COMMUNITY HOSPITAL OF SAN BERNARDINO: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HOSPITAL OF SAN BERNARDINO (EIN 95-1643373)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-02
IRS object ID: 201801229349302100
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 H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-02T19:11:55-04:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	55 SECOND STREET SUITE 1400	AddressLine1Txt
City	SAN FRANCISCO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94105	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	951643373	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Community Hospital of San Bernardino	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% MARY JOHNSON ACCT DEPT	InCareOfNm
Business Name Control	COMM	BusinessNameControlTxt
Phone	7088876333	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	185 BERRY STREET SUITE 300	AddressLine1Txt
City	SAN FRANCISCO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94107	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVE EVANS	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	9098061242	PhoneNum
Signature	2018-04-30	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	VALERIE J BALL	PreparerPersonNm
PTIN	P00178114	PTIN
Phone	4159635100	PhoneNum
Preparation	2018-05-02	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	162.135.0.62	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	94357320181225000003	FederalOriginalSubmissionId
Federal Original Submission Id	2018-05-02	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	71B798D437BAB477821F8EE737E3D2E7E02778A4	AtSubmissionCreationDeviceId
At Submission Filing Device Id	58D2EFD71874899272368D0A62EB83F204FE69E4	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JUNE COLLISON PRESIDENT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1805 MEDICAL CENTER DRIVE	AddressLine1Txt
City	SAN BERNARDINO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92411	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$222,215,278	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	http://www.dignityhealth.org/san-bernardino/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1938	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	Community Hospital of San Bernardino is committed to furthering the healing ministry of Jesus, and to providing affordable health care to the community we serve.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	1602	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$832,161	PYContributionsGrantsAmt
CY Contributions Grants	$816,060	CYContributionsGrantsAmt
PY Program Service Revenue	$246,204,668	PYProgramServiceRevenueAmt
CY Program Service Revenue	$220,691,262	CYProgramServiceRevenueAmt
PY Investment Income	$25,984	PYInvestmentIncomeAmt
CY Investment Income	$102,057	CYInvestmentIncomeAmt
PY Other Revenue	$803,720	PYOtherRevenueAmt
CY Other Revenue	$605,899	CYOtherRevenueAmt
PY Total Revenue	$247,866,533	PYTotalRevenueAmt
CY Total Revenue	$222,215,278	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,520,186	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,919,025	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$141,528,414	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$140,793,029	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$115,033,212	PYOtherExpensesAmt
CY Other Expenses	$109,051,790	CYOtherExpensesAmt
PY Total Expenses	$259,081,812	PYTotalExpensesAmt
CY Total Expenses	$251,763,844	CYTotalExpensesAmt
PY Revenues Less Expenses	-$11,215,279	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$29,548,566	CYRevenuesLessExpensesAmt
Total Assets BOY	$151,427,005	TotalAssetsBOYAmt
Total Assets EOY	$134,350,321	TotalAssetsEOYAmt
Total Liabilities BOY	$218,990,151	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$231,462,033	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$67,563,146	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$97,111,712	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	COMMUNITY HOSPITAL OF SAN BERNARDINO IS A NON-PROFIT, FULL-SERVICE, ACUTE CARE FACILITY IN BUSINESS TO PROVIDE ACUTE INPATIENT CARE, LONG-TERM CARE AND A WIDE RANGE OF ANCILLARY AND THERAPEUTIC CARE TO THE COMMUNITY WE SERVE. OUR VISION IS TO CREATE AND PROVIDE HEALTH CARE SOLUTIONS, AND MEET THE HEALTH CARE NEEDS OF OUR COMMUNITY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$217,998,118	ExpenseAmt
Grant	$1,919,025	GrantAmt
Revenue	$220,691,262	RevenueAmt
Desc	COMMUNITY HOSPITAL OF SAN BERNARDINO'S MISSION IS TO CONTRIBUTE TO THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF QUALITY SERVICES DELIVERED IN A COMPASSIONATE AND COST EFFECTIVE MANNER. THE HOSPITAL IS LICENSED FOR 431 BEDS AND CURRENTLY HAS 382 BEDS AVAILABLE. THE HOSPITAL HAD 89,031 TOTAL PATIENT DAYS, 13,555 ADMISSIONS, AND 68,598 EMERGENCY ROOM VISITS. INPATIENT SERVICES: ACUTE PATIENT CARE; MATERNAL CHILD CARE; MENTAL HEALTH CARE; NEUROLOGICAL CARE; AND A VARIETY OF OUTPATIENT CARE.	Desc
Total Program Service Expenses	$217,998,118	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	Yes (true)	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	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	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	false	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	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	Yes (true)	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
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
IRP Document	135	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1602	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	false	QuidProQuoContributionsInd
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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	5	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	false	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	false	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
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	MARY JOHNSON ACCT DEPT	PersonNm
Phone	6022944117	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3033 NORTH 3RD AVENUE	AddressLine1Txt
City	PHOENIX	CityNm
State Abbreviation	AZ	StateAbbreviationCd
ZIP	85013	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 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	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Steven Barron
Director (thru 10/25/16)	1.0	40.0	Yes (X)	$0	$1,397,699	$148,027
Mary Connick
Director	1.0	40.0	Yes (X)	$0	$1,168,686	$114,602
Hendrik DeJager MD
Ex-officio Director	1.0	0.0	Yes (X)	$27,080	$0	$0
Richard Gonzalez Esq
Director	1.0	0.0	Yes (X)	$0	$0	$0
Gary Greensweig DO
Director	1.0	40.0	Yes (X)	$0	$848,238	$132,838
Albert Karnig PhD
Director (thru 5/5/17)	1.0	0.0	Yes (X)	$0	$0	$0
Vicki R Lee
Director	1.0	0.0	Yes (X)	$0	$0	$0
Deisell Martinez PhD
Director (thru 8/2/16)	1.0	0.0	Yes (X)	$0	$0	$0
Joe M Mawad MD
Director	4.5	0.0	Yes (X)	$31,210	$0	$0
Gabriel Ramirez
Director	1.0	0.0	Yes (X)	$0	$0	$0
Frank Schnetz
Director (thru 8/22/16)	1.0	0.0	Yes (X)	$0	$0	$0
Julie Sprengel
Director	1.0	40.0	Yes (X)	$0	$409,595	$41,091
Bruce Swartz
Director	1.0	40.0	Yes (X)	$0	$925,245	$111,758
Rachelle Wenger
Director	1.0	40.0	Yes (X)	$0	$163,824	$34,195
Claudia M Davis PhD
Vice Chair	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Tony Myrell
Chair	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
June Collison
Hospital President	40.0	0.0		$0	$677,927	$109,950	Yes (X)
David J Evans
VP/CFO	40.0	0.0		$284,718	$0	$54,788	Yes (X)
Melissa Kolin
VP, Patient Care Services/CNO	40.0	0.0		$246,302	$0	$31,524		Yes (X)
Victoria Selby
VP, Ancillary & Support Svcs	40.0	0.0		$253,885	$0	$44,870		Yes (X)
Marc Marchetti
Svc Area Exec Dir of Market De	40.0	0.0		$250,171	$0	$51,482			Yes (X)
Rosilyn Nolan
Dir Home Health	40.0	0.0		$225,936	$0	$47,333			Yes (X)
Marie R Orpilla
CNIII	40.0	0.0		$244,122	$0	$45,650			Yes (X)
Deborah K Wilson
Manager, Case Management	40.0	0.0		$219,450	$0	$39,207			Yes (X)
Patricia Womack
Director of Pharmacy	40.0	0.0		$232,237	$0	$27,070			Yes (X)
Darryl VandenBosch
Former officer	0.0	40.0		$0	$506,899	$93,350				Yes (X)
Jack Ivie
Former officer	0.0	40.0		$0	$736,560	$88,490				Yes (X)
Kimiko Ford
Former Key Employee	0.0	40.0		$0	$235,236	$42,459				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,015,111	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,069,909	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,258,684	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	301	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	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
ARAMARK HEALTHCARE
27310 NETWORK PL	CHICAGO	IL	606731273	food/facilities serv	$1,936,583
AMERICAN VITALCARE LLC
VITALCARE - KINDRED HLTHCARE	LOUISVILLE	KY	40202	Medical Services	$1,736,363
PREMIER COMMUNITY ANESTHESIA
1580 MOHAVE DR	COLTON	CA	92324	Medical Services	$1,580,004
INPATIENT SPECIALISTS OF CALIF
PO BOX 742936	LOS ANGELES	CA	900742936	Medical Services	$1,472,378
ANGELICA TEXTILE SERVICES
925 S 8TH ST	COLTON	CA	92324	LINEN/LAUNDRY SVCS	$987,136

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	62	CntrctRcvdGreaterThan100KCnt
Related Organizations	$816,060	RelatedOrganizationsAmt
Noncash Contributions	$2,692	NoncashContributionsAmt
Total Contributions	$816,060	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT REV NET OF CHARITY CARE AND BAD DEBT	900099	$83,501,174	$83,501,174
MEDICARE/MEDICAID PAYMENTS	900099	$136,453,035	$136,453,035
MEANINGFUL USE INCENTIVES (EHR)	900099	-$228,422	-$228,422
MEDICAL OFFICE BUILDING	900099	$950,973	$950,973
EDUCATION	900099	$14,502	$14,502

Field	Value	IRS element (for citing)
Total Program Service Revenue	$220,691,262	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$102,057	TotalRevenueColumnAmt
Exclusion	$102,057	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	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

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 (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA	900099	$472,988	$472,988
COMMISSIONS	900099	$71,298	$71,298
RECEIPT WRITE-OFF	900099	$13,996	$13,996

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$47,617	TotalRevenueColumnAmt
Exclusion	$47,617	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$605,899	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$222,215,278	TotalRevenueColumnAmt
Related Or Exempt Func Income	$220,691,262	RelatedOrExemptFuncIncomeAmt
Exclusion	$707,956	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	$1,909,562	TotalAmt
Program Services	$1,909,562	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$9,463	TotalAmt
Program Services	$9,463	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$893,389	TotalAmt
Program Services	$827,774	ProgramServicesAmt
Management And General	$65,615	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$59,645	TotalAmt
Program Services	$59,645	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$103,640,671	TotalAmt
Program Services	$96,499,853	ProgramServicesAmt
Management And General	$7,140,818	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$10,150,417	TotalAmt
Program Services	$9,444,752	ProgramServicesAmt
Management And General	$705,665	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$18,558,204	TotalAmt
Program Services	$18,514,004	ProgramServicesAmt
Management And General	$44,200	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$7,490,703	TotalAmt
Program Services	$6,930,321	ProgramServicesAmt
Management And General	$560,382	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$332,288	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$332,288	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$36,644	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$36,644	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$83,865	TotalAmt
Program Services	$66,940	ProgramServicesAmt
Management And General	$16,925	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$37,963,848	TotalAmt
Program Services	$25,866,784	ProgramServicesAmt
Management And General	$12,097,064	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,482,114	TotalAmt
Program Services	$17,565	ProgramServicesAmt
Management And General	$1,464,549	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,247,829	TotalAmt
Program Services	$3,128,187	ProgramServicesAmt
Management And General	$1,119,642	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$13,758,666	TotalAmt
Program Services	$4,811,423	ProgramServicesAmt
Management And General	$8,947,243	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,995,466	TotalAmt
Program Services	$1,756,010	ProgramServicesAmt
Management And General	$239,456	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$180,639	TotalAmt
Program Services	$86,206	ProgramServicesAmt
Management And General	$94,433	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$34,612	TotalAmt
Program Services	$12,159	ProgramServicesAmt
Management And General	$22,453	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$10,658,458	TotalAmt
Program Services	$10,658,458	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$6,169,721	TotalAmt
Program Services	$5,864,478	ProgramServicesAmt
Management And General	$305,243	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,034,956	TotalAmt
Program Services	$2,034,956	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDI-CAL PROVIDER FEE	$13,738,302	$13,738,302	$0	$0
MEDICAL SUPPLIES	$13,926,476	$13,925,451	$1,025	$0
FOOD SUPPLIES	$1,136,463	$1,096,604	$39,859	$0
LICENSES AND TAXES	$627,831	$419,801	$208,030	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$643,612	TotalAmt
Program Services	$319,420	ProgramServicesAmt
Management And General	$324,192	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$251,763,844	TotalAmt
Program Services	$217,998,118	ProgramServicesAmt
Management And General	$33,765,726	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$7,167	BOYAmt
EOY	$6,635	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$81,104	BOYAmt
EOY	$4,814,931	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$40,661	BOYAmt
EOY	$34,046	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$21,291,114	BOYAmt
EOY	$21,389,045	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	$280,528	BOYAmt
EOY	$223,879	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,713,145	BOYAmt
EOY	$2,930,116	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$83,992,943	BOYAmt
EOY	$63,965,793	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$141,250,175	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$100,343,237	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$42,974,881	BOYAmt
EOY	$40,906,938	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	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$12,212	BOYAmt
EOY	$55,688	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	$33,250	BOYAmt
EOY	$23,250	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$151,427,005	BOYAmt
EOY	$134,350,321	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$38,547,875	BOYAmt
EOY	$35,029,459	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	$2,000,000	BOYAmt
EOY	$2,000,000	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	$529,454	BOYAmt
EOY	$381,050	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	$177,912,822	BOYAmt
EOY	$194,051,524	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$218,990,151	BOYAmt
EOY	$231,462,033	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$67,563,146	BOYAmt
EOY	-$97,111,712	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	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	-$67,563,146	BOYAmt
EOY	-$97,111,712	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$151,427,005	BOYAmt
EOY	$134,350,321	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$29,548,566	ReconcilationRevenueExpnssAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
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)
Political Expenditures	$340	PoliticalExpendituresAmt
Volunteer Hours	0	VolunteerHoursCnt
Section4955 Organization Tax	$34	Section4955OrganizationTaxAmt
Section4955 Managers Tax	$0	Section4955ManagersTaxAmt
Form4720 Filed Section4955 Tax	Yes (true)	Form4720FiledSection4955TaxInd
Correction Made	Yes (true)	CorrectionMadeInd
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
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$83,865	OtherActivitiesAmt
Total Lobbying Expenditures	$83,865	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE C, PART I-B

DURING THE YEAR, COMMUNITY HOSPITAL OF SAN BERNARDINO PAID MEMBERSHIP DUES TO THE CALIFORNIA ASSOCIATION OF HEALTH FACILITIES ("CAHF"). THE INVOICE PROVIDED FOR VOLUNTARY CONTRIBUTIONS TO CAHF'S POLITICAL ACTION FUND (PAF). THE CHECK REQUEST FOR ANNUAL DUES INADVERTENTLY INCLUDED AMOUNTS FOR VOLUNTARY CONTRIBUTIONS TO THE PAF. COMMUNITY HOSPITAL OF SAN BERNARDINO HAS POLICIES AND PROCEDURES IN PLACE TO AVOID SUCH TRANSACTIONS, AND ONCE THE ORGANIZATION BECAME AWARE OF THIS SITUATION, IMMEDIATE ACTION WAS TAKEN TO OBTAIN A REFUND FROM THE CAHF FOR THE AMOUNT DESIGNATED FOR THE PAC. A COPY OF THE REFUND CHECK, DATED 7/20/2017, EVIDENCING $340.00 OF THE PAF HAS BEEN RECOVERED, HAVE BEEN ATTACHED TO FORM 4720. THIS REPRESENTS THE FULL AMOUNT OF INADVERTENT PAYMENT MADE RELATED TO VOLUNTARY CONTRIBUTIONS TO THE CAHF'S PAF.

SCHEDULE C, PART II-B, LINE 1I

LOBBYING EXPENDITURES PAID BY THE PARENT ORGANIZATION FOR ANNUAL MEMBERSHIP DUES WHERE EXPENSES ARE ALLOCATED TO THE HOSPITAL: HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA $12,773 AMERICAN HOSPITAL ASSOCIATION $2,269 PEACH INC $66,600 CATHOLIC HEALTH ASSOCIATION $1,703 CALIFORNIA ASSOCIATION OF HEALTH FACILITIES $340 340B HEALTH (FORMERLY SAFETY NET HOSPITALS) $89 ASHP $32 INLAND ACTION INC $28 AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES $3 AMERICAN SOCIETY OF CER $26 ONCOLOGY NURSING SOCIETY $2 __________ TOTAL $ 83,865 ==========

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)
Other Cost Or Other Basis	$799,341	OtherCostOrOtherBasisAmt
Book Value	$799,341	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$92,903,555	OtherCostOrOtherBasisAmt
Depreciation	$70,257,001	DepreciationAmt
Book Value	$22,646,554	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$41,871,730	OtherCostOrOtherBasisAmt
Depreciation	$29,771,011	DepreciationAmt
Book Value	$12,100,719	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,675,549	OtherCostOrOtherBasisAmt
Depreciation	$315,225	DepreciationAmt
Book Value	$5,360,324	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$40,906,938	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTIES	$189,297,242
PENSION PAYABLE	$3,725,284
OTHER NON-CURRENT LIABILITY	$1,028,998

Field	Value	IRS element (for citing)
Total Liability	$194,051,524	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE	FormAndLineReferenceDesc
Explanation	DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.	ExplanationTxt

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)
Persons Served	131	PersonsServedCnt
Total Community Benefit Expns	$1,791,020	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,791,020	NetCommunityBenefitExpnsAmt
Total Expense	0.00710	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	65515	PersonsServedCnt
Total Community Benefit Expns	$191,384,212	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$159,633,414	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$31,750,798	NetCommunityBenefitExpnsAmt
Total Expense	0.12610	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	65646	PersonsServedCnt
Total Community Benefit Expns	$193,175,232	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$159,633,414	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$33,541,818	NetCommunityBenefitExpnsAmt
Total Expense	0.13320	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	10	ActivitiesOrProgramsCnt
Persons Served	10407	PersonsServedCnt
Total Community Benefit Expns	$1,063,877	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$70,755	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$993,122	NetCommunityBenefitExpnsAmt
Total Expense	0.00390	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	2259	PersonsServedCnt
Total Community Benefit Expns	$1,743,299	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,743,299	NetCommunityBenefitExpnsAmt
Total Expense	0.00690	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	12666	PersonsServedCnt
Total Community Benefit Expns	$2,807,176	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$70,755	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,736,421	NetCommunityBenefitExpnsAmt
Total Expense	0.01080	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	78312	PersonsServedCnt
Total Community Benefit Expns	$195,982,408	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$159,704,169	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,278,239	NetCommunityBenefitExpnsAmt
Total Expense	0.14400	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	908	PersonsServedCnt
Total Community Benefit Expns	$123,799	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$123,799	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	908	PersonsServedCnt
Total Community Benefit Expns	$123,799	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$123,799	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,662,945	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$16,206,782	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$16,564,282	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$357,500	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

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	Community Hospital of San Bernardino	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1805 Medical Center Drive	AddressLine1Txt
City	San Bernadino	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92411	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.dignityhealth.org/san-bernardino/	WebsiteAddressTxt
State License	240000198	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	Community Hospital of San Bernardino	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	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE 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
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 SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE 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
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE H, PART V, SECTION B	FormAndLineReferenceDesc
Explanation	SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT INTO THE TAX YEAR 2016 CHNA WAS DESIGNED TO VALIDATE SECONDARY DATA FINDINGS, IDENTIFY ADDITIONAL COMMUNITY ISSUES, SOLICIT INFORMATION ON DISPARITIES AMONG SUBPOPULATIONS, ASCERTAIN COMMUNITY ASSETS TO ADDRESS NEEDS AND DISCOVER GAPS IN RESOURCES. INFORMATION WAS OBTAINED THROUGH FOCUS GROUPS AND INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS, PUBLIC HEALTH, SERVICE PROVIDERS, MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, AND INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS. TWENTY-ONE TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE COMMUNITY. PARTICIPANTS WERE SELECTED TO COVER A WIDE RANGE OF SECTORS REPRESENTING DIFFERENT AGE GROUPS AND RACIAL/ETHNIC POPULATIONS. FOUR FOCUS GROUPS WERE CONDUCTED THAT ENGAGED 68 PERSONS. TWO OF THE FOCUS GROUPS WERE CONDUCTED IN ENGLISH, ONE IN SPANISH WITH A SPANISH-SPEAKING FACILITATOR, AND ONE IN ENGLISH AND SPANISH. THE FOCUS GROUP MEETINGS WERE HOSTED BY TRUSTED COMMUNITY ORGANIZATIONS. SCHEDULE H, PART V, SECTION B, LINE 6A ST. BERNARDINE MEDICAL CENTER SCHEDULE H, PART V, SECTION B, LINE 7A https://www.dignityhealth.org/socal/locations/san-bernardino/about-us/serv ing-the-community/community-health-needs-assessment-plan SCHEDULE H, PART V, SECTION B, LINE 10A DIGNITY HEALTH HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED AT https://www.dignityhealth.org/about-us/community-health/community-health-p rograms-and-reports/community-health-needs-assessments. IMPLEMENTATION STRATEGIES ARE ALSO ON EACH HOSPITAL FACILITYS WEB SITE, AT THE SAME LOCATIONS AS THEIR CHNA REPORTS LISTED IN PART V, SECTION B, LINE 7a ABOVE. SCHEDULE H, PART V, SECTION B, LINE 11 THE HOSPITAL WILL ADDRESS THE FOLLOWING IDENTIFIED SIGNIFICANT HEALTH NEEDS: ACCESS TO HEALTH CARE/PREVENTIVE PRACTICES; BIRTH INDICATORS; CHRONIC DISEASES/OVERWEIGHT AND OBESITY; HOMELESSNESS; AND YOUTH DEVELOPMENT FOR AT-RISK YOUTH, INCLUDING SAFETY AND VIOLENCE PREVENTION. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN ITS IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. ACCESS TO HEALTH CARE/PREVENTIVE PRACTICES: PATIENT FINANCIAL ASSISTANCE, DIGNITY HEALTH COMMUNITY GRANTS PROGRAM, FREE COMMUNITY HEALTH EDUCATION, COMMUNITY HEALTH NAVIGATOR, FREE FLU SHOTS. BIRTH INDICATORS: SWEET SUCCESS PROGRAM FOR GESTATIONAL DIABETIC WOMEN, COMMUNITY HEALTH EDUCATION LACTATION SUPPORT, HEALTHY PREGNANCIES, AND PRE/POST-NATAL CARE AT THE HEALTH EDUCATION CENTER, STATUS AS A BABY-FRIENDLY ACUTE CARE HOSPITAL. CHRONIC DISEASES/OVERWEIGHT AND OBESITY: CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, COMMUNITY GRANTS PROGRAM, SWEET SUCCESS, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS AT THE HEALTH EDUCATION CENTER. HOMELESSNESS: COMMUNITY GRANTS PROGRAM, COMMUNITY HEALTH NAVIGATOR TO CONNECT HOMELESS PATIENTS WITH SUPPORTIVE SOCIAL SERVICES, INCLUDING HOUSING SUPPORT. YOUTH DEVELOPMENT: STEPPING STONES HEALTH CARE CAREER EXPOSURE AND MENTORING, DONATED SPACE TO THE CATHOLIC CHARITIES FOCUS 92411 COMMUNITY HOMEWORK CENTER. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, THE HOSPITAL WILL NOT DIRECTLY ADDRESS THE FOLLOWING IDENTIFIED NEEDS: MENTAL HEALTH; SEXUALLY TRANSMITTED INFECTIONS; AND SUBSTANCE ABUSE. THE HOSPITAL CANNOT ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY. THEREFORE, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATIONS AREAS OF FOCUS AND EXPERTISE. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, AND 16C https://www.dignityhealth.org/socal/locations/san-bernardino/patients-and- visitors/for-patients/billing-payment-financial-services/financial-assista nce SCHEDULE H, PART V, SECTION B, LINE 16J ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS AND THE FINANCIAL ASSISTANCE POLICY, A COPY OF THE FINANCIAL ASSISTANCE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION. THE FACILITY'S WEB SITE ALSO CONTAINS THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY OF THE POLICY, APPLICATION, BILLING AND COLLECTION POLICY, A DESCRIPTION OF THE AMOUNT GENERALLY BILLED AND A LISTING OF PROVIDERS AT EACH FACILITY THAT ARE COVERED AND NOT COVERED BY THE FINANICAL ASSISTANCE POLICY. CONTACT INFORMATION CAN ALSO BE FOUND ON THE FACILITYS WEB PAGE.	ExplanationTxt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Community Convalescent Center	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1676 Medical Center Drive	AddressLine1Txt
City	San Bernardino	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92411	ZIPCd

Field	Value	IRS element (for citing)
Facility	SKILLED NURSING	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7	FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE, CHSB USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO THE PATIENT LEVEL. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT THE HOSPITAL WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE WORKSHEET 2 OF SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN ROLLED UP TO THE PATIENT LEVEL BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH THOSE SERVICES PROVIDED TO EACH SPECIFIC PATIENT. THIS IS DONE FOR ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED AND SELF PAY. THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF CHARITY CARE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR CHARITY CARE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH AND CASH AND IN-KIND DONATIONS.
Schedule H, Part I, Line 7b, column (f)	BEGINNING IN 2009, THE STATE OF CALIFORNIA ESTABLISHED PROVIDER FEE PROGRAMS. THESE PROGRAMS ARE FUNDED BY QUALITY ASSURANCE FEES PAID BY PARTICIPATING HOSPITALS AND MATCHING FEDERAL FUNDS. COMMUNITY HOSPITAL OF SAN BERNARDINO RECOGNIZED QUALITY ASSURANCE FEES DURING THE YEAR OF $13.73 MILLION WHICH ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO UNREIMBURSED MEDICAID (PART I, LINE 7B, COLUMN C), AND RECOGNIZED FEE-FOR-SERVICE SUPPLEMENTAL PAYMENTS OF $42.90 MILLION DURING THE YEAR REFLECTED UNDER THE MEDICAID PROGRAM AS DIRECT OFFSETTING REVENUE (PART I, LINE 7B, COLUMN D). THIS NET INCREASE IN THE COST OF THE MEDICAID PROGRAM IS DRIVING THE INCREASE IN THE OVERALL COST OF COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES WHEN COMPARED TO PRIOR YEARS. SCHEDULE H, PART I, LINE 7I THE CALIFORNIA HOSPITAL ASSOCIATION CREATED A PRIVATE PROGRAM, THE CALIFORNIA HEALTH FOUNDATION AND TRUST ("CHFT"), ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA. DURING THE YEAR, COMMUNITY HOSPITAL OF SAN BERNARDINO RECORDED A PLEDGE TO A GRANT FUND ESTABLISHED BY CHFT IN THE AMOUNT $0.98 MILLION. THE GRANT IS REPORTED UNDER OTHER BENEFITS (PART I, LINE 7I, COLUMN C), AS CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS.
Schedule H, Part II - Community Building Activities	COMMUNITY HOSPITAL OF SAN BERNARDINO (CHSB) IS DEDICATED TO COMMUNITY BUILDING IN THE SURROUNDING NEIGHBORHOODS. CHSB STAFF HAS BEEN INTEGRAL IN A MULTI- YEAR PROCESS TO DEVELOP A COUNTYWIDE COMMUNITY VITAL SIGNS TRANSFORMATIONAL PLAN, BEGINNING WITH MULTIPLE COMMUNITY MEETINGS TO DEFINE KEY ISSUES TO DEVELOPING A MULTI-AGENCY PLAN TO LEAD CHANGE THROUGH EDUCATION, ECONOMY, ACCESS TO HEALTH & WELLNESS AND SAFETY. LASTLY, THE FOLLOWING AGENCIES ARE INVOLVED IN OUR COMMUNITY PROGRAMS:, BLAIR PARK NEIGHBORHOOD ASSOCIATION, CALFRESH, CALIFORNIA STATE UNIVERSITY SAN BERNARDINO, CATHOLIC CHARITIES, COMMUNITY ACTION PARTNERSHIP UTILITIES ASSISTANCE (CAPSB), CHILDHELP USA, DEPARTMENT OF PUBLIC HEALTH, FAMILY RESOURCE CENTER, FONTANA COMMUNITY ASSISTANCE PROGRAM (CAP), HOME OF NEIGHBORLY SERVICE, HOUSING AUTHORITY, INLAND EMPIRE BABY FRIENDLY, INLAND EMPIRE BREASTFEEDING COALITION, LATINO HEALTH COLLABORATIVE, MARY'S TABLE, MEXICAN CONSULATE, PREGNANCY RESOURCE CENTER, SAN BERNARDINO ADULT SCHOOL, SAN BERNARDINO COUNTY SEXUAL ASSAULT SERVICES, SAN BERNARDINO HIGH SCHOOL, VERONICA'S HOME OF MERCY AND VICTOR COMMUNITY SUPPORT SERVICES.
SCHEDULE H, PART III, LINE 2	THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER FINANCIAL ASSISTANCE, AND ARE OTHERWISE UNINSURED. AS NOTED IN PART I, LINE 3, CHSB PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 200%, 201%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. DIGNITY HEALTH ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL DIGNITY HEALTH FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 30%. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE.
SCHEDULE H, PART III, LINE 3	CHSB MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. CHSB FOLLOWS DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY. THE FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT NO SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE WERE REPORTED AS BAD DEBT. AS SUCH, CHSB DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE.
Schedule H, Part III, Line 4	THE FOLLOWING IS AN EXCERPT FROM DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS' CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2017, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR CHARITY AND DOUBTFUL ACCOUNTS: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNT FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. CHSB MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES. RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS HAVE BEEN ESTABLISHED AND ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEET.
Schedule H, Part III, Line 8	CHSB PREPARES MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR THE INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS.
Schedule H, Part III, Line 9b	AT TIME OF PATIENT BILLING, CHSB PROVIDES TO ALL PATIENTS INFORMATION CONCERNING SERVICES AND CHARGES PROVIDED. INFORMATION PROVIDED INCLUDES PATIENT FINANCIAL ASSISTANCE INFORMATION, UNINSURED PATIENT DISCOUNT INFORMATION, INFORMATION REGARDING ELIGIBILITY ASSISTANCE FOR GOVERNMENT-SPONSORED HEALTHCARE AND PAYMENT ASSISTANCE. CHSB ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. CHSB'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHOM THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF CHSB OR THE BILLING COMPANY RETAINED BY CHSB IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED FINANCIAL ASSISTANCE OR FOR ASSISTANCE UNDER CHSB'S PATIENT FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, CHSB WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY CHSB. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNTS TO A COLLECTION AGENCY, CHSB REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.
Schedule H, Part VI, Line 2 - Needs Assessment	CALIFORNIA'S COMMUNITY BENEFIT LAW (SB 697) CREATED A PROCESS AND TOOL FOR CHSB TO DETERMINE ITS COMMUNITY BENEFIT PLAN, WHICH OUTLINES HOW THE HOSPITAL WILL GIVE BACK TO THE COMMUNITY IN THE FORM OF HEALTH CARE AND OTHER COMMUNITY SERVICES TO ADDRESS UNMET COMMUNITY HEALTH NEEDS. IN THE SPRING OF 2017 A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CARRIED OUT IN PARTNERSHIP WITH ST. BERNARDINE MEDICAL CENTER. IT INCORPORATES COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUS ON THE HEALTH AND SOCIAL NEEDS OF THE CHSB SERVICE AREA. ADDITIONALLY, SIX FOCUS GROUPS WERE CONDUCTED WITH RESIDENTS OF COMMUNITIES IN THE CHSB PRIMARY SERVICE AREA. FOUR OF THE GROUPS WERE CONDUCTED IN ENGLISH AND TWO IN SPANISH. THROUGH THE PARTICIPATION IN THIS NEEDS ASSESSMENT AND BENEFITS PLANNING PROCESS CHSB REMAINS COMMITTED TO PARTICIPATING IN COMMUNITY PROCESSES THAT UPDATE AND REFRESH THE ONGOING QUEST TO UNDERSTAND AND TO RESPOND TO THE COMMUNITY'S PRIORITIES FOR HEALTH AND QUALITY OF LIFE IMPROVEMENTS. THE CHNA CONTINUES TO BE A FOCAL POINT AND AN ESSENTIAL TOOL IN DEVELOPING THE STRATEGIC DIRECTION OF CHSB.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for	Assistance COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC: INFORMATION ABOUT DIGNITY HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE HOSPITAL MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES THE HOSPITAL SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT ALL UNINSURED PATIENTS RECEIVE AN UNINSURED DISCOUNT OF 30%, AND THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION OR WITH PROMPT PAYMENT. FINANCIAL ASSISTANCE INFORMATION, GOVERNMENT PROGRAM RESOURCE INFORMATION, TOOLS TO ASSIST PATIENTS IN FINDING HEALTH COVERAGE, ANSWERS TO FREQUENTLY ASKED BILLING QUESTIONS, AND OTHER SUCH INFORMATION CAN ALSO BE FOUND ON DIGNITY HEALTH'S WEBSITE AT WWW.DIGNITYHEALTH.ORG. AT THE POINT OF REGISTRATION, BROCHURES ARE MADE AVAILABLE TO ALL PATIENTS EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. COPIES OF THE FINANCIAL ASSISTANCE APPLICATION ARE MADE AVAILABLE TO ALL UNINSURED PATIENTS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF DIGNITY HEALTH INCLUDES LANGUAGE REQUIRING ALL INITIAL STATEMENTS TO UNINSURED PATIENTS INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF CHSB FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT OR A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.
Schedule H, Part VI, Line 4 - Community Information	COMMUNITY HOSPITAL OF SAN BERNARDINO SERVES A BROAD AND DIVERSE POPULATION RESIDING IN MULTIPLE ZIP CODES, AS IT SERVES AS A REGIONAL REFERRAL FOR HEART PROCEDURES. WHILE A FEW OF THE ZIP CODE COMMUNITIES ENJOY A HIGHER STANDARD OF LIVING, THE MAJORITY OF THE COMMUNITIES SERVED ARE HIGH NEED. SEVENTY-FIVE PERCENT (75%) OF DISCHARGES COME FROM SEVENTEEN (17) ZIP CODES CONCENTRATED IN THE FOLLOWING CITIES: BLOOMINGTON, COLTON, FONTANA, HESPERIA, HIGHLAND, RIALTO, SAN BERNARDINO, AND VICTORVILLE. Total Population: 884,175 Race/Ethnicity: White - Non-Hispanic 16.6%; Black/African American - Non-Hispanic 9.7%; Hispanic or Latino 66.8%; Asian/Pacific Islander 4.6%; All Others 2.3% Median Income: $52,159 Unemployment: 8.9% No High School Diploma: 29.3% Medicaid: 38.7% Uninsured: 8.7% OTHER AREA HOSPITALS: 5 MANY OF THE NEIGHBORHOODS SERVED HAVE BEEN FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). PORTIONS OF THE FOLLOWING ZIP CODES SERVED BY THE HOSPITAL FALL IN A MUA: 92401, 92404, 92405, 92335 AND 92336.
Schedule H, Part VI, Line 5 - Promotion of Community Health	A MAJORITY OF THE CHSB'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES, FAMILY MEMBERS NOR CONTRACTORS OF THE HOSPITAL. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. CHSB RECOGNIZES THE IMPORTANCE OF COMMUNITY HEALTH AND PROMOTES COMMUNITY HEALTH BEYOND THE WALLS OF THE HOSPITAL THROUGH A VARIETY OF METHODS: COMMUNITY EDUCATION CLASSES ON A VARIETY OF TOPICS ARE OFFERED FREE OF CHARGE THROUGHOUT THE YEAR TO COMMUNITY MEMBERS; REFERRALS TO APPROPRIATE SOCIAL AGENCIES ARE MADE TO THOSE SEEKING ASSISTANCE; FREE FLU SHOTS; COLLABORATION WITH A VARIETY OF NON-PROFIT AGENCIES SHARING A MISSION OF HEALTH, ENVIRONMENT AND SOCIAL WELFARE INCLUDING FINBANCIAL ASSISTANCE TO SOME OF THESE AGENCIES THROUGH THE DIGNITY HEALTH COMMUNITY GRANTS PRORAM; ACTIVE MEMBERSHIP ON ST. BERNARDINE MEDICAL CENTER'S COMMUNITY BENEFIT INITIATIVE COMMITTEE (CBIC) WHERE INPUT FROM KEY COMMUNITY STAKEHOLDERS IS CRITICAL IN REVIEWING THE NEEDS OF THE COMMUNITY AND ASSIST IN ESTABLISHING HEALTH PRIORITIES AND GOALS. CHSB REINVESTS ALL ITS OPERATING AND INVESTMENT INCOME IN HOSPITAL IMPROVEMENTS, TECHNOLOGY ENHANCEMENTS, COMMUNITY HEALTH PROGRAMS, AND EMPLOYEE BENEFITS. THIS ACTIVE REINVESTMENT MAKES IT POSSIBLE FOR US TO DELIVER ON OUR MISSION, INCLUDING ENSURING THAT EVERYONE HAS ACCESS TO HEALTH CARE.
Schedule H, Part VI, Line 6 - Affiliated Health Care System	CHSB is affiliated with Dignity Health. Affiliates of Dignity Health also promote the health of additional communities in Bakersfield, San Bernardino, San Francisco, San Andreas, and Grass Valley/Nevada City, California. These affiliates follow practices similar to those noted above in determining the unmet healthcare needs of their communities. The summary of Total unsponsored community benefit expense for Dignity Health and its subordinate corporations for the year ended June 30, 2017, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 88,031 98,807,000 0.8% Unpaid Costs of Medicaid/Medi-Cal 1,656,712 1,074,093,000 8.3% Other Means-tested Programs 305,907 9,812,000 0.1% Community Services: Community Health Services 351,566 38,258,000 0.3% Health Professions Education 48 177,000 0.0% Subsidized Health Services 352,535 55,272,000 0.4% Donations 111,409 23,470,000 0.2% Community Building Activities 2,233 2,064,000 0.0% Community Benefit Operations 1,732 9,012,000 0.1% Total Community Services for the poor 819,523 128,253,000 1.0% Total Benefits for the Poor 2,870,173 1,310,965,000 10.2% Benefits for the Broader Community: Community Services: Community Health Services 312,585 14,413,000 0.1% Health Professions Education 34,107 67,391,000 0.5% Subsidized Health Services 2,780 1,486,000 0.0% Research 703 8,804,000 0.1% Donations 22,184 8,543,000 0.1% Community Building Activities 20,730 2,429,000 0.0% Community Benefit Operations 54 1,180,000 0.0% Total Benefits for the Broader Community 393,143 104,246,000 0.8% Total Community Benefits 3,263,316 1,415,211,000 11.0% Unpaid Costs of Medicare 1,384,961 1,196,946,000 9.3% Total Community Benefits including Unpaid Cost of Medicare 4,648,277 2,612,157,000 20.3%

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
California Health Foundation and Trust
1215 K Street Ste 800	Sacramento	CA	95814	941498697	501(c)(3)	$976,794	N/A	N/A	Service for the poor
Dignity Health
1980 Orange Tree Lane	Redlands	CA	92374	941196203	501(c)(3)	$608,850	N/A	N/A	COMMUNITY HEALTH
Community Hospital Foundation of San Bernardino
1805 Medical Center Drive	San Bernadino	CA	92411	953051931	501(c)(3)	$316,448	N/A	N/A	Foundation Support

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
FINANCIAL ASSISTANCE TO PATIENTS/NEEDY	101	$1,257	$0	N/A	N/A
PROVISION OF FOOD/MEALS TO THE POOR	198	$0	$6,914	BOOK	THANKSGIVING MEALS
PROVISION OF CLOTHES TO PATIENTS AT DISCHARGE	241	$0	$1,292	BOOK	CLOTHING

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2	FormAndLineReferenceDesc
Explanation	THE HOSPITAL USES A SOFTWARE PACKAGE TO DOCUMENT GRANT FUNDING, TO MONITOR AND REPORT PROGRAM OUTCOMES AND TO FORMULATE CRITERIA FOR GRANT SELECTIONS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	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	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 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
Steven Barron
Director (thru 10/25/16)	$0	$592,604	$0	$459,099	$0	$345,996	$0	$90,786	$0	$57,241	$0	$1,545,726	$0	$306,908
Mary Connick
Director	$0	$402,250	$0	$392,628	$0	$373,808	$0	$70,388	$0	$44,214	$0	$1,283,288	$0	$365,291
Gary Greensweig DO
Director	$0	$451,591	$0	$383,632	$0	$13,015	$0	$74,233	$0	$58,605	$0	$981,076	$0	$0
Julie Sprengel
Director	$0	$107,979	$0	$300,000	$0	$1,616	$0	$39,787	$0	$1,304	$0	$450,686	$0	$0
Bruce Swartz
Director	$0	$455,692	$0	$444,766	$0	$24,787	$0	$78,491	$0	$33,267	$0	$1,037,003	$0	$0
Rachelle Wenger
Director	$0	$137,040	$0	$25,776	$0	$1,008	$0	$17,164	$0	$17,031	$0	$198,019	$0	$0
June Collison
Hospital President	$0	$323,419	$0	$339,691	$0	$14,817	$0	$57,113	$0	$52,837	$0	$787,877	$0	$0
David J Evans
VP/CFO	$217,993	$0	$55,000	$0	$11,725	$0	$28,730	$0	$26,058	$0	$339,506	$0	$0	$0
Melissa Kolin
VP, Patient Care Services/CNO	$199,249	$0	$45,242	$0	$1,811	$0	$22,210	$0	$9,314	$0	$277,826	$0	$0	$0
Victoria Selby
VP, Ancillary & Support Svcs	$202,940	$0	$49,206	$0	$1,739	$0	$19,714	$0	$25,156	$0	$298,755	$0	$0	$0
Marc Marchetti
Svc Area Exec Dir of Market De	$193,816	$0	$44,721	$0	$11,634	$0	$25,018	$0	$26,464	$0	$301,653	$0	$0	$0
Rosilyn Nolan
Dir Home Health	$179,586	$0	$33,620	$0	$12,730	$0	$19,950	$0	$27,383	$0	$273,269	$0	$0	$0
Marie R Orpilla
CNIII	$237,877	$0	$1,683	$0	$4,562	$0	$21,280	$0	$24,370	$0	$289,772	$0	$0	$0
Deborah K Wilson
Manager, Case Management	$116,231	$0	$18,346	$0	$84,873	$0	$13,211	$0	$25,996	$0	$258,657	$0	$0	$0
Patricia Womack
Director of Pharmacy	$198,140	$0	$24,405	$0	$9,692	$0	$22,902	$0	$4,168	$0	$259,307	$0	$0	$0
Darryl VandenBosch
Former officer	$0	$347,082	$0	$147,044	$0	$12,773	$0	$47,129	$0	$46,221	$0	$600,249	$0	$0
Jack Ivie
Former officer	$0	$338,731	$0	$352,254	$0	$45,575	$0	$62,482	$0	$26,008	$0	$825,050	$0	$0
Kimiko Ford
Former Key Employee	$0	$196,024	$0	$36,376	$0	$2,836	$0	$25,265	$0	$17,194	$0	$277,695	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3	ALTHOUGH THE ORGANIZATION EMPLOYS PERSONNEL, THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S PRESIDENT'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION.
Schedule J, PART I, LINE 4a	CERTAIN LISTED PERSONS PARTICIPATE IN A SEVERANCE PLAN ESTABLISHED BY ITS SUPPORTED ORGANIZATION. THE PLAN PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 1 MONTH TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. PAYMENTS MADE UNDER THIS PLAN OCCURED DURING 2016 FOR ONE HIGHEST COMPENSATED EMPLOYEE; D. WILSON, $33,869.
Schedule J, PART I, LINE 4b	CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2016. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS WERE MADE FOR TWO BOARD MEMBERS, WHO ARE DIGNITY HEALTH EMPLOYEES, INCLUDES S. BARRON, $306,908 AND M. CONNICK, $365,291. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
PART II - SUPPLEMENTAL DISCLOSURES	THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE DIGNITY HEALTH TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES DIGNITY HEALTH SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND DIGNITY HEALTH'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2016.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	521598225	BondIssuerEIN
CUSIP	13033FTN0	CUSIPNum
Bond Issued	2004-05-19	BondIssuedDt
Issue Price	$150,000,000	IssuePriceAmt
Purpose	BOND A: CUSIP 13033FTN0 - SEE PART	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	Yes (true)	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$2,000,000	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$0	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$2,000,000	CapitalExpendituresAmt
Other Spent Proceeds	$0	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2005	SubstantialCompletionYr
Current Refunding	false	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	Yes (true)	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	Yes (true)	MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts	Yes (true)	EngageBondCounselContractsInd
Any Research Agreements	Yes (true)	AnyResearchAgreementsInd
Engage Bond Counsel Research	Yes (true)	EngageBondCounselResearchInd
Private Bus Use By Others	0.03000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.03000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Change In Use Bond Financed Prop	0.00000	ChangeInUseBondFinancedPropPct
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	false	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	Yes (true)	NoRebateDueInd
Variable Rate Issue	Yes (true)	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	Yes (true)	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	BOND A: CUSIP 13033FTN0	FormAndLineReferenceDesc
Explanation	PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE. THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN IN PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY COMMUNITY HOSPITAL OF SAN BERNARDINO AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, COMMUNITY HOSPITAL OF SAN BERNARDINO BORROWED THE SUM OF $2,000,000 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2016, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI through PART VII	FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS DIGNITY HEALTH, A 501(C)(3) EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A DIGNITY HEALTH, AS THE SOLE CORPORATE MEMBER, RATIFIES THE SELECTION OF MEMBERS AND THE DIGNITY HEALTH BOARD APPROVES NEW BOARD MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B RESERVED RIGHTS OF THE CORPORATE MEMBER INCLUDE: ADOPTION OF MISSION & PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; DISSOLUTION OF THE CORPORATION, ACQUIRE ANOTHER CORPORATION, OR CREATE A SUBSIDIARY; MERGING OR CONSOLIDATING WITH ANOTHER CORPORATION; PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE; INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS; RATIFICATION OF BOARD MEMBER APPOINTMENTS & DISMISSALS; SELECTION OR REMOVAL OF INDEPENDENT AUDITORS; TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CFO WORKED CLOSELY WITH THE PARENT ORGANIZATION AND AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. THE BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE FINANCE COMMITTEE. MANAGEMENT PRESENTED THE DRAFT OF THE FORM 990 TO THE FINANCE COMMITTEE. THE DRAFT WAS COMPLETE EXCEPT IT EXCLUDED COMPENSATION INFORMATION FOR DIRECTORS WHO ARE ALSO KEY EXECUTIVES OF DIGNITY HEALTH, THE FILING ORGANIZATION'S SOLE MEMBER. COMPENSATION BY DIGNITY HEALTH TO THOSE DIRECTORS HAS BEEN REVIEWED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE DIGNITY HEALTH BOARD OF DIRECTORS. SUBSEQUENT TO ITS REVIEW, THE FINANCE AND INVESTMENT COMMITTEE REPORTED BACK TO THE BOARD REGARDING ITS REVIEW AND PROVIDED A DRAFT TO THE BOARD OF DIRECTORS, AGAIN EXCLUDING COMPENSATION FOR CERTAIN DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. UNDER SUCH POLICIES, THE EVP/GENERAL COUNSEL IS RESPONSIBLE FOR COLLECTING, REVIEWING AND VALIDATING ANNUAL DISCLOSURES OF ALL COVERED PERSONS (I.E., BOARD AND BOARD COMMITTEE MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE VICE PRESIDENT LEVEL AND ABOVE, AND ANY OTHER PERSONNEL AT HIS OR HER DISCRETION). ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS ARISING FROM THE BUSINESS, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERIORS AND TO RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT, OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON, AND ANNUALLY THEREAFTER. EACH COVERED PERSON IS REQUIRED TO CERTIFY AT LEAST ANNUALLY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE POLICY APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE STATEMENT AS REQUIRED BY THE POLICY. THE PRESIDENT/CEO AND EVP/GENERAL COUNSEL PREPARE ANNUAL REPORTS OF REPORTED CONFLICTS OF INTEREST, WHICH ARE PROVIDED TO THE BOARD OF DIRECTORS, COMMITTEE CHAIRS, AND KEY LEADERS OF THE ORGANIZATION TO ENABLE RESPONSIBLE INDIVIDUALS TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD OF DIRECTORS, MEMBERS OF BOARD COMMITTEES WITH SUBJECT MATTER JURISDICTION AND ANY OTHER RELEVANT DECISION-MAKERS; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED, AFTER WHICH HE/SHE SHALL LEAVE THE MEETING; (3) THE INTERESTED PERSON IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (4) IF WARRANTED, ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, AND COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) THE TRANSACTION OR ACTION IS APPROVED BY A MAJORITY OF DISINTERESTED PERSONS, CONSISTENT WITH ANY REQUIREMENTS OF BYLAWS OR POLICIES; AND (6) ANY CONFLICTING ISSUES ARISING DURING THE COURSE OF A BOARD MEETING WHICH CANNOT BE RESOLVED MAY BE REFERRED TO AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS. THERE ARE SIMILAR CONFLICTS OF INTEREST PROVISIONS UNDER DIGNITY HEALTHS STANDARDS OF CONDUCT, WHICH ARE APPLICABLE TO ALL EMPLOYEES AND WHICH ARE ADMINISTERED BY THE VP/CORPORATE COMPLIANCE OFFICER WHO HAS REPORTING RESPONSIBILITY TO THE PRESIDENT/CEO AS WELL AS TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION EMPLOYS PERSONNEL; HOWEVER, THE TOP MANAGEMENT OFFICIAL'S COMPENSATION IS SET BY A RELATED ORGANIZATION, DIGNITY HEALTH. FOR 2016, DIGNITY HEALTH'S HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF DIRECTORS. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE TRANSACTION APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED TRANSACTION AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. FORM 990, PART VI, SECTION B, LINE 15B FOR 2016 COMPENSATION, THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT CONDUCTED AN ANNUAL REVIEW AND ANALYSIS TO PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGE OF KEY EMPLOYEES. THE COMPENSATION FOR THESE INDIVIDUALS WAS BASED ON THE QUALIFICATION AND EXPERIENCE OF THE CANDIDATES. COMPENSATION IS ALSO REVIEWED ANNUALLY AS PART OF THE MERIT INCREASE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE HOSPITAL WEBSITE AND UPON REQUEST. FORM 990, PART VII, SECTION A DR J MAWAD AND DR H DEJAGER RECEIVED COMPENSATION FOR PHYSICIAN SERVICES PROVIDED TO THE FILING ORGANIZATION. S BARRON, M CONNICK, G GREENSWEIG, J SPRENGEL, B SWARTZ, R WENGER, D VANDENBOSCH, J IVIE, J COLLISON AND K FORD RECEIVED COMPENSATION FOR SERVICES PROVIDED TO A RELATED ORGANIZATION, DIGNITY HEALTH.
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL FEES TOTAL FEES:11424507
FORM 990 PART IX LINE 11G	DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:9452212
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIRS AND MAINTENANCE TOTAL FEES:6828847
FORM 990 PART IX LINE 11G	DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:5719437
FORM 990 PART IX LINE 11G	DESCRIPTION:STORAGE TOTAL FEES:3129139
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER TOTAL FEES:1409706

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 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
Community Hospital Foundation
1805 Medical Center Drive	San Bernardino	CA	92411	953051931	Fund Raising	CA	501(c)(3)	12; Type I	CHSB	Yes (true)
DIGNITY HEALTH
185 Berry Street	San Francisco	CA	94107	941196203	Hospital	CA	501(c)(3)	3	NA	false

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	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
COMMUNITY HOSPITAL SAN BERNARDINO FOUNDATION
C	$816,060	cash/non-cash
COMMUNITY HOSPITAL SAN BERNARDINO FOUNDATION
B	$316,448	SEE PART VII

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part V, line 2	FormAndLineReferenceDesc
Explanation	COMMUNITY HOSPITAL OF SAN BERNARDINO (CHSB) IS SUPPORTED BY ONE FOUNDATION. AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES FOR THE BENEFIT OF, TO RAISE FUNDS FOR, OR TO CARRY OUT THE PURPOSES OF CHSB. AS A RESULT, PAYMENTS ARE MADE DIRECTLY TO CHSB FROM THE FOUNDATION OR DIRECTLY TO THE FOUNDATION FROM CHSB. AMOUNT REPORTED UNDER TRANSACTION TYPE "B" REPRESENT FUNDS EXPENDED BY CHSB ON BEHALF OF THE FOUNDATION FOR OPERATIONAL EXPENSES. AMOUNT REPORTED AS TRANSACTION TYPE "C" REPRESENT FUNDS, BOTH CASH AND IN-KIND, RECEIVED FROM THE FOUNDATION AS GRANTS TO CHSB.	ExplanationTxt