Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Employer identification number
94-6068843
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
1,706,047
1,895,929
2,597,790
2,304,075
2,438,852
10,942,693
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
149,385,955
162,098,944
164,857,304
194,023,897
219,932,704
890,298,804
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
0
0
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
0
0
0
6
Total. Add lines 1 through 5.
151,092,002
163,994,873
167,455,094
196,327,972
222,371,556
901,241,497
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
0
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
0
0
c
Add lines 7a and 7b..
0
0
0
0
8
Public support (Subtract line 7c from line 6.)
901,241,497
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
151,092,002
163,994,873
167,455,094
196,327,972
222,371,556
901,241,497
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
429,543
731,813
710,137
558,868
632,553
3,062,914
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
429,543
731,813
710,137
558,868
632,553
3,062,914
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
299,106
0
299,106
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
0
0
0
0
13
Total support. (Add lines 9, 10c, 11, and 12.)..
151,521,545
165,025,792
168,165,231
196,886,840
223,004,109
904,603,517
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
99.628 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.644 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.339 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.303 %
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Employer identification number
94-6068843
Return Reference
Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1
MISSION STATEMENT SUTTER VISITING NURSE ASSOCIATION AND HOSPICE, DBA SUTTER CARE AT HOME (SCAH) ENHANCES THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HOME-BASED SERVICES AND PRODUCTS. THE SUTTER CARE AT HOME FOUNDATION SUPPORTS LOCAL HOME HEALTH AND END-OF-LIFE CARE, BEREAVEMENT SUPPORT SERVICES, AND COMMUNITY WELLNESS PROGRAMS PROVIDED BY SUTTER CARE AT HOME.
FORM 990, PART III, LINE 4A
EXEMPT PURPOSE ACHIEVEMENTS PRIMARY EXEMPT PURPOSE: PROVIDE HEALTH CARE TO PATIENTS IN THEIR HOMES. SERVICE ACCOMPLISHMENTS: SUTTER VNA & HOSPICE IS A STATE LICENSED, MEDICARE-CERTIFIED HOME CARE AGENCY THAT PROVIDES A BROAD SPECTRUM OF MULTI -DISCIPLINARY SERVICES AND OFFERS A RANGE OF SPECIALTY PROGRAMS TO RESIDENTS OF NORTHERN CALIFORNIA. SUTTER VNA & HOSPICE PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO REQUIRE THESE SERVICES OUTSIDE OF A HOSPITAL SETTING (PRIMARILY IN THE HOME), FOR WHICH A FEE IS CHARGED TO COVER THE COST OF PROVIDING THESE SERVICES. THESE SERVICES ARE PROVIDED TO MEDICARE, MEDI-CAL, AND PRIVATE INSURANCE PATIENTS. CHARITABLE CARE IS PROVIDED WHEN DEEMED APPROPRIATE. THERE WERE A TOTAL OF 33,715 PATIENTS SERVED IN 2013. THE HEALTH CARE SERVICES PROVIDED BY SUTTER VNA & HOSPICE INCLUDE THE FOLLOWING: - SKILLED NURSING; NURSES WORK WITH PATIENTS WHO HAVE HEART DISEASE, CANCER, DIABETES, OSTOMIES, AIDS, OR OTHER CHRONIC DISEASES AND ILLNESSES, OR WHO HAVE RECENTLY HAD SURGERY OR AN ACUTE CARE EPISODE. - REHABILITATION SERVICES INCLUDING PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. PHYSICAL AND OCCUPATIONAL THERAPY IS PROVIDED FOR PATIENTS WITH DIFFICULTIES DUE TO STROKES, AMPUTATION OR FRACTURES, SURGERY, AND FOR PATIENTS WHO ARE PARAPLEGICS OR QUADRIPLEGICS. SPEECH THERAPY IS PROVIDED FOR PATIENTS WITH SPEECH OR SWALLOWING PROBLEMS. - HOME INFUSION THERAPY SERVICES; PROVIDED FOR PATIENTS WHO NEED INTRAVENOUS TREATMENTS. SERVICES INCLUDE HYDRATION, CHEMOTHERAPY, TOTAL PARENTERAL NUTRITION, ANTIBIOTICS, INJECTABLE MEDICATIONS, PAIN MANAGEMENT, AND ENTERAL NUTRITION. - MATERNAL/CHILD CARE SERVICES; PROVIDED TO WOMEN WITH DIFFICULT PREGNANCIES AND NEW MOTHERS NEEDING ASSISTANCE. - PSYCHIATRIC HOME CARE: THIS PROGRAM PROVIDES HOME HEALTH SERVICES WITH FOCUS ON PSYCHIATRIC CARE (ASSESSMENT, TEACHING, REFERRALS AND FOLLOW-UP) BY SPECIALTY TRAINED CLINICIANS. - MEDICAL SOCIAL WORK SERVICES; PROVIDES ASSISTANCE TO PERSONS WHO NEED GUIDANCE IN DEVELOPING SELF-HELP AND PROBLEM SOLVING SKILLS, AND ACCESS TO COMMUNITY RESOURCES. - HOSPICE AND BEREAVEMENT SERVICES; HELPS TERMINALLY ILL PATIENTS AND THEIR FAMILIES WHO NEED SUPPORT AND CARE. SERVICES INCLUDE NURSING CARE, PAIN MANAGEMENT, SYMPTOM CONTROL, AND BEREAVEMENT COUNSELING. - HOME HEALTH AIDES AND VOLUNTEER RESPITE CARE; PROVIDES AID TO PATIENTS WHO CANNOT CARE FOR THEMSELVES; INCLUDES BATHING AND PERSONAL CARE, COMPANIONSHIP, AND RELIEF FOR CAREGIVERS. - RESPIRATORY THERAPY AND DURABLE MEDICAL EQUIPMENT; PROVIDES PATIENTS WITH RESPIRATORY THERAPY SERVICES, EQUIPMENT, AND SUPPLIES, BEDS, WHEELCHAIRS, AND OTHER DURABLE MEDICAL EQUIPMENT. SPECIALTY PROGRAMS: - ADVANCED ILLNESS MANAGEMENT: PROVIDES CARE MANAGEMENT FOR PATIENTS WITH HIGH DISEASE BURDEN, WHOSE HEALTH IS DECLINING AND WHO ARE AT RISK FOR DEATH IN THE NEXT 12 MONTHS. INNOVATIVE PROGRAM DEVELOPED TO PROVIDE HOME-BASED PALLIATIVE CARE AND TRANSITION MANAGEMENT FOR PATIENTS WITH ADVANCED CHRONIC ILLNESS. THIS TEAM BASED DISEASE MANAGEMENT PROGRAM IS GEARED TOWARD REDUCING HEALTH CARE UTILIZATION, LOWERING COSTS AND BETTER MANAGING 30-DAY READMISSIONS. - HEART FAILURE CONTINUUM OF CARE: A PILOT CARE TRANSITION, CARE COORDINATION, AND DISEASE MANAGEMENT PROGRAM WHICH WAS DEVELOPED TO IMPROVE THE QUALITY OF CARE OF HOSPITALIZED ACUTELY DECOMPENSATED HEART FAILURE PATIENTS, BEGINNING WITH THE PATIENT'S INPATIENT STAY AND CONTINUING AFTER DISCHARGE. - TELEMONITORING PROGRAM: PILOTED FOR HOME HEALTH HIGH RISK HEART FAILURE PATIENTS IN THE SF LOCATION, PATIENTS ARE MONITORED FOR KEY PHYSIOLOGIC CHANGES AS WELL AS QUESTIONNAIRE-DRIVEN SUBJECTIVE FINDINGS. DATA AND CLINICAL DECISIONS ARE MANAGED BY A CENTRALIZED TELEMONITORING NURSE WHO IS AN ADJUNCT TO THE CARE TEAM. THE GOAL OF THE PILOT IS TO IMPROVE QUALITY AND EFFICIENCY OF CARE. - FLU AND WELLNESS PROGRAM: THE FLU AND WELLNESS PROGRAM PROVIDES FLU PREVENTION AND HEALTH SCREENING SERVICES. OTHER VACCINATIONS OFFERED INCLUDE PNEUMONIA AND TDAP. WELLNESS SERVICES, WHICH ARE OFFERED YEAR-ROUND, INCLUDE TB TESTING, CHOLESTEROL SCREENINGS, BLOOD PRESSURE AND BODY COMPOSITION CLINICS AND BIOMETRIC SCREENINGS. ALL SERVICES ARE DELIVERED BY LICENSED AND PROFESSIONAL NURSES. - LIFELINE: LIFELINE IS A PERSONAL EMERGENCY MEDICAL RESPONSE SYSTEM THAT ENABLES INDIVIDUALS TO MAINTAIN THEIR INDEPENDENCE BY LIVING IN THEIR OWN HOMES, WHILE GIVING FAMILY MEMBERS PEACE OF MIND THAT HELP IS AVAILABLE FOR THEIR LOVED ONES AT THE PUSH OF A BUTTON. - INTEGRATED CHRONIC CARE MODEL: A CORE CARE MODEL AND SET OF COMPETENCIES FOR ALL CLINICIANS AT SCAH, WITH FOCUS ON EFFECTIVE AND MEANINGFUL ENGAGEMENT BETWEEN PATIENTS AND CLINICIANS TO DRIVE PATIENT-CENTERED, COORDINATED, EVIDENCE-BASED CARE. THE MODEL IS STRUCTURED WITH 4 PILLARS: HIGH TOUCH DELIVERY SYSTEM, THEORY-BASED SELF -MANAGEMENT SUPPORT, SPECIALIST OVERSIGHT AND USE OF TECHNOLOGY. COMMUNITY BENEFIT SERVICES IN 2013, SUTTER VNA & HOSPICE PROVIDED $146,590 WORTH OF COMMUNITY BENEFIT. THE COMMUNITY BENEFIT PROGRAMS AND SERVICES PROVIDED IN 2013 INCLUDE THE FOLLOWING: - HOSPICE BEREAVEMENT GROUPS (EX. ADULT GRIEF SUPPORT GROUPS,CHILDREN'S WORKSHOPS, DAUGHTER/MOM LOSS SUPPORT GROUP, ADULT TRAUMATIC LOSS) - BLOOD PRESSURE CLINICS, FLU SHOTS, HEALTH FAIRS, ETC. - PRECEPTORSHIPS AND INTERNSHIPS PROVIDED FOR STUDENTS CHARITABLE ACTIVITY IN 2013 SUTTER VNA & HOSPICE PROVIDED $1,528,499 WORTH OF CHARITY CARE. CHARITY CARE WAS PROVIDED IN THE FORM OF HOME HEALTH SERVICES, HOSPICE SERVICES, RESPIRATORY THERAPY AND DURABLE MEDICAL EQUIPMENT SERVICE AND PRODUCTS, AND HOME INFUSION THERAPY SERVICES. UNPAID COST OF MEDICAID IN 2013 SUTTER VNA & HOSPICE PROVIDED $5,193,440 WORTH OF UNPAID SERVICES TO MEDICAID PATIENTS.
FORM 990, PART VI, LINES 6 & 7A
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 7B
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL.
FORM 990, PART VI, LINE 11B
DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990 SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED.
FORM 990, PART VI, LINE 12
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION.
FORM 990, PART VI, LINE 15
PROCESS FOR DETERMINING COMPENSATION THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES.
FORM 990, PART VI, LINE 19
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
FORM 990, PART XI, LINE 9
OTHER CHANGES IN FUND BALANCE: EQUITY TRANSFERS (NET) $10,020,342 OTHER CHANGES IN FUND BALANCE 47 ---------- TOTAL 10,020,389
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.