2014-10-31T12:37:14-05:00 2013-12-31 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DR SUITE 500 SAN DIEGO CA 92122 990 2013-01-01 942988520 SUTTER COAST HOSPITAL % STACEY STACY SUTT 9162866665 800 E WASHINGTON BLVD Suite CRESCENT CITY CA 95531 John Gates CFO 9162866665 2014-10-28 true DEBRA HEISKALA P00649485 9162866665 2013 2015-11-30 17:44:51Z LINDA HORN 800 E WASHINGTON BLVD CRESCENT CITY CA 95531 64335833 false X WWW.SUTTERHEALTH.ORG X 1985 CA SEE SCHEDULE O 9 7 506 55 0 100393 54524 63587913 64250800 1022163 30509 0 0 64710469 64335833 69910 131728 0 0 37066697 35758821 0 0 103079 30377215 30558311 67513822 66448860 -2803353 -2113027 33722848 33659361 20882418 20359017 12840430 13300344 X SEE SCHEDULE O false false 62686359 131728 64250800 SEE SCHEDULE O 62686359 true false false false false false false false false false true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 70 0 true 506 true false false false false false false false false false false X 9 7 false false false false true true true true true false false true true true true true true true true false CA X STACEY STACY 7074644652 785 E WASHINGTON BLVD SUITE 5 CRESCENT CITY CA 95531 MOSH ARSHI DDS TRUSTEE 1.0 0.0 X SUSAN BRISTOW TRUSTEE 1.0 0.0 X MIKE COHILL SVP SUTTER HEALTH 1.0 40.0 X 0 1644928 278172 GREG DUNCAN MD TRUSTEE/CHIEF OF STAFF 1.0 0.0 X NANCY EHORN TRUSTEE, VICE CHAIR 1.0 0.0 X X 0 0 0 KEN HALL TRUSTEE, CHAIR 1.0 0.0 X X JOHN JACOBSON DVM SECRETARY/TRUSTEE 1.0 0.0 X X TOM POLIDORE MD TRUSTEE, F & P COMMITTEE CHAIR 1.0 0.0 X X EUGENE SUKSI CEO Sutter Coast Hospital 40.0 0.0 X X 0 315222 24632 LINDA HORN INTERIM CEO SCH 40.0 0.0 X X 0 321974 12331 JOHN GATES CFO EAST AND WEST REGION 1.0 40.0 X 0 1090616 103106 JOSEPH DICAPO CNE SCH (PART YEAR) 40.0 0.0 X 0 256963 29264 JOHN W TYNES MD PHYSICIAN 40.0 0.0 X 406147 0 38922 ELIE HOBEIKA MD PHYSICIAN 40.0 0.0 X 495041 0 38188 ALEXANDER LEIGHTON MD PHYSICIAN 40.0 0.0 X 233586 0 38506 CHRISTOPHER CUTTER MD PHYSICIAN 40.0 0.0 X 190496 0 35927 LIHJEN WANG DIRECTOR OF PHARMACY 40.0 0.0 X 187561 0 27766 1512831 3629703 626814 49 false true false STAFFASSIST WORKFORCE 62373 COLLECTION CTR DR CHICAGO IL 60693 STAFFING SERVICES 1915177 SOUND INPATIENT PHYSICIAN MED GROU PO BOX 742936 LOS ANGELES CA 90074 PHYSICIAN SERVICES 1493389 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PHYSICIAN SERVICES 810922 SUTTER CONNECT LLC PO BOX 254917 SACRAMENTO CA 95865 BILLING & COLLECTION 755538 CROSS COUNTRY STAFFING INC PO BOX 743425 LOS ANGELES CA 90074 STAFFING SERVICES 496826 35 54524 54524 PATIENT SERVICE REVENUE 622110 64179008 64179008 RENTAL TO AFFILIATES 900099 71792 71792 64250800 30509 30509 0 0 0 0 0 0 0 0 0 0 64335833 64250800 30509 129626 129626 2102 2102 0 0 894159 894159 0 21196461 20585958 553144 57359 1277700 1190672 83710 3318 10500241 9785037 687940 27264 1890260 1761508 123844 4908 457222 457222 121567 121567 31623 31623 0 0 43957 43957 6577757 6541443 36314 82810 635 82175 882639 858900 23739 2251617 2244153 7464 0 1021173 1021173 152951 119458 33493 0 32300 22992 9308 542036 542036 0 3693024 3693024 994268 994268 MEDICAL SUPPLIES 5541737 5527527 14210 PURCHASED SERVICES 4530373 4418760 111613 SUTTER CHARGEBACKS 1214025 1214025 HOSPITAL PROVIDER FEE 49995 49995 2337237 2006059 330256 922 66448860 62686359 3659422 103079 0 0 2414851 2201537 1000 0 11701491 12280978 0 0 0 0 0 0 619321 661807 193848 140552 60510591 44232669 17423415 16277922 14410 0 0 0 0 0 0 0 1354512 2096565 33722848 33659361 6497012 5679132 0 0 0 0 12960829 12863125 0 0 0 0 0 0 0 0 1424577 1816760 20882418 20359017 X 12767044 13220969 73386 79375 0 0 12840430 13300344 33722848 33659361 X -2113027 -43802 2616743 X false true X true false X 0 300000 300000 31990564 23207640 8782924 746504 715610 30894 24622121 20280420 4341701 2851402 28999 2822403 16277922 UNAMORTIZED FINANCING COSTS 97802 OTHER RECEIVABLES 1386154 INTERCOMPANY RECEIVABLES 23199 NOTES RECEIVABLE 9622 OTHER ASSETS 579788 2096565 0 INSURANCE LIABILITIES 358132 3RD-PARTY SETTLEMENTS 1458628 1816760 PART X, LINE 2 THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)) AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2013 AND 2012, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. true true X true X true X true true true false true true 2184063 2184063 0.03290 14317277 13197514 1119763 0.01690 3306649 1328122 1978527 0.02980 19807989 14525636 5282353 0.07960 10 182705 203690 203690 0.00310 1 10 5000 5000 0.00010 1 636 40451 40451 0.00060 15 31319 121688 121688 0.00180 27 214670 370829 370829 0.00560 27 214670 20178818 14525636 5653182 0.08520 false 1232815 21998533 25053150 -3054617 X true true 1 1 SUTTER COAST HOSPITAL 800 E WASHINGTON BLVD CRESCENT CITY CA 95531 WWW.SUTTERHEALTH.ORG 110000067 X X X SUTTER COAST HOSPITAL 1 true X X X X X X X X X 13 true false true X SEE SECTION C X SEE SECTION C X X X X X false false true true 200. true 400. true X X X X X true true X X true false X X X X true X false false LINE 3 IN CONDUCTING ITS MOST RECENT CHNA, SUTTER COAST HOSPITAL DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). KEY INFORMANTS ARE HEALTH AND COMMUNITY EXPERTS FAMILIAR WITH POPULATIONS AND GEOGRAPHIC AREAS RESIDING WITHIN THE HSA. TO GAIN A DEEPER UNDERSTANDING OF THE HEALTH ISSUES PERTAINING TO CHRONIC DISEASE AND THE POPULATIONS LIVING IN THESE VULNERABLE COMMUNITIES, INPUT FROM 11 KEY INFORMANT INTERVIEWS WAS COLLECTED USING A THEORETICALLY GROUNDED INTERVIEW GUIDE (APPENDIX A IN THE CHNA). CONTENT ANALYSIS WAS CONDUCTED ON EACH INTERVIEW TO IDENTIFY KEY THEMES AND IMPORTANT POINTS. INTERVIEWS WERE HELD WITH THE FOLLOWING PEOPLE: * HILDA YEPES CONTRERAS, SITE ADMINISTRATOR FOR DEL NORTE COMMUNITY HEALTH CENTER WITH EXPERTISE IN COMMUNITY HEALTH. INTERVIEW DATE: 4/8/13. * JESSICA VANARSDALE, MD, MPH DIRECTOR OF HEALTH RESEARCH FOR CALIFORNIA CENTER FOR RURAL POLICY WITH EXPERTISE IN RURAL HEALTH AND HEALTH RESEARCH. INTERVIEW DATE: 4/9/13. * CLARKE MOORE, BOARD MEMBER FOR DEL NORTE HEALTH CARE DISTRICT WITH EXERTISE IN COMMUNITY HEALTH. INTERVIEW DATE: 4/10/13. * GENEVA WIKI, EXECUTIVE DIRECTOR FOR WILD RIVERS COMMUNITY FOUNDATION WITH EXPERTISE IN COMMUNITY AND TRIBAL HEALTH. INTERVIEW DATE: 4/11/13. * NANETTE YANDELL, MPH, PUBLIC HEALTH POLICY COORDINATOR FOR DEL NORTE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES WITH EXPERTISE IN COMMUNITY HEALTH AND HEALTH POLICY. INTERVIEW DATE: 4/24/13. * ANNETTE KLINEFELTER, MANAGER OF PLANNING AND PUBLIC DEVELOPMENT AND JESSICA DELANEY, AMERICORPS VISTA FOR CURRY COMMUNITY HEALTH WITH EXPERTISE IN PUBLIC HEALTH AND COMMUNITY ASSESSMENT. INTERVIEW DATE: 5/15/13. * GARY BLATNICK, DIRECTOR OF DEL NORTE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES WITH EXPERTISE IN COMMUNITY HEALTH AND MENTAL HEALTH. INTERVIEW DATE: 6/11/13. * FATHER BERNIE LINDLEY OF ST. TIMOTHY'S EPISCOPAL CHURCH WITH EXPERTISE IN COMMUNITY HEALTH. INTERVIEW DATE: 6/25/13. * RONDA RICHIE, PROGRAM MANAGER FOR HOWONQUET HEAD START WITH EXPERTISE IN COMMUNITY AND TRIBAL HEALTH. INTERVIEW DATE: 6/26/13. * FRANCISCA VAN LITH, VOLUNTEER FOR ST. TIMOTHY'S CLINIC WITH EXPERTISE IN COMMUNITY HEALTH. INTERVIEW DATE: 6/27/13. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER COAST HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. LINE 4 NO OTHER HOSPITALS COLLABORATED ON THE 2013 CHNA OF SUTTER COAST HOSPITAL, MAINLY DUE TO THE RURAL LOCATION AND GEOGRAPHY OF THE HOSPITAL. HOWEVER, THE CHNA WAS STILL A COLLABORATIVE EFFORT. PRIMARY DATA COLLECTION INVOLVED GATHERING INPUT FROM MORE THAN 65 MEMBERS OF THE HOSPITAL SERVICE AREA (HSA), INCLUDING EXPERT INTERVIEWS WITH 11 KEY INFORMANTS AND FOCUS GROUP INTERVIEWS WITH 54 COMMUNITY MEMBERS. IN ADDITION, A COMMUNITY HEALTH ASSETS ASSESSMENT COLLECTED INFORMATION ABOUT 68 ASSETS IN THE GREATER HOSPITAL SERVICE AREA. LINES 5A & 5B FILING ORGANIZATION WEBSITE: HTTP://WWW.SUTTERCOAST.ORG/ABOUT/INDEX.HTML OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML LINE 7 NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER COAST HOSPITAL 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. INABILITY TO FULFILL BASIC NEEDS, INCLUDING FOOD AND SHELTER: THIS NEED IS BEING ADDRESSED BY MANY OTHER AGENCIES AND ORGANIZATIONS IN THE COMMUNITY, INCLUDING BUILDING HEALTHY COMMUNITIES, COMMUNITY ASSISTANCE LEAGUE, LOCAL MINISTRIES, DHHA AND SOVEREIGN NATIONS. AT THIS TIME, SCH DOES NOT HAVE SUFFICIENT RESOURCES (FINANCIAL, PERSONNEL AND EXPERTISE) TO ADDRESS THIS NEED. LIMITED ACCESS TO SAFE AND AFFORDABLE PLACES TO EXERCISE: SCH'S IMPLEMENTATION STRATEGY ADDRESSES HEALTH LITERACY AND EDUCATION OPPORTUNITIES, AND THIS SPECIFIC NEED IS INCLUDING WITHIN EDUCATION. AT THIS TIME, SCH DOES NOT HAVE THE EXPERTISE TO ADDRESS THIS NEED. LIMITED ACCESS TO RELIABLE TRANSPORTATION: AT THIS TIME, SCH DOES NOT HAVE THE RESOURCES TO ADDRESS THIS NEED. HOWEVER, THERE MAY BE OPPORTUNITY TO ADDRESS THIS NEED THROUGH THE EDUCATION AND LITERACY FOCUS. LACK OF ACCESS TO DENTAL CARE: SCH DOES NOT HAVE THE RESOURCES AND EXPERTISE TO ADDRESS THIS NEED. HOWEVER, SCH'S IMPLEMENTATION STRATEGY ADDRESSES HEALTH LITERACY AND EDUCATION OPPORTUNITIES, AND THIS TOPIC WILL BE INCLUDED WITHIN EDUCATION. LINE 12I BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. LINE 14G 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. LINE 20D 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. 3 SUTTER COAST HOSPITAL CLINIC 555 5TH STREET 2 BROOKINGS OR 97415 OUTPATIENT SERVICES SUTTER COAST HEALTH CENTER 780 E WASHINGTON BLVD STE 10 CRESCENT CITY CA 95531 RURAL HEALTH CLINIC SUTTER COAST MATERNITY PROGRAM 785 E WASHINGTON BLVD STE 104 CRESCENT CITY CA 95532 OUTPATIENT SERVICES 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 THAT 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/MEDI-CAL, 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-OFF 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. PART I, LINE 6A SUTTER HEALTH (EIN: 94-2788907), A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT. PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. PART I, LINE 7B IN 2010 THIS ORGANIZATION PARTICIPATED IN THE CALIFORNIA HOSPITAL FEE PROGRAM WHICH PROVIDED SUPPLEMENTAL MEDI-CAL (MEDICAID) PAYMENTS RESULTING IN A MEDICAID BENEFIT CREDIT. PART III, LINE 2 METHODOLOGY FOR CALCULATING BAD DEBT (AT COST): THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3 METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. PART III, LINE 4 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% AND 89% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2013 AND 2012 RESPECTIVELY. 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 33% AS OF 12/31/13 29% AS OF 12/31/12 MEDI-CAL 21% AS OF 12/31/13 23% AS OF 12/31/12 DURING 2013 AND 2012, 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 CHANGES 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 $375 MILLION AND $370 MILLION FOR 2013 AND 2012, RESPECTIVELY. PART III, LINE 7 MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT. 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. PART VI, LINE 2 BETWEEN JANUARY AND AUGUST 2013, VALLEY VISION, INC., CONDUCTED AN ASSESSMENT OF THE HEALTH NEEDS OF RESIDENTS LIVING IN THE SUTTER COAST HOSPITAL SERVICE AREA (HSA). A COMMUNITY-BASED PARTICIPATORY RESEARCH ORIENTATION WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INVOLVED GATHERING INPUT FROM MORE THAN 65 MEMBERS OF THE HSA, INCLUDING EXPERT INTERVIEWS WITH 11 KEY INFORMANTS AND FOCUS GROUP INTERVIEWS WITH 54 COMMUNITY MEMBERS. IN ADDITION, A COMMUNITY HEALTH ASSETS ASSESSMENT COLLECTED INFORMATION ABOUT 68 ASSETS IN THE GREATER HOSPITAL SERVICE AREA. SECONDARY DATA USED INCLUDED HEALTH OUTCOME DATA, SOCIODEMOGRAPHIC DATA, AND BEHAVIORAL AND ENVIRONMENTAL DATA AT THE ZIP CODE OR CENSUS TRACT LEVEL. HEALTH OUTCOME DATA INCLUDED EMERGENCY DEPARTMENT (ED) VISITS, HOSPITALIZATION, AND MORTALITY RATES RELATED TO HEART DISEASE, DIABETES, STROKE, HYPERTENSION, COPD, ASTHMA, SAFETY AND MENTAL HEALTH CONDITIONS. SOCIODEMOGRAPHIC DATA INCLUDED DATA ON RACE AND ETHNICITY, POVERTY (FEMALE-HEADED HOUSEHOLDS, FAMILIES WITH CHILDREN, PEOPLE OVER 65 YEARS OF AGE), EDUCATIONAL ATTAINMENT, HEALTH INSURANCE STATUS, AND HOUSING ARRANGEMENT (OWN OR RENT). FURTHER, BEHAVIORAL AND ENVIRONMENTAL DATA HELPED DESCRIBE GENERAL LIVING CONDITIONS OF THE HSA, SUCH AS CRIME RATES, ACCESS TO PARKS, AVAILABILITY OF HEALTHY FOOD, AND LEADING CAUSES OF DEATH. THE SUTTER COAST HOSPITAL SERVICE AREA (HSA) WAS IDENTIFIED THROUGH THE COLLECTION AND ANALYSIS OF ZIP CODES ASSOCIATED WITH PATIENTS DISCHARGED FROM THE HOSPITAL OVER A SIX-MONTH PERIOD. THROUGH THIS ANALYSIS, IT WAS DETERMINED THAT APPROXIMATELY 90% OF ALL PATIENTS RESIDED IN FIVE ZIP CODES SPLIT BETWEEN TWO COUNTIES AND TWO STATES. WITH THE EXCEPTION OF ZIP CODE 97415 (BROOKINGS, OR) ALL OF THE ZIP CODES IN THE HSA ARE LOCATED IN DEL NORTE COUNTY. A LIST OF PRIORITY HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH CAREFUL ANALYSIS OF BOTH QUANTITATIVE AND QUALITATIVE DATA, FOR SUTTER COAST HOSPITAL'S SERVICE AREA: 1. LACK OF ACCESS TO PRIMARY AND PREVENTATIVE SERVICES 2. LIMITED ACCESS TO MENTAL HEALTH SERVICES 3. INABILITY TO FULFILL BASIC NEEDS, INCLUDING FOOD AND SHELTER 4. LIMITED ACCESS TO RELIABLE TRANSPORTATION 5. LIMITED ACCESS TO SAFE AND AFFORDABLE PLACES TO EXERCISE 6. LACK OF ACCESS TO DENTAL CARE 7. LIMITED HEALTH LITERACY AND HEALTH EDUCATION OPPORTUNITIES THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR SUTTER COAST HOSPITAL IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. PART VI, LINE 3 SUTTER COAST HOSPITAL 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 MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, 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. PART VI, LINE 4 THE SUTTER COAST HOSPITAL SERVICE AREA (HSA) WAS IDENTIFIED THROUGH THE COLLECTION AND ANALYSIS OF ZIP CODES ASSOCIATED WITH PATIENTS DISCHARGED FROM THE HOSPITAL OVER A SIX-MONTH PERIOD. THROUGH THIS ANALYSIS, IT WAS DETERMINED THAT APPROXIMATELY 90% OF ALL PATIENTS RESIDED IN FIVE ZIP CODES SPLIT BETWEEN TWO COUNTIES AND TWO STATES. WITH THE EXCEPTION OF ZIP CODE 97415 (BROOKINGS, OR), ALL OF THE ZIP CODES IN THE HSA ARE LOCATED IN DEL NORTE COUNTY. SUTTER COAST HOSPITAL IS THE ONLY HOSPITAL SERVING THE COMMUNITY. ZIP CODE BOUNDARIES IN RURAL COMMUNITIES ARE SOMETIMES NOT REPRESENTATIVE OF POPULATION DISTRIBUTIONS ACROSS A ZIP CODE. SOME ZIP CODES, LIKE 95543 (GASQUET) AND 95548 (KLAMATH) HAVE POPULATIONS CONCENTRATED IN A RELATIVELY SMALL AREA COMPARED TO THE OVERALL SIZE OF THE ZIP CODE. IN GENERAL, THE HSA IS COMPRISED OF CITIES AND TOWNS THAT ARE SET APART FROM ONE ANOTHER AND SURROUNDED BY LARGE TRACTS OF COASTAL AND FORESTED LAND. SUTTER COAST HOSPITAL IS LOCATED IN DEL NORTE COUNTY, ALONG THE NORTHERN COAST OF CALIFORNIA. THE HSA IS HOME TO MORE THAN 42,000 RESIDENTS. CRESCENT CITY (95531) AND BROOKINGS (97415) ARE THE MOST POPULATED AREAS IN THE HSA, WHILE GASQUET (95543), KLAMATH (95548) AND SMITH RIVER (95567) ARE SMALLER, MORE RURAL COMMUNITIES. HIGHWAY 101 LINKS MOST OF THE COMMUNITIES IN THE HSA AND SERVES AS ITS MAJOR TRANSPORTATION CORRIDOR. THE SUTTER COAST HSA IS BOUNDED BY REDWOOD FORESTS TO THE EAST AND THE PACIFIC OCEAN TO THE WEST, AND ALSO CONTAINS LARGE SECTIONS OF TRIBAL LAND. NATIONAL PARKS AND BEACHES ATTRACT TOURISTS DURING THE SUMMER MONTHS, ALTHOUGH THE AREA IS PRONE TO FOG AND RAIN DURING SEVERAL MONTHS OF THE YEAR. WHITES ACCOUNTED FOR NEARLY THREE QUARTERS OF THE HSA'S RESIDENTS (72.2%). OTHER GROUPS THAT COMPRISED THE BULK OF THE HSA'S POPULATION INCLUDED HISPANICS (14.1%), AND AMERICAN INDIANS (5.2%). IN SOME CATEGORIES, DEL NORTE AND CURRY COUNTIES DEMONSTRATE POOR HEALTH OUTCOMES WHEN COMPARED TO OTHER CALIFORNIA AND OREGON COUNTIES. THE ROBERT WOOD JOHNSON FOUNDATION PRODUCES COUNTY HEALTH RANKINGS AND ROADMAPS FOR NEARLY EVERY COUNTY IN THE UNITED STATES. THE REPORT INCLUDES COUNTY-LEVEL ESTIMATES THAT ARE BASED ON DATA COLLECTED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). THE 2013 REPORT USES DATA COLLECTED OVER A SEVEN-YEAR PERIOD (2005-2011). THE 2013 COUNTY HEALTH RANKINGS INDICATED THAT DEL NORTE COUNTY WAS AMONG THE WORST COUNTIES IN CALIFORNIA FOR OVERALL HEALTH OUTCOMES WITH A RANKING OF 53 OUT OF 57. IN OREGON, CURRY COUNTY FARED SLIGHTLY BETTER WITH A RANKING OF 26 OUT OF 33 COUNTIES. MORTALITY RANKINGS SHOWED DEL NORTE COUNTY RANKED 56 OF 57, WHILE CURRY COUNTY RANKED 31 OF 33. DATA INDICATED THAT 15% OF CURRY COUNTY RESIDENTS SELF-REPORTED THEIR HEALTH AS "POOR OR FAIR," COMPARED TO AN OREGON BENCHMARK OF 14% AND A NATIONAL BENCHMARK OF 10%. FINALLY, CURRY COUNTY RESIDENTS REPORTED THAT ON AVERAGE THEY EXPERIENCED 3.6 DAYS OVER A 30-DAY PERIOD THAT THEIR PHYSICAL HEALTH WAS "NOT GOOD." THIS IS BELOW THE OREGON BENCHMARK OF 3.7 DAYS AND THE ABOVE THE NATIONAL BENCHMARK OF 2.6 DAYS. SELF-REPORTED HEALTH DATA WERE NOT AVAILABLE FOR DEL NORTE COUNTY. MOST OF THE ZIP CODES IN THE SUTTER COAST HOSPITAL HSA HAD NOTABLY HIGHER RATES OF MORTALITY, ED VISITS, AND HOSPITALIZATION DUE TO CHRONIC DISEASES, SUBSTANCE ABUSE, AND MENTAL HEALTH CONDITIONS COMPARED TO COUNTY AND STATE BENCHMARKS. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE SUTTER COAST HOSPITAL CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. PART VI, LINE 5 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 SUTTER COAST HOSPITAL DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW. SUTTER COAST HOSPITAL CURRENTLY PARTNERS WITH OPEN DOOR COMMUNITY HEALTH CENTER IN RECRUITMENT EFFORTS FOR THE COMMUNITY WE SERVE. SCH AND ODCHC ARE THE TWO MAIN CONSTITUENTS WHO RECRUIT NEW PROVIDERS. SCH IS CURRENTLY CONTRACTED WITH TWO OUTSIDE PHYSICIAN RECRUITING FIRMS WITH THE GOAL OF FINDING MORE FAMILY PRACTICE PHYSICIANS AND PEDIATRICIANS. SCH SUCCESSFULLY RECRUITED TWO NEW OB/GYN PHYSICIANS IN 2013. RECRUITING NEW PROVIDERS TO THE COMMUNITY IMPROVES ACCESS TO PRIMARY AND PREVENTATIVE SERVICES. SUTTER COAST HOSPITAL CURRENTLY OFFERS A VARIETY OF HEALTH EDUCATION PROGRAMS. THERE ARE PROGRAMS ON DIABETES IN BOTH COMMUNITIES - DEL NORTE COUNTY, CALIFORNIA AND CURRY COUNTY, OREGON. THERE ARE PROGRAMS FOR HEALTHY PREGNANCY, BREAST FEEDING, WEIGHT MANAGEMENT, CHILDHOOD DEVELOPMENT AND MORE. IN ADDITION, SUTTER COAST HOSPITAL CONTINUES TO SUPPORT ORGANIZATIONS IN THE COMMUNITY, INCLUDING CASA DEL NORTE, ROTARY CLUBS, DEL NORTE LITTLE LEAGUE, DEL NORTE UNIFIED SCHOOL DISTRICT, AND RELAY FOR LIFE. SUTTER COAST HOSPITAL PROVIDES TRANSPORTATION COSTS FOR PATIENTS UNABLE TO DRIVE AND HAVE NO OTHER MEANS OF TRANSPORTATION TO RECEIVE NECESSARY MEDICAL CARE. PART VI, LINE 6 SUTTER COAST HOSPITAL 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. IT'S BETTER FOR PATIENTS: WE BELIEVE THIS COMMUNITY-OWNED, NOT-FOR-PROFIT APPROACH TO HEALTH CARE BEST SERVES OUR PATIENTS AND OUR COMMUNITIES - FOR MULTIPLE REASONS. FIRST OF ALL, IT'S GOOD FOR PATIENTS. ACCORDING TO THE JOURNAL OF GENERAL INTERNAL MEDICINE (APRIL 2000), PATIENTS TREATED AT FOR-PROFIT OR GOVERNMENT-OWNED HOSPITALS WERE TWO-TO-FOUR TIMES MORE LIKELY TO SUFFER PREVENTABLE ADVERSE EVENTS THAN PATIENTS TREATED AT NOT-FOR-PROFIT INSTITUTIONS. OUR STOCKHOLDERS ARE OUR COMMUNITIES: INVESTOR-OWNED, FOR-PROFIT HEALTH SYSTEMS HAVE A FINANCIAL INCENTIVE TO AVOID CARING FOR UNINSURED AND UNDERINSURED PATIENTS. THEY ALSO HAVE A FINANCIAL INCENTIVE TO AVOID HARD-TO-SERVE POPULATIONS AND "UNDESIRABLE" GEOGRAPHIC AREAS SUCH AS RURAL AREAS. FOR MANY NORTHERN CALIFORNIA'S UNDERSERVED RURAL LOCALES, SUTTER HEALTH IS THE ONLY PROVIDER OF HOSPITAL AND EMERGENCY MEDICAL SERVICES IN THE COMMUNITY. PROVIDING CHARITY CARE AND SPECIAL PROGRAMS TO COMMUNITIES: OUR COMMUNITIES' SUPPORT HELPS US EXPAND SERVICES, INTRODUCE NEW PROGRAMS AND IMPROVE MEDICAL TECHNOLOGY. ACROSS OUR NETWORK, EVERY SUTTER HOSPITAL, PHYSICIAN ORGANIZATION AND CLINIC HAS A SPECIAL STORY TO TELL ABOUT FULFILLING VITAL COMMUNITY NEEDS. OUR COMMITMENT TO COMMUNITY BENEFIT: MEETING THE HEALTH CARE NEEDS OF OUR COMMUNITIES IS THE CORNERSTONE OF SUTTER HEALTH'S NOT-FOR-PROFIT MISSION. THIS INCLUDES DIRECTLY SERVING THOSE WHO CANNOT AFFORD TO PAY FOR HEALTH CARE AND SUPPORTING PROGRAMS AND SERVICES THAT HELP THOSE IN FINANCIAL NEED. SUTTER HEALTH NOW PROVIDES AN AVERAGE OF MORE THAN $3 MILLION IN CHARITY CARE PER WEEK. IN 2013, OUR NETWORK OF PHYSICIAN ORGANIZATIONS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS INVESTED $901 MILLION IN HEALTH CARE PROGRAMS, SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED. THIS INCLUDES: * THE COST OF PROVIDING CHARITY CARE; * THE UNPAID COSTS OF PARTICIPATING IN MEDI-CAL; AND * INVESTMENTS IN MEDICAL RESEARCH, HEALTH EDUCATION AND COMMUNITY-BASED PUBLIC BENEFIT PROGRAMS SUCH AS SCHOOL-BASED CLINICS AND PRENATAL CARE FOR PATIENTS. SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS CONTINUED TO GROW, REACHING ANOTHER ALL-TIME HIGH OF $166 MILLION IN 2013. PART VI, LINE 7 CALIFORNIA true DEL NORTE FAMILY RESOURCE CENTER 494 PACIFIC AVE CRESCENT CITY CA 95531 870747878 501(C)(3) 7500 GENERAL SUPPORT Open Door Community Health Center 670 Ninth Street Ste 203 ARCATA CA 95521 952671433 501(c)(3) 101000 GENERAL SUPPORT 2 PART I, LINE 2 ALL GRANTS MUST FALL UNDER ONE OF THE FOLLOWING SELECTION CRITERIA: 1) HEALTHY CHILDREN (NUTRITION, PARENTING, ETC.); 2) HEALTH EDUCATION AND PROMOTION (DRIVEN BY THE COMMUNITY NEED AND REQUEST); 3) HEALTHY BEHAVIORS (DRIVEN BY DEMOGRAPHIC REPORTS FROM THE CALIFORNIA CENTER FOR RURAL HEALTH POLICY). WE DO NOT, HOWEVER, MONITOR THE USE THE GRANT FUNDS PROVIDED. X true true true true false false false false false true false MIKE COHILL SVP SUTTER HEALTH 0 703968 0 718603 0 222357 0 256516 0 21656 0 1923100 0 696352 JOSEPH DICAPO CNE SCH (PART YEAR) 0 148855 0 48572 0 59536 0 13612 0 15652 0 286227 0 48572 JOHN GATES CFO EAST AND WEST REGION 0 870282 0 196871 0 23463 0 84396 0 18710 0 1193722 0 0 EUGENE SUKSI CEO Sutter Coast Hospital 0 70667 0 111385 0 133170 0 14293 0 10339 0 339854 0 125902 JOHN W TYNES MD PHYSICIAN 298533 0 0 0 107614 0 11467 0 27455 0 445069 0 0 0 ELIE HOBEIKA MD PHYSICIAN 262852 0 0 0 232189 0 11467 0 26721 0 533229 0 0 0 ALEXANDER LEIGHTON MD PHYSICIAN 188985 0 27500 0 17101 0 10511 0 27995 0 272092 0 0 0 CHRISTOPHER CUTTER MD PHYSICIAN 168413 0 5000 0 17083 0 8572 0 27355 0 226423 0 0 0 LINDA HORN INTERIM CEO SCH 0 274226 0 0 0 47748 0 11467 0 864 0 334305 0 0 LIHJEN WANG DIRECTOR OF PHARMACY 144963 0 20000 0 22598 0 8440 0 19326 0 215327 0 0 0 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. 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. PLEASE SEE SCHEDULE O, NARRATIVE FOR PART VI, LINE 15 FOR FURTHER INFORMATION. PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING 2013: EUGENE SUKSI: 100,756 JOSEPH DICAPO: 90,480 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. 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. A CSCDA 2011C 680164610 1307954U8 2011-12-22 38777964 SEE PART VI false false false A 0 0 38777964 0 0 38777964 0 0 0 0 0 0 true false true true A 0 A false true false false 0 false 0 false true A true GLOBAL DISCLOSURE PART I, COLUMN (E): THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO CERTAIN SUBSIDIARY ORGANIZATIONS, INCLUDING THE ORGANIZATION. THE OUTSTANDING BOND LIABILITY ALLOCATED TO THIS ORGANIZATION IS REPORTED ON FORM 990, PART X, BALANCE SHEET AND PART VI HEREIN. WITH THE EXCEPTION OF THIS PORTION OF PART VI, THE SCHEDULE K FOR THIS ORGANIZATION IS REPORTING INFORMATION FOR THE ENTIRE BOND ISSUE. PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. SCH SPECIFIC PART I, COLUMN (E): THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNT OF $13,059,964 FROM THE 2011C ISSUE. PART I, COLUMN (F): REFUNDED 1999 CERTIFICATES WHICH REFUNDED 1990 AND 1989 BONDS. FORM 990, PART I, LINE 1 AND PART III, LINE 1 WE ENHANCE THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES. FORM 990, PART III, LINE 4A SUTTER COAST HOSPITAL IS THE SOLE COMMUNITY PROVIDER LOCATED IN THE DEL NORTE COUNTY SEAT OF CRESCENT CITY, CALIFORNIA. SUTTER COAST SERVES A POPULATION OF OVER 40,000 STRETCHED ALONG 80 MILES OF PACIFIC NORTHWEST COASTLINE FROM SOUTH OF CRESCENT CITY, CALIFORNIA TO GOLD BEACH, OREGON. A COMMUNITY-BASED BOARD OF TRUSTEES GOVERNS SUTTER COAST HOSPITAL. SUTTER COAST HOSPITAL IS A 49-BED ACUTE CARE FULL SERVICE HOSPITAL OFFERING CRITICAL CARE, EMERGENCY SERVICES, FAMILY PRACTICE, OBSTETRICS, GYNECOLOGY, INTERNAL MEDICINE, ORTHOPEDICS, OPHTHALMOLOGY, RADIOLOGY, UROLOGY, OTOLARYNGOLOGY AND SURGERY SERVICES. THE HOSPITAL ALSO OFFERS PHYSICAL AND RESPIRATORY THERAPY, A FULL SERVICE COMPUTERIZED LABORATORY, SOCIAL SERVICES AND A CLINICAL PHARMACY. OTHER SPECIALIZED SERVICES INCLUDE AMBULATORY/URGENT CARE, CORONARY CARE, CARDIOLPULMONARY, PRENATAL CARE AND EEG/EKG. THERE WERE 7,286 PATIENT DAYS IN 2013. 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. 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. 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