2018-05-14T17:19:56-05:00 2017-06-30 346565596 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE SUITE 1700 IRVINE CA 92612 990 2016-07-01 201645949 CFHS HOLDINGS INC CFHS 3104487881 4650 LINCOLN BLVD MARINA DEL REY CA 90292 MARY KATHRYN HAMMACK TREASURER 3108238911 2018-05-14 1 KARA ADAMS P00023315 9497942300 2016 2022-09-23 18:48:47Z MARINA DEL REY HOSPITAL MARK GAVENS 8700 BEVERLY BLVD LOS ANGELES CA 90048 95301104 0 X WWW.MARINAHOSPITAL.COM X 2004 CA TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE. 7 6 783 6 0 0 3024613 1814768 76533037 93101152 40952 8957 1020035 376227 80618637 95301104 36100 38000 0 0 45800170 56488992 0 0 0 41553394 50104942 87389664 106631934 -6771027 -11330830 63499957 70051453 36799379 54681706 26700578 15369747 X * TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE * TO BE RECOGNIZED FOR MEDICAL EXCELLENCE * TO STRIVE TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY 0 0 87176820 38000 93477379 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 87176820 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 163 0 1 783 1 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MARY KATHRYN HAMMACK 3104487881 4640 ADMIRALTY WAY SUITE 650 MARINA DEL REY CA 90292 VERA GUERIN BOARD MEMBER 5.00 18.00 X 0 0 0 STEVEN KREMS MD BOARD MEMBER 5.00 0.00 X 0 0 0 THOMAS M PRISELAC CHAIR 5.00 75.00 X 0 2915532 1411288 MARC RAPAPORT BOARD MEMBER 5.00 18.00 X 0 0 0 NICKOLAS TOMASIC MD BOARD MEMBER 5.00 0.00 X 0 0 0 LESLIE VERMUT BOARD MEMBER 5.00 8.00 X 0 0 0 THOMAS J WAFER JR BOARD MEMBER 5.00 0.00 X 0 0 0 WALTER ZIFKIN BOARD MEMBER 5.00 0.00 X 0 0 0 MARK GAVENS CEO 6.00 61.00 X 0 1665087 87264 MARY KATHRYN HAMMACK CFO/TREASURER 50.00 5.00 X 359101 0 6200 PAULETTE HEITMEYER COO 50.00 1.00 X 0 399106 15206 SHARON MARTINEZ SECRETARY 50.00 1.00 X 142676 0 2802 MARK MILLER VP OF BUS DEVELOPMENT 50.00 0.00 X 364561 0 313 MARGARET MORGAN DIRECTOR OF HUMAN RESOURCES 50.00 5.00 X 269988 0 4875 SHAWN BOND PHYSICIAN ASST 50.00 0.00 X 227831 0 6672 KIMBERLY BOTWIN DIRECTOR PHARMACY 40.00 0.00 X 195466 0 769 ESMAT MAHMOODI STAFF RN 58.00 0.00 X 177682 0 5144 STACY SEAN FOWLER FORMER PRESIDENT 50.00 0.00 X 743759 0 18704 2481064 4979725 1559237 126 1 1 0 CASH ACCELERATION SOLUTIONS LLC 13953 PANAY WAY C325 MARINA DEL REY CA 90292 REVENUE CYCLE/BUSINESS OFFICE MANAGEMENT 271200 WATKINS SPINE INC 410 PROSPECT CIRCLE SOUTH PASADENA CA 91030 MEDICAL DIRECTORS (2) 262500 PREMIER EMERGENCY PHYSICIANS 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ED PHYSICIAN COVERAGE CONTRACT 170160 RUBEN VILLEGAS 596 S ESPLANADE STREET ORANGE CA 92869 MATERIALS MANAGEMENT DIRECTOR/CONSULTING 145920 4 1814768 1814768 NET PATIENT REVENUE 622110 52430581 52430581 MEDICARE AND MEDICAL 622110 38180377 38180377 QAF REVENUE 622110 2490194 2490194 93101152 8957 8957 OTHER REVENUE 622110 376227 376227 376227 95301104 93477379 0 8957 38000 38000 512169 372859 139310 38235138 28046373 10188765 722412 614050 108362 13443700 11158271 2285429 3575573 2681683 893890 2165548 1624163 541385 43674 28388 15286 3545 3545 5301078 3975808 1325270 1172598 879448 293150 2612908 1829038 783870 42085 10520 31565 9890 5000 4890 120274 120274 2938032 2497327 440705 3392975 2714380 678595 1479614 1109709 369905 OTHER MEDICAL SUPPLIES 12377373 12377373 PROSTHESIS/IMPLANTS 8280517 8280517 QAF EXPENSES 4822395 4822395 REPAIRS & MAINTENANCE 2453053 1839790 613263 2889383 2271728 617655 106631934 87176820 19455114 0 1726376 4865994 458664 291267 10841588 13513907 1538562 1355955 11756859 11500292 45131341 6607303 37177908 38524038 63499957 70051453 18024123 15211037 1996743 1996743 16778513 37473926 36799379 54681706 X 26700578 15369747 26700578 15369747 63499957 70051453 X -11330830 -1 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26669768 619320 26050448 15139108 4187487 10951621 3322465 1800496 1521969 38524038 DUE TO/FROM RELATED ORGANIZATION 33478968 PROPERTY TAX PAYABLE 333134 SALES TAX PAYABLE 1066 MALPRACTICE RESERVES 1553000 WORKERS COMP RESERVES 1369000 CAPITAL LEASES 738758 37473926 X PART X, LINE 2: 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. 1 1 X 1 X 1 X 450.000000000000 1 1 1 0 0 532618 532618 0.00500 14016317 4759836 9256481 0.08680 14548935 4759836 9789099 0.09180 32886 32886 0.00030 30000 30000 0.00030 62886 62886 0.00060 14611821 4759836 9851985 0.09240 3000 3000 0.00000 5000 5000 0.00000 8000 8000 0.00000 7952413 1726000 33420541 50090787 -16670246 X 1 1 1 1 MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA 90292 WWW.MARINAHOSPITAL.COM 930000096 X X X MARINA DEL REY HOSPITAL 1 0 1 0 0 1 X 200.000000000000 450.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE X HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE X HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 MARINA DEL REY HOSPITAL 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. 3 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 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 0 VENICE FAMILY CLINIC 604 ROSE AVE VENICE CA 90291 952769432 501(C)(3) 10000 GRANT FOR INTEGRATED MOBILE HEALTH TEAM OCEAN PARK COMMUNITY CENTER 1453 14TH STREET SANTA MONICA CA 90404 956143865 501(C)(3) 10000 GRANT FOR COMMUNITY HOMELESS SERVICES ST JOSEPH CENTER 204 HAMPTON DRIVE VENICE CA 90291 953874381 501(C)(3) 10000 GRANT FOR COMMUNITY HOMELESS SERVICES 3 0 PART I, LINE 2: 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. 1 1 0 0 0 0 0 0 0 THOMAS M PRISELAC CHAIR 0 1523498 0 1165496 0 226538 0 1384950 0 26338 0 4326820 0 0 MARK GAVENS CEO 0 972014 0 466298 0 226775 0 54097 0 33167 0 1752351 0 0 MARY KATHRYN HAMMACK CFO/TREASURER 199052 0 153016 0 7033 0 3804 0 2396 0 365301 0 0 0 PAULETTE HEITMEYER COO 0 176763 0 66690 0 155653 0 14493 0 713 0 414312 0 0 MARK MILLER VP OF BUS DEVELOPMENT 117481 0 42244 0 204836 0 313 0 0 0 364874 0 0 0 MARGARET MORGAN DIRECTOR OF HUMAN RESOURCES 163236 0 105930 0 822 0 4875 0 0 0 274863 0 0 0 SHAWN BOND PHYSICIAN ASST 223094 0 425 0 4312 0 6672 0 0 0 234503 0 0 0 KIMBERLY BOTWIN DIRECTOR PHARMACY 192314 0 2825 0 327 0 0 0 769 0 196235 0 0 0 ESMAT MAHMOODI STAFF RN 177257 0 425 0 0 0 5144 0 0 0 182826 0 0 0 STACY SEAN FOWLER FORMER PRESIDENT 309083 0 287736 0 146940 0 7950 0 10754 0 762463 0 0 0 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 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. 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