2014-08-13T18:37:23-05:00 2013-09-30 ERNST & YOUNG US LLP 18111 VON KARMAN AVENUE SUITE 1000 IRVINE CA 92612 990 2012-10-01 951643327 HOAG MEMORIAL HOSPITAL PRESBYTERIAN % Jennifer Mitzner HOAG 9497644624 One Hoag Drive box 6100 Suite Newport Beach CA 926586100 andrew guarni 2014-08-13 9497942300 2012 2015-11-30 17:44:51Z Robert Braithwaite ONE HOAG DRIVE NEWPORT BEACH CA 926586100 1443428949 false X WWW.HOAG.ORG X 1944 CA Our mission as a not-for-profit, faith-based hospital is to provide the highest quality health care services to the communities we serve. 18 13 5559 1600 4071844 43891293 27150246 791587501 819803004 15561345 29170024 20224648 36594478 871264787 912717752 5695206 7373264 0 0 356147500 375338238 0 0 0 429717266 441947125 791559972 824658627 79704815 88059125 2270288695 2392484752 824008683 749125003 1446280012 1643359749 X Our mission as a not-for-profit, faith-based hospital is to provide the highest quality health care services to the communities we serve. false false 517929623 7373264 850638703 Executive Summary The Community Health department at Hoag Memorial Hospital Presbyterian was established in 1995. Since its beginning the program has focused on two principal strategies: - Provide necessary healthcare-related services which are unduplicated in the community. - Provide financial support to existing community based not-for-profit organizations which already provide effective healthcare and related social services to meet community health needs. The Department of Community Health, led by its Director, Gwyn Parry, MD, is responsible for the coordination of Hoag's Community Benefit reporting, and provides free programs to assist the underserved in the community. These include Mental Health Services, Community Case Management and Health Ministries Coordination. In addition to these services, many other Hoag departments provide community health services including education and support groups which are free to the community. Hoag also has substantial relationships with local colleges and universities to invest in the education of various health professions. Community Benefit grants support Hoag Health Associates- organizations that provide a broad range of services, including the following: - Free medical and dental care - Adult day care and education for persons who suffer from Alzheimer's disease or mild dementia, with support and education for their caregivers and families - Transportation services for local senior centers Introduction The Hoag Memorial Hospital Presbyterian Community Benefit Program was formalized in 1995 and has grown significantly since that time. We have served over eighty not-for-profit community organizations in a variety of health and social service categories. We continue to emphasize the development of sustained collaborative relationships and the provision of unduplicated services to disadvantaged residents in our community as core elements of the program. Hoag's nonprofit regional healthcare delivery network consists of two acute-care hospitals, five urgent care centers and seven health centers, and has delivered a level of personalized care that is unsurpassed among Orange County's healthcare providers. Renowned for its excellence, specialized health care services and exceptional physicians and staff, Hoag is admired as one of California's leading hospitals. It is one of the county's largest employers with approximately 5,000 employees and 1,600 volunteers. Hoag's network of more than 1,500 physicians represents 52 different specialties. Hoag Hospital Newport Beach, which has served Orange County since 1952, and Hoag Hospital Irvine, which opened in 2010, are designated Magnet hospitals by the American Nurses Credentialing Center (ANCC) and are fully accredited by DNV. In 2013, Hoag entered into an affiliation with St. Joseph Health to further expand health care services in the Orange County Community. Hoag offers a variety of health care services to treat virtually any routine or complex medical condition. Through its medical staff, state-of-the-art equipment and modern facilities, Hoag provides a full spectrum of health care services including five institutes that provide specialized services in the following areas: cancer, heart and vascular, neurosciences, women's health, and orthopedics through Hoag's affiliate, Hoag Orthopedic Institute. To further Hoag's commitment to provide comprehensive care to the communities we serve, Hoag Medical Group was established in 2012 with the core values of excellence, innovation, and compassion. The physician group comprises specialties and sub-specialties in internal medicine, family medicine, pediatrics, geriatrics, sports medicine, vascular medicine, genetics, diabetes, HIV and addiction medicine. Hoag has been named one of the Best Regional Hospitals in the U.S. News & World Report Metro Edition. The organization was ranked nationally for Orthopedics and placed high-ranking in Cancer, Geriatrics, Nephrology, Pulmonary, Gastroenterology, Gynecology, Neurology & Neurosurgery, and Urology. National Research Corporation has endorsed Hoag as Orange County's most preferred hospital for the past 18 consecutive years, and for an unprecedented 18 years, residents of Orange County have chosen Hoag as the county's best hospital in a newspaper survey by the Orange County Register. History Hoag opened in 1952 as a community partnership between the Association of Presbyterian Members and the George Hoag Family Foundation, a private charitable foundation. The George Hoag Family Foundation and the Association of Presbyterian Members represent the two founding organizations of the hospital and continue to provide leadership as corporate members of the Hoag Corporation. These members annually elect the Board of Directors, which consists of 18 members with representatives from the Hoag community and medical staff. The hospitals' Chief Executive Officer is also seated on the board as a voting member. An annual meeting at the end of the fiscal year provides the corporate members the opportunity for the election/re-election of directors for the ensuing year. Since its founding the hospital has welded a strong commitment to the community that it serves, including the provision of services for those who constitute a more vulnerable, at-risk population. Such care, for both inpatients and outpatients, is often only partially compensated. With excellence of management and the diligent stewardship of funds, Hoag has been able to sustain its financial strength. As a result, Hoag has been able to maintain a continuing commitment to quality of care while developing and expanding community programs and partnerships. Most of the funds expended upon Hoag's Community Benefit Program are from operating income. 0 0 0 0 0 0 517929623 true true false true false false false false false false true false false false true false false true false false true false false false false false true true true true true false false false true false false true true false false false false true true true true false false true 747 0 true 5559 true true true false false false false false false false false false X 18 13 true false true false true true true true true false false true true true true true true true true true true CA X X Jennifer Mitzner 9497644411 ONE HOAG DRIVE BOX 6100 Newport Beach CA 926586100 Gary S McKitterick 3.0 1.0 X X 0 0 0 Robert W Evans 3.0 0.0 X X 0 0 0 John L Benner 3.0 0.0 X X 0 0 0 Dennis J Gilmore 3.0 0.0 X 0 0 0 Dick P Allen 3.0 0.0 X 0 0 0 Raymond Ricci MD 3.0 0.0 X 0 0 0 Weston G Chandler MD 3.0 0.0 X 0 0 0 Jake Easton III 3.0 0.0 X 17460 0 0 Max W Hampton 3.0 0.0 X 0 0 0 Jeffrey H Margolis 3.0 0.0 X 0 0 0 Michael D Stephens 3.0 0.0 X 0 0 0 Karen Linden 3.0 0.0 X X 0 0 0 Virginia Ueberroth 3.0 0.0 X 0 0 0 Yulun Wang PhD 3.0 0.0 X 0 0 0 Leslie A Margolin 3.0 0.0 X 10039 0 0 Cindy Stokke 3.0 2.0 X 0 0 0 George H Wood 3.0 0.0 X 0 0 0 Douglas Zusman MD 3.0 0.0 X 0 0 0 Richard Afable end 022813 50.0 9.0 X X 978250 0 228392 richard A norling 3.0 0.0 X stephen jones 3.0 0.0 X Robert Braithwaite 50.0 3.0 X 937145 0 54965 Jennifer Mitzner 50.0 3.0 X 1071872 0 54835 Jack Cox MD 50.0 0.0 X 686465 0 147457 Richard Martin 50.0 0.0 X 735138 0 44618 Sanford Smith 50.0 0.0 X 602641 0 80468 Timothy C L Moore 50.0 0.0 X 723907 0 39785 Cynthia Perazzo 50.0 0.0 X 673958 0 40812 Flynn Andrizzi 3.0 51.0 X 512441 0 49985 Jan Blue 50.0 0.0 X 569225 0 28303 Robert Dillman MD 50.0 0.0 X 433462 0 34742 Michael Brant-Zawadzki MD 50.0 0.0 X 484148 0 28335 Terri Cammarano 50.0 0.0 X 568467 0 32120 James Rice 50.0 0.0 X 382949 0 19435 Stephen Mayfield 50.0 0.0 X 345026 0 43074 Kris Iyer MD 50.0 0.0 X 329690 0 15782 ALLYSON M BROOKS 0.0 0.0 X 276607 0 0 10338890 0 943108 616 true true false Pacific Hospitalist ASSOCIATES 510 Superior Avenue Suite 290 Newport Beach CA 92663 Medical 6146006 ALLSCRIPTS 8529 SIX FORKS ROAD RALEIGH NC 27615 SOFTWARE SYSTEMS 2634090 HOWE BONNEY ASSOCIATES LLC 1411 W 190TH STREET SUITE 355 GARDENA CA 90248 project mgmt 1628267 TAYLOR AND ASSOCIATES 2220 UNIVERSITY DRIVE SUITE 200 NEWPORT BEACH CA 92660 ARCHITECTURE 3070595 NEWPORT CRITICAL CARE 17 EMERALD TRACE ALISO VIEJO CA 92656 MEDICAL 2963254 109 0 13776518 13191644 182084 0 27150246 PATIENT SERVICES 622110 689496183 689496183 0 0 HMO Capitated Payment 622110 98103874 98103874 0 0 MOB Rental Income 531190 20191573 20191573 0 0 Cafeteria Sales 722514 3956474 3956474 0 0 Refunds & Rebates 532299 3031265 3031265 0 0 5023635 5023635 0 0 819803004 17843629 17843629 218 218 54418 54418 0 0 0 541768123 269251 530023671 687526 11744452 -418275 11326177 11326177 0 0 0 0 INCOME FROM PARTNERSHIPS 525990 12606846 12156430 450416 0 MISC-HOI SERVICES 561000 9572753 6563739 3009014 0 CHILD CARE PROGRAM 624410 1632517 0 0 1632517 12727944 12115530 612414 36540060 912717752 850638703 4071844 30856959 X 7351962 7351962 21302 21302 0 0 0 0 10505574 671116 9834458 0 734117 0 734117 0 285662204 199137044 86525160 0 14560374 3338897 11221477 0 42927714 21685224 21242490 0 20948255 14398841 6549414 0 0 0 0 0 3184927 0 3184927 0 668367 2225 666142 0 33680 0 33680 0 0 0 4153709 0 4153709 0 112647355 70966281 41681074 0 1187175 18832 1168343 0 12038978 1821277 10217701 0 8960512 111503 8849009 0 0 0 0 0 40693274 16173810 24519464 0 223240 75100 148140 0 0 0 0 0 707596 143443 564153 0 19411770 19217652 194118 0 0 0 0 0 78304947 24440991 53863956 0 2378101 1238078 1140023 0 Medical Supplies 107411069 106440540 970529 0 QA CA Hospital Fee 25248867 25248867 0 0 ALL OTHER EXPENSES 24693558 5426638 19266920 0 824658627 517929623 306729004 0 0 119594584 93536365 63585347 133926782 0 0 75951414 76040407 2500000 1500000 0 0 2704536 337854 6408505 6110396 10940354 22745236 1486169238 615284201 891989376 870885037 646542056 1064476173 343872874 0 49947698 54944295 0 0 56251951 67982207 2270288695 2392484752 153334453 137439045 0 0 0 7839880 564052132 0 0 0 0 0 0 0 0 0 106622098 603846078 824008683 749125003 X 1446280012 1643207104 0 152645 0 0 1446280012 1643359749 2270288695 2392484752 X 88059125 75223053 33797559 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false 0 false 0 false 0 false 0 false 0 false 0 true 33680 33680 false Lobbying efforts Schedule C, Part II-B, Line 1I Hoag Memorial Hospital Presbyterian (HMHP) pays dues to the Hospital Association of Southern California. A portion of the dues paid by HMHP are spent on lobbying efforts by the Hospital Association. In FY 2013, $33,680 was spent on lobbying. 0 77330825 77330825 849184879 280907417 568277462 103555814 27881897 75673917 443187467 306494887 136692580 12910253 12910253 870885037 0 TAX-EXEMPT BOND LIABILITIES 540711816 Medical Cost Reports 210495 Lease Incentive Obligation-Irvine 13096818 ARO Liability 1804181 Accrued Income Guarantees 8804174 Accrued Malpractice Liability 10922000 Accrued Capitation Liability 25828092 DUE TO ST JOSEPH HEALTH SYSTEM 2468502 603846078 CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740) SCHEDULE d, PART X, LINE 2 The following footnote comes from the consolidated St. Joseph Health System audited financial statements for the year ending 6/30/13: ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY OR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2013 OR 2012. false Central America and the Caribbean Investments 181465106 East Asia and the Pacific Investments 1654591 Europe (Including Iceland and Greenland) Investments 24160845 North America Investments 3434349 210714891 210714891 true false true true true false ACCOUNTING METHOD SCHEDULE F, PART I, LINE 3, COLUMN F THE AMOUNTS REPORTED IN PART I, LINE 3, COLUMN F REPRESENT THE MARKET VALUES OF THE INVESTMENTS IN THE IDENTIFIED REGIONS AS OF THE ORGANIZATION'S FISCAL YEAR ENDED SEPTEMBER 30, 2013. true true X true X true X true true false true true 7730839 7730839 0.00900 55201337 41106487 14094850 0.01710 20804000 6486000 14318000 0.01740 83736176 47592487 36143689 0.04350 7404008 7404008 0.00900 382530 382530 0.00050 1207240 1207240 0.00150 2027738 2027738 0.00250 11021516 11021516 0.01350 94757692 47592487 47165205 0.05450 35103 35103 0.00000 10224 10224 0.00000 7414 7414 0.00000 52741 52741 0.00000 false 22754084 135051705 201379837 -66328132 X false HOAG OTHRO INST SPECIALTY HOSPITAL 0.51000 0.49000 MAIN ST SPEC SURGERY OUTPATIENT SURGERY CTR 0.42360 0.14660 hoag outpatient ctr endoscopy center 0.45250 0.49750 nwpt bch radiosrgry surgery center 0.50000 0.50000 nwpt surgical prtns surgery center 0.15000 0.60000 nwpt bch endoscopy endoscopy center 0.05000 0.55500 2 1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN

ONE HOAG DRIVE BOX 6100 NEWPORT BEACH CA 926586100

X X X X 2 HOAG ORTHOPEDIC INSTITUTE

1250 SAND CANYON IRVINE CA 92614

X ORTHOPEDIC HOSPITAL HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 true X X X X X X X X X 12 true false true X X X X X X X X X X X false false true true 200. true 400. true X X X X X X true true X X X true false X X true X false false HOAG ORTHOPEDIC INSTITUTE 2 false true true 200. true 400. true X X X X X X true true X X X true false X X false X X false false 11 hoag op imaging center

510 superior avenue newport beach CA 92663

imaging center hoag health center - huntington beach

19582 beach boulevard huntington beach CA 92648

health center hoag newport surgicare

1441 avocado suite 100 newport beach CA 92663

outpatient surgery center hoag diabetesptrehab center

520 superior avenue newport beach CA 92663

outpatient diabetes education center irvine imaging center

4870 barranca parkway irvine CA 92614

imaging center hoag health center - aliso viejo

26671 aliso creek road aliso viejo CA 92656

health center health care center - costa mesa

1190 baker costa mesa CA 92626

health center hic woodbury

6352 irvine boulevard irvine CA 62614

health center newport imaging center

360 san miguel newport beach CA 92660

imaging center main st specialty surgery center

280 main st 100 orange CA 92868

outpatient surgery center orthopedic surgery center of orange co

22 corporate plaza dr suite 150 newport beach CA 92660

outpatient orthopedic surgery center SCHEDULE H, PART VI, LINE 1 THE ORGANIZATION'S REQUIRED SCHEDULE H SPECIFIC LINE ITEM DESCRIPTIONS ARE AS FOLLOWS: Part I, Line 6a Hoag Hospital completed the FY2013 Community Benefit report and submitted it to OSHPD in February 2013. The report is available to the public through the Hoag Hospital website http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx PART I, LINE 7a-i COST ACCOUNTING SYSTEM WAS USED TO DERIVE THE COST-TO-CHARGE RATIO. OUR TOTAL COSTS (DIRECT AND INDIRECT) AND TOTAL CHARGES WERE $644,163,000 AND $2,088,657,000, RESPECTIVELY. THIS RESULTED IN A COST-TO-CHARGE RATIO OF APPROXIMATELY 32% WHICH WAS USED TO CALCULATE CHARITY CARE AT COST (GROSS PATIENT CHARGES WRITTEN OFF ON THE P&L TIMES COST-TO-CHARGE RATIO). THE COST ACCOUNTING SYSTEM ADDRESSES INPATIENT, OUTPATIENT AND VARIOUS PAYOR TYPES. FOR THE SECTIONS OF LINE 7 AS APPLICABLE, WORKSHEET 2 WAS NOT USED WHILE THE COST TO CHARGE RATIO WAS USED. PART II - COMMUNITY BUILDING ACTIVITIES The primary purpose of Hoag's Community Building activities is to improve local health in Orange County through a collaborative process with other non-profit organizations and health care delivery systems in providing funding opportunities for health related community initiatives. Hoag participates in a variety of community building such as supporting the Health Funders Partnership of Orange County ($10,224). The goal of the Partnership is to improve local health by enhancing the impact and efficiency of health philanthropy and health service delivery in Orange County. The Partnership addresses this goal by identifying strategic issues for collaborative funding and the potential to leverage community resources. Hoag also assists with community disaster preparedness planning ($35,104). In addition, Hoag partnered with Project SEARCH, a one year, high school transition program which provides skills training and work experience for young adults with disabilities ages 18 to 21. fORM 990, SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE The following footnote comes from the consolidated St. Joseph Health System audited financial statements for the year ending 6/30/13: PAGE 11 OF THE FINANCIAL STATEMENTS - THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED AND OTHERS ARE FROM VARIOUS PAYORS WHO ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS, AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Form 990, Schedule H, Part III, Line 8 MEDICARE COSTING METHODOLOGY Medicare allowable costs were calculated using a cost to charge ratio. The organization does not treat the shortfall from Medicare as a community benefit. FORM 990, SCHEDULE H, PART V, LINE 1 HOAG ORTHOPEDIC INSTITUTE HOAG ORTHOPEDIC INSTITUTE IS ON A CALENDAR TAX YEAR AND THEREFORE 2013 IS THE FIRST YEAR THAT THEY ARE REQUIRED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). FORM 990, SCHEDULE H, PART V, LINE 3 INPUT FROM COMMUNITY REPRESENTATIVES HOAG MEMORIAL HOSPITAL PRESBYTERIAN As part of this Community Health Needs Assessment, two focus groups were held on June 13, 2013. Participants included: physicians, a public health representative, other health professionals, social service providers, business leaders and other community leaders. Hoag recruited the participants for the focus groups. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Final participation included representatives of 20 local organizations. Through this process, input was gathered from a representative of public health, as well as several individuals whose organizations work with low-income, minority (including Hispanic, Asian Americans, and undocumented residents), refugees from Africa and the Middle East, and other medically underserved populations (specifically, children and college age adolescents, elderly, disabled, the uninsured/underinsured, and Medi-Cal recipients). FORM 990, SCHEDULE H, PART V, LINE 5C AVAILABILITY OF CHNA REPORT HOAG MEMORIAL HOSPITAL PRESBYTERIAN This Community Health Needs Assessment is also available to the public using the following URL: http://hoag.healthforecast.net. HealthForecast.net is an interactive, dynamic tool designed to share CHNA data with community partners and the public at large. This site: * INFORMS READERS THAT THE CHNA REPORT IS AVAILABLE AND PROVIDES instructions for downloading it; * OFFERS THE CHNA REPORT DOCUMENT IN A FORMAT THAT, WHEN ACCESSED, downloaded, viewed, and printed in hard copy, exactly reproduces the image of the report; * GRANTS ACCESS TO DOWNLOAD, VIEW, AND PRINT THE DOCUMENT WITHOUT special computer hardware or software required for that format (other than software that is readily available to members of the public without payment of any fee) and without payment of a fee to the hospital organization or facility or to another entity maintaining the website. The 2013 CHNA and Implementation Strategy is posted on the Hoag website: http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx FORM 990, SCHEDULE H, PART V, LINE 7 NEEDS NOT ADDRESSED HOAG MEMORIAL HOSPITAL PRESBYTERIAN In acknowledging the wide range of priority health issues that emerged from the CHNA process, Hoag determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence. Priority Health Issues Not Chosen for Action: * SUBSTANCE ABUSE: SUBSTANCE ABUSE TREATMENT FOR THE VULNERABLE population is currently being addressed on a limited scale by the Chemical Dependency Program at Hoag. Hoag will look for opportunities to collaborate with local community organizations that have the infrastructure and resources to better meet this need. Substance abuse prevention will be addressed through community education and outreach opportunities. * TOBACCO USE: HOAG OFFERS AN EIGHT SESSION SMOKING CESSATION PROGRAM that is free and open to the community. Other community organizations have the infrastructure and programs in place to better meet this need. Limited resources and lower priority excluded this as an area chosen for action. The 2013 CHNA and Implementation Strategy is posted on the Hoag website: http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx FORM 990, SCHEDULE H, PART V, SECTION B, LINE 12H Other basis for calculating amount charged to patient HOAG MEMORIAL HOSPITAL PRESBYTERIAN HOAG PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE FAMILY INCOME LEVELS OF UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES. HOAG GIVES CONSIDERATION TO ELIGIBLE PATIENTS WITH INSURANCE IF THEY INCUR HIGH MEDICAL COSTS AS DEFINED BY CALIFORNIA LAW, AND ALSO HAVE FAMILY INCOMES UP TO 400% OF THE FPL. HOAG'S POLICY ALSO PROVIDES FOR DISCRETIONARY DETERMINATION OF CHARITY CARE TAKING INTO CONSIDERATION INDIVIDUAL FACTS AND CIRCUMSTANCES. HOAG ORTHOPEDIC INSTITUTE HOAG ORTHOPEDIC INSTITUTE PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE FAMILY INCOME LEVELS OF UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES. HOAG GIVES CONSIDERATION TO ELIGIBLE PATIENTS WITH INSURANCE IF THEY INCUR HIGH MEDICAL COSTS AS DEFINED BY CALIFORNIA LAW, AND ALSO HAVE FAMILY INCOMES UP TO 400% OF THE FPL. HOAG ORTHOPEDIC INSTITUTE'S POLICY ALSO PROVIDES FOR DISCRETIONARY DETERMINATION OF CHARITY CARE TAKING INTO CONSIDERATION INDIVIDUAL FACTS AND CIRCUMSTANCES. FORM 990, SCHEDULE H, SECTION B, LINE 14g HOAG MEMORIAL HOSPITAL PRESBYTERIAN and hoag orthopedic institute The Policy is communicated via our website and is communicated via our Financial Counselors at each location. Further, it is communicated in our self pay customer service area along with any external collection vendors as well. Any written letters also offer the assistance program and to contact customer service for an application. FORM 990, SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT In the Spring of 2013, Hoag embarked on a comprehensive Community Health Needs Assessment (CHNA) process to identify and address the key health issues of our community. This assessment was conducted by Professional Research Consultants, Inc. (PRC). PRC is a nationally-recognized healthcare consulting firm with extensive experience conducting Community Health Needs Assessments in communities across the United States since 1994. To access the 2013 CHNA report in its entirety, please visit: http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx The Community Health Needs Assessment (CHNA) is a systematic, data-driven approach to determining the health status, behaviors and needs of residents in the service area of Hoag. Subsequently, this information may be used to inform decisions and guide efforts to improve community health and wellness. A CHNA provides information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. This CHNA will serve as a tool toward reaching three basic goals: - To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life. - To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health. - To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care. This assessment incorporates data from both quantitative and qualitative sources. Quantitative data input includes primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for trending and comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through two Key Informant Focus Groups. The survey instrument used for this study is based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. The final survey instrument was developed by Hoag and PRC. A precise and carefully executed methodology is critical in asserting the validity of the results gathered in the PRC Community Health Survey. Thus, to ensure the best representation of the population surveyed, a telephone interview methodology - one that incorporates both landline and cell phone interviews - was employed. The primary advantages of telephone interviewing are timeliness, efficiency and random selection capabilities. The sample design used for this effort consisted of a random sample of 751 individuals age 18 and older in Hoag's Service Area. All administration of the surveys, data collection and data analysis was conducted by Professional Research Consultants, Inc. (PRC). The sample design and the quality control procedures used in the data collection ensure that the sample is representative. Thus, the findings may be generalized to the total population of community members in the defined area with a high degree of confidence. A variety of existing (secondary) data sources was consulted to complement the research quality of this Community Health Needs Assessment. Data for the service area were obtained from the following sources - California Department of Public Health - Centers for Disease Control & Prevention - National Center for Health Statistics - State of California Department of Justice - US Census Bureau - US Department of Health and Human Services - US Department of Justice, Federal Bureau of Investigation As part of this Community Health Needs Assessment, two focus groups were held on June 13, 2013. Participants included: physicians, a public health representative, other health professionals, social service providers, business leaders and other community leaders. Hoag recruited the participants for the focus groups. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Final participation included representatives of 20 local organizations. Through this process, input was gathered from a representative of public health, as well as several individuals whose organizations work with low-income, minority (including Hispanic, Asian Americans, and undocumented residents), refugees from Africa and the Middle East, and other medically underserved populations (specifically, children and college-age adolescents, elderly, disabled, the uninsured/underinsured, and MediCal recipients). FORM 990, SCHEDULE H, PART VI, LINE 3 Patient education of eligibility for assistance IN ADDITION TO THE VISUAL NOTICES OF ASSISTANCE AVAILABLE, SELF PAY PATIENTS MEET WITH THE FINANCIAL COUNSELOR TO EVALUATE THEIR STATUS. FOR ALL OTHER PATIENTS, THEY WOULD BE EDUCATED AT TIME OF NEED OR UPON PATIENT'S INQUIRY ABOUT THEIR BALANCE. FORM 990, SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION Hoag's community, as defined for the purpose of the Community Health Needs Assessment, included each of the 56 residential ZIP Codes comprising the hospital's service area. This community definition was determined because a majority of Hoag's patients originate from this area. Please refer to Hoag 2013 Community Benefit report at http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx for more detailed information on Hoag's community. The population of the hospital's service area is estimated at 1,874,329 people. The age distribution of our population is similar to that of that nation as a whole, but our area is racially and ethnically much more diverse, with non-Hispanic White residents comprising only a narrow majority of residents. Please refer to Hoag 2013 Community Benefit report at http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx for more details on this information. Other Hospitals in the area include, but are not limited to: - Ahmc Anaheim Regional Medical Center - Anaheim - Anaheim General Hospital (Anaheim, Buena Park) - Chapman Medical Center - Orange - Children's Hospital At Mission - Mission Viejo - Children's Hospital of Orange County - Orange - Fountain Valley Rgnl Hosp and Med Ctr -Fountain Valley - Garden Grove Hospital and Medical Center - Garden Grove - Huntington Beach Hospital - Huntington Beach - Kaiser Permanente (Irvine, Anaheim) - Kindred Hospital (Santa Ana, Westminster) - La Palma intercommunity Hospital - La Palma - Mission Hospital Laguna Beach - Laguna Beach - Mission Hospital Regional Medical Center - Mission Viejo - Orange Coast Memorial Medical Center - Fountain Valley - Saddleback Memorial Medical Center (Laguna Hills/San Clemente) - St. Joseph Hospital - Orange - Orange - St. Jude Medical Center - Fullerton - University of California Irvine Medical Center - Orange - Western Medical Center - Santa Ana FORM 990, SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH - Community Benefit staff continuously assess the health needs of the community by serving on Board of Directors and committees of non profit organizations which allows them to be actively engaged with the community and provide support and strategic direction. - Hoag continues to collaborate with the Department of Education in support of a full-time School-Based County physician to serve the public school system in Orange County. Hoag provides the majority funding for this position. - Hoag Hospital has a relationship with local colleges and universities to invest in the education of various health professions especially with the growing need of bilingual and bicultural health professionals in Orange County. - Hoag Hospital and Share Our Selves (SOS) Clinic have nurtured a unique partnership since 1984 to provide health care to the low income, uninsured, and underinsured individuals residing in the community. The SOS and Hoag collaboration includes more than 150 volunteer healthcare specialists available to provide care to SOS patients by providing diagnostic tests, procedures, hospitalizations and ER visits for SOS patients. In addition, SOS is acquiring a pediatric clinic from the Children's Hospital of Orange County (CHOC). Hoag will be building a physical site for this clinic which will serve primarily low income families from the Costa Mesa and Newport Beach communities. - Hoag Hospital also maintains a unique relationship with the Alzheimer's Family Resource Center (AFSC) which is committed to the mission of improving the quality of life for families challenged by Alzheimer's disease or another dementia through services tailored to meet individual needs. Hoag Hospital owns the AFSC facility and provides it at no charge, including maintenance services as specified in the lease, to the agency. Additionally, the hospital provides annual operating and transportation grants, and in-kind services such as consultation in nursing and compliance-related issues to the center. - HOAG'S MENTAL HEALTH CENTER (MHC) PROVIDES BILINGUAL BICULTURAL SERVICES ON A SLIDING SCALE TO PEOPLE WHO OTHERWISE COULD NOT OBTAIN MENTAL HEALTH SERVICES. During FY 2013, the MHC PROVIDED SERVICES TO 817 CLIENTS IN THE FORM OF PSYCHOTHERAPY, RESOURCE BROKERING, AND/OR CASE MANAGEMENT. - Through the Hoag Health Ministries Program, the Faith Community Nurse's (FCN's) administered 6,540 flu vaccine doses to faith members and other community members. - In collaboration with Hoag's Neurosciences Institute and the Alzheimer's Family Services Center, Hoag Community Benefit sponsored the 2013 Spirituality Conference - Keeping the Care in Caregiving. The conference was attended by 150 community clergy, health care professionals and caregivers. - HOAG HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY THOUGH A CREDENTIALING PROCESS. MEMBERSHIP AND PRIVILEGES ARE GRANTED TO QUALIFIED MD'S, DO'S, AND OTHER ALLIED HEALTH PROFESSIONALS BY THE MEDICAL STAFF AND HOAG HOSPITAL BOARD OF DIRECTORS. - AS A NOT-FOR-PROFIT INSTITUTION, GOVERNANCE IS PROVIDED BY A VOLUNTEER BOARD OF DIRECTORS COMPRISED OF 18 VOTING MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. - THE BOARD OF DIRECTORS ALLOCATE A SIGNIFICANT PORTION OF THE NET OPERATING INCOME TO PROMOTING THE HEALTH OF THE COMMUNITY, SPECIFICALLY SERVING THE NEEDS OF THE UNINSURED AND LOW INCOME COMMUNITIES THROUGH CHARITY CARE AND A VARIETY OF FREE OR LOW COST SERVICES AND PROGRAMS PROVIDED BY THE DEPARTMENT OF COMMUNITY HEALTH. - IN AN EFFORT TO INCREASE THE COMMUNITY POOL OF AVAILABLE TRAINED AND EDUCATED HEALTH PROFESSIONALS, HOAG INVESTS ANNUALLY IN HEALTH PROFESSIONAL TRAINING AND DEVELOPMENT. THE HOSPITAL CURRENTLY WORKS WITH A NUMBER OF PROFESSIONAL GROUPS IN THIS ENDEAVOR, INCLUDING NURSES, PHYSICAL THERAPISTS, PHARMACISTS, LABORATORY PROFESSIONALS, SOCIAL WORKERS, AND CLINICAL CARE EXTENDERS. - Hoag provides uncompensated care (charity) to patients who are unable to pay for the full cost of their care. These expenditures amounted to over $37 million in Fiscal Year 2013 (October 1, 2012 through September 30, 2013.) Hoag's charity care and self pay discount policy states that self-pay and uninsured patients who are unable to pay for the full cost of their care may qualify for charity or discounts on a sliding scale for incomes up to 400% of the federal poverty level. Total quantifiable Community Benefit expenditures (excluding Medicare Cost of Unreimbursed Care) for FY2013 amounted to over $49 million. FORM 990, SCHEDULE H, PART VI, LINE 6 Affiliated health care system Hoag Hospital is a nonprofit regional healthcare delivery network consisting of two acute-care hospitals, five urgent care centers and seven health centers. In 2013, Hoag Hospital became affiliated with St. Joseph Health, an integrated healthcare delivery system sponsored by the St. Joseph Health ministry. St. Joseph Health is organized into three regions: Northern California, Southern California, and West Texas/Eastern New Mexico. The System includes 14 acute care hospitals, home health agencies, hospice care, outpatient services, community clinics, and physician organizations. FORM 990, SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CA true Share Our Selves Clinic 1550 superior ave costa mesa CA 92627 953222316 501(c)(3) 2096082 Free Medical and Dental clinic Alzheimer's Family Services Center 9451 indianapolis ave huntington beach CA 92646 953463978 501(c)(3) 1783569 Operations, Matching Grts, misc grants Childrens Hospital Orange County (CHOC) 455 s main street orange CA 92868 952321786 501(c)(3) 960000 Pediatric Diabetes Services Newport -Mesa Unified School District 2985 a bear street costa mesa CA 92628 952417783 government 250000 Expansion of 13 programs for the HOPE Clinic CHOC Foundation 455 s main street orange CA 92868 956097416 501(c)(3) 225000 IUSD/CHOC Athletic Program, Pledge CVICU/NICU Orange County Dept of Education 200 kalmus drive costa mesa CA 92628 956000943 government 200000 Grant: Support full time physician to OC students Keck School of Medicine of USC 1520 san pablo los angeles CA 90033 951642394 501(c)(3) 180000 Grant: Resident Education and Research Activites . Costa Mesa Senior Center 695 west 19th st costa mesa CA 92627 338265009 501(c)(3) 173237 Senior Transportation and program development City of Huntington Beach Council on Aging 1706 orange ave huntington beach CA 92648 510179431 government 155000 Senior Transportation/Care Managers (2) Home visit ation Age Well Senior Services (S County Sr Svc) 24300 el toro laguna woods CA 92637 931163563 501(c)(3) 147827 Grant: Senior Transportation, Operations of progra ms, Mobile Meals City of Newport Beach po box 1768 newport beach CA 92658 956000751 government 121000 Oasis Senior Center transportation, Police Explore rs, Bike Safety Program Providence Speech & Hearing Center 1301 providence ave Orange CA 92868 956154473 501(c)(3) 115000 Grant: Low income subsidy program and El Sol Clin ic Collaborative Pediatric Adolescent Diabetes Research Edu 455 S Main St Orange CA 92868 330099451 501(c)(3) 92918 Grant: Diabetes Education GRANT AT ALLEN CENTER ONE OC 1901 e 4th st santa ana CA 92705 952021700 501(c)(3) 89000 Grants and Contributions to other Non-profit servi ce organizations Orange County United Way 18012 mitchell ave irvine CA 92614 330047994 501(c)(3) 64522 Hoag employees match contribution, Executive Progr am 2 1 1 Orange County po box 14277 irvine CA 92623 330063532 501(c)(3) 50000 211 Information/Referral Call Center operating sup port Irvine Adult Day Health Services 20 lake road irvine CA 92604 330599371 501(c)(3) 45750 Expansion of Educational programs and Senior Trans portation Access California Services 2180 w crescent ave anaheim CA 92801 330826205 501(c)(3) 45000 Expansion of Mental Health Program and other progr ams Irvine Public Schools Foundation 18552 macarthur blvd irvine CA 92612 330733191 501(c)(3) 41158 Pledge for matching funds Generation Wall Hoag Irv ine Healthy Smiles 10602 chapman ave garden grove CA 92840 383675065 501(c)(3) 38000 Provide children's dental services at Oakview Dist rict in Huntington Bch Juvenile Diabetes Research Foundation 17992 mitchell south irvine CA 92614 231907729 501(c)(3) 35000 Sponsoship Walks,Gala, program support Orange County Human Relations 1300 s grand ave santa ana CA 92705 330438086 501(c)(3) 35000 Bridges School Inter Group Relations & Violence Pr evention programs Someone Care Soup Kitchen 720 w 19th st costa mesa CA 92627 330279080 501(c)(3) 31475 Support towards programs to feed the poor COMMUNITY EDUCATION MOMS 1128 w santa ana santa ana CA 92703 330518078 501(c)(3) 26000 Grant: Support educational programs Clinics City of Irvine po box 19575 irvine CA 92623 952759391 government 25000 Grant: I-CHP - support Childrens Health programs Latino Health Access 1701 n main street Santa Ana CA 92706 330562943 501(c)(3) 25000 Grants for Latino Health probems, Diabetes, etc.. EDUCATION & ADVOCACY Save Our Youth 661 hamilton costa mesa CA 92627 330585600 501(c)(3) 25000 Grant: Operating support DISTRICT IN HUNTINGTON BCH Sweet Success Express Program po box 9705 fountain valley CA 92728 342044369 501(c)(3) 22000 Grant: Diabetes Education Hurrt Family Health Clinic One Hope Drive Tustin CA 92782 330906866 501(c)(3) 21275 Mobile Clinic visits to Oak View Community Center in Huntington Beach Friends of Oasis 801 narcissus rd corona del mar CA 92625 953196296 501(c)(3) 20000 Program Grant for database resources and outreach needs Irvine Childrens Fund 14301 Yale Ave Irvine CA 92604 330177921 501(c)(3) 20000 Provides Before and After School Child Care Schola rships Youth Employment Services 114 east 19th street costa mesa CA 92627 952704522 501(c)(3) 15549 Provide pre-employemnt training, job counseling to young people American Lung Assoc 1570 e 17th st santa ana CA 92705 950362650 501(c)(3) 15000 Scamp Camp, Sponsor Oc Respiratory Rally Irvine Crohn's & Colitis 10350 santa monica Los Angeles CA 90025 136193105 501(c)(3) 15000 Sponsorship: 'Inaugural CCFS Golf Classic Activites. Girls Incorporated of Orange County 1815 anaheim Costa Mesa CA 92627 951810150 501(c)(3) 12000 Community programs - Fit Girls and Families school supplies Academy of International Dance 220 E FOURTH ST COSTA MESA CA 92627 262657759 501(c)(3) 10000 Grant: Expansion of after school activiities, Lite racy, tutoring Alzheimer's Association 17771 COWAN AVE IRVINE CA 92614 953702013 501(c)(3) 10000 Program Grant American Heart Assoc 4600 CAMPUS DRIVE IRVINE CA 32614 135613797 501(c)(3) 10000 Grant: Support Orange County Community programs California Assoc Hospitals & Health Systems 1215 K STREET SACRAMENTO CA 95814 941205308 501(c)(6) 10000 Grant: Educational Conference - Medical advancemen t/Reglatory req. COUNCIL ON AGING OC 1971 EAST 4TH ST SANTA ANA CA 92705 952874089 501(c)(3) 10000 Sponsorship: Just Imagin Luncheon Human Options PO Box 53745 IRVINE CA 92619 953667817 501(c)(3) 10000 Grant Support for programs MADD 17772 IRVINE BLVD TUSTIN CA 92780 942707273 501(c)(3) 10000 Grant: Community Education Merage Jewish Community Center 1 FEDERATION WAY IRVINE CA 92603 952407026 501(c)(3) 10000 Sponsorship: JCC Celebration Ball 'Spirit of Macca bi Newport Beach Sunrise Rotary Foundation PO BOX 8113 NEWPORT BEACH CA 92856 330222352 501(c)(3) 10000 Grant: Support Families of wounded warriors SERVICE ORGANIZATIONS Newport Community Counseling Center 2200 SAN JOAQUIN NEWPORT BEACH CA 92660 202108327 501(c)(3) 10000 Grant: Scholarship/ Mental Health Counseling progr am Orange Coast Interfaith Shelter 1963 WALLACE AVE COSTA MESA CA 92627 953613254 501(c)(3) 10000 Grant: Program support PREVENTION PROGRAMS Susan G Komen Orange County 3191 A AIRPORT LOOP COSTA MESA CA 92626 330487943 501(c)(3) 10000 Sponsorship: Orange County Race for the Cue UCI Foundation DEV OFFICE MPAA210 IRVINE CA 92697 952540117 501(c)(3) 10000 Pledge support to Paul Merage School of Business H ealthcare Mngmt Huntington Beach Union High School District 5832 BOLSA AVE HUNTINGTON BEACH CA 92649 956001644 government 5600 Oak View Mobil Health Programs 48 1 EMS SAFETY SERVICES 1 21302 Description of Organization's Procedures for Monitoring the Use of Grants Form 990, Schedule I In order to be eligible for a Community Benefit grant, an applicant organization (or fiscal agent) must be designated by the IRS as a tax exempt non-profit and submit a copy of their EXEMPT status for verification. The organization must have an Executive Director and an established Board of Directors that meets regularly. Prior to funding, research is conducted regarding the reputation and performance of the organization. Grant requests must include previous and current year budgets, program goals and objectives, and measurable outcomes for the specified program that is being funded. An interview with the Executive director and one or more board members may be conducted as well as a site visit in order to familiarize ourselves with the organization and the programs offered. Department staff may actively participate with the organization by providing in-kind services and board participation. Once a grant request has been approved and funded, we require progress reports/and or a final report on the implementation strategy and measurable outcomes. Throughout the funding period of a specified program, there may be occasional meetings with the director and program personnel to receive reports on progress and updates of the activities conducted as well as the number of individuals served. This process allows us to monitor that the donated funds are being used for the intended purpose. Those that request grant funding on a continuous basis provide a detailed year end annual report describing implementation and outcomes for the programs. X X X true true X X X X X false true false false false false false false false Richard Afable end 022813 659815 0 231695 0 86740 0 208521 0 19871 0 1206642 0 0 0 Robert Braithwaite 524022 0 411802 0 1321 0 33415 0 21550 0 992110 0 0 0 Jack Cox MD 474004 0 209192 0 3269 0 127108 0 20349 0 833922 0 0 0 Richard Martin 407761 0 325528 0 1849 0 35972 0 8646 0 779756 0 0 0 Jennifer Mitzner 464066 0 606715 0 1091 0 35284 0 19551 0 1126707 0 0 0 Sanford Smith 372276 0 226996 0 3369 0 55711 0 24757 0 683109 0 0 0 Timothy C L Moore 399527 0 322331 0 2049 0 23146 0 16639 0 763692 0 0 0 Cynthia Perazzo 373876 0 298991 0 1091 0 21623 0 19189 0 714770 0 0 0 Flynn Andrizzi 352241 0 147970 0 12230 0 20476 0 29509 0 562426 0 0 0 Jan Blue 322046 0 244313 0 2866 0 18447 0 9856 0 597528 0 0 0 Robert Dillman MD 376102 0 48678 0 8682 0 12500 0 22242 0 468204 0 0 0 Michael Brant-Zawadzki MD 417790 0 45791 0 20567 0 12500 0 15835 0 512483 0 0 0 Terri Cammarano 339719 0 227658 0 1090 0 12500 0 19620 0 600587 0 0 0 James Rice 226366 0 155558 0 1025 0 0 0 19435 0 402384 0 0 0 Stephen Mayfield 209997 0 131899 0 3130 0 26044 0 17030 0 388100 0 0 0 Kris Iyer MD 320008 0 0 0 9682 0 12500 0 3282 0 345472 0 0 0 ALLYSON M BROOKS 0 0 0 0 276607 0 0 0 0 0 276607 0 0 0 SCHEDULE J, PART I, LINE 1(A) Supplemental Compensation Information THE PREVIOUS CEO (RICK AFABLE) AND CHIEF QUALITY OFFICER ARE PROVIDED WITH A RELOCATION LOAN IN ACCORDANCE WITH THEIR EMPLOYMENT CONTRACTS. EACH YEAR, THERE IS IMPUTED INCOME THAT IS GROSSED UP FOR TAX PURPOSES WHICH IS REPORTED AS TAXABLE INCOME TO THE EXECUTIVE AND INCLUDED IN COLUMN B(III) OF PART II. THE RELOCATION LOAN OF THE PREVIOUS CEO WAS SUBSEQUENTLY PAID IN FULL AND THERE WAS NO OUTSTANDING BALANCE AT THE END OF TAX YEAR 2012. THE CEO ALSO RECEIVES A REIMBURSEMENT FOR A PORTION OF HIS CLUB DUES THAT ARE ESSENTIAL TO FUNDRAISING EFFORTS. THIS REIMBURSEMENT WAS EXCLUDED FROM TAXABLE INCOME. SCHEDULE J, PART I, LINE 4(B) Supplemental Compensation Information THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A SERP PLAN ON BEHALF OF CERTAIN MEMBERS OF SENIOR MANAGEMENT IN ACCORDANCE WITH THEIR EMPLOYMENT CONTRACTS. CONTRIBUTIONS TO THE SERP IN THE AMOUNT OF $443,639 ARE INCLUDED IN COLUMN C OF PART II. THE ORGANIZATION MAINTAINS A LEGACY DEFERRED COMPENSATION PLAN THAT IS FROZEN (NO NEW CONTRIBUTION CAN BE MADE). THERE WERE 4,003.065 SHARES EXERCISED DURING CALENDAR YEAR 2012. Jack Cox senior vp Recruitment X 1500000 1500000 false true true 1500000 RANEY ZUSMAN Board Member 780081 medical services false alexander easton Board Member 31181 compensation false HOAG ORTHOPEDIC INSTITUTE HOAG OFF. & HOI DIR. 19510019 ADMINISTRATIVE SERVICES false melissa dickerson Key Employee 69910 compensation false PACIFIC HOSPITALIST ASSOCIATES Board Member 5774280 CONTRACTED SERVICES false INTOUCH HEALTH Board Member 149017 PRODUCT PURCHASES false MARGOLIN GROUP BOARD MEMBER 13836 CONSULTING SERVICES false PROVIDENCE SPEECH AND HEARING KEY EMPLOYEE 131000 PATIENT SERVICES false BUSINESS RELATIONSHIPS FORM 990, SCHEDULE L, PART IV - DOUGLAS ZUSMAN, BOARD MEMBER OF HMHP, HAS 50% OWNERSHIP INTEREST IN RANEY & ZUSMAN WHICH PROVIDES MEDICAL SERVICES TO HMHP. - JAKE EASTON III IS A BOARD MEMBER OF HOAG MEMORIAL HOSPITAL PRESBYTERIAN ("HMHP"). HIS SON, ALEXANDER EASTON, IS AN EMPLOYEE OF HMHP. - JENNIFER MITZNER AND ROBERT BRAITHWAITE ARE OFFICERS OF HMHP AND ALSO SERVE AS BOARD MEMBERS OF HOAG ORTHOPEDIC INSTITUTE (HOI). HMHP PROVIDES ADMINISTRATIVE AND OPERATIONAL SERVICES TO HOI. - TIMOTHY MOORE IS A KEY EMPLOYEE OF HMHP. HIS DAUGHTER-IN-LAW, MELISSA DICKERSON, IS AN EMPLOYEE OF HMHP. - WESTON CHANDLER, BOARD MEMBER OF HMHP, SERVES AS PRESIDENT & CEO OF PACIFIC HOSPITALIST ASSOCIATES WHICH PROVIDES MEDICAL SERVICES TO HMHP. - YULUN WANG, BOARD MEMBER OF HMHP, SERVES AS AN OFFICER / DIRECTOR AT INTOUCH HEALTH WHICH SELLS PRODUCTS TO HMHP. - LESLIE A. MARGOLIN IS A BOARD MEMBER OF HMHP. She is ALSO the owner of The Margolin Group, which provides consulting services to HMHP. -SANFORD SMITH IS A KEY EMPLOYEE OF HMHP. His wife, Linda Smith, is the CEO of Providence Speech and Hearings, which provided in-patient speech services to HMHP. Form 990, Part VI, Line 2 Family or business relationships OFFICERS ROBERT BRAITHWAITE AND JENNIFER MITZNER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, LINE 4 CHANGES TO GOVERNING DOCUMENTS Hoag Hospital's affiliation with St. Joseph Health System became effective on March 1, 2013. The affiliation was accomplished through the creation of a new entity, St. Joseph Hoag Health, formerly known as Covenant Health Network, a California nonprofit public benefit corporation. St. Joseph Hoag Health became the third member of Hoag along with the then current members comprising of the George Hoag Family Foundation and the constituent churches of the Los Ranchos Presbytery of the Presbyterian Church (USA), as represented by the Association of Presbyterian (APM). St. Joseph Hoag health also became a member, joining the St. Joseph Health System, of the four Southern California hospital ministries; St. Joseph Hospital of Orange, St. Jude Medical Center, Mission Hospital, and St. Mary Medical Center. A majority of St. Joseph Hoag Health's board of directors is designated by St. Joseph Health System and the balance of directors is appointed by the Hoag Family Foundation and the APM. Form 990, Part VI, Line 6 Members or stockholders THE MEMBERS OF THE CORPORATION CONSISTS OF THE FOLLOWING: (I) ST. JOSEPH HOAG HEALTH (FORMERLY COVENANT HEALTH NETWORK INC), (II) THE GEORGE HOAG FAMILY FOUNDATION ("GHF FOUNDATION"), (III) THE CONSTITUENT CHURCHES OF THE LOS RANCHOS PRESBYTERY OF THE PRESBYTERIAN CHURCH (USA) (THE "APM"), AND (IV) SUCH INDIVIDUAL MEMBERS AS MAY BE APPOINTED BY THE GHF FOUNDATION OR THE APM UP TO A MAXIMUM OF FORTY-EIGHT (48) INDIVIDUAL MEMBERS TO BE DIVIDED EQUALLY BETWEEN THE GHF FOUNDATION AND THE APM. Form 990, Part VI, Line 7a Power to elect or appoint members THE MEMBERS OF THE CORPORATION HAVE THE POWER TO ELECT OR REMOVE DIRECTORS FROM THE BOARD OF DIRECTORS OF THE CORPORATION. Form 990, Part VI, Line 7b Decisions reserved to members or stockholders THE POWERS AND RESPONSIBILITIES OF THE MEMBERS OF THE CORPORATION INCLUDE, BUT ARE NOT LIMITED TO: (A) TO ASSURE THE BOARD OF DIRECTORS CARRIES OUT THE CORPORATION'S MISSION; (B) TO CONSIDER THE QUALIFICATIONS OF DIRECTORS TO BE ELECTED TO THE BOARD OF DIRECTORS; (C) TO APPROVE ANY AMENDMENT, MODIFICATION OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (D) TO APPROVE THE ELECTION, APPOINTMENT OR REMOVAL OF ANY DIRECTOR OF THE CORPORATION; AND (E) TO APPROVE ANY SALE, TRANSFER CONVEYANCE OR OTHER DISPOSITION OF ALL, SUBSTANTIALLY ALL OR A MATERIAL PORTION OF THE ASSETS OF THE CORPORATION, OR ANY MERGER, CONSOLIDATION, AFFILIATION OR DISSOLUTION OF THE CORPORATION. Form 990, Part VI, Line 11b Process used to review the Form 990 THE ORGANIZATION'S BOARD OF DIRECTORS HAS DELEGATED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD THE REVIEW OF THE FORM 990 PRIOR TO ISSUANCE. MANAGEMENT, INCLUDING AN OFFICER OF THE ORGANIZATION, PREPARES AND REVIEWS THE FORM 990. THE AUDIT AND COMPLIANCE COMMITTEE IS PROVIDED WITH A DRAFT FORM 990 AND IS PROVIDED AMPLE TIME TO READ THE DOCUMENT AND DEVELOP QUESTIONS. THE AUDIT AND COMPLIANCE COMMITTEE THEN CONVENES PRIOR TO ISSUANCE OF THE FORM 990 TO REVIEW AND DISCUSS THE DRAFT FORM 990 WITH MANAGEMENT AND EXTERNAL EXPERTS HIRED BY MANAGEMENT. AN ELECTRONIC VERSION OF THE FORM 990 IS POSTED TO A SECURE WEBSITE AVAILABLE TO ALL OF THE BOARD OF DIRECTORS PRIOR TO FILING. Form 990, Part VI, Line 12c Monitoring and enforcement of compliance with conflict of interest policy THE ORGANIZATION HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. OFFICERS, DIRECTORS, NON-DIRECTOR MEMBERS OF BOARD COMMITTEES, AND SENIOR EXECUTIVES ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. RESPONSES TO THE QUESTIONNAIRE ARE REVIEWED BY THE CHAIR AND CEO AND MATTERS ARE DISCUSSED AT THE APPROPRIATE LEVEL AS APPLICABLE GIVEN THE SITUATION. INDIVIDUAL TRANSACTIONS THAT OCCUR BETWEEN THE ANNUAL QUESTIONNAIRE ARE REVIEWED BY THE CORPORATION'S LEGAL AND COMPLIANCE OFFICERS FOR POTENTIAL CONFLICTS OF INTEREST. ANY DIRECTOR WHO HAS A CONFLICT OF INTEREST WITH RESPECT TO A PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT SHALL REFRAIN FROM VOTING ON ANY MATTER RELATING TO THE CONTRACT, TRANSACTION OR ARRANGEMENT, OR BE EXCUSED FROM ANY MEETING WHERE THE PROPOSED CONTRACT IS DISCUSSED. Form 990, Part VI, Line 15a & 15b Process for determining compensation THE COMPENSATION OF THE CEO, CFO AND ALL SENIOR VICE PRESIDENTS (KEY EMPLOYEES) IS REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, COMPRISED SOLELY OF INDEPENDENT DIRECTORS PLUS ONE OUTSIDE NON-VOTING MEMBER. THE COMPENSATION COMMITTEE RECEIVES A STUDY PERFORMED BY AN INDEPENDENT CONSULTING FIRM THAT REVIEWS LEVELS OF COMPENSATION AT COMPARABLE ORGANIZATIONS FOR COMPARABLE POSITIONS WHEN SETTING COMPENSATION OF THE KEY EXECUTIVES. THE COMPENSATION COMMITTEE'S RECOMMENDATIONS RELATIVE TO EXECUTIVE COMPENSATION ARE REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS, MEETING IN EXECUTIVE SESSION, WHOSE MINUTES DOCUMENT THAT THE APPROVED COMPENSATION IS DEEMED REASONABLE. THIS PROCESS OF USING COMPARABLE DATA TO ESTABLISH LEVELS OF COMPENSATION HAS BEEN IN PLACE FOR IN EXCESS OF 37 YEARS. THIS PROCESS WAS LAST COMPLETED IN 2013. IN ADDITION, THE INDEPENDENT CONSULTING FIRM PROVIDES THE BOARD WITH AN OPINION LETTER EACH YEAR CERTIFYING THAT THE COMPENSATION PROGRAM AND ALL PAY ELEMENTS (TOTAL REMUNERATION) APPROVED BY THE BOARD ARE DEEMED REASONABLE IN COMPLIANCE WITH IRC SECTION 4958. Form 990, Part VI, Line 19 Process for making documents available to the public The Corporation's financial statements are made available to the public in summary by inclusion in an Annual Report that is available on its web site - http://www.hoag.org/About-Hoag/Pages/Corporate-Info/Corporate-Information. aspx Hoag's Code of Conduct is posted on its public Web site as well. The Code of Conduct provides readers with an understandable review of the code of conduct that must be adhered to by all employees, directors and vendors. The Corporation makes its governing documents available upon request. Form 990, Part IX, Line 11g Other Expenses Hospital Based Physician Fees $20,133,388 Purchased Services $40,949,364 HMO Purchased Services $51,829,765 ------------- $112,912,517 form 990, part xi, line 9 changes in net assets or fund balance EQUITY TRANSFERS RELATED TO SWAP 34,187,926 OTHER REVENUE RELATED TO EXCLUDED SERVICES 152,645 PARTNERSHIP INVESTMENT INCOME (450,416) OTHER (92,596) ------------- 33,797,559 FORM 990, PART XII, LINE 2C CHANGES TO THE FINANCIAL STATEMENT OVERSIGHT PROCESS As result of affiliation with St. Joseph Health System, Hoag is included within the St. Joseph Health System consolidated financial statements. The oversight of the St. Joseph Health System consolidated financial statement audit and selection of the independent accounting firm is performed by the St. Joseph Health System audit committee. NEWPORT HEALTHCARE CENTER LLC ONE HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92663 331127904 MEDICAL BLDG CA 11128304 153036157 HMHP HOAG OUTPATIENT CENTERS LLC ONE HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92663 453587572 PATIENT SVCS CA 3020977 0 HMHP COVENANT HEALTH NETWORK INC 3345 MICHELSON DR STE 100 IRVINE CA 92612 461259908 HEALTHCARE CA 501(C)(3) 11, III SJHS true COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK TX 79410 611573313 HEALTHCARE TX 501(C)(3) 11,I CHS true COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK TX 79410 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS true COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS true COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK TX 79410 752743883 HEALTHCARE TX 501(C)(3) 3 CHS true HOAG CHARITY SPORTS 3920 BIRCH ST STE 105 NEWPORT BEACH CA 92660 452982422 SUPPORT CA 501(C)(3) 7 HHF true HOAG HOSPITAL FOUNDATION 1 HOAG DR BOX 6100 NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 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JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 200, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 100, ORANGE, CA 92868-2012 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 2301 QUAKER, LUBBOCK, TX 79410 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 3345 MICHELSON DRIVE, STE. 100, IRVINE, CA 92612 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE. 362, MISSION VIEJO, CA 92691 COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY, LLC EIN: 26-4591502 ADDRESS: ONE CITY BOULEVARD WEST, SUITE 1100, ORANGE, CA 92868 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 MAIN ST SPECIALTY SURGERY CENTER EIN: 95-4813223 ADDRESS: 280 MAIN STREET, ST 100, ORANGE, CA 92868 ORTHOPEDIC SURGERY CENTER OF OC, LLC EIN: 33-0841806 ADDRESS: 22 CORPORATE PLAZA, NEWPORT BEACH, CA 92660 advanced surgery institute, llc EIN: 26-2299255 Address: 1739 4th street, santa rosa, ca 95404