2017-04-28T19:06:42-05:00 2016-06-30 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE SUITE 1700 IRVINE CA 92612 990 2015-07-01 951914489 ST MARY MEDICAL CENTER % TRACEY FERNANDEZ VP/CFO STMA 7602422311 18300 US HIGHWAY 18 APPLE VALLEY CA 92307 TRACEY FERNANDEZ CFO 7602422311 2017-04-28 true KARA ADAMS P00023315 9497942300 2015 2021-01-29 14:40:06Z ALAN H GARRETT 18300 US HIGHWAY 18 APPLE VALLEY CA 92307 342970368 false 0928 X WWW.STMARYAPPLEVALLEY.COM X 1953 CA TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. 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true 29384 29384 false SCHEDULE C, PART II-B, LINE 1I LOBBYING ACTIVITIES DURING THE YEAR, ST. JOSEPH HEALTH SYSTEM CONDUCTED ADVOCACY EFFORTS WHICH INCLUDED SOME LOBBYING ACTIVITIES. THESE ACTIVITIES INCLUDED MEETING WITH LOCAL, STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS, AS WELL AS COMMUNICATION TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO ST. MARY MEDICAL CENTER. 623378 400000 8629 4825 1027182 634240 10138 21000 623378 566823 70417 3000 634240 549770 20053 3000 566823 530889 21881 3000 549770 0.00000 1.00000 0.00000 false true true 30153187 30153187 112922815 69524004 43398811 328078 228148 99930 77953368 59761028 18192340 29461342 1731363 27729979 119574247 0 INTERCOMPANY W/ HEALTH SYSTEM BONDS 61803295 DUE TO 3RD PARTY PAYORS 9589648 CAPITAL LEASE 1368224 457F LIABILITY 1155740 ANNUITY & TRUST PAYABLE 773541 SECURITY DEPOSIT 2654 74693102 X SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS USE ENDOWMENT FUNDS WERE DESIGNATED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE ACCOUNTING STANDARDS CODIFICATION (ASC 740), INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2016 OR 2015. ANNUAL GALA 204906 54900 150006 4000 5934 14082 3250 10102 0 204906 54900 150006 4000 5934 14082 3250 10102 37368 112638 true true X true X true X 500. true true true false true true 2165374 2165374 0.00740 95794900 85715632 10079268 0.03450 97960274 85715632 12244642 0.04190 760185 107185 653000 0.00220 371007 0 371007 0.00130 5331415 1251020 4080395 0.01400 641120 641120 0.00220 7103727 1358205 5745522 0.01970 105064001 87073837 17990164 0.06160 2407 2407 21315 21315 0.00010 1695 803 892 21230 21230 0.00010 38289 38289 0.00010 6871 6871 91807 803 91004 0.00030 false 6646643 66826064 53580997 13245067 X true true 1 1 ST MARY MEDICAL CENTER 18300 US HIGHWAY 18 APPLE VALLEY CA 92307 www.stmaryapplevalley.com 240000207 X X X ST MARY MEDICAL CENTER 1 false false true X X X X X X X X X 13 true false false true X SEE SCHEDULE H, PART V, SECTION C X true 13 true SEE SCHEDULE H, PART V, SECTION C false true X 200. 500. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT ST. JOSEPH HEALTH, ST. MARY CONDUCTED A SERIES OF FIVE (5) FOCUS GROUPS AND AN ADDITIONAL SURVEY TO GATHER COMMUNITY INPUT AND PERSPECTIVE WITH SOLUTIONS AND PARTNERS. ONE HUNDRED AND TWENTY-EIGHT (128) LOW INCOME AND HOMELESS PERSONS IDENTIFIED PRESSING HEALTH AND SOCIAL NEEDS INCLUDING ACCESS TO MORE FOOD, HOUSING, EMPLOYMENT AND THE NEED OF EYE CARE. THE SURVEY WAS DESIGNED BY THE HOSPITAL AND CONDUCTED IN THE COMMUNITY OF VICTORVILLE WITH ASSISTANCE OF FEED MY SHEEP MINISTRIES AND THE LORD'S TABLE HOT MEAL PROGRAM. THE SURVEY WAS CONDUCTED IN THE AREA OF VICTORVILLE WHERE THE HOMELESS RESIDE. COMMUNITY LEVEL MAPPING IDENTIFIES THE NEIGHBORHOOD AS HAVING "HIGHEST NEEDS". THIRTY AFRICAN AMERICAN AND SPANISH SPEAKING RESIDENTS WERE ENGAGED IN FEEDBACK SESSIONS HOSTED BY THE INSTITUTE FOR PUBLIC STRATEGIES IN VICTORVILLE AND HIGH DESERT OUTREACH IN ADELANTO. FINALLY, THE COMMUNITIES OF ADELANTO HAVE BEEN DESIGNATED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AS A MEDICALLY UNDERSERVED AREA WITH BARSTOW DESIGNATED AS BEING A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA AND A MENTAL HEALTH PROFESSIONAL SHORTAGE AREA. THE HOSPITAL SELECTED SURVEYING THE HOMELESS AFTER SUPPORTING SAN BERNARDINO COUNTYS DEPARTMENT OF BEHAVIORAL HEALTHS OFFICE OF HOMELESS SERVICES COLLABORATIVE EFFORT TO COUNT THE COUNTYS HOMELESS. A HOMELESS REPORT PRODUCED FROM THE SURVEY COUNT IDENTIFIED THE VICTOR VALLEY AS HAVING THE SECOND HIGHEST POPULATION OF CHRONICALLY HOMELESS IN SAN BERNARDINO COUNTY. ACCESS TO HEALTH SERVICES FOR HOMELESS INCLUDES EYE, ORAL AND MENTAL HEALTH. THE HOSPITAL SCHEDULES COMMUNITY INPUT MEETINGS AS PART OF COMPLETING TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENTS. COMMUNITY MEETINGS INCLUDE RESIDENT FOCUS GROUPS, STAKEHOLDER MEETINGS AND SURVEY AND INTERVIEWS OF TARGETED POPULATIONS. RESIDENTS ARE INVITED TO THESE MEETINGS WITH THE ASSISTANCE OF COMMUNITY ORGANIZATIONS THE HOSPITAL PARTNERS WITH. EXAMPLE PARTNERS INCLUDE CHURCHES, FOOD PROGRAMS, SCHOOLS AND COMMUNITY RESOURCE CENTERS. DATA FROM EACH TYPE OF MEETING IS PROVIDED TO THE HOSPITALS COMMUNITY BENEFIT COMMITTEE FOR DISCUSSION. AFTER CONSIDERING COMMUNITY INPUT, THE COMMITTEE MAKES A FINAL DETERMINATION ON THREE TO FOUR PRIORITY INITIATIVES IT WILL UNDERTAKE IN ITS COMMUNITY BENEFIT INVESTMENT PLAN. DURING COMMUNITY MEETINGS RESIDENTS AND LEADERS REVIEW HEALTH AND SOCIOECONOMIC DATA COLLECTED BY THE HOSPITAL. HEALTH DATA SHARED INCLUDES THE PREVALENCE OF CHRONIC DISEASE ACROSS A RANGE OF DISEASES INCLUDING, BUT NOT LIMITED TO: ASTHMA, DIABETES, HEART DISEASE, MENTAL HEALTH, OBESITY, TOBACCO AND ADDICTION. ADDITIONALLY, SOCIOECONOMIC DATA IS SHARED. THIS DATA INCLUDES, BUT IS NOT LIMITED TO: EDUCATION LEVELS, HOUSING, POVERTY RATES, ACCESS TO FOOD STAMPS. WHEN SHARING DATA RESIDENTS PRIORITIZE WHICH ISSUES MOST IMPACT THEM AND THEIR COMMUNITY. THIS PRIORITIZATION IS SHARED WITH THE HOSPITAL. BECAUSE THE HOSPITAL SERVES MULTIPLE COMMUNITIES IN ITS PRIMARY AND SECONDARY SERVICE AREAS, SEVERAL COMMUNITY MEETINGS ARE SCHEDULED IN AN EFFORT TO REACH EACH COMMUNITY. MULTIPLE COMMUNITY MEETINGS ENABLES THE HOSPITAL TO IDENTIFY COMMON THEMES OF "NEED" ACROSS THE SERVICE AREAS. FOR EXAMPLE, COMMUNITY SAFETY AND THE AVAILABILITY OF JOBS ARE COMMON THEMES AMONG RESIDENTS LIVING IN POOR COMMUNITIES. ADDITIONALLY, THE HOSPITAL SCHEDULES A COMMUNITY MEETING WITH LEADERS OF THE REGION INCLUDING EXECUTIVES OF LOCAL AND COUNTY GOVERNMENT AND NON-PROFIT SERVICE ORGANIZATIONS. THIS MEETING HAS HOSTED AS MANY AS 50 ATTENDEES. THIS MEETING ENABLES THE HOSPITAL TO RECEIVE NON-HEALTHCARE ISSUES IMPACTING HEALTH AND THE QUALITY OF LIFE. FOR EXAMPLE, EXECUTIVES FROM PUBLIC TRANSIT AGENCIES PROVIDE INSIGHT ON EXPANDING PUBLIC TRANSIT TO RURAL COMMUNITIES AS A STRATEGY HELPING THE POOR AND DISABLED ACCESS HEALTH PROVIDERS NOT LOCATED IN THEIR SMALL COMMUNITY. AS A RESULT, THE HOSPITAL CAN PARTNER TO BRING GRANTS FOR IMPROVE PUBLIC TRANSPORTATION OR THE CREATION OF LOCAL RIDE SHARE PROGRAMS TARGETING RURAL COMMUNITIES WITH LIMITED OR NO ACCESS TO PHYSICIANS, ESPECIALLY SPECIALTY CARE. A COMMUNITY INPUT PLAN IS DEVELOPED FOR EACH COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED BY THE HOSPITAL. INPUT FROM THE COMMUNITY IS WRITTEN INTO EACH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN. ADDITIONALLY, COMMUNITY INPUT IS SHARED REGIONALLY INCLUDING THE COUNTY PUBLIC HEALTH, BEHAVIORAL HEALTH AND COUNTY SUPERVISORS OFFICE. BY SHARING COMMUNITY FEEDBACK REGIONALLY WITH HOSPITALS AND PUBLIC HEALTH, THE HOSPITAL HOPES TO ATTRACT PARTNERS AND FUNDING TO ADDRESS NEEDS. EXAMPLES INCLUDES GRANTS TO BUILD PARKS OR ATTRACTING PARTNERS DONATING FOOD FOR DISTRIBUTION LOCALLY. SAN BERNARDINO COUNTY PUBLIC HEALTH & HEALTHY COMMUNITY PROGRAMS: PROVIDED COUNTY LEVEL HEALTH DATA AND FEEDBACK ON LOCAL HEALTH FINDINGS AND INTERVENTIONS LOCATION: SAN BERNARDINO, CA ACADEMY FOR GRASSROOTS DEVELOPMENT: HOSTED FOCUS GROUP OF 52 VICTOR VALLEY NON-PROFITS TO DISCUSS AND HELP PRIORITIZE SIGNIFICANT HEALTH ISSUES IMPACTING VICTOR VALLEY RESIDENTS. LOCATION: PHELAN, CA AND APPLE VALLEY, CA AZUSA PACIFIC UNIVERSITY: HOSTED NURSING STUDENTS TO DISCUSS AND PRIORITIZE CHRONIC DISEASE LEVELS AND PUBLIC HEALTH ISSUES IMPACTING VICTOR VALLEY. LOCATION: VICTORVILLE, CA BARSTOW NON-PROFIT COUNCIL: HOSTED FIVE LOCAL NON-PROFITS FEEDBACK ON HEALTH ISSUES IMPACTING BARSTOW VALLEY LOCATION: BARSTOW, CA HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA: HOSTS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) & COMMUNITY BENEFIT COLLABORATIVE LOCATION: RIVERSIDE, CA HIGH DESERT OUTREACH CENTER: HOSTED FOCUS GROUP OF 18 RESIDENTS, CITY NON-PROFIT AND CITY LEADERS. LOCATION: ADELANTO, CA INSTITUTE FOR PUBLIC STRATEGIES: HOSTED RESIDENT MEETING OF EIGHT TO HELP PRIORITIZE HEALTH FINDINGS AND ADVOCATE LOCAL POLICY CHANGE. LOCATION: VICTORVILLE, CA LOMA LINDA UNIVERSITY MEDICAL CENTER: PROVIDED FEEDBACK TO LOCAL HEALTH DATA INCLUDING ADVOCACY ON INTERVENTIONS AND POLICY, HOSTED UCLA LOCATION: REDLANDS, CA LORDS TABLE & FEED MY SHEEP MINISTRIES: HOSTED HOMELESS SURVEYS OF 128 LOW INCOME RESIDENTS ON HEALTH AND SOCIAL NEEDS. LOCATION: VICTORVILLE, CA KAISER PERMANENTE: PROVIDED HEALTH FINDINGS FROM ITS CHNA FOR FONTANA HOSPITAL. LOCATION: FONTANA, CA ST. JOSEPH HEALTH: PROVIDED TECHNICAL ASSISTANCE CONDUCTING CHNA INCLUDING HEALTH SURVEY DESIGN AND COMMUNITY MAPPING. LOCATION: IRVINE, CA UCLA FIELDING SCHOOL OF PUBLIC HEALTH HEALTH FORECASTING PROJECT: PROVIDED FORECASTING AND MODELING DATA FOR LOCAL HEALTH CONDITIONS TO DEVELOP LONG-TERM PERSPECTIVE ON POPULATION HEALTH, RESOURCE NEEDS AND IDENTIFICATION OF WHICH POLICIES AND INTERVENTIONS HAVE GREATEST IMPACT. LOCATION: LOS ANGELES, CA VICTOR VALLEY TRANSIT AUTHORITY: PROVIDED TECHNICAL INPUT ON PUBLIC TRANSIT OF POOR. LOCATION: HESPERIA, CA SCHEDULE H, PART V, SECTION B, LINE 7A CHNA WEBSITE ADDRESS http://www.stmaryapplevalley.com/documents/Community-Benefit/2014-Communit y-Health-Needs-Assessment-Report.pdf SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE ADDRESS HTTP://WWW.STMARYAPPLEVALLEY.COM/DOCUMENTS/COMMUNITY-BENEFIT/FY15-17-ST-MA RY-CB-AND-IS-REPORT.PDF SCHEDULE H, PART V, SECTION B, LINE 11 IN FY16 ST. JOSEPH HEALTH, ST. MARY (SMMC OR SJH, ST. MARY) IMPLEMENTED THE FOLLOWING STRATEGIES ADDRESSING PRIORITIES AS DEVELOPED IN ITS FY15-FY17 COMMUNITY BENEFIT IMPLEMENTATION PLAN. 1. EXPANDING ACCESS TO CARE TO THE POOR - PROVIDED A TOTAL OF 28,764 CLINICAL ENCOUNTERS INCLUDING 2,826 ENCOUNTERS PROVIDED WITH MOBILE MEDICAL SERVICES FOR PRIMARY AND SPECIALTY CARE - SECURED A SECOND MOBILE MEDICAL TO EXPAND CARE IN FY17 2. EXPANDING DIABETES CARE TO THE POOR - PROVIDED 2,126 TOTAL CLINICAL ENCOUNTERS FOR DIABETES CARE - 75 PATIENTS MANAGING UNCONTROLLED DIABETES THROUGH EDUCATION AND COUNSELING - EXPANDED PARTNERSHIP WITH SPECIALTY CARE AND CENTERS OF EXCELLENCE PROGRAMS 3. IMPROVING MENTAL HEALTH - PROVIDED 2,299 TOTAL CLINICAL ENCOUNTERS PROVIDING MENTAL HEALTH CARE - IDENTIFIED ONE POLICY CHANGE PROPOSING TELE-PSYCHIATRY FOR EMERGENCY ROOM CARE - COUNSELING FOR DEPRESSION AND PTSD NOW PART OF LOCAL ADDICTION RECOVERY PROGRAM 4. DECREASING OBESITY - PROVIDED 5,289 TOTAL ENCOUNTERS FOR OBESITY INCLUDING PHYSICAL ACTIVITY AND WEIGHT LOSS CAMPAIGNS - ELEVEN FAITH BASED PARTNERS PROVIDING FRUITS AND VEGETABLES TO THE POOR AS PART OF HEALTH PROMOTION EFFORT ADDRESSING SPIRITUAL, MENTAL AND PHYSICAL NEEDS OF COMMUNITY DUE TO THE FAST PACE AT WHICH THE COMMUNITY AND HEALTH CARE INDUSTRY CHANGE, ST. JOSEPH HEALTH, ST. MARY ANTICIPATES THAT IMPLEMENTATION STRATEGIES MAY EVOLVE AND THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE ST. JOSEPH HEALTH, ST. MARY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). ON AN ANNUAL BASIS ST. JOSEPH HEALTH, ST. MARY EVALUATES ITS COMMUNITY BENEFIT PLAN, SPECIFICALLY ITS STRATEGIES AND RESOURCES, AND MAKES ADJUSTMENTS AS NEEDED TO ACHIEVE ITS GOALS/OUTCOME MEASURES, AND TO ADAPT TO CHANGES IN RESOURCE AVAILABILITY. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW: - HOMELESSNESS SERVICES: THE HOSPITAL DOES NOT DIRECTLY ADDRESS HOMELESSNESS; HOWEVER IT PARTNERS WITH LOCAL SHELTERS AND AGENCIES PROVIDING THIS CARE. THE HOSPITAL HAS STAFF ON THE BOARDS OF LOCAL PROGRAMS OPERATING THE HIGH DESERT HOMELESS SHELTER AND A BETTER WAY DOMESTIC VIOLENCE SHELTER. IN FY16 HOSPITAL LEADERSHIP ASSISTED IN PROCESSING A SHORT-TERM LOAN ENABLING THE HOMELESS SHELTER TO COMPLETE $15,900 IN FACILITY UPGRADES. WHERE POSSIBLE, THE HOSPITAL ASSISTS WITH GRANT SUPPORT. ADDITIONALLY, THE HOSPITAL PROVIDES ADVOCACY TO THE SAN BERNARDINO COUNTY DEPARTMENT OF BEHAVIORAL HEALTHS OFFICE OF HOMELESS SERVICES AND THE COUNTYS INTERAGENCY TASKFORCE ADDRESSING HOMELESSNESS. A COUNTY-WIDE COLLABORATIVE EFFORT IS UNDERWAY TO OBTAIN MENTAL HEALTH FUNDING (PROPOSED UNDER AB 1618) TO PROVIDE AFFORDABLE HOUSING TO A TARGET POPULATION OF HOMELESS WHO ARE MENTALLY ILL. INTERESTED HEALTHCARE PARTNERS INCLUDE THE HOSPITAL, KAISER PERMANENTE AND THE COUNTYS MAJOR MANAGED MEDI-CAL PROVIDER: INLAND EMPIRE HEALTH PLAN (IEHP). - TRANSPORTATION: THE HOSPITAL DOES NOT PROVIDE THE PUBLIC FREE OR DISCOUNTED TRANSPORTATION WITH THE EXCEPTION OF OPERATING A MOBILE BUS TRANSPORTING PATIENTS TO THE HOSPITALS COMMUNITY CLINICS ON A CASE-BY-CASE BASIS. ADDITIONALLY, THE HOSPITAL SUBSIDIZES TRANSPORTATION ON A CASE-BY-CASE BASIS FOR PATIENTS DISCHARGED TO HOME OR TRANSFERRED FOR FOLLOW-ON CARE. THE HOSPITAL DOES PARTNER WITH LOCAL AGENCIES INCLUDING THE VICTOR VALLEY TRANSPORTATION AUTHORITY (VVTA) AND VICTOR COMMUNITY SERVICES COUNCIL (VCSC). BOTH PARTNERS OFFER PROGRAMS ASSISTING POOR SENIORS AND THE DISABLED TO ACCESS HEALTH AND SOCIAL SERVICES. VCSC ROUTINELY TRANSPORTS PATIENTS TO THE HOSPITALS WOUND CARE PROGRAM. ADDITIONALLY, VVTA DONATES BUSES TO PROGRAMS PROVIDING TRANSPORTATION TO THE POOR AND NOW REIMBURSES PERSONS FOR TRANSPORTING PATIENTS TO THEIR HEALTH APPOINTMENTS. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP IS MADE WIDELY AVAILABLE AT: HTTP://WWW.STMARYAPPLEVALLEY.COM/DOCUMENTS/FINANCIAL-ASSISTANCE-POLICY.PDF SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION FORM IS MADE WIDELY AVAILABLE AT: HTTP://WWW.STMARYAPPLEVALLEY.COM/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FI NANCIAL-ASSISTANCE-APPLICATION-SCAL-ENGLISH_3.8.16.PDF SCHEDULE H, PART V, SECTION B, LINES 16c A PLAIN LANGUAGE SUMMARY OF THE FAP IS MADE WIDELY AVAILABLE AT: http://www.stmaryapplevalley.com/documents/Patient-Financial-Assistance/St Mary_FABrochure_2016.pdf SCHEDULE H, PART V, SECTION B, LINE 16I THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA. SCHEDULE H, PART V, SECTION B, LINE 22D FOR PATIENTS WITH A FAMILY INCOME BETWEEN 201% AND 350% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USED MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR PATIENTS WITH A FAMILY INCOME BETWEEN 351% AND 500% OF FPG, THE HOSPITAL FACILITY USED THE AVERAGE OF NEGOTIATED COMMERCIAL INSURANCE RATES TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED. 5 OUTPATIENT SURGERY PAVILLION 18122 US HIGHWAY 18 APPLE VALLEY CA 92307 AMBULATORY SURGERY CENTER WOUND CARE CENTER 16077 KAMANA ROAD APPLE VALLEY CA 92307 WOUND CARE HEALTHY BEGINNINGS CLINIC 18977 S OUTER HWY 18 A APPLE VALLEY CA 92307 CLINIC ADELANTO CLINIC 11424 CHAMBERLAIN WAY STE 89 ADELANTO CA 92301 CLINIC HESPERIA CLINIC 17091 MAIN STREET STE 100 HESPERIA CA 92345 CLINIC SCHEDULE H, PART I, LINE 3C IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO DISABILITY AND HOMELESSNESS. SCHEDULE H, PART I, LINE 6A ST. MARY MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT http://www.stmaryapplevalley.com/documents/Community-Benefit/FY16_SMMC_Com munityBenefit_Report_Final.pdf SCHEDULE H, PART I, LINE 7 THE COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COST OF ALL REPORTED CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. IT INCLUDED ALL PATIENT TYPES (I.E. INPATIENT OUTPATIENT, EMERGENCY ROOM), AND WOULD ONLY INCLUDE CHARGES OR RELATED COSTS THAT PERTAIN TO EACH RESPECTIVE AREA (I.E. CHARITY, MEDICAID, MANAGED CARE, PRIVATE INSURANCE, SELF PAY, UNINSURED, ETC.). FOR UNREIMBURSED COSTS, THAT WOULD BE THE DIFFERENCE BETWEEN THE DETERMINED COSTS LESS PAYMENTS RECEIVED FOR THAT PARTIAL PAYOR GROUP. THE COSTS USED WERE NOT DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES COMMUNITY BUILDING ACTIVITIES INCLUDED ENVIRONMENTAL IMPROVEMENTS. A GROUP OF CONCERNED ADELANTO CITIZENS ORGANIZED A "CLEAN UP ADELANTO" DAY AFTER THEY DECIDED THAT THE UNCLEANLINESS OF THE STREETS DETERRED THEM FROM FEELING SAFE AND WILLING TO DO PHYSICAL ACTIVITY WITHIN THEIR OWN COMMUNITY. THIS EFFORT HAD A POSITIVE RESPONSE THAT IT IS NOW PLANNED ON A QUARTERLY BASIS, WITH CITY OFFICIALS, COUNTY OFFICIALS AND CONCERNED CITIZENS MENDED HEARTS SATELLITE AND PLANNED MONTHLY MEETINGS WITH HEART EXPERTS, AS SPEAKERS, TO TRAIN VOLUNTEERS DOING PEER TO PEER SUPPORT TO PATIENTS, FAMILY MEMBERS AND CAREGIVERS DOING HOSPITAL VISITS. LOCAL ADVOCACY ON ADDRESSING HOMELESS ISSUES. VICTORVILLE HAS THE SECOND HIGHEST HOMELESS POPULATION IN SAN BERNARDINO COUNTY WITH MANY REPORTING MENTAL HEALTH ISSUES AS WELL. ADVOCACY ALSO INCLUDED INCREASING ACCESS AND AWARENESS ON MENTAL HEALTH. TWO TRAININGS FOR FAITH BASED ORGANIZATIONS WERE DONE. THE FIRST TITLED, "MENTAL HEALTH" FIRST AID TRAINING AND THE SECOND "SUICIDE PREVENTION" TRAINING. ADVOCACY ALSO MEANT MEETING WITH THE LOCAL DEPARTMENT OF PUBLIC HEALTH, SAN BERNARDINO TO BRING MORE SERVICES TO THE HIGH DESERT REGION AND MEETING WITH OTHER PROVIDERS TO IDENTIFY GAPS AND REPORTING THESE FINDINGS BACK TO THE PUBLIC HEALTH DEPARTMENT. ADVOCACY ALSO INCLUDED PROVIDING GRANTS TO LOCAL NON-PROFITS TO ADDRESS MENTAL HEALTH ISSUES. ONE PROGRAM ADDRESSING SUBSTANCE ABUSE ISSUES, MANY OF THE PARTICIPANTS CLASSIFYING THEMSELVES AS HOMELESS, AND ANOTHER PROGRAM WORKING WITH TROUBLED YOUTH TO PROVIDE INDIVIDUAL AND FAMILY COUNSELING TO IMPROVE FAMILY RELATIONSHIPS AND SOCIAL BONDS. SCHEDULE H, PART III, LINE 2 METHODOLOGY FOR CALCULATING BAD DEBT THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS RECEIVED A 100 PERCENT WRITE-OFF OF THE BALANCE DUE. AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, LINE 4 FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT THE HEALTH SYSTEM RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE HEALTH SYSTEM BELIEVES THERE ARE NO SIGNIFICANT CREDIT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED PAYORS ARE FROM VARIOUS PAYORS WHO ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE HEALTH SYSTEM. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM REGULARLY ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, LINE 8 BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING CMS STANDARD COSTING METHODS. THIS INCLUDES STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. SCHEDULE H, PART III, LINE 9B PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT IN FY16 THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES ADDRESSING PRIORITIES AS DEVELOPED IN ITS FY15-FY17 COMMUNITY BENEFIT IMPLEMENTATION PLAN. 1. EXPANDING ACCESS TO CARE TO THE POOR - PROVIDED A TOTAL OF 28,764 CLINICAL ENCOUNTERS INCLUDING 2,826 ENCOUNTERS PROVIDED WITH MOBILE MEDICAL SERVICES FOR PRIMARY AND SPECIALTY CARE - SECURED A SECOND MOBILE MEDICAL TO EXPAND CARE IN FY17 2. EXPANDING DIABETES CARE TO THE POOR - PROVIDED 2,126 TOTAL CLINICAL ENCOUNTERS FOR DIABETES CARE - 75 PATIENTS MANAGING UNCONTROLLED DIABETES THROUGH EDUCATION AND COUNSELING - EXPANDED PARTNERSHIP WITH SPECIALTY CARE AND CENTERS OF EXCELLENCE PROGRAMS 3. IMPROVING MENTAL HEALTH - PROVIDED 2,299 TOTAL CLINICAL ENCOUNTERS PROVIDING MENTAL HEALTH CARE - IDENTIFIED ONE POLICY CHANGE PROPOSING TELE-PSYCHIATRY FOR EMERGENCY ROOM CARE - COUNSELING FOR DEPRESSION AND PTSD NOW PART OF LOCAL ADDICTION RECOVERY PROGRAM 4. DECREASING OBESITY - PROVIDED 5,289 TOTAL ENCOUNTERS FOR OBESITY INCLUDING PHYSICAL ACTIVITY AND WEIGHT LOSS CAMPAIGNS - ELEVEN FAITH BASED PARTNERS PROVIDING FRUITS AND VEGETABLES TO THE POOR AS PART OF HEALTH PROMOTION EFFORT ADDRESSING SPIRITUAL, MENTAL AND PHYSICAL NEEDS OF COMMUNITY ON AN ANNUAL BASIS ST. JOSEPH HEALTH, ST. MARY EVALUATES ITS COMMUNITY BENEFIT PLAN, SPECIFICALLY ITS STRATEGIES DUE TO THE FAST PACE AT WHICH THE COMMUNITY AND HEALTH CARE INDUSTRY CHANGE, ST. JOSEPH HEALTH, ST. MARY ANTICIPATES THAT IMPLEMENTATION STRATEGIES MAY EVOLVE AND THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE ST. JOSEPH HEALTH, ST. MARY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). ALSO ON AN ANNUAL BASIS, ST. JOSEPH HEALTH, ST. MARY EVALUATES ITS COMMUNITY BENEFIT PLAN AND MAKES ADJUSTMENTS AS NEEDED TO ACHIEVE ITS GOALS/OUTCOME MEASURES, AND TO ADAPT TO CHANGES IN RESOURCE AVAILABILITY. A CHARTER APPROVED IN 2007 ESTABLISHES THE FORMULATION OF THE COMMUNITY BENEFIT COMMITTEE AT ST. JOSEPH HEALTH, ST. MARY. THE ROLE OF THE COMMUNITY BENEFIT COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT ISSUES. THE COMMITTEE ACTS IN ACCORDANCE WITH A BOARDAPPROVED CHARTER. THE COMMUNITY BENEFIT COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS IDENTIFIED NEEDS IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORTS, AND OVERSEEING AND DIRECTING THE COMMUNITY BENEFIT ACTIVITIES. THE COMMUNITY BENEFIT COMMITTEE HAS A MINIMUM OF EIGHT MEMBERS INCLUDING THREE MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES SIX MEMBERS OF THE BOARD OF TRUSTEES AND SEVEN COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY BENEFIT COMMITTEE GENERALLY MEETS QUARTERLY. THE HOSPITAL DEVELOPS A COMMUNITY HEALTH NEEDS ASSESSMENT PLAN IN PARTNERSHIP WITH ITS CORPORATE OFFICE. PLAN ELEMENTS INCLUDE, BUT ARE NOT LIMITED TO: THE TYPES OF HEALTH DATA RESOURCES THAT WILL BE RESEARCHED AT THE NATIONAL, COUNTY AND LOCAL LEVELS, THE USE OF OTHER HEALTH AND SOCIAL ASSESSMENTS PRODUCED BY OUTSIDE PARTNERS, USE OF HOSPITAL ADMISSION AND ER DISCHARGE DATA, THE MAPPING OF COMMUNITY NEED ACROSS THE PRIMARY AND SECONDARY SERVICE AREAS AND AT THE NEIGHBORHOOD LEVEL AND THE LIMITATIONS OF DATA ESPECIALLY FOR SMALL COMMUNITIES WITH POPULATION SIZES BELOW 5,000. EXAMPLES OF LARGE DATA SOURCE INCLUDE THE US CENSUS, AMERICAN COMMUNITY SURVEY AND THE HEALTHY COUNTY RANKINGS. AN EXAMPLE NATIONAL HEALTH BENCHMARK TO REFERENCE LOCAL HEALTH AND SOCIAL CONDITIONS WOULD BE HEALTHY PEOPLE 2020. THE HOSPITAL AND CORPORATE OFFICE DEVELOP A TEAM OF STAFF WHO COLLECT AND ANALYZE DATA AND DEVELOP COMMUNITY MAPS. A DRAFT OF THE DATA IS REVIEWED AS A TEAM AND SHARED WITH THE HOSPITALS COMMUNITY BENEFIT COMMITTEE. COMMITTEE INPUT OF THE DRAFT PLAN ALLOWS THE NEEDS ASSESSMENT TEAM TO COLLECT ADDITIONAL DATA IF NEEDED OR PROVIDE INPUT ON THE PLAN TO CONDUCT COMMUNITY MEETINGS. DATA IS PREPARED BY THE ASSESSMENT TEAM AND A COMMUNITY PRESENTATION IS DEVELOPED. IN ADDITION TO CONDUCTING TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENTS, THE HOSPITAL CONDUCTS PERIODIC FOCUS GROUPS WITH COMMUNITY RESIDENTS IN ORDER TO KEEP CURRENT WITH THE REQUEST FOR SPECIFIC HEALTH SERVICES ESPECIALLY IN POOR COMMUNITIES. THESE FOCUS GROUPS ENABLE THE HOSPITAL TO BRING UNIQUE CLINICAL RESOURCES TO WEEKEND HEALTH FAIRS AT THE REQUEST OF RESIDENTS. RESIDENT FOCUS GROUPS PROVIDE HOSPITAL PROGRAMS WITH CONTINUOUS INSIGHT ON THE COMPLEX SOCIO-ECONOMIC NEEDS OF PERSONS ATTEMPTING TO ACCESS HEALTH PROMOTION PROGRAMS. THESE MEETINGS ARE ALSO OPPORTUNITIES WHERE THE HOSPITAL CAN CREATE RESIDENT ADVOCATES TO ASSIST IN BRINGING COMMUNITY CHANGE RESULTING IN SAFER STREETS, A NEW PARK, EXERCISE EQUIPMENT OR THE NEED FOR A INDOOR RECREATION CENTER. FOCUS GROUP FEEDBACK IS PROVIDED TO THE HOSPITALS COMMUNITY BENEFIT COMMITTEE AND TO STAFF OPERATING COMMUNITY CLINICS AND HEALTH PROGRAMS. FINALLY, THE HOSPITAL OBTAINS COMMUNITY NEEDS FEEDBACK FROM PARTICIPATING IN HEALTHY CITY CAMPAIGNS. THESE CITY LEVEL CAMPAIGNS BRING TOGETHER DIFFERENT SECTORS OF A CITY TO DISCUSS HEALTH AND QUALITY OF LIFE CONCERNS. BY ATTENDING THESE MEETINGS THE HOSPITAL STAYS CURRENT ON THE NEEDS OF THE COMMUNITY AND IS ABLE TO WORK TO BUILD THE CAPACITY OF THOSE WORKING TOGETHER TO ADDRESS NEEDS. FOR EXAMPLE, THE HOSPITAL HAS USED FEEDBACK FROM OPERATORS OF FOOD PROGRAMS TO ASSIST IN OBTAINING DONATED PRODUCE AND GRANTS TO INCREASE COLD STORAGE OF DONATED FOODS. ADDITIONALLY, SCHEDULING CLINICAL STAFF TO ATTEND FOOD PROGRAMS IS MADE POSSIBLE BY STAYING CURRENT WITH FOOD GIVEAWAY DATES. THE HOSPITAL ASSESSES COMMUNITY NEED BY CONDUCTING RESIDENT FOCUS GROUPS AND BY ATTENDING HEALTHY CITY MEETINGS. THIS INTERACTION ALLOWS HOSPITAL STAFF TO CUSTOMIZE BRINGING CLINICAL SCREENINGS AND EDUCATION TO TARGETED NEIGHBORHOODS. ADDITIONALLY, BY ATTENDING HEALTHY CITY MEETINGS THE HOSPITAL STAYS CURRENT WITH THE NEEDS OF RESIDENTS THAT ARE BOTH HEALTH AND NON-HEALTH RELATED. EXAMPLES INCLUDE, CRIME, STREET SAFETY, CRIME AND WORKFORCE DEVELOPMENT. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION THE SJH ST. MARY COMMUNITY BENEFIT SERVICE AREA IS DEFINED AS SERVING THE VICTOR VALLEY REGION OF SAN BERNARDINO COUNTY WITH A TOTAL POPULATION OF 430,795 AS REPORTED BY 2010 U.S CENSUS DATA. THE LARGER COMMUNITIES OF APPLE VALLEY, HESPERIA AND VICTORVILLE COMPRISE THE HOSPITALS PRIMARY SERVICE AREA AND THE SMALLER COMMUNITIES OF ADELANTO, BARSTOW, HELENDALE, LUCERNE VALLEY, ORO GRANDE, PHELAN AND OAK HILLS AND WRIGHTWOOD MAKE-UP THE HOSPITALS SECONDARY SERVICE AREA. THE HOSPITALS PRIMARY AND SECONDARY SERVICE AREAS CURRENTLY SERVE RESIDENTS OF THREE (3) OF SAN BERNARDINO COUNTYS FIVE (5) SUPERVISORY DISTRICTS. THE REGION IS 90% DESERT AND THE LARGEST NEAREST METROPOLITAN AREA, THE CITY OF SAN BERNARDINO, IS 40 MILES AWAY. THE SERVICE AREA IS NOTED AS HAVING SIGNIFICANTLY HIGHER PERCENTAGES OF INDIGENT AND UNINSURED POPULATIONS WHEN COMPARED WITH BOTH STATE AND NATIONAL LEVELS. ADDITIONALLY, RESIDENTS SUFFER FROM HEART DISEASE, DIABETES, ADULT OBESITY AND STROKE AT LEVELS WELL ABOVE CALIFORNIA AND NATIONAL BENCHMARKS. OVER 90% OF THE HOSPITALS COMMUNITY BENEFIT AREA HAS BEEN IDENTIFIED AS "HIGH NEED" FROM SCORING AND AGGREGATING SOCIOECONOMIC INDICATORS (E.G. INCOME, RACE, FAMILY SIZE) CONTRIBUTING TO HEALTH DISPARITIES. AREAS WITHIN THE HOSPITALS PRIMARY AND SECONDARY SERVICE AREAS ARE LISTED AS MEDICALLY UNDERSERVED AREAS INCLUDING THE COMMUNITY OF BARSTOW AND ADELANTO. ADDITIONALLY, THE REGION IS LISTED AS A MEDICAL HEALTH PROFESSIONAL SHORTAGE AREA FOR MENTAL HEALTH. WITH SOME EXCEPTIONS, THESE HEALTH AND SOCIAL CONDITIONS ARE LARGELY HOMOGENOUS ACROSS SAN BERNARDINO COUNTY. FOR THIS REASON NONPROFIT HOSPITALS IN SAN BERNARDINO ARE REPORTING SIMILAR INCREASES IN CHRONIC DISEASES AND OVERWHELMED SAFETY NET PROVIDERS. APPLE VALLEY HAS 69,135 RESIDENTS AS REPORTED BY THE 2010 CENSUS. THE TOWN IS THE HOME COMMUNITY TO SJH, ST. MARY. THE TOWN IS 73.5 SQUARE MILES AT AN ELEVATION OF 2,946 FEET WITH 23,598 HOUSEHOLDS WITH 69% WHITE, 29.2% HISPANIC AND 9.1% BLACK AND 2.9% ASIAN. APPROXIMATELY 31% OF RESIDENTS ARE BETWEEN THE AGES OF 0-19 YEARS JUST HIGHER THAN THE COUNTY AVERAGE AND RESIDENTS AGED 50 TO 85 YEARS (A TOTAL OF 35%) MAKE UP A HIGHER PERCENTAGE OF RESIDENTS THAN REPORTED AT THE COUNTY AND STATE LEVEL. THE SENIOR COMMUNITY HAS A HIGH PREVALENCE OF ADULT OBESITY, PROBLEMS ACCESSING SPECIALTY CARE, DIABETES AND PHYSICAL LIMITATIONS. ASIAN HOUSEHOLD INCOME IS REPORTED AT $86,719 WHICH IS HIGHER THAN COUNTY AND STATE LEVELS. MEDIAN HOUSEHOLD INCOME IS $56,547 WHICH IS HIGHER THAN THE COUNTY BUT LOWER THAN THE STATE LEVEL. HISPANICS AND BLACKS SUFFER UNEMPLOYMENT RATES OF 17.0% AND 20.9% RESPECTIVELY, NEARLY DOUBLE THE 9% RATE FOR WHITE RESIDENTS. VICTORVILLE - THE STATE OF CALIFORNIAS 50TH LARGEST CITY HAS A 2010 US CENSUS REPORTED POPULATION OF 115,903. THE CITY IS APPROXIMATELY 74 SQUARE MILES IN SIZE AT AN ELEVATION OF 2,726 FT. DEMOGRAPHIC DATA REPORTS 47.8% OF RESIDENTS ARE HISPANIC WITH WHITE 28.3% FOLLOWED BY BLACKS AT 16%. OVER 30% OF RESIDENTS ARE BETWEEN THE AGES OF 0 TO 19 YEARS OF AGE WHICH AS A PERCENTAGE IS LARGER THAN REPORTED AT THE COUNTY LEVEL. ECONOMIC DATA REPORTS THE MEDIAN INCOME IN VICTORVILLE IS $52,983 (AMONG AFRICAN AMERICAN FAMILIES JUST $44,767) WITH POVERTY HIGHEST (30%) IN AFRICAN AMERICAN FAMILIES FOLLOWED BY HISPANIC (16%) AND WHITE (9%). HESPERIA - HAS 90,173 RESIDENTS AS REPORTED BY THE 2010 CENSUS. THE CITY IS 73 SQUARE MILES AT AN ELEVATION OF 3,186 FEET. THE CITY HAS NO HOSPITAL AND RESIDENTS ARE DEPENDENT ON ACCESSING ACUTE CARE AT VICTORVILLE AND APPLE VALLEY HOSPITALS 10 TO 15 MILES AWAY. THERE ARE A REPORTED 26,431 HOUSEHOLDS WITH 21.9% OF BLACK FAMILIES LIVING IN POVERTY FOLLOWED BY 20.9% FOR HISPANIC AND 9.6% FOR WHITE FAMILIES. THESE POVERTY RATES ARE HIGHER THAN COUNTY AND STATE LEVELS. HOUSEHOLD INCOME IS $51,676, (LOWER THAN COUNTY AND STATE LEVELS) WITH HISPANIC FAMILY INCOME REPORTED AT $42,897, BLACK AT $49,185 AND WHITE AT $61,795. AN ESTIMATED 35.8% OF RESIDENTS ARE BETWEEN THE AGES OF 0-19 YEARS OF AGE A HIGHER PERCENTAGE THAN REPORTED AT THE COUNTY AND STATE LEVEL. THE PERCENTAGE OF STUDENTS WHO ARE REPORTED AS OVERWEIGHT/OBESE IS 41% SLIGHTLY HIGHER THAN THE COUNTY AND STATE RATINGS OF 39.3% AND 38% RESPECTIVELY. ADELANTO HAS 31,765 RESIDENTS AS REPORTED BY THE 2010 CENSUS. THE CITY IS 56 SQUARE MILES AND AT AN ELEVATION OF 2,871 FEET WITH 58.3% HISPANIC, 43% WHITE 20% BLACK. THERE ARE 7,809 HOUSEHOLDS. OVER 40% OF RESIDENTS ARE BETWEEN THE AGES OF 0 TO 19 YEARS SEVERAL PERCENTAGE POINTS HIGHER THAN COUNTY AND STATE LEVELS AND CONVERSELY, FEWER RESIDENTS ARE AGED 50 YEARS AND OLDER THAN WHAT IS REPORTED AT COUNTY AND STATE LEVELS. THE COMMUNITY IS DESIGNATED AS MEDICALLY UNDERSERVED BY HRSA. MEDIAN HOUSEHOLD INCOME IS $41,475 WITH BLACK FAMILIES EARNING THE LOWEST - ONLY $28,310, WHICH IS ALMOST HALF THE COUNTY AND STATE RATE FOR BLACK HOUSEHOLDS. UNEMPLOYMENT IS 15.75% AND AS HIGH AS 28.8% FOR HOUSEHOLDS OF TWO OR MORE RACES. THE CITY HAS FEW EMPLOYERS, OR COLLEGE, VERY FEW RETAILERS GENERATING SALES TAX REVENUE, WITH SEVERAL PRISONS IN OPERATION. ONLY 11.5% OF RESIDENTS ARE REPORTED TO HAVE ATTAINED COLLEGE DEGREES, SIGNIFICANTLY LESS THAN THE COUNTY AND STATE LEVELS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH ST. JOSEPH HEALTH, ST. MARY (SMMC) IS AN ACUTE-CARE HOSPITAL FOUNDED IN 1956, LOCATED IN APPLE VALLEY SERVING THE HIGH DESERT REGION. ST. JOSEPH HEALTH, ST. MARY PROVIDES VITAL HOSPITAL AND COMMUNITY SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE (TRADITIONAL CHARITY CARE) AND DISCOUNTED CARE. ST. JOSEPH HEALTH, ST. MARY IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES, 2) AN OPEN MEDICAL STAFF AND 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ARE IN PART FUNDED BY CARE FOR THE POOR DOLLARS. SMMC IS A HEALING MINISTRY OF ST. JOSEPH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. ST. JOSEPH HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPITAL CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE IN THE COMMUNITIES WE SERVE. LOCAL COMMUNITY BENEFIT COMMITTEE: THE ROLE OF THE SMMC COMMUNITY BENEFIT COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE COMMITTEE ACTS IN ACCORDANCE WITH A BOARD-APPROVED CHARTER. THE COMMUNITY BENEFIT COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS IDENTIFIED NEEDS IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORTS, AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES. THE COMMUNITY BENEFIT COMMITTEE HAS A MINIMUM OF EIGHT MEMBERS INCLUDING THREE MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES THREE MEMBERS OF THE BOARD OF TRUSTEES AND EIGHT COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY BENEFIT COMMITTEE GENERALLY MEETS BI-MONTHLY. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM ST. JOSEPH HEALTH, ST. MARY IS A HEALING MINISTRY OF ST. JOSEPH HEALTH, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITIES IT SERVES. SJH COMMUNITY PARTNERSHIP FUND (FKA ST. JOSEPH HEALTH SYSTEM FOUNDATION) IN 1986, ST. JOSEPH HEALTH SYSTEM CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND (FORMERLY KNOWN AS THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. EVERY YEAR, EACH ST. JOSEPH HEALTH HOSPITAL CONTRIBUTES 10% TEN PERCENT OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND TO SUPPORT OUTREACH EFFORTS FOR THE ECONOMICALLY POOR. IN FY16 THIS AMOUNT TOTALED $2,104,600 FOR ST. JOSEPH HEALTH, ST. MARY. 75% OF THE CONTRIBUTIONS ARE USED TO SUPPORT CARE FOR POOR PROGRAMS BY EACH HOSPITAL. 17.5% OF FUNDS ARE USED TO SUPPORT ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND INITIATIVES. THE REMAINING 7.5% ARE DESIGNATED TOWARD AN ENDOWMENT WHICH HELPS ENSURE THE FUNDS ABILITY TO SUSTAIN PROGRAMS INTO THE FUTURE THAT ASSIST LOW-INCOME AND UNDERSERVED POPULATIONS. COMMUNITY INVESTMENT FUND ST. JOSEPH HEALTH FURTHERMORE RECOGNIZES THAT THE HEALTH OF ANY COMMUNITY DEPENDS ON THE MAINTENANCE AND CREATION OF STRONG STRUCTURES- BOTH PHYSICAL AND SOCIAL- THAT CONTRIBUTE TO THE LONG-TERM WELL-BEING OF PEOPLE. THAT PHILOSOPHY INSPIRED THE INITIATION OF THE ST. JOSEPH HEALTH COMMUNITY INVESTMENT FUND- AN EFFORT TO ENABLE NON PROFIT 501(C)3 ORGANIZATIONS TO ACHIEVE THEIR FULL POTENTIAL AND PLAY A MAJOR ROLE IN THE GROWTH OF THEIR COMMUNITIES. THE SJH COMMUNITY INVESTMENT FUND PROVIDES CAPITAL IN THE FORM OF LOANS, DEPOSITS AND OTHER FORMS OF SUPPORT TO NON-PROFITS TO ENABLE THEM TO PROMOTE SOCIAL GOOD THROUGH THE DEVELOPMENT OF HEALTHIER COMMUNITIES. IN FY16, A TOTAL OF $11,200,000 WAS INVESTED INTO THE COMMUNITY THROUGH LOANS AND LINES OF CREDIT. TO LEARN MORE ABOUT ST. JOSEPH HEALTH GO TO STJHS.ORG SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA true CATHOLIC CHARITIES 1450 N D STREET SAN BERNARDINO CA 92405 953516461 501(c)(3) 20000 0 PROGRAM SUPPORT ST JOHN OF GOD 13333 PALMDALE RD VICTORVILLE CA 92392 953806996 501(c)(3) 27500 0 PROGRAM SUPPORT ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DR SUITE 100 IRVINE CA 92612 330143024 501(c)(3) 2104600 0 CARE FOR POOR 3 SCHEDULE I, PART I, LINE 2 DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS COMMUNITY BENEFIT COMMITTEE OVERSEES/MONITORS GRANT USAGE ON A MONTHLY BASIS. X true true false true false false false false false true false Joline Treanor Board of Director 0 428962 0 185825 0 38057 0 8975 0 12793 0 674612 0 0 Kevin Murphy Board of Director 0 260692 0 99144 0 34687 0 18550 0 32199 0 445272 0 0 Tracey Fernandez Chief Financial Officer 265689 0 76369 0 23158 0 10236 0 25216 0 400668 0 0 0 Tara Cowell Secretary 0 291327 0 113980 0 38475 0 18495 0 30318 0 492595 0 0 Dennis Haghighat MD Chief Medical Officer 299492 0 85075 0 33754 0 13250 0 10961 0 442532 0 0 0 Kelly Linden Chief Operating Officer 300795 0 85843 0 27299 0 10600 0 23836 0 448373 0 0 0 Marilyn Drone Chief Nursing Officer 242188 0 69023 0 27100 0 11863 0 18750 0 368924 0 0 0 Randy Bevilacqua VP Strategic Services 192652 0 54921 0 23561 0 15591 0 16197 0 302922 0 0 0 Jean Holtman VP Human Resources 161500 0 52796 0 18264 0 0 0 15503 0 248063 0 0 0 Judy Wagner VP Mission INTEGRATION 154733 0 44302 0 13778 0 4415 0 10976 0 228204 0 0 0 Paul Kaminski VP Foundation 148755 0 42774 0 13434 0 6071 0 22427 0 233461 0 0 0 Laurie Roberts Director Community Health 156538 0 50186 0 2430 0 16999 0 8218 0 234371 0 0 0 Marilyn Platt Certified Nurse Midwife 156365 0 28779 0 0 0 14220 0 8574 0 207938 0 0 0 Katherine Freeman Staff RN 182265 0 750 0 0 0 2930 0 9231 0 195176 0 0 0 Hans Lim Clinical Pharmacist 176242 0 423 0 4410 0 12422 0 20547 0 214044 0 0 0 Matthew Chandler Director, Clinical Pharmacy 171771 0 5518 0 2066 0 0 0 30710 0 210065 0 0 0 Alan Garrett President/CEO 0 501614 0 221973 0 73720 0 23850 0 24506 0 845663 0 0 DAVID O'BRIEN MD FORMER KEY EMPLOYEE 0 425145 0 200374 0 66755 0 16228 0 26544 0 735046 0 0 SCHEDULE J, PART I, LINE 1A SUPPLEMENTAL COMPENSATION INFORMATION TAX INDEMNIFICATION AND GROSS-UP PAYMENTS GIFT CARDS PROVIDED TO EMPLOYEES DURING CHRISTMAS AND THROUGHOUT THE YEAR FOR REWARD AND RECOGNITION ARE GROSSED UP AND TAXES ARE PAID BY THE MINISTRY. SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4B BEGINNING IN JULY 2015, NEW EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND ARE SUBJECT TO A FIVE YEAR OR AGE 65 VESTING SCHEDULE. EXECUTIVES PREVIOUSLY PARTICIPATED IN ANOTHER NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT WAS FROZEN EFFECTIVE DECEMBER 2007, AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED. THIS FROZEN PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. NO EMPLOYEES RECEIVED 457(F) PAYMENTS DURING THE YEAR. SCHEDULE J, PART I, LINE 7 A PORTION OF EXECUTIVES SALARIES ARE PLACED "AT-RISKARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS REALIZING OUR MISSION ST. JOSEPH HEALTH, ST. MARY HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 60 YEARS. SERVING THE COMMUNITIES OF ADELANTO, APPLE VALLEY, BARSTOW, HESPERIA, AND VICTORVILLE IN THE HIGH DESERT REGION IN THE COUNTY OF SAN BERNARDINO. ST JOSEPH HEALTH, ST. MARY IS AN ACUTE CARE HOSPITAL THAT PROVIDES QUALITY CARE IN THE AREAS OF 24 HOUR EMERGENCY SERVICES, COMPREHENSIVE CARDIAC SERVICES, OUTPATIENT SURGERY PAVILION, PEDIATRIC CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, COMMUNITY CLINICS AND MOBILE HEALTH SERVICES SERVING THE POOR, CHEST PAIN EMERGENCY CENTER, OPEN HEART SURGERY PROGRAM, LEVEL II NEONATAL INTENSIVE CARE, DIAGNOSTIC IMAGING SERVICES, DIABETES EDUCATION SERVICES, PHYSICAL REFERRAL SERVICES, ROBOTIC-ASSISTED SURGERY PROGRAM AND WOUND CARE AND HYPERBARIC MEDICINE. WITH OVER 1,650 EMPLOYEES COMMITTED TO REALIZING THE MISSION, ST. JOSEPH HEALTH, ST. MARY IS ONE OF THE LARGEST EMPLOYERS IN THE HIGH DESERT REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, ST. JOSEPH HEALTH, ST. MARY IS COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORSMINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBILITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. PATIENT FINANCIAL ASSISTANCE PROGRAM ST. JOSEPH HEALTH, ST. MARY BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY ST. JOSEPH HEALTH, ST. MARY HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY16, ST. JOSEPH HEALTH, ST. MARY PROVIDED $2,165,374 IN FREE AND DISCOUNTED CARE. MEDICAID PROGRAM ST. JOSEPH HEALTH, ST. MARY PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM. IN FY16, ST. JOSEPH HEALTH, ST. MARY PROVIDED $10,079,268 IN MEDICAID SHORTFALL. PROGRAM SERVICE ACCOMPLISHMENTS THE FOLLOWING THREE PRIORITY INITIATIVES REFLECTS KEY PROGRAM SERVICE ACCOMPLISHMENTS FOR ST. JOSEPH HEALTH, ST. MARY. EXPANDING DIABETES CARE INITIATIVE: ST. JOSEPH HEALTH, ST. MARY IS THE REGIONS ONLY PROVIDER OF COMPREHENSIVE DIABETES EDUCATION TO THE UNDERINSURED AND UNINSURED. EXPANDING DIABETES SERVICES ADDRESSES A CHRONIC CONDITION IMPACTING 15.3% OF THE COMMUNITY IN COMPARISON TO 8.6% STATEWIDE. AS PART OF ITS COMMUNITY BENEFIT PLAN, ST. JOSEPH HEALTH, ST. MARYS DIABETES PROGRAM ACHIEVED THE FOLLOWING: - 1,414 CLINICAL ENCOUNTERS; INCLUDING COUNSELING AND EDUCATION SESSIONS ON DIABETES SELF-CARE. IN ADDITION, PATIENTS RECEIVING PRIMARY CARE AT ST. MARY HIGH DESERT MEDICAL GROUP AND LOW INCOME AND UNINSURED PERSONS RECEIVING CARE AT THE HOSPITALS COMMUNITY CLINICS IN ADELANTO, APPLE VALLEY, HESPERIA FIX-SITE CLINICS OR THROUGH THE BRIGHT FUTURES MOBILE VAN. - ST. JOSEPH HEALTH, ST. MARY DIETITIAN WORKED WITH THE NON-PROFIT COMMUNITY HEALTH ACTION NETWORK TO PROVIDE DIABETES EDUCATION TO RESIDENTS LIVING IN LOW-INCOME NEIGHBORHOODS. - STARTING IN FEBRUARY OF 2016 LOCAL FAITH PARTNERS WERE PLACED IN CONTACT WITH FOOD FORWARD, A LOS ANGELES BASED SURPLUS PRODUCE DISTRIBUTION AGENCY. THIS NON-PROFIT PROVIDED SEVEN FAITH BASED HIGH DESERT PARTNERS WITH 14,000 LBS OF FRESH FRUITS AND VEGETABLES BI-WEEKLY TO SUPPORT CHURCH FOOD MINISTRIES THAT SERVE LOW-INCOME FAMILIES. ADDITIONALLY, OUR ADVOCACY RAISED AWARENESS OF HIGH DESERTS DESIGNATION AS A FOOD DESERT AND IS IN COMMUNICATION WITH COMMUNITY ACTION PARTNERSHIP, A SAN BERNARDINO CITY FOOD BANK, TO CREATE A FOOD HUB IN THE HIGH DESERT, WHERE LOCAL NON-PROFITS AND FAITH BASED ORGANIZATIONS WILL GATHER FRESH FRUITS AND VEGETABLES TO DISTRIBUTE IN THEIR RESPECTIVE COMMUNITIES. IMPROVING ACCESS TO CARE INITIATIVE: THE HOSPITALS COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS ACCESS CONCERNS BY 41.5% OF RESPONDENTS, AN INCREASE OVER 38.4% REPORTED IN 2007 AND SIGNIFICANTLY HIGHER THAN 37.7% REPORTED NATIONALLY. ACCESS ISSUES ARE EXACERBATED BY SAN BERNARDINO COUNTYS ONLY SAFETY NET HOSPITAL LOCATED 45 MILES FROM THE COMMUNITY. CHRONIC CONDITIONS INCLUDING POVERTY AND MENTAL ILLNESS OFTEN IMPAIR PEOPLE FROM ACCESSING CARE. ACCESS ISSUES INCLUDE, BUT ARE NOT LIMITED TO: LACK OF TRANSPORTATION, HEALTH INSURANCE AND COST RELATED ISSUES, THE SHORTAGE OF HEALTH CARE PROFESSIONALS PARTICULARLY PRIMARY CARE PROVIDERS WHO ARE BILINGUAL AND GAPS IN HEALTH. IN FY16, ST. JOSEPH HEALTH, ST. MARY ACHIEVED THE FOLLOWING: - COMPLETED 28,764 COMMUNITY CLINIC ENCOUNTERS WHILE SERVING POOR AND RURAL PERSONS LIVING IN THE HIGH DESERT REGION TOTALING $4,017,712, WHICH INCLUDES THE DIABETES INITIATIVE. IN ADDITION, 2,449 UNINSURED PERSONS WERE ENROLLED INTO COVERED CALIFORNIA OR MEDI-CAL INSURANCE. - COMMUNITY HEALTH IMPROVEMENT SERVICES IN THE HIGH DESERT TOTALED $322,273 FOR FY16, WHICH INCLUDED TRANSPORTATION, POST-ACUTE CARE FOR HOMELESS AND UNINSURED PATIENTS AND A GRANT AIMED AT CREATING HEALTHIER CITIES. IN RELATIONS TO OUR PRIORITY OF DECREASING OBESITY THE FOLLOWING RESULTS ARE WORTH MENTIONING: OBESITY INITIATIVE: IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT, ADULT OVERWEIGHT AND ADULT OBESITY HAD THE HIGHEST RECORDED PERCENT INCREASE FROM ITS 2007 BASELINE; INCREASING 6.6% (OVERWEIGHT) AND 6.1% (OBESITY). STATE BENCHMARKS ARE 36% AND 24%; HIGH DESERT RATES STAND AT 37% AND 33%, RESPECTIVELY. ST. JOSEPH HEALTH, ST. MARY RESPONDED TO THIS NEED BY IMPLEMENTING A WEIGHT LOSS AND NUTRITION PROGRAM IN THE COMMUNITIES OF ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE. IN FY16, ST. JOSEPH HEALTH, ST. MARY ACHIEVED THE FOLLOWING: - PROVIDED 5,289 TOTAL ENCOUNTERS FOR OBESITY INCLUDING PHYSICAL ACTIVITY. - ELEVEN FAITH BASED PARTNERS PROVIDING FRUITS AND VEGETABLES TO THE POOR AS PART OF THE HEALTH PROMOTION EFFORT ADDRESSING SPIRITUAL, MENTAL AND PHYSICAL NEEDS OF THE COMMUNITY. - FACILITATED COUNTY GRANT CREATING NEIGHBORHOOD EXERCISE PARKS AND SUPPORTING TWO INAUGURAL MAYOR WEIGHT LOSS CHALLENGES IN THE COMMUNITIES OF ADELANTO AND APPLE VALLEY. MENTAL HEALTH INITIATIVE: LOW SELF RATED MENTAL HEALTH IN THE HIGH DESERT WAS RECORDED AT 18.4%; NATIONALLY IT STANDS AT 11.7%. IN FY16, ST. JOSEPH HEALTH, ST. MARY ACHIEVED THE FOLLOWING: - PROVIDED 2,299 TOTAL CLINICAL ENCOUNTERS PROVIDING MENTAL HEALTH CARE - IDENTIFIED ONE POLICY CHANGE PROPOSING TELE-PSYCHIATRY FOR EMERGENCY ROOM CARE - COUNSELING FOR DEPRESSION AND PTSD NOW PART OF LOCAL ADDICTION RECOVERY PROGRAM FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, ST. MARY, PLEASE VISIT HTTP://WWW.STMARYAPPLEVALLEY.COM/ABOUT-US/COMMUNITY-BENEFIT.ASPX. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH SYSTEM, PLEASE VISIT WWW.STJHS.ORG. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM PAYS ALL VENDORS ON BEHALF OF ITS MINISTRY ENTITIES THROUGH ITS SHARED SERVICES AND THEREFORE ISSUES THE RELATED FORM 1099-MISC UNDER ITS TAX IDENTIFICATION NUMBER. FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS ST JOSEPH HEALTH SYSTEM AND COVENANT HEALTH NETWORK, INC. ARE THE CORPORATE MEMBERS OF ST. MARY MEDICAL CENTER FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. MARY MEDICAL CENTER HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. MARY MEDICAL CENTER BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE ST. MARY MEDICAL CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS A CORPORATE MEMBER, AND ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE TRUSTEES ARE THEN APPROVED AND ELECTED BY THE COVENANT HEALTH NETWORK, INC. BOARD. FORM 990, PART VI, LINE 7B DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, LINE 11B DESCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AND WAS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD AT THE MARCH 2017 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE. FORM 990, PART VI, LINES 15A & 15B PROCESS USED TO DETERMINE COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. EXECUTIVE COMPENSATION IS APPROVED BY THE ST. MARY MEDICAL CENTER COMPENSATION AND BENEFITS COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF FOR PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2016. DURING THE YEAR, THE ST. MARY MEDICAL CENTER COMPENSATION AND BENEFITS COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTNG FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. FORM 990, PART X, LINE 20, COLUMN (A) BEGINNING BALANCE OF $979,140 OF TAX-EXEMPT BOND LIABILITIES WAS RECLASSED TO OTHER LIABILITIES TO BE CONSISTENT WITH REPORTING OF INTERCOMPANY BOND LIABILITIES IN THE CURRENT YEAR. FORM 990, PART XI, LINE 9 CHANGES IN NET ASSETS OR FUND BALANCE SJHS EQUITY TRANSFER ($ 21,154,233) SJHHF EQUITY TRANSFER $ 4,333,982 ROUNDING $ 1 -------------- TOTAL ($ 16,820,250) COVENANT HEALTH NETWORK INC 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 461259908 HEALTHCARE CA 501(C)(3) 11,III SJHS true COVENANT ACO 3615 19TH STREET LUBBOCK TX 79410 611573313 HEALTHCARE TX 501(C)(3) 11,I CHS true COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK TX 79410 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS true COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS true COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK TX 79410 752743883 HEALTHCARE TX 501(C)(3) 3 CHS true COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK TX 79410 463516417 HEALTHCARE TX 501(C)(3) 11,I CHS true HOAG CHARITY SPORTS 330 PLACENTIA AVE NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF true HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 HMHP true HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(C)(3) 3 CHN true HOME CARE PARTNERS 1165 MONTGOMERY DR SANTA ROSA CA 95405 680318656 INACTIVE CA 501(C)(3) 3 SRMH true HOSPICE OF LUBBOCK 3702 21ST STREET LUBBOCK TX 79410 752133781 HEALTHCARE TX 501(C)(3) 9 CHS true LUBBOCK METHODIST HOSPITAL FOUNDATION 3615 19TH STREET LUBBOCK TX 79410 752220963 HEALTHCARE TX 501(C)(3) 7 CHS true METHODIST CHILDREN'S HOSPITAL 4015 22ND PLACE LUBBOCK TX 79410 752428911 HEALTHCARE TX 501(C)(3) 3 CHS true METHODIST HOSPITAL LEVELLAND 1900 COLLEGE AVENUE LEVELLAND TX 79336 752246348 HEALTHCARE TX 501(C)(3) 3 CHS true METHODIST HOSPITAL PLAINVIEW 2601 DIMMITT ROAD PLAINVIEW TX 79072 752426010 HEALTHCARE TX 501(C)(3) 3 CHS true MISSION HOSPITAL REGIONAL MEDICAL CTR 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 951643360 HEALTHCARE CA 501(C)(3) 3 CHN true QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA CA 94558 941243669 HEALTHCARE CA 501(C)(3) 3 SJHS true REDWOOD MEMORIAL FOUNDATION 3300 RENNER DRIVE FORTUNA CA 95540 942779313 HEALTHCARE CA 501(C)(3) 7 RMH true REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA CA 95540 941384665 HEALTHCARE CA 501(C)(3) 3 SJHS true SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DR SANTA ROSA CA 95405 941231005 HEALTHCARE CA 501(C)(3) 3 SJHS true SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE CA 92868 951643383 RELIGIOUS ORG CA 501(C)(3) 1 NA false SRM ALLIANCE HOSPITAL SERVICES (PVH) 400 NORTH MCDOWELL BLVD PETALUMA CA 94954 680395200 HEALTHCARE CA 501(C)(3) 3 SRMH true ST JOSEPH HEALTH MINISTRY 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 271666576 RELIGIOUS ORG CA 501(C)(3) 1 SSJO false ST JOSEPH HEALTH SYSTEM 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 953589356 HEALTHCARE CA 501(C)(3) 11, I SJHM false ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 330143024 HEALTHCARE CA 501(C)(3) 7 SJHS true ST JOSEPH HOME CARE NETWORK 1111 SONOMA STE 308 SANTA ROSA CA 95405 680331084 HEALTHCARE CA 501(C)(3) 9 SJHS true ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA CA 95501 941156596 HEALTHCARE CA 501(C)(3) 3 SJHS true ST JOSEPH HOSPITAL OF ORANGE 1100 WEST STEWART DRIVE ORANGE CA 92868 951643359 HEALTHCARE CA 501(C)(3) 3 CHN true ST JUDE HOSPITAL YORBA LINDA 200 WEST CENTER ST PROMENADE ANAHEIM CA 92805 330185031 HEALTHCARE CA 501(C)(3) 3 SJHS true ST JUDE HOSPITAL INC 101 EAST VALENCIA MESA DRIVE FULLERTON CA 92635 951643324 HEALTHCARE CA 501(C)(3) 3 CHN true ST MARY OF THE PLAINS HOSPITAL FDN 4000 24TH STREET LUBBOCK TX 79410 751653181 HEALTHCARE TX 501(C)(3) 7 CHS true TALLER SAN JOSE 801 NORTH BROADWAY SANTA ANA CA 92701 593816355 WORK DEVELOPM CA 501(C)(3) 2 SSJO true HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 11,I HMHP true COVENANT LONG-TERM CARE LP SEE PART VII ORANGE CA 92868 264591502 HEALTHCARE TX NA N/A HERITAGE INVESTMENT GROUP SEE PART VII LA PALMA CA 906231052 462611662 INVESTMENTS CA NA N/A HOAG ORTHOPEDIC INSTITUTE SEE PART VII LA PALMA CA 906231052 465497794 HEALTHCARE CA NA N/A LUBBOCK SURGERY CENTER LTD SEE PART VII ORANGE CA 92868 271000061 HEALTHCARE TX NA N/A METHODIST DIAGNOSTIC IMAGING SEE PART VII LUBBOCK TX 79410 752177401 HEALTHCARE TX NA N/A MISSION AMBULATORY SURGICENTER SEE PART VII ORANGE CA 92868 954813223 HEALTHCARE CA NA N/A NEWPORT IMAGING CENTER SEE PART VII LUBBOCK TX 79410 752343261 HEALTHCARE CA NA N/A SHA LLC SEE PART VII MISSION VIEJO CA 92691 203132592 HEALTHCARE TX NA N/A ST JOSEPH PHYSICIAN VENTURES I LLC SEE PART VII ORANGE CA 92868 454521884 REAL ESTATE CA NA N/A ST JOSEPH HLTH SYS HOME CARE SEE PART VII NEWPORT BEACH CA 92660 330841806 HOME HEALTH CA NA N/A ST JOSEPH HLTH SYS HOME HLTH SEE PART VII AUSTIN TX 78750 752569094 HOME HEALTH CA NA N/A THE INNOVATION INSTITUTE SEE PART VII ORANGE CA 92868 454521884 HEALTHCARE DE NA N/A NORTH BAY ENDOSCOPY CENTER SEE PART VII LA PALMA CA 906231052 900745066 HEALTHCARE CA NA N/A ADVANCED SURGERY INSTITUTE LLC 1739 4TH STREET SANTA ROSA CA 95404 262299255 HEALTHCARE CA NA N/A MISSION VIEJO PHYSICIAN PARTNERS I LLC 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 471559873 HEALTHCARE CA NA N/A AMERICAN UNITY GROUP LTD 90 PITTS BAY ROAD PEMBROKE HM08 BD CAPTIVE INSURANCE BD NA C-CORP COASTAL MANAGEMENT SERVICES ORGANIZATION 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA NA C-CORP DATU HEALTH INC 16150 MAIN CIRCLE DR SUITE 250 CHESTERFIELD MO 63017 463070062 IT SVCS DE NA C-CORP HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330731587 HEALTHCARE CA NA C-CORP LUBBOCK METHODIST HOSP PRACTICE MGMT 2107 OXFORD STREET STE 300 LUBBOCK TX 79410 752578995 INACTIVE TX NA C-CORP LUBBOCK METHODIST HOSPITAL SVCS PO BOX 1201 LUBBOCK TX 79410 752118585 HEALTHCARE TX NA C-CORP MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD 354 MISSION VIEJO CA 92691 330212905 HEALTHCARE CA NA C-CORP ST JOSEPH HEALTH 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 462340232 HOLDING COMPANY CA NA C-CORP ST JOSEPH HEALTH SOURCE INC 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 461900168 HEALTHCARE CA NA C-CORP ST JOSEPH PROF SVCS ENTERPRISES INC 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 330155323 HEALTHCARE CA NA C-CORP false true true false false false false false false false false false true false false true true true false ST JOSEPH HEALTH SYSTEM FOUNDATION c 1568569 CASH ST JOSEPH HEALTH SYSTEM FOUNDAITON b 2104600 CASH ST JUDE HOSPITAL YORBA LINDA b 7655280 FMV ST JUDE HOSPITAL YORBA LINDA m 857067 FMV SCHEDULE R, PART III IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE 362, MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 100, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 200 ORANGE, CA 92868-2012 THE INNOVATION INSTITUTE EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954 ADVANCED SURGERY INSTITUTE, LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 MISSION VIEJO PHYSICIAN PARTNERS I, LLC EIN: 47-1559873 ADDRESS: 27700 MEDICAL CENTER ROAD, MISSION VIEJO, CA 92691