2020-06-28T12:46:38-05:00 2019-06-30 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2018-07-01 946612446 Dignity Health Workers' Compensation Self-Insurance Trust % MARY TYREN FINANCE DIGN 4154385500 185 Berry Street suite 300 San Francisco CA 94107 MARY TYREN SYSTEM VP CONTROLLER 4154385592 2020-06-25 true LISA M MEYER MANAGER P01490170 4159635100 2020-06-27 162.135.0.60 94661320201805000005 2020-06-28 P 0BB90802FEB4DF5DF5CC028823AEE1A8FE19E846 A26228B005BD8F0E6AA549909595F1DFF8FE8F13 2018 2021-01-29 14:40:06Z DANIEL MORISSETTE 185 BERRY STREET SAN FRANCISCO CA 94107 448751508 false X www.dignityhealth.org X 1989 CA SELF-INSURED WORKERS' COMPENSATION FOR RELATED EXEMPT ORGANIZATIONS. 1 1 0 0 -78974 -78974 0 0 58930073 71081995 3679090 26859477 0 0 62609163 97941472 0 0 0 0 0 0 0 0 0 72363773 59610068 72363773 59610068 -9754610 38331404 443462822 509486104 389455892 428483659 54006930 81002445 SELF-INSURED WORKERS' COMPENSATION FOR RELATED EXEMPT ORGANIZATIONS. false false 58615447 0 71081995 ADMINISTRATION OF SELF-INSURANCE PROGRAMS FOR WORKERS' COMPENSATION FOR AFFILIATED CHARITABLE HEALTHCARE ORGANIZATIONS. 58615447 true false false false false false false false false false false true false false true true false true false false true false false false false false false false false true false false false false false false false false false false false false false true false false false true X 2260 0 true 0 false false false false false false false false false false false false X 1 1 true false false false false true true true true false false false true true true true true false false false CA X MARY TYREN FINANCE 4154385645 185 BERRY STREET SAN FRANCISCO CA 94107 STATE STREET Institutional Trustee 0.0 0.0 X 113972 859730 0 Lloyd H Dean President/ CEO 2.0 50.0 X 0 10655613 777553 Rick Grossman EVP Legal Services/General Cou 2.0 50.0 X 0 3424024 276233 Teresa M Kielhorn VP Risk Services 15.0 25.0 X 0 584306 77495 Daniel J Morissette SEVP Chief Financial Officer 2.0 50.0 X 0 2565848 257011 113972 18089521 1388292 1 false true false Sedgwick Claims Management Services PO BOX 5089 MEMPHIS TN 381015089 Management Services 3804264 MedRisk Inc 2701 Renaissance Blvd Suite 200 KING OF PRUSSIA PA 19406 Physical Therapy 1531541 Luna Levering Holmes Nale 1615 Bunker Hill Way Suite 170 SALINAS CA 93906 Legal Services 1230824 US Healthworks Medical Group PC PO Box 50042 LOS ANGELES CA 90074 Medical Services 698811 Work Comp Care PC 12405 Venice Blvd 376 LOS ANGELES CA 90066 Legal Services 564432 34 0 MGMT FEE FOR SVCS RELATED TO WORKERS'COMP EXPS 900099 71081995 71081995 0 0 71081995 6356786 -78974 6435760 0 0 0 0 0 371312727 350810036 20502691 20502691 20502691 0 0 0 0 0 0 0 0 0 0 97941472 71081995 -78974 26938451 X 0 0 0 0 0 0 0 0 0 0 0 0 16976 16976 0 0 931709 931709 7717603 7691323 26280 0 0 19656 19656 0 0 0 0 0 0 0 0 2167225 2167225 0 WORKERS' COMP. CLAIMS EXPENSE 46817340 46817340 0 0 TAXES AND LICENSES 1928901 1928901 0 0 DUES AND SUBSCRIPTION 10658 10658 0 0 59610068 58615447 994621 0 X 0 0 21958021 10597332 0 0 0 0 0 0 0 0 0 0 0 0 3365494 41130688 0 0 222112970 255940399 195993726 201775885 0 0 0 0 32611 41800 443462822 509486104 46142182 99500778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343313710 328982881 389455892 428483659 X 54006930 81002445 0 0 0 0 54006930 81002445 443462822 509486104 38331404 -11335889 X false true X true false X X 1 DIGNITY HEALTH 941196203 3 true 0 59610067 1 0 59610067 true false false false false false false false false false false false false false false true false PART I, LINE 12G THE TRUST PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART IX FOR FURTHER DETAILS. SCHEDULE A, PART IV, SECTION A, LINE 1 THE TRUST IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH AND ITS SUBSIDIARY CHARITABLE ORGANIZATIONS. THE TRUST IS ORGANIZED EXCLUSIVELY FOR CHARITABLE PURPOSES AND IS INTENDED TO BE FOR THE BENEFIT OF AND SUPPORT OF THE TRUSTOR AND PROVIDERS, TO SERVE AS A REPOSITORY FOR FUNDS PAID IN BY THE TRUSTOR AND PROVIDERS, TO MAKE PAYMENTS ON BEHALF OF THE TRUSTOR AND PROVIDERS PURSUANT TO ARTICLE VI, AND TO OPERATE AS AN INTEGRAL PART OF, AND IN SUPPORT OF THE OPERATIONS OF, THE TRUSTOR AND PROVIDERS. SCHEDULE A, PART IV, SECTION B, LINE 1 DIGNITY HEALTH, THE TRUSTOR OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE THE INSTITUTIONAL TRUSTEE. TRUSTOR MAY AMEND, ALTER OR REVOKE TRUST AGREEMENT IN WHOLE OR IN PART AT ANY TIME BY AN INSTRUMENT IN WRITING DELIVERED TO TRUSTEE PROVIDED, HOWEVER, THAT TRUSTEE'S RIGHTS, DUTIES, POWERS, AND LIABILITIES SHALL NOT BE CHANGED WITHOUT ITS WRITTEN CONSENT. TRUSTEE MAY RESIGN AT ANY TIME UPON SIXTY DAYS NOTICE TO TRUSTOR OR MAY BE REMOVED AT ANY TIME BY TRUSTOR UPON SIXTY DAYS NOTICE TO TRUSTEE. SHOULD THE OFFICE OF TRUSTEE BE VACATED, A SUCCESSOR SHALL BE APPOINTED BY TRUSTOR AND TRUSTEE SHALL ASSIGN, TRANSFER AND PAY OVER THE TRUST ESTATE, AS THEN CONSTITUTED, TO SUCH SUCCESSOR TRUSTEE. IF A SUCCESSOR TRUSTEE IS NOT SO APPOINTED, A SUCCESSOR TRUSTEE SHALL BE A RECOGNIZED INDEPENDENT CORPORATE FIDUCIARY SUCH AS A BANK OR TRUST COMPANY AND SHALL SATISFY SUCH OTHER REQUIREMENTS AS MAY BE IMPOSED. POOLED INVESTMENTS 201775885 F 201775885 0 WORKERS' COMP LIABILITIES 328982881 328982881 X PART X, LINE 2 -FIN 48 (ASC 740) FOOTNOTE COMMONSPIRIT HEALTH REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. Central America and the Caribbean 0 0 Investments none 90398989 Europe (Including Iceland and Greenland) 0 0 Investments NONE 3554777 0 0 0 0 93953766 93953766 true false true true true false PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL EUROPE: ACCRUAL false true false false false false false false false Lloyd H Dean President/ CEO 0 1854326 0 6578474 0 2222813 0 667711 0 109842 0 11433166 0 2095773 Rick Grossman EVP Legal Services/General Cou 0 707418 0 1665846 0 1050760 0 195096 0 81137 0 3700257 0 1033579 Teresa M Kielhorn VP Risk Services 0 310964 0 264478 0 8864 0 53223 0 24272 0 661801 0 0 Daniel J Morissette SEVP Chief Financial Officer 0 972459 0 1586108 0 7281 0 208886 0 48125 0 2822859 0 0 Part I, Line 3, 4A & 4b SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4A CERTAIN LISTED PERSONS PARTICIPATE IN A SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 1 TO 2 YEARS 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 PLAN. THERE WERE NO PAYMENTS RELATED TO THIS PLAN IN 2018. SCHEDULE J, PART I, LINE 4B CERTAIN LISTED PERSONS 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 RELATED TO THIS PLAN OCCURED IN 2018. CERTAIN LISTED PERSONS 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 OFFICERS OCCURRED DURING 2018 INCLUDE L. DEAN; $2,095,773 AND R. GROSSMAN; $1,033,579. CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH SUPPLEMENTAL EXECUTIVE RETENTION/RETIREMENT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN WHICH IN 2002 WAS OFFERED TO MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM BY THE DIGNITY HEALTH BOARD OF DIRECTORS AND WOULD BE PAID ONLY IF THE EXECUTIVES STAYED WITH THE ORGANIZATION FOR A SPECIFIED NUMBER OF YEARS AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION AND RETIREMENT OF THE PARTICIPANTS. THE EXECUTIVE MANAGEMENT TEAM IS RECRUITED FROM STABLE CAREERS IN ORGANIZATIONS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE SUCCESSFULLY. THE CALCULATION FOR THE PAYMENTS TO EACH EXECUTIVE IS BASED ON THE VALUE OF A FINAL AVERAGE PAY ANNUITY BENEFIT BASED ON RETIREMENT AGE AND SERVICE YEARS TO THE ORGANIZATION. DISTRIBUTION OCCURS EACH JULY 1 IF THE PLAN FORMULA WARRANTS A PAYMENT. NO PAYMENTS RELATED TO THIS PLAN OCCURED IN 2018. 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 REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). Part II - Additional Information DIGNITY HEALTH'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST DIGNITY HEALTH IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE DIGNITY HEALTH 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 2018. FORM 990, PART V AND VI FORM 990, PART V, LINE 2A THE ORGANIZATION DOES NOT HAVE EMPLOYEES. THE ORGANIZATION OPERATES AS THE ADMINISTRATION COMPANY OF THE WORKERS' COMPENSATION SELF-INSURANCE PROGRAM FOR THE SUPPORTED ORGANIZATION, DIGNITY HEALTH, AND ITS RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 2 R. GROSSMAN AND D. MORISSETTE - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 7A AND 7B DIGNITY HEALTH, THE TRUSTOR OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE THE INSTITUTIONAL TRUSTEE BY DELIVERY TO THE INSTITUTIONAL TRUSTEE OF WRITTEN NOTICE TO THAT EFFECT. THE INSTITUTIONAL TRUSTEE, AND ANY SUCCESSOR TRUSTEE, MAY RESIGN AS TRUSTEE UPON WRITTEN NOTICE TO THAT EFFECT DELIVERED TO THE TRUSTOR. SUCH REMOVAL OR RESIGNATION SHALL BECOME EFFECTIVE 60 DAYS FROM THE DATE OF THE DELIVERY OF SUCH WRITTEN NOTICE, UNLESS AN EARLIER OR LATER DATE IS AGREED UPON BY TRUSTOR AND THE TRUSTEE. 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 HEALTH IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION ("CHCF"). FORM 990, PART VI, SECTION B, LINE 11B THE SUPPORTED ORGANIZATION'S SYSTEM VICE PRESIDENT OF FINANCE-DIGNITY HEALTH CONTROLLER REVIEWED THE FORM 990. IN ADDITION, THE SUPPORTED ORGANIZATION'S VP OF FINANCIAL SERVICES AND REPORTING WORKED CLOSELY WITH AN INDEPENDENT, OUTSIDE ACCOUNTING FIRM ENGAGED TO REVIEW THE FORM 990. THE FINAL VERSION OF THE FORM 990 WAS NOT PROVIDED TO THE INSTITUTIONAL TRUSTEE BEFORE THE RETURN WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICIES (THE "COI POLICIES"). UNDER SUCH POLICIES, THE GENERAL COUNSEL IS DESIGNATED AS THE ORGANIZATION'S FILING OFFICER AND IS RESPONSIBLE FOR COLLECTING, REVIEWING AND VALIDATING ANNUAL DISCLOSURES OF ALL COVERED PERSONS INCLUDING THE MEMBERS OF DIGNITY HEALTH'S GOVERNING BODIES INCLUDING ITS BOARD OF DIRECTORS AND BOARD COMMITTEES, AS WELL AS DIGNITY HEALTH'S OFFICERS AND EXECUTIVE LEADERS, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE VICE PRESIDENT LEVEL AND ABOVE, AND ANY OTHER PERSONNEL DESIGNATED BY THE FILING OFFICER ("COVERED PERSONS"). ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS ARISING FROM THE BUSINESS, OWNERSHIP, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERVISORS AND TO RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT OF INTEREST, OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR UPON PROMOTION), AND ANNUALLY THEREAFTER. AS PART OF THE ANNUAL DISCLOSURE SURVEY CONDUCTED PURSUANT TO THE COI POLICIES, EACH COVERED PERSON IS REQUIRED TO CERTIFY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE COI POLICY OR COI POLICIES APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE COI POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE COI POLICIES, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE SURVEY AS REQUIRED BY THE COI POLICIES. USING THE INFORMATION FROM THE ANNUAL DISCLOSURE SURVEY, THE FILING OFFICER PREPARES ANNUAL REPORTS OF REPORTED CONFLICTS OF INTEREST AND DISTRIBUTES THOSE REPORTS TO THE GOVERNING BODY CHAIRS, INCLUDING THE CHAIR OF THE BOARD OF DIRECTORS AND THE CHAIR OF DIGNITY HEALTH BOARD COMMITTEES, AS WELL AS TO KEY LEADERS OF THE ORGANIZATION TO ENABLE THE RESPONSIBLE INDIVIDUALS TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES INCLUDE, BUT ARE NOT LIMITED TO: (1) THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST IS FULLY DISCLOSED TO THE APPLICABLE GOVERNING BODY AND ANY OTHER RELEVANT DECISION-MAKERS; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED, AFTER WHICH HE/SHE SHALL LEAVE THE MEETING; (3) THE INTERESTED PERSON MAY BE EXCLUDED FROM THE DISCUSSION AND MUST BE EXCUSED FROM THE MEETING PRIOR TO AND DURING THE APPROVAL OF SUCH TRANSACTION; (4) IF WARRANTED, ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, AND COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) THE TRANSACTION OR ACTION IS APPROVED BY A MAJORITY OF DISINTERESTED MEMBERS OF THE GOVERNING BODIES, CONSISTENT WITH ANY REQUIREMENTS OF BYLAWS AND COI POLICIES; AND (6) ANY CONFLICTING ISSUES ARISING DURING THE COURSE OF A GOVERNING BODY MEETING WHICH CANNOT BE RESOLVED MAY BE REFERRED TO AN INDEPENDENT COMMITTEE OF THE APPLICABLE GOVERNING BODY. THERE ARE SIMILAR CONFLICTS OF INTEREST PROVISIONS UNDER DIGNITY HEALTH'S STANDARDS OF CONDUCT, WHICH ARE APPLICABLE TO ALL EMPLOYEES AND WHICH ARE ADMINISTERED BY THE EVP/CHIEF COMPLIANCE OFFICER WHO HAS REPORTING RESPONSIBILITY TO THE PRESIDENT/CEO AS WELL AS TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 ALTHOUGH THE ORGANIZATION DOES NOT DIRECTLY EMPLOY ANY PERSONNEL, THE SUPPORTED ORGANIZATION'S BOARD OF DIRECTORS ANNUALLY APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED OF EXCLUSIVELY INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EXECUTIVES (INCLUDING THE PRESIDENT/CEO). 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 FOR OFFICERS AND KEY EMPLOYEES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF DIRECTORS. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE TRANSACTION APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED TRANSACTION AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW 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 DIGNITY HEALTH AND SUBORDINATE CORPORATIONS' CONSOLIDATED FINANCIAL STATEMENTS WHICH ARE AVAILABLE ON DIGNITY HEALTH'S WEBSITE AND UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PROF FEES FOR CLAIM PROCESS TOTAL FEES:6716177 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:891926 FORM 990 PART IX LINE 11G DESCRIPTION:ACTUARY SRVICES TOTAL FEES:109500 Bakersfield Memorial Hospital 420 34TH Street Bakersfield CA 93301 951802779 Hospital CA 501(c)(3) 3 DHDCC false Community Hospital of San Bernardino 1805 Medical Center Drive San Bernardino CA 92411 951643373 Hospital CA 501(c)(3) 3 DHDCC false Dignity Community Care 185 Berry Street Suite 300 San Francisco CA 94107 815009488 Hospital CO 501(c)(3) 3 CSH false Dignity Health 185 Berry Street Suite 300 San Francisco CA 94107 941196203 Hospital CA 501(c)(3) 3 CSH false Dignity Health Connected Living 200 Mercy Oaks Drive Redding CA 96003 237115371 Senior Center CA 501(c)(3) 7 Dignity Hlth false Dignity Health HPL Self-Insurance Trust 185 Berry Street San Francisco CA 94107 943006034 Administratio CA 501(c)(3) 12A-I Dignity Hlth false Dignity Health Insurance Nevada Ltd 185 Berry Street San Francisco NV 94107 813800752 Self Ins Fund NV 501(c)(3) 12A-I Dignity Hlth false Dignity Health Medical Foundation 3400 Data Drive Rancho Cordova CA 95670 680220314 Multi-sp CLIN CA 501(c)(3) 12A-I DHDCC false Dominican Health Services 1555 Soquel Drive Santa Cruz CA 95065 770056778 Community Hlt CA 501(c)(3) 12A-I Dignity Hlth false Dominican Oaks Corporation 1555 Soquel Drive Santa Cruz CA 95065 770127719 SR HOUSING CA 501(c)(3) 10 DHS false Mark Twain Medical Center 768 Mountain Ranch Road San Andreas CA 95249 680127677 Hospital CA 501(c)(3) 3 DHDCC false Mercy McMahon Terrace 3865 J Street Sacramento CA 95816 680117340 SR HOUSING CA 501(c)(3) 10 Dignity Hlth false Pacific Central Coast Health Centers 1400 E Church Street Santa Maria CA 93454 770447575 Clinic CA 501(c)(3) 3 DHDCC false Port City Operating Company LLC 3400 Data Drive Rancho Cordova CA 95670 465322209 Hospital CA 501(c)(3) 3 Dignity Hlth false Saint Francis Memorial Hospital 900 Hyde Street San Francisco CA 94109 941156295 Hospital CA 501(c)(3) 3 DHDCC false Sierra Nevada Memorial-Miners Hospital 155 Glasson Way Grass Valley CA 95945 941439787 Hospital CA 501(c)(3) 3 DHDCC false St Francis Hospital Support Corporation 601 E Micheltorena Street Santa Barbara CA 93103 770022302 INACTIVE CA 501(c)(3) 12A-I Dignity Hlth false St Mary Professional Building Inc 1050 Linden Avenue Long Beach CA 90813 237373088 INACTIVE CA 501(c)(3) 12A-I Dignity Hlth false Arroyo Grande Community Hospital Foundat 345 S Halcyon Rd Arroyo Grande CA 93420 203256066 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false Barrow Foundation UK 13 CHURCH STREET NUNNEY ENGLAND UK BA11 4LW 311724184 FNDRSING FND UK 501(c)(3) 12D-III-NFI NA false Barrow Neurological Foundation 350 West Thomas Road Phoenix AZ 85013 860174371 FNDRSING FND AZ 501(c)(3) 7 Dignity Hlth false California Hospital Medical Center Found 1401 South Grand Avenue Los Angeles CA 90015 954000909 FNDRSING FND CA 501(c)(3) 12A-I DHDCC false Dignity Health Foundation 185 Berry Street San Francisco CA 94107 462037641 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false Dignity Health Foundation - Inland Empir 2101 N Waterman Avenue San Bernardino CA 92404 237440086 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false Dignity Health Foundation East Valley 475 South Dobson Road Chandler AZ 85224 742418514 FNDRSING FND AZ 501(c)(3) 12A-I Dignity Hlth false Dominican Hospital Foundation 1555 Soquel Drive Santa Cruz CA 95065 942450442 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false French Hospital Medical Center Foundatio 1911 Johnson Avenue San Luis Obispo CA 93401 203256125 FNDRSING FND CA 501(c)(3) 12A-I DHDCC false Glendale Memorial Health Foundation 1420 South Central Avenue Glendale CA 91204 953625651 FNDRSING FND CA 501(c)(3) 12A-I DHDCC false Marian Regional Medical Center Foundatio 1400 E Church Street Santa Maria CA 93454 953818027 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false Mercy Foundation Bakersfield PO Box 119 Bakersfield CA 93302 770201321 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false Mercy Foundation North 2625 Edith Avenue Suite E Redding CA 96001 943136799 FNDRSING FND CA 501(c)(3) 12A-I NA false Mercy Foundation Sacramento 3400 Data Drive 3rd Flr Rancho Cordova CA 95670 237072762 FNDRSING FND CA 501(c)(3) 12A-I NA false Mercy Medical Center Merced Foundation 301 E 13th Street Merced CA 95340 770035928 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false Northridge Hospital Foundation 18300 Roscoe Blvd Northridge CA 91328 237444901 FNDRSING FND CA 501(c)(3) 12A-I DHDCC false San Gabriel Valley Medical Center Founda 438 West Las Tunas Drive San Gabriel CA 91776 953430341 INACTIVE CA 501(c)(3) 12A-I Dignity Hlth false Sequoia Hospital Foundation 170 Alameda de las Pulgas Redwood City CA 94062 942909990 FNDRSING FND CA 501(c)(3) 12D-III-NFI NA false St Francis Foundation of Santa Barbara 2323 De La Vina St Suite 104 Santa Barbara CA 93105 237137119 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false St John's Healthcare Foundation 1600 North Rose Avenue Oxnard CA 93030 202865781 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false St Joseph's Foundation 350 West Thomas Road Phoenix AZ 85013 942941245 FNDRSING FND AZ 501(c)(3) 12A-I Dignity Hlth false St Joseph's Foundation of San Joaquin 1800 N California Street Stockton CA 95204 510432777 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false St Mary Medical Center Foundation 1050 Linden Avenue Long Beach CA 90813 237153876 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false St Mary's Medical Center Foundation 450 Stanyan Street San Francisco CA 94117 943336143 FNDRSING FND CA 501(c)(3) 12A-I Dignity Hlth false St Rose Dominican Health Foundation 3001 St Rose Parkway Henderson NV 89052 880349432 FNDRSING FND NV 501(c)(3) 12A-I Dignity Hlth false Woodland Memorial Hospital Foundation 1321 Cottonwood Street 305 Woodland CA 95695 946167964 FNDRSING FND CA 501(c)(3) 7 NA false ALEGENT CREIGHTON CLINIC 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