STRATEGY STUDIO / PUBLIC DATA EXPLORER

ST JOSEPH HOSPITAL OF EUREKA: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ST JOSEPH HOSPITAL OF EUREKA (EIN 94-1156596)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-12
IRS object ID
201111329349302556
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-12T12:16:00-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line118111 VON KARMAN AVENUE SUITE 1000AddressLine1
CityIRVINECity
StateCAState
ZIP Code92612ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941156596EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST JOSEPH HOSPITAL OF EUREKABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTJONameControl
Phone7072694259Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12700 DOLBEER STREETAddressLine1
CityEUREKACity
StateCAState
ZIP Code95501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOSEPH MARKName
TitleCEOTitle
Date Signed2011-05-10DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone9497942300Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOSEPH MARKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12700 DOLBEER STREETAddressLine1
CityEUREKACity
StateCAState
ZIP Code95501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts185841093GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web Sitewww.stjosepheureka.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1942YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees1226TotalNbrEmployees
Total Nbr Volunteers301TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4336416ContributionsGrantsPriorYear
Contributions Grants Current Year6397684ContributionsGrantsCurrentYear
Program Service Revenue Prior Year162629058ProgramServiceRevenuePriorYear
Program Service Revenue CY178136955ProgramServiceRevenueCY
Investment Income Prior Year-358587InvestmentIncomePriorYear
Investment Income Current Year1180464InvestmentIncomeCurrentYear
Other Revenue Prior Year55306OtherRevenuePriorYear
Other Revenue Current Year108622OtherRevenueCurrentYear
Total Revenue Prior Year166662193TotalRevenuePriorYear
Total Revenue Current Year185823725TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year505000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1367900GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year72618446SalariesEtcPriorYear
Salaries Etc Current Year74226200SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year252600TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY9760TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year565546TotalFundrsngExpCurrentYear
Other Expense Prior Year88798966OtherExpensePriorYear
Other Expenses Current Year93747413OtherExpensesCurrentYear
Total Expenses Prior Year162175012TotalExpensesPriorYear
Total Expenses Current Year169351273TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4487181RevenuesLessExpensesPriorYear
Revenues Less Expenses CY16472452RevenuesLessExpensesCY
Total Assets BOY137626125TotalAssetsBOY
Total Assets EOY188051285TotalAssetsEOY
Total Liabilities BOY51341238TotalLiabilitiesBOY
Total Liabilities EOY82040216TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY86284887NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY106011069NetAssetsOrFundBalancesEOY
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense160382465Expense
Grants1367900Grants
Revenue178136955Revenue
DescriptionSee Schedule ODescription
Total Program Service Expense160382465TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingtrueProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096230NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1226NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRONALD YAWNamePerson
Telephone Number7074458121TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12630 HARRISON AVENUEAddressLine1
CityEUREKACity
StateCAState
ZIP Code95501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOHN ARYANPUR MD
BOARD CHAIR/VICE CHAIR5.0X000
JOANNE CENTER
BOARD MEMBER2.0X000
JOHN DALBY
BOARD MEMBER2.0X000
RONALD DILUIGI
BOARD MEMBER2.0X040419737628
BRUCE EMAD
BOARD MEMBER2.0X000
SR MARIE JEANNE GAILLAC CSJ
BOARD MEMBER2.0X000
SR DIANE HEJNA CSJ
BOARD MEMBER2.0X000
RON JONES MD
BOARD MEMBER2.0X25000805500
DENNIS LEONARDI
BOARD VICE CHAIR/MEMBER4.0X000
RODNEY MAPLES
BOARD MEMBER2.0X000
JEFF NELSON
BOARD VICE CHAIR/MEMBER4.0X000
THOMAS RYDZ MD
BOARD MEMBER2.0X1800000
SR MARIAN SCHUBERT CSJ
BOARD MEMBER2.0X000
SR ANN MARIE STEFFEN CSJ
BOARD MEMBER2.0X000
KUSUM STOKES MD
BOARD MEMBER2.0X8708300
VICTOR WALLENKAMPF MD
BOARD MEMBER2.0X000
HERBERT WOOD
BOARD MEMBER2.0X000
SR JOANNE EANNARENO CSJ
BD MEMBER/VP MISSION INTEGRATN2.0X000X
JOHN GIEREK JR
BOARD MEMBER2.0X000
SARIE TOSTE
BOARD MEMBER2.0X000
JOSEPH MARK
BOARD MEMBER/CEO43.6X048957733720X
SUSAN WHITTAKER
BOARD MEMBER/SECRETARY2.0X070150857073X
S ANDREW RYBOLT
VP, FINANCE43.6287558026114X
LAURIE WATSON-STONE
VP, FUND DEVELOPMENT & PR50.0177704038915X
WILLIAM SAGEMAN
VP, MEDICAL AFFAIRS50.012054305392X
JUAN MUNOZ
LEAD CARIOVASCULAR IMAG TECH50.0232934046031X
NIKKI COLLIER
RN FIRST ASSIST40.0202996025432X
MICHAEL GOODWILL
PHYSICIST40.018240007087X
STEVEN LINDHOLM
CLINICAL SUPERVISOR40.0174969034926X
KATE CRUZ
PHARMACIST40.0172358037646X
ROBERT BRANNIGAN
FORMER OFFICER0.0327749027510X
ROBERT SAMPSON
FORMER KEY EMPLOYEE0.0251196029052X
JOANNE WARZYNSKI
FORMER KEY EMPLOYEE0.0175767019957X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2436257TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1675832TotalReportableCompFrmRltdOrgs
Total Other Compensation426483TotalOtherCompensation
Number Individuals GT100 K82NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEDICAL STAFFING NETWORK INC
PO BOX 840721DALLASTX752840721NURSE STAFFING4590015
REDWOOD ANESTHESIA SERVICES
PO BOX 7070EUREKACA95502ANESTHESIA SERVICES1433979
QUANTUM HEALTHCARE MEDICAL ASSO INC
PO BOX 634850CINCINATTIOH452634850HOSPITALIST SERVICES1229681
NORTH COAST EMERGENCY PHYSICIANS
PO BOX 577FORTUNACA95540EMERGENCY MD SVCS937605
PETER BELAK
PO BOX 3654EUREKACA95502REPAIR & MAINTENANCE730108
FieldValueIRS element (for citing)
Number Of Contractors GT100 K30NumberOfContractorsGT100K
Fundraising Events18245FundraisingEvents
Related Organizations4278249RelatedOrganizations
Government Grants274869GovernmentGrants
All Other Contributions1826321AllOtherContributions
Total Contributions6397684TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE622110177358019177358019
CAFETERIA722310545965545965
MOB REVENUE531120145243145243
ALL OTHER PROGRAM SERVICE REVENUE9000998772887728
FieldValueIRS element (for citing)
Total Program Service Revenue178136955TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column148099TotalRevenueColumn
Exclusion$148,099ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities969147Securities
Other63218Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities969147Securities
Other63218Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1032365TotalRevenueColumn
Exclusion$1,032,365ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events125990GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events18245CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses17368FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column108622TotalRevenueColumn
Exclusion$108,622ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column185823725TotalRevenueColumn
Related Or Exempt Function Income178136955RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,289,086ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1367900Total
Program Services1367900ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2183488Total
Program Services950583ProgramServices
Management And General1232905ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total273096Total
Management And General273096ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total47247202Total
Program Services46002414ProgramServices
Management And General1029627ManagementAndGeneral
Fundraising215161Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2947548Total
Program Services2740022ProgramServices
Management And General192628ManagementAndGeneral
Fundraising14898Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total17347401Total
Program Services16436094ProgramServices
Management And General829905ManagementAndGeneral
Fundraising81402Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4227465Total
Program Services3993272ProgramServices
Management And General209520ManagementAndGeneral
Fundraising24673Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3467594Total
Program Services3192675ProgramServices
Management And General274919ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total347324Total
Management And General347324ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total155812Total
Management And General155812ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total24389Total
Program Services24389ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total9760Total
Fundraising9760Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total19160212Total
Program Services17793010ProgramServices
Management And General1225577ManagementAndGeneral
Fundraising141625Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total398948Total
Program Services346802ProgramServices
Management And General40854ManagementAndGeneral
Fundraising11292Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total39437827Total
Program Services38446233ProgramServices
Management And General956052ManagementAndGeneral
Fundraising35542Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3494820Total
Program Services3305703ProgramServices
Management And General189117ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3336864Total
Program Services3330425ProgramServices
Management And General6319ManagementAndGeneral
Fundraising120Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total307884Total
Program Services175960ProgramServices
Management And General113353ManagementAndGeneral
Fundraising18571Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total159580Total
Program Services159580ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7991536Total
Program Services7840976ProgramServices
Management And General141259ManagementAndGeneral
Fundraising9301Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1642373Total
Program Services1601373ProgramServices
Management And General41000ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PROVISION FOR BAD DEBT1011453210114532
All other expenses3707718256052211439953201

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total169351273Total
Program Services160382465ProgramServices
Management And General8403262ManagementAndGeneral
Fundraising565546Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1716295BOY
EOY14401857EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY23048027BOY
EOY23302441EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY280348BOY
EOY832115EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4389942BOY
EOY3898349EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1170458BOY
EOY1241842EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis216864806LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec87788838LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY96209098BOY
EOY129075968EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY360795BOY
EOY400936EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY627001BOY
EOY1806031EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY8613835BOY
EOY7254273EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1210326BOY
EOY5837473EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY137626125BOY
EOY188051285EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15017264BOY
EOY14036694EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY36323974BOY
EOY68003522EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY51341238BOY
EOY82040216EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY84805498BOY
EOY102761329EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY852388BOY
EOY1467888EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY627001BOY
EOY1781852EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86284887BOY
EOY106011069EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY137626125BOY
EOY188051285EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$24,389OtherActivitiesAmount
Total Lobbying Expenditures IIB24389TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferenceSchedule C, PART II-BReturnReference
ExplanationPORTION OF THE DUES PAID TO HOSPITAL ASSOCIATIONS FOR LOBBYING. DURING THE PAST YEAR, THE ST. JOSEPH HEALTH SYSTEM HAS CONDUCTED AN ADVOCACY EFFORT WHICH INCLUDED MINIMAL LOBBYING ACTIVITY. THESE INCLUDED MEETING WITH LOCAL, STATE, AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS; AND COMMUNICATIONS TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4843950OtherCostOrOtherBasis
Book Value4843950BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis60560041OtherCostOrOtherBasis
Depreciation31433785Depreciation
Book Value29126256BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1098457OtherCostOrOtherBasis
Depreciation506689Depreciation
Book Value591768BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis73078015OtherCostOrOtherBasis
Depreciation55848364Depreciation
Book Value17229651BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis77284343OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value77284343BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings129075968TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
PAYABLE TO THIRD PARTIES$5,400,825
OTHER LIABILITIES$1,880,637
INTERCO. WITH HEALTH SYSTEM-BONDS$60,722,060
FieldValueIRS element (for citing)
Total Of Amounts68003522TotalOfAmounts

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event1122507GrossReceiptsEvent1
Charitable Contributions Event115399CharitableContributionsEvent1
Gross Revenue Event1107108GrossRevenueEvent1
Other Direct Expenses Event114197OtherDirectExpensesEvent1
Name Of Event2PETER CTNTAILNameOfEvent2
Gross Receipts Event221728GrossReceiptsEvent2
Charitable Contributions Event22846CharitableContributionsEvent2
Gross Revenue Event218882GrossRevenueEvent2
Other Direct Expenses Event23171OtherDirectExpensesEvent2
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total144235GrossReceiptsTotal
Charitable Contributions Total18245CharitableContributionsTotal
Gross Revenue Total Events125990GrossRevenueTotalEvents
Other Direct Expenses Total Events17368OtherDirectExpensesTotalEvents
Direct Expense Summary Events17368DirectExpenseSummaryEvents
Net Income Summary108622NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage500.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served7564PersonsServed
Total Community Benefit Expense2117569TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2117569NetCommunityBenefitExpense
Percent Of Total Expense0.01330PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served33894PersonsServed
Total Community Benefit Expense26197975TotalCommunityBenefitExpense
Direct Offsetting Revenue17571522DirectOffsettingRevenue
Net Community Benefit Expense8626453NetCommunityBenefitExpense
Percent Of Total Expense0.05420PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Persons Served5168PersonsServed
Total Community Benefit Expense6423445TotalCommunityBenefitExpense
Direct Offsetting Revenue3677194DirectOffsettingRevenue
Net Community Benefit Expense2746251NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served46626PersonsServed
Total Community Benefit Expense34738989TotalCommunityBenefitExpense
Direct Offsetting Revenue21248716DirectOffsettingRevenue
Net Community Benefit Expense13490273NetCommunityBenefitExpense
Percent Of Total Expense0.08480PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served29758PersonsServed
Total Community Benefit Expense792917TotalCommunityBenefitExpense
Direct Offsetting Revenue47652DirectOffsettingRevenue
Net Community Benefit Expense745265NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served4038PersonsServed
Total Community Benefit Expense844780TotalCommunityBenefitExpense
Direct Offsetting Revenue33000DirectOffsettingRevenue
Net Community Benefit Expense811780NetCommunityBenefitExpense
Percent Of Total Expense0.00510PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served50738PersonsServed
Total Community Benefit Expense1451946TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1451946NetCommunityBenefitExpense
Percent Of Total Expense0.00910PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served6803PersonsServed
Total Community Benefit Expense99312TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense99312NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served91337PersonsServed
Total Community Benefit Expense3188955TotalCommunityBenefitExpense
Direct Offsetting Revenue80652DirectOffsettingRevenue
Net Community Benefit Expense3108303NetCommunityBenefitExpense
Percent Of Total Expense0.01950PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served137963PersonsServed
Total Community Benefit Expense37927944TotalCommunityBenefitExpense
Direct Offsetting Revenue21329368DirectOffsettingRevenue
Net Community Benefit Expense16598576NetCommunityBenefitExpense
Percent Of Total Expense0.10430PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served230PersonsServed
Total Community Building Expense33172TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense33172NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served290PersonsServed
Total Community Building Expense59929TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense59929NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served2713PersonsServed
Total Community Building Expense26094TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense26094NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served3569PersonsServed
Total Community Building Expense592638TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense592638NetCommunityBuildingExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served6802PersonsServed
Total Community Building Expense711833TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense711833NetCommunityBuildingExpense
Percent Of Total Expense0.00450PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,612,584BadDebtExpenseAmount
Amount Attributable To266484AmountAttributableTo
Amount Reimbursed By Medicare64752629AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare78945633CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-14193004MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
ST JOSEPH HOSPITAL OF EUREKA
2700 DOLBEER STREETEUREKACA95501XXX
INPATIENT REHABILITATION CENTER
2200 HARRISON AVENUEEUREKACA95501REHAB. CENTER
OUTPATIENT IMAGING CENTER
2330 BUHNE STREETEUREKACA95501IMAGING CENTER
AMBULATORY AND HOME INFUSION PROGRAM
2612 HARISON AVENUEEUREKACA95501AMBULATORY/HOME INF.
NORTHCOAST SURGERY CENTER
2705 HARRIS AVENUEEUREKACA95501SURGERY CENTER
OUTPATIENT REHABILITATION
2024 HARRISON AVENUEEUREKACA95501REHAB. CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedTHE COSTING METHODOLOGY WAS DERIVED BY TAKING TOTAL COST (INDIRECT AND DIRECT COST) DIVIDED BY TOTAL CHARGES TO GET THE COST TO CHARGE RATIO. THIS WAS DONE USING WORKSHEET 2 FROM THE IRS INSTRUCTIONS.CostingMethodUsed
Percent Of Total Expense ExplnBAD DEBT EXPENSE OF $10,114,532 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE OF NET COMMUNITY BENEFIT.PercentOfTotalExpenseExpln
Bad Debt FootnoteFINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT; THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED AND OTHERS ARE FROM VARIOUS PAYORS WHO ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS, AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION CONTINUALLY MONITORS AND ADJUSTS THE RESERVES ASSOCIATED WITH RECEIVABLES. THE ORGANIZATION ESTIMATES BAD DEBT EXPENSE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON HISTORICAL COLLECTION EXPERIENCE. COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 2 IS AS FOLLOWS: TOTAL PROVISION FOR BAD DEBT EXPENSE ($10,114,532) MULTIPLIED BY COST TO CHARGE RATIO CALCULATED USING THE IRS WORKSHEETS, BASED ON GROSS PATIENT REVENUE AND TOTAL OPERATING EXPENSES (25.83%) = $2,612,584. COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 3 IS AS FOLLOWS: BAD DEBT EXPENSE AT COST ($2,612,584) MULTIPLIED BY PERCENTAGE OF CHARITY CARE AS COMPARED TO TOTAL OPERATING EXPENSES (10.2%) = $266,484.BadDebtFootnote
Shortfall As Community BenefitAS A CATHOLIC HEALTH CARE MINISTRY, THE ORGANIZATION FOLLOWS THE CATHOLIC HEALTH ASSOCIATION'S COMMUNITY BENEFIT REPORTING GUIDELINES AND THEREFORE DOES NOT REPORT MEDICARE AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS AS FOLLOWS: THE COST-TO-CHARGE RATIO (25.83%) AS CALCULATED FOR FY10, BASED ON GROSS PATIENT REVENUE AND TOTAL OPERATING EXPENSES. THE AMOUNT COMES FROM THE THE MEDICARE COST REPORT.ShortfallAsCommunityBenefit
Debt Collection PolicyPRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMS AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIES FOR CHARITY CARE. ALL ACCOUNTS ARE SCREENED FOR CHARITY CARE ELIGIBILTY USING CRITERIA THAT CONSIDERS INSURANCE COVERAGE, CREDIT RATING, PAYMENT ACTIVITY, AND VALID SOCIAL SECURITY NUMBER AND/OR ACCURATE RESIDENCE ADDRESS.DebtCollectionPolicy
Needs AssessmentST. JOSEPH HEALTH SYSTEM - HUMBOLDT COUNTY COMPLETED A NEEDS ASSESSMENT IN 2008. THE COMMUNITY BENEFITS PROGRAM ACTIVITIES ARE SET ACCORDING TO THE IDENTIFIED PRIORITIES OF THE CITIZENS OF THE AREAS SERVED. THE ASSESSMENT CONTINUED THE REVIEW OF AREAS FROM PRIOR ASSESSMENTS TO TRACK CHANGES AND COMMUNITY MEMBERS' PERCEPTIONS OF NEEDS. THE ASSESSMENT FOUND GROWING CONCERNS OF CITIZENS AND ORGANIZATIONS ALIKE ON THE ISSUE OF OBESITY, INCLUDING THE LACK OF EXERCISE AMOUNG THE AREA'S CHILDREN. FY 2010 CONTINUED THE ECONOMIC DOWNTURN FOR THE AREA AND FOOD INSECURITY THROUGHOUT THE COUNTY. THESE ARE TREMENDOUS PROBLEMS AND ARE COUPLED WITH THE CONSTANT OF HIGH POVERTY AND UNEMPLOYMENT RATES. FOOD FOR PEOPLE, THE LOCAL FOOD BANK FOR ALL OF HUMBOLDT COUNTY, REPORTS THAT MANY INDIVIDUALS WHO IN PRIOR YEARS VOLUNTEERED TO ASSIST WITH FOOD DISTRIBUTIONS ARE NOW IN LINE TO RECEIVE ASSISTANCE. FOOD FOR PEOPLE ASSISTS BETWEEN 10,000 AND 12,000 INDIVIDUALS EACH MONTH, INCLUDING 35-40% CHILDREN, WITH COMODITIES AND FOOD BOX DISTRIBUTIONS, AS WELL AS THE BACKPACK FOR CHILDREN WEEKEND FOOD DISTRIBUTIONS. IN HUMBOLDT COUNTY SCHOOLS, 53.2% OF ALL THE ENROLLED CHILDREN RECEIVE FREE OR REDUCED MEALS FROM THE SCHOOL, FLUCTUATING FROM A RATE OF 10% AT SOME SCHOOLS TO A HIGH OF 85% AT OTHERS. FOR MANY, THE MEALS FROM THE SCHOOL ARE THE COMPLETE NUTRITION FOR THE DAY, AS 22% OF ALL THE SCHOOL AGED CHILDREN LIVE IN POVERTY.NeedsAssessment
Patient Education AssistanceTHE ORGANIZATION POSTS NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.PatientEducationAssistance
Community InformationHUMBOLDT COUNTY IS LOCATED IN THE NORTHWESTERN CORNER OF CALIFORNIA AND IS THE MOST POPULOUS OF THE NORTH COASTS' RURAL AND ISOLATED COUNTIES. IT IS WEALTHY IN THE COLLABORATION OF GOVERNMENT AGENCIES, NON-PROFIT ORGANIZATIONS, AND COMMUNITY MEMBERS WHO PARTNER TO DEVELOP A SYSTEM OF SERVICES THAT REACHES ACROSS CLASS AND SOCIAL BARRIERS. ELECTED OFFICIALS, PUBLIC AGENCIES, COMMUNITY PROVIDERS/ORGANIZATIONS, AND CITIZENS COME TOGETHER WITH SJHS-HC TO ACTIVELY ENGAGE IN DESIGNING PROGRAMS, AND SPONSORING ACTIVITIES IDENTIFIED AS PRIORITY NEEDS BY THE COMMUNITY. ST. JOSEPH HOSPITAL, EUREKA, IS LOCATED IN THE CITY OF EUREKA WHICH HAS A POPULATION OF ROUGHLY 27,000. HUMBOLDT COUNTY IN ENTIRETY COMPRISES A POPULATION OVER 129,000, AND IS SPREAD OVER 3,572 SQUARE MILES, ROUGHLY 80% OF WHICH ARE DESIGNATED TO RECREATION AND TIMBERLAND. THE COUNTY HAS A POPULATION DENSITY OF 36 CITIZENS PER SQUARE MILE, COMPARED TO THE STATE RURAL COMMUNITY DEFINITION OF 52 CITIZENS PER SQUARE MILE. FURTHER COMPARISION TO THE STATE AVERAGE OF 217 PERSONS PER SQUARE MILE PROVIDES AN UNDERSTANDING OF THE TRUE ISOLATION OF THE REMOTENESS. THE MAJOR TRANSPORTATION ACCESS FOR THE AREA ARE HIGHWAY 101 (NORTH/SOUTH), AND HIGHWAY 299 (EAST/WEST). SINCE 57% OF THE COUNTIES' POPULATION LIVES IN RURAL, ISOLATED AREAS OF THE COUNTY AND BASED ON THE COUNTY HAVING ONE OF THE HIGHEST AVERAGE GAS PRICES IN THE STATE, A VERY POOR TRANSIT SYSTEM, AND THE HIGH RATE OF POVERTY, FAMILIES FACE DIFFICULTIES EACH TIME THEY NEED TO COME TO THE METROPOLITAN AREAS FOR HEALTH CARE, SOCIAL SERVICE NEEDS AND LOWER FOOD COSTS.CommunityInformation
Community Building ActivitiesTHE SIX COMMUNITY RESOURCE CENTERS OF SJHS-HC ARE THE MAIN CONDUIT FOR COMMUNITY OUTREACH AND COMMUNITY BUILDING ACTIVITIES FOR THE MOST RURAL REGIONS OF HUMBOLDT COUNTY. THE CENTERS ARE LOCATED IN THE COMMUNITIES OF RIO DELL, FORTUNA, LOLETA, BLUE LAKE, EUREKA, AND WILLOW CREEK. THE CENTERS PROVIDE SUPPORT AND RESOURCES FOR EACH INDIVIDUAL COMMUNITY AS DEFINED BY COMMUNITY MEMBERS AND, ALTHOUGH ALIKE IN STRUCTURE AND MISSION, ACTIVITIES FOR ONE CENTER TO THE OTHER VARY IN SCOPE AND REACH. COLLECTIVELY, THE CENTERS PROVIDED COMMODITIES TO 5,685 NON-DUPLICATED INDIVIDUALS, OVERSAW THE SUMMER LUNCHES AND WEEKEND BACKPACK DISTRIBUTION FOR FOUR COMMUNITIES AND PROVIDED ACCESS FOR MAIL DISTRIBUTION FOR OVER 275 HOMELESS INDIVIDUALS, ALLOWING THEM TO APPLY AND RECEIVE SERVICES THAT REQUIRE A FIXED, PERMANENT ADDRESS. THESE ARE ONLY A FEW EXAMPLES OF THE MANY SUPPORT SERVICES THE CENTERS OFFERS TO THE CLIENTS THOUGHOUT HUMBOLDT COUNTY. ANOTHER AREA OF COMMUNITY BUILDING ACTIVITIES ARE THE HEALTH ADVOCACY EFFORTS, INCLUDING BUT NOT LIMITED TO COLLABORATING WITH ORGANIZATIONS AND BUSINESSES TO OUTREACH TO FAMILIES/INDIVIDUALS TO ADDRESS THE UNMET HEALTH NEEDS OF OUR COMMUNITIES, INCLUDING ACCESS TO HEALTH INSURANCE FOR CHILDREN, INCREASED FOOD RESOURCES TO THOSE FACING FOOD INSECURITY AND SAFE EXERCISE PROGRAMS AND ACTIVITIES FOR BOTH CHILDREN AND THEIR PARENTS. SJHS-HC ALSO COLLABORATED WITH OPEN DOOR COMMUNITY HEALTH CENTER TO BRING THE DENTAL VAN TO TWO LOW INCOME ELEMENTARY SCHOOLS FOR SCREENING AND TREATMENT FOR ALL THE ENROLLED CHILDREN. TO CONTINUE ST. JOSEPH HOSPITAL OF EUREKA'S MISSION, IN FY2010, ST. JOSEPH HOSPITAL OF EUREKA ASSISTED 3,233 PERSONS IN COMMUNITY BUILDING ACTIVITIES FOR A TOTAL COMMUNITY BUILDING EXPENSE TO THE HOSPITAL OF $119,195. THE COSTS ASSOCIATED WITH THESE PROGRAMS ARE REPORTED ON LINES 5, 6, AND 7 OF PART II. THE HOSPITAL PROVIDED HOUSING AND PATIENT ASSISTANCE TO MEMBERS OF THE COMMUNITY AND MEDICAL, TRAVEL, AND BASIC SUPPLIES TO MEDICAL ALERT AND OTHER PROGRAMS IN THE COMMUNITY. THESE COSTS ASSOCIATED WITH THESE PROGRAMS ARE REPORTED ON LINE 8 OF PART II.CommunityBuildingActivities
Other InformationOUR MISSION IS FURTHER REALIZED AND EMPHASIZED BY THE BOARD-DESIGNATED COMMUNITY BENEFITS COMMITTEE, WHOSE PURPOSE IT IS TO GUIDE AND PARTICIPATE IN THE PLANNING, DEVELOPMENT, IMPLEMETATION AND EVALUATION OF COMMUNITY BENEFIT ACTIVITIES. THIS COMMITTEE, CHAIRED BY A TRUSTEE, FOLLOWS THE GUIDELINES OF THE "ADVANCING THE ART OF COMMUNITY BENEFIT" AND HAS BOARD APPROVED BY-LAWS, CHARTER AND POLICIES. THE BOARD OF TRUSTEES RECEIVES MONTHLY WRITTEN REPORTS ON COMMUNITY BENEFIT ACTIVITIES AND VERBAL REPORTS FROM THE TRUSTEE COMMITTEE CHAIR, WHO CARRIES FORWARD RECOMMENDATIONS FOR PROGRAMS AND INITIATIVES THAT HAD BEEN APPROVED BY THE FULL COMMUNITY BENEFITS COMMITTEE. THE FULL COMMUNITY BENEFITS COMMITTEE INCLUDES MEMBERSHIP FROM COMMUNITY NON-PROFITS AND TWO LOCAL FOUNDATIONS. ADDITIONALLY, ST. JOSEPH HEALTH SYSTEM - HUMBOLDT COUNTY IDENTIFIES ALL OF HUMBOLDT COUNTY AS ONE WITH DISPROPORTIONATE UNMET HEALTH CARE NEEDS AND SETS THE COMMUNITY BENEFIT ACTIVITIES AND PRIORITIES FOR THE MOST ISOLATED, UNDERSERVED AREAS OF THE COUNTY. THESE ACTIVITIES INCLUDE ADRESSING THE UNMET NEEDS OF THE GROWING HISPANIC POPULATION WITH THE EDUCATION PROGRAMS OF PASO A PASO, PROVIDING COMMUNITY SPECIFIC COMMUNITY RESOURCE CENTERS TO ADDRESS COMMUNITY IDENTIFIED CONCERNS AND PARTNER WITH LIKE ORGANIZATIONS TO EXPAND SJHS-HC OUTREACH TO POPULATIONS WHO HAVE DEFINED UNMET HEALTH NEEDS.OtherInformation
Affiliated Health Care SystemGIVING BACK TO THE COMMUNITY PERMEATES EVERY ASPECT OF OUR ORGANIZATION. AS A MEMBER OF THE FAITH-BASED HEALTHY MINISTRY OF ST. JOSEPH HEALTH SYSTEM, WE HAVE A FUNDING STREAM TO ADDRESS THE NEEDS OF THE ECONOMICALLY POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE. ON AN ANNUAL BASIS, 10 PERCENT OF OUR NET OPERATING INCOME IS DEVOTED TO FUND COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR. THE ST. JOSEPH HEALTH SYSTEM FOUNDATION, A MEMBER OF ST. JOSEPH HEALTH SYSTEM, IS CHARGED WITH THE DISTRIBUTION OF THESE FUNDS. IN ADDITION TO DEVOTING A PERCENTAGE OF OUR NET OPERATING INCOME TO COMMUNITY BENEFIT SERVICES FOR THE ECONOMICALLY POOR, WE STRIVE TO ANNUALLY BUDGET A PORTION OF OUR TOTAL OPERATING EXPENSES FOR HEALTHY COMMUNITIES AND COMMUNITY HEALTH EFFORTS.AffiliatedHealthCareSystem
Reports Filed With StatesCAReportsFiledWithStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
ALCOHOL AND DRUG CARE SERVICES
528 5TH STREETEUREKACA95501680218628501(C)(3)20000PROVIDE HEALTHY MEALS THROUGH ASSISTANCE OF A NUTRITIONIST FOR CLIENTS OF THE ADCS-DETOX. CLIENTS WILL ALSO BE TAUGHT HEALTHY DIETARY PRACTICES.
ST VINCENT DE PAUL
PO BOX 1386EUREKACA95502943163269501(C)(3)9500PROVIDES HOUSING AND INTENSIVE SUPPORT FOR FAMILIES WHO ARE HOMELESS.
FOOD FOR PEOPLE
304 W 14TH STREETEUREKACA95501942772549501(C)(3)12500ENCOURAGE INCREASED CONSUMPTION OF HIGH FIBER, NUTRIENT-RICH FRESH FRUITS AND VEGETABLES BY PROVIDING INCREASED QUANTITIES OF FRESH PRODUCE TO THE LOW INCOME HOUSEHOLDS SERVED. GOAL IS TO PREVENT OBESITY, DIABETES, AND OTHER HEALTH RELATED ILLNESSES.
HUMBOLDT ALL FAITH PARTNERSHIP
701 E STREETEUREKACA95501680348781501(C)(3)20000TO CONTINUE AND/OR EXPAND THE FAMILY WELLNESS PROJ PROJECT (FWP). FWP FOCUSES ON IMPROVING THE AWARENESS AND ADOPTION OF HEALTHY EATING AND PHYSICAL ACTIVITY LEVELS BY FAMILIES, PARTICULARLY BY LOW INCOME CHILDREN AND THEIR FAMILIES.
HUMBOLDT COUNTY OFFICE OF EDUCATION
908 7TH STREETEUREKACA95501946000513Government5200ENHANCE AND EXPAND EFFORTS IN PROVIDING EXPERIENTIAL NUTRITION AND FOOD EDUCATION. PROGRAMS WILL BE OFFERED AT PLACES IN THE COUNTY THAT SERVE LOW INCOME FAMILIES-THE MAC, FOOD STAMP OFFICE, FOOD DISTRIBUTION SITES AND FAMILY RESOURCE CENTERS.
HUMBOLDT SENIOR RESOURCE CENTER
1910 CALIFORNIA STREETEUREKACA95501942261434501(C)(3)20000DEVELOP A MODEL VOLUNTEER HOME DELIVERED MEAL DELIVERY SYSTEM IN PREPARATION FOR A TRANSITION FROM PAID DRIVERS TO AN ALL VOLUNTARY DELIVERY CORPS.
NORTHCOAST CLINICS NETWORK
710 E STREETEUREKACA95501942646370501(C)(3)17800CONTINUE ONGOING EDUCATION RELATED TO HOMELESS ISSUES On POOR NUTRITION, OBESITY, AND UNHEALTHY LIVING. LIFE SKILL CLASSES WILL FOCUS ON HEALTHY EDUCATION OF RELATED ISSUES INCLUDING OBESITY, INCREASE PHYSICAL ACTIVITY, AND NUTRITION.
COMMUNITY ALLIANCE FOR FAMILY FARMERS
PO BOX 363DAVISCA95617942914745501(C)(3)15000ENHANCE AND EXPAND EFFORTS IN PROVIDING EXPERIENTIAL NUTRITION AND FOOD EDUCATION. PROGRAMS WILL BE OFFERED AT PLACES IN THE COUNTY THAT SERVE LOW INCOME FAMILIES-THE MAC, FOOD STAMP OFFICE, FOOD DISTRIBUTION SITES, AND FAMILY RESOURCE CENTERS.
REDWOOD MEMORIAL HOSPITAL
3300 RENNER DRIVEFORTUNACA95540941384665501(C)(3)100000COMMUNITY BENEFIT PROGRAM
ST JOSEPH HEALTH SYSTEM FOUNDATION
500 S MAIN STREET SUITE 1000ORANGECA928684507330143024501(C)(3)1142900PROGRAM SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants10TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSIdentifier
Return ReferenceFORM 990, SCHEDULE IReturnReference
ExplanationEACH GRANTEE REPORTS ON THE PROGESS OF THE FUNDED PROGRAM ON A BIANNUAL BASIS (EVERY 6 MONTHS) TO THE COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE REVIEWS DOCUMENTATION TO CONFIRM THAT THE GRANTEE IS COMPATIBLE WITH THE MISSION, VISION, AND VALUES OF THE ST. JOSEPH HEALTH SYSTEM. ALSO THE GRANTEE MUST DEMONSTRATE OPERATIONAL AND MANAGERIAL EFFECTIVENESS, FINANCIAL VIABILITY, AND RESPONSIBLE STEWARDSHIP OF RESOURCES. THEY MUST BE ABLE TO DEMONSTATE COLLABORATION, FLEXIBILITY, AND RESPECT FOR DIVERSE CULTURES WHILE UTILIZING EFFECTIVE STATEGIES AND OUTCOME MEASURES. THE GRANTEE MUST HAVE AN EXISTING GOVERNING AND/OR ADVISORY BOARD WITH SUFFICIENT EXPERTISE AND FAMILIARITY WITH THE PROPOSED PROGRAM/PROJECT. THE GRANTEE MUST BE WILLING TO ACKNOWLEDGE THE SUPPORT OF THE LOCAL HOSPITALS IN EXTERNAL COMMUNICATIONS, INCLUDING WEBSITES. MOST IMPORTANTLY, THE GRANTEE MUST BE A NONPROFIT ORGANIZATION IN CALIFORNIA THAT IS TAX EXEMPT. FUNDS THAT ARE TRANSFERRED TO ST. JOSEPH HEALTH SYSTEM (CARE FOR THE POOR) ARE MONITORED AND DISTRIBUTED BY THE ST. JOSEPH HEALTH SYSTEM, AND ARE NOT MONITORED ON A HOSPITAL LEVEL ONCE THE FUNDS ARE TRANSFERRED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RONALD DILUIGI
0245974070342087881016994020634044182500
S ANDREW RYBOLT
207729014616065213095730165410313672000
LAURIE WATSON-STONE
120107088940487040105400283750216619000
JUAN MUNOZ
199026010000329090167430292880278965000
NIKKI COLLIER
1799290500022568016189092430228428000
MICHAEL GOODWILL
16105601000001134400070870189487000
STEVEN LINDHOLM
157990000169780123460225800209895000
KATE CRUZ
14565500026703090220286240210004000
JOSEPH MARK
036921702892009144009772023948052329700
SUSAN WHITTAKER
042720301356280138677022036035037075858100
ROBERT SAMPSON
11923701111701208420887802017402802480418420
ROBERT BRANNIGAN
207356015425010496801079001672003552590129890
JOANNE WARZYNSKI
57053000118714035130164440195724000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL COMPENSATION INFORMATIONIdentifier
Return ReferenceSCHEDULE J, PART I, LINE 1AReturnReference
ExplanationST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL FOR CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING TRUSTEES AND OFFICERS RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION. THE BENEFITS WERE PAID BY ST. JOSEPH HOSPITAL OF EUREKA'S TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM. ROBERT BRANNIGAN - $4,565 ST. JOSEPH HOSPITAL OF EUREKA PAYS MEMBERSHIP DUES TO LOCAL ORGANIZATIONS FOR JOSEPH MARK; DUES ARE PAID FOR THE BENEFIT OF THE HOSPITAL AND ARE NOT FOR THE EMPLOYEE'S BENEFIT. JUDY BEGLEY RECEIVED $2,000 AS A HOUSING ALLOWANCE, WHICH WAS INCLUDED IN HER GROSS INCOME. SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR 990, PART VI, LINE 15A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS WERE MADE TO JOANN WARZYNSKI IN THE AMOUNT OF $118,714 AND JUAN MUNOZ IN THE AMOUNT OF $13,572. SCHEDULE J, PART I, LINE 4B EXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE DECEMBER 31, 2007 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. THE FOLLOWING INDIVIDUALS INCLUDED IN FORM FORM 990, PART VII RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: ROBERT SAMPSON - $41,842 ROBERT BRANNIGAN - $12,989 SCHEDULE J, PART I, LINE 7 A PORTION OF THE EXECUTIVE'S SALARY IS PLACED "AT-RISK" AND IS NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERES, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
NORTHCOAST EMERGENCY PHYSICIANS
VICTOR WALLENKAMPF, PTNR602993ED coverage/Medical Dir feesfalse
SHN ENGINEERING
JEFF NELSON, OWNER792063SEE SCHEDULE Ofalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART I, LINE 1 AND PART III, LINE 1AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), ST. JOSEPH HOSPITAL OF EUREKA IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THE MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. BUT THE ROOTS OF ST. JOSEPH HOSPITAL OF EUREKA AND THE LESSONS TO SERVE OUR DEAR NEIGHBORS DATE BACK TO THE YEAR 1650 WHEN THE SISTERS' FIRST CONGREGATION WAS FORMED IN LE PUY, FRANCE. SINCE THAT TIME, THE PEOPLE OF OUR ORGANIZATION CONTINUE TO ASSESS THE NEEDS OF THE COMMUNITIES WE SERVE, BUILD COLLABORATIVE PARTNERSHIPS WITH LOCAL RESIDENTS, BUSINESS AND COMMUNITY NOT-FOR-PROFITS, AND TOGETHER THROUGH THOSE PARTNERSHIPS, MEET COMMUNITY NEEDS. THE HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS--NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO - AND CONSISTS OF 14 ACUTE CARE HOSPITALS, AS WELL AS HOME HEALTH AGENCIES, HOSPICE CARE, OUT-PATIENT SERVICES, SKILLED NURSING FACILITIES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4 WHO WE ARE AND WHAT WE DO ST. JOSEPH HOSPITAL OF EUREKA CONSISTS OF TWO CAMPUSES IN EUREKA, EMPLOYING OVER 1,100 INDIVIDUALS. THE FULL SERVICE ACUTE CARE HOSPITAL IS ONE OF THE MOST ADVANCED IN FAR NORTHERN CALIFORNIA AND IS THE LEADER IN FURNISHING HEALTH CARE TO THE NORTH COAST. THE SERVICES PROVIDED INCLUDE OPEN HEART SURGERY, INTERVENTIONAL CARDIOLOGY, TOTAL JOINT REPLACEMNTS, COMPLEX EYE SURGERY, PEDIATRIC CARE, URGENT CARE AND A FULL RANGE OF WOMEN AND CHILDREN'S HEALTH CARE. SJE OFFERS COMPRHENSIVE ONCOLOGY CARE THROUGH AN ACCREDITED CANCER PROGRAM, AS WELL AS EMERGENCY MEDIICINE BOARD CERTIFIED PHYSICIANS FOR THE HOSPITAL'S FULL SERVICE EMERGENCY ROOM. THE HOSPITAL PROVIDES THE COMMUNITY WITH BOTH AN OUTPATIENT SURGERY AND AN OUTPATIENT IMAGING CENTER. ALL OF THESE SERVICES WILL BE ENHANCED IN 2011 WITH THE OPENING OF THE NEW INPATIENT TOWER. THE GENERAL HOSPITAL CAMPUS IS LOCATED ONLY BLOCKS FROM THE SJE CAMPUS AND OFFERS THE COMMUNITY A MEDICAL REHABILITATION CENTER, OCCUPATIONAL MEDICINE, OUTPATIENT LABORATORY SERVICES, A SLEEP DISORDER CLINIC AND OUTPATIENT REHABILITATION SERVICES. THE CAMPUS ALSO HOUSES MANY SUPPORT SERVICES NEEDED BY SJHS-HC INCLUDING PATIENT ACCOUNTS, CLINICAL EDUCATION, IMPROVING PERFORMANCE THE HUMBOLDT WAY TEAM MEMBERS, THE SJE FOUNDATION OFFICES AND PASO A PASO'S EDUCATIONAL PROGRAMS FOR HISPANIC FAMILIES. AS A MINISTRY OF THE ST. JOSEPH HEALTH SYSTEM WE ARE COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: - MAKING EVERY ENCOUNTER WITH OUR COMMUNITY A SACRED ENCOUNTER THE WILLOW CREEK COMMUNITY RESOURCE CENTER SERVES AS A PLACEMENT LOCATION FOR ON THE JOB TRAINING THROUGH THE 'WELFARE TO WORK' PROGRAM. A YOUNG MOTHER WHO HAD NEVER WORKED BEFORE CAME TO THE CENTER NERVOUS AND UNSURE OF HER ABILITY TO BE EMPLOYED. AT THE END OF HER ASSIGNMENT SHE REPORTED THE CARING OF HER CO-WORKERS AND THE SUPPORT THEY PROVIDED TO HER EACH DAY HAS GIVEN HER THE COURAGE TO SEEK PAID EMPLOYMENT. WHILE SHE SEARCHES FOR WORK, SHE VOLUNTEERS AT THE CENTER TO MAINTAIN CONTACT WITH THE SUPPORT THE ENCOUNTERS GIVE TO HER. NAME OF INITIATIVE OR PROGRAM: PHYSICIAN SERVICES FOR THE UNDERSERVED COMMUNITY GOAL: RURAL AREAS OF THE COMMUNITY WILL HAVE ACCESS TO CARE FOR THE VULNERABLE, UNDERINSURED COMMUNITY MEMBERS FY10 ACCOMPLISHMENTS: SJE PROVIDES THE ONLY 24 HOUR FULL SERVICES EMERGENCY SERVICES FOR THE NORTH COAST AND THE COMMUNITIES OF HUMBOLDT COUNTY. THERE WERE 21,339 UNDERINSURED PATIENTS SEEN BY THE EMERGENCY ROOM PHYSICIANS IN FY 2010, 49% OF THE TOTAL OF PATIENTS SEEN FOR OUTPATIENT TRAUMA CARE. SJE ALSO ASSISTS THE UNDERSERVED WITH PHYSICIAN COVERAGE FOR IN-PATIENTS THROUGH THE HOSPITALIST PROGRAM. FOR FY 2010, 2,111 UNDERINSURED IN-PATIENTS WERE SEEN, 29% OF THE TOTAL PATIENT POPULATION SERVED BY THIS PROGRAM. NAME OF INITIATIVE OR PROGRAM: PROGRAMS FOR HEALTH CAREER EDUCATION GOAL: THERE WILL BE INCREASED CAPACITY FOR HEALTH CAREER EDUCATION FOR HUMBOLDT COUNTY CITIZENS, LEADING TO IMPROVED HEALTH CARE ACCESS FOR COMMUNITY MEMBERS AND INCREASED ECONOMIC GROWTH FOR THE AREA KEY COMMUNITY PARTNERS: HUMBOLDT STATE UNIVERSITY, TOURO UNIVERSITY, ROBERT WOODS JOHNSON FOUNDATION, COLLEGE OF THE REDWOODS, HUMBOLDT COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PUBLIC HEALTH BRANCH FY10 ACCOMPLISHMENTS: THERE WERE 18,018 HOURS DEVOTED TO MENTORING STUDENTS IN FY 2010. THESE HOURS INCLUDED STUDENT NURSES, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, SOCIAL WORKERS, PHYSICIANS AND THE SENIOR NURSING AND SOCIAL WORK STUDENTS INVOLVED WITH CARE TRANSITIONS. DURING THE SAME TIME PERIOD, HUMBOLDT STATE NURSING PROGRAM WAS PLACED IN JEOPARDY BY FUNDING CONSTRAINTS. SJE ADMINISTRATION JOINED OTHER INTERESTED COMMUNITY MEMBERS TO FORM AN ADVISORY COMMITTEE TO WORK WITH THE UNIVERSITY TO ASSURE THE CONTINUANCE OF THIS VITAL EDUCATION PROGRAM. NAME OF INITIATIVE OR PROGRAM: DONATIONS TO ADDRESS THE NEEDS OF THE UNDERSERVED GOAL: INCREASE THE CAPACITY OF RESIDENTS TO OBTAIN HEALTHFUL FOODS AND INCREASE EXERCISE TO DECREASE OBESITY AND OBESITY RELATED ILLNESSES KEY COMMUNITY PARTNERS: FOOD FOR PEOPLE, HUMBOLDT COUNTY OFFICE OF EDUCATION, BOYS AND GIRLS CLUB, LOLETA AND LOLETA ELEMENTARY SCHOOLS FY10 ACCOMPLISHMENTS: ONE INITIATIVE INVOLVED THE TRAINING OF OUR COMMUNITY PARTNERS TO ASSIST WITH AN AFTER SCHOOL ACTIVITY AND NUTRITION ENHANCEMENT PROGRAM FOR TWO OF OUR LOCAL LOW INCOME SCHOOLS. THE EQUIPMENT, TRAINING COSTS AND PROGRAM COMPONENTS WERE PURCHASED BY SJE FOR THE BEGINNING STEP OF A MULTIYEAR PARTNERSHIP TO ADDRESS OBESITY IN OUR RURAL SCHOOLS. IN ADDITION, SEVEN (7) COMMUNITY NON-PROFIT ORGANIZATIONS WERE AWARDED FUNDING FROM SJE FOR FOOD DISTRIBUTION AND EXERCISE COMPONENTS OF THEIR OWN PROGRAMS.
CHANGES TO ORGANIZATIONAL DOCUMENTSFORM 990, PART VI, QUESTION 4THE ORGANIZATION'S BYLAWS WERE UPDATED TO DEFINE AND CLARIFY BOARD DUTIES AND OFFICER ROLES. THE NUMBER OF BOARD SEATS WAS ALSO INCREASED. IN ADDITION, THE LIST OF RESERVED RIGHTS WAS EXPANDED TO INCLUDE PROCESSES LEADING UP TO ACTION ON RESERVED RIGHTS. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH HOSPITAL OF EUREKA. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A ST. JOSEPH HOSPITAL OF EUREKA HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. JOSEPH HOSPITAL OF EUREKA BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE ST. JOSEPH HOSPITAL OF EUREKA BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11 THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 IS THEN REVIEWED BY AN OFFICER(S) OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2011 MEETING. DURING THE BOARD FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTS AND DISCUSSES CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE BOARD FINANCE COMMITTEE CHAIR THEN PROVIDES A SUMMARY AT THE FULL BOARD MEETING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, QUESTION 12COFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ON THE CONFLICT OF INTEREST DISCLOSURE FORM THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST HE/SHE MAY HAVE. ADDITIONALLY, DISCLOSURES SHALL BE MADE PROMPTLY ANYTIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, SUCH CONFLICT IS DISCLOSED TO THE COMPLIANCE COMMITTEE. IF THE CONFLICT INVOLVES A MEMBER OF THAT COMMITTEE, THE REMAINING COMMITTEE MEMBERS WILL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE OFFICER, TRUSTEE, OR KEY EMPLOYEE MAY NOT BE PRESENT DURING ANY MEETING IN WHICH THE COMMITTEE CONDUCTS IS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER IN CONSULTATION WITH SJHS GENERAL COUNSEL WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUNFORM 990, PART VI, QUESTION 15A & 15BTHE EXECUTIVE COMPENSATION PROCESS AT ST. JOSEPH HEALTH SYSTEM IS ADMINISTERED BY A COMMITTEE OF INDEPENDENT TRUSTEES. THEY FOLLOW A BOARD-APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER EMPOWERS THE SJHS BOARD WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND PROCESS ON BEHALF OF THE FULL BOARD OF TRUSTEES OF SJHS. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS THE RETENTION OF KEY MANAGEMENT TALENT. THE SJHS EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. SJHS PROVIDES COMPENSATION TO ITS SENIOR EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO FULFILL THEIR RESPONSIBILITY, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA. THEY USE THIS INFORMATION TO SUPPORT THEIR DECISIONS REGARDING ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE WORKLIFE COMMITTEE IS COMPRISED OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD. THEY MEET AT LEAST 3 TIMES A YEAR AND MAKE ALL CRITICAL DECISIONS IN EXECUTIVE SESSION. THESE DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. THE COMMITTEE IS EMPOWERED TO ENGAGE OUTSIDE COUNSEL AND CONSULTING SUPPORT AS NEEDED. THE WORKLIFE COMMITTEE PERFORMED ITS LAST COMPENSATION REVIEW FOR ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN JUNE 2010.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICFORM 990, PART VI, QUESTION 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE.
HOURS DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VIIRONALD DILUIGI SERVES ON THE BOARD OF ST. JOSEPH HOSPITAL OF EUREKA (SJE) AND IS THE VP OF ADVOCACY OF ST. JOSEPH HEALTH SYSTEM (SJHS), THE TAX-EXEMPT PARENT OF SJE. HE DEVOTES 50 HOURS PER WEEK TO SJHS AND 2 HOURS PER WEEK TO SJE. SUSAN WHITTAKER SERVES ON THE BOARD OF SJE AND IS THE SVP AND CAO OF SJHS, THE TAX-EXEMPT PARENT OF SJE. SHE DEVOTES 50 HOURS PER WEEK TO SJHS AND 2 HOURS PER WEEK TO SJE. JOSEPH MARK IS THE CEO OF SJE AND REDWOOD MEMORIAL HOSPITAL (RMH) AND IS PAID BY SJHS, THE TAX-EXEMPT PARENT OF SJE. HE DEVOTES 43.60 HOURS PER WEEK TO SJE AND 6.40 HOURS TO RMH AND NO HOURS TO SJHS. S. ANDREW RYBOLT IS THE VICE PRESIDENT OF FINANCE OF SJE AND RMH. HE DEVOTES 43.60 HOURS PER WEEK TO SJE AND 6.40 HOURS TO RMH. RON JONES RECEIVED COMPENSATION FOR PROFESSIONAL SERVICES PROVIDED TO SJE, NOT FOR HIS BOARD MEMBER SERVICE. HE DEVOTES 6 HOURS PER WEEK TO SJE AND 50 HOURS PER WEEK TO RMH FOR ON-CALL SERVICES. KUSUM STOKES RECEIVED COMPENSATION FOR PROFESSIONAL SERVICES PROVIDED TO SJE, NOT FOR HER BOARD MEMBER SERVICE. SHE DEVOTED 28 HOURS PER WEEK TO SJE. THOMAS RYDZ, MD, RECEIVED COMPENSATION FOR PROFESSIONAL SERVICES PROVIDED TO SJE, NOT FOR HIS BOARD MEMBER SERVICE. HE DEVOTED 2 HOURS PER WEEK TO SJE. OVERSIGHT OR SELECTION PROCESS FORM 990, PART XI, LINE 2C THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. BUSINESS TRANSACTIONS WITH INTERESTED PERSONS FORM 990, SCHEDULE L, PART IV JEFF NELSON, THE VICE CHAIRMAN AND BOARD MEMBER OF ST. JOSEPH OF EUREKA (SJE) IS ALSO THE OWNER OF SHN ENGINEERING. SJE CONTRACTED WITH SHN ENGINEERING TO CONSTRUCT THE NEW PATIENT TOWER. THE COSTS WERE PAID BY ST. JOSEPH HEALTH SYSTEM, THE TAX-EXEMPT PARENT, AND REIMBURSED BY SJE. THE COSTS ARE INCLUDED AS EXPENSES IN PART IX OF FORM 990.
TRANSACTIONS WITH RELATED ORGANIZATIONSFORM 990, SCHEDULE R, PART V, LINE 2THE AMOUNTS REPORTED ON SCHEDULE R, PART V, LINE 2 ARE DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING.
SECTION 409A RELIEF UNDER SECTION V.D OF IRS NOTICE 2008-113OPERATIONAL DEFECTS(A) NAMES AND SOCIAL SECURITY NUMBERS OF AFFECTED PARTICIPANTS: SEE (C) BELOW. NONE OF THE AFFECTED PARTICIPANTS ARE INSIDERS. (B) THE 409A FAILURE OCCURRED WITH RESPECT TO THE ST. JOSEPH HEALTH SYSTEM 457(F) PLAN ("PLAN"). (C) OPERATIONAL DEFECT (1): IN FEBRUARY 2010 IT WAS DISCOVERED THAT THE PLAN FAILED TO COMPLY WITH 409A BECAUSE IT PROVIDED FOR IMPERMISSIBLE ALTERNATIVE PAYMENT SCHEDULES FOR VOLUNTARY AND INVOLUNTARY SEPARATIONS FROM SERVICE AND DID NOT SPECIFY THAT PAYMENT WILL BE MADE ON THE 60TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT. IN ACCORDANCE WITH VI.B, VII.C AND XI.A OF NOTICE 2010-6, THE PLAN WAS AMENDED EFFECTIVE AS OF JANUARY 1, 2009 TO APPLY THE TIMING RULE APPLICABLE TO INVOLUNTARY TERMINATIONS TO VOLUNTARY TERMINATIONS AND TO PROVIDE THAT PAYMENT WILL BE MADE ON THE 60TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT. THIS AMENDMENT WAS SIGNED BY THE EMPLOYER ON OCTOBER 6, 2010. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 60TH DAY FOLLOWING THE PARTICIPANT SEPARATION FROM SERVICE DATE FOR THE FOLLOWING PARTICIPANTS WHO VOLUNTARILY TERMINATED IN 2009 OR 2010. (BECAUSE THE FORM 990 IS OPEN TO PUBLIC INSPECTION AND THE THREAT OF IDENTITY THEFT, SSNS WILL BE PROVIDED UPON REQUEST) NAME/SOCIAL SECURITY NUMBER: ROBERT SAMPSON DATE OF WHEN THE FAILURE OCCURRED: 12/06/2009 12/31/2009 ACCOUNT BALANCE: $100,726 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $100,726 NAME/SOCIAL SECURITY NUMBER: ROBERT BRANNIGAN DATE OF WHEN THE FAILURE OCCURRED: 05/18/2010 12/31/2009 ACCOUNT BALANCE: $32,903 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $32,903 * DISTRIBUTIONS DID NOT INCLUDE ANY INTEREST EARNED AFTER DECEMBER 31, 2009 FOR PARTICIPANTS WHO TERMINATED IN 2009. OPERATIONAL DEFECT (2): IN 2010 IT WAS DISCOVERED THAT 3 PARTICIPANTS EMPLOYED BY OTHER PARTICIPATING EMPLOYERS WERE NOT TIMELY PAID THEIR PLAN ACCOUNTS FOLLOWING INVOLUNTARY TERMINATIONS IN 2009, AS REQUIRED BY THE PLAN. USUALLY, SUCH DISTRIBUTIONS ARE MADE WITHIN 30 DAYS FOLLOWING THE INVOLUNTARY TERMINATION DATE. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 30TH DAY FOLLOWING THE INVOLUNTARY TERMINATION DATE. THE PLAN'S ADMINISTRATIVE PROCEDURES HAVE BEEN REVIEWED TO ASSURE THAT IN THE FUTURE PLAN BENEFITS ARE PAID PROMPTLY AFTER ALL INVOLUNTARY TERMINATIONS. ST. JOSEPH HOSPITAL OF EUREKA DID NOT HAVE ANY EMPLOYEES WHO WERE INVOLUNTARILY TERMINATED AND NOT TIMELY PAID THEIR PLAN BENEFIT. (D) THE PLAN QUALIFIED FOR RELIEF UNDER VI.B, VII.C AND XI.A OF IRS NOTICE 2010-6 AND ON OCTOBER 6, 2010, A PLAN AMENDMENT WAS SIGNED. THE AMENDMENT PROVIDES THAT EFFECTIVE AS OF JANUARY 1, 2009, ALL BENEFITS WILL BE PAID IMMEDIATELY UPON AN INVOLUNTARY SEPARATION FROM SERVICE (CURRENTLY THE STATUS QUO) AND ON THE 60TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON COMPETE AGREEMENT. ANY PARTICIPANT WHO VOLUNTARILY SEPARATED FROM SERVICE ON OR AFTER JANUARY 1, 2009 AND ON OR BEFORE DECEMBER 31, 2009 WAS PAID HIS CURRENT PLAN ACCOUNT BALANCE AFTER THE DATE THE AMENDMENT WAS SIGNED, BUT REDUCED FOR ANY INTEREST EARNED IN 2010 (IF ANY). AS ALLOWED BY NOTICE 2010-80, THE EMPLOYER SIGNED AN AMENDMENT ON DECEMBER 20, 2010 TO PROVIDE THAT PAYMENT WILL NO LONGER BE REQUIRED ON THE 60TH DAY FOLLOWING A VOLUNTARY SEPARATION FROM SERVICE, BUT WITHIN 60 DAYS FOLLOWING THE VOLUNTARY SEPARATION FROM SERVICE. HOWEVER, IF THE 60TH DAY FALLS IN THE SUBSEQUENT TAX YEAR, PAYMENT WILL BE MADE IN THE SUBSEQUENT TAX YEAR. THE PLAN'S ADMINISTRATIVE PROCEDURES HAVE BEEN CHANGED TO PAY PLAN ACCOUNTS IMMEDIATELY FOLLOWING A PARTICIPANT'S INVOLUNTARY SEPARATION FROM SERVICE (CURRENTLY THE STATUS QUO) AND WITHIN 60 DAYS FOLLOWING A VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT AND SUBJECT TO THE REQUIREMENT THAT IF THE 60TH DAY FALLS IN THE SUBSEQUENT TAX YEAR THEN PAYMENT WILL BE MADE IN THE SUBSEQUENT TAX YEAR. (E) THESE OPERATIONAL FAILURES ARE ELIGIBLE FOR THE CORRECTION UNDER THE TERMS OF IRS NOTICE 2008-113 AND THE EMPLOYER HAS TAKEN ALL ACTIONS REQUIRED, AND OTHERWISE MET ALL REQUIREMENTS, FOR SUCH CORRECTION.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ST JOSEPH HEALTH SYSTEM
500 S MAIN STREET SUITE 700ORANGECA92868953589356HEALTHCARECA501(c)(3)11, INA
REDWOOD MEMORIAL HOSPITAL
3300 RENNER DRIVEFORTUNACA95540941384665HEALTHCARECA501(c)(3)3SJHS
ST JOSEPH HEALTH MINISTRY
500 S MAIN STREET SUITE 400ORANGECA92868271666576RELIGIOUS ORGCA501(c)(3)1NA
QUEEN OF THE VALLEY MEDICAL CENTER
1000 TRANCAS STREETNAPACA94558941243669HEALTHCARECA501(c)(3)3SJHS
SANTA ROSA MEMORIAL HOSPITAL
1165 MONTGOMERY DRIVESANTA ROSACA95405941231005HEALTHCARECA501(c)(3)3SJHS
ST JUDE MEDICAL CENTER
101 E VALENCIA MESA DRIVEFULLERTONCA92835951643325HEALTHCARECA501(c)(3)3SJHS
ST JOSEPH HOSPITAL OF ORANGE
1100 WEST STEWART DRIVEORANGECA92868951643359HEALTHCARECA501(c)(3)3SJHS
MISSION HOSPITAL REGIONAL MEDICAL CENTER
27700 MEDICAL CENTER ROADMISSION VIEJOCA92691951643360HEALTHCARECA501(c)(3)3SJHS
ST MARY MEDICAL CENTER
18300 HIGHWAY 18APPLE VALLEYCA92307951914489HEALTHCARECA501(c)(3)3SJHS
COVENANT HEALTH SYSTEM
3615 19TH STREETLUBBOCKTX79410752765566HEALTHCARETX501(c)(3)3SJHS
ST JOSEPH HEALTH SYSTEM FOUNDATION
500 S MAIN STREET SUITE 1000ORANGECA92868330143024FOUNDATIONCA501(C)(3)7SJHS
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIAORANGECA92868951643383RELIGIOUS ORGCA501(C)(3)1na
ST JOSEPH HOME CARE NETWORK
170 PROFESSIONAL CENTER DR BROHNERT PARKCA94928680331084HEALTHCARECA501(C)(3)9SJHS
ST JOSEPH HERITAGE HEALTHCARE
279 EAST IMPERIAL HIGHWAYFULLERTONCA92835330185031HEALTHCARECA501(C)(3)3SJHS

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
ST JOSEPH PROF SVCS ENTERPRISES INC
500 S MAIN STREET 700ORANGECA92868330155323HEALTHCARE SVCASJHSC-CORP000.00000
ST JOSEPH DIVERSIFIED VENTURES INC
500 S MAIN STREET 700ORANGECA92868330148989HEALTHCARE SVCASJHSC-CORP000.00000
AMERICAN UNITY GROUP LTD
CAPTIVE INSURANCESJHSC-CORP000.0000058 PAR-LA-VILLE ROADHAMILTON HM HXBDBD
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (18 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
REDWOOD MEMORIAL HOSPITAL
B100000
ST JOSEPH HEALTH SYSTEM FOUNDATION
B1142900
ST JOSEPH HEALTH SYSTEM FOUNDATION
C510000
REDWOOD MEMORIAL HOSPITAL
N9669597
REDWOOD MEMORIAL HOSPITAL
O140700
REDWOOD MEMORIAL HOSPITAL
P240815
QUEEN OF THE VALLEY MEDICAL CENTER
0
SANTA ROSA MEMORIAL HOSPITAL
0
ST JUDE MEDICAL CENTER
0
ST JOSEPH HOSPITAL OF ORANGE
0
MISSION HOSPITAL REGIONAL MEDICAL CENTER
0
ST MARY MEDICAL CENTER
0
CONVENANT HEALTH SYSTEM
0
ST JOSEPH PROFESSIONAL SERVICES ENTERPRISES
0
ST JOSEPH DIVERSIFIED VENTURES INC
0
AMERICAN UNITY GROUP LTD
0
ST JOSEPH HERITAGE HEALTHCARE
0
ST JOSEPH HOME CARE NETWORK
0