALTH17. DENNA SANCHEZ PHD, PSYCHOLOGIST COORDINATOR, PSYCHOLOGICAL SERVICES RIO HONDO COLLEGE18. ANA SUAREZ, DISTRICT CHIEF, LA COUNTY DEPARTMENT OF MENTAL HEALTH SPA 719. JOHN VELASCO, DIRECTOR AND VICE PRESIDENT, HEART OF COMPASSION20. MARTHA VELASQUEZ, PROGRAM DIRECTOR, SPIRITT FAMILY SERVICES21. GUYLENE VELEZ, SOCIAL WORKER, PIH HEALTHFOCUS GROUPS PARTICIPANTS INCLUDED MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, INDIVIDUALS OR ORGANIZATIONS SERVING THE INTERESTS OF THESE POPULATIONS, AND PERSONS REPRESENTING THE BROAD INTEREST OF THE COMMUNITY. FOCUS GROUPS WERE CONDUCTED IN BOTH ENGLISH AND SPANISH.COMMUNITY FOCUS GROUPS1. PARTNERSHIP FOR HEALTHIER COMMUNITIES COLLABORATIVE, SIX COMMUNITY-BASED ORGANIZATIONS2. STEINMETZ SENIOR CENTER- HACIENDA HEIGHTS, 10 OLDER ADULTS3. PLAZA DE LA RAZA, FIVE PARENTS OF PRESCHOOL-AGED CHILDREN4. INTERFAITH FOOD CENTER, 10 FOOD PANTRY CLIENTS5. MY FRIEND'S HOUSE, 12 FAITH-BASED GROUP PASTORS, LAY PASTORS AND CONGREGANTS6. FRIENDS OF FAMILY HEALTH CENTER - LA HABRA, SEVEN COMMUNITY CLINIC CLIENTS PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 6A: PIH HEALTH HOSPITAL - WHITTIER'S CHNA WAS CONDUCTED WITH PIH HEALTH HOSPITAL - DOWNEY AND KAISER FOUNDATION HOSPITAL - DOWNEY MEDICAL CENTER. SHARED SERVICE AREAS AND COMMUNITY PARTNERS ALLOWED FOR COORDINATED INTERVIEWS AND FOCUS GROUPS AND SHARING OF DATA/RESULTS. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 7D: ASSESSMENT FINDINGS WERE ALSO DISTRIBUTED TO KEY STAKEHOLDERS VIA EMAIL WITH EMPHASIS ON SUPPORTING PROGRAM PLANNING AND FUND-DEVELOPMENT ENDEAVORS, AND SPARING ORGANIZATIONS THE EXPENSE OF DUPLICATIVE DATA COLLECTION EFFORTS. ASSESSMENT FINDINGS ARE ALSO SHARED ON AN ON-GOING BASIS AT COMMUNITY EVENTS AND COMMUNITY COLLABORATIVE MEETINGS. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 11: PIH HEALTH'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) ENSURES ALIGNMENT OF CHNA FINDINGS, OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PIH HEALTH'S ORGANIZATIONAL STRATEGY. TO VIEW THE 2017-2019 CHIP AND THE INITIATIVES IDENTIFIED TO ADDRESS AREAS OF FOCUS (DIABETES, HEART DISEASE, OVERWEIGHT/OBESITY, PREVENTATIVE SCREENINGS AND IMMUNIZATIONS, FOOD INSECURITY, HOMELESSNESS AND EDUCATION), VISIT PIHHEALTH.ORG/CHIP. FOR THE HEALTH NEEDS THAT WERE NOT PRIORITIZED AS AREAS OF FOCUS (ASTHMA, CANCER DEATHS, DENTAL CARE ACCESS, HEALTH INSURANCE COVERAGE/AFFORDABILITY, LUNG DISEASE DEATHS, MENTAL HEALTHCARE, AND SUBSTANCE ABUSE), PIH HEALTH HAS NEITHER THE EXPERTISE NOR THE INFRASTRUCTURE TO SERVE AS LEAD IN THESE AREAS. AS THESE HEALTH NEEDS ARE STILL VERY IMPORTANT TO PIH HEALTH AND THE COMMUNITY WE SERVE, WORK WILL CONTINUE IN THESE AREAS WHERE APPLICABLE, AND REFERRAL AND FUNDING RELATIONSHIPS WITH COMMUNITY-BASED AGENCIES ALREADY WORKING IN THESE AREAS MAY BE STRENGTHENED. PIH HEALTH HOSPITAL - WHITTIER PART V, SECTION B, LINE 13B: ASSISTANCE IS PROVIDED FREE OR DISCOUNTED FOR THOSE PATIENTS ELIGIBLE FOR FAP. THE CRITERIA FOR FAP IS IF THE PATIENT IS UNINSURED AND DOES NOT HAVE THE ABILITY TO PAY, HAS RESTRICTED MEDI-CAL BENEFITS, OR IS UNDERINSURED. THIS IS ALSO CONSIDERATIONS FOR PATIENTS WHERE THE FPG IS NOT APPLICABLE AND THE PATIENT IS INSURED WITH INADEQUATE COVERAGE OR EXCESSIVE LIABILITY. PART V, LINE 16B, FAP APPLICATION WEBSITE PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/PRICING-FINANCIAL-ASSISTANCE 12 1 - SAME DAY SURGERY 12415 WASHINGTON BLVD WHITTIER CA 90602 OUTPATIENT SURGICAL SERVICES 2 - INTERCOMMUNITY MAGNETIC RESONANCE IMAGNG 12455 WASHINGTON BLVD WHITTIER CA 90602 MRI SERVICES 3 - ERNEST D WELLS MEDICAL OFFICE BUILDING 12462 PUTNAM ST WHITTIER CA 90602 OUTPATIENT SERVICES 4 - PATRICIA L SHCEIFLY BREAST HEALTH CTR 12393 WASHINGTON BLVD WHITTIER CA 90602 BREAST HEALTH SVCS 5 - PRESBYTERIAN HEALTH MEDICAL PLAZA 12291 WASHINGTON BLVD WHITTIER CA 90602 WOUND HEALING, LAB DRAW STATION 6 - ARCADIA HOME HEALTH NURSING 351 E FOOTHILL BLVD SUITE 100 ARCADIA CA 91006 VISITING NURSES ASSOCIATION 7 - HOSPICE HOMES - DOVE 10736 VALLEY VIEW AVE WHITTIER CA 90604 HOSPICE CARE 8 - HOSPICE HOMES - ROSE 10742 VALLEY VIEW AVE WHITTIER CA 90604 HOSPICE CARE 9 - PIH HOME HEALTH 15050 IMPERIAL HWY LA MIRADA CA 90638 HOME HEALTH AGENCY 10 - PRESBYTERIAN HEALTH MEDICAL PLAZA 15088 IMPERIAL HWY LA MIRADA CA 90638 OUTPATIENT THERAPY 11 - BHP - LA MIRADA 12675 S LA MIRADA BLVD SUITE 219 LA MIRADA CA 90638 RADIOLOGY 12 - HACIENDA HEIGHTS MEDICAL OFFICE BUILDING 1850 AZUSA AVE HACIENDA HEIGHTS CA 91745 MAMMOGRAPHY PART I, LINE 6A PIH HEALTH'S COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2015-2016 ACCOUNTS FOR BOTH PIH HEALTH HOSPITAL WHITTIER AND PIH HEALTH HOSPITAL DOWNEY'S (EIN: 95-1903935) PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITY.TO VIEW THE FULL REPORT, VISIT PIHHEALTH.ORG/CBANNUALREPORT PART I, LINE 7 PATIENT CARE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE FINANCIAL ASSISTANCE. FOR ALL OTHERS, WE UTILIZED INTERNAL COSTING SYSTEM AND ACCOUNTS FOR THE VARIOUS PAYER MIX. PART II, COMMUNITY BUILDING ACTIVITIES: PIH HEALTH WORKS WITH A VARIETY OF COMMUNITY STAKEHOLDERS TO ENHANCE THE COLLECTIVE CAPACITY FOR ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS. PIH HEALTH MOBILIZES ASSETS AND INVESTS RESOURCES THROUGH A VARIETY OF COMMUNITY-BUILDING ACTIVITIES DESIGNED TO ADDRESS IDENTIFIED NEEDS, INCLUDING PARTICIPATION IN A LIGHT RAIL TRANSIT COALITION AIMED TO IMPROVE PUBLIC TRANSPORTATION RESOURCES TO THE LOCAL COMMUNITY AS WELL AS PARTICIPATION ON LOCAL CHAMBER OF COMMERCE BOARDS AIMED AT IMPROVING THE ECONOMIC, CIVIC AND CULTURAL WELLBEING OF THE COMMUNITY. PIH HEALTH ALSO UNDERTAKES DISASTER PREPAREDNESS TRAINING ABOVE AND BEYOND LICENSURE REQUIREMENTS TO ENSURE WE ARE EFFECTIVELY PREPARED TO SERVE THE COMMUNITY IN A DISASTER. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OFHISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATIONHISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARECOVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSESTHE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPONHISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE COMPANY FOLLOWSESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITHCOLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ONCOLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BADDEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS ADEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCESAND DISCOUNTS) SINCE THE COMPANY ACCEPTS AND TREATS ALL PATIENTS WITHOUTREGARD TO THE ABILITY TO PAY. PART III, LINE 4 THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED AMOUNTS. THE COMPANY MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS.AS PART OF THE COMPANY'S MISSION TO SERVE THE COMMUNITY, THE COMPANY PROVIDES CARE TO PATIENTS EVEN THOUGH THEY MAY LACK ADEQUATE INSURANCE OR MAY PARTICIPATE IN PROGRAMS WITH NEGOTIATED OR REGULATED PAYMENT AMOUNTS. THE COMPANY MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY CARE UPON ADMISSION, THROUGH DETERMINATION MAY ALSO BE MADE AT A LATER TIME. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE APPLICATION OF ANY FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT, AND REASONABLE EFFORTS TO COLLECT FROM PATIENT HAVE BEEN EXHAUSTED, THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE COMPANY.THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE COMPANY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE THE COMPANY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. PART III, LINE 8 THE COMPANY DOES NOT TAKE THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE STATE HAS SPECIFICALLY ASKED US TO REPORT THIS SEPARATELY FROM OUR COMMUNITY BENEFIT TOTALS. THE COMPANY USES A COST-TO-CHARGE (C2C) RATIO TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENT RECEIVED FROM MEDICARE, WHICH IS SIMILAR TO THE IRS SCHEDULE H METHOD. HOWEVER, THE PIH HEALTH SYSTEM IS MORE REFINED AND EXACTING, SINCE IT IS GENERATED AT THE DEPARTMENT LEVEL AND INCLUDES BOTH DIRECT COSTS AND ALLOCATED COMPANY-WIDE INDIRECT COSTS. ALL PERIOD INDIRECT COSTS ARE ALLOCATED BETWEEN PIH HEALTH DEPARTMENTS BASED ON THEIR RELATIVE GROSS CHARGES. THE SUM OF THE DIRECT AND ALLOCATED INDIRECT COSTS OF EACH DEPARTMENT ARE DIVIDED BY THE TOTAL DEPARTMENT GROSS PROCEDURE CHARGES. THE RESULTING DEPARTMENT SPECIFIC PERCENTAGE, IE. DEPARTMENT C2C %, IS LOADED INTO PIH HEALTH'S ERP SOFTWARE EACH QUARTER. THE COST SYSTEM APPLIES THE DEPARTMENT'S C2C% TO ALL PROCEDURE CHARGES ORIGINATING WITHIN THE DEPARTMENT IN ORDER TO COMPUTE THE RELATED PROCEDURE COSTS. AS SUCH, ALL COST INFORMATION REFLECTED IN PIH HEALTH'S REGULATORY REPORTING AND FINANCIAL ANALYSIS IS BASED ON THE ABOVE DEPARTMENT C2C METHODOLOGY. PART III, LINE 9B THE HOSPITAL ENCOURAGES ALL SELF-PAY PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE OR OTHER PROGRAMS. 1. ALL UNINSURED PATIENTS ARE ASSUMED TO NEED FINANCIAL ASSISTANCE AND AUTOMATICALLY RECEIVE DISCOUNTED BILLS THAT REFLECT THE CONTRACT RATE OR LESS OF A MEDICARE ADVANTAGE CONTRACT.2. ALL UNINSURED PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE AND MEDICAID APPLICATION AT THE TIME OF REGISTRATION THEREBY GIVING THEM THE OPPORTUNITY TO APPLY FOR ASSISTANCE. 3. THERE ARE SIGNS THROUGH THE FACILITY THAT EDUCATE PATIENTS AND VISITORS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. 4. THE HOSPITAL'S WEBSITE PUBLISHES THE FINANCIAL ASSISTANCE POLICY AND APPLICATIONS.5. SELF-PAY INPATIENTS ALSO MAY BE CONTACTED BY A VENDOR TO OFFER ASSISTANCE IN APPLYING FOR MEDICAID, IF ELIGIBLE. 6. STATEMENTS (WHICH REFLECT A REDUCTION IN CHARGES TO THE RATES AT OR LOWER THAN CONTRACTED RATES FOR MEDICARE ADVANTAGE MEMBERS) PROMOTE THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM7. ONLY PATIENTS WHO DO NOT QUALIFY FOR FURTHER FINANCIAL ASSISTANCE (AFTER DISCOUNTS) OR WHO DO NOT APPLY FOR PROGRAMS AND DO NOT PAY ARE REFERRED TO COLLECTION. IN ADDITION, IF A PATIENT IS REFERRED TO COLLECTION AND LATER APPLIES FOR CHARITY AND QUALIFIES, THE PATIENT'S ACCOUNT IS RETURNED TO THE HOSPITAL AND FINANCIAL ASSISTANCE IS EXTENDED. PART VI, LINE 2: IN ADDITION TO THE HOSPITAL'S CHNA, PIH HEALTH UTILIZES THE FOLLOWING METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES:COMMUNITY BENEFIT OVERSIGHT COMMITTEE- IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC), WHICH IS COMPRISED OF COMMUNITY STAKEHOLDERS AND KEY PUBLIC HEALTH AND LEGISLATIVE REPRESENTATIVES. THIS COMMITTEE MEETS REGULARLY AND ITS MEMBERS SHARE HEALTHCARE-RELATED NEEDS/CONCERNS EXPERIENCED BY THE COMMUNITY MEMBERS THEY REPRESENT AS WELL AS ASSETS OR POTENTIAL PARTNERS FOR THE HOSPITAL TO ENGAGE IN ADDRESSING THE IDENTIFIED NEEDS.COMMUNITY HEALTH IMPROVEMENT TEAM- THIS INTERNAL WORK GROUP OF HOSPITAL STAFF WHO MANAGE THE HOSPITAL'S VARIOUS COMMUNITY-BASED PROGRAMS MEETS REGULARLY TO SHARE RESOURCES THAT BENEFIT COMMUNITY MEMBERS AND TO DISCUSS ANY CHALLENGES / NEEDS AS A WAY TO ENHANCE THE PROVISION OF SERVICES.PROGRAM OUTCOMES - DATA ANALYSIS- EXTENSIVE DATA COLLECTION IS DONE FOR PIH HEALTH'S KEY COMMUNITY-BASED PROGRAMS. THIS DATA IS SUMMARIZED AND EVALUATED REGULARLY BY PROGRAM MANAGEMENT, CBOC MEMBERS, AND HOSPITAL LEADERSHIP. CHNA DATA DRIVES PROGRAM IMPROVEMENTS TO MAXIMIZE IMPACT AND MORE DIRECTLY MEET COMMUNITY NEEDS. FEEDBACK FROM COMMUNITY ORGANIZATIONS / COLLABORATIVESTHROUGH PARTICIPATION IN VARIOUS COMMUNITY COLLABORATIVES AND NETWORKING MEETINGS, PIH HEALTH IS ABLE TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY AND IDENTIFY PARTNERSHIP OPPORTUNITIES. PART VI, LINE 3: THERE ARE MANY AVENUES PIH HEALTH TAKES IN EDUCATING PATIENTS AND FAMILY MEMBERS ABOUT THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS. PATIENTS ARE ADVISED AT THE TIME OF SERVICE, DURING IN-HOUSE CARE AND POST DISCHARGES. FREE HANDOUTS OF THE FAP APPLICATION ARE PROVIDED IN BOTH ENGLISH AND SPANISH. THERE ARE POSTINGS THROUGHOUT THE HOSPITAL IN BOTH ENGLISH AND SPANISH WITH INFORMATION ABOUT OUR FAP PROGRAM. WE HAVE AN ELIGIBILITY VENDOR THAT IS CONVENIENTLY AVAILABLE TO ASSIST OUR PATIENTS IN THE EMERGENCY ROOM OR IN-HOUSE PATIENTS WITH DETERMINING ELIGIBILITY FOR VARIOUS GOVERNMENTAL PROGRAMS, AS WELL AS, ADVISE AND ASSIST THE PATIENT IWTH THE FAP. POST DISCHARGE, OUR BUSINESS OFFICE STAFF TAKES THE INITIATIVE TO ADVISE THE PATIENT OF OUR FAP PROGRAM. ALSO, WITH EACH PATIENT STATEMENT THAT IS SENT OUT, THE FAP PROGRAM IS PRINTED ON THE BACK OF THE STATEMENT. PIH'S FAP IS ALSO PUBLISHED ON OUR WEBSITE. PART VI, LINE 4: PIH HEALTH HOSPITAL - WHITTIER SERVES AN URBAN GEOGRAPHY IN THE SOUTHEAST PORTION OF LOS ANGELES COUNTY, CALIFORNIA, WITHIN SERVICE PLANNING AREA 7 (SPA 7). PRIMARY SERVICE AREA CITIES INCLUDE:DOWNEY 90241HACIENDA HEIGHTS 91745LA HABRA 90631LA HABRA HEIGHTS 90631LA MIRADA 90638LA PUENTE 91744MONTEBELLO 90640NORWALK 90650PICO RIVERA 90660ROWLAND HEIGHTS 91748SANTA FE SPRINGS 90670WALNUT 91789WHITTIER 90601-90606PRIMARY SERVICE AREA PROFILETHE POPULATION FOR PIH HEALTH HOSPITAL - WHITTIER'S PRIMARY SERVICE AREA IS 822,408. POPULATION DEMOGRAPHICS: CHILDREN AND YOUTH (AGES 0-19) MAKE UP 27.9% OF THE POPULATION; OLDER ADULTS (AGES 65+) MAKE UP 12.2% OF THE POPULATION. THE LARGEST POPULATION BY RACE AND ETHNICITY IN THE SERVICE AREA IS HISPANIC OR LATINO (65.1%). WHITE/CAUCASIANS MAKE UP 16.1% OF THE POPULATION. ASIANS COMPRISE 15.5% OF THE POPULATION, AND AFRICAN AMERICANS, NATIVE AMERICANS, HAWAIIANS, AND OTHER RACES COMBINED TOTAL 3.3% OF THE POPULATION. INCOME & POVERTY: THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA RANGES FROM $47,438 IN MONTEBELLO TO $91,623 IN WALNUT. SOME 11.6% OF THE SERVICE AREA POPULATION LIVES BELOW 100% OF THE FEDERAL POVERTY LEVEL AND 33.5% LIVE BELOW 200%. HEALTH INSURANCE: 79.1% OF THE SERVICE AREA IS INSURED, 90.9% OF CHILDREN UNDER 18 ARE INSURED AND 71% OF ADULTS AGES 18-64 ARE INSURED. IN SPA 7, 30.7% ARE MEDI-CAL RECIPIENTS.THERE ARE SEVEN OTHER HOSPITALS PROVIDING CARE IN THE SERVICE AREA POPULATION AND NO FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE SERVICE AREA. FOR ADDITIONAL DATA REGARDING THE SERVICE AREA, PLEASE SEE THE CHNA AT PIHHEALTH.ORG/CHNA PART VI, LINE 5: IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC), COMPRISED OF COMMUNITY STAKEHOLDERS AND A PUBLIC HEALTH REPRESENTATIVE. THE CBOC PROMOTES THE HEALTH OF THE COMMUNITY BY 1) REVIEWING AND VALIDATING LEGAL AND REGULATORY COMPLIANCE WITH RESPECT TO COMMUNITY BENEFIT MANDATES, 2) REVIEWING AND VALIDATING THAT PIH HEALTH'S COMMUNITY BENEFIT PROGRAMS AND SERVICES EFFECTIVELY MEET IDENTIFIED COMMUNITY HEALTH NEEDS, WITH EMPHASIS ON VULNERABLE POPULATIONS, AS AN ESSENTIAL EXPRESSION OF PIH HEALTH'S CHARITABLE MISSION AND 3) INCREASING PUBLIC AWARENESS OF COMMUNITY BENEFIT ACTIVITIES AND COMMUNITY VALUE. PART VI, LINE 6: HOSPITAL AFFILIATES INCLUDE: 1) PIH HEALTH, INC., PIH HEALTH'S PARENT COMPANY; 2) PIH HEALTH HOSPITAL - DOWNEY; 3) PIH HEALTH PHYSICIANS, A NONPROFIT MEDICAL FOUNDATION; AND 4) THE PIH HEALTH FOUNDATION, A NONPROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH'S CHARITABLE MISSIONPIH HEALTH, INC. PROVIDES TECHNICAL, FACILITY AND SUPPORT SERVICES FOR TAX-EXEMPT AFFILIATES WHOSE CHARITABLE PURPOSE IS TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO THEIR COMMUNITY BY WAY OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.PIH HEALTH HOSPITAL - DOWNEY, FORMERLY KNOWN AS DOWNEY REGIONAL MEDICAL CENTER, IS PART OF THE PIH HEALTH INTEGRATED HEALTHCARE SYSTEM. PIH HEALTH HOSPITAL - DOWNEY IS A NONPROFIT HOSPITAL WITH A RICH, 90-YEAR HISTORY OF MEETING THE HEALTHCARE NEEDS OF ITS COMMUNITY AND ESTABLISHING A VISION OF "PATIENTS FIRST." THE DOWNEY CAMPUS IS PROUD TO PROVIDE KEY SERVICES AND NEW TECHNOLOGIES AS PART OF PIH HEALTH'S INTEGRATED HEALTHCARE SYSTEM.PIH HEALTH PHYSICIANS SUPPORTS THE LOCAL COMMUNITY THROUGH ITS FINANCIAL ASSISTANCE PROGRAM, WHITTIER FIRST DAY HEALTH & WELLNESS CENTER FOR THE HOMELESS AND THOSE AT-RISK FOR HOMELESSNESS, HEALTH PROFESSIONS EDUCATION, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES. THE PIH HEALTH FOUNDATION RAISES FUNDS IN SUPPORT OF PIH HEALTH TO ENSURE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES FOR YEARS TO COME THROUGH SUPPORTING PROGRAMS THAT DIRECTLY IMPACT THE COMMUNITY, INCLUDING PIH HEALTH'S COMMUNITY BENEFIT PROGRAMS. GIFTS BIG, SMALL AND ALL WILL SUPPORT PIH HEALTH'S WORK TO PROVIDE ACCESS TO QUALITY HEALTHCARE, SCREENINGS, PREVENTATIVE CARE, PREVENTION-FOCUSED EDUCATION AND OTHER IMPORTANT INITIATIVES.FOR DETAILED INFORMATION REGARDING THESE PIH HEALTH AFFILIATES' ADDITIONAL ACTIVITIES TO SUPPORT AND PROMOTE COMMUNITY HEALTH, PLEASE SEE EACH RESPECTIVE ORGANIZATION'S IRS FORM 990. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 INTERFAITH FOOD CENTER 11819 BURKE STREET SANTA FE SPRINGS CA 90670 953889152 501(C)(3) 10000 GENERAL SUPPORT KINGDOM CAUSES BELLFLOWER 16429 BELLFLOWER BLVD BELLFLOWER CA 90706 954849998 501(C)(3) 10000 GENERAL SUPPORT YMCA OF GREATER WHITTIER 12510 E HADLEY STREET WHITTIER CA 90601 951684795 501(C)(3) 5000 GENERAL SUPPORT SOROPTIMIST INTERNATIONAL PO BOX 468 WHITTIER CA 90608 956096575 501(C)(3) 5000 GENERAL SUPPORT THE WHOLE CHILD 10155 COLIMA ROAD WHITTIER CA 90603 952031148 501(C)(3) 5000 GENERAL SUPPORT VISTA COMMUNITY CLINIC 1000 VALE TERRACE DRIVE VISTA CA 92084 952815615 501(C)(3) 5000 GENERAL SUPPORT WHITTIER AREA FIRST DAY COALITION 12426 WHITTIER BLVD WHITTIER CA 90602 931141844 501(C)(3) 5000 GENERAL SUPPORT 7 SCHOLARSHIPS 121000 PART I, LINE 2: PIH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS BASED ON 1) CHARITABLE MISSION OR PURPOSE OF THE CHARITABLE ORGANIZATION AND ITS ALIGNMENT WITH PIH'S MISSION, VALUES AND OBJECTIVES AND/OR 2) IDENTIFIED INDIVIDUAL NEED FOR HEALTH-RELATED SERVICES. FOR CONTRIBUTIONS MADE TO CHARITABLE ORGANIZATIONS, PIH ADOPTED A POLICY WHICH GUIDES THE PROCESS BY WHICH FUNDS ARE GRANTED TO ENSURE THAT PIH IS A GOOD STEWARD OF ITS RESOURCES AS A FEDERALLY REGISTERED 501(C)(3) NOT-FOR-PROFIT ENTITY. TO ENSURE ACCURATE COMMUNITY BENEFIT REPORTING, THIS POLICY ALSO SETS FORTH THAT DIRECT CONTRIBUTIONS MADE TO COMMUNITY ORGANIZATIONS MUST BE APPROPRIATELY CLASSIFIED AS EITHER A) COMMUNITY BENEFIT OR B) COMMUNITY RELATIONS/MARKETING CONTRIBUTIONS. IN COMPLIANCE WITH THIS POLICY, INFORMATION IS GATHERED FROM THE GRANTEE REGARDING THE INTENDED USE OF FUNDS AND THE PERCENT OF GRANTED FUNDS THAT WILL GO TOWARDS SUPPORTING THE ORGANIZATION'S MISSION. FOR CONTRIBUTIONS MADE TO INDIVIDUALS, PIH HAS ESTABLISHED A DEDICATED BUDGET WHICH SUBSIDIZES VITAL ASSISTANCE SUCH AS PURCHASE OF DURABLE MEDICAL EQUIPMENT OR NON-ACUTE CARE NOT COVERED BY INSURANCE UPON HOSPITAL DISCHARGE, INCLUDING PAID PLACEMENT IN SKILLED NURSING OR MENTAL HEALTH FACILITIES. IN THESE INSTANCES, A SPECIFIC SERVICE IS BEING PURCHASED AND RECEIPT OF PROPER SERVICE IS ENSURED THROUGH FOLLOW-UP BY PIH DISCHARGE PLANNERS OR SOCIAL WORKERS. 1 X X X X X 1 1 0 0 0 0 0 0 0 SUDHAKER NAYAK MD DIRECTOR 154550 1632656 0 0 0 68715 0 7950 0 26385 154550 1735706 0 0 NEAL SHINDEL MD DIRECTOR 0 1235142 0 0 0 26401 0 7950 0 26738 0 1296231 0 0 ROBERT BOHR MD DIRECTOR(AS OF 1/9/17) 0 509349 0 0 0 20182 0 7950 0 1260 0 538741 0 0 JAMES WEST PRESIDENT/CEO 981202 0 314603 0 15519 0 215373 0 19175 0 1545872 0 0 0 PEGGY CHULACK CHIEF ADMIN OFFICER 508559 0 116344 0 84720 0 102618 0 6442 0 818683 0 68461 0 GREG WILLIAMS CFO 515986 0 50000 0 6312 0 156501 0 19456 0 748255 0 0 0 ROSALIO LOPEZ MD SR VP & CMO/CSO 606781 0 109813 0 338275 0 97231 0 13215 0 1165315 0 326454 0 REANNA THOMPSON COO/CNO 415436 0 107056 0 10312 0 111383 0 720 0 644907 0 0 0 DAVID KLINGER SR VP FAC & REAL ESTATE 339427 0 51625 0 184532 0 33900 0 37 0 609521 0 174224 0 DAVIS LEE CHIEF MED INFO OFFICER 366142 0 85233 0 61679 0 73781 0 20066 0 606901 0 47724 0 SHERREL HOLLINGSWORTH CHIEF HR OFFICER 322429 0 102074 0 49097 0 84427 0 19530 0 577557 0 42371 0 DEBRA LEGAN VP MKTG & PLANNING 305060 0 48000 0 6691 0 55022 0 5387 0 420160 0 0 0 RONALD YOSHIHARA VP FINANCE & ANALYTICS 261294 0 28680 0 52005 0 69051 0 9499 0 420529 0 37577 0 PERRY EBELTOFT VP ANCILLARY SVS 255871 0 42561 0 25451 0 40747 0 19932 0 384562 0 18317 0 JOAN ROLLAND ADM ED/DISASTER SV 183766 0 17410 0 88913 0 53745 0 12663 0 356497 0 80414 0 ANUP PATEL VP ENT RSK MGMT & CORP COM 207904 0 30408 0 6636 0 55173 0 44 0 300165 0 0 0 CHICO MANNING VP SUPPLY CHAIN 184615 0 0 0 6208 0 43348 0 130 0 234301 0 0 0 SUSANNE CARLSON VP REV CYC & MGD CARE 83594 0 32504 0 44868 0 14305 0 643 0 175914 0 26218 0 JUNG HO MEDICAL PHYSICIST 261919 0 0 0 0 0 15900 0 13363 0 291182 0 0 0 JACQUELINE NGUYEN PHARMACIST CLIN 238876 0 7500 0 414 0 15138 0 8760 0 270688 0 0 0 SCOTT BREMER DIR COMP, BENEF & HRIS 218419 0 7500 0 414 0 9304 0 21805 0 257442 0 0 0 SHELLY NECKE VP POST ACUTE CR SVS 208225 0 5000 0 6414 0 43550 0 13230 0 276419 0 0 0 JACQUELYN CITUK EXEC DIR PHARM 199128 0 5000 0 13504 0 2195 0 7045 0 226872 0 0 0 MITCHELL THOMAS CFO - FORMER 0 0 0 0 165452 0 18000 0 1754 0 185206 0 58710 0 PATRICIA BRAY VP POST ACUTE CR SVS 0 0 0 0 207792 0 0 0 0 0 207792 0 207454 0 PART I, LINES 4A-B PART I, LINE 4A: IN 2016, A SEVERANCE PAYMENT OF $165,452 WAS MADE TO MITCHELL THOMAS. PART I, LINE 4B: PIH HEALTH INC. AND ITS AFFILIATES PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK GREGORY WILLIAMS PERRY EBELTOFT SHERREL HOLLINGSWORTH DAVIS LEE ROSALIO LOPEZ ANUP PATEL JOAN ROLLAND REANNA THOMPSON RON YOSHIHARA DAVID KLINGER NICHOLAS CHRISTIANSON CHICO MANNING SHELLY NECKE DEBRA LEGAN SUSANNE CARLSON THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2016 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): PEGGY CHULACK $68,461 ROSALIO LOPEZ $326,454 DAVID KLINGER $174,224 DAVIS LEE $47,724 SHERREL HOLLINGSWORTH $42,371 RON YOSHIHARA $37,577 PERRY EBELTOFT $18,317 JOAN ROLLAND $80,414 SUSANNE CARLSON $26,218 PATRICIA BRAY $207,456 MITCHELL THOMAS $58,710 A CITY OF WHITTIER 956000812 966769DA6 2009-05-14 280328878 PURCHASE OF LAND AND TO REFUND BONDS ISSUED 1/31/2007 0 0 0 B CITY OF WHITTIER 956000812 966769DH1 2011-03-31 40828054 CONSTRUCTION OF FACILITIES 0 0 0 C CITY OF WHITTIER 956000812 2012-12-31 148000000 REFUND BONDS ISSUED 5/14/2009 0 0 0 D CITY OF WHITTIER 956000812 966769DK4 2014-08-07 106612491 HOSPITAL FACILITIES CONSTRUCTION AND TO REFUND BONDS ISSUED 10/1/2013 0 0 0 A 206175000 280328878 2416738 1087414 1337383 269687344 2013 1 0 1 1 B 4095000 40828054 816561 40011493 2013 0 0 1 1 C 350000 148000000 148000000 1 0 1 1 D 106612491 1880505 6854015 97877971 2014 1 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 0 1 1 0 0 0 1 A 0 0 0 1 1 1 GOLDMAN SACHS BANK 29.500000000000 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 1 GOLDMAN SACHS BANK 23.400000000000 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART IV, LINE 2C ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR BONDS A AND B IN FY13, LISTED BELOW ARE THE ANALYSIS OPINION LETTER DATES. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY16. BOND A ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON FEBRUARY 11, 2013 FOR BOND A. BOND B ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON FEBRUARY 11, 2013 FOR BOND B. MARY WARGO SISTER OF OFFICER 98716 PEGGY CHULACK'S SISTER, MARY WARGO, IS EMPLOYED BY PIH. 0 FORM 990, PART VI, SECTION A, LINE 6 PIH HEALTH, INC. IS THE SOLE MEMBER OF PIH HEALTH HOSPITAL - WHITTIER. FORM 990, PART VI, SECTION A, LINE 7A PIH HEALTH, INC. HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF DIRECTORS OF PIH HEALTH HOSPITAL - WHITTIER. FORM 990, PART VI, SECTION A, LINE 7B PIH HEALTH, INC. HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH HEALTH HOSPITAL - WHITTIER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION, WHICH IS MADE UP OF INDEPENDENT DIRECTORS. THE FORM 990 IS THEN PROVIDED TO THE BOARD FOR ITS INFORMATION. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL MANAGEMENT AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL POSITIVE RESPONSES ARE REVIEWED BY THE COMPLIANCE OFFICER. EACH POSITIVE RESPONSE IS CONSIDERED IN LIGHT OF MAGNITUDE OF OWNERSHIP INTEREST, FINANCIAL TRANSACTION(S), ETC. IF DEEMED NECESSARY, CONFLICTS OF INTEREST COULD BE RESOLVED BY INSISTING THAT THE INCUMBENT EITHER DIVEST THEIR OWNERSHIP INTEREST, THAT THE ORGANIZATION TERMINATE THE BUSINESS RELATIONSHIP, OR EVEN THAT THE DIRECTOR RESIGN. DIRECTORS WITH POTENTIAL CONFLICTS OF INTEREST MAY RECUSE THEMSELVES FROM VOTING ON CERTAIN MATTERS AND/OR MAY EXCUSE THEMSELVES FROM MEETINGS DURING THE DISCUSSION, DELIBERATION, AND VOTING ON OF MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT, THIRD-PARTY, EXPERT COMPENSATION CONSULTANT TO REVIEW ITS EXECUTIVE SALARIES. THE CONSULTANT OBTAINS SPECIFIC ORGANIZATIONAL DATA FROM WHICH TO BASE ITS ANALYSIS (REVENUES, EXPENSES, EMPLOYEES, SERVICE AREA, JOB DESCRIPTIONS, ETC.). THE CONSULTANT'S ANALYSIS INCLUDES A REVIEW OF COMPENSATION TRENDS, REGULATORY ISSUES, THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, THE METHODOLOGY USED FOR THE ASSESSMENT, THE BASE SALARY ANALYSIS, THE INCENTIVE COMPENSATION ANALYSIS, THE TOTAL CASH COMPENSATION ANALYSIS, AND THE TOTAL COMPENSATION ANALYSIS. SALARY MOVEMENT, INCENTIVE COMPENSATION, MARKET BENEFIT, AND RECRUITMENT AND RETENTION TRENDS ARE REVIEWED. THIS ANALYSIS IS PROVIDED TO THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS. THE EXECUTIVE COMPENSATION COMMITTEE HAS APPROVED A REGIONAL PEER GROUP THAT INCLUDES HIGH-PERFORMING, COMPARABLY-SIZED CALIFORNIA HOSPITALS AND HEALTH SYSTEMS. THE CONSULTANT COMPILES COMPARABILITY DATA FROM NATIONAL AND REGIONAL PEERS; COMPARES THE ORGANIZATION'S EXECUTIVE COMPENSATION WITH PEER GROUP COMPENSATION LEVELS; AND PREPARES A REPORT THAT INCLUDES ALL OF THE BACK-UP DATA ON COMPARABILITY, PEER GROUPS, AND JOB MATCHES. THE METHODOLOGY USED BY THE CONSULTANT INCLUDES TWO PEER GROUPS: A NATIONAL PEER GROUP OF COMPARABLY-SIZED HOSPITALS AND SINGLE HOSPITAL SYSTEMS AND A REGIONAL PEER GROUP OF HOSPITALS AND SYSTEMS IN SOUTHERN CALIFORNIA, THE DATA OF WHICH IS PROVIDED TO THE COMMITTEE IN ITS REPORT. THE NATIONAL DATA IS USED AS THE PRIMARY COMPARATOR FOR THE ANALYSIS. THE COMMITTEE IS PRESENTED WITH CHARTS THAT COMPARE ORGANIZATION SALARIES TO THE LEVEL TARGETED IN THE COMPENSATION PHILOSOPHY. NEITHER PERFORMANCE NOR QUALIFICATIONS OF THE INCUMBENT IS CONSIDERED WHEN PROVIDING THE MARKET DATA. THE COMMITTEE IS PROVIDED WITH A REVIEW OF THE BASE SALARY ANALYSIS, A REVIEW OF THE INCENTIVE COMPENSATION ANALYSIS, A REVIEW OF THE TOTAL CASH COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE), AND A REVIEW OF THE TOTAL COMPENSATION ANALYSIS (BASE SALARY PLUS INCENTIVE PLUS BENEFITS/PERQUISITES). BASED UPON ALL OF THE ABOVE INFORMATION, THE CONSULTANT PROVIDES THE COMMITTEE WITH RECOMMENDED SALARY RANGES FOR THE PERIOD ASSESSED. THE EXECUTIVE COMPENSATION COMMITTEE DELIBERATES ON THE COMPARABILITY DATA TO ENSURE THAT IT IS APPROPRIATE IN REPRESENTING LIKE ORGANIZATIONS, LIKE POSITIONS, AND LIKE CIRCUMSTANCES, AND THAT IT COULD REALISTICALLY RELY ON THE COMPARABILITY DATA IN REACHING ITS DECISION THAT THE COMPENSATION IS REASONABLE AND REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED. THE EXECUTIVE COMPENSATION COMMITTEE AFFIRMS THIS PROCESS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 AND FORM 990-T ARE AVAILABLE UPON REQUEST. THE ORGANIZATION IS NOT REQUIRED TO MAKE FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS IT RECEIVED ITS TAX EXEMPTION PRIOR TO JULY 15, 1987. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 29,625,623. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,625,623. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 24,170,918. MANAGEMENT AND GENERAL EXPENSES 3,951,503. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,122,421. R&M BUILDING: PROGRAM SERVICE EXPENSES 1,712,479. MANAGEMENT AND GENERAL EXPENSES 286,023. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,998,502. COLLECTION AGENCY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,818,325. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,818,325. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 10,962,187. PENSION ADJUSTMENTS 11,353,842. EQUITY TRANSFER TO PIH HEALTH PHYSICIANS -30,000,000. EQUITY TRANSFER TO HEALTHCARE SOLUTIONS PIH HEALTH COMMUNITY PHARMACY LLC 12401 WASHINGTON BLVD WHITTIER CA 90602 264390142 PHARMACY CA 5716312 513319 PIH HEALTH HOSPITAL - WHITTIER PIH HEALTH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA 501(C)(3) LINE 7 PIH HEALTH INC 0 PIH HEALTH MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) LINE 12A, I PIH HEALTH INC 0 PIH HEALTH HOME HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 0 PIH HEALTH INC 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) LINE 12A, I 0 PIH HEALTH ADULT DAY HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 0 PIH HEALTH PHYSICIANS 12401 WASHINGTON BLVD WHITTIER CA 90602 953942828 HEALTHCARE CA 501(C)(3) LINE 10 PIH HEALTH INC 0 PIH HEALTH HOSPITAL - DOWNEY 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 951903935 HEALTHCARE CA 501(C)(3) LINE 3 PIH HEALTH INC 0 PIH INSURANCE CO A RECIPROCAL RISK RETENTION GROUP 1003 BISHOP STREET HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI PIH HEALTH INC 1 PIH HEALTH CARE SOLUTIONS 6557 GREENLEAF AVENUE WHITTIER CA 90601 462072342 HEALTHCARE CA PIH HEALTH INC 1 DRMC PROPERTIES 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 954769768 REAL ESTATE CA DRMC INC 1 PIH HEALTH RE 1003 BISHOP STREET HONOLULU HI 96813 472501390 CAPTIVE INSURANCE HI PIH HEALTH INC 1 HEALTHMED SERVICES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 300831225 HEALTHCARE CA PIH HEALTH INC 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 0 1 0 PART IV, COLUMN (E): PIH HEALTH CARE SOLUTIONS IS A NONPROFIT MUTUAL BENEFIT CORPORATION. PART IV, COLUMN (E): PIH INSURANCE COMPANY IS AN UNINCORPORATED RISK RETENTION GROUP.