TY 2015 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) KEVIN MCCARTHY...................................................................... CHAIR	2.0 ................. 0.0	X	X	0
(2) CLINT ADAMS...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(3) ROSANNE BADER...................................................................... VICE CHAIR	2.0 ................. 0.0	X	X	0
(4) KENNETH BROWN MD...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(5) RICHARD P CREAN...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(6) RICHARD FASS...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(7) ROGER GINSBURG...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(8) BILL MCCOLLUM...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(9) STEPHEN MORGAN...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(10) CURTIS W MORRIS...................................................................... DIRECTOR	2.0 ................. 2.0	X		0
(11) THOMAS F NUSS...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(12) JAN PAULSON...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(13) CID PINEDO...................................................................... DIRECTOR	2.0 ................. 0.0	X		0
(14) DWARAKNATH P REDDY...................................................................... DIRECTOR	2.0 ................. 0.0	X		22,055
(15) PAUL REISCH MD...................................................................... DIRECTOR	2.0 ................. 0.0	X		800
(16) M HELLEN RODRIGUEZ MD...................................................................... DIRECTOR	2.0 ................. 2.0	X		0
(17) TONY SPANO...................................................................... DIRECTOR	2.0 ................. 0.0	X		0

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SHARON STATLER........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0
(19) BILL STEAD........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0
(20) REGINALD WEBB........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0
(21) RICHARD YOCHUM........................................................................ PRESIDENT/CEO	36.0 .......................4.0	X	X			905,037	978,884
(22) JANE GOODFELLOW........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0
(23) RONALD T VERA........................................................................ VICE CHAIR	2.0 .......................0.0	X	X			0	0
(24) YALLAPRAGADA RAO MD........................................................................ DIRECTOR	2.0 .......................0.0	X				71,720	0
(25) CHRIS ALDWORTH........................................................................ VP, PLANNING & TRAUMA CTR	40.0 .......................0.0		X			303,807	44,498
(26) MICHAEL NELSON........................................................................ TREASURER/SECRETARY/CFO	39.0 .......................1.0		X			852,545	192,543
(27) JULI HESTER........................................................................ ASST. TREASURER/VP FINANCE	39.0 .......................1.0		X			294,688	54,616
(28) DARLENE SCAFFIDDI........................................................................ VP OF NURSING	40.0 .......................0.0			X		358,697	65,848
(29) KENNETH K NAKAMOTO........................................................................ VP MED STAFF AFF	40.0 .......................0.0				X	405,074	59,633
(30) KENT G HOYOS........................................................................ CIO	40.0 .......................0.0				X	399,500	65,602
(31) RAY INGE........................................................................ VP HUMAN RESOURCES & PAY ROLL	40.0 .......................0.0				X	328,803	55,732
(32) MICHAEL L VESTINO........................................................................ VP, SUPPORT SERVICES	40.0 .......................0.0				X	306,523	57,594
(33) JAMES MC DALE........................................................................ VP, DEVELOPMENT	4.0 .......................36.0				X	302,095	42,312

(A) Name and business address	(B) Description of services	(C) Compensation
PREMIER FAMILY MEDICINE ASSOC, 1770 N Orange Grove POMONA,CA91767	MEDICAL SERVICES	8,276,528
EMERALD TEXTILES LLC, 1725 DORMOTH CT STE 101 SAN DIEGO,CA921547206	LAUNDRY SERVICES	1,921,125
HOSPITALIST CORP OF THE INLAND EMPI, 840 TOWNE CENTER DRIVE POMONA,CA91767	MEDICAL SERVICES	1,839,231
NURSE BRIDGE CONSULTANTS, 1010 NORTH 102ND STREET SUITE 300 OMAHA,NE68114	RN STAFFING AGENCY	1,626,400
CHAPARRAL MEDICAL GROUP, 840 TOWNE CENTER DRIVE POMONA,CA91767	MEDICAL SERVICES	1,332,909
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 56

- 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.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

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 (Form 990 or 990-EZ))

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

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(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)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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—2014. 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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—2014. 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) 2015

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.

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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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).

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

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

2015

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

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 other 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization POMONA VALLEY HOSPITAL MEDICAL CENTER

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization POMONA VALLEY HOSPITAL MEDICAL CENTER		Employer identification number 95-1115230

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization POMONA VALLEY HOSPITAL MEDICAL CENTER			Employer identification number 95-1115230
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.) $ 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) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

33,033

Total. Add lines 1c through 1i ....................................................................................................

33,033

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

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

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1I	LOBBYING EXPENSE LOBBYING EXPENSE IS INCLUDED IN THE ANNUAL DUES FOR THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND CHA/CAHHS.

Schedule C (Form 990 or 990EZ) 2015

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," on 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

2015

Open to Public Inspection

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	7,711,079	9,702,737	8,449,302	8,486,234	7,920,987
b	Contributions ...	340,670	245,470	181,102	635,575	774,547
c	Net investment earnings, gains, and losses	-34,511	361,425	1,072,333	-672,507	-209,300
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,025,546	2,598,553
f	Administrative expenses ....
g	End of year balance ......	6,991,692	7,711,079	9,702,737	8,449,302	8,486,234

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

Board designated or quasi-endowment SchDMd Bullet

6.150 %

Permanent endowment SchDMd Bullet

88.210 %

Temporarily restricted endowment SchDMd Bullet

5.640 %

The percentages on 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)

Yes

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

Yes

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' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	6,515,017	14,118,390		20,633,407
b	Buildings		173,822,779	94,172,798	79,649,981
c	Leasehold improvements		11,639,983	8,018,206	3,621,777
d	Equipment ...		414,705,961	320,140,520	94,565,441
e	Other ...		42,201,257	0	42,201,257
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					240,671,863

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) MALPRACTICE RECEIVABLE				5,208,500
(2) WORKERS COMP RECEIVABLE				5,002,596
(3) RETIREMENT PLAN ASSETS				721,837
(4) INTEREST RECEIVABLE				8,259,344
(5) DEFERRED COMPENSATION				796,116
(6) HOSPITAL FEE RECEIVABLE				17,560,979
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				37,549,372

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
SELF INSURANCE RESERVES	21,982,027
DEFERRED COMPENSATION	2,331,330
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	24,313,357
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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 V, LINE 4

POMONA VALLEY HOSPITAL MEDICAL CENTER HAS A PERMANENTLY RESTRICTED ENDOWMENT FROM A RESTRICTED DONATION RECEIVED THROUGH A UNITRUST. THE INCOME FROM THIS IS USED TO SUPPORT THE HOSPITAL'S OPERATIONS. IN ADDITION, POMONA VALLEY HOSPITAL MEDICAL CENTER FOUNDATION HAS ENDOWMENTS THAT CONSISTS OF FUNDS RAISED FOR VARIOUS PROJECTS AS DESIGNATED BY THE HOSPITAL BOARD INCLUDING THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CENTER ENDOWMENT FUND AND THE STEAD HEART AND VASCULAR CENTER ENDOWMENT FUND. ANNUALLY, 85% OF THE INTEREST INCOME FROM THE CANCER CENTER ENDOWMENT FUND IS DISTRIBUTED TO THE HOSPITAL FOR PROJECTS INVOLVING EDUCATION, SCREENINGS AND SUPPORT GROUPS. THE ENDOWMENTS HELD BY THE FOUNDATION ARE INCLUDED IN THE AMOUNTS REPORTED ON PART V OF SCHEDULE D.

SCHEDULE D, PART V, COLUMN B

THE PRIOR YEAR COLUMN HAS BEEN UPDATED TO MATCH THE AMOUNTS AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THEREFORE, The END OF YEAR BALANCE IN THE PRIOR YEAR COLUMN WILL NOT MATCH THE AMOUNTS REPORTED ON PRIOR YEAR'S FORM 990.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on 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

2015

Open to Public Inspection

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

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? . . . . . .

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) . . .			3,382,741		3,382,741	0.660 %
b	Medicaid (from Worksheet 3, column a) . . . . .			244,470,230	199,029,812	45,440,418	8.850 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			247,852,971	199,029,812	48,823,159	9.510 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	82	42,033	2,115,110	1,354,873	760,237	0.150 %
f	Health professions education (from Worksheet 5) . . .	24	5,478	4,207,254	766,104	3,441,150	0.670 %
g	Subsidized health services (from Worksheet 6) . . . .	18	557	4,349,531		4,349,531	0.850 %
h	Research (from Worksheet 7) .	2	51	99,780		99,780	0.020 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1		698,054		698,054	0.140 %
j	Total. Other Benefits . .	127	48,119	11,469,729	2,120,977	9,348,752	1.830 %
k	Total. Add lines 7d and 7j .	127	48,119	259,322,700	201,150,789	58,171,911	11.340 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	2	4,500	8,700		8,700	0 %
3	Community support	5	1,400	16,150		16,150	0 %
4	Environmental improvements
5	Leadership development and training for community members	1	100	400		400	0 %
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	2	150	529,534		529,534	0.100 %
9	Other	17	30,645	191,086	2,636	188,450	0.040 %
10	Total	27	36,795	745,870	2,636	743,234	0.140 %

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. ......

23,345,351

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).....

68,109,223

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

59,888,528

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

8,220,695

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 %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

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)
1	Pomona Valley Hospital Medical Center 1798 N Garey Avenue Pomona,CA91767 WWW.PVHMC.ORG 930000128	X	X	X	X

Schedule H (Form 990) 2015

Page 4

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)

	POMONA VALLEY HOSPITAL MEDICAL CENTER
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 15

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

6 a

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

Yes

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):

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 15

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

12b

If "Yes" on 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	POMONA VALLEY HOSPITAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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):

SEE PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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) 2015

Page 6

Part VFacility Information (continued)

	POMONA VALLEY HOSPITAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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 19. (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) 2015

Page 7

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	The 2015 Community Needs Assessment included input from Los Angeles County SPA 3 and SPA 4 public health officer, Christin Mondy. In a telephone interview conducted on December 5, 2014, PVHMC research objectives included identifying community health concerns, barriers to care, recommendations for community benefit programs, and recommendations for collaboration in the community. Public health needs identified included physical fitness and nutrition needs, high incidence of diabetes, substance abuse, concerns for safety in the community as it relates to physical activity among children, homelessness, and lack of routine preventative care. Public health recommendations for collaboration and implementation of community benefit programs included increasing communication of available education and classes offered at PVHMC, providing programs for healthy food and nutrition education, and providing diabetes education and management resources. The Institute of Applied Research (IAR) is pleased to present the results of its 2015 Community Needs Assessment for Pomona Valley Hospital Medical Center (PVHMC). Whereas in 2009 and 2012 IAR contributed to the needs assessment by collecting primary data for the study, the 2015 report summarizes IARs results of both primary data and secondary data collection, as well as focus groups composed primarily of individuals representing minority and low-income individuals (a medically underserved population). Primary data was collected via telephone survey and consisted of input from 333 residents- including low income, medically-underserved and minority members- within eleven communities that we serve. Telephone interviews were conducted by the Institute of Applied Research at California State University, San Bernardino using computer assisted telephone interviewing (CATI) equipment and software. The surveys were conducted between January 7 and January 10, 2015. Surveys were conducted on a variety of days and times Wednesday, Thursday, and Friday from 3:00 p.m. to 9:00 p.m.; and Saturday 10:00 a.m. to 5:00 p.m. in order to maximize the chances of completing a survey with the selected respondents. A total of 333 residents were surveyed from the eleven cities within PVHMCs service area, resulting in a 95 percent level of confidence and an accuracy of +/- 5.4%. A total of 12% of the surveys were conducted in Spanish. Primary data was collected via a telephone survey from residents within PVHMCs service area to determine their perceptions and needs regarding various health issues, and to see if there have been any changes since the 2009 and 2012 data in previous needs assessments. Specific issues and questions included: Demographic profile (including self-reported health evaluation); Health insurance coverage: insurance coverage, type of insurance, reason(s) for no coverage; Barriers to receiving needed health services; Utilization of health care services for routine primary/preventative care: how long since last physical, childrens preventative care and immunizations; adults routine health screening tests; Utilization of urgent care services; Need for specialty health care: chronic or ongoing health problems, adequate help dealing with disease, unmet needs; History of getting screened for cancer (and reasons for not being screened); Experience with and evaluation of PVHMC: reasons for selecting PVHMC, health care services, classes, support groups, emergency room, improving the health of the community; and Suggestions for ways PVHMC can improve the health of the community. In addition, secondary data were collected from a variety of sources regarding health status indicators and major health influencers for PVHMCs service area: Health status indicators: cardiovascular disease, diabetes, cancer, high blood pressure, obesity, leading cause of death. These indicators were compared to Healthy People 2020 goals at the SPA (Service Planning Area) 3 level, Los Angeles County level, and San Bernardino County level; Major health influencers: smoking/tobacco use, physical activity levels, health insurance coverage. These indicators were compared to Healthy People 2020 goals at the SPA 3 level, Los Angeles County level, and San Bernardino County level. Finally, IAR conducted a focus group consisting of representatives of low-income, minority, and medically underserved populations. On January 20, 2015, IAR had the opportunity to meet with six community leaders representing minorities and medically underserved individuals. More specifically, these leaders represented the homeless, low income, youth and adults, and domestic violence victims. They are on the front lines, providing services such as: delivering comprehensive health care for individuals of all ages; organizing fitness programs for families and individuals who are trying to regain or maintain a healthy lifestyle; working with victims of domestic violence who have suffered emotional and physical trauma and need counseling, intervention, shelter, transitional housing, and anger management services; providing primary care; overseeing services such as emergency food and shelter, and a community Farmers Market; and engaging in community outreach and health care coverage enrollment. PVHMC representatives conducted two additional focus groups studies on October 2, 2014 and again on January 6, 2015 with stakeholders in the community: Community Senior Services, a not-for-profit organization primary serving the needs of our senior population, and The Health Consortium of the Greater San Gabriel Valley, comprised of representatives from various health organizations and federally qualified health clinics whose primary focus is on improving the health and well-being of Los Angeles Countys SPA 3 through collaborative partnerships that strengthen the healthcare safety net. Every attempt was made to solicit primary, secondary, and health-related information relative to the communities we serve. In some instances, PVHMCs ability to assess the health needs was limited by lack of existing data at the city and county level. Additionally, in some instances, comparable health-related data was limited across both counties in which our primary service area encompasses.
SCHEDULE H, PART V, SECTION B, LINE 6B	POMONA VALLEY HOSPITAL MEDICAL CENTER CONDUCTED IT'S CHNA WITH CALIFORNIA STATE UNIVERSITY SAN BERNARDINO'S INSTITUTE OF APPLIED RESEARCH.
SCHEDULE H, PART V, SECTION B, LINE 7A	CHNA URL https://www.pvhmc.org/uploads/files/pdf_494_11.pdf
SCHEDULE H, PART V, SECTION B, LINE 10A	IMPLEMENTATION STRATEGY URL https://www.pvhmc.org/uploads/files/pdf_494_4.pdf
SCHEDULE H, PART V, SECTION B, LINE 11	Significant health needs identified in our 2015 community needs assessment are health education classes and support groups, diabetes, obesity, high blood pressure, Alzheimers and dementia, access to primary and specialty care, care coordination, transportation, promotoras, mental health services, and better promotion of what PVHMC already offers to the community. PVHMC prioritized these needs into three overarching themes as a framework for PVHMC to organize, maintain, and implement community benefit programs and services. These prioritized health needs are chronic disease management, health education and support groups, and access to care. The community needs assessment and health needs priorities were adopted by our governing Board of Directors on May 7, 2015. Community health needs were determined to be significant through evaluation of primary and secondary data, whereby those identified health needs were prioritized based upon: (1) community respondents and key informants identified the need to be significant, or largely requested specific services that they would like to see Pomona Valley Hospital Medical Center provide in the community (2) feasibility of providing interventions for the unmet need identified in the community, in such that Pomona Valley Hospital Medical Center currently has, or has the current means of developing the resources to meet the need, and (3) alignment between the identified health need and Pomona Valley Hospital Medical Centers mission, vision, and strategic plan. In support of PVHMCs Community Health Needs Assessment (CHNA), and ongoing Community Benefit Plan initiatives, Pomona Valley Hospital Medical Centers supporting Implementation Strategy documents the priority health needs for which PVHMC will address in the community and translates our CHNA data and research into actual strategies and objectives that can be carried out to improve health outcomes. PVHMC determined a broad, flexible approach was best as strategies and programs for community benefit are budgeted annually and may be adjusted during this 12-month period of time. Accordingly, the Implementation Strategy will be continuously monitored for progress in addressing our communitys health needs and will serve as a tool around which our community benefit programs will be tailored. PVHMC is addressing the needs of Chronic Disease Management through the following strategies: Providing glucose screenings at health fairs and events (local and on-campus); Providing free education classes to promote cardiovascular health and risk reduction; Offering free blood pressure screenings at health fairs and events (local and on-campus); Publishing and distributing free information on cardiovascular health, diabetes, cancer treatment, and available resources to address these conditions; Providing care coordination services that seek to assure patients are positioned for a safe discharge home; Providing Cancer Care Patient Coordinators and Social Services to guide patients with making appointments, receiving financial assistance, and enrolling in support groups; providing free cancer care support groups and wellness classes with emphasis on the social, emotional, nutritional, and physical aspects of chronic disease. The following programs and services are provided by PVHMC, specifically designated to address Priority Need 1, Chronic Disease Management: Stead Heart and Vascular Center lectures and classes for cardiovascular health; Saving Strokes Event; Community blood pressure screenings; Diabetic Education Fair (on-campus); Nutrition education; The Robert and Beverly Lewis Family Cancer Care Center education, wellness classes, workshops, forums, and events; Cancer Program Annual publication; Stead Heart and Vascular Center publications. PVHMC is addressing the community needs for Health Education and Support Services through the following strategies: Providing free or low-cost health education classes, wellness support groups, and other health improvement services both at PVHMC and out in a community setting; Collaborating with community partners and participate in community-wide initiatives to improve the health of the community; Increasing awareness of available classes offered at PVHMC through reaching out directly to the community and other organizations through written and verbal communication and publications; Developing education, resources, and/or classes that promotes healthy eating, disease prevention, and weight management; Participating and hosting speaking engagements to communicate to the community about health and services in the community; Providing comprehensive, culturally sensitive health forums, support groups, and workshops that provide hands-on healthy lifestyle support to the community. The following programs and services provided by PVHMC are specifically designated to address Priority Need 2 Health Education and Support Services: The Robert and Beverly Lewis Family Cancer Care Center wellness classes, support groups, early detection and prevention lectures, and community forums; Womens and Childrens Services health and education classes; Stead Heart and Vascular Center Risk Reduction Class; cardiac education; Cancer Program Annual Report; Health Fairs/Community Events; Hands-Only CPR; Sleep Disorders Meetings; Nutrition education; Hospital tours in English, Spanish, and Chinese; Inpatient smoking cessation education; Inpatient asthma education and "Every 15 minutes" drunk driving education. PVHMC is addressing the community needs for Priority Area 3, Access to Care, through the following strategies: Providing on-site enrollment assistance and for appropriate health insurance plans; participation in the hospital presumptive eligibility program; Increasing community awareness about health services offered, wellness classes, and support groups; Providing discharge transportation for vulnerable patients who are otherwise unable to get home; Providing free, low-cost or reduced-cost health services, medications, and medical devices; Providing free or reduced cost screenings and immunizations at local health fairs; Collaborating with primary care providers and clinics to improve access to preventative and specialty care; Working closely with PVHMCs Family Medicine Residency Program through UCLA to increase the number of primary care physicians in the region; expanding the emergency department to increase PVHMCs capacity to care for patients needing emergency treatment, trauma services, surgery, and primary care. Programs and services provided by PVHMC, specifically designated to address Priority Need 3 Access to Care are: PVHMC Family Medicine Residency Program; Sports Injury Evening Clinic providing free and low cost sports injury examinations and x-rays; Enrollment assistance in appropriate health plans for our patients who are admitted without insurance; Discharge transportation services for our vulnerable patients; ambulance transports; Free and low cost medication assistance; Free and low cost immunizations provided in the community. Of the health needs identified through our needs assessment, PVHMC will not address the mental health, Alzheimer's, "Promotorastransportation needs in our implementation strategy. PVHMC evaluated its capacity to serve the mental health, Alzheimer's services, "Promotorastransportation needs of our community. PVHMC does not have a licensed psychiatric facility, or the current capacity, to provide inpatient and outpatient mental health treatment services. While PVHMC has some services in place to assist with mental health and substance abuse, such as emergent psychiatric consultations, mental health referrals, and smoking cessation education, it was determined that this critical need is best served by others. PVHMC does not currently have trained "Promotoras" staff to perform peer-to-peer education out in the community. PVHMC does not currently have in place, or the current capacity to develop an Alzheimers services program; however, PVHMC does seek to continue to address this need indirectly through our social services and care coordination efforts with local community-based organizations. Additionally, while PVHMC does have in place some transportation services to assist patients, it was determined that this need at a community-wide level is best served by others. Accordingly, PVHMC will continue to support Tri-City Mental Health, Prototypes, the Department of Mental Health, the YWCA of the San Gabriel and Inland Communities, Community Senior Services, and other community based organizations that directly provide these services to address these needs. We are strongly committed to our relationships with these organizations and continuously seek partnerships and opportunities to directly address these needs in the future.
SCHEDULE H, PART V, SECTION B, LINE 13H	CALIFORNIA STATE REGULATIONS
SCHEDULE H, PART V, SECTION B, LINE 15E	The hospital will provide guidance and/or direct assistance to patients or their family representative as necessary to facilitate completion of FAP applications. Financial counselors, eligibility services liaisons and/or patient account representatives are available to provide guidance over the phone or meet in person.
SCHEDULE H, PART V, SECTION B, LINE 16A	FINANCIAL ASSISTANCE POLICY URL https://www.pvhmc.org/uploads/files/Patient%20Financial%20Assistance%20Pro gram%20Policy.pdf SCHEDULE H, PART V, SECTION B, LINE 16B FINANCIAL ASSISTANCE POLICY APPLICATION URL https://www.pvhmc.org/uploads/files/Financial%20assistance%20application.p df SCHEDULE H, PART V, SECTION B, LINE 16C FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY URL https://www.pvhmc.org/uploads/files/Financial%20Assistance%20Policy%20Plan .pdf
SCHEDULE H, PART V, SECTION B, LINE 16I	THE HOSPITAL FACILITY PUBLICIZED THE FINANCIAL ASSISTANCE POLICY BY MAKING A SUMMARY AVAILABLE IN THE FOLLOWING WAYS: - ATTACHING TO BILLING INVOICES - POSTING IN THE EMERGENCY/WAITING ROOMS - POSTING IN THE ADMISSIONS OFFICES - PROVIDING, IN WRITING, TO PATIENTS ON ADMISSION TO THE HOSPITAL - PROVIDING THE POLICY UPON REQUEST
SCHEDULE H, PART V, SECTION B, LINE 22D	FOR FINANCIAL ASSISTANCE ELIGIBLE INPATIENTS, THE "PROSPECTIVE" METHOD WILL BE USED TO DISCOUNT SERVICES PROVIDED TO ELIGIBLE UNINSURED PATIENTS. THE APPLICABLE MEDICAL APR DRG REIMBURSEMENT APPLIES TO OBSTETRICS, NEWBORNS, NEONATAL INTENSIVE CARE AND PEDIATRICS. THE MEDICARE DRG APPLIES TO ALL OTHER INPATIENT SERVICES. FOR FINANCIAL ASSISTANCE ELIGIBLE OUTPATIENTS, THE "LOOK BACK" METHOD WILL BE USED. THE REIMBURSEMENT RATE WILL BE CALCULATED BY DIVIDING THE TOTAL COLLECTIONS ON THE CLAIMS PAID IN FULL FOR THE PRECEDING CALENDAR YEAR BY THE TOTAL BILLED CHARGES ON THE CLAIMS PAID IN FULL, ADJUSTED FOR THE ANNUAL RATE INCREASE EFFECTIVE JANUARY 1 OF THE CURRENT YEAR. THE RATE CALCULATED WILL BE ROUNDED UP TO THE NEAREST 5/100TH OF A PERCENT.

Schedule H (Form 990) 2015

Page 8

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?19
Name and address		Type of Facility (describe)
1	PVHMC Radiation Therapy 1910 Royalty Drive Pomona,CA91767	RADIATION THERAPY
2	PVHMC Imaging Claremont 1601 Monte Vista Avenue Claremont,CA91711	DIAGNOSTIC CENTER
3	PVHMC Imaging Chino Hills 2140 Grand Avenue Suite 125 Chino Hills,CA91709	DIAGNOSTIC CENTER
4	PVHMC Women's Imaging 1910 Royalty Drive Pomona,CA91767	DIAGNOSTIC CENTER
5	PVHMC Milestone Physical Therapy Center 1601 Monte Vista Avenue Claremont,CA91711	REHABILITATION CENTER
6	PVHMC Sleep Center 2140 Grand Avenue Suite 125 Chino Hills,CA91709	DIAGNOSTIC CENTER
7	PVHMC Covina OP Physical Therapy Clinic 420 W Rowland Street Covina,CA91723	REHABILITATION CENTER
8	PVHMC Physical Therapy Chino Hills 2140 Grand Avenue Suite 125 Chino Hills,CA91709	REHABILITATION CENTER
9	Pomona Valley Health Center 1770 N Orange Grove Pomona,CA91767	OUTPATIENT PHYSICIAN CLINIC
10	PVHMC Physical Therapy Claremont 1601 Monte Vista Avenue Claremont,CA91711	REHABILITATION CENTER
11	PVHMC Claremont Urgent Care 1601 Monte Vista Avenue Claremont,CA91711	OUTPATIENT PHYSICIAN CLINIC
12	PVHMC Crossroads Urgent Care 3110 Chino Avenue Suite 150 Chino Hills,CA91709	OUTPATIENT PHYSICIAN CLINIC
13	PVHMC Claremont Primary Care 1601 Monte Vista Avenue Claremont,CA91711	OUTPATIENT PHYSICIAN CLINIC
14	Pomona Valley Health Center Chino Hills 2140 Grand Avenue Suite 125 Chino Hills,CA91709	OUTPATIENT PHYSICIAN CLINIC
15	PVHMC Crossroads Primary Care 3110 Chino Avenue Suite 150 Chino Hills,CA91709	OUTPATIENT PHYSICIAN CLINIC
16	PVHMC Imaging Crossroads 3110 Chino Avenue Suite 150 Chino Hills,CA91709	DIAGNOSTIC CENTER
17	Pomona Valley Imaging Center Grandview 13768 Roswell Avenue Suite 103 Chino Hills,CA91709	REHABILITATION CENTER
18	PVHMC Imaging Western University 309 Pomona Mall POMONA,CA91767	DIAGNOSTIC CENTER
19	PVHMC Claremont Aquatic Therapy Pool 481 S Indian Hill Blvd Claremont,CA91711	REHABILITATION CENTER

Schedule H (Form 990) 2015

Page 9

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
PART I, LINES 7B & 7I	The California Hospital Fee Program (the Program) was signed into law by the Governor of California and became effective on January 1, 2010. Amending legislation, to conform to changes requested by the Centers for Medicare & Medicaid Services during the approval process, was signed into law by the Governor of California and became effective September 8, 2010. The primary legislation and amending legislation contain two components. The Quality Assurance Fee Act (QAF Act) governs the "hospital fee"quality assurance fee" (QA Fee) paid by participating hospitals. The Medi-Cal Hospital Provider Stabilization Act governs supplemental Medi-Cal payments (Supplemental Payments) made to providers from the fund. Hospital participation is mandatory, with limited exceptions. The QAF Act was further expanded for 30 months from July 1, 2011 through December 31, 2013 (30-month program). The 30-month program is the third hospital fee (QAF-3) implemented in California, and it decouples the Fee-For-Service component from the Managed Care component of the Program. The fourth hospital fee (QAF-4) for the 36 months from January 1, 2014 to December 31, 2016, like the 30-month program, decouples the Fee-For-Service component from the Managed Care component of the Program. For QAF-4, the portion of the legislation addressing the Fee-For-Service component was approved in December 2014, and the Managed Care non-Medicaid Expansion portion from January 1, 2014 to June 30, 2014, was approved in June 2015. The Medical Center expensed payments to Department of Health Care Services in the accompanying consolidated statements of operations for the QA Fee in the amount of $35,483,209 in 2015 and $32,381,008 in 2014 INCLUDED ON SCHEDULE H, PART I, LINE 7B, COLUMN C. The Medical Center also recorded Pledge payments of $698,054 in 2015 and $1,225,517 in 2014 IN CONJUNCTION WITH THE PROGRAM, WHICH IS REPORTED ON SCHEDULE H, PART I, LINE 7I, COLUMN C. The QA Fee and pledge payments are recorded in California hospital fee quality assurance fee and pledge payments within the accompanying consolidated statements of operations. The Medical Center recognized supplemental payments of $87,145,744 in 2015 INCLUDED ON SCHEDULE H, PART I, LINE 7B, COLUMN D, which pertains to the period January 1, 2015 to December 31, 2015, for the Fee-For-Service portion, and January 1, 2014 to June 30, 2014, for the Managed Care non-Medicaid Expansion portion. THE INCLUSION OF THESE AMOUNTS ON LINE 7B OF PART I IN THE CURRENT YEAR DECREASES THE PERCENTAGE OF THE TOTAL EXPENSE, AS COMPARED TO 2009 (THE LAST YEAR BEFORE THE PROGRAM WAS IN EFFECT.)
PART I, LINES 7A-7I	LINE 7A USED COST-TO CHARGE METHODOLOGY USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. LINE 7B USED COST-TO CHARGE METHODOLOGY USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. LINE 7E USED ACTUAL AMOUNTS PER THE GENERAL LEDGER. LINE 7F USED ACTUAL AMOUNTS PER THE GENERAL LEDGER. LINE 7G USED ACTUAL AMOUNTS PER THE GENERAL LEDGER. LINE 7H USED ACTUAL AMOUNTS PER THE GENERAL LEDGER. LINE 7I USED ACTUAL AMOUNTS PER THE GENERAL LEDGER.
PART I, LINE 7F	HEALTH PROFESSION EDUCATION Pomona Valley Hospital Medical Center is committed to creating a healthy community in the Pomona Valley region, and in realizing this commitment, assists local schools (e.g. Chaffey College, Western University of Health Sciences, Mount San Antonio College, Citrus College, Chaffey College) in meeting requirements for their Nursing programs and to provide health profession externships, Preceptorship, and clinical experience for respiratory, radiology, and dietetic students alike. Pomona Valley Hospital Medical Center works with local area middle and high schools to introduce careers in health care by inviting them to tour our hospital and by visiting them on their campus. Our Family Medicine Residency Program trains 18 physicians each year to develop outstanding clinical skills, compassion, and excellent communication and leadership abilities. The residency is affiliated with the David Geffen School of Medicine at UCLA.
PART I, LINE 7G	Subsidized Health Services None of the money identified under the subsidized health services category pertains to a physician clinic in our Community Benefit Report.
PART II	Community Building Activities Pomona Valley Hospital Medical Center participates on the steering committee for the Los Angeles County service planning area (SPA 3s) health planning group (San Gabriel Valley Health Consortium). We participate to the to look at access to care, promotion of health and access and availability of specialty care, and how this need particularly affects our most vulnerable and medically underserved populations. Pomona Valley Hospital Medical Center is committed to providing access to care for our community through our Physician Assistance Program. This program provides loans to new physicians in specialties identified as a need, to help them with starting their practices in the community. These physicians provide needed medical care to many of our MediCal and indigent patients as a condition of participation in the assistance program. The costs and persons served associated with conducting our needs assessment are reflected on Line 8 of Part II as Workforce Development. Pomona Valley Hospital Medical Center assists local schools (e.g. Chaffey College, Western University of Health Sciences, Mount San Antonio College, Citrus College) in meeting requirements for their Nursing programs, our education department serves on the advisory boards to these schools. The costs and persons served associated are reflected on Line 3 & 8 of Part II as Community Support and Workforce Development. Pomona Valley Hospital Medical Center supports the economic development of the community by allowing local not-for-profit organization to participate in creating a sponsorship ad for their organization in our hospitals program books for community events. The costs and persons served associated with conducting our needs assessment are reflected on Line 2 of Part II as Economic Development. Pomona Valley Hospital Medical Center is one of 13 designated Disaster Resource Centers (DRC) in Los Angeles County as part of the National BioTerrorism Hospital Preparedness Program. As the DRC for the region, Pomona Valley Hospital Medical Center is responsible for 12 "umbrella" facilities in the area and coordinates drills, training, and sharing of plans to bring together the community and our resources for disaster preparedness.
PART III, LINE 2	THE BAD DEBT EXPENSE IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO SELF-PAY PATIENTS, INCLUDING BOTH UNINSURED PATIENTS AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THEIR BALANCE. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE MEDICAL CENTER'S POLICIES.
PART III, LINE 3	BAD DEBT EXPENSE IS AN ESTIMATE OF THE AMOUNT OF REVENUE DUE FROM PATIENTS COMPRISED OF 1) BALANCES DUE FROM PATIENTS AFTER INSURANCE HAS PAID WHICH MAINLY INCLUDES DEDUCTIBLES, COINSURANCE AND COPAYMENTS, AND 2) BALANCES DUE FROM UNINSURED PATIENTS WHICH INCLUDE BALANCES DISCOUNTED IN ACCORDANCE WITH THE HOSPITALS PARTIAL CHARITY POLICY FOR THOSE PATIENTS WHO QUALIFY AND OTHER BALANCES DUE FROM UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY. THE METHODOLOGY COMBINES HISTORICAL BAD DEBT WRITE-OFF TRENDS AS A PERCENTAGE OF GROSS REVENUES. THE METHODOLOGY ALSO RECOGNIZES MANY ACCOUNTS ARE WRITTEN OFF AS A BAD DEBT DUE TO LACK OF INFORMATION NEEDED TO QUALIFY THE PATIENT FOR CHARITY DISCOUNTS BUT SUBSEQUENTLY DETERMINED TO QUALIFY FOR CHARITY AFTER ADDITIONAL INFORMATION IS OBTAINED. THE LAG IN RECLASSIFYING A BAD DEBT TO CHARITY IS BUILT INTO THE METHODOLOGY USING THE HISTORICAL RATIO OF BAD DEBT EXPENSE VS. CHARITY ADJUSTMENTS. AS SUCH, THE ESTIMATED BAD DEBT EXPENSE SHOULD ONLY INCLUDE TRUE BAD DEBTS NOT PATIENTS WHO MAY BE ELIGIBLE UNDER THE HOSPITALS CHARITY POLICY.
PART III, LINE 4	THE HOSPITAL'S FINANCIAL STATEMENT INCLUDES A BAD DEBT FOOTNOTE REGARDING FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, "HEALTH CARE ENTITIES" (TOPIC 954) REGARDING THE PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES. THE BAD DEBT FOOTNOTE CAN BE FOUND ON PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8	THE COSTING METHODOLOGY USED IS COST TO CHARGE RATIO. THE SOURCE OF INFORMATION IS THE MEDICARE COST REPORT. PART III, LINE 9B THE HOSPITAL'S CREDIT AND COLLECTION POLICY APPLIES TO ALL PATIENTS WHO RECEIVE SERVICES AT POMONA VALLEY HOSPITAL MEDICAL CENTER WHO HAVE A FINANCIAL OBLIGATION TO THE HOSPITAL. THIS POLICY DEFINES THE REQUIREMENTS AND PROCESSES USED BY THE HOSPITAL BUSINESS OFFICE WHEN MAKING PAYMENT ARRANGEMENTS WITH INDIVIDUAL PATIENTS OR THEIR ACCOUNT GUARANTORS. THE CREDIT AND COLLECTION POLICY SPECIFIES THE STANDARDS AND PRACTICES USED BY THE HOSPITAL FOR THE COLLECTION OF DEBTS ARISING FROM THE PROVISION OF SERVICES TO PATIENTS AT PVHMC. THESE PRACTICES ARE APPLIED CONSISTENTLY TO PATIENTS WHOSE BALANCE RESULTS FROM AN UNPAID DEDUCTIBLE, COINSURANCE AND/OR COPAY, PATIENTS WHO HAVE BEEN APPROVED FOR FINANCIAL ASSISTANCE IN WHICH THEIR BALANCE IS DISCOUNTED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, PATIENTS WHO HAVE AGREED TO THE TERMS OF A PROMPT PAYMENT DISCOUNT AS WELL AS PATIENTS WHO HAVE NOT AGREED TO THE TERMS OF A DISCOUNT PROGRAM. IN THE EVENT THAT A PATIENT OR PATIENT'S GUARANTOR HAS MADE A DEPOSIT PAYMENT, OR OTHER PARTIAL PAYMENT FOR SERVICES AND SUBSEQUENTLY IS DETERMINED TO QUALIFY FOR FULL CHARITY CARE OR DISCOUNT PARTIAL CHARITY CARE, ALL AMOUNTS PAID WHICH EXCEED THE PAYMENT OBLIGATION, IF ANY, AS DETERMINED THROUGH THE FINANCIAL ASSISTANCE PROGRAM PROCESS, SHALL BE REFUNDED TO THE PATIENT WITH INTEREST. HOWEVER, SINCE THE APPLICATION PROCESS FOR PARTIAL CHARITY CARE MAY BE APPLIED TO ALL PRE-EXISTING ACCOUNT BALANCES OUTSTANDING AT THE TIME OF CHARITY QUALIFICATION, A PATIENT OVERPAYMENT ON ONE ACCOUNT MAY REDUCE THE PATIENT'S OUTSTANDING OBLIGATION ON ANOTHER ACCOUNT AFTER A PARTIAL CHARITY DISCOUNT HAS BEEN APPLIED. THE HOSPITAL WILL REVIEW ALL OF THE PATIENT'S ACCOUNTS AND COMPLETE A RECONCILIATION OF DISCOUNTED AMOUNTS DUE LESS TOTAL AMOUNTS PAID TO DETERMINE IF THE PATIENT OVERPAID. INTEREST SHALL BEGIN TO ACCRUE ON THE FIRST DAY THAT PAYMENT BY THE PATIENT IS RECEIVED BY THE HOSPITAL. INTEREST AMOUNTS SHALL BE ACCRUED AT THE INTEREST RATE SET FORTH IN SECTION 685.010 OF THE CODE OF CIVIL PROCEDURE. IN THE EVENT THAT THE AMOUNT OF INTEREST AND/OR THE AMOUNT OWED TO THE PATIENT IS IN THE "SMALL BALANCE RANGE" AS DEFINED BY THE HOSPITAL'S SMALL BALANCE POLICY, THE BALANCE WILL BE PROCESSED IN ACCORDANCE WITH THE SMALL BALANCE POLICY. OTHER OVERPAYMENTS FROM PATIENTS WILL BE PROCESSED IN ACCORDANCE WITH THE REFUND REQUEST POLICY.
PART VI, LINE 2	Needs Assesment In 2015, a Community Needs Assessment was completed. The assessment is intended to be a resource for PVHMC to become involved with developing and maintaining activities and programs that can help improve the health and well-being of the residents of Pomona Valley. The Community Needs Assessment process included primary and secondary data collection, including valuable community, stakeholder, and public health input that was examined to prioritize the most critical needs of our community and serve as the basis for our community benefit plan initiatives and implementation strategy. PVHMC partnered with California State university San Bernardinos Institute of Applied Research to acquire input from 333 residents via telephone survey- including low income, medically-underserved and minority members- within eleven communities that we serve. Telephone surveys were conducted between January 7 and January 10, 2015. The Principal Investigator was Barbara Sirotnik, PhD and the Project Coordinator was Lori Aldana, MBA. Additional primary data was obtained through a PVHMCs independent community health needs interview with Christin Mondy, Los Angeles County SPA 3 and SPA 4 Health Officer, and also through three focus group meetings with organizations who represent the broad interests of the communities we serve. The research objectives were to look at the demographic profile of the community, health insurance coverage, health access barriers, utilization of health care services for routine primary/preventative care, utilization of urgent care services, need for specialty health care and experience with PVHMC including classes, support groups, and the emergency department, as well as identify groups within our community that are experiencing health disparities and identify areas for potential collaboration with other community-based organizations. The Community Needs Assessment has been made widely available to the public at http://www.pvhmc.org/Community-Outreach.asp The following is a summary of findings from surveying 333 members of our community. When respondents were asked "would you say that in general your health is excellent, very good, fair or poor", most of the respondents (68.8%) said "excellent"very good". Only 3.3% said their health is "poor." These figures are not a significant shift from 2009 and 2012 needs assessment values. The majority of respondents (80.5%) said that all of the adults in the household are covered by insurance, with another 14.0% saying that some of the adults are covered. Only 5.5% of them said that none of the adults are covered by health insurance. This is a significant improvement from previous years needs assessments when only 76.6% of respondents said that all of the adults in the household were covered by insurance. The health insurance trend found in the 2015 assessment is as follows: Younger people are less likely to have all adults covered than older people, Hispanics are less likely to have all adults covered than non-Hispanics, People with higher incomes are more likely to have all adults covered than those with lower incomes, and Those people with more education are most likely to report that all adults are covered. When examining barriers to health care, 11.6% of respondents reported they or anyone in their family had needed any health services within the past year that they could not get, As might be expected, income was strongly related to the this question: 24% of those making $35,000 a year or less reported that they had needed services that they couldnt get, as opposed to 11% of those making $35,000 up to $80,000, and 5% of those making $80,000 or more. When asked what kept them from getting needed services (Question 8a), cost was the number one factor, with 27.0% (10 people) saying they are worried about the cost of services and/or co-payments, and 13.5% (5 people) indicating a concern about the cost of needed prescriptions. Another 9 said they do not have health insurance and 3 said their provider wouldnt accept their insurance coverage. What services were those people unable to get in the last year? The answers from the 37 people who responded were quite varied: 7 mentioned dental care, 4 mentioned some type of surgery, three mentioned vision, and another 3 indicated that they couldnt get prescriptions filled. The 2015 Community Needs Assessment also examined community utilization of primary and preventative care services as well as barriers to receiving needed care. In the survey findings, most respondents reported that they keep up with regular doctor visits. That is, 80.3% of them said they had visited their doctor for a general physical exam (as opposed to an exam for a specific injury, illness or condition) within the past year and 83.2% said that all of their children had a preventative health care check-up within the past year; another 0.8% said that some of the children had a check-up. On the other hand, that still means that 16.0% said their children did NOT have a health-care check-up within the past year. It is unknown why the 16% (20 families) did not seek that service since almost all of them (19 of the 20) had earlier indicated that all of the children are covered by insurance. This question was noted for consideration in future needs assessment surveys. Furthermore, considering that these screening tests have proven over time to be invaluable in detecting medical problems early, we examined why these members of our community chose not to get them. The predominant reasons cited in an open ended multiple response question included being too old or too young to need the test (47.5%), not thinking the test is important or necessary (21.0%), the perception that "healthy people don't need it" (11.5%), and not having insurance (9.0%). Very few people (2.5%) indicated that a fear or dislike of the test kept them from getting the screening. PVHMC works to meet these needs of our community members who are unable to get needed resources to socioeconomic and environmental barriers, providing free, low-cost, or reduced-cost health services such as immunizations, mammograms, medications, and medical devices, among others. We can continue to do more to make use of our primary care and urgent care services to meet the needs of our community and offload a large proportion of the pressure on our Emergency Department. As a private community safety net hospital, also with the designation as a disproportionate share hospital ("DSH"), we care for a greater population of low-income, medically vulnerable patients. They often require an increased need of accessible, high quality, and cost-effective health care services. We deliver care to all patients in our ED, with or without insurance. The necessity to improve and build upon the efficiency of our ED is critical for PVHMC in order for us to keep up with the growing demands being placed upon our system every day. The 2015 community needs assessment further revealed the need for specialty healthcare. Respondents were give a list of various chronic or ongoing health conditions and asked if they or any member of their family have any of the conditions. in total, 59.0% of respondents answered "yes" to having chronic or ongoing high blood pressure conditions, 31.5% with diabetes, 19.0% with asthma, 14.5% with cancer, 14.0% with obesity, 14.0% with osteoporosis, 5.5 % with chronic heart failure, and 16.0% stated they have other ongoing health conditions. Understanding the need for community health status improvement, a focus of our 2016 community benefit plan is in making the community more aware of the programs, classes and support groups offered by the hospital to help prevent, manage, or improve health outcomes for those at risk or living with chronic disease or illness. Nutrition (8.7%), Diabetes (7.3%), Obesity and Weight Loss (6.4%), High Blood Pressure (5.5%) and Cancer Care (5.5%) were the most requested health classes during our needs assessment. The hospital currently provides many of the classes the respondents were interested in; therefore we are dedicated to providing greater communication about the availability of these existing resources. The 2015 Community Benefit Plan and Implementation Strategy, adopted by our governing Board of Directors, reflects our commitment to meet the needs of our community, as the majority of our services are tied into providing information and education to the community regarding availability and accessibility to health and social services. By fostering greater coordination and collaboration among local service providers, we are able to continue to offer comprehensive medical services and programs to a large community. Our services show how the communitys needs drive the conception and establishment of the services we provide and contribute to its growth and improvement. Every activity and program is budgeted to manage the use of available resources. Our commitment to these vital services
PART VI, LINE 3	THE HOSPITAL MAKES EVERY EFFORT TO INFORM ITS PATIENTS OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. SPECIFICALLY: - EVERY REGISTERED PATIENT RECEIVES A WRITTEN NOTICE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WRITTEN IN PLAIN LANGUAGE PER IRC 501(R); - UPON REQUEST, PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION FORM AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE MADE AVAILABLE FREE OF CHARGE. THESE DOCUMENTS ARE ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE; - WHENEVER POSSIBLE, DURING THE REGISTRATION PROCESS, UNINSURED PATIENTS ARE SCREENED FOR ELIGIBILITY WITH GOVERNMENT; -SPONSORED PROGRAMS INCLUDING MEDI-CAL HOSPITAL PRESUMPTIVE ELIGIBILITY AND/OR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM; - PUBLIC NOTICES ARE POSTED THROUGHOUT THE HOSPITAL NOTIFYING THE PUBLIC OF FINANCIAL ASSISTANCE FOR THOSE WHO QUALIFY (SEE "REPORTING & BILLING: PUBLIC NOTICE" WITHIN THIS POLICY FOR MORE INFORMATION); SUCH NOTICES ARE POSTED IN HIGH VOLUME INPATIENT, AREAS AND IN OUTPATIENT SERVICE AREAS OF THE HOSPITAL, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, INPATIENT ADMISSION AND OUTPATIENT REGISTRATION AREAS, OR OTHER COMMON PATIENT WAITING AREAS OF THE HOSPITAL. NOTICES ARE ALSO POSTED AT ALL LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT MAY OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR SUCH ASSISTANCE. THESE NOTICES ARE WRITTEN IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. - GUARANTOR BILLING STATEMENTS CONTAIN INFORMATION TO ASSIST PATIENTS IN OBTAINING GOVERNMENT SPONSORED COVERAGE AND/OR FINANCIAL ASSISTANCE PROVIDED BY THE HOSPITAL. CONSISTENT WITH HEALTH AND SAFETY CODE SECTION 127420, THE HOSPITAL WILL INCLUDE THE FOLLOWING CLEAR AND CONSPICUOUS INFORMATION ON A PATIENT'S BILL: (1) A STATEMENT OF CHARGES FOR SERVICES RENDERED BY THE HOSPITAL (2) A REQUEST THAT THE PATIENT INFORM THE HOSPITAL IF THE PATIENT HAS HEALTH INSURANCE COVERAGE, MEDICARE, MEDI-CAL, OR OTHER COVERAGE (3) A STATEMENT THAT IF THE CONSUMER DOES NOT HAVE HEALTH INSURANCE COVERAGE, THE CONSUMER MAY BE ELIGIBLE FOR COVERAGE OFFERED THROUGH THE CALIFORNIA HEALTH BENEFIT EXCHANGE (COVERED CA), MEDICARE, MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM, OR CHARITY CARE (4) A STATEMENT INDICATING HOW PATIENTS MAY OBTAIN AN APPLICATION FOR THE MEDI-CAL PROGRAM, COVERAGE OFFERED THROUGH THE CALIFORNIA HEALTH BENEFIT EXCHANGE, OR OTHER STATE- OR COUNTY-FUNDED HEALTH COVERAGE PROGRAMS AND THAT THE HOSPITAL WILL PROVIDE THESE APPLICATIONS. IF THE PATIENT DOES NOT INDICATE COVERAGE BY A THIRD-PARTY PAYER OR REQUESTS A DISCOUNTED PRICE OR CHARITY CARE, THEN THE HOSPITAL SHALL PROVIDE AN APPLICATION FOR THE MEDI-CAL PROGRAM, OR OTHER STATE- OR COUNTY-FUNDED PROGRAMS TO THE PATIENT. THIS APPLICATION SHALL BE PROVIDED PRIOR TO DISCHARGE IF THE PATIENT HAS BEEN ADMITTED OR TO PATIENTS RECEIVING EMERGENCY OR OUTPATIENT CARE. THE HOSPITAL SHALL ALSO PROVIDE PATIENTS WITH A REFERRAL TO A LOCAL CONSUMER ASSISTANCE CENTER HOUSED AT LEGAL SERVICES OFFICES (5) INFORMATION REGARDING THE FINANCIALLY QUALIFIED PATIENT AND CHARITY CARE APPLICATION, INCLUDING THE FOLLOWING: (A) A STATEMENT THAT INDICATES THAT IF THE PATIENT LACKS, OR HAS INADEQUATE INSURANCE, AND MEETS CERTAIN LOW- AND MODERATE-INCOME REQUIREMENTS, THE PATIENT MAY QUALIFY FOR DISCOUNTED PAYMENT OR CHARITY CARE. (B) THE NAME AND TELEPHONE NUMBER OF A HOSPITAL EMPLOYEE OR OFFICE FROM WHOM THE PATIENT MAY OBTAIN INFORMATION ABOUT THE HOSPITAL'S DISCOUNT PAYMENT AND CHARITY CARE POLICIES, AND HOW TO APPLY FOR THAT ASSISTANCE. (C) IF A PATIENT APPLIES, OR HAS A PENDING APPLICATION, FOR ANOTHER HEALTH COVERAGE PROGRAM AT THE SAME TIME THAT HE OR SHE APPLIES FOR A HOSPITAL CHARITY CARE OR DISCOUNT PAYMENT PROGRAM, NEITHER APPLICATION SHALL PRECLUDE ELIGIBILITY FOR THE OTHER PROGRAM. - THE HOSPITAL WILL PROVIDE PATIENTS WITH A REFERRAL TO A LOCAL CONSUMER ASSISTANCE CENTER HOUSED IN A LEGAL SERVICES OFFICE.
PART VI, LINE 4	Community Information Our Mission - PVHMC is a not-for-profit regional Medical Center dedicated to providing high quality, cost effective health care services to residents of the greater Pomona Valley. The Medical Center offers a full range of services from local primary acute care to highly specialized regional service. Selection of all services is based on community need, availability of financing and the organizations technical ability to provide high quality results. Basic to our mission is our commitment to strive continuously to improve the status of health by reaching out and serving the needs of our diverse ethnic, religious and cultural community. Our Community PVHMC is dedicated to meeting the health care demands of the growing populations of Los Angeles and San Bernardino counties. Our Primary Service Area is defined as the cities of Pomona, Claremont, Chino, Chino Hills, La Verne, Montclair, Ontario, Rancho Cucamonga, Alta Loma, Upland and San Dimas and make up a population of 840,789 according to the 2010 United States Census. According to the Office of Statewide Health and Planning 2012 data, Pomona East and South are designated as a Medically Underserved Area, specifically as an area with a Primary Care shortage. As a private community safety net hospital, also with the designation as a disproportionate share hospital ("DSH"), we care for a greater population of low-income, medically vulnerable patients. They often require an increased need of accessible, high quality, and cost-effective health care services. We deliver care to all patients in our ED, with or without insurance. Based on the 2010 Census, the ethnic diversity of Pomona is such that 48.0% are White, 70.5% are Hispanic or Latino, 7.3% are Black or African American, 1.2% are American Indian, 8.5% are Asian, 0.2% are Hawaiian or Pacific Islander, 30.3% identify as Other, and 4.5% identify as two or more races. Among this population, According to the 2006-2010 American Community Survey 5 year estimates, retrieved from the California Department of Finance, Pomonas Median household income is $50,497, with 17.2% of families living below the Federal Poverty Level. Educational attainment data was also retrieved from the 2006-2010 ACS Survey, showing 21.1% of Pomona residents over the age of 25 have less than a 9th grade education level, 15.7% have completed less than 12th grade, 26.0% have a high school diploma, 6.1% have an Associates degree, 10.2% have a Bachelors degree, and 4.0% have earned a Graduate or Professional degree. Market Share- Several other hospitals serve our community. These hospitals are Kaiser Foundation Hospital of Fontana, San Antonio Community Hospital, Chino Valley Medical Center, Arrowhead Regional Medical Center, Montclair Hospital Medical Center, Loma Linda University Medical Center, Canyon Ridge Hospital, Kaiser Foundation Hospital of Baldwin Park, Community Hospital of San Bernardino, San Dimas Community Hospital, and Citrus Valley Health Partners-Queen of the Valley Campus.
PART VI, LINE 5	Promotion of Community Health Pomona Valley Hospital Medical Center is governed by a Board of Directors whose members are representative of the community, hospital and medical staff leadership. Consistent with the IRS "community benefit standard" a majority of the Board of Directors are neither employees, contractors nor family members of the organization. Pomona Valley Hospital Medical Center is a community based disproportionate share hospital. In addition, we participate in Medicare, MediCal, CHAMPUS, Tricare. Pomona Valley Hospital Medical Center is an open medical staff, extending staff privileges to all qualified physicians for all areas and departments of our facility. Pomona Valley Hospital Medical Center is home to the only 24-hours-a-day, full service Emergency Department (ED) in Pomona. Our ED treats all patients regardless of their ability to pay; Pomona Valley Hospital Medical Center provides Emergency Services to all patients with our without insurance. The Emergency Department's dedicated staff is experienced in providing prompt, accurate diagnosis and skillful medical treatment. This expert team includes board-certified emergency physicians, physician assistants; board certified nurses, emergency medical technicians, respiratory therapists and other highly trained emergency care professionals. All are dedicated to providing technologically advanced, lifesaving medical services with compassionate, culturally appropriate care. A part of PVHMC's mission is our dedication to "continuously strive to improve the status of health by reaching out and serving the needs of our diverse ethnic, religious and cultural community." PVHMC has partnered in initiatives like the Pomona Community Health Center (PCHC) and the Portable Wellness Clinic that allow the Hospital to reach out to the medically underserved local community.
PART VI, LINE 6	POMONA VALLEY HOSPITAL MEDICAL CENTER IS A STAND ALONE HOSPITAL, NOT PART OF A HEALTH CARE SYSTEM.
PART VI, LINE 7	CALIFORNIA

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number
95-1115230

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) California Health Foundation & Trust 1215 K Steet Ste 800 Sacramento,CA95814	94-1498697	501(c)(3)	698,054	Hospital Fee Program
(2) National Health Foundation 515 S Figueroa St Los Angeles,CA90071	95-2557452	501(c)(3)	16,000	PROGRAM SUPPORT
(3) Coalition to Protect America's Healthcare PO Box 30211 Bethesda,MD208240211	52-2253225	501(c)(4)	10,000
(4) Boys & Girls Club(Pomona) PO BOX 1149 POMONA,CA91769	23-7314808	501(C)(3)	10,000
(5) Special Olympics of Southern California 1600 Forbes Way Long Beach,CA90810	95-4538450	501(C)(3)	20,000	Program Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

FORM 990, SCHEDULE I, PART I, LINE 2

THE CALIFORNIA HOSPITAL FEE PROGRAM (THE PROGRAM) WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA AND BECAME EFFECTIVE ON JANUARY 1, 2010. THE HOSPITAL MADE PLEDGE PAYMENTS (GRANT) TO THE CALIFORNIA HEALTH FOUNDATION & TRUST TOTALING $689,054 IN CONJUNCTION WITH THIS PROGRAM, NO MONITORING IS COMPLETED AFTER THE GRANT IS MADE. POMONA VALLEY HOSPITAL MEDICAL CENTER CONFIRMED THAT THE ORGANIZATIONS RECEIVING GRANTS ARE 501(C)3 & 501(C)4 ORGANIZATIONS AND IS CONFIDENT THAT THE GRANTS ARE BEING USED FOR PROPER PURPOSES AND TO FURTHER THE CHARITABLE PURPOSE OF THOSE ORGANIZATIONS ALTHOUGH NO FORMAL MONITORING IS DONE.

Schedule I (Form 990) 2015

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" on 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

2015

Open to Public Inspection

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

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 on 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 .........

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? ..

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 on 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? ................

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 on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Were any amounts reported on 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" on 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) 2015

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 on 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 on 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)
1RICHARD YOCHUMPRESIDENT/CEO	(i) (ii)	738,578 ------------- 0	150,000 ------------- 0	16,459 ------------- 0	947,354 ------------- 0	31,530 ------------- 0	1,883,921 ------------- 0	0 ------------- 0
2CHRIS ALDWORTHVP, PLANNING & TRAUMA CTR	(i) (ii)	240,612 ------------- 0	45,800 ------------- 0	17,395 ------------- 0	18,332 ------------- 0	26,166 ------------- 0	348,305 ------------- 0	0 ------------- 0
3MICHAEL NELSONTREASURER/SECRETARY/CFO	(i) (ii)	470,239 ------------- 0	103,000 ------------- 0	279,306 ------------- 0	161,082 ------------- 0	31,461 ------------- 0	1,045,088 ------------- 0	269,814 ------------- 0
4JULI HESTERASST. TREASURER/VP FINANCE	(i) (ii)	244,793 ------------- 0	44,000 ------------- 0	5,895 ------------- 0	17,600 ------------- 0	37,016 ------------- 0	349,304 ------------- 0	0 ------------- 0
5DARLENE SCAFFIDDIVP OF NURSING	(i) (ii)	280,877 ------------- 0	65,000 ------------- 0	12,820 ------------- 0	21,200 ------------- 0	44,648 ------------- 0	424,545 ------------- 0	0 ------------- 0
6KENNETH K NAKAMOTOVP MED STAFF AFF	(i) (ii)	332,258 ------------- 0	60,760 ------------- 0	12,056 ------------- 0	15,900 ------------- 0	43,733 ------------- 0	464,707 ------------- 0	0 ------------- 0
7KENT G HOYOSCIO	(i) (ii)	335,539 ------------- 0	60,000 ------------- 0	3,961 ------------- 0	21,200 ------------- 0	44,402 ------------- 0	465,102 ------------- 0	0 ------------- 0
8RAY INGEVP HUMAN RESOURCES & PAY ROLL	(i) (ii)	275,605 ------------- 0	45,320 ------------- 0	7,878 ------------- 0	11,330 ------------- 0	44,402 ------------- 0	384,535 ------------- 0	0 ------------- 0
9MICHAEL L VESTINOVP, SUPPORT SERVICES	(i) (ii)	237,601 ------------- 0	44,000 ------------- 0	24,922 ------------- 0	13,200 ------------- 0	44,394 ------------- 0	364,117 ------------- 0	0 ------------- 0
10JAMES MC DALEVP, DEVELOPMENT	(i) (ii)	241,462 ------------- 0	43,000 ------------- 0	17,633 ------------- 0	10,750 ------------- 0	31,562 ------------- 0	344,407 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

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 4B

THE HOSPITAL HAS EMPLOYMENT CONTRACTS WITH MR. YOCHUM AND MR. NELSON. THE CONTRACTS PROVIDE FOR A PAYMENT OF 6.00 FOR MR. NELSON AND 6.00 FOR MR. YOCHUM TIMES ANNUAL CASH COMPENSATION IF THE EXECUTIVE REMAINS EMPLOYED UNTIL THE END OF THE CONTRACT. EMPLOYMENT REQUIREMENTS ARE 39 YEARS FOR MR. YOCHUM AND 39 YEARS FOR MR. NELSON. IN THE EVENT OF VOLUNTARY TERMINATION OR TERMINATION FOR CAUSE, ALL BENEFITS UNDER THE CONTRACT ARE FORFEITED. IN THE EVENT OF EARLY TERMINATION BECAUSE OF DEATH OR DISABILITY, A PRORATED BENEFIT WOULD BE PAID. THE CONTRACT AFFIRMS THE THE BOARD OF DIRECTORS HAS THE RIGHT TO TERMINATE THE CONTRACT, WITH OR WITHOUT CAUSE, AT ITS DISCRETION, AND PROVIDES A FORMULA FOR CALCULATING THE SEVERANCE PAYMENT IN THE EVENT OF INVOLUNTARY TERMINATION. ONCE THE EMPLOYEE HAS MET ALL VESTING REQUIREMENTS, AND THE AMOUNT IS NOT SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, THE AMOUNT IS INCLUDED IN OTHER REPORTABLE COMPENSATION (SCHEDULE J, PART II, B(III)). SCHEDULE J, PART II, COLUMN C INCLUDES DEFERRED COMPENSATION OF $926,154 FOR MR. YOCHUM AND $139,882 FOR MR. NELSON. MICHAEL NELSON RECEIVED A DEFERRED COMPENSATION PAYOUT OF $269,814 IN 2015 OF WHICH $269,814 WAS REPORTED ON PRIOR YEAR'S FORM 990.

Schedule J (Form 990) 2015

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

2015

Open to Public Inspection

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

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) 2015

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) GREGORY DALY	SEE PART V	136,994	COMPENSATION FOR SERVICES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS	GREGORY DALY IS THE BROTHER OF DARLENE SCAFFIDDI, KEY EMPLOYEE OF THE ORGANZATION.

Schedule L (Form 990 or 990-EZ) 2015

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

2015

Open to Public
Inspection

Name of the organization

POMONA VALLEY HOSPITAL MEDICAL CENTER

Employer identification number

95-1115230

Return Reference	Explanation
FORM 990, PART I, LINE 1	POMONA VALLEY HOSPITAL MEDICAL CENTER IS A NOT-FOR-PROFIT, REGIONAL MEDICAL CENTER DEDICATED TO PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE SERVICES TO RESIDENTS OF THE GREATER POMONA VALLEY.
FORM 990, PART III, LINE 1	OUR MISSION - PVHMC IS A NOT-FOR-PROFIT REGIONAL MEDICAL CENTER DEDICATED TO PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE SERVICES TO RESIDENTS OF THE GREATER POMONA VALLEY. THE MEDICAL CENTER OFFERS A FULL RANGE OF SERVICES FROM LOCAL PRIMARY ACUTE CARE TO HIGHLY SPECIALIZED REGIONAL SERVICE. SELECTION OF ALL SERVICES IS BASED ON COMMUNITY NEED, AVAILABILITY OF FINANCING AND THE ORGANIZATIONS TECHNICAL ABILITY TO PROVIDE HIGH QUALITY RESULTS. BASIC TO OUR MISSION IS OUR COMMITMENT TO STRIVE CONTINUOUSLY TO IMPROVE THE STATUS OF HEALTH BY REACHING OUT AND SERVING THE NEEDS OF OUR DIVERSE ETHNIC, RELIGIOUS AND CULTURAL COMMUNITY. OUR VISION - PVHMCS VISION IS TO BE THE REGIONS MOST RESPECTED AND RECOGNIZED MEDICAL CENTER AND MARKET LEADER IN THE DELIVERY OF QUALITY HEALTH CARE SERVICES; BE THE MEDICAL CENTER OF CHOICE FOR PATIENTS AND FAMILIES BECAUSE THEY KNOW THEY WILL RECEIVE THE HIGHEST QUALITY CARE AND SERVICES AVAILABLE ANYWHERE; BE THE MEDICAL CENTER WHERE PHYSICIANS PREFER TO PRACTICE BECAUSE THEY ARE VALUED CUSTOMERS AND TEAM MEMBERS SUPPORTED BY EXPERT HEALTH CARE PROFESSIONALS, THE MOST ADVANCED SYSTEMS AND STATE-OF-THE-ART TECHNOLOGY; BE THE MEDICAL CENTER WHERE HEALTH CARE WORKERS CHOOSE TO WORK BECAUSE PVHMC IS RECOGNIZED FOR EXCELLENCE, INITIATIVE IS REWARDED, SELF-DEVELOPMENT IS ENCOURAGED, AND PRIDE AND ENTHUSIASM IN SERVING CUSTOMERS ABOUNDS; BE THE MEDICAL CENTER BUYERS DEMAND (EMPLOYERS, PAYORS, ETC.) FOR THEIR HEALTH CARE SERVICES BECAUSE THEY KNOW WE ARE THE PROVIDER OF CHOICE FOR THEIR BENEFICIARIES AND THEY WILL RECEIVE THE HIGHEST VALUE FOR THE BENEFIT DOLLAR; AND, BE THE MEDICAL CENTER THAT COMMUNITY LEADERS, VOLUNTEERS AND BENEFACTORS CHOOSE TO SUPPORT BECAUSE THEY GAIN SATISFACTION FROM PROMOTING AN INSTITUTION THAT CONTINUOUSLY STRIVES TO MEET THE HEALTH NEEDS OF OUR COMMUNITIES, NOW AND IN THE FUTURE. OUR COMMUNITY PVHMC IS LOCATED IN LOS ANGELES COUNTY SERVICE PLANNING AREA 3 (SPA3) AND IS DEDICATED TO MEETING THE HEALTH CARE DEMANDS OF THE GROWING POPULATIONS OF BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES. OUR PRIMARY SERVICE AREA IS DEFINED AS THE CITIES OF POMONA, CLAREMONT, CHINO, CHINO HILLS, LA VERNE, MONTCLAIR, ONTARIO, RANCHO CUCAMONGA, ALTA LOMA, UPLAND AND SAN DIMAS AND MAKE UP A POPULATION OF 840,789. OUR SECONDARY SERVICE AREA INCLUDES ADDITIONAL SURROUNDING CITIES IN SAN GABRIEL VALLEY AND WESTERN SAN BERNARDINO COUNTY. IN 2010 AS DERIVED FROM THE STATISTICS REPORTED BY THE U.S. CENSUS BUREAU, THE ETHNIC DIVERSITY REPRESENTED BY THE DEMOGRAPHICS OF THE CITY OF POMONA WAS SUCH THAT 33.6% IS HISPANIC OR LATINO, 14.4% IS WHITE, 7.3% IS BLACK/AFRICAN-AMERICAN, 8.5% IS ASIAN, 1.2% IS AMERICAN INDIAN, 0.2% HAWAIIAN/PACIFIC ISLANDER, 30.3% IS OTHER, AND 4.5% IS TWO OR MORE RACES.
FORM 990, PART III, LINE 4A	EXECUTIVE SUMMARY - POMONA VALLEY HOSPITAL MEDICAL CENTER (PVHMC) IS A 437-BED, FULLY ACCREDITED, ACUTE CARE HOSPITAL SERVING EASTERN LOS ANGELES AND WESTERN SAN BERNARDINO COUNTIES. FOR OVER A CENTURY, PVHMC HAS BEEN COMMITTED TO SERVING OUR COMMUNITY AND PLAYS AN ESSENTIAL ROLE AS A SAFETY-NET PROVIDER AND TERTIARY REFERRAL FACILITY FOR THE REGION. A NATIONALLY RECOGNIZED, NOT-FOR-PROFIT FACILITY, THE HOSPITALS SERVICES INCLUDE CENTERS OF EXCELLENCE IN CANCER CARE, CARDIAC AND VASCULAR CARE, WOMENS AND CHILDRENS SERVICES, AND KIDNEY STONES. SPECIALIZED SERVICES INCLUDE CENTERS FOR BREAST HEALTH, SLEEP DISORDERS, A NEONATAL ICU, A PERINATAL CENTER, PHYSICAL THERAPY/SPORTS MEDICINE, A FULL-SERVICE EMERGENCY DEPARTMENT WHICH INCLUDES OUR LOS ANGELES COUNTY AND SAN BERNARDINO COUNTY STEMI RECEIVING CENTER DESIGNATION, ROBOTIC SURGERY, AND THE FAMILY MEDICINE RESIDENCY PROGRAM AFFILIATED WITH UCLA. SATELLITE CENTERS IN CHINO HILLS, CLAREMONT, COVINA, AND POMONA PROVIDE A WIDE RANGE OF OUTPATIENT SERVICES INCLUDING PHYSICAL THERAPY, URGENT CARE, RADIOLOGY AND OCCUPATIONAL HEALTH. ALONG WITH BEING NAMED ONE OF HEALTHGRADES 100 BEST HOSPITALS FOR CARDIAC CARE, 2014-2015 (ONLY ONE OF THREE IN CALIFORNIA TO RECEIVE ALL 3 TOP 100 RECOGNITIONS IN 2014-2015) AND RECEIVING HEALTHGRADES 2015 PATIENT SAFETY AWARD, THE JOINT COMMISSION HAS GIVEN PVHMC THE GOLD SEAL OF APPROVAL FOR CERTIFICATION AS A PRIMARY STROKE CENTER FOR LOS ANGELES COUNTY, DEMONSTRATING WHAT WE HAVE BEEN DOING ALL ALONG - PROVIDING QUALITY CARE AND SERVICES IN THE HEART OF OUR COMMUNITY. AS A COMMUNITY HOSPITAL, WE CONTINUOUSLY REFLECT UPON OUR RESPONSIBILITY TO PROVIDE HIGH-QUALITY HEALTHCARE SERVICES, ESPECIALLY TO OUR MOST VULNERABLE POPULATIONS IN NEED, AND TO RENEW OUR COMMITMENT WHILE FINDING NEW WAYS TO FULFILL OUR CHARITABLE PURPOSE. PART OF THAT COMMITMENT IS SUPPORTING ADVANCED LEVELS OF TECHNOLOGY AND PROVIDING APPROPRIATE STAFFING, TRAINING, EQUIPMENT, AND FACILITIES. PVHMC WORKS VIGOROUSLY TO MEET OUR ROLE IN MAINTAINING A HEALTHY COMMUNITY BY IDENTIFYING HEALTH-RELATED PROBLEMS AND DEVELOPING WAYS TO ADDRESS THEM. IN 2015, IN COMPLIANCE WITH SECTION 501(R)(3) OF THE INTERNAL REVENUE CODE, CREATED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (2010), A COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED. THIS ASSESSMENT IS INTENDED TO BE A RESOURCE FOR PVHMC IN THE DEVELOPMENT OF ACTIVITIES AND PROGRAMS THAT CAN HELP IMPROVE AND ENHANCE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF POMONA VALLEY. IN RESPONSE TO THE ASSESSMENTS FINDINGS, A 2015 COMMUNITY BENEFIT IMPLEMENTATION STRATEGY WAS DEVELOPED TO OPERATIONALIZE THE INTENT OF PVHMCS COMMUNITY BENEFIT PLAN INITIATIVES THROUGH DOCUMENTED GOALS, PERFORMANCE MEASURES, AND STRATEGIES. PVHMC DEMONSTRATES ITS PROFOUND COMMITMENT TO ITS LOCAL COMMUNITY AND HAS WELCOMED THIS OCCASION TO FORMALIZE OUR COMMUNITY BENEFIT PLAN AND IMPLEMENTATION STRATEGY. OUR COMMUNITY IS CENTRAL TO US AND IT IS REPRESENTED IN ALL OF THE WORK WE DO. PVHMC HAS SERVED THE POMONA VALLEY FOR 110 YEARS, AND WE VALUE MAINTAINING THE HEALTH OF OUR COMMUNITY.
FORM 990, PART III, LINE 4A (CONT'D)	COMMUNITY NEEDS ASSESSMENT- IN 2015, A COMMUNITY NEEDS ASSESSMENT WAS COMPLETED. THE ASSESSMENT IS INTENDED TO BE A RESOURCE FOR PVHMC TO BECOME INVOLVED WITH DEVELOPING AND MAINTAINING ACTIVITIES AND PROGRAMS THAT CAN HELP IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF POMONA VALLEY. THE COMMUNITY NEEDS ASSESSMENT PROCESS INCLUDED PRIMARY AND SECONDARY DATA COLLECTION, INCUDING VALUABLE COMMUNITY, STAKEHOLDER, AND PUBLIC HEALTH INPUT THAT WAS EXAMINED TO PRIORITIZE THE MOST CRITICAL NEEDS OF OUR COMMUNITY AND SERVE AS THE BASIS FOR OUR COMMUNITY BENEFIT PLAN INITIATIVES AND IMPLEMENTATION STRATEGY. PVHMC PARTNERED WITH CALIFORNIA STATE UNIVERSITY SAN BERNARDINOS INSTITUDE OF APPLIED REASEARCH TO CONDUCT 333 COMMUNITY MEMBER SURVEYS, CONDUCTED A TOTAL OF 3 COMMUNITY FOCUS GROUPS, AND SOUGHT INPUT FROM CHRISTIN MONDY, PUBLIC HEALTH DEPARTMENT OFFICER FOR LOS ANGELES SERVICE PLANNING AREAS 3 AND 4. THE RESEARCH OBJECTIVES WERE TO LOOK AT THE DEMOGRAPHIC PROFILE OF THE COMMUNITY, HEALTH INSURANCE COVERAGE, HEALTH ACCESS BARRIERS, UTILIZATION OF HEALTH CARE SERVICES FOR ROUTINE PRIMARY/PREVENTATIVE CARE, UTILIZATION OF URGENT CARE SERVICES, NEED FOR SPECIALTY HEALTH CARE AND EXPERIENCE WITH PVHMC INCLUDING CLASSES, SUPPORT GROUPS, AND THE EMERGENCY DEPARTMENT. THE FOLLOWING SUMMARIZES THE 2015 NEEDS ASSESSMENT FINDINGS FROM SURVEYING 333 MEMBERS OF OUR COMMUNITY. WHEN RESPONDENTS WERE ASKED "WOULD YOU SAY THAT IN GENERAL YOUR HEALTH IS EXCELLENT, VERY GOOD, FAIR OR POOR", MOST OF THE RESPONDENTS (68.8%) SAID "EXCELLENT"VERY GOOD". ONLY 3.3% SAID THEIR HEALTH IS "POOR." THESE FIGURES ARE NOT A SIGNIFICANT SHIFT FROM 2009 AND 2012 NEEDS ASSESSMENT VALUES. THE MAJORITY OF RESPONDENTS (80.5%) SAID THAT ALL OF THE ADULTS IN THE HOUSEHOLD ARE COVERED BY INSURANCE, WITH ANOTHER 14.0% SAYING THAT SOME OF THE ADULTS ARE COVERED. ONLY 5.5% OF THEM SAID THAT NONE OF THE ADULTS ARE COVERED BY HEALTH INSURANCE. THIS IS A SIGNIFICANT IMPROVEMENT FROM PREVIOUS YEARS NEEDS ASSESSMENTS WHEN ONLY 76.6% OF RESPONDENTS SAID THAT ALL OF THE ADULTS IN THE HOUSEHOLD WERE COVERED BY INSURANCE. THE HEALTH INSURANCE TREND FOUND IN THE 2015 ASSESSMENT IS AS FOLLOWS: YOUNGER PEOPLE ARE LESS LIKELY TO HAVE ALL ADULTS COVERED THAN OLDER PEOPLE, HISPANICS ARE LESS LIKELY TO HAVE ALL ADULTS COVERED THAN NON-HISPANICS, PEOPLE WITH HIGHER INCOMES ARE MORE LIKELY TO HAVE ALL ADULTS COVERED THAN THOSE WITH LOWER INCOMES, AND THOSE PEOPLE WITH MORE EDUCATION ARE MOST LIKELY TO REPORT THAT ALL ADULTS ARE COVERED. WHEN EXAMINING BARRIERS TO HEALTH CARE, 11.6% OF RESPONDENTS REPORTED THEY OR ANYONE IN THEIR FAMILY HAD NEEDED ANY HEALTH SERVICES WITHIN THE PAST YEAR THAT THEY COULD NOT GET, AS MIGHT BE EXPECTED, INCOME WAS STRONGLY RELATED TO THE THIS QUESTION: 24% OF THOSE MAKING $35,000 A YEAR OR LESS REPORTED THAT THEY HAD NEEDED SERVICES THAT THEY COULDNT GET, AS OPPOSED TO 11% OF THOSE MAKING $35,000 UP TO $80,000, AND 5% OF THOSE MAKING $80,000 OR MORE. WHEN ASKED WHAT KEPT THEM FROM GETTING NEEDED SERVICES (QUESTION 8A), COST WAS THE NUMBER ONE FACTOR, WITH 27.0% (10 PEOPLE) SAYING THEY ARE WORRIED ABOUT THE COST OF SERVICES AND/OR CO-PAYMENTS, AND 13.5% (5 PEOPLE) INDICATING A CONCERN ABOUT THE COST OF NEEDED PRESCRIPTIONS. ANOTHER 9 SAID THEY DO NOT HAVE HEALTH INSURANCE AND 3 SAID THEIR PROVIDER WOULDNT ACCEPT THEIR INSURANCE COVERAGE. WHAT SERVICES WERE THOSE PEOPLE UNABLE TO GET IN THE LAST YEAR? THE ANSWERS FROM THE 37 PEOPLE WHO RESPONDED WERE QUITE VARIED: 7 MENTIONED DENTAL CARE, 4 MENTIONED SOME TYPE OF SURGERY, THREE MENTIONED VISION, AND ANOTHER 3 INDICATED THAT THEY COULDNT GET PRESCRIPTIONS FILLED. THE 2015 COMMUNITY NEEDS ASSESSMENT ALSO EXAMINED COMMUNITY UTILIZATION OF PRIMARY AND PREVENTATIVE CARE SERVICES AS WELL AS BARRIERS TO RECEIVING NEEDED CARE. IN THE SURVEY FINDINGS, MOST RESPONDENTS REPORTED THAT THEY KEEP UP WITH REGULAR DOCTOR VISITS. THAT IS, 80.3% OF THEM SAID THEY HAD VISITED THEIR DOCTOR FOR A GENERAL PHYSICAL EXAM (AS OPPOSED TO AN EXAM FOR A SPECIFIC INJURY, ILLNESS OR CONDITION) WITHIN THE PAST YEAR AND 83.2% SAID THAT ALL OF THEIR CHILDREN HAD A PREVENTATIVE HEALTH CARE CHECK-UP WITHIN THE PAST YEAR; ANOTHER 0.8% SAID THAT SOME OF THE CHILDREN HAD A CHECK-UP. ON THE OTHER HAND, THAT STILL MEANS THAT 16.0% SAID THEIR CHILDREN DID NOT HAVE A HEALTH-CARE CHECK-UP WITHIN THE PAST YEAR. IT IS UNKNOWN WHY THE 16% (20 FAMILIES) DID NOT SEEK THAT SERVICE SINCE ALMOST ALL OF THEM (19 OF THE 20) HAD EARLIER INDICATED THAT ALL OF THE CHILDREN ARE COVERED BY INSURANCE. THIS QUESTION WAS NOTED FOR CONSIDERATION IN FUTURE NEEDS ASSESSMENT SURVEYS. FURTHERMORE, CONSIDERING THAT THESE SCREENING TESTS HAVE PROVEN OVER TIME TO BE INVALUABLE IN DETECTING MEDICAL PROBLEMS EARLY, WE EXAMINED WHY THESE MEMBERS OF OUR COMMUNITY CHOSE NOT TO GET THEM. THE PREDOMINANT REASONS CITED IN AN OPEN ENDED MULTIPLE RESPONSE QUESTION INCLUDED BEING TOO OLD OR TOO YOUNG TO NEED THE TEST (47.5%), NOT THINKING THE TEST IS IMPORTANT OR NECESSARY (21.0%), THE PERCEPTION THAT "HEALTHY PEOPLE DON'T NEED IT" (11.5%), AND NOT HAVING INSURANCE (9.0%). VERY FEW PEOPLE (2.5%) INDICATED THAT A FEAR OR DISLIKE OF THE TEST KEPT THEM FROM GETTING THE SCREENING. PVHMC WORKS TO MEET THESE NEEDS OF OUR COMMUNITY MEMBERS WHO ARE UNABLE TO GET NEEDED RESOURCES TO SOCIOECONOMIC AND ENVIRONMENTAL BARRIERS, PROVIDING FREE, LOW-COST, OR REDUCED-COST HEALTH SERVICES SUCH AS IMMUNIZATIONS, MAMMOGRAMS, MEDICATIONS, AND MEDICAL DEVICES, AMONG OTHERS. WE CAN CONTINUE TO DO MORE TO MAKE USE OF OUR PRIMARY CARE AND URGENT CARE SERVICES TO MEET THE NEEDS OF OUR COMMUNITY AND OFFLOAD A LARGE PROPORTION OF THE PRESSURE ON OUR EMERGENCY DEPARTMENT. AS A PRIVATE COMMUNITY SAFETY NET HOSPITAL, ALSO WITH THE DESIGNATION AS A DISPROPORTIONATE SHARE HOSPITAL ("DSH"), WE CARE FOR A GREATER POPULATION OF LOW-INCOME, MEDICALLY VULNERABLE PATIENTS. THEY OFTEN REQUIRE AN INCREASED NEED OF ACCESSIBLE, HIGH QUALITY, AND COST-EFFECTIVE HEALTH CARE SERVICES. WE DELIVER CARE TO ALL PATIENTS IN OUR ED, WITH OR WITHOUT INSURANCE. THE NECESSITY TO IMPROVE AND BUILD UPON THE EFFICIENCY OF OUR ED IS CRITICAL FOR PVHMC IN ORDER FOR US TO KEEP UP WITH THE GROWING DEMANDS BEING PLACED UPON OUR SYSTEM EVERY DAY. THE 2015 COMMUNITY NEEDS ASSESSMENT FURTHER REVEALED THE NEED FOR SPECIALTY HEALTHCARE. RESPONDENTS WERE GIVEN A LIST OF VARIOUS CHRONIC OR ONGOING HEALTH CONDITIONS AND ASKED IF THEY OR ANY MEMBER OF THEIR FAMILY HAVE ANY OF THE CONDITIONS. IN TOTAL, 59.0% OF RESPONDENTS ANSWERED "YES" TO HAVING CHRONIC OR ONGOING HIGH BLOOD PRESSURE CONDITIONS, 31.5% WITH DIABETES, 19.0% WITH ASTHMA, 14.5% WITH CANCER, 14.0% WITH OBESITY, 14.0% WITH OSTEOPOROSIS, 5.5 % WITH CHRONIC HEART FAILURE, AND 16.0% STATED THEY HAVE OTHER ONGOING HEALTH CONDITIONS. UNDERSTANDING THE NEED FOR COMMUNITY HEALTH STATUS IMPROVEMENT, A FOCUS OF OUR 2015 COMMUNITY BENEFIT PLAN IS IN MAKING THE COMMUNITY MORE AWARE OF THE PROGRAMS, CLASSES AND SUPPORT GROUPS OFFERED BY THE HOSPITAL TO HELP PREVENT, MANAGE, OR IMPROVE HEALTH OUTCOMES FOR THOSE AT RISK OR LIVING WITH CHRONIC DISEASE OR ILLNESS. NUTRITION (8.7%), DIABETES (7.3%), OBESITY AND WEIGHT LOSS (6.4%), HIGH BLOOD PRESSURE (5.5%) AND CANCER CARE (5.5%) WERE THE MOST REQUESTED HEALTH CLASSES DURING OUR NEEDS ASSESSMENT. THE HOSPITAL CURRENTLY PROVIDES MANY OF THE CLASSES THE RESPONDENTS WERE INTERESTED IN; THEREFORE WE ARE DEDICATED TO PROVIDING GREATER COMMUNICATION ABOUT THE AVAILABILITY OF THESE EXISTING RESOURCES. THE 2015 COMMUNITY NEEDS ASSESSMENT ALSO INCLUDED INPUT FROM LOS ANGELES COUNTY SPA 3 AND SPA 4 PUBLIC HEALTH OFFICER CHRISTIN MONDY. IN A TELEPHONE INTERVIEW CONDUCTED ON DECEMBER 5, 2014, PVHMC RESEARCH OBJECTIVES INCLUDED IDENTIFYING PUBLIC HEALTH CONCERNS, BARRIERS TO CARE, RECOMMENDATIONS FOR COMMUNITY BENEFIT PROGRAMS, AND RECOMMENDATIONS FOR COLLABORATION IN THE COMMUNITY. PUBLIC HEALTH NEEDS IDENTIFIED INCLUDED PHYSICAL FITNESS AND NUTRITION NEEDS, HIGH INCIDENCE OF DIABETES, SUBSTANCE ABUSE, CONCERNS FOR SAFETY IN THE COMMUNITY AS IT RELATES TO PHYSICAL ACTIVITY AMONG CHILDREN, HOMELESSNESS, AND LACK OF ROUTINE PRVENTATIVE CARE. PUBLIC HEALTH RECOMMENDATIONS FOR COLLABORATION AND IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS INCLUDED INCREASING COMMUNICATION OF AVAILABLE EDUCATION AND CLASSES OFFERED AT PVHMC, PROVIDING PROGRAMS FOR HEALTHY FOOD AND NUTRITION EDUCATION, AND PROVIDING DIABETES EDUCATION AND MANAGEMENT RESOURCES.
FORM 990, PART III, LINE 4A (CONT'D)	SIGNIFICANT HEALTH NEEDS IDENTIFIED IN OUR 2015 COMMUNITY NEEDS ASSESSMENT WERE HEALTH EDUCATION CLASSES AND SUPPORT GROUPS, DIABETES, OBESITY, HIGH BLOOD PRESSURE, ALZHEIMERS AND DEMENTIA, ACCESS TO PRIMARY AND SPECIALTY CARE, CARE COORDINATION, TRANSPORTATION, PROMOTORAS, MENTAL HEALTH SERVICES, AND BETTER PROMOTION OF WHAT PVHMC ALREADY OFFERS TO THE COMMUNITY. PVHMC PRIORITIZED THESE NEEDS INTO THREE OVERARCHING THEMES AS A FRAMEWORK FOR PVHMC TO ORGANIZE, MAINTAIN, AND IMPLEMENT COMMUNITY BENEFIT PROGRAMS AND SERVICES. THESE PRIORITIZED HEALTH NEEDS ARE CHRONIC DISEASE MANAGEMENT, HEALTH EDUCATION AND SUPPORT GROUPS, AND ACCESS TO CARE. THE COMMUNITY NEEDS ASSESSMENT AND HEALTH NEEDS PRIORITIES WERE ADOPTED BY OUR GOVERNING BOARD OF DIRECTORS ON MAY 7, 2015. COMMUNITY HEALTH NEEDS WERE DETERMINED TO BE SIGNIFICANT THROUGH EVALUATION OF PRIMARY AND SECONDARY DATA, WHEREBY THOSE IDENTIFIED HEALTH NEEDS WERE PRIORITIZED BASED UPON: (1) COMMUNITY RESPONDENTS AND KEY INFORMANTS IDENTIFIED THE NEED TO BE SIGNIFICANT, OR LARGELY REQUESTED SPECIFIC SERVICES THAT THEY WOULD LIKE TO SEE POMONA VALLEY HOSPITAL MEDICAL CENTER PROVIDE IN THE COMMUNITY (2) FEASIBILITY OF PROVIDING INTERVENTIONS FOR THE UNMET NEED IDENTIFIED IN THE COMMUNITY, IN SUCH THAT POMONA VALLEY HOSPITAL MEDICAL CENTER CURRENTLY HAS, OR HAS THE CURRENT MEANS OF DEVELOPING THE RESOURCES TO MEET THE NEED, AND (3) ALIGNMENT BETWEEN THE IDENTIFIED HEALTH NEED AND POMONA VALLEY HOSPITAL MEDICAL CENTERS MISSION, VISION, AND STRATEGIC PLAN. OF THE HEALTH NEEDS IDENTIFIED THROUGH OUR NEEDS ASSESSMENT, PVHMC WILL NOT ADDRESS THE MENTAL HEALTH, ALZHEIMER'S, "PROMOTORASTRANSPORTATION NEEDS IN OUR IMPLEMENTATION STRATEGY. PVHMC EVALUATED ITS CAPACITY TO SERVE THE MENTAL HEALTH, ALZHEIMER'S SERVICES, "PROMOTORASTRANSPORTATION NEEDS OF OUR COMMUNITY. PVHMC DOES NOT HAVE A LICENSED PSYCHIATRIC FACILITY, OR THE CURRENT CAPACITY, TO PROVIDE INPATIENT AND OUTPATIENT MENTAL HEALTH TREATMENT SERVICES. WHILE PVHMC HAS SOME SERVICES IN PLACE TO ASSIST WITH MENTAL HEALTH AND SUBSTANCE ABUSE, SUCH AS EMERGENT PSYCHIATRIC CONSULTATIONS, MENTAL HEALTH REFERRALS, AND SMOKING CESSATION EDUCATION, IT WAS DETERMINED THAT THIS CRITICAL NEED IS BEST SERVED BY OTHERS. PVHMC DOES NOT CURRENTLY HAVE TRAINED "PROMOTORAS" STAFF TO PERFORM PEER-TO-PEER EDUCATION OUT IN THE COMMUNITY. PVHMC DOES NOT CURRENTLY HAVE IN PLACE, OR THE CURRENT CAPACITY TO DEVELOP AN ALZHEIMERS SERVICES PROGRAM; HOWEVER, PVHMC DOES SEEK TO CONTINUE TO ADDRESS THIS NEED INDIRECTLY THROUGH OUR SOCIAL SERVICES AND CARE COORDINATION EFFORTS WITH LOCAL COMMUNITY-BASED ORGANIZATIONS. ADDITIONALLY, WHILE PVHMC DOES HAVE IN PLACE SOME TRANSPORTATION SERVICES TO ASSIST PATIENTS, IT WAS DETERMINED THAT THIS NEED AT A COMMUNITY-WIDE LEVEL IS BEST SERVED BY OTHERS. ACCORDINGLY, PVHMC WILL CONTINUE TO SUPPORT TRI-CITY MENTAL HEALTH, PROTOTYPES, THE DEPARTMENT OF MENTAL HEALTH, THE YWCA OF THE SAN GABRIEL AND INLAND COMMUNITIES, COMMUNITY SENIOR SERVICES, AND OTHER COMMUNITY BASED ORGANIZATIONS THAT DIRECTLY PROVIDE THESE SERVICES TO ADDRESS THESE NEEDS. WE ARE STRONGLY COMMITTED TO OUR RELATIONSHIPS WITH THESE ORGANIZATIONS AND CONTINUOUSLY SEEK PARTNERSHIPS AND OPPORTUNITIES TO DIRECTLY ADDRESS THESE NEEDS IN THE FUTURE. IMPLEMENTATION STRATEGY - THE 2015 COMMUNITY BENEFIT PLAN AND IMPLEMENTATION STRATEGY, ADOPTED BY OUR GOVERNING BOARD OF DIRECTORS, REFLECTS OUR COMMITMENT TO MEET THE NEEDS OF OUR COMMUNITY, AS THE MAJORITY OF OUR SERVICES ARE TIED INTO PROVIDING INFORMATION AND EDUCATION TO THE COMMUNITY REGARDING AVAILABILITY AND ACCESSIBILITY TO HEALTH AND SOCIAL SERVICES. BY FOSTERING GREATER COORDINATION AND COLLABORATION AMONG LOCAL SERVICE PROVIDERS, WE ARE ABLE TO CONTINUE TO OFFER COMPREHENSIVE MEDICAL SERVICES AND PROGRAMS TO A LARGE COMMUNITY. OUR SERVICES SHOW HOW THE COMMUNITYS NEEDS DRIVE THE CONCEPTION AND ESTABLISHMENT OF THE SERVICES WE PROVIDE AND CONTRIBUTE TO ITS GROWTH AND IMPROVEMENT. EVERY ACTIVITY AND PROGRAM IS BUDGETED TO MANAGE THE USE OF AVAILABLE RESOURCES. OUR COMMITMENT TO THESE VITAL SERVICES IS DEMONSTRATED THROUGH THE CONCERTED EFFORTS OF EACH DEPARTMENT TO ENSURE THAT ESSENTIAL SERVICES CONTINUE TO BE PROVIDED TO THE COMMUNITY. PVHMC DEMONSTRATES ITS PROFOUND COMMITMENT TO ITS LOCAL COMMUNITY, BOTH HISTORICALLY AND ON A CONTINUING BASIS. PVHMC HAS WELCOMED THIS OCCASION TO FORMALIZE, ENHANCE AND DOCUMENT THE MULTITUDE OF COMMUNITY BENEFIT INITIATIVES AND PROGRAMS IN WHICH THE HOSPITAL IS IMMERSED. OUR COMMUNITY IS CENTRAL TO US, AND IT IS REPRESENTED IN ALL OF THE WORK WE DO. PVHMC HAS SERVED THE POMONA VALLEY FOR OVER 110 YEARS, AND WE VALUE MAINTAINING THE HEALTH OF OUR COMMUNITY BY PROVIDING ACCESSIBLE, HIGH QUALITY MEDICAL CARE. COMMUNITY BENEFIT PLAN & IMPLEMENTATION STRATEGY FOCUS STUDY UPDATE, 2016 PVHMCS 2016 FOCUS STUDY HIGHLIGHTS SOME OF OUR MANY EFFORTS TO PROMOTE AN IMPROVED QUALITY OF LIFE AND EVALUATES OUR CURRENT STRATEGIES AND THE ANTICIPATED IMPACT THOSE STRATEGIES AND PROGRAMS HAVE IN ADDRESSING PRIORITY HEALTH NEEDS IDENTIFIED IN OUR NEEDS ASSESSMENT. PROGRAMS FROM FISCAL YEAR 2015 THAT PVHMC HAS CHOSEN TO HIGHLIGHT THE IN FOCUS STUDY ARE: DIABETES CARE HEALTH NEEDS ASSESSMENT PRIORITY 1 (CHRONIC DISEASE MANAGEMENT) EMERGENCY DEPARTMENT PATIENT NAVIGATOR PROGRAM HEALTH NEEDS ASSESSENT PRIORITY AREA 2 (ACCESS TO CARE) POMONA COMMUNITY HEALTH CENTER HEALTH NEEDS ASSESSMENT PRIORITY AREA 3 (ACCESS TO CARE)
FORM 990, PART III, LINE 4A (CONT'D)	DIABETES CARE TYPE 2 DIABETES (T2D) IS A GROWING PROBLEM. IT HAS TRIPLED OVER THE LAST DECADE AND IT IS ANTICIPATED TO TRIPLE OVER THE NEXT SEVERAL DECADES (CDC, 2015). APPROXIMATELY 9.3% OF AMERICANS HAVE DIABETES; 90-95% OF WHICH IS T2D. THIS EQUATES TO 21 MILLION INDIVIDUALS DIAGNOSED WITH DIABETES (CDC 2014 REPORT CARD ON DM). MORE SO, IT IS ESTIMATED THAT 8.1 MILLION INDIVIDUALS ARE UNDIAGNOSED (CDC 2014 REPORT CARD ON DM). THIS IS A STAGGERING NUMBER, AND PREDIABETES DIAGNOSES ARE ALSO ON THE RAPID RISE. FURTHERMORE, IN PVHMCS 2015 COMMUNITY HEALTH NEEDS ASSESSMENT, APPROXIMATELY 25.9% SAID THAT THEY OR A FAMILY MEMBER WERE LIVING WITH A DIAGNOSIS OF EITHER TYPE 1 OR TYPE II DIABETES. THIS PERCENTAGE IS IN ALIGNMENT WITH ESTIMATES OF THE PREVALENCE OF DIABETES WITHIN THE PATIENTS DISCHARGED FROM PVHMC WITH AN EXISTING OR NEW DIAGNOSIS OF DIABETES (AVERAGE OF 25% OF PATIENTS DISCHARGED FROM PVHMC). WE KNOW, HOWEVER, THIS IS LIKELY TO BE AN UNDERESTIMATE GIVEN THAT UNTIL NOW THERE HAS BEEN NO ROUTINE SCREENING FOR DIABETES ACROSS HOSPITAL SERVICES. MOST OF KNOWN T2D CASES ALSO SUFFER FROM COMORBIDITIES, INCLUDING ESPECIALLY CARDIOVASCULAR DISEASE. THE INCIDENCE OF HIGH BLOOD PRESSURE (42%), OBESITY (21%, LIKELY A LOW ESTIMATE), AND ARTERIOSCLEROSIS (32%), WERE ALSO SIGNIFICANT IN OUR COMMUNITY RESPONSES. SUCH DATA PAINTS A POOR PROGNOSIS FOR THE RESIDENTS OF POMONA AND THE SURROUNDING COMMUNITIES. IT IS FOR THE REASONS ABOVE THAT PVHMC IDENTIFIED DIABETES AS A PRIORITY AREA TO ADDRESS IN THE COMMUNITY. TO FURTHER EXPLORE THE NEED TO MANAGE AND PREVENT DIABETES AND TAKE ACTIONABLE STEPS TO IMPROVE THE HEALTH OF OUR COMMUNITY, PVHMC IN PARTNERSHIP WITH THE POMONA COMMUNITY HEALTH CENTER (PCHC), IMPLEMENTED DIABETES SCREENINGS FOR PATIENTS. ALTHOUGH DATA ON PREDIABETES AND DIABETES IN HOSPITAL, CLINIC, AND COMMUNITY POPULATIONS IN POMONA VALLEY ARE SPARSE AND FRAGMENTED GIVEN THE LACK OF ROUTINE SCREENINGS IN ANY OF THOSE SETTINGS UNTIL NOW, WE PRESENT HERE THE BEST DATA AVAILABLE. OUT OF 1673 ADULT PATIENTS SEEN IN THE POMONA COMMUNITY HEALTH CENTER IN THE 6-MONTH PERIOD JANUARY 6 JULY 6, 2015, 28.3% WERE DIABETIC. ON JUNE 17TH OF 2015, WE BEGAN TESTING/COLLECTING A1C VALUES ON ALL ADULT ADMISSIONS TO MEDICAL-SURGICAL AND TELEMETRY UNITS OF PVHMC. SINCE THAT DATE, 395 TESTS WERE PERFORMED ON THIS POPULATION. OF THE 395 TESTS PERFORMED, 207 PATIENTS HAD A VALUE RANGE BETWEEN 5.7-6.4, APPROXIMATELY 53% OF THOSE TESTED. HOWEVER, ALTHOUGH IN PARTNERSHIP WE WERE ABLE TO EFFECTIVELY SCREEN AND EDUCATE MORE THAN 2000 RESIDENTS, NO COMMUNITY-BASED GENERAL DIABETES SCREENINGS HAVE BEEN CARRIED OUT IN POMONA REGION COMMUNITIES TO DATE. COMMUNITY BASED PREDIABETES SCREENINGS IN A SIMILAR POPULATION IN NEARBY COMMUNITIES OF RIVERSIDE COUNTY REVEALED A PREDIABETES RATE OF 34.1% IN ADULTS, INCREASING WITH AGE, AND A COMBINED OVERWEIGHT/OBESITY RATE OF 85% REGARDLESS OF AGE, FURTHER SUPPORTED PVHMCS DECISION TO MAKE DIABETES MANAGEMENT A PRIORITY FOR OUR COMMUNITY. STEMMING FROM OUR 2015 CHNA, PVHMCS IMPLEMENTATION STRATEGY HIGHLIGHTED ACTIONABLE STRATEGIES TO ADDRESS DIABETES AND OTHER CHRONIC DISEASES SUCH AS HIGH BLOOD PRESSURE AND HEART DISEASE IN THE COMMUNITY. THESE STRATEGIES INCLUDED, BUT NOT LIMITED TO, PROVIDING FREE GLUCOSE SCREENINGS ON CAMPUS AND OUT IN THE COMMUNITY, PROVIDING FREE OR LOW COST DIABETES EDUCATION, WEIGHT MANAGEMENT AND NUTRITION EDUCATION, PROVIDING CARDIOVASCULAR EDUCATION AND RISK REDUCTION RESOURCES. WORKING WITH OUR COMMUNITY PARTNERS, WE WILL BE ABLE TO MAKE THIS STRATEGY A REALITY. THROUGH THE COLLABORATIVE EFFORTS OF PVHMC, THE POMONA COMMUNITY HEALTH CENTER (PCHC), CLAREMONT GRADUATE UNIVERSITY (CGU) AND THE COMMUNITY TRANSLATIONAL RESEARCH INSTITUTE (CTRI), WE WILL EXAMINE THE FEASIBILITY OF POPULATION-BASED SCREENINGS FOR THREE DIFFERENT PATIENT POPULATIONS OF INTEREST TO THE INTERVENTION(S) WE ARE PLANNING-(1) INDIVIDUALS WHO MEET THE CRITERIA FOR PREDIABETES (A1C = 5.7-6.4 FOR ADULTS, AND TWO OR MORE OF OBESITY, FAMILIAL RISK, AND A1C (5.3-5.8) FOR CHILDREN), 2) INDIVIDUALS WHO HAVE UNDIAGNOSED T2D (A1C ABOVE 6.5 FOR ADULTS AND 5.8 FOR CHILDREN), AND 3) INDIVIDUALS ALREADY DIAGNOSED WITH DIABETES WHO EXHIBIT POOR ADHERENCE IN THE MANAGEMENT OF THEIR DISEASE (A1C >9.0). THESE SCREENINGS WILL HELP US UNDERSTAND THE TRUE PREVALENCE OF THE DISEASE AT THREE CRITICAL STAGES (PRE-, EARLY-, AND ADVANCED/UNCONTROLLED T2D) IN EACH OF THE THREE POPULATIONS (HOSPITAL, CLINIC, AND COMMUNITY), AND GUIDE THE DESIGN OF THE INTERVENTIONS WE WILL PROPOSE FOR EACH POPULATION AND DISEASE STAGE. ONCE IMPLEMENTED, THE INTERVENTION DESIGNED DURING THIS PLANNING PHASE WILL: A) PREVENT AND DELAY PROGRESSION FROM PREDIABETES TO T2D, B) PREVENT/DELAY PROGRESSION FROM EARLY STAGE DIABETES TO ADVANCED STAGES WITH CO-MORBIDITIES, AND C) IMPROVE THE CONTROL OF ADVANCED CASES OF DIABETES IN THE PATIENT POPULATIONS OF POMONA VALLEY HOSPITAL MEDICAL CENTER (PVHMC), ITS RELATED POMONA COMMUNITY HEALTH CENTER (PCHC), AND THE COMMUNITIES THEY SERVE. THERE WILL BE A LIFESPAN APPROACH CONCENTRATING FIRST ON ADULTS AT RISK OF DISEASE PROGRESSION, AND SECOND ON CHILDREN AND ADOLESCENTS AT HIGH RISK OF DEVELOPING T2D IN THE SHORT AND LONG TERM. THE UNIQUE INCLUSION OF CHILDREN AND ADOLESCENTS IN OUR PILOT TESTING AND SCREENING (AND AS-NEEDED INTERVENTIONS) ADDRESSES ONE OF OUR GREATEST HOPES, EXTRAPOLATING A GOAL FROM OUR PROJECT TITLE, "STOPPING DIABETES IN ITS TRACKS." WITH ADDITIONAL SUPPORT FROM THE UNIHEALTH FOUNDATION, PVHMC AND ITS PARTNERS HAVE BEGUN THE PLANNING PROCESS TO DEVELOP AND TEST THIS DATA-DRIVEN, INTEGRATED AND SUSTAINABLE 3-LEVEL PREDIABETES AND DIABETES-SCREENING PROGRAM WHICH WILL LEAD TO DEVELOPING AN INTERVENTION THAT TRANSLATES EVIDENCE-BASED APPROACHES TO OBESITY AND DIABETES PREVENTION AND CONTROL INTO EFFECTIVE AND SUSTAINABLE PROGRAMS. DURING THE 9-MONTH PERIOD WE WILL UNDERGO EXTENSIVE PLANNING EFFORTS THAT HELP TO SET THE STAGE FOR EFFECTIVE AND EFFICIENT IMPLEMENTATION OF AN INTERVENTION THAT ADDRESSES IMPORTANT HEALTH NEEDS WITHIN THE COMMUNITY OF POMONA. TO ACHIEVE THESE ENDS, WE WILL DEVELOP THE LEADERSHIP STRUCTURE, TEAM ORGANIZATION, AND OPERATIONAL PROCEDURES NECESSARY TO ACHIEVE THE SCREENING, INTERVENTION, AND EVALUATION OBJECTIVES DURING THE IMPLEMENTATION PHASE. IN AN EFFORT TO DEVELOP THE MOST CUTTING-EDGE AND EFFECTIVE INTERVENTION FOR THIS COMMUNITY CONTEXT, OUR TEAM WILL ALSO TRANSLATE EXISTING EVIDENCE-BASED APPROACHES TO OBESITY AND DIABETES PREVENTION AND CONTROL INTO THE FINAL INTERVENTION WE PROPOSE FOR IMPLEMENTATION. THIS NOVEL, APPROACH WILL FACILITATE THE IDENTIFICATION OF AN INTERVENTION THAT IS CAREFULLY TAILORED TO THE COMMUNITY OF INTEREST AND CAPABLE OF IDENTIFYING AND EMPOWERING INDIVIDUALS WHO FACE THE GREATEST RISK AND HAVE THE GREATEST NEED FOR AN EFFECTIVE APPROACH AT MANAGING DIABETES.
FORM 990, PART III, LINE 4A (CONT'D)	KEY ACTIVITIES OF OUR DIABETES CARE PLANNING PROCESS ARE TO: A. DEVELOP A STRUCTURE AND PROCESS OF PROGRAM LEADERSHIP AND ORGANIZATION B. IDENTIFY TEAM FUNCTIONS AND FORM COLLABORATIVE TEAMS INTEGRATING KEY PERSONNEL FROM THE PARTICIPATING ORGANIZATIONS: PVHMC, PCHC, CGU, AND CTRI. THESE TEAMS ARE: - LEADERSHIP TEAM - SCREENING TEAM - INTERVENTION TEAM - EVALUATION TEAM C. EXPLORE ADDITIONAL COMMUNITY RESOURCES THAT MAY BE NEEDED FOR EFFECTIVE SCREENINGS AND PROGRAM IMPLEMENTATION (E.G., COMMUNITY CENTERS, CHURCHES, SCHOOLS THAT HAVE FACILITIES IN WHICH THE TEAM CAN PERFORM SCREENINGS AS WELL AS FACILITIES SUCH AS KITCHENS AND RECREATIONAL FACILITIES THAT WILL HELP TO SUPPORT OTHER KEY INTERVENTION COMPONENTS) D. CARRY OUT A PILOT TEST OF POPULATION SCREENINGS TO ASSESS FEASIBILITY IN HOSPITAL, CLINIC, AND COMMUNITY SETTINGS, AND DO A PRELIMINARY ASSESSMENT OF THE PREVALENCE OF PREDIABETES AND T2D IN THE POPULATIONS OF THOSE SETTINGS. E. CONDUCT SCREENINGS OF AT LEAST 100 ADULTS IN EACH THE HOSPITAL, THE HEALTH CENTER, AND IN COMMUNITY SETTINGS, AND AT LEAST 50 CHILDREN AT PCHC. ACTUAL NUMBERS OF PERSONS SCREENED COULD BE MUCH HIGHER IN THE HOSPITAL AND CLINIC, AT LEAST FOR ADULTS. F. PERFORM A PROCESS EVALUATION SPECIFICALLY EXAMINING THE PARTICIPATION RATE IN THE SCREENING PILOT AND REASONS FOR HIGH/LOW PARTICIPATION. G. SCAN CLINIC AND HOSPITAL DATA TO QUANTIFY THE NUMBER OF INDIVIDUALS WHO HAVE BEEN PREVIOUSLY DIAGNOSED WITH DIABETES AND PERSONS WITH OTHER RISK FACTORS AND CO-MORBIDITIES, INCLUDING OBESITY AND HYPERTENSION. H. USE GEOGRAPHIC INFORMATION SYSTEMS TO IDENTIFY "HOTSPOTS"COLD SPOTS,CONSIDER USING SMART PHONES TO COMMUNICATE WITH PATIENTS IN ORDER TO ENCOURAGE BEHAVIORS THAT SHOULD LEAD TO BETTER OUTCOMES. HOTSPOTS WOULD BE OF TWO TYPES: LARGE CLUSTERS OF FAST FOOD AND CONVENIENCES STORES THAT MIGHT LEAD TO UNHEALTHY EATING AND CLUSTERS OF AREAS IN WHICH PEOPLE LIVE THAT HAVE A HIGH CONCENTRATION OF INDIVIDUALS WITH DIABETES AND PREDIABETES. COLD SPOTS INCLUDE CLUSTERS OF LOCATIONS SUCH AS: (1) FARMERS MARKETS AND OTHER HEALTHY EATING VENUES AND (2) PLACES WHERE INDIVIDUALS CAN EXERCISE. I. DEVELOP A PLAN TO MEET THE OBJECTIVES OF THE ULTIMATE PROGRAM WE WILL PROPOSE TO THE UNIHEALTH FOUNDATION AND PREPARE A GRANT PROPOSAL ACCORDINGLY. J. DEVELOP AN EVALUATION PLAN - UTILIZE THE GENERAL APPROACH OUTLINED IN THE CDC FRAMEWORK FOR PROGRAM EVALUATION IN PUBLIC HEALTH (1999) TO DEVELOP AN EVALUATION PLAN. ENGAGE TEAM AND OTHER STAKEHOLDERS (AS APPROPRIATE) IN DESCRIBING THE INTERVENTION, ITS INTENDED OUTCOMES, AND CAUSAL PATHWAYS. SPECIFICALLY: - DELINEATE THE INTENDED OUTCOMES OF THE INTERVENTION. THIS INCLUDES PERFORMING A LITERATURE REVIEW AND HOSTING DISCUSSIONS WITH PRINCIPAL INVESTIGATORS OF SIMILAR INTERVENTION APPROACHES TO UNDERSTAND WHAT TYPES OF OUTCOMES WE WOULD ANTICIPATE ARISING AS A RESULT OF OUR EFFORTS AND THE TIMING OF SUCH OUTCOMES (E.G., DO THEY OCCUR 1 MONTH, 6 MONTHS, 1 YEAR AFTER INTERVENTION EXPOSURE). - IN COLLABORATION WITH THE PLANNING TEAM AND OTHER STAKEHOLDERS (AS APPROPRIATE), DELINEATE THE HYPOTHESIZED CAUSAL PATHWAYS BETWEEN INTERVENTION IMPLEMENTATION AND OUTCOMES. SIMILAR TO THE IDENTIFICATION OF OUTCOMES, THIS STEP WILL ALSO LEVERAGE INFORMATION ALREADY AVAILABLE FOR SIMILAR EVIDENCE-BASED INTERVENTIONS REGARDING PRESUMED CAUSAL PATHWAYS. ULTIMATELY, THE AIM OF THE PLANNING GRANT PERIOD IS TO DESIGN A PROGRAM THAT WILL SIGNIFICANTLY REDUCE THE PREVALENCE AND SEVERITY OF UNTREATED TD2 THOUGH AN INTEGRATED SCREENING, INTERVENTION AND ADHERENCE PROGRAM, SPECIFICALLY DEVELOP AN INTERVENTION THAT WILL LEAD TO THE FOLLOWING: - ACTIVE AND SUSTAINED PATIENT PARTICIPATION IN AN INTEGRATED PROGRAM OF CLASSES, COACHING AND TECHNOLOGY TO REDUCE RISK THROUGH LIFESTYLE MODIFICATION, LEADING TO - REDUCTION IN BMI - REDUCTION IN A1C - REDUCTION IN BLOOD PRESSURE - REDUCTION IN MEDICATION(S) TO MANAGE DM - IMPROVED KIDNEY FUNCTION - LIPID REDUCTION - REDUCTION IN PREVALENCE OF T2D IN THE HOSPITAL, CLINIC, AND COMMUNITY POPULATIONS (MEASUREABLE IN THE LONG RUN IF NOT WITHIN THE PERIOD OF THIS GRANT FUNDING) SPECIFIC HEALTH-RELATED NEEDS BEING MET BY THIS PROJECT INCLUDE: A. IDENTIFICATION OF ADULTS (OVER AGE 21) WHO ARE PRE-DIABETIC BY A1C (5.7-6.4%) CRITERIA AND INTRODUCTION OF PREVENTION INTERVENTIONS TO FORESTALL THE DEVELOPMENT OF T2D. B. IDENTIFICATION OF CHILDREN AND ADOLESCENTS (AGES 5-21) WHO EXHIBIT HIGH LEVELS OF KNOWN RISK FACTORS FOR T2D, INCLUDING TWO OR MORE OF OBESITY, A1C=5.3-5.8, AND AT LEAST ONE PARENT WHO IS KNOWN TO BE DIABETIC OR PREDIABETIC C. IDENTIFICATION OF PREVIOUSLY UNKNOWN CASES OF T2D (ADULT A1C>6.4, CHILD A1C>5.8). D. IDENTIFICATION OF INDIVIDUALS WITH POORLY CONTROLLED T2D (A1C > 9.0) E. REDUCTION OF CARDIAC AND NEUROLOGICAL RISKS THROUGH IMPROVED GLYCEMIC CONTROL, WEIGHT LOSS AND LIPID REDUCTION. F. RECRUITMENT OF IDENTIFIED PREDIABETICS AND DIABETICS INTO AN EVIDENCE BASED PROGRAM FOR DIABETES PREVENTION AND CONTROL G. REDUCTION IN THE USE AND COST OF SERVICES INCLUDING FEWER INPATIENT HOSPITALIZATIONS, FEWER EMERGENCY ROOM VISITS. H. REDUCTION AND/OR BETTER CONTROL OF COMORBIDITIES. I. IMPROVED ADHERENCE TO MEDICATION MANAGEMENT AND LIFESTYLE CHANGES. BENEFITS INCLUDE: REDUCED RISK OF HEART ATTACK AND STROKE, THE DEVELOPMENT OF CARDIOVASCULAR AND KIDNEY DISEASE AND THE DEVELOPMENT OF AUTONOMIC NEUROPATHY DISORDERS. TYPE-2 DIABETES IS PREVENTABLE, PRIMARILY BY CONTROL OF BODY WEIGHT AS EVIDENCED BY TRIALS IN THE U.S., FINLAND, AND CHINA. THERE IS EVIDENCE THAT THE RISK OF T2D CAN BE REDUCED AS WELL BY EFFECTIVE BLOOD PRESSURE AND LIPID CONTROL, AND BY REDUCTION OF EXPOSURE TO ENVIRONMENTAL POLLUTANTS, ESPECIALLY TOBACCO SMOKE. IN ADDITION TO OUR EFFORTS TO ADDRESS DIABESTES, AS DESCRIBED ABOVE,WE WILL ADAPT THE BEST EVIDENCE BASED STRATEGIES FOR OBESITY CONTROL FOR ALL, AND FOR BP, LIPID, AND TOBACCO SMOKE EXPOSURE WHERE APPROPRIATE. OUR SCREENINGS WILL ADD THE IMPORTANT COMPONENT OF IDENTIFYING THE IMPACT THAT THE ABOVE HAVE ON ADULTS AS WELL AS CHILDREN AND ADOLESCENTS AND ADDRESS THE OTHER CHRONIC DIESEASE RISK FACTORS AND CAUSES THAT GIVE DIABETES A FOOTHOLD.
FORM 990, PART III, LINE 4A (CONT'D)	EMERGENCY DEPARTMENT PATIENT NAVIGATORS AS IDENTIFIED IN OUR 2015 COMMUNITY NEEDS ASSESSMENT, CARE OF SERIOUSLY ILL PATIENTS IS OFTEN POORLY COORDINATED. OFTENTIMES, THERE ARE MANY CONSULTING PHYSICIANS, POOR COMMUNICATION ACROSS PROVIDERS, LACK OF KNOWLEDGE AVAILABLE IN THE COMMUNITY AND A LACK OF CLEAR TRANSITION GOALS. HEALTH BRIDGES IS A NOT-FOR-PROFIT ORGANIZATION THAT SEEKS TO BRIDGE THE LANGUAGE GAPS IN HEALTH CARE SERVICES BY LEVERAGING THE MULTILINGUAL SKILLS OF COLLEGE STUDENTS. IT WAS FOUNDED IN 2015 BY THREE POMONA COLLEGE STUDENTS, WHO HAD WITNESSED THEIR OWN IMMIGRANT PARENTS STRUGGLE TO OBTAIN QUALITY HEALTHCARE SERVICES BECAUSE OF THE LANGUAGE BARRIER. SINCE SEPTEMBER 2015, HEALTH BRIDGES HAS PARTNERED WITH POMONA VALLEY HOSPITAL MEDICAL CENTER (PVHMC) TO CARRY OUT ITS PILOT PROJECT IN THE EMERGENCY ROOM. THE GOAL OF THIS PARTNERSHIP IS TO HELP ADDRESS THE CONTINUING AND EMERGING NEEDS OF THE LOW-INCOME, LIMITED ENGLISH PROFICIENT (LEP), AND/OR MEDICALLY UNDERSERVED POPULATION IN PVHMCS SERVICE AREAS, SPECIFICALLY BY ADDRESSING THE NEED FOR ACCESS TO CARE. HEALTH BRIDGES BILINGUAL COLLEGE VOLUNTEERS ARE RECRUITED AND TRAINED TO ENGAGE IN THREE MAIN ACTIVITIES. FIRST, THEY INCREASE THE TARGET POPULATIONS' ACCESS TO HEALTH INSURANCE COVERAGE BY ENROLLING PVHMC'S LOW-INCOME, UNINSURED PATIENTS (REGARDLESS OF THEIR IMMIGRATION STATUS OR ENGLISH PROFICIENCY) IN HOSPITAL PRESUMPTIVE ELIGIBILITY (HPE)-A TEMPORARY FULL-SCOPE MEDI-CAL PROGRAM, EXPLAINING TO THEM IN THEIR NATIVE LANGUAGES HOW TO USE THE TEMPORARY INSURANCE AND MAKING APPOINTMENTS FOR ELIGIBLE PATIENTS WITH INSURANCE ENROLLMENT COUNSELORS IN ORDER TO COMPLETE THE FULL MEDI-CAL APPLICATION. SECOND, HEALTH BRIDGES VOLUNTEERS HELP IMPROVE UNDERSTANDING OF AND TRUST IN THE GENERAL HEALTHCARE SYSTEM BY OFFERING IN-PERSON LANGUAGE ASSISTANCE TO LEP PATIENTS WHO HAVE TROUBLE FINDING THEIR WAY INSIDE THE HOSPITAL, UNDERSTANDING HOSPITAL PROCEDURES, AND EXPRESSING THEIR BASIC QUESTIONS AND CONCERNS TO THE MEDICAL STAFF. BETWEEN OCTOBER 20, 2015 AND DECEMBER 9, 2015 NINE HEALTH BRIDGES VOLUNTEERS SPENT A TOTAL OF APPROXIMATELY 140 HOURS VOLUNTEERING IN THE EMERGENCY ROOM (ER). DURING THIS TIME, THEY HELPED 21 PATIENTS SUCCESSFULLY ENROLL IN TEMPORARY MEDI-CAL, AND GAVE THEM INFORMATION IN THEIR NATIVE LANGUAGES ABOUT HOW TO COMPLETE THE FULL MEDI-CAL APPLICATION. APPROXIMATELY 75% OF THESE PATIENTS HAD LIMITED ENGLISH PROFICIENCY. THEY ALSO ASSISTED 15 PATIENTS WITH BASIC LANGUAGE INTERPRETATION AND HOSPITAL NAVIGATION (10 SPANISH SPEAKERS AND 5 MANDARIN SPEAKERS). IN THE UPCOMING MONTHS AND YEARS, HEALTH BRIDGES HOPES TO EXPAND ITS WORK BY SIGNIFICANTLY INCREASING THE NUMBER OF VOLUNTEERS AND SERVING PATIENTS FROM OTHER DEPARTMENTS WITHIN THE MEDICAL CENTER. IT ALSO AIMS TO INCREASE LOW-INCOME AND LEP PATIENTS AWARENESS ABOUT HEALTH AND SOCIAL RESOURCES OFFERED BOTH AT PVHMC AND IN THE COMMUNITY BY HAVING ITS BILINGUAL COLLEGE VOLUNTEERS SCREEN THEIR CLIENTS FOR NEEDS SUCH AS CHRONIC DISEASE MANAGEMENT, FOOD INSECURITIES, AND A LACK OF ACCESS TO PRIMARY SERVICES AND MEDICATION BECAUSE OF COST AND/OR IMMIGRATION STATUS. AFTER THE INITIAL SCREENING, HEALTH BRIDGES VOLUNTEERS WILL INFORM THEIR CLIENTS-THROUGH MULTILINGUAL FLYERS AND FOLLOW-UP PHONE CALLS-APPROPRIATE RESOURCES FOR WHICH THE PATIENTS ARE ELIGIBLE. POMONA COMMUNITY HEALTH CENTER EXPANSION FOUNDED WITH THE SAME PURPOSE, POMONA COMMUNITY HEALTH CENTER (PCHC) AND KIDS COME FIRST HAVE BEEN SERVING THE GREATER POMONA VALLEY SINCE THE LATE 1990S. AS NOT-FOR-PROFIT, SAFETY-NET CLINICS, PCHC AND KIDS COME FIRST HAVE PAVED THE WAY FOR ACCESS TO HIGH QUALITY, LOW-COST HEALTH CARE AND SUPPORT SERVICES TO THE POMONA AND ONTARIOS MOST VULNERABLE PATIENTS AND FAMILIES. AS PCHC STATES, "NO ONE IS EVERY TURNED AWAY DUE TO LACK OF FUNDS." UNDERSTANDING THE PIVOTAL ROLE THESE TWO CLINICS WOULD PLAY IN IMPROVING ACCESS TO HEALTH CARE FOR THIS REGION, PVHMC BECAME A FOUNDING PARTNER FOR BOTH CLINICS MORE THAN 17 YEARS AGO. NOW, THESE CLINICS SERVE MORE THAN 5,400 PATIENTS ANNUALLY IN OUR COMMUNITY. PVHMC RECOGNIZES THE SUCCESS OF THIS PARTNERSHIP AND CONTINUES TO PROVIDE VISIONARY SUPPORT TO ENSURE THAT OUR MISSION, VISION, AND DEDICATION TO MEETING THE DIVERSE NEEDS OF OUR COMMUNITY ARE FULFILLED. TODAY, PCHC HAS TWO LOCATIONS SITUATED IN THE CITY OF POMONA TO SERVE THE NEEDS OF THE COMMUNITY, OFFERING PRIMARY CARE, OBSTETRICAL AND PRENATAL CARE, MEDICATIONS, IMMUNIZATIONS, SOCIAL SERVICES, HOMELESS HEALTH CARE AND CASE MANAGEMENT, CHRONIC DISEASE MANAGEMENT, MEDI-CAL AND COVERED CALIFORNIA ENROLLMENT, WIC HEALTH SCREENINGS AND MORE. ACCORDING TO OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) 2015 DATA, PCHC ASSISTED MORE THAN 3,922 UNIQUE PATIENTS ACROSS 13,553 VISITS. AMONG THESE PATIENTS, 85% WERE BETWEEN THE AGES OF 20 AND 64 YEARS. IN CONTRAST, KIDS COME FIRST SERVES ONLY A PEDIATRIC POPULATION (2,950 UNIQUE PATIENTS IN 7,507 VISITS ACCORDING TO 2015 OSHPD DATA), OF WHICH APPROXIMATELY 85% QUALIFY FOR ONE OF MORE INSURANCE PROGRAMS AND THE OTHER 15% REMAIN UNINSURED. KCF SERVICES INCLUDE TREATMENT AND FOLLOW-UP CARE FOR ILLNESS AND INJURY, WELL-CHILD CARE AND PHYSICAL EXAMS, IMMUNIZATIONS, VISION AND HEARING SCREENINGS, TEEN SERVICES, AND HEALTH GUIDANCE AND SUPPORT FOR PARENTS AND GUARDIANS, ENCOURAGING HEALTHY LIFESTYLE CHOICES. IN ADDITION, KCF PROVIDES LITERACY SUPPORT, FOOD STAMP ASSISTANCE AND RESOURCES SUCH AS SHOES, CLOTHING AND FOOD FOR THOSE IN NEED. IN AUGUST OF 2015, REALIZING THAT EVEN MORE CAN BE ACCOMPLISHED TOGETHER, POMONA COMMUNITY HEALTH CENTER ENTERED INTO DISCUSSIONS TO ACQUIRE KIDS COME FIRST IN A MUTUAL DECISION TO EXPAND SERVICES AND FURTHER INCREASE ACCESS TO QUALITY HEALTH CARE. THIS IDEAL PARTNERSHIP CAME TO FRUITION IN FEBRUARY 2016 AS A MERGER OF MISSIONS, SHARING OF BEST-PRACTICES AND AN ACQUISITION OF OPERATIONS. NOW AS ONE ENTITY, PCHC WILL BE ABLE TO ADDRESS THE HEALTHCARE NEEDS TO ADULT AND PEDIATRIC POPULATIONS WITHOUT THE NEED FOR PATIENTS TO TRAVEL ACROSS CITIES. PCHC AT ITS NOW THREE SITES (TWO IN POMONA AND ONE IN ONTARIO) ARE PROVIDING ACCESS TO CARE FOR THE MOST UNDERSERVED AND VULNERABLE PATIENTS IN OUR COMMUNITY AND PVHMC PRIDE ITSELF IN THESE PARTNERSHIPS. ALTHOUGH ACCESS TO CARE IS IDENTIFIED AS A PRIORITY NEED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT, PVHMC, PCHC AND KIDS COME FIRST HAVE BEEN WORKING AND COLLABORATING TO MEET THIS NEED FOR NEARLY TWO DECADES. LIVING TRUE TO PVHMCS VALUE OF GROWING CONTINUOUSLY, PVHMC IS LOOKING FORWARD TO FURTHER PARTNERING WITH PCHC ON THE EXPANSION OF SERVICES ACROSS OUR COMMUNITY.
FORM 990, PART III, LINE 4A (CONT'D)	ACCESS TO EMERGENCY CARE POMONA VALLEY HOSPITALS VAST EFFORTS TO PROMOTE COMMUNITY HEALTH DEMONSTRATES OUR WORK TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN OUR COMMUNITY NEEDS ASSESSMENT, SPCIFICALLY PVHMC PRIORITIZED NEEDS OF IMPROVING ACCESS TO CARE, PROVIDING HEALTH EDUCATION AND WELLNESS SUPPORT, AND MANAGING AND PREVENTING CHRONIC DISEASES LIKE HIGH BLOOD PRESSURE, HEART FAILURE, DIABETES, AND CANCER. THESE ARE THE ISSUES OUR COMMUNITY NEEDS ASSESSMENT DEMONSTRATED AS THE BIGGEST HEALTH CONCERNS FOR OUR COMMUNITY. WE ADDRESS AND ALLOCATE OUR RESOURCES TO SERVE THE NEED OF OUR ENTIRE COMMUNITY, FOCUSING ON THOSE THAT ARE AT RISK AND HAVE THE LEAST ACCESS TO THE NECESSARY SERVICES AND CARE NEEDED. WE REACH OUT AND MEET OUR COMMUNITYS NEED FOR CHRONIC DISEASE MANGEMENT, HEALTH EDUCATION AND WELLNESS SUPPORT, AND ACCESS TO CARE THROUGH: - PROVIDING FREE AND PARTIAL PAYMENT HOSPITAL SERVICES FOR THOSE WITHOUT THE ABILITY TO PAY OR LIMITED FINANCIAL RESOURCES - REACHING OUT TO OUR LOCAL SCHOOLS AND COMMUNITY GROUPS ON THE IMPORTANCE OF HEALTH LIVING - PROVIDING MEDICAL SERVICES IN UNDERSERVED AREAS THROUGH FREE AND COMMUNITY BASED CLINICS. - PROVIDING VACCINATIONS AND SCREENINGS TO CHILDREN AND THE ELDERLY. - TRAINING HEALTH PROFESSIONALS LIKE FAMILY PRACTICE RESIDENTS AND NURSING STUDENTS IN ORDER TO MEET THE NEEDS OF THE FUTURE. WE FURTHER DEMONSTRATE THE WAYS WE SERVE OUR COMMUNITY AS OUR COMMITMENT TO IMPROVING THEIR HEALTH STATUS BY PROVIDING SPECIFIC WAYS WE ARE ADDRESSING HEALTH NEEDS: PVHMC IS ADDRESSING THE NEEDS OF CHRONIC DISEASE MANAGEMENT THROUGH THE FOLLOWING STRATEGIES: PROVIDING GLUCOSE SCREENINGS AT HEALTH FAIRS AND EVENTS (LOCAL AND ON-CAMPUS); PROVIDING FREE EDUCATION CLASSES TO PROMOTE CARDIOVASCULAR HEALTH AND RISK REDUCTION; OFFERING FREE BLOOD PRESSURE SCREENINGS AT HEALTH FAIRS AND EVENTS (LOCAL AND ON-CAMPUS); PUBLISHING AND DISTRIBUTING FREE INFORMATION ON CARDIOVASCULAR HEALTH, DIABETES, CANCER TREATMENT, AND AVAILABLE RESOURCES TO ADDRESS THESE CONDITIONS; PROVIDING CARE COORDINATION SERVICES THAT SEEK TO ASSURE PATIENTS ARE POSITIONED FOR A SAFE DISCHARGE HOME; PROVIDING CANCER CARE PATIENT COORDINATORS AND SOCIAL SERVICES TO GUIDE PATIENTS WITH MAKING APPOINTMENTS, RECEIVING FINANCIAL ASSISTANCE, AND ENROLLING IN SUPPORT GROUPS; PROVIDING FREE CANCER CARE SUPPORT GROUPS AND WELLNESS CLASSES WITH EMPHASIS ON THE SOCIAL, EMOTIONAL, NUTRITIONAL, AND PHYSICAL ASPECTS OF CHRONIC DISEASE. THE FOLLOWING PROGRAMS AND SERVICES ARE PROVIDED BY PVHMC, SPECIFICALLY DESIGNATED TO ADDRESS PRIORITY NEED 1, CHRONIC DISEASE MANAGEMENT: STEAD HEART AND VASCULAR CENTER LECTURES AND CLASSES FOR CARDIOVASCULAR HEALTH; SAVING STROKES EVENT; COMMUNITY BLOOD PRESSURE SCREENINGS; DIABETIC EDUCATION FAIR (ON-CAMPUS); NUTRITION EDUCATION; THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CARE CENTER EDUCATION, WELLNESS CLASSES, WORKSHOPS, FORUMS, AND EVENTS; CANCER PROGRAM ANNUAL PUBLICATION; STEAD HEART AND VASCULAR CENTER PUBLICATIONS. PVHMC IS ADDRESSING THE COMMUNITY NEEDS FOR HEALTH EDUCATION AND SUPPORT SERVICES THROUGH THE FOLLOWING STRATEGIES: PROVIDING FREE OR LOW-COST HEALTH EDUCATION CLASSES, WELLNESS SUPPORT GROUPS, AND OTHER HEALTH IMPROVEMENT SERVICES BOTH AT PVHMC AND OUT IN A COMMUNITY SETTING; COLLABORATING WITH COMMUNITY PARTNERS AND PARTICIPATE IN COMMUNITY-WIDE INITIATIVES TO IMPROVE THE HEALTH OF THE COMMUNITY; INCREASING AWARENESS OF AVAILABLE CLASSES OFFERED AT PVHMC THROUGH REACHING OUT DIRECTLY TO THE COMMUNITY AND OTHER ORGANIZATIONS THROUGH WRITTEN AND VERBAL COMMUNICATION AND PUBLICATIONS; DEVELOPING EDUCATION, RESOURCES, AND/OR CLASSES THAT PROMOTES HEALTHY EATING, DISEASE PREVENTION, AND WEIGHT MANAGEMENT; PARTICIPATING AND HOSTING SPEAKING ENGAGEMENTS TO COMMUNICATE TO THE COMMUNITY ABOUT HEALTH AND SERVICES IN THE COMMUNITY; PROVIDING COMPREHENSIVE, CULTURALLY SENSITIVE HEALTH FORUMS, SUPPORT GROUPS, AND WORKSHOPS THAT PROVIDE HANDS-ON HEALTHY LIFESTYLE SUPPORT TO THE COMMUNITY.
FORM 990, PART III, LINE 4A (CONT'D)	THE FOLLOWING PROGRAMS AND SERVICES PROVIDED BY PVHMC ARE SPECIFICALLY DESIGNATED TO ADDRESS PRIORITY NEED 2 HEALTH EDUCATION AND SUPPORT SERVICES: THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CARE CENTER WELLNESS CLASSES, SUPPORT GROUPS, EARLY DETECTION AND PREVENTION LECTURES, AND COMMUNITY FORUMS; WOMENS AND CHILDRENS SERVICES HEALTH AND EDUCATION CLASSES; STEAD HEART AND VASCULAR CENTER RISK REDUCTION CLASS; CARDIAC EDUCATION ; CANCER PROGRAM ANNUAL REPORT; HEALTH FAIRS/COMMUNITY EVENTS; HANDS-ONLY CPR; SLEEP DISORDERS MEETINGS; NUTRITION EDUCATION; HOSPITAL TOURS IN ENGLISH, SPANISH, AND CHINESE; INPATIENT SMOKING CESSATION EDUCATION; INPATIENT ASTHMA EDUCATION AND "EVERY 15 MINUTES" DRUNK DRIVING EDUCATION. PVHMC IS ADDRESSING THE COMMUNITY NEEDS FOR PRIORITY AREA 3, ACCESS TO CARE, THROUGH THE FOLLOWING STRATEGIES: PROVIDING ON-SITE ENROLLMENT ASSISTANCE AND FOR APPROPRIATE HEALTH INSURANCE PLANS; PARTICIPATION IN THE HOSPITAL PRESUMPTIVE ELIGIBILITY PROGRAM; INCREASING COMMUNITY AWARENESS ABOUT HEALTH SERVICES OFFERED, WELLNESS CLASSES, AND SUPPORT GROUPS; PROVIDING DISCHARGE TRANSPORTATION FOR VULNERABLE PATIENTS WHO ARE OTHERWISE UNABLE TO GET HOME; PROVIDING FREE, LOW-COST OR REDUCED-COST HEALTH SERVICES, MEDICATIONS, AND MEDICAL DEVICES; PROVIDING FREE OR REDUCED COST SCREENINGS AND IMMUNIZATIONS AT LOCAL HEALTH FAIRS; COLLABORATING WITH PRIMARY CARE PROVIDERS AND CLINICS TO IMPROVE ACCESS TO PREVENTATIVE AND SPECIALTY CARE; WORKING CLOSELY WITH PVHMCS FAMILY MEDICINE RESIDENCY PROGRAM THROUGH UCLA TO INCREASE THE NUMBER OF PRIMARY CARE PHYSICIANS IN THE REGION; EXPANDING THE EMERGENCY DEPARTMENT TO INCREASE PVHMCS CAPACITY TO CARE FOR PATIENTS NEEDING EMERGENCY TREATMENT, TRAUMA SERVICES, SURGERY, AND PRIMARY CARE. PROGRAMS AND SERVICES PROVIDED BY PVHMC, SPECIFICALLY DESIGNATED TO ADDRESS PRIORITY NEED 3 ACCESS TO CARE ARE: PVHMC FAMILY MEDICINE RESIDENCY PROGRAM; SPORTS INJURY EVENING CLINIC PROVIDING FREE AND LOW COST SPORTS INJURY EXAMINATIONS AND X-RAYS; ENROLLMENT ASSISTANCE IN APPROPRIATE HEALTH PLANS FOR OUR PATIENTS WHO ARE ADMITTED WITHOUT INSURANCE; DISCHARGE TRANSPORTATION SERVICES FOR OUR VULNERABLE PATIENTS; AMBULANCE TRANSPORTS; FREE AND LOW COST MEDICATION ASSISTANCE; FREE AND LOW COST IMMUNIZATIONS PROVIDED IN THE COMMUNITY. PVHMC ALSO RECOGNIZES THE IMPORTANCE OF EMERGENCY CARE SERVICES TO THE COMMUNITY AND WE ARE COMMITTED TO MEETING THE NEEDS OF OUR PATIENTS.OUR HOSPITAL HAS LEARNED FROM EVALUATIONS OF THE ED THAT THE NECESSITY TO IMPROVE AND BUILD UPON THE EFFICIENCY OF OUR ED IS CRITICAL IN ORDER TO KEEP UP WITH THE GROWING DEMANDS BEING PLACED UPON OUR SYSTEM EVERYDAY. IN 2009, 2013 AND AGAIN IN 2015, OUR ED RECEIVED MODERATE COSMETIC RECONSTRUCTION THAT INCLUDED ADDITIONS TO OUR PATIENT CARE AREAS. THIS REMODEL LOGISTICALLY AIDED IN IMPROVING TIMELINESS OF TREATMENT AND ED FLOW, IN-TURN, REDUCING WAIT TIMES AND INCREASING ACCESS TO CARE. ADDITIONALLY, THE NEWLY REMODELED SPACE ELIMINATED BARRIERS AT THE NURSES STATION AND INCREASED VISIBILITY OF OUR MEDICAL TEAM, IMPROVING PATIENT SATISFACTION AND ENHANCING PATIENT SAFETY. AS A DESIGNATED STEMI RECEIVING CENTER (SRC) IN BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES, PVHMC BECAME THE FIRST HOSPITAL IN THE REGION WITH DUAL COUNTY DESIGNATION. AN ACUTE HEART ATTACK CAUSED BY BLOOD CLOTS IS CALLED AN ST-ELEVATED MYOCARDIAL INFARCTION, OR STEMI. WITHOUT RAPID ANGIOPLASTY, HEART MUSCLE IS PERMANENTLY DAMAGED. IN ORDER TO QUALIFY FOR THIS DESIGNATION, HOSPITALS ARE REQUIRED TO PROVIDE ANGIOPLASTY TREATMENT IN LESS THAN 90 MINUTES. CURRENTLY, PVHMC AVERAGES 50-MINUTE DOOR-TO-BALLOON TIMES, RANKING IN THE TOP 5 PERCENT NATIONALLY. OUR EMERGENCY DEPARTMENT (ED) HAS BEEN ENHANCED WITH ROUND THE CLOCK PHYSICIAN COVERAGE OF FULL-TIME LABORISTS (HOSPITAL-BASED OBSTETRICS/GYNECOLOGY PHYSICIANS WHO DO DELIVERIES), A HOSPITALIST TEAM, AND A DEDICATED INTENSIVIST PROGRAM IN THE INTENSIVE CARE UNIT (ICU). A FULL SERVICE ED BACK UP CALL PROVIDES ADEQUATE COVERAGE OF SPECIALISTS WHICH IS CRITICAL TO THE ABILITY OF THE HOSPITAL TO PROVIDE SPECIALTY MEDICINE TO PATIENTS. ALONG WITH THE PROGRESS WE HAVE MADE TO IMPROVE EMERGENCY CARE SERVICES ON OUR MAIN CAMPUS, AND RECOGNIZING THAT THE ED IS STILL A SOURCE OF PRIMARY HEALTH CARE FOR THE COMMUNITY, WE HAVE INCREASED ACCESS TO PRIMARY HEALTH CARE SERVICES OUTSIDE OF THE HOSPITALS ED. WE ADDRESSED THE NEED FOR ADDITIONAL ACCESS THROUGH THE DEVELOPMENT OF OUR FAMILY MEDICINE RESIDENCY PROGRAM IN THE MID 1990S TO HELP ADDRESS THE LOOMING SHORTAGE IN PRIMARY CARE PROVIDERS. OVER TIME, PVHMC AND THE RESIDENCY FACULTY MEDICAL GROUP WORKED TOGETHER TO PROVIDE ADDITIONAL ACCESS POINTS THROUGHOUT OUR COMMUNITY IN ADDITION TO THE POMONA BASED FAMILY HEALTH CENTER. THROUGH THE RECRUITMENT OF GRADUATING RESIDENTS WE OPENED AND STAFFED THE POMONA VALLEY HEALTH CENTER IN CHINO HILLS (OPENED IN 2003, REPLACING A SMALLER OFFICE THAT HAD OPENED IN 1999); THE POMONA VALLEY HEALTH CENTER AT CROSSROADS (ALSO IN CHINO HILLS, OPENED IN 2007) AND THE POMONA VALLEY HEALTH CENTER IN CLAREMONT (OPENED IN 2009). IN TOTAL, THESE NETWORKED CENTERS OFFER FAMILY MEDICINE, URGENT CARE, PHYSICAL THERAPY AND REHABILITATION, SLEEP MEDICINE AND WIDE RANGING IMAGING SERVICES. THESE SITES ARE DIGITALLY CONNECTED THROUGH AN ELECTRONIC MEDICAL RECORD THAT ALLOWS ACCESS TO PATIENT HISTORY THROUGHOUT THE SYSTEM. ANOTHER PROJECT TO EXPAND ACCESS TO PRIMARY CARE SERVICES IN OUR COMMUNITY IS THE GROWTH OF THE POMONA COMMUNITY HEALTH CENTER. BEGINNING IN THE MID 1990S, AND PARTNERING WITH A GRADUATING FAMILY MEDICINE RESIDENT, THE HOSPITAL WORKED WITH LOS ANGELES COUNTY AND OTHER COMMUNITY PARTNERS TO OPEN THE POMONA COMMUNITY HEALTH CENTER WITHIN THE L.A. COUNTY DEPARTMENT OF PUBLIC HEALTH. THIS SMALL, TWO EXAM ROOM CLINIC, OFFERED FREE PRIMARY CARE TO UNINSURED COUNTY RESIDENTS AS AN OUTPATIENT SERVICE OF THE HOSPITAL. IN 2010, THE CLINIC AND HOSPITAL ORCHESTRATED A SUCCESSFUL SEPARATION OF THE CLINIC INTO ITS OWN NOT-FOR-PROFIT COMMUNITY CLINIC AND BEGAN A PROCESS THAT WOULD ALLOW IT TO BE ACCREDITED AS A FEDERALLY QUALIFIED HEALTH CENTER WHILE EMBARKING ON A CAPITAL GRANT CAMPAIGN TO ALLOW FOR EXPANSION TO BOTH ADD CAPACITY AND ALLOW FOR IT TO SERVE UN AND UNDERINSURED RESIDENTS OF SAN BERNARDINO COUNTY AS WELL. IN OCTOBER OF 2011 THE PCHC RECEIVED THEIR FEDERAL DESIGNATION, AND A SUCCESSFUL CAPITAL CAMPAIGN HAS ALLOWED FOR THE RECENT COMPLETION AND FURNISHING OF A 13 BED FEDERALLY QUALIFIED HEALTH CENTER. THE NEW SITE IS LOCATED IN POMONA, IN A MULTI SERVICES MALL OWNED BY THE POMONA UNIFIED SCHOOL DISTRICT, AND SITS A FEW HUNDRED YARDS FROM THE SAN BERNARDINO COUNTY LINE, ALLOWING FOR EASY ACCESS. THE SITE IS SIZED TO PROVIDE A MEDICAL HOME THAT HAS THE CAPACITY FOR 25,000 ANNUAL PATIENT VISITS THAT WILL BE TARGETED FOR INCREASING ACCESS TO CARE FOR THE LOW INCOME COMMUNITY. SINCE THE OPENING OF THESE NEW SITES WE HAVE SEEN YEAR OVER YEAR GROWTH IN OUR PRIMARY CARE AND URGENT CARE BASE, DEMONSTRATING THAT THESE EFFORTS ARE INCREASNIG ACCESS TO PRIMARY AND PREVENTATIVE CARE IN THE COMMUNITY. IN ADDITION, THESE 29 URGENT CARE BEDS TO THE REGION HAS HELPED RELIEVE PVHMCS EMERGENCY ROOM BURDEN BY OFFERING A MORE DISEASE APPROPRIATE SETTING FOR MANY PRIMARY CARE NEEDS. THE INTEGRATED PRIMARY CARE COMPONENTS, LICENSED AS COMMUNITY HEALTH CENTERS, ARE THEN AVAILABLE TO SERVE AS PRIMARY CARE HOMES FOR PATIENTS WHO MAY HAVE SEEN THE EMERGENCY ROOM AS THEIR PRIMARY SOURCE OF HEALTH CARE.
FORM 990, PART III, LINE 4A (CONT'D)	COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS, 2015 THE EXAMPLES PRESENTED IN THIS REPORT ARE INSIGHTS INTO PVHMCS ACTIVE EFFORTS AND SPECIFIC PROGRAMS WE PROVIDE TO IMPROVE THE HEALTH STATUS OF RESIDENTS LIVING IN THE POMONA VALLEY. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS - MANY DEPARTMENTS AT PVHMC OFFER CLASSES AND SUPPORT GROUPS BOTH IN THE HOSPITAL AND OUT IN THE COMMUNITY. IN WOMEN'S AND CHILDRENS SERVICES, MANY OF THE CLASSES ("CHILDBIRTH PREPARATION", "YOUR CESAREAN", "BIG BROTHER/BIG SISTER") OFFERED AT THE HOSPITAL ARE NOT AVAILABLE AT NEIGHBORING HOSPITALS. PVHMC ALSO OFFERS FREE SUPPORT GROUPS ("BOOTCAMP FOR DADS", "MOMMY N ME"). A HEALTH NEWSLETTER "REGARDING WOMEN" IS DISTRIBUTED QUARTERLY TO RESIDENTS IN THE COMMUNITY. AT THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CARE CENTER (CCC), THERE ARE PATIENT WORKSHOPS ("YOGA"), AND SUPPORT GROUPS ("LOOK GOOD...FEEL BETTER", "BREAT CANCER SUPPORT") AND EARLY DETECTION (SKIN SCREENINGS). THE STEAD HEART AND VASCULAR CENTER (SHVC) OFFERS HEART FAILURE EDUCATION AND AWARENESS TO RECOGNIZE RISK FACTORS, SIGNS AND SYMPTOMS. THERE IS ALSO A HEART FAILURE PROGRAM THAT HELPS PATIENTS IN MAINTAINING THEIR DISEASE AND PROVIDES SUPPORT LEADING TO DECREASED SUBSEQUENT HOSPITALIZATIONS. THE "CARDIOVASCULAR EDUCATION" SERIES IS OPEN TO PATIENTS AND THE PUBLIC AND PROVIDES RISK REDUCTION EDUCATION SUCH AS NUTRITION, EXERCISE, HYPERTENSION, AND STRESS REDUCTION INFORMATION. THE "STEAD HEART FOR WOMEN" PROGRAM PROVIDES EDUCATION, SUPPORT AND COMMUNITY FORUMS DESIGNED SPECIFICALLY TO RAISE AWARENESS FOR HEART DISEASE AND STROKE PREVENTION. RECOGNIZING THE IMPORTANCE OF PREVENTIVE HEALTH, OUR MARKETING DEPARTMENT COLLABORATES WITH OUR CLINICAL ASSOCIATES TO ORGANIZE AND PARTICIPATE IN HEALTH FAIRS AND SPEAKERS BUREAUS, PROVIDING HEALTH CARE INFORMATION AND HEALTH SCREENINGS. IN 2014, PVHMC HOSTED DIABETES AWARENESS FAIR ON CAMPUS, OPEN TO ASSOCIATES AND THE PUBLIC ALIKE, PROVIDING ATTENDEES WITH DIABETIC EDUCATION AND RESOURCES AND GIVING FREE BLOOD GLUCOSE SCREENINGS. THE VOLUNTEER SERVICES DEPARTMENT ORGANIZES FLU SHOTS IN A DRIVE-THRU SETTING WITH THE HELP OF PVHMCS NURSES, GIVING 300 FREE FLU-SHOT IMMUNIZATIONS TO SENIORS IN THE COMMUNITY IN 2015. AGAIN IN 2015, FREE FLU VACCINES WERE OFFERED AT TWO COMMUNITY BASED LOCATIONS FOR ALL INDIVIDUALS AND FAMILIES IN THE COMMUNITY. PVHMC ALSO WORKS WITH LA COUNTY AND LOCAL NOT-FOR-PROFIT ORGANIZATIONS TO PUT TOGETHER AN ANNUAL KIDS HEALTH FAIR PROVIDING FREE HEALTH SCREENINGS, IMMUNIZATIONS AND MEDICAL INFORMATION FOR UNINSURED AND UNDER-INSURED CHILDREN AGES TWO MONTHS TO 18 YEARS. THE SPORTS MEDICINE CENTER OFFERS FREE SPORTS INJURY ASSESSMENTS AND COLLABORATES WITH LOCAL AREA HIGHSCHOOLS TO PROVIDE REDUCED-COST SPORTS PHYSICALS. AS THE FIRST HOSPITAL-BASED SPORTS MEDICINE PROGRAM IN THE REGION, THE SPORTS MEDICINE CENTER (SMC) AT PVHMC HAS BEEN SETTING THE PACE IN THE EDUCATION, PREVENTION, TREATMENT, AND REHABILITATION OF SPORTS-RELATED INJURIES FOR ATHLETES OF ALL AGES AND SKILL LEVELS SINCE 1983.THIS PROGRAM PROVIDES SUPPORT, EDUCATION, SERVICE, AND ASSESSMENT TO LOCAL STUDENT AND SCHOOLS THROUGH THE UTILIZATION OF THE SPORTS MEDICINE CLINIC (SMC) RESOURCES. THE RESPIRATORY SERVICES DEPARTMENT OFFERS ASTHMA EDUCATION, AVAILABLE IN SPANISH, AND A SMOKING CESSATION PROGRAM. BREATHING BUDDIES IS A SUPPORT GROUP FOR SENIORS WHO HAVE CHRONIC LUNG DISEASE BY PROVIDING THE LATEST HEALTH INFORMATION, REVIEWING THEIR MEDICATIONS, AND PROVIDING INSTRUCTION (E.G., ON HOW TO TRAVEL WITH OXYGEN). THE FOOD AND NUTRITION SERVICES DEPARTMENT OFFERS NUTRITION INFORMATION SUCH AS SENIOR NUTRITION, PROSTATE CANCER FORUM, DIABETES WORKSHOP, HEALTHY EATING, AND OSTOMY SUPPORT. HEALTH PROFESSIONS EDUCATION - OUR HOSPITAL PROVIDES MANY TRAINING OPPORTUNITIES THROUGH THE VARIOUS DEPARTMENTS THAT WORK WITH THE LOCAL COLLEGES AND HEALTH PROFESSIONAL PROGRAMS. PVHMC IS A CLINICAL SITE FOR NURSING STUDENTS IN PROGRAMS AT THE LOCAL COMMUNITY COLLEGES AND UNIVERSITIES. THE PARISH NURSE PROGRAM THROUGH THE SHVC EDUCATES AND TRAINS BOTH CLINICAL AND NON-CLINICAL SUPPORT STAFF. PVHMCS FAMILY MEDICINE RESIDENCY PROGRAM TRAINS NURSE PRACTITIONER AND MEDICAL STUDENTS AT THE FAMILY HEALTH CENTER. FOOD AND NUTRITION PROVIDES OPPORTUNITES FOR DIETETIC STUDENTS TO DO THEIR INTERNSHIP ROTATIONS AT PVHMC WHERE THEY LEARN ABOUT FOOD PRODUCTION AND MANAGEMENT. THE HOSPITAL IS ALSO A TRAINING LOCATION FOR PHLEBOTOMY, PHYSICIAN BILLING, SOCIAL SERVICES, RESPIRATORY AND SURGICAL TECH STUDENTS. IN RADIOLOGY, OUR HOSPITAL IS A TRAINING SITE FOR RADIOLOGIC TECHNOLOGY, ULTRASOUND AND NUCLEAR MEDICINE STUDENTS. WE ALSO WELCOME CHAPLAINS IN THE COMMUNITY TO RECEIVE CLINICAL CHAPLAIN TRAINING AT PVHMC. FOR THE MEDICAL COMMUNITY, THE HOSPITAL ORGANIZES WEEKLY CONTINUING MEDICAL EDUCATION AT NO COST TO PHYSICIANS. WE OFFER A PERINATAL SYMPOSIUM WHICH IS LABOR AND DELIVERY AND NEONATAL EDUCATION. THE CANCER CARE CENTER OFFERS SEMINARS ON LUNG AND GASTROINTESTINAL CANCERS. SUBSIDIZED HEALTH SERVICES PVHMC IS A MAJOR PROVIDER IN OUR REGION, PARTICULARLY FOR MEDI-CAL AND INDIGENT PATIENTS IN BOTH LOS ANGELES AND SAN BERNARDINO COUNTIES. IT IS ESSENTIAL FOR OUR HOSPITAL TO HAVE ADEQUATE COVERAGE OF SPECIALISTS TO PROVIDE NEEDED SPECIALTY MEDICINE TO PATIENTS. WE HAVE ROUND THE CLOCK PHYSICIAN COVERAGE IN THE ED, FULL-TIME LABORISTS (HOSPITAL-BASED OB/GYN PHYSICIANS WHO DO DELIVERIES), A HOSPITALIST TEAM, AND A DEDICATED INTENSIVIST PROGRAM IN THE INTENSIVE CARE UNIT. RESEARCH THE ROBERT AND BEVERLY LEWIS FAMILY CANCER CARE CENTER OF PVHMC PARTICIPATES IN CLINICAL RESEARCH STUDIES IN BREAST CANCER, GASTROINTESTINAL CANCERS, HEAD & NECK CANCERS, LUNG CANCER, PROSTATE CANCER, AND SYMPTOM MANAGEMENT. CASH AND IN-KIND CONTRIBUTIONS - OUR HOSPITAL PROVIDES SUPPORT TO VARIOUS LOCAL COMMUNITY SERVICE ORGANIZATIONS INCLUDING THE HOUSE OF RUTH (SERVICES AND ASSISTANCE TO VICTIMS OF DOMESTIC VIOLENCE), PROJECT SISTER (SEXUAL ASSAULT CRISIS AND PREVENTION SERVICES),THE BOYS AND GIRLS CLUB OF POMONA VALLEY, THE LEARNING CENTERS AT FAIRPLEX, CASA COLINA HEALTH FOUNDATION, AND THE CHINO VALLEY YMCA. IN-KIND CONTRIBUTIONS TO OUR PATIENTS AND TO THE COMMUNITY INCLUDE TOYS GIVEN TO PEDIATRIC SURGERY PATIENTS AND INFANT LAYETTES AND CAR SEATS TO NEW MOTHERS IN NEED. THE FACILITIES DEPARTMENT PARTICIPATES IN THE CITY-WIDE CLEAN-UP BY DONATING STAFF AND SUPPLIES. FOOD AND NUTRITION SERVICES "MEALS ON WHEELS" PROGRAM PROVIDES FOOD TO HOMEBOUND MEMBERS OF OUR COMMUNITY. THE CANCER CARE CENTER GIVES WIGS TO CANCER PATIENTS AT NO COST. COMMUNITY BUILDING ACTIVITIES - PVHMC WORKS WITH LOCAL AREA MIDDLE AND HIGH SCHOOLS AS WELL AS GIRL SCOUTS AND SCHOOL GROUPS TO INTRODUCE CAREERS IN HEALTH CARE BY INVITING THEM TO TOUR OUR HOSPITAL AND BY VISITING THEM ON THEIR CAMPUS (HIGH SCHOOL CAREER DAY). PVHMC PARTICIPATES IN LA COUNTY SERVICE PLANNING AREA 3S HEALTH PLANNING GROUP ON THE STEERING COMMITTEE. PVHMC FINANCIALLY SUPPORTS THE RECRUITMENT OF PRIMARY CARE AND SPECIALTY CARE PHYSICIANS IN RESPONSE TO THE OUR COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITY NEEDS TO EXPAND ACCESS TO CARE AND IMPROVE COMMUNITY HEALTH, PARTICULARLY AMONG OUR MOST VULNERABLE AND LOW-INCOME COMMUNITY MEMBERS. PVHMC IS A ONE OF 13 DESIGNATED DISASTER RESOURCE CENTERS (DRC) IN LOS ANGELES COUNTY AS PART OF THE NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS PROGRAM. AS THE DRC FOR THE REGION, PVHMC IS RESPONSIBLE FOR 12 "UMBRELLA" FACILITIES IN THE AREA AND COORDINATES DRILLS, TRAINING, AND SHARING OF PLANS TO BRING TOGETHER THE COMMUNITY AND OUR RESOURCES FOR DISASTER PREPAREDNESS. VALUATION OF COMMUNITY BENEFIT PROGRAMS - FOR 2015, PVHMCS TOTAL COMMUNITY BENEFITS CAME TO $41,657,946 WHICH CONSISTS OF TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS ($32,264,014) AND TOTAL OTHER BENEFITS ($8,839,148). TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS IS MADE UP OF CHARITY CARE ($3,479,629), MEDI-CAL INPATIENT OR THE NET UNREIMBURSED COST, WHICH IS EQUIVALENT TO UNREIMBURSED COST LESS THE DISPROPORTIONATE SHARE PAYMENT, AND MEDI-CAL OUTPATIENT UNREIMBURSED COSTS ($28,784,385). OTHER BENEFITS ARE MADE UP OF COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ($760,237), HEALTH PROFESSIONS EDUCATION ($3,441,150), SUBSIDIZED HEALTH SERVICES ($4,349,531), RESEARCH ($99,780), AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS ($188,450), WHICH IS REPORTED UNDER COMMUNITY BUILDING ACTIVITIES. ADDITIONALLY, THE VALUE OF COMMUNITY BUILDING ACTIVITIES IS $554,784. THE ECONOMIC VALUE OF THE DOCUMENTED COMMUNITY BENEFITS WAS DETERMINED AS FOLLOWS: UNCOMPENSATED CARE WAS VALUED IN THE SAME MANNER THAT SUCH SERVICES WERE REPORTED IN THE HOSPITALS ANNUAL REPORT TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. CHARITY CARE WAS VALUED BY COMPUTING THE ESTIMATED COST OF CHARGES (INCLUDING CHARITY CARE DONATIONS). OTHER SERVICES WERE VALUED BY ESTIMATING THE COSTS OF PROVIDING THE SERVICES AND SUBTRACTI
FORM 990, PART VI, LINE 11B	A COPY OF THE TAX RETURN ALONG WITH A NARRATIVE FROM EY, THE HOSPITAL'S EXTERNAL ACCOUNTING FIRM, IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING IN NOVEMBER 2016. REPRESENTATIVES FROM EY REVIEW THE RETURN DIRECTLY WITH THE DIRECTORS AND ANSWERS ANY QUESTIONS THEY MAY HAVE. THE INTERNAL PROCESS INCLUDES (A) PREPARATION OF THE FINANCIAL DATA BY HOSPITAL PERSONNEL, AND (B) SURVEYS OF DIRECTORS, OFFICERS AND KEY EMPLOYEES REGARDING INFORMATION IN RESPONSE TO QUESTIONS IN PART VI. THIS INFORMATION IS DISCLOSED IN SCHEDULE L. THE COMPLETED 990 IS REVIEWED FOR OVERALL COMPLETENESS AND ACCURACY BY THE CEO AND CFO.
FORM 990, PART VI, LINE 12C	EACH YEAR OFFICERS, DIRECTORS, AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS PURSUANT TO HOSPITAL POLICY. THE STATEMENTS ARE THEN REVIEWED BY THE OFFICERS OF THE BOARD (THE CHAIRMAN AND THE TWO VICE CHAIRMEN) BEFORE PRESENTED TO THE FULL BOARD AT THE ANNUAL ORGANIZATIONAL MEETING OF THE BOARD. ANY CONFLICTS OF CONCERN ARE ADDRESSED BY THE OFFICERS AND DISCUSSED BY THE FULL BOARD AT THE ORGANIZATIONAL MEETING. THEREAFTER, IT IS THE RESPONSIBILITY OF EACH MEMBER TO RAISE AN ISSUE OF POTENTIAL CONFLICT TO THE BOARD AND/OR ITS OFFICERS FOR DISPOSITION. IF A CONFLICT IS DEEMED TO EXIST, THE MEMBER IS EXCUSED FROM THE MEETING AND/OR TOPIC WHERE THE CONFLICT EXISTS.
FORM 990, PART VI, LINE 15A	THE BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE WHICH ANNUALLY REVIEWS AND DETERMINES THE COMPENSATION FOR THE CEO. THE DETERMINATION OF THE CEO'S COMPENSATION IS BASED UPON INDEPENDENT REVIEW OF THE CEO COMPENSATION COMPARED TO INDUSTRY PRACTICE. IN 2015 THE COMPENSATION COMMITTEE USED THE HAY GROUP FOR THIS PURPOSE. THE COMPENSATION REVIEW PROCESS IS DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE. THIS PROCESS WAS LAST COMPLETED IN FEBRUARY 2015.
FORM 990, PART VI, LINE 15B	FOR OTHER OFFICERS AND KEY EMPLOYEES, THE SAME PROCESS IS USED AS ABOVE, WITH THE EXCEPTION THAT THE CEO PRESENTS HIS RECOMMENDATION FOR COMPENSATION TO THE COMPENSATION COMMITTEE BASED UPON THE REPORT FOR TOTAL COMPENSATION COMPARISONS SUPPLIED BY THE HAY GROUP. THE POSITIONS COVERED BY THE PROCESS ARE THE COO, CFO, VP SATELLITES, VP NURSING, VP MEDICAL STAFF AFFAIRS, VP HUMAN RESOURCES, CHIEF INFORMATION OFFICER, VICE PRESIDENT OF FINANCE, VP SUPPORT SERVICES, DIRECTOR OF MANAGED CARE, COMPLIANCE OFFICER, DIRECTOR OF UTILIZATION MANAGEMENT. THIS PROCESS WAS LAST COMPLETED IN FEBRUARY 2015 AND WAS ALSO DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE.
FORM 990, PART VI, LINE 18	THE HOSPITAL IS NOT REQUIRED TO MAKE ITS FORM 1023 AVAILABLE AS IT FILED FOR TAX EXEMPT STATUS PRIOR TO JULY 15, 1987. THE HOSPITAL MAKES ITS 990 AND 990T AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, LINE 19	THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS.
FORM 990, PART XI, LINE 9	EFFECT OF ADOPTION OF FASB STATEMENT 158 $ 46,857 LOSS FROM SUBSIDIARIES $(766,305) ------------ TOTAL $(719,448)

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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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	24
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	21
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	3,293
6	Total number of volunteers (estimate if necessary) .............	6	976
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	289,381
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	78,318

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	10,948,584	6,246,046
9	Program service revenue (Part VIII, line 2g) .........	512,715,894	542,370,062
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,958,078	1,182,850
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,250,969	4,703,098
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	530,873,525	554,502,056
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,318,545	886,502
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)	267,899,341	283,236,765
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	208,979,937	229,464,637
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	478,197,823	513,587,904
19	Revenue less expenses. Subtract line 18 from line 12.......	52,675,702	40,914,152
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	442,331,753	448,627,719
21	Total liabilities (Part X, line 26).............	134,550,899	100,694,743
22	Net assets or fund balances. Subtract line 21 from line 20.....	307,780,854	347,932,976

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 475,480,639 including grants of $ 886,502 ) (Revenue $ 546,934,530 )
	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 expenses475,480,639

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,551,344	0	1,617,262

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	0
d	Related organizations		1d	5,530,099
e	Government grants (contributions)		1e	249,512

f	All other contributions, gifts, grants, and similar amounts not included above		1f	466,435

g	Noncash contributions included in lines 1a-1f:$ 0
h Total.Add lines 1a-1f.......		6,246,046

			Business Code
2a	PATIENT CARE REVENUE	622110	541,846,580	541,846,580	0	0
b	PHYSICIAN OFFICE RENTAL	621111	234,101	234,101	0	0
c	NON-PATIENT LAB REVENUE	621511	289,381	0	289,381	0
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			542,370,062

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			1,182,635			1,182,635
4 Income from investment of tax-exempt bond proceeds			215			215
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		319,261
b	Less: rental expenses		180,631
c	Rental income or (loss)	0	138,630
d	Net rental income or (loss)......			138,630			138,630
		(ii) Other	(i) Securities
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 $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
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
Business Code			Miscellaneous Revenue
11a	FOOD SALES		722212	1,238,025	1,238,025	0	0
b	REBATES & REFUNDS		622110	1,088,543	1,088,543	0	0
c	HEALTH EDUCATION		923110	93,960	93,960	0	0
d	All other revenue ....			2,143,940	2,143,940	0	0
e	Total. Add lines 11a–11d ......			4,564,468
12	Total revenue. See Instructions......			554,502,056	546,645,149	289,381	1,321,480

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	886,502	886,502
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	3,918,325	94,575	3,823,750	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0			0
7	Other salaries and wages	216,726,451	210,745,035	5,981,416	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,991,257	10,441,694	549,563	0
9	Other employee benefits .......	35,969,330	34,666,474	1,302,856	0
10	Payroll taxes ...........	15,631,402	15,070,918	560,484	0
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	2,067,708	300,809	1,766,899	0
c	Accounting ...........	286,843	0	286,843	0
d	Lobbying ...........	33,033	33,033	0	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	47,422,673	40,830,921	6,591,752
12	Advertising and promotion ....	1,334,776	964,091	370,685	0
13	Office expenses .......	12,895,528	11,103,050	1,792,478	0
14	Information technology ......	8,087,342	6,963,201	1,124,141	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	9,362,076	8,060,747	1,301,329	0
17	Travel ............	328,950	237,834	91,116	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	455,033	334,335	120,698	0
20	Interest ...........	40,862	35,182	5,680	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	24,399,295	21,007,793	3,391,502	0
23	Insurance ...	4,415,614	3,801,844	613,770	0
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 Supplies	58,150,185	50,067,309	8,082,876	0
b	California Hospital Fee	35,483,211	35,483,211	0	0
c	Capitation Expense	20,047,376	20,047,376	0	0
d	Dues & Subscriptions	2,158,223	2,158,223	0	0
e	All other expenses	2,495,909	2,146,482	349,427
25	Total functional expenses. Add lines 1 through 24e	513,587,904	475,480,639	38,107,265	0
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).	0

1	Cash–non-interest-bearing ........			443,067	1	1,377,813
2	Savings and temporary cash investments .........			10,997,065	2	59,531,976
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			78,987,218	4	95,947,350
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 ....			279,918	7	265,556
8	Inventories for sale or use ........			3,097,635	8	3,167,344
9	Prepaid expenses and deferred charges ......			8,360,184	9	7,420,787
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	663,003,387
b	Less: accumulated depreciation	10b	422,331,524	218,414,384	10c	240,671,863
11	Investments—publicly traded securities .			29,976,049	11	6,022,435
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			-2,782,472	13	-3,326,777
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			94,558,705	15	37,549,372
16	Total assets. Add lines 1 through 15 (must equal line 34)...			442,331,753	16	448,627,719

17	Accounts payable and accrued expenses .....	84,075,413	17	54,824,262
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	27,100,000	20	21,500,000
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 ..	791,955	23	57,124
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	22,583,531	25	24,313,357
26	Total liabilities. Add lines 17 through 25..	134,550,899	26	100,694,743

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	306,802,646	27	346,940,117
28	Temporarily restricted net assets ...........	272,168	28	286,816
29	Permanently restricted net assets	706,040	29	706,043
	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 ...........	307,780,854	33	347,932,976
34	Total liabilities and net assets/fund balances ........	442,331,753	34	448,627,719

(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)POMONA VALLEY HOSPITAL MEDICAL CTR FDN 1798 N GAREY AVENUE POMONA,CA91767 95-3403287	SUPPORT PVHMC	CA	501(c)(3)	7	NA		No
(2)THE AUXILIARY OF PVHMC 1798 N GAREY AVENUE POMONA,CA91767 95-6053224	SUPPORT PVHMC	CA	501(c)(3)	11, III-FI	PVHMC	Yes

(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) POMONA VALLEY MEDICAL PLAZA 1798 N GAREY AVENUE POMONA,CA91767 95-4175295	LEASING	CA	PVHMC	RELATED	-631,335	4,185,394		No	0		No	90.000 %

(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