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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T12:55:19-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 CALIFORNIA STREET SUITE 2700 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94111 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 912154437 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Louise Regional Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MUKESH SANGHVI | InCareOfNm |
| Business Name Control | SAIN | BusinessNameControlTxt |
| Phone | 4088482000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9400 No Name Uno | AddressLine1Txt |
| City | Gilroy | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95020 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN FORNEY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6505516501 | PhoneNum |
| Signature | 2017-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rosemarie Brown CPA | PreparerPersonNm |
| PTIN | P01278077 | PTIN |
| Phone | 4159863900 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Jordan Herget | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9400 No Name Uno | AddressLine1Txt |
| City | Gilroy | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $83,111,067 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 6153 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://stlouise.verity.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Saint 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 Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 594 | TotalEmployeeCnt |
| Total Volunteers | 150 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $625,973 | PYContributionsGrantsAmt |
| CY Contributions Grants | $60,110 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $88,658,281 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,898,283 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$10,318 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,404,819 | PYOtherRevenueAmt |
| CY Other Revenue | $152,674 | CYOtherRevenueAmt |
| PY Total Revenue | $90,678,755 | PYTotalRevenueAmt |
| CY Total Revenue | $83,111,067 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $360,600 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $39,749 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $54,760,488 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $51,497,200 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45,264,338 | PYOtherExpensesAmt |
| CY Other Expenses | $44,726,320 | CYOtherExpensesAmt |
| PY Total Expenses | $100,385,426 | PYTotalExpensesAmt |
| CY Total Expenses | $96,263,269 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,706,671 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$13,152,202 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $66,642,041 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,629,622 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $110,098,462 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $101,287,816 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$43,456,421 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$63,658,194 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Saint 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $73,068,533 | ExpenseAmt |
| Grant | $39,749 | GrantAmt |
| Revenue | $82,898,283 | RevenueAmt |
| Desc | Saint 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 | $73,068,533 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 104 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 594 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MUKESH SANGHVI | PersonNm |
| Phone | 6505516502 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 203 REDWOOD SHORES PKWY 800 | AddressLine1Txt |
| City | Redwood City | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94065 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Sr Ann Leitao DC | ||||||||||
| Board Chair through 12/2015 | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Sr Marion Bill DC | ||||||||||
| Board Member through 12/2015 | 1.0 | 7.0 | Yes (X) | $0 | $0 | $0 | ||||
| Sr Fran Ciluaga DC | ||||||||||
| Secretary through 12/2015 | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Sr Judith Schomisch DC | ||||||||||
| Board Member through 12/2015 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Sr Arthur Gordon DC | ||||||||||
| Board Member through 12/2015 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Robert Issai | ||||||||||
| Board Member through 12/2015 | 1.0 | 46.0 | Yes (X) | $0 | $3,832,601 | $282,571 | ||||
| George Green MD | ||||||||||
| Board Member through 12/2015 | 1.0 | 1.0 | Yes (X) | $152,720 | $0 | $0 | ||||
| Mitch Creem | ||||||||||
| Board Member start 12/2015 | 1.0 | 45.0 | Yes (X) | $0 | $0 | $0 | ||||
| Mark Ahn MD | ||||||||||
| Secretary | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Scott Benninghoven MD | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $17,300 | $0 | $0 | ||||
| George Chiala | ||||||||||
| Board Member | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| Allen Hayes | ||||||||||
| Vice Chair | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Sr Margaret Keaveney DC | ||||||||||
| Int Pres & CEO through 12/2015 | 20.0 | 22.0 | Yes (X) | $0 | $0 | $0 | ||||
| Robert Minkin | ||||||||||
| President & CEO start 12/2015 | 20.0 | 22.0 | Yes (X) | $0 | $131,910 | $5,815 | ||||
| Sandra Martin | ||||||||||
| Interim VP/CFO through 03/2016 | 20.0 | 22.0 | Yes (X) | $0 | $62,433 | $747 | ||||
| Eric Hardy | ||||||||||
| VP/CFO start 03/2016 | 20.0 | 22.0 | Yes (X) | $0 | $0 | $0 | ||||
| Carol Furgurson | ||||||||||
| CAO through 02/2016 | 40.0 | 0.0 | $533,773 | $0 | $64,156 | Yes (X) | ||||
| Lori Katterhagen | ||||||||||
| VP Patient Care/Clinical Svcs | 40.0 | 0.0 | $248,751 | $0 | $47,386 | Yes (X) | ||||
| Marc Quarles | ||||||||||
| Ultrasound Tech III | 40.0 | 0.0 | $268,010 | $0 | $47,273 | Yes (X) | ||||
| Elizabeth Agoo | ||||||||||
| Staff Nurse IV | 40.0 | 0.0 | $254,745 | $0 | $30,779 | Yes (X) | ||||
| Cynthia Murray | ||||||||||
| Staff Nurse III | 40.0 | 0.0 | $246,295 | $0 | $39,402 | Yes (X) | ||||
| Mary Lou Roach | ||||||||||
| Staff Nurse III | 40.0 | 0.0 | $221,282 | $0 | $27,432 | Yes (X) | ||||
| Paul Dickson | ||||||||||
| Staff Nurse II | 40.0 | 0.0 | $212,640 | $0 | $35,563 | Yes (X) | ||||
| James Dover | ||||||||||
| Former President & CEO | 0.0 | 0.0 | $0 | $267,425 | $33,936 | Yes (X) | ||||
| Joanne Evelyn Allen | ||||||||||
| Former President & CEO | 0.0 | 42.0 | $0 | $1,164,477 | $66,926 | Yes (X) | ||||
| David Carroll | ||||||||||
| Former CFO | 0.0 | 0.0 | $0 | $397,747 | $12,898 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,155,516 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,856,593 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $694,884 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 150 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Elite Anesthesia Medical Group Inc | |||||
| 18535 Serra Avenida Dr | MORGAN HILL | CA | 95037 | Medical Services | $874,117 |
| California Emergency Physicians | |||||
| 1601 Cummins Dr | MODESTO | CA | 95358 | Medical Services | $508,311 |
| Fritter Schulz | |||||
| 9460 No Name Uno | GILROY | CA | 95020 | Medical Services | $380,138 |
| Learn Speech Pathology | |||||
| 662 Hazel Dell Rd | CARRALITOS | CA | 95076 | Medical Services | $371,148 |
| Fastaff LLC | |||||
| PO Box 911452 | DENVER | CO | 80291 | Registry Nursing | $325,686 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $60,110 | RelatedOrganizationsAmt |
| Total Contributions | $60,110 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $82,898,283 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,898,283 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,898,283 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722514 | $110,232 | $110,232 |
| GIFT SHOP | 453220 | $34,983 | $34,983 |
| MISCELLANEOUS REVENUE | 900099 | $7,459 | $7,459 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $152,674 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,111,067 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,898,283 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $152,674 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,749 | TotalAmt |
| Program Services | $39,749 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $864,750 | TotalAmt |
| Program Services | $466,157 | ProgramServicesAmt |
| Management And General | $398,593 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,083,426 | TotalAmt |
| Program Services | $28,017,248 | ProgramServicesAmt |
| Management And General | $9,066,178 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,719,611 | TotalAmt |
| Program Services | $2,806,851 | ProgramServicesAmt |
| Management And General | $912,760 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,165,246 | TotalAmt |
| Program Services | $5,377,023 | ProgramServicesAmt |
| Management And General | $1,788,223 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,664,167 | TotalAmt |
| Program Services | $1,998,125 | ProgramServicesAmt |
| Management And General | $666,042 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,202 | TotalAmt |
| Management And General | $667,202 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,730,498 | TotalAmt |
| Program Services | $10,534,797 | ProgramServicesAmt |
| Management And General | $1,195,701 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,144 | TotalAmt |
| Management And General | $43,144 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $444,474 | TotalAmt |
| Program Services | $311,132 | ProgramServicesAmt |
| Management And General | $133,342 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,410,678 | TotalAmt |
| Program Services | $3,069,610 | ProgramServicesAmt |
| Management And General | $341,068 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,118,066 | TotalAmt |
| Program Services | $782,646 | ProgramServicesAmt |
| Management And General | $335,420 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,469 | TotalAmt |
| Management And General | $17,469 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,759 | TotalAmt |
| Program Services | $37,631 | ProgramServicesAmt |
| Management And General | $16,128 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,178,231 | TotalAmt |
| Program Services | $2,178,231 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,659,260 | TotalAmt |
| Program Services | $2,659,260 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,191,543 | TotalAmt |
| Program Services | $338,146 | ProgramServicesAmt |
| Management And General | $853,397 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,762,788 | TotalAmt |
| Program Services | $1,233,952 | ProgramServicesAmt |
| Management And General | $528,836 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,263,269 | TotalAmt |
| Program Services | $73,068,533 | ProgramServicesAmt |
| Management And General | $23,194,736 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,485,527 | BOYAmt |
| EOY | $3,934,486 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,300,471 | BOYAmt |
| EOY | $10,631,033 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,877 | BOYAmt |
| EOY | $24,017 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,283,035 | BOYAmt |
| EOY | $1,254,409 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,932 | BOYAmt |
| EOY | $1,224,067 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $51,003,590 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,904,786 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,149,890 | BOYAmt |
| EOY | $12,098,804 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,818 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,011,491 | BOYAmt |
| EOY | $8,462,806 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,642,041 | BOYAmt |
| EOY | $37,629,622 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,265,017 | BOYAmt |
| EOY | $11,256,593 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,012,259 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,821,186 | BOYAmt |
| EOY | $90,031,223 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,098,462 | BOYAmt |
| EOY | $101,287,816 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$43,456,421 | BOYAmt |
| EOY | -$63,658,194 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$43,456,421 | BOYAmt |
| EOY | -$63,658,194 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,642,041 | BOYAmt |
| EOY | $37,629,622 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$13,152,202 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$7,049,571 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,616,600 | OtherCostOrOtherBasisAmt |
| Book Value | $4,616,600 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,630,090 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,907,118 | DepreciationAmt |
| Book Value | $4,722,972 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,989,808 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,885,556 | DepreciationAmt |
| Book Value | $2,104,252 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $767,092 | OtherCostOrOtherBasisAmt |
| Depreciation | $112,112 | DepreciationAmt |
| Book Value | $654,980 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,098,804 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED ORGANIZATIONS | $5,854,575 |
| DUE FROM GOVERNMENT AGENCIES | $218,795 |
| OTHER RECEIVABLES | $2,372,255 |
| DEPOSITS | $17,181 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,462,806 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED ORGANIZATIONS | $83,071,969 |
| PENSION OBLIGATIONS | $6,959,254 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $90,031,223 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Verity 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 295 | PersonsServedCnt |
| Total Community Benefit Expns | $621,796 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $621,796 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00630 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18469 | PersonsServedCnt |
| Total Community Benefit Expns | $33,414,154 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,331,944 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,082,210 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18764 | PersonsServedCnt |
| Total Community Benefit Expns | $34,035,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,331,944 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,704,006 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13790 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3851 | PersonsServedCnt |
| Total Community Benefit Expns | $259,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $243,876 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12 | PersonsServedCnt |
| Total Community Benefit Expns | $183,057 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $183,057 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $3,736 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,736 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 286 | PersonsServedCnt |
| Total Community Benefit Expns | $23,271 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,271 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4149 | PersonsServedCnt |
| Total Community Benefit Expns | $469,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $453,940 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 22913 | PersonsServedCnt |
| Total Community Benefit Expns | $34,505,390 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,347,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,157,946 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14250 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $248,326 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $248,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $248,326 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $248,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,088,267 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $23,324,982 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $36,183,458 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$12,858,476 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Louise Regional Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9400 No Name Uno | AddressLine1Txt |
| City | Gilroy | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://stlouise.verity.org/ | WebsiteAddressTxt |
| State License | 070000266 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Louise Regional Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section B, Lines 2, 3j, 7d, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c | 21d, 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | De Paul Urgent Care Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18550 De Paul Drive Suite 109 | AddressLine1Txt |
| City | Morgan Hill | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95037 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Urgent Care Center | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 Expense | Form 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Verity Medical Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 Race Street | AddressLine1Txt |
| City | San Jose | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95126 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 453691852 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $39,749 | CashGrantAmt |
| Purpose Of Grant | General Support | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Saint 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 Payments | Schedule 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 Plan | Schedule 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 Compensation | Schedule 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 11G | DESCRIPTION:REGISTRY NURSING TOTAL FEES:1653608 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER CONTRACT LABOR TOTAL FEES:1576323 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL FEES TOTAL FEES:4383075 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURHASED SRVCS: OUTSIDE ORGS TOTAL FEES:3831814 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS TOTAL FEES:285678 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Daughters of Charity Ministry Svcs Corp | ||||||||||
| 26000 Altamont Rd | Los Altos Hills | CA | 94022 | 770482943 | Outreach | CA | 501(c)(3) | 01 | DOC SVDP | false |
| Verity Health System of California Inc | ||||||||||
| 203 Redwood Shores Pkwy 800 | Redwood City | CA | 94065 | 912145484 | Hosp Ldrship | CA | 501(c)(3) | 11-III FI | NA | false |
| O'Connor Hospital | ||||||||||
| 2105 Forest Avenue | San Jose | CA | 95128 | 912154436 | Healthcare | CA | 501(c)(3) | 03 | VHS | false |
| O'Connor Hospital Foundation | ||||||||||
| 2105 Forest Avenue | San Jose | CA | 95128 | 770006295 | Fundraising | CA | 501(c)(3) | 11-I | OCH | false |
| Robert F Kennedy Medical Center Found | ||||||||||
| 203 Redwood Shores Pkwy 800 | Redwood City | CA | 94065 | 953745227 | Fundraising | CA | 501(c)(3) | 11-I | RFKMC | false |
| St Francis Medical Center | ||||||||||
| 3630 East Imperial Highway | Lynwood | CA | 90262 | 912154439 | Healthcare | CA | 501(c)(3) | 03 | VHS | false |
| St Francis Med Center of Lynwood Found | ||||||||||
| 3630 East Imperial Highway | Lynwood | CA | 90262 | 953190773 | Fundraising | CA | 501(c)(3) | 11-I | SFMC | false |
| Saint Louise Regional Hospital Found | ||||||||||
| 9400 No Name Uno | Gilroy | CA | 95020 | 562384735 | Fundraising | CA | 501(c)(3) | 11-I | SLRH | Yes (true) |
| St Vincent Medical Center | ||||||||||
| 2131 West Third Street | Los Angeles | CA | 90057 | 912154438 | Healthcare | CA | 501(c)(3) | 03 | VHS | false |
| St Vincent Dialysis Center | ||||||||||
| 2131 West Third Street | Los Angeles | CA | 90057 | 953749293 | Healthcare | CA | 501(c)(3) | 03 | SVMC | false |
| St Vincent Foundation | ||||||||||
| 2131 West Third Street | Los Angeles | CA | 90057 | 953922511 | Fundraising | CA | 501(c)(3) | 11-I | SVMC | false |
| Seton Medical Center | ||||||||||
| 1900 Sullivan Avenue | Daly City | CA | 94015 | 912154441 | Healthcare | CA | 501(c)(3) | 03 | VHS | false |
| Seton Medical Center Foundation | ||||||||||
| 1900 Sullivan Avenue | Daly City | CA | 94015 | 942824033 | Fundraising | CA | 501(c)(3) | 11-I | SMC | false |
| Verity Business Services | ||||||||||
| 203 Redwood Shores Pkwy 800 | Redwood City | CA | 94065 | 510659139 | Hosp Support | CA | 501(c)(3) | 11-II | VHS | false |
| Verity Medical Foundation | ||||||||||
| 400 Race Street | San Jose | CA | 95126 | 453691852 | Healthcare | CA | 501(c)(3) | 09 | VHS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'Connor Health Center 1 | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1960 The Alameda Suite 20 | AddressLine1Txt |
| City | San Jose | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95126 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 770419045 | EIN |
| Primary Activities | Rental | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VHS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Marillac Insurance Company LTD | |||||||||||||
| PO Box 69 | Grand Cayman | CJ | KY1-1102 | 980417930 | Captive Insurance | CJ | VHS | false | |||||
| Robert F Kennedy Medical Center | |||||||||||||
| 912154440 | Inactive | VHS | false | 203 Redwood Shores Pkwy 800 | Redwood City | CA | 94065 | CA | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Saint Louise Regional Hospital Foundation | ||
| c | $57,065 | Cost |
| Saint Louise Regional Hospital Foundation | ||
| o | $89,528 | Cost |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part II: | FormAndLineReferenceDesc |
| Explanation | Daughters 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 |