SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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

Yes

 
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
 
No
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
 
 
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) . . . 		    322,769,662 9,624,967 313,144,696 1.160 %
b Medicaid (from Worksheet 3, column a) . . . . .     2,037,061,871 1,296,138,382 740,923,488 2.730 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     2,002,056 1,127,105 874,951 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     2,361,833,589 1,306,890,454 1,054,943,135 3.890 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     38,915,239 0 38,915,239 0.140 %
f Health professions education (from Worksheet 5) . . .     158,828,051 25,271,553 133,556,497 0.490 %
g Subsidized health services (from Worksheet 6) . . . .     0 0 0 0 %
h Research (from Worksheet 7) .     143,486,319 108,989,757 34,496,562 0.130 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     207,549,492 0 207,549,492 0.770 %
j Total. Other Benefits . .     548,779,101 134,261,310 414,517,790 1.530 %
k Total. Add lines 7d and 7j .     2,910,612,690 1,441,151,764 1,469,460,925 5.420 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
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 Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
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
0
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
0
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
384,831,856
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
540,400,882
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-155,569,026
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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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?42Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 KAISER FDN HOSPITAL - LOS ANGELES
4867 SUNSET BLVD
LOS ANGELES,CA90027
http://www.kp.org
930000077 		X X   X   X X     A
2 KAISER FOUNDATION HOSPITAL- ROSEVILLE
1600 Eureka Rd
Roseville,CA95661
http://www.kp.org
550001681 		X X   X   X X     F
3 KAISER FOUNDATION HOSPITAL - FONTANA
9961 SIERRA AVE
FONTANA,CA92335
http://www.kp.org
240000159 		X X   X   X X     A
4 KAISER FDN HOSPITAL - SANTA CLARA
700 LAWRENCE EXPRESSWAY
SANTA CLARA,CA95051
http://www.kp.org
070000661 		X X   X   X X     A
5 KAISER FOUNDATION HOSPITAL - OAKLAND
275 W MACARTHUR BLVD
OAKLAND,CA94611
http://www.kp.org
140000052 		X X   X   X X     A
6 MAUI MEMORIAL MEDICAL CENTER
221 Mahalani Street
Wailuku,HI96793
mauihealthsystem.org
3-H 		X X         X     B
7 KAISER FDN HOSP - SUNNYSIDE MED CTR
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015
http://www.kp.org
1073 		X X   X     X     C
8 KAISER FOUNDATION HOSPITAL - DOWNEY
9333 IMPERIAL HIGHWAY
DOWNEY,CA90242
http://www.kp.org
930000078 		X X   X   X X     A
9 KAISER FDN HOSPITAL- SOUTH SACRAMENTO
6600 BRUCEVILLE RD
SOUTH SACRAMENTO,CA95823
http://www.kp.org
030000228 		X X   X   X X     A
10 KAISER FDN HOSPITAL - SD (Clairemont)
9455 CLAIREMOMT MESA BLVD
SAN DIEGO,CA92123
http://www.kp.org
080000062 		X X   X   X X     D
11 KAISER FOUNDATION HOSPITAL - HONOLULU
3288 MOANALUA RD
HONOLULU,HI96819
http://www.kp.org
OHCA#31-H 		X X   X     X     D
12 KAISER FDN HOSPITAL - SAN FRANCISCO
2425 GEARY BLVD
SAN FRANCISCO,CA94115
http://www.kp.org
220000188 		X X   X   X X     A
13 KAISER FOUNDATION HOSPITAL - ANAHEIM
3440 E LA PALMA AVE
ANAHEIM,CA92806
http://www.kp.org
060000091 		X X   X   X X     D
14 KAISER FDN HOSPITAL - SACRAMENTO
2025 MORSE AVE
SACRAMENTO,CA95825
http://www.kp.org
030000052 		X X   X   X X     A
15 KAISER FDN HOSPITAL - WALNUT CREEK
1425 S MAIN ST
WALNUT CREEK,CA94596
http://www.kp.org
140000290 		X X   X   X X     A
16 KAISER FOUNDATION HOSPITAL - VALLEJO
975 SERENO DR
VALLEJO,CA94589
http://www.kp.org
110000026 		X X   X   X X     A
17 KAISER FDN HOSPITAL - SAN LEANDRO
2500 MERCED ST
SAN LEANDRO,CA94577
http://www.kp.org
550002678 		X X   X   X X     A
18 KAISER FOUNDATION HOSPITAL- RIVERSIDE
10800 MAGNOLIA AVE
RIVERSIDE,CA92505
http://www.kp.org
250000327 		X X   X   X X     A
19 KAISER FOUNDATION HOSPITAL - ONTARIO
2295 S VINEYARD AVE
ONTARIO,CA91761
http://www.kp.org
240000159 		X X   X   X X     A
20 KAISER FOUNDATION HOSPITAL - SAN JOSE
250 HOSPITAL PARKWAY
SAN JOSE,CA95119
http://www.kp.org
070000117 		X X   X   X X     A
21 KAISER FDN HOSPITAL - BALDWIN PARK
1011 BALDWIN PARK BLVD
BALDWIN PARK,CA91706
http://www.kp.org
930000920 		X X   X   X X     E
22 KAISER FOUNDATION HOSPITAL - MODESTO
4601 DALE RD
MODESTO,CA95356
http://www.kp.org
030000393 		X X   X   X X     E
23 KAISER FDN HOSPITAL - SOUTH BAY
25825 S VERMONT AVE
HARBOR CITY,CA90710
http://www.kp.org
930000079 		X X   X   X X     A
24 KAISER FOUNDATION HOSPITAL - IRVINE
6640 ALTON PARKWAY
IRVINE,CA92618
http://www.kp.org
060000091 		X X   X   X X     D
25 KAISER FOUNDATION HOSPITAL - FRESNO
7300 N FRESNO ST
FRESNO,CA93720
http://www.kp.org
040000384 		X X   X   X X     A
26 KAISER FDN HOSPITAL - SANTA ROSA
401 BICENTENNIAL WAY
SANTA ROSA,CA95403
http://www.kp.org
110000213 		X X   X   X X     A
27 KAISER FDN HOSPITAL - W LOS ANGELES
6041 CADILLAC AVE
LOS ANGELES,CA90034
http://www.kp.org
930000081 		X X   X   X X     D
28 KAISER FDN HOSPITAL- SAN DIEGO(ZION)
4647 ZION AVE
SAN DIEGO,CA92120
http://www.kp.org
080000062 		X X   X   X X     D
29 KAISER FDN HOSPITAL - PANORAMA CITY
13652 CANTARA ST
PANORAMA CITY,CA91402
http://www.kp.org
930000080 		X X   X   X X     D
30 KAISER FDN HOSPITAL - WOODLAND HILLS
5601 DE SOTO AVE
WOODLAND HILLS,CA91367
http://www.kp.org
930000358 		X X   X   X X     D
31 KAISER FOUNDATION HOSPITAL - ANTIOCH
4501 SAND CREEK RD
ANTIOCH,CA94531
http://www.kp.org
550000614 		X X   X   X X     A
32 KAISER FDN HOSPITAL - REDWOOD CITY
1100 VETERANS BLVD
REDWOOD CITY,CA94063
http://www.kp.org
220000021 		X X   X   X X     A
33 KAISER WESTSIDE MEDICAL CENTER
2875 NW STUCKI ROAD
HILLSBORO,OR97124
http://www.kp.org
14-1472 		X X   X     X     C
34 KAISER FOUNDATION HOSPITAL- VACAVILLE
1 QUALITY DR
VACAVILLE,CA95688
http://www.kp.org
550001207 		X X   X   X X     A
35 KAISER FDN HOSP - SOUTH SAN FRANCISCO
1200 EL CAMINO REAL
SOUTH SAN FRANCISCO,CA94080
http://www.kp.org
220000022 		X X   X   X X     A
36 KAISER FOUNDATION HOSPITAL - FREMONT
39400 PASEO PADRE PARKWAY
FREMONT,CA94538
http://www.kp.org
140000053 		X X   X   X X     A
37 KAISER FDN HOSPITAL - MORENO VALLEY
27300 IRIS AVE
MORENO VALLEY,CA92555
http://www.kp.org
550000810 		X X   X   X X     A
38 KAISER FDN HOSPITAL - SAN RAFAEL
99 MONTECILLO RD
SAN RAFAEL,CA94903
http://www.kp.org
110000357 		X X   X   X X     A
39 KAISER FOUNDATION HOSPITAL - RICHMOND
901 NEVIN ST
RICHMOND,CA94801
http://www.kp.org
140000052 		X X   X   X X     A
40 KAISER FOUNDATION HOSPITAL - MANTECA
1777 W YOSEMITE AVE
MANTECA,CA95337
http://www.kp.org
030000393 		X X   X   X X     A
41 KULA HOSPITAL
100 Keokea Place
Kula,HI96790
mauihealthsystem.org
25-H 		X X     X   X     B
42 LANAI COMMUNITY HOSPITAL
628 SEVENTH STREET
LANAI CITY,HI96763
mauihealthsystem.org
28-H 		X X     X   X     B
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
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)
A-26 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.kp.org/chna
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A-26 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.kp.org/mfa/
b
http://www.kp.org/mfa/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
A-26 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A-26 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
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)
B-3 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.kp.org/chna
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
B-3 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.kp.org/mfa/
b
http://www.kp.org/mfa/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
B-3 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
B-3 Facilities - See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
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)
C-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.kp.org/chna
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
C-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.kp.org/mfa/
b
http://www.kp.org/mfa/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
C-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
C-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
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)
D-8 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.kp.org/chna
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
D-8 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.kp.org/mfa/
b
http://www.kp.org/mfa/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
D-8 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
D-8 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
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)
E-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.kp.org/chna
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
E-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.kp.org/mfa/
b
http://www.kp.org/mfa/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
E-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
E-2 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
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)
F-1 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.kp.org/chna
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
F-1 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.kp.org/mfa/
b
http://www.kp.org/mfa/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
F-1 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
F-1 Facilities See Part V Sec C
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Line 5: The following response pertains to all Hospital Facilities: Community input was provided by a broad range of community members using key informant interviews, group interviews, focus groups, community events and listening sessions. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from county public health departments, school districts, local non-profits, regional public and private organizations as well as leaders, representatives, or members who reside and/or provide services in an under-resourced or medically underserved, low-income, and minority communities. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Line 6a: KFH Anaheim & KFH Irvine: Hoag Memorial Hospital, St. Jude Medical Center, St. Joseph Medical Center, Mission Hospital, CHOC Children's Hospital KFH Antioch: John Muir Health, Sutter Health Bay Area KFH Downey: PIH Health Hospitals, St. Francis Medical Center KFH Fremont: Eden Medical Center, KFH San Leandro, St. Rose Hospital, UCSF Benioff Children's Hospital Oakland, Washington Hospital Healthcare System KFH Fontana: KFH Ontario KFH Fresno: Adventist Health Hanford, Adventist Health Reedley, Adventist Health Selma, Clovis Community Medical Center, Community Regional Medical, Fresno Heart and Surgery, Kaweah Delta Health Care District, Madera Community Hospital, San Joaquin Valley Rehabilitation Hospital, Sierra View Medical Center, Saint Agnes Community Medical Center, Valley Children's Healthcare KFH Honolulu: Adventist Health Castle, Kahi Mohala, Kahuku Medical Center, Kapiolani Medical Center for Women & Children, Kuakini Medical Center, Pali Momi Medical Center, The Queen's Medical Center, The Queen's Medical Center West Oahu, Rehabilitation Hospital of the Pacific, Shriners Hospitals for Children Honolulu, Straub Medical Center, Wahiawa General Hospital KFH Los Angeles: KFH West Los Angeles KFH Manteca: Adventist Health Lodi Memorial, Dameron Hospital, Dignity Health St. Joseph's Medical Center, Sutter Health KFH Moreno Valley: KFH Riverside KFH Oakland: Alta Bates Summit Medical Center, John Muir Health, UCSF Benioff Children's Hospital Oakland KFH Ontario: KFH Fontana KFH Panorama City: Dignity Health Northridge Hospital Medical Center, Providence Holy Cross Medical Center, Providence St. Joseph Medical Center KFH Redwood City: Dignity Health Sequoia Hospital, KFH South San Francisco, Lucile Packard Children's Hospital Stanford, Seton Medical Center and Seton Coastside, Stanford Health Care, Sutter Health Menlo Park Surgical Hospital and Sutter Health Mills-Peninsula Medical Center KFH Richmond: John Muir Health KFH Riverside: KFH Moreno Valley KFH Sacramento: Dignity Health, Sutter Health, University of California - Davis Medical Center KFH San Diego (Clairemont) & KFH San Diego (Zion): Palomar Health, Rady Children's Hospital San Diego, Scripps Health, Sharp HealthCare, Tri-City Medical Center, University of California - San Diego Health KFH San Francisco: Chinese Hospital, Dignity Health Saint Francis Memorial Hospital, Dignity Health St. Mary's Medical Center, Sutter Health - California Pacific Medical Center, University of California - San Francisco Medical Center KFH San Jose: El Camino Hospital, KFH Santa Clara, Lucile Packard Children's Hospital Stanford, O'Connor Hospital-Verity, Stanford Health Care, Saint Louise Regional Hospital-Verity KFH San Leandro: Eden Medical Center, KFH Fremont, St. Rose Hospital, UCSF Benioff Children's Hospital Oakland, Washington Hospital Healthcare System KFH San Rafael: Marin General Hospital, Sutter Health Novato Community Hospital KFH Santa Clara: El Camino Hospital, KFH San Jose, Lucile Packard Children's Hospital Stanford, O'Connor Hospital-Verity, Stanford Health Care, Saint Louise Regional Hospital-Verity KFH Santa Rosa: St. Joseph Health, Santa Rosa Memorial Hospital, Sutter Health Santa Rosa Regional Hospital KFH South Bay: Providence Little Company of Mary Medical Center, Torrance Memorial Medical Center KFH South Sacramento: Dignity Health, Sutter Health, University of California, Davis Medical Center KFH South San Francisco: Dignity Health Sequoia Hospital, Lucile Packard Children's Hospital Stanford, Seton Medical Center and Seton Coastside, Stanford Health Care, Sutter Health Menlo Park Surgical Hospital and Sutter Health Mills Peninsula Medical Center, KFH Redwood City KFH Sunnyside & KFH Westside: Adventist Medical Center, Legacy Health System, Oregon Health & Science University, PeaceHealth Southwest Medical Center, Providence Health, Tuality Community Hospital KFH Vacaville: NorthBay Healthcare, Sutter Health KFH Vallejo: Sutter Health KFH Walnut Creek: John Muir Health, San Ramon Regional Medical Center, Stanford Health Care-ValleyCare KFH West Los Angeles: Cedars Sinai, Providence Saint John's Health Center, UCLA Health, KFH Los Angeles KFH Woodland Hills: Valley Care Community Consortium, Ventura County Public Health KULA HOSPITAL, LANAI COMMUNITY HOSPITAL & MAUI MEMORIAL MEDICAL CENTER: MOLOKAI GENERAL HOSPITAL (QUEEN'S)
Line 6b: KFH Antioch: Contra Costa County Health Services, Contra Costa County Employment & Human Services KFH Baldwin Park: San Gabriel Valley Consortium on Homelessness, San Gabriel Valley Mental Health Consortium, National Alliance on Mental Illness KFH Downey: Interfaith Food Center, Santa Fe Springs, Kaiser Permanente Watts Counseling and Learning Center, Compton Youth Build, Los Angeles County Service Area 7 Health Action Lab Coalitions KFH Fontana & KFH Ontario: Oral Health Action Coalition-Inland Empire, Hospital Association of Southern California Homeless Systems Assessment of Care, San Bernardino County Homeless Partnership, Office of Homeless Services, the High Desert Food Collaborative, Kaiser Permanente San Bernardino County Area Community Mental and Behavioral Health Convening KFH Fremont: Alameda County Health Care Services, Alameda County Public Health Department, Community Health Center Network, Alameda County Behavioral Health Care Services, First 5 Alameda County KFH Fresno: United Health Centers, Cal Viva Health Net, Fresno County Public Health KFH Los Angeles: A Place Called Home, Asian Pacific AIDS Intervention Team, Bienestar, Bravo Medical Magnet High School, Brotherhood Crusade, California Community Foundation, CHIRLA, Esperanza Community Housing Corporation, Foothill Family Services, Heart of Los Angeles, Hollywood Community Housing Corporation, Hollywood DMH, JWCH Institute, LA Care, LA Conservation Corps Sheila Kuehl, LA Promise Fund, Los Angeles Christian Health Services, Los Angeles Neighborhood Legal Services, LURN, Mayor's Office of Resident Engagement, Mi Centro Latino Equality Alliance, My Friends Place, Pasadena Black Infant Health Program, Pasadena Public Health Department, Pasadena Public Health Department, Tobacco Control, Pasadena Unified School District, PATH, RootDownLA, South Central Family Health Services, SPA 4 Health Office, St. Barnabas, St. Francis Center, STEM Academy, StepUp on 2nd, TEACH Public Schools, The Center at Blessed Sacrament, The Los Angeles LGBT Center, To Help Everyone Health and Wellness Centers, TransLatin Coalition, Youth Policy Institute KFH Manteca: First 5 San Joaquin, Health Net, Health Plan of San Joaquin, Community Medical Centers, San Joaquin County Public Health Services KFH Modesto: Stanislaus County Health Services Agency, Stanislaus County Behavioral Health Services, Stanislaus County Office of Education, First 5 Stanislaus County KFH Moreno Valley: Clinicas de Salud del Pueblo, Riverside Community Health Foundation, University of California - Riverside School of Medicine KFH Oakland: Alameda County Health Care Services, Alameda County Public Health Department, Alameda County Behavioral Health Services, First 5 Alameda County KFH Redwood City: San Mateo County Health Department, County of San Mateo Human Services Agency, Peninsula Health Care District KFH Richmond: Contra Costa County Health Care Services, West Contra Costa Unified School District, Community Clinic Consortium of Contra Costa and Solano Counties, Richmond Office of Neighborhood Safety KFH Riverside: Borrego Health, Riverside Community Health Foundation, University of California - Riverside School of Medicine KFH Sacramento: Sacramento County Department of Public Health, Yolo County Department of Health and Human Services KFH San Francisco: African American Community Health Equity Council, APA Family Support Services, Asian Pacific Islander Health Parity Coalition, Chicano Latino Indigena Health Equity Coalition, Bayview Hunter's Point Foundation for Community Improvement, Instituto Familiar de la Raza, Rafiki Wellness, Metta Fund, San Francisco Community Clinic Consortium, San Francisco Human Services Network, San Francisco Interfaith Council, San Francisco Department of Public Health, San Francisco Mayor's Office, San Francisco Unified School District, University of California - San Francisco KFH San Jose: Santa Clara County Community Benefit Coalition, Hospital Council of Northern & Central California, Santa Clara County Public Health Department KFH San Leandro: Alameda County Health Care Services, Alameda County Public Health Department, Community Health Center Network, Alameda County Behavioral Health Care Services, First 5 Alameda County KFH San Rafael: Marin County Health and Human Services, Hospital Council of Northern and Central California, Northbay Leadership Council, Marin County Office of Education, Marin Community Foundation, San Rafael Chamber of Commerce KFH Santa Clara: Santa Clara County Community Benefit Coalition, Hospital Council of Northern & Central California, Santa Clara County Public Health Department KFH Santa Rosa: Sonoma County Department of Health Services KFH South Bay: Boys and Girls Clubs LA Harbor, Boys and Girls Clubs of Metro Los Angeles, Boys and Girls Clubs of the South Bay, Compton Youthbuild, Kaiser Permanente Watts Counseling and Learning Center, Positive Results Corporation, Save Black Boys, ShareFest Community Development Inc., South Bay Coalition to End Homelessness KFH South Sacramento: Sacramento County Public Health Department KFH South San Francisco: Hospital Consortium of San Mateo County, County of San Mateo Human Services Agency, Peninsula Health Care District, Stanford Health Care KFH Sunnyside & KFH Westside: Health Share of Oregon, Clackamas County Public Health Division, Clark County Public Health Department, Multnomah County Health Department, Washington County Public Health Division, Community Action, Immigrant & Refugee Community Organization, Oregon Community Health Workers Association, Oregon Health Equity Alliance 8, Our House of Portland KFH Vacaville: Solano County Health and Social Services, Community Health Insights KFH Vallejo: Napa County Health and Human Services, Solano County Health and Social Services, Community Health Insights KFH Walnut Creek: Contra Costa County Health Services Department, Contra Costa County Employment & Human Services
Line 11 Part 1: significant needs identified in Kaiser Foundation Hospitals facilities' most recently conducted CHNAs. Health Need: Access to care The following response pertains to all Hospital Facilities: - Charitable health coverage: Provide access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage. - Medical financial assistance: Provide financial assistance to low-income individuals who receive care at KAISER FOUNDATION HOSPITALS facilities and cannot afford medical expenses. - Medicaid: Provide high-quality medical care to Medicaid participants who would otherwise struggle to access care. - Support screening for social and non-medical service needs and connect low-income individuals and families to community and government resources. - Increase access to health care coverage and care for underserved communities through targeted outreach, enrollment, and retention strategies. Health Need: Mental and behavioral health The following response pertains to these hospital facilities: Anaheim, Antioch, Baldwin Park, Downey, Fontana, Fremont, Fresno, Irvine, Los Angeles, Manteca, Modesto, Moreno Valley, Northwest (Kaiser Westside Medical Center and Sunnyside Medical Center), Oakland, Panorama City, Ontario, Redwood City, Richmond, Riverside, Roseville, Sacramento, San Diego, San Francisco, San Jose, San Leandro, San Rafael, Santa Clara, Santa Rosa, South Bay, South Sacramento, South San Francisco, Vacaville, Vallejo, Walnut Creek, West Los Angeles, Woodland Hills - Support the infrastructure and capacity building of community organizations and clinics to improve access to quality mental health care. - Provide workforce pipeline and training programs to ensure a culturally competent mental health workforce with the skills to meet the needs of diverse communities. - Support and participate in school-based programs to build student and staff capacity to address trauma and adverse childhood experiences. - Implement a multi-media campaign to reduce stigma towards mental health conditions. Health Need: Economic Security The following response pertains to these hospital facilities: Anaheim, Antioch, Baldwin Park, Downey, Fontana, Fremont, Fresno, Honolulu, Irvine, Los Angeles, Manteca, Modesto, Moreno Valley, Northwest (Kaiser Westside Medical Center and Sunnyside Medical Center), Oakland, Panorama City, Ontario, Redwood City, Richmond, Riverside, Roseville, Sacramento, San Diego, San Leandro, San Rafael, South Bay, South Sacramento, South San Francisco, Vacaville, Vallejo, Walnut Creek, West Los Angeles, Woodland Hills - Improve food security, including support of outreach and enrollment campaigns to increase eligible community members' enrollment in the Supplemental Nutrition Assistance Program. - Increase access to permanent supportive housing, and support programs and services for those experiencing homelessness. - Support long-term economic vitality of communities through purchasing, hiring and workforce development, small business development, impact investing, and improvements in the built environment. - Support programs helping vulnerable youth access resources needed to graduate from high school and prepare for college. Health Need: Obesity / HEAL / Diabetes The following response pertains to these hospital facilities: Fresno, Manteca, Modesto, Moreno Valley, Honolulu, Panorama City, Redwood City, Riverside, Roseville, San Francisco, San Jose, Santa Clara, South San Francisco, Woodland Hills - Support community-driven efforts to increase access to healthy food and physical activity, including community gardens, farmers markets, parks, and safe play areas for children. - Support high-need schools with the adoption and implementation of healthy eating active living policies and practices. - Provide opportunities for increasing awareness of prevention and management of chronic disease, including cardiovascular health, diabetes, and obesity. - Support action-oriented research into healthy eating and active living, including the connections between food insecurity and health and active transportation gaps. Health Need: Community and family safety The following response pertains to these hospital facilities: Kula Hospital, Lanai Community Hospital, Maui Memorial Medical Center, Sacramento, South Sacramento, Vacaville, Vallejo - Support community efforts to reduce violence, including firearm prevention. - Increase access to parks and public spaces and beautification of neighborhood outdoor spaces serving low income and vulnerable populations. - Support domestic violence and child abuse prevention and provide community trauma education. Health Need: Housing/homelessness The following response pertains to these hospital facilities: San Francisco, San Jose, Santa Clara, Santa Rosa - Strengthen local homeless system of care through the Housing and Health Initiative. - Support availability of permanent supportive housing. - Support long-term housing for transitional-aged foster youth. Health Need: Social determinants/ Racism/ Racial equity The following response pertains to these hospital facilities: South Bay, West Los Angeles - Incorporate an equity lens throughout planning, implementation, and execution of implementation strategies. - Contribute to statewide policy conversations focused on mental health promotion and early childhood development. Health Need: Education and literacy The following response pertains to these hospital facilities: San Rafael, Santa Rosa - Support programs that enrich mathematics instruction and improve 3rd grade reading. - Support tutoring and mentoring programs for academic success. Health Need: HIV/AIDS/STDs The following response pertains to this hospital facility: Los Angeles - Support programs that improve referral of patients to evidence-based health promotion programs. - Build capacity for organizations to expand their offering of evidence-based programs addressing STI/HIV prevention and management.
Line 11 Part 2: needs identified but not currently addressed in Kaiser Foundation Hospitals facilities' most recently conducted CHNAs. Health Need: Climate and health/ Environment The following response pertains to these hospital facilities: Antioch, Fremont, Fresno, Kula Hospital, Lanai Community Hospital, Manteca, Maui Memorial Medical Center, Modesto, Honolulu, Oakland, Redwood City, Sacramento, San Jose, San Leandro, Santa Clara, South Sacramento, South San Francisco, Walnut Creek - Less feasibility to make an impact on this need. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Lack of feasible evidence-based or promising practices to address this need. - Less ability to leverage community assets to address this need. Health Need: Community and family safety/ Violence and injury prevention The following response pertains to these hospital facilities: Antioch, Fremont, Fresno, Manteca, Modesto, Oakland, Richmond, San Francisco, San Jose, San Leandro, San Rafael, Santa Clara, Santa Rosa, Walnut Creek - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Aspects of this need will be addressed in strategies for other needs. - Lack of feasible evidence-based or promising practices to address this need. - Less feasibility to make an impact on this need. Health Need: Obesity/ HEAL/ Diabetes The following response pertains to these hospital facilities: Antioch, Fontana, Fremont, Northwest (Kaiser Westside Medical Center and Sunnyside Medical Center), Oakland, Ontario, Richmond, San Diego, San Leandro, San Rafael, Santa Rosa, South Sacramento, Vacaville, Vallejo, Walnut Creek - This need is incorporated into other needs selected. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Significant KAISER FOUNDATION HOSPITALS investments already have been made to address this need. Health Need: Education and literacy The following response pertains to these hospital facilities: Antioch, Fremont, Oakland, Richmond, San Leandro, South Bay, Vacaville, Vallejo, Walnut Creek, Woodland Hills - This need is incorporated into other needs selected. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Less feasibility to make an impact on this need. Health Need: Housing/ homelessness The following response pertains to these hospital facilities: Antioch, Fremont, Oakland, Richmond, San Leandro, San Rafael, South Bay, South San Francisco, Vacaville, Vallejo, Walnut Creek - This need is incorporated into other needs selected. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Less feasibility to make an impact on this need. Health Need: Transportation and traffic The following response pertains to these hospital facilities: Antioch, Fremont, Oakland, San Jose, San Leandro, Walnut Creek - This need is incorporated into other needs selected. Health Need: Asthma The following response pertains to these hospital facilities: Fontana , Fresno, Manteca, Modesto, Moreno Valley, Ontario, Riverside, San Jose, Santa Clara - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Less ability to leverage community assets to address this need. - Severity of this need is relatively low. Health Need: Cancer The following response pertains to these hospital facilities: Modesto, Moreno Valley, Redwood City, Riverside, San Jose, Santa Clara, South San Francisco - This need is incorporated into other needs selected. Severity of this need is relatively low. - Sufficient community resources exist to address this need. Health Need: Maternal and child health The following response pertains to these hospital facilities: Fontana, Northwest (Kaiser Westside Medical Center and Sunnyside Medical Center), Panorama City, Ontario, Roseville, San Rafael, Santa Rosa, South Sacramento, Vacaville, Vallejo - This need is incorporated into other needs selected. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. Health Need: Substance use/ tobacco The following response pertains to these hospital facilities: Fontana, Fresno, Northwest (Kaiser Westside Medical Center and Sunnyside Medical Center), Kula Hospital, Lanai Community Hospital, Manteca, Maui Memorial Medical Center, Modesto, Ontario, San Diego - This need is incorporated into other needs selected. Health Need: HIV/ AIDS/ STDs The following response pertains to these hospital facilities: Moreno Valley, Panorama City, Riverside, San Francisco - Severity of this need is relatively low. - Sufficient community resources exist to address this need. Health Need: Economic security The following response pertains to these hospital facilities: Kula Hospital, Lanai Community Hospital, Maui Memorial Medical Center, San Jose, Santa Clara, Santa Rosa - Aspects of this need will be addressed in strategies for other needs. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. - Lack of feasible evidence-based or promising practices to address this need. - Less feasibility to make an impact on this need. Health Need: Oral health The following response pertains to these hospital facilities: Fresno, Manteca, Modesto, Redwood City, San Rafael, South San Francisco - Aspects of this need will be addressed in strategies for other needs. - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. Health Need: Chronic disease/ CVD/ stroke The following response pertains to these hospital facilities: Anaheim, Irvine, Panorama City, Santa Rosa, Woodland Hills - This need is incorporated into other needs selected. Health Need: Mental/behavioral health The following response pertains to these hospital facilities: Kula Hospital, Lanai Community Hospital, Maui Memorial Medical Center, Honolulu - Less ability for KAISER FOUNDATION HOSPITALS to leverage expertise or assets to address this need. Health Need: Suicide The following response pertains to these hospital facilities: Anaheim, Irvine - This need is incorporated into other needs selected. Health Need: SDOH/ Structural racism and exclusion/ Racial equity The following response pertains to these hospital facilities: Los Angeles, San Rafael - This need is incorporated into other needs selected.
Line 13a: The following response pertains to all hospital facilities located in California and Hawaii: THE HOSPITAL PROVIDES FREE CARE (100% DISCOUNT) ON THE PATIENT COST FOR ELIGIBLE SERVICES TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. The following response pertains to hospital facilities: Sunnyside Medical Center and Westside Medical Center: THE HOSPITALS PROVIDE FREE CARE (100% DISCOUNT) ON THE PATIENT COST FOR ELIGIBLE SERVICES TO ALL CHARITY ELIGIBLE PATIENTS WITH A HOUSEHOLD INCOME LESS THAN OR EQUAL TO 300% OF THE FEDERAL POVERTY GUIDELINES (FPG). ELIGIBLE PATIENTS WITH A HOUSEHOLD INCOME GREATER THAN 300% AND LESS THAN OR EQUAL TO 400% OF THE FPG RECEIVE DISCOUNTED CARE ON THE PATIENT COST FOR ELIGIBLE SERVICES AS FOLLOW: - ELIGIBLE PATIENTS WITH A HOUSEHOLD INCOME GREATER THAN 300% AND LESS THAN OR EQUAL TO 350% OF THE FPG RECEIVE A 50% DISCOUNT) - ELIGIBLE PATIENTS WITH A HOUSEHOLD INCOME GREATER THAN 350% AND LESS THAN OR EQUAL TO 400% OF THE FPG RECEIVE A 25% DISCOUNT. - DISCOUNTS ON ELIGIBLE SERVICES ARE AVAILABLE TO ALL PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED.
Line 13h: The following response pertains to all hospital facilities located in California, Hawaii (excluding Maui) and Oregon: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR FREE CARE. The following response pertains to hospital facilities located in California only: KAISER FOUNDATION HEALTH PLAN, INC. (KFHP) MEMBERS WHO HAVE A DEDUCTIBLE MUST HAVE INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR FREE CARE. The following response pertains to these hospital facilities: Maui Memorial Medical Center, Kula Hospital, and Lanai Community Hospital: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 15% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR FREE CARE. Line 20a: The hospitals in facility reporting group B do not perform extraordinary collection actions.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. 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?11
Name and address Type of Facility (describe)
1 KAISER PERMANENTE POST ACUTE CARE CENTER
1440 168TH AVE
SAN LEANDRO,CA94578 		SKILLED NURSING
2 MENTAL HEALTH CENTER
765 W COLLEGE ST
LOS ANGELES,CA90012 		MENTAL HEALTH
3 SUNNYBROOK SURGICAL CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		AMBULATORY SURGERY
4 INTERSTATE SURGICAL CENTER
3500 N INTERSTATE AVE
PORTLAND,OR97227 		AMBULATORY SURGERY
5 SANTA CLARA PHF
3840 HOMESTEAD RD
SANTA CLARA,CA95051 		MENTAL HEALTH
6 SKYLINE SURGICAL CENTER
5135 SKYLINE ROAD SOUTH
SALEM,OR97306 		AMBULATORY SURGERY
7 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
Clackamas,OR97015 		INPATIENT MENTAL HEALTH SVCS
8 KULA HOSPITAL - 35N
100 KEOKEA PLACE
KULA,HI96790 		SKILLED NURSING & INTERMEDIATE CARE FACILITY
9 LANAI COMMUNITY HOSPITAL 43-N
628 SEVENTH STREET
LANAI CITY,HI96763 		SKILLED NURSING & INTERMEDIATE CARE FACILITY
10 KULA HOSPITAL - IMR-7
100 KEOKEA PLACE
KULA,HI96790 		IMMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES
11 CENTER FOR HEALTH RESEARCH
3800 N INTERSTATE AVE
PORTLAND,OR97227 		RESEARCH CENTER
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
1 - Part I Line 3c ********************************************************************** There are three distinct eligibility criteria for free care under KP's medical financial assistance policy; (1) means tested (income-based), (2) high medical expenses and (3) situations where the patient has been prequalified. Means-tested: A patient of a household income less than or equal to KFH's means testing criteria as a percentage of the Federal Poverty Guidelines (FPG) is eligible for financial assistance. Note: Assets are not used in eligibility determination. High Medical Expenses: A patient of any household income level with incurred out-of-pocket medical and pharmacy expenses for eligible services over a 12 month period greater than or equal 10% of annual household income is eligible for financial assistance. Prequalification: A patient is presumed to meet the program eligibility criteria and is not required to provide personal, financial and other information to verify financial status when he or she: 1. Is enrolled in a Community MFA (CMFA) program to which patients have been referred and prequalified through (1) federal, state or local government, (2) a partnering community-based organization, or (3) at a KFH sponsored community health event, or 2. Is enrolled in a KP Community Benefit program designed to support access to care for low-income patients and prequalified by designated KFH/HP personnel, or 3. Is enrolled in a credible means-tested health coverage program (e.g., Medicare Low Income Subsidy Program), or 4. Was granted a prior medical financial assistance award within the last 30 days. 1 - Part I Line 7 ********************************************************************** THE LOSSES ATTRIBUTED TO PROVIDING CHARITY CARE (MEDICAL FINANCIAL ASSISTANCE AND CHARITABLE HEALTH COVERAGE) AND PARTICIPATION IN SELECT GOVERNMENT OR COMMUNITY SPONSORED HEALTH COVERAGE PROGRAMS ARE CALCULATED USING A COST-BASED METHODOLOGY FOR PATIENTS IN THOSE PROGRAMS. THE COST-BASED LOSS IS GENERATED THROUGH THE STANDARD SYSTEMS USED TO REPORT ON MARKET SEGMENTS FOR KFHP/KFH'S COMMERCIAL BUSINESS LINES.
1 - Part III Line 8 ********************************************************************** None of the amounts reported on Part III, line 7 has been treated as community benefit. The Medicare hospital cost reports are the source document to capture the Medicare revenue and Medicare allowable costs. To determine the direct costs, the cost report takes inputs from the general ledger by hospital location and applies a step-down methodology to allocate overhead costs. The costs are then passed through additional cost report computations to determine allowable Medicare costs. The total allowable Medicare cost is subtracted from the total revenue by region to determine the Medicare surplus or shortfall.
1 - Part III Line 9b ********************************************************************** When a patient/guarantor indicates an inability to pay (charity care), the patient/guarantor will be evaluated for charity care in accordance with established criteria outlined in the Medical Financial Assistance (MFA) policy. In addition, outside collection agencies will cancel and return on a retrospective basis any accounts that either would have qualified or now qualify for charity care according to the criteria outlined in the MFA policy. Additionally, information related to extraordinary collections actions is included in the National MFA policy.
2 - needs assessment ********************************************************************** IN CALIFORNIA, HAWAII (INCLUDING THE MAUI HEALTH SYSTEM), AND OREGON EACH KFH MEDICAL CENTER IS REQUIRED TO CONDUCT A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. THE ASSESSMENTS MAY BE CONDUCTED INDIVIDUALLY BY EACH HOSPITAL OR IN COLLABORATION WITH OTHER HOSPITALS, COMMUNITY-BASED AGENCIES AND PUBLIC SERVICE ORGANIZATIONS. EACH NEEDS ASSESSMENT PROVIDES A SUMMARY OF THE NEEDS ASSESSMENT PROCESS UNDERTAKEN INCLUDING THE METHODOLOGIES AND DATA SOURCES UTILIZED, INDIVIDUALS AND ORGANIZATIONS CONSULTED, A COMPLETE LISTING OF THE NEEDS IDENTIFIED AND DESCRIPTION OF THE METHOD USED TO PRIORITIZE NEEDS FOR INCLUSION IN THE INDIVIDUAL COMMUNITY BENEFIT PLANS. THE MOST RECENT NEEDS ASSESSMENTS WERE COMPLETED IN 2019.
3 - patient education of eligibility for assistance ********************************************************************** IN CALIFORNIA, HAWAII, AND OREGON INFORMATION REGARDING ASSISTANCE IS WIDELY AVAILABLE THROUGHOUT THE FACILITIES TO ALL PATIENTS. INFORMATION REGARDING THE AVAILABILITY OF KAISER PERMANENTE'S MEDICAL FINANCIAL ASSISTANCE PROGRAM (MFAP) IS POSTED IN THE EMERGENCY DEPARTMENTS AND ADMITTING AREAS OF ALL KAISER PERMANENTE HOSPITALS. THE POSTED INFORMATION CONTAINS CONTACT INFORMATION FOR FURTHER ASSISTANCE. KAISER PERMANENTE ADMISSION AND DISCHARGE STAFF ARE ALSO A SOURCE OF INFORMATION FOR PATIENTS THAT EXPRESS FINANCIAL HARDSHIP OR REQUEST MEDICAL FINANCIAL ASSISTANCE. THIS STAFF CAN PROVIDE A COPY OF THE FINANCIAL ASSISTANCE POLICY SUMMARY, PROGRAM APPLICATION, OR CONNECT A PATIENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST PATIENTS IN DETERMINING ELIGIBILITY FOR GOVERNMENT PROGRAMS OR THE MFAP. PATIENT DISCHARGE PACKETS ALSO INCLUDE A COPY OF THE MFAP POLICY SUMMARY. IN ADDITION, MFAP INFORMATION, INCLUDING THE POLICY, POLICY PLAIN LANGUAGE SUMMARY AND APPLICATION, CAN ALSO BE FOUND ON THE PUBLICLY ACCESSIBLE KP MEDICAL FINANCIAL ASSISTANCE WEBSITE. ALL PATIENT BILLING STATEMENTS INCLUDE INFORMATION THAT FINANCIAL ASSISTANCE IS AVAILABLE AS WELL AS WHERE TO GET ADDITIONAL INFORMATION OR ASSISTANCE. THE MFAP POLICY PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED WITH THE FIRST HOSPITAL BILLING STATEMENT TO ALL PATIENTS. ADDITIONALLY, IF PATIENTS ARE REFERRED TO BAD DEBT COLLECTIONS, PRIOR TO PERFORMING EXTRAORDINARY COLLECTIONS ACTIONS, THE PATIENT RECEIVES NOTIFICATION THAT FINANCIAL ASSISTANCE IS AVAILABLE. THE PROGRAM POLICY, POLICY PLAIN LANGUAGE SUMMARY, AND APPLICATION ARE AVAILABLE WITHOUT CHARGE IN ENGLISH AS WELL AS ALL THE LANGUAGES THAT MEET THE LIMITED ENGLISH PROFICIENCY POPULATION CRITERIA (LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY). LANGUAGES SUPPORTED INCLUDE, BUT ARE NOT LIMITED TO SPANISH, CHINESE, JAPANESE, KOREAN, LAOTIAN, TAGALOG, RUSSIAN, FARSI AND VIETNAMESE. IN HAWAII'S MAUI HEALTH SYSTEM (MHS), INFORMATION REGARDING ASSISTANCE IS WIDELY AVAILABLE THROUGHOUT THE FACILITIES TO ALL PATIENTS. INFORMATION REGARDING THE AVAILABILITY OF MHS FINANCIAL ASSISTANCE PROGRAM (FAP) IS POSTED IN THE EMERGENCY DEPARTMENTS AND ADMITTING AREAS OF THE MHS HOSPITAL. THE POSTED INFORMATION CONTAINS CONTACT INFORMATION FOR FURTHER ASSISTANCE. MHS ADMISSION AND DISCHARGE STAFF ARE ALSO A SOURCE OF INFORMATION FOR PATIENTS THAT EXPRESS FINANCIAL HARDSHIP OR REQUEST FINANCIAL ASSISTANCE. THIS STAFF CAN PROVIDE A COPY OF THE FINANCIAL ASSISTANCE POLICY SUMMARY, PROGRAM APPLICATION, OR CONNECT A PATIENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST PATIENTS IN DETERMINING ELIGIBILITY FOR GOVERNMENT PROGRAMS OR THE FAP. PATIENT DISCHARGE PACKETS ALSO INCLUDE A COPY OF THE FAP POLICY SUMMARY. IN ADDITION, FAP INFORMATION, INCLUDING THE POLICY, POLICY PLAIN LANGUAGE SUMMARY AND APPLICATION, CAN ALSO BE FOUND ON THE PUBLICLY ACCESSIBLE MHS FINANCIAL ASSISTANCE WEBSITE. ALL PATIENT BILLING STATEMENTS INCLUDE INFORMATION THAT FINANCIAL ASSISTANCE IS AVAILABLE AS WELL AS WHERE TO GET ADDITIONAL INFORMATION OR ASSISTANCE. THE FAP POLICY PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED WITH THE FIRST HOSPITAL BILLING STATEMENT TO ALL PATIENTS. THE PROGRAM POLICY, POLICY PLAIN LANGUAGE SUMMARY, AND APPLICATION ARE AVAILABLE WITHOUT CHARGE IN ENGLISH AS WELL AS ALL THE LANGUAGES THAT MEET THE LIMITED ENGLISH PROFICIENCY POPULATION CRITERIA (LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY).
4 - community information ********************************************************************** KAISER FOUNDATION HOSPITALS (KFH) SERVES COMMUNITIES IN CALIFORNIA, HAWAII (INCLUDING THE MAUI HEALTH SYSTEM), AND OREGON. THE COMMUNITIES WE SERVE ARE DIVERSE AND INCLUDE BOTH LESS POPULOUS AND DENSELY POPULATED CITIES AND COUNTIES. OUR COMMUNITIES ARE DIVERSE IN MANY WAYS INCLUDING INCOME, RATE OF UNINSURED, HIGH SCHOOL GRADUATION AND LIMITED ENGLISH PROFICIENCY. OUR FACILITIES AND THE PEOPLE WHO WORK WITHIN THEM ARE LOCATED WITHIN AND ARE PART OF OUR COMMUNITIES. KFH OWNS AND OPERATES 42 LICENSED HOSPITALS, INCLUDING FIVE LICENSED HOSPITALS WITH MULTIPLE CAMPUSES IN CALIFORNIA, HAWAII AND OREGON. IN CALIFORNIA, KFH MEDICAL CENTERS ARE LOCATED IN THE CITIES OF ANAHEIM, ANTIOCH, BALDWIN PARK, DOWNEY, FONTANA, FREMONT, FRESNO, HARBOR CITY, IRVINE, LOS ANGELES, MANTECA, MODESTO, MORENO VALLEY, OAKLAND, ONTARIO, PANORAMA CITY, REDWOOD CITY, RICHMOND, RIVERSIDE, ROSEVILLE, SACRAMENTO, SAN DIEGO, SAN FRANCISCO, SAN JOSE, SAN LEANDRO, SAN RAFAEL, SANTA CLARA, SANTA ROSA, SOUTH SACRAMENTO, SOUTH SAN FRANCISCO, VACAVILLE, VALLEJO, WALNUT CREEK, WEST LOS ANGELES, AND WOODLAND HILLS. IN HAWAII, THE MOANALUA MEDICAL CENTER IS LOCATED IN THE CITY OF HONOLULU ON THE ISLAND OF OAHU. THE MAUI HEALTH SYSTEM OPERATES MAUI MEMORIAL MEDICAL CENTER, KULA HOSPITAL, AND LANAI COMMUNITY HOSPITAL ALL LOCATED IN MAUI COUNTY IN THE STATE OF HAWAII. IN OREGON, THE SUNNYSIDE MEDICAL CENTER IS LOCATED IN THE CITY OF CLACKAMAS AND KAISER WESTSIDE MEDICAL CENTER IN HILLSBORO. Ncal scal Hawaii nw ---- ---- ------ -- Total population in area (mil)** 12.5 22.3 1.4 3.5 Median Household Income**** $98,609 $78,287 $84,196 $75,110 below 100% fpl* 13.2% 15.10% 10.30% 14.00% w/o public or private health ins** 5.90% 9.90% 4.10% 6.80% Limited English Proficiency* 16.40% 20.40% 12.50% 6.60% High School Graduation Rate** 85.9% 80.20% 91.80% 90.8% Unemployment Rate (%)*** 14.8% 16.4% 19.4% 10.8% * US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY: 2013-17 ** US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY: 2014-18 *** KAISER PERMANENTE UTILITY FOR CARE DATA ANALYSIS, ESRI 2020 KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY AND PROMOTION OF COMMUNITY HEALTH SINCE OUR BEGINNINGS, WE HAVE BEEN COMMITTED TO HELPING SHAPE THE FUTURE OF HEALTH CARE. KAISER PERMANENTE IS DEDICATED TO CARE INNOVATIONS, CLINICAL RESEARCH, HEALTH EDUCATION AND THE SUPPORT OF COMMUNITY HEALTH. KFH IS COMMITTED TO THE BELIEF THAT GOOD HEALTH IS A FUNDAMENTAL RIGHT SHARED BY ALL, AND WE RECOGNIZE THAT GOOD HEALTH EXTENDS BEYOND THE DOCTOR'S OFFICE AND THE HOSPITAL. LIKE OUR APPROACH TO MEDICINE, OUR WORK IN THE COMMUNITY TAKES A PREVENTION-FOCUSED, EVIDENCE-BASED APPROACH. WE GO BEYOND TRADITIONAL CORPORATE PHILANTHROPY OR GRANT-MAKING TO LEVERAGE FINANCIAL RESOURCES WITH MEDICAL RESEARCH, PHYSICIAN EXPERTISE, AND CLINICAL PRACTICES. HISTORICALLY, WE HAVE FOCUSED OUR INVESTMENTS IN THREE AREAS-HEALTH ACCESS, HEALTHY COMMUNITIES, AND HEALTH EQUITY TO ADDRESS CRITICAL HEALTH ISSUES IN OUR COMMUNITIES. FOR MANY YEARS, WE HAVE WORKED COLLABORATIVELY WITH OTHER ORGANIZATIONS TO ADDRESS SERIOUS PUBLIC HEALTH ISSUES SUCH AS OBESITY, ACCESS TO CARE, AND VIOLENCE. WE HAVE CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) TO BETTER UNDERSTAND EACH COMMUNITY'S UNIQUE NEEDS AND RESOURCES. THE CHNA PROCESS INFORMS OUR COMMUNITY INVESTMENTS AND HELPS US DEVELOP STRATEGIES AIMED AT MAKING LONG-TERM, SUSTAINABLE CHANGE-AND IT ALLOWS US TO DEEPEN THE STRONG RELATIONSHIPS WE HAVE WITH OTHER ORGANIZATIONS THAT ARE WORKING TO IMPROVE COMMUNITY HEALTH. THE KFHP/KFH BOARD HAS A STANDING COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF DIRECTORS TO OVERSEE THE PROGRAM-WIDE COMMUNITY BENEFIT PROGRAM. KAISER PERMANENTE ALSO HAS A NATIONAL EXECUTIVE OF KFHP AND KFH TO LEAD KAISER PERMANENTE'S COMMUNITY BENEFIT PROGRAM AS A FULL-TIME ASSIGNMENT.
5 - promotion of community health ********************************************************************** KFH's principal purpose is to provide hospital, medical, and surgical care, including emergency services, extended care and home health care to members of the public without regard to age, sex, race, religion or national origin, or to the individual's ability to pay. KFH shares THE KAISER PERMANENTE mission, of providing affordable high quality health care to our members, and improving the health of our members and the communities we serve. KFH's general community benefits include: Emergency departments - KFH operates full-time emergency departments in each of its 42 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii, and Oregon. Emergency medical services are available to all individuals regardless of their ability to pay. Care provided to all patients - Hospital care is provided to individuals with health care coverage from any private or government-sponsored health plan, insured and uninsured referrals from safety net and other public health partnerships, and uninsured patients admitted through the emergency department. Open Medical Staff Privileges - Staff privileges in the hospitals are available to community practitioners who are not affiliated with a Permanente Medical Group. Reinvestment of Surplus Revenues - KFHP pays KFH for hospital services and surplus revenues are reinvested IN THE furtherance OF THE EXEMPT PURPOSE, for capital replacement or expansion of facilities and equipment, debt amortization, improvement in patient care and services, and other community benefit services including charity care, medical education and research. In addition, KFH is committed to operating to intentionally protect and preserve the environment and scarce resources. Poor environmental quality contributes to disease and economic insecurity. Kaiser Foundation Hospitals has therefore committed itself to protecting and improving the natural environment as a key component of our mission to improve healthcare quality and affordability. To fulfill this commitment, Kaiser Foundation Hospitals maintains a structure for environmental stewardship that enables the organization to continuously improve its environmental performance. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in five organization-wide focus areas that have been selected based on their ability to have the most impact on the environmental forces that shape environmental- and human-health: 1. Finding safe alternatives to harmful industrial chemicals 2. Responding to climate change 3. Promoting sustainable farming and food choices 4. Reducing, reusing, and recycling to eliminate waste 5. Conserving water In each of these focus areas, Kaiser Foundation Hospitals has established ambitious goals, implemented initiatives, achieved measurable improvements, and regularly reported progress to our Board of Directors, our staff, and the communities we serve.
6 - affiliated health care system ********************************************************************** Kaiser Permanente is a not for profit, integrated health care delivery system comprised of Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, and The Permanente Medical Groups. For more than 75 years, Kaiser Permanente has been dedicated to providing high-quality, affordable health care services and to improving the health of our members and the communities we serve. Kaiser Foundation Hospitals (KFH) and Kaiser Foundation Health Plan, Inc. (KFHP), with its five principal operating tax-exempt subsidiary health plans-Kaiser Foundation Health Plan of Colorado; Kaiser Foundation Health Plan of Georgia, Inc.; Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Kaiser Foundation Health Plan of the Northwest; and Kaiser Foundation Health Plan of Washington, are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." Kaiser Permanente is an integrated health care delivery system that combines the provision and financing of health care services. People who elect to enroll in a Kaiser Permanente health plan receive a full range of prepaid health care services, including hospital care, professional care in hospitals and physicians' offices, x-ray and laboratory services, physical therapy, emergency, ambulance transportation, preventive services, health education and certain prescribed drugs. More comprehensive drug coverage is also provided through a separate coverage rider. Persons enroll in Kaiser Permanente through KFHP or one of the Health Plan subsidiaries ("Health Plan"). Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis and fulfills its contractual obligations to group and individual members by contracting with KFH, in CA, HI, and OR based regions, and a Permanente Medical Group to provide the required health care services. KFHP and KFH are separate corporations governed by identical boards of directors. KFH accepts responsibility to provide or arrange necessary hospital services and facilities for Health Plan members. KFH owns and operates 42 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon. KFH provides emergency and in-patient services to all persons in the community regardless of membership or ability to pay. Staff privileges are available on a nondiscriminatory basis to physicians in the communities served. KFH also contracts with other community hospitals to provide hospital services to members for specialized care and other services.
7 - state filing of community benefit report ********************************************************************** KFH annually prepares and submits a Consolidated Community Benefit Plan to the California Office of Statewide Health Planning and Development in compliance with Health and Safety Code Section 127340 et seq. The consolidated plan includes a hospital-specific community benefit plan for each individual medical center campus in California. KFH also annually prepares and submits a comprehensive Oregon Community Benefit Report to the Department of Human Services, Office for Oregon Health Policy and Research for the Sunnyside and Westside Medical Centers.
Schedule H (Form 990) 2020
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