2016-11-06T14:31:44-06:00 2015-12-31 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DR STE 500 SAN DIEGO CA 92122 990 2015-01-01 990298651 SUTTER HEALTH PACIFIC % QUIN OGAWA CFO SUTT 9162866665 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 LEONARD LICINA CEO 2016-10-31 true DEBRA HEISKALA P00649485 8585357200 2015 2017-02-10 21:41:12Z KAHI MOHALA LEONARD LICINA 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 23468695 false X WWW.SUTTERHEALTH.ORG X 1992 CA SEE SCHEDULE O 10 8 318 0 0 83657 47263 21703447 23410491 11241 10941 0 0 21798345 23468695 0 0 0 0 15562797 16025345 0 0 25735 5391287 5372222 20954084 21397567 844261 2071128 11708802 14241629 2031097 1893625 9677705 12348004 X SEE SCHEDULE O false false 18727166 0 23410491 SEE SCHEDULE O 18727166 true true false false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 14 0 true 318 true false false false false false false false false false false X 10 8 false false false false true true true true true false false true true true true true true true true false CA X QUIN OGAWA CFO 8086772580 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 J KUHIO ASAM MD TRUSTEE 1.0 0.0 X 0 0 0 DIANNE BROOKINS TRUSTEE 1.0 0.0 X 0 0 0 PATRICK DUARTE TRUSTEE/VICE CHAIR 1.0 0.0 X X 0 0 0 DAVID HUDSON TRUSTEE/CHAIR 1.0 0.0 X X 0 0 0 LEONARD LICINA CEO SUTTER HEALTH PACIFIC 40.0 0.0 X X 0 290815 47923 CAMERON NEKOTA TRUSTEE 1.0 0.0 X 0 0 0 TINA SHELTON TRUSTEE 1.0 0.0 X 0 0 0 DIANE STEWART TRUSTEE/VICE CHAIR OF FINANCE 1.0 0.0 X X 0 0 0 JUDGE ALLENE SUEMORI RET TRUSTEE 1.0 0.0 X 0 0 0 JAMES E CONFORTI CEO SHSSR 1.0 40.0 X X 0 1358530 401195 ROSE CHOY CFO SUTTER HEALTH PACIFIC 40.0 0.0 X 0 214768 13656 PENNY WESTFALL VP & REGIONAL COUNSEL SHSSR 1.0 40.0 X 0 545472 112211 STEVEN CHAPLIN MD MEDICAL DIRECTOR/EX-OFFICIO 40.0 0.0 X 437774 0 21212 GREGORY PRIER MD PSYCHIATRIST 40.0 0.0 X 324071 0 21212 ELENA SHARIPOVA MD PSYCHIATRIST 40.0 0.0 X 144208 0 21219 JEREMY ROBERTS MD PSYCHIATRIST 40.0 0.0 X 227475 0 30313 CHRISTINA ENOKA DIRECTOR HUMAN RESOURCES 40.0 0.0 X 132902 0 12916 CHARLES ST LOUIS JR DIRECTOR NURSING 40.0 0.0 X 138784 0 7767 KENNETH DELANO DIRECTOR HEALING FORCES 40.0 0.0 X 192782 0 23667 SARAH KREVANS COO SUTTER HEALTH 0.0 40.0 X 0 2077694 496140 1597996 4487279 1209431 23 true true false 0 7018 10000 3962 26283 47263 PATIENT SERVICE REVENUE 623990 23410491 23410491 23410491 8941 8941 0 0 0 0 0 2000 2000 2000 2000 0 0 0 0 23468695 23410491 10941 0 0 0 0 788207 392540 395667 0 11043329 10285285 758044 342722 318719 24003 2878211 2300974 577237 972876 883097 89779 0 26224 26224 0 0 0 3693 3693 181418 181418 24151 24151 449233 333176 116057 75808 75808 0 814003 814003 29157 4821 24336 0 15510 15245 265 300000 300000 0 649372 649372 275474 275474 PURCHASED SERVICES 1238917 1045675 167553 25689 FOOD 397465 397465 SYSTEM ALLOCATION 354696 354696 MEDICAL SUPPLIES 306532 306532 230569 97187 133336 46 21397567 18727166 2644666 25735 0 0 540221 681007 2271 2770 4816514 7780012 0 0 0 0 0 0 16623 14821 481183 528888 14081471 9019139 5479987 5062332 0 0 0 0 0 0 0 0 372003 171799 11708802 14241629 1154782 1263230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876315 630395 2031097 1893625 X 9581886 12237062 95819 110942 0 0 9677705 12348004 11708802 14241629 X 2071128 -829 600000 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11393673 6961033 4432640 2623882 2058106 565776 63916 0 63916 5062332 0 INSURANCE LIABILITIES 630395 630395 X SCHEDULE D, PART X, LINE 2 THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)) AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2015 AND 2014, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. true true X true X 400. true true false true true 5043 5043 0.00020 1600655 3047930 1605698 3047930 5043 0.00020 4 14 26023 26023 0.00120 9 68 42386 42386 0.00200 13 4196 104087 120 103967 0.00490 26 4278 172496 120 172376 0.00810 26 4278 1778194 3048050 177419 0.00830 4 95 13675 13675 0.00070 1 19 529 529 1 0 6282 6282 0.00030 4 16 32800 32800 0.00160 10 130 53286 53286 0.00260 false 12764 21204 51420 -30216 X true true 1 1 SUTTER HEALTH PACIFIC - KAHI MOHALA 91-2301 FORT WEAVER ROAD EWA BEACH HI 96706 www.kahimohala.org LICENSE #33-H X SUTTER HEALTH PACIFIC - KAHI MOHALA 1 false false true X X X X X X X X X 13 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C true 13 true SEE PART V, SECTION C false false true X 400. 0. X X true true X X X X true X X X X X X true X false X X X X true X X false false SCHEDULE H, PART V, SECTION B, LINE 5 IN CONDUCTING ITS MOST RECENT CHNA, SUTTER HEALTH PACIFIC - KAHI MOHALA, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. IN ORDER TO SUPPLEMENT THE QUANTITATIVE FINDINGS, KEY INFORMANTS WERE INTERVIEWED TO FURTHER ASSESS THE UNDERLYING DRIVERS FOR HEALTH OUTCOMES, CURRENT COMMUNITY EFFORTS, AND OBSTACLES TO HEALTH. THESE KEY INFORMANTS WERE CHOSEN BY THE HAWAII ASSOCIATION OF HOSPITALS (HAH) ADVISORY COMMITTEE ON NOVEMBER 7-8, 2012 THROUGH A STRUCTURED NOMINATION AND SELECTION PROCESS, WHICH FOLLOWED A THOROUGH REVIEW OF THE PRELIMINARY CORE INDICATOR DATA. ADVISORY MEMBERS NOMINATED COMMUNITY MEMBERS WITH EXPERTISE IN PUBLIC HEALTH, IN THE TOP TEN TOPIC AREAS FROM THE CORE INDICATOR ANALYSIS, AS WELL AS IN THOSE TOPIC AREAS WHERE THERE WERE DATA GAPS. KEY INFORMANTS WERE ALSO NOMINATED FOR THEIR KNOWLEDGE OF VULNERABLE POPULATIONS, SUCH AS LOW-INCOME OR MORE ADVERSELY IMPACTED RACIAL/ETHNIC GROUPS. AFTER THE NOMINATION PROCESS, THE ADVISORY MEMBERS PRIORITIZED THE LIST THROUGH A VOTING PROCESS. THE KEY INFORMANT INTERVIEW PROCESS WAS PART OF A LARGER STATEWIDE CHNA EFFORT IN WHICH A TOTAL OF 105 COMMUNITY EXPERTS WERE NOMINATED, THEN PRIORITIZED DOWN TO A LIST OF 75. THE REMAINING 30 NOMINATED KEY INFORMANTS WERE MAINTAINED ON AN ALTERNATE LIST, IN THE EVENT THAT A KEY INFORMANT WAS NOT AVAILABLE. ROUGHLY 15 KEY INFORMANTS WERE ALLOTTED FOR EACH OF THE FOUR COUNTIES AND FOR THE OVERALL STATE PERSPECTIVE. 22 KEY INFORMANTS WERE INTERVIEWED FOR THEIR STATE-WIDE KNOWLEDGE OF HEALTH NEEDS; WHEN CERTAIN TOPIC AREAS WERE LACKING AN INTERVIEW WITH A STATE-WIDE PERSPECTIVE, RELEVANT FINDINGS FROM HONOLULU COUNTY INTERVIEWS WERE INCLUDED. THE INTERVIEWS WERE CONDUCTED BY LOCAL CONSULTANTS, STORYLINE CONSULTING. THE INTERVIEWS TOOK PLACE BETWEEN NOVEMBER 19, 2012 AND JANUARY 2, 2013 AND LASTED 30-60 MINUTES IN LENGTH. MOST INTERVIEWS TOOK PLACE BY PHONE; A FEW TOOK PLACE IN PERSON. STORYLINE CONSULTING TYPED NOTES FROM THE INTERVIEWS DURING THE CONVERSATION, CAPTURING THE BULK OF THE CONVERSATION VERBATIM. INTERVIEW NOTES WERE THEN CONDENSED AND ENTERED INTO A DATA COLLECTION SPREADSHEET. INTERVIEWS WERE HELD WITH THE FOLLOWING PEOPLE: - JENNIFER DANG, STATE DIRECTOR FOR HAWAII NUTRITION AND PHYSICAL ACTIVITY COALITION, DEPARTMENT OF EDUCATION WITH EXPERTISE IN EXERCISE, NUTRITION & WEIGHT. INTERVIEW DATE: 12/20/2012. - LYNN FALLIN, DEPUTY DIRECTOR FOR THE BEHAVIORAL HEALTH SERVICES ADMINISTRATION, HAWAII DEPARTMENT OF HEALTH WITH EXPERTISE IN MENTAL HEALTH & MENTAL DISORDERS. INTERVIEW DATE: 12/12/2012. - DR. KENNY FINK, ADMINISTRATOR FOR THE DEPARTMENT OF HUMAN SERVICES, MED-QUEST DIVISION WITH EXPERTISE IN ACCESS TO HEALTH SERVICES. INTERVIEW DATE: 12/10/2012. - LORETTA FUDDY, DIRECTOR FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN MENTAL HEALTH, MENTAL DISORDERS AND SUBSTANCE ABUSE. INTERVIEW DATE: 12/12/2012. - BETH GIESTING, HEALTHCARE TRANSFORMATION OFFICER FOR THE OFFICE OF THE GOVERNOR WITH EXPERTISE IN ACCESS TO HEALTH SERVICES AND ORAL HEALTH. INTERVIEW DATE: 12/20/2012. - DR. JOSH GREEN, STATE SENATOR, EXECUTIVE MEDICAL DIRECTOR FOR HAWAII INDEPENDENT PHYSICIANS ASSOCIATION AND AN EMERGENCY ROOM PHYSICIAN WITH EXPERTISE IN DIABETES AND SUBSTANCE ABUSE. INTERVIEW DATE: 11/28/2012. - ROBERT HIROKAWA, CEO OF HAWAII PRIMARY CARE ASSOCIATION WITH EXPERTISE IN RESPIRATORY DISEASE AND SOCIAL ENVIRONMENT. INTERVIEW DATE: 12/19/2012. - LOLA IRVIN, HEALTHY HAWAII INITIATIVE, TOBACCO SETTLEMENT PROJECT MANAGER FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN CANCER, EXERCISE, NUTRITION, WEIGHT, AND RESPIRATORY DISEASE. INTERVIEW DATE: 12/17/2012. - DR. BLISS KANESHIRO, PROFESSOR OF OBSTETRICS/GYNECOLOGY AND DIRECTOR OF FAMILY PLANNING FOR JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAII WITH EXPERTISE IN FAMILY PLANNING. INTERVIEW DATE: 12/17/2012. - LESLIE LAM, EXECUTIVE DIRECTOR OF AMERICAN DIABETES ASSOCIATION HAWAII WITH EXPERTISE IN DIABETES. INTERVIEW DATE: 12/28/2012. - DEE JAY MAILER, CEO OF KAMEHAMEHA SCHOOLS WITH EXPERTISE IN EDUCATION. INTERVIEW DATE: 12/17/2012. - KATHY MATAYOSHI, SUPERINTENDENT OF EDUCATION FOR HAWAII STATE DEPARTMENT OF EDUCATION WITH EXPERTISE IN MENTAL HEALTH AND MENTAL DISORDERS. INTERVIEW DATE: 12/26/2012. - DEE DEE NELSON, DIRECTOR OF MOUNTAIN-PACIFIC QUALITY HEALTH WITH EXPERTISE IN HEART DISEASE, OLDER ADULTS AND AGING. INTERVIEW DATE: 12/3/2012. - MAY OKIHIRO, DIRECTOR OF HAWAII INITIATIVE FOR CHILDHOOD OBESITY RESEARCH AND EDUCATION FOR THE JOHN A. BURNS SCHOOL OF MEDICINE DEPARTMENT OF PEDIATRICS, UNIVERSITY OF HAWAII WITH EXPERTISE IN EXERCISE, NUTRITION, AND WEIGHT. INTERVIEW DATE: 12/10/2012. - DR. BILL OSHEROFF, CHIEF MEDICAL OFFICER OF HAWAII MEDICAL SERVICE ASSOCIATION WITH EXPERTISE IN MATERNAL, FETAL AND INFANT HEALTH. INTERVIEW DATE: 12/20/2012. - DR. NEAL PALAFOX, PROFESSOR FOR JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAII WITH EXPERTISE IN ACCESS TO HEALTH SERVICES CANCER. INTERVIEW DATE: 12/26/2012. - DR. SARAH PARK, CHIEF, DISEASE OUTBREAK CONTROL DIVISION FOR DEPARTMENT OF HEALTH WITH EXPERTISE IN IMMUNIZATIONS AND INFECTIOUS DISEASE. INTERVIEW DATE: 12/4/2012. - DR. LINDA ROSEN, CHIEF, EMERGENCY MEDICAL SERVICES AND INJURY PREVENTION SYSTEMS BRANCH FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN INJURY PREVENTION AND SAFETY. INTERVIEW DATE: 12/20/2012. - DAVID SAKAMOTO, DEPUTY DIRECTOR, HEALTH SERVICES FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN MENTAL HEALTH AND MENTAL DISORDERS. INTERVIEW DATE: 12/12/2012. - EMILIE SMITH, ADMINISTRATOR FOR CARERESOURCE HAWAII WITH EXPERTISE IN OLDER ADULTS, AGING, AND TRANSPORTATION. INTERVIEW DATE: 12/6/2012. - HARDY SPOEHR, EXECUTIVE DIRECTOR OF PAPA OLA LOKAHI WITH EXPERTISE IN ACCESS TO HEALTH SERVICES AND SOCIAL ENVIRONMENT. INTERVIEW DATE: 12/19/2012. - LORI SUAN, EXECUTIVE DIRECTOR OF AMERICAN HEART ASSOCIATION, HAWAII CHAPTER WITH EXPERTISE IN HEART DISEASE. INTERVIEW DATE: 12/10/2012. - DR. JACKIE YOUNG, CHIEF STAFF OFFICER, HIGH PLAINS DIVISION FOR AMERICAN CANCER SOCIETY HAWAII SITE WITH EXPERTISE IN CANCER. INTERVIEW DATE: 12/26/2012. - KEN ZERI, PRESIDENT AND CEO, FOR HOSPICE HAWAII WITH EXPERTISE IN OLDER ADULTS AND AGING. INTERVIEW DATE: 12/6/2012. A SMALL SAMPLE OF COMMUNITY RESIDENTS, VIA AN ONLINE SURVEY, SUPPLEMENTED THE KEY INFORMANT INTERVIEWS. HIGHLIGHTS OF THESE SURVEYS, OR "VOICES FROM THE COMMUNITY," ARE INCORPORATED IN KAHI MOHALAS CHNA. THE FINDINGS FROM KEY INFORMANT INTERVIEWS IN KAHI MOHALA'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, SECTION B, LINE 6A THE STATE OF HAWAII IS UNIQUE IN THAT ALL OF ITS COMMUNITY HOSPITALS AND HOSPITAL SYSTEMS JOINED EFFORTS TO FULFILL NEW REQUIREMENTS UNDER THE AFFORDABLE CARE ACT, WHICH THE IRS DEVELOPED GUIDELINES TO IMPLEMENT. THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) LED THIS COLLABORATION TO CONDUCT STATE- AND COUNTY-WIDE ASSESSMENTS FOR ITS MEMBERS. TWENTY-SIX MEMBER HOSPITALS IN HAWAII PARTICIPATED IN THE CHNA PROJECT: - CASTLE MEDICAL CENTER - HALE HO`OLA HAMAKUA - HILO MEDICAL CENTER - KAHI MOHALA - KAHUKU MEDICAL CENTER - KAISER PERMANENTE MEDICAL CENTER - KAPI`OLANI MEDICAL CENTER FOR WOMEN & CHILDREN - KA`U HOSPITAL - KAUAI VETERANS MEMORIAL HOSPITAL - KOHALA HOSPITAL - KONA COMMUNITY HOSPITAL - KUAKINI MEDICAL CENTER - KULA HOSPITAL - LANA`I COMMUNITY HOSPITAL - LEAHI HOSPITAL - MAUI MEMORIAL MEDICAL CENTER - MOLOKAI GENERAL HOSPITAL - NORTH HAWAII COMMUNITY HOSPITAL - PALI MOMI MEDICAL CENTER - REHABILITATION HOSPITAL OF THE PACIFIC - SAMUEL MAHELONA MEMORIAL HOSPITAL - SHRINERS HOSPITALS FOR CHILDREN - HONOLULU - STRAUB CLINIC & HOSPITAL - THE QUEEN'S MEDICAL CENTER - WAHIAWA GENERAL HOSPITAL - WILCOX MEMORIAL HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 6B SUTTER HEALTH PACIFIC - KAHI MOHALA UTILIZED THE STATE-WIDE CHNA WHICH WAS CONDUCTED BY THE HEALTHCARE ASSOCIATION OF HAWAII IN PARTNERSHIP WITH THE HEALTHY COMMUNITIES INSTITUTE. THIS WAS A COLLABORATIVE EFFORT AND INCLUDED DATA PROVIDED BY: - HAWAII DEPARTMENT OF HEALTH - HAWAII HEALTH MATTERS - HAWAII HEALTH INFORMATION CORPORATION - STORYLINE CONSULTING - VOICES FROM THE COMMUNITY SCHEDULE H, PART V, SECTION B, LINE 7A, 7B AND 10A FILING ORG WEBSITE: HTTP://WWW.KAHIMOHALA.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, SECTION B, LINE 11 THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT KAHI MOHALA INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: - MENTAL HEALTH AND DISORDERS - SUBSTANCE ABUSE DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH ADDITIONAL EFFORTS ON BEHALF OF KAHI MOHALA. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. KAHI MOHALA IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. KAHI MOHALA DOES NOT HAVE SPECIFIC PLANS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: - CANCER - DIABETES - DISABILITIES - ECONOMY - EDUCATION - ENVIRONMENT - FAMILY PLANNING - HEART DISEASE & STROKE - IMMUNIZATIONS & INFECTIOUS DISEASES - INJURY PREVENTION & SAFETY - OLDER ADULTS & AGING - ORAL HEALTH - RESPIRATORY DISEASES - SOCIAL ENVIRONMENT - TRANSPORTATION DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, LINE 5. SCHEDULE H, PART V, SECTION B, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE - OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, SECTION B, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITYS FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. ON AN ANNUAL BASIS SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT. SCHEDULE H, PART I, LINE 3C FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENTS FAMILY INCOME. SCHEDULE H, PART I, LINE 6A SUTTER HEALTH, A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: KAHI MOHALA FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. KAHI MOHALA EMPLOYEES SERVE ON THE BOARD FOR ORGANIZATIONS SUCH AS THE AMERICAN HOSPITAL ASSOCIATION, HEALTHCARE ASSOCIATION OF HAWAII, HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION, HAWAII CHAPTER AND THE GOODWILL INDUSTRIES OF HAWAII. KAHI MOHALA PROVIDES USE OF ROOM/FACILITIES TO THE INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY WHICH IS A NON-PROFIT ORGANIZATION DEDICATED TO PROFESSIONALS INVOLVED IN MANAGING AND DIRECTING SECURITY AND SAFETY PROGRAMS IN HEALTHCARE INSTITUTES. KAHI MOHALA PARTNERS WITH QUEENS WEST OAHU TO PROVIDE BEHAVIORAL HEALTH SUPPORT WHICH INCLUDES INPATIENT CONSULTS, STAFF EDUCATION AND TRAINING. KAHI MOHALA ALSO PROVIDED QUEENS WEST WITH A ROPES DAY AT KAHI WHERE THEY WERE GIVEN THE OPPORTUNITY TO DEVELOP AND STRENGTHEN TEAM BUILDING SKILLS, COMMUNITY AND TRUST. KAHI MOHALA SUPPORTS ARMY ONE SOURCE, WHICH HAS CREATED STATE-LEVEL ALLIANCES TO RAISE AWARENESS, IMPROVE SERVICE DELIVERY AND GENERATE COMMUNITY SUPPORT FOR OUR SERVICE MEMBERS AND FAMILIES. IT ALSO EDUCATES THE BEHAVIORAL HEALTH COMMUNITY ON MILITARY CULTURE AND BEST PRACTICES FOR ASSESSING AND TREATING BEHAVIORAL HEALTH ISSUES RESULTING FROM THE TRAUMA OF WAR. KAHI MOHALA SUPPORTS TALK STORY TIME, A COMMUNITY SUPPORT NETWORK MEETING FOR MILITARY SPOUSES AND SIGNIFICANT OTHERS WHO HAVE EXPERIENCED TRAUMATIC EVENTS IN OR OUTSIDE OF MILITARY COMBAT. SCHEDULE H, PART III, LINE 2 METHODOLOGY FOR CALCULATING BAD DEBT (AT COST): THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE: AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. SCHEDULE H, PART III, LINE 4 AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE A FOOTNOTE FOR PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS. PATIENT SERVICE REVENUE FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS AND THIRD-PARTY PAYERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SUTTER'S SELF-PAY WRITE-OFFS WERE $192 MILLION AND $287 MILLION FOR 2015 AND 2014, RESPECTIVELY. SCHEUDLE H, PART III, LINE 7 MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT. SCHEDULE H, PART III, LINE 9B DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL AND CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: THE CHNA REPORT WAS DEVELOPED THROUGH A COLLABORATIVE PROCESS AND PROVIDES AN OVERVIEW OF THE HEALTH NEEDS IN HAWAII. THE GOAL OF THE REPORT IS TO OFFER A MEANINGFUL UNDERSTANDING OF THE HEALTH NEEDS IN THE COMMUNITY, AS WELL AS HELP GUIDE KAHI MOHALA WITH THEIR COMMUNITY BENEFIT PLANNING EFFORTS AND DEVELOPMENT OF AN IMPLEMENTATION STRATEGY TO ADDRESS PRIORITIZED NEEDS. SPECIAL ATTENTION HAS BEEN GIVEN TO IDENTIFY HEALTH DISPARITIES, THE NEEDS OF VULNERABLE POPULATIONS, AND UNMET HEALTH NEEDS OR GAPS IN SERVICES. ALTHOUGH THIS REPORT FOCUSES ON NEEDS WITHIN THE COMMUNITY, THERE ARE INNUMERABLE COMMUNITY ASSETS AND A TRUE ALOHA SPIRIT THAT PROVIDES AMPLE FOUNDATION FOR COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. IN FALL 2012, THE HEALTHCARE ASSOCIATION OF HAWAII PARTNERED WITH HEALTHY COMMUNITIES INSTITUTE TO CONDUCT A CHNA FOR HAWAII. OUR APPROACH FOLLOWED THE PUBLIC HEALTH MODEL OF ASSESSING AND UNDERSTANDING COMMUNITY HEALTH HOLISTICALLY. A FRAMEWORK FOR ANALYSIS WAS CONSTRUCTED BASED ON DETERMINANTS OF HEALTH; THE FRAMEWORK INCLUDED A BROAD DEFINITION OF COMMUNITY HEALTH THAT CONSIDERS EXTENSIVE SECONDARY DATA ON THE SOCIAL, ECONOMIC, AND PHYSICAL ENVIRONMENTS, AS WELL AS HEALTH RISKS AND OUTCOMES. THE INFLUENCE OF MAUKA ("TOWARD THE MOUNTAINS"), OR UPSTREAM FACTORS, AND THE RESULTING MAKAI ("TOWARD THE OCEAN"), OR DOWNSTREAM IMPACTS, ON HEALTH IS A TRANSCENDING THEME. KEY INFORMANT INTERVIEWS WITH THOSE HAVING SPECIAL KNOWLEDGE OF HEALTH NEEDS, HEALTH DISPARITIES, AND VULNERABLE POPULATIONS PROVIDED VITAL INFORMATION THAT INCREASED THE UNDERSTANDING OF THE HEALTH NEEDS IN HAWAII. A SMALL SET OF COMMUNITY RESIDENTS PROVIDED ADDITIONAL INSIGHTS ON THE HEALTH NEEDS IN HAWAII. IT IS HOPED THAT THE REPORT WILL PROVIDE A FOUNDATION FOR COMMUNITY HEALTH IMPROVEMENT EFFORTS AND THAT COMMUNITY HEALTH PARTNERS WILL BUILD ON THIS REPORT. AN EXTENSIVE ARRAY OF SECONDARY AND PRIMARY DATA WAS COLLECTED AND SYNTHESIZED FOR THE REPORT. CORE INDICATORS: SECONDARY DATA WAS ANALYZED USING HAWAII HEALTH MATTERS (WWW.HAWAIIHEALTHMATTERS.ORG), A PUBLICLY AVAILABLE DATA PLATFORM WITH A DASHBOARD OF OVER 140 INDICATORS FROM OVER 20 SOURCES; MUCH OF THE DATA COMES FROM HAWAII DEPARTMENT OF HEALTH, ALLOWING FOR HAWAII-SPECIFIC RACE, AGE AND GENDER DETAILS. THE REPORT PROVIDES AN OVERVIEW OF HAWAII COMMUNITY HEALTH NEEDS. COMMUNITY HEALTH WAS ASSESSED FOR HAWAII AS A WHOLE, FOR RACE SUB-GROUPS, AND FOR SUB-GEOGRAPHIES. THE FINDINGS REVEALED OVERALL OR SUB-POPULATION COMMUNITY NEEDS IN THE FOLLOWING AREAS: - ACCESS TO HEALTH SERVICES - CANCER - DIABETES - DISABILITIES - ECONOMY - EDUCATION - ENVIRONMENT - EXERCISE, NUTRITION, & WEIGHT - FAMILY PLANNING - HEART DISEASE & STROKE - IMMUNIZATIONS & INFECTIOUS DISEASES - INJURY PREVENTION & SAFETY - MATERNAL, FETAL & INFANT HEALTH - MENTAL HEALTH & MENTAL DISORDERS - OLDER ADULTS & AGING - ORAL HEALTH - RESPIRATORY DISEASES - SOCIAL ENVIRONMENT - SUBSTANCE ABUSE & LIFESTYLE - TRANSPORTATION THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR KAHI MOHALA IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART VI, LINE 3 KAHI MOHALA FOLLOWS A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. FOR A MORE DETAILED LOOK AT SUTTER HEALTH'S CHARITY CARE POLICIES BY REGION, PLEASE VISIT THE OFFICE OF STATEWIDE AND HEALTH PLANNING'S WEBSITE AT HTTP://SYFPHR.OSHPD.CA.GOV. COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS) B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION". B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR HEALTHY FAMILIES OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. SCHEDULE H, PART VI, LINE 4 THE HOSPITAL SERVICE AREA IS DEFINED BY A GEOGRAPHICAL BOUNDARY OF THE STATE OF HAWAII. THE STATE WILL SERVE AS THE UNIT OF ANALYSIS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. HENCE, THE HEALTH NEEDS DISCUSSED IN THE ASSESSMENT WILL PERTAIN TO INDIVIDUALS LIVING WITHIN THIS GEOGRAPHIC BOUNDARY. WHEN POSSIBLE, HIGHLIGHTS FOR SUB-GEOGRAPHIES WITHIN HAWAII ARE PROVIDED. THERE ARE 26 HOSPITALS THAT SERVE THE COMMUNITY. IN 2011, HAWAII HAD A POPULATION OF 1,374,810. AS MEASURED BY THE DECENNIAL CENSUS, THE POPULATION DENSITY IN THE STATE IS MUCH HIGHER THAN THE U.S. OVERALL. WITHIN THE STATE, HAWAII COUNTY GREW THE FASTEST BETWEEN 2000 AND 2010, WHILE HONOLULU COUNTY GREW THE SLOWEST. HAWAII'S POPULATION IS SLIGHTLY OLDER THAN THE REST OF THE COUNTRY, WITH A MEDIAN AGE OF 38.5 (COMPARED TO 37.3 FOR THE U.S.). CHILDREN UNDER 18 MAKE UP ONLY 22.1% OF THE STATE'S POPULATION, WHILE 23.7% OF THE TOTAL U.S. POPULATION IS UNDER 18. WITHIN THE STATE, KAUAI COUNTY HAS THE OLDEST POPULATION WITH A MEDIAN AGE OF 42.2. HONOLULU COUNTY HAS THE YOUNGEST, WITH A MEDIAN AGE OF 37.6. THE LARGEST SINGLE RACE GROUP IN HAWAII IS ASIAN AT 38.1%. THE MAJORITY OF THE ASIAN POPULATION IS FILIPINO OR JAPANESE (WHICH INCLUDES ALL RESIDENTS REPORTING A RACE OF ASIAN ONLY REGARDLESS OF HISPANIC/LATINO ETHNICITY). HAWAII ALSO HAS MUCH LARGER NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER (9.3%) AND MULTIRACIAL POPULATIONS (24.1%) THAN THE REST OF THE COUNTRY. NATIVE HAWAIIANS, AT 5.6% OF THE TOTAL POPULATION, MAKE UP THE LARGEST SHARE OF THE NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER SINGLE RACE GROUP. A HIGHER PERCENT OF HAWAII IS FOREIGN-BORN COMPARED TO THE U.S. IN 2006-2010, 17.7% OF THE STATE WAS FOREIGN-BORN, COMPARED TO 12.7% OF THE U.S. OVERALL. A HIGHER PERCENT OF HAWAII HOUSEHOLDS WERE LINGUISTICALLY ISOLATED AS WELL: 6.2% OF HOUSEHOLDS REPORTED THAT ALL OF ITS MEMBERS AGES 14 AND OVER HAD SOME DIFFICULTY SPEAKING ENGLISH, CONTRASTED WITH JUST 4.8% OF HOUSEHOLDS IN THE U.S. INCOME IN HAWAII OVERALL IS HIGH. MEDIAN HOUSEHOLD INCOME IN 2006-2010 WAS $66,420, SUBSTANTIALLY HIGHER THAN THE NATIONAL VALUE OF $51,914. WHILE THE GAP IS SMALLER AMONG PER CAPITA INCOMES, HAWAII'S $28,882 IS STILL HIGHER THAN THE U.S.'S $27,334. HAWAII ALSO HAS A SMALLER POPULATION LIVING IN POVERTY COMPARED TO THE U.S., AT 9.6% VS. 13.8%. WITHIN THE STATE, HONOLULU COUNTY IS TIED WITH KAUAI COUNTY FOR THE LOWEST LEVELS OF POVERTY (8.8%). HAWAII COUNTY HAS THE HIGHEST, AT 14.4%. CERTAIN RACE/ETHNICITY GROUPS ARE ALSO MORE AFFECTED BY POVERTY. THE AMERICAN INDIAN/ALASKA NATIVE AND NATIVE HAWAIIAN/OTHER P.I. POPULATIONS HAVE THE HIGHEST POVERTY RATES AT 19.7% AND 18.2% RESPECTIVELY. THE TWO LEAST IMPOVERISHED GROUPS ARE ASIAN (6.3%) AND BLACK OR AFRICAN AMERICAN (9.7%). IT IS IMPORTANT TO NOTE THAT FEDERAL DEFINITIONS OF POVERTY ARE NOT GEOGRAPHICALLY ADJUSTED, SO THE DATA MAY NOT ADEQUATELY REFLECT THE PROPORTION OF HAWAII RESIDENTS WHO STRUGGLE TO PROVIDE FOR THEMSELVES DUE TO THE HIGH COST OF LIVING IN THE STATE. HAWAII RESIDENTS ARE WELL-EDUCATED COMPARED TO THE REST OF THE NATION. IN 2006-2010, 89.8% OF THE STATE'S RESIDENTS AGED 25 AND OLDER HAD AT LEAST A HIGH SCHOOL DEGREE, AND 29.4% HAD AT LEAST A BACHELOR'S DEGREE. BY CONTRAST, ONLY 85.0% OF THE NATION'S 25+ POPULATION HAD A HIGH SCHOOL DEGREE OR HIGHER, AND ONLY 27.9% HAD A BACHELOR'S DEGREE OR HIGHER. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN KAHI MOHALA'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE 2013 - 2015 IMPLEMENTATION STRATEGY FOR KAHI MOHALA DEFINES PROGRAMS THAT WILL ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. KAHI MOHALA SUPPORTS THE CRISIS RESPONSE PILOT PROJECT FOR EMERGENCY ROOM PATIENTS. THE PILOT PROJECT WILL PROVIDE AN EXPERIENCED BEHAVIORAL HEALTH PROFESSIONAL TO LEEWARD AND CENTRAL OAHU HOSPITALS AND EMERGENCY ROOMS, SUCH AS WAHIAWA GENERAL HOSPITAL, PALI MOMI MEDICAL CENTER AND OTHERS, TO ASSESS, EVALUATE AND DE-ESCALATE PSYCHIATRIC PATIENTS IN CRISIS. THE BEHAVIORAL HEALTH EVALUATOR WILL BE A 'COMMUNITY CONNECTOR' TO RECOMMEND COMMUNITY RESOURCES AND PLACEMENT. THE BEHAVIORAL HEALTH PROFESSIONAL WILL ALSO PROVIDE TRAINING TO EMERGENCY ROOM STAFF IN DE-ESCALATION TECHNIQUES AND MANAGEMENT OF BEHAVIORAL HEALTH PATIENTS. TRAINING TOPICS MAY INCLUDE HOW TO RECOGNIZE SIGNS, SYMPTOMS, AND ENGAGE IN PRACTICAL TECHNIQUES FOR PATIENTS EXHIBITING BEHAVIORAL HEALTH ISSUES (SUCH AS SUBSTANCE ABUSE, SUICIDAL IDEATION, AND TRAUMA). THE TRAININGS WILL BE OFFERED AT THE MOST CONVENIENT LOCATION FOR EMERGENCY ROOM STAFF, EITHER AT THEIR HOSPITAL OR ON THE KAHI MOHALA CAMPUS. 2015 UPDATE ON THE PILOT PROJECT: AS THE NEED IN THE COMMUNITY DRASTICALLY DECREASED ONCE THE QUEENS MEDICAL CENTER-WEST, THE NEARBY HOSPITAL, REOPENED, KAHI MOHALA DISCONTINUED TREATING THE ADULT ACUTE CARE POPULATION AND RE-FOCUSED THEIR ATTENTION TO TREATING THE CHILD AND ADOLESCENT POPULATION AS WELL AS STARTING A NEW "HEALING FORCES" PROGRAM, WHICH FOCUSED ON PROVIDING INPATIENT AND OUTPATIENT SERVICES TO THE ACTIVE MILITARY POPULATION SUFFERING FROM POST-TRAUMATIC STRESS DISORDERS. KAHI MOHALA SERVED 50 PATIENTS TOTALING 1,893 INPATIENT DAYS AS WELL AS 685 OUTPATIENT VISITS. KAHI SUPPORTS THE COMMUNITY HEALTH CENTER CARE COORDINATION PROGRAM. THIS PROGRAM HELPS TO ESTABLISH A SINGLE POINT OF CONTACT BETWEEN A KAHI MOHALA CASE MANAGER AND WAIANAE COAST COMPREHENSIVE HEALTH CENTER (WCCHC) AFTERCARE COORDINATOR TO IMPROVE COMMUNICATION WITH THE PATIENT'S PRIMARY CARE PHYSICIAN, TO MORE EFFECTIVELY SCHEDULE AFTERCARE APPOINTMENTS, AND TO ENSURE A SEAMLESS DISCHARGE FROM KAHI MOHALA. IN 2015, KAHI BEGAN ACCEPTING MEDICAL STUDENTS FROM WCCHC AND HAVING THEM EXPERIENCE CLINICAL ROTATIONS AT THEIR FACILITY. UPON FURTHER REVIEW OF THE DATA, THIS PROGRAM WAS REDUCED IN SCALE DUE TO THE CHANGE IN PATIENT MIX WHICH RESULTED IN LOWER VOLUMES OF PATIENTS COMING FROM AND/OR BEING DISCHARGED TO WCCHC. IN ADDITION TO THESE INITIATIVES, KAHI IMPLEMENTS SEVERAL OTHER COMMUNITY BENEFIT PROGRAMS INCLUDING: - KAHI PROVIDES THE USE OF THEIR ROOMS/FACILITIES FOR SEVERAL COMMUNITY PROGRAMS INCLUDING THE 12-STEP RECOVERY PROGRAM FOR ADDICTION-AFFECTED FAMILY MEMBERS, ALCOHOLICS ANONYMOUS, NARCOTICS ANONYMOUS, AND CHILD & FAMILY SERVICES FOR THOSE AFFECTED BY DOMESTIC VIOLENCE. - KAHI SPONSORS THE ANNUAL INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA CONFERENCE, WHICH WORKS ON PREVENTING, ASSESSING AND TREATING CHILDHOOD, ADOLESCENT AND ADULT TRAUMA. - KAHI SPONSORS THE ANNUAL NATIONAL ASSOCIATION ON MENTAL ILLNESS WALK, WHICH RAISES MONEY AND AWARENESS OF MENTAL ILLNESS. IN ADDITION TO REGISTERED WALKERS, KAHI HELD AN ON CAMPUS WALK FOR STAFF AND ITS RESIDENTIAL PATIENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE ORGANIZATION IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF HOSPITALS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS WHO CARE FOR PEOPLE WHO LIVE IN MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES AS WELL AS THE HAWAII PACIFIC RIM COMMUNITY. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. THE HOSPITAL'S MISSION IS TO ENHANCE THE WELL-BEING OF THE PEOPLE IN OUR COMMUNITIES THROUGH COMPASSION, EXCELLENCE AND INNOVATION IN HEALTH CARE SERVICES, RESEARCH AND EDUCATION. OVER THE PAST FIVE YEARS, SUTTER HEALTH HAS COMMITTED NEARLY $4 BILLION TO CARE FOR PATIENTS WHO COULDN'T AFFORD TO PAY, AND TO SUPPORT PROGRAMS THAT IMPROVE COMMUNITY HEALTH. OUR 2015 COMMITMENT OF $843 MILLION INCLUDES UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, TRADITIONAL CHARITY CARE AND INVESTMENTS IN HEALTH EDUCATION AND PUBLIC BENEFIT PROGRAMS. FOR EXAMPLE: - TO PROVIDE CARE TO MEDI-CAL PATIENTS IN 2015, SUTTER HEALTH INVESTED $712 MILLION MORE THAN THE STATE PAID. SUTTER HEALTH HOSPITALS PROUDLY SERVE MORE MEDI-CAL PATIENTS IN OUR NORTHERN CALIFORNIA SERVICE AREA THAN ANY OTHER HEALTH CARE PROVIDER. - IN 2015, SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS WAS $52 MILLION. - THROUGHOUT OUR HEALTH CARE SYSTEM, WE PARTNER WITH AND SUPPORT COMMUNITY HEALTH CENTERS TO ENSURE THAT THOSE IN NEED HAVE ACCESS TO PRIMARY AND SPECIALTY CARE. WE ALSO SUPPORT CHILDREN'S HEALTH CENTERS, FOOD BANKS, YOUTH EDUCATION, JOB TRAINING PROGRAMS AND SERVICES THAT PROVIDE COUNSELING TO DOMESTIC VIOLENCE VICTIMS. EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESSES REAL COMMUNITY NEEDS. X true true X X X X false true false false false false false true false STEVEN CHAPLIN MD MEDICAL DIRECTOR/EX-OFFICIO 225637 0 209545 0 2592 0 13792 0 7420 0 458986 0 0 0 ROSE CHOY CFO SUTTER HEALTH PACIFIC 0 148266 0 57411 0 9091 0 12803 0 853 0 228424 0 22992 LEONARD LICINA CEO SUTTER HEALTH PACIFIC 0 204595 0 77578 0 8642 0 33380 0 14543 0 338738 0 29238 GREGORY PRIER MD PSYCHIATRIST 182894 0 138373 0 2804 0 13792 0 7420 0 345283 0 0 0 ELENA SHARIPOVA MD PSYCHIATRIST 128648 0 15211 0 349 0 7499 0 13720 0 165427 0 0 0 JEREMY ROBERTS MD PSYCHIATRIST 0 0 227090 0 385 0 11829 0 18484 0 257788 0 0 0 PENNY WESTFALL VP & REGIONAL COUNSEL SHSSR 0 353869 0 190142 0 1461 0 100142 0 12069 0 657683 0 78012 JAMES E CONFORTI CEO SHSSR 0 707108 0 579602 0 71820 0 376742 0 24453 0 1759725 0 363827 SARAH KREVANS COO SUTTER HEALTH 0 1045572 0 888993 0 143129 0 470092 0 26048 0 2573834 0 559293 KENNETH DELANO DIRECTOR HEALING FORCES 191091 0 1600 0 91 0 10025 0 13642 0 216449 0 0 0 SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY. SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTHS OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTERS PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR ELIGIBLE EARNINGS BEYOND THE IRS DEFINITION OF INCLUDIBLE COMPENSATION ("PENSION PAY CAP"). THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F)) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTHS QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTERS NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 10% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD UP TO 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE. FORM 990, PART I, LINE 1 AND PART III, LINE 1 SUTTER HEALTH PACIFIC (DBA KAHI MOHALA) IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES. FORM 990, PART III, LINE 4A SUTTER HEALTH PACIFIC, A CALIFORNIA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION WAS ORGANIZED TO OPERATE KAHI MOHALA, AN 88 BED, FREESTANDING PSYCHIATRIC HOSPITAL. KAHI MOHALA HAS BEEN OPERATIONAL SINCE 1983 AND IS SITUATED ON A 14.5-ACRE CAMPUS. THE HOSPITAL IS LICENSED BY THE STATE OF HAWAII AND IS ACCREDITED BY THE JOINT COMMISSION UNDER THE ACCREDITATION MANUAL OF HOSPITALS AND BEHAVIORAL HEALTH MANUALS. THERE WERE 27,255 PATIENT DAYS IN 2015. KAHI MOHALA'S MISSION IS: "KAHI MOHALA IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES." TREATMENT PROGRAMS KAHI MOHALA IS DEDICATED NOT ONLY TO PSYCHIATRIC, EMOTIONAL AND BEHAVIORAL STABILIZATION, BUT ALSO TO RECOVERY THROUGH EMPOWERMENT. TEACHING INDIVIDUALS THE SKILLS TO SELF-MANAGE AND SELF-REGULATE TO THE FULLEST POSSIBLE EXTENT IS A FUNDAMENTAL GOAL WITHIN THE TREATMENT AND RECOVERY PROCESS. LEVELS OF CARE - ACUTE CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - RESIDENTIAL CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - ADOLESCENT PARTIAL HOSPITALIZATION PROGRAM (PHP) INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) - HEALING FORCES TRAUMA RECOVERY MILITARY PROGRAMS INPATIENT AND PARTIAL HOSPITALIZATION - ELECTROCONVULSIVE THERAPY (ECT) SPECIALIZED TREATMENT SERVICES - PSYCHIATRIC EVALUATION/TREATMENT AND MEDICATION MANAGEMENT - NURSING ASSESSMENT - PSYCHOLOGICAL TESTING - SUBSTANCE ABUSE/DUAL DIAGNOSIS SERVICES - EATING DISORDER SERVICES THERAPEUTIC SERVICES AVAILABLE - INDIVIDUAL, FAMILY AND GROUP THERAPY - EDUCATIONAL SERVICES - OCCUPATIONAL THERAPY - RECREATIONAL THERAPY - ART THERAPY - REALITY-ORIENTED PHYSICAL EXPERIENTIAL SERVICES (ROPES) THIS CORPORATION WAS FORMED FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION: A. TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NOT-FOR-PROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BEDS AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS AND TO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; B. TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED, OR TO THE PROMOTION OF HEALTH; C. TO PROMOTE AND CARRY OUT SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; D. TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITY SERVED; AND E. TO CONTRIBUTE TO THE GROWTH, DEVELOPMENT AND FINANCIAL STRENGTH OF SUTTER HEALTH SYSTEM. KAHI MOHALA - LIST OF COMMUNITY BENEFITS - TWELVE-STEP PROGRAMS (ALCOHOLICS ANONYMOUS, ALANON, NARCOTICS ANONYMOUS) PURPOSE: PEER-LED, SELF-HELP GROUPS OF PERSONS RECOVERING FROM ADDICTIONS, OR FAMILY MEMBERS OF PERSONS RECOVERING FROM ADDICTIONS. GOALS AND OBJECTIVES: TO GAIN SUPPORT AND EDUCATION IN A GROUP SETTING. - INTERNSHIP, RESIDENCY AND PRACTICUM PROGRAMS PURPOSE: TO PROVIDE A SUPERVISED CLINICAL PRACTICE SETTING FOR MEDICAL STUDENTS, SOCIAL WORKERS, NURSES, PSYCHOLOGISTS, SUBSTANCE ABUSE COUNSELORS AND OCCUPATIONAL THERAPISTS. GOALS AND OBJECTIVES: TO OBTAIN DIRECT PRACTICE EXPERIENCE IN THE STUDENTS FIELD. - INFORMATION AND REFERRAL PURPOSE: TO PROVIDE TELEPHONE INFORMATION AND REFERRAL TO THE PUBLIC REGARDING MENTAL HEALTH AND CHEMICAL DEPENDENCY RESOURCES. GOAL: TO PROVIDE A FREE COMMUNITY RESOURCE. - MEMBERSHIPS ON COMMUNITY BOARDS AND COMMITTEES: GOODWILL INDUSTRIES, KAPOLEI ROTARY, HEALTHCARE ASSOCIATION OF HAWAII, HFMA, CHAMBER OF COMMERCE, MENTAL HEALTH AMERICA OF HAWAII (MHA), NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), HAWAII YOUTH SERVICES NETWORK (HYSN), COMMUNITY CHILDRENS COUNCIL (CCCS), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE PURPOSE: TO VOLUNTEER EXPERTISE ON VARIOUS COMMUNITY BOARDS AND COMMITTEES. GOALS AND OBJECTIVES: TO SUPPORT OUR COMMUNITY BY HELPING OTHERS MEET THE GOALS AND OBJECTIVES OF THE VARIOUS ORGANIZATIONS AND COMMITTEES. - COMMUNITY ROPES GROUPS PURPOSE: PROVIDE PROBLEM SOLVING, TEAM BUILDING, AND LEADERSHIP AWARENESS THROUGH THE USE OF GAMES AND ELEMENTS ON THE ROPES COURSE. GOALS AND OBJECTIVES: PROVIDE THE YOUTH/AT RISK YOUTH THE OPPORTUNITY TO EXPERIENCE TEAM BUILDING/PROBLEM SOLVING EXERCISES THROUGH THE USE OF OUR ROPES COURSE. - HAWAII FOOD BANK CASH DONATION AND CANNED FOOD DRIVE PURPOSE: CASH DONATION & CANNED FOOD COLLECTION GOALS AND OBJECTIVES: PROVIDE ASSISTANCE TO THE HUNGRY AND HOMELESS IN THE COMMUNITY - CHILD & FAMILY SERVICE PURPOSE: USE OF ROOM/FACILITIES GOALS AND OBJECTIVES: TO PROVIDE A MEETING PLACE FOR THE DOMESTIC VIOLENCE PROGRAM - MILITARY SPOUSES SUPPORT NETWORK PURPOSE: PROVIDE COMMUNITY SUPPORT NETWORK FOR MILITARY SPOUSES/SIGNIFICANT OTHERS WHOSE PARTNERS HAVE EXPERIENCED TRAUMATIC EVENTS IN OR OUTSIDE OF MILITARY COMBAT. GOALS AND OBJECTIVES: TO PROVIDE SUPPORT TIME IN A SAFE ENVIRONMENT WHERE SPOUSES OF ALL BRANCHES OF SERVICE AND VETERANS CAN SHARE THEIR FEELINGS, LEARN COPING SKILLS AND CONNECT WITH OTHERS. TO PROVIDE A PLACE WHERE SPOUSES AND SIGNIFICANT OTHERS CAN ATTEND WORKSHOPS, GROUP OUTINGS AND INSPIRATIONAL EXPERIENCES. - CPR TRAINING PURPOSE: TO PROVIDE CPR TRAINING TO COMMUNITY GOAL: TRAIN CHILDREN IN HAWAII HOW TO PERFORM CPR - NATIONAL ASSOCIATION ON MENTAL ILLNESS (NAMI) WALK PURPOSE: PARTICIPATION IN ANNUAL NAMI WALK GOALS AND OBJECTIVES: TO RAISE MONEY AND AWARENESS OF MENTAL ILLNESS - PRINCE KUHIO TOASTMASTERS PURPOSE: TO PROVIDE PROFESSIONAL DEVELOPMENT TRAINING TO COMMUNITY GOAL: ENCOURAGE PROFESSIONAL DEVELOPMENT ACTIVITY IN COMMUNITY FORM 990, PART VI, LINE 1A THE AFFAIRS AND MANAGEMENT OF SUTTER HEALTH PACIFIC (SHP) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHO HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SHP DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR OF THE BOARD WHO SERVES AS CHAIR OF THE COMMITTEE, THE PRESIDENT, THE VICE CHAIR, AND THE VICE CHAIR FOR FINANCE. FORM 990, PART VI, LINES 6 & 7A THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. FORM 990, PART VI, LINE 11B SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM. FORM 990, PART VI, LINE 12C EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. FORM 990, PART VI, LINES 15A & 15B THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN DECEMBER OF 2015. FORM 990, PART VI, LINE 19 THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART XI, LINE 9 EQUITY TRANSFER (NET) $600,000 ADOLESCENT TREATMENT CENTERS INC C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680088443 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true BETTER HEALTH EAST BAY FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 510160184 FUNDRAISING CA 501(C)(3) 7 SUTTER EBH true CALIFORNIA PACIFIC MEDICAL CTR FOUND C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942728423 FUNDRAISING CA 501(C)(3) 7 SUTTER WBH true EAST BAY PERINATAL CENTER 3012 SUMMIT STREET 3RD FLOOR OAKLAND CA 94609 510172285 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true EDEN MEDICAL CENTER C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942948100 HEALTHCARE CA 501(C)(3) 9 SUTTER HLTH true MEMORIAL HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942290244 FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH true MILLS-PENINSULA HEALTH SERVICES C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941156265 HOSPITAL CA 501(C)(3) 3 PAMF true MILLS-PENINSULA HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 237288765 FUNDRAISING CA 501(C)(3) 7 MPHS true PALO ALTO MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941156581 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SAMUEL MERRITT UNIVERSITY 450 30TH STREET STE 2820 OAKLAND CA 94609 942992642 UNIVERSITY CA 501(C)(3) 2 SUTTER EBH true SUTTER AUBURN FAITH HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942594966 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER CENTRAL VALLEY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941080917 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER COAST HOSPITAL C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942988520 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER DAVIS HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680217870 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER EAST BAY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941196176 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER EAST BAY MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942690415 HEALTHCARE CA 501(C)(3) 11b - II SUTTER HLTH true SUTTER GOULD MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941682256 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SUTTER HEALTH C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942788907 SUPPORTING OR CA 501(C)(3) 11c III-FI NA false SUTTER HEALTH PLAN C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 461183948 HEALTH PLAN CA PENDING PENDING SUTTER HLTH true SUTTER HEALTH SACRAMENTO SIERRA REGION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941156621 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER INSURANCE SERVICES CORPORATION 745 FORT STREET SUITE 1100 HONOLULU HI 96813 990289310 INSURANCE SER HI 501(C)(3) 11c III-FI SUTTER HLTH true SUTTER MEDICAL CENTER FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942788906 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER MEDICAL CENTER CASTRO VALLEY C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 770146047 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER VALLEY MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680273974 HEALTHCARE CA 501(C)(3) 11b - II SUTTER HLTH true SUTTER ROSEVILLE MEDICAL CTR FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680040113 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER SOLANO CHARITABLE FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942668262 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER VISITING NURSE ASSOC AND HOSPICE C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 946068843 HEALTHCARE CA 501(C)(3) 9 SUTTER HLTH true SUTTER WEST BAY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 940562680 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER WEST BAY MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942948131 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true TRACY HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680318845 FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH true MAGNETIC IMAGING AF 2125 OAK GROVE WLN CK CA 94598 942953833 PATIENT CARE CA NA SURG CTR OF ABSMC 3875 TELEGRAPH OAKLAND CA 94609 470946086 OUTPATIENT SURG CA NA ALTA CT SERVICES LP 2125 OAK GROVE WLN CK CA 94598 943083464 PATIENT CARE CA NA CA PACIFIC ADV IMAGING LLC PO BOX 6102 NOVATO CA 94948 562311840 MRI JOINT VENTURE CA NA SAN FRANCISCO ENDOSCOPY CTR LLC 3000 RIVERCHASE BIRMINGHAM AL 35244 912160588 ENDOSCOPY JV CA NA PRESIDIO SURGERY CENTER LLC 1635 DIVISADERO SF CA 94115 320144060 AMBULATORY SURG CA NA SUTTER FAIRFIELD SURGERY CTR 2700 LOW CT FAIRFIELD CA 94533 300233892 SURGERY CA NA TWIN CITIES SURGICAL HOSPITAL LLC 250 S WACKER CHICAGO IL 60606 352182617 SURGERY CA NA SUTTER AMADOR SURGERY CTR LLC 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 461398093 SURGERY CA NA ROSEVILLE ENDOSCOPY CENTER LLC 4 MEDICAL PLAZA SUITE 210 ROSEVILLE CA 95661 870710513 ENDOSCOPY JV CA NA MEMORIAL MEDICAL OFFICE BLDG 1 1800 COFFEE RD SUITE 76 MODESTO CA 95355 770234236 OFFICE RENTAL CA NA MEMORIAL MEDICAL OFFICE BLDG 2 1800 COFFEE RD SUITE 76 MODESTO CA 95355 770287288 OFFICE RENTAL CA NA DRZ EMERGING MRKETS 250 PARK AVE S WINTER PARK FL 32789 611729868 INVESTMENTS FL NA ASC OPTRS-SLO LLC 2200 RIVER PLZ SACRAMENTO CA 95833 272673776 PATIENT CARE CA NA MAGNETIC IMAGING AFFILIATES LLC 2125 OAK GROVE RD STE 200 WALNUT CREEK CA 94598 473696091 PATIENT CARE CA NA SF PEDIATRIC VENTURE 2200 RIVER PLAZA DR SACRAMENTO CA 95833 454474910 PATIENT CARE CA NA false false false false false false false false false false false false false false false true false true true SUTTER INSURANCE SERVICES CORPORATION P 246920 FMV