SUTTER HEALTH PACIFIC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: SUTTER HEALTH PACIFIC (EIN 99-0298651)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-10-30
IRS object ID: 201523039349301087
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 D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-10-30T17:54:45-05:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4370 LA JOLLA VILLAGE DR STE 500	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92122	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	990298651	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SUTTER HEALTH PACIFIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% ROSE CHOY	InCareOfNm
Business Name Control	SUTT	BusinessNameControlTxt
Phone	9162866665	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 OLD FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LEONARD LICINA	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	9162866665	PhoneNum
Signature	2015-10-29	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DEBRA HEISKALA	PreparerPersonNm
PTIN	P00649485	PTIN
Phone	8585357200	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	KAHI MOHALA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	LEONARD LICINA	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$21,798,345	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SUTTERHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1992	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	317	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$145,646	PYContributionsGrantsAmt
CY Contributions Grants	$83,657	CYContributionsGrantsAmt
PY Program Service Revenue	$23,615,169	PYProgramServiceRevenueAmt
CY Program Service Revenue	$21,703,447	CYProgramServiceRevenueAmt
PY Investment Income	$5,532	PYInvestmentIncomeAmt
CY Investment Income	$11,241	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$23,766,347	PYTotalRevenueAmt
CY Total Revenue	$21,798,345	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$16,272,041	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$15,562,797	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$34,035	CYTotalFundraisingExpenseAmt
PY Other Expenses	$5,758,117	PYOtherExpensesAmt
CY Other Expenses	$5,391,287	CYOtherExpensesAmt
PY Total Expenses	$22,030,158	PYTotalExpensesAmt
CY Total Expenses	$20,954,084	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,736,189	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$844,261	CYRevenuesLessExpensesAmt
Total Assets BOY	$13,635,979	TotalAssetsBOYAmt
Total Assets EOY	$11,708,802	TotalAssetsEOYAmt
Total Liabilities BOY	$2,102,083	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,031,097	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$11,533,896	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$9,677,705	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$19,593,799	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$21,703,447	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$19,593,799	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	18	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	317	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	ROSE CHOY	PersonNm
Phone	8086772580	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 OLD FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
J KUHIO ASAM MD
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
DIANNE BROOKINS
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
PATRICK DUARTE
TRUSTEE/VICE CHAIR	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
DAVID HUDSON
TRUSTEE/CHAIR	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
LEONARD LICINA
CEO SUTTER HEALTH PACIFIC	40.0	0.0	Yes (X)	$0	$308,913	$24,527	Yes (X)
CAMERON NEKOTA
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
NANCY E PACE MD MSPH
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
TINA SHELTON
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
DIANE STEWART
TRUSTEE/VICE CHAIR OF FINANCE	1.0	0.0	Yes (X)	$0	$1,783	$0	Yes (X)
JUDGE ALLENE SUEMORI RET
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
JEFFREY VENTURA
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
JAMES E CONFORTI
CEO SHSSR	1.0	40.0	Yes (X)	$0	$1,074,810	$332,008	Yes (X)
ROSE CHOY
CFO SUTTER HEALTH PACIFIC	40.0	0.0		$0	$199,749	$8,972	Yes (X)
PENNY WESTFALL
VP & REGIONAL COUNSEL SHSSR	1.0	40.0		$0	$564,797	$73,392	Yes (X)
STEVEN CHAPLIN MD
MEDICAL DIRECTOR/EX-OFFICIO	40.0	0.0		$507,546	$0	$12,126		Yes (X)
GREGORY PRIER MD
PSYCHIATRIST	40.0	0.0		$281,239	$0	$12,126		Yes (X)
ELENA SHARIPOVA MD
PSYCHIATRIST	40.0	0.0		$264,954	$0	$22,826			Yes (X)
JEREMY ROBERTS MD
PSYCHIATRIST	40.0	0.0		$225,035	$0	$20,620			Yes (X)
JOHN DONKERVOET
DIR. PSYCH,/THERAPUTIC SVCS	40.0	0.0		$127,693	$0	$3,099			Yes (X)
CHRISTINA ENOKA
DIRECTOR HUMAN RESOURCES	40.0	0.0		$129,289	$0	$8,144			Yes (X)
MICHELLE FERNANDEZ
RN MANAGER	40.0	0.0		$123,143	$0	$11,028			Yes (X)
SARAH KREVANS
COO SUTTER HEALTH	0.0	0.0		$0	$1,762,486	$424,237				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,658,899	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,912,538	TotReportableCompRltdOrgAmt
Total Other Compensation	$953,105	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	17	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$3,931	FederatedCampaignsAmt
Government Grants	$62,197	GovernmentGrantsAmt
All Other Contributions	$17,529	AllOtherContributionsAmt
Total Contributions	$83,657	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT SERVICE REVENUE	Desc
Business	622110	BusinessCd
Total Revenue Column	$21,703,447	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,703,447	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$21,703,447	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,131	TotalRevenueColumnAmt
Exclusion	$7,131	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$4,110	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$4,110	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,110	TotalRevenueColumnAmt
Exclusion	$4,110	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$21,798,345	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,703,447	RelatedOrExemptFuncIncomeAmt
Exclusion	$11,241	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$836,849	TotalAmt
Program Services	$457,163	ProgramServicesAmt
Management And General	$379,686	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,473,353	TotalAmt
Program Services	$10,320,497	ProgramServicesAmt
Management And General	$152,856	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$261,347	TotalAmt
Program Services	$256,476	ProgramServicesAmt
Management And General	$4,871	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,049,223	TotalAmt
Program Services	$2,758,412	ProgramServicesAmt
Management And General	$290,811	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$942,025	TotalAmt
Program Services	$907,831	ProgramServicesAmt
Management And General	$34,194	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$90,807	TotalAmt
Management And General	$90,807	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$6,167	TotalAmt
Management And General	$6,167	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$138,321	TotalAmt
Program Services	$138,321	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$26,948	TotalAmt
Program Services	$26,948	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$394,360	TotalAmt
Program Services	$296,339	ProgramServicesAmt
Management And General	$97,829	ManagementAndGeneralAmt
Fundraising	$192	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$52,924	TotalAmt
Program Services	$52,679	ProgramServicesAmt
Management And General	$245	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$831,199	TotalAmt
Program Services	$831,199	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$39,483	TotalAmt
Program Services	$28,967	ProgramServicesAmt
Management And General	$10,516	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$26,333	TotalAmt
Program Services	$26,333	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$264,000	TotalAmt
Program Services	$264,000	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$632,674	TotalAmt
Program Services	$632,674	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$272,578	TotalAmt
Program Services	$272,578	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
FOOD	$383,615	$383,615
MEDICAL SUPPLIES	$293,104	$292,973	$131
PURCHASED SERVICES	$1,009,726	$835,678	$143,864	$30,184
INTERCOMPANY CHARGEBACK	$459,232	$459,232

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$469,816	TotalAmt
Program Services	$351,884	ProgramServicesAmt
Management And General	$114,273	ManagementAndGeneralAmt
Fundraising	$3,659	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,954,084	TotalAmt
Program Services	$19,593,799	ProgramServicesAmt
Management And General	$1,326,250	ManagementAndGeneralAmt
Fundraising	$34,035	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$752,094	BOYAmt
EOY	$540,221	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$21,399	BOYAmt
EOY	$2,271	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,366,117	BOYAmt
EOY	$4,816,514	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$16,987	BOYAmt
EOY	$16,623	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$451,983	BOYAmt
EOY	$481,183	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$13,885,803	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$8,405,816	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$5,737,372	BOYAmt
EOY	$5,479,987	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$290,027	BOYAmt
EOY	$372,003	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$13,635,979	BOYAmt
EOY	$11,708,802	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,301,816	BOYAmt
EOY	$1,154,782	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$800,267	BOYAmt
EOY	$876,315	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,102,083	BOYAmt
EOY	$2,031,097	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,334,134	BOYAmt
EOY	$9,581,886	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$199,762	BOYAmt
EOY	$95,819	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$11,533,896	BOYAmt
EOY	$9,677,705	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$13,635,979	BOYAmt
EOY	$11,708,802	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$844,261	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$8,513	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$2,708,965	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp
Land		LandGrp

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,330,925	OtherCostOrOtherBasisAmt
Depreciation	$6,507,050	DepreciationAmt
Book Value	$4,823,875	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,417,283	OtherCostOrOtherBasisAmt
Depreciation	$1,898,766	DepreciationAmt
Book Value	$518,517	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$137,595	OtherCostOrOtherBasisAmt
Book Value	$137,595	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$5,479,987	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	INSURANCE LIABILITIES	Desc
Amt	$876,315	Amt

Field	Value	IRS element (for citing)
Total Liability	$876,315	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PART X, LINE 2	FormAndLineReferenceDesc
Explanation	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, 2014 AND 2013, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,214	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$38,214	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,444,812	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,615,493	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$1,170,681	NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,483,026	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,615,493	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$1,132,467	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	61	PersonsServedCnt
Total Community Benefit Expns	$57,694	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$57,694	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	153	PersonsServedCnt
Total Community Benefit Expns	$82,124	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$82,124	NetCommunityBenefitExpnsAmt
Total Expense	0.00390	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	4057	PersonsServedCnt
Total Community Benefit Expns	$99,630	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$99,630	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	4271	PersonsServedCnt
Total Community Benefit Expns	$239,448	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$239,448	NetCommunityBenefitExpnsAmt
Total Expense	0.01150	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	4271	PersonsServedCnt
Total Community Benefit Expns	$2,722,474	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,615,493	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$893,019	NetCommunityBenefitExpnsAmt
Total Expense	0.01330	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$4,963	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,963	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$6,212	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,212	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$11,175	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$11,175	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Reimbursed By Medicare	$330,374	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$306,007	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$24,367	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SUTTER HEALTH PACIFIC - KAHI MOHALA	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	91-2301 FORT WEAVER ROAD	AddressLine1Txt
City	EWA BEACH	CityNm
State Abbreviation	HI	StateAbbreviationCd
ZIP	96706	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.kahimohala.org	WebsiteAddressTxt
State License	LICENSE # 33-H	StateLicenseNum

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SUTTER HEALTH PACIFIC - KAHI MOHALA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE PART V, SECTION C	OtherWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Medicare Rates	Yes (X)	MedicareRatesInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. 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 7A, 7B AND 10A	FILING ORG WEBSITE: HTTP://WWW.KAHIMOHALA.ORG/ABOUT/ 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 13H	ELIGIBILITY CRITERIA - OTHER ADDITIONAL FACTOrS USED IN DETERMinING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES.
SCHEDULE H, PART V, SECTION B, LINE 16I	MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE.
SCHEDULE H, PART V, SECTION B, LINE 22D	AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) PARTIAL CHARITY CARE, (3) SPECIAL CIRCUMSTANCES CHARITY CARE, (4) CATASTROPHIC CHARITY CARE, (5) HIGH COST MEDICAL CHARITY CARE, (6) UNINSURED PATIENT DISCOUNT, AND (7) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

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SCHEDULE H, PART I, LINE 3C	TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES APPLIES TO UNINSURED PATIENTS WHOSE FAMILY INCOMES ARE BETWEEN 201% AND 400%. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDICAID, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 350% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURE HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAT 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. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR A 20% DISCOUNT IF 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE.
SCHEDULE H, PART I, LINE 6A	SUTTER HEALTH, A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT.
SCHEDULE H, PART I, LINE 7	MEDICAID REVENUES IN 2014 INCLUDE PROVIDER FEES TO OFFSET MEDICAID & UNCOMPENSATED CARE SHORTFALLS IN PREVIOUS YEARS. 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 SUPPORTS ARMY ONCE SOURCE WHICH HAS CREATED STATE-LEVEL ALLIANCES TO RAISE AWARENESS, IMPROVE SERICE 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 4	AUDIT FOOTNOTE: THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. 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. 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 FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE ESTIMATED BASED UPON AN EVALUATION OF HISTORICAL PAYMENTS, NEGOTIATED CONTRACTS AND GOVERNMENTAL REIMBURSEMENTS. SUTTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 90% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2014 AND 2013. ADJUSTMENTS AND CHANGES IN ESTIMATES ARE RECORDED IN THE PERIOD IN WHICH THEY ARE DETERMINED. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 29% AS OF 12/31/14 33% AS OF 12/31/13 MEDI-CAL 27% AS OF 12/31/14 21% AS OF 12/31/13 DURING 2014 AND 2013, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT THE ESTIMATION MAY CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS 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 $287 MILLION AND $375 MILLION FOR 2014 AND 2013, RESPECTIVELY.
SCHEUDLE H, PART III, LINE 7	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	BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO.
SCHEDULE H, 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 THE 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.
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 OUR 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. 2014 UPDATE ON THE PILOT PROJECT: WE PLANNED TO IMPLEMENT THIS PROJECT IN 2014 BUT EXPERIENCED SETBACKS IN OBTAINING ED PRIVILEGES FOR OUR ADVANCE PRACTICE REGISTERED NURSE. WE WILL CONTINUE TO SEEK OPPORTUNITIES TO SUPPORT EMERGENCY ROOMS TO ASSESS, EVALUATE, AND DE-ESCALATE PATIENTS IN CRISIS. 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 2014, KAHI MOHALA SET-UP A SINGLE POINT OF CONTACT WITH WCCHC, WHICH RESULTED IN PATIENTS GETTING FASTER APPOINTMENTS TO AFTER CARE. 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	KAHI MOHALA IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF ALMOST 50,000 PHYSICIANS, EMPLOYEES, AND VOLUNTEERS WHO CARE FOR MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS.
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT: CALIFORNIA

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
STEVEN CHAPLIN MD
MEDICAL DIRECTOR/EX-OFFICIO	$223,618	$0	$280,892	$0	$3,036	$0	$5,199	$0	$6,927	$0	$519,672	$0	$0	$0
ROSE CHOY
CFO SUTTER HEALTH PACIFIC	$0	$143,410	$0	$47,130	$0	$9,209	$0	$8,112	$0	$860	$0	$208,721	$0	$5,400
LEONARD LICINA
CEO SUTTER HEALTH PACIFIC	$0	$204,009	$0	$72,833	$0	$32,071	$0	$11,538	$0	$12,989	$0	$333,440	$0	$0
GREGORY PRIER MD
PSYCHIATRIST	$184,432	$0	$96,527	$0	$280	$0	$5,199	$0	$6,927	$0	$293,365	$0	$0	$0
ELENA SHARIPOVA MD
PSYCHIATRIST	$171,071	$0	$93,793	$0	$90	$0	$5,199	$0	$17,627	$0	$287,780	$0	$0	$0
JEREMY ROBERTS MD
PSYCHIATRIST	$420	$0	$224,594	$0	$21	$0	$4,501	$0	$16,119	$0	$245,655	$0	$0	$0
PENNY WESTFALL
VP & REGIONAL COUNSEL SHSSR	$0	$340,787	$0	$195,043	$0	$28,967	$0	$62,721	$0	$10,671	$0	$638,189	$0	$0
JAMES E CONFORTI
CEO SHSSR	$0	$594,704	$0	$425,250	$0	$54,856	$0	$309,954	$0	$22,054	$0	$1,406,818	$0	$50,081
SARAH KREVANS
COO SUTTER HEALTH	$0	$916,159	$0	$689,878	$0	$156,449	$0	$399,554	$0	$24,683	$0	$2,186,723	$0	$142,787

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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	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	THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S 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. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B 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 EARNINGS BEYOND THE 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 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S 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	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% OF GROSS PAY. 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 +/- 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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 HOSPITAL, AN 88 BED, FREESTANDING PSYCHIATRIC HOSPITAL. KAHI MOHALA HOSPITAL 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, WITH THE EXCEPTION OF THE LONGER TERM PROGRAMS FOR CHILDREN AND ADOLESCENTS, WHICH ARE ACCREDITED UNDER THE CONSOLIDATED STANDARDS. THERE WERE 25,060 PATIENT DAYS IN 2014. 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 BEHAVIORAL HEALTH 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 INPATIENT - CHILDREN AGES 3-12 - ADOLESCENTS AGES 13-18 - ADULTS AGES 18 AND UP - RESIDENTIAL TREATMENT PROGRAMS - CHILDREN AGES 3-12 - ADOLESCENTS AGES 13-18 - PARTIAL HOSPITALIZATION - ADOLESCENTS AGES 13-18 - ADULTS AGES 18 AND UP - ELECTROCONVULSIVE THERAPY (ECT) - ADULTS AGES 18 AND UP 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 STUDENT'S 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 CHILDREN'S COUNCIL (CCCS), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, HAWAII 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 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 ENVIROMNENT 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 12	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, LINE 15	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 2014.
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) ($2,800,000) EQUIPMENT ACQUISITION $ 91,035 ----------- TOTAL ($2,708,965)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ADOLESCENT TREATMENT CENTERS INC
390 40TH STREET	OAKLAND	CA	94609	680088443	HEALTHCARE	CA	501(C)(3)	3	SUTTER EBH	Yes (true)
BETTER HEALTH EAST BAY FOUNDATION
3012 SUMMIT STREET 3RD FLOOR	OAKLAND	CA	94609	510160184	FUNDRAISING	CA	501(C)(3)	7	SUTTER EBH	Yes (true)
CALIFORNIA PACIFIC MEDICAL CTR FOUND
2015 STEINER STREET 2ND FLOOR	SAN FRANCISCO	CA	94115	942728423	FUNDRAISING	CA	501(C)(3)	7	SUTTER WBH	Yes (true)
EAST BAY PERINATAL CENTER
3012 SUMMIT STREET 3RD FLOOR	OAKLAND	CA	94609	510172285	HEALTHCARE	CA	501(C)(3)	3	SUTTER EBH	Yes (true)
EDEN MEDICAL CENTER
20103 LAKE CHABOT ROAD	CASTRO VALLEY	CA	94546	942948100	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
MEMORIAL HOSPITAL FOUNDATION
1800 COFFEE ROAD SUITE 76	MODESTO	CA	95355	942290244	FUNDRAISING	CA	501(C)(3)	11a - I	SUTTER CVH	Yes (true)
MILLS-PENINSULA HEALTH SERVICES
1501 TROUSDALE DRIVE	BURLINGAME	CA	94010	941156265	HOSPITAL	CA	501(C)(3)	3	PAMF	Yes (true)
MILLS-PENINSULA HOSPITAL FOUNDATION
1501 TROUSDALE DRIVE	BURLINGAME	CA	94010	237288765	FUNDRAISING	CA	501(C)(3)	7	MPHS	Yes (true)
PALO ALTO MEDICAL FOUNDATION
2350 EL CAMINO REAL	MOUNTAIN VIEW	CA	94040	941156581	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SAMUEL MERRITT UNIVERSITY
450 30TH STREET 2840	OAKLAND	CA	94609	942992642	UNIVERSITY	CA	501(C)(3)	2	SUTTER EBH	Yes (true)
SUTTER AUBURN FAITH HOSPITAL FOUNDATION
11815 EDUCATION ST	AUBURN	CA	95602	942594966	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes (true)
SUTTER CENTRAL VALLEY HOSPITALS
1800 COFFEE ROAD SUITE 76	MODESTO	CA	95355	941080917	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER COAST HOSPITAL
800 E WASHINGTON BLVD	CRESCENT CITY	CA	95531	942988520	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER DAVIS HOSPITAL FOUNDATION
PO BOX 1617	DAVIS	CA	95617	680217870	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes (true)
SUTTER EAST BAY HOSPITALS
3012 SUMMIT STREET 3RD FLOOR	OAKLAND	CA	94609	941196176	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER EAST BAY MEDICAL FOUNDATION
3687 MT DIABLO BLVD 200	LAFAYETTE	CA	94549	942690415	HEALTHCARE	CA	501(C)(3)	11b - II	SUTTER HLTH	Yes (true)
SUTTER GOULD MEDICAL FOUNDATION
600 COFFEE ROAD	MODESTO	CA	95355	941682256	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER HEALTH
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	942788907	SUPPORTING OR	CA	501(C)(3)	11c III-FI	NA	false
SUTTER HEALTH PLAN
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	461183948	HEALTH PLAN	CA	PENDING	PENDING	SUTTER HLTH	Yes (true)
SUTTER HEALTH SACRAMENTO SIERRA REGION
PO BOX 160727	SACRAMENTO	CA	95816	941156621	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER INSURANCE SERVICES CORPORATION
745 FORT STREET SUITE 800	HONOLULU	HI	96813	990289310	INSURANCE SER	HI	501(C)(3)	11c III-FI	SUTTER HLTH	Yes (true)
SUTTER MEDICAL CENTER FOUNDATION
PO BOX 160727	SACRAMENTO	CA	95816	942788906	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes (true)
SUTTER MEDICAL CENTER CASTRO VALLEY
2200 RIVER PLAZA DRIVE	SACRAMENTO	CA	95833	770146047	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER MEDICAL FOUNDATION
2800 L STREET 7TH FLOOR	SACRAMENTO	CA	95816	680273974	HEALTHCARE	CA	501(C)(3)	11b - II	SUTTER HLTH	Yes (true)
SUTTER ROSEVILLE MEDICAL CTR FOUNDATION
ONE MEDICAL PLAZA	ROSEVILLE	CA	95661	680040113	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes (true)
SUTTER SOLANO CHARITABLE FOUNDATION
300 HOSPITAL DRIVE	VALLEJO	CA	94589	942668262	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes (true)
SUTTER VISITING NURSE ASSOC AND HOSPICE
1900 POWELL ST 300	EMERYVILLE	CA	94608	946068843	HEALTHCARE	CA	501(C)(3)	9	SUTTER HLTH	Yes (true)
SUTTER WEST BAY HOSPITALS
2333 BUCHANAN STREET	SAN FRANCISCO	CA	94115	940562680	HOSPITAL	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
SUTTER WEST BAY MEDICAL FOUNDATION
2015 STEINER STREET 1ST FLOOR	SAN FRANCISCO	CA	94115	942948131	HEALTHCARE	CA	501(C)(3)	3	SUTTER HLTH	Yes (true)
TRACY HOSPITAL FOUNDATION
1420 N TRACY BLVD	TRACY	CA	95376	680318845	FUNDRAISING	CA	501(C)(3)	11a - I	SUTTER CVH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MAGNETIC IMAGING AF
175 LENNON	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
175 LENNON	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	NA	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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	HEALTH VENTURES INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	350 HAWTHORNE ST	AddressLine1Txt
City	OAKLAND	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94609	ZIPCd

Field	Value	IRS element (for citing)
EIN	942918780	EIN
Primary Activities	HEALTH SERVICES	PrimaryActivitiesTxt
Legal Domicile State	CA	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C CORP	EntityTypeTxt
Controlled Organization	Yes (true)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd