MARIN GENERAL HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MARIN GENERAL HOSPITAL (EIN 94-2823538)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-16
- IRS object ID
- 201513209349311276
- Schema version
- 2014v5.0
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-16T15:18:32-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942823538 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARIN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARI | BusinessNameControlTxt |
| Phone | 4159257000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 BON AIR ROAD | AddressLine1Txt |
| City | GREENBRAE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEE DOMANICO | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4159257000 | PhoneNum |
| Signature | 2015-11-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RENIE BURBANK | PreparerPersonNm |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LEE DOMANICO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 BON AIR ROAD | AddressLine1Txt |
| City | GREENBRAE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $353,326,009 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MARINGENERAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1829 | TotalEmployeeCnt |
| Total Volunteers | 338 | TotalVolunteersCnt |
| Total Gross UBI | $41,486 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,750,424 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,264,934 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $314,837,387 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $342,550,097 | CYProgramServiceRevenueAmt |
| PY Investment Income | $9,130 | PYInvestmentIncomeAmt |
| CY Investment Income | $282,386 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,682,675 | PYOtherRevenueAmt |
| CY Other Revenue | $4,776,541 | CYOtherRevenueAmt |
| PY Total Revenue | $323,279,616 | PYTotalRevenueAmt |
| CY Total Revenue | $350,873,958 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $9,048,701 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $14,996,385 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $176,921,525 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $186,875,779 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $128,172,123 | PYOtherExpensesAmt |
| CY Other Expenses | $130,332,785 | CYOtherExpensesAmt |
| PY Total Expenses | $314,142,349 | PYTotalExpensesAmt |
| CY Total Expenses | $332,204,949 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,137,267 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $18,669,009 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $198,919,079 | TotalAssetsBOYAmt |
| Total Assets EOY | $220,313,642 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $124,723,149 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $141,584,908 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $74,195,930 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $78,728,734 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $302,727,890 | ExpenseAmt |
| Grant | $14,996,385 | GrantAmt |
| Revenue | $342,550,097 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $302,727,890 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 328 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1829 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| 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 | JAMES P MCMANUS | PersonNm |
| Phone | 4154642090 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 B DRAKES LANDING SUITE 250 | AddressLine1Txt |
| City | GREENBRAE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| PAUL KIRINCIC | |||||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| STEVEN A SCHROEDER MD | |||||||||
| VICE CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARA PEREZ PHD | |||||||||
| MGH BOARD MEMBER/SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JEREMY FAIR | |||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DAVID HILL | |||||||||
| MGH BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ANN KAO MD | |||||||||
| MGH BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| GENE MARIE O'CONNELL | |||||||||
| MGH BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| DEREK PARKER | |||||||||
| MGH BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT PEIRCE | |||||||||
| MGH BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| TIMOTHY SOWERBY MD | |||||||||
| MGH BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| LEE DOMANICO | |||||||||
| CEO/MGH BOARD EX-OFFICIO | 36.00 | Yes (X) | $1,124,368 | $0 | $17,419 | 4.00 | |||
| DAVID W COX | |||||||||
| CFO THRU 6/30/14 | 38.00 | Yes (X) | $359,730 | $0 | $73,055 | 2.00 | |||
| RONALD K SPERLING | |||||||||
| CFO 6/30-12/15/14 | 40.00 | Yes (X) | $300,343 | $0 | $0 | 0.00 | |||
| JON D FRIEDENBERG | |||||||||
| CHF ADMINISTRATIVE OFFICER | 32.00 | $523,047 | $0 | $44,638 | 8.00 | Yes (X) | |||
| MARK A ZIELAZINSKI | |||||||||
| CHIEF INFO & TECH OFFICER | 40.00 | $426,251 | $0 | $34,723 | Yes (X) | ||||
| JOEL SKLAR | |||||||||
| CHIEF MEDICAL OFFICER | 28.00 | $341,680 | $0 | $35,704 | Yes (X) | ||||
| LINDA LANG | |||||||||
| CHF HR OFFICER | 40.00 | $298,794 | $0 | $23,001 | Yes (X) | ||||
| GOONASAGRIE NAIDOO | |||||||||
| VP OF NURSING THRU 9/12/14 | 40.00 | $299,788 | $0 | -$663 | Yes (X) | ||||
| GREGORY LEE | |||||||||
| CARD CATH TECH IV | 40.00 | $443,822 | $0 | $40,629 | Yes (X) | ||||
| SANDY D AUGUSTUS | |||||||||
| CLINICAL RN III | 40.00 | $357,482 | $0 | $52,505 | Yes (X) | ||||
| MARGARET M ROBERTS | |||||||||
| CLINICAL RN III | 40.00 | $333,106 | $0 | $52,811 | Yes (X) | ||||
| CHUN LI | |||||||||
| CHIEF CLIN PHYSICIST | 40.00 | $312,304 | $0 | $54,651 | Yes (X) | ||||
| SUSAN S CUMMING | |||||||||
| MEDICAL DIRECTOR MGH | 40.00 | $304,841 | $0 | $29,916 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,425,556 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $458,389 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 537 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PRIMA MEDICAL FOUNDATION | |||||
| 4 HAMILTON LANDING STE 100 | NOVATO | CA | 94949 | PHYSICIAN SERVICES | $3,188,092 |
| MARIN HOSPITALIST MEDICAL GROUP | |||||
| PO BOX 708 | NOVATO | CA | 94948 | PHYSICIAN SERVICES | $2,456,157 |
| ANESTHESIOLOGY CONSULTANTS OF | |||||
| 540 SAN PEDRO COVE | SAN RAFAEL | CA | 94901 | PHYSICIAN SERVICES | $1,539,196 |
| QUEST DIAGNOSTICS INC | |||||
| 3924 COLLECTION CTR DR | CHICAGO | IL | 60693 | LABORATORY/TESTING SERVICES | $1,294,031 |
| DMS HEALTH TECHNOLOGIES | |||||
| 26273 NETWORK PLACE | CHICAGO | IL | 60673 | RADIOLOGY SERVICES | $890,366 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 53 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,053,477 | RelatedOrganizationsAmt |
| All Other Contributions | $211,457 | AllOtherContributionsAmt |
| Total Contributions | $3,264,934 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REV. | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $342,550,097 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $342,550,097 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $342,550,097 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $282,386 | TotalRevenueColumnAmt |
| Exclusion | $282,386 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,916,347 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,452,051 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$535,704 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$535,704 | TotalRevenueColumnAmt |
| Exclusion | -$535,704 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| ALL OTHER REVENUES | 900099 | $3,056,104 | $41,486 | $3,014,618 |
| EHR REVENUE | 541519 | $1,311,482 | $1,311,482 | |
| INVESTMENT IN PARTNERSHIP | 900099 | $944,659 | $944,659 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,312,245 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $350,873,958 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $342,550,097 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $41,486 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,017,441 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,944,499 | TotalAmt |
| Program Services | $14,944,499 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,886 | TotalAmt |
| Program Services | $51,886 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,902,017 | TotalAmt |
| Management And General | $3,902,017 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,264,735 | TotalAmt |
| Program Services | $128,996,018 | ProgramServicesAmt |
| Management And General | $9,268,717 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,001,501 | TotalAmt |
| Program Services | $8,335,735 | ProgramServicesAmt |
| Management And General | $665,766 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,594,572 | TotalAmt |
| Program Services | $23,398,756 | ProgramServicesAmt |
| Management And General | $2,195,816 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,112,954 | TotalAmt |
| Program Services | $9,122,825 | ProgramServicesAmt |
| Management And General | $990,129 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,322,522 | TotalAmt |
| Program Services | $2,310,590 | ProgramServicesAmt |
| Management And General | $11,932 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,086 | TotalAmt |
| Management And General | $295,086 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $952,217 | TotalAmt |
| Program Services | $952,217 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,409,087 | TotalAmt |
| Program Services | $3,344,780 | ProgramServicesAmt |
| Management And General | $64,307 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,946,579 | TotalAmt |
| Program Services | $3,538,108 | ProgramServicesAmt |
| Management And General | $408,471 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,373,757 | TotalAmt |
| Program Services | $16,769,345 | ProgramServicesAmt |
| Management And General | $1,604,412 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,326 | TotalAmt |
| Program Services | $149,326 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,141,560 | TotalAmt |
| Program Services | $1,141,560 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,556,523 | TotalAmt |
| Program Services | $13,556,523 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,983,579 | TotalAmt |
| Program Services | $1,785,221 | ProgramServicesAmt |
| Management And General | $198,358 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $41,028,465 | $41,028,465 | |
| PURCHASED SERVICES | $30,258,121 | $20,884,314 | $9,373,807 |
| PRO. FEES - PHYSICIANS | $12,755,528 | $12,755,528 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,435 | TotalAmt |
| Program Services | -$337,806 | ProgramServicesAmt |
| Management And General | $498,241 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,204,949 | TotalAmt |
| Program Services | $302,727,890 | ProgramServicesAmt |
| Management And General | $29,477,059 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,172,713 | BOYAmt |
| EOY | $47,165,087 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $372,553 | BOYAmt |
| EOY | $384,208 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,559,372 | BOYAmt |
| EOY | $57,309,159 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,860,164 | BOYAmt |
| EOY | $5,379,712 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,533,877 | BOYAmt |
| EOY | $4,369,756 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $230,989,650 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $159,344,511 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,369,892 | BOYAmt |
| EOY | $71,645,139 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,637,971 | BOYAmt |
| EOY | $8,503,260 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,412,537 | BOYAmt |
| EOY | $25,557,321 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,919,079 | BOYAmt |
| EOY | $220,313,642 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,366,876 | BOYAmt |
| EOY | $53,813,846 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,734,801 | BOYAmt |
| EOY | $46,953,983 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,621,472 | BOYAmt |
| EOY | $40,817,079 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,723,149 | BOYAmt |
| EOY | $141,584,908 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,195,930 | BOYAmt |
| EOY | $78,728,734 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,195,930 | BOYAmt |
| EOY | $78,728,734 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,919,079 | BOYAmt |
| EOY | $220,313,642 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $18,669,009 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$14,136,205 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $48,003 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $48,003 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO HOSPITAL COUNCIL NORTHERN CENTRAL CALIFORNIA (HCNCC) AND DISTRICT HOSPITAL LEADERSHIP FORUM. A PORTION OF THE DUES PAID WERE USED FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $214,643 | BeginningYearBalanceAmt |
| End Year Balance | $214,643 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $214,643 | BeginningYearBalanceAmt |
| End Year Balance | $214,643 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $214,643 | BeginningYearBalanceAmt |
| End Year Balance | $214,643 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $214,643 | BeginningYearBalanceAmt |
| End Year Balance | $214,643 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $214,643 | BeginningYearBalanceAmt |
| End Year Balance | $214,643 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,512,684 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,187,206 | DepreciationAmt |
| Book Value | $325,478 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $66,003,620 | OtherCostOrOtherBasisAmt |
| Depreciation | $51,709,653 | DepreciationAmt |
| Book Value | $14,293,967 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,533,292 | OtherCostOrOtherBasisAmt |
| Depreciation | $81,186,036 | DepreciationAmt |
| Book Value | $36,347,256 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,940,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $261,616 | DepreciationAmt |
| Book Value | $20,678,438 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $71,645,139 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $8,419,043 |
| ASSETS LIMITED TO USE | $5,247,491 |
| DEPOSITS | $618,400 |
| INTERCOMPANY RECEIVABLES | $6,336,725 |
| THIRD PARTY SETTLEMENTS | $4,935,662 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $25,557,321 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INSURANCE LIABILITIES | $4,680,429 |
| POST-RETIREMENT HEALTH OBLIGATION | $8,627,252 |
| INTERCOMPANY PAYABLES | $4,833,121 |
| ACCRUED PENSION LIABILITIES | $22,676,277 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,817,079 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $337,277,056 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$16,048,952 | OtherRevenueAmt |
| Revenue Not Reported | -$16,048,952 | RevenueNotReportedAmt |
| Revenue Subtotal | $353,326,008 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$2,452,050 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$2,452,050 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $350,873,958 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $328,285,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,452,064 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,452,064 | ExpensesNotReportedAmt |
| Expenses Subtotal | $325,832,936 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $6,372,013 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $6,372,013 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $332,204,949 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUNDS ARE NOW ADMINISTERED BY FOUNDATION OF WHICH THE ORGANIZATION IS THE SOLE CORPORATE PARENT. EARNINGS FROM GENERAL ENDOWMENT FUND ARE AVAILABLE TO BE DESIGNATED BY FOUNDATION BOARD. THE EARNINGS FROM THE OTHER ENDOWMENT FUNDS ARE TRANSFERRED TO RELATED TEMPORARILY RESTRICTED FUNDS. |
| PART X, LINE 2: | MGH IS ORGANIZED AS A NOT-FOR-PROFIT ENTITY UNDER THE GENERAL NONPROFIT CORPORATION LAWS OF THE STATE OF CALIFORNIA. EXEMPTIONS FROM FEDERAL INCOME TAXATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA FRANCHISE TAXATION HAVE BEEN OBTAINED. CERTAIN ACTIVITIES AND SUBSIDIARIES MAY BE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION -3,947,000. CHANGE IN BENEFIT PLAN -5,730,333. EQUITY TRANSFER TO FOUNDATION RECLASSIFIED TO GRANT EXPENSE -540,000. EQUITY TRANSFER TO PRIMA RECLASSIFIED TO GRANT EXPENSE -572,013. RECLASSIFICATION OF SUPPORT TO RELATED ORGANIZATIONS -5,260,000. AUDITED FINANCIAL STATEMENT ROUNDING 394. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RECLASSIFICATION OF RENTAL EXPENSES FROM EXPENSES -2,452,050. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | AUDITED FINANCIAL STATEMENT ROUNDING 14. RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE 2,452,050. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EQUITY TRANSFER TO FOUNDATION RECLASSIFIED FROM REVENUES 540,000. RECLASSIFICATION OF SUPPORT TO RELATED ORGANIZATIONS 5,260,000. EQUITY TRANSFER TO PRIMA RECLASSIFIED TO GRANT EXPENSE 572,013. |
| PARTS XI, XII, & XIII - RECONCILIATIONS: | THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS; HOWEVER, SEPARATE FINANCIAL INFORMATION IS MAINTAINED FOR EACH ORGANIZATION. THE SEPARATE FINANCIAL INFORMATION FOR THIS ORGANIZATION IS THE BASIS FOR THE RECONCILIATIONS AT SCHEDULE D, PARTS XI, XII, & XIII. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 400.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,013,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,013,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00910 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $54,278,368 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,765,310 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $48,513,058 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14600 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $361,508 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $361,508 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $57,652,876 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,765,310 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $51,887,566 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6556 | PersonsServedCnt |
| Total Community Benefit Expns | $268,875 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,327 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $260,548 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 954 | PersonsServedCnt |
| Total Community Benefit Expns | $444,430 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,085 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $425,345 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,541 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,541 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,472,283 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,472,283 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7510 | PersonsServedCnt |
| Total Community Benefit Expns | $11,192,129 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,412 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,164,717 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03360 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7510 | PersonsServedCnt |
| Total Community Benefit Expns | $68,845,005 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,792,722 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $63,052,283 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18980 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,608 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,608 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,608 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,608 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,608,569 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $84,944,066 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $138,047,308 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$53,103,242 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 MGHSCA LLC | |||
| OUTPATIENT SURGERY CENTER | 0.51000 | 0.00000 | 0.00000 |
| 2 MARIN MAGNETIC RESONANCE IMAGING CENTER | |||
| OUTPATIENT IMAGING/MRI CENTER | 0.51000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | MARIN GENERAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 BON AIR ROAD | AddressLine1Txt |
| City | GREENBRAE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 110000361 | 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 | MARIN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MARINGENERAL.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MARINGENERAL.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 400.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| 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 (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MARIN GENERAL HOSPITAL | PART V, SECTION B, LINE 5: COMMUNITY INPUT:INDIVIDUALS WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN, PUBLIC HEALTH THAT PROVIDED INPUT INCLUDED:- MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT- COMMUNITY EPIDEMIOLOGY CHIEF, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT- FACULTY, FAMILY HEALTH OUTCOMES PROJECT, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO- FORMER DIRECTOR, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, PREVIOUSLY SERVED 17 YEARS WITH SAN FRANCISCO PUBLIC HEALTH DEPARTMENT, CURRENTLY PRESIDENT, MARIN COMMUNITY FOUNDATION- MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, PUBLIC HEALTH OFFICER- MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, CHIEF OF DIVISION OF ALCOHOL, TOBACCO & OTHER DRUGSTHESE PUBLIC HEALTH EXPERTS PARTICIPATED IN KEY INFORMANT INTERVIEWS AND THREE ALSO PARTICIPATED IN THE HEALTHY MARIN PARTNERSHIP(HMP)-COORDINATED COMMUNITY CONVENING. THE COMMUNITY EPIDEMIOLOGY CHIEF WAS ALSO A CONSULTANT TO THE CHNA WORK GROUP AND PROCESS. FROM APRIL 23, 2012 TO JUNE 11, 2012 THE ABINADER GROUP CONDUCTED 25 PHONE INTERVIEWS OF STAKEHOLDERS SELECTED BY HMP LEADERSHIP. STAKEHOLDERS INTERVIEWED WERE HMP LEADERSHIP AND REPRESENTATIVES FROM HOSPITAL AND HEALTH ORGANIZATIONS, PUBLIC HEALTH EXPERTS, FUNDING INSTITUTIONS, GOVERNMENT, BUSINESS, EDUCATION, AND COMMUNITY BASED AGENCIES. KEY INFORMANTS, COMMUNITY PHYSICIANS AND THOSE PARTICIPATING IN THE HMP-COORDINATED COMMUNITY CONVENING INCLUDED 44 MARIN COUNTY RESIDENTS AND LEADERS REPRESENTING KEY POPULATIONS AS FOLLOWS. MOST OF THE KEY INFORMANTS ALSO PARTICIPATED IN THE COMMUNITY CONVENING.FOCUS GROUPS, LED BY MARIN HEALTH AND HUMAN SERVICES, WERE HELD IN MARIN CITY, NOVATO, CANAL, SAN GERONIMO, WEST MARIN, WHISTLESTOP AND AT THE YOUTH LEADERSHIP INSTITUTE BETWEEN APRIL 16 AND MAY 9, 2012. THE SURVEY ASKED FOCUS GROUP PARTICIPANTS ABOUT: IMPORTANT HEALTH ISSUES THEY FACE, THEIR FAMILIES, AND THEIR COMMUNITIES FACED; WHAT THEY SAW AS HEALTHY AND UNHEALTHY ABOUT THEIR COMMUNITIES; AND WHAT THEY'D CHANGE IN THEIR COMMUNITIES TO MAKE THEM HEALTHIER. A TOTAL OF 103 ENGLISH AND 50 SPANISH RESPONSES WERE OBTAINED. FOCUS GROUPS INCLUDED 144 COMMUNITY RESIDENTS REPRESENTING LOW INCOME, MEDICALLY UNDERSERVED, MINORITY RESIDENTS AS WELL AS THOSE WITH CHRONIC DISEASES. |
| MARIN GENERAL HOSPITAL | PART V, SECTION B, LINE 6A: OTHER HOSPITALS THAT PARTICIPATED WITH MARIN GENERAL HOSPITAL INCLUDED KAISER FOUNDATION HOSPITAL-SAN RAFAEL AND SUTTER NOVATO COMMUNITY HOSPITAL. |
| MARIN GENERAL HOSPITAL | PART V, SECTION B, LINE 11: IN ORDER TO SELECT THE HOSPITAL PRIORITIES, THE COMMUNITY BENEFIT COMMITTEE REVIEWED THE CHNA DATA AND COMMUNITY-IDENTIFIED PRIORITIES, UPDATED ITS PRIORITIZATION CRITERIA FROM PREVIOUS CHNA PERIODS AND REVIEWED THE AVAILABLE COMMUNITY RESOURCES FOR THE COMMUNITY-IDENTIFIED PRIORITIES. CRITERIA INCLUDED MAGNITUDE AND SEVERITY OF THE HEALTH NEED, OPPORTUNITY FOR MARIN GENERAL HOSPITAL TO MAKE A MEANINGFUL CONTRIBUTION, HEALTH DISPARITIES, ABILITY TO COLLABORATE WITH EXISTING COMMUNITY PARTNERSHIPS, COMMUNITY PRIORITY, OPPORTUNITY TO PREVENT MORE SERIOUS HEALTH ISSUES AND AVAILABILITY OF EFFECTIVE STRATEGIES TO ADDRESS HEALTH ISSUES.MARIN GENERAL HOSPITAL SELECTED ACCESS TO HEALTH CARE AS ITS COMMUNITY HEALTH NEED PRIORITY FOR 2014-2016. IN CONJUNCTION WITH THE CHNA REPORT, MARIN GENERAL HOSPITAL DEVELOPED AN IMPLEMENTATION STRATEGY WORK PLAN. LISTED BELOW IS A DESCRIPTION OF THE SELECTED HEALTH PRIORITY, INCLUDING THE NEED STATEMENT, THE LONG-TERM GOAL AND THE ANTICIPATED IMPACT OF THE STRATEGIES.HEALTH NEED PRIORITYACCESS TO HEALTH CARE/MEDICAL HOMES/INSURANCE COVERAGE IS A HEALTH NEED BECAUSE OF ITS IMPACT ON OBTAINING TIMELY AND EFFECTIVE TREATMENT FOR ALL HEALTH OUTCOME NEEDS SUCH AS CANCER, HEART DISEASE, ASTHMA, MENTAL HEALTH, SUBSTANCE ABUSE AND DIABETES.GOAL: INCREASE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO AND RECEIVE APPROPRIATE HEALTH CARE SERVICES IN MARIN COUNTY.ANTICIPATED IMPACT:A. INCREASED ACCESS TO CARE.B. INCREASED THE NUMBER OF PATIENTS SEEN AND/OR THE RANGE OF SERVICES OFFERED AT COMMUNITY HEALTH CENTERS AND CLINICS.ONGOING PROGRAMS TO ADDRESS SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY:CARE FOR LOW INCOME AND UNINSURED RESIDENTS: THE HOSPITAL WILL CONTINUE TO PROVIDE CHARITY CARE TO THE INDIGENT AND CARE FOR MEDI-CAL BENEFICIARIES FOR WHOM MGH IS REIMBURSED LESS THAN THE COST OF PROVIDING CARE.HEALTH EDUCATION EVENTS: MARIN GENERAL HOSPITAL WILL CONTINUE TO PROVIDE HEALTH EDUCATION PROGRAMS, PATIENT SUPPORT GROUPS AND COMMUNITY CONSULTATION THROUGH PHONE SUPPORT FOR RESIDENTS WITH BREASTFEEDING AND NUTRITION QUESTIONS AS WELL AS LOW-COST MAMMOGRAM SCREENINGS.CENTER FOR INTEGRATIVE HEALTH & WELLNESS: MARIN GENERAL HOSPITAL WILL OFFER INTEGRATIVE HEALTH THERAPIES AND EDUCATIONAL CLASSES TO THE BROADER COMMUNITY.FINANCIAL SUPPORT FOR KEY COMMUNITY HEALTH PROGRAMS: MARIN GENERAL HOSPITAL WILL CONTINUE FINANCIAL AND INKIND SUPPORT TO A VARIETY OF ORGANIZATIONS, WITH PRIORITY GIVEN TO THOSE WHO ARE DIRECTLY HEALTH RELATED AND SUPPORT THE VULNERABLE COMMUNITIES IN MARIN COUNTY.PROFESSIONAL AND STUDENT EDUCATION: MARIN GENERAL HOSPITAL, IN COOPERATION WITH LOCAL COLLEGES AND UNIVERSITIES, WILL CONTINUE TO PROVIDE PRECEPTORSHIPS AND CLINICAL ROTATIONS FOR HEALTH PROFESSIONALS IN DEPARTMENTS SUCH AS NURSING, PHARMACY, RADIOLOGY, RESPIRATORY THERAPY AND REHABILITATION SERVICES AS WELL AS EDUCATION FOR CURRENT PHYSICIANS, NURSES AND STAFF. MARIN GENERAL HOSPITAL ALSO OFFERS JOB-SHADOWING OPPORTUNITIES FOR THOSE INTERESTED IN HEALTH CAREERS.MARIN GENERAL HOSPITAL DOES NOT INTEND TO SPECIFICALLY ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS EXCEPT THROUGH ITS ACCESS PROGRAMS AND COMMUNITY COLLABORATIONS:1. MENTAL HEALTH2. SUBSTANCE ABUSE3. SOCIOECONOMIC STATUS (INCOME, EMPLOYMENT, EDUCATION LEVEL)4. HEALTHY EATING AND ACTIVE LIVING (NUTRITION/HEALTHY FOOD/FOOD ACCESS/PHYSICAL ACTIVITY5. SOCIAL SUPPORTS (FAMILY AND COMMUNITY SUPPORT SYSTEMS AND SERVICES; CONNECTEDNESS)6. CANCER7. HEART DISEASETHE REASONS FOR NOT ADDRESSING THESE NEEDS AS A COMMUNITY BENEFIT PRIORITY INCLUDE: RESOURCE CONSTRAINTS AND LIMITED ABILITY TO HAVE A MEANINGFUL IMPACT. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| MARIN GENERAL HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | WWW.MARINGENERAL.ORG |
| MARIN GENERAL HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | WWW.MARINGENERAL.ORG |
| MARIN GENERAL HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: | WWW.MARINGENERAL.ORG |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| IMAGING CENTER | ||||
| 1350 S ELISEO DRIVE 105 205 | GREENBRAE | CA | 94904 | OUTPATIENT IMAGING |
| ONCOLOGY SERVICES | ||||
| 1350 S ELISEO DRIVE 100 140 | GREENBRAE | CA | 94904 | OUTPATIENT ONCOLOGY |
| OUTPATIENT LAB | ||||
| 655 REDWOOD HWY 100 | MILL VALLEY | CA | 94941 | OUTPATIENT LAB |
| OUTPATIENT LAB | ||||
| 5 BON AIR ROAD 119 | LARKSPUR | CA | 94939 | OUTPATIENT LAB |
| OUTPATIENT LAB | ||||
| 900 S ELISEO DRIVE 104 | GREENBRAE | CA | 94904 | OUTPATIENT LAB |
| PHYSICAL THERAPY | ||||
| 1350 S ELISEO DRIVE 250 | GREENBRAE | CA | 94904 | PHYSICAL THERAPY |
| OUTPATIENT SURGERY CENTER | ||||
| 505 SIR FRANCIS DRAKE BLVD | GREENBRAE | CA | 94904 | OUTPATIENT SURGERY |
| PRIMA MEDICAL FOUNDATION | ||||
| 100 A DRAKES LANDING | GREENBRAE | CA | 94904 | PHYSICIAN'S MEDICAL GROUP |
| OUTPATIENT LAB | ||||
| 100 A DRAKES LANDING | GREENBRAE | CA | 94904 | OUTPATIENT LAB |
| MARIN MAGNETIC IMAGING | ||||
| 1260 S ELISEO | GREENBRAE | CA | 94904 | OUTPATIENT IMAGING |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINE (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: 1) SPECIAL CIRCUMSTANCES CHARITY CARE: A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, INELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING MGH'S CHARITY CARE ELIGIBILITY CRITERIA. 2) CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR INCOME. 3) UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. 4) PROMPT PAYMENT DISCOUNT: ADDITIONAL DISCOUNT FOR PATIENTS RECEIVING THE UNINSURED DISCOUNT OF AT LEAST 10% WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR 20% IF THE 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE. |
| PART I, LINE 6: AVAILABILITY OF COMMUNITY BENEFIT REPORT | MGH POSTS THEIR COMMUNITY BENEFIT REPORT ON THEIR WEBSITE AND SUBMITS THE REPORT TO CALIFORNIA AGENCIES. ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE AT THE MARIN GENERAL HOSPITAL BOARD MEETING AND THE MARIN HEALTHCARE DISTRICT BOARD MEETING. |
| PART I, LINE 7E: COMMUNITY HEALTH IMPROVEMENT SERVICES | COMMUNITY HEALTH IMPROVEMENT SERVICES - CHARITY CARE, MEDI-CAL AND GOVERNMENT MEANS-TESTED PROGRAMS ARE NOT LISTED BELOW BUT ARE INCLUDED IN THE TOTAL QUANTIFIABLE COMMUNITY BENEFIT.-COMMUNITY HEALTH EDUCATION-BREAST CANCER SUPPORT GROUP: OFFERED THROUGH CENTER FOR INTEGRATIVE HEALTH AND WELLNESS-BREASTFEEDING SUPPORT TELEPHONE LINE: FREE ADVICE LINE OPEN TO THE COMMUNITY-CENTER FOR INTEGRATIVE HEALTH AND WELLNESS EVENTS: OFFERED TO THE COMMUNITY TO PROMOTE HEALTH AWARENESS-COMMUNITY REGISTERED DIETITIAN PHONE LINE: FREE ADVICE LINE OPEN TO THE COMMUNITY FOR NUTRITION INFORMATION-FAMILY SAFETY AND CAR SEAT CHECKS: SUPPORT FOR NEW PARENTS IN THE COMMUNITY-HANDS ON CPR AND AED TRAINING: FREE COMMUNITY WIDE CPR AND AED TRAINING-HEART HEALTH PROGRAMS AND EVENTS: OFFERED TRHOUGH CENTER FOR INTEGRATIVE HEALTH AND WELLNESS-INDIGENT FUNDED SERVICES FOR CASE MANAGEMENT: INCLUDING TRANSPORTATION, LODGING, MEALS AND OTHER NEEDS-LOW COST MAMMO DAY: MAMMOGRAMS OFFERED TO UNDERSERVED WOMEN-MARIN COUNTY SENIOR FAIR: BOOTH AT ONE DAY FAIR EVENT FOR SENIORS-MOM'S GROUP: FREE SUPPORT GROUP TO THE COMMUNITY THAT DISCUSSES NEWBORN CARE, BREASTFEEDING, PARENTING, ETC.-NEW FATHER CLASS: FREE CLASS FOR NEW FATHERS ON HAVING A NEWBORN-OUTPATIENT LACTATION CENTER TELEPHONE LINE: PROVIDES LACTATION SUPPORT FOR BREASTFEEDING MOTHERS IN THE COMMUNITY-SHUTTLE PROGRAM FOR SENIOR PARTIAL ADULT DAY CARE PROGRAM: FREE SHUTTLE SERVICES FOR BEHAVIORAL HEALTH PROGRAM-WOMEN'S SUPPORT GROUP: PROVIDES SUPPORT FOR ANAL CANCER |
| PART I, LINE 7F: HEALTH PROFESSIONS EDUCATION | -GRAND ROUNDS: EDUCATION PROGRAMS OPEN TO COMMUNITY DOCTORS AND NURSE PRACTITIONERS-NURSING STUDENT ROTATIONS-BEHAVIORAL HEALTH INTERSHIP PROGRAM: TRAINING HOURS PROVIDED BY STAFF-CASE MANAGEMENT TRAINING OF CASE MANAGEMENT STUDENTS-CHAPLAIN RESIDENT PROGRAM: TRAINING HOURS PROVIDED BY STAFF-PRECEPTORSHIP FOR NUTRITION STUDENTS: TRAINING HOURS PROVIDED BY STAFF-RESPIRATORY THERAPY STUDENTS INTERNS: TRAINING HOURS PROVIDED BY STAFF-TRAUMA: THE MARIN SERIES: EDUCATION CLASSES FOR PARAMEDICS, EMTS, FIRE DEPARTMENT AND OTHER HEALTH CARE WORKERS |
| PART I, LINE 7H: RESEARCH PROGRAMS | THE MARIN CANCER INSTITUTE AT MARIN GENERAL HOSPITAL PARTICIPATES IN CANCER RESEARCH TRIALS. |
| PART I, LINE 7I: CASH AND IN-KIND CONTRIBUTIONS | -CASH DONATIONS-COASTAL HEALTH ALLIANCE: PROVIDES CARE FOR THE UNINSURED-COMPASSIONATE DISCHARGE PRESCRIPTIONS: PROVIDES PRESCRIPTION MEDICATION TO UNDERSERVED-HOMEWARD BOUND OF MARIN: PROVIDES SHELTER AND SERVICES FOR HOMELESS FAMILIES AND INDIVIDUALS-MARIN CITY HEALTH AND WELLNESS: PROVIDES CARE FOR THE UNINSURED-MARIN COMMUNITY CLINICS: MEDICAL CARE PROVIDED TO THE UNDERSERVED-MHD 1206(B) CLINICS: OPERATION OF CLINICS-PRIMA MEDICAL FOUNDATION: SUPPORTING AND SUSTAINING PRIMARY CARE IN MARIN-RITTER CENTER: FOOD PANTRY IN COUNTY-ROTACARE SAN RAFAEL: PROVIDES CARE OFR UNDERSERVED THROUGH ROTACARE PROGRAM-TO CELEBRATE LIFE: PROVIDES SUPPORT FOR UNDERSERVED BREAST CANCER PATIENTS-WHISTLESTOP: PROVIDES PARATRANSIT SUPPORT FOR SENIOR AND DISABLED POPULATION-IN-KIND CONTRIBUTIONS-COMMUNITY DISCHARGE PRESCRIPTIONS: DISCOUNTED PRESCRIPTION PROGRAM-MEETING ROOM SPACE: MEETING ROOMS PROVIDED TO COMMUNITY GROUPS |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES: MARIN GENERAL HOSPITAL PARTICIPATES IN THE HEALTHY MARIN PARTNERSHIP, WHICH IS A COMMUNITY COLLABORATIVE THAT INCLUDES ALL THREE ACUTE CARE HOSPITALS IN THE COUNTY, THE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, COUNTY OFFICE OF EDUCATION, NORTH BAY LEADERSHIP COUNCIL, MARIN COMMUNITY FOUNDATION, HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA, UNITED WAY OF THE BAY AREA AND THE SAN RAFAEL CHAMBER OF COMMERCE. THE HEALTHY MARIN PARTNERSHIP COORDINATES THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND SUPPORTS VARIOUS HEALTHY COMMUNITY INITIATIVES SUCH AS: CHILDREN'S HEALTH INITIATIVE TO ENROLL ELIGIBLE CHILDREN IN HEALTH INSURANCE PROGRAMS; HEALTHY TEENS MARIN WHICH SPONSORS AN ANNUAL PEER SUMMIT COVERING HEALTH-RELATED TOPICS SUCH AS ALCOHOL, TOBACCO AND OTHER DRUG USE, PEER RELATIONS, COMMUNICATION, MENTAL HEALTH, BODY IMAGE, HEALTHY EATING AND MORE; PLAY FAIR MARIN WHICH IS A COLLABORATIVE FORMED TO REPLACE ALCOHOL SPONSORSHIP AT THE MARIN COUNTY FAIR AND WHICH HAS EXPANDED TO INCLUDE SMOKE-FREE FAIR, HEALTHY FAIR FOOD, AND BABY SANCTUARY WITH ROVING HEALTH AMBASSADORS PROVIDING HEALTH INFORMATION TO FAIR GOERS; AND RXSAFE MARIN TO ADDRESS PRESCRIPTION DRUG MISUSE AND ABUSE. EXPENSES REPORTED HERE ARE FOR STAFF PARTICIPATION IN THE HEALTHY MARIN PARTNERSHIP.COALITION BUILDING: MARIN GENERAL HOSPITAL WORKS WITH THE AGRICULTURAL INSTITUTE OF MARIN AND HEALTH COUNCIL OF MARIN TO PROMOTE HEALTHY INITIATIVES IN THE COMMUNITY. |
| PART III, LINE 4: | 1. 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 2.2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.3. ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS - MGH'S NET PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, MGH ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, MGH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PAYMENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), MGH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST ALLOWANCE FOR DOUBTFUL ACCOUNTS.MGH'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 3% AND 5% OF GROSS PATIENT ACCOUNTS RECEIVABLE AT DECEMBER 31, 2014 AND 2013. IN ADDITION, MGH'S WRITE-OFFS WERE APPROXIMATELY $11,609 AND $16,786 FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013. MGH HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2014 OR 2013.SIGNIFICANT CONCENTRATIONS OF NET PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS:COMMERCIAL - 64%MEDICARE - 20%MEDI-CAL - 10%PRIVATE PAY AND OTHER - 6%MGH PROVIDES FOR ESTIMATED LOSSES ON PATIENT ACCOUNTS RECEIVABLE BASED ON PRIOR BAD DEBT EXPERIENCE AND GENERALLY DOES NOT CHARGE INTEREST ON PAST DUE BALANCES. PAST DUE STATUS IS BASED UPON THE DATE OF SERVICES PROVIDED. UNCOLLECTIBLE RECEIVABLES ARE CHARGED OFF WHEN DEEMED UNCOLLECTIBLE. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. |
| PART III, LINE 8: | THE ORGANIZATION DID NOT COUNT THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. ALL MEDICARE REVENUE AND COST WAS INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. |
| PART III, LINE 9B: | COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. 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 30 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. |
| PART VI, LINE 2: | NEEDS ASSESSMENT: IN ADDITION TO THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, HEALTH NEEDS ARE MONITORED AS FOLLOWS:- MARIN GENERAL HOSPITAL PARTICIPATION IN THE HEALTHY MARIN PARTNERSHIP DESCRIBED IN SCHEDULE H, PART II;- MARIN HEALTHCARE DISTRICT BOARD MEETINGS, WHICH INCLUDE PUBLIC COMMENTS AND WHICH THE MARIN GENERAL HOSPITAL CEO ATTENDS AND SHARES COMMUNITY INPUT WITH HOSPITAL STAFF AS APPROPRIATE;- MARIN GENERAL HOSPITAL BOARD MEMBERS ARE ALL COMMUNITY RESIDENTS AND SHARE COMMUNITY HEALTH CONCERNS WHEN APPROPRIATE;- COMMUNITY COMMENTS ON THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE INVITED ON THE MARIN GENERAL HOSPITAL WEBSITE AND ARE MONITORED BY THE COMMUNITY RELATIONS DEPARTMENT. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: MGH'S CHARITY CARE POLICY INCLUDES THE FOLLOWING DETAILS RELATED TO PATIENT EDUCATION FOR ELIGIBIITY ASSISTANCE. COMMUNICATION OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILTY 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 MARIN GENERAL HOSPITAL STANDARIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION". 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL 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 SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, MGH 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 MGH WEBSITE. 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 THIRD-PARTY LIENS, AND DISPUTE INITIATION POLICY. C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVENRMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGES OF MGH'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATION 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 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 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. |
| PART VI, LINE 4: | COMMUNITY INFORMATION: MARIN GENERAL HOSPITAL DEFINES THE COMMUNITY SERVED BY THE HOSPITAL AS THOSE INDIVIDUALS RESIDING WITHIN ITS HOSPITAL SERVICE AREA. A HOSPITAL SERVICE AREA INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS. THE MARIN GENERAL HOSPITAL SERVICE AREA INCLUDES ALL OF MARIN COUNTY. THE CITIES INCLUDED ARE: BELVEDERE, CORTE MADERA, FAIRFAX, LARKSPUR, MILL VALLEY, NOVATO, ROSS, SAN ANSELMO, SAN RAFAEL, SAUSALITO, TIBURON, AND THE COASTAL TOWNS OF STINSON BEACH, BOLINAS, POINT REYES, INVERNESS, MARSHALL, AND TOMALES. CERTAIN SPECIALTY PROGRAMS, INCLUDING ITS TRAUMA SERVICE, SERVE A BROADER POPULATION, INCLUDING PATIENTS FROM SONOMA COUNTY, THE BROADER SAN FRANCISCO BAY AREA AND BEYOND.THE KEY DRIVERS OF HEALTH STATUS ARE INCOME, EDUCATION AND HEALTH INSURANCE. WHILE MARIN COUNTY COMPARES WELL WITH THE STATE, THERE ARE CLEAR VULNERABLE POPULATIONS WHOSE HEALTH STATUS IS MOST AT RISK; 19.14% OF RESIDENTS LIVING BELOW 200% FEDERAL POVERTY LEVEL (FPL); 8.94% OF CHILDREN LIVING BELOW 200% FPL; 8.91% OF RESIDENTS WHO ARE UNINSURED; 7.62% OF RESIDENTS WITHOUT A HIGH SCHOOL DIPLOMA; 15.3% OF RESIDENTS ARE HISPANIC/LATINO; 2.85% OF RESIDENTS ARE BLACK AND 5.63% OF RESIDENTS ARE ASIAN. |
| PART VI, LINE 5: | PROMOTION OF COMMUNITY HEALTH: IN ADDITION TO THE SERVICES LISTED IN PART I, LINE 7, MARIN GENERAL HOSPITAL IS THE ONLY FULL SERVICE ACUTE CARE HOSPITAL IN THE COUNTY, THE ONLY HOSPITAL WITH AN OBSTETRICAL SERVICE OR IN PATIENT BEHAVIORAL HEALTH SERVICE. IT SERVES AS THE TRAUMA CENTER FOR MARIN COUNTY AND SURROUNDING AREAS. THE BOARD OF DIRECTORS IS COMPOSED OF COMMUNITY RESIDENTS. ALL FUNDS ARE USED TO IMPROVE HEALTH CARE SERVICES, MAINTAIN UPTODATE FACILITIES AND SUPPORT TRAINING PROGRAMS FOR HEALTH PROFESSIONALS IN AREAS SUCH AS NURSING, PHARMACY, RADIOLOGY, RESPIRATORY THERAPY, REHABILITATION SERVICES AND BEHAVIORAL HEALTH. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| MARIN GENERAL HOSPITAL VOLUNTEERS | |||||||
| 250 BON AIR RD | GREENBRAE | CA | 94904 | 942823538 | 501(C)(3) | $65,329 | GENERAL SUPPORT |
| MARIN ECONOMIC FORUM | |||||||
| 3501 CIVIC CENTER DRIVE | SAN RAFAEL | CA | 94903 | 680101012 | 501(C)(3) | $10,000 | GENERAL SUPPORT |
| SAN RAFAEL CHAMBER OF COMMERCE | |||||||
| 817 MISSION AVE | SAN RAFAEL | CA | 94901 | 940839470 | 501(C)(6) | $6,000 | GENERAL SUPPORT |
| MARIN GENERAL HOSPITAL FOUNDATION | |||||||
| 100B DRAKES LANDING 255 | GREENBRAE | CA | 94904 | 946127213 | 501(C)(3) | $540,000 | GENERAL SUPPORT |
| PRIMA MEDICAL FOUNDATION | |||||||
| 4 HAMILTON LANDING SUITE 100 | NOVATO | CA | 94949 | 271376321 | 501(C)(3) | $8,998,580 | GENERAL SUPPORT |
| MARIN HEALTHCARE DISTRICT | |||||||
| 100B DRAKES LANDING 200 | GREENBRAE | CA | 94904 | 911886269 | HC DISTRICT ENTITY | $4,935,191 | SUPPORT 1206 CLINICS |
| PALM DRIVE HEALTH CARE DISTRICT DBA PALM DRIVE HOSPITAL | |||||||
| 501 PETALUMA AVE | SEBASTOPOL | CA | 95472 | HC DISTRICT ENTITY | $325,000 | PATIENT SERVICES | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | PATIENT ASSISTANCE | GrantTypeTxt |
| Recipient | 230 | RecipientCnt |
| Cash Grant | $51,886 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL DOES NOT REQUIRE ACCOUNTING OF THE USE OF GRANT FUNDS PROVIDED. IN THE CASES OF GENERAL PURPOSE GRANTS, THE GRANTEE'S CHARITABLE PURPOSE IS REVIEWED PRIOR TO THE ISSUANCE OF THE GRANT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LEE DOMANICO | ||||||||||||||
| CEO/MGH BOARD EX-OFFICIO | $724,625 | $0 | $203,000 | $0 | $196,743 | $0 | $17,419 | $0 | $0 | $0 | $1,141,787 | $0 | $0 | $0 |
| DAVID W COX | ||||||||||||||
| CFO THRU 6/30/14 | $240,981 | $0 | $118,749 | $0 | $0 | $0 | $61,619 | $0 | $11,436 | $0 | $432,785 | $0 | $0 | $0 |
| RONALD K SPERLING | ||||||||||||||
| CFO 6/30-12/15/14 | $300,343 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $300,343 | $0 | $0 | $0 |
| JON D FRIEDENBERG | ||||||||||||||
| CHF ADMINISTRATIVE OFFICER | $377,870 | $0 | $145,177 | $0 | $0 | $0 | $14,722 | $0 | $29,916 | $0 | $567,685 | $0 | $0 | $0 |
| MARK A ZIELAZINSKI | ||||||||||||||
| CHIEF INFO & TECH OFFICER | $306,608 | $0 | $119,643 | $0 | $0 | $0 | $13,485 | $0 | $21,238 | $0 | $460,974 | $0 | $0 | $0 |
| JOEL SKLAR | ||||||||||||||
| CHIEF MEDICAL OFFICER | $277,430 | $0 | $64,250 | $0 | $0 | $0 | $14,466 | $0 | $21,238 | $0 | $377,384 | $0 | $0 | $0 |
| LINDA LANG | ||||||||||||||
| CHF HR OFFICER | $255,037 | $0 | $43,757 | $0 | $0 | $0 | $12,907 | $0 | $10,094 | $0 | $321,795 | $0 | $0 | $0 |
| GOONASAGRIE NAIDOO | ||||||||||||||
| VP OF NURSING THRU 9/12/14 | $267,418 | $0 | $32,370 | $0 | $0 | $0 | -$23,813 | $0 | $23,150 | $0 | $299,125 | $0 | $0 | $0 |
| GREGORY LEE | ||||||||||||||
| CARD CATH TECH IV | $443,822 | $0 | $0 | $0 | $0 | $0 | $30,535 | $0 | $10,094 | $0 | $484,451 | $0 | $0 | $0 |
| SANDY D AUGUSTUS | ||||||||||||||
| CLINICAL RN III | $357,482 | $0 | $0 | $0 | $0 | $0 | $22,589 | $0 | $29,916 | $0 | $409,987 | $0 | $0 | $0 |
| MARGARET M ROBERTS | ||||||||||||||
| CLINICAL RN III | $333,106 | $0 | $0 | $0 | $0 | $0 | $31,573 | $0 | $21,238 | $0 | $385,917 | $0 | $0 | $0 |
| CHUN LI | ||||||||||||||
| CHIEF CLIN PHYSICIST | $280,144 | $0 | $32,160 | $0 | $0 | $0 | $33,413 | $0 | $21,238 | $0 | $366,955 | $0 | $0 | $0 |
| SUSAN S CUMMING | ||||||||||||||
| MEDICAL DIRECTOR MGH | $304,841 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $29,916 | $0 | $334,757 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3, OTHER REPORTABLE COMPENSATION: | THE TAXABLE COMPENSATION RECEIVED BY THE EXECUTIVE TEAM WAS FOR HEALTH AND WELFARE BENEFITS, DEFINED BENEFIT RETIREMENT PENSION PLAN, DISBILITY, LONG-TERM CARE INSURANCE, LIFE INSURANCE AND ACCIDENTIAL DEATH AND DISMEMBERMENT INSURANCE. THE TAXABLE COMPENSATION RECEIVED BY THE KEY EMPLOYEES AND FIVE HIGHEST COMPENSATED EMPLOYEES WAS FOR GROUP TERM LIFE INSURANCE. THE OTHER REPORTABLE COMPENSATION WAS INCLUDED IN THEIR FORM W-2. |
| PART I, LINE 6: | THE CALCULATION OF BONUSES IS DEPENDENT ON MANY FACTORS THAT ARE ASSIGNED VARIOUS WEIGHTINGS. THOSE FACTORS ARE: - PATIENT SATISFACTION SURVEY SCORES - EMPLOYEE SATISFACTION SURVEY SCORES - PHYSICIAN SATISFACTION SURVEY SCORES - EXCESS OF REVENUE OVER EXPENSES - REVENUE GROWTH - COMMUNITY BENEFIT PROGRAMS - QUALITY AND SAFETY RESULTS |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A : EXEMPT PURPOSE ACHIEVEMENTS | MARIN GENERAL HOSPITAL (MGH) IS A NOT-FOR-PROFIT HOSPITAL LOCATED IN GREENBRAE, CALIFORNIA, WITH 235 LICENSED ACUTE CARE BEDS, IT IS THE LARGEST ACUTE CARE HOSPITAL IN MARIN COUNTY AND PROVIDES BOTH PRIMARY AND SECONDARY CARE AND GENERAL SERVICES SUCH AS THE CANCER INSTITUTE AND THE HAYNES CARDIOVASCULAR INSTITUTE. OTHER SERVICES INCLUDE A LEVEL III TRAUMA CENTER AND FULL COMPLEMENT OF ACUTE CARE AND ANCILLARY SERVICES SUCH AS NEONATAL INTENSIVE CARE, PEDIATRICS, A FAMILY BIRTHING CENTER, ADULT BEHAVIORAL HEALTH SERVICES, AN ELECTROPHYSIOLOGY LABORATORY, STROKE PROGRAM AND CARDIAC CATHETERIZATION LABORATORY. MGH IS ACCREDITED BY THE JOINT COMMISSION AND HAS RECEIVED THE HEALTHGRADES DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE FOR THE PAST TWO YEARS. THIS AWARD IS GIVEN TO THE TOP 5% OF HOSPITALS IN THE NATION. MISSION AND VISION: MISSION OF MGH IS AS FOLLOWS: TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. VISION OF MGH IS AS FOLLOWS: TO EXCEED EACH COMMUNITY MEMBER'S HIGHEST EXPECTATIONS FOR QUALITY HEALTH CARE. GOVERNANCE: MGH IS AN INDEPENDENT 501(C)(3) NOT FOR PROFIT HOSPITAL. ITS SOLE CORPORATE MEMBER IS THE MARIN HEALTHCARE DISTRICT, A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA, WHICH RETAINS CERTAIN RESERVE POWERS OVER THE ORGANIZATION. MGH IS GOVERNED BY ITS OWN BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 3 | DURING THE YEAR, THE ORGANIZATION DELEGATED CHIEF FINANCIAL OFFICER DUTIES TO A CONSULTANT, RONALD SPERLING AND INCURRED REPORTABLE COMPENSATION COSTS OF $300,343. |
| FORM 990, PART VI, SECTION A, LINE 6 | MARIN HEALTHCARE DISTRICT IS THE SOLE CORPORATE MEMBER OF MARIN GENERAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF THE GENERAL MEMBER MAY, BY RESOLUTION, AUTHORIZE A PERSON OR COMMITTEE OF PERSONS TO EXERCISE ITS VOTE ON ANY MATTER TO COME BEFORE THE MEMBERSHIP OF THIS CORPORATION. IN ADDITION, THE GENERAL MEMBER MAY EXERCISE ITS MEMBERSHIP RIGHTS AT ANY REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS OF THE GENERAL MEMBER. THE FUNCTIONS REQUIRED BY LAW OR BY THE BYLAWS TO BE PERFORMED AT THE ANNUAL MEMBERSHIP MEETING OR ANY REGULAR OR SPECIAL MEETING OF THE MEMBERS OF THIS CORPORATION MAY BE PERFORMED AT ANY REGULAR OR SPECIAL MEETING OF THE GENERAL MEMBER'S OWN BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | OTHER RESERVED RIGHTS INCLUDE: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. DISPOSITION OF A SIGNIFICANT PORTION OF THE ASSETS OF THE ORGANIZATION; AND C. ISSUANCE OF LONG TERM DEBT EXCEEDING A CERTAIN PORTION OF THE ORGNIZATION'S ASSETS. |
| FORM 990, PART VI, SECTION B, LINE 11 | OUR TAX ADVISOR PROVIDES AND PREPARES THE RETURN IN CONSULTATION WITH OUR ACCOUNTING DEPARTMENT. THE INFORMATION IS THEN REVIEWED BY OUR CHIEF FINANCIAL OFFICER. A COPY OF THE FORM WAS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BOARD FOR THEIR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH INDIVIDUAL BOARD MEMBER AND OFFICER HAS TO SIGN AN ACKNOWLEDGEMENT FORM THAT THEY HAVE READ THE POLICY. A DISCLOSURE STATEMENT IS COMPLETED BY ALL OFFICERS AND BOARD MEMBERS. 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 LEGAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED TRUSTEE 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 TRUSTEE TO LEAVE THE ROOM OR NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED TRUSTEE SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE MGH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE EXECUTIVE COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF MGH'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 AND REGIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS MGH ARE MOST APPROPRIATE. ALL OFFICERS OF THE ORGANIZATION UNDERGO A REVIEW ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | MARIN GENERAL HOSPITAL WILL MAKE THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION -3,947,000. CHANGE IN BENEFIT PLAN -5,730,333. AUDITED FINANCIAL STATEMENT ROUNDING 575. CHANGE IN INVESTMENT - MGHF -4,459,447. |
| FORM 990, PART XII, LINE 2C : AUDIT COMMITTEE AND OVERSIGHT | MARIN GENERAL HOSPITAL HAD AN AUDIT OF ITS BALANCE SHEET AND STATEMENT OF OPERATIONS PERFORMED BY INDEPENDENT AUDITORS. AN AUDIT COMMITTEE SELECTS THE AUDITORS AND REVIEWS RESULTS. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MARIN HEALTHCARE DISTRICT | |||||||||||
| 100 B DRAKES LANDING RD STE 250 | GREENBRAE | CA | 94904 | 911886269 | CORPORATE PARENT | CA | HC DISTRICT ENTITY | N/A | 0 | ||
| MARIN GENERAL HOSPITAL FOUNDATION | |||||||||||
| 100 B DRAKES LANDING RD STE 250 | GREENBRAE | CA | 94904 | 946127213 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | Yes (1) | 11-I | MARIN GENERAL HOSPITAL | |
| PRIMA MEDICAL FOUNDATION | |||||||||||
| 4 HAMILTON LANDING STE 100 | NOVATO | CA | 94949 | 271376321 | PHYSICIAN MEDICAL FOUNDATION | CA | 501(C)(3) | 0 | 9 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MGHSCA LLC | |||||||
| 100B DRAKES LANDING RD STE 190 | GREENBRAE | CA | 94904 | 383861395 | OUTPATIENT SURGERY CENTER | CA | N/A |
| MARIN MAGNETIC RESONANCE IMAGING CENTER | |||||||
| 1260 SOUTH ELISEO | GREENBRAE | CA | 94904 | 680055977 | OUTPATIENT IMAGING | CA | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MARIN GENERAL HOSPITAL FOUNDATION | ||
| B | $540,000 | BOOK VALUE |
| MARIN GENERAL HOSPITAL FOUNDATION | ||
| C | $3,053,477 | BOOK VALUE |
| MARIN GENERAL HOSPITAL FOUNDATION | ||
| M | $592,976 | BOOK VALUE |
| MARIN GENERAL HOSPITAL FOUNDATION | ||
| O | $502,718 | BOOK VALUE |
| MARIN GENERAL HOSPITAL FOUNDATION | ||
| Q | $507,396 | BOOK VALUE |
| PRIMA MEDICAL FOUNDATION | ||
| B | $8,998,580 | BOOK VALUE |
| MARIN MAGNETIC RESONANCE IMAGING CENTER | ||
| S | $530,400 | BOOK VALUE |
| MGHSCA LLC | ||
| S | $602,594 | BOOK VALUE |
| MARIN HEALTHCARE DISTRICT | ||
| R | $4,935,191 | BOOK VALUE |