Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
MARIN GENERAL HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
250 BON AIR ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
GREENBRAE, CA94904
D Employer identification number

94-2823538
E Telephone number

G Gross receipts $ 306,040,683
F Name and address of principal officer:
LEE DOMANICO
250 BON AIR ROAD
GREENBRAE,CA94904
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MARINGENERAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1991
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 28
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 27
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 1,671
6 Total number of volunteers (estimate if necessary) .... 6 253
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,661,211 545,848
9 Program service revenue (Part VIII, line 2g) ......... 283,078,883 303,746,448
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 113,458 82,896
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 615,798 -44,771
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 285,469,350 304,330,421
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 657,021 936,069
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 144,976,810 164,384,873
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 117,853,578 137,481,167
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 263,487,409 302,802,109
19 Revenue less expenses. Subtract line 18 from line 12...... 21,981,941 1,528,312
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 119,602,882 166,218,678
21 Total liabilities (Part X, line 26)............ 46,193,897 120,835,394
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 73,408,985 45,383,284
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 275,896,363 including grants of $ 865,413 ) (Revenue $ 304,568,086 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 275,896,363
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
202
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
1,671
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
28
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
27
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
Yes
 
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DAVID COX
100 B DRAKES LANDING SUITE 250
GREENBRAE,CA94904
(415) 464-2090
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ED BERDICK
DIRECTOR/SUTTER REPRESENTATIVE
 5.00 X   X       0 0 0
(2) DAVID BRADLEY
CEO/SUTTER REPRESENTATIVE
 30.00 X   X       0 0 0
(3) MARTIN BROTMAN
DIRECTOR/SUTTER REPRESENTATIVE
 5.00 X   X       0 0 0
(4) OLIVER DIBBLE
DIRECTOR
 2.00 X           0 0 0
(5) DAVID GALLAND MD
DIRECTOR
 2.00 X           0 0 0
(6) BRUCE HART
DIRECTOR/SECRETARY
 2.00 X   X       0 0 0
(7) ROBERT HELLER
CHAIRMAN
 2.00 X   X       0 0 0
(8) CHARLES LEE
DIRECTOR
 2.00 X           0 0 0
(9) KERRY DAVIDSON MD
DIRECTOR/CHIEF OF STAFF
 2.00 X           75,000 0 0
(10) MATTHEW TADDEI
DIRECTOR
 2.00 X           0 0 0
(11) FRANK TAVEL MD
VICE CHAIRMAN
 2.00 X   X       0 0 0
(12) CAROLYN WORTH
DIRECTOR
 2.00 X   X       0 0 0
(13) DAVID OGDEN MD
DIRECTOR
 2.00 X           0 0 0
(14) JAMES CLEVER MD
MHD CHAIRMAN
 1.00 X   X       0 2,300 0
(15) JENNIFER RIENKS
MHD VICE CHAIRPERSON
 1.00 X   X       0 2,600 0
(16) HARRIS SIMMONDS MD
MHD SECRETARY
 1.00 X   X       0 3,000 0
(17) LARRY BEDARD MD
MHD DIRECTOR
 1.00 X           0 1,800 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) SHARON JACKSON
MHD DIRECTOR
 1.00 X           0 3,100 0
(19) JEREMY FAIR
TREASURER
 2.00 X   X       0 0 0
(20) DAVID HILL
DIRECTOR
 2.00 X           0 0 0
(21) ANN KAO
DIRECTOR
 2.00 X           0 0 0
(22) PAUL KIRINCIC
CHAIRMAN
 2.00 X   X       0 0 0
(23) GENE MARIE O'CONNELL
DIRECTOR
 2.00 X           0 0 0
(24) DEREK PARKER
DIRECTOR
 2.00 X           0 0 0
(25) MARA PEREZ
SECRETARY
 2.00 X   X       0 0 0
(26) STEVEN A SCHROEDER
VICE CHAIRMAN
 2.00 X   X       0 0 0
(27) TIMOTHY SOWERBY MD
DIRECTOR
 2.00 X           0 0 0
(28) HARVEY BICHKOFF
DIRECTOR
 2.00 X           0 0 0
(29) LEE DOMANICO
CEO
 28.00     X       0 1,002,268 6,961
(30) DAVID COX
CFO
 28.00     X       0 469,662 16,292
(31) JON FRIEDENBERG
CHF BUS DEVELOPMENT OFF'R
 28.00     X       0 337,273 5,341
(32) THERESA DAUGHTON
CFO
 40.00     X       0 0 0
(33) JEFFREY DIETZ MD
MEDICAL SRVC PROVIDER
 2.00     X       0 0 0
(34) CHARLES PROSPER
CAO
 40.00     X       0 0 0
(35) THERESA E GIANFORTUNE
CHIEF HUMAN RESOURCE OFF'R
 40.00     X       0 207,027 6,308
(36) JOEL SKLAR
CHIEF MEDICAL OFFICER
 40.00     X       85,140 20,700 2,699
(37) SUSAN S CUMMING
MEDICAL DIRECTOR
 40.00       X     329,948 0 35,338
(38) CHUN LI
CHF CLIN PHYSICIST & DIR RAD ONC
 40.00       X     292,384 0 44,589
(39) VERNON A MORENO
EXECUTIVE DIRECTOR SUPPORT SERVICES
 40.00       X     241,529 0 44,514
(40) MICHAEL W SILLMAN
DIR PHARMACY SERVICES
 40.00       X     207,159 0 60,820
(41) LINDA MILLER
DIR LABORATORY SERVICES
 40.00       X     200,121 0 66,679
(42) LUISITO L MANILA
DIR CARDIO & NEUROVASCULAR SVCS
 40.00       X     199,590 0 15,986
(43) SANDRA A BATT
DIR EDUCATION DEV AND SVC EXCELLENCE
 40.00       X     200,228 0 19,361
(44) MARY J MARTIN-BOYD
DIR EMERGENCY SERVICES
 40.00       X     188,333 0 46,036
(45) MARCELLA L BRINK
DIR BEHAVIORAL HEALTH
 40.00       X     187,068 0 69,527
(46) JACQUELINE I JEWELL
DIR CLINICAL SYSTEMS INTEGRATION
 40.00       X     181,270 0 28,642
(47) JOAN L MCCREADY
DIR QUALITY MGMT SERVICES
 40.00       X     181,688 0 21,778
(48) SANDRA J DOMERACKI
Z-COORD EMPLOYEE HEALTH SRVCS
 40.00       X     178,318 0 18,245
(49) ELISABET BORREGARD
DIR EDUCATION DEV & SVC
 40.00       X     175,843 0 10,654
(50) LYNELLE S TAKIGAWA
MGR CLINICAL SYSTEMS INTEGRATION
 40.00       X     152,602 0 15,059
(51) JANA BECKLUND
SUPV TECH IMAGING/BREAST CNTR
 40.00       X     152,056 0 37,959
(52) GREGORY LEE
CARD CATH TECH IV
 40.00         X   439,641 0 28,009
(53) SANDY D AUGUSTUS
CLINICAL RN III
 40.00         X   326,709 0 39,421
(54) MARGARET M ROBERTS
CLINICAL RN III
 40.00         X   322,035 0 43,484
(55) JAMES I WHITLOCK
RAD TECH IV
 40.00         X   267,056 0 36,567
(56) JEFFREY W WESTERBERG
RAD TECH IV
 40.00         X   244,835 0 31,788
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,828,553 2,049,730 752,057
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet418
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CROSS COUNTRY TRAVCORPS INC
FILE 50941
LOS ANGELES,CA90074 		NURSING SERVICES 2,848,650
SODEXHO INC AND AFFILIATES
DEPT 48283
LOS ANGELES,CA90088 		MANAGEMENT SERVICES 2,308,279
CALIFORNIA PACIFIC MEDICAL CTR FOUNDATIO
1255 POST ST 700
SAN FRANCISCO,CA94109 		PERFUSION SVCS/MANAGEMENT SVCS 1,982,709
ANESTHESIOLOGY CONSULTANTS OF MARIN INC
540 SAN PEDRO COVE
SAN RAFAEL,CA94901 		ANESTHESIOLOGY SERVICES 1,530,354
MARIN HOSPITALIST MEDICAL GROUP
PO BOX 708
NOVATO,CA94948 		HOSPITALIST SERVICE 1,492,667
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet75
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 205,991
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		339,857
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 545,848
Program Service Revenue Business Code
2a PATIENT SERVICE REV. 621,100 303,746,448 303,746,448    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 303,746,448
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 61,093     61,093
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 843,853  
b Less: rental expenses 1,710,262  
c Rental income or (loss) -866,409  
d Net rental income or (loss).......MediumBullet -866,409     -866,409
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 21,803  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 21,803  
d Net gain or (loss)..........MediumBullet 21,803     21,803
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA/NP FOOD SERV 900,099 625,795 625,795    
b REBATES/REFUNDS 900,099 168,449 168,449    
c MED REC ABSTRACTS 900,099 20,991 20,991    
d All other revenue .... 6,403 6,403    
e Total. Add lines 11a–11d ......MediumBullet 821,638
12 Total revenue. See Instructions....MediumBullet 304,330,421 304,568,086 0 -783,513
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 865,413 865,413
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 70,656 70,656
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,747,094 3,248,732 498,362  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 120,803,909 104,716,374 16,087,535  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 7,375,151 6,394,256 980,895  
9 Other employee benefits ....... 23,886,348 20,709,464 3,176,884  
10 Payroll taxes ........... 8,572,371 7,432,246 1,140,125  
11 Fees for services (non-employees):        
a Management ...... 1,709,345   1,709,345  
b Legal ......... 2,561,777 2,561,777    
c Accounting ........... 254,394   254,394  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 21,172,391 21,172,391    
12 Advertising and promotion ....        
13 Office expenses ....... 7,147,516 7,147,516    
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 5,963,429 5,696,249 267,180  
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 2,128,901 2,128,901    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 12,168,657 12,168,657    
23 Insurance .............. 2,366,597 2,129,937 236,660  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a MEDICAL SUPPLIES 27,854,678 27,854,678    
b PROVISION FOR BAD DEBTS 19,097,735 19,097,735    
c PURCHASED SERVICES 16,593,809 14,369,144 2,224,665  
d PRO. FEES - PHYSICIANS 11,138,539 11,138,539    
e OTHER EXPENSES 7,323,399 6,993,698 329,701  
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 302,802,109 275,896,363 26,905,746 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1 32,847,319
2 Savings and temporary cash investments ....... 10,412,598 2 337,927
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 42,087,310 4 60,981,690
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 4,912,741 8 4,479,432
9 Prepaid expenses and deferred charges ............ 8,763,775 9 7,439,015
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 169,914,829
b Less: accumulated depreciation. ..... 10b 114,717,450 39,196,277 10c 55,197,379
11 Investments—publicly traded securities .......... 5,776,680 11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 .. 6,306,457 13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 2,147,044 15 4,935,916
16 Total assets. Add lines 1 through 15 (must equal line 34)... 119,602,882 16 166,218,678
Liabilities 17 Accounts payable and accrued expenses . 21,337,509 17 35,644,616
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 9,311,323 23 46,489,058
24 Unsecured notes and loans payable to unrelated third parties ....   24 20,900,000
25 Other liabilities. Complete Part X of Schedule D..... 15,545,065 25 17,801,720
26 Total liabilities. Add lines 17 through 25..... 46,193,897 26 120,835,394
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 69,634,473 27 43,537,000
28 Temporarily restricted net assets ..... 3,559,869 28 1,846,284
29 Permanently restricted net assets ..... 214,643 29 0
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 73,408,985 33 45,383,284
34 Total liabilities and net assets/fund balances ..... 119,602,882 34 166,218,678
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
304,330,421
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
302,802,109
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
1,528,312
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
73,408,985
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-29,554,013
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
45,383,284
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
MARIN GENERAL HOSPITAL
  		Employer identification number

94-2823538
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
MARIN GENERAL HOSPITAL
  		Employer identification number

94-2823538
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
MARIN GENERAL HOSPITAL
  		Employer identification number

94-2823538
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
18,146
j
Total. lines 1c through 1i ...................................
18,146
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: THE ORGANIZATION PAYS MEMBERSHIP DUES TO CA HEALTHCARE ASSOCIATION AND HOSPITAL COUNCIL NORTHERN CENTRAL CALIFORNIA (CHA/HCNCC). A PORTION OF THE DUES PAID (APPROXIMATELY 16.61%) WERE USED FOR LOBBYING PURPOSES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 214,643 214,643 293,280
b Contributions ........      
c Investment earnings or losses ...     -78,637
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ...... 214,643 214,643 214,643
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................   26,915,268 25,264,203 1,651,065
c Leasehold improvements ............   52,874,785 36,552,149 16,322,636
d Equipment ................   83,759,113 52,653,500 31,105,613
e Other .................   6,365,663 247,598 6,118,065
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 55,197,379
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
INSURANCE LIABILITIES 4,576,338
OTHER LIABILITIES 7,159,281
THIRD PARTY SETTLEMENTS 135,306
INTERCOMPANY PAYABLES 2,172,950
ACCRUED PENSION LIABILITIES 3,757,845




Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 17,801,720
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 304,330,421
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 302,802,109
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 1,528,312
4 Net unrealized gains (losses) on investments .......................... 4 -75,789
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -29,478,224
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -29,554,013
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -28,025,701
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 277,981,000
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -75,789
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d -27,983,894
e Add lines 2a through 2d ..................... 2e -28,059,683
3 Subtract line 2e from line 1..................... 3 306,040,683
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b -1,710,262
c Add lines 4a and 4b....................... 4c -1,710,262
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 304,330,421
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 304,662,000
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 149,629
e Add lines 2a through 2d...................... 2e 149,629
3 Subtract line 2e from line 1..................... 3 304,512,371
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b -1,710,262
c Add lines 4a and 4b....................... 4c -1,710,262
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 302,802,109
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE NOW ADMINISTERED BY FOUNDATION OF WHICH THE ORGANIZATION IS THE SOLE CORPORATE PARENT. EARNINGS FROM GENERAL ENDOWMENT FUND ARE AVAILABLE TO BE DESIGNATED BY FOUNDATION BOARD. THE EARNINGS FROM THE OTHER ENDOWMENT FUNDS ARE TRANSFERRED TO RELATED TEMPORARILY RESTRICTED FUNDS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   LOSS ON SETTLEMENT OF PENSION PLAN -12,563,035. DECREASE IN THE BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION -3,139,873. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 10,058,478. AFS ROUNDING ON CONTRIBUTIONS RECLASSIFIED FROM TEMP. RESTRICTED NET ASSETS -1,405. PRIOR PERIOD ADJUSTMENT RELATED TO PREPAID RENT 5,212,774. AUDITED FINANCIAL STATEMENT ROUNDING 191. PRIOR PERIOD ADJUSTMENT FOR FOUNDATION NET ASSETS INCLUDED IN TAX RETURN -6,306,457. TRANSFER OF ASSETS BY SUTTER HEALTH, CORPORATE MEMBER -22,569,093. OTHER CHANGE IN FUND BALANCES 199,442. EQUITY TRANSFERS TO MARIN GENERAL HOSPITAL FOUNDATION -369,246.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   LOSS ON SETTLEMENT OF PENSION PLAN -12,563,035. DECREASE IN THE BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION -3,139,873. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 10,058,478. OTHER CHANGE IN FUND BALANCES 199,442. AFS ROUNDING ON CONTRIBUTIONS RECLASSIFIED FROM TEMP. RESTRICTED NET ASSETS -1,405. EQUITY TRANSFERS TO MARIN GENERAL HOSPITAL FOUNDATION -369,246. FOUNDATION EXPENSES PAID BY HOSPITAL REIMBURSED BY FOUNDATION 149,000. TRANSFER OF ASSETS BY SUTTER HEALTH, CORPORATE MEMBER -22,569,093. PRIOR PERIOD ADJUSTMENT FOR FOUNDATION NET ASSETS 251,509. AFS ROUNDING 329.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   RECLASS OF RENTAL EXPENSES FROM EXPENSES -1,710,262.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   AUDITED FINANCIAL STATEMENT ROUNDING 629. FOUNDATION EXPENSES PAID BY HOSPITAL REIMBURSED BY FOUNDATION 149,000.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:   RECLASS OF RENTAL EXPENSES TO REVENUE -1,710,262.
    PARTS XI, XII, & XIII - RECONCILIATIONS: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS; HOWEVER, SEPARATE FINANCIAL INFORMATION IS MAINTAINED FOR EACH ORGANIZATION. THE SEPARATE FINANCIAL INFORMATION FOR THIS ORGANIZATION IS THE BASIS FOR THE RECONCILIATIONS AT SCHEDULE D, PARTS XI, XII, & XIII. IN ADDITION, THE AMOUNT ON SCHEDULE D, PART XI, LINE 10 DOES NOT TIE TO THE CHANGE IN NET ASSETS PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THIS AMOUNT IS THE CHANGE IN NET ASSETS FOR THIS ORGANIZATION ONLY.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    3,009,007   3,009,007 0.990 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    37,801,823 17,637,809 20,164,014 6.660 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     11,765,970 6,069,423 5,696,547 1.880 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    52,576,800 23,707,232 28,869,568 9.530 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		19 6,852 297,996 4,000 293,996 0.100 %
f Health professions education
(from Worksheet 5) .. 		3 1,545 58,934   58,934 0.020 %
g Subsidized health services
(from Worksheet 6) .. 		0 0 0 0    
h Research (from Worksheet 7) 1 20 5,506 0 5,506 0 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		16 20 3,928,050 0 3,928,050 1.300 %
jTotal Other Benefits ... 39 8,437 4,290,486 4,000 4,286,486 1.420 %
kTotal. Add lines 7d and 7j. .. 39 8,437 56,867,286 23,711,232 33,156,054 10.950 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 1   50,000   50,000 0.020 %
7 Community health improvement advocacy 2 1,850 4,212   4,212 0 %
8 Workforce development            
9 Other            
10 Total 3 1,850 54,212   54,212 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
4,984,509
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
62,345,578
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
110,640,116
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-48,294,538
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MARIN GENERAL HOSPITAL
250 BON AIR ROAD
GREENBRAE,CA94904 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:MARIN GENERAL HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?6
Name and address Type of Facility (Describe)
1 IMAGING CENTER
1350 S ELISEO DRIVE 105 205
GREENBRAE,CA94904 		OUTPATIENT IMAGING
2 IMAGING CENTER
1350 S ELISEO DRIVE 105 205
GREENBRAE,CA94904 		OUTPATIENT IMAGING
3 IMAGING CENTER
1350 S ELISEO DRIVE 105 205
GREENBRAE,CA94904 		OUTPATIENT IMAGING
4 IMAGING CENTER
1350 S ELISEO DRIVE 105 205
GREENBRAE,CA94904 		OUTPATIENT IMAGING
5 IMAGING CENTER
1350 S ELISEO DRIVE 105 205
GREENBRAE,CA94904 		OUTPATIENT IMAGING
6 IMAGING CENTER
1350 S ELISEO DRIVE 105 205
GREENBRAE,CA94904 		OUTPATIENT IMAGING
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 3C: TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINE (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: 1) SPECIAL CIRCUMSTANCES CHARITY CARE: A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, INELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING MGH'S CHARITY CARE ELIGIBILITY CRITERIA. 2) CATASTROPHIC CHARITY CARE: PARTIAL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 30% OF PATIENT'S FAMILY INCOME. PATIENTS THAT MEET THE CRITERIA WILL RECEIVE A FULL WRITE-OFF OF UNDISCOUNTED CHARGES THAT EXCEED 30% OF THEIR INCOME. 3) UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. 4) PROMPT PAYMENT DISCOUNT: ADDITIONAL DISCOUNT FOR PATIENTS RECEIVING THE UNINSURED DISCOUNT OF AT LEAST 10% WHO PAY WITHIN 30 DAYS OF FINAL BILLING, OR 20% IF THE 50% OF THE ESTIMATED BILL IS PAID PRIOR TO DISCHARGE.
AVAILABILITY OF COMMUNITY BENEFIT REPORT PART I, LINE 6 MGH POSTS THEIR COMMUNITY BENEFIT REPORT ON THEIR WEBSITE AND SUBMITS THE REPORT TO CALIFORNIA AGENCIES. ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE AT THE MARIN GENERAL HOSPITAL BOARD MEETING AND THE MARIN HEALTHCARE DISTRICT BOARD MEETING. MARIN GENERAL HOSPITAL ALSO PROVIDES RELEASES TO THE MEDIA ON SPECIFIC ACTIVITIES.
BAD DEBT EXPENSE PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON PART I, LINE 7, COLUMN (F). THE BAD DEBT EXPENSE AMOUNT IS $19,097,735.
    PART II: COALITION BUILDING: MARIN GENERAL HOSPITAL IS A MEMBER OF THE HEALTHY MARIN PARTNERSHIP, A COLLABORATION OF DIVERSE MARIN COUNTY ORGANIZATIONS THAT WAS FORMED TO ADDRESS HEALTH ISSUES IN MARIN COUNTY. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: MARIN GENERAL HOSPITAL PARTICIPATES ON A COMMUNITY COMMITTEE THROUGH THE MARIN MOBILITY CONSORTIUM FOUNDATION THAT IS WORKING TO DEVELOP A PROGRAM TO COORDINATE RIDES FOR SENIORS, DISABLED AND PARATRANSIT PERSONS. MARIN GENERAL ALSO PARTICIPATES IN MEETINGS AND FUNDRAISING FOR THE ROTARY OF CENTRAL MARIN FOUNDATION.
    PART III, LINE 4: 1. AUDIT FOOTNOTE: THE ORGANIZATION'S AUDIT DOES NOT INCLUDE A BAD DEBT FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE FOOTNOTES FOR PATIENT ACCOUNTS RECEIVABLE AND PATIENT SERVICE REVENUES LISTED BELOW.NET PATIENT ACCOUNTS RECEIVABLE FOOTNOTE - MGH'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSIST OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES AND PRIVATE PATIENTS. MGH MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR DISCOUNTS AND UNCOLLECTIBLE AMOUNTS.SIGNIFICANT CONCENTRATIONS OF NET PATIENT ACCOUNTS RECEIVABLE ARE AS FOLLOWS: - COMMERCIAL - 61% - MEDICARE - 23% - MEDI-CAL - 8% - PRIVATE PAY AND OTHER - 8%MGH PROVIDES FOR ESTIMATED LOSSES ON ACCOUNTS RECEIVABLE BASED ON PRIOR BAD DEBT EXPERIENCE AND GENERALLY DOES NOT CHARGE INTEREST ON PAST DUE BALANCES. PAST DUE STATUS IS BASED UPON THE DATE OF SERVICES PROVIDED. UNCOLLECTIBLE RECEIVABLES ARE CHARGED OFF WHEN DEEMED UNCOLLECTIBLE. DUE TO THE INHERENT VARIABILITY IN THIS AREA OF PATIENT RECEIVABLE COLLECTIONS, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM.NET PATIENT SERVICE REVENUES FOOTNOTE - PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYORS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES.2. THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS IN THE AMOUNT OF $4,984,509. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
    PART III, LINE 8: THE ORGANIZATION DID NOT COUNT THE MEDICARE SHORTFALL AS COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. THE COST TO CHARGE METHODOLOGY IS USED FOR ALL PATIENT SEGMENTS.
    PART III, LINE 9B: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 30 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE AND THEY HAVE BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.
FACILITY POLICIES AND PRACTICES PART V, SECTION B PURSUANT TO IRS ANNOUNCEMENT 2011-37, TAX-EXEMPT ORGANIZATIONS THAT OPERATE ONE OR MORE HOSPITAL FACILITIES ARE NOT REQUIRED TO COMPLETE SCHEDULE H, PART V, SECTION B FOR 2010 TAX YEAR. MARIN GENERAL HOSPITAL HAS ELECTED NOT TO COMPLETE PART V, SECTION B SO THEY CAN FAMILIARIZE THEMSELVES WITH THE INFORMATION REQUIRED AND TO REPORT COMPLETE AND ACCURATE INFORMATION ON SECTION B.
    PART VI, LINE 2: MARIN GENERAL HOSPITAL IS A MEMBER OF THE HEALTHY MARIN PARTNERSHIP, A COLLABORATION OF DIVERSE MARIN COUNTY ORGANIZATIONS THAT WAS FORMED TO ADDRESS HEALTH ISSUES IN MARIN COUNTY. MEMBERS INCLUDE HEALTH CARE INSTITUTIONS, COUNTY GOVERNMENT, EDUCATIONAL ORGANIZATIONS, BUSINESS ORGANIZATIONS AND OTHER ORGANIZATIONS SUCH AS FOUNDATIONS, THE MARIN INTERFAITH COUNCIL AND THE UNITED WAY. EVERY THREE YEARS, SINCE 1996, THE HEALTHY MARIN PARTNERSHIP CONDUCTS A COMMUNITY NEEDS ASSESSMENT THAT IDENTIFIES HEALTH ISSUES IN MARIN. THIS ASSESSMENT SERVES AS A BASIS FOR PLANNING ON BEHALF OF BOTH THE INDIVIDUAL ORGANIZATIONS AS WELL AS THE PARTNERSHIP AS A WHOLE, WHICH PLANS AND IMPLEMENTS SPECIFIC COMMUNITY PROGRAMS. THE 2008 NEEDS ASSESSMENT WAS BASED ON A REVIEW OF A VARIETY OF DATA SOURCES INCLUDING THE FOLLOWING: CALIFORNIA HEALTH INTERVIEW, CALIFORNIA STUDENT SURVEY, CALIFORNIA HEALTH KIDS SURVEY, CALIFORNIA FIT GRAM RESULTS, YOUTH RISK BEHAVIOR SURVEY AND THE SHERIFF'S DEPARTMENT SURVEY. THE 2008 REPORT CAN BE FOUND AT WWW.HEALTHYMARINPARTNERSHIP.ORG.
    PART VI, LINE 3: MGH'S CHARITY CARE POLICY INCLUDES THE FOLLOWING DETAILS RELATED TO PATIENT EDUCATION FOR ELIGIBIITY ASSISTANCE. COMMUNICATION OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL SHALL PROVIDE: A. ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILTY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS). B. PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE MARIN GENERAL HOSPITAL STANDARIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION"2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, MARIN GENERAL HOSPITAL FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION". B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE MGH WEBSITE. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE COLLECTION PRACTICES, HOSPITAL THIRD-PARTY LIENS, AND DISPUTE INITIATION POLICY. C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVENRMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGES OF MGH'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATION TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS.
    PART VI, LINE 4: MARIN GENERAL HOSPITAL PRIMARILY SERVES RESIDENTS OF MARIN COUNTY. CERTAIN SPECIALTY PROGRAMS SERVICE A BROADER POPULATION, INCLUDING PATIENTS FROM SONOMA COUNTY, THE BROADER SAN FRANCISCO BAY AREA AND BEYOND. KIDSDATA.ORG, FUNDED BY THE LUCILE PACKARD FOUNDATION, REPORTS THAT THE MEDIAN HOUSEHOLD INCOME DROPPED SIGNIFICANTLY DUE TO THE RECESSION, FROM $104,830 IN 2008 TO $88,101 IN 2009. THE COUNTY'S POPULATION INCREASED SLIGHTLY - FROM 259,880 IN 2009 TO 261,837 IN 2010, ACCORDING TO THE STATE OF CALIFORNIA, DEPARTMENT OF FINANCE. THE POPULATION HAS AGED SINCE 1990 WHEN THE MEDIAN AGE WAS 38 YEARS, ACCORDING TO A 2007 REPORT BY THE MARIN ECONOMIC COMMISSION. BY 2000 THE MEDIAN AGE WAS 41.3 YEARS. SENIOR CITIZENS (65 AND OLDER) HAVE INCREASED SIGNIFICANTLY, FROM 9.7 PERCENT OF THE POPULATION IN 1980 TO 15.8 PERCENT IN 2008. ACCORDING TO THE 2000 CENSUS, 84 PERCENT OF THE POPULATION IS CAUCASIAN, FOLLOWED BY PERSONS OF HISPANIC ORIGIN AT 11.1 PERCENT. WHILE THE MARIN POPULATION IS BECOMING MORE ETHNICALLY DIVERSE, IT IS DOING SO AT A SLOWER RATE THAN OTHER CALIFORNIA COUNTIES. ALTHOUGH MARIN COUNTY HAS BEEN NAMED "THE HEALTHIEST COUNTY IN CALIFORNIA," IT CONTINUES TO HAVE ONE OF THE HIGHEST RATES OF BREAST CANCER AND PROSTATE CANCER IN CALIFORNIA. CANCER, HEART DISEASE AND STROKE REMAIN THE PRIMARY CAUSES OF DEATH FOR BOTH MEN AND WOMEN. AMONG NON-WHITES, THERE ARE HIGHER RATES OF POVERTY AND ADOLESCENT PREGNANCIES, LOWER LEVELS OF ADEQUATE PRENATAL CARE, HIGHER RATES OF LOW BIRTH RATE INFANTS, AND CULTURAL/LINGUISTIC BARRIERS TO ACCESSING HEALTH CARE.
    PART VI, LINE 6: MARIN GENERAL HOSPITAL (MGH) UNDERTAKES COMMUNITY BUILDING ACTIVITIES THROUGH THE HEALTHY MARIN PARTNERSHIP AND FINANCIAL SUPPORT TO COMMUNITY HEALTH IMPROVEMENT ADVOCACY GROUPS. THE HEALTHY MARIN PARTNERSHIP, OF WHICH MGH IS A FOUNDING MEMBER, PLANS AND IMPLEMENTS PROGRAMS TO SPECIFICALLY ADDRESS THE COMMUNITY-WIDE HEALTH NEEDS IDENTIFIED IN THE COMMUNITY ASSESSMENTS. AS PART OF ITS COMMITMENT TO INCREASING HEALTH CARE FOR THE UNDER AND UNINSURED, MGH PROVIDES ONGOING FINANCIAL SUPPORT TO KEY HEALTH CARE SAFETY NET ORGANIZATIONS, INCLUDING THE MARIN COMMUNITY CLINICS, ROTACARE, TOM STEEL AIDS CLINIC, AND HOMEWARD BOUND HOMELESS SHELTER. PROGRAMMATICALLY, MGH PHYSICIANS AND STAFF DIRECTLY PARTICIPATE IN A VARIETY OF ADDITIONAL COMMUNITY BUILDING ACTIVITIES, INCLUDING PROVIDING FREE SURGERIES THROUGH OPERATION ACCESS AND PROVIDING A VARIETY OF HEALTH CARE SCREENINGS. THROUGHOUT THE YEAR, FREE COMMUNITY EDUCATIONAL EVENTS AND SCREENINGS ARE HELD COVERING TOPICS SUCH AS HEART DISEASE, BREAST CANCER, PROSTATE CANCER, AND NUTRITION.
REPORTS FILED WITH STATES PART VI, LINE 7 CA
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number
94-2823538
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) MARIN COMMUNITY CLINIC300 PROFESSIONAL CENTER PARKWAY
SAN RAFAEL,CA94903 		94-2237120 501(C)(3) 228,137       GENERAL PROGRAM SUPPORT
(2) HOMEWARD BOUND199 GREENFIELD AVENUE
SAN RAFAEL,CA94901 		68-0011405 501(C)(3) 45,920       GENERAL PROGRAM SUPPORT
(3) HEALTHY MARIN PARTNERSHIP99 MONTECILLO ROAD
SAN RAFAEL,CA94903 		94-3007979 501(C)(3) 50,000       GENERAL PROGRAM SUPPORT
(4) COLLEGE OF MARIN835 COLLEGE AVENUE
KENTFIELD,CA94904 		68-0194359   25,000       NURSING PROGRAM SUPPORT
(5) TOM STEELE CLINIC655 REDWOOD HIGHWAY 200
MILL VALLEY,CA94941 		94-3213100 501(C)(3) 25,000       GENERAL PROGRAM SUPPORT
(6) CALIFORNIA PACIFIC MEDICAL CENTERPO BOX 7999
SAN FRANCISCO,CA94120 		94-0562680 501(C)(3) 10,000       BREAST CANCER SUPPORT
(7) MARIN GENERAL HOSPITAL VOLUNTEERS250 BON AIR RD
GREENBRAE,CA94904 		94-2823538 501(C)(3) 93,473       GENERAL PROGRAM SUPPORT
(8) COUNTY OF MARIN3501 CIVIC CENTER DR
SAN RAFAEL,CA94903 		GOVERNMENT 7,995       GENERAL PROGRAM SUPPORT
(9) COMMITTEE FOR SAN RAFAEL PARAMEDIC SERVICESPO BOX 150711
SAN RAFAEL,CA94915 		GOVERNMENT 5,000       PARAMEDIC PROGRAM SUPPORT
(10) MARIN GENERAL HOSPITAL FOUNDATION100B DRAKES LANDING ROAD SUITE 250
GREENBRAE,CA94904 		94-6127213 501(C)(3) 367,769       GENERAL PROGRAM SUPPORT




2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
11
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) PATIENT ASSISTANCE 148 70,656      













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE HOSPITAL DOES NOT REQUIRE ACCOUNTING OF THE USE OF GRANT FUNDS PROVIDED. IN THE CASES OF GENERAL PURPOSE GRANTS, THE GRANTEE'S CHARITABLE PURPOSE IS REVIEWED PRIOR TO THE ISSUANCE OF THE GRANT. A GRANT WAS AWARDED TO THE MARIN COMMUNITY CLINIC, AN ORGANIZATION WITH LOCATIONS BOTH ON AND OFF-SITE FROM THE HOSPITAL, WHICH THE HOSPITAL INTERACTS WITH THE CLINIC ON A DAILY BASIS.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) LEE DOMANICO (i)
(ii)		 0
523,212 		0
322,953 		0
156,103 		0
6,961 		0
0 		0
1,009,229 		0
0
(2) DAVID COX (i)
(ii)		 0
300,000 		0
110,000 		0
59,662 		0
16,292 		0
0 		0
485,954 		0
0
(3) JON FRIEDENBERG (i)
(ii)		 0
252,083 		0
22,917 		0
62,273 		0
5,341 		0
0 		0
342,614 		0
0
(4) THERESA E GIANFORTUNE (i)
(ii)		 0
168,750 		0
11,250 		0
27,027 		0
6,308 		0
0 		0
213,335 		0
0
(5) SUSAN S CUMMING (i)
(ii)		 287,674
0 		42,274
0 		0
0 		7,700
0 		27,638
0 		365,286
0 		0
0
(6) CHUN LI (i)
(ii)		 256,123
0 		36,261
0 		0
0 		25,993
0 		18,596
0 		336,973
0 		0
0
(7) VERNON A MORENO (i)
(ii)		 191,839
0 		49,690
0 		0
0 		17,073
0 		27,441
0 		286,043
0 		0
0
(8) MICHAEL W SILLMAN (i)
(ii)		 179,906
0 		27,253
0 		0
0 		33,744
0 		27,076
0 		267,979
0 		0
0
(9) LINDA MILLER (i)
(ii)		 174,955
0 		25,166
0 		0
0 		48,735
0 		17,944
0 		266,800
0 		0
0
(10) LUISITO L MANILA (i)
(ii)		 173,366
0 		26,224
0 		0
0 		8,063
0 		7,923
0 		215,576
0 		0
0
(11) SANDRA A BATT (i)
(ii)		 163,636
0 		36,592
0 		0
0 		9,043
0 		10,318
0 		219,589
0 		0
0
(12) MARY J MARTIN-BOYD (i)
(ii)		 164,615
0 		23,718
0 		0
0 		22,586
0 		23,450
0 		234,369
0 		0
0
(13) MARCELLA L BRINK (i)
(ii)		 162,748
0 		24,320
0 		0
0 		51,140
0 		18,387
0 		256,595
0 		0
0
(14) JACQUELINE I JEWELL (i)
(ii)		 157,755
0 		23,515
0 		0
0 		12,209
0 		16,433
0 		209,912
0 		0
0
(15) JOAN L MCCREADY (i)
(ii)		 158,001
0 		23,687
0 		0
0 		12,397
0 		9,381
0 		203,466
0 		0
0
(16) SANDRA J DOMERACKI (i)
(ii)		 178,318
0 		0
0 		0
0 		9,576
0 		8,669
0 		196,563
0 		0
0
(17) ELISABET BORREGARD (i)
(ii)		 153,235
0 		22,608
0 		0
0 		5,065
0 		5,589
0 		186,497
0 		0
0
(18) LYNELLE S TAKIGAWA (i)
(ii)		 152,602
0 		0
0 		0
0 		5,878
0 		9,181
0 		167,661
0 		0
0
(19) JANA BECKLUND (i)
(ii)		 152,056
0 		0
0 		0
0 		14,381
0 		23,578
0 		190,015
0 		0
0
(20) GREGORY LEE (i)
(ii)		 439,641
0 		0
0 		0
0 		17,770
0 		10,239
0 		467,650
0 		0
0
(21) SANDY D AUGUSTUS (i)
(ii)		 326,709
0 		0
0 		0
0 		14,238
0 		25,183
0 		366,130
0 		0
0
(22) MARGARET M ROBERTS (i)
(ii)		 322,035
0 		0
0 		0
0 		24,992
0 		18,492
0 		365,519
0 		0
0
(23) JAMES I WHITLOCK (i)
(ii)		 267,056
0 		0
0 		0
0 		12,139
0 		24,428
0 		303,623
0 		0
0
(24) JEFFREY W WESTERBERG (i)
(ii)		 244,835
0 		0
0 		0
0 		7,463
0 		24,325
0 		276,623
0 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL INFORMATION PART III PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THE ORGANIZATION WAS AN EMPLOYEE OF MARIN HEALTHCARE DISTRICT DURING 2010. THE BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE BOARD OF DIRECTORS USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF MARIN HEALTHCARE DISTRICT'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. FORM 990, PART VII & SCHEDULE J, PART II COMPENSATION FROM RELATED ORGANIZATIONS: ON SEPTEMBER 9, 2011, MARIN GENERAL HOSPITAL ELECTRONICALLY SENT A REQUEST TO SUTTER HEALTH TO OBTAIN COMPENSATION AND BENEFIT INFORMATION FOR THE THREE SUTTER REPRESENTATIVES THAT SERVED ON THE BOARD OF DIRECTORS AS OFFICERS OF MARIN GENERAL HOSPITAL DURING CALENDAR YEAR ENDED DECEMBER 31, 2010. THE COMPENSATION AND BENEFIT INFORMATION WAS NOT RECEIVED FROM SUTTER HEALTH, THUS NOT REPORTED ON EITHER PART VII OR SCHEDULE J. PART I, LINE 7 AND SCHEDULE J, PART II BONUS & INCENTIVE COMPENSATION: LEE DOMANICO, CEO RECEIVED A ONE-TIME 18 MONTH BONUS IN THE AMOUNT OF $322,953 FROM MARIN HEALTHCARE DISTRICT. THE BONUS WAS IN RECOGNITION FOR THE SUCCESSFUL COMPLETION OF THE TRANSFER OF CONTROL WHEN SUTTER HEALTH RESIGNED AS THE CORPORATE MEMBER IN FAVOR OF MARIN HEALTHCARE DISTRICT. OTHER REPORTABLE COMPENSATION: THE TAXABLE COMPENSATION RECEIVED BY THE EXECUTIVE TEAM WAS FOR THE PURCHASE OF BENEFITS, INCLUDING HEALTH AND WELFARE BENEFITS, DEFINED BENEFIT RETIREMENT PENSION PLAN, DISBILITY, LONG-TERM CARE INSURANCE, AND LIFE INSURANCES AND ACCIDENTIAL DEATH AND DISMEMBERMENT INSURANCE.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MARIN HOSPITALIST MEDICAL GROUP
  		CHIEF OF STAFF OF MGH IS CHAIRMAN FOR MHMG 1,492,667 PROVISION OF HOSPITALIST SERVICES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 4   THERE WAS A CHANGE IN THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 5   DURING 2010, THE BOARD OF DIRECTORS OF MARIN GENERAL HOSPITAL DETERMINED THAT THE PRIOR MEMBER OF THE ORGANIZATION, THROUGH ITS REPRESENTATIVES, VIOLATED ITS FIDUCIARY DUTY TO MARIN GENERAL HOSPITAL BY USING ITS POSITION OF CONTROL TO INAPPROPRIATELY DIVERT ASSETS TOTALING IN EXCESS OF $100 MILLION TO ITS OWN ACCOUNTS WITHOUT THE FORMAL CONSENT OF THE ORGANIZATION AND WITHOUT ADEQUATE CONSIDERATION. THE BOARD OF DIRECTORS HAS INITIATED LEGAL ACTION AGAINST THE PRIOR MEMBER TO RECOVER THESE ASSETS.
FORM 990, PART VI, SECTION A, LINE 6   THIS CORPORATION IS AN INDEPENDENT 501(C)(3) NOT FOR PROFIT WHOSE SOLE CORPORATE MEMBER IS THE MARIN HEALTHCARE DISTRICT, A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA.
FORM 990, PART VI, SECTION A, LINE 7A   THE MARIN HEALTHCARE DISTRICT IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION AND RETAINS CERTAIN RIGHTS OVER MARIN GENERAL HOSPITAL, WHICH IS GOVERNED BY ITS OWN BOARD OF DIRECTORS. THE DISTRICT ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS OF MARIN GENERAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B   OTHER RESERVED RIGHTS INCLUDE: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. DISPOSITION OF A SIGNIFICANT PORTION OF THE ASSETS OF THE ORGANIZATION; C. ISSUANCE OF LONG TERM DEBT EXCEEDING A CERTAIN PORTION OF THE ORGNIZATIONS ASSETS.
FORM 990, PART VI, SECTION B, LINE 11   OUR TAX ADVISOR PROVIDES AND PREPARES THE RETURN IN CONSULTATION WITH OUR ACCOUNTING DEPARTMENT. THE INFORMATION IS THEN REVIEWED BY OUR CHIEF FINANCIAL OFFICER PRIOR TO FILING.
  FORM 990, PART VI, SECTION B, LINE 12C EACH INDIVIDUAL BOARD MEMBER AND OFFICER HAS TO SIGN AN ACKNOWLEDGEMENT FORM THAT THEY HAVE READ THE POLICY. ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL OFFICERS AND BOARD MEMBERS. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYEMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH LEGAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED TRUSTEE MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE TRUSTEE TO LEAVE THE ROOM OR NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED TRUSTEE SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION.
  FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE MGH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE EXECUTIVE COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF MGH'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL AND REGIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS MGH ARE MOST APPROPRIATE. ALL OFFICERS OF THE ORGANIZATION (I.E. CEO, CFO, CMO, CNO) UNDERGO A REVIEW AND BOARD APPROVAL ANNUALLY.
  FORM 990, PART VI, SECTION C, LINE 19 MARIN GENERAL HOSPITAL POSTS IT ANNUAL AUDIT AND ANNUAL REPORT ON ITS WEBSITE AT WWW.MARINGENERAL.ORG AND ALSO PROVIDES THIS INFORMATION TO THE MARIN HEALTCARE DISTRICT.
HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS 990, PART VII, SECTION A, COLUMN B LEE DOMANICO'S TIME IS DIVIDED AS FOLLOWS: MARIN HEALTHCARE DISTRICT: 12.00 HOURS MARIN GENERAL HOSPITAL: 24.00 HOURS MARIN GENERAL HOSPITAL FOUNDATION: 4.00 HOURS AVERAGE HOURS PER WEEK: 40.00 HOURS DAVID COX'S TIME IS DIVIDED AS FOLLOWS: MARIN HEALTHCARE DISTRICT: 8.00 HOURS MARIN GENERAL HOSPITAL: 30.00 HOURS MARIN GENERAL HOSPITAL FOUNDATION: 2.00 HOURS AVERAGE HOURS PER WEEK: 40.00 HOURS JON FRIEDENBERG'S TIME IS DIVIDED AS FOLLOWS: MARIN HEALTHCARE DISTRICT: 4.00 HOURS MARIN GENERAL HOSPITAL: 28.00 HOURS MARIN GENERAL HOSPITAL FOUNDATION: 8.00 HOURS AVERAGE HOURS PER WEEK: 40.00 HOURS JEFFREY "JIM" DIETZ, MD'S TIME IS DIVIDED AS FOLLOWS: MARIN GENERAL HOSPITAL: 2.00 HOURS MARIN GENERAL HOSPITAL FOUNDATION: 0.50 HOURS AVERAGE HOURS PER WEEK: 2.50 HOURS
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -75,789. LOSS ON SETTLEMENT OF PENSION PLAN -12,563,035. DECREASE IN THE BENEFICIAL INTEREST IN PRIMA MEDICAL FOUNDATION -3,139,873. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 10,058,478. AFS ROUNDING ON CONTRIBUTIONS RECLASSIFIED FROM TEMP. RESTRICTED NET ASSETS -1,405. PRIOR PERIOD ADJUSTMENT RELATED TO PREPAID RENT 5,212,774. AUDITED FINANCIAL STATEMENT ROUNDING 191. PRIOR PERIOD ADJUSTMENT FOR FOUNDATION NET ASSETS INCLUDED IN TAX RETURN -6,306,457. TRANSFER OF ASSETS BY SUTTER HEALTH, CORPORATE MEMBER -22,569,093. OTHER CHANGE IN FUND BALANCES 199,442. EQUITY TRANSFERS TO MARIN GENERAL HOSPITAL FOUNDATION -369,246. TOTAL TO FORM 990, PART XI, LINE 5: -29,554,013.
AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C MARIN GENERAL HOSPITAL HAD AN AUDIT OF ITS BALANCE SHEET AND STATEMENT OF OPERATIONS PERFORMED BY INDEPENDENT AUDITORS. AN AUDIT COMMITTEE SELECTS THE AUDITORS AND REVIEWS RESULTS.
EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINE 4A MARIN GENERAL HOSPITAL (MGH) IS A NOT-FOR-PROFIT HOSPITAL LOCATED IN GREENBRAE, CALIFORNIA, WITH 235 LICENSED ACUTE CARE BEDS, IT IS THE LARGEST ACUTE CARE HOSPITAL IN MARIN COUNTY AND PROVIDES BOTH PRIMARY AND SECONDARY CARE AND GENERAL SERVICES SUCH AS THE MARIN CANCER INSTITUTE AND THE MARIN HEART INSTITUTE. OTHER SERVICES INCLUDE A LEVEL III TRAUMA CENTER AND FULL COMPLEMENT OF ACUTE CARE AND ANCILLARY SERVICES SUCH AS NEONATAL INTENSIVE CARE, PEDIATRICS, A FAMILY BIRTHING CENTER, SHARED CARE, HOME CARE (MARIN HOME CARE WAS TRANSFERRED TO SUTTER VNA ON OCTOBER 1, 2004), ADULT BEHAVIORAL HEALTH SERVICES, AN ELECTROPHYSIOLOGY LABORATORY, A STROKE PROGRAM AND CARDIAC CATHETERIZATION LABORATORY. MGH IS ACCREDITED BY THE JOINT COMMISSION. MISSION AND VALUES: THE MISSION OF MGH IS AS FOLLOWS: TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT. MGH'S VALUES ARE: MARIN GENERAL HOSPITAL WILL BE THE INDISPENSABLE PROVIDER OF HEALTH CARE IN MARIN, RECOGNIZING AND VALUED BY OUR COMMUNITY, PATIENTS, PHYSICIANS, AND EMPLOYEES FOR DELIVERING SUPERIOR CLINICAL OUTCOMES IN A SUSTAINABLE STATE-OF-THE-ART FACILITY. GOVERNANCE: MGH IS AN INDEPENDENT 501(C)(3) NOT FOR PROFIT HOSPITAL. ITS SOLE CORPORATE MEMBER IS THE MARIN HEALTHCARE DISTRICT, A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA, WHICH RETAINS CERTAIN RESERVE POWERS OVER THE ORGANIZATION. MGH IS GOVERNED BY ITS OWN BOARD OF DIRECTORS. PROGRAMS, FACILITIES, AND SERVICES: OPENED IN MAY 1952, MGH HAS CONTINUED TO EXPAND ITS PROGRAMS, SERVICES AND FACILITIES. SERVICES INCLUDE A BASIC EMERGENCY DEPARTMENT, MEDICAL AND SURGICAL SERVICES, MATERNITY SERVICES, PEDIATRICS, NEONATAL INTENSIVE CARE, AN ADULT PSYCHIATRIC UNIT, A CANCER CENTER, PARTIAL HOSPITALIZATION FOR ADULT PSYCHIATRIC PATIENTS, A HEARING AND SPEECH CENTER, OUTPATIENT LABORATORIES, AND RADIOLOGY SERVICES. SPECIFIC SERVICES ARE AS FOLLOWS: -ANGIOPLASTY: FULL SERVICES TO ASSIST CLEARING OF ARTERY BLOCKAGES. -AMBULATORY SURGERY CENTER: THE SURGERY CENTER OF MARIN PROVIDES ELECTIVE OUTPATIENT SURGERIES AND DIAGNOSTIC PROCEDURES. -CARDIAC AND SPECIALTY UNIT: PROVIDES CARE TO COMPLEX MULTI-SYSTEM NEEDS AND CARDIAC MONITORING. -CARDIAC CATHETERIZATION LABORATORY: 24-HOUR PROGRAM CONDUCTS PROCEDURES TO DIAGNOSE AND TREAT CORONARY ARTERY HEART VALVES AND FUNCTIONS. THE MGH CARDIAC TEAM WAS FOUND TO EXCEED NATIONAL STANDARDS FOR QUICK RESPONSE TO HEART ATTACKS THAT HAS RESULTED IN HIGHER PATIENT SURVIVAL RATES. ACCORDING TO THE NATIONAL REGISTRY OF MYOCARDIAL INFARCTION (NRMI), HEART ATTACK PATIENTS ARRIVING AT MGH'S EMERGENCY DEPARTMENT ARE MORE THAN TWICE AS LIKELY TO RECEIVE EMERGENCY ANGIOPLASTY WITHIN THE OPTIMAL 90 MINUTE TIME PERIOD THAN PATIENTS AT THE AVERAGE CALIFORNIA HOSPITAL. -CHAPLAINCY PROGRAM: PROVIDES EMOTIONAL AND SPIRITUAL SUPPORT SERVICES FOR PATIENTS AND THEIR FAMILIES AND FRIENDS. -ELECTROPHYSIOLOGY LAB: USES STATE-OF-THE-ART TECHNOLOGY TO DIAGNOSE AND TREAT PATIENTS WITH IRREGULAR HEARTBEATS (ARRHYTHMIA). -EMERGENCY DEPARTMENT: MARIN COUNTY'S LEVEL III TRAUMA CENTER, WITH A PARAMEDIC BASE STATION AND 24-HOUR SERVICE. THE HOSPITAL IS THE BASE FOR THE COUNTY WIDE SEXUAL ASSAULT MEDICAL ASSESSMENT PROGRAM. STAFFED BY SPECIALLY TRAINED EMERGENCY DEPARTMENT NURSES AND BOARD CERTIFIED EMERGENCY CARE PHYSICIANS. -FAMILY BIRTHING CENTER: OFFERS PRIVATE ROOMS AND A VARIETY OF BIRTHING OPTIONS IN A FAMILY ENVIRONMENT, INCLUDING THE ABILITY TO MEET SPECIAL MEDICAL NEEDS. -GENERAL SURGICAL UNIT -HEARING AND SPEECH PROGRAM: AN OUTPATIENT PROGRAM OFFERING COMPREHENSIVE DIAGNOSTIC AND REHABILITATIVE SPEECH, LANGUAGE AND HEARING SERVICES. -HUMANITIES PROGRAM: PROVIDES INPATIENT AND OUTPATIENT PROGRAMS WHICH COMPLEMENT MEDICAL CARE, INCLUDING MASSAGE THERAPY, SUPPORT GROUPS, GUIDED IMAGERY, ART THERAPY AND YOGA. -INTENSIVE CARE UNIT -LABORATORY: COMPREHENSIVE DIAGNOSTIC TESTING SERVICES ON-SITE ALONG WITH SATELLITE LOCATIONS OFF-SITE. -LACTATION CENTER: COMPREHENSIVE EDUCATIONAL AND RETAIL SERVICES FOR BREASTFEEDING MOTHERS, INCLUDING THE BABYNOOK STORE. -LITHOTRIPSY: PROVIDES STATE-OF-THE-ART REMOVAL OF KIDNEY STONES. -MAGNETIC RESONANCE IMAGING CENTER (MRI): OPERATES A MOBILE UNIT THAT PROVIDES DEFINITIVE IMAGING OF INTERNAL BODY STRUCTURES -MARIN CANCER INSTITUTE: PROVIDES COMPREHENSIVE MEDICAL EDUCATION, RESEARCH AND SUPPORTIVE SERVICES FOR CANCER PATIENTS WITH SPECIAL EMPHASIS ON RADIATION ONCOLOGY AND BREAST CANCER. INSTITUTED PROSTATE CANCER PROGRAM IN 2004. PROVIDES RADIATION THERAPY SERVICES FOR ALL MARIN COUNTY HOSPITALS, PLACED INTO SERVICE SECOND OF TWO NEW LINEAR ACCELERATORS IN AUGUST 2008. -MARIN HEART INSTITUTE: PROVIDES COMPREHENSIVE SERVICES FOR EDUCATION, PREVENTION, DIAGNOSIS, TREATMENT AND RESEARCH OF CARDIOVASCULAR DISEASE. -MARIN HOSPITALIST MEDICAL GROUP: INTERNAL MEDICINE PHYSICIANS WHO CARE FOR HOSPITALIZED PATIENTS. HOSPITALISTS ARE PHYSICIANS WHO ARE EXPERTS IN TREATING ACUTE ILLNESSES AND THEIR ENTIRE ATTENTION IS DIRECTED TOWARD PATIENTS WHILE THEY ARE IN THE HOSPITAL. -MARIN MAMMOGRAPHY AND BREAST HEALTH CENTER: OFFERS BREAST HEALTH SERVICES AND EDUCATION -MEDICAL UNITS -NEONATAL INTENSIVE CARE UNIT: THE ONLY LEVEL II UNIT IN MARIN COUNTY. AFFILIATED WITH SPECIALISTS IN SAN FRANCISCO. -NUCLEAR MEDICINE: INPATIENT AND EMERGENCY SERVICES AVAILABLE 24/7. ROUTINE OUTPATIENT SERVICES AVAILABLE ON WEEKDAYS AND SATURDAYS. -PEDIATRICS PHARMACY: 24-HOUR SERVICES FOR INPATIENTS. -PHYSICAL THERAPY: PROVIDES SERVICES FOR INPATIENTS AND OUTPATIENTS, SPECIALIZING IN LYMPHEDEMA AND URINARY INCONTINENCE. -BEHAVIORAL HEALTH UNIT: CONTAINS INPATIENT UNIT, PARTIAL DAY CARE AND PARTIAL HOSPITALIZATION. -RADIOLOGY: PROVIDES X-RAYS, CT SCANNING, ULTRASOUND AND DIGITAL SUBTRACTION ANGIOGRAPHY. -RESPIRATORY CARE: PROVIDES 24 HOUR INPATIENT CARE, AS WELL AS OUTPATIENT CARE, BEDSIDE SPIROMETRY AND HOME CARE. -SHARED CARE UNIT: INCORPORATES FAMILY INTO THE PATIENT CARE ENVIRONMENT AND PROVIDES FAMILY TEACHING. -SURGERY SINCE 1952, THE HOSPITAL HAS UNDERGONE MAJOR EXPANSIONS. IN 1989, THE "HOSPITAL OF THE FUTURE" - A $36 MILLION NEW WEST WING, WAS OPENED AND HOUSES CARDIAC SURGERY, INTENSIVE CARE, EMERGENCY AND GENERAL SURGERY. IN 1992, THE CANCER INSTITTUTE WAS EXPANDED. LATER, A STATE OF THE ART FAMILY BIRTHING CENTER WAS ADDED, AND IN 2006, THE CARDIAC CATHETERIZATION LABORATORY WAS COMPLETELY RENOVATED. IN 2001, THE $3.4 MILLION JOHNSON FAMILY FOUNDATION ELECTROPHYSIOLOGY LAB WAS OPENED. IN 2005, THE HOSPITAL PURCHASED TWO STATE-OF-THE-ART DIGITAL MAMMOGRAPHY MACHINES, WITH A THIRD MACHINE BEING ADDED IN 2008. QUALITY IMPROVEMENT: QUALITY PATIENT CARE IS THE TOP PRIORITY AT MGH. THE GOAL OF OUR PATIENT CARE TEAMS IS TO TREAT THE WHOLE PERSON WITH PERSONAL, COMPASSIONATE, AND EXPERT CARE. PHYSICIANS HAVE PRIMARY RESPONSIBILITY FOR ASSURING DELIVERY OF HIGH QUALITY CARE. A NUMBER OF SPECIFIC FORMAL STRUCTURES AND PROCESSES ARE IN PLACE TO MONITOR AND EVALUATE QUALITY AND TO FACILITATE CONTINUOUS QUALITY IMPROVEMENT. THESE INCLUDE A QUALITY COMMITTEE OF THE BOARD OF DIRECTORS, PARTICIPATION IN ACCREDITATION SURVEYS AND AN INTERNAL "QUALITY DASHBOARD" IN WHICH SPECIFIC OUTCOME INDICATORS ARE REVIEWED ON A ROUTINE BASIS AND COMPARED TO REGIONAL AND NATIONAL STANDARDS. ON A QUALITY BASIS, AN INDEPENDENT SURVEY (PRESS-GANEY) IS CONDUCTED TO ASSESS PATIENT SATISFACTION WITH THEIR CARE AT MGH. CONSISTENTLY, 88% OR MORE OF RESPONDING PATIENTS SURVEYED RATED THE CARE THEY RECEIVED AS "GOOD" OR "VERY GOOD" (THE HIGHEST RATING).
    AWARDS AND ACCREDITATIONS: JOINT COMMISSION ACCREDITATIONS - ACCREDITED PROGRAMS & CERTIFICATIONS (2010): MARIN GENERAL HOSPITAL HAS EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ACCREDITATION BY DEMONSTRATING COMPLIANCE WITH THE JOINT COMMISSION'S NATIONAL STANDARDS FOR HEALTH CARE QUALITY AND SAFETY IN HOSPITALS AND IN BEHAVIORAL HEALTH CARE. MARIN GENERAL HOSPITAL ALSO EARNED PRIMARY STROKE CENTER CERTIFICATION FROM THE JOINT COMMISSION ON MAY 13, 2010. SOCIETY OF CHEST PAIN CENTERS (SCPC) - CHEST PAIN CENTER ACCREDITATION WITH PCI (PERCUTANEOUS CORONARY INTERVENTION) (2010): MARIN GENERAL HOSPITAL IS ONE OF ONLY 21 FULLY ACCREDITED CHEST PAIN CENTERS IN CALIFORNIA. THE DESIGNATION DENOTES FACILITIES THAT UTILIZE STANDARDIZED DIAGNOSTIC AND TREATMENT PROGRAMS TO IMPROVE EVALUATION AND SPEED UP THE EFFECTIVE ADMINISTRATION OF TREATMENT TO CHEST PAIN PATIENTS. AMERICAN STROKE ASSOCIATION - SILVER STROKE PERFORMANCE AWARD (2010): THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION RECOGNIZE THE HOSPITALS FOR THEIR SUCCESS IN USING GET WITH THE GUIDELINES TO IMPROVE QUALITY OF CARE FOR HEART DISEASE AND STROKE PATIENTS. SILVER PERFORMANCE AWARD HOSPITALS HAVE MAINTAINED THIS PERFORMANCE LEVEL FOR AT LEAST TWELVE MONTHS. NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS - ACCREDITED PROGRAM (2010): THE BREAST DIAGNOSTIC CENTER OF MARIN IS ACCREDITED AS A BREAST IMAGING CENTER OF EXCELLENCE DEMONSTRATING EXCELLENCE IN MAMMOGRAPHY, STEREOTACTIC BREAST BIOPSY, BREAST ULTRASOUND AND ULTRASOUND-GUIDED BREAST BIOPSY. CALIFORNIA MEDICAL ASSOCIATION INSTITUTE FOR MEDICAL QUALITY - ACCREDITATION FOR CONTINUING MEDICAL EDUCATION (2010): PHYSICIANS WHO ATTEND CME COURSES OFFERED BY IMQ/CMA ACCREDITED PROVIDERS MEET THE MEDICAL BOARD OF CALIFORNIA'S DIVISION OF LICENSURE REQUIREMENTS FOR PHYSICIAN LICENSURE AND THE CALIFORNIA MEDICAL ASSOCIATION'S CERTIFICATION IN CONTINUING MEDICAL EDUCATION. CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CALRECYCLE) - WASTE REDUCTION AWARDS WINNER (2010): THE AWARDS ARE MADE IN CONJUNCTION WITH AMERICA RECYCLES DAY TO ENCOURAGE AND RECOGNIZE GREEN BUSINESS PRACTICES AS PART OF THE AGENCY'S WASTE REDUCTION AWARDS PROGRAM (WRAP). WRAP ACKNOWLEDGES BUSINESSES THROUGHOUT CALIFORNIA RECOGNITION FOR IMPLEMENTING PRACTICES THAT HELP PROTECT THE ENVIRONMENT AND PRESERVE OUR NATURAL RESOURCES. THE BLUE CROSS HMO QUALITY SCORECARD NAMED THE MARIN INDIVIDUAL PRACTICE ASSOCIATION (MIPA) AS THE BEST PERFORMING PHYSICIAN GROUP IN NORTHERN CALIFORNIA IN 2003. MGH IS THE HOSPITAL OF CHOICE FOR THE PHYSICIANS IN THE MIPA. RESEARCH PROGRAMS: MGH HAS A STRONG CLINICAL RESEARCH PROGRAM, WHICH BENEFITS THE COMMUNITY AND PATIENTS. OUR PARTICIPATION IN THESE PROGRAMS HELPS BRING THE LATEST TREATMENT OPTIONS - OPTIONS THAT MIGHT NOT OTHERWISE BE AVAILABLE IN A COMMUNITY HOSPITAL. THE MARIN CANCER INSTITUTE AT MGH HAS PARTICIPATED IN CANCER RESEARCH TRIALS FOR OVER 20 YEARS, MANY OF WHICH ARE IN THE AREA OF BREAST CANCER. THE HOSPITAL PARTICIPATES IN HEART AND STROKE RESEARCH. COMMUNITY BENEFIT PROGRAMS: MGH PLACES STRONG EMPHASIS ON PROGRAMS AND ACTIVITIES THAT BENEFIT THE GREATER COMMUNITY OUTSIDE THE HOSPITAL'S WALLS. THESE INCLUDE PREVENTION, DETECTION, EDUCATION, AND PROFESSIONAL EDUCATION PROGRAMS AS WELL AS PARTICIPATION AS A FOUNDING AGENCY IN HEALTHY MARIN PARTNERSHIPS. MGH PROGRAMS AND ACTIVITIES RANGE FROM PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS, PROVIDING FUNDING TO COMMUNITY PROGRAMS, DIRECT SERVICE IN THE COMMUNITY, AND PROVIDING CHARITY MEDICAL CARE. EXAMPLES INCLUDE: CONTRIBUTING $228,137 TO THE MARIN COMMUNITY CLINIC (A NON-PROFIT MEDICAL CLINIC LOCATED ON THE MGH CAMPUS WHICH PROVIDES SERVICES TO THE UNDERINSURED AND UNINSURED); ANNUAL SKIN CANCER SCREENING CLINIC (DONE IN CONJUNCTION WITH THE AMERICAN CANCER SOCIETY AND OTHER HOSPITALS); FREE FLU SHOT CLINICS FOR SENIORS; LOW COST MAMMOGRAM SCREENINGS; AND A MONTHLY PUBLIC HEALTH EDUCATION SERIES. MARIN GENERAL HOSPITAL CONTRIBUTED $26.6 MILLION (9.46 PERCENT OF NET PATIENT REVENUES) IN SUPPORT OF COMMUNITY PROGRAMS AND SERVICES IN 2010. THE MAJORITY OF THIS SPENDING WAS FOR CHARITY CARE AND UN-REIMBURSED CARE. THE UNPAID COST FOR MEDI-CAL WAS $20.09 MILLION. THE HOSPITAL SPONSORED A VARIETY OF PROGRAMS AND SERVICES IN 2010, INCLUDING FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS OF STAFF SERVICES TO THE HEALTHY MARIN PARTNERSHIP AND THE MARIN COMMUNITY CLINIC, FREE AND LOW COST PUBLIC EDUCATION SEMINARS AND SUPPORT GROUPS FOR BREAST AND PROSTATE CANCER PATIENTS. COMMUNITY BENEFIT PROGRAMS (EXCLUDES UNREIMBURSED CHARITY CARE, MEDI-CAL AND CMSP): -MEDICAL CARE SERVICES -MARIN COMMUNITY CLINIC, FUNDING AND IN-KIND SUPPORT -ACUTE PSYCHIATRIC AND PARTIAL HOSPITALIZATION FOR ADULT POOR AND ELDERLY -LACTATION SERVICES OTHER BENEFITS FOR VULNERABLE POPULATIONS: -HEALTHY MARIN PARTNERSHIP, IN-KIND DONATION OF STAFF SERVICES -MAMMOGRAMS FOR LOW-INCOME WOMEN -SUPPORT GROUPS FOR CANCER PATIENTS, CANCER SURVIVORS AND FAMILIES -BREAST CANCER AND LYMPHEDEMA RECOVERY WORKSHOPS -BREAST CANCER OUTREACH PROGRAMS -MEDI-CAL, HEALTHY FAMILIES AND CMSP APPLICATION ASSISTANCE OTHER BENEFITS FOR THE BROADER COMMUNITY -PUBLIC EDUCATION SEMINARS (FREE OR LOW-COST) INCLUDED THOSE ON BREAST CANCER AND BREASTFEEDING -THE MARIN CANCER INSTITUTE'S CANCER RESOURCE AND RECOVERY CENTER -SUPPORT GROUP REFERRAL -PARTICIPATION IN MARIN'S ANNUAL AREA AGENCY ON AGING SYMPOSIUM -MEDICAL LIBRARY OPEN TO THE PUBLIC -MEETING SPACE FOR COMMUNITY GROUPS -HEALTHY MARIN PARTNERSHIP PLAY FAIRS FUN FEST AT THE MARIN COUNTY FAIR - PROVIDES STAFFING AND SUPPORT FOR THE DIABETES INFORMATION BOOTH -OPERATION ACCESS - A NON-PROFIT ORGANIZATION THAT HELPS CONNECT UNINSURED PATIENTS WITH FREE SURGICAL CARE THROUGH A NETWORK OF BAY AREA MEDICAL VOLUNTEERS, HOSPITALS AND COMMUNITY CLINICS. -FREE MEETING SPACE AND STAFF SUPPORT FOR A VARIETY OF SELF-HELP ORGANIZATIONS, INCLUDING THE PROSTATE CANCER SUPPORT GROUP AND THE MARIN FOOD BANK. HEALTH RESEARCH, EDUCATION AND TRAINING: -NURSING EDUCATION (BACCALAUREATE AND MASTER'S LEVELS) PRECEPTORSHIPS FOR COLLEGE OF MARIN AND DOMINICAN UNIVERSITY STUDENTS -PARTICIPATION IN CONTINUING EDUCATION WITH COUNTYWIDE EMERGENCY MEDICAL SYSTEM -SCHOOL TO CAREER AND NATIONAL YOUTH LEADERSHIP FORUM PROGRAMS -ONCOLOGY CLINICAL RESEARCH -INSTITUTIONAL REVIEW BOARD APPROVAL OF HUMAN SUBJECTS FOR MEDICAL AND HEALTH RESEARCH SUSTAINABILITY: MGH LEADERSHIP HAS LONG RECOGNIZED THE CHALLENGE OF MAINTAINING THE HOSPITAL'S HIGH LEVEL OF PATIENT CARE WITHIN THE REALITIES OF FALLING REVENUES. LEADERSHIP HAS ANTICIPATED NATIONAL HEALTH CARE TRENDS, AND HAS OVER THE YEARS TAKEN STEPS IN ORDER TO MAINTAIN THIS BALANCE. THESE INCLUDE: WORK REDESIGN AND REDUCTIONS IN MANAGEMENT POSITIONS IN ORDER TO REDUCE MGH'S OPERATING BUDGET; AND DEVELOPING STRONG PARTNERSHIPS WITH THE PHYSICIAN COMMUNITY.
COMPENSATION FROM RELATED ORGANIZATIONS FORM 990, PART VII; SCHEDULE J, PART I; SCHEDULE R, PART V, LINE 1N FROM JANUARY 1996 THROUGH JUNE 29, 2010, MARIN GENERAL HOSPITAL WAS AN AFFILIATE OF SUTTER HEALTH. EFFECTIVE JUNE 30, 2010, SUTTER HEALTH RESIGNED AS THE CORPORATE MEMBER IN FAVOR OF MARIN HEALTHCARE DISTRICT. ON SEPTEMBER 9, 2011, MARIN GENERAL HOSPITAL ELECTRONICALLY SENT A REQUEST TO SUTTER HEALTH TO OBTAIN COMPENSATION AND BENEFIT INFORMATION FOR THE THREE SUTTER REPRESENTATIVES THAT SERVED ON THE BOARD OF DIRECTORS AS OFFICERS OF MARIN GENERAL HOSPITAL DURING CALENDAR YEAR ENDED DECEMBER 31, 2010. SUTTER HEALTH DID NOT RESPOND TO OUR REQUEST. AS A RESULT, THESE OFFICERS ARE ONLY LISTED ON PART VII WITHOUT COMPENSATION AND BENEFITS FOR 2010.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARIN GENERAL HOSPITAL
 
Employer identification number

94-2823538
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) MARIN HEALTHCARE DISTRICT

100 B DRAKES LANDING ROAD SUITE 250

GREENBRAE,CA94904
91-1886269 		CORP PARENT 6/30/10 - 12/31/10 CA     N/A
 
No
(2) MARIN GENERAL HOSPITAL FOUNDATION

100 B DRAKES LANDING ROAD SUITE 250

GREENBRAE,CA94904
94-6127213 		FUNDRAISING FOUNDATION CA 501(C)(3) 11-I MARIN GENERAL HOSPITAL
 
Yes
 
(3) SUTTER HEALTH

2200 RIVER PLAZA DRIVE

SACRAMENTO,CA95833
94-2788907 		CORP MEMBER 1/1/10 - 6/29/10 CA 501(C)(3) 11-III-FI N/A
 
No
(4) ADOLESCENT TREATMENT CENTERS INC

390 40TH STREET

OAKLAND,CA94609
68-0088443 		HOSPITAL CA 501(C)(3) 3 SUTTER EBH
 
 
No
(5) ALTA BATES SUMMIT FOUNDATION

2855 TELEGRAPH AVENUE SUITE 601

BERKELEY,CA94705
51-0160184 		FUNDRAISING CA 501(C)(3) 11-I SUTTER EBH
 
 
No
(6) SUTTER EAST BAY HOSPITALS

2450 ASHBY AVENUE

BERKELEY,CA94705
94-1196176 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(7) SUTTER WEST BAY HOSPITALS

2333 BUCHANAN STREET

SAN FRANCISCO,CA94115
94-0562680 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(8) CALIFORNIA PACIFIC MEDICAL CENTER FOUND

1255 POST STREET SUITE 700

SAN FRANCISCO,CA94109
94-2728423 		FUNDRAISING CA 501(C)(3) 11-I SUTTER WBH
 
 
No
(9) DELTA MEMORIAL HOSPITAL FOUNDATION

3901 LONE TREE WAY

ANTIOCH,CA94509
94-2417022 		FUNDRAISING CA 501(C)(3) 11-I SUTTER DELTA
 
 
No
(10) EAST BAY PERINATAL CENTER

350 HAWTHORNE AVENUE

OAKLAND,CA94609
51-0172285 		HOSPITAL CA 501(C)(3) 3 SUTTER EBH
 
 
No
(11) EDEN MEDICAL CENTER

20103 LAKE CHABOT ROAD

CASTRO VALLEY,CA94546
94-2948100 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(12) MARIN COMMUNITY HEALTH

250 BON AIRE ROAD

GREENBRAE,CA94904
94-2994751 		SUPPORTING CA 501(C)(3) 11-II SUTTER HEALTH
 
 
No
(13) MEMORIAL HOSPITAL LOS BANOS

520 W I STREET

LOS BANOS,CA93635
94-1551464 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(14) SUTTER CENTRAL VALLEY HOSPITALS

1700 COFFEE STREET

MODESTO,CA95355
94-1080917 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(15) MILLS-PENINSULA HEALTH SERVICES

1501 TROUSDALE DRIVE

BURLINGAME,CA94010
94-1156265 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(16) MILLS-PENINSULA HOSPITAL FOUNDATION

1501 TROUSDALE DRIVE

BURLINGAME,CA94010
23-7288765 		FUNDRAISING CA 501(C)(3) 11-I MPHS
 
 
No
(17) MILLS-PENINSULA SENIOR FOCUS

1720 EL CAMINO REAL

BURLINGAME,CA94010
94-2663918 		HEALTH CARE CA 501(C)(3) 9 MPHS
 
 
No
(18) PALO ALTO MEDICAL FOUNDATION

2350 EL CAMINO REAL

MOUNTAIN VIEW,CA94040
94-1156581 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(19) PALO ALTO MEDICAL FOUNDATION HOSPITAL CO

570 WILLOW ROAD

MENLO PARK,CA94025
94-2206441 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(20) SUTTER WEST BAY MEDICAL FOUNDATION

1700 CALIFORNIA STREET SUITE 530

SAN FRANCISCO,CA94109
94-2948131 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(21) SAMUEL MERRITT UNIVERSITY

450 30TH STREET SUITE 2840

OAKLAND,CA94609
94-2992642 		UNIVERSITY CA 501(C)(3) 2 SUTTER EBH
 
 
No
(22) ST LUKE'S HEALTH CARE CENTER

3555 CAESAR CHAVEZ STREET

SAN FRANCISCO,CA94110
51-0201241 		HOSPITAL CA 501(C)(3) 3 SUTTER WBH
 
 
No
(23) SUTTER AMADOR HOSPITAL

200 MISSION BOULEVARD

JACKSON,CA95642
68-0291072 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(24) SUTTER AUBURN FAITH HOSPITAL FOUNDATION

11815 EDUCATION STREET

AUBURN,CA95602
94-2594966 		FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
 
No
(25) SUTTER COAST HOSPITAL

800 E WASHINGTON BOULEVARD

CRESCENT CITY,CA95531
94-2988520 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(26) SUTTER DAVIS HOSPITAL FOUNDATION

2000 SUTTER PLACE

DAVIS,CA95616
68-0217870 		FUNDRAISING CA 501(C)(3) 11-I SUTTER SSR
 
 
No
(27) SUTTER DELTA MEDICAL CENTER

3901 LONE TREE WAY

ANTIOCH,CA94509
94-1552887 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(28) SUTTER EAST BAY MEDICAL FOUNDATION

3687 MT DIABLO BOULEVARD SUITE 200

LAFAYETTE,CA94549
94-2690415 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(29) SUTTER GOULD MEDICAL FOUNDATION

600 COFFEE ROAD

MODESTO,CA95355
94-1682256 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(30) SUTTER HEALTH PACIFIC

91-2301 FT WEAVER ROAD

EWA BEACH,HI96706
99-0298651 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(31) SUTTER HEALTH SACRAMENTO SIERRA REGION

2800 L STREET 7TH FLOOR

SACRAMENTO,CA95816
94-1156621 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(32) SUTTER INSURANCE SERVICES CORPORATION

745 FORT STREET SUITE 800

HONOLULU,HI96813
99-0289310 		INSURANCE SE HI 501(C)(3) 11-II SUTTER HEALTH
 
 
No
(33) SUTTER LAKESIDE HOSPITAL

5176 HILL ROAD EAST

LAKEPORT,CA95453
94-1628356 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(34) SUTTER MARIN

180 ROWLAND WAY

NOVATO,CA94945
51-0206463 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(35) SUTTER MATERNITY SURGERY CTR SANTA CRUZ

2900 CHANTICLEER AVENUE

SANTA CRUZ,CA95065
68-0279954 		HOSPITAL CA 501(C)(3) 3 PAMF
 
 
No
(36) SUTTER MEDICAL CENTER FOUNDATION

20130 LAKE CHABOT ROAD SUITE 103

CASTRO VALLEY,CA94546
94-2788906 		FUNDRAISING CA 501(C)(3) 7 SUTTER HEALTH
 
 
No
(37) SUTTER MEDICAL CENTER OF CASTRO VALLEY

2800 L STREET SUITE 620

SACRAMENTO,CA95816
77-0146047 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(38) SUTTER MEDICAL CENTER OF SANTA ROSA

3325 CHANATE ROAD

SANTA ROSA,CA95404
68-0374805 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(39) SUTTER MEDICAL FOUNDATION

2800 L STREET 7TH FLOOR

SACRAMENTO,CA95816
68-0273974 		HEALTH CARE CA 501(C)(3) 11-II SUTTER HEALTH
 
 
No
(40) SUTTER NORTH MEDICAL FOUNDATION

969 PLUMAS STREET SUITE 205

YUBA CITY,CA95991
94-1080019 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(41) SUTTER REGIONAL MEDICAL FOUNDATION

2720 LOW COURT

FAIRFIELD,CA94534
20-0078199 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(42) SUTTER ROSEVILLE MEDICAL CTR FOUNDATION

ONE MEDICAL PLAZA

ROSEVILLE,CA95661
68-0040113 		FUNDRAISING CA 501(C)(3) 11-I SUTTER SSR
 
 
No
(43) SUTTER SOLANO CHARITABLE FOUNDATION

300 HOSPITAL DRIVE

VALLEJO,CA94589
94-2668262 		FUNDRAISING CA 501(C)(3) 11-I SUTTER SOLA
 
 
No
(44) SUTTER SOLANO MEDICAL CENTER

300 HOSPITAL DRIVE

VALLEJO,CA94589
94-1241942 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(45) SUTTER TRACY COMMUNITY HOSPITAL

1420 N TRACY BOULEVARD

TRACY,CA95376
94-1196220 		HOSPITAL CA 501(C)(3) 3 SUTTER HEALTH
 
 
No
(46) SUTTER VISITING NURSE ASSOC AND HOSPICE

1900 POWELL STREET SUITE 300

EMERYVILLE,CA94608
94-6068843 		HEALTH CARE CA 501(C)(3) 9 SUTTER HEALTH
 
 
No
(47) SUTTER VNA AND HOSPITAL FOUNDATION

1900 POWELL STREET SUITE 300

EMERYVILLE,CA94608
94-2607708 		FUNDRAISING CA 501(C)(3) 9 SUTTER VNA
 
 
No
(48) TRACY HOSPITAL FOUNDATION

1420 N TRACY BOULEVARD

TRACY,CA95376
68-0318845 		FUNDRAISING CA 501(C)(3) 11-I SUTTER TRAC
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) SUTTER CONNECT
10470 OLD PLACERVILLE ROAD
SACRAMENTO,CA95827
68-0209157 		HEALTH CARE CA N/A
 C      












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
Yes
 
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
Yes
 
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MARIN GENERAL HOSPITAL FOUNDATION

 B 367,769 BOOK VALUE
(2) MARIN GENERAL HOSPITAL FOUNDATION

 C 205,991 BOOK VALUE
(3) MARIN GENERAL HOSPITAL FOUNDATION

 E 2,008,219 BOOK VALUE
(4) MARIN GENERAL HOSPITAL FOUNDATION

 L 475,410 BOOK VALUE
(5) MARIN GENERAL HOSPITAL FOUNDATION

 N 219,006 BOOK VALUE
(6) MARIN GENERAL HOSPITAL FOUNDATION

 P 149,000 BOOK VALUE
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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