Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
SUTTER WEST BAY HOSPITALS
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 7999
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SAN FRANCISCO, CA94120
D Employer identification number

94-0562680
E Telephone number

G Gross receipts $ 1,733,808,051
F Name and address of principal officer:
MICHAEL COHILL
PO BOX 7999
SAN FRANCISCO,CA94120
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SUTTERHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1854
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 8,367
6 Total number of volunteers (estimate if necessary) ............. 6 1,201
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,281,563
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 231,093
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 29,978,182 28,064,707
9 Program service revenue (Part VIII, line 2g) ......... 1,507,113,696 1,600,426,315
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 18,113,121 52,698,040
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,897,333 11,199,354
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,559,102,332 1,692,388,416
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,750,207 2,421,600
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 799,647,156 804,731,578
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet542,316    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 806,028,142 735,032,629
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,607,425,505 1,542,185,807
19 Revenue less expenses. Subtract line 18 from line 12....... -48,323,173 150,202,609
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,783,161,518 2,108,117,533
21 Total liabilities (Part X, line 26)............. 665,509,264 652,154,419
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,117,652,254 1,455,963,114
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,385,158,425 including grants of $ 2,421,600 ) (Revenue $ 1,600,427,707 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,385,158,425
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) .... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
Yes
 
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
1,068
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
8,367
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
20
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
16
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCHRIS BOUDREAUX
9100 FOOTHILLS BOULVARD
ROSEVILLE,CA95747 (916) 297-8007
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) WILLIAM L BRUNETTI........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(2) MICHAEL COHILL........................................................................
REGIONAL PRESIDENT, WEST BAY
40.0
.......................4.0
X   X       0 1,891,770 292,596
(3) SUSAN DAY MD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(4) THEODORE DEIKEL........................................................................
TRUSTEE/CHAIR OF FINANCE
1.0
.......................1.0
X   X       0 0 0
(5) THOMAS J DIETZ PHD........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(6) ROY EISENHARDT........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(7) KATHERINE T HSAIO MD........................................................................
TRUSTEE/CHIEF GYN DIV
1.0
.......................0.0
X           21,712 0 0
(8) PETER JACOBI........................................................................
TRUSTEE
1.0
.......................7.0
X           0 27,500 0
(9) FREDERICK JOHNSON MD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(10) SARAH KREVANS........................................................................
COO, SUTTER HEALTH
1.0
.......................40.0
X           0 1,762,486 424,237
(11) STEVEN E LEVENBERG DO........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(12) THOMAS E LINCOLN........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(13) ALASTAIR A MACTAGGART........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(14) TIMOTHY MURPHY MD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(15) DENNIS J O'CONNELL........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(16) STEVEN H OLIVER........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(17) ROBERT A ROSENFELD........................................................................
TRUSTEE, VICE CHAIR
1.0
.......................1.0
X   X       0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) LEO C H SOONG........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(19) MICHAEL N VALAN MD........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(20) ANTHONY G WAGNER........................................................................
TRUSTEE, CHAIR
1.0
.......................1.0
X   X       0 0 0
(21) RICHARD C WATTS........................................................................
TRUSTEE
1.0
.......................9.0
X           0 0 0
(22) DEBORAH D WYATT MD........................................................................
TRUSTEE
1.0
.......................1.0
X           0 0 0
(23) MICHAEL DUNCHEON........................................................................
VP, REG COUNSEL, WEST BAY
40.0
.......................0.0
    X       0 621,974 87,193
(24) JOHN GATES........................................................................
REG CFO & VP FINANCE, EB & WB
40.0
.......................0.0
    X       0 1,058,493 146,579
(25) WARREN BROWNER MD........................................................................
CEO, SAN FRANCISCO HOSPITALS
40.0
.......................0.0
      X     0 964,514 367,972
(26) GRANT DAVIES........................................................................
EXECUTIVE VP, WEST BAY
40.0
.......................0.0
      X     0 952,315 181,221
(27) ANN BARR........................................................................
REGIONAL CIO, WEST BAY
40.0
.......................0.0
        X   0 498,372 83,239
(28) MARK KIMBELL........................................................................
CPMC FOUNDATION DIRECTOR
40.0
.......................0.0
        X   0 536,335 40,527
(29) HON-WAI LAM........................................................................
REGIONAL VP & CMO, WEST BAY
40.0
.......................0.0
        X   0 598,635 99,376
(30) MICHAEL PURVIS........................................................................
CAO, SMCSR
40.0
.......................0.0
        X   0 544,864 99,585
(31) CHRISTOPHER WILLRICH........................................................................
REG VP, STRATEGY WEST BAY
40.0
.......................0.0
        X   0 513,020 83,784
(32) MARTIN BROTMAN MD........................................................................
SVP, SH
0.0
.......................40.0
          X 0 992,845 91,019
(33) PATRICK FRY........................................................................
PRESIDENT & CEO, SH
0.0
.......................40.0
          X 0 3,626,367 2,728,330
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 21,712 14,589,490 4,725,658
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet2,352
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
MEDICAL SOLUTIONS LLC,
1010 NO 102ND ST STE 300
OMAHA,NE68114
STAFFING SERVICES 9,578,405
HERRERO BUILDERS INC,
2100 OAKDALE AVE
SAN FRANCISCO,CA94124
CONSTRUCTION 8,449,981
PACIFIC INPATIENT MEDICAL GROUP IN,
PO BOX 1230
SUISUN CITY,CA945851230
MEDICAL SERVICES 7,812,402
TOWERS WATSON DELAWARE INC,
LOCKBOX 28025 NETWORK PL
CHICAGO,IL606731280
CONSULTING SERVICES 4,990,662
DPR CONSTRUCTION INC,
945 FRONT ST
SAN FRANCISCO,CA94111
CONSTRUCTION 4,219,491
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet138
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 378,487
d Related organizations...1d 10,078,498
e Government grants (contributions)1e 14,757,873
f All other contributions, gifts, grants, and
similar amounts not included above
1f
2,849,849
g Noncash contributions included in lines
1a-1f:$
23,238
h Total. Add lines 1a-1f.......MediumBullet 28,064,707
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 622110 1,583,798,152 1,583,798,152    
b CA PACIFIC ADVANCED IMAGING 621512 1,799,132 1,799,132    
c SAN FRAN ENDOSCOPY CENTER 621498 4,782,579 4,782,579    
d PRESIDIO SURGERY CENTER LLC 621493 6,350,693 6,350,693    
e RENTAL TO AFFILIATES 900099 3,693,728 3,693,728    
f All other program service revenue . 2,031 3,423 -1,392  
g Total. Add lines 2a–2f........MediumBullet 1,600,426,315
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 30,367,752   5,575 30,362,177
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 13,397     13,397
(i) Real (ii) Personal
6a Gross rents 13,880,295  
b Less: rental expenses 8,536,244  
c Rental income or (loss) 5,344,051 0
d Net rental income or (loss).......MediumBullet 5,344,051   170 5,343,881
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 52,147,271 2,983,848
b Less: cost or other basis and sales expenses 32,029,218 771,613
c Gain or (loss) 20,118,053 2,212,235
d Net gain or (loss)..........MediumBullet 22,330,288     22,330,288
8a Gross income from fundraising events (not including
$ 378,487
of contributions reported on line 1c). See Part IV, line 18 ..
a 78,932
b Less: direct expenses ...b 82,560
c Net income or (loss) from fundraising events..MediumBullet -3,628   -3,628
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 16,170
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 16,170     16,170
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a UBI - LABORATORY 621500 78,890   78,890  
b UBI - PARKING 812930 2,193,912   2,193,912  
c CAFETERIA 900099 3,537,178     3,537,178
d All other revenue .... 19,384   4,408 14,976
e Total. Add lines 11a–11d ...... MediumBullet 5,829,364
12 Total revenue. See Instructions......MediumBullet 1,692,388,416 1,600,427,707 2,281,563 61,614,439
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 2,421,600 2,421,600
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 6,564,627   6,564,627  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 317,307 317,307    
7 Other salaries and wages .... 509,450,372 490,198,384 19,251,988  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 55,526,496 47,197,522 8,328,974  
9 Other employee benefits ....... 189,337,640 160,936,994 28,400,646  
10 Payroll taxes ........... 43,535,136 37,004,866 6,530,270  
11 Fees for services (non-employees):        
a Management ...... 5,381,169   5,381,169  
b Legal ......... 2,812,444 2,006,232 806,212  
c Accounting ........... 105,263 39,866 65,397  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 782,488   782,488  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 83,178,064 83,073,459 104,605  
12 Advertising and promotion .... 1,860,714 99,458 1,761,256  
13 Office expenses ....... 9,984,336 6,845,641 3,111,472 27,223
14 Information technology ...... 54,576,397 54,290,458 285,939  
15 Royalties .. 0      
16 Occupancy ........... 24,012,562 24,012,562    
17 Travel ............ 1,338,819 1,071,055 264,972 2,792
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 1,061,273 554,071 504,684 2,518
20 Interest ........... 12,050,182 12,050,182    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 84,293,960 84,154,652 139,308  
23 Insurance .............. 11,072,887 8,298,876 2,774,011  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a FEDERAL TAXES 89,395 89,395    
b PURCHASED SERVICES 173,667,398 145,882,231 27,785,167  
c HOSPITAL FEE 43,806,526 43,806,526    
d MEDICAL SUPPLIES 162,039,850 143,821,569 18,218,281  
e All other expenses 62,918,902 36,985,519 25,423,600 509,783
25 Total functional expenses. Add lines 1 through 24e 1,542,185,807 1,385,158,425 156,485,066 542,316
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 0
2 Savings and temporary cash investments ......... 30,845,261 2 36,811,219
3 Pledges and grants receivable, net ........... 2,185,188 3 1,554,186
4 Accounts receivable, net ............. 219,029,254 4 201,763,000
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 16,667,720 8 16,301,522
9 Prepaid expenses and deferred charges .......... 4,476,583 9 6,908,917
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,412,031,057
b Less: accumulated depreciation ..... 10b 892,307,045 1,256,444,104 10c 1,519,724,012
11 Investments—publicly traded securities .......... 172,566,815 11 158,166,871
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 7,435,368 13 6,653,003
14 Intangible assets ............... 2,980,359 14 2,980,359
15 Other assets. See Part IV, line 11 ........... 70,530,866 15 157,254,444
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,783,161,518 16 2,108,117,533
Liabilities 17 Accounts payable and accrued expenses ......... 235,061,681 17 231,758,367
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 420,048,236 20 413,127,670
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 10,399,347 25 7,268,382
26 Total liabilities. Add lines 17 through 25......... 665,509,264 26 652,154,419
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 1,092,627,539 27 1,435,939,933
28 Temporarily restricted net assets ........... 25,024,715 28 20,023,181
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 1,117,652,254 33 1,455,963,114
34 Total liabilities and net assets/fund balances ........ 1,783,161,518 34 2,108,117,533
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,692,388,416
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,542,185,807
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
150,202,609
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,117,652,254
5
Net unrealized gains (losses) on investments ...............
5
-24,187,161
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
212,295,412
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,455,963,114
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
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......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
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.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   165,452,707 165,452,707
b Buildings ................   1,041,724,095 526,520,559 515,203,536
c Leasehold improvements ............   31,554,238 26,206,553 5,347,685
d Equipment ................   532,098,319 331,995,878 200,102,441
e Other .................   641,201,698 7,584,055 633,617,643
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,519,724,012
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) UNAMORTIZED FINANCING COSTS 1,883,709
(2) INTERCOMPANY RECEIVABLES 36,061,768
(3) OTHER RECEIVABLES 85,482,993
(4) OTHER ASSETS 33,825,974





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 157,254,444
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
INSURANCE LIABILITIES 5,242,507
OTHER LIABILITIES 1,906,076
3RD PARTY SETTLEMENTS 119,799






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 7,268,382
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART X, LINE 2 ASC 740 (FIN48) FOOTNOTE FROM AUDIT: THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)), AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2014 AND 2013, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ
filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

CATWALK
(event type)
(b) Event #2

GATSBY GALA
(event type)
(c) Other events

1
(total number)
(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 218,174 163,170 76,075 457,419
2 Less: Contributions . . 190,774 137,069 50,644 378,487
3 Gross income (line 1
minus line 2) . . .
27,400 26,101 25,431 78,932
VerticalDirectExpenses 4 Cash prizes . . .     2,500 2,500
5 Noncash prizes . . 7,500 2,500 6,066 16,066
6 Rent/facility costs . . 7,600   12,554 20,154
7 Food and beverages .   24,601 12,836 37,437
8 Entertainment . . .   1,500   1,500
9 Other direct expenses . 4,003 2,466 10,934 17,403
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 95,060
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow -16,128
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . . 5,515 1,100 9,555 16,170
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow 16,170
9
Enter the state(s) in which the organization conducts gaming activities: CA
a
Is the organization licensed to conduct gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 3
11
Does the organization conduct gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activities conducted in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
100.000 %
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
SEE SCH G PART IV
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $  
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
SEE SCH G PART IV
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$ 14,553
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information (see instructions).
Return Reference Explanation
SCHEDULE G, PART III, LINE 14 NAME: PENNY CLEARY ADDRESS: SR 30 MAR WEST SPRING ROAD SANTA ROSA, CA 95403 NAME: MARGARET WALKER ADDRESS: 180 ROWLAND WAY NOVATO, CA 94945
SCHEDULE G, PART III, LINE 16 NAME: PENNY CLEARY GAMING COMPENSATION: $2,011 SERVICES PROVIDED: COORDINATES GREAT GATSBY AND CATWALK FOR CURE. POSITION: EMPLOYEE OF SUTTER WEST BAY HOSPITALS NAME: MARGARET WALKER GAMING COMPENSATION: $2,199 SERVICES PROVIDED: COORDINATES THE GOLF EVENT. POSITION: EMPLOYEE OF SUTTER WEST BAY HOSPITALS
Schedule G (Form 990 or 990-EZ) 2014
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    14,293,651   14,293,651 0.930 %
b Medicaid (from Worksheet 3,
column a) ....
    282,766,051 176,960,663 105,805,388 6.860 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
    386,545 208,348 178,197 0.010 %
d Total Financial Assistance
and Means-Tested
Government Programs .
    297,446,247 177,169,011 120,277,236 7.800 %
Other Benefits
41 121,556 2,489,489 328,700 2,160,789 0.140 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
18 200 35,055,948 4,792,937 30,263,011 1.960 %
g Subsidized health services
(from Worksheet 6) ..
16 39,396 50,178,582 35,358,539 14,820,043 0.960 %
h Research (from Worksheet 7) 1 1,312 18,144,957 432,926 17,712,031 1.150 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
57 20,760 5,636,754 120,922 5,515,832 0.360 %
j Total. Other Benefits .. 133 183,224 111,505,730 41,034,024 70,471,706 4.570 %
k Total. Add lines 7d and 7j . 133 183,224 408,951,977 218,203,035 190,748,942 12.370 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 4 9,914 27,771   27,771  
4 Environmental improvements 1   5,000   5,000  
5 Leadership development and training for community members 2   4,395   4,395  
6 Coalition building 5 1,799 50,896   50,896  
7 Community health improvement advocacy 3   29,829   29,829  
8 Workforce development 9 245 237,258 43,483 193,775 0.010 %
9 Other            
10 Total 24 11,958 355,149 43,483 311,666 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
3,794,740
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
336,755,066
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
391,216,406
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-54,461,340
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?8
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 CPMC-ST LUKE'S CAMPUS
3555 CESAR CHAVEZ STREET
SAN FRANCISCO,CA941104403
www.cpmc.org
LICENSE 220000070
X X         X     A
2 CPMC-PACIFIC CAMPUS
2333 BUCHANAN STREET
SAN FRANCISCO,CA94115
www.cpmc.org
LICENSE 220000197
X X         X     A
3 CPMC-CALIF WEST CAMPUS
3700 CALIFORNIA STREET
SAN FRANCISCO,CA94118
www.cpmc.org
LICENSE 220000197
X X         X     A
4 CPMC-EAST CAMPUS
3698 CALIFORNIA STREET
SAN FRANCISCO,CA94118
www.cpmc.org
LICENSE 220000197
X X         X     A
5 CPMC-DAVIES CAMPUS
601 DUBOCE AVENUE
SAN FRANCISCO,CA94117
www.cpmc.org
LICENSE 220000197
X X         X     A
6 NOVATO COMMUNITY HOSPITAL
180 ROWLAND WAY
NOVATO,CA949455009
www.novatocommunity.org
LICENSE 110000375
X X         X      
7 SUTTER LAKESIDE HOSPITAL
5176 HILL ROAD
LAKEPORT,CA954636300
www.sutterlakeside.org
LICENSE 110000094
X X     X   X      
8 SUTTER SANTA ROSA REGIONAL HOSPITAL
30 MARK WEST SPRINGS ROAD
SANTA ROSA,CA95403
www.suttersantarosa.org
LICENSE 110000005
X X         X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
15
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
6
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
7
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See Section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SUTTER MEDICAL CENTER SANTA ROSA
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
8
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

SUTTER MEDICAL CENTER SANTA ROSA
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

SUTTER MEDICAL CENTER SANTA ROSA
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
REPORTING FACILITY: A SCHEDULE H, PART V, LINE 5 CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): IN CONDUCTING ITS MOST RECENT CHNA, CALIFORNIA PACIFIC MEDICAL CENTER, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THE COMMUNITY BENEFIT PARTNERSHIP WORKED COLLECTIVELY TO IDENTIFY THE COMMUNITY'S HEALTH NEEDS AND TO DEVELOP THE CHNA REPORT. IN COLLABORATION WITH ACADEMIC PARTNERS, THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH AS WELL AS THE BROADER SAN FRANCISCO COMMUNITY, THE COMMUNITY BENEFIT PARTNERSHIP BUILT ON THE STRONG FOUNDATION OF YEARS WORKING ON THE PAST TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS. AN OUTGROWTH OF THE BUILDING A HEALTHIER SAN FRANCISCO (BHSF) NEEDS ASSESSMENT PROCESS AND THE CHARITY CARE PROJECT (CCP), THE COMMUNITY BENEFIT PARTNERSHIP SEEKS TO HARNESS THE COMBINED ENERGY AND RESOURCES OF SAN FRANCISCO'S PRIVATE NONPROFIT HOSPITALS, CITY DEPARTMENTS (PUBLIC HEALTH AND HUMAN SERVICES), COMMUNITY CLINICS, HEALTH PLANS, NONPROFIT PROVIDERS AND ADVOCACY GROUPS TO IMPROVE THE HEALTH STATUS OF SAN FRANCISCO RESIDENTS. THE COMMUNITY BENEFIT PARTNERSHIP WAS CONCEIVED IN 1999 TO COLLABORATIVELY IDENTIFY COMMUNITY HEALTH NEEDS AND SUPPORT COORDINATED DECISION-MAKING TO ADDRESS THE NEEDS. IT IS WITH THIS SAME DETERMINATION THAT THE PARTNERS UNDERTOOK A COMMUNITY ORIENTED PROCESS - IN ALIGNMENT WITH THE VALUES EXPRESSED BY THE NEIGHBORHOOD RESIDENTS - FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. DURING 2012, A NUMBER OF OTHER COMMUNITY-BASED NEEDS ASSESSMENTS WERE UNDERWAY AT THE SAME TIME AS THE CHNA. IN ORDER TO REDUCE DUPLICATION OF EFFORT, LEVERAGE RESOURCES, AND RESPECT COMMUNITY MEMBERS' TIME COMMITMENT TO THE PROCESS, THE CHNA PROCESS WAS COMBINED WITH THE DEPARTMENT OF PUBLIC HEALTH'S PROCESS TO COMPLETE A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND ITS COMMUNITY HEALTH ASSESSMENT (CHA). THIS COMBINATION OF EFFORTS BROUGHT TOGETHER A NUMBER OF ADDITIONAL PARTNERS THAT ENRICHED THE INPUT THROUGH A VARIETY OF PERSPECTIVES AND CONTRIBUTIONS TO THE PROCESS. SPECIFICALLY, THE COLLABORATING ORGANIZATIONS AND INDIVIDUALS INCLUDED: - HOSPITAL AND ACADEMIC PARTNERS, WHO CONTINUED TO PARTNER WITH San Francisco Department of Public Health (SFDPH) ON SAN FRANCISCO'S CHA/CHIP LEADERSHIP COUNCIL, WHICH HAS GUIDED THE DEVELOPMENT AND WILL GUIDE THE IMPLEMENTATION OF SAN FRANCISCO'S CHIP. - COMMUNITY STAKEHOLDERS - INCLUDING REPRESENTATIVES FROM SAN FRANCISCO'S NONPROFIT HOSPITALS, ACADEMIC INSTITUTIONS, HEALTH PLANS, THE AFRICAN AMERICAN HEALTH DISPARITIES PROJECT, SAN FRANCISCO HUMAN SERVICES AGENCY, AND SFDPH. - COMMUNITY RESIDENTS AND MEMBERS OF THE LOCAL PUBLIC HEALTH SYSTEM - INCLUDING REPRESENTATIVES FROM K-12 EDUCATION, HIGHER EDUCATION, PHILANTHROPY, NONPROFIT AGENCIES, MINORITY HEALTH EQUITY COALITIONS, GOVERNMENT (INCLUDING THE SAN FRANCISCO MAYOR'S OFFICE AND HEALTH COMMISSION), HOSPITALS, AND MORE. - HEALTH CONTENT EXPERTS ENGAGED WITH SFDPH AS WELL AS ITS HOSPITAL AND ACADEMIC PARTNERS TO REFINE PRIORITY GOALS, OBJECTIVES, MEASURES, AND STRATEGIES THAT HAVE COME TO FORM THE CURRENT CHIP. A NUMBER OF CONSULTING FIRMS AND CONSULTANTS WERE INVOLVED THROUGHOUT THIS PROCESS, INCLUDING: 1) HEARTBEETS, FOR COMMUNITY ENGAGEMENT; 2) CIRCLE POINT, FOR ONGOING COMMUNICATION WITH STAKEHOLDERS; 3) HARDER+COMPANY, FOR DATA COLLECTION AND ANALYSIS; AND 4) NANCY SHEMICK, MPA, FOR MEETING FACILITATION AND REPORT-WRITING. A COMPREHENSIVE LISTING OF THE MEETING ATTENDEES AND INVITEES ARE AVAILABLE IN CPMC'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A & 6B CHNA HOSPITAL COLLABORATORS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): A COMPLETE LISTING OF HOSPITALS AND PARTNERS WHO COLLABORATED ON THE CHNA IS AVAILABLE FOR DOWNLOAD AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.CPMC.ORG/ABOUT/COMMUNITY/ - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): The following significant health needs were identified in the 2013 Community Health Needs Assessment and are needs that CPMC intends to address through its implementation strategy: Increase access to high-quality health care and services - Access to comprehensive, high-quality health care and other services is essential in preventing illness, promoting wellness, and fostering vibrant communities. This priority strives to bridge existing gaps in health care access due to: low income; language/literacy barriers or lack of cultural competency of service providers; lack of insurance or providers not accepting coverage such as Medi-Cal because of low reimbursement rates. Increase healthy eating and physical activity - Science links health conditions such as heart disease, diabetes, and cancer to daily practices like eating a healthy, balanced diet and getting regular exercise. This priority strives to demonstrate the link between diet, inactivity, and chronic disease and to help San Francisco create environments that make healthy choices easier. Disparities exist due to socioeconomic and environmental factors such as affordability and accessibility of healthy food options, and neighborhood safety when engaging in exercise. Obesity risk also varies according to different racial/ethnic groups. Ensure safe and healthy living environments - This priority highlights the need for health and wellness-oriented land use planning, meaningful opportunities for outdoor recreation, and a positive built environment for the health of all individuals and communities. It seeks to address disparities in access to parks, public transit, grocery stores with healthier food choices, and other resources that benefit health and wellness. Certain neighborhoods and racial/ethnic groups - often poor communities of color - are more impacted by crime and violence, and are closer to fast food and alcohol outlets, freeways, industrial pollutants, and other factors that contribute to high rates of disease, death, injury, and violence. Descriptions of the community benefit programs that address these significant health needs can be found in Part VI. SCHEDULE H, PART V, LINE 13H ELIGIBILITY CRITERIA - OTHER: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. SCHEDULE H, PART V, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART V, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) SPECIAL CIRCUMSTANCES CHARITY CARE, (3) CATASTROPHIC CHARITY CARE, (4) HIGH COST MEDICAL CHARITY CARE, (5) UNINSURED PATIENT DISCOUNT, AND (6) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE.
REPORTING FACILITY: #6, NOVATO COMMUNITY HOSPITAL SCHEDULE H, PART V, LINE 5 NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): IN CONDUCTING ITS MOST RECENT CHNA, NOVATO COMMUNITY HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA THE THREE MARIN COUNTY NOT-FOR-PROFIT HOSPITALS (MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL, AND KAISER PERMANENTE) WORKED TOGETHER WITH THE HEALTHY MARIN PARTNERSHIP (HMP) TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CONSULTANTS FOR THE 2013 CHNA INCLUDED: - HUMAN IMPACT PARTNERS - ROCHELLE EREMAN, MS, MPH, MARIN HEALTH AND HUMAN SERVICES DEPARTMENT EPIDEMIOLOGIST - ABINADER GROUP - CO HERNNDEZ, MFT - LYNN H. BASKETT, MBA - WESTED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN, PUBLIC HEALTH THAT PROVIDED INPUT INCLUDED: - LARRY MEREDITH, PHD, DIRECTOR, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT - ROCHELLE EREMAN, MS, MPH, COMMUNITY EPIDEMIOLOGY CHIEF, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT - JENNIFER REINKS, PH.D., FACULTY, FAMILY HEALTH OUTCOMES PROJECT, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO - TOM PETERS, PH.D., PRESIDENT, MARIN COMMUNITY FOUNDATION AND FORMER DIRECTOR, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT - MATHEW WILLIS, MD, MPH, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, PUBLIC HEALTH OFFICER - D.J. PIERCE, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, CHIEF OF DIVISION OF ALCOHOL, TOBACCO & OTHER DRUGS THESE PUBLIC HEALTH EXPERTS PARTICIPATED IN KEY INFORMANT INTERVIEWS. LARRY MEREDITH, PHD, JENNIFER REINKS, PHD, AND MATHEW WILLIS, M.D. ALSO PARTICIPATED IN THE HMP-COORDINATED COMMUNITY CONVENING AND MS. EREMAN WAS A CONSULTANT TO THE CHNA WORK GROUP AND PROCESS. FROM APRIL 23, 2012 TO JUNE 11, 2012 SELMA ABINADER OF ABINADER GROUP CONDUCTED 25 PHONE INTERVIEWS OF STAKEHOLDERS SELECTED BY HMP LEADERSHIP. STAKEHOLDERS WERE HMP LEADERSHIP AND REPRESENTATIVES FROM HOSPITAL AND HEALTH ORGANIZATIONS, PUBLIC HEALTH EXPERTS, FUNDING INSTITUTIONS, GOVERNMENT, BUSINESS, EDUCATION, AND COMMUNITY BASED AGENCIES. KEY INFORMANTS, COMMUNITY PHYSICIANS AND THOSE PARTICIPATING IN THE HMP-COORDINATED COMMUNITY CONVENING INCLUDED 44 MARIN COUNTY RESIDENTS AND LEADERS REPRESENTING KEY POPULATIONS (MEDICALLY-UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE). FOCUS GROUPS WERE CONDUCTED BETWEEN APRIL 16 AND MAY 9, 2012 BY THE COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES. THEY WERE HELD IN MARIN CITY, NOVATO, CANAL, SAN GERONIMO, WEST MARIN, WHISTLESTOP AND THE YOUTH LEADERSHIP INSTITUTE. A TOTAL OF 103 ENGLISH AND 50 SPANISH RESPONSES WERE OBTAINED. FOCUS GROUP PARTICIPANTS WERE SURVEYED ABOUT: - IMPORTANT HEALTH ISSUES THEY, THEIR FAMILIES, AND THEIR COMMUNITIES FACED - WHAT THEY SAW AS HEALTHY AND UNHEALTHY ABOUT THEIR COMMUNITIES - WHAT THEY WOULD CHANGE TO MAKE THEIR COMMUNITIES HEALTHIER. ADDITIONAL DETAILS ON KEY INFORMANTS, COLLABORATIVE PARTNERS AND FOCUS GROUPS CAN BE FOUND IN NOVATO COMMUNITY HOSPITAL'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A & 6B NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): THE THREE MARIN COUNTY NOT-FOR-PROFIT HOSPITALS, MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL, AND KAISER PERMANENTE, WORKED TOGETHER WITH THE HEALTHY MARIN PARTNERSHIP TO COMPLETE THE CHNA. SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/COMMUNITY_BENEFITS.HTML - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): The following significant health needs were identified in the 2013 Community Health Needs Assessment and are needs that Novato Community Hospital intends to address through its implementation strategy: Access to primary and specialty care - Although access to health care as measured by health insurance is relatively high in Marin, there are significant geographies where residents lack insurance and obtaining timely and effective screening and treatment is lacking. Limitations on access affect participation in screenings and treatment of early diagnosis for cancer, heart disease, asthma, mental health, substance abuse, and diabetes. Healthy eating and active living - Eating healthy foods and engaging in an active lifestyle are determinants of health for diabetes, cancer, heart disease, and mental health. Social supports (including family and community support systems) - These systems and services directly affect mental health, substance abuse, access to health care, and falls. Mental health - A greater percentage of Marin adults report poor mental health and higher suicide rates than California and Healthy people 2020. Descriptions of the community benefit programs that address these significant health needs can be found in Part VI, along with other critical efforts on behalf of Novato Community Hospital. SCHEDULE H, PART V, LINE 13H ELIGIBILITY CRITERIA - OTHER: NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. SCHEDULE H, PART V, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART V, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: NOVATO COMMUNITY HOSPITAL (Hospital Facility #6): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) SPECIAL CIRCUMSTANCES CHARITY CARE, (3) CATASTROPHIC CHARITY CARE, (4) HIGH COST MEDICAL CHARITY CARE, (5) UNINSURED PATIENT DISCOUNT, AND (6) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE.
REPORTING FACILITY: #7, SUTTER LAKESIDE HOSPITAL SCHEDULE H, PART V, LINE 5 SUTTER LAKESIDE HOSPITAL (Hospital Facility #7): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER LAKESIDE HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THREE PRIMARY METHODS OF COLLECTING INPUT FROM THE COMMUNITY WERE USED IN THE ASSESSMENT - COMMUNITY SURVEY, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. KEY INFORMANT INTERVIEWS: TELEPHONE INTERVIEWS USING A STRUCTURED SET OF QUESTIONS (WITH ADDITIONAL, PERSONALIZED QUESTIONS TO OBTAIN MORE IN-DEPTH INFORMATION) WERE CONDUCTED WITH 16 INDIVIDUALS WHOSE PERCEPTIONS AND EXPERIENCE WERE INTENDED TO INFORM THE ASSESSMENT. THE INTERVIEWS PROVIDED AN INFORMED PERSPECTIVE FROM THOSE WORKING DIRECTLY WITH THE PUBLIC, INCREASED AWARENESS ABOUT AGENCIES AND SERVICES, OFFERED INPUT ABOUT GAPS AND POSSIBLE DUPLICATION IN SERVICES, AND SOLICITED IDEAS ABOUT RECOMMENDED STRATEGIES AND SOLUTIONS. THE INTERVIEWS ALSO FOCUSED THE NEEDS ASSESSMENT ON PARTICULAR ISSUES OF CONCERN WHERE INDIVIDUALS WITH CERTAIN EXPERTISE COULD CONFIRM OR DISPUTE PATTERNS IN THE DATA AND IDENTIFY DATA AND OTHER STUDIES THE COLLABORATIVE MIGHT NOT OTHERWISE BE AWARE OF. KEY INFORMANTS INTERVIEWED INCLUDE THE FOLLOWING: - DAVID SANTOS, VICE PRESIDENT OF OPERATIONS, ST. HELENA HOSPITAL CLEAR LAKE - DENISE RUSHING, SUPERVISOR, LAKE COUNTY BOARD OF SUPERVISORS - DENNIS FAY, EXECUTIVE DIRECTOR, COMMUNITY CARE MANAGEMENT CORPORATION - DIANE PEGE, MD, VICE PRESIDENT, MEDICAL AFFAIRS, SUTTER LAKESIDE HOSPITAL - KIMBERLY TANGERMANN, MANAGER, LIVE WELL & KONOCTI WELLNESS CENTER, ST. HELENA HOSPITAL CLEAR LAKE - LINDA MORRIS, DEPUTY DIRECTOR, CLINICAL SERVICES, LAKE COUNTY BEHAVIORAL HEALTH DEPARTMENT - LYN SCURI, HEALTH PLANNER, PARTNERSHIP HEALTH PLAN - MARK BUEHNERKEMPER, OPTOMETRIST, LAKE COUNTY RESIDENT - MERYL FEATHERSTONE, TRIBAL HEALTH - MONTE WINTERS, SPRING VALLEY RESIDENT - ROB BROWN, SUPERVISOR, LAKE COUNTY BOARD OF SUPERVISORS - ROBERT GARDNER, M.D., MEDICAL DIRECTOR, LUCERNE COMMUNITY CLINIC - SIRI NELSON, CHIEF EXECUTIVE OFFICER, SUTTER LAKESIDE HOSPITAL - STEPHANIE LILLY, DIRECTOR OF PROGRAMS, LAKE FAMILY RESOURCE CENTER - TERESA CAMPBELL, CHIEF NURSING EXECUTIVE, SUTTER LAKESIDE HOSPITAL - WALLY HOLBROOK, SUPERINTENDENT OF SCHOOLS, LAKE COUNTY OFFICE OF EDUCATION - BOB PENNY, LAKE COUNTY VETERAN'S SERVICES - MARTA FULLER, DENTAL DISEASE PREVENTION, LAKE COUNTY PUBLIC HEALTH DEPARTMENT - SHERYLIN TAYLOR, LAKE COUNTY PUBLIC HEALTH DEPARTMENT THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER LAKESIDE HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A & 6B SUTTER LAKESIDE HOSPITAL (Hospital Facility #7): THE COLLABORATIVE INCLUDED THE TWO LAKE COUNTY HOSPITALS, ST. HELENA CLEAR LAKE AND SUTTER LAKESIDE. SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: SUTTER LAKESIDE HOSPITAL (Hospital Facility #7): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.SUTTERLAKESIDE.ORG/ABOUT/ - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 SUTTER LAKESIDE HOSPITALS (Hospital Facility #7): The following significant health needs were identified in the 2013 Community Health Needs Assessment are needs that Sutter Lakeside Hospital intends to address through its implementation strategy: -Risk factors and implications from tobacco use, high blood pressure, physical inactivity and obesity; -Lack of access to community-based mental health services; and -High rates of alcohol and drug use. Descriptions of the community benefit programs that address these significant health needs can be found in Part VI, along with additional efforts on behalf of Sutter Coast Hospital. SCHEDULE H, PART V, LINE 13H ELIGIBILITY CRITERIA - OTHER: SUTTER LAKESIDE HOSPITAL (Hospital Facility #7): ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES. SCHEDULE H, PART V, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: SUTTER LAKESIDE HOSPITAL (Hospital Facility #7): A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL'S FACILITY'S WEBSITE, WAS ATTACHED TO BILLING INVOICES, WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY/WAITING ROOM, WAS POSTED IN THE HOSPITAL'S ADMISSIONS OFFICE, WAS PROVIDED IN WRITING ON ADMISSION TO THE HOSPITAL, AND WAS AVAILABLE ON REQUEST. PATIENTS ELIGIBLE FOR CHARITY CARE ARE TRACKED IN THE HOSPITAL'S LEGACY SYSTEM AND ARE REMINDED 30 DAYS AFTER CHARITY CARE PACKET IS RECEIVED IF PAPERWORK HAS NOT BEEN SUBMITTED. ORGANIZATION USES AN INCOME VALIDATION TOOL TO ALERT PATIENTS THAT THEY MAY BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART V, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: SUTTER LAKESIDE HOSPITAL (Hospital Facility #7): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR DIFFERENT LEVELS OF ASSISTANCE FOR PATIENTS BASED ON VARIOUS ELIGIBILITY REQUIREMENTS INCLUDING, BUT NOT LIMITED TO (1) FULL CHARITY CARE, (2) PARTIAL CHARITY CARE, (3) SPECIAL CIRCUMSTANCES CHARITY CARE, (4) CATASTROPHIC CHARITY CARE, (5) HIGH COST MEDICAL CHARITY CARE, (6) UNINSURED PATIENT DISCOUNT, AND (7) PROMPT PAYMENT DISCOUNT. THE MAXIMUM AMOUNT BILLED TO THE PATIENT IS CALCULATED DIFFERENTLY DEPENDING ON THE CATEGORY OF FINANCIAL ASSISTANCE FOR WHICH THEY ARE ELIGIBLE.
REPORTING FACILITY: #8, SUTTER SANTA ROSA REGIONAL HOSPITAL SCHEDULE H, PART V, LINE 5 SUTTER SANTA ROSA REGIONAL HOSPITAL (Hospital Facility #8): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER SANTA ROSA REGIONAL HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. KEY INFORMANT INTERVIEWS ARE IN-DEPTH EXPLORATIONS OF ISSUES OR CONCERNS. THE PURPOSE OF KEY INFORMANT INTERVIEWS IS TO COLLECT INFORMATION FROM A RANGE OF LEADERS WHO HAVE FIRST-HAND KNOWLEDGE ABOUT THE COMMUNITY. THIS TECHNIQUE IS A QUALITATIVE PROCESS THAT CONCENTRATES ON REVEALING UNDERLYING REASONING. THESE COMMUNITY EXPERTS, WITH THEIR PARTICULAR KNOWLEDGE AND UNDERSTANDING, PROVIDE IMPORTANT INSIGHTS ON THE NATURE OF COMMUNITY HEALTH ISSUES. BABS KAVANAUGH AND BARBARA GRAVES, CONSULTANTS, CONDUCTED EIGHTEEN KEY INFORMANT INTERVIEWS WITH INDIVIDUALS SELECTED BECAUSE OF THEIR EXPERTISE AND LEADERSHIP IN HEALTH AND SOCIAL SERVICES IN SONOMA COUNTY. THE PURPOSE OF THE INTERVIEWS WAS TO EXPLORE ISSUES THAT ARE IMPACTING THE HEALTH OF RESIDENTS IN SONOMA COUNTY, TO IDENTIFY THOSE POPULATIONS MOST AFFECTED BY THESE ISSUES AND TO GATHER INPUT ABOUT SYSTEM CHANGES AND PREVENTION APPROACHES THAT COULD HAVE POSITIVE IMPACT ON THESE ISSUES. ALL PARTICIPANTS RECEIVED THE SAME SET OF QUESTIONS IN ADVANCE OF THE INTERVIEWS. IN AN EFFORT TO GATHER DIVERSE POINTS OF VIEW THOSE INTERVIEWED REPRESENTED THE FOLLOWING SECTORS, SERVICES, ORGANIZATIONS AND AGENCIES: - HEALTH AND HUMAN SERVICES (6) - HOSPITALS (3) - SONOMA COUNTY SCHOOLS (1) - ORAL HEALTH SERVICES (1) - COMMUNITY HEALTH CENTERS (4) - COMMUNITY BASED ORGANIZATIONS (1) - HEALTH INSURANCE PLANS (1) - ECONOMIC DEVELOPMENT (1) KEY INFORMANTS INTERVIEWED INCLUDE: - RITA SCARDACI, DIRECTOR, DEPARTMENT OF HEALTH SERVICES - ELIZABETH CHICOINE, DIRECTOR OF PUBLIC HEALTH NURSING, DEPT OF HEALTH SERVICES, PUBLIC HEALTH DIVISION - MARK NETHERDA, MD, SC DEPUTY PUBLIC HEALTH OFFICER AND LYNN SILVER OF THE DEPARTMENT OF HEALTH SERVICES - ELLEN BAUER, HEALTH ACTION PROGRAM MANAGER, DEPT OF HEALTH SERVICES, PUBLIC HEALTH DIVISION - MIKE KENNEDY, MH/AODS DIRECTOR, DEPT OF HEALTH SERVICES, MENTAL HEALTH DIVISION - DIANE KALJIAN, DIRECTOR, DEPT OF HUMAN SERVICES, ADULT AND AGING DIVISION - KIRK PAPPAS, MD, KAISER PERMANENTE MEDICAL CENTER, SANTA ROSA - BILL CARROLL, CHIEF MEDICAL OFFICER, SUTTER SANTA ROSA REGIONAL HOSPITAL - GARY GREENSWEIG, CHIEF MEDICAL OFFICER, ST JOSEPH HEALTH SYSTEM, SONOMA COUNTY - MARY MADDUX-GONZALEZ, MD, EXECUTIVE DIRECTOR, REDWOOD COMMUNITY HEALTH COALITION - MOLIN MALICAY, CHIEF EXECUTIVE OFFICER, SONOMA COUNTY INDIAN HEALTH PROJECT - FRANCISCO TRILLA, MD, CHIEF MEDICAL OFFICER, SANTA ROSA COMMUNITY HEALTH CENTER - KATHIE POWELL, EXECUTIVE DIRECTOR, PETALUMA HEALTH CENTER - MICHAEL SPEILMAN, DRUG ABUSE ALTERNATIVE CENTER - BOB MOORE, MEDICAL DIRECTOR, PARTNERSHIP HEALTH PLAN OF CALIFORNIA - LYNN GARRIC, SCOE - SAFE SCHOOL PROJECT DIRECTOR - SUSAN COOPER, DDS, SONOMA COUNTY ORAL HEALTH ACCESS COALITION - BEN STONE, ECONOMIC DEVELOPMENT BOARD THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER SANTA ROSA REGIONAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A & 6B SUTTER SANTA ROSA REGIONAL HOSPITAL (Hospital Facility #8): SUTTER SANTA ROSA REGIONAL HOSPITAL, IN COLLABORATION WITH LOCAL PARTNERS KAISER PERMANENTE, ST. JOSEPH'S HEALTH SYSTEM AND THE SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2013. SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: SUTTER SANTA ROSA REGIONAL HOSPITAL (Hospital Facility #8): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.SUTTERSANTAROSA.ORG/RELATIONS/COMMUNITY_BENEFITS.HTML - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 SUTTER SANTA ROSA REGIONAL HOSPITAL (Hospital Facility #8): The following significant health needs were identified in the 2013 Community Health Needs Assessment and are needs that Sutter Santa Rosa Regional Hospital intends to address through its implementation strategy: Healthy eating and physical fitness - Poor nutrition and lack of physical activity are driving a national and local obesity epidemic and are contribution to increasing rates of chronic disease, disability and premature mortality in Sonoma County. Low-income children and families are especially at risk when they reside in neighborhoods that offer few options to obtain healthy, nutritious food or engage safely in physical activity. Expansion of current efforts in schools and communities to improve nutrition and fitness among youth and adults can help to reduce the growing burden of disease. Gaps in access to primary care - Strong primary care systems are associated with improved health outcomes and reduced health care costs. While most Sonoma County residents have a regular source of care and can access health care when they need it, too many do not. Those who are uninsured, low-income, or are members of racial and ethnic minorities are less likely to have an ongoing source of care and more likely to defer needed care, medicines and diagnostics, often at the cost of unnecessary suffering and poor health outcomes. Increasing access to affordable, prevention-focused primary care can help to eliminate health disparities and promote health and well-being. Access to Services for Substance Use Disorders - Treatment works. Early screening, intervention and appropriate treatment for harmful substance use and addiction behaviors are critical to intervening with teens, pregnant women and others who can benefit from treatment. Unfortunately, despite increasing levels of addiction, access to substance abuse treatment in Sonoma County is severely limited for low-income individuals without health care coverage. Insuring timely access to culturally competent substance abuse treatment, tailored to the specific needs of those seeking help, can break the cycle of addiction and benefit individuals, families and the community. Access to Mental Health Services - Many mental health problems can be effectively treated and managed with access to assessment, early detection, and links to ongoing treatment and supports. In Sonoma County, however, many low income individuals with mental health concerns do not have access to the treatment they need. Insufficient private insurance coverage for mental health services and insufficient availability of publicly-funded treatment services are significant barriers for many. Limited integration of mental health services within the health care system also leads to missed opportunities for early problem identification and prevention. Cardiovascular Disease - Cardiovascular disease is the third leading cause of death for people ages 18 - 59 in Sonoma County. For residents, age 60 and older, coronary heart disease and stroke are the second and third most common cause of death, behind cancer. Major behavioral contributors to cardiovascular disease include tobacco use, physical inactivity, unhealthy diet and harmful use of alcohol. Education and prevention efforts targeting these "lifestyle" choices and behaviors should be expanded along with continued emphasis on early detection and management of chronic disease. Access to Health Care Coverage - Ensuring access to affordable, quality health care services is important to protecting both individual and population health, eliminating health disparities and promoting overall quality of life in the community. For uninsured people, the cost of both routine and emergency care can be financially devastating. Individuals without health care insurance coverage may defer needed care, diagnostics and medicines for themselves and their families and may, as a result, experience higher rates of preventable illness, suffering, disability and mortality than those who have insurance. While a significant portion of Sonoma County's uninsured population will be eligible for more affordable health care coverage under the Affordable Care Act, financial barriers may still exist for low-wage earners who are unable to meet premium requirements. And, undocumented individuals will continue to be ineligible for publicly-funded coverage, leaving many individuals and families vulnerable. Coordination and Integration of Local Health Care System - Integration of health care services may take a variety of forms, but essentially consists of the coordination of care to reduce fragmentation and unnecessary use of services, prevent avoidable conditions, and promote independence and self-care. The ability of care providers to effectively develop and use Electronic Medical Records will be critical to the coordination and integration of care. The Affordable Care Act expands health care coverage options for more Sonoma County residents. To maximize resources and provide high quali
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?25
Name and address Type of Facility (describe)
1 CALIFORNIA PACIFIC MEDICAL CENTER
1625 VAN NESS AVENUE
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - CHILD DEVELOPMENT
2 CALIFORNIA PACIFIC MEDICAL CENTER
1580 VALENCIA STREET SUITE 440
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - CHILD DEVELOPMENT
3 CALIFORNIA PACIFIC MEDICAL CENTER
3838 CALIFORNIA STREET SUITE 106
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - LABORATORY/IMAGING
4 CALIFORNIA PACIFIC MEDICAL CENTER
101 NORTH EL CAMINO SUITE 1
SAN MATEO,CA94402
OUTPATIENT SERVICES - HAND THERAPY
5 SUTTER MED CTR SANTA ROSA-PERINATAL CTR
3327 CHANATE ROAD
SANTA ROSA,CA95404
OUTPATIENT SERVICES
6 SMC SANTA ROSA-SPORTS & ORTHOPEDIC REHAB
4729 HORN AVENUE SUITE A
SANTA ROSA,CA95405
OUTPATIENT SERVICES
7 TERRA LINDA HEALTH PLAZA
4000 CIVIC CENTER DRIVE
SAN RAFAEL,CA94903
OUTPATIENT SERVICES
8 PHYSICAL THERAPY & SPORT FITNESS
100 ROWLAND WAY
NOVATO,CA94945
OUTPATIENT SERVICES
9 CALIFORNIA PACIFIC MEDICAL CENTER
2351 CLAY STREET 4TH FLOOR
SAN FRANCISCO,CA94115
CHRONIC DIALYSIS
10 CALIFORNIA PACIFIC MEDICAL CENTER
2340 CLAY STREET SUITE 114A
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - HEART TRANSPLANT CLINIC
11 CALIFORNIA PACIFIC MEDICAL CENTER
2351 CLAY STREET SUITE 600
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES-IES
12 CALIFORNIA PACIFIC MEDICAL CENTER
2340 CLAY STREET 4TH FLOOR
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - LIVER, PANCREAS & KIDNEY TRANSPLANT CLINIC
13 CALIFORNIA PACIFIC MEDICAL CENTER
2340 CLAY STREET 5TH FLOOR
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - OPHTHAMOLOGY CLINIC
14 CALIFORNIA PACIFIC MEDICAL CENTER
2360 CLAY STREET
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - PT, OT & CARDIAC REHAB
15 CALIFORNIA PACIFIC MEDICAL CENTER
2100 WEBSTER STREET SUITE 103
SAN FRANCISCO,CA94115
RAD/LAB/ULTRASOUND SERVICES
16 CALIFORNIA PACIFIC MEDICAL CENTER
2351 CLAY STREET SUITE 150
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES-ALS
17 SUTTER LAKESIDE FAMILY MEDICAL CLINIC
5176 HILL ROAD EAST
LAKEPORT,CA95453
RURAL HEALTH CLINIC
18 SUTTER LAKESIDE OUTPATIENT DRAW STATION
5132 HILL ROAD EAST
LAKEPORT,CA95453
OUTPATIENT SERVICES
19 SUTTER LAKESIDE UPPER LAKE COMM CLINIC
750 OLD LUCERNE ROAD
UPPER LAKE,CA95485
RURAL HEALTH CLINIC
20 DIAGNOSTIC CENTER
165 ROWLAND WAY
NAVATO,CA94945
OUTPATIENT SERVICES
21 SURGERY TRANSFUSION SERVICES
180 ROWLAND WAY
NOVATO,CA94945
OUTPATIENT SERVICES
22 IMAGING SERVICES
1375 SUTTER STREET
SAN FRANCISCO,CA94119
OUTPATIENT SERVICES
23 SAN FRANCISCO ENDOSCOPY CENTER
3468 CALIFORNIA STREET
SAN FRANCISCO,CA94118
OUTPATIENT SERVICES
24 PRESIDIO SURGERY CENTER
1635 DIVISADERA STREET SUITE 200
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES
25 CALIFORNIA PACIFIC ADVANCED IMAGING
504 REDWOOD BLVD 300
NOVATO,CA94949
OUTPATIENT SERVICES
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART I, LINE 3A & 3C FPG FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY: SUTTER WEST BAY HOSPITALS USE THE FOLLOWING INCOME LIMITS FOR FREE CARE ELIGIBILITY: - CALIFORNIA PACIFIC MEDICAL CENTER, 400%; - NOVATO COMMUNITY HOSPITAL, 400%; - SUTTER LAKESIDE HOSPITAL, 200%; AND - SUTTER MEDICAL CENTER SANTA ROSA, 300%. FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 15% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 15% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 400% OF FPG. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 20% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING. NOVATO COMMUNITY HOSPITAL: TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 15% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 15% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 400% OF FPG. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAn THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING. SUTTER LAKESIDE HOSPITAL: TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. PARTIAL CHARITY CARE IS A PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR COVERED SERVICES AVAILABLE TO PATIENTS WHOSE FAMILY INCOMES ARE BETWEEN 201% AND 400% OF FEDERAL POVERTY GUIDELINES. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 15% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 15% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): FULL OR PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR COVERED SERVICES. HIGH MEDICAL COST CHARITY CARE IS NOT AVAILABLE FOR PATIENTS RECEIVING SERVICES THAT ARE ALREADY DISCOUNTED. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF A 15% TO 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 OR 60 DAYS OF FINAL BILLING. SUTTER MEDICAL CENTER SANTA ROSA: TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 300% OF FPG. PARTIAL CHARITY CARE IS A PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR COVERED SERVICES AVAILABLE TO PATIENTS WHOSE FAMILY INCOME ARE BETWEEN 301% AND 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: - SPECIAL CIRCUMSTANCES CHARITY CARE: FOR UNINSURED PATIENTS WHO DO NOT MEET THE FINANCIAL ASSISTANCE CRITERIA SET FORTH BY THE ORGANIZATION, A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, ELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE ORGANIZATION'S CHARITY CARE ELIGIBILITY CRITERIA. - CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 15% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 15% OF THEIR FAMILY INCOME. - HIGH MEDICAL COST CHARITY CARE (FOR INSURED PATIENTS): PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 350% OF FPG, MEDICAL EXPENSES EXCEED 10% OF THE PATIENT'S FAMILY INCOME, AND THE PATIENT'S INSURER HAS NOT PROVIDED A DISCOUNT. - UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. - PROMPT PAYMENT DISCOUNT: PARTIAL WRITE-OFF AVAILABLE TO UNINSURED PATIENTS WHO PAY PROMPTLY, CONSISTING OF AT LEAST A 10% DISCOUNT FOR THOSE WHO PAY WITHIN 30 DAYS OF FINAL BILLING.
SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.
SCHEDULE H, PART I, LINE 7G CALIFORNIA PACIFIC MEDICAL CENTER: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $20,189,551.
SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: CALIFORNIA PACIFIC MEDICAL CENTER: CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. BUILDING THE SAN FRANCISCO WORKFORCE, ESPECIALLY BY CREATING OPPORTUNITIES FOR YOUTH, IS A MAJOR FOCUS FOR CPMC. IN 2014, CPMC PROVIDED WORK-READINESS TRAINING AND CAREER EXPLORATION EXPERIENCES TO INDIVIDUALS THROUGH ITS COMMUNITY WORKFORCE PROGRAMS. THESE PARTNERSHIPS HELP EDUCATE AND INSPIRE UNDERSERVED YOUTH TO PURSUE HEALTH CAREERS. THEY INCLUDE: GALILEO HEALTH ACADEMY OFFERS TWO 12-WEEK SPEAKER SERIES THAT TAKE PLACE IN THE SPRING AND FALL OF THE ACADEMIC YEAR FOR HIGH SCHOOL JUNIORS. TWICE A WEEK, CPMC EMPLOYEES PROVIDE LECTURES, DEMONSTRATIONS, TOURS AND ACTIVITIES TO ENHANCE STUDENTS' UNDERSTANDING OF THE COMPLEXITIES AND OPPORTUNITIES IN A MODERN, COMPREHENSIVE ACUTE CARE MEDICAL CENTER. CPMC ALSO PROVIDES SIX-WEEK SUMMER INTERNSHIPS FOR GALILEO STUDENTS TO GAIN EXPERIENCE WORKING IN A HOSPITAL ENVIRONMENT. YEAR UP PLACES LOW-INCOME YOUNG ADULTS BETWEEN THE AGES OF 18 AND 24 INTO INFORMATION TECHNOLOGY INTERNSHIPS AT CPMC. ENABLING PATIENTS TO VOTE IS A PROGRAM THAT PROVIDES PATIENTS WITH THE OPPORTUNITY TO VOTE IN THE ELECTIONS. VOLUNTEERS ASSIST IN PROMOTING THIS PROGRAM THROUGHOUT CPMC OVER THE COURSE OF SEVERAL DAYS. VOLUNTEERS ALSO FAX BALLOT REQUESTS TO CITY HALL, PICK-UP ABSENTEE BALLOTS, DISTRIBUTE BALLOTS TO PATIENTS, COLLECTING BALLOTS AT THE END OF THE DAY, AND DROPPING OFF BALLOTS AT POLLING SITES, AND CITY HALL, FOR TABULATION IN A TIMELY MANNER. PROJECT HOMELESS CONNECT IS SAN FRANCISCO'S SIGNATURE PROGRAM TO PROVIDE SERVICES TO ITS HOMELESS POPULATION. THE MISSION OF PROJECT HOMELESS CONNECT IS TO PROVIDE A SINGLE LOCATION WHERE NONPROFIT MEDICAL AND SOCIAL SERVICES PROVIDERS COLLABORATE TO SERVE THE HOMELESS OF SAN FRANCISCO WITH COMPREHENSIVE, HOLISTIC SERVICES. CPMC VOLUNTEERS HELP PROJECT HOMELESS CONNECT PROVIDE MEDICAL AND SOCIAL SERVICES TO SAN FRANCISCO'S MOST IMPOVERISHED RESIDENTS, INCLUDING PRIMARY MEDICAL CARE, EYE EXAMS, WHEELCHAIR REPAIR, DENTAL TREATMENT, SUBSTANCE ABUSE CONNECTIONS, AND EVEN ACUPUNCTURE AND MASSAGE. CPMC'S CHILD DEVELOPMENT CENTER IS PART OF THE FIRST 5 CALIFORNIA COALITIONS. FIRST 5 CALIFORNIA REPRESENTS AN IMPORTANT PART OF OUR STATE'S EFFORT TO NURTURE AND PROTECT OUR MOST PRECIOUS RESOURCE - OUR CHILDREN. FIRST 5 CALIFORNIA'S SERVICES AND SUPPORT ARE DESIGNED TO ENSURE THAT MORE CHILDREN ARE BORN HEALTH AND REACH THEIR FULL POTENTIAL. JVS FOSTER YOUTH HEALTHCARE CAREER EXPLORATION PROGRAM: A CPMC EMPLOYEE SPENDS TIME PREPARING AND GIVING TOURS OF OUR ST. LUKE'S CAMPUS TO PROGRAM PARTICIPANTS. THE PROGRAM IS FOR 17 - 21 YEAR OLDS WHO ARE CONSIDERING A FUTURE HEALTH CARE CAREER, OFFERING 1) 3 UNITS OF CREDIT AT CITY COLLEGE OF SF WITH OVERVIEW OF HEALTH CARE CAREERS AND MEDICAL TERMINOLOGY; 2) WEEKLY WORKSHOPS AT JVS TO BUILD COMPUTER, ACADEMIC, AND JOB READINESS SKILLS; 3) A PAID INTERNSHIP IN A HEALTH CARE SETTING; 4) CONNECTIONS WITH EMPLOYERS WHO CAN GET PARTICIPANTS STARTED IN A NEW CAREER. LIFE LEARNING ACADEMY: THIS PROGRAM MENTORS A LIFE LEARNING ACADEMY HIGH SCHOOL STUDENT ON-HALF HOUR PER WEEK FOR 12 WEEKS. AT RISK YOUTH INTERNSHIP PARTNERS CPMC WITH COMMUNITY AGENCIES TO PROVIDE INTERNSHIPS FOR AT-RISK YOUTH THROUGH THE VOLUNTEER SERVICES DEPARTMENT BOTH DURING THE SCHOOL YEAR AS WELL AS OFFERING SUMMER PROGRAMS. THE NATIONAL COUNCIL ON AGING SENIOR COMMUNITY SERVICE PROGRAM: CREATED IN 1965, Senior Community Service Employment Program (SCSEP) IS THE NATION'S OLDEST PROGRAM TO HELP LOW-INCOME, UNEMPLOYED INDIVIDUALS AGED 55+ FIND WORK. A CPMC EMPLOYEE SPENDS TIME SUPPORTING TWO PROGRAM PARTICIPANTS. NOVATO COMMUNITY HOSPITAL: NOVATO COMMUNITY HOSPITAL (NCH) FUNDS THE FOLLOWING PROGRAM THAT HELPS ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. IN 1995, THE HEALTHY MARIN PARTNERSHIP WAS FORMED IN RESPONSE TO CALIFORNIA SENATE BILL 697, A LEGISLATIVE MANDATE REQUIRING NOT-FOR-PROFIT HOSPITALS TO COMPLETE A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. NCH PARTICIPATES IN THIS PARTNERSHIP, ALONG WITH OTHER KEY STAKEHOLDERS, TO PRODUCE THE COMMUNITY HEALTH NEEDS ASSESSMENT. NOVATO COMMUNITY HOSPITAL PARTNERS WITH THE FRIENDS OF STAFFORD LAKE BICYCLE PARK TO PROMOTE HEALTHY EATING AND ACTIVE LIVING BY BUILDING AND MAINTAINING AN OFF-ROAD CYCLING PARK ON COUNTY LAND TO PROVIDE A SAFE RIDING ENVIRONMENT FOR ALL AGES WITH A COMPONENT TO INVOLVE YOUNG CHILDREN IN LEARNING THE SPORT. SUTTER LAKESIDE HOSPITAL: SUTTER LAKESIDE HOSPITAL FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. SUTTER LAKESIDE HOSPITAL STAFF MEMBERS ARE ASSIGNED TO COMMUNITY BOARDS, PANELS, COMMITTEES, AND GROUPS. SUTTER LAKESIDE HOSPITAL HOSTED ITS INAUGURAL HEROES OF HEALTH AND SAFETY FAIR, WHICH SERVES AS AN OPPORTUNITY FOR THEIR COMMUNITY TO SEE ALL OF THE COUNTY'S HEALTH AND SAFETY RESOURCES IN ONE LOCATION. SUTTER SANTA ROSA REGIONAL HOSPITAL: SUTTER SANTA ROSA REGIONAL HOSPITAL FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. SUTTER SANTA ROSA REGIONAL HOSPITAL SUPPORTS THE COMPACT FOR SUCCESS PROGRAM FOR ELSIE ALLEN HIGH SCHOOL. COMPACT FOR SUCCESS IS A PROGRAM DESIGNED TO SUPPORT STUDENTS FROM LOW SOCIOECONOMIC STATUS BACKGROUNDS IN GRADUATING HIGH SCHOOL, ATTENDING AND COMPLETING COLLEGE, AND PREPARING FOR COMMUNITY LEADERSHIP. SUTTER SANTA ROSA REGIONAL HOSPITAL PROVIDES STAFF TIME TO COVERED SONOMA. COVERED SONOMA IS A COMMUNITY-WIDE COLLABORATIVE DESIGNED TO IDENTIFY AND PROVIDE ACCESS TO HEALTH INSURANCE FOR ALL ELIGIBLE UNINSURED PEOPLE IN SONOMA COUNTY. THE HEALTHCARE WORKFORCE DEVELOPMENT ROUNDTABLE IS A GROUP THAT PROMOTES THE INTEREST IN HEALTH PROFESSIONS AND CREATES OPPORTUNITIES TO PURSUE HEALTH CAREERS FOR DIVERSE POPULATIONS IN SONOMA COUNTY. THIS PROGRAM IS A PARTNERSHIP WITH SANTA ROSA JUNIOR COLLEGE AND HAS BEEN AWARDED MULTIPLE GRANTS OVER THE YEARS TO CONTINUE ITS IMPORTANT OUTREACH, RECRUITMENT AND SUPPORT EFFORTS. SUTTER SANTA ROSA REGIONAL HOSPITAL CONTINUES TO PROVIDE LEADERS TO THIS EFFORT, BOTH IN STRATEGIC PLANNING AND PROVIDING OPPORTUNITIES FOR STUDENTS TO SHADOW STAFF IN A VARIETY OF HEALTH PROFESSIONS WITH THE HOSPITAL SETTING. TODAY, THIS PARTNERSHIP HAS GROWN INTO A ROBUST CONTINUUM OF PROGRAMS AND SERVICES TARGETING HIGH SCHOOL AND COLLEGE STUDENTS OF COLOR.
SCHEDULE H, PART III, LINE 2 METHODOLOGY FOR CALCULATING BAD DEBT (AT COST): THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
SCHEDULE H, PART III, LINE 3 METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE: AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE.
SCHEDULE H, PART III, LINE 4 AUDIT FOOTNOTE: THE ORGANIZATION MAKES EVERY EFFORT TO QUALIFY THOSE ELIGIBLE FOR CHARITY CARE. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW. PATIENT ACCOUNTS RECEIVABLE AUDIT FOOTNOTE: SUTTER'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. SUTTER MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE ESTIMATED BASED UPON AN EVALUATION OF HISTORICAL PAYMENTS, NEGOTIATED CONTRACTS AND GOVERNMENTAL REIMBURSEMENTS. SUTTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 90% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2014 AND 2013. ADJUSTMENTS AND CHANGES IN ESTIMATES ARE RECORDED IN THE PERIOD IN WHICH THEY ARE DETERMINED. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: MEDICARE 29% AS OF 12/31/14 33% AS OF 12/31/13 MEDI-CAL 27% AS OF 12/31/14 21% AS OF 12/31/13 DURING 2014 AND 2013, CERTAIN AFFILIATES COLLECTED ON ACCOUNTS THAT WERE PREVIOUSLY DEEMED UNCOLLECTIBLE AND RESERVED. SUCH RECOVERIES ARE RECOGNIZED IN THE PERIOD THAT CASH IS RECEIVED AND WERE NOT MATERIAL. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT THE ESTIMATION MAY CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. PATIENT SERVICE REVENUES FOOTNOTE: PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SUTTER'S SELF-PAY WRITE-OFFS WERE $287 MILLION AND $375 MILLION FOR 2014 AND 2013, RESPECTIVELY.
SCHEDULE H, PART III, LINE 7 MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS.
SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.
SCHEDULE H, PART III, LINE 9B DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.
SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A): DURING 2013, A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE CITY AND COUNTY OF SAN FRANCISCO WAS CONDUCTED BY CPMC, THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, LOCAL NONPROFIT HOSPITALS AND ACADEMIC PARTNERS, AND MORE THAN 500 COMMUNITY RESIDENTS. SERVING CALIFORNIA'S ONLY CONSOLIDATED CITY AND COUNTY AND A DIVERSE POPULATION OF 805,235 RESIDENTS, THE PARTNERS MADE EVERY EFFORT TO CREATE A COMMUNITY-ORIENTED PROCESS ALIGNED WITH THE FOLLOWING VALUES: - TO FACILITATE ALIGNMENT OF SAN FRANCISCO'S PRIORITIES, RESOURCES, AND ACTIONS TO IMPROVE HEALTH AND WELL-BEING. - TO ENSURE THAT HEALTH EQUITY IS ADDRESSED THROUGHOUT PROGRAM PLANNING AND SERVICE DELIVERY. - TO PROMOTE COMMUNITY CONNECTIONS THAT SUPPORT HEALTH AND WELL-BEING. THE MEMBERS OF THIS COMMUNITY BENEFIT PARTNERSHIP, WITH A LONG HISTORY OF SUCCESSFUL COLLABORATION, AGREED TO TACKLE A NEW REQUIREMENT UNDER THE AFFORDABLE CARE ACT: TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS. THIS EFFORT IS NOT UNFAMILIAR TO SAN FRANCISCO'S NONPROFIT HOSPITALS, AS THEY HAVE UNDERGONE A SIMILAR PROCESS EVERY THREE YEARS SINCE CALIFORNIA SENATE BILL 697 WAS PASSED IN 1994; FOR MORE THAN A DECADE THIS COLLABORATIVE HAS CONDUCTED COLLECTIVE COMMUNITY NEEDS ASSESSMENTS. HELPFUL TO THIS YEAR'S PROCESS WAS THE NUMBER OF SIMILAR EFFORTS BEING UNDERTAKEN TO ASSESS COMMUNITY HEALTH NEEDS AND IMPROVEMENT STRATEGIES, SUCH AS THE HEALTH CARE SERVICES MASTER PLAN AND ACCREDITATION FOR THE SAN FRANCISCO PUBLIC HEALTH DEPARTMENT (SFDPH). TO LEVERAGE RESOURCES REQUIRED FOR THESE ENDEAVORS, THE COMMUNITY BENEFIT PARTNERSHIP MADE USE OF A COMMUNITY-DRIVEN PROCESS THAT ENGAGED MORE THAN 500 COMMUNITY RESIDENTS AND LOCAL PUBLIC HEALTH SYSTEM PARTNERS WHO IDENTIFIED THE FOLLOWING KEY HEALTH PRIORITIES FOR ACTION: - ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS - INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY - INCREASE ACCESS TO HIGH-QUALITY HEALTH CARE AND SERVICES FROM JULY 2011 UNTIL FEBRUARY 2013, THE PARTNERS ENGAGED IN A PROCESS TO: A) AGREE ON DATA ELEMENTS AND INDICATORS TO BE COLLECTED B) DETERMINE THE PARTIES RESPONSIBLE TO COLLECT THOSE DATA C) AGREE ON METHODS TO SOLICIT AND INCORPORATE COMMUNITY INPUT D) SHARE FINDINGS E) IDENTIFY PRIORITIZATION CRITERIA TO BE USED F) CONDUCT THE PRIORITIZATION PROCESS G) GET COMMUNITY STAKEHOLDERS' INPUT ON STRATEGIES TO ADDRESS THE HEALTH NEEDS TO YIELD A REPRESENTATIVE AND TRANSPARENT ASSESSMENT PROCESS, THE COMMUNITY BENEFIT PARTNERSHIP SOUGHT TO ENGAGE A RANGE OF COMMUNITY RESIDENTS AND LOCAL PUBLIC HEALTH SYSTEM PARTNERS AT EACH STEP. SPECIFICALLY: - COMMUNITY RESIDENTS FROM EACH OF SAN FRANCISCO'S 21 NEIGHBORHOOD AREAS CAME TOGETHER FOR A DAY-LONG EVENT TO DISCUSS THEIR VIEWS OF HEALTH AND THEIR HOPES FOR SAN FRANCISCO'S HEALTH FUTURE. THIS RESULTED IN ELEMENTS OF A COMMUNITY-GUIDED HEALTH VISION FOR THE CITY AND COUNTY OF SAN FRANCISCO. - SFDPH CONVENED A 42-MEMBER TASK FORCE TO SUPPORT SAN FRANCISCO'S CHA AND A PARALLEL EFFORT, THE HEALTH CARE SERVICES MASTER PLAN (HCSMP). TASK FORCE MEMBERS REPRESENTED A RANGE OF COMMUNITY STAKEHOLDERS SUCH AS HOSPITALS/CLINICS, K-12 EDUCATION, SMALL BUSINESS, URBAN PLANNING, CONSUMER GROUPS, NONPROFITS REPRESENTING DIFFERENT ETHNIC MINORITY GROUPS, AND MORE. TO ENSURE COMMUNITY PARTICIPATION IN THE HCSMP AND CHA PROCESSES, THE TASK FORCE MET A TOTAL OF 10 TIMES BETWEEN JULY 2011 AND MAY 2012 - FOUR OF THOSE IN DIFFERENT SAN FRANCISCO NEIGHBORHOODS - AND ENGAGED MORE THAN 100 COMMUNITY RESIDENTS IN DIALOGUE TO BETTER DETERMINE HOW TO IMPROVE THE HEALTH OF ALL SAN FRANCISCANS WITH A PARTICULAR FOCUS ON THE CITY/COUNTY'S MOST VULNERABLE POPULATIONS. TO ENCOURAGE COMMUNITY DIALOGUE, TASK FORCE NEIGHBORHOOD MEETINGS TOOK PLACE IN THE EVENING, AND SFDPH PROVIDED INTERPRETATION SERVICES IN SPANISH AND CANTONESE. - SAN FRANCISCO ENGAGED 224 COMMUNITY RESIDENTS IN FOCUS GROUPS AND INTERVIEWED 40 COMMUNITY STAKEHOLDERS TO LEARN MORE ABOUT SAN FRANCISCANS' DEFINITIONS OF HEALTH AND WELLNESS AS WELL AS THEIR PERCEPTIONS OF SAN FRANCISCO'S STRENGTHS VERSUS AREAS FOR HEALTH IMPROVEMENT. FOCUS GROUPS TARGETED SAN FRANCISCO SUBPOPULATIONS (SENIORS AND PERSONS WITH DISABILITIES, TRANSGENDERED PEOPLE, MONOLINGUAL SPANISH SPEAKERS, AND TEENS) AND SPECIFIC NEIGHBORHOODS (BAYVIEW HUNTERS POINT, CHINATOWN, EXCELSIOR, MISSION, SUNSET/RICHMOND, AND TENDERLOIN). FOCUS GROUP PARTICIPANTS GREATLY INFORMED SAN FRANCISCO'S HEALTH VISION AS WELL AS THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT. - A 10-MEMBER DATA ADVISORY COMMITTEE COMPRISED OF LOCAL PUBLIC HEALTH SYSTEM PARTNERS, RESIDENTS, AND SFDPH STAFF OVERSAW THE SELECTION OF DATA INDICATORS FOR THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA). THIS BODY ALSO ENSURED THE INTEGRITY OF THE CHSA'S METHODOLOGY AND QUANTITATIVE DATA. - IN JUNE 2013, THE CHIP AND CHNA WERE PUBLICLY LAUNCHED AT THE MAYOR'S BREAKFAST ATTENDED BY 400 COMMUNITY PARTNERS. SECONDARY DATA WERE GATHERED WITH THE ASSISTANCE OF HARDER+COMPANY. THE REPORT "COMMUNITY HEALTH STATUS ASSESSMENT: CITY AND COUNTY OF SAN FRANCISCO" WAS COMPLETED IN JULY 2012. THE HEALTH INDICTORS, SELECTED BY MEMBERS OF THE LEADERSHIP GROUP WITHIN THE COALITION, AS WELL AS EACH INDICATOR'S DATA SOURCE, ARE ALSO INCLUDED IN THE REPORT. THE PARTNERS CONDUCTED FOUR HEALTH ASSESSMENTS TO IDENTIFY COMMUNITY HEALTH NEEDS AND INFORM HEALTH PRIORITY SELECTION: COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, FORCES OF CHANGE ASSESSMENT, AND A COMMISSIONED COMMUNITY HEALTH STATUS ASSESSMENT. ONCE COLLECTED, SFDPH STAFF GROUPED DATA BY COMMON THEMES GROUPING LIKE DATA POINTS. THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR CALIFORNIA PACIFIC MEDICAL CENTER IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. NOVATO COMMUNITY HOSPITAL: NOVATO COMMUNITY HOSPITAL (NCH) AND HEALTHY MARIN PARTNERSHIP (HMP) HAVE CONDUCTED COMMUNITY NEEDS ASSESSMENTS SINCE 1995 TO COMPLY WITH THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. THE 2013 CHNA RESULTED IN A RE- EXAMINATION OF OUR PROCESS AND ATTENTION TO COMMUNITY INPUT, TRANSPARENCY, SUBJECT MATTER EXPERTISE AND DATA COLLECTION. HMP CONDUCTED A COMMUNITY CONVENING OF MORE THAN 30 REPRESENTATIVES OF UNDERSERVED COMMUNITIES, PUBLIC HEALTH EXPERTS, AND COMMUNITY LEADERS. THEY PRESENTED THE GROUP WITH EXTENSIVE DATA, KEY INFORMANT INTERVIEWS AND COMMUNITY FOCUS GROUPS RESULTS. THE GROUP WAS ENGAGED IN A PROCESS TO EXAMINE AND DISCUSS THE INFORMATION. AS A FINAL STEP THEY IDENTIFIED THE FOLLOWING MARIN COUNTY HEALTH NEEDS IN PRIORITY ORDER: 1. MENTAL HEALTH 2. SUBSTANCE ABUSE 3. ACCESS TO HEALTH CARE/MEDICAL HOMES/HEALTH CARE COVERAGE 4. SOCIOECONOMIC STATUS (INCOME, EMPLOYMENT, EDUCATION LEVEL) 5. HEALTHY EATING AND ACTIVE LIVING (NUTRITION/HEALTHY FOOD/FOOD ACCESS/PHYSICAL ACTIVITY 6. SOCIAL SUPPORTS (FAMILY AND COMMUNITY SUPPORT SYSTEMS AND SERVICES; CONNECTEDNESS) 7. CANCER 8. HEART DISEASE THE NOVATO COMMUNITY HOSPITAL SERVICE AREA INCLUDES THE NORTHERN CALIFORNIA COUNTY OF MARIN AND PARTS OF SOUTHERN SONOMA COUNTY. FOR PURPOSES OF THIS CHNA, ACTIVITIES WERE RESTRICTED TO RESIDENTS WITHIN THE BORDERS OF MARIN COUNTY. THE COUNTY OF SONOMA IS ADDRESSED BY SUTTER SANTA ROSA REGIONAL HOSPITAL. MARIN'S THREE NOT-FOR-PROFIT HOSPITALS, MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL AND KAISER PERMANENTE COLLABORATED WITH HMP TO COMPLETE THE CHNA. THE PROCESS INCLUDED FOUR PRIMARY ACTIVITIES: 1. KEY INFORMANT INTERVIEWS (PUBLIC HEALTH EXPERTS AND COMMUNITY LEADERS) 2. FOCUS GROUPS (UNDERSERVED COMMUNITIES IN ENGLISH AND SPANISH, WITH ADDITIONAL TRANSLATION AVAILABLE) 3. THE HMP COMMUNITY CONVENING (EXPERTS, LEADERS, AND RESIDENTS) 4. A COMPREHENSIVE DATA REVIEW OF 153 HEALTH INDICATORS. FINDINGS WERE COMPARED TO STATE AND NATIONAL AVERAGES AND, WHEN POSSIBLE MAPPED BY CENSUS TRACTS TO SHOW VARIATIONS AMONG GEOGRAPHIC AREAS ACROSS THE COUNTY. THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR NOVATO COMMUNITY HOSPITAL IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. SUTTER LAKESIDE HOSPITAL: A COMMUNITY HEALTH NEEDS ASSESSMENT BUILDS THE FOUNDATION FOR ALL COMMUNITY HEALTH PLANNING, AND PROVIDES APPROPRIATE INFORMATION ON WHICH POLICYMAKERS, PROVIDER GROUPS, AND COMMUNITY ADVOCATES CAN BASE IMPROVEMENT EFFORTS; IT CAN ALSO INFORM FUNDERS ABOUT DIRECTING GRANT DOLLARS MOST APPROPRIATELY. IN 2012-2013, A COLLABORATIVE THAT INCLUDED THE TWO LAKE COUNTY HOSPITALS, ST. HELENA CLEAR LAKE AND SUTTER LAKESIDE, JOINED BY PUBLIC HEALTH AND OTHER LOCAL ORGANIZATIONS, RETAINED BARBARA AVED ASSOCIATES (BAA) TO UPDATE THE COMMUNITY HEALTH NEEDS ASSESSMENT BAA CONDUCTED IN 2010. THE PURPOSE OF THE STUDY WAS TO EXAMINE RELEVANT COMMUNITY HEALTH INDICATORS, IDENTIFY THE HIGHEST UNMET NEEDS AND PRIORITIZE AREAS FOR IMPROVING COMMUNITY HEALTH. THE ASSESSMENT MEETS THE PROVISIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE
SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER WEST BAY HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. FOR A MORE DETAILED LOOK AT OUR CHARITY CARE POLICIES BY REGION, PLEASE VISIT THE OFFICE OF STATEWIDE AND HEALTH PLANNING'S WEBSITE AT HTTP://SYFPHR.OSHPD.CA.GOV COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: - ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS) - PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION". B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS.
SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CALIFORNIA PACIFIC MEDICAL FOUNDATION (REPORTING GROUP A): THE HOSPITAL SERVICE AREA FOR CALIFORNIA PACIFIC MEDICAL CENTER INCLUDES ALL POPULATIONS RESIDING IN THE CITY AND COUNTY OF SAN FRANCISCO. THERE ARE 12 HOSPITALS SERVING THE COMMUNITY. THE TOTAL POPULATION OF CPMC'S HOSPITAL SERVICE AREA IS 805,235. 48.5% OF THE POPULATION IS WHITE. 15.1% IS LATINO. 6.1% IS AFRICAN AMERICAN. 33.7% IS ASIAN AND PACIFIC ISLANDER. 0.5% IS NATIVE AMERICAN. MEDIAN AGE IS 38.2 YEARS. AVERAGE HOUSEHOLD INCOME IS $73,127. 11.86% OF THE POPULATION IS LIVING IN POVERTY. 15% OF CHILDREN ARE LIVING IN POVERTY. 9.5% OF THE POPULATION IS UNEMPLOYED. 11.53% OF THE POPULATION IS UNINSURED. 27.59% IS LIVING UNDER 200% POVERTY LEVEL. 24.78% IS LINGUISTICALLY ISOLATED. AND 14.29% OF THE POPULATION HAS NO HIGH SCHOOL DIPLOMA. (SOURCES: HTTP://WWW.COUNTYHEALTHRANKINGS.ORG; HTTP://WWW.CHNA.ORG/KP; HTTP://WWW.SFDPH.ORG/DPH/FILES/REPORTS/POLICYPROCOFC/CHSA_10162012.PDF). AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE CALIFORNIA PACIFIC MEDICAL CENTER CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. NOVATO COMMUNITY HOSPITAL: THE NOVATO COMMUNITY HOSPITAL SERVICE AREA INCLUDES THE NORTHERN CALIFORNIA COUNTY OF MARIN AND PARTS OF SOUTHERN SONOMA COUNTY. FOR PURPOSES OF THIS STUDY, ACTIVITIES WERE RESTRICTED TO RESIDENTS WITHIN THE BORDERS OF MARIN COUNTY. SUTTER SANTA ROSA REGIONAL HOSPITAL ADDRESSES THE COUNTY OF SONOMA. THERE ARE THREE HOSPITALS SERVING THE COMMUNITY. THE NOVATO COMMUNITY HOSPITAL SERVICE AREA COMPRISES MARIN COUNTY UNINCORPORATED AREAS AND CITIES INCLUDING BELVEDERE, CORTE MADERA, FAIRFAX, LARKSPUR, MILL VALLEY, NOVATO, ROSS, SAN ANSELMO, SAN RAFAEL, SAUSALITO, AND TIBURON AND THE COASTAL TOWNS OF STINSON BEACH, BOLINAS, POINT REYES, INVERNESS, MARSHALL, AND TAMALES. THE TOTAL POPULATION IN MARIN COUNTY IS 352,544. WHITES MAKE UP 81.94% OF MARIN COUNTY'S POPULATION. 16.68% ARE LATINO. 2.38% ARE AFRICAN AMERICAN. 5.33% ARE ASIAN AND PACIFIC ISLANDER. 0.36% ARE NATIVE AMERICAN. (DATA SOURCE: US CENSUS BUREAU, 2006-2010 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATE. KFH-SAN RAFAEL SERVICE AREA DATA) MEDIAN AGE IS 44 YEARS, WITH 15.47% OF THE POPULATION OVER THE AGE OF 65. 91.68% OF THE POPULATION GRADUATED ON TIME FROM HIGH SCHOOL. 9.22% OF CHILDREN LIVE IN POVERTY. THE MEDIAN HOUSEHOLD INCOME IS $89,268. 9.36% OF THE POPULATION HAVE NO HIGH SCHOOL DIPLOMA. 8.6% OF THE POPULATION ARE MEDI-CAL/MEDI-CAID RECIPIENTS. THE UNEMPLOYMENT RATE IS 6.16%. 10.0% ARE UNINSURED, AND 11.33% LACK A SOURCE OF CONSISTENT PRIMARY CARE. MARIN COUNTY IS A HEALTHY AND AFFLUENT COUNTY COMPARED TO CALIFORNIA, AND THE NATION, AS A WHOLE. HOWEVER, A SUB-COUNTY GEOGRAPHIC QUANTITATIVE AND QUALITATIVE DATA ANALYSIS IDENTIFIES DISPARITIES IN SOCIOECONOMIC STATUS THAT LIMIT ACCESS TO HEALTH CARE AND THE CAPACITY OF SOME RESIDENTS TO MAKE CHOICES THAT CONTRIBUTE TO A HEALTHY LIFESTYLE. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS OF THE SERVICE AREA IS AVAILABLE IN THE NOVATO COMMUNITY HOSPITAL'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML. SUTTER LAKESIDE HOSPITALS: SUTTER LAKESIDE HOSPITAL'S HOSPITAL SERVICE AREA IS DEFINED AS LAKE COUNTY. THERE ARE TWO HOSPITALS SERVING THE COMMUNITY. LAKE COUNTY IS LOCATED IN NORTHERN CALIFORNIA JUST TWO HOURS BY CAR FROM THE SAN FRANCISCO BAY AREA, THE SACRAMENTO VALLEY, OR THE PACIFIC COAST. THE COUNTY'S ECONOMY IS BASED LARGELY ON TOURISM AND RECREATION, DUE TO THE ACCESSIBILITY AND POPULARITY OF ITS SEVERAL LAKES AND ACCOMPANYING RECREATIONAL AREAS. IT IS PREDOMINANTLY RURAL, ABOUT 100 MILES LONG BY ABOUT 50 MILES WIDE, AND INCLUDES THE LARGEST NATURAL LAKE ENTIRELY WITHIN CALIFORNIA BORDERS. LAKE COUNTY IS MOSTLY AGRICULTURAL, WITH TOURIST FACILITIES AND SOME LIGHT INDUSTRY. MAJOR CROPS INCLUDE PEARS, WALNUTS AND, INCREASINGLY, WINE GRAPES. DOTTED WITH VINEYARDS AND WINERIES, ORCHARDS AND FARM STANDS, AND SMALL TOWNS, THE COUNTY IS HOME TO CLEAR LAKE, CALIFORNIA'S LARGEST NATURAL FRESHWATER LAKE, KNOWN AS "THE BASS CAPITAL OF THE WEST," AND MT. KONOCTI, WHICH TOWERS OVER CLEAR LAKE. WITHIN LAKE COUNTY THERE ARE TWO INCORPORATED CITIES, THE COUNTY SEAT OF LAKEPORT AND THE CITY OF CLEARLAKE, THE LARGEST CITY, AND THE COMMUNITIES OF BLUE LAKES, CLEARLAKE OAKS, COBB, FINLEY, GLENHAVEN, HIDDEN VALLEY LAKE, KELSEYVILLE, LOCH LOMOND, LOWER LAKE, LUCERNE, NICE, MIDDLETOWN, SPRING VALLEY, ANDERSON SPRINGS, UPPER LAKE, AND WITTER SPRINGS. LAKE COUNTY IS BORDERED BY MENDOCINO AND SONOMA COUNTIES ON THE WEST; GLENN, COLUSA AND YOLO COUNTIES ON THE EAST; AND NAPA COUNTY ON THE SOUTH. THE TWO MAIN TRANSPORTATION CORRIDORS THROUGH THE COUNTY ARE STATE ROUTES 29 AND 20. STATE ROUTE 29 CONNECTS NAPA COUNTY WITH LAKEPORT AND STATE ROUTE 20 TRAVERSES CALIFORNIA AND PROVIDES CONNECTIONS TO HIGHWAY 101 AND INTERSTATE 5. ACCORDING TO CALIFORNIA LABOR MARKET DATA ABOUT COUNTY-TO-COUNTY COMMUTE PATTERNS (WHICH HAVE NOT BEEN UPDATED SINCE 2000), THE TOTAL NUMBER OF WORKERS THAT LIVE AND WORK IN LAKE IS 15,566 PERSONS: THE TOTAL FOR WORKERS COMMUTING IN WAS 1,046, AND 4,320 WORKERS COMMUTED OUT. ABOUT 67% OF PEOPLE WHO LIVE IN LAKE COUNTY ALSO WORK WITHIN THE COUNTY. WHILE THE POPULATION SIZE OF LAKE COUNTY WAS ESTIMATED AT 64,394 RESIDENTS IN JULY 2012, THE POPULATION CAN SWELL WITH DAYTIME WORK COMMUTERS AND SEASONAL TOURISTS. DEMOGRAPHICS: - POPULATION CHANGE IS MOSTLY STATIC. ESTIMATES OF ANNUAL PERCENT CHANGE BETWEEN JANUARY 2011 AND JANUARY 2012 SHOW ZERO GROWTH FOR THE COUNTY OVERALL. - WITH 21% OF RESIDENTS OVER THE AGE OF 65, THE COUNTY HAS NEARLY TWICE THE PROPORTION OF OLDER RESIDENTS THAN CALIFORNIA AS A WHOLE. THE OVER-AGE-60 GROUP IS ESTIMATED TO INCREASE 59% FROM 2010 TO 2030. THE ANTICIPATED SIGNIFICANT GROWTH IN THIS AGE GROUP WILL PUT A LARGER BURDEN ON THE HEALTH CARE SYSTEM AND LOCAL ECONOMY, WHICH MAY NOT HAVE SUFFICIENT COMMUNITY SERVICES OR TAX BASE TO SUPPORT IT. - LAKE COUNTY'S POPULATION IS PROJECTED TO BECOME INCREASINGLY CULTURALLY DIVERSE IN COMING YEARS. FOR EXAMPLE, THE HISPANIC POPULATION IS PROJECTED TO INCREASE SLIGHTLY MORE THAN 3-FOLD AND PERSONS IDENTIFYING AS MULTI-RACE BY ABOUT 2-FOLD FROM 2010 TO 2050. SOCIOECONOMIC FACTORS: - RECOVERY FROM THE RECESSION HAS BEEN SLOW; 21.4% (UP FROM 17.9% IN 2008) OF LAKE COUNTY RESIDENTS, ONE-THIRD HIGHER THAN THE STATE AVERAGE, LIVED BELOW THE FEDERAL POVERTY LEVEL IN 2011. - ONE-THIRD OF THE POPULATION WAS REPORTED TO BE "FOOD INSECURE." AND, IN 2011, 61% OF STUDENTS ACROSS THE COUNTY WERE RECEIVING FREE-REDUCED PRICE LUNCHES. THESE FINDINGS, HOWEVER, SHOWED SLIGHT IMPROVEMENT FROM THE PRIOR ASSESSMENT PERIOD. - THE PROPORTION OF THE NON ELDERLY POPULATION (AGES 0-64) WHO WERE UNINSURED ALL OR PART OF THE YEAR IN LAKE COUNTY IS VERY SIMILAR TO THE STATEWIDE AVERAGE. - THERE WERE FEWER UNINSURED CHILDREN IN LAKE COUNTY THAN IN CALIFORNIA IN 2009, BUT THE PERCENTAGE COVERED BY EMPLOYMENT-BASED INSURANCE, 44.5%, WAS LOWER THAN THE STATE AVERAGE. - LAKE COUNTY HAS THE HIGHEST PERCENTAGE OF SENIORS COVERED BY A COMBINATION OF MEDICARE AND MEDI-CAL IN THE NORTHERN AND SIERRA COUNTIES REGION. IT HAS THE SECOND LOWEST PERCENTAGE OF SENIORS THAT HAVE PRIVATE SUPPLEMENTAL COVERAGE IN ADDITION TO MEDICARE. - MORE PEOPLE IN LAKE COUNTY, 86.3%, COMPARED TO CALIFORNIA, 80.7%, HAVE COMPLETED HIGH SCHOOL OR HIGHER. - LAKE COUNTY'S OVERALL HIGH SCHOOL DROPOUT RATE IN 2011-12, 2.8%, WAS MORE FAVORABLE THAN THE STATEWIDE RATE OF 4.0%, BUT SLIGHTLY HIGHER THAN THE PRIOR SCHOOL YEAR. NATIVE AMERICAN AND AFRICAN AMERICAN STUDENTS DROP OUT OF SCHOOL AT HIGHER RATES THAN THE OVERALL COUNTY AVERAGE. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE HOSPITAL CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SUTTER SANTA ROSA REGIONAL HOSPITAL: SUTTER SANTA ROSA REGIONAL HOSPITAL'S HOSPITAL SERVICE AREA IS DEFINED AS SONOMA COUNTY. THERE ARE THREE HOSPITALS SERVING THE COMMUNITY. DEMOGRAPHIC OVERVIEW: SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. THE COUNTY'S TOTAL POPULATION IS CURRENTLY ESTIMATED AT 487,011. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%). GEOGRAPHIC DISTRIBUTION OF POPULATION: SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION OF 168,841 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. SONOMA COUNTY'S UNINCORPORATED AREAS ARE HOME TO 146,739 RESIDENTS, 30.1% OF THE TOTAL POPULA
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC): THE 2013 - 2015 IMPLEMENTATION STRATEGY FOR CALIFORNIA PACIFIC MEDICAL CENTER DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: CPMC'S ST. LUKE'S HEALTH CARE CENTER (SLHCC) PROVIDES A FULL RANGE OF OBSTETRIC AND GYNECOLOGICAL CARE AT ITS WOMEN'S CENTER; WELL-BABY CARE, WELL-CHILD CARE, AND CARE FOR ILL OR INJURED CHILDREN AT ITS PEDIATRIC CLINIC; AND PRIMARY, ACUTE AND CHRONIC CARE AT ITS ADULT INTERNAL MEDICINE CLINIC FOR TEENAGERS AND ADULTS. SLHCC'S CLINICIANS AND STAFF ARE BILINGUAL IN ENGLISH AND SPANISH, ENSURING CULTURALLY COMPETENT AND SENSITIVE CARE. SLHCC IS ANTICIPATED TO IMPROVE ACCESS TO CARE FOR UNINSURED AND UNDERINSURED PATIENTS RESIDING IN COMMUNITIES SOUTH OF MARKET STREET IN SAN FRANCISCO. IN 2014, ABOUT 12,000 UNIQUE PATIENTS WERE SEEN AT ST. LUKE'S HEALTH CARE CENTER, WITH OVER 44,000 PATIENT VISITS. HEALTHFIRST, SLHCC'S AFFILIATED CENTER FOR HEALTH EDUCATION AND DISEASE PREVENTION, HAD OVER 1,900 PATIENT VISITS, SERVING OVER 650 PATIENTS IN CHRONIC DISEASE MANAGEMENT. CPMC MAINTAINS SLHCC AT ITS ST. LUKE'S CAMPUS IN ORDER TO PROVIDE SUBSIDIZED PRIMARY CARE AND PREVENTIVE SERVICES TO UNDERSERVED RESIDENTS OF THE MISSION, AS WELL AS BAYVIEW, DOWNTOWN/CIVIC CENTER, VISITACION VALLEY AND EXCELSIOR - SOME OF THE SAN FRANCISCO NEIGHBORHOODS IDENTIFIED AS HAVING THE HIGHEST DISPARITIES RELATED TO IMPORTANT SOCIO-ECONOMIC DETERMINANTS OF HEALTH. BY PROVIDING SERVICES SUCH AS THESE, CPMC CONTRIBUTES TO IMPROVED ACCESS TO CARE AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR TRACKING THE NUMBER OF SAN FRANCISCANS WITH A USUAL SOURCE OF HEALTH CARE (FROM 86.8% IN 2009 TO 88.8% IN 2011-2012) (WWW.SFHIP.ORG). BY ENSURING THAT SERVICES ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE, CPMC HELPS TO BRIDGE GAPS IN ACCESSIBILITY DUE TO LANGUAGE AND CULTURAL BARRIERS FOR NON-NATIVE-ENGLISH SPEAKERS, AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR MEASURING SAN FRANCISCO'S PERCENTAGE OF ADULTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME WHO HAVE DIFFICULTY UNDERSTANDING THEIR DOCTORS (FROM 2.1% IN 2009 TO 1.7% IN 2011-2012) (WWW.SFHIP.ORG). THESE SERVICES ALSO COUNTER LIMITED ACCESS THAT MAY BE CAUSED BY PRIMARY CARE PROVIDERS BEING LESS LIKELY TO SERVE MEDI-CAL BENEFICIARIES DUE TO LOW GOVERNMENT REIMBURSEMENT RATES. CPMC'S KALMANOVITZ CHILD DEVELOPMENT CENTER (KCDC) PROVIDES DIAGNOSIS, EVALUATION, TREATMENT AND COUNSELING FOR CHILDREN AND ADOLESCENTS WITH LEARNING DISABILITIES AND DEVELOPMENTAL OR BEHAVIORAL PROBLEMS CAUSED BY PREMATURITY, AUTISM SPECTRUM DISORDER, EPILEPSY, DOWN SYNDROME, ATTENTION DEFICIT DISORDER, OR CEREBRAL PALSY. ITS COMPREHENSIVE ASSESSMENTS AND ONGOING THERAPY PROGRAMS INCLUDE THE FOLLOWING DISCIPLINES: DEVELOPMENTAL/BEHAVIORAL PEDIATRICS; PSYCHOLOGY AND PSYCHIATRY; SPEECH/LANGUAGE AND AUDITORY PROCESSING; OCCUPATIONAL THERAPY; BEHAVIOR MANAGEMENT CONSULTATIONS; EARLY INTERVENTION/ PARENT-INFANT PROGRAM; SOCIAL SKILLS GROUPS; FEEDING ASSESSMENT AND THERAPY; ASSESSMENT AND THERAPY FOR THE NEONATAL INTENSIVE CARE UNIT AND ASSESSMENT FOR THE FOLLOW-UP CLINIC; EDUCATIONAL ASSESSMENT, THERAPY AND TREATMENT. BESIDES OPERATING ITS OWN CLINICS, KCDC ALSO EXTENDS ITS SERVICES TO A LARGE NUMBER OF AT-RISK CHILDREN BY PARTNERING WITH LOCAL SCHOOLS AND OTHER COMMUNITY ORGANIZATIONS, SUCH AS DE MARILLAC ACADEMY, IMMACULATE CONCEPTION ACADEMY, AND FIRST 5 SAN FRANCISCO. KCDC IS ANTICIPATED TO IMPROVE ACCESS TO CARE FOR UNINSURED AND UNDERINSURED PATIENTS RESIDING IN SAN FRANCISCO. IN 2014, KCDC LOCATIONS TOGETHER HAD NEARLY 20,000 PATIENT VISITS, SERVING OVER 1,850 UNIQUE PATIENTS WHO OTHERWISE MAY NOT HAVE BEEN ABLE TO RECEIVE CHILD DEVELOPMENTAL SERVICES. THESE SERVICES PROVIDED AT REDUCED OR NO COST TO FAMILIES ARE PARTICULARLY IMPORTANT SINCE CHILDREN FROM LOW-INCOME FAMILIES HAVE A 50% HIGHER RISK OF DEVELOPMENTAL DISABILITIES; EARLY IDENTIFICATION AND TREATMENT CAN CHANGE THE COURSE OF THESE CHILDREN'S LIVES. KCDC PROVIDED ADDITIONAL SERVICES THROUGH CPMC'S NEW "JOINT VENTURE HEALTH" WITH UC BERKELEY'S SCHOOL OF PUBLIC HEALTH AND NORTH EAST MEDICAL SERVICES (NEMS); IN THIS PARTNERSHIP, KCDC DONATED THE LABOR TIME OF A DEDICATED CHILD DEVELOPMENT SPECIALIST STATIONED AT NEMS SO THAT KIDS WITH DEVELOPMENTAL DISABILITIES COULD RECEIVE DEVELOPMENTAL SERVICES AT AN INTEGRATED MEDICAL HOME WHERE THEY ALSO RECEIVE PRIMARY CARE. THROUGH THIS PROGRAM, MORE THAN 400 KIDS UNDER AGE 11 WERE SCREENED, OF WHOM 14 PERCENT WERE AT MODERATE OR HIGH RISK FOR DEVELOPMENTAL AND SOCIAL/EMOTIONAL DELAYS. BAYVIEW CHILD HEALTH CENTER (BCHC) OFFERS ROUTINE PREVENTATIVE AND URGENT PEDIATRIC CARE IN ONE OF SAN FRANCISCO'S MOST MEDICALLY UNDERSERVED NEIGHBORHOODS, AND ADDRESSES PREVALENT COMMUNITY HEALTH ISSUES SUCH AS WEIGHT CONTROL AND ASTHMA MANAGEMENT. THE CENTER IS PARTICULARLY ATTUNED TO THE IMPACT OF COMMUNITY VIOLENCE AND CHILDHOOD TRAUMA ON CHILDREN'S MENTAL AND PHYSICAL HEALTH. THE CLINIC ALSO OFFERS PSYCHOLOGICAL AND CASE MANAGEMENT SERVICES TO FAMILIES THROUGH A PARTNERSHIP WITH THE CENTER FOR YOUTH WELLNESS. DENTAL SERVICES ARE PROVIDED ON SITE THROUGH A PARTNERSHIP WITH THE NATIVE AMERICAN HEALTH CENTER. THE CLINIC IS A COLLABORATION BETWEEN CPMC, SUTTER PACIFIC MEDICAL FOUNDATION, AND CPMC FOUNDATION. IN 2014, THE CLINIC SERVED AN ESTIMATED 1,000 UNIQUE PATIENTS, WITH AN ESTIMATED 2,500 TOTAL PATIENT VISITS. CPMC AND ITS PARTNERS OPENED BCHC IN ORDER TO PROVIDE SUBSIDIZED PRIMARY CARE TO CHILDREN IN ONE OF THE MOST VULNERABLE, UNDERSERVED NEIGHBORHOODS IN SAN FRANCISCO. THROUGH SERVICES SUCH AS THESE, CPMC HAS CONTRIBUTED TO IMPROVED ACCESS TO CARE AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR TRACKING THE NUMBER OF SAN FRANCISCANS WITH A USUAL SOURCE OF HEALTH CARE (FROM 86.8% IN 2009 TO 88.8% IN 2011-2012) (WWW.SFHIP.ORG). BY ENSURING THAT SERVICES ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE, CPMC HELPS TO BRIDGE GAPS IN ACCESSIBILITY DUE TO LANGUAGE AND CULTURAL BARRIERS FOR NON-NATIVE-ENGLISH SPEAKERS, AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR MEASURING SAN FRANCISCO'S PERCENTAGE OF ADULTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME WHO HAVE DIFFICULTY UNDERSTANDING THEIR DOCTORS (FROM 2.1% IN 2009 TO 1.7% IN 2011-2012) (WWW.SFHIP.ORG). THESE SERVICES ALSO COUNTER LIMITED ACCESS THAT MAY BE CAUSED BY PRIMARY CARE PROVIDERS BEING LESS LIKELY TO SERVE MEDI-CAL BENEFICIARIES DUE TO LOW GOVERNMENT REIMBURSEMENT RATES. CPMC'S AFRICAN AMERICAN BREAST HEALTH (AABH) AND SISTER TO SISTER PROGRAMS OFFER WOMEN MAMMOGRAPHY SCREENING AND ALL THE SUBSEQUENT BREAST HEALTH DIAGNOSTIC TESTING AND TREATMENT THEY MAY NEED AT NO COST. PARTNERSHIP ORGANIZATIONS, SUCH AS BAYVIEW HUNTERS POINT SENIOR CENTER, CALVARY HILL COMMUNITY CHURCH, GLIDE HEALTH SERVICES, SAN FRANCISCO FREE CLINIC, AND CLINIC BY THE BAY, REFER UNINSURED, UNDERINSURED, DISADVANTAGED AND AT-RISK WOMEN FOR MAMMOGRAPHY SERVICES. CPMC'S BREAST CENTER AT THE ST. LUKE'S CAMPUS PROMOTES BREAST HEALTH IN UNDERSERVED COMMUNITIES BY PARTNERING WITH NEIGHBORHOOD CLINICS AND COMMUNITY AGENCIES, INCLUDING SOUTHEAST HEALTH CENTER, MISSION NEIGHBORHOOD HEALTH CENTER, AND LATINA BREAST CANCER AGENCY. IN 2014, CPMC'S AFRICAN AMERICAN AND SISTER TO SISTER BREAST HEALTH PROGRAMS PROVIDED 229 SCREENINGS, WITH 284 TOTAL PATIENT VISITS, AND 23 FIRST-TIME MAMMOGRAMS PROVIDED. CPMC'S GRANT TO LATINA BREAST CANCER AGENCY PROVIDED ASSISTANCE FOR LOW-INCOME PATIENTS TO RECEIVE 370 MAMMOGRAMS AT CPMC'S ST. LUKE'S CAMPUS. IN LATE 2014, CPMC IMPLEMENTED A NEW GRANT TO SHANTI PROJECT'S MARGOT MURPHY BREAST CANCER PROGRAM TO ADDRESS THE NEED FOR CARE NAVIGATION SERVICES FOR SHANTI PATIENTS RECEIVING FREE BREAST CANCER TREATMENT, PRIORITIZING WOMEN WHO FACE PARTICULAR CHALLENGES IN COMPLETING TREATMENT DUE TO BEING LOW-INCOME, UNINSURED/UNDERINSURED, LIMITED ENGLISH PROFICIENT, AND/OR FROM IMMIGRANT POPULATIONS. CPMC'S COMING HOME HOSPICE PROVIDES 24-HOUR CARE FOR TERMINALLY ILL CLIENTS AND THEIR FAMILIES IN A CARING, HOMELIKE SETTING. CPMC ENSURES THAT HIGH-QUA
SCHEDULE H, PART VI, LINE 5 (CONTINUED) PROMOTION OF COMMUNITY HEALTH (CONTINUED) NOVATO COMMUNITY HOSPITAL: THE 2013-2015 IMPLEMENTATION STRATEGY FOR NOVATO COMMUNITY HOSPITAL DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: THE ROTOCARE CLINIC IS OPERATED BY LOCAL ROTARY CLUBS AND DEPENDS ON DONATIONS AND IN-KIND SERVICES FROM HEALTH CARE PROVIDERS TO OFFER CARE TO UNDERSERVED AND UNDOCUMENTED INDIVIDUALS IN THE COMMUNITY. NOVATO COMMUNITY HOSPITAL PROVIDES FUNDING AND OUTPATIENT LABORATORY EXAMS FOR THE ROTACARE PATIENTS. IN 2O14, DIAGNOSTIC LABORATORY SERVICES WERE PROVIDED TO 59 INDIVIDUALS, ALLOWING ROTACARE TO PROVIDE MUCH NEEDED CARE TO PATIENTS. AND NCH PROVIDED FUNDING TO SUPPORT OVERALL CLINIC OPERATIONS. HOMEWARD BOUND OF MARIN PROVIDES SERVICES TO THE COUNTY'S HOMELESS POPULATION, INCLUDING A TRANSITION SITE WHERE HOMELESS PATIENTS CAN BE SAFELY DISCHARGED FROM THE HOSPITAL TO RECUPERATE FROM INJURIES AND ILLNESSES. NCH PROVIDES AN ANNUAL GRANT TO SUPPORT THIS PROGRAM. IN 2014, HOMEWARD BOUND WAS ABLE TO PROVIDE 63 PATIENT DAYS IN RESPITE BEDS WITH SUPPORT FROM THE NCH CONTRIBUTION. NCH SUPPORTS WHISTLESTOP, A COMMUNITY-BASED ORGANIZATION THAT PROVIDES SERVICES TO SENIORS AND DISABLED ADULTS IN THE COUNTY THROUGH A PROGRAM CALLED HEALTH EXPRESS. IN 2014, 362 RIDES TO MEDICAL APPOINTMENTS WERE PROVIDED TO LOW INCOME SENIORS AND DISABLED PERSONS. NOVATO COMMUNITY HOSPITAL PROVIDES A GRANT TO NUSD TO COVER THE COST OF MEDICAL CARE FOR UNDERSERVED STUDENTS. IN 2014, 81 UNDERSERVED STUDENTS RECEIVED EPISODIC HEALTH CARE SUCH AS SPECIALIST, EYE AND DENTAL APPOINTMENTS. 25 STUDENTS RECEIVED ONE-ON-ONE NURSING CARE FOR ACUTE CONDITIONS SUCH AS TYPE 1 DIABETES AND SPINA BIFIDA. IN ADDITION, 3000 STUDENTS BENEFITTED FROM THE PURCHASE OF RESTAURANT QUALITY BLENDERS TO PROVIDE HEALTHY SMOOTHIES AS PART OF THE DISTRICT'S HEAL PROGRAM. THE ANNUAL INFLUENZA SEASON FROM OCTOBER THROUGH MARCH AFFECTS ALL MEMBERS OF THE COMMUNITY AND IT IS IN THE BEST INTEREST OF PUBLIC HEALTH TO IMMUNIZE AS MANY INDIVIDUALS AS POSSIBLE. NOVATO COMMUNITY HOSPITAL HOSTS FREE IMMUNIZATION CLINICS FOR THE COMMUNITY AND IN 2014, 155 VACCINES WERE ADMINISTERED. OPERATION ACCESS IS A NON-PROFIT ORGANIZATION THAT RECRUITS PHYSICIAN VOLUNTEERS AND HOSPITALS TO PROVIDE AMBULATORY SURGERIES FOR INDIVIDUALS WHO REQUIRE PROCEDURES NOT COVERED BY INSURANCE. NOVATO COMMUNITY HOSPITAL PROVIDES ITS SURGERY SERVICES DEPARTMENT, INCLUDING THE SURGERY SUITES AND STAFF, FOR THESE SURGERIES. IN 2014, TWO PATIENTS RECEIVED SURGERY FREE OF CHARGE AT NOVATO COMMUNITY HOSPITAL. A LEADING CAUSE OF STROKE IS AN UNHEALTHY LIFESTYLE AND IN RESPONSE TO THIS HEALTH NEED, NOVATO COMMUNITY HOSPITAL PROVIDES A FREE EDUCATION PROGRAM TAUGHT BY A REGISTERED NURSE FOR THE COMMUNITY. CLASSES ARE HELD AT SENIOR CENTERS AND OTHER COMMUNITY GATHERING PLACES. THE CLASSES DISCUSS HOW UNHEALTHY EATING AND LACK OF EXERCISE CAN LEAD TO HIGH BLOOD PRESSURE, DIABETES, HEART DISEASE AND STROKE. PARTICIPANTS RECEIVE SAMPLE DIETS, EXERCISES, AND LEARN HOW TO RECOGNIZE THE SYMPTOMS OF A STROKE. 1040 PEOPLE RECEIVED INFORMATION FROM AN RN ABOUT STROKE PREVENTION IN 2014. SUTTER LAKESIDE HOSPITAL: SLH PROVIDES A FOOD BANK DONATION SITE LOCATED IN THE HOSPITAL'S FRONT LOBBY. COLLECTIONS ARE DELIVERED TO LOCAL FOOD BANK. 1200 POUNDS OF FOOD WAS DONATED IN 2014. SUTTER LAKESIDE HOSPITAL HAS A STROKE SUPPORT GROUP THAT HELPS IMPROVE THE EMOTIONAL HEALTH AND WELL-BEING OF STROKE SUFFERERS. IN 2014, MONTHLY MEETINGS WERE HELD FOR COMMUNITY MEMBERS OF LAKE COUNTY. THE GROUPS ALLOWED STROKE SURVIVORS AND THEIR FAMILIES TO NETWORK WITH OTHER INDIVIDUALS AND BUILD UPON SHARED EXPERIENCES, DISCUSS CHALLENGES AND PROBLEM SOLVE. SUTTER LAKESIDE HOSPITAL SUPPORTS SEVERAL LOCAL COMMUNITY PROGRAMS THAT AID THE UNDERSERVED COMMUNITY SUCH AS THE LAKE COUNTY HUNGER TASK FORCE, THE LAKE FAMILY RESOURCE CENTER, AND THE LAKE FAMILY RESOURCE CENTER. SUTTER SANTA ROSA REGIONAL HOSPITAL: THE 2013-2015 IMPLEMENTATION STRATEGY FOR SUTTER SANTA ROSA REGIONAL HOSPITAL DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: A SURVEY OF THE RESIDENTS' PATIENTS AT THE COMMUNITY HEALTH CENTER PARTNER REVEALED THAT MORE THAN 60% OF THEIR PATIENTS EXPERIENCE REGULAR FOOD INSECURITY AND OFTEN NEED TO MAKE UNHEALTHY FOOD CHOICES BASED ON AFFORDABILITY, OR DON'T EAT AT ALL. IN RESPONSE TO THIS HEALTH NEED, SUTTER SANTA ROSA REGIONAL HOSPITAL ENTERED INTO A PARTNERSHIP WITH THE REDWOOD EMPIRE FOOD BANK TO BE A FOOD DROP-OFF LOCATION. EACH MONDAY, PATIENTS OF THE VISTA CLINIC ARE INVITED TO COME AND PICK UP ONE BOX OF HEALTHY, FRESH FOOD FOR THEIR FAMILIES. PATIENTS ARE ALSO EDUCATED ABOUT OTHER FOOD PROGRAMS AND FOOD STAMP EXCHANGES AT FARMERS MARKETS. IN THE BEGINNING OF 2014, 70 FAMILIES RECEIVED FOOD. BUT WITH INCREASED AWARENESS AND EDUCATION, 120 FAMILIES/PATIENTS OF THE RESIDENCY REQUESTED TO PICK UP FRESH FOOD EACH WEEK. SUTTER SANTA ROSA REGIONAL HOSPITAL SPONSORS A THREE-YEAR TRAINING PROGRAM FOR MEDICAL SCHOOL GRADUATES DESIRING TO BE PRIMARY CARE DOCTORS. THE TRAINING IS PROVIDED BY SUTTER PHYSICIANS WHO ARE ALSO ADJUNCT PROFESSORS WITH OUR PARTNER, THE UCSF MEDICAL SCHOOL. RESIDENTS ARE TRAINED IN THE HOSPITAL AND IN THE CLINIC SETTING BY CARING FOR PATIENTS UNDER THE CLINICAL SUPERVISION OF FACULTY. SUTTER HAS BEEN SPONSORING THE PROGRAM SINCE 1996 BUT IT HAS EXISTED IN OUR COMMUNITY FOR MORE THAN 40 YEARS. FUELING THE PRIMARY CARE PIPELINE IN SONOMA COUNTY IS VITAL TO THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THE COST OF LIVING IS QUITE HIGH AND WITHOUT THIS PROGRAM, IT WOULD BE VERY DIFFICULT TO RECRUIT FAMILY PHYSICIANS TO THE AREA. THE IMPACT OF THE SANTA ROSA FAMILY MEDICINE PROGRAM CAN BE MEASURED IN MANY MULTI-FACTORIAL WAYS BUT IN TERMS OF INCREASING ACCESS TO PRIMARY CARE IN OUR COMMUNITY, THE TWO BIGGEST WAYS OF MEASURING IMPACT ARE IN THE NUMBERS OF PATIENTS SEEN BY THE RESIDENTS (PRIMARILY LOW-INCOME) AND IN THE NUMBER OF GRADUATES WHO STAY AND PRACTICE IN SONOMA COUNTY FOLLOWING GRADUATION. IN 2014, 6 OUT OF 12 GRADUATES ARE PRACTICING IN SONOMA COUNTY. ADDITIONALLY, 4 OUT OF 6 GRADUATES ARE PRACTICING EXCLUSIVELY AT LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHC). THE SANTA ROSA FAMILY MEDICINE RESIDENCY PROGRAM PARTNERS WITH REDWOOD COALITION FOR HEALTH CARE, TO STAFF THEIR SANTA ROSA COMMUNITY HEALTH CENTER VISTA CLINIC WITH 36 FAMILY MEDICINE RESIDENTS, SUPERVISED BY FACULTY PHYSICIANS. THIS PARTNERSHIP ESSENTIALLY OFFERS FREE PHYSICIAN STAFFING TO A CLINIC THAT WOULD OTHERWISE HAVE TO HIRE STAFF PHYSICIANS, PROVIDING A SIGNIFICANTLY INCREASED CAPACITY THAT THE CLINIC WOULD NOT BE ABLE TO SUSTAIN ON ITS OWN. 21,987 PATIENT VISITS OCCURRED IN 2014 THROUGH THIS PARTNERSHIP, INCLUDING AN APPROXIMATE $1.4 MILLION SAVING TO THE FQHC IN PHYSICIAN SALARY. THE HOMELESS YOUTH MOBILE VAN IS A PARTNERSHIP BETWEEN THE SANTA ROSA FAMILY MEDICINE RESIDENCY, SANTA ROSA COMMUNITY HEALTH CENTERS AND SOCIAL ADVOCATES FOR YOUTH (SAY). ONCE PER MONTH, TWO TO THREE RESIDENT PHYSICIANS, A VOLUNTEER COMMUNITY PRECEPTOR, A MEDICAL ASSISTANT AND AN HIV TESTING AND OUTREACH WORKER GO TO THE SHELTER RUN BY SAY IN A VAN EQUIPPED WITH TWO TREATMENT ROOMS AND MEDICAL SUPPLIES. WE OFFER BASIC URGENT CARE SERVICES, SUCH AS TREATMENT OF SKIN INFECTIONS AND RASHES, ASSESSMENTS OF WOUNDS AND ABRASIONS, GENERAL HEALTH SCREENING, HIV TESTING, REFERRALS FOR FULL STD TESTING, FAMILY PLANNING SERVICES, TESTING AND TREATMENT OF URINARY TRACT INFECTIONS, SCREENING FOR DIABETES, ETC. WHEN WE CANNOT TREAT PATIENTS AT THE VAN WE REFER THEM TO BROOKWOOD HEALTH CENTER FOR MORE COMPREHENSIVE CARE. WE ALSO OFFER INITIAL MENTAL HEALTH CONSULTATIONS AND HAVE EVEN SEEN PATIENTS FOR PRENATAL AND POSTPARTUM VISITS. IN ADDITION TO THESE SERVICES, WE SPEND TIME HANGING OUT WITH THE YOUTH AND WORKING TO BUILD RAPPORT AND A LONGER PARTNERSHIP. IN ADDITION, OUR HIV OUTREACH TEAM OFFERS RAPID TESTING AND OUR MEDICAL ASSISTANT ENROLLS PATIENTS IN MEDICAL FAMILY PLANNING ACCESS CARE AND TREATMENT PROGRAMS (FPACT) AND PROVIDES INFORMATION ON MEDI-CAL. IN 2014, THE MOBILE CLINIC PROVIDED 40 MEDICAL VISITS AND 13 VACCINATIONS (TDAP AND INFLUENZA). SERVICES PROVIDED AT THE MOBILE VAN INCLUDED FAMILY PLANNING/SEXUAL HEALTH, MENTAL HEALTH, ASTHMA/RESPIRATORY CARE, MUSCULOSKELATAL AND SKIN CONCERNS. THE SONOMA COUNTY TASK FORCE ON THE HOMELESS CONVENED A WORK GROUP IN 2010 FOR THE COORDINATION OF HEALTH CARE SERVICES FOR HOMELESS PEOPLE IN OUR COMMUNITY. ALL OF THE HOSPITALS SEE A HIGH PERCENTAGE OF HOMELESS PEOPLE IN THE ED AND IN THE HOSPITAL BED. PROVIDING GOOD TRANSITIONS OF CARE FOR THIS POPULATION IS VERY CHALLENGING. THE GROUP WORKS TO DEVELOP PROCESSES AND "WRAP AROUND" SERVICES WITH THE GOAL
SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: SUTTER WEST BAY HOSPITALS ARE AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF HOSPITALS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS WHO CARE FOR PEOPLE WHO LIVE IN MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. THE HOSPITAL'S MISSION IS TO ENHANCE THE WELL-BEING OF THE PEOPLE IN OUR COMMUNITIES THROUGH COMPASSION, EXCELLENCE AND INNOVATION IN HEALTH CARE SERVICES, RESEARCH AND EDUCATION. OVER THE PAST FIVE YEARS, SUTTER HEALTH HAS COMMITTED NEARLY $4 BILLION TO CARE FOR PATIENTS WHO COULDN'T AFFORD TO PAY, AND TO SUPPORT PROGRAMS THAT IMPROVE COMMUNITY HEALTH. OUR 2014 COMMITMENT OF $767 MILLION INCLUDES UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, TRADITIONAL CHARITY CARE AND INVESTMENTS IN HEALTH EDUCATION AND PUBLIC BENEFIT PROGRAMS. FOR EXAMPLE: - TO PROVIDE CARE TO MEDI-CAL PATIENTS IN 2014, SUTTER HEALTH INVESTED $535 MILLION MORE THAN THE STATE PAID. SUTTER HEALTH HOSPITALS PROUDLY SERVE MORE MEDI-CAL PATIENTS IN OUR NORTHERN CALIFORNIA SERVICE AREA THAN ANY OTHER HEALTH CARE PROVIDER. - IN 2014, SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS WAS $91 MILLION. OUR CHARITY CARE INVESTMENT REPRESENTED AN AVERAGE OF NEARLY $1.8 MILLION PER WEEK. - THROUGHOUT OUR HEALTH CARE SYSTEM, WE PARTNER WITH AND SUPPORT COMMUNITY HEALTH CENTERS TO ENSURE THAT THOSE IN NEED HAVE ACCESS TO PRIMARY AND SPECIALTY CARE. WE ALSO SUPPORT CHILDREN'S HEALTH CENTERS, FOOD BANKS, YOUTH EDUCATION, JOB TRAINING PROGRAMS AND SERVICES THAT PROVIDE COUNSELING TO DOMESTIC VIOLENCE VICTIMS. EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESSES REAL COMMUNITY NEEDS.
SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: CALIFORNIA
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number
94-0562680
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) SOUTH OF MARKET HEALTH CENTER
229 7TH ST
SAN FRANCISCO,CA94103
23-7304921 501(C)(3) 825,000       GENERAL SUPPORT
(2) PATIENT ASSISTANCE FOUNDATION
2100 WEBSTER ST STE 100
SAN FRANCISCO,CA94115
94-2944137 501(C)(3) 503,050       GENERAL SUPPORT
(3) THE CENTER FOR YOUTH WELLNESS
3450 THIRD ST STE 2A
SAN FRANCISCO,CA94124
45-2527627 501(C)(3) 205,000       GENERAL SUPPORT
(4) NORTHERN CALIFORNIA CENTER FOR WELL BEING
365 TESCONI CIR STE B
SANTA ROSA,CA95401
93-1144835 501(C)(3) 140,584       GENERAL SUPPORT
(5) PORTOLA FAMILY CONNECTIONS
2565 SAN BRUNO AVE
SAN FRANCISCO,CA94134
94-3213689 501(C)(3) 55,000       GENERAL SUPPORT
(6) YEAR UP INC
93 SUMMER ST
BOSTON,MA02110
04-3534407 501(C)(3) 43,853       GENERAL SUPPORT
(7) NORTH EAST MEDICAL SERVICE
1520 STOCKTON ST
SAN FRANCISCO,CA94133
94-1722562 501(C)(3) 35,000       GENERAL SUPPORT
(8) SAN FRANCISCO CHILD ABUSE PREVENTION CTR
1757 WALLER ST
SAN FRANCISCO,CA94117
94-2455072 501(C)(3) 30,000       GENERAL SUPPORT
(9) ICA SAN FRANCISCO WORK STUDY
3625 24TH ST
SAN FRANCISCO,CA94131
26-4450576 501(C)(3) 30,000       GENERAL SUPPORT
(10) TIDES CENTERBODY POSITIVE
PO BOX 29907
SAN FRANCISCO,CA941290907
94-3213100 501(C)(3) 25,500       GENERAL SUPPORT
(11) AMBULATORY SURGERY ACCESS COALITION
115 SANSOME ST STE 1205
SAN FRANCISCO,CA94104
94-3180356 501(C)(3) 25,000       GENERAL SUPPORT
(12) APA FAMILY SUPPORT SERVICES
10 NOTTINGHAM PL
SAN FRANCISCO,CA94133
94-3164091 501(C)(3) 25,000       GENERAL SUPPORT
(13) ASIAN & PACIFIC ISLANDER WELLNESS CENTER
730 POLK ST 4TH FL
SAN FRANCISCO,CA94109
94-3096109 501(C)(3) 25,000       GENERAL SUPPORT
(14) KIMOCHI INC
1715 BUCHANAN ST
SAN FRANCISCO,CA94115
23-7117402 501(C)(3) 25,000       GENERAL SUPPORT
(15) LATINA BREAST CANCER AGENCY
4271 MISSION ST 2ND FL
SAN FRANCISCO,CA94112
01-0628124 501(C)(3) 25,000       GENERAL SUPPORT
(16) SAN FRANCISCO LGBT COMMUNITY CENTER
1800 MARKET ST
SAN FRANCISCO,CA94102
94-3236718 501(C)(3) 25,000       GENERAL SUPPORT
(17) SHANTI PROJECT
730 POLK ST 3RD FL
SAN FRANCISCO,CA94109
94-2297147 501(C)(3) 25,000       GENERAL SUPPORT
(18) MARIN COMMUNITY FOUNDATION
10 NO SAN PEDRO RD STE 1012
SAN RAFAEL,CA94903
94-3007979 501(C)(3) 25,000       GENERAL SUPPORT
(19) RICHMOND AREA MULTI SERVICES
639 14TH AVE
SAN FRANCISCO,CA94118
23-7389436 501(C)(3) 25,000       GENERAL SUPPORT
(20) MAITRI COMPASSIONATE CARE
401 DUBOCE AVE
SAN FRANCISCO,CA94117
94-3189198 501(C)(3) 20,000       GENERAL SUPPORT
(21) MISSION NEIGHBORHOOD CENTER
362 CAPP ST
SAN FRANCISCO,CA94110
94-1408150 501(C)(3) 20,000       GENERAL SUPPORT
(22) SAN FRANCISCO PLANNING & URBAN RSRCH ASSOC
654 MISSION ST
SAN FRANCISCO,CA94105
94-1498232 501(C)(3) 18,500       GENERAL SUPPORT
(23) EPISCOPAL COMMUNITY SERVICES SAN FRANCISCO
165 8TH ST 3RD FL
SAN FRANCISCO,CA94103
94-3096716 501(C)(3) 16,000       GENERAL SUPPORT
(24) ASIAN WEEK FOUNDATION
564 MARKET ST
SAN FRANCISCO,CA94104
20-1719535 501(C)(3) 15,000       GENERAL SUPPORT
(25) SELF-HELP FOR THE ELDERLY
731 SANSOME ST STE 100
SAN FRANCISCO,CA94111
94-1750717 501(C)(3) 15,000       GENERAL SUPPORT
(26) CURRY SENIOR CENTER
333 TURK ST
SAN FRANCISCO,CA94102
23-7362588 501(C)(3) 15,000       GENERAL SUPPORT
(27) CHINATOWN COMMUNITY DEVELOPMENT CENTER
1525 GRANT AVE
SAN FRANCISCO,CA94133
94-2514053 501(C)(3) 15,000       GENERAL SUPPORT
(28) MARIN SENIOR COORDINATING COUNCIL INC
930 TAMALPAIS AVE
SAN RAFAEL,CA94901
94-1422463 501(C)(3) 13,162       GENERAL SUPPORT
(29) ON LOK INC
1333 BUSH ST
SAN FRANCISCO,CA94109
95-3101464 501(C)(3) 12,500       GENERAL SUPPORT
(30) SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM
1550 BRYANT ST STE 450
SAN FRANCISCO,CA94103
94-2897258 501(C)(3) 10,000       GENERAL SUPPORT
(31) CONARD HOUSE INC
1385 MISSION ST STE 200
SAN FRANCISCO,CA94103
94-1489356 501(C)(3) 10,000       GENERAL SUPPORT
(32) GLIDE FOUNDATION
330 ELLIS ST
SAN FRANCISCO,CA94102
94-1156481 501(C)(3) 10,000       GENERAL SUPPORT
(33) MARIN COMMUNITY CLINIC
PO BOX 760
LARKSPUR,CA949770760
94-2237120 501(C)(3) 10,000       GENERAL SUPPORT
(34) ROTA CARE BAY AREA INC
PO BOX 6461
SAN RAFAEL,CA94903
77-0328723 501(C)(3) 10,000       GENERAL SUPPORT
(35) AMERICAN RED CROSS CAPITAL
PO BOX 142
YUBA CITY,CA95992
53-0196605 501(C)(3) 9,500       GENERAL SUPPORT
(36) CENTER FOR VOLUNTEER & NONPROFIT LEADERSHIP MARIN
650 LAS GALLINAS AVE
SAN RAFAEL,CA94903
68-0101012 501(C)(3) 8,000       GENERAL SUPPORT
(37) GUM MOON RESIDENCE HALL
940 WASHINGTON ST
SAN FRANCISCO,CA94108
94-1156357 501(C)(3) 7,500       GENERAL SUPPORT
(38) TO CELEBRATE LIFE BREAST
PO BOX 511
KENTFIELD,CA94914
94-3323358 501(C)(3) 7,250       GENERAL SUPPORT
(39) YOUNG MENS CHRISTIAN ASSN OF SAN FRANCISCO
1670 SO AMPHLITT BLVD
SAN MATEO,CA94407
94-0997140 501(C)(3) 6,200       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
39
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: COMMUNITY HEALTH PROGRAM GRANTEES SIGN A CONTRACT WITH AFFILIATE OUTLINING TERMS AND CONDITIONS OF RECEIVING GRANT FUNDS SPECIFYING OBJECTIVES AND OUTCOMES. EACH AGENCY RECEIVING THE COMMUNITY HEALTH GRANTS ARE REQUIRED TO PREPARE AND SUBMIT OUTCOME-BASED REPORTS AT SIX-MONTHS AND TWELVE-MONTHS. AGENCIES RECEIVING SPONSORSHIP FUNDS GO THROUGH A DIFFERENT PROCESS; THEY ARE REQUESTED TO PROVIDE THE PURPOSE OF THE EVENT PRIOR TO SPONSORSHIP AS WELL AS A BRIEF SUMMARY OF THE OUTCOMES OF EVENT SOON AFTER THE EVENT.
Schedule I (Form 990) 2014


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1ANN BARRREGIONAL CIO, WEST BAY (i)
(ii)
0
...............................
305,569
0
...............................
192,192
0
...............................
611
0
...............................
68,221
0
...............................
15,018
0
...............................
581,611
0
...............................
0
2MARTIN BROTMAN MDSVP, SH (i)
(ii)
0
...............................
516,884
0
...............................
372,679
0
...............................
103,282
0
...............................
74,699
0
...............................
16,320
0
...............................
1,083,864
0
...............................
87,587
3WARREN BROWNER MDCEO, SAN FRANCISCO HOSPITALS (i)
(ii)
0
...............................
582,032
0
...............................
298,640
0
...............................
83,842
0
...............................
348,386
0
...............................
19,586
0
...............................
1,332,486
0
...............................
0
4MICHAEL COHILLREGIONAL PRESIDENT, WEST BAY (i)
(ii)
0
...............................
759,301
0
...............................
933,166
0
...............................
199,303
0
...............................
269,054
0
...............................
23,542
0
...............................
2,184,366
0
...............................
132,919
5GRANT DAVIESEXECUTIVE VP, WEST BAY (i)
(ii)
0
...............................
557,288
0
...............................
319,488
0
...............................
75,539
0
...............................
160,585
0
...............................
20,636
0
...............................
1,133,536
0
...............................
46,957
6MICHAEL DUNCHEONVP, REG COUNSEL, WEST BAY (i)
(ii)
0
...............................
366,803
0
...............................
222,860
0
...............................
32,311
0
...............................
74,321
0
...............................
12,872
0
...............................
709,167
0
...............................
23,207
7PATRICK FRYPRESIDENT & CEO, SH (i)
(ii)
0
...............................
1,523,132
0
...............................
1,687,050
0
...............................
416,185
0
...............................
2,693,377
0
...............................
34,953
0
...............................
6,354,697
0
...............................
396,136
8JOHN GATESREG CFO & VP FINANCE, EB & WB (i)
(ii)
0
...............................
604,705
0
...............................
303,767
0
...............................
150,021
0
...............................
128,539
0
...............................
18,040
0
...............................
1,205,072
0
...............................
51,581
9MARK KIMBELLCPMC FOUNDATION DIRECTOR (i)
(ii)
0
...............................
214,786
0
...............................
144,990
0
...............................
176,559
0
...............................
27,499
0
...............................
13,028
0
...............................
576,862
0
...............................
120,168
10SARAH KREVANSCOO, SUTTER HEALTH (i)
(ii)
0
...............................
916,159
0
...............................
689,878
0
...............................
156,449
0
...............................
399,554
0
...............................
24,683
0
...............................
2,186,723
0
...............................
142,787
11HON-WAI LAMREGIONAL VP & CMO, WEST BAY (i)
(ii)
0
...............................
430,687
0
...............................
167,608
0
...............................
340
0
...............................
92,251
0
...............................
7,125
0
...............................
698,011
0
...............................
0
12MICHAEL PURVISCAO, SMCSR (i)
(ii)
0
...............................
331,706
0
...............................
187,321
0
...............................
25,837
0
...............................
84,465
0
...............................
15,120
0
...............................
644,449
0
...............................
19,525
13CHRISTOPHER WILLRICHREG VP, STRATEGY WEST BAY (i)
(ii)
0
...............................
318,015
0
...............................
170,193
0
...............................
24,812
0
...............................
68,721
0
...............................
15,063
0
...............................
596,804
0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART I, LINE 1A RELEVANT INFORMATION REGARDING COMPENSATION ITEMS: TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY.
SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH.
SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR EARNINGS BEYOND THE PENSION PAY CAP. THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. SPOT AWARDS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 10% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP): THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD UP TO 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT.
SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number
94-0562680
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CHFFA 2007A
 
52-1643828 13033fq37 05-01-2007 790,998,316 Construct & Equip Facility   X   X   X
B CHFFA 2008A
 
52-1643828 13033fel3 05-14-2008 329,041,638 Construct & Refunding 07, 04 & 02   X   X   X
C CHFFA 2011D
 
52-1643828 13033lvw4 12-22-2011 331,759,643 Construct & Refunding Pre 1/1/13   X   X   X
D CHFFA 2013A
 
52-1643828 13033lw52 04-24-2013 187,683,000 Construct & Equip Facility   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 104,255,000 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 858,694,930 329,041,638 334,684,174 496,712,142
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 55,398,317 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 65,070,000 0
7 Issuance costs from proceeds . . . . . . . . . . . . 0 0 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 783,091,871 0 145,589,174 450,364,483
11 Other spent proceeds . . . . . . . . . . . . . . 20,057,199 329,041,638 124,025,000 0
12 Other unspent proceeds . . . . . . . . . . . . . . 147,543 0 0 46,347,659
13 Year of substantial completion . . . . . . . . . . . . 2011 2014
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X X   X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X       X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X             X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X         X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.570 % 1.020 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0.070 % 0 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.570 % 1.090 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . . X     X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X   X   X   X  
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
 
0
 
0
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
 
0
 
0
 
0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO CERTAIN SUBSIDIARY ORGANIZATIONS, INCLUDING THE ORGANIZATION. THE OUTSTANDING BOND LIABILITY ALLOCATED TO THIS ORGANIZATION IS REPORTED ON FORM 990, PART X, BALANCE SHEET AND PART VI HEREIN. WITH THE EXCEPTION OF THIS PORTION OF PART VI, THE SCHEDULE K FOR THIS ORGANIZATION IS REPORTING INFORMATION FOR THE ENTIRE BOND ISSUE.
SCHEDULE K, PART I, COLUMN (E): THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNTS OF: $165,813,667 FROM THE 2007A ISSUE, $55,943,275 FROM THE 2008A ISSUE, $47,567,042 FROM THE 2011D ISSUE AND $187,683,000 FROM THE 2013A ISSUE. SCHEDULE K, PART I, LINE B, COLUMN (F)(CHFFA 2008A): THE REFUNDING OCCURRED VIA THE REPAYMENT OF A DRAW ON A TAXABLE LINE OF CREDIT, DRAWN IN SEVERAL INSTALLMENTS BETWEEN APRIL 7 AND APRIL 11, 2008, USED TO REFUND THE 2007 ISSUE. THE REFUNDED BONDS ISSUED IN 2007 WERE USED TO REFUND BONDS ISSUED IN 1996 THAT WERE USED TO REFUND BONDS ISSUED IN 1985, 1989, 1990, AND 1991. SCHEDULE K, PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. SCHEDULE K, PART III: THE CHFFA 2013A BONDS ARE "NEW MONEY" BONDS FOR CONSTRUCTION NOT YET COMPLETED.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) ANDREE S HEST SEE PART V 195,685 SEE PART V   No
(2) RUTH M LINCOLN SEE PART V 64,052 SEE PART V   No
(3) ANTHONY WAGNER SEE PART V 57,570 SEE PART V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART IV DESCRIPTION OF BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: DEBORAH WYATT, TRUSTEE, ANTHONY WAGNER, TRUSTEE, AND TOM LINCOLN, TRUSTEE OF SUTTER WEST BAY HOSPITALS (SWBH) EACH HAVE A FAMILY MEMBER WHO WORKS FOR SWBH.
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Return Reference Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1 MISSION STATEMENT: WE ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES.
FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS: GENERAL DESCRIPTION SUTTER WEST BAY HOSPITALS (SWBH) WAS FORMED JANUARY 1, 2010. IT CONSISTS OF FOUR HOSPITALS: CALIFORNIA PACIFIC MEDICAL CENTER, NOVATO COMMUNITY HOSPITAL, SUTTER SANTA ROSA REGIONAL HOSPITAL, AND LAKESIDE HOSPITAL. THERE WERE A TOTAL OF 219,078 PATIENT DAYS FOR 2014. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) IS ONE OF THE LARGEST PRIVATE, COMMUNITY BASED, NOT-FOR-PROFIT, TEACHING MEDICAL CENTERS IN CALIFORNIA. CPMC IS A TERTIARY REFERRAL CENTER PROVIDING ACCESS TO LEADING EDGE MEDICINE WHILE DELIVERING THE BEST POSSIBLE PERSONALIZED CARE. IT PROVIDES A WIDE VARIETY OF SERVICES, INCLUDING ACUTE, POST-ACUTE AND OUTPATIENT HOSPITAL CARE; HOSPICE SERVICES; PREVENTIVE AND COMPLEMENTARY CARE; AND HEALTH EDUCATION. CPMC IS COMPRISED OF THE FOUR OLDEST HOSPITALS IN SAN FRANCISCO. THE DAVIES CAMPUS, FORMERLY DAVIES MEDICAL CENTER, WAS FOUNDED IN 1854 TO HELP SAN FRANCISCO'S GERMAN-SPEAKING IMMIGRANTS FIND WORK, SHELTER, FOOD, CLOTHING AND HEALTH CARE. THE PACIFIC CAMPUS WAS FOUNDED IN 1857 AND WAS THE FIRST MEDICAL SCHOOL IN THE AMERICAN WEST. THE CALIFORNIA CAMPUS WAS FOUNDED IN 1875 AS THE PACIFIC DISPENSARY FOR WOMEN AND CHILDREN, A HOSPITAL RUN BY WOMEN, FOR WOMEN. FINALLY, THE ST. LUKE'S CAMPUS FORMED IN 1870'S HAS BEEN PROVIDING QUALITY HEALTH SERVICES TO ALL SAN FRANCISCANS FOR OVER 140 YEARS. TOGETHER THE DAVIES, CALIFORNIA, PACIFIC AND ST. LUKE'S CAMPUSES COMPRISE CPMC'S 1,154 LICENSED BEDS. NOVATO COMMUNITY HOSPITAL (NOVATO) HAS SERVED THE NORTHERN MARIN AND SOUTHERN SONOMA COMMUNITIES SINCE 1961. IN 1985, THE HOSPITAL BECAME AN AFFILIATE OF SUTTER. THE NOVATO FACILITY IS LOCATED AT 180 ROWLAND WAY AND IS A 47-BED ACUTE CARE HOSPITAL NOTED FOR ITS ORTHOPEDIC SURGERY PROGRAM. SUTTER SANTA ROSA REGIONAL HOSPITAL (SSRRH) HAS A LONG HISTORY IN SONOMA COUNTY DATING BACK TO 1866 WHEN THE FIRST HOSPITAL OPENED. IN 1996, SSRRH BECAME AN AFFILIATE OF SUTTER HEALTH. A NEW STATE-OF-THE ART MEDICAL FACILITY OPENED WITH A NEW NAME IN OCTOBER 2014 WITH A FULL RANGE OF FIVE-STAR PERSONALIZED CARE SERVICES. THE HOSPITAL WAS RELOCATED TO 30 MARK WEST SPRINGS ROAD, SANTA ROSA, CA. SUTTER LAKESIDE HOSPITAL (LAKESIDE) IS A 25-BED CRITICAL ACCESS HOSPITAL AND IS ONE OF ONLY TWO HOSPITALS THAT SERVE THE 64,000 RESIDENTS OF LAKE COUNTY. IN 1992, THE HOSPITAL AFFILIATED WITH SUTTER HEALTH. LAKESIDE PROVIDES A WIDE VARIETY OF SERVICES, INCLUDING ACUTE, POST-ACUTE AND OUTPATIENT HOSPITAL CARE; SURGICAL SERVICES; PREVENTIVE CARE; AND HEALTH EDUCATION. SWBH CARED FOR NEARLY 645 ADULT & PEDIATRIC INPATIENTS A DAY; ITS SEVEN EMERGENCY ROOMS ATTRACTED 385 VISITS A DAY; AND ALMOST 70 SURGERIES PER DAY WERE PERFORMED IN ITS FACILITIES. SEE ADDITIONAL DETAIL BELOW ON PATIENT ACTIVITY BY LOCATION. SWBH 2014 PATIENT ACTIVITY TOTAL ER VISITS 139,854 ACUTE DISCHARGES (INCL. PSYCH, REHAB) 37,894 SNF/ALZHEIMER/SUB ACUTE DISCHARGES 1,570 TOTAL DISCHARGES 39,464 DELIVERIES 7,871 TRANSPLANTS 290 SWBH CLINICAL PROGRAMS INCLUDE: - ASTHMA EDUCATION PROGRAM - BREAST FEEDING CENTERS - BREAST HEALTH CENTERS - CALIFORNIA PACIFIC MEDICAL CENTER RESEARCH INSTITUTE - CANCER RECOVERY PROGRAMS - COMING HOME HOSPICE - COMMUNITY BENEFITS PROGRAMS (DETAILED BELOW) - COMMUNITY HEALTH RESOURCE CENTER - COMPREHENSIVE STROKE CENTER - DIABETES EDUCATION PROGRAM - END-STAGE ORGAN FAILURE/TRANSPLANTATION PROGRAMS (HEART, KIDNEY, LIVER, PANCREAS) - FORBES NORRIS MDA/ALDS CENTER - HAND CLINIC - HOSPITALIST PROGRAM - INSTITUTE FOR HEALTH AND HEALING - IRENE SWINDELLS ALZHEIMER'S RESIDENTIAL CARE CENTER - LION'S EYE CLINIC - LOW VISION REHABILITATION CENTER - MUSCULAR DYSTROPHY ASSOCIATION NEUROMUSCULAR CLINIC - PACIFIC VISION FOUNDATION - PALLIATIVE CARE PROGRAM - PEDIATRIC SPECIALTY SERVICES - REHABILITATION SERVICES (ACUTE AND OUTPATIENT) - SIBLING CENTER - SMITH KETTLEWELL EYE RESEARCH INSTITUTE (THEY ARE INDEPENDENT OF CPMC.) - SUB-ACUTE CARE PROGRAM - TELEMEDICINE SERVICE (STROKE) - VISITING NURSES AND HOSPICE OF SAN FRANCISCO - WHITNEY NEWBORN ICU FOLLOW-UP CLINIC - WOMEN'S HEALTH RESOURCE CENTER - WOMEN'S SERVICES CLINICAL SERVICE OFFERINGS INCLUDE: - AIDS & HIV SERVICES - ALZHEIMER'S - ARTHRITIS - BARIATRIC SURGERY SERVICES - CANCER SERVICES - CARDIOVASCULAR SERVICES - CLINICAL LABORATORY - COMPLEMENTARY MEDICINE - COMPREHENSIVE STROKE SERVICES - CRITICAL CARE SERVICES - DIABETES SERVICES (ADULT & PEDIATRIC) - DIAGNOSTIC SERVICES/LABORATORIES - DIALYSIS SERVICES - EMERGENCY SERVICES - EPILEPSY - GASTROENTEROLOGY DISEASE SERVICES - HOME HEALTH & HOSPICE - INTERVENTIONAL ENDOSCOPY SERVICES - KALMONOVITZ CHILD DEVELOPMENT CENTERS - MEDICAL TRANSPORT SERVICES - MICROSURGERY AND LIMB SALVAGE SERVICES - NEONATAL INTENSIVE CARE - NEUROLOGY - NEURO-ONCOLOGY SURGERY - NUCLEAR MEDICINE - NUTRITION AND WEIGHT MANAGEMENT - OBSTETRICS & GYNECOLOGY - OCCUPATIONAL HEALTH - OPHTHALMOLOGY - ORGAN TRANSPLANTATION - ORTHOPEDICS - OTOLARYNGOLOGY - OUTPATIENT CLINICS & SERVICES - PATHOLOGY - PEDIATRIC EMERGENCY DEPARTMENT - PEDIATRIC SERVICES/PROGRAMS - PERIOPERATIVE SERVICES (OR AND POST-ANESTHESIA RECOVERY UNIT) - PHARMACY - PHYSICAL MEDICINE & REHABILITATION SERVICES - PSYCHIATRY - RADIOLOGY & DIAGNOSTIC IMAGING - RESPIRATORY CARE - RESIDENCY TRAINING AND FELLOWSHIP PROGRAMS - SURGICAL SERVICES/AMBULATORY SURGERY - URGENT CARE CENTER - VENTRICULAR ASSIST DEVICE (VAD) PROGRAM - WOMEN'S HEALTH PROGRAMS - WOUND CARE NON-CLINICAL SERVICES INCLUDE: - ADMINISTRATIVE SERVICES - CHAPLAINCY SERVICES - CHARITY CARE PROGRAM - COMMUNITY HEALTH RESOURCE CENTER - CONTINUING MEDICAL EDUCATION - INTERPRETER SERVICES - PATIENT SERVICES - RESEARCH INSTITUTE - SURGICAL TRAINING CENTER - VOLUNTEER SERVICES - WEB NURSERY - CALIFORNIA PACIFIC MEDICAL CENTER FOUNDATION - NOVATO COMMUNITY HOSPITAL DEVELOPMENT OFFICE - SUTTER LAKESIDE FOUNDATION
FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS CONTINUED: COMMUNITY BENEFITS THE FOUR MEDICAL CENTERS IN SUTTER WEST BAY HOSPITALS (SWBH) PLAY INTEGRAL ROLES IN PROVIDING DIRECT HEALTH CARE SERVICES AS WELL AS MONETARY GRANTS OR SPONSORSHIPS TO NON-PROFIT ORGANIZATIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS OF VULNERABLE, UNDERINSURED, AND UNINSURED POPULATIONS IN THEIR COMMUNITIES. THE HOSPITALS' COMMUNITY BENEFIT REPRESENTATIVES WORK COLLABORATIVELY AND IN PARTNERSHIPS WITH A BROAD AND DIVERSE NETWORK OF COMMUNITY-BASED NON-PROFITS, CITY AND COUNTY AGENCIES, PHYSICIANS, AND NEIGHBORHOOD GROUPS TO IDENTIFY LOCAL NEEDS, FORMULATE COMMUNITY BENEFIT PLANS, AND TAKE APPROPRIATE FUNDING ACTIONS. WHILE SUTTER WEST BAY REGIONAL MANAGEMENT SETS OVERALL GOALS FOR COMMUNITY BENEFITS, EACH OF THE AFFILIATES MEDICAL CENTER ADMINISTRATORS ARE RESPONSIBLE FOR IDENTIFYING HOW LOCAL NEEDS ARE TO BE ADDRESSED. IN FISCAL YEAR 2014, SUTTER WEST BAY HOSPITALS PROVIDED A REGIONAL TOTAL OF $138.9 MILLION IN COST OF SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED: $14.3 MILLION IN TRADITIONAL CHARITY CARE, $105.8 MILLION IN THE UNPAID COSTS OF MEDICAID, $200K IN COSTS FOR OTHER MEANS-TESTED PROGRAMS, AND $18.6 MILLION IN OTHER BENEFITS FOR THE POOR AND UNDERSERVED. IN ADDITION, SUTTER WEST BAY HOSPITALS PROVIDED AN ADDITIONAL $52.1 MILLION IN BENEFITS TO THE BROADER COMMUNITY, FOR A TOTAL OF $191 MILLION IN QUANTIFIABLE COMMUNITY BENEFIT. IN ADDITION, THE FOLLOWING ARE HIGHLIGHTS BY HOSPITAL OF QUANTIFIABLE COMMUNITY BENEFITS. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) IN 2014, CPMC PROVIDED $125.5 MILLION IN COST OF SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED AND $37.8 MILLION IN BENEFITS TO THE BROADER COMMUNITY, FOR A TOTAL OF $163.3 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS. CPMC SUSTAINS ROBUST MEDICAL, NURSING, AND ALLIED HEALTH PROFESSIONS RESIDENCY PROGRAMS AS WELL AS A RESEARCH INSTITUTE THAT PROVIDES SIGNIFICANT COMMUNITY BENEFIT. CPMC IS A MEMBER OF THE SAN FRANCISCO CHARITY CARE PARTNERSHIP AND SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP) CONSORTIUMS LED BY THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH. THESE CONSORTIUMS CONSIST OF REPRESENTATIVES FROM ALL OF THE CITY'S HOSPITALS AND OTHER HEALTHCARE-RELATED NON-PROFIT STAKEHOLDERS. CONSORTIUM MEMBERS CONDUCT A TRI-ANNUAL COMMUNITY NEEDS ASSESSMENT, AS REQUIRED BY THE STATE AND FEDERAL GOVERNMENTS, AND COORDINATE EFFORTS TO ADDRESS THE CITY'S HEALTH DISPARITIES IN SPECIFIC AT-RISK NEIGHBORHOODS OR VULNERABLE POPULATIONS. THE 2013-2014 COMMUNITY NEEDS ASSESSMENT IDENTIFIED THREE COMMUNITY HEALTH PRIORITIES; THESE PRIORITIES GUIDE CPMC'S COMMUNITY BENEFITS STRATEGY: 1. INCREASE ACCESS TO HIGH-QUALITY HEALTH CARE AND SERVICES - CPMC MANAGES OR FUNDS MANY PROGRAMS FOCUSED ON IMPROVING ACCESS TO CARE, INCLUDING THE FOLLOWING: - ST. LUKE'S HEALTH CARE CENTER (ADULT, PEDIATRIC, AND WOMEN'S CLINICS) - KALMANOVITZ CHILD DEVELOPMENT CENTER (COMPREHENSIVE DEVELOPMENTAL ASSESSMENT AND TREATMENT PROGRAMS FOR INFANTS, PRESCHOOLERS, SCHOOL-AGE CHILDREN, AND FAMILIES) - BAYVIEW CHILD HEALTH CENTER (PRIMARY CARE FOR LOW-INCOME CHILDREN) - AFRICAN AMERICAN AND SISTER TO SISTER BREAST HEALTH PROGRAMS, AND ST. LUKE'S BREAST HEALTH PARTNERSHIPS (CANCER SCREENING AND PREVENTION) - COMING HOME HOSPICE (24-HOUR CARE FOR TERMINALLY ILL CLIENTS AND THEIR FAMILIES REGARDLESS OF ABILITY TO PAY) - JOINT VENTURE HEALTH (DEVELOPMENTAL SERVICES FOR CHILDREN AT THE CLINICS WHERE THEY RECEIVE PRIMARY CARE, SUCH AS NORTH EAST MEDICAL SERVICES) - MANAGED MEDI-CAL PARTNERSHIP WITH NORTH EAST MEDICAL SERVICES (PROVIDE AND TAKE RISK FOR INPATIENT AND SELECT OUTPATIENT SERVICES FOR ALMOST 18,000 MEDI-CAL AND HEALTHY KIDS MEMBERS) - HEALTHY SAN FRANCISCO (PROVIDE FREE HOSPITALIZATION AND SELECT SPECIALTY CARE TO HSF PARTICIPANTS WHO ARE ENROLLED IN NORTH EAST MEDICAL SERVICES OR BROWN & TOLAND AS THEIR MEDICAL HOME) - LIONS EYE CLINIC (OUTPATIENT COMPLEX EYE SERVICES FOR LOW-INCOME INDIVIDUALS) - OPERATION ACCESS (FREE DIAGNOSTIC SCREENINGS, SPECIALTY PROCEDURES, AND SURGICAL CARE TO LOW-INCOME UNINSURED) - PROJECT HOMELESS CONNECT (MEDICAL AND SOCIAL SERVICES TO THE HOMELESS) 2. INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY - CPMC MANAGES OR FUNDS PROGRAMS THAT AIM TO INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY AMONG LOW-INCOME POPULATIONS, INCLUDING THE FOLLOWING: - HEALTHFIRST: A CENTER FOR PREVENTION AND EDUCATION (MANAGEMENT OF CHRONIC DISEASES SUCH AS DIABETES THROUGH NUTRITION EDUCATION AND LIFESTYLE CHANGES) - COMMUNITY-BASED SERVICES FOR YOUTH THAT FOCUS ON HEALTHY LIFESTYLES, SUCH AS BAYVIEW CHILD HEALTH CENTER'S NUTRITION SERVICES, WILLIAM MCKINLEY ELEMENTARY SCHOOL'S NOON HOUR WELLNESS PROGRAM, AND DE MARILLAC ACADEMY'S HEALTH CHAMPIONS PROGRAM 3. ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS - CPMC'S COMMUNITY HEALTH GRANTS AND SPONSORSHIPS PROVIDE PROGRAM SUPPORT TO ORGANIZATIONS THAT PROMOTE SAFE AND HEALTHY LIVING ENVIRONMENTS, INCLUDING THE FOLLOWING: - APA FAMILY SUPPORT SERVICES (IN-HOME SUPPORT SERVICES TO ASIAN/PACIFIC ISLANDER CHILDREN AND FAMILIES) - THE CENTER FOR YOUTH WELLNESS (TRAUMA-INFORMED PEDIATRIC CARE THAT ADDRESSES THE ROOT CAUSES OF POOR HEALTH OUTCOMES FOR CHILDREN AND YOUTH IN HIGH-RISK COMMUNITIES) - CHINATOWN COMMUNITY DEVELOPMENT CENTER (NEIGHBORHOOD ADVOCATES, COMMUNITY ORGANIZERS, PLANNERS, DEVELOPERS, AND MANAGERS OF AFFORDABLE HOUSING) - SAN FRANCISCO CHILD ABUSE PREVENTION CENTER AND THE CHILD ADVOCACY CENTER (SUPPORTIVE SERVICES TO CHILDREN AND FAMILIES; EDUCATION FOR CHILDREN, CAREGIVERS AND SERVICE PROVIDERS; AND ADVOCACY FOR SYSTEMS IMPROVEMENT AND COORDINATION) - KIMOCHI (JAPANESE LANGUAGE-BASED SERVICES TO SENIORS, INCLUDING IN-HOME SUPPORT SERVICES, TRANSPORTATION, SOCIAL SERVICES, RESIDENT/RESPITE CARE, ADULT SOCIAL DAY CARE, AND MEALS PROGRAM) SUTTER SANTA ROSA REGIONAL HOSPITAL (SSRRH) SSRRH SERVES SONOMA COUNTY, AS WELL AS OTHER COUNTIES IN THE NORTH BAY. IN 2014, SSRRH PROVIDED $19,998,815 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS AND CASH TO THE BROADER COMMUNITY. COMMUNITY COLLABORATION SSRRH IS AN ACTIVE PARTNER IN MANY INNOVATIVE AND IMPORTANT COMMUNITY COLLABORATIONS THAT SEEK TO DEVELOP ACTIONABLE STRATEGIES IMPROVE THE HEALTH AND WELLBEING OF OUR COMMUNITY, PARTICULARLY AROUND ACCESS TO HEALTH AND DENTAL CARE. BELOW IS A PARTIAL LIST OF WORKGROUPS AND PROGRAMS: - COVERED SONOMA - SONOMA HEALTH ALLIANCE - HEALTH ACTION - FLUORIDE ADVISORY COUNCIL - DENTAL HEALTH NETWORK - HEALTHCARE WORKFORCE DEVELOPMENT ROUNDTABLE - DRUG FREE BABIES - SONOMA COUNTY FLU CONSORTIUM - HEALTHCARE FOR THE HOMELESS TASKFORCE - NORTHERN CALIFORNIA CENTER FOR WELL BEING - AMERICAN HEART ASSOCIATION - MARCH OF DIMES - OPERATION ACCESS - ELSIE ALLEN HIGH SCHOOL COMPACT FOR SUCCESS FORMER WARRACK HOSPITAL DONATED TO SOCIAL ADVOCATES FOR YOUTH (SAY) THE DONATION OF THE FORMER WARRACK HOSPITAL TO SOCIAL ADVOCATES FOR YOUTH (SAY) TO ADVANCE THEIR MISSION TO PROVIDE EDUCATION AND HOUSING FOR AT-RISK SONOMA COUNTY YOUTH WAS FINALIZED IN 2014. IN 2008, SUTTER MEDICAL CENTER OF SANTA ROSA'S WARRACK HOSPITAL BUILDING WAS CLOSED TO CONSOLIDATE SERVICES AT THE CHANATE FACILITY. THIS CLOSURE RENDERED THE MAJORITY OF THE WEST SIDE OF THE BUILDING VACANT. FOR THE PAST SEVERAL YEARS, SUTTER PACIFIC MEDICAL FOUNDATION LAB, X-RAY AND THE INSTITUTE FOR HEALTH AND HEALING HAVE OCCUPIED THE EAST WING OF THE FORMER HOSPITAL AND WILL REMAIN IN OPERATION AS NEIGHBORS TO SAY. LATINO HEALTH FORUM THE HEALTH AND SOCIAL NEEDS OF THE LATINO COMMUNITY ARE ADDRESSED AT THE ANNUAL LATINO HEALTH FORUM WHICH IS PRESENTED BY FAMILY MEDICINE RESIDENTS AND FACULTY. THE 22ND ANNUAL FORUM SAW THE GREATEST ATTENDANCE IN THE FORUM'S HISTORY. THIS CONFERENCE HAS BECOME KNOWN FOR ATTRACTING NATIONALLY RENOWNED KEYNOTE SPEAKERS AND FOR ITS RELEVANT AND INNOVATE BREAKOUT SESSIONS THAT PROVIDE ATTENDEES WITH INFORMATION AND RESOURCES THEY CAN USE IN THEIR WORK WITH CLIENTS. THE CONFERENCE TOPICS WERE BEHAVIORAL AND SPIRITUAL HEALTH. COMMUNITY BENEFIT IMPLEMENTATION PLAN UPDATES THE 2014-2018 IMPLEMENTATION PLANS (UNDER THE NEW FEDERAL GUIDELINES OF THE AFFORDABLE CARE ACT) WAS COMPLETED IN DECEMBER OF 2013. THE PLAN AND 2014 UPDATES CAN BE FOUND AT WWW.SUTTERSANTAROSA.ORG/COMMUNITY. NOVATO COMMUNITY HOSPITAL (NOVATO) NOVATO COMMUNITY HOSPITAL SERVES MARIN COUNTY, AS WELL AS PORTIONS OF SOUTHERN SONOMA COUNTY. IN 2014, NOVATO PROVIDED A TOTAL OF $303 THOUSAND IN QUANTIFIABLE COMMUNITY BENEFITS AND CASH TO THE BROADER COMMUNITY. NOVATO IS A MEMBER OF THE HEALTHY MARIN PARTNERSHIP A COLLABORATION OF THE THREE MARIN HOSPITALS - KAISER PERMANENTE SAN RAFAEL, MARIN GENERAL HOSPITAL, AND NOVATO COMMUNITY HOSPITAL. THE GROUP WAS INITIALLY FORMED 15 YEARS AGO TO RESPOND TO CALIFORNIA SB697, WHICH REQUIRES ALL NOT-FOR-PROFIT HOSPITALS TO CONDUCT A TRI-ANNUAL COMMUNITY NEEDS ASSESSMENT. 2012 WAS THE FIRST YEAR OF AN ACCOUNTABLE CARE ACT FEDERAL MANDATE THAT 501(C)3 HOSPITALS CONDUCT A TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENT. NCH AGAIN WORKED WI
FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS CONTINUED: SUTTER LAKESIDE HOSPITAL (LAKESIDE) IN 2014, LAKESIDE PROVIDED A TOTAL OF OVER $7 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS AND CASH TO THE BROADER COMMUNITY. THE POPULATION SERVED INCLUDES A HIGH PERCENTAGE OF FAMILIES WHOSE LOW INCOME AFFECTS THEIR ACCESS TO HEALTHCARE. SUTTER LAKESIDE'S COMMUNITY BENEFITS STRATEGY INCLUDES PREVENTIVE CARE, CLINICAL EDUCATION, AND SUBSIDIZING HEALTH SERVICES. LAKESIDE PREVENTIVE CARE INCLUDES THE SPONSORING AND FUNDING OF PROGRAMS THAT PROVIDE FREE OR LOW-COST PREVENTIVE CARE SCREENINGS AND TESTS, SUCH AS MAMMOGRAMS AND SEASONAL FLU VACCINATIONS. LAKESIDE'S ROLE IN CLINICAL EDUCATION IS TO PROVIDE OPPORTUNITIES FOR STUDENTS FROM MULTIPLE CLINICAL PROGRAMS TO APPLY THEIR LEARNING UNDER THE GUIDANCE AND SUPERVISION OF LAKESIDE'S STAFF. FINALLY, LAKESIDE SUBSIDIZES THE OPERATING COSTS OF HEALTH SERVICES THAT ARE CRUCIAL TO THE HEALTH AND WELLBEING OF THE COMMUNITY, INCLUDING; EMERGENCY DEPARTMENT, RURAL HEALTH CLINIC, MOBILE HEALTH CLINIC, AND BIRTH CENTER. CPMC RESEARCH INSTITUTE FOSTERING CLOSE COLLABORATIONS AMONG SCIENTISTS WITHIN THE SUTTER HEALTH SYSTEM AND AT PARTNERING INSTITUTIONS, THE CPMC RESEARCH INSTITUTE (CPMCRI) IS A UNIQUE CENTER FOR TRANSLATIONAL RESEARCH. OUR INVESTIGATORS TAKE A CROSS-DISCIPLINARY APPROACH TO DISCOVERY RESEARCH IN COMMON HUMAN ILLNESSES-TRANSFORMING LABORATORY FINDINGS INTO NEW DIAGNOSTICS, PERSONALIZED THERAPIES, AND SUCCESSFUL CLINICAL STUDIES. OVER 80 CLINICAL INVESTIGATORS AT CPMC AND ACROSS THE SUTTER WEST BAY AREA LEAD INNOVATIVE RESEARCH INTO COMMON, CHRONIC ILLNESSES THAT IMPACT MILLIONS OF AMERICANS. OUR INVESTIGATORS MERGE RESEARCH INSTITUTE INTEREST WITH THE NEEDS OF OUR MEDICAL CENTERS, MAKING RESEARCH AN INTEGRAL FOUNDATION FOR IMPROVED PATIENT CARE. RESEARCH IS CONDUCTED IN BOTH BASIC SCIENCE AND THE CLINICAL SETTING, INCLUDING MOLECULAR BIOLOGISTS, IMMUNOLOGISTS, PHARMACOLOGISTS, BIOCHEMISTS, PHYSICISTS, EPIDEMIOLOGISTS, BEHAVIORAL SCIENTISTS, BIOSTATISTICIANS, AND COMPUTER SCIENTISTS WORK WITHIN THE RESEARCH INSTITUTE AND THE MEDICAL CENTER. INNOVATIVE BIOMEDICAL RESEARCH IS CONDUCTED IN SUCH DIVERSE AREAS AS AGING, ARTHRITIS, EPILEPSY, DIABETES, NEUROBIOLOGY OF PAIN, CARDIOVASCULAR DISEASE, OSTEOPOROSIS, ORGAN TRANSPLANTATION, MECHANISMS OF DRUG ADDICTION, NEURODEGENERATIVE DISEASES (E.G. AMYOTROPHIC LATERAL SCLEROSIS), CANCER, AIDS, HEPATITIS AND OTHER INFECTIOUS DISEASES. SOME OF THESE SCIENTISTS ARE ENGAGED IN RESEARCH THAT WILL HELP US UNDERSTAND THE FUNCTION OF CERTAIN HUMAN CELLS, GENES, PROTEINS AND OTHER FUNDAMENTAL STRUCTURES WITHIN OUR BODIES. LARGE MULTI-CENTER STUDIES IN WOMEN'S HEALTH, AGING, COGNITIVE FUNCTION, CARDIOVASCULAR DISEASE, BREAST CANCER PREVENTION, OSTEOPOROSIS, AND ARTHRITIS INITIATED AT CPMCRI IN PARTNERSHIP WITH THE SAN FRANCISCO COORDINATING CENTER HAVE SIGNIFICANTLY ADVANCED RESEARCH INTO COMMON, CHRONIC ILLNESSES. OUR STUDIES ON LONGEVITY HAVE ACCUMULATED THE LARGEST, RICHEST DATASETS ABOUT AGING IN THE U.S. LARGE-COHORT STUDIES IN OSTEOPOROSIS AND BREAST CANCER HAVE YIELDED SOME OF THE MOST POWERFUL DATASETS IN THE U.S. TO HELP IMPROVE THE TREATMENT OF THESE ILLNESSES. OVER 200 CLINICAL TRIALS, SPONSORED BY PHARMACEUTICAL, BIOTECHNOLOGY AND THE NATIONAL CANCER INSTITUTE, ARE CURRENTLY CONDUCTED AT THE MEDICAL CENTER THROUGH THE CPMCRI OFFICE OF CLINICAL RESEARCH. OUR SCIENTISTS RECEIVED MORE THAN $18 MILLION IN RESEARCH FUNDING IN 2014. ONE OF OUR KEY PRIORITIES LIES IN TRAINING THE NEXT GENERATION OF CLINICIANS- SCIENTISTS. CPMCRI OFFERS RESOURCES FOR RESIDENTS AND FELLOWS AT CPMC WHO ARE MOTIVATED TO GAIN RESEARCH EXPERIENCE AND TRAINING, INCLUDING OPPORTUNITIES TO DESIGN AND CONDUCT THEIR OWN RESEARCH PROJECTS WITH CPMCRI CLINICAL AND BASIC SCIENCE RESEARCH FACULTY. OUR BASIC SCIENCE DISCOVERY LABS ALSO OFFER POST-DOCTORAL FELLOWSHIP TRAINING, AND CAN PROVIDE A MENTORED RESEARCH EXPERIENCE FOR VOLUNTEERS WHO WISH TO PURSUE A CAREER IN BASIC SCIENCE. HEALTH EDUCATION AND TRAINING TWO OF THE FOUR SUTTER WEST BAY HOSPITALS HAVE FORMAL HEALTH EDUCATION AND TRAINING PROGRAMS. SUTTER SANTA ROSA REGIONAL HOSPITAL ESTABLISHED ITS FAMILY MEDICINE TRAINING PROGRAM IN 1938. THE SANTA ROSA FAMILY MEDICINE RESIDENCY IS A CRITICAL STRATEGIC HEALTHCARE ASSET THAT ADDRESSES THE GROWING PHYSICIAN SHORTAGE IN SONOMA COUNTY. THE RESIDENCY HAS BEEN THE LARGEST SINGLE SOURCE OF FAMILY PHYSICIANS TO SONOMA COUNTY FOR OVER 80 YEARS; RESIDENCY GRADUATES COMPRISE NEARLY HALF OF FAMILY PHYSICIANS IN SONOMA COUNTY. RESIDENCY GRADUATES FILL POSITIONS IN PRIVATE PRACTICES, COMMUNITY CLINICS, AND LARGE MEDICAL GROUPS SUCH AS SUTTER MEDICAL GROUP OF THE REDWOODS, THE PERMANENTE MEDICAL GROUP, LOCAL COMMUNITY HEALTH CENTERS, AND SONOMA COUNTY HEALTH SERVICES AND LEADERSHIP POSITIONS THROUGHOUT THE MEDICAL COMMUNITY. THE THREE YEAR PROGRAM IS AFFILIATED WITH THE UCSF DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE. CALIFORNIA PACIFIC MEDICAL CENTER PROVIDES A MODEL OF SPECIALTY CARE BY BLENDING EXCELLENCE IN ACADEMICS AND RESEARCH WITH A FOCUS ON PATIENT-CENTERED CARE. CPMC IS A MAJOR TEACHING AFFILIATE OF DARTMOUTH MEDICAL SCHOOL, PROVIDING CLERKSHIPS IN MEDICINE, PSYCHIATRY, NEUROLOGY, PEDIATRICS AND OBSTETRICS-GYNECOLOGY. ADDITIONAL CLERKSHIPS (IN SURGERY AND OBSTETRICS-GYNECOLOGY) ARE PROVIDED FOR STUDENTS FROM UCSF. MEDICAL STUDENTS FROM OTHER PRESTIGIOUS SCHOOLS ON OCCASION ARE GRANTED CLERKSHIPS IN DEPARTMENTS WHICH SPONSOR RESIDENCIES HERE. THE GRADUATE MEDICAL RESIDENCY TRAINING PROGRAMS OFFERED AT CPMC ARE OF THE HIGHEST CALIBER WITH CPMC'S PHYSICIANS EMBRACING THE ROLE OF EDUCATORS AS WELL AS CLINICIANS. RESIDENCIES EDUCATE PHYSICIANS IN SPECIFIC SPECIALTIES. CPMC HAS INDEPENDENT RESIDENCY AND FELLOWSHIP PROGRAMS IN INTERNAL MEDICINE, PSYCHIATRY, RADIATION ONCOLOGY, OPHTHALMOLOGY, CARDIOVASCULAR DISEASES, GASTROENTEROLOGY, PULMONARY/CRITICAL CARE MEDICINE, HEPATOLOGY/TRANSPLANT, ENDOCRINOLOGY, HAND SURGERY, KIDNEY TRANSPLANT, NEUROCRITICAL CARE, MRL, RETINA, OCULOPLASTIC SURGERY, MELANOMA SURGERY, AND SHOULDER SURGERY. CPMC ALSO OFFERS TRAINING IN SURGERY, ORTHOPEDIC SURGERY, AND PLASTIC SURGERY TO UCSF RESIDENTS. IN ADDITION, CPMC IS A TRAINING SITE FOR OPERATING ROOM NURSING STUDENTS, OCCUPATIONAL THERAPISTS, PHYSICAL THERAPISTS AND SURGICAL TECHNOLOGISTS. IN ADDITION TO THE AFOREMENTIONED EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS (UNDERGRADUATE MEDICAL EDUCATION) AND RESIDENTS/FELLOWS (GRADUATE MEDICAL EDUCATION), CPMC PROVIDES AN EXTENSIVE SELECTION OF CONTINUING MEDICAL EDUCATION THROUGH ITS NUMEROUS CONFERENCES FOR PHYSICIANS IN PRACTICE. CPMC'S PHYSICIANS ALSO PROVIDE OUTREACH PROGRAMS IN CONTINUING MEDICAL EDUCATION LOCALLY, REGIONALLY, AND NATIONALLY. EDUCATION LOCALLY, REGIONALLY, AND NATIONALLY. PHYSICIANS IN PRACTICE. CPMC'S PHYSICIANS ALSO PROVIDE OUTREACH PROGRAMS IN CONTINUING MEDICAL EDUCATION LOCALLY, REGIONALLY, AND NATIONALLY.
FORM 990, PART VI, LINE 1A THE AFFAIRS AND MANAGEMENT OF SUTTER WEST BAY MEDICAL FOUNDATION (SWBMF) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SWBMF DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF SWBMF'S CHAIR WHO SERVES AS CHAIR OF THE COMMITTEE, THE VICE CHAIR, THE CHAIR OF THE FINANCE AND PLANNING COMMITTEE, THE PRESIDENT OF SWBMF AND UP TO NINE ADDITIONAL DIRECTORS. AT LEAST ONE COMMITTEE MEMBER IS A PHYSICIAN DIRECTOR. 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 DESCRIPTION OF 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 LEADERS OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN DECEMBER OF 2014.
FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMT 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) 232,335,401 PARTNERSHIP INCOME BOOKED ON RETURN 12,670,060 K-1 ORDINARY INCOME (12,934,435) K-1 INTEREST INCOME (15,057) K-1 ORDINARY DIVIDENDS (351,678) K-1 SHORT TERM CAPITAL GAIN 10,019,010 K-1 LONG TERM CAPITAL GAIN (29,041,984) K-1 SECTION 1231 GAIN (22,229) K-1 RENTAL INCOME (130,769) K-1 1250 GAIN 2 K-1 ROYALTY INCOME (13,397) K-1 OTHER INCOME (19,384) PRIOR PERIOD ADJ (236,840) OTHER ADJ TO BEG BALANCE 36,712 ------------ 212,295,412 ============
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SUTTER WEST BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) CATHEDRAL HEIGHTS LLC
PO BOX 7999
SAN FRANCISCO,CA94120
20-0511266
RENTAL PROP. CA 46 833,693 SWBH
 










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) ADOLESCENT TREATMENT CENTERS INC
390 40TH STREET

OAKLAND,CA94609
68-0088443
HEALTHCARE CA 501(C)(3) 3 SUTTER EBH
 
Yes
 
(2) BETTER HEALTH EAST BAY FOUNDATION
3012 SUMMIT STREET 3RD FLOOR

OAKLAND,CA94609
51-0160184
FUNDRAISING CA 501(C)(3) 7 SUTTER EBH
 
Yes
 
(3) CALIFORNIA PACIFIC MEDICAL CTR FOUND
2015 STEINER STREET 2ND FLOOR

SAN FRANCISCO,CA94115
94-2728423
FUNDRAISING CA 501(C)(3) 7 SUTTER WBH
 
Yes
 
(4) EAST BAY PERINATAL CENTER
3012 SUMMIT STREET 3RD FLOOR

OAKLAND,CA94609
51-0172285
HEALTHCARE CA 501(C)(3) 3 SUTTER EBH
 
Yes
 
(5) EDEN MEDICAL CENTER
20103 LAKE CHABOT ROAD

CASTRO VALLEY,CA94546
94-2948100
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(6) MEMORIAL HOSPITAL FOUNDATION
1800 COFFEE ROAD SUITE 76

MODESTO,CA95355
94-2290244
FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH
 
Yes
 
(7) MILLS-PENINSULA HEALTH SERVICES
1501 TROUSDALE DRIVE

BURLINGAME,CA94010
94-1156265
HOSPITAL CA 501(C)(3) 3 PAMF
 
Yes
 
(8) MILLS-PENINSULA HOSPITAL FOUNDATION
1501 TROUSDALE DRIVE

BURLINGAME,CA94010
23-7288765
FUNDRAISING CA 501(C)(3) 7 MPHS
 
Yes
 
(9) PALO ALTO MEDICAL FOUNDATION
2350 EL CAMINO REAL

MOUNTAIN VIEW,CA94040
94-1156581
HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(10) SAMUEL MERRITT UNIVERSITY
450 30TH STREET 2840

OAKLAND,CA94609
94-2992642
UNIVERSITY CA 501(C)(3) 2 SUTTER EBH
 
Yes
 
(11) SUTTER AUBURN FAITH HOSPITAL FOUNDATION
11815 EDUCATION ST

AUBURN,CA95602
94-2594966
FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(12) SUTTER CENTRAL VALLEY HOSPITALS
1800 COFFEE ROAD SUITE 76

MODESTO,CA95355
94-1080917
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(13) SUTTER COAST HOSPITAL
800 E WASHINGTON BLVD

CRESCENT CITY,CA95531
94-2988520
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(14) SUTTER DAVIS HOSPITAL FOUNDATION
PO BOX 1617

DAVIS,CA95617
68-0217870
FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(15) SUTTER EAST BAY HOSPITALS
3012 SUMMIT STREET 3RD FLOOR

OAKLAND,CA94609
94-1196176
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(16) SUTTER EAST BAY MEDICAL FOUNDATION
3687 MT DIABLO BLVD 200

LAFAYETTE,CA94549
94-2690415
HEALTHCARE CA 501(C)(3) 11B-II SUTTER HLTH
 
Yes
 
(17) SUTTER GOULD MEDICAL FOUNDATION
600 COFFEE ROAD

MODESTO,CA95355
94-1682256
HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(18) SUTTER HEALTH
2200 RIVER PLAZA DRIVE

SACRAMENTO,CA95833
94-2788907
SUPPORTING OR CA 501(C)(3) 11c III-FI NA
 
 
No
(19) SUTTER HEALTH PACIFIC
91-2301 FT WEAVER RD

EWA BEACH,HI96706
99-0298651
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(20) SUTTER HEALTH PLAN
2200 RIVER PLAZA DRIVE

SACRAMENTO,CA95833
46-1183948
HEALTH PLAN CA PENDING PENDING SUTTER HLTH
 
Yes
 
(21) SUTTER HEALTH SACRAMENTO SIERRA REGION
PO BOX 160727

SACRAMENTO,CA95816
94-1156621
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(22) SUTTER INSURANCE SERVICES CORPORATION
745 FORT STREET SUITE 800

HONOLULU,HI96813
99-0289310
INSURANCE SVC HI 501(C)(3) 11C III-FI SUTTER HLTH
 
Yes
 
(23) SUTTER MEDICAL CENTER FOUNDATION
PO BOX 160727

SACRAMENTO,CA95816
94-2788906
FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(24) SUTTER MEDICAL CENTER CASTRO VALLEY
2200 RIVER PLAZA DRIVE

SACRAMENTO,CA95833
77-0146047
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(25) SUTTER MEDICAL FOUNDATION
2800 L STREET 7TH FLOOR

SACRAMENTO,CA95816
68-0273974
HEALTHCARE CA 501(C)(3) 11b - II SUTTER HLTH
 
Yes
 
(26) SUTTER ROSEVILLE MEDICAL CTR FOUNDATION
ONE MEDICAL PLAZA

ROSEVILLE,CA95661
68-0040113
FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(27) SUTTER SOLANO CHARITABLE FOUNDATION
300 HOSPITAL DRIVE

VALLEJO,CA94589
94-2668262
FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(28) SUTTER VISITING NURSE ASSOC AND HOSPICE
1900 POWELL ST 300

EMERYVILLE,CA94608
94-6068843
HEALTHCARE CA 501(C)(3) 9 SUTTER HLTH
 
Yes
 
(29) SUTTER WEST BAY MEDICAL FOUNDATION
2015 STEINER STREET 1ST FLOOR

SAN FRANCISCO,CA94115
94-2948131
HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(30) TRACY HOSPITAL FOUNDATION
1420 N TRACY BLVD

TRACY,CA95376
68-0318845
FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) MAGNETIC IMAGING AF

175 LENNON
WLN CK,CA94598
94-2953833
PATIENT CARE CA NA
 
                 
(2) SURG CTR OF ABSMC

3875 TELEGRAPH
OAKLAND,CA94609
47-0946086
OUTPATIENT SURG CA NA
 
                 
(3) ALTA CT SERVICES LP

175 LENNON
WLN CK,CA94598
94-3083464
PATIENT CARE CA NA
 
                 
(4) CALIFORNIA PACIFIC ADV IMAGING LLC

PO BOX 6102
NOVATO,CA94948
56-2311840
MRI JOINT VENTURE CA SWBH
 
RELATED 1,799,602 991,693   No 0 Yes   51.000 %
(5) SAN FRANCISCO ENDOSCOPY CENTER LLC

3000 RIVERCHASE
BIRMINGHAM,AL35244
91-2160588
ENDOSCOPY JV CA SWBH
 
RELATED 4,782,579 1,390,208   No 0 Yes   51.000 %
(6) PRESIDIO SURGERY CENTER LLC

1635 DIVISADERO
SF,CA94115
32-0144060
AMBULATORY SURG CA SWBH
 
RELATED 6,352,633 4,284,909   No 0 Yes   51.000 %
(7) SUTTER FAIRFIELD SURGERY CTR

2700 LOW CT
FAIRFIELD,CA94533
30-0233892
SURGERY CA NA
 
                 
(8) TWIN CITIES SURGICAL HOSPITAL LLC

250 S WACKER
CHICAGO,IL60606
35-2182617
SURGERY CA NA
 
                 
(9) SUTTER AMADOR SURGERY CENTER LLC

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
46-1398093
SURGERY CA NA
 
                 
(10) ROSEVILLE ENDOSCOPY CENTER LLC

4 MEDICAL PLAZA SUITE 210
ROSEVILLE,CA95661
87-0710513
ENDOSCOPY JV CA NA
 
                 
(11) MEMORIAL MEDICAL OFFICE BUILDING PRTNR I

1800 COFFEE RD SUITE 76
MODESTO,CA95355
77-0287288
OFFICE RENTAL CA NA
 
                 
(12) MEMORIAL MEDICAL OFFICE BUILDING PRTNR I

1800 COFFEE RD SUITE 76
MODESTO,CA95355
77-0287288
OFFICE RENTAL CA NA
 
                 
(13) SAN FRANCISCO PEDIATRIC VENTURE LLC

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
45-4474910
PATIENT CARE CA SWBH
 
RELATED -400 267,000   No 0 Yes   50.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) HEALTH VENTURES INC

350 HAWTHORNE ST
OAKLAND,CA94609
94-2918780
HEALTH SERVIC CA NA
 
C CORP       Yes  
(2) CHARITABLE REMAINDER TRUSTS (1)

 
 
CRT CA N/A
TRUST       Yes  










Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) CALIFORNIA PACIFIC MEDICAL CENTER FOUNDATION

S 7,615,030 FMV
(2) MILLS-PENINSULA HOSPITAL SERVICES

M 611,574 FMV
(3) SUTTER CENTRAL VALLEY HOSPITALS

M 104,112 FMV
(4) SUTTER EAST BAY HOSPITALS

M 1,227,676 FMV
(5) SUTTER EAST BAY HOSPITALS

L 82,606 FMV
(6) SUTTER MEDICAL CENTER OF CASTRO VALLEY

M 993,351 FMV
(7) SUTTER WEST BAY MEDICAL FOUNDATION

K 4,120,987 FMV
(8) SUTTER WEST BAY MEDICAL FOUNDATION

M 24,018,152 FMV
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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