4A (Expenses $ 658492074 including grants of $ 50000) (Revenue $ 675399468)
NORTHBAY HEALTHCARE GROUP OPERATES TWO NON-PROFIT HOSPITALS WITHIN SOLANO COUNTY: NORTHBAY MEDICAL CENTER AND VACAVALLEY HOSPITAL. NORTHBAY MEDICAL CENTER, A 132-BED ACUTE-CARE HOSPITAL, IS COMMITTED TO MEETING THE CHANGING HEALTH NEEDS OF LOCAL RESIDENTS, MAKING STATE-OF-THE-ART SERVICES AVAILABLE CLOSE TO HOME. THESE SERVICES INCLUDE: A 24-HOUR EMERGENCY DEPARTMENT AND STEMI RECEIVING CENTER, A LEVEL II TRAUMA CENTER, AN ACCREDITED CHEST PAIN CENTER WITH PCI, A PRIMARY STROKE CENTER, A MODERN MATERNITY UNIT WITH PRIVATE BIRTHING SUITES, A NEWBORN INTENSIVE CARE UNIT FOR PREMATURE AND CRITICALLY ILL NEWBORNS, STATE-OF-THE-ART CRITICAL CARE UNITS, COMPREHENSIVE DIAGNOSTIC IMAGING SERVICES, SURGICAL SERVICES, A CARDIAC CATHERIZATION LAB, THE NORTHBAY HEART & VASCULAR CENTER, AND A CANCER CENTER ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS.VACAVALLEY HOSPITAL IS A 50-BED, NON-PROFIT HOSPITAL PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF VACAVILLE AND SURROUNDING COMMUNITIES OF NORTHERN SOLANO COUNTY. VACAVALLEY HOSPITAL PROVIDES A 24-HOUR EMERGENCY DEPARTMENT, 44 MEDICAL-SURGICAL BEDS, A SIX-BED CRITICAL CARE UNIT FOR HIGH-LEVEL INTENSIVE CARE, TWO SURGERY SUITES, A FULL SERVICE LABORATORY, AND DIAGNOSTIC IMAGING SERVICES WITH A FULLY EQUIPPED RADIOLOGY DEPARTMENT INCLUDING CT SCANNER.

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: NORTHBAY MEDICAL CENTER, - FACILITY 2: NORTHBAY VACAVALLEY HOSPITAL

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 5:
A BROAD RANGE OF COMMUNITY MEMBERS PROVIDED INPUT THROUGH KEY INFORMANT INTERVIEWS, GROUP INTERVIEWS, AND FOCUS GROUPS. WE CONSULTED INDIVIDUALS WITH KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM HEALTH DEPARTMENTS, SCHOOL DISTRICTS, LOCAL NON-PROFITS, AND OTHER REGIONAL PUBLIC AND PRIVATE ORGANIZATIONS. IN ADDITION, WE GATHERED INPUT FROM COMMUNITY LEADERS, CLIENTS OF LOCAL SERVICE PROVIDERS, AND OTHER INDIVIDUALS REPRESENTING PEOPLE WHO ARE MEDICALLY UNDERSERVED, LOW INCOME, OR WHO FACE UNIQUE BARRIERS TO HEALTH (E.G., RACE/ETHNIC MINORITIES AND INDIVIDUALS EXPERIENCING HOMELESSNESS).THERE WERE A TOTAL OF EIGHT KEY INFORMANT INTERVIEWS OCCURRING BETWEEN 8/8/2018 AND 9/7/2018 WITH REPRESENTATIVES FROM VACAVILLE FAMILY RESOURCE CENTER, WINTERS HEALTHCARE, SOLANO COUNTY BOARD OF SUPERVISORS, CAMINAR, SOLANO COUNTY DEPARTMENT OF HEALTH AND SOCIAL SERVICES, SOLANO COUNTY PUBLIC HEALTH DEPARTMENT, PARTNERSHIP HEALTHPLAN, AND SOLANO COUNTY DEPARTMENT OF HEALTH AND SOCIAL SERVICES. IN ADDITION, THERE WERE FOUR GROUP INTERVIEWS: (1) A GROUP-INTERVIEW ON 8/30/2018 WITH SEVEN INDIVIDUALS REPRESENTING FIRST 5 SOLANO PARTNER ORGANIZATIONS, INCLUDING RIO VISTA CARE, CHILD START INC., SOLANO FAMILY AND CHILDREN'S SERVICES, COUNTY OF SOLANO MENTAL HEALTH SERVICES, AND THE SOLANO COUNTY OFFICE OF EDUCATION; (2) A GROUP-INTERVIEW ON 9/20/2018 WITH TWELVE INDIVIDUALS FROM THE WORKFORCE DEVELOPMENT BOARD; (3) A GROUP INTERVIEW ON 9/20/2018 WITH FOUR INDIVIDUALS FROM THE LEAVEN; AND (4) A GROUP INTERVIEW ON 9/28/2018 WITH FIVE INDIVIDUALS FROM SENIOR SERVICE PROVIDERS OLDER AND DISABLED ADULT SERVICES, FOOD BANK OF CONTRA COSTA AND SOLANO COUNTY, NORTH BAY REGIONAL CENTER, AND BORN TO AGE. ALL FOCUS GROUPS TARGETED INDIVIDUALS WHICH WORKED WITH THE MEDICALLY-UNDERSERVED, LOW-INCOME, AND MINORITY TARGET GROUPS.LASTLY, THERE WERE SEVEN SEPARATE FOCUS GROUPS HELD (IN BOTH ENGLISH AND SPANISH) IN WHICH 63 INDIVIDUALS PARTICIPATED ON THE FOLLOWING DATES: 9/26/2018, 10/1/2018, 10/5/2018, 10/5/2018, 10/5/2018, 10/8/2018, AND 10/8/2018. ALL FOCUS GROUPS INCLUDED INDIVIDUALS FROM THE MEDICAL-UNDERSERVED, LOW-INCOME, AND MINORITY TARGET GROUPS.

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 6A:
THE ORGANIZATION CONDUCTED ITS CHNA IN CONJUNCTION WITH THE SOLANO COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE (SOLANO CHNA COLLABORATIVE) WHICH INCLUDED THE FOLLOWING HOSPITAL FACILITIES (OTHER THAN THE ORGANIZATION ITSELF): (I) KAISER FOUNDATION AND (II) SUTTER HEALTH.

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 6B:
THE OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES WHICH PARTNERED WITH THE ORGANIZATION TO COMPLETE THE CHNA INCLUDE: (I) SOLANO COUNTY HEALTH AND SOCIAL SERVICES AND (II) COMMUNITY HEALTH INSIGHTS. ADDITIONALLY, THE ORGANIZATION CONSULTED WITH HARDER+COMPANY COMMUNITY RESEARCH, A SOCIAL RESEARCH AND PLANNING FIRM WHICH ASSISTS IN PLANNING, EVALUATING, AND IMPROVING SERVICES FOR VULNERABLE POPULATIONS.

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 7D:
THE REPORT IS ALSO AVAILABLE ON THE WEBSITES OF SOLANO COUNTY HEALTH AND SOCIAL SERVICES AS WELL AS THE SOLANO COALITION FOR BETTER HEALTH, AND CAN BE REQUESTED IN HARD COPY FROM THOSE AGENCIES.

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 11:
"FOR THE PURPOSES OF THE CHNA, NORTHBAY HEALTHCARE DEFINES A ""HEALTH NEED"" AS A HEALTH OUTCOME AND/OR THE RELATED CONDITIONS THAT CONTRIBUTE TO A DEFINED HEALTH NEED. HEALTH NEEDS ARE IDENTIFIED BY THE COMPREHENSIVE IDENTIFICATION, INTERPRETATION, AND ANALYSIS OF A ROBUST SET OF PRIMARY AND SECONDARY DATA.THE FOLLOWING SEVEN HEALTH NEEDS WERE DETERMINED TO BE SIGNIFICANT (IN PRIORITIZED ORDER):1. ECONOMIC SECURITY: ECONOMIC SECURITY MEANS HAVING THE FINANCIAL RESOURCES, PUBLIC SUPPORTS, CAREER AND EDUCATIONAL OPPORTUNITIES, AND HOUSING NECESSARY TO BE ABLE TO LIVE YOUR FULLEST LIFE. 2. BEHAVIORAL HEALTH: BEHAVIORAL HEALTH IS THE FOUNDATION FOR HEALTHY LIVING AND ENCOMPASSES MENTAL ILLNESS, SUBSTANCE USE AND OVERDOSES, AND ACCESS TO SERVICE PROVIDERS FOR PREVENTIVE CARE AND TREATMENT. 3. ACCESS TO CARE: ACCESS TO QUALITY HEALTH CARE INCLUDES AFFORDABLE HEALTH INSURANCE, USE OF PREVENTIVE CARE, AND ULTIMATELY REDUCED RISK OF UNNECESSARY DISABILITY AND PREMATURE DEATH. 4. HEAL: HEALTHY EATING AND ACTIVE LIVING (HEAL) RELATES TO FAIRFIELD/VACAVILLE SERVICE AREA RESIDENTS' ABILITY TO SHAPE THEIR HEALTH OUTCOMES THROUGH NUTRITION AND PHYSICAL ACTIVITY. 5. VIOLENCE AND INJURY PREVENTION: DIRECT AND INDIRECT EXPOSURE TO VIOLENCE AND INJURY, SUCH AS DOMESTIC AND COMMUNITY VIOLENCE, HAVE SIGNIFICANT EFFECTS ON WELL-BEING AND HEALTH. 6. HOUSING: ACCESS TO SAFE, SECURE, AND AFFORDABLE HOUSING IS AN IMPORTANT SOCIAL DETERMINANT OF HEALTH. FAMILIES WITH FEWER FINANCIAL RESOURCES ARE MORE LIKELY TO EXPERIENCE SUBSTANDARD HOUSING CONDITIONS AND THE ASSOCIATED RISKS. 7. MATERNAL & INFANT HEALTH: MOTHERS IN THE FAIRFIELD/VACAVILLE SERVICE AREA FACE MANY BARRIERS RELATED TO THEIR OWN WELL-BEING AND THAT OF THEIR CHILDREN.TO COMBAT THE HEALTH NEED OF ECONOMIC SECURITY, NORTHBAY HEALTHCARE INTENDS ON: (I) FURTHERING THE GOALS OF MOVING SOLANO FORWARD, A PROGRAM OPERATED BY THE SOLANO ECONOMIC DEVELOPMENT CORP., WHICH SEEKS BUSINESS ATTRACTION AND JOB CREATION, BY BEING A LEADING FINANCIAL SUPPORTER AND BY PARTICIPATING ON THE BOARD OF DIRECTORS OF THE SOLANO EDC ADVOCACY COUNCIL; (II) HELP THE LOCAL BUSINESS COMMUNITY FLOURISH AND RETAIN EXISTING JOBS BY BEING A FINANCIAL SUPPORTER AND PARTICIPATE ON THE BOARD OF DIRECTORS OF MOST OF THE NINE CHAMBERS OF COMMERCE'S IN SOLANO COUNTY AND BY CONDUCTING JOB AND RECRUITMENT FAIRS TO CONNECT THE UNEMPLOYED TO BUSINESSES THAT ARE HIRING; (III) CONDUCT A WEEKEND HEALTH AND RESOURCE FAIR FOR FAMILIES IN DISADVANTAGED NEIGHBORHOODS; (IV) FINANCIALLY SUPPORT THE PROGRAMS OF THE RAY KROC CENTER IN THE LOW-INCOME NEIGHBORHOODS OF SUISUN CITY OPERATED BY THE SALVATION ARMY; AND (V) THROUGH A COMMUNITY BENEFIT GRANT, ASSIST THE VACAVILLE NEIGHBORHOOD BOYS & GIRLS CLUB WITH PROGRAMS TO ASSIST LOW-INCOME FAMILIES BY PROVIDING AN OUT-OF-SCHOOL PLACE THAT OFFERS LIFE-ENHANCING EXPERIENCES, INCLUDING HEALTH MEALS AND ACTIVITIES.TO COMBAT THE HEALTH NEED OF BEHAVIORAL HEALTH, NORTHBAY HEALTHCARE INTENDS ON: (I) WORKING WITH SOLANO COUNTY HEALTH & SOCIAL SERVICES AS IT CONSTRUCTS A NEW MENTAL HEALTH SERVICES UNIT ON BECK AVENUE IN FAIRFIELD; (II) INCREASE THE PATIENT CONTACTS FOR BEHAVIORAL HEALTH SERVICES IN BOTH THE INPATIENT AND OUTPATIENT SETTINGS, CONNECTING THEM DIRECTLY TO COUNTY AND COMMUNITY RESOURCES; AND (III) PROVIDE A GRANT TO HORSEPLAY THERAPEUTIC RIDING CENTER, WHICH OFFERS A YEAR-ROUND RECREATIONAL RIDING PROGRAM FOR SPECIAL NEEDS CHILDREN AND ADULTS.TO COMBAT THE HEALTH NEED OF ACCESS TO CARE, NORTHBAY HEALTHCARE INTENDS ON: (I) PARTNERING WITH OLE HEALTH, A FEDERAL QUALIFIED HEALTH CENTER, BY PROVIDING 2,000 SQUARE FEET OF CLINIC SPACE TO OLE HEALTH ON THE CAMPUS OF NORTHBAY MEDICAL CENTER, WHICH WILL REDUCE UTILIZATION OF EMERGENCY ROOM RESOURCES AND RESULT IN BETTER OUTCOMES FOR PATIENTS OF OLE HEALTH WHO REQUIRE HOSPITALIZATION; (II) PROVIDE ACCESS TO CARE FOR AS MANY OF THOSE WHO CANNOT AFFORD THE COST AS POSSIBLE VIA THE ORGANIZATION'S CHARITY CARE PROGRAM; (III) INCREASE THE ADMISSION OF HOSPICE PATIENTS BY 5% IN 2020, EXTENDING THE PROGRAM'S REACH IN SOLANO COUNTY, WHILE EXPANDING THE POOL OF STAFF AND VOLUNTEERS TO ENSURE CAPACITY; AND (IV) CONTINUING TO OPERATE THE NORTHBAY ADULT DAY CENTER, WHICH OFFERS CLIENTS WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIAS THE OPPORTUNITY TO SOCIALIZE AND PARTICIPATE IN STIMULATING ACTIVITIES.TO COMBAT THE HEALTH NEED OF HEALTHY EATING AND ACTIVE LIVING, NORTHBAY HEALTHCARE INTENDS ON: (I) CONDUCTING COMMUNITY OUTREACH INITIATIVES TO AFFECT THE PUBLIC'S BEHAVIOR IN ORDER TO REDUCE THE INCIDENCE AND PREVALENCE OF CARDIOVASCULAR DISEASES, AS WELL AS OFFERING HANDS-ONLY CPR AND AUTOMATED DEFIBRILLATION EDUCATION TO A LOCAL BUSINESS AND LOCAL SCHOOL; (II) PROVIDE FINANCIAL ASSISTANCE TO MEALS ON WHEELS, WHICH SUPPORTS SENIOR INDEPENDENCE, HEALTH, AND WELL-BEING BY REGULARLY PROVIDING NUTRITIOUS MEALS AND HUMAN CONNECTION; (III) PROVIDE GRANT FUNDING FOR THE FAIRFIELD CERTIFIED FARMERS' MARKET, WHICH WILL HELP FUND A 2-FOR-1 MATCHING PROGRAM THAT PROVIDES NEEDY FAMILIES AN ADDITIONAL $10 PER MONTH, WHICH INCREASES ACCESS TO HEALTH FOODS; AND (IV) PROVIDE A GRANT TO SOLANO LAND TRUST, WHICH WILL CONDUCT OUTDOOR EDUCATION PROGRAMS, DOCENT-LED TOURS AND COMMUNITY EVENTS TO CONNECT SCHOOL CHILDREN AND THEIR FAMILIES TO NATURE.TO COMBAT THE HEALTH NEED OF VIOLENCE AND INJURY PREVENTION, NORTHBAY HEALTHCARE INTENDS ON: (I) PROVIDING A BUILDING FACILITY FOR THE PROGRAMS OF THE LEAVEN (A NON-PROFIT ORGANIZATION WHICH BRINGS AFTER-SCHOOL MENTORING AND TUTORING PROGRAMS AS A REVITALIZATION TOOL TO STRUGGLING NEIGHBORHOODS), AS WELL AS BY COVERING ALL OPERATIONAL COSTS; (II) SUPPORTING AND PARTNERING WITH THE ROBBY POBLETE FOUNDATION, WHICH OPERATES A FIREARMS BUYBACK EVENT, WITH THE GOAL OF GETTING AT LEAST 150 WEAPONS OFF THE STREET AS WELL AS OFFERING SCHOLARSHIPS TO INDIVIDUALS SEEKING A CAREER PATHWAY AWAY FROM A LIFE OF CRIME; AND (III) PROVIDE FINANCIAL ASSISTANCE TO THE JIM CAPOOT ""CHARGE ON"" FOUNDATION, WHICH BRINGS YOUTH UNDER THE SUPERVISION AND POSITIVE INFLUENCE OF A LAW ENFORCEMENT AGENCY AND EXPANDS PUBLIC AWARENESS ABOUT THE ROLE OF A POLICE OFFICER AND REINFORCEMENT OF THE RESPONSIBLE VALUES AND ATTITUDES INSTILLED IN YOUNG PEOPLE BY THEIR PARENTS.TO COMBAT THE HEALTH NEED OF HOUSING, NORTHBAY HEALTHCARE INTENDS ON: (I) PROVIDING FINANCIAL SUPPORT TO SOLANO DREAM CENTER, WHICH PROVIDES HOMELESS INDIVIDUALS WITH EMERGENCY SHELTER AND CONNECTIONS TO EMPLOYMENT ASSISTANCE AND OTHER SERVICES; (II) PROVIDE COMMUNITY BENEFIT GRANT FUNDING TO SUSTAIN A PROGRAM PROVIDING A SAFE ENVIRONMENT FOR HOMELESS OR NEAR-HOMELESS PATIENTS WHO ARE READY FOR DISCHARGE, CONNECTING THEM WITH PRIMARY CARE, LONG-TERM HOUSING, AND OTHER RESOURCES; (III) PROVIDE $150,000 IN START-UP FUNDING FOR THE VALLEJO NAVIGATION CENTER, WHICH WILL PROVIDE ACCESS TO TEMPORARY HOUSING AND WRAP-AROUND SERVICES TO SUPPORT MEN AND WOMEN LIVING UNSHELTERED IN THE CITY OF VALLEJO; AND (IV) THROUGH A COMMUNITY BENEFIT GRANT, ASSIST IN THE FUNDING OF A GROUP HOUSING PROJECT IN THE CITY OF RIO VISTA FOR HOMELESS VETERANS, WHICH WILL SERVE SIX TO EIGHT HOMELESS VETERANS, CONNECTING THEM TO VA SERVICES, EMPLOYMENT ASSISTANCE, AND HEALTH CARE SERVICES.TO COMBAT THE HEALTH NEED OF MATERNAL & INFANT HEALTH, NORTHBAY HEALTHCARE WILL PARTICIPATE IN CALIFORNIA PERINATAL QUALITY CARE COLLABORATIVE (CPQCC) AND CALIFORNIA MATERNAL QUALITY CARE COLLABORATIVE (CMQCC) TO HELP ADDRESS THE OPIOID USE EPIDEMIC AS IT HAS IMPACTED FAMILIES IN SOLANO COUNTY. NORTHBAY WOMEN AND CHILDREN'S SERVICES PROVIDERS WILL ENCOURAGE NON-PHARMACOLOGIC TREATMENT FOR NEONATAL ABSTINENCE SYNDROME (NAS) WHERE APPROPRIATE BASED ON EVIDENCE DEMONSTRATING ITS SUPERIORITY.NORTHBAY HEALTHCARE, IN ITS 2020 IMPLEMENTATION STRATEGY, ADDRESSES EACH OF THE SEVEN PRIORITIZED NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT."

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 13B:
BANKRUPTCY AND DECEASED PATIENTS WITH NO ESTATE.

GROUP A-FACILITY 1 -- NORTHBAY HEALTHCARE GROUP PART V, SECTION B, LINE 16J:
THE POLICY IS POSTED ON THE CALIFORNIA OSHPD WEBSITE.

PART I, LINE 7:
A COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS ON SCHEDULE H, PART I, LINES 7A AND 7B. THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED TO DETERMINE AMOUNTS ON LINE 7E.

PART II, COMMUNITY BUILDING ACTIVITIES:
PHYSICAL IMPROVEMENTS AND HOUSING - NORTHBAY DONATED FUNDS TO PROVIDE OR REHABILITATE HOUSING FOR VULNERABLE POPULATIONS WHICH WILL BE USED FOR NEW INITIATIVES THAT RELATE TO HOMELESSNESS. THIS INCLUDES FUNDING TO THE SOLANO DREAM CENTER, WHOSE MISSION IS TO TRANSFORM OTHERS SUFFERING FROM ADDITION, DOMESTIC, VIOLENCE, HOMELESSNESS AND TRAUMA.ECONOMIC DEVELOPMENT - SUPPORT FOR CHILD HAVEN, CHILDREN'S NETWORK, THE LEAVEN, MISSION SOLANO, WE CARE FOR CHILDREN SOLANO, AND MEALS ON WHEELS, WHICH COMPRISE A NETWORK OF SUPPORT FOR VULNERABLE POPULATIONS IN OUR COMMUNITY. SERVICES INCLUDE A HAVEN FOR ABUSED AND ABANDONED CHILDREN, EARLY CHILDHOOD EDUCATION, AN AFTER-SCHOOL MENTORING PROGRAM FOR CHILDREN LIVING IN UNDERSERVED NEIGHBORHOODS AND SHELTER AND WRAP-AROUND SERVICES FOR THE HOMELESS.COMMUNITY SUPPORT - FINANCIAL SUPPORT INCLUDES FOR ADOPT-A-SCHOOL, SALVATION ARMY KROC CENTER, VACAVILLE BOYS AND GIRLS CLUB, VACAVILLE CHRISTMAS WISH, AND THE WELLNESS CHALLENGE AT MARKHAM ELEMENTARY.COALITION BUILDING - SOLANO COALITION FOR BETTER HEALTH IS A CONSORTIUM OF LOCAL HEALTH CARE SYSTEMS, THE COUNTY, NON-PROFIT SOCIAL SERVICE AGENCIES AND COMMUNITY CLINIC NETWORKS THAT WORK TOGETHER TO ASSESS THE COMMUNITY HEALTH NEEDS AND COLLABORATE TO MEET THEM.

PART III, LINE 2:
IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS ON A CONSOLIDATED BASIS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WITH THIRD-PARTY INSURANCE COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTABLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (THOSE WITHOUT THIRD-PARTY INSURANCE COVERAGE) AND RECEIVABLES REPRESENTING DEDUCTIBLES AND COPAYMENTS REQUIRED FROM PATIENTS BY THEIR INSURANCE PLANS, THE SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS HISTORICALLY COLLECTED AFTER ALL REASONABLE COLLECTIONS HAVE BEEN EXHAUSTED IS THE ESTIMATED UNCOLLECTABLE RATE. THIS RATE IS APPLIED TO EXISTING ACCOUNTS TO RECORD AN ESTIMATE FOR UNCOLLECTABLE ACCOUNTS.

PART III, LINE 3:
A COST-TO-CHARGE RATIO (WHICH IS UTILIZED FOR CALCULATING CHARITY CARE COSTS ON SCHEDULE H, PART I, LINE 7A) WAS APPLIED TO TOTAL BAD DEBT EXPENSE TO ARRIVE AT THE ESTIMATED AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY.

PART III, LINE 4:
"THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT CONTAIN A SEPARATE FOOTNOTE ADDRESSING ""BAD DEBT EXPENSE"". HOWEVER, THE FOOTNOTE THAT ADDRESSES ""PATIENTS ACCOUNTS RECEIVABLE"" CAN BE FOUND ON PAGES 9 AND 27-30 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS."

PART III, LINE 8:
TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE, EXPENSES ARE DISALLOWED BASED ON PRIOR YEARS' COST REPORTS AUDITS AND STANDARD MEDICARE NON-REIMBURSABLE EXPENSES, AS DIRECTED BY THE MEDICARE PROGRAM. THE MEDICARE COST REPORT AND ITS RULES OF ALLOWABLE COSTS TO WERE USED AS THE COSTING METHODOLOGY TO DETERMINE THE AMOUNT ON SCHEDULE H, PART III, LINE 6.IT IS THE HOSPITAL'S BELIEF THAT THE SHORTFALL REFLECTED ON PART III, LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN THE HOSPITAL'S COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS.

PART III, LINE 9B:
NORTHBAY HEALTHCARE'S COLLECTION POLICIES OUTLINE THE TYPES OF COLLECTION EFFORTS THAT CONTRACTED COLLECTION AGENCIES MAY OR MAY NOT TAKE TO COLLECT ON PAST-DUE ACCOUNTS. IT IS RECOGNIZED THAT AS PART OF THE FINANCIAL ASSISTANCE PROCESS, PATIENTS MAY FROM TIME TO TIME BREAK THEIR PROMISE TO PAY MADE ON THE FINANCIAL ASSISTANCE APPLICATION. IN THESE INSTANCES, PATIENTS WITH PAST-DUE FINANCIAL ASSISTANCE OBLIGATIONS MAY BE REFERRED TO COLLECTION IN THE SAME MANNER AS ANY OTHER PATIENT WITH AN UNPAID PAST-DUE ACCOUNT. HOWEVER, IN NO INSTANCE WILL ANY PATIENT RECEIVING FINANCIAL ASSISTANCE UNDER THIS POLICY BE SUBJECT TO ABUSIVE TELEPHONE COLLECTION PRACTICES, LIENS BEING PLACED ON THEIR PRIMARY RESIDENCE, WAGE GARNISHMENTS, OR INVOLUNTARY COURT HOLD ORDERS.

PART VI, LINE 2:
IN PARTNERSHIP WITH THE SOLANO COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE, A NEEDS ASSESSMENT WAS CONDUCTED IN 2019. IT RESULTED IN A DETAILED LIST OF PRIORITY HEALTH NEEDS, INCLUDING A DESCRIPTION OF UNWANTED HEALTH OUTCOMES AND ASSOCIATED DRIVERS. THE NEEDS ASSESSMENT IS AVAILABLE ON THE WEBSITE, WWW.NORTHBAY.ORG. IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, NORTHBAY OPERATES MANY SEMINARS, SUPPORT GROUPS, AND COMMUNITY EVENTS WHICH ALLOWS IT TO FURTHER ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY.

PART VI, LINE 3:
NORTHBAY HEALTHCARE POSTS NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL PATIENT REGISTRATION AREAS IN ALL PATIENT AREAS, IN PATIENT HANDBOOKS, AT ITS PATIENT BUSINESS SERVICES DEPARTMENT, AND ON ITS WEBSITE. NOTICES ARE POSTED IN ENGLISH AND SPANISH. PATIENTS ARE ALSO PROVIDED WITH INFORMATION REGARDING THE CHARITY CARE AND DISCOUNT POLICY AT THE POINT OF ACCESS. IF A PATIENT FEELS THAT THEY MAY BE ELIGIBLE UNDER THE POLICY, HE/SHE IS REFERRED TO NORTHBAY FINANCIAL COUNSELING FOR FURTHER ASSISTANCE. A FINAL DETERMINATION IS MADE WITHIN 30 DAYS OF A COMPLETE APPLICATION AND ALL REQUESTED DOCUMENTATION BEING SUBMITTED. ONCE A DECISION IS MADE FOR THE APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE, A LETTER IS SENT TO THE PATIENT AS NOTIFICATION OF THE DECISION.

PART VI, LINE 5:
NORTHBAY CONTINUALLY PROMOTES PUBLIC HEALTH THROUGH DOZENS OF PROGRAMS, FROM FREE PRENATAL CARE TO LOW-INCOME PREGNANT WOMEN, TO FREE HOSPICE AND BEREAVEMENT SERVICES. A SUBSIDIZED DEMENTIA DAY CARE FACILITY AND A TRANSITIONAL CARE FACILITY FOR THE HOMELESS WHO REQUIRE POST-DISCHARGE CONTINUITY OF CARE ARE ALSO PROVIDED. UP TO 30 PUBLIC EDUCATION PROGRAMS -- HEALTH FAIRS, FREE SCREENINGS, DRIVE-THROUGH FLU VACCINATIONS, INJURY PREVENTION DEMONSTRATIONS, DRUNKEN DRIVING PREVENTION PROGRAMS AT LOCAL SCHOOLS AND DIABETES AWARENESS -- ARE CONDUCTED EVERY YEAR IN COMMUNITY FACILITIES CLOSE TO THOSE WHO CAN BENEFIT FROM THEM.

PART VI, LINE 4:
THE NORTHBAY HEALTHCARE SERVICE AREA INCLUDES ALL OF SOLANO COUNTY COMMUNITIES WITH A CONCENTRATION OF RESIDENTS IN THE CENTRAL SOLANO COMMUNITIES OF FAIRFIELD, SUISUN CITY, AND VACAVILLE. NORTHBAY HEALTHCARE IS CENTRALLY LOCATED ALONG THE INTERSTATE 80 CORRIDOR IN SOLANO COUNTY.THE TOTAL POPULATION IN THE SERVICE AREA IS ESTIMATED AT 287,540; OF THIS POPULATION 43.7% IDENTIFIES AS NON-HISPANIC WHITE, 27.52% IDENTIFIES AS HISPANIC OR LATINO, 11.4% IDENTIFIES AS ASIAN, 11.1% IDENTIFIES AS BLACK OR AFRICAN AMERICAN, 5.3% IDENTIFIES WITH MULTIPLES RACES, .3% IDENTIFIES AS NATIVE AMERICAN/ALASKAN NATIVE, .8% IDENTIFIES AS HAWAIIAN/PACIFIC ISLANDER, AND .2% IDENTIFIES AS SOME OTHER RACE.WITHIN THE SERVICE AREA, 11.3% OF THE TOTAL POPULATION IS LIVING IN POVERTY (<100% FEDERAL POVERTY LEVEL), WITH 16.6% OF THE CHILDREN IN THE SERVICE AREA LIVING IN POVERTY. THE UNEMPLOYMENT RATE IS 3.9%, WITH 8.5% OF THE POPULATION UNINSURED. ADULTS WITH NO HIGH SCHOOL DIPLOMA MAKE UP 13.5% OF THE POPULATION.

PART VI, LINE 7, REPORTS FILED WITH STATES
CA