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 680127677 Mark Twain Medical Center % LARA CARTOSCELLI ACCOUNTING MARK 2097543521 185 BERRY STREET SUITE 300 SAN FRANCISCO CA 94107 JOHN CHIVERS CFO 2097542614 2020-06-25 true LISA M MEYER Manager P01490170 4159635100 2020-06-27 162.135.0.60 94661320201805000004 2020-06-28 P 6C6F510C6DBB30CB6B3A10A52E01BBA2D1FA3EEF A26228B005BD8F0E6AA549909595F1DFF8FE8F13 2018 2020-09-23 17:36:50Z JOHN CHIVERS CFO 768 MOUNTAIN RANCH ROAD SAN ANDREAS CA 95249 71548902 false X www.marktwainmedicalcenter.org X 1987 CA To continuously improve the health status of our community. of our community. 5 2 358 19 0 0 239735 1024116 66253752 66841927 587435 376546 288826 308267 67369748 68550856 510380 406300 0 0 34519535 37732373 0 0 0 33916576 31508614 68946491 69647287 -1576743 -1096431 38023384 57355585 5918718 14561807 32104666 42793778 X TO CONTINUOUSLY IMPROVE THE HEALTH STATUS OF OUR COMMUNITY. false false 55726151 406300 66841927 THE HOSPITAL PROVIDES ROUTINE PATIENT CARE IN PRIVATE AND SEMI-PRIVATE ROOMS AS WELL AS VARIOUS INPATIENT AND OUTPATIENT ANCILLARY SERVICES SUCH AS X-RAY, LAB, EMERGENCY ROOM, ETC. DURING THE FISCAL YEAR 2019, 916 PATIENTS WERE ADMITTED TO THE FACILITY AND 76,803 OUTPATIENT VISITS WERE RECORDED INCLUDING VISITS AT OUR 5 RURAL HEALTH CLINICS. 55726151 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true 73 0 true 358 true false false false false false false false false false false false false X 5 2 false false true false false true true true true false false false true true true true true false false false CA X LARA CARTOSCELLI ACCOUNTING 9166313337 10901 GOLD CENTER DRIVE 3RD FLOOR RANCHO CORDOVA CA 95670 X Susan Atkinson Ex-off Brd Member thru 5/2019 4.0 0.0 X 0 0 0 Christopher M Champlin Ex-off Brd Member -STRT 6/2019 4.0 0.0 X 0 460755 66848 Andrea N Ochoa Ex-off Brd Member -STRT 6/2019 4.0 0.0 X 0 255468 41395 Andrew McCoy MD Ex-off Brd Member thru 5/2019 40.0 0.0 X 0 0 0 Lin Reed Ex-off Brd Member -STRT 6/2019 4.0 0.0 X 0 0 0 Charles Kassis Chairman (START 6/2019) 4.0 40.0 X X 0 575614 94898 Randall Ross Vice Chairman (START 6/2019) 4.0 0.0 X X 0 0 0 William Griffin MD Chairman (thru 5/2019) 4.0 0.0 X X 0 0 0 David Woodhams DDS Brd Membr/Treasurer THRU6/2019 4.0 0.0 X X 0 0 0 Douglas P Archer President & CEO started 3/2019 40.0 0.0 X 0 0 0 John M Chivers VP & CFO (start 4/2019) 40.0 0.0 X 0 0 0 Robert Diehl President & CEO (thru 8/2018) 40.0 0.0 X 0 507704 70810 Chris L Roberts VP & CFO (thru 1/2019) 40.0 0.0 X 198288 0 50255 Katherine McCoy VP & CNE 40.0 0.0 X 203464 0 37636 Lonnie Smith MD CMO 40.0 0.0 X 314007 0 36896 Peggy E Seever Registered Nurse 40.0 0.0 X 192729 0 31740 James F Brennan Physician 40.0 0.0 X 271483 0 65097 Ermenegildo Eld Frezza Physician 40.0 0.0 X 268867 0 34500 Jill Ortiz Director of Pharmacy 40.0 0.0 X 212961 0 53787 Mohamad A Parsa MD Physician 40.0 0.0 X 344220 0 69979 Robert Allen Former Officer 0.0 40.0 X 426551 0 80590 Katherine A Medeiros Former Officer 0.0 40.0 X 0 615968 102205 2432570 2415509 836636 92 true true false WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 Medical Services 1464245 INPATIENT SVC OF CA INC 7032 COLLECTION CTR DR CHICAGO IL 60693 Medical Services 1364198 RODGER ORMAN MD INC PO BOX 2189 MURPHYS CA 95247 Medical Services 821674 ELISABETH SIEGLER MD A PC PO BOX 37 ALTAVILLE CA 95221 Medical Services 679338 CRAIG H LOVETT MD INC PO BOX 610 ALTAVILLE CA 95221 Medical Services 651596 15 1024116 1024116 PATIENT NET OF CHARITY AND BAD DEBT/PRICE CONCESSI 900099 37391469 37391469 0 0 MEDICARE/MEDICAID PAYMENTS 900099 29380136 29380136 0 0 CASE MANAGEMENT 900099 87821 87821 0 0 MEDICAL OFFICE BUILDING 900099 31497 31497 0 0 BLOODWORK FEES 900099 16840 16840 0 0 -65836 -65836 0 0 66841927 159793 159793 0 0 0 0 0 3214799 2998046 216753 216753 216753 0 0 0 0 0 0 0 0 0 CAFETERIA 561000 193980 0 0 193980 TENANT SERVICES 561110 98161 0 0 98161 MEDICAL RECORDS/ABSTRACT SALES 900099 6165 0 0 6165 9961 0 0 9961 308267 68550856 66841927 0 684813 X 405800 405800 500 500 0 0 1010962 912269 98693 0 26906912 24485021 2421891 1045698 962042 83656 6837811 5058975 1778836 1930990 1795821 135169 0 2525 2525 13736 13736 5901 5901 0 25218 25218 13401120 8437985 4963135 0 487955 2408 485547 1402373 873905 528468 2513149 165606 2347543 0 1817703 1394518 423185 70286 39501 30785 0 52806 50684 2122 0 0 3136654 3036454 100200 388177 388177 MEDICAL SUPPLIES 7416065 7416065 0 0 BAD DEBT 184747 0 184747 0 LICENSES & TAXES 116086 39433 76653 0 UNRELATED BUSINESS INC TAXES 10958 0 10958 0 463155 260987 202168 69647287 55726151 13921136 0 X 2800 3215 3446878 2646560 0 0 8250248 11379713 0 0 0 0 99384 3000 1100747 1163188 3792118 3248892 28086593 816243 12759165 27270350 3430144 1038549 2275810 1451259 2423799 1961082 0 0 442291 7189777 38023384 57355585 4984424 7218478 0 0 0 89804 0 0 0 0 0 0 0 7016182 0 0 934294 237343 5918718 14561807 X 29680867 40832696 2423799 1961082 0 0 32104666 42793778 38023384 57355585 X -1096431 -93677 355594 11523626 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5901 5901 false PART II - B, Line 1i LOBBYING EXPENDITURES PAID BY THE PARENT ORGANIZATION FOR ANNUAL MEMBERSHIP DUES AND OTHER LOBBYING ACTIVITIES WHERE EXPENSES ARE ALLOCATED TO THE HOSPITAL: AMERICAN HOSPITAL ASSOCIATION $ 1,057 HOSPITAL ASSOCIATION OF SO CALIFORNIA $ 4,375 CATHOLIC HEALTH ASSOCIATION $ 412 340B HEALTH $ 57 -------- TOTAL $ 5,901 ======= 1290000 1290000 13422257 279534 13142723 1431744 46267 1385477 6268229 479464 5788765 5674363 10978 5663385 27270350 OTHER LONG TERM ASSETS 4887541 PREPAID PENSION EXPENSE 1369635 DUE FROM RELATED PARTIES 932601 7189777 0 DUE TO RELATED PARTIES 141581 PENSION PAYABLE 56868 OTHER NON-CURRENT LIABILITIES 38894 237343 X SCHEDULE D, PART VI LAND, BUILDING, AND EQUIPMENT DUE TO THE ACQUISITION ACCOUNTING TREATMENT APPLIED TO THE AFFILIATION BETWEEN DIGNITY HEALTH AND CHI, THE ASSETS AND LIABILITIES OF DIGNITY HEALTH AND ITS RELATED ORGANIZATIONS WERE MEASURED AND RECORDED AT FAIR VALUE UPON THE EFFECTIVE DATE OF FEBRUARY 1, 2019. Schedule D, 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. true true X true X 250. true X 500. true true false true true 231 179442 0 179442 0.00260 25206 18720632 13457386 5263246 0.07580 14 5016 454 4562 0.00010 25451 18905090 13457840 5447250 0.07850 3 247 113956 0 113956 0.00160 0 0 0 0 0.00000 2 499 115064 4278 110786 0.00160 0 0 0 0 0.00000 5 811 182305 0 182305 0.00260 10 1557 411325 4278 407047 0.00580 10 27008 19316415 13462118 5854297 0.08430 true 752956 0 16138649 25683142 -9544493 X true true 1 1 Mark Twain Medical Center 768 Mountain Ranch Road San Andreas CA 95249 dignityhealth.org/marktwainmedical/ 030000058 X X X X Mark Twain Medical Center 1 false false true X X X X X X X X X 16 true false false true X SEE SECTION C X true 16 true SEE SECTION C false true X 250. 500. X X X X true true X X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 CHNA INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN FISCAL YEAR 2017 (TAX YEAR 2016). IT WAS A COLLABORATIVE EFFORT WITH INPUT FROM THE MARK TWAIN MEDICAL CENTER COMMUNITY BOARD OF DIRECTORS, THE CALAVERAS COUNTY DEPARTMENT OF PUBLIC HEALTH, PRACTICING PHYSICIANS, THE CALAVERAS COUNTY UNIFIED SCHOOL DISTRICT, RESOURCE CONNECTION FOOD BANK, AND FIRST 5 CALAVERAS. MTMC WORKED TO COLLECT THE PRIMARY AND SECONDARY DATA REQUIREMENTS OF THE CHNA WITH APPLIED SURVEY RESEARCH (ASR), A NONPROFIT SOCIAL RESEARCH FIRM. THE CHNA DATA COLLECTION PROCESS TOOK PLACE OVER TWO MONTHS AND CULMINATED IN A REPORT WRITTEN FOR THE HOSPITAL IN JUNE OF 2017. THE CHNA USED THREE STRATEGIES FOR COLLECTING COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH HEALTH EXPERTS, A COMMUNITY SUMMIT WITH A SELECTION OF COMMUNITY PARTNERS AND LOCAL EXPERTS, AND A SURVEY OF MARK TWAIN MEDICAL CENTER STAFF. ASR CONDUCTED PRIMARY RESEARCH VIA KEY INFORMANT INTERVIEWS WITH FOUR CALAVERAS COUNTY EXPERTS FROM VARIOUS ORGANIZATIONS, INCLUDING THE COUNTY HEALTH OFFICER AND THE DIRECTOR OF PUBLIC HEALTH NURSING. INFORMANTS WERE ASKED TO IDENTIFY THE TOP NEEDS OF THEIR CONSTITUENCIES, HOW ACCESS TO HEALTHCARE HAS CHANGED IN THE POST-AFFORDABLE CARE ACT ENVIRONMENT, THE IMPACT OF THE PHYSICAL ENVIRONMENT ON HEALTH, AND THE EFFECT OF THE USE OF NEW TECHNOLOGIES FOR HEALTH-RELATED ACTIVITIES. IN APRIL 2017, MTMC SURVEYED STAFF AND STAKEHOLDERS (35 HOSPITAL EMPLOYEES AND 12 COMMUNITY STAKEHOLDERS) REGARDING THE PRIORITIZED HEALTH NEEDS. FOR THE FOUR IDENTIFIED NEEDS, THE SURVEY ASKED HOW THEIR WORK WAS IMPACTED, WHAT CURRENT EFFORTS THEY WERE INVOLVED IN TO ADDRESS THOSE NEEDS, AND IF THEY HAD SUGGESTIONS FOR STRATEGIES THAT THE HOSPITAL COULD IMPLEMENT, EITHER ALONE OR IN COLLABORATION WITH OTHER STAKEHOLDERS. THE SURVEY ALSO ASKED RESPONDENTS TO IDENTIFY ANY OTHER HIGH-PRIORITY NEEDS THAT HAD NOT YET BEEN DISCUSSED. SCHEDULE H, PART V, SECTION B, LINE 7A HTTP://WWW.DIGNITYHEALTH.ORG/MARKTWAINMEDICAL/COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 10A DIGNITY HEALTH HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED AT https://www.dignityhealth.org/about-us/community-health/community-health-p rograms-and-reports/community-health-needs-assessments IMPLEMENTATION STRATEGIES ARE ALSO ON EACH HOSPITAL FACILITY'S WEB SITE, AT THE SAME LOCATIONS AS THEIR CHNA REPORTS LISTED IN PART V, SECTION B, LINE 7A ABOVE. SCHEDULE H, PART V, SECTION B, LINE 11 MARK TWAIN MEDICAL CENTER TOOK SEVERAL ACTIONS TO HELP ADDRESS IDENTIFIED 2017 CHNA NEEDS. SIGNIFICANT HEALTH NEEDS INCLUDE: MENTAL HEALTH, ACCESS TO PRIMARY AND SPECIALTY CARE, CHRONIC DISEASE MANAGEMENT, AND MATERNAL AND CHILD HEALTH. MENTAL HEALTH: THE HOSPITAL DELIVERED TELEHEALTH PSYCHIATRIC CARE TO AID IN STABILITZATION, PRESCRIPTIONS, AND TREATMENT RECOMMENDATIONS. MTMC CONTINUED ITS ACTIVE PARTICIPATION IN THE PROFESSIONAL MENTAL HEALTH COUNTY-WIDE TASK FORCE TO DEVELOP BEST PRACTICES WITH LOCAL RESOURCES. THE HOSPITAL GRANTED FUNDS TO THE FAMILY WELLNESS PROGRAM OF CATHOLIC CHARITIES MOTHER LODE OFFICE, TO A PROGRAM THAT AIMS TO PROVIDE INTERVENTION COUNSELING SERVICES TO RESIDENTS OF TUOLUMNE AND CALAVERAS COUNTIES. SERVICES WERE PROVIDED TO INDIVIDUALS OVER 55 YEARS OF AGE REFERRED BY OTHER AGENCIES, LOCAL PARISHES AND CHURCHES, AND WHO SELF-REFER DUE TO OUTREACH IN THE AREA. ELIGIBLE CLIENTS RECEIVED 8-16 COUNSELING SESSIONS PROVIDED IN AN ACCESSIBLE LOCATION. REFERRALS ARE MADE TO COMMUNITY PARTNERS FOR OTHER SERVICES AS NEEDED. ACCESS TO PRIMARY AND SPECIALTY CARE: MTMC EMPLOYED A GRANT-FUNDED PATIENT NAVIGATOR IN THE EMERGENCY DEPARTMENT TO WORK WITH PATIENTS COVERED BY CALIFORNIA HEALTH AND WELLNESS, AS WELL AS WITH OTHER PATIENTS TO HELP ARRANGE PRIMARY CARE PROVIDERS AND OTHER LINKAGES TO POST-ACUTE SERVICES. THE HOSPITAL OPERATES SPECIALTY CARE CENTERS: IN ANGELS CAMP FOR ORTHOPEDICS AND IN SAN ANDREAS FOR CANCER AND INFUSION THERAPY, AND SURGICAL SPECIALTY CARE. MTMC OPERATES FIVE PRIMARY CARE CLINICS IN ARNOLD, ANGELS CAMP, COPPEROPOLIS, SAN ANDREAS, AND VALLEY SPRINGS. THESE OFFER IMMEDIATE CARE, PRIMARY CARE, BEHAVIORAL HEALTH, OCCUPATIONAL HEALTH, PEDIATRICS, GENERAL X-RAY, LABORATORY DRAWS AND HEALTH EDUCATION. THE HOSPITAL RUNS AND PARTICIPATES IN COMMUNITY HEALTH FAIRS DELIVERING CHOLESTEROL SCREENING, BLOOD PRESSURE CHECKS, BONE DENSITY STUDIES, AND HEALTH EDUCATION. THE HOSPITAL MAINTAINS AN ACTIVE PROVIDER RECRUITMENT EFFORT, WHICH IS CRITICAL IN MTMC'S LOW-POPULATION RURAL COMMUNITY. AS A PART OF THE DIGNITY HEALTH SYSTEM, SPECIALISTS CAN AT TIMES BE SECURED FROM MORE URBAN AREAS IN THE REGION. CHRONIC DISEASE MANAGEMENT: TO ADDRESS TWO OF THE MORE PREVALENT CHRONIC HEALTH NEEDS OF THE COMMUNITY, MTMC CONTINUED TO FOCUS ON PROVIDING EDUCATION AND INSTRUCTION IN SECONDARY PREVENTION AND SELF-MANAGEMENT FOR CONGESTIVE HEART FAILURE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND FOR DIABETES. THESE PROGRAMS ARE DELIVERED AT NO OR NOMINAL COST TO COMMUNITY RESIDENTS WHO HAVE COMPLETED AN ACUTE CARE EPISODE AND WISH TO MAINTAIN AND IMPROVE THEIR HEALTH GAINS. PROGRAMS ARE LED BY TRAINED CLINICIANS AND HEALTH EDUCATORS. THE GOAL OF THESE PROGRAMS IS TO IMPROVE QUALITY OF LIFE FOR PARTICIPANTS BY INCREASING THEIR SELF-EFFICACY AND AVOIDING UNNECESSARY ACUTE CARE. IN ADDITION, THE HOSPITAL DELIVERS THE "A PLAN FOR ME" SERIES OF HEALTH EDUCATION SESSIONS FREE OF CHARGE TO THE COMMUNITY ON A VARIETY OF TOPICS, INCLUDING CHRONIC DISEASE INCLUDING CARDIOVASCULAR HEALTH. MATERNAL AND CHILD HEALTH: THE HOSPITAL IS UNABLE TO DIRECTLY ADDRESS THIS CHNA NEED, DUE IN PART TO THE PHYSICIAN AND HEALTH PROFESSIONALS SHORTAGE IN THE SERVICE AREA. AT THIS TIME, PATIENTS ARE REFERRED OUTSIDE THE COUNTY TO ACCESS OBSTETRICAL AND GYNECOLOGICAL SERVICES. CHILD HEALTH WAS ADDRESSED IN PART THROUGH GRANT SUPPORT FOR THE CALAVERAS YOUTH HEALTH INITIATIVE TARGETED AT MENTAL, EMOTIONAL AND PHYSICIAL HEALTH OF THE COMMUNITY'S YOUNG PEOPLE. OTHER ORGANIZATONS IN THE COMMUNITY, INCLUDING THE SCHOOL DISTRICT, OFFER PROGRAMS AND SERVICES TO ADDRESS CHILDHOOD HEALTH MORE DIRECTLY. SCHEDULE H, PART V, SECTION B, LINES 16A THROUGH 16C HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-cALIFORNIA/LOCATIONS/MARKTWAINMEDICA L/PATIENTS-AND-VISITORS/PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16J ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS AND THE FINANCIAL ASSISTANCE POLICY, A COPY OF THE FINANCIAL ASSISTANCE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION. THE FACILITY'S WEB SITE ALSO CONTAINS THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY OF THE POLICY, APPLICATION, BILLING AND COLLECTION POLICY, A DESCRIPTION OF THE AMOUNT GENERALLY BILLED AND A LISTING OF PROVIDERS AT EACH FACILITY THAT ARE COVERED AND NOT COVERED BY THE FINANICAL ASSISTANCE POLICY. CONTACT INFORMATION CAN ALSO BE FOUND ON EACH FACILITY'S WEB PAGE. THE POLICY'S PLAIN LANGUAGE SUMMARY IS INCLUDED IN THE HOSPITAL'S ANNUAL COMMUNITY BENEFIT REPORT, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. THE HOSPITAL SHARED THE PLAIN LANGUAGE SUMMARY WITH ITS PATIENT ADVISORY COMMITTEE, CURRENT AND PAST GRANT RECIPIENTS, THE CALAVERAS COUNTY PUBLIC HEALTH DEPARTMENT AND HUMAN SERVICES DEPARTMENT, TWO LOCAL SCHOOL DISTRICTS, AND THE MARK TWAIN HEALTH CARE DISTRICT. 5 Valley Springs Family Medical Center 1919 VISTA DEL LAGO DRIVE VALLEY SPRINGS CA 95252 OUTPATIENT CLINIC Angels Camp Familly Medical Center 222 SOUTH MAIN STREET ANGELS CAMP CA 95222 OUTPATIENT CLINIC Arnold Family Medical Center 2182 Highway 4 Arnold CA 95223 Outpatient Clinic San Andreas Clinic 704 Mt Ranch Road Suite 103 San Andreas CA 95249 Outpatient Clinic Copperopolis Family Medical Center 3505 Spangler Lane Suite 400 Copperopolis CA 95228 Outpatient Clinic SCHEDULE H, PART I, LINE 7 MARK TWAIN MEDICAL CENTER (MTMC) FOLLOWS THE METHOD USED BY DIGNITY HEALTH. FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE, MTMC USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO THE PATIENT LEVEL. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL FACILITY WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE WORKSHEET 2 OF SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN ROLLED UP TO THE PATIENT LEVEL BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH THOSE SERVICES PROVIDED TO EACH SPECIFIC PATIENT. THIS IS DONE FOR ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED AND SELF-PAY. THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF CHARITY CARE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR CHARITY CARE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND DONATIONS. SCHEDULE H, PART I, LINE 7, 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. MTMC RECOGNIZED FEE-FOR-SERVICE SUPPLEMENTAL PAYMENTS OF $4.06 MILLION DURING THE YEAR REFLECTED UNDER THE MEDICAID PROGRAM AS DIRECT OFFSETTING REVENUE (PART I, LINE 7B, COLUMN D). SCHEDULE H, PART I, LINE 7I INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $137,769 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. Schedule H, Part II - Community Building Activities THE HOSPITAL DID NOT REPORT EXPENSES ASSOCIATED WITH COMMUNITY BUILDING PROGRAM ACTIVITIES DURING FY19. SCHEDULE H, PART III, LINE 2 THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) 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. ANY PORTION OF A PATIENT BILL REMAINING AFTER APPLYING FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT THAT ARE ULTIMATELY DETERMINED TO BE UNCOLLECTIBLE ARE WRITTEN OFF TO BAD DEBT. MTMC PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 250%, 251%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. MTMC ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 30%. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 MTMC MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. MTMC FOLLOWS DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY. DIGNITY 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. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED 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 NO SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE WERE REPORTED AS BAD DEBT. AS SUCH, DIGNITY HEALTH 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. SCHEDULE H, PART III, LINE 4 THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT HEALTH'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2019, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR DOUBTFUL ACCOUNTS AND PATIENT REVENUE: 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. MTMC MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES. RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS HAVE BEEN ESTABLISHED AND ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEET. SCHEDULE H, PART III, LINE 8 MTMC PREPARES MEDICARE COST REPORTS IN A MANNER THAT COMPORTS 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, INCLUDING DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS, WHICH INCLUDES MARK TWAIN, BELIEVES THAT THE ENTIRE MEDICARE SHORTFALL OF $2.2 BILLION, AS REPORTED BELOW IN PART VI, LINE 6, 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 MTMC 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. THIS SHORTFALL INCLUDES $9.5 MILLION REPORTED ON PART III, SECTION B, LINE 7, PRIMARILY FOR FEE FOR SERVICE MEDICARE PATIENTS, AS WELL AS THE UNREIMBURSED PORTION OF MEDICARE MANAGED CARE AND MEDICARE CAPITATED PROGRAMS FOR MTMC. SCHEDULE H, PART III, LINE 9B MTMC ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. MTMC ALSO FOLLOWS DIGNITY HEALTH'S COLLECTION POLICY. DIGNITY HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHOM THE ORGANIZATION KNOWS QUALIFY FOR CHARITY CARE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF MTMC OR BILLING COMPANY RETAINED BY DIGNITY 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 DIGNITY HEALTH'S FINANCIAL ASISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, MTMC WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. 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 BILLING COMPANY RETAINED BY MTMC. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, MTMC REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. Schedule H, Part VI, Line 2 - Needs Assessment HOSPITAL LEADERSHIP OVERSEES COMMUNITY BENEFIT ACTIVITIES FOR THE HOSPITAL AS IT STRIVES TO MEET THE HEALTH AND WELLNESS NEEDS OF THE LOCAL COMMUNITY. MEMBERS OF MARK TWAIN'S SENIOR AND MIDDLE MANAGEMENT TEAM SERVE THE COMMUNITY ON A VARIETY OF COMMUNITY-BASED NOT-FOR-PROFIT BOARDS, OTHER SERVICE CLUBS, LOCAL CHURCHES AND CHAMBER OF COMMERCE, AND PROVIDE INSIGHT INTO THE UNIQUE NEEDS OF THE COMMUNITY THAT MAY NOT BE APPARENT IN SECONDARY DATA. MTMC BOARD OF DIRECTORS, MANY OF WHOM ARE RECOGNIZED COMMUNITY LEADERS, ALSO REPRESENTED THE MEDICAL COMMUNITY. AS REPRESENTATIVES OF THE COMMUNITY, THESE LEADERS AND BOARD MEMBERS PROVIDED INSIGHT INTO NEEDS THROUGH DISCUSSION AT MEETINGS. THE HOSPITAL HAS CLOSE WORKING RELATIONSHIPS WITH THE MARK TWAIN HEALTH CARE DISTRICT, THE COUNTY HEALTH AND HUMAN SERVICES AGENCY, THE PUBLIC SCHOOLS AND OTHERS THROUGHOUT THE YEAR. THESE RELATIONSHIPS ENSURE FREQUENT DIALOGUE ABOUT A WIDE RANGE OF COMMUNITY HEALTH NEEDS. Schedule H, Part VI, Line 3 - Patient Education of Eligibility for ASSISTANCE COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC: INFORMATION ABOUT PATIENT FINANCIAL ASSISTANCE IS AVAILABLE AT MTMC AND ALL OF ITS COMMUNITY LOCATIONS AND WEBSITES, INCLUDING A CONTACT NUMBER FOR PATIENTS TO CALL FOR INFORMATION AND ASSISTANCE. THE INFORMATION IS DISSEMINATED BY MTMC BY VARIOUS MEANS TO INCLUDE NOTICES ON PATIENT BILLS, BROCHURES AT ALL REGISTRATION DESKS AND IN ALL WAITING ROOMS, AND NOTICES POSTED IN THE EMERGENCY DEPARTMENT. SUCH INFORMATION IS PROVIDED IN ENGLISH AND SPANISH. AT THE POINT OF REGISTRATION, ALL PATIENTS RECEIVE BROCHURES EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. UNINSURED PATIENTS RECEIVE COPIES OF THE FINANCIAL ASSISTANCE AND MEDICAID APPLICATIONS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED 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 WITHOUT INSURANCE COVERAGE THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR CHARITY CARE AND THE PROVISION OF SUCH APPLICATIONS. ANY MEMBER OF MTMC STAFF OR MEDICAL STAFF MAY REFER A PATIENT FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE. Schedule H, Part VI, Line 4 - Community Information MTMC SERVES CALAVERAS COUNTY, APPROXIMATELY 130 MILES EAST OF SAN FRANCISCO, 60 MILES SOUTHEAST OF SACRAMENTO, AND 50 MILES EAST OF STOCKTON. THE RURAL COUNTY'S GEOGRAPHY BEGINS NEAR SEA-LEVEL IN THE WEST AND CULMINATES NEAR 8,200 FEET IN THE EASTERN PART OF THE COUNTY, IN THE SIERRA NEVADA RANGE. CALAVERAS COUNTY IS A HEALTH PROFESSIONAL SHORTAGE AREA AND PORTIONS OF THE COUNTY ARE MEDICALLY UNDERSERVED AREAS. BESIDES MARK TWAIN MEDICAL CENTER, ITS FIVE AMBULATORY CARE CENTERS AND FOUR SPECIALTY CARE CENTERS, THE FOLLOWING FACILITIES AND RESOURCES ARE AVAILABLE: CONVALESCENT HOSPITAL, ASSISTED LIVING, COMMUNITY CLINICS, CHILDREN SERVICES, HOME HEALTH CARE, HOSPICE, MENTAL HEALTH, DRUG & ALCOHOL ABUSE SERVICES, SUPPORT GROUPS & SERVICES, AND TRANSPORTATION. THE COUNTY HAS A RELATIVELY MATURE POPULATION WITH A HIGHER PROPORTION OF PERSONS AGED 65 YEARS AND OVER (26.9%) COMPARED TO CALIFORNIA (13.9%), AND A HIGHER PROPORTION OF MILITARY VETERANS (10%) COMPARED TO CALIFORNIA (4%). TOTAL POPULATION: 44,987 RACE/ETHNICITY: WHITE - NON-HISPANIC 80.6%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 0.9%; HISPANIC OR LATINO 12.2%; ASIAN/PACIFIC ISLANDER 1.7%; ALL OTHERS 4.6% MEDIAN INCOME: $58,605 UNEMPLOYMENT: 5.9% NO HIGH SCHOOL DIPLOMA: 8.3% MEDICAID: 23.3% UNINSURED: 7.6% OTHER AREA HOSPITALS: 0 Schedule H, Part VI, Line 5 - Promotion of Community Health HOSPITAL LEADERSHIP OVERSEES COMMUNITY BENEFIT ACTIVITIES FOR THE HOSPITAL AS IT MEETS THE HEALTH AND WELLNESS NEEDS OF THE LOCAL COMMUNITY. SEVERAL MEMBERS OF MARK TWAIN MEDICAL CENTER'S MANAGEMENT TEAM SERVE THE COMMUNITY ON A VARIETY OF COMMUNITY BASED NOT FOR PROFIT BOARDS. THE HOSPITAL IS GOVERNED BY A BOARD OF TRUSTEES, THE MAJORITY OF WHOM RESIDE WITHIN ITS PRIMARY SERVICE AREA AND WHO ARE NOT EMPLOYEES, CONTRACTORS OR FAMILY MEMBERS THEREOF. IN THE RURAL ENVIRONMENT OF OUR COMMUNITY, SMALL BUSINESS, AGENCIES AND THE HOSPITAL PARTNER TO PROVIDE VARIOUS EVENTS THROUGHOUT THE YEAR THAT ARE FOCUSED ON PROMOTING THE HEALTH OF THE COMMUNITY, ENHANCING QUALITY OF LIFE FOR THE RESIDENTS AND SHOWCASING THE UNIQUE HISTORY AND NATURAL WONDERS OF OUR ENVIRONMENT. BASED ON THE PRIORITIZED HEALTH NEED OF THE COMMUNITY, A SPECIFIC FOCUS HAS BEEN ON WOMEN'S HEALTH ISSUES AND PRIMARY CARE AND PREVENTION. MARK TWAIN MEDICAL CENTER PUBLISHED A COMMUNITY RESOURCES BROCHURE FOR RESIDENTS. THE ORGANIZATIONS IN THIS BROCHURE WORK WITH US TO PROVIDE COMMUNITY RESOURCES THAT CAN MAKE A DIFFERENCE. IN ADDITION, MANY EMPLOYEES HAVE LINKAGES TO VARIOUS SERVICE ORGANIZATIONS THROUGHOUT THE COMMUNITIES. COMMUNITY INVOLVEMENT IS EVIDENCED BY PARTICIPATION OF LOCAL BUSINESS AND COMMUNITY LEADERS IN THE HOSPITAL'S GOVERNING BOARDS, FINANCE COMMITTEE, ETHICS COMMITTEE AND OUR PATIENT ADVISORY COMMITTEE. MTMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN AND OUTSIDE ITS COMMUNITY WHO REQUEST SAID PRIVILEGES. ALL SURPLUS FUNDS GENERATED BY MTMC ARE REINVESTED BACK INTO THE ORGANIZATION TO IMPROVE PATIENT CARE AND PROVIDE HEALTH CARE SERVICES TO ITS COMMUNITY. Schedule H, Part VI, Line 6 - Affiliated Health Care System AFFILIATES OF MARK TWAIN MEDICAL CENTER ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN BAKERSFIELD, SAN BERNARDINO, SAN FRANCISCO, SAN ANDREAS, GRASS VALLEY/NEVADA CITY, CALIFORNIA, PHOENIX, CHANDLER AND GILBERT, ARIZONA, AND LAS VEGAS AND HENDERSON, NEVADA. 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 MARK TWAIN MEDICAL CENTER, FOR THE YEAR ENDED JUNE 30, 2019, IS AS FOLLOWS (IN MILLIONS): Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 317 289 1.4% Unpaid Costs of Medicaid/Medi-Cal 4,550 1,441 6.8% Other Means-tested Programs 23 13 0.1% Community Services: Community Health Services 58 31 0.1% Subsidized Health Services 33 32 0.2% Donations 52 50 0.2% Total Community Services for the poor 143 113 0.5% Total Benefits for the Poor 5,033 1,856 8.8% Benefits for the Broader Community: Community Services: Community Health Services 103 99 0.5% Health Professions Education 128 113 0.5% Subsidized Health Services 23 17 0.1% Research 131 95 0.4% Donations 7 6 0.0% Total Benefits for the Broader Community 392 330 1.5% Total Community Benefits 5,425 2,186 10.3% Unpaid Costs of Medicare 5,957 2,249 10.6% Total Community Benefits including Unpaid Cost of Medicare 11,382 4,435 20.9% true Mark Twain Medical Center Foundation 768 Mountain Ranch Road San Andreas CA 95249 680023507 501(c)(3) 244201 0 N/A N/A Foundation Support California Health Foundation and Trust 1215 K Street Suite 800 Sacramento CA 95814 941498697 501(c)(3) 137769 0 N/A N/A Community Health The Resource Connection of Amador and Calaveras Co PO Box 919 San Andreas CA 95249 942705790 501(C)(3) 0 5662 book food COMMUNITY health 3 0 PART I, LINE 1 AS A 501(C)(3) ORGANIZATION, WE PROVIDE ASSISTANCE TO VARIOUS CHARITABLE ORGANIZATIONS TO PROMOTE MTMC'S MISSION. A DESIGNATED COMMITTEE CONSISTING PRIMARILY OF THE EXECUTIVE TEAM ESTABLISHES AND EVALUATES PRIORITIES AND ALLOCATION OF FUNDS WITH EMPHASIS ON PROMOTION OF HEALTHY COMMUNITIES AND COMMUNITY COLLABORATION. WE DO NOT MONITOR AND REPORT PROGRAM OUTCOMES. SPENDING IS TRACKED ON AN ONGOING BASIS TO ENSURE THAT IT IS GENERALLY WITHIN THE BUDGETED AMOUNT. true true false false false false false false false Christopher M Champlin Ex-off Brd Member -STRT 6/2019 0 303214 0 149535 0 8006 0 35577 0 31271 0 527603 0 0 Andrea N Ochoa Ex-off Brd Member -STRT 6/2019 0 207024 0 47337 0 1107 0 27315 0 14080 0 296863 0 0 Charles Kassis Chairman (START 6/2019) 0 347154 0 213497 0 14963 0 52221 0 42677 0 670512 0 0 Robert Diehl President & CEO (thru 8/2018) 0 162533 0 0 0 345171 0 21318 0 49492 0 578514 0 0 Chris L Roberts VP & CFO (thru 1/2019) 195569 0 0 0 2719 0 21468 0 28787 0 248543 0 0 0 Katherine McCoy VP & CNE 197937 0 0 0 5527 0 21302 0 16334 0 241100 0 0 0 Lonnie Smith MD CMO 309096 0 0 0 4911 0 32359 0 4537 0 350903 0 0 0 Peggy E Seever Registered Nurse 190629 0 500 0 1600 0 17775 0 13965 0 224469 0 0 0 James F Brennan Physician 268517 0 0 0 2966 0 28918 0 36179 0 336580 0 0 0 Ermenegildo Eld Frezza Physician 234762 0 25000 0 9105 0 20316 0 14184 0 303367 0 0 0 Jill Ortiz Director of Pharmacy 197793 0 2020 0 13148 0 22541 0 31246 0 266748 0 0 0 Mohamad A Parsa MD Physician 318731 0 25000 0 489 0 35190 0 34789 0 414199 0 0 0 Robert Allen Former Officer 323933 0 101158 0 1460 0 42786 0 37804 0 507141 0 0 0 Katherine A Medeiros Former Officer 0 309796 0 278935 0 27237 0 54503 0 47702 0 718173 0 0 PART I, LINE 3 ALTHOUGH THE ORGANIZATION EMPLOYS PERSONNEL, 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 15A FOR ADDITIONAL INFORMATION. PART I, LINE 4a THE ORGANIZATION'S KEY EMPLOYEES AND ITS HIGHEST COMPENSATED EMPLOYEES PARTICIPATE IN A SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 6 MONTHS 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. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR ONE OFFICER OCCURRED DURING 2018 INCLUDE R. DIEHL $308,916. PART I, LINE 4b 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. NO PAYMENTS WERE MADE UNDER THIS PLAN DURING 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 - SUPPLEMENTAL DISCLOSURES THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION 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 IT 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 THE ORGANIZATION'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 I, LINE 22 AFFILIATION OF CHI AND DIGNITY HEALTH ON FEBRUARY 1, 2019 CATHOLIC HEALTH INITIATIVES ("CHI") AND DIGNITY HEALTH EFFECTED A BUSINESS COMBINATION AS DISCUSSED IN NOTE 1 OF COMMONSPIRIT HEALTH'S ("COMMONSPIRIT") AUDITED FINANCIAL STATEMENTS AS OF AND FOR THE YEAR ENDED JUNE 30, 2019. DUE TO THE CIRCUMSTANCES OF THE BUSINESS COMBINATION BETWEEN CHI AND DIGNITY HEALTH, THROUGH THE ALIGNMENT UNDER CATHOLIC HEALTH CARE FEDERATION ("CHCF"), THE TRANSACTION QUALIFIED FOR ACQUISITION ACCOUNTING WITH COMMONSPIRIT (FORMERLY KNOWN AS CHI) AS THE ACCOUNTING ACQUIRER OF DIGNITY HEALTH. NO CASH CONSIDERATION WAS INVOLVED IN THE AFFILIATION. AS PART OF THE AFFILIATION, DIGNITY HEALTH CAUSED TO TRANSFER EIGHT NON-CATHOLIC OWNED COMMUNITY HOSPITALS, NON-CATHOLIC SUBSIDIARY HOSPITALS (INCLUDING THE FILING ORGANIZATION), AND CERTAIN OTHER NON-CATHOLIC OPERATIONS TO DIGNITY COMMUNITY CARE. THE TRANSFER OF THESE NET ASSETS, STEPPED UP TO FAIR VALUE PURSUANT TO THE APPLICATION OF ACQUISITON ACCOUNTING, IS RECORDED IN NET ASSETS (SEE PART XI, LINE 9). FORM 990, PART VI, SECTION A, LINE 4 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"). AS PART OF THE ALIGNMENT, ON THE EFFECTIVE DATE OF FEBRUARY 1, 2019, DIGNITY HEALTH CAUSED TO TRANSFER NON-CATHOLIC OWNED COMMUNITY HOSPITALS, NON-CATHOLIC SUBSIDIARY HOSPITALS, AND CERTAIN OTHER NON-CATHOLIC OPERATIONS TO DIGNITY COMMUNITY CARE, A COLORADO NONPROFIT CORPORATION. EFFECTIVE JUNE 1, 2019, UPON DISSOLUTION OR WINDING UP OF THE ORGANIZATION, NINETY-NINE PERCENT (99%) OF ITS ASSETS REMAINING AFTER PAYMENT OR PROVISION FOR PAYMENT, OF ALL DEBTS AND LIABILITIES OF THE ORGANIZATION SHALL BE DISTRIBUTED TO DIGNITY COMMUNITY CARE. DIGNITY COMMUNITY CARE, THE PARENT CORPORATION, AND COMMONSPIRIT HEALTH, THE SYSTEM CORPORATION SHALL EACH HAVE SPECIFIC RESERVED RIGHTS AND POWERS SET FORTH IN THE SYSTEM GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 6 PRIOR TO JUNE 1, 2019, MARK TWAIN MEDICAL CENTER WAS JOINTLY OWNED BY DIGNITY HEALTH, A 501(C)(3) EXEMPT ORGANIZATION AND MARK TWAIN HEALTHCARE DISTRICT (THE DISTRICT). EFFECTIVE JUNE 1, 2019, UNDER A COMPREHENSIVE MANAGEMENT AGREEMENT, MARK TWAIN MEDICAL CENTER IS JOINTLY OWNED BY DIGNITY COMMUNITY CARE, A 501(C)(3) EXEMPT ORGANIZATION AND MARK TWAIN HEALTHCARE DISTRICT (THE DISTRICT) AT 99% AND 1%, RESPECTIVELY. THE ORGANIZATION HAS NO MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A DIGNITY COMMUNITY CARE RATIFIES THE SELECTION OF MEMBERS AND APPROVES NEW BOARD MEMBERS OF THE ORGANIZATION. THE ORGANIZATION SHALL HAVE FIVE VOTING MEMBERS. THE BOARD OF DIRECTORS WILL SELECT AND RECOMMEND FOUR DIRECTORS AND THE DISTRICT SHALL NOMINATE ONE OF ITS INCUMBENT BOARD MEMBERS FOR THE ORGANIZATION TO RECOMMEND TO DIGNITY COMMUNITY CARE FOR APPROVAL AS THE FIFTH DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7B PRIOR TO JUNE 1, 2019, RESERVED RIGHTS OF THE CORPORATE MEMBERS (DIGNITY HEALTH AND THE DISTRICT) INCLUDE ADOPTION OF MISSION AND PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS, DISSOLUTION OF THE CORPORATION, ACQUISITION OF ANOTHER CORPORATION, CREATION OF A NEW SUBSIDIARY, MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION, PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE, INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS, RATIFICATION OF BOARD MEMBER APPOINTMENTS AND DISMISSALS, SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, AND TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS. EFFECTIVE JUNE 1, 2019, DIGNITY COMMUNITY CARE, THE PARENT CORPORATION, AND COMMONSPIRIT HEALTH, THE SYSTEM CORPORATION SHALL EACH HAVE SPECIFIC RESERVED RIGHTS AND POWERS SET FORTH IN THE SYSTEM GOVERNANCE MATRIX. THE ORGANIZATION IS SUBJECT TO THE GOVERNANCE REQUIREMENTS OF THE SYSTEM GOVERNANCE MATRIX. THUS, MANY KEY DECISIONS ADDRESSED IN THE BYLAWS REQUIRE THE ORGANIZATION TO ACT BY MAKING A "RECOMMENDATION," WHICH IS THEN FORMALLY ACTED ON BY THE DIGNITY COMMUNITY CARE BOARD. EXAMPLES INCLUDE AMENDING CORPORATE DOCUMENTS, APPROVING MEMBERS OF GOVERNING BOARD, APPROVING REMOVAL OF MEMBERS OF GOVERNING BOARD, APPROVAL OF DISSOLUTION AND SELLING OR DISPOSING OF ASSETS AND ADOPTING LONG RANGE AND STRATEGIC PLANS. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PRESENTED THE DRAFT OF THE FORM 990 TO THE BOARD BEFORE FILING THE FORM WITH THE INTERNAL REVENUE SERVICE. THE BOARD'S REVIEW INCLUDED ALL INFORMATION REPORTED ON THE FORM 990 WITH THE EXCEPTION OF INDIVIDUALS' COMPENSATION AMOUNTS REPORTED WHICH WERE DIRECTLY REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES. IN THE PROCESS OF ITS PREPARATION, THE FORM 990 WAS REVIEWED AT VARIOUS LEVELS OF FINANCE AND ACCOUNTING (REGIONAL DIGNITY HEALTH MANAGEMENT AND CORPORATE TAX DEPARTMENT), AS WELL AS REVIEWED BY MARK TWAIN'S FINANCE MANAGER AND CFO (WHO SIGNS THE FORM) AND BY AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. THE ORGANIZATION'S BOARD IS CHARGED WITH MONITORING PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. PURSUANT TO THESE POLICIES, THE GENERAL COUNSEL IS DESIGNATED AS THE ORGANIZATION'S FILING OFFICER AND 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 B FORM 990, PART VI, SECTION B, LINE 15A ALTHOUGH THE ORGANIZATION EMPLOYS PERSONNEL, THE TOP MANAGEMENT OFFICIAL IS COMPENSATED BY DIGNITY HEALTH. FOR 2018 COMPENSATION, DIGNITY HEALTH'S 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 B, LINE 15B THE HOSPITAL 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 CHIEF FINANCIAL OFFICER'S COMPENSATION. COMPENSATION OF OTHER HIGHLY PAID KEY EMPLOYEES IS BASED ON A COMPREHENSIVE EVALUATION FOCUSING ON ALL ASPECTS OF THE INCUMBENT'S ASSIGNED DUTIES AND ASSESSED PERFORMANCE IN CARRYING OUT THE PHILOSOPHY AND MISSION OF MTMC. ADDITIONALLY, COMPARATIVE DATA AND MARKET SURVEYS REGARDING COMPENSATION IN THE SURROUNDING MARKETPLACE ARE CONSIDERED. 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 MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A THE ORGANIZATION DOES NOT COMPENSATE CURRENT AND FORMER BOARD MEMBERS OR OFFICERS, C. CHAMPLIN, A. N. OCHOA, C. KASSIS, D. ARCHER, R. DIEHL AND K. MEDEIROS. THE COMPENSATION REPORTED REPRESENTS COMPENSATION FOR EMPLOYMENT SERVICES PROVIDED TO A RELATED ORGANIZATION. FORM 990, PART XI, LINE 9 INTEREST IN NET ASSETS OF UNCONSOLIDATED FOUNDATION; $(462,717) ADJUSTMENT OF ASSETS AND LIABILITIES, NET, TO FAIR VALUE PURSUANT TO ACQUISITION ACCOUNTING; $11,986,343 FORM 990 PART IX LINE 11G DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:148492 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN/MEDICAL SERVICES TOTAL FEES:6812404 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION SERVICES TOTAL FEES:4083591 FORM 990 PART IX LINE 11G DESCRIPTION:BUILDING SERVICES TOTAL FEES:1859740 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:253931 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:242962 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 Dignity Health Workers' Comp Self-Insura 185 Berry Street San Francisco CA 94107 946612446 Administratio CA 501(c)(3) 12A-I Dignity Hlth 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 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 12809 W DODGE RD OMAHA NE 68154 470765154 HEALTHCARE NE 501(c)(3) 3 ACH false ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - BERGAN MERCY HEALTH SYS 7500 MERCY RD OMAHA NE 68124 470484764 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - COMMUNITY MEMORIAL HOSP 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HEALTHCARE IA 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUY 104 W 17TH ST SCHUYLER NE 68661 470399853 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - MERCY HOSPITAL CORNING PO BOX 368 CORNING IA 50841 420782518 HEALTHCARE IA 501(c)(3) 3 CHI NEBRASKA false ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(c)(3) 10 CSH false APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(c)(3) 10 SFH false BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(c)(3) 12A-I SLCHS false BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(c)(3) 3 SLHS false BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 HEALTHCARE PA 501(c)(3) 12A-I CSH false BRAZOSPORT HEALTH FOUNDATION INC 1 West Way Ct LAKE JACKSON TX 77566 760080110 FUNDRAISING TX 501(c)(3) 12A-I BRHS false BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 HEALTHCARE TX 501(c)(3) 3 BRHS false BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTHCARE TX 501(c)(3) 3 SJSC false BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 HEALTHCARE TX 501(c)(3) 10 SJSC false CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HEALTHCARE ND 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES - COLORADO 9100 East Mineral Circle Centennial CO 80112 840405257 HEALTHCARE CO 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HEALTHCARE IA 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES COLORADO FOU 1150 Kelly Johnson Blvd 204 COLORADO SPRINGS CO 80920 840902211 FUNDRAISING CO 501(c)(3) 7 CHIC false CATHOLIC HEALTH INITIATIVES NATIONAL FOU 1150 Kelly Johnson Blvd 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING CO 501(c)(3) 12A-I CSH false CATHOLIC HEALTH INITIATIVES VIRTUAL HEAL 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 HEALTHCARE CO 501(c)(3) 12A-I CHINS false CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 PHYSICIANS OR 501(c)(3) 10 MMC false CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 480543724 SURGERY CENTE KS 501(c)(3) 3 CSH false CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 HEALTHCARE MN 501(c)(3) 10 CSH false CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING NE 501(c)(3) 7 ACH false CHI INSTITUTE FOR RESEARCH AND INNOVATIO 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 HEALTHCARE CO 501(c)(3) 12A-I CSH false CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 HEALTHCARE KY 501(c)(3) 12A-I CSH false CHI LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO OH 43623 341892096 HEALTHCARE OH 501(c)(3) 12A-II SFH false CHI Memorial Hospital - Georgia 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HEALTHCARE GA 501(c)(3) 3 MHCS false CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HEALTHCARE CO 501(c)(3) 10 CHI NS false CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HEALTHCARE CO 501(c)(3) 12A-I CSH false CHI NEBRASKA 12809 West Dodge Road Omaha NE 68510 363233121 HEALTHCARE NE 501(c)(3) 12A-I CSH false CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(c)(3) 12A-I CSH false CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(c)(3) 12A-I CSH false CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HEALTHCARE AR 501(c)(3) 3 CHISVHS false CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(c)(3) 12A-II SVIMC false CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 HEALTHCARE AR 501(c)(3) 3 CHISVHS false COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(c)(3) 12A-I NA false COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 237419853 HOLDING CO OH 501(c)(4) N/A GSH false COMMUNITY MEMORIAL HOSPITAL MEDICAL SERV 631 N 8TH ST MISSOURI VALLEY IA 51555 421294399 FUNDRAISING IA 501(c)(3) 12A-I AH-CMHMV false CONTINUING CARE HOSPITAL One Saint Joseph Drive LEXINGTON KY 40504 611400619 LT ACH KY 501(c)(3) 3 SJHS false East Texas Clinical Services 2801 VIA FORTUNA SUITE 500 AUSTIN TX 78746 454736213 HEALTHCARE TX 501(c)(3) 12A-I SLHS false ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HEALTHCARE WA 501(c)(3) 3 FHS false FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HEALTHCARE KY 501(c)(3) 3 KOH false FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING KY 501(c)(3) 12A-I FH false FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(c)(3) 10 FLC false FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING WA 501(c)(3) 10 FHS false FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HEALTHCARE WA 501(c)(3) 3 CSH false FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA WA 98402 431882377 PHYSICIANS MO 501(c)(3) 10 CSH false FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 HEALTHCARE WA 501(c)(3) 10 FHS false FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 391093829 HEALTHCARE WI 501(c)(3) 10 CSH false GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HEALTHCARE ND 501(c)(3) 3 SAMC false GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 MINISTRIES CO 501(c)(3) 12A-I CSH false GOOD SAMARITAN COLLEGE OF NURSING & HEAL 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 311778403 EDUCATION OH 501(c)(3) 2 GSH false GOOD SAMARITAN FOUNDATION OF CINCINNATI 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 311206047 FUNDRAISING OH 501(c)(3) 12A-I GSH false GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA false GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING NE 501(c)(3) 7 GSH false HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON WA 98310 910565546 HEALTHCARE WA 501(c)(3) 3 FHS false HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON WA 98310 911197626 FUNDRAISING WA 501(c)(3) 7 HMC false HEALTH FOUNDATION OF KENTUCKYONE INC 1451 HARRODSBURG RD STE D-308 LEXINGTON KY 40504 832170324 FUNDRAISING KY 501(c)(3) 12A-II KOH false HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE MN 56520 760761782 FUNDRAISING MN 501(c)(3) 12A-I SFMC false HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 910712166 HEALTHCARE WA 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ENTITIES TRANSFERRED DURING THE YEAR LIST DIGNITY HEALTH AND DIGNITY COMMUNITY CARE, "DH/DCC", AS THE DIRECT CONTROLLING ENTITY ON SCHEDULES R, PART II SINCE BOTH ENTITIES HELD CONTROL AT SOME POINT DURING THE YEAR.