2024-11-11T13:48:53-06:00 2023-12-31 346565596 ERNST & YOUNG US LLP 370 17TH STREET SUITE 4800 DENVER CO 80202 990 2023-01-01 951914489 ST MARY MEDICAL CENTER STMA 7602422311 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 JIM MARTIN CHIEF ACCOUNTING OFFICER 7602422311 2024-10-30 1 1 ANDREW JAMESON P01894820 7209314000 2024-10-25 2023 2024-10-15 13:58:12Z PROVIDENCE ST MARY MEDICAL CENTER RANDY CASTILLO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 395765409 0 0928 X PROVIDENCE.ORG/LOCATIONS/ST-MARY-MEDICAL-CENTER X 1953 CA AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 14 13 1868 58 -42442 0 19377824 6448492 372128655 369563490 10233907 12059893 1983561 7648734 403723947 395720609 3309395 2369483 0 0 144678128 151048204 0 0 1103369 224288771 232637972 372276294 386055659 31447653 9664950 684909059 619205470 158736822 74659632 526172237 544545838 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 374368792 2369483 377102441 SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA AS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND ADVANCING OUR WASTE OPTIMIZATION WORK ACROSS ALL HOSPITALS AND CLINICS.2023 PROGRAM SERVICE ACCOMPLISHMENTSIN 2023, PROVIDENCE ST. MARY MEDICAL CENTER (SMMC) CONTINUED ITS TRADITION OF COMPASSION AND DEDICATION TO OUR COMMUNITIES BY INVESTING IN ADDRESSING COMMUNITY NEEDS. THE FOCUS OF SMMC'S COMMUNITY BENEFIT ACTIVITIES AND INVESTMENTS WAS CONSISTENT WITH THE PRIORITY HEALTH NEEDS ADDRESSED IN THE 2020-2023 COMMUNITY HEALTH IMPROVEMENT PLAN (I.E., ACCESS TO CARE, HOUSING AND HOMELESSNESS, MENTAL HEALTH, OBESITY, AND SUBSTANCE USE). PRIORITY 1: ACCESS TO CARE INCLUDES FACTORS IMPACTING UTILIZATION, SUCH AS: 1. TRANSPORTATION; 2. PROVIDER SHORTAGES, PARTICULARLY SPECIALISTS SUCH AS PEDIATRICIANS, DENTISTS, AND ORTHOPEDISTS; 3. LANGUAGE BARRIERS; AND 4. RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS. THIS NEED EMERGED AS A CONSISTENT PRIORITY.IN THE PREVIOUS CHNA PROCESS, ACCESS TO CARE WAS A MAJOR DISCUSSION POINT IN EVERY FOCUS GROUP AND RECEIVED SUBSTANTIAL SUPPORT IN THE COMMUNITY FORUM. DATA SHOW THAT THE COUNTY OF SAN BERNARDINO HAS RELATIVELY FEW PHYSICIANS AND DENTISTS COMPARED TO THE STATE OF CALIFORNIA AVERAGES. THE COMMUNITY BENEFIT COMMITTEE DISCUSSED EXPANDING COMMUNITY BENEFIT PROGRAMS AND CLINIC VISITS FOR THE POOR. IN 2023, ACCESS TO CARE WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS: 1. COVID-19 PREVENTION & MITIGATION EFFORTS: SMMC PARTNERED WITH EL SOL NEIGHBORHOOD EDUCATION CENTER AND THE SYMBA CENTER TO INCREASE COVID-19 VACCINATION RATES AMONG THE POPULATIONS DISPROPORTIONATELY IMPACTED BY COVID-19 (I.E, AGRICULTURAL WORKERS, BLACK, LATINX, IMMIGRANTS, UNHOUSED INDIVIDUALS) IN SAN BERNARDINO COUNTY'S HIGH DESERT REGION. AS A RESULT, MORE THAN 38,536 COMMUNITY MEMBERS WERE PROVIDED RAPID COVID TESTS, PERSONAL PROTECTION EQUIPMENT, HEALTH EDUCATION MATERIALS, AND VACCINATIONS. 2. BRIDGES FOR FAMILIES RESOURCE CENTER - OFFERED A NURTURING PARENTING PROGRAM TO FAMILIES AND CONNECTED THEM TO OTHER RESOURCES.3. ST. MARY MEDICAL CENTER PROVIDED $2,079,093 IN FINANCIAL SUPPORT TO ST. JUDE NEIGHBORHOOD HEALTH CENTERS (IN ADELANTO, APPLE VALLEY AND HESPERIA), WHICH PROVIDED HEALTH SERVICES TO 3,077 INDIVIDUALS. ST. JUDE NEIGHBORHOOD HEALTH CENTER IS A HEALTH RESOURCE AND SERVICE ADMINISTRATION-DESIGNATED FEDERALLY QUALIFIED HEALTH CENTER.4. MOTHER/BABY ASSESSMENT CENTER AND LACTATION CLINIC - OUTPATIENT LACTATION SUPPORT WAS PROVIDED TO 2,919 MOTHERS REGARDLESS OF INSURANCE, MEDICAL HOME, AND ABILITY TO PAY. PRIORITY 2: MENTAL HEALTH & SUBSTANCE USE COVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. THIS INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. SUBSTANCE USE PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY. MENTAL HEALTH CHALLENGES CAN IMPEDE PEOPLE'S ABILITIES TO REALIZE THEIR POTENTIAL, COPE WITH STRESSES, WORK PRODUCTIVELY AND FRUITFULLY, AND MAKE CONTRIBUTIONS TO THEIR COMMUNITIES. THESE WERE COMBINED BY THE COMMUNITY BENEFIT COMMITTEE. COMMITTEE MEMBERS DISCUSSED THAT MENTAL HEALTH WILL BE A PRIORITY FOCUS OF PROVIDENCE ST. JOSEPH HEALTH OVER THE NEXT TEN YEARS. MENTAL HEALTH WAS A FREQUENT THEME IN THE 2017 CHNA FOCUS GROUPS AND THE FORUM, PARTICULARLY FOCUSING ON THE STRESSES CAUSED BY ECONOMIC INSECURITY, THE CHALLENGES FACED BY CHILDREN AND TEENS, AND THE LACK OF PROVIDERS. DATA SHOW THAT THERE ARE RELATIVELY FEW PROVIDERS IN THE COUNTY OF SAN BERNARDINO WHEN COMPARED TO THE STATE. IN 2023, MENTAL HEALTH & SUBSTANCE USE WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS:1. SUBSTANCE USE NAVIGATION PROGRAM - DURING 2023, THE EMERGENCY DEPARTMENT NAVIGATOR HELPED 1,416 PATIENTS OBTAIN MEDICATION-ASSISTED TREATMENT FOR OPIOID MISUSE, REHABILITATION SERVICES, AND/OR OTHER COMMUNITY SUPPORTS. 374368792 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 130 0 1 1868 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 CA GA X JIM MARTIN 4255253985 1801 LIND AVE SW RENTON WA 98057 RANDY CASTILLO TRUSTEE/CEO 55.00 0.00 X X 0 914713 120052 ADOLPH COLLASO TRUSTEE/CHAIR 1.00 0.00 X 0 0 0 CR BURKE TRUSTEE 0.50 0.00 X 0 0 0 DEREK KING EDD TRUSTEE 0.50 0.00 X 0 0 0 JASON CUNNINGHAM TRUSTEE 0.50 0.00 X 0 0 0 JASON LAMOREAUX TRUSTEE 0.50 0.00 X 0 0 0 JEANNETTEE GEHRKE TRUSTEE - THRU 12/31/23 0.50 0.00 X 0 0 0 JOVY YANKASKAS TRUSTEE 0.50 0.00 X 0 0 0 MARK LAURON MD TRUSTEE 0.50 0.00 X 0 0 0 PAUL GOSTANIAN TRUSTEE 0.50 0.00 X 0 0 0 REGINA WEATHERSPOON-BELL TRUSTEE 0.50 0.00 X 0 0 0 SISTER JUDITH DUGAN TRUSTEE 0.50 0.50 X 0 0 0 SISTER PAULETTE DETERS TRUSTEE 0.50 0.00 X 0 0 0 SYED RAZA M D TRUSTEE - THRU 12/31/23 0.50 0.00 X 0 0 0 JIM WATSON ESQ SECRETARY 0.50 54.50 X 0 968691 146931 JIM MARTIN ASSISTANT TREASURER (PART YEAR) 1.00 54.00 X 0 828928 115635 GENE GUTIERREZ CHIEF FINANCIAL OFFICER 27.50 27.50 X 0 408887 59470 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0.50 54.50 X 0 292875 30846 SHARON BROWN COO SMMC - THRU 7/23 55.00 0.00 X 193837 0 23333 JOHN KOZYRA EXECUTIVE DIRECTOR ACUTE CARE OPS. 50.00 0.00 X 281200 0 54573 FE NAVARRETE ACUTE CARE RN 50.00 0.00 X 276105 0 56191 NARCISO VIZCARRA ACUTE CARE RN 50.00 0.00 X 279447 0 45976 KEVIN PARK CHIEF MEDICAL OFFICER HOSPITAL 50.00 0.00 X 275207 0 35715 RAVNEET KAUR ACUTE CARE RN 50.00 0.00 X 265558 0 30601 JO ANN ESCASA-HAIGH FRMR ASSISTANT TREASURER 0.00 1.00 X 0 3291797 10754 1571354 6705891 730077 576 1 1 0 AMN LOS ANGELES AMN SHIFTWISE 12400 HIGH BLUFF DR CORP HQ SAN DIEGO CA 92130 STAFFING SERVICES 16439790 AYA HEALTHCARE INC PO BOX 674907 DALLAS TX 75267 STAFFING SERVICES 4859307 ALLIED ANEST MEDICAL GROUP INC PO BOX 1628 ORANGE CA 92856 MEDICAL SERVICES 4850750 LOMA LINDA UNIV MED GROUP 350 COMMERCIAL RD 101 SAN BERNARDINO CA 92408 MEDICAL SERVICES 3383354 CASS INFORMATION SYSTEMS INC 12444 POWERSCOURT DR 550 ST LOUIS MO 63131 TECHNOLOGY SERVICES 3212908 64 86412 70000 974663 5317417 6448492 NET PATIENT REVENUE 622110 368445962 368445962 OTHER PATIENT SVC REV 622110 1117528 1117528 369563490 7200648 -42442 7243090 22903 0 22903 22903 22903 4481843 377402 0 0 4481843 377402 4859245 4859245 131680 86412 44800 86880 86880 CAFETERIA REVENUE 722514 680689 680689 INTERAFFILIATE REVENUE 900099 467990 467990 EDUCATION REVENUE 611710 365544 365544 6024728 6024728 7538951 395720609 377102441 -42442 12212118 X 2369483 2369483 217170 209864 6614 692 136941859 132334631 4170925 436303 3168848 3062236 96516 10096 776707 750575 23657 2475 9943620 9609080 302859 31681 565242 546225 17216 1801 3596 3475 110 11 35629 35629 65525950 63321417 1995765 208768 35033 33854 1067 112 4110765 3972464 125204 13097 5967 5766 182 19 5052248 4882271 153880 16097 118405 114422 3606 377 123882 119714 3773 395 1858820 1796283 56615 5922 10400438 10050529 316773 33136 SYSTEM COST ALLOCATION 103498119 100016061 3152308 329750 MEDICAL SUPPLIES 36683503 36683503 0 0 LICENSES AND TAXES 871082 841776 26531 2775 UBI TAXES PAID 15500 14979 472 49 3733793 3630184 93796 9813 386055659 374368792 10583498 1103369 1816576 110567643 106745439 1655670 2711403 2463556 54868535 57211124 4129649 5141073 207239 43946 296222300 184551190 118590935 111671110 309204636 228899909 2050000 86634647 99501439 684909059 619205470 35081899 27543338 745986 787584 122908937 46328710 158736822 74659632 X 516279774 531609147 9892463 12936691 526172237 544545838 684909059 619205470 X 9664950 8678468 30183 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 45817 45817 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: THE LOBBYING EXPENDITURES REPORTED REPRESENT THE PORTION OF DUES PAID TO ALLIANCE OF CATHOLIC HEALTH CARE, AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING ACTIVITIES. 1947557 2699 151114 0 4750 0 2096620 2184881 6061 -231635 11750 1947557 1746006 9713 429162 2184881 1748966 12338 -15298 1746006 1196864 439605 160042 35500 12045 1748966 0.00000 0.66270 0.33730 0 0 47402199 47402199 117001572 84145075 32856497 450395 185342 265053 121421974 100220773 21201201 9946160 9946160 111671110 HOSPITAL FEE/PROVIDER TAX RECEIVABLE 95309368 OTHER ASSETS 2021018 DUE FROM THIRD PARTY 923797 RIGHT OF USE OPERATING LEASES 668227 CHARITABLE GIFT ANNUITIES 579029 99501439 I/C - TAX-EXEMPT BOND LIABILITIES 24010960 OTHER LIABILITIES 12404780 DUE TO THIRD PARTY 4552398 ACCRUED RETIREMENT COMPENSATION 2021016 DUE TO AFFILIATES 1746855 CAPITAL LEASE OBLIGATIONS 1592701 46328710 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS USE ENDOWMENT FUNDS WERE DESIGNED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS. 0 2023 GALA 218092 86412 131680 0 3000 33000 2200 5000 1600 218092 86412 131680 3000 33000 2200 5000 1600 44800 86880 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 3368363 0 3368363 0.00870 143379891 124826983 18552908 0.04810 146748254 124826983 21921271 0.05680 1070522 548158 522364 0.00140 51845 0 51845 0.00010 2080125 0 2080125 0.00540 3202492 548158 2654334 0.00690 149950746 125375141 24575605 0.06370 0 130626404 157188459 -26562055 X 1 0 1 1 ST MARY MEDICAL CENTER 18300 US HIGHWAY 18 APPLE VALLEY CA 92307 WWW.PROVIDENCE.ORG/LOCATIONS 240000207 X X X ST MARY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 23 1 0 0 1 X SEE PART V, SECTION C X 1 23 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 1 PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN SECTION IV OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART V, SECTION B, LINE 5 FOR THE 2023 CHNA, INPUT FROM PEOPLE REPRESENTING THE BROAD AND LOCAL COMMUNITIES (AKA. KEY INFORMANTS) FOR ST. MARY MEDICAL CENTER'S SERVICE AREA WERE SOLICITED. ADDITIONALLY, TO ENSURE ANY COMMUNITY BENEFIT ACTIVITIES RESULTING FROM THE COMPLETION OF 2023 CHNA ADVANCE HEALTH EQUITY WITHIN OUR PRIMARY SERVICE AREA, EFFORTS WERE MADE TO SECURE SURVEY PARTICIPATION FROM PRIMARILY LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS TO UNDERSTAND THE CURRENT HEALTH DISPARITIES.MULTIPLE ATTEMPTS WERE MADE BETWEEN 5/15/23 AND 11/16/2023, RESULTING IN THE COMPLETION OF 471 SURVEYS, ALONG WITH 46 INTERVIEWS CONDUCTED WITH KEY INFORMANTS. FOR COMPARABILITY OF RESPONSES BETWEEN COMMUNITY MEMBERS AND KEY INFORMANTS, THE COMMUNITY WELL-BEING SURVEY WAS ORALLY ADMINISTERED TO KEY INFORMANTS DURING THE INTERVIEW PROCESS. IN ADDITION TO BEING ORALLY ADMINISTERED THE COMMUNITY WELL-BEING SURVEY, KEY INFORMANTS WERE ASKED TO DISCUSS THE FOLLOWING TOPICS: (1) THE TOP HEALTH PROBLEMS IN THE COMMUNITY THEY SERVE AND OBSTACLES TO ADDRESS THEM; (2) THE COMMUNITY STRENGTHS; (3) PRIORITIZATION AND DISCUSSION OF UNMET HEALTH-RELATED NEEDS IN THE COMMUNITY, INCLUDING SOCIAL DETERMINANTS OF HEALTH; (4) SUGGESTIONS FOR HOW TO LEVERAGE COMMUNITY STRENGTHS TO ADDRESS COMMUNITY NEEDS; (5) SUCCESSFUL COMMUNITY HEALTH INITIATIVES AND PROGRAMS, AND (6) OPPORTUNITIES FOR COLLABORATION BETWEEN ORGANIZATIONS TO ADDRESS HEALTH EQUITY. THE 46 COMMUNITY INFORMANTS INTERVIEWED REPRESENTED THE FOLLOWING AGENCIES: INSTITUTE FOR PUBLIC HEALTH STRATEGIES, HIGH DESERT COMMUNITY COALITION, HESPERIA UNIFIED SCHOOL DISTRICT, RESCUE MISSION ALLIANCE - VICTOR VALLEY, HIGH DESERT FOOD COLLABORATIVE, EXCELSIOR CHARTER SCHOOLS - VICTORVILLE, SNOWLINE SCHOOL DISTRICT, LIFE LINE CHURCH OF THE HIGH DESERT, VICTOR VALLEY CHURCH OF CHRIST, CITY OF ADELANTO, ST. JUDE COMMUNITY HEALTH CENTER, GOODWILL SOCAL - VICTORVILLE, FAMILY ASSISTANCE CENTER, SAN BERNARDINO COUNTY EQUITY ELEMENT GROUP, RE-IMAGINING OUR COMMUNITIES OF MILLIONAIRE MIND KIDS, CALIFORNIA HEALTH COLLABORATIVE, TOWN OF APPLE VALLEY, VICTOR VALLEY FAMILY RESOURCE CENTER, HIGHER PRAISE TABERNACLE NORTH, SAN BERNARDINO COUNTY HOMELESS PROVIDER NETWORK, SYMBA CENTER, ROCKING OUR DISABILITIES, HIGH DESERT SECOND CHANCE, PLANNED PARENTHOOD - VICTORVILLE, SAN BERNARDINO COUNTY FIRST DISTRICT SUPERVISOR - PAUL COOK, INLAND EMPIRE HEALTH PLAN, YOUNG VISIONARY YOUTH LEADERSHIP ACADEMY, ST. JOHN OF GOD HEALTHCARE SERVICES, SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH, EL SOL NEIGHBORHOOD EDUCATIONAL CENTER, KINGDOM HALL OF JEHOVAH'S WITNESS, CALVARY CHAPEL APPLE VALLEY, VICTOR VALLEY CHRISTIAN CHURCH, OUR LADY OF THE DESERT, ST. HILARY'S EPISCOPAL CHURCH, HIGH DESERT CHURCH, DESERT COMMUNITIES UNITED WAY, LIFE POINT BAPTIST CHURCH, AZUSA PACIFIC UNIVERSITY, FIRST5 SAN BERNARDINO COUNTY, MOURNING SUN CHILDREN'S FOUNDATION, MOUNTAIN DESERT CAREER PATHWAYS, AND CITY OF VICTORVILLE. SCHEDULE H, PART V, SECTION B, LINE 7A CHNA REPORT WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE "SOUTHERN CALIFORNIA" TAB SCHEDULE H, PART V, SECTION B, LINE 9 THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 30, 2024, IN ACCORDANCE WITH THE INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1). SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE "SOUTHERN CALIFORNIA" TAB SCHEDULE H, PART V, SECTION B, LINE 11 DESPITE COMPLETION OF CHNA IN 2023, THE RESULTING 2024-2026 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) THAT DETAILS HOW ST. MARY MEDICAL CENTER WILL ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED (I.E., ACCESS TO CARE, BEHAVIORAL HEALTH, AND CHRONIC DISEASE MANAGEMENT AND PREVENTION) WAS NOT APPROVED UNTIL APRIL 2024. THE COMMUNITY BENEFIT ACTIVITIES CONDUCTED IN 2023 WERE DRIVEN BY THE SIGNIFICANT HEALTH NEEDS (I.E., ACCESS TO CARE, MENTAL HEALTH, SUBSTANCE USE, AND HOUSING & HOMELESSNESS) IDENTIFIED IN THE 2020 CHNA AND ACTIVITIES OUTLINED IN THE 2021-2023 CHIP.PRIORITY 1: ACCESS TO CAREINCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS TRANSPORTATION, A SHORTAGE OF PROVIDERS, PARTICULARLY SPECIALISTS SUCH AS PEDIATRICIANS, DENTISTS, AND ORTHOPEDISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS. THIS NEED EMERGED AS A CONSISTENT PRIORITY.IN 2023, ACCESS TO CARE WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS:1. ST. MARY MEDICAL CENTER PROVIDED $2,079,093 IN FINANCIAL SUPPORT TO ST. JUDE NEIGHBORHOOD HEALTH CENTERS (IN ADELANTO, APPLE VALLEY & HESPERIA), WHICH PROVIDED HEALTH SERVICES TO 3,077 INDIVIDUALS. ST. JUDE NEIGHBORHOOD HEALTH CENTER IS A HEALTH RESOURCE AND SERVICE ADMINISTRATION-DESIGNATED FEDERALLY QUALIFIED HEALTH CENTER (FQHC). 2. MOTHER/BABY ASSESSMENT CENTER AND LACTATION CLINIC - OUTPATIENT LACTATION SUPPORT WAS PROVIDED TO 2,919 MOTHERS REGARDLESS OF INSURANCE, MEDICAL HOME, AND ABILITY TO PAY. PRIORITY 2: MENTAL HEALTH & SUBSTANCE USECOVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. SUBSTANCE USE PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY. MENTAL HEALTH CHALLENGES CAN IMPEDE PEOPLE'S ABILITIES TO REALIZE THEIR POTENTIAL, COPE WITH STRESSES, WORK PRODUCTIVELY AND FRUITFULLY, AND MAKE CONTRIBUTIONS TO THEIR COMMUNITIES. THESE WERE COMBINED BY THE COMMUNITY BENEFIT COMMITTEE. COMMITTEE MEMBERS DISCUSSED THAT MENTAL HEALTH WILL BE A PRIORITY FOCUS OF PROVIDENCE ST. JOSEPH HEALTH OVER THE NEXT TEN YEARS. MENTAL HEALTH WAS A FREQUENT THEME IN THE 2017 CHNA FOCUS GROUPS AND THE FORUM, PARTICULARLY FOCUSING ON THE STRESSES CAUSED BY ECONOMIC INSECURITY, THE CHALLENGES FACED BY CHILDREN AND TEENS, AND THE LACK OF PROVIDERS. DATA SHOWS THAT THERE ARE RELATIVELY LOW PROVIDERS IN THE COUNTY OF SAN BERNARDINO WHEN COMPARED TO THE STATE.IN 2023, MENTAL HEALTH AND SUBSTANCE USE WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS:1. YOUTH SUICIDE PREVENTION: DUE TO THE EFFORTS OF ST. MARY MEDICAL CENTER IN CY 2021 AND 2022, A REGIONAL LEARNING COLLABORATIVE COMPRISED OF AREA SCHOOL DISTRICTS (I.E., HESPERIA UNIFIED SCHOOL DISTRICT, VICTOR VALLEY UNION HIGH SCHOOL DISTRICT, AND APPLE VALLEY UNIFIED SCHOOL DISTRICT) WAS FORMED IN LATE 2022 AND CONTINUES TO BE FACILITATED BY DESERT MOUNTAIN EDUCATIONAL SERVICES TO GUIDE THE ADOPTION OF SOCIAL EMOTIONAL LEARNING. AS A RESULT OF THE AFOREMENTIONED, A COMMUNITY BENEFIT EXPENSE WAS NOT INCURRED BY THE MEDICAL CENTER IN 2023. 2. EMERGENCY DEPARTMENT SUBSTANCE USE NAVIGATION PROGRAM: LAUNCHED IN APRIL 2022, THE SUBSTANCE USE NAVIGATION CONTINUES TO PROVIDE SUPPORT TO EMERGENCY AND MOTHER BABY DEPARTMENT PATIENTS SEEKING SUBSTANCE USE DISORDER TREATMENT AT ST. MARY MEDICAL CENTER. DUE TO GRANTS RECEIVED AFTER THE PROGRAM'S LAUNCH AND PAY-FOR-PERFORMANCE INCENTIVES RECEIVED FROM INLAND EMPIRE HEALTH PLAN, THE SUBSTANCE USE NAVIGATION PROGRAM COULD NOT BE REPORTED AS A COMMUNITY BENEFIT EXPENSE IN 2023. PRIORITY 3: HOUSING & HOMELESSNESSPRIMARILY FOCUSED ON THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. HOMELESSNESS AND AFFORDABLE HOUSING ARE SIGNIFICANT NEEDS IN OUR COMMUNITIES. HOMELESSNESS HAS A RIPPLE EFFECT THROUGHOUT THE COMMUNITY; IT IMPACTS THE AVAILABILITY OF HEALTHCARE RESOURCES, CRIME AND SAFETY, THE WORKFORCE, AND THE USE OF TAX DOLLARS. AFFORDABLE HOUSING BENEFITS OUR COMMUNITIES AND CREATES STRONGER OUTCOMES - IN EMPLOYMENT, HEALTH AND EDUCATION. SOCIAL DETERMINANTS OF HEALTH, LIKE HOUSING, HAVE A SUBSTANTIAL IMPACT ON HEALTH BEHAVIORS AND HEALTH OUTCOMES. ADDRESSING HOUSING INSTABILITY, HOUSING AFFORDABILITY, AND PREVENTING HOMELESSNESS WILL IMPROVE HEALTH AND THE COMMUNITIES WE SERVE. IN 2023, PROVIDENCE ST. MARY MEDICAL CENTER ADDRESSED HOUSING AND HOMELESSNESS THROUGH: 1. IMPLEMENTATION OF AN EMERGENCY DEPARTMENT HOMELESS NAVIGATOR PROGRAM. A FULL-TIME ED HOMELESS COMMUNITY HEALTH WORKER (CHW) WAS HIRED IN FEBRUARY 2023. A TOTAL OF 87 UNHOUSED INDIVIDUALS WERE ASSISTED BY THE CHW BETWEEN MARCH AND JULY OF 2023, RESULTING IN A TOTAL EXPENSE OF $6,202.2. HOUSING POLICY ADVOCACY. THE MANAGER OF THE COMMUNITY HEALTH INVESTMENT DEPARTMENT WAS AN ACTIVE MEMBER OF THE CITY OF VICTORVILLE'S HOMELESS SOLUTIONS TASKFORCE AND SAN BERNARDINO COUNTY'S DESERT REGION STEERING COMMITTEE.PRIORITY 4: OBESITYPRIMARILY DEFINED AS THE HEALTH CONDITION IN WHICH INDIVIDUALS ARE SUFFICIENTLY OVERWEIGHT AS TO HAVE DETRIMENTAL EFFECTS ON THEIR OVERALL HEALTH. THIS DOES NOT INCLUDE ISSUES OF EXERCISE OR FOOD CHOICES, WHICH ARE LISTED AS SEPARATE ISSUES. OBESITY WAS FREQUENTLY DISCUSSED IN THE 2017 CHNA FOCUS GROUPS, PARTICULARLY IN CONJUNCTION WITH ROOT CAUSES SUCH AS NUTRITION AND LACK OF EXERCISE, WITH CHALLENGES WITH WALKABILITY. IN 2023, ST. MARY MEDICAL CENTER ADDRESSED OBESITY BY BEING A CONTRACTOR OF SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH'S CALFRESH HEALTHY LIVING PROGRAM. THROUGH IMPLEMENTATION OF THIS PROGRAM, 503 LOW-INCOME HIGH DESERT RESIDENTS RECEIVED DIRECT PHYSICAL ACTIVITY AND NUTRITION EDUCATION RESULTING IN A NET COMMUNITY BENEFIT EXPENSE OF $21,096. NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM AS MANY OF THE SIGNIFICANT HEALTH NEEDS (I.E., CANCER, DIABETES, CEREBROVASCULAR & CARDIOVASCULAR HEALTH, OBESITY AND RESPIRATORY HEALTH) IDENTIFIED IN THE 2023 CHNA HAVE THE SAME COMMON MODIFIABLE (I.E., UNHEALTHY DIET, PHYSICAL INACTIVITY, AND NICOTINE PRODUCT USE) AND INTERMEDIATE RISK FACTORS (I.E., RAISED BLOOD PRESSURE, ELEVATED GLUCOSE, ABNORMAL BLOOD LIPIDS, AND OVERWEIGHT/OBESITY), THE COMMUNITY HEALTH COMMITTEE AGREED TO FOCUS ON CHRONIC DISEASE PREVENTION AND TREATMENT. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 24 IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE. 1 1 - PROVIDENCE ST MARY MEDICAL CENTER 11965 CACTUS RD STE J ADELANTO CA 923014907 SPECIALTY CLINIC PART I, LINE 3C: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. PART I, LINE 6A: ST. MARY MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLYAVAILABLE ATHTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/SOCAL/ST-MARY-MEDICAL-CENTER/ABOUT-US/COMMUNITY-BENEFIT PART I, LINE 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO AND GENERAL LEDGER. PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. PART III, LINE 4: AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019. PART III, LINE 8: COMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. PART III, LINE 9B: COLLECTION ACTIVITYOUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY. PART VI, LINE 2: A HIGH DESERT GEOGRAPHIC GAP ANALYSIS WAS CONDUCTED IN 2020. THE PURPOSE OF THE ANALYSIS WAS TO INFORM AMBULATORY PLANNING IN THE SPECIFIED HIGH DESERT AREA WITH ANALYSES OF THE REGION'S DEMOGRAPHICS AND DEMAND FOR HEALTH CARE SERVICES. THE ANALYSIS PROPOSED TO UNDERSTAND THE POPULATION'S DISTRIBUTION AND CHARACTERISTICS, ESTIMATE CURRENT SERVICE USE RATES FOR SELECTED OUTPATIENT SERVICES, AND COMPARE THE CURRENT DEMAND AND SUPPLY OF PHYSICIANS IN THE REGION. FURTHERMORE, PROJECT THE DEMAND FOR SPECIFIED OUTPATIENT SERVICES ASSOCIATED WITH MARKET SHARE TARGETS, AND TRANSLATE VOLUME PROJECTIONS INTO ASSET AND SPACE ESTIMATES. FINDINGS INCLUDE THE AREA'S POPULATION IS PROJECTED TO GROW BY OVER 20,000 OVER THE NEXT 5 YEARS WITH THE LARGEST GROWTH RATES IN THE AGED 65+ COHORT. DISPROPORTIONATE NEED FOR PHYSICIAN SPECIALTIES, FAMILY MEDICINE AND INTERNAL MEDICINE, AND ANCILLARY SERVICES. THIS DATA WILL BE CRITICAL IN DETERMINING HOW BEST TO ADDRESS UNMET NEEDS AND HEALTH EQUITY AMONG THE HIGH DESERT POPULATION. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE.PROVIDENCE ENSURES THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES. TRAINING IS PROVIDED TO STAFF MEMBERS (I.E., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS.WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, PROVIDENCE ATTEMPTS TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.PROVIDENCE SHARES THEIR FINANCIAL ASSISTANCE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS. PART VI, LINE 4: COMMUNITY INFORMATIONST. MARY MEDICAL CENTER PROVIDES THE VICTOR VALLEY AND BARSTOW COMMUNITIES WITH ACCESS TO ADVANCED CARE. THE FACILITY IS THE ONLY PROVIDENCE ST. JOSEPH HEALTH HOSPITAL OPERATING IN SAN BERNARDINO COUNTY AND THE ONLY NON-PROFIT HOSPITAL IN THE HIGH DESERT REGION. THE HOSPITAL'S TOTAL SERVICE AREA EXTENDS FROM HIGHWAY 58 AND THE I-15 FREEWAY IN THE NORTH, HIGHWAY 395 AND THE I-15 FREEWAY IN THE SOUTH, UNINCORPORATED COMMUNITIES INCLUDING LUCERNE VALLEY IN THE EAST AND UNINCORPORATED COMMUNITIES OF EL MIRAGE IN THE WEST. OUR HOSPITAL'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF ADELANTO, APPLE VALLEY, BARSTOW, HESPERIA, ORO GRANDE, VICTORVILLE, AND SEVERAL SMALLER UNINCORPORATED COMMUNITIES (I.E., HELENDALE, LUCERNE VALLEY, OAK HILLS, PHELAN, SNOWLINE, AND WRIGHTWOOD). TOTAL SERVICE AREA:THE 2023 CHNA WAS PREPARED TO IDENTIFY THE HEALTH NEEDS IN PROVIDENCE ST. MARY MEDICAL CENTER'S PRIMARY SERVICE AREA. A ZIP CODE WAS IDENTIFIED TO BE WITHIN OUR PRIMARY SERVICE AREA (AKA. HIGH NEED AREA) IF 70% OR MORE INPATIENT ADMISSIONS WERE RECEIVED FROM A PARTICULAR ZIP CODE DURING THE PRECEDING FISCAL YEAR. AS SUCH, THE PRIMARY SERVICE AREA FOR PROVIDENCE ST. MARY MEDICAL CENTER FOR THE 2023 CHNA IS COMPRISED OF THE FOLLOWING 13 ZIP CODES: ADELANTO (92301), APPLE VALLEY (92307 & 92308), HELENDALE (92342), HESPERIA (92344 & 92345), LUCERNE VALLEY (92356), ORO GRANDE (92368), PHELAN (92371), PINON HILLS (92372) AND VICTORVILLE (92392, 92394 & 92395). THE TOTAL POPULATION FOR THE NINE TOWNS AND CITIES THAT COMPRISE PROVIDENCE ST. MARY MEDICAL CENTER'S SERVICE AREA IN 2021, WAS ESTIMATED AT 419,075.POPULATION AND AGE DEMOGRAPHICS:THE POPULATION IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA MAKES UP 19% OF SAN BERNARDINO COUNTY. BY 2030, THE CALIFORNIA DEPARTMENT OF FINANCE ESTIMATES THAT ONE IN FOUR CALIFORNIANS WILL BE 60 YEARS AND OLDER. DESPITE THIS, THE SERVICE AREA IS AGING AT A SLOWER RATE EVIDENT BY: (A) 11.8% INDIVIDUALS 65 YEARS AND OLDER COMPARED TO THE STATE (14.4%); (B) 29.7% OF INDIVIDUALS AGED 0-17 COMPARED TO COUNTY (26.4%) AND STATE (22.8%); AND (C) MEDIAN AGE FALLING BELOW THE STATE (37 YRS.), APART FROM LUCENCE VALLEY (40.2 YRS.) AND HELENDALE (42.1 YRS.) IN 2021. POPULATION BY RACE AND ETHNICITY: INDIVIDUALS WHO IDENTIFY AS HISPANIC, "OTHER" RACE, AND BLACK ARE MORE LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS. PEOPLE IDENTIFYING AS ASIAN AND WHITE ARE LESS LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS. ACCORDING TO THE U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY 2017-2021 POPULATION ESTIMATES, THE RACIAL AND ETHNIC COMPOSITION OF ST. MARY MEDICAL CENTER IS: 36.8% WHITE, 7% BLACK, 0.31% AMERICAN INDIAN/ALASKA NATIVE, 3.5% ASIAN, 0.22% NATIVE HAWAIIAN/ PACIFIC ISLANDER, 4.4% TWO OR MORE RACES, AND 47.6% HISPANIC/LATINO.SOCIOECONOMIC INDICATORS:THE POPULATION IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA IS MORE LIKELY TO BE AT OR BELOW 200% FPL COMPARED TO SAN BERNARDINO COUNTY OVERALL, INCLUDING NEARLY 60% OF HOUSEHOLDS IN THE "HIGH NEED SERVICE AREA". THE MEDIAN INCOME IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA IS ALMOST $8,000 LOWER THAN THAT OF THE COUNTY OVERALL. THE MEDIAN INCOME FOR HOUSEHOLDS IN THE HIGH NEED CENSUS TRACTS ARE APPROXIMATELY $20,000 LOWER THAN THE "BROADER SERVICE AREA".HOUSING COST BURDEN:SEVERE HOUSING COST BURDEN REPRESENTS HOUSEHOLDS THAT SPEND 50% OR MORE OF THEIR INCOME ON HOUSING COSTS. A SLIGHTLY GREATER PROPORTION OF RENTER HOUSEHOLDS ARE SEVERELY HOUSING COST BURDENED IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA COMPARED TO SAN BERNARDINO COUNTY. ON AVERAGE, ABOUT 31% OF HOUSEHOLDS IN THE TOTAL SERVICE AREA ARE SEVERELY BURDENED BY HOUSING COST. IN THE "HIGH NEED SERVICE AREA", 35% OF RENTER HOUSEHOLDS ARE SEVERELY HOUSING COST BURDENED, COMPARED TO 26% IN THE "BROADER SERVICE AREA".HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND MEDICALLY UNDERSERVED AREAS (MUA) & MEDICALLY UNDERSERVED POPULATIONS (MUP):THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA) DEMOGRAPHICS (I.E., LOW-INCOME POPULATION) OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). ST. MARY MEDICAL CENTER IS LOCATED IN A REGION LISTED AS A MEDICAL HEALTH PROFESSIONAL SHORTAGE AREA FOR PRIMARY CARE AND MENTAL HEALTH.MEDICALLY UNDERSERVED AREAS (MUA) AND MEDICALLY UNDERSERVED POPULATIONS (MUP) ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MUA ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDERSERVICE". MUP ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MUA AND MUP ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. THE AREA WEST OF THE HOSPITAL INCLUDING PORTIONS OF VICTORVILLE AND ADELANTO ARE DESIGNATED MUAS, SIGNIFYING THE IMPORTANCE OF ST. MARY MEDICAL CENTER TO THE COMMUNITY IT SERVES. OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITAL IN THE COMMUNITY INCLUDE: DESERT VALLEY HOSPITAL, KPC HEALTH - VICTOR VALLEY GLOBAL MEDICAL CENTER, AND BARSTOW COMMUNITY HOSPITAL. ST. MARY MEDICAL CENTER IS THE ONLY NON-PROFIT HOSPITAL IN THE ENTIRE HIGH DESERT REGION. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHST. MARY MEDICAL CENTER PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. ST. MARY MEDICAL CENTER IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1. A COMMUNITY HEALTH COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES.2. OPEN MEDICAL STAFF.3. ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. PLEASE SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.LOCAL COMMUNITY HEALTH COMMITTEE:THE ROLE OF THE ST. MARY MEDICAL CENTER'S COMMUNITY HEALTH COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE COMMUNITY HEALTH COMMITTEE ACTS IN ACCORDANCE WITH A BOARD APPROVED CHARTER. THE COMMUNITY HEALTH COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS "IDENTIFIED SIGNIFICANT NEEDS" IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES.THE COMMUNITY HEALTH COMMITTEE HAS A MINIMUM OF EIGHT (8) MEMBERS INCLUDING THREE (3) MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES FIVE (5) MEMBERS OF THE BOARD OF TRUSTEES AND FIVE (5) COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY HEALTH COMMITTEE GENERALLY MEETS BIYEARLY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WAAS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTINVESTING IN OUR COMMUNITIES IS AN ESSENTIAL WAY WE LIVE OUR MISSIONFOR GENERATIONS, THE PROVIDENCE FAMILY OF ORGANIZATIONS HAS SERVED AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. GUIDED BY COMMUNITY HEALTH NEEDS ASSESSMENTS, WE CONTINUE OUR LONGSTANDING COMMITMENT TO THOSE IN NEED THROUGH COMMUNITY BENEFIT AND OTHER HIGH-IMPACT INVESTMENTS. OUR INVESTMENTS GO BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS AND DEEP INTO COMMUNITIES TO SUPPORT ORGANIZATIONS AND CAUSES THAT SERVE THOSE IN NEED; ADDRESS GAPS IN SERVICES AND RESOURCES THAT CONTRIBUTE TO OVERALL HEALTH; AND ENHANCE CARE DELIVERY WITH INNOVATIVE SOLUTIONS TO HEALTH CARE'S BIGGEST CHALLENGES. THIS IS HOW WE INVEST IN HEALTH TODAY TO CREATE A BETTER FUTURE. BELOW WE HIGHLIGHT KEY EXAMPLES.ST. JOSEPH COMMUNITY PARTNERSHIP FUND SINCE 1986, THE ST. JOSEPH COMMUNITY PARTNERSHIP FUND HAS MADE INVESTMENTS AND BUILT PARTNERSHIPS IN THE CALIFORNIA COMMUNITIES SERVED BY ST. JOSEPH HEALTH MINISTRIES. AFTER 35 YEARS, WE HAD THE OPPORTUNITY TO EXPAND OUR FOCUS AND SUPPORT PROGRAMS AND COMMUNITIES THROUGHOUT PROVIDENCE. TODAY, THE FUND REPRESENTS PROVIDENCE'S SHARED COMMITMENT TO SOLVING COMPLEX CHALLENGES AND BUILDING VIBRANT, HEALTHY COMMUNITIES. WE DO THIS BY BUILDING CAPACITY AND CREATING LINKAGES ACROSS THE COMMUNITIES PROVIDENCE SERVES. THIS HELPS US MAXIMIZE THE DIRECT IMPACT OF OUR INVESTMENTS AND ADDRESS COMMON ISSUES THAT AFFECT PEOPLE THROUGHOUT OUR SYSTEM. THE ST. JOSEPH COMMUNITY PARTNERSHIP FUND SERVES AS PROVIDENCE'S STRATEGIC GRANT MAKING FOUNDATION FOR FUNDING KEY SYSTEM AND REGIONAL INITIATIVES IN THE AREAS OF HOUSING, EDUCATION, DISASTER RESPONSE AND RECOVERY, AND NONPROFIT AND COMMUNITY CAPACITY BUILDING. THROUGH THE FUND WE INCUBATE AND ACCELERATE PROGRAMS THAT CREATE SCALABLE IMPACT IN OUR COMMUNITIES TO IMPROVE THE HEALTH AND WELLBEING OF THE ECONOMICALLY POOR, UTILIZE THE STRENGTHS AND DIVERSITY OF OUR NEIGHBORS TO BUILD VIBRANT COMMUNITIES AND LEVERAGE BEST PRACTICES AND LESSONS LEARNED FROM THESE INVESTMENTS TO EXPAND TO COMMUNITIES ACROSS OUR GEOGRAPHICAL FOOTPRINT. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/COMMUNITY-PARTNERSHIPS/ST-JOSEPH-COMMUNITY-PARTNERSHIP-FUND HEALTH EQUITY CHANGE BEGINS WITH USAT PROVIDENCE, WE RECOGNIZE THAT INEQUITY PERSISTS IN NEARLY EVERY MAJOR FACET OF SOCIETY. THAT INCLUDES IN HEALTH CARE AND THE SOCIAL DETERMINANTS OF HEALTH. AND THE CONSEQUENCES ARE OFTEN DEADLY, LEADING TO HIGHER MORTALITY AND MORBIDITY RATES FOR COMMUNITIES OF COLOR AND MARGINALIZED POPULATIONS. TOWARD THAT END:-WE ARE INVESTING $50 MILLION OVER FIVE YEARS TO IMPROVE HEALTH EQUITY IN OUR COMMUNITIES. OUR HEALTH EQUITY STRAT12EGIC PLAN AND INTERVENTIONS ARE INFORMED BY ADVANCED DATA ANALYTICS AND THE HEALTH PRIORITIES IDENTIFIED WITH OUR LOCAL COMMUNITY PARTNERS AND CARE TEAMS.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/HEALTH-EQUITYADVOCACY AND SOCIAL RESPONSIBILITY IN PARTNERSHIP WITH COMMUNITIES, THE PROVIDENCE FAMILY OF ORGANIZATIONS ADVOCATES FOR RESPONSIBLE, SUSTAINABLE, AND EQUITABLE POLICIES AND PRACTICES. WE REACH BEYOND THE WALLS OF HOSPITALS AND CARE FACILITIES TO WORK WITH LOCAL, STATE AND NATIONAL PARTNERS TO ADVANCE POLICIES TO SERVE VULNERABLE POPULATIONS AND PROMOTE JUSTICE. WE ALSO PARTNER TO PROMOTE PRACTICES AND INFRASTRUCTURE THAT WILL SUSTAIN THE PLANET FOR FUTURE GENERATIONS AND TRANSFORM OUR COMMUNITIES FOR A HEALTHIER, MORE EQUITABLE WORLD.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ADVOCACY-AND-SOCIAL-RESPONSIBILITY ENVIRONMENTAL STEWARDSHIP THE PROVIDENCE FAMILY OF ORGANIZATIONS HAS A VISION OF HEALTH FOR A BETTER WORLD. AS SUCH, WE ARE CALLED TO CARE WISELY FOR OUR COMMUNITIES, RESOURCES, AND EARTH. OUR ORGANIZATIONS STRIVE TO BECOME CARBON NEGATIVE BY 2030. THIS BOLD COMMITMENT GOES BEYOND ADDRESSING CARBON EMISSIONS. THE CLIMATE CRISIS CANNOT BE SOLVED WITHOUT ALSO RESPONDING TO SOCIAL AND RACIAL INEQUITIES.WE ARE COMMITTED TO HEALTH EQUITY, INCLUDING ENVIRONMENTAL EQUITY, AS CLIMATE CHANGE IMPACTS WORSEN, AND DISPARITIES AND INEQUITIES WIDEN DUE TO HISTORICAL AND STRUCTURAL CAUSES OF OPPRESSION.THE CURRENT CRISIS CALLS FOR US TO ACT BOLDLY, WITH COMPASSION. WE ARE DOING SO BY HELPING TO CARE FOR OUR COMMON HOME, ENSURING EQUITY TODAY, AND PASSING A HEALTHY PLANET TO THE GENERATIONS OF TOMORROW.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ADVOCACY-AND-SOCIAL-RESPONSIBILITY/ENVIRONMENTAL-STEWARDSHIP WELL BEING TRUST PROVIDENCE'S WELL BEING TRUST IS A FOUNDATION DEDICATED TO ADVANCING THE MENTAL, SOCIAL, AND SPIRITUAL HEALTH FOR ALL. WITH A BOLD MISSION, VISION AND OVERARCHING GOAL, WELL BEING TRUST IS INVESTING IN APPROACHES THAT HAVE THE POTENTIAL TO MODEL THE WAY FORWARD AND ADVANCE CLINICAL, COMMUNITY AND CULTURAL CHANGETO TRANSFORM THE HEALTH OF THE NATION AND IMPROVE WELL-BEING FOR EVERYONE.FOR MORE INFORMATION GO TO: HTTPS://WELLBEINGTRUST.ORG/ABOUT/ PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 ST JUDE NEIGHBORHOOD HEALTH CENTERS 731 S HIGHLAND AVENUE FULLERTON CA 92832 453977605 501(C)(3) 0 2079093 OPPERATIONAL SUPPORT 1 0 PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. 1 1 0 0 0 0 0 1 0 JO ANN ESCASA-HAIGH FRMR ASSISTANT TREASURER 0 44915 0 1744873 0 1502009 0 8269 0 2485 0 3302551 0 603250 JIM WATSON ESQ SECRETARY 0 480026 0 399066 0 89599 0 107204 0 39727 0 1115622 0 64477 RANDY CASTILLO TRUSTEE/CEO 0 452716 0 375937 0 86060 0 87628 0 32424 0 1034765 0 61014 JIM MARTIN ASSISTANT TREASURER (PART YEAR) 0 435246 0 339361 0 54321 0 83489 0 32146 0 944563 0 52013 GENE GUTIERREZ CHIEF FINANCIAL OFFICER 0 352339 0 53000 0 3548 0 17493 0 41977 0 468357 0 0 JOHN KOZYRA EXECUTIVE DIRECTOR ACUTE CARE OPS. 221376 0 37312 0 22512 0 14160 0 40413 0 335773 0 0 0 FE NAVARRETE ACUTE CARE RN 243708 0 22450 0 9947 0 25508 0 30683 0 332296 0 0 0 NARCISO VIZCARRA ACUTE CARE RN 244250 0 23400 0 11797 0 18035 0 27941 0 325423 0 0 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 266681 0 24827 0 1367 0 15474 0 15372 0 323721 0 0 KEVIN PARK CHIEF MEDICAL OFFICER HOSPITAL 203532 0 50000 0 21675 0 12293 0 23422 0 310922 0 0 0 RAVNEET KAUR ACUTE CARE RN 234360 0 20950 0 10248 0 14065 0 16536 0 296159 0 0 0 SHARON BROWN COO SMMC - THRU 7/23 150555 0 31857 0 11425 0 2975 0 20358 0 217170 0 0 0 PART I, LINE 1A PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN 2023: JO ANN ESCASA-HAIGH - $811,814 ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: JO ANN ESCASA-HAIGH - $603,250 JIM WATSON, ESQ - $64,477 RANDY CASTILLO - $61,014 JIM MARTIN - $52,013 PART I, LINE 7 NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE - BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID - IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE - THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) PRIORITY 3: HOUSING & HOMELESSNESS PRIMARILY FOCUSED ON THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTING HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. HOMELESSNESS AND AFFORDABLE HOUSING ARE SIGNIFICANT NEEDS IN OUR COMMUNITIES. HOMELESSNESS HAS A RIPPLE EFFECT THROUGHOUT THE COMMUNITY; IT IMPACTS THE AVAILABILITY OF HEALTHCARE RESOURCES, CRIME AND SAFETY, THE WORKFORCE, AND THE USE OF TAX DOLLARS. AFFORDABLE HOUSING BENEFITS OUR COMMUNITIES AND CREATES STRONGER OUTCOMES IN EMPLOYMENT, HEALTH AND EDUCATION. SOCIAL DETERMINANTS OF HEALTH, LIKE HOUSING, HAVE A SUBSTANTIAL IMPACT ON HEALTH BEHAVIORS AND HEALTH OUTCOMES. ADDRESSING HOUSING INSTABILITY, HOUSING AFFORDABILITY, AND PREVENTING HOMELESSNESS WILL IMPROVE HEALTH AND THE COMMUNITIES WE SERVE. IN 2023, HOUSING AND HOMELESSNESS WAS ADDRESSED BY: 1. HOMELESS NAVIGATION PROGRAM - A FULL-TIME HOMELESS COMMUNITY HEALTH WORKER WAS HIRED IN FEBRUARY 2023. BY THE END OF THE FISCAL YEAR, 87 UNHOUSED INDIVIDUALS WHO PRESENTED IN THE EMERGENCY DEPARTMENT WERE PROVIDED SUPPORT BY THE HOMELESS COMMUNITY HEALTH WORKER. 2. HOUSING POLICY ADVOCACY - THE MANAGER OF COMMUNITY HEALTH INVESTMENTS IS AN ACTIVE MEMBER OF THE CITY OF VICTORVILLE'S HOMELESS SOLUTIONS TASK FORCE AND SAN BERNARDINO COUNTY'S DESERT REGION STEERING COMMITTEE THAT MEETS MONTHLY. PRIORITY 4: OBESITY IS PRIMARILY DEFINED AS THE HEALTH CONDITION IN WHICH INDIVIDUALS ARE SUFFICIENTLY OVERWEIGHT TO HAVE DETRIMENTAL EFFECTS ON THEIR OVERALL HEALTH. THIS DOES NOT INCLUDE ISSUES OF EXERCISE OR FOOD CHOICES, WHICH ARE LISTED AS SEPARATE ISSUES. OBESITY WAS FREQUENTLY DISCUSSED IN THE 2017 CHNA FOCUS GROUPS, IN CONJUNCTION WITH ROOT CAUSES SUCH AS NUTRITION AND LACK OF EXERCISE, WITH CHALLENGES WITH WALKABILITY. IN 2023, OBESITY WAS ADDRESSED BY SMMC THROUGH IMPLEMENTATION OF CALFRESH HEALTHY LIVING PROGRAM, FURTHERED BY A GRANT RECEIVED FROM SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH. A TOTAL OF 503 HIGH DESERT RESIDENTS RECEIVED DIRECT OR INDIRECT NUTRITION EDUCATION. AS PART OF THE AFOREMENTIONED EFFORTS, ASSISTANCE ENROLLING WITH CALFRESH WAS PROVIDED BY CALFRESH GRANT STAFF. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/SOCAL/ST-MARY-MEDICAL-CENTER FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ST. MARY MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. MARY MEDICAL CENTER HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT THE ST. MARY MEDICAL CENTER'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE ST. MARY MEDICAL CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER AND ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, REVISED IN 2023, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY CORE LEADERS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS RECUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE A PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN JUNE 2024. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. FORM 990, PART IX, LINE 11G AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 20,984,592. MANAGEMENT AND GENERAL EXPENSES 661,393. FUNDRAISING EXPENSES 69,186. TOTAL EXPENSES 21,715,171. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 5,137,291. MANAGEMENT AND GENERAL EXPENSES 161,917. FUNDRAISING EXPENSES 16,937. TOTAL EXPENSES 5,316,145. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 22,444,246. MANAGEMENT AND GENERAL EXPENSES 707,398. FUNDRAISING EXPENSES 73,998. TOTAL EXPENSES 23,225,642. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 9,986,870. MANAGEMENT AND GENERAL EXPENSES 314,766. FUNDRAISING EXPENSES 32,926. TOTAL EXPENSES 10,334,562. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 4,768,418. MANAGEMENT AND GENERAL EXPENSES 150,291. FUNDRAISING EXPENSES 15,721. TOTAL EXPENSES 4,934,430. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 104,291. OTHER CHANGES IN NET ASSETS -74,108. 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