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DIAGNOSTIC CENTER PVHMC Imaging Chino Hills

2140 Grand Avenue STE 125 CHINO HILLS CA 91709

DIAGNOSTIC CENTER PVHMC Milestone Physical Therapy Center

1775 Monte Vista Avenue Claremont CA 91711

REHABILITATION CENTER PVHMC Covina OP Physical Therapy Clinic

420 W Rowland Street Covina CA 91723

REHABILITATION CENTER PVHMC Physical Therapy Chino Hills

2140 Grand Avenue STE 125 Chino Hills CA 91709

REHABILITATION CENTER Pomona Valley Health Center

1770 N Orange Grove POMONA CA 91767

OUTPATIENT PHYSICIAN CLINIC PVHC Claremont Urgent Care

1601 Monte Vista Avenue CLAREMONT CA 91711

OUTPATIENT PHYSICIAN CLINIC PVHC Crossroads Urgent Care

3110 Chino Avenue STE 150 CHINO HILLS CA 91709

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1601 Monte Vista Avenue Claremont CA 91711

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1601 Monte Vista Avenue CLAREMONT CA 91711

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2140 Grand Avenue STE 125 Chino Hills CA 91709

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3110 Chino Avenue STE 150 CHINO HLLS CA 91709

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13768 Roswell Avenue STE 103 CHINO HILLS CA 91709

DIAGNOSTIC CENTER Pomona Clinic Coalition

Park Avenue POMONA CA 91767

COMMUNITY CLINIC PVHMC Imaging Western University

309 Pomona Mall POMONA CA 91767

DIAGNOSTIC CENTER PVHMC Claremont Aquatic Therapy Pool

481 S Indian Hill Blvd CLAREMONT CA 91711

REHABILITATION CENTER PART I, LINES 7B & 7I THE CALIFORNIA HOSPITAL FEE PROGRAM (THE PROGRAM) WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA AND BECAME EFFECTIVE ON JANUARY 1, 2010. AMENDING LEGISLATION, TO CONFORM TO CHANGES REQUESTED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) DURING THE APPROVAL PROCESS, WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA AND BECAME EFFECTIVE SEPTEMBER 8, 2010. THE PRIMARY LEGISLATION (AB 1383) AND AMENDING LEGISLATION (AB 1653) CONTAIN TWO COMPONENTS. THE QUALITY ASSURANCE FEE ACT GOVERNS THE "HOSPITAL FEE" OR "QUALITY ASSURANCE FEE" (QA FEE) PAID BY PARTICIPATING HOSPITALS. THE MEDI-CAL HOSPITAL PROVIDER STABILIZATION ACT GOVERNS SUPPLEMENTAL MEDI-CAL PAYMENTS (SUPPLEMENTAL PAYMENTS) MADE TO PROVIDERS FROM THE FUND. HOSPITAL PARTICIPATION IS MANDATORY WITH LIMITED EXCEPTIONS. THE QAF ACT WAS FURTHER EXPANDED FOR 30 MONTHS FROM JULY 1, 2011 THROUGH DECEMBER 31, 2013 WITH SB 335 AND SB 920. THE 30-MONTH PROGRAM IS THE THIRD HOSPITAL FEE IMPLEMENTED IN CALIFORNIA, AND IT DECOUPLES THE FEE-FOR-SERVICE PAYMENT WAS APPROVED IN JUNE 2012. THE MANAGED CARE PORTION OF THE PAYMENT IS PENDING CMS APPROVAL AT WHICH TIME THE RESPECTIVE PAYMENT WILL BE RECORDED. THE MEDICAL CENTER MADE PAYMENTS TO DHCS AND RECORDED THE AMOUNT IN THE CONSOLIDATED STATEMENT OF OPERATIONS FOR THE QA FEE IN THE AMOUNT OF $37,489,862 IN 2012 INCLUDED ON SCHEDULE H, PART I, LINE 7B, COLUMN C. THE MEDICAL CENTER ALSO MADE PLEDGE PAYMENTS OF $2,521,277 IN 2012 TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST IN CONJUNCTION WITH THE PROGRAM, WHICH IS REPORTED ON SCHEDULE H, PART I, LINE 7I, COLUMN C. THE MEDICAL CENTER RECOGNIZED SUPPLEMENTAL PAYMENTS OF APPROXIMATELY $74,345,363 IN 2012 INCLUDED ON SCHEDULE H, PART I, LINE 7B, COLUMN D, WHICH PERTAINS TO THE PERIOD JANUARY 1, 2012 TO JUNE 30, 2012. THE INCLUSION OF THESE AMOUNTS ON LINE 7B OF PART I IN THE CURRENT YEAR DECREASES THE PERCENTAGE OF THE TOTAL EXPENSE, AS COMPARED TO 2009 (THE LAST YEAR BEFORE THE PROGRAM WAS IN EFFECT). PART I, LINES 7A-7I LINE 7A USED COST-TO-CHARGE METHODOLOGY. LINE 7B USED COST-TO-CHARGE METHODOLOGY. LINE 7C USED COST-TO-CHARGE METHODOLOGY. LINE 7E USED ACTUAL AMOUNTS PER THE GENERAL LEDGER. LINE 7F ACTUAL AMOUNTS PER THE GENERAL LEDGER. LINE 7G ACTUAL AMOUNTS PER THE GENERAL LEDGER. HEALTH PROFESSION EDUCATION PART I, LINE 7F POMONA VALLEY HOSPITAL MEDICAL CENTER'S FAMILY MEDICINE RESIDENCY PROGRAM IS COMMITTED TO CREATING A HEALTHY COMMUNITY IN THE POMONA VALLEY REGION. IN REALIZING THIS COMMITMENT, THE RESIDENCY PROGRAM TRAINS 18 PHYSICIANS EACH YEAR TO DEVELOP OUTSTANDING CLINICAL SKILLS, COMPASSION, AND EXCELLENT COMMUNICATION AND LEADERSHIP ABILITIES. THE RESIDENCY IS AFFILIATED WITH THE DAVID GEFFEN SCHOOL OF MEDICINE AT UCLA. PART I, LINE 7G NONE OF THE MONEY IDENTIFIED UNDER THE SUBSIDIZED HEALTH SERVICES CATEGORY PERTAINS TO A PHYSICIAN CLINIC IN OUR COMMUNITY BENEFIT REPORT. COMMUNITY BUILDING ACTIVITIES PART II POMONA VALLEY HOSPITAL MEDICAL CENTER PARTICIPATES ON THE STEERING COMMITTEE FOR THE LOS ANGELES COUNTY SERVICE PLANNING AREA (SPA 3'S) HEALTH PLANNING GROUP AND SPECIALTY CARE COALITION. WE PARTICIPATE TO LOOK AT ACCESS TO CARE, PROMOTION OF HEALTH AND ACCESS AND AVAILABILITY OF SPECIALTY CARE. POMONA VALLEY HOSPITAL MEDICAL CENTER ASSISTS LOCAL SCHOOLS (E.G. CHAFFEY COLLEGE, WESTERN UNIVERSITY OF HEALTH SCIENCES, MOUNT SAN ANTONIO COLLEGE, CITRUS COLLEGE) IN MEETING REQUIREMENTS FOR THEIR NURSING PROGRAMS, OUR EDUCATION DEPARTMENT SERVES ON THE ADVISORY BOARDS TO THESE SCHOOLS. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINES 3 & 8 OF PART II AS COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. POMONA VALLEY HOSPITAL MEDICAL CENTER SUPPORTS THE ECONOMIC DEVELOPMENT OF THE COMMUNITY BY ALLOWING LOCAL NOT-FOR-PROFIT ORGANIZATION TO PARTICIPATE IN CREATING A SPONSORSHIP AD FOR THEIR ORGANIZATION IN OUR HOSPITAL'S PROGRAM BOOKS FOR COMMUNITY EVENTS. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINE 2 OF PART II AS COMMUNITY SUPPORT. POMONA VALLEY HOSPITAL MEDICAL CENTER IS ONE OF 13 DESIGNATED DISASTER RESOURCE CENTERS (DRC) IN LOS ANGELES COUNTY AS PART OF THE NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS PROGRAM. AS THE DRC FOR THE REGION, POMONA VALLEY HOSPITAL MEDICAL CENTER IS RESPONSIBLE FOR 10 "UMBRELLA" FACILITIES IN THE AREA AND COORDINATES DRILLS, TRAINING, AND SHARING OF PLANS TO BRING TOGETHER THE COMMUNITY AND OUR RESOURCES FOR DISASTER PREPAREDNESS. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINES 3 & 8 OF PART II AS COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. PART III, LINE 2 COSTING METHODOLOGY USED IS COST-TO-CHARGE RATIO USING WORKSHEET 2 AND WORKSHEET A. WHEN A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED FROM A PATIENT, THE PATIENT'S ACCOUNT IS ASSIGNED A SPECIFIC USER DEFINED CODE. THIS CODE ALLOWS THE HOSPITAL TO IDENTIFY ALL ACCOUNTS PENDING FINANCIAL ASSISTANCE REVIEW AND PREVENTS THE ACCOUNT FROM PROGRESSING THROUGH THE NORMAL COLLECTION PROCESS. AFTER THE FINANCIAL ASSISTANCE APPLICATION AND THE PATIENT'S REQUIRED SUPPORTING DOCUMENTATION IS REVIEWED, THE PATIENT IS INFORMED OF THE RESULTS OF THE REVIEW OF THEIR APPLICATION. IF THE PATIENT'S APPLICATION IS APPROVED, THE ACCOUNT BALANCE IS ADJUSTED ACCORDING TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IF THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE USER DEFINED CODE IS REMOVED AND THE ACCOUNT PROCEEDS THROUGH THE NORMAL COLLECTION CYCLE WHICH ENDS IN A TRANSFER TO A COLLECTION AGENCY IF THE PATIENT FAILS TO PAY THEIR BALANCE IN FULL. PART III, LINE 3 COSTING METHODOLOGY USED IS COST-TO-CHARGE RATIO USING WORKSHEET 2 AND WORKSHEET A. ACCOUNTS RETURNED FROM THE COLLECTION AGENCY ARE WRITTEN OFF TO BAD DEBT EXPENSE. LINE 3 CONSISTS OF AMOUNTS WRITTEN OFF DUE TO INCOMPLETE RECORDS FOR PATIENTS WHO LIKELY QUALIFIED FOR CHARITY CARE. PART III, LINE 4 COSTING METHODOLOGY USED IS COST-TO-CHARGE RATIO USING WORKSHEET 2 AND WORKSHEET A. THE HOSPITAL'S FINANCIAL STATEMENT INCLUDES A BAD DEBT FOOTNOTE REGARDING FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ACCOUNTING STANDARDS UPDATE(ASU) NO. 2011-07, "HEALTH CARE ENTITIES" (TOPIC 954) REGARDING THE PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES. THE BAD DEBT FOOTNOTE CAN BE FOUND ON PAGE TEN OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 THE COSTING METHOD USED IS COST TO CHARGE RATIO. THE SOURCE OF INFORMATION IS THE MEDICARE COST REPORT. PART III, LINE 9B THE CREDIT & COLLECTIONS DEPARTMENT SENDS A STATEMENT TO EACH PATIENT/GUARANTOR AS NOTIFICATION OF THE PATIENT RESPONSIBILITY AND AMOUNT DUE. IF THE PATIENT HAS INSURANCE COVERAGE, THE CHARGES INCURRED ARE BILLED TO THE INSURANCE PLAN/CARRIER PROVIDED BY THE PATIENT AND VERIFIED AS ELIGIBLE COVERAGE BY POMONA VALLEY HOSPITAL MEDICAL CENTER STAFF. THE AMOUNT BILLED TO THE PATIENT IS THE AMOUNT DETERMINED BY THE INSURANCE CARRIER AS PATIENT RESPONSIBILITY. FOR UNINSURED PATIENTS, A COMPLETE ITEMIZED STATEMENT OF CHARGES IS MAILED TO THE PATIENT. THE HOSPITAL SENDS FIRST PARTY LETTERS TO THE PATIENT WHEN BILLING THE PATIENT THEIR PORTION AFTER INSURANCE HAS PAID OR THEIR BALANCE IF UNINSURED. FIRST PARTY LETTERS ARE GENERATED FROM THE PATIENT ACCOUNTING FINANCIAL SYSTEM AND MAILED TO EACH PATIENT/GUARANTOR IN AN EFFORT TO COLLECT MONIES OWED. THE LETTER SERIES CONSISTS OF THREE SYSTEM GENERATED LETTERS. EACH LETTER MAILED INDICATES THE AMOUNT OWED AND INSTRUCTS THE PATIENT TO CONTACT THE BUSINESS OFFICE TO DISCUSS THEIR OPTIONS AND/OR MAKE PAYMENT ARRANGEMENTS. IF THE PATIENT CALLS AND EXPRESSES AN INABILITY TO PAY, THE BUSINESS OFFICE ASSOCIATE WILL EXPLAIN THE OPTIONS AVAILABLE INCLUDING 1) A MONTHLY INSTALLMENT OPTION AT NO INTEREST IF PAID WITHIN 12 MONTHS OR AN AGREED UPON PERIOD, 2) PATIENTS WITHOUT INSURANCE ARE OFFERED A PROMPT PAY DISCOUNT, GREATLY DISCOUNTING THEIR BALANCE IF PAID WITHIN 30 DAYS, AND 3) WHEN A PATIENT EXPRESSES AN INABILITY TO PAY, THE PATIENT IS INFORMED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND IF THE PATIENT IS INTERESTED, A FINANCIAL ASSISTANCE APPLICATION IS MAILED TO THE PATIENT. IF THE PATIENT FAILS TO RESPOND TO THE FIRST STATEMENT/ LETTER MAILED TO THE PATIENT, A PHONE CALL IS PLACED. DURING THE CALL, THE OPTIONS ABOVE ARE SHARED WITH THE PATIENT. IF THE COLLECTOR IS UNABLE TO CONTACT THE PATIENT BY PHONE DUE TO A DISCONNECTED PHONE NUMBER, AN "UNABLE TO REACH BY PHONE" LETTER IS SENT TO THE PATIENT. THIS LETTER INFORMS THE PATIENT OF PAYMENT ARRANGEMENT OPTIONS AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO ASSIST THEM WITH THEIR FINANCIAL OBLIGATIONS. A SECOND STATEMENT IS MAILED TO THE PATIENT ADVISING THE PATIENT TO CONTACT THE BUSINESS OFFICE IF THE PATIENT IS UNABLE TO REMIT THE FULL AMOUNT DUE. IF AND WHEN A PATIENT CALLS THE BUSINESS OFFICE IN RESPONSE TO PVHMC'S COLLECTION CORRESPONDENCE, THE PATIENT IS INFORMED OF THE VARIOUS FINANCIAL ASSISTANCE OPTIONS. IN THE EVENT A PATIENT HAS A QUESTION IN COMPLETING THE APPLICATION, THE BUSINESS OFFICE SUPERVISOR, MANAGER AND/OR DIRECTOR ARE AVAILABLE TO ASSIST THE PATIENT IN COMPLETING THE APPLICATION. PART V, LINE 14G THE HOSPITAL FACILITY PUBLICIZED THE FINANCIAL ASSISTANCE POLICY BY MAKING A SUMMARY AVAILABLE IN THE FOLLOWING WAYS: - ATTACHING TO BILLING INVOICES - POSTING IN THE EMERGENCY/WAITING ROOMS - POSTING IN THE ADMISSIONS OFFICES - PROVIDING, IN WRITING, TO PATIENTS ON ADMISSION TO THE HOSPITAL - PROVIDING THE POLICY UPON REQUEST PART V, LINE 19 THE MAXIMUM INPATIENT RATES CHARGED TO PATIENTS ELIGIBLE FOR THE HOSPITAL'S FAP PROGRAM ARE ON A SLIDING SCALE: 200% OR BELOW ARE FULLY WRITTEN OFF. 200-300% PRICING COMPARABLE TO MEDI-CAL RATES. 300-400% PRICING BASED ON MEDICARE FEE SCHEDULE. 400-500% PRICING BASED ON WORKERS COMP FEE SCHEDULE. SINCE THE HOSPITAL'S FAP COVERS PATIENTS WITH INCOME UP TO 500% FPG AND THE CALIFORNIA GOVERNMENT REQUIREMENT IS 350% FPG, WE PROVIDE FINANCIAL ASSISTANCE TO MORE PATIENTS THAN WE ARE REQUIRED TO. NEEDS ASSESSMENT PART VI, LINE 2 IN 2012, A COMMUNITY NEEDS ASSESSMENT WAS COMPLETED BY RESEARCHERS FROM A LOCAL UNIVERSITY. OUR METHODOLOGY INCLUDED COLLECTING PRIMARY DATA FROM A RANDOM SAMPLE OF RESIDENTS LIVING IN THE HOSPITAL'S PRIMARY SERVICE AREA THROUGH TELEPHONE SURVEYS GIVEN IN BOTH ENGLISH AND SPANISH. INFORMATION GATHERED FROM THE NEEDS ASSESSMENT INCLUDED DEMOGRAPHIC PROFILE AND SELF-REPORTED HEALTH EVALUATION, HEALTH INSURANCE COVERAGE, BARRIERS TO RECEIVING NEEDED HEALTH SERVICES, UTILIZATION OF HEALTH CARE SERVICES FOR ROUTINE PRIMARY/PREVENTATIVE CARE, UTILIZATION OF URGENT CARE SERVICES, NEED FOR SPECIALTY HEALTH CARE, AND EXPERIENCE WITH POMONA VALLEY HOSPITAL MEDICAL CENTER (INCLUDING VISITS TO THE EMERGENCY DEPARTMENT, OR THROUGH EDUCATION). PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 PUBLIC NOTICE: PUBLIC NOTICES ARE POSTED IN PVHMC'S REGISTRATION AND BILLING AREAS NOTIFYING PATIENTS, FAMILY AND GENERAL PUBLIC THAT WE OFFER CHARITABLE ASSISTANCE TO THOSE WHO QUALIFY. THE NOTICE PROVIDES A BUSINESS OFFICE PHONE NUMBER WHERE THEY MAY CONTACT A BUSINESS OFFICE REPRESENTATIVE TO OBTAIN ADDITIONAL INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS. THE NOTICES ARE POSTED IN BOTH ENGLISH AND SPANISH. THESE PUBLIC POSTINGS ARE LOCATED IN THE AREAS LISTED BELOW: - ADMITTING REGISTRATION SITE I - ADMITTING REGISTRATION SITE II - ADMITTING REGISTRATION LAB - ADMITTING REGISTRATION PRE OPERATIVE UNIT - CASHIERS OFFICE - ADMITTING SOUTH REGISTRATION - ADMITTING WOMEN'S CENTER REGISTRATION - ADMITTING EMERGENCY REGISTRATION - OFF-SITE INSURANCE VERIFICATION - CONTRACTS BILLING SUITE 120 AND 160 - BUSINESS SERVICES SYSTEMS - GOVERNMENT AND PATIENT BILLING FINANCIAL COUNSELING - EMERGENCY SERVICES: AN ELIGIBILITY LIAISON IS STAFFED IN THE EMERGENCY SERVICES DEPARTMENT AT TIMES WHEN HIGH VOLUMES ARE EXPECTED, SUNDAY THROUGH FRIDAY, 12:00 PM TO 10:30 PM, TO ASSIST OUR UNINSURED OR UNDERINSURED PATIENTS WITH POSSIBLE LINKS TO MEDI-CAL, THE STATE OF CALIFORNIA'S MEDICAID PROGRAM OR REFERRALS TO CHARITY ASSISTANCE. - PRIOR TO ELECTIVE SERVICE: FINANCIAL COUNSELORS FROM OUR INSURANCE VERIFICATION DEPARTMENT ARE AVAILABLE TO MEET WITH PATIENTS PRIOR TO RENDERING MEDICAL SERVICES TO DISCUSS POSSIBLE LINKS TO GOVERNMENT PROGRAMS SUCH AS MEDI-CAL, HEALTHY FAMILIES, MEDICARE OR OTHER FINANCIAL ASSISTANCE PROGRAMS OFFERED BY PVHMC. FINANCIAL COUNSELORS MAY REFER PATIENTS TO PVHMC'S ELIGIBILITY SERVICES DEPARTMENT FOR ASSISTANCE IN APPLYING FOR GOVERNMENT PROGRAMS. FINANCIAL COUNSELORS ALSO DISTRIBUTE AND ASSIST PATIENTS IN COMPLETING THE UNCOMPENSATED CARE APPLICATION. FOR THOSE PATIENTS WHO HAVE THE ABILITY TO PAY, FINANCIAL OPTIONS ARE DISCUSSED AND PAYMENT ARRANGEMENTS ARE ESTABLISHED. - DURING A PATIENT'S CONFINEMENT: FINANCIAL COUNSELORS ARE ALSO ASSIGNED TO ALL UNINSURED OR UNDERINSURED PATIENTS ADMITTED TO PVHMC IF FINANCIAL COUNSELING DID NOT OCCUR IN ADVANCE OF THE ADMISSION OR DURING THE EMERGENCY VISIT. THE FINANCIAL COUNSELOR PROVIDES THE SAME LEVEL OF SERVICE TO THESE PATIENTS AS DESCRIBED ABOVE UNDER "PRIOR TO ELECTIVE SERVICE." ELIGIBILITY SERVICES: PATIENTS MAY BE REFERRED TO OUR ELIGIBILITY SERVICES TEAM WHO ASSIST OUR PATIENTS WITH LINKS TO MEDI-CAL AND THE HEALTH FAMILIES PROGRAMS. THE ELIGIBILITY SERVICES REPRESENTATIVES ASSIST THE PATIENT IN COMPLETING THE PROGRAM APPLICATION(S) AND SUBMIT THE COMPLETED APPLICATION TO THE APPLICABLE PROGRAM ON BEHALF OF THE PATIENT. IF THE PATIENT DOES NOT QUALIFY FOR MEDI-CAL OR THE HEALTHY FAMILIES PROGRAM, THE PATIENT IS PROVIDED INFORMATION REGARDING THE FOLLOWING ASSISTANCE PROGRAMS: - ACCESS FOR INFANTS & MOTHERS (AIM): COVERS OBSTETRIC PATIENTS WHO ARE AT HIGHER INCOME LEVELS AND ARE NOT ELIGIBLE FOR MEDI-CAL - OUTPATIENT REDUCED-COST SIMPLIFIED APPLICATION (ORSA): LOS ANGELES COUNTY PROGRAM FOR ADULTS WHO DO NOT QUALIFY FOR MEDI-CAL AND RESIDE WITHIN LOS ANGELES COUNTY - PUBLIC PRIVATE PARTNERSHIP PROGRAM (PPP ALSO KNOWN AS THE PCC PROGRAM): LOS ANGELES COUNTY PROGRAM FOR ADULTS WHO DO NOT QUALIFY FOR MEDI-CAL AND RESIDE WITHIN LOS ANGELES COUNTY IN POMONA AND SURROUNDING COMMUNITIES - MEDICALLY INDIGENT ADULT PROGRAM (MIA): FOR ADULTS WHO DO NOT QUALIFY FOR MEDI-CAL AND RESIDE WITHIN SAN BERNARDINO COUNTY BILLING: FIRST PARTY LETTERS ARE GENERATED FROM THE PATIENT ACCOUNTING FINANCIAL SYSTEM AND MAILED TO EACH PATIENT/GUARANTOR IN AN EFFORT TO COLLECT MONIES OWED. THE LETTERS PROVIDE THE PHONE NUMBER AND BUSINESS HOURS OF THE HOSPITAL'S BUSINESS OFFICE. THE CUSTOMER SERVICE REPRESENTATIVES IN THE BUSINESS OFFICE ARE AVAILABLE TO DISCUSS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS AND MAKE PAYMENT ARRANGEMENTS. A CHARITY LIAISON IS ALSO AVAILABLE TO ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. ENGLISH AS A SECOND LANGUAGE ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN SPANISH IN ADDITION TO THE AVAILABILITY OF BILINGUAL STAFF IN ALL ADMITTING AND REGISTRATION AREAS, ELIGIBILITY SERVICES AND THE BUSINESS OFFICE. THE STAFF IN ALL PATIENT ACCESS AND BILLING AREAS HAS BEEN TRAINED ON ACCESSING EXTERNAL INTERPRETATIVE SERVICES WHEN PATIENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AND SPANISH. TRAINING: IN DECEMBER 2007, ALL PATIENT ACCESS AND BILLING OFFICE STAFF WERE TRAINED ON THE REQUIREMENTS OF AB774 AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE STAFF IS UPDATED ON THE HOSPITAL'S POLICY ON AN AS NEEDED BASIS. BEGINNING IN 2010, KEY PATIENT ACCESS STAFF AND PATIENT COLLECTION STAFF WILL BE UPDATED ON BOTH THE FINANCIAL ASSISTANCE AND CREDIT AND COLLECTION POLICIES AT LEAST ANNUALLY. ANNUAL REVIEW OF FINANCIAL ASSISTANCE PROGRAM: THE PATIENT FINANCIAL ASSISTANCE PROGRAM POLICY IS REVIEWED ANNUALLY FOR ANY SIGNIFICANT CHANGES TO THE DISCOUNT PAYMENT, CHARITY, ELIGIBILITY PROCEDURES AND REVIEW PROCESS. THE BUSINESS OFFICE IS RESPONSIBLE FOR THE ELECTRONIC SUBMISSION OF THE APPROVED POLICY AND ANY APPLICABLE CHANGES TO OSHPD IN ACCORDANCE TO TITLE 22, SECTIONS 96040-96050. COMMUNITY INFORMATION PART VI, LINE 4 OUR MISSION - PVHMC IS A NOT-FOR-PROFIT REGIONAL MEDICAL CENTER DEDICATED TO PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE SERVICES TO RESIDENTS OF THE GREATER POMONA VALLEY. THE MEDICAL CENTER OFFERS A FULL RANGE OF SERVICES FROM LOCAL PRIMARY ACUTE CARE TO HIGHLY SPECIALIZED REGIONAL SERVICE. SELECTION OF ALL SERVICES IS BASED ON COMMUNITY NEED, AVAILABILITY OF FINANCING AND THE ORGANIZATION'S TECHNICAL ABILITY TO PROVIDE HIGH QUALITY RESULTS. BASIC TO OUR MISSION IS OUR COMMITMENT TO STRIVE CONTINUOUSLY TO IMPROVE THE STATUS OF HEALTH BY REACHING OUT AND SERVING THE NEEDS OF OUR DIVERSE ETHNIC, RELIGIOUS AND CULTURAL COMMUNITY. OUR PATIENTS- IN 2012, POMONA VALLEY HOSPITAL MEDICAL CENTER REGISTERED 170,466 PATIENTS FOR SERVICES. AMONG THOSE, 21,039 WERE INPATIENT ADMISSIONS, 83,402 WERE ED VISITS, AND 6,919 WERE DELIVERIES. THE REMAINDER IS COMPRISED OF SURGERIES, OUTPATIENT VISITS, AND AMBULATORY SERVICES. A TOTAL OF 78,219 PATIENTS IN 2012 WERE UNINSURED OR MEDI-CAL RECIPIENTS, REPRESENTING 45.6% OF OUR TOTAL PATIENT POPULATION. OUR COMMUNITY - PVHMC IS DEDICATED TO MEETING THE HEALTH CARE DEMANDS OF THE GROWING POPULATIONS OF LOS ANGELES AND SAN BERNARDINO COUNTIES. OUR PRIMARY SERVICE AREA IS DEFINED AS THE CITIES OF POMONA, CLAREMONT, CHINO, CHINO HILLS, LA VERNE, MONTCLAIR, ONTARIO, RANCHO CUCAMONGA, ALTA LOMA, UPLAND AND SAN DIMAS AND MAKE UP A POPULATION OF 840,789. ACCORDING TO THE OFFICE OF STATEWIDE HEALTH AND PLANNING 2012 DATA, POMONA EAST AND SOUTH ARE DESIGNATED AS A MEDICALLY UNDERSERVED AREA, SPECIFICALLY AS AN AREA WITH A PRIMARY CARE SHORTAGE. BASED ON THE 2010 CENSUS, THE ETHNIC DIVERSITY OF POMONA IS SUCH THAT 48.0% ARE WHITE, 70.5% ARE HISPANIC OR LATINO, 7.3% ARE BLACK OR AFRICAN AMERICAN, 1.2% ARE AMERICAN INDIAN, 8.5% ARE ASIAN, 0.2% ARE HAWAIIAN OR PACIFIC ISLANDER, 30.3% IDENTIFY AS OTHER, AND 4.5% IDENTIFY AS TWO OR MORE RACES. ACCORDING TO THE 2006-2010 AMERICAN COMMUNITY SURVEY 5 YEAR ESTIMATES, RETRIEVED FROM THE CALIFORNIA DEPARTMENT OF FINANCE, POMONA'S MEDIAN HOUSEHOLD INCOME IS $50,497, WITH 14.3% OF FAMILIES LIVING BELOW THE FEDERAL POVERTY LEVEL. EDUCATIONAL ATTAINMENT DATA WAS ALSO RETRIEVED FROM THE 2006-2010 ACS SURVEY, SHOWING 21.1% OF POMONA RESIDENT'S OVER THE AGE OF 25 HAVE LESS THAN A 9TH GRADE EDUCATION LEVEL, 15.7% HAVE COMPLETED LESS THAN 12TH GRADE, 26.0% HAVE A HIGH SCHOOL DIPLOMA, 6.1% HAVE AN ASSOCIATE'S DEGREE, 10.2% HAVE A BACHELOR'S DEGREE, AND 4.0% HAVE EARNED A GRADUATE OR PROFESSIONAL DEGREE. MARKET SHARE- SEVERAL OTHER HOSPITALS SERVE OUR COMMUNITY. THESE HOSPITALS ARE KAISER FOUNDATION HOSPITAL OF FONTANA, SAN ANTONIO COMMUNITY HOSPITAL, CHINO VALLEY MEDICAL CENTER, ARROWHEAD REGIONAL MEDICAL CENTER, MONTCLAIR HOSPITAL MEDICAL CENTER, LOMA LINDA UNIVERSITY MEDICAL CENTER, CANYON RIDGE HOSPITAL, KAISER FOUNDATION HOSPITAL OF BALDWIN PARK, COMMUNITY HOSPITAL OF SAN BERNARDINO, SAN DIMAS COMMUNITY HOSPITAL, AND CITRUS VALLEY HEALTH PARTNERS-QUEEN OF THE VALLEY CAMPUS. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 POMONA VALLEY HOSPITAL MEDICAL CENTER IS GOVERNED BY A BOARD OF DIRECTORS WHOSE MEMBERS ARE REPRESENTATIVE OF THE COMMUNITY, HOSPITAL AND MEDICAL STAFF LEADERSHIP. CONSISTENT WITH THE IRS "COMMUNITY BENEFIT STANDARD" A MAJORITY OF THE BOARD OF DIRECTORS ARE NEITHER EMPLOYEES, CONTRACTORS OR FAMILY MEMBERS OF THE ORGANIZATION. POMONA VALLEY HOSPITAL MEDICAL CENTER IS A COMMUNITY BASED, DISPROPORTIONATE SHARE HOSPITAL. IN ADDITION, WE PARTICIPATE IN MEDICARE, MEDICAL, CHAMPUS, TRICARE. POMONA VALLEY HOSPITAL MEDICAL CENTER IS AN OPEN MEDICAL STAFF, EXTENDING STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS FOR ALL AREAS AND DEPARTMENTS OF OUR FACILITY. POMONA VALLEY HOSPITAL MEDICAL CENTER IS HOME TO THE ONLY 24-HOURS-A-DAY, FULL SERVICE EMERGENCY DEPARTMENT (ED) IN POMONA. OUR ED TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY; POMONA VALLEY HOSPITAL MEDICAL CENTER PROVIDES EMERGENCY SERVICES TO ALL PATIENTS WITH OR WITHOUT INSURANCE. THE EMERGENCY DEPARTMENT'S DEDICATED STAFF IS EXPERIENCED IN PROVIDING PROMPT, ACCURATE DIAGNOSIS AND SKILLFUL MEDICAL TREATMENT. THIS EXPERT TEAM INCLUDES BOARD-CERTIFIED EMERGENCY PHYSICIANS, PHYSICIAN ASSISTANTS, BOARD CERTIFIED NURSES, EMERGENCY MEDICAL TECHNICIANS, RESPIRATORY THERAPISTS AND OTHER HIGHLY TRAINED EMERGENCY CARE PROFESSIONALS. ALL ARE DEDICATED TO PROVIDING TECHNOLOGICALLY ADVANCED, LIFESAVING MEDICAL SERVICES WITH COMPASSIONATE, CULTURALLY APPROPRIATE CARE. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 POMONA VALLEY HOSPITAL MEDICAL CENTER IS A STAND ALONE HOSPITAL, NOT PART OF A HEALTH CARE SYSTEM. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 CALIFORNIA false CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K STREET STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 1991971 HOSPITAL FEE PROGRAM BOYS REPUBLIC 1907 BOYS REPUBLIC DR CHINO HILLS CA 91709 951647813 501(C)(3) 5493 PROGRAM SUPPORT NATIONAL HEALTH FOUNDATION 515 S FIGUEROA ST LOS ANGELES CA 90071 237314808 501(C)(3) 30000 PROGRAM SUPPORT 3 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS FORM 990, SCHEDULE I, PART I, LINE 2 THE CALIFORNIA HOSPITAL FEE PROGRAM (THE PROGRAM) WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA AND BECAME EFFECTIVE ON JANUARY 1, 2010. THE HOSPITAL MADE PLEDGE PAYMENTS (GRANT) TO THE CALIFORNIA HEALTH FOUNDATION & TRUST TOTALING $2,521,277 IN CONJUNCTION WITH THIS PROGRAM. NO MONITORING IS COMPLETED AFTER THE GRANT IS MADE. X X X X X false true false false false false false false false RICHARD YOCHUM 572703 0 128750 0 13736 0 252060 0 23688 0 990937 0 0 0 MICHAEL NELSON 378518 0 75704 0 10588 0 93689 0 23418 0 581917 0 0 0 KURT WEINMEISTER 347002 0 0 0 6375 0 0 0 16136 0 369513 0 0 0 CHRIS ALDWORTH 198870 0 0 0 9092 0 14779 0 33071 0 255812 0 0 0 JULI HESTER 211538 0 40000 0 7050 0 12000 0 33350 0 303938 0 0 0 DARLENE SCAFFIDDI 255423 0 43264 0 31962 0 17306 0 33088 0 381043 0 0 0 KENNETH K NAKAMOTO 290293 0 38123 0 14877 0 12500 0 30661 0 386454 0 0 0 KENT HOYOS 285961 0 53000 0 4051 0 15000 0 29800 0 387812 0 0 0 JAMES MCL DALE 219800 0 31200 0 5095 0 9308 0 23489 0 288892 0 0 0 JOSEPH BAUMGARTNER 212414 0 34767 0 6216 0 16499 0 32899 0 302795 0 0 0 RAY INGE 231776 0 30900 0 5095 0 10327 0 36823 0 314921 0 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4B THE HOSPITAL HAS EMPLOYMENT CONTRACTS WITH MR. YOCHUM AND MR. NELSON. THE CONTRACTS PROVIDE FOR A PAYMENT OF 5.24 FOR MR. NELSON AND 4.77 FOR MR. YOCHUM TIMES ANNUAL CASH COMPENSATION IF THE EXECUTIVE REMAINS EMPLOYED UNTIL THE END OF THE CONTRACT. EMPLOYMENT REQUIREMENTS ARE 36 YEARS FOR MR. YOCHUM AND 34 YEARS FOR MR. NELSON. IN THE EVENT OF VOLUNTARY TERMINATION OR TERMINATION FOR CAUSE, ALL BENEFITS UNDER THE CONTRACT ARE FORFEITED. IN THE EVENT OF EARLY TERMINATION BECAUSE OF DEATH OR DISABILITY, A PRORATED BENEFIT WOULD BE PAID. THE CONTRACT AFFIRMS THE THE BOARD OF DIRECTORS HAS THE RIGHT TO TERMINATE THE CONTRACT, WITH OR WITHOUT CAUSE, AT ITS DISCRETION, AND PROVIDES A FORMULA FOR CALCULATING THE SEVERANCE PAYMENT IN THE EVENT OF INVOLUNTARY TERMINATION. ONCE THE EMPLOYEE HAS MET ALL VESTING REQUIREMENTS, AND THE AMOUNT IS NOT SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, THE AMOUNT IS INCLUDED IN OTHER REPORTABLE COMPENSATION (SCHEDULE J, PART II, B(III)). SCHEDULE J, PART II, COLUMN C INCLUDES DEFERRED COMPENSATION OF $232,060 FOR MR. YOCHUM AND $73,689 FOR MR. NELSON. PREMIER FAMILY MEDICINE SEE PART V 5555459 COMPENSATION FOR SERVICES false POMONA VALLEY IMAGING MED GRP SEE PART V 633219 PRINCIPAL & INT ON CAP LEASE false POMONA VALLEY IMAGING MED GRP SEE PART V 317332 COMPENSATION FOR SERVICES false SAN GABRIEL VALLEY PERINATAL MED GR SEE PART V 200000 COMPENSATION FOR SERVICES false GREGORY DALY SEE PART V 127956 COMPENSATION FOR SERVICES false BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV 1. GREG DHALQUIST, MD A DIRECTOR OF THE ORGANIZATION'S BOARD, IS A GREATER THAN 5% OWNER OF PREMIER FAMILY MEDICINE. 2 & 3. JOHNSON LIGHTFOOTE, MD, A DIRECTOR OF THE ORGANIZATION'S BOARD, IS A GREATER THAN 5% OWNER OF POMONA VALLEY IMAGING MEDICAL GROUP. 4. HELLEN RODRIGUEZ, MD, A DIRECTOR OF THE ORGANIZATION'S BOARD IS A GREATER THAN 5% OWNER OF SAN GABRIEL VALLEY PERINATAL MEDICAL GROUP. 5. GREGORY DALY IS THE BROTHER OF DARLENE SCAFFIDDI, A KEY EMPLOYEE OF THE ORGANIZATION. X MEDICAL EQUIPMENT 1 0 FMV false false false NON-CASH CONTRIBUTIONS SCHEDULE M, PART I, LINE 25 MEDICAL EQUIPMENT WAS DONATED TO THE HOSPITAL BY THE POMONA VALLEY HOSPITAL MEDICAL CENTER FOUNDATION, A RELATED ORGANIZATION. THE DONATION WAS NOT RECORDED ON THE HOSPITAL'S BOOKS. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 POMONA VALLEY HOSPITAL MEDICAL CENTER IS A NOT FOR PROFIT, REGIONAL MEDICAL CENTER DEDICATED TO PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE SERVICES TO RESIDENTS OF THE GREATER POMONA VALLEY. THE MEDICAL CENTER OFFERS A FULL RANGE OF SERVICES FROM LOCAL PRIMARY ACUTE CARE TO HIGHLY SPECIALIZED REGIONAL SERVICES. SELECTION OF ALL SERVICES IS BASED UPON COMMUNITY NEED, AVAILABILITY OF FINANCING, AND THE ORGANIZATION'S TECHNICAL ABILITY TO PROVIDE HIGH QUALITY RESULTS. BASIC TO OUR MISSION IS OUR COMMITMENT TO STRIVE CONTINUOUSLY TO IMPROVE THE STATUS OF HEALTH BY REACHING OUT AND SERVING THE NEEDS OF OUR DIVERSE COMMUNITY. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A POMONA VALLEY HOSPITAL MEDICAL CENTER (PVHMC) IS A 453-BED, FULLY ACCREDITED, ACUTE CARE HOSPITAL SERVING EASTERN LOS ANGELES AND WESTERN SAN BERNARDINO COUNTIES. A NATIONALLY RECOGNIZED, NOT-FOR-PROFIT FACILITY, THE HOSPITAL'S SERVICES INCLUDE CENTERS OF EXCELLENCE IN ONCOLOGY AND CANCER CARE, CARDIAC AND VASCULAR CARE, WOMEN'S AND CHILDREN'S SERVICES, AND KIDNEY STONES. SPECIALIZED SERVICES INCLUDING CENTERS FOR BREAST HEALTH, SLEEP DISORDERS, A NEONATAL ICU, A PERINATAL CENTER, PHYSICAL THERAPY/SPORTS MEDICINE, A FULL-SERVICE EMERGENCY DEPARTMENT WHICH INCLUDES OUR LOS ANGELES COUNTY AND SAN BERNARDINO COUNTY STEMI RECEIVING CENTER DESIGNATION, ROBOTIC SURGERY, AND THE FAMILY MEDICINE RESIDENCY PROGRAM AFFILIATED WITH UCLA. SATELLITE CENTERS IN CHINO HILLS, CLAREMONT AND POMONA PROVIDE A WIDE RANGE OF OUTPATIENT SERVICES INCLUDING PHYSICAL THERAPY, URGENT CARE, RADIOLOGY AND OCCUPATIONAL HEALTH. ADDITIONALLY, WE ARE PRIMARY STROKE CENTER CERTIFIED. THE JOINT COMMISSION RECENTLY NOTIFIED US THAT WE HAVE EARNED THE GOLD SEAL OF APPROVAL FOR CERTIFICATION AS A PRIMARY STROKE CENTER FOR LOS ANGELES COUNTY, ALONG WITH BEING NAMED ONE OF THOMSON REUTER'S 2011 50 TOP CARDIO HOSPITALS IN THE NATION DEMONSTRATES WHAT WE HAVE BEEN DOING ALL ALONG; PROVIDING QUALITY CARDIOVASCULAR CARE IN THE HEART OF OUR COMMUNITY. AS A COMMUNITY HOSPITAL, WE CONTINUOUSLY REFLECT UPON OUR RESPONSIBILITY TO PROVIDE HIGH QUALITY HEALTH CARE SERVICES, ESPECIALLY TO OUR MOST VULNERABLE POPULATIONS IN NEED, AND TO RENEW OUR COMMITMENT WHILE FINDING NEW WAYS TO FULFILL OUR CHARITABLE PURPOSE. PART OF THAT COMMITMENT IS SUPPORTING ADVANCED LEVELS OF TECHNOLOGY, STAFFING, TRAINING, EQUIPMENT, AND FACILITIES. PVHMC WORKS VIGOROUSLY TO MEET OUR ROLE IN MAINTAINING A HEALTHY COMMUNITY BY IDENTIFYING HEALTH-RELATED PROBLEMS AND DEVELOPING WAYS TO ADDRESS THEM. IN 2012, A COMMUNITY NEEDS ASSESSMENT WAS COMPLETED. THE ASSESSMENT IS INTENDED TO BE A RESOURCE FOR PVHMC TO BECOME INVOLVED WITH DEVELOPING AND MAINTAINING ACTIVITIES AND PROGRAMS THAT CAN HELP IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF POMONA VALLEY. THE RESEARCH OBJECTIVES WERE TO LOOK AT THE DEMOGRAPHIC PROFILE OF THE COMMUNITY, HEALTH INSURANCE COVERAGE, HEALTH ACCESS BARRIERS, UTILIZATION OF HEALTH CARE SERVICES FOR ROUTINE PRIMARY/PREVENTATIVE CARE, UTILIZATION OF URGENT CARE SERVICES, NEED FOR SPECIALTY HEALTH CARE AND EXPERIENCE WITH PVHMC INCLUDING CLASSES, SUPPORT GROUPS, AND THE EMERGENCY ROOM. IN THE 2012 FINDINGS, OUT OF 138 RESPONSES, 99 (OR 73.3%) OF THE PATIENTS WHO VISITED THE EMERGENCY DEPARTMENT (ED) SAID THEY DID NOT TRY TO SEE THEIR DOCTOR BEFORE GOING TO THE ED. THE MAIN REASONS GIVEN FOR NOT TRYING TO SEE THEIR DOCTOR FIRST WERE BECAUSE IT WAS AFTER HOURS (32 OR 36%), IT WAS AN EMERGENCY SITUATION (22 OR 24.7%), OR THEY WERE BROUGHT BY AMBULANCE (15 OR 16.9%). MORE PATIENTS USED THE ED WHEN IT SEEMED APPROPRIATE AS IT RELATED TO THE DAY AND TO THE EXTENT OF THE EMERGENCY COMPARED TO THE 2008 COMMUNITY NEEDS ASSESSMENT. WE ARE DOING A BETTER JOB OF INFORMING OUR COMMUNITIES OF THE DIFFERENCES BETWEEN EMERGENT SITUATIONS AND WHAT CAN WAIT FOR A VISIT WITH THEIR PRIMARY CARE PHYSICIAN, AND THE USE OF URGENT CARE SERVICES. IN ADDITION, WE CAN DO MORE TO MAKE USE OF OUR PRIMARY CARE AND URGENT CARE SERVICES TO MEET THE NEEDS OF OUR COMMUNITY AND OFFLOAD A LARGE PROPORTION OF THE PRESSURE ON OUR EMERGENCY DEPARTMENT. IN RECOGNIZING THAT OVERCROWDED ED'S IS A NATIONWIDE CRISIS, PVHMC WANTED TO EXPLORE HOW THE HOSPITAL MET THE NEEDS OF OUR COMMUNITY AND WHAT THE HOSPITAL WAS DOING FOR THE FUTURE TO DETER MUCH OF THE PRESSURE BEING PLACED ON OUR OVERCROWDED ED. THE EMERGENCY DEPARTMENT IS OFTEN STILL THE SOURCE OF PRIMARY HEALTH CARE FOR MANY OF OUR RESIDENTS, ALTHOUGH WE CONTINUE TO PROVIDE OUTREACH AND EDUCATE THE COMMUNITY ON OTHER RESOURCES AVAILABLE TO THEM. AS A PRIVATE COMMUNITY SAFETY NET HOSPITAL, ALSO WITH THE DESIGNATION AS A DISPROPORTIONATE SHARE HOSPITAL ("DSH"), WE CARE FOR A GREATER POPULATION OF LOW-INCOME, MEDICALLY VULNERABLE PATIENTS. THEY OFTEN REQUIRE AN INCREASED NEED OF ACCESSIBLE, HIGH QUALITY, AND COST-EFFECTIVE HEALTH CARE SERVICES. WE DELIVER CARE TO ALL PATIENTS IN OUR ED, WITH OR WITHOUT INSURANCE. THE NECESSITY TO IMPROVE AND BUILD UPON THE EFFICIENCY OF OUR ED IS CRITICAL FOR PVHMC IN ORDER FOR US TO KEEP UP WITH THE GROWING DEMANDS BEING PLACED UPON OUR SYSTEM EVERY DAY. THE 2012 COMMUNITY NEEDS ASSESSMENT ALSO REVEALED THE NEED FOR SPECIALTY HEALTHCARE. RESPONDANTS WERE GIVE A LIST OF VARIOUS CHRONIC OR ONGOING HEALTH CONDITIONS AND ASKED IF THEY OR ANY MEMBER OF THEIR FAMILY HAVE ANY OF THE CONDITIONS. IN TOTAL, 59.0% OF RESPONDANTS ANSWERED "YES" TO HAVING CHRONIC OR ONGOING HIGH BLOOD PRESSURE CONDITIONS, 31.5% WITH DIABETES, 19.0% WITH ASTHMA, 14.5% WITH CANCER, 14.0% WITH OBESITY, 14.0% WITH OSTEOPOROSIS, 5.5 % WITH CHRONIC HEART FAILURE, AND 16.0% STATED THEY HAVE OTHER ONGOING HEALTH CONDITIONS. UNDERSTANDING THE NEED FOR COMMUNITY HEALTH IMPROVEMENT, A FOCUS OF OUR 2013 COMMUNITY BENEFIT PLAN IS IN MAKING THE COMMUNITY MORE AWARE OF THE CLASSES AND SUPPORT GROUPS OFFERED BY THE HOSPITAL. THE HOSPITAL CURRENTLY PROVIDES MANY OF THE CLASSES THE RESPONDANTS WERE INTERESTED IN, THEREFORE WE ARE DEDICATED TO PROVIDING GREATER COMMUNICATION ABOUT THE AVAILABILITY OF THESE EXISTING RESOURCES. THE 2013 COMMUNITY BENEFIT PLAN REFLECTS OUR COMMITMENT TO MEET THE NEEDS OF OUR COMMUNITY, AS THE MAJORITY OF OUR SERVICES ARE TIED INTO PROVIDING INFORMATION AND EDUCATION TO THE COMMUNITY REGARDING AVAILABILITY AND ACCESSIBILITY TO HEALTH AND SOCIAL SERVICES. BY FOSTERING GREATER COORDINATION AND COLLABORATION AMONG LOCAL SERVICE PROVIDERS, WE ARE ABLE TO CONTINUE TO OFFER COMPREHENSIVE MEDICAL SERVICES AND PROGRAMS TO A LARGE COMMUNITY. OUR SERVICES SHOW HOW THE COMMUNITY'S NEEDS DRIVE THE CONCEPTION AND ESTABLISHMENT OF THE SERVICES WE PROVIDE AND CONTRIBUTE TO ITS GROWTH AND IMPROVEMENT. EVERY ACTIVITY AND PROGRAM IS BUDGETED TO MANAGE THE USE OF AVAILABLE RESOURCES. OUR COMMITMENT TO THESE VITAL SERVICES IS DEMONSTRATED THROUGH THE CONCERTED EFFORTS OF EACH DEPARTMENT TO ENSURE THAT ESSENTIAL SERVICES CONTINUE TO BE PROVIDED TO THE COMMUNITY. PVHMC DEMONSTRATES ITS PROFOUND COMMITMENT TO ITS LOCAL COMMUNITY, BOTH HISTORICALLY AND ON A CONTINUING BASIS. PVHMC HAS WELCOMED THIS OCCASION TO FORMALIZE, ENHANCE AND DOCUMENT THE MULTITUDE OF COMMUNITY BENEFIT INITIATIVES IN WHICH THE HOSPITAL IS IMMERSED. OUR COMMUNITY IS CENTRAL TO US, AND IT IS REPRESENTED IN ALL OF THE WORK WE DO. PVHMC HAS SERVED THE POMONA VALLEY FOR OVER 100 YEARS, AND WE VALUE MAINTAINING THE HEALTH OF OUR COMMUNITY BY PROVIDING ACCESSIBLE, HIGH QUALITY MEDICAL CARE. THANK YOU FOR TAKING THE TIME TO ALLOW US TO SHARE WITH YOU OUR COMMUNITY ACTIVITIES AND PROGRAMS FOR THE MOST RECENT YEAR. ABOUT PVHMC PRESIDENT/CHIEF EXECUTIVE OFFICER, RICHARD E. YOCHUM AND CHAIRMAN, BOARD OF DIRECTORS, JANE GOODFELLOW. OUR ORGANIZATIONAL STRUCTURE - PVHMC IS GOVERNED BY A BOARD OF DIRECTORS WHOSE MEMBERS ARE REPRESENTATIVE OF THE COMMUNITY, HOSPITAL AND MEDICAL STAFF LEADERSHIP. OUR MISSION - PVHMC IS A NOT-FOR-PROFIT REGIONAL MEDICAL CENTER DEDICATED TO PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE SERVICES TO RESIDENTS OF THE GREATER POMONA VALLEY. THE MEDICAL CENTER OFFERS A FULL RANGE OF SERVICES FROM LOCAL PRIMARY ACUTE CARE TO HIGHLY SPECIALIZED REGIONAL SERVICE. SELECTION OF ALL SERVICES IS BASED ON COMMUNITY NEED, AVAILABILITY OF FINANCING AND THE ORGANIZATION'S TECHNICAL ABILITY TO PROVIDE HIGH QUALITY RESULTS. BASIC TO OUR MISSION IS OUR COMMITMENT TO STRIVE CONTINUOUSLY TO IMPROVE THE STATUS OF HEALTH BY REACHING OUT AND SERVING THE NEEDS OF OUR DIVERSE ETHNIC, RELIGIOUS AND CULTURAL COMMUNITY. OUR COMMUNITY - PVHMC IS DEDICATED TO MEETING THE HEALTH CARE DEMANDS OF THE GROWING POPULATIONS OF LOS ANGELES AND SAN BERNARDINO COUNTIES. OUR PRIMARY SERVICE AREA IS DEFINED AS THE CITIES OF POMONA, CLAREMONT, CHINO, CHINO HILLS, LA VERNE, MONTCLAIR, ONTARIO, RANCHO CUCAMONGA, ALTA LOMA, UPLAND AND SAN DIMAS AND MAKE UP A POPULATION OF 840,789. IN 2010 AS DERIVED FROM THE STATISTICS REPORTED BY THE U.S. CENSUS BUREAU. THE ETHNIC DIVERSITY REPRESENTED BY THE DEMOGRAPHICS OF THE CITY OF POMONA IN 2010 WAS SUCH THAT 33.6% IS HISPANIC OR LATINO, 14.4% IS WHITE, 7.3% IS BLACK/AFRICAN-AMERICAN, 8.5% IS ASIAN, 1.2% IS AMERICAN INDIAN, 0.2% HAWAIIAN/PACIFIC ISLANDER, 30.3% IS OTHER, AND 4.5% IS TWO OR MORE RACES, ACCORDING TO THE U.S. CENSUS BUREAU. COMMUNITY BENEFIT PLAN FOCUS STUDY, 2013 UPDATE - BASED ON OUR 2012 NEEDS ASSESSMENT, OUR COMMUNITY HAS STATED THAT THEY WANT TO BE MADE AWARE OF THE CLASSES AND SUPPORT GROUPS OFFERED BY THE HOSPITAL. OUR COMMUNITY STATED THAT THEY ARE INTERESTED IN CPR CLASSES, PARENTING CLASSES, AND PREVENTATIVE CARE CLASSES. WE OFFER THESE CLASSES AND MANY OTHERS, AND OUR FOCUS FOR 2013 AND 2014 WILL BE TO FIND WAYS TO BETTER PROMOTE AND ENCOURAGE OUR COMMUNITY TO PARTICIPATE. CONDUCTING THE SURVEY ALLOWED US THE OPPORTUNITY TO LEARN ABOUT WHAT IS IMPORTANT TO THEM. POMONA VALLEY HOSPITAL'S VAST EFFORTS TO PROMOTE COMMUNITY HEALTH SERVES AS AN OPPORTUNITY TO ASSIST OUR COMMUNITY WITH ISSUES LIKE HIGH BLOOD PRESSURE, DIABETES, ASTHMA, CANCER, OBESITY, OSTEOPOROSIS AND CHRONIC HEART FAILURE. THESE ARE THE ISSUES OUR COMMUNITY NEEDS ASSESSMENT DEMONSTRATED AS THE BIGGEST HEALTH CONCERNS FOR OUR COMMUNITY. WE ADDRESS AND ALLOCATE OUR RESOURCES TO SERVE THE NEED OF OUR ENTIRE COMMUNITY, FOCUSING ON THOSE THAT ARE AT RISK AND HAVE THE LEAST ACCESS TO THE NECESSARY SERVICES AND CARE NEEDED. WE REACH OUT AND MEET OUR COMMUNITY'S HEALTH NEEDS THROUGH: - PROVIDING FREE AND PARTIAL PAYMENT HOSPITAL SERVICES FOR THOSE WITHOUT THE ABILITY TO PAY OR LIMITED FINANCIAL RESOURCES - REACHING OUT TO OUR LOCAL SCHOOLS AND COMMUNITY GROUPS ON THE IMPORTANCE OF HEALTH LIVING - PROVIDING MEDICAL SERVICES IN UNDERSERVED AREAS THROUGH FREE AND COMMUNITY BASED CLINICS. - PROVIDING YEARLY VACCINATIONS AND SCREENINGS TO CHILDREN AND THE ELDERLY. - TRAINING HEALTH PROFESSIONALS LIKE FAMILY PRACTICE RESIDENTS AND NURSING STUDENTS IN ORDER TO MEET THE NEEDS OF THE FUTURE. THROUGHOUT THIS DOCUMENT WE DEMONSTRATE THE SPECIFIC WAYS WE SERVE OUR COMMUNITY AS OUR COMMITMENT TO IMPROVING THEIR HEALTH STATUS. ONE MAJOR PUBLIC HEALTH CONCERN IN OUR COMMUNITY IS STROKE. AS THE 2ND LEADING CAUSE OF DEATH IN THE SAN GABRIEL VALLEY, PVHMC RECOGNIZED THAT OUR COMMUNITY WAS SIGNIFICANTLY UNDERSERVED WITH REGARD TO STROKE CARE, CARING FOR MORE THAN 500 STROKE PATIENTS ANNUALLY. PVHMC BEGAN TO WORK WITH THE LOS ANGELES COUNTY EMS AGENCY TO ADDRESS THIS NEED. IN 2009 LOS ANGELES COUNTY EMS AGENCY ESTABLISHED A PRIMARY STROKE CENTER APPROACH, DIRECTING EMS PROVIDERS TO BYPASS LOCAL COMMUNITY HOSPITALS AND TAKE STROKE VICTIMS TO PRIMARY STROKE CENTERS. PRIMARY STROKE CENTERS ARE REQUIRED TO ABIDE BY THE REGULATORY GUIDELINES SET FORTH BY THE JOINT COMMISSION. IN 2010 ONLY 13 PRIMARY STROKE CENTERS WERE RECOGNIZED BY LOS ANGELES COUNTY, ALL MORE THAN THIRTY MILES WEST OF THE POMONA VALLEY, WITH TRANSPORT TIMES DURING PEAK COMMUTE TRAFFIC OF MORE THAN 60 MINUTES. THE COORDINATION OF CARE FOR SAN BERNARDINO COUNTY STROKE VICTIMS WAS EVEN MORE DISMAL WITH VERY LIMITED SERVICES SPREAD ACROSS THE LARGEST COUNTY IN AMERICA. IN 2011 PVHMC BECAME ONE OF THE FIRST TWO PRIMARY STROKE CENTER FOR SAN BERNARDINO COUNTY, PRIMARY STROKE CENTERS. AS A DESIGNATED STEMI RECEIVING CENTER (SRC) IN BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES, PVHMC BECAME THE FIRST HOSPITAL IN THE REGION WITH DUAL COUNTY DESIGNATION. AN ACUTE HEART ATTACK CAUSED BY BLOOD CLOTS IS CALLED AN ST-ELEVATED MYOCARDIAL INFARCTION, OR STEMI. WITHOUT RAPID ANGIOPLASTY, HEART MUSCLE IS PERMANENTLY DAMAGED. IN ORDER TO QUALIFY FOR THIS DESIGNATION, HOSPITALS ARE REQUIRED TO PROVIDE ANGIOPLASTY TREATMENT IN LESS THAN 90 MINUTES. CURRENTLY, PVHMC AVERAGES 50-MINUTE DOOR-TO-BALLOON TIMES, RANKING IN THE TOP 5 PERCENT NATIONALLY. THE STEAD HEART AND VASCULAR CENTER ADDITIONALLY OFFERS ONE OF THE MOST COMPLETE LINES OF CARDIOVASCULAR AND STROKE SERVICES IN LOS ANGELES AND SAN BERNARDINO COUNTIES. POMONA VALLEY HOSPITAL MEDICAL CENTER DEVELOPED AND CONTINUES TO SUPPORT A PRIMARY STROKE CENTER PROGRAM IMPLEMENTING CARE COORDINATION TO MEET THE NEEDS OF OUR COMMUNITY: - CALL COVERAGE CONTRACT TO ADDRESS 24/7/365 RAPID AND TIMELY RESPONSE OF OUR NEUROLOGISTS * $172,500/YEAR CALL COVERAGE - CONDUCTED A MINIMUM OF 8 HOURS OF TRAINING FOR ALL NURSING STAFF IN STROKE UNITS WITHIN THE HOSPITAL (OVER 300 NURSES). * $96,000/ YEAR OF MANDATED TRAINING - MANDATED NATIONAL INSTITUTE OF HEALTH STROKE SCALE TRAINING AND CERTIFICATION OF ALL ED STAFF NURSES AND STROKE UNIT CHARGE NURSES ( APPROX. 150 NURSES) * $24,000/YEAR OF MAINTAINED CERTIFICATION - PROVIDE 3 ANNUAL PHYSICIAN CME/EDUCATIONAL FORUMS * $12,000/YEAR - DEVELOPED A STROKE COORDINATOR POSITION TO PROVIDE CARE COORDINATION, PROGRAM IMPLEMENTATION AND COMPLIANCE * $120,000/YEAR - PROVIDE 20 COMMUNITY EDUCATION FORUMS, SYMPOSIUMS AND OUTREACH ANNUALLY * $3,900/YEAR - DEVELOPED EDUCATIONAL AND OUTREACH MATERIAL TO EDUCATE THE COMMUNITY OF THE EARLY WARNING SIGNS OF STROKE * $15,000/YEAR - PROVIDE MONTHLY EMS AGENCY EDUCATION PROGRAMS * $7,800 - PRIMARY STROKE CENTER CERTIFICATION FEES * $5,000/ YEAR THE JOINT COMMISSION FEE * $20,000/YEAR SAN BERNARDINO PRIMARY STROKE CENTER DESIGNATION FEE POMONA VALLEY HOSPITAL MEDICAL CENTER NOW SERVES MORE THAN 650 STROKE AND TIA VICTIMS ANNUALLY. PVHMC ALSO RECOGNIZES THE IMPORTANCE OF EMERGENCY CARE SERVICES TO THE COMMUNITY AND WE ARE COMMITTED TO MEETING THE NEEDS OF OUR PATIENTS. OUR HOSPITAL HAS LEARNED FROM EVALUATIONS OF THE ED THAT THE NECESSITY TO IMPROVE AND BUILD UPON THE EFFICIENCY OF OUR ED IS CRITICAL IN ORDER TO KEEP UP WITH THE GROWING DEMANDS BEING PLACED UPON OUR SYSTEM EVERYDAY. IN 2009 AND AGAIN IN EARLY 2013, OUR ED RECEIVED MODERATE COSMETIC RECONSTRUCTION THAT INCLUDED A REFRESH OF THE WAITING ROOM AND ADDITIONS TO OUR PATIENT CARE AREAS. THE CHANGES PROVIDE MORE COMFORT FOR OUR PATIENTS AND EXPANSION OF OUR SERVICES. OUR ED HAS BEEN ENHANCED WITH ROUND THE CLOCK PHYSICIAN COVERAGE OF FULL-TIME LABORISTS (HOSPITAL-BASED OBSTETRICS/GYNECOLOGY PHYSICIANS WHO DO DELIVERIES), A HOSPITALIST TEAM, AND A DEDICATED INTENSIVIST PROGRAM IN THE INTENSIVE CARE UNIT (ICU). A FULL SERVICE ED BACK UP CALL PROVIDES ADEQUATE COVERAGE OF SPECIALISTS WHICH IS CRITICAL TO THE ABILITY OF THE HOSPITAL TO PROVIDE SPECIALTY MEDICINE TO PATIENTS. THE CALIFORNIA EMERGENCY PHYSICIAN GROUP (CEP) AT POMONA VALLEY HOSPITAL MEDICAL CENTER HAS DEVELOPED AND PIONEERED A NUMBER OF PROVEN BEST PRACTICES REFERRED TO COLLECTIVELY AS THE RAPID MEDICAL EVALUATION (RME) METHODOLOGY TO EXPEDITE ED CARE AND THROUGHPUT. THIS ALLOWS THE PROVIDER TO EVALUATE THE PATIENT AND BEGIN TREATMENT AS QUICKLY AS POSSIBLE. IT ALLOWS FOR PARALLEL PROCESSING OF ED PATIENT THUS IMPROVING OPERATIONAL EFFICIENCY, PATIENT FLOW, AND PATIENT'S SATISFACTION, WHILE DECREASING DIVERSION TIME AND ED OVERCROWDING. GOALS OF THE RME PROGRAM INCLUDE: - INITIAL PROVIDER EVALUATION WILL OCCUR IMMEDIATELY UPON A PATIENT'S ARRIVAL; - ORDERS WILL BE INITIATED IMMEDIATELY; AND, - BED AVAILABILITY WILL NOT DELAY A PATIENT FROM SEEING A PROVIDER IMMEDIATELY. AS ED VOLUME CONTINUED TO INCREASE, THE ED HAS ADDED ADDITIONAL NURSING STAFF (A TOTAL OF 23 LICENSED AS COMPARED TO 19 IN 2009) AS WELL AS ADDITIONAL PROVIDER (PHYSICIAN/PHYSICIAN ASSISTANT) COVERAGE TO HAVE A PROVIDER IN TRIAGE DURING THE TIMES OF HEAVIEST PATIENT VOLUMES. SHIFTS ARE FROM 10:00 AM TO 10:00 PM. WE HAVE REDUCED THE PERCENT OF "LEFT WITHOUT BEING SEEN" TO 1.07% FOR 2011 (COMPARED WITH THE NATIONAL AVERAGE OF 1.4%). WE HAVE DECREASED OUR AVERAGE "DOOR-TO-PROVIDER TIME" IN 2011 TO 25-MINUTES AND REACHED OUR GOAL OF 40-MINUTES (CALIFORNIA EMERGENCY PHYSICIAN GROUP) WHICH CONTINUES TO BE OUR GOAL FOR 2013. ALONG WITH THE PROGRESS WE HAVE MADE TO IMPROVE EMERGENCY CARE SERVICES ON OUR MAIN CAMPUS, AND RECOGNIZING THAT THE ED IS STILL A SOURCE OF PRIMARY HEALTH CARE FOR THE COMMUNITY, WE HAVE INCREASED ACCESS TO PRIMARY HEALTH CARE SERVICES OUTSIDE OF THE HOSPITAL'S ED. WE ADDRESSED THE NEED FOR ADDITIONAL ACCESS THROUGH THE DEVELOPMENT OF OUR FAMILY MEDICINE RESIDENCY PROGRAM IN THE MID 1990'S TO HELP ADDRESS THE LOOMING SHORTAGE IN PRIMARY CARE PROVIDERS. OVER TIME, PVHMC AND THE RESIDENCY FACULTY MEDICAL GROUP WORKED TOGETHER TO PROVIDE ADDITIONAL ACCESS POINTS THROUGHOUT OUR COMMUNITY IN ADDITION TO THE POMONA BASED FAMILY HEALTH CENTER. THROUGH THE RECRUITMENT OF GRADUATING RESIDENTS WE OPENED AND STAFFED THE POMONA VALLEY HEALTH CENTER IN CHINO HILLS (OPENED IN 2003, REPLACING A SMALLER OFFICE THAT HAD OPENED IN 1999); THE POMONA VALLEY HEALTH CENTER AT CROSSROADS (ALSO IN CHINO HILLS, OPENED IN 2007) AND THE POMONA VALLEY HEALTH CENTER IN CLAREMONT (OPENED IN 2009). IN TOTAL, THESE NETWORKED CENTERS OFFER FAMILY MEDICINE, URGENT CARE, PHYSICAL THERAPY AND REHABILITATION, SLEEP MEDICINE AND WIDE RANGING IMAGING SERVICES. THESE SITES ARE DIGITALLY CONNECTED THROUGH AN ELECTRONIC MEDICAL RECORD THAT ALLOWS ACCESS TO PATIENT HISTORY THROUGHOUT THE SYSTEM. ANOTHER PROJECT TO EXPAND ACCESS TO PRIMARY CARE SERVICES IN OUR COMMUNITY IS THE GROWTH OF THE POMONA COMMUNITY HEALTH CENTER. BEGINNING IN THE MID 1990'S, AND PARTNERING WITH A GRADUATING FAMILY MEDICINE RESIDENT, THE HOSPITAL WORKED WITH LOS ANGELES COUNTY AND OTHER COMMUNITY PARTNERS TO OPEN THE POMONA COMMUNITY HEALTH CENTER WITHIN THE L.A. COUNTY DEPARTMENT OF PUBLIC HEALTH. THIS SMALL, TWO EXAM ROOM CLINIC, OFFERED FREE PRIMARY CARE TO UNINSURED COUNTY RESIDENTS AS AN OUTPATIENT SERVICE OF THE HOSPITAL. IN 2010, THE CLINIC AND HOSPITAL ORCHESTRATED A SUCCESSFUL SEPARATION OF THE CLINIC INTO ITS OWN NOT-FOR-PROFIT COMMUNITY CLINIC AND BEGAN A PROCESS THAT WOULD ALLOW IT TO BE ACCREDITED AS A FEDERALLY QUALIFIED HEALTH CENTER WHILE EMBARKING ON A CAPITAL GRANT CAMPAIGN TO ALLOW FOR EXPANSION TO BOTH ADD CAPACITY AND ALLOW FOR IT TO SERVE UN AND UNDERINSURED RESIDENTS OF SAN BERNARDINO COUNTY AS WELL. IN OCTOBER OF 2011 THE PCHC RECEIVED THEIR FEDERAL DESIGNATION, AND A SUCCESSFUL CAPITAL CAMPAIGN HAS ALLOWED FOR THE RECENT COMPLETION AND FURNISHING OF A 13 BED FEDERALLY QUALIFIED HEALTH CENTER. THE NEW SITE IS LOCATED IN POMONA, IN A MULTI SERVICES MALL OWNED BY THE POMONA UNIFIED SCHOOL DISTRICT, AND SITS A FEW HUNDRED YARDS FROM THE SAN BERNARDINO COUNTY LINE, ALLOWING FOR EASY ACCESS. THE SITE IS SCHEDULED TO OPEN IN MID-2012 AND IS SIZED TO PROVIDE A MEDICAL HOME THAT HAS THE CAPACITY FOR 25,000 ANNUAL PATIENT VISITS THAT WILL BE TARGETED TO THE LOW INCOME COMMUNITY. THE HOSPITAL CONTINUES TO PROVIDE GAP OPERATIONAL FUNDING FOR THE PROGRAM IN THE FORM OF A COMMUNITY BENEFIT GRANT OF UP TO $1.5 MILLION PER YEAR. SINCE THE OPENING OF THESE NEW SITES WE HAVE SEEN YEAR OVER YEAR GROWTH IN OUR PRIMARY CARE AND URGENT CARE BASE. THE ADDITION OF THESE 29 URGENT CARE BEDS TO THE REGION HAS HELPED RELIEVE PVHMC'S EMERGENCY ROOM BURDEN BY OFFERING A MORE DISEASE APPROPRIATE SETTING FOR MANY PRIMARY CARE NEEDS. THE INTEGRATED PRIMARY CARE COMPONENTS, LICENSED AS COMMUNITY HEALTH CENTERS, ARE THEN AVAILABLE TO SERVE AS PRIMARY CARE HOMES FOR PATIENTS WHO MAY HAVE SEEN THE EMERGENCY ROOM AS THEIR PRIMARY SOURCE OF HEALTH CARE. COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS - THE EXAMPLES PRESENTED IN THIS COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS - THE EXAMPLES PRESENTED IN THIS REPORT ARE INSIGHTS INTO A COMMUNITY ACTIVELY INVOLVED IN IMPROVING THE HEALTH STATUS OF RESIDENTS LIVING IN THE POMONA VALLEY. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS -IN ADDITION TO THE ASSISTANCE IN OPENING THE POMONA COMMUNITY HEALTH CENTER THE HOSPITAL ALSO HAS OTHER IMPORTANT COMMUNITY BASED PROGRAMS. THE NEWBORN ABANDONMENT PREVENTION LAW ALLOWS A PARENT OF A NEWBORN LESS THAN 72 HOURS OF AGE TO RELINQUISH THEIR BABY ANONYMOUSLY TO AN EMPLOYEE AT ANY HOSPITAL ED WITHIN THE STATE OF CALIFORNIA. PVHMC CREATED A PRIVATE AREA OUTSIDE OF THE ED FOR THIS PURPOSE, THE SAFE SURRENDER PROGRAM. THE PROGRAM HAS BEEN SHARED WITH LOCAL SCHOOLS AND COMMUNITY PROGRAMS; HOWEVER, THE NEED TO INCREASE AWARENESS IS CRUCIAL TO THE ONGOING SUCCESS OF THE PROGRAM. MANY DEPARTMENTS IN THE HOSPITAL OFFER CLASSES AND SUPPORT GROUPS TO THE COMMUNITY. IN WOMEN'S AND CHILDREN'S SERVICES, MANY OF THE CLASSES ("CHILDBIRTH PREPARATION", "YOUR CESAREAN", "BIG BROTHER/BIG SISTER") OFFERED AT THE HOSPITAL ARE NOT AVAILABLE AT NEIGHBORING HOSPITALS. PVHMC ALSO OFFERS FREE SUPPORT GROUPS ("BOOTCAMP FOR DADS", "MOMMY N ME"). A HEALTH NEWSLETTER "REGARDING WOMEN" IS DISTRIBUTED QUARTERLY TO RESIDENTS IN THE COMMUNITY. AT THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CARE CENTER (CCC), THERE ARE PATIENT WORKSHOPS ("LAUGHTER YOGA"), AND SUPPORT GROUPS ("LOOK GOOD...FEEL BETTER", "LIVING IN THE HERE & NOW"). WE ALSO HAVE A SPECIAL "KIDZ GROUP" FOR AGES 7 THROUGH 17 WHO HAVE A PARENT OR LOVED ONE WITH CANCER TO PROVIDE UNDERSTANDING AND COPING SKILLS. THE STEAD HEART AND VASCULAR CENTER (SHVC) OFFERS HEART FAILURE EDUCATION AND AWARENESS TO RECOGNIZE RISK FACTORS, SIGNS AND SYMPTOMS. THERE IS ALSO A HEART FAILURE PROGRAM THAT HELPS PATIENTS IN MAINTAINING THEIR DISEASE AND PROVIDES SUPPORT LEADING TO DECREASED SUBSEQUENT HOSPITALIZATIONS. THE STEAD HEART FOR WOMEN PROGRAM PROVIDES EDUCATION, SUPPORT AND RESOURCES SPECIFICALLY ON HEART DISEASE AND STROKE PREVENTION. WE RECOGNIZE THE IMPORTANCE OF PREVENTIVE HEALTH AND WE PARTICIPATE AND ORGANIZE COMMUNITY HEALTH FAIRS WITH HEALTH CARE INFORMATION AND HEALTH SCREENINGS. THE VOLUNTEER SERVICES DEPARTMENT ORGANIZES FLU SHOTS IN A DRIVE-THRU SETTING WITH THE HELP OF PVHMC'S NURSES. PVHMC WORKS WITH LA COUNTY AND LOCAL NOT-FOR-PROFIT ORGANIZATIONS TO PUT TOGETHER AN ANNUAL KIDS HEALTH FAIR PROVIDING FREE HEALTH SCREENINGS, IMMUNIZATIONS AND MEDICAL INFORMATION FOR UNINSURED AND UNDER-INSURED CHILDREN AGES TWO MONTHS TO 18 YEARS. THE CCC OFFERS EARLY DETECTION (SKIN SCREENINGS) AND PREVENTION. THE EPIDEMIOLOGY AND INFECTION CONTROL DEPARTMENT EDUCATES THE COMMUNITY ON INFECTION CONTROL AWARENESS, HAND HYGIENE AND DEMONSTRATION, AND HOME CLEANLINESS. THEY ALSO OFFER EDUCATION TO THE COMMUNITY REGARDING FLU SEASON AND COUGH ETIQUETTE. THE SLEEP CENTER PROVIDES AWAKE MEETINGS TO EDUCATE THE COMMUNITY ON NEW MASKS AND MACHINES. THE RESPIRATORY SERVICES DEPARTMENT OFFERS FREE ASTHMA EDUCATION, AVAILABLE IN SPANISH, AND A SMOKING CESSATION PROGRAM. BREATHING BUDDIES IS A SUPPORT GROUP FOR SENIORS WHO HAVE CHRONIC LUNG DISEASE BY PROVIDING THE LATEST HEALTH INFORMATION, REVIEWING THEIR MEDICATIONS, AND PROVIDING INSTRUCTION (E.G., ON HOW TO TRAVEL WITH OXYGEN). THE FOOD AND NUTRITION SERVICES DEPARTMENT OFFERS POR LA VIDA NUTRITION CLASSES FOR SPANISH SPEAKING COMMUNITY MEMBERS TO LEARN ABOUT HEALTHY EATING. HEALTH PROFESSIONS EDUCATION - OUR HOSPITAL PROVIDES MANY TRAINING OPPORTUNITIES THROUGH THE VARIOUS DEPARTMENTS THAT WORK WITH THE LOCAL COLLEGES AND HEALTH PROFESSIONAL PROGRAMS. PVHMC IS A CLINICAL SITE FOR NURSING STUDENTS IN PROGRAMS AT THE LOCAL COMMUNITY COLLEGES AND UNIVERSITIES. THE PARISH NURSE PROGRAM THROUGH THE SHVC EDUCATES AND TRAINS BOTH CLINICAL AND NON-CLINICAL SUPPORT STAFF. PVHMC'S FMRP TRAINS NURSE PRACTITIONER AND MEDICAL STUDENTS AT THE FHC. FNS PROVIDES OPPORTUNITIES FOR DIETETIC STUDENTS TO DO THEIR INTERNSHIP ROTATIONS AT PVHMC WHERE THEY LEARN ABOUT FOOD PRODUCTION AND MANAGEMENT. THE HOSPITAL IS ALSO A TRAINING LOCATION FOR PHLEBOTOMY, PHYSICIAN BILLING, RESPIRATORY AND SURGICAL TECH STUDENTS. IN RADIOLOGY, OUR HOSPITAL IS A TRAINING SITE FOR RADIOLOGIC TECHNOLOGY, ULTRASOUND AND NUCLEAR MEDICINE STUDENTS. WE ALSO WELCOME CHAPLAINS IN THE COMMUNITY TO RECEIVE CLINICAL CHAPLAIN TRAINING AT PVHMC. FOR THE MEDICAL COMMUNITY, THE HOSPITAL ORGANIZES WEEKLY CONTINUING MEDICAL EDUCATION AT NO COST TO PHYSICIANS. WE OFFER A PERINATAL SYMPOSIUM WHICH IS LABOR AND DELIVERY AND NEONATAL EDUCATION. THE CCC OFFERS SEMINARS ON LUNG AND GASTROINTESTINAL CANCERS. SUBSIDIZED HEALTH SERVICES PVHMC IS A MAJOR PROVIDER IN OUR REGION, PARTICULARLY FOR MEDI-CAL AND INDIGENT PATIENTS IN BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES. IT IS ESSENTIAL FOR OUR HOSPITAL'S ED TO HAVE ADEQUATE COVERAGE OF SPECIALISTS TO PROVIDE NEEDED SPECIALTY MEDICINE TO PATIENTS. IN ADDITION, WE HAVE ROUND THE CLOCK PHYSICIAN COVERAGE OF FULL-TIME LABORISTS (HOSPITAL-BASED OB/GYN PHYSICIANS WHO DO DELIVERIES), A HOSPITALIST TEAM, AND A DEDICATED INTENSIVIST PROGRAM IN THE INTENSIVE CARE UNIT. RESEARCH - THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CARE CENTER OF PVHMC PARTICIPATES IN CLINICAL RESEARCH STUDIES IN BREAST CANCER, GASTROINTESTINAL CANCERS, HEAD & NECK CANCERS, LUNG CANCER, PROSTATE CANCER, AND SYMPTOM MANAGEMENT. CASH AND IN-KIND CONTRIBUTIONS - OUR HOSPITAL PROVIDES SUPPORT TO VARIOUS LOCAL COMMUNITY SERVICE ORGANIZATIONS INCLUDING THE HOUSE OF RUTH (SERVICES AND ASSISTANCE TO VICTIMS OF DOMESTIC VIOLENCE), PROJECT SISTER (SEXUAL ASSAULT CRISIS AND PREVENTION SERVICES), AND YMCA. IN-KIND CONTRIBUTIONS TO OUR PATIENTS AND TO THE COMMUNITY INCLUDE TOYS GIVEN TO PEDIATRIC SURGERY PATIENTS. THE FACILITIES DEPARTMENT PARTICIPATES IN THE CITY-WIDE CLEAN BY DONATING STAFF AND SUPPLIES. FOOD AND NUTRITION SERVICES "MEALS ON WHEELS" PROGRAM PROVIDES FOOD TO HOMEBOUND MEMBERS OF OUR COMMUNITY AND DONATES CANNED FOODS TO THE SALVATION ARMY "PROJECT SHIELD & SHELTER." OUR VOLUNTEER SERVICES DEPARTMENT GIVES INFANT LAYETTES AND CAR SEATS TO NEEDY FAMILIES. THE CANCER CARE CENTER GIVES WIGS TO PATIENTS AT NO COST. COMMUNITY BUILDING ACTIVITIES - PVHMC WORKS WITH LOCAL AREA MIDDLE AND HIGH SCHOOLS AS WELL AS GIRL SCOUTS AND SCHOOL GROUPS TO INTRODUCE CAREERS IN HEALTH CARE BY INVITING THEM TO TOUR OUR HOSPITAL AND BY VISITING THEM ON THEIR CAMPUS (CLAREMONT HIGH SCHOOL CAREER DAY). PVHMC PARTICIPATES IN LA COUNTY SERVICE PLANNING AREA 3'S HEALTH PLANNING GROUP ON THE STEERING COMMITTEE AND THE SPECIALTY CARE COALITION. PVHMC IS A ONE OF 13 DESIGNATED DISASTER RESOURCE CENTERS (DRC) IN LOS ANGELES COUNTY AS PART OF THE NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS PROGRAM. AS THE DRC FOR THE REGION, PVHMC IS RESPONSIBLE FOR 10 "UMBRELLA" FACILITIES IN THE AREA AND COORDINATES DRILLS, TRAINING, AND SHARING OF PLANS TO BRING TOGETHER THE COMMUNITY AND OUR RESOURCES FOR DISASTER PREPAREDNESS. PLANS FOR 2012/2013 PUBLIC REVIEW - PVHMC PLANS TO CONTINUE SUPPORTING ITS VARIED COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS CURRENTLY IN PLACE. THE COMMUNICATION OF OUR COMMUNITY BENEFIT IS A COMBINATION OF PRESENTATIONS GIVEN TO VARIOUS ORGANIZATIONS INCLUDING THE CITY GOVERNMENT, AND DISTRIBUTION OF COPIES OF THE REPORT TO ALL INTERESTED MEMBERS (COMMUNITY COLLABORATORS, LIBRARIES, COMMUNITY CENTERS, AND BUSINESSES) WITHIN OUR COMMUNITY UPON THEIR REQUEST. PVHMC'S CHARITY CARE POLICY - PVHMC POSTS NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. SUCH NOTICES ARE POSTED IN HIGH VOLUME INPATIENT, AND OUTPATIENT SERVICE AREAS OF THE HOSPITAL, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, INPATIENT ADMISSION AND OUTPATIENT REGISTRATION AREAS OR OTHER COMMON PATIENT WAITING AREAS OF THE HOSPITAL. NOTICES ARE POSTED AT ANY LOCATION WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT MAY OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR SUCH ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. A COPY OF THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE TO THE PUBLIC ON A REASONABLE BASIS. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B A COPY OF THE TAX RETURN ALONG WITH A NARRATIVE FROM EY, THE HOSPITAL'S EXTERNAL ACCOUNTING FIRM, IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING IN NOVEMBER 2013. THE INTERNAL PROCESS INCLUDES PREPARATION OF THE FINANCIAL DATA BY HOSPITAL PERSONNEL, SURVEYS OF DIRECTORS, OFFICERS AND KEY EMPLOYEES REGARDING INFORMATION IN RESPONSE TO QUESTIONS IN PART IV, AND DISCLOSED IN SCHEDULE L. THE COMPLETE 990 IS REVIEWED FOR OVERALL COMPLETENESS AND ACCURACY BY THE CEO AND CFO. WRITTEN CONFLICT OF INTEREST POLICY ENFORCEMENT FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR OFFICERS, DIRECTORS, AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS PURSUANT TO HOSPITAL POLICY. THE STATEMENTS ARE THEN REVIEWED BY THE OFFICERS OF THE BOARD (THE CHAIRMAN AND THE TWO VICE CHAIRMEN) BEFORE PRESENTED TO THE FULL BOARD AT THE ANNUAL ORGANIZATIONAL MEETING OF THE BOARD. ANY CONFLICTS OF CONCERN ARE ADDRESSED BY THE OFFICERS AND DISCUSSED BY THE FULL BOARD AT THE ORGANIZATIONAL MEETING. THEREAFTER, IT IS THE RESPONSIBILITY OF EACH MEMBER TO RAISE AN ISSUE OF POTENTIAL CONFLICT TO THE BOARD AND/OR ITS OFFICERS FOR DISPOSITION. IF A CONFLICT IS DEEMED TO EXIST, THE MEMBER IS EXCUSED FROM THE MEETING AND/OR TOPIC WHERE THE CONFLICT EXISTS. DETERMINATION OF COMPENSATION FOR CEO Form 990, Part VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE WHO ANNUALLY REVIEW AND DETERMINE THE COMPENSATION FOR THE CEO. THEIR REVIEW DETERMINATION OF THE CEO'S COMPENSATION IS BASED UPON INDEPENDENT REVIEW OF THE CEO COMPENSATION COMPARED TO INDUSTRY PRACTICE. IN 2012 THE COMPENSATION COMMITTEE USED THE HAY GROUP FOR THIS PURPOSE. THE COMPENSATION REVIEW PROCESS IS DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE. DETERMINATION OF COMPENSATION FOR OTHER KEY EMPLOYEES FORM 990, PART VI, SECTION B, LINE 15B FOR OTHER OFFICERS AND KEY EMPLOYEES, THE SAME PROCESS IS USED AS ABOVE, WITH THE EXCEPTION, THAT THE CEO PRESENTS HIS RECOMMENDATION FOR COMPENSATION TO THE COMPENSATION COMMITTEE BASED UPON THE REPORT FOR TOTAL COMPENSATION COMPARISONS SUPPLIED BY THE HAY GROUP. THE POSITIONS COVERED BY THE PROCESS ARE THE COO, CFO, VP SATELLITES, VP NURSING, VP MEDICAL STAFF AFFAIRS, VP HUMAN RESOURCES, CHIEF INFORMATION OFFICER, VICE PRESIDENT OF FINANCE, VP SUPPORT SERVICES, DIRECTOR OF MANAGED CARE, COMPLIANCE OFFICER, DIRECTOR OF UTILIZATION MANAGEMENT. THIS PROCESS WAS LAST COMPLETED IN 2012 AND WAS ALSO DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE. REASON WHY FORMS ARE NOT MADE AVAILABLE TO THE PUBLIC FORM 990, PART VI, QUESTION 18 THE HOSPITAL IS NOT REQUIRED TO MAKE ITS FORM 1023 AVAILABLE AS IT FILED FOR TAX EXEMPT STATUS PRIOR TO JULY 15, 1987. THE HOSPITAL MAKES ITS 990 AND 990T AVAILABLE TO THE PUBLIC UPON REQUEST. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 EFFECT OF ADOPTION OF FASB STATEMENT 158 $( 478,804) LOSS FROM SUBSIDIARIES $( 529,735) S-CORP K1 $( 48,482) ROUNDING $( 1) ------------ TOTAL $(1,057,022) Pomona Valley Hospital Medical Ctr Fdn 1798 North Garey Avenue Pomona CA 91767 953403287 SUPPORT PVHMC CA 501(C)(3) 7 NA false Pomona Valley Hospital Medical Ctr Aux 1798 North Garey Avenue Pomona CA 91767 956053224 Support PVHMC CA 501(C)(3) 11, I PVHMC true Pomona Valley Medical Plaza 1798 NORTH GAREY AVENUE POMONA CA 91767 954175295 LEASING CA PVHMC RELATED -478557 3839778 false 0 false 0.90000 Pomona Valley Health Facilities 1798 North Garey Avenue Pomona CA 91767 954104554 R.E. OPERATION CA PVHMC C CORP 31725 -78147 1.00000 true Pomona North Medical Building Inc 1798 North Garey Avenue Pomona CA 91767 952629873 R.E. Rental CA PVHMC S CORP 48482 593523 1.00000 true true false true false false false false false true false false false true false true false false false POMONA VALLEY MEDICAL PLAZA A - ( 465232 ACCRUAL METHOD IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP SCHEDULE R, PART III, COLUMN (A) POMONA VALLEY MEDICAL PLAZA 1798 NORTH GAREY AVENUE POMONA, CA 91767 EIN: 95-4175295