2023-11-14T18:42:54-06:00 2022-12-31 ERNST & YOUNG US LLP 560 MISSION ST STE 1600 SAN FRANCISCO CA 94105 990 2022-01-01 680273974 SUTTER VALLEY MEDICAL FOUNDATION % KENNETH YOUNG SUTT 9162866665 C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 DOMINIC NAKIS CFO 9162866665 2023-11-06 true DOMINIC NAKIS 999009999 EVA NITTA P01286320 4158948000 2023-11-03 2 2022 2023-04-26 12:10:37Z TODD SMITH MD SAME AS C ABOVE SACRAMENTO CA 95833 1855885976 false X WWW.SUTTERHEALTH.ORG X 1992 CA SEE SCHEDULE O 14 10 4703 31 42983 0 23585249 14558582 1780807669 1835027600 2624471 1494500 104710 112270 1807122099 1851192952 42140 30683 0 0 458470465 437885505 0 0 345699 1267625352 1301410174 1726137957 1739326362 80984142 111866590 666026093 722732834 414838314 424771019 251187779 297961815 X SEE SCHEDULE O false false 1625668903 30683 1835027600 SEE SCHEDULE O 1625668903 true true false false false false false true false true true false false true true true false true false false false false false 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SVMF 2.0 40.0 X 0 625807 84305 Peter Hull MD SME SRMC/Chair 4.0 40.0 X X 0 482723 53918 Michael D Marino VP, HR, SH FOUNDATIONS 0.0 40.0 X 0 478079 47900 Ali Layeghi Manager, Dosimetry 40.0 0.0 X 400795 0 23851 Jonathan K Bareng Medical Physicist III 40.0 0.0 X 358517 0 24933 Sy Fangyan Z Executive, Quality 40.0 1.0 X 330929 5422 31457 Benjamin Kirk DEPUTY GEN COUNS, SEC 2.0 40.0 X 0 317494 37403 Jennifer S Glass Medical Physicist III 40.0 0.0 X 275140 0 29760 Chuan Wu Chief Physicist 40.0 0.0 X 269019 0 29654 Penny Westfall Former SH VP, CLO, SH 0.0 40.0 X 0 198372 487 Thomas Blinn Frmr CEO, Valley Area FOUNDAT. 0.0 0.0 X 0 128537 0 I-Mei Hsiu MD DIRECTOR & SH BOARD 2.0 9.0 X 0 27500 0 David Adkins MD DIRECTOR 2.0 2.0 X 0 0 0 Timothy Byrd Director 2.0 2.0 X 0 0 0 Viva Ettin MD DIRECTOR 2.0 2.0 X 0 0 0 Bronwyn Fields RN DIRECTOR 2.0 2.0 X 0 0 0 Dan Flores Chair Finance & Planning 4.0 4.0 X X 0 0 0 Maria Pallavicini Director 2.0 2.0 X 0 0 0 Gail Russell MD DIRECTOR 2.0 2.0 X 0 0 0 Fatima Seward DIRECTOR 2.0 2.0 X 0 0 0 Kurt Shuler MD DIRECTOR 2.0 3.0 X 0 0 0 Jerry Tokunaga DIRECTOR 2.0 2.0 X 0 0 0 1634400 15220784 4617999 799 true true false Sutter North Medical Group 969 PLUMAS ST YUBA CITY CA 95991 Physician Services 43511766 CT BRAYTON AND SONS INC PO BOX 95 ESCALON CA 953200095 Construction SVCS 3982288 WFC BUILDERS INC 6050 WAREHOUSE WY SACRAMENTO CA 958264922 Construction SVCS 2728308 ADVANCED BUILDING MAINTENANCE 1804 TRIBUTE RD STE K SACRAMENTO CA 958154313 Janitorial SVCS 2530178 HEALTHCARE LOGISTICS MGMT INC PO BOX 749469 LOS ANGELES CA 900749469 Medical Courier SVCS 1962044 77 250 21900 688582 13273512 574338 9498 14558582 PATIENT SERVICE REVENUE 621110 1829981363 1829981363 HEALTHCARE RELATED JV INCOME 621110 2651554 2651554 RENTAL TO AFFILIATES 621110 1285423 1285423 GUARANTEED PAYMENT JV INCOME 621110 1109260 1109260 1835027600 1580726 1580726 0 0 77043 5164 71879 0 71879 71878 0 4597902 114111 4570017 -114111 27885 -86226 -86226 1140 21900 3732 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ARTWORK BEING DISPLAYED IN PUBLIC PLACES OF THE MEDICAL FACILITY FOR DECORATIVE PURPOSES. SCHEDULE D, PART V, LINE 4 THE INTENTIONS FOR THE ENDOWMENT FUNDS ARE AS FOLLOWS: DR. HUDLIN MEDICAL SCHOLARSHIP ENDOWMENT - THE EARNINGS OF THE ENDOWMENT ARE TO BE SPENT FOR THE PURPOSE OF PROVIDING SCHOLARSHIP SUPPORT FOR DISADVANTAGED HIGH SCHOOL STUDENTS PURSUING MEDICAL CAREERS. CHILDRENS BRAIN HEALTH ENDOWMENT - TO SUPPORT THE GENERAL NEEDS RELATED TO THE PSYCHOLOGICAL ASSESSMENT OF CHILDREN. SCHEDULE D, PART X, LINE 2 ASC 740 AUDIT FOOTNOTE THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH 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 2019 THROUGH 2021 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, 2022 AND 2021. 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X X true true X X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false STANISLAUS SURGICAL HOSPITAL 2 false false true X X X X X X X X X 19 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C true 19 true SEE PART V, SECTION C false true X 100 350. X X X true true X X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X false X X false false SCHEDULE H, PART V, SECTION B, LINE 3E TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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, SECTION B, LINE 5 TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: INPUT FROM THE COMMUNITY SERVED WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E.,MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WAS COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. TWIN CITIES SURGICAL HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN JANUARY 3, 2022, AND MARCH 8, 2022. THE FOLLOWING COMMUNITY HEALTH EXPERTS, KEY INFORMANTS, AND FOCUS GROUPS, REPRESENTING THE RESIDENTS OF SUTTER COUNTY, YUBA COUNTY, LINDA COUNTY, PUNJABI COUNTY, LOW-INCOME RESIDENTS AT RISK RESIDENTS, CHILDREN, ADOLESCENTS, MEDI-CAL RECIPIENTS, AND OTHERS, ALL CONTRIBUTED INPUT TO THE CHNA: -SUTTER COUNTY DEPARTMENT OF PUBLIC HEALTH -YUBA COUNTY HEALTH AND HUMAN SERVICES DIVISION -YUBA SUTTER HEALTHCARE COUNCIL -ADVENTIST HEALTH AND RIDEOUT STAFF -PEACH TREE HEALTH -HARMONY HEALTH -SUTTER CARE AT HOME -SUTTER MEDICAL FOUNDATION -ANTHEM BLUE CROSS -SUTTER COUNTY BOARD OF SUPERVISORS THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN TWIN CITIES SURGICAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTML SCHEDULE H, PART V, SECTION B, LINES 6A TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): CHNA HOSPITAL COLLABORATORS: WORKING COLLABORATIVELY, RIDEOUT MEMORIAL HOSPITAL (RMH), DBA ADVENTIST HEALTH AND RIDEOUT, AND TWIN CITIES SURGICAL HOSPITAL, DBA SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV) CONTRACTED WITH COMMUNITY HEALTH INSIGHTS TO CONDUCT A CHNA FOR THEIR MUTUAL SERVICE AREAS. SCHEDULE H, PART V, SECTION B, LINE 7A, 7B, AND 10A TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): REPORTING ORG WEBSITE: HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ABOUT-US/ COMMUNITY-NEEDS-ASSESSMENT.HTML OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 11 TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT TWIN CITIES SURGICAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE USE SERVICES 2. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 3. ACTIVE LIVING AND HEALTHY EATING 4. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 5. ACCESS TO FUNCTIONAL NEEDS 6. INJURY AND DISEASE PREVENTION AND MANAGEMENT 7. INCREASED COMMUNITY CONNECTIONS 8. SAFE AND VIOLENCE-FREE ENVIRONMENT DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH ADDITIONAL CRITICAL EFFORTS ON BEHALF OF TWIN CITIES SURGICAL HOSPITAL. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. TWIN CITIES SURGICAL 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 2022 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS TO SPECIALTY AND EXTENDED CARE: SUTTER SURGICAL HOSPITAL - NORTH VALLEY PLANS TO SEEK OUT OPPORTUNITIES FOR COMMUNITY BENEFIT PROGRAMS THAT ADDRESS SPECIALTY AND EXTENDED CARE WITH LOCAL COMMUNITY BENEFIT ORGANIZATIONS. SCHEDULE H, PART V, SECTION B, LINE 15E TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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, SECTION B, LINES 16A, 16B, & 16C TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16J TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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, SECTION B, LINE 22D TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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. SCHEDULE H, PART V, SECTION B, LINE 3 STANISLAUS SURGICAL HOSPITAL (FACILITY 2): STANISLAUS SURGICAL HOSPITAL WAS SOLD TO AN UNRELATED THIRD PARTY EFFECTIVE JUNE 1, 2022. QUESTIONS 3 THROUGH 11 WERE LEFT BLANK BECAUSE UNDER TREASURY REGULATION SECTION 1.501(R)-3(D)(4), A HOSPITAL ORGANIZATION IS NOT REQUIRED TO MEET THE REQUIREMENTS OF SECTION 501(R)(3) WITH RESPECT TO A HOSPITAL FACILITY IN A TAXABLE YEAR IF BEFORE THE END OF THAT TAXABLE YEAR, THE HOSPITAL ORGANIZATION TRANSFERS ALL OWNERSHIP OF THE HOSPITAL FACILITY TO ANOTHER ORGANIZATION OR OTHERWISE CEASES ITS OPERATION OF THE HOSPITAL FACILITY. SCHEDULE H, PART V, SECTION B, LINE 15E STANISLAUS SURGICAL HOSPITAL (FACILITY 2): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY SUBMIT CHARITY CARE APPLICATION TO THE COLLECTIONS SUPERVISOR. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, AND 16C STANISLAUS SURGICAL HOSPITAL (FACILITY 2): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY WERE PREVIOUSLY AVAILABLE ON THE STANISLAUS SURGICAL HOSPITAL WEBSITE AT: HTTPS://STANISLAUSSURGICAL.COM/FINANCIAL-ASSISTANCE AS OF 6/1/2022 SUTTER HEALTH NO LONGER OWNS OR OPERATES STANISLAUS SURGICAL HOSPITAL. THESE DOCUMENTS WERE REMOVED FROM THE WEBSITE AFTER THIS DATE. SCHEDULE H, PART V, SECTION B, LINE 16J STANISLAUS SURGICAL HOSPITAL (FACILITY 2): 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 (ENGLISH & SPANISH). DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED THE FINANCIAL ASSISTANCE POLICY IS POSTED IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL, INCLUDING, BUT NOT LIMITED TO THE BILLING OFFICE, ADMISSIONS OFFICE, AND PATIENT WAITING AREA. HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A COPY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST. 80 SUTTER MED CARE CT & AMBULATORY SURG CT 460 Plumas Yuba City CA 95991 Outpatient Services/Surgery Center Modesto Urgent Care 600 Coffee Road Modesto CA 95355 Urgent Care Stockton Medical Plaza I 2545 West Hammer Lane Stockton CA 95209 Urgent Care/Surgery Center/ Outpatient Services Stockton Medical Plaza II 2505 West Hammer Lane Stockton CA 95209 Urgent Care/Surgery Center/ Outpatient Services Stockton Surgery Center 8011 Don Avenue Stockton CA 95209 Surgery Center Patterson Care Center 801 E Street Patterson CA 95363 Lab/Outpatient Services Turlock Care Center 3100 W Christoffersen Parkway Turlock CA 95382 Urgent Care/Radiology/ Laboratory Briggsmore Specialty Center 1409 E Briggsmore Modesto CA 95355 Outpatient Services Sutter Imaging Sacramento 3161 L Street Sacramento CA 95816 Imaging Sutter Roseville Cancer Center 8 Medical Plaza Drive ROSEVILLE CA 95661 Outpatient Services 3 Medical Plaza Care Center 3 MEDICAL PLAZA DRIVE ROSEVILLE CA 95661 Outpatient Services Sutter Imaging Roseville Parkway 1640 East Roseville Parkway ROSEVILLE CA 95661 Imaging Sutter Imaging Roseville II 2 Medical Plaza Drive ROSEVILLE CA 95661 Imaging Sutter Medical Plaza - Sutter Place 2020 SUTTER PLACE Davis CA 95616 Outpatient Services Sutter Urgent Care Fairfield 2702 Low Court Fairfield CA 94534 Outpatient Services Sutter Yuba City Medical Center 480 Plumas Yuba City CA 95991 Outpatient Services Sutter Medical Plaza Vacaville 770 Mason Street Vacaville CA 95687 Outpatient Services Sutter Medical Plaza Vallejo 100 Hospital Drive Vallejo CA 94589 Outpatient Services Sutter Amador Surgery Center 223 Clinton Road Jackson CA 95642 Outpatient Services Sutter Fairfield Surgery Center 2700 Low Court Fairfield CA 94534 Surgery Center Urgent CareLabRadiologyCardiology 440 Plumas Yuba City CA 95991 Urgent Care/Lab/Radiology/ Cardiology Auburn Gastroenterology & Neurology 11795 Education Street Auburn CA 95602 Gastroenterology and Neurology ROSEVILLE - FAMILY PRACTICE AND PHY TH 568 N SUNRISE AVE ROSEVILLE CA 95661 Outpatient Services and Physical Therapy GRASS VALLEY FAMILY PRACTICE & PHY TH 10058 WOLF ROAD GRASS VALLEY CA 95949 Outpatient Services and PHYSICAL THERAPY Sutter Medical Foundation PHY TH 420 B St Yuba City CA 95991 Physical Therapy Sutter Fairfield Diagnostic Imaging CTR 2700 Low Court Fairfield CA 94534 Diagnostic Imaging Center Sutter Medical Plaza Folsom 2575 E BIDWELL ST FOLSOM CA 95630 Outpatient Services Fort Sutter Surgery Center 2801 K ST SACRAMENTO CA 95816 Outpatient Services Sutter Medical Plaza Roseville 3100 DOUGLAS BLVD ROSEVILLE CA 95661 Outpatient Services Alhambra Medical Office & Urgent Care 1201 ALHAMBRA BLVD SACRAMENTO CA 95816 Outpatient Services 635 Anderson Road Care Center 635 ANDERSON RD Davis CA 95616 Outpatient Services West Sacramento Walk-In Care 2055 Town Center Plaza West Sacramento CA 95691 Outpatient Services Natomas Walk-In Care 2860 Del Paso Road Sacramento CA 95834 Outpatient Services West Roseville Care Center 2050 Blue Oaks Boulevard Roseville CA 95747 Outpatient Services Davis Walk-In Care 4647 2nd Street Davis CA 95618 Outpatient Services Sutter Medical Plaza Elk Grove 8170 LAGUNA BLVD ELK GROVE CA 95758 Outpatient Services Sutter Elk Grove Surgery Center 8200 LAGUNA BLVD ELK GROVE CA 95758 Ambulatory Surgery Center Sutter Imaging RosevillePET 2241 Douglas Boulevard Roseville CA 95661 Imaging Sutter Medical Plaza Natomas 2951 Benefit Way SACRAMENTO CA 95834 Outpatient Services Sutter Medical Plaza Lincoln 685 TWELVE BRIDGES DR LINCOLN CA 95648 Outpatient Services Sutter Imaging Folsom I 1655 Creekside Drive FOLSOM CA 95630 Diagnostic Imaging Center Sutter Imaging Folsom II 1661 Creekside Drive FOLSOM CA 95630 Diagnostic Imaging Center Sutter Medical Plaza Woodland 475 PIONEER AVE WOODLAND CA 95776 Outpatient Services Sutter Medical Plaza Dixon 125 N LINCOLN ST DIXON CA 95620 Outpatient Services Bell Road Medical Offices 3320 BELL RD AUBURN CA 95603 Outpatient Services Sutter Medical Plaza Greenback Lab 5767 GREENBACK LANE SACRAMENTO CA 95825 Laboratory Sutter Medical Plaza Greenhaven Lab 7420 GREENHAVEN DR SACRAMENTO CA 95831 Laboratory Sutter Imaging Auburn 3123 Professional Drive Auburn CA 95603 Diagnostic Imaging Center Sutter Imaging Carmichael 6620 Coyle Avenue Carmichael CA 95608 Diagnostic Imaging Center Procedure Center 550 B St Yuba City CA 95991 Procedure Center 400 Plumas Care Center 400 Plumas Yuba City CA 95991 Outpatient Services Davis Internal MED AND GASTROENTEROLOGY 2068 John Jones Road Davis CA 95616 Internal Medicine and GASTROENTEROLOGY L STREET MEDICAL NEUROLOGY 2800 L Street SACRAMENTO CA 95819 Neurology 470 Plumas Care Center 470 Plumas Yuba City CA 95991 Orthopedics & Podiatry Sutter Obstetrics and Gynecology 969 Plumas Yuba City CA 95991 Obstetrics Sutter Advanced Dermatology & LASER CTR 350 Del Norte Yuba City CA 95991 Dermatology Sacramento - Midtown Walk-In Care 1360 16th Street Sacramento CA 95814 Outpatient Services Sacramento - Loehmanns PL WALK-IN CARE 2537 Fair Oaks Boulevard Sacramento CA 95825 Outpatient Services Roseville - Foothills Walk-In Care 4010 Foothills Boulevard ROSEVILLE CA 95747 Outpatient Services El Dorado Hills Walk-In Care 3919 Park Drive El Dorado Hills CA 95762 Outpatient Services Elk Grove Walk-In Care 4810 Elk Grove Boulevard ELK GROVE CA 95758 Outpatient Services Citrus Heights Walk-In Care 5406 Sunrise Boulevard Citrus Heights CA 95610 Outpatient Services Roseville Walk-In Care 781 Pleasant Grove Boulevard Roseville CA 95678 Outpatient Services Folsom Walk-In Care 2766 East Bidwell Street FOLSOM CA 95630 Outpatient Services Vacaville Walk-in Care 2060 Harbison Drive Vacaville CA 95687 Outpatient Services Sutter Gould CARD STOCKTON CARE CTR 1801 East March Lane Stockton CA 95210 Cardiology Radiation Oncology Services-Vacaville 200 Bella Vista Road Vacaville CA 95687 Outpatient Services Ceres Care Center Lab 2516 Whitmore Avenue Ceres CA 95307 Outpatient Services Tracy Care Center 445 W Eaton Ave Tracy CA 95376 Outpatient Services Sutter Medical Plaza Jackson 100 Mission Blvd Jackson CA 95642 Laboratory Sutter Medical Plaza Brownsville 16911 Willow Glen Road Brownsville CA 95919 Outpatient Services Fairmont Specialty Center 918 South Fairmont Ave Lodi CA 95240 Outpatient Surgery Palmer Drive Care Center 3581 Palmer Drive Cameron Park CA 95682 Cancer Services Eye Care Center 1011 Sylvan Avenue Modesto CA 95350 Outpatient Services Sutter Imaging 29th Street 1020 29th Street Ste 120 SACRAMENTOS CA 95816 Imaging Sutter Imaging South 8118 Timberlake Way Ste 110 SACRAMENTO CA 95823 Diagnostic Imaging Center Sutter Phys & Hand Therapy Elk Grove 9280 West Stockton Blvd Ste 116 ELK GROVE CA 95758 Outpatient Rehab./Phys.Therapy Sutter Physical & Hand Therapy Auburn 11930 Heritage Oak Place Ste 9 AUBURN CA 95602 Outpatient Rehab./Phys.Therapy Behavioral Health Center 3425 Coffee Road MODESTO CA 95355 Behavioral Healthcare Manteca Care Center 165 St Dominics Drive MANTECA CA 95337 Weight Loss Center & Out SVCS SCHEDULE H, PART I, LINES 3A & 3C FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: SUTTER VALLEY MEDICAL FOUNDATION OWNS 100% OF TWIN CITIES SURGICAL HOSPITAL, WHICH PROVIDES PREDOMINANTLY ELECTIVE SURGERIES AND DOES NOT PROVIDE EMERGENCY CARE. FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THIS FACILITY USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION TWIN CITIES SURGICAL HOSPITAL 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 VALLEY MEDICAL FOUNDATION IS COMMITTED TO PROVIDING CHARITY CARE. TWIN CITIES SURGICAL HOSPITAL PROVIDES FREE CARE AT HIGH PERCENTAGE OF FPG, SO IT DOES NOT PROVIDE DISCOUNTED CARE. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. SCHEDULE H, PART I, SECTION 7G FINANCIAL ASSISTANCE/OTHER COMMUNITY BENEFITS AT COST RELATED TO SUBSIDIZED HEALTH SERVICES: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $1,002,032. SCHEDULE H, PART II SUTTER VALLEY MEDICAL FOUNDATION (SVMF) DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT FOR 2022. SCHEDULE H, PART III, 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, LINE 7 MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT. SCHEDULE H, PART III, LINE 9B DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF 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 THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2022-2024 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. 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 PROVIDED 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 THE DEFINITION OF THE COMMUNITY SERVED WAS THE PRIMARY SERVICE AREA JOINTLY SHARED BY RIDEOUT MEMORIAL HOSPITAL (RMH) AND TWIN CITIES SURGICAL HOSPITAL, DBA SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV). THIS AREA WAS DEFINED BY FIVE ZIP CODES: 95901, 95953, 95961, 95991, AND 95993. THIS SERVICE AREA WAS DESIGNATED BECAUSE THE MAJORITY OF PATIENTS SERVED BY BOTH RMH AND SSHNV RESIDED IN THESE ZIP CODES. RMH IS LOCATED IN MARYSVILLE, CA, AND SSHNV IS LOCATED IN YUBA CITY, CA. SEPARATED BY THE FEATHER RIVER, THESE CITIES ARE LOCATED ADJACENT TO ONE ANOTHER AND ARE PART OF THE YUBA CITY METROPOLITAN STATISTICAL AREA AS DESIGNATED BY THE US OFFICE OF MANAGEMENT AND BUDGET,8 WHICH IS LOCATED APPROXIMATELY 40 MILES DUE NORTH OF CALIFORNIA'S CAPITAL-SACRAMENTO. THE SERVICE AREA IS HOME TO OVER 147,000 COMMUNITY RESIDENTS AND ENCOMPASSES PORTIONS OF BOTH SUTTER AND YUBA COUNTIES. THERE ARE FOUR HOSPITALS THAT SERVE THE COMMUNITY. COMMUNITIES OF CONCERN ARE GEOGRAPHIC AREAS WITHIN THE SERVICE AREA THAT HAVE THE GREATEST CONCENTRATION OF POOR HEALTH OUTCOMES AND ARE HOME TO MORE MEDICALLY UNDERSERVED, LOW-INCOME, AND DIVERSE POPULATIONS AT GREATER RISK FOR POORER HEALTH. COMMUNITIES OF CONCERN ARE IMPORTANT TO THE OVERALL CHNA METHODOLOGY BECAUSE, AFTER THE SERVICE AREA IS ASSESSED MORE BROADLY, THEY ALLOW FOR A FOCUS ON THOSE PORTIONS OF THE REGION LIKELY EXPERIENCING THE GREATEST HEALTH DISPARITIES. GEOGRAPHIC COMMUNITIES OF CONCERN WERE IDENTIFIED USING A COMBINATION OF PRIMARY AND SECONDARY DATA SOURCES. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR ZIP CODES THAT MET THE CRITERIA TO BE CLASSIFIED AS A COMMUNITY OF CONCERN. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR COMMUNITIES THAT MET THE CRITERIA FOR CLASSIFICATION AS A COMMUNITY OF CONCERN. THESE COMMUNITIES ARE MARYSVILLE, LIVE OAK, OLIVEHURST AND SOUTH YUBA CITY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: -BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; -SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND -PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. THE 2022-2024 IMPLEMENTATION STRATEGY FOR TWIN CITIES SURGICAL HOSPITAL (SSHNV) DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW. PROGRAMS ADDRESSING: ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES FIT QUEST PROGRAM THE FIT QUEST PROGRAM IS A COMPREHENSIVE CHILDREN'S WELLNESS PROGRAM FOCUSING ON IMPROVING NUTRITION, FITNESS, AND MENTAL WELLNESS. THE ON-SITE SCHOOL PROGRAM, GEARED TOWARD 5TH AND 6TH GRADE STUDENTS, TEACHES STUDENTS EASY WAYS TO INCORPORATE HEALTHY CHOICES INTO DAILY LIVING. THE CURRICULUM IS DESIGNED TO IMPROVE OVERALL HEALTH IN A FUN AND MEANINGFUL WAY. THE FIT QUEST PROGRAM IS INCREDIBLY IMPACTFUL, REACHING OVER 40 SCHOOLS IN YUBA AND SUTTER COUNTY, PROVIDING SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS. THE EXPANDED CURRICULUM AND ROLE MODELING OF AND INTERACTIONS WITH THE NATURALISTS IN CHOOSING TO DRINK WATER, AND STAYING ACTIVE HAVE IMPACTED OVER 2,400 STUDENTS. SPECIALISTS HAVE BEEN ENGAGED THROUGHOUT THE PROCESS ATTENDING ASSEMBLIES AND PROVIDING GUIDANCE AND SUGGESTIONS AT PLANNING MEETINGS FOR CONTINUED ENHANCEMENTS IN THE FIT QUEST PROGRAM. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES; AND ACTIVE LIVING AND HEALTHY EATING. THE GOAL OF FIT QUEST IS TO TEACH CHILDREN HEALTHY LESSONS ABOUT THE IMPORTANCE OF PHYSICAL FITNESS, MENTAL WELLNESS AND NUTRITIOUS EATING. IN 2022, THE PROGRAM SERVED 1,945 INDIVIDUALS WITH 2,009 SERVICES. FIT QUEST FAMILY CAMP FIT QUEST FAMILY CAMP IS A FUN-FILLED WEEKEND FOR THE WHOLE FAMILY, WHERE BOTH KIDS AND PARENTS EXPERIENCE HEALTHY COOKING CLASSES; GARDENING; LOW-ROPES CHALLENGE COURSE; WORKSHOPS ON NUTRITION, MENTAL WELLNESS AND PHYSICAL ACTIVITY; NATURALIST-LED HIKES AND GAMES; SWIMMING; AND AN EVENING PROGRAM. THE PROGRAM IS AVAILABLE FOR UP TO 24 FAMILIES ANNUALLY AND HAS COMPONENTS LED BY A PE SPECIALIST, REGISTERED DIETICIAN, PSYCHOLOGIST AND REGISTERED YOGA THERAPIST. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES; AND ACTIVE LIVING AND HEALTHY EATING. THE GOAL OF THE PROGRAM IS TO TEACH CHILDREN AND THEIR FAMILIES HEALTHY LESSONS ABOUT THE IMPORTANCE OF PHYSICAL FITNESS, MENTAL WELLNESS AND NUTRITIOUS EATING. IN 2022, THE PROGRAM SERVED 25 FAMILIES. VICTIM SUPPORT SERVICES THE LIV ON FOUNDATION SEEKS TO FILL GAPS FOR VICTIM SERVICES IN YUBA-SUTTER COUNTIES BY PROVIDING WEEKLY SUPPORT GROUPS AND CREATING A STATEWIDE DIRECTORY OF RESOURCES. BARRIERS FOR VICTIMS TO ESCAPE UNSAFE HOME ENVIRONMENTS INCLUDE NOT HAVING ENOUGH TIME TO SAFELY RETRIEVE PERSONAL BELONGINGS WITH LAW ENFORCEMENT ASSISTANCE AND FINDING PET-FRIENDLY ACCOMMODATIONS. LIV ON WILL PROVIDE SECURITY FOR SAFE RETRIEVAL OF BELONGINGS FOR UP TO AN HOUR AND PET-FRIENDLY LODGING ASSISTANCE FOR VICTIMS. ALSO, AS PART OF AN EARLY INTERVENTION AND PREVENTION, YEARLY EDUCATIONAL WORKSHOPS WILL BE PROVIDED FOR AREA YOUTH IN PARTNERSHIP WITH LOCAL SCHOOL DISTRICTS. THE GOAL OF THE PROGRAM IS TO CONNECT VICTIMS OF DOMESTIC VIOLENCE TO SUPPORT SERVICES AND REMOVE BARRIERS FOR VICTIMS TO SEEK SAFE ENVIRONMENTS. IN ADDITION, THE PROGRAM SEEKS TO PREVENT DOMESTIC VIOLENCE SITUATIONS THROUGH EDUCATION WITH YOUTH. IN 2022, THE PROGRAM SERVED 71 INDIVIDUALS WITH 139 SERVICES. COUNSELING FOR PEOPLE EXPERIENCING OR AT-RISK FOR HOMELESSNESS FUNDING WILL ALLOW CLIENTS EXPERIENCING OR AT-RISK FOR HOMELESSNESS, WHOM DO NOT HAVE CALIFORNIA HEALTH AND WELLNESS AND BLUE SHIELD TO HAVE ACCESS TO COUNSELING WITH LICENSED MENTAL HEALTH PROFESSIONALS. COUNSELING IS OFFERED AT TWO LOCATIONS IN A PRIVATE OFFICE ALLOWING CLIENTS TO WORK ONE ON ONE WITH A COUNSELOR. COUNSELORS DETERMINE THE FREQUENCY OF COUNSELING SERVICES WITH EACH CLIENT AND HELP TO CONNECT THEM WITH ANY NEEDED OUTSIDE RESOURCES THE COUNSELOR DETERMINES IS NEEDED. THE GOAL IS TO PROVIDE COUNSELING SERVICES TO ALL CLIENTS REQUESTING ASSISTANCE WHO ARE EXPERIENCING OR AT-RISK FOR HOMELESSNESS. BY PROVIDING COUNSELING WITH LICENSED MENTAL HEALTH PROFESSIONALS, CLIENTS CAN OVERCOME PERSONAL CONCERNS AND BETTER THEIR QUALITY OF LIFE, WITH THE GOAL OF REINTEGRATING INTO THE COMMUNITY. IN 2022, THE PROGRAM SERVED 65 INDIVIDUALS WITH 116 SERVICES. HARM REDUCTION COALITION THE YUBA SUTTER HEALTHCARE COUNCIL CREATED A HARM REDUCTION COALITION (HRC) TO HELP WITH OPIOID CRISIS IN THE COMMUNITY. THE HRC IS ASSEMBLED OF COMMUNITY STAKEHOLDERS TO DEVELOP A PLAN FOR ADDRESSING OPIOID USAGE AMONG CLIENTS AND REDUCING DEATHS RELATED TO SUBSTANCE USE. THE GOALS OF THE PROGRAM ARE TO PARTNER WITH COMMUNITY ORGANIZATIONS TO DEVELOP A RESPONSE PLAN AND EDUCATE THE COMMUNITY. IN 2022, THE PROGRAM PROVIDED 33 SERVICES. PROGRAMS ADDRESSING: ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD PREVENTION AND DIVERSION PROGRAM THE PREVENTION AND DIVERSION PROGRAM IS A COLLABORATION WITH SUTTER YUBA HOMELESS CONSORTIUM, SALVATION ARMY OF YUBA CITY, AND BRIDGES TO HOUSING. THE PROGRAM IS DESIGNED TO ASSIST INDIVIDUALS AND FAMILIES IN THE YUBA SUTTER AREA NOT ELIGIBLE FOR GOVERNMENT EVICTION ASSISTANCE. REFERRALS ARE RECEIVED FROM THE COORDINATED ENTRY SYSTEM MANAGED BY SYHC OR DIRECTLY TO THE AGENCIES. THESE INDIVIDUALS MUST DISPLAY FINANCIAL NEED THROUGH COMMUNICATION BY A LANDLORD OR UTILITY COMPANY. PARTICIPANTS OF THE PROGRAM ARE AT RISK OF BEING EVICTED FROM THEIR CURRENT HOUSING THE PREVENTION AND DIVERSION PROGRAM WILL PROVIDE FINANCIAL ASSISTANCE OF DEPOSITS, RENT, UTILITIES, OR OTHER COSTS TO KEEP A CLIENT REMAINING IN CURRENT HOUSING OR WHEN CURRENT HOUSING IS NO LONGER AN OPTION, PAY DEPOSIT AND/OR RENT TO MOVE CLIENT TO AN ALTERNATIVE HOUSING SITUATION. THE GOAL OF THE PROGRAM IS TO PREVENT HOMELESS THROUGH CONNECTING INDIVIDUALS WITH FINANCIAL ASSISTANCE OR OTHER COMMUNITY RESOURCES. IN 2022, THE PROGRAM SERVED 375 INDIVIDUALS WITH 133 SERVICES. FOOD RESCUE PROGRAM IN PARTNERSHIP WITH SUTTER HEALTH, YUBA SUTTER FOOD BANK WILL EXPAND THE FOOD RESCUE PROGRAM THROUGH REPLACEMENT OF A DECOMMISSIONED TRUCK. DISTRIBUTION TARGETS PARTS OF COUNTIES VAPID OF FRESH FRUIT, VEGETABLES, AND OTHER HEALTHFUL WHOLE FOODS, USUALLY FOUND IN IMPOVERISHED AREAS. FOOD IS ALSO DISTRIBUTED TO OVER 30 PARTNER AGENCIES WHO SUPPORT FOOD ACCESS IN YUBA AND SUTTER COUNTY THROUGH A VARIETY OF PROGRAMS, INCLUDING FOOD PANTRIES AND HOT MEALS. THE GOAL OF THE PROGRAM IS TO RECOVER AN ESTIMATED 83,000 POUNDS OF SURPLUS FOOD FOR DISTRIBUTION TO NEARLY 8,000 PEOPLE WHO HAVE LIMITED ACCESS TO HEALTHY FOODS WILL IMPROVE THEIR OVERALL HEALTH AND WELL BEING. IN 2022, THE PROGRAM SERVED 5,689 INDIVIDUALS WITH 1,002,536 POUNDS OF FOOD. PROGRAMS ADDRESSING: ACTIVE LIVING AND HEALTHY EATING FIT QUEST PROGRAM THE FIT QUEST PROGRAM IS A COMPREHENSIVE CHILDREN'S WELLNESS PROGRAM FOCUSING ON IMPROVING NUTRITION, FITNESS, AND MENTAL WELLNESS. THE ON-SITE SCHOOL PROGRAM, GEARED TOWARD 5TH AND 6TH GRADE STUDENTS, TEACHES STUDENTS EASY WAYS TO INCORPORATE HEALTHY CHOICES INTO DAILY LIVING. THE CURRICULUM IS DESIGNED TO IMPROVE OVERALL HEALTH IN A FUN AND MEANINGFUL WAY. THE FIT QUEST PROGRAM IS INCREDIBLY IMPACTFUL, REACHING OVER 40 SCHOOLS IN YUBA AND SUTTER COUNTY, PROVIDING SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS. THE EXPANDED CURRICULUM AND ROLE MODELING OF AND INTERACTIONS WITH THE NATURALISTS IN CHOOSING TO DRINK WATER, AND STAYING ACTIVE HAVE IMPACTED OVER 2,400 STUDENTS. SPECIALISTS HAVE BEEN ENGAGED THROUGHOUT THE PROCESS ATTENDING ASSEMBLIES AND PROVIDING GUIDANCE AND SUGGESTIONS AT PLANNING MEETINGS FOR CONTINUED ENHANCEMENTS IN THE FIT QUEST PROGRAM. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, SCHEDULE H, PART VI, LINE 6 SUTTER SURGICAL HOSPITAL - NORTH VALLEY IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT, INTEGRATED HEALTHCARE SYSTEM THAT IS COMMITTED TO DELIVERING INNOVATIVE, HIGH-QUALITY, EQUITABLE PATIENT CARE AND HELPING TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. SUTTER HEALTH IS A NOT-FOR-PROFIT, INTEGRATED HEALTHCARE SYSTEM THAT IS COMMITTED TO DELIVERING INNOVATIVE, HIGH-QUALITY, EQUITABLE PATIENT CARE AND HELPING TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. OUR 65,000 EMPLOYEES AND ASSOCIATED CLINICIANS SERVE MORE THAN 3 MILLION PATIENTS IN CALIFORNIA THROUGH OUR HOSPITALS, PRIMARY AND SPECIALTY CARE CENTERS, 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 2022 WAS $899 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 SYSTEM HAS IMPLEMENTED CHARITY CARE POLICIES TO HELP PROVIDE ACCESS TO MEDICALLY NECESSARY CARE FOR ELIGIBLE PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2022, SUTTER HEALTH INVESTED $82 MILLION IN CHARITY CARE. SUTTER'S CHARITY CARE POLICIES FOR HOSPITAL SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: 1. UNINSURED PATIENTS ARE ELIGIBLE FOR FULL CHARITY CARE FOR MEDICALLY NECESSARY HOSPITAL SERVICES IF THEIR FAMILY INCOME IS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL ("FPL"). 2. INSURED PATIENTS ARE ELIGIBLE FOR HIGH MEDICAL COST CHARITY CARE FOR MEDICALLY NECESSARY HOSPITAL SERVICES IF THEIR FAMILY INCOME IS AT OR BELOW 400% OF THE FPL AND THEY INCURRED OR PAID MEDICAL EXPENSES AMOUNTING TO MORE THAN 10% OF THEIR FAMILY INCOME OVER THE LAST 12 MONTHS. (SUTTER HEALTH'S FINANCIAL ASSISTANCE POLICY DETERMINES THE CALCULATION OF A PATIENT'S FAMILY INCOME.) 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 DO NOT COVER THE FULL COSTS OF PROVIDING CARE. IN 2022, SUTTER HEALTH INVESTED $615 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS. THROUGH COMMUNITY BENEFIT INVESTMENTS, SUTTER HELPS LOCAL COMMUNITIES 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 AND WORKS TO ACHIEVE HEALTH EQUITY BY VISITING SUTTERHEALTH.ORG/COMMUNITY-BENEFIT. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: CA true SUTTER VALLEY HOSPITALS 2200 RIVER PLAZA DR SACRAMENTOCA SACRAMENTO CA 95833 941156621 501(C)3 9783 PROGRAM SUPPORT WELLSPACE HEALTH 777 12TH ST STE 250 SACRAMENTO CA 95814 941713704 501(C)3 7900 PROGRAM SUPPORT 2 0 SCHOLARSHIP 8 8000 FMV 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 MONITO 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 SUCCESS 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 EACH YEAR/REPORTING PERIOD, COMMUNITY BENEFIT ANALYZES FULL-YEAR 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 THAT 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. WE ALSO RELY ON THE GOVERNANCE PRACTICES OF THE RECIPIENT ORGANIZATION TO MONITOR THE USE OF THE FUNDS. true true false false false false false true false Sarah Krevans CEO Emeritus, Sutter Health 0 1980063 0 2749625 0 395119 0 242765 0 32838 0 5400410 0 362776 James Conforti SH SVP, Interim CEO 0 1501356 0 988152 0 429753 0 193665 0 33327 0 3146253 0 235967 Theresa Frei SH INT COO & PRES/CEO, SVMF 0 964911 0 412501 0 120252 0 86365 0 29254 0 1613283 0 99950 Jeff Szczesny SH VP, HR Ops 0 335841 0 403335 0 168078 0 64065 0 25572 0 996891 0 46905 Gary Zufelt FND AREA CEO, NORTH VALLEY 0 537359 0 239625 0 70188 0 69465 0 24840 0 941477 0 52405 Todd Smith MD FND AREA CEO, SOUTH VALLEY 0 509436 0 227205 0 15110 0 51965 0 36858 0 840574 0 0 Patrina White CEO, SSCD/SWC 0 536248 0 103501 0 74907 0 67765 0 30445 0 812866 0 47443 Suheir Haddad CFO FOUNDATION, SVMF 0 438325 0 136301 0 51181 0 55265 0 29040 0 710112 0 42176 Peter Hull MD SME SRMC/Chair 0 409060 0 30885 0 42778 0 33165 0 20753 0 536641 0 33746 Michael D Marino VP, HR, SH FOUNDATIONS 0 369312 0 75933 0 32834 0 28165 0 19735 0 525979 0 26506 Ali Layeghi Manager, Dosimetry 354377 0 41805 0 4613 0 5065 0 18786 0 424646 0 0 0 Jonathan K Bareng Medical Physicist III 297480 0 57778 0 3259 0 4938 0 19995 0 383450 0 0 0 Sy Fangyan Z Executive, Quality 277934 5412 52189 0 806 10 4614 90 26246 507 361789 6019 0 0 Benjamin Kirk DEPUTY GEN COUNS, SEC 0 282118 0 34890 0 486 0 4683 0 32720 0 354897 0 0 Thomas Warner Pres. & CEO SH (PT-YR) 0 190661 0 0 0 3624 0 3260621 0 4521 0 3459427 0 0 Jennifer S Glass Medical Physicist III 259343 0 15000 0 797 0 4305 0 25455 0 304900 0 0 0 Chuan Wu Chief Physicist 253541 0 15000 0 478 0 4209 0 25445 0 298673 0 0 0 Penny Westfall Former SH VP, CLO, SH 0 0 0 0 0 198372 0 0 0 487 0 198859 0 0 Thomas Blinn Frmr CEO, Valley Area FOUNDAT. 0 0 0 0 0 128537 0 0 0 0 0 128537 0 0 SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: 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 "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH. SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED Severance PAYMENTS DURING THE YEAR: James Conforti: $ 92,308 Penny Westfall: $ 20,006 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 AND SOCIAL SECURITY BENEFITS. 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 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. 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. 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, AVERAGE AMOUNT OF SPOT AWARDS TEND 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 A LONG TERM PERFORMANCE PLAN WHICH IS 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. A CHFFA 2016B 521643828 13032UDW5 2016-08-17 901627093 Refund 2005BC, 2003AB, 2007A true false false B CHFFA 2017A 521643828 13032UNY0 2017-07-06 496319743 Refund 2004CD, 2008A (pt), 2008BC true false false A 0 0 902923938 0 0 0 0 0 0 0 902923938 0 2016 false true true true B 0 0 496319743 0 0 0 0 0 0 0 496319743 0 2017 false true true true A false true true true true true 0.00880 0.00010 0.00890 false false false true B false true true true true true 0.00480 0.00010 0.00490 false false false true A false false false true false false 0 false 0 false true B false false true true false false 0 false 0 false true A true B true SCHEDULE K: The organization's sole corporate member is a conduit borrower of tax-exempt bond issues that allocates portions of each issue to certain 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 ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNT OF: $53,216,412 FROM THE 2016B ISSUE AND; $117,119,861 FROM THE 2017A 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, PART IV, LINE 2C DATE REBATE COMPUTATION WAS PERFORMED 2016B ISSUE: 9/9/2021 2017A ISSUE: 7/22/2019 SUBSTANTIAL CONTRIBUTOR Substanital contributor 348917 Payment in ordinary business false SUBSTANTIAL CONTRIBUTOR Substanital contributor 43511766 Payment in ordinary business false FORM 990, PART I, LINE 1 & PART III, LINE 1 MISSION STATEMENT: WE ENHANCE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES. FORM 990, PART III, LINE 4A Sutter Valley Medical Foundation (SVMF) is a community based, not-for-profit medical organization serving Central and Northern California communities and supporting the Sutter Health-affiliated hospitals. SVMF has care centers located in Amador, Placer, Sacramento, San Joaquin, Solano, Stanislaus, Sutter, Yolo, and Yuba Counties. Our mission is to enhance the health and well-being of people in the communities we serve through not-for-profit commitment to compassion and excellence in health care. We value excellence and quality, caring and compassion, honesty and integrity, teamwork, and community. Sutter Valley Medical Foundation is aligned with physician and mid-level providers of Gould Medical Group, Sutter Medical Group and Sutter North Medical Group. We offer a full range of primary care and specialty care medical services, including ambulatory surgery, urgent and walk-in care clinics and state of the art imaging, lab and cardiology technology. In addition, we operate the Twin Cities Surgical Hospital in Yuba County, as well as Rural Health Clinics in Amador and Yuba Counties and the Maino Community Health Library in Stanislaus County. In 2015, Sutter Medical Foundation changed its name to Sutter Valley Medical Foundation and in 2016, Sutter Gould Medical Foundation merged into Sutter Valley Medical Foundation. In 2022, the Foundation provided more than $45 million in charity care and community benefits and provided patient services of 6.4 million patient visits. The Foundation also provides community support through donations and participation in various not-for profit community programs including, but not limited to, the following: . American Cancer Society . American Heart Association . Fitquest program supporting student wellness thought schools in Sutter, Yuba, Sacramento, and Placer Counties . Girls on The Run . Health Careers Academy program for high school students . Kiwanis . Look Good Feel Better program supporting women receiving cancer treatment . March of Dimes . National Diabetes Society . Rotary . Salvation Army . Soroptimist . Sponsor of support groups for disease related education including but not limited to diabetes, childbirth education, autism, and Parkinson's . Tats Off, tattoo removal program . United Way STANISLAUS SURGICAL HOSPITAL WAS SOLD TO AN UNRELATED THIRD PARTY EFFECTIVE JUNE 1, 2022. FORM 990, PART VI, LINE 1A THE AFFAIRS AND MANAGEMENT OF SUTTER VALLEY MEDICAL FOUNDATION (SVMF) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SVMF DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTOR. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CORPORATION'S CHAIR WHO SHALL SERVE AS CHAIR OF THE COMMITTEE, THE CHAIR OF THE FINANCE AND PLANNING COMMITTEE, THE CHIEF OPERATING OFFICER OF THE GENERAL MEMBER (IF THIS POSITION IS OCCUPIED) AND TWO ADDITIONAL DIRECTORS. IF THE POSITION OF THE CHIEF OPERATING OFFICER OF THE GENERAL MEMBER IS NOT OCCUPIED, THEN THE PRESIDENT AND CEO OF THE GENERAL MEMBER MAY APPOINT EITHER A DESIGNATED DIRECTOR OR AN APPOINTED DIRECTOR AS A MEMBER. AT LEAST ONE EXECUTIVE COMMITTEE MEMBER SHALL BE A PHYSICIAN DIRECTOR. 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 OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. FORM 990, PART VI, LINE 11B 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 INDEPENDENT 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. TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL 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 NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH, ADJUSTED TO THE CALIFORNIA MARKET. THIS METHOD IS MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION UNDERGO AN ANNUAL REVIEW BY THE COMPENSATION COMMITTEE OR A DELEGATED SUB-COMMITTEE.? APPROVAL IS RECORDED IN THE MINUTES. THE 2022 EXECUTIVE COMPENSATION APPROVAL WAS COMPLETED IN FEBRUARY 2022. 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 COMPENSATION OF BOARD MEMBERS: 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. -WARNER THOMAS -THERESA FREI -PETER HULL -SARAH KREVANS -JAMES CONFORTI INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID FULL-TIME 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 FUND BALANCE: GAIN/(LOSS) ON HEALTH CARE INVESTMENTS $ 13,387,967 HEALTHCARE RELATED JV INCOME (2,651,554) GUARANTEED PAYMENT JV INCOME (1,109,260) EQUITY TRANSFERS (NET) (74,975,700) STOCK AND OTHER ITEMS 2,228,849 -------------- TOTAL: $ (63,119,698) FORM 990 PART IX LINE 11G DESCRIPTION:MED. GROUP COMPENSATION TOTAL FEES:XXX-XX-XXXX FORM 990 PART IX LINE 11G DESCRIPTION:PROF FEE - PHYSICIAN TOTAL FEES:7317207 FORM 990 PART IX LINE 11G DESCRIPTION:NON-PHYSICIAN MEDICAL TOTAL FEES:163212 FORM 990 PART IX LINE 11G DESCRIPTION:THERAPISTS/OTHER MEDICAL TOTAL FEES:918855 FORM 990 PART IX LINE 11G DESCRIPTION:NURSE REGISTRY FEES TOTAL FEES:681654 TWIN CITIES SURGICAL HOSPITAL LLC 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 352182617 SURGERY CA 31206462 17017207 SUTTER VMF CALIFORNIA PACIFIC MEDICAL CTR FOUND C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942728423 FUNDRAISING CA 501(C)(3) 7 SUTTER BH true EAST BAY PERINATAL CENTER C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 510172285 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true MEMORIAL HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942290244 FUNDRAISING CA 501(C)(3) 12A - I SUTTER VH true MILLS-PENINSULA HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 237288765 FUNDRAISING CA 501(C)(3) 7 SUTTER BH true SUTTER AUBURN FAITH HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942594966 FUNDRAISING CA 501(C)(3) 7 SUTTER VH true SUTTER BAY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 940562680 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER BAY MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941156581 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SUTTER COAST HOSPITAL C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942988520 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER DAVIS HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680217870 FUNDRAISING CA 501(C)(3) 7 SUTTER VH true SUTTER HEALTH 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 942788907 SUPPORTING OR CA 501(C)(3) 12C III-FI NA false SUTTER HEALTH PACIFIC 91-2301 FT WEAVER RD EWA BEACH HI 96706 990298651 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER HEALTH PLAN C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 461183948 HEALTH PLAN CA 501(C)(4) N/A SUTTER HLTH true SUTTER MEDICAL CENTER FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942788906 FUNDRAISING CA 501(C)(3) 7 SUTTER VH true SUTTER ROSEVILLE MEDICAL CTR FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680040113 FUNDRAISING CA 501(C)(3) 7 SUTTER VH true SUTTER VALLEY HOSPITALS C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 941156621 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER VISITING NURSE ASSOC AND HOSPICE C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 946068843 HEALTHCARE CA 501(C)(3) 10 SUTTER HLTH true TRACY HOSPITAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680318845 FUNDRAISING CA 501(C)(3) 12A - 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