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LIKE ALL ENDOWMENTS, ONLY THE DISTRIBUTED EARNED INCOME IS AVAILABLE FOR USE. THE UNRESTRICTED INCOME IS USED AT THE DISCRETION OF THE EXECUTIVE LEADERSHIP OF THE HOSPITAL FOR CAPITAL/BUILDING, EQUIPMENT AND PROGRAM NEEDS. Harris Connect INC CHESAPEAKE VA Telephone OUTREACH false GALA 1000999 818343 182656 0 0 14495 99074 19950 198350 FASHION SHOW 420354 295167 125187 0 0 4029 52425 10000 40707 5 915026 764743 150283 0 0 90719 75296 0 163769 2336379 1878253 458126 0 0 109243 226795 29950 402826 768814 -310688 160275 3500 39000 0 0 true 1.00000 160275 3500 39000 0 0 42500 117775 CA false SEE SCHEDULE G, PART IV. false false false 1.00000 JOHN D MILLER 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 false JOHN D MILLER 11990 Director/officer X true 144248 SCHEDULE G, PART III, LINE 9B GAMING MISSION HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION AND GAMING IS NOT THE PRIMARY FUNDRAISING ACTIVITY. AS A HOSPITAL, THEY ARE NOT REQUIRED TO REGISTER WITH THE CALIFORNIA ATTORNEY GENERAL. THERE WERE RAFFLES FOR PRIZE BASKETS AND CASH PRIZES TOTALING $160,275. 90% OF THE PROCEEDS WERE RETAINED AS REQUIRED. true true X true X true X 500. true true false true true 8543217 8543217 0.01370 93562394 110075614 0 0 0 102105611 110075614 8543217 0.01370 3632952 214122 3418830 0.00550 106427 106427 0.00020 307668 2500 305168 0.00050 3974364 3974364 0.00640 8021411 216622 7804789 0.01260 110127022 110292236 16348006 0.02620 51090 51090 0.00010 37244 37244 0.00010 168104 168104 0.00030 58850 58850 0.00010 315288 315288 0.00060 false 7050282 120266705 147520355 -27253650 X true true MECC - SEE PART VI PHYSICIAN OFFICE & CONF ED CT 0.5 0.5 MAS - SEE PART VI OUTPATIENT SURGERY CENTER 0.367 0.633 MVPPI - SEE PART VI MEDICAL OFFICE BUILDING 0.248 0.1264 1 1 MISSION HOSPITAL REGIONAL MEDICAL CTR 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 WWW.MISSION4HEALTH.COM 06000146 X X X MISSION HOSPITAL REGIONAL MEDICAL CTR 1 false false true X X X X X X X X X 16 true false false true X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 200. 500. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM COMMUNITY THE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS BETWEEN JANUARY MAY 2016: COMMUNITY RESIDENT FOCUS GROUPS, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND COMMUNITY FORUMS. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTIVE KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY MISSION HOSPITAL. WE DEVELOPED A PROTOCOL FOR EACH GROUP TO ENSURE CONSISTENCY ACROSS INDIVIDUAL FOCUS GROUPS, ALTHOUGH THE FACILITATORS HAD SOME DISCRETION ON ASKING FOLLOW-UP QUESTIONS OR PROBES AS THEY SAW FIT. INVITATION AND RECRUITMENT PROCEDURES VARIED FOR EACH TYPE OF GROUP. APPENDIX OF THE CHNA INCLUDES A FULL REPORT OF THE COMMUNITY INPUT PROCESS AND FINDINGS ALONG WITH DESCRIPTIONS OF THE PARTICIPANTS. RESIDENT FOCUS GROUPS FOR COMMUNITY RESIDENT GROUPS, COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMITTEES AND THE SYSTEM OFFICE, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME. TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THE PARTICIPANTS. 55 HISPANIC RESIDENTS PARTICIPATED IN 4 FOCUS GROUPS, WITH OVER 75% REPRESENTING INCOME LEVELS BELOW $75,000 ANNUALLY. THE MAJORITY OF RESIDENTS WERE BETWEEN THE AGES OF 18 64 YEARS OF AGE. NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP FOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FROM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITALS SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH. RESIDENT COMMUNITY FORUMS RECRUITMENT FOR THE COMMUNITY RESIDENT FORUMS WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUMS AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUMS WERE CONDUCTED BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. THE COMMUNITY FORUMS CONSISTED PRIMARILY OF HISPANIC RESIDENTS WHOSE HOUSEHOLD INCOME WAS LESS THAN $75,000 ANNUALLY. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUMS FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS DESIGN, THE FORUMS SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTPS://WWW.STJHS.ORG/OUR-PROGRAMS/COMMUNITY-PARTNERSHIPS/COMMUNITY-BENEFI T/REPORTS-COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ SCHEDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTPS://WWW.MISSION4HEALTH.COM/SUPPORT-SERVICES/COMMUNITY-BENEFIT/ SCHEDULE H, PART V, SECTION B, LINE 11 IN RESPONSE TO IDENTIFIED UNMET NEEDS IN THE 2016/17 COMMUNITY HEALTH NEEDS ASSESSMENT, MISSION HOSPITAL WILL FOCUS ON THREE INITIATIVES FOR THE BROADER AND UNDERSERVED MEMBERS OF OUR COMMUNITIES: 1) MENTAL HEALTH 2) IMMIGRANT SUPPORT & SOLIDARITY 3) ECONOMIC STABILITY. MENTAL HEALTH WILL BE ADDRESSED THROUGH BOTH FAMILY RESOURCE CENTERS BY UTILIZING THE PHQ-9 AS A TOOL TO ASSESS PARTICIPANTS DEPRESSION AND WORKING ON LOWERING THE SCORE. IT WILL ALSO BE ADDRESSED THROUGH THE EACH MIND MATTERS CAMPAIGN AND BY COLLABORATING WITH SCHOOLS. BOTH IMMIGRANT SUPPORT AND SOLIDARITY AND ECONOMIC STABILITY WILL BE ADDRESSED BY CONNECTING PARTICIPANTS TO A VARIETY OF SOCIAL SERVICES. WE WILL ALSO ADDRESS ECONOMIC STABILITY BY OFFERING PROGRAMS AT BOTH FAMILY RESOURCE CENTERS. NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT PROGRAMS AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR PROGRAM MANAGED BY THE MISSION HOSPITAL. FURTHERMORE, MISSION HOSPITAL WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT MISSION HOSPITAL SERVICE AREAS. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW: ACCESS TO RESOURCES: MISSION HOSPITAL WILL CONTINUE TO FINANCIALLY SUPPORT CAMINO HEALTH CENTER TO PROVIDE PRIMARY CARE SERVICES TO THE LOW-INCOME RESIDENTS OF SOUTH ORANGE COUNTY AND DEPENDING ON THEIR EXPERTISE FOR SERVICE PROVISION. WE WILL MAINTAIN MANY OF THE PROGRAMS CURRENTLY IN PLACE THROUGH ITS COMMUNITY BENEFIT PROGRAM TO CONTINUE PROVIDING ACCESS TO CARE SUCH AS HEALTH INSURANCE ENROLLMENT, PREVENTIVE SCREENINGS, EDUCATIONAL CLASSES AND MEDICAL TRANSPORTATION SERVICES. DENTAL CARE: MISSION HOSPITAL DOES NOT DIRECTLY ADDRESS DENTAL NEEDS AS THIS IS OUTSIDE OUR SCOPE OF EXPERTISE; HOWEVER, WE WILL WORK IN COLLABORATION WITH CAMINO HEALTH CENTER DENTAL SERVICES, LINKING CLIENTS OF THE FAMILY RESOURCE CENTERS TO CAMINO SERVICES. DIABETES: CAMINO HEALTH CENTER IS THE PRIMARY MEDICAL PROVIDER FOR LOW-INCOME RESIDENTS AND HAS IDENTIFIED THIS CONDITION AS ONE OF THEIR 16 AREAS OF CLINICAL FOCUS. WE WILL CONTINUE TO WORK COLLABORATIVELY WITH CAMINO TO CONNECT RESIDENTS IN NEED OF MEDICAL SERVICES WITH THEIR CENTER. FOOD AND NUTRITION: GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT NEEDS ASSESSMENT, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS. HOMELESSNESS: MISSION HOSPITAL DOES NOT HAVE THE EXPERTISE TO DIRECTLY ADDRESS HOMELESSNESS; HOWEVER WE PARTNER WITH SEVERAL ORGANIZATIONS THAT SERVE THE HOMELESS, INCLUDING FAMILY ASSISTANCE MINISTRY, FRIENDSHIP SHELTER AND THE ILLUMINATION FOUNDATION. HOUSING CONCERNS: WE HAVE CONCENTRATED ON AFFORDABLE HOMES FOR MANY YEARS IN SOUTH ORANGE COUNTY. RESIDENTS SHARE THAT HOUSING COSTS REMAIN UNAFFORDABLE. WITH THE RECENT CHANGES IN REDEVELOPMENT FUNDS AND THE LACK OF LOCAL RESOURCES AND COLLABORATIVE EFFORTS NEEDED TO FOCUS ON THIS ISSUE, THE COMMITTEE FELT OUR MINISTRY RESOURCES COULD BE BETTER UTILIZED IN THE OTHER AREAS IDENTIFIED. WE WILL CONTINUE TO WORK WITH AGENCIES WHO PROVIDE HOUSING ASSISTANCE SUCH AS ILLUMINATION FOUNDATION, FRIENDSHIP SHELTER, AND FAMILY ASSISTANCE MINISTRY. INSURANCE AND COST OF CARE: GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT NEEDS ASSESSMENT, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS. LACK OF EDUCATION: GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT NEEDS ASSESSMENT, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS. LACK OF EXERCISE: GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT NEEDS ASSESSMENT, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS. LANGUAGE AND CULTURAL BARRIERS: MISSION HOSPITAL MAY CONSIDER HOW TO ADDRESS BARRIERS RELATED TO LANGUAGE AND CULTURE IN THE IMMIGRATION AND ECONOMIC STABILITY INITIATIVES. OBESITY: GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT NEEDS ASSESSMENT, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER BASIS FOR CALCULATING AMOUNT CHARGED TO PATIENTS THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. SCHEDULE H, PART V, SECTION B, LINE 16A HTTP://WWW.MISSION4HEALTH.COM/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE.ASPX SCHEDULE H, PART V, SECTION B, LINE 16B HTTP://WWW.MISSION4HEALTH.COM/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE.ASPX SCHEDULE H, PART V, SECTION B, LINE 16C HTTP://WWW.MISSION4HEALTH.COM/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE.ASPX 4 MISSION AMBULATORY SURGICENTER LTD 26730 CROWN VALLEY PARKWAY MISSION VIEJO CA 92691 OUTPATIENT SURGERY CENTER CALIFORNIA SPECIALTY SURGERY CENTER LP 26371 CROWN VALLEY PARKWAY MISSION VIEJO CA 92691 OUTPATIENT SURGERY CENTER FAMILY RESOURCE CENTER 22481 ASPAN STREET LAKE FOREST CA 92630 COMMUNITY OUTREACH CENTER CHEC FAMILY RESOURCE CENTER 27412 CALLE ARROYO MISSION VIEJO CA 92675 COMMUNITY OUTREACH CENTER SCHEDULE H, PART I, LINE 3C IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. SCHEDULE H, PART I, LINE 6A MISSION HOSPITAL REGIONAL MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT WWW.MISSION4HEALTH.COM SCHEDULE H, PART I, LINE 7 THE AMOUNTS REPORTED IN THE TABLE WERE DERIVED FROM THE COST ACCOUNTING SYSTEM AND GENERAL LEDGER. SCHEDULE H, PART I, LINE 7, COLUMN (F) JOINT VENTURE COSTS OF $3,945,338 WERE INCLUDED IN THE TOTAL EXPENSE AMOUNT USED TO CALCULATE PERCENTAGES IN PART I, LINE 7, COLUMN F. SCHEDULE H, PART I, LINE 7G NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES FOSTERING A PREPARED AND PRODUCTIVE WORKFORCE IS THE PRIMARY FOCUS OF OUR COMMUNITY BUILDING AT MISSION HOSPITAL. WE COMPLETE THIS EFFORT THROUGH CONTINUED COLLABORATION WITH CAPISTRANO UNIFIED SCHOOL DISTRICT ADULT TRANSITION PROGRAM. SINCE 2006, MISSION HOSPITAL HOSTS YOUNG ADULTS WITH DISABILITIES EACH FALL TO PROVIDE WORK EXPERIENCE IN A HOSPITAL SETTING. THESE STUDENT INTERNS ARE PLACED IN HOSPITAL DEPARTMENTS SUCH AS NUTRITIONAL CARE SERVICES, ENVIRONMENTAL SERVICES AND CENTRAL SUPPLY TO LEARN JOB SKILLS THAT WILL HELP THEM ATTAIN LONG-TERM EMPLOYMENT EITHER AT THE HOSPITAL OR A LOCAL ORGANIZATION. MANY OF THESE STUDENTS WOULD BE HIGHLY CHALLENGED TO FIND PERMANENT, ON-GOING WORK BECAUSE OF THEIR DISABILITIES. IN 2018, 4 INTERNS RECEIVED MENTORING/JOB COACHING SUPPORT. EMERGENCY ASSISTANCE/HOMELESS OUTREACH: PROVIDED EMERGENCY ASSISTANCE TO RESIDENTS FACING HOMELESSNESS. 55 FAMILIES RECEIVED SUPPORT TO CONTINUE THEIR HOUSING NEEDS. COMMUNITY SUPPORT: MISSION HOSPITAL CONTINUED ITS IMPLEMENTATION OF SAFE RIDES, A FREE, ANONYMOUS PROGRAM THAT PROVIDES TRANSPORTATION FOR YOUTH WHO HAVE FOUND THEMSELVES WITHOUT A RIDE HOME ON THE WEEKENDS DUE TO DRINKING OR OTHER RISKY BEHAVIORS. 186 RIDES WERE PROVIDED TO LOCAL TEENS. LEADERSHIP DEVELOPMENT: MISSION HOSPITAL HAS PARTNERED WITH THE SISTERS OF ST. JOSEPH TO FOSTER LEADERSHIP DEVELOPMENT AS PART OF THEIR ST. JOSEPH WORKER PROGRAM. THIS PROGRAM SUPPORTS WOMEN FOR A 10 MONTH FORMATION PROGRAM WITH THE SISTERS WHILE THEY WORK WITH LOCAL COMMUNITIES AND DEVELOP PUBLIC HEALTH AND ADVOCACY SKILLS. THE FOLLOWING ARE INCLUDED UNDER OTHER COMMUNITY BUILDING EXPENSES: FOOD DONATIONS: MISSION HOSPITAL PARTNERS WITH NON-PROFIT ORGANIZATIONS TO FEED THE HOMELESS. FOOD DONATIONS ARE MADE TO LOCAL CHARITIES AND FAITH COMMUNITIES TO DISTRIBUTE TO HOMELESS RESIDENTS IN SOUTH ORANGE COUNTY. SCHEDULE H, PART III, LINE 2 METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 METHODOLOGY OF ESTIMATING BAD DEBT EXPENSE ATTRIBUTABLE TO FAP PATIENTS THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, LINE 4 FINANCIAL STATEMENT BAD DEBT EXPENSE FOOTNOTE FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED 12/31/2018 THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. SCHEDULE H, PART III, LINE 8 THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. SCHEDULE H, PART III, LINE 9B PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. SCHEDULE H, PART IV, COLUMN (A) NAME OF ENTITY 1. MISSION EDUCATION CONFERENCE CENTER, LLC 2. MISSION AMBULATORY SURGICENTER, LTD, DBA MISSION SURGERY CENTER 3. MISSION VIEJO PHYSICIAN PARTNERS I, LLC SCHEDULE H, PART VI, LINE 2 NEEDS ASSESMENT AN ANNUAL MARKET ASSESSMENT IS COMPLETED FOR OUR LOCAL MARKET THAT PROVIDES INFORMATION ON DEMOGRAPHICS, COUNTY HEALTH RANKINGS, PHYSICIAN LANDSCAPE, ACUTE CARE UTILIZATION RATES, MARKET SHARE, OUTMIGRATION TO OTHER MEDICAL FACILITIES FOR TREATMENT, EMERGENCY DEPARTMENT AND ANCILLARY UTILIZATION, AS WELL AS SERVICE LINE FORECASTS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION MISSION HOSPITAL'S TOTAL HOSPITAL SERVICE AREA (TSA) INCLUDES PORTIONS OF SOUTH ORANGE COUNTY. THE TOTAL HOSPITAL SERVICE AREA POPULATION IS 609,266 WITH A MEDIAN HOUSHOLD INCOME OF NEARLY $100,000. THE TOTAL SERVICE AREA HAS 12.4 PERCENT OF THE POPULATION WITH A HOUSEHOLD INCOME BELOW 200% FPL AND 7.7 PERCENT OF CHILDREN AND 7.1 PERCENT OF OLDER ADULTS LIVE BELOW 100% OF POVERTY LEVEL. WHEN LOOKING AT THE PRIMARY SERVICE AREA, 22.3 PERCENT OF THE POPULATION IS UNDER THE AGE OF 18 AND 15.1 PERCENT OF THE POPULATION IS OVER THE AGE OF 65. FUTHERMORE, 13 PERCENT OF THE POPULATIONS HOUSEHOLD INCOME IS BELOW 200% FPL AND 8.5 PERCENT OF CHILDREN AND 6.6 PERCENT OF OLDER ADULTS LIVE BELOW 100% OF FEDERAL POVERTY LEVEL. MISSION HOSPITALS TSA IS PRIMARILY CAUCASIAN, REPRESENTING 64.1 PERCENT OF THE TOTAL POPULATION. HISPANIC RESIDENTS MAKE UP 20.1 PERCENT AND THE REMAINING 15 PERCENT ARE OTHER ETHNICITIES. THE REPRESENTATION OF RACIAL AND ETHNIC DIVERSITY IS THE VIRTUALLY THE SAME IN MISSION HOSPITALS PSA. BECAUSE OF THE EXTREME DIVERSITY OF INCOME IN MISSION HOSPITAL'S TSA, ONLY ONE ZIP CODE IS IDENTIFIED AS HAVING HIGH NEEDS: SAN JUAN CAPISTRANO, ZIP CODE 92675. HOWEVER, THERE ARE MANY POCKETS OF POVERTY WITHIN THE TSA THAT REMAIN HIDDEN DUE TO THE WIDE VARIANCE OF HOUSEHOLD INCOMES BY ZIP CODE. OTHER HOSPITALS IN THE COMMUNITY INCLUDE: SADDLEBACK HOSPITAL CAN BE FOUND IN MISSION HOSPITALS SECONDARY SERVICE AREA (SSA). HEALTH PROFESSIONS SHORTAGE AREA MENTAL, DENTAL, OTHER THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). MISSION HOSPITAL IS NOT LOCATED IN A SHORTAGE AREA. MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREAS LEVEL OF MEDICAL "UNDER SERVICE." MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. MISSION HOSPITAL MISSION VIEJO AND MISSION HOSPITAL LAGUNA BEACH ARE NOT LOCATED IN MEDICALLY UNDERSERVED AREAS. HOWEVER, COASTAL COMMUNITIES WITHIN THEIR SERVICE AREA, STRETCHING BETWEEN DANA POINT AND SAN CLEMENTE, ARE DESIGNATED AS MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATION AREAS, SIGNIFYING THE IMPORTANCE OF MISSION HOSPITAL TO THE COMMUNITY IT SERVES. FOR MORE INFORMATION, GO TO THE MISSION HOSPITAL'S FY18 COMMUNITY BENEFIT REPORT POSTED AT WWW.MISSION4HEALTH.COM. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH MISSION HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. MISSION HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES. 2) OPEN MEDICAL STAFF. 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS AND OVER 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA true AMERICAN HEART ASSOCIATION PO BOX 50085 PRESCOTT CA 863045085 135613797 501(c)(3) 10000 PROGRAM SUPPORT BOYS AND GIRLS CLUB OF LAGUNA BEACH 1085 LAGUNA CANYON RD LAGUNA BEACH CA 92651 951878822 501(c)(3) 100000 PROGRAM SUPPORT CAMINO HEALTH CENTER 30300 CAMINO CAPISTRANO SAN JUAN CAPISTRANO CA 92675 330574214 501(c)(3) 1922727 PROGRAM SUPPORT CHILD GUIDANCE CENTER 525 CABRILLO PARK DRIVE 300 SAN ANA CA 92701 952546170 501(c)(3) 81280 PROGRAM SUPPORT CHOC CHILDREN FOUNDATION 1201 WEST LA VETA AVE ORANGE CA 92868 956097416 501(c)(3) 15000 PROGRAM SUPPORT COALITION FOR HUMANE IMMIGRATION RIGHTS 2533 W 3RD STREET SUITE 101 LOS ANGELES CA 90004 954421521 501(c)(3) 100000 PROGRAM SUPPORT FRIENDSHIP SHELTER PO BOX 4252 LAGUNA BEACH CA 92652 330218404 501(C)(3) 102000 PROGRAM SUPPORT SACRED HEART RETREAT APOSTOLATE 2927 S GREENVILLE STREET SANTA ANA CA 92704 432005333 501(c)(3) 6500 PROGRAM SUPPORT LAGUNA ART MUSEUM 307 CLIFF DRIVE LAGUNA BEACH CA 92651 330717157 501(c)(3) 7500 PROGRAM SUPPORT LAGUNA BEACH COMMUNITY CLINIC 362 THIRD ST LAGUNA BEACH CA 92651 952637633 501(c)(3) 262000 PROGRAM SUPPORT LEGAL AID SOCIETY OF ORANGE COUNTY 2101 N TUSTIN AVE SAN ANA CA 92705 951994337 501(c)(3) 83479 PROGRAM SUPPORT OC HUMAN RELATIONS 1801 E EDINGER AVE SUITE 115 SAN ANTA CA 92705 330438086 501(c)(3) 50000 PROGRAM SUPPORT RANCHO MISSION VIEJO RODEO PO BOX 9 SAN JUAN CAPISTRANO CA 92693 330954148 10000 SPONSORSHIPS ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW RENTON WA 980579016 330143024 501(c)(3) 5742700 CARE FOR THE POOR THE ILLUMINATION FOUNDATION 2691 RICHTER AVE STE 107 IRVINE CA 92606 711047686 501(c)(3) 14950 PROGRAM SUPPORT LAGUNA HILLS HEALTH AND REHABILITATION 24452 HEALTH CENTER DR LAGUNA HILLS CA 92653 562384926 9757 PROGRAM SUPPORT ST TIMOTHY CATHOLIC CHURCH 29102 CROWN VALLEY PKWY LAG NIG CA LAGUNA NIGUEL CA 92677 953656905 501(c)(3) 15075 FOOD DONATION PROGRAM SUPPORT MISSION BASILICA SAN JUAN CAPISTRANO 31520 CAM CAPISTRANO CAPISTRANO CA 92675 951904079 501(c)(3) 24898 FOOD DONATION PROGRAM SUPPORT WELCOME INN 30791 MARBELLA VIS SAN JUAN CAPISTRANO CA 92675 611503624 501(c)(3) 15789 FOOD DONATION PROGRAM SUPPORT 17 2 HELPING HANDS-PAID TO PATIENTS 231 17367 TRANSPORTATION ASSISTANCE 21 13994 BENEFITS PROVIDED TO COMMUNITY 543 7382 COMMUNITY HEALTH INITIATIVE OF OC 250 KIDS CONNECTED 2500 WELLNESS AND PREVENTION CENTER 1000 VARIOUS NON-CASH DONATIONS 2898 8088 FMV TURKEYS ST. TIMOTHY CATHOLIC CHURCH 1 100 FUNERALS 9 12506 ST. JOSEPH HOME CARE SERVICES 25 3767 SCHEDULE I, PART I, LINE 2 DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS MISSION HOSPITAL HAS AN AFFILIATION AGREEMENT WITH CAMINO HEALTH CENTER THAT CALLS FOR THE STEERING COMMITTEE, WHICH INCLUDES AN OFFICER FROM THE HOSPITAL, TO PROVIDE OVERSIGHT OF FUNDS GRANTED TO CAMINO BY THE HOSPITAL. THE CARE FOR THE POOR FUNDS GIVEN TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION IS GOVERNED BY THE HEALTH SYSTEM FOUNDATION. THE DISBURSEMENT OF THE FUNDS FOLLOWS SPECIFICS SET FORTH BY THE HEALTH SYSTEM POLICY "CARE FOR THE POOR PROGRAM ACCOUNTING." THERE IS NO MONITORING DONE IN THE OTHER GRANTS. true true false false false false false true false MICHAEL MARINO DO SVP, CHIEF MED INFO OFFICER 0 522502 0 74228 0 101954 0 19250 0 33589 0 751523 0 0 TAREK SALAWAY CHIEF EXECUTIVE 0 440878 0 193962 0 5445 0 9875 0 14075 0 664235 0 0 TARA COWELL VP/ASSOC. GENERAL COUNSEL/SEC. 0 314661 0 43479 0 41337 0 22000 0 42180 0 463657 0 0 EILEEN HAUBL CHIEF FINANCIAL OFFICER 344360 0 53274 0 58186 0 23888 0 26968 0 506676 0 0 0 MARK JABLONSKI CHIEF MISSION INTEGRATION 0 260438 0 61515 0 36195 0 24750 0 20950 0 403848 0 0 MICHAEL BECK CHIEF ADMIN OFFICER - LB 265246 0 42146 0 36637 0 24750 0 39642 0 408421 0 0 0 JENNIFER CORD CHIEF NURSING OFFICER 282920 0 0 0 69356 0 0 0 29730 0 382006 0 0 0 WENDY FERRO-GRANT DIRECTOR, SURGICAL SERVICES 186170 0 17384 0 3755 0 17394 0 28361 0 253064 0 0 0 DEANNE NIEDZIELA DIRECTOR, NURSING 199774 0 34362 0 5833 0 18699 0 26401 0 285069 0 0 0 TERRENCE WOOTEN VP, INTEGRATED OPERATIONS 209050 0 31931 0 22220 0 18670 0 10041 0 291912 0 0 0 ANNABELLE BRAUN DIRECTOR, NURSING 232688 0 21427 0 2688 0 9487 0 26239 0 292529 0 0 0 LAUREN DWINELL EXEC DIR, CHIEF OPS-PAT. FLOW 253506 0 39967 0 3444 0 7688 0 36297 0 340902 0 0 0 TERRI FOX-COVERT DIRECTOR, HUMAN RESOURCES 238491 0 37317 0 25896 0 22008 0 29204 0 352916 0 0 0 EVELYN SCHLOSSER EXEC DIR, QLTY & PAT SAFETY 217827 0 33597 0 3488 0 3572 0 22760 0 281244 0 0 0 LINDA SIEGLEN CHIEF MEDICAL OFFICER 388539 0 60383 0 42771 0 11000 0 29808 0 532501 0 0 0 LINDA JOHNSON FORMER KEY EMPLOYEE 0 0 0 0 112375 0 0 0 0 0 112375 0 0 0 KENNETH MCFARLAND FORMER OFFICER & TRUSTEE 0 0 0 0 0 295676 0 0 0 0 0 295676 0 0 SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FOR EITHER PART OR ALL OF THE YEAR: KENNETH MCFARLAND - $295,676 LINDA JOHNSON - $112,375 SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PSJH SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. EXECUTIVES PREVIOUSLY PARTICIPATED IN ANOTHER NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT WAS FROZEN EFFECTIVE DECEMBER 2007, AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED. THIS FROZEN PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS A PORTION OF EXECUTIVE SALARIES ARE PLACED AT-RISK AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE STRATEGIC OBJECTIVES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. X 28 2075979 COST / SELLING PRICE X GIFTS IN KIND 502 300370 SEE PART II false true false SCHEDULE M, PART I, COLUMN (B) AMOUNTS IN THIS COLUMN WERE BASED ON THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, LINE 25 GIFTS IN KIND WITH AN ESTIMATED VALUE OF $300,370 WERE RECEIVED DURING THE YEAR AND WERE NOT INCLUDED ON THE BOOKS. VALUE WAS ESTIMATED FROM DONOR'S APPROXIMATION OF VALUE. REVENUE FROM THE SALE OF THESE ITEMS IS INCLUDED IN FUNDRAISING REVENUE ON FORM 990, PART VIII, LINE 8A. FORM 990, PART III, LINE 4A PROVIDENCE ST. JOSEPH HEALTH SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH AND SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) FORMED A NEW ORGANIZATION, PROVIDENCE ST. JOSEPH HEALTH, WITH THE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH HAS THE POTENTIAL TO SEEK GREATER AFFORDABILITY, ACHIEVE OUTSTANDING AND RELIABLE CLINICAL CARE, IMPROVE THE PATIENT EXPERIENCE AND INTRODUCE NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS AND 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE. PROVIDENCE HEALTH & SERVICES IN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH IN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIF., TO PROVIDE EDUCATION AND HEALTH CARE. THE MINISTRY LATER ESTABLISHED ROOTS IN ORANGE, CALIF., AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, THE CALIFORNIA HIGH DESERT, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIF. REALIZING OUR MISSION MISSION HOSPITAL REGIONAL MEDICAL CENTER IS PART OF NEWLY FORMED PROVIDENCE ST. JOSEPH HEALTH. MISSION HOSPITAL IS AN ACUTE-CARE HOSPITAL FOUNDED IN 1971, LOCATED AT MISSION VIEJO AND LAGUNA BEACH, CALIFORNIA. THE FACILITY HAS 552 LICENSED BEDS AND A STAFF OF MORE THAN 2,600 COMMITTED CAREGIVERS. MAJOR PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, CRITICAL CARE, DIAGNOSTIC IMAGING, EMERGENCY MEDICINE AND OBSTETRICS. PROGRAM SERVICE ACCOMPLISHMENTS FAMILY RESOURCE CENTERS (FRCS): MISSION HOSPITAL OPERATES TWO FAMILY RESOURCE CENTERS TO PROVIDE ACCESS TO SOCIAL SERVICES FOR COMMUNITY MEMBERS WITH LIMITED RESOURCES. THESE CENTERS ARE LIFELINES FOR MANY PEOPLE IN THE COMMUNITY AND SERVE A MUCH-NEEDED LINKAGE TO COMMUNITY PROGRAMS. ESTABLISHED IN 1996, THE SOUTH ORANGE COUNTY FAMILY RESOURCE CENTER (SOCFRC) IS LOCATED IN LAKE FOREST, CA. OUR SECOND LOCATION IN SAN JUAN CAPISTRANO OPENED IN 2001. THE TWO FRCS PROVIDE MENTAL HEALTH SERVICES, HEALTH INSURANCE ACCESS, PARENTING SUPPORT & EDUCATION, CHILDRENS CLASSES, FAMILY ADVOCACY, INFORMATION & RESOURCE SERVICES, PERSONAL EMPOWERMENT PROGRAMS, FINANCIAL COUNSELING, AND LIMITED EMERGENCY ASSISTANCE. IN JANUARY 2017, THE SOUTH ORANGE COUNTY FAMILY RESOURCE CENTER RELOCATED TO A NEW 20,000 SQUARE FOOT BUILDING THAT HOUSES BOTH THE FRC AND A 3RD LOCATION FOR CAMINO HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). BOTH FRCS HAD A COMBINED 28,036 ENCOUNTERS THAT SERVED 3,354 UNIQUE PERSONS. BOTH CENTERS CONTINUE AS DESIGNATED FRCS WITH THE FAMILIES AND COMMUNITIES TOGETHER (FACT) CONTRACT FROM THE COUNTY OF ORANGE, CHILDREN AND FAMILIES COMMISSION. CAMINO HEALTH CENTER: MISSION HOSPITAL CONTRIBUTED $1,922,727 DOLLARS IN 2018 TO SUPPORT THE EFFORTS OF CAMINO HEALTH CENTER. MISSION HOSPITAL IS THE SOLE CORPORATE SPONSOR FOR THIS FEDERALLY QUALIFIED HEALTH CENTER, PROVIDING AFFORDABLE, QUALITY PRIMARY MEDICAL, BEHAVIORAL HEALTH, DENTAL CARE, SPECIALTY CARE AND WIC NUTRITION SERVICES FOR THE LOW-INCOME POPULATION OF SOUTH ORANGE COUNTY. THE CENTER ACCOMMODATED 50,489 VISITS AT ITS THREE FIXED CLINIC SITE LOCATIONS IN LAKE FOREST, SAN CLEMENTE, AND SAN JUAN CAPISTRANO. IN THE EARLIER PART OF 2017, THREE NEW SPECIALTY CARE SERVICES WERE ADDED IN TO THE HEALTH CENTERS SCOPE OF SERVICES: NEPHROLOGY, NEUROLOGY, AND PULMONOLOGY. CAMINO COMPLETED THE BUILDOUT OF THE NEW 10,000 SQUARE FOOT HEALTH CENTER LOCATION IN LAKE FOREST, COMPLETE WITH 16 EXAM ROOMS, FIVE DENTAL OPERATORIES, AND A WIC SUITE. THIS LOCATION IS CO-LOCATED WITH MISSION HOSPITALS FAMILY RESOURCE CENTER AND CREATES WRAP-AROUND SERVICES FOR COMMUNITY MEMBERS. COMMUNITY GRANTS: RECOGNIZING THAT LOCAL NON-PROFITS CONDUCT WORK THAT COMPLEMENTS MISSION HOSPITAL COMMUNITY BENEFIT PRIORITY AREAS, A COMPETITIVE, INVITATION-ONLY COMMUNITY GRANT PROGRAM WAS IMPLEMENTED TO HELP FURTHER ADDRESS IDENTIFIED NEEDS IN THE COMMUNITY AND CREATE STRONGER PARTNERSHIPS WITH LOCAL PROVIDERS. IN 2018, MISSION HOSPITAL AWARDED OVER $511,759 IN GRANTS TO SIX (6) AGENCIES THAT SERVE SOUTH ORANGE COUNTY LOW-INCOME RESIDENTS: 1. CHILD GUIDANCE CENTER 2. FRIENDSHIP SHELTER 3. LEGAL AID SOCIETY OF ORANGE COUNTY 4. OC HUMAN RELATIONS 5. BOYS AND GIRLS CLUB OF LAGUNA BEACH 6. COALITION FOR HUMAN IMMIGRATION RIGHTS THESE AGENCIES WILL BE WORKING IN 2018 TO IMPLEMENT THEIR PROGRAMS TO IMPROVE THE LIVES OF THE VULNERABLE. MENTAL HEALTH INITIATIVE: THROUGH AN INTEGRATED NETWORK OF CARE, MISSION HOSPITAL AIMS TO IMPROVE MENTAL HEALTH SERVICES FOR THE VULNERABLE POPULATION IN SOUTH ORANGE COUNTY THROUGH PREVENTION AND BY ENSURING ACCESS TO APPROPRIATE, QUALITY MENTAL HEALTH SERVICES. MISSION HOSPITAL IS WORKING TO IMPROVE THE MENTAL HEALTH OF THE MOST VULNERABLE MEMBERS OF SOUTH ORANGE COUNTY. IN 2018 MISSION DEDICATED OVER $845,363 IN RESOURCES FOR THE IMPLEMENTATION OF OUR MENTAL HEALTH INITIATVE. THE STIGMA REDUCTION CAMPAIGN IN PARTNERSHIP WITH CALIFORNIAS EACH MIND MATTERS MOVEMENT CONTINUED THROUGH 2018. THIS LOCALLY ACTIVATED CAMPAIGN, PROMISE TO TALK, INCLUDED OUTREACH, CLOSE COLLABORATION WITH COMMUNITY PARTNERS, VIDEO PUBLIC SERVICE ANNOUNCEMENTS, BUS ADVERTISING, ENGAGING BILINGUAL LITERATURE AND SOCIAL MEDIA. THE CAMPAIGN RESULTED IN 750 PROMISES TO TALK ABOUT MENTAL HEALTH, 4,586 ENCOUNTERS AND 6.8 MILLION IMPRESSIONS THROUGH SOCIAL MEDIA HITS AND COMMUNITY PROMOTIONS AND EVENTS. FOR MORE INFORMATION ABOUT MISSION HOSPITAL, PLEASE VISIT MISSION4HEALTH.COM FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT HTTPS://WWW.PSJHEALTH.ORG/ FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR MISSION HOSPITAL FROM ITS SHARED SERVICES. SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM AND COVENANT HEALTH NETWORK, INC. ARE THE CORPORATE MEMBERS OF MISSION HOSPITAL REGIONAL MEDICAL CENTER. FORM 990, PART VI, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS MISSION HOSPITAL HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE MISSION HOSPITAL BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE MISSION HOSPITAL BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE TRUSTEES ARE THEN APPROVED AND ELECTED BY THE COVENANT HEALTH NETWORK, INC. BOARD. FORM 990, PART VI, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBERS, ST. JOSEPH HEALTH SYSTEM AND COVENANT HEALTH NETWORK, RESERVE THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, LINE 11B PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSELS OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST (COI) IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY. FORM 990, PART VI, LINES 15A & 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE ST. JOSEPH HEALTH IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTHS LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED IN MARCH 5, 2019. FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PSJH INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS CHANGE IN TEMPORARY RESTRICTED NET ASSETS $ 7,048,363 GRANTS TO INDVIDUALS & ORGS AND OTHER $ 8,693,278 UNRESTRICTED DISTRIBUTIONS & DIVIDENDS $ 2,892,425 POPULATION HEALTH NET INCOME FOR 990 $ 3,393,193 FDN CAPITAL CONTRIBUTIONS RESTRICTED FUNDS ($ 12,544,915) EQUITY TRANSFERS TO SUBSIDIARIES/JOINT VENTURES ($ 20,702,718) CAPITAL CONTRIBUTION TO HERITAGE ($ 23,046,649) RECLASS TO PY UNRESTRICTED FUNDS ($ 31,289,788) MISCELLANEOUS $ 13,992 --------------- TOTAL ($ 65,542,819) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:41999059 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESS. & MED PHYSICIAN FEES TOTAL FEES:23326496 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL PURCHASED SERVICES TOTAL FEES:9605357 FORM 990 PART IX LINE 11G DESCRIPTION:BIOMEDICAL PURCHASED SERVICES TOTAL FEES:5477342 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:3932685 COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 611573313 HEALTHCARE TX 501(C)(3) 12, I CHS true COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 461259908 HEALTHCARE CA 501(C)(3) 12, III SJHS true COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 463516417 HEALTHCARE TX 501(C)(3) 12, I CHS true COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS true COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752897026 HEALTHCARE TX 501(C)(3) 7 CHS true COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 822913146 HEALTHCARE TX 501(C)(3) 3 CHS true COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752743883 HEALTHCARE TX 501(C)(3) 3 CHS true E WA & MT UNEMPLOYMENT COMP INSR TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911082119 UNEMPLOYMENT WA 501(C)(3) 12, I PHS WA true EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANS. CARE WA 501(C)(3) 10 NA false FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 954322584 SUPPORT CA 501(C)(3) 7 PHS SOCAL true GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 201910170 SUPPORT WA 501(C)(3) 7 PHS WA true GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(C)(3) 7 SHS true HMTS INC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 12, I HMHP true HOAG CHARITY SPORTS 2081 BUSINESS CTR DR STE 195 IRVINE CA 92612 452982422 SUPPORT CA 501(C)(3) 7 HHF true HOAG CLINIC (FKA COASTAL MGMT SVCS ORG) 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA 501(C)(3) 10 HMHP true HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 HMHP true HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH CA 92658 951643327 HEALTHCARE CA 501(C)(3) 3 CHN true HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752133781 HEALTHCARE TX 501(C)(3) 10 CHS true INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911307555 HEALTHCARE WA 501(C)(3) 3 PHS WA true INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 814260130 HEALTHCARE WA 501(C)(3) 7 PHSSJHS true INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 912003593 HEALTHCARE WA 501(C)(3) 7 WHC true JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 954291515 HEALTHCARE CA 501(C)(3) 4 PSJHC true KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 916033089 SUPPORT WA 501(C)(3) 12, III KRMC true KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 237005501 SUPPORT WA 501(C)(3) 12, I KRMC true KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 910655392 HEALTHCARE WA 501(C)(3) 3 WHC true LITTLE COMPANY OF MARY ANCILLARY SVCS CO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 330844408 IMAGING SVCS CA 501(C)(3) 10 PHS SOCAL true LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752220963 HEALTHCARE TX 501(C)(3) 7 CHS true LUNDBERG ASSOCIATIONPROVIDENCE HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911562797 SUPPORT OR 501(C)(3) 7 PHS OR true MARSHA RIVKIN CTR FOR OVARIAN CANCER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 912054035 RESEARCH WA 501(C)(3) 7 SHS true METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752428911 HEALTHCARE TX 501(C)(3) 3 CHS true METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752246348 HEALTHCARE TX 501(C)(3) 3 CHS true METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752426010 HEALTHCARE TX 501(C)(3) 3 CHS true NORTHWEST HOPE & HEALING FOUNDATION PO BOX 16069 SEATTLE WA 98116 200799737 SUPPORT WA 501(C)(3) 12,I SHS true PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 562290878 HEALTHCARE WA 501(C)(3) 10 WHC true PH&S FOUNDATIONSFVSA & SCVSA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 953544877 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL true PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 920093565 HEALTHCARE AK 501(C)(3) 12, I PHS WA true PROVIDENCE BENEDICTINE NURSING CTR FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911940286 HEALTHCARE OR 501(C)(3) 7 PHS OR true PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911789266 SUPPORT WA 501(C)(3) 7 PHS WA true PROVIDENCE CHILDREN'S HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930800140 SUPPORT OR 501(C)(3) 7 PHS OR true PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930692907 HEALTHCARE OR 501(C)(3) 7 PHS OR true PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 473385506 SUPPORT WA 501(C)(3) 7 NA false PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 311744654 SUPPORT WA 501(C)(3) 7 PHS WA true PROVIDENCE HEALTH & SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911549796 HEALTHCARE WA 501(C)(3) 12, II PSJH false PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 810231793 HEALTHCARE MT 501(C)(3) 3 PHS WA true PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 510216587 HEALTHCARE OR 501(C)(3) 3 PHS true PROVIDENCE HEALTH & SERVICES - WA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 510216586 HEALTHCARE WA 501(C)(3) 3 PHS true PROVIDENCE HEALTH & SERVICES - WEST WA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911303277 HEALTHCARE WA 501(C)(3) 3 PMWHC true PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 550828701 MEDICAID OR 501(C)(4) N/A PHP true PROVIDENCE HEALTH CARE FNDN - E WA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 320014330 HEALTHCARE WA 501(C)(3) 7 PHS WA true PROVIDENCE HEALTH CARE FNDN (CENTRALIA) 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911433382 HEALTHCARE WA 501(C)(3) 7 PHS W WA true PROVIDENCE HEALTH PLAN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930863097 HEALTHCARE OR 501(C)(4) N/A PPP true PROVIDENCE HEALTH SYSTEM - SO CAL 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 510216589 HEALTHCARE CA 501(C)(3) 3 PHS true PROVIDENCE HOOD RIVER MEM HOSP FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930921990 HEALTHCARE OR 501(C)(3) 7 PHS OR true PROVIDENCE HOSPICE AND HOME CARE FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 272552749 HEALTHCARE WA 501(C)(3) 7 PHS W WA true PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 912077378 HEALTHCARE WA 501(C)(3) 7 PHS W WA true PROVIDENCE LITTLE COMPANY OF MARY FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 510224944 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL true PROVIDENCE MARIANWOOD FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 931554288 HEALTHCARE WA 501(C)(3) 12, I PHS W WA true PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 330283773 HEALTHCARE CA 501(C)(3) 12, I PHS SOCAL true PROVIDENCE MILWAUKIE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 943079515 HEALTHCARE OR 501(C)(3) 7 PHS OR true PROVIDENCE MINISTRIES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 RELIGIOUS ORG WA 501(C)(3) 1 NA false PROVIDENCE MOUNT ST VINCENT FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911188119 HEALTHCARE WA 501(C)(3) 7 PHS WA true PROVIDENCE NEWBERG HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930889144 HEALTHCARE OR 501(C)(3) 7 PHS OR true PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 311629656 SUPPORT WA 501(C)(3) 7 PHS WA 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PACIFIC COAST HWY, #100 NEWPORT BEACH, CA 92663 NEWPORT BEACH ENDOSCOPY CENTER, LLC EIN: 77-0368744 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SN MIGUEL, NEWPORT BEACH, CA 92660 NEWPORT SURGICAL PARTNERS, LLC EIN: 39-2060266 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NORTH BAY ENDOSCOPY CENTER EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD, SUITE 110, PETALUMA, CA 94954 OREGON ADVANCED IMAGING, LLC EIN: 45-0471748 ADDRESS: 881 O'HARE PARKWAY, MEDFORD, OR 97504 OREGON OUTPATIENT SURGERY CENTER EIN: 22-3883387 ADDRESS: 7300 SW CHILDS ROAD, TIGARD, OR 97224 PET/CT IMAGING AT SWEDISH CANCER INSTITUTE, LLC EIN: 20-3132044 ADDRESS: 1221 MADISON STREET SEATTLE, WA 98104 PHS INVESTMENT TRANSITION PORTFOLIO EIN: 47-2279711 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2015 PRIVATE ASSETS PORTFOLIO EIN: 47-3393740 ADDRESS: 1801 LIND AVE. 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SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST MLP PORTFOLIO EIN: 47-2367538 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC DEBT PORTFOLIO EIN: 47-2353569 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC EQUITY PORTFOLIO EIN: 47-2283974 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RELATIVE VALUE PORTFOLIO EIN: 47-2314743 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RISK PARITY PORTFOLIO EIN: 47-2336377 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO EIN: 81-2701056 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TACTICAL TRADING PORTFOLIO EIN: 47-2327491 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TIPS PORTFOLIO EIN: 47-2402609 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PORTLAND MEDICAL IMAGING, LLC EIN: 20-1054971 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROV. RADIATION ONCOLOGY DEVELOP. ASSN., LLC EIN: 26-0682491 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROVIDENCE CHILDREN'S NEONATAL SERVICES EIN: 47-0918549 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE IMAGING CENTER JOINT VENTURE EIN: 92-0118807 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE PARTNERS FOR HEALTH, LLC EIN: 45-4041798 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 PROVIDENCE ST. JOSEPH HEALTH LONG TERM PORTFOLIO EIN: 82-3190634 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE SURGERY CENTER, LLC EIN: 84-1401625 ADDRESS: 902 N. ORANGE ST MISSOULA, MT 59802 PROVIDENCE/SILVERTON REHAB, LLC EIN: 48-1287267 ADDRESS: 4400 NE HALSEY #425, PORTLAND, OR 97213 PROVIDENCE/USP SANTA CLARITA GP, LLC EIN: 20-2829660 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 PROVIDENCE/USP SURGERY CENTERS, LLC EIN: 20-0905938 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 SJO ASC HOLDINGS LLC EIN: 82-1655501 ADDRESS: 1140 W. LA VETA AVE ORANGE, CA 92868 ST JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH/SATELLITE DIALYSIS CENTERS, LLC EIN: 81-4657391 ADDRESS: 300 SANTANA ROW, SUITE 300 SAN JOSE, CA 95128 ST. JUDE SURGICAL CENTERS, LLC EIN: 82-3352570 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 SURGERY CENTER AT TANASBOURNE, LLC EIN: 20-8187971 ADDRESS: 11221 ROE AVE., STE 300, LEAWOOD, KS 66211 TARZANA PEDIATRIC VENTURES LLC EIN: 82-1308306 ADDRESS: 18321 CLARK ST, TARZANA, CA 91356 THE MADISON SPOKANE INN, LLC EIN: 84-1606484 ADDRESS: 15 WEST ROCKWOOD BLVD. SPOKANE, WA 99204