SIERRA NEVADA MEMORIAL-MINERS HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: SIERRA NEVADA MEMORIAL-MINERS HOSPITAL (EIN 94-1439787)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-05-06
IRS object ID: 201611279349301071
Schema version: 2014v6.0
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 O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-06T14:16:36-05:00	ReturnTs
Tax Period End	2015-06-30	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	2014-07-01	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	2016-05-06	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	2016-05-06	PreparationDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	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	$207,672,864	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	10	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	928	TotalEmployeeCnt
Total Volunteers	93	TotalVolunteersCnt
Total Gross UBI	$8,111	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$1,602	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,075,455	PYContributionsGrantsAmt
CY Contributions Grants	$1,003,110	CYContributionsGrantsAmt
PY Program Service Revenue	$132,763,933	PYProgramServiceRevenueAmt
CY Program Service Revenue	$148,797,515	CYProgramServiceRevenueAmt
PY Investment Income	$15,441,807	PYInvestmentIncomeAmt
CY Investment Income	$7,492,224	CYInvestmentIncomeAmt
PY Other Revenue	$630,723	PYOtherRevenueAmt
CY Other Revenue	$641,210	CYOtherRevenueAmt
PY Total Revenue	$149,911,918	PYTotalRevenueAmt
CY Total Revenue	$157,934,059	CYTotalRevenueAmt
PY Grants And Similar Paid	$6,000,503	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$5,422,875	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$84,288,028	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$90,326,370	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$47,262,916	PYOtherExpensesAmt
CY Other Expenses	$61,100,968	CYOtherExpensesAmt
PY Total Expenses	$137,551,447	PYTotalExpensesAmt
CY Total Expenses	$156,850,213	CYTotalExpensesAmt
PY Revenues Less Expenses	$12,360,471	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,083,846	CYRevenuesLessExpensesAmt
Total Assets BOY	$247,735,568	TotalAssetsBOYAmt
Total Assets EOY	$251,963,383	TotalAssetsEOYAmt
Total Liabilities BOY	$29,653,296	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$33,385,953	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$218,082,272	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$218,577,430	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	$133,611,315	ExpenseAmt
Grant	$5,422,875	GrantAmt
Revenue	$148,793,688	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 2015 INCLUDED 149,389 OUTPATIENT VISITS, 33,978 EMERGENCY VISITS, AND 2,440 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	$133,611,315	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	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	123	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	928	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	10	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	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

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

Form990 Part VII Section A Form990PartVIISectionAGrp (22 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
Tom Walker Brown
Board Member (thru 1/5/15)	2.0	0.0	Yes (X)	$0	$0	$0
Andrew Chang MD
Board Member (thru 12/31/14)	2.0	0.0	Yes (X)	$0	$0	$0
Dale Creighton
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
Kathryn Rappath
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	$540,435	$81,039
Alan Wong
Board Member	2.0	0.0	Yes (X)	$18,000	$0	$0
Katherine A Medeiros
CEO/ Service Area Leader	40.0	0.0	Yes (X)	$0	$472,879	$75,478	Yes (X)
Edward Sylvester
Board Secretary	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Michele White
Board Vice Chair	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Sarah Woerner MD
Board Chair (thru 6/30/15)	2.0	0.0	Yes (X)	$30,650	$0	$0	Yes (X)
Carolyn Canady
CFO/Board Treasurer	40.0	0.0		$215,437	$0	$26,387	Yes (X)
Brian Evans
VP, CMO	40.0	0.0		$249,308	$0	$49,397		Yes (X)
Jill McWilliams
VP/CNE	40.0	0.0		$205,961	$0	$35,590		Yes (X)
Debbie L Plass
VP Operations	40.0	0.0		$162,693	$0	$31,725		Yes (X)
Timothy Stephens
VP Ancillary Services	40.0	0.0		$156,234	$0	$36,561		Yes (X)
Gregory T Smith
Registered Nurse	40.0	0.0		$243,177	$0	$47,202			Yes (X)
Jonathan D Stone
Director of Pharmacy	40.0	0.0		$189,795	$0	$32,249			Yes (X)
William S Swindling
Pharmacist	40.0	0.0		$164,782	$0	$12,495			Yes (X)
Tzvetan I Tzvetanov
Physicist	40.0	0.0		$263,633	$0	$21,057			Yes (X)
Gail A Van Vleck
Charge Nurse IP/OP Surgery	40.0	0.0		$175,007	$0	$33,086			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,074,677	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,013,314	TotReportableCompRltdOrgAmt
Total Other Compensation	$482,266	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	220	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	$1,324,808
SIERRA NEVADA ANESTHESIA
970 E MAIN ST SUITE 100	GRASS VALLEY	CA	95945	Medical Services	$1,201,626
DELPHI OF TEAM HEALTH
PO BOX 634850	CINCINNATI	OH	45263	Medical Services	$791,938
ALLIEDBARTON SECURITY SERVICES LLC
161 WASHINGTON ST SUITE 600	CONSHOHOCKEN	PA	19428	Security Services	$480,674
SWOPE MEDICAL GROUP INC
PO BOX 1886	NEVADA CITY	CA	95959	Medical Services	$214,134

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	12	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$928,661	RelatedOrganizationsAmt
Government Grants	$41,872	GovernmentGrantsAmt
All Other Contributions	$32,577	AllOtherContributionsAmt
Total Contributions	$1,003,110	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT NET OF CHARITY & BAD DEBT	900099	$71,912,750	$71,912,750
MEDICARE/MEDICAID PAYMENTS	900099	$75,117,979	$75,117,979
MEANINGFUL USE INCENTIVES (EHR)	900099	$707,773	$707,773
MEDICAL OFFICE BLDG	621300	$136,370	$136,370
GS HIO MAINTENANCE	900099	$355,284	$355,284

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$567,359	TotalRevenueColumnAmt
Related Or Exempt Func Income	$563,532	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$3,827	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$148,797,515	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,577,912	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$2,577,912	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	$1,165	RealAmt

Less Rental Expenses LessRentalExpensesGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,165	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,165	TotalRevenueColumnAmt
Exclusion	$1,165	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$54,649,961	SecuritiesAmt
Other	$2,904	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$49,738,553	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,911,408	SecuritiesAmt
Other	$2,904	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,914,312	TotalRevenueColumnAmt
Exclusion	$4,914,312	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	$1,016	GamingGrossIncomeAmt
Gaming Direct Expenses	$252	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$764	TotalRevenueColumnAmt
Exclusion	$764	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	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
GIFT SHOPS	453220	$142,710	$0	$142,710
CAFETERIA/CATERING	722320	$174,106	$4,284	$169,822
FINANCE CHARGES	900099	$77,667		$77,667

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$244,798	TotalRevenueColumnAmt
Exclusion	$244,798	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$639,281	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$157,934,059	TotalRevenueColumnAmt
Related Or Exempt Func Income	$148,793,688	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$8,111	UnrelatedBusinessRevenueAmt
Exclusion	$8,129,150	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	$5,418,875	TotalAmt
Program Services	$5,418,875	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$4,000	TotalAmt
Program Services	$4,000	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	$1,134,539	TotalAmt
Program Services	$1,052,924	ProgramServicesAmt
Management And General	$81,615	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$66,854,228	TotalAmt
Program Services	$62,849,171	ProgramServicesAmt
Management And General	$4,005,057	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$4,510,039	TotalAmt
Program Services	$4,256,977	ProgramServicesAmt
Management And General	$253,062	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$13,120,929	TotalAmt
Program Services	$12,400,963	ProgramServicesAmt
Management And General	$719,966	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,706,635	TotalAmt
Program Services	$4,442,542	ProgramServicesAmt
Management And General	$264,093	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	$89,799	TotalAmt
Management And General	$89,799	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$35,637	TotalAmt
Management And General	$35,637	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$50,994	TotalAmt
Management And General	$50,994	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	$768,301	TotalAmt
Management And General	$768,301	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$24,536,912	TotalAmt
Program Services	$18,695,450	ProgramServicesAmt
Management And General	$5,841,462	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$340,920	TotalAmt
Program Services	$17,627	ProgramServicesAmt
Management And General	$323,293	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,238,680	TotalAmt
Program Services	$2,297,475	ProgramServicesAmt
Management And General	$941,205	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$10,001,388	TotalAmt
Program Services	$630,760	ProgramServicesAmt
Management And General	$9,370,628	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,639,894	TotalAmt
Program Services	$1,588,864	ProgramServicesAmt
Management And General	$51,030	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$218,117	TotalAmt
Program Services	$159,940	ProgramServicesAmt
Management And General	$58,177	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	$79,830	TotalAmt
Program Services	$35,746	ProgramServicesAmt
Management And General	$44,084	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$733,252	TotalAmt
Program Services	$733,252	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$5,040,600	TotalAmt
Program Services	$5,016,717	ProgramServicesAmt
Management And General	$23,883	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$803,850	TotalAmt
Program Services	$803,850	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$12,757,847	$12,754,721	$3,126	$0
DUES & SUBSCRIPTIONS	$195,500	$28,236	$167,264	$0
LICENSES & TAXES	$103,840	$62,623	$41,217	$0
BAD DEBT	$16,706	$0	$16,706	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$448,901	TotalAmt
Program Services	$360,602	ProgramServicesAmt
Management And General	$88,299	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$156,850,213	TotalAmt
Program Services	$133,611,315	ProgramServicesAmt
Management And General	$23,238,898	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	$6,175	BOYAmt
EOY	$6,388	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,707,840	BOYAmt
EOY	$2,264,536	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	$22,592,217	BOYAmt
EOY	$28,887,452	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	$149,618	BOYAmt
EOY	$473,610	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,825,906	BOYAmt
EOY	$1,940,027	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,572,252	BOYAmt
EOY	$5,766,887	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$123,037,358	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$81,157,831	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$38,054,473	BOYAmt
EOY	$41,879,527	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$118,899,478	BOYAmt
EOY	$111,818,708	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$52,246,405	BOYAmt
EOY	$53,246,572	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$6,681,204	BOYAmt
EOY	$5,679,676	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	$247,735,568	BOYAmt
EOY	$251,963,383	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$12,436,128	BOYAmt
EOY	$15,705,874	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	$211,023	BOYAmt
EOY	$266,436	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	$0	BOYAmt
EOY	$413,203	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	$12,671,780	BOYAmt
EOY	$12,666,075	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$29,653,296	BOYAmt
EOY	$33,385,953	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$213,306,085	BOYAmt
EOY	$214,817,106	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,408,509	BOYAmt
EOY	$2,392,646	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	$218,082,272	BOYAmt
EOY	$218,577,430	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$247,735,568	BOYAmt
EOY	$251,963,383	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,083,846	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$312,127	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$900,815	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	$50,994	OtherActivitiesAmt
Total Lobbying Expenditures	$50,994	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 $3 WOUND OSTOMY AND CONTINENCE NURSES SOCIETY $1 ASTRO $186 LOBBYING EXPENDITURES PAID BY THE PARENT ORGANIZATION FOR ANNUAL MEMBERSHIP DUES WHERE EXPENSES ARE ALLOCATED TO THE HOSPITAL: CATHOLIC HEALTH ASSOCIATION $692 AMERICAN HOSPITAL ASSOCIATION $2,544 HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA $8,503 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME $38 VISITING NURSE ASSOCIATION OF AMERICA $149 CALIFORNIA HOSPITAL ASSOCIATION $38,878 TOTAL EXPENDITURES PAID TO ORGANIZATIONS $50,994	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	$2,296,400	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$66,097	InvestmentEarningsOrLossesAmt
End Year Balance	$2,362,497	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,423,093	BeginningYearBalanceAmt
Contributions	$57,110	ContributionsAmt
Investment Earnings Or Losses	$350,442	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,230,900	OtherExpendituresAmt
End Year Balance	$1,599,745	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.60000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.40000	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	$63,225,301	OtherCostOrOtherBasisAmt
Depreciation	$41,234,065	DepreciationAmt
Book Value	$21,991,236	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	$46,072,409	OtherCostOrOtherBasisAmt
Depreciation	$36,773,231	DepreciationAmt
Book Value	$9,299,178	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,309,904	OtherCostOrOtherBasisAmt
Depreciation	$2,860,944	DepreciationAmt
Book Value	$9,448,960	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$41,879,527	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	POOLED INVESTMENTS	Desc
Book Value	$53,246,572	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$53,246,572	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTIES	$9,782,946
PENSION PAYABLE	$2,883,129

Field	Value	IRS element (for citing)
Total Liability	$12,666,075	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	5281	PersonsServedCnt
Total Community Benefit Expns	$2,213,911	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,213,911	NetCommunityBenefitExpnsAmt
Total Expense	0.01410	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	33081	PersonsServedCnt
Total Community Benefit Expns	$33,619,742	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$34,020,664	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$400,922	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Persons Served	28	PersonsServedCnt
Total Community Benefit Expns	$85,834	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$35,734	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$50,100	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	38390	PersonsServedCnt
Total Community Benefit Expns	$35,919,487	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$34,056,398	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,863,089	NetCommunityBenefitExpnsAmt
Total Expense	0.01180	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	12083	PersonsServedCnt
Total Community Benefit Expns	$426,177	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$720	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$425,457	NetCommunityBenefitExpnsAmt
Total Expense	0.00270	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	26	PersonsServedCnt
Total Community Benefit Expns	$49,951	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$49,951	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	663	PersonsServedCnt
Total Community Benefit Expns	$1,251,307	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,251,307	NetCommunityBenefitExpnsAmt
Total Expense	0.00800	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	32	ActivitiesOrProgramsCnt
Persons Served	12772	PersonsServedCnt
Total Community Benefit Expns	$1,727,435	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$720	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,726,715	NetCommunityBenefitExpnsAmt
Total Expense	0.01100	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	32	ActivitiesOrProgramsCnt
Persons Served	51162	PersonsServedCnt
Total Community Benefit Expns	$37,646,922	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$34,057,118	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,589,804	NetCommunityBenefitExpnsAmt
Total Expense	0.02280	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	25	PersonsServedCnt
Total Community Benefit Expns	$56,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$56,293	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	25	PersonsServedCnt
Total Community Benefit Expns	$56,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$56,293	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,655,624	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$39,834,468	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$62,332,851	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$22,498,383	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	0.22800	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.00000	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.31590	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	www.SNMH.org	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	13	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
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.healthylivingmap.com	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SECTION C	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
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 App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.snmh.org	FAPAppAvailableOnWebsiteURLTxt
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 THE JUNE 2013 CHNA WAS GUIDED BY AN OBJECTIVE THAT FOCUSED ON IDENTIFYING COMMUNITIES, AND SPECIFIC GROUPS WITHIN THESE COMMUNITIES, EXPERIENCING HEALTH DISPARITIES. ANOTHER OBJECTIVE WAS TO IDENTIFY CONTRIBUTING FACTORS THAT CREATE BOTH BARRIERS AND OPPORTUNITIES FOR SPECIFIC POPULATIONS TO LIVE HEALTHIER LIVES. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS, AND KEY INFORMANTS INCLUDING: NEVADA COUNTY AND SURROUNDING COUNTY PUBLIC HEALTH AGENCIES, MINERS COMMUNITY CLINIC, COMMUNITY RECOVERY SERVICES, AND THE NEVADA CITY UNIFIED SCHOOL DISTRICT. A FOCUS GROUP CONSISTING OF 12 COMMUNITY MEMBERS WAS CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. SECONDARY QUANTITATIVE DATA WAS COLLECTED ON HEALTH, DEMOGRAPHIC, BEHAVIORAL, AND ENVIRONMENTAL FACTORS. COUNTY, STATE, AND HEALTHY PEOPLE 2020 TARGETS (WHEN AVAILABLE) WERE USED AS BENCHMARKS TO DETERMINE SEVERITY OF HEALTH ISSUES. 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 HTTP://WWW.DIGNITYHEALTH.ORG/SACRAMENTO/HOSPITALS/SIERRA-NEVADA-MEMORIAL-H OSPITAL/ABOUT-US/SERVING-THE-COMMUNITY SCHEDULE H, PART V, SECTION B, LINE 10A http://www.dignityhealth.org/cm/media/documents/Sierra-Nevada-Memorial-Hos pital-IS.pdf SCHEDULE H, PART V, SECTION B, LINE 11 SIERRA NEVADA MEMORIAL HOSPITAL IDENTIFIED AS PRIORITY HEALTH NEEDS IN THE CHNA INCLUDE: 1. LACK OF ACCESS TO PRIMARY CARE AND PREVENTIVE SERVICES; 2. LACK OF INTEGRATION OF BEHAVIORAL HEALTH AND PRIMARY CARE; 3. TRANSPORTATION ISSUES AND LIMITATIONS; 4. LIMITED ACCESS TO HEALTHY FOODS, FOOD SECURITY; 5. LACK OF ACCESS TO SPECIALTY CARE; 6. LACK OF DENTAL CARE; 7. LACK OF ACCESS TO MENTAL HEALTH SERVICES; 8. ELIGIBILITY REQUIREMENTS FOR MEDI-CAL AND OTHER SOCIAL SERVICES; 9. LACK OF ACCESS TO OUTDOOR AND RECREATIONAL ACTIVITIES; 10. LACK OF ACCESS TO PHYSICAL THERAPY. LACK OF ACCESS TO PRIMARY CARE: THE HOSPITAL SUPPORTS THIS CENTER'S CURRENT EFFORTS TO SERVE AS A PRIMARY HEALTH CARE HOME TO THE UNDERSERVED. TO PROVIDE MUCH NEEDED SPACE (ONE CONTRIBUTOR TO POOR ACCESS IDENTIFIED THROUGH QUALITATIVE DATA IN THE CHNA) THE HOSPITAL HAS ENABLED THE CLINIC TO UTILIZE HOSPITAL-OWNED FACILITIES IN GRASS VALLEY FOR ADDITIONAL CAPACITY AT A REDUCED RATE. LACK OF ACCESS TO PREVENTATIVE SERVICES: THE HOSPITAL IS ONE OF THE FEW PROVIDERS IN THE REGION ADDRESSING THE NEED FOR HEALTH EDUCATION THAT FOCUSES ON DISEASE PREVENTION AND MANAGEMENT OF CHRONIC DISEASE. THROUGH THE HOSPITAL'S WELLNESS EDUCATION DEPARTMENT, THOUSANDS OF RESIDENTS HAVE BEEN SERVED OVER THE PAST 15 YEARS, RECEIVING THE NECESSARY RESOURCES AND SKILLS TO CONTROL HEALTH CONDITIONS AND LEAD HEALTHIER LIVES. DIABETES: TAKE CONTROL! IS AN ACTIVE AND GROWING PROGRAM FOCUSED ON EDUCATION AND NUTRITION COUNSELING TO ENABLE RESIDENTS TO BETTER MANAGE THIS CHRONIC CONDITION, STAY HEALTHY, AND AVOID HOSPITALIZATIONS FOR UNCONTROLLED SYMPTOMS. BETTER BREATHER AND PULMONARY REHABILITATION, AND SMOKING CESSATION CLASSES ARE ALSO OFFERED, RESPONDING TO THE CHRONIC DISEASES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ASTHMA, WHICH WAS ALSO SHOWN TO BE PREVALENT IN THE CHNA. BUILDING CAPACITY FOR PREVENTATIVE SERVICES: COLLABORATIVE EFFORTS ARE UNDERWAY BY THE HOSPITAL WITH WESTERN SIERRA MEDICAL CLINIC TO INCREASE ACCESS TO PREVENTATIVE SERVICES. THE HOSPITAL IS TRAINING KEY MEMBERS OF THE CLINIC'S STAFF TO BE ABLE TO PROVIDE EDUCATION AND TO FACILITATE CHRONIC DISEASE SELF MANAGEMENT CLASSES, EXTENDING THE REACH OF THESE PROGRAMS IN THE REGION, AND IN PARTICULAR TO COMMUNITIES OF CONCERN. LACK OF MENTAL HEALTH SERVICES AND SUBSTANCE ABUSE TREATMENT: SIERRA NEVADA MEMORIAL HOSPITAL RECOGNIZES THE MAJOR GAP IN SERVICES FOR MENTAL HEALTH CARE, AND THE HIGH SUBSTANCE ABUSE PROBLEM IN THE REGION, AND IS RESPONDING THROUGH COLLABORATIVE MEASURES THAT BUILD CAPACITY IN THE COMMUNITY FOR SERVICES ADDRESSING THESE NEEDS. LACK OF ACCESS TO SPECIALTY CARE: THE HOSPITAL CONTINUES TO GROW ITS NURSE NAVIGATOR AND PEER SUPPORT PROGRAMS WITHIN ITS EXISTING SERVICE LINES, PARTICULARLY FOR STROKE VICTIMS. STROKE, SPECIFICALLY AMONG THE LARGE ELDERLY MALE POPULATION IN THE REGION, WAS IDENTIFIED AS A HIGH-RISK HEALTH ISSUE IN THE CHNA. THE HOSPITAL IS ALSO DEVELOPING A LUNG CANCER SCREENING PROGRAM TO RESPOND TO THE GROWING PREVALENCE OF LUNG CANCER, WHICH WAS INDICATED IN THE CHNA AS AN INCREASING CONCERN. UNINTENTIONAL INJURY. FALLS PREVENTION CLASSES ARE OFFERED, AND THE HOSPITAL IS INVOLVED IN THE FALLS PREVENTION COALITION OF NEVADA COUNTY, AN ORGANIZATION DEDICATED TO REDUCING THE RISK OF FALLS THROUGH EDUCATION. ELIGIBILITY REQUIREMENTS FOR MEDI-CAL AND OTHER SOCIAL SERVICES: SIERRA NEVADA MEMORIAL HOSPITAL'S ACTIVE ENROLLMENT ASSISTANCE PROGRAM IS DIRECTLY ALIGNED WITH THIS CHNA PRIORITY. THE PROGRAM IDENTIFIES PATIENTS WITHOUT INSURANCE AND NAVIGATES THEM THROUGH THE COMPLICATED AND OFTEN CONFUSING ENROLLMENT PROCESS. THE NEEDS OF NEVADA COUNTY ARE MONUMENTAL, AND AS THE SOLE HOSPITAL SERVING THIS EXPANSIVE RURAL REGION, SIERRA NEVADA MEMORIAL HOSPITAL, AS A RURAL COMMUNITY HOSPITAL, DOES NOT HAVE THE RESOURCES AVAILABLE TO DEVELOP AND/OR DUPLICATE INITIATIVES TO MEET EVERY PRIORITY NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. THE COUNTY PUBLIC HEALTH DEPARTMENT AND OTHER COMMUNITY-BASED NONPROFIT ORGANIZATIONS FOR INSTANCE, ARE PROVIDING MENTAL HEALTH SERVICES. COMMUNITY RECOVERY RESOURCES DIRECTLY RESPONDS TO THE ISSUE OF SUBSTANCE ABUSE, AND IN FACT, IS BUILDING A NEW INPATIENT TREATMENT FACILITY. THE CITY OF GRASS VALLEY AND NEVADA CITY OFFER WEEKLY FARMERS MARKETS, MAKING FRESH FOODS AVAILABLE AT AN AFFORDABLE COST TO RESIDENTS. SCHEDULE H, PART V, SECTION B, LINE 16B http://www.dignityhealth.org/sacramento/hospitals/sierra-nevada-memorial-h ospital/patients-and-visitors/patients/billing-information/payment-assista nce SCHEDULE H, PART V, SECTION B, LINE 16I ADDITIONAL MEASURES TAKEN TO PUBLICIZE SNMH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS, A COPY OF THE CHARITY CARE 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, AND THE FACILITY'S WEBPAGE ADDRESS WHERE ADDITIONAL INFORMATION AND APPLICATIONS CAN BE ACCESSED. SCHEDULE H, PART V, SECTION B, LINE 22D PATIENTS WHO ARE APPLYING FOR DISCOUNTS UNDER THE DISCOUNT PROVISION POLICY WHOSE HOUSEHOLD INCOME IS AT OR BELOW 350% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES FROM MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT SPONSORED HEALTH PROGRAM OR HEALTH BENEFIT IN WHICH THE HOSPITAL PARTICIPATES. PATIENTS WHOSE INCOME IS ABOVE 350% BUT NOT MORE THAN 500% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT 135% OF THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES TO PATIENTS COVERED BY MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT-SPONSORED HEALTH PROGRAM OF HEALTH BENEFITS IN WHICH THE HOSPITAL PARTICIPATES.	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 7, column (f) THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) IS $16,706 AND HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN 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 $14.6 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. 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 $0.6 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 FINANCIAL ASSISTANCE, AND ARE OTHERWISE UNINSURED. ANY PORTION OF A PATIENT BILL REMAINING AFTER APPLYING FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT THAT ARE ULTIMATELY DETERMINED TO BE UNCOLLECTIBLE ARE WRITTEN OFF TO BAD DEBT. 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. SNMMH 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 RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 25% FOR PATIENTS SEEN. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. 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, 2015, 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 $756 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 $22.5 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 FROM EARLY 2012 THOURGH FEBRUARY 2013 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 CONTRUCTED 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 PATIENT FINANCIAL ASSISTANCE AVAILABLE FROM SNMMH, INCLUDING A CONTACT NUMBER, IS DISSEMINATED BY THE HOSPITAL BY VARIOUS MEANS, INCLUDING THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN THE EMERGENCY AND ADMITTING DEPARTMENTS, CENTRAL LOBBIES, AND WAITING ROOMS. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATIONS SERVED BY THE HOSPITAL. IN ADDITION, PAYMENT DISCUSSIONS ARE HELD WITH PATIENTS AT THE TIME OF REGISTRATION AND AGAIN WHEN DISCHARGED. THE PATIENT IS GIVEN A BROCHURE AT THESE TIMES. FINANCIAL ADVISORS ARE ALSO AVAILABLE DURING THE PATIENT'S VISIT. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF THE HOSPITAL REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ANY MEMBER OF SNMMH'S STAFF OR MEDICAL STAFF MAY MAKE REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT OR A FAMILY MEMBER, A CLOSE FRIEND OR 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 IN NEVADA COUNTY ENCOMPASSING THREE ZIP CODES IN THE COMMUNITIES OF GRASS VALLEY, PENN VALLEY AND NEVADA CITY. POPULATION: POPULATION WITHIN SIERRA NEVADA MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA IS 99,000; A LARGE PERCENTAGE WHO ARE RETIRED. WITHIN THE HOSPITAL'S PRIMARY SERVICE AREA, PEOPLE BETWEEN THE AGES OF 35 AND 64 MAKE UP THE LARGEST PERCENTAGE OF THE POPULATION (44.4%). OVER 16% OF THE POPULATION IS BETWEEN 18 AND 34 YEARS OF AGE. CHILDREN AGE 17 AND YOUNGER MAKE UP 18.8% OF THE POPULATION, AND SENIORS 65 YEARS AND OLDER ACCOUNT FOR NEARLY 20.6% OF THE POPULATION. GROWTH IN THE SENIOR POPULATION IS ANTICIPATED IN THE FUTURE. OVER HALF OF THE POPULATION IS FEMALE. ETHNICITY: THE MAJORITY OF THE POPULATION IN SIERRA NEVADA MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA IS CAUCASIAN (87.7%). SOME GROWTH IS EXPECTED IN THE HISPANIC COMMUNITY. IN THE 2009 OSHPD DATA, 9% OF ITS RESIDENTS LIVE BELOW THE POVERTY LINE. 19.71% RECEIVE MEDICARE, 10.95% RECEIVE MEDICAL, 16.71% ARE UNINSURED AND 52.62% ARE SELF-PAID (12.97% RISK AND 39.64% NON-RISK). SIERRA NEVADA MEMORIAL HOSPITAL IS THE COMMUNITY'S SOLE HEALTHCARE PROVIDER. THE NEAREST HOSPITAL IS SUTTER AUBURN FAITH WHICH IS 22 MILES AWAY. PRIMARY CARE AND MENTAL HEALTH SERVICES HAVE BEEN FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.
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 COMMUNITY 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 FREE OR DISCOUNTED CLASSES ADDRESSING HEALTH ISSUES INCLUDING DIABETES, CHRONIC DISEASE SELF-MANAGEMENT, SMOKING CESSATION, AGING, HEALTHY COOKING, AND PRENATAL CARE. - FREE NUTRITIONAL COUNSELING BY A REGISTERED DIETICIAN FOR THOSE THAT ARE UNINSURED OR CAN'T AFFORD TO PAY. - FREE OR LOW COST LAB TESTING FOR ALL IN THE COMMUNITY, WITH AN EMPHASIS ON POOR AND VULNERABLE. - 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, 2015, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 155,869 144,043,000 1.2% Unpaid Costs of Medicaid/Medi-Cal 1,529,842 582,988,000 4.9% Other Means-tested Programs 269,823 9,201,000 0.1% Community Services: Community Health Services 376,686 41,756,000 0.3% Health Professions Education 79 3,000 0.0% Subsidized Health Services 96,294 24,872,000 0.2% Donations 123,504 36,533,000 0.3% Community Building Activities 7,795 1,818,000 0.0% Community Benefit Operations 143 7,124,000 0.1% Total Community Services for the poor 604,501 112,106,000 0.9% Total Benefits for the Poor 2,560,035 848,338,000 7.1% Benefits for the Broader Community: Community Services: Community Health Services 278,419 12,046,000 0.1% Health Professions Education 27,306 67,915,000 0.6% Subsidized Health Services 3,641 1,441,000 0.0% Research 14,806 10,910,000 0.1% Donations 31,341 8,662,000 0.1% Community Building Activities 7,583 3,822,000 0.0% Community Benefit Operations 31 1,333,000 0.0% Total Benefits for the Broader Community 363,127 106,129,000 0.9% Total Community Benefits 2,923,162 954,467,000 8.0% Unpaid Costs of Medicare 1,042,065 756,109,000 6.3% Total Community Benefits including Cost of Medicare 3,965,227 1,710,576,000 14.3%

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
California Health Foundation and Trust
1215 K Street Suite 800	Sacramento	CA	95814	941498697	501(c)(3)	$563,051	$0	N/A	N/A	Community Health
Sierra Nevada Hospital Foundation
140 Litton Drive	Grass Valley	CA	95945	680005939	501(c)(3)	$591,058		N/A	N/A	Foundation Support
Dignity Health Medical Foundation
3400 Data Drive	Rancho Cordova	CA	95670	680220314	501(c)(3)	$4,257,508		N/A	N/A	Medical Fnd Support

Field	Value	IRS element (for citing)
Total501c3 Org	3	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 (12 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	$325,589	$0	$204,626	$0	$10,220	$0	$44,385	$0	$36,654	$0	$621,474	$0	$0
Katherine A Medeiros
CEO/ Service Area Leader	$0	$290,607	$0	$167,652	$0	$14,620	$0	$39,560	$0	$35,918	$0	$548,357	$0	$0
Carolyn Canady
CFO/Board Treasurer	$188,302	$0	$27,135	$0	$0	$0	$14,945	$0	$11,442	$0	$241,824	$0	$0	$0
Brian Evans
VP, CMO	$226,083	$0	$22,116	$0	$1,109	$0	$17,126	$0	$32,271	$0	$298,705	$0	$0	$0
Jill McWilliams
VP/CNE	$180,243	$0	$25,718	$0	$0	$0	$14,211	$0	$21,379	$0	$241,551	$0	$0	$0
Debbie L Plass
VP Operations	$142,215	$0	$20,478	$0	$0	$0	$11,390	$0	$20,335	$0	$194,418	$0	$0	$0
Timothy Stephens
VP Ancillary Services	$108,612	$0	$19,657	$0	$27,965	$0	$8,988	$0	$27,573	$0	$192,795	$0	$0	$0
Gregory T Smith
Registered Nurse	$233,509	$0	$375	$0	$9,293	$0	$16,698	$0	$30,504	$0	$290,379	$0	$0	$0
Jonathan D Stone
Director of Pharmacy	$171,404	$0	$18,391	$0	$0	$0	$13,127	$0	$19,122	$0	$222,044	$0	$0	$0
William S Swindling
Pharmacist	$161,466	$0	$3,316	$0	$0	$0	$11,370	$0	$1,125	$0	$177,277	$0	$0	$0
Tzvetan I Tzvetanov
Physicist	$254,870	$0	$8,751	$0	$12	$0	$18,362	$0	$2,695	$0	$284,690	$0	$0	$0
Gail A Van Vleck
Charge Nurse IP/OP Surgery	$174,632	$0	$375	$0	$0	$0	$12,248	$0	$20,838	$0	$208,093	$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 2014.
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 2014. 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 6/30/2015.

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 1/28/2014.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 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; (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 2014, 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 employees. 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 EARNINGS FROM EXEMPT CORPORATION; 65,051 INTEREST IN NET ASSETS OF AN UNCONSOLIDATED FOUNDATION; (1,015,866) REFUND OF PRIOR YEAR GRANT EXPENSE; 50,000 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:MEDICAL SERVICES TOTAL FEES:7610357
FORM 990 PART IX LINE 11G	DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:5998077
FORM 990 PART IX LINE 11G	DESCRIPTION:INTERCOMPANY ASSESSMENT TOTAL FEES:4151431
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER TOTAL FEES:6777047

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
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