2013-05-13T17:13:38-05:00 2012-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2011-07-01 941429628 HOSPITAL COMMITTEE FOR THE LIVERMORE PLEASANTON AREA HOSP 9253738000 1111 E STANLEY BOULEVARD LIVERMORE CA 94550 KENNETH A JENSEN 9253738000 2013-05-08 1 RICHARD CROGHAN P00089862 4159561500 2011 2016-02-24 21:20:13Z MARCELINA FEIT 1111 E STANLEY BOULEVARD LIVERMORE CA 94550 261174726 0 X WWW.VALLEYCARE.COM X 1958 CA THE HOSPITAL COMMITTEE FOR THE LIVERMORE-PLEASANTON AREAS, DBA VALLEYCARE HEALTH SYSTEM IS A CALIFORNIA NON-FOR-PROFIT CORPORATION THAT PROVIDES BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. 13 12 1646 398 550579 174701 1486839 751417 249745011 250625109 234223 93759 10373305 7902628 261839378 259372913 0 0 0 0 121596721 127410631 0 0 0 131405612 124595962 253002333 252006593 8837045 7366320 234643468 238998204 135345786 135664974 99297682 103333230 X VALLEYCARE HEALTH SYSTEM'S MISSION IS TO ASSUME THE LEADERSHIP ROLE FOR THE HEALTH OF THE TRI-VALLEY COMMUNITY. 0 0 187179860 251386909 OPERATION OF TWO ACUTE CARE HOSPITALS WITH A TOTAL OF 167 ACUTE, 26 SKILLED NURSING AND 14 ACUTE PSYCHIATRIC BEDS. SERVICES INCLUDE ICU/CCU, MEDICAL, SURGICAL, OBSTETRIC, NURSERY INPATIENT SERVICE, AND EMERGENCY ROOM, URGENT CARE AND OUTPATIENT SERVICES. ALSO CARE IS PROVIDED TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE CHARITY-CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. ANY PROFITS MADE FROM OPERATIONS ARE INVESTED INTO NEW FACILITIES, EQUIPMENT AND SERVICES. WE ALSO SERVE THE COMMUNITY WITH OUTREACH PROGRAMS INCLUDING THE MOBILE HEALTH UNIT AND NURSES TRAINING.MEDICAL AND SURGICAL SERVICES. THE CORPORATION'S SERVICES INCLUDE ACUTE INPATIENT MEDICAL AND SURGICAL CARE, ADVANCED DIAGNOSTIC SERVICES, EMERGENCY AND URGENT CARE, CRITICAL CARE, OBSTETRICS, PEDIATRICS, SKILLED NURSING, GERIATRIC PSYCHIATRIC CARE, INPATIENT AND OUTPATIENT REHABILITATION, AND AN INTEGRATED MEDICAL FITNESS CENTER. THE PLEASANTON CAMPUS HAS BEEN DESIGNATED BY ALAMEDA COUNTY AS A CARDIAC RECEIVING CENTER. OTHER PROGRAMS OF THE CORPORATION INCLUDE ONCOLOGY SERVICES, A BARIATRICS PROGRAM, A COUMADIN CLINIC, CARDIO-VASCULAR SERVICES, A PEDIATRIC HOSPITALIST PROGRAM WITH A LOCAL TERTIARY HOSPITAL, AND AN ONCOLOGY RESEARCH PROGRAM WITH THE UNIVERSITY OF CALIFORNIA AT DAVIS.NURSE EDUCATION. THE CORPORATION OPENED THE MERTES-FEIT EDUCATION CENTER (THE "EDUCATION CENTER") ON THE LIVERMORE CAMPUS IN 2003. PARTNERING WITH THE LOCAL COMMUNITY COLLEGE SYSTEM, THE CORPORATION OPENED THE CHABOT COLLEGE NURSING PROGRAM, EXTENDED CAMPUS AT VALLEYCARE, WITH THE FIRST 10 STUDENTS ENROLLED IN SEPTEMBER 2003 AND GRADUATED IN MAY 2005. CURRENTLY, THE PROGRAM HAS 40 NURSING STUDENTS. THE NURSING PROGRAM IS INTENDED TO PROVIDE A CONTINUOUS STREAM OF REGISTERED NURSES TO MEET THE IMMEDIATE AND FUTURE STAFFING NEEDS OF THE CORPORATION. THE EDUCATION CENTER, WHICH HOUSES THE NURSING PROGRAM, ALSO HAS THE FIRST FULLY FUNCTIONAL SIMULATION LABORATORY IN THE EAST BAY AREA AND IS USED AS A TRAINING SITE FOR A NUMBER OF HEALTHCARE DISCIPLINES.COMMUNITY EDUCATION. THE VALLEYCARE MEDICAL PLAZA (THE "MEDICAL PLAZA"), LOCATED AT W. LAS POSITAS AND STONERIDGE, HOUSES THE CORPORATION'S HEALTH LIBRARY AND RYAN COMER CANCER RESOURCE CENTER, WHICH OPENED IN 1991. ITS MISSION IS TO PROVIDE ACCESS TO CURRENT, EASILY UNDERSTOOD HEALTH AND MEDICAL INFORMATION IN A RELAXED AND SUPPORTIVE ENVIRONMENT.COMMUNITY OUTREACH. IN ADDITION TO THE SERVICES PROVIDED AT THE PLEASANTON CAMPUS, THE LIVERMORE CAMPUS, AND THE MEDICAL PLAZA, THE CORPORATION PROVIDES A VARIETY OF PROGRAMS WITHIN THE COMMUNITY, INCLUDING A "MEALS ON WHEELS" PROGRAM, WHICH IS BASED AT THE LIVERMORE CAMPUS KITCHEN, FOR HOMEBOUND SENIORS. THE CORPORATION WAS FIRST AWARDED THE CONTRACT TO PROVIDE THIS PROGRAM IN 1997.ANOTHER COMMUNITY SERVICE IS THE CORPORATION'S NUTRITION PROGRAM, WHICH HAS SERVED LOCAL HEAD START CENTERS SINCE 1998. THIS PROGRAM ADDRESSES THE UNIQUE NEEDS OF CHILDREN IN THE LOCAL COMMUNITY AND SUPPORTS LOCAL AGENCIES IN ADDRESSING SOCIAL NEEDS THAT AFFECT HEALTH BY DELIVERING HOT MEALS ON SCHOOL DAYS FOR LOW-INCOME CHILDREN AT HEAD START CENTERS. IN ADDITION TO THE HEAD START MEALS, THE CORPORATION ALSO PROVIDES HOT MEALS TO CHILDREN IN THE LIVERMORE PLAY SCHOOL PER REQUESTS FROM PARENTS AND STAFF. EACH SUMMER THE CORPORATION ALSO PARTICIPATES IN A JOINT PROGRAM WITH THE LIVERMORE HOUSING AUTHORITY AND CAPE, INC. PRESCHOOLS TO PROVIDE SUMMER RECREATION AND FREE MEALS TO LOW-INCOME CHILDREN.AT THE LAS POSITAS COLLEGE STUDENT HEALTH CENTER, A CHABOT COMMUNITY COLLEGE (AT LAS POSITAS COMMUNITY COLLEGE), THE CORPORATION PROVIDES A PROGRAM THAT GIVES STUDENTS ACCESS TO PRIMARY DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS OFFERING CRITICAL ACCESS TO INFORMATION TO HELP STUDENTS IMPROVE AND MAINTAIN THEIR HEALTH. THE CORPORATION'S PUBLIC HEALTH NURSE WORKS CLOSELY WITH THE COMMUNITY ON A VARIETY OF PROJECTS INCLUDING THE BAY AREA REGIONAL IMMUNIZATION REGISTRY, SENIOR INJURY PREVENTION, PASTORAL CARE, AND THE PROCUREMENT OF A MOBILE MEDICAL VAN TO BRING MEDICAL SERVICES AND CONTINUITY OF CARE TO THE REGION'S UNDERSERVED POPULATION, INCLUDING CHILDREN AND SENIORS. THE CORPORATION ALSO FINANCIALLY SUPPORTS TWO NURSES IN THE PLEASANTON UNIFIED SCHOOL DISTRICT. 187179860 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 188 0 1 1646 1 1 1 0 0 0 0 0 0 0 0 0 X 13 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X NICOLE PEDIGO 9253738006 1111 E STANLEY BLVD LIVERMORE CA 94550 X DEBORAH MCKEEHAN 2.00 X 0 0 18697 MARTY INDERBITZEN 2.00 X 0 0 18697 RALPH CAMACHO MD 2.00 X 0 0 13417 VALERIE CHIRURGI MD 2.00 X 0 0 0 BARBARA MERTES 2.00 X 0 0 7664 DAVID MERTES 2.00 X 0 0 7664 JOHN LOUIE MD 2.00 X 0 0 0 JOHN SENSIBA 2.00 X 0 0 18697 MARCELINA FEIT 36.10 X X 905148 0 36976 JANET CRISTIANO 2.00 X 0 0 0 JOHN NUNES MD 2.00 X 0 0 0 TOM VARGAS 2.00 X 0 0 10524 TIM WEAVER 2.00 X 0 0 13417 ALCINA WEGRZYNOWSKI 2.00 X 0 0 0 KENNETH JENSEN 36.10 X 1047047 0 21903 CYNTHIA NOONAN 40.00 X 826890 0 29337 LAVERN BROWN 39.80 X 1044345 0 27717 JESSICA JORDAN 40.00 X 294700 0 10509 CLAIRE SHOEN 30.00 X 317566 0 7536 DOREEN MAPLES 40.00 X 199612 0 14784 SONJA MCLENDON 40.00 X 252923 0 19261 KENNETH BARTLETT 40.00 X 209223 0 3403 PAUL MUSER 40.00 X 233104 0 19609 ROBIN AMERSON 40.00 X 222991 0 9110 KIUN FORSCHEN 40.00 X 211414 0 17919 JOY CHAU 40.00 X 215998 0 0 5980961 0 326841 381 0 1 0 SIEMENS MEDICAL SOLUTIONS DEPT LA 21536 PASADENA CA 911851536 IT SERVICES 7300509 MEDICAL ANESTHESIA CONSULTANTS PO BOX 512107 LOS ANGELES CA 900510107 PROFESSIONAL MEDICAL SERVICES 974445 ARUP INC PO BOX 27964 SALT LAKE CITY UT 84108 LABORATORY SERVICES 859945 CALIFORNIA SERVICE BUREAU 3050 FITE CIRCLE SUITE 107 SACRAMENTO CA 95827 PROFESSIONAL A/R SERVICES 806935 REGENTS OF UCSF 505 PARNASSUS AVE BOX 0110 SAN FRANCISCO CA 94131 PROFESSIONAL MEDICAL SERVICES 728444 49 579907 171510 751417 ANCILLARY PTNT SRVCS 621990 461452490 461452490 OUTPATIENT SRVCS 621990 401166736 401166736 INPATIENT SRVCS 621990 219873210 219873210 LAB SERVICES 621500 550579 550579 CONTRACTUAL ALLOWANCE 621990 -832417906 -832417906 250625109 92753 92753 2061035 1801813 259222 259222 259222 1006 0 1006 1006 1006 MONTHLY DUES-LIFESTYLE 624310 4028959 4028959 OTHER REVENUES 900099 3423147 1312379 2110768 K-1 INCOME 900099 191300 191300 7643406 259372913 251386909 550579 6684008 3542980 3542980 100959089 73773043 27186046 3060593 2238909 821684 12680922 9200745 3480177 7167047 5162825 2004222 657652 657652 140237 140237 19968846 10798736 9170110 45724749 38584232 7140517 8102877 5813004 2289873 9294575 7679762 1614813 405355 16465 388890 116401 17633 98768 5445881 4099612 1346269 7755051 6010516 1744535 1252910 1007467 245443 BAD DEBTS 22709354 22709354 3022074 67557 2954517 252006593 187179860 64826733 0 9049315 5705379 25370092 22904022 40603402 44044870 622400 622400 4535355 4529729 4682053 1316859 215112084 116685015 100041662 98427069 16011536 15792723 33727653 45655153 234643468 238998204 30648827 31718420 3897311 1200571 86093501 83337081 8689692 8788965 6016455 10619937 135345786 135664974 X 99263910 103127947 33772 205283 99297682 103333230 234643468 238998204 X 7366320 -3330772 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 19275 19275 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO CHA/HCNCC AND AHA. A PORTION OF THE DUES PAID ARE USED FOR LOBBYING PURPOSES. 1779852 11157847 12937699 114437209 58125740 56311469 12341603 7329387 5012216 55898870 43798303 12100567 19496703 7431585 12065118 98427069 ASSETS LIMITED AS TO USE 15792723 F 15792723 DEFERRED FINANCING COSTS 1523952 DEPOSITS 1190443 NON PATIENT RECEIVABLES 262271 EQUITY INVESTMENT (PPA-II) 1263803 THIRD PARTY PAYOR RECEIVABLE 1806108 INTERCOMPANY RECEIVABLE 39608576 45655153 MINIMUM PENSION LIABILITY 6326000 LIABILITY FOR SELF INSURANCE RESERVES 1377477 BOND INTEREST PAYABLE 2064952 REFUNDABLE DEPOSITS 19918 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 831590 10619937 259372913 252006593 7366320 -3326679 -4093 -3330772 4035548 260500000 1801813 1801813 258698187 674726 674726 259372913 253808000 1802413 1802413 252005587 1006 1006 252006593 PART XI, LINE 8 - OTHER ADJUSTMENTS: BOOK-TAX DIFFERENCE ON PPA II INCOME -4,857. AUDITED FINANCIAL STATEMENT ROUNDING 764. TOTAL TO SCHEDULE D, PART XI, LINE 8: -4,093. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE SECTION 1,801,813. PART XII, LINE 4B - OTHER ADJUSTMENTS: BOOK-TAX DIFFERENCE ON PPA II INCOME 4,857. RECLASSIFICATION OF CONTRIBUTIONS FROM OTHER CHANGES IN FUND BALANCE 668,538. RECLASSIFICATION OF GAIN ON SALE OF FIXED ASSETS FROM EXPENSE SECTION 1,006. AUDITED FINANCIAL STATEMENT ROUNDING 325. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION OF RENTAL EXPENSES TO REVENUE SECTION 1,801,813. AUDITED FINANCIAL STATEMENT ROUNDING 600. PART XIII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF GAIN ON SALE OF FIXED ASSETS TO REVENUES SECTION 1,006. 1 1 X 1 X 1 X 1 1 0 1 1 3 950 3178639 1850761 1327878 0.00580 10110169 8365232 1744937 0.00760 10131788 4644305 5487483 0.02390 3 950 23420596 14860298 8560298 0.03730 3643802 1457844 2185958 0.00950 1586030 2094 1583936 0.00690 5229832 1459938 3769894 0.01640 3 950 28650428 16320236 12330192 0.05370 1 4775930 51307075 71956560 -20649485 X 1 1 2 1 VALLEY MEMORIAL HOSPITAL

1111 E STANLEY BLVD LIVERMORE CA 94550

X LIFESTYLE RX MEDICAL FITNESS FACILITY 2 VALLEYCARE MEDICAL CENTER

5555 W LAS POSITAS BLVD PLEASANTON CA 94558

X X X VALLEYCARE MEDICAL CENTER 1 1 1 200.000000000000 1 350.000000000000 1 X X X 1 1 X X X X X X 1 X X 1 X X X X X X 1 X 0 1 VALLEY MEMORIAL HOSPITAL 2 1 1 200.000000000000 1 350.000000000000 1 X X X 1 1 X X X X X X 1 X X 1 X X X X X X 1 X 0 1 3 LIFESTYLE RX

1119 E STANLEY BLVD LIVERMORE CA 94550

MEDICAL FITNESS FACILITY VCHS - URGENT CARE CENTER

1133 E STANLEY BLVD LIVERMORE CA 94550

URGENT CARE CENTER VCHS - URGENT CARE CENTER

4000 DUBLIN BLVD STE 150 DUBLIN CA 94568

URGENT CARE CENTER PART I, LINE 7: RATIO OF PATIENT CARE COST TO CHARGES WAS USED TO CALCULATE THE AMOUNTS INCLUDED IN THE TABLE AT SCHEDULE H, PART I, LINE 7. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 22709354. PART III, LINE 4: BAD DEBT EXPENSE ON THE INCOME STATEMENT FOR FISCAL YEAR 2012 WAS $22,709,000, WHICH IS AT CHARGES. BAD DEBT IS BASED ON REMAINING ACCOUNT BALANCE AFTER ANY DISCOUNTS OR PAYMENTS HAVE BEEN APPLIED. VCHS DOES NOT RECLASSIFY ANY BAD DEBT TO CHARITY UNLESS THE PATIENT QUALIFIES UNDER THE CHARITY CARE POLICY. A COST TO CHARGE RATIO WAS USED TO DETERMINE COST. PER THE AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS OF APPROXIMATELY 23,651,000 AND $28,605,000 FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, RESPECTIVELY, REPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES FOR SERVICES PROVIDED PRIMARILY TO SELF-PAY AND PRIVATE HEALTH INSURANCE PATIENTS.PATIENT ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENT AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. VHS GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. VHS MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES. THE SIGNIFICANT CONCENTRATION OF RECEIVABLES FROM PATIENTS AND THIRD-PARTY PAYORS IS AS FOLLOWS AT JUNE 30: MEDICARE 23%, MEDI-CAL 8%, SELF PAYORS 7% AND CONTRACTED THIRD-PARTY PAYORS 62%. PART III, LINE 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL OF $20,649,485 REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT.REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE:1. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER MEANS-BASED GOVERNMENT PROGRAMS,2. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS,3. THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION ON REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUAL, AND4. THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE OR OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: THE AMOUNT DETERMINED AS CHARITY CARE ARE NOT COLLECTED AND WRITTEN OFF TO CHARITY. IF A REDUCED RATE IS GIVEN, THE AMOUNT DETERMINED AS PATIENT BALANCE IS COLLECTED ON IN THE SAME MANNER AS ALL OTHER PATIENTS. VALLEYCARE MEDICAL CENTER PART V, SECTION B, LINE 19D: WE BILL FULL CHARGES, DISCOUNTS ARE GIVEN DEPENDING ON CIRCUMSTANCES VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 19D: WE BILL FULL CHARGES, DISCOUNTS ARE GIVEN DEPENDING ON CIRCUMSTANCES. VALLEYCARE MEDICAL CENTER PART V, SECTION B, LINE 21: ALL BILLS ARE AT GROSS CHARGES. VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 21: ALL BILLS ARE AT GROSS CHARGES. PART VI, LINE 2: VCHS IS A PARTICIPANT IN THE COMMUNITY NEEDS ASSESSMENT, PLANNING, AND EDUCATION UNIT COLLABORATIVE, WHICH COMPILES INFORMATION FOR ALL PARTICIPATING HOSPITALS TO PRODUCE A REPORT EVERY 3 YEARS FOR THE HOSPITAL COUNCIL OF NO. CALIFORNIA. THE 9/10 REPORT IDENTIFIES THE UNINSURED POPULATION, WHICH MOST ARE ELIGIBLE FOR MEDI-CAL. THE REPORT WAS STUDIED IN THE COUNTY FOR RECOMMENDATIONS REGARDING CARE AND ACCESS ISSUES. NEXT REPORT WILL BE COMPLETED BY JULY 2013. PART VI, LINE 3: VALLEYCARE HEALTH SYSTEM WILL INTERVIEW EACH PATIENT/GUARANTOR AND DETERMINE THE CAPABILITY TO MEET HIS/HER FINANCIAL OBLICATIONS FOR MEDICAL CARE. THOSE WHO ARE UNABLE TO MEET THE FINANCIAL OBLIGATION WILL FIRST BE SCREENED FOR POSSIBLE ELIGIBILITY UNDER STATE OR FEDERAL HEALTHCARE PROGRAMS. IF THEY DO NOT MEET STATE OR FEDERAL CRITERIA FOR HEALTHCARE BENEFITS, THEY WILL BE INTERVIEWD TO DETERMINE WHETHER THEY MEET THE CRITERIA FOR FINANCIAL ASSISTANCE, AS DEFINED IN THE FINANCIAL ASSISTANCE/CHARITY CARE POLICY. PART VI, LINE 4: THE TRI-VALLEY REGION IS BASED AROUND THE FOUR SUBURBAN CITIES OF LIVERMORE, PLEASANTON, DUBLIN AND SAN RAMON IN THE THREE VALLEYS FROM WHICH IT TAKES ITS NAME: AMADOR VALLEY, LIVERMORE VALLEY AND SAN RAMON VALLEY. LIVERMORE, PLEASANTON AND DUBLIN ARE IN ALAMEDA COUNTY, WHILE SAN RAMON IS IN CONTRA COSTA COUNTY. VALLEYCARE'S PRIMARY SERVICE AREA IS THE TRI-VALLEY. VALLEYCARE HAS FACILITIES IN PLEASANTON, LIVERMORE, AND TRACY (A CITY WITHIN ITS SECONDARY SERVICE AREA). THE TRI-VALLEY ACCOUNTS FOR OVER 80% OF VALLEYCARE'S INPATIENT DISCHARGES. THE CURRENT POPULATION OF THE TRI-VALLEY IS ESTIMATED AT MORE THAN 268,000 PEOPLE. THE OVERALL POPULATION IS PROJECTED TO GROW AT 1.4 PERCENT PER YEAR FOR THE NEXT SEVERAL YEARS. THE LOCAL SENIOR POPULATION IS GROWING AT AN AGGRESSIVE 6.9 PERCENT PER YEAR, COMPARED TO A RATE OF TWO PERCENT PER YEAR FOR ALAMEDA AND CONTRA COSTA COUNTIES. THE TRI-VALLEY POPULATION HAS A RACIAL BLEND OF 71.8 PERCENT WHITE, 15.5 PERCENT ASIAN, AND 12.7 PERCENT "OTHER". THE HISPANIC ETHNIC BLEND IS 12.5% HISPANIC; 87.5% NON-HISPANIC PART VI, LINE 5: THE FOLLOWING PROGRAMS AND SERVICES FURTHER THE ORGANIZATION'S EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY:PLEASANTON CAMPUS. VALLEYCARE MEDICAL CENTER, WHICH OPENED IN DECEMBER 1991, IS AN ACUTE CARE COMMUNITY HOSPITAL WITH APPROXIMATELY 114,000 SQUARE FEET OF SPACE THAT PROVIDES A COMPREHENSIVE RANGE OF MEDICAL AND SURGICAL INPATIENT AND OUTPATIENT ACUTE SERVICES, INCLUDING AN OUTPATIENT SURGICAL CENTER, A DIAGNOSTIC IMAGING CENTER INCLUDING COMPUTERIZED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING AND A WOMEN'S CENTER (MAMMOGRAPHY), CARDIAC CARE, EMERGENCY ROOM, INTENSIVE CARE, OBSTETRICS, PEDIATRICS AND OPERATING AND RECOVERY ROOMS. THE CURRENT LICENSED BED CAPACITY OF VALLEYCARE MEDICAL CENTER IS 167 ACUTE CARE BEDS (ALL OF WHICH ARE STAFFED), INCLUDING 116 MEDICAL/SURGICAL ACUTE CARE, 15 PERINATAL, 22 CRITICAL CARE, 4 PEDIATRIC, AND 10 INTENSIVE CARE NURSERY BEDS.LIVERMORE CAMPUS. VALLEY MEMORIAL HOSPITAL, ON THE LIVERMORE CAMPUS, IS AN ACUTE CARE COMMUNITY HOSPITAL WITH APPROXIMATELY 125,000 SQUARE FEET OF SPACE THAT INCLUDES 26 SKILLED NURSING, AND 14 GERIATRIC PSYCHIATRIC BEDS. ADDITIONAL SERVICES AT VALLEY MEMORIAL HOSPITAL INCLUDE URGENT CARE, LABORATORY, OCCUPATIONAL HEALTH, DIAGNOSTIC IMAGING (ULTRASOUND, MAMMOGRAPHY, BONE DENSITOMETRY) AND RADIOLOGY. THE AMBULATORY SURGERY CENTER ON THE LIVERMORE CAMPUS, OPENED IN JULY 2003, HAS FOUR OPERATING ROOMS, THREE GASTRO-INTESTINAL (GI) SUITES, AND A 21-BED-PRE-OP AND POST ANESTHESIA CARE UNIT. THE URGENT CARE UNIT ON THE LIVERMORE CAMPUS, ALSO OPENED IN JULY 2003, HAS NINE EXAMINATION ROOMS WHERE PATIENTS RECEIVE CARE FOR CONDITIONS OF AN URGENT NATURE.THE LIVERMORE CAMPUS IS ALSO THE LOCATION OF LIFESTYLE RX, AN INTEGRATED MEDICAL FITNESS CENTER OWNED AND OPERATED BY THE CORPORATION. IT IS DESIGNED TO PROMOTE COMMUNITY WELLNESS THROUGH SERVICES SUCH AS MEDICALLY BASED FITNESS, CARDIAC AND PULMONARY REHABILITATION, STRENGTH AND CARDIAC TRAINING, PHYSICAL AND SPORTS MEDICINE, AND WATER THERAPIES. LICENSED AND STAFFED BEDS THE LICENSED AND STAFFED BEDS FOR 2010 AT VALLEYCARE MEDICAL CENTER WERE 167, WHILE AT THE VALLEY MEMORIAL HOSPITAL THE NUMBER OF LICENSED BEDS IS 75, WITH STAFFED BEDS AT 40. REPORTS FILED WITH STATES PART VI, LINE 7 CA X X X X X X 0 0 0 0 0 0 0 0 0 MARCELINA FEIT 602992 0 200000 0 102156 0 12250 0 24726 0 942124 0 0 0 KENNETH JENSEN 432702 0 602863 0 11482 0 3675 0 18228 0 1068950 0 0 0 CYNTHIA NOONAN 374133 0 446470 0 6287 0 12250 0 17087 0 856227 0 0 0 LAVERN BROWN 296650 0 740665 0 7030 0 12250 0 15467 0 1072062 0 0 0 JESSICA JORDAN 240810 0 45000 0 8890 0 9183 0 1326 0 305209 0 0 0 CLAIRE SHOEN 232365 0 45000 0 40201 0 3625 0 3911 0 325102 0 0 0 DOREEN MAPLES 191612 0 8000 0 0 0 3793 0 10991 0 214396 0 0 0 SONJA MCLENDON 219885 0 30000 0 3038 0 3247 0 16014 0 272184 0 0 0 KENNETH BARTLETT 115292 0 0 0 93931 0 3382 0 21 0 212626 0 0 0 PAUL MUSER 116266 0 0 0 116838 0 3577 0 16032 0 252713 0 0 0 ROBIN AMERSON 126000 0 0 0 96991 0 1878 0 7232 0 232101 0 0 0 KIUN FORSCHEN 114244 0 0 0 97170 0 1887 0 16032 0 229333 0 0 0 JOY CHAU 118771 0 0 0 97227 0 0 0 0 0 215998 0 0 0 CALIFORNIA ENTERPRISE DEVELOPMENT AUTHORITY 352273601 2009-07-15 10500000 BUILDING AND EQUIPMENT 0 0 0 CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2007-05-31 54310000 REFUNDING OF PRIOR ISSUE 0 0 0 10406075 10406075 2011 0 0 1 1 53224097 5222973 48000349 1085903 990 1 1 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 X FORM 990, PART VI, SECTION A, LINE 2 DAVID MERTES AND BARBARA MERTES ARE HUSBAND AND WIFE AND BOTH SERVE AS BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE DEPARTMENT REVIEWS THE FORM 990 FOR ACCURACY. PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE, A COMPLETE COPY OF THE FORM 990 IS SENT ELECTRONICALLY TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW. THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS AND INVITED QUESTIONS. ONCE THESE STEPS ARE COMPLETE, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C VCHS USES AN RFP PROCESS FOR THESE ACTIVITIES AND DOCUMENT THE DECISION-MAKING PROCESS TO DEMONSTRATE WHY WE CHOSE A SPECIFIC CONTRACTOR, VENDOR, OR PRODUCT. THUS EVEN IF SOMEONE HAS AN INTEREST IN ONE OF THESE, WE CAN DEMONSTRATE THAT THE DECISION WAS MADE FOR REASONS SUCH AS QUALITY, COST AVAILABILITY, ETC. FORM 990, PART VI, SECTION B, LINE 15 VCHS UTILIZES THE SERVICES OF RODEGHERO CONSULTING GROUP FOR COMPENSATION BENCHMARKING, ANALYSIS, AND REPORTING. THE BOARD OF DIRECTORS HAS A COMPENSATION SUB-COMMITTEE WHO REVIEW THE RESULTS OF THE COMPENSATION REVIEW AND IS ASSURED THAT TOTAL COMPENSATION IS CONSISTENT WITH THE MARKET. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS, GOVERNING/ORGANIZING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS 990, PART VII, SECTION A, COLUMN B RALPH CAMACHO, M.D.'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS JANET CRISTIANO'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS MARTY INDERBITZEN'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS JOHN LOUIE, M.D.'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS DEBORAH MCKEEHAN'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE MEDICAL FOUNDATION INC. 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS BARBARA MERTES' TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS DAVID MERTES' TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE CHARITABLE FOUNDATION 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS JOHN NUNES, M.D.'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS JOHN SENSIBA'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS TOM VARGAS' TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE MEDICAL FOUNDATION INC. 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS TIM WEAVER'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE CHARITABLE FOUNDATION 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS ALCINA WEGRZYNOWSKI'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS VALARIE CHIRURGI, M.D.'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 2.00 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS MARCELINA FEIT'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 36.10 HRS VALLEYCARE CHARITABLE FOUNDATION .20 HRS VALLEYCARE MEDICAL FOUNDATION INC. 3.50 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS KENNETH JENSEN'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 36.10 HRS VALLEYCARE CHARITABLE FOUNDATION .20 HRS VALLEYCARE MEDICAL FOUNDATION INC. 3.50 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS LAVERN BROWN'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 39.80 HRS VALLEYCARE SENIOR HOUSING, INC. .20 HRS CLAIRE SHOEN'S TIME IS DIVIDED AS FOLLOWS: VALLEYCARE HEALTH SYSTEM 30.00 HRS VALLEYCARE MEDICAL FOUNDATION INC. 10.00 HRS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PRIOR PERIOD ADJUSTMENTS: -3,326,679. BOOK-TAX DIFFERENCE ON PPA II INCOME -4,857. AUDITED FINANCIAL STATEMENT ROUNDING 764. TOTAL TO FORM 990, PART XI, LINE 5: -3,330,772. AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. VALLEYCARE CHARITABLE FOUNDATION 1111 E STANLEY BLVD LIVERMORE CA 94550 942941652 FUNDRAISING CA 501(C)(3) 9 HOSPITAL COMMITTEE FOR THE L-P AREA 1 VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE CA 94550 943382224 INDEPENDENT AND ASSISTED LIVING FOR SENIORS CA 501(C)(3) 11-III-FI HOSPITAL COMMITTEE FOR THE L-P AREA 1 VALLEYCARE MEDICAL FOUNDATION INC 5655 W LAS POSITAS BLVD 220 PLEASANTON CA 94588 262593526 TO SUPPORT THE MISSION OF THE VCHS CA 501(C)(3) 9 HOSPITAL COMMITTEE FOR THE L-P AREA 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 VALLEYCARE CHARITABLE FOUNDATION C 579907 BOOK/ACTUAL VALUE VALLEYCARE MEDICAL FOUNDATION INC D 11202073 BOOK/ACTUAL VALUE VALLEYCARE CHARITABLE FOUNDATION P 247590 BOOK/ACTUAL VALUE