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SONORA COMMUNITY HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SONORA COMMUNITY HOSPITAL (EIN 94-1415069)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201113199349310876
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-15T19:53:30-08:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941415069EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sonora Community HospitalBusinessNameLine1
Business Name Line2dba Sonora Regional Medical CenterBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSONONameControl
Phone2095365000Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameAndrew JahnName
TitleTreas/Sr VP FinTitle
Date Signed2011-11-15DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts178115651GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number1071GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1958YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionFollowing the example of Jesus, we alleviate human suffering by providing physical, mental and spiritual healing.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees1382TotalNbrEmployees
Total Gross UBI116627TotalGrossUBI
Net Unrelated Business Txbl Income-261NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year345213ContributionsGrantsPriorYear
Contributions Grants Current Year678344ContributionsGrantsCurrentYear
Program Service Revenue Prior Year155297255ProgramServiceRevenuePriorYear
Program Service Revenue CY176612107ProgramServiceRevenueCY
Investment Income Prior Year393320InvestmentIncomePriorYear
Investment Income Current Year666452InvestmentIncomeCurrentYear
Other Revenue Prior Year268520OtherRevenuePriorYear
Other Revenue Current Year125427OtherRevenueCurrentYear
Total Revenue Prior Year156304308TotalRevenuePriorYear
Total Revenue Current Year178082330TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year78528GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY83632GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year71921702SalariesEtcPriorYear
Salaries Etc Current Year81993826SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year258584TotalFundrsngExpCurrentYear
Other Expense Prior Year76695262OtherExpensePriorYear
Other Expenses Current Year85661566OtherExpensesCurrentYear
Total Expenses Prior Year148695492TotalExpensesPriorYear
Total Expenses Current Year167739024TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7608816RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10343306RevenuesLessExpensesCY
Total Assets BOY91714025TotalAssetsBOY
Total Assets EOY99152006TotalAssetsEOY
Total Liabilities BOY67605235TotalLiabilitiesBOY
Total Liabilities EOY64654240TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY24108790NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34497766NetAssetsOrFundBalancesEOY
Mission DescriptionFollowing the example of Jesus, we alleviate human suffering by providing physical, mental and spiritual healing.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense151564177Expense
Revenue176520527Revenue
DescriptionSonora Community Hospital (SCH) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of SCH, the organization recognizes that not all individuals possess the ability to pay for essential medical services.SCH's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:- providing free care and/or subsidized care- providing care to persons covered by governmental programs at below cost- providing health/wellness activities and community education programsNot only does SCH provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. SCH recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. Inpatient services in 2010 were provided to approximately 4,953 patients. These services included:- Babies: 567 deliveries- Surgeries: 3,154 hours- Radiology: 10,068 procedures - Laboratory tests: 131,033 tests Outpatient services in 2010 were provided to about 260,000 patients. Including:- Emergency room: 26,174 visits- Outpatient surgeries: 4,589 hours- Radiology procedures: 50,906 performed- Laboratory tests: 267,656 performed- Medical clinics: 157,641 visitsSonora Community Hospital provides home care services in its surrounding communities. These services include, but are not limited to:- Respiratory Care- Elderly Care- Geriatric Case Management- Ostomy & Wound Care- Diabetes Care- IV Home TherapySCH recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission:Project HOPE, which stands for Health, Outreach, Prevention and Education- delivers dozens of free physicals and other services to indigent children and their parents at various locations throughout California's Tuolumne County with the help of volunteer nurses and physicians.Community Events - First aid stations at the local Mother Lode Fair, Home and Garden show and the Tuolumne Me-Wuk Health Fair. Exhibits at the Groveland Family Wellness Fair and the Tuolumne County Youth Health Fair. Close to 4,000 health screenings done at the annual Tuolumne County Health Fair.Health Education and Support ProgramsThe many support groups and health education classes conducted, including but not limited to:Cancer support group, Diabetes support group, Depression Recovery Program class, Spiritual Care training, CHIP Coronary Health Improvement Project, Epilepsy/Seizure Support Group, La Leche League, Childbirth Preparation Classes, Preparation for Cesarean Birth Classes, OakPlus Wellness Seminars, Quit for Life: Tobacco Cessation Classes, Lifeline Emergency Response ProgramMaintained and monitored up to 320 Lifeline Emergency Response Units. This 24-hour-a-day system offers immediate response to those whose physical condition could otherwise limit their ability to summon help.Spiritual SupportSCH's chaplains provided over 4,000 patient visits and over 1,500 hours of patient counseling, and provided over 300 hours of employee counseling, conducted memorial services and officiated at weddings.Community SupportSCH donated $26,450 to 33 community service organizations in 2010.Description
Total Program Service Expense151564177TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096155NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1382NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledtrueForm8899Filed
Form1098 C FiledtrueForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonAndrew JahnNamePerson
Telephone Number2095365000TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekFormerFormerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeOfficerOfficerIndividual Trustee Or DirectorIndividualTrusteeOrDirectorHighest Compensated EmployeeHighestCompensatedEmployee
Alan Rice
Former Asst Sec0.00X026450230663
Rick Dodds
VP HR50.00013515023769X
Pauline Campbell
VP Off Site Ser50.00019749035700X
Julie Kline
Sr VP Pt Care50.00023445053987X
Alan J Rice
Former Asst Sec0.00026450230663
David Larsen
Treas/Sr VP Fin50.00024015268484X
Douglas Duffield
VP Bus Planning50.000145651696X
Jeff Eller
President & CEO50.00038818988750X
Rodney Wehtje
Asst Treas50.000484703160891X
Scott Reiner
Asst Sec50.000706956142451X
Douglas Rebok
Asst Sec50.000701547140807X
Larry Dodds
V Chair / Sec50.000789424159012XX
Robert Carmen
Chairman50.0001485849256139XX
Max Torkelsen
Director1.000185474X
WES RIPPEY
Director1.00014470474X
Al Reimche
Director1.000144074X
Meredith Jobe
Director1.0001624674X
Steven Herber
Director1.00014675474X
Ricardo Graham
Director1.000230974X
Christine Friestad
Director1.000131174X
Ruthita Fike
Director1.00040574X
Lynn Creitz
Director1.000212374X
LARRY CAVINESS
Director1.000250574X
Robert Bradshaw
Director1.000132174X
Deborah Goreham
RN0.0020583100X
David Schwartz
Physical Therapist40.0025850300X
Shane Tipton
Physician's Assist40.0024072800X
Paul Bauman
Chief Pharm45.0024474000X
Susan Shinkai
Pharmacist40.0017864100X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1128443TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6228451TotalReportableCompFrmRltdOrgs
Total Other Compensation1193826TotalOtherCompensation
Number Individuals GT100 K108NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sierra Cardiology Med Assoc
900 Greenely Rd Ste 911SonoraCA95370Medical Group2787606
Sound Physicians
1123 Pacific AveTacomaWA98402Medical Group1041607
Robert DAcquisto MD Inc
900 Greenley RdSonoraCA95370Medical Group976888
Sonora Anesthesia Services
PO Box 845SonoraCA95370Medical Group875611
Sierra Emergency Medical Group
PO Box 4685SonoraCA95370Medical Group2633493
FieldValueIRS element (for citing)
Number Of Contractors GT100 K46NumberOfContractorsGT100K
Fundraising Events95065FundraisingEvents
Government Grants24002GovernmentGrants
All Other Contributions559277AllOtherContributions
Total Contributions678344TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountBusiness CodeBusinessCodeRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Pharmacy91580$91,580
Other Revenue203819900099203819
Rent - Medical Offices217365531120217365
Dietary459555900099459555
Patient Service Revenue175630478900099175630478

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column9310TotalRevenueColumn
Related Or Exempt Function Income9310RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue176612107TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column666452TotalRevenueColumn
Exclusion$666,452ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events42121GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events95065CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses33321FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column8800TotalRevenueColumn
Exclusion$8,800ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenue
Company Store6219901403714037
Sonora Oxygen Service6216104081740817
Retail Pharmacy4461105476054760

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column7013TotalRevenueColumn
Unrelated Business Revenue7013UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue116627TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column178082330TotalRevenueColumn
Related Or Exempt Function Income176520527RelatedOrExemptFunctionIncome
Unrelated Business Revenue116627UnrelatedBusinessRevenue
Exclusion$766,832ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total26449Total
Program Services26449ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total57183Total
Program Services57183ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

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Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total60930444Total
Program Services57048555ProgramServices
Management And General3729238ManagementAndGeneral
Fundraising152651Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2383757Total
Program Services2204546ProgramServices
Management And General174270ManagementAndGeneral
Fundraising4941Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total14240291Total
Program Services13196884ProgramServices
Management And General1015946ManagementAndGeneral
Fundraising27461Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4439334Total
Program Services4159923ProgramServices
Management And General268701ManagementAndGeneral
Fundraising10710Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total271530Total
Management And General271530ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total342744Total
Management And General342744ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18770141Total
Program Services16763006ProgramServices
Management And General2003875ManagementAndGeneral
Fundraising3260Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total322596Total
Management And General322596ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total29846011Total
Program Services29165224ProgramServices
Management And General661586ManagementAndGeneral
Fundraising19201Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3696047Total
Program Services3696047ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4392712Total
Program Services4128194ProgramServices
Management And General264518ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total533498Total
Program Services404836ProgramServices
Management And General127213ManagementAndGeneral
Fundraising1449Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total198974Total
Program Services137704ProgramServices
Management And General59983ManagementAndGeneral
Fundraising1287Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2069789Total
Program Services2069789ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4603785Total
Program Services4603785ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1313055Total
Program Services1313055ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Equipment rentals1548928153268316245
Miscellaneous1582234724859857375
Purchased services1616952210331455580044337624

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total167739024Total
Program Services151564177ProgramServices
Management And General15916263ManagementAndGeneral
Fundraising258584Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1073672BOY
EOY92183EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12160366BOY
EOY21010900EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20612385BOY
EOY19724199EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

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EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3178202BOY
EOY3386731EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1097247BOY
EOY1487266EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis96560189LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec45471932LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY51401421BOY
EOY51088257EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY53562BOY
EOY388589EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2137170BOY
EOY1973881EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY91714025BOY
EOY99152006EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9843362BOY
EOY9325129EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY489167BOY
EOY-122933EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY5088034BOY
EOY4579230EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY52184672BOY
EOY50872814EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY67605235BOY
EOY64654240EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY23400659BOY
EOY33592462EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY708131BOY
EOY905304EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24108790BOY
EOY34497766EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY91714025BOY
EOY99152006EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10343306ReconcilationRevenueExpenses
Reconcilation Other Changes45670ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Church170b1 AiXChurch170b1Ai

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$10,609OtherActivitiesAmount
Total Lobbying Expenditures IIB10609TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

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

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance427428BeginningOfYearBalance
Contributions331644Contributions
Other Expenditures186989OtherExpenditures
End Of Year Balance572083EndOfYearBalance
FieldValueIRS element (for citing)
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2195922OtherCostOrOtherBasis
Book Value2195922BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis55738342OtherCostOrOtherBasis
Depreciation18528594Depreciation
Book Value37209748BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6367742OtherCostOrOtherBasis
Depreciation1937321Depreciation
Book Value4430421BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis31636345OtherCostOrOtherBasis
Depreciation25006017Depreciation
Book Value6630328BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis621838OtherCostOrOtherBasis
Book Value621838BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51088257TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Other liabilities-$164,542
Payables to third-party payers$1,942,475
Workers' comp liability$4,742,411
Payables to related orgs$44,352,470
FieldValueIRS element (for citing)
Total Of Amounts50872814TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteThe audited combined financial statement footnotes do not contain a FIN 48 disclosure.
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesDonated property $45670
Part V, Line 4Part V, Line 4: Intended uses of the endowment fund.Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GalaNameOfEvent1
Gross Receipts Event175396GrossReceiptsEvent1
Charitable Contributions Event148290CharitableContributionsEvent1
Gross Revenue Event127106GrossRevenueEvent1
Rent Facility Costs Event12500RentFacilityCostsEvent1
Food And Beverage Event110269FoodAndBeverageEvent1
Entertainment Event1400EntertainmentEvent1
Other Direct Expenses Event15213OtherDirectExpensesEvent1
Name Of Event2Golf TournamentNameOfEvent2
Gross Receipts Event261790GrossReceiptsEvent2
Charitable Contributions Event246775CharitableContributionsEvent2
Gross Revenue Event215015GrossRevenueEvent2
Cash Prizes Event2500CashPrizesEvent2
Non Cash Prizes Event23969NonCashPrizesEvent2
Rent Facility Costs Event25192RentFacilityCostsEvent2
Food And Beverage Event23060FoodAndBeverageEvent2
Other Direct Expenses Event22218OtherDirectExpensesEvent2
Gross Receipts Total137186GrossReceiptsTotal
Charitable Contributions Total95065CharitableContributionsTotal
Gross Revenue Total Events42121GrossRevenueTotalEvents
Cash Prizes Total Events500CashPrizesTotalEvents
Non Cash Prizes Total Events3969NonCashPrizesTotalEvents
Rent Facility Costs Total Events7692RentFacilityCostsTotalEvents
Food And Beverage Total Events13329FoodAndBeverageTotalEvents
Entertainment Total Events400EntertainmentTotalEvents
Other Direct Expenses Total Events7431OtherDirectExpensesTotalEvents
Direct Expense Summary Events33321DirectExpenseSummaryEvents
Net Income Summary8800NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1137562TotalCommunityBenefitExpense
Direct Offsetting Revenue319647DirectOffsettingRevenue
Net Community Benefit Expense817914NetCommunityBenefitExpense
Percent Of Total Expense0.00490PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense25016256TotalCommunityBenefitExpense
Direct Offsetting Revenue31183074DirectOffsettingRevenue
Net Community Benefit Expense-6166818NetCommunityBenefitExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense7590149TotalCommunityBenefitExpense
Direct Offsetting Revenue5391620DirectOffsettingRevenue
Net Community Benefit Expense2198529NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense33743967TotalCommunityBenefitExpense
Direct Offsetting Revenue36894341DirectOffsettingRevenue
Net Community Benefit Expense-3150375NetCommunityBenefitExpense
Percent Of Total Expense0.01800PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense165535TotalCommunityBenefitExpense
Net Community Benefit Expense165535NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1484420TotalCommunityBenefitExpense
Net Community Benefit Expense1484420NetCommunityBenefitExpense
Percent Of Total Expense0.00880PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense28674TotalCommunityBenefitExpense
Net Community Benefit Expense28674NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1678629TotalCommunityBenefitExpense
Net Community Benefit Expense1678629NetCommunityBenefitExpense
Percent Of Total Expense0.01000PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense35422596TotalCommunityBenefitExpense
Direct Offsetting Revenue36894341DirectOffsettingRevenue
Net Community Benefit Expense-1471746NetCommunityBenefitExpense
Percent Of Total Expense0.02800PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,088,648BadDebtExpenseAmount
Amount Attributable To206843AmountAttributableTo
Amount Reimbursed By Medicare66374262AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5074939CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall61299323MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities29NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (29 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeOtherOtherLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
Sonora Regional Wound Care
2912811 Covey CircleSonoraCA95370Wound Care clinic
Cedar Road Family Medical Cent
2820044 Cedar RoadSonoraCA95370Physician Office
Twain Harte Family Medical Cen
2722629 Twain Harte DriveTwain HarteCA95383Physician Office
Sonora Oxygen and Medical Supp
26358 W Stockton StreetSonoraCA95370Home oxygen supplier
Sierra Vascular Clinic
25690 Guzzi Lane Suite 104SonoraCA95370Physician office
Hillside Internal Medicine
24690 Guzzi Lane BSonoraCA95370Physician office
Groveland Family Medical Cente
2318661 Highway 120GrovelandCA95321Physician office
Sonora Regional Surgery Center
22905 Morning Star DriveSonoraCA95370OP Surgery Center
Foothill Primary Care
21650 Pauline CourtSonoraCA95370Physician Office
Community Pharmacy -Forest Rd
20193 S Fairview Ln Suite ASonoraCA95370Pharmacy
Sonora Regional Home Health
19467 South Main StAngels CampCA95222Home Health agency
Radiation Oncology
18900 Greenley Road Suite 901SonoraCA95370Radiation Therapy treatment center
Sierra Internal Medicine Cente
17900 Greenley Road Suite 922SonoraCA95370Physician Office
Sierra Cardiology
16900 Greenley Road Suite 911SonoraCA95370Physician Office
Sierra Cancer Center
15900 Greenley Road Suite 902SonoraCA95370Physician office
Community Pharmacy
14900 Greenley Road Suite 912SonoraCA95370Outpatient Pharmacy
Cedarwood Internal Medicine Ce
13690 Guzzi Lane Suite ASonoraCA95370Physician office
Arnold Family Medical Center
122037 Highway FourArnoldCA95223Physician Office
Angels Camp Family Medical Cen
11445 S Main StreetAngels CampCA95222Physician office
Sonora Regional Home Health
1020100 Cedar Road NorthSonoraCA95370Home Health agency
Cardiac and Pulmonary Rehab
919747 Greenley RdSonoraCA95370Outpatient services
Anticoagulation Clinic
8193 S Fairview Lane Suite LSonoraCA95370Outpatient clinic
Sonora Care Center
7538 Ponderosa DrSonoraCA95370Skilled Nursing Facility
Transitional Care Unit
6179 S Fairview LnSonoraCA95370Skilled Nursing Facility
Sonora Regional Imaging Center
512811 Covey CircleSonoraCA95370Imaging Center
Prompt Care Indian Rock
414540 Mono WaySonoraCA95370Urgent care clinic
Forest Rd Health and Wellness
3193 Fairview LnSonoraCA95370Physician offices and prompt care
Community Infusion Center
2900 Greenley RodSonoraCA95370OP Infusion center
Sonora Regional Medical Center
11000 Greenley RdSonoraCA95370XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (29 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeUses FPG DiscountedUsesFPGDiscountedExplains BasisExplainsBasisExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
Sonora Regional Wound Care
29falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Cedar Road Family Medical Cent
28falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Twain Harte Family Medical Cen
27falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Oxygen and Medical Supp
26falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sierra Vascular Clinic
25falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Hillside Internal Medicine
24falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Groveland Family Medical Cente
23falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Regional Surgery Center
22falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Foothill Primary Care
21falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Community Pharmacy -Forest Rd
20falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Regional Home Health
19falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Radiation Oncology
18falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sierra Internal Medicine Cente
17falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sierra Cardiology
16falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sierra Cancer Center
15falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Community Pharmacy
14falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Cedarwood Internal Medicine Ce
13falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Arnold Family Medical Center
12falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Angels Camp Family Medical Cen
11falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Regional Home Health
10falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Cardiac and Pulmonary Rehab
9falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Anticoagulation Clinic
8falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Care Center
7falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Transitional Care Unit
6falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Regional Imaging Center
5falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Prompt Care Indian Rock
4falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Forest Rd Health and Wellness
3falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Community Infusion Center
2falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse
Sonora Regional Medical Center
1falsefalsefalsefalsefalsefalsefalsefalsefalsetruefalsefalse

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part VI - Additional InformationPart V, Section BSchedule H, Part V, Section B is optional for the reporting organization as the tax year began prior to March 23, 2010. Further, IRS Announcement 2011-37 states the entire Part V, Section B is optional for the 2010 Form 990. Lacerte software has not provided a tool for an organization to indicate that it is opting not to complete Part V, Section B. In addition, the software has been programmed so that it populates responses when the organization chooses to provide no data inputs. Part V, Section B should be blank as the reporting organization opts to not complete it.
Part VI - States Where Community Benefit Report FiledCA
Part VI - Affilated Health Care System Roles and PromotionThe hospital is a member of a larger health care system, which provides services in diversified areas of the Western United States. The hospital shares some services with other hospitals in its geographic area. Using today's technology, hospitals outside the geographic area are able to support the hospital by providing remote services such as telepharmacy and robotics surgery. The Corporate Office provides support for the rural health clinics, quality of care, and other clinical needs.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeThe hospital continues to operate its 24-hour emergency department. The hospital has open medical staff to all qualified individuals. The hospital continues to expand its primary care outreach program through outpatient clinics, including a mobile clinic. The hospital operates skilled nursing facilities, which serve those who are unable to continue living without assistance due chronic medical conditions.
Part VI - Community Building ActivitiesOur hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H.
Part VI - Community InformationThe hospital is the only health care system in the area serving two counties and surrounding areas. In early 2009 the hospital was designated as a "sole community hospital" by Medicare. The area is rural. Agriculture, logging and tourism are the major employment opportunities. The population includes a large number of retired individuals.
Part VI - Patient Education of Eligibility for AssistanceAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients also are orally informed of their right to request charity assistance. Signs and other communiqus are posted and displayed throughout the hospital in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance.
Part VI - Needs AssessmentThe health system retains outside research firms every 3 years to assess changes in the market and community perception. Data is collected through a variety of vehicles, including phone surveys, paper surveys, and focus groups. Questions were added to the survey to help assess the impact of our community benefit activities and residents' barriers to access for health care services as well as unmet community needs.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsWhen a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL:Medicare cost report revenue - 57,732,860Prior year settlements - 269,819Cost Report remimbursable bad debts - 412,762Clinic 1206(D) revenue - 3,590,324Estimates and Accrual Variances - (285,927)Other - 4,654,424Total Medicare Revenue - 66,374,262*Note The Medicare cost report revenue does not include the bad debt reimbursement. The cost report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue alraedy accounted for in the co-pay and deductible amounts.
Part III, Line 4 - Bad Debt ExpenseUncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide audited combined financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2.The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information, those accounts would have been reclassified from bad debt expense to charity care.The system-wide audited combined financial statements do not contain a footnote describing bad debt expense.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuation
Utilities, food, other emergency assist25022107Cash
Transportation cancer pts to treatments50035076Cash

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationHospital does not monitor use of funds.Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Related OrgsBonusRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Rick Dodds
1280657085729616473158919
Pauline Campbell
16002013562197351596523319023908
Julie Kline
18602018287380061598128843730143
Alan J Rice
22761536887143671629629516532697
David Larsen
2002406544464442204030863633368
Jeff Eller
31008012835686612008947693965274
Rodney Wehtje
32443088697144827160646455947157654524
Scott Reiner
5105806104412232320128849407135332
Douglas Rebok
5127805098512248818319842354137782
Larry Dodds
5889304760314291216100948436152891
Robert Carmen
920840329087235392207471741988235922211163
Deborah Goreham
205831205831
David Schwartz
258503258503
Shane Tipton
240728240728
Paul Bauman
244740244740
Susan Shinkai
178641178641
Alan Rice
22761536887143671629629516532697

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 6bIdentifier
Return ReferencePart I, Line 6b: Explanation of organization compensation contingent on net earnings from related orReturnReference
ExplanationAn incentive plan is included as part of the board-approved compensation plan for hospital executives. [Use only if true statement - The hospital has a similar plan for department directors.] The purpose of these plans is to provide incentives to hospital management to accomplish the financial, operational, quality, and mission objectives of the hospital during each fiscal year. Each member of the management team is evaluated against pre-determined objectives to arrive at the incentive amount, if any, for the fiscal year. See Schedule O for additional detail.Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
Jeff Eller
HousingX$150,000148500falsetruetrue
Rick Dodds
HousingX$100,00099300falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due247800TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonAmanda HardcastleNamePerson
FieldValueIRS element (for citing)
RelationshipWehtje officerRelationship
Amount Of Transaction77545AmountOfTransaction
Description Of TransactionEmploymentDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI, Line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital
Form 990, Part VII, Line 1a - Board CompThe directors serve on the Board without compensation. Amounts reported generally are for taxable benefits. Further explanation for those directors who receive compensation for services rendered in their professional capacity follows. Steven Herber, MD is the Chief Medical Officer (CMO) for St. Helena Hospital. The hospital paid Dr. Herber $144,001 for his services. The CMO services were provided under contract approved by the Board Compliance Committee.Jobe & Stoterau, a law practice with which Meredith Jobe is affiliated, provided legal services regarding real estate matters to White Memorial Medical Center in the amount of $13,791. Wesley Rippey, MD is the Chief Medical Officer for Portland Adventist Medical Center. The hospital paid Dr. Rippey $57,600 for his CMO services. Additionally, Dr. Rippey provides vascular study interpretations and on call coverage for patients of the hospital. The hospital paid $85,818 for these professional services. These services were provided under contract approved by the Board Compliance Committee.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsDuring the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board after their review but prior to filing.Form 990, Part VI, Line 11
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (20 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
WILLITS HOSPITAL INC
1 Madrone StWillitsCA95490680108919HospitalCA501(C)(3)1Adventist Health SystemWestfalse
WHITE MEMORIAL MEDICAL CENTER
1720 Cesar E Chavez AveLos AngelesCA90033952282647HospitalCA501(C)(3)1Adventist Health SystemWestfalse
WALLA WALLA GENERAL HOSPITAL
1025 S Second StWalla WallaWA99362910617726HospitalWA501(C)(3)1Adventist Health SystemWestfalse
UKIAH ADVENTIST HOSPITAL
275 Hospital DrUkiahCA95482941639901HospitalCA501(C)(3)1Adventist Health SystemWestfalse
SOUTH COAST MEDICAL CENTER
2100 Douglas BlvdRosevilleCA95661952037291HospitalCA501(C)(3)1Adventist Health SystemWestfalse
SIMI VALLEY HOSPITAL & HEALTH CARE SERVI
2975 N Sycamore DrSimi ValleyCA93065956064971HospitalCA501(C)(3)1Adventist Health SystemWestfalse
SELMA COMMUNITY HOSPITAL INC
1141 Rose AveSelmaCA93662770509133Supporting Hanford Community HospitalCA501(C)(3)11, type 3 functionaAdventist Health SystemWestfalse
SAN JOAQUIN COMMUNITY HOSPITAL
2615 Chester AveBakersfieldCA93301952294234HospitalCA501(C)(3)1Adventist Health SystemWestfalse
ST HELENA HOSPITAL
10 Woodland RdSt HelenaCA94574941279779HospitalCA501(C)(3)1Adventist Health SystemWestfalse
PORTLAND ADVENTIST MEDICAL CENTER
10123 SE Market StPortlandOR97216930429015HospitalOR501(C)(3)1Adventist Health SystemWestfalse
PORT HUENEME ADVENTIST HOSPITAL
2100 Douglas BlvdRosevilleCA95661952915819Dissolution in processCA501(C)(3)1Adventist Health SystemWestfalse
PARADISE VALLEY HOSPITAL
2100 Douglas BlvdRosevilleCA95661951816034Wind down after sale of hospital facilitiesCA501(C)(3)1Adventist Health SystemWestfalse
NORTHWEST MEDICAL FOUNDATION OF TILLAMOO
1000 Third StTillamookOR97141930622075HospitalOR501(C)(3)1Adventist Health SystemWestfalse
HANFORD COMMUNITY HOSPITAL
450 Greenfield AveHanfordCA93230940535360HospitalCA501(C)(3)1Adventist Health SystemWestfalse
GLENDALE ADVENTIST MEDICAL CENTER
1509 Wilson TerraceGlendaleCA91206951816017HospitalCA501(C)(3)1Adventist Health SystemWestfalse
Feather River Hospital
5974 Pentz RdParadiseCA95969941101228HospitalCA501(C)(3)1Adventist Health SystemWestfalse
CENTRAL VALLEY GENERAL HOSPITAL
1025 N Douty StHanfordCA93230770324630HospitalCA501(C)(3)1Adventist Health SystemWestfalse
CASTLE MEDICAL CENTER
640 Ulukahiki StKailuaHI96734990107330HospitalHI501(C)(3)1Adventist Health SystemWestfalse
ADVENTIST HEALTH CLEARLAKE HOSPITAL INC
Ave 18 at Hwy 53ClearlakeCA95422680395149HospitalCA501(C)(3)3Adventist Health SystemWestfalse
ADVENTIST HEALTH SYSTEMWEST
2100 Douglas BlvdRosevilleCA95661953484589SUPPORT AND MANAGE System wide activitiesCA501(C)(3)1NAfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
ADVENTIST HEALTH SYSTEMWEST
l6041599
ADVENTIST HEALTH SYSTEMWEST
e44352470