SRM ALLIANCE HOSPITAL SERVICES: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: SRM ALLIANCE HOSPITAL SERVICES (EIN 68-0395200)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-14
IRS object ID: 201841349349309589
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-14T17:01:36-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	18101 VON KARMAN AVE STE 1700	AddressLine1Txt
City	IRVINE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92612	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	680395200	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SRM ALLIANCE HOSPITAL SERVICES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% JONI MURPHY	InCareOfNm
Business Name Control	SRMA	BusinessNameControlTxt
Phone	7075221570	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MCDOWELL BLVD	AddressLine1Txt
City	PETALUMA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94954	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TODD SALNAS	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Signature	2018-05-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KARA ADAMS	PreparerPersonNm
PTIN	P00023315	PTIN
Phone	9497942300	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PETALUMA VALLEY HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	TODD SALNAS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MCDOWELL BLVD	AddressLine1Txt
City	PETALUMA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94954	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$98,880,719	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.STJOSEPHHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1996	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	604	TotalEmployeeCnt
Total Volunteers	175	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,066,498	PYContributionsGrantsAmt
CY Contributions Grants	$951,913	CYContributionsGrantsAmt
PY Program Service Revenue	$90,119,971	PYProgramServiceRevenueAmt
CY Program Service Revenue	$97,786,014	CYProgramServiceRevenueAmt
PY Investment Income	$54,676	PYInvestmentIncomeAmt
CY Investment Income	$56,958	CYInvestmentIncomeAmt
PY Other Revenue	-$66,678	PYOtherRevenueAmt
CY Other Revenue	-$55,692	CYOtherRevenueAmt
PY Total Revenue	$91,174,467	PYTotalRevenueAmt
CY Total Revenue	$98,739,193	CYTotalRevenueAmt
PY Grants And Similar Paid	$9,750	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$89,172	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$46,526,325	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$51,987,109	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$548,702	CYTotalFundraisingExpenseAmt
PY Other Expenses	$45,156,963	PYOtherExpensesAmt
CY Other Expenses	$44,940,632	CYOtherExpensesAmt
PY Total Expenses	$91,693,038	PYTotalExpensesAmt
CY Total Expenses	$97,016,913	CYTotalExpensesAmt
PY Revenues Less Expenses	-$518,571	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,722,280	CYRevenuesLessExpensesAmt
Total Assets BOY	$32,106,690	TotalAssetsBOYAmt
Total Assets EOY	$32,318,608	TotalAssetsEOYAmt
Total Liabilities BOY	$25,694,800	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$26,227,582	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$6,411,890	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$6,091,026	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	WE ARE COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$91,046,609	ExpenseAmt
Grant	$89,172	GrantAmt
Revenue	$97,819,342	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$91,046,609	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	604	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JONI MURPHY	PersonNm
Phone	7075255300	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	141 STONY CIRCLE SUITE 140	AddressLine1Txt
City	SANTA ROSA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95401	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
JIM CARR
BOARD MEMBER	2.0	0.0	Yes (X)	$0	$0	$0
ROBERT CURRY
BOARD MEMBER, VICE CHAIRPERSON	5.0	0.0	Yes (X)	$0	$0	$0
RICHARD IGRAM
BOARD MEMBER (PART YEAR)	2.0	48.0	Yes (X)	$0	$613,275	$32,776
ANTHONY KOSINSKI
CHIEF OF STAFF	2.0	2.0	Yes (X)	$0	$27,250	$0
KEVIN MANEMANN
BOARD MEMBER (PART YEAR)	2.0	0.0	Yes (X)	$0	$792,983	$45,493
SISTER MARY BERNADETTE MCNULTY
BOARD MEMBER, TREASURER	2.0	48.0	Yes (X)	$0	$0	$0	Yes (X)
KATHIE POWELL
BOARD MEMBER (PART YEAR)	2.0	0.0	Yes (X)	$0	$0	$0
SCOTT PRITCHARD
BOARD MEMBER, VICE CHAIRPERSON	4.0	0.0	Yes (X)	$0	$0	$0
RAJESH RANADIVE
BOARD MEMBER (PART YEAR)	2.0	0.0	Yes (X)	$0	$0	$0
TODD SALNAS
BOARD MEMBER/PRESIDENT, SJH-SC	6.0	44.0	Yes (X)	$0	$824,623	$48,322	Yes (X)
SISTER MARIAN SCHUBERT
BOARD MEMBER, EVP MISION INTEG	2.0	48.0	Yes (X)	$0	$0	$0	Yes (X)
JOSEPHINE THORNTON
BOARD MEMBER	2.0	0.0	Yes (X)	$0	$0	$0
MICHAEL TOMASINI
BOARD MEMBER	2.0	0.0	Yes (X)	$0	$0	$0
PAMELA TUFT
BD MEMBER, CHAIRPERSON (PT YR)	2.0	0.0	Yes (X)	$0	$0	$0
OLUYEMI ADEYANJU
SECRETARY	2.0	48.0		$0	$475,496	$10,990	Yes (X)
MICHEL RICCIONI
CFO	6.0	44.0		$0	$602,515	$53,316	Yes (X)
JAYNIE BOREN
N.CA REG VP-STRATEGIC SVCS	4.0	46.0		$0	$444,251	$33,304		Yes (X)
RICHARD CARVOLTH
CHIEF MEDICAL OFFICER	8.0	42.0		$0	$429,644	$29,019		Yes (X)
TERRI DENTE
VP-MISSION INTEGRATION	8.0	42.0		$0	$260,768	$49,142		Yes (X)
MAUREEN DISBOT
REG VP, QUALITY & SAFETY-N. CA	4.0	46.0		$0	$437,276	$32,125		Yes (X)
ROBERT EISEN
REGIONAL VP HR	4.0	46.0		$0	$370,407	$21,488		Yes (X)
ROBERT JUST III
N.CA REGION, COO	4.0	46.0		$0	$452,101	$46,165		Yes (X)
KEVIN KLOCKENGA
REGIONAL EVP-NCA	4.0	46.0		$0	$1,270,400	$31,292		Yes (X)
JOHN OMEL
INTERIM REGIONAL VP HR	4.0	46.0		$0	$465,398	$0		Yes (X)
MARK PROVAN
N.CA REG VP- POST ACUTE CARE	4.0	46.0		$0	$318,302	$37,168		Yes (X)
JANE READ
VP-OPERATIONS	50.0	0.0		$328,640	$0	$22,586		Yes (X)
VICKI WHITE
CHIEF NURSING OFFICER	8.0	42.0		$0	$210,325	$11,058		Yes (X)
DAVID ZIOLKOWSKI
CHIEF OPERATING OFFICER	8.0	42.0		$0	$420,157	$31,493		Yes (X)
THELMA COLLINS
HOUSE SUPERVISOR	40.0	0.0		$201,944	$0	$34,983			Yes (X)
GAY CORDERO-JOLAVAR
STAFF NURSE IV	40.0	0.0		$200,643	$0	$13,094			Yes (X)
CAROLINE DELLA
STAFF NURSE IV	40.0	0.0		$200,894	$0	$44,260			Yes (X)
HAI GAO
STAFF NURSE IV	40.0	0.0		$200,010	$0	$37,218			Yes (X)
WENDI THOMAS
DIR. NURSING	40.0	0.0		$229,430	$0	$42,163			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,361,561	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,415,171	TotReportableCompRltdOrgAmt
Total Other Compensation	$707,455	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	102	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
AMN HEALTHCARE INC
PO BOX 56157	LOS ANGELES	CA	90074	MEDICAL SERVICES	$1,377,828
M ATCHISON CRNA INC
107 MACINNES CT	NAPA	CA	94558	MEDICAL SERVICES	$503,250
PETALUMA SURGICAL ASSOCIATES
1496 PROFESSIONAL DR STE 601	PETALUMA	CA	94954	MEDICAL SERVICES	$464,455
EMPRES POST ACUTE REHABILITATION
300 DOUGLAS STREET	PETALUMA	CA	94952	MEDICAL SERVICES	$338,202
UNIVERSAL PROTECTION SERVICE LP
PO BOX 101034	PASADENA	CA	91189	SECURITY SERVICES	$271,220

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	19	CntrctRcvdGreaterThan100KCnt
Fundraising	$300,554	FundraisingAmt
Related Organizations	$2,450	RelatedOrganizationsAmt
All Other Contributions	$648,909	AllOtherContributionsAmt
Noncash Contributions	$1,006	NoncashContributionsAmt
Total Contributions	$951,913	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
NET PATIENT REVENUE	622110	$95,887,212	$95,887,212	$0	$0
ELECTRONIC HEALTH RECORDS	622110	$98,614	$98,614	$0	$0
CAFETERIA	722514	$91,449	$91,449	$0	$0
All other program service revenue	900099	$1,708,739	$1,708,739	$0	$0

Field	Value	IRS element (for citing)
Total Program Service Revenue	$97,786,014	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$56,958	TotalRevenueColumnAmt
Exclusion	$56,958	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$52,506	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$300,554	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$141,526	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$89,020	TotalRevenueColumnAmt
Exclusion	-$89,020	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
CASH PURCHASES & DISCOUNTS	900099	$27,765	$27,765	$0	$0
MEDICAL RECORDS & REPORTS	900099	$5,563	$5,563	$0	$0

Field	Value	IRS element (for citing)
Other Revenue Total	$33,328	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$98,739,193	TotalRevenueColumnAmt
Related Or Exempt Func Income	$97,819,342	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$32,062	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$89,172	TotalAmt
Program Services	$89,172	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,081,367	TotalAmt
Program Services	$990,535	ProgramServicesAmt
Management And General	$90,832	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$34,433,135	TotalAmt
Program Services	$32,474,674	ProgramServicesAmt
Management And General	$1,757,678	ManagementAndGeneralAmt
Fundraising	$200,783	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,022,585	TotalAmt
Program Services	$1,884,099	ProgramServicesAmt
Management And General	$126,746	ManagementAndGeneralAmt
Fundraising	$11,740	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$11,593,326	TotalAmt
Program Services	$10,975,220	ProgramServicesAmt
Management And General	$514,964	ManagementAndGeneralAmt
Fundraising	$103,142	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,856,696	TotalAmt
Program Services	$2,706,569	ProgramServicesAmt
Management And General	$132,281	ManagementAndGeneralAmt
Fundraising	$17,846	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$6,685,610	TotalAmt
Program Services	$6,638,828	ProgramServicesAmt
Management And General	$46,782	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$720,486	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$720,486	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$622,225	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$622,225	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$7,666	TotalAmt
Program Services	$7,666	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$14,996,562	TotalAmt
Program Services	$14,348,460	ProgramServicesAmt
Management And General	$636,321	ManagementAndGeneralAmt
Fundraising	$11,781	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$202,464	TotalAmt
Program Services	$94,964	ProgramServicesAmt
Management And General	$76,152	ManagementAndGeneralAmt
Fundraising	$31,348	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,107,747	TotalAmt
Program Services	$2,978,304	ProgramServicesAmt
Management And General	$108,540	ManagementAndGeneralAmt
Fundraising	$20,903	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,655,419	TotalAmt
Program Services	$1,552,437	ProgramServicesAmt
Management And General	$95,113	ManagementAndGeneralAmt
Fundraising	$7,869	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,610,299	TotalAmt
Program Services	$1,530,252	ProgramServicesAmt
Management And General	$3,678	ManagementAndGeneralAmt
Fundraising	$76,369	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$415,624	TotalAmt
Program Services	$339,320	ProgramServicesAmt
Management And General	$73,224	ManagementAndGeneralAmt
Fundraising	$3,080	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$14,334	TotalAmt
Program Services	$10,065	ProgramServicesAmt
Management And General	$4,269	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,328	TotalAmt
Program Services	$1,108	ProgramServicesAmt
Management And General	$3,220	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,057,375	TotalAmt
Program Services	$2,054,943	ProgramServicesAmt
Management And General	$2,432	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$536,612	TotalAmt
Program Services	$536,612	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$7,101,177	$7,091,766	$9,411	$0
CA HOSPITAL FEE PROGRAM	$2,785,818	$2,785,818	$0	$0
REPAIRS AND MAINTENANCE	$748,098	$742,766	$211	$5,121
EXTRAORDINARY ITEMS	$489,282	$489,282	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,179,506	TotalAmt
Program Services	$723,749	ProgramServicesAmt
Management And General	$397,037	ManagementAndGeneralAmt
Fundraising	$58,720	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$97,016,913	TotalAmt
Program Services	$91,046,609	ProgramServicesAmt
Management And General	$5,421,602	ManagementAndGeneralAmt
Fundraising	$548,702	FundraisingAmt

Total Joint Costs TotalJointCostsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,059	BOYAmt
EOY	$2,059	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$3,262,742	BOYAmt
EOY	$3,725,961	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$11,189,226	BOYAmt
EOY	$13,439,324	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,302,090	BOYAmt
EOY	$1,472,440	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$781,299	BOYAmt
EOY	$653,032	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$48,663,380	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$38,082,752	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$12,267,585	BOYAmt
EOY	$10,580,628	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$163,916	BOYAmt
EOY	$195,379	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,137,773	BOYAmt
EOY	$2,249,785	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$32,106,690	BOYAmt
EOY	$32,318,608	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$9,032,917	BOYAmt
EOY	$9,823,086	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$16,661,883	BOYAmt
EOY	$16,404,496	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$25,694,800	BOYAmt
EOY	$26,227,582	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,115,103	BOYAmt
EOY	$4,454,302	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,296,787	BOYAmt
EOY	$1,636,724	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$6,411,890	BOYAmt
EOY	$6,091,026	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$32,106,690	BOYAmt
EOY	$32,318,608	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,722,280	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$2,043,144	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Media Advertisements	$0	MediaAdvertisementsAmt
Mailings Members	false	MailingsMembersInd
Mailings Members	$0	MailingsMembersAmt
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Publications Or Broadcast	$0	PublicationsOrBroadcastAmt
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Grants Other Organizations	$0	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Direct Contact Legislators	$0	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Rallies Demonstrations	$0	RalliesDemonstrationsAmt
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$7,666	OtherActivitiesAmt
Total Lobbying Expenditures	$7,666	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	DURING THE YEAR, ST. JOSEPH HEALTH SYSTEM CONDUCTED ADVOCACY EFFORTS WHICH INCLUDED SOME LOBBYING ACTIVITIES. THESE ACTIVITIES INCLUDED MEETING WITH LOCAL, STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS, AS WELL AS COMMUNICATION TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO SRM ALLIANCE HOSPITAL SERVICES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Book Value	$0	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,800,495	OtherCostOrOtherBasisAmt
Depreciation	$9,182,885	DepreciationAmt
Book Value	$617,610	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,604,175	OtherCostOrOtherBasisAmt
Depreciation	$4,544,459	DepreciationAmt
Book Value	$3,059,716	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,583,361	OtherCostOrOtherBasisAmt
Depreciation	$24,355,408	DepreciationAmt
Book Value	$4,227,953	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,675,349	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$2,675,349	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$10,580,628	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
RESTRICTED FUNDS HOSPICE	$995,740
RESTRICTED FUNDS OTHER	$637,363
HOSPITAL FEE	$596,763
OTHER	$19,919

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,249,785	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
ACCRUED LIABILITIES	$2,587,449
DUE TO AFFILIATES	$13,378,832
PAYABLE TO THIRD PARTY PAYORS	$237,682
OTHER NON CURRENT LIABILITIES	$200,533

Field	Value	IRS element (for citing)
Total Liability	$16,404,496	TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	BENEDETTI	Event1Nm
Gross Receipts Event1	$266,950	GrossReceiptsEvent1Amt
Charitable Contri Event1	$240,940	CharitableContriEvent1Amt
Gross Revenue Event1	$26,010	GrossRevenueEvent1Amt
Cash Prizes Event1	$0	CashPrizesEvent1Amt
Non Cash Prizes Event1	$0	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$12,000	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$28,507	FoodAndBeverageEvent1Amt
Entertainment Event1	$400	EntertainmentEvent1Amt
Other Direct Expenses Event1	$43,472	OtherDirectExpensesEvent1Amt
Event2	HOSPICE GOLF	Event2Nm
Gross Receipts Event2	$86,110	GrossReceiptsEvent2Amt
Charitable Contri Event2	$59,614	CharitableContriEvent2Amt
Gross Revenue Event2	$26,496	GrossRevenueEvent2Amt
Cash Prizes Event2	$0	CashPrizesEvent2Amt
Non Cash Prizes Event2	$8,500	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$10,986	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$11,003	FoodAndBeverageEvent2Amt
Entertainment Event2	$0	EntertainmentEvent2Amt
Other Direct Expenses Event2	$26,658	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$353,060	GrossReceiptsTotalAmt
Charitable Contributions Tot	$300,554	CharitableContributionsTotAmt
Gross Revenue Total Events	$52,506	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$0	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$8,500	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$22,986	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$39,510	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$400	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$70,130	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$141,526	DirectExpenseSummaryEventsAmt
Net Income Summary	-$89,020	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	500.	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$979,088	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$979,088	NetCommunityBenefitExpnsAmt
Total Expense	0.01010	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,732,159	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,677,500	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,054,659	NetCommunityBenefitExpnsAmt
Total Expense	0.12490	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,541	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$26,541	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,737,788	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,677,500	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,060,288	NetCommunityBenefitExpnsAmt
Total Expense	0.13530	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$202,444	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,475	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$159,969	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$106,927	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$106,927	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$309,371	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,475	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$266,896	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,047,159	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,719,975	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,327,184	NetCommunityBenefitExpnsAmt
Total Expense	0.13810	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,646	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,238	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,408	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,646	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,238	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,408	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$3,038,711	BadDebtExpenseAmt
Reimbursed By Medicare	$19,433,645	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$30,788,991	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$11,355,346	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SRM ALLIANCE HOSPITAL SERVICES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MCDOWELL BLVD	AddressLine1Txt
City	PETALUMA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94954	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.STJOESONOMA.ORG	WebsiteAddressTxt
State License	110000001	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SRM ALLIANCE HOSPITAL SERVICES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SCHEDULE H, PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SCHEDULE H, PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS WAS GUIDED BY THE FUNDAMENTAL UNDERSTANDING THAT MUCH OF A PERSON AND COMMUNITYS HEALTH IS DETERMINED BY THE CONDITIONS IN WHICH THEY LIVE, WORK, PLAY, AND PRAY. IN GATHERING INFORMATION ON THE COMMUNITIES SERVED, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, HEALTH BEHAVIORS, AND THE AVAILABILITY OF CLINICAL CARE. THIS FRAMEWORK FOCUSES ATTENTION ON THE SOCIAL DETERMINANTS OF HEALTH TO LEARN MORE ABOUT OPPORTUNITIES FOR INTERVENTION THAT WILL HELP PEOPLE BECOME AND STAY HEALTHY WITHIN THEIR COMMUNITY. IN ADDITION, WE RECOGNIZED THAT WHERE PEOPLE LIVE TELLS US A LOT ABOUT THEIR HEALTH AND HEALTH NEEDS, AND THAT THERE CAN BE POCKETS WITHIN COUNTIES AND CITIES WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE SUBSTANTIALLY WORSE THAN NEARBY AREAS. WHEN DATA WAS PUBLICLY AVAILABLE, IT WAS COLLECTED AT THE ZIP CODE LEVEL TO SHOW THE DISPARITIES IN HEALTH AND THE SOCIAL DETERMINANTS OF HEALTH THAT OCCUR WITHIN THE HOSPITAL SERVICE AREA. THE OLIN GROUP IS A SOCIALLY CONSCIOUS CONSULTING FIRM WORKING ACROSS NONPROFIT, PUBLIC, PRIVATE, AND PHILANTHROPIC SECTORS TO BRING ABOUT COMMUNITY TRANSFORMATION. BASED IN SANTA ANA, CALIFORNIA, THE OLIN GROUP HAS 15 YEARS OF EXPERIENCE WORKING ON EVALUATION, PLANNING, ASSESSMENT, FUNDRAISING, COMMUNICATION, AND OTHER SERVICES FOR NONPROFIT ORGANIZATIONS, AND HAD PREVIOUSLY SUPPORTED THE CHNA PROCESS OF MULTIPLE HOSPITALS IN THE ST. JOSEPH HEALTH SYSTEM. THE OLIN GROUP SERVED AS THE LEAD CONSULTANT IN THE CHNA PROCESS, COORDINATING THE QUANTITATIVE AND QUALITATIVE DATA COLLECTION PROCESSES AND ASSISTING IN THE PRIORITIZATION AND SELECTION OF HEALTH NEEDS. COMMUNITY PARTNERS: PETALUMA VALLEY HOSPITAL, IN COLLABORATION WITH SANTA ROSA MEMORIAL HOSPITAL, PARTNERED WITH THE FOLLOWING COMMUNITY GROUPS TO RECRUIT FOR AND HOST THE FOCUS GROUPS AND FORUM: THE COMMUNITY CHILD CARE COUNCIL OF SONOMA COUNTY KNOWN AS 4CS IS A NONPROFIT AGENCY DEDICATED TO SUPPORTING AND PROVIDING QUALITY, ACCESSIBLE AND AFFORDABLE PRESCHOOL AND CHILD CARE SERVICES FOR CHILDREN, FAMILIES AND CHILD CARE PROFESSIONALS THROUGH EDUCATION, RESOURCES, AND DIRECT SERVICES. 4CS ALSO OPERATES ELEVEN STATE-FUNDED PRESCHOOLS THROUGHOUT SONOMA COUNTY. THE MISSION OF THE COMMUNITY CHILD CARE COUNCIL IS TO INSPIRE OUR COMMUNITY TO SUPPORT THE WELL-BEING OF EVERY CHILD AND TO IMPROVE THE QUALITY AND AVAILABILITY OF CHILD CARE IN SONOMA COUNTY. PETALUMA PEOPLE SERVICES CENTER (PPSC) IS A MULTI-SERVICE NONPROFIT SOCIAL SERVICES AGENCY SERVING THE COMMUNITIES OF PETALUMA AND SOUTHERN SONOMA COUNTY WITH MORE THAN 53 HUMAN SERVICES PROGRAMS BASED ON BEST PRACTICE RESEARCH WITH MEASURABLE OUTCOMES. PPSC HAS FIVE SIGNIFICANT CORE SERVICE AREAS: - SENIOR SERVICES MEALS-ON-WHEELS, ADULT DAY CARE, CASE MANAGEMENT, NUTRITION SITE - SENIOR CAFE, TRANSPORTATION - HOMELESS PREVENTION, SHARE OF SONOMA AND FAIR HOUSING SONOMA COUNTY - EMPLOYMENT & TRAINING ADULT AND YOUTH - COUNSELING INDIVIDUAL, COUPLES & FAMILY, DRUG & ALCOHOL PREVENTION, GANG PREVENTION - PETALUMA BOUNTY HEALTHY FOOD FOR ALL LA LUZ IS THE PRIMARY SOCIAL SERVICE AGENCY IN THE SONOMA VALLEY REGION WHICH INCLUDES ONE OF SONOMA COUNTYS PROMINENT AREAS OF NEED WITH ONE OF THE HIGHEST CONCENTRATIONS OF WORKING POOR LATINO FAMILIES. LA LUZ PROVIDES ENGLISH LANGUAGE TRAINING AND FINANCIAL SUPPORT SERVICES, TEACHES COMPUTER SKILLS, DISTRIBUTES FOOD, HOSTS MEDICAL AND LEGAL SERVICES, OFFERS CRISIS COUNSELING, AND SUPPORTS EVENTS THAT CELEBRATE THE MULTICULTURAL RICHNESS OF THE COMMUNITY. LA LUZ SERVICES ENSURE THAT SONOMA VALLEY RESIDENTS FACING ALL TYPES OF CHALLENGES HAVE THE OPPORTUNITY TO IMPROVE THEIR LIVES. COMMUNITY ACTION PARTNERSHIP OF SONOMA COUNTY (CAP SONOMA) HAS BEEN PARTNERING WITH LOW-INCOME FAMILIES AND INDIVIDUALS TO HELP THEM ACHIEVE ECONOMIC AND SOCIAL STABILITY; TO BUILD COMMUNITY, AND TO ADVOCATE FOR SOCIAL AND ECONOMIC JUSTICE SINCE 1967. AS THE SURVIVING COMMUNITY ACTION AGENCY FOR SONOMA COUNTY FROM THE WAR ON POVERTY IN THE '60S, CAP SONOMA IS THE LARGEST NONPROFIT SOCIAL SERVICES AGENCY IN SONOMA COUNTY. SECONDARY DATA/PUBLICLY AVAILABLE DATA WITHIN THE GUIDING HEALTH FRAMEWORK FOR THE CHNA, PUBLICLY AVAILABLE DATA WAS SOUGHT THAT WOULD PROVIDE INFORMATION ABOUT THE COMMUNITIES (AT THE CITY AND ZIP CODE LEVEL WHEN AVAILABLE) AND PEOPLE WITHIN OUR SERVICE AREA. IN ADDITION, COMPARISON DATA WAS GATHERED TO SHOW HOW THE SERVICE AREA COMMUNITIES ARE FARING COMPARED TO THE COUNTY OR STATE. INDICATORS WERE CHOSEN IF THEY WERE WIDELY ACCEPTED AS VALID AND APPROPRIATE MEASURES AND WOULD READILY COMMUNICATE THE HEALTH NEEDS OF THE SERVICE AREA. PREFERENCE WAS GIVEN TO DATA THAT WAS OBTAINED IN THE LAST 5 YEARS AND WAS AVAILABLE AT THE ZIP CODE LEVEL. THE DATA SOURCES USED ARE HIGHLY REGARDED AS RELIABLE SOURCES OF DATA (E.G., ESRI BUSINESS ANALYST ONLINE, US CENSUS BUREAU AMERICAN FACTFINDER, AND CALIFORNIA HEALTH INTERVIEW SURVEY NEIGHBORHOOD EDITION). IN TOTAL, 81 INDICATORS WERE SELECTED TO DESCRIBE THE HEALTH NEEDS IN THE HOSPITALS SERVICE AREA. IF AN INDICATOR HAD ZIP CODE LEVEL DATA AVAILABLE, DATA WAS POOLED TO DEVELOP INDICATOR VALUES FOR THE TOTAL SERVICE AREA (TSA), PRIMARY SERVICE AREA (PSA), AND SECONDARY SERVICE AREA (SSA) OF THE HOSPITAL. THIS ENABLED COMPARISONS OF ZIP CODE LEVEL DATA TO THE HOSPITAL SERVICE AREA AND COMPARISONS OF THE HOSPITAL SERVICE AREA TO COUNTY AND STATE MEASURES. AFTER THE DATA WAS GATHERED, THE ZIP CODE LEVEL DATA WAS COMPARED TO THE TOTAL SERVICE AREA VALUES AND COLOR CODED LIGHT PINK TO DARK RED DEPENDING ON HOW MUCH WORSE A ZIP CODE AREA WAS COMPARED TO THE TSA VALUE. THIS MADE IT EASIER TO VISUALIZE THE GEOGRAPHIC AREAS WITH GREATER HEALTH NEEDS. COMMUNITY INPUT THE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUPS, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY SANTA ROSA MEMORIAL 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. RESIDENT FOCUS GROUPS FOR COMMUNITY RESIDENT GROUPS, HOSPITAL COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMUNITY BENEFIT COMMITTEES AND THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIPS DEPARTMENT, 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. THE COMMUNITY-BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND 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. 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 FORUM RECRUITMENT FOR THE COMMUNITY RESIDENT FORUM 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 FORUM AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM 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 INDI
SCHEDULE H, PART V, SECTION B, LINE 6A	MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING HOSPITAL FACILITIES: - SUTTER HEALTH - KAISER PERMANENTE
SCHEDULE H, PART V, SECTION B, LINE 6B	MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: - SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES - COMMUNITY CHILD CARE COUNCIL (4CS) OF SONOMA COUNTY - FIRST 5 SONOMA COUNTY PARTNERSHIP - BURBANK HOUSING - COMMUNITY FOUNDATION SONOMA COUNTY - SONOMA COUNTY SHERIFFS OFFICE - CITY OF SANTA ROSA VIOLENCE PREVENTION
SCHEDULE H, PART V, SECTION B, LINE 7A	THE WEB ADDRESS IS: HTTPS://WWW.STJOESONOMA.ORG/DOCUMENTS/COMMUNITY-BENEFIT/PVH-CHNA-FY17.PDF
SCHEDULE H, PART V, SECTION B, LINE 10A	THE WEB ADDRESS IS: HTTPS://WWW.STJOESONOMA.ORG/DOCUMENTS/COMMUNITY-BENEFIT/PVH-CBPLAN-IS-REPO RT-FY18-FY20.PDF
SCHEDULE H, PART V, SECTION B, LINE 11	PETALUMA VALLEY HOSPITAL IS A COMMUNITY HOSPITAL FOUNDED IN 1980 BY THE PETALUMA HEALTH CARE DISTRICT, AND IS LOCATED IN PETALUMA, CALIFORNIA. ST. JOSEPH HEALTH HAS MANAGED OPERATIONS OF THE FACILITY SINCE 1997. THE FACILITY HAS 80 LICENSED BEDS AND A CAMPUS THAT IS 14.63 ACRES IN SIZE. PETALUMA VALLEY HOSPITAL (PVH) HAS A STAFF OF 501 EMPLOYEES AND PROFESSIONAL RELATIONSHIPS WITH MORE THAN 260 LOCAL PHYSICIANS. PVH IS A LEAPFROG A-RATED FACILITY, A JOINT COMMISSION STROKE-READY CERTIFIED HOSPITAL, HAS BEEN DESIGNATED AS A BABY-FRIENDLY HOSPITAL BY BABY-FRIENDLY USA, AND AS A BLUE DISTINCTION SPECIALTY CARE FACILITY BY BLUE CROSS BLUE SHIELD FOR MATERNITY SERVICES. MAJOR PROGRAMS AND SERVICES ALSO INCLUDE EMERGENCY CARE, OUTPATIENT SURGERY, OBSTETRICAL SERVICES, AND PULMONARY REHABILITATION. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS ST. JOSEPH HEALTH (SJH), PVH IS PART OF A COUNTYWIDE MINISTRY, ST. JOSEPH HEALTH-SONOMA COUNTY (SJH-SC) THAT INCLUDES TWO HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRYS CORE FACILITIES ARE PVH, AN 80-BED ACUTE CARE HOSPITAL, AND SANTA ROSA MEMORIAL HOSPITAL (SRMH), A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMENS AND CHILDRENS SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY. PVH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM ROHNERT PARK IN THE NORTH, INVERNESS IN THE SOUTH AND WEST, AND PETALUMA IN THE EAST. PVHS TOTAL SERVICE AREA INCLUDES THE CITIES OF PETALUMA, ROHNERT PARK, AND COTATI. THIS INCLUDES A POPULATION OF APPROXIMATELY 133,000 PEOPLE. THE PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES THAT COMPRISE THE CITY OF PETALUMA, WHILE THE SECONDARY SERVICE AREA (SSA) IS LARGELY COMPRISED OF COTATI, PENNGROVE, AND ROHNERT PARK. APPROXIMATELY 95% OF THE POPULATION OF THE SERVICE AREA IS IN SONOMA COUNTY. COMPARED TO THE STATE, THE SERVICE AREA IS OLDER AND HAS A HIGHER PERCENTAGE OF NON-LATINO WHITES. THE MEDIAN INCOME OF THE TSA IS HIGHER THAN CALIFORNIAS AVERAGE AND THERE IS LESS REPORTED POVERTY, ALTHOUGH THE SSA IS LESS AFFLUENT THAN THE PSA. PVH DEDICATES RESOURCES TO IMPROVE THE HEALTH AND QUALITY OF LIFE FOR THE COMMUNITIES IT SERVES, WITH SPECIAL EMPHASIS ON THE NEEDS OF THE ECONOMICALLY POOR AND UNDERSERVED. EACH YEAR, PVH ALLOCATES 10 PERCENT OF ITS NET INCOME TO THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. 75 PERCENT OF THESE CONTRIBUTIONS ARE USED TO SUPPORT LOCAL HOSPITAL CARE FOR THE POOR PROGRAMS. IN ADDITION, PVH SPENDS PORTIONS OF ITS ANNUAL OPERATING BUDGET TO OPERATE ONGOING COMMUNITY BENEFIT PROGRAMS TARGETED AT BOTH THE ECONOMICALLY POOR AND UNDERSERVED AS WELL AS THE BROADER COMMUNITY. THESE PROGRAMS INCLUDE A FREE MOBILE HEALTH CLINIC, MOBILE DENTAL CLINIC, FIXED-SITE DENTAL CLINIC, A HOUSE CALLS PROGRAM PROVIDING IN-HOME CARE TO CHRONICALLY ILL PATIENTS, A PROMOTORES DE SALUD PROGRAM OFFERING SPANISH-LANGUAGE HEALTH AND NUTRITION EDUCATION AND HEALTH SCREENINGS, AND SCHOOL-BASED PROGRAMS PROVIDING HEALTH AND NUTRITION EDUCATION AND PEER SUPPORT GROUPS. FY18-FY20 CB PLAN PRIORITIES/IMPLEMENTATION STRATEGIES AS A RESULT OF THE FINDINGS OF OUR FY17 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES AND HOSPITAL STRATEGIC PLAN, PVH WILL FOCUS ON THE FOLLOWING AREAS FOR ITS FY18-FY20 COMMUNITY BENEFIT EFFORTS: - ACCESS TO RESOURCES: ENSURING ACCESS TO AFFORDABLE, QUALITY HEALTH CARE SERVICES IS IMPORTANT TO PROTECTING BOTH INDIVIDUAL AND POPULATION HEALTH, ELIMINATING HEALTH DISPARITIES AND PROMOTING OVERALL QUALITY OF LIFE IN THE COMMUNITY. THIS INCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS INCOME, LACK OF ADEQUATE INSURANCE, IMMIGRATION STATUS, TRANSPORTATION, A SHORTAGE OF PROVIDERS AND SPECIALISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS. - HOMELESSNESS AND HOUSING CONCERNS: HOUSING IS CONSIDERED A PRIMARY SOCIAL DETERMINANT OF HEALTH, AND THE LACK OF HOUSING OR AFFORDABLE HOUSING CONTRIBUTES TO AND EXACERBATES MULTIPLE ADVERSE HEALTH CONDITIONS. OUR PRIMARY FOCUS WILL BE ON THE CONDITION OF HOMELESSNESS, INCLUDING THE DEVELOPMENT OF PERMANENT SUPPORTIVE HOUSING, PROVIDING HEALTH CARE TO HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. WE ALSO INTEND TO PARTNER WITH OTHER COMMUNITY ORGANIZATIONS TO ADDRESS ISSUES OF HOUSING AFFORDABILITY, AVAILABILITY, OVERCROWDING, AND QUALITY. - MENTAL HEALTH AND SUBSTANCE USE: COVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES, INCLUDING ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS MENTAL HEALTH CONDITIONS, WITH A PARTICULAR FOCUS ON TRAUMA-INFORMED COMMUNITY-BASED PREVENTION AND RESILIENCE IN THE FACE OF ADVERSE COMMUNITY EXPERIENCES. BECAUSE THE CO-OCCURRENCE OF SUBSTANCE USE DISORDERS IS SO PREVALENT WITH THOSE CONFRONTING MENTAL HEALTH CHALLENGES, THIS PRIORITY FOCUS AREA WILL ALSO INCLUDE ADDRESSING ISSUES PERTAINING TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, METHAMPHETAMINES, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. NEEDS BEYOND THE HOSPITALS SERVICE PROGRAM: NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE RECOGNIZE THAT IN CHOOSING TO FOCUS ON THE NEEDS WE HAVE PRIORITIZED, WE WILL NOT BE ADDRESSING DIRECTLY OTHER NEEDS THAT ARE ALSO IMPORTANT IN OUR COMMUNITY. FOR INSTANCE, WE RECOGNIZE THAT CARDIOVASCULAR DISEASE IS THE LEADING CAUSE OF DEATH IN OUR COMMUNITY, AND THAT HEART DISEASE, OBESITY, AND DIABETES WERE ALL AMONG THE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN OUR CHNA PROCESS. IN NOT SELECTING ANY OF THESE CHRONIC CONDITIONS AS ONE OF OUR COMMUNITY BENEFIT PRIORITY FOCUS AREAS, WE ARE AWARE THAT OTHER ONGOING PROGRAMS IN OUR MINISTRY AND IN OUR COMMUNITY ARE FULLY ENGAGED IN ADDRESSING THEM. WE ARE COMMITTED TO CONTINUE OUR INVOLVEMENT WITH COMMUNITY INITIATIVES SUCH AS HEARTS OF SONOMA AND THE CALIFORNIA ACCOUNTABLE COMMUNITIES FOR HEALTH INITIATIVE, FINANCIAL SUPPORT FOR NONPROFIT ORGANIZATIONS SUCH AS THE NORTHERN CALIFORNIA CENTER FOR WELL BEING, AND THE HEARTWORKS CARDIAC REHAB PROGRAM. WITH RESPECT TO SOME OF THE OTHER NEEDS IDENTIFIED IN THE CHNA PROCESS THAT WERE NOT PRIORITIZED FOR ACTION THROUGH THIS PLAN, WE INTEND TO REMAIN ENGAGED IN ADDRESSING ORAL HEALTH NEEDS THROUGH OUR ONGOING ST. JOSEPH HEALTH COMMUNITY DENTAL CLINIC AND MOBILE DENTAL CLINIC; CRIME AND SAFETY THROUGH OUR CONTINUED INVOLVEMENT ON THE SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP; AND INSURANCE AND COST OF CARE THROUGH OUR CONTINUED INVOLVEMENT ON THE COVERED SONOMA AND SONOMA HEALTH ACTION COMMUNITY HEALTH IMPROVEMENT COMMITTEES. WE ALSO INTEND TO INCORPORATE OTHER ISSUES SUCH AS EARLY CHILDHOOD DEVELOPMENT IN OUR BEHAVIORAL HEALTH STRATEGY AS IT IS SUCH A FUNDAMENTAL DETERMINANT OF MENTAL HEALTH LATER IN LIFE; AND ECONOMIC INSECURITY IN OUR HOUSING CONCERNS STRATEGY AS IT IS A NECESSARY INGREDIENT IN HOUSING AFFORDABILITY. SIMILARLY, WITH RESPECT TO IMMIGRATION, WE LACK APPROPRIATE EXPERTISE OR COMPETENCY TO OFFER A PROGRAM, BUT WE INTEND TO DEVELOP A MEDICAL LEGAL PARTNERSHIP WITH A LOCAL LEGAL AID ORGANIZATION THAT WILL ASSIST RESIDENTS AND PATIENTS WITH IMMIGRATION ISSUES, AMONG OTHERS. AND WHILE FOOD AND NUTRITION IS NOT TO BE DIRECTLY ADDRESSED BY OUR OWN PROGRAMMING, WE ANTICIPATE THAT OUR ONGOING SUPPORT OF LOCAL INITIATIVES AND ORGANIZATIONS INVOLVED IN CARDIOVASCULAR DISEASE PREVENTION WILL INCLUDE A CONSIDERATION AND INCLUSION OF STRATEGIES TO ADDRESS THIS NEED. FURTHERMORE, WE WILL CONTINUE FUNDING OTHER LOCAL NONPROFIT ORGANIZATIONS THROUGH GRANTS FROM OUR CARE FOR THE POOR PROGRAM MANAGED BY THE PVH COMMUNITY BENEFIT DEPARTMENT, AND WE WILL ENCOURAGE AND ENDORSE LOCAL NONPROFIT 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 THE PVH SERVICE AREAS.
SCHEDULE H, PART V, SECTION B, LINE 13H	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 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	THE WEB ADDRESS IS: HTTP://WWW.STJOESONOMA.ORG/DOCUMENTS/FINANCIAL-ASSISTANCE-POLICY.PDF
SCHEDULE H, PART V, SECTION B, LINE 16B	THE WEB ADDRESS IS: HTTP://WWW.STJOESONOMA.ORG/DOCUMENTS/SONOMA-FAA-ENGLISH.PDF
SCHEDULE H, PART V, SECTION B, LINE 16C	THE WEB ADDRESS IS: HTTP://WWW.STJOESONOMA.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/ SONOMA_FABROCHURE_2016.PDF SCHEDULE H, PART V, SECTION B, LINE 16J THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
HOSPICE OF PETALUMA
416 PAYRAN STREET	PETALUMA	CA	94954	HOSPICE
HOSPICE OF SANTA ROSA
439 COLLEGE AVE	SANTA ROSA	CA	95401	HOSPICE
HOSPICE OF SANTA ROSA
447 COLLEGE AVE	SANTA ROSA	CA	95401	HOSPICE
LYNCH CREEK LABORATORY
151 LYNCH CREEK	PETALUMA	CA	95954	LAB OUTREACH
LYNCH CREEK IMAGING
151 LYNCH CREEK	PETALUMA	CA	95954	IMAGING/RADIOLOGY
HOSPICE OF NORTH COUNTY
205 EAST STREET	HEALDSBURG	CA	95448	HOSPICE

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, 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	PETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT WWW.STJOESONOMA.ORG.
SCHEDULE H, PART I, LINES 7A-7I	COST-TO-CHARGE RATIO USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE WAS USED TO DETERMINE AMOUNTS ON LINE 7.
SCHEDULE H, PART II	NEIGHBORHOOD CARE STAFF (NCS) PROGRAM SERVES AS THE COMMUNITY OUTREACH AND ENGAGEMENT ARM OF THE COMMUNITY BENEFIT DEPARTMENT. NCS STAFF ENGAGE COMMUNITY RESIDENT LEADERS AND AGENCY PARTNERS TO ADDRESS LOCAL COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES, FACILITATE COMMUNITY CONVERSATIONS AND PLANNING, SUPPORT COLLABORATIVE INITIATIVES, AND DRIVE POLICY AND PROGRAM DEVELOPMENT EMERGING FROM THESE EFFORTS. IN FY17, IN THE PETALUMA AREA, NEIGHBORHOOD CARE STAFF ENGAGED 81 PERSONS OVER THE COURSE OF 464 ENCOUNTERS THROUGH THEIR INVOLVEMENT WITH THE COMMUNITY HEALTH INITIATIVE OF THE PETALUMA AREA AND IN COMMUNITY AND SCHOOL GARDEN PROJECTS IN THE MCKINLEY AND MCDOWELL SCHOOL DISTRICTS.
SCHEDULE H, PART III, SECTION A, LINE 2	COSTING METHODOLOGY 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, SECTION A, LINE 3	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, SECTION A, LINE 4 FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED 12/31/2017 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, SECTION B, LINE 8 COMMUNITY BENEFITS THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING CMS STANDARD COSTING METHODS. THIS INCLUDES STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS.
SCHEDULE H, PART III, SECTION C, 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 VI, LINE 2	NEEDS ASSESSMENT THE GOAL OF THE CHNA DATA DEVELOPMENT PROCESS WAS TO GATHER, ANALYZE AND SUMMARIZE CURRENT LOCAL DATA ON THE RESIDENTS OF SONOMA COUNTY, THEIR HEALTH STATUS AND THE VARIETY OF FEATURES AND CONDITIONS WHICH IMPACT THEIR HEALTH, HEALTHY DEVELOPMENT AND QUALITY OF LIFE. TO ACCOMPLISH THIS, THE CHNA PARTNERS DEVELOPED AND UTILIZED BOTH PRIMARY AND SECONDARY DATA SOURCES. THE PARTNERS CONDUCTED THE FOLLOWING ACTIVITIES TO CREATE THE FY17 SONOMA COUNTY CHNA: - DEMOGRAPHIC SUMMARY: DEVELOPED A DEMOGRAPHIC SUMMARY OF SONOMA COUNTYS CURRENT POPULATION ALONG WITH POPULATION GROWTH PROJECTIONS WHEN AVAILABLE. INFORMATION IS PROVIDED ON A VARIETY OF DEMOGRAPHIC INDICATORS INCLUDING POPULATION DISTRIBUTION, AGE, ETHNICITY, INCOME, HEALTHCARE COVERAGE, EDUCATION AND EMPLOYMENT. - SECONDARY SOURCES: ASSEMBLED SUMMARY DATA FROM A VARIETY OF SECONDARY SOURCES IDENTIFYING HEALTH BEHAVIORS AND CONDITIONS THAT COMPROMISE THE HEALTH AND HEALTHY DEVELOPMENT OF CHILDREN AND CONTRIBUTE MOST PROMINENTLY TO ILLNESS AND INJURY, DISABILITY AND DEATH FOR SONOMA COUNTY ADULTS AND CHILDREN. WHERE KNOWN, INFORMATION ON CONTRIBUTING FACTORS IS PRESENTED ALONG WITH EACH HEALTH INDICATOR. HEALTH DISPARITIES ARE HIGHLIGHTED. - KEY INFORMANT INTERVIEWS AND FOCUS GROUPS: CONDUCTED KEY INFORMANT INTERVIEWS, COMMUNITY-BASED FOCUS GROUPS AND A COUNTYWIDE RANDOM TELEPHONE SURVEY TO GATHER DATA ON HEALTH STATUS AND ELICIT INFORMATION ON COMMUNITY HEALTH ISSUES OF GREATEST CONCERN AND PERSPECTIVES ON LOCAL OPPORTUNITIES TO IMPROVE POPULATION HEALTH AND/OR THE HEALTHCARE DELIVERY SYSTEM. PRIORITY COMMUNITY HEALTH NEEDS: THE PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE FY17 CHNA PROCESS INCLUDE THE FOLLOWING. 1. HEALTHY EATING AND PHYSICAL FITNESS 2. GAPS IN ACCESS TO PRIMARY CARE 3. ACCESS TO SERVICES FOR SUBSTANCE USE DISORDERS 4. BARRIERS TO HEALTHY AGING 5. ACCESS TO MENTAL HEALTH SERVICES 6. DISPARITIES IN EDUCATIONAL ATTAINMENT 7. CARDIOVASCULAR DISEASE 8. ADVERSE CHILDHOOD EXPERIENCES OR EXPOSURE TO STRESS (ACES) 9. ACCESS TO HEALTH CARE COVERAGE 10. TOBACCO USE 11. COORDINATION AND INTEGRATION OF LOCAL HEALTH CARE SYSTEM 12. DISPARITIES IN ORAL HEALTH 13. LUNG, BREAST, AND COLORECTAL CANCER NEEDS BEYOND THE HOSPITALS 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 PROGRAMMING AND BY FUNDING OTHER NONPROFIT ORGANIZATIONS THROUGH OUR CARE FOR THE POOR PROGRAM MANAGED BY SRMH. FURTHERMORE, ST. JOSEPH HEALTH, PVH WILL ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES, RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGH ST. JOSEPH HEALTH COMMUNITIES.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ONE WAY PETALUMA VALLEY HOSPITAL INFORMS THE PUBLIC OF THE PATIENT FINANCIAL ASSISTANCE PROGRAM IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. IN FY17, PETALUMA VALLEY HOSPITAL MINISTRY PROVIDED $979,088 FREE (CHARITY CARE) AND DISCOUNTED CARE AND 864 ENCOUNTERS. PETALUMA VALLEY HOSPITAL PROVIDED ACCESS TO THE UNINSURED AND UNDERINSURED BY PARTICIPATING IN MEDICAID, ALSO KNOWN AS MEDI-CAL IN CALIFORNIA, AND OTHER LOCAL MEANS-TESTED GOVERNMENT PROGRAMS. IN FY16, PETALUMA VALLEY HOSPITAL MINISTRY PROVIDED $11,355,346 IN MEDICAID (MEDI-CAL) SHORTFALL.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION PVH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM ROHNERT PARK IN THE NORTH, INVERNESS IN THE SOUTH AND WEST, AND PETALUMA IN THE EAST. OUR HOSPITAL TOTAL SERVICE AREA INCLUDES THE CITIES OF PETALUMA, ROHNERT PARK, AND COTATI. THIS INCLUDES A POPULATION OF APPROXIMATELY 133,000 PEOPLE. PVH IS THE ONLY HOSPITAL IN PETALUMA. COMMUNITY PROFILE: THE TOTAL SERVICE AREA (TSA) OF PETALUMA VALLEY HOSPITAL INCLUDES APPROXIMATELY 133,000 PEOPLE. THE PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES THAT COMPRISE THE CITY OF PETALUMA, WHILE THE SECONDARY SERVICE AREA (SSA) IS LARGELY COMPRISED OF COTATI, PENNGROVE, AND ROHNERT PARK. APPROXIMATELY 95% OF THE POPULATION OF THE SERVICE AREA IS IN SONOMA COUNTY, SO COMPARISONS TO COUNTY DATA WILL BE MADE TO SONOMA BUT NOT MARIN COUNTY. MARINS DATA IS PRESENTED HERE FOR COMPLETENESS. COMPARED TO THE STATE, THE SERVICE AREA IS OLDER AND HAS A HIGHER PERCENTAGE OF NON-LATINO WHITES. THE MEDIAN INCOME OF THE TSA IS HIGHER THAN CALIFORNIAS AVERAGE AND THERE IS LESS REPORTED POVERTY, ALTHOUGH THE SSA IS LESS AFFLUENT THAN THE PSA. HOSPITAL TOTAL SERVICE AREA: THE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF THE HOSPITALS INPATIENTS. THE HOSPITAL TOTAL SERVICE AREA IS THE COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWING CRITERIA: - PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS) - SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY) - INCLUDES ZIP CODES FOR CONTINUITY - NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.) - CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTH. THE PRIMARY SERVICE AREA ("PSA") IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF THE HOSPITALS PATIENTS ORIGINATE. THE SECONDARY SERVICE AREA ("SSA") IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE PSA IS COMPRISED OF THE CITY OF PETALUMA. THE SSA IS COMPRISED OF THE SONOMA COUNTY CITIES OF ROHNERT PARK AND COTATI, WITH A SMATTERING OF NORTHWESTERN MARIN TOWNS. COMMUNITY NEED INDEX (ZIP CODE LEVEL) BASED ON NATIONAL NEED THE COMMUNITY NEED INDEX (CNI) WAS DEVELOPED BY DIGNITY HEALTH (FORMERLY KNOWN AS CATHOLIC HEALTHCARE WEST (CHW)) AND TRUVEN HEALTH ANALYTICS. THE COMMUNITY NEED INDEX (CNI) IDENTIFIES THE SEVERITY OF HEALTH DISPARITY FOR EVERY ZIP CODE IN THE UNITED STATES AND DEMONSTRATES THE LINK BETWEEN COMMUNITY NEED, ACCESS TO CARE, AND PREVENTABLE HOSPITALIZATIONS. CNI AGGREGATES FIVE SOCIOECONOMIC INDICATORS THAT CONTRIBUTE TO HEALTH DISPARITY (ALSO KNOWN AS BARRIERS): - INCOME BARRIERS (ELDER POVERTY, CHILD POVERTY AND SINGLE PARENT POVERTY); - CULTURE BARRIERS (NON-CAUCASIAN LIMITED ENGLISH); - EDUCATIONAL BARRIERS (% POPULATION WITHOUT HS DIPLOMA); - INSURANCE BARRIERS (INSURANCE, UNEMPLOYED AND UNINSURED); - HOUSING BARRIERS (HOUSING, RENTING PERCENTAGE). THIS OBJECTIVE MEASURE IS THE COMBINED EFFECT OF FIVE SOCIOECONOMIC BARRIERS (INCOME, CULTURE, EDUCATION, INSURANCE AND HOUSING). A SCORE OF 1.0 INDICATES A ZIP CODE WITH THE FEWEST SOCIOECONOMIC BARRIERS, WHILE A SCORE OF 5.0 REPRESENTS A ZIP CODE WITH THE MOST SOCIOECONOMIC BARRIERS. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATIONS FOR MANAGEABLE CONDITIONS SUCH AS EAR INFECTIONS, PNEUMONIA OR CONGESTIVE HEART FAILURE COMPARED TO COMMUNITIES WITH THE LOWEST CNI SCORES. (REF (ROTH R, BARSI E., HEALTH PROG. 2005 JUL-AUG; 86(4):32-8.) THE CNI IS USED TO A DRAW ATTENTION TO AREAS THAT NEED ADDITIONAL INVESTIGATION SO THAT HEALTH POLICY AND PLANNING EXPERTS CAN MORE STRATEGICALLY ALLOCATE RESOURCES. FOR EXAMPLE, THE ZIP CODE 95407 ON THE CNI MAP IS SCORED 4.2-5.0, MAKING IT A HIGHEST NEED COMMUNITY. 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). ALTHOUGH PVH IS NOT LOCATED IN A SHORTAGE AREA PARTS OF THE HOSPITALS SERVICE AREA TO THE NORTH AND EAST ARE SHORTAGE DESIGNATED, INDICATING A NEED FOR ADDITIONAL PRIMARY CARE PHYSICIANS. THE MAP BELOW DEPICTS THESE SHORTAGE AREAS RELATIVE TO PVHS LOCATION. 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 AREA'S 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.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH PETALUMA VALLEY HOSPITAL (PVH) IS A COMMUNITY HOSPITAL FOUNDED IN 1980 BY THE PETALUMA HEALTH CARE DISTRICT, AND IS LOCATED IN PETALUMA, CALIFORNIA. ST. JOSEPH HEALTH HAS MANAGED OPERATIONS OF THE FACILITY SINCE 1997. THE FACILITY HAS 80 LICENSED BEDS AND A CAMPUS THAT IS 14.63 ACRES IN SIZE. PVH HAS A STAFF OF 501 EMPLOYEES AND PROFESSIONAL RELATIONSHIPS WITH MORE THAN 260 LOCAL PHYSICIANS. PVH IS A LEAPFROG A-RATED FACILITY, A JOINT COMMISSION STROKE-READY CERTIFIED HOSPITAL, HAS BEEN DESIGNATED AS A BABY-FRIENDLY HOSPITAL BY BABY-FRIENDLY USA, AND AS A BLUE DISTINCTION SPECIALTY CARE FACILITY BY BLUE CROSS BLUE SHIELD FOR MATERNITY SERVICES. MAJOR PROGRAMS AND SERVICES ALSO INCLUDE EMERGENCY CARE, OUTPATIENT SURGERY, OBSTETRICAL SERVICES, AND PULMONARY REHABILITATION. PVH PROVIDES VITAL HOSPITAL AND COMMUNITY SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE (TRADITIONAL CHARITY CARE) AND DISCOUNTED CARE. PVH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF 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) AN OPEN MEDICAL STAFF AND 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ARE IN PART FUNDED BY CARE FOR THE POOR DOLLARS. LOCAL COMMUNITY BENEFIT COMMITTEE: THE ROLE OF THE PVH COMMUNITY BENEFIT COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE COMMITTEE ACTS IN ACCORDANCE WITH A BOARD-APPROVED CHARTER. THE COMMUNITY BENEFIT COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS IDENTIFIED NEEDS IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORTS, AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES. THE COMMUNITY BENEFIT COMMITTEE HAS A MINIMUM OF EIGHT MEMBERS INCLUDING THREE MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES THREE MEMBERS OF THE BOARD OF TRUSTEES AND EIGHT COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY BENEFIT COMMITTEE GENERALLY MEETS EVERY OTHER MONTH. THE PVH AND SRMH COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY WAS DEVELOPED BASED ON THE CHNA WITH INPUT FROM COMMUNITY GROUPS. FY17 PRIORITIES INCLUDE: - ACCESS TO HEALTH CARE SERVICES OUR MOBILE HEALTH CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, VACCINATIONS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN FY17, IN THE SONOMA COUNTY (SRMH & PVH) SERVICE AREA, THE CLINIC SAW 1,563 PATIENTS AND PROVIDED 3,256 ENCOUNTERS. - HEALTHY EATING AND PHYSICAL FITNESS THE PROMOTORES DE SALUD (HEALTH PROMOTERS) BRIDGE LANGUAGE AND CULTURE, PROVIDING HEALTH INFORMATION AND REFERRALS, CONDUCTING HEALTH SCREENINGS AT HEALTH FAIRS AND OTHER COMMUNITY EVENTS, AND PRESENTING COOKING AND NUTRITION CLASSES. IN FY17, THE PROMOTORES DE SALUD SERVED 12 LOW-INCOME INDIVIDUALS THROUGH 76 SERVICE ENCOUNTERS IN THE COMBINED PVH SERVICE AREA. HEALTHY FOR LIFE IS A SCHOOL-BASED PHYSICAL ACTIVITY AND NUTRITION PROGRAM THAT WORKS TO TEACH HEALTHY BEHAVIORS AT AN EARLY AGE AND ENSURE GOOD HEALTH FOR YEARS TO COME. THIS YEAR, IN THE PVH SERVICE AREA, HEALTHY FOR LIFE PARTNERED WITH 6 SCHOOLS, 10 CHAMPION TEACHERS AND SERVED MORE THAN 1,027 STUDENTS AND PARENTS WHO PARTICIPATED IN FITNESS AND NUTRITION COURSES ACROSS 10,928 ENCOUNTERS. - ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES CIRCLE OF SISTERS (COS) IS A POSITIVE YOUTH DEVELOPMENT AFTER-SCHOOL PROGRAM FOR 9- TO 12-YEAR-OLD GIRLS OFFERED AT NO COST. PROGRAM PARTICIPANTS ATTEND SCHOOLS WITH HIGH RATES OF ELIGIBILITY FOR THE FREE AND REDUCED LUNCH PROGRAM. IN FY17, IN THE PVH SERVICE AREA, COS SERVED 20 YOUNG WOMEN IN 581 ENCOUNTERS. THE PROGRAM HELPS WITH SELF-ESTEEM AND MAKING GOOD CHOICES ABOUT THE FUTURE, AND ADDRESSES MENTAL HEALTH ISSUES SUCH AS SELF-HARM, THE RISKS OF SUBSTANCE USE, AND THE VALUE OF BUILDING STRONG AND RESILIENT RELATIONSHIPS. - BARRIERS TO HEALTHY AGING OUR HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE HOUSE CALLS TEAM, WHICH INCLUDES NURSE PRACTITIONERS, NURSES, CASE MANAGERS, AND HOME HEALTH ASSISTANTS, PROVIDED 340 PATIENT ENCOUNTERS DURING FY17, WHICH HELP TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE FOR 9 INDIVIDUALS. - DISPARITIES IN ORAL HEALTH OUR CONTINUUM OF ORAL HEALTH SERVICES INCLUDE A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA THAT SERVES CHILDREN FROM THROUGHOUT THE COUNTY, THE MOBILE DENTAL CLINIC, THE MIGHTY MOUTH SCHOOLBASED DENTAL DISEASE PREVENTION PROGRAM, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. DURING FY17 5,196 INDIVIDUALS RECEIVED 8,576 SERVICE ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PROGRAM SAW 5,388 MOSTLY EDUCATION AND PREVENTION VISITS WITH A TOTAL OF 4,099 PATIENTS. MIGHTY MOUTH ALSO PROVIDED EDUCATION FOR AN ADDITIONAL 3,789 ENCOUNTERS.
SCHEDULE H, PART VI, LINE 6	DESCRIPTION OF COMMUNITY SERVED AFFILIATED HEALTH CARE SYSTEM PVH IS A HEALING MINISTRY OF PROVIDENCE ST. JOSEPH HEALTH, A NEW ORGANIZATION CREATED BY PROVIDENCE HEALTH & SERVICES AND ST. JOSEPH HEALTH WITH THE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. TOGETHER, OUR 111,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 50 HOSPITALS, 829 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE SYSTEM INCLUDES 50 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. 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, CALIFORNIA. SJH COMMUNITY PARTNERSHIP FUND (FORMERLY THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) IN 1986, ST. JOSEPH HEALTH (SJH) CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND (FORMERLY KNOWN AS THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. EVERY YEAR, EACH ST. JOSEPH HEALTH HOSPITAL CONTRIBUTES TEN PERCENT OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND TO SUPPORT OUTREACH EFFORTS FOR THE ECONOMICALLY POOR. IN FY17 THIS AMOUNT TOTALED $20,836 FOR SRM ALLIANCE HOSPITAL. 75% OF THE CONTRIBUTIONS ARE USED TO SUPPORT CARE FOR POOR PROGRAMS BY EACH HOSPITAL. 17.5% OF FUNDS ARE USED TO SUPPORT ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND INITIATIVES. THE REMAINING 7.5% ARE DESIGNATED TOWARD AN ENDOWMENT WHICH HELPS ENSURE THE FUND'S ABILITY TO SUSTAIN PROGRAMS INTO THE FUTURE THAT ASSIST LOW-INCOME AND UNDERSERVED POPULATIONS. COMMUNITY INVESTMENT FUND ST. JOSEPH HEALTH FURTHERMORE RECOGNIZES THAT THE HEALTH OF ANY COMMUNITY DEPENDS ON THE MAINTENANCE AND CREATION OF STRONG STRUCTURES- BOTH PHYSICAL AND SOCIAL- THAT CONTRIBUTE TO THE LONG-TERM WELL-BEING OF PEOPLE. THAT PHILOSOPHY INSPIRED THE INITIATION OF THE ST. JOSEPH HEALTH COMMUNITY INVESTMENT FUND- AN EFFORT TO ENABLE NON PROFIT 501(C)3 ORGANIZATIONS TO ACHIEVE THEIR FULL POTENTIAL AND PLAY A MAJOR ROLE IN THE GROWTH OF THEIR COMMUNITIES. IN FY17, A TOTAL OF $11.5 MILLION WAS INVESTED INTO THE COMMUNITY THROUGH LOANS AND LINES OF CREDIT. FUNDED NON-PROFITS INCLUDE THOSE THAT SERVE THE HOMELESS, PROVIDE AFFORDABLE HOUSING, PROVIDE ACCESS TO PRIMARY MEDICAL CARE, AND ADDRESS YOUTH DEVELOPMENT. TO LEARN MORE ABOUT ST. JOSEPH HEALTH AND PROVIDENCE JOSEPH HEALTH GO TO HTTP://WWW.STJHS.ORG HTTP://WWW.PSJHEALTH.ORG/ABOUT-US
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST JOSEPH HEALTH SYSTEM FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3345 MICHELSON DRIVE SUITE 100	AddressLine1Txt
City	IRVINE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92612	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	330143024	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Non Cash Assistance	$83,300	NonCashAssistanceAmt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	DONATIONS TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION OF PETALUMA VALLEY HOSPITAL. WE DO NOT MONITOR DONATIONS MADE.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RICHARD IGRAM
BOARD MEMBER (PART YEAR)	$0	$304,083	$0	$172,775	$0	$136,417	$0	$22,335	$0	$10,441	$0	$646,051	$0	$0
KEVIN MANEMANN
BOARD MEMBER (PART YEAR)	$0	$447,649	$0	$280,702	$0	$64,632	$0	$18,550	$0	$26,943	$0	$838,476	$0	$0
TODD SALNAS
BOARD MEMBER/PRESIDENT, SJH-SC	$0	$430,790	$0	$342,104	$0	$51,729	$0	$13,250	$0	$35,072	$0	$872,945	$0	$0
OLUYEMI ADEYANJU
SECRETARY	$0	$324,633	$0	$120,656	$0	$30,207	$0	$2,034	$0	$8,956	$0	$486,486	$0	$0
MICHEL RICCIONI
CFO	$0	$387,200	$0	$155,385	$0	$59,930	$0	$18,261	$0	$35,055	$0	$655,831	$0	$0
JAYNIE BOREN
N.CA REG VP-STRATEGIC SVCS	$0	$293,760	$0	$121,508	$0	$28,983	$0	$10,600	$0	$22,704	$0	$477,555	$0	$0
RICHARD CARVOLTH
CHIEF MEDICAL OFFICER	$0	$288,194	$0	$112,451	$0	$28,999	$0	$10,210	$0	$18,809	$0	$458,663	$0	$0
TERRI DENTE
VP-MISSION INTEGRATION	$0	$180,607	$0	$57,759	$0	$22,402	$0	$14,397	$0	$34,745	$0	$309,910	$0	$0
MAUREEN DISBOT
REG VP, QUALITY & SAFETY-N. CA	$0	$289,747	$0	$120,139	$0	$27,390	$0	$7,950	$0	$24,175	$0	$469,401	$0	$0
ROBERT EISEN
REGIONAL VP HR	$0	$235,415	$0	$113,682	$0	$21,310	$0	$7,889	$0	$13,599	$0	$391,895	$0	$0
ROBERT JUST III
N.CA REGION, COO	$0	$295,463	$0	$117,552	$0	$39,086	$0	$18,550	$0	$27,615	$0	$498,266	$0	$0
KEVIN KLOCKENGA
REGIONAL EVP-NCA	$0	$640,039	$0	$548,569	$0	$81,792	$0	$13,250	$0	$18,042	$0	$1,301,692	$0	$0
JOHN OMEL
INTERIM REGIONAL VP HR	$0	$465,398	$0	$0	$0	$0	$0	$0	$0	$0	$0	$465,398	$0	$0
MARK PROVAN
N.CA REG VP- POST ACUTE CARE	$0	$230,353	$0	$81,582	$0	$6,367	$0	$2,230	$0	$34,938	$0	$355,470	$0	$0
JANE READ
VP-OPERATIONS	$227,071	$0	$76,001	$0	$25,568	$0	$11,407	$0	$11,179	$0	$351,226	$0	$0	$0
VICKI WHITE
CHIEF NURSING OFFICER	$0	$189,284	$0	$5,000	$0	$16,041	$0	$0	$0	$11,058	$0	$221,383	$0	$0
DAVID ZIOLKOWSKI
CHIEF OPERATING OFFICER	$0	$233,013	$0	$80,962	$0	$106,182	$0	$6,914	$0	$24,579	$0	$451,650	$0	$0
THELMA COLLINS
HOUSE SUPERVISOR	$182,174	$0	$2,600	$0	$17,170	$0	$10,040	$0	$24,943	$0	$236,927	$0	$0	$0
GAY CORDERO-JOLAVAR
STAFF NURSE IV	$194,056	$0	$0	$0	$6,587	$0	$9,862	$0	$3,232	$0	$213,737	$0	$0	$0
CAROLINE DELLA
STAFF NURSE IV	$197,659	$0	$2,826	$0	$409	$0	$8,436	$0	$35,824	$0	$245,154	$0	$0	$0
HAI GAO
STAFF NURSE IV	$199,752	$0	$0	$0	$258	$0	$10,105	$0	$27,113	$0	$237,228	$0	$0	$0
WENDI THOMAS
DIR. NURSING	$183,148	$0	$43,756	$0	$2,526	$0	$16,021	$0	$26,142	$0	$271,593	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3	THE ORGANIZATION'S PRESIDENT 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 4B	BEGINNING IN JULY 2015, NEW EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND ARE SUBJECT TO A FIVE YEAR OR AGE 65 VESTING SCHEDULE. NO INDIVIDUALS RECEIVED A PAYMENT DURING THE YEAR.
SCHEDULE J, PART I, LINE 7	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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1	ORGANIZATION'S MISSION STATEMENT SRM ALLIANCE HOSPITAL IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE.
FORM 990, PART III, LINE 4A	ST. JOSEPH HEALTH SYSTEM THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORSMINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. PROVIDENCE ST. JOSEPH HEALTH ON JULY 1, 2016, PROVIDENCE HEALTH SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT, THE PURPOSE OF WHICH WAS TO BETTER SERVE BOTH ORGANIZATIONS COMMUNITIES, MAINTAIN STRONG TRADITIONS OF CATHOLIC HEALTHCARE, AND PROVIDE GREATER AFFORDABILITY AND ACCESS TO HEALTHCARE SERVICES. AS PART OF THE BUSINESS COMBINATION, PHS AND SJHS ALIGNED UNDER A SINGLE PARENT CORPORATION, PROVIDENCE ST. JOSEPH HEALTH, WITH A CONSOLIDATED BOARD OF DIRECTORS AND COSPONSORSHIP FROM THE PUBLIC JURIDIC PERSONS PROVIDENCE MINISTRIES AND ST. JOSEPH HEALTH MINISTRY. REALIZING OUR MISSION PETALUMA VALLEY HOSPITAL (PVH) HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 20 YEARS. SERVING THE COMMUNITIES OF SONOMA COUNTY, PVH IS AN 80-BED ACUTE CARE HOSPITAL THAT PROVIDES QUALITY CARE IN THE AREAS OF CARDIAC CARE, DIAGNOSTIC IMAGING, AND A WIDE RANGE OF SPECIALTY SERVICES, EMERGENCY MEDICINE AND OBSTETRICS. WITH OVER 600 EMPLOYEES COMMITTED TO REALIZING THE MISSION, PETALUMA VALLEY HOSPITAL IS ONE OF THE LARGEST EMPLOYERS IN THE SONOMA COUNTY REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, PETALUMA VALLEY HOSPITAL IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. PATIENT FINANCIAL ASSISTANCE PROGRAM PETALUMA VALLEY HOSPITAL BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY PETALUMA VALLEY HOSPITAL HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY17, PVH PROVIDED $979,088 IN FREE AND DISCOUNTED CARE. MEDICAID PROGRAM PETALUMA VALLEY HOSPITAL PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM. IN FY17, PVH PROVIDED $11,355,346 IN MEDICAID SHORTFALL. PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY BENEFIT INVESTMENT IS DEMONSTRATED THROUGH THE FOLLOWING KEY PROGRAMS: - PETALUMA VALLEY HOSPITAL'S CONTINUUM OF ORAL HEALTH SERVICES INCLUDE A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA THAT SERVES CHILDREN FORM THROUGHOUT THE COUNTY, THE MOBILE DENTAL CLINIC, THE MIGHTY MOUTH SCHOOL-BASED DENTAL DISEASE PREVENTION PROGRAM, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO VERY YOUNG CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. DURING FY17, 5,196 PATIENTS WERE SERVED OVER 8,576 ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PREVENTION PROGRAM SERVED 4,099 PATIENTS AND COMPLETED 9,177 ENCOUNTERS COUNTYWIDE. OF THE MOMMY AND ME PARTICIPANTS THROUGHOUT THE COUNTY, THERE WAS A 1% DECAY RATE AMONG ONE-YEAR OLDS, COMPARED TO 10% DECAY RATE AMONG PATIENTS IN THE CLINIC WHO DID NOT PARTICIPATE IN THE PROGRAM. WE SAW A 14% DECAY RATE AMONG RETURNING 2-5 YEAR-OLDS IN MOMMY AND ME PROGRAM, COMPARED TO NON-PARTICIPATING CHILDREN IN THE SAME AGE GROUP WITH 30% DECAY RATE. - PETALUMA VALLEY HOSPITAL'S MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN FY17, IN OUR SERVICE AREA, THE CLINIC SERVED 1,563 PATIENTS OVER 3,256 ENCOUNTERS AT SEVERAL LOCATIONS, INCLUDING THE CITIES OF SONOMA/BOYES HOT SPRINGS, SANTA ROSA, AND WINDSOR. - PETALUMA VALLEY HOSPITAL'S HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE PROGRAM TEAM, WHICH INCLUDES NURSE PRACTITIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED SERVICE TO 152 PATIENTS AND COMPLETED OVER 7,347 ENCOUNTERS COUNTYWIDE, HELPING TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE. FOR MORE INFORMATION ABOUT PETALUMA VALLEY HOSPITAL, PLEASE VISIT WWW.STJOESONOMA.ORG. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH SYSTEM AND PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT WWW.SJHS.ORG AND WWW.PSJHEALTH.ORG. FORM 990, PART IV, LINE 11F AND 12B & PART XII, LINE 2B SRM ALLIANCE HOSPITAL WAS INCLUDED IN CONSOLIDATED, INDEPENDENT AUDITED FINANCIAL STATEMENTS FOR PROVIDENCE ST. JOSEPH HEALTH FOR THE PERIOD ENDED DECEMBER 31, 2017. AS SUCH, AUDITED FINANCIAL STATEMENTS WERE NOT PREPARED FOR THE TAX YEAR ENDED JUNE 30, 2017. THE REPORTING ORGANIZATION WILL CHANGE ITS TAX YEAR END TO DECEMBER 31 FOR 2017.
FORM 990, PART V, LINE 1A	ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJH ENTITIES UNDER SJH AP SHARED SERVICES. THEREFORE, SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID. SJHS COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS.
FORM 990, PART VI, LINE 6	DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS SANTA ROSA MEMORIAL HOSPITAL IS THE SOLE CORPORATE MEMBER OF SRM ALLIANCE HOSPITAL SERVICES.
FORM 990, PART VI, LINE 7A	DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS SRM ALLIANCE HOSPITAL SERVICES HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE SRM ALLIANCE HOSPITAL SERVICES BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE SRM ALLIANCE HOSPITAL SERVICES BOARD AS NOMINATIONS MUST BE APPROVED BY SANTA ROSA MEMORIAL HOSPITAL.
FORM 990, PART VI, LINE 7B	DESCR OF CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY SANTA ROSA MEMORIAL HOSPITAL, ITS SOLE CORPORATE MEMBER, FOR THE FOLLOWING: A. ESTABLISHING THE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE ORGANIZATION; B. LONG-TERM AND SHORT-TERM FINANCING; C. SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; D. ANNUAL BUDGETS; E. CAPITAL EXPENDITURES; F. ORGANIZATION'S STRATEGIC PLANS; G. MERGER OR DISSOLUTION; H. APPOINTMENT OR REMOVAL OF FISCAL AUDITORS; I. APPOINTMENT OR REMOVAL OF TRUSTEES, OFFICERS OF THE BOARD AND CHIEF EXECUTIVE OFFICER; J. AMENDMENT OR RESCISSION OF THE BYLAWS; K. EXERCISE THE POWERS WHICH ARE RESERVED TO THE ORGANIZATION IN ITS CAPACITY AS A CORPORATE MEMBER OF ANY SUBSIDIARY; AND L. EXERCISE SUCH OTHER POWERS AS MAY BE REQUIRED OR PERMITTED BY LAW AND BY THE ARTICLES OF INCORPORATION AND THE BYLAWS.
FORM 990, PART VI, LINE 11B	DESCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AND WAS REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD AT THE APRIL 2018 MEETING. MANAGEMENT PRESENTED A SUMMARY AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990 AT THE MEETING. THE FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING.
FORM 990, PART VI, LINE 12C	MONITORING & ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE.
FORM 990, PART VI, LINES 15A & 15B	PROCESS FOR DETERMINING COMPENSATION It is St. Joseph Health System's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how St. Joseph Health System 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. St. Joseph Health System has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the St. Joseph Health System Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of St. Joseph Health System's legal entities. St. Joseph Health System also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. St. Joseph Health System 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 and approved by the full Board of Directors, none of whom is a St. Joseph Health System employee. 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. St. Joseph Health System 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 St. Joseph Health System. Additionally, St. Joseph Health Systems labor market continues to spread across health care and into general industry. Because of this, St. Joseph Health System also takes into consideration general industry for-profit market data, where applicable. Base salaries for St. Joseph Health System 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 St. Joseph Health System operating commitments and strategic objectives. The Board of Directors conducts a thorough 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. THIS PROCESS WAS LAST COMPLETED IN SEPTEMBER 2016.
FORM 990, PART VI, LINE 19	PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AND WAS REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD AT THE APRIL 2018 MEETING. MANAGEMENT PRESENTED A SUMMARY AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990 AT THE MEETING.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS EQUITY TRANSFERS (1,979,850) CFTP TRANSFER (62,508) SJH CORRECTION (786) ----------- TOTAL (2,043,144)
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN FEES TOTAL FEES:4994952
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT SERVICES TOTAL FEES:4781752
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:5219858

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (110 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COVENANT HEALTH NETWORK INC
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	461259908	HEALTHCARE	CA	501(C)(3)	12,III	SJHS	Yes (true)
COVENANT ACO
3615 19TH STREET	LUBBOCK	TX	79410	611573313	HEALTHCARE	TX	501(C)(3)	12,I	CHS	Yes (true)
COVENANT HEALTH SYSTEM
3615 19TH STREET	LUBBOCK	TX	79410	752765566	HEALTHCARE	TX	501(C)(3)	3	SJHS	Yes (true)
COVENANT HEALTH SYSTEM FOUNDATION
3623 22ND PLACE	LUBBOCK	TX	79410	752897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
COVENANT MEDICAL GROUP
3420 22ND PLACE	LUBBOCK	TX	79410	752743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
COVENANT HEALTH PARTNERS
3615 19TH STREET	LUBBOCK	TX	79410	463516417	HEALTHCARE	TX	501(C)(3)	12,I	CHS	Yes (true)
HMTS INC
1 HOAG DRIVE	NEWPORT BEACH	CA	92658	453583707	HEALTHCARE	CA	501(C)(3)	12,I	HMHP	Yes (true)
HOAG CHARITY SPORTS
330 PLACENTIA AVE	NEWPORT BEACH	CA	92663	452982422	SUPPORT	CA	501(C)(3)	7	HHF	Yes (true)
HOAG HOSPITAL FOUNDATION
330 PLACENTIA AVE	NEWPORT BEACH	CA	92663	953222343	FUNDRAISING	CA	501(C)(3)	7	HMHP	Yes (true)
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
1 HOAG ROAD BOX 6100	NEWPORT BEACH	CA	92663	951643327	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
HOSPICE OF LUBBOCK
3702 21ST STREET	LUBBOCK	TX	79410	752133781	HEALTHCARE	TX	501(C)(3)	10	CHS	Yes (true)
LUBBOCK METHODIST HOSPITAL FOUNDATION
3615 19TH STREET	LUBBOCK	TX	79410	752220963	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
METHODIST CHILDREN'S HOSPITAL
3610 21ST STREET	LUBBOCK	TX	79410	752428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
METHODIST HOSPITAL LEVELLAND
1900 COLLEGE AVENUE	LEVELLAND	TX	79336	752246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
METHODIST HOSPITAL PLAINVIEW
2601 DIMMITT ROAD	PLAINVIEW	TX	79072	752426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
MISSION HOSPITAL REGIONAL MEDICAL CTR
27700 MEDICAL CENTER ROAD	MISSION VIEJO	CA	92691	951643360	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
QUEEN OF THE VALLEY MEDICAL CENTER
1000 TRANCAS STREET	NAPA	CA	94558	941243669	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
REDWOOD MEMORIAL FOUNDATION
3300 RENNER DRIVE	FORTUNA	CA	95540	942779313	HEALTHCARE	CA	501(C)(3)	7	RMH	Yes (true)
REDWOOD MEMORIAL HOSPITAL
3300 RENNER DRIVE	FORTUNA	CA	95540	941384665	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SANTA ROSA MEMORIAL HOSPITAL
1165 MONTGOMERY DRIVE	SANTA ROSA	CA	95405	941231005	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JOSEPH HEALTH SYSTEM
3345 MICHELSON DRIVE	IRVINE	CA	92612	953589356	HEALTHCARE	CA	501(C)(3)	12,I	PSJH	false
ST JOSEPH HEALTH SYSTEM FOUNDATION
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	330143024	HEALTHCARE	CA	501(C)(3)	7	SJHS	Yes (true)
ST JOSEPH HOME CARE NETWORK
1111 SONOMA STE 308	SANTA ROSA	CA	95405	680331084	HEALTHCARE	CA	501(C)(3)	10	SJHS	Yes (true)
ST JOSEPH HOSPITAL OF EUREKA
2700 DOLBEER STREET	EUREKA	CA	95501	941156596	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JOSEPH HOSPITAL OF ORANGE
1100 WEST STEWART DRIVE	ORANGE	CA	92868	951643359	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST JOSEPH HERITAGE HEALTHCARE
200 WEST CENTER ST PROMENADE	ANAHEIM	CA	92805	330185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JUDE HOSPITAL INC
101 EAST VALENCIA MESA DRIVE	FULLERTON	CA	92635	951643324	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST MARY MEDICAL CENTER
18300 HIGHWAY 18	APPLE VALLEY	CA	92307	951914489	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST MARY OF THE PLAINS HOSPITAL FDN
4000 24TH STREET	LUBBOCK	TX	79410	751653181	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
ST JOSEPH HEALTH NOR CAL LLC
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	814791043	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIA	ORANGE	CA	92868	951643383	RELIGIOUS ORG	CA	501(C)(3)	1	NA	false
ST JOSEPH HEALTH MINISTRY
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	271666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO	false
E WA & MT UNEMPLOYMENT COMP INSR TRUST
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	911082119	UNEMPLOYMENT	WA	501(C)(3)	12,I	PHS WA	Yes (true)
EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128 EVERETT	EVERETT	WA	982065128	943264605	TRANS. CARE	WA	501(C)(3)	10	NA	false
FACEY MEDICAL FOUNDATION
15451 SAN FERNANDO MISSION BLVD 2	MISSION HILLS	CA	91345	954322584	SUPPORT	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
GAMELIN WASHINGTON ASSOCIATION
1423 FIRST AVENUE	SEATTLE	WA	98101	201910170	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104	SEATAC	WA	98188	273133200	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes (true)
INLAND NORTHWEST HEALTH SERVICES
601 W 1ST AVENUE	SPOKANE	WA	99201	911307555	HEALTHCARE	WA	501(C)(3)	3	PHS WA	Yes (true)
INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVENUE SW 9016	RENTON	WA	98057	814260130	HEALTHCARE	WA	501(C)(3)	7	PHS SJHS	Yes (true)
INSTITUTE FOR SYSTEMS BIOLOGY
401 TERRY AVE N	SEATTLE	WA	98109	912003593	HEALTHCARE	WA	501(C)(3)	7	WHC	Yes (true)
JOHN WAYNE CANCER INSTITUTE
2200 SANTA MONICA BLVD	SANTA MONICA	CA	90404	954291515	HEALTHCARE	CA	501(C)(3)	4	PSJHC	Yes (true)
KADLEC AUXILIARY INC
888 SWIFT BLVD	RICHLAND	WA	99352	916033089	SUPPORT	WA	501(C)(3)	12,III	KRMC	Yes (true)
KADLEC FOUNDATION
888 SWIFT BLVD	RICHLAND	WA	99352	237005501	SUPPORT	WA	501(C)(3)	12,I	KRMC	Yes (true)
KADLEC NEUROLOGICAL RESOURCE CENTER
1268 LEE BLVD	RICHLAND	WA	99352	911266345	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes (true)
KADLEC REGIONAL MEDICAL CENTER
888 SWIFT BLVD	RICHLAND	WA	99352	910655392	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
LITTLE COMPANY OF MARY ANCILLARY SVCS CO
4101 TORRANCE BLVD	TORRANCE	CA	90503	330844408	IMAGING SERVI	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
LUNDBERG ASSOCIATIONPROVIDENCE HOUSE
5921 E BURNSIDE	PORTLAND	OR	97215	911562797	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes (true)
MARSHA RIVKIN CENTER FOR OVARIAN CANCER
747 BROADWAY	SEATTLE	WA	98122	912054035	RESEARCH	WA	501(C)(3)	7	SHS	Yes (true)
PACMED CLINICS
1200 12TH AVENUE S	SEATTLE	WA	98144	562290878	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes (true)
PH&S FOUNDATIONSFVSA & SCVSA
501 S BUENA VISTA STREET	BURBANK	CA	91505	953544877	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
PROVIDENCE ALASKA FOUNDATION
3300 PROVIDENCE DR TOWER 2	ANCHORAGE	AK	99508	920093565	HEALTHCARE	AK	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE BENEDICTINE NURSING CTR FNDN
540 SOUTH MAIN STREET	MT ANGEL	OR	973629532	911940286	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE BLANCHET ASSOCIATION
1700 PROVIDENCE PL	CENTRALIA	WA	98531	911789266	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE CHILD CENTER FOUNDATION
830 NE 47TH	PORTLAND	OR	97213	930800140	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE COMMUNITY HEALTH FOUNDATION
1111 CRATER LAKE AVE	MEDFORD	OR	97504	930692907	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE DETHMAN HOUSE
1205 MONTELLO AVE	HOOD RIVER	OR	97031	473385506	SUPPORT	WA	501(C)(3)	7	NA	false
PROVIDENCE FOUNDATION
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	943078543	HEALTHCARE	WA	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE GAMELIN HOUSE ASSOCIATION
4515 MLK JR WAY S STE 200	SEATTLE	WA	98108	311744654	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH & SERVICES
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	911549796	HEALTHCARE	WA	501(C)(3)	12,II	PSJH	false
PROVIDENCE HEALTH & SERVICES - MONTANA
500 W BROADWAY PO BOX 4587	MISSOULA	MT	598064587	810231793	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes (true)
PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	510216587	HEALTHCARE	OR	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HEALTH & SERVICES - WA
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	510216586	HEALTHCARE	WA	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HEALTH & SERVICES - WEST WA
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	911303277	HEALTHCARE	WA	501(C)(3)	3	PMWHC	Yes (true)
PROVIDENCE HEALTH ASSURANCE
4400 NE HALSEY BLDG 2	PORTLAND	OR	97213	550828701	MEDICAID	OR	501(C)(4)	N/A	PHP	Yes (true)
PROVIDENCE HEALTH CARE FNDN - E WA
101 W 8TH AVENUE	SPOKANE	WA	99204	320014330	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH CARE FNDN (CENTRALIA)
914 S SCHEUBER ROAD	CENTRALIA	WA	98531	911433382	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH PLAN
4400 NE HALSEY BLDG 2	PORTLAND	OR	97213	930863097	HEALTHCARE	OR	501(C)(4)	N/A	PPP	Yes (true)
PROVIDENCE HEALTH SYSTEM - SO CAL
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	510216589	HEALTHCARE	CA	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HOOD RIVER MEM HOSP FDN
811 13TH ST	HOOD RIVER	OR	97031	930921990	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE HOSPICE AND HOME CARE FNDN
2731 WETMORE AVENUE STE 500	EVERETT	WA	98201	272552749	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
425 PONTIUS AVENUE NORTH 300	SEATTLE	WA	980195452	912077378	HEALTHCARE	WA	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE LITTLE COMPANY OF MARY FNDN
4101 TORRANCE BLVD	TORRANCE	CA	90503	510224944	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
PROVIDENCE MARIANWOOD FOUNDATION
3725 PROVIDENCE POINT DRIVE SE	ISSAQUAH	WA	980297219	931554288	HEALTHCARE	WA	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE MEDICAL INSTITUTE
4101 TORRANCE BLVD	TORRANCE	CA	90503	330283773	HEALTHCARE	CA	501(C)(3)	12,I	PHS SOCAL	Yes (true)
PROVIDENCE MILWAUKIE FOUNDATION
10150 SE 32ND	MILWAUKIE	OR	97222	943079515	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE MOUNT ST VINCENT FOUNDATION
4831 35TH AVENUE SW	SEATTLE	WA	981262799	911188119	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE NEWBERG HEALTH FOUNDATION
1001 PROVIDENCE DRIVE	NEWBERG	OR	97132	930889144	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE PETER CLAVER ASSOCIATION
7101 38TH AVENUE SOUTH	SEATTLE	WA	98118	311629656	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE PLAN PARTNERS
4400 NE HALSEY BLDG 2	PORTLAND	OR	97213	911861964	HEALTHCARE	WA	501(C)(4)	N/A	PHS OR	Yes (true)
PROVIDENCE PORTLAND MEDICAL FOUNDATION
4805 NE GLISAN STREET	PORTLAND	OR	972132967	931231494	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE ROSSI ASSOCIATION
1700 PROVIDENCE PLACE	CENTRALIA	WA	98531	311584166	SUPPORT	WA	501(C)(3)	10	PHS WA	Yes (true)
PROVIDENCE SAINT JOHN'S HEALTH CENTER
2121 SANTA MONICA BLVD	SANTA MONICA	CA	90404	951684082	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes (true)
PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATI
20555 EARL ST	TORRANCE	CA	90503	814542216	HEALTHCARE	CA	501(C)(3)	Pending	PHS SOCAL	Yes (true)
PROVIDENCE SEASIDE HOSPITAL FOUNDATION
725 S WAHANNA RD	SEASIDE	OR	97138	930927320	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE ST ELIZABETH HOUSE ASSOC
3201 SW GRAHAM ST	SEATTLE	WA	98126	912171539	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST FRANCIS ASSOCIATION
3415 12TH AVENUE NE	OLYMPIA	WA	98506	943244854	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVENUE SW 9016	RENTON	WA	98057	811244422	HEALTHCARE	WA	501(C)(3)	12,III	NA	false
PROVIDENCE ST JOSEPH MEDICAL CENTER
PO BOX 1010	POLSON	MT	598601010	810463482	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes (true)
PROVIDENCE ST MARY FOUNDATION
401 W POPLAR STREET	WALLA WALLA	WA	99362	452841492	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST PETER FOUNDATION
413 LILLY ROAD NE	OLYMPIA	WA	985065166	911097056	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST VINCENT MEDICAL FNDN
9205 SW BARNES ROAD	PORTLAND	OR	97225	930575982	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE TRINITYCARE HOSPICE
5315 TORRANCE BLVD STE B1	TORRANCE	CA	90503	953264139	HEALTHCARE	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
PROVIDENCE TRINITYCARE HOSPICE FNDN
5315 TORRANCE BLVD STE B1	TORRANCE	CA	90503	330261016	HEALTHCARE	CA	501(C)(3)	7	PTCH	Yes (true)
PROVIDENCE WILLAMETTE FALLS MEDICAL FNDN
1500 DIVISION STREET	OREGON CITY	OR	97045	931003750	HEALTHCARE	OR	501(C)(3)	12, I	PHS OR	Yes (true)
SAINT JOHN'S HOSPITALHEALTH CENTER FNDN
2121 SANTA MONICA BLVD	SANTA MONICA	CA	90404	956100079	SUPPORT	CA	501(C)(3)	7	PSJHC	Yes (true)
SEATTLE SCIENCE FOUNDATION
550 17TH AVENUE	SEATTLE	WA	98122	611502822	PHYSN COLLAB	WA	501(C)(3)	7	WHC	Yes (true)
SISTERS OF PROVIDENCE OF MONTANA CORP
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	262612415	SHELL CORP	MT	501(C)(3)	1	PHS WA
ST LUKE ASSOCIATION
350 WASHINGTON AVE SE	CHEHALIS	WA	98352	943176618	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
ST PATRICK HOSPITAL FOUNDATION
500 WEST BROADWAY PO BOX 4587	MISSOULA	MT	598064587	237056976	HEALTHCARE	MT	501(C)(3)	7	PHS WA	Yes (true)
ST THOMAS CHILD AND FAMILY CENTER
1710 BENEFIS COURT	GREAT FALLS	MT	59405	810233495	EDUCATION	MT	501(C)(3)	10	PHS WA	Yes (true)
SWEDISH EDMONDS
21601 76TH AVENUE	EDMONDS	WA	98026	272305304	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
SWEDISH HEALTH SERVICES
747 BROADWAY	SEATTLE	WA	98122	910433740	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
SWEDISH MEDICAL CENTER FOUNDATION
747 BROADWAY	SEATTLE	WA	98122	910983214	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes (true)
SWEDISH MJM HOLDINGS
747 BROADWAY	SEATTLE	WA	98122	273139262	HOLDING CO	WA	501(C)(3)	12,I	SHS	Yes (true)
THE GAMELIN ASSOCIATION
312 NORTH FOURTH STREET	YAKIMA	WA	98901	911180824	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
THE GAMELIN CALIFORNIA ASSOCIATION
540 23RD STREET	OAKLAND	CA	94612	911293869	SUPPORT	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
THE GAMELIN OREGON ASSOCIATION
5520 NE GLISAN	PORTLAND	OR	97213	911214491	SUPPORT	OR	501(C)(3)	10	PHS OR	Yes (true)
UNIVERSITY OF GREAT FALLS
1301 20TH STREET SOUTH	GREAT FALLS	MT	59405	810231777	EDUCATION	MT	501(C)(3)	2	PHS	Yes (true)
WESTERN HEALTHCONNECT
747 BROADWAY	SEATTLE	WA	98122	454171900	SHELL CORP	WA	501(C)(3)	12,II	PHS W WA	Yes (true)
PROVIDENCE MINISTRIES
1801 LIND AVENUE SW 9016	RENTON	WA	980579016		RELIGIOUS ORG	WA	501(C)(3)	1	NA	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (58 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
ADVANCED SURGERY INSTITUTE LLC
1739 4TH STREET	SANTA ROSA	CA	95404	262299255	HEALTHCARE	CA	NA	N/A
COVENANT LONG-TERM CARE LP
4000 24TH STREET	LUBBOCK	TX	79410	205033419	HEALTHCARE	TX	NA	N/A
HERITAGE INVESTMENT GROUP I LLC
500 S MAIN STREET STE 1000	ORANGE	CA	92868	271000061	INVESTMENTS	CA	NA	N/A
HOAG ORTHOPEDIC INSTITUTE
1 HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92658	611588294	HEALTHCARE	CA	NA	N/A
METHODIST DIAGNOSTIC IMAGING
4005 24TH STREET	LUBBOVK	TX	79410	752343261	HEALTHCARE	TX	NA	N/A
NEWPORT IMAGING CENTER
360 SN MIGUEL	NEWPORT BEACH	CA	92660	330191776	HEALTHCARE	CA	NA	N/A
SHA LLC
12940 NORTH HIGHWAY 183	AUSTIN	TX	78750	752569094	HEALTHCARE	TX	NA	N/A
ST JOSEPH PHYSICIAN VENTURES I LLC
1100 WEST STEWART DRIVE	ORANGE	CA	92868	454521884	REAL ESTATE	CA	NA	N/A
NORTH BAY ENDOSCOPY CENTER
1383 N MCDOWELL BLVD SUITE 110	PETALUMA	CA	94954	611559876	HEALTHCARE	CA	NA	N/A
SOUTHERN CALIFORNIA SURGERY CENTER LLC
18321 VENTURA BLVD STE 740	TARZANA	CA	91356	330939000	HEALTHCARE	CA	NA	N/A
COASTAL ASC HOLDINGS LLC
ONE HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92664	810986844	HEALTHCARE	CA	NA	N/A
ST JOSEPHSATELLITE DIALYSIS CENTERS
300 SANTANA ROW SUITE 300	SAN JOSE	CA	95128	814657391	HEALTHCARE	CA	NA	N/A
ALPHA MEDICAL LABORATORY LLC
611 N PERRY	SPOKANE	WA	99202	912017347	OUTPATIENT LAB	ID	NA	N/A
BROADWAY IMAGING LLC
500 W BROADWAY	MISSOULA	MT	59802	522405971	MEDICAL IMAGING	MT	NA	N/A
CALIFORNIA LABORATORY ASSOCIATES LLC
501 BUENA VISTA	BURBANK	CA	91505	273888692	OUTPATIENT LAB	CA	NA	N/A
CENTER FOR SPECIALTY SURGERY LLC
11782 SW BARNES RD	PORTLAND	OR	97225	263638838	AMBULATORY SURG	OR	NA	N/A
CLACKAMAS RADIATION ONCOLOGY CENTER LLC
4400 NE HALSEY ST BLDG II 495	PORTLAND	OR	97213	260381897	RADIATION ONCOL	OR	NA	N/A
CTR FOR MED IMAGING-BRIDGEPORT LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	260796953	IMAGING DIAG.	OR	NA	N/A
CTR FOR MED IMAGING-TANASBOURNE LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	200477972	IMAGING DIAG.	OR	NA	N/A
GREATER VALLEY MEDICAL BUILDING LP
501 S BUENA VISTA ST	BURBANK	CA	91505	954570858	REAL ESTATE - MOB	CA	NA	N/A
MINOR & JAMES MEDICAL PLLC
515 MINOR AVENUE 200	SEATTLE	WA	98104	911340223	PHYSICIAN CLINIC	WA	NA	N/A
MOUNTAINSTAR CLINICAL LABORATORIES LLC
611 N PERRY	SPOKANE	WA	99202	261345983	OUTPATIENT LAB	MT	NA	N/A
OREGON ADVANCED IMAGING LLC
881 OHARE PARKWAY	MEDFORD	OR	97504	450471748	MEDICAL IMAGING	OR	NA	N/A
OREGON OUTPATIENT SURGERY CENTER
7300 SW CHILDS RD	TIGARD	OR	97224	223883387	AMBULATORY SURG	OR	NA	N/A
PACLAB LLC
611 N PERRY SPOKANE	SPOKANE	WA	99202	911743952	OUTPATIENT LAB	WA	NA	N/A
PATHOLOGY ASSOCIATES MEDICAL LABORATORIE
611 N PERRY SPOKANE	SPOKANE	WA	99202	270943279	OUTPATIENT LAB	WA	NA	N/A
PETCT IMAGING AT SWEDISH CANCER INSTITU
1221 MADISON STREET	SEATTLE	WA	98104	203132044	MEDICAL IMAGING	WA	NA	N/A
PORTLAND MEDICAL IMAGING LLC
4400 NE HALSEY	PORTLAND	OR	97213	201054971	IMAGING DIAGNOSTI	OR	NA	N/A
PROV RADIATION ONCOLOGY DEVELOP ASSN
4400 NE HALSEY	PORTLAND	OR	97213	260682491	REAL ESTATE - MOB	OR	NA	N/A
PROVIDENCE IMAGING CENTER
3340 PROVIDENCE DRIVE	ANCHORAGE	AK	99508	920118807	MEDICAL IMAGING	AK	NA	N/A
PROVIDENCE PARTNERS FOR HEALTH LLC
501 S BUENA VISTA ST	BURBANK	CA	91505	454041798	CLIN QUALITY/INT	CA	NA	N/A
PROVIDENCE SURGERY CENTER LLC
902 N ORANGE ST	MISSOULA	MT	59802	841401625	AMBULATORY SURG	MT	NA	N/A
PROVIDENCESILVERTON REHAB LLC
4400 NE HALSEY 425	PORTLAND	OR	97213	481287267	REHAB SERVICES	OR	NA	N/A
PROVIDENCEUSP SANTA CLARITA GP LLC
11550 INDIAN HILLS ROAD	MISSION HILLS	CA	91345	202829660	AMBULATORY SURG	CA	NA	N/A
PROVIDENCEUSP SURGERY CTRS LLC
11550 INDIAN HILLS ROAD	MISSION HILLS	CA	91345	200905938	AMBULATORY SURG	CA	NA	N/A
SOUTHERN IDAHO REGIONAL LABORATORY LLC
611 N PERRY SPOKANE	SPOKANE	WA	99202	820511819	OUTPATIENT LAB	ID	NA	N/A
THE MADISON SPOKANE INN LLC
15 WEST ROCKWOOD BLVD	SPOKANE	WA	99204	841606484	HOTEL SERVICES	WA	NA	N/A
TRI-CITIES LABORATORY LLC
611 N PERRY	SPOKANE	WA	99202	911773986	OUTPATIENT LAB	WA	NA	N/A
HCSA PROPERTIES LLC
1600 M STREET NW	AUBURN	WA	98001	460620892	REAL ESTATE RENT	WA	NA	N/A
PHS INVESTMENT TRUST HEDGE FUND PORTFOLI
1801 Lind Avenue SW No 9016	Renton	WA	98057	472293255	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST BANK LOANS PORTFOLI
1801 Lind Avenue SW No 9016	Renton	WA	98057	472357735	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRANSITION PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472279711	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST RISK PARITY PORTFOL
1801 Lind Avenue SW No 9016	Renton	WA	98057	472336377	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST LONG TREASURIES POR
1801 Lind Avenue SW No 9016	Renton	WA	98057	472385238	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST MLP PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472367538	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST RELATIVE VALUE PORT
1801 Lind Avenue SW No 9016	Renton	WA	98057	472314743	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST TIPS PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472402609	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST PUBLIC EQUITY PORTF
1801 Lind Avenue SW No 9016	Renton	WA	98057	472283974	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST LDI PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472392060	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST PUBLIC DEBT PORTFOL
1801 Lind Avenue SW No 9016	Renton	WA	98057	472353569	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST TACTICAL TRADING PO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472327491	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST COMMODITIES PORTFOL
1801 Lind Avenue SW No 9016	Renton	WA	98057	472269004	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2015 PRIVATE ASSETS
1801 Lind Avenue SW No 9016	Renton	WA	98057	473393740	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST SHORT TERM INVESTME
1801 Lind Avenue SW No 9016	Renton	WA	98057	812701056	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2016 PRIVATE ASSETS
1801 Lind Avenue SW No 9016	Renton	WA	98057	811532735	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2016 PRIVATE REAL E
1801 Lind Avenue SW No 9016	Renton	WA	98057	812960145	INVESTMENTS	WA	NA	N/A
LSC REAL PROPERTY LLC
2301 QUAKER AVENUE	LUBBOCK	TX	79410	474646059	REAL ESTATE	TX	NA	N/A
CALIFORNIA SPECIALTY SURGERY CENTER LP
26371 CROWN VALLEY PARKWAY	MISSION VIEJO	CA	92691	330939003	HEALTHCARE	CA	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd
AMERICAN UNITY GROUP LTD
90 PITTS BAY ROAD	PEMBROKE	BD	HM08	CAPTIVE INSURANCE	BD	NA	C-CORP
COASTAL MANAGEMENT SERVICES ORGANIZATION
				HEALTHCARE		NA	C-CORP	1 HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92658	330676831	CA
DATU HEALTH INC AND SUBSIDIARIES
				IT SVCS		NA	C-CORP	16150 MAIN CIRCLE DR SUITE 250	CHESTERFIELD	MO	63017	463070062	DE
HOAG MANAGEMENT SERVICES INC
				HEALTHCARE		NA	C-CORP	1 HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92658	330731587	CA
LUBBOCK METHODIST HOSP PRACTICE MGMT
				INACTIVE		NA	C-CORP	2107 OXFORD STREET STE 300	LUBBOCK	TX	79410	752578995	TX
LUBBOCK METHODIST HOSPITAL SVCS
				HEALTHCARE		NA	C-CORP	PO BOX 1201	LUBBOCK	TX	79410	752118585	TX
MISSION VIEJO MEDICAL VENTURES
				HEALTHCARE		NA	C-CORP	27800 MEDICAL CENTER RD	MISSION VIEJO	CA	92691	330212905	CA
ST JOSEPH HEALTH
				HOLDING COMPANY		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	462340232	CA
ST JOSEPH HEALTH SOURCE INC
				HEALTHCARE		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	461900168	CA
ST JOSEPH PROF SVCS ENTERPRSES INC
				HEALTHCARE		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	330155323	CA
OPHIE HEALTHCARE SERVICES INC
				HEALTHCARE		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	271002825	CA
PROVIDENCE HEALTH VENTURES INC
				INVESTMENT		NA	C-CORP	4101 TORRANCE BLVD	TORRANCE	CA	90503	330122216	CA
CARON HEALTH CORPORATION
				MED PHYS SVCS		NA	C-CORP	510 W FRONT ST	MISSOULA	MT	59802	810486082	MT
PROVIDENCE HEALTH CARE VENTURES INC
				CLIN/MED LAB		NA	C-CORP	101 W 8TH AVE TAF C-9	SPOKANE	WA	99204	900155714	WA
PROVIDENCE PHYSICIAN SERVICES CO
				CLIN/MED LAB		NA	C-CORP	101 W 8TH AVE TAF C-9	SPOKANE	WA	99204	911216033	WA
YAKIMA MEDICAL ARTS INC
				RENT REAL ESTATE		NA	C-CORP	611 N PERRY 100	SPOKANE	WA	99202	910787963	WA
BOURGET HEALTH SERVICES INC
				CLIN/MED LAB		NA	C-CORP	PO BOX 2687	SPOKANE	WA	99220	911354431	WA
1221 MADISON STREET OWNERS ASSOC
				OWNERS' ASSOC.		NA	C-CORP	747 BROADWAY	SEATTLE	WA	98122	201954319	WA
WESTERN HEALTHCONNECT VENTURES INC
				INVESTMENTS		NA	C-CORP	1801 LIND AVE SW 9016	RENTON	WA	98057	800953654	WA
PHN HOLDINGS
				STRAT PLAN SVCS		NA	C-CORP	20555 EARL STREET	TORRANCE	CA	90503	461814184	CA
PROVIDENCE HEALTH NETWORK
				PREPAID HEALTH		NA	C-CORP	20555 EARL STREET	TORRANCE	CA	90503	800886966	CA
PIONEER INNOVATIONS INC
				HEALTH INNOVATNS		NA	C-CORP	800 5TH AVE 10TH FLOOR	SEATTLE	WA	98104	364818191	WA
VINSERRA INC
				INVESTMENTS		NA	C-CORP	1328 22ND STREET	SANTA MONICA	CA	90403	953943315	CA

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ST JOSEPH HEALTH SYSTEM FOUNDATION
b	$83,300	ACCRUAL
SANTA ROSA MEMORIAL HOSPITAL
p	$7,150,000	CASH

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE R, PART III	FormAndLineReferenceDesc
Explanation	IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP ADVANCED SURGERY INSTITUTE, LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD, STE 110, PETALUMA, CA 94954 SOUTHERN CALIFORNIA SURGERY CENTER, LLC EIN: 33-0939000 ADDRESS: 18321 VENTURA BLVD, STE 740, TARZANA, CA 91356 COASTAL ASC HOLDINGS LLC EIN: 81-0986844 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92664 ST. JOSEPH/SATELLITE DIALYSIS CENTERS, LLC EIN: 81-4657391 ADDRESS: 300 SANTANA ROW, STE 300, SAN JOSE, CA 95128 ALPHA MEDICAL LABORATORY, LLC EIN: 91-2017347 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 BROADWAY IMAGING, LLC EIN: 52-2405971 ADDRESS: 500 W. BROADWAY, MISSOULA, MT 59802 CALIFORNIA LABORATORY ASSOCIATES, LLC EIN: 27-3888692 ADDRESS: 501 BUENA VISTA, BURBANK, CA 91505 CENTER FOR SPECIALTY SURGERY, LLC EIN: 26-3638838 ADDRESS: 11782 SW BARNES ROAD, PORTLAND, OR 97225 CLACKAMAS RADIATION ONCOLOGY CENTER, LLC EIN: 26-0381897 ADDRESS: 4400 NE HALSEY ST., BLDG. II #495, PORTLAND, OR 97213 CENTER FOR MEDICAL IMAGING-BRIDGEPORT, LLC EIN: 26-0796953 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 CENTER FOR MEDICAL IMAGING-TANASBOURNE, LLC EIN: 20-0477972 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 GREATER VALLEY MEDICAL BUILDING, LP EIN: 95-4570858 ADDRESS: 501 S. BUENA VISTA STREET, BURBANK, CA 91505 MINOR & JAMES MEDICAL, PLLC EIN: 91-1340223 ADDRESS: 515 MINOR AVENUE #200, SEATTLE, WA 98104 MOUNTAINSTAR CLINICAL LABORATORIES, LLC EIN: 26-1345983 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 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 PACLAB, LLC EIN: 91-1743952 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 PATHOLOGY ASSOCIATES MEDICAL LABORATORIES, LLC EIN: 27-0943279 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 PET/CT IMAGING AT SWEDISH CANCER INSTITUTE, LLC EIN: 20-3132044 ADDRESS: 1221 MADISON STREET, SEATTLE, WA 98104 PORTLAND MEDICAL IMAGING, LLC EIN: 20-1054971 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 PROVIDENCE RADIATION ONCOLOGY DEVELOPMENT ASSOCIATION, LLC EIN: 26-0682491 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 PROVIDENCE IMAGING CENTER EIN: 92-0118807 ADDRESS: 3340 PROVIDENCE DRIVE, ANCHORAGE, AK 99508 PROVIDENCE PARTNERS FOR HEALTH, LLC EIN: 45-4041798 ADDRESS: 501 S. BUENA VISTA STREET, BURBANK, CA 91505 PROVIDENCE SURGERY CENTER, LLC EIN: 84-1401625 ADDRESS: 902 N. ORANGE STREET, 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 SOUTHERN IDAHO REGIONAL LABORATORY, LLC EIN: 82-0511819 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 THE MADISON SPOKANE INN, LLC EIN: 84-1606484 ADDRESS: 15 WEST ROCKWOOD BLVD, SPOKANE, WA 99204 TRI-CITIES LABORATORY, LLC EIN: 91-1773986 ADDRESS: 611 N. 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