2024-05-29T11:39:01-05:00 2023-12-31 450250958 EIDE BAILLY LLP 17501 17TH ST STE 100 TUSTIN CA 927807924 990 2023-01-01 830936055 MEDICAL STAFF OF SAINT JOSEPH HOSPITAL O MEDI 7147718013 1100 W STEWART DR ORANGE CA 92868 JAMES ROUM SECRETARY/TREASURER 7147718013 2024-05-08 1 JAMES ROUM XXX-XX-XXXX 1 JANET T ANDERSON CPA P01222713 7145059000 2024-05-08 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z JAMES ROUM 1100 W STEWART DRIVE ORANGE CA 92868 541287 0 X N/A X 2017 CA MAINTAIN THE QUALITY OF MEDICAL SERVICES DELIVERED TO PATIENTS BOTH ADMITTED TO THE HOSPITAL AND THOSE TREATED AS OUTPATIENTS. 6 6 0 19 0 0 0 0 484552 524629 777 16658 0 0 485329 541287 28000 20000 0 0 0 0 0 0 0 457274 412399 485274 432399 55 108888 2076395 2185283 0 0 2076395 2185283 MAINTAIN THE QUALITY OF MEDICAL SERVICES DELIVERED TO PATIENTS BOTH ADMITTED TO THE HOSPITAL AND THOSE TREATED AS OUTPATIENTS. 0 0 MONITOR QUALIFICATIONS OF PHYSICIANS APPLYING FOR PRACTICE PRIVILEGE AND THOSE PROVIDING OTHER ALLIED HEALTH SERVICES.MEMBERS ARE SUBJECT TO A RIGOROUS CREDENTIALING PROCESS. TO APPLY, FORMS APPROVED BY THE MEDICAL EXECUTIVE COMMITTEE (MEC) ARE REQUIRED TO BE COMPLETED AND REVIEWED. THIS PROCESS IS PERFORMED BOTH FOR NEW APPOINTMENTS AS WELL AS FOR REAPPOINTMENTS (EVERY TWO YEARS). ASCERTAIN THAT MEMBERS ARE ADHEREING TO STANDARDS OF CARE, UTILIZATION DISCUSSIONS AND PEER REVIEW PRACTICES. REPORTS, COMPLAINTS AND/OR CONCERNS REGARDING PATIENT CARE ARE DEALT WITH AT THE DEPARTMENTAL LEVEL, WITH REPORTING TO THE MEC FOR RECOMMENDATIONS AS TO RESOLUTION. IN ADDITION, RECOMMENDATIONS FOR CHANGES IN PATIENT CARE STANDARDS FLOW UP THROUGH DIVISIONAL AND DEPARTMENTAL REVIEW AND ARE PASSED TO THE MEC FOR CONSIDERATION. REPRESENT MEMBERS BEFORE THE HOSPITAL ADMINISTRATIVE STAFF AND/OR THE GOVERNING BOARD OF THE HOSPITAL WHEN THERE ARE CONCERNS ARISING BETWEEN A MEMBER AND THE HOSPITAL ADMINSTRATION AND/OR PERSONNEL. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X MELISSA A RUDOLPH 7147718013 1100 W STEWART DRIVE ORANGE CA 92868 X MICHAEL ARQUILLA MD MEMBER AT LARGE 1.00 X 0 0 0 JAMES ROUM MD MEMBER AT LARGE 1.00 X 0 0 0 MELISSA RUDOLPH MD SECRETARY/TREASURER 1.00 X 0 0 0 BRIAN BOYD MD IMMEDIATE PAST CHIEF OF ST 1.00 X 0 0 0 PETER SMETHURST MD CHIEF OF STAFF 1.00 X 0 0 0 JOHN CROSS MD VICE CHIEF OF STAFF 1.00 X 0 0 0 0 0 0 0 0 0 0 0 MEMBERSHIP DUES 621400 418700 418700 APPLICATION FEES 621400 99450 99450 SERVICE FEES 621400 3279 3279 MEDICAL RECORDS FINES 621400 2200 2200 REAPPOINTMENT FEES 621400 1000 1000 524629 16658 16658 541287 541287 0 0 20000 8561 24920 43595 HOSPITAL REIMBURSEMENT 278505 DOCTOR'S DAY EXPENSES 31560 RECOGNITION EVENTS AND 8295 OUTSIDE SERVICES 4700 12263 432399 516005 874410 1560390 1310873 2076395 2185283 0 0 X 0 0 0 0 2076395 2185283 2076395 2185283 2076395 2185283 108888 0 X 0 0 0 0 1 0 1 PROVIDENCE ST JOSEPH HOSPITAL FOUNDATION INC 1010 WEST LA VETA STE 300 ORANGE CA 92868 951643359 501(C)(3) 20000 0 DONATION 1 2 PART I, LINE 2: THE WORKING RELATIONSHIP WITH THE GRANTEE ALLOWS THE EXEMPT ORGANIZATION TO MONITOR THE USE OF GRANT FUNDS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE CHIEF OF STAFF PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC.