SUTTER HEALTH PACIFIC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SUTTER HEALTH PACIFIC (EIN 99-0298651)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-10-25
- IRS object ID
- 201332989349301253
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-10-25T17:10:01-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4370 LA JOLLA VILLAGE DR SUITE 500 | AddressLine1 |
| City | SAN DIEGO | City |
| State | CA | State |
| ZIP Code | 92122 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990298651 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER HEALTH PACIFIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % ROSE CHOY | InCareOfName |
| Name Control | SUTT | NameControl |
| Phone | 9162866665 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 FORT WEAVER ROAD | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROSE CHOY | Name |
| Title | CFO | Title |
| Phone | 9162866665 | Phone |
| Date Signed | 2013-10-21 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8585357200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAHI MOHALA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LEONARD LICINA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 FORT WEAVER ROAD | AddressLine1 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 20895356 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SUTTERHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 331 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 655671 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 667578 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17657329 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20220769 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5659 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7009 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18318659 | TotalRevenuePriorYear |
| Total Revenue Current Year | 20895356 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13645894 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 15325651 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 41683 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5148123 | OtherExpensePriorYear |
| Other Expenses Current Year | 5117396 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18794017 | TotalExpensesPriorYear |
| Total Expenses Current Year | 20443047 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -475358 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 452309 | RevenuesLessExpensesCY |
| Total Assets BOY | 10052223 | TotalAssetsBOY |
| Total Assets EOY | 12887568 | TotalAssetsEOY |
| Total Liabilities BOY | 1605194 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1990131 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8447029 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10897437 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | true | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 19210481 | Expense |
| Grants | 0 | Grants |
| Revenue | 20220769 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 19210481 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 19 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 331 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ROSE CHOY | NamePerson |
| Telephone Number | 8086772580 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 FORT WEAVER ROAD | AddressLine1 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| J KUHIO ASAM MD | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| DIANNE BROOKINS | |||||||||
| TRUSTEE/CHAIR | 1.0 | 0.0 | X | 0 | 0 | 0 | X | ||
| PATRICK DUARTE | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| DAVID HUDSON | |||||||||
| TRUSTEE/VICE CHAIR FINANCE | 1.0 | 0.0 | X | 0 | 0 | 0 | X | ||
| SARAH KREVANS | |||||||||
| COO SUTTER HEALTH | 1.0 | 40.0 | X | 0 | 1546710 | 974314 | X | ||
| LEONARD LICINA | |||||||||
| CEO SUTTER HEALTH PACIFIC | 40.0 | 0.0 | X | 0 | 247886 | 113754 | X | ||
| CAMERON NEKOTA | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| NANCY E PACE MD MSPH | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| TINA SHELTON | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| DIANE STEWART | |||||||||
| TRUSTEE/VICE CHAIR | 1.0 | 0.0 | X | 0 | 631 | 0 | X | ||
| JUDGE ALLENE SUEMORI | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| SHELLEY WILSON | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| JEFFREY VENTURA | |||||||||
| TRUSTEE | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| ROSE CHOY | |||||||||
| CFO SUTTER HEALTH PACIFIC | 40.0 | 0.0 | 0 | 158193 | 67750 | X | |||
| STEVEN CHAPLIN MD | |||||||||
| MEDICAL DIRECTOR/EX-OFFICIO | 40.0 | 0.0 | 480474 | 0 | 22214 | X | |||
| GREGORY PRIER MD | |||||||||
| PSYCHIATRIST | 40.0 | 0.0 | 323176 | 0 | 21507 | X | |||
| ELENE SHARIPOVA MD | |||||||||
| PSYCHIATRIST | 40.0 | 0.0 | 221152 | 0 | 21564 | X | |||
| THOMAS HENRY MD | |||||||||
| PSYCHIATRIST | 40.0 | 0.0 | 147050 | 0 | 18746 | X | |||
| JEREMY ROBERTS MD | |||||||||
| PSYCHIATRIST | 40.0 | 0.0 | 140127 | 0 | 13729 | X | |||
| RICHARD JACOBSON MD | |||||||||
| PSYCHIATRIST | 40.0 | 0.0 | 127160 | 0 | 15429 | X | |||
| JOHN DONKERVOET | |||||||||
| DIRECTOR | 40.0 | 0.0 | 116922 | 0 | 8142 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1556061 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1953420 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1277149 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| T IIDA CONTRACTING LTD | |||||
| PO BOX 1 | KANEOHE | HI | 96744 | ARCHITECT SERVICES | 582027 |
| UNITED LAUNDRY SERVICE | |||||
| 2291 ALAHAO PLACE | HONOLULU | HI | 96819 | LAUNDRY SERVICES | 103264 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Federated Campaigns | 1294 | FederatedCampaigns |
| Government Grants | 614311 | GovernmentGrants |
| All Other Contributions | 51973 | AllOtherContributions |
| Total Contributions | 667578 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 20220769 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20220769 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20220769 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7009 | TotalRevenueColumn |
| Exclusion | $7,009 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20895356 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20220769 | RelatedOrExemptFunctionIncome |
| Exclusion | $7,009 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1209729 | Total |
| Program Services | 803650 | ProgramServices |
| Management And General | 406079 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9902074 | Total |
| Program Services | 9835357 | ProgramServices |
| Management And General | 66717 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 346162 | Total |
| Program Services | 340865 | ProgramServices |
| Management And General | 5297 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2892789 | Total |
| Program Services | 2603150 | ProgramServices |
| Management And General | 289639 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 974897 | Total |
| Program Services | 945522 | ProgramServices |
| Management And General | 29375 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7693 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 7693 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5599 | Total |
| Management And General | 5599 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 303326 | Total |
| Program Services | 303326 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18723 | Total |
| Program Services | 18723 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 415296 | Total |
| Program Services | 340074 | ProgramServices |
| Management And General | 74874 | ManagementAndGeneral |
| Fundraising | 348 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5489 | Total |
| Program Services | 5294 | ProgramServices |
| Management And General | 195 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 812770 | Total |
| Program Services | 812770 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33178 | Total |
| Program Services | 10920 | ProgramServices |
| Management And General | 22258 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10661 | Total |
| Program Services | 52 | ProgramServices |
| Management And General | 10609 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 215004 | Total |
| Program Services | 215004 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 547254 | Total |
| Program Services | 547254 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132210 | Total |
| Program Services | 132210 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| FOOD | 393101 | 393101 | ||
| MEDICAL SUPPLIES | 333755 | 333714 | 41 | |
| PURCHASED SERVICES | 936058 | 736363 | 160276 | 39419 |
| ALL OTHER EXPENSES | 947279 | 833132 | 112231 | 1916 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20443047 | Total |
| Program Services | 19210481 | ProgramServices |
| Management And General | 1190883 | ManagementAndGeneral |
| Fundraising | 41683 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 816241 | BOY |
| EOY | 1780040 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15273 | BOY |
| EOY | 2713 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2953157 | BOY |
| EOY | 4351847 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14804 | BOY |
| EOY | 17165 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 429352 | BOY |
| EOY | 402908 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 13191746 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7202299 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5742976 | BOY |
| EOY | 5989447 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20228 | BOY |
| EOY | 18328 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60192 | BOY |
| EOY | 325120 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10052223 | BOY |
| EOY | 12887568 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 824083 | BOY |
| EOY | 1116742 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 781111 | BOY |
| EOY | 873389 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1605194 | BOY |
| EOY | 1990131 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8165067 | BOY |
| EOY | 10625144 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 281962 | BOY |
| EOY | 272293 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8447029 | BOY |
| EOY | 10897437 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10052223 | BOY |
| EOY | 12887568 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 452309 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -1901 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 2000000 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9950751 | OtherCostOrOtherBasis |
| Depreciation | 5554534 | Depreciation |
| Book Value | 4396217 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 2088343 | OtherCostOrOtherBasis |
| Depreciation | 1647765 | Depreciation |
| Book Value | 440578 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1152652 | OtherCostOrOtherBasis |
| Book Value | 1152652 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5989447 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INSURANCE LIABILITIES | Description |
| Amount | $873,389 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 873389 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ASC 740 (FIN 48) AUDIT FOOTNOTE | Identifier |
| Return Reference | PART X, LINE 2 | ReturnReference |
| Explanation | THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)), AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE COMBINED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2012 AND 2011, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 307876 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 307876 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01510 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3994145 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4396324 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -402179 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4302021 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4396324 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -94303 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 460 | PersonsServed |
| Total Community Benefit Expense | 24590 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 24590 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 152 | PersonsServed |
| Total Community Benefit Expense | 56577 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 56577 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 2199 | PersonsServed |
| Total Community Benefit Expense | 24297 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 24297 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 13 | NumberOfActivitiesOrPrograms |
| Persons Served | 2811 | PersonsServed |
| Total Community Benefit Expense | 105464 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 105464 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 13 | NumberOfActivitiesOrPrograms |
| Persons Served | 2811 | PersonsServed |
| Total Community Benefit Expense | 4407485 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4396324 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11161 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Building Expense | 953 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 953 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Building Expense | 953 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 953 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $165,262 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 839950 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 828691 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 11259 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER HEALTH PACIFIC - KAHI MOHALA | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 91-2301 FORT WEAVER ROAD | AddressLine1 |
| City | EWA BEACH | City |
| State | HI | State |
| ZIP Code | 96706 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SUTTERHEALTH.ORG | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUTTER HEALTH PACIFIC - KAHI MOHALA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| PART I, QUESTION 3C | TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES APPLIES TO UNINSURED PATIENTS THAT WHOSE FAMILY INCOMES ARE BETWEEN 201% AND 400%. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 350% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURER HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAT THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR A 20% DISCOUNT IF 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE. | |
| PART I, QUESTION 6A | SUTTER HEALTH, A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT. | |
| PART I, QUESTION 7 | COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. | |
| PART II | KAHI MOHALA BEHAVIORAL HEALTH FUNDS THE FOLLOWING PROGRAMS THAT HELPED ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. A) HAWAII LITERACY: REVIEW/PREPARE WEEKLY EDUCATION PLANS FOR STUDENTS. MEETS WITH STUDENTS, TEACHING THEM TO READ AND WRITE AS WELL AS ASSISTING THEM IN MEETING STATED GOALS FOR SELF-DEVELOPMENT. B) VIDEO-TELECONFERENCE COURT HEARING: COMMUNITY PROVIDERS REQUESTED THE USE OF KAHI MOHALA VIDEO-TELECONFERENCE EQUIPMENT TO FACILITATE COURT HEARING BETWEEN ISLAND COURTS. KAHI MOHALA STAFF WAS PRESENT TO ESCORT, FACILITATE EQUIPMENT USE AND GUIDE PROVIDERS TOWARD DESIRED OUTCOME. | COMMUNITY BUILDING ACTIVITIES |
| PART III, QUESTION 2 | METHODOLOGY FOR CALCULATING BAD DEBT (AT COST) THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. | |
| PART III, QUESTION 3 | METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. | |
| PART III, QUESTION 4 | THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE ESTIMATED BASED UPON AN EVALUATION OF HISTORICAL PAYMENTS, NEGOTIATED CONTRACTS AND GOVERNMENTAL REIMBURSEMENTS. SUTTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 89% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2012. ADJUSTMENTS AND CHANGES IN ESTIMATES ARE RECORDED IN THE PERIOD IN WHICH THEY ARE DETERMINED. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 27% AS OF 12/31/11 29% AS OF 12/31/12 MEDI-CAL 21% AS OF 12/31/11 23% AS OF 12/31/12 DURING 2011 AND 2012, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. SUTTER HAD NO CHANGES IN ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES IN 2012. | |
| PART III, QUESTION 7 | MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. | |
| PART III, QUESTION 8 | COSTING METHODOLOGY MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. | BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: |
| PART III, QUESTION 9B | COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. | |
| PART V, SECTION B, QUESTION 12H | ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. | BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: |
| PART V, SECTION B, QUESTION 14G | A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. THE ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. PART V, SECTION B, QUESTION 18E THE ORGANIZATION MADE NO SUCH EFFORTS. | MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: |
| PART V, SECTION B, QUESTION 20D | FOR PATIENTS WHO HAVE NO INSURANCE COVERAGE: - SHP BILLS GUARANTOR GROSS CHARGES - PATIENT APPLIES FOR MED-QUEST (STATE OF HAWAII MEDICAID PROGRAM) AND MED-QUEST MAKES A DETERMINATION IF PATIENT IS ELIGIBLE FOR COVERAGE BASED ON FAMILY INCOME, ASSETS, DEBT - ONCE ELIGIBILITY IS DETERMINED, PATIENT IS COVERED BY MEDICAID FFS - PATIENT THEN SELECTS A MEDICAID-QUEST OR MEDICAID-QEXA PLAN BASED ON THE DETERMINATION - IF PATIENT IS ELIGIBLE FOR QUEST OR QEXA, SHP WILL REQUEST RETRO AUTHORIZATIONS AND BILL THE PLAN - IF PATIENT IS ELIGIBLE FOR MEDICAID FFS - PATIENT FINANCIAL SERVICES WILL HAVE PATIENT COMPLETE CHARITY CARE APPLICATION | AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: |
| NEEDS ASSESSMENT | KAHI MOHALA ASSESSES COMMUNITY NEED FOR PSYCHIATRIC SERVICES IN A NUMBER OF WAYS. - THROUGH PARTICIPATION IN STATE HEALTH PLANNING DEVELOPMENT AGENCY'S PLAN DEVELOPMENT COMMITTEE. THE CHARGE OF THE COMMITTEE IS TO UPDATE THE STATE'S HEALTH SERVICE AND FACILITY PLAN TO REFLECT THE ANTICIPATED NEED FOR ALL LEVELS OF PSYCHIATRIC AND SUBSTANCE ABUSE CARE, TO ASSESS CURRENT PROVIDER CAPACITY, AND TO RECOMMEND STRATEGIES TO BRIDGE THE GAP BETWEEN NEED AND CAPACITY. - WE ADDRESS COMMUNITY NEEDS ASSESSMENT IN ANNUAL STRATEGIC PLANNING PROCESS WITH THE HELP OF INTERNAL AND EXTERNAL CONSULTANTS. - MONTHLY REVIEW OF ADMISSION AND REFERRAL PATTERNS TO DETECT CHANGES IN COMMUNITY NEED. - FREQUENT CONTACT WITH STATE AGENCIES AND OTHER PROVIDERS TO ASSESS THEIR CHANGING NEEDS AND CAPACITY TO PROVIDE SERVICE. - FREQUENT CONTACT WITH REFERRAL SOURCES, OTHER BUSINESSES, AND COMMUNITY ORGANIZATIONS TO ASSESS THEIR NEEDS. | PART VI, QUESTION 2 |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | KAHI MOHALA BEHAVIORAL HEALTH FOLLOWS A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS) B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION" B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS. 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. | PART VI, QUESTION 3 |
| COMMUNITY INFORMATION | HONOLULU COUNTY ACCORDING TO THE 2010 U.S. CENSUS BUREAU THE POPULATION OF HONOLULU COUNTY WAS 953,207 AND CONSISTED OF 50.1% MEN AND 49.9% WOMEN WITH A MEDIAN AGE OF 36.2 YEARS. THE POPULATION DENSITY WAS 1,586.7 PEOPLE PER SQUARE MILE IN 2010 WHICH IS OVER SEVEN TIMES THAT OF THE HAWAII STATE DENSITY OF 211.8. HONOLULU COUNTY'S POPULATION CONSISTS OF 43.9 % ASIAN, 20.8% WHITE AND 8/% HISPANIC OR LATINO. A LARGE MAJORITY OF RESIDENTS (71.1%) SPEAK ENGLISH AT HOME WHILE 25.9% SPEAK ASIAN OR PACIFIC ISLAND. THE MEDIAN HOUSEHOLD SIZE IS 2.96 PEOPLE WITH A 2010 AVERAGE INCOME OF $70,093 AND A MEDIAN HOUSE VALUE OF $559,000. THE GREATER PART (89.9%) OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A HIGH SCHOOL DEGREE OR HIGHER WHILE 31.1% OF RESIDENTS 25 YEARS OF AGE OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER. IN HONOLULU COUNTY THE POVERTY LEVEL IN 2010 WAS AT 8.8% OF RESIDENTS, BELOW BOTH THE HAWAII STATE LEVEL OF 9.6% AND THE FEDERAL POVERTY LEVEL OF 15.1%.THE UNEMPLOYMENT RATE WAS AT 6.4% IN APRIL 2010 WHICH WAS NEARLY THE SAME AS THE HAWAII STATE LEVEL OF 6.7% AND BELOW THE FEDERAL LEVEL OF 9.9%. HONOLULU COUNTY FOOD SUPPLIES CONSIST OF 195 GROCERY STORES, 9 SUPER CENTER AND 734 FULL SERVICE RESTAURANTS. IN 2007, HEALTH ISSUES IN THIS COUNTY INCLUDED 17.8% OF ADULTS BEING OBESE, 6.9% OF ADULTS WITH DIABETES AND 23.9% WITH HIGH BLOOD PRESSURE. IN 2007 THERE WERE 6,572 DEATHS AND OF THOSE THE THREE LEADING CAUSES WERE HEART DISEASE, CANCER AND ALL OTHER RESIDUAL DISEASES COMBINED. IN 2007 THERE WERE 13,575 BIRTHS WITH 94 INFANT DEATHS OCCURRING THAT YEAR. THE LIFE EXPECTANCY AT BIRTH IS 80.4 YEARS WHICH IS RIGHT ABOVE THE HAWAII LIFE EXPECTANCY OF 79.2 YEARS. IN 2010 THERE WERE 7.2% OF ADULTS WITHOUT ANY HEALTH INSURANCE, 6.2% OF THAT WERE EMPLOYED DURING THAT TIME AND STILL DID NOT HAVE COVERAGE. DURING 2009 THE LESS INCOME THAT WAS BROUGHT INTO A HOME MEANT A MUCH HIGHER PERCENTAGE OF UNINSURED RESIDENTS. | PART VI, QUESTION 4 |
| PROMOTION OF COMMUNITY HEALTH | SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF AND IS RUN BY A COMMUNITY BOARD. A FEW HIGHLIGHTS OF KAHI MOHALA'S COMMUNITY BENEFIT ACTIVITIES IN 2012: KAHI MOHALA SUPPORTS THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) CFO ROUNDTABLE, A GROUP WHO FOCUSES THEIR EFFORTS TOWARDS REDUCING THE NUMBER OF INDIVIDUALS IN HAWAII WHO DO NOT HAVE HEALTH INSURANCE. THEY ALSO EDUCATE DECISION-MAKERS ON THE NEED FOR ADEQUATE PAYMENTS TO PROVIDERS TO COVER THE COSTS OF CARE. KAHI MOHALA PARTICIPATES AND HOLDS AN ON-CAMPUS WALK FOR STAFF AND ITS RESIDENTIAL PATIENTS IN SUPPORT OF THE NATIONAL ASSOCIATION ON MENTAL ILLNESS (NAMI) WALK, WHICH RAISES MONEY AND AWARENESS OF MENTAL ILLNESS. KAHI MOHALA ALSO SUPPORTS THE ALOHA HARVEST WITH MONETARY DONATIONS TO HELP THE HUNGRY AND HOMELESS IN THE COMMUNITY. KAHI MOHALA OFFERS MEETING ROOM SPACE AND USE OF FACILITIES FOR NUMEROUS NONPROFIT ORGANIZATIONS IN THE COMMUNITY SUCH AS ALANON, ALCOHOLICS ANONYMOUS AND NARCOTICS ANONYMOUS. | PART VI, QUESTION 5 |
| AFFILIATED HEALTH CARE SYSTEM | KAHI MOHALA BEHAVIORAL HEALTH IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF 48,000 PHYSICIANS, EMPLOYEES, AND VOLUNTEERS WHO CARE FOR MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING FOR A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. IT'S BETTER FOR PATIENTS: WE BELIEVE THIS COMMUNITY-OWNED, NOT-FOR-PROFIT APPROACH TO HEALTH CARE BEST SERVES OUR PATIENTS AND OUR COMMUNITIES - FOR MULTIPLE REASONS. FIRST OF ALL, IT'S GOOD FOR PATIENTS. ACCORDING TO THE JOURNAL OF GENERAL INTERNAL MEDICINE (APRIL 2000), PATIENTS TREATED AT FOR-PROFIT OR GOVERNMENT-OWNED HOSPITALS WERE TWO-TO-FOUR TIMES MORE LIKELY TO SUFFER PREVENTABLE ADVERSE EVENTS THAN PATIENTS TREATED AT NOT-FOR-PROFIT INSTITUTIONS. OUR STOCKHOLDERS ARE OUR COMMUNITIES: INVESTOR-OWNED, FOR-PROFIT HEALTH SYSTEMS HAVE A FINANCIAL INCENTIVE TO AVOID CARING FOR UNINSURED AND UNDERINSURED PATIENTS. THEY ALSO HAVE A FINANCIAL INCENTIVE TO AVOID HARD-TO-SERVE POPULATIONS AND "UNDESIRABLE" GEOGRAPHIC AREAS SUCH AS RURAL AREAS. IN MANY NORTHERN CALIFORNIA'S UNDERSERVED RURAL LOCALES, SUTTER HEALTH IS THE ONLY PROVIDER OF HOSPITAL AND EMERGENCY MEDICAL SERVICES IN THE COMMUNITY. PROVIDING CHARITY CARE AND SPECIAL PROGRAMS TO COMMUNITIES: OUR COMMUNITIES' SUPPORT HELPS US EXPAND SERVICES, INTRODUCE NEW PROGRAMS AND IMPROVE MEDICAL TECHNOLOGY. ACROSS OUR NETWORK, EVERY SUTTER HOSPITAL, PHYSICIAN ORGANIZATION AND CLINIC HAS A SPECIAL STORY TO TELL ABOUT FULFILLING VITAL COMMUNITY NEEDS. OUR COMMITMENT TO COMMUNITY BENEFIT: MEETING THE HEALTH CARE NEEDS OF OUR COMMUNITIES IS THE CORNERSTONE OF SUTTER HEALTH'S NOT-FOR-PROFIT MISSION. THIS INCLUDES DIRECTLY SERVING THOSE WHO CANNOT AFFORD TO PAY FOR HEALTH CARE AND SUPPORTING PROGRAMS AND SERVICES THAT HELP THOSE IN FINANCIAL NEED. SUTTER HEALTH NOW PROVIDES $2.9 MILLION IN CHARITY CARE PER WEEK. IN 2012, OUR NETWORK OF PHYSICIAN ORGANIZATIONS, HOSPITALS AND OTHER HEALTH CARE PROVIDERS INVESTED $795 MILLION IN HEALTH CARE PROGRAMS, SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED. THIS INCLUDES: - THE COST OF PROVIDING CHARITY CARE - THE UNPAID COSTS OF PARTICIPATING IN MEDI-CAL - INVESTMENTS IN MEDICAL RESEARCH, HEALTH EDUCATION AND COMMUNITY-BASED PUBLIC BENEFIT PROGRAMS SUCH AS SCHOOL-BASED CLINICS AND PRENATAL CARE FOR PATIENTS. SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS CONTINUED TO GROW, REACHING ANOTHER ALL-TIME HIGH OF $153 MILLION IN 2012 - OR AN AVERAGE OF NEARLY $3 MILLION PER WEEK. * SERVICES FOR THE POOR AND UNDERSERVED INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED, AS WELL AS THE COSTS OF PUBLIC PROGRAMS TREATING MEDI-CAL AND INDIGENT BENEFICIARIES. COSTS ARE COMPUTED BASED ON A RELATIONSHIP OF COSTS TO CHARGES. SERVICES FOR THE POOR AND UNDERSERVED ALSO INCLUDE THE COST OF OTHER SERVICES FOR INDIGENT POPULATIONS, AND CASH DONATIONS ON BEHALF OF THE POOR AND NEEDY. ** BENEFITS FOR THE BROADER COMMUNITY INCLUDE COSTS OF PROVIDING THE FOLLOWING SERVICES: HEALTH SCREENINGS AND OTHER HEALTH-RELATED SERVICES, TRAINING HEALTH PROFESSIONALS, EDUCATING THE COMMUNITY WITH VARIOUS SEMINARS AND CLASSES, THE COST OF PERFORMING MEDICAL RESEARCH AND THE COSTS ASSOCIATED WITH PROVIDING FREE CLINICS AND COMMUNITY SERVICES. BENEFITS FOR THE BROADER COMMUNITY ALSO INCLUDE CONTRIBUTIONS SUTTER HEALTH MAKES TO COMMUNITY AGENCIES TO FUND CHARITABLE ACTIVITIES. | PART VI, QUESTION 6 |
| STATE FILING OF COMMUNITY BENEFIT REPORT | N/A | PART VI, QUESTION 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN CHAPLIN MD | ||||||||||||||
| MEDICAL DIRECTOR/EX-OFFICIO | 219261 | 0 | 258349 | 0 | 2864 | 0 | 15095 | 0 | 7119 | 0 | 502688 | 0 | 0 | 0 |
| ROSE CHOY | ||||||||||||||
| CFO SUTTER HEALTH PACIFIC | 0 | 135585 | 0 | 20280 | 0 | 2328 | 0 | 66866 | 0 | 884 | 0 | 225943 | 0 | 4800 |
| SARAH KREVANS | ||||||||||||||
| COO SUTTER HEALTH | 0 | 1006640 | 0 | 527546 | 0 | 12524 | 0 | 951242 | 0 | 23072 | 0 | 2521024 | 0 | 652265 |
| LEONARD LICINA | ||||||||||||||
| CEO SUTTER HEALTH PACIFIC | 0 | 215496 | 0 | 32002 | 0 | 388 | 0 | 101769 | 0 | 11985 | 0 | 361640 | 0 | 32002 |
| GREGORY PRIER MD | ||||||||||||||
| PSYCHIATRIST | 185898 | 0 | 134941 | 0 | 2337 | 0 | 15095 | 0 | 6412 | 0 | 344683 | 0 | 0 | 0 |
| ELENE SHARIPOVA MD | ||||||||||||||
| PSYCHIATRIST | 144939 | 0 | 76157 | 0 | 56 | 0 | 13358 | 0 | 8206 | 0 | 242716 | 0 | 0 | 0 |
| THOMAS HENRY MD | ||||||||||||||
| PSYCHIATRIST | 118827 | 0 | 25958 | 0 | 2265 | 0 | 8882 | 0 | 9864 | 0 | 165796 | 0 | 0 | 0 |
| JEREMY ROBERTS MD | ||||||||||||||
| PSYCHIATRIST | 2025 | 0 | 138081 | 0 | 21 | 0 | 8464 | 0 | 5265 | 0 | 153856 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELEVANT INFORMATION REGARDING COMPENSATION ITEMS | PART I, QUESTION 1A | TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY. |
| SUPPLEMENTAL COMPENSATION INFORMATION | PART I, QUESTION 3 | THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. |
| NONQUALIFIED RETIREMENT PLAN | PART I, QUESTION 4B | THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR EARNINGS BEYOND THE PENSION PAY CAP. THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. |
| NON-FIXED PAYMENTS | PART I, QUESTION 7 | SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MISSION STATEMENT | FORM 990, PART I, LINE 1 AND PART III, LINE 1 | "SUTTER HEALTH PACIFIC (DBA KAHI MOHALA) IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES." |
| NEW SIGNIFICANT PROGRAM SERVICES | FORM 990, PART III, LINE 2 | KAHI MOHALA OPENED AN ELECTROCONVULSIVE THERAPY PROGRAM IN JUNE 2012, PROVIDING SERVICE TO BOTH INPATIENTS AND OUTPATIENTS, THREE TIMES A WEEK. |
| EXEMPT PURPOSE ACHIEVEMENTS | FORM 990, PART III, LINE 4A | SUTTER HEALTH PACIFIC, A CALIFORNIA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION WAS ORGANIZED TO OPERATE KAHI MOHALA HOSPITAL, AN 88 BED, FREESTANDING PSYCHIATRIC HOSPITAL. KAHI MOHALA HOSPITAL HAS BEEN OPERATIONAL SINCE 1983 AND IS SITUATED ON A 14.5 ACRE CAMPUS. THE HOSPITAL IS LICENSED BY THE STATE OF HAWAII AND IS ACCREDITED BY THE JOINT COMMISSION UNDER THE ACCREDITATION MANUAL OF HOSPITALS, WITH THE EXCEPTION OF THE LONGER TERM PROGRAMS FOR CHILDREN AND ADOLESCENTS, WHICH ARE ACCREDITED UNDER THE CONSOLIDATED STANDARDS. FOR 2012, THE NUMBER OF PATIENT DAYS IS 24,218. KAHI MOHALA'S MISSION IS: "KAHI MOHALA IS DEDICATED TO CARING FOR PEOPLE IN NEED BY PROVIDING INNOVATIVE, QUALITY AND EFFECTIVE BEHAVIORAL HEALTH SERVICES." TREATMENT PROGRAMS KAHI MOHALA BEHAVIORAL HEALTH IS DEDICATED NOT ONLY TO PSYCHIATRIC, EMOTIONAL AND BEHAVIORAL STABILIZATION, BUT ALSO TO RECOVERY THROUGH EMPOWERMENT. TEACHING INDIVIDUALS THE SKILLS TO SELF-MANAGE AND SELF-REGULATE TO THE FULLEST POSSIBLE EXTENT IS A FUNDAMENTAL GOAL WITHIN THE TREATMENT AND RECOVERY PROCESS. LEVELS OF CARE - ACUTE INPATIENT - CHILDREN AGES 3-12 - ADOLESCENTS AGES 13-18 - ADULTS AGES 18 AND UP - RESIDENTIAL TREATMENT PROGRAMS - CHILDREN AGES 3-12 - ADOLESCENTS AGES 13-18 - PARTIAL HOSPITALIZATION - ADOLESCENTS AGES 13-18 - ADULTS AGES 18 AND UP - ELECTROCONVULSIVE THERAPY - ADULTS AGES 18 AND UP SPECIALIZED TREATMENT SERVICES - PSYCHIATRIC EVALUATION/TREATMENT AND MEDICATION MANAGEMENT - NURSING ASSESSMENT - PSYCHOLOGICAL TESTING - SUBSTANCE ABUSE/DUAL DIAGNOSIS SERVICES - EATING DISORDER SERVICES THERAPEUTIC SERVICES AVAILABLE - INDIVIDUAL, FAMILY AND GROUP THERAPY - EDUCATIONAL SERVICES - OCCUPATIONAL THERAPY - RECREATIONAL THERAPY - ART THERAPY - REALITY-ORIENTED PHYSICAL EXPERIENTIAL SERVICES (ROPES) THIS CORPORATION WAS FORMED FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION: A. TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NOT-FOR-PROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BEDS AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS AND TO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; B. TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED, OR TO THE PROMOTION OF HEALTH; C. TO PROMOTE AND CARRY OUT SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; D. TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITY SERVED; AND E. TO CONTRIBUTE TO THE GROWTH, DEVELOPMENT AND FINANCIAL STRENGTH OF SUTTER HEALTH SYSTEM. KAHI MOHALA - LIST OF COMMUNITY BENEFITS: - TWELVE-STEP PROGRAMS (ALCOHOLICS ANONYMOUS, ALANON, NARCOTICS ANONYMOUS) PURPOSE: PEER-LED, SELF-HELP GROUPS OF PERSONS RECOVERING FROM ADDICTIONS, OR FAMILY MEMBERS OF PERSONS RECOVERING FROM ADDICTIONS. GOALS AND OBJECTIVES: TO GAIN SUPPORT AND EDUCATION IN A GROUP SETTING. - INTERNSHIP, RESIDENCY AND PRACTICUM PROGRAMS PURPOSE: TO PROVIDE A SUPERVISED CLINICAL PRACTICE SETTING FOR MEDICAL STUDENTS, SOCIAL WORKERS, NURSES, PSYCHOLOGISTS, SUBSTANCE ABUSE COUNSELORS AND OCCUPATIONAL THERAPISTS. GOALS AND OBJECTIVES: TO OBTAIN DIRECT PRACTICE EXPERIENCE IN THE STUDENT'S FIELD. - INFORMATION AND REFERRAL PURPOSE: TO PROVIDE TELEPHONE INFORMATION AND REFERRAL TO THE PUBLIC REGARDING MENTAL HEALTH AND CHEMICAL DEPENDENCY RESOURCES. GOAL: TO PROVIDE A FREE COMMUNITY RESOURCE. - MEMBERSHIPS ON COMMUNITY BOARDS AND COMMITTEES (GOODWILL INDUSTRIES, KAPOLEI ROTARY, HEALTHCARE ASSOCIATION OF HAWAII, HFMA, CHAMBER OF COMMERCE), MENTAL HEALTH AMERICA OF HAWAII (MHA), NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), HAWAII YOUTH SERVICES NETWORK (HYSN), COMMUNITY CHILDREN'S COUNCIL (CCCS), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, HAWAII BEHAVIORAL HEALTH ALLIANCE PURPOSE: TO VOLUNTEER EXPERTISE ON VARIOUS COMMUNITY BOARDS AND COMMITTEES. GOALS AND OBJECTIVES: TO SUPPORT OUR COMMUNITY BY HELPING OTHERS MEET THE GOALS AND OBJECTIVES OF VARIOUS ORGANIZATIONS AND COMMITTEES. - COMMUNITY ROPES GROUPS PURPOSE: PROVIDE PROBLEM SOLVING, TEAM BUILDING, AND LEADERSHIP AWARENESS THROUGH THE USE OF GAMES AND ELEMENTS ON THE ROPES COURSE. GOALS AND OBJECTIVES: PROVIDE THE YOUTH/AT RISK YOUTH THE OPPORTUNITY TO EXPERIENCE TEAM BUILDING/PROBLEM SOLVING EXERCISES THROUGH THE USE OF OUR ROPES COURSE. - ALOHA HARVEST PURPOSE: CASH DONATION. GOALS AND OBJECTIVES: PROVIDE ASSISTANCE TO THE HUNGRY AND HOMELESS IN THE COMMUNITY. - CHILD & FAMILY SERVICES PURPOSE: USE OF ROOM/FACILITIES. GOALS AND OBJECTIVES: TO PROVIDE A MEETING PLACE FOR THE DOMESTIC VIOLENCE PROGRAM. - HAWAII LITERACY PURPOSE: MEET WITH STUDENTS TO REVIEW/PREPARE WEEKLY EDUCATION PLAN FOR STUDENTS. GOALS AND OBJECTIVES: TO ASSIST STUDENTS IN MEETING STATED GOALS FOR SELF-DEVELOPMENT. - NATIONAL ASSOCIATION ON MENTAL ILLNESS (NAMI) WALK PURPOSE: PARTICIPATION IN ANNUAL NAMI WALK. GOALS AND OBJECTIVES: TO RAISE MONEY AND AWARENESS OF MENTAL ILLNESS. - THANKSGIVING MEAL PURPOSE: PREPARE AND SERVE THANKSGIVING LUNCH. GOALS AND OBJECTIVES: TO PROVIDE THANKSGIVING LUNCH TO HUNGRY AND HOMELESS IN THE COMMUNITY. -VIDEO-TELECONFERENCING PURPOSE: PROVIDE USE OF TELECONFERENCING EQUIPMENT TO FACILITATE COURT HEARING BETWEEN ISLAND COURTS. GOALS AND OBJECTIVES: TO PROVIDE THE COURT WITH UPDATES ON FORMER PATIENTS' PROGRESS IN THE COMMUNITY AND EVENTUAL GRANTING OF PERMANENT CONDITIONAL RELOCATION. |
| DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS | FORM 990, PART VI, QUESTIONS 6 & 7A | THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. |
| DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS | FORM 990, PART VI, QUESTION 7B | SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. |
| DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990 | FORM 990, PART VI, QUESTION 11B | SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM. |
| DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST | FORM 990, PART VI, QUESTION 12 | EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. |
| PROCESS FOR DETERMINING COMPENSATION | FORM 990, PART VI, QUESTION 15 | THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. |
| AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC | FORM 990, PART VI, QUESTION 19 | THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| OTHER CHANGES IN FUND BALANCE | FORM 990, PART XI, LINE 9 | EQUITY TRANSFER (NET) $2,000,000 ========== |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (32 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ADOLESCENT TREATMENT CENTERS INC | ||||||||||
| 390 40TH STREET | OAKLAND | CA | 94609 | 680088443 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER EBH | true |
| ALTA BATES SUMMIT FOUNDATION | ||||||||||
| 3012 SUMMIT STREET 3RD FLOOR | OAKLAND | CA | 94609 | 510160184 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER EBH | true |
| CALIFORNIA PACIFIC MEDICAL CTR FOUND | ||||||||||
| 2015 STEINER STREET 2ND FLOOR | SAN FRANCISCO | CA | 94115 | 942728423 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER WBH | true |
| DELTA MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 3901 LONE TREE WAY | ANTIOCH | CA | 94509 | 942417022 | FUNDRAISING | CA | 501(C)(3) | 11a - I | SUTTER EBH | true |
| EAST BAY PERINATAL CENTER | ||||||||||
| 3012 SUMMIT STREET 3RD FLOOR | OAKLAND | CA | 94609 | 510172285 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER EBH | true |
| EDEN MEDICAL CENTER | ||||||||||
| 20103 LAKE CHABOT ROAD | CASTRO VALLEY | CA | 94546 | 942948100 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| MARIN COMMUNITY HEALTH | ||||||||||
| 250 BON AIRE ROAD | GREENBRAE | CA | 94904 | 942994751 | SUPPORTING OR | CA | 501(C)(3) | 11b - II | SUTTER HLTH | true |
| MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 1800 COFFEE ROAD SUITE 76 | MODESTO | CA | 95355 | 942290244 | FUNDRAISING | CA | 501(C)(3) | 11a - I | SUTTER CVH | true |
| MILLS-PENINSULA HEALTH SERVICES | ||||||||||
| 1501 TROUSDALE DRIVE | BURLINGAME | CA | 94010 | 941156265 | HOSPITAL | CA | 501(C)(3) | 3 | PAMF | true |
| MILLS-PENINSULA HOSPITAL FOUNDATION | ||||||||||
| 1501 TROUSDALE DRIVE | BURLINGAME | CA | 94010 | 237288765 | FUNDRAISING | CA | 501(C)(3) | 7 | MPHS | true |
| PALO ALTO MEDICAL FOUNDATION | ||||||||||
| 2350 EL CAMINO REAL | MOUNTAIN VIEW | CA | 94040 | 941156581 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SAMUEL MERRITT UNIVERSITY | ||||||||||
| 450 30TH STREET 2840 | OAKLAND | CA | 94609 | 942992642 | UNIVERSITY | CA | 501(C)(3) | 2 | SUTTER EBH | true |
| SUTTER AUBURN FAITH HOSPITAL FOUNDATION | ||||||||||
| 11815 EDUCATION ST | AUBURN | CA | 95602 | 942594966 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | true |
| SUTTER CENTRAL VALLEY HOSPITALS | ||||||||||
| 1800 COFFEE ROAD SUITE 76 | MODESTO | CA | 95355 | 941080917 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER COAST HOSPITAL | ||||||||||
| 800 E WASHINGTON BLVD | CRESCENT CITY | CA | 95531 | 942988520 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER DAVIS HOSPITAL FOUNDATION | ||||||||||
| PO BOX 1617 | DAVIS | CA | 95617 | 680217870 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | true |
| SUTTER EAST BAY HOSPITALS | ||||||||||
| 3012 SUMMIT STREET 3RD FLOOR | OAKLAND | CA | 94609 | 941196176 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER EAST BAY MEDICAL FOUNDATION | ||||||||||
| 3687 MT DIABLO BLVD 200 | LAFAYETTE | CA | 94549 | 942690415 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER GOULD MEDICAL FOUNDATION | ||||||||||
| 600 COFFEE ROAD | MODESTO | CA | 95355 | 941682256 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER HEALTH | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 942788907 | SUPPORTING OR | CA | 501(C)(3) | 11c III-FI | NA | false |
| SUTTER HEALTH PLAN | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 461183948 | HEALTH PLAN | CA | PENDING | PENDING | SUTTER HLTH | true |
| SUTTER HEALTH SACRAMENTO SIERRA REGION | ||||||||||
| PO BOX 160727 | SACRAMENTO | CA | 95816 | 941156621 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER INSURANCE SERVICES CORPORATION | ||||||||||
| 745 FORT STREET SUITE 800 | HONOLULU | HI | 96813 | 990289310 | INSURANCE SER | HI | 501(C)(3) | 11b - II | SUTTER HLTH | true |
| SUTTER MEDICAL CENTER FOUNDATION | ||||||||||
| PO BOX 160727 | SACRAMENTO | CA | 95816 | 942788906 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | true |
| SUTTER MEDICAL CENTER CASTRO VALLEY | ||||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 770146047 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER MEDICAL FOUNDATION | ||||||||||
| 2800 L STREET 7TH FLOOR | SACRAMENTO | CA | 95816 | 680273974 | HEALTHCARE | CA | 501(C)(3) | 11b - II | SUTTER HLTH | true |
| SUTTER ROSEVILLE MEDICAL CTR FOUNDATION | ||||||||||
| ONE MEDICAL PLAZA | ROSEVILLE | CA | 95661 | 680040113 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | true |
| SUTTER SOLANO CHARITABLE FOUNDATION | ||||||||||
| 300 HOSPITAL DRIVE | VALLEJO | CA | 94589 | 942668262 | FUNDRAISING | CA | 501(C)(3) | 7 | SUTTER SSR | true |
| SUTTER VISITING NURSE ASSOC AND HOSPICE | ||||||||||
| 1900 POWELL ST 300 | EMERYVILLE | CA | 94608 | 946068843 | HEALTHCARE | CA | 501(C)(3) | 9 | SUTTER HLTH | true |
| SUTTER WEST BAY HOSPITALS | ||||||||||
| 2333 BUCHANAN STREET | SAN FRANCISCO | CA | 94115 | 940562680 | HOSPITAL | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| SUTTER WEST BAY MEDICAL FOUNDATION | ||||||||||
| 2015 STEINER STREET 1ST FLOOR | SAN FRANCISCO | CA | 94115 | 942948131 | HEALTHCARE | CA | 501(C)(3) | 3 | SUTTER HLTH | true |
| TRACY HOSPITAL FOUNDATION | ||||||||||
| 1420 N TRACY BLVD | TRACY | CA | 95376 | 680318845 | FUNDRAISING | CA | 501(C)(3) | 11a - I | SUTTER CVH | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType |
|---|---|---|---|---|---|---|---|---|
| MAGNETIC IMAGING AF | ||||||||
| 175 LENNON | WLN CK | CA | 94598 | 942953833 | PATIENT CARE | CA | NA | N/A |
| SURG CTR OF ABSMC | ||||||||
| 3875 TELEGRAPH | OAKLAND | CA | 94609 | 470946086 | OUTPATIENT SURG | CA | NA | N/A |
| ALTA CT SERVICES LP | ||||||||
| 175 LENNON | WLN CK | CA | 94598 | 943083464 | PATIENT CARE | CA | NA | N/A |
| CALIFORNIA PACIFIC ADV IMAGING LLC | ||||||||
| PO BOX 6102 | NOVATO | CA | 94948 | 562311840 | MRI JOINT VENTURE | CA | NA | N/A |
| SAN FRANCISCO ENDOSCOPY CENTER LLC | ||||||||
| 3000 RIVERCHASE | BIRMINGHAM | AL | 35244 | 912160588 | ENDOSCOPY JV | CA | NA | N/A |
| PRESIDIO SURGERY CENTER LLC | ||||||||
| 1635 DIVISADERO | SF | CA | 94115 | 320144060 | AMBULATORY SURG | CA | NA | N/A |
| SUTTER FAIRFIELD SURGERY CTR | ||||||||
| 2700 LOW CT | FAIRFIELD | CA | 94533 | 300233892 | SURGERY | CA | NA | N/A |
| TWIN CITIES SURGICAL HOSPITAL LLC | ||||||||
| 250 S WACKER | CHICAGO | IL | 60606 | 352182617 | SURGERY | CA | NA | N/A |
| SUTTER AMADOR SURGERY CENTER LLC | ||||||||
| 2200 RIVER PLAZA DRIVE | SACRAMENTO | CA | 95833 | 461398093 | SURGERY | CA | NA | N/A |
| ROSEVILLE ENDOPSCOPY CENTER LLC | ||||||||
| 4 MEDICAL PLAZA SUITE 210 | ROSEVILLE | CA | 95661 | 870710513 | ENDOSCOPY JV | CA | NA | N/A |
| MEMORIAL MEDICAL OFFICE BUILDING PRTNR I | ||||||||
| 1800 COFFEE RD SUITE 76 | MODESTO | CA | 95355 | 770287288 | OFFICE RENTAL | CA | NA | N/A |
| MEMORIAL MEDICAL OFFICE BUILDING PRTNR I | ||||||||
| 1800 COFFEE RD SUITE 76 | MODESTO | CA | 95355 | 770287288 | OFFICE RENTAL | CA | NA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH VENTURES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 HAWTHORNE ST | AddressLine1 |
| City | OAKLAND | City |
| State | CA | State |
| ZIP Code | 94609 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942918780 | EIN |
| Primary Activity | HEALTH SERVICE | PrimaryActivity |
| Legal Domicile State | CA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Controlled Org | true | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |