2024-05-15T09:27:25-05:00 2023-06-30 PWC US TAX LLP 655 NEW YORK AVE NW SUITE 1100 WASHINGTON DC 20001 990 2022-07-01 951643336 USC ARCADIA HOSPITAL % WILLIAM GRIGG USCA 6268988000 300 WEST HUNTINGTON DRIVE ARCADIA CA 91007 WILLIAM GRIGG SVP/CFO 6268988000 2024-05-14 true WILLIAM GRIGG 999009999 TRAVIS L PATTON P00369623 2024141000 2024-05-14 3 2022 2023-04-26 12:10:37Z WILLIAM GRIGG 300 WEST HUNTINGTON DRIVE ARCADIA CA 91007 483396236 false X WWW.USCARCADIAHOSPITAL.ORG X 1912 CA TO PROVIDE HIGH-QUALITY HEALING SERVICES WHILE CARING FOR THE PATIENT'S EMOTIONAL AND SPIRITUAL NEEDS AND ENABLING THEM TO ACHIEVE HEALTH FOR LIFE. 14 12 1496 249 0 0 3354679 7500099 180556482 283015568 3435237 13034332 1129840 2420357 188476238 305970356 3840 23780 0 0 66028612 149396857 0 0 0 133820195 197077996 199852647 346498633 -11376409 -40528277 556402657 804507637 344266541 334448187 212136116 470059450 TO PROVIDE HIGH-QUALITY HEALING SERVICES WHILE CARING FOR THE PATIENT'S EMOTIONAL AND SPIRITUAL NEEDS AND ENABLING THEM TO ACHIEVE HEALTH FOR LIFE. false false 287056926 23780 283015568 USC ARCADIA HOSPITAL IS A 348-LICENSE BED, NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN ARCADIA, CA. FOUNDED IN 1903, USC ARCADIA HOSPITAL IS COMMITTED TO PROVIDING EXCELLENT PATIENT CARE DELIVERED WITH COMPASSION AND RESPECT. USC ARCADIA HOSPITAL PROVIDES CLINICAL SERVICES THAT INCLUDE EMERGENCY SERVICES, DIAGNOSTIC TESTING, INPATIENT AND OUTPATIENT SURGERY, INTENSIVE CARE UNITS, TRANSITIONAL CARE UNIT, CARDIAC CATHETERIZATION, CARDIAC SURGERY, CHEST PAIN CENTER, A STROKE PROGRAM, CANCER SERVICES, HIP AND KNEE REPLACEMENT, SPINE SURGERY, MATERNITY SERVICES, WEIGHT LOSS SURGERY, PHYSICAL THERAPY, ACUTE PHYSICAL REHABILITATION, AND WOUND HEALING CENTER. 287056926 true true false true false false false false false true true false false false true false false true false false true false false false false false true true false true true true false false false false false true false false false false false false false false true true true true false false true X 200 0 true 1496 true false false false false false false false false false false true false X 14 12 false false true false true true true true true false false true true true true true true true true false CA X WILLIAM GRIGG 6268212310 300 WEST HUNTINGTON DRIVE ARCADIA CA 91007 ROD HANNERS DIRECTOR 1.0 56.5 X 0 2006403 58277 DAN AUSMAN DIR/PRES/CEO(UNTIL 4/7/2023) 39.0 1.0 X X 1291367 0 14040 WILLIAM GRIGG ASSISTANT TREASURER/CFO 39.0 1.0 X 605132 0 23190 STEVE SISTO SR. VICE PRESIDENT/COO 40.0 0.0 X 601084 0 23190 BALA S CHANDRASEKHAR MD CHIEF MEDICAL OFFICER 40.0 0.0 X 570145 0 23190 CLIFFORD DANIELS CHIEF STRATEGY OFFICER 40.0 0.0 X 429771 0 22025 JOHN PEEPLES VP/HUMAN RESOURCES 40.0 0.0 X 441466 0 9516 DEBORAH L MCCOY CHIEF NURSING OFFICER 40.0 0.0 X 412463 0 16121 CATHERINE TONECK VP/CHIEF COMPLIANCE OFFICER 40.0 0.0 X 388151 0 16161 BENJAMIN FUERTE REGISTERED NURSE 40.0 0.0 X 333326 0 33935 DONNA TEMPLO REGISTERED NURSE 40.0 0.0 X 348978 0 9367 KATHRYN J PUNCER ASSISTANT SECRETARY 40.0 0.0 X 100710 0 17147 E DEWAYNE MCMULLIN DIRECTOR/SECRETARY 2.0 0.0 X X 0 12300 0 AJA TULLENERS LESH PHD RN DIRECTOR 2.0 0.0 X 0 0 0 AMY A ROSS DIRECTOR 2.0 5.0 X 0 0 0 ANDREW LEE MD DIRECTOR 2.0 0.0 X 0 0 0 DOUGLAS VAN KIRK DIRECTOR 2.0 2.0 X 0 0 0 ELIAS TARAKJI MD DIRECTOR 2.0 0.0 X 0 0 0 GEORGE P BLANCO DIRECTOR 2.0 0.0 X 0 0 0 IKENNA MMEJE DIR/PRES/CEO (AS OF 3/13/2023) 39.0 1.0 X X 0 0 0 JACKIE CAMPBELL DIRECTOR 2.0 0.0 X 0 0 0 JAMES ROMO DIRECTOR 2.0 0.0 X 0 0 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X X X X true true X X X true X SEE PART V, SECTION C X SEE PT V, SECTION C X SEE PT V,SEC C 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 USC ARCADIA HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT COMPILED A VARIETY OF DEMOGRAPHIC AND HEALTH DATA AND INFORMATION, GATHERED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES. WE DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FINDINGS ARE BASED ON SURVEYS WITH REPRESENTATIVES OF COMMUNITY AND PUBLIC ORGANIZATIONS CONDUCTED IN DECEMBER 2022. THE FIRST PHASE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT INVOLVED COLLECTION AND ANALYSIS OF NUMEROUS DEMOGRAPHIC AND HEALTH STATUS AND DATA AND INFORMATION FOR USC ARCADIA HOSPITAL SERVICE AREA AND SERVICE PLANNING AREA (SPA) 3 - SAN GABRIEL VALLEY. THE FOLLOWING TYPES OF DATA WERE ANALYZED: POPULATION, HOUSEHOLD AND FAMILY DEMOGRAPHICS; BIRTH STATISTICS, DEATH STATISTICS, DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS, LARGE-SCALE HOUSEHOLD TELEPHONE SURVEYS DESIGNED TO MEASURE HEALTH ACCESS, UTILIZATION OF HEALTH SERVICES, AND HEALTH BEHAVIORS. WHEREVER POSSIBLE, THE SERVICE AREA HEALTH EXPERIENCE WAS BENCHMARKED TO HEALTHY PEOPLE 2020 TARGETS. IN ADDITION, TO ASSIST WITH PROVIDING CONTEXT TO THE DEMOGRAPHICS, USC ARCADIA HOSPITAL SERVICE AREA IS COMPARED TO LOS ANGELES COUNTY. THE FOLLOWING WERE IDENTIFIED AS THE COMMUNITY'S TOP HEALTH ISSUES (BASED ON FREQUENCY OF OVERALL MENTION): - ACCESS TO HEALTH CARE SPECIFIC TO HEALTH INSURANCE COVERAGE, AVAILABILITY OF PROVIDERS IN THE COMMUNITY, LANGUAGE BARRIERS, AND LACK OF TRANSPORTATION. - DISEASE PREVENTION AND HEALTH PROMOTION, SPECIFIC TO DIABETES, OBESITY, HEART DISEASE, HIGH BLOOD PRESSURE, CANCER, MENTAL HEALTH AND DEMENTIA, AND INFLUENZA AND PNEUMONIA. ACCORDING TO MANY OF THOSE INTERVIEWED, THE SAN GABRIEL VALLEY IN GENERAL AND PERSONS OF ALL AGES, REGARDLESS OF INCOME OR RACIAL/ETHNIC AND CULTURAL BACKGROUNDS, ARE AFFECTED BY THESE HEALTH ISSUES. FOR EXAMPLE, MANY FACE CHALLENGES ASSOCIATED WITH HEALTH CARE ACCESS AND ALZHEIMER'S DISEASE AFFECTS ALL AGE SIXTY AND OLDER. NEIGHBORHOOD AREAS SPECIFICALLY MENTIONED BY THOSE PARTICIPATING IN THE COMMUNITY INTERVIEWS INCLUDED: - ARCADIA - ALHAMBRA - DUARTE - EL MONTE - MONROVIA - SAN GABRIEL - TEMPLE CITY POPULATIONS SPECIFICALLY IDENTIFIED BY THOSE PARTICIPATING IN THE INTERVIEWS: - LOWER SOCIOECONOMIC STATUS - LOWER EDUCATIONAL ATTAINMENT - CHINESE IMMIGRANT FAMILIES WITH LIMITED ENGLISH PROFICIENCY - SPANISH-SPEAKING PERSONS - RACIAL AND ETHNIC MINORITIES - ASIANS, LATINOS, AND AFRICAN AMERICANS - CHILDREN AND ADOLESCENTS - WOMEN - SENIORS - HOMELESS PERSONS THE SECOND PHASE OF THE NEEDS ASSESSMENT FOCUSED ON QUALITATIVE PRIMARY RESEARCH. REPRESENTATIVES FROM USC ARCADIA HOSPITAL AGREED THAT TELEPHONE INTERVIEWS WITH HEALTH DEPARTMENT CONTACTS AND REPRESENTATIVES FROM PUBLIC AND PRIVATE ORGANIZATIONS WOULD BE A COST-EFFECTIVE APPROACH TO GAIN AN UNDERSTANDING OF IMPORTANT HEALTH ISSUES AND POTENTIAL OPPORTUNITIES TO COLLABORATE WITH THESE ORGANIZATIONS. THE FOLLOWING SOURCES OF DATA AND INFORMATION WERE USED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT: - CALIFORNIA DEPARTMENT OF EDUCATION - CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - CENTER FOR SOCIAL SCIENCES RESEARCH AT UNIVERSITY OF CALIFORNIA AT BERKELEY - DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) - LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH - LOS ANGELES HOMELESS SERVICES AUTHORITY - LOS ANGELES COUNTY 211.COM AND CITY WEBSITES LOCATED IN THE USC ARCADIA HOSPITAL SERVICE AREA - CLARITAS - UCLA CENTER FOR HEALTH POLICY RESEARCH - UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) USC ARCADIA HOSPITAL UTILIZED THE INPUT RECEIVED FROM ALL OF THE ABOVE ORGANIZATIONS, PLUS QUANTITATIVE DATA GATHERED FROM USC ARCADIA HOSPITAL AND PUBLIC SOURCES TO IMPROVE OUR UNDERSTANDING OF KEY HEALTH ISSUES IN THE SAN GABRIEL VALLEY, AND TO IDENTIFY POTENTIAL OPPORTUNITIES TO COLLABORATE WITH THESE ORGANIZATIONS TO IMPROVE THE OVERALL HEALTH STATUS OF OUR SERVICE AREA POPULATION. SCHEDULE H, PART V, SECTION B, LINE 7A THE CHNA IS AVAILABLE AT: HTTPS://WWW.USCARCADIAHOSPITAL.ORG/DOCUMENTS/2022-COMMUNITY-HEALTH-NEEDS-A SSESSMENT.PDF SCHDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE AT: HTTPS://WWW.USCARCADIAHOSPITAL.ORG/DOCUMENTS/2023-25-IMPLEMENTATION-STRATE GY.PDF SCHEDULE H, PART V, SECTION B, LINE 11 BASED ON QUANTITATIVE AND QUALITATIVE ANALYSIS, USC ARCADIA HOSPITAL'S 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (2022 CHNA) IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEEDS: - ACCESS TO HEALTH SERVICES - AVAILABILITY OF MENTAL HEALTH SERVICES - SCREENING, CARE, AND MANAGEMENT OF INDIVIDUAL HEALTH THE IMPLEMENTATION STRATEGY ADDRESSES BOTH SIGNIFICANT PRIORITY HEALTH NEEDS, WITHIN THE HOSPITAL'S MISSION AND FINANCIAL CAPACITY. THE FOLLOWING OUTLINES THE ACTIONS USC ARCADIA HOSPITAL WILL TAKE TO ADDRESS THESE COMMUNITY HEALTH NEEDS, PLANNED COLLABORATIONS, AND EVALUATION PLANS. SIGNIFICANT HEALTH NEED: ACCESS TO HEALTH SERVICES FOR ADULTS AN IMPORTANT SOURCE OF ACCESS TO ADULT HEALTH SERVICES IS THE HOSPITAL'S EMERGENCY DEPARTMENT. THE EMERGENCY DEPARTMENT IS OPEN 24-HOURS A DAY AND IS APPROVED BY LOS ANGELES COUNTY EMERGENCY MEDICAL SERVICES AS A STROKE CENTER AND STEMI RECEIVING CENTER. USC ARCADIA HOSPITAL'S EMERGENCY DEPARTMENT IS ALSO CERTIFIED AS AN EMERGENCY DEPARTMENT APPROVED FOR PEDIATRICS (EDAP). USC ARCADIA HOSPITAL WILL CONTINUE TO OFFER A FREE PHYSICIAN REFERRAL SERVICE TO ASSIST AREA RESIDENTS WITH FINDING A PHYSICIAN, EITHER BY TELEPHONE TO A DEDICATED PHYSICIAN REFERRAL CENTER OR VIA WEB SEARCH. WE WILL ALSO CONTINUE TO PROVIDE A DEDICATED CHINESE HOT LINE. PHYSICIAN REFERRALS ARE FULFILLED BASED ON PHYSICIAN SPECIALTY, LOCATION, GENDER, LANGUAGE, AND OFFICE HOURS; AND HEALTH INSURANCE (INCLUDING MEDICAL AND SENIOR INSURANCE PLANS). USC ARCADIA HOSPITAL'S COMMUNITY OUTREACH DEPARTMENT STAFF WILL CONTINUE TO RESPOND TO THE HEALTH NEEDS OF OUR COMMUNITY. STAFF MEMBERS ACTIVELY COLLABORATE WITH AREA ORGANIZATIONS TO ADDRESS THE UNIQUE NEEDS OF PERSONS LIVING IN OUR SERVICE AREA. SOME EXAMPLES INCLUDE ACTIVE PARTICIPATION IN CHINESE (LUNAR) NEW YEAR STREET FESTIVAL AND AN ASIAN HEALTH FAIR; AND PROGRAM DEVELOPMENT AND COORDINATION WITH AREA SENIOR CENTERS TO PROVIDE SUPPORT FOR SCREENINGS AND HEALTH FAIRS. PLANNED COLLABORATIONS: TO IMPROVE ACCESS TO HEALTH SERVICES IN OUR COMMUNITY, LEADERSHIP AND STAFF WILL REMAIN ACTIVE IN THE FOLLOWING GROUPS: HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, LOS ANGELES COUNTY SERVICE PLANNING AREA (SPA) 3 COUNCIL, ARCADIA COMMUNITY COORDINATING COUNCIL, MONROVIA COMMUNITY COORDINATING COUNCIL, ASIAN PACIFIC DIABETES COALITION, SOUTHERN CALIFORNIA WOMEN'S HEALTH CONFERENCE, AS WELL AS VARIOUS JOINT OPERATING COMMITTEES (COMPRISED OF LEADERS FROM THE HOSPITAL, LOCAL PHYSICIANS ORGANIZATIONS, AND HEALTH PLANS). EVALUATION PLAN: USC ARCADIA HOSPITAL WILL MONITOR AND REPORT: ACTIVITY IN OUR EMERGENCY DEPARTMENT, PERSONS SERVED BY PHYSICIAN REFERRALS, AND RESULTS OF CALIFORNIA HEALTH INTERVIEW SURVEYS FOR SERVICE PLANNING AREA 3 (SAN GABRIEL VALLEY) BENCHMARKED TO HEALTHY PEOPLE 2020 NATIONAL OBJECTIVES FOR: NON-ELDERLY PERSONS WITH HEALTH INSURANCE, USUAL SOURCE OF ONGOING CARE, DELAYS IN GETTING MEDICAL CARE, DELAYS IN GETTING PRESCRIPTION MEDICATIONS, DEATHS DUE TO CORONARY HEART DISEASE AND CIRRHOSIS, SENIORS WHO RECEIVED A FLU SHOT, AND SENIORS WITH HIGH BLOOD PRESSURE. SIGNIFICANT HEALTH NEED: DISEASE PREVENTION AND HEALTH PROMOTION TO ADDRESS THE COMMUNITY NEED FOR SERVICES FOR HEALTH CONDITIONS, USC ARCADIA HOSPITAL WILL CONTINUE TO PROVIDE STRONG DIAGNOSTIC AND TREATMENT SERVICES ADDRESSING HEART DISEASE, STROKE, AND CANCER: USC ARCADIA HOSPITAL'S HIGHLY SPECIALIZED CARDIAC SERVICES INCLUDE: - AVAILABILITY OF A CARDIAC CARE TEAM 24-HOURS A DAY, SEVEN DAYS A WEEK - DEDICATED HANDLING OF STEMI PATIENTS IN THE HOSPITAL'S EMERGENCY DEPARTMENT - SEVERAL CARDIAC CATHETERIZATION LABORATORIES - DEDICATED OPERATING ROOMS FOR OPEN-HEART SURGERY AND VALVE REPLACEMENTS - SPECIALIZED CORONARY CARE UNIT AND CARDIAC PATIENT CARE UNIT - INPATIENT AND OUTPATIENT CARDIAC REHABILITATION PROGRAMS USC ARCADIA HOSPITAL IS A DESIGNATED STROKE RECEIVING CENTER FOR LA COUNTY EMS. USC ARCADIA HOSPITAL ALSO PROVIDES NEURO-INTERVENTIONAL RADIOLOGY SERVICES. USC ARCADIA HOSPITAL OFFERS THE FULL COMPLEMENT OF ONCOLOGY SERVICES, INCLUDING EARLY DETECTION CANCER SCREENINGS, SURGERY, CHEMOTHERAPY, RECONSTRUCTIVE SURGERY, PAIN MANAGEMENT, AND SUPPORT GROUPS. USC ARCADIA HOSPITAL ALSO PROVIDES HOSPITAL AND PHYSICIAN SERVICES AT TWO SPECIALIZED OUTPATIENT CLINICS: GYN ONCOLOGY INSTITUTE AND THE INSTITUTE FOR SURGICAL SPECIALTIES - TO CONTINUE TO EXPAND ACCESS TO OUTSTANDING CLINICAL SERVICES TO RESIENTS AND VISITORS ACROSS OUR SERVICE AREA. TO PROACTIVELY ADDRESS HEALTH CONDITIONS OF IMPORTANCE TO RESIDENTS OF THE SERVICE AREA, USC ARCADIA HOSPITAL WILL PROVIDE ADDITIONAL RESOURCES THROUGH HEALTH EDUCATION AND SCREENING PROGRAMS, AS FOLLOWS: - HEALTH FAIRS AND SCREENINGS: USC ARCADIA HOSPITAL WILL PARTICIPATE IN HEALTH FAIRS ADDRESSING SENIORS AND ADULTS, THE LATINO COMMUNITY, AND THE ASIAN COMMUNITY. - BLOOD PRESSURE TESTING: USC ARCADIA HOSPITAL WILL OFFER BLOOD PRESSURE SCREENINGS ON A MONTHLY BASIS AT SCHEDULED TIMES AT THE ARCADIA COMMUNITY CENTER, MONROVIA COMMUNITY CENTER, AND SIERRA MADRE HART PARK HOUSE; AND CONTINUE TO SPONSOR A HEART CHECK CENTER FREE BLOOD PRESSURE TESTING KIOSK DISPLAY AT THE WESTFIELD SANTA ANITA MALL IN ARCADIA. - DIABETES AND RELATED HEALTH CONDITIONS CLASSES: TO ASSIST THOSE WITH DIABETES AND RELATED HEALTH CONDITIONS, USC ARCADIA HOSPITAL WILL HAVE DIETITIANS ASSIST COMMUNITY MEMBERS WITH EDUCATION AND SUPPORT IN A VARIETY OF MONTHLY PROGRAMS, INCLUDING: BARIATRIC NUTRITION CLASS BARIATRIC SUPPORT GROUP, DIABETES, OBESITY AND WEIGHTLOSS, GESTATIONAL DIABETES, ORTHOPEDIC, WOUND HEALING, AND CANCER, RENAL AND OTHER NUTRITIONAL CONSULTS. - 50+ HEALTH CONNECTION PROGRAM: CONTINUE TO PROVIDE FREE HEALTH EDUCATION, SCREENING, ANNUAL FLU CLINICS, AND PHYSICIAN REFERRALS FOR SENIORS. - HEALTH MINISTRIES PROGRAM: CONTINUE TO ASSIST LOCAL CONGREGATIONS BY PROVIDING GUIDANCE, SUPPORT, AND RESOURCES TO PARISH NURSES AND HEALTH CABINETS. - EXPANDED WEB SITE: CONTINUE TO EXPAND ITS PRESENCE ON THE INTERNET TO INCLUDE A WEBSITE DEDICATED TO PROVIDING HEALTH NEWS, PUBLICATIONS AND INFORMATION, VIDEOS, AND VIRTUAL TOURS FOR PATIENTS, EMPLOYEES (BOTH CURRENT AND FUTURE), PHYSICIANS, VOLUNTEERS, VISITORS AND VENDORS, IN ADDITION TO CONVENIENT SERVICES SUCH AS A FREE PHYSICIAN REFERRAL, ONLINE CLASS REGISTRATION, AND ONLINE BILL PAYMENT. USC ARCADIA HOSPITAL ALSO PUBLISHES NEWS AND INFORMATION ON SOCIAL MEDIA VIA FACEBOOK, INSTAGRAM, X (PREVIOUSLY KNOWN AS TWITTER), WECHAT, YOUTUBE, PINTEREST, LINKEDIN, AND YELP TO INFORM THE COMMUNITY ABOUT HOSPITAL SERVICES AND EVENTS. -USC ARCADIA HOSPITAL ALSO PROVIDES MONTHLY IN-PERSON EDUCATIONAL SEMINARS ON TOPICS OF INTEREST THAT ADDRESS HEALTH NEEDS OF THE LOCAL COMMUNITY. SEMINARS ARE PRESENTED BY PHYSICIAN EXPERTS, WHOSE TOPICS INCLUDE DISEASE MANAGEMENT, HEALTHY EATING, BACK PAIN, HEART HEALTH, AS WELL AS COVID-19 AWARENESS AND SAFE PRACTICES. THESE SEMINARS HELP RAISE AWARENESS ABOUT THE LOCAL AVAILABILITY OF KEY SERVICES. PLANNED COLLABORATIONS: TO SUPPORT DISEASE PREVENTION AND HEALTH PROMOTION ACTIVITIES, USC ARCADIA HOSPITAL WILL WORK CLOSELY WITH CHURCHES; CITIES OF ARCADIA, MONROVIA AND SIERRA MADRE; AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, AND WESTFIELD SANTA ANITA MALL. EVALUATION PLAN: USC ARCADIA HOSPITAL WILL MONITOR AND REPORT PARTICIPATION, ATTENDANCE AND PROGRAM EVALUATIONS AT VARIOUS COMMUNITY ACTIVITIES; RESULTS OF CALIFORNIA HEALTH INTERVIEW SURVEYS BENCHMARKED TO HEALTHY PEOPLE 2020 NATIONAL OBJECTIVES FOR: DIAGNOSED WITH HIGH BLOOD PRESSURE, DIAGNOSED WITH DIABETES, HEALTHY WEIGHT AND OBESITY; AND ANALYSIS OF AGE-ADJUSTED DEATH RATES DUE TO CORONARY HEART DISEASE, STROKE, DIABETES-RELATED DEATHS, AND VARIOUS CANCERS. LOS ANGELES COUNTY DID NOT MEET THE OBJECTIVES RELATED TO HOMICIDE AND CHRONIC LIVER DISEASE AND CIRRHOSIS. THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED TWO HEALTH NEEDS NOT DIRECTLY ADDRESSED BY THE SERVICES PROVIDED BY THE HOSPITAL. THEY ARE HOMELESSNESS AND FOOD INSECURITY. WHILE THE HOSPITAL DOES NOT HAVE ANY PROGRAMS THAT SEEK TO ALLEVIATE HOMELESSNESS, THE HOSPITAL DOES PROVIDE EMERGENCY AND OTHER URGENT MEDICAL CARE TO HOMELESS INDIVIDUALS. AS PART OF THE MEDICAL SERVICES THE HOSPITAL MAY PROVIDE FOOD, CLOTHING, MEDICINE AND DIRECT NOMINAL CASH ASSISTANCE TO HOMELESS PATIENTS ON DISCHARGE TO ENSURE THEY HAVE ACCESS TO FOLLOW UP CARE OR HAVE TRANSPORTATION TO FAMILY OR FACILITIES THAT CAN PROVIDE TEMPORARY HOUSING. REGARDING FOOD SECURITY, AGAIN THE HOSPITAL HAS NO DIRECT PROGRAMS WHICH ADDRESS THE ISSUE, BUT MAY UPON DISCHARGE PROVIDE FOOD OR NOMINAL CASH ASSISTANCE, IN ADDITION TO REFERRALS TO FOOD BANKS, TO PATIENTS WHO HAVE BEEN IDENTIFIED AT RISK FOR FOOD INSECURITY. THE ISSUE, BUT MAY UPON DISCHARGE PROVIDE FOOD OR NOMINAL CASH ASSISTANCE, IN ADDITION TO REFERRALS TO FOOD BANKS, TO PATIENTS WHO HAVE BEEN IDENTIFIED AT RISK FOR FOOD INSECURITY. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C THE FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: HTTPS://WWW.USCARCADIAHOSPITAL.ORG/FOR-PATIENTS-VISITORS-VENDORS/FINANCIAL -ASSISTANCE-FOR-PATIENTS/ SCHEDULE H, PART I, LINE 3C THE DISCOUNT AMOUNT IS BASED ON FAMILY INCOME COMPARED TO THE FEDERAL POVERTY LEVEL ("FPL") FOR THE CURRENT YEAR. PATIENTS WITH FAMILY INCOME UNDER 200% FPL WILL BE ELIGIBLE FOR FREE CARE FOR THE DATES OF SERVICES FOR WHICH AN APPLICATION IS COMPLETED. UNINSURED OR UNDER-INSURED PATIENTS WITH FAMILY INCOME BETWEEN 201% AND 400% FPL WILL BE ELIGIBLE FOR CARE AT A SLIDING SCALE DISCOUNT. UNINSURED PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPL WILL RECEIVE THE COMPACT DISCOUNTED RATE. IF IT IS DETERMINED THAT THE FAMILY INCOME IS ABOVE 400% OF THE FPL, THE HOSPITALS MAY STILL CONSIDER THE PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE AND REQUIRE THE FOLLOWING INFORMATION BE PROVIDED: INDIVIDUAL OR FAMILY NET WORTH, INCLUDING ASSETS, BOTH LIQUID AND NON-LIQUID, LIABILITIES AND CLAIMS AGAINST ASSETS; EMPLOYMENT STATUS WILL BE CONSIDERED IN THE CONTEXT OF WHETHER THE LIKELIHOOD OF FUTURE EARNINGS WILL BE SUFFICIENT TO MEET THE COST OF PAYING FOR HEALTHCARE SERVICES WITHIN A REASONABLE PERIOD OF TIME; UNUSUAL EXPENSES OR LIABILITIES; AND ADDITIONAL INFORMATION AS REQUIRED FOR SPECIAL CIRCUMSTANCES. SCHEDULE H, PART I, LINE 7 A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED FOR LINES 7A AND 7B. A COST ACCOUNTING SYSTEM WHICH ADDRESSES ALL SEGMENTS WAS USED FOR LINE 7G. OTHER BENEFITS - BASED ON ACTUAL COSTS PROVIDED BY VARIOUS DEPARTMENTS OF THE ORGANIZATION AND COLLECTED/VALIDATED BY THE COMMUNITY OUTREACH DEPARTMENT. SCHEDULE H, PART I, LINE 7G NONE OF THE COSTS ARE ATTRIBUTABLE TO PHYSICIAN CLINICS. SCHEDULE H, PART II 2023 COMMUNITY BUILDING ACTIVITIES IN 2023 USC ARCADIA HOSPITAL PROVIDED A VARIETY OF PROGRAMS AND SERVICES IN SUPPORT OF THE COMMUNITY. SOME OF THE SERVICES PROVIDED WERE: - IN FISCAL YEAR 2023, USC ARCADIA HOSPITAL CONTINUED TO SPONSOR A HEART CHECK CENTER KIOSK AT THE SANTA ANITA MALL IN ARCADIA, PROVIDING FREE BLOOD PRESSURE AND BODY MASS INDEX (BMI) TESTING, AS WELL AS FREE HEALTH INFORMATION. DURING FISCAL YEAR 2023, MALL VISITORS ACCESSED THE KIOSK FOR APPROXIMATELY 16,000 BLOOD PRESSURE SCREENINGS AND 1,400 BMI SCREENINGS. THE KIOSK ALSO ALLOWS PARTICIPANTS TO CONFIDENTIALLY EMAIL THEIR PERSONAL RESULTS AND ACCESS ASSISTANCE IN FINDING A PHYSICIAN. - IN ADDITION, STAFF AT USC ARCADIA HOSPITAL PROVIDED INFORMATIONAL LECTURES AND BODY MASS INDEX (BMI) AND BLOOD PRESSURE SCREENINGS AT VARIOUS COMMUNITY AND VIRTUAL EVENTS IN FISCAL YEAR 2023, INCLUDING: -JULY 12, 2022: ARCADIA CHAMBER OF COMMERCE CONNECT AND PROSPER MIXER AT TONG TAK HOUSE (25 PERSONS ATTENDED) - JULY 23: ASIAN AMERICAN ECONOMIC DEVELOPMENT AND CHINATOWN SERVICES CENTER HEALTH CARE EXPO AND CAREER FAIR AT ALMANSOR COURT ALHAMBRA (550 PERSONS ATTENDED) - AUGUST 2: FOOTHILL UNITY BACK TO SCHOOL EVENT AT SANTA ANITA RACE TRACK (2,000 PERSONS ATTENDED) - AUGUST 28: HANDS ONLY CPR EDUCATION AT ST. BRIDGET CATHOLIC CHURCH (150 PERSONS ATTENDED) - SEPTEMBER 2: ARCADIA SENIOR HEALTH FAIR, LUNCH AND LEARN ON SEASONAL ALLERGIES AND COVID-19 OUTLOOK AT ARCADIA COMMUNITY CENTER (250 PERSONS ATTENDED) - SEPTEMBER 22: MEET AND GREET WITH LEADERS FROM USC ARCADIA HOSPITAL AT ARCADIA COMMUNITY CENTER (35 PERSONS ATTENDED) - OCTOBER 4: TASTE OF TOWN AZUSA AT AZUSA VETERANS FREEDOM PARK (500 PERSONS ATTENDED) - OCTOBER 16: ANNUAL HEALTH FAIR WITH BUDDHA'S LIGHT INTERNATIONAL ASSOCIATION AT USC ARCADIA HOSPITAL (500 PERSONS ATTENDED) - OCTOBER 28: OPTUM PATIENT APPRECIATION EVENT AT PASADENA CONVENTION CENTER (500 PERSONS ATTENDED) - NOVEMBER 18: OPTUM PATIENT APPRECIATION EVENT AT ALMANSOR COURT ALHAMBRA (350 PERSONS ATTENDED) - NOVEMBER 19: OPTUM PATIENT APPRECIATION EVENT AT OPTUM GLENDORA(150 PERSONS ATTENDED) - JANUARY 11, 2023: ASK A DIETITIAN AT MONROVIA COMMUNITY CENTER (2 PERSONS ATTENDED) - JANUARY 14 AND JANUARY 15: ASIAN AMERICAN EXPO AT POMONA FAIRPLEX (38,000 PERSONS ATTENDED THESE TWO DAYS) - JANUARY 28: SAN MARINO LUNAR NEW YEAR CELEBRATION AT LACY PARK IN SAN MARINO (700 PERSONS ATTENDED) - FEBRUARY 8: ASK A DIETITIAN AT MONROVIA COMMUNITY CENTER (5 PERSONS ATTENDED) - FEBRUARY 23: MONROVIA SENIOR HEALTH FAIR AT MONROVIA COMMUNITY CENTER (80 PERSONS ATTENDED) -MARCH 8: ASK A DIETITIAN AT MONROVIA COMMUNITY CENTER (9 PERSONS ATTENDED) - APRIL 4: CITY OF HOPE RESOURCE FAIR AT CITY OF HOPE NATIONAL MEDICAL CENTER IN DUARTE (100 PERSONS ATTENDED) -APRIL 8: SANTA ANITA DERBY DAY 5K AT SANTA ANITA RACE TRACK (6,000 PERSONS ATTENDED) - APRIL 12: 3M EMPLOYEE HEALTH FAIR IN MONROVIA (700 PERSONS ATTENDED) - MAY 6: ARCADIA FIREFIGHTERS PANCAKE BREAKFAST AT ARCADIA FIRE STATION 106 (4,000 PERSONS ATTENDED) - MAY 11: ARCADIA CHAMBER OF COMMERCE GOLF CLASSIC AT CALIFORNIA COUNTRY CLUB IN WHITTIER (100 PERSONS ATTENDED) - MAY 19, MAY 25, AND MAY 26: LA COUNTY FAIR AT POMONA FAIRPLEX (600 PERSONS ATTENDED) - MAY 20: FOOTHILL UNITY ANNUAL HEALTH AND RESOURCE FAIR AT FOOTHILL UNITY CENTER IN MONROVIA (200 PERSONS ATTENDED) - MAY 27: MOUNT WILSON TRAIL RACE 2023 AT KERSTING COURT IN SIERRA MADRE (600 PERSONS ATTENDED) SCHEDULE H, PART III, LINE 2, 3 AND 4 USC ARCADIA HOSPITAL ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ACCOUNTING STANDARDS UPDATE 2014-09 TOPIC 606 (ASU 606) EFFECTIVE JANUARY 1, 2019. ASU 606 AND THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) DIFFERENTIATE BAD DEBT FROM IMPLICIT PRICE CONCESSIONS. ACCORDINGLY, USC ARCADIA HOSPITAL NO LONGER SEPARATELY PRESENTS A PROVISION FOR BAD DEBTS ON THE STATEMENT OF OPERATIONS OR THE RELATED ALLOWANCE FOR BAD DEBTS ON THE BALANCE SHEET. THE ORGANIZATION ESTIMATES BAD DEBT EXPENSE BASED ON AN ACCOUNTS RECEIVABLE AGING METHOD. SCHEDULE H, PART III, LINE 8 THE EXTENT TO WHICH ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT: MEDICARE SHORTFALLS SHOULD BE REPORTED AS A COMMUNITY BENEFIT BECAUSE THE COST OF PROVIDING HEALTHCARE TO THE PATIENTS EXCEEDS THE REIMBURSEMENT. IN SUMMARY, THE HEALTHCARE SERVICES ARE PROVIDED OR RENDERED AT A LOSS. THE METHODOLOGY FOR CALCULATING THE LOSS IS BASED ON THE AS FILED MEDICARE COST REPORT. COSTING METHODOLOGY USED: MEDICARE COST IS CALCULATED USING THE COST-TO-CHARGE RATIO. SCHEDULE H, PART III, LINE 9B CHARITY CARE PROVISION: IF A PATIENT IS DEEMED TO QUALIFY FOR 100% FINANCIAL ASSISTANCE THE PATIENT LIABILITY IS WRITTEN OFF ENTIRELY AND THERE ARE NO FURTHER COLLECTION ACTIVITIES. HOWEVER, IF A PATIENT IS QUALIFIED FOR A PARTIAL FINANCIAL ASSISTANCE WRITE OFF (INCOME FALLS BETWEEN 201% AND 400% OF THE FEDERAL POVERTY GUIDELINES) THE AMOUNT APPROVED FOR FINANCIAL ASSISTANCE IS WRITTEN OFF BASED ON A TIER SCALE AND WRITTEN OFF AS A PARTIAL ASSISTANCE APPROVAL. THIS LEAVES THE PATIENT A SMALL PERCENTAGE AS PATIENT LIABILITY. UNINSURED PATIENTS ARE ENCOURAGED TO APPLY FOR USC ARCADIA HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM (UNCOMPENSATED CARE). PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE WILL BE REPORTED TO CREDIT AGENCIES, IN ACCORDANCE WITH THE USC ARCADIA HOSPITAL'S BAD DEBT POLICY. ACCOUNTS WILL NOT BE APPROVED FOR LEGAL ACTION (BEYOND REPORTING TO CREDIT AGENCIES) UNTIL THE AGENCY SCREENS THE PATIENT FOR UNDERCOMPENSATED CARE. ONLY THOSE PATIENTS WHOSE INCOME EXCEEDS 200% OF FEDERAL POVERTY GUIDELINES WILL BE APPROVED FOR LEGAL ACTION. USC ARCADIA HOSPITAL WILL NOT GARNISH WAGES. SCHEDULE H, PART VI, LINE 2 IN PREPARING THE COMMUNITY HEALTH NEEDS ASSESSMENT, USC ARCADIA HOSPITAL COMBINED QUANTITATIVE DATA ABOUT SERVICE AREA DEMOGRAPHICS, AVAILABILITY OF HEALTH INSURANCE, HEALTH ACCESS TO AND UTILIZATION OF KEY SERVICES, HEALTH STATUS, AND HEALTH BEHAVIORS WITH QUALITATIVE DATA ON OPINIONS OF IMPORTANT HEALTH ISSUES IN THE COMMUNITY. THE FOLLOWING CRITERIA WERE USED TO IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY: - HEALTHY PEOPLE 2020 METRICS - FOCI OF HEALTHY PEOPLE 2030 - NUMBER OF PERSONS AFFECTED - IDENTIFICATION AND/OR VALIDATION AS AN IMPORTANT HEALTH ISSUE IN THE COMMUNITY CONSULTATIONS - IDENTIFIED BY COMMUNITY ORGANIZATIONS AS AN OPPORTUNITY TO WORK COLLABORATIVELY TO ADDRESS HEALTH ISSUE. SCHEDULE H, PART VI, LINE 3 USC ARCADIA HOSPITAL INFORMS MEDICAL STAFF AND EMPLOYEES OF AVAILABLE LOW AND NO-COST RESOURCES. THIS INFORMATION IS DISTRIBUTED THROUGH COMMUNITY OUTREACH RESOURCE TABLES AT EMPLOYEE FAIRS, INTERNAL BULLETINS, AND MANAGEMENT MEETINGS. THE HOSPITAL ALSO PROVIDES MEDICARE COUNSELING TO STAFF AND EMPLOYEES. USC ARCADIA HOSPITAL DISTRIBUTES ITS FINANCIAL ASSISTANCE POLICY AND RELEVANT CONTACT INFORMATION TO PATIENTS UPON THEIR ADMITTANCE TO THE HOSPITAL. USC ARCADIA HOSPITAL POSTS ITS FINANCIAL ASSISTANCE POLICY IN THE EMERGENCY AND ADMITTING DEPARTMENTS. THIS INFORMATION IS ALSO PROVIDED TO PATIENTS UPON DISCHARGE AND IS PROVIDED AMONG THE BILLING DOCUMENTS. SCHEDULE H, PART VI, LINE 4 THE SERVICE AREA POPULATION (2022) IS ESTIMATED AT 763,737 PERSONS. THE POPULATION IN THE SERVICE AREA IS FORECAST TO INCREASE 0.4 PERCENT IN THE NEXT FIVE YEARS, TO 766,589 PERSONS. GROWTH PROJECTIONS FOR HOUSEHOLDS AND FAMILIES ARE ESTIMATED TO INCREASE 0.6 PERCENT AND 0.5 PERCENT. THE FOLLOWING TABLE SUMMARIZES THE SERVICE AREA POPULATION, HOUSEHOLDS, AND FAMILIES. THE 2022 DEMOGRAPHIC DISTRIBUTION IS AS FOLLOWS: - AGE GROUP: -0 TO 4 YEARS - 5.3% -5 TO 9 YEARS - 5.7% -10 TO 14 YEARS - 5.8% -15 TO 17 YEARS - 3.6% -18 TO 20 YEARS - 3.6% -21 TO 24 YEARS - 4.9% -25 TO 34 YEARS - 14.8% -35 TO 44 YEARS - 13.3% -45 TO 54 YEARS - 13.0% -55 TO 64 YEARS - 13.0% -65 TO 74 YEARS - 9.7% -75 TO 84 YEARS - 5.0% -85 YEARS AND OLDER - 2.3% - RACE/ETHNICITY - WHITE - 16.9% - BLACK - 2.8% - AMERICAN INDIAN/ALASKAN NATIVE - 0.1% - ASIAN - 33.3% - NATIVE HAWAIIAN OR PACIFIC ISLANDER - 0.1% - HISPANIC - 44.9% - SOME OTHER RACE - 0.2% - TWO OR MORE RACES - 1.8% - LANGUAGE SPOKEN AT HOME: - ENGLISH ONLY - 35.0% - SPANISH - 33.7% - ASIAN OR PACIFIC ISLAND LANGUAGE - 28.1% - EUROPEAN LANGUAGE - 2.5% - OTHER LANGUAGE - 0.6% - SERVICE AREA AVERAGE HOUSEHOLD INCOME - $117,329 - SERVICE AREA PERCENTAGE BELOW FEDERAL POVERTY LEVEL - 8.9% VS LOS ANGELES COUNTY AVERAGE OF 10.4% SCHEDULE H, PART VI, LINE 5 USC ARCADIA HOSPITAL'S BOARD OF DIRECTORS CONSISTS ALMOST ENTIRELY OF MEMBERS WHO RESIDE IN ITS SERVICE AREA. THE BOARD IS DEDICATED TO MEETING THE UNIQUE HEALTH NEEDS AND DEMANDS IN ITS COMMUNITY. ADDITIONALLY, THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF WHICH ENCOURAGES PHYSICIAN COVERAGE FOR NEEDED SERVICES. TO PROACTIVELY ADDRESS HEALTH CONDITIONS OF THE SERVICE AREA, USC ARCADIA HOSPITAL PROVIDED ADDITIONAL RESOURCES THROUGH HEALTH EDUCATION AND SCREENING PROGRAMS FOR ADULTS. FOR 2023, THE HOSPITAL PROVIDED: - SPONSORED A HEART CHECK CENTER FREE BLOOD PRESSURE TESTING KIOSK DISPLAY AT THE WESTFIELD SANTA ANITA MALL IN ARCADIA. -TO ASSIST THOSE WITH DIABETES AND RELATED HEALTH CONDITIONS, USC ARCADIA HOSPITAL OFFERED A NUMBER OF SPECIALIZED CLASSES IN FISCAL YEAR 2023. DIETITIANS ASSISTED COMMUNITY MEMBERS WITH EDUCATION AND SUPPORT IN A VARIETY OF MONTHLY PROGRAMS, INCLUDING: BARIATRIC NUTRITION, BARIATRIC SUPPORT GROUP, DIABETES, OBESITY AND WEIGHT LOSS, GESTATIONAL DIABETES, WOUND HEALING, AND CANCER, RENAL AND OTHER NUTRITIONAL CONSULTS. -TO MEET THE NEEDS OF ACTIVE, OLDER ADULTS, USC ARCADIA HOSPITAL OFFERS OUR "50+ HEALTH CONNECTION" PROGRAM. THIS PROGRAM MEMBERS TO PARTICIPATE IN FREE HEALTH EDUCATION, SCREENINGS, ANNUAL FLU CLINICS, AND PHYSICIAN REFERRALS. IN FISCAL YEAR 2023, USC ARCADIA HOSPITAL AND ARCADIA RECREATION AND COMMUNITY SERVICES HOSTED SIX HYBRID (BOTH IN-PERSON AND VIRTUAL) HEALTH TALKS BY PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS ADDRESSING THE FOLLOWING TOPICS: - OCTOBER 27, 2022: HEALTHY HOLIDAY COOKING DEMONSTRATION - JANUARY 24, 2023: GUT HEALTH - MARCH 31: LYMPHEDEMA AND WOUND CARE - APRIL 25: FOODS THAT FIGHT INFLAMMATION - MAY 12: RELIEF FROM BACK AND LEG PAIN - JUNE 20: HEAD AND NECK DISORDERS SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT IN CALIFORNIA. true SCHOLARSHIPS 17 23780 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORS GRANTS: USC ARCADIA HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO FUND THE EDUCATIONAL NEEDS OF HOSPITAL STAFF BASED ON BOTH MERIT AND NEEDS-BASED CRITERIA. REQUIREMENTS ARE PUBLISHED IN ADVANCE AND CANDIDATES ARE REQUIRED TO SUBMIT AN APPLICATION AND SUPPORTING DOCUMENTS DEMONSTRATING THAT THEY MEET THE REQUIREMENTS. FINALLY, BEFORE FUNDS ARE DISBURSED TO THE CANDIDATES THEY MUST SUBMIT DOCUMENTS PROVING THAT THEY ARE PARTICIPATING IN THE COURSE OR COURSES FOR WHICH THEY ARE RECEIVING THE SCHOLARSHIP. X true true X X X X false true false false false false false true false BALA S CHANDRASEKHAR MD CHIEF MEDICAL OFFICER 428825 0 135387 0 5933 0 9150 0 14040 0 593335 0 0 0 CATHERINE TONECK VP/CHIEF COMPLIANCE OFFICER 276982 0 86680 0 24489 0 9001 0 7160 0 404312 0 0 0 CLIFFORD DANIELS CHIEF STRATEGY OFFICER 321179 0 99631 0 8961 0 9086 0 12939 0 451796 0 0 0 DAN AUSMAN DIR/PRES/CEO(UNTIL 4/7/2023) 852328 0 428371 0 10668 0 0 0 14040 0 1305407 0 0 0 DEBORAH L MCCOY CHIEF NURSING OFFICER 296392 0 91937 0 24134 0 8961 0 7160 0 428584 0 0 0 JOHN PEEPLES VP/HUMAN RESOURCES 320473 0 97531 0 23462 0 9016 0 500 0 450982 0 0 0 ROD HANNERS DIRECTOR 0 1176716 0 596612 0 233075 0 30500 0 27777 0 2064680 0 37500 STEVE SISTO SR. VICE PRESIDENT/COO 448807 0 141609 0 10668 0 9150 0 14040 0 624274 0 0 0 WILLIAM GRIGG ASSISTANT TREASURER/CFO 457872 0 141716 0 5544 0 9150 0 14040 0 628322 0 0 0 BENJAMIN FUERTE REGISTERED NURSE 276205 0 56620 0 501 0 13689 0 20246 0 367261 0 0 0 DONNA TEMPLO REGISTERED NURSE 310389 0 38589 0 0 0 9367 0 0 0 358345 0 0 0 SCHEDULE J, PART I, LINE 1A USC ARCADIA HOSPITAL PAID COUNTRY CLUB DUES ON BEHALF OF ONE OFFICER, PRESIDENT/CEO. HOWEVER, NONE OF THE DUES IS INCLUDED IN HIS TAXABLE INCOME AS IT WAS STRICTLY FOR BUSINESS USE ONLY. SCHEDULE J, PART I, LINE 4B USC ARCADIA HOSPITAL (USCAH) HAS A FUNDED NONCONTRIBUTORY DEFINED SPLIT-DOLLAR LIFE INSURANCE ARRANGEMENTS FOR CERTAIN EXECUTIVE OFFICERS. LIFE INSURANCE PREMIUM PAYMENTS ARE PAID ON BEHALF OF EACH PARTICIPANT AND ARE SCHEDULED TO BE REPAID TO USCAH FROM THE DEATH BENEFIT ASSOCIATED WITH EACH LIFE INSURANCE CONTRACT. USCAH MAY RECEIVE PROCEEDS FROM THE DEATH BENEFIT IN EXCESS OF THE LOAN AMOUNTS. THE PREMIUM LOANS ARE SECURED THROUGH COLLATERAL AGREEMENTS ON THE CASH VALUE AND DEATH BENEFIT FOR EACH INSURANCE CONTRACT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS PLAN: - DAN AUSMAN - CLIFFORD DANIELS - MICHAEL DRIEBE - WILLIAM GRIGG - STEVE SISTO - BALA CHANDRASEKHAR NO INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING THE YEAR. ROD HANNERS: DURING CALENDAR YEAR 2022, CEO OF KECK MEDICINE OF USC, PARTICIPATED IN A RETENTION PROGRAM. THE RETENTION AWARDS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. A PAYMENT OF $250,000 VESTED IN DECEMBER 2021 AND WAS PAID IN FEBRUARY 2022. THE PAYMENT AMOUNT HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II). ANOTHER PAYMENT OF $250,000 WAS SCHEDULED TO VEST IN DECEMBER 2022 AND BE PAYABLE IN JANUARY 2023. A RATABLE ACCRUAL OF $0 HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AS THE PAYMENT WAS MADE WITHIN TWO AND A HALF MONTHS AFTER THE END OF CALENDAR YEAR 2022. SCHEDULE J, PART I, LINE 7 CERTAIN EXECUTIVE TEAM MEMBERS ARE ELIGIBLE TO RECEIVE PERFORMANCE BASED AWARDS WHEN CERTAIN METRIC BASED GOALS ARE MET. GOALS ARE RELATED TO PATIENT SATISFACTION, PATIENT SAFETY, QUALITY OF CARE, AND FINANCIAL PERFORMANCE. SCHEDULE J, PART II PART II DURING 2022, TWO DIRECTORS REPORTED ON SCHEDULE J, PART II WERE PAID BY THE UNIVERSITY OF SOUTHERN CALIFORNIA ("USC"), A RELATED ORGANIZATION. ONE DIRECTOR IS A FULL-TIME EMPLOYEE OF THE USC ADMINISTRATION AND ONE DIRECTOR RECEIVED FACULTY PAY; THEY WERE NOT COMPENSATED FOR THEIR ROLES AS DIRECTORS OF USC ARCADIA HOSPITAL. A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13081KAX8 2018-12-11 251770000 SEE PART VI false false false A 0 4945000 266422428 0 0 263719202 2352213 0 0 0 0 351013 2011 true false true true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false true false false false false 0 false 0 false true A true Schedule K, Part I, Line A, Column (F) THE PROCEEDS OF THE SERIES 2018 BONDS REFINANCED A 2009 PROJECT, WHICH ADDRESSED THE HOSPITAL'S OBLIGATION TO MEET THE CALIFORNIA SEISMIC SAFETY ACT'S REQUIREMENT, BY REPAYING IN FULL A 2015 TAXABLE LOAN. THE 2015 LOAN DEFEASED THE SERIES 2009 FHA INSURED MORTGAGE REVENUE BONDS WHICH FINANCED THE 2009 PROJECT. Schedule K, Part II, Line 3 DIFFERENCE BETWEEN ISSUE PRICE AND TOTAL PROCEEDS TOTAL PROCEEDS OF ISSUE DIFFERS FROM THE ISSUE PRICE REPORTED IN PART I (BOND ISSUES), COLUMN (E) DUE TO THE PREMIUM OF THE BOND. DAN AUSMAN PRESIDENT/CEO SPLIT $ LIFE INS X 6202014 6513475 false true true DAN AUSMAN PRESIDENT/CEO SPLIT $ LIFE INS X 6038994 6330166 false true true WILLIAM GRIGG ASSISTANT TREASURER/CFO SPLIT $ LIFE INS X 2350800 2478017 false true true WILLIAM GRIGG ASSISTANT TREASURER/CFO SPLIT $ LIFE INS X 2269894 2386096 false true true STEVEN SISTO SR. VICE PRESIDENT/COO SPLIT $ LIFE INS X 2613289 2764292 false true true STEVEN SISTO SR. VICE PRESIDENT/COO SPLIT $ LIFE INS X 2566022 2707858 false true true BALA CHANDRASEKHAR MD CHIEF MEDICAL OFFICER SPLIT $ LIFE INS X 1972100 2071356 false true true BALA CHANDRASEKHAR MD CHIEF MEDICAL OFFICER SPLIT $ LIFE INS X 1897834 1987526 false true true BALA CHANDRASEKHAR MD CHIEF MEDICAL OFFICER SPLIT $ LIFE INS X 700000 725327 false true true 27964113 SCHEDULE L, PART II USC ARCADIA HOSPITAL HAS A FUNDED NONCONTRIBUTORY DEFINED SPLIT-DOLLAR LIFE INSURANCE ARRANGEMENTS FOR CERTAIN EXECUTIVE OFFICERS. LIFE INSURANCE PREMIUM PAYMENTS ARE PAID ON BEHALF OF EACH PARTICIPANT AND ARE SCHEDULED TO BE REPAID TO USC ARCADIA HOSPITAL FROM THE DEATH BENEFIT ASSOCIATED WITH EACH LIFE INSURANCE CONTRACT. USC ARCADIA HOSPITAL MAY RECEIVE PROCEEDS FROM THE DEATH BENEFIT IN EXCESS OF THE LOAN AMOUNTS. THE PREMIUM LOANS ARE SECURED THROUGH COLLATERAL AGREEMENTS ON THE CASH VALUE AND DEATH BENEFIT FOR EACH INSURANCE CONTRACT. FORM 990, PART I, LINE 6 NUMBER OF VOLUNTEERS AND HOURS THE NUMBER OF VOLUNTEERS AND HOURS SERVED IS DETERMINED THROUGH AN ACTUAL UNDUPLICATED COUNT OF VOLUNTEERS. HOURS OF SERVICE ARE LOGGED AS VOLUNTEERS CLOCK IN AND OUT FOR VARIOUS ASSIGNMENTS. VOLUNTEERS SERVE IN SUPPORTIVE ROLES TO ENHANCE THE PATIENT EXPERIENCE. VOLUNTEERS PROVIDE NON-MEDICAL SERVICES AND INFORMATION TO PATIENTS AND FAMILIES; ASSIST WITH WAY FINDING AND ERRANDS/ESCORT; PROVIDE HOSPITALITY SERVICES TO WAITING AREAS AND PATIENT AND FAMILY VISITORS; AND ASSIST IN CLINICAL AREAS BY SUPPORTING THE SERVICES OF THE DEPARTMENT SUCH AS ASSEMBLY OF EDUCATIONAL PACKETS FOR PATIENTS. ADMINISTRATIVE VOLUNTEERS MAY SERVE IN DEPARTMENTS ASSISTING OFFICE STAFF WITH FILING AND ERRANDS. VOLUNTEERS ALSO SERVE OUTSIDE THE HOSPITAL ENVIRONMENT PRODUCING BABY BLANKETS, HATS, CANCER RESOURCE CENTER GIFTS AND VARIOUS GIFTS FOR PATIENTS AND THEIR FAMILIES. FORM 990, PART VI, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED TO REFLECT THAT ON JULY 1, 2022, USC HEALTH SYSTEM ENTERED INTO AN AFFILIATION AGREEMENT WITH AND BECAME SOLE CORPORATE MEMBER OF USC ARCADIA HOSPITAL THROUGH A MEMBER SUBSTITUTION. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS OF THE ORGANIZATION USC HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION THROUGH A MEMBER SUBSTITUTION AGREEMENT, EFFECTIVE JULY 1, 2022. FORM 990, PART VI, LINE 7A THE SOLE CORPORATE MEMBER OF THE ORGANIZATION ELECTS THE DIRECTORS OF THE BOARD. FORM 990, PART VI, LINE 11 PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW THE FORM 990 THE FORM 990 IS PROVIDED TO AND REVIEWED WITH BOARD MEMBERS IN ADVANCE OF ITS FILING WITH ADEQUATE TIME TO MAKE AND ANSWER INQUIRIES. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST ALL OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND FILE IT WITH THE VP, CHIEF COMPLIANCE AND RISK OFFICER OR THE PRESIDENT OF USC ARCADIA HOSPITAL, FOR REVIEW. A SUMMARY OF THE DISCLOSURES WILL BE PREPARED BY THE VP, CHIEF COMPLIANCE AND RISK OFFICER AND SUBMITTED TO THE FINANCE, AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND DISCUSSION. SUCH DISCUSSION WILL BE FORWARDED AS AN EXECUTIVE SUMMARY TO THE FULL BOARD AT THE NEXT BOARD MEETING. IF THERE IS A CHANGE IN AN INTERESTED PARTY'S DISCLOSED CONFLICTS AT ANY TIME DURING THE YEAR, SUCH CHANGE IS REQUIRED BE DISCLOSED IMMEDIATELY IN WRITING TO THE PRESIDENT AND/OR THE VP, CHIEF COMPLIANCE AND RISK OFFICER OF THE HOSPITAL. AN INDIVIDUAL COVERED BY THIS POLICY IS REQUIRED TO NOTIFY THE VP, CHIEF COMPLIANCE AND RISK OFFICER, PRESIDENT OR CHAIRMAN OF THE BOARD OF ANY TRANSACTION WHICH MIGHT INVOLVE A CONFLICT OF INTEREST. WHEN A POTENTIAL CONFLICT ARISES, THE VP, CHIEF COMPLIANCE AND RISK OFFICER WILL NOTE SUCH DISCLOSURE(S) AND WORK WITH THE INDIVIDUAL(S) TO ENACT PROCEDURES THAT REMOVE THE PRESENCE OF SAID CONFLICT. BASED ON THE ASSESSMENT OF THE MATERIALITY OF THE CONFLICT, THE INTERESTED OFFICER OR DIRECTOR MAY BE ASKED TO ONLY PROVIDE INPUT INTO THE DISCUSSION BUT REFRAIN FROM VOTING; OR MAY BE REMOVED FROM THE DISCUSSION AS WELL AS REFRAINED FROM VOTING. CONFLICTS WHICH PRESENT MORE COMPLEX RESPONSES, RISK, OR COMMUNICATION CHALLENGES WILL BE DISCUSSED WITH THE PRESIDENT AND THE CHAIRMAN OF THE BOARD. FORM 990, PART VI, LINES 15A & 15B COMPENSATION ARRANGEMENTS INVOLVING ANY OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES ARE ESTABLISHED PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION OF REASONABLENESS AS PROVIDED FOR IN IRC SEC 4958 (EXCESS BENEFIT TRANSACTION TAX). THIS PROCESS REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PERSONS, THE USE OF COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE DECISION MAKING PROCESS. THE BOARD PERFORMS PERIODIC REVIEW AND DETERMINATION OF APPROPRIATE COMPENSATION LEVELS FOR THE PREVIOUSLY MENTIONED OFFICERS AND KEY EMPLOYEES BASED UPON EXTERNAL SALARY DATA. THEIR MOST RECENT REVIEW INCLUDED A REPORT FROM AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT WHICH USED BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EMPLOYEES, INCLUDING TOTAL ECONOMIC BENEFITS PAID BY ORGANIZATIONS WHICH THE GOVERNING BODY BELIEVES ARE SIMILARLY SITUATED FOR SIMILAR JOB RESPONSIBILITIES, AS OBTAINED FROM INDEPENDENT THIRD-PARTY SOURCES. THE BOARD'S WRITTEN RECORDS INCLUDE (1) THE TERMS OF THE ARRANGEMENT WITH THE DISQUALIFIED PERSON (INCLUDING THE DATE THE ARRANGEMENT WAS APPROVED); (2) A LIST OF MEMBERS PRESENT DURING THE DEBATE OF THE TRANSACTION (AND HOW THE MEMBERS VOTED WHEN IT WAS APPROVED); AND (3) A DESCRIPTION OF THE COMPARABLE DATA RELIED ON BY THE COMMITTEE. THE KEY DELIBERATIONS, A DESCRIPTION OF THE COMPARABILITY DATA, HOW IT WAS OBTAINED, THE MEMBERS PRESENT AND HOW THEY VOTED, WERE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES FOR ITS MEETING IN 2023. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC UNDER CURRENT FEDERAL LAW THE ORGANIZATION IS NOT REQUIRED TO MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION. HOWEVER, THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, ATTACHED TO PUBLIC INSPECTION COPY OF THE FORM 990. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: CHANGES IN UNRESTRICTED NET ASSETS $ 31,946 CHANGES IN RESTRICTED NET ASSETS $ (477,292) CHANGES IN USCAH WITHOUT DONOR RESTRICTIONS $ 296,034,420 ------------------ TOTAL $ 295,589,074 FORM 990 PART IX LINE 11G DESCRIPTION:REGISTRY TOTAL FEES:25964861 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SPECIALISTS TOTAL FEES:8469577 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:795632 ARCADIA ACCOUNTABLE CARE LLC 300 WEST HUNTINGTON DRIVE ARCADIA CA 91007 455513761 INACTIVE CA 0 0 USCAH ICT PRODUCTIONS INC C/O USC UGB203 LOS ANGELES CA 90089 954843260 EDUC. 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