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SONORA COMMUNITY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SONORA COMMUNITY HOSPITAL (EIN 94-1415069)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201323199349300707
Schema version
2012v2.0
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

FieldValueIRS element (for citing)
Timestamp2013-11-15T02:31:42-08:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941415069EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sonora Community HospitalBusinessNameLine1
Business Name Line2dba Sonora Regional Medical CenterBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSONONameControl
Phone2095325000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 Greenley RdAddressLine1
CitySonoraCity
StateCAState
ZIP Code95370ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAndrew JahnName
TitleTreas/Sr VP FinTitle
Date Signed2013-11-15DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJeff EllerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11000 Greenley RdAddressLine1
CitySonoraCity
StateCAState
ZIP Code95370ZIPCode
FieldValueIRS element (for citing)
Gross Receipts201508840GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number1071GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.sonoramedicalcenter.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1958YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionThe hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees1414TotalNbrEmployees
Total Nbr Volunteers168TotalNbrVolunteers
Total Gross UBI102067TotalGrossUBI
Net Unrelated Business Txbl Income-135NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1247651ContributionsGrantsPriorYear
Contributions Grants Current Year687309ContributionsGrantsCurrentYear
Program Service Revenue Prior Year189247231ProgramServiceRevenuePriorYear
Program Service Revenue CY198435421ProgramServiceRevenueCY
Investment Income Prior Year868911InvestmentIncomePriorYear
Investment Income Current Year1286881InvestmentIncomeCurrentYear
Other Revenue Prior Year135731OtherRevenuePriorYear
Other Revenue Current Year198042OtherRevenueCurrentYear
Total Revenue Prior Year191499524TotalRevenuePriorYear
Total Revenue Current Year200607653TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year72945GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY114003GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year90858325SalariesEtcPriorYear
Salaries Etc Current Year92247186SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year302203TotalFundrsngExpCurrentYear
Other Expense Prior Year90450391OtherExpensePriorYear
Other Expenses Current Year88679201OtherExpensesCurrentYear
Total Expenses Prior Year181381661TotalExpensesPriorYear
Total Expenses Current Year181040390TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10117863RevenuesLessExpensesPriorYear
Revenues Less Expenses CY19567263RevenuesLessExpensesCY
Total Assets BOY110165596TotalAssetsBOY
Total Assets EOY131911126TotalAssetsEOY
Total Liabilities BOY65549967TotalLiabilitiesBOY
Total Liabilities EOY67728234TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY44615629NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY64182892NetAssetsOrFundBalancesEOY
Mission DescriptionOur mission is to share God's love by providing physical, mental, and spiritual healing.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense161887253Expense
Grants114003Grants
DescriptionSonora Community Hospital (SCH) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of SCH, the organization recognizes that not all individuals possess the ability to pay for essential medical services.SCH's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:- providing free care and/or subsidized care- providing care to persons covered by governmental programs at below cost- providing health/wellness activities and community education programsNot only does SCH provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. SCH recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. Inpatient services in 2012 were provided to approximately 5,316 patients. These services included:- Babies: 533 deliveries- Surgeries: 2,843 hours- Radiology: 10,699 procedures - Laboratory tests: 128,580 tests Outpatient services in 2012 were provided to about 289,000 patients. Including:- Emergency room: 26,411 visits- Outpatient surgeries: 5,554 hours- Radiology procedures: 58,179 performed- Laboratory tests: 289,388 performed- Medical clinics: 161,025 visitsSonora Community Hospital provides home care services in its surrounding communities. These services include, but are not limited to:- Respiratory Care- Elderly Care- Geriatric Case Management- Ostomy & Wound Care- Diabetes Care- IV Home TherapySCH recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission:Project HOPE, which stands for Health, Outreach, Prevention and Education- delivers dozens of free physicals and other services to indigent children and their parents at various locations throughout California's Tuolumne County with the help of volunteer nurses and physicians.Community Events - First aid stations at the local Mother Lode Fair, Home and Garden show and the Tuolumne Me-Wuk Health Fair. Exhibits at the Groveland Family Wellness Fair and the Tuolumne County Youth Health Fair. Close to 4,000 health screenings done at the annual Tuolumne County Health Fair.Health Education and Support ProgramsThe many support groups and health education classes conducted, including but not limited to:Cancer support group, Diabetes support group, Depression Recovery Program class, Spiritual Care training, CHIP Coronary Health Improvement Project, Epilepsy/Seizure Support Group, La Leche League, Childbirth Preparation Classes, Preparation for Cesarean Birth Classes, OakPlus Wellness Seminars, Quit for Life: Tobacco Cessation Classes, Lifeline Emergency Response ProgramMaintained and monitored up to 320 Lifeline Emergency Response Units. This 24-hour-a-day system offers immediate response to those whose physical condition could otherwise limit their ability to summon help.Spiritual SupportSCH's chaplains provided over 4,000 patient visits and over 1,500 hours of patient counseling, and provided over 300 hours of employee counseling, conducted memorial services and officiated at weddings.Community SupportSCH donated $15,260 to 28 community service organizations in 2012.Description
Total Program Service Expense161887253TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096213NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1414NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonAndrew JahnNamePerson
Telephone Number2095325000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 Greenley RdAddressLine1
CitySonoraCity
StateCAState
ZIP Code95370ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Helmuth Jones
Director0.001.00X011270
Larry Innocent
Director0.001.00X012730
Melody Gabriel
Director0.001.00X03000
Scott Reiner
V Chair / Sec0.0050.00X0915400183744X
Robert Carmen
Chairman0.0050.00X0181444238864X
Max Torkelsen
Director0.001.00X022330
Wesley Rippey
Director0.001.00X01004060
Alan Reimche
Director0.001.00X022900
Meredith Jobe
Dir/VP/Gen Coun0.001.00X031802173755
Ricardo Graham
Director0.001.00X025560
Christine Friestad
Director0.001.00X025860
Ruthita Fike
Director0.001.00X06950
Lynn Creitz
Director0.001.00X040520
Larry Caviness
Director0.001.00X032450
Charles Dickinson
Director0.001.00X030850
Bill Wing
Asst Sec0.0050.000665195154613X
Andrew Jahn
Treas/VP Fin50.000.00024034838676X
Jeff Eller
President & CEO50.000.000535195106562X
Rodney Wehtje
Asst Treas0.0050.000534490210115X
Douglas Rebok
Asst Sec0.0050.000872315159731X
Rick Dodds
VP HR50.000.00018190533502X
Pauline Campbell
VP Off Site Svcs50.000.00017474541326X
Julie Kline
Sr VP Pt Care Svcs50.000.00028293562796X
Jeph Solo
Lead Surgery RN55.000.00200528016691X
Jacquie Cituk
Pharmacy Director50.000.00194602032200X
David Schwartz
Home Health PT44.000.0018755209734X
John Frank
Pharmacist40.000.00176157024804X
Susan Shinkai
Pharmacist40.000.00176012018982X
Larry Dodds
Former Dir/V Chair/Sec0.000.0007884218492X
FieldValueIRS element (for citing)
Total Reportable Comp From Org934851TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6737681TotalReportableCompFrmRltdOrgs
Total Other Compensation1224587TotalOtherCompensation
Number Individuals GT100 K126NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sierra Cardiology Med Assoc
900 Greenely Rd Ste 911SonoraCA95370Medical Group2475977
Sound Physicians
1123 Pacific AveTacomaWA98402Medical Group1471645
Greenley Oaks Ear Nose & Throat
795 Morning Star DrSonoraCA95370Medical Group833841
Sonora Anesthesia Services
PO Box 845SonoraCA95370Medical Group1053168
Sierra Emergency Medical Group
PO Box 4685SonoraCA95370Medical Group3120051
FieldValueIRS element (for citing)
Number Of Contractors GT100 K71NumberOfContractorsGT100K
Fundraising Events27200FundraisingEvents
Government Grants19954GovernmentGrants
All Other Contributions640155AllOtherContributions
Total Contributions687309TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Rent - Medical Offices531120220286220286
Other Revenue900099292357292357
Dietary722210458382458382
EMR Incentives90009922580032258003
Patient Service Revenue900099195072362195072362

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column134031TotalRevenueColumn
Exclusion$134,031ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue198435421TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1389797TotalRevenueColumn
Exclusion$1,389,797ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

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Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

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Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other765241Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other868157Other

Gain Or Loss GainOrLoss

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Other-102916Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-102916TotalRevenueColumn
Related Or Exempt Function Income-102916RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events129005GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events27200CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses33030FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column95975TotalRevenueColumn
Exclusion$95,975ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenue
Company Store62199076457645
Sonora Oxygen Service6216103539635396
Retail Pharmacy4461105817558175

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column851TotalRevenueColumn
Unrelated Business Revenue851UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue102067TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column200607653TotalRevenueColumn
Related Or Exempt Function Income198198474RelatedOrExemptFunctionIncome
Unrelated Business Revenue102067UnrelatedBusinessRevenue
Exclusion$1,619,803ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total15260Total
Program Services15260ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total98743Total
Program Services98743ProgramServices

Foreign Grants ForeignGrants

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Total0Total

Benefits To Members BenefitsToMembers

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Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

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Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total66754335Total
Program Services60507681ProgramServices
Management And General6092319ManagementAndGeneral
Fundraising154335Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2542449Total
Program Services2542449ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total18175095Total
Program Services16024427ProgramServices
Management And General2112378ManagementAndGeneral
Fundraising38290Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4775307Total
Program Services4357581ProgramServices
Management And General406751ManagementAndGeneral
Fundraising10975Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total354067Total
Management And General354067ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total346612Total
Management And General346612ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

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Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total20445318Total
Program Services19817135ProgramServices
Management And General628183ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total484298Total
Management And General484298ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4964120Total
Program Services4251403ProgramServices
Management And General693328ManagementAndGeneral
Fundraising19389Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5300974Total
Program Services5300974ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4996973Total
Program Services4683842ProgramServices
Management And General311669ManagementAndGeneral
Fundraising1462Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total535082Total
Program Services404020ProgramServices
Management And General129244ManagementAndGeneral
Fundraising1818Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

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Total156902Total
Program Services123595ProgramServices
Management And General32329ManagementAndGeneral
Fundraising978Fundraising

Interest Interest

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Total1951501Total
Program Services1951501ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

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Total5346410Total
Program Services5279780ProgramServices
Management And General66630ManagementAndGeneral

Insurance Insurance

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Total865206Total
Program Services865206ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Equipment rentals95125293840512847
Miscellaneous13559953256191030376
Purchased services158574789632619614990374956
Pt Care Supplies2476701324767013

All Other Expenses AllOtherExpenses

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Total0Total

Total Functional Expenses TotalFunctionalExpenses

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Program Services161887253ProgramServices
Management And General18850934ManagementAndGeneral
Fundraising302203Fundraising

Cash Non Interest Bearing CashNonInterestBearing

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BOY961034BOY
EOY2133763EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

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BOY29610488BOY
EOY49223988EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

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EOY0EOY

Accounts Receivable AccountsReceivable

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BOY22310697BOY
EOY19547286EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

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EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

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EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

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EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

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BOY3008037BOY
EOY2917808EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

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BOY1535079BOY
EOY1965331EOY
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Land Buildings Equipment Basis106926503LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec55165385LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY49656225BOY
EOY51761118EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

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BOY1608598BOY
EOY1510593EOY

Investments Other Securities InvestmentsOtherSecurities

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EOY0EOY

Investments Program Related InvestmentsProgramRelated

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EOY0EOY

Intangible Assets IntangibleAssets

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BOY374617BOY
EOY11644EOY

Other Assets Total OtherAssetsTotal

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BOY1100821BOY
EOY2839595EOY

Total Assets TotalAssets

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BOY110165596BOY
EOY131911126EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

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BOY10852156BOY
EOY11825209EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY38530BOY
EOY615585EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

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BOY4070426BOY
EOY3561622EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY50588855BOY
EOY51725818EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY65549967BOY
EOY67728234EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

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BOY43727814BOY
EOY63188936EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY887815BOY
EOY993956EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY44615629BOY
EOY64182892EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY110165596BOY
EOY131911126EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses19567263ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Church170b1 AiXChurch170b1Ai

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$11,755OtherActivitiesAmount
Total Lobbying Expenditures IIB11755TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationA portion of industry association dues is allocated to lobbying activities.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance887815BeginningOfYearBalance
Contributions497849Contributions
Grants Or Scholarships98743GrantsOrScholarships
Other Expenditures292965OtherExpenditures
End Of Year Balance993956EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance905304BeginningOfYearBalance
Contributions378471Contributions
Grants Or Scholarships50891GrantsOrScholarships
Other Expenditures345069OtherExpenditures
End Of Year Balance887815EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance708131BeginningOfYearBalance
Contributions538837Contributions
Other Expenditures341664OtherExpenditures
End Of Year Balance905304EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance572083BeginningOfYearBalance
Contributions325741Contributions
Other Expenditures189693OtherExpenditures
End Of Year Balance708131EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance427428BeginningOfYearBalance
Contributions331644Contributions
Other Expenditures186989OtherExpenditures
End Of Year Balance572083EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4644321OtherCostOrOtherBasis
Book Value4644321BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis55507870OtherCostOrOtherBasis
Depreciation21610540Depreciation
Book Value33897330BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2957059OtherCostOrOtherBasis
Depreciation1768972Depreciation
Book Value1188087BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis35950473OtherCostOrOtherBasis
Depreciation29459980Depreciation
Book Value6490493BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7866780OtherCostOrOtherBasis
Depreciation2325893Depreciation
Book Value5540887BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51761118TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Other liabilities$184,670
Payables to third-party payers$3,565,378
Workers' comp liability$6,224,522
Payables to related orgs$41,751,248
FieldValueIRS element (for citing)
Total Of Amounts51725818TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPart V, Line 4Identifier
Return ReferencePart V, Line 4: Intended uses of the endowment fund.ReturnReference
ExplanationBoard-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.Explanation

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GalaNameOfEvent1
Gross Receipts Event186570GrossReceiptsEvent1
Charitable Contributions Event120400CharitableContributionsEvent1
Gross Revenue Event166170GrossRevenueEvent1
Rent Facility Costs Event12850RentFacilityCostsEvent1
Food And Beverage Event14608FoodAndBeverageEvent1
Entertainment Event1200EntertainmentEvent1
Other Direct Expenses Event16920OtherDirectExpensesEvent1
Name Of Event2Golf TournamentNameOfEvent2
Gross Receipts Event269635GrossReceiptsEvent2
Charitable Contributions Event26800CharitableContributionsEvent2
Gross Revenue Event262835GrossRevenueEvent2
Cash Prizes Event2500CashPrizesEvent2
Non Cash Prizes Event24134NonCashPrizesEvent2
Rent Facility Costs Event26768RentFacilityCostsEvent2
Food And Beverage Event24749FoodAndBeverageEvent2
Other Direct Expenses Event22301OtherDirectExpensesEvent2
Gross Receipts Total156205GrossReceiptsTotal
Charitable Contributions Total27200CharitableContributionsTotal
Gross Revenue Total Events129005GrossRevenueTotalEvents
Cash Prizes Total Events500CashPrizesTotalEvents
Non Cash Prizes Total Events4134NonCashPrizesTotalEvents
Rent Facility Costs Total Events9618RentFacilityCostsTotalEvents
Food And Beverage Total Events9357FoodAndBeverageTotalEvents
Entertainment Total Events200EntertainmentTotalEvents
Other Direct Expenses Total Events9221OtherDirectExpensesTotalEvents
Direct Expense Summary Events33030DirectExpenseSummaryEvents
Net Income Summary95975NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1684415TotalCommunityBenefitExpense
Direct Offsetting Revenue-137465DirectOffsettingRevenue
Net Community Benefit Expense1821880NetCommunityBenefitExpense
Percent Of Total Expense0.01040PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense6708047TotalCommunityBenefitExpense
Direct Offsetting Revenue3624376DirectOffsettingRevenue
Net Community Benefit Expense3083671NetCommunityBenefitExpense
Percent Of Total Expense0.01760PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8392462TotalCommunityBenefitExpense
Direct Offsetting Revenue3486911DirectOffsettingRevenue
Net Community Benefit Expense4905551NetCommunityBenefitExpense
Percent Of Total Expense0.02800PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense173059TotalCommunityBenefitExpense
Net Community Benefit Expense173059NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1098690TotalCommunityBenefitExpense
Net Community Benefit Expense1098690NetCommunityBenefitExpense
Percent Of Total Expense0.00630PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense23039TotalCommunityBenefitExpense
Net Community Benefit Expense23039NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1294788TotalCommunityBenefitExpense
Net Community Benefit Expense1294788NetCommunityBenefitExpense
Percent Of Total Expense0.00740PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9687250TotalCommunityBenefitExpense
Direct Offsetting Revenue3486911DirectOffsettingRevenue
Net Community Benefit Expense6200339NetCommunityBenefitExpense
Percent Of Total Expense0.03540PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,556,632BadDebtExpenseAmount
Amount Attributable To373592AmountAttributableTo
Amount Reimbursed By Medicare70096213AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare74440265CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4344052MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sonora Regional Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11000 Greenley RdAddressLine1
CitySonoraCity
StateCAState
ZIP Code95370ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Sonora Regional Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent300.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities38NumberOfOtherFacilities

Other Facilities OtherFacilities (38 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Foothill Specialty Group
680 Guzzi Ln Ste 206SonoraCA95370Specialty Care Clinic
Angels Camp Physicial Therapy
467 S Main StAngels CampCA95222Outpatient Physical Therapy Services
Foothill Primary Care
650 Pauline CtSonoraCA95370Primary Care Clinic
Mountain Medical Family Practice
680 Guzzi Ln Ste 101SonoraCA95370Primary Care Clinic
Hillside Internal Medicine
690 Guzzi Ln Ste BSonoraCA95370Primary Care Clinic
Sierra Vascular Surgery
690 Guzzi Ln Ste 104SonoraCA95370Specialty Care Clinic
Cedarwood Internal Medicine Center
690 Guzzi Ln Ste ASonoraCA95370Primary Care Clinic
Arnold Family Medical Center
2037 Hwy 4ArnoldCA95223Primary Care Clinic
Groveland Family Medical Center
18661 Hwy 120GrovelandCA95321Primary Care Clinic
Cardiac and Pulmonary Rehab
19747 Greenley RdSonoraCA95370Outpatient Services
Greenley Primary Care
19747 Greenley Rd Ste S2SonoraCA95370Primary Care Clinic
Angels Camp Family Medical Center
445 S Main StAngels CampCA95222Primary Care Clinic
Job Care Occupational Health Clinic
19747 Greenley Rd Ste S2SonoraCA95370Occupational Health Clinic
Sierra Cancer Center
900 Greenley Rd Ste 902SonoraCA95370Specialty Care Clinic
Greenley Oaks Physical Therapy
940 Sylva Ln Ste D1SonoraCA95370Outpatient Physical Therapy Services
Anticoagulation Clinic
193 S Fairview Ln Ste LSonoraCA95370Outpatient Services
Indian Rock Physicial Therapy
14540 Mono Wy Ste 130SonoraCA95370Outpatient Physical Therapy Services
Community Pharmacy Forest Road
193 S Fairview Ln Ste ASonoraCA95370Outpatient Pharmacy
Yosemite Joint Replacement
680 Guzzi Ln Ste 102SonoraCA95370Specialty Care Clinic
Angels Camp Prompt Care
23 N Main StAngels CampCA95222Urgent Care Clinic
Sonora Oxygen and Medical Supply
358 W Stockton StSonoraCA95370Oxygen and Durable Medical Equipment Supplier
Sierra Surgical Associates
680 Guzzi Ln Ste 204SonoraCA95370Specialty Care Clinic
Sierra Internal Medicine Center
900 Greenley Rd Ste 922SonoraCA95370Primary Care Clinic
Sierra OBGYN
680 Guzzi Ln Ste 106SonoraCA95370Specialty Care Clinic
Greenley Oaks Ear Nose and Throat
795 Morningstar DrSonoraCA95370Specialty Care Clinic
Center for Wound Care
12811 Covey CirSonoraCA95370Wound Care Clinic
Community Pharmacy Greenley Road
900 Greenley Rd Ste 912SonoraCA95370Outpatient Pharmacy
Indian Rock Prompt Care
14540 Mono WySonoraCA95370Urgent Care Clinic
Sierra Cardiology
900 Greenley Rd Ste 911SonoraCA95370Specialty Care Clinic
Sonora Care Center
538 Ponderosa DrSonoraCA95370Skilled Nursing Facility
Transitional Care Unit
179 S Fairview LnSonoraCA95370Skilled Nursing Facility
Community Infusion Center
900 Greenley RdSonoraCA95370Outpatient Services
Radiation Oncology
900 Greenley Rd Ste 901SonoraCA95370Radiation Therapy Center
Forest Rd Health and Wellness
193 Fairview LnSonoraCA95370Primary, Specialty, Dental and Urgent Care Clinic
Sonora Regional Home Health Angels Camp
467 S Main StAngels CampCA95222Home Health Agency
Sonora Regional Home Health
20100 Cedar Rd NSonoraCA95370Home Health Agency
Sonora Regional Surgery Center
905 Morning Star DrSonoraCA95370Outpatient Surgery Center
Sonora Regional Imaging Center
12811 Covey CirSonoraCA95370Diagnostic Imaging Center

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationPart V, Section B, Lines 1 through 7Schedule H, Part V, Section B, Lines 1 through 7 is optional for the reporting organization as the tax year began prior to March 23, 2012, according to the instructions for Schedule H. Part V, Section B should be blank as the reporting organization opts to not complete it.
Part VI - States Where Community Benefit Report FiledCA
Part VI - Affilated Health Care System Roles and PromotionThe hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communites served by all member hospitals.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeThe hospital continues to operate its 24-hour emergency department. The hospital has open medical staff to all qualified individuals. The hospital continues to expand its primary care outreach program through outpatient clinics, including a mobile clinic. The hospital operates skilled nursing facilities, which serve those who are unable to continue living without assistance due chronic medical conditions.
Part VI - Community Building ActivitiesOur hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H.
Part VI - Community InformationThe hospital is the only health care system in the area serving two counties and surrounding areas. In early 2009 the hospital was designated as a "sole community hospital" by Medicare. The area is rural. Agriculture, logging and tourism are the major employment opportunities. The population includes a large number of retired individuals.
Part VI - Patient Education of Eligibility for AssistanceAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients also are orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. The hospital charity assistance policy is posted on the hospital website.
Part VI - Needs AssessmentThe health system retains outside research firms every 3 years to assess changes in the market and community perception. Data is collected through a variety of vehicles, including phone surveys, paper surveys, and focus groups. Questions were added to the survey to help assess the impact of our community benefit activities and residents' barriers to access for health care services as well as unmet community needs.
Part V, Line 20d - Other Billing Determination of Individuals Without InsuranceThe hospital's financial assistance policy has three income ranges for patients who received emergency medical care, which provides a discount based on Medicare rates. There are also three income ranges for patients who received non-emergency medical care; the two lower income ranges provide a discount based on Medicare rates. The higher income range provides a discount from the balance due after the uninsured discount, that is available to all uninsured patients without regard to income. Only five of the six income ranges are discounted based on Medicare rates.Number of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsWhen a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL*Medicare Cost Report Revenue 69,760,801Prior Year Settlements 0Cost Report Reimbursable Bad Debts 428,141Clinic 1206(D) Revenue 0Estimates and Accrual Variances (92,729)Other 0Subtotal - Amount reported in Pt III, line 5 70,096,213Amounts include in Part 1, lines g and f 0Total Medicare Revenue 70,096,213*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts.
Part III, Line 4 - Bad Debt ExpenseThe system-wide combined audited financial statements do not contain a footnote describing bad debt expense.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitThe portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt.
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseUncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide combined audited financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2.
Part I, Line 7 - Explanation of Costing MethodologyThe costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income)_____________________________________________________________________________ Gross patient charges

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuation
Utilities, food, other emergency assist25022565Cash
Transportation cancer pts to treatments50076178Cash

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationPrior to issuing grants, hospital evaluates organization requesting grant and ensures alignment with hospital's exempt purpose and mission. After disbursing grant funds, hospital does not monitor use of funds.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Rick Dodds
VP HR1552501802986261062122881215407
Pauline Campbell
VP Off Site Svcs134754202671972425732155942160719272
Julie Kline
Sr VP Pt Care Svcs2112702420047465440591873734573132657
Bill Wing
Asst Sec554320771973367813187622737819808
Andrew Jahn
Treas/VP Fin2022409308288001367824998279024
Jeff Eller
President & CEO3660007049898697835552300764175760220
Rodney Wehtje
Asst Treas362899715821000091912881882774460563809
Scott Reiner
V Chair / Sec65400014953411186616071923025109914442890
Douglas Rebok
Asst Sec561780137623172912138641210901032046116805
Robert Carmen
Chairman98257124068059119115298235661853306472760
Meredith Jobe
Dir/VP/Gen Coun262685553365635817397391776
Susan Shinkai
Pharmacist16297049138129101198863194994
John Frank
Pharmacist164152120051026814536200961
David Schwartz
Home Health PT18257049829451283197286
Jacquie Cituk
Pharmacy Director184752874311071148520715226802
Jeph Solo
Lead Surgery RN196610301190778378854217219
Larry Dodds
Former Dir/V Chair/Sec7828056235641492897334

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
990, Part VI, Line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy available upon request. The hospital files monthly/quarterly summary financial reports with the state health-planning agency.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementSee explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation.Form 990, Part VI, Line 15a
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsDuring the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board after their review but prior to filing.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital.The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West.Form 990, Part VI, Line 6
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtKey Employee Rick Dodds is the child of Larry Dodds, a former officer listed on Schedule J.Form 990, Part VI, Line 2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Reedley Community Hospital
372 W Cypress AveReedleyCA93654453220509HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Adventist Health Physicians Network
2100 Douglas BlvdRosevilleCA95661680357690Medical FoundationCA501(c)(311b, IIAdventist Health SystemWestfalse
Willits Hospital Inc
1 Madrone StWillitsCA95490680108919HospitalCA501(c)(3)1Adventist Health SystemWestfalse
White Memorial Medical Center
1720 Cesar E Chavez AveLos AngelesCA90033952282647HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Walla Walla General Hospital
1025 S Second StWalla WallaWA99362910617726HospitalWA501(c)(3)1Adventist Health SystemWestfalse
Ukiah Adventist Hospital
275 Hospital DrUkiahCA95482941639901HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Simi Valley Hospital & Health Care Svcs
2975 N Sycamore DrSimi ValleyCA93065956064971HospitalCA501(c)(3)1Adventist Health SystemWestfalse
San Joaquin Community Hospital
2615 Chester AveBakersfieldCA93301952294234HospitalCA501(c)(3)1Adventist Health SystemWestfalse
St Helena Hospital
10 Woodland RdSt HelenaCA94574941279779HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Portland Adventist Medical Center
10123 SE Market StPortlandOR97216930429015HospitalOR501(c)(3)1Adventist Health SystemWestfalse
Paradise Valley Hospital
2100 Douglas BlvdRosevilleCA95661951816034Wind down after sale of hospital facilitiesCA501(c)(3)1Adventist Health SystemWestfalse
NW Medical Foundation of Tillamook
1000 Third StTillamookOR97141930622075HospitalOR501(c)(3)1Adventist Health SystemWestfalse
Hanford Community Hospital
450 Greenfield AveHanfordCA93230940535360HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Glendale Adventist Medical Center
1509 Wilson TerraceGlendaleCA91206951816017HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Feather River Hospital
5974 Pentz RdParadiseCA95969941101228HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Central Valley General Hospital
1025 N Douty StHanfordCA93230770324630HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Castle Medical Center
640 Ulukahiki StKailuaHI96734990107330HospitalHI501(c)(3)1Adventist Health SystemWestfalse
Adventist Health Clearlake Hospital
Ave 18 at Hwy 53ClearlakeCA95422680395149HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Adventist Health SystemWest
2100 Douglas BlvdRosevilleCA95661953484589Support / manage system-wide activitiesCA501(c)(3)1NAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1South Coast Medical CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12100 Douglas BlvdAddressLine1
CityRosevilleCity
StateCAState
ZIP Code95661ZIPCode
FieldValueIRS element (for citing)
EIN952037291EIN
Primary ActivityWind down after sale of hospitalPrimaryActivity
Legal Domicile StateCALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityC CorpTypeOfEntity
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg