SIERRA NEVADA MEMORIAL-MINERS HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: SIERRA NEVADA MEMORIAL-MINERS HOSPITAL (EIN 94-1439787)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-05
IRS object ID: 201741259349301374
Schema version: 2015v3.0
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 L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-05T13:13:30-05:00	ReturnTs
Tax Period End	2016-06-30	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	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	941439787	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Sierra Nevada Memorial - Miners Hospital Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% LARA HARROWFINANCE DEPT	InCareOfNm
Business Name Control	SIER	BusinessNameControlTxt
Phone	5302746099	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	CAROLYN CANADY	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	5302746099	PhoneNum
Signature	2017-04-24	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	2017-05-01	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Carolyn Canady	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	155 Glasson Way	AddressLine1Txt
City	Grass Valley	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95945	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$211,599,731	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.SNMH.Org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1934	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	TO CONTRIBUTE TO THE WELLNESS OF OUR COMMUNITY THROUGH THE PROVISION OF QUALITY SERVICES DELIVERED IN A COMPASSIONATE AND COST-EFFECTIVE MANNER.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	973	TotalEmployeeCnt
Total Volunteers	94	TotalVolunteersCnt
Total Gross UBI	$7,672	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$2,014	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,003,110	PYContributionsGrantsAmt
CY Contributions Grants	$693,819	CYContributionsGrantsAmt
PY Program Service Revenue	$148,797,515	PYProgramServiceRevenueAmt
CY Program Service Revenue	$152,838,258	CYProgramServiceRevenueAmt
PY Investment Income	$7,492,224	PYInvestmentIncomeAmt
CY Investment Income	$5,677,937	CYInvestmentIncomeAmt
PY Other Revenue	$641,210	PYOtherRevenueAmt
CY Other Revenue	$775,973	CYOtherRevenueAmt
PY Total Revenue	$157,934,059	PYTotalRevenueAmt
CY Total Revenue	$159,985,987	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,422,875	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$7,565,667	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$90,326,370	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$98,152,219	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$61,100,968	PYOtherExpensesAmt
CY Other Expenses	$65,489,223	CYOtherExpensesAmt
PY Total Expenses	$156,850,213	PYTotalExpensesAmt
CY Total Expenses	$171,207,109	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,083,846	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$11,221,122	CYRevenuesLessExpensesAmt
Total Assets BOY	$251,963,383	TotalAssetsBOYAmt
Total Assets EOY	$232,844,651	TotalAssetsEOYAmt
Total Liabilities BOY	$33,385,953	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$34,322,609	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$218,577,430	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$198,522,042	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO CONTRIBUTE TO THE WELLNESS OF OUR COMMUNITY THROUGH THE PROVISION OF QUALITY SERVICES DELIVERED IN A COMPASSIONATE AND COST-EFFECTIVE MANNER,COLLABORATING WITH OTHERS IN THE COMMUNITY TO IMPROVE QUALITY OF LIFE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$142,296,996	ExpenseAmt
Grant	$7,565,667	GrantAmt
Revenue	$152,833,703	RevenueAmt
Desc	SIERRA NEVADA MEMORIAL HOSPITAL'S MISSION IS TO CONTRIBUTE TO THE WELLNESS OF OUR COMMUNITY THROUGH THE PROVISION OF QUALITY SERVICES DELIVERED IN A COMPASSIONATE AND COST-EFFECTIVE MANNER, COLLABORATING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. THE HOSPITAL OFFERS A WIDE RANGE OF SERVICES AND SPECIALTIES TO ACCOMMODATE THE GROWING NEEDS OF WESTERN NEVADA COUNTY. AS THE SOLE ACUTE CARE PROVIDER IN OUR SERVICE AREA, SIERRA NEVADA MEMORIAL HOSPITAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. SIERRA NEVADA MEMORIAL HOSPITAL IS LICENSED WITH 104 ACUTE BEDS, SPECIALIZING IN ORTHOPEDICS, ONCOLOGY AND GENERAL MEDICAL SERVICE. SERVICES PROVIDED IN FISCAL YEAR 2016 INCLUDED 152,762 OUTPATIENT VISITS, 30,515 EMERGENCY VISITS, AND 2,444 INPATIENT AND OUTPATIENT SURGERIES. SIERRA NEVADA MEMORIAL HOSPITAL'S LIST OF INPATIENT, OUTPATIENT AND SUPPORT SERVICES IS QUITE EXHAUSTIVE. INPATIENT SERVICES INCLUDE ACUTE MEDICAL/SURGICAL CARE; INTENSIVE CARE; PHARMACY; ORTHOPEDIC AND GENERAL SURGERY; AND WOMEN & INFANT CARE UNIT. OUTPATIENT SERVICES: AMBULATORY TREATMENT CENTER; CARDIAC REHABILITATION; CARDIOPULMONARY; DIAGNOSTIC IMAGING; LABORATORY; OUTPATIENT SURGERY CENTER; NUEROLOGICAL REHABILITATION SERVICES; WOUND CARE CENTER; AMBULANCE; CANCER CENTER; AND EMERGENCY SERVICES.	Desc
Total Program Service Expenses	$142,296,996	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	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	false	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	Yes (true)	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	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	117	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	973	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
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	11	GoverningBodyVotingMembersCnt
Independent Voting Member	9	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	LARA HARROWFINANCE DEPT	PersonNm
Phone	9168512104	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3400 DATA DRIVE	AddressLine1Txt
City	Rancho Cordova	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95670	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 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
Dale Creighton
Board Member	2.0	0.0	Yes (X)	$0	$0	$0
Monty East
Board Member	2.0	0.0	Yes (X)	$0	$0	$0
Stacy Fore DDS
Board Member	2.0	0.0	Yes (X)	$0	$0	$0
Alex Klistoff MD
Board Member	2.0	0.0	Yes (X)	$0	$0	$0
Scott Robertson
Board Member	2.0	0.0	Yes (X)	$0	$0	$0
Kevin Vaziri
Board Member	2.0	40.0	Yes (X)	$0	$619,760	$93,288
Alan Wong
Board Member	2.0	0.0	Yes (X)	$1,500	$0	$0
Katherine A Medeiros
CEO/ Service Area Leader	40.0	0.0	Yes (X)	$0	$518,947	$80,837	Yes (X)
Kathryn Rappath
Board Vice Chair	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Edward Sylvester
Board Chair	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Michele White
Board Secretary	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Carolyn Canady
CFO/Board Treasurer	40.0	0.0		$239,544	$0	$44,495	Yes (X)
Brian Evans
VP, CMO	40.0	0.0		$282,203	$0	$54,287		Yes (X)
Jill McWilliams
VP/CNE	40.0	0.0		$223,238	$0	$41,786		Yes (X)
Debbie L Plass
VP Operations	40.0	0.0		$187,603	$0	$44,548		Yes (X)
Gregory T Smith
Registered Nurse	40.0	0.0		$242,899	$0	$53,402			Yes (X)
Jonathan D Stone
Director of Pharmacy	40.0	0.0		$203,070	$0	$50,224			Yes (X)
William S Swindling
Pharmacist	40.0	0.0		$201,331	$0	$24,868			Yes (X)
Tzvetan I Tzvetanov
Physicist	40.0	0.0		$276,890	$0	$47,051			Yes (X)
Gail A Van Vleck
Charge Nurse IP/OP Surgery	40.0	0.0		$225,084	$0	$40,980			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,083,362	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,138,707	TotReportableCompRltdOrgAmt
Total Other Compensation	$575,766	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	252	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
COGENT HEALTHCARE OF CA
PO BOX 645037	CINCINNATI	OH	452645037	Medical Services	$2,627,606
TRIMEDX LLC
5451 LAKEVIEW PKWY S DR	INDIANAPOLIS	IN	46268	Management services	$1,565,614
SIERRA NEVADA ANESTHESIA
1020 MCCOURTNEY RD SUITE A	GRASS VALLEY	CA	95949	Medical Services	$1,191,982
ARAMARK HEALTHCARE
27310 NETWORK PL	CHICAGO	IL	606731273	Management food/faci	$1,023,276
DELPHI OF TEAM HEALTH
2600 UNIVERSITY PARKWAY	CORALVILLE	IA	522413212	Medical Services	$890,485

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	34	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$610,615	RelatedOrganizationsAmt
Government Grants	$36,310	GovernmentGrantsAmt
All Other Contributions	$46,894	AllOtherContributionsAmt
Total Contributions	$693,819	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT NET OF CHARITY & BAD DEBT	900099	$81,482,412	$81,482,412
MEDICARE/MEDICAID PAYMENTS	900099	$69,183,694	$69,183,694
MEANINGFUL USE INCENTIVES (EHR)	900099	$492,246	$492,246
GS HIO MAINTENANCE	900099	$452,364	$452,364
RISK POOL PAYMENT REVENUE	900099	$452,515	$452,515

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$775,027	TotalRevenueColumnAmt
Related Or Exempt Func Income	$770,472	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,555	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$152,838,258	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,302,621	TotalRevenueColumnAmt
Exclusion	$2,302,621	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

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,626	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,626	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,626	TotalRevenueColumnAmt
Exclusion	$2,626	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$54,957,490	SecuritiesAmt
Other	$31,305	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$51,613,478	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,344,012	SecuritiesAmt
Other	$31,305	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,375,316	TotalRevenueColumnAmt
Exclusion	$3,375,316	ExclusionAmt

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	$1,189	GamingGrossIncomeAmt
Gaming Direct Expenses	$266	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$923	TotalRevenueColumnAmt
Exclusion	$923	ExclusionAmt

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	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
REBATES AND REFUNDS	900099	$189,829	$189,829
CAFETERIA/CATERING	722320	$190,842	$187,725	$3,117
FINANCE CHARGES	900099	$180,195	$180,195

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$211,558	TotalRevenueColumnAmt
Exclusion	$211,558	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$772,424	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$159,985,987	TotalRevenueColumnAmt
Related Or Exempt Func Income	$152,833,703	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$7,672	UnrelatedBusinessRevenueAmt
Exclusion	$6,450,793	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	$7,561,167	TotalAmt
Program Services	$7,561,167	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$4,500	TotalAmt
Program Services	$4,500	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	$1,117,924	TotalAmt
Program Services	$1,018,863	ProgramServicesAmt
Management And General	$99,061	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$200,374	TotalAmt
Program Services	$200,374	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$70,905,612	TotalAmt
Program Services	$64,472,818	ProgramServicesAmt
Management And General	$6,432,794	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$4,562,044	TotalAmt
Program Services	$4,203,364	ProgramServicesAmt
Management And General	$358,680	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$16,424,790	TotalAmt
Program Services	$15,132,960	ProgramServicesAmt
Management And General	$1,291,830	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,941,475	TotalAmt
Program Services	$4,552,809	ProgramServicesAmt
Management And General	$388,666	ManagementAndGeneralAmt

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	$76,730	TotalAmt
Management And General	$76,730	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$35,224	TotalAmt
Management And General	$35,224	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$49,369	TotalAmt
Management And General	$49,369	ManagementAndGeneralAmt

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	$721,321	TotalAmt
Management And General	$721,321	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$26,258,315	TotalAmt
Program Services	$19,127,357	ProgramServicesAmt
Management And General	$7,130,958	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$669,306	TotalAmt
Program Services	$13,034	ProgramServicesAmt
Management And General	$656,272	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,983,760	TotalAmt
Program Services	$2,001,742	ProgramServicesAmt
Management And General	$982,018	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$10,815,244	TotalAmt
Program Services	$673,981	ProgramServicesAmt
Management And General	$10,141,263	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,611,619	TotalAmt
Program Services	$1,550,227	ProgramServicesAmt
Management And General	$61,392	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$266,359	TotalAmt
Program Services	$168,182	ProgramServicesAmt
Management And General	$98,177	ManagementAndGeneralAmt

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	$37,555	TotalAmt
Program Services	$29,258	ProgramServicesAmt
Management And General	$8,297	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$679,457	TotalAmt
Program Services	$679,327	ProgramServicesAmt
Management And General	$130	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$6,109,407	TotalAmt
Program Services	$6,038,806	ProgramServicesAmt
Management And General	$70,601	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$800,976	TotalAmt
Program Services	$800,976	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$13,643,607	$13,639,233	$4,374	$0
FOOD & OTHER EXPENSES	$420,568	$326,572	$93,996	$0
DUES & SUBSCRIPTIONS	$136,965	$30,364	$106,601	$0
LICENSES & TAXES	$146,333	$71,082	$75,251	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$27,108	TotalAmt
Management And General	$27,108	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$171,207,109	TotalAmt
Program Services	$142,296,996	ProgramServicesAmt
Management And General	$28,910,113	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

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

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$6,388	BOYAmt
EOY	$6,128	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,264,536	BOYAmt
EOY	$4,979,028	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$28,887,452	BOYAmt
EOY	$22,389,577	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	$473,610	BOYAmt
EOY	$485,482	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,940,027	BOYAmt
EOY	$1,984,663	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,766,887	BOYAmt
EOY	$6,563,055	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$128,367,583	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$86,897,718	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$41,879,527	BOYAmt
EOY	$41,469,865	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$111,818,708	BOYAmt
EOY	$65,353,626	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$53,246,572	BOYAmt
EOY	$83,988,750	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$5,679,676	BOYAmt
EOY	$5,624,477	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	$0	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$251,963,383	BOYAmt
EOY	$232,844,651	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$15,705,874	BOYAmt
EOY	$17,957,996	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	$266,436	BOYAmt
EOY	$216,137	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,334,365	BOYAmt
EOY	$4,334,365	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	$413,203	BOYAmt
EOY	$326,521	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	$12,666,075	BOYAmt
EOY	$11,487,590	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,385,953	BOYAmt
EOY	$34,322,609	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$214,817,106	BOYAmt
EOY	$194,794,622	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,392,646	BOYAmt
EOY	$2,359,742	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,367,678	BOYAmt
EOY	$1,367,678	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$218,577,430	BOYAmt
EOY	$198,522,042	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$251,963,383	BOYAmt
EOY	$232,844,651	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$11,221,122	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$8,801,362	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$32,904	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	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	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
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	$49,369	OtherActivitiesAmt
Total Lobbying Expenditures	$49,369	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1	FormAndLineReferenceDesc
Explanation	SCHEDULE C, PART II-B, LINE 1 LOBBYING EXPENDITURES PAID DIRECTLY BY THE FILING ORGANIZATION FOR ANNUAL MEMBERSHIP DUES: AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES $3 ASTRO $145 LOBBYING EXPENDITURES PAID BY THE PARENT ORGANIZATION FOR ANNUAL MEMBERSHIP DUES WHERE EXPENSES ARE ALLOCATED TO THE HOSPITAL: CATHOLIC HEALTH ASSOCIATION $745 AMERICAN HOSPITAL ASSOCIATION $1,628 HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA $7,614 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME $60 VISITING NURSE ASSOCIATION OF AMERICA $205 CALIFORNIA HOSPITAL ASSOCIATION $38,879 340 B HEALTH $90 TOTAL EXPENDITURES PAID TO ORGANIZATIONS $49,369	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,362,497	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$388,783	InvestmentEarningsOrLossesAmt
End Year Balance	$1,973,714	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,296,400	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$66,097	InvestmentEarningsOrLossesAmt
End Year Balance	$2,362,497	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,367,108	BeginningYearBalanceAmt
Contributions	$570	ContributionsAmt
Investment Earnings Or Losses	$928,722	InvestmentEarningsOrLossesAmt
End Year Balance	$2,296,400	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,351,797	BeginningYearBalanceAmt
Contributions	$15,311	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
End Year Balance	$1,367,108	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,599,745	BeginningYearBalanceAmt
Contributions	$61,959	ContributionsAmt
Investment Earnings Or Losses	-$309,907	InvestmentEarningsOrLossesAmt
End Year Balance	$1,351,797	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.69000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.31000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,140,153	OtherCostOrOtherBasisAmt
Book Value	$1,140,153	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$63,603,486	OtherCostOrOtherBasisAmt
Depreciation	$43,008,985	DepreciationAmt
Book Value	$20,594,501	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$289,591	OtherCostOrOtherBasisAmt
Depreciation	$289,591	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$52,951,006	OtherCostOrOtherBasisAmt
Depreciation	$40,632,379	DepreciationAmt
Book Value	$12,318,627	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,383,347	OtherCostOrOtherBasisAmt
Depreciation	$2,966,763	DepreciationAmt
Book Value	$7,416,584	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$41,469,865	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	POOLED INVESTMENTS	Desc
Book Value	$83,988,750	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$83,988,750	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTIES	$8,918,468
PENSION PAYABLE	$2,569,122

Field	Value	IRS element (for citing)
Total Liability	$11,487,590	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Sch D, PART V, LINE 4	The endowment funds are intended to be used to support Alzheimer's research, the Cancer Center, the Cardiac program and other hospital program needs.
Sch D, PART X, LINE 2	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.

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	2716	PersonsServedCnt
Total Community Benefit Expns	$1,093,146	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$161,232	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$931,914	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	32376	PersonsServedCnt
Total Community Benefit Expns	$36,987,855	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$31,633,607	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,354,248	NetCommunityBenefitExpnsAmt
Total Expense	0.03130	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	35092	PersonsServedCnt
Total Community Benefit Expns	$38,081,001	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$31,794,839	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,286,162	NetCommunityBenefitExpnsAmt
Total Expense	0.03670	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	22	ActivitiesOrProgramsCnt
Persons Served	9089	PersonsServedCnt
Total Community Benefit Expns	$765,477	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$765,477	NetCommunityBenefitExpnsAmt
Total Expense	0.00450	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	10	PersonsServedCnt
Total Community Benefit Expns	$95	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$95	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	131	PersonsServedCnt
Total Community Benefit Expns	$24,818	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,818	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	177	PersonsServedCnt
Total Community Benefit Expns	$1,335,639	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,335,639	NetCommunityBenefitExpnsAmt
Total Expense	0.00780	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	30	ActivitiesOrProgramsCnt
Persons Served	9407	PersonsServedCnt
Total Community Benefit Expns	$2,126,029	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,126,029	NetCommunityBenefitExpnsAmt
Total Expense	0.01240	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	30	ActivitiesOrProgramsCnt
Persons Served	44499	PersonsServedCnt
Total Community Benefit Expns	$40,207,030	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$31,794,839	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,412,191	NetCommunityBenefitExpnsAmt
Total Expense	0.04910	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	125	PersonsServedCnt
Total Community Benefit Expns	$66,718	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$66,718	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$398	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$398	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	125	PersonsServedCnt
Total Community Benefit Expns	$67,116	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$67,116	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,626,203	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$44,179,482	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$67,648,288	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$23,468,806	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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	GRASS VALLEY OP SURG	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	AMBULATORY SURGERY CENTER	PrimaryActivitiesTxt
Org Profit Or Ownership	0.228	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.0	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.3159	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
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	Sierra Nevada Memorial-Miners Hospita	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	155 Glasson Way	AddressLine1Txt
City	Grass Valley	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95945	ZIPCd

Field	Value	IRS element (for citing)
Website Address	http://www.snmh.org/index.htm	WebsiteAddressTxt
State License	230000152	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	Sierra Nevada Memorial-Minors Hosp	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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	15	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	15	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	www.snmh.org	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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp

Field	Value	IRS element (for citing)
Form And Line Reference	SCH H, PART V	FormAndLineReferenceDesc
Explanation	SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT AND PRIMARY DATA ON HEALTH NEEDS WERE OBTAINED VIA INTERVIEWS WITH SERVICE PROVIDERS AND COMMUNITY KEY INFORMANTS AND THROUGH FOCUS GROUPS WITH MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. TRANSCRIPTS AND NOTES FROM INTERVIEWS AND FOCUS GROUPS WERE ANALYZED TO LOOK FOR THEMES AND TO DETERMINE IF A HEALTH NEED WAS IDENTIFIED AS SIGNIFICANT AND/OR A PRIORITY TO ADDRESS. PARTICIPANTS INCLUDED THE COUNTY PUBLIC HEALTH DEPARTMENT AND PUBLIC AND NON-PROFIT AGENCIES, COMMUNITY MEMBERS AND SERVICE PROVIDERS; A COMPLETE LIST OF KEY INFORMANT INTERVIEW DATA SOURCES, AREAS OF EXPERTISE AND POPULATIONS SERVED, ALONG WITH LISTS OF FOCUS GROUPS WITH PARTICIPANT DEMOGRAPHIC INFORMATION IS IN THE CHNA REPORT APPENDICES. SCHEDULE H, PART V, SECTION B, LINE 6A MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, MERCY SAN JUAN MEDICAL CENTER, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER SCHEDULE H, PART V, SECTION B, LINE 7A https://www.dignityhealth.org/-/media/cm/media/documents/CHNA/CHNA-SNMH-20 16.ashx?la=en SCHEDULE H, PART V, SECTION B, LINE 10A https://www.dignityhealth.org/-/media/cm/media/documents/CHNA/CHNA-SNMH-20 16.ashx?la=en SCHEDULE H, PART V, SECTION B, LINE 11 SIERRA NEVADA MEMORIAL WILL ADDRESS THE 2016 CHNA SIGNIFICANT HEALTH NEEDS OF: ACCESS TO BEHAVIORAL HEALTH; ACCESS TO HIGH QUALITY HEALTH CARE; AND CHRONIC DISEASE PREVENTION, MANAGEMENT, AND TREATMENT. BEHAVIORAL HEALTH INCLUDES INDICATORS RELATED TO MENTAL HEALTH AND SUBSTANCE USE. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: INTEGRATED CARE COORDINATION FOR FAMILY WELLNESS; MENTAL HEALTH CRISIS SUPPORT PARTNERSHIP; CRISIS STABILIZATION UNIT; TELE-PSYCHIATRIC CARE; CLASSES ADDRESSING MENTAL HEALTH; PENN VALLEY SATELLITE LAB AND X-RAY CLINIC; CANCER NURSE NAVIGATOR; EMERGENCY DEPARTMENT NAVIGATION; ALZHEIMERS OUTREACH PROGRAM; FALLS PREVENTION PROGRAM; HEART FAILURE PROGRAM; DIABETES MANAGEMENT AND PREVENTION WORKSHOPS; WELLNESS CLASSES ADDRESSING PREVENTION AND HEALTH MANAGEMENT; CANCER SCREENINGS; HEALTH FAIRS; TAXI VOUCHER PROGRAM; ANTI-HUMAN TRAFFICKING INITIATIVE; AND HOMELESS OUTREACH PROJECT. SIERRA NEVADA MEMORIAL, AS A RURAL COMMUNITY HOSPITAL, DOES NOT HAVE THE CAPACITY OR RESOURCES TO ADDRESS ALL PRIORITY HEALTH ISSUES IDENTIFIED IN NEVADA COUNTY. THE HOSPITAL IS NOT DIRECTLY ADDRESSING THE FOLLOWING PRIORITIES, ALTHOUGH PROGRAMS ARE IN PLACE TO ASSIST COMMUNITY RESIDENTS IN LIMITED CAPACITY: AFFORDABLE AND ACCESSIBLE TRANSPORTATION; SAFE, CRIME AND VIOLENCE FREE COMMUNITIES; ACTIVE LIVING AND HEALTH EATING; AND BASIC NEEDS. IN ADDITION, THE HOSPITAL WILL CONTINUE TO SEEK COLLABORATIVE OPPORTUNITIES THAT ADDRESS NEEDS THAT HAVE NOT BEEN SELECTED AS PRIORITIES. THE HOSPITAL IS NOT ADDRESSING POLLUTION-FREE LIVING AND WORKING ENVIRONMENTS, AS THIS PRIORITY IS BEYOND THE CAPACITY AND EXPERTISE OF SIERRA NEVADA MEMORIAL. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C https://www.dignityhealth.org/Service%20Areas/sacramento/patients-and-visi tors/for-patients/billing-information/payment-assistance SCHEDULE H, PART V, SECTION B, LINE 16I ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS AND THE FINANCIAL ASSISTANCE POLICY, A COPY OF THE FINANCIAL ASSISTANCE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION.THE FACILITY'S WEB SITE ALSO CONTAINS THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY OF THE POLICY, APPLICATION, BILLING AND COLLECTION POLICY, A DESCRIPTION OF THE AMOUNT GENERALLY BILLED AND A LISTING OF PROVIDERS AT EACH FACILITY THAT ARE COVERED AND NOT COVERED BY THE FINANICAL ASSISTANCE POLICY. CONTACT INFORMATION CAN ALSO BE FOUND ON EACH FACILITYS WEB PAGE. SCHEDULE H, PART V, SECTION B, LINE 22D THE MAXIMUM CHARGE THAT MAY BE BILLED TO A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY IS KNOWN AS THE AMOUNT GENERALLY BILLED (AGB). NO PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED MORE THAN THE AGB FOR THE ELIGIBLE SERVICE(S) PROVIDED TO THE PATIENT. DIGNITY HEALTH CALCULATES THE AGB ON A FACILITY-BY-FACILITY USING THE "LOOKBACK" METHOD BY MULTIPLYING THE "GROSS CHARGES" FOR ANY ELIGIBLE SERVICES THAT IT PROVIDES BY AGB PERCENTAGES WHICH ARE BASED UPON PAST CLAIMS ALLOWED UNDER MEDICARE AND PRIVATE INSURANCE AS SET FORTH IN FEDERAL LAW.	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	GRASS VALLEY SURGERY CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	408 Sierra College Drive	AddressLine1Txt
City	GRASS VALLEY	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95945	ZIPCd

Field	Value	IRS element (for citing)
Facility	OUTPATIENT SURGERY CENTER	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCH H, Part I, Lines 7 & 7B, column (f)	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. SIERRA NEVADA MEMORIAL HOSPITAL RECOGNIZED FEE-FOR-SERVICE SUPPLEMENTAL PAYMENTS OF $10.48 MILLION DURING THE YEAR REFLECTED UNDER THE MEDICAID PROGRAM AS DIRECT OFFSETTING REVENUE (PART I, LINE 7B, COLUMN D). THIS NET REDUCTION IN THE COST OF THE MEDICAID PROGRAM IS DRIVING THE DECREASE IN THE OVERALL COST OF COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES WHEN COMPARED TO PRIOR YEARS. LINE 7I COLUMN C 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, SIERRA NEVADA MEMORIAL HOSPITAL RECORDED A PLEDGE TO A GRANT FUND ESTABLISHED BY CHFT IN THE AMOUNT $0.17 MILLION. THE GRANT IS REPORTED UNDER OTHER BENEFITS (PART I, LINE 7I, COLUMN C), AS CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS.
SCH H, PART I, LINE 7	FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE, SNMMH USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO THE PATIENT LEVEL. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL 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.
SCH H, PART II - COMMUNITY BUILDING ACTIVITIES	ADVOCACY TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND THE QUALITY OF LIFE FOR RESIDENTS IN NEVADA COUNTY IS A PRIORITY. SIERRA NEVADA MEMORIAL HOSPITAL IS INVOLVED IN VARIOUS ORGANIZATIONS TO REPRESENT THE NEEDS OF THE UNDERSERVED, DEVELOP INITIATIVES FOR HEALTHIER COMMUNITIES, AND ENHANCE THE OVERALL ECONOMY OF THE COMMUNITY. SIGNIFICANT VOLUNTEER TIME IS SPENT SERVING THE COMMUNITY IN THIS CAPACITY ON THE BOARDS OF ORGANIZATIONS THAT INCLUDE: -MINERS/WESTERN SIERRA CLINIC -GRASS VALLEY CHAMBER OF COMMERCE -COMMUNITY RECOVERY RESOURCES -ROTARY OF GRASS VALLEY -ROTARY OF NEVADA COUNTY SOUTH -THE FRIENDSHIP CLUB -ELDERCARE PROVIDERS -ECONOMIC RESOURCE COUNCIL THE HOSPITAL ALSO PARTICIPATES IN FUNDRAISING EVENTS TO SUPPORT MEANINGFUL HEALTH IMPROVEMENT PROGRAMS AND SERVICES BY COMMUNITY BASED NONPROFIT ORGANIZATIONS.
SCH H, PART III	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 PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED. AS NOTED IN PART I, LINE 3B, SNMMH 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 SNMMH MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. SNMMH FOLLOWS DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY. THIS 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 A PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL 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, SNMH DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL 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, 2016, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR CHARITY AND DOUBTFUL ACCOUNTS: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE ARE REPORTED AT THE NET REALIZABLE AMOUNT FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. SNMMH 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 SNMMH PREPARES MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. DIGNITY HEALTH BELIEVES THAT THE ENTIRE MEDICARE SHORTFALL OF $895 MILLION, AS REPORTED BELOW IN PART VI, LINE 6, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY DIGNITY HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THIS SHORTFALL INCLUDES $23.5 MILLION REPORTED ON PART III, SECTION B, LINE 7, PRIMARILY FOR FEE FOR SERVICE MEDICARE PATIENTS, AS WELL AS THE UNREIMBURSED PORTION OF MEDICARE MANAGED CARE AND MEDICARE CAPITATED PROGRAMS FOR SNMMH. SCHEDULE H, PART III, LINE 9B SNMMH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. SNMMH'S COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE SNMMH OR BILLING COMPANY RETAINED BY SNMMH 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 SNMMH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, SNMMH 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 HOSPITAL PATIENT FINANCIAL ASSISTANCE DEPARTMENT. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, SNMMH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.
Sch H, Part VI, Line 2 - Needs Assessment	THE HOSPITAL IS ADDRESSING PRIORITY NEEDS IDENTIFIED IN THE NEEDS ASSESSMENT, FOCUSING ON ACCESS TO CARE AS A PRIORITY NEED AND BY IMPLEMENTING A CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. NEEDS ARE ALSO ASSESSED EACH YEAR WORKING WITH COMMUNITY ORGANIZATIONS DURING OUR COMMUNITY GRANTS PROGRAM. SIERRA NEVADA MEMORIAL HOSPITAL ENGAGED VALLEY VISION, INC. TO CONDUCT AN ASSESSMENT OF THE HEALTH NEEDS OF THE RESIDENTS LIVING IN THE SERVICE AREA. THE ASSESSMENT WAS CONDUCTED OVER A PERIOD OF EIGHTEEN MONTHS, BEGINNING IN JANUARY 2015 AND CONCLUDED IN JUNE 2016 USING A MIXED METHOD DATA COLLECTION APPROACH THAT INCLUDED PRIMARY DATA SUCH AS KEY INFORMANT INTERVIEWS, COMMUNITY FOCUS GROUPS, AND COMMUNITY ASSET ASSESSMENTS. SECONDARY DATA INCLUDED HEALTH OUTCOMES, DEMOGRAPHIC DATA, BEHAVIORAL DATA AND ENVIRONMENTAL DATA. SNMMH LEADERSHIP REVIEWED AND COMPARED THE FINDINGS OF THE ASSESSMENT WITH COMMUNITY BENEFIT PROGRAMS AND SERVICES CURRENTLY BEING OFFERED BY THE HOSPITAL AND DETERMINED SNMMH IS RESPONDING TO A NUMBER OF PRIORITY NEEDS. SNMMH LEADERSHIP HAS CONSTRUCTED AN ACTION PLAN AND IS WORKING WITH COMMUNITY PARTNERS TO FURTHER ADDRESS THE NEEDS INDENTIFIED IN THE ASSESSMENT.
Sch H, Part VI, Line 3- Patient Education of Eligibility for ASSISTANCE	COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC: INFORMATION ABOUT THE ORGANIZATION'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 FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES SNMMH 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 FACILITY'S WEBSITE AT https://www.dignityhealth.org/Service%20Areas/sacramento/patients-and-visi tors/for-patients/billing-information/payment-assistance. 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 THAT 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 REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS TO INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF THE SNMMH FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.
Sch H, Part VI Line 4: - Community Information	PRIMARY SERVICE AREA: SIERRA NEVADA MEMORIAL HOSPITAL IS LOCATED WEST OF LAKE TAHOE IN THE SIERRA NEVADA MOUNTAINS, NEVADA COUNTY IS IN THE HEART OF CALIFORNIA'S HISTORIC GOLD COUNTRY. THE HOSPITALS SERVICE AREA ENCOMPASSES SEVEN ZIP CODES IN THE COMMUNITIES OF GRASS VALLEY, PENN VALLEY, ROUGH AND READY, NEVADA CITY, NORTH SAN JUAN AND WASHINGTON (95945, 95946, 95949, 95959, 95960, 95975, AND 95986). FOUR OF THE ZIP CODES HAD PORTIONS THAT WERE DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR PRIMARY CARE. Total Population: 75,301 Race/Ethnicity: White - Non-Hispanic 87.0%; Black/African American - Non-Hispanic 0.6%; Hispanic or Latino 7.1%; Asian/Pacific Islander 1.4%; All Others 3.9% Median Income: $55,724 Unemployment: 4.7% No High School Diploma: 7.6% Medicaid: 25.9% Uninsured: 6.1% OTHER AREA HOSPITALS: 1
Sch H, Part VI, Line 5 - Promotion of Community Health	SIERRA NEVADA MEMORIAL HOSPITAL OFFERS MEDICAL STAFF PRIVILEGES TO ANY QUALIFYING PHYSICIANS. THE HOSPITAL'S FIDUCIARY BOARD SERVES IN AN OVERSIGHT ROLE TO ENSURE THAT COMMUNITY BENEFIT PRACTICES AND PROGRAMS ARE ALIGNED WITH AND SUPPORT THE MISSION, POLICY AND PRIORITIES OF THE REGION AND THE ORGANIZATION. THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY RESIDES IN THE PRIMARY SERVICE AREA AND IS NOT EMPLOYED BY NOR CONTRACTED WITH THE ORGANIZATION. SNMMH UTILIZES A COMMUNITY NEEDS ASSESSMENT PROCESS THAT RESULTS IN A DOCUMENT DESCRIBING THE HEALTH CARE NEEDS OF THE SURROUNDING POPULATION. IN ADDITION A COMPANION DOCUMENT LISTING COMMUNITY HEALTH ASSETS IS PREPARED AND THEN COMPARED TO THE NEEDS ASSESSMENT. UNMET NEEDS ARE IDENTIFIED AND USED IN PLANNING FOR PHYSICIAN RECRUITMENT, ADDING NEW SERVICES AND PROGRAMS, AND OFFERING COMMUNITY EDUCATION. SIERRA NEVADA MEMORIAL HOSPITAL SPECIFICALLY SPONSORS AND TAKES AN ACTIVE ROLE IN PROGRAMS THAT ADDRESS PRIORITIES WITHIN ITS SERVICE AREA SUCH AS: - CHAMP (CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM) THAT PROVIDES A VITAL MEDICAL LINK TO HEART FAILURE PATIENTS WHEN THEY LEAVE THE HOSPITAL TO IMPROVE THEIR UNDERSTANDING AND ABILITY TO MANAGE THIS CHRONIC DISEASE, AND REDUCE THEIR RISK OF READMISSION. -FREE OR DISCOUNTED CARDIAC REHAB PROGRAMS TO THOSE WHO ARE UNABLE TO PAY AS A COMPLEMENTARY PROGRAM TO CHAMP. - WELLNESS EDUCATION PROGRAM THAT OFFERS A WIDE VARIETY OF CLASSES ADDRESSING HEALTH ISSUES INCLUDING DIABETES, CHRONIC DISEASE SELF-MANAGEMENT, SMOKING CESSATION, AGING, HEALTH COOKING, AND PRENATAL CARE. THE FEE IS DISCOUNTED OR ELIMINATED FOR THOSE WHO ARE UNABLE TO PAY. - FREE NUTRITIONAL COUNSELING BY A REGISTERED DIETICIAN FOR THOSE THAT ARE UNINSURED OR CAN'T AFFORD TO PAY. - ASSISTANCE TO ALZHEIMER'S PATIENTS AND THEIR CAREGIVERS/FAMILIES BY THE HOSPITAL'S HOME CARE DEPARTMENT. - CANCER SCREENINGS AND CANCER SUPPORT GROUPS. - TRAUMATIC BRAIN INJURY, STROKE AND OTHER SUPPORT GROUPS. - EDUCATIONAL TRAINING FOR THOSE ENTERING THE PROFESSIONAL AND MEDICAL HEALTH FIELD. SIERRA NEVADA MEMORIAL HOSPITAL ALSO PROVIDES ASSISTANCE TO UNINSURED PATIENTS FOR ENROLLMENT IN GOVERNMENT SPONSORED HEALTH INSURANCE PROGRAMS, AND FREE TRANSPORTATION TO THOSE IN NEED.
Sch H, Part VI, Line 6 - Affiliated Health Care System	SNMMH is affiliated with Dignity Health. Affiliates of Dignity Health 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. Total unsponsored community benefit expense for Dignity Health and its subordinate corporations for the year ended June 30, 2016, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 140,490 96,453,000 0.8% Unpaid Costs of Medicaid/Medi-Cal 1,623,229 927,750,000 7.3% Other Means-tested Programs 275,647 7,027,000 0.1% Community Services: Community Health Services 371,669 44,816,000 0.4% Health Professions Education 84 48,000 0.0% Subsidized Health Services 321,882 47,172,000 0.4% Donations 108,977 22,245,000 0.2% Community Building Activities 6,090 1,679,000 0.0% Community Benefit Operations 65 8,030,000 0.1% Total Community Services for the poor 808,767 123,990,000 1.1% Total Benefits for the Poor 2,848,133 1,155,220,000 9.3% Benefits for the Broader Community: Community Services: Community Health Services 307,874 13,768,000 0.1% Health Professions Education 24,127 70,327,000 0.6% Subsidized Health Services 5,215 1,147,000 0.0% Research 565 7,370,000 0.1% Donations 36,410 6,544,000 0.1% Community Building Activities 16,623 2,724,000 0.0% Community Benefit Operations 28 1,318,000 0.0% Total Benefits for the Broader Community 390,842 103,198,000 0.8% Total Community Benefits 3,238,975 1,258,418,000 10.1% Unpaid Costs of Medicare 1,098,561 895,491,000 7.1% Total Community Benefits including Cost of Medicare 4,337,536 2,153,909,000 17.2%

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
Western Sierra Medical Clinic Inc
1345 Whispering Pines Lane	Grass Valley	CA	95945	942279011	501(c)(3)	$180,720	$0	N/A	N/A	Community Health
Sierra nevada Hospital Foundation
140 Litton Drive	Grass Valley	CA	95945	680005939	501(c)(3)	$708,068	$0	N/A	N/A	Foundation Support
California Health Foundation and Trust
1215 K Street Suite 800	Sacramento	CA	95814	941498697	501(c)(3)	$168,313	$0	N/A	N/A	Community Health
Dignity Health Medical Foundation
3400 Data Drive	Rancho Cordova	CA	95670	680220314	501(c)(3)	$6,366,234	$0	N/A	N/A	Medical Fnd Support
Nevada County Bahavioral Health Department
500 Crown Point Circle Suite 120	Grass Valley	CA	95945	946000526	Govt	$131,178	$0	N/A	N/A	Community Health

Field	Value	IRS element (for citing)
Total501c3 Org	5	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, line 2	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION'S CFO REVIEWS FINANCIAL INFORMATION MONTHLY AND APPROVES THE GRANT PAYMENT BASED ON THAT REVIEW. THE GRANTS TO THE FOUNDATION ARE BASED ON ACTUAL EXPENSES, NOT TO EXCEED THE APPROVED BUDGET.	ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
Kevin Vaziri
Board Member	$0	$333,364	$0	$275,789	$0	$10,607	$0	$52,601	$0	$40,687	$0	$713,048	$0	$0
Katherine A Medeiros
CEO/ Service Area Leader	$0	$296,172	$0	$207,397	$0	$15,378	$0	$42,233	$0	$38,604	$0	$599,784	$0	$0
Carolyn Canady
CFO/Board Treasurer	$196,210	$0	$39,502	$0	$3,832	$0	$31,981	$0	$12,514	$0	$284,039	$0	$0	$0
Brian Evans
VP, CMO	$235,066	$0	$47,137	$0	$0	$0	$20,601	$0	$33,686	$0	$336,490	$0	$0	$0
Jill McWilliams
VP/CNE	$185,658	$0	$37,580	$0	$0	$0	$16,424	$0	$25,362	$0	$265,024	$0	$0	$0
Debbie L Plass
VP Operations	$156,534	$0	$31,069	$0	$0	$0	$21,791	$0	$22,757	$0	$232,151	$0	$0	$0
Gregory T Smith
Registered Nurse	$233,860	$0	$500	$0	$8,539	$0	$19,966	$0	$33,436	$0	$296,301	$0	$0	$0
Jonathan D Stone
Director of Pharmacy	$176,195	$0	$26,875	$0	$0	$0	$26,835	$0	$23,389	$0	$253,294	$0	$0	$0
William S Swindling
Pharmacist	$182,777	$0	$5,226	$0	$13,328	$0	$23,791	$0	$1,077	$0	$226,199	$0	$0	$0
Tzvetan I Tzvetanov
Physicist	$263,483	$0	$13,407	$0	$0	$0	$44,395	$0	$2,656	$0	$323,941	$0	$0	$0
Gail A Van Vleck
Charge Nurse IP/OP Surgery	$224,584	$0	$500	$0	$0	$0	$19,895	$0	$21,085	$0	$266,064	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3	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 SERVICE AREA LEADER'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION.
PART I, LINE 4a	SCHEDULE J, PART I, LINE 4A THE ORGANIZATION'S KEY EMPLOYEES, CERTAIN OFFICERS AND HIGHLY COMPENSATED EMPLOYEES PARTICIPATE IN A SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION PAYMENTS OF UP TO 6 MONTHS 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. NO PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT OCCURRED DURING 2015.
PART I, LINE 4b	CERTAIN LISTED PERSONS are eligible to participate in one of two non-qualified 457(f) plans that are subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is for executives hired prior to June 30, 2006. The benefit is intended to bridge the difference, if any, between the benefit provided under the Dignity Health Excess Benefit Plan had benefit service not been frozen at January 1, 2008, and the benefits provided from all other qualified and non-qualified plans. Benefits vest under this 457(f) plan at the later of the date the participant attains age 62 or is credited with 15 years of service. The 2010 Executive Deferred Compensation Plan is for certain officers and key employees, primarily those who are not eligible to participate in the Dignity Health Excess Benefit Plan or the 2007 Executive Deferred Compensation Plan described above. This benefit provides an annual accrual of 10% of total compensation and is payable annually on July 1 once vested, which is age 62 with 5 years of service; the plan also allows for special awards. NO PAYMENTS WERE MADE UNDER THIS PLAN DURING 2015. 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 to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities it serves, promoting patient and employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Human Resources and Compensation Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and the organization's commitment to serving the poor and disenfranchised in the communities it serves. Total compensation, which includes base salary, annual and long-term incentive compensation, is established to approximate the prevailing market conditions for executives of companies of similar size, revenues and complexity.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
A	521598225	13033FTN0	2004-05-19	$150,000,000	BOND A: CUSIP 13033FTN0-SEE PRT VI	false	false	Yes (true)
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
B	521643828	13033FYE4	2005-11-10	$200,000,000	BOND B: CUSIP 13033FYE4-SEE PRT VI	false	false	Yes (true)

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$0	$0	$2,000,000	$0	$0	$0	$0	$0	$0	$2,000,000	$0	$0	2005	false	false	Yes (true)	Yes (true)
B	$0	$0	$2,334,365	$0	$0	$0	$0	$0	$0	$2,334,365	$0	$0	2008	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0.00100	0.00300	0.00400	false	false	0.00000	false	Yes (true)
B	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0.00100	0.00300	0.00400	false	false	0.00000	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	false	Yes (true)	Yes (true)	false	false	0	Yes (true)	Yes (true)
0
B	false	false	false	Yes (true)	Yes (true)	false	false	0	Yes (true)	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

BOND A: CUSIP 13033FTN0

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 OF THE fact 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 SIERRA NEVADA HOSPITAL 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, SIERRA NEVADA MEMORIAL HOSPITAL 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 CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.

BOND B: CUSIP 13033FYE4

PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE fact 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 SIERRA NEVADA HOSPITAL 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 IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFOMED ON 1/28/2015.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	LEANNA KLISTOFF	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	FAMILY MEMBER, A KLISTOFF	RelationshipDescriptionTxt
Transaction	$103,974	TransactionAmt
Transaction	EMPLOYMENT	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV	FormAndLineReferenceDesc
Explanation	A KLISTOFF IS A BOARD MEMBER OF THE FILING ORGANIZATION.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, VII, XI and XII	FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SOLE CORPORATE MEMBER, DIGNITY HEALTH, A 501(C)(3) EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER CAN ELECT ONE MEMBER AND APPOINT TWO OTHER MEMBERS IF NOMINATED BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B RESERVED RIGHTS OF THE CORPORATE MEMBER INCLUDE ADOPTION OF MISSION AND PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS, DISSOLUTION OF THE CORPORATION, ACQUISITION OF ANOTHER CORPORATION, CREATION OF A NEW SUBSIDIARY, MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION, PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE, INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS, RATIFICATION OF BOARD MEMBER APPOINTMENTS AND DISMISSALS, SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, AND TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CFO REVIEWED THE FORM 990. IN ADDITION, IN THE PROCESS OF PREPARATION, THE FORM 990 WAS REVIEWED BY FINANCE AND ACCOUNTING (REGIONAL DIGNITY HEALTH MANAGEMENT AND CORPORATE TAX DEPARTMENT), WHICH WORKED CLOSELY WITH AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. DUE TO TIMING, THE FORM 990 WILL BE SHARED WITH THE ORGANIZATION'S BOARD SUBSEQUENT TO FILING WITH THE INTERNAL REVENUE SERVICE. 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 real 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 the 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 ALTHOUGH THE ORGANIZATION EMPLOYS PERSONNEL, THE SERVICE AREA LEADER IS COMPENSATED BY DIGNITY HEALTH. FOR 2015, 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 COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS BASED ON A COMPREHENSIVE EVALUATION FOCUSING ON ALL ASPECTS OF THE INCUMBENT'S ASSIGNED DUTIES AND ASSESSED PERFORMANCE IN CARRYING OUT THE PHILOSOPHY AND MISSION OF SNMMH. ADDITIONALLY, COMPARATIVE DATA AND MARKET SURVEYS REGARDING COMPENSATION IN THE SURROUNDING MARKETPLACE ARE CONSIDERED. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION. FORM 990 AND THE COPY OF AUDITED FINANCIAL STATEMENTS ATTACHED TO IT ARE MADE AVAILABLE UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON OUR WEBSITE. FORM 990, PART XI, LINE 9 INTEREST IN NET ASSETS OF AN UNCONSOLIDATED FOUNDATION; (32,904) FORM 990, PART XII, LINE 3B THE ORGANIZATION'S FEDERAL AWARDS WERE INCLUDED IN DIGNITY HEALTH'S CONSOLIDATED OMB CIRCULAR A-133 AUDITED SCHEDULE OF FEDERAL EXPENDITURES.
SAFE HARBOR ELECTION DISCLOSURE	Tangible Property Regulation Statement Section 1.263(A)-1(F) de minimis safe harbor election Taxpayer is making the de minimis safe harbor election under Treasury Regulation 1.263(A)-1(F) for all eligible amounts paid or incurred during the taxable year.
FORM 990 PART IX LINE 11G	DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:4286410
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL SERVICES TOTAL FEES:10091674
FORM 990 PART IX LINE 11G	DESCRIPTION:MAINTENANCE/REPAIRS/JANITORIAL TOTAL FEES:3263932
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL CONSULTING TOTAL FEES:1540798
FORM 990 PART IX LINE 11G	DESCRIPTION:LAUNDRY& LINE SVCS TOTAL FEES:413637
FORM 990 PART IX LINE 11G	DESCRIPTION:STORAGE & SHREDDING SVCS TOTAL FEES:102531
FORM 990 PART IX LINE 11G	DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:4387507
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:2171826

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
Sierra Nevada Memorial Hospital Fdtn
140 Litton Drive	Grass Valley	CA	95945	680005939	Fundraising	CA	501(c)(3)	11;type 3	NA	false
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	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

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