MARK TWAIN MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: MARK TWAIN MEDICAL CENTER (EIN 68-0127677)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-01
IRS object ID: 201341219349300984
Schema version: 2011v1.5
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 O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-01T18:46:01-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	55 SECOND STREET SUITE 1400	AddressLine1
City	SAN FRANCISCO	City
State	CA	State
ZIP Code	94105	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	680127677	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mark Twain St Joseph's	BusinessNameLine1
Business Name Line2	Healthcare Corporation	BusinessNameLine2

Field	Value	IRS element (for citing)
In Care Of Name	% CRYSTAL CARRASCO FINANCE DE	InCareOfName
Name Control	MARK	NameControl
Phone	2097543521	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	768 Mountain Ranch Road	AddressLine1
City	San Andreas	City
State	CA	State
ZIP Code	95249	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Jacob Lewis	Name
Title	CFO	Title
Date Signed	2013-04-23	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	4159635100	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	JACOB LEWIS CFO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	768 MOUNTAIN RANCH ROAD	AddressLine1
City	SAN ANDREAS	City
State	CA	State
ZIP Code	95249	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	68320788	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.dignityhealth.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1987	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	To continuously improve the health status of our community.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	8	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	4	NbrIndependentVotingMembers
Total Nbr Employees	344	TotalNbrEmployees
Total Nbr Volunteers	42	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	368501	ContributionsGrantsPriorYear
Contributions Grants Current Year	46555	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	51421244	ProgramServiceRevenuePriorYear
Program Service Revenue CY	50114674	ProgramServiceRevenueCY
Investment Income Prior Year	1239637	InvestmentIncomePriorYear
Investment Income Current Year	1359373	InvestmentIncomeCurrentYear
Other Revenue Prior Year	312068	OtherRevenuePriorYear
Other Revenue Current Year	203032	OtherRevenueCurrentYear
Total Revenue Prior Year	53341450	TotalRevenuePriorYear
Total Revenue Current Year	51723634	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	451057	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	457511	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	27204408	SalariesEtcPriorYear
Salaries Etc Current Year	27205394	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	1740	TotalFundrsngExpCurrentYear
Other Expense Prior Year	23068280	OtherExpensePriorYear
Other Expenses Current Year	25732288	OtherExpensesCurrentYear
Total Expenses Prior Year	50723745	TotalExpensesPriorYear
Total Expenses Current Year	53395193	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2617705	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1671559	RevenuesLessExpensesCY
Total Assets BOY	47454837	TotalAssetsBOY
Total Assets EOY	42747759	TotalAssetsEOY
Total Liabilities BOY	9679791	TotalLiabilitiesBOY
Total Liabilities EOY	7370903	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	37775046	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	35376856	NetAssetsOrFundBalancesEOY
Mission Description	TO CONTINUOUSLY IMPROVE THE HEALTH STATUS OF OUR COMMUNITY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	46265867	Expense
Grants	457511	Grants
Revenue	50114674	Revenue
Description	The hospital provides routine patient care in private and semi-private rooms as well as various inpatient and outpatient ancillary services such as x-ray, lab, emergency room, etc. During the fiscal year 2012, 1,340 patients were admitted to the facility and 72,542 patient visits were recorded at our 5 rural health clinics.	Description
Total Program Service Expense	46265867	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	135	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	344	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	8	NbrVotingGoverningBodyMembers
Number Independent Voting Members	4	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	CRYSTAL CARRASCO FINANCE DE	NamePerson
Telephone Number	9168512106	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3400 DATA DRIVE	AddressLine1
City	RANCHO CORDOVA	City
State	CA	State
ZIP Code	95670	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Dr Dean Kelaita
Board Member	4.0	X	24000	0	0
Dr Chris Krpan
Ex-officio board Member	4.0	X	78500	0	0
Ken McInturf
Board Member	4.0	X	0	0	0
Lewis Steele
Board Member	4.0	X	0	0	0
Donald Wiley
Board Member	4.0	X	0	638670	83873
Robert Campana
Chairman (thru 12/31/11)	4.0	X	0	0	0	X
Dr William Griffin
Chairman/Chief-of-Staff	4.0	X	0	0	0	X
Katherine Medeiros
Board Member/ President SNMH	4.0	X	0	425234	68186	X
David Woodhams DDS
Treasurer	4.0	X	0	0	0	X
Feliciano Jiron
President & CEO (thru 9/2011)	40.0		0	672194	44902	X
Jacob Lewis
VP & CFO	40.0		0	190867	24324	X
Craig Marks
President & CEO (start 5/2012)	40.0		0	0	0	X
Patty Monczewski
Interim President & CEO	16.0		0	265391	23484	X
Melissa M Cuevas
VP & CNE	40.0		190886	0	48551		X
Star Hildabrand
Physician Assistant	40.0		166718	0	30342			X
Jill Ortiz
Director of Pharmacy	40.0		195421	0	48350			X
Rafael A Rosado-Cosme
Physician	40.0		199764	0	17501			X
Peggy E Seever
Registered Nurse	40.0		225529	0	26712			X
Johanna Vermeltfoort
Manager RN Nursing	40.0		160983	0	21253			X
Tracy Church
Former Officer			0	157113	27769				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1241801	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2349469	TotalReportableCompFrmRltdOrgs
Total Other Compensation	465247	TotalOtherCompensation
Number Individuals GT100 K	72	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
RODGER ORMAN MD INC
PO BOX 2189	MURPHYS	CA	95247	Medical Services	673187
DIEDE CONSTRUCTION
PO BOX 1007	WOODBRIDGE	CA	95258	Construction Service	587808
ALLIANCE HEALTHCARE SERVICES
FILE 55826	LOS ANGELES	CA	900745826	Imaging Services	412692
DAVIS REED CONSTRUCTION INC
12250 EL CAMINO REAL SUITE 325	SAN DIEGO	CA	92130	Construction Service	362588
RENNER IAN G MD
704 MOUNTAIN RANCH RD SUITE 104	SAN ANDREAS	CA	95249	Physician Services	306254

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	15	NumberOfContractorsGT100K
Government Grants	46555	GovernmentGrants
Total Contributions	46555	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
MEDICARE / MEDICAID PAYMENTS	900099	26505661	26505661	0	$0
PATIENT REV/CHARITY CARE	900099	23501901	23501901	0	$0
MED OFFICE BLDG	900099	53888	53888
HEALTH FAIR REVENUE	900099	32959	32959
EDUCATION	900099	8149	8149

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	12116	TotalRevenueColumn
Related Or Exempt Function Income	12116	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	50114674	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	422053	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$422,053	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	0	Real
Personal	0	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	0	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Exclusion	$0	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	17534474	Securities
Other	0	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	16597154	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	937320	Securities
Other	0	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	937320	TotalRevenueColumn
Exclusion	$937,320	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

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

Net Income From Gaming NetIncomeFromGaming

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

Net Income Or Loss NetIncomeOrLoss

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

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
ADMIN SERVICES FOR MOB TENANTS	561000	51588	$51,588
ACCOUNTING SERVICES FOR DISTRICT	561499	42000	$42,000
CAFETERIA	900099	66180	$66,180

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	43264	TotalRevenueColumn
Exclusion	$43,264	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	203032	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	51723634	TotalRevenueColumn
Related Or Exempt Function Income	50114674	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$1,562,405	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	453106	Total
Program Services	453106	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	4405	Total
Program Services	4405	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	351197	Total
Program Services	320927	ProgramServices
Management And General	30270	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	21330352	Total
Program Services	19490132	ProgramServices
Management And General	1838480	ManagementAndGeneral
Fundraising	1740	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	606958	Total
Program Services	551295	ProgramServices
Management And General	55663	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	3368256	Total
Program Services	3059515	ProgramServices
Management And General	308741	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1548631	Total
Program Services	1406760	ProgramServices
Management And General	141871	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	137379	Total
Management And General	137379	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	47967	Total
Management And General	47967	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	6404	Total
Management And General	6404	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	93089	Total
Management And General	93089	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	7959168	Total
Program Services	5191937	ProgramServices
Management And General	2767231	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	408696	Total
Program Services	12385	ProgramServices
Management And General	396311	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1193031	Total
Program Services	1058483	ProgramServices
Management And General	134548	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	2336668	Total
Program Services	2305356	ProgramServices
Management And General	31312	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	939180	Total
Program Services	628764	ProgramServices
Management And General	310416	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	132656	Total
Program Services	61107	ProgramServices
Management And General	71549	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	55888	Total
Program Services	16982	ProgramServices
Management And General	38906	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	290415	Total
Program Services	290415	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2078632	Total
Program Services	2044025	ProgramServices
Management And General	34607	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1336580	Total
Program Services	975954	ProgramServices
Management And General	360626	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BAD DEBT	4787546	4787546	0
MEDICAL SUPPLIES	3417746	3414251	3495
FOOD SUPPLIES	162730	135585	27145
RECRUITING	149595	0	149595

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	198918	Total
Program Services	56937	ProgramServices
Management And General	141981	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	53395193	Total
Program Services	46265867	ProgramServices
Management And General	7127586	ManagementAndGeneral
Fundraising	1740	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1260	BOY
EOY	1260	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	2654800	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	11392797	BOY
EOY	5353438	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	49705	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	541999	BOY
EOY	449993	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	983299	BOY
EOY	1065218	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	324345	BOY
EOY	2085043	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	33814019	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	19779902	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	14132584	BOY
EOY	14034117	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	15817415	BOY
EOY	12732428	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	3570518	BOY
EOY	3315475	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	333101	BOY
EOY	673811	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	307814	BOY
EOY	382176	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	47454837	BOY
EOY	42747759	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2057037	BOY
EOY	2551177	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	904583	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	6718171	BOY
EOY	4819726	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	9679791	BOY
EOY	7370903	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	37441946	BOY
EOY	34703045	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	249331	BOY
EOY	590042	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	83769	BOY
EOY	83769	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	37775046	BOY
EOY	35376856	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	47454837	BOY
EOY	42747759	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-1671559	ReconcilationRevenueExpenses
Reconcilation Other Changes	-726631	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$6,404	OtherActivitiesAmount
Total Lobbying Expenditures IIB	6404	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	PART II - B, Line 1i	Identifier
Explanation	Lobbying expenditures paid directly by the filing organization for annual membership dues: National Association of Rural Health $180 American Association of Diabetes Educators $ 41 SHRM ORG $ 14 AICPA $ 10 ----- SUBTOTAL $245 Lobbying expenditures paid by the Parent organization for annual membership dues where expenses are allocated to the hospital: California Hospital Association $4,653 Catholic Health Association $429 American Hospital Association $1,077 ------ SUBTOTAL $6,159 ------ TOTAL $6,404 ======	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Current Year Minus3 Years		CurrentYearMinus3Years

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Book Value	0	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	16233932	OtherCostOrOtherBasis
Depreciation	8698551	Depreciation
Book Value	7535381	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3077059	OtherCostOrOtherBasis
Depreciation	2016365	Depreciation
Book Value	1060694	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	13050682	OtherCostOrOtherBasis
Depreciation	8362949	Depreciation
Book Value	4687733	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1452346	OtherCostOrOtherBasis
Depreciation	702037	Depreciation
Book Value	750309	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	14034117	TotalOfBookValueLandBuildings
Financial Derivatives		FinancialDerivatives
Closely Held Equity Interests		CloselyHeldEquityInterests

Other Securities OtherSecurities

Field	Value	IRS element (for citing)
Description	POOLED INVESTMENTS	Description
Book Value	3315475	BookValue
Method Of Valuation	F	MethodOfValuation

Field	Value	IRS element (for citing)
Total Of Book Value Securities	3315475	TotalOfBookValueSecurities
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
DEFERRED COMPENSATION	$57,303
DUE TO RELATED PARTIES	$4,600,359
PENSION PAYABLE	$133,000
OTHER NON-CURRENT LIABILITIES	$29,064

Field	Value	IRS element (for citing)
Total Of Amounts	4819726	TotalOfAmounts

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	500.	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	689	PersonsServed
Total Community Benefit Expense	418145	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	418145	NetCommunityBenefitExpense
Percent Of Total Expense	0.00860	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	17290	PersonsServed
Total Community Benefit Expense	8149563	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6484190	DirectOffsettingRevenue
Net Community Benefit Expense	1665373	NetCommunityBenefitExpense
Percent Of Total Expense	0.03430	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Persons Served	4173	PersonsServed
Total Community Benefit Expense	2421536	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1091129	DirectOffsettingRevenue
Net Community Benefit Expense	1330407	NetCommunityBenefitExpense
Percent Of Total Expense	0.02740	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	22152	PersonsServed
Total Community Benefit Expense	10989244	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7575319	DirectOffsettingRevenue
Net Community Benefit Expense	3413925	NetCommunityBenefitExpense
Percent Of Total Expense	0.07030	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	9	NumberOfActivitiesOrPrograms
Persons Served	2399	PersonsServed
Total Community Benefit Expense	34349	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	34349	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	20	PersonsServed
Total Community Benefit Expense	5206	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	5206	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	5	NumberOfActivitiesOrPrograms
Persons Served	2143	PersonsServed
Total Community Benefit Expense	120339	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	120339	NetCommunityBenefitExpense
Percent Of Total Expense	0.00250	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	15	NumberOfActivitiesOrPrograms
Persons Served	4562	PersonsServed
Total Community Benefit Expense	159894	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	159894	NetCommunityBenefitExpense
Percent Of Total Expense	0.00330	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	15	NumberOfActivitiesOrPrograms
Persons Served	26714	PersonsServed
Total Community Benefit Expense	11149138	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7575319	DirectOffsettingRevenue
Net Community Benefit Expense	3573819	NetCommunityBenefitExpense
Percent Of Total Expense	0.07360	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	20	PersonsServed
Total Community Building Expense	274	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	274	NetCommunityBuildingExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	20	PersonsServed
Total Community Building Expense	274	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	274	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$1,843,438	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	16154361	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	19418814	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-3264453	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mark Twain St Joseph's Healthcare Corp	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	768 Mountain Ranch Rd	AddressLine1
City	San Andreas	City
State	CA	State
ZIP Code	95249	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Mark Twain St Joseph's Healthcare Corp	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	500.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	5	NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
Angels Camp Family Medical Center
Angels Towne Center 222 S Main Str	Angels Camp	CA	95222	HEALTH CENTER
Valley Springs Family Medical Center
1919 Vista Del Lago Drive	Valley Springs	CA	95222	health center
San Andreas Clinic
704 Mt Ranch Road Suite 103	San Andreas	CA	95249	HEALTH CENTER
Arnold Family Medical Center
Meadowmont Center 2182 Highway 4	ARNOLD	CA	95223	HEALTH CENTER
Copperopolis Family Medical Center
3505 Spangler Lane 400	Copperopolis	CA	95228	HEALTH CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Schedule H, Part I, Line 7, column (f)	The amount of bad debt expense included on Form 990, Part IX, line 25, column (A) is $4,787,546 and has been subtracted for purposes of calculating the percentages in column (f).
Schedule H, Part I, Line 7	MTSJHC follows the method used by Dignity Health. For purposes of calculating the amounts provided in the table, MTSJHC 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 facility 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 and cash and in-kind donations.
Schedule H, Part II - Community Building Activities	Mark Twain St. Joseph's Hospital has formed many relationships with community organizations to improve community health, improve access to health care, and provide health education and in other ways that benefit our residents. In the area of Local Community Organizing, Mark Twain St. Joseph's Hospital provides transportation services to persons who have scheduled appointments for radiation therapy outside the local community. This transportation is also available to other patients if schedule permits. We work closely on developing community-wide plans for disaster preparedness and provide respirator fit testing for all first responders in the community.
Schedule H, Part III, Line 4	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 3, MTSJHC provides free or discounted care to uninsured or under-insured individuals at or below 500% of the Federal Poverty Level. MTSJH also provides patients options for prompt pay discounts, discounts for the medically indigent, 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. MTSJHC makes every effort in determining if a patient qualifies for charity care upon admission. MTSJHC follows Dignity Health's financial assistance policy. Dignity Health's 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 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 charity care 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 financial assistance. In its development, special attention was paid to those socio-economic 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 charity are reported as bad debt. As such, MTSJHC does not believe that any amounts included in Part III, Line 2, are attributable to patients eligible under the organization's charity care policy. The following is an excerpt from Dignity Health and its subordinate corporations' consolidated annual audited financial statements for the year ended June 30, 2012, 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 payers, and others for services rendered. MTSJHC 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	MTSJHC 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 $519.9 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 MTSJHC 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 $3.2 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 MTSJHC.
Schedule H, Part III, Line 9b	MTSJHC ensures that patient accounts are processed fairly and consistently. MTSJHC also follows Dignity Health's collection policy. Dignity Health's collection policy contains provisions that prohibit the collection of amounts due from patients who the organization knows qualify for charity care. Accounts with incorrect or incomplete demographic information are assigned to a collection agency if MTSJHC or billing company retained by Dignity Health 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 Dignity Health's Patient Payment Assistance Policy, or where the patient is attempting in good faith to settle an outstanding bill with the facility via payment plans, MTSJHC 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. MTSJHC does not impose wage garnishments or liens on primary residences. 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 MTSJHC'S patient financial assistance department. Upon assignment of such a patient account to a collection agency, MTSJHC requires the agency to comply with the Fair Debt Collection Practices Act.
Schedule H, Part V, Section B	Part V, Section B, Line 13g All language regarding the policy is communicated to patients via the methods outlined below. 1. Signage in all admitting areas; 2. At the point of registration, all patients receive brochures explaining the facility's charity care program and the availability of government sponsored programs; 3. All initial statements to uninsured patients includes verbiage informing patients of the facility's charity care program and a copy of the charity care application. A telephone number is provided for patients to request further information about the program and assistance is available in languages other than English; 4. Information about the facility's charity care program, access to the application, and contact information is available on the facility's webpage. Part V, Section B, Line 19d Patients who are applying for discounts under the discount provision of Hospital Fair Pricing Act - California Health and Safety Code 127400 whose household income is at or below 350% of the FPL are eligible to receive services at the highest average rate the hospital would receive for providing services from Medicare, Medicaid, or any other government-sponsored health program of health benefit in which the hospital participates, whichever is greater.
Schedule H, Part VI, Line 2 - Needs Assessment	A Community Health Needs Assessment was last conducted in 2011, as required by State law (SB 697). It was a collaborative effort involving the Mark Twain St. Joseph's Health Care District Board of Directors, The Calaveras County Department of Public Health, practicing physicians, various community members and the Calaveras County Superintendent of Schools and various Board members. The needs assessment was a primary tool used by the hospital to determine its community benefit plan, which outlined how the hospital gave back to the community in the form of health care and other community services to address unmet community health needs. This assessment incorporated components of primary data collection and secondary data analysis that focused on the health and social needs of the MTSJH Service Area. The primary Service Area encompassed the cities, towns and communities of Calaveras County that include 20 zip code areas. Targeted interviews were used to gather primary data collection information and opinions from members of the MTSJH community. For the interviews, community leaders were contacted and asked to participate in the needs assessment. 80% of those contacted agreed to participate. Secondary data were collected by obtaining and analyzing a variety of local, county and state sources to present a community profile, birth and death characteristics, access to health care, chronic diseases, social issues, and school and student characteristics. The Community Needs Assessment identified the following sizeable and severe needs: Health Issues -Residents have high rates of death from cancer, lung disease and heart disease. -A large percentage of youth (16.2%) suffer from asthma. -Disease rates of arthritis, asthma, cancer, heart disease and hypertension are high in the County. -The area has high rates of skin, cervical and colon cancer. -Limited services and service providers make it difficult to access mental health, obstetrical and specialty care services. -Females suffer from diabetes at higher rates than men in the County. -An increase in preventive care is needed, including flu shots, Pap smears, mammograms and other recommended routine screening tests. -There is inadequate attention given to preventive care, healthy lifestyles, nutrition and exercise. Social/Demographic Issues -The area reflects an aging population with a median age of 49.2 years. The population of seniors is 30.3%. -A declining economy is impacting the community by increased joblessness, decreases in employer-based health insurance, higher costs for transportation and decreased availability of affordable housing. -A lack of providers in the County (primary care, mental health, specialists) negatively impacts access to care and requires residents to travel outside of the County to obtain services. -Large numbers of youth and adults are overweight and obese. -Smoking among adults and teens is a concern. -ER usage increases among the County's poorest residents.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for	Communication of the Financial Assistance Program to Patients and the Public: Information about patient financial assistance is available at MTSJHC and all of its community locations, including a contact number for patients to call for information and assistance. The information is disseminated by MTSJHC by various means to include notices on patient bills, brochures at all registration desks and in all waiting rooms, and notices posted in the emergency department. Such information is provided in English and Spanish. At the point of registration, all patients receive brochures explaining the facility's charity care program and the availability of government sponsored programs. Uninsured patients receive copies of the charity care and Medicaid applications in addition to the brochure upon admission to the facility. It is MTSJHC's policy that at the time of patient billing, MTSJHC provides to all uninsured patients the same billing information concerning services and charges provided to all other patients who receive care at MTSJHC. 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 charity care, instructions on how to apply for a government program or charity care and the provision of such applications. Additionally, MTSJHC, in partnership with Calaveras County, provides County Social Workers to assist patients in obtaining governmental assistance in the Valley Springs and Arnold Rural Health Clinics. Any member of MTSJHC staff or medical staff may refer a patient for financial assistance. The patient, a family member, a close friend or an associate of the patient may also make a request for financial assistance.	Assistance
Schedule H, Part VI, Line 4 - Community Information	Calaveras County is approximately 130 miles east of San Francisco, 60 miles southeast of Sacramento, and 50 miles east of Stockton. The total population is about 43,000 with an area of 1,008 square miles. Our only incorporated city, the Angels Camp, has a population of about 5,400. In Calaveras County, the poorest residents have been severely impacted by the recession and the elimination of programs and services that local governments are no longer able to fund. The growing gap in needed services has placed at risk the health of hundreds of underserved individuals and families who are now turning to emergency departments for basic non-acute medical services because they have lost or lack a primary care provider. Our 5 Family Medical Centers (rural health clinics) help to fill this gap. However, it is still estimated that 28% of the visits to the ED are for non-emergent care. Access to care for these patient populations requires collaborative problem solving at the community level. Not-for-profit health providers must work together to leverage resources and maximize health assets in innovative ways to restore what has been lost, enhance what still exists and ensure sustainable health programs and services are developed and available over the long-term to the populations that need them the most. Community-based collaboration has been and will be a priority and will continue to drive community benefit efforts in the future. It will become more important for community stakeholders to work in partnerships to maximize the limited resources that are available. * Total population - 45,052 * The population by ethnic group is 82.9% White, 10.8% Hispanic, 1.4% Asian, and 1.0% Black and 3.9% other. * Average income is $53,037 * Uninsured is 18.42% * Unemployment is 13.1% * No High School Diploma is 1.8% * Renter is 21% * CNI Score is 3.1% * Medicaid patients is 18.42% * Other hospitals: 0 Calaveras County is a Health Professional Shortage Area (HPSA) and portions of the County are Medically Underserved Areas (MUA).
Schedule H, Part VI, Line 5 - Promotion of Community Health	Hospital Leadership oversees community benefit activities for the hospital as it meets the health and wellness needs of the local community. Several members of Mark Twain's senior and middle management team serve the community on a variety of community based not for profit Boards, such as Children and Families Commission, Habitat for Humanity, Calaveras County Business Council, Soroptomists International, Chamber of Commerce and United Way, to name a few. The Hospital is governed by a Board of Trustees, the majority of whom reside within its primary service area and who are not employees, contractors or family members thereof. In addition, most employees have linkages to various service organizations throughout the communities. Community involvement is evidenced by participation of local business and community leaders in the Hospital's Governing Boards, Finance Committee, Ethics Committee and our Parish Nurse Advisory Committee. MTSJHC extends medical staff privileges to all qualified physicians in and outside its community who request said privileges. All surplus funds generated by MTSJHC are reinvested back into the organization to improve patient care and provide health care services to its community.
Schedule H, Part VI, Line 6 - Affiliated Health Care System	MTSJHC is affiliated with Dignity Health. Affiliates of Dignity Health also promote the health of additional communities in Bakersfield, San Bernardino, San Francisco, San Andreas, and Grass Valley/Nevada City, California. These affiliates follow practices similar to those noted above in determining the unmet healthcare needs of their communities. Total unsponsored community benefit expense for Dignity Health and its subordinate corporations for the year ended June 30, 2012, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 108,530 188,380,000 2.0% Unpaid Costs of Medicaid/Medi-Cal 1,060,508 571,491,000 6.0% Other Means-tested Programs 280,517 66,067,000 0.7% Community Services: Community Health Services 525,831 53,467,000 0.6% Health Professions Education 86 27,000 0.0% Subsidized Health Services 193,751 28,297,000 0.3% Donations 155,219 33,140,000 0.3% Community Building Activities 12,811 1,623,000 0.0% Community Benefit Operations 3,884 8,911,000 0.1% Total Community Services for the poor 891,582 125,465,000 1.3% Total Benefits for the Poor 2,341,137 951,403,000 10.0% Benefits for the Broader Community: Community Services: Community Health Services 585,949 17,034,000 0.2% Health Professions Education 68,974 69,132,000 0.7% Subsidized Health Services 9,430 2,210,000 0.0% Research 26,281 30,049,000 0.3% Donations 165,149 7,584,000 0.1% Community Building Activities 38,641 3,138,000 0.0% Community Benefit Operations 87 1,446,000 0.0% Total Benefits for the Broader Community 894,511 130,593,000 1.3% Total Community Benefits 3,235,648 1,081,996,000 11.3% Unpaid Costs of Medicare 1,116,214 519,981,000 5.4% Total Community Benefits including Cost of Medicare 4,351,862 1,601,977,000 16.7%
STATE FILING OF COMMUNITY BENEFIT REPORT	CA,	990 SCHEDULE H, PART VI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
Mark Twain Foundation
768 Mountain Ranch Rd	San Andreas	CA	95249	680023507	501(c)(3)	238699	0	N/A	N/A	Foundation Support
California Health Foundation and Trust
1215 K Str Ste 800	Sacramento	CA	95814	941498697	501(c)(3)	209856	0	N/A	N/A	Service for the Poor and betterment of healthcare

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PART I, LINE 2	Identifier
Explanation	As a 501(C)(3) organization, we provide assistance to various charitable organizations to promote Dignity Health's mission. A designated committee consisting primarily of the executive team establishes and evaluates priorities and allocation of funds with emphasis on promotion of healthy communities and community collaboration. We do not monitor and report program outcomes. Spending is tracked on an ongoing basis to ensure that it is generally within the budgeted amount.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Donald Wiley
0	390141	0	231865	0	16664	0	43254	0	40619	0	722543	0	0
Katherine Medeiros
0	276630	0	130121	0	18483	0	30624	0	37562	0	493420	0	0
Feliciano Jiron
0	181758	0	138069	0	352367	0	18347	0	26555	0	717096	0	0
Jacob Lewis
0	157050	0	30340	0	3477	0	16706	0	7618	0	215191	0	0
Patty Monczewski
0	222698	0	41633	0	1060	0	15113	0	8371	0	288875	0	0
Melissa M Cuevas
160293	0	29392	0	1201	0	16645	0	31906	0	239437	0	0	0
Star Hildabrand
91231	0	71319	0	4168	0	9298	0	21044	0	197060	0	0	0
Jill Ortiz
174568	0	13118	0	7735	0	16527	0	31823	0	243771	0	0	0
Rafael A Rosado-Cosme
124288	0	0	0	75476	0	7098	0	10403	0	217265	0	0	0
Peggy E Seever
223764	0	1100	0	665	0	16097	0	10615	0	252241	0	0	0
Johanna Vermeltfoort
146798	0	6950	0	7235	0	8821	0	12432	0	182236	0	0	0
Tracy Church
0	118846	0	0	0	38267	0	11588	0	16181	0	184882	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

IdentifierIdentifier	ExplanationExplanation
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 top management official's compensation. See Schedule O disclosure for Form 990, Part VI, Section B, Line 15a for additional information.
PART I, LINE 4a	The organization's key employees and its highest compensated employees participate in a severance plan that provides market-standard compensation, ranging from payments of 6 months to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. Payments were made to one officer and one top highest compensated employee during 2011 pursuant to this plan; Feliciano Jiron, $346,676, and Rafael Rosado-Cosme, $69,024.
PART I, LINE 4b	Certain officers and key employees participate in the DIGNITY HEALTH Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the DIGNITY HEALTH retirement plan whose benefits are affected by the limitations imposed by Sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. No payments were made to any listed persons during 2011 pursuant to this plan. Certain listed persons are eligible to participate in the 2007 DIGNITY HEALTH Executive Deferred Compensation Plan, a nonqualified 457(f) plan that is 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. No benefit under this formula will vest under this 457(f) plan before the attainment of age 62 or the completion of 15 years of service. No payments were made under this plan during 2011. Certain listed persons participate in the DIGNITY HEALTH Key Employee Share Option Plan (KeySOP), which was frozen in May 2002. The KeySOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. No payments were made under this plan during 2011.
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 the organization 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 the organization 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.
Part III - Supplemental Disclosures	Dr. Dean Kelaita'S and Dr. Chris Krpan's compensation is for physician services provided to the organization.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PARTS VI and XII	FORM 990, PART VI, SECTION A, LINE 6: The hospital is jointly owned by Dignity Health, a 501(c)(3) exempt organization and Mark Twain Healthcare District (the district). FORM 990, PART VI, SECTION A, LINE 7a: DIGNITY HEALTH and the District, as the corporate members, ratify the selection of members and approve new Board members of the organization. Each owner designates two Board members, and each pair of designated Board members selects a county resident; these six select the seventh voting member, who must also be a county resident. FORM 990, PART VI, SECTION A, LINE 7b: Reserved rights of the corporate members (DIGNITY HEALTH and the District) 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 11A: Management presented the draft of the Form 990 to the Board before filing the form with the Internal Revenue Service. The Board's review included all information reported on the Form 990 with the exception of individuals' compensation amounts reported which were directly reviewed by the Vice President of Human Resources. In the process of its preparation, the Form 990 was reviewed at various levels of Finance and Accounting (Regional DIGNITY HEALTH management and Corporate Tax Department), as well as reviewed by Mark Twain's Finance Manager and CFO (who signs the form) and by an independent accounting firm engaged to review the return before filing. FORM 990, PART VI, SECTION B, LINE 12c: The Organization has adopted DIGNITY HEALTH's Conflicts of Interest Policy. The Organization's Board is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to these policies, an annual conflict of interest disclosure statement, aimed at determining any family and business relationships and transactions, or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees and all management personnel whose responsibilities include business decisions which may give rise to conflicts of interest). Covered persons are also required to disclose real or potential conflicts at the time such conflicts arise. When an individual becomes a covered person and annually thereafter, each covered person is required to submit an updated disclosure statement and to sign a statement affirming that he/she: (1) has received a copy of the policy applicable to their 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 in the organization's best interests. The procedures for addressing any 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; (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 person with the conflict of interest 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 must be approved by a majority of disinterested persons, based on certain criteria; 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. FORM 990, PART VI, SECTION B, LINE 15a: Although the organization employs personnel, the top management official is compensated by Dignity Health. For 2011 compensation, DIGNITY HEALTH's Compensation and Benefits department conducted an annual review and analysis to provide benchmarking data for the total compensation and benefits package of the top management official. Appropriate comparability data for similar jobs in peer companies (both taxable and tax-exempt) WAS obtained from independent third-party survey sources. FORM 990, PART VI, SECTION B, LINE 15b: The Hospital 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 Chief Financial Officer's compensation. Compensation of other highly paid 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 DIGNITY HEALTH. 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, conflict of interest policy and financial statements be made available for public inspection. The organization makes its financial statements available upon request. FORM 990, PART XI, LINE 5 Change in unrealized (losses); $(1,067,341). Interest in net assets of unconsolidated Foundation; $340,710. 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.
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Donald Wiley TITLE:Board Member HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Katherine Medeiros TITLE:Board Member/ President SNMH HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Patty Monczewski TITLE:Interim President & CEO HOURS:24	FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
Dignity Health
185 Berry Street	San Francisco	CA	94107	941196203	Hospital	CA	501(c)(3)	3	NA	false
Mark Twain St Joseph Hospital Auxiliary
788 Mountain Ranch Rd	San Andreas	CA	95249	942340081	Volunteer svc	CA	501(c)(3)	11d	NA	false

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	true	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	NONE	BusinessNameLine1