SUTTER HEALTH PACIFIC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SUTTER HEALTH PACIFIC (EIN 99-0298651)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-10-30
- IRS object ID
- 201433039349300338
- Schema version
- 2013v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-10-30T17:42:46-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4370 LA JOLLA VILLAGE DR STE 500 | AddressLine1 |
| City | SAN DIEGO | City |
| State | CA | State |
| ZIP Code | 92122 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990298651 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER HEALTH PACIFIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % ROSE CHOY | InCareOfNm |
| Business Name Control | SUTT | BusinessNameControlTxt |
| Phone | 9162866665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 OLD FORT WEAVER ROAD | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEONARD LICINA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9162866665 | PhoneNum |
| Signature | 2014-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEBRA HEISKALA | PreparerPersonNm |
| PTIN | P00649485 | PTIN |
| Phone | 9162866665 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAHI MOHALA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LEONARD LICINA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 FORT WEAVER ROAD | AddressLine1 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,766,347 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SUTTERHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 326 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $667,578 | PYContributionsGrantsAmt |
| CY Contributions Grants | $145,646 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,220,769 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,615,169 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,009 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,532 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $20,895,356 | PYTotalRevenueAmt |
| CY Total Revenue | $23,766,347 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,325,651 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,272,041 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $45,366 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,117,396 | PYOtherExpensesAmt |
| CY Other Expenses | $5,758,117 | CYOtherExpensesAmt |
| PY Total Expenses | $20,443,047 | PYTotalExpensesAmt |
| CY Total Expenses | $22,030,158 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $452,309 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,736,189 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,887,568 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,635,979 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,990,131 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,102,083 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,897,437 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,533,896 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $20,778,994 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $23,615,169 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $20,778,994 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 326 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROSE CHOY | PersonNm |
| Phone | 8086772580 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 OLD FORT WEAVER ROAD | AddressLine1 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| J KUHIO ASAM MD | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| DIANNE BROOKINS | ||||||||||
| TRUSTEE/CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | ||||||
| PATRICK DUARTE | ||||||||||
| TRUSTEE/VICE CHAIR FINANCE | 1.0 | 0.0 | Yes (X) | Yes (X) | ||||||
| DAVID HUDSON | ||||||||||
| TRUSTEE/VICE CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | ||||||
| LEONARD LICINA | ||||||||||
| CEO SUTTER HEALTH PACIFIC | 40.0 | 0.0 | Yes (X) | Yes (X) | $0 | $313,558 | $38,821 | |||
| CAMERON NEKOTA | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| NANCY E PACE MD MSPH | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| TINA SHELTON | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| DIANE STEWART | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $3,022 | $309 | ||||
| JUDGE ALLENE SUEMORI RET | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| SHELLEY WILSON | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| JEFFREY VENTURA | ||||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | |||||||
| JAMES E CONFORTI | ||||||||||
| TRUSTEE/SECRETARY CEO SHHR | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $1,122,894 | $209,404 | |||
| ROSE CHOY | ||||||||||
| CFO SUTTER HEALTH PACIFIC | 40.0 | 0.0 | Yes (X) | $0 | $206,873 | $19,582 | ||||
| STEVEN CHAPLIN MD | ||||||||||
| MEDICAL DIRECTOR/EX-OFFICIO | 40.0 | 0.0 | $557,994 | $0 | $18,238 | Yes (X) | ||||
| GREGORY PRIER MD | ||||||||||
| CHIEF OF STAFF | 40.0 | 0.0 | $329,162 | $0 | $18,238 | Yes (X) | ||||
| ELENA SHARIPOVA MD | ||||||||||
| PSYCHIATRIST | 40.0 | 0.0 | $353,385 | $0 | $28,639 | Yes (X) | ||||
| JEREMY ROBERTS MD | ||||||||||
| PSYCHIATRIST | 40.0 | 0.0 | $269,873 | $0 | $27,162 | Yes (X) | ||||
| RICHARD JACOBSON MD | ||||||||||
| PSYCHIATRIST | 40.0 | 0.0 | $150,660 | $0 | $13,371 | Yes (X) | ||||
| JOHN DONKERVOET | ||||||||||
| DIR. PSYCH,/THERAPUTIC SVCS | 40.0 | 0.0 | $120,817 | $0 | $5,998 | Yes (X) | ||||
| CHRISTINA ENOKA | ||||||||||
| DIRECTOR HR | 40.0 | 0.0 | $120,681 | $0 | $10,869 | Yes (X) | ||||
| SARAH KREVANS | ||||||||||
| COO SUTTER HEALTH | 0.0 | 0.0 | $0 | $2,264,199 | $372,873 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,902,572 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,910,546 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $763,504 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | UNITED LAUNDRY SERVICE | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2291 ALAHAO PLACE | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96819 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | LAUNDRY SERVICES | ServicesDesc |
| Compensation | $100,490 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $1,969 | FederatedCampaignsAmt |
| Government Grants | $53,029 | GovernmentGrantsAmt |
| All Other Contributions | $90,648 | AllOtherContributionsAmt |
| Total Contributions | $145,646 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $23,615,169 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,615,169 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,615,169 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,532 | TotalRevenueColumnAmt |
| Exclusion | $5,532 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,766,347 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,615,169 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,532 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,410,609 | TotalAmt |
| Program Services | $1,036,636 | ProgramServicesAmt |
| Management And General | $373,973 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,533,678 | TotalAmt |
| Program Services | $10,435,217 | ProgramServicesAmt |
| Management And General | $98,461 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,327 | TotalAmt |
| Program Services | $296,535 | ProgramServicesAmt |
| Management And General | $3,792 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,925,711 | TotalAmt |
| Program Services | $2,618,459 | ProgramServicesAmt |
| Management And General | $307,252 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,101,716 | TotalAmt |
| Program Services | $1,071,062 | ProgramServicesAmt |
| Management And General | $30,654 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,857 | TotalAmt |
| Management And General | $38,857 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,090 | TotalAmt |
| Management And General | $2,090 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,000 | TotalAmt |
| Program Services | $287,000 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,317 | TotalAmt |
| Program Services | $26,317 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,762 | TotalAmt |
| Program Services | $334,258 | ProgramServicesAmt |
| Management And General | $86,461 | ManagementAndGeneralAmt |
| Fundraising | $43 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,389 | TotalAmt |
| Program Services | $90,194 | ProgramServicesAmt |
| Management And General | $195 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $926,870 | TotalAmt |
| Program Services | $926,870 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,945 | TotalAmt |
| Program Services | $15,663 | ProgramServicesAmt |
| Management And General | $20,282 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,852 | TotalAmt |
| Program Services | $28,647 | ProgramServicesAmt |
| Management And General | $205 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,000 | TotalAmt |
| Program Services | $204,000 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $622,641 | TotalAmt |
| Program Services | $622,641 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,794 | TotalAmt |
| Program Services | $297,794 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| FOOD | $423,617 | $423,617 | ||
| MEDICAL SUPPLIES | $352,267 | $352,262 | $5 | |
| PURCHASED SERVICES | $978,490 | $801,090 | $135,541 | $41,859 |
| INTERCOMPANY CHARGEBACK | $515,627 | $515,627 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $506,599 | TotalAmt |
| Program Services | $395,105 | ProgramServicesAmt |
| Management And General | $108,030 | ManagementAndGeneralAmt |
| Fundraising | $3,464 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,030,158 | TotalAmt |
| Program Services | $20,778,994 | ProgramServicesAmt |
| Management And General | $1,205,798 | ManagementAndGeneralAmt |
| Fundraising | $45,366 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,780,040 | BOYAmt |
| EOY | $752,094 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,713 | BOYAmt |
| EOY | $21,399 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,351,847 | BOYAmt |
| EOY | $6,366,117 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,165 | BOYAmt |
| EOY | $16,987 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,908 | BOYAmt |
| EOY | $451,983 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,562,312 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,824,940 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,989,447 | BOYAmt |
| EOY | $5,737,372 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,328 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,120 | BOYAmt |
| EOY | $290,027 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,887,568 | BOYAmt |
| EOY | $13,635,979 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,116,742 | BOYAmt |
| EOY | $1,301,816 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $873,389 | BOYAmt |
| EOY | $800,267 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,990,131 | BOYAmt |
| EOY | $2,102,083 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,625,144 | BOYAmt |
| EOY | $11,334,134 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,293 | BOYAmt |
| EOY | $199,762 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,897,437 | BOYAmt |
| EOY | $11,533,896 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,887,568 | BOYAmt |
| EOY | $13,635,979 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,736,189 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$19,916 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,079,814 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,279,705 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,036,235 | DepreciationAmt |
| Book Value | $5,243,470 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,208,620 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,788,705 | DepreciationAmt |
| Book Value | $419,915 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,987 | OtherCostOrOtherBasisAmt |
| Book Value | $73,987 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,737,372 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INSURANCE LIABILITIES | Desc |
| Amt | $800,267 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $800,267 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, QUESTION 2 | FormAndLineReferenceDesc |
| Explanation | THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)) AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2013 AND 2012, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $313,006 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $313,006 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01420 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,219,121 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,249,748 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$1,030,627 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04680 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,532,127 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,249,748 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$717,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03260 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 392 | PersonsServedCnt |
| Total Community Benefit Expns | $60,530 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $60,530 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 248 | PersonsServedCnt |
| Total Community Benefit Expns | $45,836 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $45,836 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 3201 | PersonsServedCnt |
| Total Community Benefit Expns | $98,511 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $98,511 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 20 | ActivitiesOrProgramsCnt |
| Persons Served | 3841 | PersonsServedCnt |
| Total Community Benefit Expns | $204,877 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $204,877 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 20 | ActivitiesOrProgramsCnt |
| Persons Served | 3841 | PersonsServedCnt |
| Total Community Benefit Expns | $3,737,004 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,249,748 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$512,744 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02330 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 65 | PersonsServedCnt |
| Total Community Benefit Expns | $8,450 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $6,081 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,081 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 65 | PersonsServedCnt |
| Total Community Benefit Expns | $14,531 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,531 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $171,956 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $708,016 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $645,954 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $62,062 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER HEALTH PACIFIC - KAHI MOHALA | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 FORT WEAVER ROAD | AddressLine1 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SUTTERHEALTH.ORG | WebsiteAddressTxt |
| State License | 33-H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER HEALTH PACIFIC - KAHI MOHALA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SECTION C | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| QUESTION 3 | IN CONDUCTING ITS MOST RECENT CHNA, KAHI MOHALA, A FACILITY OF SUTTER HEALTH PACIFIC, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. IN ORDER TO SUPPLEMENT THE QUANTITATIVE FINDINGS, KEY INFORMANTS WERE INTERVIEWED TO FURTHER ASSESS THE UNDERLYING DRIVERS FOR HEALTH OUTCOMES, CURRENT COMMUNITY EFFORTS, AND OBSTACLES TO HEALTH. THESE KEY INFORMANTS WERE CHOSEN BY THE HAH ADVISORY COMMITTEE ON NOVEMBER 7-8, 2012 THROUGH A STRUCTURED NOMINATION AND SELECTION PROCESS, WHICH FOLLOWED A THOROUGH REVIEW OF THE PRELIMINARY CORE INDICATOR DATA. ADVISORY MEMBERS NOMINATED COMMUNITY MEMBERS WITH EXPERTISE IN PUBLIC HEALTH, IN THE TOP TEN TOPIC AREAS FROM THE CORE INDICATOR ANALYSIS, AS WELL AS IN THOSE TOPIC AREAS WHERE THERE WERE DATA GAPS. KEY INFORMANTS WERE ALSO NOMINATED FOR THEIR KNOWLEDGE OF VULNERABLE POPULATIONS, SUCH AS LOW-INCOME OR MORE ADVERSELY IMPACTED RACIAL/ETHNIC GROUPS. AFTER THE NOMINATION PROCESS, THE ADVISORY MEMBERS PRIORITIZED THE LIST THROUGH A VOTING PROCESS. THE KEY INFORMANT INTERVIEW PROCESS WAS PART OF A LARGER STATEWIDE CHNA EFFORT IN WHICH A TOTAL OF 105 COMMUNITY EXPERTS WERE NOMINATED, THEN PRIORITIZED DOWN TO A LIST OF 75. THE REMAINING 30 NOMINATED KEY INFORMANTS WERE MAINTAINED ON AN ALTERNATE LIST, IN THE EVENT THAT A KEY INFORMANT WAS NOT AVAILABLE. ROUGHLY 15 KEY INFORMANTS WERE ALLOTTED FOR EACH OF THE FOUR COUNTIES AND FOR THE OVERALL STATE PERSPECTIVE. 22 KEY INFORMANTS WERE INTERVIEWED FOR THEIR STATE-WIDE KNOWLEDGE OF HEALTH NEEDS; WHEN CERTAIN TOPIC AREAS WERE LACKING AN INTERVIEW WITH A STATE-WIDE PERSPECTIVE, RELEVANT FINDINGS FROM HONOLULU COUNTY INTERVIEWS WERE INCLUDED. THE INTERVIEWS WERE CONDUCTED BY LOCAL CONSULTANTS, STORYLINE CONSULTING. THE INTERVIEWS TOOK PLACE BETWEEN NOVEMBER 19, 2012 AND JANUARY 2, 2013 AND LASTED 30-60 MINUTES IN LENGTH. MOST INTERVIEWS TOOK PLACE BY PHONE; A FEW TOOK PLACE IN PERSON. STORYLINE CONSULTING TYPED NOTES FROM THE INTERVIEWS DURING THE CONVERSATION, CAPTURING THE BULK OF THE CONVERSATION VERBATIM. INTERVIEW NOTES WERE THEN CONDENSED AND ENTERED INTO A DATA COLLECTION SPREADSHEET. INTERVIEWS WERE HELD WITH THE FOLLOWING PEOPLE: - JENNIFER DANG, STATE DIRECTOR FOR HAWAII NUTRITION AND PHYSICAL ACTIVITY COALITION, DEPARTMENT OF EDUCATION WITH EXPERTISE IN EXERCISE, NUTRITION & WEIGHT. INTERVIEW DATE: 12/20/2012. - LYNN FALLIN, DEPUTY DIRECTOR FOR THE BEHAVIORAL HEALTH SERVICES ADMINISTRATION, HAWAII DEPARTMENT OF HEALTH WITH EXPERTISE IN MENTAL HEALTH & MENTAL DISORDERS. INTERVIEW DATE: 12/12/2012. - DR. KENNY FINK, ADMINISTRATOR FOR THE DEPARTMENT OF HUMAN SERVICES, MED-QUEST DIVISION WITH EXPERTISE IN ACCESS TO HEALTH SERVICES. INTERVIEW DATE: 12/10/2012. - LORETTA FUDDY, DIRECTOR FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN MENTAL HEALTH, MENTAL DISORDERS AND SUBSTANCE ABUSE. INTERVIEW DATE: 12/12/2012. - BETH GIESTING, HEALTHCARE TRANSFORMATION OFFICER FOR THE OFFICE OF THE GOVERNOR WITH EXPERTISE IN ACCESS TO HEALTH SERVICES AND ORAL HEALTH. INTERVIEW DATE: 12/20/2012. - DR. JOSH GREEN, STATE SENATOR, EXECUTIVE MEDICAL DIRECTOR FOR HAWAII INDEPENDENT PHYSICIANS ASSOCIATION AND AN EMERGENCY ROOM PHYSICIAN WITH EXPERTISE IN DIABETES AND SUBSTANCE ABUSE. INTERVIEW DATE: 11/28/2012. - ROBERT HIROKAWA, CEO OF HAWAII PRIMARY CARE ASSOCIATION WITH EXPERTISE IN RESPIRATORY DISEASE AND SOCIAL ENVIRONMENT. INTERVIEW DATE: 12/19/2012. - LOLA IRVIN, HEALTHY HAWAII INITIATIVE, TOBACCO SETTLEMENT PROJECT MANAGER FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN CANCER, EXERCISE, NUTRITION, WEIGHT, AND RESPIRATORY DISEASE. INTERVIEW DATE: 12/17/2012. - DR. BLISS KANESHIRO, PROFESSOR OF OBSTETRICS/GYNECOLOGY AND DIRECTOR OF FAMILY PLANNING FOR JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAII WITH EXPERTISE IN FAMILY PLANNING. INTERVIEW DATE: 12/17/2012. - LESLIE LAM, EXECUTIVE DIRECTOR OF AMERICAN DIABETES ASSOCIATION HAWAII WITH EXPERTISE IN DIABETES. INTERVIEW DATE: 12/28/2012. - DEE JAY MAILER, CEO OF KAMEHAMEHA SCHOOLS WITH EXPERTISE IN EDUCATION. INTERVIEW DATE: 12/17/2012. - KATHY MATAYOSHI, SUPERINTENDENT OF EDUCATION FOR HAWAII STATE DEPARTMENT OF EDUCATION WITH EXPERTISE IN MENTAL HEALTH AND MENTAL DISORDERS. INTERVIEW DATE: 12/26/2012. - DEE DEE NELSON, DIRECTOR OF MOUNTAIN-PACIFIC QUALITY HEALTH WITH EXPERTISE IN HEART DISEASE, OLDER ADULTS AND AGING. INTERVIEW DATE: 12/3/2012. - MAY OKIHIRO, DIRECTOR OF HAWAII INITIATIVE FOR CHILDHOOD OBESITY RESEARCH AND EDUCATION FOR THE JOHN A. BURNS SCHOOL OF MEDICINE DEPARTMENT OF PEDIATRICS, UNIVERSITY OF HAWAII WITH EXPERTISE IN EXERCISE, NUTRITION, AND WEIGHT. INTERVIEW DATE: 12/10/2012. - DR. BILL OSHEROFF, CHIEF MEDICAL OFFICER OF HAWAII MEDICAL SERVICE ASSOCIATION WITH EXPERTISE IN MATERNAL, FETAL AND INFANT HEALTH. INTERVIEW DATE: 12/20/2012. - DR. NEAL PALAFOX, PROFESSOR FOR JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAII WITH EXPERTISE IN ACCESS TO HEALTH SERVICES CANCER. INTERVIEW DATE: 12/26/2012. - DR. SARAH PARK, CHIEF, DISEASE OUTBREAK CONTROL DIVISION FOR DEPARTMENT OF HEALTH WITHE EXPERTISE IN IMMUNIZATIONS AND INFECTIOUS DISEASE. INTERVIEW DATE: 12/4/2012. - DR. LINDA ROSEN, CHIEF, EMERGENCY MEDICAL SERVICES AND INJURY PREVENTION SYSTEMS BRANCH FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN INJURY PREVENTION AND SAFETY. INTERVIEW DATE: 12/20/2012. - DAVID SAKAMOTO, DEPUTY DIRECTOR, HEALTH SERVICES FOR HAWAII STATE DEPARTMENT OF HEALTH WITH EXPERTISE IN MENTAL HEALTH AND MENTAL DISORDERS. INTERVIEW DATE: 12/12/2012. - EMILIE SMITH, ADMINISTRATOR FOR CARERESOURCE HAWAII WITH EXPERTISE IN OLDER ADULTS, AGING, AND TRANSPORTATION. INTERVIEW DATE: 12/6/2012. - HARDY SPOEHR, EXECUTIVE DIRECTOR OF PAPA OLA LOKAHI WITH EXPERTISE IN ACCESS TO HEALTH SERVICES AND SOCIAL ENVIRONMENT. INTERVIEW DATE: 12/19/2012. - LORI SUAN, EXECUTIVE DIRECTOR OF AMERICAN HEART ASSOCIATION, HAWAII CHAPTER WITH EXPERTISE IN HEART DISEASE. INTERVIEW DATE: 12/10/2012. - DR. JACKIE YOUNG, CHIEF STAFF OFFICER, HIGH PLAINS DIVISION FOR AMERICAN CANCER SOCIETY HAWAII SITE WITH EXPERTISE IN CANCER. INTERVIEW DATE: 12/26/2012. - KEN ZERI, PRESIDENT AND CEO, FOR HOSPICE HAWAII WITH EXPERTISE IN OLDER ADULTS AND AGING. INTERVIEW DATE: 12/6/2012. THE FINDINGS FROM KEY INFORMANT INTERVIEWS IN KAHI MOHALA'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML |
| QUESTION 4 | THE STATE OF HAWAII IS UNIQUE IN THAT ALL OF ITS COMMUNITY HOSPITALS AND HOSPITAL SYSTEMS JOINED EFFORTS TO FULFILL NEW REQUIREMENTS UNDER THE AFFORDABLE CARE ACT, WHICH THE IRS DEVELOPED GUIDELINES TO IMPLEMENT. THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) LED THIS COLLABORATION TO CONDUCT STATE- AND COUNTY-WIDE ASSESSMENTS FOR ITS MEMBERS. TWENTY-SIX MEMBER HOSPITALS IN HAWAII PARTICIPATED IN THE CHNA PROJECT: - CASTLE MEDICAL CENTER - HALE HO`OLA HAMAKUA - HILO MEDICAL CENTER - KAHI MOHALA - KAHUKU MEDICAL CENTER - KAISER PERMANENTE MEDICAL CENTER - KAPI`OLANI MEDICAL CENTER FOR WOMEN & CHILDREN - KA`U HOSPITAL - KAUAI VETERANS MEMORIAL HOSPITAL - KOHALA HOSPITAL - KONA COMMUNITY HOSPITAL - KUAKINI MEDICAL CENTER - KULA HOSPITAL - LANA`I COMMUNITY HOSPITAL - LEAHI HOSPITAL - MAUI MEMORIAL MEDICAL CENTER - MOLOKAI GENERAL HOSPITAL - NORTH HAWAII COMMUNITY HOSPITAL - PALI MOMI MEDICAL CENTER - REHABILITATION HOSPITAL OF THE PACIFIC - SAMUEL MAHELONA MEMORIAL HOSPITAL - SHRINERS HOSPITALS FOR CHILDREN - HONOLULU - STRAUB CLINIC & HOSPITAL - THE QUEEN'S MEDICAL CENTER - WAHIAWA GENERAL HOSPITAL - WILCOX MEMORIAL HOSPITAL |
| QUESTION 5A & 5B | FILING ORG WEBSITE: HTTP://WWW.KAHIMOHALA.ORG/ABOUT/ OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML |
| QUESTION 7 | NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. KAHI MOHALA IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. KAHI MOHALA DOES NOT HAVE SPECIFIC PLANS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: - CANCER - DIABETES - DISABILITIES - ECONOMY - EDUCATION - ENVIRONMENT - FAMILY PLANNING - HEART DISEASE & STROKE - IMMUNIZATIONS & INFECTIOUS DISEASES - INJURY PREVENTION & SAFETY - OLDER ADULTS & AGING - ORAL HEALTH - RESPIRATORY DISEASES - SOCIAL ENVIRONMENT - TRANSPORTATION |
| QUESTION 12I | BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. |
| QUESTION 14G | MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. THE ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. |
| QUESTION 20D | HOW DID THE FACILITY DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED FAP ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. FOR PATIENTS WHO HAVE NO INSURANCE COVERAGE: - SHP BILLS GUARANTOR GROSS CHARGES - PATIENT APPLIES FOR MED-QUEST (STATE OF HAWAII MEDICAID PROGRAM) AND MED-QUEST MAKES A DETERMINATION IF PATIENT IS ELIGIBLE FOR COVERAGE BASED ON FAMILY INCOME, ASSETS, DEBT - ONCE ELIGIBILITY IS DETERMINED, PATIENT IS COVERED BY MEDICAID FFS - PATIENT THEN SELECTS A MEDICAID-QUEST OR MEDICAID-QEXA PLAN BASED ON THE DETERMINATION - IF PATIENT IS ELIGIBLE FOR QUEST OR QEXA, SHP WILL REQUEST RETRO AUTHORIZATIONS AND BILL THE PLAN - IF PATIENT IS ELIGIBLE FOR MEDICAID FFS - PATIENT FINANCIAL SERVICES WILL HAVE PATIENT COMPLETE CHARITY CARE APPLICATION |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, QUESTION 3C | TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES APPLIES TO UNINSURED PATIENTS THAT WHOSE FAMILY INCOMES ARE BETWEEN 201% AND 400%. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 350% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURE HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAT THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR A 20% DISCOUNT IF 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE. |
| PART I, QUESTION 6A | SUTTER HEALTH, A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT. |
| PART I, QUESTION 7 | COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. |
| COMMUNITY BUILDING ACTIVITIES | KAHI MOHALA FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. KAHI SUPPORTS THE HAWAII BEHAVIORAL HEALTH ALLIANCE, AN ORGANIZATION THAT HELPS RAISE AWARENESS, IMPROVE SERVICE DELIVERY AND GENERATE COMMUNITY SUPPORT FOR SERVICE MEMBERS AND FAMILIES. KAHI MOHALA PATIENTS AND STAFF CREATED ITEMS FOR HOLIDAY CARE PACKAGES FOR THE AIR FORCE RESERVE UNIT SERVING IN AFGHANISTAN. KAHI MOHALA SUPPORTS TALK STORY TIME, A COMMUNITY SUPPORT NETWORK MEETING FOR MILITARY SPOUSES AND SIGNIFICANT OTHERS WHO HAVE EXPERIENCED TRAUAMATIC EVENTS IN OR OUTSIDE OF MILITARY COMBAT. KAHI PROVIDES MEETING FACILITY SPACE FOR THE INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY (IAHSS). IAHSS IS A NOT-FOR-PROFIT ORGANIZATION DEDICATED TO PROFESSIONALS INVOLVED IN MANAGING AND DIRECTING SECURITY AND SAFETY PROGRAMS IN HEALTHCARE INSTITUTES. |
| PART III, QUESTION 2 | METHODOLOGY FOR CALCULATING BAD DEBT (AT COST) THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. |
| PART III, QUESTION 3 | METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE: AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. |
| PART III, QUESTION 4 | THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE ESTIMATED BASED UPON AN EVALUATION OF HISTORICAL PAYMENTS, NEGOTIATED CONTRACTS AND GOVERNMENTAL REIMBURSEMENTS. SUTTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 90% AND 89% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2013 AND 2012 RESPECTIVELY. ADJUSTMENTS AND CHANGES IN ESTIMATES ARE RECORDED IN THE PERIOD IN WHICH THEY ARE DETERMINED. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 33% AS OF 12/31/13 29% AS OF 12/31/12 MEDI-CAL 21% AS OF 12/31/13 23% AS OF 12/31/12 DURING 2013 AND 2012, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT THE ESTIMATION MAY CHANGES BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SUTTER'S SELF-PAY WRITE-OFFS WERE $375 MILLION AND $370 MILLION FOR 2013 AND 2012, RESPECTIVELY. |
| PART III, QUESTION 7 | MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. |
| PART III, QUESTION 8 | BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. |
| PART III, QUESTION 9B | COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. |
| PART VI, QUESTION 2 | THE CHNA REPORT WAS DEVELOPED THROUGH A COLLABORATIVE PROCESS AND PROVIDES AN OVERVIEW OF THE HEALTH NEEDS IN HAWAII. THE GOAL OF THE REPORT IS TO OFFER A MEANINGFUL UNDERSTANDING OF THE HEALTH NEEDS IN THE COMMUNITY, AS WELL AS HELP GUIDE KAHI MOHALA WITH THEIR COMMUNITY BENEFIT PLANNING EFFORTS AND DEVELOPMENT OF AN IMPLEMENTATION STRATEGY TO ADDRESS PRIORITIZED NEEDS. SPECIAL ATTENTION HAS BEEN GIVEN TO IDENTIFY HEALTH DISPARITIES, THE NEEDS OF VULNERABLE POPULATIONS, AND UNMET HEALTH NEEDS OR GAPS IN SERVICES. ALTHOUGH THIS REPORT FOCUSES ON NEEDS WITHIN THE COMMUNITY, THERE ARE INNUMERABLE COMMUNITY ASSETS AND A TRUE ALOHA SPIRIT THAT PROVIDES AMPLE FOUNDATION FOR COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. IN FALL 2012, THE HEALTHCARE ASSOCIATION OF HAWAII PARTNERED WITH HEALTHY COMMUNITIES INSTITUTE TO CONDUCT A CHNA FOR HAWAII. OUR APPROACH FOLLOWED THE PUBLIC HEALTH MODEL OF ASSESSING AND UNDERSTANDING COMMUNITY HEALTH HOLISTICALLY. A FRAMEWORK FOR ANALYSIS WAS CONSTRUCTED BASED ON DETERMINANTS OF HEALTH; THE FRAMEWORK INCLUDED A BROAD DEFINITION OF COMMUNITY HEALTH THAT CONSIDERS EXTENSIVE SECONDARY DATA ON THE SOCIAL, ECONOMIC, AND PHYSICAL ENVIRONMENTS, AS WELL AS HEALTH RISKS AND OUTCOMES. THE INFLUENCE OF MAUKA ("TOWARD THE MOUNTAINS"), OR UPSTREAM FACTORS, AND THE RESULTING MAKAI ("TOWARD THE OCEAN"), OR DOWNSTREAM IMPACTS, ON HEALTH IS A TRANSCENDING THEME. KEY INFORMANT INTERVIEWS WITH THOSE HAVING SPECIAL KNOWLEDGE OF HEALTH NEEDS, HEALTH DISPARITIES, AND VULNERABLE POPULATIONS PROVIDED VITAL INFORMATION THAT INCREASED THE UNDERSTANDING OF THE HEALTH NEEDS IN HAWAII. A SMALL SET OF COMMUNITY RESIDENTS PROVIDED ADDITIONAL INSIGHTS ON THE HEALTH NEEDS IN HAWAII. IT IS HOPED THAT THE REPORT WILL PROVIDE A FOUNDATION FOR COMMUNITY HEALTH IMPROVEMENT EFFORTS AND THAT COMMUNITY HEALTH PARTNERS WILL BUILD ON THIS REPORT. AN EXTENSIVE ARRAY OF SECONDARY AND PRIMARY DATA WAS COLLECTED AND SYNTHESIZED FOR THE REPORT. CORE INDICATORS: SECONDARY DATA WAS ANALYZED USING HAWAII HEALTH MATTERS (WWW.HAWAIIHEALTHMATTERS.ORG), A PUBLICLY AVAILABLE DATA PLATFORM WITH A DASHBOARD OF OVER 140 INDICATORS FROM OVER 20 SOURCES; MUCH OF THE DATA COMES FROM HAWAII DEPARTMENT OF HEALTH, ALLOWING FOR HAWAII-SPECIFIC RACE, AGE AND GENDER DETAILS. THE REPORT PROVIDES AN OVERVIEW OF HAWAII COMMUNITY HEALTH NEEDS. COMMUNITY HEALTH WAS ASSESSED FOR HAWAII AS A WHOLE, FOR RACE SUB-GROUPS, AND FOR SUB-GEOGRAPHIES. THE FINDINGS REVEALED OVERALL OR SUB-POPULATION COMMUNITY NEEDS IN THE FOLLOWING AREAS: - ACCESS TO HEALTH SERVICES - CANCER - DIABETES - DISABILITIES - ECONOMY - EDUCATION - ENVIRONMENT - EXERCISE, NUTRITION, & WEIGHT - FAMILY PLANNING - HEART DISEASE & STROKE - IMMUNIZATIONS & INFECTIOUS DISEASES - INJURY PREVENTION & SAFETY - MATERNAL, FETAL & INFANT HEALTH - MENTAL HEALTH & MENTAL DISORDERS - OLDER ADULTS & AGING - ORAL HEALTH - RESPIRATORY DISEASES - SOCIAL ENVIRONMENT - SUBSTANCE ABUSE & LIFESTYLE - TRANSPORTATION THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR KAHI MOHALA IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. |
| PART VI, QUESTION 3 | KAHI MOHALA FOLLOWS A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. FOR A MORE DETAILED LOOK AT OUR CHARITY CARE POLICIES BY REGION, PLEASE VISIT THE OFFICE OF STATEWIDE AND HEALTH PLANNING'S WEBSITE AT HTTP://SYFPHR.OSHPD.CA.GOV. COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: - ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLION INFORMATION FOR UNINSURED PATIENTS) - PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION". B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. |
| PART VI, QUESTION 4 | THE HOSPITAL SERVICE AREA IS DEFINED BY A GEOGRAPHICAL BOUNDARY OF THE STATE OF HAWAII. THE STATE WILL SERVE AS THE UNIT OF ANALYSIS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. HENCE, THE HEALTH NEEDS DISCUSSED IN THE ASSESSMENT WILL PERTAIN TO INDIVIDUALS LIVING WITHIN THIS GEOGRAPHIC BOUNDARY. WHEN POSSIBLE, HIGHLIGHTS FOR SUB-GEOGRAPHIES WITHIN HAWAII ARE PROVIDED. THERE ARE 26 HOSPITALS THAT SERVE THE COMMUNITY. IN 2011, HAWAII HAD A POPULATION OF 1,374,810. AS MEASURED BY THE DECENNIAL CENSUS, THE POPULATION DENSITY IN THE STATE IS MUCH HIGHER THAN THE U.S. OVERALL. WITHIN THE STATE, HAWAII COUNTY GREW THE FASTEST BETWEEN 2000 AND 2010, WHILE HONOLULU COUNTY GREW THE SLOWEST. HAWAII'S POPULATION IS SLIGHTLY OLDER THAN THE REST OF THE COUNTRY, WITH A MEDIAN AGE OF 38.5 (COMPARED TO 37.3 FOR THE U.S.). CHILDREN UNDER 18 MAKE UP ONLY 22.1% OF THE STATE'S POPULATION, WHILE 23.7% OF THE TOTAL U.S. POPULATION IS UNDER 18. WITHIN THE STATE, KAUAI COUNTY HAS THE OLDEST POPULATION WITH A MEDIAN AGE OF 42.2. HONOLULU COUNTY HAS THE YOUNGEST, WITH A MEDIAN AGE OF 37.6. THE LARGEST SINGLE RACE GROUP IN HAWAII IS ASIAN AT 38.1%. THE MAJORITY OF THE ASIAN POPULATION IS FILIPINO OR JAPANESE (WHICH INCLUDES ALL RESIDENTS REPORTING A RACE OF ASIAN ONLY REGARDLESS OF HISPANIC/LATINO ETHNICITY). HAWAII ALSO HAS MUCH LARGER NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER (9.3%) AND MULTIRACIAL POPULATIONS (24.1%) THAN THE REST OF THE COUNTRY. NATIVE HAWAIIANS, AT 5.6% OF THE TOTAL POPULATION, MAKE UP THE LARGEST SHARE OF THE NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER SINGLE RACE GROUP. A HIGHER PERCENT OF HAWAII IS FOREIGN-BORN COMPARED TO THE U.S. IN 2006-2010, 17.7% OF THE STATE WAS FOREIGN-BORN, COMPARED TO 12.7% OF THE U.S. OVERALL. A HIGHER PERCENT OF HAWAII HOUSEHOLDS WERE LINGUISTICALLY ISOLATED AS WELL: 6.2% OF HOUSEHOLDS REPORTED THAT ALL OF ITS MEMBERS AGES 14 AND OVER HAD SOME DIFFICULTY SPEAKING ENGLISH, CONTRASTED WITH JUST 4.8% OF HOUSEHOLDS IN THE U.S. INCOME IN HAWAII OVERALL IS HIGH. MEDIAN HOUSEHOLD INCOME IN 2006-2010 WAS $66,420, SUBSTANTIALLY HIGHER THAN THE NATIONAL VALUE OF $51,914. WHILE THE GAP IS SMALLER AMONG PER CAPITA INCOMES, HAWAII'S $28,882 IS STILL HIGHER THAN THE U.S.'S $27,334. HAWAII ALSO HAS A SMALLER POPULATION LIVING IN POVERTY COMPARED TO THE U.S., AT 9.6% VS. 13.8%. WITHIN THE STATE, HONOLULU COUNTY IS TIED WITH KAUAI COUNTY FOR THE LOWEST LEVELS OF POVERTY (8.8%). HAWAII COUNTY HAS THE HIGHEST, AT 14.4%. CERTAIN RACE/ETHNICITY GROUPS ARE ALSO MORE AFFECTED BY POVERTY. THE AMERICAN INDIAN/ALASKA NATIVE AND NATIVE HAWAIIAN/OTHER P.I. POPULATIONS HAVE THE HIGHEST POVERTY RATES AT 19.7% AND 18.2% RESPECTIVELY. THE TWO LEAST IMPOVERISHED GROUPS ARE ASIAN (6.3%) AND BLACK OR AFRICAN AMERICAN (9.7%). IT IS IMPORTANT TO NOTE THAT FEDERAL DEFINITIONS OF POVERTY ARE NOT GEOGRAPHICALLY ADJUSTED, SO THE DATA MAY NOT ADEQUATELY REFLECT THE PROPORTION OF HAWAII RESIDENTS WHO STRUGGLE TO PROVIDE FOR THEMSELVES DUE TO THE HIGH COST OF LIVING IN THE STATE. HAWAII RESIDENTS ARE WELL-EDUCATED COMPARED TO THE REST OF THE NATION. IN 2006-2010, 89.8% OF THE STATE'S RESIDENTS AGED 25 AND OLDER HAD AT LEAST A HIGH SCHOOL DEGREE, AND 29.4% HAD AT LEAST A BACHELOR'S DEGREE. BY CONTRAST, ONLY 85.0% OF THE NATION'S 25+ POPULATION HAD A HIGH SCHOOL DEGREE OR HIGHER, AND ONLY 27.9% HAD A BACHELOR'S DEGREE OR HIGHER. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN KAHI MOHALA'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. |
| PART VI, QUESTION 5 | SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE 2013 - 2015 IMPLEMENTATION STRATEGY FOR KAHI MOHALA DEFINES PROGRAMS THAT WILL ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. KAHI MOHALA SUPPORTS THE CRISIS RESPONSE PILOT PROJECT FOR EMERGENCY ROOM PATIENTS. THE PILOT PROJECT WILL PROVIDE AN EXPERIENCED BEHAVIORAL HEALTH PROFESSIONAL TO LEEWARD AND CENTRAL OAHU HOSPITALS AND EMERGENCY ROOMS, SUCH AS WAHIAWA GENERAL HOSPITAL, PALI MOMI MEDICAL CENTER AND OTHERS, TO ASSESS, EVALUATE AND DE-ESCALATE PSYCHIATRIC PATIENTS IN CRISIS. THE BEHAVIORAL HEALTH EVALUATOR WILL BE A 'COMMUNITY CONNECTOR' TO RECOMMEND COMMUNITY RESOURCES AND PLACEMENT. THE BEHAVIORAL HEALTH PROFESSIONAL WILL ALSO PROVIDE TRAINING TO EMERGENCY ROOM STAFF IN DE-ESCALATION TECHNIQUES AND MANAGEMENT OF BEHAVIORAL HEALTH PATIENTS. TRAINING TOPICS MAY INCLUDE HOW TO RECOGNIZE SIGNS, SYMPTOMS, AND ENGAGE IN PRACTICAL TECHNIQUES FOR PATIENTS EXHIBITING BEHAVIORAL HEALTH ISSUES (SUCH AS SUBSTANCE ABUSE, SUICIDAL IDEATION, AND TRAUMA). THE TRAININGS WILL BE OFFERED AT THE MOST CONVENIENT LOCATION FOR EMERGENCY ROOM STAFF, EITHER AT THEIR HOSPITAL OR ON THE KAHI MOHALA CAMPUS. KAHI SUPPORTS THE COMMUNITY HEALTH CENTER CARE COORDINATION PROGRAM. THIS PROGRAM HELPS TO ESTABLISH A SINGLE POINT OF CONTACT BETWEEN A KAHI MOHALA CASE MANAGER AND WAIANAE COAST COMPREHENSIVE HEALTH CENTER (WCCHC) AFTERCARE COORDINATOR TO IMPROVE COMMUNICATION WITH THE PATIENT'S PRIMARY CARE PHYSICIAN, TO MORE EFFECTIVELY SCHEDULE AFTERCARE APPOINTMENTS, AND TO ENSURE A SEAMLESS DISCHARGE FROM KAHI MOHALA. |
| PART VI, QUESTION 6 | KAHI MOHALA IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF ALMOST 50,000 PHYSICIANS, EMPLOYEES, AND VOLUNTEERS WHO CARE FOR MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. IT'S BETTER FOR PATIENTS: WE BELIEVE THIS COMMUNITY-OWNED, NOT-FOR-PROFIT APPROACH TO HEALTH CARE BEST SERVES OUR PATIENTS AND OUR COMMUNITIES - FOR MULTIPLE REASONS. FIRST OF ALL, IT'S GOOD FOR PATIENTS. ACCORDING TO THE JOURNAL OF GENERAL INTERNAL MEDICINE (APRIL 2000), PATIENTS TREATED AT FOR-PROFIT OR GOVERNMENT-OWNED HOSPITALS WERE TWO-TO-FOUR TIMES MORE LIKELY TO SUFFER PREVENTABLE ADVERSE EVENTS THAN PATIENTS TREATED AT NOT-FOR-PROFIT INSTITUTIONS. OUR STOCKHOLDERS ARE OUR COMMUNITIES: INVESTOR-OWNED, FOR-PROFIT HEALTH SYSTEMS HAVE A FINANCIAL INCENTIVE TO AVOID CARING FOR UNINSURED AND UNDERINSURED PATIENTS. THEY ALSO HAVE A FINANCIAL INCENTIVE TO AVOID HARD-TO-SERVE POPULATIONS AND "UNDESIRABLE" GEOGRAPHIC AREAS SUCH AS RURAL AREAS. FOR MANY NORTHERN CALIFORNIA'S UNDERSERVED RURAL LOCALES, SUTTER HEALTH IS THE ONLY PROVIDER OF HOSPITAL AND EMERGENCY MEDICAL SERVICES IN THE COMMUNITY. PROVIDING CHARITY CARE AND SPECIAL PROGRAMS TO COMMUNITIES: OUR COMMUNITIES' SUPPORT HELPS US EXPAND SERVICES, INTRODUCE NEW PROGRAMS AND IMPROVE MEDICAL TECHNOLOGY. ACROSS OUR NETWORK, EVERY SUTTER HOSPITAL, PHYSICIAN ORGANIZATION AND CLINIC HAS A SPECIAL STORY TO TELL ABOUT FULFILLING VITAL COMMUNITY NEEDS. OUR COMMITMENT TO COMMUNITY BENEFIT: MEETING THE HEALTH CARE NEEDS OF OUR COMMUNITIES IS THE CORNERSTONE OF SUTTER HEALTH'S NOT-FOR-PROFIT MISSION. THIS INCLUDES DIRECTLY SERVING THOSE WHO CANNOT AFFORD TO PAY FOR HEALTH CARE AND SUPPORTING PROGRAMS AND SERVICES THAT HELP THOSE IN FINANCIAL NEED. SUTTER HEALTH NOW PROVIDES AN AVERAGE OF MORE THAN $3 MILLION IN CHARITY CARE PER WEEK. IN 2013, OUR NETWORK OF PHYSICIAN ORGANIZATIONS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS INVESTED $901 MILLION IN HEALTH CARE PROGRAMS, SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED. THIS INCLUDES: - THE COST OF PROVIDING CHARITY CARE; - THE UNPAID COSTS OF PARTICIPATING IN MEDI-CAL; AND - INVESTMENTS IN MEDICAL RESEARCH, HEALTH EDUCATION AND COMMUNITY-BASED PUBLIC BENEFIT PROGRAMS SUCH AS SCHOOL-BASED CLINICS AND PRENATAL CARE FOR PATIENTS. SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS CONTINUED TO GROW, REACHING ANOTHER ALL-TIME HIGH OF $166 MILLION IN 2013. |
| PART VI, QUESTION 7 | CALIFORNIA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN CHAPLIN MD | ||||||||||||||
| MEDICAL DIRECTOR/EX-OFFICIO | $221,060 | $0 | $334,305 | $0 | $2,629 | $0 | $11,467 | $0 | $6,771 | $0 | $576,232 | $0 | $0 | $0 |
| ROSE CHOY | ||||||||||||||
| CFO SUTTER HEALTH PACIFIC | $0 | $138,428 | $0 | $59,342 | $0 | $9,103 | $0 | $18,707 | $0 | $875 | $0 | $226,455 | $0 | $5,100 |
| LEONARD LICINA | ||||||||||||||
| CEO SUTTER HEALTH PACIFIC | $0 | $207,321 | $0 | $83,685 | $0 | $22,552 | $0 | $26,163 | $0 | $12,658 | $0 | $352,379 | $0 | $83,685 |
| GREGORY PRIER MD | ||||||||||||||
| CHIEF OF STAFF | $178,188 | $0 | $148,881 | $0 | $2,093 | $0 | $11,467 | $0 | $6,771 | $0 | $347,400 | $0 | $0 | $0 |
| ELENA SHARIPOVA MD | ||||||||||||||
| PSYCHIATRIST | $169,325 | $0 | $183,978 | $0 | $82 | $0 | $11,467 | $0 | $17,172 | $0 | $382,024 | $0 | $0 | $0 |
| JEREMY ROBERTS MD | ||||||||||||||
| PSYCHIATRIST | $420 | $0 | $269,431 | $0 | $22 | $0 | $11,467 | $0 | $15,695 | $0 | $297,035 | $0 | $0 | $0 |
| RICHARD JACOBSON MD | ||||||||||||||
| PSYCHIATRIST | $41,171 | $0 | $109,467 | $0 | $22 | $0 | $6,780 | $0 | $6,591 | $0 | $164,031 | $0 | $0 | $0 |
| JAMES E CONFORTI | ||||||||||||||
| TRUSTEE/SECRETARY CEO SHHR | $0 | $586,008 | $0 | $472,842 | $0 | $64,044 | $0 | $187,180 | $0 | $22,224 | $0 | $1,332,298 | $0 | $470,876 |
| SARAH KREVANS | ||||||||||||||
| COO SUTTER HEALTH | $0 | $909,010 | $0 | $875,587 | $0 | $479,602 | $0 | $348,316 | $0 | $24,557 | $0 | $2,637,072 | $0 | $1,312,940 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, QUESTION 1A | TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY. |
| PART I, QUESTION 3 | THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. |
| PART I, QUESTION 4B | THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR EARNINGS BEYOND THE PENSION PAY CAP. THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. |
| PART I, QUESTION 7 | SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, QUESTION 1 AND PART III, QUESTION 1 | SUTTER HEALTH PACIFIC (DBA KAHI MOHALA) IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES. |
| FORM 990, PART III, QUESTION 4A | SUTTER HEALTH PACIFIC, A CALIFORNIA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION WAS ORGANIZED TO OPERATE KAHI MOHALA HOSPITAL, AN 88 BED, FREESTANDING PSYCHIATRIC HOSPITAL. KAHI MOHALA HOSPITAL HAS BEEN OPERATIONAL SINCE 1983 AND IS SITUATED ON A 14.5 ACRE CAMPUS. THE HOSPITAL IS LICENSED BY THE STATE OF HAWAII AND IS ACCREDITED BY THE JOINT COMMISSION UNDER THE ACCREDITATION MANUAL OF HOSPITALS, WITH THE EXCEPTION OF THE LONGER TERM PROGRAMS FOR CHILDREN AND ADOLESCENTS, WHICH ARE ACCREDITED UNDER THE CONSOLIDATED STANDARDS. THERE WERE 27,808 PATIENT DAYS IN 2013. KAHI MOHALA'S MISSION IS: "KAHI MOHALA IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES." TREATMENT PROGRAMS KAHI MOHALA BEHAVIORAL HEALTH IS DEDICATED NOT ONLY TO PSYCHIATRIC, EMOTIONAL AND BEHAVIORAL STABILIZATION, BUT ALSO TO RECOVERY THROUGH EMPOWERMENT. TEACHING INDIVIDUALS THE SKILLS TO SELF-MANAGE AND SELF-REGULATE TO THE FULLEST POSSIBLE EXTENT IS A FUNDAMENTAL GOAL WITHIN THE TREATMENT AND RECOVERY PROCESS. LEVELS OF CARE - ACUTE INPATIENT - CHILDREN AGES 3-12 - ADOLESCENTS AGES 13-18 - ADULTS AGES 18 AND UP - RESIDENTIAL TREATMENT PROGRAMS - CHILDREN AGES 3-12 - ADOLESCENTS AGES 13-18 - PARTIAL HOSPITALIZATION - ADOLESCENTS AGES 13-18 - ADULTS AGES 18 AND UP - ELECTROCONVULSIVE THERAPY (ECT) - ADULTS AGES 18 AND UP SPECIALIZED TREATMENT SERVICES - PSYCHIATRIC EVALUATION/TREATMENT AND MEDICATION MANAGEMENT - NURSING ASSESSMENT - PSYCHOLOGICAL TESTING - SUBSTANCE ABUSE/DUAL DIAGNOSIS SERVICES - EATING DISORDER SERVICES THERAPEUTIC SERVICES AVAILABLE - INDIVIDUAL, FAMILY AND GROUP THERAPY - EDUCATIONAL SERVICES - OCCUPATIONAL THERAPY - RECREATIONAL THERAPY - ART THERAPY - REALITY-ORIENTED PHYSICAL EXPERIENTIAL SERVICES (ROPES) THIS CORPORATION WAS FORMED FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION: A. TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NOT-FOR-PROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BEDS AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS AND TO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; B. TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED, OR TO THE PROMOTION OF HEALTH; C. TO PROMOTE AND CARRY OUT SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; D. TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITY SERVED; AND E. TO CONTRIBUTE TO THE GROWTH, DEVELOPMENT AND FINANCIAL STRENGTH OF SUTTER HEALTH SYSTEM. KAHI MOHALA - LIST OF COMMUNITY BENEFITS: - TWELVE-STEP PROGRAMS (ALCOHOLICS ANONYMOUS, ALANON, NARCOTICS ANONYMOUS) PURPOSE: PEER-LED, SELF-HELP GROUPS OF PERSONS RECOVERING FROM ADDICTIONS, OR FAMILY MEMBERS OF PERSONS RECOVERING FROM ADDICTIONS. GOALS AND OBJECTIVES: TO GAIN SUPPORT AND EDUCATION IN A GROUP SETTING. - INTERNSHIP, RESIDENCY AND PRACTICUM PROGRAMS PURPOSE: TO PROVIDE A SUPERVISED CLINICAL PRACTICE SETTING FOR MEDICAL STUDENTS, SOCIAL WORKERS, NURSES, PSYCHOLOGISTS, SUBSTANCE ABUSE COUNSELORS AND OCCUPATIONAL THERAPISTS. GOALS AND OBJECTIVES: TO OBTAIN DIRECT PRACTICE EXPERIENCE IN THE STUDENT'S FIELD. - INFORMATION AND REFERRAL PURPOSE: TO PROVIDE TELEPHONE INFORMATION AND REFERRAL TO THE PUBLIC REGARDING MENTAL HEALTH AND CHEMICAL DEPENDENCY RESOURCES. GOAL: TO PROVIDE A FREE COMMUNITY RESOURCE. - MEMBERSHIPS ON COMMUNITY BOARDS AND COMMITTEES (GOODWILL INDUSTRIES, KAPOLEI ROTARY, HEALTHCARE ASSOCIATION OF HAWAII, HFMA, CHAMBER OF COMMERCE), MENTAL HEALTH AMERICA OF HAWAII (MHA), NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), HAWAII YOUTH SERVICES NETWORK (HYSN), COMMUNITY CHILDREN'S COUNCIL (CCCS), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, HAWAII BEHAVIORAL HEALTH ALLIANCE PURPOSE: TO VOLUNTEER EXPERTISE ON VARIOUS COMMUNITY BOARDS AND COMMITTEES. GOALS AND OBJECTIVES: TO SUPPORT OUR COMMUNITY BY HELPING OTHERS MEET THE GOALS AND OBJECTIVES OF VARIOUS ORGANIZATIONS AND COMMITTEES. - COMMUNITY ROPES GROUPS PURPOSE: PROVIDE PROBLEM SOLVING, TEAM BUILDING, AND LEADERSHIP AWARENESS THROUGH THE USE OF GAMES AND ELEMENTS ON THE ROPES COURSE. GOALS AND OBJECTIVES: PROVIDE THE YOUTH/AT RISK YOUTH THE OPPORTUNITY TO EXPERIENCE TEAM BUILDING/PROBLEM SOLVING EXERCISES THROUGH THE USE OF OUR ROPES COURSE. - CHILD & FAMILY SERVICE PURPOSE: USE OF ROOM/FACILITIES GOALS AND OBJECTIVES: TO PROVIDE A MEETING PLACE FOR THE DOMESTIC VIOLENCE PROGRAM - MILITARY SPOUSES SUPPORT NETWORK PURPOSE: PROVIDE COMMUNITY SUPPORT NETWORK FOR MILITARY SPOUSES/SIGNIFICANT OTHERS WHOSE PARTNERS HAVE EXPERIENCED TRAUMATIC EVENTS IN OR OUTSIDE OF MILITARY COMBAT. GOALS AND OBJECTIVES: TO PROVIDE SUPPORT TIME IN A SAFE ENVIROMNENT WHERE SPOUSES OF ALL BRANCHES OF SERVICE AND VETERANS CAN SHARE THEIR FEELINGS, LEARN COPING SKILLS AND CONNECT WITH OTHERS. TO PROVIDE A PLACE WHERE SPOUSES AND SIGNIFICANT OTHERS CAN ATTEND WORKSHOPS, GROUP OUTINGS AND INSPIRATIONAL EXPERIENCES. - CPR TRAINING PURPOSE: TO PROVIDE CPR TRAINING TO COMMUNITY GOAL: TRAIN CHILDREN IN HAWAII HOW TO PERFORM CPR |
| FORM 990, PART VI, QUESTIONS 6 & 7A | THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, QUESTION 7B | SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. |
| FORM 990, PART VI, QUESTION 11B | SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM. |
| FORM 990, PART VI, QUESTION 12 | EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. |
| FORM 990, PART VI, QUESTION 15 | THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. |
| FORM 990, PART VI, QUESTION 19 | THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990, PART XI, QUESTION 9 | EQUITY TRANSFER (NET) ($1,200,000) EQUIPMENT AQUISITION 120,186 ========== TOTAL ($1,079,814) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ADOLESCENT TREATMENT CENTERS INC | ||||||||||
| 390 40TH STREET | OAKLAND | CA | 94609 | 680088443 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER EBH | Yes (true) |
| ALTA BATES SUMMIT FOUNDATION | ||||||||||
| 3012 SUMMIT STREET 3RD FLOOR | OAKLAND | CA | 94609 | 510160184 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER EBH | Yes (true) |
| CALIFORNIA PACIFIC MEDICAL CTR FOUND | ||||||||||
| 2015 STEINER STREET 2ND FLOOR | SAN FRANCISCO | CA | 94115 | 942728423 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER WBH | Yes (true) |
| DELTA MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 3901 LONE TREE WAY | ANTIOCH | CA | 94509 | 942417022 | FUNDRAISING | CA | 501(C)(3) | 11a - I | SUTTER EBH | Yes (true) |
| EAST BAY PERINATAL CENTER | ||||||||||
| 3012 SUMMIT STREET 3RD FLOOR | OAKLAND | CA | 94609 | 510172285 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER EBH | Yes (true) |
| EDEN MEDICAL CENTER | ||||||||||
| 20103 LAKE CHABOT ROAD | CASTRO VALLEY | CA | 94546 | 942948100 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 1800 COFFEE ROAD SUITE 76 | MODESTO | CA | 95355 | 942290244 | FUNDRAISING | CA | 501(C)(3) | 11a - I | SUTTER CVH | Yes (true) |
| MILLS-PENINSULA HEALTH SERVICES | ||||||||||
| 1501 TROUSDALE DRIVE | BURLINGAME | CA | 94010 | 941156265 | HOSPITAL | CA | 501(C)(3) | 3 | PAMF | Yes (true) |
| MILLS-PENINSULA HOSPITAL FOUNDATION | ||||||||||
| 1501 TROUSDALE DRIVE | BURLINGAME | CA | 94010 | 237288765 | FUNDRAISING | CA | 501(C)(3) | 7 | MPHS | Yes (true) |
| PALO ALTO MEDICAL FOUNDATION | ||||||||||
| 2350 EL CAMINO REAL | MOUNTAIN VIEW | CA | 94040 | 941156581 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SAMUEL MERRITT UNIVERSITY | ||||||||||
| 450 30TH STREET 2840 | OAKLAND | CA | 94609 | 942992642 | UNIVERSITY | CA | 501(C)(3) | 2 | SUTTER EBH | Yes (true) |
| SUTTER AUBURN FAITH HOSPITAL FOUNDATION | ||||||||||
| 11815 EDUCATION ST | AUBURN | CA | 95602 | 942594966 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | Yes (true) |
| SUTTER CENTRAL VALLEY HOSPITALS | ||||||||||
| 1800 COFFEE ROAD SUITE 76 | MODESTO | CA | 95355 | 941080917 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER COAST HOSPITAL | ||||||||||
| 800 E WASHINGTON BLVD | CRESCENT CITY | CA | 95531 | 942988520 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER DAVIS HOSPITAL FOUNDATION | ||||||||||
| PO BOX 1617 | DAVIS | CA | 95617 | 680217870 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | Yes (true) |
| SUTTER EAST BAY HOSPITALS | ||||||||||
| 3012 SUMMIT STREET 3RD FLOOR | OAKLAND | CA | 94609 | 941196176 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER EAST BAY MEDICAL FOUNDATION | ||||||||||
| 3687 MT DIABLO BLVD 200 | LAFAYETTE | CA | 94549 | 942690415 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER GOULD MEDICAL FOUNDATION | ||||||||||
| 600 COFFEE ROAD | MODESTO | CA | 95355 | 941682256 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER HEALTH | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 942788907 | SUPPORTING OR | CA | 501(C)(3) | 11c III-FI | NA | false |
| SUTTER HEALTH PLAN | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 461183948 | HEALTH PLAN | CA | PENDING | PENDING | SUTTER HLTH | Yes (true) |
| SUTTER HEALTH SACRAMENTO SIERRA REGION | ||||||||||
| PO BOX 160727 | SACRAMENTO | CA | 95816 | 941156621 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER INSURANCE SERVICES CORPORATION | ||||||||||
| 745 FORT STREET SUITE 800 | HONOLULU | HI | 96813 | 990289310 | INSURANCE SER | HI | 501(C)(3) | 11b - II | SUTTER HLTH | Yes (true) |
| SUTTER MEDICAL CENTER FOUNDATION | ||||||||||
| PO BOX 160727 | SACRAMENTO | CA | 95816 | 942788906 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | Yes (true) |
| SUTTER MEDICAL CENTER CASTRO VALLEY | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 770146047 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER MEDICAL FOUNDATION | ||||||||||
| 2800 L STREET 7TH FLOOR | SACRAMENTO | CA | 95816 | 680273974 | HEALTHCARE | CA | 501(C)(3) | 11b - II | SUTTER HLTH | Yes (true) |
| SUTTER ROSEVILLE MEDICAL CTR FOUNDATION | ||||||||||
| ONE MEDICAL PLAZA | ROSEVILLE | CA | 95661 | 680040113 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | Yes (true) |
| SUTTER SOLANO CHARITABLE FOUNDATION | ||||||||||
| 300 HOSPITAL DRIVE | VALLEJO | CA | 94589 | 942668262 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | Yes (true) |
| SUTTER VISITING NURSE ASSOC AND HOSPICE | ||||||||||
| 1900 POWELL ST 300 | EMERYVILLE | CA | 94608 | 946068843 | HEALTHCARE | CA | 501(C)(3) | 9 | SUTTER HLTH | Yes (true) |
| SUTTER WEST BAY HOSPITALS | ||||||||||
| 2333 BUCHANAN STREET | SAN FRANCISCO | CA | 94115 | 940562680 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| SUTTER WEST BAY MEDICAL FOUNDATION | ||||||||||
| 2015 STEINER STREET 1ST FLOOR | SAN FRANCISCO | CA | 94115 | 942948131 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | Yes (true) |
| TRACY HOSPITAL FOUNDATION | ||||||||||
| 1420 N TRACY BLVD | TRACY | CA | 95376 | 680318845 | FUNDRAISING | CA | 501(C)(3) | 11a - I | SUTTER CVH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (12 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|
| MAGNETIC IMAGING AF | |||||||
| 175 LENNON | WLN CK | CA | 94598 | 942953833 | PATIENT CARE | CA | NA |
| SURG CTR OF ABSMC | |||||||
| 3875 TELEGRAPH | OAKLAND | CA | 94609 | 470946086 | OUTPATIENT SURG | CA | NA |
| ALTA CT SERVICES LP | |||||||
| 175 LENNON | WLN CK | CA | 94598 | 943083464 | PATIENT CARE | CA | NA |
| CALIFORNIA PACIFIC ADV IMAGING LLC | |||||||
| PO BOX 6102 | NOVATO | CA | 94948 | 562311840 | MRI JOINT VENTURE | CA | NA |
| SAN FRANCISCO ENDOSCOPY CENTER LLC | |||||||
| 3000 RIVERCHASE | BIRMINGHAM | AL | 35244 | 912160588 | ENDOSCOPY JV | CA | NA |
| PRESIDIO SURGERY CENTER LLC | |||||||
| 1635 DIVISADERO | SF | CA | 94115 | 320144060 | AMBULATORY SURG | CA | NA |
| SUTTER FAIRFIELD SURGERY CTR | |||||||
| 2700 LOW CT | FAIRFIELD | CA | 94533 | 300233892 | SURGERY | CA | NA |
| TWIN CITIES SURGICAL HOSPITAL LLC | |||||||
| 250 S WACKER | CHICAGO | IL | 60606 | 352182617 | SURGERY | CA | NA |
| SUTTER AMADOR SURGERY CENTER LLC | |||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 461398093 | SURGERY | CA | NA |
| ROSEVILLE ENDOSCOPY CENTER LLC | |||||||
| 4 MEDICAL PLAZA SUITE 210 | ROSEVILLE | CA | 95661 | 870710513 | ENDOSCOPY JV | CA | NA |
| MEMORIAL MEDICAL OFFICE BLDG 1 | |||||||
| 1800 COFFEE RD SUITE 76 | MODESTO | CA | 95355 | 770287288 | OFFICE RENTAL | CA | NA |
| MEMORIAL MEDICAL OFFICE BLDG 2 | |||||||
| 1800 COFFEE RD SUITE 76 | MODESTO | CA | 95355 | 770287288 | OFFICE RENTAL | CA | NA |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH VENTURES INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 HAWTHORNE ST | AddressLine1 |
| City | OAKLAND | City |
| State | CA | State |
| ZIP Code | 94609 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942918780 | EIN |
| Primary Activities | HEALTH SERVIC | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER INSURANCE SERVICES CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | $218,856 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |