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1798 North Garey Ave Pomona CA 91767

X X X X Pomona Valley Hospital Medical Center 1 18 Robert & Beverley Lewis Cancer Care Cntr

1910 Royalty Drive Pomona CA 91767

DIAGNOSTIC CENTER & CANCER TREATMENT PVHMC Imaging Claremont

1601 Monte Vista Avenue Claremont CA 91711

DIAGNOSTIC CENTER PVHMC Imaging Chino Hills

2140 Grand Avenue Suite 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 Pomona Valley Health Center

1770 N Orange Grove Pomona CA 91767

OUTPATIENT PHYSICIAN CLINIC PVHMC Physical Therapy Chino Hills

2140 Grand Avenue Suite 125 Chino Hills CA 91709

REHABILITATION CENTER PV Health Center Claremont Urgent Care

1601 Monte Vista Avenue Claremont CA 91711

OUTPATIENT PHYSICIAN CLINIC Pomona Valley Health Center Chino Hills

2140 Grand Avenue Suite 125 Chino Hills CA 91709

OUTPATIENT PHYSICIAN CLINIC PV Health Center Crossroads Urgent Care

3110 Chino Avenue Suite 150 Chino Hills CA 91709

OUTPATIENT PHYSICIAN CLINIC PV Health Center Claremont Primary Care

1601 Monte Vista Avenue Claremont CA 91711

OUTPATIENT PHYSICIAN CLINIC PVHMC Physical Therapy Claremont

1601 Monte Vista Avenue Claremont CA 91711

REHABILITATION CENTER PV Health Center Crossroads Primary Care

3110 Chino Avenue Suite 150 Chino Hills CA 91709

OUTPATIENT PHYSICIAN CLINIC Pomona Clinic Coalition

Park Avenue Pomona CA 91767

COMMUNITY CLINIC Pomona Valley Imaging Center Grandview

13768 Roswell Avenue Suite 103 Chino Hills CA 91709

DIAGNOSTIC CENTER PVHMC Imaging Crossroads

3110 Chino Avenue Suite 150 Chino Hills CA 91709

DIAGNOSTIC CENTER PVHMC Claremont Aquatic Therapy Pool

481 S Indian Hill Blvd Claremont CA 91711

REHABILITATION CENTER PVHMC Imaging Western University

309 Pomona Mall Pomona CA 91767

DIAGNOSTIC CENTER PART I, LINE 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 PROGRAM WAS APPROVED BY CMS IN DECEMBER 2010. THE AMENDED LEGISLATION ALLOWED CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (DHCS) TO BEGIN ASSESSING FEES AND MAKING SUPPLEMENTAL PAYMENTS IN SEPTEMBER 2010. DHCS BEGAN ASSESSING FEES IN OCTOBER 2010. POMONA VALLEY HOSPITAL MEDICAL CENTER ("THE HOSPITAL") MADE PAYMENTS TO DHCS FOR THE QA FEE IN THE AMOUNT OF $30,359,400 IN 2010, INCLUDED ON SCHEDULE H, PART I, LINE 7B, COLUMN C. THE HOSPITAL ALSO MADE PLEDGE PAYMENTS OF $3,170,390 TO THE CALIFORNIA HEALTH FOUNDATION & TRUST IN CONJUNCTION WITH THE PROGRAM, WHICH ARE REPORTED ON SCHEDULE H, PART I, LINE 7I, COLUMN C. THE HOSPITAL RECEIVED SUPPLEMENTAL PAYMENTS OF APPROXIMATELY $73,819,018, INCLUDED ON SCHEDULE H, PART I, LINE 7B, COLUMN D OVER THE COURSE OF THE PROGRAM IN 2010, WHICH PERTAINS TO THE PERIOD FROM APRIL 1, 2009 TO DECEMBER 31, 2010. THE INCLUSION OF THESE AMOUNTS ON LINE 7B OF PART I IN THE CURRENT YEAR DECREASE THE PERCENTAGE OF TOTAL EXPENSE, AS COMPARED TO THE PRIOR YEAR. PART I, LINE 7G NONE OF THE EXPENSES IDENTIFIED UNDER THE SUBSIDIZED HEALTH SERVICES CATEGORY PERTAINS TO A PHYSICIAN CLINIC IN OUR COMMUNITY BENEFIT REPORT. PART I, LINE 7, COLUMN F BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED HERE EQUALS $29,149,308. PART I, LINE 7 COSTING METHODOLOGY USED IS COST-TO-CHARGE RATIO USING WORKSHEETS 1, 2, AND 3. COMMUNITY BUILDING ACTIVITIES PART II POMONA VALLEY HOSPITAL MEDICAL CENTER SUPPORTS THE ECONOMIC DEVELOPMENT OF THE COMMUNITY BY ALLOWING A 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 ECONOMIC DEVELOPMENT. 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. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINE 3 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 LINE 3 OF PART II AS COMMUNITY SUPPORT. POMONA VALLEY HOSPITAL MEDICAL CENTER'S EMERGENCY DEPARTMENT IS INVOLVED WITH "EVERY 15 MINUTES" A PROGRAM THAT EDUCATES HIGH SCHOOL STUDENTS OF THE DANGERS OF DRUNK DRIVING THAT ALSO INVOLVES THE LOCAL FIRE AND POLICE DEPARTMENTS, AND AMBULANCES. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINE 3 OF PART II AS COMMUNITY SUPPORT. POMONA VALLEY HOSPITAL MEDICAL CENTER 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). THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINE 8 OF PART II AS WORKFORCE DEVELOPMENT. POMONA VALLEY HOSPITAL MEDICAL CENTER IS COMMITTED TO PROVIDING ACCESS TO CARE FOR OUR COMMUNITY THROUGH OUR PHYSICIAN ASSISTANCE PROGRAM. THIS PROGRAM PROVIDES LOANS TO NEW PHYSICIANS IN SPECIALTIES IDENTIFIED AS A NEED, TO HELP THEM WITH STARTING THEIR PRACTICES IN OUR COMMUNITY. THESE PHYSICIANS PROVIDE NEEDED MEDICAL CARE TO MANY OF OUR MEDICAL AND INDIGENT PATIENTS AS A CONDITION OF PARTICIPATION IN THE ASSISTANCE PROGRAM. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINE 8 OF PART II AS WORKFORCE DEVELOPMENT. 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 AND OUR EDUCATION DEPARTMENT SERVES ON THE ADVISORY BOARDS TO THESE SCHOOLS. THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINE 8 OF PART II AS WORKFORCE DEVELOPMENT. POMONA VALLEY HOSPITAL MEDICAL CENTER SUPPORTS OUR COMMUNITY THROUGH CONTRIBUTIONS AND DONATIONS FOR THE VULNERABLE POPULATIONS AS WELL AS THE BENEFIT OF THE BROADER COMMUNITY. EXAMPLES OF OUR PROGRAMS INCLUDE: WIGS FOR NEWLY DIAGNOSED CANCER PATIENTS, MEALS TO THOSE RESIDENTS THAT ARE HOME-BOUND AND CAR SEATS FOR PARENTS UNABLE TO PROVIDE THEM FOR THE NEWBORN BABY, AS WELL AS CONTRIBUTIONS TO OTHER NON-PROFIT ORGANIZATIONS COMMITTED TO ADVANCING THE WELL BEING OF THE RESIDENTS WE SERVE. PART III, LINE 4 THE COSTING METHODOLOGY USED IS COST-TO-CHARGE RATIO, CALCULATED USING WORKSHEET 2 AND WORKSHEET A. THE HOSPITAL'S FINANCIAL STATEMENT DOES NOT INCLUDE A BAD DEBT FOOTNOTE. BAD DEBT EXPENSE IS ESTIMATED APPLYING HISTORICAL PERCENTAGES (BASED ON THE PRIOR YEARS' BAD DEBT ACTIVITY) TO THE CURRENT ACCOUNTS RECEIVABLE PATIENT RESPONSIBILITY PAYOR CLASSES. PATIENTS WITHOUT INSURANCE ARE OFFERED A PROMPT PAY DISCOUNT, GREATLY DISCOUNTING THEIR BALANCE IF PAID WITHIN 30 DAYS. ALL DISCOUNTS AND PAYMENTS ARE APPLIED TO THE BAD DEBT ACCOUNT BEFORE THE ACCOUNT IS WRITTEN OFF. 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. ACCOUNTS RETURNED FROM THE COLLECTION AGENCY ARE WRITTEN OFF TO BAD DEBT EXPENSE. LINE 3 CONSISTS OF THE ACCOUNTS WRITTEN OFF, WHICH WERE ALSO DECLINED FOR FINANCIAL ASSISTANCE PER THE HISTORICAL ACCOUNT RECORDS, AND CONVERTED TO COST BY USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. 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. NEEDS ASSESSMENT IN 2009, 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). THE COSTS AND PERSONS SERVED ARE REFLECTED ON LINES 3 & 8 OF PART II AS COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE 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 POMONA VALLEY HOSPITAL MEDICAL CENTER 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 771,236 IN 2000 AND AN ESTIMATED POPULATION OF 844,140 IN 2006-2008 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 2006-2008 WAS SUCH THAT 29.02% IS HISPANIC OR LATINO, 11.71% IS WHITE, 7.3% IS BLACK/AFRICAN-AMERICAN, 6.8% IS ASIAN, 0.97% IS AMERICAN INDIAN, 0.1% HAWAIIAN/PACIFIC ISLANDER, 40.7% IS OTHER, AND 3.4% IS TWO OR MORE RACES, ACCORDING TO THE U.S. CENSUS BUREAU. PROMOTION OF COMMUNITY HEALTH 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, MEDI-CAL, CHAMPUS, AND 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. AFFILIATED HEALTH CARE SYSTEM POMONA VALLEY HOSPITAL MEDICAL CENTER IS A STAND ALONE HOSPITAL, NOT PART OF A HEALTH CARE SYSTEM. STATE FILING OF COMMUNITY BENEFIT REPORT CA false CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K STREET STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 3170390 HOSPITAL FEE PROGRAM 1 0 X X X X X false true false false false false false true false RICHARD YOCHUM 553131 0 0 0 7904 0 201890 0 20715 0 783640 0 0 0 MICHAEL NELSON 405815 0 0 0 639816 0 82052 0 20731 0 1148414 0 631424 0 KURT WEINMEISTER 340792 0 0 0 6802 0 12250 0 15874 0 375718 0 0 0 CHRIS ALDWORTH 185400 0 0 0 17548 0 14604 0 26990 0 244542 0 0 0 JULI HESTER 200007 0 0 0 3639 0 11346 0 15590 0 230582 0 0 0 DARLENE SCAFFIDDI 232960 0 0 0 7358 0 17306 0 29297 0 286921 0 0 0 KENNETH K NAKAMOTO 263930 0 0 0 8814 0 12250 0 29090 0 314084 0 0 0 JOSEPH P BAUMGAERTNER 224074 0 44574 0 4389 0 16498 0 27081 0 316616 0 0 0 KENT G HOYOS 233136 0 0 0 3554 0 11401 0 29090 0 277181 0 0 0 RICHARD ROSSMAN 204148 0 40253 0 8775 0 14899 0 29244 0 297319 0 0 0 JAMES LENTS 215796 0 84760 0 4330 0 6029 0 20526 0 331441 0 0 0 DEFERRED COMPENSATION PLAN SCHEDULE J, PART I, LINE 4B MR. NELSON'S COMPENSATION INCLUDES A PAYMENT OF $631,424 MADE ACCORDING TO THE PROVISIONS OF THE EMPLOYMENT CONTRACT DESCRIBED BELOW. THE AMOUNT REPRESENTS DEFERRED COMPENSATION SET ASIDE FOR 34 YEARS OF EMPLOYMENT AND REQUIRED UNDER IRS GUIDELINES TO BE PAID IN 2010 UNDER THE EMPLOYMENT AGREEMENT. THE HOSPITAL HAS EMPLOYMENT CONTRACTS WITH MR. YOCHUM AND MR. NELSON. THE CONTRACTS PROVIDE FOR THE PAYMENT OF FOUR TIMES ANNUAL CASH COMPENSATION IF THE EXECUTIVE REMAINS EMPLOYED UNTIL THE CONTRACT. EMPLOYMENT REQUIREMENTS ARE 31 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 BOARD OF DIRECTORS HAS THE 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)). IN ADDITION, SCHEDULE J, PART II, COLUMN C INCLUDES A CURRENT YEAR DEFERRAL AMOUNT OF $182,290 FOR MR. YOCHUM AND $62,452 FOR MR. NELSON. NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 CERTAIN MEMBERS OF MANAGEMENT ARE AWARDED INCENTIVE COMPENSATION IN RECOGNITION OF SIGNIFICANT CONTRIBUTIONS TO ACHIEVING CORPORATE GOALS. THESE AMOUNTS ARE LISTED IN SCHEDULE J, PART II, COLUMN B(II). Pomona Valley Imaging Med Grp SEE PART V 401185 COMPENSATION FOR SERVICES false Tamera Freehling SEE PART V 87580 COMPENSATION FOR SERVICES false Gregory Daly SEE PART V 123936 COMPENSATION FOR SERVICES false BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV 1. JOHNSON LIGHTFOOTE, MD, A DIRECTOR OF THE ORGANIZATION'S BOARD, IS A GREATER THAN 5% OWNER OF POMONA VALLEY IMAGING MEDICAL GROUP. 2. TAMERA FREEHLING IS THE DAUGHTER-IN-LAW OF FRED FREEHLING, A DIRECTOR OF THE ORGANIZATION'S BOARD. 3. GREGORY DALY IS THE BROTHER OF DARLENE SCAFFIDDI, A KEY EMPLOYEE OF THE ORGANIZATION. X MEDICAL EQUIPMENT 1 0 NONE 0 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 I, LINE 1 & 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 ACUTE CARE COMMUNITY HOSPITAL. WE SERVE A CULTURALLY DIVERSE POPULATION AND ARE A MAJOR PROVIDER IN OUR REGION, PARTICULARLY FOR MEDI-CAL AND INDIGENT PATIENTS IN BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES. OUR COMMUNITY IS IMPORTANT TO US, AND IT IS REPRESENTED IN ALL OF THE WORK WE DO. IN 2009, 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 PVHMC (INCLUDING VISITS TO THE EMERGENCY DEPARTMENT, OR ED). PVHMC'S ED IS A VITAL COMPONENT OF THE WELL-BEING OF OUR COMMUNITY RESIDENTS. WE DELIVER CARE TO ALL PATIENTS IN OUR ED, WITH OR WITHOUT INSURANCE. PVHMC HAS LEARNED FROM THIS STUDY THAT THE NECESSITY TO IMPROVE AND BUILD UPON THE EFFICIENCY OF OUR ED IS CRITICAL IN ORDER FOR US TO KEEP UP WITH THE GROWING DEMANDS BEING PLACED UPON OUR SYSTEM EVERYDAY. PVHMC CONTINUES TO REACH OUT TO OUR COMMUNITY AND EDUCATE THEM ON A VARIETY OF HEALTH ISSUES, ESPECIALLY THE ESSENTIAL REGIONAL SERVICES WE PROVIDE TO MAINTAIN A HEALTHY COMMUNITY. MANY OF THE ACTIVITIES AND PROGRAMS IN OUR COMMUNITY BENEFIT PLAN ADDRESS IDENTIFIED PUBLIC HEALTH NEEDS. 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. ABOUT PVHMC - PRESIDENT/CHIEF EXECUTIVE OFFICER, RICHARD E. YOCHUM AND CHAIRMAN, BOARD OF DIRECTORS, ROGER GINSBURG. 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 771,236 IN 2000 AND AN ESTIMATED POPULATION OF 844,140 IN 2006-2008 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 2006-2008 WAS SUCH THAT 71.3% IS HISPANIC OR LATINO, 40.8% IS WHITE, 7.3% IS BLACK/AFRICAN-AMERICAN, 6.8% IS ASIAN, 0.97% IS AMERICAN INDIAN, 0.1% HAWAIIAN/PACIFIC ISLANDER, 40.7% IS OTHER, AND 3.4% IS TWO OR MORE RACES, ACCORDING TO THE U.S. CENSUS BUREAU. COMMUNITY BENEFIT PLAN FOCUS STUDY - 2009 UPDATE. MEETING THE NEEDS OF OUR GROWING COMMUNITY THROUGH THE EMERGENCY DEPARTMENT (ED) HAS BEEN ONE OF THE TOP PRIORITIES OF OUR ORGANIZATION. PVHMC IS HOME TO THE ONLY 24-HOURS-A-DAY, FULL SERVICE ED IN POMONA WITH OVER 78,000 PATIENT VISITS LAST YEAR. OUR ED TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. SOME OF THE IMPROVEMENTS WE HAVE MADE IN THE ED IN 2010 INCLUDE THE RE-DESIGN OF THE RAPID MEDICAL EVALUATION (RME) PROGRAM. THE CALIFORNIA EMERGENCY PHYSICIAN (CEP) GROUP AT PVHMC HAS DEVELOPED AND PIONEERED A NUMBER OF PROVEN BEST PRACTICES REFERRED TO COLLECTIVELY AS THE 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 SATISFACTION WHILE DECREASING DIVERSION TIME AND ED OVERCROWDING. GOALS OF THE RME PROGRAM INCLUDE INITIAL PHYSICIAN EVALUATION 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 ADDED ADDITIONAL NURSING STAFF (A TOTAL OF 21 LICENSED AS COMPARED TO 19 IN 2008) AS WELL AS ADDITIONAL PROVIDER (PHYSICIAN/PHYSICIAN ASSISTANT) COVERAGE TO HAVE A PROVIDER IN TRIAGE DURING THE TIMES OF HEAVIEST PATIENT VOLUMES. WE HAVE DECREASED OUR AVERAGE "DOOR-TO-PROVIDER TIME" IN 2010 TO 43-MINUTES AND SURPASSED OUR GOAL OF 45-MINUTES (CEP GROUP). OUR GOAL FOR 2011 IS 40 MINUTES. THE ADDITION OF BIOSITE CARDIAC/SHORTNESS OF BREATH LABORATORY POINT-OF-CARE TESTING IN THE ED ALLOWS FOR A FASTER, RELIABLE BEDSIDE LAB TEST FOR ANY PATIENTS PRESENTING WITH CHEST PAIN AND SHORTNESS OF BREATH. USING BIOSITE REDUCES THE TIME TO RECEIVE RESULTS FROM 1-1.5 HOURS TO 15 MINUTES AND REDUCES A PATIENT'S OVERALL TURN-AROUND TIME BY AS MUCH AS AN HOUR. IN 2009, WE IMPLEMENTED AN ED SURGE CAPACITY PLAN CALLED "CAPACITY ALERT" THAT ESTABLISHES A HOSPITAL-WIDE APPROACH TO MAXIMIZE CAPABILITIES AND HOSPITAL INTEGRATION IN RESPONSE TO PATIENT INFLUX OF THE ED. THIS ALERT WAS DEMONSTRATED TO BE EFFECTIVE DURING THE H1N1 PANDEMIC DURING MAY AND OCTOBER 2009 WHEN THE ED HAD TO ABSORB ADDITIONAL PATIENT VOLUME. THE ED SEES MANY TRAUMA PATIENTS AND ALTHOUGH WE ARE NOT A DESIGNATED TRAUMA CENTER WE OFFERED OUR EMERGENCY NURSES A NATIONAL COURSE, TRAUMA NURSING CORE COURSE WHICH IS A "NATIONAL CERTIFICATE" TO EDUCATE OUR NURSES IN THE CARE OF TRAUMA PATIENTS. IN 2009, THE ED PASSED THE EMERGENCY DEPARTMENT APPROVED FOR PEDIATRICS (EDAP) SURVEY AND WAS RECERTIFIED AS AN EDAP FOR LOS ANGELES COUNTY. THE EDAP RATING RECOGNIZES THAT PVHMC PROVIDES SPECIALIZED EMERGENCY CARE THAT CAN GREATLY IMPROVE OUTCOMES FOR YOUNG PATIENTS. OUR PEDIATRIC TRANSPORT UNIT STANDS READY 24-HOURS-A-DAY TO TRANSPORT CRITICALLY ILL OR INJURED CHILDREN TO PVHMC FOR CARE IN OUR ED. WE OPERATE ONE OF THE 20 REMAINING PARAMEDIC BASE STATIONS IN LOS ANGELES COUNTY SINCE JULY 1979 AND WE WERE RECERTIFIED IN 2009. THE BASE STATION IS MANNED BY SPECIALLY TRAINED NURSES, MOBILE INTENSIVE CARE NURSES, CERTIFIED BY LOS ANGELES COUNTY. THIS VITAL COMPONENT OF PATIENT CARE PROVIDES EMERGENCY CARE GIVERS IN THE FIELD WITH A DIRECT LINK TO THE ED, ALLOWING DIRECT CONTACT WITH THE MOBILE INTENSIVE CARE NURSE, AND IF NECESSARY THE ED PHYSICIAN. THE ED STAFF IS BETTER PREPARED FOR THE IMMINENT ARRIVAL OF A CRITICALLY ILL OR INJURED PATIENT, RECOGNIZING POTENTIAL PROBLEMS EARLY OR REDIRECTING THE PARAMEDICS IF NECESSARY TO ANOTHER MORE APPROPRIATE FACILITY SUCH AS A TRAUMA CENTER OR OTHER SPECIALTY CENTER. PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED WE HAVE INITIATED IN 2009 A GOLD ALERT, EARLY GOAL DIRECTED THERAPY AS EVIDENCED BY BEST PRACTICE FOR SEPTIC PATIENTS. SEVERE SEPSIS IS THE LEADING CAUSE OF DEATH IN NON-CORONARY INTENSIVE CARE UNIT (ICU) PATIENTS. IT AFFECTS 10% OF ALL ICU PATIENTS. SINCE THE IMPLEMENTATION OF OUR SEPSIS PROGRAM IN 2009, WE HAVE MADE SIGNIFICANT STRIDES INCLUDING LOWER LENGTH OF STAY AND IMPROVED OUTCOMES. INTENSE EDUCATION ON EARLY GOAL DIRECTED THERAPY AND SEPSIS PROTOCOL IMPLEMENTATION TOOK PLACE WITH THE SUPPORT OF OUR CRITICAL CARE DIRECTOR, CRITICAL CARE NURSE PRACTITIONER, AND CLINICAL NURSE SPECIALIST IN THE ED. OUR SEPSIS TASK FORCE WHICH CONSISTS OF NURSING STAFF FROM BOTH THE ICU AND THE ED WAS INVOLVED IN THE DEVELOPMENT OF THE SEPSIS PROTOCOL ORDER SETS, CHECKLIST AND REMINDERS TO INCREASE UTILIZATION OF THE SEPSIS PROTOCOL. THE TASK FORCE ALSO PERFORMS CHART AUDITS; INITIATES THE SEPSIS PROTOCOL, ANALYZES DATA, REPORTS DEFICIENCIES AND IDENTIFIES AREAS FOR IMPROVEMENT; AND, DEVELOPS STRATEGIES TO IMPROVE THE CARE OF SEPSIS PATIENTS. THE ICU ALSO COLLABORATED WITH THE ED TO FACILITATE THE TIMELY TRANSFER OF SEPTIC PATIENTS FROM THE ED TO THE ICU. BUILDING A BRIDGE BETWEEN THE ED AND ICU STAFF THROUGH THE NURSING LEADERSHIP TEAM CONTRIBUTES TO THE SUCCESS OF OUR SEPSIS PROGRAM. PVHMC IS A DESIGNATED STEMI RECEIVING CENTER (SRC) IN BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES. 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. FOR FOURTH QUARTER 2009, THE AVERAGE WAS 57 MINUTES FOR DOOR-TO-BALLOON TIME. IN CONJUNCTION WITH THE STEAD HEART AND VASCULAR CENTER, IN 2010 WE IMPLEMENTED STROKE ALERT. AS IS SIMILAR TO THE PROCESSES FOR A STEMI, THE STROKE ALERT PROTOCOL HAS BEEN ESTABLISHED TO PROPERLY RECOGNIZE, DIAGNOSE AND FAST TRACK POSSIBLE STROKE/TRANSIENT ISCHEMIC ATTACK (TIA) VICTIMS TO THE CORRECT TREATMENT PLAN. ALONG WITH THE PROGRESS WE HAVE MADE TO IMPROVE EMERGENCY CARE SERVICES, IN 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 HAVE OPENED TWO PRIMARY CARE OFFICES IN OUR COMMUNITY (CHINO HILLS) WITH 15 URGENT CARE AND PRIMARY CARE EXAM ROOMS AND ANOTHER WITH NINE URGENT CARE ROOMS AND ANOTHER NINE PRIMARY CARE ROOMS. IN MARCH 2009, WE MADE AVAILABLE THE POMONA VALLEY HEALTH CENTER AT CLAREMONT BASED UPON OUR COMMUNITY'S INCREASED NEED FOR PRIMARY CARE AND URGENT CARE SERVICES. THE CLINICS ARE STAFFED BY PHYSICIANS OF OUR HOSPITAL'S FAMILY MEDICINE RESIDENCY PROGRAM (FMRP) WHO HAVE REMAINED IN THE COMMUNITY AFTER GRADUATING FROM TRAINING. THE GROWTH OF SERVICES SUCH AS OUR ED AND OUR LOCAL CLINICS HAVE BEEN HIGHLY ENCOURAGED BY THE COMMUNITY'S INPUT, THE STRONG TEAM OF PHYSICIANS AND STAFF WHO ARE ABLE AND WILLING TO WORK TOWARDS FULFILLING THE COMMUNITY RESIDENTS' HEALTH CARE NEEDS, AND THE HOSPITAL'S CONTINUOUS EFFORT TO SUPPORT QUALITY SERVICES THAT ARE NECESSARY TO FUNCTION AS A PREMIER HOSPITAL IN OUR REGION. IT IS VERY LIKELY THAT THESE CRITICAL NEEDS WOULD OTHERWISE NOT BE MET OR AVAILABLE TO THE COMMUNITY WITHOUT THE FULL SUPPORT OF THE HOSPITAL AND OUR STATISTICS CLEARLY SUPPORT THE DEMAND. OVERALL, OUR COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS SEEK TO CONNECT RESIDENTS/PATIENTS WITH MUCH NEEDED HEALTH CARE SERVICES. 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 - PVHMC SERVES AS THE LEAD AGENCY FOR THE POMONA CLINIC COALITION (PCC), ASSUMING RESPONSIBILITY FOR LOS ANGELES COUNTY'S POMONA HEALTH CENTER AND FORMING A PUBLIC-PRIVATE PARTNERSHIP. THE PCC OFFERS PRIMARY HEALTH CARE SERVICES AT NO COST TO PATIENTS. IN ADDITION, OUTREACH SERVICES ARE GIVEN TO THE HOMELESS AT SHELTER SITES. PVHMC PROVIDES STAFF, SUPPLIES, AND ANCILLARY OUTPATIENT DIAGNOSTIC SERVICES (X-RAYS AND LABS). THE PORTABLE WELLNESS CLINIC IS A PARTNERSHIP BETWEEN COMPASSION NET, PVHMC'S FAMILY MEDICINE RESIDENCY PROGRAM (FMRP) AND FAMILY HEALTH CENTER (FHC) TO INCREASE ACCESSIBILITY TO PRIMARY HEALTH CARE SERVICES AT A LOW COST. PVHMC PROVIDES THE MEDICAL PERSONNEL, MOSTLY DOCTORS FROM THE FMRP. COMPASSION NET PROVIDES THE VEHICLE AND COORDINATES THE OUTREACH EFFORT. THE MOBILE UNIT TRANSPORTS EQUIPMENT AND SUPPLIES TO THREE POMONA LOCATIONS BIMONTHLY. 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. TO DATE,THREE NEWBORNS HAVE BEEN SURRENDERED AND WHOSE LIVES WERE SAVED. 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 TO THE COMMUNITY AND SUPPORT GROUPS WITH TRAINED PROFESSIONALS. 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 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 MOBILE FLU CLINICS TO OFFER FREE FLU SHOTS TO SENIORS AT LOCAL COMMUNITY SENIOR SETTINGS AND 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 RESPIRATORY SERVICES DEPARTMENT CONDUCTS PULMONARY SCREENINGS AT COMMUNITY HEALTH FAIRS. 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 OPPORTUNITES 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. PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED 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. PVHMC'S ED IS INVOLVED WITH "EVERY 15 MINUTES", A PROGRAM THAT EDUCATES HIGH SCHOOL STUDENTS OF THE DANGERS OF DRUNK DRIVING THAT ALSO INVOLVES THE LOCAL FIRE AND POLICE DEPARTMENTS, AND AMBULANCES. VALUATION OF COMMUNITY BENEFIT PROGRAMS - FOR 2010, PVHMC'S TOTAL COMMUNITY BENEFITS CAME TO $137,824,109 WHICH CONSISTS OF TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS ($131,264,740) AND TOTAL OTHER BENEFITS ($6,559,369). TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS IS MADE UP OF CHARITY CARE ($45,488,664), MEDI-CAL INPATIENT OR THE NET UNREIMBURSED COST, WHICH IS EQUIVALENT TO UNREIMBURSED COST LESS THE DISPROPORTIONATE SHARE PAYMENT ($52,194,096), MEDI-CAL OUTPATIENT UNREIMBURSED COSTS ($19,948,420), MEDICARE INPATIENT UNREIMBURSED COST ($3,238,631), AND MEDICARE OUTPATIENT UNREIMBURSED COST ($10,394,929). OTHER BENEFITS IS MADE UP OF COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ($1,370,593), HEALTH PROFESSIONS EDUCATION ($3,319,693), SUBSIDIZED HEALTH SERVICES ($1,738,464), AND RESEARCH ($28,300). ADDITIONALLY, THE VALUE OF COMMUNITY BUILDING ACTIVITIES IS $794,400. THESE AMOUNTS ARE MEASURED AT STANDARD COSTS. THE ECONOMIC VALUE OF THE DOCUMENTED COMMUNITY BENEFITS WAS DETERMINED AS FOLLOWS: UNCOMPENSATED CARE WAS VALUED IN THE SAME MANNER THAT SUCH SERVICES WERE REPORTED IN THE HOSPITAL'S ANNUAL REPORT TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. CHARITY CARE WAS VALUED BY COMPUTING THE DIFFERENCE BETWEEN CHARGES AND ACTUAL REVENUE RECEIVED (INCLUDING CHARITY CARE DONATIONS). OTHER SERVICES WERE VALUED BY ESTIMATING THE COSTS OF PROVIDING THE SERVICES AND SUBTRACTING ANY REVENUES RECEIVED FOR SUCH SERVICES. COSTS WERE DETERMINED BY ESTIMATING STAFF AND SUPERVISION HOURS INVOLVED IN PROVIDING THE SERVICES. OTHER DIRECT COSTS SUCH AS SUPPLIES AND PURCHASED SERVICES WERE ALSO ESTIMATED. ANY OFFSETS (CORPORATE SPONSORSHIP, ATTENDANCE FEES, OR OTHER INCOME CONTRIBUTED OR GENERATED) WERE SUBTRACTED FROM THE COSTS REPORTED. PLANS FOR 2011/2012 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. ORGANIZATION'S GOVERNING BODY PROCEDURES FOR FORM 990 REVIEW FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE TAX RETURN ALONG WITH A NARRATIVE FROM ERNST & YOUNG, THE HOSPITAL'S EXTERNAL ACCOUNTING FIRM, IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING IN NOVEMBER 2011. 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 AND DIRECTORS 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 2010 ALL MANAGEMENT SALARIES WERE FROZEN SO THERE WAS NO REVIEW OF UPPER MANAGEMENT BROUGHT FORWARD TO THE COMPENSATION COMMITTTEE AND NO REVIEW OF A HAY GROUP REPORT. 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, EXECUTIVE DIRECTOR OF FINANCE, DIRECTOR OF MANAGED CARE, COMPLIANCE OFFICER, DIRECTOR OF UTILIZATION MANAGEMENT. THIS PROCESS IS ALSO DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE. PUBLIC DISCLOSURE OF GOVERNING DOCUMENTS AND POLICY FORM 990, PART VI, SECTION C, LINE 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. PUBLIC DISCLOSURE OF GOVERNING DOCUMENTS AND POLICY FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII RICHARD YOCHUM, MICHAEL NELSON, AND JULI HESTER DEVOTE TWO HOURS SERVING ON THE BOARD OF POMONA VALLEY HOSPITAL MEDICAL CENTER FOUNDATION. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 NET UNREALIZED GAIN(LOSS) FROM INVESTMENTS: $404,026 EFFECT OF ADOPTION OF FASB STATEMENT NO. 158: -$215,689 LOSS FROM SUBSIDIARY: -$514,758 S-CORP K1: -$ 42,223 ROUNDING: $ 30 TOTAL OTHER CHANGES IN NET ASSETS: -$368,614 Pomona Valley Hospital Medical Ctr Fdn 1798 North Garey Avenue Pomona CA 91767 953403287 Support PVHMC CA 501(C)(3) 7 NA Pomona Valley Hospital Medical Ctr Aux 1798 North Garey Avenue Pomona CA 91767 956053224 Support PVHMC CA 501(C)(3) 11, I NA Pomona Valley Medical Plaza 1798 NORTH GAREY AVENUE POMONA CA 91767 954175295 LEASING CA NA RELATED -506938 4386497 false 0 false 1.00000 Pomona Valley Health Facilities 1798 North Garey Avenue Pomona CA 91767 954104554 R.E. 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