2025-05-14T08:46:41-05:00 2024-06-30 135565207 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2023-07-01 465322209 PORT CITY OPERATING COMPANY LLC PORT 2099432000 3400 DATA DRIVE RANCHO CORDOVA CA 95670 NIKKI OCHOA CFO 2094676442 2025-05-14 1 1 JAMES R LANCASTER P00742579 4159635100 2023 2025-03-06 01:10:19Z DONALD WILEY 3400 DATA DRIVE RANCHO CORDOVA CA 95670 1217943172 0 X WWW.DIGNITYHEALTH.ORG X 2014 CA AS AN AFFILIATE OF COMMONSPIRIT HEALTH ("COMMONSPIRIT"), PORT CITY OPERATING COMPANY, LLC, ("PORT CITY") IS COMMITTED TO MAKE THE HEALING PRESENCE OF GOD KNOWN BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 7 3 0 144 2702248 0 10641257 5634672 751145063 852606532 7997509 15997511 14763718 4380453 784547547 878619168 16894311 13316097 0 0 0 0 0 0 0 709829992 791990434 726724303 805306531 57823244 73312637 808946654 958255865 151799057 202181700 657147597 756074165 X PORT CITY LLC IS COMMITTED TO FURTHERING THE CHARITABLE AND COMMUNITY-BASED HEALTH CARE PURPOSES, MISSION, VISION AND CORE VALUES OF DIGNITY HEALTH AND KAISER FOUNDATION HOSPITALS BY PROMOTING HEALTH AND PROVIDING AND EXPANDING ACCESS TO HEALTH CARE SERVICES FOR A BROAD CROSS-SECTION OF THE INDIVIDUALS WHO RESIDE IN STOCKTON, CALIFORNIA AND THE SURROUNDING COMMUNITIES. 0 0 671889709 13316097 806619229 ST. JOSEPH'S MEDICAL CENTER (SJMC) OPERATES AND IS LICENSED AT THE SAME LEVEL WITH THE STATE OF CALIFORNIA, SERVING THE COUNTY OF SAN JOAQUIN AND OUTLYING AREAS. SJMC IS A 355-BED LICENSED ACUTE CARE FACILITY, PROVIDING GENERAL MEDICAL/ SURGICAL CARE, OBSTETRICS, NEONATAL ICU, EMERGENCY SERVICES, CANCER SERVICES, WITH SPECIALITIES IN CARDIAC SURGERY AND CARDIOVASCULAR CARE, RESPIRATORY, AND ORTHOPEDICS. THERE ARE NUMEROUS ANCILLARY AND OUTPATIENT SUPPORT SERVICES. PORT CITY IS COMMITTED TO FURTHERING THE CHARITABLE AND COMMUNITY-BASED HEALTH CARE PURPOSES, MISSION, VISION AND CORE VALUES OF DIGNITY HEALTH AND KAISER FOUNDATION HOSPITALS BY PROMOTING HEALTH AND PROVIDING AND EXPANDING ACCESS TO HEALTH CARE SERVICES FOR A BROAD CROSS-SECTION OF THE INDIVIDUALS WHO RESIDE IN STOCKTON, CALIFORNIA AND THE SURROUNDING COMMUNITIES. 32683186 30840592 ST. JOSEPH'S BEHAVIORAL HEALTH CENTER (BHC) OPERATES AND IS LICENSED AT THE SAME LEVEL WITH THE STATE OF CALIFORNIA, SERVING THE COUNTY OF SAN JOAQUIN AND OUTLYING AREAS. BHC IS A 35 BED ACUTE PSYCHIATRIC AND CHEMICAL DEPENDENCY HOSPITAL, PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES. 9781074 14436438 ST. JOSEPH'S MEDICAL CENTER HOME HEALTH (SJHHA) OPERATES AND IS LICENSED AS A HOSPITAL BASED HOME HEALTH AGENCY WITH THE STATE OF CALIFORNIA. SJHHA PROVIDES SKILLED NURSING CARE SERVICES, SOCIAL SERVICES, OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPIES, AS WELL AS HOME HEALTH AIDES. 714353969 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 115 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 3 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 1 CA X LARA CARTOSCELLI ACCOUNTING DEPT 9166313334 3400 DATA DRIVE RANCHO CORDOVA CA 95670 X JULIE SPRENGEL BOARD MEMBER (THRU 3/28/24) 2.00 50.00 X 0 4257621 94843 JOHN E PETERSDORF VICE CHAIR/ SECRETARY 2.00 50.00 X X 0 2089747 992820 DONALD J WILEY PRESIDENT AND CEO 50.00 4.00 X 0 1201824 425608 ROBERT QUINN MD BOARD MEMBER 2.00 50.00 X 0 1244617 108608 BENJAMIN BJ PREDUM BOARD MEMBER 2.00 50.00 X 0 805053 91617 SUE PIETRAFESO BOARD MEMBER 2.00 50.00 X 0 642456 57683 ANDREA NIKKI OCHOA CHIEF FINANCIAL OFFICER 45.00 5.00 X 0 354685 65952 MARTY ARDRON BOARD MEMBER 2.00 0.00 X 0 0 0 APHRIEKAH DUHANEY-WEST BOARD MEMBER 2.00 0.00 X 0 0 0 DEBRA CUNNINGHAM CHAIR 2.00 0.00 X X 0 0 0 0 10596003 1837131 0 0 1 0 ANESTHESIA SRV OF SAN JOAQUIN 450 MAMARONECK AVE HARRISON NY 10528 MEDICAL/PHYSICIAN SERVICES 11891119 INPATIENT SPECIALISTS OF CALIF PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL/PHYSICIAN SERVICES 8423882 MEDICAL SOLUTIONS LLC 1010 N 102ND ST OMAHA NE 68114 STAFFING SERVICES 8321851 TOURO UNIVERSITY MEDICAL GROUP 1805 N CALIFORNIA ST STOCKTON CA 95204 MEDICAL/PHYSICIAN SERVICES 7055288 SAN JOAQUIN CRITICAL CARE 1801 E MARCH LANE STE C300 STOCKTON CA 95210 MEDICAL/PHYSICIAN SERVICES 3218122 90 4480525 506820 647327 14864 5634672 PATIENT NET OF CHARITY 900099 523715934 523715934 MEDICARE / MEDICAID PA 900099 325501761 325501761 STUDENT ROTATIONS 900099 1018065 1018065 PROGRAM RELATED RENTAL 900099 733196 733196 LABORATORY 621500 710273 710273 927303 927303 852606532 6061751 6061751 138902 0 138902 138902 138902 349132405 127359 339324004 0 9808401 127359 9935760 9935760 MANAGEMENT SERVICE AGR 561000 1991975 1991975 CAFETERIA 722514 1411888 1411888 AR FINANCE CHARGES 900099 289268 289268 548420 548420 4241551 878619168 851896259 2702248 18385989 X 13238205 13238205 77892 77892 1074171 1074171 36346 36346 986230 986230 556129795 499659627 56470168 1872344 24952 1847392 11241224 10542694 698530 28195651 468930 27726721 8952801 8828544 124257 523113 297772 225341 357827 340372 17455 3071985 3071985 22802245 22802245 4979186 4979186 MEDICAL SUPPLIES 78209787 78209787 MED-CAL PROVIDER FEE 66329849 66329849 FOOD COST 3584066 3564330 19736 UBI TAXES PAID 20000 0 20000 3623814 1917599 1706215 805306531 714353969 90952562 0 2690 2690 64141902 52225859 2898776 2394213 94888613 97404627 0 0 1239422 1127045 8054921 8132859 72198834 81863793 317732550 97623581 226375012 220108969 120141300 147672678 194152914 273446666 1920910 2435956 10310000 10310000 12621360 61130510 808946654 958255865 71378941 108791024 175475 306829 6218692 6089287 74025949 86994560 151799057 202181700 X 656711475 755540985 436122 533180 657147597 756074165 808946654 958255865 X 73312637 21875178 -3850 3742603 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 2086 0 0 0 0 1 34260 36346 0 PART II-B, LINE 1: SCHEDULE C, PART II - B, LINE 1D PORT CITY ENGAGED IN LETTER-WRITING CAMPAIGNS, CO-SPONSORSHIP CAMPAIGNS, EDUCATION WITH MEMBERS OF CONGRESS, AND OTHER LOBBYING ACTIVITIES AIMED AT INFLUENCING PUBLIC POLICY. THIS IS DONE PRIMARILY THROUGH EMPLOYED DIVISION-LEVEL ADVOCACY LEADERS WITH LEADERSHIP AND GUIDANCE FROM NATIONAL EMPLOYEES. DRAFT LETTERS WERE PROVIDED ON THE ORGANIZATION'S ADVOCACY PRIORITIES; DIVISION-EMPLOYED ADVOCACY LEADERS WERE ABLE TO CREATE THEIR OWN LETTERS AS WELL. THE ORGANIZATION COMMUNICATES WITH LEADERS OF THE SYSTEM'S HOSPITALS AND HEALTH CARE ORGANIZATIONS ON ADVOCACY ACTIVITIES PRIMARILY THROUGH E-MAIL. MOST COMMUNICATIONS WITH CONGRESS OCCUR THROUGH EMAIL AND PHONE. ADVOCACY ACTIVITIES INVOLVED COMMUNICATIONS ON THE ORGANIZATION'S ADVOCACY PRIORITIES, INCLUDING ISSUES RELATED TO ACCESS AND COVERAGE FOR ALL, HOSPITAL AND HEALTH PROVIDER REIMBURSEMENT, COVID-19 RELIEF FOR INDIVIDUALS AND HEALTH ENTITIES, PHYSICIAN AND NURSING SHORTAGES, AND SOCIAL JUSTICE ISSUES (E.G. ENVIRONMENTAL STEWARDSHIP, HOUSING). CENTRAL TO THE ORGANIZATION'S MISSION AND VISION IS A COMMITMENT TO ADVOCATE FOR SYSTEMIC CHANGES TO IMPROVE THE HEALTH AND WELL-BEING OF INDIVIDUALS AND COMMUNITIES WITH A SPECIFIC CONCERN FOR PERSONS WHO ARE POOR AND MARGINALIZED. THE HOSPITAL'S ADVOCACY ACTIVITIES ARE INEXTRICABLY LINKED TO ITS FUNDAMENTAL GOAL TO BUILD HEALTHIER COMMUNITIES. ONE DIMENSION OF THE ORGANIZATION'S ADVOCACY PROGRAM FOCUSES ON PUBLIC POLICY ADVOCACY, WHICH INCLUDES ATTENTION TO FEDERAL LEGISLATIVE AND REGULATORY MEASURES, FORMATION OF POSITIONS ON PRIORITY ISSUES, AND POLITICAL ACTIVISM. THE COMMONSPIRIT HEALTH PUBLIC POLICY AGENDA INCLUDES BOTH TRADITIONAL HEALTH CARE POLICIES (E.G., PAYMENT ISSUES, QUALITY AND SAFETY, ETC.) AS WELL AS SOCIAL JUSTICE POLICIES. SCHEDULE C, PART II - B, LINE 1I LOBBYING EXPENDITURES PAID DIRECTLY BY THE FILING ORGANIZATION FOR ANNUAL MEMBERSHIP DUES: 340 B HEALTH: $311 ALLIANCE OF CATHOLIC HEALTHCARE: $3,802 AMERICAN ACADEMY OF FAMILY PHYSICIANS: $130 AMERICAN COLLEGE OF CARDIOLOGY: $17 AMERICAN COLLEGE OF EMERGENCY PHYSICIANS: $341 AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES: $7 AMERICAN COLLEGE OF PHYSICIANS: $535 AMERICAN HEART ASSOCIATION: $198 AMERICAN HOSPITAL ASSOCIATION: $6,765 AMERICAN MEDICAL ASSOCIATION: $315 AMERICAN SOCIETY OF ANESTHESIOLOGISTS: $2 AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS: $808 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES: $105 CALIFORNIA MEDICAL ASSOCIATION: $617 HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA: $20,080 SOCIETY OF HUMAN RESOURCES MANAGEMENT: $2 SOCIETY OF TEACHERS OF FAMILY MEDICINE: $225 TOTAL EXPENDITURES PAID TO ORGANIZATIONS: $34,260 14924873 14924873 208426811 47370287 161056524 267900 244153 23747 70741841 49638208 21103633 23371125 370933 23000192 220108969 CSH POOLED INVESTMENTS 273446666 F 273446666 MCAL SUPP PYMT RECEIVABLE PROVIDER FEE 50508234 PREPAID PENSION EXPENSE 6736926 RIGHT OF USE ASSET 3885350 61130510 PENSION PAYABLE 12233667 ASSET RETIREMENT OBLIGATION LIABILITY 19080093 DUE TO RELATED PARTIES 55680800 86994560 X PART X, LINE 2: ST. JOSEPH'S MEDICAL CENTER OF STOCKTON AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER REVIEW ITS TAX QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 250.000000000000 1 X 500.000000000000 1 1 1 0 1 1 0 6875 8345675 8345675 0.01040 0 62934 266342621 238970418 27372203 0.03400 0 0 69809 274688296 238970418 35717878 0.04440 36 82866 4466068 603022 3863046 0.00480 10 1065 33568597 10175446 23393151 0.02900 1 2156 561304 0 561304 0.00070 1 0 142083 5613 136470 0.00020 7 830 1807415 0 1807415 0.00220 55 86917 40545467 10784081 29761386 0.03690 55 156726 315233763 249754499 65479264 0.08130 3069 0 3069 0.00000 3069 3069 0.00000 1 2579835 150111238 137489191 12622047 X 1 1 1 ST JOSEPH'S SURGERY CENTER LP SURGERY CENTER 0.66300 0.00000 0.13300 2 1 ST JOSEPHS MEDICAL CENTER OF STOCKTON 1800 N CALIFORNIA ST STOCKTON CA 95204 WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORN 030000284 X X X X A 2 ST JOSEPHS BEHAVIORAL HEALTH CENTER 2510 N CALIFORNIA ST STOCKTON CA 95204 WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORN 030000367 X A FACILITY GROUP A 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 250.000000000000 500.000000000000 X 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 0 PART V, SECTION A: PRESENTATION OF HOSPITALS' COMPLETE WEBSITE ADDRESSES:ST. JOSEPH'S MEDICAL CENTER OF STOCKTONWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTONST. JOSEPH'S BEHAVIORAL HEALTH CENTERWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ST JOSEPHS MEDICAL CENTER OF STOCKTON, - FACILITY 2: ST JOSEPHS BEHAVIORAL HEALTH CENTER FACILITY GROUP A PART V, SECTION B, LINE 5: COMMUNITY INPUT OR CONTRIBUTIONS TO THIS IMPLEMENTATION STRATEGY INCLUDED INTERVIEWS WITH 10 KEY INFORMANTS, 29 FOCUS GROUP DISCUSSIONS WITH 291 DIVERSE COMMUNITY RESIDENTS, AND DATA ANALYSES OF OVER 100 INDICATORS, CREATING A ROBUST PICTURE OF THE ISSUES AFFECTING PEOPLE'S HEALTH WHERE THEY LIVE, WORK, AND PLAY. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM LOCAL GOVERNMENTAL AND PUBLIC HEALTH AGENCIES, COMMUNITY-BASED ORGANIZATIONS, AS WELL AS LEADERS, REPRESENTATIVES, OR MEMBERS OF UNDERSERVED, LOW-INCOME, AND RACIAL/ETHNIC POPULATIONS. ADDITIONALLY, WHERE APPLICABLE, OTHER INDIVIDUALS WITH EXPERTISE ON LOCAL HEALTH NEEDS WERE CONSULTED.BELOW IS THE FULL LIST OF ORGANIZATIONS THAT CONTRIBUTED TO THE DEVELOPMENT OF THE SAN JOAQUIN COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS PROCESS: 211 SAN JOAQUIN; ADVENTIST HEALTH, LODI MEMORIAL AND DAMERON HOSPITALS; AMELIA ADAMS WHOLE LIFE CENTER; ASIAN PACIFIC SELF-DEVELOPMENT AND RESIDENTIAL ASSOCIATION (APSARA); BOYS AND GIRLS CLUB; CATHOLIC CHARITIES STOCKTON DIOCESE; CHILD ABUSE PREVENTION COUNCIL; CITY OF STOCKTON - OFFICE OF THE MAYOR & OFFICE OF VIOLENCE PREVENTION; COMMUNITY FOUNDATION OF SAN JOAQUIN; COMMUNITY MEDICAL CENTERS; DATA CO-OP; DELTA HEALTH CARE; CALIFORNIA DEPARTMENT OF HEALTH AND HUMAN SERVICES, REGION 9; DIGNITY HEALTH, ST. JOSEPH'S MEDICAL CENTER AND BEHAVIORAL HEALTH CENTER; EL CONCILIO; EMERGENCY FOOD BANK; FAITH IN THE VALLEY; FIRST 5 OF SAN JOAQUIN; HEALTH FORCE PARTNERS; HEALTH NET; HEALTH PLAN OF SAN JOAQUIN; HISPANIC CHAMBER OF COMMERCE; KAISER PERMANENTE; LITTLE MANILA RISING; LOVE INC. MANTECA; MARY MAGDALENE COMMUNITY SERVICES; PUBLIC HEALTH ADVOCATES; REINVENT SOUTH STOCKTON COALITION; SAN JOAQUIN PRIDE CENTER; SIERRA VISTA HOMES, RESIDENTS COUNCIL; SAN JOAQUIN COUNTY (SJC) BEHAVIORAL HEALTH SERVICES; SJC CHILDREN'S ALLIANCE; SJC CLINICS; SJC COUNCIL OF GOVERNMENTS; SJC OFFICE OF EDUCATION EARLY CHILDHOOD EDUCATION & COMPREHENSIVE HEALTH PROGRAMS; SJC HEALTH CARE SERVICES AGENCY AND WHOLE PERSON CARE PROGRAM; SJC HUMAN SERVICES AGENCY: AGING AND COMMUNITY SERVICES; SJC PUBLIC HEALTH SERVICES; ST. MARY'S DINING ROOM; STOCKTONIANS TAKING ACTION TO NEUTRALIZE DRUGS (STAND); STOCKTON NAACP; SUTTER HEALTH VALLEY AREA; THIRD CITY COALITION; UNIVERSITY OF THE PACIFIC, SCHOOL OF HEALTH SCIENCES; VISIONARY HOME BUILDERS; WOMEN'S CENTER YOUTH AND FAMILY SERVICES AGENCY. FACILITY GROUP A PART V, SECTION B, LINE 6A: ADVENTIST HEALTH; LODI MEMORIAL AND DAMERON HOSPITALS; DIGNITY HEALTH ST. JOSEPH'S MEDICAL CENTER AND BEHAVIORAL HEALTH CENTER; KAISER PERMANENTE; SAN JOAQUIN GENERAL HOSPITAL; SUTTER HEALTH VALLEY AREA FACILITY GROUP A PART V, SECTION B, LINE 6B: COMMUNITY FOUNDATION OF SAN JOAQUIN; COMMUNITY MEDICAL CENTERS; FIRST 5 OF SAN JOAQUIN; HEALTH NET; HEALTH PLAN OF SAN JOAQUIN; SAN JOAQUIN COUNTY CLINICS; SAN JOAQUIN COUNTY OFFICE OF EDUCATION; SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES; UNIVERSITY OF THE PACIFIC FACILITY GROUP A PART V, SECTION B, LINE 7D: THE 2022 (TY 2021) CHNA REPORT WAS ANNOUNCED AND DISSEMINATED TO OVER 350 CONTACTS VIA AN E-NEWSLETTER HIGHLIGHTING VARIOUS COMMUNITY HEALTH DEPARTMENT UPDATES. RECIPIENTS OF THE INFORMATION INCLUDE BOTH HOSPITAL STAFF, COMMUNITY BASED ORGANIZATION LEADERS, AND OTHER PUBLIC AND PRIVATE STAKEHOLDERS. ADDITIONALLY, ALL OTHER CONTRIBUTING HOSPITALS AND FUNDING PARTNERS HAVE ALSO SHARED WIDELY. FACILITY GROUP A PART V, SECTION B, LINE 11: ST. JOSEPH'S MEDICAL CENTER OF STOCKTON:THE HOSPITAL HAS MANY PROGRAMS AND SERVICES TO HELP ADDRESS ALL IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS.MENTAL HEALTH/BEHAVIORAL HEALTH INCLUDING SUBSTANCE USE: COMMUNITY HEALTH SOCIAL WORKER STAFFED TO ADVANCE MENTAL HEALTH PROGRAMMING; YOUTH OVERCOMING LIFE'S OBSTACLES (YOLO) GROUP (AGES 14-17); MENTAL HEALTH FIRST AID TRAINING; TRAUMA INFORMED SYSTEMS TRAINING THROUGH EMBEDDED LOCAL TRAINERS AND LOCAL COACHES; ESTABLISHED PSYCHIATRY RESIDENCY IN PARTNERSHIP WITH TOURO UNIVERSITY; SUBSTANCE USE NAVIGATOR FUNDING ACQUIRED AND POSITION STAFFED IN THE EMERGENCY DEPARTMENT.ACCESS TO CARE: EXPANSION OF GRADUATE MEDICAL EDUCATION; CONTINUED FOCUS PROGRAMMING TO FULLY INTEGRATE ROUTINE OPT-OUT HEP C, HIV, AND SYPHILIS SCREENING IN THE ED AND ENSURE PATIENT LINKAGES TO CARE THROUGH NAVIGATION SERVICES; CONTINUED THE HOMECOMING PROGRAM IN PARTNERSHIP WITH CATHOLIC CHARITIES TO PROVIDE A SUCCESSFUL POST HOSPITAL RECOVERY THROUGH COMPREHENSIVE CASE MANAGEMENT, ADDRESSING BOTH HEALTH AND HEALTH RELATED SOCIAL NEEDS.INCOME AND EMPLOYMENT: IMPLEMENTATION OF THE CONNECTED COMMUNITY NETWORK (CCN) TO STREAMLINE COMMUNITY RESOURCE CONNECTIONS AND COMMUNICATIONS AMONG SOCIAL SERVICE PROVIDERS; LAUNCH OF COMMUNITY HEALTH ADVOCATE PILOT TO IDENTIFY HEALTH RELATED SOCIAL NEEDS OF PATIENTS IN THE SJMC EMERGENCY DEPT AND REFER THEM TO COMMUNITY RESOURCES (THIS PROGRAM SUPPORTS MANY OTHER HEALTH NEEDS AS WELL); IMPLEMENTATION OF THE PATHWAYS COMMUNITY HUB, AN EVIDENCE BASED, PAY FOR OUTCOMES MODEL, THAT SUPPORTS THE VALUABLE ROLE OF COMMUNITY HEALTH WORKERS.HOUSING: INCREASED INVESTMENTS THROUGH A HOMELESS HEALTH INITIATIVE FUND WHICH EXPANDED MOBILE STREET OUTREACH IN PARTNERSHIP WITH THE SALVATION ARMY OF STOCKTON, INCREASED PERMANENT HOUSING SOLUTIONS IN COLLABORATION WITH STAND AFFORDABLE HOUSING AND SAN JOAQUIN COUNTY WHOLE PERSON CARE, AND COMPREHENSIVE CASE MANAGEMENT SERVICES FOR EMERGENCY DEPARTMENT PATIENTS POST DISCHARGE; CONTINUED COLLABORATION WITH THE GOSPEL CENTER RESCUE MISSION TO ENSURE SAFE PATIENT DISCHARGES THROUGH THE RECUPERATIVE CARE PROGRAM; ACTIVE INVOLVEMENT WITH THE SAN JOAQUIN COUNTY CONTINUUM OF CARE TO COLLECTIVELY FIND SOLUTIONS TO ADDRESS HOMELESSNESS.CHRONIC DISEASE/HEALTHY EATING & ACTIVE LIVING (HEAL): INVESTMENTS TO SUPPORT THE COMMUNITY HEALTH IMPROVEMENT PLAN INCLUDING IMPROVING PARK BEAUTIFICATION & INCREASING PARK ACTIVATION TO ADDRESS COMMUNITY SAFETY, HEALTH AND WELLNESS IN CHNA PRIORITY NEIGHBORHOODS; IMPLEMENTATION OF MULTIPLE DIABETES EDUCATION PROGRAMS, INCLUDING DIABETES NAVIGATION SERVICES, POWER HOUR, DIABETES EMPOWERMENT EDUCATION PROGRAM (DEEP), CERTIFIED DIABETES CARE & EDUCATION SPECIALIST (CDCES) CONSULTATIONS, THE SUGAR FIX SUPPORT GROUP, AND PSYCHO-SOCIAL ASSESSMENTS AND RESOURCE REFERRALS FOR PATIENTS EXPERIENCING SOCIAL BARRIERS TO DIABETES CARE; THE ANNUAL COMMUNITY GRANTS PROGRAM SUPPORTS THE CHNA NEEDS THROUGH A COMPETITIVE APPLICATION PROCESS.COMMUNITY SAFETY: INVESTMENTS TO IMPROVE PARK BEAUTIFICATION & INCREASE PARK ACTIVATION TO ADDRESS COMMUNITY SAFETY, HEALTH AND WELLNESS IN CHNA PRIORITY NEIGHBORHOODS; ACTIVE PARTICIPATION IN THE SAN JOAQUIN HUMAN TRAFFICKING TASK FORCE TO BRING AWARENESS OF, EDUCATION AND SUPPORT TO VICTIMS OF HUMAN TRAFFICKING AND LEADERSHIP IN THE HEALTHCARE WORKGROUP TO SUPPORT RESPONSE PROTOCOLS WITHIN OTHER HEALTHCARE FACILITIES.FAMILY AND SOCIAL SUPPORT: CONNECTED COMMUNITY NETWORK IMPROVE REFERRAL LINKAGES & ENHANCE COMMUNICATION AMONG SOCIAL SERVICE PARTNERS; IMPLEMENTATION OF THE PATHWAYS COMMUNITY HUB, MITIGATES HEALTH RELATED SOCIAL RISK FACTORS, THROUGH THE ASSESSMENT OF CLOSURE OF 21 SPECIFIC "PATHWAYS; COMMUNITY HEALTH ADVOCATE PROGRAM, OFFERING SOCIAL NEEDS SCREENING AND REFERRALS TO EMERGENCY DEPARTMENT PATIENTS TO PROACTIVELY MITIGATE RISKS THAT INCREASE POOR HEALTH OUTCOMES IF LEFT UNADDRESSED; CONTINUED THE LIFELINE HOME MONITORING SERVICES IN AN EFFORT TO IMPROVE INDEPENDENT LIVING AND SAFETY FOR OLDER ADULTS AND INDIVIDUALS WITH DISABILITIES.EDUCATION: EXPANDED THE CONNECTED COMMUNITY NETWORK INTO THE EDUCATION SECTOR BY ONBOARDING THE SAN JOAQUIN COUNTY OFFICE OF EDUCATION TO IMPROVE EDUCATIONAL ATTAINMENT BY ADDRESSING UNMET SOCIAL NEEDS; ESTABLISHED A RELATIONSHIP WITH LOCAL UNIVERSITIES TO SUPPORT MASTERS LEVEL SOCIAL WORK INTERNSHIPS.TRANSPORTATION: CONNECTED COMMUNITY NETWORK IMPROVE REFERRAL LINKAGES & ENHANCE COMMUNICATION AMONG SOCIAL SERVICE PARTNERS; HOMECOMING PROJECT IN PARTNERSHIP WITH CATHOLIC CHARITIES TO PROVIDE A SUCCESSFUL POST HOSPITAL RECOVERY THROUGH COMPREHENSIVE CASE MANAGEMENT, ADDRESSING BOTH HEALTH AND HEALTH RELATED SOCIAL NEEDS.ST. JOSEPH'S BEHAVIORAL HEALTH CENTER:AS A HOSPITAL EXCLUSIVELY DELIVERING BEHAVIORAL HEALTH SERVICES, NEEDS IDENTIFIED IN THE BROADER CHNA BEYOND MENTAL HEALTH, ACCESS TO CARE, AND FAMILY AND SOCIAL SUPPORTS ARE NOT ONES THAT THE HOSPITAL IS ABLE TO ADDRESS, HOWEVER, IT IS OUR MISSION TO WORK COLLABORATIVELY WITH ST. JOSEPH'S MEDICAL CENTER AND OTHER STAKEHOLDERS TO SUPPORT INITIATIVES BY LENDING OUR EXPERTISE.THE FOLLOWING PROGRAMS ARE SUPPORTING THE IDENTIFIED NEEDS OF MENTAL HEALTH, ACCESS TO CARE, AND FAMILY/SOCIAL SUPPORTS: 24/7/365 BEHAVIORAL EVALUATION SERVICES, WHICH PROVIDES FREE EVALUATION TO INDIVIDUALS WITH BEHAVIORAL HEALTH CONCERNS. MEDICATION ASSISTED THERAPY (MAT) PROGRAM, COMMUNITY SUPPORT GROUPS, AND AFTERCARE SERVICES, WHICH PROVIDE FREE SUPPORT PROGRAMS TO INDIVIDUALS LIVING WITH LIFEAFFECTING SUBSTANCE AND/OR CONTINUING BEHAVIOR HEALTH ISSUES. SUPPORT OF THE GRADUATE MEDICAL EDUCATION PSYCHIATRY PROGRAM PROVIDES RESIDENTS WITH QUALITY EDUCATION AND EXPERIENCE, IN AN EFFORT TO ENCOURAGE CONTINUED PRACTICE IN SAN JOAQUIN COUNTY. ADDITIONALLY, MEETING SPACE IS MADE AVAILABLE TO COMMUNITY GROUPS TO GATHER AND PROVIDE COMMUNITY SERVICES AT NO COST. TRANSPORTATION ASSISTANCE FOR QUALIFIED CLIENTS THAT OTHERWISE WOULD NOT BE ABLE TO ATTEND SJBHC OUTPATIENT SERVICES GROUPS. THROUGH A FORMAL PROCESS, GRANTS ARE ADMINISTERED ANNUALLY TO NON-PROFIT ORGANIZATIONS THAT BEST DEMONSTRATE THEIR ABILITY TO IMPACT COMMUNITY HEALTH NEEDS THROUGH COLLABORATION WITH OTHER ORGANIZATIONS. FACILITY GROUP A PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, BALANCES BELOW TEN DOLLARS ($10.00) WOULD BE ADJUSTED USING A SMALL BALANCE ADJUSTMENT AND NOT BILLED TO THE PATIENT/GUARANTOR.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM. PART V, SECTION B, LINE 7A CHNA REPORT WEB SITE LOCATIONS FOR ST JOSEPH'S MEDICAL CENTER OF STOCKTON AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER ARE PROVIDED BELOW.HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-HEALTH-NEEDS-ASSESMENTHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/ABOUT-US/COMMUNITY-HEALTHSCHEDULE H, PART V, SECTION B, LINE 7BWWW.HEALTHIERSANJOAQUIN.ORG PART V, SECTION B, LINE 10A THE HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED ATHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-HEALTH-NEEDS-ASSESMENTHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/ABOUT-US/COMMUNITY-HEALTH PART V, SECTION B, LINE 16A, 16B AND 16C ST. JOSEPH'S MEDICAL CENTER OF STOCKTON:HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEST. JOSEPH'S BEHAVIORAL HEALTH CENTER:HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/PATIENTS-AND-VISITORS/PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE 1 1 - ST JOSEPH'S SURGERY CENTER LP 1800 N CALIFORNIA STREET SUITE 1 STOCKTON CA 95204 SURGERY CENTER PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.- THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 13H, 3RD PARAGRAPH.- THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:- RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;- HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;- PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);- FOOD STAMP ELIGIBILITY;- ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);- LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR- PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM. PART I, LINE 7: PORT CITY OPERATING COMPANY, LLC, (PORT CITY) DBA ST. JOSEPH'S MEDICAL CENTER OF STOCKTON (SJMC) AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER (BHC) FOLLOWS THE METHOD USED BY COMMONSPIRIT HEALTH. FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE, THE ORGANIZATION USES AN ADJUSTED COST TO CHARGE RATIO (CCR) CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 IS USED IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS.SCHEDULE H, PART I, LINE 7B, COLUMN (F)BEGINNING IN 2009, THE STATE OF CALIFORNIA ESTABLISHED PROVIDER FEE PROGRAMS. THESE PROGRAMS ARE FUNDED BY QUALITY ASSURANCE FEES PAID BY PARTICIPATING HOSPITALS AND MATCHING FEDERAL FUNDS. PORT CITY'S HOSPITAL FACILITIES RECOGNIZED QUALITY ASSURANCE FEES DURING THE YEAR OF $66 MILLION WHICH ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO UNREIMBURSED MEDICAID (PART I, LINE 7B, COLUMN C), AND RECOGNIZED FEE-FOR-SERVICE SUPPLEMENTAL PAYMENTS OF $127 MILLION DURING THE YEAR REFLECTED UNDER THE MEDICAID PROGRAM AS DIRECT OFFSETTING REVENUE (PART I, LINE 7B, COLUMN D).SCHEDULE H, PART I, LINE 7IINCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $1.3 MILLION IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST ("CHFT") FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA, CONSISTENT WITH CHFT'S MISSION OF SUPPORTING HEALTH CARE, ACCESS TO HEALTH CARE, RESEARCH AND EDUCATION. PART II, COMMUNITY BUILDING ACTIVITIES: SCREENING & REFERRAL: COMMUNITY HEALTH ADVOCATE: HEALTH RELATED SOCIAL NEEDS SCREENING IN THE EMERGENCY DEPARTMENT, TO IDENTIFY AND HELP MEET NON-MEDICAL NEEDS OF VULNERABLE PATIENTS. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE PART I, LINE 7) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER FINANCIAL ASSISTANCE, AND ARE OTHERWISE UNINSURED. PORT CITY PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES: AT OR BELOW 250%, 251%-400% OR 401%-500% OF THE FEDERAL POVERTY LEVEL. PORT CITY ALSO PROVIDES PATIENTS OPTIONS FOR UNINSURED PATIENT DISCOUNT AND SELF-PAY DISCOUNTS. IN CALIFORNIA, PATIENTS WHO ARE UNINSURED OR WITH HIGH MEDICAL COSTS ARE ELIGIBLE TO RECEIVE DISCOUNTED CARE IN ADDITION TO AN INTEREST-FREE EXTENDED PAYMENT PLAN THAT WILL ALLOW PAYMENT OF THE DISCOUNTED AMOUNT OVER TIME. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: PORT CITY FOLLOWS THE COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. PORT CITY MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. COMMONSPIRIT HEALTH ALSO UTILIZES A WAYSTAR (FORMERLY PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. WAYSTAR IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, THE HOSPITAL DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT HEALTH'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2024, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT HEALTH CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12.PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES. PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPLIES WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT:TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS.COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B: PORT CITY ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. PORT CITY ALSO FOLLOWS COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY. COMMONSPIRIT'S COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE HOSPITAL FACILITIES OR THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED FINANCIAL ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, PORT CITY WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY.ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE HOSPITAL PATIENT FINANCIAL ASSISTANCE DEPARTMENT. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNTS TO A COLLECTION AGENCY, PORT CITY REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 2: ST. JOSEPH'S MEDICAL CENTER OF STOCKTON AND ST. JOSEPH'S BEHAVIORAL HEALTH:THE HOSPITALS TOGETHER HAVE VISIBILITY TO THE EMERGING HEALTH CARE NEEDS THROUGH THE COURSE OF SERVICE PROVISION OF FOLLOWING PROGRAMS: THE COMMUNITY HEALTH ADVOCATE PROGRAM AS A STRATEGY TO ADDRESS MULTIPLE IDENTIFIED UNMET NEEDS THROUGH A UNIVERSAL SCREENING OF THE SOCIAL DETERMINANTS OF HEALTH FOR PATIENTS IN THE HOSPITAL EMERGENCY DEPARTMENT; AND THE HOMECOMING PROGRAM THAT ASSESS THE HEALTH AND SOCIAL SERVICE NEEDS OF INDIVIDUALS POST HOSPITALIZATION BY PROVIDING SHORT-TERM CASE MANAGEMENT TO ENSURE A SAFE RECOVERY. ADDITIONALLY, THE CONNECTED COMMUNITY NETWORK OF SAN JOAQUIN IS A NETWORK OF HEALTH AND SOCIAL SERVICE PROVIDERS UNITED THROUGH A SHARED TECHNOLOGY PLATFORM THAT ALLOWS VISIBILITY TO COMMUNITY CARE COORDINATION AND HELPS TO ASSESS SERVICE GAPS AND CAPACITY ISSUES AMONG IN-NETWORK PROVIDERS. PART VI, LINE 3: INFORMATION ABOUT PORT CITY'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE PORT CITY'S FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES PORT CITY'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES.IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRES THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: SAN JOAQUIN COUNTY, IN THE CENTRAL VALLEY OF CALIFORNIA, IS ROUGHLY 60 MILES EAST OF SAN FRANCISCO AND 35 MILES SOUTH OF SACRAMENTO, WITH A TOTAL POPULATION OF 742,603 (2019). HISTORICALLY, AGRICULTURE HAS BEEN A STRONG DRIVER OF OUR ECONOMY AND MANY MIGRANTS AND IMMIGRANTS HAVE SETTLED HERE TO WORK IN THE FIELDS AND HELP WITH AGRICULTURAL PROCESSING OR SHIPPING. THE COUNTY IS MOSTLY RURAL, WITH ONE LARGE URBAN CORE (STOCKTON) AND SEVEN SMALLER CITIES, AS WELL AS MANY RANCHING AND FARMING COMMUNITIES SCATTERED ACROSS THE COUNTY.SAN JOAQUIN COUNTY IS HOME TO A HIGH CONCENTRATION OF RESIDENTS AT ELEVATED RISK FOR COVID-19 AND WHO HAVE EXPERIENCED ENORMOUS IMPACTS FROM THE PANDEMIC. A QUARTER OF RESIDENTS ARE FOREIGN-BORN. OVERALL, 14.5% OF RESIDENTS LIVE IN POVERTY AND RESIDENTS AGED 65 YEARS AND OLDER HAVE A POVERTY RATE OF 10.5%. THE EDUCATIONAL ATTAINMENT OF SAN JOAQUIN COUNTY RESIDENTS IS MUCH LOWER THAN CALIFORNIA RESIDENTS. ONLY 18.8% OF COUNTYRESIDENTS AGED 25 AND OLDER HAVE A BACHELOR'S DEGREE OR HIGHER, COMPARED TO 33.9% OF CALIFORNIANS AGED 25 AND OLDER THAT HAVE A BACHELOR'S DEGREE OR HIGHER. THE DEMOGRAPHICS DATA BELOW REPRESENTS ONLY THE TOP 75% OF ST. JOSEPH'S HOSPITAL DISCHARGES (BASED ON ZIP CODE):TOTAL POPULATION: 799,267ASIAN/PACIFIC ISLANDER: 18.6%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 7.0%HISPANIC OR LATINO: 43.5%WHITE NON-HISPANIC: 24.8%ALL OTHERS: 6.1%% BELOW POVERTY (FAMILIES): 10.5%UNEMPLOYMENT: 6.2%NO HIGH SCHOOL DIPLOMA: 20.1%MEDICAID: 33.4%UNINSURED: 5.8%OTHER AREA HOSPITALS: 7WITHIN SAN JOAQUIN COUNTY THERE ARE A TOTAL OF SEVEN HOSPITALS, TWO BEHAVIORAL HEALTH HOSPITALS, AND TWO FEDERALLY QUALIFIED HEALTH CENTERS TO MEET THE ACCESS TO CARE NEEDS OF THOSE MEDICALLY UNDERSERVED. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS.HOSPITAL LEADERSHIP CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS HOSPITAL LEADERS SIT ON MANY COMMUNITY BOARDS, STEERING COMMITTEES, AND OTHER COMMUNITY ADVISORY COMMITTEES INCLUDING THE SAN JOAQUIN BUSINESS COUNCIL, WOMEN'S CENTER YOUTH AND FAMILY SERVICES, CONTINUUM OF CARE, COMMUNITY PARTNERSHIP FOR FAMILIES OF SAN JOAQUIN, SAN JOAQUIN COMMUNITY FOUNDATION, SAN JOAQUIN HISPANIC CHAMBER OF COMMERCE AND REINVENT SOUTH STOCKTON COALITION. PART VI, LINE 6: PORT CITY IS 80% OWNED BY DIGNITY HEALTH AND THEREFORE AFFILIATED WITH ALL ENTITIES WITHIN COMMONSPIRIT HEALTH. AFFILIATES OF PORT CITY ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN CALIFORNIA, ARIZONA, AND NEVADA AND IN 20 ADDITIONAL STATES THROUGH THE ALLIANCE WITHIN COMMONSPIRIT HEALTH SYSTEM. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES.TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE NET OF OFFSETTING REVENUE FOR COMMONSPIRIT HEALTH AND ITS AFFILIATED CORPORATIONS, WHICH INCLUDES PORT CITY, FOR THE YEAR ENDED JUNE 30, 2024, IS $2.6 BILLION. A SUMMARY OF COMMONSPIRIT'S COMMUNITY BENEFITS CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT HEALTH CONSOLIDATED FINANCIAL STATEMENTS ON PAGE 41. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 DIGNITY HEALTH MEDICAL FOUNDATION 3400 DATA DRIVE RANCHO CORDOVA CA 95670 680220314 501(C)(3) 9244180 0 N/A N/A MEDICAL FND SUPPORT CALIFORNIA HEALTH FOUNDATION AND TRUST 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 1315733 0 N/A N/A COMMUNITY HEALTH ST JOSEPH'S FOUNDATION OF SAN JOAQUIN 1800 N CALIFORNIA STREET STOCKTON CA 95204 510432777 501(C)(3) 1182589 0 N/A N/A FOUNDATION SUPPORT DIGNITY HEALTH 185 BERRY STREET SUITE 200 SAN FRANCISCO CA 94107 941196203 501(C)(3) 596012 0 N/A N/A HOSPITAL SUPPORT UNIVERSITY OF THE PACIFIC MCGEORGE SCHOOL OF LAW 3601 PACIFIC AVE STOCKTON CA 95211 941156266 501(C)(3) 104748 0 N/A N/A COMMUNITY HEALTH ST MARYS DINING ROOM 545 W SONORA ST STOCKTON CA 95203 942687280 501(C)(3) 102500 0 N/A N/A COMMUNITY HEALTH SECOND HARVEST OF THE GREATER VALLEY 1220 VANDERBILT CIR MANTECA CA 95337 680376587 501(C)(3) 101000 0 N/A N/A COMMUNITY HEALTH THE COMMUNITY PARTNERSHIP FOR FAMILIES OF SAN JOAQUIN 2044 FAIR ST STOCKTON CA 95206 680475602 501(C)(3) 96798 0 N/A N/A COMMUNITY HEALTH TRUST FOR PUBLIC LAND 101 MONTGOMERY ST SUITE 900 SAN FRANCISCO CA 94104 237222333 501(C)(3) 94922 0 N/A N/A COMMUNITY HEALTH ASIAN PACIFIC SELF DEVELOPMENT AND RESIDENTIAL ASSOCIATION 3830 N ALVARADO ST SUITE C STOCKTON CA 95204 680224100 501(C)(3) 65000 0 N/A N/A COMMUNITY HEALTH UNITED WAY OF SAN JOAQUIN COUNTY 777 N PERSHING AVE SUITE 2B STOCKTON CA 95203 941279805 501(C)(3) 34000 0 N/A N/A COMMUNITY HEALTH SAN JOAQUIN COMMUNITY FOUNDATION INC 6731 HERNDON PL STOCKTON CA 95219 261476916 501(C)(3) 32500 0 N/A N/A COMMUNITY HEALTH HOSPICE OF SAN JOAQUIN 3888 PACIFIC AVE STOCKTON CA 95204 942777980 501(C)(3) 9130 0 N/A N/A COMMUNITY HEALTH TIDES CENTER 1012 TORNEY AVE SAN FRANCISCO CA 94129 943213100 501(C)(3) 6900 0 N/A N/A COMMUNITY HEALTH YOUNG MENS CHRISTIAN ASSOCIATION OF SAN JOAQUIN COUNTY 2105 W MARCH LN SUITE 1 STOCKTON CA 95207 941156319 501(C)(3) 6000 0 N/A N/A COMMUNITY HEALTH TOURO UNIVERSITY 1310 CLUB DRIVE VALLEJO CA 94592 133838740 501(C)(3) 5200 0 N/A N/A COMMUNITY HEALTH SAINT JOSEPH HEALTH SYSTEM INC ONE ST JOSEPHS DRIVE LEXINGTON KY 40504 611334601 501(C)(3) 0 127359 BOOK MEDICAL EQUIPMENT HOSPITAL SUPPORT 17 0 PROVISION OF FOOD/MEALS 4029 26758 BOOK FOOD/MEALS TRANSPORTATION 275 3221 FMV TRANSPORTATION DONATION OF CLOTHING/OTHER TO PATIENTS/NEEDY 4775 42679 FMV CLOTHING/HYGIENE KITS/BACK PACKS/COATS MEDICAL SUPPLIES/EQUIPMENT TO PATIENTS/INDIGENTS 37 5233 FMV MEDICAL SUPPLIES PART I, LINE 2: DONATIONS ARE PROVIDED TO THE COMMUNITY TO FURTHER THE MISSION OF THE MEDICAL CENTER AND SUPPORT VARIOUS COMMUNITY PROGRAMS. ST. JOSEPH'S MEDICAL CENTER PROVIDES DONATIONS TO SUPPORT COMMUNITY PROGRAMS THAT MEET SPECIFIC CRITERIA THROUGH ITS COMMUNITY HEALTH DEPARTMENT AND ALSO DONATES DIRECTLY TO VARIOUS COMMUNITY EVENTS AND PROGRAMS THROUGH THE MARKETING AND BUSINESS DEVELOPMENT DEPARTMENTS. 0 1 0 0 0 0 0 0 0 JULIE SPRENGEL BOARD MEMBER (THRU 3/28/24) 0 1536875 0 2701713 0 19033 0 75781 0 19061 0 4352463 0 0 JOHN E PETERSDORF VICE CHAIR/ SECRETARY 0 645040 0 716812 0 727895 0 923913 0 68907 0 3082567 0 713173 DONALD J WILEY PRESIDENT AND CEO 0 515436 0 522414 0 163974 0 362316 0 63292 0 1627432 0 130053 ROBERT QUINN MD BOARD MEMBER 0 573677 0 657620 0 13320 0 77782 0 30826 0 1353225 0 0 BENJAMIN BJ PREDUM BOARD MEMBER 0 498251 0 303003 0 3799 0 47340 0 44277 0 896670 0 0 SUE PIETRAFESO BOARD MEMBER 0 414868 0 220064 0 7524 0 33443 0 24240 0 700139 0 0 ANDREA NIKKI OCHOA CHIEF FINANCIAL OFFICER 0 267446 0 83534 0 3705 0 40928 0 25024 0 420637 0 0 PART I, LINE 3 ALTHOUGH THE ORGANIZATION DOES NOT EMPLOY PERSONNEL, THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, COMMONSPIRIT, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S CEO'S COMPENSATION: (1) HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT BOARD OF STEWARDSHIP TRUSTEES; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; AND (4) APPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4A CERTAIN LISTED PERSONS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 TO 24 MONTHS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN LISTED PERSONS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2023. PART I, LINE 4B CERTAIN OFFICERS ARE ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2023. DIGNITY HEALTH'S CERTAIN OFFICERS ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR TWO LISTED PERSON DURING 2023 INCLUDE J. PETERSDORF, $713,173 AND D. WILEY, $130,053. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). SCHEDULE J, PART III SUPPLEMENTAL DISCLOSURES THE ORGANIZATION FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES DIGNITY HEALTH SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND DIGNITY HEALTH'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023. FORM 990, PART V, LINE 2A THE ORGANIZATION DOES NOT HAVE EMPLOYEES. THE ORGANIZATION UTILIZES THE EMPLOYEES OF DIGNITY HEALTH, A RELATED ORGANIZATION, PER THE EMPLOYEE LEASE AGREEMENT. THE SALARIES OF THESE EMPLOYEES ARE INCLUDED ON DIGNITY HEALTH'S FORM W-3 AND FEDERAL EMPLOYMENT TAX RETURNS FORM 990, PART VI, SECTION A, LINE 2 CERTAIN REPORTABLE INDIVIDUALS HAVE BUSINESS RELATIONSHIPS WITH THE RELATED ENTITIES OF PORT CITY (INCLUDING FOR-PROFIT SUBSIDIARIES OR JOINT VENTURES) AS A RESULT OF SERVING AS OFFICERS OR BOARD MEMBERS OF THOSE ENTITIES. BOARD OFFICER MEMBERSHIP ON THE GOVERNING BODIES OF THOSE RELATED ENTITIES ARE AS FOLLOWS. DONALD WILEY, ANDREA NIKKI OCHOA - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 PORT CITY IS 80% OWNED BY DIGNITY HEALTH AND 20% BY KAISER FOUNDATION HOSPITAL (KFH), BOTH 501(C)(3) EXEMPT ORGANIZATIONS. DIGNITY HEALTH IS THE MANAGING MEMBER OF PORT CITY. ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. COMMONSPIRIT IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION (CHCF"). FORM 990, PART VI, SECTION A, LINE 7A DIGNITY HEALTH AND KFH, KNOWN AS THE COMPANY MEMBERS, APPOINT A BOARD OF MANAGERS. FORM 990, PART VI, SECTION A, LINE 7B RESERVED RIGHTS OF THE COMPANY MEMBERS INCLUDE: SELL, LEASE, EXCHANGE OR OTHERWISE DISPOSE OF ALL, OR SUBSTANTIALLY ALL, OF THE ORGANIZATION'S PROPERTY, WITH OR WITHOUT THE GOODWILL, OUTSIDE OF THE ORDINARY COURSE OF THE ORGANIZATION'S ACTIVITIES, APPROVE A MERGER OR CONVERSION, UNDERTAKE ANY OTHER ACT OUTSIDE OF THE ORDINARY COURSE OF THE ORGANIZATION'S ACTIVITIES, AND AMEND THE ORGANIZATION'S AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B PORT CITY'S CFO REVIEWED THE FORM 990. IN ADDITION, COMMONSPIRIT'S TAX DEPARTMENT WORKED CLOSELY WITH AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. DUE TO TIMING, THE FORM 990 WILL BE REVIEWED BY THE BOARD OF MANAGERS AND/OR SUBCOMMITTEE OF THE BOARD OF MANAGERS SUBSEQUENT TO FILING WITH THE INTERNAL REVENUE SERVICE. COPIES OF FORM 990, EXCLUDING COMPENSATION INFORMATION WERE PROVIDED VIA EMAIL TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS ADOPTED THE RELATED ORGANIZATION, COMMONSPIRIT'S CONFLICTS OF INTEREST POLICY. THE CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") WAS PUT IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S PERSONNEL IS COMPENSATED BY DIGNITY HEALTH. FOR 2023 COMPENSATION, COMPENSATION LEVELS FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL WERE ESTABLISHED BY THE RELATED ORGANIZATION, COMMONSPIRIT. COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PRACTICES FOR THE ORGANIZATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO VALIDATE THE ORGANIZATION'S BENCHMARKING APPROACH FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES FOR CERTAIN EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED BY THE COMMONSPIRIT HEALTH COMPENSATION DEPARTMENT FROM INDEPENDENT THIRD-PARTY SALARY SURVEYS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). THE DOCUMENTATION OF COMPENSATION DECISIONS INCLUDES (A) THE DECISION MADE AND THE DATE APPROVED; AND (B) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMPENSATION DEPARTMENT AND THE SOURCES FROM WHICH THE DATA WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION IS INCLUDED IN COMMONSPIRIT'S CONSOLIDATED FINANCIAL STATEMENTS WHICH ARE AVAILABLE ON COMMONSPIRIT'S WEBSITE AND UPON REQUEST. FORM 990, PART VII, SECTION A S. PIETRAFESO, R. QUINN, MD, J. SPRENGEL AND J. PETERSDORF RECEIVED COMPENSATION FOR SERVICES PROVIDED TO A RELATED ORGANIZATION, DIGNITY HEALTH. A. N. OCHOA AND D. WILEY ARE EMPLOYEES OF DIGNITY HEALTH BUT PROVIDE SERVICES AS OFFICERS TO PORT CITY. FORM 990, PART IX, LINE 11G REVENUE CYCLE SERVICES: PROGRAM SERVICE EXPENSES 13,705,602. MANAGEMENT AND GENERAL EXPENSES 141,437. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,847,039. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 416,986,270. MANAGEMENT AND GENERAL EXPENSES 45,152,082. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 462,138,352. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 52,759,260. MANAGEMENT AND GENERAL EXPENSES 9,421,562. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,180,822. MAINTENANCE/REPAIRS: PROGRAM SERVICE EXPENSES 8,621,346. MANAGEMENT AND GENERAL EXPENSES 933,536. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,554,882. PROFESSIONAL FEES/CONSULTING: PROGRAM SERVICE EXPENSES 2,181,255. MANAGEMENT AND GENERAL EXPENSES 236,190. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,417,445. LAUNDRY /LINEN: PROGRAM SERVICE EXPENSES 1,611,615. MANAGEMENT AND GENERAL EXPENSES 174,509. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,786,124. JANITORIAL/LANDSCAPE/STORAGE: PROGRAM SERVICE EXPENSES 891,905. MANAGEMENT AND GENERAL EXPENSES 96,577. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 988,482. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,902,374. MANAGEMENT AND GENERAL EXPENSES 314,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,216,649. FORM 990, PART XI, LINE 9: GAIN ON ADOPTION OF ASU 2017-07 3,917,963. CHANGE IN OWNERSHIP INTEREST OF ST JOSEPH'S SURGERY CENTER, LP -175,360. FORM 990, PART XII, LINE 2C THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. FORM 990, PART XII, LINE 3B THE ORGANIZATION'S FEDERAL AWARDS WERE INCLUDED IN COMMONSPIRIT'S CONSOLIDATED UNIFORM GUIDANCE AUDITED SCHEDULE OF FEDERAL EXPENDITURES FOR THE PERIOD OF JULY 1, 2023, TO JUNE 30, 2024. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE 0 BARROW FOUNDATION UK 13 CHURCH STREET NUNNEY ENGLAND UK BA11 4LW 311724184 FUNDRAISING FOUNDATION UK 501(C)(3) PF N/A 0 BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX AZ 85013 860174371 FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 7 N/A 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(C)(3) LINE 3 TCHB 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) LINE 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC 0 CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 12A, I CSH 0 CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 TELEHEALTH CO 501(C)(3) LINE 12A, I CSH 0 CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(C)(3) LINE 10 MMC - ROSEBURG 0 CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD CA 93311 844171789 CLINIC CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE 0 CENTRAL KANSAS MEDICAL CENTER 9100 E MINERAL CIRCLE CENTENNIAL CO 80112 480543724 INACTIVE KS 501(C)(3) LINE 3 CSH 0 CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 SENIOR LIVING MN 501(C)(3) LINE 10 CSH 0 CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 ACH 0 CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 INVESTMENTS KY 501(C)(3) LINE 12A, I CSH 0 CHI LIVING COMMUNITIES 930 S WYNN ROAD OREGON OH 43616 341892096 SENIOR LIVING OH 501(C)(3) LINE 12A, I SFH-OH 0 CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(C)(3) LINE 3 MHCS 0 CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA NE 68510 363233121 HOLDING CO NE 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(C)(3) LINE 12A, I CSH 0 CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HOSPITAL AR 501(C)(3) LINE 3 CHI-SVHS 0 CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) LINE 12A, I SVIMC 0 CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 PHYSICIANS AR 501(C)(3) LINE 3 CHI-SVHS 0 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 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HEALTH MEDICAL FOUNDATION 3400 DATA DRIVE RANCHO CORDOVA CA 95670 680220314 MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE 0 DOMINICAN HEALTH SERVICES 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 770056778 COMMUNITY HEALTH SYSTEM CA 501(C)(3) LINE 12A, I DIGNITY HEALTH 0 DOMINICAN HOSPITAL FOUNDATION 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 942450442 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH 0 DOMINICAN OAKS CORPORATION 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 770127719 OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS CA 501(C)(3) LINE 10 DHS 0 ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HOSPITAL WA 501(C)(3) LINE 3 FHS 0 FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HOSPITAL KY 501(C)(3) LINE 3 KOH 0 FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I FH 0 FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(C)(3) LINE 10 CHILC 0 FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING FOUNDATION WA 501(C)(3) LINE 10 FHS 0 FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HOSPITAL WA 501(C)(3) LINE 3 CSH 0 FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 PHYSICIANS WA 501(C)(3) LINE 10 FHS 0 FRENCH HOSPITAL MEDICAL CENTER FOUNDATION 1911 JOHNSON AVENUE SAN LUIS OBISPO CA 93401 203256125 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE 0 GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HOSPITAL ND 501(C)(3) LINE 3 SAMC 0 GLENDALE MEMORIAL HEALTH FOUNDATION 1420 SOUTH CENTRAL AVENUE GLENDALE CA 91204 953625651 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE 0 GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 INACTIVE CO 501(C)(3) LINE 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STE 800 LOUISVILLE KY 40202 611352729 PHYSICIANS KY 501(C)(3) LINE 10 JHSMH 0 KENTUCKYONE HEALTH INC ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 611029769 HEALTHCARE KY 501(C)(3) LINE 12A, I CSH 0 LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 410758434 HOSPITAL MN 501(C)(3) LINE 3 CSH 0 LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE MN 56623 411893795 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 7 LHC 0 LEGACY FOUNDATION OF KENTUCKIANA INC 1451 HARRODSBURG RD STE D-308 LEXINGTON KY 40504 832170324 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I KOH 0 LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 820558836 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 LONGMONT UNITED HOSPITAL 1950 MOUNTAIN VIEW AVE LONGMONT CO 80501 840460697 HOSPITAL CO 501(C)(3) LINE 3 CHIC 0 LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN TX 75901 820563768 PROPERTY MGMT TX 501(C)(3) LINE 12A, I MHSET 0 MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS KY 51017 610654635 ASSISTED LIVING KY 501(C)(3) LINE 10 CHILC 0 MARIAN REGIONAL MEDICAL CENTER FOUNDATION 1400 E CHURCH STREET SANTA MARIA CA 93454 953818027 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH 0 MARK TWAIN MEDICAL CENTER 768 MOUNTAIN RANCH ROAD SAN ANDREAS CA 95249 680127677 HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE 0 MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA TN 37404 621839548 FUNDRAISING FOUNDATION TN 501(C)(3) LINE 7 MHCS 0 MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA TN 37404 620532345 HOSPITAL TN 501(C)(3) LINE 3 CSH 0 MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA TN 37411 030417049 HEALTHCARE TN 501(C)(3) LINE 10 MHCS 0 MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN TX 75902 750755367 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN TX 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