2024-11-15T12:37:20-06:00 2023-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2023-01-01 942823538 MARIN GENERAL HOSPITAL MARI 4159257000 250 BON AIR ROAD GREENBRAE CA 94904 ERIC BRETTNER CFO 4159257000 2024-11-14 1 0 MICHAEL LUMSDEN P01262236 4159561500 2023 2024-10-15 13:58:12Z MARINHEALTH MEDICAL CENTER DAVID KLEIN MD MBA 250 BON AIR ROAD GREENBRAE CA 94904 699110708 0 X WWW.MYMARINHEALTH.ORG X 1991 CA TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. 15 14 2157 140 0 0 9945124 11143790 532926564 575388680 454361 4978418 -1581161 -1540732 541744888 589970156 22984704 27560182 0 0 258995015 281822375 0 0 0 244456036 270721850 526435755 580104407 15309133 9865749 571672909 660842624 398449401 469721050 173223508 191121574 X TO BE THE DESTINATION FOR HEALTH AND HEALING IN THE NORTH BAY. 0 0 519939346 27560182 575388680 MARIN GENERAL HOSPITAL DBA MARINHEALTH MEDICAL CENTER IS A 327-BED INDEPENDENT HOSPITAL WITH DEEP ROOTS IN THE COMMUNITY. WE HAVE BEEN MEETING THE HEALTHCARE NEEDS OF THE NORTH BAY SINCE FIRST OPENING OUR DOORS AS MARIN GENERAL HOSPITAL IN 1952. AS MARIN'S ONLY FULL-SERVICE, ACUTE CARE HOSPITAL, WE PROVIDE COMPREHENSIVE CARE ACROSS ALL MAJOR SERVICE LINES. OUR LEVEL III TRAUMA CENTER AND EMERGENCY DEPARTMENT RECEIVE 70% OF THE COUNTY'S AMBULANCE TRAFFIC, AND WE PROVIDE LIFE-SAVING CARE FOR OUR STROKE AND HEART ATTACK PATIENTS. WE ALSO OFFER THE ONLY HOSPITAL-BASED LABOR & DELIVERY UNIT IN MARIN. ADDITIONAL SERVICES PROVIDED INCLUDE: BEHAVIORAL HEALTH; CANCER CARE; CRITICAL CARE; EMERGENCY & TRAUMA; IMAGING & RADIOLOGY; STROKE CARE; SPINE & BRAIN CARE; AND SURGERY & PROCEDURES, AMONGST MANY OTHER SPECIALTIES.AS A DISTRICT HOSPITAL, OWNED BY MARIN HEALTHCARE DISTRICT, WE ANSWER ONLY TO THE COMMUNITY WE SERVE. THIS GIVES US THE FLEXIBILITY TO PLAN CARE THAT TRULY MEETS OUR COMMUNITY'S NEEDS. BUILDING ON A DECADES-LONG RELATIONSHIP, MARINHEALTH AND UCSF HEALTH FORMED A STRATEGIC ALLIANCE IN 2019 THAT EXPANDS ACCESS TO HIGH-QUALITY CLINICAL CARE IN MARIN COUNTY AND THROUGHOUT THE NORTH BAY. 519939346 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 239 0 1 2157 1 0 0 0 0 0 0 0 0 0 0 1 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X ERIC BRETTNER 4154642090 100B DRAKES LANDING SUITE 190 GREENBRAE CA 94904 ANDREA SCHULTZ CHAIR 2.00 0.50 X X 0 0 0 ROBERT PEIRCE VICE CHAIR 2.00 0.00 X X 0 0 0 JOSEPH C EUPHRAT TREASURER 2.00 0.00 X X 0 0 0 JOE ABRAMS SECRETARY 2.00 1.00 X X 0 0 0 JOSHUA ADLER MD BOARD MEMBER 2.00 0.00 X 0 0 0 MARTIN ARRICK MBA PMH BOARD MEMBER 2.00 0.00 X 0 0 0 LISA CARMEL BOARD MEMBER 2.00 1.00 X 0 0 0 SHELBY DECOSTA MHA BOARD MEMBER 2.00 0.00 X 0 0 0 MICHAEL K KWOK MD BOARD MEMBER 2.00 0.00 X 0 0 0 DENISE LUCY EDD BOARD MEMBER 2.00 0.00 X 0 0 0 HADLEY MULLIN MBA BOARD MEMBER 2.00 0.00 X 0 0 0 ADAM NEVITT BOARD MEMBER 2.00 0.00 X 0 0 0 DANIEL VASQUEZ CBE MBA MPP BOARD MEMBER 2.00 0.00 X 0 0 0 K JENNIFER VOSS MD BOARD MEMBER 2.00 0.00 X 0 0 0 DAVID KLEIN MD CEO & BOARD MEMBER 46.00 4.00 X X 1803170 0 37266 ERIC BRETTNER CHIEF FINANCIAL OFFICER 46.00 4.00 X 701911 0 51508 MARY FRIEDMAN CHIEF STRATEGY OFFICER 48.00 2.00 X 438102 0 62669 ELIZABETH KOLCUN CHIEF DEVELOPENT OFFICER 4.00 46.00 X 438656 0 56996 KARIN SHAVELSON MD FAAP CHIEF MEDICAL OFFICER 50.00 0.00 X 487401 0 24099 ANDREW APOLINARSKI MSN RN CNL CHIEF NURSING OFFICER 50.00 0.00 X 563469 0 132799 COLIN LEARY JD GENERAL COUNSEL 50.00 0.00 X 586857 0 50890 EUGENE LEWIS CHIEF HUMAN RESOURCES OFFICER 50.00 0.00 X 392293 0 34049 JENNIFER SCHAAB MHMN PRESIDENT 0.00 50.00 X 537307 0 17034 SUSAN CUMMING MED DIR PATIENT EXPERIENCE 40.00 0.00 X 394373 0 64936 CHUN LI CHIEF CLIN PHYSICIST & DIR RAD ONC 40.00 0.00 X 412543 0 129919 RUSSELL PECKENPAUGH VP IS ADMINISTRATION 40.00 0.00 X 385106 0 39915 MICHAEL KIM MD MHMN VP OF MEDICAL AFFAIRS 0.00 40.00 X 524927 0 17041 GREGORY LEE IR/CATH/EP TECH LEAD 40.00 0.00 X 588183 0 64809 8254298 0 783930 977 0 1 0 PRIMA MEDICAL GROUP 4 HAMILTON LANDING SUITE 100 NOVATO CA 94949 PHYSICIAN SERVICES 32625153 OPTUMINSIGHT INC PO BOX 84019 CHICAGO IL 60689 FINANCIAL SERVICES 18737871 MEDEFIS INC 2121 N 117TH AVE SUITE 200 OMAHA NE 68164 REGISTERED NURSE SERVICES 14766720 UNIVERSITY OF CALIFORNIA SAN FRANCISCO 1550 BRYANT ST 100 SAN FRANCISCO CA 94103 INFORMATION TECHNOLOGY SERVICES 8505920 PRIMA MEDICAL FOUNDATION 9 COMMERCIAL BLVD SUITE 200 NOVATO CA 94949 PHYSICIAN SERVICES 6889760 60 4898988 6244802 11143790 NET PATIENT SERVICE REVENUE 624100 520579488 520579488 CAPITATION REVENUE 624100 46070340 46070340 OTHER OPERATING REVENUE 624100 6406168 6406168 RENTAL REVENUE FROM MHMN 531120 2332684 2332684 575388680 5658876 5658876 12912 12912 887962 3359440 -2471478 -2471478 -2471478 105087742 105781112 -693370 -693370 -693370 CAFETERIA 722514 930746 930746 930746 589970156 575388680 0 3437686 X 27470689 27470689 89493 89493 6416477 1207767 5208710 216379728 198141103 18238625 6630883 5388349 1242534 36569632 32201841 4367791 15825655 14055680 1769975 986707 986707 280886 280886 123116 123116 149679320 125964283 23715037 1789625 1789625 1466803 1419591 47212 8834377 7939368 895009 14694259 14068393 625866 125320 125320 12071008 12071008 25189057 25189057 2488608 2239747 248861 MEDICAL SUPPLIES 28280251 28280251 REPAIRS & MAINTENANCE 17230021 15499045 1730976 LICENSES & TAXES 3556649 3556649 RENTAL EQUIPMENT 1189968 1189968 2735875 1065412 1670463 580104407 519939346 60165061 0 26802241 20589781 1435507 950226 1549037 834219 99239844 97300166 4709800 4701900 8163689 8210991 9048314 10449047 510962777 305189066 210369194 205773711 57538004 110015725 15774993 38169948 5758463 5590578 741007 741007 130542816 157515325 571672909 660842624 91943733 87856289 3268807 337143 96880933 93975335 104940112 205438015 101415816 82114268 398449401 469721050 X 151855511 168385558 21367997 22736016 173223508 191121574 571672909 660842624 X 9865749 6630739 -540000 1941578 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10995 10995 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO: (I) THE CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS, AND (II) THE DISTRICT HOSPITAL LEADERSHIP FORUM. A PORTION OF THESE DUES PAID WERE USED FOR LOBBYING PURPOSES. 32539458 28340080 4199378 208671315 95456844 113214471 202661698 171886999 30774699 67090306 9505143 57585163 205773711 LIMITED PARTNERSHIP INVESTMENT 38169948 F 38169948 OTHER RECEIVABLES 38803255 DEPOSITS 3387010 DUE FROM RELATED ORGANIZATIONS 33767202 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1536682 OPERATING LEASE RIGHT-OF-USE ASSETS 41046387 BENEFICIAL INTEREST IN MARINHEALTH FOUNDATION 32935195 WORKERS COMP RECOVERY 2221408 PENSION BENEFIT ASSET 3818186 157515325 WORKERS' COMPENSATION OBLIGATION 5468311 POST-RETIREMENT HEALTH OBLIGATION 8048502 PROFESSIONAL LIABILITY OBLIGATION 1660000 UCSF CONTRACT LIABILITY 20000000 OPERATING LEASE LIABILITIES 46937455 82114268 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 734559 734559 0.00130 98410933 52460842 45950091 0.07920 99145492 52460842 46684650 0.08050 478808 72962 405846 0.00070 2922974 2922974 0.00500 28959066 28959066 0.04990 32360848 72962 32287886 0.05560 131506340 52533804 78972536 0.13610 11571 11571 0.00000 11571 11571 0.00000 1 6297671 1509764 198033827 293636964 -95603137 X 1 1 1 1 MARIN GENERAL HOSPITAL DBA MARINHEALTH MEDICAL CENTER 250 BON AIR ROAD GREENBRAE CA 94904 WWW.MYMARINHEALTH.ORG 110000361 X X X ACUTE PSYCHIATRIC HOSPITAL MARIN GENERAL HOSPITAL DBA MARINHEALTH 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTPS://WWW.MYMARINHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/ X 1 22 1 HTTPS://WWW.MYMARINHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/ 0 1 X 400.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X WWW.MYMARINHEALTH.ORG/PATIENTS-VISITORS/MEDICAL-CENTER-PATIENTS-VISITORS/ X WWW.MYMARINHEALTH.ORG/PATIENTS-VISITORS/MEDICAL-CENTER-PATIENTS-VISITORS/ X WWW.MYMARINHEALTH.ORG/PATIENTS-VISITORS/MEDICAL-CENTER-PATIENTS-VISITORS/ X X X X X X 1 X 0 X X X X 1 X 0 0 MARIN GENERAL HOSPITAL DBA MARINHEALTH PART V, SECTION B, LINE 5: INPUT FROM THE COMMUNITY SERVED BY MARIN COUNTY WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, 12 SMALL GROUP INTERVIEWS WITH 32 COMMUNITY HEALTH EXPERTS WERE CONDUCTED FROM SEPTEMBER 22, 2021 TO MARCH 24, 2022. PARTICIPANTS INCLUDED COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (E.G., MEMBERS OF SOCIAL SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTH CARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN ONE-ON-ONE AND IN GROUP SETTINGS. KEY INFORMANTS FOR THE GROUP INTERVIEWS INCLUDE REPRESENTATIVES FROM: WEST MARIN COMMUNITY SERVICES; MARGUERITA C. JOHNSON SENIOR CENTER; MARIN COUNTY HEALTH AND HUMAN SERVICES: MARIN CITY PEOPLE'S PLAN; MULTICULTURAL CENTER OF MARIN; MARINHEALTH MEDICAL CENTER STAFF; MARINHEALTH AND HUMAN SERVICES; INTEGRATED COMMUNITY SERVICES; REDWOOD COMMUNITY HEALTH COALITION; MARIN COUNTY BEHAVIORAL HEALTH AND RECOVERY SERVICES PREVENTION OUTREACH TEAM; MARIN COUNTY SUICIDE PREVENTION COLLABORATIVE; MARIN COUNTY PROBATION DEPARTMENT; NOVATO COMMUNITY HOSPITAL AND KAISER PERMANENTE; MARIN COUNTY OFFICE OF EDUCATION; MARIN PROMISE PARTNERSHIP; COLLEGE OF MARIN; AND MARIN CITY HEALTH AND WELLNESS.SECOND, A FOCUS GROUP WAS CONDUCTED ON MARCH 28, 2022 WITH FOUR COMMUNITY RESIDENTS. THE FOCUS GROUP WAS CONDUCTED WITH SERVICE PROVIDERS WORKING IN THE GEOGRAPHIC AREA OF MARIN COUNTY IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CAME FROM REFERRALS FROM SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS.ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT. DATA WERE COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. ADDITIONALLY, A WEB-BASED SURVEY WAS ADMINISTERED TO COMMUNITY SERVICE PROVIDERS WHO DELIVERED HEALTH AND SOCIAL SERVICES TO COMMUNITY RESIDENTS OF MARIN COUNTY. A LIST OF COMMUNITY SERVICE PROVIDERS AFFILIATED WITH THE NONPROFIT HOSPITALS INCLUDED IN THIS REPORT WAS USED AS AN INITIAL SAMPLING FRAME. AN EMAIL RECRUITMENT MESSAGE WAS SENT TO THESE COMMUNITY SERVICE PROVIDERS DETAILING THE SURVEY AIMS AND INVITING THEM TO PARTICIPATE. PARTICIPANTS WERE ALSO ENCOURAGED TO FORWARD THE RECRUITMENT MESSAGE TO OTHER COMMUNITY SERVICE PROVIDERS IN THEIR NETWORKS. THE SURVEY WAS DESIGNED USING QUALTRICS, AN ONLINE SURVEY PLATFORM, AND WAS AVAILABLE FOR APPROXIMATELY TWO WEEKS; 25 RESPONDENTS COMPLETED THE SURVEY. WHEN THE SURVEY PERIOD WAS OVER, INCOMPLETE, AND DUPLICATE RESPONSES WERE REMOVED FROM THE DATASET AND THE SURVEY RESPONSES WERE DOUBLE-CHECKED FOR ACCURACY. DESCRIPTIVE STATISTICS AND FREQUENCIES WERE USED TO SUMMARIZE THE HEALTH NEEDS. THIS INFORMATION WAS USED ALONG WITH OTHER DATA SOURCES TO IDENTIFY AND RANK SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY, AND TO DESCRIBE HOW THE HEALTH NEEDS ARE EXPRESSED. MARIN GENERAL HOSPITAL DBA MARINHEALTH PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN CONJUNCTION WITH SUTTER HEALTH NOVATO COMMUNITY HOSPITAL. MARIN GENERAL HOSPITAL DBA MARINHEALTH PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COLLABORATION WITH HEALTHY MARIN PARTNERSHIP. MARIN GENERAL HOSPITAL DBA MARINHEALTH PART V, SECTION B, LINE 11: MARINHEALTH'S 2022 CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS: ACCESS TO DENTAL CARE; ACCESS TO HEALTHCARE; ACCESS TO SPECIALTY SERVICES; BASIC NEEDS (HOUSING, FOOD, EMPLOYMENT, ETC.); CHRONIC CONDITIONS; COMMUNITY CONNECTIONS (SUPPORT NETWORKS AND RESOURCES); ENVIRONMENTAL CONDITIONS (POLLUTION AND ENVIRONMENT); FUNCTIONAL NEEDS (TRANSPORTATION, ACCESS FOR PERSONS WITH PHYSICAL DISABILITIES); HEALTHY EATING AND ACTIVE LIVING; INJURY PREVENTION; MENTAL HEALTH AND SUBSTANCE USE; SAFETY AND VIOLENCE PREVENTION; AND SYSTEM NAVIGATION (SOCIAL SERVICE AND HEALTH CARE SYSTEMS).TO REFLECT THE COMMUNITY'S VOICE, KEY INFORMANTS AND FOCUS-GROUP PARTICIPANTS WERE ASKED TO IDENTIFY THE MOST SIGNIFICANT NEEDS, WHICH WERE PRIORITIZED. THE PRIORITIZED HEALTH NEEDS FOR MARIN COUNTY ARE LISTED BELOW IN PRIORITY ORDER:1. ACCESS TO BASIC NEEDS (HOUSING, JOBS, FOOD)2. ACCESS TO BEHAVIORAL HEALTH, MENTAL HEALTH, AND SUBSTANCE USE SERVICES3. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES4. INCREASED COMMUNITY CONNECTIONS5. ACCESS TO FUNCTIONAL NEEDSIN 2023, MARINHEALTH MEDICAL CENTER ENGAGED IN ACTIVITIES AND PROGRAMS THAT ADDRESSED THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2023-2025 IMPLEMENTATION STRATEGY. ACTIVITIES AND PROGRAMS IN 2023 THAT HIGHLIGHT THE HOSPITAL'S COMMITMENT TO THE COMMUNITY ARE DETAILED BELOW.RESPONSE TO NEED - ACCESS TO CARE:IN RESPONSE TO THE COMMUNITY HEALTH NEED OF ACCESS TO CARE, MARINHEALTH: PROVIDED FINANCIAL ASSISTANCE THROUGH FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES, CONSISTENT WITH MARINHEALTH'S FINANCIAL ASSISTANCE POLICY; PROVIDED TRANSPORTATION TO PATIENTS TO ACCESS HEALTHCARE SERVICES; SUPPORTED 1,163 INDIVIDUALS WITH COMPASSIONATE DISCHARGE SERVICES AND PRESCRIPTIONS; SUPPORTED PRIMARY AND SPECIALTY CARE SERVICES FOR THE UNINSURED AT MARINHEALTH MEDICAL NETWORK CLINICS; PARTICIPATED IN THE MARIN CITY HEALTH FAIR AND CANAL DISTRICT HEALTH FAIR HOSTED BY THE MARIN HEALTHCARE DISTRICT, WHERE HEALTH EDUCATION AND RESOURCES WERE PROVIDED TO 164 INDIVIDUALS AND FAMILIES; PROVIDED BREAST EXAMS AND LOW-COST MAMMOGRAMS (THROUGH THE BREAST HEALTH CENTER) TO 66 LOW-INCOME AND UNDERSERVED WOMEN IN CONJUNCTION WITH THE MARIN COMMUNITY CLINICS; HOSTED THE MOM'S GROUP (OPEN TO ANY MOTHER IN THE COMMUNITY, REGARDLESS OF WHERE THEY DELIVERED THEIR BABY), WHICH SUPPORTED 516 NEW MOTHERS WITH FREE SUPPORT GROUPS AND EDUCATION ON NEWBORN CARE, BREASTFEEDING, AND PARENTING; PROVIDED FREE EDUCATION, COUNSELING, AND BREASTFEEDING SUPPORT TO WOMEN IN THE COMMUNITY THROUGH THE BREASTFEEDING TELEPHONE SUPPORT LINE, WHERE MORE THAN 1,173 ENCOUNTERS WERE PROVIDED; HOSTED INFANT AND CHILDBIRTH CARE CLASSES, WHICH ARE OPEN TO THE COMMUNITY AND REACHED 288 PERSONS; HOSTED PATHWAYS, A SUPPORT GROUP FOR POSTPARTUM MOMS, WHICH ASSISTED 27 PERSONS WITH EDUCATION ON MOOD ISSUES, IDENTITY SHIFTS, CHANGES IN PARTNER RELATIONSHIPS WHEN A NEW BABY ARRIVES, AND SELF-CARE TOOLS; PROVIDED OUTPATIENT CARE COORDINATION AND TRANSITIONS OF CARE THROUGH THE SUPPORTIVE CARE CENTER AND PROVIDED PALLIATIVE CARE, ADVANCE CARE PLANNING, AND SPIRITUAL CARE, WHICH REMOVED BARRIERS FOR VULNERABLE PATIENTS AND THEIR CAREGIVERS; REACHED OVER 1,500 PEOPLE WITH HEALTH EDUCATION AND RESOURCES AT THE MARIN SENIOR FAIR; PROVIDED COMMUNITY EDUCATION, PODCASTS, AND OUTREACH ON SUCCESSFUL AGING, HEALTH AND WELLBEING, NUTRITION, MATERNITY CARE, SPINE AND BRAIN, CANCER CARE, AND CARDIOVASCULAR EDUCATION.ADDITIONALLY, THROUGH THE COMMUNITY BENEFIT GRANT PROGRAM, MARINHEALTH PROVIDED GRANTS TO THE FOLLOWING ORGANIZATIONS THAT ADDRESSED ACCESS TO CARE INCLUDE GRANTS TO: COMMUNITY ACTION MARIN; MARIN CENTER FOR INDEPENDENT LIVING; MARIN COMMUNITY CLINICS; OPERATION ACCESS; RITTER CENTER; ROTACARE BAY AREA; AND THE SPAHR CENTER.RESPONSE TO NEED - HEALTHY EATING AND ACTIVE LIVING:IN RESPONSE TO THE COMMUNITY HEALTH NEED OF HEALTHY EATING AND ACTIVE LIVING, MARINHEALTH: PROVIDED FREE DIABETES SUPPORT GROUPS, COMMUNITY EDUCATION, AND SCREENINGS TO 695 COMMUNITY MEMBERS THROUGH THE BRADEN DIABETES CENTER; PROVIDED 628 COMMUNITY MEMBERS WITH EDUCATION, SUPPORT GROUPS, HEALTHY WEIGHT FOR WELLNESS, YOGA, AND QI GONG EVENTS (ALL FREE TO THE PUBLIC) AT THE INTEGRATIVE WELLNESS CENTER; PROVIDED FREE BLOOD PRESSURE CHECKS, GLUCOSE SCREENINGS, AND STROKE EDUCATION TO 65 COMMUNITY MEMBERS AT THE MARIN CITY CLIMATE RESILIENCE AND HEALTH EVENT; DISTRIBUTED THE FREE HEALTH CONNECTION E-NEWSLETTER AND EDUCATIONAL PODCASTS TO THE PUBLIC, WHICH PROVIDED EDUCATION ON HEALTHY EATING AND ACTIVE LIVING; PROVIDED FREE NUTRITION ADVICE TO THE PUBLIC, INCLUDING A CLASS TO EQUIP CAREGIVERS WORKING WITH PEOPLE WITH DIABETES AND OTHER CHRONIC DISEASES; PROVIDED NUTRITION ADVICE FOR 36 INDIVIDUALS RECOVERING FROM ADDICTION; PROVIDED VASCULAR HEALTH SCREENINGS, SKIN CANCER SCREENINGS, BLOOD PRESSURE SCREENINGS, AND GLUCOSE SCREENINGS AT NO COST TO RESIDENTS AT COMMUNITY EVENTS.ADDITIONALLY, THROUGH THE COMMUNITY BENEFIT GRANT PROGRAM, MARINHEALTH PROVIDED GRANTS TO THE FOLLOWING ORGANIZATIONS THAT ADDRESSED HEALTHY EATING AND ACTIVE LIVING: CERES COMMUNITY PROJECT; KIDS COOKING FOR LIFE; SAN GERONIMO VALLEY COMMUNITY CENTER; THE SPAHR CENTER; WEST MARIN SENIOR SERVICESRESPONSE TO NEED - HOUSING AND HOMELESSNESS:IN RESPONSE TO THE COMMUNITY HEALTH NEED OF HOUSING AND HOMELESSNESS MARINHEALTH: PROVIDED CLOTHING AND MEALS FOR PEOPLE EXPERIENCING HOMELESSNESS UPON THEIR DISCHARGE; PROVIDED TRANSPORTATION TO PATIENTS TO ACCESS HEALTHCARE SERVICES; SUPPORTED 1,163 INDIVIDUALS WITH COMPASSIONATE DISCHARGE SERVICES AND PRESCRIPTIONS; PROVIDED PRIMARY AND SPECIALTY CARE SERVICES FOR THE UNINSURED AT MARINHEALTH MEDICAL NETWORK CLINICS.ADDITIONALLY, THROUGH THE COMMUNITY BENEFIT GRANT PROGRAM, MARINHEALTH PROVIDED GRANTS TO THE FOLLOWING ORGANIZATIONS THAT ADDRESSED HOUSING AND HOMELESSNESS: HOMEWARD BOUND; AND ST. VINCENT DE PAUL SOCIETY.RESPONSE TO NEED - MENTAL HEALTH AND SUBSTANCE USE:IN RESPONSE TO THE COMMUNITY HEALTH NEED OF MENTAL HEALTH AND SUBSTANCE USE, MARINHEALTH: THROUGH ITS BEHAVIORAL HEALTH PROGRAM (MARIN COUNTY'S ONLY INPATIENT PSYCHIATRIC PROGRAM AND DESIGNATED 5150 FACILITY, WITH 17 ADULT INPATIENT BEDS), PROVIDED ACCREDITED HOSPITAL INPATIENT AND OUTPATIENT BEHAVIORAL HEALTHCARE SERVICES, INCLUDING PARTIAL HOSPITALIZATION AND CO-OCCURRING BEHAVIORAL HEALTH AND SUBSTANCE USE; PROVIDED CARE COORDINATION AND LINKAGES TO SERVICES FOR PATIENTS WHO PRESENTED TO THE EMERGENCY DEPARTMENT WITH COMPLEX PSYCHOSOCIAL ISSUES RELATED TO HOMELESSNESS, POVERTY, DOMESTIC VIOLENCE, HUMAN TRAFFICKING, VIOLENT CRIMES, AND TRAUMA; PARTICIPATED IN MARIN HEALTHCARE DISTRICT'S TEEN WELLNESS EVENT AND AN EATING DISORDER SEMINAR, WHICH PROVIDED INFORMATION TO 132 TEENS AND THEIR FAMILIES FOR MENTAL HEALTH RESOURCES; PARTICIPATED IN THE CALBRIDGE NAVIGATOR PROGRAM, WHICH ADDRESSED SUBSTANCE USE DISORDER AS A TREATABLE MEDICAL EMERGENCY, UTILIZING TRAINED BEHAVIORAL HEALTH (BH) NAVIGATORS TO FACILITATE MEDICATION FOR ADDICTION TREATMENT (MAT) AND MADE REFERRALS TO ONGOING TREATMENT FOR SUBSTANCE USE AND MENTAL HEALTH SERVICES.ADDITIONALLY, THROUGH THE COMMUNITY BENEFIT GRANT PROGRAM, MARINHEALTH PROVIDED GRANTS TO THE FOLLOWING ORGANIZATIONS THAT ADDRESSED MENTAL HEALTH AND SUBSTANCE USE: BUCKELEW PROGRAMS; COMMUNITY INSTITUTE FOR PSYCHOTHERAPY; HUCKLEBERRY TEEN HEALTH PROGRAM; JEWISH FAMILY AND CHILDREN'S SERVICES; MARIN COMMUNITY CLINICS; NATIONAL ALLIANCE ON MENTAL ILLNESS; NORTH MARIN COMMUNITY SERVICES; THE SPAHR CENTER.RESPONSE TO NEED - COMMUNITY SAFETY AND INJURY PREVENTION:IN RESPONSE TO THE COMMUNITY HEALTH NEED OF COMMUNITY SAFETY AND INJURY PREVENTION, MARINHEALTH: HOSTED CHILD AND INFANT CPR CLASSES; AND HOSTED 92 COMMUNITY MEMBERS PARTICIPATING IN HANDS-ONLY CPR, NARCAN EDUCATION, AND "STOP THE BLEED" PROGRAM, ENCOURAGING BYSTANDERS TO BECOME TRAINED, EQUIPPED, AND EMPOWERED TO HELP IN A BLEEDING EMERGENCY BEFORE PROFESSIONAL HELP ARRIVES.ADDITIONALLY, THROUGH THE COMMUNITY BENEFIT GRANT PROGRAM, MARINHEALTH PROVIDED GRANTS TO THE FOLLOWING ORGANIZATIONS THAT ADDRESSED COMMUNITY SAFETY AND INJURY PREVENTION: HUCKLEBERRY TREEN HEALTH PROGRAM AND THE SPAHR CENTER.MARINHEALTH CANNOT ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN THE COMMUNITY, AND INSTEAD WILL CONCENTRATE ON THOSE NEEDS IT CAN MOST EFFECTIVELY ADDRESS GIVEN ITS AREAS OF FOCUS AND EXPERTISE. 78 1 - MARIN SPECIALTY SURGERY CENTER 1 THORNDALE DR SUITE 210 SAN RAFAEL CA 94903 SPECIALTY SURGERY CENTER 2 - MARINHEALTH BONE DENSITY TESTING 100A DRAKES LANDING ROAD SUITE 140 GREENBRAE CA 94904 BONE DENSITY TESTING CLINIC 3 - MARINHEALTH BRADEN DIABETES CENTER 1100 SOUTH ELISEO DRIVE SUITE 2 GREENBRAE CA 94904 DIABETES CENTER 4 - MARINHEALTH BREAST HEALTH CENTER 100A DRAKES LANDING ROAD SUITE 140 GREENBRAE CA 94904 BREAST HEALTH CENTER 5 - MARINHEALTH BREAST SURGERY BREASTFEEDIN 1350 SOUTH ELISEO DRIVE SUITE 300 GREENBRAE CA 94904 BREAST HEALTH CENTER 6 - MARINHEALTH CANCER CARE 1350 SOUTH ELISEO DRIVE GREENBRAE CA 94904 CANCER CARE CENTER 7 - MARINHEALTH CARDIOVASCULAR MEDICINE A 2 BON AIR ROAD SUITE 100 LARKSPUR CA 94939 CARDIOVASCULAR MEDICINE CENTER 8 - MARINHEALTH CARDIOVASCULAR MEDICINE A 75 ROWLAND WAY SUITE 250 NOVATO CA 94945 CARDIOVASCULAR MEDICINE CENTER 9 - MARINHEALTH CARDIOVASCULAR MEDICINE A 651 FIRST STREET WEST SUITE L SONOMA CA 95476 CARDIOVASCULAR MEDICINE CENTER 10 - MARINHEALTH CARDIOVASCULAR MEDICINE A 3250 BEARD ROAD NAPA CA 94558 CARDIOVASCULAR MEDICINE CENTER 11 - MARINHEALTH CARDIOVASCULAR MEDICINE A 104 LYNCH CREEK WAY SUITE 10 PETALUMA CA 94954 CARDIOVASCULAR MEDICINE CENTER 12 - MARINHEALTH CARDIOVASCULAR PERFORMANCE C 75 ROWALND WAY SUITE 250 NOVATO CA 94945 CARDIOVASCULAR PERFORMANCE CENTER 13 - MARINHEALTH CONTINUOUS CARE 4000 CIVIC CENTER DRIVE SUITE 206 SAN RAFAEL CA 94903 CONTINUOUS CARE CENTER 14 - MARINHEALTH CRITICAL CARE & PULMONOLOGY 1100 LARKSPUR LANDING SUITE 10 LARKSPUR CA 94939 CRITICAL CARE & PULMONOLOGY CENTER 15 - MARINHEALTH DERMATOLOGY A UCSF HEALTH 5000 CIVIC CENTER DRIVE SAN RAFAEL CA 94903 DERMATOLOGY HEALTH CENTER 16 - MARINHEALTH DERMATOLOGY A UCSF HEALTH 75 ROWLAND WAY SUITE 101 NOVATO CA 94945 DERMATOLOGY HEALTH CENTER 17 - MARINHEALTH ENDOCRINE & DIABETES CARE 900 SOUTH ELISEO DRIVE SUITE 201 GREENBRAE CA 94904 ENDOCRINE & DIABETES HEALTH CENTER 18 - MARINHEALTH ENDOCRINE & DIABETES CARE 75 ROWLAND WAY SUITE 230 NOVATO CA 94945 ENDOCRINE & DIABETES HEALTH CENTER 19 - MARINHEALTH ENT HEAD & NECK SURGERY A 1701 FOURTH STREET SUITE 120 SANTA ROSA CA 95404 ENT, HEAD & NECK SURGERY CENTER 20 - MARINHEALTH GASTROENTEROLOGY A UCSF HE 200 TAMAL PLAZA SUITE 200 CORTE MADERA CA 94925 GASTROENTEROLOGY HEALTH CENTER 21 - MARINHEALTH GASTROENTEROLOGY A UCSF HE 7120 REDWOOD BOULEVARD NOVATO CA 94945 GASTROENTEROLOGY HEALTH CENTER 22 - MARINHEALTH GENERAL & COLORECTAL SURGERY 5 BON AIR ROAD SUITE 101 LARKSPUR CA 94939 GENERAL & COLORECTAL SURGERY CENTER 23 - MARINHEALTH GENERAL SURGERY A UCSF HEA 75 ROWLAND WAY SUITE 230 NOVATO CA 94945 GENERAL SURGERY CENTER 24 - MARINHEALTH HEARING & SPEECH 1350 SOUTH ELISEO DRIVE SUITE 130 LARKSPUR CA 94904 HEARING & SPEECH CENTER 25 - MARINHEALTH INFECTIOUS DISEASE A UCSF 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR CA 94939 INFECTIOUS DISEASE CENTER 26 - MARINHEALTH INTEGRATIVE WELLNESS CENTER 1350 SOUTH ELISEO DRIVE SUITE 120 GREENBRAE CA 94904 INTEGRATIVE WELLNESS CENTER 27 - MARINHEALTH INTERNAL MEDICINE A UCSF H 1341 SOUTH ELISEO DRIVE SUITE 200 GREENBRAE CA 94904 INTERNAL MEDICINE CENTER 28 - MARINHEALTH INTERNAL MEDICINE A UCSF H 23 REED BOULEVARD SUITE 120 MILL VLLEY CA 94941 INTERNAL MEDICINE CENTER 29 - MARINHEALTH INTERNAL MEDICINE A UCSF H 104 LYNCH CREEK WAY SUITE 10 PETALUMA CA 94954 INTERNAL MEDICINE CENTER 30 - MARINHEALTH LACTATION SERVICES 250 BON AIR ROAD FLOOR 4 GREENBRAE CA 94904 LACTATION SERVICES CENTER 31 - MARINHEALTH NEPHROLOGY A UCSF HEALTH C 1341 SOUTH ELISEO DRIVE SUITE 200 GREENBRAE CA 94904 NEPHROLOGY HEALTH CENTER 32 - MARINHEALTH NEUROLOGY A UCSF HEALTH CL 75 ROWLAND WAY SUITE 230 NOVATO CA 94945 NEUROLOGY HEALTH CENTER 33 - MARINHEALTH NEUROLOGY A UCSF HEALTH CL 3 HARBOR DRIVE SUITE 111 SAUSALITO CA 94965 NEUROLOGY HEALTH CENTER 34 - MARINHEALTH OBGYN A UCSF HEALTH CLINI 100A DRAKES LANDING ROAD SUITE 225 GREENBRAE CA 94904 OB/GYN HEALTH CENTER 35 - MARINHEALTH OBGYN A UCSF HEALTH CLINI 75 ROWLAND WAY SUITE 100 NOVATO CA 94945 OB/GYN HEALTH CENTER 36 - MARINHEALTH OBGYN A UCSF HEALTH CLINI 1496 PROFESSIONAL DRIVE SUITE 603 PETALUMA CA 94954 OB/GYN HEALTH CENTER 37 - MARINHEALTH ORTHOPEDIC CARE A UCSF HEA 347 ANDRIEUX STREET SONOMA CA 95476 ORTHOPEDIC HEALTH CENTER 38 - MARINHEALTH ORTHOPEDIC CARE A UCSF HEA 104 LYNCH CREEK WAY SUITE 10 PETALUMA CA 94954 ORTHOPEDIC HEALTH CENTER 39 - MARINHEALTH ORTHOPEDIC CARE A UCSF HEA 4000 CIVIC CENTER DRIVE SUITE 209 SAN RAFAEL CA 94903 ORTHOPEDIC HEALTH CENTER 40 - MARINHEALTH ORTHOPEDIC CARE A UCSF HEA 7100 REDWOOD BOULEVARD SUITE 200 NOVATO CA 94945 ORTHOPEDIC HEALTH CENTER 41 - MARINHEALTH ORTHOPEDIC CARE A UCSF HEA 18 BON AIR ROAD LARKSPUR CA 94939 ORTHOPEDIC HEALTH CENTER 42 - MARINHEALTH OUTPATIENT IMAGING CENTER 1260 SOUTH ELISEO DRIVE SUITE 100 GREENBRAE CA 94904 OUTPATIENT IMAGING CENTER 43 - MARINHEALTH OUTPATIENT IMAGING CENTER 1240 SOUTH ELISEO DRIVE SUITE 103 GREENBRAE CA 94904 OUTPATIENT IMAGING CENTER 44 - MARINHEALTH OUTPATIENT IMAGING CENTER 4000 CIVIC CENTER DRIVE SUITE 209 SAN RAFAEL CA 94903 OUTPATIENT IMAGING CENTER 45 - MARINHEALTH OUTPATIENT IMAGING CENTER 75 ROWLAND WAY SUITE 131 NOVATO CA 94945 OUTPATIENT IMAGING CENTER 46 - MARINHEALTH OUTPATIENT IMAGING CENTER 2 BON AIR ROAD SUITE 120A LARKSPUR CA 94939 OUTPATIENT IMAGING CENTER 47 - MARINHEALTH OUTPATIENT PHYSICAL THERAPY 1350 SOUTH ELISEO DRIVE SUITE 250 GREENBRAE CA 94904 OUTPATIENT PHYSICAL THERAPY 48 - MARINHEALTH PEDIATRIC AFTER-HOURS CARE 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR CA 94939 PEDIATRIC AFTER-HOURS CLINIC 49 - MARINHEALTH PEDIATRIC CARE A UCSF HEAL 4000 CIVIC CNETER DRIVE SUITE 205 SAN RAFAEL CA 94903 PEDIATRIC CARE CENTER 50 - MARINHEALTH PEDIATRIC CARE A UCSF HEAL 651 FIRST STREET WEST SUITE H SONOMA CA 95476 PEDIATRIC CARE CENTER 51 - MARINHEALTH PEDIATRIC CARE A UCSF HEAL 75 ROWLAND WAY SUITE 275 NOVATO CA 94945 PEDIATRIC CARE CENTER 52 - MARINHEALTH PETCT IMAGING 4000 CIVIC CENTER DRIVE SUITE 110 SAN RAFAEL CA 94903 PET/CT IMAGING 53 - MARINHEALTH PHYSICAL THERAPY A UCSF HEAL 7100 REDWOOD BOULEVARD SUITE 100 NOVATO CA 94945 PHYSICAL THERAPY CLINIC 54 - MARINHEALTH PHYSICAL THERAPY A UCSF HEAL 5 BON AIR ROAD SUITE 129 LARKSPUR CA 94949 PHYSICAL THERAPY CLINIC 55 - MARINHEALTH PODIATRIC SPORTS MEDICINE 4000 CIVIC CENTER DRIVE SUITE 209 SAN RAFAEL CA 94903 PODIATRIC SPORTS MEDICINE CENTER 56 - MARINHEALTH PRIMARY CARE A UCSF HEALTH 651 FIRST STREET WEST SUITE H SONOMA CA 95476 PRIMARY CARE CENTER 57 - MARINHEALTH PRIMARY CARE A UCSF HEALTH 4000 CIVIC CENTER DRIVE SUITE 200B SAN RAFAEL CA 94903 PRIMARY CARE CENTER 58 - MARINHEALTH PRIMARY CARE A UCSF HEALTH 3 HARBOR DRIVE SUITE 111 SAUSALITO CA 94965 PRIMARY CARE CENTER 59 - MARINHEALTH PRIMARY CARE A UCSF HEALTH 75 ROWLAND WAY SUITE 200 NOVATO CA 94945 PRIMARY CARE CENTER 60 - MARINHEALTH PRIMARY CARE A UCSF HEALTH 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR CA 94939 PRIMARY CARE CENTER 61 - MARINHEALTH PSYCHIATRY A UCSF HEALTH C 75 ROWLAND WAY SUITE 220 NOVATO CA 94945 PSYCHIATRY CARE CENTER 62 - MARINHEALTH RHEUMATOLOGY A UCSF HEALTH 4000 CIVIC CENTER DRIVE SUITE 200A SAN RAFAEL CA 94903 RHEUMATOLOGY CARE CENTER 63 - MARINHEALTH SPINE INSTITUTE A UCSF HEA 2 BON AIR ROAD SUITE 120 LARKSPUR CA 94939 SPINE CARE CENTER 64 - MARINHEALTH SPINE INSTITUTE A UCSF HEA 4000 CIVIC CENTER DRIVE SUITE 209 SAN RAFAEL CA 94903 SPINE CARE CENTER 65 - MARINHEALTH SUPPORTIVE CARE CENTER 1350 SOTUH ELISEO DRIVE SUITE 140 GREENBRAE CA 94904 SUPPORTIVE CARE CENTER 66 - MARINHEALTH URGENT CARE A UCSF HEALTH 4000 CIVIC CENTER DRIVE SUITE 206 SAN RAFAEL CA 94903 URGENT CARE CENTER 67 - MARINHEALTH UROGYNECOLOGY A UCSF HEALT 75 ROWALND WAY SUITE 100 NOVATO CA 94945 UROGYNECOLOGY CARE CENTER 68 - MARINHEALTH UROGYNECOLOGY A UCSF HEALT 100A DRAKES LANDING ROAD SUITE 225 GREENBRAE CA 94904 UROGYNECOLOGY CARE CENTER 69 - MARINHEALTH UROLOGY A UCSF HEALTH CLIN 75 ROWLAND WAY SUITE 100 NOVATO CA 94945 UROLOGY CARE CENTER 70 - MARINHEALTH UROLOGY A UCSF HEALTH CLIN 3250 BEARD ROAD NAPA CA 94558 UROLOGY CARE CENTER 71 - MARINHEALTH UROLOGY A UCSF HEALTH CLIN 1240 SOUTH ELISEO DRIVE SUITE 200 GREENBRAE CA 94904 UROLOGY CARE CENTER 72 - MARINHEALTH UROLOGY A UCSF HEALTH CLIN 1496 PROFESSIONAL DRIVE SUITE 603 PETALUMA CA 94954 UROLOGY CARE CENTER 73 - MARINHEALTH VASCULAR SURGERY A UCSF HE 75 ROWLAND WAY SUITE 131 NOVATO CA 94945 VASCULAR SURGERY CENTER 74 - MARINHEALTH VASCULAR SURGERY A UCSF HE 1701 FOURTH STREET SUITE 120 SANTA ROSA CA 95404 VASCULAR SURGERY CENTER 75 - MARINHEALTH VASCULAR SURGERY A UCSF HE 1100 SOUTH ELISEO DRIVE SUITE 2A GREENBRAE CA 94904 VASCULAR SURGERY CENTER 76 - MARINHEALTH VASCULAR SURGERY A UCSF HE 651 FIRST STREET WEST SUITE K SONOMA CA 95476 VASCULAR SURGERY CENTER 77 - UCSF NEUROSURGERY 1100 SOUTH ELISEO DRIVE SUITE 1 GREENBRAE CA 94904 NEUROSURGERY CENTER 78 - UCSF PRENATAL DIAGNOSTIC CENTER 1300 SOUTH ELISEO DRIVE SUITE 200 GREENBRAE CA 94904 PRENATAL DIAGNOSTIC CENTER PART I, LINE 3C: TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINE (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: 1) SPECIAL CIRCUMSTANCES CHARITY CARE: A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, INELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE HOSPITAL'S CHARITY CARE ELIGIBILITY CRITERIA. 2) CATASTROPHIC CHARITY CARE: FULL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 10% OF PATIENT'S FAMILY INCOME.3) UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. 4) PROMPT PAYMENT DISCOUNT: ADDITIONAL DISCOUNT FOR PATIENTS RECEIVING THE UNINSURED DISCOUNT OF AT LEAST 10% WHO PAYS ESTIMATED BILL PRIOR TO DISCHARGE. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS ON LINES 7B, AND 7C. COST ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS ON LINES 7A, 7E, 7F, AND 7I. PART II, COMMUNITY BUILDING ACTIVITIES: ECONOMIC DEVELOPMENT - THE HOSPITAL PARTICIPATED IN CHAMBER OF COMMERCE ACTIVITIES THAT FOCUSED ON COMMUNITY HEALTH IMPROVEMENT AND SAFETY. PART III, LINE 2: THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON SCHEDULE H, PART III, LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 4: MHMC'S AUDITED FINANCIAL STATEMENTS DOES NOT HAVE A SEPARATE BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE FOOTNOTE WHICH ADDRESSES "PATIENTS ACCOUNTS RECEIVABLE, NET" CAN BE FOUND ON PAGES 12-13 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AS MEDICARE RATES ARE NON-NEGOTIABLE AND SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS. BY CONTINUING TO TREAT PATIENTS ELIGIBLE TO MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. ADDITIONALLY, IRS REV. RUL. 69-545 STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.ALL MEDICARE REVENUES AND COSTS WERE INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. PART III, LINE 9B: THE MEDICAL CENTER INCLUDES AN EXTENDED PAYMENT PLAN TO ALLOW PAYMENT OF THE DISCOUNTED PRICE OVER TIME. THE MEDICAL CENTER AND THE PATIENT MAY NEGOTIATE THE TERMS OF THE PAYMENT PLAN. THE MEDICAL CENTER WILL NOT CHARGE INTEREST ON THE EXTENDED PAYMENT PLAN DEBT. AN EXTENDED PAYMENT PLAN MAY BE NEGOTIATED WITH THE PATIENT IF THE PATIENT FAILS TO MAKE ALL CONSECUTIVE PAYMENTS DURING A 90-DAY PERIOD. PRIOR TO DECLARING AN EXTENDED PAYMENT PLAN INOPERABLE THE PATIENT MUST BE: 1. CONTACTED OR ATTEMPTED TO BE CONTACTED BY TELEPHONE (LAST KNOWN NUMBER)2. GIVEN NOTICE IN WRITING THAT THE PLAN MAY BE INOPERABLE (LAST KNOWN ADDRESS)3. INFORMED THAT THERE IS AN OPPORTUNITY TO RE-NEGOTIATE THE PAYMENT PLAN.UNTIL THE PAYMENT PLAN IS DECLARED INOPERABLE, NO REPORT MAY BE MADE TO A CONSUMER CREDIT REPORTING AGENCY AND NO CIVIL ACTION MAY COMMENCE. ANY ADVANCING OF DEBT FOR COLLECTION OR REPORTING REQUIRES THE APPROVAL OF EACH PATIENT BY THE DIRECTOR OF PATIENT FINANCIAL SERVICES. ADVANCING OF DEBT COLLECTION SHALL OCCUR AFTER 150 DAYS OF AN INOPERABLE PAYMENT PLAN. CREDIT REPORTING SHALL NOT OCCUR UNTIL AFTER 150 DAYS OF THE PAYMENT PLAN BEING INOPERABLE.IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING MARINHEALTH MEDICAL CENTER'S CHARITY CARE ELIGIBILITY CRITERIA, THE PATIENT ACCOUNT MAY BE CONSIDERED CHARITY CARE, EVEN IF THEY WERE ORIGINALLY CLASSIFIED FOR COLLECTION OR AS A BAD DEBT. COLLECTION AGENCY PATIENT ACCOUNTS MEETING CHARITY CARE CRITERIA SHOULD BE RETURNED TO MARINHEALTH MEDICAL CENTER'S BILLING OFFICE AND REVIEWED FOR CHARITY CARE ELIGIBILITY. PART VI, LINE 2: IN ADDITION TO THE TRIENNIAL CHNA, HEALTH NEEDS ARE MONITORED AS FOLLOWS: (I) MARIN HEALTHCARE DISTRICT BOARD MEETINGS, WHICH INCLUDE PUBLIC COMMENTS AND WHICH THE HOSPITAL CEO ATTENDS AND SHARES COMMUNITY INPUT WITH HOSPITAL STAFF AS APPROPRIATE; (II) HOSPITAL BOARD MEMBERS ARE ALL COMMUNITY RESIDENTS AND SHARE COMMUNITY HEALTH CONCERNS WHEN APPROPRIATE; (III) COMMUNITY COMMENTS ON THE TRIENNIAL CHNA AND IMPLEMENTATION STRATEGY ARE COLLECTED ON THE HOSPITAL WEBSITE AND ARE MONITORED BY THE COMMUNITY RELATIONS DEPARTMENT; AND (IV) THE HOSPITAL ENGAGES A COMMUNITY BENEFIT ADVISORY COMMITTEE, WHICH INCLUDES MEMBERS REPRESENTING COMMUNITY-BASED ORGANIZATIONS AND IS SUPPORTED BY FACILITY STAFF. THIS COMMITTEE MEETS REGULARLY TO REVIEW AND VALIDATE LEGAL AND REGULATORY COMPLIANCE SPECIFIC TO COMMUNITY BENEFIT MANDATES, ASSURES COMMUNITY BENEFIT PROGRAMS AND SERVICES ARE EFFECTIVELY MEETING IDENTIFIED HEALTH NEEDS (WITH AN EMPHASIS ON POPULATIONS WITH UNMET NEEDS), AND INCREASES TRANSPARENCY AND AWARENESS OF COMMUNITY BENEFIT ACTIVITIES. PART VI, LINE 3: A) CHARITY CARE INFORMATION PROVIDED AT PATIENT INTAKE: EXCEPT IN THE CASE OF EMERGENCY SERVICES, MARINHEALTH MEDICAL CENTER SHALL PROVIDE PATIENTS WITH INFORMATION REGARDING CHARITY CARE AND DISCOUNT PAYMENTS DURING THE PATIENT INTAKE PROCESS. MARINHEALTH MEDICAL CENTER SHALL ALSO PROVIDE PATIENTS WITH CONTACT INFORMATION FOR A MARINHEALTH MEDICAL CENTER EMPLOYEE OR OFFICE FROM WHICH THE PATIENT MAY OBTAIN FURTHER INFORMATION ABOUT CHARITY CARE AND DISCOUNT PAYMENTS. THE INFORMATION PROVIDED SHALL BE IN THE PRIMARY LANGUAGE(S) OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. A LANGUAGE IS A PRIMARY LANGUAGE OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA IF 5% OR MORE OF MARINHEALTH MEDICAL CENTER'S LOCAL POPULATION SPEAKS THE LANGUAGE. B) CHARITY CARE INFORMATION PROVIDED AT ALL OTHER TIMES: MARINHEALTH MEDICAL CENTER SHALL PROVIDE PATIENTS WITH INFORMATION REGARDING CHARITY CARE AND DISCOUNT PAYMENTS DURING THE INTAKE PROCESS, OR AT ANY OTHER TIME UPON PATIENT REQUEST. MARINHEALTH MEDICAL CENTER SHALL PROVIDE UNINSURED PATIENTS WITH THE MARINHEALTH MEDICAL CENTER CHARITY CARE APPLICATION FORM, THE "STATEMENT OF FINANCIAL CONDITION," IMMEDIATELY UPON PATIENT REQUEST. THE INFORMATION PROVIDED SHALL BE IN THE PRIMARY LANGUAGE(S) OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. A LANGUAGE IS A PRIMARY LANGUAGE OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA IF 5% OR MORE OF MARINHEALTH MEDICAL CENTER'S LOCAL POPULATION SPEAKS THE LANGUAGE. C) PUBLIC NOTICE AND POSTING: PUBLIC NOTICE OF THE AVAILABILITY OF ASSISTANCE THROUGH THIS POLICY SHOULD BE MADE BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION. NOTICES MUST BE POSTED IN AT LEAST THE EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMITTING OFFICES, AND MEDICAL CENTER OUTPATIENT SERVICE SETTINGS. POSTED NOTICES SHALL BE IN LANGUAGES REFLECTING THAT SPOKEN IN THE SERVICE AREA IS 5% OR MORE OF THE POPULATIONS SPEAK THIS LANGUAGE. POSTED NOTICES SHALL CONTAIN THE FOLLOWING INFORMATION: 1) A STATEMENT INDICATING THAT MARINHEALTH MEDICAL CENTER HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND THAT THIS POLICY PROVIDES FOR FULL OR PARTIAL CHARITY CARE WRITE-OFF.2) IDENTIFICATION OF A MEDICAL CENTER CONTACT PHONE NUMBER THAT THE PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND ABOUT HOW TO APPLY FOR ASSISTANCE.D) INCLUDE POLICY INFORMATION ON BILLS AND STATEMENTS SENT TO PATIENTS INDICATING:1) IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM OR QUALIFY FOR CHARITY CARE OR DISCOUNT PAYMENT FROM MARINHEALTH MEDICAL CENTER. THE INCOME REQUIREMENTS SHALL BE STATED ON THE NOTICE.2) NOTIFICATION TO THE PATIENT THAT EMERGENCY PHYSICIANS ARE REQUIRED TO HAVE A DISCOUNT POLICY TO UNINSURED AND HIGH MEDICAL COST PATIENTS WHICH MAY HAVE DIFFERENT ELIGIBILITY CRITERIA THAN THAT OF THE MEDICAL CENTER BUT AT LEAST AT 350% OF THE FPL. 3) A MEDICAL CENTER PHONE NUMBER THAT PATIENTS MAY CALL FOR FURTHER INFORMATION. 4) POSTING NOTICE OF THE AVAILABILITY OF ASSISTANCE AND A CONTACT PHONE NUMBER ON MARINHEALTH MEDICAL CENTER'S WEB SITE. 5) PROVIDING UNINSURED PATIENTS A DOCUMENT OUTLINING THE TYPES OF FINANCIAL ASSISTANCE AVAILABLE. PART VI, LINE 4: MARINHEALTH MEDICAL CENTER IS LOCATED AT 250 BON AIR ROAD, GREENBRAE, CA 94904. THE SERVICE AREA COMPRISES ALL OF MARIN COUNTY, WHICH CONSISTS OF 30 ZIP CODES AND INCLUDES THE CITIES OF BELVEDERE, CORTE MADERA, FAIRFAX, LARKSPUR, MILL VALLEY, NOVATO, ROSS, SAN ANSELMO, SAN RAFAEL, SAUSALITO, TIBURON, AND THE COASTAL TOWNS OF STINSON BEACH, BOLINAS, POINT REYES, INVERNESS, MARSHALL, AND TOMALES.MARIN COUNTY COVERS 520 SQUARE MILES, MUCH OF WHICH IS PRESERVED AS PARKS, TIDELANDS, AND AGRICULTURAL AREAS. AMONG THEM ARE THE POINT REYES NATIONAL SEASHORE, MOUNT TAMALPAIS STATE PARK AND GAME REFUGE AND SAMUEL P. TAYLOR STATE PARK. A LARGE PORTION OF THE POPULATION LIVES ALONG THE HIGHWAY 101 CORRIDOR, DIVIDING THE COUNTY INTO A MORE URBAN ENVIRONMENT IN THE EASTERN PART OF THE COUNTY, AND MORE RURAL ENVIRONMENT ALONG THE COAST AND THE WESTERN SIDE OF THE COUNTY. THE COUNTY IS HOME TO SAN QUENTIN STATE PRISON, A MAXIMUM-SECURITY PRISON, LOCATED IN THE EASTERN PORTION OF THE COUNTY. MARIN COUNTY HAS THE 6TH LARGEST INCOME PER CAPITA OF ALL COUNTIES IN THE U.S., YET AREAS OF THE COUNTY HAVE LARGE PROPORTIONS OF ECONOMICALLY VULNERABLE POPULATIONS, WHICH INCLUDE NOVATO, MARIN CITY, THE COMMUNITIES OF WEST MARIN, AND PORTIONS OF SAN RAFAEL, TO NAME A FEW.THE TOTAL POPULATION OF MARIN COUNTY IN 2019 WAS 259,943. THE MEDIAN AGE IN MARIN COUNTY IS 46.8, WHICH IS HIGHER THAN THE AVERAGE OF 36.5 FOR ALL OF CALIFORNIA. ADDITIONALLY, THE MEDIAN INCOME IN MARIN COUNTY IS $115,246, WHICH IS ALSO HIGHER THAN AVERAGE OF $75,235 FOR ALL OF CALIFORNIA. THE PERCENTAGE OF RESIDENTS EXPERIENCING POVERTY IN MARIN COUNTY IS 7.2%, WHICH IS LOWER WHEN COMPARED TO THE 13.4% OF RESIDENTS THROUGHOUT CALIFORNIA EXPERIENCING POVERTY. MARIN COUNTY ALSO HAS A LOWER PERCENTAGE OF RESIDENTS WITHOUT A HIGH SCHOOL DIPLOMA (6.7%) WHEN COMPARED TO ALL OF CALIFORNIA (16.7%), AS WELL AS A LOWER PERCENTAGE OF RESIDENTS WITH DISABILITIES (9.1%) WHEN COMPARED TO ALL OF CALIFORNIA (10.6%).THE RACIAL AND ETHNIC PROFILE OF MARIN COUNTY IS AS FOLLOWS: 71.2% WHITE, 16% HISPANIC OR LATINX, 5.8% ASIAN, 3.8% TWO OR MORE RACES, 2.1% BLACK OR AFRICAN AMERICAN, .9% OTHER RACES, .2% AMERICAN INDIAN AND ALASKA NATIVE, AND .1% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER. PART VI, LINE 5: MARINHEALTH MEDICAL CENTER IS THE ONLY FULL-SERVICE ACUTE CARE HOSPITAL IN THE COUNTY AND THE ONLY HOSPITAL WITH AN OBSTETRICAL SERVICE OR IN PATIENT BEHAVIORAL HEALTH SERVICE. IT SERVES AS THE TRAUMA CENTER FOR MARIN COUNTY AND SURROUNDING AREAS. THE BOARD OF DIRECTORS IS COMPOSED OF UNCOMPENSATED COMMUNITY RESIDENTS. ALL FUNDS ARE USED TO IMPROVE HEALTH CARE SERVICES, MAINTAIN UP-TO-DATE FACILITIES, AND SUPPORT TRAINING PROGRAMS FOR HEALTH PROFESSIONALS IN AREAS SUCH AS NURSING, PHARMACY, RADIOLOGY, RESPIRATORY THERAPY, REHABILITATION SERVICES AND BEHAVIORAL HEALTH. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS. PART VI, LINE 6: MARIN HEALTHCARE DISTRICT IS THE GENERAL MEMBER OF MARINHEALTH MEDICAL CENTER; MARIN HEALTHCARE DISTRICT IS RESPONSIBLE FOR PROMOTING THE HEALTH AND WELFARE OF THE RESIDENTS OF MARIN COUNTY, INCLUDING MAINTAINING COUNTY-WIDE ACCESS TO CARE THROUGH THE MARIN HEALTHCARE DISTRICT HEALTH CENTERS. IN ADDITION, MARINHEALTH MEDICAL CENTER OPERATES IN CONJUNCTION WITH MARINHEALTH MEDICAL NETWORK, WHICH IS A MEDICAL FOUNDATION OFFERING A WIDE RANGE OF PHYSICIANS AND PROVIDERS. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 SAN RAFAEL CHAMBER OF COMMERCE 817 MISSION AVE SAN RAFAEL CA 94901 940839470 501(C)(6) 7610 0 TO SUPPORT ECONONOMIC VITALITY OF SAN RAFAEL MARIN ECONOMIC FORUM 1050 NORTHGATE DRIVE STE 54 SAN RAFAEL CA 94903 454194417 501(C)(3) 10000 0 TO SUPPORT ECONONOMIC VITALITY OF MARIN PECOS LEAGUE OF PROFESSIONAL BASEBALL CLUB PO BOX 271489 HOUSTON TX 77277 273494029 20000 0 SPONSORSHIP PRIMA MEDICAL FOUNDATION 9 COMMERCIAL BLVD NOVATO CA 94949 271376321 501(C)(3) 27412429 0 TO SUPPORT PROVISION OF HEALTH CARE SERVICES 2 2 SCHOLARSHIPS 1 1792 PATIENT ASSISTANCE 43 87701 PART I, LINE 2: FOR GRANTS TO INDIVIDUALS, THE ORGANIZATION PRE-SCREENS THE INDIVIDUALS FOR ELIGIBILITY. GRANTS ARE PAID DIRECTLY TO THE PROVIDER OF SERVICES TO PATIENTS. THE HOSPITAL DOES NOT REQUIRE ACCOUNTING OF THE USE OF GRANT FUNDS PROVIDED, HOWEVER, THE ORGANIZATION HISTORICALLY HAS A CLOSE WORKING RELATIONSHIP WITH GRANTEES LISTED ON SCHEDULE I, PART II. IN THE CASES OF GENERAL PURPOSE GRANTS, THE GRANTEE'S CHARITABLE PURPOSE IS REVIEWED PRIOR TO THE ISSUANCE OF THE GRANT. X X X 0 0 0 0 0 0 0 0 0 DAVID KLEIN MD CEO & BOARD MEMBER 1127775 0 385037 0 290358 0 17568 0 19698 0 1840436 0 0 0 ERIC BRETTNER CHIEF FINANCIAL OFFICER 555558 0 145111 0 1242 0 18100 0 33408 0 753419 0 0 0 ANDREW APOLINARSKI MSN RN CNL CHIEF NURSING OFFICER 443448 0 117552 0 2469 0 108238 0 24561 0 696268 0 0 0 GREGORY LEE IR/CATH/EP TECH LEAD 588183 0 0 0 0 0 54821 0 9988 0 652992 0 0 0 COLIN LEARY JD GENERAL COUNSEL 467083 0 118964 0 810 0 17482 0 33408 0 637747 0 0 0 JENNIFER SCHAAB MHMN PRESIDENT 456749 0 79748 0 810 0 17034 0 0 0 554341 0 0 0 CHUN LI CHIEF CLIN PHYSICIST & DIR RAD ONC 346981 0 62390 0 3172 0 118518 0 11401 0 542462 0 0 0 MICHAEL KIM MD MHMN VP OF MEDICAL AFFAIRS 452078 0 70569 0 2280 0 17041 0 0 0 541968 0 0 0 KARIN SHAVELSON MD FAAP CHIEF MEDICAL OFFICER 351133 0 135364 0 904 0 17568 0 6531 0 511500 0 0 0 MARY FRIEDMAN CHIEF STRATEGY OFFICER 352762 0 84976 0 364 0 29261 0 33408 0 500771 0 0 0 ELIZABETH KOLCUN CHIEF DEVELOPENT OFFICER 339677 0 98316 0 663 0 23588 0 33408 0 495652 0 0 0 SUSAN CUMMING MED DIR PATIENT EXPERIENCE 360936 0 30000 0 3437 0 31528 0 33408 0 459309 0 0 0 EUGENE LEWIS CHIEF HUMAN RESOURCES OFFICER 329992 0 62078 0 223 0 22648 0 11401 0 426342 0 0 0 RUSSELL PECKENPAUGH VP IS ADMINISTRATION 330333 0 52397 0 2376 0 28514 0 11401 0 425021 0 0 0 A CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SUG7 2018-05-23 100032761 CONSTRUCT NEW HOSPITAL FACILITY/AMBULATORY SERVICES BLDG/PARKING STRUCTURE 0 0 0 A 100032761 1132761 1100000 97800000 2020 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/23/2023 FORM 990, PART VI, SECTION A, LINE 6 MARINHEALTH MEDICAL CENTER (MHMC) HAS ONE GENERAL MEMBER, MARIN HEALTHCARE DISTRICT (MHD), A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA. IN ADDITION, THE BYLAWS PROVIDE FOR A "SPECIAL MEMBER" (WITH THE POWER TO NOMINATE 2 MEMBERS OF THE BOARD OF DIRECTORS): THE REGENTS OF THE UNIVERSITY OF CALIFORNIA ON BEHALF OF UCSF HEALTH. FORM 990, PART VI, SECTION A, LINE 7A MARIN HEALTHCARE DISTRICT (THE "GENERAL MEMBER") DOES NOT HAVE THE POWER TO APPOINT MEMBERS OF THE GOVERNING BODY; HOWEVER, THE GENERAL MEMBER DOES HAVE THE RIGHT TO REJECT ALL APPOINTEES TO THE BOARD OF DIRECTORS. THE REGENTS OF THE UNIVERSITY OF CALIFORNIA ON BEHALF OF UCSF HEALTH (THE "SPECIAL MEMBER") MAY NOMINATE TWO MEMBERS OF THE BOARD OF DIRECTORS, WHO MUST ALSO BE APPROVED BY THE GENERAL MEMBER. FORM 990, PART VI, SECTION A, LINE 7B NEITHER THE BOARD NOR ANY OFFICER OR EMPLOYEE OF MHMC MAY TAKE ANY OF THE FOLLOWING ACTIONS, OR APPROVE A SUBSIDIARY OR AN AFFILIATE TAKING THE FOLLOWING ACTIONS, WITHOUT THE PRIOR APPROVAL, OR ANY OF THE SPECIFIED ACTIONS, OF THE GENERAL MEMBER: (A) ANY CORPORATE MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THIS CORPORATION THAT WOULD CHANGE THE GENERAL MEMBER'S STATUS AS SOLE CORPORATE MEMBER OR OWNER OF THE LAND AND ASSETS LEASED BY THIS CORPORATION; (B) ANY TRANSACTION REQUIRING THE CONSENT OR APPROVAL OF THE GENERAL MEMBER PURSUANT TO THE LEASE OF THE MHMC CAMPUS AND FACILITIES BY THE GENERAL MEMBER TO THIS CORPORATION, COMMENCING DECEMBER 2, 2015, AS IT HAS BEEN OR MAY BE AMENDED ("THE LEASE"). (C) ANY MATERIAL TRANSFER BY SALE, LEASE, DEBT OR ENCUMBRANCE, OR OTHER DISPOSITION, OF ANY OF THE ASSETS OF THE CORPORATION, REAL OR PERSONAL, OUTSIDE THE ORDINARY COURSE OF HOSPITAL BUSINESS. NOTWITHSTANDING THE FOREGOING, THE FOLLOWING WILL NOT REQUIRE THE PRIOR APPROVAL OF THE GENERAL MEMBER: (I) ANY TRANSACTION AMOUNTING TO A TRANSFER OF LESS THAN TEN PERCENT (10%) OF THE ASSETS OF THE CORPORATION, AS OF THE MONTH IMMEDIATELY PRECEDING THE TRANSACTION, TO ANOTHER LEGAL ENTITY IN CONNECTION WITH AN AFFILIATION OR JOINT VENTURE INVESTMENT OR SERVICE OPERATION OFF THE MHMC CAMPUS; (II) A FINANCING TRANSACTION, INCLUDING, BUT NOT LIMITED TO, DEBT FINANCING OR BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS, EXPECTED TO AMOUNT IN TOTAL PRINCIPAL VALUE TO LESS THAN TEN PERCENT (10%) OF NET PATIENT SERVICES REVENUE, AS OF THE MONTH IMMEDIATELY PRECEDING THE TRANSACTION; (III) THE GENERAL MEMBER SHALL IN ITS DISCRETION CONSIDER EXTENDING THE ABOVE THRESHOLD REQUIREMENTS BASED ON ADDITIONAL PERCENTAGES OF TOTAL ASSETS OR PATIENT REVENUE, AND ANY SUCH ALLOWANCE SHALL COMPLY WITH APPLICABLE CALIFORNIA LAWS OR REGULATIONS GOVERNING TRANSFERS OF ASSETS OF A HEALTHCARE DISTRICT (E.G., HEALTH & SAFETY CODE SECTION 32121 (P)). (D) IN ADDITION TO THRESHOLDS FOR APPROVALS REQUIRED FOR INDIVIDUAL TRANSACTIONS DESCRIBED IN SUBSECTION (C) ABOVE, APPROVAL OF THE GENERAL MEMBER SHALL BE REQUIRED FOR ANY TRANSACTION WHICH, ON A PROFORMA BASIS, WOULD CAUSE THE CORPORATION TO BE IN VIOLATION OF ANY FINANCIAL LOAN OR BOND COVENANT, AS THEY EXIST AT THE TIME OF THE TRANSACTION, OR THAT WOULD CAUSE THE CORPORATION'S DEBT TO CAPITALIZATION RATIO TO EXCEED 50%. (E) ANY TRANSACTIONS WITH LONG-TERM (MORE THAN THREE-YEAR) LAND OR FACILITY IMPACTS (E.G., NEW CONSTRUCTION OR RENOVATION) REQUIRING GENERAL MEMBER APPROVAL PURSUANT TO THE LEASE OR COSTING THE EQUIVALENT OF TEN PERCENT (10%) OR MORE OF MHMC THEN EXISTING TOTAL ASSETS (APPROXIMATELY $27 MILLION AT DECEMBER 31, 2015). (F) ANY LONG-TERM CAMPUS DEVELOPMENT PLAN THAT RESTRICTS FUTURE LAND USE OPTIONS OR REQUIRES REGULATORY CHANGES TO LAND USE PERMITS/DESIGNATIONS WILL REQUIRE GENERAL MEMBER APPROVAL. (G) ANY TRANSACTION THAT CAUSES OR IS ANTICIPATED TO CAUSE A DOWNGRADE IN BOND RATING BY A STANDARD RATING AGENCY REQUIRES GENERAL MEMBER APPROVAL REGARDLESS OF SIZE OF THE TRANSACTION. (H) THE GENERAL MEMBER SHALL RETAIN AN INDEPENDENT AUDIT FIRM CONSISTENT WITH STANDARD INDUSTRY FINANCIAL PRACTICE ON BEHALF OF THE CORPORATION. THE AUDIT FIRM WILL THEN PROVIDE SERVICES TO MHMC'S MANAGEMENT AND ITS BOARD AS OVERSEEN BY THE MHMC BOARD AUDIT SUBCOMMITTEE. FINAL AUDIT REPORTS WILL BE PRESENTED TO THE GENERAL MEMBER (SUBJECT TO PUBLIC REVIEW), THE BOARD, AND MANAGEMENT OF MHMC. (I) CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL, OR SUBSTANTIALLY ALL (50 PERCENT OR GREATER), OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THIS CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. (J) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION. (K) BYLAW APPROVALS (L) ANY CHANGES TO THE MISSION STATEMENT OF THE CORPORATION FOR MHMC. (M) ANY CHANGES TO THE CORPORATE DISSOLUTION RIGHTS (INITIATION OF DISSOLUTION AND DISPOSITION OF ASSETS) OF THE GENERAL MEMBER. (N) APPROVAL OF INDIVIDUALS FOR BOARD MEMBERSHIP. IN ADDITION, THE SPECIAL MEMBER SHALL HAVE THE FOLLOWING RIGHTS AND PRIVILEGES: (A) TO NOMINATE INDIVIDUALS TO SERVE ON THE BOARD OF DIRECTORS AS "SPECIAL MEMBER NOMINEES; AND (B) TO APPROVE CERTAIN AMENDMENTS TO THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTANT, IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE DEPARTMENT. THE DRAFT FORM 990 IS THEN REVIEWED BY THE CONTROLLER AND CFO; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH INDIVIDUAL BOARD MEMBER AND OFFICER SIGNS AN ACKNOWLEDGEMENT FORM THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. IN ADDITION, A DISCLOSURE STATEMENT IS COMPLETED BY ALL OFFICERS AND BOARD MEMBERS ANNUALLY. ON THIS STATEMENT THE COVERED INDIVIDUAL LISTS A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR REVIEWS THESE STATEMENTS AND MONITORS SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH LEGAL COUNSEL AS NECESSARY. IN THE EVENT OF A POTENTIAL CONFLICT OF INTEREST, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE CONFLICTED INDIVIDUAL TO LEAVE THE ROOM OR NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE CONFLICTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE EXECUTIVE COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS-LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF THE HOSPITAL'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE), AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG-TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL AND REGIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS THE HOSPITAL ARE MOST APPROPRIATE. ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION UNDERGO A REVIEW ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 52,915,313. MANAGEMENT AND GENERAL EXPENSES 23,715,037. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,630,350. PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 73,048,970. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,048,970. FORM 990, PART XI, LINE 9: BENEFIT PLAN RELATED CHANGES -2,163,161. CHANGE IN BENEFICIAL INTEREST IN MARINHEALTH FOUNDATION 4,104,739. 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