2014-11-14T10:46:36-06:00 2013-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192303 990 2013-01-01 941044474 LODI MEMORIAL HOSPITAL ASSOCIATION INC LODI 2093343411 975 S FAIRMONT AVENUE LODI CA 95240 JOSEPH P HARRINGTON CEO & PRESIDENT 2093343411 2014-11-14 1 TRACY S PAGLIA P00366884 2099556100 2013 2015-11-30 17:44:51Z LODI MEMORIAL HOSPITAL & LODI HEALTH JOSEPH P HARRINGTON 975 S FAIRMONT AVENUE LODI CA 95240 210981339 0 X WWW.LODIHEALTH.ORG X 1945 CA PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY 17 15 1561 208 53825 0 509921 479674 190645854 203455454 1773545 1276688 38829 158468 192968149 205370284 163525 259063 0 0 86177988 94731082 0 0 180758 108578472 122576161 194919985 217566306 -1951836 -12196022 271434032 264618252 167772972 168836580 103661060 95781672 X AS A NOT-FOR-PROFIT, HEALTH-CARE DELIVERY SYSTEM, LODI MEMORIAL HOSPITAL IS DEDICATED TO:- IMPROVING COMMUNITY HEALTH;- PROVIDING QUALITY AND TIMELY HEALTH-CARE SERVICES, RANGING FROM HEALTH PROMOTION AND EDUCATION TO DIAGNOSTICS, ACUTE-INPATIENT CARE, REHABILITATION SERVICES AND HOME CARE;- EXPANDING COMMUNITY ACCESS TO CARE. 0 0 169694371 259063 198451758 LODI MEMORIAL HOSPITAL IS A NON-PROFIT, ACUTE CARE HOSPITAL PROVIDING HIGH QUALITY SERVICES THAT PROMOTE HEALTH AND REHABILITATION, PREVENT DISEASE, AND TREAT AND CARE FOR THE SICK AND INJURED. HOSPITAL STAFF, MEDICAL STAFF AND THE GOVERNING BOARD ARE DEDICATED TO TREATING ALL PATIENTS AND VISITORS AS INDIVIDUALS WITH EQUAL DIGNITY, RESPECT AND QUALITY OF CARE.LODI MEMORIAL HOSPITAL TREATS AND PROVIDES CARE TO ITS PATIENTS THROUGH INPATIENT AND OUTPATIENT SERVICES. INPATIENTS RECEIVE CARE THROUGH MEDICAL-SURGICAL, PERI-OPERATIVE, PERI-NATAL, PEDIATRIC, INTENSIVE CARE, AND ACUTE-PHYSICAL REHABILITATION SERVICES.OUTPATIENT CARE INCLUDES 24-HOUR EMERGENCY, DIAGNOSTIC SERVICES, SURGERY, REHABILITATION AND EDUCATION.LODI MEMORIAL HOSPITAL IDENTIFIES THE HEALTH-CARE AND HEALTH MAINTENANCE NEEDS AND PREFERENCES OF THE COMMUNITY IT SERVES. DIAGNOSTIC, REHABILITATIVE, EDUCATIONAL, TREATMENT AND PREVENTATIVE SERVICES ARE DEVELOPED AS APPROPRIATE FOR A HOSPITAL OF THIS SIZE AND ROLE.LODI MEMORIAL HOSPITAL, CONSISTENT WITH ITS NON-PROFIT STATUS, DEVELOPS FINANCIAL RESOURCES TO ADEQUATELY SUPPORT HEALTH MAINTENANCE AND PATIENT-CARE SERVICES; CHARITY CARE FOR THOSE UNABLE TO PAY, WORKING CAPITAL NEEDS; AND CAPITAL REQUIREMENTS OF PLANT, EQUIPMENT AND ENVOLVING TECHNOLOGY. EVERY EFFORT IS MADE TO KEEP COSTS AFFORDABLE FOR PATIENTS WHILE CONTINUOUSLY STRIVING TO IMPROVE THE QUALITY OF SERVICE. 9051932 0 5008368 LODI MEMORIAL COMMUNITY CLINICS ARE LICENSED UNDER THE DEPARTMENT OF PUBLIC HEALTH SERVICES REGULATIONS, AND ARE OWNED AND OPERATED BY THE LODI MEMORIAL HOSPITAL ASSOCIATION, INC., A NOT-FOR-PROFIT ENTITY AND WILL PROVIDE MEDICAL CARE TO ANY AGE. A COMMUNITY CLINIC UNIT OFFERS SERVICES DURING POSTED HOURS OF BUSINESS, WITH AT LEAST ONE PHYSICIAN EXPERIENCED IN THE COMMUNITY CLINIC PRACTICE. SPECIALTY CONSULTATION WILL BE AVAILABLE BY PHONE OR REFERRAL TO MEMBERS OF THE MEDICAL STAFF. IN 2013, THERE WERE FOUR (4) COMMUNITY CLINICS LICENSED AND OPERATIONAL. 178746303 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 437 0 1 1561 1 1 1 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X CYNTHIA BUTLER CONTROLLER 2093343411 975 S FAIRMONT AVE FINANCE DEPT LODI CA 95240 SORBERA THOMAS MD BOARD MEMBER & LMCC PHYSICIAN 40.00 X 345901 0 7979 ADDINGTON RON BOARD MEMBER 2.00 X 0 0 0 AGUIRE ELIZABETH BOARD MEMBER 2.00 X 0 0 0 CRABTREE STEVE VICE CHAIR 2.00 X X 0 0 0 CUMMINS WILLIAM LEE BOARD MEMBER 2.00 X 0 0 0 DILLON CECIL BOARD MEMBER, CHAIR 5.00 X X 0 0 0 FERREE CHRISTEEN BOARD MEMBER 2.00 X 0 0 0 GILL PARAMPAL MD BOARD MEMBER 2.00 X 186525 0 0 HALEY PAUL BOARD MEMBER 2.00 X 0 0 0 KIRST JEFF BOARD MEMBER 2.00 X 0 0 0 KHAN TAJ BOARD MEMBER 2.00 X 0 0 0 OLSON DEBBIE BOARD MEMBER 2.00 X 0 0 0 PHELPS DAN SECRETARY/TREASURER 2.00 X X 0 0 0 PATRICK ROBERT PAT BOARD MEMBER 2.00 X 0 0 0 SHULMAN MONA BOARD MEMBER 2.00 X 0 0 0 FETZER STEVE BOARD MEMBER 2.00 X 0 0 0 ALI SYED MD CHIEF OF MEDICAL STAFF (2013) 2.00 X 0 0 0 HARRINGTON JOSEPH P CEO & PRESIDENT 50.00 X 349458 0 64014 BUTLER CYNTHIA B INTERIM CFO (6/23/12-10/13/13) 50.00 X 168870 0 12221 DEAK TERRANCE A CFO & VICE PRES. (EFF 10/2013) 50.00 X 44375 0 2558 MORENO DEBBE JOYCE CHIEF NURSING OFFICER 50.00 X 199956 0 15894 SEY MARK CHIEF ADMINISTRATIVE OFFICER 50.00 X 186644 0 12603 WOOTON ROBYN VP OF FUND DEVELOPMENT (THRU 6/2013) 50.00 X 161151 0 4084 SCHNEIDER PAMELA EXECUTIVE DIRECTOR-O/P SVC 50.00 X 155653 0 11920 LAVIOLA STEVEN MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 451435 0 5815 CONNOLY JOHN PATRICK MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 346441 0 10012 FREUND EDMUND A MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 379409 0 8298 SOROUR NAGUI MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 485708 0 0 SCHOCH DENNY MD PHYSICIAN, COMMUNITY CLINICS 40.00 X 379186 0 1713 3840712 0 157111 192 0 1 0 QUANTUM HEALTHCARE MEDICAL ASSOCIATES I PO BOX 634850 CINCINNATI OH 45263 PHYSICIAN PROFESSIONAL SERVICES - HOSPIT 2577327 KIMMEL CONSTRUCTION INC 10 MAIN AVE SUITE 2 SACRAMENTO CA 95838 CONSTRUCTION CONTRACTOR 1933490 PREMIER ANESTHESIA 2655 NORTHWINDS PARKWAY ALPHAETA GA 30009 PHYSICIAN PROFESSIONAL SERVICES - ANESTH 1852398 GE HEALTHCARE 3000 N GRANDVIEW BLVD WAUKESHA WI 53188 BIOMEDICAL MAINTENANCE SERVICE 936478 SIERRA MULTISURGICAL 5635 STRATFORD CIRCLE B-27 STOCKTON CA 95207 PHYSICIAN PROFESSIONAL SERVICES - E D CA 933180 49 16540 118529 344605 479674 PATIENT SVC REVENUE 621400 203811071 203811071 CAPITATION FEES 621990 2088910 2088910 LOSS FROM ADVANCED IMAGING CENTER 621400 -74837 -74837 LOSS FROM LODI SURGICAL 621400 -107715 -107715 LOSS FR TRINITY PLAZA SURGERY CEN 621400 -4785584 -4785584 2523609 2523609 203455454 934491 934491 -49644 -49644 229063 223936 5127 5127 4672 455 5751155 27805 5288043 99076 463112 -71271 391841 391841 OTHER REVENUE 900099 99971 99971 MANAGEMENT FEES - VITAL 541610 53370 53370 153341 205370284 203460126 53825 1376659 223063 223063 36000 36000 1929807 1414477 434754 80576 212541 162573 49968 80196998 61319036 18847041 30921 1126443 860782 264570 1091 5170313 3946560 1213016 10737 6094980 4656858 1431334 6788 220481 220481 1224112 895942 328170 56247 56247 47171 36081 11090 107545 107545 17241315 13175923 4049757 15635 208072 154172 47386 6514 23147893 17702619 5441083 4191 2207286 1688353 518933 10710554 8179845 2514160 16549 161594 123603 37991 52 52 151956 116010 35657 289 12019909 9194029 2825880 994271 760518 233753 BAD DEBTS 40249322 40249322 HOSP MEDI-CAL QLTY ASSU 12995235 12995235 DUES, SUBSCRIPTIONS, BO 287861 216007 66392 5462 BUSINESS TAXES & LICENS 247841 189574 58267 297444 229240 66251 1953 217566306 178746303 38639245 180758 162960 181436 12631307 9536469 2553635 2297624 35817702 36512423 3380948 3325440 5488204 4670820 257707751 97160523 166521636 160547228 31526218 32431079 4725422 3769407 8626000 11346326 271434032 264618252 23982081 28003568 143020000 140030000 770891 803012 167772972 168836580 X 102924259 94959340 736801 822332 103661060 95781672 271434032 264618252 X -12196022 1009758 3306876 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 47171 47171 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO CALIFORNIA HOSPITAL ASSOCIATION & THE HOSPITAL COUNCIL OF NORTHERN CALIFORNIA ARE CONSIDERED TO BE FOR LOBBYING ACTIVITIES. 3655763 3655763 614559 132757482 37875819 95496222 3554131 1444894 2109237 108274757 56335056 51939701 8851059 1504754 7346305 160547228 CONDITIONAL ASSET RETIREMENT 803012 803012 X PART X, LINE 2: WE FOLLOW FASB GUIDANCE RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THESE GUIDELINES PRESCRIBE A COMPREHENSIVE MODEL FOR RECOGNIZING, MEASURING, PRESENTING AND DISCLOSING IN THE CONSOLIDATED FINANCIAL STATEMENTS TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THEY ALSO PROVIDE ACCOUNTING GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. AS OF DECEMBER 31, 2013, WE ARE NOT AWARE OF ANY UNCERTAIN TAX POSITIONS FOR ANY YEARS OPEN UNDER FEDERAL OR STATE OF CALIFORNIA STATUTES OF LIMITATIONS. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 1 1253 2502743 0 2502743 0.01410 15 49485 40493166 41139606 -646440 0.00000 16 50738 42995909 41139606 1856303 0.01410 12 21409 3592811 10585 3582226 0.02020 199849 71345 128504 0.00070 6 22762 10118666 7593755 2524911 0.01420 330958 330958 0.00190 18 44171 14242284 7675685 6566599 0.03700 34 94909 57238193 48815291 8422902 0.05110 237561 237561 0.00130 237561 237561 0.00130 1 39743318 13910161 44948991 49959467 -5010476 X 1 1 1 TRINITY PLAZA SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.94000 0.00000 0.06000 2 ADVANCED IMAGING CENTER AT LODI MEMORIAL HOSPITAL LLC DIAGNOSTIC IMAGING CENTER (WITH MRI) 0.51000 0.00000 0.49000 3 LODI OUTPATIENT SURGERY CENTER AMBULATORY SURGERY CENTER 0.31000 0.00000 0.40100 4 ENDOSCOPY CENTER OF LODI LLC AMBULATORY SURGERY CENTER 0.31000 0.00000 0.40100 2 1 LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE LODI CA 95240 LODIHEALTH.ORG X X X GENERAL ACUTE CARE BEDS = 190 A 2 LODI MEMORIAL HOSPITAL - WEST 800 LOWER SACRAMENTO ROAD ACUTE PHYS LODI CA 95242 LODIHEALTH.ORG X X ACUTE PHY REHAB = 24 BEDS (NOTE BEDS IN SUSPENSE / NOT OCCUPIED ALL YEAR) A FACILITY REPORTING GROUP - A 1 X X X X X X X X X 13 1 1 1 X WWW.LODIHEALTH.ORG X X X X X X X X X X 0 0 1 1 300.000000000000 1 350.000000000000 1 X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: LODI MEMORIAL HOSPITAL, - FACILITY 2: LODI MEMORIAL HOSPITAL - WEST FACILITY 1 -- LODI MEMORIAL HOSPITAL PART V, SECTION B, LINE 3: LODI MEMORIAL HOSPITAL ASSOCIATION, INC (ALSO KNOWN AS LODI HEALTH) CONDUCTED ITS FIRST COMMUNITY-HEALTH NEEDS ASSESSMENT IN 1995 AND, SINCE THEN, HAS DONE SO EVERY THREE YEARS. TO DETERMINE COMMUNITY-HEALTH NEEDS, THE NEEDS ASSESSMENT INCLUDES THE GATHERING AND REVIEW OF THE FOLLOWING DATA: CENSUS DATA, SOCIOECONOMIC AND GEOGRAPHIC INDICATORS; STATEWIDE HEALTH-INDICATOR DATA; COUNTYWIDE HEALTH INDICATORS; EXISTING REGIONAL PROGRAMS AND SERVICES MEETING THE COMMUNITY'S HEALTH NEEDS (ASSET MAPPING); AND SYSTEM-SPECIFIC UTILIZATION DATA. RESULTS FROM THE MOST RECENT 2013 ASSESSMENT, INCLUDING RELEVANT SOCIO-DEMOGRAPHIC DATA, ARE REVIEWED BY YEAR'S END BY SEVERAL INTERNAL AND EXTERNAL STAKEHOLDER GROUPS, INCLUDING NGOS, AND A LIST OF HEALTH PRIORITIES IS DEVELOPED FOR CONSIDERATION. THE LIST IS REVIEWED AND EVALUATED TO DETERMINE WHERE LODI HEALTH MAY BE ABLE TO DEDICATE ADDITIONAL RESOURCES TO IMPROVE COMMUNITY HEALTH. THE 2014 COMMUNITY BENEFIT PLAN WAS DEVELOPED IN THE LATTER PART OF 2013 IN COLLABORATION WITH COMMUNITY GROUPS, NGOS AND HEALTH PROVIDERS. STAKEHOLDER INVOLVEMENT: THOSE INVOLVED IN THE REVIEW, PRIORITIZATION AND PLANNING PROCESS INCLUDE THE SYSTEM'S COMMUNITY-ADVISORY BOARD, REPRESENTING A BROAD CROSS-SECTION OF THE SYSTEM'S COMMUNITY; MEMBERS OF THE SAN JOAQUIN COUNTY HEALTHIER COMMUNITIES COALITION, A COUNTYWIDE GROUP OF HEALTH, EDUCATION AND HUMAN-SERVICE PROVIDERS; SYSTEM STAFF; MEDICAL STAFF; AND SYSTEM BOARD MEMBERS. AS COMMUNITY NEEDS ARE REVIEWED, THE ABILITY OF THE SYSTEM TO MEET THOSE NEEDS WITHIN THE REALM OF ITS RESOURCES AND, WHEN POSSIBLE, IN COLLABORATION WITH COMMUNITY PARTNERSHIPS IS DISCUSSED. DISCUSSION AND RECOMMENDATION PROCESS IS AGENDIZED AT REGULARLY SCHEDULED MEETINGS OF THE COMMUNITY-ADVISORY BOARD AND THE SYSTEM'S STRATEGIC-PLANNING COMMITTEE. RECOMMENDATIONS FROM THOSE REVIEW GROUPS ARE DIRECTED TO THE SYSTEM'S STRATEGIC-PLANNING COMMITTEE SO THEY MAY MAKE RECOMMENDATIONS TO THE SYSTEM'S FULL BOARD OF DIRECTORS FOR DISCUSSION AND APPROVAL. CURRENTLY, THE REVIEW GROUPS' MAJOR FOCUS HAS BEEN TO ASSESS AND RECOMMEND HOW LODI HEALTH AND ITS RELATED BUSINESSES MAY BEST MEET THE COMMUNITY'S NEED RELATIVE TO THE CURRENT ECONOMY AND IN RESPONSE TO THE AFFORDABLE CARE ACT. KEY AREAS OF ASSESSMENT INCLUDE HOW TO BETTER ENGAGE COMMUNITY MEMBERS RELATIVE TO WELLNESS AND PREVENTION; ALIGNING PHYSICIAN AND SYSTEM INCENTIVES IN ORDER TO BEST MEET THE COMMUNITY'S NEED; AND STRENGTHENING COMMUNITY COLLABORATION TO IMPROVE COMMUNITY HEALTH.HOW THE LODI HEALTH STRATEGIC PLAN IS DEVELOPED: LODI HEALTH IS A 190-BED, TWO-CAMPUS, ACUTE-CARE HOSPITAL WITH 59 SEPARATE INPATIENT AND OUTPATIENT PROGRAMS AND SERVICES. SERVICES BEGAN IN 1952. SINCE ITS OPENING, LODI HEALTH HAS EXPANDED AND GROWN TO ITS CURRENT SIZE, WHICH INCLUDES TWO INPATIENT FACILITIES, LODI MEMORIAL HOSPITAL, LOCATED AT 975 SOUTH FAIRMONT AVE., AND LODI HEALTH WEST, LOCATED AT 800 SOUTH LOWER SACRAMENTO RD. LODI HEALTH WEST WAS ACQUIRED IN 1990. LODI HEALTH ALSO OPERATES FIVE PRIMARY-CARE MEDICAL PRACTICES; TWO PRENATAL PRACTICES; A PEDIATRIC PRACTICE; A PULMONARY PRACTICE; TWO CARDIOLOGY PRACTICES; AN OCCUPATIONAL-MEDICINE PRACTICE; A WOUND-CARE AND HYPERBARIC PRACTICE; A FREE OUTREACH PRACTICE; A GENERAL SURGERY PRACTICE; AN ORTHOPEDIC PRACTICE; AND A NEUROLOGY AND ENDOCRINOLOGY PRACTICE. IN ADDITION TO ITS INPATIENT ACUTE-CARE SERVICES AND MEDICAL PRACTICES, LODI HEALTH OPERATES A HOME HEALTH AGENCY, A DURABLE-MEDICAL-EQUIPMENT COMPANY, AN ADULT-DAY-CARE PROGRAM, A CHILD-CARE PROGRAM, A MEDICAL-SERVICES ORGANIZATION FOR PHYSICIANS AND A FULL ARRAY OF CLINICAL-OUTPATIENT SERVICES, INCLUDING LABORATORY, PHYSICAL THERAPY AND DIAGNOSTIC SERVICES.THE LODI MEMORIAL HOSPITAL ASSOCIATION IS THE SOLE CORPORATE MEMBER AND WAS INCORPORATED IN 1945. LODI MEMORIAL HOSPITAL ASSOCIATION IS A CALIFORNIA PUBLIC-BENEFIT, NON-PROFIT CORPORATION WITH APPROXIMATELY 1,500 MEMBERS. MEMBERSHIP IS OPEN TO ANY INTERESTED MEMBER FOR A LIFETIME FEE OF $100. THE MEMBERS ANNUALLY ELECT DIRECTORS TO THE BOARD, WHICH IS THE GOVERNING BODY FOR THE SYSTEM. THE ASSOCIATION AND THE SYSTEM HAVE BEEN SUCCESSFUL OVER THE PAST DECADES BECAUSE OF THEIR COMMITMENT AND ABILITY TO FULFILL THEIR ORIGINAL MISSION OF PROVIDING QUALITY HEALTH CARE TO RESIDENTS, WHILE CONTINUING TO ADAPT TO THE CHANGING HEALTH-CARE NEEDS OF THE COMMUNITY.THIS STRATEGIC PLAN IS A CONTINUING EFFORT OF THAT COMMITMENT AND EMPHASIZES THE LINK BETWEEN THE COMMUNITY AND THE SYSTEM. THE PLAN IS A COLLABORATIVE WORK OF COMMUNITY MEMBERS, BOARD MEMBERS, MEDICAL STAFF, MANAGEMENT AND STAFF EMPLOYEES. IT REPRESENTS LODI HEALTH'S BEST EFFORT TO ORGANIZE ITS VISION, MISSION, GOALS AND VALUES INTO A COHESIVE AND COMPREHENSIVE BLUEPRINT FOR THE SUCCESSFUL DELIVERY OF A WIDE CONTINUUM OF HEALTH SERVICES TO THE COMMUNITY, WITH THE ULTIMATE GOAL OF IMPROVING THE QUALITY OF LIFE IN AND BEYOND THE HOSPITAL WALLS.THE PLAN IS AN ONGOING, DYNAMIC DOCUMENT, WHICH REPRESENTS A CONTINUATION OF PREVIOUS AND CURRENT PLANS. THE PLAN IS OPEN TO REVISION, REFINEMENT AND CHANGE AS NEW INFORMATION IS ADDED TO OUR PLANNING PROFILE AND AS THE INTERNAL/EXTERNAL ENVIRONMENT DICTATE CHANGES. LODI HEALTH IS COMMITTED TO REMAINING A COMMUNITY-BASED ORGANIZATION AND, ALL THE WHILE, WILLING TO COOPERATE AND/OR COLLABORATE WITH ALL ENTITIES FOR THE BENEFIT OF THE LODI HEALTH SYSTEM, ITS PHYSICIANS, EMPLOYEES, VOLUNTEERS, ADVISORY BOARDS AND THE COMMUNITY AT LARGE. THAT SAID, LODI HEALTH WILL CONTINUE TO EXPLORE PARTNERSHIPS WITH OTHER HEALTH SYSTEMS AND PROVIDERS IN ORDER TO BEST SERVE THE NEEDS OF RESIDENTS IN ITS SERVICE AREA.THE ELEMENTS OF THE PLAN ARE INTENTIONALLY TIED TOGETHER TO ESTABLISH AND MAINTAIN THE ALIGNMENT BETWEEN THE VISION, MISSION, VALUES, GOALS AND PROJECTS. IT IS THE SYSTEM'S SINCERE COMMITMENT TO KEEP THE FOCUS ON THIS ALIGNMENT BETWEEN THE PLAN ELEMENTS TO INCREASE THE CHANCES FOR SUCCESSFUL IMPLEMENTATION. MAJOR GOALS HAVE BEEN DEVELOPED ALONG WITH STRATEGIES THAT ARE DESIGNED TO ACHIEVE THOSE GOALS. FINAL RESPONSIBILITY FOR IMPLEMENTATION OF THIS PLAN LIES WITH THE SYSTEM PRESIDENT AND CHIEF EXECUTIVE OFFICER. METRICS HAVE BEEN ESTABLISHED TO MONITOR PROGRESS OF PROJECTS. THIS PROCESS WILL SERVE TO COMMUNICATE TO ALL OF THE SYSTEM INTERNAL STAKEHOLDERS THE PRIORITIES AND DIRECTION OF THE SYSTEM. STANDING COMMITTEES OF THE SYSTEM BOARD WILL REVIEW AND MONITOR CHANGES TO THE PLAN.PUBLIC REVIEW: EVERY THREE YEARS THE SYSTEM CONDUCTS A COMMUNITY-HEALTH-NEEDS ASSESSMENT TO INCLUDE A REVIEW AND ASSESSMENT OF HEALTH STATUS AND COMMUNITY NEED. AFTER ITS COMMUNITY-NEEDS ASSESSMENT AND DATA-GATHERING ACTIVITIES ARE COMPLETED, FINDINGS ARE REPORTED TO ALL SYSTEM PLANNING PARTICIPANTS AND THE GENERAL PUBLIC, SUMMARIZING COMMENTS, SUGGESTIONS AND ISSUES ROSE.THE SYSTEM THEN MAKES FORMAL PRESENTATIONS TO ITS INTERNAL AND EXTERNAL-PLANNING PARTNERS, INCLUDING THE COMMUNITY-ADVISORY BOARD, MEDICAL STAFF, SYSTEM MANAGEMENT, STRATEGIC-PLANNING COMMITTEE, NGOS AND OTHER COMMUNITY STAKEHOLDERS. INPUT IS SOLICITED AT ALL MEETINGS TO BETTER MEET COMMUNITY NEED, AND AN IMPLEMENTATION PLAN IS DEVELOPED.THIS PAST YEAR IN DECEMBER 2013, THE BOARD OF DIRECTORS ADOPTED THE 2014 COMMUNITY BENEFIT IMPLEMENTATION PLAN.(SEE CONTINUATION FOR PROCESS DESCRIPTION) FACILITY 1 -- LODI MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: YES, HOWEVER, THE PROCESS WAS NOT IN CONJUNCTION WITH OTHER REGIONAL HOSPITALS, BUT DONE CONSULTATIVELY AND DATA WAS SHARED. AS THE MOST NORTHERNLY HOSPITAL IN OUR COUNTY, AND ONLY HOSPITAL IN OUR CITY, OUR SERVICE AREA DIFFERS SIGNIFICANTLY FROM OTHER AREA HOSPITALS WHICH FOCUS PRIMARILY ON ONE COUNTY, WHILE LODI HEALTH FOCUSES ON ITS FIVE COUNTY SERVICE AREA. ADDITIONALLY, THE TIMING REQUIREMENTS FOR OTHER AREA HOSPITALS TO COMPLETE THEIR NEEDS ASSESSMENTS PRECEDES LODI HEALTH BY ONE YEAR.HOSPITALS IN SAN JOAQUIN COUNTY INCLUDE:- DAMERON HOSPITAL- ST. JOSEPH'S BEHAVORIAL HEALTH CENTER- ST. JOSEPH'S MEDICAL CENTER- SUTTER TRACY COMMUNITY HOSPITAL FACILITY 1 -- LODI MEMORIAL HOSPITAL PART V, SECTION B, LINE 5D: DISTRIBUTED ELECTRONICALLY TO STAFF, MEDICAL STAFF, MEDIA AND COMMUNITY ORGANIZATIONS. FACILITY 1 -- LODI MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: AFTER PRIORITIZING THE HEALTH NEEDS, THE HOSPITAL AND ITS COMMUNITY PLANNING GROUP DETERMINED THAT RESOURCES WERE NOT AVAILABLE TO ADDRESS ALL EIGHT HEALTH PRIORITIES IDENTIFIED IN THE CHNA. IT PRIORITIZED ITS FOCUS TO THE TOP FIVE THAT WERE MOST ALIGNED WITH THE HEALTH SYSTEMS CORE MISSION, CAPABILITIES AND RESOURCES. THOSE SELECTED TO BE ADDRESSED WERE ACCESS TO CARE, CULTURALLY APPROPRIATE CARE, HEALTH LITERACY AND EDUCATION, ACCESS TO MENTAL HEALTH SERVICES AND SAFE AND AFFORDABLE PLACES TO EXERCISE. THOSE THAT WILL NOT BE DIRECTLY ADDRESSED ARE HEALTH LITERACY, AFFORDABLE DENTAL SERVICES AND ACCESS TO HEALTHY FOOD. FACILITY 1 -- LODI MEMORIAL HOSPITAL PART V, SECTION B, LINE 20D: THE FINANCIAL ASSISTANCE (CHARITY CARE) POLICY CHARGES THE PATIENT 10% OF GROSS CHARGES IF THEIR POVERTY LEVEL IS BETWEEN 300% AND 350% OF THE FEDERAL GUIDELINES. THE 10% OF GROSS CHARGES APPROXIMATES THE HOSPITAL'S REIMBURSEMENT FROM MEDICARE AND IS THE MAXIMUM CHARGED TO INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE. FACILITY 2 -- LODI MEMORIAL HOSPITAL - WEST PART V, SECTION B, LINE 3: LODI MEMORIAL HOSPITAL ASSOCIATION, INC (ALSO KNOWN AS LODI HEALTH) CONDUCTED ITS FIRST COMMUNITY-HEALTH NEEDS ASSESSMENT IN 1995 AND, SINCE THEN, HAS DONE SO EVERY THREE YEARS. TO DETERMINE COMMUNITY-HEALTH NEEDS, THE NEEDS ASSESSMENT INCLUDES THE GATHERING AND REVIEW OF THE FOLLOWING DATA: CENSUS DATA, SOCIOECONOMIC AND GEOGRAPHIC INDICATORS; STATEWIDE HEALTH-INDICATOR DATA; COUNTYWIDE HEALTH INDICATORS; EXISTING REGIONAL PROGRAMS AND SERVICES MEETING THE COMMUNITY'S HEALTH NEEDS (ASSET MAPPING); AND SYSTEM-SPECIFIC UTILIZATION DATA. RESULTS FROM THE MOST RECENT 2013 ASSESSMENT, INCLUDING RELEVANT SOCIO-DEMOGRAPHIC DATA, ARE REVIEWED BY YEAR'S END BY SEVERAL INTERNAL AND EXTERNAL STAKEHOLDER GROUPS, INCLUDING NGOS, AND A LIST OF HEALTH PRIORITIES IS DEVELOPED FOR CONSIDERATION. THE LIST IS REVIEWED AND EVALUATED TO DETERMINE WHERE LODI HEALTH MAY BE ABLE TO DEDICATE ADDITIONAL RESOURCES TO IMPROVE COMMUNITY HEALTH. THE 2014 COMMUNITY BENEFIT PLAN WAS DEVELOPED IN THE LATTER PART OF 2013 IN COLLABORATION WITH COMMUNITY GROUPS, NGOS AND HEALTH PROVIDERS. STAKEHOLDER INVOLVEMENT: THOSE INVOLVED IN THE REVIEW, PRIORITIZATION AND PLANNING PROCESS INCLUDE THE SYSTEM'S COMMUNITY-ADVISORY BOARD, REPRESENTING A BROAD CROSS-SECTION OF THE SYSTEM'S COMMUNITY; MEMBERS OF THE SAN JOAQUIN COUNTY HEALTHIER COMMUNITIES COALITION, A COUNTYWIDE GROUP OF HEALTH, EDUCATION AND HUMAN-SERVICE PROVIDERS; SYSTEM STAFF; MEDICAL STAFF; AND SYSTEM BOARD MEMBERS. AS COMMUNITY NEEDS ARE REVIEWED, THE ABILITY OF THE SYSTEM TO MEET THOSE NEEDS WITHIN THE REALM OF ITS RESOURCES AND, WHEN POSSIBLE, IN COLLABORATION WITH COMMUNITY PARTNERSHIPS IS DISCUSSED. DISCUSSION AND RECOMMENDATION PROCESS IS AGENDIZED AT REGULARLY SCHEDULED MEETINGS OF THE COMMUNITY-ADVISORY BOARD AND THE SYSTEM'S STRATEGIC-PLANNING COMMITTEE. RECOMMENDATIONS FROM THOSE REVIEW GROUPS ARE DIRECTED TO THE SYSTEM'S STRATEGIC-PLANNING COMMITTEE SO THEY MAY MAKE RECOMMENDATIONS TO THE SYSTEM'S FULL BOARD OF DIRECTORS FOR DISCUSSION AND APPROVAL. CURRENTLY, THE REVIEW GROUPS' MAJOR FOCUS HAS BEEN TO ASSESS AND RECOMMEND HOW LODI HEALTH AND ITS RELATED BUSINESSES MAY BEST MEET THE COMMUNITY'S NEED RELATIVE TO THE CURRENT ECONOMY AND IN RESPONSE TO THE AFFORDABLE CARE ACT. KEY AREAS OF ASSESSMENT INCLUDE HOW TO BETTER ENGAGE COMMUNITY MEMBERS RELATIVE TO WELLNESS AND PREVENTION; ALIGNING PHYSICIAN AND SYSTEM INCENTIVES IN ORDER TO BEST MEET THE COMMUNITY'S NEED; AND STRENGTHENING COMMUNITY COLLABORATION TO IMPROVE COMMUNITY HEALTH.HOW THE LODI HEALTH STRATEGIC PLAN IS DEVELOPED: LODI HEALTH IS A 190-BED, TWO-CAMPUS, ACUTE-CARE HOSPITAL WITH 59 SEPARATE INPATIENT AND OUTPATIENT PROGRAMS AND SERVICES. SERVICES BEGAN IN 1952. SINCE ITS OPENING, LODI HEALTH HAS EXPANDED AND GROWN TO ITS CURRENT SIZE, WHICH INCLUDES TWO INPATIENT FACILITIES, LODI MEMORIAL HOSPITAL, LOCATED AT 975 SOUTH FAIRMONT AVE., AND LODI HEALTH WEST, LOCATED AT 800 SOUTH LOWER SACRAMENTO RD. LODI HEALTH WEST WAS ACQUIRED IN 1990. LODI HEALTH ALSO OPERATES FIVE PRIMARY-CARE MEDICAL PRACTICES; TWO PRENATAL PRACTICES; A PEDIATRIC PRACTICE; A PULMONARY PRACTICE; TWO CARDIOLOGY PRACTICES; AN OCCUPATIONAL-MEDICINE PRACTICE; A WOUND-CARE AND HYPERBARIC PRACTICE; A FREE OUTREACH PRACTICE; A GENERAL SURGERY PRACTICE; AN ORTHOPEDIC PRACTICE; AND A NEUROLOGY AND ENDOCRINOLOGY PRACTICE. IN ADDITION TO ITS INPATIENT ACUTE-CARE SERVICES AND MEDICAL PRACTICES, LODI HEALTH OPERATES A HOME HEALTH AGENCY, A DURABLE-MEDICAL-EQUIPMENT COMPANY, AN ADULT-DAY-CARE PROGRAM, A CHILD-CARE PROGRAM, A MEDICAL-SERVICES ORGANIZATION FOR PHYSICIANS AND A FULL ARRAY OF CLINICAL-OUTPATIENT SERVICES, INCLUDING LABORATORY, PHYSICAL THERAPY AND DIAGNOSTIC SERVICES.THE LODI MEMORIAL HOSPITAL ASSOCIATION IS THE SOLE CORPORATE MEMBER AND WAS INCORPORATED IN 1945. LODI MEMORIAL HOSPITAL ASSOCIATION IS A CALIFORNIA PUBLIC-BENEFIT, NON-PROFIT CORPORATION WITH APPROXIMATELY 1,500 MEMBERS. MEMBERSHIP IS OPEN TO ANY INTERESTED MEMBER FOR A LIFETIME FEE OF $100. THE MEMBERS ANNUALLY ELECT DIRECTORS TO THE BOARD, WHICH IS THE GOVERNING BODY FOR THE SYSTEM. THE ASSOCIATION AND THE SYSTEM HAVE BEEN SUCCESSFUL OVER THE PAST DECADES BECAUSE OF THEIR COMMITMENT AND ABILITY TO FULFILL THEIR ORIGINAL MISSION OF PROVIDING QUALITY HEALTH CARE TO RESIDENTS, WHILE CONTINUING TO ADAPT TO THE CHANGING HEALTH-CARE NEEDS OF THE COMMUNITY.THIS STRATEGIC PLAN IS A CONTINUING EFFORT OF THAT COMMITMENT AND EMPHASIZES THE LINK BETWEEN THE COMMUNITY AND THE SYSTEM. THE PLAN IS A COLLABORATIVE WORK OF COMMUNITY MEMBERS, BOARD MEMBERS, MEDICAL STAFF, MANAGEMENT AND STAFF EMPLOYEES. IT REPRESENTS LODI HEALTH'S BEST EFFORT TO ORGANIZE ITS VISION, MISSION, GOALS AND VALUES INTO A COHESIVE AND COMPREHENSIVE BLUEPRINT FOR THE SUCCESSFUL DELIVERY OF A WIDE CONTINUUM OF HEALTH SERVICES TO THE COMMUNITY, WITH THE ULTIMATE GOAL OF IMPROVING THE QUALITY OF LIFE IN AND BEYOND THE HOSPITAL WALLS.THE PLAN IS AN ONGOING, DYNAMIC DOCUMENT, WHICH REPRESENTS A CONTINUATION OF PREVIOUS AND CURRENT PLANS. THE PLAN IS OPEN TO REVISION, REFINEMENT AND CHANGE AS NEW INFORMATION IS ADDED TO OUR PLANNING PROFILE AND AS THE INTERNAL/EXTERNAL ENVIRONMENT DICTATE CHANGES. LODI HEALTH IS COMMITTED TO REMAINING A COMMUNITY-BASED ORGANIZATION AND, ALL THE WHILE, WILLING TO COOPERATE AND/OR COLLABORATE WITH ALL ENTITIES FOR THE BENEFIT OF THE LODI HEALTH SYSTEM, ITS PHYSICIANS, EMPLOYEES, VOLUNTEERS, ADVISORY BOARDS AND THE COMMUNITY AT LARGE. THAT SAID, LODI HEALTH WILL CONTINUE TO EXPLORE PARTNERSHIPS WITH OTHER HEALTH SYSTEMS AND PROVIDERS IN ORDER TO BEST SERVE THE NEEDS OF RESIDENTS IN ITS SERVICE AREA.THE ELEMENTS OF THE PLAN ARE INTENTIONALLY TIED TOGETHER TO ESTABLISH AND MAINTAIN THE ALIGNMENT BETWEEN THE VISION, MISSION, VALUES, GOALS AND PROJECTS. IT IS THE SYSTEM'S SINCERE COMMITMENT TO KEEP THE FOCUS ON THIS ALIGNMENT BETWEEN THE PLAN ELEMENTS TO INCREASE THE CHANCES FOR SUCCESSFUL IMPLEMENTATION. MAJOR GOALS HAVE BEEN DEVELOPED ALONG WITH STRATEGIES THAT ARE DESIGNED TO ACHIEVE THOSE GOALS. FINAL RESPONSIBILITY FOR IMPLEMENTATION OF THIS PLAN LIES WITH THE SYSTEM PRESIDENT AND CHIEF EXECUTIVE OFFICER. METRICS HAVE BEEN ESTABLISHED TO MONITOR PROGRESS OF PROJECTS. THIS PROCESS WILL SERVE TO COMMUNICATE TO ALL OF THE SYSTEM INTERNAL STAKEHOLDERS THE PRIORITIES AND DIRECTION OF THE SYSTEM. STANDING COMMITTEES OF THE SYSTEM BOARD WILL REVIEW AND MONITOR CHANGES TO THE PLAN.PUBLIC REVIEW: EVERY THREE YEARS THE SYSTEM CONDUCTS A COMMUNITY-HEALTH-NEEDS ASSESSMENT TO INCLUDE A REVIEW AND ASSESSMENT OF HEALTH STATUS AND COMMUNITY NEED. AFTER ITS COMMUNITY-NEEDS ASSESSMENT AND DATA-GATHERING ACTIVITIES ARE COMPLETED, FINDINGS ARE REPORTED TO ALL SYSTEM PLANNING PARTICIPANTS AND THE GENERAL PUBLIC, SUMMARIZING COMMENTS, SUGGESTIONS AND ISSUES ROSE.THE SYSTEM THEN MAKES FORMAL PRESENTATIONS TO ITS INTERNAL AND EXTERNAL-PLANNING PARTNERS, INCLUDING THE COMMUNITY-ADVISORY BOARD, MEDICAL STAFF, SYSTEM MANAGEMENT, STRATEGIC-PLANNING COMMITTEE, NGOS AND OTHER COMMUNITY STAKEHOLDERS. INPUT IS SOLICITED AT ALL MEETINGS TO BETTER MEET COMMUNITY NEED, AND AN IMPLEMENTATION PLAN IS DEVELOPED.THIS PAST YEAR IN DECEMBER 2013, THE BOARD OF DIRECTORS ADOPTED THE 2014 COMMUNITY BENEFIT IMPLEMENTATION PLAN.(SEE CONTINUATION FOR PROCESS DESCRIPTION) FACILITY 2 -- LODI MEMORIAL HOSPITAL - WEST PART V, SECTION B, LINE 4: YES, HOWEVER, THE PROCESS WAS NOT IN CONJUNCTION WITH OTHER REGIONAL HOSPITALS, BUT DONE CONSULTATIVELY AND DATA WAS SHARED. AS THE MOST NORTHERNLY HOSPITAL IN OUR COUNTY, AND ONLY HOSPITAL IN OUR CITY, OUR SERVICE AREA DIFFERS SIGNIFICANTLY FROM OTHER AREA HOSPITALS WHICH FOCUS PRIMARILY ON ONE COUNTY, WHILE LODI HEALTH FOCUSES ON ITS FIVE COUNTY SERVICE AREA. ADDITIONALLY, THE TIMING REQUIREMENTS FOR OTHER AREA HOSPITALS TO COMPLETE THEIR NEEDS ASSESSMENTS PRECEDES LODI HEALTH BY ONE YEAR.HOSPITALS IN SAN JOAQUIN COUNTY INCLUDE:- DAMERON HOSPITAL- ST. JOSEPH'S BEHAVORIAL HEALTH CENTER- ST. JOSEPH'S MEDICAL CENTER- SUTTER TRACY COMMUNITY HOSPITAL FACILITY 2 -- LODI MEMORIAL HOSPITAL - WEST PART V, SECTION B, LINE 5D: DISTRIBUTED ELECTRONICALLY TO STAFF, MEDICAL STAFF, MEDIA AND COMMUNITY ORGANIZATIONS. FACILITY 2 -- LODI MEMORIAL HOSPITAL - WEST PART V, SECTION B, LINE 7: AFTER PRIORITIZING THE HEALTH NEEDS, THE HOSPITAL AND ITS COMMUNITY PLANNING GROUP DETERMINED THAT RESOURCES WERE NOT AVAILABLE TO ADDRESS ALL EIGHT HEALTH PRIORITIES IDENTIFIED IN THE CHNA. IT PRIORITIZED ITS FOCUS TO THE TOP FIVE THAT WERE MOST ALIGNED WITH THE HEALTH SYSTEMS CORE MISSION, CAPABILITIES AND RESOURCES. THOSE SELECTED TO BE ADDRESSED WERE ACCESS TO CARE, CULTURALLY APPROPRIATE CARE, HEALTH LITERACY AND EDUCATION, ACCESS TO MENTAL HEALTH SERVICES AND SAFE AND AFFORDABLE PLACES TO EXERCISE. THOSE THAT WILL NOT BE DIRECTLY ADDRESSED ARE HEALTH LITERACY, AFFORDABLE DENTAL SERVICES AND ACCESS TO HEALTHY FOOD. FACILITY 2 -- LODI MEMORIAL HOSPITAL - WEST PART V, SECTION B, LINE 20D: THE FINANCIAL ASSISTANCE (CHARITY CARE) POLICY CHARGES THE PATIENT 10% OF GROSS CHARGES IF THEIR POVERTY LEVEL IS BETWEEN 300% AND 350% OF THE FEDERAL GUIDELINES. THE 10% OF GROSS CHARGES APPROXIMATES THE HOSPITAL'S REIMBURSEMENT FROM MEDICARE AND IS THE MAXIMUM CHARGED TO INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, FACILITY INFORMATION: SECTION B APPLIES TO BOTH LODI MEMORIAL HOSPITAL AND LODI MEMORIAL HOSPITAL - WEST. SCH H, PART V, SECTION B, LINE 3, CONTINUATION THE PROCESS:THE LODI HEALTH BOARD OF DIRECTORS' STRATEGIC-PLANNING COMMITTEE IS CHARGED WITH DEVELOPING AND MONITORING THE SYSTEM'S STRATEGIC PLAN. THEIR PROCESS IS:* ANNUALLY REVIEW THE EXTERNAL HEALTH-CARE ENVIRONMENT, INCLUDING NEW AND UPDATED INFORMATION FROM THE:- CALIFORNIA HEALTHCARE ASSOCIATION (CHA) "VIEW OF THE FUTURE" LATEST RELEASE;- AMERICAN HOSPITAL ASSOCIATION (AHA) "VISION OF THE FUTURE" LATEST RELEASE; AND- MAJOR NATIONAL, STATE AND LOCAL EVENTS THAT HAVE OR MAY AFFECT OUR LOCAL MARKET.* ANNUALLY REVIEW THE INTERNAL ENVIRONMENTS, INCLUDING:- AUDITED FINANCIALS FOR THE LAST THREE YEARS FOR TRENDS;- MARKET-SHARE INFORMATION, FOR SYSTEM AND ALL BUSINESS LINES, I.E. INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, HOME-HEALTH AGENCY, ACUTE-PHYSICAL REHABILITATION AND CLINICS;- PAYER MIX BY SERVICE AND ZIP CODE;- UTILIZATION DATA;- LIST OF MAJOR EMPLOYEE, BOARD AND MEDICAL STAFF ISSUES CURRENTLY OPEN/IN- PROGRESS;- COMMUNITY-NEEDS ASSESSMENT AND BENEFIT PLAN;- QUALITY PERFORMANCE, CLINICAL AND PATIENT SATISFACTION;- EMPLOYEE SATISFACTION;- PHYSICIAN SATISFACTION; AND- INFORMATION-TECHNOLOGY CAPABILITIES.* REVIEW THE FINDINGS AND RECOMMENDATIONS OF THE COMMUNITY-NEEDS ASSESSMENT, CONDUCTED EVERY THREE YEARS, TO DETERMINE THE COMMUNITY'S HEALTH STATUS AND NEED FOR HEALTH SERVICES AND INTEGRATE THOSE INTO THE SYSTEM'S STRATEGIC PLAN. ANNUALLY, THE NEEDS-ASSESSMENT FINDINGS SHALL BE REVISITED PRIOR TO EACH APRIL MEETING TO ASSESS WHETHER LODI HEALTH, WITHIN THE REALM OF ITS RESOURCES, CAN OR SHOULD DEVELOP PROGRAMS AND SERVICES TO MEET COMMUNITY NEED AND/OR WORK WITH OTHER LOCAL HEALTH PROVIDERS, SCHOOLS AND ORGANIZATIONS TO MEET COMMUNITY-HEALTH NEEDS FOR WELLNESS, PREVENTION AND TREATMENT.* ANNUALLY REVIEW THE SYSTEM MISSION, VISION AND VALUES FOR BOARD APPROVAL AT ITS MAY MEETING.* ANNUALLY DEVELOP LONG AND SHORT-TERM GOALS AND OBJECTIVES FOR SUBMISSION TO THE BOARD FOR APPROVAL. 9 LODI MEMORIAL HOSP HOME HEALTH AGENCY 800 S LOWER SACRAMENTO RD LODI CA 95242 HOME HEALTH AGENCY LODI MEMORIAL COMM CLINIC - MILLSBRIDGE 1901 KETTLEMAN LANE SUITE 200 LODI CA 95242 COMMUNITY CLINIC LODI OUTPATIENT SURGERY CENTER 521 S HAM LANE LODI CA 95242 AMBULATORY SURGICAL CENTERS ENDOSCOPY CENTER OF LODI LLC 840 S FAIRMONT AVE SUITE 1 LODI CA 95240 AMBULATORY SURGERY CENTER LODI MEMORIAL COMMUNITY CLINIC - VINE 1235 W VINE ST SUITE 22 LODI CA 95240 COMMUNITY CLINIC ADV IMAGING CENTER AT LODI MEM HOSP LLC 999 S FAIRMONT AVENUE SUITE 110 LODI CA 95240 DIAGNOSTIC IMAGING OUTPATIENT CENTER LODI MEMORIAL SURGICAL GROUP 999 S FAIRMONT AVENUE SUITE 100 LODI CA 95240 COMMUNITY CLINC LODI MEMORIAL COMMUNITY CLINIC - TRINITY 10200 TRINITY PARKWAY SUITE 102 STOCKTON CA 95219 COMMUNITY CLINIC TRINITY PLAZA SURGICAL CENTER LLC 10200 TRINITY PARKWAY SUITE 101 STOCKTON CA 95219 AMBULATORY SURGERY CENTER PART I, LINE 7: COST IS ASSIGNED UTILIZING OUR INTERNAL COST ACCOUNTING SYSTEM (EPSI). COST IS ESTIMATED BY UTILIZING RELATIVE VALUE UNITS ASSIGNED TO EACH PRODUCT (I.E. CHARGEABLE TEST, SUPPLY, OR PROCEDURE). EACH PRODUCT'S RELATIVE VALUE IS ESTIMATED BY EACH DEPARTMENT DIRECTOR BASED ON RESOURCES EXPENDED FOR EACH DEPARTMENT PRODUCT. DEPARTMENT COSTS ARE ALLOCATED TO EACH PRODUCT BASED ON ACCUMULATED RELATIVE VALUES. EACH PATIENT ACCUMULATES PRODUCTS DURING THEIR VISIT. THE TOTAL COST FOR EACH PATIENT REPRESENTS THE SUM OF ALL THE PRODUCTS PROVIDED TO THEM DURING THEIR VISIT OR INPATIENT STAY. THE ABOVE METHOD IS THE CALCULATION FOR HOSPITAL CHARGES. FOR COMMUNITY CLINICS, HOSPITAL BASED CLINICS, HOSPITAL BASED HOME HEALTH AGENCY AND TWO SURGERY CENTER JOINT VENTURES A COST TO CHARGE RATIO WAS CALCULATED BASED ON THE DIRECT COSTS OF THESE LINES OF BUSINESS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 40,249,322. SCHEDULE H, PART I EXPLANATION OVERVIEW:CHA: "THE HOSPITAL PROVIDER FEE IS CRUCIAL TO THE PRESERVATION OF CALIFORNIA'S ENTIRE SAFETY NET, WHICH IS WHY CALIFORNIA'S SAFETY-NET HOSPITALS INITIATED PROVIDER FEE LEGISLATION, AND WHY ALL CALIFORNIA HOSPITALS SUPPORT IT. THE PROGRAM USES FEES ASSESSED BY THE STATE ON HOSPITALS TO DRAW DOWN FEDERAL MATCHING FUNDS, WHICH ARE THEN ISSUED AS SUPPLEMENTAL PAYMENTS TO HOSPITALS. THE HOSPITAL PROVIDER FEE IS AN INTEGRAL ELEMENT TO IMPROVING ACCESS TO HEALTH CARE FOR SOME OF CALIFORNIA'S MOST VULNERABLE RESIDENTS."THE 30 MONTH HOSPITAL QA FEE / SUPPLEMENTAL MEDI-CAL FEE FOR SERVICE (FFS) REVENUE PROGRAM WAS APPROVED BY CMS IN JUNE 2012. 24 MONTHS OF THE MEDI-CAL MANAGED CARE PORTION WAS APPROVED IN JUNE 2013. PERIOD COVERED JULY 1, 2011 - DECEMBER 31, 2013, WHICH COMPRISE 10 CALENDAR QUARTERS.BENEFIT TO LMH:IN 2013 WE RECORDED ON A PRORATED BASIS 12 MONTHS (1/1/2013-12/31/2013) OF THE HOSPITAL QA FEE / SUPPLEMENTAL MEDI-CAL FEE FOR SERVICE (FFS) PROGRAM'S EXPENSES AND REVENUES AND 24 MONTHS OF THE MANAGED CARE PORTION EXPENSES AND REVENUES. - TOTAL REVENUES EARNED FROM THIS PROGRAM TOTALED $18,218,878.41 - TOTAL FEES EXPENSED FOR THIS PROGRAM TOTALED $12,995,234.53 - ADDITIONAL FEES EXPENSED FOR THE CALIFORNIA HEALTH FOUNDATION AND TRUST TOTALED $201,537.46INCOME EARNED WAS CREDITED TO THE MEDI-CAL PROGRAM AND GREATLY REDUCED THE UNREIMBURSED COST OF THE MEDI-CAL PROGRAM IN 2013 WHICH IN TURN REDUCED THE CHARITY CARE COSTS REPORTED ON SCHEDULE H COMPARED TO 2012. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PROVIDES MANY COMMUNITY-BUILDING ACTIVITIES TO INCREASE ACCESS TO PRIMARY-CARE SERVICES AND REDUCE THE NUMBER OF PATIENTS WHO PRESENT THEMSELVES TO THE EMERGENCY DEPARTMENT SEEKING CARE FOR MEDICAL CONDITIONS OR INJURIES THAT COULD HAVE EASILY BEEN TREATED AT THE ONSET BY A PRIMARY-CARE PHYSICIAN. THE FOLLOWING WERE LAUNCHED AND ARE NOW SUSTAINED BY THE HOSPITAL TO ADDRESS THE NEED FOR ACCESS TO CARE: A FREE CLINIC; THREE HOSPITAL BASED PRIMARY-CARE CLINICS, AN OBSTETRIC CLINIC AND A PEDIATRIC CLINIC; TWO PRIMARY-CARE COMMUNITY CLINICS AND TWO SPECIALTY COMMUNITY CLINICS. THE CLINICS ALSO KEEP LOCAL PHYSICIANS PRACTICING MEDICINE IN THE AREA. MANY PHYSICIANS WOULD HAVE RETIRED OR MOVED OUT OF THE AREA TO PRACTICE IN A HEALTH SYSTEM HAD THE HOSPITAL NOT AGREED TO EMPLOY THEM OR MANAGE THEIR PRACTICES. SO THAT ADULTS CAN WORK WHILE THEIR CHILDREN AND PARENTS ARE SAFELY AND LOVINGLY CARED FOR DURING THE DAY, THE HOSPITAL OFFERS AN AFFORDABLE CHILD-CARE CENTER AND AN ADULT-DAY-CARE CENTER. ADDITIONALLY, THE HOSPITAL PROVIDES NURSE TRAINING, SALARIES AND SUPPORT FOR NINE PARISH-NURSE PROGRAMS SO THAT PEOPLE IN THEIR CHURCHES HAVE ACCESS TO HEALTH EDUCATION, PREVENTION AND OTHER SUPPORTIVE SERVICES. TO PREVENT DISEASE AND INJURY AND ENCOURAGE WELLNESS, HEALTH NEWSLETTERS ARE MAILED TO 85,000 SERVICE-AREA HOUSEHOLDS AND MADE AVAILABLE ON THE HOSPITAL WEBSITE THREE TIMES A YEAR. SAN JOAQUIN COUNTY IS AMONG THE MOST DIFFICULT COUNTIES IN THE STATE WHEN IT COMES TO RECRUITING PHYSICIANS TO PRACTICE MEDICINE, AND THE HOSPITAL DEVOTES SIGNIFICANT FINANCIAL AND HUMAN RESOURCES TO THAT EFFORT. CURRENTLY THE HOSPITAL IS ATTEMPTING TO ESTABLISH A RESIDENCY PROGRAM IN CONJUNCTION WITH THE LOCAL COUNTY HOSPITAL, A TEACHING FACILITY, IN HOPES THAT ONCE PHYSICIANS COME TO PRACTICE HERE THEY WILL APPRECIATE THE REGION AND STAY AND ESTABLISH MEDICAL PRACTICE OR AFFILIATE WITH AN EXISTING PRACTICE. PART III, LINE 4: COSTING METHODOLOGY:UTILIZING THE PREVIOUS COSTING METHODOLOGY AS OUTLINED IN RESPONSE TO PART I LINE 7, ALL PATIENTS ARE ASSIGNED A PAYOR CLASS (I.E. CHARITY, SELF PAY, MEDICARE, MEDI-CAL, MANAGED CARE). THE COST BY PAYOR IS A SUMMATION OF ALL PATIENTS IN THE ASSIGNED PAYOR CLASS. THE AMOUNTS WRITTEN OFF AS BAD DEBT (ASSIGNED TO A COLLECTION AGENCY) ARE NET OF ANY APPLICABLE PAYMENTS OR DISCOUNTS. ANY PAYMENTS RECEIVED AFTER AN ACCOUNT IS ASSIGNED TO A COLLECTION AGENCY REDUCE THE BAD DEBT EXPENSE IN THE PERIOD RECEIVED.OF THE TOTAL UNINSURED PATIENTS SEEN IN 2013: 34% QUALIFIED FOR CHARITY CARE AND 54% WERE WRITTEN OFF TO BAD DEBTS. IT IS DIFFICULT TO ASCERTAIN HOW MANY UNINSURED WRITTEN OFF TO BAD DEBTS WOULD QUALIFY FOR CHARITY CARE. ALL BAD DEBT WRITE OFFS ARE SENT TO A COLLECTION AGENCY. IF AN ACCOUNT QUALIFIES FOR CHARITY CARE AFTER BEING SENT TO AN AGENCY, NO FURTHER COLLECTION ACTIVITY IS PURSUED AND THE "BAD DEBT" ACCOUNT IS WRITTEN OFF IN FULL - WE HAVE NOT TRACKED THESE IN THE PAST AS PART OF OUR CHARITY CARE EXPENSE BUT ESTIMATE AT LEAST 35% OF OUR BAD DEBT COSTS REPRESENTS CHARITY CARE.COMMUNITY BENEFIT RATIONALE: UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE. OFTEN THE INFORMATION GATHERED IN THE MEDICAID APPLICATION WILL MAKE THIS DETERMINATION "AUTOMATIC". IF ADDITIONAL INFORMATION IS REQUIRED WE ATTEMPT TO CONTACT THE PATIENT.BAD DEBT FOOTNOTE CAN BE FOUND ON PAGE 27 OF THE ORGANIZATION'S FINANCIAL STATEMENTS (NOTE 19 - UNCOMPENSATED CARE AND COMMUNITY BENEFIT COSTS). ALSO SEE FOOTNOTE 2 ON THE FINANCIAL STATEMENT THAT DISCUSSES "PATIENT ACCOUNTS RECEIVABLE". PART III, LINE 8: THE COSTS OF PROVIDING CARE TO MEDICARE RECIPIENTS OFTEN EXCEED THE GOVERNMENT'S REIMBURSEMENT FOR THESE SERVICES. FOR COST ASSIGNED TO MEDICARE PATIENTS, PLEASE SEE RESPONSE IN PART III, LINE 4.FEE REIMBURSED CHARGES FOR LABORATORY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY WITH INCIDENTAL CHARGES FOR SUPPLIES AND DRUGS WERE OBTAINED FROM THE MEDICARE PS&R. COST TO CHARGE RATIOS (CCR) FROM THE FILED COST REPORT WERE UTILIZED TO CALCULATE MEDICARE COSTS. MEDICARE REVENUES FOR THESE SERVICES WERE $44,948,991; COSTS WERE $49,959,467.THE COST ACCOUNTING SYSTEM IS USED FOR HOSPITAL CHARGES - ALL INPATIENT, OUTPATIENT, EMERGENCY AND URGENT CARE - FOR ALL PAYORS. A COST-TO-CHARGE RATIO WAS USED FOR SEGMENTS THAT ARE NOT YET INCLUDED IN THE COST ACCOUNTING SYSTEM: PRIMARILY HOSPITAL BASED CLINICS, COMMUNITY CLINICS, HOME HEALTH AND OUR RURAL HEALTHCARE CLINIC. 96.3% OF OUR CONSOLIDATED GROSS REVENUES ARE CAPTURED IN THE COST ACCOUNTING SYSTEM. PART III, LINE 9B: UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE (FINANCIAL ASSISTANCE)POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE (FINANCIAL ASSISTANCE). PART VI, LINE 2: EVERY THREE YEARS LODI MEMORIAL HOSPITAL ASSESSES COMMUNITY HEALTH NEEDS BY 1)CONSULTING WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY GROUPS TO REVIEW THE NEEDS OF EACH CONSTITUENCY; 2)REVIEWING SERVICE-AREA MORBIDITY AND MORTALITY HEALTH DATA PROVIDED BY THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES; 3)COMPILING SOCIO-ECONOMIC DATA TO DETERMINE WHERE THE GREATEST NEEDS EXIST WITHIN THE HOSPITAL-SERVICE AREA; AND 4)ASKING AREA RESIDENTS TO COMPLETE A HEALTH SURVEY REGARDING THEIR PERSONAL HEALTH AND NOTIONS ABOUT GOOD HEALTH. ONCE THE DATA IS COLLECTED, IT IS REVIEWED AND ASSESSED BY THE HOSPITAL'S COMMUNITY ADVISORY BOARD, BOARD OF DIRECTORS AND HOSPITAL MANAGERS TO DETERMINE WHAT SERVICES AND GAP AREAS MAY NEED ENHANCING OR ADDRESSING TO IMPROVE HEALTH WITHIN THE REALM OF THE HOSPITAL'S RESOURCES TO DO SO. PART VI, LINE 3: SIGNS ARE PROMINENTLY POSTED IN THE ADMISSIONS, EMERGENCY AND BILLING DEPARTMENTS OF THE HOSPITAL, IN ADDITION TO ALL THE HOSPITAL CLINICS, TO ADVISE PATIENTS AND VISITORS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND HOW TO WORK WITH HOSPITAL STAFF TO OBTAIN IT. THE SAME INFORMATION IS INCLUDED IN PATIENT-ADMISSION PACKETS AND POSTED ON THE HOSPITAL WEBSITE. HOSPITAL CASE MANAGERS ARE VIGILANT OF PATIENTS NEEDING FINANCIAL ASSISTANCE AND FOLLOW UP WITH THOSE IN NEED. FINANCIAL ASSISTANCE INCLUDES APPLYING FOR MEDICAID AS WELL AS CHARITY CARE. PART VI, LINE 4: NEARLY ALL OF THE INDIVIDUALS SEEKING CARE FROM LODI MEMORIAL HOSPITAL RESIDE IN ONE OF FIVE COUNTIES: SAN JOAQUIN, SACRAMENTO, SOLANO, AMADOR, AND CALAVERAS. ABOUT HALF OF THE HOSPITAL'S PATIENTS RESIDES WITHIN A FIVE-MILE RADIUS OF THE HOSPITAL IN SAN JOAQUIN COUNTY. GEOGRAPHICALLY, THE HOSPITAL SITS AT THE NORTHERN END OF THE SAN JOAQUIN VALLEY WHERE THE RESIDENTS ARE AMONG THE POOREST AND LEAST EDUCATED OF ALL THE STATE'S COUNTIES. IN ADDITION, SAN JOAQUIN COUNTY HAS AMONG THE WORST UNEMPLOYMENT RATES IN THE STATE'S COUNTIES; NEARLY TWO IN 10 RESIDENTS ARE UNEMPLOYED. ALSO SAN JOAQUIN COUNTY IS GROUND-ZERO FOR THE MORTGAGE CRISIS IN THIS COUNTRY. THE COUNTY IS ALSO AMONG THE MOST VIOLENT COUNTIES IN WHICH TO LIVE IN THE COUNTRY DUE TO SIGNIFICANT GANG ACTIVITY, LOW LEVELS OF EDUCATION, AND POVERTY. HOSPITAL PATIENTS REPRESENT DIVERSITY: ABOUT 40 PERCENT ARE HISPANIC, WITH MANY OF THOSE PATIENTS BEING MONOLINGUAL SPANISH SPEAKERS. ANOTHER THREE PERCENT ARE PAKISTANI, MANY OF WHOM SPEAK ONLY URDU OR PASHTU. ADDITIONALLY THERE IS A SIGNIFICANT POPULATION OF HOSPITAL PATIENTS WHO ARE GREATER THAN 80 YEARS OF AGE. THE MAJOR HEALTH ISSUES OF PATIENTS ARE HEART DISEASE, STROKE, CANCER, DIABETES AND OBESITY. PART VI, LINE 5: THE HOSPITAL CONDUCTS MYRIAD ACTIVITIES TO PROMOTE COMMUNITY HEALTH. THOSE ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO: HEALTH FAIRS WITH FREE MEDICAL SCREENINGS FOR HIGH CHOLESTEROL, HIGH-BLOOD PRESSURE, DIABETES AND LOW-OXYGEN SATURATION LEVELS; REFERRALS TO FREE CLINICS OR LOCAL PHYSICIANS FOR THOSE WITH HIGH VALUES; A VARIETY OF LINKED VIDEOS TO THE HOSPITAL WEB PAGE, FACEBOOK PAGE, YOUTUBE PAGE, AND TWITTER RELATED TO HEALTH EDUCATION AND PREVENTION; A WELLNESS PROGRAM FOR HOSPITAL EMPLOYEES THAT IS ROOTED IN EXERCISE AND NUTRITION SO THAT EMPLOYEES MAY LEAD BY EXAMPLE; A MONTHLY NUTRITION COLUMN IN THE LOCAL NEWSPAPER; HOSPITAL STAFF SERVING ON THE BOARDS OF REGIONAL NGOS; DONATIONS OF MATERIALS AND EQUIPMENT TO NGOS; EMPLOYEE DONATIONS OF FOOD AND CLOTHING TO THE NEEDY. THE HOSPITAL IS ALSO THE SECOND LARGEST YEAR-ROUND EMPLOYER IN LODI, WITH EMPLOYEES REINVESTING THEIR EARNINGS IN THE LOCAL ECONOMY. THE HOSPITAL HAS ALSO ADOPTED THE MOST IMPOVERISHED, LARGEST AND MOST DIVERSE SCHOOL IN THE LOCAL SCHOOL DISTRICT TO HELP EDUCATE STUDENTS, PARENTS AND TEACHERS IN PREVENTION. IN THAT EFFORT, THE HOSPITAL HOSTS AT THE SCHOOL HEALTH AND EDUCATION FAIRS; PARTICIPATES IN CLASSROOM TEACHING AND HEALTH DEMONSTRATIONS; AND PARTICIPATES IN CAREERS FAIRS AT THE SCHOOL. DUE TO HAND-WASHING EDUCATION ALONE, THE SCHOOLS ABSENTEE RATES HAVE DECLINED DRAMATICALLY. FOR STUDENTS TO LEARN, THEY MUST BE IN SCHOOL; AND FOR SCHOOLS TO RECEIVE STATE FUNDING, THEY MUST MAINTAIN THEIR ATTENDANCE. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K ST STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 201537 HOSPITAL QA FEE PROGRAM PLEDGES 1 0 STIPENDS AND SCHOLARSHIPS 36 36000 PART I, LINE 2: THROUGH THE USE OF TEMPORARILY RESTRICTED ACCOUNTS, WE TRACK AND MONITOR THE INCOMING RECEIPTS FROM GRANTS AND THE UTILIZATION OF GRANT FUNDS. EACH GRANT IS TRACKED SEPARATELY. SHOULD THE GRANTOR AGENCY REQUIRE SPECIFIC REPORTS, WE COMPLY WITH THEIR REPORTING REQUIREMENTS. THE GRANTS WE MONITOR ARE SPECIFIC TO THE GRANTOR'S NEEDS AND REQUESTS. IN 2013 WE RECEIVED GRANT FUNDS TO USE AS STIPENDS OR SCHOLARSHIPS FOR MEDICAL ASSISTANT STUDENTS THAT INTERN AT OUR CLINICS. THE MAXIMUM GIVEN TO ANY ONE STUDENT IS $1,000 AFTER THEY COMPLETE THE INTERNSHIP PROGRAM. 1099'S ARE ISSUED ON THESE SCHOLARSHIPS. X X X X 1 1 0 0 0 0 0 0 0 SORBERA THOMAS MD BOARD MEMBER & LMCC PHYSICIAN 330633 0 14193 0 1075 0 0 0 7979 0 353880 0 0 0 GILL PARAMPAL MD BOARD MEMBER 186525 0 0 0 0 0 0 0 0 0 186525 0 0 0 HARRINGTON JOSEPH P CEO & PRESIDENT 343207 0 0 0 6251 0 56098 0 7916 0 413472 0 0 0 BUTLER CYNTHIA B INTERIM CFO (6/23/12-10/13/13) 168238 0 0 0 632 0 4305 0 7916 0 181091 0 0 0 MORENO DEBBE JOYCE CHIEF NURSING OFFICER 195756 0 0 0 4200 0 4811 0 11083 0 215850 0 0 0 SEY MARK CHIEF ADMINISTRATIVE OFFICER 181707 0 0 0 4937 0 4687 0 7916 0 199247 0 0 0 WOOTON ROBYN VP OF FUND DEVELOPMENT (THRU 6/2013) 85300 0 0 0 75851 0 2182 0 1902 0 165235 0 0 0 SCHNEIDER PAMELA EXECUTIVE DIRECTOR-O/P SVC 154724 0 0 0 929 0 4004 0 7916 0 167573 0 0 0 LAVIOLA STEVEN MD PHYSICIAN, COMMUNITY CLINICS 350827 0 31358 0 69250 0 0 0 5815 0 457250 0 0 0 CONNOLY JOHN PATRICK MD PHYSICIAN, COMMUNITY CLINICS 317215 0 28851 0 375 0 0 0 10012 0 356453 0 0 0 FREUND EDMUND A MD PHYSICIAN, COMMUNITY CLINICS 354338 0 24871 0 200 0 0 0 8298 0 387707 0 0 0 SOROUR NAGUI MD PHYSICIAN, COMMUNITY CLINICS 447365 0 37968 0 375 0 0 0 0 0 485708 0 0 0 SCHOCH DENNY MD PHYSICIAN, COMMUNITY CLINICS 354186 0 25000 0 0 0 0 0 1713 0 380899 0 0 0 PART I, LINES 4A-B LINE 4A - SEVERANCE PAY WAS PAID TO ROBYN WOOTON IN THE AMOUNT OF $75,601 (VP OF FUND DEVELOPMENT POSITION ELIMINATED). LINE 4B - LMH HAS A 457(F) SERP WHICH IS LIMITED TO SELECT MEMBERS OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. PARTICIPANTS ARE SELECTED BY THE BOARD OF DIRECTORS OR AN AUTHORIZED OFFICER. THE AMOUNT OF THE DEFERRED COMPENSATION UNDER THE PLAN FOR A PARTICIPANT FOR A PLAN YEAR SHALL BE SPECIFIED IN THE PARTICIPANT'S PARTICIPATION AGREEMENT OR, IF NOT SO SPECIFIED, THE AMOUNT DETERMINED BY THE EMPLOYER FOR SUCH PLAN YEAR IN THE EMPLOYER'S SOLE AND ABSOLUTE DISCRETION. A PARTICIPANT BECOMES FULLY VESTED IN THE PARTICIPANT'S ACCOUNT UPON THE EARLIEST OF NORMAL RETIREMENT, DATE OF DEATH OR DATE OF DISABILITY WHILE STILL AN EMPLOYEE, DATE OF TERMINATION OR DEMOTION BY THE EMPLOYER IF THE EVENT OCCURS WITHIN THE TWELVE MONTH PERIOD FOLLOWING A CHANGE IN CONTROL, THE EMPLOYER'S INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE. IF THE PARTICIPANT CEASES TO BE AN EMPLOYEE PRIOR TO BECOMING FULLY VESTED, THE EMPLOYEE SHALL NOT BE ENTITLED TO ANY BENEFIT UNDER THIS PLAN. ANY AMOUNTS CREDITED TO A PARTICIPANT'S ACCOUNT THAT ARE NOT VESTED AT THAT TIME SHALL BE FORFEITED. DISTRIBUTIONS UNDER THE PLAN COMMENCE WITHIN 90 DAYS FOLLOWING VESTING AND NOT LATER THAN MARCH 15 OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR OF VESTING. CONTRIBUTIONS OF $100,000 WERE MADE TO THE PLAN DURING THE YEAR. NO PAYMENTS WERE MADE. A CALIFORNIA STATEWIDE COMMUNITES DEVELOPMENT AUTHORITY 680164610 2007-12-01 150629537 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 9970000 155144987 11156542 18234618 1547800 5651669 118554358 2012 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 0 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA STATEWIDE COMMUNITES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/26/2014 SCHEDULE K SUPPLENTAL INFORMATION THE DIFFERENCE OF $4,515,450 BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN PART II, LINE 3 IS DUE TO THE CUMULATIVE INVESTMENT EARNINGS (2007-2013) ON PROJECT FUNDS AND RESERVE FUNDS. PART I; COLUMN F: TO CONSTRUCT AND EQUIP: GENERAL ACUTE CARE ADDITION & NEW EMERGENCY DEPT. TO ALSO REMODEL WITH NEW EQUIPMENT: KITCHEN AND CAFETERIA. P GILL OBSTETRICS AND GYNECOLOGY >5% OWNED PARTNERSHIP BY PARAMPAL GILL, CURRENT BOARD MEMBER 212541 PHYSICIAN PROFESSIONAL SERVICE-OB CLINIC 0 FORM 990, PART VI, SECTION A, LINE 6 ASSOCIATION MEMBERSHIP IS OPEN TO ANYONE FOR A ONE-TIME, LIFETIME FEE OF $100. MEMBERS PARTICIPATE IN THE ANNUAL ELECTION OF BOARD MEMBERS WHO DIRECT THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS PARTICIPATE IN THE ANNUAL ELECTION OF BOARD MEMBERS WHO DIRECT THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS CANNOT SELL OR DISSOLVE THE CORPORATION - A 2/3RDS VOTE OF THE ASSOCIATION MEMBERS WOULD BE REQUIRED. FORM 990, PART VI, SECTION B, LINE 11 THE DRAFT OF THE FORM 990 IS PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF LODI MEMORIAL HOSPITAL TO REVIEW. THE REVIEWED DRAFT COPY IS THEN PROVIDED ELECTRONICALLY TO THE FULL BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD, COMMITTEES, OFFICERS AND MANAGEMENT ARE REQUIRED TO REVIEW, ATTEST AND DISCLOSE ANY POTENTIAL CONFLICT OF INTERESTS ON AN ANNUAL BASIS. IN ADDITION, IT IS VERBALLY REQUESTED AT EVERY BOARD MEETING FOR ALL MEMBERS TO DECLARE IF THEY HAVE A CONFLICT OF INTEREST ON ANY AGENDA ITEM AND TO ABSTAIN FROM VOTING ON SAID ITEM. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS A CEO COMPENSATION COMMITTEE, WHO REVIEWS THE CEO'S PERFORMANCE AND COMPENSATION AT LEAST ANNUALLY WHOSE SPECIFIC RESPONSIBILITIES INCLUDE: SCHEDULING AND COMPLETING AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE, REVIEWING AND ESTABLISHING PERFORMANCE CRITERIA FOR THE CEO, AN ANNUAL REVIEW OF THE CEO'S JOB DESCRIPTION, SOLICITING INPUT FROM OTHER SOURCES ON CEO PERFORMANCE, ANNUALLY REVIEWING MARKET AREA COMPENSATION AND BENEFITS FOR HOSPITAL CEOS TO DETERMINE FAIR MARKET VALUE COMPENSATION, ANNUALLY PROVIDE VERBAL AND WRITTEN FEEDBACK TO CEO ON PERFORMANCE. THE BOARD OF DIRECTORS HAS A CEO COMPENSATION COMMITTEE THAT ALSO ESTABLISHES A COMPENSATION PHILOSOPHY FOR CEO AND SENIOR MANAGEMENT, REVIEWS AND APPROVES THE CEO RECOMMENDATION FOR CAO, CNO, CFO AND VP COMPENSATION AND REVIEWS AND APPROVES MANAGEMENT COMMITTEE INCENTIVE COMPENSATION. IN ADDITION, LODI MEMORIAL HOSPITAL (LMH) PARTICIPATES IN AN ANNUAL COMPENSATION SURVEY SPONSORED BY THE CALIFORNIA HOSPITAL ASSOCIATION, THE HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA AND THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA. LMH SUBMITS THEIR WAGE AND SALARY DATA TO AN INDENDENDENT THIRD PARTY WHICH PRODUCES A REPORT BY JOB TITLE AND JOB DESCRIPTION THAT COMPARES SALARIES BY REGION WITHIN CALIFORNIA FOR ALL HOSPITALS WHO PARTICIPATE IN THE SURVEY. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: INCOME OF SUBSIDIARY - VITAL 62,263. INCOME OF SUBSIDIARY - LRHS -162,278. BOOK/TAX K-1 DIFFERENCES 3,406,891. 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