TY 2014 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JAMES CONFORTI........................................................................ REGIONAL PRESIDENT, SAC SIERRA	4.0 .......................40.0	X	X	1,074,810	332,008
(2) VIVA ETTIN........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(3) PATRICK FRY........................................................................ PRESIDENT & CEO, SUTTER HEALTH	2.0 .......................40.0	X		3,626,366	2,728,330
(4) GARY HOOPER........................................................................ TRUSTEE, CHAIR F & P	4.0 .......................2.0	X	X	0	0
(5) SCOTT HOWELL........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(6) PETER HULL MD........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(7) JEFFREY JENKINS MD........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(8) CHRISTOPHER JOHNSON........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(9) RICHARD KRAMER........................................................................ TRUSTEE	2.0 .......................4.0	X		0	0
(10) SARAH KREVANS........................................................................ COO SUTTER HEALTH	2.0 .......................40.0	X		1,762,485	424,237
(11) PAT FONG KUSHIDA........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(12) MARION LEFF MD........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(13) JERRY MAY PHD........................................................................ TRUSTEE, VICE CHAIR	4.0 .......................4.0	X	X	0	0
(14) MIKE NEWELL........................................................................ TRUSTEE, CHAIR	4.0 .......................4.0	X	X	0	0
(15) PAT PATHIPATI........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(16) PAIGE STAUSS........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0
(17) HELEN THOMSON........................................................................ TRUSTEE	2.0 .......................2.0	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) JEFFREY SPRAGUE........................................................................ CFO, SAC SIERRA (PART-YEAR)	4.0 .......................40.0	X				0	1,054,869	399,561
(19) PAIGE TERRA........................................................................ CFO (PART-YEAR)	40.0 .......................0.0	X				0	555,721	101,568
(20) PENNY WESTFALL........................................................................ VP & REG. COUNSEL SAC SIERRA	4.0 .......................40.0	X				0	564,797	73,392
(21) TOM BLINN........................................................................ CEO, SUTTER MED FOUNDATION	40.0 .......................0.0		X			0	841,783	165,872
(22) THERESA FREI........................................................................ COO, SMF	40.0 .......................0.0		X			0	406,035	53,565
(23) GLEN GROVES........................................................................ FINANCE EXECUTIVE, SMF WEST	40.0 .......................0.0		X			188,270	22,240	19,432
(24) SUHEIR HADDAD........................................................................ FINANCE ADMIN SMF CENTRAL	40.0 .......................0.0		X			0	335,128	58,624
(25) THERESA HEYLEN RUIZ........................................................................ FINANCE EXECUTIVE, SMF NORTH	40.0 .......................0.0		X			0	243,810	15,463
(26) ERIC RASMUSSEN........................................................................ DIRECTOR GROWTH & DEVELOPMENT	40.0 .......................0.0		X			226,713	0	25,273
(27) JOHN RAY........................................................................ EXECUTIVE, SMF WEST DIVISION	40.0 .......................0.0		X			0	285,445	16,434
(28) TERESA WILSON........................................................................ SENIOR DIRECTOR MANAGED CARE	40.0 .......................0.0		X			241,280	0	21,032
(29) DAVID YAMAMOTO........................................................................ CEO, SMF NORTH	40.0 .......................0.0		X			0	226,847	19,895
(30) GARY ZUFELT........................................................................ COO, SMF CENTRAL	40.0 .......................0.0		X			0	619,260	109,422
(31) PAMELA ADDY........................................................................ REGIONAL OPERATIONS DIRECTOR	40.0 .......................0.0			X		185,284	0	23,562
(32) DAVID ASCHE........................................................................ DIRECTOR RADIATION PHYSICS	40.0 .......................0.0			X		204,926	0	13,612
(33) JONATHAN BARENG........................................................................ CHIEF PHYSICIST	40.0 .......................0.0			X		198,897	0	18,790
(34) LISA BYNUM........................................................................ DIRECTOR, CONTRACTS	40.0 .......................0.0			X		186,874	0	24,296
(35) ROSETTA LI........................................................................ REGIONAL FIN DIRECTOR (PT YR)	40.0 .......................0.0			X		227,616	0	23,518
(36) KEVIN ENGLE........................................................................ SERVICE LINE MANAGER	0.0 .......................40.0				X	141,665	0	5,250
(37) MICHAEL D MARINO........................................................................ DIRECTOR HR, SMF	40.0 .......................0.0				X	0	259,333	20,498

(A) Name and business address	(B) Description of services	(C) Compensation
SUTTER MEDICAL GROUP, 2800 L STREET SUITE 630 SACRAMENTO,CA95816	MEDICAL SERVICES	264,410,250
SUTTER NORTH MEDICAL GROUP, 969 PLUMAS ST STE 203 YUBA CITY,CA95991	MEDICAL SERVICES	33,778,782
SUTTER CONNECT, PO BOX 255448 SACRAMENTO,CA95865	MANAGEMENT SERVICES	18,794,889
TOWERS WATSON DELAWARE INC, LOCKBOX 28025 NETWORK PL CHICAGO,IL606731280	CONSULTING SERVICES	5,646,248
QUEST DIAGNOSTICS INC, 3924 COLLECTION CTR CHICAGO,IL606930039	LABORATORY SERVICES	1,576,320
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 67

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 ....	0
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 ....	4,141,821		4,141,821
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	34,175	34,175
7	Other salaries and wages ....	154,020,882	137,906,493	15,978,093	136,296
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,749,157	7,628,877	1,112,742	7,538
9	Other employee benefits .......	67,885,598	59,193,234	8,648,172	44,192
10	Payroll taxes ...........	14,022,821	12,227,279	1,783,461	12,081
11	Fees for services (non-employees):
a	Management ......	633,795	2,111	631,684
b	Legal .........	1,128,660		1,128,660
c	Accounting ...........	52,776		52,776
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	136,661		136,661
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	6,456,041	6,456,041
12	Advertising and promotion ....	410,954	410,954
13	Office expenses .......	11,830,165	6,586,649	5,235,582	7,934
14	Information technology ......	23,982,373	23,686,410	295,963
15	Royalties ..	0
16	Occupancy ...........	31,909,312	31,909,312
17	Travel ............	1,450,975	1,265,186	182,016	3,773
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	216,119	189,041	27,078
20	Interest ...........	7,026,779	7,026,779
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	40,244,108	40,244,108
23	Insurance ..............	811,007	621,597	189,410
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	MEDICAL GROUP COMPENSATION	323,408,121	323,408,121
b	PURCHASED SERVICES	94,415,611	54,940,850	39,474,761
c	CAPITATED SERVICES	67,376,140	67,376,140
d	MEDICAL SUPPLIES	39,943,849	39,943,849
e	All other expenses	24,923,404	5,703,315	19,090,254	129,835
25	Total functional expenses. Add lines 1 through 24e	925,211,304	826,760,521	98,109,134	341,649
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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	0	1	0
2	Savings and temporary cash investments .........	30,867,283	2	30,066,242
3	Pledges and grants receivable, net ...........	309,085	3	215,322
4	Accounts receivable, net .............	59,261,118	4	67,030,838
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 ..............	4,774,229	8	6,114,270
9	Prepaid expenses and deferred charges ..........	1,334,245	9	1,902,922
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	436,069,731
b	Less: accumulated depreciation .....	10b	221,181,098	201,807,436	10c	214,888,633
11	Investments—publicly traded securities ..........	2,562,549	11	3,115,075
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	19,927,549	13	18,999,289
14	Intangible assets ...............	2,225,876	14	21,076,327
15	Other assets. See Part IV, line 11 ...........	22,139,125	15	17,558,706
16	Total assets. Add lines 1 through 15 (must equal line 34)......	345,208,495	16	380,967,624
	17	Accounts payable and accrued expenses .........	77,338,486	17	84,608,010
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	39,935,348	20	38,861,688
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 ....	199,909	24	76,887
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....................	5,764,781	25	7,166,179
26	Total liabilities. Add lines 17 through 25.........	123,238,524	26	130,712,764
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	220,607,771	27	248,493,750
28	Temporarily restricted net assets ...........	1,362,200	28	1,761,110
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	221,969,971	33	250,254,860
34	Total liabilities and net assets/fund balances ........	345,208,495	34	380,967,624

- TIN:

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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ............................. 1

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)
(i)Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) SUTTER HEALTH SACRAMENTO SIERRA REGION	941156621	03		No	26,722,053	0

Total 1					26,722,053

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

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)		(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)		(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.

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 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)		(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.)..

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

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

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

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.

Yes

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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....

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Yes

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

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

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, PART IV, LINE 6	In 2014, our not-for-profit Sutter Health network invested $767 million
SCHEDULE A, PART IV, SECTION C	SUTTER MEDICAL FOUNDATION (SMF) IS A SUPPORTING ORGANIZATION TO SUTTER

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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 MEDICAL FOUNDATION

Employer identification number

68-0273974

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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 MEDICAL FOUNDATION

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

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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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

(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

(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

(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

(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:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? .......................................

Yes No

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.

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.

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

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:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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 ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

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		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	18,775,421		18,775,421
b	Buildings ................	189,713,139	68,507,049	121,206,090
c	Leasehold improvements ............	52,855,002	27,287,207	25,567,795
d	Equipment ................	147,940,754	118,498,082	29,442,672
e	Other .................	26,785,415	6,888,760	19,896,655
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				214,888,633

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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.)

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









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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		501,571
OTHER LIABILITIES		6,664,608







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		7,166,179
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

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) AUDIT FOOTNOTE 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.

Return Reference

Explanation

SCHEDULE D, PART X, LINE 2

ASC 740 (FIN48) AUDIT FOOTNOTE 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:

- TIN:

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 arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information 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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

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?

Yes

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)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total .................

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

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 SWING INTO HLTH (event type)	(b) Event #2 HORSES & HATS (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	103,527	33,290	136,817
2	Less: Contributions . .	82,856	20,563	103,419
3	Gross income (line 1 minus line 2) . . .	20,671	12,727	33,398
4	Cash prizes . . .
5	Noncash prizes . .	5,419		5,419
6	Rent/facility costs . .	7,704		7,704
7	Food and beverages .	8,294	3,542	11,836
8	Entertainment . . .
9	Other direct expenses .	851	1,914	2,765
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			27,724
11	Net income summary. Subtract line 10 from line 3, column (d)...........			5,674

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.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (add col.(a) through col.(c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? ............

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2014

Page 3

Does the organization conduct gaming activities with nonmembers? .................

YesNo

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? ..........................

YesNo

Indicate the percentage of gaming activities conducted in:

The organization's facility ......................

13a

An outside facility ........................

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

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

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

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

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 (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

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 MEDICAL FOUNDATION

Employer identification number

68-0273974

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: .........

Yes

200% 250% 300% 350% 400% Other %

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.

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"? ..............

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

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? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) ..			1,964,720		1,964,720	0.210 %
b	Medicaid (from Worksheet 3, column a) ....			57,942,609	23,057,041	34,885,569	3.680 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .			441	1,455	-1,014
d	Total Financial Assistance and Means-Tested Government Programs .			59,907,770	23,058,496	36,849,275	3.890 %
Other Benefits		2		74,224		74,224	0.010 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	2		74,224		74,224	0.010 %
f	Health professions education (from Worksheet 5) ..	1		368,294	231,756	136,538	0.010 %
g	Subsidized health services (from Worksheet 6) ..	5		5,490,383	3,910,106	1,580,277	0.170 %
h	Research (from Worksheet 7)	1		429,150	287,381	141,769	0.010 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	5	286	154,738	450	154,288	0.020 %
j	Total. Other Benefits ..	14	286	6,516,789	4,429,693	2,087,096	0.220 %
k	Total. Add lines 7d and 7j .	14	286	66,424,559	27,488,189	38,936,371	4.110 %

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)	(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	27,620	27,620
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	1	27,620	27,620

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

14,961,821

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

3,153,084

Enter Medicare allowable costs of care relating to payments on line 5.....

4,457,406

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-1,304,322

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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.......................

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 %	(e) Physicians' profit % or stock ownership %
1SUT AMADOR SURG CNTR	MEDICAL SERVICES	32.000 %	27.000 %
2
3
4
5
6
7
8
9
10
11
12
13

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?1 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)				Other (describe)
1	SUTTER SURGICAL HOSPITAL-NORTH VALLEY 455 PLUMAS BLVD YUBA CITY,CA959915074 SUTTERSURGICALHOSPITALNORTHVALLEY.ORG LICENSE #550000989	X	X	OUTPATIENT SERVICES

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 SURGICAL HOSPITAL NORTH VALLEY
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):

Yes

Community Health Needs Assessment

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?.......................

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..........

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....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

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 .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url): SEE PART V, SECTION C

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

	SUTTER SURGICAL HOSPITAL NORTH VALLEY
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

The FAP application form was widely available on a website (list url):

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	SUTTER SURGICAL HOSPITAL NORTH VALLEY
Name of hospital facility or letter of facility reporting group

Yes

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?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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? ................................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

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
SCHEDULE H, PART V, SECTION B, LINE 5	CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: IN CONDUCTING ITS MOST RECENT CHNA, SUTTER SURGICAL HOSPITAL NORTH VALLEY, A FACILITY OF SUTTER MEDICAL FOUNDATION (SMF), DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). KEY INFORMANTS WERE HEALTH AND COMMUNITY EXPERTS FAMILIAR WITH POPULATIONS AND GEOGRAPHIC AREAS RESIDING WITHIN THE HSA. TO GAIN A DEEPER UNDERSTANDING OF THE HEALTH ISSUES PERTAINING TO CHRONIC DISEASE AND THE POPULATIONS LIVING IN THESE VULNERABLE COMMUNITIES, INPUT FROM SIX KEY INFORMANT INTERVIEWS WAS COLLECTED AND ANALYZED USING A THEORETICALLY GROUNDED INTERVIEW GUIDE. ANALYSIS WAS CONDUCTED ON EACH INTERVIEW TO IDENTIFY KEY THEMES. INTERVIEWS WERE HELD WITH THE FOLLOWING PEOPLE: - AMERJIT BHATTAL, ASSISTANT DIRECTOR OF HUMAN SERVICES FOR SUTTER COUNTY PUBLIC HEALTH WITH EXPERTISE IN PUBLIC HEALTH. (INTERVIEW DATE: 6/5/13) - MONICA BROKENBROUGH, CENTER MANAGER FOR PLANNED PARENTHOOD MAR MONTE WITH EXPERTISE IN COMMUNITY HEALTH. (INTERVIEW DATE: 6/5/13) - DR. LOU ANNE CUMMINGS, HEALTH OFFICER FOR SUTTER COUNTY PUBLIC HEALTH WITH EXPERTISE IN PUBLIC HEALTH. (INTERVIEW DATE: 6/5/13) - MARY DELONG, DIRECTOR OF STUDENT NUTRITION AND WAREHOUSE FOR YUBA CITY UNIFIED SCHOOL DISTRICT WITH EXPERTISE IN NUTRITION. (INTERVIEW DATE: 6/5/13) - RACHAEL FARELL, PA-C, CEO OF HARMONY HEALTH WITH EXPERTISE IN COMMUNITY HEALTH. (INTERVIEW DATE: 6/6/13) - KATRINA HENRY, DIRECTOR OF NURSES FOR YUBA COUNTY, PUBLIC HEALTH DIVISION WITH EXPERTISE IN PUBLIC HEALTH. (INTERVIEW DATE: 6/6/13) - MICHELLE LAUGHLIN, SITE MANAGER FOR TRIBAL HEALTH WITH EXPERTISE IN TRIBAL HEALTH. (INTERVIEW DATE: 6/6/13) - SUSANA RAMIREX, CENTER MANAGER FOR PLANNED PARENTHOOD MAR MONTE WITH EXPERTISE IN COMMUNITY HEALTH. (INTERVIEW DATE: 6/5/13) THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER SURGICAL HOSPITAL NORTH VALLEY'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML.
SCHEDULE H, PART V, SECTION B, LINE 6A	CHNA HOSPITAL COLLABORATORS: THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR SUTTER SURGICAL HOSPITAL NORTH VALLEY WAS NOT CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIES; HOWEVER, IT WAS A COLLABORATIVE EFFORT.
SCHEDULE H, PART V, SECTION B, LINE 7A, 7B AND 10A	REPORTING ORG WEBSITE HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ABOUT-US/COMMUNITY-NEEDS- ASSESSMENT.HTML OTHER WEBSITE HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML
SCHEDULE H, PART V, SECTION B, LINE 11	The following significant health needs were identified in the 2013 Community Health Needs Assessment are needs that Sutter Surgical Hospital North Valley intends to address through its implementation strategy: - Limited access to healthcare - No health insurance, isolation in the Foothills, limited transportation, chronic diseases, respiratory problems, mental and emotion health issues and dental issues - Poor Diet - Unaffordable fresh foods; unavailability of fresh foods; high concentration of fast food restaurants - Obesity/physical inactivity - Limited parks and recreation opportunities and lack of walk-friendly communities - Lack of preventative care - Policies that do not support health and wellbeing - Poverty Descriptions of the community benefit programs that address these significant health needs can be found in Part VI, along with additional critical efforts on behalf of Sutter Surgical Hospital North Valley.
SCHEDULE H, PART V, SECTION B, LINE 13H	ELIGIBILITY CRITERIA - OTHER: ADDITIONAL FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDES HOUSEHOLD SIZE, WHICH IS PART OF THE FEDERAL POVERTY GUIDELINES.
SCHEDULE H, PART V, SECTION B, LINE 16I	MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: 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, SECTION B, LINE 22D	AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: 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.

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?70
Name and address		Type of Facility (describe)
1	MEDICAL OFFICE BUILDING 2702 LOW COURT FAIRFIELD,CA94534	OUTPATIENT SERVICES
2	MEDICAL OFFICE BUILDING 480 PLUMAS YUBA CITY,CA95991	OUTPATIENT SERVICES
3	SUTTER FAIRFIELD SURGERY CENTER 2700 LOW COURT 2ND FLOOR FAIRFIELD,CA94534	SUTTER FAIRFIELD SURGERY CENTER
4	AUBURN AMC FAMILY PRACTICE & ORTHOPEDICS 3133 PROFESSIONAL DRIVE AUBURN,CA95603	FAMILY PRACTICE AND ORTHOPEDICS
5	URGENT CARELABRADIOLOGYCARDIOLOGY 440 PLUMAS YUBA CITY,CA95991	URGENT CARE, LAB, RADIOLOGY AND CARDIOLOGY
6	MEDICAL OFFICE BLDG-AMBULATORY SURG CTR 460 PLUMAS YUBA CITY,CA95991	OUTPATIENT SERVICES AND SURGERY CENTER
7	CARE CENTER AND CALL CENTER 2450 MARTIN ROAD FAIRFIELD,CA94533	OUTPATIENT SERVICES AND CALL CENTER
8	AMADOR CARDIO INVASIVE AND LAB 815 COURT STREET JACKSON,CA95642	CARDIOLOGY
9	AUBURN GASTROENTEROLOGY & NEUROLOGY 11795 EDUCATION STREET AUBURN,CA95602	GASTROENTEROLOGY AND NEUROLOGY
10	CLINICAL LAB 2715 K STREET SACRAMENTO,CA95816	LAB SERVICES
11	ROSEVILLE FAMILY PRACTICE & PHYS THERAPY 568 N SUNRISE AVE ROSEVILLE,CA95661	OUTPATIENT SERVICES AND PHYSICAL THERAPY
12	ELK GROVE - PHYSICAL THERAPY 9280 W STOCKTON BLVD ELK GROVE,CA95758	PHYSICAL THERAPY
13	GRASS VLY FAMILY PRACTICE & PHYS THERAPY 10058 WOLF ROAD GRASS VALLEY,CA95949	OUTPATIENT SERVICES AND PHYSICAL THERAPY
14	AUBURN PHYSICAL THERAPY 11930 HERITAGE OAKS PLACE AUBURN,CA95603	PHYSICAL THERAPY
15	DAVIS - PHYSICAL THERAPY 1340 LAKE BLVD DAVIS,CA95616	PHYSICAL THERAPY
16	LINCOLN PHYSICAL THERAPY 965 ORCHARD CREEK LANE LINCOLN,CA95648	PHYSICAL THERAPY
17	PHYSICAL THERAPY 420 B ST YUBA CITY,CA95991	PHYSICAL THERAPY
18	AUBURN OCCUPATIONAL MEDICINE 1330 AIRPORT BLVD AUBURN,CA95602	OCCUPATIONAL MEDICINE
19	OCCUPATIONAL HEALTH 1014 NORTH MARKET BLVD SACRAMENTO,CA95834	OCCUPATIONAL HEALTH
20	SUTTER FAIRFIELD DIAGNOSTIC IMAGING CTR 2700 LOW COURT 1ST FLOOR FAIRFIELD,CA94534	DIAGNOSTIC IMAGING CENTER
21	ROSEVILLE PATIENT SERVICE CENTERS MEDICAL PLAZA DRIVE ROSEVILLE,CA95661	OUTPATIENT SERVICES
22	DAVIS MEDICAL OFFICE BLDG ANESTHESIOLOGY 1801 HANOVER DR DAVIS,CA95616	OUTPATIENT SERVICES AND ANESTHESIOLOGY
23	DAVIS PATIENT SERVICE CENTERS 2020 SUTTER PLACE DAVIS,CA95616	OUTPATIENT SERVICES
24	SACRAMENTO AREA PATIENT SERVICE CENTERS 5301 F ST SACRAMENTO,CA95816	OUTPATIENT SERVICES
25	FORT SUTTER PATIENT SERVICE CENTERS 1020 29TH STREET SACRAMENTO,CA95816	OUTPATIENT SERVICES
26	FOLSOM PATIENT SERVICE CENTERS 2575 E BIDWELL ST FOLSOM,CA95630	OUTPATIENT SERVICES
27	SACRAMENTO AREA PATIENT SERVICE CENTERS 1625 STOCKTON BLVD SACRAMENTO,CA95816	OUTPATIENT SERVICES
28	FORT SUTTER PATIENT SERVICE CENTERS 2801 K ST SACRAMENTO,CA95816	OUTPATIENT SERVICES
29	NORTHEAST SAC PATIENT SERVICE CENTERS 3100 DOUGLAS BLVD ROSEVILLE,CA95661	OUTPATIENT SERVICES
30	NORTHEAST SAC PATIENT SERVICE CENTERS 83 SCRIPPS DR SACRAMENTO,CA95825	OUTPATIENT SERVICES
31	SACRAMENTO AREA PATIENT SERVICE CENTERS 1201 ALHAMBRA BLVD SACRAMENTO,CA95816	OUTPATIENT SERVICES
32	SACRAMENTO AREA PATIENT SERVICE CENTERS 2725 CAPITOL AVE SACRAMENTO,CA95816	OUTPATIENT SERVICES
33	YOLO AREA PATIENT SERVICE CENTERS 635 ANDERSON RD DAVIS,CA95616	OUTPATIENT SERVICES
34	SACRAMENTO AREA PATIENT SERVICE CENTERS 8170 LAGUNA BLVD ELK GROVE,CA95758	OUTPATIENT SERVICES
35	YOLO AREA PATIENT SERVICE CENTERS 2210 DEL PASO RD SACRAMENTO,CA95831	OUTPATIENT SERVICES
36	PLACER AREA PATIENT SERVICE CENTERS 1160 SUNSET BLVD ROCKLIN,CA95765	OUTPATIENT SERVICES
37	PLACER AREA PATIENT SERVICE CENTERS 685 TWELVE BRIDGES DR LINCOLN,CA95648	OUTPATIENT SERVICES
38	RANCHO CORDOVA - PATIENT SERVICE CENTERS 11121 SUN CENTER DR RANCHO CORDOVA,CA95670	OUTPATIENT SERVICES
39	WOODLAND PATIENT SERVICES CENTER 475 PIONEER AVE WOODLAND,CA95776	OUTPATIENT SERVICES
40	YOLO AREA PATIENT SERVICE CENTERS 125 N LINCOLN ST DIXON,CA95620	OUTPATIENT SERVICES
41	PLACER AREA PATIENT SERVICE CENTERS 3288 BELL RD AUBURN,CA95603	OUTPATIENT SERVICES
42	NORTHEAST SAC PATIENT SERVICE CENTERS 5767 GREENBACK LANE SACRAMENTO,CA95814	OUTPATIENT SERVICES
43	YOLO AREA PATIENT SERVICE CENTERS 7420 GREENHAVEN DR SACRAMENTO,CA95831	OUTPATIENT SERVICES
44	ROCKLIN - FAMILY PRACTICE 1160 SUNSET BLVD ROCKLIN,CA95765	OUTPATIENT SERVICES
45	AUBURN PARKHILL FAMILY PRACTICE 404 AUBURN-FOLSOM ROAD AUBURN,CA95603	FAMILY PRACTICE
46	VACAVILLE CARE CENTER 770 MASON STREET VACAVILLE,CA95687	OUTPATIENT SERVICES
47	RIO VISTA CARE CENTER 690 MAIN STREET RIO VISTA,CA94571	OUTPATIENT SERVICES
48	VALLEJO CARE CENTER 100 HOSPITAL DRIVE 2ND FLOOR VALLEJO,CA94589	OUTPATIENT SERVICES
49	SACRAMENTO CARDIO-INVASIVE 2575 E BIDWELL ST FOLSOM,CA95630	CARDIO-INVASIVE
50	SACRAMENTO PATIENT SERVICE CENTERS 2800 L ST SACRAMENTO,CA95816	OUTPATIENT SERVICES
51	SMUD OCCUPATIONAL HEALTH 1708 59TH ST SACRAMENTO,CA95816	OCCUPATIONAL HEALTH
52	WINTERS - FAMILY PRACTICE 111 EAST GRANT AVE WINTERS,CA95694	OUTPATIENT SERVICES
53	PROCEDURE CENTER 550 B ST YUBA CITY,CA95991	PROCEDURE CENTER
54	HOME HEALTHHOSPICE 400 PLUMAS YUBA CITY,CA95991	HOME HEALTH/HOSPICE
55	DAVIS INTERNAL MEDICINE GASTROENTEROLOGY 2068 JOHN JOES WAY DAVIS,CA95616	INTERNAL MEDICINE AND GASTROENTEROLOGY
56	L STREET MEDICAL NEUROLOGY 5275 F ST SACRAMENTO,CA95819	NEUROLOGY
57	ROSEVILLE EXPRESS CLINIC 4004 FOOTHILLS BLVD ROSEVILLE,CA95747	OUTPATIENT SERVICES
58	EXPRESS CLINIC - PLACERVILLE ROAD 10470 OLD PLACERVILLE RD SACRAMENTO,CA95827	OUTPATIENT SERVICES
59	EXPRESS CLINIC - GREENHAVEN 980 FLORIN RD SACRAMENTO,CA95831	OUTPATIENT SERVICES
60	EXPRESS CLINIC - NATOMAS 2751 DEL PASO RD SACRAMENTO,CA95835	OUTPATIENT SERVICES
61	ORTHOPEDICS 470 PLUMAS YUBA CITY,CA95991	ORTHOPEDICS
62	OBSTETRICS 924 CHESTNUT YUBA CITY,CA95991	OBSTETRICS
63	OBSTETRICS 969 PLUMAS YUBA CITY,CA95991	OBSTETRICS
64	AUBURN MRI 11815 EDUCATION STREET AUBURN,CA95602	MRI
65	DAVIS ALLERGY CENTER 1970 LAKE BLVD DAVIS,CA95616	ALLERGY TESTING
66	DERMATOLOGY 350 DEL NORTE YUBA CITY,CA95991	DERMATOLOGY
67	ROSEVILLE ENDOSCOPY CENTER 4 MEDICAL PLAZA ROSEVILLE,CA95661	OUTPATIENT SERVICES
68	SUTTER AMADOR SURGERY CENTER 223 CLINTON ROAD JACKSON,CA95642	OUTPATIENT SERVICES
69	SUTTER FAIRFIELD SURGERY CENTER 2700 LOWER COURT FAIRFIELD,CA94533	OUTPATIENT SERVICES
70	SUTTER SURGICAL HOSPITAL NORTH VALLEY 455 PLUMAS BLVD YUBA CITY,CA95991	OUTPATIENT SERVICES

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 3C	FREE CARE ELIGIBILITY: TO BE ELIGIBLE FOR FREE CARE THE FILING ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 200% OF FPG. PARTIAL WRITE-OFF OF THE HOSPITAL'S UNDISCOUNTED CHARGES APPLIES TO UNINSURED PATIENTS THAT WHOSE FAMILY INCOMES ARE BETWEEN 200% AND 400%. 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 30% OF THE PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% 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, 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 THAT 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, OR A 20% DISCOUNT IF 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.
SCHEDULE H, PART I, LINE 7G	FINANCIAL ASSISTANCE/OTHER COMMUNITY BENEFITS AT COST RELATED TO SUBSIDIZED HEALTH SERVICES: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $1,525,882. SCHEDULE H, PART II SUTTER MEDICAL FOUNDATION EMPLOYEES DEDICATE STAFF TIME AND EXPERTISE TO A VARIETY OF NATIONAL AND LOCAL NOT-FOR-PROFIT BOARDS, INCLUDING THE ELK GROVE REGIONAL SCHOLARSHIP FOUNDATION, ROSEVILLE HOMESTART, AND THE BEAR PROGRAM.
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	BAD DEBT AUDITED FINANCIALS 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 12/31/13 33% AS OF 12/31/13 MEDI-CAL 27% AS OF 12/31/13 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 SURPLUS/SHORTFALL: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. THEREFORE THE AMOUNT REFLECTED ON THE COST REPORT WILL LIKELY DIFFER FROM ACTUAL COSTS WHICH MAY BE REFLECTED IN THE COMMUNITY BENEFIT REPORT AND ON THIS FORM.
SCHEDULE H, PART III, LINE 8	MEDICARE SHORTFALL 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 PRACTICE: 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: SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV) OF YUBA CITY, CALIFORNIA CONDUCTED A CHNA OF THE HOSPITAL SERVICE AREA (HSA). VALLEY VISION, INC. CONDUCTED THE CHNA OVER A PERIOD OF MONTHS. VALLEY VISION (WWW.VALLEYVISION.ORG) IS A NONPROFIT 501(C)(3) CONSULTING FIRM SERVING A BROAD RANGE OF COMMUNITIES ACROSS NORTHERN CALIFORNIA. THE ORGANIZATION'S MISSION IS TO IMPROVE QUALITY OF LIFE THROUGH THE DELIVERY RESEARCH ON IMPORTANT TOPICS SUCH AS HEALTHCARE, ECONOMIC DEVELOPMENT, AND SUSTAINABLE ENVIRONMENTAL PRACTICES. VALLEY VISION HAS CONDUCTED MULTIPLE CHNAS ACROSS AN ARRAY OF COMMUNITIES FOR OVER SEVEN YEARS. AS THE LEAD CONSULTANT, VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT THAT INCLUDED: 1) A PUBLIC HEALTH EXPERT WITH OVER A DECADE OF EXPERIENCE IN CONDUCTING CHNAS, 2) A GEOGRAPHER WITH EXPERTISE IN USING GIS TECHNOLOGY TO MAP HEALTH-RELATED CHARACTERISTICS OF POPULATIONS ACROSS LARGE GEOGRAPHIC AREAS, AND 3) ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR SUTTER SURGICAL HOSPITAL NORTH VALLEY IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER SURGICAL HOSPITAL NORTH VALLEY FOLLOWS 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: A. 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). B. 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: THE HSA WAS DETERMINED BY ANALYZING PATIENT DISCHARGE DATA WHERE IT WAS DETERMINED THAT APPROXIMATELY 74% OF ALL PATIENTS RESIDED IN FOUR ZIP CODES THAT WERE LOCATED IN TWO COUNTIES. ZIP CODES 95901 (MARYSVILLE AND LINDA AREAS) AND 95961 (OLIVEHURST AREA) ARE BOTH LOCATED IN YUBA COUNTY. ZIP CODES 95991 (SOUTH CENTRAL YUBA CITY AREA) AND 95933 (WESTERN YUBA CITY AREA) ARE BOTH LOCATED IN SUTTER COUNTY. A MAP OF THE SERVICE AREA IS SHOWN IN FIGURE 1. ZIP CODE BOUNDARIES IN RURAL COMMUNITIES ARE SOMETIMES NOT REPRESENTATIVE OF POPULATION DISTRIBUTIONS ACROSS A ZIP CODE. THERE ARE FOUR HOSPITALS THAT SERVE THE COMMUNITY. A KEY TO UNDERSTANDING COMMUNITY HEALTH IS UNDERSTANDING COMMUNITY VULNERABILITY TO POOR OR UNWANTED HEALTH OUTCOMES. THIS IS ACCOMPLISHED BY EXAMINING CERTAIN SOCIO-DEMOGRAPHICS, OFTEN REFERRED TO AS THE SOCIAL DETERMINANTS OF HEALTH, IN ORDER TO IDENTIFY AREAS OF THE HSA WITH HIGH VULNERABILITY TO UNWANTED HEALTH OUTCOMES. TO ACCOMPLISH THIS, RACE AND ETHNICITY, HOUSEHOLD MAKEUP, INCOME, AND AGE VARIABLES WERE COMBINED INTO A VULNERABILITY INDEX THAT DESCRIBED THE LEVEL OF VULNERABILITY OF EACH CENSUS TRACT. THIS INDEX WAS THEN MAPPED FOR THE ENTIRE HSA. A TRACT WAS CONSIDERED MORE VULNERABLE, OR MORE LIKELY TO HAVE HIGHER UNWANTED HEALTH OUTCOMES THAN OTHERS IN THE HSA, IF IT HAD HIGHER: 1) PERCENT NON-WHITE OR HISPANIC POPULATION; 2) PERCENT SINGLE FEMALE PARENT HEADED HOUSEHOLDS; 3) PERCENT BELOW 125% OF THE POVERTY LEVEL; 4) PERCENT UNDER FIVE YEARS OLD; AND 5) PERCENT 65 YEARS OF AGE OR OLDER LIVING IN THE CENSUS TRACT. FIGURE 2 SHOWS THE VULNERABILITY INDEX FOR EACH CENSUS TRACT LOCATED ALL OR IN PART OF THE SSHNV HSA. IN THE MAP, DARKER GRADIENT COLORS INDICATE HIGHER VULNERABILITY. CENTRAL YUBA CITY, THE LINDA AREA, AND PORTIONS OF OLIVEHURST WERE AREAS IDENTIFIED WITH THE HIGHEST VULNERABILITY IN THE HSA. THE HSA IS HOME TO APPROXIMATELY 135,000 RESIDENTS. THE RACIAL AND ETHNIC MAKEUP OF THE COMMUNITY IS SHOW IN TABLE 3 IN THE FULL REPORT. WHITES ACCOUNTED FOR OVER HALF OF THE HSA'S RESIDENTS (52.5% COMPARED TO ALL OF CA 40.7%). OTHER GROUPS THAT COMPRISED THE BULK OF THE HSA'S POPULATION INCLUDED HISPANICS (27.1%), ASIANS (12.3%), MULTI-RACE (2.4%), BLACKS (2.3%), AND AMERICAN INDIANS (1.0%). THE 2013 COUNTY HEALTH RANKINGS INDICATED THAT YUBA COUNTY RANKED 50 OUT OF 57 COUNTIES IN CALIFORNIA FOR OVERALL HEALTH. SUTTER COUNTY RANKED 33. MORTALITY RANKINGS SHOWED YUBA COUNTY RANKED 48 OF 57, WHILE SUTTER COUNTY RANKED 36. AS TO OVERALL MORBIDITY, YUBA RANKED 46 OF 57, WHILE SUTTER RANKED 30. DATA INDICATED THAT 22% AND 23% OF YUBA AND SUTTER COUNTY RESIDENTS, RESPECTIVELY, SELF-REPORTED THEIR HEALTH AS "POOR OR FAIR," COMPARED TO A CALIFORNIA BENCHMARK OF 19%, AND NATIONAL BENCHMARK OF 10%. FURTHER, YUBA AND SUTTER COUNTY RESIDENTS REPORTED THAT THAT ON AVERAGE THEY EXPERIENCED 4.1 AND 4.3 DAYS, RESPECTIVELY, OVER A 30-DAY PERIOD THAT THEIR PHYSICAL HEALTH WAS "NOT GOOD." THIS COMPARES TO THE STATE BENCHMARK OF 3.7 AND NATIONAL BENCHMARK OF 2.6 DAYS.
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. THE 2013 - 2015 IMPLEMENTATION STRATEGY FOR SUTTER SURGICAL HOSPITAL NORTH VALLEY 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: SSHNV HOSTS WOMEN'S HEALTH SCREENING DAY ANNUALLY AND JOINS FORCES WITH THE YUBA-SUTTER PINK OCTOBER COMMITTEE TO INCREASE AWARENESS OF EARLY DETECTION OF BREAST CANCER. WOMEN'S HEALTH SCREENING DAY PROVIDES RECTAL, CLINICAL BREAST, PAP AND BONE DENSITY SCREENINGS AT A FREE OR MINIMAL COST TO WOMEN WHO EITHER ARE UNDER OR NOT INSURED. PROVIDERS FROM SUTTER NORTH MEDICAL GROUP, IN YUBA CITY AND THE RURAL COMMUNITY OF BROWNSVILLE, DONATE THEIR TIME TO THE WOMEN'S HEALTH SCREENING DAY WHICH SERVED 157 WOMEN IN 2014. INSURANCE ENROLLMENT SPECIALISTS FROM COVERED CALIFORNIA ATTENDED SOME OF THE SCREENING EVENTS TO EDUCATE, CONNECT AND ENROLL PATIENTS WHO NEED IT, IN HEALTH INSURANCE. AS A RESULT, THE COVERED CA TEAM MADE GREAT CONNECTIONS AND WILL BE FOLLOWING UP WITH MANY OF THE WOMEN TO HELP ENROLL THEM IN INSURANCE. THE ANNUAL PROSTATE SCREENING EVENT TAKES PLACE IN SEPTEMBER, IN HONOR OF PROSTATE AWARENESS MONTH. THIS EVENT TARGETS UNDERINSURED MEN, AND PROVIDES A PHYSICAL EXAM AND A BLOOD TEST CALLED PSA (PROSTATE SPECIFIC ANTIGEN) FOR $15. OUR GOAL IS NOT ONLY TO SCREEN THE UN AND UNDERINSURED MEN, BUT WE ALSO USE THESE EVENTS AS A CONNECTION POINT FOR THE UNDERSERVED MEMBERS OF OUR COMMUNITY, TO LINK THEM WITH A PRIMARY CARE PROVIDER AND FOLLOW UP RESOURCES IF NEEDED, AS WELL AS INSURANCE ENROLLMENT INFORMATION. IN 2014, DUE TO A STAFF SHORTAGE, ONLY A HALF DAY OF SCREENINGS WAS OFFERED. 31 MEN RECEIVED LOW COST SCREENINGS AT THE HALF DAY EVENT. MUCH LIKE THE WOMEN'S HEALTH AND MAMMO SCREENINGS, WE HAD INSURANCE ENROLLMENT SPECIALISTS FROM COVERED CALIFORNIA ATTEND THE PROSTATE SCREENING TO EDUCATE, CONNECT AND ENROLL PATIENTS WHO NEED IT, IN HEALTH INSURANCE. THE COVERED CA TEAM MADE MANY GREAT CONNECTIONS WITH MANY PATIENTS AND FOLLOWED UP WITH MANY OF THE MEN THEY MET AT THE PROSTATE SCREENING. ENROLLING THE UN- AND UNDERINSURED POPULATION WILL BE A MAJOR COMPONENT OF OUR CHNA IMPLEMENTATION PLANNING, AS THIS IS THE FIRST STEP TO CONNECTING PATIENTS WITH PRIMARY CARE. THIS PROGRAM WILL CONTINUE TO EVOLVE AS WE SEE THE NUMBER OF SCREENINGS DECREASE DUE TO THE IMPLEMENTATION OF ACA. SSHNV PROVIDED FUNDING TO SACRAMENTO COVERED TO PROVIDE ENROLLMENT SPECIALISTS FOR THE WOMEN'S HEALTH SCREENING AND PROSTATE SCREENING EVENTS, TO LINK THE UNINSURED AND UNDERINSURED WITH INSURANCE ENROLLMENT INFORMATION AND SERVICES. THIS SUPPORT NOT ONLY BENEFITS SSHNV'S ACTIVITIES, BUT SUPPORTS SACRAMENTO COVERED'S OUTREACH THROUGHOUT THE REGION. IN 2014, THE SUCCESSFUL BE STRONG PROGRAM MERGED WITH THE THRIVING FIT QUEST CURRICULUM, FOR A PILOT PROGRAM THAT INCLUDED ALL 5TH AND 6TH GRADE YUBA AND SUTTER COUNTY STUDENTS PARTICIPATING IN THE SHADY CREEK OUTDOOR PROGRAM. IN ADDITION TO THE CLASS BASED PROGRAM, THE EXPANSION INCLUDED A NEW FIT QUEST FAMILY CAMP, A WEEKEND LONG HEALTH, WELLNESS, AND FITNESS EDUCATION PROGRAM FOR FAMILIES OF STUDENTS PARTICIPATING IN THE FIT QUEST PROGRAM TO BE HELD AT SHADY CREEK. STUDENTS PARTICIPATED IN APPROPRIATE GRADE STANDARD BASED NUTRITION AND PHYSICAL FITNESS EXPERIENTIAL LEARNING PROGRAM WHICH WILL INCLUDE INSTRUCTION IN THE CLASSROOM AND EXTENSIVE INSTRUCTION DURING THEIR TIME AT SHADY CREEK. THE MERGER OF THE BE STRONG PROGRAM WITH FIT QUEST CURRICULUM ALLOWS SUTTER MEDICAL FOUNDATION TO BRING ONE COMPREHENSIVE YOUTH WELLNESS PROGRAM TO THE YUBA-SUTTER COMMUNITY AND REACH OVER 1,400 STUDENTS. THE PROGRAM PARTNERS WITH 25 SCHOOLS AND INCLUDES 75 SITE VISITS FROM TRAINED STAFF. THE PROGRAM TARGETS 5TH AND 6TH GRADE STUDENTS WHO ARE ELIGIBLE TO ATTEND SHADY CREEK OUTDOOR SCHOOL. STUDENTS LEARN HOW TO EAT MORE NUTRITIOUSLY, INCREASE PHYSICAL ACTIVITY AND ENHANCE MENTAL WELLNESS. CLASS PARTICIPANTS LEARN ABOUT ADOPTING A HEALTHIER LIFESTYLE THROUGH INTERACTIVE GAMES, PHYSICAL ACTIVITIES, COOKING DEMONSTRATIONS AND DISCUSSIONS ABOUT FOOD CHOICES AND BEHAVIORS. SSHNV CONTINUES TO PROVIDE GRANT FUNDING TO SUPPLEMENT THE SALARY FOR A PHYSICAL EDUCATION SPECIALIST THAT SERVICES THE YUBA CITY UNIFIED SCHOOL DISTRICT, GRADES K-8. WITHOUT THIS GRANT, THERE WOULD ONLY BE ONE PE SPECIALIST, WHICH IS NOT ENOUGH TO SUPPORT THE PE PROGRAMS IN THE LOCAL SCHOOLS, WHICH WOULD FURTHER CONTRIBUTE TO CHILDHOOD OBESITY, LACK OF EXERCISE AND ESTABLISHING A PATTERN OF UNHEALTHY HABITS FOR THE YOUTH IN THE SSHNV HSA. SSHNV ALSO PROVIDES PHYSICALS FOR THE FOOTBALL PLAYERS AT MARYSVILLE HIGH SCHOOL.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: SUTTER SURGICAL HOSPITAL NORTH VALLEY IS 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:

- TIN:

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 MEDICAL FOUNDATION

Employer identification number

68-0273974

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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....

Yes

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? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1PAMELA ADDYREGIONAL OPERATIONS DIRECTOR	(i) (ii)	162,848 ............................... 0	12,025 ............................... 0	10,411 ............................... 0	3,706 ............................... 0	19,856 ............................... 0	208,846 ............................... 0	0 ............................... 0
2DAVID ASCHEDIRECTOR RADIATION PHYSICS	(i) (ii)	203,998 ............................... 0	0 ............................... 0	928 ............................... 0	4,099 ............................... 0	9,513 ............................... 0	218,538 ............................... 0	0 ............................... 0
3JONATHAN BARENGCHIEF PHYSICIST	(i) (ii)	197,074 ............................... 0	0 ............................... 0	1,823 ............................... 0	3,978 ............................... 0	14,812 ............................... 0	217,687 ............................... 0	0 ............................... 0
4TOM BLINNCEO, SUTTER MED FOUNDATION	(i) (ii)	0 ............................... 468,913	0 ............................... 296,489	0 ............................... 76,381	0 ............................... 148,086	0 ............................... 17,786	0 ............................... 1,007,655	0 ............................... 60,906
5LISA BYNUMDIRECTOR, CONTRACTS	(i) (ii)	171,895 ............................... 0	13,750 ............................... 0	1,229 ............................... 0	3,737 ............................... 0	20,559 ............................... 0	211,170 ............................... 0	0 ............................... 0
6JAMES CONFORTIREGIONAL PRESIDENT, SAC SIERRA	(i) (ii)	0 ............................... 594,704	0 ............................... 425,250	0 ............................... 54,856	0 ............................... 309,954	0 ............................... 22,054	0 ............................... 1,406,818	0 ............................... 50,081
7KEVIN ENGLESERVICE LINE MANAGER	(i) (ii)	121,159 ............................... 0	9,475 ............................... 0	11,031 ............................... 0	2,833 ............................... 0	2,417 ............................... 0	146,915 ............................... 0	0 ............................... 0
8THERESA FREICOO, SMF	(i) (ii)	0 ............................... 289,810	0 ............................... 90,723	0 ............................... 25,502	0 ............................... 42,292	0 ............................... 11,273	0 ............................... 459,600	0 ............................... 0
9PATRICK FRYPRESIDENT & CEO, SUTTER HEALTH	(i) (ii)	0 ............................... 1,523,132	0 ............................... 1,687,050	0 ............................... 416,184	0 ............................... 2,693,377	0 ............................... 34,953	0 ............................... 6,354,696	0 ............................... 396,136
10GLEN GROVESFINANCE EXECUTIVE, SMF WEST	(i) (ii)	166,919 ............................... 0	13,075 ............................... 0	8,276 ............................... 22,240	0 ............................... 3,765	0 ............................... 15,667	188,270 ............................... 41,672	0 ............................... 0
11SUHEIR HADDADFINANCE ADMIN SMF CENTRAL	(i) (ii)	0 ............................... 216,043	0 ............................... 79,091	0 ............................... 39,994	0 ............................... 44,737	0 ............................... 13,887	0 ............................... 393,752	0 ............................... 10,400
12THERESA HEYLEN RUIZFINANCE EXECUTIVE, SMF NORTH	(i) (ii)	0 ............................... 174,386	0 ............................... 61,374	0 ............................... 8,050	0 ............................... 3,401	0 ............................... 12,062	0 ............................... 259,273	0 ............................... 7,862
13SARAH KREVANSCOO SUTTER HEALTH	(i) (ii)	0 ............................... 916,159	0 ............................... 689,878	0 ............................... 156,448	0 ............................... 399,554	0 ............................... 24,683	0 ............................... 2,186,722	0 ............................... 142,787
14ROSETTA LIREGIONAL FIN DIRECTOR (PT YR)	(i) (ii)	169,488 ............................... 0	13,350 ............................... 0	44,778 ............................... 0	4,552 ............................... 0	18,966 ............................... 0	251,134 ............................... 0	0 ............................... 0
15MICHAEL D MARINODIRECTOR HR, SMF	(i) (ii)	0 ............................... 178,978	0 ............................... 55,795	0 ............................... 24,560	0 ............................... 10,600	0 ............................... 9,898	0 ............................... 279,831	0 ............................... 6,300
16ERIC RASMUSSENDIRECTOR GROWTH & DEVELOPMENT	(i) (ii)	196,746 ............................... 0	15,375 ............................... 0	14,592 ............................... 0	4,534 ............................... 0	20,739 ............................... 0	251,986 ............................... 0	0 ............................... 0
17JOHN RAYEXECUTIVE, SMF WEST DIVISION	(i) (ii)	0 ............................... 34,054	0 ............................... 98,632	0 ............................... 152,759	0 ............................... 15,076	0 ............................... 1,358	0 ............................... 301,879	0 ............................... 0
18JEFFREY SPRAGUECFO, SAC SIERRA (PART-YEAR)	(i) (ii)	0 ............................... 560,401	0 ............................... 340,633	0 ............................... 153,835	0 ............................... 379,654	0 ............................... 19,907	0 ............................... 1,454,430	0 ............................... 146,695
19PAIGE TERRACFO (PART-YEAR)	(i) (ii)	0 ............................... 349,201	0 ............................... 191,624	0 ............................... 14,896	0 ............................... 86,451	0 ............................... 15,117	0 ............................... 657,289	0 ............................... 10,967
20PENNY WESTFALLVP & REG. COUNSEL SAC SIERRA	(i) (ii)	0 ............................... 340,787	0 ............................... 195,043	0 ............................... 28,967	0 ............................... 62,721	0 ............................... 10,671	0 ............................... 638,189	0 ............................... 0
21TERESA WILSONSENIOR DIRECTOR MANAGED CARE	(i) (ii)	222,209 ............................... 0	14,400 ............................... 0	4,671 ............................... 0	4,826 ............................... 0	16,206 ............................... 0	262,312 ............................... 0	0 ............................... 0
22DAVID YAMAMOTOCEO, SMF NORTH	(i) (ii)	0 ............................... 9,647	0 ............................... 100,469	0 ............................... 116,731	0 ............................... 17,310	0 ............................... 2,585	0 ............................... 246,742	0 ............................... 0
23GARY ZUFELTCOO, SMF CENTRAL	(i) (ii)	0 ............................... 366,282	0 ............................... 218,174	0 ............................... 34,804	0 ............................... 90,565	0 ............................... 18,857	0 ............................... 728,682	0 ............................... 24,990

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 PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH.
SCHEDULE J, PART I, LINE 4A	THE FOLLOWING PEOPLE RECEVED SEVERANCE PAYMENTS IN 2014: - ROSETTA LI: $35,388 - GLEN GROVES: $22,240 - DAVID YAMAMOTO: $95,894 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. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. 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:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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.
SchKMediumBullet

Information 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 MEDICAL FOUNDATION

Employer identification number
68-0273974

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CSCDA 2003AB	68-0164610	130911NE6	05-01-2007	101,118,867	CONSTRUCT & REFUNDING - 1/30/2003		X		X		X
B	CSCDA 2004CD	68-0164610	130795TE7	05-06-2008	87,750,717	CONSTRUCT & REFUNDING - 2/17/2004		X		X		X
C	CHFFA 2008A	52-1643828	13033F2L3	05-14-2008	329,041,638	CONSTRUCT & REFUNDING - 2/17/2004		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	0		18,180,000		104,255,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	105,555,193		88,924,485		329,041,638
4 Gross proceeds in reserve funds . . . . . . . . . . . .	8,937,127		8,608,201		0
5 Capitalized interest from proceeds . . . . . . . . . . .	0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	0		0		0
8 Credit enhancement from proceeds . . . . . . . . . . .	0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		0		0
11 Other spent proceeds . . . . . . . . . . . . . .	96,618,066		80,316,284		329,041,638
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0
13 Year of substantial completion . . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	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		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

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
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
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		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 . .	0.090 %		0.040 %		1.020 %
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 . . . . . . .	0.010 %		0 %		0.070 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0.100 %		0.040 %		1.090 %
7 Does the bond issue meet the private security or payment test? . . . . .		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %				0 %
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
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

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
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X		X		X
b Exception to rebate? . . . . . . . .		X		X		X
c No rebate due? . . . . . . . .		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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		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

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
b Name of provider . . . . . . . . .	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
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	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

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, LINE A, COLUMN (E)	The filing organization received bond proceeds in the amounts of: $16,846,004 from the 2003AB issue; $11,483,497 from the 2004 CD issue and $15,965,405 from the 2008A issue. SCHEDULE K, PART I, LINE A, COLUMN (F) (CSCDA 2003AB) THE INITIAL BONDS ISSUED IN 2003 WERE "NEW MONEY" BONDS THAT WERE RETIRED AND REISSUED ON MAY 1, 2007. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE ORIGINAL "NEW MONEY BONDS". SCHEDULE K, PART I, LINE B, COLUMN (F) (CSCDA 2004CD): THE INITIAL BONDS ISSUED IN 2004 WERE "NEW MONEY" BONDS THAT WERE RETIRED AND REISSUED ON MAY 6, 2008. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE ORIGINAL "NEW MONEY" BONDS. SCHEDULE K, PART I, LINE C, 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 2004 ISSUE. THE REFUNDED BONDS ISSUED IN 2004 WERE USED FOR EXPANSION.
SCHEDULE K, PART II, LINE 7	ISSUANCE COSTS FROM PROCEEDS: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
MediumBullet

Information 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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

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

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) VICKY LUCAS	SEE PART V	34,175	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, COLUMN (D)	DESCRIPTION OF BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: THERESA HEYLEN (RUIZ), KEY EMPLOYEE OF SUTTER MEDICAL FOUNDATION, HAS A FAMILY MEMBER WHO WORKS AS A MEDICAL ASSISTANT FOR SMF-NORTH.

Schedule L (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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: SUTTER MEDICAL FOUNDATION (SMF) IS A COMMUNITY BASED, NOT-FOR-PROFIT MEDICAL ORGANIZATION SERVING NORTHERN CALIFORNIA COMMUNITIES AND SUPPORTING THE FOLLOWING CHARITABLE ORGANIZATIONS: SUTTER MEDICAL CENTER OF SACRAMENTO, SUTTER AUBURN FAITH HOSPITAL, SUTTER DAVIS HOSPITAL, SUTTER ROSEVILLE MEDICAL CENTER, SUTTER SOLANO HOSPITAL AND SUTTER AMADOR HOSPITAL. WITH CARE CENTERS LOCATED IN SACRAMENTO, YOLO, SUTTER, YUBA, SOLANO PLACER AND AMADOR COUNTIES WE DO OUR PART TO ENSURE THE HEALTH AND WELL BEING OF OUR COMMUNITIES. OUR MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH NOT FOR PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE. WE VALUE EXCELLENCE AND QUALITY, CARING AND COMPASSION, HONESTY AND INTEGRITY, TEAMWORK AND COMMUNITY. SUTTER MEDICAL FOUNDATION IS ALIGNED WITH PHYSICIAN AND MID-LEVEL PROVIDERS OF SUTTER MEDICAL GROUP AND SUTTER NORTH MEDICAL GROUP OFFERING PRIMARY CARE AND SPECIALTY CARE TO OUR PATIENTS. OFFERING A FULL RANGE OF MEDICAL SERVICES, SUTTER MEDICAL FOUNDATION PROVIDES AMBULATORY SURGERY, URGENT CARE CLINICS, HOME HEALTH, HOSPICE AND STATE OF THE ART IMAGING AND CARDIOLOGY TECHNOLOGY. IN ADDITION WE OPERATE A RURAL HEALTH CLINIC IN THE COMMUNITY OF BROWNSVILLE, YUBA COUNTY. THE FOUNDATION PROVIDED MORE THAN $37 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT PROGRAMMING. THE FOUNDATION SERVED 3,860,432 PATIENTS IN 2014. FOCUS ON CHILDHOOD OBESITY AND HEALTH EDUCATION SUTTER MEDICAL FOUNDATION HAS PARTNERED WITH YUBA CITY UNIFIED SCHOOL DISTRICT TO ENHANCE THE PHYSICAL EDUCATION PROGRAMS FOR STUDENTS K-5. THE PARTNERSHIP INCLUDES DEDICATED TEACHING STAFF FOR PHYSICAL EDUCATION AND FAMILY EDUCATION PROGRAMS TO ASSIST PARENTS AND GUARDIANS IN MAKING HEALTHY CHOICES FOR THEIR FAMILIES. SMF ALSO PROVIDES PHYSICALS FOR THE FOOTBALL PLAYERS AT MARYSVILLE HIGH SCHOOL. IN ADDITION, SMF RUNS THE KIDSHAPE PROGRAM, WHICH EVOLVED INTO THE BESTRONG PROGRAM IN 2012. BESTRONG IS A PROGRAM DESIGNED FOR THE ENTIRE FAMILY AND TARGETS CHILDREN WHO CAN BENEFIT FROM EATING MORE NUTRITIOUSLY, INCREASING PHYSICAL ACTIVITY AND ENHANCING MENTAL WELLNESS. CLASS PARTICIPANTS LEARN ABOUT ADOPTING A HEALTHIER LIFESTYLE THROUGH INTERACTIVE GAMES, PHYSICAL ACTIVITIES, COOKING DEMONSTRATIONS AND DISCUSSIONS ABOUT FOOD CHOICES AND BEHAVIORS. IN 2013, SMF ANNOUNCED ITS PARTNERSHIP WITH FIT QUEST, WHICH HAS EXPANDED ITS NUTRITION AND FITNESS PROGRAM FOR YOUTH IN YUBA CITY AND MARYSVILLE SCHOOL DISTRICTS. THE MERGER OF THE BESTRONG PROGRAM WITH FIT QUEST CONTINUES TO ALLOW SMF TO BRING ONE COMPREHENSIVE CHILDREN WELLNESS PROGRAM TO THE YUBA-SUTTER COMMUNITY. FIT QUEST PROGRAM HAS EXPANDED TO REACH 36 SCHOOLS IN YUBA AND SUTTER COUNTIES IN THIS 2014/2015 SCHOOL YEAR, WITH 108 SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS AT SHADY CREEK OUTDOOR SCHOOL. OVER 2,400 LOCAL STUDENTS HAVE BEEN IMMERSED IN THE YEARLONG EXPOSURE TO THE FIT QUEST CURRICULUM, WHICH ARE 1,300 MORE STUDENTS THAN LAST YEAR. SEVERAL HUNDRED ADDITIONAL LOCAL STUDENTS HAVE PARTICIPATED IN THE FIT QUEST ASSEMBLIES AT VARIOUS SCHOOLS THAT ALSO INCLUDE THE YOUNGER STUDENTS. THE EXPANDED CURRICULUM AND ROLE MODELING OF THE NATURALISTS HAVE FAVORABLY IMPACTED THE NEARLY 5000 STUDENTS WHO HAVE ATTENDED FROM ALL COUNTIES IN OUR SERVICE AREA, IN CHOOSING TO DRINK WATER, MAKE BETTER NUTRITION CHOICES, TO STAY ACTIVE AND AN IMPROVED SENSE OF SELF. SUPPORT GROUPS SUTTER MEDICAL FOUNDATION PROVIDES A VARIETY OF FREE SUPPORT GROUPS TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. PATIENTS CAN RECEIVE SUPPORT FOR DIABETES, CHILDBIRTH EDUCATION, AUTISM AND PARKINSON'S. LOOK GOOD, FEEL BETTER THE "LOOK GOOD FEEL BETTER" IS A NATIONWIDE PROGRAM THAT IS DESIGNED FOR WOMEN WHO ARE GOING THROUGH CANCER TREATMENT. THE PROGRAM SHOWS SURVIVORS HOW TO USE MAKE-UP, SCARVES AND WIGS THAT WILL HELP THEM LOOK MORE LIKE THEIR PRE-TREATMENT SELVES. PINK OCTOBER, WOMEN'S HEALTH SCREENING DAY & FREE MAMMO SCREENINGS SUTTER MEDICAL FOUNDATION HOSTS WOMEN'S HEALTH SCREENING DAY ANNUALLY AND JOINS FORCES WITH THE YUBA-SUTTER PINK OCTOBER COMMITTEE TO INCREASE AWARENESS OF EARLY DETECTION OF BREAST CANCER. WOMEN'S HEALTH SCREENING DAY PROVIDES RECTAL, CLINICAL BREAST, PAP AND BONE DENSITY SCREENINGS AT A FREE OR MINIMAL COST TO WOMEN WHO EITHER ARE UNDER OR NOT INSURED. PROVIDERS FROM SUTTER NORTH MEDICAL GROUP, IN YUBA CITY AND THE RURAL COMMUNITY OF BROWNSVILLE, DONATE THEIR TIME TO THE WOMEN'S HEALTH SCREENING DAY. ADDITIONALLY, THROUGHOUT THE MONTH OF OCTOBER, SUTTER DIAGNOSTIC IMAGING CENTERS ACROSS THE REGION PROVIDED UNINSURED AND UNDERINSURED WOMEN THE OPPORTUNITY TO RECEIVE FREE DIGITAL MAMMOGRAMS. AS A RESULT OF THESE COLLABORATIVE EVENTS, WE WERE ABLE TO SCREEN 395 UNINSURED WOMEN. IN YUBA CITY, THE ANNUAL PINK OCTOBER EFFORT WAS ANOTHER RESOUNDING SUCCESS, WITH 181 UNDERINSURED WOMEN RECEIVING LOW-COST MAMMOGRAMS AT OUR SUTTER FACILITIES IN THE YUBA-SUTTER SERVICE AREA, WHILE ANOTHER 157 WOMEN RECEIVED LOW COST WELL WOMAN EXAMS THROUGH THE WOMEN'S HEALTH SCREENING EVENT HELD AT SUTTER FACILITIES IN YUBA CITY AND BROWNSVILLE. BETWEEN THESE TWO CRUCIAL BREAST CANCER AWARENESS EFFORTS AND THE LOW COST HEALTH SCREENINGS, WE SERVED A TOTAL OF 733 WOMEN THROUGHOUT THE SUTTER HEALTH SACRAMENTO SIERRA REGION IN THE MONTH OF OCTOBER. AT MANY OF THE FREE MAMMOGRAM EVENTS, WE HAD INSURANCE ENROLLMENT SPECIALISTS FROM SACRAMENTO COVERED ONSITE TO EDUCATE, CONNECT AND ENROLL PATIENTS WHO NEEDED HEALTH INSURANCE. AS A RESULT, THE SACRAMENTO COVERED TEAM CONNECTED WITH 175 WOMEN AND PROVIDED THEM WITH INSURANCE EDUCATION AND RESOURCES. IN ADDITION, OUR ED NAVIGATORS FROM WELLSPACE HEALTH ATTENDED SOME OF THE SCREENING EVENTS TO PROVIDE ONSITE PRIMARY AND MENTAL HEALTH CARE REFERRALS AND OTHER COMMUNITY RESOURCES TO THE WOMEN, AS CONNECTING THE UN- AND UNDERINSURED POPULATION TO INSURANCE, COMMUNITY RESOURCES AND A MEDICAL HOME IS MORE CRITICAL THAN EVER. THE WELLSPACE HEALTH NAVIGATORS PROVIDED REFERRAL SERVICES AND EDUCATION TO 63 WOMEN. PROSTATE SCREENING SUTTER MEDICAL FOUNDATION CONTINUES TO HOST THE PROSTATE SCREENING EVENT. IN 2014, WE REDUCED THE EVENT TO A HALF DAY DUE TO BEING DOWN ONE PROVIDER. A TOTAL OF 30 MEN RECEIVED LOW COST SCREENINGS. MUCH LIKE THE WOMEN'S HEALTH AND MAMMO SCREENINGS, WE HAD INSURANCE ENROLLMENT SPECIALISTS FROM COVERED CALIFORNIA ATTEND THE PROSTATE SCREENING TO EDUCATE, CONNECT AND ENROLL PATIENTS WHO NEEDED HEALTH INSURANCE. THE COVERED CA TEAM MADE MANY GREAT CONNECTIONS WITH MANY PATIENTS AND FOLLOWED UP WITH MANY OF THE MEN THEY MET AT THE PROSTATE SCREENING. ENROLLING THE UN- AND UNDERINSURED POPULATION WILL BE A MAJOR COMPONENT OF OUR CHNA IMPLEMENTATION PLANNING, AS THIS IS THE FIRST STEP TO CONNECTING PATIENTS WITH PRIMARY CARE. 2014 COMMUNITY SPONSORED EVENTS IN 2014, SUTTER MEDICAL FOUNDATION DONATED TO SEVERAL VARIOUS COMMUNITY EVENTS. WE MAKE IT OUR POLICY TO SUPPORT LOCAL AND NATIONAL NOT-FOR-PROFIT ORGANIZATIONS AND PUBLIC INSTITUTIONS IN NEED OF ASSISTANCE. MOREOVER, OUR EMPLOYEES MAKE EVERY EFFORT TO DONATE THEIR TIME TO LOCAL CAUSES AND YOU WILL FIND MANAGEMENT, PROVIDERS AND STAFF VOLUNTEERING WITH THE AMERICAN CANCER SOCIETY, UNITED WAY, MARCH OF DIMES, NATIONAL DIABETES SOCIETY, AMERICAN HEART ASSOCIATION, KIWANIS, ROTARY, SOROPTIMIST, GIRLS ON THE RUN, CHAMBER OF COMMERCE AND IN COMMUNITY SCHOOLS AND RELIGIOUS ORGANIZATIONS. TATTOO REMOVAL PROGRAM THE TATTOO REMOVAL PROGRAM (TATS OFF) REMOVES VISIBLE GANG TATTOOS FROM THE FACE, NECK, HANDS OR WRISTS (AND ANKLES FOR WOMEN), ELIMINATING THE STIGMA OF A PAST LIFESTYLE. IT NORMALLY TAKES FROM THREE TO TEN LASER TREATMENTS TO COMPLETE THE REMOVAL OF EACH DESIGN. THESE SESSIONS ARE SCHEDULED ONE MONTH APART TO FACILITATE PROPER HEALING BEFORE THE NEXT TREATMENT. THE OBJECTIVE IS TO MAKE IT EASIER FOR PEOPLE TO BEGIN A NEW LIFE, OBTAIN EMPLOYMENT AND ESCAPE BEING NEGATIVELY AND INACCURATELY STEREOTYPED.
FORM 990, PART VI, LINE 1A	THE AFFAIRS AND MANAGEMENT OF SUTTER MEDICAL FOUNDATION (SMF) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SMF DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF AT LEAST FIVE BOARD MEMBERS INCLUDING SMF'S CHAIR WHO SHALL SERVE AS CHAIR OF THE COMMITTEE, THE VICE CHAIR, THE CHAIR OF THE FINANCE AND PLANNING COMMITTEE, AN ADDITIONAL DIRECTOR AND THE PRESIDENT OF SMF. AT LEAST ONE COMMITTEE MEMBER IS A PHYSICIAN DIRECTOR.
FORM 990, PART VI, LINE 6 & 7A	DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS: THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 7B	DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS: SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL.
FORM 990, PART VI, LINE 11B	DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990: SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM.
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 2014.
FORM 990, PART XI, LINE 19	AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GENERAL 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: GAIN/(LOSS) ON HEALTH CARE INVESTMENTS $ 9,402,956 K-1 ORDINARY INCOME (9,326,030) K-1 GUARANTEED PAYMENTS (712,670) K-1 INTEREST INCOME (5,113) K-1 SECTION 1231 47,041 EQUITY TRANSFERS (NET) 31,713,018 OTHER CHANGES IN FUND BALANCE 14,822 TOTAL ------------- 31,134,024 =============

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach 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 MEDICAL FOUNDATION

Employer identification number

68-0273974

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

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?
(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	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 MED 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 SER	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 ROSEVILLE MEDICAL CTR FOUNDATION ONE MEDICAL PLAZA ROSEVILLE,CA95661 68-0040113	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes
(26) SUTTER SOLANO CHARITABLE FOUNDATION 300 HOSPITAL DRIVE VALLEJO,CA94589 94-2668262	FUNDRAISING	CA	501(C)(3)	7	SUTTER SSR	Yes
(27) SUTTER VISITING NURSE ASSOC AND HOSPICE 1900 POWELL ST 300 EMERYVILLE,CA94608 94-6068843	HEALTHCARE	CA	501(C)(3)	9	SUTTER HLTH	Yes
(28) SUTTER WEST BAY HOSPITALS 2333 BUCHANAN STREET SAN FRANCISCO,CA94115 94-0562680	HOSPITAL	CA	501(C)(3)	3	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

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	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 VEN	CA	NA
(5) SAN FRANCISCO ENDOSCOPY CENTER LLC 3000 RIVERCHASE BIRMINGHAM,AL35244 91-2160588	ENDOSCOPY JV	CA	NA
(6) PRESIDIO SURGERY CENTER LLC 1635 DIVISADERO SF,CA94115 32-0144060	AMBULATORY SURG	CA	NA
(7) SUTTER FAIRFIELD SURGERY CTR 2700 LOW CT FAIRFIELD,CA94533 30-0233892	SURGERY	CA	SUTTER MED FDN	RELATED	2,191,879	1,490,164		No	0	Yes		82.500 %
(8) TWIN CITIES SURGICAL HOSPITAL LLC 250 S WACKER CHICAGO,IL60606 35-2182617	SURGERY	CA	SUTTER MED FDN	RELATED	1,151,711	5,271,516		No	0		No	51.470 %
(9) SUTTER AMADOR SURGERY CENTER LLC 2200 RIVER PLAZA DRIVE SACRAMENTO,CA95833 46-1398093	SURGERY	CA	NA	RELATED	-14,456	910,241		No	0	Yes		32.000 %
(10) ROSEVILLE ENDOSCOPY CENTER LLC 4 MEDICAL PLAZA SUITE 210 ROSEVILLE,CA95661 87-0710513	ENDOSCOPY JV	CA	NA	RELATED	2,007,239	460,024		No	0	Yes		40.000 %
(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

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) HEALTH VENTURES INC 350 HAWTHORNE ST OAKLAND,CA94609 94-2918780	HEALTH SERVIC	CA	NA	C CORP			Yes

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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) SUTTER MEDICAL CENTER CASTRO VALLEY	m	151,025	FMV
(2) SUTTER HEALTH SACRAMENTO SIERRA REGION	k	9,035,978	FMV
(3) SUTTER HEALTH SACRAMENTO SIERRA REGION	s	17,686,075	FMV
(4) SUTTER HEALTH SACRAMENTO SIERRA REGION	l	31,088,512	FMV
(5) SUTTER HEALTH SACRAMENTO SIERRA REGION	M	7,529,313	FMV

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	3,683
6	Total number of volunteers (estimate if necessary) .............	6	34
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	300,222
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	938,651	638,319
9	Program service revenue (Part VIII, line 2g) .........	765,084,058	920,684,101
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	332,187	245,738
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	249,098	309,448
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	766,603,994	921,877,606
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	51,212	0
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)	194,564,978	248,854,454
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 341,649
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	571,525,154	676,356,850
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	766,141,344	925,211,304
19	Revenue less expenses. Subtract line 18 from line 12.......	462,650	-3,333,698
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	345,208,495	380,967,624
21	Total liabilities (Part X, line 26).............	123,238,524	130,712,764
22	Net assets or fund balances. Subtract line 21 from line 20.....	221,969,971	250,254,860

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 826,760,521 including grants of $ 0 ) (Revenue $ 920,684,101 )
	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 expenses826,760,521

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,801,525	11,878,929	4,693,634

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a		908
b	Membership dues....1b
c	Fundraising events....1c		103,419
d	Related organizations...1d
e	Government grants (contributions)1e		750

f	All other contributions, gifts, grants, and similar amounts not included above1f		533,242

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			638,319
			Business Code
2a	PATIENT SERVICE REVENUE		621110	905,650,010	905,650,010
b	ROSEVILLE ENDOSCOPY		621110	2,007,239	2,007,239
c	SUTTER FAIRFIELD SURGERY CENTER		621110	2,191,879	2,191,879
d	TWIN CITIES SURGICAL HOSPITAL		621110	1,150,803	1,150,803
e	ASC OPERATORS LLC		621110	4,636,521	4,636,521
f	All other program service revenue .			5,047,649	5,047,649
g	Total. Add lines 2a–2f........			920,684,101
3	Investment income (including dividends, interest, and other similar amounts).......			245,738			245,738
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	176,159
b	Less: rental expenses	176,159
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ 103,419 of contributions reported on line 1c). See Part IV, line 18 ..
	a		33,398
b	Less: direct expenses ...b		27,724
c	Net income or (loss) from fundraising events..			5,674			5,674
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		3,585
b	Less: direct expenses ...b		33
c	Net income or (loss) from gaming activities...			3,552			3,552
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..			0
Miscellaneous Revenue			Business Code
11a	UBI - SFSC ADMIN FEE		541610	24,569		24,569
b	UBI - TWIN CITIES MANAGEMENT FEE		541900	275,653		275,653
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			300,222
12	Total revenue. See Instructions......			921,877,606	920,684,101	300,222	254,964


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			0	1	0
2	Savings and temporary cash investments .........			30,867,283	2	30,066,242
3	Pledges and grants receivable, net ...........			309,085	3	215,322
4	Accounts receivable, net .............			59,261,118	4	67,030,838
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 ..............			4,774,229	8	6,114,270
9	Prepaid expenses and deferred charges ..........			1,334,245	9	1,902,922
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	436,069,731
b	Less: accumulated depreciation .....	10b	221,181,098	201,807,436	10c	214,888,633
11	Investments—publicly traded securities ..........			2,562,549	11	3,115,075
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			19,927,549	13	18,999,289
14	Intangible assets ...............			2,225,876	14	21,076,327
15	Other assets. See Part IV, line 11 ...........			22,139,125	15	17,558,706
16	Total assets. Add lines 1 through 15 (must equal line 34)......			345,208,495	16	380,967,624
17	Accounts payable and accrued expenses .........			77,338,486	17	84,608,010
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			39,935,348	20	38,861,688
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 ....			199,909	24	76,887
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....................			5,764,781	25	7,166,179
26	Total liabilities. Add lines 17 through 25.........			123,238,524	26	130,712,764
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			220,607,771	27	248,493,750
28	Temporarily restricted net assets ...........			1,362,200	28	1,761,110
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			221,969,971	33	250,254,860
34	Total liabilities and net assets/fund balances ........			345,208,495	34	380,967,624