Form990
Click to see attachment
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Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2021 , and ending 12-31-2021
BCheck if applicable:
CName of organization
SUTTER BAY HOSPITALS
 
% JONATHAN ZACHRESON
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
C/O SH TAX 2200 RIVER PLAZA DR
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SACRAMENTO, CA95833
D Employer identification number

94-0562680
E Telephone number

G Gross receipts $ 4,557,775,453
F Name and address of principal officer:
David Cheney
PO BOX 7999
SACRAMENTO,CA95833
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SUTTERHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1854
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 16,670
6 Total number of volunteers (estimate if necessary) ............. 6 422
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,672,464
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 322,036,417 80,771,543
9 Program service revenue (Part VIII, line 2g) ......... 4,003,438,659 4,428,849,909
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 11,110,772 26,497,078
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 17,673,088 17,058,853
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 4,354,258,936 4,553,177,383
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,552,821 10,960,220
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) 2,211,287,302 2,158,111,860
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet3,248,596    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 2,425,923,033 2,447,479,235
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 4,644,763,156 4,616,551,315
19 Revenue less expenses. Subtract line 18 from line 12....... -290,504,220 -63,373,932
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 6,006,535,883 5,967,678,052
21 Total liabilities (Part X, line 26)............. 2,708,812,072 2,483,547,897
22 Net assets or fund balances. Subtract line 21 from line 20..... 3,297,723,811 3,484,130,155
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 4,132,068,520 including grants of $ 10,960,220 ) (Revenue $ 4,428,849,909 )
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 expensesMediumBullet4,132,068,520
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV..................... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
1,695
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
16,670
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
16
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJONATHAN ZACHRESON9100 FOOTHILLS BOULEVARD   ROSEVILLE,CA95747 (916) 286-6665
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Sarah Krevans......................................................................
President & CEO Sutter Health
2.0
.................
40.0
X           0 9,160,299 379,211
(2) James Conforti......................................................................
SH SVP / COO & SBH Asst Sec.
4.0
.................
40.0
X   X       0 2,036,409 557,262
(3) Julie A Petrini......................................................................
CEO, Bay Area Hospitals
2.0
.................
40.0
    X       0 1,308,421 126,509
(4) Warren Browner MD......................................................................
CEO, CPMC
0.0
.................
40.0
      X     0 1,192,753 122,102
(5) David Cheney......................................................................
CEO, Bay & Valley Hospitals
2.0
.................
40.0
    X       0 1,161,813 111,532
(6) John Gates......................................................................
CFO, SH Bay Area
2.0
.................
40.0
    X       0 955,170 100,252
(7) Janet A Wagner......................................................................
Hospital Area CEO, South Bay
0.0
.................
40.0
      X     0 884,884 106,662
(8) Samareh H Rad......................................................................
Coord, Transfer Center RN
40.0
.................
0.0
        X   904,694 0 46,066
(9) David Clark......................................................................
CEO, ABSMC
0.0
.................
40.0
      X     0 802,659 136,969
(10) Brian Alexander......................................................................
Hospital Area CEO, N. Valley
0.0
.................
40.0
          X 0 836,778 100,224
(11) Penny Westfall......................................................................
SH VP, CLO, SH & SBH Sec
2.0
.................
40.0
    X       0 778,774 1,812
(12) Daniel Peterson......................................................................
CEO, SSRRH
0.0
.................
40.0
      X     0 647,505 87,790
(13) Maynard L Jenkins III......................................................................
SH VP, HR Support Functions
0.0
.................
40.0
          X 0 627,697 79,278
(14) Stephen Gray......................................................................
CAO, SMSC & Bay Found Ops Exec
0.0
.................
40.0
          X 0 615,057 86,250
(15) Cynthia Lee......................................................................
SH VP, Chief Strgy & Corp Dev
0.0
.................
40.0
          X 0 608,550 85,791
(16) Vernon Giang......................................................................
CME, CPMC
0.0
.................
40.0
          X 0 583,845 69,038
(17) Sami E Nawwar......................................................................
Nurse-Staff II 12 Hour Cert
40.0
.................
0.0
        X   599,217 0 46,517
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Steven R Cummings........................................................................
Exec Dir, SF Coordinating Ctr
40.0
.......................0.0
        X   591,925 0 40,189
(19) Jason G Bradshaw........................................................................
Nuclear Med Technologist
40.0
.......................0.0
        X   573,284 0 46,328
(20) Richard M Deits........................................................................
Staff Physician, Comm Clinic
40.0
.......................0.0
        X   567,819 0 37,575
(21) Theresa C Glubka........................................................................
CEO, SSCD
0.0
.......................40.0
          X 0 553,580 11,632
(22) Jeff Gerard........................................................................
Frmr SH SVP / Strat Svcs & CSO
0.0
.......................40.0
          X 0 538,462 469
(23) Gregory Brown........................................................................
SH VP, Legal Transac & SBH Sec
2.0
.......................40.0
    X       0 424,040 72,550
(24) Edward Battista........................................................................
VP, HR, North Bay & East Bay
0.0
.......................40.0
      X     0 417,833 53,785
(25) Michael Purvis........................................................................
Former CEO, SSRRH & NCH
0.0
.......................40.0
          X 0 140,098 0
(26) Jill Kacher Cobb MD........................................................................
Director
2.0
.......................2.0
X           0 24,375 0
(27) Diana Bell........................................................................
Director
2.0
.......................2.0
X           0 0 0
(28) David Black MD........................................................................
Director/Chair
4.0
.......................4.0
X   X       0 0 0
(29) Jeff T Chen MD........................................................................
Director
2.0
.......................2.0
X           0 0 0
(30) Emil Roy Eisenhardt........................................................................
Director
2.0
.......................2.0
X           0 0 0
(31) Eric Flowers........................................................................
Director
2.0
.......................2.0
X           0 0 0
(32) Katherine Hsiao MD........................................................................
Director
2.0
.......................2.0
X           0 0 0
(33) Kimberly Long........................................................................
Director
2.0
.......................2.0
X           0 0 0
(34) Juli Maxworthy........................................................................
Director
2.0
.......................2.0
X           0 0 0
(35) Yumi Nakagawa........................................................................
Director
2.0
.......................2.0
X           0 0 0
(36) Dennis O'Connell........................................................................
Director
2.0
.......................3.0
X           0 0 0
(37) Steven Oliver........................................................................
Director/Chair Finance & Plan
4.0
.......................4.0
X   X       0 0 0
(38) Umesh Padval........................................................................
Director
2.0
.......................2.0
X           0 0 0
(39) Yvonne Richardson........................................................................
Director
2.0
.......................2.0
X           0 0 0
(40) John Ryan........................................................................
Director
2.0
.......................2.0
X           0 0 0
(41) Ron Sinha MD........................................................................
Director
2.0
.......................2.0
X           0 0 0
(42) Jane Varner MD........................................................................
Director
2.0
.......................2.0
X           0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 3,236,939 24,274,627 2,505,793
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet7,011
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
HERRERO BOLDT LLC,
2100 OAKDALE AVE
SAN FRANCISCO,CA941241516
GENERAL CONTRACTOR 46,867,594
DONOR NETWORK WEST,
12667 ALCOSTA BLVD STE 500
SAN RAMON,CA945834427
Organ Donation SVCS 15,877,220
PACIFIC INPATIENT MEDICAL,
PO BOX 1230
SUISUN CITY,CA945851230
Physician Services 15,115,146
GIFTED NURSES LLC,
2748 METAIRIE LAWN DR
METAIRIE,LA700026190
Staffing Services 12,863,849
UNIVERSAL PROTECTION SVC LP,
161 WASHINGTON ST STE 600
CONSHOHOCKEN,PA194282083
Security Services 12,296,791
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet445
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a 3,615
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 37,199,408
e Government grants (contributions)1e 14,293,107
f All other contributions, gifts, grants, and similar amounts not included above1f 29,275,413
g Noncash contributions included in lines 1a - 1f:$ 1g 912,726
h Total. Add lines 1a-1f.......MediumBullet 80,771,543
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621110 4,384,861,429 4,384,861,429    
b HEALTHCARE RELATED JV INCOME 900099 27,861,997 27,861,997    
c RENTAL TO AFFILIATES 900099 16,126,483 16,126,483    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 4,428,849,909
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 4,652,790     4,652,790
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   15,795,359 6a
b Less: rental expenses   4,356,058 6b
c Rental income or (loss) 0 11,439,301 6c
d Net rental income or (loss).......MediumBullet 11,439,301     11,439,301
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 3,844,521 18,241,779 7a
b Less: cost or other basis and sales expenses 242,012   7b
c Gain or (loss) 3,602,509 18,241,779 7c
d Net gain or (loss).........MediumBullet 21,844,288     21,844,288
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a CAFETERIA 900099 3,947,088     3,947,088
b PARKING 812930 1,215,285   1,215,285  
c LABORATORY 621500 306,087   306,087  
d All other revenue .... 151,092   151,092  
e Total. Add lines 11a–11d ...... MediumBullet 5,619,552
12 Total revenue. See instructions.....MediumBullet 4,553,177,383 4,428,849,909 1,672,464 41,883,467
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 10,506,102 10,506,102
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 454,118 454,118
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 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) ......... 185,965   185,965  
7 Other salaries and wages........ 1,413,064,547 1,350,424,126 61,347,048 1,293,373
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 107,042,260 102,357,745 4,664,002 20,513
9 Other employee benefits ....... 524,178,456 500,661,043 22,812,968 704,445
10 Payroll taxes ........... 113,640,632 108,669,057 4,951,581 19,994
11 Fees for services (non-employees):        
a Management ...... 36,128,411 8,266,412 27,850,678 11,321
b Legal ......... 3,371,421 3,371,421    
c Accounting ........... 111,113   73,758 37,355
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 1,290,926   1,290,926  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 316,660,527 284,638,620 32,021,907  
12 Advertising and promotion .... 227,030   227,030  
13 Office expenses ....... 41,019,843 6,543,520 34,447,485 28,838
14 Information technology ...... 175,823,639 112,589,083 63,234,556  
15 Royalties .. 0      
16 Occupancy ........... 84,551,839 80,606,579 3,828,454 116,806
17 Travel ............ 674,999 644,939 23,990 6,070
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 457,962 401,143 56,819  
20 Interest ........... 86,177,782 86,177,782    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 361,665,620 336,353,494 25,311,266 860
23 Insurance ... 32,760,913 22,219,576 10,491,232 50,105
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 524,765,665 524,765,286 267 112
b SYSTEM ALLOCATION FEE 310,733,906 154,764,531 155,436,923 532,452
c PURCHASED SERVICES 192,991,083 166,553,721 26,088,633 348,729
d HOSPITAL FEE 183,384,228 183,384,228    
e All other expenses 94,682,328 87,715,994 6,888,711 77,623
25 Total functional expenses. Add lines 1 through 24e 4,616,551,315 4,132,068,520 481,234,199 3,248,596
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 0 1 0
2 Savings and temporary cash investments ......... 135,944,726 2 126,013,031
3 Pledges and grants receivable, net ...... 3,571,901 3 4,061,803
4 Accounts receivable, net ............. 467,800,309 4 533,341,253
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 63,967,683 8 62,082,151
9 Prepaid expenses and deferred charges ...... 16,054,689 9 21,175,328
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 7,633,809,812
b Less: accumulated depreciation 10b 3,251,211,681 4,531,833,629 10c 4,382,598,131
11 Investments—publicly traded securities . 219,840,972 11 246,558,693
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 27,435,531 13 27,431,834
14 Intangible assets ............... 4,565,324 14 4,565,324
15 Other assets. See Part IV, line 11 ........... 535,521,119 15 559,850,504
16 Total assets. Add lines 1 through 15 (must equal line 33)... 6,006,535,883 16 5,967,678,052
Liabilities 17 Accounts payable and accrued expenses ..... 624,352,182 17 595,981,979
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 1,509,176,309 20 1,477,217,720
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 575,283,581 25 410,348,198
26 Total liabilities. Add lines 17 through 25.. 2,708,812,072 26 2,483,547,897
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 3,224,353,411 27 3,406,883,503
28 Net assets with donor restrictions ........... 73,370,400 28 77,246,652
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 3,297,723,811 32 3,484,130,155
33 Total liabilities and net assets/fund balances ........ 6,006,535,883 33 5,967,678,052
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
4,553,177,383
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
4,616,551,315
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-63,373,932
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
3,297,723,811
5
Net unrealized gains (losses) on investments ...............
5
7,265,135
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
242,515,141
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
3,484,130,155
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 0.015 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 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2021
(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2021. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2022. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

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






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
SUTTER BAY HOSPITALS
 
Employer identification number
94-0562680
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2021)
Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB 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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" 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 .... 201,584,004 179,842,229 139,131,376 97,476,962 92,793,529
b Contributions ... 751,586 2,224,433 14,428,493 36,236,977 5,507,832
c Net investment earnings, gains, and losses 24,549,933 28,897,640 29,485,743 5,925,287 15,840,643
d Grants or scholarships ... 0 0 0 0 3,105,457
e Other expenditures for facilities
and programs ...
10,122,241 9,380,298 3,203,383 507,850 13,559,585
f Administrative expenses .... 0 0 0 0 0
g End of year balance ...... 216,763,282 201,584,004 179,842,229 139,131,376 97,476,962
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet42.750 %
b
Permanent endowment SchDMd Bullet36.110 %
c
Term endowment SchDMd Bullet21.140 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....   257,793,666 257,793,666
b Buildings ....   5,594,541,151 2,128,266,721 3,466,274,430
c Leasehold improvements   126,538,281 43,627,615 82,910,666
d Equipment ....   1,282,990,481 1,009,831,717 273,158,764
e Other .....   371,946,233 69,485,628 302,460,605
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 4,382,598,131
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other 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.)Small Bullet  
Part VIII
Investments - Program 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.)Small Bullet  
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)OTHER RECEIVABLES 386,677,749
(2)INTERCOMPANY RECEIVABLES 35,203,346
(3)OTHER ASSETS 137,969,409
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 559,850,504
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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 410,348,198
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) 2021

Schedule D (Form 990) 2021
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 INTENDED USE OF ENDOWMENT FUNDS AE BENNETT COMMUNITY ENDOWMENT - EARNINGS TO BE USED FOR MENTAL HEALTH, PSYCHOLOGY AND NEUROLOGY PROGRAMS IN THE EAST BAY, AE BENNETT COMMITTEE. BEGEN FAMILY ENDOWMENT - INCOME IS TO BE USED FOR THE GENERAL NEEDS OF ALTA BATES SUMMIT MEDICAL CENTER. B. LOPEZ ENDOWMENT - INCOME IS FOR THE GENERAL SUPPORT OF THE NEWBORN INTENSIVE CARE UNIT. BENIOFF MEMORIAL ENDOWMENT FUND - PROVIDE A LECTURESHIP IN PERPETUITY THROUGH AN ENDOWMENT. CADENASSO FAMILY ENDOWMENT - INCOME FROM ENDOWMENT IS FOR UNRESTRICTED PURPOSES OF ALTA BATES SUMMIT MEDICAL CENTER. CLOROX CAPITAL ENDOWMENT FUND - INCOME IS TO BE USED FOR CAPITAL EQUIPMENT. DENICOLAI RESEARCH ENDWOMENT - INCOME IS FOR THE GENERAL USE OF REDI (RESEARCH & EDUCATION INSTITUTE). ELAINE MAKAROUNIS ENDOWMENT - TO BE USED FOR CANCER CARE PROGRAMS AND SERVICES. EVELYN STRODE & RALPH A VAN ORSDEL MEMORIAL ENDOWMENT - TO BENEFIT THE ABSMC EMERGENCY DEPARTMENT. GARRETT QUASI ENDOWMENT - FOR THE GENERAL SUPPORT OF ORTHOPEDICS PROGRAMS. GOGGIO QUASI-ENDOWMENT - TO ENDOW A CARDIOLOGY CONFERENCE ANNUALLY. IN THE FUTURE IT WILL BE POSSIBLE TO SPEND FUNDS IN OTHER MANNERS IF THE DONOR, FOUNDATION CEO OR THE BOARD OF TRUSTEES APPROVE CHANGE. HAAS FAMILY QUASI-ENDOWMENT - UNRESTRICTED. HELEN E MAC NAB QUASI-ENDOWMENT - UNRESTRICTED. HENRY & ELSIE CLAY ENDOWMENT - TO SUPPORT ALTA BATES HOSPITAL IN THE DIAGNOSIS, PREVENTION, AND TREATMENT OF DISEASE. HENRY B. LASKY ENDOWMENT - EARNINGS ARE TO BE USED EQUALLY (SPLIT 50/50) FOR THE GENERAL PURPOSES OF THE CANCER SUPPORT SERVICES PROGRAM AND FOR THE GENERAL PURPOSES OF THE GROVE AT SUTTER SANTA ROSA REGIONAL HOSPITAL. J & C CONDON ENDOWMENT - UNRESTRICTED. JANE PAXSON QUASI ENDOWMENT - TO BE USED FOR MEDICAL RESEARCH ACTIVITIES AT ALTA BATES SUMMIT MEDICAL CENTER TO HELP ATTAIN AND SUSTAIN EXCELLENCE IN MEDICAL RESEARCH. JAY ADAMS ENDOWMENT - INCOME IS FOR PALLIATIVE CARE PROGRAMS TO HELP ALLEVIATE THE PAIN AND SUFFERING OF PATIENTS. JORDAN FUND - UNRESTRICTED. LEGACY FUND - UNRESTRICTED. LIBBEY ENDOWMENT - EARNINGS TO BE USED TO SUPPORT THE PRIORITY NEEDS OF SUTTER DELTA MEMORIAL HOSPITAL. MAKAROUNIS PERM ENDOWMENT - TO PROVIDE CANCER CARE PROGRAMS AND SERVICES. MARION ROSS ENDOWMENT - EARNINGS TO BE USED TO FUND THE CARDIOLOGY PROGRAM AT ALTA BATES. MARKSTEIN ENDOWMENT FUND - INCOME IS FOR MARKSTEIN CANCER EDUCATION AND PREVENTION PROGRAM TO BE USED FOR PROGRAMS, SERVICES, AND EQUIPMENT. MEMORIAL FUND - UNRESTRICTED. NONA JORDAN ENDOWMENT - UNRESTRICTED. OCKELS FAMILY ENDOWMENT - UNRESTRICTED. PROVIDENCE QUASI ENDOWMENT - INCOME TO BE USED FOR PASTORAL CARE, ELDER CARE (I.E. ADULT DAY, LIFELINE), AND ETHICS EDUCATION. SEIM FAMILY ENDOWMENT - UNRESTRICTED. SOUTH UNIT ENDOWMENT FUND - FOR THE GENERAL NEEDS OF THE 5 SOUTH UNIT (EXCLUDING SALARIES). SWEETLAND EDUCATIONAL ENDOWMENT FUND - DRUG EDUCATION FOR CHILDREN AND ADOLESCENT PATIENTS. TURNLEY FAMILY ENDOWMENT - GENERAL NEEDS OF THE ALTA BATES SUMMIT MEDICAL CENTER. WALKER MEMORIAL QUASI ENDOWMENT FUND - UNRESTRICTED. WALL HELP - FOR SUPPORT OF CHILDREN'S HOSPICE NEEDS IN BERKELEY. ELLIS PERMANENT ENDOWMENT - INCOME TO BE USED TO PROVIDE SCHOLARSHIPS AND GRANTS TO NEEDY GIRLS SEEKING CAREERS IN MEDICAL AND ALLIED FIELDS. REID PERMANENT ENDOWMENT - EARNINGS TO SUPPORT FREE BEDS, CLINICS, AND MEDICAL SERVICES TO THE POOR AND NEEDY. MALMQUIST PERMANENT ENDOWMENT - INCOME TO SUPPORT THE HOSPITAL'S HEALTH CARE SERVICES RELATED TO ARTHRITIS, UNTIL AND UNLESS SUCH A USE WOULD NOT BE POSSIBLE AT THE HOSPITALS, IN WHICH CASE, THE FOUNDATION'S BOARD OF TRUSTEES MAY CHOOSE ANOTHER USE FOR THE INCOME AND MAY, IF NECESSARY AND IN THE BEST INTERESTS OF THE HOSPITALS EXPEND THE PRINCIPAL. BARSHAD PERMANENT ENDOWMENT - INCOME TO BE USED TO BENEFIT THE SENIOR FOCUS PROGRAM. COAKLEY PERMANENT ENDOWMENT - INCOME SHALL BE USED TO SUPPORT ANY PURPOSE EXCEPT CONSTRUCTION OR GENERAL EXPENSES OF MILLS PENINSULA MEDICAL CENTER. RAFFO PERMANENT ENDOWMENT - TO SUPPORT CANCER AND CARDIAC CARE, BUT NOT FOR ANIMAL RESEARCH. RUPPART PERMANENT ENDOWMENT - INCOME USED TO SUPPORT PURPOSES DEEMED MOST APPROPRIATE BY THE BOARD OF TRUSTEES OF MILLS PENINSULA HOSPITAL FOUNDATION AND THE PRINCIPAL BE MAINTAINED IN ITS ENTIRELY. DESIRED, BUT NOT MANDATORY IS THAT THE INCOME BE USED TO FUND CARE AND MAINTAIN THE SPECIAL CARE UNIT AND SHORT STAY SURGICAL RECOVERY UNIT. ZIELINSKY PERMANENT ENDOWMENT - FUND INCOME, BUT NO PART OF THE PRINCIPAL OR APPRECIATION (REALIZED OR UNREALIZED), SHALL BE USED TO FURTHER THE GENERAL OBJECTS AND PURPOSES OF THE MILLS PENINSULA HOSPITAL FOUNDATION. MCKAY PERMANENT ENDOWMENT - INCOME ONLY (INTEREST), BUT NO PART OF THE FUND PRINCIPAL OR APPRECIATION (REALIZED OR UNREALIZED), SHALL BE USED TO FURTHER THE GENERAL OBJECTS AND PURPOSES OF MILLS PENINSULA HOSPITAL FOUNDATION. DISTINGUISHED ENDOWED CHAIR IN CARDIOLOGY- QUASI ENDOWMENT - SUPPORT THE WORK OF CPMC'S ATRIAL FIBRILLATION & ARRHYTHMIA PROGRAM'S SR. MEDICAL DIRECTOR. PROGRAM IN MEDICINE & HUMANS QUASI-ENDOWMENT - EARNINGS SUPPORT PROGRAM IN MEDICINE & HUMAN VALUES. ROSENBERG/NICHOLS OVARIAN/REPRODUCTIVE CANCER QUASI-ENDOWMENT - ANNUAL RELEASE OF 5% WILL GO TO SUPPORT OVARIAN/REPRODUCTIVE CANCER RECOVERY PROGRAM GENERAL EXPENSES. MCCLELLAND FUND - DIV OF CARDIOLOGY QUASI-ENDOWMENT - FOR THE GENERAL USE BY THE DIVISION OF CARDIOLOGY. PAYDEN CENTER FOR MELANOMA RESEARCH & TREATMENT QUASI-ENDOWMENT - SUPPORT THE MELANOMA CENTER IN ITS EFFORTS WITH RESEARCH, EDUCATION, PATIENT CARE, SALARY SUPPORT & EQUIPMENT PURCHASE. CHAIR IN MELANOMA RESEARCH AND TREATMENT QUASI-ENDOWMENT - SUPPORT THE MELANOMA CENTER IN EFFORTS WITH RESEARCH & EDUCATION, PATIENT CARE, SALARY SUPPORT & EQUIPMENT PURCHASE. RAY DOLBY CHAIR IN BRAIN HEALTH RESEARCH QUASI-ENDOWMENT - SUPPORT A CHAIR AT THE CPMC RAY DOLBY BRAIN HEALTH CENTER. CHAIR IN BREAST HEALTH SERVICES QUASI-ENDOWMENT - SUPPORT A CHAIR IN BREAST HEALTH SERVICES. MISSION BERNAL (FORMERLY ST. LUKE'S ENDOWMENT) - TO SUPPORT MISSION BERNAL'S GENERAL OPERATIONS. H. SMITH ENDOWED CHAIR ENDOWMENT - ENDOWED CHAIR AT CPMCRI. WILLIAM GREENBACH ENDOWMENT - CANCER RESEARCH AT CPMCRI. CANCER RESEARCH CPMCRI G. BRUSH ENDOWMENT - CANCER RESEARCH AT CPMCRI. M. WILCOX ENDOWMENT - FOR EQUIPMENT; REFURBISHING OF ROOMS/ACCOMMODATIONS & FOR EDUCATION OF STAFF & PATIENTS RELATED TO CANCER RESEARCH. BASSO-KLEISER/GUEST FUND IN CARDIOLOGY ENDOWMENT - SUPPORT A CHAIR IN CARDIOLOGY. F. GERBODE HEART RESEARCH ENDOWMENT - HEART RESEARCH. HEART RESEARCH EDUCATIONAL ENDOWMENT - HEART RESEARCH, EDUCATION AND/OR PROGRAM DEVELOPMENT. BIOETHICS ENDOWMENT - PROGRAM IN MEDICINE & HUMAN VALUES. CPMC PMHV SENIOR SCHOLAR ENDOWMENT - SUPPORT RESEARCH, EDUCATION AND SCHOLARSHIP INITIATIVES IN CLINICAL ETHICS. M. HAIM ENDOWMENT - SUPPORT THE MICHAEL HAIM, M.D. MEMORIAL LECTURE IN DERMATOLOGY, SUBJECT CHOSEN BY THE CHIEF OF DEPARTMENT. J. GAMBLE TEACHING ENDOWMENT - DEPARTMENT OF MEDICINE TEACHING FUND. NOBLE ENDOWED CHAIR - SUSTAIN & ENHANCE EDUCATION OF RESIDENTS, WHILE CONTRIBUTING TO THE EXCELLENCE OF PATIENT CARE THROUGH AN ENDOWED CHAIR. CPMCF BROTHERTON PERINATAL MENTAL HEALTH ENDOWMENT - TO FUND PERINATAL MENTAL HEALTH CARE AT CPMC'S VALENCIA AND CESAR CHAVEZ CAMPUS. CPMCRI C&A FINLEY ENDOWED CHAIR NEURO RESEARCH - ENDOWED CHAIR AT CPMCRI. WATKINS BURBANK LOAN & SCHOLARSHIP ENDOWMENT - TO SUPPORT THE NURSING EDUCATION ACTIVITIES AT ST. LUKE'S. JOHN N CALLANDER ORTHOPEDIC ENDOWMENT - PRIORITY NEEDS OF THE CPMC'S ORTHOPEDIC DEPARTMENT. C. HUGHEY TRUST ENDOWMENT - SUPPORT PATIENT CARE FOR CRIPPLED CHILDREN'S PROGRAM. CPMC A. MORRISON CHILD DEVELOPMENT ENDOWMENT - GENERAL USE FOR THE CHILD DEVELOPMENT DEPARTMENT. CMPCF TAKAHASHI SENIOR SERVICE ENDOWMENT - TOMOYE TAKAHASHI EDNOWMENT FUND TO BENEFIT SENIOR SERVICES. MARGARET H. PAGE ENDOWMENT - PROGRAM AND CAPITAL SUPPORT. ST. LUKE'S ENDOWMENT - TO SUPPORT ST. LUKE'S GENERAL OPERATIONS. SF POLYCLINIC ENDOWMENT - PROVIDE CARE OF MEDICALLY INDIGENT PATIENTS AND SUBSIDIZE PROGRAMS OF INTEREST TO THE PRIMARY PHYSICIAN. IN MEMORY OF RUTH MARY PRITCHARD JENKINS ENDOWMENT - HELD AS AN ENDOWMENT IN MEMORY OF RUTH MARY PRITCHARD JENKINS, THE WIFE OF THE RT. REV. THOMAS JENKINS, INCOME FROM WHICH SHALL BE USED TO CARE FOR CLERGY AND THEIR FAMILIES IN THE HOSPITAL. CPMC SHREM CARDIOLOGY FELLOWSHIP ENDOWMENT - THE PURPOSE OF THE GIFT IS TO ESTABLISH A PERMANENT ENDOWMENT FUND TO SUPPORT THE CPMC JAN SHREM AND MARIA MANETTI SHREM CPMC CARDIOLOGY FELLOWSHIP PROGRAM AT CPMC. CPMC PHYLLIS WATTIS ESTATE HOME HOSPICE ENDOWMENT - FOR THE GENERAL PURPOSES OF THE HOME HOSPICE CARE PROGRAM. M. NOTKIN BREAST CANCER RECOVERY ENDOWMENT - EARNINGS PROVIDE SERVICES OF NURSE EDUCATION, PSYCHOLOGIST & PATIENT NAVIGATOR TO WOMEN UNDERGOING TREATMENT FOR BREAST CANCER. MPHF CARE NAVIGATION ENDOWMENT - ENDOWMENT EARNINGS TO SUPPORT NAVIGATION FOR HIGH-RISK PATIENTS DIAGNOSED WITH CHRONIC ILLNESS AND THEIR FAMILIES. DOROTHY PARRY ENDOWMENT: MEDICAL RESEARCH IN CANCER, GLAUCOMA AND/OR ARTHRITIS. CAN SUPPORT PATIENT COST
SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE FROM AUDIT: THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH AND MANY AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS, ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE STATUTE OF LIMITATIONS FOR TAX YEARS 2018 THROUGH 2020 REMAINS OPEN IN U.S. TAX JURISDICTIONS IN WHICH SUTTER AND ITS AFFILIATES ARE SUBJECT TO TAXATION. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO SUCH UNCERTAIN TAX POSITIONS RECOGNIZED for the years ended December 31, 2021 and 2020.
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

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

4

Yes

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

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    42,671,987   42,671,987 0.920 %
b Medicaid (from Worksheet 3, column a) . . . . .     1,100,826,232 774,950,546 325,875,686 7.070 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     43,456,591 24,669,503 18,787,088 0.410 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     1,186,954,810 799,620,049 387,334,761 8.400 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 100 53,605 8,715,473 295,123 8,420,350 0.180 %
f Health professions education (from Worksheet 5) . . . 23 357 51,148,793 6,525,903 44,622,890 0.970 %
g Subsidized health services (from Worksheet 6) . . . . 37 1,584 91,642,189 57,795,748 33,846,441 0.730 %
h Research (from Worksheet 7) . 3 89 30,074,287 24,864,468 5,209,819 0.110 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 141 25,575 17,771,474 118,152 17,653,322 0.380 %
j Total. Other Benefits . . 304 81,210 199,352,216 89,599,394 109,752,822 2.370 %
k Total. Add lines 7d and 7j . 304 81,210 1,386,307,026 889,219,443 497,087,583 10.770 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 2   9,511   9,511  
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy 2   1,443   1,443  
8 Workforce development 3 4 31,250   31,250  
9 Other            
10 Total 7 4 42,204   42,204  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
 
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
902,365,179
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
1,036,813,403
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-134,448,224
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1SF ENDOSCOPY LLC
 
MEDICAL SERVICES 51 % 0 % 47.2 %
2SL SURGERY CENTER
 
MEDICAL SERVICES 48.03 % 0 % 42.63 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?17Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ALTA BATES SUMMIT MEDICAL CENTER
350 HAWTHORNE AVENUE
OAKLAND,CA94609
WWW.ALTABATESSUMMIT.ORG
#140000284
X X         X     C
2 ALTA BATES CAMPUS
2450 ASHBY AVENUE
BERKELEY,CA94705
WWW.ALTABATESSUMMIT.ORG
#140000004
X X         X     C
3 CPMC - VAN NESS CAMPUS
1101 VAN NESS AVENUE
SAN FRANCISCO,CA94109
WWW.CPMC.ORG
#220000197
X X         X     A
4 MILLS-PENINSULA MEDICAL CENTER
1501 TROUSDALE DRIVE
BURLINGAME,CA94010
WWW.MILLS-PENINSULA.ORG
#220000037
X X         X   OUTPATIENT SERVICES B
5 CPMC - DAVIES CAMPUS
601 DUBOCE AVENUE
SAN FRANCISCO,CA94117
WWW.CPMC.ORG
#220000197
X X         X     A
6 SUTTER DELTA MEDICAL CENTER
3901 LONE TREE WAY
ANTIOCH,CA94509
WWW.SUTTERDELTA.ORG
#140000258
X X         X     C
7 EDEN MEDICAL CENTER
20103 LAKE CHABOT ROAD
CASTRO VALLEY,CA94546
WWW.EDENMEDICALCENTER.ORG
#140000030
X X         X   OUTPATIENT SERVICES  
8 CPMC - MISSION BERNAL CAMPUS
3555 CESAR CHAVEZ STREET
SAN FRANCISCO,CA94110
WWW.ALTABATESSUMMIT.ORG
#220000070
X X         X     A
9 SUTTER SANTA ROSA REGIONAL HOSPITAL
30 MARK WEST SPRINGS ROAD
SANTA ROSA,CA95403
WWW.SUTTERSANTAROSA.ORG
#110000005
X X         X      
10 SUMMIT CAMPUS
3100 SUMMIT STREET
OAKLAND,CA94609
WWW.ALTABATESSUMMIT.ORG
#140000284
X X         X     C
11 ALTA BATES - HERRICK CAMPUS
2001 DWIGHT WAY
BERKELEY,CA94704
WWW.ALTABATESSUMMIT.ORG
#140000004
X X         X     C
12 MILLS HEALTH CENTER
100 SOUTH SAN MATEO DRIVE
SAN MATEO,CA94401
WWW.MILLS-PENINSULA.ORG
#220000037
X X             OUTPATIENT SERVICES B
13 NOVATO COMMUNITY HOSPITAL
180 ROLAND WAY
NOVATO,CA94945
WWW.NOVATOCOMMUNITY.ORG
#110000375
X X         X      
14 SUTTER LAKESIDE HOSPITAL
5176 HILL ROAD
LAKEPORT,CA95463
WWW.SUTTERLAKESIDE.ORG
#110000094
X X     X   X      
15 SUTTER MATERNITY & SURGERY SANTA CRUZ
2900 CHANTICLEER AVENUE
SANTA CRUZ,CA95065
WWW.SUTTERSANTACRUZ.ORG
#070000399
X X             OUTPATIENT SERVICES B
16 MPI CHEMICAL DEPENDENCY RECOVERY HOSP
3012 SUMMIT STREET
OAKLAND,CA94609
WWW.ALTABATESSUMMIT.ORG/MPI
#130000232
X                 C
17 CPMC - Psychiatric
2323 SACRAMENTO STREET
SAN FRANCISCO,CA94115
www.cpmc.org
#220000197
X                 A
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
B
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 No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
B
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
B
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
B
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
C
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 No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
C
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
C
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
EDEN 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):
7
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
EDEN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
EDEN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
EDEN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
SUTTER SANTA ROSA REGIONAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
9
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SUTTER SANTA ROSA REGIONAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
SUTTER SANTA ROSA REGIONAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
SUTTER SANTA ROSA REGIONAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
13
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
NOVATO COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
14
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
SUTTER LAKESIDE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
REPORTING GROUP: A (3, 5, 8, & 17) PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, LINE 5 CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): IN CONDUCTING ITS MOST RECENT CHNA, CALIFORNIA PACIFIC MEDICAL CENTER, A FACILITY OF SUTTER BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THE GOALS OF THE COMMUNITY ENGAGEMENT COMPONENT OF THE CHNA WERE TO: -IDENTIFY SAN FRANCISCANS' HEALTH PRIORITIES, ESPECIALLY THOSE OF VULNERABLE POPULATIONS. -OBTAIN DATA ON POPULATIONS AND ISSUES FOR WHICH WE HAVE LITTLE QUANTITATIVE DATA. -BUILD RELATIONSHIPS BETWEEN THE COMMUNITY AND SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP). -MEET THE REGULATORY REQUIREMENTS INCLUDING THE IRS RULES FOR 501(C)(3) CHARITABLE HOSPITALS, PUBLIC HEALTH ACCREDITATION BOARD REQUIREMENTS FOR THE SAN FRANCISCO HEALTH DEPARTMENT, AND SAN FRANCISCO'S PLANNING CODE REQUIREMENTS FOR A HEALTH CARE SERVICES MASTER PLAN. THE 2019 CHNA INCLUDES FOUR CATEGORIES OF FOCUS GROUPS: SFHIP KEY INFORMANT GROUP INTERVIEW, EQUITY COALITION FOCUS GROUPS, FOOD-INSECURE PREGNANT WOMEN FOCUS GROUPS, AND KAISER FOCUS GROUPS. SFHIP KEY INFORMANT GROUP INTERVIEW ONE FOCUS GROUP WAS COMPRISED OF SFHIP MEMBERS WHO ARE ALL SUBJECT MATTER EXPERTS. TWO SERIES OF QUESTIONS WERE ASKED: 1) WHAT ARE THE HEALTHIEST CHARACTERISTICS OF THIS COMMUNITY? WHAT SUPPORTS PEOPLE TO LIVE HEALTHIER LIVES? 2) WHAT ARE THE BIGGEST HEALTH ISSUES AND/OR CONDITIONS YOUR COMMUNITY STRUGGLES WITH? WHAT DO YOU THINK CREATES THOSE ISSUES? EQUITY COALITION FOCUS GROUPS THREE FOCUS GROUPS WERE CONDUCTED WITH EACH OF THE THREE HEALTH EQUITY COALITIONS IN SAN FRANCISCO: CHICANO/LATINO/INDIGENA HEALTH EQUITY COALITION, ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION, AND AFRICAN AMERICAN COMMUNITY HEALTH EQUITY COUNCIL. USING THE TECHNOLOGY OF PARTICIPATION (TOP) CONSENSUS METHOD, THE QUESTION POSED TO EACH FOCUS GROUP WAS, "WHAT ACTIONS CAN WE TAKE TO IMPROVE HEALTH?" FOOD-INSECURE PREGNANT WOMEN FOCUS GROUPS THE HOMELESS PRENATAL PROGRAM HELD FOUR FOCUS GROUPS WITH WOMEN WHO EXPERIENCED FOOD INSECURITY WHILE PREGNANT. EACH FOCUS GROUP FOCUSED ON A DIFFERENT GROUP OF WOMEN: SPANISH-SPEAKERS, CHINESE-SPEAKERS, MULTI-ETHNIC ENGLISH-SPEAKERS, AND BLACK/AFRICAN AMERICANS. THE QUESTION TO RESPOND TO WAS, "WHAT ACTIONS CAN WE TAKE TO IMPROVE YOUR FOOD NEEDS?" KAISER-LED FOCUS GROUPS KAISER CONDUCTED FOUR FOCUS GROUPS, ONE EACH WITH KAISER PERMANENTE LEADERSHIP, KAISER PERMANENTE STAFF, SPANISH-SPEAKING PARENTS REGARDING HEALTHY EATING AND ACTIVE LIVING AMONG YOUTH, AND HOMELESS AND/OR HIV-POSITIVE YOUTH. FURTHER DETAILS ON THE METHODS AND FINDINGS ARE AVAILABLE IN 2019 CHNA COMMUNITY ENGAGEMENT" SECTION. HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/CPMC-2019-CHNA.PDF SCHEDULE H, PART V, LINE 6A & 6B CHNA HOSPITAL COLLABORATORS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): AS A MEMBER OF SFHIP, CPMC PARTICIPATES IN A COLLECTIVE NEEDS ASSESSMENT PROCESS TO ENSURE THAT OUR COMMUNITY BENEFIT INVESTMENTS ARE RESPONSIVE TO REAL COMMUNITY HEALTH NEEDS. THIS CHNA REPORT HAS AS ITS FOUNDATION THE CHNA REPORT THAT WAS COLLECTIVELY DEVELOPED BY THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP)-SAN FRANCISCO COMMUNITY HEALTH NEEDS ASSESSMENT 2019. THE PROCESSES AND FINDINGS DESCRIBED WITHIN THIS DOCUMENT REFER TO THOSE OF SFHIP'S 2019 NEEDS ASSESSMENT. THE ORIGINAL 2019 CHNA DOCUMENT COLLECTIVELY DEVELOPED BY SFHIP AND PREPARED BY SFDPH CAN BE FOUND AT WWW.SFHIP.ORG. SFHIP IS A COLLABORATIVE BODY WHOSE MISSION IS TO EMBRACE COLLECTIVE IMPACT AND TO IMPROVE COMMUNITY HEALTH AND WELLNESS IN SAN FRANCISCO. MEMBERSHIP IN SFHIP INCLUDES: -SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH -AFRICAN AMERICAN COMMUNITY HEALTH EQUITY COUNCIL -ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION -CHICANO/LATINO/INDIGENA HEALTH EQUITY COALITION -SAN FRANCISCO HUMAN SERVICES NETWORK -DIGNITY HEALTH SAINT FRANCIS MEMORIAL HOSPITAL -DIGNITY HEALTH ST. MARY'S MEDICAL CENTER -SUTTER HEALTH CALIFORNIA PACIFIC MEDICAL CENTER -KAISER PERMANENTE -CHINESE HOSPITAL -SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM -METTA FUND -SAN FRANCISCO INTERFAITH COUNCIL -SAN FRANCISCO UNIFIED SCHOOL DISTRICT -SAN FRANCISCO MAYOR'S OFFICE -UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE'S COMMUNITY ENGAGEMENT AND HEALTH POLICY PROGRAM A COMPLETE LISTING OF HOSPITALS AND PARTNERS WHO COLLABORATED ON THE CHNA IS AVAILABLE FOR DOWNLOAD AT: HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/CPMC-2019-CHNA.PDF SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.CPMC.ORG/ABOUT/COMMUNITY/COMMUNITY-NEEDS-ASSESSMENT.HTML - OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINE 11 CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT CPMC INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO COORDINATED, CULTURALLY AND LINGUISTICALLY APPROPRIATE CARE AND SERVICES 2. FOOD SECURITY, HEALTHY EATING, AND ACTIVE LIVING 3. HOUSING SECURITY AND AN END TO HOMELESSNESS 4. SAFETY FROM VIOLENCE AND TRAUMA 5. SOCIAL, EMOTIONAL, AND BEHAVIORAL HEALTH DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY, CPMC IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: -ECONOMIC BARRIERS TO HEALTH -RACIAL HEALTH INEQUITIES -SAFETY AND VIOLENCE -HOUSING STABILITY AND HOMELESSNESS -SUBSTANCE ABUSE AS A MEMBER OF THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP), CPMC WILL CONTINUE TO WORK IN COLLABORATION WITH OTHER LOCAL HOSPITALS AND HEALTH PLANS TO IDENTIFY GAPS IN SERVICE AND TO DETERMINE WHERE EFFORTS SHOULD BE COLLECTIVELY REDIRECTED IN ORDER TO MOST EFFECTIVELY IMPROVE THE HEALTH OF SAN FRANCISCO RESIDENTS. FOR MORE INFORMATION ABOUT SFHIP, PLEASE VISIT WWW.SFHIP.ORG. SCHEDULE H, PART V, LINE 15E CALIFORNIA PACIFIC MEDICAL (REPORTING GROUP A, 3, 5, 8, & 17): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/FINANCIAL-ASSISTANCE.HTML SCHEDULE H, PART V, LINE 16J CALIFORNIA PACIFIC MEDICAL (REPORTING GROUP A, 3, 5, 8, & 17): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART V, LINE 22D CALIFORNIA PACIFIC MEDICAL (REPORTING GROUP A, 3, 5, 8, & 17) AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BE
REPORTING FACILITY: B, (4, 12, & 15) SCHEDULE H, PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, LINE 5 CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: MILLS PENINSULA MEDICAL CENTER (REPORTING GROUP B, 4 & 12): IN CONDUCTING ITS MOST RECENT CHNA, MILLS-PENINSULA MEDICAL CENTER DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. ACTIONABLE INSIGHTS (AI) CONDUCTED PRIMARY RESEARCH FOR THIS ASSESSMENT. AI USED THREE STRATEGIES FOR COLLECTING COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH HEALTH AND COMMUNITY-SERVICE EXPERTS, AND FOCUS GROUPS WITH PROFESSIONALS, AND FOCUS GROUPS WITH RESIDENTS. AI RECORDED EACH INTERVIEW AND FOCUS GROUP AS A STANDALONE PIECE OF DATA. RECORDINGS WERE TRANSCRIBED, THEN THE TEAM USED QUALITATIVE RESEARCH SOFTWARE TOOLS TO ANALYZE THE TRANSCRIPTS FOR COMMON THEMES. AI ALSO TABULATED HOW MANY TIMES HEALTH NEEDS HAD BEEN PRIORITIZED BY EACH OF THE FOCUS GROUPS OR DESCRIBED AS A PRIORITY IN A KEY INFORMANT INTERVIEW. THE HCC USED THIS TABULATION TO HELP ASSESS COMMUNITY HEALTH PRIORITIES. ACROSS THE KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, AI SOLICITED INPUT FROM MORE THAN 60 COMMUNITY LEADERS AND REPRESENTATIVES OF VARIOUS ORGANIZATIONS AND SECTORS. THESE REPRESENTATIVES EITHER WORK IN THE HEALTH FIELD OR IN A COMMUNITY-BASED ORGANIZATION THAT FOCUSES ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED HIGH-NEED TARGET POPULATIONS.28 IN THE LIST BELOW, THE NUMBER IN PARENTHESES INDICATES THE NUMBER OF PARTICIPANTS FROM EACH SECTOR. - SAN MATEO COUNTY HEALTH (3) - OTHER SAN MATEO COUNTY EMPLOYEES (FROM BEHAVIORAL HEALTH AND RECOVERY SERVICES, HUMAN SERVICES AGENCY, OFFICE OF EDUCATION, ETC.) (10) - OTHER PUBLIC EMPLOYEES (FROM CITIES, SCHOOL DISTRICTS, ETC.) (5) - OTHER HOSPITALS, CLINICS, AND HEALTH CARE SYSTEMS (6) - MENTAL HEALTH, SUBSTANCE USE, AND VIOLENCE PREVENTION PROVIDERS (4) - OTHER NONPROFIT COMMUNITY-BASED ORGANIZATIONS (33), INCLUDING THOSE SERVING CHILDREN, YOUTH, SENIORS, PARENTS, ETHNIC MINORITIES, AND OTHER VULNERABLE POPULATIONS, SUCH AS IMMIGRANTS, THOSE EXPERIENCING HOMELESSNESS, THOSE EXPERIENCING FOOD INSECURITY, AND THOSE SUFFERING FROM DEMENTIA, MENTAL HEALTH, AND SUBSTANCE USE DISORDERS - COMMUNITY GROUPS, INCLUDING COLLABORATIVES AND COALITIONS (1) - FAITH-BASED (1) - BUSINESS SECTOR (1) BETWEEN APRIL AND JUNE 2018, AI CONDUCTED PRIMARY RESEARCH VIA KEY INFORMANT INTERVIEWS WITH 19 SAN MATEO COUNTY EXPERTS FROM VARIOUS ORGANIZATIONS. THESE EXPERTS INCLUDED THE DEPUTY CHIEF OF THE COUNTY HEALTH SYSTEM, COMMUNITY CLINIC MANAGERS, AND CLINICIANS. INTERVIEWS WERE CONDUCTED IN PERSON OR BY TELEPHONE FOR APPROXIMATELY ONE HOUR. AI ASKED INFORMANTS: - WHAT ARE THE MOST IMPORTANT/PRESSING HEALTH NEEDS IN SAN MATEO COUNTY? - WHAT DRIVERS OR BARRIERS ARE IMPACTING THE TOP HEALTH NEEDS? - TO WHAT EXTENT IS HEALTH CARE ACCESS A NEED IN THE COMMUNITY? - TO WHAT EXTENT IS MENTAL HEALTH A NEED IN THE COMMUNITY? - WHAT POLICIES OR RESOURCES ARE NEEDED TO IMPACT HEALTH NEEDS? FOUR FOCUS GROUPS WERE CONDUCTED WITH A TOTAL OF 45 PROFESSIONALS AND COMMUNITY LEADERS FROM APRIL TO MAY 2018. THE QUESTIONS WERE THE SAME AS THOSE USED WITH KEY INFORMANTS. AI CONDUCTED FIVE RESIDENT FOCUS GROUPS WITH A TOTAL OF 45 RESIDENTS BETWEEN APRIL AND JUNE 2018. THE DISCUSSIONS CENTERED ON THE SAME FIVE QUESTIONS AS THE KEY INFORMANTS, WHICH AI MODIFIED APPROPRIATELY FOR EACH AUDIENCE. NONPROFIT HOSTS, SUCH AS THE PENINSULA CONFLICT RESOLUTION CENTER, RECRUITED PARTICIPANTS FOR THE GROUPS. TO PROVIDE A VOICE TO THE COMMUNITY IT SERVES IN SAN MATEO COUNTY, AND IN ALIGNMENT WITH IRS REGULATIONS, THE FOCUS GROUPS TARGETED RESIDENTS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, OR OF A MINORITY POPULATION. A TOTAL OF 45 COMMUNITY MEMBERS PARTICIPATED IN THE FOCUS GROUP DISCUSSIONS ACROSS SAN MATEO COUNTY. AI ASKED ALL PARTICIPANTS TO COMPLETE AN ANONYMOUS DEMOGRAPHIC SURVEY. THE RESULTS: - 41 PERCENT OF RESPONDENTS WERE LATINX, 25 PERCENT WERE WHITE, 18 PERCENT WERE PACIFIC ISLANDER, 5 PERCENT WERE ASIAN, 5 PERCENT WERE AFRICAN ANCESTRY, AND THE REST WERE OF MULTIPLE ETHNICITIES. - 20 PERCENT OF RESPONDENTS WERE AGE 25 OR YOUNGER, AND 50 PERCENT WERE AGE 65 OR OLDER. - 73 PERCENT WERE FEMALE, 22 PERCENT WERE MALE, AND 5 PERCENT WERE GENDER-NONCONFORMING. - 68 PERCENT REPORTED HAVING AN ANNUAL HOUSEHOLD INCOME OF LESS THAN $49,000 PER YEAR, WHICH IS BELOW THE 2018 CALIFORNIA SELF-SUFFICIENCY STANDARD29 FOR SAN MATEO COUNTY FOR TWO ADULTS WITH NO CHILDREN ($67,243). HALF WERE LOW-INCOME (I.E., MEDI-CAL ELIGIBLE30 OR EARNING LESS THAN $25,000). THIS DEMONSTRATES A HIGH LEVEL OF NEED AMONG PARTICIPANTS IN AN AREA WHERE THE COST OF LIVING IS EXTREMELY HIGH COMPARED WITH OTHER AREAS OF CALIFORNIA. THE FINDINGS IN MILLS PENINSULA MEDICAL CENTER'S CHNA ARE AVAILABLE AT: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment SUTTER MATERNITY & SURGERY CENTER, SANTA CRUZ (REPORTING GROUP B, 15): SUTTER MATERNITY & SURGERY CENTER SANTA CRUZ (SMSC), A FACILITY OF MPMC, CONTRACTED WITH ACTIONABLE INSIGHTS (AI) TO COLLECT AND REVIEW SECONDARY QUANTITATIVE (STATISTICAL) DATA FROM OTHER SOURCES AND PRIMARY QUALITATIVE DATA THROUGH KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. ACTIONABLE INSIGHTS CONDUCTED PRIMARY RESEARCH FOR THIS ASSESSMENT. AI USED TWO STRATEGIES FOR COLLECTING COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH HEALTH AND COMMUNITY-SERVICE EXPERTS AND FOCUS GROUPS WITH PROFESSIONALS AND COMMUNITY MEMBERS. PRIMARY RESEARCH PROTOCOLS WERE GENERATED BY AI IN COLLABORATION WITH SMSC, BASED ON A DISCUSSION WITH SMSC ABOUT WHAT IT WISHED TO LEARN DURING THE 2019 CHNA. SMSC SOUGHT TO BUILD UPON PRIOR CHNAS BY FOCUSING THE PRIMARY RESEARCH ON THE COMMUNITY'S PERCEPTIONS OF MENTAL HEALTH AND HOUSING AND HOMELESSNESS, AS WELL AS ITS EXPERIENCE WITH HEALTH CARE ACCESS AND DELIVERY. ALL THREE ISSUES WERE IDENTIFIED AS A MAJOR HEALTH NEEDS IN 2016. RELATIVELY LITTLE TIMELY QUANTITATIVE DATA EXISTS ON THESE SUBJECTS. AI RECORDED EACH INTERVIEW AND FOCUS GROUP AS A STANDALONE PIECE OF DATA. RECORDINGS WERE TRANSCRIBED, AFTER WHICH THE TEAM USED QUALITATIVE RESEARCH SOFTWARE TOOLS TO ANALYZE THE TRANSCRIPTS FOR COMMON THEMES. AI ALSO TABULATED HOW MANY TIMES HEALTH NEEDS HAD BEEN PRIORITIZED BY EACH OF THE FOCUS GROUPS OR DESCRIBED AS A PRIORITY IN A KEY INFORMANT INTERVIEW. SMSC USED THIS TABULATION TO HELP ASSESS COMMUNITY HEALTH PRIORITIES. ACROSS THE KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, AI SOLICITED INPUT FROM 25 COMMUNITY LEADERS AND REPRESENTATIVES OF VARIOUS ORGANIZATIONS AND SECTORS. THESE REPRESENTATIVES EITHER WORK IN THE HEALTH FIELD OR IN A COMMUNITY-BASED ORGANIZATION THAT FOCUSES ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED HIGH-NEED TARGET POPULATIONS. IN THE LIST BELOW, THE NUMBER IN PARENTHESES INDICATES THE NUMBER OF PARTICIPANTS FROM EACH SECTOR. - SANTA CRUZ COUNTY HEALTH (3) - OTHER PUBLIC EMPLOYEES (FROM COUNTY AGENCIES, SCHOOL DISTRICTS, ETC.) (3) - OTHER HOSPITALS, CLINICS, AND HEALTH CARE SYSTEMS (13) - MENTAL HEALTH, SUBSTANCE USE, AND VIOLENCE PREVENTION PROVIDERS (2) - OTHER NONPROFIT COMMUNITY-BASED ORGANIZATIONS (4), INCLUDING THOSE SERVING CHILDREN, YOUTH, SENIORS, PARENTS, ETHNIC MINORITIES, AND OTHER VULNERABLE POPULATIONS, SUCH AS IMMIGRANTS, THOSE EXPERIENCING HOMELESSNESS, AND THOSE EXPERIENCING FOOD INSECURITY. KEY INFORMANT INTERVIEWS BETWEEN APRIL AND MAY 2019, AI CONDUCTED PRIMARY RESEARCH VIA KEY INFORMANT INTERVIEWS WITH SEVEN SANTA CRUZ COUNTY EXPERTS FROM VARIOUS ORGANIZATIONS. THESE EXPERTS INCLUDED THE DIRECTOR OF THE COUNTY HEALTH SYSTEM AND LEADERS OF COMMUNITY-BASED ORGANIZATIONS. INTERVIEWS WERE CONDUCTED IN PERSON OR BY TELEPHONE FOR APPROXIMATELY ONE HOUR. AI ASKED INFORMANTS: - WHAT ARE THE MOST IMPORTANT/PRESSING HEALTH NEEDS IN SAN MATEO COUNTY? - WHAT DRIVERS OR BARRIERS ARE IMPACTING THE TOP HEALTH NEEDS? - TO WHAT EXTENT IS HEALTH CARE ACCESS A NEED IN THE COMMUNITY? - TO WHAT EXTENT IS MENTAL HEALTH A NEED IN THE COMMUNITY? - TO WHAT EXTENT IS HOUSING A NEED IN THE COMMUNITY? - WHAT POLICIES OR RESOURCES ARE NEEDED TO IMPACT HEALTH NEEDS? FOCUS GROUPS TWO FOCUS GROUPS WERE CONDUCTED IN MAY 2019 WITH A TOTAL OF 19 PROFESSIONALS AND COMMUNITY LEADERS.THE QUESTIONS WERE THE SAME AS THOSE USED WITH KEY INFORMANTS. THE FINDINGS IN SUTTER MATERNITY & SURGERY CENTER'S CHNA ARE AVAILABLE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINES 6A & 6B MILLS-PENINSULA MEDICAL CENTER (REPORTING GROUP B, 4 & 12): MILLS-PENINSULA MEDICAL CENTER (MPMC) AND ITS PARTNERS IN THE HEALTHY COMMUNITY COLLABORATIVE (HCC) OF SAN MATEO COUNTY ARE PLEASED TO HAVE PRODUCED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE HCC CONSISTS OF REPRESENTATIVES FROM NONPRO
REPORTING FACILITY: C, (1-2, 6, 10-11, & 16) PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART V, LINE 5 ALTA BATES SUMMIT MEDICAL CENTER (REPORTING GROUP C, 1-2, 10-11 & 16): IN CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), ALTA BATES SUMMIT MEDICAL CENTER (ABSMC), A FACILITY OF SUTTER BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. ACTIONABLE INSIGHTS (AI) CONDUCTED THE PRIMARY RESEARCH FOR THIS ASSESSMENT. AI USED THREE STRATEGIES FOR COLLECTING COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH HEALTH EXPERTS, FOCUS GROUPS WITH PROFESSIONALS, AND FOCUS GROUPS WITH RESIDENTS. PRIMARY RESEARCH PROTOCOLS GENERATED BY AI IN COLLABORATION WITH THE HOSPITALS IN ALAMEDA AND CONTRA COSTA COUNTIES WERE BASED ON FACILITATED DISCUSSION AMONG THE HOSPITALS' REPRESENTATIVES ABOUT WHAT THEY WISHED TO LEARN DURING THE 2019 CHNA. THE HOSPITALS SOUGHT TO BUILD UPON PRIOR CHNAS BY FOCUSING THE PRIMARY RESEARCH ON THE COMMUNITY'S PERCEPTION OF MENTAL HEALTH (IDENTIFIED AS A MAJOR HEALTH NEED IN THE 2016 CHNA) AND THEIR EXPERIENCE WITH HEALTHCARE ACCESS AND DELIVERY (ALSO IDENTIFIED AS A MAJOR HEALTH NEED IN 2016). RELATIVELY LITTLE TIMELY QUANTITATIVE DATA EXIST ON THESE SUBJECTS. AI RECORDED EACH INTERVIEW AND FOCUS GROUP AS A STANDALONE PIECE OF DATA. RECORDINGS WERE TRANSCRIBED, AND THEN THE TEAM USED QUALITATIVE RESEARCH SOFTWARE TOOLS TO ANALYZE THE TRANSCRIPTS FOR COMMON THEMES. AI ALSO TABULATED HOW MANY TIMES HEALTH NEEDS HAD BEEN PRIORITIZED BY EACH OF THE FOCUS GROUPS OR DESCRIBED AS A PRIORITY IN KEY INFORMANT INTERVIEWS. THE NORTHERN ALAMEDA COUNTY HOSPITALS ("THE N-AC HOSPITALS") USED THIS TABULATION TO HELP ASSESS COMMUNITY HEALTH PRIORITIES. THROUGH THE KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, AI SOLICITED INPUT FROM 36 RESIDENTS AND 68 COMMUNITY LEADERS AND REPRESENTATIVES. THE LEADERS AND REPRESENTATIVES WORKED EITHER IN THE HEALTHCARE FIELD OR IN COMMUNITY-BASED ORGANIZATIONS FOCUSED ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED HIGH-NEED POPULATIONS. KEY INFORMANT INTERVIEWS BETWEEN JUNE AND AUGUST 2018, AI CONDUCTED PRIMARY RESEARCH VIA KEY INFORMANT INTERVIEWS WITH 16 LOCAL AND/OR REGIONAL EXPERTS FROM VARIOUS ORGANIZATIONS. THESE EXPERTS INCLUDED INDIVIDUALS FROM THE PUBLIC HEALTH DEPARTMENT, COMMUNITY CLINIC MANAGERS, AND CLINICIANS. INTERVIEWS WERE CONDUCTED IN PERSON OR BY TELEPHONE FOR APPROXIMATELY ONE HOUR. AI ASKED INTERVIEWEES: -WHAT ARE THE MOST IMPORTANT/PRESSING HEALTH NEEDS IN THE LOCAL AREA? -WHAT DRIVERS OR BARRIERS ARE IMPACTING THE TOP HEALTH NEEDS? -TO WHAT EXTENT IS HEALTHCARE ACCESS A NEED IN THE COMMUNITY? -TO WHAT EXTENT IS MENTAL HEALTH A NEED IN THE COMMUNITY? -WHAT POLICIES OR RESOURCES ARE NEEDED TO IMPACT HEALTH NEEDS? FOCUS GROUPS INPUT FROM PROFESSIONALS AND COMMUNITY LEADERS SEVEN FOCUS GROUPS WERE CONDUCTED FROM JULY TO SEPTEMBER 2018 WITH A TOTAL OF 54 PROFESSIONALS AND COMMUNITY LEADERS. THE QUESTIONS WERE THE SAME AS THOSE USED WITH KEY INFORMANT INTERVIEWEES. INPUT FROM RESIDENTS AI CONDUCTED TWO RESIDENT FOCUS GROUPS WITH A TOTAL OF 36 RESIDENTS IN AUGUST AND SEPTEMBER 2018. THE DISCUSSIONS CENTERED AROUND THE SAME FIVE QUESTIONS ASKED OF THE KEY INFORMANT INTERVIEWEES, WHICH AI MODIFIED APPROPRIATELY FOR EACH AUDIENCE. NONPROFIT HOSTS SUCH AS YOUTH RADIO RECRUITED PARTICIPANTS FOR THE GROUPS. TO GIVE A VOICE TO THE COMMUNITY, AND IN ALIGNMENT WITH IRS REGULATIONS, THE FOCUS GROUPS TARGETED RESIDENTS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, OR OF A MINORITY POPULATION. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN ABSMC'S CHNA ARE AVAILABLE AT: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment SUTTER DELTA MEDICAL CENTER (REPORTING GROUP C, 6): IN CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), SUTTER DELTA MEDICAL CENTER (SDMC), A FACILITY OF SUTTER BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (KEY INFORMANTS). ACTIONABLE INSIGHTS CONDUCTED THE PRIMARY RESEARCH FOR THIS ASSESSMENT. AI USED THREE STRATEGIES FOR COLLECTING COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH HEALTH EXPERTS, FOCUS GROUPS WITH PROFESSIONALS, AND FOCUS GROUPS WITH RESIDENTS. PRIMARY RESEARCH PROTOCOLS GENERATED BY AI IN COLLABORATION WITH THE HOSPITALS IN ALAMEDA AND CONTRA COSTA COUNTIES WERE BASED ON FACILITATED DISCUSSION AMONG THE HOSPITALS' REPRESENTATIVES ABOUT WHAT THEY WISHED TO LEARN DURING THE 2019 CHNA. THE HOSPITALS SOUGHT TO BUILD UPON PRIOR CHNAS BY FOCUSING THE PRIMARY RESEARCH ON THE COMMUNITY'S PERCEPTION OF MENTAL HEALTH (IDENTIFIED AS A MAJOR HEALTH NEED IN THE 2016 CHNA) AND THEIR EXPERIENCE WITH HEALTHCARE ACCESS AND DELIVERY (ALSO IDENTIFIED AS A MAJOR HEALTH NEED IN 2016). RELATIVELY LITTLE TIMELY QUANTITATIVE DATA EXIST ON THESE SUBJECTS. AI RECORDED EACH INTERVIEW AND FOCUS GROUP AS A STANDALONE PIECE OF DATA. RECORDINGS WERE TRANSCRIBED, AND THEN THE TEAM USED QUALITATIVE RESEARCH SOFTWARE TOOLS TO ANALYZE THE TRANSCRIPTS FOR COMMON THEMES. AI ALSO TABULATED HOW MANY TIMES HEALTH NEEDS HAD BEEN PRIORITIZED BY EACH OF THE FOCUS GROUPS OR DESCRIBED AS A PRIORITY IN A KEY INFORMANT INTERVIEW. THE E-CCC HOSPITALS USED THIS TABULATION TO HELP ASSESS COMMUNITY HEALTH PRIORITIES. THROUGH THE KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, AI SOLICITED INPUT FROM 37 RESIDENTS AND 43 COMMUNITY LEADERS AND REPRESENTATIVES. THE LEADERS AND REPRESENTATIVES WORKED EITHER IN THE HEALTH FIELD OR IN COMMUNITY-BASED ORGANIZATIONS FOCUSED ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED HIGH-NEED POPULATIONS.19 CONTRA COSTA HEALTH SERVICES (THE PUBLIC HEALTH DEPARTMENT) FACILITATED THE FOCUS GROUPS AND PROVIDED INPUT INTO THE PROTOCOLS. KEY INFORMANT INTERVIEWS BETWEEN JUNE AND AUGUST 2018, AI CONDUCTED PRIMARY RESEARCH VIA KEY INFORMANT INTERVIEWS WITH 16 LOCAL AND/OR REGIONAL EXPERTS FROM VARIOUS ORGANIZATIONS. THESE EXPERTS INCLUDED INDIVIDUALS FROM THE PUBLIC HEALTH DEPARTMENT, COMMUNITY CLINIC MANAGERS, AND CLINICIANS. INTERVIEWS WERE CONDUCTED IN PERSON OR BY TELEPHONE FOR APPROXIMATELY ONE HOUR. AI ASKED: -WHAT ARE THE MOST IMPORTANT/PRESSING HEALTH NEEDS IN THE LOCAL AREA? -WHAT DRIVERS OR BARRIERS ARE IMPACTING THE TOP HEALTH NEEDS? -TO WHAT EXTENT IS HEALTHCARE ACCESS A NEED IN THE COMMUNITY? -TO WHAT EXTENT IS MENTAL HEALTH A NEED IN THE COMMUNITY? -WHAT POLICIES OR RESOURCES ARE NEEDED TO IMPACT HEALTH NEEDS? FOCUS GROUPS INPUT FROM PROFESSIONALS AND COMMUNITY LEADERS THREE FOCUS GROUPS WERE CONDUCTED WITH A TOTAL OF 27 PROFESSIONALS AND COMMUNITY LEADERS IN AUGUST AND SEPTEMBER 2018. THE QUESTIONS WERE THE SAME AS THOSE USED WITH KEY INFORMANT INTERVIEWEES. INPUT FROM RESIDENTS FOUR RESIDENT FOCUS GROUPS WERE CONDUCTED WITH A TOTAL OF 37 RESIDENTS IN AUGUST AND SEPTEMBER 2018. THE DISCUSSIONS CENTERED AROUND THE SAME FIVE QUESTIONS ASKED OF THE KEY INFORMANT INTERVIEWEES, WHICH AI MODIFIED APPROPRIATELY FOR EACH AUDIENCE. NONPROFIT HOSTS SUCH AS LOAVES & FISHES RECRUITED PARTICIPANTS FOR THE GROUPS. TO PROVIDE A VOICE TO THE COMMUNITY, AND IN ALIGNMENT WITH IRS REGULATIONS, THE FOCUS GROUPS TARGETED RESIDENTS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, OR OF A MINORITY POPULATION. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER DELTA MEDICAL CENTER'S CHNA ARE AVAILABLE AT: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment PART V, LINE 6A ALTA BATES SUMMIT MEDICAL CENTER (REPORTING GROUP C, 1-2, 10-11 & 16): COMMUNITY BENEFIT MANAGERS FROM ALTA BATES SUMMIT MEDICAL CENTER AND THREE OTHER HOSPITALS IN NORTHERN ALAMEDA COUNTY ("THE N-AC HOSPITALS") CONTRACTED WITH ACTIONABLE INSIGHTS IN 2018 TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. THE HOSPITALS THAT PARTNERED WITH ALTA BATES SUMMIT MEDICAL CENTER IN NORTHERN ALAMEDA COUNTY WERE: -JOHN MUIR HEALTH -KAISER PERMANENTE-EAST BAY AREA (KAISER FOUNDATION HOSPITAL-OAKLAND) -UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND SUTTER DELTA MEDICAL CENTER (REPORTING GROUP C, 6): COMMUNITY BENEFIT MANAGERS FROM SUTTER DELTA MEDICAL CENTER AND TWO OTHER LOCAL HOSPITALS IN EASTERN CONTRA COSTA COUNTY ("THE E-CCC HOSPITALS") CONTRACTED WITH ACTIONABLE INSIGHTS IN 2018 TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. THE HOSPITALS THAT PARTNERED WITH SUTTER DELTA MEDICAL CENTER IN EASTERN CONTRA COSTA COUNTY WERE: -CONTRA COSTA HEALTH SERVICES -JOHN MUIR HEALTH -KAISER FOUNDATION HOSPITAL-ANTIOCH PART V, LINE 7A, 7B, 10A ALTA BATES SUMMIT MEDICAL CENTER (REPORTING GROUP C, 1-2, 10-11 & 16): FILING ORGANIZATION WEBSITE: http://www.altabatessummit.org/about/ communitybenefit/community-assessment.html OTHER ORGANIZATION WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-A
REPORTING FACILITY: #7, EDEN MEDICAL CENTER PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART V, LINE 5 IN CONDUCTING ITS MOST RECENT CHNA, EDEN MEDICAL CENTER (EMC) DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. ACTIONABLE INSIGHTS CONDUCTED THE PRIMARY RESEARCH FOR THIS ASSESSMENT. AI USED THREE STRATEGIES FOR COLLECTING COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH HEALTH EXPERTS, FOCUS GROUPS WITH PROFESSIONALS, AND FOCUS GROUPS WITH RESIDENTS. AI RECORDED EACH INTERVIEW AND FOCUS GROUP AS A STANDALONE PIECE OF DATA. RECORDINGS WERE TRANSCRIBED, AND THEN THE TEAM USED QUALITATIVE RESEARCH SOFTWARE TOOLS TO ANALYZE THE TRANSCRIPTS FOR COMMON THEMES. AI ALSO TABULATED HOW MANY TIMES HEALTH NEEDS HAD BEEN PRIORITIZED BY EACH OF THE FOCUS GROUPS OR DESCRIBED AS A PRIORITY IN KEY INFORMANT INTERVIEWS. THE SL/H HOSPITALS USED THIS TABULATION TO HELP ASSESS COMMUNITY HEALTH PRIORITIES. THROUGH THE KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, AI SOLICITED INPUT FROM 34 RESIDENTS AND 39 COMMUNITY LEADERS AND REPRESENTATIVES OF VARIOUS ORGANIZATIONS AND SECTORS. THESE REPRESENTATIVES EITHER WORK IN THE HEALTHCARE FIELD OR IN COMMUNITY-BASED ORGANIZATIONS FOCUSED ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED HIGH-NEED POPULATIONS. KEY INFORMANT INTERVIEWS BETWEEN JUNE AND AUGUST 2018, AI CONDUCTED PRIMARY RESEARCH VIA KEY INFORMANT INTERVIEWS WITH 15 LOCAL AND/OR REGIONAL EXPERTS FROM VARIOUS ORGANIZATIONS. THESE EXPERTS INCLUDED INDIVIDUALS FROM THE PUBLIC HEALTH DEPARTMENT, COMMUNITY CLINIC MANAGERS, AND CLINICIANS. INTERVIEWS WERE CONDUCTED IN PERSON OR BY TELEPHONE FOR APPROXIMATELY ONE HOUR. AI ASKED INFORMANTS: -WHAT ARE THE MOST IMPORTANT/PRESSING HEALTH NEEDS IN THE LOCAL AREA? -WHAT DRIVERS OR BARRIERS ARE IMPACTING THE TOP HEALTH NEEDS? -TO WHAT EXTENT IS HEALTHCARE ACCESS A NEED IN THE COMMUNITY? -TO WHAT EXTENT IS MENTAL HEALTH A NEED IN THE COMMUNITY? -WHAT POLICIES OR RESOURCES ARE NEEDED TO IMPACT HEALTH NEEDS? FOCUS GROUPS INPUT FROM PROFESSIONALS AND COMMUNITY LEADERS FOUR FOCUS GROUPS WERE CONDUCTED WITH A TOTAL OF 24 PROFESSIONALS AND COMMUNITY LEADERS IN AUGUST AND SEPTEMBER 2018. THE QUESTIONS WERE THE SAME AS THOSE USED WITH KEY INFORMANT INTERVIEWEES. INPUT FROM RESIDENTS AI CONDUCTED THREE RESIDENT FOCUS GROUPS WITH A TOTAL OF 34 RESIDENTS IN JULY AND AUGUST 2018. THE DISCUSSIONS CENTERED AROUND THE SAME FIVE QUESTIONS ASKED OF THE KEY INFORMANT INTERVIEWEES, WHICH AI MODIFIED APPROPRIATELY FOR EACH AUDIENCE. NONPROFIT HOSTS SUCH AS LA FAMILIA COUNSELING RECRUITED PARTICIPANTS FOR THE GROUPS. TO GIVE A VOICE TO THE COMMUNITY, AND IN ALIGNMENT WITH IRS REGULATIONS, THE FOCUS GROUPS TARGETED RESIDENTS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, OR OF A MINORITY POPULATION. THE FINDINGS IN EDEN MEDICAL CENTER'S CHNA ARE AVAILABLE AT https://www.sutterhealth.org/for-patients/ community-health-needs-assessment PART V, LINE 6 EDEN MEDICAL CENTER (REPORTING FACILITY #7): COMMUNITY BENEFIT MANAGERS FROM EDEN MEDICAL CENTER AND FOUR OTHER HOSPITALS IN THE SAN LEANDRO/ HAYWARD REGION ("THE SL/H HOSPITALS") CONTRACTED WITH ACTIONABLE INSIGHTS IN 2018 TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. THE HOSPITALS THAT PARTNERED WITH EDEN MEDICAL CENTER IN THE SAN LEANDRO/HAYWARD REGION WERE: -KAISER FOUNDATION HOSPITAL-SAN LEANDRO -ST. ROSE HOSPITAL -UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND -WASHINGTON HOSPITAL HEALTHCARE SYSTEM PART V, LINES 7A, 7B, 10A EDEN MEDICAL CENTER (REPORTING FACILITY #7): HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/EDEN/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 11 EDEN MEDICAL CENTER (REPORTING FACILITY #7): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT EDEN MEDICAL CENTER INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: -BEHAVIORAL HEALTH -ECONOMIC SECURITY -HOUSING AND HOMELESSNESS -HEALTHCARE ACCESS AND DELIVERY DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. EDEN MEDICAL CENTER IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: -EDUCATION AND LITERACY -COMMUNITY AND FAMILY SAFETY -HEALTHY EATING/ACTIVE LIVING -TRANSPORTATION AND TRAFFIC -CLIMATE/NATURAL ENVIRONMENT EDEN MEDICAL CENTER WILL FOCUS ON THE TOP FIVE HEALTH NEEDS THAT WERE IDENTIFIED AND PRIORITIZED THROUGH THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THE DECISION TO NOT DIRECTLY ADDRESS THE REMAINING FOUR HEALTH NEEDS, LISTED ABOVE, WAS BASED ON THE MAGNITUDE AND SCALE OF HEALTH NEEDS, RESOURCES AVAILABLE, AND COMMITMENT TO DEVELOPING A FOCUSED STRATEGY IN RESPONSE TO THE NEEDS ASSESSMENT. SCHEDULE H, PART V, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: EDEN MEDICAL CENTER (FACILITY #7): PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C EDEN MEDICAL CENTER (FACILITY #7): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/FINANCIAL-ASSISTANCE.HTML SCHEDULE H, PART V, LINE 16J MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: EDEN MEDICAL CENTER (FACILITY #7): THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART V, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: EDEN MEDICAL CENTER (FACILITY #7): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.
REPORTING FACILITY #9, SUTTER SANTA ROSA REGIONAL HOSPITAL PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, LINE 5 SUTTER SANTA ROSA REGIONAL HOSPITAL (REPORTING FACILITY #9): COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS THROUGH KEY INFORMANT INTERVIEWS, GROUP INTERVIEWS, AND FOCUS GROUPS. INDIVIDUALS WITH THE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM HEALTH DEPARTMENTS, SCHOOL DISTRICTS, LOCAL NON-PROFITS, AND OTHER REGIONAL PUBLIC AND PRIVATE ORGANIZATIONS AS WELL AS COMMUNITY LEADERS, CLIENTS OF LOCAL SERVICE PROVIDERS, AND OTHER INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND SUB-POPULATIONS THAT FACE UNIQUE BARRIERS TO HEALTH (E.G., RACE/ETHNIC MINORITY POPULATIONS, INDIVIDUALS EXPERIENCING HOMELESSNESS). II. METHODOLOGY FOR COLLECTION AND INTERPRETATION IN AN EFFORT TO INCLUDE A WIDE RANGE OF COMMUNITY VOICES FROM INDIVIDUALS WITH DIVERSE PERSPECTIVES AND EXPERIENCES AND THOSE WHO WORK WITH OR REPRESENT UNDERSERVED POPULATIONS AND GEOGRAPHIC COMMUNITIES WITHIN THE SRRH SERVICE AREA, HARDER+COMPANY STAFF USED SEVERAL METHODS TO IDENTIFY COMMUNITIES FOR QUALITATIVE DATA COLLECTION ACTIVITIES IN BOTH ENGLISH AND SPANISH. FIRST, HARDER+COMPANY STAFF REVIEWED THE PARTICIPANT LISTS FROM PREVIOUS CHNA REPORTS IN THE SAME SERVICE AREA. SECOND, THEY EXAMINED REPORTS PUBLISHED BY LOCAL 9 ORGANIZATIONS AND AGENCIES (E.G., COUNTY AND CITY PLANS, COMMUNITY-BASED ORGANIZATIONS) TO IDENTIFY ADDITIONAL HIGH-NEED COMMUNITIES. FINALLY, STAFF RESEARCHED LOCAL NEWS STORIES TO IDENTIFY EMERGING HEALTH NEEDS AND SOCIAL CONDITIONS AFFECTING COMMUNITY HEALTH THAT MAY NOT YET BE INDICATED IN SECONDARY DATA. IMPORTANTLY, THE INCLUSION OF SERVICE PROVIDERS (THROUGH KEY INFORMANTS AND PROVIDER GROUP INTERVIEWS) AND COMMUNITY MEMBERS (THROUGH FOCUS GROUPS) ALLOWED US TO IDENTIFY HEALTH NEEDS FROM THE PERSPECTIVES OF SERVICE DELIVERY GROUPS AND BENEFICIARIES. HARDER+COMPANY CONDUCTED KEY INFORMANT INTERVIEWS OVER THE PHONE BY A SINGLE INTERVIEWER, WHILE PROVIDER GROUP INTERVIEWS AND COMMUNITY FOCUS GROUPS WERE IN PERSON AND COMPLETED BY BOTH A FACILITATOR AND NOTETAKER. WHEN RESPONDENTS GRANTED PERMISSION, WE RECORDED AND TRANSCRIBED ALL INTERVIEWS. PRIMARY QUALITATIVE (I.E., COMMUNITY INPUT) DATA WAS ESSENTIAL FOR IDENTIFYING NEEDS THAT HAVE EMERGED SINCE THE PREVIOUS CHNA, SINCE IN ORDER TO BE IDENTIFIED AS A POTENTIAL "HEALTH NEED" AN ISSUE HAD TO BE MENTIONED IN AT LEAST HALF OF THE QUALITATIVE DATA COLLECTION ACTIVITIES. HEALTH NEED IDENTIFICATION USED QUALITATIVE DATA BASED ON THE NUMBER OF INTERVIEWEES OR GROUPS WHO REFERENCED EACH HEALTH NEED AS A CONCERN, REGARDLESS OF THE NUMBER OF MENTIONS WITHIN EACH TRANSCRIPT. THE FINDINGS FROM KEY INFORMANT INTERVIEWS and FOCUS GROUPS IN SUTTER SANTA ROSA REGIONAL HOSPITAL'S CHNA ARE AVAILABLE AT: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment SCHEDULE H, PART V, LINE 6A & 6B SUTTER SANTA ROSA REGIONAL HOSPITAL (REPORTING FACILITY #9): SUTTER SANTA ROSA REGIONAL HOSPITAL WORKED WITH BOTH HOSPITAL AND OTHER PARTNER ORGANIZATIONS WITH SIMILAR SERVICE AREAS IN SONOMA COUNTY TO FORM THE SONOMA COUNTY CHNA COLLABORATIVE TO SUPPORT THE 2018/19 CHNA. THIS GROUP DEVELOPED A COORDINATED APPROACH TO PRIMARY DATA COLLECTION, AND THEN DETERMINED THE LIST OF SIGNIFICANT HEALTH NEEDS BASED ON BOTH PRIMARY AND SECONDARY DATA ANALYSIS. SUTTER SANTA ROSA REGIONAL HOSPITAL THEN COORDINATED WITH THESE PARTNERS TO ENGAGE A BROADER GROUP OF COMMUNITY STAKEHOLDERS TO PRIORITIZE THE IDENTIFIED HEALTH NEEDS (DESCRIBED IN SECTION VI-B). COLLABORATIVE HOSPITAL PARTNERS: -KAISER FOUNDATION HOSPITAL - SANTA ROSA -ST. JOSEPH HEALTH - SANTA ROSA MEMORIAL HOSPITAL -SUTTER HEALTH - SANTA ROSA REGIONAL HOSPITAL ADDITIONAL PARTNERS: -SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: SUTTER SANTA ROSA REGIONAL HOSPITAL (REPORTING FACILITY #9): - HOSPITAL FACILITY'S WEBSITE: http://www.suttersantarosa.org/relations/ community-needs-assessment.html - OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINE 11 SUTTER SANTA ROSA REGIONAL HOSPITAL (REPORTING FACILITY #9): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER SANTA ROSA REGIONAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1.HOUSING AND HOMELESSNESS 2.EDUCATION 3.ECONOMIC SECURITY 4.ACCESS TO CARE 5.CARDIOVASCULAR DISEASE, STROKE AND TOBACCO USE DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER SANTA ROSA REGIONAL HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: -MATERNAL AND CHILD HEALTH, HEAL, VIOLENCE AND INJURY PREVENTION - ALTHOUGH SIGNIFICANT ISSUES FACING THE COMMUNITY, IT IS NOT WITHIN THE SCOPE OF SERVICES FOR A HOSPITAL TO ADDRESS. THOUGH NOT MAJOR PRIORITIES FOR SSRRH, WE HAVE AND WILL CONTINUE TO RESPOND TO MODEST REQUESTS FOR FUNDING TO SUPPORT PROGRAMS THAT ADDRESS THESE ISSUES. SCHEDULE H, PART V, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: SUTTER SANTA ROSA REGIONAL HOSPITAL (HOSPITAL FACILITY #9): PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C SUTTER SANTA ROSA REGIONAL HOSPITAL (HOSPITAL FACILITY #9): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/FINANCIAL-ASSISTANCE.HTML SCHEDULE H, PART V, LINE 16J Sutter Santa Rosa Regional Hospital (Hospital Facility #9): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART V, LINE 22D Sutter Santa Rosa Regional Hospital (Hospital Facility #9): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.
REPORTING FACILITY: #13, NOVATO COMMUNITY HOSPITAL SCHEDULE H, PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, LINE 5 NOVATO COMMUNITY HOSPITAL (REPORTING FACILITY #13): IN CONDUCTING ITS MOST RECENT CHNA, NOVATO COMMUNITY HOSPITAL, A FACILITY OF SUTTER BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS THROUGH KEY INFORMANT INTERVIEWS, GROUP INTERVIEWS, AND FOCUS GROUPS. INDIVIDUALS WITH THE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM HEALTH DEPARTMENTS, SCHOOL DISTRICTS, LOCAL NON-PROFITS, AND OTHER REGIONAL PUBLIC AND PRIVATE ORGANIZATIONS AS WELL AS COMMUNITY LEADERS, CLIENTS OF LOCAL SERVICE PROVIDERS, AND OTHER INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND SUB-POPULATIONS THAT FACE UNIQUE BARRIERS TO HEALTH (E.G., RACE/ETHNIC MINORITY POPULATIONS, INDIVIDUALS EXPERIENCING HOMELESSNESS) IN AN EFFORT TO INCLUDE A WIDE RANGE OF COMMUNITY VOICES FROM INDIVIDUALS WITH DIVERSE PERSPECTIVES AND EXPERIENCES AND THOSE WHO WORK WITH OR REPRESENT UNDERSERVED POPULATIONS AND GEOGRAPHIC COMMUNITIES WITHIN THE NCH SERVICE AREA, HARDER+COMPANY STAFF USED SEVERAL METHODS TO IDENTIFY COMMUNITIES FOR QUALITATIVE DATA COLLECTION ACTIVITIES. FIRST, HARDER+COMPANY STAFF REVIEWED THE PARTICIPANT LISTS FROM PREVIOUS CHNA REPORTS IN THE SAME SERVICE AREA. SECOND, THEY EXAMINED REPORTS PUBLISHED BY LOCAL ORGANIZATIONS AND AGENCIES (E.G., COUNTY AND CITY PLANS, COMMUNITY-BASED ORGANIZATIONS) TO IDENTIFY ADDITIONAL HIGH-NEED COMMUNITIES. FINALLY, STAFF RESEARCHED LOCAL NEWS STORIES TO IDENTIFY EMERGING HEALTH NEEDS AND SOCIAL CONDITIONS AFFECTING COMMUNITY HEALTH THAT MAY NOT YET BE INDICATED IN SECONDARY DATA. IMPORTANTLY, THE INCLUSION OF SERVICE PROVIDERS (THROUGH KEY INFORMANTS AND PROVIDER GROUP INTERVIEWS) AND COMMUNITY MEMBERS (THROUGH FOCUS GROUPS) ALLOWED US TO IDENTIFY HEALTH NEEDS FROM THE PERSPECTIVES OF SERVICE DELIVERY GROUPS AND BENEFICIARIES. THE CONSULTING TEAM DEVELOPED INTERVIEW AND FOCUS GROUP PROTOCOLS, WHICH THE CHNA COLLABORATIVE REVIEWED. PROTOCOLS WERE DESIGNED TO INQUIRE ABOUT HEALTH NEEDS IN THE COMMUNITY, AS WELL AS A BROAD RANGE OF SOCIAL DETERMINANTS OF HEALTH (I.E., SOCIAL, ECONOMIC, AND ENVIRONMENTAL), BEHAVIORAL, AND CLINICAL CARE FACTORS. SOME OF THE IDENTIFIED FACTORS REPRESENTED BARRIERS TO CARE WHILE OTHERS IDENTIFIED SOLUTIONS OR RESOURCES TO IMPROVE COMMUNITY HEALTH. PARTICIPANTS WERE ALSO ASKED TO DESCRIBE ANY NEW OR EMERGING HEALTH ISSUES AND TO PRIORITIZE THE TOP HEALTH CONCERNS IN THEIR COMMUNITY. HARDER+COMPANY CONDUCTED KEY INFORMANT INTERVIEWS OVER THE PHONE BY A SINGLE INTERVIEWER, WHILE PROVIDER GROUP INTERVIEWS AND COMMUNITY FOCUS GROUPS WERE IN PERSON AND COMPLETED BY BOTH A FACILITATOR AND NOTETAKER. WHEN RESPONDENTS GRANTED PERMISSION, WE RECORDED AND TRANSCRIBED ALL INTERVIEWS. ALL QUALITATIVE DATA WERE CODED AND ANALYZED USING ATLAS.TI SOFTWARE (GMBH, BERLIN, VERSION 7.5.18). A CODEBOOK WITH ROBUST DEFINITIONS WAS DEVELOPED TO CODE TRANSCRIPTS FOR INFORMATION RELATED TO EACH POTENTIAL HEALTH NEED, AS WELL AS TO IDENTIFY COMMENTS RELATED TO SUBPOPULATIONS OR GEOGRAPHIC REGIONS DISPROPORTIONATELY AFFECTED; BARRIERS TO CARE; EXISTING ASSETS OR RESOURCES; AND COMMUNITY-RECOMMENDED HEALTHCARE SOLUTIONS. AT THE ONSET OF ANALYSIS, THREE INTERVIEW TRANSCRIPTS (ONE FROM EACH TYPE OF DATA COLLECTION) WERE CODED BY ALL NINE HARDER+COMPANY TEAM MEMBERS TO ENSURE INTER-CODER RELIABILITY AND MINIMIZE BIAS. FOLLOWING THE INTER-CODER RELIABILITY CHECK, THE CODEBOOK WAS FINALIZED TO ELIMINATE REDUNDANCIES AND CAPTURE ALL EMERGING HEALTH ISSUES AND ASSOCIATED FACTORS. ALL TRANSCRIPTS WERE ANALYZED ACCORDING TO THE FINALIZED CODEBOOK TO IDENTIFY HEALTH ISSUES MENTIONED BY INTERVIEW RESPONDENTS. IN COMPARISON TO SECONDARY (I.E., QUANTITATIVE) DATA SOURCES, PRIMARY QUALITATIVE (I.E., COMMUNITY INPUT) DATA WAS ESSENTIAL FOR IDENTIFYING NEEDS THAT HAVE EMERGED SINCE THE PREVIOUS CHNA. HEALTH NEED IDENTIFICATION USED QUALITATIVE DATA BASED ON THE NUMBER OF INTERVIEWEES OR GROUPS WHO REFERENCED EACH HEALTH NEED AS A CONCERN, REGARDLESS OF THE NUMBER OF MENTIONS WITHIN EACH TRANSCRIPT. FOR ANY PRIMARY DATA COLLECTION ACTIVITIES CONDUCTED IN SPANISH, BILINGUAL STAFF FROM THE HARDER+COMPANY TEAM FACILITATED AND TOOK NOTES. ALL RECORDINGS (IF GRANTED PERMISSION) WERE THEN TRANSCRIBED, BUT NOT TRANSLATED INTO ENGLISH. BILINGUAL STAFF CODED THESE TRANSCRIPTS AND TRANSLATED ANY KEY FINDINGS OR REPRESENTATIVE QUOTES NEEDED FOR THE HEALTH NEED PROFILES. ADDITIONAL DETAILS ON KEY INFORMANTS, COLLABORATIVE PARTNERS AND FOCUS GROUPS CAN BE FOUND IN NOVATO COMMUNITY HOSPITAL'S CHNA AT: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment SCHEDULE H, PART V, LINES 6A & 6B NOVATO COMMUNITY HOSPITAL (REPORTING FACILITY #13): NOVATO COMMUNITY HOSPITAL CONNECTED WITH BOTH HOSPITAL AND OTHER PARTNER ORGANIZATIONS WITH SIMILAR SERVICE AREAS IN MARIN COUNTY TO SUPPORT THE CHNA. IN MARIN COUNTY, MANY OF THESE PARTNERS WERE ALREADY ENGAGED IN A COLLABORATIVE, THE HEALTHY MARIN PARTNERSHIP (HMP), WHICH WAS FORMED IN 1995 AS A RESULT OF WORKING TOGETHER ON PRIOR CHNAS. THIS GROUP DEVELOPED A COORDINATED APPROACH TO PRIMARY DATA COLLECTION, AND THEN DETERMINED THE LIST OF SIGNIFICANT HEALTH NEEDS BASED ON BOTH PRIMARY AND SECONDARY DATA. NCH THEN ORGANIZED WITH THESE PARTNERS TO ENGAGE A BROADER GROUP OF COMMUNITY STAKEHOLDERS TO PRIORITIZE THE IDENTIFIED HEALTH NEEDS (DESCRIBED IN SECTION VI-B). COLLABORATIVE HOSPITAL PARTNERS: - KAISER FOUNDATION HOSPITAL - SAN RAFAEL - MARIN GENERAL HOSPITAL - SUTTER HEALTH - NOVATO COMMUNITY HOSPITAL ADDITIONAL PARTNERS: - MARIN COUNTY HEALTH AND HUMAN SERVICES - HEALTHY MARIN PARTNERSHIP HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA - NORTHBAY LEADERSHIP COUNCIL - MARIN COUNTY OFFICE OF EDUCATION - MARIN COMMUNITY FOUNDATION - SAN RAFAEL CHAMBER OF COMMERCE SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #13): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/ COMMUNITY-NEEDS-ASSESSMENT.HTML - OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINE 11 NOVATO COMMUNITY HOSPITAL (REPORTING FACILITY #13): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT NOVATO COMMUNITY HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO CARE 2. VIOLENCE AND INJURY PREVENTION DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH OTHER CRITICAL EFFORTS ON BEHALF OF NOVATO COMMUNITY HOSPITAL. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. NOVATO COMMUNITY HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ECONOMIC SECURITY 2. EDUCATION 3. MENTAL HEALTH/SUBSTANCE ABUSE 4. ACCESS TO CARE 5. HOUSING/HOMELESSNESS 6. HEAL 7. MATERNAL/INFANT HEALTH 8. VIOLENCE/INJURY PREVENTION 9. ORAL HEALTH 10. SOCIAL CONNECTION SCHEDULE H, PART V, LINE 15E Novato Community Hospital (Reporting Facility #13): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C Novato Community Hospital (Reporting Facility #13): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/FINANCIAL-ASSISTANCE.HTML SCHEDULE H, PART V, LINE 16J Novato Community Hospital (Reporting Facility #13): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE AP
REPORTING FACILITY: #14, SUTTER LAKESIDE HOSPITAL SCHEDULE H, PART V, LINE 3E SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY #14): THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, LINE 5 SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY #14): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER LAKESIDE HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THE COMMUNITY INPUT-USING A WIDELY DISTRIBUTED SURVEY, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. THE SOURCE OF ALL THE FIGURES INCLUDED IN THIS SECTION IS THE LAKE COUNTY COMMUNITY HEALTH ASSESSMENT SURVEY (2019), DESIGNED BY CONDUENT HCI AND DISSEMINATED BY THE PARTNER MEMBERS OF THE HOPE RISING LAKE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE. A TOTAL OF 708 RESPONSES WERE COLLECTED. THE SAMPLE SIZE MET THE CONDITIONS OF 95% CONFIDENCE INTERVAL AND HAD A MARGIN OF ERROR OF 3.7%. THIS WAS A CONVENIENCE SAMPLE, WHICH MEANS RESULTS MAY BE VULNERABLE TO SELECTION BIAS. THE RESULTS ARE GENERALIZABLE TO THE POPULATION OF LAKE COUNTY. PROFILE OF SURVEY PARTICIPANTS OF THE TOTAL SURVEY PARTICIPANTS, 98.8% (696) SPOKE IN ENGLISH AT HOME AND 8.1% (57) WERE SPANISH SPEAKERS. SURVEY PARTICIPANTS WERE MORE LIKELY TO BE FEMALE THAN MALE (78.4% FEMALE VERSUS 20.4% MALE), HAVE ANNUAL HOUSEHOLD INCOMES ABOVE $50,000 (59.5%) AND HAVE 1-3 YEARS OF EDUCATION (42.5%). THE BULK OF THE SURVEY PARTICIPANTS WERE OF WHITE/CAUCASIAN (79.6%) WHILE THE REMAINDER WERE OF HISPANIC OR LATINO, AMERICAN INDIAN OR ALASKAN NATIVE, AND BLACK OR AFRICAN AMERICAN RACE/ETHNICITY (10.8%, 2.2%, AND 0.57% RESPECTIVELY). THE SURVEY WAS ABLE TO REACH MOST OF THE AGE-GROUPS EQUALLY. FOUR DIFFERENT AGE GROUPS (25-34, 35-44, 45-54, AND 55-64) HAD NEARLY 20% REPRESENTATION IN THIS SURVEY WITH THE HIGHEST GROUP BEING 55-64 YEAR OLDS AT 22.2%. THIS IS IN KEEPING WITH THE AGE PROFILE OF THE COMMUNITY WHICH HAS AN OLDER MEDIAN AGE THAN THE STATE AVERAGE. THE TWO AGE GROUPS - 18-24 YEAR OLDS (4%) AND 75+ YEAR OLDS (2.4%) - CONSTITUTED THE REST OF THE PARTICIPANTS. REGARDING REGULAR HEALTHCARE, 73.3% OF THE SURVEY PARTICIPANTS HAVE A REGULAR PHYSICIAN; 12.26% DO NOT RECEIVE ROUTINE HEALTHCARE OR USE URGENT CARE OR EMERGENCY ROOMS (ER). MOST OF THE PARTICIPANTS HAVE INSURANCE COVERAGE; 93.9% PAY FOR HEALTH CARE WITH THEIR INSURANCE, 19.7% HAVE MEDI-CAL OR MEDICARE AND 6.61% PAY WITH CASH OR OTHER METHODS. OVER 80% OF THE PARTICIPANTS HAD ACHIEVED AN EDUCATION LEVEL HIGHER THAN 1-3 YEARS AT COLLEGE. THE MOST HAD ATTENDED SOME COLLEGE OR TECHNICAL SCHOOL IN THE PAST (42.6%), FOLLOWED BY GRADUATION WITH A COLLEGE DEGREE (AT 20.9%), OR AN ADVANCED DEGREE (AT 20.4%). THE REMAINING PARTICIPANTS INCLUDED THOSE WHO ONLY HAD A HIGH SCHOOL DIPLOMA OR GED (AT 13.8%), AND THOSE WHO HAD LESS THAN A HIGH SCHOOL EDUCATION, WHICH WAS LESS THAN 3%. ONE OF THE KEY OBJECTIVES OF THIS ASSESSMENT WAS TO ENGAGE THE COMMUNITY, INCLUDING VULNERABLE POPULATIONS, PHYSICIANS, AND OTHER SERVICE PROVIDERS TO SHARE THEIR PERCEPTIONS ON HEALTH NEEDS FOR LAKE COUNTY RESIDENTS. KEY INFORMANT INTERVIEWS AND FOCUS GROUP DISCUSSIONS HELPED TO DEVELOP A DEEPER UNDERSTANDING FOR THE REASONS BEHIND THE HEALTH DATA SEEN IN THE PREVIOUS SECTIONS. IT SERVED ALSO TO IDENTIFY THE HIGH PRIORITIES FOR LAKE COUNTY STAKEHOLDERS. IN THE CASE OF THE KEY INFORMANTS, THE INTERVIEWS TOUCHED UPON MANY ISSUES THAT WERE SPECIFIC TO THEIR AREA OF WORK, ESPECIALLY WITH VULNERABLE POPULATIONS, WHEREAS THE FOCUS GROUP DISCUSSIONS WITH COMMUNITY MEMBERS FOCUSED ON AGE, RACE AND/OR GENDER ISSUES RELATED TO ACCESSING HEALTHCARE AND BARRIERS TO ACCESS. THE FINDINGS FROM KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND SURVEY IN SUTTER LAKESIDE HOSPITAL'S CHNA ARE AVAILABLE AT: https://www.sutterhealth.org/for-patients/ community-health-needs-assessment SCHEDULE H, PART V, LINES 6A & 6B SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY #14): HOPE RISING LAKE COUNTY IS AN ACCOUNTABLE COMMUNITY FOR HEALTH COLLABORATIVE THAT WAS ESTABLISHED IN 2015. HOPE RISING LAKE COUNTY'S VISION IS TO ENSURE THAT LAKE COUNTY IS A HEALTHY PLACE FOR EVERY PERSON TO LIVE, LEARN, ENGAGE AND THRIVE. A FORMAL PARTNERSHIP OF FOURTEEN HEALTH AGENCIES - HEALTH SYSTEMS, COUNTY LEADERS, NON-PROFIT ORGANIZATIONS AND OTHER RELEVANT ORGANIZATIONS OF LAKE COUNTY - THE PURPOSE OF HOPE RISING LAKE COUNTY IS TO MOBILIZE AND INSPIRE COMMUNITY PARTNERSHIPS AND ACTIONS THAT SUPPORT INDIVIDUAL, COLLECTIVE AND COMMUNITY HEALTH. PARTNERING ORGANIZATIONS IN HOPE RISING LAKE COUNTY - ADVENTIST HEALTH CLEAR LAKE - COUNTY OF LAKE BOARD OF SUPERVISORS - LAKE COUNTY HEALTH DEPARTMENT - LAKE COUNTY OFFICE OF EDUCATION - LAKEVIEW HEALTH CENTER - NORTH COAST OPPORTUNITIES - REDWOOD COMMUNITY SERVICES - THE WAY TO WELLVILLE - COUNTY OF LAKE BEHAVIORAL HEALTH - DEPARTMENT OF SOCIAL SERVICES - MENDOCINO COUNTY HEALTH CLINIC - PARTNERSHIP HEALTH PLAN OF CALIFORNIA - SUTTER LAKESIDE HOSPITAL - WOODLAND COMMUNITY COLLEGE SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY #14): - HOSPITAL FACILITY'S WEBSITE: http://www.sutterlakeside.org/about/ community-needs-assessment.html - OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINE 11 SUTTER LAKESIDE HOSPITALS (REPORTING FACILITY #14): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT SUTTER LAKESIDE HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ADDRESS SUBSTANCE/DRUG ABUSE WITHIN THE COMMUNITY 2. PROVIDE COMMUNITY OUTREACH AND ENGAGEMENT FOR ALL HIGH BURDEN AND/OR DISENFRANCHISED COMMUNITIES 3. INCREASE OPPORTUNITIES FOR CANCER PREVENTION AND SCREENINGS DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER LAKESIDE HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: - HOUSING AND HOMELESSNESS SCHEDULE H, PART V, LINE 15E Sutter Lakeside Hospital (Reporting Facility #14): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY #14): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/FINANCIAL-ASSISTANCE.HTML SCHEDULE H, PART V, LINE 16J Sutter Lakeside Hospital (Reporting Facility #14): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART V, LINE 22D SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY #14): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 9
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?33
Name and address Type of Facility (describe)
1 California Pacific Medical Center
3698 CALIFORNIA STREET
SAN FRANCISCO,CA94118
Ambulatory Care Center, Imaging, and Lab.
2 SAN FRANCISCO ENDOSCOPY CENTER
3468 CALIFORNIA STREET
SAN FRANCISCO,CA94118
OUTPATIENT SERVICES
3 CALIFORNIA PACIFIC MEDICAL CENTER
2100 WEBSTER STREET SUITE 103
SAN FRANCISCO,CA94115
RAD/LAB/ULTRASOUND SERVICES
4 CALIFORNIA PACIFIC MEDICAL CENTER
3838 CALIFORNIA STREET SUITE 106
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - LABORATORY/IMAGING
5 CPMC PACIFIC CAMPUS - STANFORD BUILDING
2351 CLAY STREET
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES
6 CPMC PACIFIC CAMPUS - ANNEX BUILDING
2340 CLAY STREET SUITE 114A
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - HEART TRANSPLANT CLINIC
7 CPMC PACIFIC CAMPUS - ANNEX BUILDING
2340 CLAY STREET 4TH FLOOR
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES - LIVER, PANCREAS, KIDNEY TRANSPLANT CLINIC
8 CPMC PACIFIC CAMPUS - ANNEX BUILDING
2340 CLAY STREET 5TH FLOOR
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES OPTHAMOLOGY CLINIC
9 VAN NESS CAMPUS MEDICAL OFFICE BUILDING
1100 VAN NESS AVENUE
SAN FRANCISCO,CA94109
LAB/OUTPATIENT SERVICES
10 100 ROWLAND WAY CARE CENTER
100 ROWLAND WAY
NOVATO,CA94945
Physical Therapy and SPORTS WELLNESS
11 DIAGNOSTIC CENTER
165 ROWLAND WAY
NOVATO,CA94945
OUTPATIENT SERVICES - LABORATORY
12 OAKLAND CARE CENTER
350 30TH STREET
OAKLAND,CA94609
OUTPATIENT SERVICES
13 IMAGING SERVICES
1375 SUTTER STREET
SAN FRANCISCO,CA94119
OUTPATIENT SERVICES
14 MONTEAGLE MEDICAL CENTER
1580 VALENCIA STREET
SAN FRANCISCO,CA94110
OUTPATIENT SERVICES
15 KALMANOVITZ CHILD DEVELOPMENT CENTER
1625 VAN NESS AVENUE
SAN FRANCISCO,CA94109
OUTPATIENT SERVICES - CHILD DEVELOPMENT
16 PRESIDIO SURGERY CENTER
1635 DIVISADERO STREET SUITE 200
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES
17 MILLS-PENINSULA SKILLED NURSING FACILITY
1609 TROUSDALE DRIVE
BURLINGAME,CA94010
SKILLED NURSING FACILITY
18 SAN LEANDRO SURGERY CENTER
15035 EAST 14TH STREET
SAN LEANDRO,CA94578
OUTPATIENT SERVICES
19 EDEN MEDICAL CENTER OUTPATIENT REHAB
1375 141ST AVENUE
SAN LEANDRO,CA94578
OUTPATIENT SERVICES
20 AMBULATORY CARE CLINIC
20126 STANTON AVENUE
CASTRO VALLEY,CA94546
OUTPATIENT SERVICES
21 SDMC OUTPATIENT SERVICES
3903 LONE TREE WAY
ANTIOCH,CA94509
PT/OT/SPEECH SERVICES
22 CPMC Pacific Heights Outpatient Center
2333 Buchanan Street
San Francisco,CA94115
Outpatient Services/ RADIATION ONCOLOGY
23 ABSMC INFANT CLINIC
3011 TELEGRAPH AVENUE
BERKELEY,CA94705
OUTPATIENT SERVICES
24 ABSMC CARDIAC REHAB
3030 TELEGRAPH AVENUE
BERKELEY,CA94705
OUTPATIENT SERVICES
25 ALTA BATES SUMMIT MEDICAL CENTER PT
5700 TELEGRAPH AVENUE
BERKELEY,CA94709
OUTPATIENT SERVICES
26 MAGNETIC IMAGING AFFILIATES
5730 TELEGRAPH AVENUE
BERKELEY,CA94709
Radiology Services
27 LAFAYETTE WOMEN'S HEALTH CENTER
3595 MT DIABLO BLVD SUITE 350
LAFAYETTE,CA94549
OUTPATIENT SERVICES
28 ALTA BATES SUMMIT MEDICAL CENTER
450 30TH STREET
OAKLAND,CA94609
OUTPATIENT/PEDIATRIC SERVICES, NUCLEAR MEDICINE
29 SURGERY CTR OF ALTA BATES SUMMIT MED CTR
3875 TELEGRAPH AVENUE
OAKLAND,CA94609
Ambulatory Surgery Center
30 EYEMD LASER AND SURGERY CENTER
481 30TH STREET
OAKLAND,CA94609
OUTPATIENT SERVICES
31 MEDICAL CENTER MAGNETIC IMAGING
3000 TELEGRAPH AVENUE
OAKLAND,CA94609
OUTPATIENT SERVICES
32 CPMC DEPT OF OPHTHALMOLOGY
711 VAN NESS AVENUE
OAKLAND,CA94102
VISION CARE/EYE SURGERY
33 CPMC PACIFIC CAMPUS INST OF HLTH & HEAL
2300 CALIFORNIA STREET
SAN FRANCISCO,CA94115
OUTPATIENT SERVICES
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART I, LINES 3A & 3C FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENT'S FAMILY INCOME.
SCHEDULE H, PART I, LINE 3B SUTTER BAY HOSPITALS IS COMMITTED TO PROVIDING CHARITY CARE AND THEREFORE, PROVIDES FREE CARE AT HIGH PERCENTAGE OF FPG. THE ORGANIZATION DOES NOT PROVIDE DISCOUNTED CARE. SCHEDULE H, PART I, LINE 6A JOINT COMMUNITY BENEFIT REPORT: THE COMMUNITY BENEFIT REPORT WAS PREPARED ON BEHALF OF TWO BAY AREA ENTITIES: SUTTER BAY HOSPITALS (EIN: 94-0562680) AND SUTTER BAY MEDICAL FOUNDATION (EIN: 68-0273974).
SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.
SCHEDULE H, PART I, LINE 7G CALIFORNIA PACIFIC MEDICAL CENTER: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $19,298,189.
SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSE OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. BUILDING THE SAN FRANCISCO WORKFORCE, ESPECIALLY CREATING OPPORTUNITIES FOR YOUTH, IS A MAJOR FOCUS FOR CPMC. IN 2021, CPMC PROVIDED WORK-READINESS TRAINING AND CAREER EXPLORATION EXPERIENCES TO INDIVIDUALS THROUGH ITS COMMUNITY WORKFORCE PROGRAMS. THESE PARTNERSHIPS HELP EDUCATE AND INSPIRE UNDERSERVED YOUTH TO PURSUE HEALTH CAREERS. THEY INCLUDE: CPMC CONTRIBUTES TO IMMACULATE CONCEPTION ACADEMY WORK STUDY PROGRAM, WHICH PROVIDES A COLLEGE PREPARATORY EDUCATION WITH MEANINGFUL WORK STUDY EXPERIENCE TO STUDENTS COMING FROM FAMILIES WITH LIMITED FINANCIAL MEANS. CPMC CONTRIBUTES TO JEWISH VOCATIONAL SERVICE TO HELP YOUTH AND ADULTS BUILD IN-DEMAND SKILLS AND FIND GOOD JOBS. CPMC'S COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE ENCOURAGING COMMUNITY SUPPORT NETWORKS AND COMMUNITY HEALTH IMPROVEMENT ADVOCACY THROUGH SPONSORSHIPS AND CONTRIBUTIONS. MILLS PENINSULA MEDICAL CENTER (REPORTING GROUP B, 4 & 12) MILLS PENINSULA MEDICAL CENTER SUPPORTS IMMACULATE CONCEPTION ACADEMY'S WORKFORCE DEVELOPMENT PROGRAM. STUDENTS FROM THE HIGH SCHOOL SPEND TIME ROTATING BETWEEN DIFFERENT DEPARTMENTS AND LEARNING BASIC JOB SKILLS. SUTTER MATERNITY & SURGERY CENTER (REPORTING GROUP B, 15) SUTTER MATERNITY & SURGERY CENTER DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT IN 2021. ALTA BATES SUMMIT MEDICAL CENTER (REPORTING GROUP C, 1-2, 10-11, & 16) ALTA BATES SUMMIT MEDICAL CENTER DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT IN 2021. SUTTER DELTA MEDICAL CENTER (REPORTING GROUP C, 6) SUTTER DELTA MEDICAL CENTER DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT IN 2021. EDEN MEDICAL CENTER (REPORTING FACILITY 7) EDEN MEDICAL CENTER FUNDS DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT IN 2021. SUTTER SANTA ROSA REGIONAL HOSPITAL (REPORTING FACILITY 9) IN 2021, SUTTER SANTA ROSA REGIONAL HOSPITAL SUPPORTED COMMUNITY HEALTH IMPROVEMENT ADVOCACY THROUGH SENIOR LEADERSHIP'S SERVICE ON SONOMA COUNTY HEALTH ACTION COALITION'S COMMITTEE FOR HEALTHCARE IMPROVEMENT. NOVATO COMMUNITY HOSPITAL (REPORTING FACILITY 13) NOVATO COMMUNITY HOSPITAL DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT IN 2021. SUTTER LAKESIDE HOSPITAL (REPORTING FACILITY 14) SUTTER LAKESIDE HOSPITAL SUPPORTS HOPE RISING, WHICH BRINGS TOGETHER LEADERS IN LAKE COUNTY TO IDENTIFY ISSUES, DEVELOP INNOVATIVE SOLUTIONS, AND IMPLEMENT AGREED-UPON ACTIONS WITH ACCOUNTABILITY AND MEASURABLE OUTCOMES.
SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT AUDIT FOOTNOTE: THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. EFFECTIVE JANUARY 1, 2018, SUTTER ENTITIES IMPLEMENTED THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS UPDATE (ASU), REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE ACCOUNTING CHANGE MODIFIED BAD DEBT REPORTING, AND AS A RESULT, BAD DEBT IS ONLY REPORTED IN LIMITED SITUATIONS.
SCHEDULE H, PART III, SECTION B, LINE 7 MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.
SCHEDULE H, PART III, SECTION B, LINE 9B DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL AND CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.
SCHEDULE H, PART VI, LINE 2 CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, 3, 5, 8, & 17): THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. MILLS PENINSULA MEDICAL CENTER (REPORTING GROUP B, 4 & 12): THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER MATERNITY & SURGERY CENTER (REPORTING GROUP B, 15): THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. ALTA BATES SUMMIT MEDICAL CENTER (REPORTING GROUP C, 1-2, 10-11, & 16): THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER DELTA MEDICAL CENTER (REPORTING GROUP C, 6): THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. EDEN MEDICAL CENTER: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER SANTA ROSA REGIONAL HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. NOVATO COMMUNITY HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER LAKESIDE HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED.
SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. LANGUAGES: THE POLICY SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA. IN ADDITION, ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY INFORMATION PROVIDED TO PATIENTS DURING THE PROVISION OF HOSPITAL SERVICES: A. DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND IDENTIFY THE DEPARTMENT THAT PATIENTS CAN VISIT TO RECEIVE INFORMATION ABOUT, AND ASSISTANCE WITH APPLYING FOR, FINANCIAL ASSISTANCE. B. FINANCIAL ASSISTANCE COUNSELORS: PATIENTS WHO MAY BE UNINSURED PATIENTS SHALL BE ASSIGNED FINANCIAL COUNSELORS, WHO SHALL VISIT WITH THE PATIENTS IN PERSON AT THE HOSPITAL, PROVIDE PATIENTS A FINANCIAL ASSISTANCE APPLICATION, ASSIST WITH THE APPLICATION PROCESS, AND PROVIDE A CONTACT INFORMATION FOR THE PATIENT TO CALL FOR QUESTIONS. C. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITALS SHALL PROVIDE ALL PATIENTS A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. D. APPLICATIONS PROVIDED AT DISCHARGE: AT THE TIME OF DISCHARGE, HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. E. INFORMATION PROVIDE TO PATIENTS AT OTHER TIMES: 1. CONTACT INFORMATION WHICH INCLUDES A PHONE NUMBER AND HOSPITAL DEPARTMENT TO OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE APPLICATION PROCESS. 2. BILLING STATEMENTS: BILLING STATEMENTS PROVIDED TO PATIENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, A PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS ABOUT FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE PATIENTS CAN OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE INCLUDING THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY OF THE POLICY, AND THE APPLICATION FOR FINANCIAL ASSISTANCE. 3. UPON REQUEST: HOSPITALS SHALL PROVIDE PATIENTS WITH PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST AND WITHOUT CHARGE. F. PUBLICITY OF FINANCIAL ASSISTANCE INFORMATION 1. PUBLIC POSTING: HOSPITALS SHALL POST COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IN A PROMINENT LOCATION IN THE EMERGENCY ROOM, ADMISSIONS AREA, AND ANY OTHER LOCATION IN THE HOSPITAL WHERE THERE IS A HIGH VOLUME OF PATIENT TRAFFIC, INCLUDING BUT NOT LIMITED TO THE WAITING ROOMS, BILLING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS. THESE PUBLIC NOTICES SHALL INCLUDE INFORMATION ABOUT THE RIGHT TO REQUEST AN ESTIMATE OF FINANCIAL RESPONSIBILITY FOR SERVICES. 2. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY SHALL BE AVAILABLE IN A PROMINENT PLACE ON THE SUTTER HEALTH WEBSITE (WWW.SUTTERHEALTH.ORG) AND ON EACH INDIVIDUAL HOSPITAL'S WEBSITE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. 3. MAIL: PATIENTS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY BE SENT BY MAIL, AT NO COST TO THE PATIENT. 4. ADVERTISEMENTS/PRESS RELEASES: AS NECESSARY AND ON AT LEAST AN ANNUAL BASIS, SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT HOSPITALS IN THE PRINCIPAL NEWSPAPER(S) IN THE COMMUNITIES SERVED BY SUTTER HEALTH, OR WHEN DOING SO IS NOT PRACTICAL, SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THIS INFORMATION, OR USE OTHER MEANS THAT SUTTER HEALTH CONCLUDES WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY TO AFFECTED PATIENTS IN OUR COMMUNITIES. 5. COMMUNITY AWARENESS: SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CALIFORNIA PACIFIC MEDICAL FOUNDATION (REPORTING GROUP A, 3, 5, 8, & 17): THE HOSPITAL SERVICE AREA FOR CALIFORNIA PACIFIC MEDICAL CENTER INCLUDES ALL POPULATIONS RESIDING IN THE CITY AND COUNTY OF SAN FRANCISCO. THERE ARE 13 HOSPITALS IN SAN FRANCISCO COUNTY. SAN FRANCISCO IS THE CULTURAL AND COMMERCIAL CENTER OF THE BAY AREA AND IS THE ONLY CONSOLIDATED CITY AND COUNTY JURISDICTION IN CALIFORNIA. AT ROUGHLY 47 SQUARE MILES, IT IS THE SMALLEST COUNTY IN THE STATE, BUT IS THE MOST DENSELY POPULATED LARGE CITY IN CALIFORNIA (WITH A POPULATION DENSITY OF 17,352 RESIDENTS PER SQUARE MILE) AND THE SECOND MOST DENSELY POPULATED MAJOR CITY IN THE U.S., AFTER NEW YORK CITY. BETWEEN 2011 AND 2018, THE POPULATION IN SAN FRANCISCO GREW BY ALMOST 8 PERCENT TO 888,817, OUTPACING POPULATION GROWTH IN CALIFORNIA (6 PERCENT). BY 2030, SAN FRANCISCO'S POPULATION IS EXPECTED TO TOTAL MORE THAN 980,000. THE PROPORTION OF SAN FRANCISCO'S POPULATION THAT IS 65 YEARS AND OLDER IS EXPECTED TO INCREASE FROM 17 PERCENT IN 2018 TO 21 PERCENT IN 2030; PERSONS 75 AND OLDER WILL MAKE UP ABOUT 11 PERCENT. AT THE SAME TIME, IT IS ESTIMATED THAT THE PROPORTION OF WORKING-AGE RESIDENTS (25 TO 64 YEARS OLD) WILL DECREASE FROM 61 PERCENT IN 2018 TO 56 PERCENT IN 2030. THIS SHIFT COULD HAVE IMPLICATIONS FOR THE PROVISION OF SOCIAL SERVICES. POPULATION GROWTH IS EXPECTED FOR ALL RACES AND ETHNICITIES EXCEPT FOR BLACK/AFRICAN AMERICANS, WHO ARE PROJECTED TO DROP FROM 5 PERCENT OF THE POPULATION IN 2018 TO 4 PERCENT IN 2030. ASIANS AND WHITES WILL REMAIN THE MOST POPULOUS GROUPS AND WILL GROW AS A PERCENTAGE OF THE OVERALL POPULATION. POPULATION GROWTH IS EXPECTED TO BE LOWER FOR LATINOS AND PACIFIC ISLANDERS, AND LATINOS ARE EXPECTED TO DROP FROM 15.1 TO 14.9 PERCENT OF THE POPULATION. CURRENTLY, 35 PERCENT OF SAN FRANCISCO'S POPULATION IS FOREIGN BORN, AND 20 PERCENT OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME AND SPEAK ENGLISH LESS THAN "VERY WELL." THE MAJORITY OF THE FOREIGN-BORN POPULATION COMES FROM ASIA (65 PERCENT), WHILE 18 PERCENT WERE BORN IN LATIN AMERICA, MAKING CHINESE (MANDARIN, CANTONESE, AND OTHER) (43 PERCENT) AND SPANISH (26 PERCENT) THE MOST COMMON NON-ENGLISH LANGUAGES SPOKEN IN THE CITY. ALTHOUGH SAN FRANCISCO HAS A RELATIVELY SMALL PROPORTION OF HOUSEHOLDS WITH CHILDREN (19 PERCENT) COMPARED TO THE STATE OVERALL (34 PERCENT), THE NUMBER OF SCHOOL-AGED CHILDREN IS PROJECTED TO RISE. AS OF 2017, SAN FRANCISCO WAS HOME TO 67,740 FAMILIES WITH CHILDREN, 26 PERCENT OF WHICH WERE HEADED BY SINGLE PARENTS. THERE WERE APPROXIMATELY 132,330 CHILDREN UNDER THE AGE OF 18. THE NUMBER OF SCHOOL-AGED CHILDREN IS PROJECTED TO RISE BY 24 PERCENT BY 2030. THE NEIGHBORHOODS WITH THE GREATEST PROPORTION OF HOUSEHOLDS WITH CHILDREN ARE: SEACLIFF, BAYVIEW HUNTERS POINT, VISITACION VALLEY, OUTER MISSION, EXCELSIOR, TREASURE ISLAND, AND PORTOLA (ALL OVER 30 PERCENT). ALMOST ONE IN FOUR SAN FRANCISCANS (22 PERCENT) LIVE BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. - FOR A FAMILY OF FOUR, 200 PERCENT OF THE FEDERAL POVERTY LEVEL IS $50,200 (2018). - A FAMILY OF FOUR IN SAN FRANCISCO REQUIRES AN INCOME OF GREATER THAN $120,000 TO MEET ALL THEIR NEEDS. - 40 PERCENT OF NEW JOBS IN SAN FRANCISCO ARE EXPECTED TO BE LOW-WAGE JOBS (LESS THAN $54,000/YEAR). - 18 PERCENT OF CHILDREN UNDER 6 YEARS OF AGE IN SAN FRANCISCO LIVE IN POVERTY (LESS THAN 200 PERCENT OF THE FEDERAL POVERTY LEVEL). AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE CALIFORNIA PACIFIC MEDICAL CENTER CHNA AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT MILLS PENINSULA MEDICAL CENTER (MPMC) (REPORTING GROUP B, 4 & 12): THE HOSPITAL SERVICE AREA OF MPMC AND MPSC IS DEFINED AS SAN MATEO COUNTY (SMC). THERE ARE FIVE HOSPITALS IN SAN MATEO COUNTY. IN 2017, AN ESTIMATED 771,410 PEOPLE RESIDED IN SAN MATEO COUNTY, MAKING IT THE 14TH LARGEST IN CALIFORNIA BY POPULATION. THE COUNTY OCCUPIES 455 SQUARE MILES OF LAND ON THE PENINSULA SOUTH OF SAN FRANCISCO, WITH THE SAN FRANCISCO BAY TO THE EAST AND THE PACIFIC OCEAN TO THE WEST. THE COUNTY ALSO INCLUDES NEARLY 58 MILES OF COASTLINE AND 292 SQUARE MILES OF WATER. REDWOOD CITY IS THE LARGEST CITY IN THE COUNTY BY AREA, AND DALY CITY IS THE LARGEST CITY IN THE COUNTY BY POPULATION (WITH OVER 107,000 RESIDENTS, OR 14 PERCENT OF THE COUNTY'S TOTAL). SAN MATEO COUNTY ALSO INCLUDES THE FOLLOWING UNINCORPORATED TOWNS AND AREAS, MANY OF WHICH ARE LOCATED IN THE COASTSIDE AREA: BROADMOOR, BURLINGAME HILLS, DEVONSHIRE, EL GRANADA, EMERALD LAKE HILLS, FAIR OAKS, HIGHLANDS/BAYWOOD PARK, LADERA, LA HONDA, LOMA MAR, LOS TRANCOS WOODS/VISTA VERDE, MENLO OAKS, MONTARA, MOSS BEACH, NORTH FAIR OAKS, PALOMAR PARK, PESCADERO, PRINCETON, SAN FRANCISCO INTERNATIONAL AIRPORT, SAN GREGORIO, SOUTH COAST/SKYLINE, SEQUOIA TRACT, SKYLONDA, STANFORD LANDS, AND WEST MENLO PARK. NEARLY 22 PERCENT OF THE POPULATION IN SAN MATEO COUNTY IS UNDER THE AGE OF 18, AND 15 PERCENT IS 65 YEARS OR OLDER. THE MEDIAN AGE IS 39.5 YEARS OLD. SAN MATEO COUNTY IS ALSO HIGHLY DIVERSE. NOTABLY, RESIDENTS OF "SOME OTHER RACE" (I.E., ONE NOT SPECIFICALLY CALLED OUT IN DATA SETS) ARE THE THIRD LARGEST RACIAL GROUP, ACCOUNTING FOR 11 PERCENT OF THE POPULATION. MORE THAN HALF (58 PERCENT) OF THE POPULATION IS WHITE, AND NEARLY ONE THIRD IS ASIAN (30 PERCENT). ONE QUARTER (25 PERCENT) OF RESIDENTS HAVE LATINX HERITAGE. MORE THAN ONE THIRD (37 PERCENT) OF SAN MATEO COUNTY RESIDENTS ARE FOREIGN-BORN. APPROXIMATELY 9 PERCENT OF THE COUNTY'S POPULATION LIVES IN A LINGUISTICALLY ISOLATED HOUSEHOLD, MARKED BY WIDE GEOGRAPHIC DIFFERENCES. FOR EXAMPLE, LESS THAN 1 PERCENT OF THE POPULATION IN PARTS OF WOODSIDE LIVES IN A LINGUISTICALLY ISOLATED HOUSEHOLD, COMPARED WITH MORE THAN 50 PERCENT IN PARTS OF DALY CITY, SOUTH SAN FRANCISCO, AND REDWOOD CITY/NORTH FAIR OAKS. TWO KEY SOCIAL DETERMINANTS, INCOME AND EDUCATION, HAVE A SIGNIFICANT IMPACT ON HEALTH OUTCOMES. SAN MATEO COUNTY HAS ONE OF THE HIGHEST ANNUAL MEDIAN INCOMES IN THE COUNTRY AND ONE OF THE HIGHEST COSTS OF LIVING. AS DISPLAYED IN THE FOLLOWING CHART, ABOUT HALF OF THE POPULATION LIVE IN HOUSEHOLDS WITH INCOMES OF $100,000 OR MORE, ABOUT ONE-FOURTH IN HOUSEHOLDS WITH INCOMES BETWEEN $50,000 AND $100,000, AND ANOTHER FOURTH BELOW $50,000. BY COMPARISON, THE 2018 SELF-SUFFICIENCY STANDARD FOR A TWO-ADULT FAMILY WITH TWO SCHOOL-AGED CHILDREN IN SAN MATEO COUNTY WAS $111,191. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE MILLS PENINSULA MEDICAL CENTER'S CHNA AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SUTTER MATERNITY & SURGERY CENTER SANTA CRUZ (SMSC) (REPORTING GROUP B, 15): SMSC RELIED ON THE INTERNAL REVENUE SERVICE'S DEFINITION OF THE COMMUNITY SERVED BY A HOSPITAL AS "THOSE PEOPLE LIVING WITHIN ITS HOSPITAL SERVICE AREA." A HOSPITAL SERVICE AREA COMPRISES ALL RESIDENTS OF A DEFINED GEOGRAPHIC AREA AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS. SMSC IS LOCATED IN SANTA CRUZ COUNTY AND SERVES THE ENTIRE COUNTY. THERE ARE TWO HOSPITALS IN SANTA CRUZ COUNTY. SANTA CRUZ COUNTY OCCUPIES 445 SQUARE MILES OF LAND APPROXIMATELY 35 MILES SOUTHWEST OF SILICON VALLEY, WITH THE PACIFIC OCEAN TO THE WEST. IT INCLUDES 29 MILES OF COASTLINE, FORMING THE NORTHERN COAST OF MONTEREY BAY. IN 2019, AN ESTIMATED 276,603 PEOPLE RESIDED IN THE SANTA CRUZ COUNTY. MORE THAN ONE IN FIVE COUNTY RESIDENTS LIVES IN THE CITY OF SANTA CRUZ, MAKING IT THE LARGEST LOCAL MUNICIPALITY BY POPULATION. THE OTHER INCORPORATED CITIES ARE CAPITOLA, SCOTTS VALLEY, AND WATSONVILLE. SANTA CRUZ COUNTY ALSO INCLUDES THE FOLLOWING UNINCORPORATED TOWNS AND AREAS: AMESTI, APTOS, APTOS HILLS-LARKIN VALLEY, BEN LOMOND, BONNY DOON, BOULDER CREEK, BROOKDALE, CORRALITOS, DAVENPORT, DAY VALLEY, FELTON, FREEDOM, INTERLAKEN, LA SELVA BEACH, LIVE OAK, LOMPICO, MOUNT HERMON, PAJARO DUNES, PARADISE PARK, PASATIEMPO, PLEASURE POINT, RIO DEL MAR, SOQUEL, TWIN LAKES, AND ZAYANTE. NEARLY 20 PERCENT OF THE POPULATION IN SANTA CRUZ COUNTY IS UNDER THE AGE OF 18, AND 14 PERCENT IS 65 YEARS OLD OR OLDER. THESE PROPORTIONS ARE SIMILAR TO THOSE IN CALIFORNIA'S POPULATION OVERALL (23 PERCENT OF STATE RESIDENTS ARE UNDER AGE 18, AND 13 PERCENT ARE AGE 65 OR OLDER). THE MEDIAN AGE IN SANTA CRUZ COUNTY IS 37.3 YEARS, SLIGHTLY OLDER THAN THE STATE MEDIAN AGE OF 36.1 YEARS. SANTA CRUZ COUNTY IS ALSO RELATIVELY DIVERSE. NOTABLY, RESIDENTS OF "SOME OTHER RACE" (I.E., ONE NOT SPECIFICALLY CALLED OUT IN DATA SETS) ARE THE COUNTY'S THIRD LARGEST RACIAL GROUP, ACCOUNTING FOR 12 PERCENT OF THE POPULATION. MORE THAN THREE QUARTERS (77 PERCENT) OF THE POPULATION IS WHITE, AND 5 PERCENT IS ASIAN. (BY COMPARISON, LESS THAN TWO THIRDS OF CALIFORNIA'S POPULATION IS WHITE, AND 14 PERCENT IS ASIAN.) ONE THIRD (33 PERCENT) OF SANTA CRUZ COUNTY RESIDENTS HAVE LATINX HERITAGE (COMPARED TO 39 PERCENT STATEWIDE). NEARLY ONE FIFTH (18 PERCENT) OF COUNTY RESI
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) (REPORTING GROUP A, 3, 5, 8, & 17): THE 2019 - 2021 IMPLEMENTATION STRATEGY FOR CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: CPMC'S AFRICAN AMERICAN & SISTER TO SISTER BREAST HEALTH PROGRAM OFFERS WOMEN MAMMOGRAPHY SCREENING AND ALL THE SUBSEQUENT BREAST HEALTH DIAGNOSTIC TESTING AND TREATMENT THEY MAY NEED AT NO COST. PARTNERING ORGANIZATIONS SUCH AS HEALTHRIGHT 360, SAN FRANCISCO FREE CLINIC, AND CLINIC BY THE BAY REFER UNINSURED, UNDERINSURED, DISADVANTAGED AND AT-RISK WOMEN FOR MAMMOGRAPHY SERVICES. IN 2021, 94 PEOPLE WERE SERVED BY CPMC'S AFRICAN AMERICAN & SISTER TO SISTER BREAST HEALTH PROGRAM; AN ADDITIONAL 190 PEOPLE RECEIVED 312 CANCER SCREENINGS THROUGH CPMC'S GRANT TO BAY AREA CANCER CONNECTIONS. THE COMMUNITY HEALTH RESOURCE CENTER (CHRC) COLLABORATES WITH OVER 20 DIFFERENT HEALTHCARE CENTERS IN SAN FRANCISCO, PROVIDING SUPPORTIVE SERVICES TO THOUSANDS OF CLIENTS THROUGH THE MANY FREE OR LOW-COST PROGRAMS, SCREENINGS AND COUNSELING SERVICES THAT ARE AVAILABLE TO ANYONE IN THE COMMUNITY. PROGRAMS INCLUDE DIETITIANS, SOCIAL WORK COUNSELING, NUTRITION GUIDANCE, COMMUNITY HEALTH SCREENINGS, EDUCATIONAL LECTURES INCLUDING MONTHLY WELLNESS EVENTS, HEALTH INFORMATION AND LOCAL RESOURCES, EMPLOYEE AND GROUP WELLNESS PRESENTATIONS, AND SUPPORT GROUPS. IN 2021, AN ESTIMATED 4,000 PEOPLE WERE SERVED OVERALL. APPROXIMATELY 1,900 PEOPLE WERE SERVED WITH 3,207 VISITS WITH REGISTERED DIETICIANS. 1,411 HEALTH SCREENINGS RELATED TO DIET/EXERCISE AND LIFESTYLE CHANGES WERE PROVIDED. 49 HEALTH EDUCATION CLASSES WERE ATTENDED BY A TOTAL OF 4,737 PEOPLE. APPROXIMATELY 2,350 PEOPLE WERE SERVED WITH 3,917 VISITS FOR BEHAVIORAL HEALTH/SOCIAL WORK SERVICES. CPMC'S MISSION BERNAL CLINICS (FORMERLY ST. LUKE'S HEALTH CARE CENTER) PROVIDE A FULL RANGE OF OBSTETRIC AND GYNECOLOGICAL CARE AT ITS WOMEN'S CENTER; WELL-BABY CARE, WELL-CHILD CARE, AND CARE FOR ILL OR INJURED CHILDREN AT ITS PEDIATRIC CLINIC; AND PRIMARY, ACUTE AND CHRONIC CARE AT ITS ADULT INTERNAL MEDICINE CLINIC FOR TEENAGERS AND ADULTS. IN 2021, CPMC'S MISSION BERNAL CLINICS TRANSFERRED THE ASSETS OF THE ADULT CLINIC, THE PEDIATRIC CINIC, AND THE PEDIATRIC AFTER HOURS CLINIC TO MISSION NEIGHBORHOOD HEALTH CENTER (MNHC). CPMC PROVIDES CASH CONTRIBUTIONS TO MNHC TO PARTIALLY FUND ORGANIZATIONAL AND OPERATIONAL COSTS RELATED TO ITS EXPANSION OF SERVICES. FOR THE PORTION OF THE YEAR THAT THE CLINICS WERE UNDER CPMC OPERATION (INCLUDING THE WOMEN'S CLINIC, WHICH CPMC RETAINED), THEY SERVED MORE THAN 4,900 PEOPLE WITH 14,500 ENCOUNTERS. HEALTHFIRST, A CENTER FOR HEALTH EDUCATION AND DISEASE PREVENTION AFFILIATED WITH MISSION BERNAL CLINICS (FORMERLY ST. LUKE'S HEALTH CARE CENTER), SERVES PATIENTS IN CHRONIC DISEASE MANAGEMENT BY INTEGRATING COMMUNITY HEALTH WORKERS (CHWS) INTO THE MULTIDISCIPLINARY HEALTHCARE TEAM. IN 2021, HEALTHFIRST SERVED 652 PEOPLE WITH A TOTAL OF 2,061 ENCOUNTERS. CPMC'S KALMANOVITZ CHILD DEVELOPMENT CENTER PROVIDES DIAGNOSIS, EVALUATION, TREATMENT AND COUNSELING FOR CHILDREN AND ADOLESCENTS WITH LEARNING DISABILITIES AND DEVELOPMENTAL OR BEHAVIORAL PROBLEMS CAUSED BY PREMATURITY, AUTISM SPECTRUM DISORDER, EPILEPSY, DOWN SYNDROME, ATTENTION DEFICIT DISORDER, OR CEREBRAL PALSY. BESIDES OPERATING ITS OWN CLINICS, KCDC ALSO EXTENDS ITS SERVICES TO A LARGE NUMBER OF AT-RISK CHILDREN AND BRINGS SERVICES TO THEM IN THEIR COMMUNITY BY PARTNERING WITH LOCAL SCHOOLS AND OTHER COMMUNITY ORGANIZATIONS. IN 2021, A TOTAL OF 16,842 CLINIC VISITS TOOK PLACE. OF THE 1,330 PEOPLE SERVED, 1,230 WERE SEEN AT THE TWO SAN FRANCISCO CLINIC LOCATIONS, 100 THROUGH OUTREACH AT DE MARILLAC ACADEMY. LIONS EYE FOUNDATION AND CPMC PARTNER TOGETHER TO PROVIDE HIGHLY SPECIALIZED EYE CARE PROCEDURES FREE OF CHARGE TO PEOPLE WITHOUT INSURANCE OR FINANCIAL RESOURCES. THROUGHOUT 2021, 385 INDIVIDUALS WERE SERVED FOR A TOTAL OF 3,545 ENCOUNTERS. PROCEDURES PERFORMED INCLUDED 376 GENERAL SURGICAL PROCEDURES, 150 LASER SURGERIES, 769 INTRAVITREOUS INJECTIONS FOR MACULAR DEGENERATION AND COMPLICATIONS DUE TO DIABETES, AND 3,297 DIAGNOSTIC TESTS (OCTS, B-SCANS, ANGIOGRAMS, ETC.) A KEY PART OF CPMC'S MEDI-CAL PROGRAM IS THE MEDI-CAL MANAGED CARE PARTNERSHIP WITH NORTH EAST MEDICAL SERVICES (NEMS) COMMUNITY CLINIC AND SAN FRANCISCO HEALTH PLAN, A LICENSED COMMUNITY HEALTH PLAN THAT PROVIDES AFFORDABLE HEALTHCARE COVERAGE TO OVER 150,000 LOW- AND MODERATE-INCOME SAN FRANCISCO RESIDENTS. WORKING TOGETHER WITH NEMS, CPMC SERVES AS THE HOSPITAL PARTNER FOR THESE MEDI-CAL BENEFICIARIES WHO SELECT NEMS AS THEIR MEDICAL GROUP THROUGH SAN FRANCISCO HEALTH PLAN, PROVIDING THEM WITH INPATIENT SERVICES, HOSPITAL-BASED SPECIALTY AND ANCILLARY SERVICES, AND EMERGENCY CARE. CPMC ALSO PROVIDES ACCESS TO QUALITY SERVICES AT THE MISSION BERNAL CAMPUS FOR PATIENTS WHO SELECT HILL PHYSICIANS OR BROWN & TOLAND AS THEIR MEDICAL GROUP THROUGH SAN FRANCISCO HEALTH PLAN. IN 2021, 44,321 PERSONS WERE SERVED: NEMS ENROLLEES 41,008; BROWN & TOLAND ENROLLEES 1,431; HILL PHYSICIANS ENROLLEES 1,882. CPMC PROVIDED FREE LAB SERVICES FOR NEARLY 16,000 OF THESE NEMS PATIENTS IN ORDER TO FURTHER IMPROVE ACCESS AND SUPPORT NEMS AND THEIR PATIENTS. CPMC PARTNERS WITH OPERATION ACCESS AND THE SAN FRANCISCO ENDOSCOPY CENTER TO PROVIDE ACCESS TO DIAGNOSTIC SCREENINGS, SPECIALTY PROCEDURES, AND SURGICAL CARE AT NO COST FOR UNINSURED BAY AREA PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. CPMC PHYSICIANS VOLUNTEER THEIR TIME TO PROVIDE THESE FREE SURGICAL SERVICES, WHILE THE HOSPITAL DONATES THE USE OF ITS OPERATING ROOMS. CPMC ALSO PROVIDES A GRANT TO SUPPORT OPERATION ACCESS'S OPERATING COSTS. IN 2021, OPERATION ACCESS SERVED 73 PEOPLE WITH 77 SURGICAL PRODECURES INCLUDING 28 OPERATING ROOM PROCEDURES, 24 GASTROENTEROLOGY PROCEDURES, 7 MINOR PROCEDURES OR RADIOLOGY, AND 18 SPECIALIST EVALUATIONS OR PHYSICAL THERAPY. MEALS ON WHEELS SAN FRANCISCO (MOWSF) HELPS LOW-INCOME, HOMEBOUND SENIORS TO AGE SAFELY AT HOME BY PROVIDING NOURISHING MEALS, SAFETY SUPPORT, AND INTERPERSONAL AND COMMUNITY CONNECTIONS. MOWSF CURRENTLY PROVIDES 83 PERCENT OF HOME-DELIVERED MEALS IN SAN FRANCISCO, BUT ITS CURRENT FACILITY CANNOT KEEP PACE WITH DEMAND AS THE CITY'S SENIOR POPULATION GROWS. THE CPMC GRANT SUPPORTS THE ORGANIZATION TO BUILD AND EQUIP A 45,000 SQUARE FOOT MEAL PRODUCTION FACILITY THAT WILL INCLUDE A FULL-CAPACITY, COMMERCIAL KITCHEN FOR FOOD PREPARATION, STORAGE, ACCESS SPACE AND DISTRIBUTION YARD. THROUGHOUT 2021, MEALS ON WHEELS SERVED 5,600 SENIORS AND ADULTS WITH DISABILITIES WITH HOME-DELIVERED MEALS, AND DELIVERED GROCERIES AND MEALS TO OVER 20,450 FOOD-INSECURE QUARANTINED INDIVIDUALS. 3,100 WERE PROVIDED WITH NUTRITION EDUCATION, AND A TOTAL OF 2,800,000 MEALS WERE DISTRIBUTED. CPMC SUPPORTS SOUTH OF MARKET BAYVIEW CHILD HEALTH CENTER (BCHC), WHICH OFFERS ROUTINE PREVENTATIVE AND URGENT PEDIATRIC CARE IN ONE OF SAN FRANCISCO'S MOST MEDICALLY UNDERSERVED NEIGHBORHOODS, AND ADDRESSES PREVALENT COMMUNITY HEALTH ISSUES SUCH AS WEIGHT CONTROL AND ASTHMA MANAGEMENT. BCHC FOCUSES ON KEEPING INFANTS, CHILDREN AND ADOLESCENTS HEALTHY, AND ON CLOSELY MANAGING THEIR CARE WHEN THEY ARE ILL. IN 2021, 909 INDIVIDUALS RECEIVED PRIMARY CARE WITH A TOTAL OF 2,523 ENCOUNTERS; 90 OF THESE PATIENTS WERE ALSO CONNECTED TO MENTAL HEALTH SERVICES. IN 2021, CPMC SUPPORTED ORGANIZATIONS SUCH AS EDGEWOOD CENTER FOR CHILDREN AND FAMILIES AND LARKIN STREET YOUTH SERVICES THROUGH COMMUNITY GRANTS TO ADDRESS SOCIAL, EMOTIONAL AND BEHAVIORAL HEALTH. THROUGH SUCH SUPPORT, MORE THAN 7,200 PEOPLE RECEIVED MENTAL HEALTH SERVICES, AND MORE THAN 1,200 RECEIVED SUBSTANCE USE SERVICES. CPMC SUPPORTS COMPASS FAMILY SERVICES, WHICH OPERATES PROGRAMS THAT PROVIDE YEAR-ROUND SERVICES TO HOMELESS FAMILIES AND FAMILIES AT IMMINENT RISK FOR HOMELESSNESS. IN 2021, COMPASS SERVED 2,159 FAMILIES INCLUDING MORE THAN 5,000 INDIVIDUAL FAMILY MEMBERS. 593 PEOPLE RECEIVED MENTAL HEALTH SERVICES, 211 OBTAINED INTERIM HOUSING, AND 502 OBTAINED STABLE HOUSING. 95% OF F
SCHEDULE H, PART VI, LINE 6 SUTTER HEALTH IS THE NOT-FOR-PROFIT PARENT OF NOT-FOR-PROFIT AND FOR-PROFIT COMPANIES THAT TOGETHER FORM AN INTEGRATED HEALTHCARE SYSTEM LOCATED IN NORTHERN CALIFORNIA. THE SYSTEM IS COMMITTED TO HEALTH EQUITY, COMMUNITY PARTNERSHIPS AND INNOVATIVE, HIGH-QUALITY PATIENT CARE. OUR OVER 65,000 EMPLOYEES AND ASSOCIATED CLINICIANS SERVE MORE THAN 3 MILLION PATIENTS THROUGH OUR HOSPITALS, CLINICS AND HOME HEALTH SERVICES. LEARN MORE ABOUT HOW WE'RE TRANSFORMING HEALTHCARE AT SUTTERHEALTH.ORG AND VITALS.SUTTERHEALTH.ORG. SUTTER HEALTH'S TOTAL INVESTMENT IN COMMUNITY BENEFIT IN 2021 WAS $872 MILLION. THIS AMOUNT INCLUDES TRADITIONAL CHARITY CARE AND UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS. THIS AMOUNT ALSO INCLUDES INVESTMENTS IN COMMUNITY HEALTH PROGRAMS TO ADDRESS PRIORITIZED HEALTH NEEDS AS IDENTIFIED BY REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENTS. AS PART OF SUTTER HEALTH'S COMMITMENT TO FULFILL ITS NOT-FOR-PROFIT MISSION AND HELP SERVE SOME OF THE MOST VULNERABLE IN ITS COMMUNITIES, THE SUTTER HEALTH NETWORK HAS IMPLEMENTED CHARITY CARE POLICIES TO HELP PROVIDE ACCESS TO MEDICALLY NECESSARY CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2021, SUTTER HEALTH INVESTED $91 MILLION IN CHARITY CARE. OVERALL, SINCE THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT, GREATER NUMBERS OF PREVIOUSLY UNINSURED PEOPLE NOW HAVE MORE ACCESS TO HEALTHCARE COVERAGE THROUGH THE MEDI-CAL AND MEDICARE PROGRAMS. THE PAYMENTS FOR PATIENTS WHO ARE COVERED BY MEDI-CAL AND MEDICARE DO NOT COVER THE FULL COSTS OF PROVIDING CARE. IN 2021, SUTTER HEALTH INVESTED $557 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS. THROUGH COMMUNITY BENEFIT INVESTMENTS, SUTTER HELPED LOCAL COMMUNITES ACCESS PRIMARY, MENTAL HEALTH AND ADDICTION CARE, AND BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD. SEE MORE ABOUT HOW SUTTER HEALTH REINVESTS INTO THE COMMUNITY BY VISITING SUTTERPARTNERS.ORG. IN ADDITION, EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTHCARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESSES REAL COMMUNITY NEEDS. FOR MORE FACTS AND INFORMATION VISIT SUTTERHEALTH.ORG.
SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: CALIFORNIA
Schedule H (Form 990) 2021
Additional Data


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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number
94-0562680
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" 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
noncash assistance
(h) Purpose of grant
or assistance
(1) MISSION AREA HEALTH ASSOC
240 SHOTWELL ST
SAN FRANCISCO,CA94110
94-2284365 501(C)(3) 1,500,848        
(2) COMMUNITY HEALTH CENTER NETWORK
101 CALLAN AVE
SAN LEANDRO,CA94577
94-3253662 501(C)(3) 775,000       PROGRAM SUPPORT
(3) Sutter Bay Medical Foundation
2200 River Plaza Drive
Sacramento,CA95833
94-1156581 501(C)(3) 448,869       PROGRAM SUPPORT
(4) SOUTH COUNTY COMM HLTH CTR INC
1885 BAY RD
PALO ALTO,CA94303
94-3372130 501(C)(3) 400,000       PROGRAM SUPPORT
(5) SAMARITAN HOUSE
4031 PACIFIC BLVD
SAN MATEO,CA94403
23-7416272 501(C)(3) 350,000       PROGRAM SUPPORT
(6) LIFE LONG MEDICAL CARE
PO BOX 11247
BERKELEY,CA94712
94-2502308 501(C)(3) 300,000       PROGRAM SUPPORT
(7) SAN FRANCISCO MEDICAL CENTER
229 7TH ST
SAN FRANCISCO,CA94103
23-7304921 501(C)(3) 227,767       PROGRAM SUPPORT
(8) WELLNESS TOGETHER
5701 LONETREE BLVD
ROCKLIN,CA95765
81-1653329 501(C)(3) 225,000       PROGRAM SUPPORT
(9) SANTA CRUZ COMMUNITY HEALTH CENTERS
PO BOX 542
SANTA CRUZ,CA95061
23-7428303 501(C)(3) 185,000       PROGRAM SUPPORT
(10) NOVATO UNIFIED SCHOOL DISTRICT
1015 SEVENTH ST
NOVATO,CA94945
68-0112169 GOVT 162,400       PROGRAM SUPPORT
(11) CATHOLIC CHARITIES OF THE DIOCESE OF SANTA ROSA
PO BOX 4900
SANTA ROSA,CA95402
94-2479393 501(C)(3) 161,370       PROGRAM SUPPORT
(12) SALUD PARA LA GENTE
195 AVIATION WY
WATSONVILLE,CA95076
94-2705747 501(C)(3) 150,000       PROGRAM SUPPORT
(13) NORTHERN CALIFORNIA CENTER FOR WELL BEING
101 BROOKWOOD AVE
SANTA ROSA,CA95404
93-1144835 501(C)(3) 143,793       PROGRAM SUPPORT
(14) TRI CITY HEALTH CENTER
39500 LIBERTY ST
FREMONT,CA94538
23-7255435 501(C)(3) 125,000       PROGRAM SUPPORT
(15) AXIS COMMUNITY HEALTH
4361 RAILROAD AVE
PLEASANTON,CA94566
94-2232394 501(C)(3) 125,000       PROGRAM SUPPORT
(16) COMMUNITY CLINIC CONSORTIUM
3720 BARRETT AVE
RICHMOND,CA94805
20-0782029 501(C)(3) 125,000       PROGRAM SUPPORT
(17) ELDER CARE ALLIANCE
1301 MARINA VILLAGE PKWY
ALAMEDA,CA94501
94-3260975 501(C)(3) 118,152       PROGRAM SUPPORT
(18) HEALTHIER KIDS FOUNDATION SANTA CLARA COUNTY
4010 MOORPARK AVE
SAN JOSE,CA95117
77-0545774 501(C)(3) 115,000       PROGRAM SUPPORT
(19) INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
1333 MERIDIAN AVE
SAN JOSE,CA95125
94-2476242 501(C)(3) 115,000       PROGRAM SUPPORT
(20) ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT
2400 MOORPARK AVE
SAN JOSE,CA95128
94-2292491 501(C)(3) 115,000       PROGRAM SUPPORT
(21) CAMINAR
2600 SO EL CAMINO REAL
SAN MATEO,CA94403
94-1639389 501(C)(3) 115,000       PROGRAM SUPPORT
(22) SAN FRANCISCO VILLAGE
3220 FULTON ST
SAN FRANCISCO,CA94118
26-1300020 501(C)(3) 111,677       PROGRAM SUPPORT
(23) BERKELEY FOOD AND HOUSING PROJECT
3225 ADELINE ST
BERKELEY,CA94703
94-2979073 501(C)(3) 100,000       PROGRAM SUPPORT
(24) EDGEWOOD CENTER FOR CHILDREN AND FAMILIES
1801 VICENTE ST
SAN FRANCISCO,CA94116
94-1186168 501(C)(3) 95,000       PROGRAM SUPPORT
(25) SAN MATEO COUNTY OF HEALTH CENTER FOUNDATION
222 W 39TH AVE
SAN MATEO,CA94403
94-3116070 501(C)(3) 95,000       PROGRAM SUPPORT
(26) HEALTHRIGHT 360
1563 MISSION ST
SAN FRANCISCO,CA94103
94-6129071 501(C)(3) 80,000       PROGRAM SUPPORT
(27) VOLUNTEERS IN MEDICINE SF
4877 MISSION ST
SAN FRANCISCO,CA94112
26-2593712 501(C)(3) 80,000       PROGRAM SUPPORT
(28) TIBURCIO VASQUEZ HEALTH CTR
33255 9TH ST
UNION CITY,CA94587
23-7118361 501(C)(3) 75,000       PROGRAM SUPPORT
(29) EAST BAY ASIAN LOCAL DEVELOPMENT CORPORATION
1825 SAN PABLO AVE
OAKLAND,CA94612
51-0171851 501(C)(3) 75,000       PROGRAM SUPPORT
(30) CTY OF CONTRA COSTA HLTH HOUSING & HOMELESS
2400 BISSO LN STE D FLR 2
CONCORD,CA94520
82-5065577 GOVT 75,000       PROGRAM SUPPORT
(31) Family Service Agency of San Mateo County
24 2nd Avenue
SAN MATEO,CA94401
94-1186169 501(C)(3) 75,000       PROGRAM SUPPORT
(32) PENINSULA HEALTHCARE CONNECTION INC
33 ENCINA AVE STE 103
PALO ALTO,CA94301
20-2886131 501(C)(3) 75,000       PROGRAM SUPPORT
(33) HUMAN INVESTMENT PROJECT INC
800 SO CLAREMONT ST
SAN MATEO,CA94402
94-2154614 501(C)(3) 70,000       PROGRAM SUPPORT
(34) COMPASS FAMILY SERVICES
37 GROVE ST
SAN FRANCISCO,CA94102
94-1156622 501(C)(3) 65,000       PROGRAM SUPPORT
(35) ANTIOCH UNIFIED SCHOOL DISTRICT
510 G ST
ANTIOCH,CA94509
86-1134505 GOVT 65,000       PROGRAM SUPPORT
(36) COMMUNITY OVERCOMING RELATIONSHIP ABUSE
PO BOX 4245
BURLINGAME,CA94011
94-2481188 501(C)(3) 60,000       PROGRAM SUPPORT
(37) HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ COUNT
343 SOQUEL AVE STE 343
SANTA CRUZ,CA95062
01-0826156 501(C)(3) 57,500       PROGRAM SUPPORT
(38) LARKIN STREET YOUTH SERVICES
134 GOLDEN GATE AVE
SAN FRANCISCO,CA94102
94-2917999 501(C)(3) 55,000       PROGRAM SUPPORT
(39) YOUTH ALIVE
3300 ELM ST
OAKLAND,CA94609
94-3143254 501(C)(3) 53,884       PROGRAM SUPPORT
(40) ABODE SERVICES
40849 FREMONT BLVD
FREMONT,CA94538
94-3087060 501(C)(3) 50,000       PROGRAM SUPPORT
(41) INDIVIDUALS NOW INC
2447 SUMMERFIELD RD
SANTA ROSA,CA95405
94-1711490 501(C)(3) 50,000       PROGRAM SUPPORT
(42) COMMUNITY GATEPATH
350 TWIN DOLPHIN DR
REDWOOD CITY,CA94065
94-1156502 501(C)(3) 50,000       PROGRAM SUPPORT
(43) MEALS ON WHEELS OF SAN FRANCISCO INC
1375 FAIRFAX AVE
SAN FRANCISCO,CA94124
94-1741155 501(C)(3) 50,000       PROGRAM SUPPORT
(44) SAN FRANCISCO FREE CLINIC
4900 CALIFONRIA ST
SAN FRANCISCO,CA94118
94-3186248 501(C)(3) 50,000       PROGRAM SUPPORT
(45) BAY AREA COMMUNITY SVC
390 40TH ST
OAKLAND,CA94609
94-1708069 501(C)(3) 50,000       PROGRAM SUPPORT
(46) SANTA ROSA COMMUNITY HEALTH CENTERS
3569 ROUND BARN CIR
SANTA ROSA,CA95403
68-0365296 501(C)(3) 50,000       PROGRAM SUPPORT
(47) OPPORTUNITY JUNCTION
3102 DELTA FAIR BLVD
ANTIOCH,CA94509
68-0459131 501(C)(3) 50,000       PROGRAM SUPPORT
(48) DAVIS STREET COMMUNITY CENTER
3081 TEAGARDEN ST
SAN LEANDRO,CA94577
94-3121699 501(C)(3) 50,000       PROGRAM SUPPORT
(49) ALAMEDA POINT COLLABORATIVE
677 W RANGER AVE
ALAMEDA,CA94501
94-3361464 501(C)(3) 50,000       PROGRAM SUPPORT
(50) SIDE BY SIDE
300 SUNNY HILLS DR
SAN ANSELMO,CA94960
94-1156301 501(C)(3) 50,000       PROGRAM SUPPORT
(51) EPISCOPAL COMMUNITY SERVICES
165 8TH ST 3RD FL
SAN FRANCISCO,CA94103
94-3096716 501(C)(3) 50,000       PROGRAM SUPPORT
(52) PUENTE DE LA COSTA SUR
620 NORTH ST
PESCADERO,CA94060
37-1484262 501(C)(3) 45,000       PROGRAM SUPPORT
(53) SAFE AND SOUND
12886 INTERURBAN AVE SO
TUKWILA,WA98168
94-2455072 501(C)(3) 45,000       PROGRAM SUPPORT
(54) DIENTES COMMUNITY DENTAL CARE
1830 COMMERCIAL WY
SANTA CRUZ,CA95065
77-0311752 501(C)(3) 40,000       PROGRAM SUPPORT
(55) SPANISH SPEAKING UNITY COUNCIL
1900 FRUITVALE AVE STE 2A
OAKLAND,CA94601
94-1670490 501(C)(3) 40,000       PROGRAM SUPPORT
(56) Operation Access
1119 MARKET ST
SAN FRANCISCO,CA94103
94-3180356 501(C)(3) 40,000       PROGRAM SUPPORT
(57) ENCOMPASS COMMUNITY SERVICES
380 ENCINAL ST STE 200
SANTA CRUZ,CA95060
23-7275290 501(C)(3) 40,000       PROGRAM SUPPORT
(58) NORTH MARIN COMMUNITY SERVICES
680 WILSON AVE
NOVATO,CA94947
94-1735064 501(C)(3) 37,500       PROGRAM SUPPORT
(59) STARVISTA
610 ELM ST STE 212
SAN CARLOS,CA94070
94-3094966 501(C)(3) 37,500       PROGRAM SUPPORT
(60) HOUSING MATTERS
115 CORAL ST STE B
SANTA CRUZ,CA95060
77-0126783 501(C)(3) 35,000       PROGRAM SUPPORT
(61) UNITED WAY OF SANTA CRUZ CNTY
4450 CAPITOLA RD STE 106
CAPITOLA,CA95010
94-1422471 501(C)(3) 35,000       PROGRAM SUPPORT
(62) SCOPA HAS A DREAM INC
PO BOX 1004
HEALDSBURG,CA95448
27-3044487 501(C)(3) 32,000       PROGRAM SUPPORT
(63) HOMELESS PRENATAL PROGRAM INC
2500 18TH ST
SAN FRANCISCO,CA94110
94-3146280 501(C)(3) 30,000       PROGRAM SUPPORT
(64) ROTACARE BAY AREA INC
514 VALLEY WY
MILPITAS,CA95035
77-0328723 501(C)(3) 27,500       PROGRAM SUPPORT
(65) BAY AREA CANCER CONNECTIONS
2335 EL CAMINO REAL
PALO ALTO,CA94306
77-0417605 501(C)(3) 27,500       PROGRAM SUPPORT
(66) HOPE IS RISING LAKE COUNTY
371 LAKEPORT BLVD
LAKEPORT,CA95453
84-2638355 501(C)(3) 26,500       PROGRAM SUPPORT
(67) SF LGBT COMMUNITY CENTER
1800 MARKET ST
SAN FRANCISCO,CA94102
94-3236718 501(C)(3) 25,000       PROGRAM SUPPORT
(68) BERKELEY YOUTH ALTERNATIVES
1255 ALLSTON WY
BERKELEY,CA94702
94-1711728 501(C)(3) 25,000       PROGRAM SUPPORT
(69) NATIVE AMERICAN HEALTH CTR INC
2920 INTERNATIONAL BLVD
OAKLAND,CA94601
23-7135928 501(C)(3) 25,000       PROGRAM SUPPORT
(70) ASIAN AND PACIFIC ISLANDER WELLNESS CENTER
730 POLK ST 4TH FLR
SAN FRANCISCO,CA94109
94-3096109 501(C)(3) 25,000       PROGRAM SUPPORT
(71) DESIGNING JUSTICE DESIGNING SPACES
2744 E 11TH ST STE H03
OAKLAND,CA94601
81-2658023 501(C)(3) 25,000       PROGRAM SUPPORT
(72) ASHBY VILLAGE INC
1821 CATALINA AVE
BERKELEY,CA94707
27-2174330 501(C)(3) 25,000       PROGRAM SUPPORT
(73) KOREA TOWN OAKLAND
2633 TELEGRAPH AVE
OAKLAND,CA94612
41-2260418 501(C)(3) 25,000       PROGRAM SUPPORT
(74) ORDER OF MALTA CLINIC OF NORTHERN CALIFORNIA
2121 HARRISON ST STE 120
OAKLAND,CA94612
20-5969389 501(C)(3) 25,000       PROGRAM SUPPORT
(75) LATINO SERVICE PROVIDERS
1015A CENTER DR
SANTA ROSA,CA95403
46-4107589 501(C)(3) 25,000       PROGRAM SUPPORT
(76) JEFFERSON HIGH SCHOOL
6996 MISSION ST
DALY CITY,CA94014
94-3083772 GOVT 25,000       PROGRAM SUPPORT
(77) MAGICAL BRIDGE FOUNDATION
552 WAVERLEY ST STE 200
PALO ALTO,CA94301
81-2377796 501(C)(3) 25,000       PROGRAM SUPPORT
(78) ROOTS COMMUNITY HEALTH CENTER
7272 MACARTHUR BLVD
OAKLAND,CA94605
26-2583954 501(C)(3) 25,000       PROGRAM SUPPORT
(79) LA FAMILIA COUNSELING SVC
24301 SOUTHLAND DR
HAYWARD,CA94545
94-2297155 501(C)(3) 25,000       PROGRAM SUPPORT
(80) HAMILTON FAMILIES
273 NINTH ST
SAN FRANCISCO,CA94103
94-3055602 501(C)(3) 25,000       PROGRAM SUPPORT
(81) KIMOCHI INC
1715 BUCHANAN ST
SAN FRANCISCO,CA94115
23-7117402 501(C)(3) 25,000       PROGRAM SUPPORT
(82) VILLAGE COMMUNITY RESOURCE CTR
633 VILLAGE DR
BRENTWOOD,CA94513
41-2045701 501(C)(3) 25,000       PROGRAM SUPPORT
(83) SHANTI PROJECT
3170 23RD ST
SAN FRANCISCO,CA94110
94-2297147 501(C)(3) 25,000       PROGRAM SUPPORT
(84) BRIGHTER BEGINNINGS
2727 MACDONALD AVE
RICHMOND,CA94804
94-2949749 501(C)(3) 25,000       PROGRAM SUPPORT
(85) LA CLINICA DE LA RAZA
1515 FRUITVALE AVE
OAKLAND,CA94601
94-1744108 501(C)(3) 25,000       PROGRAM SUPPORT
(86) BUILDING OPPORTUNITIES FOR SELF SUFFICIENCY
1918 UNIVERSITY AVE
BERKELEY,CA94704
51-0173390 501(C)(3) 25,000       PROGRAM SUPPORT
(87) DOMINICAN HOSPITAL
PO BOX 742990
LOS ANGELES,CA90074
72-1561119   25,000       PROGRAM SUPPORT
(88) CONTRA COSTA FAMILY JUSTICE ALLIANCE
256 24TH ST
RICHMOND,CA94804
47-4082871 501(C)(3) 25,000       PROGRAM SUPPORT
(89) CURRY SENIOR CENTER
315 TURK ST
SAN FRANCISCO,CA94102
23-7362588 501(C)(3) 25,000       PROGRAM SUPPORT
(90) RAIZES COLLECTIVE
PO BOX 8606
SANTA ROSA,CA95407
47-3129493 501(c)(3) 25,000       PROGRAM SUPPORT
(91) SIMPLY THE BASICS
1768 HELANE CT
BENICIA,CA94510
81-1369151 501(C)(3) 25,000       PROGRAM SUPPORT
(92) SHELTER INC
PO BOX 5368
CONCORD,CA94524
68-0117241 501(C)(3) 25,000       PROGRAM SUPPORT
(93) APA FAMILY SUPPORT SERVICES
10 NOTTINGHAM PL
SAN FRANCISCO,CA94133
94-3164091 501(C)(3) 25,000       PROGRAM SUPPORT
(94) DISTRICT COUNCIL OF CONTRA COSTA COUNTY SOCIETY OF
2210 GLADSTONE DR
PITTSBURG,CA94565
94-1448577 501(C)(3) 25,000       PROGRAM SUPPORT
(95) DEMARILLAC ACADEMY
175 GOLDEN GATE AVE
SAN FRANCISCO,CA94102
94-3390330 501(C)(3) 25,000       PROGRAM SUPPORT
(96) LOAVES AND FISHES OF CONTRA COSTA
835 FERRY ST
MARTINEZ,CA94553
68-0018077 501(C)(3) 25,000       PROGRAM SUPPORT
(97) JEWISH VOCATIONAL AND CAREER COUNSELING SERVICE
17 GEARY ST STE 401
SAN FRANCISCO,CA94108
94-2213100 501(C)(3) 25,000       PROGRAM SUPPORT
(98) MAITRI COMPASSIONATE CARE
401 DUBOCE AVE
SAN FRANCISCO,CA94117
94-3189198 501(C)(3) 25,000       PROGRAM SUPPORT
(99) CASTRO VALLEY UNIFIED SCHOOL
25118 CENTURY OAKS
CASTRO VALLEY,CA94552
94-1694282 GOVT 25,000       PROGRAM SUPPORT
(100) FAMILY SUPPORT SERVICES
303 HEGENBERGER RD
OAKLAND,CA94621
94-3108205 501(C)(3) 25,000       PROGRAM SUPPORT
(101) HOMEWARD BOUND OF MARIN
1385 NO HAMILTON PKWY
NOVATO,CA94949
68-0011405 501(C)(3) 21,084       PROGRAM SUPPORT
(102) HOME AND HOPE
1720 EL CAMINO REAL
BURLINGAME,CA94010
94-3356735 501(C)(3) 20,000       PROGRAM SUPPORT
(103) BOARD OF TRUSTEES OF THE GLIDE FOUNDATION
330 ELLIS ST
SAN FRANCISCO,CA94102
94-1156481 501(C)(3) 20,000       PROGRAM SUPPORT
(104) HUMANIDAD THERAPY AND EDUCATION SERVICES
1260 NO DUTTON AVE
SANTA ROSA,CA95401
46-3725156 501(C)(3) 20,000       PROGRAM SUPPORT
(105) EDEN HOUSING RESIDENT SVC INC
22645 GRAND ST
HAYWARD,CA94541
94-3315887 501(C)(3) 20,000       PROGRAM SUPPORT
(106) HORIZON SERVICES INC
PO BOX 4217
HAYWARD,CA94540
94-2365021 501(C)(3) 20,000       PROGRAM SUPPORT
(107) CABRILLO COLLEGE FOUNDATION
6500 SOQUEL DR
APTOS,CA95003
94-6121953 501(C)(3) 20,000       PROGRAM SUPPORT
(108) MONUMENT IMPACT
1760 CLAYTON ST
CONCORD,CA94520
94-3370919 501(C)(3) 20,000       PROGRAM SUPPORT
(109) SONRISAS DENTAL HEALTH INC
430 NO EL CAMINO REAL
SAN MATEO,CA94401
94-3390196 501(C)(3) 20,000       PROGRAM SUPPORT
(110) REDWOOD COMMUNITY SERVICES INC
PO BOX 2077
UKIAH,CA95482
68-0367894 501(C)(3) 20,000       PROGRAM SUPPORT
(111) ICA SAN FRANCISCO WORK STUDY
3625 24TH ST
SAN FRANCISCO,CA94110
26-4450576 501(C)(3) 20,000       PROGRAM SUPPORT
(112) SAFE ALTERNATIVES TO VIOLENT ENVIRONMENTS
1900 MOWRY AVE STE 201
FREMONT,CA94538
94-2520559 501(C)(3) 20,000       PROGRAM SUPPORT
(113) ALAMEDA COUNTY
1221 OAK ST
OAKLAND,CA94612
94-6000501 GOVT 20,000       PROGRAM SUPPORT
(114) CONARD HOUSE INC
1385 MISSION ST
SAN FRANCISCO,CA94103
94-1489356 501(C)(3) 20,000       PROGRAM SUPPORT
(115) Sutter Health
2200 River Plaza Drive
Sacramento,CA95833
94-2788907 501(C)(3) 17,500       PROGRAM SUPPORT
(116) EL CENTRO DE LIBERTAD
500 ALLERTON AVE
REDWOOD CITY,CA94063
94-3189174 501(C)(3) 15,000       PROGRAM SUPPORT
(117) SELF HELP FOR THE ELDERLY
731 SANSOME ST
SAN FRANCISCO,CA94111
94-1750717 501(C)(3) 15,000       PROGRAM SUPPORT
(118) HUCKLEBERRY YOUTH PROGRAM INC
3450 GEARY BLVD
SAN FRANCISCO,CA94118
94-1687559 501(C)(3) 15,000       PROGRAM SUPPORT
(119) ON LOK INC
1333 BUSH ST
SAN FRANCISCO,CA94109
94-3101464 501(C)(3) 15,000       PROGRAM SUPPORT
(120) SONOMA COUNTY JUNIOR COLLEGE DISTRICT
1501 MENDOCINO AVE
SANTA ROSA,CA95401
94-6033759 GOVT 15,000       PROGRAM SUPPORT
(121) LA LUZ CENTER
17560 GREGER ST
SONOMA,CA95476
68-0228235 501(C)(3) 15,000       PROGRAM SUPPORT
(122) YMCA OF SILICON VALLEY
3412 ROSS RD
PALO ALTO,CA94303
94-1156318 501(C)(3) 15,000       PROGRAM SUPPORT
(123) SECOND HARVEST FOOD BANK
750 CURTNER AVE
SAN JOSE,CA95125
94-2614101 501(C)(3) 15,000       PROGRAM SUPPORT
(124) PLANNED PARENTHOOD SHASTA DIABLO INC
2185 PACHECO ST
CONCORD,CA94520
94-1575233 501(C)(3) 15,000       PROGRAM SUPPORT
(125) SANTA CRUZ LESBIAN AND GAY COMMUNITY CENTER
PO BOX 8280
SANTA CRUZ,CA95061
77-0212967 501(C)(3) 15,000       PROGRAM SUPPORT
(126) WEST COUNTY HEALTH CENTERS
PO BOX 1449
GUERNEVILLE,CA95446
23-7310613 501(C)(3) 15,000       PROGRAM SUPPORT
(127) UNITED WAY SANTA CRUZ
PO BOX 1458
CAPITOLA,CA95010
94-1422471 501(C)(3) 14,000       PROGRAM SUPPORT
(128) CHILDRENS HEALTH COUNCIL
650 CLARK WY
PALO ALTO,CA94304
94-1312311 501(C)(3) 12,500       PROGRAM SUPPORT
(129) MENDOCINO LAKE COMMUNITY COLLEGE
1000 HENSLEY CREEK RD
UKIAH,CA95482
94-6002711 GOVT 12,500       PROGRAM SUPPORT
(130) REACH FOR HOME
443 HUDSON ST
HEALDSBURG,CA95448
47-2692320 501(C)(3) 12,500       PROGRAM SUPPORT
(131) CANCER SUPPORT COMMUNITY SAN FRANCISCO BAY AREA
3276 MCNUTT AVE
WALNUT CREEK,CA94597
68-0157858 501(C)(3) 12,000       HOMELESS ASSISTANCE
(132) FAMILY SERVICE AGENCY OF THE CENTRAL COAST
104 WALNUT AVE STE 208
SANTA CRUZ,CA95060
94-1716354 501(C)(3) 10,500        
(133) INSTITUTE ON AGING
3575 GEARY BLVD
SAN FRANCISCO,CA94118
94-2978977 501(C)(3) 10,000        
(134) AYUDANDO LATINOS A SONAR
636 PURISSIMA ST
HALF MOON BAY,CA94019
46-2464722 501(C)(3) 10,000        
(135) PROJECT OPEN HAND
730 POLK ST
SAN FRANCISCO,CA94109
94-3023551 501(C)(3) 10,000        
(136) ACKNOWLEDGE ALLIANCE
2483 OLD MIDDLEFld
MOUNTAIN VIEW,CA94043
77-0393676 501(C)(3) 10,000        
(137) SIENA HOUSE MATERNITY HOME OF SANTA CRUZ COUNTY
108 HIGH ST
SANTA CRUZ,CA95060
77-0518866 501(C)(3) 10,000        
(138) HEALTH CAREER CONNECTION
300 FRANK H OGAWA PLAZA
OAKLAND,CA94612
25-1904312 501(C)(3) 10,000        
(139) ARTS COUNCIL SANTA CRUZ COUNTY
7960 SOQUEL DR STE I
APTOS,CA95003
94-2600140 501(C)(3) 10,000        
(140) SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM
170 CAPP ST STE C
SAN FRANCISCO,CA94110
94-2897258 501(C)(3) 10,000        
(141) GUM MOON RESIDENCE HALL
940 WASHINGTON ST
SAN FRANCISCO,CA94108
94-1156357 501(C)(3) 10,000        
(142) DISCOVERY COUNSELING CENTER OF THE SAN RAMON VALLE
115 TOWN AND COUNTRY DR
DANVILLE,CA94526
94-1705971 501(C)(3) 10,000        
(143) MISSION HOSPICE AND HOME CARE
66 BOVET RD STE 100
SAN MATEO,CA94402
94-2567162 501(C)(3) 10,000        
(144) PACIFIC STROKE ASSOCIATION
3801 MIRANDA AVE BLDG 6
PALO ALTO,CA94304
77-0500631 501(C)(3) 10,000        
(145) Natl Assoc for the Advcmt of Colored People
1290 FILLMORE ST
SAN FRANCISCO,CA94115
23-7177411 501(C)(4) 10,000        
(146) ASIAN HEALTH SERVICES
101 8TH ST STE 100
OAKLAND,CA94607
94-2235908 501(C)(3) 10,000        
(147) ACTERRA ACTION FOR A HEALTHY PLANET
3921 E BAYSHORE RD
PALO ALTO,CA94303
23-7064937 501(C)(3) 10,000        
(148) RUBICON PROGRAMS INC
2500 BISSELL AVE
RICHMOND,CA94804
94-2301550 501(C)(3) 10,000        
(149) SAINT ANTHONY FOUNDATION
150 GOLDEN GATE AVE
SAN FRANCISCO,CA94102
94-1513140 501(C)(3) 10,000        
(150) MARIN COMMUNITY CLINIC
9 COMMERCIAL BLVD STE 100
NOVATO,CA94949
94-2237120 501(C)(3) 10,000        
(151) RICHMOND PROMISE
440 CIVIC CENTER PLAZA
RICHMOND,CA94804
81-1653085 501(C)(3) 10,000        
(152) FRIENDS FOR YOUTH
3460 W BAYSHORE RD
PALO ALTO,CA94303
94-2961034 501(C)(3) 10,000        
(153) RYSE INC
205 41ST ST
RICHMOND,CA94805
26-0692904 501(C)(3) 10,000        
(154) EXTENDED CHILD CARE COALITION OF SONOMA COUNTY
1745 COPPERHILL PKWY
SANTA ROSA,CA95403
94-2526630 501(C)(3) 10,000        
(155) PARTNERS AND ADVOCATES FOR REMARKABLE CHILDREN AND
800 AIRPORT BLVD
BURLINGAME,CA94010
94-1650851 501(C)(3) 10,000        
(156) HEALTH TRUST
3180 NEWBERRY DR STE 200
SAN JOSE,CA95118
94-6050231 501(C)(3) 10,000        
(157) SUNNYVALE COMMUNITY SERVICES
725 KIFER RD
SUNNYVALE,CA94086
94-1713897 501(C)(3) 10,000        
(158) WEST VALLEY COMMUNITY SERVICES OF SANTA CLARA COUN
10104 VISTA DR
CUPERTINO,CA95014
94-2211685 501(C)(3) 10,000        
(159) LIFE STEPS FOUNDATION INC
5757 W CENTURY BLVD
LOS ANGELES,CA90045
95-3909174 501(C)(3) 10,000        
(160) SILICON VALLEY LEADERSHIP GROUP FOUNDATION
2001 GATEWAY PL STE 101E
SAN JOSE,CA95110
91-2140464 501(C)(3) 9,000        
(161) SOCIAL GOOD FUND
12651 SAN PABLO AVE
RICHMOND,CA94805
46-1323531 501(C)(3) 7,500        
(162) JEWISH COMMUNITY CTR OF SF
3200 CALIFORNIA ST
SAN FRANCISCO,CA94118
94-3227260 501(C)(3) 7,500        
(163) JEWISH FAMILY CHILDRENS SVC
2150 POST ST
SAN FRANCISCO,CA94115
94-1156528 501(C)(3) 7,200        
(164) CHALLENGE SUCCESS
531 LASUEN MALL 20053
STANFORD,CA94305
45-3767621 501(C)(3) 6,000        
(165) ELSIE ALLEN HIGH SCHOOL FNDT
599 BELLEVUE AVE
SANTA ROSA,CA95407
46-4580953 501(C)(3) 6,000        
(166) NEW WAY HOMES INC
1040 MYSTERY SPOT RD
SANTA CRUZ,CA95065
47-4091853 501(C)(3) 6,000        
(167) CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN F
1555 39TH AVE
SAN FRANCISCO,CA94122
94-1498472 501(C)(3) 5,500        
(168) LAKE FAMILY RESOURCE CENTER
5350 MAIN ST
KELSEYVILLE,CA95451
68-0353914 501(C)(3) 5,500        
(169) LA FAMILIA SANA
PO BOX 158
CLOVERDALE,CA95425
86-1711899 501(c)(3) 5,500        
(170) OPEN HEART KITCHEN OF LIVERMORE INC
1141 CATALINA DR
LIVERMORE,CA94550
94-3396038 501(C)(3) 5,500        
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
168
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) PATIENT ASSISTANCE 10282   454,118   HOMELESS 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
SCHEDULE I, PART I, LINE 2 IN ORDER TO CLOSELY MONITOR EFFICIENCY AND EFFECTIVENESS, THE COMMUNITY BENEFIT FUNCTION OUTLINES MEASURABLE REPORTING (QUARTERLY, SIX-MONTH AND/OR YEAR-END), PROGRAM AND FUNDING REQUIREMENTS IN A MEMORANDUM OF UNDERSTANDING (MOU), BUSINESS SERVICES AGREEMENT (BSA), OR JOINT VENTURE AGREEMENT FOR EACH INVESTMENT MADE WITH A COMMUNITY PARTNER. WHERE IT IS DETERMINED NECESSARY, ADDITIONAL EFFORTS ARE MADE TO MONITOR EFFECTIVENESS AND EFFICIENCY OF INVESTMENTS, WHICH COULD INCLUDE: - QUARTERLY MEETINGS WITH COMMUNITY PARTNERS - E-MAIL AND TELEPHONIC COMMUNICATIONS WITH COMMUNITY PARTNERS - CONTINUED DIALOGUE WITH INVOLVED HOSPITAL STAFF AND COMMUNITY PARTNERS THROUGHOUT DURATION OF PROGRAM - SITE VISITS WITH COMMUNITY PARTNERS - BI-ANNUAL "OUTCOMES" SURVEY (6-MONTH AND/OR YEAR-END OUTCOMES) - REVIEW OF HOSPITAL USAGE AND PATIENT LEVEL DATA - COLLECTION OF PATIENT STORIES AND NARRATIVES - COLLABORATIVE DISCUSSIONS AROUND AD-HOC SUCCESSES AND CHALLENGES THAT ARISE - REPORTING TO INCLUDE YEAR-END FINANCIAL SUMMARY THAT COMPARES ACTUAL EXPENDITURES TO THE FUNDED PROJECT'S BUDGET, INDICATING ANY UNUSED AMOUNT OF GRANT FUNDS. at the end of THE APPROPRIATE reporting PERIOD, COMMUNITY BENEFIT ANALYZES DATA TO ENSURE COMMUNITY PARTNERS MET THE OBJECTIVES OUTLINED IN THE MOU OR BSA. IF THE COMMUNITY PARTNERS DID NOT REACH THE ANTICIPATED OUTCOMES, COMMUNITY BENEFIT WORKS TO UNDERSTAND WHAT CIRCUMSTANCES PREVENTED THE ORGANIZATION FROM MEETING THE GOALS TO HELP IDENTIFY WAYS TO IMPROVE OR PERHAPS RE-EVALUATE WHAT SUCCESS OF THIS PROGRAM LOOKS LIKE, AND MAKES THE DETERMINATION TO CONTINUE OR TERMINATE FUNDING.
Schedule I (Form 990) 2021



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Sarah Krevans
President & CEO Sutter Health
(i)

(ii)
0
-------------
1,935,922
0
-------------
0
0
-------------
7,224,377
0
-------------
344,838
0
-------------
34,373
0
-------------
9,539,510
0
-------------
4,135,265
2James Conforti
SH SVP / COO & SBH Asst Sec.
(i)

(ii)
0
-------------
1,119,575
0
-------------
709,247
0
-------------
207,587
0
-------------
526,438
0
-------------
30,824
0
-------------
2,593,671
0
-------------
306,460
3Julie A Petrini
CEO, Bay Area Hospitals
(i)

(ii)
0
-------------
748,647
0
-------------
413,540
0
-------------
146,234
0
-------------
114,338
0
-------------
12,171
0
-------------
1,434,930
0
-------------
112,115
4Warren Browner MD
CEO, CPMC
(i)

(ii)
0
-------------
693,579
0
-------------
393,557
0
-------------
105,617
0
-------------
99,138
0
-------------
22,964
0
-------------
1,314,855
0
-------------
150,708
5David Cheney
CEO, Bay & Valley Hospitals
(i)

(ii)
0
-------------
722,832
0
-------------
334,238
0
-------------
104,743
0
-------------
93,338
0
-------------
18,194
0
-------------
1,273,345
0
-------------
145,914
6John Gates
CFO, SH Bay Area
(i)

(ii)
0
-------------
676,376
0
-------------
189,868
0
-------------
88,926
0
-------------
80,038
0
-------------
20,214
0
-------------
1,055,422
0
-------------
86,217
7Janet A Wagner
Hospital Area CEO, South Bay
(i)

(ii)
0
-------------
546,043
0
-------------
246,940
0
-------------
91,901
0
-------------
84,538
0
-------------
22,124
0
-------------
991,546
0
-------------
121,382
8Samareh H Rad
Coord, Transfer Center RN
(i)

(ii)
893,924
-------------
0
10,770
-------------
0
0
-------------
0
17,638
-------------
0
28,428
-------------
0
950,760
-------------
0
0
-------------
0
9David Clark
CEO, ABSMC
(i)

(ii)
0
-------------
649,391
0
-------------
131,528
0
-------------
21,740
0
-------------
111,138
0
-------------
25,831
0
-------------
939,628
0
-------------
0
10Brian Alexander
Hospital Area CEO, N. Valley
(i)

(ii)
0
-------------
525,231
0
-------------
237,621
0
-------------
73,926
0
-------------
70,538
0
-------------
29,686
0
-------------
937,002
0
-------------
104,285
11Penny Westfall
SH VP, CLO, SH & SBH Sec
(i)

(ii)
0
-------------
9,958
0
-------------
138,902
0
-------------
629,914
0
-------------
606
0
-------------
1,206
0
-------------
780,586
0
-------------
0
12Daniel Peterson
CEO, SSRRH
(i)

(ii)
0
-------------
456,133
0
-------------
151,567
0
-------------
39,805
0
-------------
56,438
0
-------------
31,352
0
-------------
735,295
0
-------------
60,120
13Maynard L Jenkins III
SH VP, HR Support Functions
(i)

(ii)
0
-------------
454,103
0
-------------
123,061
0
-------------
50,533
0
-------------
59,738
0
-------------
19,540
0
-------------
706,975
0
-------------
55,460
14Stephen Gray
CAO, SMSC & Bay Found Ops Exec
(i)

(ii)
0
-------------
364,114
0
-------------
196,321
0
-------------
54,622
0
-------------
54,838
0
-------------
31,412
0
-------------
701,307
0
-------------
78,949
15Cynthia Lee
SH VP, Chief Strgy & Corp Dev
(i)

(ii)
0
-------------
436,251
0
-------------
123,257
0
-------------
49,042
0
-------------
58,638
0
-------------
27,153
0
-------------
694,341
0
-------------
54,831
16Vernon Giang
CME, CPMC
(i)

(ii)
0
-------------
470,431
0
-------------
68,337
0
-------------
45,077
0
-------------
49,538
0
-------------
19,500
0
-------------
652,883
0
-------------
37,842
17Sami E Nawwar
Nurse-Staff II 12 Hour Cert
(i)

(ii)
599,118
-------------
0
0
-------------
0
99
-------------
0
17,638
-------------
0
28,879
-------------
0
645,734
-------------
0
0
-------------
0
18Steven R Cummings
Exec Dir, SF Coordinating Ctr
(i)

(ii)
535,398
-------------
0
51,233
-------------
0
5,294
-------------
0
17,638
-------------
0
22,551
-------------
0
632,114
-------------
0
0
-------------
0
19Jason G Bradshaw
Nuclear Med Technologist
(i)

(ii)
573,146
-------------
0
0
-------------
0
138
-------------
0
17,638
-------------
0
28,690
-------------
0
619,612
-------------
0
0
-------------
0
20Richard M Deits
Staff Physician, Comm Clinic
(i)

(ii)
567,819
-------------
0
0
-------------
0
0
-------------
0
17,638
-------------
0
19,937
-------------
0
605,394
-------------
0
0
-------------
0
21Theresa C Glubka
CEO, SSCD
(i)

(ii)
0
-------------
75,393
0
-------------
253,189
0
-------------
224,998
0
-------------
6,136
0
-------------
5,496
0
-------------
565,212
0
-------------
47,605
22Jeff Gerard
Frmr SH SVP / Strat Svcs & CSO
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
538,462
0
-------------
0
0
-------------
469
0
-------------
538,931
0
-------------
0
23Gregory Brown
SH VP, Legal Transac & SBH Sec
(i)

(ii)
0
-------------
301,181
0
-------------
84,632
0
-------------
38,227
0
-------------
45,838
0
-------------
26,712
0
-------------
496,590
0
-------------
41,290
24Edward Battista
VP, HR, North Bay & East Bay
(i)

(ii)
0
-------------
337,417
0
-------------
48,962
0
-------------
31,454
0
-------------
43,038
0
-------------
10,747
0
-------------
471,618
0
-------------
24,408
25Michael Purvis
Former CEO, SSRRH & NCH
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
140,098
0
-------------
0
0
-------------
0
0
-------------
140,098
0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THIS ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE INDEPENDENT DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARM'S LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH.
SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: Jeff Gerard: $538,462 Penny Westfall: $500,140
SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PENSION PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA PROVIDES 6% TO 12% OF BASE SALARY PLUS ANNUAL INCENTIVE PLAN AWARD (COMMENSURATE WITH MANAGEMENT LEVEL). CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTH'S QUALIFIED PENSION PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. THE FOLLOWING INDIVIDUALS RECEIVED 457(F) NON-QUALIFIED PAYMENTS DURING THE YEAR: Sarah Krevans: $6,833,449 Penny Westfall: $117,086 Theresa C. Glubka: $220,074
SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 15% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP): THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, OPERATING UNIT AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. LONG TERM PERFORMANCE PLANS: SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL LONG TERM PERFORMANCE PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT.
Schedule J (Form 990) 2021

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number
94-0562680
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CHFFA 2016B
 
52-1643828 13032UDW5 08-17-2016 901,627,093 REFUNDING 2005BC, 2003AB, 2007A X     X   X
B CHFFA 2017A
 
52-1643828 13032UNY0 07-06-2017 496,319,743 REFUND 2004CD, 2008A (PARTIAL), 20 X     X   X
C CHFFA 2018A
 
52-1643828 13032URP5 04-04-2018 699,997,776 Construction, Equipment   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 0 0 0  
2 Amount of bonds legally defeased .............. 0 0 0  
3 Total proceeds of issue .................. 902,923,938 496,319,743 699,997,776  
4 Gross proceeds in reserve funds ............. 0 0 0  
5 Capitalized interest from proceeds ............. 0 0 0  
6 Proceeds in refunding escrows ............... 0 0 0  
7 Issuance costs from proceeds ............... 0 0 0  
8 Credit enhancement from proceeds ............. 0 0 0  
9 Working capital expenditures from proceeds ............. 0 0 0  
10 Capital expenditures from proceeds ............. 0 0 0  
11 Other spent proceeds ............. 902,923,938 496,319,743 699,997,776  
12 Other unspent proceeds ............. 0 0 0  
13 Year of substantial completion ............. 2016 2017 2019
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........
  X   X   X    
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
X   X     X    
16 Has the final allocation of proceeds been made? .......... X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X      
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X      
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X      
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.920 % 1.520 % 0.050 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0.010 % 0.020 % 0.030 %  
6 Total of lines 4 and 5 ............. 0.930 % 1.540 % 0.080 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X    
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X      
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X   X   X      
b Exception to rebate? ........   X   X   X    
c No rebate due? .........   X   X   X    
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X   X   X    
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X      
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
SCHEDULE K REPORTING The organization's sole corporate member is a conduit borrower of tax-exempt bond issues that allocates portions of each issue to certain subsidiaries, including the organization. The outstanding bond liability allocated to this organization is reported on Form 990, Part X, Balance Sheet, and Part VI herein. With the exception of this portion of Part VI, the Schedule K for this organization is reporting information for the entire bond issue.
Schedule K, Part I, Column E The filing organization received bond proceeds in the amounts of: $629,448,648 from the 2016B issue, $15,870,248 from the 2017A issue, and $699,997,776 from the 2018A issue. The difference between the issue price reported in Part I, Column (E) and the proceeds of issue in part II, Line 3 is due to investment earnings.
SCHEDULE K, PART II, LINE 7 Issuance costs were funded through equity contributions.
Schedule K (Form 990) 2021

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Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 19,716,974 Indpndt Contractor Arrangement   No
(2) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 18,198,984 Indpndt Contractor Arrangement   No
(3) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 16,426,501 Indpndt Contractor Arrangement   No
(4) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 5,177,715 Indpndt Contractor Arrangement   No
(5) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 4,345,866 Indpndt Contractor Arrangement   No
(6) Alameda Anesthesia Assoc Med Group See Part V 3,607,718 See Part V   No
(7) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2,559,036 Indpndt Contractor Arrangement   No
(8) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1,411,907 Indpndt Contractor Arrangement   No
(9) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1,047,412 Indpndt Contractor Arrangement   No
(10) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 509,878 Indpndt Contractor Arrangement   No
(11) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 351,565 Indpndt Contractor Arrangement   No
(12) Lori Petrini Daughter of Officer 143,504 Compensation as Employee   No
(13) SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 125,732 Indpndt Contractor Arrangement   No
(14) Anthony Wagner II Son of Board Member 42,461 Compensation as Employee   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part IV David Black, MD, SBH Director/Chair, is the managing partner and CEO of Alameda Anesthesia Associates Medical Group. SBH contracts with the medical group through a professional services agreement. ANTHONY WAGNER II IS THE SON OF DIRECTOR, ANTHONY WAGNER, AND IS EMPLOYED BY SBH AS AN HR BUSINESS PARTNER. LORI PETRINI IS THE DAUGHTER OF SBH OFFICER, JULIE A. PETRINI, AND IS EMPLOYED BY SBH AS A BUSINESS DEVELOPMENT MANAGER.
Schedule L (Form 990) 2021


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SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 5 910,122 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Bottles of Wine ) X 2 1,404 FMV
26 Other Right pointing arrow large image ( Wellness Juice ) X 1 1,200 FMV
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2021)
Schedule M (Form 990) (2021)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
PART I, COLUMN (B) COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.
Schedule M (Form 990) (2021)

Additional Data


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

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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

94-0562680
Return Reference Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1 MISSION STATEMENT: WE ENHANCE THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES.
FORM 990, PART III, LINE 4A Sutter Bay Hospitals (SBH) is a group of medical facilities located in the Greater Bay Area and consists of California Pacific Medical Center, Eden Medical Center, Mills-Peninsula Medical Center, Novato Community Hospital, Sutter Lakeside Hospital, Sutter Santa Rosa Regional Hospital, Eden Medical Center, Alta Bates Summit Medical Center, and Sutter Delta Medical Center. Sutter Bay Hospitals had a total of 444,191 patient days in 2021. California Pacific Medical Center (CPMC) is one of the largest private, community based, not-for-profit, teaching medical centers in California. CPMC is a tertiary referral center providing access to leading edge medicine while delivering the best possible personalized care. It provides a wide variety of services, including acute, post-acute and outpatient hospital care; hospice services; preventive and complementary care; and health education. CPMC comprises four of the oldest hospitals in San Francisco. The Davies Campus, formerly Davies Medical Center, was founded in 1854 to help San Francisco's German-speaking immigrants find work, shelter, food, clothing and health care. The Pacific Campus was founded in 1857 and was the first medical school in the American West. The California Campus was founded in 1875 as the Pacific Dispensary for Women and Children, a hospital run by women, for women. In August 2018, CPMC completed the seismic build of the new Mission Bernal Campus to replace the former facility. The Mission Bernal Campus formerly St. Luke's Campus, was formed in the 1870's and had been providing quality health services to all San Franciscans for over 140 years. In March of 2019, CPMC completed the Van Ness Campus which has replaced inpatient acute care services for both the California Campus and Pacific Campus. Together the Van Ness, Mission Bernal, Davies, and Pacific campuses comprise CPMC's 603 licensed beds. Eden Medical Center (EMC) Eden Medical Center is a state-of-the-art facility that replaced the old Eden Medical Center in December 2012. Eden Medical Center brings together patient-centered care, technology and sophisticated design in a LEED-certified sustainable and seismically-safe building. The facility has 130 private patient rooms, with an additional 34-bed Universal Care Unit and is home to the Sutter East Bay Neuroscience Institute, a Primary Stroke Center, the regional Level II Trauma Center for Southern Alameda County, and a wide range of Centers of Excellence including cancer care, advanced imaging services, rehabilitation and complete surgical and acute-care services. Our award-winning hospital has been recognized by the following organizations: - The Centers for Medicare and Medicaid Services (CMS) | Eden Medical Center earned four stars out of five, higher than the National average of three stars, in the CMS Overall Hospital Quality Star Ratings. - Cal Hospital Compare | Maternity Care Honor Roll. - American Stroke Association | Get with the Guidelines for Stroke Care, Gold Plus, Target Stroke Elite Honor Roll. - American Heart Association | Get with the Guidelines for Heart Failure, Bronze - Human Rights Campaign | Leader in LGBT Healthcare Equality - Health Grades | Eden Medical Center was ranked among America's 50 Best Hospitals for overall Clinical Quality and among America's 100 Best Hospitals in Stroke and Critical Care. Eden Medical Center also earned Clinical Excellence Awards in Neurosciences, Stroke, Gastrointestinal and Critical Care. Eden Medical Center was named among the Top 5% of hospitals in the Nation for Stroke and Critical Care. - U.S. Department of Health and Human Services | Hospital Organ Donation Platinum Award - Blue Cross Blue Shield Association | Blue Distinction Center for Maternity Care and Knee and Hip Replacement - Sutter President's Award for Living the Sutter Values - Transition of Care Pharmacy - Donor Network Work Place Partnership for Life 2020 Platinum Award - Donor Network West Innovation Award for Organ Donation Eden Medical Center is part of the Sutter Health network of care, a family of doctors, not-for-profit hospitals and other health care service providers that join resources and share expertise to advance health care quality and access for patients in more than 100 Northern California cities and towns. Mills-Peninsula Medical Center (MPMC) was founded by prominent Californian Elizabeth Mills Reid, in 1908 with just six beds. To meet the growing needs of the community, Mills-Peninsula opened a new 241-bed hospital in 2011. Located in Burlingame, the 450,000 square foot general acute care hospital features 24-hour emergency care, all private patient rooms, and family sleeping accommodations in all medical/surgical, obstetric, intensive care, and neonatal intensive care rooms and 60 psychiatric beds. MPMC also includes: - Mills Health Center in San Mateo which provides a wide range of outpatient services, including surgery, rehabilitation and diagnostics. The Mills Health Center is also home to Mills-Peninsula's inpatient rehabilitation program. - Mills-Peninsula Senior Focus program serving as educator, service provider, and advocate for elders both in the hospital and at home in the community. Our award-winning hospital has been recognized by the following organizations: - Healthgrades America's 50 Best Hospitals. Mills-Peninsula is in the top 1% of hospitals in the nation for providing overall clinical excellence across a broad spectrum of conditions and procedures. Also recognized among America's 100 Best for Cardiac Care, Critical Care, Coronary Intervention Excellence. - American Heart Association, American Stroke Association. Stroke Gold Plus Quality Achievement Award, recognizing performance for 24 consecutive months or more, with Target Stroke Honor Roll for time to thrombolytic therapy, Type 2 Diabetes Honor Roll. Gold Quality Achievement Award for high quality heart failure. - U.S. News & World Report - Among the top hospitals in Northern California Metro Area. - American College of Surgeons National Surgical Quality Improvement Program - Meritorious status for exemplary outcomes for surgical care in the high-risk category. - Five Star Rating from CMS - Earned Five Stars - The highest ranking possible from the Centers for Medicare and Medicaid Services (CMS). - Women's Choice - Best 100 hospitals for patient experience. - Baby Friendly USA - Baby Friendly Hospital designation. - Silver level Baldrige at the California state-level - American College of Emergency Physicians (ACEP): Geriatric Emergency Department Accreditation Sutter Maternity and Surgery Center of Santa Cruz opened in 1996 and offers state-of-the-art maternity and medical/surgical services, combining patient-centered care and family convenience with the safety and security of a licensed and accredited acute care hospital. With 28 licensed beds, doctors and midwives staff our maternity services. The facility has six operating rooms, three procedure suites, 12 birthing suites and 16 medical/surgical patient suites. The hospital is fully accredited by The Joint Commission. Sutter Maternity & Surgery Center has earned recognitions that include: - Human Rights Campaign Leader in LGBTQ Healthcare Equality - Baby-Friendly Hospital designation: Re-certification by the World Health Organization, United Nations Children's Fund - The Joint Commission Perinatal Certification as a Center of Excellence - American Society of Gastroenterology Unit Recognition Program - Center of Excellence in Robotic Surgery - Center of Excellence in Minimally Invasive GYN Surgery Novato Community Hospital (NCH) has served the Northern Marin and Southern Sonoma communities since 1961. NCH is a 47 bed acute care hospital which operates a 24-hour Emergency Department, inpatient/outpatient surgery, a critical care unit, imaging services, outpatient laboratory, physical therapy and is noted for its orthopedic surgery program. Sutter Santa Rosa Regional Hospital (SSRRH), formerly Sutter Medical Center Santa Rosa, has a long history in Sonoma County dating back to 1866 when the hospital first opened. The 84 bed state-of-the art medical facility opened in 2014 with a full range of five-star personalized care services.
FORM 990, PART III, LINE 4A (CONTINUED) Sutter Lakeside Hospital (Lakeside) is a 25 bed critical access care Hospital and is one of only two hospitals that serve the 68,000 residents of Lake County, California. Sutter Lakeside provides a wide variety of services, including acute, post-acute and outpatient hospital care; surgical services; family birth services; preventive care; and primary care and specialty care through two rural health clinics. - Get with the Guidelines Gold Plus award for Heart Failure - CMQCC Maternity Honor Roll - National recognition for glycemic control from the Society of Hospital Medicine - Awarded LGBTQ+ Healthcare Equality Leader - Sutter Health Quality Award Winner - Stroke Center designation - Trauma Center designation - Four Star Rating from CMS - Patient survey ratings. Alta Bates Summit Medical Center (ABSMC) is located on three campuses in Oakland and Berkeley. It is licensed for 824 acute care beds and 68 psych beds. ABSMC operates Medical Center Magnetic Imaging, a freestanding imaging center, and Alta Bates Perinatal Center. Specialty hospital services include the following: acute rehabilitation, bariatrics, behavioral health, cardiovascular surgery, comprehensive community cancer center, East Bay AIDS Clinic, Level III NICU. -U.S. News & World Report - Alta Bates Summit was ranked among the top 55 hospitals in California and recognized as one of the best hospitals in the San Francisco Bay Area region and #7 in the San Francisco metro area. Alta Bates Summit received "high performer" recognition in Heart Bypass Surgery; Congestive Heart Failure; and Chronic Obstructive Pulmonary Disease (COPD). -American College of Surgeons | Meritorious Award for quality of surgical care, National Surgical Quality Improvement Program (ACS NSQIP for eighth time in 11 years). Alta Bates Summit is one of only 89 hospitals out of 719 participating NSQIP hospitals in the nation to achieve meritorious outcomes for surgical patient care. -For nine consecutive years, Alta Bates Summit has earned the American Heart Association/American Stroke Association's (AHA/ASA) Get With The Guidelines Gold Plus Quality Achievement Award. In addition, Alta Bates Summit achieved the Target Stroke Elite Honor Roll Award for the quick treatment of stroke patients with the clot-breaking drug: tissue plasminogen activator, or tPA. -Alta Bates Summit's Comprehensive Cancer Center Receives reaccreditation by the Quality Oncology Practice Initiative (QOPI) Certification Program. The QOPI Certification Program provides a three-year certification for outpatient hematology-oncology practices that meet the highest standards for quality cancer care. -Healthgrades America's 100 Best Hospitals. Alta Bates Summit is in the top 5% of hospitals in the nation for providing overall clinical excellence across a broad spectrum of conditions and procedures. The Summit Campus also earned Clinical Excellence Awards in Cardiac Care, Cardiac Surgery, and Patient Safety. Both campuses earned Clinical Excellence Awards in Stroke, Critical, and Pulmonary Care, with the Alta Bates Campus also earning a Clinical Excellence Award in Neurosciences. -California Health and Human Services honors Alta Bates Summit as being among the lowest cesarean section (C-section) rates in the state and reducing C-sections for first-time moms with low-risk pregnancies. -Baby-Friendly Hospital Designation: Alta Bate Summit has achieved the Baby-Friendly Designation from Baby-Friendly USA, the independent organization that evaluates hospitals on how well they adhere to the evidence-based practices recommended by the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) for optimal newborn feeding support. -Blue Cross Blue Shield Association: The Summit Campus earned Blue Distinction Center designation for Bariatric Surgery, and Knee and Hip Replacement. The Alta Bates Campus earned Blue Distinction Center designation for Knee and Hip Replacement, Maternity Care and Spine Surgery. -Alta Bates Summit earns the Society of Thoracic Surgeons (STS) prestigious 3 Star rating. The 3 Star rating represents the highest award for heart surgery practices participating in STS national specialty database. -Healthcare Equality Index: Alta Bates Summit Medical Center recognized as a "Leader in LGBTQ Healthcare Equality" from the Human Rights Campaign Foundation. -Forbes Best Employer | Sutter Health was named one of the 100 best place to work in the state of California. -Forbes Best Employer | Sutter Health was named one of 22 healthcare systems on Forbes' 2020 list of America's Best Employers for Women. Sutter Delta Medical Center (SDMC) is located in Antioch, CA. SDMC is licensed for 141 acute care beds and is a designated STEMI receiving center. Specialty hospital services include breast health, Wound Care Center, Oncology, Pain Management, Neonatal ICU, Diabetes, Heart Failure and COPD. Sutter Bay Hospitals Clinical programs include: -Arthritis Support Services Program -Asthma Education Program -Asthma Management Resource Center -Breast Feeding Centers -Breast Feeding Support Program -Breast Health Centers -California Pacific Medical Center Research Institute -Cancer Recovery Programs -Care Transitions Nurse Program and ED Navigator Program -Coming Home Hospice -Community Benefits Programs (detailed below) -Community Event Donations and Sponsorships -Community Health Fairs and Education -Community Health Resource Center -Comprehensive Stroke Center -Diabetes Education Program -Diabetes Discharge Program (DDP) -Disable Community Health Clinic -End-Stage Organ Failure/Transplantation Programs (Heart, Kidney, Liver, Pancreas) -Every Woman Counts/Save a Life Sister -Forbes Norris MDA/ALDS Center -Hand Clinic -Hospitalist Program -Healthy Families, Medi-Cal and County Enrollments -Hospital Quality Assurance CHFT Pledge -Infant Follow-Up Program -Institute for Health and Healing -Irene Swindells Alzheimer's Residential Care Center -Labor and Delivery Parent Education/Childbirth Education Program -La Clinical Pittsburg Clinic -Lions Eye Clinic -Low Vision Rehabilitation Center -Neonatal Transport -Muscular Dystrophy Association Neuromuscular Clinic -Pacific Vision Foundation -Palliative Care Program -Physical and Occupational Therapy Educational Program -Psychiatric Evaluation Reimbursement to On-Call Physician -Rehabilitation Services (Acute and Outpatient) -Rehab Caregivers Support Group -Residency Training and Fellowship Programs -Sibling Center -Smith Kettlewell Eye Research Institute (They are independent of CPMC.) -Special Care Nursery Subsidized Service -Special Connections Program -Stroke Support Group Program -Sub-Acute Care Program -Support after Neonatal Death (SAND) -Telemedicine Service (Stroke) -Tele-Care Program -The Parent Share Support Program -Visiting Nurses and Hospice of San Francisco -Ventricular Assist Device (VAD) program -Whitney Newborn ICU Follow-Up Clinic -Women's Health Programs -Women's Health Resource Center Clinical service offerings include: -AIDS & HIV Services -Arthritis -Bariatric Surgery Services -Cancer Services -Cardiovascular Services -Chronic Disease Services -Clinical Laboratory -Complementary Medicine -Comprehensive Stroke Services -Critical Care Services -Diabetes Services (Adult & Pediatric) -Diagnostic Services/Laboratories -Dialysis Services -Emergency Services -Epilepsy -Gastroenterology Disease Services -Home Health & Hospice -Interventional Endoscopy Services -Kalmonovitz Child Development Centers -Medical Transport Services -Microsurgery and Limb Salvage Services -Neonatal Intensive Care -Neurology -Neuro-oncology Surgery -Nuclear Medicine -Nutrition and Weight Management -Obstetrics & Gynecology -Occupational Health -Older Adult Services -Oncology Services -Ophthalmology -Organ Transplantation -Orthopedics -Otolaryngology -Outpatient Clinics & Services -Pathology -Pediatric Emergency Department -Pediatric Specialty Services -Perioperative Services (OR and Post-Anesthesia Recovery Unit) -Pharmacy -Physical Medicine & Rehabilitation Services -Psychiatry -Radiology & Diagnostic Imaging -Rehabilitation Services -Respiratory Care -Surgical Services/Ambulatory Surgery -Urgent Care Center -Wound Care -Women and Infant Services -Women's Services
FORM 990, PART III, LINE 4A (CONTINUED) Non-clinical services include: -ABSMC Nursing Education -Administrative Services -Care Transitions Nurse Program and ED Navigator Program -Chaplaincy Services -Charity Care Program -Community Health Resource Center -Continuing Medical Education -Health Ministry Program -Health Science Libraries -Interpreter Services -Interim Care Program for Homeless -MPI -Patient Assistance Fund -Patient Services -Research Institute -Surgical Training Center -Volunteer Services -Web Nursery -California Pacific Medical Center Foundation -Novato Community Hospital Development Office -Samuel Merritt College -Scholarships and Funding for Professional Education -Sutter Lakeside Foundation -Thunder Road -Transportation -Tuition Reimbursement -Youth Bridge Career Development Program Community Benefit The medical facilities in Sutter Bay Hospitals (SBH) play integral roles in providing direct health care services as well as monetary grants or sponsorships to non-profit organizations to address the community health needs of vulnerable, underinsured, and uninsured populations in their communities. The community benefit representatives of SBH work collaboratively and in partnerships with a broad and diverse network of community-based non-profits, city and county agencies, physicians, and neighborhood groups to identify local needs, formulate community benefit plans, and take appropriate funding actions. While SBH management sets overall goals for community benefits, each of the facilities medical center administrators are responsible for identifying how local needs are to be addressed. In fiscal year 2021, Sutter Bay Hospitals provided a regional total of $497 million in cost of services and benefits for the poor and underserved: $6,216,839 Community Health Improvement Services, $44,622,890 in Health Professionals Education, $33,846,441 Subsidized Health Services, $5,209,819 in Research, $17,653,322 in Financial and In-Kind Contributions, $42,204 in Community Building Activities and $2,203,511 in Community Benefit Operations, while providing $42,671,987 in Financial Assistance with Means-Tested Programs of $18,787,088 and Medicaid $325,875,686.
FORM 990, Part VI, Line 4 SIGNIFICANT CHANGES TO ORGANIZATIONS GOVERNING DOCUMENTS: IN 2021, SUTTER BAY HOSPITALS UPDATED ITS BYLAWS TO CHANGE THE NUMBER OF BOARD OF DIRECTORS. THE FORMER BYLAWS NOTED BETWEEN SEVENTEEN (17) TO TWENTY-FIVE (25) BOARD MEMBERS. THE AMENDED BYLAWS STATE THERE CAN BE BETWEEN NINE (9) AND NINETEEN (19) BOARD MEMBERS.
FORM 990, PART VI, LINE 6 & 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS: THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS: SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION ORANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL.
FORM 990, PART VI, LINE 11B PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW FORM 990: SUTTER HEALTH HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED.
FORM 990, PART VI, LINE 12 PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST: EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. THE BOARD MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR (OR COMMITTEE CHAIR AS APPLICABLE) MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL LEAVE THE ROOM PRIOR TO THE BOARD'S FINAL DISCUSSION AND VOTE.
FORM 990, PART VI, LINES 15A & 15B PROCESS FOR DETERMINING COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE), (C) TOTAL DIRECT CASH (BASE SALARY + ANNUAL INCENTIVE + LONG TERM INCENTIVE) AND (D) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY ADJUSTMENTS MAY BE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL ANNUALLY, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE 2021 EXECUTIVE COMPENSATION APPROVAL WAS COMPLETED IN FEBRUARY 2021.
FORM 990, PART VI, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, COI POLICY & FINANCIAL STATEMENTS: THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
FORM 990, PART VII, SECTION A THE FOLLOWING BOARD MEMBERS OF THE ORGANIZATION ARE FULL-TIME EMPLOYEES (40 HOURS PER WEEK) OF SUTTER HEALTH AND THEIR SUTTER HEALTH SALARIES ARE REPORTED HEREIN. THESE INDIVIDUALS RECEIVE NO COMPENSATION FOR THEIR SERVICE AS BOARD MEMBERS OF THIS ORGANIZATION. - JAMES CONFORTI - SARAH KREVANS INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID FULLTIME BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF SUTTER HEALTH, A SEPARATE LEGAL ENTITY. IT IS THE INTENTION OF SUTTER HEALTH AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE SUTTER HEALTH EMPLOYEES WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION.
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE: EQUITY TRANSFERS (NET) $ 244,368,547 K-1 ACTIVITY (27,744,975) Partnership Income on Books 27,519,162 ANNUITY TRUE-UP (2,199,870) CHANGE IN SPLIT INTEREST 288,659 DONATED LONG LIVE ASSETS 270,000 Stock and Other Items 13,618 --------------- TOTAL $242,515,141 ===============
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SUTTER BAY HOSPITALS
 
Employer identification number

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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) CATHEDRAL HEIGHTS LLC
633 Folsom St 7th Fl
SAN FRANCISCO,CA94120
20-0511266
RENTAL PROP. CA   0 NA
 
(2) MEDICAL CENTER MAGNETIC IMAGING LLC
350 HAWTHORNE AVE
OAKLAND,CA94609
56-2442446
HEALTHCARE CA   0 NA
 
(3) ALTA BATES SUMMIT MED CTR SURG PRPTY CO
350 HAWTHORNE AVE
OAKLAND,CA94609
BLDG RENTAL CA   0 NA
 






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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)CALIFORNIA PACIFIC MEDICAL CTR FOUND
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-2728423
FUNDRAISING CA 501(C)(3) 7 SUTTER BH
 
Yes
 
(2)EAST BAY PERINATAL CENTER
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
51-0172285
HEALTHCARE CA 501(C)(3) 3 SUTTER BH
 
Yes
 
(3)MEMORIAL HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-2290244
FUNDRAISING CA 501(C)(3) 12A - I SUTTER VH
 
Yes
 
(4)MILLS-PENINSULA HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
23-7288765
FUNDRAISING CA 501(C)(3) 7 SUTTER BH
 
Yes
 
(5)SAMUEL MERRITT UNIVERSITY
450 30TH STREET STE 2840

OAKLAND,CA94609
94-2992642
UNIVERSITY CA 501(C)(3) 2 SUTTER BH
 
Yes
 
(6)SUTTER AUBURN FAITH HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-2594966
FUNDRAISING CA 501(C)(3) 7 SUTTER VH
 
Yes
 
(7)SUTTER BAY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-1156581
HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(8)SUTTER COAST HOSPITAL
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-2988520
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(9)SUTTER DAVIS HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
68-0217870
FUNDRAISING CA 501(C)(3) 7 SUTTER VH
 
Yes
 
(10)SUTTER HEALTH
2200 RIVER PLAZA DRIVE

SACRAMENTO,CA95833
94-2788907
SUPPORTING OR CA 501(C)(3) 12C III-FI NA
 
 
No
(11)SUTTER HEALTH PACIFIC
91-2301 FT WEAVER RD

EWA BEACH,HI96706
99-0298651
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(12)SUTTER HEALTH PLAN
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
46-1183948
HEALTH PLAN CA 501(C)(4) N/A SUTTER HLTH
 
Yes
 
(13)SUTTER INSURANCE SERVICES CORPORATION
745 FORT STREET SUITE 1110

HONOLULU,HI96813
99-0289310
INSURANCE SER HI 501(C)(3) 12C III-FI SUTTER HLTH
 
Yes
 
(14)SUTTER MEDICAL CENTER FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-2788906
FUNDRAISING CA 501(C)(3) 7 SUTTER VH
 
Yes
 
(15)SUTTER ROSEVILLE MEDICAL CTR FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
68-0040113
FUNDRAISING CA 501(C)(3) 7 SUTTER VH
 
Yes
 
(16)SUTTER VALLEY HOSPITALS
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-1156621
HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(17)SUTTER VALLEY MEDICAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
68-0273974
HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(18)SUTTER VISITING NURSE ASSOC AND HOSPICE
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
94-6068843
HEALTHCARE CA 501(C)(3) 10 SUTTER HLTH
 
Yes
 
(19)TRACY HOSPITAL FOUNDATION
C/O SH TAX 2200 RIVER PLAZA DR

SACRAMENTO,CA95833
68-0318845
FUNDRAISING CA 501(C)(3) 12A - I SUTTER VH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) SURG CTR OF ABSMC

3875 TELEGRAPH
OAKLAND,CA94609
47-0946086
Patient Care CA SUTTER BH
 
        No 0      
(2) CA PACIFIC ADV IMAG

PO BOX 6102
NOVATO,CA94598
56-2311840
Patient Care DE SUTTER BH
 
        No 0      
(3) SF ENDOSCOPY CENTER

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
91-2160588
Patient Care CA SUTTER BH
 
        No 0      
(4) PRESIDIO SURG CNTR

1635 DIVISADERO
SAN FRANCISCO,CA94115
32-0144060
Patient Care CA SUTTER BH
 
        No 0      
(5) SUTTER FAIRFIELD SURGERY CENTER LLC

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
30-0233892
Patient Care CA NA
 
                 
(6) SUTTER AMADOR SURGERY CENTER LLC

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
46-1398093
patient care CA NA
 
                 
(7) ROSEVILLE ENDOSCOPY CENTER

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
87-0710513
patient care CA NA
 
                 
(8) STANISLAUS SURGICAL HOSPITAL LLC

1421 OAKDALE ROAD
MODESTO,CA95355
91-1754157
patient care CA NA
 
                 
(9) MEMORIAL MEDICAL BUILDING 1

1800 COFFEE RD 76
MODESTO,CA95355
77-0234236
OFFICE RENTAL CA NA
 
                 
(10) MAGNETIC IMAGING AFFILIATES LLC

2125 OAK GROVE ROAD
WALNUT CREEK,CA94598
47-3696091
PATIENT CARE CA SUTTER BH
 
        No 0      
(11) ASC OPERATORS - SANTA ROSA LLC

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
26-3386169
care manageme CA NA
 
                 
(12) ASC OPERATORS - SAN LUIS OBISPO LLC

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
27-2673776
care manageme CA NA
 
                 
(13) CARLSBAD SURGERY CENTER LLC

6121 PASEO DEL NORTE STE 100
CARLSBAD,CA92011
20-1413484
patient care CA NA
 
                 
(14) COAST CTR FOR ORTHOPEDIC & ARTHROSCOPIC

3444 KEARNY VILLA ROAD
SAN DIEGO,CA92123
33-0839637
patient care CA NA
 
                 
(15) OTAY LAKES SURGERY CENTER LLC

955 LANE AVE SUITE 100
CHULA VISTA,CA91914
20-0794766
patient care CA NA
 
                 
(16) ICG CREDIT OPPORTUNITIES FUND LP

11111 SANTA MONICA BLVD SUITE 2100
LOS ANGELES,CA90025
81-4220441
INVESTMENTS CA NA
 
                 
(17) MADISON INTERNATIONAL GLOBAL VALUE REAL

410 PARK AVENUE 10TH FLOOR
NEW YORK,NY10022
98-1310251
INVESTMENTS NY NA
 
                 
(18) DIVISADERO HOLDINGS LLC

1635 Divisadero Street Suite 200
SAN FRANCISCO,CA94115
32-0621050
Outpatient su CA NA
 
                 
(19) PENINSULA ENDOSCOPY

2200 RIVER PLAZA
SACRAMENTO,CA95833
27-1905059
PATIENT CARE CA SBH
 
RELATED 2,129,055 3,359,029   No 0   No 45.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) SUTTER HEALTH DEFERRED COMP PLANS' TRUST

2200 RIVER PLAZA DRIVE
SACRAMENTO,CA95833
27-6851989
RABBI TRUST CA NA
 
TRUST       Yes  
(2) NORTHWOOD EUROPE TE FEEDER LP

1819 WAZEE ST 2ND FLOOR
DENVER,CO90202
98-1272216
HOLDING COMPANY CJ SUTTER HLTH
 
C CORP       Yes  
(3) HEALTH VENTURES INC

350 HAWTHORNE AVE
OAKLAND,CA94609
94-2918780
HEALTH SERVICES CA SUTTER BH
 
C CORP       Yes  
(4) LYXSOP SEGREGATED PORTFOLIO 1

PO BOX 10008
WILLOW HOUSE CRICKET SQ,GRAND CAYMAN  
CJ
INVESTMENT CJ SUTTER HLTH
 
C CORP       Yes  
(5) LYXSOP SEGREGATED PORTFOLIO 2

PO BOX 10008
WILLOW HOUSE CRICKET SQ,GRAND CAYMAN  
CJ
INVESTMENT CJ SUTTER HLTH
 
C CORP       Yes  
(6) AQR REAL RETURN OFFSHORE FUND LP

89 NEXUS WAY
CAMANA BAY,GRAND CAYMANKY1-9009
CJ
98-0700570
INVESTMENT CJ SUTTER HLTH
 
c corp       Yes  


Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Sutter Health Plan

S 82,295,827 FMV
(2) Sutter Insurance Services Corporation

P 34,666,123 FMV
(3) California Pacific Medical Center Foundation

Q 15,098,526 FMV
(4) California Pacific Medical Center Foundation

C 28,612,135 FMV
(5) California Pacific Medical Center Foundation

M 7,335,868 FMV
(6) Mills-Peninsula Hospital Foundation

P 494,078 FMV
(7) Mills-Peninsula Hospital Foundation

C 7,828,454 FMV
(8) Mills-Peninsula Hospital Foundation

M 2,495,723 FMV
(9) Health Ventures Inc

Q 639,251 FMV
(10) Samuel Merritt University

Q 539,279 FMV
(11) THE SURGERY CTR OF ALTA BATES SUMMIT MED CTR

P 85,938 FMV
(12) Sutter Bay Medical Foundation

Q 4,372,351 FMV
(13) East Bay Perinatal Center

R 2,276,399 FMV
(14) Sutter Bay Medical Foundation

S 55,063,781 FMV
(15) Sutter Valley Hospitals

S 53,391,982 FMV
(16) Sutter Valley Medical Foundation

S 261,929 FMV
(17) Sutter Bay Medical Foundation

C 619,495 FMV
(18) Sutter Bay Medical Foundation

B 448,869 FMV
(19) Sutter Bay Medical Foundation

J 10,270,182 FMV
(20) California Pacific Advanced Imaging LLC

J 161,229 FMV
(21) East Bay Perinatal Center

J 212,953 FMV
(22) Magnetic Imaging Affiliates LLC

J 653,596 FMV
(23) Samuel Merritt University

J 4,018,746 FMV
(24) THE SURGERY CTR OF ALTA BATES SUMMIT MED CTR

J 709,187 FMV
(25) Sutter Bay Medical Foundation

K 950,963 FMV
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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