CEDARS-SINAI MARINA HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CEDARS-SINAI MARINA HOSPITAL (EIN 20-1645949)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-14
- IRS object ID
- 201841349349309689
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-14T17:19:56-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 VON KARMAN AVENUE SUITE 1700 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201645949 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CFHS HOLDINGS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CFHS | BusinessNameControlTxt |
| Phone | 3104487881 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4650 LINCOLN BLVD | AddressLine1Txt |
| City | MARINA DEL REY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90292 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY KATHRYN HAMMACK | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3108238911 | PhoneNum |
| Signature | 2018-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARA ADAMS | PreparerPersonNm |
| PTIN | P00023315 | PTIN |
| Phone | 9497942300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARINA DEL REY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK GAVENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8700 BEVERLY BLVD | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90048 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $95,301,104 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MARINAHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 783 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,024,613 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,814,768 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $76,533,037 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $93,101,152 | CYProgramServiceRevenueAmt |
| PY Investment Income | $40,952 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,957 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,020,035 | PYOtherRevenueAmt |
| CY Other Revenue | $376,227 | CYOtherRevenueAmt |
| PY Total Revenue | $80,618,637 | PYTotalRevenueAmt |
| CY Total Revenue | $95,301,104 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $36,100 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $38,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $45,800,170 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $56,488,992 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $41,553,394 | PYOtherExpensesAmt |
| CY Other Expenses | $50,104,942 | CYOtherExpensesAmt |
| PY Total Expenses | $87,389,664 | PYTotalExpensesAmt |
| CY Total Expenses | $106,631,934 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,771,027 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$11,330,830 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $63,499,957 | TotalAssetsBOYAmt |
| Total Assets EOY | $70,051,453 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,799,379 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $54,681,706 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,700,578 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,369,747 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | * TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE * TO BE RECOGNIZED FOR MEDICAL EXCELLENCE * TO STRIVE TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $87,176,820 | ExpenseAmt |
| Grant | $38,000 | GrantAmt |
| Revenue | $93,477,379 | RevenueAmt |
| Desc | CFHS HOLDINGS, INC., DOING BUSINESS AS MARINA DEL REY HOSPITAL ("THE HOSPITAL"), IS A 133-BED NON-PROFIT HOSPITAL AND AFFILIATE OF THE CEDARS-SINAI HEALTH SYSTEM. WE ARE FULLY ACCREDITED WITH THE NATIONALLY RECOGNIZED JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) FOR SAFE AND EFFECTIVE QUALITY CARE. WE HAVE 24-HOUR EMERGENCY CARE, ICU, TELEMETRY, INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES, AND THE MOST ADVANCED SURGICAL TECHNOLOGY AVAILABLE, CAREFULLY PRACTICED UNDER THE WATCHFUL EYES AND SKILLED HANDS OF OUR WORLD-CLASS PHYSICIANS, NURSES AND HEALTH PROFESSIONALS. MARINA DEL REY HOSPITAL IS DEDICATED TO PATIENT-FOCUSED, PERSONALIZED CARE TO ACHIEVE THE HIGHEST LEVEL OF PATIENT OUTCOMES AND SATISFACTION.(SEE SCHEDULE O FOR CONTINUATION)(CONTINUED FROM PAGE 2)HOSPITAL SERVICES:24-HOUR EMERGENCY CARETELEMEDICINE STROKE PROGRAM INTENSIVE CARE UNITTELEMETRY (CARDIAC MONITORED BEDS)INPATIENT AND OUTPATIENT CAREINPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES - IMAGING, GASTROINTESTINAL, LABORATORY, CARDIOLOGY AND EMERGENCYNATIONALLY-RECOGNIZED SURGERY PROGRAMS (SPINE, BARIATRIC, AND ROBOTIC)THE MOST ADVANCED SURGICAL TECHNOLOGY AVAILABLE, PRACTICED UNDER THE WATCHFUL EYES AND SKILLED HANDS OF OUR WORLD-CLASS PHYSICIANS, NURSES AND HEALTH PROFESSIONALS - MAKO ORTHOPAEDIC, DA VINCI (MINIMALLY INVASIVE SURGICAL SERVICES - HERNIA, APPENDECTOMY, GALLBLADDER, COLON, ANTI REFLUX, BARIATRIC) IMAGINGHOSPITAL STATISTICS:EMPLOYEES 783PHYSICIANS WITH HOSPITAL PRIVILEGES 367SURGEONS WITH HOSPITAL PRIVILEGES 185NUMBER OF SURGERIES ANNUALLY 3,911NUMBER OF ER VISITS ANNUALLY 28,122PAYOR % - HMO/PPO (51%); MEDICARE (35%); MEDI-CAL (5%); COMMERCIAL/OTHER (6%); SELF-PAY/CHARITY (3%)COMMUNITY SUPPORT AND ENGAGEMENT HIGHLIGHTS- OUR TWO OUTPATIENT CLINICS ARE NATIONALLY RECOGNIZED AS LEADING SURGICAL CENTERS OF CARE. THE MARINA SPINE CENTER IS A MULTIDISCIPLINARY CENTER OFFERING COMPREHENSIVE SPINE SERVICES, FROM EVALUATION AND DIAGNOSIS TO SURGERY AND REHABILITATION. OUR MARINA WEIGHT LOSS CLINIC IS ACCREDITED BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP) FOR EXCELLENCE.- MARINA DEL REY HOSPITAL IS THE ONLY HOSPITAL LOCATED WITHIN LOS ANGELES' 11TH DISTRICT, AND WE ARE ACTIVELY INVOLVED IN COUNCILMAN MIKE BONIN'S HOMELESS INITIATIVE, VENICE FORWARD. IN ADDITION, WE HAVE JOINED FORCES WITH OUR COMMUNITY PARTNERS (VENICE FAMILY CLINIC, ST. JOSEPH CENTER, AND OPCC) TO HELP STEM THE HOMELESS CRISIS ON THE WESTSIDE. - ALTHOUGH HEALTHCARE REFORM AND THE AFFORDABLE CARE ACT HAVE PLACED SIGNIFICANT FINANCIAL CHALLENGES ON SMALL, COMMUNITY HOSPITALS LIKE MDRH THROUGH REIMBURSEMENT REDUCTIONS AND THE TRANSITION OF CARE TO OTHER HEALTHCARE ENTITIES, MDRH HAS REMAINED RESILIENT IN OUR MISSION TO SERVE OUR LOCAL COMMUNITY.- OUR PATIENT-CENTRIC APPROACH ALLOWS US TO ATTRACT AND RETAIN ELITE, PRIVATE PRACTICE SURGEONS AND EXTEND WORLD-CLASS CARE IN AN INTIMATE SETTING. FROM TREATING PROFESSIONAL ATHLETES TO LOCAL FIREMEN AND POLICE OFFICERS, OUR SURGEONS AND PRIMARY CARE PHYSICIANS SERVE OUR COMMUNITY PROUDLY. WE LOOK FORWARD TO CONTINUED GROWTH AS A NEW MEMBER OF THE CEDARS-SINAI HEALTH SYSTEM.PROGRAM ACCOMPLISHMENTS/DEVELOPMENT:TELE-STROKE PROGRAM (FEBRUARY 2017) - COLLABORATING WITH CEDARS-SINAI'S NEUROLOGY DEPARTMENT- TELEMEDICINE FOR SUSPECT AND DIAGNOSED STROKE- ONBOARDING NEUROLOGISTS INCLUDING APPOINTMENT OF FIRST STROKE DIRECTOR- EDUCATION/TRAINING TO COMMUNITY IS ONGOING - WORKING TOWARD PRIMARY STROKE CENTER CERTIFICATIONJOINT REPLACEMENT SERVICE LINE- PURCHASED MAKO ROBOT - DECEMBER 2016 GO LIVE- PARTNERING WITH CEDARS-SINAI, FOUNDATION AND KERLAN/JOBE ORTHOPAEDIC CLINIC (DR. TIBERI) - ONE OF FIVE HOSPITALS IN THE SOUTHWEST REGION TO HAVE THE MAKO AND THE ONLY HOSPITAL WITH THE MAKO TOTAL KNEE CAPABILITYOTOLARYNGOLOGIST - EARS, NOSE AND THROAT (ENT) PROGRAM- COLLABORATING WITH CEDARS-SINAI FOUNDATION ENT (DR. GENE LIU)- EXPANDING SERVICES | Desc |
| Total Program Service Expenses | $87,176,820 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 163 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 783 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY KATHRYN HAMMACK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3104487881 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4640 ADMIRALTY WAY SUITE 650 | AddressLine1Txt |
| City | MARINA DEL REY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90292 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| VERA GUERIN | |||||||||
| BOARD MEMBER | 5.00 | 18.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN KREMS MD | |||||||||
| BOARD MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS M PRISELAC | |||||||||
| CHAIR | 5.00 | 75.00 | Yes (X) | $0 | $2,915,532 | $1,411,288 | |||
| MARC RAPAPORT | |||||||||
| BOARD MEMBER | 5.00 | 18.00 | Yes (X) | $0 | $0 | $0 | |||
| NICKOLAS TOMASIC MD | |||||||||
| BOARD MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LESLIE VERMUT | |||||||||
| BOARD MEMBER | 5.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS J WAFER JR | |||||||||
| BOARD MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WALTER ZIFKIN | |||||||||
| BOARD MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK GAVENS | |||||||||
| CEO | 6.00 | 61.00 | $0 | $1,665,087 | $87,264 | Yes (X) | |||
| MARY KATHRYN HAMMACK | |||||||||
| CFO/TREASURER | 50.00 | 5.00 | $359,101 | $0 | $6,200 | Yes (X) | |||
| PAULETTE HEITMEYER | |||||||||
| COO | 50.00 | 1.00 | $0 | $399,106 | $15,206 | Yes (X) | |||
| SHARON MARTINEZ | |||||||||
| SECRETARY | 50.00 | 1.00 | $142,676 | $0 | $2,802 | Yes (X) | |||
| MARK MILLER | |||||||||
| VP OF BUS DEVELOPMENT | 50.00 | 0.00 | $364,561 | $0 | $313 | Yes (X) | |||
| MARGARET MORGAN | |||||||||
| DIRECTOR OF HUMAN RESOURCES | 50.00 | 5.00 | $269,988 | $0 | $4,875 | Yes (X) | |||
| SHAWN BOND | |||||||||
| PHYSICIAN ASST | 50.00 | 0.00 | $227,831 | $0 | $6,672 | Yes (X) | |||
| KIMBERLY BOTWIN | |||||||||
| DIRECTOR PHARMACY | 40.00 | 0.00 | $195,466 | $0 | $769 | Yes (X) | |||
| ESMAT MAHMOODI | |||||||||
| STAFF RN | 58.00 | 0.00 | $177,682 | $0 | $5,144 | Yes (X) | |||
| STACY SEAN FOWLER | |||||||||
| FORMER PRESIDENT | 50.00 | 0.00 | $743,759 | $0 | $18,704 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,481,064 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,979,725 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,559,237 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 126 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CASH ACCELERATION SOLUTIONS LLC | |||||
| 13953 PANAY WAY C325 | MARINA DEL REY | CA | 90292 | REVENUE CYCLE/BUSINESS OFFICE MANAGEMENT | $271,200 |
| WATKINS SPINE INC | |||||
| 410 PROSPECT CIRCLE | SOUTH PASADENA | CA | 91030 | MEDICAL DIRECTORS (2) | $262,500 |
| PREMIER EMERGENCY PHYSICIANS | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ED PHYSICIAN COVERAGE CONTRACT | $170,160 |
| RUBEN VILLEGAS | |||||
| 596 S ESPLANADE STREET | ORANGE | CA | 92869 | MATERIALS MANAGEMENT DIRECTOR/CONSULTING | $145,920 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,814,768 | AllOtherContributionsAmt |
| Total Contributions | $1,814,768 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $52,430,581 | $52,430,581 |
| MEDICARE AND MEDICAL | 622110 | $38,180,377 | $38,180,377 |
| QAF REVENUE | 622110 | $2,490,194 | $2,490,194 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $93,101,152 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,957 | TotalRevenueColumnAmt |
| Exclusion | $8,957 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $376,227 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $376,227 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $376,227 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,301,104 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $93,477,379 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,957 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,000 | TotalAmt |
| Program Services | $38,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $512,169 | TotalAmt |
| Program Services | $372,859 | ProgramServicesAmt |
| Management And General | $139,310 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,235,138 | TotalAmt |
| Program Services | $28,046,373 | ProgramServicesAmt |
| Management And General | $10,188,765 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,412 | TotalAmt |
| Program Services | $614,050 | ProgramServicesAmt |
| Management And General | $108,362 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,443,700 | TotalAmt |
| Program Services | $11,158,271 | ProgramServicesAmt |
| Management And General | $2,285,429 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,575,573 | TotalAmt |
| Program Services | $2,681,683 | ProgramServicesAmt |
| Management And General | $893,890 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,165,548 | TotalAmt |
| Program Services | $1,624,163 | ProgramServicesAmt |
| Management And General | $541,385 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,674 | TotalAmt |
| Program Services | $28,388 | ProgramServicesAmt |
| Management And General | $15,286 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,545 | TotalAmt |
| Management And General | $3,545 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,301,078 | TotalAmt |
| Program Services | $3,975,808 | ProgramServicesAmt |
| Management And General | $1,325,270 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,172,598 | TotalAmt |
| Program Services | $879,448 | ProgramServicesAmt |
| Management And General | $293,150 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,612,908 | TotalAmt |
| Program Services | $1,829,038 | ProgramServicesAmt |
| Management And General | $783,870 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,085 | TotalAmt |
| Program Services | $10,520 | ProgramServicesAmt |
| Management And General | $31,565 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,890 | TotalAmt |
| Program Services | $5,000 | ProgramServicesAmt |
| Management And General | $4,890 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,274 | TotalAmt |
| Management And General | $120,274 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,938,032 | TotalAmt |
| Program Services | $2,497,327 | ProgramServicesAmt |
| Management And General | $440,705 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,392,975 | TotalAmt |
| Program Services | $2,714,380 | ProgramServicesAmt |
| Management And General | $678,595 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,479,614 | TotalAmt |
| Program Services | $1,109,709 | ProgramServicesAmt |
| Management And General | $369,905 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER MEDICAL SUPPLIES | $12,377,373 | $12,377,373 | |
| PROSTHESIS/IMPLANTS | $8,280,517 | $8,280,517 | |
| QAF EXPENSES | $4,822,395 | $4,822,395 | |
| REPAIRS & MAINTENANCE | $2,453,053 | $1,839,790 | $613,263 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,889,383 | TotalAmt |
| Program Services | $2,271,728 | ProgramServicesAmt |
| Management And General | $617,655 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,631,934 | TotalAmt |
| Program Services | $87,176,820 | ProgramServicesAmt |
| Management And General | $19,455,114 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,726,376 | BOYAmt |
| EOY | $4,865,994 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,664 | BOYAmt |
| EOY | $291,267 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,841,588 | BOYAmt |
| EOY | $13,513,907 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,538,562 | BOYAmt |
| EOY | $1,355,955 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,756,859 | BOYAmt |
| EOY | $11,500,292 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,131,341 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,607,303 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,177,908 | BOYAmt |
| EOY | $38,524,038 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,499,957 | BOYAmt |
| EOY | $70,051,453 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,024,123 | BOYAmt |
| EOY | $15,211,037 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,996,743 | BOYAmt |
| EOY | $1,996,743 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,778,513 | BOYAmt |
| EOY | $37,473,926 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,799,379 | BOYAmt |
| EOY | $54,681,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,700,578 | BOYAmt |
| EOY | $15,369,747 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,700,578 | BOYAmt |
| EOY | $15,369,747 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,499,957 | BOYAmt |
| EOY | $70,051,453 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$11,330,830 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,669,768 | OtherCostOrOtherBasisAmt |
| Depreciation | $619,320 | DepreciationAmt |
| Book Value | $26,050,448 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,139,108 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,187,487 | DepreciationAmt |
| Book Value | $10,951,621 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,322,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,800,496 | DepreciationAmt |
| Book Value | $1,521,969 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $38,524,038 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO/FROM RELATED ORGANIZATION | $33,478,968 |
| PROPERTY TAX PAYABLE | $333,134 |
| SALES TAX PAYABLE | $1,066 |
| MALPRACTICE RESERVES | $1,553,000 |
| WORKERS COMP RESERVES | $1,369,000 |
| CAPITAL LEASES | $738,758 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $37,473,926 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING STATEMENT IS TAKEN FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CEDARS-SINAI MEDICAL CENTER THAT INCLUDES CFHS HOLDINGS, INC. THE CORPORATION COMPLETED AN ANALYSIS OF ITS TAX POSITIONS, IN ACCORDANCE WITH ASC 740, INCOME TAXES, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN. THE CORPORATION HAS RECOGNIZED NO INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CORPORATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2013. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 450.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $532,618 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $532,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,016,317 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,759,836 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,256,481 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08680 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,548,935 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,759,836 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,789,099 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09180 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,886 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $62,886 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $62,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,611,821 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,759,836 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,851,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09240 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $7,952,413 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,726,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $33,420,541 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $50,090,787 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$16,670,246 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARINA DEL REY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4650 LINCOLN BLVD | AddressLine1Txt |
| City | MARINA DEL REY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90292 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MARINAHOSPITAL.COM | WebsiteAddressTxt |
| State License | 930000096 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARINA DEL REY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 450.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | MARINA DEL REY HOSPITAL | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 2: CEDARS-SINAI MEDICAL CENTER BECAME THE SOLE CORPORATE MEMBER OF CFHS HOLDINGS, INC., DOING BUSINESS AS MARINA DEL REY HOSPITAL ("THE HOSPITAL"), ON SEPTEMBER 1, 2015 AND CONVERTED THE HOSPITAL FROM A FOR-PROFIT TO A NON-PROFIT ENTITY. THE ACQUISITION WAS PART OF CEDARS-SINAI MEDICAL CENTER'S ONGOING DEVELOPMENT AS A COMPREHENSIVE HEALTHCARE ORGANIZATION OFFERING HEALTHCARE SERVICES OPERATING IN MULTIPLE LOCATIONS, MAKING IT EASIER FOR MORE PEOPLE TO ACCESS COORDINATED QUALITY CARE CLOSE TO HOME. THE HOSPITAL'S CONVERSION TO NONPROFIT STATUS RESULTS IN AN ENHANCED ABILITY TO SERVE THE HEALTHCARE NEEDS OF THE LOCAL COMMUNITY, INCLUDING PROVISION OF COMMUNITY BENEFIT PROGRAMS, CONSISTENT WITH CEDARS-SINAI'S CHARITABLE PURPOSES. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MARINA DEL REY HOSPITAL | ||||
| 4658 LINCOLN BLVD | MARINA DEL REY | CA | 90292 | OUTPATIENT SERVICES - GEN/LAB/RADIOLOGY/MRI/CT SCANNER |
| 2 - MARINA DEL REY HOSPITAL | ||||
| 4640 ADMIRALTY WAY STE 600 | MARINA DEL REY | CA | 90292 | OUTPATIENT SERVICES - SPINE CENTER |
| 3 - MARINA DEL REY HOSPITAL | ||||
| 4644 LINCOLN BLVD STE 450 | MARINA DEL REY | CA | 90292 | OUTPATIENT SERVICES - BARIATRICS CENTER |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | FINANCIAL ASSISTANCE AND MEDI-CAL COSTS AS A PERCENTAGE OF TOTAL HOSPITAL EXPENSES WERE DETERMINED BASED ON THE RATIO OF TOTAL FINANCIAL ASSISTANCE AND MEDI-CAL REVENUE OVER TOTAL CHARGES DURING THE FISCAL YEAR ENDING ON 6/30/2017. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL IS INVOLVED IN COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. COMMUNITY CONCERNS ARE ADDRESSED SUCH AS HEALTH IMPROVEMENT, POVERTY, AND WORKFORCE DEVELOPMENT. THE HOSPITAL WORKS WITH OTHER TAX-EXEMPT ORGANIZATIONS TO PROMOTE HEALTH AND WELLNESS AND DISEASE PREVENTION. THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. |
| PART III, LINE 2: | PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR BAD DEBTS, AND ACCOUNTS RECEIVABLE IS REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON MANY FACTORS, INCLUDING PAYER MIX, AGE OF RECEIVABLES, HISTORICAL CASH COLLECTION EXPERIENCE, AND OTHER RELEVANT INFORMATION. A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED, AND A SIGNIFICANT PORTION OF THE HOSPITAL'S INSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR CO-PAYMENTS AND DEDUCTIBLES. THUS, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS RELATED TO THESE INSURED AND UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE HOSPITAL WRITES DOWN THE EXPECTED REIMBURSEMENT AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED. |
| PART III, LINE 3: | IT IS OUR BELIEF THAT $1,726,000 OF BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL WE MUST PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF ABILITY TO PAY FOR THAT CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS A COMMUNITY BENEFIT. AS PART OF OUR BAD DEBT ASSESSMENT, WE STUDIED THE CHARACTERISTICS OF THE UNINSURED POPULATION IN OUR RESERVES AND IDENTIFIED THOSE PATIENTS WHO WERE UNABLE TO PAY FOR ANY OF THEIR SERVICES. WE BELIEVE THAT THE ESTIMATED AMOUNT ENTERED ON PART III, LINE 3 INCLUDE INDIVIDUALS WHO WOULD HAVE LIKELY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY AND SHOULD BE COUNTED AS COMMUNITY BENEFIT. |
| PART III, LINE 4: | AUDITED FINANCIAL STATEMENTS - PAGE 13PART III, LINE 6: MEDICARE ALLOWABLE COSTS AS A PERCENTAGE OF TOTAL HOSPITAL EXPENSES WERE DETERMINED BASED ON THE RATIO OF TOTAL MEDICARE REVENUE OVER TOTAL CHARGES DURING THE FISCAL YEAR ENDING ON 6/30/2017. |
| PART III, LINE 8: | IT IS OUR BELIEF THAT ALL OF THE $16,670,246 SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. 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. |
| PART III, LINE 9B: | REASONABLE EFFORTS BASED ON BILLING STATEMENT NOTIFICATION AND AMOUNTS NOT ELIGIBLE:THE HOSPITAL SHALL NOTIFY PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAMS BEFORE INITIATING ANY EXTRAORDINARY COLLECTION ACTIVITIES TO OBTAIN PAYMENT FOR THE CARE AND REFRAIN FROM INITIATING SUCH EXTRAORDINARY COLLECTION ACTIVITIES FOR AT LEAST 120 DAYS FROM THE DATE THE HOSPITAL PROVIDES THE BILLING STATEMENT FOR THE CARE IF THE PATIENT HAS NOT SUBMITTED AN APPLICATION OR THE HOSPITAL HAS DETERMINED THE PATIENT IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE FOR THE AMOUNTS SOUGHT TO BE COLLECTED BASED ON THE PATIENT'S APPLICATION.NOTIFICATIONS TO PATIENTS 30 DAYS BEFORE ACTIONS:IN ADDITION TO THE FOREGOING, AT LEAST 30 DAYS BEFORE FIRST INITIATING ANY EXTRAORDINARY COLLECTION ACTIVITIES, THE HOSPITAL SHALL HAVE PROVIDED THE PATIENT WITH A WRITTEN NOTICE THAT INDICATES FINANCIAL ASSISTANCE IS AVAILABLE AS DESCRIBED IN THIS POLICY, IDENTIFY ALL THE EXTRAORDINARY COLLECTION ACTIVITIES THAT THE HOSPITAL INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE, AND THAT STATE A DEADLINE AFTER WHICH SUCH EXTRAORDINARY COLLECTION ACTIVITIES MAY BE INITIATED (WHICH DATE SHALL BE NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED). THE NOTICE SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS.ADDITIONAL ORAL NOTICE BEFORE ACTIONS:IN ADDITION TO ALL WRITTEN NOTICES, PRIOR TO INITIATING ANY EXTRAORDINARY COLLECTION ACTIVITIES, THE HOSPITAL SHALL MAKE A REASONABLE EFFORT TO ORALLY NOTIFY THE PATIENT ABOUT THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS AND ABOUT HOW THE PATIENT MAY OBTAIN ASSISTANCE WITH THE APPLICATION PROCESS. |
| PART VI, LINE 2: | ASSESSING COMMUNITY NEEDS:THE HOSPITAL IS REQUIRED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) BY JUNE 30, 2018, FOLLOWED BY AN IMPLEMENTATION STRATEGY. WHILE THE HOSPITAL HAS NOT COMPLETED THE 2018 CHNA, THE HOSPITAL ENGAGED IN A PROCESS LAST YEAR TO UNDERSTAND THE COMMUNITY THROUGH DATA ASSESSMENT AND COVERSATIONS WITH KEY PARTNERS. BELOW IS A SUMMARY OF HIGH LEVEL NEEDS VALIDATED BY DATA AND EXPERIENCED ANECDOTALLY THROUGH THE HOSPITAL'S EMERGENCY ROOM CARE TEAM. SIGNIFICANT HEALTH NEEDS:HEALTH NEEDS WERE IDENTIFIED FROM SECONDARY DATA USING THE SIZE OF THE PROBLEM (RELATIVE PORTION OF POPULATION AFFLICTED BY THE PROBLEM) AND THE SERIOUSNESS OF THE PROBLEM (IMPACT AT INDIVIDUAL, FAMILY, AND COMMUNITY LEVELS). TO DETERMINE SIZE OR SERIOUSNESS OF THE PROBLEM, THE HEALTH NEED INDICATORS IDENTIFIED IN THE SECONDARY DATA WERE MEASURED AGAINST BENCHMARK DATA, SPECIFICALLY COUNTY RATES, STATE RATES AND/OR HEALTHY PEOPLE 2020 OBJECTIVES. INDICATORS RELATED TO THE HEALTH NEEDS THAT PERFORMED POORLY AGAINST ONE OR MORE OF THESE BENCHMARKS MET THIS CRITERION TO BE CONSIDERED A HEALTH NEED. THESE NEEDS ARE PRESENTED IN ALPHABETICAL ORDER, NOT IN ORDER ACCORDING TO SEVERITY OR PRIORITY.* ACCESS TO HEALTH CARE* CANCER* CARDIOVASCULAR DISEASE* HOMELESSNESS* MENTAL HEALTH* OVERWEIGHT AND OBESITY* PREVENTIVE PRACTICES (IMMUNIZATIONS AND SCREENINGS)* SUBSTANCE ABUSEMEETING THE NEEDS OF THE COMMUNITY:IN FISCAL YEAR 2017, THE HOSPITAL ENGAGED KEY PARTNERS TO SUPPORT CARING FOR THE HOMELESS POPULATION OF MARINA DEL REY.AS PART OF THE TRANSITION TO NON-PROFIT STATUS, THE HOSPITAL INITIATED KEY CONVERSATIONS WITH INTERNAL STAFF AND LEADERSHIP, A SCAN OF PERTINENT COMMUNITY ORGANIZATIONS AND AN ANALYSIS OF AVAILABLE SECONDARY DATA TO DETERMINE INITIAL STRATEGY AND DIRECTION PRIOR TO COMPLETING THE FIRST OFFICIAL CHNA. BASED ON THE INITIAL ASSESSMENT, THE HOSPITAL HAS FOCUSED ON SUPPORTING HOMELESS SERVICES AND MULTIDISCIPLINARY REGIONAL COLLABORATION TO ADDRESS HOMELESSNESS IN THE AREA.HOMELESSNESS IS PREVALENT IN THE BEACH CITIES AREA OF THE HOSPITAL. A SIGNIFICANT NUMBER OF THE HOSPITAL'S EMERGENCY ROOM PATIENT VISITS ARE WITH HOMELESS INDIVIDUALS WHO RESIDE IN THE AREA. IN AN EFFORT TO BEGIN STRATEGIC AND REGIONAL PROBLEM-SOLVING OF HOMELESSNESS IN THE AREA, THE HOSPITAL HAS ACTIVELY SOUGHT OUT PARTNERS AND COLLABORATIVES IN ORDER TO UNDERSTAND AND SERVE THE COMMUNITY BETTER.GRANT-MAKING:IN FISCAL YEAR 2017, THE HOSPITAL DISTRIBUTED GRANTS TO LOCAL HOMELESS SERVICE ORGANIZATIONS: * THE PEOPLE CONCERN (OCEAN PARK COMMUNITY CENTER) * ST. JOSEPH'S CENTER * VENICE FAMILY CLINIC'S INTEGRATED MOBILE HEALTH TEAM COLLABORATIVE WORK:IN FISCAL YEAR 2017, THE HOSPITAL GREW PARTICIPATION IN LOCAL EFFORTS TO ASSIST HOMELESS INDIVIDUALS IN THE COMMUNITY: * LOS ANGELES CITY COUNCILMEMBER MIKE BONIN'S VENICE FORWARD COLLABORATIVE EFFORTS* REPRESENTED BY CEDARS-SINAI AT THE WESTSIDE HEALTH ACCESS STAKEHOLDER GROUP, EMERGENCY DEPARTMENT COMMITTEE* CITY-WIDE HOMELESSNESS COLLABORATIVES AS APPROPRIATEADDITIONAL COMMUNITY PROGRAMS:* COMMUNITY DANCE FITNESS CLASSES* COMMUNITY YOGA CLASSES* PARTICIPATION IN LOCAL COMMUNITY EVENTS* TAI CHI COMMUNITY CLASSESIN FISCAL YEAR 2018, THE HOSPITAL WILL SEEK STRATEGIES TO ADDRESS THE IDENTIFIED SIGNIFICANT AND PRIORITY HEALTH NEEDS IN ACCORDANCE WITH THE 2018 CHNA PROCESS. |
| PART VI, LINE 3: | THE HOSPITAL PROVIDES THE FOLLOWING NOTICES REGARDING FULL AND PARTIAL FINANCIAL ASSISTANCE FOR THE FINANCIALLY QUALIFIED PATIENTS:A) POSTED SIGNAGE - NOTICE OF THIS POLICY IS POSTED IN THE FOLLOWING LOCATIONS: THE EMERGENCY DEPARTMENT, THE ADMITTING DEPARTMENT, CENTRALIZED AND DECENTRALIZED REGISTRATION AREAS AND OTHER OUTPATIENT SETTINGS AS DEEMED APPROPRIATE.B) NOTICES HAND-DELIVERED TO PATIENTS - DURING THE REGISTRATION OR ADMISSION PROCESS (OR OTHERWISE PRIOR TO DISCHARGE), PATIENTS SHALL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THIS POLICY AND THE HOSPITAL'S OTHER FINANCIAL ASSISTANCE PROGRAMS IN THE FORM OF THE SUMMARY OF FINANCIAL ASSISTANCE POLICY AND OTHER PROGRAMS. PATIENTS WILL BE ASKED TO ACKNOWLEDGE RECEIPT OF THIS VIA AN ELECTRONIC SIGNATURE. THE NOTICE TO A SPECIFIC PATIENT WILL BE CONSIDERED CONTINUALLY IN EFFECT UNTIL A REVISION TO THE FORM IS REQUIRED (AND A NEW ACKNOWLEDGEMENT OBTAINED) OR THREE YEARS FROM THE DATE OF THE ORIGINAL ACKNOWLEDGEMENT.C) PATIENT STATEMENT NOTICES - THE HOSPITAL WILL PRINT A NOTICE ON THE SIDE OF THE LAST PAGE OF THE PATIENT BILLING STATEMENTS THAT WILL DESCRIBE ITS FINANCIAL ASSISTANCE PROGRAMS AND THAT WILL INFORM PATIENTS HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY AND OTHER ASSISTANCE PROGRAMS.THE HOSPITAL WILL PRINT ANY WRITTEN NOTICE OR COMMUNICATION DESCRIBED IN THIS POLICY, INCLUDING ANY PLAIN LANGUAGE SUMMARY OF THE POLICY, ON A BILLING STATEMENT OR ALONG WITH OTHER DESCRIPTIVE OR EXPLANATORY MATTER, PROVIDED THAT THE REQUIRED INFORMATION IS CONSPICUOUSLY PLACED AND OF SUFFICIENT SIZE TO BE CLEARLY READABLE.THE HOSPITAL MAY PROVIDE ELECTRONICALLY ANY WRITTEN NOTICE OR COMMUNICATION DESCRIBED IN THIS POLICY TO ANY PATIENT WHO INDICATES HE OR SHE PREFERS TO RECEIVE THE WRITTEN NOTICE OR COMMUNICATION ELECTRONICALLY. |
| PART VI, LINE 4: | THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES NEIGHBORHOODS AND BEACH CITIES IN EIGHT ZIP CODES ON THE WEST COAST OF LOS ANGELES COUNTY. THE POPULATION CHARACTERISTICS BELOW ARE AGGREGATED FOR THE HOSPITAL'S EIGHT ZIP CODES: 90292 (MARINA DEL REY), 90291 (VENICE), 90293 (PLAYA DEL REY), 90230 (CULVER CITY), 90045 (WESTCHESTER/LA), 90066 (MAR VISTA/DEL REY), 90405 (SANTA MONICA) AND 90094 (PLAYA VISTA). ALL OF THE HOSPITAL'S ZIP CODES ARE LOCATED IN LOS ANGELES COUNTY SERVICE PLANNING AREA (SPA) 5. POPULATION CHARACTERISTICS: DATA SOURCE: U.S. CENSUS BUREAU, 2011-2015 AMERICAN COMMUNITY SURVEYTHE HOSPITAL SERVES A POPULATION BASE OF 230,101.RACE/ETHNICITY:WHITE - 53.9%HISPANIC/LATINO - 21.8%ASIAN - 12.2%BLACK/AFRICAN AMERICAN - 7.1%NATIVE HAWAIIAN/PACIFIC ISLANDER - 0.2%AMERICAN INDIAN/ALASKA NATIVE - 0.1%OTHER OR MULTIPLE RACES - 4.7%AGE:LESS THAN 18 YEARS - 15.5%18-64 YEARS - 71.1%65+ YEARS - 13.4%GENDER:FEMALE - 50.7%MALE - 49.3%SOCIOECONOMIC STATUS:FAMILIES LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) - 11.8%FAMILIES LIVING AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL) - 24.7%COMMUNITY SUPPORT AND ENGAGEMENT:THE HOSPITAL IS THE ONLY HOSPITAL LOCATED WITHIN THE 11TH DISTRICT AND IS ACTIVELY INVOLVED IN THE HOMELESS INITIATIVE, VENICE FORWARD. IN ADDITION, THE HOSPITAL HAS JOINED FORCES WITH ITS COMMUNITY PARTNERS: VENICE FAMILY CLINIC, ST. JOSEPH CENTER, AND OCEAN PARK COMMUNITY CENTER. |
| PART VI, LINE 6: | THE HOSPITAL IS AN AFFILIATE OF CEDARS-SINAI HEALTH SYSTEM. THE 133-BED SURGICAL HOSPITAL IS FULLY ACCREDITED THROUGH THE JOINT COMMISSION FOR SAFE AND EFFECTIVE QUALITY CARE. BY CONCENTRATING FOUR AREAS OF EXPERTISE: SPINE, WEIGHT LOSS, ORTHOPEDICS, AND MINIMALLY INVASIVE SURGERY, THE HOSPITAL IS ABLE TO PROVIDE EXCELLENT CARE IN AN INTIMATE, PERSONAL AND CONVENIENT SETTING.THE HOSPITAL IS COMMITTED TO THE FOLLOWING:* COMMITMENT TO THE COMMUNITY: PROVIDING EXCELLENT AND PROMPT ACUTE MEDICAL SERVICES AND 24/7 EMERGENCY ROOM CARE. * TALENTED CUSTOMER SERVICE-DRIVEN TEAM: BELIEVES KINDNESS IS JUST AS IMPORTANT AS STATE-OF-THE-ART MEDICAL TECHNOLOGY. * NATIONALLY RECOGNIZED PHYSICIANS: RECOGNIZED FOR CLINICAL EXCELLENCE AND DEVOTED TO DELIVERING COMPASSIONATE, RESPONSIVE CARE.THE HOSPITAL'S MISSION:* TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE * TO BE RECOGNIZED FOR MEDICAL EXCELLENCE * TO STRIVE TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES ORGANIZATIONAL LEADERSHIP IN FOSTERING THE COMMITMENT TO COMMUNITY BENEFIT. THE BOARD OF DIRECTORS FUNCTIONS AS AN OVERSIGHT AND POLICY-MAKING BODY FOR THE HOSPITAL'S COMMUNITY BENEFIT COMMITMENTS, EFFORTS AND STRATEGIC ALIGNMENT WITH COMMUNITY NEEDS. DURING THE TAX YEAR, THE HOSPITAL'S COMMUNITY BENEFIT EXPENSE TOTALED $9,851,985 DIVIDED AMONG THE FOLLOWING CATEGORIES:* UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR THE POOR AND UNDERSERVED - $9,789,099 (CHARITY CARE - $532,618; UNREIMBURSED COST: CARING FOR MEDI-CAL PATIENTS - $9,256,481) (EXCLUDES THE UNREIMBURSED COST OF CARING FOR MEDICARE PATIENTS) COMMUNITY BENEFIT PROGRAMS, INCLUDING CHARITABLE DONATIONS - $62,886 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| VENICE FAMILY CLINIC | |||||||
| 604 ROSE AVE | VENICE | CA | 90291 | 952769432 | 501(C)(3) | $10,000 | GRANT FOR INTEGRATED MOBILE HEALTH TEAM |
| OCEAN PARK COMMUNITY CENTER | |||||||
| 1453 14TH STREET | SANTA MONICA | CA | 90404 | 956143865 | 501(C)(3) | $10,000 | GRANT FOR COMMUNITY HOMELESS SERVICES |
| ST JOSEPH CENTER | |||||||
| 204 HAMPTON DRIVE | VENICE | CA | 90291 | 953874381 | 501(C)(3) | $10,000 | GRANT FOR COMMUNITY HOMELESS SERVICES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION CONSISTENTLY CONTRIBUTES TO WELL ESTABLISHED EXEMPT ORGANIZATIONS AND RELIES ON THE GOVERNING BODY OF EACH OF THESE ORGANIZATIONS TO ENSURE THAT GRANT FUNDS DONATED TO EACH AND EVERY ORGANIZATION ARE USED FOR PROPER PURPOSES AND NOT OTHERWISE DIVERTED FROM THE INTENDED USE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS M PRISELAC | ||||||||||||||
| CHAIR | $0 | $1,523,498 | $0 | $1,165,496 | $0 | $226,538 | $0 | $1,384,950 | $0 | $26,338 | $0 | $4,326,820 | $0 | $0 |
| MARK GAVENS | ||||||||||||||
| CEO | $0 | $972,014 | $0 | $466,298 | $0 | $226,775 | $0 | $54,097 | $0 | $33,167 | $0 | $1,752,351 | $0 | $0 |
| MARY KATHRYN HAMMACK | ||||||||||||||
| CFO/TREASURER | $199,052 | $0 | $153,016 | $0 | $7,033 | $0 | $3,804 | $0 | $2,396 | $0 | $365,301 | $0 | $0 | $0 |
| PAULETTE HEITMEYER | ||||||||||||||
| COO | $0 | $176,763 | $0 | $66,690 | $0 | $155,653 | $0 | $14,493 | $0 | $713 | $0 | $414,312 | $0 | $0 |
| MARK MILLER | ||||||||||||||
| VP OF BUS DEVELOPMENT | $117,481 | $0 | $42,244 | $0 | $204,836 | $0 | $313 | $0 | $0 | $0 | $364,874 | $0 | $0 | $0 |
| MARGARET MORGAN | ||||||||||||||
| DIRECTOR OF HUMAN RESOURCES | $163,236 | $0 | $105,930 | $0 | $822 | $0 | $4,875 | $0 | $0 | $0 | $274,863 | $0 | $0 | $0 |
| SHAWN BOND | ||||||||||||||
| PHYSICIAN ASST | $223,094 | $0 | $425 | $0 | $4,312 | $0 | $6,672 | $0 | $0 | $0 | $234,503 | $0 | $0 | $0 |
| KIMBERLY BOTWIN | ||||||||||||||
| DIRECTOR PHARMACY | $192,314 | $0 | $2,825 | $0 | $327 | $0 | $0 | $0 | $769 | $0 | $196,235 | $0 | $0 | $0 |
| ESMAT MAHMOODI | ||||||||||||||
| STAFF RN | $177,257 | $0 | $425 | $0 | $0 | $0 | $5,144 | $0 | $0 | $0 | $182,826 | $0 | $0 | $0 |
| STACY SEAN FOWLER | ||||||||||||||
| FORMER PRESIDENT | $309,083 | $0 | $287,736 | $0 | $146,940 | $0 | $7,950 | $0 | $10,754 | $0 | $762,463 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO OF CFHS HOLDINGS, INC.(DBA MARINA DEL REY HOSPITAL) IS COMPENSATED BY CEDARS-SINAI MEDICAL CENTER, A RELATED TAX-EXEMPT ORGANIZATION. CEDARS-SINAI MEDICAL CENTER USED THE FOLLOWING METHODS IN ESTABLISHING THE CFHS HOLDINGS, INC. CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) WRITTEN EMPLOYMENT CONTRACT; 4) COMPENSATION SURVEY OR STUDY; AND 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINES 4A-B | THERE ARE TWO NONQUALIFIED DEFERRED COMPENSATION PLANS IN WHICH ONE OR MORE OF THE LISTED PERSONS PARTICIPATE. THE FIRST PLAN IS A DEFERRED COMPENSATION PLAN. THIS IS A "GRANDFATHERED" TRADITIONAL DEFINED BENEFIT PLAN (NO NEW PARTICIPANTS HAVE BEEN ADDED SINCE 1986). THE BENEFIT FORMULA IS A PERCENTAGE OF THE HIGHEST FIVE YEARS AVERAGE ANNUAL SALARY TIMES THE NUMBER OF YEARS OF ELIGIBLE SERVICE, WITH A MAXIMUM CREDITED SERVICE OF 30 YEARS. THE SECOND PLAN IS A SUPPLEMENTAL RETIREMENT ALLOWANCE THAT IS PAYABLE DIRECTLY TO THE PARTICIPANTS EACH QUARTER. THE BENEFIT FORMULA FOR THIS PLAN HAS ANNUAL CONTRIBUTIONS THAT ARE EITHER A PERCENTAGE OF SALARY, OR ARE DESIGNED TO FUND A PERCENTAGE OF THE ESTIMATED FINAL 5-YEAR AVERAGE SALARY. THE FOLLOWING LISTED PERSONS RECEIVED PAYMENTS DURING THE YEAR ENDED DECEMBER 31, 2016 RELATED TO THE PLANS REFERENCED ABOVE. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II AND ARE NOT INCREMENTAL PAYMENTS. IN ADDITION, TWO EMPLOYEES RECEIVED SEVERANCE PAY. THOMAS M. PRISELAC 136,505 MARK GAVENS 216,205 PAULETTE HEITMEYER 155,653 MARK MILLER 191,437 STACY SEAN FOWLER 117,227 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CEDARS-SINAI MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF CFHS HOLDINGS, INC. DOING BUSINESS AS MARINA DEL REY HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | CEDARS-SINAI MEDICAL CENTER, AS THE SOLE CORPORATE MEMBER, CAN ELECT BOARD OF DIRECTORS TO MARINA DEL REY HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | RESERVED RIGHTS OF CEDARS-SINAI MEDICAL CENTER, THE SOLE CORPORATE MEMBER OF MARINA DEL REY HOSPITAL ("THE HOSPITAL"). THE FOLLOWING ACTIONS MUST BE APPROVED OR ACTED UPON BY CEDARS-SINAI MEDICAL CENTER BEFORE BECOMING EFFECTIVE: (A) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE HOSPITAL; (B) ANY AMENDMENT TO THE HOSPITAL'S PURPOSE OR MISSION; (C) ANY CHANGE IN THE MEMBERSHIP OR MEMBERSHIP POWERS OF THE HOSPITAL OR ITS SUBSIDIARY; (D) HIRING, ELECTING, REMOVING, OR TERMINATING ANY OF THE OFFICERS OF THE HOSPITAL; (E) REMOVAL AND APPOINTMENT OF DIRECTORS OF THE HOSPITAL; (F) CHANGING THE NUMBER OF DIRECTORS ON THE BOARD OF DIRECTORS; (G) SELECTION AND APPOINTMENT OF THE AUDITORS AND LEGAL COUNSEL OF THE HOSPITAL; (H) ANY SALE OR OTHER DISPOSITION OF ALL OR A SUBSTANTIAL PORTION OF THE ASSETS OF THE HOSPITAL; (I) MERGER, CONSOLIDATION, REORGANIZATION, DIVESTITURE, AFFILIATION, LIQUIDATION, OR DISSOLUTION; (J) BORROWING MONEY AND INCURRING INDEBTEDNESS ON BEHALF OF THE HOSPITAL; (K) APPROVING THE HOSPITAL'S ANNUAL OPERATING AND CAPITAL BUDGETS; (L) DECLARING OR CONSENTING TO THE FILING OF PROCEEDINGS TO DECLARE BANKRUPTCY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE REVIEW OF THE FORM 990 INVOLVES VARIOUS MANAGEMENT PERSONNEL INCLUDING THE HOSPITAL'S TREASURER, AND A BIG FOUR ACCOUNTING FIRM. A COMPLETE COPY WILL BE PRESENTED AT A BOARD OF DIRECTORS' MEETING TO BE HELD ON MARCH 28, 2018. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE PURPOSE OF THE CONFLICTS OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF THE HOSPITAL WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE HOSPITAL OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO THE HOSPITAL. DEFINITIONS: INTERESTED PERSON - ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, AS DEFINED BELOW, IS AN INTERESTED PERSON. IF A PERSON IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE HEALTH CARE SYSTEM OF WHICH THE HOSPITAL IS A PART, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. FINANCIAL INTEREST - A PERSON HAS A FINANCIAL INTEREST IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: A) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH THE HOSPITAL HAS A TRANSACTION OR ARRANGEMENT, OR B) A COMPENSATION ARRANGEMENT WITH THE HOSPITAL OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE HOSPITAL HAS A TRANSACTION OR ARRANGEMENT, OR C) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE HOSPITAL IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. A FINANCIAL INTEREST IS NOT NECESSARILY A CONFLICT OF INTEREST UNTIL DETERMINED TO BE SO BY THE BOARD OF DIRECTORS ("BOARD") OR A COMMITTEE OF THE BOARD WITH BOARD-DELEGATED POWERS ("COMMITTEE"). PROCEDURES: DUTY TO DISCLOSE - IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATING THERETO TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS - AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATING THERETO, AND AFTER ANY DISCUSSION THEREOF, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: A) AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B) THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C) AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE HOSPITAL CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D) IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE HOSPITAL AND SHALL MAKE ITS DECISIONS AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: A) IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. B) IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. RECORDS OF PROCEEDINGS: THE MINUTES OF THE BOARD AND ALL COMMITTEES SHALL CONTAIN: A) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. B) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. COMPENSATION: A) A VOTING MEMBER OF THE BOARD WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. B) A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. C) NO VOTING MEMBER OF THE BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING COMPENSATION. D) PHYSICIANS WHO RECEIVE COMPENSATION FROM THE HOSPITAL, WHETHER DIRECTLY OR INDIRECTLY OR AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS. NO PHYSICIAN, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING PHYSICIAN COMPENSATION. E) NO MEMBER OF THE BOARD OR ANY COMMITTEE SHALL RECEIVE, DIRECTLY OR INDIRECTLY, ANY COMPENSATION WHATSOEVER FROM THE HOSPITAL FOR HIS OR HER SERVICE AS A MEMBER OF THE BOARD OR SUCH COMMITTEE, ALTHOUGH ACTUAL EXPENSES MAY BE REIMBURSED. ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTANDS THE HOSPITAL IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS: TO ENSURE THAT THE HOSPITAL OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, THE HOSPITAL SHALL CONDUCT PERIODIC REVIEWS OF THE IMPLEMENTATION OF THE POLICY. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S-LENGTH BARGAINING, B) WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS, IF ANY, CONFORM TO THE HOSPITAL'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES, AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. USE OF OUTSIDE EXPERTS: WHEN CONDUCTING PERIODIC REVIEWS, THE HOSPITAL MAY, BUT NEED NOT, USE OUTSIDE ADVISORS. IF OUTSIDE ADVISORS ARE USED, THEIR USE SHALL NOT RELIEVE THE BOARD OF ITS RESPONSIBILITY FOR ENSURING PERIODIC REVIEWS ARE CONDUCTED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL'S CHIEF EXECUTIVE OFFICER IS COMPENSATED BY THE HOSPITAL'S SOLE CORPORATE MEMBER, CEDARS-SINAI MEDICAL CENTER. THE EXECUTIVE PERSONNEL COMMITTEE OF CEDARS-SINAI MEDICAL CENTER REVIEWS AND APPROVES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION. SINCE THE HOSPITAL DOES NOT COMPENSATE ITS CHIEF EXECUTIVE OFFICER, THE RESPONSE TO THIS QUESTION IS NO, IN ACCORDANCE WITH SPECIFIC INSTRUCTIONS FROM THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE ATTACHED TO ITS FORM 990. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | ROUNDING -1. |
| FORM 990, PART XII, LINE 2C: | THE HOSPITAL'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH ITS PARENT FOR FISCAL YEAR ENDED JUNE 30, 2017. THE OVERSIGHT OF THE AUDIT WAS PERFORMED BY ITS PARENT'S AUDIT COMMITTEE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER | |||||||||||
| 8700 BEVERLY BOULEVARD | LOS ANGELES | CA | 90048 | 951644600 | ACUTE-CARE, TEACHING AND RESEARCH HOSPITAL | CA | 501 (C) (3) | 3 | CEDARS-SINAI HEALTH SYSTEM | 0 | |
| CALIFORNIA HEART CENTER FOUNDATION | |||||||||||
| 8536 WILSHIRE BLVD 3RD FLOOR | BEVERLY HILLS | CA | 90211 | 954772979 | PROMOTE, SUPPORT, AND DEVELOP EDUCATIONAL AND SCIENTIFIC RESEARCH | CA | 501 (C) (3) | 7 | CEDARS-SINAI MEDICAL CENTER | Yes (1) | |
| CEDARS-SINAI MEDICAL CARE FOUNDATION | |||||||||||
| 200 N ROBERTSON BLVD 101 | BEVERLY HILLS | CA | 90211 | 954457756 | PROVISION OF MEDICAL CARE, TEACHING AND RESEARCH | CA | 501 (C) (3) | 11, I | CEDARS-SINAI MEDICAL CENTER | Yes (1) | |
| KERLAN-JOBE ORTHOPAEDIC FOUNDATION | |||||||||||
| 6801 PARK TERRACE | LOS ANGELES | CA | 90045 | 954707606 | EDUCATION AND RESEARCH RELATED TO ORTHOPEDIC MEDICINE | CA | 501 (C) (3) | 7 | CEDARS-SINAI MEDICAL CARE FOUNDATION | Yes (1) | |
| SANTA MONICA ORTHOPAEDIC & SPORTS MED RESEARCH FDN | |||||||||||
| 2020 SANTA MONICA BLVD 4TH FL | SANTA MONICA | CA | 90404 | 954789926 | EDUCATION AND RESEARCH RELATED TO ORTHOPEDIC AND NEUROLOGIC CONDITIONS | CA | 501 (C) (3) | PF | CEDARS-SINAI MEDICAL CARE FOUNDATION | Yes (1) | |
| CEDARS-SINAI HEALTH SYSTEM | |||||||||||
| 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 300990905 | SUPPORT SPECIFIED NONPROFIT HEALTHCARE ORGANIZATIONS | CA | 501 (C) (3) | LINE 12C, III-FI | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| CEDARS-SINAI BH ASC LLC | |||||||
| 200 N ROBERTSON BLVD 101 | BEVERLY HILLS | CA | 90211 | 812266744 | HOLDING COMPANY | CA | N/A |
| CS-BH ASC HOLDINGS LLC | |||||||
| 200 N ROBERTSON BLVD 101 | BEVERLY HILLS | CA | 90211 | 812246488 | HOLDING COMPANY | CA | N/A |
| DEL REY SURGERY CENTER LLC | |||||||
| 4640 ADMIRALTY WAY 1020 | MARINA DEL REY | CA | 90292 | 462305372 | AMBULATORY SURGERY CENTER | CA | N/A |
| DEL REY SURGERY INVESTORS LLC | |||||||
| 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 364756208 | INVESTMENT IN AMBULATORY SURGERY CENTER | DE | N/A |
| ENDOSCOPY CENTER OF SANTA MONICA LLC | |||||||
| 2001 SANTA MONICA 360W | SANTA MONICA | CA | 90404 | 113652210 | ENDOSCOPIES AND THE RELATED PROCEDURES | CA | N/A |
| ISS ASC HOLDINGS LLC | |||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 471890805 | INVESTMENT IN HEALTHCARE SERVICES | CA | N/A |
| INTERNATIONAL SPINE & ORTHOPEDIC INSTITUTE LLC | |||||||
| 8500 W 110TH ST | OVERLAND PARK | KS | 66210 | 263738893 | SPINE AND ORTHOPEDIC INSTITUTE | DE | N/A |
| SANTA MONICA IMAGING GROUP LLC | |||||||
| 200 N ROBERTSON BLVD 101 | BEVERLY HILLS | CA | 90211 | 820760657 | IMAGING CENTER | CA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CENTINELA FREEMAN HOLDINGS INC | |||||||||
| 4650 LINCOLN BLVD | MARINA DEL REY | CA | 90292 | 593811890 | REAL ESTATE RENTALS | CA | N/A | C | Yes (1) |
| OPTIMATRIX HEALTH SOLUTIONS INC | |||||||||
| 6500 WILSHIRE BLVD 9TH FLOOR | LOS ANGELES | CA | 90048 | 954522779 | INACTIVE | CA | N/A | C | Yes (1) |
| OTOHARMONICS CORPORATION | |||||||||
| 411 SW 6TH AVE | PORTLAND | OR | 97204 | 461119421 | HEALTHCARE PRODUCT DEVELOPMENT | DE | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CENTINELA FREEMAN HOLDINGS INC | ||
| K | $2,308,137 | FAIR MARKET VALUE |
| CENTINELA FREEMAN HOLDINGS INC | ||
| Q | $1,038,146 | FAIR MARKET VALUE |
| CENTINELA FREEMAN HOLDINGS INC | ||
| S | $401,224 | FAIR MARKET VALUE |