STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SAINT LOUISE REGIONAL HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SAINT LOUISE REGIONAL HOSPITAL (EIN 91-2154437)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-15
IRS object ID
201711359349306966
Schema version
2015v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-15T12:55:19-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 CALIFORNIA STREET SUITE 2700AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94111ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN912154437EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Saint Louise Regional HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MUKESH SANGHVIInCareOfNm
Business Name ControlSAINBusinessNameControlTxt
Phone4088482000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19400 No Name UnoAddressLine1Txt
CityGilroyCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95020ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEPHEN FORNEYPersonNm
Person TitleCFOPersonTitleTxt
Phone6505516501PhoneNum
Signature2017-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRosemarie Brown CPAPreparerPersonNm
PTINP01278077PTIN
Phone4159863900PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJordan HergetPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19400 No Name UnoAddressLine1Txt
CityGilroyCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95020ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$83,111,067GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption6153GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://stlouise.verity.org/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionSaint Louise Regional Hospital is a 93 bed acute care hospital offering a wide range of services to residents in both Santa Clara and San Benito counties.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee594TotalEmployeeCnt
Total Volunteers150TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$625,973PYContributionsGrantsAmt
CY Contributions Grants$60,110CYContributionsGrantsAmt
PY Program Service Revenue$88,658,281PYProgramServiceRevenueAmt
CY Program Service Revenue$82,898,283CYProgramServiceRevenueAmt
PY Investment Income-$10,318PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$1,404,819PYOtherRevenueAmt
CY Other Revenue$152,674CYOtherRevenueAmt
PY Total Revenue$90,678,755PYTotalRevenueAmt
CY Total Revenue$83,111,067CYTotalRevenueAmt
PY Grants And Similar Paid$360,600PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$39,749CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$54,760,488PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$51,497,200CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$45,264,338PYOtherExpensesAmt
CY Other Expenses$44,726,320CYOtherExpensesAmt
PY Total Expenses$100,385,426PYTotalExpensesAmt
CY Total Expenses$96,263,269CYTotalExpensesAmt
PY Revenues Less Expenses-$9,706,671PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$13,152,202CYRevenuesLessExpensesAmt
Total Assets BOY$66,642,041TotalAssetsBOYAmt
Total Assets EOY$37,629,622TotalAssetsEOYAmt
Total Liabilities BOY$110,098,462TotalLiabilitiesBOYAmt
Total Liabilities EOY$101,287,816TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$43,456,421NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$63,658,194NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSaint Louise Regional Hospital is organized and operated for the purposes of (i) maintaining an acute care hospital and related facilities, (ii) promoting research related to healthcare services, (iii) maintaining health plans using systems designed to maximize benefits to the communities served, (iv) promoting the general health of the community, and (v) providing financial and other forms of assistance for the benefit of other healthcare facilities affiliated with Verity.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$73,068,533ExpenseAmt
Grant$39,749GrantAmt
Revenue$82,898,283RevenueAmt
DescSaint Louise Regional Hospital ("SLRH"), a California nonprofit corporation, is a 93-bed acute care hospital in Gilroy, CA which serves South Santa Clara and San Benito Counties. SLRH also operates an urgent care center on its Morgan Hill campus--De Paul Health Center. The organization plays a vital role in continuing to emphasize high-quality, compassionate service to the underserved. SLRH provides the only emergency services within 30 miles, is a Certified Stroke Center and has diagnostic services, ICU, and general medical surgical services, including obstetric services. SLRH also provides minimally invasive surgical procedures, general medicine (including specialties that are not often seen in a community hospital), maternal and child health services, wound care, hyperbaric medicine with two hyperbaric oxygen chambers on site, stroke and a telemedicine program, physician referral services, and support groups. The hospital's Breast Care Center also provides mammography, other methods of cancer detection, and bone density screening. During the June 30, 2016 fiscal year, SLRH provided over $14 million in community benefit programs to the community in addition to the more than $12 million in care for the elderly. Annually, SLRH oversees approximately 3,000 inpatient discharges, 47,000 outpatient visits, 2,000 surgical cases, 500 births, 29,000 emergency visits, and 7,500 urgent care center visits.Desc
Total Program Service Expenses$73,068,533TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document104IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee594EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMUKESH SANGHVIPersonNm
Phone6505516502PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1203 REDWOOD SHORES PKWY 800AddressLine1Txt
CityRedwood CityCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94065ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Sr Ann Leitao DC
Board Chair through 12/20151.00.0Yes (X)Yes (X)$0$0$0
Sr Marion Bill DC
Board Member through 12/20151.07.0Yes (X)$0$0$0
Sr Fran Ciluaga DC
Secretary through 12/20151.01.0Yes (X)Yes (X)$0$0$0
Sr Judith Schomisch DC
Board Member through 12/20151.00.0Yes (X)$0$0$0
Sr Arthur Gordon DC
Board Member through 12/20151.00.0Yes (X)$0$0$0
Robert Issai
Board Member through 12/20151.046.0Yes (X)$0$3,832,601$282,571
George Green MD
Board Member through 12/20151.01.0Yes (X)$152,720$0$0
Mitch Creem
Board Member start 12/20151.045.0Yes (X)$0$0$0
Mark Ahn MD
Secretary1.00.0Yes (X)$0$0$0
Scott Benninghoven MD
Board Member1.00.0Yes (X)$17,300$0$0
George Chiala
Board Member1.01.0Yes (X)$0$0$0
Allen Hayes
Vice Chair1.00.0Yes (X)Yes (X)$0$0$0
Sr Margaret Keaveney DC
Int Pres & CEO through 12/201520.022.0Yes (X)$0$0$0
Robert Minkin
President & CEO start 12/201520.022.0Yes (X)$0$131,910$5,815
Sandra Martin
Interim VP/CFO through 03/201620.022.0Yes (X)$0$62,433$747
Eric Hardy
VP/CFO start 03/201620.022.0Yes (X)$0$0$0
Carol Furgurson
CAO through 02/201640.00.0$533,773$0$64,156Yes (X)
Lori Katterhagen
VP Patient Care/Clinical Svcs40.00.0$248,751$0$47,386Yes (X)
Marc Quarles
Ultrasound Tech III40.00.0$268,010$0$47,273Yes (X)
Elizabeth Agoo
Staff Nurse IV40.00.0$254,745$0$30,779Yes (X)
Cynthia Murray
Staff Nurse III40.00.0$246,295$0$39,402Yes (X)
Mary Lou Roach
Staff Nurse III40.00.0$221,282$0$27,432Yes (X)
Paul Dickson
Staff Nurse II40.00.0$212,640$0$35,563Yes (X)
James Dover
Former President & CEO0.00.0$0$267,425$33,936Yes (X)
Joanne Evelyn Allen
Former President & CEO0.042.0$0$1,164,477$66,926Yes (X)
David Carroll
Former CFO0.00.0$0$397,747$12,898Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,155,516TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,856,593TotReportableCompRltdOrgAmt
Total Other Compensation$694,884TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K150IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Elite Anesthesia Medical Group Inc
18535 Serra Avenida DrMORGAN HILLCA95037Medical Services$874,117
California Emergency Physicians
1601 Cummins DrMODESTOCA95358Medical Services$508,311
Fritter Schulz
9460 No Name UnoGILROYCA95020Medical Services$380,138
Learn Speech Pathology
662 Hazel Dell RdCARRALITOSCA95076Medical Services$371,148
Fastaff LLC
PO Box 911452DENVERCO80291Registry Nursing$325,686
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K20CntrctRcvdGreaterThan100KCnt
Related Organizations$60,110RelatedOrganizationsAmt
Total Contributions$60,110TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business621110BusinessCd
Total Revenue Column$82,898,283TotalRevenueColumnAmt
Related Or Exempt Func Income$82,898,283RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$82,898,283TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA722514$110,232$110,232
GIFT SHOP453220$34,983$34,983
MISCELLANEOUS REVENUE900099$7,459$7,459
FieldValueIRS element (for citing)
Other Revenue Total$152,674OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,111,067TotalRevenueColumnAmt
Related Or Exempt Func Income$82,898,283RelatedOrExemptFuncIncomeAmt
Exclusion$152,674ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$39,749TotalAmt
Program Services$39,749ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$864,750TotalAmt
Program Services$466,157ProgramServicesAmt
Management And General$398,593ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$37,083,426TotalAmt
Program Services$28,017,248ProgramServicesAmt
Management And General$9,066,178ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,719,611TotalAmt
Program Services$2,806,851ProgramServicesAmt
Management And General$912,760ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,165,246TotalAmt
Program Services$5,377,023ProgramServicesAmt
Management And General$1,788,223ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,664,167TotalAmt
Program Services$1,998,125ProgramServicesAmt
Management And General$666,042ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$667,202TotalAmt
Management And General$667,202ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,730,498TotalAmt
Program Services$10,534,797ProgramServicesAmt
Management And General$1,195,701ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$43,144TotalAmt
Management And General$43,144ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$444,474TotalAmt
Program Services$311,132ProgramServicesAmt
Management And General$133,342ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,410,678TotalAmt
Program Services$3,069,610ProgramServicesAmt
Management And General$341,068ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,118,066TotalAmt
Program Services$782,646ProgramServicesAmt
Management And General$335,420ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$17,469TotalAmt
Management And General$17,469ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$53,759TotalAmt
Program Services$37,631ProgramServicesAmt
Management And General$16,128ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,178,231TotalAmt
Program Services$2,178,231ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,659,260TotalAmt
Program Services$2,659,260ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,191,543TotalAmt
Program Services$338,146ProgramServicesAmt
Management And General$853,397ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$7,186,232$7,186,232
ALLOCATED HEALTH SYSTEM EXP.$6,231,233$6,231,233
PROVIDER FEES$3,943,476$3,943,476
BAD DEBT EXPENSE$2,088,267$2,088,267

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,762,788TotalAmt
Program Services$1,233,952ProgramServicesAmt
Management And General$528,836ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$96,263,269TotalAmt
Program Services$73,068,533ProgramServicesAmt
Management And General$23,194,736ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$11,485,527BOYAmt
EOY$3,934,486EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,300,471BOYAmt
EOY$10,631,033EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$66,877BOYAmt
EOY$24,017EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,283,035BOYAmt
EOY$1,254,409EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$200,932BOYAmt
EOY$1,224,067EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$51,003,590LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$38,904,786LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,149,890BOYAmt
EOY$12,098,804EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$143,818BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$24,011,491BOYAmt
EOY$8,462,806EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$66,642,041BOYAmt
EOY$37,629,622EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,265,017BOYAmt
EOY$11,256,593EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
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Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,012,259BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
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EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
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FieldValueIRS element (for citing)
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Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$76,821,186BOYAmt
EOY$90,031,223EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$110,098,462BOYAmt
EOY$101,287,816EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$43,456,421BOYAmt
EOY-$63,658,194EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$43,456,421BOYAmt
EOY-$63,658,194EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$66,642,041BOYAmt
EOY$37,629,622EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$13,152,202ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$7,049,571OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

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ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,616,600OtherCostOrOtherBasisAmt
Book Value$4,616,600BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,630,090OtherCostOrOtherBasisAmt
Depreciation$9,907,118DepreciationAmt
Book Value$4,722,972BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,989,808OtherCostOrOtherBasisAmt
Depreciation$28,885,556DepreciationAmt
Book Value$2,104,252BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$767,092OtherCostOrOtherBasisAmt
Depreciation$112,112DepreciationAmt
Book Value$654,980BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,098,804TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DUE FROM RELATED ORGANIZATIONS$5,854,575
DUE FROM GOVERNMENT AGENCIES$218,795
OTHER RECEIVABLES$2,372,255
DEPOSITS$17,181
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,462,806TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO RELATED ORGANIZATIONS$83,071,969
PENSION OBLIGATIONS$6,959,254
FieldValueIRS element (for citing)
Total Liability$90,031,223TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2:FormAndLineReferenceDesc
ExplanationVerity Health System of California, Inc. and its affiliates do not have a liability for uncertain tax positions under FIN 48 (ASC 740) on their consolidated financial statements for the year ended June 30, 2016. As such, there was no FIN 48 (ASC 740) disclosure in the footnotes to the consolidated financial statements of Verity Health System of California, Inc.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent350Yes (X)Percent350Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served295PersonsServedCnt
Total Community Benefit Expns$621,796TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$621,796NetCommunityBenefitExpnsAmt
Total Expense0.00630TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served18469PersonsServedCnt
Total Community Benefit Expns$33,414,154TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,331,944DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,082,210NetCommunityBenefitExpnsAmt
Total Expense0.13160TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served18764PersonsServedCnt
Total Community Benefit Expns$34,035,950TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,331,944DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,704,006NetCommunityBenefitExpnsAmt
Total Expense0.13790TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served3851PersonsServedCnt
Total Community Benefit Expns$259,376TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$243,876NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served12PersonsServedCnt
Total Community Benefit Expns$183,057TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$183,057NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served0PersonsServedCnt
Total Community Benefit Expns$3,736TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,736NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served286PersonsServedCnt
Total Community Benefit Expns$23,271TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,271NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served4149PersonsServedCnt
Total Community Benefit Expns$469,440TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$453,940NetCommunityBenefitExpnsAmt
Total Expense0.00460TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served22913PersonsServedCnt
Total Community Benefit Expns$34,505,390TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,347,444DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,157,946NetCommunityBenefitExpnsAmt
Total Expense0.14250TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$248,326TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$248,326NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$248,326TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$248,326NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,088,267BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$23,324,982ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$36,183,458CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$12,858,476MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Saint Louise Regional HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19400 No Name UnoAddressLine1Txt
CityGilroyCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95020ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps://stlouise.verity.org/WebsiteAddressTxt
State License070000266StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Saint Louise Regional HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section B, Lines 2, 3j, 7d, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c21d, 22d, 23, and 24: N/A
Part V, Section B, Line 5:See disclosure for Part VI, Question 2: Needs Assessment
Part V, Section B, Line 6a:Saint Louise Regional Hospital's ("SLRH") Community Health Needs Assessment ("CHNA") was conducted in conjunction with the Santa Clara County Community Benefit Coalition, which includes seven nonprofit hospitals. The hospitals included in the Coalition are: Saint Louise Regional Hospital, El Camino Hospital, Kaiser Permanente South Bay (Santa Clara and San Jose Kaiser Foundation Hospitals), Lucile Packard Childrens Hospital at Stanford, OConnor Hospital, Stanford Health Care, and Sutter Health.
Part V, Section B, Line 6b:The non-hospital organizations included in the Santa Clara County Community Benefit Coalition, which SLRH worked in conjunction with to complete its CHNA, include the Hospital Council of Northern & Southern California (a nonprofit multi-specialty medical group) and the Santa Clara County Public Health Department.
Part V, Section B, Line 7a:The CHNA report is posted on SLRHs website at: https://stlouise.verity.org/about-us/community-benefit/
Part V, Section B, Line 10a:SLRHs most recently adopted implementation strategy is posted on its website at: https://stlouise.verity.org/about-us/community-benefit/
Part V, Section B, Line 11:The SLRH 2016 Community Benefit Advisory Committee (CBAC) met on April 27, 2016 and reviewed countywide health needs identified by the Santa Clara County Community Benefit Coalition CHNA. The CBAC is comprised of hospital representatives, including seven clinical directors, two non-clinical directors, and the Chief Nursing Executive. Following the collaborative review of the county-wide health needs, this group identified health needs to be prioritized for the community directly served by SLRH. The criteria used were: (i) the severity of the need, (ii) the magnitude/scale of the need, (iii) clear disparities or inequities, and (iv) the multiplier effect. The CBAC discussed all of the 17 county-wide health needs identified in the CHNA and determined through discussion and group consensus the five that were a priority to the SLRH community. Each member ranked their top seven, followed by each individual presenting their prioritization and their reasoning. This led to an engaging discussion. Some members of the group then re-prioritized their lists. The final lists were reviewed and the health needs ranked according to the votes they received. The following top five health needs, in order of priority, were deemed applicable to the community served by SLRH: 1. Obesity and Diabetes 2. Behavioral Health 3. Access to Healthcare 4. Violence & Abuse 5. Birth Outcomes Below are the actions SLRH plans to take to address the prioritized health needs for FY2017-FY2019. Some of these actions are a continuation of current programs and some are planned as new activities. Obesity and Diabetes is a health need as marked by relatively high rates of diabetes among adults in Santa Clara County. County-wide, diabetes prevalence is at 8% (no better than the state average), but for the countys Latino population (a population heavily served by SLRH) diabetes prevalence is 11%. A major driver of diabetes rate is obesity, directly linked to poor nutrition and lack of exercise, and physical environment such as availability of fresh food versus convenient, fast food. Obesity is a health need as indicated by high rates of obese youth (24%-31%) and adults (21%) in Santa Clara County, and high rates of overweight individuals as well (14% in youth and 36% in adults). SLRH has a goal of increasing the awareness of the dangers of diabetes and the direct link between diabetes and obesity. In doing so, SLRH plans to provide educational activities to targeted populations in different languages. By presenting information in a native language, SLRH hopes to reach a larger number of community members and enable them to make healthier choices when it comes to food and exercises. It is anticipated that education will improve the prevalence of diabetes and obesity over time. Education resources include: The Health Benefits Resource Center, which provides CalFresh and Brown Bag Program enrollment assistance; a monthly diabetes support group (to be reinstated); educational information and glucose screenings at health fairs provided throughout the year; and the reinstatement of the "Talking Health" program which will offer educational classes on a variety of topics, including weight management and diabetes. Behavioral Health is prioritized as a health need and includes mental health (including depression and anxiety) and substance abuse. Community input indicates high concern about stress and depression specifically and the rising rates of marijuana and binge drinking among youth. Primarily through our emergency department, SLRH encounters community members with behavioral health issues. SLRH has a goal of enhancing staff awareness of resources available to community members, as well as to increase collaboration with outside agencies. While overall, SLRH does not have the resources or expertise to address behavioral health issues, through referral services, SLRH can continue to assist with this health need. Such examples include participation in the New Directions Program and the sponsorship of the Medical Respite Program (programs which provide homeless clients with assistance in accessing substance abuse programs), both coordinated through the Hospital Council of Northern & Central California. Additionally, if there is an indication of a patient-need relating to mental health or substance abuse problems, the staff social worker will conduct an evaluation and work collaboratively with the case management team to determine appropriate referrals. Access to Healthcare services is a health need in Santa Clara County because socioeconomic conditions (poverty, low levels of education, lack of quality health insurance) as well as factors including language and transportation barriers all impact access to care, which negatively impacts health. With a goal of continuing to provide healthcare and the ability to access said healthcare through assistance with insurance, transportation, prescriptions, and health education, SLRH will continue to meet the communitys health care needs by providing charity care and caring for those with public insurance. In addition, health education programs offered by SLRH will expand to cover new topics and will be presented in languages other than English. SLRH will also continue to support programs that provide health professionals education opportunities to improve in overall health and well-being. It is also anticipated that through these actions, individuals will have increased access to health care services. Such programs include: coordinating transportation with OUTREACH for those community members who do not have transportation to SLRH; participation in the Hospital Council of Northern & Central Californias New Directions Programs which provides case management for the chronically homeless; regularly paying for taxi fares to patients without transportation; paying for prescriptions when patients are unable to do so; continuing to be a clinical teaching setting for nursing students, radiological technicians and clinical lab specialist; and continuing to offer pregnancy and parenting classes. Violence and Abuse is a rising health need. In addition to other indicators, the rate of youth homicide in Santa Clara County is higher than the Healthy People target and the county has seen an increase in homicides in recent years. Domestic violence and child abuse rates also miss the benchmark for some ethnic subgroups. Drivers of this health need include mental health and social determinants of health such as poverty and unemployment. SLRH has a goal of enhancing staff awareness of resources available to community members and increasing collaboration with outside agencies. While overall, SLRH does not have the resources or expertise to address issues of Violence and Abuse, through referral services, SLRH can continue to assist with this health need. An example of such includes participation in the aforementioned New Directions Program. Additionally, if there is an indication of a patient-need relating to mental health or substance abuse problems, the staff social worker will conduct an evaluation and work collaboratively with the case management team to determine appropriate referrals. Lastly, during the next three years, SLRH will increase collaborative efforts with other social services at local health fairs and other educational events. Birth Outcomes is a health need in Santa Clara County as marked by the percentage of low birth weight babies, which is no better than the state average, though below Health People 2020 targets. Ironically, in the community served by SLRH, high birth weights is also a concern. While low birth weight often accompany premature births, high birth weights are typically associated with health concerns for the pregnant woman, such as diabetes. With a goal of increasing the number of healthy birth weights while decreasing health issues for pregnant women and newborns, SLRH provides or undertakes the following: free childbirth preparation classes, which cover prenatal health, delivery and infant care; free pre- and post-natal yoga classes; distribution of educational information associated with the Maternal Child Health Services department of SLRH at multiple health fairs throughout the year; individualized lactation support; and a breast-feeding support group. In addition, SLRH is in the process of becoming Baby Friendly certified. While acknowledging the importance of all of the community needs identified through the CHNA, the limited resources and availability of expertise to the hospital result in the need to select the top needs to focus attention. The following needs are not specifically addressed by SLRH in its implementation plan, however, several needs are addressed through lesser methods. Alzheimer's Disease and Dementia is a health need because of the increasing proportion of Santa Clara County residents living with Alzheimers disease, and because it is one of the top ten leading causes of death in the county. This need
Part V, Section B, Lines 16a, 16b, and 16c:The FAP, FAP application form, and the plain language summary of the FAP is widely available on the organizations website at https://stlouise.verity.org/patients-and-visitors/financial-assistance/. These documents were not on the website at the start of the June 30, 2017 tax year (the tax year starting in 2016, when the IRC Section 501r regulations came into effect), but has since been corrected at the time of the filing of this return.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1De Paul Urgent Care CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line118550 De Paul Drive Suite 109AddressLine1Txt
CityMorgan HillCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95037ZIPCd
FieldValueIRS element (for citing)
FacilityUrgent Care CenterFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:N/A
Part I, Line 6a:Saint Louise Regional Hospital ("SLRH") prepares an annual Community Benefit Report. It is developed in conjunction with SLRHs strategic planning process that is based on the Community Health Needs Assessment, organizational capacity, and resource allocation. Reports on community benefit activities and outcomes are provided by managers and directors responsible for specific community benefit programs. Quarterly reports are presented to the SLRH Board of Directors and Verity Health System of California, Inc. ("VHS") corporate officers. An annual update is prepared and presented to the SLRH Board of Directors for approval. The annual update is made available to medical center leadership, key stakeholders, VHS, and the community. The annual update is presented to the California Office of Statewide Planning and Development, in accordance with SB697. SLRHs Community Benefit Report is developed using results from the Community Health Needs Assessment, data and input provided by the managers and directors responsible for specific community benefit programs, and feedback from the Community Benefits Committee. SLRHs Board of Directors reviews and gives final approval of SLRH's Community Benefit Report. Continual monitoring and evaluation of existing Healthy Community Initiatives provide vital information to the strategic planning process for community benefit programs.
Part I, Line 7, Column (f): Bad Debt ExpenseForm 990, Part IX, line 25, Column A for SLRH reflects a bad debt expense of $2,088,267 which is not included in the line 7 calculation.
Part I, Line 7g:N/A
Part I, Line 7:SLRH utilizes a cost accounting system that determines costs for providing medical services based on the organizations relationship of costs to charges.
Part II:Refer to Part VI questions 4 and 5.
Part III, Line 2:Bad debt expense is estimated by utilizing historical collections data of self-pay patients. Management also considers business and general economic conditions in its service area.
Part III, Line 3:N/A
Part III, Line 4:SLRH is included in the VHS Consolidated Audited Financial Statements. The financial statements for the 6/30/2016 fiscal year do not contain a separate footnote on bad debts.
Part III, Line 8:As a not-for-profit hospital, it is SLRH's mission to improve the health status of all people within its community and provide healthcare to all patients regardless of their ability to pay or their insurance status. SLRH accepts Medicare which results in shortfalls in the costs for caring for patients utilizing this program. SLRH utilizes a cost accounting system that determines costs for providing medical services based on the organizations relationship of costs to charges. The entire shortfall shown on Part III, Line 7 should be reflected as a community benefit.
Part III, Line 9b:SLRH follows the Collection Practices as outlined in VHS Charity Care and Financial Discount and Financial Assistance operating policies. For patients who qualify for charity care and financial discount, SLRH provides the patient with a written notice prior to commencing collection activities. The notice states that nonprofit counseling services may be available in the area and provides information concerning state and federal law requirements for debt collectors. SLRH does not pursue legal action for non-payment of bills against any household where the primary wage earner(s) is unemployed or there are not significant income sources. SLRH does not assign patients meeting an agreed upon monthly payment plan to a collection agency and does not report the patient to credit bureaus. SLRH does not report adverse information to a consumer credit agency or commence civil action for nonpayment of a patient debt prior to 150 days after the initial billing of the patient. SLRH does not use wage garnishments or liens on real property as a means of collecting unpaid hospital bills for eligible patients. SLRH expects its external collection agencies to not pursue legal action against an eligible patient without prior approval from SLRH. SLRH expects its external collection agencies to follow Fair Debt and Collection Practices, Assembly Bill AB774, and act in a manner that treats individuals with dignity, respect and compassion. In addition, for patients who qualify for financial assistance, SLRH does not pursue legal action for non-payment of bills against any household where the primary wage earner(s) is unemployed, uninsured or there are not significant income sources or assets. SLRH does not assign eligible patients meeting an agreed upon monthly payment plan to a collection agency and does not report the patient to credit bureaus. SLRH does not use liens on real property as a means of collecting unpaid hospital bills for eligible patients.
Part VI, Question 2:The Santa Clara County Community Benefit Coalition ("the Coalition") began the 2016 CHNA planning process in the fall of 2014. The Coalitions goal for the CHNA was to collectively gather community feedback and existing data about health status to inform the member hospitals respective needs prioritization and selection. The Coalition contracted with Applied Survey Research ("ASR"), which prepared the CHNA on behalf of the Coalition. ASR obtained community input during the winter and spring of 2015 via key informant interviews with local health experts, focus groups with community leaders and representatives, and resident focus groups. This primary qualitative data included input from various populations including: low-income, minority, the medically underserved, linguistically isolated populations, youth, older adults, and undocumented immigrants. ASR conducted three out of five resident focus groups in languages other than English and intentionally recruited people with low incomes for resident focus groups. ASR also solicited input from almost 100 community leaders, invited an additional 65 community leaders with expertise in serving the community to participate in an online survey, conducted primary research via key informant interviews with five Santa Clara County experts from various organizations within the health sector, and conducted community leader focus groups in which 68 professionals participated. ASR recorded and summarized each group and interview as a stand-alone piece of data. When all data had been collected, the team used qualitative research software tools to analyze the information. ASR then tabulated how many times health needs had been prioritized by each of the focus groups or described as a priority in a key informant interview. The Coalition used this tabulation to help assess community health priorities. In addition, ASR collected quantitative and qualitative secondary data from multiple Santa Clara County Public Health Department sources, including: 2014 Santa Clara County Community Health Assessment; Behavioral Risk Factors Survey (BRFS) Quick Facts 2014; Status of Africa/African Ancestry Health: Santa Clara County, 2014; Status of LGBTQ Health: Santa Clara County, 2013; Status of Vietnamese Health: Santa Clara County, 2011; and HIV/AIDS Epidemic in Santa Clara County, 2012. In September 2015, ASR identified health needs by synthesizing primary qualitative research and secondary data, and then filtering those needs against the following criteria: (i) The issue must fit the definition of a "health need (ii) The issue is suggested or confirmed by more than one source of secondary and/or primary data; (iii) The issue meets either qualitative or quantitative data criteria (meaning at least one related indicator performs poorly against the Healthy People 2020 benchmark or state average, and, the community prioritized it in three of eleven focus groups, or it was mentioned by a key informant). Based on community input and secondary data, the Coalition generated list of health needs that reflected the communitys priorities. The Coalition generated a list of 17 health needs, as follows: 1. Obesity and Diabetes 2. Behavioral Health 3. Access to Healthcare and Healthcare Delivery 4. Violence 5. Birth Outcomes 6. Alzheimers Disease and Dementia 7. Cancer 8. Cerebrovascular Diseases 9. Communicable Diseases 10. Economic Security 11. Housing 12. Learning Disabilities 13. Oral and Dental Health 14. Respiratory Conditions 15. Sexual Health 16. Tobacco Use 17. Unintentional Injuries For further details, including statistical data and citations, please consult the full health needs descriptions in Section 6 of the CHNA report found in the full Health Needs Assessment. Please refer to Schedule H, Part V for a description on how SLRH is addressing to the five health needs it has identified as a priority.
Part VI, Question 3:Patients who present at SLRHs Emergency Department and SLRHs Admitting Department are provided with a financial assistance packet that consists of an informational flyer on various programs for which they may be eligible, along with the contact number for SLRHs Health Benefits Resource Center (HBRC). The flyer is in English and Spanish. The packet includes a Medi-Cal application, as well as a Charity Care application. Should they make an appointment with HBRC, patients can fill out the forms prior to their appointment. HBRC staff visits Cash/Self-Pay patients at bedside, screens patients and identifies the programs for which they are eligible. If they have no linkage, HBRC provides information about other programs for which they may qualify such as Charity Care. In addition, there are signs posted in English and Spanish in the Patient Financial Services department and at every point of registration stating that SLRH has financial assistance and charitable programs available for qualified low income, uninsured patients who may not have the ability to meet the financial obligation of their hospital services and a contact number to call. After discharge, the back of the monthly patient bills includes this same statement.
Part VI, Question 4:Santa Clara County is located in the San Francisco Bay Area. The 2014 estimated population was 1.89 million people, making it the sixth largest county in California by population. Twelve percent (12%) of the population is linguistically isolated in the county overall, with wide differences seen across cities. Nearly one quarter (23%) of the population in Santa Clara County is under the age of 18, while 11% is 65 years or older, leaving two thirds of adults between 18 65 years of age. Santa Clara is also very diverse. Notably, those of "some other race" are the third largest racial group behind White and Asian, comprising 10% of the population. Nearly 5% of the population is of two or more races. About half of the population is White alone. Over a third (37%) of Santa Clara county residents are foreign-born. Two key social determinants, income and education, have a significant impact on health outcomes. Santa Clara County has one of the highest annual median incomes in the country and one of the highest costs of living. The median household income is $91,201, which is far higher than California ($59,645) and higher than neighboring San Mateo County ($86,245). Despite the fact that half of households in the county earn more than $100,000 per year, one in five (20%) county residents live below 200% of the federal poverty level, with a disproportionate amount found within SLRHs service area. In addition more than 25% of the population aged 25+ do not have a high school diploma in the towns of Morgan Hill and Gilroy, which are within SLRHs service area. SLRH is the largest hospital serving South Santa Clara and San Benito Counties, with only one other hospital in its service area. SLRH also provides the only emergency services within 30 miles. The percentage of uninsured adults in Santa Clara County was 12% in 2014.
Part VI, Question 5:SLRH, a California nonprofit corporation, is a 93 bed acute-care hospital in Gilroy, CA. SLRH is the largest hospital serving the growing communities of southern Santa Clara County and northern San Benito County, with only one other small hospital in our service area. Currently we also operate an Urgent Care Center on our Morgan Hill campus: De Paul Health Center. We believe our not-for-profit hospital plays a vital role in continuing to emphasize high quality, compassionate service to the underserved in this changing, challenging environment. The majority of the organizations Board of Directors at year-end represent those who currently reside in the SLRHs primary service area; all but 2 of those individuals are not compensated as independent contractors or employees of the organization. In addition, the organization utilizes any surplus funds to assist with Care; in fiscal year 2016, SLRH provided services for 503 cases at a net cost of $622,000. In addition, SLRH provided services to more than 18,000 Medi-Cal cases at a net cost of approximately $13 million. SLRH also provides health screenings to the community at a variety of businesses and health fairs and hosts support groups for individuals suffering with bereavement, tremors, dystonia, and weight loss. Since August of 2015, the hospital has offered prenatal health and education classes to the community, free of charge. This includes childbirth preparation classes and pre- and post-natal yoga classes. SLRH has also partnered with local organizations and agencies to promote the health of the community, as follows: The South County Collaborative is a community partnership sharing strengths and resources. Over 50 agencies are represented including schools, healthcare, businesses, and community members. The Collaborative meets monthly and annually sets goals to improve the quality of life in South County. The Director of Community Health serves as a member of the Board of Directors as well as the co-chair of the Nutrition and Health Sub-Committee. The Nutrition and Health Sub-Committee meets monthly to collaborate on ways to improve health and nutrition in South County. Some of the activities of this committee included: planning and sponsoring of a workshop related to the effects of poverty on health in the Latino community during Binational Health Week annually; advocacy for prevention activities related to obesity and chronic health conditions; increased utilization of the Food Stamp program by providing food assistance training; supported the implementation of a breastfeeding project; and the CUP grant to promote drug/alcohol free communities. Gilroy Community Health Day is a collaborative effort of several local agencies serving the underserved. SLRH was actively involved with the planning and sponsorship of this event. The health screening results assisted us in setting priorities. The Gilroy Unified School District Health Council is a collaborative group that meets regularly to address the implementation of the Wellness Policy in each school. Participation on this council provided input into the many obstacles to healthy eating which are present in the schools and therefore in the community at large. The Council continues to work with parents to provide 100% compliance with this policy. In addition, members of Senior Management and SLRH associates served in a variety of roles on the various Chambers, Rotary and other community organizations.
Part VI, Question 6:Prior to December 14, 2015, SLRH was a part of Daughters of Charity Health System ("DCHS") a regional health care system of hospitals and medical centers spanning the California coast from the San Francsico Bay Area to Los Angeles, formed and operated as religious corporations. In July 2015, DCHS selected BlueMountain Capital Management LLC, a private investment firm, to recapitalize its operations and transition leadership of the hospital system to the new Verity Health System. The transaction was approved by the California Attorney General on December 14, 2015, whereby DCHS amended its name to Verity Health System of Claifornia, Inc. ("VHS") and VHS and all of its nonprofit corporate affiliates (including SLRH) changed status from religious corporations to public benefit corporations under the California Nonprofit Corporation Law. As a non-profit, non-religious health care system, VHS seeks to build on the rich legacy left by the Daughters of Charity Health System. SLRH is a 93-bed acute care hospital in Gilroy, CA which serves South Santa Clara and San Benito Counties. SLRH provides the only emergency services within 30 miles, is a Certified Stroke Center and has diagnostic services, ICU, and general medical surgical services including obstetrics. A CALSTAR emergency helicopter transport is based on the premises. SLRH also provides minimally invasive surgical procedures, general medicine including specialties that are not often seen in a small community hospital, maternal and child health services, wound care and hyperbaric medicine with two hyberbaric oxygen champers on site, stroke and a telemedicine program, physician referral services, and support groups. The hospitals Breast Care Center provides mammography, other methods of cancer detection, and bone density screening.
Part VI, Question 7:SLRH annually updates its Community Benefits Report and files a copy of it on an annual basis with the State of California.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Verity Medical FoundationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Race StreetAddressLine1Txt
CitySan JoseCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95126ZIPCd
FieldValueIRS element (for citing)
Recipient EIN453691852RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$39,749CashGrantAmt
Purpose Of GrantGeneral SupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2:FormAndLineReferenceDesc
ExplanationSaint Louise Regional Hospital is a part of a group of related tax-exempt organizations, which includes Verity Medical Foundation. During the June 30, 2016 fiscal year, Saint Louise Regional Hospital made equity transfers to Verity Medical Foundation, whose sole corporate member is also Verity Health System of California, Inc. Proper use of transferred amounts is monitored through common control throughout the health system.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Robert Issai
Board Member through 12/2015$0$1,123,278$0$0$0$2,709,323$0$233,622$0$48,949$0$4,115,172$0$0
George Green MD
Board Member through 12/2015$152,720$0$0$0$0$0$0$0$0$0$152,720$0$0$0
Carol Furgurson
CAO through 02/2016$273,066$0$176,975$0$83,732$0$40,571$0$23,585$0$597,929$0$0$0
Lori Katterhagen
VP Patient Care/Clinical Svcs$165,765$0$58,150$0$24,836$0$12,571$0$34,815$0$296,137$0$0$0
Marc Quarles
Ultrasound Tech III$249,143$0$0$0$18,867$0$15,393$0$31,880$0$315,283$0$0$0
Elizabeth Agoo
Staff Nurse IV$220,495$0$0$0$34,250$0$4,511$0$26,268$0$285,524$0$0$0
Cynthia Murray
Staff Nurse III$221,547$0$0$0$24,748$0$4,378$0$35,024$0$285,697$0$0$0
Mary Lou Roach
Staff Nurse III$202,661$0$0$0$18,621$0$3,706$0$23,726$0$248,714$0$0$0
Paul Dickson
Staff Nurse II$193,616$0$0$0$19,024$0$3,741$0$31,822$0$248,203$0$0$0
James Dover
Former President & CEO$0$260,274$0$0$0$7,151$0$9,596$0$24,340$0$301,361$0$0
Joanne Evelyn Allen
Former President & CEO$0$435,320$0$0$0$729,157$0$39,515$0$27,411$0$1,231,403$0$0
David Carroll
Former CFO$0$132,161$0$50,249$0$215,337$0$9,908$0$2,990$0$410,645$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Methods Used to Establish compensation of CEO by a Related Organization:Schedule J, Part I, Line 3: The President & CEO is an employee of Verity Health System of California, Inc. ("VHS"). VHS uses the following methods to establish top management officials' compensation: independent compensation consultant, compensation survey or study, approval by the Board or Compensation Committee, Form 990 of other organizations, and written employment contracts.
Severance PaymentsSchedule J, Part I, Line 4a: The following individuals received a severance payment from related organizations during the 2015 calendar year, which was reported as taxable compensation on Form 990, Part VII, Section A, Column (E) and Schedule J, Part II, Column (b)(iii): Robert Issai $1,893,008 Joanne Evelyn Allen $ 720,387 David Carroll $ 188,431 Additionally, some of the individuals listed on Schedule J, Part II have a severance provision as a part of their employment arrangement. The severance provision ranges from 6 months to 2 years, dependent on the job title, length of service, and reason for termination.
Nonqualified Retirement PlanSchedule J, Part I, Line 4b: The following individuals participated in a supplemental nonqualified retirement plan provided by the organization or a related organization, which is included in compensation reported on Form 990, Part VII, Section A, Column (F) and Schedule J, Part II, Column (c): Robert Issai $58,059 Carol Furgurson $17,383 Joanne Evelyn Allen $ 6,983
Explanation of Other Reportable CompensationSchedule J, Part II, Column (b)(iii): Two individuals listed on Schedule J, Part II received a one-time payout of a 401(a)(17) plan; the taxable amount of that payout is reflected as other reportable compensation on Schedule J, Part II, Column (b)(iii).

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 4:During the June 30, 2016 fiscal-year, the organization amended its mission and exempt purpose in its Articles of Incorporation to reflect language indicative of the Health Systems change from religious corporations to public benefit corporations under the California Nonprofit Corporation Law. In addition, the organization made similar changes to its bylaws, as well as the following additional changes: (1) changes to the composition of its Board of Directors, including mandating that no more than twenty percent of the members of the Board of Directors should have any financial relationship with BlueMountain Capital Management, LLC (which infused VHS with financing in exchange for an option to acquire the assets VHS), or Integrity Healthcare, LLC (its wholly owned subsidiary); (2) provided that VHS, as the sole corporate member of the organization, has the authority to appoint and remove the chairperson, president, and chief executive officer of the organization and its direct subsidiaries (3) provided that VHS has the authority to dissolve the organizations audit committee and direct its responsibilities to the audit committee of VHS; (4) included restrictions on transactions with interested directors; (5) provided that Directors may receive reasonable compensation fixed by VHS; and (6) provided that members of the audit committee may receive compensation not to exceed the compensation paid to Directors, but may not be employees of the organization or have a material financial interest in entities doing business with the organization.
Form 990, Part VI, Section A, Line 6:Saint Louise Regional Hospital has one member, Verity Health System of California, Inc. (formerly known as Daughters of Charity Health System through December 14, 2015), a California nonprofit corporation.
Form 990, Part VI, Section A, Line 7a:The organization's sole member, Verity Health System of California, Inc. ("VHS") has the power to fix the number and appoint and remove the Trustees of Saint Louise Regional Hospital ("SLRH").
Form 990, Part VI, Section A, Line 7b:As the sole member of SLRH, VHS has the power to take or approve the following actions as it relates to SLRH: (1) approve or change the mission, role, and purpose of this organization; (2) amend the Bylaws and Articles of Incorporation (or authorize the Board of Trustee to do so); (3) approve the formation, merger, dissolution, consolidation, divestiture, closure, change in corporate membership or control and reorganization of each direct Affiliate of this Corporation; (4) fix the number and appoint and remove the Trustees of this Corporation; (5) appoint and remove the Chairperson of the Board and President and Chief Executive Officer of this Corporation and of each direct Affiliate or Subsidiary of this Corporation; (6) approve the merger, consolidation, reorganization, dissolution, or disposition of assets of this Corporation or any direct Affiliate of this Corporation; (7) approve the acquisition, sale, lease, mortgage, transfer or other alienation of real or personal property of this Corporation; (8) approve the capital and operating budgets; (9) approve the incurrence of debt or guaranties; (10) establish policy concerning quality of care and services for the Corporation; (11) establish policy and procedures concerning finance and resources; (12) establish criteria for the long-range financial and strategic plans of the Corporation; (13) establish an internal auditing program and approve any material element of the internal auditing program; (14) approve capital expenditures; (15) approve the transfer of funds, by gift or loan, between this Corporation and one or more other Affiliates of Verity health System; (16) approve any other action by this Corporation or for any Affiliate controlled by this Corporation that has been established by resolution of the Corporate Member as requiring its approval, including, but not limited to, any approvals of authority necessary to ensure compliance with any credit agreement, master indenture or loan agreement to which this Corporation is a party.
Form 990, Part VI, Section B, Line 11b:The organizations independent tax preparers and finance staff work together to gather the required information necessary to complete the Form 990. The initial draft Form 990 is reviewed by the organizations finance and legal department. After the Form 990 is reviewed, recommended changes are discussed and a final Form 990 is prepared. Prior to filing with the Internal Revenue Service, the final version Form 990 is distributed to the organizations Board of Directors for review.
Form 990, Part VI, Section B, Line 12c:VHS has a Conflict of Interest Policy that covers VHS and all of its affiliates. The policy provides for a systematic and ongoing method of requiring individuals who have decision making responsibilities to disclose and address potential and actual conflicts of interest. Covered individuals are required to complete an annual statement disclosing any conflicts of interest and have a duty to update the disclosure for any potential conflicts of interest that arise during the year. The President & CEOs of the individual hospitals within the health system report the conflict of interest findings and resolutions to their respective Board of Directors. This policy is reviewed annually for compliance by VHSs Corporate Responsibility Officer.
Form 990, Part VI, Section B, Lines 15a and 15b:The VHS compensation programs cover VHS and all of its affiliated hospitals. The President & CEO of each hospital is employed by VHS; as such, Form 990, Part VI, Section B, Line 15a has been answered "no" as mandated by the Form 990 instructions. The VHS compensation programs are designed to recruit, retain, and motivate qualified executives. The programs are designed for positions that have a significant impact on the high-level strategic and policy direction of VHS and its affiliated hospitals. All of the hospital President & CEOs are paid directly by VHS and covered by the VHS compensation programs. Market data analyses are made of comparable organizations within the industry and within the region. Total compensation is established for all executive positiions to target similar total compensation of comparable organization's market compensation. Base pay is established for all executive positions to target the median range of comparable organization market compensation. VHS utilized a Benefits committee to review compensation and benefits. The VHS Board of Directors reviews and approves compensation recommended by the Benefits Committee, and documents its conclusion that the proposed compensation is reasonable. In evaluating and finalizing its determination of base pay and total compensation for comparable positions at comparable organizations in comparable markets, VHS utilizes available market data analyses which includes independent compensation consultants, Form 990s of other organizations, written employment contracts, compensation surveys or studies, and recommendations from the Benefits Committee and approval by the VHS Board of Directors.
Form 990, Part VI, Section C, Line 19:The audited financial statements are made available to the public upon request. The Articles of Incorporation, Bylaws, and Conflict of Interest Policy are not made available to the public.
Form 990, Part XI, Line 9:The other changes in net assets or fund balances consist of a change in the funded status of pension plans of ($1,817,000) and a net transfer of medical office buildings to Verity Health System of California, Inc., a related organization, of ($5,232,571).
FORM 990 PART IX LINE 11GDESCRIPTION:REGISTRY NURSING TOTAL FEES:1653608
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER CONTRACT LABOR TOTAL FEES:1576323
FORM 990 PART IX LINE 11GDESCRIPTION:MEDICAL FEES TOTAL FEES:4383075
FORM 990 PART IX LINE 11GDESCRIPTION:PURHASED SRVCS: OUTSIDE ORGS TOTAL FEES:3831814
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTANTS TOTAL FEES:285678

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Daughters of Charity Ministry Svcs Corp
26000 Altamont RdLos Altos HillsCA94022770482943OutreachCA501(c)(3)01DOC SVDPfalse
Verity Health System of California Inc
203 Redwood Shores Pkwy 800Redwood CityCA94065912145484Hosp LdrshipCA501(c)(3)11-III FINAfalse
O'Connor Hospital
2105 Forest AvenueSan JoseCA95128912154436HealthcareCA501(c)(3)03VHSfalse
O'Connor Hospital Foundation
2105 Forest AvenueSan JoseCA95128770006295FundraisingCA501(c)(3)11-IOCHfalse
Robert F Kennedy Medical Center Found
203 Redwood Shores Pkwy 800Redwood CityCA94065953745227FundraisingCA501(c)(3)11-IRFKMCfalse
St Francis Medical Center
3630 East Imperial HighwayLynwoodCA90262912154439HealthcareCA501(c)(3)03VHSfalse
St Francis Med Center of Lynwood Found
3630 East Imperial HighwayLynwoodCA90262953190773FundraisingCA501(c)(3)11-ISFMCfalse
Saint Louise Regional Hospital Found
9400 No Name UnoGilroyCA95020562384735FundraisingCA501(c)(3)11-ISLRHYes (true)
St Vincent Medical Center
2131 West Third StreetLos AngelesCA90057912154438HealthcareCA501(c)(3)03VHSfalse
St Vincent Dialysis Center
2131 West Third StreetLos AngelesCA90057953749293HealthcareCA501(c)(3)03SVMCfalse
St Vincent Foundation
2131 West Third StreetLos AngelesCA90057953922511FundraisingCA501(c)(3)11-ISVMCfalse
Seton Medical Center
1900 Sullivan AvenueDaly CityCA94015912154441HealthcareCA501(c)(3)03VHSfalse
Seton Medical Center Foundation
1900 Sullivan AvenueDaly CityCA94015942824033FundraisingCA501(c)(3)11-ISMCfalse
Verity Business Services
203 Redwood Shores Pkwy 800Redwood CityCA94065510659139Hosp SupportCA501(c)(3)11-IIVHSfalse
Verity Medical Foundation
400 Race StreetSan JoseCA95126453691852HealthcareCA501(c)(3)09VHSfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1O'Connor Health Center 1BusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11960 The Alameda Suite 20AddressLine1Txt
CitySan JoseCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95126ZIPCd
FieldValueIRS element (for citing)
EIN770419045EIN
Primary ActivitiesRentalPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1VHSBusinessNameLine1Txt
FieldValueIRS element (for citing)
General Or Managing PartnerfalseGeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
Marillac Insurance Company LTD
PO Box 69Grand CaymanCJKY1-1102980417930Captive InsuranceCJVHSfalse
Robert F Kennedy Medical Center
912154440InactiveVHSfalse203 Redwood Shores Pkwy 800Redwood CityCA94065CA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Saint Louise Regional Hospital Foundation
c$57,065Cost
Saint Louise Regional Hospital Foundation
o$89,528Cost

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule R, Part II:FormAndLineReferenceDesc
ExplanationDaughters of Charity Ministry Services Corporation was a related organization of Verity Health System of California, Inc., formerly known as Daughters of Charity Health System ("Parent"), until December 14, 2015 by reason of Daughters of Charity Ministry Services Corporation being the sole member of the Parent with the power to appoint the majority of the Board of Directors. On December 14, 2015, the California Attorney General approved a System Restructuring and Support Agreement to change the governance of and recapitalize the Parent and its subsidiaries. Under the Restructuring Agreement, the Parent and other members were converted from religious corporations to public benefit corporations. Effective December 14, 2015, the Board of Directors of the Parent resigned and Daughters of Charity Ministry Services Corporation, acting as sole corporate member of the Parent, appointed an independent board of the Parent and amended the bylaws of the Parent to eliminate the corporate membership rights of Daughters of Charity Ministry Services Corporation, effectively converting the Parent into a nonprofit corporation without members.ExplanationTxt