2023-11-08T15:41:39-08:00 2022-12-31 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2022-01-01 941415069 Sonora Community Hospital dba Adventist Health Sonora SONO 2095325000 1000 Greenley Rd Sonora CA 95370 McCulloch Gregory Tres/A Sec 2023-11-08 true McCulloch Gregory 999009999 true S Clement P01218012 8185475701 X 2 AAL1 IAL1 FAL1 2022 2023-04-26 12:10:37Z Michelle Fuentes 304821683 false 1071 X www.adventisthealth.org/sonora X 1958 CA Living Gods love by inspiring health, wholeness and hope. 13 12 1421 76 78334 1113 279617 1362272 313031792 281695120 7952510 -3424819 32384 8876865 321296303 288509438 162329 238414 0 101558102 113845159 0 282742 169806723 190476750 271527154 304560323 49769149 -16050885 379691129 341499704 147257108 130484412 232434021 211015292 Living Gods love by inspiring health, wholeness and hope. false false 232197629 238414 265542833 Sonora Community Hospital, dba Adventist Health Sonora (AHSR), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay.Although, reimbursement for services rendered is critical to the operation and stability of Sonora Community Hospital, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: Free care and/or subsidized care Care to persons covered by governmental programs at/or below cost Health/wellness activities and community education programsNot only does Sonora Community Hospital provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits.AHSR recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2022 was $1,167,336.The following Inpatient services were provided to all our patients:483 babies delivered854 surgeries performed32,453 patient days The following Outpatient services were provided to all our patients:34,254 emergency department visits3,047 outpatient surgeries performed159,634 outpatient visits 202,920 clinic visitsAHSR recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2022 was $29,042,344.Adventist Healths mission statement of living Gods love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in Gods image has experienced the best health today, hope for tomorrow, and Gods love that endures forever.The following story illustrates how Adventist Health Sonora is able to provide quality care for our community in an extraordinary way:Between maintaining their property in rural Coulterville, California, and caring for the animals at their rescue ranch which shelters everything from dogs to emus to horses Richard and Lula Taylor stay happily busy.When they both faced cancer diagnoses, they were referred to the nearest cancer treatment center: the Diana J. White Cancer Institute at Adventist Health Sonora, over an hours drive from their ranch.We travel an hour and a half to get here, and driving home, Richard explains. The days are really tied up. Coming here, getting it done, and going home.Battling cancer is far from easy, even in the best of physical, emotional, and financial circumstances. For patients like Richard and Lula, who live on a fixed income and travel far from home multiple times a week for care, the financial and logistical challenges can be overwhelming.Thats where the Cancer Patient Support Fund steps in to help. The fund, made possible solely by Adventist Health Sonora donors, provides resources directly to cancer patients to cover expenses that are not covered by health insurance like gas, groceries, utility bills, and medication co-pays so patients can focus on their treatment and healing.That supportive fund and the support structure that the hospital has developed around it is more than helpful, Richard says. We wouldn't have made it It just would've been too costly. This has really helped us. With those gas cards that we received, that allowed us to keep going and not break the routine. We did not miss a single day [of treatment] for either of us.Compassionate, high-quality patient care; life-saving and life-preserving medical and surgical services; essential emergency services-these are the reasons we are in Sonora.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 232197629 true true false true false false false false false true true false false true true true false true false false false false false false true false true true true false true false false false false false false false false false false false false false true false false false true 0 0 true 1421 true true true false false false false false false 0 false false false false false false false X 13 12 false false false false true true true true true false false true true true true true true true true false CA X John Beaman 9164060000 PO Box 619135 Roseville CA 95661 Wing Bill - Departed 122 Dir/VC/Asst Sec 0.00 50.00 X X 0 2511347 53289 Heinrich Kerry Director/CEO 0.00 50.00 X X 0 2131444 48069 Hofheins Todd COO Eff 1/22 0.00 50.00 X 0 1971652 55964 Jahn Andrew-Care Div Pres thru 222 President, Southern CA Network 0.00 50.00 0 1409539 60092 Beaman John CFO/Secretary 0.00 50.00 X 0 1361096 61075 Nahapetian Arby-Care Div Med Off th Chief Clinical Officer 0.00 50.00 0 1334111 60780 Spents Brett-Care Div Fin Off thru Sr. Finance Officer & CIO 0.00 50.00 0 1322824 40922 Stevens Eric-Care Div Ops Exec thru President, No Cal/HI State Network 0.00 50.00 0 1315314 46881 Reiner Scott Former Dir/Chair/CEO thru 12/21 0.00 0.00 0 1222073 25188 Jobe Meredith Secretary 0.00 50.00 X 0 930036 49067 Fuentes Michelle President, AHSR 50.00 0.00 X 0 711119 53910 Heard Alexander-Departed 422 Medical Officer 50.00 0.00 0 701197 62046 McCulloch Gregory Treas/Asst Sec 50.00 0.00 X 0 480591 53809 Estenson Kara Patient Care Executive 50.00 0.00 0 366559 32064 Newton Tyler Operations Executive 50.00 0.00 0 339095 53591 Pickering Christine-Departed 422 Communication Dir, CCR 0.00 0.00 0 343094 39906 Calindas Nemia RN 50.00 0.00 265532 0 57660 Butterworth Faith Director, Pharmacy 50.00 0.00 230483 0 52547 Holaday Patricia RN Nurse Lead 50.00 0.00 230376 0 48502 Shinkai Susan Lead Pharmacist 50.00 0.00 224021 0 50261 Suess Andy Physician Assistan 50.00 0.00 228531 0 43472 Rogers Melissa RN Nurse Lead 50.00 0.00 218880 0 44960 Stuart Stephanie Medical Officer 50.00 0.00 0 218993 36579 Stuart Stephanie Medical Officer Eff 5/22 50.00 0.00 0 218993 36309 Piche Leanne Manager of Pharmacy 50.00 0.00 198949 0 49598 Casey Christy Administrative Director, Operations 50.00 0.00 184503 0 41940 Gillmeister Edward Cardiovascular Services Director 50.00 0.00 196541 0 27672 Chen Steven-Departed 322 Former Finance Officer, CCR 0.00 0.00 0 127975 15047 Westbie Donald Medical Director, Phy & Amb Svcs 50.00 0.00 0 124366 0 Freedman John Director 0.00 4.00 X 0 26858 0 Woodson Marc Director 0.00 4.00 X 0 26728 0 Banks David Director 0.00 4.00 X 0 26478 0 Cherry Robert Director 0.00 4.00 X 0 26478 0 Davis Andrew Director 0.00 4.00 X 0 26478 0 Innocent Larry Director 0.00 4.00 X 0 26478 0 Reiner Richard Director 0.00 4.00 X 0 26478 0 Newton Bradford Director 0.00 4.00 X 0 25180 0 Salazar Velino Director 0.00 4.00 X 0 21478 0 Fehr Joy Director 0.00 4.00 X 0 430 0 Ocampo Lucy Director 0.00 4.00 X 0 430 0 1977816 19374912 1301200 245 true true false Sierra Emergency Medical Group PO Box 4685 Sonora CA 95370 Physician Services 2642979 Northern California Spine Institute 5725 W Las Positas Blvd Ste 200 Pleasanton CA 94588 Physician Services 2440012 Sonora Anesthesia Services 1000 Greenley Road Sonora CA 95370 Physician Services 1911817 Galen Inpatient Physicians Inc 2100 Powell St STE 900 Emeryville CA 94608 Physician Services 1710808 Yousef Khelfa MD Medical Corporation 6467 Saint Andrews Dr Stockton CA 95219 Physician Services 1479687 67 162078 549381 650813 1362272 CARES Act Income 900099 582891 582891 Dietary 722514 605631 605631 Medical Office Rentals 531120 141509 141509 Patient Care Services 900099 274295627 274295627 Pharmacy 446110 5866216 5866216 203246 198349 4897 281695120 12722571 12722571 0 0 0 1158 16148548 -16148548 1158 -16147390 -16147390 95662 162078 142584 -46922 -46922 0 8944900 21113 8923787 73437 8850350 0 288509438 265542833 78334 21525999 X 238414 238414 0 0 0 0 0 89711101 80039081 9518310 153710 3280418 2932740 341351 6327 14467556 12918551 1522755 26250 6386084 5796040 578337 11707 32194880 32194880 222360 222360 465 465 0 0 0 54199732 48991875 5195871 11986 52996 52996 2474831 2192893 255444 26494 9649745 1729211 7920534 0 8832144 7589490 1227554 15100 350284 313047 31616 5621 0 60803 33617 24991 2195 2811712 2811712 0 9691997 8345251 1346746 1707282 1656338 50944 Patient Care Supplies 54107965 53868222 222891 16852 Other Expenses 13050091 1671684 11371907 6500 Equipment Rentals 874741 874741 Quality Assurance 192722 192722 2000 2000 304560323 232197629 72079952 282742 0 214493862 184591504 10497 310915 35166568 34418461 0 0 0 7070720 7063853 583607 404626 200732263 113285593 93261528 87446670 0 0 0 433978 433978 28670369 26829697 379691129 341499704 22282761 20334393 177080 124797267 110150019 147257108 130484412 X 230868515 209561121 1565506 1454171 232434021 211015292 379691129 341499704 -16050885 -5367844 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 41803 41803 false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to Noteware were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. Part IV - Additional Information 1565506 1416799 -1162 1526972 1454171 1949771 367851 1706 753822 1565506 2151843 200241 402313 1949771 6385177 1433834 5667168 2151843 5475403 1387610 477836 6385177 1.00000 false true true 7960473 7960473 111612978 54360768 57252210 9739254 6645314 3093940 71419558 52279511 19140047 87446670 Other Assets 52000 Other Receivables 301129 Receivables from related organizations 1064955 Receivables from Third Parties 25411613 26829697 Other Liabilities 8666887 Payables to Related Organizations 101997959 Payables to Third Parties -514827 110150019 X Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. Part X : FIN48 Footnote The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2022 and 2021, no such assets or liabilities were recorded.The System currently files Form 990 (informational return of organizations exempt from income taxes) and form 990-T (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2018 in major tax jurisdictions. X X X X X X X true CA Gala 216350 130258 86092 48930 24665 225 45464 Golf Tournament 41390 31820 9570 9348 13765 187 257740 162078 95662 58278 38430 225 45651 142584 -46922 Part I, Line 2b - Fundraiser Additional Information Fundraising Consulting Services Only true true X true X true X true true true false true true 1167336 1167336 0.00380 1167336 1167336 0.00380 355175 9255 345920 0.00110 204846 204846 0.00070 70200825 41828747 28372078 0.09320 119500 119500 0.00040 70880346 41838002 29042344 0.09540 72047682 41838002 30209680 0.09920 1263437 1263437 0.00410 55881 55881 0.00020 1319318 1319318 0.00430 true 1232356 96278 105154501 115971862 -10817361 X true true 1 1 Sonora Community Hospital 1000 Greenley Rd Sonora CA 95370 030000094 X X X false false true X X X X X X X X X 22 true false true true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 22 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X X X true true X X X X true X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 The CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate key informant interviews to ensure that minority populations the voices of those with chronic disease, low incomes and the underserved were heard. Civic government, community-based healthcare workers focusing on behavioral health, faith, law enforcement, low-income, medically underserved, minority populations, older adults, providers and unhoused populations participated in fourteen key informant interviews. This Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved individual key informant interviews with local leaders. These were conducted in person and virtually. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS). Survey data was gathered from the Central Valley region (region name defined by survey administrator, UC Berkeley IGS). Facility: - Part V, Section B, Line 11 The COVID-19 global pandemic has caused extraordinary challenges for Adventist Health hospitals and health care systems across the world including keeping front line workers safe, shortages of protective equipment, limited ICU bed space and developing testing protocols. They have also focused on helping patients and families deal with the isolation needed to stop the spread of the virus, and more recently vaccine roll out efforts. Adventist Health, like other health care systems, had to pivot its focus to meet the most urgent healthcare needs of its community during the pandemic, as well as reassess the ability to continue with some community health strategies due public health guidelines for social distancing. Adjustments have been made to continue community health improvement efforts as possible, while ensuring the health and safety of those participating. Tax year 2022 was year three of the Implementation Strategy for the 2019 CHNA. All programs and activities provided to the community were in response to the priority health needs identified in the 2019 CHNA. Our 2019 CHNA identified four areas of significant need: Access to Health Care, Mental and Behavioral Health, Housing and Homelessness, and Chronic Disease. Priority Need 1- Access to Care- The goal is to increase access to local health care through an increased number of providers and removing barriers to medical care. Strategy 1- Increase the number of access points to medical services and social services. Activity 1.1- Physician Recruiting in MUA - 8 providers were onboarded. Providers were added into the following areas: gastroenterology surgery, physical medicine & rehabilitation, primary care, urology, orthopedics, and OBGYN. NEW: Activity 1.2- Community Information Center- A collaborative project with the County of Tuolumne is currently in the planning stages. In 2022, the community felt that a resource center in person would not be as helpful as a digital system that could be accessed by people anywhere. The work to expand the Unite Us platform, support Area 12 Agency on Agings update of their resource website (https://adrcofthemotherlode.myresourcedirectory.com), and the development of a new resource guide in partnership with Public Health became the focus in 2022. NEW: Activity 1.4- Project HOPE- Is a charitable fund administered by Sonora Community Hospitals Well-Being Department. Due to the pandemic, Project HOPEs outreach component has grown to assist community members facing financial hardship. Project HOPE has provided applicants with payment of medical bills, purchases of medical equipment, transportation and lodging and other health supporting assistance. In 2022, over 50 individuals were provided various forms of assistance. Priority Need 2- Mental and Behavioral Health- The goal is to increase access to classes and care pertaining to mental and behavioral health. Strategy 1- Raise awareness of substance misuse and increase efforts in mental health screening creating more opportunities for healthful choices. Activity 1.1- Opioid Safety Coalition. The Red Feather Opioid Coalition under the leadership of Monica Lewis of the Mathiesen Memorial Health Clinic continued in 2022. The organization met 10 times throughout the year and presented a comprehensive review of opioid use in Tuolumne County for the first time. Additionally, Narcan training for all public and private school staff was held, and free Narcan was provided to school sites who requested. Activity 1.2- Drug Store Project- Activity - An anti-substance abuse program aimed at seventh graders, was held in October 2022. All public schools participated and over 400 students attended. 1.3- ACEs Pilot Program- this grant covered program hopes to improve access to mental and behavioral health, by providing screenings by checking children for Adverse Childhood Experiences (ACEs). The ACEs Pilot Program continues as part of the Sonora Community Hospitals (AHSR) strategy to improve access to mental and behavioral health. AHSR pediatricians screen children for adverse childhood experiences (ACEs), resulting in a score that can prompt referrals to mental and behavioral health care and other support services for children and their families. Expansion opportunities included onboarding a new Director who has extensive experience in ACEs. A new data analysis collection tool was developed to accurately track the number of referrals and the types of services provided Additional activities: 1. Prescription Drug Take-back Days are ongoing. In 2022, hosted by the U.S. Drug Enforcement Administration, events were held April 30, 2022, and October 29, 2022. Additionally, AHSR has a drug take-back containers in its pharmacies. 2. Sonora Community Hospital continues to sponsor TeenWorks Mentoring, a program that provides faith-based mentoring to at risk youth, and Spiritual Roads, a faith-based recovery program. Priority Need 3- Housing and Homelessness- The goal is to increase access to shelters, tiny homes, and affordable housing through strategic partnerships. Strategy 1- Partner with county and local programs to have a greater impact on creating access to shelter and housing. Activities include the following: 1. Resiliency Village Project and Camp Hope Project. Resiliency Village has served over 15 individuals and families since opening their doors with a continuous occupancy of 10 which is the maximum including families. This project provides a safe living environment with multiple wrap service providers including behavioral health, adult education, job assistance, and substance use disorder counseling. Sonora Community Hospital was able to support the expansion of the house by funding construction to add 3 additional bedrooms and a wheelchair accessible bathroom. Resiliency Village continues to manage the Room Key Program, which has maintained housing in Twain Harte and Columbia which are areas with little to no affordable housing. 2. County of Tuolumne Homeless Committee. Adventist Health Foundation representatives were invited to serve on the County of Tuolumne Homeless Committee as advisory members to discuss the need for more affordable housing for families and vulnerable populations in the community. The County of Tuolumne has secured several funding sources to address the needs of unhoused individuals and families including Homeless Housing, Assistance and Prevention (HAPP) funds. These funds can be used in conjunction with other affordable housing financing to build an affordable housing rental complex in Tuolumne County. Adventist Health supports efforts to increase the amount of affordable rental housing for families in the community and owns an approximately 6.7-acre vacant parcel at the intersection of Greenley Road and Cabezut Road, APN 044-420-037, that is close to services and amenities. The project has been approved by the Tuolumne Board of Supervisors and studies are being completed.Priority Need 4- Chronic Disease- The goal is to reduce incidences of chronic disease through education. Strategy 1- Increase support for local education addressing smoking, diabetes, asthma and cancer. Activities included: 1. The Heart Health walk took place in February 2022. 2. The first Annual Turkey Trot to highlight diabetes awareness took place in November 2022. 3. Ladies Night Out took place in October 2022 and over 400 participants attended. Sonora Community Hospital used the event to launch the online mammogram scheduling platform. 4. Pulmonary Rehab Phase 3 is ongoing and there has been an increase in the number of community fitness classes offered at the Living Well Fitness Center including the addition of weekend and evening classes. Additional Activities: The Blue Zones Project in Tuolumne County has grown exponentially in 2022. The Blue Zone Project Tuolumne County kickoff event in April 2022 included 31 community partners and over 1,200 participants. The project has helped create walking moais (groups) in Twain Harte, Tuolumne, Sonora, Columbia, and East Sonora. In 2022, over 80 engagements have been held including cooking demonstrations that provide healthy, inexpensive meal preparation for a variety of partners including senior living facilities, restaurants, and grocery stores. Sonora Community Hospital and Blue Zones were involved in the first walking event in November at Jamestown Elementary (Jimtown Walk) where 150 participants walked and were provided nutrition counseling, blood testing, and other services to promote healthy living. Blue Zone Project also supported Red Ribbon Week which provided tobacco awareness and education through healthy alternatives to tobacco use, to 1,158 students in grades 5th through 8th. In December, the first non-smoking area was designated at the Christmas Parade with the support of Sonora City Council and local businesses. Facility: - Part V, Section B, Line 13h Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets. Health Pavilion 900 Mono Wy Sonora CA 95370 Clinic and Medical Services Surgery Center 12811 Covey Cir Sonora CA 95370 Outpatient Procedures Sierra Orthopedic Institute 680 Guzzi Ln Ste 105 Sonora CA 95370 Clinic Services Indian Rock Prompt Care 14590 Mono Wy Sonora CA 95370 Clinic Services Center for Wound Care 12811 Covey Cir Sonora CA 95370 Clinic Services Community Pharmacy Stockton St 220 W Stockton St Sonora CA 95370 Pharmacy Northern California Spine Institute 900 Greenley Rd Ste 914 Sonora CA 95370 Clinic Services Greenley Oaks Ear Nose and Throat 795 Morningstar Dr Sonora CA 95370 Clinic Services Community Pharmacy Greenley Rd 900 Greenley Rd Sonora CA 95370 Pharmacy Hillside Internal Medicine 1 690 Guzzi Ln Ste B Sonora CA 95370 Clinic Services Bones Sports Medicine and Rehabilitation 13808 Mono Wy Sonora CA 95370 Clinic Services Sierra Care Center Unit 7 538 Ponderosa Dr Sonora CA 95370 Long-Term Care Oxygen and Medical Supply 220 W Stockton St Sonora CA 95370 Oxygen and Durable Medical Equipment Sierra Cardiology 900 Greenley Rd Ste 911 915 Sonora CA 95370 Clinic Services Sierra Care Center Unit 6 179 S Fairview Ln Sonora CA 95370 Long-Term Care Sierra OBGYN 900 Greenley Rd Ste 922 Sonora CA 95370 Clinic Services Foothill Specialty Group 680 Guzzi Ln Ste 206 Sonora CA 95370 Clinic Services Rural Health Primary Care 193 S Fairview Ln Ste B Sonora CA 95370 Clinic Services Sonora Urology Clinic 690 Guzzi Suite B Sonora CA 95370 Clinic Services Angels Camp Rapid Care 23 N Main St Angels Camp CA 95222 Clinic Services Rural Health Dental Care 193 S Fairview Ln Ste J Sonora CA 95370 Clinic Services Rural Health Specialty Care 193 S Fairview Ln Ste C F Sonora CA 95370 Clinic Services Sonora Sleep Lab 729 Pauline Ct Sonora CA 95370 Medical Services General Surgery Associates 680 Guzzi Ln Ste 206 Sonora CA 95370 Clinic Services Angels Camp Family Medical Office 445 S Main St Angels Camp CA 95222 Clinic Services Yosemite Orthopedics and Joint Replacement 680 Guzzi Ln Ste 102 Sonora CA 95370 Clinic Services Foothill Pediatrics and Rheumatology 12791 Cabezut Rd Sonora CA 95370 Clinic Services Live Well Be Well Center 19747 Greenley Rd Sonora CA 95370 Clinic Services Angels Camp Orthopedics 23 N Main St Angels Camp CA 95222 Clinic Services Rural Health Pediatric Care 193 S Fairview Ln Ste L Sonora CA 95370 Clinic Services Groveland Family Medical Office 18661 Hwy 120 Groveland CA 95321 Clinic Services Cedarwood Internal Medicine 690 Guzzi Ln Ste A Sonora CA 95370 Clinic Services Sierra Pulmonology 900 Greenley Rd Ste 923 Sonora CA 95370 Clinic Services Greenley Primary Care 19747 Greenley Rd Sonora CA 95370 Clinic Services Angels Camp Physical Therapy 457 S Main St Angels Camp CA 95222 Clinic Services Sierra Internal Medicine 680 Guzzi Ln Ste 201 Sonora CA 95370 Clinic Services JobCare 19747 Greenley Rd Sonora CA 95370 Home Health Arnold Family Medical Office 2037 Hwy 4 Arnold CA 95223 Clinic Services Cardiac Rehabilitation 19747 Greenley Rd Sonora CA 95370 Clinic Services Pulmonary Rehabilitation 19747 Greenley Rd Sonora CA 95370 Clinic Services Living Well Fitness CntrRadiology AHSR 4 S Forest Rd Sonora CA 95370 Clinic Services Oxygen and Medical Supply - Hanford 440 Greenfield Ave Ste A Hanford CA 93230 Oxygen and Durable Medical Equipment Hillside Internal Medicine 2 680 Guzzi Ln Ste 204 Sonora CA 95370 Clinic Services Cancer Center 900 Greenley Rd Ste 902 Sonora CA 95370 Clinic Services Anticoagulation Clinic 19747 Greenley Rd Sonora CA 95370 Clinic Services Part I, Line 7 - Explanation of Costing Methodology The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:(Total expenses - (Provision for bad debts + Other revenue + Interest income)) / Gross patient charges Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio is multiplied times the hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments too many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information please refer to schedule H part III section B. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low incomeX and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2 - Needs Assessment The hospital's 2022 CHNA, the 2022 Community Health Plan (CHP) for fiscal year 2022 and the 2023 Implementation Strategy are posted on the hospital's website at https://www.adventisthealth.org/sonora/about-us/community-benefit/ The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2022, 2021 and 2020 Community Health Plan Updates are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/In addition to the CHNA, our hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. Part VI, Line 3 - Patient Education of Eligibility for Assistance The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the hospital's website at:1.https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ 2.https://www.adventisthealth.org/documents/financial-assistance/13863-Self-Pay-Billing-and-Collection-Policy.pdfThese documents are available in multiple languages.At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. Part VI, Line 4 - Community Information Located in the heart of Californias gold country, Tuolumne County is nestled in the Sierra Nevada Foothills and is the gateway to the world famous Yosemite National Park. Founded during the California Gold Rush, Sonora, has a rich heritage, small town feel, and historic charm. These are all communities represented in the Sonora CHNA service area where the largest age group is over age 55 (45.13%). The community is vibrant and cultured with art, galleries, festivals, events and small businesses. Of the population, 12.57% are Hispanic and 74.74% own their home. The median household income is $58,959 of which 58.6% is spent on housing and transportation. Among this population, 15.2% of children live in poverty and 5.45% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. The following zip codes represent Sonora Community Hospitals primary service area (PSA), accounting for 75% of hospital discharges. Additionally, we took a collaborative approach and expanded our PSA by inviting Steering Committee members to include the zip codes of those they serve. The Sonora Community Hospital CHNA market has a total population of 84,499 (based on the 2020 Decennial Census). The largest city in the service area is Sonora, with a population of 4,904. The service area is comprised of the following zip codes: 95311, 95310, 95248, 95251, 95224, 95318, 95223, 95370, 95383, 95321, 95364, 95247, 95329, 95222, 95372, 95305, 95346, 95379, 95375, 95233, 95327, 95335, 95228, 95249, 95246. 74.74% of the population own their home and 25.26% of the population rents their home. Total Population by Age Groups: Age 0-4: 4.4%, Age 5-17: 11.9%, Age 18-24: 6.3%, Age 25-34: 11.5%, Age 35-44: 9.8. Part VI, Line 4 - Community Building Activities The hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint, and as we entered 2022 these projects are active. Blue Zones widens our impact from only reaching our hospitals communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H.Other Community Benefits:On April 9, 2022, Sonora Community Hospital proudly launched Blue Zones Project Tuolumne County (BZPTC). The BZPTC team wakes up each morning focused on partnering and collaborating with community leaders and organizations active in the sectors of built environment, education, economic and workforce development, mental and physical well-being, policy and public health. Together the BZPTC team and sector leaders will develop a community Blueprint that strategically aligns and leverages the actions and resources of the sectors where we live, learn, work and play to help advance the efforts around the communitys biggest Social Determinant of Health challenges while connecting them to Health-Related Social Needs organizations. Part VI, Line 5 - Promotion of Community Health Our hospitals mission is, Living Gods love by inspiring health, wholeness and hope. Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the Triple Aim. The Triple Aim concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given todays state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthyeven though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population; 2) Factors that cause the present outcomes distribution; and 3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2) Improve care quality and patient safety, and 3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6 - Affilated Health Care System The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7 - States Filing of Community Benefit Report CA Part VI - Additional Information Identified Needs from CHNA, Not Addressed and Why (Based on FY 2022) CHP Update - No hospital can address all the health needs identified in its community. Adventist Health Sonora is committed to serving the community be adhering to its mission, and using its skills, expertise and resources to provide a range of community-benefit programs. Poverty: Adventist Health Sonora will not be addressing poverty directly as many aspects of poverty will be addressed in our current CHNA priorities. Other Items:Primary website address: See Form 990, Pg 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education true Amador Tuolumne Community Act 427 N Highway 49 Sonora CA 95370 942765408 501(c)(3) 27024 0 Fund Transfer Sponsorship-Housing Services CA Health Fund & Trust 1215 K St Ste 800 Sacramento CA 95814 941498697 501(c)(3) 61690 0 Fund Transfer Health services for uninsured pt. Groveland Trail Heads 21133 Jimmersall Ln Groveland CA 95321 461697267 501(c)(3) 9000 0 Fund Transfer Sponsorship Horses of Warriors 11896 Campo Seco Rd Sonora CA 95370 825391446 501(c)(3) 10000 0 Fund Transfer Sponsorship Sonora Area Foundation 362 S Stewart St Sonora CA 95370 931023051 501(c)(3) 7000 0 Fund Transfer Sponsorship The Refuge Recovery Center 19401 Susan Way Sonora CA 95370 851413804 501(c)(3) 17200 0 Fund Transfer Sponsorship Tuolumne County Schools 175 Fairview Ln Sonora CA 95370 946050189 Government 25000 0 Fund Transfer Sponsorship Twain Harte Community Service PO Box 649 Twain Harte CA 95383 770432917 501(c)(3) 6000 0 Fund Transfer Sponsorship 8 0 Grantmaker's Description of How Grants are Used Prior to issuing grants, hospital evaluates organization requesting grant and ensures alignment with hospital's exempt purpose and mission. After disbursing grant funds, hospital does not monitor use of funds. X X X X true true false false false false false false false Beaman John CFO/Secretary 1047636 298600 14860 12310 48765 1422171 Butterworth Faith Director, Pharmacy 219231 10686 566 10565 41982 283030 Calindas Nemia RN 251380 14152 12310 45350 323192 Casey Christy Administrative Director, Operations 169569 14638 296 8320 33620 226443 Estenson Kara Patient Care Executive 295454 62018 9087 12310 19754 398623 Fuentes Michelle President, AHSR 510591 124672 75856 12310 41600 765029 Gillmeister Edward Cardiovascular Services Director 180653 14780 1108 8706 18966 224213 Heard Alexander-Departed 422 Medical Officer 455182 102263 143752 12310 49736 763243 Heinrich Kerry Director/CEO 1817710 76 313658 12310 35759 2179513 Hofheins Todd COO Eff 1/22 1358421 376216 237015 12310 43654 2027616 Holaday Patricia RN Nurse Lead 229725 651 11591 36911 278878 Jahn Andrew-Care Div Pres thru 222 President, Southern CA Network 1047840 349414 12285 12310 47782 1469631 Jobe Meredith Secretary 639741 154687 135608 12310 36757 979103 McCulloch Gregory Treas/Asst Sec 354631 72861 53099 12310 41499 534400 Nahapetian Arby-Care Div Med Off th Chief Clinical Officer 927049 234212 172850 12310 48470 1394891 Newton Tyler Operations Executive 259485 52827 26783 12310 41281 392686 Piche Leanne Manager of Pharmacy 198896 53 10024 39574 248547 Pickering Christine-Departed 422 Communication Dir, CCR 85004 74747 183343 3766 36140 383000 Reiner Scott Former Dir/Chair/CEO thru 12/21 348458 870709 2906 12310 12878 1247261 Rogers Melissa RN Nurse Lead 210703 8177 10796 34164 263840 Shinkai Susan Lead Pharmacist 223970 51 11059 39202 274282 Spents Brett-Care Div Fin Off thru Sr. Finance Officer & CIO 817612 416845 88367 12310 28612 1363746 Stevens Eric-Care Div Ops Exec thru President, No Cal/HI State Network 896507 250602 168205 12310 34571 1362195 Stuart Stephanie Medical Officer Eff 5/22 190650 51 28292 9250 27059 255302 Stuart Stephanie Medical Officer 190650 51 28292 9520 27059 255572 Suess Andy Physician Assistan 223977 4554 11059 32413 272003 Wing Bill - Departed 122 Dir/VC/Asst Sec 263334 662638 1585375 12310 40979 2564636 Edward Clinite Fmr Key EE 85433 Building Lease false Tyler Newton Son-Board Member 392686 Employment false Walker Heard Key EE Son 701197 Employment false Schedule L, Part V Supplemental Information Additional information regarding interested persons listed above:1. Edward Clinite, a Former Key Employee, is the owner of a property the hospital rents.2. Tyler Newton is the son of Board Member, Bradford Newton.3. Tina Walker is the daughter of Key Employee, Alexander Heard.Edward Clinite,D.O. and his wife own property placed in a trust that is being leased by the hospital at fair market rental value. The transaction is subject to the organization's compliance program and is approved through the appropriate organizational approval process, which may include the Compliance Committee of the Board. Form 990, Part VI, Section A, Line 6 The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Section A, Line 7a The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, Line 7b The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Section B, Line 11b This Form 990, including all supporting schedules, was prepared by a public accounting firm, reviewed by the System Controller and market Finance Officer, and shared by electronic communication with the corporation's Board of Directors prior to filing. Form 990, Part VI, Section B, Line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president immediately.The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Copies for the officers and key employees' COIs are kept in their personnel files. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, Line 15a The Organization's Board of Directors has established a Human Performance Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. Form 990, Part VI, Section B, Line 15b See Line 15a explanation. Form 990, Part VI, Section C, Line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Prior Period Adjustments Prior Period adjustments were a result of cash balance correction and clean up of books due to prior period activities including debt service, capital expenditures, and other items. 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