2014-11-13T15:48:14-06:00 2013-12-31 861065772 DELOITTE TAX LLP 555 MISSION STREET SAN FRANCISCO CA 94105 990 2013-01-01 941461843 JOHN MUIR HEALTH JOHN 9259393000 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 MICHAEL MOODY CFO 9259393000 2014-11-07 1 JOAN S MCMAHON P00966494 4157834000 2013 2015-11-30 17:44:51Z MICHAEL MOODY 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 1414214215 0 X WWW.JOHNMUIRHEALTH.COM X 1958 CA TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION 15 8 5971 1600 4354708 -648321 4105048 3699470 1195995964 1166718051 47101504 64226111 42940493 38283080 1290143009 1272926712 6134770 12775105 0 0 659774951 648015674 0 0 0 496753347 525245038 1162663068 1186035817 127479941 86890895 2150008139 2419203102 934485305 1017643102 1215522834 1401560000 X THE MISSION OF JOHN MUIR HEALTH IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION. JOHN MUIR HEALTH OFFERS THE COMMUNITY A NETWORK OF PRIMARY CARE AND SPECIALTY PHYSICIANS, TWO MEDICAL CENTERS, INCLUDING THE COUNTY'S ONLY TRAUMA CENTER, AND A BEHAVIORAL HEALTH CENTER. THE HEALTH SYSTEM ALSO OFFERS A FULL-RANGE OF MEDICAL SERVICES, INCLUDING PRIMARY CARE, OUTPATIENT AND IMAGING SERVICES, AND IS WIDELY RECOGNIZED AS A LEADER IN MANY SPECIALTIES NEUROSCIENCES, ORTHOPEDIC, CANCER, CARDIOVASCULAR, TRAUMA, EMERGENCY, PEDIATRICS AND HIGH-RISK OBSTETRICS CARE. 0 0 431204329 12775105 426283556 HOSPITAL SERVICES - GENERAL MEDICINE AND SURGERY. THE CORE OF JOHN MUIR HEALTH'S SERVICE TO THE COMMUNITY IS IN ITS GENERAL MEDICINE AND SURGERY PROGRAM, WHICH PROVIDES COMPREHENSIVE CARE FROM EMERGENCY SERVICES TO HIGH LEVEL CRITICAL CARE TO DISCHARGE SUPPORT AND HOME HEALTH FOR PATIENTS WITH A VARIETY OF CONDITIONS. JOHN MUIR MEDICAL CENTER, WALNUT CREEK SERVES AS THE ONLY COUNTY-DESIGNATED TRAUMA CENTER FOR THE AREA, WORKING CLOSELY WITH LOCAL EMERGENCY SERVICES LEADERS. NATIONAL RECOGNITIONS RECEIVED IN 2013 INCLUDE (1) RECOGNITION OF JOHN MUIR MEDICAL CENTER, WALNUT CREEK BY U.S. NEWS & WORLD REPORT FOR THE SEVENTH YEAR IN A ROW AS ONE OF "AMERICA'S BEST HOSPITALS" FOR GASTROENTEROLOGY & GI SURGERY, GYNECOLOGY, GERIATRICS AND ORTHOPEDICS, (2) RECOGNITION OF JOHN MUIR MEDICAL CENTER, CONCORD BY U.S. NEWS & WORLD REPORT AS ONE OF "AMERICA'S BEST HOSPITALS" FOR DIABETES & ENDOCRINOLOGY AND ORTHOPEDICS, (3) RECOGNITION OF 12 SERVICES COMBINED AT THE WALNUT CREEK AND CONCORD HOSPITALS AS NATIONALLY RANKED OR HIGH PERFORMING BY U.S. NEWS & WORLD REPORT (4) U.S. NEWS AND WORLD REPORT ALSO RANKED JOHN MUIR MEDICAL CENTER, WALNUT CREEK #2 AND JOHN MUIR MEDICAL CENTER, CONCORD #3 OUT OF ALL 45 HOSPITALS IN THE SAN FRANCISCO-OAKLAND AREA BASED ON PATIENT SURVIVAL, PATIENT SAFETY, CARE-RELATED FACTORS SUCH AS NURSING AND PATIENT SERVICES, AND REPUTATION. THE TWO HOSPITALS WERE ALSO RANKED #7 AND #11 IN CALIFORNIA OUT OF 400 HOSPITALS, (5) JOHN MUIR MEDICAL CENTER, WALNUT CREEK WAS NAMED ONE OF AMERICA'S 100 BEST HOSPITALS BY HEALTHGRADES, (6) JOHN MUIR MEDICAL CENTER , CONCORD WAS RANKED AS ONE OF THE COUNTRY'S 100 GREAT COMMUNITY HOSPITALS BY BECKER'S HEALTHCARE REVIEW (7) JOHN MUIR MEDICAL CENTER, WALNUT CREEK WAS RANKED AMONG THE TOP FIVE PERCENT OF HOSPITALS NATIONALLY FOR QUALITY OF CARE BY HEALTHGRADES, AND BOTH HOSPITALS RECEIVED FIVE-STAR RATINGS AND RANKINGS IN THE TOP 10% IN THE NATION FOR SEVERAL SERVICES, PROCEDURES AND TREATMENTS. OUR PROGRAM EMPHASIS IN 2013 WAS ON CONTINUED OUTREACH TO UNINSURED, UNDERSERVED, AND VULNERABLE POPULATIONS IN OUR SERVICE AREA THROUGH COMMUNITY PARTNERSHIPS TO PROVIDE DIRECT SERVICES INCLUDING GERIATRIC CARE COORDINATION, MOBILE DENTAL CLINIC, MOBILE HEALTH CLINIC, AND SUPPORT FOR TEEN PREGNANCY PROGRAMS, OPERATION ACCESS (A PROGRAM WHEREBY INDIGENT AND THOSE IN NEED RECEIVE FREE SURGICAL AND HOSPITAL CARE FOR ACUTE CONDITIONS), VIOLENCE PREVENTION, AND PARISH-BASED NURSING. 115380581 125680138 CARDIOVASCULAR CARE IS THE SECOND LARGEST HOSPITAL-BASED SERVICE OF JOHN MUIR HEALTH. ACHIEVEMENTS IN 2013 INCLUDED RECOGNITION BY THE AMERICAN HEART ASSOCIATION OF JOHN MUIR HEALTH'S CONCORD MEDICAL CENTER FOR PROVIDING OUTSTANDING CARE TO HIGH RISK HEART ATTACK PATIENTS BY AWARDING THE MISSION LIFELINE GOLD PERFORMANCE ACHIEVEMENT AWARD FOR STEMI CARE. JOHN MUIR HEALTH'S CONCORD AND WALNUT CREEK MEDICAL CENTERS ALSO RECEIVED THE GOLD PLUS ACHIEVEMENT AWARD FOR HEART FAILURE CARE, AND THE GET WITH THE GUIDELINES PLATINUM AWARD FOR HEART ATTACK CARE. BOTH JOHN MUIR HEALTH MEDICAL CENTERS HOLD THE HIGHEST LEVEL OF ACCREDITATION FROM THE SOCIETY OF CHEST PAIN CENTERS AND ARE DESIGNATED AS HIGH-RISK HEART ATTACK (STEMI) RECEIVING CENTERS BY THE COUNTY DEPARTMENT OF EMERGENCY MEDICAL SERVICES. 95461361 156532418 WOMEN'S AND CHILDREN'S IS THE THIRD LARGEST PROGRAM WITHIN JOHN MUIR HEALTH. ACHIEVEMENTS IN 2013 INCLUDED, (1) REDUCED THE NUMBER OF TIMES CRITICALLY ILL NEWBORNS WERE TRANSFERRED TO OTHER HOSPITALS FOR PEDIATRIC SPECIALTY CARE AND MINOR SURGERIES BY ARRANGING FOR LOCAL CONSULTATIONS BY PEDIATRIC SPECIALISTS, (2) EXPERIENCED CONSISTENT GROWTH IN THE CENTER FOR WOMEN'S CONTINENCE AND PELVIC HEALTH RESULTING IN 70% OF PATIENTS REPORTING SUCCESSFUL TREATMENT WITHOUT INVASIVE SURGERY, (3)INTRODUCED NEW PEDIATRIC SURGICAL SUBSPECIALISTS IN GENERAL AND ORTHOPEDIC SURGERY AND PEDIATRIC MEDICAL SUBSPECIALISTS IN RHEUMATOLOGY AND PULMONOLOGY ALLOWING FOR CHILDREN REQUIRING THESE SERVICES TO STAY IN OUR COMMUNITY FOR THEIR CARE, (4) IMPLEMENTED QUALITY IMPROVEMENT INITIATIVES INCLUDING DVT PROPHYLAXIS FOR GYN SURGERIES AND CASE TRACKING FOR SERIAL READMISSIONS FOR UROSEPSIS THROUGH THE CENTER FOR WOMEN'S CONTINENCE, (5) CONTINUED CHILD-FRIENDLY POLICIES TO SUPPORT PROCESSES FOR PEDIATRIC PATIENTS INCLUDING FAMILY CENTERED CARE, POLICIES FOR PROCEDURES AND ADMISSIONS TO JOHN MUIR HEALTH AND ACCOMMODATION FOR FAMILIES WHO HAVE CHILDREN ADMITTED TO THE HOSPITAL, (6) ADDED A CHILD LIFE SPECIALIST WHO HELPS CHILDREN COPE WITH THE STRESS OF MEDICAL PROCEDURES OR STAYING IN THE HOSPITAL BY HELPING THEM FEEL MORE IN CONTROL AND GIVING THEM SPACE TO PLAY AND BE KIDS. 407731137 488283726 407731137 488283726 1049777408 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 750 0 1 5971 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 15 8 1 0 1 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X X MICHAEL MOODY 9259393000 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 DAVID L GOLDSMITH CHAIR 5.00 3.00 X X 0 0 0 THOMAS G RUNDALL PHD VICE CHAIR 5.00 3.00 X X 0 0 0 PHILIP J BATCHELOR TREASURER 5.00 3.00 X X 0 0 0 WILLIAM F CRONK SECRETARY 5.00 3.00 X X 0 0 0 CALVIN KNIGHT PRESIDENT/CEO/DIRECTOR 60.00 3.00 X X 1468271 0 703952 MICHAEL MOODY CFO 60.00 3.00 X 669105 0 238289 NANCY OLSON ASSISTANT SECRETARY 60.00 3.00 X 615895 0 186371 LINDA BEST DIRECTOR 5.00 3.00 X 0 0 0 ROBERT E EDMONDSON DIRECTOR 5.00 3.00 X 2083 0 0 MARILYN M GARDNER DIRECTOR 5.00 3.00 X 2083 0 0 RAVI HUNDAL MD DIRECTOR 5.00 3.00 X 0 0 0 TAEJOON AHN MD DIRECTOR 5.00 3.00 X 0 0 0 MARK MUSCO MD DIRECTOR 5.00 3.00 X 0 0 0 BIMAL PATEL MD DIRECTOR 5.00 3.00 X 0 0 0 DEBORAH L KERLIN MD DIRECTOR 5.00 3.00 X 1250 0 0 DAVID BIRDSALL MD DIRECTOR 5.00 3.00 X 0 0 0 MIKE ROBINSON DIRECTOR 5.00 3.00 X 0 0 0 STUART B SHIKORA MD DIRECTOR (THROUGH SEPT) 5.00 3.00 X 0 0 0 F RYAN ANDERSON MD DIRECTOR (THROUGH SEPT) 5.00 3.00 X 0 0 0 SAN S YUAN MD DIRECTOR (THROUGH SEPT) 5.00 3.00 X 0 0 0 RONALD K MULLIN DIRECTOR (THROUGH SEPT) 5.00 3.00 X 0 0 0 JOHN D ZUORSKI MD DIRECTOR (THROUGH DEC) 5.00 3.00 X 62400 0 0 WILLIAM K HODDICK MD DIRECTOR (THROUGH DEC) 5.00 3.00 X 615 0 0 PATRICIA E CURTIN DIRECTOR (THROUGH FEB) 5.00 3.00 X 0 0 0 IRVING PIKE CMO 60.00 X 605064 0 203529 JANE WILLEMSEN CAO (WALNUT CREEK CAMPUS) 60.00 X 715619 0 366502 MICHAEL THOMAS CAO (CONCORD CAMPUS) 60.00 X 652726 0 325633 GEORGE KAZAGLIS VP/COO 60.00 X 634758 0 153068 MARTI TARNOWSKI VP PLANNING & MARKETING 60.00 X 488628 0 192582 MICHAEL MONALDO VP FACILITIES DEVELOPMENT 60.00 X 458258 0 146398 DEBRA PENDERGAST VP PATIENT CARE SERVICES 60.00 X 469046 0 166132 DONNA BRACKLEY CHIEF NURSING OFFICER 60.00 X 427876 0 171809 KENNETH MEEHAN FORMER EXECUTIVE VP OPERATIONS 0.00 X 881494 0 471154 8155171 0 3325419 2317 1 1 0 IMPACT ADVISORS LLC 931 WEST 75TH STREET SUITE 137-304 NAPERVILLE IL 60565 CONSULTING SERVICES 12052211 PARTNER PROFESSIONAL SOLUTIONS LLC 4605 GALBRATH CINCINNATI OH 45248 CONSULTING SERVICES 6620985 OXFORD GLOBAL RESOURCES INC PO BOX 3256 BOSTON MA 02241 STAFFING SERVICES 6095915 CROSS COUNTRY STAFFING LA LOCKBOX FILE 50941 LOS ANGELES CA 90074 STAFFING SERVICES 4750615 HEALTHCARE SECURITY SERVICES OF CA INC PO BOX 17033 DENVER CO 80217 SECURITY SERVICES 4250235 167 39600 3659870 3699470 PATIENT REVENUE 900099 902750450 902750450 MEDICARE REVENUE 900099 258129154 258129154 PREMIUM REVENUE 900099 5838447 5838447 1166718051 9633557 9633557 6040828 1128745 4912083 4912083 4912083 157593647 37104426 94515296 45590223 63078351 -8485797 54592554 -8143000 62735554 137960 39600 53239 84721 84721 OTHER OPERATING INCOME 900099 33286276 28931568 4354708 33286276 1272926712 1187506619 4354708 77365915 12735105 12735105 40000 40000 4726680 4197765 528915 486709185 432289955 54419230 20320708 17602503 2718205 110252624 101308077 8944547 26006477 21661517 4344960 7681741 3861504 3820237 385902 192951 192951 13897805 9752714 4145091 1215189 874761 340428 20885845 19726022 1159823 58672017 55174385 3497632 8081268 4251704 3829564 SUPPLIES 122436924 120215867 2221057 0 PURCHASED SERVICES 114249525 100105821 14143704 0 BAD DEBT EXPENSE 67989914 67989914 0 0 PROFESSIONAL FEES 47899038 46871826 1027212 0 61849870 30925017 30924853 1186035817 1049777408 136258409 0 122027751 141431635 223441904 203581685 7023087 6606789 14409227 15783218 1510286352 577897576 924315329 932388776 761702200 890177316 0 106022000 0 6501811 97088641 116709872 2150008139 2419203102 186041473 199321006 428436740 540268547 89800000 89800000 230207092 188253549 934485305 1017643102 X 1214386265 1400106000 1136569 1454000 1215522834 1401560000 2150008139 2419203102 X 86890895 55108271 -10786000 54824000 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 0 0 1 56184 56184 0 PART II-B, LINE 1: JOHN MUIR HEALTH CONTRIBUTED $56,184 TO CALIFORNIA HOSPITALS COMMITTEE ON ISSUES (CHCI) SPONSORED BY CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) IN 2013 TO SUPPORT LOBBYING EFFORTS. 16353302 4208174 1183086 4756777 16987785 17002903 2037125 859349 3546075 16353302 37397465 4810336 10029 25214927 17002903 28132000 9915590 599321 1249446 37397465 33638031 12706231 1333441 19545703 28132000 0.28000 0.72000 0 1 1 34416748 34416748 892597324 248367495 644229829 6195755 2814332 3381423 482382257 326715749 155666508 94694268 94694268 932388776 WORKERS COMPENSATION 61625901 POST RETIREMENT COMP BENEFITS 47038872 PENSION LIABILITY 36286738 OTHER NON-CURRENT LIABILITIES 43302038 188253549 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS (TERM AND PERMANENT) HELD BY THE JOHN MUIR HEALTH FOUNDATION ARE USED FOR RESTRICTED PURPOSES AS DIRECTED BY THE DONOR UPON RECEIPTS OF THEIR DONATION. INCOME EARNED FROM PERMANENT ENDOWMENT FUNDS WITHOUT RESTRICTION AS TO PURPOSE IS USED TO SUPPORT PATIENT CARE PROGRAMS AND SERVICES OF JOHN MUIR HEALTH. TERM ENDOWMENTS AND INCOME EARNED FROM OTHER PERMANENT ENDOWMENTS ARE RESTRICTED BY THE DONOR FOR USE IN PROGRAMS INCLUDING NURSING EDUCATION, CARDIAC CARE EQUIPMENT, RADIATION ONCOLOGY, WOMEN'S HEALTH CENTER EDUCATION, AND THE JOHN MUIR HEALTH BUILDING PROGRAM. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENTS 90251367 0 0 0 0 0 0 90251367 0 90251367 1 0 1 1 1 0 GOLF TOURNAMENT 177560 39600 137960 47499 5740 177560 39600 137960 47499 5740 53239 84721 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 24922374 24922374 0.02230 58773876 58773876 0.05260 83696250 83696250 0.07490 10212662 1587052 8625610 0.00770 6705320 3352660 3352660 0.00300 1636788 1636788 0.00150 2958056 1479028 1479028 0.00130 5079311 2599516 2479795 0.00220 26592137 9018256 17573881 0.01570 110288387 9018256 101270131 0.09060 4802 4802 0.00010 93247 93247 0.00010 11560 11560 0.00010 534209 534209 0.00010 643818 643818 0.00040 0 67989914 258129154 419375086 -161245932 X 1 1 1 ASPEN SURGERY CENTER LLC OPERATES A MULTISPECIALTY AMBULATORY SURGERY CENTER 0.33000 0.01000 0.43000 2 BRENTWOOD SURGERY CENTER LLC OPERATES A MULTISPECIALTY AMBULATORY SURGERY CENTER 0.38000 0.00000 0.35000 3 MUIR DIABLO OCCUPATIONAL MEDICINE OPERATES OUTPATIENT OCCUPATIONAL HEALTH CLINICS 0.50000 0.00000 0.50000 4 SAN RAMON REGIONAL MEDICAL CENTER LLC OPERATES A GENERAL ACUTE CARE HOSPITAL 0.49000 0.00000 0.00000 5 SAN RAMON NETWORK JOINT VENTURE LLC DEVELOPMENT OF AMBULATORY CARE CONTINUUM 0.49000 0.00000 0.00000 6 CONTRA COSTA PEDIATRIC VENTURE LLC OPERATES PEDIATRIC SERVICES JV WITH LUCILLE PACKARD CHILDRENS HOSPITAL 0.50000 0.00000 0.00000 2 1 JOHN MUIR MEDICAL CENTER WALNUT CREEK 1601 YGNACIO VALLEY ROAD WALNUT CREEK CA 94598 WWW.JOHNMUIRHEALTH.COM 140000265 X X X 2 JOHN MUIR MEDICAL CENTER CONCORD 2540 EAST STREET CONCORD CA 94520 WWW.JOHNMUIRHEALTH.COM 140000128 X X X JOHN MUIR MEDICAL CENTER WALNUT CREEK 1 1 X X X X X X X X 13 1 1 1 X WWW.JOHNMUIRHEALTH.COM X X X X X X X 0 0 1 1 400.000000000000 1 350.000000000000 1 X X X X X X X X 1 1 X X X X X 1 0 1 X 0 0 JOHN MUIR MEDICAL CENTER CONCORD 2 1 X X X X X X X X 13 1 1 1 X WWW.JOHNMUIRHEALTH.COM X X X X X X X 0 0 1 1 400.000000000000 1 350.000000000000 1 X X X X X X X X 1 1 X X X X X 1 0 1 X 0 0 JOHN MUIR MEDICAL CENTER WALNUT CREEK PART V, SECTION B, LINE 3: JOHN MUIR HEALTH COLLECTED COMMUNITY INPUT IN TWO FORMS. FIRST, THE FINDINGS REGARDING COMMUNITY HEALTH CONCERNS WAS GATHERED FROM THE SECONDARY DATA AND DISCUSSED WITH GROUPS OF PEOPLE FROM UNDERSERVED, MINORITY AND LOW-INCOME POPULATIONS. SEVEN COMMUNITY CONVERSATIONS WERE CONDUCTED IN THE JOHN MUIR HEALTH SERVICE AREA:- VILLAGE RESOURCE CENTER, BRENTWOOD (OCTOBER 1, 2012 IN SPANISH): 14 PARTICIPANTS AGED 23-65 REPRESENTING THE FOLLOWING POPULATIONS: LATINO, LOW-INCOME, AND LIVING WITH CHRONIC ILLNESSES- LOAVES AND FISHES, MARTINEZ (OCTOBER 3, 2012): 23 PARTICIPANTS AGED 29-65 REPRESENTING THE FOLLOWING POPULATIONS: HOMELESS, LOW-INCOME, LIVING WITH CHRONIC CONDITIONS- CAMBRIDGE SCHOOL, CONCORD (OCTOBER 5, 2012 IN SPANISH): 12 PARTICIPANTS AGED 30-49 REPRESENTING THE FOLLOWING POPULATIONS: LATINO, LOW-INCOME, PARENTS- MONUMENT CRISIS CENTER, CONCORD (OCTOBER 5, 2012 IN SPANISH): 12 PARTICIPANTS REPRESENTING THE FOLLOWING POPULATIONS: LOW INCOME AND LIVING WITH CHRONIC CONDITIONS- MIND, BODY AND SOUL, PITTSBURG (OCTOBER 8, 2012): 26 PARTICIPANTS AGED 18-60 REPRESENTING THE FOLLOWING POPULATIONS: LOW-INCOME AND AFRICAN AMERICAN- PROMOTORES, LOCATION VARIES (OCTOBER 9, 2012): 14 PARTICIPANTS AGED 23-79 REPRESENTING THE FOLLOWING POPULATIONS: LATINO AND LIVING WITH CHRONIC CONDITIONS- SOLOMON TEMPLE CHURCH, PITTSBURG (OCTOBER 10, 2012): 18 PARTICIPANTS AGED 30-72 REPRESENTING THE FOLLOWING POPULATIONS: AFRICAN AMERICAN AND LIVING WITH CHRONIC CONDITIONSTHE RESULTS OF THESE COMMUNITY CONVERSATIONS WERE CONSIDERED ALONG WITH THE SECONDARY DATA, AND A SET OF "COMMUNITY HEALTH NEEDS" WAS IDENTIFIED. THE DEFINED LIST OF COMMUNITY HEALTH NEEDS WAS SHARED AND DISCUSSED WITH A LARGE MEETING OF PUBLIC HEALTH AND SOCIAL SERVICE AGENCY LEADERS WHO WERE ASKED TO DETERMINE RELATIVE PRIORITY AMONG THE NEEDS USING ESTABLISHED CRITERIA (PERSONS INCLUDED BELOW).- ALEXIS ADORADOR, FAMILIAS UNIDAS- ALVARO FUENTES, COMMUNITY CLINIC CONSORTIUM- AUDREY TORMEY, YOUTH HOMES- BARBARA HUNT, ST VINCENT DE PAUL OF CONTRA COSTA COUNTY- BENJAMIN AUNE, OPERATION ACCESS- CHRISTY KAPLAN, JOHN MUIR HEALTH- CYNTHIA BELON, CONTRA COSTA HEALTH SERVICES - BEHAVIORAL HEALTH SERVICES ADMINISTRATION- GENNIFER MOUNTAIN, MEALS ON WHEELS AND SENIOR OUTREACH SERVICE- HELENE GLASSER, ROTACARE PITTSBURG FREE MEDICAL CLINIC AT ST VINCENT DE PAUL- JOANNE GENET, PUBLIC AND ENVIRONMENTAL HEALTH ADVISORY BOARD- KATE GOHEEN, MD, CONTRA COSTA HEALTH SERVICES - CONCORD HEALTH CENTER- LUZ GOMEZ, OFFICE OF SUPERVISOR JOHN GIOIA- MARIANA MOORE, HUMAN SERVICES ALLIANCE OF CONTRA COSTA- NICOLE RAMOS, JOHN MUIR HEALTH- REBECCA ROZEN, HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CA- ROBIN POPPINO-KUNTZ, PLANNED PARENTHOOD SHASTA PACIFIC- ROSA MARIA STEMBERG, PUBLIC AND ENVIRONMENTAL HEALTH ADVISORY BOARD- SANDRA WASHINGTON, JOHN MUIR HEALTH- VIC MONTOYA, CONTRA COSTA HEALTH SERVICES - MENTAL HEALTH/OLDER ADULT PROGRAM- VIOLA LUJAN, LA CLINICA DE LA RAZA- WILLIAM WALKER, MD, CONTRA COSTA HEALTH SERVICES JOHN MUIR MEDICAL CENTER CONCORD PART V, SECTION B, LINE 3: JOHN MUIR HEALTH COLLECTED COMMUNITY INPUT IN TWO FORMS. FIRST, THE FINDINGS REGARDING COMMUNITY HEALTH CONCERNS WAS GATHERED FROM THE SECONDARY DATA AND DISCUSSED WITH GROUPS OF PEOPLE FROM UNDERSERVED, MINORITY AND LOW-INCOME POPULATIONS. SEVEN COMMUNITY CONVERSATIONS WERE CONDUCTED IN THE JOHN MUIR HEALTH SERVICE AREA:- VILLAGE RESOURCE CENTER, BRENTWOOD (OCTOBER 1, 2012 IN SPANISH): 14 PARTICIPANTS AGED 23-65 REPRESENTING THE FOLLOWING POPULATIONS: LATINO, LOW-INCOME, AND LIVING WITH CHRONIC ILLNESSES- LOAVES AND FISHES, MARTINEZ (OCTOBER 3, 2012): 23 PARTICIPANTS AGED 29-65 REPRESENTING THE FOLLOWING POPULATIONS: HOMELESS, LOW-INCOME, LIVING WITH CHRONIC CONDITIONS- CAMBRIDGE SCHOOL, CONCORD (OCTOBER 5, 2012 IN SPANISH): 12 PARTICIPANTS AGED 30-49 REPRESENTING THE FOLLOWING POPULATIONS: LATINO, LOW-INCOME, PARENTS- MONUMENT CRISIS CENTER, CONCORD (OCTOBER 5, 2012 IN SPANISH): 12 PARTICIPANTS REPRESENTING THE FOLLOWING POPULATIONS: LOW INCOME AND LIVING WITH CHRONIC CONDITIONS- MIND, BODY AND SOUL, PITTSBURG (OCTOBER 8, 2012): 26 PARTICIPANTS AGED 18-60 REPRESENTING THE FOLLOWING POPULATIONS: LOW-INCOME AND AFRICAN AMERICAN- PROMOTORES, LOCATION VARIES (OCTOBER 9, 2012): 14 PARTICIPANTS AGED 23-79 REPRESENTING THE FOLLOWING POPULATIONS: LATINO AND LIVING WITH CHRONIC CONDITIONS- SOLOMON TEMPLE CHURCH, PITTSBURG (OCTOBER 10, 2012): 18 PARTICIPANTS AGED 30-72 REPRESENTING THE FOLLOWING POPULATIONS: AFRICAN AMERICAN AND LIVING WITH CHRONIC CONDITIONSTHE RESULTS OF THESE COMMUNITY CONVERSATIONS WERE CONSIDERED ALONG WITH THE SECONDARY DATA, AND A SET OF "COMMUNITY HEALTH NEEDS" WAS IDENTIFIED. THE DEFINED LIST OF COMMUNITY HEALTH NEEDS WAS SHARED AND DISCUSSED WITH A LARGE MEETING OF PUBLIC HEALTH AND SOCIAL SERVICE AGENCY LEADERS WHO WERE ASKED TO DETERMINE RELATIVE PRIORITY AMONG THE NEEDS USING ESTABLISHED CRITERIA (PERSONS INCLUDED BELOW).- ALEXIS ADORADOR, FAMILIAS UNIDAS- ALVARO FUENTES, COMMUNITY CLINIC CONSORTIUM- AUDREY TORMEY, YOUTH HOMES- BARBARA HUNT, ST VINCENT DE PAUL OF CONTRA COSTA COUNTY- BENJAMIN AUNE, OPERATION ACCESS- CHRISTY KAPLAN, JOHN MUIR HEALTH- CYNTHIA BELON, CONTRA COSTA HEALTH SERVICES - BEHAVIORAL HEALTH SERVICES ADMINISTRATION- GENNIFER MOUNTAIN, MEALS ON WHEELS AND SENIOR OUTREACH SERVICE- HELENE GLASSER, ROTACARE PITTSBURG FREE MEDICAL CLINIC AT ST VINCENT DE PAUL- JOANNE GENET, PUBLIC AND ENVIRONMENTAL HEALTH ADVISORY BOARD- KATE GOHEEN, MD, CONTRA COSTA HEALTH SERVICES - CONCORD HEALTH CENTER- LUZ GOMEZ, OFFICE OF SUPERVISOR JOHN GIOIA- MARIANA MOORE, HUMAN SERVICES ALLIANCE OF CONTRA COSTA- NICOLE RAMOS, JOHN MUIR HEALTH- REBECCA ROZEN, HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CA- ROBIN POPPINO-KUNTZ, PLANNED PARENTHOOD SHASTA PACIFIC- ROSA MARIA STEMBERG, PUBLIC AND ENVIRONMENTAL HEALTH ADVISORY BOARD- SANDRA WASHINGTON, JOHN MUIR HEALTH- VIC MONTOYA, CONTRA COSTA HEALTH SERVICES - MENTAL HEALTH/OLDER ADULT PROGRAM- VIOLA LUJAN, LA CLINICA DE LA RAZA- WILLIAM WALKER, MD, CONTRA COSTA HEALTH SERVICES JOHN MUIR MEDICAL CENTER WALNUT CREEK PART V, SECTION B, LINE 4: ALL JOHN MUIR HEALTH ENTITIES (JOHN MUIR MEDICAL CENTER, WALNUT CREEK, JOHN MUIR MEDICAL CENTER, CONCORD AND JOHN MUIR HEALTH BEHAVIORAL HEALTH COLLABORATED WITH KAISER FOUNDATION HOSPITAL WALNUT CREEK AND KAISER FOUNDATION HOSPITAL ANTIOCH ON THE COMMUNITY HEALTH NEEDS ASSESSMENT. JOHN MUIR MEDICAL CENTER CONCORD PART V, SECTION B, LINE 4: ALL JOHN MUIR HEALTH ENTITIES (JOHN MUIR MEDICAL CENTER, WALNUT CREEK, JOHN MUIR MEDICAL CENTER, CONCORD AND JOHN MUIR HEALTH BEHAVIORAL HEALTH COLLABORATED WITH KAISER FOUNDATION HOSPITAL WALNUT CREEK AND KAISER FOUNDATION HOSPITAL ANTIOCH ON THE COMMUNITY HEALTH NEEDS ASSESSMENT. JOHN MUIR MEDICAL CENTER WALNUT CREEK PART V, SECTION B, LINE 7: THE JOHN MUIR HEALTH COMMUNITY HEALTH NEEDS ADVISORY COMMITTEE SELECTED THREE OF THE TEN IDENTIFIED COMMUNITY HEALTH NEEDS TO FOCUS ON USING SELECTION CRITERIA INCLUDING ORGANIZATIONAL EXPERTISE AND RESOURCES. THE HEALTH NEED FOCUS AREAS INCLUDE: PRIMARY CARE SERVICES AND INFORMATION INCLUDING ADEQUATE SPANISH CAPACITY, SPECIALTY CARE, AND AFFORDABLE, LOCAL MENTAL HEALTH SERVICES. JMH WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE CHNA AS A PART OF THIS COMMUNITY HEALTH IMPROVEMENT PLAN DUE TO THE NEED TO ALLOCATE SIGNIFICANT, FOCUSED RESOURCES TO THE THREE PRIORITY HEALTH NEEDS IDENTIFIED ABOVE. INCREASE EXERCISE AND ACTIVITY & HEALTHY EATINGJMH BELIEVES THESE HEALTH NEEDS ARE IMPORTANT, HOWEVER WE ARE NOT EQUIPPED AT THIS TIME TO ADDRESS EXERCISE AND HEALTHY EATING ON A LARGE SCALE IN THE COMMUNITY. ADDITIONALLY, MANY OTHER ORGANIZATIONS HAVE BEEN ENGAGED IN THESE ACTIVITIES. WHILE NOT A PRIORITY FOCUS FOR JMH, WE WILL CONTINUE TO PROVIDE SUPPORT OF COLLABORATIONS THAT PROVIDE PRIMARY PREVENTION AND INFORMATION TO THE MOST VULNERABLE COMMUNITIES IN THE AREA. ECONOMIC SECURITYADDRESSING ECONOMIC SECURITY IS A LARGE SCOPE INITIATIVE THAT JMH CANNOT ADDRESS ALONE, DUE TO LIMITED INFRASTRUCTURE AND RESOURCES. OTHER ORGANIZATIONS ARE CURRENTLY WORKING TO ENHANCE THE SAFETY NET IN CONTRA COSTA COUNTY BY ADDRESSING ECONOMIC SECURITY. JMH WILL CONTINUE TO BE A PART OF THE DIALOGUE ON THIS IMPORTANT ISSUE BUT WILL NOT CONTRIBUTE RESOURCES GIVEN ITS CONTRIBUTIONS IN OTHER AREAS.ASTHMA PREVENTION AND MANAGEMENT & PERI-NATAL CAREASTHMA PREVENTION AND MANAGEMENT AND PERI-NATAL CARE WERE NOT SPECIFICALLY SELECTED AS PRIORITY FOCUS AREAS BECAUSE OF THE MAGNITUDE OF RESOURCES NEEDED FOR OUR SELECTED NEEDS. HOWEVER, JMH WILL SUPPORT ACCESS TO HEALTH CARE INCLUDING OUR CLINICAL EXPERTISE THAT WILL CONTRIBUTE TO IMPROVING NEGATIVE HEALTH OUTCOMES ASSOCIATED WITH ASTHMA AND PERI-NATAL CARE. AFFORDABLE, LOCAL SUBSTANCE ABUSE TREATMENT SERVICES & PARENTING SKILLS AND SUPPORTAFFORDABLE, LOCAL SUBSTANCE ABUSE TREATMENT SERVICES AND PARENTING SKILLS AND SUPPORT WERE NOT SELECTED AS PRIORITY FOCUS AREAS BECAUSE OF RESOURCE CONSTRAINTS AND THE PRIORITY RANKING. HOWEVER, JMH BELIEVES THE SELECTED HEALTH NEEDS WILL ALSO ADDRESS SUBSTANCE ABUSE ISSUES, AND PARENTING NEEDS BY FOCUSING ON MENTAL HEALTH INTERVENTIONS. JOHN MUIR MEDICAL CENTER CONCORD PART V, SECTION B, LINE 7: THE JOHN MUIR HEALTH COMMUNITY HEALTH NEEDS ADVISORY COMMITTEE SELECTED THREE OF THE TEN IDENTIFIED COMMUNITY HEALTH NEEDS TO FOCUS ON USING SELECTION CRITERIA INCLUDING ORGANIZATIONAL EXPERTISE AND RESOURCES. THE HEALTH NEED FOCUS AREAS INCLUDE: PRIMARY CARE SERVICES AND INFORMATION INCLUDING ADEQUATE SPANISH CAPACITY, SPECIALTY CARE, AND AFFORDABLE, LOCAL MENTAL HEALTH SERVICES. JMH WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE CHNA AS A PART OF THIS COMMUNITY HEALTH IMPROVEMENT PLAN DUE TO THE NEED TO ALLOCATE SIGNIFICANT, FOCUSED RESOURCES TO THE THREE PRIORITY HEALTH NEEDS IDENTIFIED ABOVE. INCREASE EXERCISE AND ACTIVITY & HEALTHY EATINGJMH BELIEVES THESE HEALTH NEEDS ARE IMPORTANT, HOWEVER WE ARE NOT EQUIPPED AT THIS TIME TO ADDRESS EXERCISE AND HEALTHY EATING ON A LARGE SCALE IN THE COMMUNITY. ADDITIONALLY, MANY OTHER ORGANIZATIONS HAVE BEEN ENGAGED IN THESE ACTIVITIES. WHILE NOT A PRIORITY FOCUS FOR JMH, WE WILL CONTINUE TO PROVIDE SUPPORT OF COLLABORATIONS THAT PROVIDE PRIMARY PREVENTION AND INFORMATION TO THE MOST VULNERABLE COMMUNITIES IN THE AREA. ECONOMIC SECURITYADDRESSING ECONOMIC SECURITY IS A LARGE SCOPE INITIATIVE THAT JMH CANNOT ADDRESS ALONE, DUE TO LIMITED INFRASTRUCTURE AND RESOURCES. OTHER ORGANIZATIONS ARE CURRENTLY WORKING TO ENHANCE THE SAFETY NET IN CONTRA COSTA COUNTY BY ADDRESSING ECONOMIC SECURITY. JMH WILL CONTINUE TO BE A PART OF THE DIALOGUE ON THIS IMPORTANT ISSUE BUT WILL NOT CONTRIBUTE RESOURCES GIVEN ITS CONTRIBUTIONS IN OTHER AREAS.ASTHMA PREVENTION AND MANAGEMENT & PERI-NATAL CAREASTHMA PREVENTION AND MANAGEMENT AND PERI-NATAL CARE WERE NOT SPECIFICALLY SELECTED AS PRIORITY FOCUS AREAS BECAUSE OF THE MAGNITUDE OF RESOURCES NEEDED FOR OUR SELECTED NEEDS. HOWEVER, JMH WILL SUPPORT ACCESS TO HEALTH CARE INCLUDING OUR CLINICAL EXPERTISE THAT WILL CONTRIBUTE TO IMPROVING NEGATIVE HEALTH OUTCOMES ASSOCIATED WITH ASTHMA AND PERI-NATAL CARE. AFFORDABLE, LOCAL SUBSTANCE ABUSE TREATMENT SERVICES & PARENTING SKILLS AND SUPPORTAFFORDABLE, LOCAL SUBSTANCE ABUSE TREATMENT SERVICES AND PARENTING SKILLS AND SUPPORT WERE NOT SELECTED AS PRIORITY FOCUS AREAS BECAUSE OF RESOURCE CONSTRAINTS AND THE PRIORITY RANKING. HOWEVER, JMH BELIEVES THE SELECTED HEALTH NEEDS WILL ALSO ADDRESS SUBSTANCE ABUSE ISSUES, AND PARENTING NEEDS BY FOCUSING ON MENTAL HEALTH INTERVENTIONS. JOHN MUIR MEDICAL CENTER WALNUT CREEK PART V, SECTION B, LINE 20D: IF IT IS DETERMINED THAT A PATIENT IS ELIGIBLE FOR JOHN MUIR HEALTH'S FINANCIAL ASSISTANCE PLAN, ANY BILLS PREVIOUSLY SENT TO THAT PATIENT ARE RECALCULATED TO $0. JOHN MUIR MEDICAL CENTER CONCORD PART V, SECTION B, LINE 20D: IF IT IS DETERMINED THAT A PATIENT IS ELIGIBLE FOR JOHN MUIR HEALTH'S FINANCIAL ASSISTANCE PLAN, ANY BILLS PREVIOUSLY SENT TO THAT PATIENT ARE RECALCULATED TO $0. PART I, LINE 3C: THE MAJORITY OF CHARITY CARE IS GIVEN BASED EITHER ON THE FEDERAL POVERTY GUIDELINES ("FPG") AS CALCULATED FROM DOCUMENTATION AND STATEMENTS MADE ON AN INTERNAL JOHN MUIR HEALTH CHARITY CARE APPLICATION, OR ON THE FPG AS ESTIMATED BY A CONTRACTED THIRD PARTY. THE THIRD PARTY HAS DEVELOPED AN ALGORITHM BASED ON ESTIMATED HOUSEHOLD INCOME, WHICH IS THEN TRANSLATED INTO FPG FOR THE HOUSEHOLD. JOHN MUIR HEALTH HAS NO INPUT INTO THE CRITERIA USED FOR THE ALGORITHM, WHICH IS THE SAME CALCULATION USED BY THE CONTRACTED THIRD PARTY FOR ALL OF THEIR CLIENTS NATIONWIDE. OTHER CRITERIA USED IS BASED ON THE PATIENT'S ELIGIBILITY FOR LOW-INCOME PROGRAMS THAT HAVE THE SAME OR MORE STRICT (LOWER) INCOME CRITERIA AS THE JOHN MUIR HEALTH CHARITY CARE PROGRAM. THIS INCLUDES PATIENTS WHO ARE QUALIFIED WITHIN SIX MONTHS OF THE DATE OF SERVICE FOR THE CALIFORNIA MEDICAID (MEDI-CAL) PROGRAM, OR FOR THE COUNTY'S MEDICALLY INDIGENT PROGRAM. IN ADDITION TO FORMAL QUALIFICATION IN A RECOGNIZED PROGRAM SERVING THE LOW-INCOME AND INDIGENT POPULATION, CHARITY CARE IS ALSO EXTENDED TO PATIENTS SEEN IN OUR EMERGENCY DEPARTMENTS AND WHO HAVE BEEN DOCUMENTED IN THE MEDICAL RECORD AS BEING HOMELESS, OR HAVE A LACK OF HOUSING. CHARITY CARE IS ALSO APPLIED TO OUTSTANDING BALANCES FOR EMERGENCY SERVICES RENDERED TO DOCUMENTED MINOR AND ELDERLY VICTIMS OF ABUSE, BASED ON COMPASSION AS JOHN MUIR HEALTH HAS NO KNOWLEDGE OF THE CURRENT HOME ENVIRONMENT OF THESE PATIENTS. WE ALSO HAVE A PARTNERSHIP WITH A COMMUNITY PROGRAM, OPERATION ACCESS, WHICH SERVES THE LOW-INCOME INDIVIDUALS IN OUR COUNTY, TO PROVIDE FREE CARE ON A REFERRED, CASE-BY-CASE BASIS. OPERATION ACCESS HAS ALREADY PERFORMED THE SCREENING OF THEIR REFERRED PATIENTS FOR INCOME ELIGIBILITY. JMH CONTINUED A PARTNERSHIP WITH LA CLINICA DE LA RAZA TO PROVIDE SPECIALTY CARE FOR UNINSURED AND LOW INCOME PATIENTS. LA CLINICA DE LA RAZA HAS ALREADY PERFORMED SCREENING OF THEIR REFERRED PATIENTS FOR INCOME ELIGIBILITY.PART I, LINE 4: DOES THE ORGANIZATION'S POLICY PROVIDE FREE OR DISCOUNTED CARE TO THE "MEDICALLY INDIGENT."WE PROVIDE HEALTH CARE TO THE MOST VULNERABLE INDIVIDUALS OF OUR COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY THROUGH OUR MEDICAL CENTERS IN WALNUT CREEK AND CONCORD. THIS INCLUDES THE CRITICAL EMERGENCY AND TRAUMA SERVICES AT OUR MEDICAL CENTER CAMPUSES. JOHN MUIR HEALTH HAS A NUMBER OF PROGRAMS TO HELP OUR PATIENTS WITH THEIR MEDICAL BILLS FOR SERVICES THEY RECEIVE AT ONE OF OUR MEDICAL CENTERS. THESE PROGRAMS INCLUDE A PATIENT ASSISTANCE PROGRAM TO ABSORB PART, OR ALL, OF THE BILL BASED ON INCOME AND OTHER PROGRAM GUIDELINES, ASSISTANCE ENROLLING IN A NUMBER OF INSURANCE PROGRAMS, AND EXTENDED PAYMENT PLANS.JOHN MUIR HEALTH MAY ALSO ASSIGN ACCOUNTS TO PRESUMPTIVE CHARITY, WITHOUT A PATIENT ASSISTANCE APPLICATION SUBMITTED BY THE PATIENT, BASED ON PREDETERMINED CRITERIA COLLECTED FROM APPROVED SOURCES. THIS CRITERIA INCLUDES:THE PATIENT HAVING DOCUMENTED IN HIS/HER MEDICAL RECORD AS BEING HOMELESS OR VERIFICATION RECEIVED THROUGH THE MEDICAL CENTER OR A FAMILY MEMBER THAT THE PATIENT IS CURRENTLY INCARCERATED.ORTHE PATIENT QUALIFIES FOR A GOVERNMENT PROGRAM WITH ELIGIBILITY REQUIREMENTS THAT REASONABLY MEET THE QUALIFICATIONS FOR THE JOHN MUIR HEALTH CHARITY CARE PROGRAM WITHIN SIX (6) MONTHS OF THE DATE THE PATIENT RECEIVED SERVICES AT THE MEDICAL CENTER.ORAFTER NORMAL COLLECTION EFFORTS HAVE NOT PRODUCED ANY PAYMENT, AND JOHN MUIR HEALTH HAS IDENTIFIED WITH REASONABLE EFFORT AND ASSURANCE THAT THE PATIENT'S ESTIMATED INCOME IS AT 250 PERCENT OR LESS OF THE FPL (FEDERAL POVERTY LEVEL). PART I, LINE 7: JOHN MUIR HEALTH HAS ADOPTED THE GUIDELINES DEVELOPED BY THE CATHOLIC HEALTHCARE ASSOCIATION AND VHA INC. FOR REPORTING THE ECONOMIC VALUE OF ITS COMMUNITY BENEFITS CONTRIBUTIONS. PART I, LN 7 COL(F): INCLUDED ON FORM 990, PART IX LINE 25 IS BAD DEBT EXPENSE TOTALING $67,989,914. THIS AMOUNT WAS EXCLUDED BEFORE CALCULATING THE PERCENTAGES FOUND IN COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: JOHN MUIR HEALTH'S COMMUNITY BUILDING PROGRAMS AND ACTIVITIES ADDRESS SOCIOECONOMIC BARRIERS TO OPTIMAL PHYSICAL AND MENTAL HEALTH SUCH AS JOBS, EDUCATION, POVERTY, LANGUAGE, CULTURE, RACE, ETHNICITY, TRANSPORTATION, ETC. OUR PRIMARY AREAS OF FOCUS ARE MONUMENT IMPACT AND WORKFORCE DEVELOPMENT.MONUMENT IMPACTTHE MONUMENT COMMUNITY COMPRISES A DISTINCTIVE SOCIO-ECONOMIC DEMOGRAPHIC WITH UNIQUE CHALLENGES. MANY RESIDENTS FACE LANGUAGE, EDUCATION AND CULTURAL BARRIERS, WHILE HAVING LIMITED ACCESS TO THE RESOURCES NECESSARY TO OVERCOME THESE BARRIERS.MONUMENT IMPACT'S MISSION IS TO ACTIVELY ENGAGE WITH THE MONUMENT COMMUNITY TO PROVIDE TRAINING AND TOOLS, IN ORDER FOR PEOPLE TO BECOME:1. ECONOMICALLY SELF-SUFFICIENT2. HEALTHY AND SAFE 3. CIVICALLY ENGAGED4. CONNECTED TO EACH OTHER5. COMMITTED TO LIFELONG LEARNING MONUMENT IMPACT WORKS TO INVOLVE RESIDENTS OF ALL AGES, ETHNICITIES AND IMMIGRATION STATUS AS EQUAL PARTNERS WITH LOCAL PUBLIC AND PRIVATE ORGANIZATIONS IN PRODUCTIVE, ACTION-BASED COLLABORATION. THROUGH THREE PRIMARY PROGRAM AREAS, THE ORGANIZATION WORKS TOWARDS ITS GOAL OF A VIBRANT COMMUNITY WITH A HEALTHY AND STRONG QUALITY OF LIFE: 1. ECONOMIC DEVELOPMENT2. HEALTHY LIVING3. CIVIC ENGAGEMENTWORKFORCE DEVELOPMENTJOHN MUIR HEALTH WORKS WITH A WIDE RANGE OF ORGANIZATIONS TO SUPPORT GREATER EXPOSURE OF YOUTH TO HEALTH CAREERS THROUGH A SPEAKERS' BUREAU, HEALTH CAREER FAIRS, WORKSHOPS, PRESENTATIONS AND HANDS ON LEARNING OPPORTUNITIES IN THE FOLLOWING AREAS:1. REGISTERED NURSING2. MEDICAL ASSISTANTS3. MEDICAL IMAGING TECHNOLOGY4. SONOGRAPHERS5. LAB PROFESSIONS, E.G. CLINICAL LAB SCIENTISTS, MEDICAL LAB TECHS6. PHARMACISTS AND PHARMACY TECHS7. RESPIRATORY THERAPISTS8. PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY PARTNERS:1. 3 AREA HIGH SCHOOLS AND HEALTH ACADEMIES, 2. CONTRA COSTA ECONOMIC PARTNERSHIP (CCEP), HELP TO REACH UNDERSERVED STUDENTS3. SAMUEL MERRITT COLLEGE4. CONTRA COSTA COLLEGES ( DIABLO VALLEY AND LOS MEDANOS COLLEGE)5. EAST COUNTY BUSINESS AND EDUCATION ALLIANCE6. CALIFORNIA STATE UNIVERSITY, EAST BAY PART III, LINE 4: THE ORGANIZATION DOES NOT ISSUE SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN CONSOLIDATED, INDEPENDENT AUDITED FINANCIAL STATEMENTS THAT DO NOT INCLUDE A DESCRIPTION OF BAD DEBT EXPENSE. BAD DEBT COST IS DETERMINED USING THE COST-TO-CHARGE METHODOLOGY. THE ORGANIZATION DOES NOT INCLUDE BAD DEBT IN COMMUNITY BENEFIT. PART III, LINE 8: THE ORGANIZATION DOES NOT TREAT MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE COST TO CHARGE RATIOS USED TO COMPUTE THE MEDICARE SHORTFALLS ARE FROM THE 2013 MEDICARE COST REPORT FILED WITH CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS). PART III, LINE 9B: OTHER THAN SENDING STATEMENTS AND NOTIFICATIONS TO THE PATIENT, JOHN MUIR HEALTH DOES NOT CONDUCT PATIENT-OWED COLLECTIONS INTERNALLY. THESE TYPES OF FUNCTIONS ARE OUTSOURCED TO AN OUTSIDE AGENCY. THE COLLECTION POLICY IS IN THE FORM OF, AND INCORPORATED INTO, THE CONTRACT AGREEMENT WITH THE OUTSIDE AGENCY AS A FULL ADDENDUM TO THE CONTRACT, WITH A SEPARATE SIGNATURE LINE FOR JOHN MUIR HEALTH AND THE AGENCY AS PART OF THE ADDENDUM. IN ADDITION TO THE CUSTOMIZED JOHN MUIR HEALTH COLLECTION GUIDELINES, THE ADDENDUM ALSO CONTAINS THE COLLECTION CRITERIA AND REQUIREMENTS FOUND IN CALIFORNIA LAW UNDER ASSEMBLY BILL 774. PART VI, LINE 2: HOW DO WE DETERMINE THE NEEDS OF OUR COMMUNITY?THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (REPORTED IN PART V, SECTION B) INCLUDES A COMPREHENSIVE NEEDS ASSESSMENT OF THE COMMUNITY SERVED, WHICH HAS BEEN USED TO DEVELOP OUR ANNUAL AND TRIENNIAL COMMUNITY BENEFIT PLANS. FOR MORE INFORMATION, THE CHNA REPORT AND IMPLEMENTATION STRATEGY CAN BE FOUND HERE: HTTP://WWW.JOHNMUIRHEALTH.COM/ABOUT-JOHN-MUIR-HEALTH/COMMUNITY-COMMITMENT.HTML IN ADDITION TO THE CHNA, JOHN MUIR HEALTH IS CONTINUALLY ASSESSING THE NEEDS OF THE COMMUNITY IN A VARIETY OF WAYS. FIRST, JOHN MUIR HEALTH KEEPS ABREAST OF CURRENT HEALTH ISSUES OF IMPORTANCE TO THE COMMUNITY BY ACTIVE PARTICIPATION AND COMMUNICATION WITH A VARIETY OF COMMUNITY GROUPS INCLUDING BUT NOT LIMITED TO EAST CONTRA COSTA COUNTY ACCESS TO CARE TEAM, ACCESS TO CARE STAKEHOLDERS, HEALTHY AND LIVABLE PITTSBURG, AFRICAN AMERICAN HEALTH COLLABORATIVE, BAY POINT PARTNERSHIP, AND FAMILIES CAN. SECOND, JOHN MUIR HEALTH CONTINUALLY ANALYZES ITS EMERGENCY AND TRAUMA ROOM DATA TO DETERMINE COMMUNITY NEEDS. FOR EXAMPLE, THE JOHN MUIR MEDICAL CENTER, WALNUT CREEK BEYOND VIOLENCE PROGRAM WAS DEVELOPED THIS WAY. LASTLY, COMMUNITY ORGANIZATIONS ALSO SEEK OUT JOHN MUIR HEALTH AS A PARTNER. IN 2008, THE COMMUNITY NURSE PROGRAM WAS DEVELOPED BASED ON THE 2007 COMMUNITY ASSESSMENT THAT IDENTIFIED CHILDHOOD OBESITY AND DIABETES PREVENTION AS AREAS OF FOCUS IN SCHOOLS. AFTER THE PROGRAM'S SUCCESS, A SECOND SCHOOL DISTRICT ASKED JOHN MUIR HEALTH TO EXPAND ITS COMMUNITY NURSING PROGRAM INTO THEIR DISTRICT DURING 2010. PART VI, LINE 3: JOHN MUIR HEALTH HAS SIGNAGE POSTED IN PATIENT ACCESS AREAS/LOBBIES INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR THEIR HEALTH CARE BILLS AND ELIGIBILITY, SERVICES TO AID THE PATIENT IN QUALIFYING FOR AN APPROPRIATE ASSISTANCE PROGRAM IN THE EMERGENCY DEPARTMENT. ALL PATIENTS RECEIVE A "PATIENT ASSISTANCE" BROCHURE, WHICH IDENTIFIES VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO THE PATIENT, INCLUDING THE JOHN MUIR HEALTH CHARITY CARE PROGRAM AS WELL AS PROGRAMS THROUGH GOVERNMENT AGENCIES (STATE, COUNTY, ETC). THE BROCHURE ALSO LISTS CONTACT INFORMATION FOR THESE PROGRAMS. PATIENTS IN THE EMERGENCY DEPARTMENT TALK TO A TRAINED FINANCIAL COUNSELOR, AND, IF APPROPRIATE, ARE ALSO ASKED TO SIGN A FORM ACKNOWLEDGING RECEIPT OF THE PATIENT ASSISTANCE MATERIALS, OR DECLINING TO ACCEPT THE MATERIAL. TRAINED FINANCIAL COUNSELORS ARE ALSO AVAILABLE FOR PATIENTS WHO ARE NOT PRESENT FOR SERVICES THROUGH THE EMERGENCY DEPARTMENT. THE APPLICATION FORM AND A COPY OF THE POLICY FOR THE JOHN MUIR HEALTH CHARITY CARE PROGRAM IS ALSO AVAILABLE IN THE EMERGENCY DEPARTMENT AS WELL AS THE MAJOR PATIENT ACCESS AREAS AND THE BUSINESS OFFICE.NOTIFICATION THAT PROGRAMS, INCLUDING CHARITY CARE, ARE AVAILABLE IS ALSO PRINTED ON PATIENT BILLING STATMENTS, ACCOMPANIED BY THE ABILITY FOR A PATIENT TO REQUEST THE VARIOUS PROGRAM MATERIALS BE SENT TO HIS/HER HOME. CONTACT INFORMATION IS ALSO LISTED ON THE PATIENT STATEMENT. INFORMATION ON THE HEALTH SYSTEM'S CHARITY CARE PROGRAM IS POSTED ON THE JOHN MUIR HEALTH INTERNET WEBSITE AS WELL.PATIENTS ADMITTED TO THE HOSPITAL, AND WHO HAVE NO THIRD PARTY INSURANCE LISTED, ARE INTERVIEWED BY TRAINED FINANCIAL COUNSELORS DURING THEIR HOSPITAL STAY TO INFORM THEM OF THE VARIOUS PROGRAMS WHICH ARE AVAILABLE, AND DETERMINE IF THE PATIENT WOULD LIKE ASSISTANCE TO OBTAIN ELIGIBILITY FOR THE STATE MEDICAID (MEDI-CAL) PROGRAM, STATE DISABILITY, CHARITY CARE OR OTHER AVAILABLE PROGRAMS IN THE COUNTY. THIS ELIGIBILITY ASSISTANCE, WHICH INCLUDES HELP IN FILLING OUT THE APPLICATIONS, GATHERING REQUIRED DOCUMENTS, AND TRANSPORTAION TO ELIGIBILITY APPOINTMENTS, IF NECESSARY, IS OFFERED AT NO CHARGE TO THE PATIENT. IN ADDITION, PATIENT ACCOUNTING REPRESENTATIVES MAY ALSO CONTACT PATIENTS AFTER DISCHARGE TO ASK ABOUT PAYMENT ARRANGEMENTS AND TO INFORM THEM OF THE CHARITY CARE PROGRAM IF THE PATIENT NEEDS ASSISTANCE IN PAYING FOR THE MEDICAL BILLS. PART VI, LINE 4: HOW DO WE DEFINE OUR COMMUNITY?JOHN MUIR HEALTH'S PRIMARY AND SECONDARY SERVICE AREA EXTENDS FROM SOUTHERN SOLANO COUNTY INTO EASTERN CONTRA COSTA COUNTY AND SOUTH TO SAN RAMON IN SOUTHERN CONTRA COSTA COUNTY. THE COMMUNITIES THAT COMPRISE THE PRIMARY SERVICE AREA INCLUDE CONCORD, WALNUT CREEK, PLEASANT HILL, MARTINEZ, LAFAYETTE, DANVILLE, ALAMO, ORINDA, MORAGA AND CLAYTON. THE COMMUNITIES THAT COMPRISE THE SECONDARY SERVICE AREA INCLUDE BRENTWOOD, OAKLEY, DISCOVERY BAY, BYRON, KNIGHTSEN, BETHEL ISLAND, BENICIA, PITTSBURG, BAY POINT, ANTIOCH AND SAN RAMON. JOHN MUIR HEALTH'S TRAUMA CENTER SERVES ALL OF CONTRA COSTA COUNTY, AS WELL AS SOUTHERN SOLANO COUNTY AND IS THE BACKUP TRAUMA CENTER FOR ALAMEDA COUNTY.THE PRIMARY FOCUS OF OUR COMMUNITY BENEFIT PROGRAMS IS ON THE NEEDS OF VULNERABLE POPULATIONS. WE DEFINE VULNERABLE POPULATIONS AS THOSE WITH EVIDENCED-BASED DISPARITIES IN HEALTH OUTCOMES, SIGNIFICANT BARRIERS TO CARE AND THE ECONOMICALLY DISADVANTAGED. THESE CRITERIA RESULT IN A PRIMARY COMMUNITY BENEFIT SERVICE AREA THAT INCLUDES THE COMMUNITIES OF THE MONUMENT AREA IN CONCORD AND THE EASTERN CONTRA COSTA COUNTY CITIES OF BAY POINT, PITTSBURG, ANTIOCH, OAKLEY, BRENTWOOD AND FARTHER EAST PARTS OF UNINCORPORATED CONTRA COSTA COUNTY.THE JOHN MUIR HEALTH SERVICE AREA OF EAST AND CENTRAL CONTRA COSTA COUNTY HAS THE FOLLOWING DEMOGRAPHIC PROFILE: CENTRAL CONTRA COSTA COUNTY- UNDER 5 YEARS OLD: 6.09%- AGES 5-17: 17.75%- AGES 18-34: 18.86%- AGES 35-64: 44.69%- AGES 65+: 12.62%- WHITE: 72.77%- BLACK: 2.54%- ASIAN: 15.05%- HISPANIC: 14.02%- LINGUISTICALLY ISOLATED: 9.33%EAST CONTRA COSTA COUNTY- UNDER 5 YEARS OLD: 7.61%- AGES 5-17: 22.13%- AGES 18-34: 22.47%- AGES 35-64: 39.87%- AGES 65+: 8.98%- WHITE: 56.15%- BLACK: 12.44%- ASIAN: 9.35%- HISPANIC: 34.16%- LINGUISTICALLY ISOLATED: 14.89% PART VI, LINE 5: JOHN MUIR HEALTH IS A NOT-FOR-PROFIT, COMMUNITY-BASED ORGANIZATION THAT IS GOVERNED LOCALLY BY THOSE WHO LIVE IN THE COMMUNITIES WE SERVE. COMMUNITY RESIDENTS ARE ACTIVELY INVOLVED IN OUR VARIOUS BOARDS AND BOARD COMMITTEES. OUR FOCUS REMAINS FIRMLY ON IMPROVING THE HEALTH OF THE PEOPLE OF CONTRA COSTA COUNTY AND SURROUNDING COMMUNITIES. AS A NOT-FOR-PROFIT ORGANIZATION, THERE ARE NO SHAREHOLDERS WHO BENEFIT FROM OUR FINANCIAL SURPLUSES. INSTEAD, WE REINVEST ANY SURPLUSES INTO THE COMMUNITY WITH NEW PROGRAM IMPLEMENTATION, ADVANCED TECHNOLOGY, COMMUNITY SERVICES AND BUILDING PROJECTS. AS ONE OF THE LARGEST EMPLOYEES IN THE COUNTY WITH MORE THAN 5,500 EMPLOYEES, JOHN MUIR HEALTH ALSO CONTRIBUTES SIGNIFICANTLY TO THE ECONOMIC VITALITY OF THE COUNTY. JOHN MUIR MEDICAL CENTER, WALNUT CREEK ALSO SERVES AS CONTRA COSTA COUNTY'S ONLY TRAUMA CENTER, WHICH REPRESENTS AN ENORMOUS FINANCIAL AND SERVICE COMMITMENT TO THE ENTIRE REGION. OUR TWO HOSPITAL EMERGENCY DEPARTMENTS SERVE ALL RESIDENTS REGARDLESS OF THEIR ABILITY TO PAY. JOHN MUIR HEALTH IS RECOGNIZED AS A PREEMINENT PROVIDER OF REGIONAL CARDIOVASCULAR, ORTHOPEDICS, NEUROSCIENCES, CANCER, EMERGENCY, TRAUMA AND OBSTETRIC CARE. OTHER AREAS OF SPECIALTY INCLUDE GENERAL SURGERY, PEDIATRICS, ADVANCED ENDOSCOPIC AND ROBOTIC SURGERY AND WEIGHT-LOSS SURGERY. IN ADDITION, JOHN MUIR HEALTH IS THE ONLY PROVIDER OF SEVERAL SPECIALTY SERVICES IN CONTRA COSTA COUNTY, INCLUDING HIGH RISK NEONATAL SERVICES, INPATIENT PSYCHIATRIC SERVICES, INCLUDING CHILD AND ADOLESCENT SERVICES, AND SUBSTANCE ABUSE SERVICES. OUR MEDICAL STAFFS ARE OPEN TO QUALIFIED PHYSICIANS IN THE COMMUNITY. AS A NOT-FOR -PROFIT HEALTH SYSTEM, JOHN MUIR HEALTH HAS AN OBLIGATION TO MAKE A CHARITABLE CONTRIBUTION TO THE COMMUNITY, BUT OUR COMMITMENT TO KEEPING THE COMMUNITIES WE SERVE HEALTHY GOES FAR DEEPER THAN THAT. JOHN MUIR HEALTH'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION ACCURATELY REFLECTS OUR COMMUNITY HEALTH EFFORTS AS A CORPORATE LEADER AND COMMUNITY PARTNER. IN 2013, APPROXIMATELY 91% OF JOHN MUIR HEALTH'S COMMUNITY BENEFIT ACTIVITIES WERE SPECIFICALLY TARGETED TO THOSE INDIVIDUALS AND FAMILIES THAT EXPERIENCE SOCIAL AND ECONOMIC BARRIERS THAT PRECLUDE THEIR ACCESS TO NECESSARY HEALTH CARE SERVICES. JOHN MUIR HEALTH SERVED OVER 153,288 RESIDENTS THROUGH OUR COMMUNITY BENEFIT PROGRAMS IN 2013.IT IS THE EXPERTISE PROVIDED BY COMMUNITY-BASED ORGANIZATIONS, COUPLED WITH JOHN MUIR HEALTH'S RESOURCES AND COMMITMENT TO SERVE THE COMMUNITY THAT PROVIDE THE GREATEST OPPORTUNITY FOR SUCCESS IN ADDRESSING THE MANY UNMET HEALTH NEEDS AND HEALTH DISPARITIES IN CENTRAL AND EASTERN CONTRA COSTA COUNTY.THIS LOCAL COMMITMENT IS EXPRESSED IN THE MANY INITIATIVES WE DELIVER TO THE COMMUNITY, INCLUDING MEDICAL SERVICES FOR VULNERABLE POPULATIONS IN THE COUNTY. FOR MANY INDIVIDUALS AND FAMILIES WITH NO INSURANCE AND LIMITED MEANS, JOHN MUIR HEALTH PROVIDES CHARITY CARE. IN 2013, WE PROVIDED $25.1 MILLION IN CHARITY CARE COSTS. JOHN MUIR HEALTH ALSO ABSORBED $60.7 MILLION, THE FINANCIAL COST OF PROVIDING CARE TO INDIVIDUALS THAT EXCEEDS THE PAYMENTS WE RECEIVE FROM MEDI-CAL. IN ADDITION TO THIS DIRECT DELIVERY OF CARE, JOHN MUIR HEALTH PROVIDES BROAD FINANCIAL AND TECHNICAL SUPPORT TO PROMOTE COMMUNITY WELLNESS. EACH YEAR, THE ORGANIZATION CONTRIBUTES MORE THAN $1 MILLION TO THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND. THE FUND'S GOAL IS TO FOSTER SYSTEMIC CHANGE THAT IMPROVES THE HEALTH OF PEOPLE MOST LIKELY TO EXPERIENCE HEALTH CARE DISPARITIES IN CENTRAL AND EASTERN CONTRA COSTA COUNTY. BY WORKING WITH LEADING COMMUNITY GROUPS, JOHN MUIR HEALTH HAS HELPED FOSTER MANY INNOVATIVE HEALTH CARE PROGRAMS, INCLUDING OUR MOBILE HEALTH CLINIC, THE DENTAL COLLABORATIVE OF CONTRA COSTA WHICH OPERATES A MOBILE DENTAL CLINIC, THE FAITH AND HEALTH PARTNERSHIP AND COMMUNITY NURSES IN ELEMENTARY SCHOOLS IN PITTSBURG AND CONCORD.IN 2013, WE CONTINUED OUR PARTNERSHIPS WITH LA CLINICA DE LA RAZA AND THE CONTRA COSTA HEALTH SERVICES DEPARTMENT TO SERVE LOW-INCOME RESIDENTS THROUGH THE JOHN MUIR HEALTH MOBILE HEALTH CLINIC AND THE DENTAL COLLABORATIVE OF CONTRA COSTA. THROUGH A PARTNERSHIP WITH LA CLINICA DE LA RAZA, JOHN MUIR HEALTH PROVIDED SPECIALTY CARE FOR UNINSURED AND LOW-INCOME PATIENTS. ACCESS TO SPECIALTY CARE HAS BEEN IDENTIFIED AS ONE OF THE GREATEST HEALTH CARE NEEDS OF LOW INCOME, UNINSURED RESIDENTS IN CONTRA COSTA COUNTY. JOHN MUIR HEALTH ALSO SEEKS TO SERVE AT-RISK, OLDER ADULTS IN THE COMMUNITY. AMONG THE PROGRAMS WE SUPPORT ARE THE CARING HANDS VOLUNTEER CAREGIVER PROGRAM, WHICH CREATES ONE-TO-ONE MATCHES BETWEEN VOLUNTEERS AND SENIORS WHO ARE FRAIL, ISOLATED, AND/OR DISABLED. FREE, NON-MEDICAL, IN-HOME ASSISTANCE ENABLES THESE SENIORS TO STAY IN THEIR HOMES AND REMAIN INDEPENDENT AND SAFE. THE FALL PREVENTION PROGRAM OF CONTRA COSTA COUNTY, WHICH IS ALSO SUPPORTED BY JOHN MUIR HEALTH, WORKS WITH SENIOR GROUPS TO GENERATE AWARENESS AND REDUCE INJURIES DUE TO FALLS THROUGH HOME SAFETY ASSESSMENTS AND HOME MODIFICATIONS FOR LOW INCOME SENIORS. COMMUNITY BENEFITS ALSO INCLUDE HEALTH PROFESSIONS EDUCATION PROGRAMS FOR STUDENTS INTERESTED IN THE AREAS OF NURSING, PHYSICAL THERAPY, ULTRASOUND TECHNOLOGY, RADIOLOGIC TECHNOLOGY, REHABILITATION AND CLINICAL PASTORAL CARE.THE JOHN MUIR HEALTH FOUNDATION ALSO RAISES FUNDS TO ENHANCE JOHN MUIR HEALTH PROGRAMS AND, IN THIS WAY, MITIGATES THE COST OF CARE PROVIDED AND ASSISTS JOHN MUIR HEALTH IN MAINTAINING STATE-OF-THE-ART FACILITIES, EQUIPMENT AND PROGRAMS FOR THE COMMUNITY. PART VI, LINE 6: JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND1399 YGNACIO VALLEY ROAD, SUITE 36, WALNUT CREEK, CATHE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND IS THE COMMUNITY BENEFIT GRANT-MAKING ARM OF JOHN MUIR HEALTH. THE FUND'S GOAL IS TO FOSTER SYSTEMIC CHANGE THAT IMPROVES THE HEALTH OF PEOPLE IN CENTRAL AND EASTERN CONTRA COSTA COUNTY WHO ARE UN- OR UNDER-INSURED, HAVE LIMITED ACCESS TO HEALTH CARE, ARE MOST AT-RISK FOR POOR HEALTH, AND ARE MOST LIKELY TO EXPERIENCE HEALTH CARE DISPARITIES. TO ACCOMPLISH THIS GOAL, THE FUND DEVELOPED A FUNDING PROCESS THAT NURTURES LONG-TERM PARTNERSHIPS WITH AND AMONG COMMUNITY-BASED ORGANIZATIONS. THIS LEADS TO VISIONARY HEALTH INITIATIVES THAT BUILD AND SUSTAIN THE CAPACITY TO DELIVER ON THE PROMISE OF GOOD HEALTH AND AFFORDABLE HEALTH CARE FOR ALL. FROM 1997, THE YEAR THE COMMUNITY HEALTH FUND WAS FORMED, THROUGH 2013, THE FUND HAS GRANTED OVER $22 MILLION JOHN MUIR HEALTH COMMUNITY BENEFIT DOLLARS INTO LOCAL COMMUNITY-BASED HEALTH PROJECTS. MORE DETAILED INFORMATION ABOUT THE FUND, ITS GOVERNANCE, GRANT PROGRAM AND COMMUNITY BENEFIT REPORTS CAN FOUND ON ITS WEBSITE: WWW.JMMDCOMMUNITYHEALTHFUND.COM. JOHN MUIR PHYSICIAN NETWORK1350 TREAT BOULEVARD, SUITE 450, WALNUT CREEK, CA THE JOHN MUIR PHYSICIAN NETWORK IS A NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION, WHOSE SOLE CORPORATE MEMBER IS JOHN MUIR HEALTH. SINCE ITS INCEPTION IN 1996, IT HAS BECOME ONE OF THE LARGEST PROVIDERS OF PHYSICIAN AND ALLIED HEALTH SERVICES IN NORTHERN CALIFORNIA, WITH 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS WHO DELIVER COORDINATED PATIENT CARE. PHYSICIANS ASSOCIATED WITH THE PHYSICIAN NETWORK BELONG TO EITHER JOHN MUIR MEDICAL GROUP (JMMG) OR MUIR MEDICAL GROUP IPA, INC. THE PHYSICIAN NETWORK OWNS AND OPERATES PRIMARY CARE PRACTICE CENTERS STAFFED BY JMMG PHYSICIANS IN NUMEROUS LOCATIONS FROM BRENTWOOD TO PLEASANTON. JMMG ALSO PROVIDES HOSPITALISTS (IN-PATIENT MEDICAL SERVICES) AT JOHN MUIR HEALTH'S HOSPITALS. THE PHYSICIAN NETWORK IS ACTIVE IN COMMUNITY SERVICE, HEALTH EDUCATION AND CLINICAL RESEARCH. THE PHYSICIAN NETWORK CURRENTLY HOLDS CONTRACTS WITH SIX MAJOR HEALTH PLANS FOR MORE THAN 48,000 COMMERCIAL AND SENIOR HMO MEMBERS. ADDITIONALLY, THE PHYSICIAN NETWORK PROVIDES A PHYSICIAN PANEL, MEDICAL MANAGEMENT AND CLAIMS SERVICES FOR MORE THAN 9,500 JOHN MUIR HEALTH EMPLOYEES AND DEPENDENTS PARTICIPATING IN THE EXCLUSIVE PROVIDER ORGANIZATION HEALTH PLAN. THE PHYSICIAN NETWORK MANAGES HEALTH PLAN CONTRACTING FOR JOHN MUIR HEALTH AND ITS HOSPITALS AND ENGAGES IN PHYSICIAN RECRUITMENT TO MEET COMMUNITY NEEDS. THE PHYSICIAN NETWORK ALSO OPERATES THE JMH MEDICARE ACO WHICH PROVIDES FOR COORDINATION OF CARE FOR ITS MEDICARE ACO MEMBERS. JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF THE JOHN MUIR PHYSICIAN NETWORK. JOHN MUIR HEALTH BEHAVIORAL HEALTH CENTER2740 GRANT STREET, CONCORD, CAJOHN MUIR HEALTH OFFERS COMPLETE INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH PROGRAMS AND SERVICES THROUGH THE JOHN MUIR HEALTH BEHAVIORAL HEALTH CENTER, THE HEALTH SYSTEM'S FULLY ACCREDITED, 73-BED PSYCHIATRIC HOSPITAL LOCATED IN CONCORD. THE JOHN MUIR HEALTH BEHAVIORAL HEALTH CENTER OFFERS PSYCHIATRIC TREATMENT FOR ADULTS, CHILDREN AND ADOLESCENTS WHO ARE EXPERIENCING EMOTIONAL OR BEHAVIORAL PROBLEMS. FOR THOSE WHO ARE DEPENDENT ON ALCOHOL OR DRUGS, THE BEHAVIORAL HEALTH CENTER OFFERS A FULL ARRAY OF CHEMICAL DEPENDENCY TREATMENT PROGRAMS. THE JOHN MUIR HEALTH BEHAVIORAL HEALTH CENTER IS ACCREDITED BY THE JOINT COMMISSION. JOHN MUIR HEALTH FOUNDATION1400 TREAT, WALNUT CREEK, CATHE FOUNDATION RAISES FUNDS FOR PROGRAMS AND PROJECTS OF JOHN MUIR HEALTH, INCLUDING VARIOUS EDUCATION PROGRAMS, OPERATIONS, BUILDINGS AND EQUIPMENT. JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF JOHN MUIR HEALTH FOUNDATION. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 JOHN MUIRMT DIABLO COMMUNITY HEALTH FUND 1399 YGNACIO VALLEY ROAD SUITE 36 WALNUT CREEK CA 94598 911788973 501(C)(3) 2378691 CASH VALUE COMMUNITY GRANTS JOHN MUIR BEHAVIORAL HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680249685 501(C)(3) 7271355 CASH VALUE GENERAL SUPPORT JOHN MUIR HEALTH FOUNDATION 1400 TREAT BOULEVARD SUITE 300 WALNUT CREEK CA 94597 942650855 501(C)(3) 3085059 CASH VALUE GENERAL SUPPORT 3 0 SCHOLARSHIPS 10 40000 0 PART I, LINE 2: JOHN MUIR HEALTH AND FINANCIAL MANAGEMENT MONITOR THE USE OF THE RESTRICTED FUNDS TO MEET THE INTENDED PURPOSES. SCHOLARSHIPS MADE IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSE ARE SUBJECT TO CONDITIONS ESTABLISHED TO ENSURE THAT INDIVIDUALS RECEIVING SCHOLARSHIPS ARE ADEQUATELY INVESTIGATED TO VERIFY THEY ARE QUALIFIED RECIPIENTS. X X X 1 1 X X X X 1 1 0 0 0 1 1 0 0 CALVIN KNIGHT PRESIDENT/CEO/DIRECTOR 912343 0 470936 0 84992 0 683676 0 20276 0 2172223 0 470936 0 MICHAEL MOODY CFO 462093 0 165490 0 41522 0 216461 0 21828 0 907394 0 165490 0 NANCY OLSON ASSISTANT SECRETARY 381410 0 147852 0 86633 0 170994 0 15377 0 802266 0 147852 0 IRVING PIKE CMO 451289 0 87162 0 66613 0 184443 0 19086 0 808593 0 87162 0 JANE WILLEMSEN CAO (WALNUT CREEK CAMPUS) 463923 0 233784 0 17912 0 349916 0 16586 0 1082121 0 233784 0 MICHAEL THOMAS CAO (CONCORD CAMPUS) 431287 0 203162 0 18277 0 303805 0 21828 0 978359 0 203162 0 GEORGE KAZAGLIS VP/COO 254072 0 365262 0 15424 0 134561 0 18507 0 787826 0 0 0 MARTI TARNOWSKI VP PLANNING & MARKETING 334090 0 127809 0 26729 0 176401 0 16181 0 681210 0 127809 0 MICHAEL MONALDO VP FACILITIES DEVELOPMENT 292178 0 117099 0 48981 0 124570 0 21828 0 604656 0 117099 0 DEBRA PENDERGAST VP PATIENT CARE SERVICES 321360 0 110152 0 37534 0 147046 0 19086 0 635178 0 110152 0 DONNA BRACKLEY CHIEF NURSING OFFICER 288122 0 107225 0 32529 0 153302 0 18507 0 599685 0 0 0 KENNETH MEEHAN FORMER EXECUTIVE VP OPERATIONS 0 0 254182 0 627312 0 447673 0 23481 0 1352648 0 254182 0 PART I, LINE 1A THE COMPANY HAS A POLICY WHEREBY CERTAIN PAYMENTS TO EMPLOYEES AND MEMBERS OF THE BOARD OF DIRECTORS ARE GROSSED UP. THESE PAYMENTS ARE NOT AN USUAL OCCURRENCE AND ARE EVALUATED AND APPROVED BY THE CEO OR CFO. ADDITIONALLY, FOR CERTAIN MEMBERS OF MANAGEMENT THAT ARE RECRUITED FROM OUTSIDE OF THE AREA, A HOUSING ALLOWANCE MAY BE PROVIDED AS PART OF THE RECRUITMENT PROCESS. EACH RECRUITMENT IS EVALUATED ON A CASE-BY-CASE BASED ON THE CURRENT MARKET AND THE QUALIFICATIONS OF THE CANDIDATE TO DETERMINE WHETHER OR NOT THE INCLUSION OF A HOUSING ALLOWANCE WILL BE PART OF THE RECRUITMENT PACKAGE. FOR CERTAIN MEMBERS OF MANAGEMENT A REIMBURSEMENT OF UP TO 50% OF HEALTH CLUB DUES IS AVAILABLE. THIS PERQUISITE IS INCLUDED AS PART OF THE EVALUATION OF THE ANNUAL COMPENSATION EVALUATION PROCESS. ALL COMPONENTS DISCUSSED IN THIS SECTION ARE TREATED AS TAXABLE INCOME FOR THE EMPLOYEE RECEIVING THE PAYMENT. PART I, LINE 1B THE CORPORATION, WITH THE OVERSIGHT AND APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, BASES A PORTION OF ANNUAL MANAGEMENT INCENTIVE PAYMENTS ON THE CONSOLIDATED NET EARNINGS TARGETS OF JOHN MUIR HEALTH. IN ADDITION TO THE CONSOLIDATED NET EARNINGS THE MANAGEMENT INCENTIVE PAYMENTS ARE BASED ON VARIOUS QUALITY AND PATIENT SATISFACTION METRICS. PAYMENTS TO MANAGEMENT PERSONNEL ARE MADE IN THE SUBSEQUENT YEAR BASED ON THE LEVEL OF ACHIEVEMENT OF ALL ELEMENTS OF THE INCENTIVE PROGRAM, OF WHICH NET EARNINGS TARGETS ARE A COMPONENT. THEREFORE, EACH YEAR AN ACCRUAL OF THE ESTIMATED PAYMENTS FOR MANAGEMENT INCENTIVES IS INCLUDED IN THE CALCULATION OF NET EARNINGS TARGETS FOR THAT YEAR. THE INCENTIVE PROGRAMS FOR THE MANAGEMENT OF JOHN MUIR HEALTH ARE DEVELOPED AND REVIEWED BY AN OUTSIDE CONSULTANT WHOSE EXPERTISE IS IN COMPENSATION AND WHO DEVELOPS MARKET DATA FOR SIMILAR ORGANIZATIONS AS A BASIS FOR THE CORPORATION'S INCENTIVE PROGRAM. THE INCENTIVE PROGRAM AND MARKET DATA IS REVIEWED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART I, LINE 3 THE CORPORATION, WITH THE OVERSIGHT AND APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, BASES A PORTION OF ANNUAL MANAGEMENT INCENTIVE PAYMENTS ON THE CONSOLIDATED NET EARNINGS TARGETS OF JOHN MUIR HEALTH. PAYMENTS TO MANAGEMENT PERSONNEL ARE MADE IN THE SUBSEQUENT YEAR BASED ON THE LEVEL OF ACHIEVEMENT OF ALL ELEMENTS OF THE INCENTIVE PROGRAM, OF WHICH NET EARNINGS TARGETS ARE A COMPONENT. THEREFORE, EACH YEAR AN ACCRUAL OF THE ESTIMATED PAYMENTS FOR MANAGEMENT INCENTIVES IS INCLUDED IN THE CALCULATION OF NET EARNINGS TARGETS FOR THAT YEAR. THE INCENTIVE PROGRAMS FOR THE MANAGEMENT OF JOHN MUIR HEALTH ARE DEVELOPED AND REVIEWED BY AN OUTSIDE CONSULTANT WHOSE EXPERTISE IS IN COMPENSATION AND WHO DEVELOPS MARKET DATA FOR SIMILAR ORGANIZATIONS AS A BASIS FOR THE CORPORATION'S INCENTIVE PROGRAM. THE INCENTIVE PROGRAM AND MARKET DATA IS REVIEWED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART I, LINES 4A-B IN 2013, JMH IMPLEMENTED A "VOLUNTARY SEPARATION PROGRAM" (VSP) TO ALLOW ELIGIBLE EMPLOYEES TO EXIT JMH VOLUNTARILY BASED ON THEIR PERSONAL CHOICES AND CIRCUMSTANCES. THE VSP WAS OPEN TO ALL EMPLOYEES, WITH THOSE ACCEPTED RECEIVING A BASIC SEVERANCE PAYMENT PLUS ADDITIONAL FINANCIAL INCENTIVE BASED ON YEARS OF SERVICE IN EXCHANGE FOR THEIR AGREEMENT TO SEPARATE VOLUNTARILY FROM JMH. THE VSP WAS IMPLEMENTED AT JMH AND ALL JMH SUBSIDIARIES. KENNETH MEEHAN RECEIVED SEVERANCE OF $524,826 PART I, LINE 4B: JANE ANN WILLEMSEN $163,124 SERP PLAN MICHAEL THOMAS $128,220 SERP PLAN CALVIN KNIGHT $216,307 SERP PLAN MARTI TARNOWSKI $ 70,137 RESTORATION PLAN MICHAEL D MOODY $ 73,143 RESTORATION PLAN NANCY OLSON $ 48,908 RESTORATION PLAN MICHAEL MONALDO $ 27,831 RESTORATION PLAN IRVING PIKE $ 51,781 RESTORATION PLAN KENNETH MEEHAN $251,756 RESTORATION PLAN GEORGE KAZAGLIS $ 66,951 RESTORATION PLAN DEBRA PENDERGAST $ 41,782 RESTORATION PLAN DONNA BRACKLEY $ 57,925 RESTORTAION PLAN SUPPLEMENTAL INFORMATION COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, OTHER OFFICERS AND KEY EMPLOYEES ARE ESTABLISHED ANNUALLY BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE UTILIZES AN OUTSIDE CONSULTANT WHO IS A COMPENSATION EXPERT. THE OUTSIDE CONSULTANT PROVIDES MARKET DATA FOR EACH INDIVIDUAL BASED UPON THEIR LEVEL OF RESPONSIBILITIES AND THAT DATA IS USED BY THE COMPENSATION COMMITTEE TO ESTABLISH THE ANNUAL COMPENSATION PACKAGE FOR EACH INDIVIDUAL. IT IS THE PHILOSOPHY OF THE ORGANIZATION TO ESTABLISH A COMPENSATION PACKAGE FOR EACH INDIVIDUAL THAT REFLECTS THE MEDIAN OF THE MARKET AS ESTABLISHED BY THE OUTSIDE CONSULTANT. SCHEDULE J, PART II, COLUMN B(III): IN DECEMBER 2013, JMH IMPLEMENTED A "PAID TIME OFF CAP" TO BE EFFECTIVE BEGINNING IN 2014. IN CONNECTION WITH THE NEW POLICY TO LIMIT BENEFIT-ELIGIBLE EMPLOYEE AT 125% OF THEIR TOTAL PAID TIME OFF ACCRUAL VALUE (BASED ON YEARS OF SERVICE), JMH CASHED OUT EMPLOYEE BALANCES IN EXCESS OF 100% OF THEIR PAID TIME OFF ACCRUAL CAPS. THE NEW POLICY IS EFFECTIVE AT JMH AND ALL JMH SUBSIDIARIES. A CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130911J84 2005-05-10 50290253 SEE PART VI 0 0 0 B CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130911Y87 2006-06-14 203016972 SEE PART VI 0 0 0 C CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130795UC9 2008-05-02 145800000 SEE PART VI 0 0 0 D CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130795N86 2009-10-29 101911952 SEE PART VI 0 0 0 A 23805000 50290253 908703 644000 48737550 1 0 1 1 B 231090613 23598317 2140116 205352180 2011 0 0 1 1 C 50700000 145800000 1155297 497539 144165164 1 0 1 1 D 5850000 101922259 1911852 99973171 37236 2011 0 0 0 1 A 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 0 0 0.00000 0.00010 0.00010 0 0 1 C 0 0 1 0 0 0.00000 0.00010 0.00010 0 0 1 D 0 0 1 0 0 0.00000 0.00010 0.00010 0 0 1 A 0 0 0 1 0 0 0 0 1 B 1 0 0 0 1 1 C 0 0 0 1 1 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 0 B 0 C 0 D 0 SCHEDULE K SUPPLENTAL INFORMATION DIFFERENCE BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. PART I, LINE A, COLUMN (F) - TO PAY THE OUTSTANDING PRINCIPAL AMOUNT OF THE CITY OF WALNUT CREEK CERTIFICATES OF PARTICIPATION REFUNDING SERIES 1994, ORIGINALLY ISSUED 2/17/1994. PART I, LINE B, COLUMN (F) - THE BONDS WERE ISSUED FOR THE PURPOSE OF (I) FINANCING AND REFINANCING THE COST OF ACQUISITION, CONSTRUCTION, IMPROVEMENT, EQUIPPING, RENOVATION, REHABILITATION, REMODELING AND OTHER CAPITAL PROJECTS ON OR ABOUT THE JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS, (II) FINANCING VARIOUS ROUTINE CAPITAL EXPENDITURES AND THE COST OF ACQUISITION OF EQUIPMENT TO BE LOCATED ON THE JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS, (III) PROVIDING FOR PAYMENT OF A PORTION OF INTEREST ON THE BONDS, AND (IV) PAYING CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS. PART I, LINE C, COLUMN (D) - 5/2/08 AND 5/13/08. PART I, LINE C, COLUMN (F) - 2008 A AND B TO (1) REFUND AND PAY IN FULL THE OUTSTANDING PRINCIPAL AMOUNT OF THE $100,000,000 AGGREGATE PRINCIPAL AMOUNT CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BONDS (JOHN MUIR HEALTH) SERIES 2006 B AND SERIES 2006 C (THE "SERIES 2006 BONDS") ORIGINALLY ISSUED 6/14/2006 AND (2) TO PAY CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS. 2008 C TO (1) REFUND AND PAY IN FULL THE VARIABLE RATE PORTION OF THE CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY $90,000,000 CERTIFICATES OF PARTICIPATION, JOHN MUIR/MT. DIABLO HEALTH SYSTEM (1997) ORIGINALLY ISSUED 10/29/1997, IN THE OUTSTANDING PRINCIPAL AMOUNT OF $44,000,000 AND (2) TO PAY CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2008 C BONDS. PART I, LINE D, COLUMN (F) - THE BONDS WERE ISSUED FOR THE PURPOSES OF (1) FINANCING THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, RENOVATION, REHABILITATION, REMODELING AND OTHER CAPITAL PROJECTS ON OR ABOUT THE JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS AND ON OR ABOUT THE JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS AND (2) PAYING CERTAIN COSTS OF ISSUANCE. PART I, LINE E, COLUMN (F) - THE BONDS WERE ISSUED FOR THE PURPOSE OF REFUND AND PAYMENT IN FULL OF THE OUTSTANDING PRINCIPAL AMOUNT AND INTEREST DUE ON THE 1997 CERTIFICATES OF PARTICIPATION AND THE SERIES 2008B BONDS ISSUED 10/29/1997 AND 5/2/2008 RESPECTIVELY. PART III, LINE 3B AND 3D - JOHN MUIR HEALTH ENGAGES BOND COUNSEL IN CONNECTION WITH PUBLIC DEBT OFFERINGS OR REFINANCING, DURING WHICH BOND COUNSEL REVIEWS MANAGEMENT OR SERVICE CONTRACTS RELATED TO FINANCED PROPERTY. PART IV, LINE 6, COLUMN B - SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. PART V - IN MAY 2012, JOHN MUIR HEALTH ENTERED INTO AN AGREEMENT WITH THE CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY (CSCDA) IN WHICH JOHN MUIR HEALTH COVENANTS TO COMPLY WITH THE REQUIREMENTS AND PROCEDURES SET FORTH IN THE CSCDA POST-ISSUANCE TAX COMPLIANCE PROCEDURES FOR TAX EXEMPT BONDS. JOHN MUIR HEALTH IS ASSESSING THE NEED TO ESTABLISH WRITTEN PROCEDURES IN CONNECTION WITH THE COVENANT TO COMPLY. A CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 2012-05-23 89800000 SEE PART VI 0 0 0 A 3061250 89800000 502197 89170000 127803 1 0 0 1 A 0 0 1 0 0 0.00000 0.00010 0.00010 0 0 1 A 0 0 0 1 1 0 0 0 1 A 0 CALVIN KNIGHT CEO/OFFICER HOUSING RELOCATION X 250000 129167 0 1 1 DEBRA PENDERGAST HIGHEST COMPENSATED HOUSING RELOCATION X 125000 101250 0 1 1 230417 AMY ANDERSON SPOUSE OF A BOARD MEMBER 143805 EMPLOYEE 0 BAY AREA SURGICAL SPECIALIST BOARD MEMBER HAS OWNERSHIP INTEREST 1376958 CONTRACTS FOR PROFESSIONAL AND ADMINISTRATIVE SERVICES 0 JOHN MUIR MEDICAL GROUP COMMON BOARD MEMBERS 464681 CONTRACTS FOR PROFESSIONAL AND ADMINISTRATIVE SERVICES 0 EAST BAY MEDICAL ONCOLOGY HEMATOLOGY MEDICAL ASSOCIATES INC BOARD MEMBER HAS OWNERSHIP INTEREST 400598 CONTRACTS FOR PROFESSIONAL AND ADMINISTRATIVE SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 THOMAS RUNDALL (JMH VICE CHAIR AND DIRECTOR) IS A BOARD MEMBER OF ON LOK, INC., A NOT-FOR-PROFIT COMMUNITY ORGANIZATION WHICH EMPLOYS ROBERT EDMONDSON (JMH DIRECTOR) AS CEO. FORM 990, PART VI, SECTION A, LINE 4 THROUGH THE WORK OF THE JMH AD HOC GOVERNANCE COMMITTEE OF THE JMH BOARD, THE JMH GOVERNANCE COMMITTEE AND BOARD EVALUATED AND RESTRUCTURED THE GOVERNANCE OF JOHN MUIR HEALTH (JMH) AND TWO OF ITS AFFILIATED ENTITIES, JOHN MUIR PHYSICIAN NETWORK (JMPN) AND JOHN MUIR BEHAVIORAL HEALTH (JMBH). THESE CHANGES WERE DEVELOPED TO (I) PROVIDE BROAD OVERSIGHT OF THE ACTIVITIES OF THE JMH HEALTH SYSTEM, (II) INCLUDE A DIVERSITY OF PERSPECTIVES OF BOTH COMMUNITY AND COMMUNITY PHYSICIANS AND (III) INCREASE TRANSPARENCY. THE JMH BYLAWS WERE AMENDED AS OF SEPTEMBER 1, 2013 TO IMPLEMENT GOVERNANCE CHANGES RELATED TO JMH. A. BOARD COMPOSITION. THE BOARD SIZE REMAINED THE SAME, INCLUDING THE CEO AS A VOTING MEMBER. THE NUMBER OF VOTING MEMBERS WAS CHANGED TO INCLUDE 8 COMMUNITY MEMBERS AND 6 PHYSICIANS (PREVIOUSLY, 10 COMMUNITY MEMBERS AND 4 PHYSICIANS). UNTIL JANUARY 1, 2018, MUIR MEDICAL GROUP IPA (IPA) WILL RECOMMEND FOUR OF THE PHYSICIAN VOTING MEMBERS OF THE BOARD AND JOHN MUIR MEDICAL GROUP (JMMG) WILL RECOMMEND TWO. THE BYLAWS PROVIDE THAT THESE RECOMMENDATIONS ARE SUBJECT TO APPROVAL BY THE JMH BOARD. B. DIRECTOR COMPENSATION. THE BYLAWS PERMIT (BUT DO NOT REQUIRE) COMPENSATION OF VOTING BOARD MEMBERS AND COMMITTEE MEMBERS. C. COMMITTEE MEMBERSHIP. I. EXECUTIVE COMMITTEE. THE COMPOSITION WAS CHANGED TO ADD AN ADDITIONAL PHYSICIAN BOARD MEMBER, SHIFTING FROM A TOTAL OF SIX OR SEVEN BOARD MEMBERS, TO SEVEN OR EIGHT (DEPENDING ON WHETHER THE PAST CHAIR CONTINUED TO BE A BOARD MEMBER). THE BYLAWS ALSO CLARIFIED THAT ONLY VOTING BOARD MEMBERS MAY VOTE WHEN THE COMMITTEE EXERCISES DELEGATED BOARD AUTHORITY. II. GOVERNANCE COMMITTEE. THE COMPOSITION WAS CHANGED FROM A RANGE OF FIVE TO SEVEN TO FIVE, WITH THREE COMMUNITY BOARD MEMBERS AND TWO PHYSICIAN BOARD MEMBERS (ONE RECOMMENDED BY EACH OF THE IPA AND JMMG THROUGH THE END OF 2019). THE BYLAWS CLARIFIED THAT ONLY VOTING BOARD MEMBERS MAY VOTE WHEN THE COMMITTEE EXERCISES DELEGATED BOARD AUTHORITY. III. FINANCE COMMITTEE. THE BYLAWS LIMITED THE NUMBER OF COMMITTEE MEMBERS TO 11, RESULTING IN A RANGE OF SEVEN TO 11 MEMBERS. IN ADDITION, THE CHAIR OF THE AUDIT AND COMPLIANCE COMMITTEE WAS ADDED AS A MEMBER. FINALLY, THE ROLE OF THE COMMITTEE WAS EXPANDED TO INCLUDE REAL ESTATE AND CONSTRUCTION OVERSIGHT. IV. INVESTMENT SUBCOMMITTEE. THE MINIMUM NUMBER OF MEMBERS AS INCREASED FROM SEVEN TO NINE, RESULTING IN A RANGE OF NINE TO 11. THE BYLAWS WERE ALSO CHANGED TO ADD A REQUIREMENT THAT THE CHAIR BE A VOTING BOARD MEMBER AND THAT MEMBERS HAVE FINANCE EXPERTISE. V. STRATEGIC PLANNING AND MARKETING COMMITTEE. THE MINIMUM NUMBER OF MEMBERS WAS INCREASED FROM SEVEN TO NINE, INCLUDING AN INCREASE IN THE MINIMUM NUMBER OF PHYSICIANS FROM TWO TO FOUR. THE BYLAWS ALSO ADDED THE JMH PRESIDENT/CEO AS AN EX OFFICIO NON-VOTING MEMBER. VI. AUDIT AND COMPLIANCE COMMITTEE. THE BYLAWS ADDED S REQUIREMENT THAT ALL MEMBERS BE "FINANCIALLY LITERATE," AND ALSO THAT AT LEAST ONE MEMBER BE A "FINANCIAL EXPERT" (AS DEFINED UNDER SARBANES-OXLEY). VII. QUALITY AND PATIENT SAFETY COMMITTEE. THE MINIMUM NUMBER OF MEMBERS WAS INCREASED FROM NINE TO 12 (INCLUDING AT LEAST FIVE PHYSICIANS). THE LIMIT ON THE NUMBER OF MEMBERS WAS REMOVED. FORM 990, PART VI, SECTION A, LINE 6 MT. DIABLO HEALTHCARE DISTRICT AND JOHN MUIR ASSOCIATION HAVE THE RIGHT TO APPROVE CERTAIN SIGNIFICANT CORPORATE ACTIONS (AS DESCRIBED IN SCHEDULE O). FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF JOHN MUIR HEALTH PROVIDE THAT JOHN MUIR HEALTH MAY NOT, WITHOUT THE PRIOR WRITTEN CONSENT OF THE MT. DIABLO HEALTHCARE DISTRICT, A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA, AND THE JOHN MUIR ASSOCIATION, A CALIFORNIA NONPROFIT CORPORATION: (I) SELL, TRANSFER, OR OTHERWISE DISPOSE OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF JOHN MUIR HEALTH; (II) ISSUE A MEMBERSHIP IN JOHN MUIR HEALTH TO ANY PERSON OR ENTITY; (III) MERGE WITH ANY OTHER PERSON OR ENTITY, UNLESS JOHN MUIR HEALTH IS THE SURVIVING CORPORATION IN THE MERGER; OR (IV) AMEND SECTION 5.6 OF THE BYLAWS OF JOHN MUIR HEALTH (WHICH OBLIGATES JOHN MUIR HEALTH TO, AMONG OTHER THINGS, PROVIDE AT LEAST ONE MILLION DOLLARS ($1,000,000) ANNUALLY TO FUND CERTAIN COMMUNITY BENEFIT PROJECTS SPONSORED BY THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND). FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED AND CONSCIENTIOUS REVIEW BY ALL MEMBERS. AN OVERVIEW OF THE FORM 990, WITH SUFFICIENT DETAIL, IS PRESENTED TO THE BOARD WITH THE COMPLETED FORM 990. ALL QUESTIONS AND CONCERNS OF THE BOARD OF DIRECTORS WILL BE ADDRESSED BY THE CHIEF FINANCIAL OFFICER OR HIS DESIGNEE AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. AFTER ALL OF THE INPUT FROM THE BOARD OF DIRECTORS HAS BEEN APPROPRIATELY ADDRESSED, SENIOR MANAGEMENT OF JOHN MUIR HEALTH WILL FILE THE FINAL FORM 990 AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE JOHN MUIR HEALTH ("JMH") BOARD CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO BOARD MEMBERS, ALONG WITH A CONFLICT OF INTEREST DISCLOSURE FORM REQUIRED TO BE COMPLETED AND SIGNED. FOLLOWING DISTRIBUTION OF THE POLICY, THE GENERAL COUNSEL PROVIDES AN EDUCATIONAL SESSION RELATING TO BOARD MEMBER FIDUCIARY DUTIES AND CONFLICTS OF INTEREST COVERING, AMONG OTHER THINGS, REQUIRED DISCLOSURES AND THE PROCESS FOR APPROVAL OF TRANSACTIONS INVOLVING A POTENTIAL CONFLICT. DISCLOSED CONFLICTS ARE COMPILED IN A DOCUMENT AND REVIEWED BY THE BOARD CHAIR, PRESIDENT/CEO AND GENERAL COUNSEL. TOGETHER, THESE INDIVIDUALS MONITOR ANY POTENTIAL CONFLICTS AND THE GENERAL COUNSEL ATTENDS BOARD MEETINGS TO ENSURE COMPLIANCE WITH THE POLICY. TRANSACTIONS INVOLVING A POTENTIAL CONFLICT ARE REVIEWED AND APPROVED IN ADVANCE BY THE GENERAL COUNSEL, THE GOVERNANCE COMMITTEE, AND FOR CERTAIN TRANSACTIONS WITH CURRENT BOARD MEMBERS, THE BOARD. THE POLICY ALSO REQUIRES BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICTS DURING THE YEAR. AS QUESTIONS ABOUT POTENTIAL CONFLICTS ARISE DURING THE YEAR, THE GENERAL COUNSEL REVIEWS THEM WITH THE AFFECTED BOARD MEMBER, THE PRESIDENT/CEO AND THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED ANNUALLY BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE UTILIZES AN OUTSIDE CONSULTANT WHO IS A COMPENSATION EXPERT. THE OUTSIDE CONSULTANT PROVIDES MARKET DATA FOR EACH INDIVIDUAL BASED UPON THEIR LEVEL OF RESPONSIBILITIES AND THAT DATA IS USED BY THE COMPENSATION COMMITTEE TO ESTABLISH THE ANNUAL COMPENSATION PACKAGE FOR EACH INDIVIDUAL. IT IS THE PHILOSOPHY OF THE ORGANIZATION TO ESTABLISH A COMPENSATION PACKAGE FOR EACH INDIVIDUAL THAT REFLECTS THE MEDIAN OF THE MARKET AS ESTABLISHED BY THE OUTSIDE CONSULTANT. FORM 990, PART VI, SECTION C, LINE 19 JOHN MUIR HEALTH PROVIDES FINANCIAL INFORMATION ON A QUARTERLY BASIS THROUGH VARIOUS BOND DISCLOSURE DATABASES. THIS FINANCIAL INFORMATION IS AVAILABLE FOR JOHN MUIR HEALTH ON A CONSOLIDATED AND CONSOLIDATING BASIS, INCLUDING SUBSIDIARIES. REQUESTS FOR THE PROVISION OF GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE DIRECTED TO OUR LEGAL DEPARTMENT FOR THE APPROPRIATE RESPONSE. FORM 990, PART XI, LINE 9: CHANGE IN PENSION FUND LIABILITY 54,824,000. 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