2024-11-14T16:59:10-06:00 2023-12-31 ERNST & YOUNG US LLP 560 MISSION ST STE 1600 SAN FRANCISCO CA 94105 990 2023-01-01 990298651 SUTTER HEALTH PACIFIC % MARIA ELENA LOPEZ SUTT 9162866665 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 CONRAD VIAL MD PRESIDENT 8086772580 2024-11-05 true true EVA NITTA P01286320 4158948000 2024-10-27 2023 2024-10-15 13:58:12Z KAHI MOHALA CONRAD VIAL MD SAME AS C ABOVE EWA BEACH HI 96706 22034419 false X WWW.SUTTERHEALTH.ORG X 1992 CA SEE SCHEDULE O 10 7 282 7 0 0 427920 153862 20603422 21855640 7791 23830 0 0 21039133 22033332 0 0 0 0 19126458 18121535 0 0 12534 6319529 7703200 25445987 25824735 -4406854 -3791403 17366570 16753527 5767023 6624071 11599547 10129456 X SEE SCHEDULE O false false 24110946 21855640 SEE SCHEDULE O 24110946 true true false false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 30 0 true 282 true false false false false false false false false false false false false X 10 7 false false false false true true true true true false false true true true true true true true true false CA X MARIA ELENA LOPEZ 8086772511 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 X JAMES E CONFORTI FORMER INTERIM PRES & CEO, SH 0.0 0.0 X 0 6356149 0 CONRAD VIAL MD President, SHP 2.0 40.0 X X 0 2565244 265445 MARK WHEELER CFO, SVNAH & SH PACIFIC 1.0 40.0 X 0 467787 58274 Ben Kirk SH VP, Legal Ops, Valley 1.0 40.0 X 0 394894 116296 Celia Ona CHIEF MEDICAL EXECUTIVE 40.0 0.0 X 445291 0 8146 Elena Sharipova MD PSYCHIATRIST 40.0 0.0 X 352595 0 9453 Tina Mai PSYCHIATRIST 40.0 0.0 X 316447 0 19893 Mark Linscott DIRECTOR/EXEC, SERVICE LINE 40.0 0.0 X X 245538 0 10694 Michelle Fernandez DIRECTOR, INPATIENT NURSING 40.0 0.0 X 192596 0 10073 Issar Daryanani MANAGER, PSYCHOLOGY 40.0 0.0 X 149638 0 11543 Steven Chaplin MD Director, Psychiatrist 40.0 0.0 X 148514 0 1739 Katherine W Bennett DIRECTOR 1.0 0.0 X 0 0 0 Millard Brown DIRECTOR 1.0 0.0 X 0 0 0 Nicholas Hughey DIRECTOR 1.0 0.0 X 0 0 0 Evan Leong DIRECTOR 1.0 0.0 X 0 0 0 Dee Jay Mailer DIRECTOR 1.0 0.0 X 0 0 0 Gidget Ruscetta DIRECTOR 1.0 0.0 X 0 0 0 Charles Sted DIRECTOR/CHAIR 2.0 2.0 X X 0 0 0 1850619 9784074 511556 47 true true false CHG Companies Inc Comp Health In PO Box 972651 DALLAS TX 753972651 Psychiatry Services 331914 VISTA STAFFING SOLUTIONS INC 2800 E COTTONWOOD PKWY STE 400 COTTONWOOD HEIGHTS UT 841217296 PSYCHIATRY SERVICES 326487 VIRTUAL MEDICAL STAFF 2655 NORTHWINDS PKWY ALPHARETTA GA 30009 PSYCHIATRY SERVICES 275261 LOCUMTENENSCOM LLC PO BOX 405547 ATLANTA GA 30384 PSYCHIATRY SERVICES 270715 UNIVERSAL PROTECTION SVC LP 161 WASHINGTON ST STE 600 CONSHOHOCKEN PA 194282083 SECURITY SERVICES 141328 7 1279 142843 9740 153862 PATIENT SERVICE REVENUE 623990 21855640 21855640 21855640 24917 0 24917 0 0 0 0 0 0 1087 -1087 -1087 -1087 0 0 0 0 0 0 0 0 0 0 22033332 21855640 0 23830 0 0 0 0 689543 355244 334299 0 0 0 0 12136138 11653652 482486 415393 398879 16514 3675980 3456186 219794 1204481 1119424 85057 0 1385 1385 0 0 0 1712 1712 2491359 2491359 9760 9760 748595 587803 148415 12377 137398 1621 135777 0 730797 730497 300 121272 105105 16167 0 17892 10926 6966 0 0 612379 612379 306191 306191 PURCHASED SERVICES 1650397 1456365 193875 157 FOOD 457637 457637 MEDICAL SUPPLIES 296951 296821 130 DUES AND SUBSCRIPTIONS 59726 30857 28869 59749 30240 29509 25824735 24110946 1701255 12534 0 0 1013982 1409784 0 0 5175131 4397931 0 0 0 0 0 0 6059 7267 160663 264430 22936872 12272176 11001249 10664696 0 0 0 0 0 0 0 0 9486 9419 17366570 16753527 1483850 1001237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4283173 5622834 5767023 6624071 X 11524140 10065322 75407 64134 11599547 10129456 17366570 16753527 X -3791403 13405 2307907 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 8115975 8115975 0 12691285 10592403 2098882 0 1644103 1304315 339787 0 485509 375458 110052 10664696 0 INSURANCE LIABILITIES 1906935 OTHER LIABILITIES 3715899 5622834 X SCHEDULE D, PART X, LINE 2 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 2020 THROUGH 2022 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, 2023 AND 2022. true true X true X 400. true false true true 4 9 17098 17098 0.00070 4 79 269681 269681 0.01040 7 745 28244 28244 0.00110 15 833 315023 315023 0.01220 15 833 315023 315023 0.01220 1 8116 8116 0.00030 1 172 5049 5049 0.00020 1 4183 4183 0.00020 3 172 17348 17348 0.00070 false 0 0 0 X true true 1 1 SUTTER HEALTH PACIFIC - KAHI MOHALA 91-2301 OLD FORT WEAVER ROAD EWA BEACH HI 96706 https://www.sutterhealth.org/kahi #33-H X SUTTER HEALTH PACIFIC - KAHI MOHALA 1 false false true X X X X X X X X X 22 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 22 true SEE PART V, SECTION C false true X 400. 0. 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 SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 5 IN CONDUCTING ITS MOST RECENT CHNA, SUTTER HEALTH PACIFIC - KAHI MOHALA DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) PARTNERED WITH WARD RESEARCH, A HAWAII-BASED MARKET RESEARCH FIRM SPECIALIZING IN BOTH QUALITATIVE AND QUANTITATIVE RESEARCH, WITH A WIDE RANGE OF PUBLIC AND PRIVATE SECTOR PARTNERS. WARD RESEARCH HAS WORKED WITH HAWAII'S HEALTHCARE SYSTEMS FOR DECADES IN SUPPORTING PUBLIC HEALTH POLICY, UNDERSTANDING CLIENT EXPERIENCES, EVALUATING EXISTING PROGRAMS IN MEETING CLIENT NEEDS AND FOCUSING ON HEALTH AND HUMAN SERVICE NEEDS. WARD RESEARCH BUILT A TEAM TO ENGAGE MEANINGFULLY WITH COMMUNITY MEMBERS, ORGANIZATIONS, ORGANIZERS, LEADERS, AND THOSE INVOLVED IN BOTH DIRECT HEALTHCARE AND IN ADDRESSING UPSTREAM SOCIAL DETERMINANTS THAT SIGNIFICANTLY IMPACT HEALTH OUTCOMES. A SPECIFIC EFFORT WAS MADE TO LEARN ABOUT THE EXPERIENCE OF HEALTH IN VULNERABLE COMMUNITIES, INCLUDING DISADVANTAGED MINORITIES, RURAL RESIDENTS, YOUTH, SENIORS, PLACES THAT ARE MEDICALLY UNDERSERVED, AND PEOPLE WITH LOW INCOMES. THE MEETINGS WERE NOT LIMITED TO THESE POPULATIONS AND INCLUDED A DIVERSE SAMPLE OF GEOGRAPHIES, AGES, ETHNICITIES, AND SOCIOECONOMIC BACKGROUNDS. INPUT WAS GATHERED THROUGH A RANGE OF METHODS, INCLUDING COMMUNITY MEETINGS, KEY INFORMANT INTERVIEWS, AND SMALL GROUPS. WARD RESEARCH PARTNERED WITH ORGANIZATIONS AND INDIVIDUALS WITH STRONG CONNECTIONS WITHIN THEIR COMMUNITIES TO ORGANIZE AND HOST THESE MEETINGS. ALL THE HOSTS WORK IN COMMUNITY HEALTH, COMMUNITY SERVICE AND/OR COMMUNITY BUILDING AND ENGAGE ON ISSUES AFFECTING HEALTH AND WELLBEING. AS HOSTS, THEY PLAYED A CRITICAL ROLE IN CREATING A SAFE SPACE AND INVITING THE RIGHT PEOPLE INTO THE SPACE, INCLUDING PATIENTS, STAFF, OR COMMUNITY MEMBERS WHO HAD IMPORTANT STORIES AND COULD FEEL COMFORTABLE SHARING THEM. THE MEETINGS WERE KEPT RELATIVELY SMALL-BETWEEN THREE TO 20 PEOPLE-AND DESIGNED TO MAXIMIZE EVERYONE'S COMFORT LEVEL. PARTICIPANTS WERE PRIMARILY MEMBERS OF FOCUS SUBPOPULATIONS OR SOCIAL WORKERS AND OTHER COMMUNITY SERVICE PROVIDERS DOING FRONTLINE WORK WITH THOSE COMMUNITIES. FACILITATORS FROM DIFFERENT ISLANDS WOULD LEAD THE GROUP IN AN ORGANIC DISCUSSION BEGINNING WITH THE 2018 PRIORITIES AND DISCUSSING TOP PRIORITIES THAT WERE SIMILAR TO OR DIFFERENT FROM TODAY, UNDERSTANDING THE IMPACT OF COVID-19, AND TEASING OUT OPPORTUNITIES FOR HAWAII HOSPITALS TO BE A PARTNER IN ADDRESSING THE COMMUNITY HEALTH NEEDS IDENTIFIED BOTH AT THE OPERATIONAL AS WELL AS THE SYSTEMIC LEVEL. THE WARD TEAM SOUGHT OUT A DIVERSITY OF PERSPECTIVES, INCLUDING: GEOGRAPHIC THROUGH HAVING AT LEAST ONE MEETING ON EACH ISLAND; A MIXTURE OF THOSE THAT PARTICIPATED IN 2018 AND THOSE THAT DID NOT; MULTIPLE DIFFERENT ETHNIC COMMUNITIES; AND VARIOUS VULNERABLE POPULATIONS WITH UNIQUE HEALTH NEEDS. COMMUNITY MEETINGS WERE CONDUCTED IN VARIOUS LOCATIONS, FROM AGRICULTURAL PLOTS IN KUNIA, OAHU TO YOUTH RESIDENTIAL FACILITIES IN KAILUA, OAHU, AND NONPROFIT OFFICES IN LIHUE, KAUAI. EVERY EFFORT WAS MADE TO ENSURE THAT LIMITED-ENGLISH PROFICIENT (LEP) AND OTHERLY-ABLED INDIVIDUALS WERE SUPPORTED THROUGH INTERPRETATION, CULTURALLY APPROPRIATE FACILITATION, AND GRAPHIC REPRESENTATIONS OF THE 2018 PRIORITIES. PARTICIPANTS WERE ASSURED THAT THEIR COMMENTS WOULD BE ANONYMOUS AND THEIR IDENTITY NOT INCLUDED. IN SITUATIONS WITH ESPECIALLY VULNERABLE POPULATIONS SUCH AS FOREIGN-BORN FOLKS OR SURVIVORS OF INTIMATE PARTNER VIOLENCE, FACILITATORS REFRAINED FROM RECORDING THE MEETINGS IF THE PARTICIPANTS WERE UNCOMFORTABLE. THE WARD TEAM CONDUCTED 80 KEY INFORMANT INTERVIEWS WITH INDIVIDUALS IN KEY STAKEHOLDER POSITIONS ABLE TO PROVIDE INPUT AND INSIGHT ON BEHALF OF A TARGET POPULATION. THESE TENDED TO BE ORGANIZATIONAL LEADERS SERVING STAKEHOLDER COMMUNITIES VERSUS MEMBERS OF THOSE ACTUAL POPULATIONS THAT JOINED COMMUNITY MEETINGS. INTERVIEWS WERE TYPICALLY ONE ON ONE BETWEEN AN INTERVIEWER AND A KEY INFORMANT, LASTING ANYWHERE FROM 45 TO 90 MINUTES THE WARD TEAM ALSO HELD A SERIES OF PRIVATE SMALL GROUP MEETINGS WITH KEY LEADERS IN THREE OF THESE AREAS (FOOD SECURITY, MENTAL HEALTH, AND HOUSING). THE FINDINGS FROM KEY INFORMANT INTERVIEWS IN KAHI MOHALA'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/KAHI/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SCHEDULE H, PART V, SECTION B, LINES 6A AND 6B THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) LED THIS COLLABORATION TO CONDUCT STATE- AND COUNTY-WIDE ASSESSMENTS FOR ITS MEMBERS. ITS 170 MEMBER ORGANIZATIONS ENCOMPASS ACUTE CARE HOSPITALS, SKILLED NURSING FACILITIES, ASSISTED LIVING FACILITIES, TYPE II ADULT RESIDENTIAL CARE HOMES, MEDICARE-CERTIFIED HOME HEALTH AGENCIES, AND HOSPICES. ADDITIONAL MEMBERS INCLUDE HOME INFUSION/PHARMACIES, CASE MANAGEMENT FIRMS, AIR AND GROUND AMBULANCE PROVIDERS, THE BLOOD BANK OF HAWAII, DIALYSIS PROVIDERS, AND MORE. HAH AIMS TO BE THE UNIFYING VOICE OF HAWAII'S HEALTHCARE PROVIDERS AND AN AUTHORITATIVE AND RESPECTED LEADER IN SHAPING HAWAII'S HEALTHCARE POLICY. FOUNDED IN 1939, HAH REPRESENTS THE STATE'S HOSPITALS, NURSING FACILITIES, ASSISTED LIVING FACILITIES, HOME HEALTH AGENCIES, HOSPICES, AND OTHER HEALTHCARE PROVIDERS. HAH WORKS WITH COMMITTED PARTNERS AND STAKEHOLDERS TO ESTABLISH A MORE EQUITABLE, SUSTAINABLE HEALTHCARE SYSTEM DRIVEN TO IMPROVE QUALITY, EFFICIENCY, AND EFFECTIVENESS FOR PATIENTS AND COMMUNITIES. SCHEDULE H, PART V, SECTION B, LINE 7A FILING ORG WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/KAHI/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 7B OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 10A OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/ COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 11 THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT KAHI MOHALA INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: -MENTAL HEALTH -TRUST & EQUITABLE ACCESS DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. KAHI MOHALA 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: -FINANCIAL SECURITY -FOOD SECURITY -HOUSING AS A MENTAL AND BEHAVIORAL HEALTH FACILITY KAHI MOHALA DOES NOT HAVE THE RESOURCES AND/OR EXPERTISE TO RESPOND TO THESE COMMUNITY NEEDS AT THIS TIME. SCHEDULE H, PART V, SECTION B, LINE 15E 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 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 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 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 I, LINES 3A AND 3C FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENT'S FAMILY INCOME. SCHEDULE H, PART I, LINE 3B SUTTER HEALTH PACIFIC - KAHI MOHALA IS COMMITTED TO PROVIDING CHARITY CARE AND THEREFORE, PROVIDES FREE CARE AT HIGH PERCENTAGE OF FPG. THE ORGANIZATION DOES NOT PROVIDE DISCOUNTED CARE. SCHEDULE H, PART I, LINE 6A SUTTER HEALTH, A RELATED ORGANIZATION, PREPARES A COMBINED COMMUNITY BENEFIT REPORT. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: KAHI MOHALA FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. KAHI MOHALA WAS PART OF THE PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE FOCUSED ON DEVELOPING EFFECTIVE BEHAVIORAL HEALTH PREVENTION STRATEGIES. KAHI MOHALA FOCUSED ON ENVIRONMENTAL IMPROVEMENTS THROUGH ITS KAHI MOHALA NEIGHBORHOOD LITTER/GRAFFITI REMOVAL PROGRAM. KAHI MOHALA SUPPORTED COMMUNITY HEALTH IMPROVEMENT ADVOCACY WITH SUPPORT OF LOCAL ORGANIZATIONS SUCH AS THE HEALTH CARE ASSOCIATION OF HAWAII, HAWAII PUBLIC HEALTH ASSOCIATION, AND THE STATE HEALTH PLANNING DEPARTMENT. 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 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 PROVIDE TO PATIENTS AT OTHER TIMES: 1. CONTACT INFORMATION WHICH INCLUDES A PHONE NUMBER AND HOSPITAL DEPARTMENT TO OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE APPLICATION PROCESS. 2. BILLING STATEMENTS: BILLING STATEMENTS PROVIDED TO PATIENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, A PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS ABOUT FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE PATIENTS CAN OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE INCLUDING THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY OF THE POLICY, AND THE APPLICATION FOR FINANCIAL ASSISTANCE. 3. UPON REQUEST: HOSPITALS SHALL PROVIDE PATIENTS WITH PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST AND WITHOUT CHARGE. F. PUBLICITY OF FINANCIAL ASSISTANCE INFORMATION 1. PUBLIC POSTING: HOSPITALS SHALL POST COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IN A PROMINENT LOCATION IN THE EMERGENCY ROOM, ADMISSIONS AREA, AND ANY OTHER LOCATION IN THE HOSPITAL WHERE THERE IS A HIGH VOLUME OF PATIENT TRAFFIC, INCLUDING BUT NOT LIMITED TO THE WAITING ROOMS, BILLING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS. THESE PUBLIC NOTICES SHALL INCLUDE INFORMATION ABOUT THE RIGHT TO REQUEST AN ESTIMATE OF FINANCIAL RESPONSIBILITY FOR SERVICES. 2. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY SHALL BE AVAILABLE IN A PROMINENT PLACE ON THE SUTTER HEALTH WEBSITE (WWW.SUTTERHEALTH.ORG) AND ON EACH INDIVIDUAL HOSPITAL'S WEBSITE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. 3. MAIL: PATIENTS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY BE SENT BY MAIL, AT NO COST TO THE PATIENT. 4. ADVERTISEMENTS/PRESS RELEASES: AS NECESSARY AND ON AT LEAST AN ANNUAL BASIS, SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT HOSPITALS IN THE PRINCIPAL NEWSPAPER(S) IN THE COMMUNITIES SERVED BY SUTTER HEALTH, OR WHEN DOING SO IS NOT PRACTICAL, SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THIS INFORMATION, OR USE OTHER MEANS THAT SUTTER HEALTH CONCLUDES WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY TO AFFECTED PATIENTS IN OUR COMMUNITIES. 5. COMMUNITY AWARENESS: SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 THE HOSPITAL SERVICE AREA IS THE WHOLE STATE OF HAWAII AND ASIA PACIFIC BUT IS PREDOMINANTLY DEFINED BY A GEOGRAPHICAL BOUNDARY OF THE HONOLULU COUNTY AS THE MAJORITY OF OUR PATIENTS SERVED COME FROM THE ISLAND OF OAHU. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN KAHI MOHALA'S CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH REACHES BEYOND THE WALLS OF OUR HOSPITALS AND care FACILITIES through our community health initiatives. 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 KAHI MOHALA DEFINES PROGRAMS THAT WILL ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. THE FOLLOWING REPRESENTS COMMUNITY PROGRAMS THAT ARE BEING SUPPORTED BY KAHI. One training area of focus will be Suicide Prevention. Suicide Prevention is actually: food security, affordable housing, youth suicide prevention courses, peer norm activities, affordable healthcare, housing stabilization policies, destigmatizing mental illnesses, community engagement activities, strengthening household financial security, increasing access and decreasing stigma to mental health care, parenting skills and family relationship programs, and family acceptance of individuals who identify as LGBTQIA+. Training in trauma-informed care is a strategy being undertaken to help trust and equitable access as well as providing meeting space to allow support groups to provide meeting locations for community members. To address mental health and behavioral health, "Addressing the Importance of Behavioral Health in Teenagers" program collaborate with community providers to create programs for teenagers that will help improve their knowledge of Behavioral Health issues, resources, and treatments. The goal is to provide teenagers with behavioral health educational resources and information they can use to help themselves and others. The anticipated outcomes are increased prevention, recognition, and treatment of behavioral health issues in teenagers which will hopefully lead to a better quality of life. Kahi was able to restart providing donated space for community meetings in 2023: Alocholics anonymous (AA), Narcotics Anonymous (NA), Al-Anon, and Child and family services. Kahi has traditionally provided space for THESE MEETINGS AS IT IS IMPORTANT FOR COMMUNITY MEMBERS TO BE TO ATTEND MEETINGS THAT ARE LOCATED IN THEIR NEIGHBORHOODS. COVID RESTRICTIONS HAD PAUSED THESE MEETINGS. SCHEDULE H, PART VI, LINE 6 Sutter Health is a not-for-profit healthcare system dedicated to providing comprehensive care throughout California. Committed to health equity, community partnerships, and innovative, high-quality patient care, Sutter Health is pursuing a bold new plan to reach more people and make excellent healthcare more connected and accessible. Currently serving nearly 3.5 million patients, thanks to our dedicated team of more than 57,000 employees and clinicians, and 12,000+ affiliated physicians, with a unified focus on expanding care to serve more patients. Sutter Health delivers exceptional and affordable care through its hospitals, medical groups, ambulatory surgery centers, urgent care clinics, telehealth, home health, and hospice services. Dedicated to transforming healthcare, at Sutter Health, getting better never stops. Learn more about how Sutter Health is transforming healthcare at sutterhealth.org and vitals.sutterhealth.org. As part of Sutter Health's commitment to fulfill its not-for-profit mission and to help serve some of the most vulnerable in its communities, Sutter invests annually in community benefit programs that help improve the overall health and wellbeing of the regions Sutter serves. Sutter's community benefit investments were $822 million in 2023, which includes investments in community health programs to address prioritized health needs as identified by regional community health needs assessments, traditional charity care, and unreimbursed Medi-Cal costs. Through community benefit investments, Sutter helps local communities access primary, mental health and addiction care services, and basic needs such as housing, economic opportunity, job training 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: N/A X X X X true true false false false false false true false JAMES E CONFORTI FORMER INTERIM PRES & CEO, SH 0 0 0 1304102 0 5052047 0 0 0 0 0 6356149 0 0 CONRAD VIAL MD President, SHP 0 1129458 0 1285257 0 150529 0 216664 0 48781 0 2830689 0 127928 MARK WHEELER CFO, SVNAH & SH PACIFIC 0 360513 0 72564 0 34710 0 26564 0 31710 0 526061 0 29263 Ben Kirk SH VP, Legal Ops, Valley 0 341987 0 45018 0 7889 0 85989 0 30307 0 511190 0 0 Celia Ona CHIEF MEDICAL EXECUTIVE 444055 0 0 0 1236 0 3864 0 4282 0 453437 0 0 0 Elena Sharipova MD PSYCHIATRIST 352595 0 0 0 0 0 3864 0 5589 0 362048 0 0 0 Tina Mai PSYCHIATRIST 309887 0 0 0 6560 0 3628 0 16265 0 336340 0 0 0 Mark Linscott DIRECTOR/EXEC, SERVICE LINE 219900 0 25500 0 138 0 10575 0 119 0 256232 0 0 0 Michelle Fernandez DIRECTOR, INPATIENT NURSING 166838 0 25500 0 258 0 9954 0 119 0 202669 0 0 0 Issar Daryanani MANAGER, PSYCHOLOGY 144590 0 5000 0 48 0 4697 0 6846 161181 0 0 0 Steven Chaplin MD Director, Psychiatrist 148514 0 0 0 0 0 1739 0 0 0 150253 0 0 0 SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THIS ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE INDEPENDENT DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARM'S LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: JAMES E. CONFORTI RECEIVED SEVERANCE PAYMENTS OF $1,599,998. SCHEDULE J, PART I, LINE 4B 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 LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL LONG TERM PERFORMANCE PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT. 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 LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL LONG TERM PERFORMANCE PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO PAYMENT. FORM 990, PART I, LINE 1 AND PART III, LINE 1 MISSION STATEMENT: MISSION: CARING FOR OUR PATIENTS FIRST AND OUR PEOPLE ALWAYS. VISION: TO BE THE MOST COMPREHENSIVE, INTEGRATED AND CONNECTED HEALTH SYSTEM FOR GETTING AND STAYING WELL. VALUES: EXCELLENCE - We deliver high-quality, equitable care and take on the toughest challenges. CURIOSITY - We are constantly learning and creating new ways to advance healthcare. TEAMWORK - We collaborate with humility and solve for ONE Sutter. COMPASSION - We show empathy and understanding in every personal interaction. INCLUSION - We respect our differences and similarities, and cultivate a sense of belonging. INTEGRITY - We earn trust by doing the right thing and delivering on our commitments. commitments. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS: SUTTER HEALTH PACIFIC, A CALIFORNIA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION, WAS ORGANIZED TO OPERATE AS KAHI MOHALA, AN 88 BED, FREESTANDING NOT-FOR-PROFIT PSYCHIATRIC HOSPITAL. KAHI MOHALA HAS BEEN OPERATIONAL SINCE 1983 AND IS SITUATED ON A 14.5-ACRE CAMPUS. THE HOSPITAL IS LICENSED BY THE STATE OF HAWAII AND IS ACCREDITED BY THE JOINT COMMISSION. THERE WERE 24,190 PATIENT DAYS IN 2023. KAHI MOHALA'S MISSION IS: "KAHI MOHALA IS DEDICATED TO IMPROVING THE QUALITY OF LIFE AND RESTORING HOPE FOR INDIVIDUALS AND FAMILIES AFFECTED BY MENTAL ILLNESS." TREATMENT PROGRAMS KAHI MOHALA IS DEDICATED NOT ONLY TO PSYCHIATRIC, EMOTIONAL AND BEHAVIORAL STABILIZATION, BUT ALSO TO RECOVERY THROUGH EMPOWERMENT. TEACHING INDIVIDUALS THE SKILLS TO SELF-MANAGE AND SELF-REGULATE TO THE FULLEST POSSIBLE EXTENT IS A FUNDAMENTAL GOAL WITHIN THE TREATMENT AND RECOVERY PROCESS. LEVELS OF CARE -ACUTE CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER (18 YEARS OLD IF STILL ENROLLED IN SCHOOL) -RESIDENTIAL CHILD AND ADOLESCENT PROGRAMS INDIVIDUALS 17 YEARS OF AGE AND UNDER(18 YEARS OLD IF STILL ENROLLED IN SCHOOL) SPECIALIZED TREATMENT SERVICES - PSYCHIATRIC EVALUATION/TREATMENT AND MEDICATION MANAGEMENT - NURSING ASSESSMENT - PSYCHOLOGICAL TESTING - SUBSTANCE ABUSE/DUAL DIAGNOSIS SERVICES - EATING DISORDER SERVICES THERAPEUTIC SERVICES AVAILABLE - INDIVIDUAL, FAMILY AND GROUP THERAPY - EDUCATIONAL SERVICES - OCCUPATIONAL THERAPY - RECREATIONAL THERAPY - ART THERAPY - REALITY-ORIENTED PHYSICAL EXPERIENTIAL SERVICES (ROPES) THIS CORPORATION WAS FORMED FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION: A.TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NOT-FOR-PROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BEDS AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTSTO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; B.TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED, OR TO THE PROMOTION OF HEALTH; C.TO PROMOTE AND CARRY OUT SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; D.TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITY SERVED; AND E.TO CONTRIBUTE TO THE GROWTH, DEVELOPMENT AND FINANCIAL STRENGTH OF SUTTER HEALTH SYSTEM. KAHI MOHALA - LIST OF COMMUNITY BENEFITS 2023: - TWELVE-STEP PROGRAMS (ALCOHOLICS ANONYMOUS, ALANON, NARCOTICS ANONYMOUS) PURPOSE: PEER-LED, SELF-HELP GROUPS OF PERSONS RECOVERING FORM ADDICTIONS, OR FAMILY MEMBERS OF PERSONS RECOVERING FROM ADDICTIONS. GOALS AND OBJECTIVES: TO GAIN SUPPORT AND EDUCATION IN A GROUP SETTING. - INTERNSHIP, RESIDENCY AND PRACTICUM PROGRAMS PURPOSE: TO PROVIDE A SUPERVISED CLINICAL PRACTICE SETTING FOR MEDICAL STUDENTS, SOCIAL WORKERS, NURSES, PSYCHOLOGISTS, SUBSTANCE ABUSE COUNSELORS AND OCCUPATIONAL THERAPISTS. GOALS AND OBJECTIVES: TO OBTAIN DIRECT PRACTICE EXPERIENCE IN THE STUDENT'S FIELD. - INFORMATION AND REFERRAL PURPOSE: TO PROVIDE TELEPHONE INFORMATION AND REFERRAL TO THE PUBLIC REGARDING MENTAL HEALTH AND CHEMICAL DEPENDENCY RESOURCES. GOAL: TO PROVIDE A FREE COMMUNITY RESOURCE. - MEMBERSHIPS ON COMMUNITY BOARDS AND COMMITTEES: GOODWILL INDUSTRIES, ROTARY, HEALTHCARE ASSOCIATION OF HAWAII (HAH), HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA), CHAMBER OF COMMERCE, MENTAL HEALTH AMERICA OF HAWAII (MHA), NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), HAWAII YOUTH SERVICES NETWORK (HYSN), INSTITUTE ON VIOLENCE, ABUSE AND TRAUMA (IVAT) CULTURAL COMMITTEE, PACIFIC REGION BEHAVIORAL HEALTH ALLIANCE PURPOSE: TO VOLUNTEER EXPERTISE ON VARIOUS COMMUNITY BOARDS AND COMMITTEES. GOALS AND OBJECTIVES: TO SUPPORT OUR COMMUNITY BY HELPING OTHERS MEET THE GOALS AND OBJECTIVES OF THE VARIOUS ORGANIZATIONS AND COMMITTEES. - COMMUNITY ROPES GROUPS PURPOSE: PROVIDE PROBLEM SOLVING, TEAM BUILDING, AND LEADERSHIP AWARENESS THROUGH THE USE OF GAMES AND ELEMENTS ON THE ROPES COURSE. GOALS AND OBJECTIVES: PROVIDE THE YOUTH/AT RISK YOUTH THE OPPORTUNITY TO EXPERIENCE TEAM BUILDING/PROBLEM SOLVING EXERCISES THROUGH THE USE OF OUR ROPES COURSE. - COMMUNITY EDUCATION SERIES - APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST) PURPOSE: PROVIDE TWO DAY WORKSHOP IN SUICIDE FIRST AID. GOALS AND OBJECTIVES: PROVIDES MEMBERS OF THE COMMUNITY A COURSE TO IDENTIFY THOSE WHO MAY BE AT RISK OF SUICIDE AND HOW TO CREATE A PLAN FOR THEIR IMMEDIATE SAFETY. - CHILD & FAMILY SERVICE PURPOSE: USE OF ROOM/FACILITIES. GOALS AND OBJECTIVES: TO PROVIDE A MEETING PLACE FOR THE DOMESTIC VIOLENCE PROGRAM. - CPR TRAINING PURPOSE: TO PROVIDE CPR TRAINING TO COMMUNITY. GOAL: TRAIN EWA BEACH COMMUNITY HOW TO PERFORM CPR. - HAWAII FOOD BANK CASH DONATION AND CANNED FOOD DRIVE PURPOSE: CASH DONATION & CANNED FOOD COLLECTION. GOALS AND OBJECTIVES: PROVIDE ASSISTANCE TO THE HUNGRY AND HOMELESS IN THE COMMUNITY. - NATIONAL ASSOCIATION ON MENTAL ILLNESS (NAMI) WALK PURPOSE: PARTICIPATION IN ANNUAL NAMI WALK. GOALS AND OBJECTIVES: TO RAISE MONEY AND AWARENESS OF MENTAL ILLNESS. - LITTER & GRAFFITI REMOVAL PURPOSE: TO REMOVE BLIGHT FROM NEIGHBORHOOD. GOAL: MAINTAIN LITTER AND TAG FREE ENVIRONMENT FOR AREA SURROUNDING KAHI MOHALA. FORM 990, PART VI, LINE 1A GOVERNING BODY: THE AFFAIRS AND MANAGEMENT OF SUTTER HEALTH PACIFIC (SHP) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHO HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SHP DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR OF THE BOARD WHO SERVES AS CHAIR OF THE COMMITTEE, THE ADMINISTRATOR/CEO, AND AT LEAST ONE ADDITIONAL DIRECTOR. FORM 990, PART VI, LINES 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 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. 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; N.ANY SELF-DEALING TRANSACTION BETWEEN A DIRECTOR OF THE CORPORATION AND THE CORPORATION OR A SUBSIDIARY OF THE CORPORATION; OR O.REHIRING, CONTRACTING WITH, OR OTHERWISE COMPENSATING A SUTTER HEALTH EXECUTIVE, OR ANY OFFICER OR MEMBER OF MANAGEMENT OF THE CORPORATION OR ANY AFFILIATED ENTITY AFTER THEIR EMPLOYMENT HAS ENDED. 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 2023 EXECUTIVE COMPENSATION APPROVAL WAS COMPLETED IN MAY 2023. 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. - CONRAD VIAL - MARK LINSCOTT COMMON LAW EMPLOYEES: INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID FULLTIME BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF SUTTER HEALTH, A SEPARATE LEGAL ENTITY. IT IS THE INTENTION OF SUTTER HEALTH AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE SUTTER HEALTH EMPLOYEES WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: EQUITY TRANSFERS (NET): $ 2,307,907 -------------------- TOTAL $ 2,307,907 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 BH 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 Sansum Clinic C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 956419205 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH 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 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 INSURANCE SERVICES CORPORATION 745 FORT STREET SUITE 1100 HONOLULU HI 96813 990289310 INSURANCE CA 501(C)(3) 12C III-FI SUTTER HLTH true SUTTER MEDICAL CENTER FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 942788906 FUNDRAISING HI 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 VALLEY MEDICAL FOUNDATION C/O SH TAX 2200 RIVER PLAZA DR SACRAMENTO CA 95833 680273974 HEALTHCARE 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 - I SUTTER VH true CA PACIFIC ADV IMAG PO BOX 6102 NOVATO CA 94598 562311840 PATIENT CARE DE NA SF ENDOSCOPY CENTER 2200 RIVER P DR SACRAMENTO CA 95833 912160588 PATIENT CARE CA NA SUT FAIRFIELD SURG 2200 RIVER P DR SACRAMENTO CA 95833 300233892 PATIENT CARE CA NA SUT AMADOR SURG CTR 2200 RIVER P DR SACRAMENTO CA 95833 461398093 PATIENT CARE CA NA ROSEVILLE ENDOSCOPY 2200 RIVER P DR SACRAMENTO CA 95833 870710513 PATIENT CARE CA NA MEMORIAL MED BLDG 1800 COFFEE RD 76 MODESTO CA 95355 770234236 OFFICE RENTAL CA NA MAGNETIC IMAGING AF 2125 OAK GR R WALNUT CREEK CA 94598 473696091 PATIENT CARE CA NA ASC OPTRS SNTA ROSA 2200 RIVER P DR SACRAMENTO CA 95833 263386169 CARE MANAGEMENT CA NA ASC OPTRS - SLO LLC 2200 RIVER P DR SACRAMENTO CA 95833 272673776 CARE MANAGEMENT CA NA ICG CREDIT OPP FUND 11111 SANTA MONICA BLVD LA CA 90025 814220441 INVESTMENTS CA NA CARLSBAD SURGERY CTR 6121 PASEO DEL N CARLSBAD CA 92011 201413484 PATIENT CARE CA NA SURG CTR OF ABSMC 3875 TELEGRAPH OAKLAND CA 94609 470946086 Patient Care CA NA DIVISADERO HOLD LLC 1635 DIVISADERO SF CA 94115 320621050 Outpatient su CA NA PENINSULA ENDOSCOPY 1720 El Camino Real Burlingame CA 94010 271905059 PATIENT CARE CA NA S Placer Surgery CTR 8 MEDICAL PLAZA Roseville CA 95661 421540694 Patient Care CA NA SAC SURG CTR ASSOC 1800 TRIBUTE RD SACRAMENTO CA 95815 680516588 Patient Care CA NA FORT SUT SURG CTR 2801 K ST SACRAMENTO CA 95816 680116391 Patient Care CA NA SUT ALHAMBRA SURG 1201 Alhambra SACRAMENTO CA 95816 631221949 Patient Care CA NA AUBURN SURG CTR 148 MAPLE ST AUBURN Auburn CA 95603 364123623 Patient Care CA NA ASC Operators LLC 2200 RIVER P DR SACRAMENTO CA 95833 208970704 CARE MANAGEMENT CA NA DE SHAW ALP PLUS 1166 AVE AMERICAS NEW YORK NY 10036 882890454 Investment DE NA ICG CR OPP FUND 1 11111 SANTA MONICA LA CA 90025 825045573 Investment DE NA ICG CR OPP FUND 2A 11111 SANTA MONICA LA CA 90025 852303976 Investment DE NA MAKENA RE II 2755 SAND HILL Menlo Park CA 94025 981298071 Investment CJ NA DE SHAW ALL CTRY 1166 AVE AMERICAS NEW YORK NY 10036 832024364 Investment DE NA ICG SPEC OPP FND I 11111 SANTA MONICA LA CA 90025 863196460 Investment DE NA TAP CMDITYBLDR FUND 257 PARK AVENUE SOUTH SUITE 7 NEW YORK NY 10010 274871720 INVESTMENT NY NA MAKENA STRATEGIC OPPORTUNITIES FUND - SH 2755 SAND HILL ROAD SUITE 200 MENLO PARK CA 94025 844965838 INVESTMENT DE NA SUTTER HEALTH DEFERRED COMP PLANS' TRUST 2200 RIVER PLAZA DRIVE SACRAMENTO CA 95833 276851989 RABBI TRUST CA NA TRUST true NORTHWOOD EUROPE TE FEEDER LP 1819 WAZEE ST 2ND FLOOR DENVER CO 80202 981272216 HOLDING COMPANY CJ NA C CORP true WILSOP SEGREGATED PORTFOLIO 1 PO BOX 10008 WILLOW HOUSE CRICKET SQUARE GRAND CAYMAN CJ INVESTMENT CJ NA C CORP true WILSOP SEGREGATED PORTFOLIO 2 PO BOX 10008 WILLOW HOUSE CRICKET SQUARE GRAND CAYMAN CJ INVESTMENT CJ NA C CORP true AQR REAL RETURN OFFSHORE FUND LP 89 NEXUS WAY CAMANA BAY GRAND CAYMAN CJ KY1-9009 980700570 INVESTMENT CJ NA c corp true BRIGADE LEVERAGED CAPITAL STRUCTURE OFFS ONE NEXUS WAY CAMANA BAY GRAND CAYMAN CJ KY1-9005 981020330 Investment CJ NA C Corp true AQR MULTI-STRATEGY FUND XXIII LP ONE GREENWICH PLAZA STE 130 GREENWICH CT 06830 981716386 INVESTMENT CJ NA C CORP true false false false false false false false false false false false false false false true false false true Sutter Insurance Services Corporation P 207860 FMV