Civic Intelligence

Sutter Central Valley Hospitals

990 • Fiscal year 2017 • EIN 94-1080917

Jan 01, 2017 to May 01, 2017 • Filed on Apr 12, 2018

C/O Sh Tax 2200 River Plaza DriveSacramento, CA 95833

(916) 286-6665

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on this filing.

Source year 2017

Liabilities / Revenue

2nd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2017 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2017

Net Margin

27th percentile

-0.8%

Higher net margin than 27% of similar nonprofits.

2017 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2017

Top Officer Pay

94th percentile

$2,293,000

Higher top officer pay than 94% of similar nonprofits.

Top officer pay equals 1.0% of source-year revenue.

2017 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2017

Asset Growth

1st percentile

-100%

Faster asset growth than 1% of similar nonprofits.

2017 filings • 501(c)3 • $100M-$250M nonprofits • Annualized from 2016 to 2017

Revenue Growth

1st percentile

-70%

Faster revenue growth than 1% of similar nonprofits.

2017 filings • 501(c)3 • $100M-$250M nonprofits • Annualized from 2016 to 2017

Assets

Down

$0

Down $459,233,145 (-100%) from 2016

Net Assets

Down

$0

Down $179,770,868 (-100%) from 2016

Liabilities

Down

$0

Down $279,462,277 (-100%) from 2016

Revenue

Down

$227,810,766

Down $544,131,817 (-70%) from 2016

Expenses

Down

$229,620,338

Down $474,906,343 (-67%) from 2016

Net Income

Down

-$1,809,572

Down $69,225,474 (-103%) from 2016

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$600M$400M$200M$0Assets 2010: $515,041,074Liabilities 2010: $284,865,965Net Assets 2010: $230,175,1092010Assets 2011: $533,499,264Liabilities 2011: $271,597,817Net Assets 2011: $261,901,4472011Assets 2012: $442,034,767Liabilities 2012: $272,884,992Net Assets 2012: $169,149,7752012Assets 2013: $469,621,036Liabilities 2013: $282,042,820Net Assets 2013: $187,578,2162013Assets 2014: $465,268,659Liabilities 2014: $263,694,025Net Assets 2014: $201,574,6342014Assets 2015: $435,331,123Liabilities 2015: $242,114,970Net Assets 2015: $193,216,1532015Assets 2016: $459,233,145Liabilities 2016: $279,462,277Net Assets 2016: $179,770,8682016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017

Highlighted filing

2017

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$800M$600M$400M$200M$0-$200MExpenses 2010: $676,833,8522010Expenses 2011: $613,922,3952011Expenses 2012: $642,757,4642012Revenue 2013: $709,222,374Expenses 2013: $625,515,377Net Income 2013: $83,706,9972013Revenue 2014: $719,936,328Expenses 2014: $636,460,835Net Income 2014: $83,475,4932014Revenue 2015: $734,966,494Expenses 2015: $691,009,110Net Income 2015: $43,957,3842015Revenue 2016: $771,942,583Expenses 2016: $704,526,681Net Income 2016: $67,415,9022016Revenue 2017: $227,810,766Expenses 2017: $229,620,338Net Income 2017: -$1,809,5722017

Highlighted filing

2017

Revenue$227,810,766
Expenses$229,620,338
Net Income-$1,809,572
Jump To
Filing Snapshot
Filing Period
Jan 1, 2017 to May 1, 2017
Signed
Apr 12, 2018
Return Version
2016v3.1
Gross Receipts
$227,861,734
Mission and Program Overview

Mission

SEE SCHEDULE O

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$264,981,977$0▼ $264,981,977
Accounts Receivable$88,294,242$0▼ $88,294,242
Investments in Publicly Traded Securities$25,079,900$0▼ $25,079,900
Inventories for Sale or Use$8,477,149$0▼ $8,477,149
Savings and Temporary Cash Investments$3,166,420$0▼ $3,166,420
Prepaid Expenses and Deferred Charges$2,711,440$0▼ $2,711,440
Other Notes and Loans Receivable, Net$2,012,246$0▼ $2,012,246
Cash and Non-Interest-Bearing Accounts$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Intangible Assets$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$459,233,145$0▼ $459,233,145
Other Assets Total$64,509,771$0▼ $64,509,771
Liabilities
Tax Exempt Bond Liabilities$160,707,087$0▼ $160,707,087
Accounts Payable and Accrued Expenses$116,310,129$0▼ $116,310,129
Other Liabilities$2,445,061$0▼ $2,445,061
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Total Liabilities$279,462,277$0▼ $279,462,277
Net Assets / Fund Balance
Unrestricted Net Assets$179,325,218$0▼ $179,325,218
Temporarily Rstr Net Assets$445,650$0▼ $445,650
Permanently Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$179,770,868$0▼ $179,770,868
Total Liabilities and Net Assets / Fund Balance$459,233,145$0▼ $459,233,145

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2015$16,035,221-▲ $1,153,883$200,000$16,989,104
2014$16,952,978-▼ $761,468$156,289$16,035,221
2013$6,365,309$10,989,849▲ $325,816$727,996$16,952,978
2012$5,950,512$617,005▲ $118,185$320,393$6,365,309
Compensation and Service Providers

Employees

NameTitleOtherTotal
Todd Smith MdTrustee$9,167$9,167

Board Members and Trustees

NameTitle
Fatima SewardChair F&p/trustee
Michael NewellChair/trustee
David P BennFormer Regional President, Cv
Sarah KrevansPresident & CEO Sutter Health
James ConfortiPresident, Sh Valley Area
David Adkins MdTrustee
Gary HooperTrustee
Helen ThomsonTrustee
I-mei Hsiu MdTrustee
Kurt Shuler MdTrustee
Pat PathipatiTrustee
Scott HowellTrustee
Ted Leland PhdTrustee
Timothy ByrdTrustee
Viva Ettin MdTrustee
Peter Hull MdTrustee/CME Svh
Doug ArcherAdmin, Mhlb
Daryn KumarCEO, Memorial Medical CTR.
David M ThompsonCEO, Stch & Mhlb
Grant DaviesCEO, Valley Area Hospitals
Paige TerraCFO Valley Area
Penny WestfallChief Legal Officer, Va/sec.
Bruce R Laverty MdCME, Mmc
Philip Yu MdCME, Stch
Asit Gokli MdCMO Valley Area
John B Mesic MdPhys Exec, Sh Valley Area
Eric DaltonSh VP, Shared Svcs, Finance
Betty LopezVP Patient Care Services
Jeffrey D SzczesnyVP, Hr, Valley Area

Highest Paid Contractors

ContractorServicesLocationCompensation
Unger Construction CoConstruction Svcs910 X ST, Sacramento, CA 95818$548,527
Hss INCSecurity ServicesPO BOX 17033, Denver, CO 80217$530,843
Crothall Laundry Services INCLaundry Services13028 COLLECTIONS CENTER DR, Chicago, IL 60693$501,075
Ct Brayton And Sons INCConstruction Svcs1804 JACKSON AVE, Escalon, CA 95320$497,208
Dva Renal Healthcare INCMedical ServicesPO BOX 781607, Philadelphia, PA 19178-1607$441,802
Revenue and Support

Revenue Composition

Contributions and Grants
$188,663
Program Service Revenue
$227,169,886
Investment Income
$371,913
Other Revenue
$80,304
All Other Contributions
$13,851
Change in Net Assets
$-1,809,572
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$117,900,067
Salaries, Compensation, and Employee Benefits$111,567,090
Grants and Similar Amounts Paid$153,181
Total Fundraising Expense$25,511
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$69,473,813$1,008,275$2,057$70,484,145
Other Employee Benefits$25,780,634$901,899$9,125$26,691,658
Fees for Services Other$14,573,743$588,007-$15,161,750
Depreciation Depletion$12,317,054$153,336-$12,470,390
Information Technology$6,956,685$2,786,516$642$9,743,843
Payroll Taxes$6,267,817$221,489-$6,489,306
Pension Plan Contributions$6,236,884$220,396-$6,457,280
Occupancy$2,420,764$288,028-$2,708,792
Office Expenses$2,298,234$107,653$96$2,405,983
Insurance$1,526,652$448,136-$1,974,788
Interest$1,712,976--$1,712,976
Current Officers, Directors, Trustees, and Key Employees-$1,439,340$5,361$1,444,701
All Other Expenses$873,505$322,285$5,979$1,201,769
Other Expenses$996,538$1,669$1,975$998,207
Fees for Services Management-$184,890-$184,890
Conferences and Meetings$149,906$28,171-$178,077
Grants to Domestic Orgs$153,181--$153,181
Fees for Services Legal-$145,349-$145,349
Travel$86,019$21,479$26$107,524
Fees for Service Investment Mgmnt Fees-$68,217-$68,217
Fees for Services Accounting-$15,592-$15,592
Advertising$2,500$3,156-$5,656
Total Functional Expenses$211,533,184$18,061,643$25,511$229,620,338
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Valley Consortium for Medical EducationModesto, CA501(c)(3)General Support$124,581
Dentists Organized for VeteransWalnut Creek, CA501(c)(3)General Support$25,000
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Line 1B

The affairs and management of sutter central valley hospitals (scvh) are supervised by the executive committee which has the power to transact all regular business of scvh during the period between meetings of the board or directors. The executive committee consists of the scvh's chair who serves as chair of the committee, the vice chair, the chair of the finance and planning committee, an additional director and the president of scvh. At least one committee member is a physician director.

Form 990, Part VI, Lines 6 & 7A

Description of classes of persons and the nature of their rights: this corporation is an affiliate of sutter health, a california nonprofit public benefit corporation. Sutter health is the sole member with the right to elect at least a majority of the members of the board of directors.

Form 990, Part VI, Line 7B

Describe classes of persons, decisions requiring approval & the type of voting rights: sutter health as the sole member of the organization is entitled to exercise fully all rights and privileges of members of nonprofit corporations under the california nonprofit public benefit corporation law, and all other applicable laws. The member has the rights and powers to appoint (and remove) members of the corporation's board of directors, subject to the provisions of the bylaws. In addition, the member has the right to approve the following actions of the corporation's board of directors: a. Merger, consolidation, reorganization, or dissolution of the corporation or any subsidiary or affiliate entity; b. Amendment or restatement of the articles of incorporation or the bylaws of the corporation or any subsidiary or affiliate entity; c. Adoption of operating budgets of the corporation or any subsidiary or affiliate entity, including consolidated or combined budgets of the corporation and all subsidiary organizations of the corporation; d. Adoption of capital budgets of the corporation or any subsidiary or affiliate entity; e. Aggregate operating or capital expenditures on an annual basis that exceed approved operating or capital budgets by a specified dollar amount to be determined from time to time by the general member; f. Long-term or material agreements including, but not limited to, borrowings, equity financings, capitalized leases and installment contracts; and purchase, sale, lease, disposition, hypothecation, exchange, gift, pledge, or encumbrance of any asset, real or personal, with a fair market value in excess of a dollar amount to be determined from time to time by the directors of the general member, which shall not be less than 10% of the total annual capital budget of the corporation; g. Appointment of an independent auditor and hiring of independent counsel except in conflict situations between the general member and the corporation or any subsidiary or affiliate entity; h. The creation or acquisition of any subsidiary or affiliate entity; i. Contracting with an unrelated third party for all or substantially all of the management of the assets or operations of the corporation or any subsidiary or affiliate entity; j. Approval of major new programs and clinical services of the corporation or any subsidiary or affiliate entity. The general member shall from time to time define the term "major" in this context; k. Approval of strategic plans of the corporation or any subsidiary or affiliate entity; l. Adoption of quality assurance policies not in conformity with policies established by the general member; m. Any transaction between the corporation, a subsidiary or affiliate and a director of the corporation or an affiliate of such director. In addition, the general member shall have the authority (by a vote of not less than two-thirds (2/3) of its board), to declare a major activity requiring approval. Requiring approval.

Form 990, Part VI, Line 11B

Describe the process used by management &/or governing body to review form 990: sutter health, a related tax-exempt organization, has a centralized tax department responsible for the preparation of the form 990. Annually the tax department provides training and education to affiliate personnel who assist the tax department in collecting and reviewing data to be reported on the form 990. The preparation material is reviewed by various departments including tax, finance, legal, and human resources. A national accounting firm prepares and/or reviews the return. A completed return is then reviewed by the tax department, the affiliate, and the cfo before the return is filed.

Form 990, Part VI, Line 12

Description of process to monitor transactions for conflicts of interest: employees are educated on the conflict of interest policy and the need to make disclosure as part of annual compliance education. In addition, annually a disclosure statement is completed by all directors and officers that includes an acknowledgement that they have read the conflict of interest policy. On this statement the individual will list a wide range of information which includes business relationships, employment relationships, property interests, and those of related parties. The ceo and board chair will review the statements and monitor situations that may pose a potential conflict of interest. The ceo and board chair may consult with the office of the general counsel as necessary. If there is a potential conflict of interest related to a particular transaction, the interested individual must disclose the existence and nature of the relationship. The board chair may appoint a disinterested person or committee to investigate the conflict. Until the potential conflict is resolved, the board chair may request the individual to not participate during related presentations and discussions. In all circumstances involving an actual conflict, the interested individual shall refrain from voting on any matter related to the transaction.

Form 990, Part VI, Lines 15A & 15B

Process for determining compensation: the compensation committee of the sutter health board of directors retains ultimate discretionary authority over all elements of compensation to assure that organizational purposes are appropriately being served. The compensation committee uses credible data sources and maintains an objective "arm's length" decision-making process, ensuring the integrity of sutter's executive programs and consistency with the organization's overall mission. In order to ensure external competitiveness, national compensation data comparisons are reviewed. Competitive analysis includes: (a) base salary, (b) total cash (base salary + annual incentive), (c) total direct cash (base salary + annual incentive + long term incentive) and (d) total remuneration (base salary + annual incentive + benefits and long term incentive). This analysis includes national comparisons for organizations similar in size, scope and complexity as sutter health. This method is most appropriate since it is a national marketplace in which sutter competes for executive talent. Officers and key employees of this organization undergo an annual review by the compensation committee or a delegated sub-committee. Approval is recorded in the minutes. Executive compensation review was last completed in december 2016.

Form 990, Part VI, Line 19

Availability of governing documents, conflict of interest policy, & financial statements to the general public: the sutter health system posts its current and past audited financial statements at sutterhealth.org. Other documents are also located at this website including the annual report, mission statement, history, and links to affiliate websites. The governing documents are not available to the public at this time.

Form 990, Part VII, Section A

The compensation being reported is an estimate for the period 1/1/17 to 4/30/17. Full 2017 compensation will be reported on sutter valley hospitals 12/31/17 form 990. The following board member of sutter central valley hospitals is a full-time employee (40 hours per week) of sutter health and his sutter health salary is reported herein. The following individual received no compensation for his service as a board member of this organization. - peter hull

Filing and Contact Details

Filer

Filer Name
Sutter Central Valley Hospitals
EIN
94-1080917
In Care Of
% CARLA WHITE-SNYDER
Phone
9162866665
Address
C/O SH TAX 2200 RIVER PLAZA DRIVE, SACRAMENTO, CA 95833

Signing Officer

Name
Paige Terra
Title
CFO
Phone
9162866665
Signed
2018-04-12
Discuss with paid preparer
Yes

Organization Details

Principal Officer
James Conforti
Formed
1947
Legal Domicile
CA
Voting Board Members
16
Independent Board Members
13
Employees
0
Volunteers
349

Preparer

Firm
Ernst & Young US Llp
Address
560 MISSION ST SUITE 1600, SAN FRANCISCO, CA 94105
Preparer
Eva Nitta
Phone
4158948000
Supplemental Narrative

Additional Explanations

Form 990, Part I, Line 1 and Part III, Line 1

Mission statement: sutter central valley hospitals provide high-quality, compassionate care to each patient, while exercising prudent fiscal responsibility. Sutter central valley hospitals is a not-for-profit organization that exists to maintain and improve the health status of the communities of greater stanislaus county, san joaquin and merced county. We extend selected services to other communities whenever this will meet a critical need and when it will enhance the productivity of local resources. We pursue our mission by providing and promoting effective health care services and by fostering an integrated system of care in partnership with physicians, other health care providers and payers. We provide access to a full continuum of care, built upon a core of sophisticated hospital-based services.

Form 990, Part III, Line 3

Sutter central valley hospitals merged into sutter valley hospitals effective may 1st of 2017.

Form 990, Part III, Line 4A

Exempt purpose achievements: sutter central valley hospitals the total benefits were $2,077,861, which includes $49,660 for community health improvement services, a total of $61,463 for community benefit operations and community building activities, $10,775 for health professions education, $796,192 for subsidized health services, and $1,010,037 for cash and in-kind contributions for community benefit. Sutter central valley hospitals merged into a related 501(c)(3) tax-exempt entity, sutter valley hospitals (ein: 94-1156621), effective may 1, 2017. Memorial medical center general description: memorial medical center is an acute care facility located in modesto, california, 90 miles south of sacramento in stanislaus county. Centrally located to serve our immediate county and outlying areas, memorial was established in 1970. Memorial medical center is currently licensed for 423 acute care beds and is a sutter health affiliate. Services available at memorial medical center include: - in-patient and out-patient surgery - telemetry - obstetrics and perinatal care - laboratory - pediatrics - pulmonary rehabilitation - oncology - modern family birthing center - congestive heart failure program - medical library access - cancer center and cancer/tumor registry - nutritional support services - social services - pastoral care - cardiac catheterization laboratory - patient and community - cardiac rehabilitation - education respiratory therapy - critical care - diagnostic imaging - 24-hour emergency treatment - radiation oncology - major trauma patient receiving center - diabetes treatment program - bariatric surgery - lactation assistance program memorial provides support to the community by assisting non-profit agencies with cash and in-kind donations. In 2017, memorial medical center provided $671,276 in cash and in-kind donations and $756,647 in subsidized health services. In summary, a total of $1,392,389 was contributed to benefit the broader community, and $156,361 was invested to support the poor and underserved. A sampling of 2017 community benefit programs: combating obesity memorial has joined with stanislaus county office of education "after school" program to support healthy nutrition and to learn activities to combat and ultimately decrease the incidence of childhood obesity. Adult obesity is on the rise as well. The support group for weight loss surgery is open to all patients regardless of where surgery was performed. Heart disease prevention and treatment programs memorial provides the only cardiac rehab program in the county. A long standing heart coalition of stanislaus county member, memorial is one of our countys resources for heart education and preventing heart disease. Along with partner sutter gould medical group, we provide twice a year, free to the community education heat (heart education and training) seminars to the public. With periodic health screening, which is open to the community, we are able to direct at-risk patients to appropriate resources. We also support the mended heart support group. Improving cancer awareness as cancer is the second leading cause of death in our community, memorial is committed to informing and advising the people of stanislaus county to better understand signs, symptoms, treatment and prevention of cancer. Memorial also offers complementary therapies to cancer patients, family and the community at large. We provide prevention programs and encourage early screening. Education and training for health careers as the community increases in unemployment and decreases in available jobs, memorial continues to support our career opportunities in nursing, pharmacy, clinical lab, respiratory therapy, radiology and radiation therapy, physical therapy, emergency medical tech, phlebotomy and other departments. In addition to serving as a site for training programs, memorials supervisors and staff members are actively involved in the creation and teaching of local college level programs for

Form 990, Part III, Line 4A (continued)

Sutter tracy community hospial general description: since 1948, sutter tracy community hospital (stch) continues to be the only full-service, acute care hospital within a 15-mile radius geographically. Located in tracy, california, stch staff has the opportunity to deliver culturally competent care to the diverse population within its service area. As a state-of-the-art facility, it features the latest medical technology and diagnostic equipment and offers a comprehensive array of inpatient and outpatient services on par with many larger, urban hospitals. Additionally, sutter tracy is committed to bringing the best and brightest physicians and the latest advances in medicine to the community. It is affiliated with many remarkable, local physicians who are at the forefront of their field. Services and medical departments: - cardiovascular services - community benefit - continence - diagnostic imaging - dialysis - emergency services - family birth center - laboratory services - outpatient lactation program - pain medicine - pharmacy - rehabilitation / physical therapy - respiratory care - social services - specialty care - spiritual services - surgical services - wound ostomy care sutter tracy community hospital community benefit and economic value for 2017 the hospital is focused in delivering a variety of community benefit programs that are impactful to bring about community health improvement and that provide essential services to the poor and underserved. The programs and services in 2017 are part of the hospitals implementation plan to address community health needs as prioritized in the san joaquin countys community health needs assessment. At sutter tracy community hospital, 60% of the total $449,606 of community benefit expenditures in 2017, were in the form of grants to community based organizations dedicated to addressing identified community needs and social determinants of health. $319,084 was reinvested into the community via cash and in-kind donations to help expand health access, improve community health education, and support community initiatives that focus on aiding the poor, vulnerable and underserved in the hospitals service area. To implement and deliver effective community benefit services, $40,981 was spent in community benefit operations and in addition, $20,482 was dedicated towards community building activities. Subsidized health services totaled, $39,546, and community health improvement services amounted to $29,513. In summary of the total investment $321,809 was invested in services that directly targeted the poor and underserved within the hospitals service area and the remaining, $127,796 supported needs for the broader community. Below is a list of all the hospitals community benefit programs and services for 2017, excluding medi-cal shortfalls and charity care which are addressed above. Community health improvement services community health education: - break free from smoking a smoking cessation course, available for the broader community to assist individuals to break their tobacco addictions for good. - car seat safety low income patients needing assistance with a car seat for their infant, are provided with one for free and are educated on the proper installation, usage and safety guidelines. - cpr classes 2 year american heart association certification course, to ensure that the community can respond in emergency situations. Community based clinical services: - flu clinic free flu shots for anyone meeting the age criteria for the vaccine. Open to the public, but targeted marketing to encourage vulnerable, under-served populations to attend. Health care support services: - cancer support services a registered nurse trained in cancer support provides complimentary, ongoing case management services to patients for as long as services are needed. Services include resource and referral help in addition to emotional support. - health insurance enrollment assistance program insurance enrollment hel

Form 990, Part III, Line 4A (continued)

Community building activities coalition building: - community benefit dedicated staff costs related to meetings, seminars and conferences at both a local and county level that increase collaborative efforts. - healthier communities coalition membership and fees related to the san joaquin county health collaborative. Community benefit operations assigned staff: - community benefit program coordination & execution salary costs for dedicated professionals in the area of community benefit who oversee all hospital activities and programs community needs/health assets assessment: - community benefits program assessment & reporting salary costs for dedicated staff involved with community - health needs assessment process and who complete mandated, regulatory reports. Other resources: - community health advisory council expenses related to the meetings for this group that review community grant applications and provide advice on the hospitals community benefit implementation plan and strategy. Through these efforts it is anticipated that both directly and indirectly, the health of an undetermined amount of people are positively impacted. On outputs that could be measured, sutter tracy community hospital was able to serve 3,264 people, with approximately 77% (2,513) of those considered as underserved members of the community. Form 990, part v, line 1 & 2 at the beginning of 2017, in preparation for the merger, all scvh employees were transferred to and paid by sutter valley hospitals, a related 501(c)(3) tax-exempt organization.

Form 990, Part XI, Line 9

Other changes in fund balance: k-1 rental income $(33,337) partnership income $(88,351) equity transfers (net) $(55,977,603) transfer to sutter valley hospitals for merger $(121,960,673) -------------- total $(178,059,964)

Financial Statement Notes

Schedule D, Part V, Line 4

Endowment funds intended use: the funds are unrestricted quasi endowment funds from tracy hospital foundation and are intended to further the exempt purpose of this foundation. Upon merger with sutter valley hospitals, endowment funds were transferred to sutter valley hospitals and remain intact.

Schedule D, Part X, Line 2

This organization was part of a consolidated financial system audit. The asc 740 audit footnote disclosure for the sutter system is as follows: sutter health, the legal entity, and many affiliates have been determined to be exempt organizations by the internal revenue service and the california franchise tax board and generally are not subject to taxes on income. Certain activities of sutter are subject to income taxes; however, such activities are not significant to the consolidated financial statements. With respect to its taxable activities, sutter records income taxes using the liability method, under which deferred tax assets and liabilities are determined based on the differences between the financial accounting and tax bases of assets and liabilities. Deferred tax assets or liabilities at the end of each period are determined using the currently enacted tax rate expected to apply to taxable income in the periods that the deferred tax asset or liability is expected to be realized or settled. Sutter recognizes the tax benefit from uncertain tax positions, only if it is more likely than not that the tax positions will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The statute of limitations for tax years 2014 through 2016 remain open in u.s. Tax jurisdictions in which sutter and its affiliates are subject to taxation. Sutter recognizes interest and penalties related to income tax matters in operating expenses. At december 31, 2017 and 2016, there were no such uncertain tax positions. The tax cuts and jobs act (tax act) was enacted on december 22, 2017. The tax act reduces the us federal corporate tax rate from 35% to 21%, requires companies to pay a one-time transition tax on earnings of certain foreign subsidiaries that were previously tax deferred, creates new taxes on certain foreign sourced earnings, provides for a new excise tax on certain compensation of exempt organizations over $1 million, and requires the separate calculation of unrelated business taxable income for each trade or business carried on. As of december 31, 2017, we have not completed our accounting for the tax effects of enacting the tax act, therefore we continue to account for those items based on our existing accounting under asc 740, income taxes, and the provisions of the tax laws that were in effect immediately prior to enactment. We will continue to make and refine our calculations as additional analysis is completed. In addition, our estimates may also be affected as we gain a more thorough understanding of the tax law as well as receiving guidance from the internal revenue service on how these provisions apply to tax-exempt organizations and taxable affiliates.

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