SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
CEDARS-SINAI MEDICAL CENTER
 
Employer identification number

95-1644600
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

 

No
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    33,481,808 5,891,936 27,589,872 1.150 %
b Medicaid (from Worksheet 3,
column a) .... 		    190,326,553 105,879,008 84,447,545 3.530 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    14,266,670 7,527,784 6,738,886 0.280 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		    238,075,031 119,298,728 118,776,303 4.960 %
Other Benefits
     14,559,819 99,950 14,459,869 0.600 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    70,257,611 10,469,593 59,788,018 2.500 %
g Subsidized health services
(from Worksheet 6) .. 		    4,389,547 4,306,807 82,740 0 %
h Research (from Worksheet 7)     130,078,639 0 130,078,639 5.440 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    2,408,408 0 2,408,408 0.100 %
j Total. Other Benefits ..     221,694,024 14,876,350 206,817,674 8.640 %
k Total. Add lines 7d and 7j .     459,769,055 134,175,078 325,593,977 13.600 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     2,375   2,375 0 %
2 Economic development     90,725   90,725 0 %
3 Community support     2,748,859   2,748,859 0.110 %
4 Environmental improvements     0      
5 Leadership development and training for community members     49,400   49,400 0 %
6 Coalition building     23,680   23,680 0 %
7 Community health improvement advocacy     27,455   27,455 0 %
8 Workforce development     651,159   651,159 0.030 %
9 Other     1,500   1,500 0 %
10 Total     3,595,153   3,595,153 0.140 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
214,530,802
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
190,340,433
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
528,914,000
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
709,948,900
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-181,034,900
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
11 NA
  		       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 CEDARS-SINAI MEDICAL CENTER
8700 BEVERLY BLVD
LOS ANGELES,CA90048 		X X   X   X X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
CEDARS-SINAI MEDICAL CENTER
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 450.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?8
Name and address Type of Facility (describe)
1 CEDARS-SINAI MEDICAL CENTER
310 SAN VICENTE BLVD
WEST HOLLYWOOD,CA90048 		OUTPATIENT SURGICAL
2 CEDARS-SINAI MEDICAL CENTER
8723 ALDEN DRIVE
LOS ANGELES,CA90048 		OUTPATIENT SERVICES-AMBULATORY CARE/ENDOCRINOLOGY/PRIMARY ADULT CARE
3 CEDARS-SINAI MEDICAL CENTER
8631 W 3RD STREET
LOS ANGELES,CA90048 		OUTPATIENT SERVICES-BLOOD DRAW/CARDIOLOGY/PITUITARY CTR/RADIOLOGY/ETC.
4 CEDARS-SINAI MEDICAL CENTER
8536 WILSHIRE BLVD
BEVERLY HILLS,CA90211 		OUTPATIENT SERVICES-NUCLEAR CARDIAC STRESS
5 CEDARS-SINAI MEDICAL CENTER
444 S SAN VICENTE BLVD
LOS ANGELES,CA90048 		OUTPATIENT SERVICES-GAMMA KNIFE/PAIN CTR/PRENATAL DIAG/REHAB/ETC.
6 CEDARS-SINAI MEDICAL CENTER
8635 W 3RD STREET
BEVERLY HILLS,CA90211 		OUTPATIENT SERVICES-ORGAN TRANSPLANT/ETC.
7 CEDARS-SINAI MEDICAL CENTER
9090 WILSHIRE BLVD
BEVERLY HILLS,CA90211 		OUTPATIENT SERVICES-CANCER TREATMENT CENTER
8 CEDARS-SINAI MEDICAL CENTER
127 S SAN VICENTE BLVD
LOS ANGELES,CA90048 		OUTPATIENT SERVICES-NEUROSCIENCES/HEART INST/IMAGING/LAB SVC
9
10
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
    PART I, LINE 7: COSTING METHODOLOGY USED TO CALCULATE AMOUNTS ON LINE 7 WERE DERIVED FROM COST ACCOUNTING SYSTEM. COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS - INPATIENT, OUTPATIENT, EMERGENCY ROOM, ETC. AND ALL PAYERS - PRIVATE INSURANCE, MEDICARE, MEDI-CAL, UNINSURED AND SELF-PAY.PART I, LINE 4: THE MEDICALLY INDIGENT AND HIGH MEDICAL COST:WHILE NOT SPECIFICALLY REFERENCED IN OUR FINANCIAL ASSISTANCE POLICY (FAP), INDIVIDUALS WHO MAY BE CONSIDERED "MEDICALLY INDIGENT" CAN APPLY FOR FINANCIAL ASSISTANCE AT CEDARS-SINAI MEDICAL CENTER (CSMC).ASSEMBLY BILL-774'S DEFINITION OF A PATIENT WITH HIGH MEDICAL COST MEANS A PERSON WHOSE FAMILY INCOME DOES NOT EXCEED 350% OF THE FEDERAL POVERTY LEVEL (FPL), IF THAT INDIVIDUAL DOES NOT RECEIVE A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF HIS OR HER THIRD-PARTY COVERAGE. FOR THESE PURPOSES, IT MEANS (1) ANNUAL OUT-OF-POCKET COSTS THAT EXCEED 10% OF PATIENT'S FAMILY INCOME AND (2) A LOWER LEVEL FPL DETERMINED BY THE HOSPITAL IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY.THERE ARE TWO TESTS USED TO DETERMINE HIGH MEDICAL COST:1. THE FIRST TEST INVOLVES A COMPARISON OF THE SPECIFIC PATIENT'S OUT-OF-POCKET "INCURRED" AT THE HOSPITAL TO THE PATIENT'S FAMILY INCOME FOR THE PAST 12 MONTHS.2. THE SECOND TEST COMPARES THE MEDICAL EXPENSES "PAID" BY THE PATIENT OR THE PATIENT'S FAMILY WITHIN THE LAST 12 MONTHS.CSMC IS MORE GENEROUS IN ITS DEFINITION OF HIGH MEDICAL COSTS. RATHER THAN USING THE STATED 350% FPL THRESHOLD, CSMC USES A MORE LIBERAL 450% THRESHOLD.
    PART II: CEDARS-SINAI IS INVOLVED IN NUMEROUS COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. NUMEROUS COMMUNITY CONCERNS ARE ADDRESSED, INCLUDING HEALTH IMPROVEMENT, EDUCATION, POVERTY, WORKFORCE DEVELOPMENT AND ACCESS TO CARE. WE ALSO ENCOURAGE OUR EMPLOYEES TO PARTICIPATE IN HEALTH ADVOCACY PROGRAMS AND PHYSICAL IMPROVEMENT PROJECTS. WE WORK WITH OTHER TAX-EXEMPT ORGANIZATIONS TO PROMOTE HEALTH AND WELLNESS AND DISEASE PREVENTION. THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H.
    PART III, LINE 4: PER THE AUDITED FINANCIAL STATEMENTS FOOTNOTE 1 - PROVISION FOR UNCOLLECTIBLE ACCOUNTSPATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR BAD DEBTS, AND ACCOUNTS RECEIVABLE IS REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE MEDICAL CENTER ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON MANY FACTORS, INCLUDING PAYER MIX, AGE OF RECEIVABLES, HISTORICAL CASH COLLECTION EXPERIENCE, AND OTHER RELEVANT INFORMATION. A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED AND A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S INSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR CO-PAYMENTS AND DEDUCTIBLES. THUS THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO THESE INSURED AND UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE MEDICAL CENTER WRITES DOWN THE EXPECTED REIMBURSEMENT AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED.PART III, LINE 3: IT IS OUR BELIEF THAT $190,340,433 OF BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL WE MUST PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF ABILITY TO PAY FOR THAT CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS A COMMUNITY BENEFIT. AS PART OF OUR BAD DEBT ASSESSMENT, WE STUDIED THE CHARACTERISTICS OF THE UNINSURED POPULATION IN OUR RESERVES AND IDENTIFIED THOSE PATIENTS WHO WERE UNABLE TO PAY FOR ANY OF THEIR SERVICES. WE BELIEVE THAT THE ESTIMATED AMOUNT ENTERED ON PART III, LINE 3 INCLUDE INDIVIDUALS WHO WOULD HAVE LIKELY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY AND SHOULD BE COUNTED AS COMMUNITY BENEFIT.
    PART III, LINE 8: - RATIONALE FOR MEDICARE SHORTFALL AMOUNT ATTRIBUTABLE TO COMMUNITY BENEFIT: IT IS OUR BELIEF THAT ALL OF THE $181,034,900 SHORTFALL SHOULD BE CONSIDERED AS 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 MEDICAL CENTER IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE MEDICAL CENTER 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 6 - COSTING METHODOLOGY: REVENUE AND ALLOWABLE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT WHICH WAS COMPILED UNDER MEDICARE COSTING RULES AND REGULATIONS AS ISSUED BY THE HEALTH CARE FINANCING ADMINISTRATION AND ENFORCED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES.
    PART III, LINE 9B: NOTICE OF FINANCIAL ASSISTANCE AVAILABILITY (INCLUDED IN COLLECTION POLICY):IN ITS BILLS TO ALL PATIENTS, CEDARS-SINAI WILL INCLUDE A STATEMENT TO THE EFFECT THAT IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS THE PATIENT MAY BE ELIGIBLE FOR GOVERNMENT-SPONSORED PAYOR PROGRAMS OR FINANCIAL ASSISTANCE FROM THE MEDICAL CENTER. BILLS WILL ALSO INCLUDE THE NAME/TITLE OR DEPARTMENT AND TELEPHONE NUMBER TO CONTACT FOR MORE INFORMATION ABOUT THE MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM AND APPLICATION PROCESS.ASSIGNMENT OF PATIENT ACCOUNTS TO COLLECTION AGENCIES (APPLICABLE TO ALL PATIENTS).THE MEDICAL CENTER SHALL NOT ASSIGN ANY PATIENT ACCOUNT TO A COLLECTION AGENCY UNLESS THE MEDICAL CENTER (OR A SUBCONTRACTOR ACTING ON THE MEDICAL CENTER'S BEHALF) HAS FIRST PERFORMED TO THE BEST OF ITS ABILITY A PATIENT PROFILE/SCREEN AND DETERMINED TO THE MEDICAL CENTER'S SATISFACTION THAT THE PATIENT:(A) DOES NOT QUALIFY FOR ALTERNATIVE PAYOR SOURCES, (B) IS NOT AGREEABLE TO A PAYMENT PLAN OR IS NO LONGER COOPERATING WITH A NEGOTIATED PAYMENT PLAN,(C) DOES NOT QUALIFY FOR THE MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM (OR HAS QUALIFIED AND BEEN GIVEN FINANCIAL ASSISTANCE, IN WHICH CASE ONLY THE AMOUNT AS ADJUSTED TO REFLECT THE FINANCIAL ASSISTANCE AVAILABLE IS FORWARDED FOR COLLECTION) AND, (D) HAS SUFFICIENT ASSETS AVAILABLE TO PAY THE AMOUNT OWING. FOR PURPOSES OF THIS POLICY, THE MEDICAL CENTER HAS PERFORMED THE DETERMINATIONS LISTED ABOVE TO THE BEST OF ITS ABILITY WHERE THE MEDICAL CENTER HAS MADE A REASONABLE ATTEMPT TO GATHER THE NECESSARY INFORMATION FROM A PATIENT AND THE PATIENT EITHER DOES NOT RESPOND WITHIN AREASONABLE TIME OR IS UNCOOPERATIVE IN PROVIDING THE NECESSARY INFORMATION.ASSIGNMENT OF PATIENT ACCOUNTS TO COLLECTION AGENCIES (APPLICABLE TO PATIENTS ON FINANCIAL ASSISTANCE PROGRAM).FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT SPONSORED COVERAGE OR FOR THE MEDICAL CENTER'S OWN FINANCIAL ASSISTANCE PROGRAM, THE MEDICAL CENTER SHALL NOT KNOWINGLY SEND OR ASSIGN SUCH PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY PRIOR TO 120 DAYS FROM THE DATE OF THE MEDICAL CENTER'S INITIAL BILLING OF THAT ACCOUNT.FOR PATIENTS WHO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE OR WHO HAVE NEGOTIATED A PAYMENT PLAN AND ARE REASONABLY COOPERATING WITH THE MEDICAL CENTER IN SETTLING AN OUTSTANDING BILL, THE MEDICAL CENTER WILL NOT KNOWINGLY SEND OR ASSIGN SUCH PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY IF THE MEDICAL CENTER KNOWS THAT DOING SO MAY NEGATIVELY IMPACT A PATIENT'S CREDIT.
CEDARS-SINAI MEDICAL CENTER   PART V, SECTION B, LINE 1J: CEDARS-SINAI COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REQUIREMENTS OF BOTH THE STATE OF CALIFORNIA AND FEDERAL LAWS. CALIFORNIA SENATE BILL 697 AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND IRC SECTION 501(R)(3) DIRECT TAX EXEMPT HOSPITALS TO CONDUCT A CHNA AND DEVELOP AN IMPLEMENTATION STRATEGY EVERY THREE YEARS. THE RESPONSES REPORTED ON LINES 1 TO 8 OF THIS SECTION ARE BASED ON THE CHNA CONDUCTED DURING FISCAL YEAR ENDED JUNE 30, 2013. THE CHNA IS THE PRIMARY TOOL USED BY CEDARS-SINAI TO DETERMINE COMMUNITY BENEFIT PROGRAMS AND SERVICES STRATEGIES TO ADDRESS PRIORITIZED UNMET HEALTH NEEDS IN THE CEDARS-SINAI COMMUNITY BENEFIT SERVICE AREA. THE CHNA INCORPORATES ANALYSIS OF PRIMARY AND SECONDARY DATA TO DRIVE COMMUNITY BENEFIT PLANNING AND REPORTING. ORGANIZATIONAL COMMITMENT:THE CLEAREST DEMONSTRATION OF CEDARS-SINAI MEDICAL CENTER'S COMMITMENT TO ITS COMMUNITY IS THE INVOLVEMENT AND DEDICATION OF THE BOARD OF DIRECTORS, EXECUTIVE MANAGEMENT, PHYSICIANS AND STAFF. THE COMMUNITY BENEFIT COMMITTEE, A COMMITTEE OF THE BOARD OF DIRECTORS, IS CHARGED WITH POLICY AND PRIORITY SETTING FOR CEDARS-SINAI'S COMMUNITY BENEFIT EFFORTS. COMMUNITY BENEFIT ACTIVITIES ARE DELIVERED THROUGHOUT THE MEDICAL CENTER, WITH A SIGNIFICANT INVESTMENT IN CEDARS-SINAI'S SIGNATURE COMMUNITY BENEFIT PROGRAMS, WHICH ARE IMPLEMENTED SPECIFICALLY TO MEET THE HEALTH NEEDS OF THE COMMUNITY. CEDARS-SINAI'S COMMITMENT TO IMPROVE HEALTH OF THE COMMUNITY, THE FOURTH LEG OF OUR MISSION, HAS BEEN FULLY INTEGRATED INTO THE GOVERNANCE, EXECUTIVE MANAGEMENT AND SYSTEM-WIDE GOALS OF THE ORGANIZATION. SENIOR MANAGEMENT PLAYS A KEY LEADERSHIP ROLE IN SUPPORTING COMMUNITY BENEFIT AND ALLOCATES SIGNIFICANT HUMAN AND FINANCIAL RESOURCES TO THIS END.CEDARS-SINAI'S COMMUNITY:CEDARS-SINAI IS LOCATED AT 8700 BEVERLY BOULEVARD, LOS ANGELES, CALIFORNIA 90048. THE COMMUNITY BENEFIT SERVICE AREA INCLUDES LARGE PORTIONS OF LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH'S SERVICE PLANNING AREAS (SPAS): 4 (METRO), 5 (WEST) AND 6 (SOUTH), AND PART OF SPA 8 (SOUTH BAY). THE COMMUNITY BENEFIT SERVICE AREA INCLUDES 44 ZIP CODES, REPRESENTING 25 CITIES OR COMMUNITIES.COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) 2013:CEDARS-SINAI ENGAGED BIEL CONSULTING TO LEAD THE CHNA EFFORT. THE CHNA RESULTS INTEGRATE SECONDARY DATA OBTAINED FROM NUMEROUS DATA SOURCES, AS WELL AS PRIMARY DATA COLLECTED THROUGH A SERIES OF INTERVIEWS ON COMMUNITY HEALTH NEEDS. THE CHNA DATA COLLECTION AND ANALYSIS OCCURRED FROM JULY TO OCTOBER, 2012. THE PRELIMINARY CHNA RESULTS WERE PRESENTED TO THE COMMUNITY BENEFIT COMMITTEE, A COMMITTEE OF THE BOARD OF DIRECTORS, IN NOVEMBER 2012. THE COMMUNITY BENEFIT COMMITTEE PROVIDED FEEDBACK ON THE PRELIMINARY ANALYSIS. SECONDARY DATA SECONDARY DATA WERE COLLECTED FROM A VARIETY OF LOCAL, COUNTY, AND STATE SOURCES TO PRESENT COMMUNITY DEMOGRAPHICS, SOCIAL AND ECONOMIC FACTORS, HEALTH ACCESS, BIRTH CHARACTERISTICS, LEADING CAUSES OF DEATH, CHRONIC DISEASE AND HEALTH BEHAVIORS. BASED ON AVAILABLE DATA, ANALYSES WERE CONDUCTED AT THE MOST LOCAL LEVEL POSSIBLE FOR CEDARS-SINAI'S COMMUNITY BENEFIT SERVICE AREA. FOR EXAMPLE, DEMOGRAPHIC DATA, BIRTH AND DEATH DATA ARE BASED ON ZIP CODES. HOUSING AND ECONOMIC INDICATORS ARE AVAILABLE BY CITY. OTHER DATA ARE ONLY AVAILABLE BY SPA OR COUNTY. FOR THE PURPOSES OF THE CHNA, WHEN EXAMINING DATA BY SPA THE PRIORITY GEOGRAPHIC AREAS OF SPAS 4, 6, AND 5 ARE PRESENTED. SOURCES OF DATA INCLUDE THE HEALTHY COMMUNITIES INSTITUTE/CLARITAS, U.S. CENSUS 2010 DECENNIAL CENSUS, CALIFORNIA HEALTH INTERVIEW SURVEY, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA EMPLOYMENT DEVELOPMENT DEPARTMENT, LOS ANGELES COUNTY HEALTH SURVEY, LOS ANGELES HOMELESS SERVICES AUTHORITY, UNIFORM DATA SET, CDC NATIONAL HEALTH STATISTICS, NATIONAL CANCER INSTITUTE, U.S. DEPARTMENT OF EDUCATION, AND OTHERS. WHEN PERTINENT, THESE DATA SETS ARE PRESENTED IN THE CONTEXT OF LOS ANGELES COUNTY AND THE STATE OF CALIFORNIA, FRAMING THE SCOPE OF AN ISSUE AS IT RELATES TO THE BROADER COMMUNITY. THE REPORT INCLUDES BENCHMARK COMPARISON DATA THAT MEASURES CEDARS-SINAI COMMUNITY DATA FINDINGS WITH HEALTHY PEOPLE 2020 OBJECTIVES. HEALTHY PEOPLE 2020 OBJECTIVES ARE A NATIONAL INITIATIVE TO IMPROVE THE PUBLIC'S HEALTH BY PROVIDING MEASURABLE OBJECTIVES AND GOALS THAT ARE APPLICABLE AT NATIONAL, STATE, AND LOCAL LEVELS.PRIMARY DATA COLLECTION TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. INTERVIEWS WERE COMPLETED FROM JULY, 2012 THROUGH SEPTEMBER 2012. FOR THE INTERVIEWS, COMMUNITY STAKEHOLDERS IDENTIFIED BY CEDARS-SINAI WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. PER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND IRC SECTION 501(R)(3), COMMUNITY STAKEHOLDERS INCLUDED LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS, OR REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. INPUT WAS OBTAINED FROM LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH OFFICIALS. THE INTERVIEW QUESTIONS REQUESTED OPINIONS AND FEEDBACK ABOUT UNMET HEALTH NEEDS IN CEDARS-SINAI'S COMMUNITY BENEFIT SERVICE AREA, WITH A PARTICULAR FOCUS ON SPAS 4, 6, AND 5, WHERE APPLICABLE. ORGANIZATIONS REPRESENTED IN COMMUNITY STAKEHOLDER INTERVIEWS: * BEST FIT, LA'S BEST AFTER-SCHOOL PROGRAM* VENICE FAMILY CLINIC* AMERICAN DIABETES ASSOCIATION, LOS ANGELES CHAPTER* SABAN COMMUNITY CLINIC* KOREAN AMERICAN FAMILY SERVICE CENTER* CITY OF WEST HOLLYWOOD* LATINO COALITION FOR A HEALTHY CALIFORNIA* HEALTHY AFRICAN AMERICAN FAMILIES* THE MAPLE COUNSELING CENTER* AMERICAN HEART ASSOCIATION, GREATER LOS ANGELES DIVISION* LOS ANGELES COUNTY DEPT. OF PUBLIC HEALTH - SPA 6 AREA HEALTH OFFICE* LOS ANGELES COUNTY DEPT. OF PUBLIC HEALTH - SPA 4 AREA HEALTH OFFICE* LOS ANGELES URBAN LEAGUE* CLINICA MSR. OSCAR ROMERO* T.H.E. CLINIC* JEWISH FAMILY SERVICE - LOS ANGELES* OFFICE OF LOS ANGELES COUNTY SUPERVISOR ZEV YAROSLAVSKY* CHRONIC DISEASE & INJURY PREVENTION DIVISION, LOS ANGELES COUNTY DEPT. OF PUBLIC HEALTH* CALIFORNIA CENTER FOR PUBLIC HEALTH ADVOCACY* LOS ANGELES CITY DEPARTMENT ON AGING* OFFICE OF LOS ANGELES COUNTY SUPERVISOR MARK RIDLEY-THOMASIDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS HEALTH NEEDS WERE IDENTIFIED BASED ON THE RESULTS OF THE PRIMARY AND SECONDARY DATA COLLECTION, AND THE EXAMINATION OF AMBULATORY CARE SENSITIVE CONDITIONS. EACH HEALTH NEED WAS CONFIRMED BY MORE THAN ONE INDICATOR OR DATA SOURCE (I.E., THE HEALTH NEED WAS SUGGESTED BY MORE THAN ONE SOURCE OF SECONDARY OR PRIMARY DATA). IN ADDITION, THE HEALTH NEEDS WERE BASED ON THE SIZE OF THE PROBLEM (NUMBER OF PEOPLE PER 1,000, 10,000, OR 100,000 POPULATION); OR THE SERIOUSNESS OF THE PROBLEM (IMPACT AT INDIVIDUAL, FAMILY, AND COMMUNITY LEVELS). TO DETERMINE SIZE OR SERIOUSNESS OF A PROBLEM, THE HEALTH NEED INDICATORS IDENTIFIED IN THE SECONDARY DATA WERE MEASURED AGAINST BENCHMARK DATA, SPECIFICALLY CALIFORNIA STATE RATES OR HEALTHY PEOPLE 2020 OBJECTIVES. INDICATORS CONNECTED TO THE HEALTH NEEDS THAT PERFORMED POORLY AGAINST BENCHMARKS WERE CONSIDERED TO HAVE MET THE SIZE OR SERIOUSNESS CRITERIA. ADDITIONALLY, PRIMARY DATA SOURCES WERE ASKED TO IDENTIFY COMMUNITY AND HEALTH ISSUES BASED ON THE PERCEIVED SIZE OR SERIOUSNESS OF A PROBLEM. THE IDENTIFIED HEALTH NEEDS IN ALPHABETICAL ORDER: ACCESS TO CARE * DENTAL CARE * INSURANCE COVERAGE * MEDICATIONS * MENTAL HEALTH * PRIMARY CARE * SPECIALTY CARE * TRANSPORTATION CHRONIC DISEASE * ASTHMA * CANCER * CARDIOVASCULAR DISEASE * DIABETES * MEDICATIONS * OVERWEIGHT AND OBESITY: HEALTHY FOOD CHOICES * OVERWEIGHT AND OBESITY: PHYSICAL ACTIVITY * PREVENTIVE CARE AND ONGOING MONITORING HEALTH BEHAVIORS * ALCOHOL USE * HEALTH EDUCATION * PREVENTIVE CARE (PAP SMEARS, MAMMOGRAMS, VACCINES) * SEXUALLY TRANSMITTED DISEASES * SMOKING
CEDARS-SINAI MEDICAL CENTER   PART V, SECTION B, LINE 1J: CONTINUEDPRIORITIZATION PROCESS PRIORITY SETTING IS A REQUIRED STEP IN THE COMMUNITY BENEFIT PLANNING PROCESS. THE INTERNAL REVENUE SERVICE REGULATIONS INDICATE THAT THE CHNA MUST PROVIDE A PRIORITIZED DESCRIPTION OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, AND INCLUDE A DESCRIPTION OF THE PROCESS AND CRITERIA USED IN PRIORITIZING THE HEALTH NEEDS. CEDARS-SINAI COMPLETED THE FOLLOWING STEPS TO PRIORITIZE HEALTH NEEDS THAT EMERGED AS A RESULT OF THE CHNA: THE CEDARS-SINAI COMMUNITY BENEFIT ADVISORY GROUP, MADE UP OF CEDARS-SINAI MANAGEMENT AND EXECUTIVES ACROSS DISCIPLINES, MET IN FEBRUARY 2013 TO REVIEW THE CHNA RESULTS AND COMMUNITY HEALTH NEEDS. THE COMMUNITY BENEFIT ADVISORY GROUP PRIORITIZED HEALTH NEEDS RANKING EACH HEALTH NEED LOW, MEDIUM OR HIGH FOR ALL THE IDENTIFIED CRITERIA. PRIORITY SETTING CRITERIA* CURRENT AREA OF COMMUNITY BENEFIT FOCUS: CEDARS-SINAI HAS ACKNOWLEDGED COMPETENCIES AND EXPERTISE TO ADDRESS THE HEALTH NEED; AND THE HEALTH NEED FITS WITH THE ORGANIZATIONAL MISSION. * ESTABLISHED RELATIONSHIPS: CEDARS-SINAI HAS ESTABLISHED RELATIONSHIPS WITH COMMUNITY PARTNERS TO ADDRESS THE HEALTH NEED. * ORGANIZATIONAL CAPACITY: CEDARS-SINAI HAS THE CAPACITY TO ADDRESS THE HEALTH NEED. BASED ON THESE CRITERIA, HEALTH NEEDS THAT OBTAINED HIGH RANKINGS ON ANY OF THE CRITERIA WERE IDENTIFIED AS COMMUNITY BENEFIT PRIORITY AREAS.THE PRIORITIZED HEALTH NEEDS WERE PRESENTED TO THE COMMUNITY BENEFIT COMMITTEE IN FEBRUARY 2013 FOR REVIEW AND APPROVAL. TIME WAS ALLOTTED TO INCORPORATE FEEDBACK ON THE PRIORITIZED NEEDS. THE APPROVED PRIORITIZED HEALTH NEEDS ARE: 1. GEOGRAPHY: PRIORITIZED BY AREAS OF HIGHEST NEED IN CEDARS-SINAI'S SERVICE AREA, WITH A PARTICULAR FOCUS ON SPAS 4 AND 6 (INCLUDING ZIP CODES THAT MAY BE SLIGHTLY OUTSIDE OUR SERVICE AREA), THESE PLANNING AREAS INCLUDE DIVERSE, LOW-INCOME COMMUNITIES WHERE THERE ARE MORE UNINSURED ADULTS AND CHILDREN AND GREATER HEALTH CHALLENGES THAN IN OTHER PARTS OF LOS ANGELES. WE ALSO FOCUS ON HIGH-NEED POPULATIONS CLOSER TO CEDARS-SINAI. 2. ACCESS TO CARE: SELECTED COMMUNITY BENEFIT EFFORTS ARE FOCUSED ON INCREASING AND SUPPORTING ACCESS TO HEALTH CARE SERVICES THROUGH DIRECT PROGRAMS AND PARTNERSHIPS WITH LOCAL COMMUNITY-BASED ORGANIZATIONS. *PRIMARY CARE *SPECIALTY CARE *MENTAL HEALTH *PREVENTIVE CARE *HEALTH EDUCATION 3. CHRONIC DISEASE: SELECTED COMMUNITY BENEFIT EFFORTS FOCUSED ON THE PREVENTION OF KEY CHRONIC HEALTH CONDITIONS AND THEIR UNDERLYING RISK FACTORS. *CARDIOVASCULAR DISEASE *DIABETES *CANCER *OVERWEIGHT/OBESITY: HEALTHY FOOD CHOICES AND PHYSICAL ACTIVITY *PREVENTIVE CARE *HEALTH EDUCATION THE CHNA, THE PRIORITIZED HEALTH NEEDS AND CEDARS-SINAI'S IMPLEMENTATION STRATEGY WERE PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL IN MAY 2013. AS OF JUNE 30, 2013, THE CHNA WAS MADE WIDELY AVAILABLE TO THE PUBLIC. SCHEDULE H, PART V, SECTION B, LINE 5A:THE CHNA AND THE IMPLEMENTATION STRATEGY ARE POSTED ON THE HOSPITAL'S WEBSITE WWW.CEDARS-SINAI.EDU/COMMUNITY-BENEFIT/COMMUNITY-NEEDS-ASSESSMENT AND ARE AVAILABLE UPON REQUEST.
CEDARS-SINAI MEDICAL CENTER   PART V, SECTION B, LINE 7: THE PRIORITY HEALTH NEEDS IDENTIFIED WERE DETERMINED THROUGH A DATA COLLECTION, ANALYSIS AND PRIORITIZATION PROCESS. DUE TO THE SHEER QUANTITY AND SCOPE OF ALL OF THE COMMUNITY'S HEALTH NEEDS IDENTIFIED, IT IS CRUCIAL THAT THERE BE PRIORITIZATION TO ENSURE THAT THE COMMUNITY BENEFIT INITIATIVES UNDERTAKEN ARE EFFECTIVE IN IMPROVING THE HEALTH OF THE COMMUNITIES. THE PRIORITIZATION CRITERIA INCLUDE GEOGRAPHY (TO FOCUS ON THOSE SPAS IN GREATEST NEED), EXISTING RELATIONSHIPS WITH COMMUNITY PARTNER ORGANIZATIONS AND ORGANIZATIONAL CAPACITY. IN LINE WITH CEDARS-SINAI'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY, CEDARS-SINAI IS ALSO ENGAGING IN COMMUNITY BENEFIT PROGRAM EVALUATIONS TO ENSURE MAXIMUM IMPACT OF CEDARS-SINAI'S SIGNATURE COMMUNITY BENEFIT STRATEGIES. THE NUMEROUS AND DIVERSE PROGRAMS, PARTNERSHIPS AND STRATEGIES PRIORITIZED HIGHEST, BASED ON THE IDENTIFIED CRITERIA, WERE SELECTED IN ORDER TO MAXIMIZE EFFECTIVENESS IN ADDRESSING HEALTH NEEDS IN UNDERSERVED COMMUNITIES SERVED BY CEDARS-SINAI. IN ANY PRIORITIZATION TO MAXIMIZE EFFECTIVENESS, THERE WILL BE SOME AREAS THAT DO NOT MEET AS MANY OF THE CRITERIA OF THE PRIORITY AREAS, AND THUS MAY NOT BE ADDRESSED IN THE IMPLEMENTATION. THIS IS NOT INTENDED TO MINIMIZE THE IMPORTANCE OF THOSE HEALTH NEEDS; IT IS A REALITY OF HAVING A STRATEGIC FOCUS ON EFFECTIVENESS TO IMPROVE COMMUNITY HEALTH. THE HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA BUT NOT PRIORITIZED FOR 2013-2016 WERE MEDICATIONS, HEALTHCARE INSURANCE OUTREACH AND ENROLLMENT, DENTAL CARE, ASTHMA, ALCOHOL AND DRUG USE, TRANSPORTATION, SMOKING AND SEXUALLY TRANSMITTED DISEASES. ALTHOUGH ALL OF THESE AREAS REPRESENT IMPORTANT COMMUNITY HEALTH NEEDS, THEY WERE PRIORITIZED LOWER BECAUSE THEY MET FEWER OF THE CRITERIA (E.G., EXISTING RELATIONSHIPS WITH COMMUNITY PARTNER ORGANIZATIONS, ORGANIZATIONAL CAPACITY).
CEDARS-SINAI MEDICAL CENTER   PART V, SECTION B, LINE 14G: SINCE THE MEDICAL CENTER'S POLICY (INCLUDING ATTACHMENTS) IS A 40+ PAGE DOCUMENT, IT IS NOT DISTRIBUTED TO PATIENTS IN ITS ENTIRETY. THE MEDICAL CENTER OFFERS A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS FOR PATIENTS, ALONG WITH TELEPHONE NUMBERS TO CALL. THE INFORMATION IS POSTED IN THE EMERGENCY DEPARTMENT, THE ADMITTING DEPARTMENT AND CENTRALIZED AND DECENTRALIZED REGISTRATION AREAS. INFORMATION REGARDING THE POLICY IS DISTRIBUTED TO PATIENTS DURING THE ADMISSION OR REGISTRATION PROCESS. IT IS ALSO INCLUDED ON OUR BILLING STATEMENTS. THE POLICY, INCLUDING ALL ATTACHMENTS, IS AVAILABLE FOR REVIEW ON THE WEBSITE OF THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) AT WWW.OSHPD.CA.GOV/. THE MEDICAL CENTER ALSO ATTEMPTS TO LINK THOSE PATIENTS WHO ARE POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE TO GOVERNMENT PROGRAMS.
CEDARS-SINAI MEDICAL CENTER   PART V, SECTION B, LINE 20D: CEDARS-SINAI'S POLICY INDICATES THAT THE MOST RECENTLY PUBLISHED FEDERAL POVERTY LEVEL IS USED TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE BASED ON FINANCIAL NEED. CEDARS-SINAI HAS AN ELIGIBILITY SCALE, BASED ON SPECIFIC PARAMETERS (GREATER THAN 200% OF FEDERAL POVERTY LEVEL AND LESS THAN 450% OF FEDERAL POVERTY LEVEL), TO CALCULATE ANY AMOUNT DUE FROM THOSE INDIVIDUALS WHO QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE. THE PERCENTAGE DISCOUNT APPLIED FOR PATIENTS WHO QUALIFY IS BASED ON A SLIDING SCALE USING THE INCOME LEVEL AND SIZE OF THE PATIENT'S FAMILY UNIT. PATIENTS TREATED ON AN INPATIENT BASIS AND QUALIFIED FOR A FINANCIAL ASSISTANCE DISCOUNT OF LESS THAN 100% WILL NOT BE FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNT OF THE MEDICARE DRG RATES. PATIENTS THAT WERE TREATED ON AN OUTPATIENT BASIS AND QUALIFIED FOR A FINANCIAL ASSISTANCE DISCOUNT LESS THAN 100% WILL NOT BE FINANCIALLY RESPONSIBLE FOR MORE THAN THE MEDICAL CENTER'S AVERAGE OUTPATIENT MEDICARE REIMBURSEMENT RATE.
    PART VI, LINE 2: A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED FOR FISCAL YEAR ENDED 6/30/13. INFORMATION RELATED TO THE 2013 CHNA IS SHOWN ON PAGES 157 TO 166 IN THIS RETURN.
    PART VI, LINE 3: NOTIFICATION OF FINANCIAL ASSISTANCE POLICY:ASSEMBLY BILL 774, ARTICLE 3, ADDED REQUIREMENTS REGARDING HOSPITAL FAIR PRICING POLICIES, SPECIFICALLY RELATED TO CHARITY (NO PATIENT LIABILITY) AND DISCOUNTED (PATIENT HAS A SIGNIFICANTLY REDUCED FINANCIAL LIABILITY) CARE. IT SPEAKS TO PROVIDING FINANCIAL ASSISTANCE TO INDIVIDUALS WHO MEET OUR FINANCIAL ASSISTANCE REQUIREMENTS. IT ALSO TALKS TO PROVIDING PATIENTS WITH NOTICE THAT CONTAINS INFORMATION ABOUT THE HOSPITAL'S DISCOUNT PAYMENT AND CHARITY CARE POLICIES, INCLUDING INFORMATION ABOUT ELIGIBILITY AND ATTEMPTING TO DETERMINE THE AVAILABILITY OF PRIVATE OR PUBLIC HEALTH INSURANCE COVERAGE FOR EACH PATIENT.CEDARS-SINAI MEDICAL CENTER (CSMC) PROVIDES NOTIFICATION OF OUR FINANCIAL ASSISTANCE POLICY (FAP) TO OUR PATIENT POPULATION AND THOSE ACCOMPANYING THEM TO ADMITTING AND REGISTRATION AREAS. TO INSURE COMPLIANCE WITH STATE REGULATIONS, WE PROVIDE WRITTEN NOTICE TO ALL PATIENTS, UPON ADMISSION OR REGISTRATION. THE 40+ PAGE FAP IS IMMEDIATELY AVAILABLE UPON REQUEST. IN ADDITION TO OUR FAP NOTICE, CSMC PROVIDES NOTIFICATION OF CASH DISCOUNTS, CASH PACKAGES AND GOVERNMENT PROGRAMS. FURTHERMORE, THE ROSENTHAL FAIR DEBT COLLECTION PRACTICES ACT IS PRINTED ON THE BACKSIDE OF THIS NOTIFICATION.IN ADDITION TO HANDING THE NOTIFICATION DOCUMENT TO THE PATIENT, WE HAVE POSTED SIGNAGE IN ALL AREAS AS DEFINED IN REGULATIONS AND AS DEEMED APPROPRIATE. THIS INCLUDES BUT IS NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICE, ADMISSION AND REGISTRATION AREAS AND OTHER OUTPATIENT AREAS.
    PART VI, LINE 4: THE COMMUNITY IS DEFINED AS THOSE INDIVIDUALS IN ZIP CODES SURROUNDING THE MEDICAL CENTER (90048): 41% ARE HISPANIC, 29% ARE WHITE, 16% ARE AFRICAN AMERICAN, 11% ARE ASIAN/PACIFIC ISLANDER/NATIVE HAWAIIAN, .2% ARE NATIVE AMERICAN/ALASKAN NATIVE, AND 3% ARE OTHER. AMONG THE PEOPLE WHO LIVE IN THE SERVICE AREA, 7% ARE LESS THAN 5 YEARS OF AGE, 13% ARE 5-14 YEARS OF AGE, 8% ARE 15-19 YEARS OF AGE, 22% ARE 20-34 YEARS OF AGE, 39% ARE 35-64 YEARS OF AGE AND 11% ARE 65 YEARS OF AGE OR OLDER. OVERALL, 17% OF FAMILIES ARE BELOW THE POVERTY LINE. THE MEDIAN HOUSEHOLD INCOME IS $47,608.
    PART VI, LINE 5: CEDARS-SINAI IS DRIVEN BY ITS MISSION TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROVIDE LEADERSHIP AND EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. THE DEPARTMENT OF COMMUNITY HEALTH AND EDUCATION IS CHARGED WITH ENHANCING CEDARS-SINAI'S SERVICE TO, AND CONNECTION WITH, THE COMMUNITY AS MEASURED BY ITS COMMUNITY EDUCATION, SERVICE PROGRAMS, PARTICIPATION AND INVOLVEMENT WITH OTHER COMMUNITY SERVICE ORGANIZATIONS. WITH THE EXPERIENCE AND EXPERTISE OF MEDICAL AND ADMINISTRATIVE STAFF THROUGHOUT THE MANY DEPARTMENTS OF CEDARS-SINAI, AND WITH ITS COLLABORATIVE RELATIONSHIPS WITH COMMUNITY PARTNERS, CEDARS-SINAI HAS MADE A SIGNIFICANT CONTRIBUTION, BOTH IN QUANTIFIABLE AND NONQUANTIFIABLE TERMS, TO THE BENEFIT OF THE COMMUNITY.CEDARS-SINAI IS GOVERNED BY A BOARD OF DIRECTORS THAT IS COMPRISED OF MEMBERS OF THE COMMUNITY. FURTHER, THE COMMUNITIES ARE SERVED BY AN OPEN MEDICAL STAFF. ALSO, ANY SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO FURTHER SUPPORT THE COMMUNITY.DURING THE TAX YEAR, CEDARS-SINAI'S COMMUNITY BENEFIT EXPENSES TOTALED OVER $325,000,000 DIVIDED AMONG FIVE MAJOR CATEGORIES. FOR PURPOSES OF ESTIMATING CEDARS-SINAI'S FINANCIAL CONTRIBUTION TO COMMUNITY BENEFIT, THE FOLLOWING DEFINITIONS ARE USED:UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR THE POOR AND UNDERSERVED - INCLUDES THE UNREIMBURSED COST OF FREE AND DISCOUNTED HEALTHCARE SERVICES PROVIDED TO PERSONS WHO MEET THE ORGANIZATION'S CRITERIA FOR FINANCIAL ASSISTANCE AND ARE THEREFORE, DEEMED UNABLE TO PAY FOR ALL OR A PORTION OF THE SERVICES. TRADITIONAL CHARITY CARE IS INCLUDED IN THE INTERNAL REVENUE SERVICE (IRS) FORM 990 SCHEDULE H PART I LINE 7A.UNPAID COST OF STATE PROGRAMS - THIS AMOUNT REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PATIENTS IN THE MEDI-CAL PROGRAM AND ENROLLED IN HMO AND PPO PLANS UNDER CONTRACT WITH THE MEDI-CAL PROGRAM. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINE 7B. IN THE STATE OF CALIFORNIA THE MEDICAID PROGRAM IS CALLED MEDI-CAL. UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR MEDICARE PATIENTS - PRIMARILY BENEFITS THE ELDERLY. THIS AMOUNT REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PATIENTS IN THE MEDICARE PROGRAM AND ENROLLED IN HMO AND PPO PLANS UNDER CONTRACT WITH THE MEDICARE PROGRAM. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION B.COMMUNITY BENEFIT PROGRAMS, AS WELL AS EDUCATION AND TRAINING FOR PHYSICIANS AND OTHER HEALTH PROFESSIONALS - COST OF SERVICES THAT ARE BENEFICIAL TO THE BROADER COMMUNITY. THIS CATEGORY INCLUDES UNREIMBURSED COSTS OF HEALTH PROFESSIONS EDUCATION, COMMUNITY HEALTH IMPROVEMENT, COMMUNITY BENEFIT OPERATIONS, AND CASH DONATIONS. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINES 7E, 7F, 7G, AND 7I. BELOW ARE SOME EXAMPLES OF COSTS INCLUDED IN THIS CATEGORY OF THE COMMUNITY BENEFIT CONTRIBUTION:HEALTH PROFESSIONS EDUCATIONAS AN ACADEMIC MEDICAL CENTER, CEDARS-SINAI OFFERS GRADUATE MEDICAL EDUCATION AND MANY OTHER EDUCATION PROGRAMS FOR A VARIETY OF HEALTH PROFESSIONALS. THEY INCLUDE OFFERING GRADUATE EDUCATION TRAINING PROGRAMS IN OVER 50 SPECIALTY AND SUBSPECIALTY AREAS AND OTHER HEALTH PROFESSIONS EDUCATION PROGRAMS, AS WELL AS A SUBSTANTIAL PORTION OF THE EDUCATION TO UNIVERSITY OF CALIFORNIA LOS ANGELES MEDICAL STUDENTS, INCLUDING DEGREE PROGRAMS AND EXTENSIVE EDUCATIONAL RESOURCES FOR ASPIRING AND CURRENT NURSES. COMMUNITY HEALTH IMPROVEMENT* CLINICAL SERVICES ARE PROVIDED TO UNDERSERVED COMMUNITIES DAILY, THROUGH AN ON-SITE PRIMARY ADULT CARE CLINIC; AND THROUGH MOBILE MEDICAL UNITS AND FREE COMMUNITY CLINICS THROUGHOUT LOS ANGELES - ALL SERVING UNDERSERVED, UNINSURED AND UNDERINSURED POPULATIONS.* EACH YEAR, CEDARS-SINAI TAKES PART IN COMMUNITY-BASED ACTIVITIES WITH MORE THAN 170,000 ENCOUNTERS, INCLUDING HEALTH FAIRS, EXERCISE PROGRAMS, AND SCREENING PROGRAMS FOR CONDITIONS SUCH AS CARDIOVASCULAR DISEASE, DEPRESSION, DIABETES AND HYPERTENSION, AS WELL AS IMMUNIZATION PROGRAMS, LECTURES, AND WORKSHOPS. ALSO OFFERED ARE DISEASE-SPECIFIC SUPPORT GROUPS, PATIENT EDUCATION PROGRAMS, AND PROGRAM AFFILIATES.* CEDARS-SINAI PLANS AND IMPLEMENTS LONG-TERM COMPREHENSIVE STRATEGIES TO MEET THE HEALTH NEEDS OF UNDERSERVED COMMUNITIES. SIGNATURE COMMUNITY BENEFIT PROGRAMS SEEK TO IMPROVE HEALTH IN COMMUNITIES BY BUILDING STRONG PARTNERSHIPS, BUILDING COMMUNITY CAPACITIES AND PROVIDING DIRECT EDUCATION.RESEARCH PROGRAMS - COST OF PROVIDING TRANSLATIONAL AND CLINICAL RESEARCH AND STUDIES ON HEALTH CARE DELIVERY. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINE 7H.
REPORTS FILED WITH STATES PART VI, LINE 7 CA
Schedule H (Form 990) 2012
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