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
KAISER FOUNDATION HOSPITALS
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
ONE KAISER PLAZA 15L
 
Room/suite
City or town, state or country, and ZIP + 4
OAKLAND, CA94612
D Employer identification number

94-1105628
E Telephone number

G Gross receipts $ 21,243,910,620
F Name and address of principal officer:
GEORGE C HALVORSON
ONE KAISER PLAZA 15L
OAKLAND,CA94612
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
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: 1948
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 69,433
6 Total number of volunteers (estimate if necessary) .... 6 7,473
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,291,786
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -3,040,292
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 96,521,648 133,521,152
9 Program service revenue (Part VIII, line 2g) ......... 15,435,355,226 15,903,379,451
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -327,150,295 494,874,341
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 57,337,762 60,462,846
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 15,262,064,341 16,592,237,790
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 105,179,437 88,566,500
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) 5,723,244,756 6,249,584,279
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).... 8,537,370,446 8,882,396,666
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 14,365,794,639 15,220,547,445
19 Revenue less expenses. Subtract line 18 from line 12...... 896,269,702 1,371,690,345
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 22,753,179,736 25,745,696,667
21 Total liabilities (Part X, line 26)............ 14,835,509,031 16,666,321,040
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 7,917,670,705 9,079,375,627
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 HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE
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 $ 13,797,743,397 including grants of $ 41,457,671 ) (Revenue $ 15,615,904,896 )
Provides Hospital and Medical Care, Training and charity care Kaiser Foundation Hospitals (KFH) provides hospital, medical and surgical care, including emergency services, extended care and home health care without regards to age, sex, race, religion or national origin or the ability to pay. KFH educates and trains medical students, physicians and other health care professionals and promotes scientific research and medical and nursing education in order to improve care for our members and our community. KFH directly invests in improvements in community health by working to increase access for the underserved, disseminating care improvements, altering the social determinants of health and educating to improve health. KFH provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. MFA - KFH offers financial assistance to help families and individuals that are unable to pay for all or part of the cost of urgent or emergent care provided in a Kaiser Permanente facility. CHC - these programs are available to low income adults and children who are not eligible for other public or privately sponsored coverage. More than 94,000 patients received comprehensive care for up to four years through this program.
4b (Code:   ) (Expenses $ 623,112,459 including grants of $ 0 ) (Revenue $ 262,210,973 )
Medicaid and Other Government Sponsored Programs KFH is committed to improving the way Medicaid beneficiaries receive care, not only in our facilities, but also in the communities we serve. In 2010, KFH participated in a number of government programs. Medicaid Managed Care - provided comprehensive care for more than 191,000 managed care members; Medicaid Fee for Service - California and Hawaii participated in the State Children's Health Initiative - providing comprehensive health care, to more than 188,000 members.
4c (Code:   ) (Expenses $ 140,265,711 including grants of $ 0 ) (Revenue $ 0 )
Medical Research Programs For more than 40 years, Kaiser Permanente researchers have leveraged modest grants financed through the Federal Government, KFH's Community Benefit Programs and other private foundations into major discoveries that have served our communities, influenced national policy, and informed medical practice throughout the nation and the world. Many of the research studies address current health issues and improve care for common conditions where treatment is often linked to community-based efforts, and are broadly disseminated through articles and professional presentations. Kaiser Permanente investigators in California, Hawaii, Oregon, and Washington participated in research and evaluation studies, partnering with several prominent academic research institutions, including Harvard University, Oregon Health & Sciences University, Stanford University, University of California (Los Angeles, Berkeley, and San Francisco), University of Southern California, University of Washington, National Institutes of Health, Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention.
(Code:   ) (Expenses $ 402,907,205 including grants of $ 47,108,829 ) (Revenue $ 25,263,582 )
SEE part iii, line 4a-d description
4d Other program services. (Describe in Schedule O.)
(Expenses $ 402,907,205 including grants of $ 47,108,829 ) (Revenue $ 25,263,582 )
4e Total program service expensesMediumBullet$ 14,964,028,772
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 I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
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
 
No
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
Yes
 
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. ..... Click to see attachment
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
 
No
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................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
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
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
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
Yes
 
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
 
No
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
Yes
 
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
4,586
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
69,433
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
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletID
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
14
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
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
Yes
 
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
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
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
Yes
 
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
Yes
 
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
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA , CO , DC , GA , HI , MD , OH , OR , VA , WA
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
VP - NATIONAL TAX COMPLIANCE
ONE KAISER PLAZA 15L
OAKLAND,CA94612
(510) 271-6385
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) Christine K Cassel
Director
 2.5 X           0 172,625 0
(2) Thomas W Chapman Edd
Director
 2.8 X           0 185,427 59,810
(3) Daniel P Garcia
SVP, Chief Compliance Officer
 20.0 X   X       0 1,280,238 73,787
(4) William R Graber
Director
 2.25 X           0 232,123 0
(5) J Eugene Grigsby III PhD
Director
 2.25 X           0 193,743 0
(6) George C Halvorson
Chairman and CEO
 13.0 X   X       0 7,667,335 76,092
(7) Judith Johansen
Director
 2.1 X           0 184,560 0
(8) Kim J Kaiser
Director
 3.0 X           0 122,875 0
(9) Philip Marineau
Director
 2.0 X           0 193,623 0
(10) Jenny J Ming
Director
 2.0 X           0 182,748 0
(11) Edward Pei
Director
 3.0 X           0 168,250 16,500
(12) J Neal Purcell
Director
 3.0 X           0 219,738 0
(13) Cynthia Telles PHD
Director
 2.3 X           0 182,647 0
(14) Sandra Thompkins
Director
 2.0 X           0 166,951 0
(15) Gregory A Adams
Region President - NCAL
 25.0     X       0 1,232,518 269,122
(16) Peter Andruszkiewicz
Regional President, Georgia
 25.0     X       0 645,209 157,929
(17) Anthony A Barrueta
SVP, Government Relations
 22.0     X       0 571,456 116,411
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) Raymond J Baxter
SVP, Comm Benefit, Research &
 25.0     X       0 1,336,781 75,549
(19) Benjamin K Chu
Region President - SCAL
 25.0     X       0 1,372,162 272,291
(20) Charles E Columbus
SVP, Chief Human Resources Off
 25.0     X       0 797,854 110,755
(21) Steven Doshay
Senior Counsel
 15.0     X       0 259,987 54,672
(22) Philip Fasano
EVP & CIO
 25.0     X       0 1,762,184 306,487
(23) Jerry C Fleming
SVP, Health Plan Manager
 20.0     X       0 1,021,122 183,648
(24) Diane E Gage Lofgren
SVP, Brand Mgmt & Communicatio
 25.0     X       0 802,687 151,731
(25) Jennifer M Gardner
Special Asst to BOD
 17.0     X       0 103,247 54,938
(26) Sandra A Golze
VP, Regional Counsel - NCAL
 25.0     X       0 391,834 98,692
(27) Mitchell J Goodstein
SVP, Actuarial, U/W & Pricing
 5.0     X       0 899,064 159,889
(28) Marilyn Kawamura
Region President - Mid-Atlanti
 15.0     X       0 961,205 207,332
(29) Patricia Kennedy-Scott
Region President - Ohio
 10.0     X       0 714,655 166,810
(30) Kathryn Lancaster
EVP & CFO
 12.0     X       0 1,558,076 296,474
(31) Janet A Liang
Region President - Hawaii
 25.0     X       0 677,785 140,790
(32) Donna Lynne
Region President - Colorado
 24.0     X       0 820,658 182,750
(33) Andrew R McCulloch
Region President - Northwest
 25.0     X       0 813,153 207,622
(34) Judith M Mears
VP & Asst Gen Counsel
 3.0     X       0 405,969 97,948
(35) Thomas R Meier
SVP, Corporate Treasurer
 15.0     X       0 647,785 107,439
(36) Indrajit Obeysekere
Section Head
 21.0     X       0 312,955 54,587
(37) Donald H Orndoff
SVP, NFS
 13.0     X       0 508,058 70,932
(38) Paul B Records
SVP, Human Resources
 25.0     X       0 2,241,536 83,758
(39) Frank P Richardson
VP, Regional Counsel - HI
 25.0     X       0 251,732 42,092
(40) Rochelle M Roth
Senior Director, QRM
 18.0     X       0 182,639 51,575
(41) Jacqueline Sellers
Senior Counsel
 50.0     X       0 259,476 69,102
(42) Arthur M Southam
EVP, Health Plan Operations
 5.0     X       0 2,020,299 353,928
(43) Deborah Stokes
SVP, Corp Controller, CAO
 12.4     X       0 622,642 123,860
(44) Bernard J Tyson
President & COO
 12.0     X       0 1,942,514 359,961
(45) Herman M Weil
SVP, Federal & State Programs
 25.0     X       0 750,346 256,145
(46) Jed Weissberg
SVP, Quality & Care Delivery E
 25.0     X       0 723,731 220,719
(47) Carlos Zaragoza
VP, Practice Leader - Labor &
 25.0     X       0 424,685 137,471
(48) Steven R Zatkin
SVP, General Counsel & Secreta
 12.0     X       0 1,247,253 97,716
(49) Victoria B Zatkin
VP, Off of Brd & Corp Gov Svcs
 14.0     X       0 311,369 83,647
(50) Mark S Zemelman
SVP, General Counsel & Secreta
 15.0     X       0 806,199 150,636
(51) Terry L Austen
SVP & Area Mgr - San Jose
 30.0       X     0 486,728 170,240
(52) Mary Ann Barnes
SVP, Exec Dir - San Diego
 30.0       X     0 512,079 123,977
(53) Michael O Brady
SVP, Infrastructure Mgmt Group
 30.0       X     0 592,939 99,617
(54) Virginia C Campbell
SVP & Area Mgr - Diablo
 30.0       X     0 459,857 97,937
(55) William B Caswell
SVP, Operations
 30.0       X     0 642,176 109,997
(56) Judith L Coffey
SVP & Area Mgr - Marin/Sonoma
 30.0       X     0 537,264 212,718
(57) Mark E Costa
Exec Dir - Los Angeles
 30.0       X     0 431,496 85,837
(58) Richard D Daniels
SVP, Business Info Officer - H
 30.0       X     0 810,813 129,413
(59) Elizabeth Jane Finley
SVP & Exec Dir - Bellflower
 30.0       X     0 484,647 106,317
(60) Edward S Glavis
SVP & Area Mgr - North Valley
 30.0       X     0 575,132 121,789
(61) Corwin Nathaniel Harper
SVP & Area Mgr - Central Valle
 30.0       X     0 414,389 86,556
(62) Linda J Jensen
SVP & Area Mgr - San Mateo
 30.0       X     0 444,569 118,840
(63) Gerald A McCall
SVP Operations
 30.0       X     0 702,038 136,721
(64) Colleen M McKeown
SVP & Area Mgr - Greater So. A
 30.0       X     0 488,781 109,656
(65) Julie Miller-Phipps
SVP & Exec Dir - Orange
 30.0       X     0 517,244 110,012
(66) Nathaniel L Oubre
SVP & Area Mgr - East Bay
 30.0       X     0 565,303 103,877
(67) Thomas J Risse
VP, CFO - Hawaii
 30.0       X     0 509,309 53,227
(68) Christine Robisch
SVP & Area Manager - San Franc
 30.0       X     0 418,500 89,259
(69) Max Villalobos
SVP & Area Manager - Napa/Sola
 30.0       X     0 557,658 96,591
(70) Vita M Willett
Exec Dir - Riverside
 30.0       X     0 397,442 101,298
(71) Anne D Barr
VP Integrated Planng & Delvry
 30.0         X   0 515,538 51,701
(72) Diane Comer
SVP, Business Info Officer - H
 30.0         X   0 549,384 95,590
(73) Lazaro M Garcia
VP, Data Center Svcs
 20.0         X   0 582,134 150,985
(74) Garry L Hurlbut
VP, COO-KPIT
 30.0         X   0 654,517 72,003
(75) Henry Neidermeier
VP, Technology SOX & Complianc
 30.0         X   0 742,253 108,964
(76) Christine L Malcolm
FORMER SVP
 0.0           X 0 568,721 12,021
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 55,714,619 8,556,740
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet18,235
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
Yes
 
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
HENSEL PHELPS CONSTRUCTION CO
20 SIXTH AVENUE
GEELY,CO80632 		CONSTRUCTION SERVICE 110,337,153
UCSF MEDICAL CENTER
POB 39000 DEPT 3-9157
SAN FRANCISCO,CA94139 		HEALTHCARE SERVICES 102,314,488
BERGEN BRUNSWIG
PO BOX 959
VALLEY FORGE,PA19482 		PHARMACEUTICAL 97,716,722
WHITING TURNER CONTRACTING CO
3 CORPORATE PARK
IRVINE,CA92606 		CONSTRUCTION SERVICE 84,040,421
MCCARTHY BUILDING COMPANIES INC
9301 B IMPERIAL HIGHWAY
DOWNEY,CA90242 		CONSTRUCTION SERVICE 154,715,680
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet1,433
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 20,299,319
e Government grants (contributions)1e 66,122,366
f All other contributions, gifts, grants, and
similar amounts not included above1f 		47,099,467
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 133,521,152
Program Service Revenue Business Code
2a HOSPITAL SERV REV 900,099 13,941,987,026 13,941,987,026    
b NON-PLAN & IND REV 900,099 452,375,656 452,375,656    
c OTHR PRGM SERV REV 900,099 1,443,065,947 1,443,065,947    
d MEDICARE PAYMENTS 900,099 65,950,822 65,950,822    
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 15,903,379,451
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 181,206,301   -91,182 181,297,483
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 1,731     1,731
(i) Real (ii) Personal
6a Gross Rents 1,197,575  
b Less: rental expenses    
c Rental income or (loss) 1,197,575  
d Net rental income or (loss).......MediumBullet 1,197,575     1,197,575
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 4,937,578,016 27,762,854
b Less: cost or other basis and sales expenses 4,648,657,611 3,015,219
c Gain or (loss) 288,920,405 24,747,635
d Net gain or (loss)..........MediumBullet 313,668,040     313,668,040
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 0    
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 0      
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 0      
Miscellaneous Revenue Business Code
11a CAFETERIA 722,210 16,385,572     16,385,572
b PARKING GARAGES 812,930 7,494,978     7,494,978
c KP ONCALL 900,099 34,074,062   4,401,950 29,672,112
d All other revenue .... 1,308,928   -3,018,982 4,327,910
e Total. Add lines 11a–11d ......MediumBullet 59,263,540
12 Total revenue. See Instructions....MediumBullet 16,592,237,790 15,903,379,451 1,291,786 554,045,401
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 88,566,500 88,566,500
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0 0
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0 0    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 4,296,330,031 4,190,981,001 105,349,030  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 468,274,217 456,791,804 11,482,413  
9 Other employee benefits ....... 1,048,646,312 1,022,932,768 25,713,544  
10 Payroll taxes ........... 436,333,719 425,634,510 10,699,209  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 483,280   483,280  
c Accounting ........... 2,661,826   2,661,826  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 30,310,868 29,567,624 743,244  
g Other .......... 0      
12 Advertising and promotion .... 3,311,569   3,311,569  
13 Office expenses ....... 1,900,515,386 1,853,913,414 46,601,972  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 177,212,865 172,867,481 4,345,384  
17 Travel ............ 18,131,861 17,687,255 444,606  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 8,523,461   8,523,461  
20 Interest ........... 115,977,242 113,133,399 2,843,843  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 672,380,902 655,893,650 16,487,252  
23 Insurance .............. 58,316,595 56,886,631 1,429,964  
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 BASIC CONTRACTUAL PAYMENTS 2,611,036,463 2,611,036,463    
b PURCHASED MEDICAL SERVICES 2,303,273,915 2,303,273,915    
c PURCHASED NON-MEDICAL SVC 589,974,750 575,508,155 14,466,595  
d BAD DEBT EXPENSE 245,705,279 245,705,279    
e EMPLOYEE RELATED EXPENSES 4,692,644 4,577,577 115,067  
f All other expenses 139,887,760 139,071,346 816,414  
25 Total functional expenses. Add lines 1 through 24f 15,220,547,445 14,964,028,772 256,518,673 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 .......... 57,732,324 1 37,015,352
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 342,960,176 4 264,067,372
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 ............. 24,440,925 7 215,356,692
8 Inventories for sale or use .............. 378,063,079 8 357,691,588
9 Prepaid expenses and deferred charges ............ 126,524,054 9 246,189,527
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 23,006,124,254
b Less: accumulated depreciation. ..... 10b 9,828,335,689 12,352,211,445 10c 13,177,788,565
11 Investments—publicly traded securities .......... 8,015,376,625 11 9,738,877,605
12 Investments—other securities. See Part IV, line 11 ...... 1,307,665,124 12 1,588,745,055
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 4,200,000 14 7,366,237
15 Other assets. See Part IV, line 11 ........... 144,005,984 15 112,598,674
16 Total assets. Add lines 1 through 15 (must equal line 34)... 22,753,179,736 16 25,745,696,667
Liabilities 17 Accounts payable and accrued expenses . 2,093,032,552 17 2,255,184,139
18 Grants payable ..........   18  
19 Deferred revenue .......... 540 19 31,147,451
20 Tax-exempt bond liabilities .......... 5,502,555,362 20 5,490,197,030
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 .. 813,202,418 23 1,289,691,972
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 6,426,718,159 25 7,600,100,448
26 Total liabilities. Add lines 17 through 25..... 14,835,509,031 26 16,666,321,040
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 .....   27  
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
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 ..... 13,299,700 31 11,778,805
32 Retained earnings, endowment, accumulated income, or other funds 7,904,371,005 32 9,067,596,822
33 Total net assets or fund balances ..... 7,917,670,705 33 9,079,375,627
34 Total liabilities and net assets/fund balances ..... 22,753,179,736 34 25,745,696,667
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
16,592,237,790
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
15,220,547,445
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
1,371,690,345
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
7,917,670,705
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-209,985,423
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
9,079,375,627
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
Yes
 
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
Yes
 
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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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
KAISER FOUNDATION HOSPITALS
  		Employer identification number

94-1105628
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
KAISER FOUNDATION HOSPITALS
  		Employer identification number

94-1105628
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
KAISER FOUNDATION HOSPITALS
  		Employer identification number

94-1105628
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 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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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 ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .................   867,382,714 867,382,714
b Buildings ................   14,461,041,241 6,067,060,360 8,393,980,881
c Leasehold improvements ............   163,969,728 128,368,259 35,601,469
d Equipment ................   2,239,050,521 1,599,433,698 639,616,823
e Other .................   5,274,680,050 2,033,473,371 3,241,206,679
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 13,177,788,565
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    
(3)Other
(A) ABSOLUTE RETURN FUNDS 		1,210,346,726 F

(B) TACTICAL ASSET ALLOC FUNDS 		0 F

(C) PRIVATE EQUITY FUNDS 		378,398,329 F

(D) TREASURY SECURITY FUNDS 		0 F





Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 1,588,745,055
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 0
DUE TO RELATED ENTITIES 811,950,348
RESERVE FOR UNCLAIMED PROPERTY 773,448
RESERVE FOR WORKERS COMP RISKS 304,900,109
RESERVE FOR PROF/PUBLIC LIAB 1,447,120
RESERVE FOR SELF-INS RISK AUTO 140,000
RESERVE FOR MEDICARE 8,835,996
RESERVE FOR RESTRUCTURING CHGS 8,926,942
POST RETIREMENT LIABILITIES 6,067,326,214
OTHER LIABILITIES 302,323,193
OTHER CURRENT LIABILITIES 93,477,078
Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 7,600,100,448
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  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
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  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
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  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
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  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
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
FIN 48 FOOTNOTE SCHEDULE D, PART X NOT REQUIRED
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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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
Yes
 
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
 
No
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) .. 		    265,313,996 25,263,582 240,050,414 1.600 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    474,158,408 172,559,334 301,599,074 2.010 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     146,049,640 89,651,639 56,398,001 0.380 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    885,522,044 287,474,555 598,047,489 3.990 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    35,248,915   35,248,915 0.240 %
f Health professions education
(from Worksheet 5) .. 		    89,231,086 20,743,813 68,487,273 0.460 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)     135,596,986 26,879,270 108,717,716 0.730 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    41,122,916   41,122,916 0.310 %
jTotal Other Benefits ...     301,199,903 47,623,083 253,576,820 1.740 %
kTotal. Add lines 7d and 7j. ..     1,186,721,947 335,097,638 851,624,309 5.730 %
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     289,706 0 289,706 0 %
2 Economic development     170,000 0 170,000 0 %
3 Community support     1,612,934 0 1,612,934 0.010 %
4 Environmental improvements     107,000 0 107,000 0 %
5 Leadership development and training for community members     591,990 0 591,990 0 %
6 Coalition building     412,500 0 412,500 0 %
7 Community health improvement advocacy     2,128,253 0 2,128,253 0.010 %
8 Workforce development     545,030 0 545,030 0 %
9 Other     128,500 0 128,500 0 %
10 Total     5,985,913 0 5,985,913 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
227,845,452
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
541,385
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
178,570,449
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
252,668,986
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-74,098,537
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?38
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 KAISER FOUNDATION HOSPITAL - SUNSET
4867 SUNSET BLVD
LOS ANGELES,CA90027 		X     X     X    
2 KAISER FOUNDATION HOSPITAL - SAN DIEGO
4647 ZION AVE
SAN DIEGO,CA92120 		X X   X     X    
3 KAISER FOUNDATION HOSPITAL - FONTANA
9961 SIERRA AVE
FONTANA,CA92335 		X X   X     X    
4 KAISER FOUNDATION HOSPITAL - ROSEVILLE
1600 EUREKA RD
ROSEVILLE,CA95661 		X X   X     X    
5 KAISER FOUNDATION HOSPITAL - SANTA CLARA
700 LAWRENCE EXPRESSWAY
SANTA CLARA,CA95051 		X X   X     X    
6 KAISER FOUNDATION HOSPITAL - BELLFLOWER
9400 E ROSECRANS AVE
BELLFLOWER,CA90706 		X X   X     X    
7 KAISER FOUNDATION HOSPITAL - OAKLAND
280 W MACARTHUR BLVD
OAKLAND,CA94611 		X X   X     X    
8 KAISER FOUNDATION HOSPITAL -WALNUT CREEK
1425 S MAIN ST
WALNUT CREEK,CA94596 		X X   X     X    
9 KAISER FDN HOSPITAL - SAN FRANCISCO
2425 GEARY BLVD
SAN FRANCISCO,CA94115 		X X   X     X    
10 KAISER FOUNDATION HOSPITAL - SACRAMENTO
2025 MORSE AVE
SACRAMENTO,CA95825 		X X   X     X    
11 KAISER FOUNDATION HOSPITAL - RIVERSIDE
10800 MAGNOLIA AVE
RIVERSIDE,CA92505 		X X   X     X    
12 KAISER FDN HOSP - SUNNYSIDE MEDICAL CTR
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		X X   X     X    
13 KAISER FDN HOSPITAL - WOODLAND HILLS
5601 DE SOTO AVE
WOODLAND HILLS,CA91367 		X X   X     X    
14 KAISER FOUNDATION HOSPITAL - HARBOR CITY
25825 S VERMONT AVE
HARBOR CITY,CA90710 		X X   X     X    
15 KAISER FOUNDATION HOSPITAL - HONOLULU
3288 MOANALUA RD
HONOLULU,HI96819 		X X   X     X    
16 KAISER FOUNDATION HOSPITAL -BALDWIN PARK
1011 BALDWIN PARK BLVD
BALDWIN PARK,CA91706 		X X   X     X    
17 KAISER FOUNDATION HOSPITAL - VALLEJO
975 SERENO DR
VALLEJO,CA94589 		X X   X     X    
18 KAISER FDN HOSPITAL - PANORAMA CITY
13652 CANTARA ST
PANORAMA CITY,CA91402 		X X   X     X    
19 KAISER FDN HOSPITAL - SOUTH SACRAMENTO
6600 BRUCEVILLE RD
SOUTH SACRAMENTO,CA95823 		X X   X     X    
20 KAISER FDN HOSPITAL - W LOS ANGELES
6041 CADILLAC AVE
W LOS ANGELES,CA90034 		X X   X     X    
21 KAISER FOUNDATION HOSPITAL - HAYWARD
27400 HESPERIAN BLVD
HAYWARD,CA94545 		X X   X     X    
22 KAISER FOUNDATION HOSPITAL -ANAHEIM
441 N LAKEVIEW AVE
ANAHEIM,CA92807 		X X   X     X    
23 KAISER FOUNDATION HOSPITAL - SAN JOSE
250 HOSPITAL PARKWAY
SAN JOSE,CA95119 		X X   X     X    
24 KAISER FOUNDATION HOSPITAL - IRVINE
6640 ALTON PARKWAY
IRVINE,CA92618 		X X   X     X    
25 KAISER FOUNDATION HOSPITAL -REDWOOD CITY
1150 VETERANS BLVD
REDWOOD CITY,CA94063 		X X   X     X    
26 KAISER FOUNDATION HOSPITAL - SANTA ROSA
401 BICENTENNIAL WAY
SANTA ROSA,CA95403 		X X   X     X    
27 KAISER FOUNDATION HOSPITAL - FRESNO
7300 N FRESNO ST
FRESNO,CA93720 		X X   X     X    
28 KAISER FOUNDATION HOSPITAL - MODESTO
4601 DALE RD
MODESTO,CA95356 		X X         X    
29 KAISER FOUNDATION HOSPITAL - ANTIOCH
4501 SAND CREEK RD
ANTIOCH,CA94531 		X X         X    
30 KAISER FDN HOSPITAL -SOUTH SAN FRANCISCO
1200 EL CAMINO REAL
SOUTH SAN FRANCISCO,CA94080 		X X         X    
31 KAISER FOUNDATION HOSPITAL - SAN RAFAEL
90 MONTECILLO RD
SAN RAFAEL,CA94903 		X X   X     X    
32 KAISER FOUNDATION HOSPITAL - FREMONT
39400 PASEO PADRE PARKWAY
FREMONT,CA94538 		X X   X     X    
33 KAISER FDN HOSPITAL - MORENO VALLEY
27300 IRIS AVE
MORENO VALLEY,CA92555 		X X   X     X    
34 KAISER FOUNDATION HOSPITAL - VACAVILLE
1 QUALITY DR
VACAVILLE,CA95688 		X X         X    
35 KAISER FOUNDATION HOSPITAL - RICHMOND
901 NEVIN ST
RICHMOND,CA94804 		X X   X     X    
36 KAISER FOUNDATION HOSPITAL - MANTECA
1777 W YOSEMITE AVE
MANTECA,CA95336 		X X         X    
37 KAISER FDN HOSPITAL - SANTA CLARA PHF
3840 HOMESTEAD ROAD
SANTA CLARA,CA95051 		X X   X     X    
38 KAISER FDN HOSPITAL - MENTAL HEALTH CTR
765 W College St
LOS ANGELES,CA90012 		X 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:KAISER FOUNDATION HOSPITAL - SUNSET
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 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:KAISER FOUNDATION HOSPITAL - SAN DIEGO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

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 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:KAISER FOUNDATION HOSPITAL - FONTANA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

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 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:KAISER FOUNDATION HOSPITAL - ROSEVILLE
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

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 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:KAISER FOUNDATION HOSPITAL - SANTA CLARA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):5

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 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:KAISER FOUNDATION HOSPITAL - BELLFLOWER
Line Number of Hospital Facility (from Schedule H, Part V, Section A):6

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 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:KAISER FOUNDATION HOSPITAL - OAKLAND
Line Number of Hospital Facility (from Schedule H, Part V, Section A):7

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 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:KAISER FOUNDATION HOSPITAL -WALNUT CREEK
Line Number of Hospital Facility (from Schedule H, Part V, Section A):8

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 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:KAISER FDN HOSPITAL - SAN FRANCISCO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):9

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 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:KAISER FOUNDATION HOSPITAL - SACRAMENTO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):10

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 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:KAISER FOUNDATION HOSPITAL - RIVERSIDE
Line Number of Hospital Facility (from Schedule H, Part V, Section A):11

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 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:KAISER FDN HOSP - SUNNYSIDE MEDICAL CTR
Line Number of Hospital Facility (from Schedule H, Part V, Section A):12

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 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:KAISER FDN HOSPITAL - WOODLAND HILLS
Line Number of Hospital Facility (from Schedule H, Part V, Section A):13

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 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:KAISER FOUNDATION HOSPITAL - HARBOR CITY
Line Number of Hospital Facility (from Schedule H, Part V, Section A):14

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 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:KAISER FOUNDATION HOSPITAL - HONOLULU
Line Number of Hospital Facility (from Schedule H, Part V, Section A):15

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 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:KAISER FOUNDATION HOSPITAL -BALDWIN PARK
Line Number of Hospital Facility (from Schedule H, Part V, Section A):16

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 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:KAISER FOUNDATION HOSPITAL - VALLEJO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):17

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 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:KAISER FDN HOSPITAL - PANORAMA CITY
Line Number of Hospital Facility (from Schedule H, Part V, Section A):18

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 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:KAISER FDN HOSPITAL - SOUTH SACRAMENTO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):19

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 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:KAISER FDN HOSPITAL - W LOS ANGELES
Line Number of Hospital Facility (from Schedule H, Part V, Section A):20

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 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:KAISER FOUNDATION HOSPITAL - HAYWARD
Line Number of Hospital Facility (from Schedule H, Part V, Section A):21

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 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:KAISER FOUNDATION HOSPITAL -ANAHEIM
Line Number of Hospital Facility (from Schedule H, Part V, Section A):22

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 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:KAISER FOUNDATION HOSPITAL - SAN JOSE
Line Number of Hospital Facility (from Schedule H, Part V, Section A):23

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 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:KAISER FOUNDATION HOSPITAL - IRVINE
Line Number of Hospital Facility (from Schedule H, Part V, Section A):24

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 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:KAISER FOUNDATION HOSPITAL -REDWOOD CITY
Line Number of Hospital Facility (from Schedule H, Part V, Section A):25

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 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:KAISER FOUNDATION HOSPITAL - SANTA ROSA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):26

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 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:KAISER FOUNDATION HOSPITAL - FRESNO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):27

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 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:KAISER FOUNDATION HOSPITAL - MODESTO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):28

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 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:KAISER FOUNDATION HOSPITAL - ANTIOCH
Line Number of Hospital Facility (from Schedule H, Part V, Section A):29

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 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:KAISER FDN HOSPITAL -SOUTH SAN FRANCISCO
Line Number of Hospital Facility (from Schedule H, Part V, Section A):30

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 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:KAISER FOUNDATION HOSPITAL - SAN RAFAEL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):31

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 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:KAISER FOUNDATION HOSPITAL - FREMONT
Line Number of Hospital Facility (from Schedule H, Part V, Section A):32

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 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:KAISER FDN HOSPITAL - MORENO VALLEY
Line Number of Hospital Facility (from Schedule H, Part V, Section A):33

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 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:KAISER FOUNDATION HOSPITAL - VACAVILLE
Line Number of Hospital Facility (from Schedule H, Part V, Section A):34

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 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:KAISER FOUNDATION HOSPITAL - RICHMOND
Line Number of Hospital Facility (from Schedule H, Part V, Section A):35

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 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:KAISER FOUNDATION HOSPITAL - MANTECA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):36

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 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:KAISER FDN HOSPITAL - SANTA CLARA PHF
Line Number of Hospital Facility (from Schedule H, Part V, Section A):37

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 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:KAISER FDN HOSPITAL - MENTAL HEALTH CTR
Line Number of Hospital Facility (from Schedule H, Part V, Section A):38

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 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		IMPATIENT MENTAL HEALTH SERVICES
2 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		IMPATIENT MENTAL HEALTH SERVICES
3 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		IMPATIENT MENTAL HEALTH SERVICES
4 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		IMPATIENT MENTAL HEALTH SERVICES
5 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		IMPATIENT MENTAL HEALTH SERVICES
6 BROOKSIDE RESIDENTIAL TREATMENT CENTER
10180 SOUTHEAST SUNNYSIDE RD
CLACKAMAS,OR97015 		IMPATIENT MENTAL HEALTH SERVICES
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 7   The losses attributed to providing charity care (medical financial assistance and charitable health coverage) and participation in select government or community sponsored health coverage programs are calculated using a cost-based methodology for patients in those programs. The cost-based loss is generated through the standard systems used to report on market segments for KFHP/H's commercial business lines. In order to calculate the percentages reported in column (f) bad debt was excluded from total expenses. Bad debt of $245,705,279 was excluded from total expenses of $15,220,547,445 reported in part ix, line 25, column (a)
Part II   In keeping with the organization's mission to provide high quality, affordable health care services and to improve the health of our members and the communities we serve, Kaiser Foundation Hospitals funded a variety of organizations, programs, and activities that address, support, and encourage Community Building. For IRS Schedule H reporting purposes these activities and grants are excluded from our Community Benefit totals and reported in Part II of IRS 990 Schedule H. 1. Physical Improvement Project support includes the provision or rehabilitation of housing for vulnerable populations, such as removing building materials that harm the health of residents; neighborhood improvement or revitalization projects; provision of housing for vulnerable patients upon discharge from an inpatient facility; housing for low-income seniors; and the development or maintenance of parks and playgrounds to promote physical activity - KFH in Northern California provided a grant to Playing and Learning in Adaptable Environments, Inc. (PLAE) to support Pogo Park and its Blueprint for Healthy Living project. PLAE's goal is to transform Elm Playlot into a healthy place for local children to play, promoting physical activity and healthy food choices while providing families with access to affordable fresh fruit and vegetables. Renovation of the playlot is facilitated by Elm Playlot Action Committee (EPAC), which implemented a comprehensive community engagement strategy focused on community revitalization. It included opportunities for youth engagement and development, workforce development, team building and management, fundraising, construction project planning and management, collaborating with multiple agencies, and developing service partnerships. This is an example of a whole community revitalization project that is transforming this Iron Triangle neighborhood, where one in every three households lives below the poverty line. Thus far, PLAE has reached 300 individuals. - KFH in Southern California provided a $100,000 grant to the Trust for Public Land (TPL) to assist cities and communities in the Los Angeles basin with the creation and expansion of parks and recreation areas located in underserved, low-income communities. Specifically, the grant supports the creation of Fitness Zones, custom-designed, easy-to-use outdoor gym equipment stations. The work also increases community awareness about the importance of open space within built environments, engages community members on health education issues, and creates and strengthens new and existing coalitions with nonprofit partners and public agencies to address open space equity issues throughout Los Angeles County. 2. Economic Development Initiatives support included contributions to assist small business development in neighborhoods with vulnerable populations, and creating new employment opportunities in areas with high rates of joblessness - WISE (Women's Initiative for Self-Employment) received a $70,000 grant to train, fund, and support low-income and minority women entrepreneurs to become self-sufficient, to create jobs, and to revitalize local communities. WISE has proven that women create jobs for themselves and others, access the mainstream economy, and increase their economic self-sufficiency when they are given business planning and financing support. By assisting women-owned businesses throughout the San Francisco Bay Area at seven training sites, WISE directly contributes to the economic growth of communities. - Watts Healthy Farmers Market received a grant to increase access to fresh produce for residents of Watts and surrounding low-income neighborhoods and provides local employment opportunities. 3. Community Support includes charitable contributions which support child care and mentoring programs for vulnerable populations or neighborhoods, neighborhood support groups, violence prevention programs, and disaster readiness and public health emergency activities, such as community disease surveillance or readiness training beyond what is required by accrediting bodies or government entities - KFH-Sacramento and KFH-South Sacramento awarded $65,000 to City of Sacramento Office of Youth Development to support continued implementation of its comprehensive Street Outreach Program. Designed to raise community awareness, identify at-risk youth, and help them receive appropriate services to avoid risky behaviors, the program targets neighborhoods across Sacramento, including Del Paso Heights, North and South Natomas, Florin, Oak Park, and Meadowview. Based on the belief that it is best to reach at-risk youth in their community/environment and provide access to often unknown available resources prior to law enforcement contact or incarceration, the main objective is reconnecting disconnected youth. From 6pm to midnight, outreach teams comb select areas, providing information about and facilitating access to programs, training, and employment. Community-based organizations are required to collaborate with other community-based organizations to accomplish program goals. In the first 10 months of 2010, working with Roberts Family Development Center, the outreach team engaged 881 youth and adults and made 524 referrals to community organizations. - KFH in Southern California provided support to numerous community programs including the Young Women's Christian Association (YWCA) Pasadena-Foothill Valley's Just For Girls (JFG), an education and mentoring after school program focused on the health and well-being of economically disadvantaged girls. JFG is designed to have girls succeed in academics and develop physical and emotionally healthy lifestyles. The participants in the program are primarily low-income, Latino and African American girls' ages 9 to 17. 4. Environmental Improvements include activities to address environmental hazards that affect community health, such as alleviation of water or air pollution, safe removal or treatment of garbage or other waste products, and other activities to protect the community from environmental hazards. Following are a few examples of the grants we provided to other non-profits to address environmental issues: - MedShare International, a nonprofit organization dedicated to improving the environment and healthcare through the efficient recovery and redistribution of surplus medical supplies and equipment to underserved health care facilities in Northern California and abroad received a grant to support their redistribution efforts. - Bay Area Community Resources (BACR) received a grant to support advocacy for ordinances that promote smoke-free multiunit housing and surrounding areas. As of this writing, two communities are slated to vote on ordinances this spring. This work has also spurred interest in introducing ordinances regarding tobacco sales to minors. BACR, founded in 1976, promotes the healthy development of individuals, families, and communities through direct services, volunteerism, and partnerships in Marin County and the San Francisco Bay Area. BACR's diverse programs focus on after- school programs, youth development, alcohol and drugs, tobacco, mental health, national service, and community health. - Stand Up To Falls, a City of Sacramento Department of Parks and recreation Older Adult Services program received a grant to support a reduction in the number of falls among older residents in Elk Grove and South Sacramento. Components include community workshops geared toward residents who have not experienced a fall but are entering the at-risk years; workshops designed for seniors who have already experienced a fall and now have a fear of falling; home safety modification; and a fall prevention-focused wellness newsletter. As of October 2010, 101 older adults with fall risk factors and concerns participated in four Fall Prevention 101 workshops and one Matter of Balance series (eight two-hour sessions). Participants learned about fall risks and fall reduction strategies, resources for further education and exercise opportunities, equipment, and home safety modification information. Approximately 95% of respondents reported that they had made lifestyle changes to reduce their fall risk, and 90% had made specific changes to their fitness activities. Rebuilding Together performed home safety assessments and necessary modifications (installation of safety equipment and elimination of unsafe conditions) for eight seniors. An additional 12 to 25 seniors will be assessed by the end of the grant period. The City of Sacramento used remaining grant funds to update and distribute 10,000 copies of a special 24-page newsletter, All about Falls, and 9,750 copies of an eight-page newsletter, which were distributed to individuals, agencies, and health care offices with senior clientele. - ICLEI - Local Governments for Sustainability USA received a grant to provide trainings, technical assistance, data collection tools, and report templates to seven cities
Part III Line 4   The organization's financial statement is part of a combined report, The combined statement does not have a footnote related to bad debt. The organization reports Accounts Receivable - net. The calculation begins with gross revenue and multiplies that value by a bad debt percentage which is based on a look back period that is aligned with our reserve model timelines. For specific revenue types within Account Receivable, we applied that bad debt percentage to the general ledger self pay gross charges to determine the bad debt amount. Copay charge codes (less POS payments) we apply a bad debt ratio based on a lag model to give us our estimated copay bad debt. DHMO and HDHP is also based on a clarity report that pulls their respective gross charges and applies a ratio based on a lag model for those lines of business to calculate our estimated bad debt.
Part III Line 8   None of the amounts reported on Part III, line 7 has been treated as community benefit. The cost accounting system takes inputs from the General Ledger, utilization and other statistics, products from the chargemasters, and Relative Value Units (RVUs) to cost the individual products. These costs are then aggregated to form an encounter cost. Revenues received are applied to reduce the cost to a net loss, which is the reported value. Our systems aggregate these costs into the patient's assigned line of business to create our standard line of reporting.
Part III Line 9b   When a patient/guarantor indicates an inability to pay (charity care), the patient/guarantor will be evaluated for charity care in accordance with established criteria outlined in the Medical Financial Assistance (MFA) Program. In addition, outside collection agencies will cancel and return on a retrospective basis any accounts that either would have qualified or now qualify for charity care according to the criteria outlined in the MFA Program.
needs assessment   In California, Hawaii and Oregon each KFH medical center is required to conduct a community needs assessment every three years. The assessments may be conducted individually by each hospital or in collaboration with other hospitals, community-based agencies and public service organizations. Each needs assessment provides a summary of the needs assessment process undertaken including the methodologies and data sources utilized, individuals and organizations consulted, a complete listing of the needs identified and description of the method used to prioritize needs for inclusion in the individual community benefit plans. The most recent needs assessments were completed in 2010.
patient education of eligibility for assistance   In California, Hawaii, Oregon and Washington, information regarding assistance is widely available to patients and the general public as well as Health Plan members throughout the facility. Kaiser Permanente physicians and staff are also a source of information for patients requesting medical financial assistance. The availability and contact information about Kaiser Permanente's Medical Financial Assistance Program (MFAP) are posted in the emergency departments, billing and admitting offices and hospital-based outpatient departments. Information is also publicly posted on our websites and in public entrances of hospitals, medical office buildings, urgent care and outpatient pharmacies. In addition, a special MFAP 800# hotline (in several languages) has been established. This number is included on all bill correspondence, brochures and signage. MFAP information can also be found on the publicly accessible KP web site. All patients identified as "self pay" and who have received care in a Kaiser Permanente emergency department or hospital-based outpatient department are required to receive a Medical Financial Assistance brochure which contains eligibility information on the charity care programs and self pay discounts. All brochures and applications are provided in English or other appropriate languages such as Spanish, Chinese, Armenian, Russian and Farsi.
community information   KFH owns and operates 38 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon. In California, KFH medical centers are located in the cities of Anaheim, Antioch, Baldwin Park, Downey, Fontana, Fremont, Fresno, Harbor City, Hayward, Irvine, Los Angeles, Manteca, Modesto, Moreno Valley, Oakland, Panorama City, Redwood City, Richmond, Riverside, Roseville, Sacramento, San Diego, San Francisco, San Jose, San Rafael, Santa Clara, Santa Rosa, South Sacramento, South San Francisco, Vacaville, Vallejo, Walnut Creek, West Los Angeles, and Woodland Hills. In Hawaii, the Moanalua Medical Center is located in the City of Honolulu on the island of Oahu. In Oregon, the Sunnyside Medical Center is located in the City of Clackamas. KFH serves 7.3 million Kaiser Foundation Health Plan members in the four states in which it operates with 120,170 full time administrative, clerical and technical employees, as well as more than 14,146 Permanente physicians representing all specialties. Kaiser Permanente members are representative of the various ages and income groups as well as the social, ethnic, and culture distinction of each community located within KFH service areas. ncal scal Hawaii nw Total population in area (mil) 11.6 21.6 1.3 2.2 Average family income $98,459 $85,050 $90,072 $78,278 % below fpl 14 16 11 14 % without public or private health ins 14 21 8 16 (SOURCE: US CENSUS 2010 AMERICAN COMMUNITY SURVEY S2701, CPO3, AND DP03 LIMITED TO APPROXIMATE KAISER SERVICE AREAS (MSA) IN EACH OF the 4 REGIONS. (INCLUDES the ENTIRE STATE OF HAWAII))
other information   promotion of community health KFH's principal purpose is to provide hospital, medical, and surgical care, including emergency services, extended care and home health care to members of the public without regard to age, sex, race, religion or national origin, or to the individual's ability to pay. KFH's general community benefits are: Emergency departments - KFH operates full-time emergency departments in each of its 38 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon. Emergency medical services are available to all individuals regardless of their ability to pay. Care provided to all patients - Hospital care is provided to individuals with health care coverage from any private or government-sponsored health plan, insured and uninsured referrals from safety net and other public health partnerships, and uninsured patients admitted through the emergency department. Open Medical Staff Privileges - Staff privileges in the hospitals are available to community practitioners who are not affiliated with a Permanente Medical Group. Board of Directors - KFH and KFHP have identical 14-member Boards of Directors. The board is comprised of individuals from the academic world and private industry who are representative of the community. George C. Halvorson serves as the Chairman and Chief Executive Officer for the KFHP and KFH Boards of Directors. Reinvestment of Surplus Revenues - KFHP pays KFH for hospital services and all surplus revenues are reinvested for capital replacement or expansion of facilities and equipment, debt amortization, improvement in patient care and services, and other community benefit services including charity care, medical education and research.
affiliated health care system   Kaiser Foundation Hospitals (KFH) and Kaiser Foundation Health Plan, Inc. (KFHP), with its five principal operating tax-exempt subsidiary health plans-Kaiser Foundation Health Plan of Colorado; Kaiser Foundation Health Plan of Georgia, Inc.; Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Kaiser Foundation Health Plan of the Northwest; and Kaiser Foundation Health Plan of Ohio, are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." Kaiser Permanente is an integrated health care delivery system that combines the provision and financing of health care services. People who elect to enroll in a Kaiser Permanente health plan receive a full range of prepaid health care services, including hospital care, professional care in hospitals and physicians' offices, x-ray and laboratory services, physical therapy, emergency, ambulance transportation, preventive services, health education and certain prescribed drugs. More comprehensive drug coverage is also provided through a separate coverage rider. In the hospital-based regions-California, Hawaii, Oregon and Washington, Kaiser Permanente is comprised of several separate legal organizations: KFH - a California nonprofit public benefit corporation exempt from federal income tax under Internal Revenue Code 501(c)(3); KFHP - a California nonprofit public benefit corporation exempt from federal income tax under Internal Revenue Code 501(c)(3); Northwest Health Plan - an Oregon nonprofit corporation. Kaiser Permanente contracts with various medical groups in each respective region to provide services to members. Persons enroll in Kaiser Permanente through KFHP or one of the Health Plan subsidiaries ("Health Plan"). Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis and fulfills its contractual obligations to group and individual members by contracting with KFH and a Permanente Medical Group to provide the required health care services. KFHP and KFH are separate corporations governed by identical boards of directors. KFH accepts responsibility to provide or arrange necessary hospital services and facilities for Health Plan members. KFH owns and operates 38 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon, which provide emergency and in-patient services to all persons in the community regardless of membership or ability to pay. Staff privileges are available on a nondiscriminatory basis to physicians in the communities served. KFH also contracts with other community hospitals to provide hospital services to members for specialized care and other services. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Through the Kaiser Permanente mission, the organization contributes to the health of the communities in two related ways. First, Kaiser Permanente strives for excellence in serving its 8.7 million members through market-leading performance in quality, service and affordability. By doing so, Kaiser Permanente provides a discipline in the marketplace by demonstrating meaningful value and affordability, and generating resources to reinvest in the community's health. Second, Kaiser Permanente directly invests in improvements to community health by working to increase access for the underserved, disseminating care improvements, altering the social determinants of health, educating healthcare workers and consumers, and informing public policy. This latter approach, which Kaiser Permanente calls the Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre, Safety Net Partnerships, Community Health Initiatives and Charitable Coverage Programs. The KFHP/H Board has a standing Community Benefit Committee of the Board of Directors to oversee the program-wide Community Benefit program. Kaiser Permanente also has a national executive of KFHP and KFH to lead Kaiser Permanente's Community Benefit Program as a full-time assignment. Raymond J. Baxter, PhD is the Senior Vice President for Community Benefit, Research and Health Care Policy reporting to the CEO and Chairman of the Board.
state filing of community benefit report   KFH annually prepares and submits a Consolidated Community Benefit Plan to the California Office of Statewide Health Planning and Development in compliance with Health and Safety Code Section 127340 et seq. The consolidated plan includes a hospital-specific community benefit plan for each individual medical center campus in California. KFH also annually prepares and submits a comprehensive Community benefit report to the Department of Human Services, Office for Oregon Health Policy and Research for the Sunnyside Medical Center located in the City of Clackamas.
STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI CA, OR,
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
KAISER FOUNDATION HOSPITALS
 
Employer identification number
94-1105628
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) 100 Black Men of the Bay Area1638 12th St
Oakland,CA946071404 		94-3065997 501(c)(3) 66,500       Youth Movement, Fundraising & Awards Gala
(2) A Better LA1150 S Olive St 340
Los Angeles,CA90015 		20-2274095 501(c)(3) 50,000       Summer Night Lights 2010
(3) A More Excellent Way Health Improvement Org215 Lighthouse Dr
Vallejo,CA945904030 		14-2011697 501(c)(3) 15,000       Breastfeeding Peer Counselor Program
(4) A Place Called Home2830 South Central Ave
Los Angeles,CA90011 		95-4427291 501(c)(3) 7,500       APCH Counseling Program
(5) A Window Between Worlds710 4th Ave 5
Venice,CA90291 		95-4448606 501(c)(3) 7,000       Children's Windows Art Program
(6) A Milton Miller Memorial Fund Inc dba Disability R919 Albany St
Los Angeles,CA90015 		95-2960607 501(c)(3) 25,000       Cancer Legal Resource Center (a program of)
(7) ABC Unified School District16700 Norwalk Blvd
Cerritos,CA90703 		95-2380644 GOVT ENTITY 12,000       Bridge Builders Youth Development Program
(8) Abode Services40849 Fremont Blvd
Fremont,CA94538 		94-3087060 501(c)(3) 7,400       Fifth Annual Journey Home Breakfast; GSAA Communit
(9) Access California Services2180 West Crescent Ave C
Anaheim,CA92801 		33-0826205 501(c)(3) 10,000       Health Care Access
(10) Access Institute for Psychological Services110 Gough St 301
San Francisco,CA941025945 		01-0595862 501(c)(3) 15,000       In-school Mental Health Program grant
(11) Afgan Care22470 Foothill Blvd
Hayward,CA94541 		94-3132203 501(c)(3) 14,000       Senior Health Fair; Health Management and Educatio
(12) Afghan Elderly Association (AEA)3300 Capitol Ave Bldg B
Fremont,CA94536 		94-3290111 501(c)(3) 7,000       Weight Control Project
(13) African American Prostate Cancer Initiative9521 Folsom Blvd R
Sacramento,CA95827 		94-3387471 501(c)(3) 10,000       Health Fair/ Healthy Men, Healthy Families Worksho
(14) Agricultural Institute of Marin76 San Pablo Ave 200
San Rafael,CA949034169 		86-1156712 501(c)(3) 8,500       Intergenerational Nutrition Education
(15) america's health insurance plans601 Pennsylvania Avenue NW
Washington,DC20004 		36-2087641 501(c)(3) 1,000,000       Charitable donations
(16) AIDS Assistance Program1276 North Palm Canyon Dr 108
Palm Springs,CA92262 		33-0566442 501(c)(3) 8,000       Food Voucher Program
(17) AIDS Project Los Angeles Inc611 S Kingsley Dr
Los Angeles,CA90005 		95-3842506 501(c)(3) 5,500       APLA Dental Services
(18) AIDS Research Alliance of America1400 South Grand Ave 701
Los Angeles,CA90015 		95-4264845 501(c)(3) 12,000       Accessing HIV/AIDS Clinical Trials - Partnership
(19) AIDS Services Center Inc909 South Fair Oaks Ave
Pasadena,CA91105 		95-4165358 501(c)(3) 18,100       HIV/AIDS Clinical Services
(20) AIDS Services Foundation of Orange County17982 Skypark Circle J
Irvine,CA92614 		33-0126481 501(c)(3) 22,875       HIV Case Management Program
(21) Airport Marina Counseling Service7891 La Tijera Blvd
Los Angeles,CA90045 		95-2224149 501(c)(3) 9,000       Comprehensive Mental Health Services for Low Incom
(22) Alameda County1000 San Leandro Blvd 300
San Leandro,CA94577 		94-6000501 GOVT ENTITY 44,000       Let's CHAT Pregnancy
(23) Alameda County Deputy Sheriff's Assoc16378 E 14th St 101
San Leandro,CA94578 		83-0410537 GOVT ENTITY 16,500       Urban Garden Party
(24) Alameda County Health Care Foundation2001 Broadway M
Oakland,CA94602 		94-3103136 501(c)(3) 87,500       Capacity Bldg; Cardiac Care Proj
(25) Albert Schweitzer Fellowship Inc330 Brookline Ave
Boston,MA02215 		13-1982786 501(c)(3) 63,333       The Los Angeles Schweitzer Fellows Program
(26) Albertina Kerr Centers Foundation Inc424 NE 22nd Ave
Portland,OR972322809 		93-1297104 501(c)(3) 15,000       Crisis Psychiatric I Care Program
(27) Aldea Inc3299 Claremont Way
Napa,CA945583382 		94-2159248 501(c)(3) 20,000       Therapy Program
(28) Alexandria House426 South Alexandria Ave
Los Angeles,CA90020 		95-4809755 501(c)(3) 10,000       Counseling Program for Homeless Women and Children
(29) All for Health Health for All519 E Broadway
Glendale,CA91205 		95-4773684 501(c)(3) 10,000       Outreach Program to Uninsured Youth
(30) Al-Shifa Clinic Inc2034-B Mallory St
San Bernardino,CA92407 		33-0855769 501(c)(3) 65,000       general operating support
(31) AltaMed Health Services Corp500 Citadel Dr 490
Los Angeles,CA90040 		95-2810095 501(c)(3) 9,400       HIV/AIDS Oral Health Care Expansion Project
(32) Alternatives for Better Living701 School St
Napa,CA94559 		94-3306094 501(c)(3) 7,241       Teen Anger Mgmt & Violence Prevention
(33) Alzheimer's Association or No CA and Nevada1060 La Avenida St
Mountain View,CA940431422 		94-2897949 501(c)(3) 35,000       Community Education
(34) Alzheimer's Disease and Related Disorders Associat17771 Cowan 200
Irvine,CA92614 		95-3702013 501(c)(3) 12,000       Alzheimer's Association: Physician Outreach and Ed
(35) Alzheimer's Services of the East Bay561 A St
Hayward,CA94541 		94-3081330 501(c)(3) 10,000       Prevention and Management of Diabetes and Cardiova
(36) Ambrose Recreation and Park District3105 Willow Pass Rd
Bay Point,CA945653217 		94-1622656 GOVT ENTITY 18,000       Garden Project; After School Staff Wellness
(37) American Cancer Society1710 Webster
Oakland,CA94604 		94-1170350 501(c)(3) 46,978       Community Giving Campaign on behalf of Northern Ca
(38) American Diabetes Association4600 Roseville Rd 130
Sacramento,CA95660 		13-1623888 501(c)(3) 41,185       Father of the Year; World Diabetes Day
(39) American Diabetes Association Inc5060 Shoreham Dr 100
San Diego,CA92122 		13-1623888 501(c)(3) 15,000       Por tu Familia: Diabetes Awareness and Prevention
(40) American Heart Assoc East Bay Division426 17th St 300
Oakland,CA946122816 		13-5613797 501(c)(3) 163,070       Start! Bay Area Heart Walk
(41) American Heart Association Inc816 South Figueroa St
Los Angeles,CA90017 		13-5613797 501(c)(3) 10,000       event support
(42) American Lung Association in CA424 Pendleton Way
Oakland,CA94621 		94-0362650 501(c)(3) 70,000       Oakland Kicks Asthma; So Alameda Asthma Management
(43) American Lung Association in California1570 East 17th St
Santa Ana,CA92705 		94-0362650 501(c)(3) 10,000       Southern California Asthma Management Program (SCA
(44) American Lung Association of California441 Mac Kay Dr
San Bernardino,CA92408 		94-0362650 501(c)(3) 10,000       Comprehensive School-Based Asthma Management : Ope
(45) American Red Cross Bay Area85 Second St 8th Fl
San Francisco,CA941053459 		94-3045430 501(c)(3) 36,000       CPR Saturday
(46) Antelope Valley College Foundation3041 West Ave K
Lancaster,CA935365426 		95-4398700 501(c)(3) 10,000       Antelope Valley College Counseling Center Program
(47) Antelope Valley Community Clinic45074 10th St West 109
Lancaster,CA93534 		26-0574826 501(c)(3) 75,000       Diabetes Self Management Education and Community O
(48) Antelope Valley Domestic Violence Council1150 West Ave I
Lancaster,CA93539 		95-3582588 501(c)(3) 10,000       Sexual Assault Response Service Program
(49) Antelope Valley Partners for Health45104 10TH St West
Lancaster,CA93534 		47-0957404 501(c)(3) 15,000       Asthma Management Project Program
(50) APPLE FamilyWorks4 Joseph Court
San Rafael,CA949032609 		94-2540980 501(c)(3) 10,000       Explorando La Maternidad Juntas/ Exploring Motherh
(51) ARC Riverside8138 Mar Vista Court
Riverside,CA92504 		95-1907771 501(c)(3) 10,000       The NineZero Project
(52) Area Agency on Aging Serving Napa Solano400 Contra Costa St
Vallejo,CA945905950 		94-2742309 501(c)(3) 25,000       Latino Outreach Coordinator
(53) Arrowhead United Way646 North D St
San Bernardino,CA92402 		95-1934586 501(c)(3) 13,000       Community Health Awareness Program
(54) Arthritis Association of Kern County1800 Westwind Dr Bldg 500
Bakersfield,CA93301 		95-3669747 501(c)(3) 10,000       IMPROVING THE CHRONIC DISEASE MANAGEMENT AND PREVE
(55) Ashland Free Medical Clinic50 E Lewelling San Lorenzo HS Room
San Lorenzo,CA94580 		68-0554276 501(c)(3) 7,000       Diabetes and Asthma Project
(56) Asian & Pacific Islander Wellness Center730 Polk St 4th Fl
San Francisco,CA941097813 		94-3096109 501(c)(3) 15,000       Community Education & Screening Program grant
(57) Asian American Recovery Services1115 Mission Rd
South San Francisco,CA940801302 		94-3007538 501(c)(3) 35,000       Community Outreach & Engagement Program
(58) Asian Americans for Community Involvement2400 Moorpark Ave 300
San Jose,CA951282680 		94-2292491 501(c)(3) 23,220       Senior Wellness Program; Annual Fundraising Lunche
(59) Asian Community Center of Sacramento Valley7311 Greenhaven Dr 187
Sacramento,CA95831 		94-2271380 501(c)(3) 22,791       Chronic Disease Self Management Program
(60) Asian Community Mental Health Board310 8th St 201
Oakland,CA946076526 		94-2248390 501(c)(3) 17,500       Anniversary Gala and Awards Ceremony; Healthy Eati
(61) Asian Pacific American Legal Center of Southern Ca1145 Wilshire Blvd Second Fl
Los Angeles,CA90017 		95-3854152 501(c)(3) 9,450       27th Anniversary Dinner
(62) Asian Pacific Health Care Venture Inc1530 Hillhurst Ave 200
Los Angeles,CA90027 		95-4177752 501(c)(3) 75,000       2009 KP QI Initiative
(63) Asian Resources Inc5709 Stockton Blvd
Sacramento,CA958241613 		94-2658135 501(c)(3) 6,320       Anniversary Dinner; CACHE Program
(64) Aspiranet400 Oyster Point Blvd 501
South San Francisco,CA940807600 		94-2442955 501(c)(3) 18,000       CRREST
(65) Assistance League of Redlands700 E Redlands Blvd U-290
Redlands,CA92374 		95-2131653 501(c)(3) 15,000       Dental Center
(66) Assistance League of San Bernardino580 West 6th St
San Bernardino,CA92410 		95-6065105 501(c)(3) 15,000       Children's Dental Health Center
(67) Asthma Resource Center of San Francisco Inc527 Baker St
San Francisco,CA941025411 		94-3320216 501(c)(3) 25,000       Grant: Reduce Asthma Disparities and Model Cultura
(68) Aurora Dawn Foundation4766 Serra Ave
Fremont,CA945381135 		94-3183217 501(c)(3) 15,000       GFV Nutrition and Education
(69) Axis Community Health Inc4361 RailRoad Ave
Pleasanton,CA945666611 		94-2232394 501(c)(3) 30,000       Leadership Develop Grant; Access to Health Care fo
(70) Azusa Pacific University901 E Alosta Ave
Azusa,CA91702 		95-1744369 501(c)(3) 21,500       Healthcare Outreach for the Homeless at ESGVCH Eme
(71) Bakersfield City School District Educational Found1300 Baker St
Bakersfield,CA933054399 		77-0235399 501(c)(3) 10,000       Building a Healthy Body
(72) Baldwin Park Unified School District4640 North Maine Ave
Baldwin Park,CA91706 		95-6000213 GOVT ENTITY 12,500       The Moveable Feast
(73) Baldwin Park Unified School District4640 North Maine Ave
Baldwin Park,CA91706 		95-6000213 GOVT ENTITY 22,500       The Moveable Feast - Nutrition Education in the Co
(74) Bay Area After School All Stars514 Valley Way
Milpitas,CA950354106 		77-0441284 501(c)(3) 15,000       Fit for Learning
(75) Bay Area Bicycle Coalition571 Valley St
San Francisco,CA94131 		94-3023347 501(c)(3) 35,000       Bike to Work Day
(76) Bay Area Community Resources171 Carlos Dr
San Rafael,CA949032005 		94-2346815 501(c)(3) 28,500       Marin Smoke-Free Cities Proj; Grant-Straight Forwa
(77) Bay Area Council Foundation201 California St
San Francisco,CA94111 		20-1826827 501(c)(3) 80,600       Annual Dinner Hall of Fame
(78) Bay Area Partnership for Children and Youth1611 Telegraph Ave 404
Oakland,CA94612 		04-3653529 501(c)(3) 75,000       Summer Learning and Wellness Initiative
(79) Bay Area Rescue Mission2114 Macdonald Ave
Richmond,CA948013311 		94-6124054 501(c)(3) 50,000       Essential Services Program
(80) Bay Area Sports Organizing Committee81 Encina Ave upper Fl
Palo Alto,CA94301 		94-3052945 501(c)(3) 10,000       Senior Games
(81) Bay Area Womens Sports Initiative1922 The Alameda 100
San Jose,CA95126 		55-0897084 501(c)(3) 35,348       Programs in Gilroy; Expanding BAWSI Girls program
(82) Benicia Community Action Council480 Military East
Benicia,CA945102813 		68-0294153 501(c)(3) 7,500       Senior's Home Delivered Meals project
(83) Benicia Unified School District350 East K St
Benicia,CA945103437 		30-0385724 GOVT ENTITY 20,000       Nutrition Education Program
(84) Bethany Services1600 East Truxton Ave
Bakersfield,CA93305 		95-2858936 501(c)(3) 50,000       David L. Harmon Center
(85) Big Brothers Big Sisters Northwest1827 NE 44th Ave 100
Portland,OR97213 		93-1303640 501(c)(3) 7,500       African American Mentoring Program
(86) Big Brothers Big Sisters of Central CA905 N Fulton St
Fresno,CA937283411 		94-1668376 501(c)(3) 25,260       Mentoring Children of Prisoners
(87) Big Brothers Big Sisters of North Bay Inc1652 West Texas Ave 201
Fairfield,CA945335952 		94-2502278 501(c)(3) 20,000       Operation Thrive Mentoring Program
(88) Big Brothers Big Sisters of Ventura County Incorpo445 Rosewood St Q
Fillmore,CA93010 		20-3425568 501(c)(3) 15,000       One Step a La Vez Towards a Healthier Me!
(89) Bikes Belong Foundation1928 Pearl St
Boulder,CO80302 		20-4306888 501(c)(3) 45,000       Safe Routes to School National Partnership 2010-20
(90) Bill Wilson Center3490 The Alameda
Santa Clara,CA950504333 		94-2221849 501(c)(3) 15,000       2nd Street One-Stop Drop -In Center
(91) Black Coalition on AIDS2800 Third St
San Francisco,CA941073502 		94-3098879 501(c)(3) 10,000       Grant - Treatment Adherence ABC's
(92) BOSTON UNIVERSITY85 East Newton St
Boston,MA02118 		04-2103547 501(c)(3) 148,287       Pass Through from Northern California region for v
(93) Boys & Girls Club of Fontana7723 Almeria Ave
Fontana,CA92336 		33-0443344 501(c)(3) 10,000       SMART Moves (Skills Mastery and Resistance Trainin
(94) Boys & Girls Club of Redlands Inc1251 Clay St
Redlands,CA92374 		95-6187083 501(c)(3) 10,000       Triple Play (Childhood Overwight)
(95) Boys & Girls Club of San Gabriel Valley2740 Mountain View Rd
El Monte,CA91732 		95-2307624 501(c)(3) 15,000       Serving the needs of the Hungry
(96) Boys & Girls Clubs North San Mateo County201 West Orange Ave
South San Francisco,CA940804445 		94-1497000 501(c)(3) 30,000       Nutrition, Cooking and Fitness Programs
(97) Boys & Girls Clubs of Huntington Valley16582 Brookhurst St
Fountain Valley,CA92708 		95-6192466 501(c)(3) 10,000       Triple Play: A Game Plan for the Mind, Body, and S
(98) Boys & Girls Clubs of Silicon518 Valley Way
Milpitas,CA95035 		94-1294898 501(c)(3) 22,500       Triple Play: Mind Body Soul
(99) Boys & Girls Clubs of Southwest County28790 Pujol St
Temecula,CA92590 		33-0475756 501(c)(3) 8,000       Triple Play at Alberhill Ranch Clubhouse
(100) Boys and Girls Club of Greater Sacramento5212 Lemon Hill Ave
Sacramento,CA95824 		68-0338324 501(c)(3) 5,299       Summer Program; Triple Play- Sponsor a Kid
(101) Boys and Girls Club of Petaluma203 Maria Dr
Petaluma,CA949542301 		94-1244390 501(c)(3) 10,920       SMART MOVES; Annual Crab Feed
(102) Boys and Girls Club of the Coastside600 Church St
Half Moon Bay,CA94019 		94-3193725 501(c)(3) 9,500       Healthy Eating - Active Training
(103) Boys and Girls Clubs of Anaheim Inc311 East Broadway
Anaheim,CA92805 		33-0356284 501(c)(3) 10,000       Motel Kids Outreach Program
(104) Boys and Girls Clubs of Carson2255 E 220th St 175
Long Beach,CA90810 		33-0475452 501(c)(3) 10,000       Triple Play
(105) Boys and Girls Clubs of Greater Sacramento5212 Lemon Hill Ave
Sacramento,CA95824 		68-0338324 501(c)(3) 19,840       Gang Prevention Support; Triple Play
(106) Breast Cancer Connections390 Cambridge Ave
Palo Alto,CA94306 		77-0417605 501(c)(3) 20,000       The Gabriella Patser Program
(107) Breast Cancer Emergency Fund12 Grace St 300
San Francisco,CA941032607 		20-3203899 501(c)(3) 18,750       this Old Bag
(108) Breathe CA Golden Gate Public Health Partn2171 Junipero Serra Blvd 720
Daly City,CA940141982 		94-0836760 501(c)(3) 9,500       Breath of Life Walk; 2010 Clean Air Awards;
(109) Breathe CA of Sacramento-Emigrant Trails909 12th St
Sacramento,CA958142931 		94-1641240 501(c)(3) 25,500       Emigrant Trails Bike Trek; Asthma Toolkit 'Your As
(110) Breathe California of the Bay Area1469 Park Ave
San Jose,CA951262530 		94-1156307 501(c)(3) 15,000       Children's Asthma Program
(111) Brighter Beginnings2648 International Blvd
Oakland,CA94601 		94-2949749 501(c)(3) 62,000       Self-Care IS Health Care, Staff Wellness Retreat;
(112) Building a Generation129 East Vine St
Redlands,CA92373 		54-2104001 501(c)(3) 10,000       Family Focus Mental Health Initiative
(113) Buttonwillow Union School District42600 Highway 58
Buttonwillow,CA93206 		95-6000425 GOVT ENTITY 10,000       Buttonwillow Union School District Family Resource
(114) Calif Center for Public Health Advocacy1947 Galileo Ct 101
Davis,CA956184882 		95-4723901 501(c)(3) 46,366       CA Convergence-CA Beverage Policy Campaign
(115) California Academy of Family Physicians Foundation1520 Pacific Ave
San Francisco,CA941092627 		94-2938597 501(c)(3) 20,000       2010 Family Medicine Summit
(116) California Association of Food Banks1624 Franklin St 722
Oakland,CA94612 		68-0392816 501(c)(3) 100,000       Better Nutrition Through Food Banking: Healthy Ea
(117) California Black Chamber Foundation2951 Sunrise Blvd 175
Rancho Cordova,CA95742 		68-0416294 501(c)(3) 10,000       Business Economic Summit & Scholarship Awards Banq
(118) California Black Women's Health Project101 North La Brea Ave 610
Inglewood,CA90301 		95-4702923 501(c)(3) 7,500       Policy Summit
(119) California Center For Public Health Advocacy1947 Galileo Ct 101
Davis,CA956184882 		95-4723901 501(c)(3) 166,667       Healthy Eating Active Living Cities Campaign
(120) California Community Foundation445 South Figueroa St 3400
Los Angeles,CA90071 		95-3510055 501(c)(3) 11,000,000       The Southern California Kaiser Permanente Fund for
(121) California Dragon Boat Association268 Bush St 888
San Francisco,CA94104 		52-2153488 501(c)(3) 10,000       San Francisco International Boat Festival
(122) California Elected Women's Assoc for Education268 Bush St 888
San Francisco,CA94104 		51-0184448 501(c)(3) 10,000       2010 Event and (Statewide)
(123) California Family Health Council Inc3600 Wilshire Blvd 600
Los Angeles,CA900102603 		95-2564024 501(c)(3) 205,000       Core Support
(124) California Food Policy Advocates436 14th St 1220
Oakland,CA946122723 		94-3163142 501(c)(3) 325,000       Nutrition Policy for Healthy Eating in Hard Times
(125) California Institute for Nursing and Health Care663 13th St 300
Oakland,CA94612 		82-0570413 501(c)(3) 395,000       Los Angeles Simulation Collaborative
(126) California Parenting Institute3650 Standish Ave
Santa Rosa,CA954078113 		94-2541640 501(c)(3) 11,580       Child Abuse Treatment Project (CHAT); 4-A-Child Ev
(127) California Primary Care Association1231 I St 400
Sacramento,CA95814 		94-3215565 501(c)(3) 425,000       Core Support; Nutrition Policy for Healthy Eating
(128) California Public Health Association North555 - 12th St 10th Fl
Oakland,CA946074046 		94-3111992 501(c)(3) 10,000       Building CPHA-N Operational Capacity
(129) California School Health Centers Assoc1203 Preservation Park Way 302
Oakland,CA94612 		94-3201896 501(c)(3) 105,000       Strengthening School Health Centers in West Contra
(130) California State Univ Fresno Foundation4910 N Chestnut Ave
Fresno,CA93726 		94-6003272 501(c)(3) 13,800       Health Career Connections
(131) California State University Bakersfield9001 Stockdale Highway
Bakersfield,CA93311 		77-0314545 GOVT ENTITY 25,000       Community Preventative Health Collaborative
(132) California State University Northridge Foundation18111 Nordhoff St
Northridge,CA913308285 		95-6196006 501(c)(3) 85,000       Faculty Enhancement Program
(133) California WIC Association1107 Ninth St 625
Sacramento,CA95814 		68-0271696 501(c)(3) 100,000       Core Operating Support
(134) Camarillo Health Care District3639 E Las Posas Rd 117
Camarillo,CA93010 		95-2834854 GOVT ENTITY 90,000       Ventura County Healthier Living Program Expansion
(135) Cangress530 S Main St
Los Angeles,CA90013 		02-0661629 501(c)(3) 10,000       Health Promotion and Education
(136) Caring Connections Collaborative16703 S Clark Ave
Bellflower,CA90706 		33-0953881 501(c)(3) 21,000       Caring Connections Support for Students
(137) Cascadia Behavioral Healthcare Inc874 NE 19th
Portland,OR97207 		93-0770054 501(c)(3) 50,000       Families and Children Together
(138) Catalyst Foundation for Aids Awareness and Care44758 Elm Ave
Lancaster,CA93534 		77-0357456 501(c)(3) 15,500       ACE Study-Based, Trauma Informed Primary Medical C
(139) Catholic Charities of Santa Clara County2625 Zanker Rd
San Jose,CA951342130 		94-2762269 501(c)(3) 92,000       Day Break Respite & Caregiver Support Services; Es
(140) Catholic Charities of the Diocese Oakland433 Jefferson St
Oakland,CA946073592 		94-2677202 501(c)(3) 80,000       Multicultural Senior Svc Network-Health Promotion;
(141) Catholic Charities of the Diocese Sta Rosa987 Airway Court
Santa Rosa,CA954032048 		94-2479393 501(c)(3) 50,000       Essential Services Program - Emergency Services fo
(142) Catholic Charities of the Diocese Stockton400 12th St 4
Modesto,CA953542410 		94-1629114 501(c)(3) 78,876       Children's Health Initiative; Food Stamp Outreach
(143) Catholic Charities San BernardinoRiverside1450 North D St
San Bernardino,CA92405 		95-3516461 501(c)(3) 16,000       Hope in the City-Healthcare Initiative
(144) Catholic Healthcare West185 Berry St 300
San Francisco,CA94107 		94-1196203 501(c)(3) 80,000       Quality Improvement in Perinatal Care to Reduce Di
(145) Center for Community Health & Well-Being1900 T St
Sacramento,CA958116822 		68-0248303 501(c)(3) 20,000       Access to Healthcare
(146) Center for Domestic Peace734 A St
San Rafael,CA949013923 		94-2415856 501(c)(3) 20,000       Women?s Community Advocacy Project
(147) Center for Healthcare Decisions3400 Data Dr
Rancho Cordova,CA956707956 		68-0441958 501(c)(3) 10,000       Putting POLST into Action
(148) Center for Human Development391 Taylor Blvd 120
Pleasant Hill,CA945232275 		94-2520840 501(c)(3) 52,444       Wellness Challenge; Teens Nix Tobacco; Enrollment
(149) Center for Individual and Family Counseling5445 Laurel Canyon Blvd
North Hollywood,CA91607 		51-0204566 501(c)(3) 7,500       CIFC School Based Mental Health Program
(150) Center for the Pacific Asian Family Inc543 North Fairfax Ave 108
Los Angeles,CA90036 		95-3532351 501(c)(3) 11,000       Domestic Violence Intervention Program for API sur
(151) Center Joint Unified School District3401 Scotland Dr
Antelope,CA95843 		94-6002490 GOVT ENTITY 8,000       Healthy Eating Active Living Program
(152) Center on Policy Initiatives3727 Camino Del Rio South 100
San Diego,CA92108 		33-0824881 501(c)(3) 75,000       expansion of health care coverage for low-income p
(153) Centinela Youth Services Inc11539 Hawthorne Blvd Fl 5
Hawthorne,CA90250 		95-3821576 501(c)(3) 9,500       Student Police and Diversity Dialogues
(154) Central City Concern232 NW 6th Ave
Portland,OR97209 		93-0728816 501(c)(3) 80,000       Recuperative Care Program (RCP)
(155) Central City Lutheran Mission1354 North G St
San Bernardino,CA92405 		33-0634580 501(c)(3) 11,000       Mental Health Services for HIV+ Underserved Person
(156) Central Valley Childrens Services Network1911 North Helm
Fresno,CA937271614 		77-0026968 501(c)(3) 54,467       Ages & Stages Assessment Proj; Huron Family Resour
(157) Central Valley Health Network Inc2000 O St 100
Sacramento,CA95811 		68-0429643 501(c)(3) 47,000       Promising Practices Forum & Annual CVHN Conference
(158) Centralia School District6625 La Palma Ave
Buena Park,CA90620 		95-6000552 GOVT ENTITY 10,000       Expansion of Health Services to Danbrook Neighborh
(159) Centro Binacional para Desarrollo Indigena744 N Abby St
Fresno,CA937011051 		77-0337939 501(c)(3) 30,000       Na Yivi Daatun Uvi: Gente Saludable 2
(160) Centro de Salud-HEW 1 San Ysidro Health Center4004 Beyer Blvd
San Ysidro,CA92173 		95-2801772 501(c)(3) 72,000       Support for 990 uninsured patients
(161) Cesar E Chavez Foundation634 S Spring St 400
Los Angeles,CA90014 		77-0379630 501(c)(3) 9,175       10th Annual Si Se Puede 'Yes We Can' Awards Dinner
(162) Chabot College Foundation25555 Hesperian Blvd 220
Hayward,CA94545 		20-0027721 501(c)(3) 20,000       Chabot College Empower; Kreative Korner Creative A
(163) Charles Drew University of Medicine & Science1731 E 120th St
Los Angeles,CA90059 		95-6151774 501(c)(3) 10,000       Saturday Science Academy
(164) Child & Family Center Foundation21545 Centre Pointe Parkway
Santa Clarita,CA91350 		95-4705370 501(c)(3) 8,400       School-Based Mental Health Prevention and Early In
(165) Child Abuse Prevention Council Sacramento4700 Roseville Rd
North Highlands,CA956605143 		94-2833431 501(c)(3) 27,150       Infant Safe Sleeping Campaign; Inspirations Boogi
(166) Child Advocates of Silicon Valley509 Valley Way Bldg 2
Milpitas,CA950354105 		77-0250773 501(c)(3) 15,000       Healthy Choices for Foster Youth
(167) Child Care Coordinating Council San Mateo2121 S El Camino Real A-100
San Mateo,CA944031819 		94-2226587 501(c)(3) 26,741       Child Care Food Program; Child Care Coordinating C
(168) Childhood Matters221 Oak St B
Oakland,CA946074511 		26-0098527 501(c)(3) 43,300       Childhood Matters and Nuestros Ninos Radio Shows
(169) Children Now1212 Broadway 5th Fl
Oakland,CA946121805 		94-3059243 501(c)(3) 30,000       Expanding California Children's Access to and Use
(170) Children's Cancer Association433 NW 4th Ave 100
Portland,OR97209 		93-1181662 501(c)(3) 15,000       LifeSupport Family Enrichment Program
(171) Childrens Dental Center300 South Buckthorn St
Inglewood,CA90301 		95-4533883 501(c)(3) 12,000       Dental Home Initiative
(172) Childrens Dental Foundation455 E Columbia St
Long Beach,CA90806 		95-2111124 501(c)(3) 20,000       A Dental Home for Underserved Children
(173) Children's Health Initiative Napa County2610 Jefferson St 110
Napa,CA94559 		25-1924934 501(c)(3) 16,000       Anniversary Benefit Celebration
(174) Children's Hospital & Research Ctr Oakland747 52nd St
Oakland,CA94618 		94-0382330 501(c)(3) 10,000       Camp Breathe Easy; Asthma Forum
(175) Children's Network of Solano County2320 Courage Dr 107
Fairfield,CA94533 		68-0014506 501(c)(3) 8,640       Family Centered Asthma Education Program
(176) Children's Service Fund9680 Citrus Ave
Fontana,CA92334 		33-0035918 501(c)(3) 15,000       Immediate Dental and Medical Assistance for Childr
(177) Chinatown Service Center767 North Hills St 400
Los Angeles,CA90012 		95-2918844 501(c)(3) 135,000       39th Anniversary Dinner & Silent Auction
(178) Christian Help Center2166 Sacramento St
Vallejo,CA94592 		94-2825148 501(c)(3) 50,000       2010 Essential Services Program
(179) Christie's Place Inc2440 Third Ave
San Diego,CA92101 		91-1878632 501(c)(3) 12,000       Coordinated Service Center
(180) City of Baldwin Park14403 E Pacific Ave
Baldwin Park,CA91706 		95-6005574 GOVT ENTITY 22,491       PRIDE Platoon
(181) City of Fontana16860 Valencia Ave
Fontana,CA92335 		95-6004770 GOVT ENTITY 10,000       Healthy Fontana: Expand Healthy Jr. Chef Program
(182) City of Fremont3300 Capitol Ave Bldg B
Fremont,CA94538 		94-6027361 GOVT ENTITY 30,000       Health Prevention and Maintenance Classes for Seni
(183) City of Fresno770 North San Pablo Ave
Fresno,CA93728 		94-6000338 GOVT ENTITY 60,000       Healthy Lifestyle Fitness Camp
(184) City of La Mesa4975 Memorial Dr
La Mesa,CA91942 		95-6000731 GOVT ENTITY 30,000       Local Partnership Grant: Ready...Set...Live Well P
(185) City of Livermore1052 S Livermore Ave
Livermore,CA945684813 		94-6000359 GOVT ENTITY 35,000       Cooking Together; Live Well Livermore Healthy City
(186) City of Long Beach Department of Health and Human2525 Grand Ave
Long Beach,CA90815 		95-6000733 GOVT ENTITY 50,000       Weed and Seed Youth Leadership Program
(187) City of Montclair5111 Benito St
Montclair,CA91763 		95-6005731 GOVT ENTITY 65,000       Capacity Building
(188) City of Oakland Department of Human Svc150 Frank Ogawa Plaza 4223
Oakland,CA94612 		94-6000384 GOVT ENTITY 15,000       Summer Food Service Prog;
(189) City of Oakland Office of the MayorOne Frank H Ogawa Plaza 3rd Fl
Oakland,CA946121932 		94-6000384 GOVT ENTITY 20,000       Mayor's Summer Job Program
(190) City of Pasadena - Public Health Department1845 N Fair Oaks Ave Rm 2408
Pasadena,CA91103 		95-6000759 GOVT ENTITY 50,000       Scholastic Partnership for Immunization Initiative
(191) City of Portland OregonCity Hall 1221 SW 4th Ave Rm 110
Portland,OR97204 		93-6002236 GOVT ENTITY 147,000       Sunday Parkways
(192) City of Sacramento Ofc of Youth DevelopmentCity Hall 915 I St 5th Fl
Sacramento,CA95814 		94-6000410 GOVT ENTITY 106,160       Street Outreach Program
(193) City of San Bernardino1350 South E St
San Bernardino,CA92408 		95-6000772 GOVT ENTITY 25,000       City of San Bernardino Open Swim and Learn-to-Swim
(194) City of Union City34009 Alvarado-Niles Rd
Union City,CA94587 		94-6036941 GOVT ENTITY 18,000       10th Street Community Center
(195) Clinica Sierra Vista1430 Truxtun Ave Fourth Fl
Bakersfield,CA93301 		95-2707101 501(c)(3) 113,937       2009 KP QI Initiative
(196) Clovis Unified School District1450 Herndon Ave
Clovis,CA93611 		94-2840774 GOVT ENTITY 10,000       Medical Supplies for School Based Health Centers
(197) Coalition of Orange County Community Clinics17701 Cowan Ave 220
Irvine,CA92614 		95-2900725 501(c)(3) 265,000       expand access to specialty care services
(198) Coastside Adult Day Health Center645 Correas
Half Moon Bay,CA940191962 		94-2935784 501(c)(3) 11,000       Memory Enhancement Prog; Donation to purchase medi
(199) Coastside Medical Dental Clinics210 San Mateo Rd 104
Half Moon Bay,CA940191708 		94-3390196 501(c)(3) 9,047       Helping Seniors Smile
(200) Coalition for Livable Future107 SE Washington 239
Portland,OR97214 		93-1278845 501(c)(3) 20,000       Regional Atlas 2.0: Disease & Health Outcome Data
(201) Collaborative Autism Training Support ProgSSU-Psychology 1801 East Cotati Ave
Rohnert Park,CA94928 		99-0157509 GOVT ENTITY 6,000       Child & Family Autism Support & Community Educatio
(202) COLUMBIA UNIVERSITY1700 Broadway
New York,NY10019 		13-1624202 501(c)(3) 160,209       Pass Through from Northern California region for v
(203) Committee For Economic Development2000 L Street NW 700
Washington,DC20036 		13-1623973 501(c)(3) 10,000       charitable donations
(204) Common Ground - The Westside HIV Community Center2012 Lincoln Blvd
Santa Monica,CA90405 		95-4460765 501(c)(3) 6,000       HIV Care Services
(205) CommuniCare Health Centers2051 John Jones Rd
Davis,CA956169701 		94-2188574 501(c)(3) 40,000       Integrated Behavioral Health Program
(206) Communities Advocating Emerging AIDS Relief1718 1/2 Florida Ave NW
Washington,DC200091361 		94-2922039 501(c)(3) 7,250       Partnership Award Reception
(207) Community Action Marin29 Mary St
San Rafael,CA94901 		94-6136365 501(c)(3) 7,500       Breast Cancer Awareness
(208) Community Action Partnership of Kern300 19th St
Bakersfield,CA93301 		95-2402760 501(c)(3) 40,000       Piccolo Xpress Chemistry Analyzer
(209) Community Action Partnership of San Bernardino Cou696 South Tippecanoe Ave
San Bernardino,CA92415 		95-2376882 501(c)(3) 30,000       Healthy Eating In Hard Times: San Bernardino Count
(210) Community Action Partnership of Sonoma Co1300 North Dutton Ave
Santa Rosa,CA954014610 		94-1648949 501(c)(3) 10,000       Healthy Communities
(211) Community Alliance with Family Farmers Fdtn36355 Russell Blvd
Davis,CA95616 		94-2914745 501(c)(3) 50,000       Supporting Local Food System Activities in Norther
(212) Community Chaplaincy7812 El Reno Ave
Elverta,CA95626 		20-0241444 501(c)(3) 15,000       Four volunteer academies for 2011-2012
(213) Community Child Care Coord Council Alameda22351 City Center Dr 200
Hayward,CA94541 		23-7218859 501(c)(3) 31,500       4C?s Asthma Friendly Environments for Children;
(214) Community Child Care Council of Sonoma Co131-A Stony Circle 300
Santa Rosa,CA94501 		94-2274620 501(c)(3) 10,143       Healthy Habits for Life
(215) Community Choices1101 Broadway 110
Vancouver,WA98660 		91-2094479 501(c)(3) 25,000       Building Health Equity in our Community - Enhancin
(216) Community Clinic Association of Los Angeles County1055 Wilshire Blvd 1400
Los Angeles,CA90017 		95-4576023 501(c)(3) 176,500       2011 Consortia Core Operating Support
(217) Community Clinics Health Network7535 Metropolitan Dr
San Diego,CA92108 		33-0759107 501(c)(3) 500,000       Project A-L-L
(218) Community Coalition For Substance Abuse Prevention8101 South Vermont Ave
Los Angeles,CA90044 		95-4298811 501(c)(3) 25,000       20th Anniversary Gala Dinner
(219) Community Cycling Center1700 NE Alberta
Portland,OR97211 		93-1127186 501(c)(3) 15,000       Pride - A media advocacy campaign to change percep
(220) Community Family Guidance Center10929 South St 208B
Cerritos,CA90703 		95-3083776 501(c)(3) 10,000       CFGC Parenting Groups
(221) Community Health Alliance of Pasadena1855 North Fair Oaks Ave 200
Pasadena,CA91103 		95-4536824 501(c)(3) 9,400       2010 Fundraising Gala
(222) Community Health Awareness Council711 Church St
Mountain View,CA940412030 		94-2223670 501(c)(3) 18,800       Challenge Team Champions for Youth Breakfast
(223) Community Health Councils Inc3731 Stocker St 201
Los Angeles,CA90008 		95-4487664 501(c)(3) 30,000       Local Partnership Grant: Improve access and qualit
(224) Community Health Partners1452 Hudson St 208
Longview,WA98632 		91-2016542 501(c)(3) 25,000       Cowlitz Free Medical Center
(225) Community Health Systems Inc22675 Alessandro Blvd
Moreno Valley,CA92553 		33-0056551 501(c)(3) 65,000       Capacity Building Funds
(226) Community Initiatives354 Pine St 700
San Francisco,CA94104 		94-3255070 501(c)(3) 10,000       Grant - Get-Moving, Get-Well, Get-to-the-Doctor
(227) Community Institute for Psychotherapy1330 Lincoln Ave 201
San Rafael,CA949012141 		94-2499583 501(c)(3) 10,000       Help for Disadvantaged Families and Individuals at
(228) Community Medical Centers Inc (EIP)7210 Murray Dr
Stockton,CA952103339 		94-2437106 501(c)(3) 98,389       Support Svcs; Chronic Disease Self Management Prog
(229) Community Partners1000 North Alameda St 240
Los Angeles,CA90012 		95-4302067 501(c)(3) 785,000       Technical Assistance Provider
(230) Community Partnership Families-San Joaquin4707 Kentfield Rd C
Stockton,CA95207 		68-0475602 501(c)(3) 140,000       Mobile FRC; Essential Services Prog-Proj Family Ec
(231) Community Pride Project5625 Stockton Blvd
Sacramento,CA95824 		20-0364162 501(c)(3) 27,450       Increased Access to Care Through Peer Based Outrea
(232) Community Resource Project Inc250 Harris Ave
Sacramento,CA95838 		94-2280427 501(c)(3) 50,000       Essential Services Program - Utility Assistance Su
(233) Community Resources for Independent Living439 A St
Hayward,CA945415013 		94-2598873 501(c)(3) 12,000       Healthy Living Workshops and Medical Services Case
(234) Community Services Agency204 Stierlin Rd
Mountain View,CA940434618 		94-1422465 501(c)(3) 17,000       Senior Services Case Management
(235) Community Services Planning Council909 12th St 200
Sacramento,CA95814 		94-1201196 501(c)(3) 105,000       Children's Report Card; People's Guide to Health,
(236) Community Settlement Association of Riverside4366 Bermuda Ave
Riverside,CA925075040 		95-0642985 501(c)(3) 15,000       project support - Counseling and Assessment for Family effectiveness
(237) Community Svc Educ & Research Fund (CSERF)5380 Elvas Ave
Sacramento,CA958192300 		23-7003581 501(c)(3) 15,000       SPIRIT Partnership
(238) Comprehensive Youth Services of Fresno Inc3795 E Shields Ave
Fresno,CA937267029 		94-2219412 501(c)(3) 50,000       John Steinbeck Elementary School Student Assistan
(239) Conejo Free Clinic80 East Hillcreast Dr 102
Thousand Oaks,CA91360 		95-3177953 501(c)(3) 7,500       Medical Services Program
(240) Congressional District Programs Inc6201 Leesburg Pike
Falls Church,VA22044 		65-0970090 501(c)(3) 10,000       Diabetic Amputation Prevention Foundation's Black
(241) Continuing Development Incorporated111 North Market St 500
San Jose,CA95113 		94-2376637 501(c)(3) 37,000       5 Keys Classes- Health Referrals
(242) Contra Costa Child Care Council1035 Detroit Ave 200
Concord,CA945182478 		94-2383037 501(c)(3) 23,750       Sponsorship of Rethink Your Drink Contra Costa
(243) Contra Costa County50 Douglas Dr
Martinez,CA945534098 		94-6000509 GOVT ENTITY 65,500       Project HOPE; Monument Nutrition Exercise & Wellne
(244) Contra Costa County Office of Education77 Santa Barbara Rd
Pleasant Hill,CA945234215 		94-2675635 GOVT ENTITY 20,000       Community Challenge
(245) Contra Costa Crisis CenterPO BOX 3364
Walnut Creek,CA94598 		94-1747227 501(c)(3) 72,000       211 Contra Costa; Employee Wellness Prog
(246) Contra Costa Interfaith Sponsoring Comm724 Ferry St
Martinez,CA945531624 		68-0361176 501(c)(3) 17,250       Community Health Project
(247) COPE Family Center1340 Fourth St
Napa,CA945592924 		94-2322399 501(c)(3) 20,000       Home Visitation Program
(248) Cope Health Solutions2400 South Flower St Lowman Buildin
Los Angeles,CA90007 		47-0864952 501(c)(3) 27,000       2010 Annual Awards Gala
(249) Coppertower Family Medical Center Inc6 Tarman Dr
Cloverdale,CA954253932 		68-0345901 501(c)(3) 15,000       Every Body In, No Body Out
(250) CORA (Comm Overcoming Relationship Abuse)1633 Bayshore Highway 280
Burlingame,CA940101515 		94-2481188 501(c)(3) 47,830       Helping Hands Event; Donation to reproduce and pri
(251) Cornerstone Community Development Corp1395 Bancroft Ave
San Leandro,CA945775103 		94-3100741 501(c)(3) 30,000       Building Futures Free from Family Violence
(252) CORO Northern California Inc601 Montgomery St 800
San Francisco,CA941112611 		94-3117758 501(c)(3) 59,560       Exploring Leadership - Operational Support
(253) Coro Southern California Inc1000 N Alameda St 240
Los Angeles,CA90012 		95-4274561 501(c)(3) 11,500       35th Annual Crystal Eagle Awards Gala Dinner
(254) Corona-Norco Family Young Mens Christian Associati1331 River Rd
Corona,CA92882 		95-2879893 501(c)(3) 14,000       UNITY HELPS - Healthy Eating and Lifestyle Program
(255) Council of Community Clinics7535 Metropolitan Dr
San Diego,CA92108 		95-3008850 501(c)(3) 400,000       Specialty Care Initiative Phase II: San Diego Spec
(256) Council Of Orange County Society Of St Vincent De8014 Marine Way
Irvine,CA926182235 		95-3033494 501(c)(3) 45,000       Healthy Eating In Hard Times: Second Harvest Food
(257) Council on Aging Services for Seniors30 Kawana Springs Rd
Santa Rosa,CA954046309 		94-6138714 501(c)(3) 10,000       Transportation for Seniors grant
(258) County of Kern1700 Mount Vernon Ave
Bakersfield,CA93305 		95-6000925 501(c)(3) 450,000       Specialty Care Initiative Phase II: Decentralize s
(259) County of Los Angeles Department of Public Health313 N Figueroa St 8th Fl Room 806
Los Angeles,CA90012 		95-6000927 GOVT ENTITY 105,000       Child Obesity Prevention
(260) County of Orange - Social Services Agency888 North Main St
Santa Ana,CA92701 		95-6000928 GOVT ENTITY 75,000       Healthy Eating In Hard Times: One-e-App Orange Cou
(261) County of San Bernardino120 Carousel Mall
San Bernardino,CA92415 		95-6002748 GOVT ENTITY 50,000       Federally Qualified Health Center (FQHC) Strategic
(262) County of San Diego Health & Human Services Agency1700 Pacific Highway
San Diego,CA921012417 		95-6000934 GOVT ENTITY 20,000       TB Testing Among HIV/AIDS Population
(263) County of Santa Clara1400 Parkmoor 120B
San Jose,CA95126 		94-6000533 501(c)(3) 28,500       Walk & Bike to School Week
(264) County of Ventura2323 Knoll Dr 3rd Fl
Ventura,CA93003 		95-6000944 GOVT ENTITY 330,000       Local Partnership Grant: Community Gardens
(265) Court Appointed Special Advocates Fresno Co1252 Fulton Mall
Fresno,CA937211916 		77-0401361 501(c)(3) 52,500       Advocating for Healthy and Successful Lives for Ad
(266) Court Appointed Special Advocates of Kern County2000 24th St 130
Bakersfield,CA93301 		77-0344298 501(c)(3) 10,000       Middle Years Health and Wellness Project
(267) Cover The Homeless Ministry1332 South Orange Dr
Los Angeles,CA90019 		91-2094255 501(c)(3) 7,000       Life with a Purpose
(268) CSULA University Auxiliary Services Inc5151 State University Dr FA 130
Los Angeles,CA90032 		95-4016653 501(c)(3) 74,160       Health Policy Outreach Center (HPOC)
(269) Culver City Education FoundationPO Box 4178
Culver City,CA90231 		95-3641300 501(c)(3) 9,000       CCEF is a charitable non-profit organization dedic
(270) Daly City Peninsula Partnership Collaborat101 Lake Merced Blvd
Daly City,CA940151048 		06-1734338 501(c)(3) 26,000       HART Program: Healthy Aging Response Team
(271) Darin M Camarena Health Centers344 E 6th St
Madera,CA936383631 		94-2503904 501(c)(3) 6,000       Annual Scholarship Fundraiser; Natl Health Center
(272) Delta 2000301 West 10th St 2
Antioch,CA94509 		68-0420357 Other 21,000       Get Fit
(273) Desarollo Familiar205 39th St
Richmond,CA948052212 		94-2751073 501(c)(3) 30,000       Proyecto Bienestar; Youth Matters
(274) Desert AIDS Project1695 North Sunrise Way
Palm Springs,CA92262 		33-0068583 501(c)(3) 30,000       Counseling, Testing and Referral Program
(275) DIVA Foundation9000 Sunset Blvd 709
West Hollywood,CA90069 		95-4419536 501(c)(3) 52,500       Ladies First; DIVAS Simply Singing
(276) Dixon Family Services155 N 2nd St
Dixon,CA95620 		68-0041829 501(c)(3) 17,000       Mental Health Continuum of Care Project
(277) Dixon Unified School District180 South First St 6
Dixon,CA956203447 		32-0183755 GOVT ENTITY 20,000       Health Access & Oral Health Improvement
(278) Doctors Medical Center Foundation730 McHenry Ave
Modesto,CA953505413 		51-0140385 501(c)(3) 49,988       Prevention of Type 2 Diabetes in Children Through
(279) Downey Unified School District co True Lasting Co13220 Bellflower Blvd
Downey,CA90242 		95-6006586 GOVT ENTITY 20,000       Access to Health Care Services
(280) Drug Abuse Alternatives Center2403 Professional Dr 102
Santa Rosa,CA95403 		94-1694676 501(c)(3) 7,000       The Perinatal Day Treatment Prog; Annual Addiction
(281) Dunwoody United Methodist Church Inc1548 Mt Vernon Rd
Dunwoody,GA30338 		58-1994231 501(c)(3) 6,250       Charitable Donation
(282) Early Childhood Mental Health Program4101 Macdonald Ave
Richmond,CA948052333 		94-2883469 501(c)(3) 20,000       Los Buenos Padres
(283) Earth Team2525 10th St Unit B
Berkeley,CA94710 		68-0347329 501(c)(3) 25,000       An Air pollution and Asthma Research and Action Pr
(284) East Bay Agency for Children303 Van Buren Ave
Oakland,CA94610 		94-1358309 501(c)(3) 10,000       Child Assault Prevention
(285) East Co Faith Based Subcom Child Welfare4549 Delta Fair Blvd
Antioch,CA945093950 		20-8682635 501(c)(3) 15,000       Kitchen starter sets/Food boxes
(286) East County Kids-N-Motion3444 Chandler Circle
Bay Point,CA945656913 		41-2207708 501(c)(3) 10,000       IMPLEMENTATION PROJECT FOR EAST COUNTY KIDS - N -
(287) East San Gabriel Valley Coalition for the HomelessSt John Vianney Church 1345 Turnbul
Hacienda Heights,CA91745 		95-4508436 501(c)(3) 18,000       Emergency Assistance Center
(288) East Valley Community Health Center Inc420 South Glendora Ave
West Covina,CA91790 		23-7068586 501(c)(3) 325,437       Specialty Care Initiative Phase II.
(289) Eating Disorders Resource Center2105 S Bascom Ave 220
Campbell,CA95008 		68-0616393 501(c)(3) 12,500       Every Body's Beautiful Essay contest & ED Awarenes
(290) Eden I&R Inc570 B St
Hayward,CA94541 		94-2339050 501(c)(3) 50,000       211 Alameda County
(291) Eden Youth & Family Center680 West Tennyson Rd
Hayward,CA94544 		94-2442586 501(c)(3) 9,300       Healthy Alternatives for a New Start
(292) El Centro de Accion Social37 E Del Mar Blvd
Pasadena,CA91105 		51-0192257 501(c)(3) 35,000       2010 Summer School in the Park Program
(293) El Centro de Libertad1230 A Hopkins
Redwood City,CA940621674 		94-3189174 501(c)(3) 15,000       Youth Intervention Program
(294) El Concilio del Condado de Ventura301 South C St
Oxnard,CA930305808 		95-3792795 501(c)(3) 7,500       Youth for Success
(295) El Concilio of San Mateo County1419 Burlingame Ave N
Burlingame,CA940104122 		94-2772110 501(c)(3) 20,000       'Nuestro Canto de Salud' Project
(296) El MonteSo El Monte Emergency Resources Associati2645 Lee Ave 6
South El Monte,CA91733 		95-6097318 501(c)(3) 9,500       Meeting Health Needs to Strengthen Families
(297) El Sol Neighborhood Educational Center1717 West 5th St
San Bernardino,CA92401 		33-0552297 501(c)(3) 20,000       Promotores de Salud/Community Health Promoters
(298) El Viento Foundation17261 Oak Lane
Huntington Beach,CA92647 		33-0905269 501(c)(3) 10,000       El Viento Swim Program: Encouraging Healthful Livi
(299) Elementary Institute of Science608 51ST St
San Diego,CA92114 		94-1669545 501(c)(3) 20,779       Project Safeway
(300) Elk Grove Food Bank Services8820 Elk Grove Blvd
Elk Grove,CA956241876 		38-3664737 501(c)(3) 10,000       Mobile Pantry
(301) Elk Grove Unified School District9510 Elk Grove-Florin Rd
Elk Grove,CA956241801 		94-6002501 GOVT ENTITY 61,174       Don't Buy the Lie; Student Health Access and Refer
(302) Emergency Housing Consortium Santa Clara Co507 Valley Way
Milpitas,CA95035 		94-2684272 501(c)(3) 50,000       Medical Respite Program
(303) Emergency Shelter Program Inc1180 B St
Hayward,CA94541 		94-2212241 501(c)(3) 11,000       ESP Community Health Outreach; Annual Dinner and A
(304) Enroll America1201 New York Avenue NW 1100
Washington,DC20005 		27-1661221 501(c)(3) 75,000       Charitable donations
(305) Essential Health Clinic266 West Main St
Hillsboro,OR97123 		38-3672046 501(c)(3) 25,000       Maintaining Hillsboro Clinic Service Level
(306) Evergreen Habitat for Humanity521 E 33rd St
Vancouver,WA98660 		91-1557462 501(c)(3) 8,500       Women's Build
(307) Every Neighborhood Partnership7676 N Palm 101
Fresno,CA937115783 		87-0814198 501(c)(3) 7,500       Off The Front Bicycle Program
(308) Explorit Science Center2801 2nd St
Davis,CA956187717 		68-0010584 501(c)(3) 12,300       Corporate Science Challenge
(309) Face to Face Sonoma County AIDS873 Second St
Santa Rosa,CA954044621 		68-0052664 501(c)(3) 11,500       Art for Life
(310) Fairfield Police Activity League1250 Travis Blvd 350
Fairfield,CA945334836 		26-1184406 GOVT ENTITY 20,000       Biggest Winner
(311) Fairfield-Suisun Community Action Council416 Union Ave
Fairfield,CA94533 		68-0041385 501(c)(3) 30,000       Interim Care Program-Solano County
(312) Fairfield-Suisun Unified School District2490 Hillborn Rd
Fairfield,CA94533 		94-6001297 GOVT ENTITY 15,000       Eat Healthy Be Healthy Program
(313) Faith In Action3303 Whitemarsh Lane
Fairfield,CA945347135 		68-0431992 501(c)(3) 15,000       Children's Health Access Program
(314) Familia Unida Living with Multiple Sclerosis4716 East Cesar E Chavez Ave
Los Angeles,CA90022 		91-1898199 501(c)(3) 7,000       Health Access Personal Investment (H.A.P.I. )
(315) Families Forward9221 Irvine Blvd
Irvine,CA92618 		33-0086043 501(c)(3) 11,310       Community Cares Program
(316) Family Bridges Inc168 11th St
Oakland,CA946074841 		94-1725018 501(c)(3) 6,854       Superstar Benefit Concert
(317) Family Emergency Shelter Coalition21455 Birch St 5
Hayward,CA94541 		94-3029991 501(c)(3) 10,000       Annual Shelter Shuffle Walk
(318) Family Health Care Centers of Greater Los Angeles6501 South Garfield Ave
Bell Gardens,CA90201 		95-1641454 501(c)(3) 23,000       Diabetic Podiatric Care
(319) Family Health Centers of San Diego Inc823 Gateway Center Way
San Diego,CA92102 		95-2833205 501(c)(3) 40,000       City Heights Family Health Center Project
(320) Family Service Agency of San Bernardino1669 North E St
San Bernardino,CA92405 		95-1641436 501(c)(3) 10,000       Therapeutic Counseling and Educational Support Ser
(321) Family Service Agency of San Francisco1010 Gough St
San Francisco,CA941097622 		94-1156530 501(c)(3) 10,000       Grant - Healthy Families Healthy Lives
(322) Family Service Agency of Sonoma County Inc751 Lombardi Court C
Santa Rosa,CA954076793 		94-1617635 501(c)(3) 10,000       The Culturally Sensitive Intern Training and Affor
(323) Family Service Association of Redlands612 Lawton St
Redlands,CA92374 		95-1655614 501(c)(3) 10,000       Healthy Families
(324) Family Services of the Desert Inc81-711 Hwy 111 101
Indio,CA92201 		95-2549152 501(c)(3) 15,000       Mental Health Counseling
(325) Family Violence Law CenterPO Box 22009
Oakland,CA946232009 		94-2527939 501(c)(3) 16,712       Stand for Peace
(326) Feeding America San Diego9151 Rehco Rd B
San Diego,CA921213288 		26-0457477 501(c)(3) 45,000       Healthy Eating In Hard Times: Cold Storage for Fre
(327) Fighting Back Partnership505 Santa Clara St 3rd Fl
Vallejo,CA94590 		68-0298092 501(c)(3) 35,000       Vallejo Family Strengthening Project
(328) Filipinos for Affirmative Action Inc310 8th St 306
Oakland,CA946076526 		94-2218907 501(c)(3) 30,660       Katarungan: Rooted and Rising
(329) Folsom Cordova Unified School District909 Mormon St
Folsom,CA956302412 		94-6002505 GOVT ENTITY 30,000       SPARK Program; Free Summer Lunch Program
(330) Food Bank of Contra Costa and Solano4010 Nelson Ave
Concord,CA945201200 		94-2418054 501(c)(3) 58,490       Farm 2 Kids prog; An Afternoon in the Admiral's Ga
(331) Food In Need of Distribution Inc83775 Citrus Ave
Indio,CA92201 		33-0006007 501(c)(3) 49,420       Healthy Eating In Hard Times: Food Stamp Outreach
(332) FOOD Inc3403 East Central Ave
Fresno,CA937252542 		77-0320851 501(c)(3) 100,000       BackPack Program
(333) FOOD Share Inc4156 Southbank Rd
Oxnard,CA93036 		77-0018162 501(c)(3) 40,000       Healthy Eating In Hard Times: SNAP Outreach
(334) Foothill AIDS Project233 W Harrison Ave
Claremont,CA91711 		33-0341665 501(c)(3) 20,000       Integrated Treatment Program for People Living wit
(335) Foothill Family Service2500 E Foothill Blvd 300
Pasadena,CA91107 		95-1690990 501(c)(3) 14,000       Adolescent Family Life Program
(336) Foothill Family Shelter Inc1501 W Ninth St D
Upland,CA91786 		33-0341818 501(c)(3) 11,000       Bright Smiles for Bright Futures
(337) Foothill Unity Center415 West Chestnut Ave
Monrovia,CA91016 		95-4310817 501(c)(3) 15,000       Dental Care for Children
(338) Foundation for AIDS Research120 Wall St 13th Fl
New York,NY10005 		13-3163817 501(c)(3) 10,000       San Francisco Fall Gala
(339) Foundation for the California State University San5500 University Parkway
San Bernardino,CA924072318 		95-6067343 501(c)(3) 10,000       Weighing Your Choices Initiative
(340) Fred Finch Youth Center3800 Coolidge Ave
Oakland,CA946023311 		94-0474080 501(c)(3) 20,000       Trauma-Informed Evidenced-Based Services
(341) Free Clinic Of Simi Valley2060 Tapo St
Simi Valley,CA93063 		23-7108154 501(c)(3) 25,000       support to expand primary care services
(342) Free Clinic of SW Washington4100 Plomondon St
Vancouver,WA98661 		91-1707542 501(c)(3) 7,500       Clinic Operation - MLK Day
(343) Fresh Approach5060 Commercial Circle A
Concord,CA94520 		26-2438206 501(c)(3) 82,000       Spring Into Health; Farmers' Market Food Stamp Inc
(344) Fresno Child Abuse Prevention Council924 N Van Ness Ave
Fresno,CA937282428 		94-2788744 501(c)(3) 7,575       Shaken Baby Syndrome Project
(345) Fresno County Econ Opportunities Commission1920 Mariposa Mall 300
Fresno,CA937211312 		94-1606519 501(c)(3) 115,000       SOUL (School of Unlimited Learning) - Career Choic
(346) Fresno Healthy Communities Access Partners2043 Divisadero St
Fresno,CA93701 		20-4210175 501(c)(3) 50,000       OERU III Partnership
(347) Fresno Philharmonic Association2377 West Shaw Ave 101
Fresno,CA937113438 		94-1309738 501(c)(3) 15,000       Youth and Family Concerts
(348) Fresno Rescue Mission310 G St
Fresno,CA937063421 		94-1279785 501(c)(3) 5,500       Wellness Program
(349) Fresno Street Saints1727 L St
Fresno,CA937211119 		90-0388971 501(c)(3) 34,080       Summer Youth Employment Training
(350) Fresno Unified School District4784 E Dayton Ave
Fresno,CA937266406 		94-6002206 GOVT ENTITY 33,100       New Nursing and Medical Supplies for Special Needs
(351) Friends For Youth Inc1741 Broadway
Redwood City,CA94063 		94-2961034 501(c)(3) 9,000       Alcohol, Drug, and Violence Prevention Project
(352) Friends of Children with Special Needs2300 Peralta Blvd
Fremont,CA94539 		77-0446853 501(c)(3) 9,700       The Biggest Loser and Healthiest Winner
(353) Full Circle Treatment Center730 Sunrise Ave 250
Roseville,CA95661 		20-8680425 501(c)(3) 25,000       Intensive Outpatient Treatment Scholarship/Sliding
(354) Fuller Theological Seminary135 North Oakland
Pasadena,CA91182 		95-1699394 501(c)(3) 25,000       Mental Health Services
(355) GEISINGER CLINIC100 N Academy Ave
Danville,PA178224400 		23-6291113 501(c)(3) 108,007       Pass Through from Northern California region for v
(356) Generations Community Wellness Centers1250 Oakmead Parkway 109
Sunnyvale,CA94085 		20-0737711 501(c)(3) 40,000       Early Childhood Movetrition
(357) GEORGETOWN UNIVERSITY2121 Wisconsin Ave
Washington,DC20007 		53-0196603 501(c)(3) 44,203       Pass Through from Northern California region for v
(358) Gilda's Club of the Desert625 E Palm Canyon Dr 7A
Cathedral City,CA92234 		33-0911108 501(c)(3) 15,000       Basic III Plus Cancer Survivor Program
(359) Girl Scouts of Central California South1377 West Shaw Ave
Fresno,CA93711 		94-6000662 501(c)(3) 15,000       Girls of Healthy Futures
(360) Girls Incorporated of Alameda County13666 East 14th St
San Leandro,CA945782538 		94-1558073 501(c)(3) 17,000       HEART; WOW!
(361) Girls Incorp of W Contra Costa County260 Broadway
Richmond,CA94804 		51-0172193 501(c)(3) 8,000       Sexual Health/STD Prevention Forum
(362) Give Every Child A Chance610 Commerce Court
Manteca,CA953365068 		68-0399384 501(c)(3) 42,544       Eating Appropriately Teaches Success
(363) Giving Back Hope IncPO Box 31337
Los Angeles,CA90031 		43-2060726 501(c)(3) 8,000       Annual Outreach Event and Monthly Lunches
(364) Glendale Community Free Health Clinic134 N Kenwood St
Glendale,CA91206 		87-0732681 501(c)(3) 10,000       Disease management for Free Clinic patients
(365) Glide Memorial United Methodist Church330 Ellis St 4th Fl 418
San Francisco,CA94102 		94-1156481 501(c)(3) 50,000       2010 Essential Services Program - Glide Integrated
(366) Go kids Inc8120 Arroyo Circle
Gilroy,CA95020 		94-2535812 501(c)(3) 20,000       Viva La Vida
(367) Golden State Warriors Foundation1011 Broadway
Oakland,CA946074019 		94-3253780 501(c)(3) 75,000       Corporate HEAL Get Fit Timeout
(368) Goodwill Serving the People of Southern Los Angele800 W Pacific Coast Highway
Long Beach,CA90806 		95-1644017 501(c)(3) 25,000       Healthcare Training Program
(369) Gospel Center Rescue Mission Inc445 S San Joaquin St
Stockton,CA952033537 		94-1375835 501(c)(3) 79,672       New Life Addiction Treatment Program
(370) Governor's Council on Physical Fitness and SportsPO Box 25445
Los Angeles,CA90025 		20-1937322 501(c)(3) 150,000       Charitable donations
(371) Grandparents as Parents Inc22048 Sherman Way 217
Canoga Park,CA91303 		33-0592916 501(c)(3) 17,500       Spanish Language Support Services for Kinship Care
(372) Grossmont-Cuyamaca Community College District Auxi8800 Grossmont College Dr
El Cajon,CA920201799 		33-0905402 501(c)(3) 50,000       Counseling and case management support for healthc
(373) GROUP HEALTH COOPERATIVE1730 Minor Ave
Seattle,WA98101 		91-0511770 501(c)(3) 654,124       Pass Through from Northern California region for v
(374) Group Health FoundationPO Box 34590
Seattle,WA98124 		91-1246278 501(c)(3) 10,000       Charitable donations
(375) Growing Gardens2003 NE 42nd Ave 3
Portland,OR97213 		93-1213728 501(c)(3) 12,500       Home Garden Program
(376) Guru Granth Sahib Foundation Inc1805 Hill Ave
Hayward,CA94541 		94-3157327 501(c)(3) 8,000       Health Improvement Project
(377) H Street Clinic1329 North H St
San Bernardino,CA92405 		20-8191393 501(c)(3) 78,000       Capacity building
(378) Habitat for Humanity Fresno County2219 San Joaquin
Fresno,CA93721 		77-0076649 501(c)(3) 15,000       MLK Jr Day of Service 2010 - Fresno
(379) Habitat for Humanity Portland Metro East1478 NE Killingsworth
Portland,OR972110527 		93-0801200 501(c)(3) 10,000       Portland Pride Build
(380) Habitat for Humanity Stanislaus630 Kearney Ave
Modesto,CA95354 		77-0233512 501(c)(3) 15,000       MLK Jr Day of Service 2010( Central Valley) - Mode
(381) Hamburger Home7120 Franklin Ave
Los Angeles,CA90046 		95-1693616 501(c)(3) 10,000       Therapeutic Component in Residential Treatment for
(382) Hands On Bay Area135 Bluxome St 2nd Fl
San Francisco,CA94107 		77-0195144 501(c)(3) 97,500       MLK Day of Service (San Mateo/So San Francisco)
(383) Harbor Area Gang Alternatives Program Inc309 W Opp St
Wilmington,CA90744 		33-0322451 501(c)(3) 15,000       Gangfree Life Middle School Gang Prevention Progra
(384) Harbor City-Harbor Gateway Boys & Girls Club1220 West 256th St
Harbor City,CA90710 		33-0450797 501(c)(3) 13,000       Gateway/Torrance and Harbor Gateway-Gardena Expans
(385) Harbor Free Clinic Inc593 W 6th St
San Pedro,CA90731 		23-7103245 501(c)(3) 9,500       Prenatal Care, up to 36 weeks
(386) Harriett Buhai Center for Family Law3250 Wilshire Blvd 710
Los Angeles,CA90010 		95-3943493 501(c)(3) 12,000       Community College Domestic Violence Outreach and E
(387) HARVARD PILGRIM HEALTH CAREPO Box 3672
Boston,MA022413672 		04-2452600 501(c)(3) 257,591       Pass Through from Northern California region for v
(388) HARVARD UNIVERSITY1350 Massachusetts Ave
Cambridge,MA02138 		04-2103580 501(c)(3) 43,094       Pass Through from Northern California region for v
(389) Hathaway-Sycamores Child and Family Services210 South DeLacey Ave 110
Pasadena,CA91105 		95-1691005 501(c)(3) 10,000       Center for Grief & Loss
(390) Hayward Community Gardens25051 Whitman St
Hayward,CA94544 		94-2440240 501(c)(3) 6,000       HumanHealth in Correlation to Environmental Health
(391) Hayward Unified School District24411 Amador St
Hayward,CA94540 		94-1693499 GOVT ENTITY 20,000       Not the City for Obesity
(392) HC2 The Healthy Community Consortium200 Douglas St
Petaluma,CA94952 		68-0475211 501(c)(3) 15,000       Annual Partnership Funding
(393) Health Care Interpreter Network6400 Hollis St 9
Emeryville,CA94608 		26-3075264 501(c)(3) 150,000       Core Support for the HCIN
(394) Health Educ Council Serving Pop At Risk3950 Industrial Blvd 600
West Sacramento,CA956916509 		68-0249296 501(c)(3) 25,000       South Sacramento Farm Stand
(395) Health Education Research and Evaluation Foundatio9370 Chesapeake Dr 220
San Diego,CA92123 		33-0496092 501(c)(3) 100,000       San Diego County Childhood Obesity Initiative
(396) HEALTH PARTNERS RESEARCHPO Box 1524
Minneapolis,MN554401524 		41-1670163 501(c)(3) 225,618       Pass Through from Northern California region for v
(397) Health Professions Education Foundation400 R St 460
Sacramento,CA958116213 		68-0178150 501(c)(3) 60,000       Allied Healthcare Scholarship Program
(398) Health Research Association Inc1640 Marengo St 7th Flr
Los Angeles,CA90033 		95-1683862 501(c)(3) 300,000       Specialty Care Initiative Phase II: Camino De Salu
(399) HEALTH RESEARCH INCPO Box 2966
Buffalo,NY142402966 		14-1402155 501(c)(3) 198,563       Pass Through from Northern California region for v
(400) Healthcare Foundation6230 Claremont Ave
Oakland,CA94618 		86-1174825 501(c)(3) 60,000       Models of Healthcare Interpreting
(401) Healthy Aging Association121 Downey Ave 102
Modesto,CA953541235 		77-0546574 501(c)(3) 35,000       'Young at Heart' Fall Prevention Education/Outreac
(402) Healthy Smiles for Kids of Orange County10602 Chapman Ave 200
Garden Grove,CA92840 		38-3675065 501(c)(3) 20,000       Increasing Access to Care - Healthy Smiles' IV Sed
(403) Healthy Smiles Mobile Dental Foundation1275 West Shaw 101
Fresno,CA937113710 		77-0530538 501(c)(3) 46,600       Smiles for Migrant Children
(404) Heart of Los Angeles Youth Inc2701 Wilshire Blvd
Los Angeles,CA90057 		95-4397418 501(c)(3) 7,000       Youth and Family Counseling Program
(405) Helen Vine Detox Center301 Smith Ranch Rd
San Rafael,CA94903 		91-1767175 501(c)(3) 10,000       Operational support
(406) HENRY FORD HEALTH SYSTEM1 Ford Place-5C69
Detroit,MI48202 		38-1357020 501(c)(3) 80,693       Pass Through from Northern California region for v
(407) Herald Family Rebuilding Center39155 Liberty St D450
Fremont,CA94538 		26-1431045 501(c)(3) 10,000       Break The Silence
(408) Hispanas Organized Political Equality CA634 South Spring St 920
Los Angeles,CA900143903 		95-4718409 501(c)(3) 13,800       Latinas Action Day and Corporate Sponsorship 2010
(409) Hispanic College Fund Inc1301 K St NW 450-A West
Washington,DC20005 		52-1809680 501(c)(3) 25,000       2010 Los Angeles Hispanic Youth Institute Kick Off
(410) Hmong Women's Heritage Association2245 Florin Rd
Sacramento,CA95822 		68-0350323 501(c)(3) 5,500       Youth Leadership Training, Hmong Health Family Hea
(411) Hollywood Community Housing Corporation5020 Santa Monica Blvd
Los Angeles,CA90029 		95-4198215 501(c)(3) 7,000       Supportive Services / Group Therapy
(412) Hollywood Sunset Free Clinic3324 Sunset Blvd
Los Angeles,CA90026 		23-7074488 501(c)(3) 8,500       Access To Primary Care Program
(413) Holy Family Day Homes of San Francisco299 Dolores St
San Francisco,CA94103 		94-1156492 501(c)(3) 15,000       Charitable Donation
(414) Hooked On Nature4848 San Felipe Rd 150-230
San Jose,CA95135 		68-0628398 501(c)(3) 15,000       The Learning Project
(415) Hope Productions Foundation2020 Hurley Way 185
Sacramento,CA95825 		26-2365867 501(c)(3) 10,000       2011 Grant Applicant Training
(416) Horizon House Inc22652 Second St
Hayward,CA94541 		94-2365021 501(c)(3) 5,500       Gay Prom June 12, 2010
(417) Horn of Africa Community in North America5296 University Ave F
San Diego,CA92105 		33-0696380 501(c)(3) 26,000       Families Together Program
(418) House of Ruth IncPO Box 459
Claremont,CA91711 		95-3276033 501(c)(3) 10,000       Child Abuse Treatment Program
(419) Huckleberry Youth Programs Inc3310 Geary Blvd
San Francisco,CA941183324 		94-1687559 501(c)(3) 25,000       Huckleberry Wellness Academy - Marin
(420) Hughson Family Resource Center Inc2413 3rd St
Hughson,CA953260234 		87-0729778 501(c)(3) 47,200       Neighborhood Connections for Southeast Stanislaus
(421) Human Options Inc5540 Trabuco Rd 100
Irvine,CA92620 		95-3667817 501(c)(3) 12,500       Low Cost Counseling for Domestic Violence Victims
(422) Hunger Action Los Angeles961 S Mariposa 205
Los Angeles,CA90006 		20-5142259 501(c)(3) 25,000       General support
(423) ICLEI - Local Governments for Sustainability USA180 Canal St 401
Boston,MA02114 		04-3116623 501(c)(3) 25,000       Greenhouse gas inventories program
(424) Imperial Beach Community Clinic949 Palm Ave
Imperial Beach,CA91932 		23-7209592 501(c)(3) 33,854       Sustains family practice residency providers parti
(425) Indian Health Center of Santa Clara Valley1333 Meridian Ave
San Jose,CA951255212 		94-2476242 501(c)(3) 20,000       American Indian Elders Wellness Program
(426) Individuals Now Inc Soc Advocates for Youth3440 Airway Dr E
Santa Rosa,CA954032065 		94-1711490 501(c)(3) 20,000       Cloverdale Environmental Prevention Program
(427) Inland Congregations United for Change Sponsoring1441 North D St 208
San Bernardino,CA924054730 		33-0480298 501(c)(3) 75,000       Healthy Living in San Bernardino and Healthy Foods
(428) Inland Counties1737 Atlanta Ave H5
Riverside,CA92507 		23-7058717 501(c)(3) 10,000       The Pink Ribbon Place Free Mammography Program
(429) Inland Counties Regional Center1365 S Waterman
San Bernardino,CA92408 		23-7121672 501(c)(3) 20,000       Access to Medical/Health Services and Equipment Pr
(430) Inland Valley Council of Churches1753 N Park Ave
Pomona,CA91768 		95-2674837 501(c)(3) 10,000       Urban Gleaning Network Study and Pilot Project
(431) INMED Partnerships for Children Inc409 East Palmer St
Compton,CA90221 		52-1482339 501(c)(3) 23,000       Teen Pregnancy and STD Prevention Mentoring Progra
(432) InnVision The Way Home1900 The Alameda 400
San Jose,CA951252344 		77-0033628 501(c)(3) 40,000       Healthcare for the Homeless; 2010 Essential Svc. P
(433) Inside Out Community Arts Inc2210 Lincoln Blvd
Venice,CA90291 		95-4647876 501(c)(3) 10,000       Neighborhood Arts Program
(434) Institute on Aging3330 Geary Blvd
San Francisco,CA941183347 		94-2978977 501(c)(3) 15,000       2010 Grant - Medication Oversight Program (MOP)
(435) Instituto Familiar De La Raza Inc2919 Mission St
San Francisco,CA941103917 		94-2523608 501(c)(3) 10,000       2010 Grant - La Cultura Cura Case Management Progr
(436) Intercommunity Child Guidance Center dba The Whole10155 Colima Rd
Whittier,CA90603 		95-2031148 501(c)(3) 17,500       general operating support
(437) Interfaith Council of Solano County724 Ohio St
Fairfield,CA945336236 		68-0440432 501(c)(3) 25,000       Mental Health Screening
(438) International Association for Human Values708 Tramway Dr
Milpitas,CA950353607 		52-2178069 501(c)(3) 10,000       YES! in High Schools
(439) International Community Foundation2505 N Ave
National City,CA91950 		26-1640148 501(c)(3) 15,000       Olivewood Gardens
(440) International Rescue Committee Inc5348 University Ave 205
San Diego,CA92105 		13-5660870 501(c)(3) 21,977       Healthy eating interventions for recently-arrived
(441) Interval House6615 E Pacific Coast Highway 170
Long Beach,CA90803 		95-3389113 501(c)(3) 10,000       Interval House Health & Wellness Program for Victi
(442) Irvine Community Alliance Fund1 Civic Center Plaza
Irvine,CA92623 		33-0258368 501(c)(3) 25,000       Irvine Children's Health Program
(443) Jack London Aquatic Center Inc115 Embarcadero
Oakland,CA946065138 		94-3204535 501(c)(3) 15,000       Aquatic Summer Camps
(444) Jefferson Union High School District2780 Junipero Serra Blvd
Daly City,CA940154132 		94-3083772 GOVT ENTITY 27,000       Mental Health Svc; JUHSD-Youth Training Youth
(445) Jewish Community Free Clinic490 City Center Dr
Rohnert Park,CA949282403 		94-3386103 501(c)(3) 16,000       Free Immunizations, Labs and In-House Pharmacy
(446) Jewish Family & Childrens Service of Long Beach-We3801 E Willow St
Long Beach,CA90815 		95-2273033 501(c)(3) 15,000       Low Income Counseling Program
(447) Jewish Family & Children's Svcs East Bay2484 Shattuck Ave 210
Berkeley,CA947042076 		94-3250304 501(c)(3) 32,220       Multicultural Mind-Body Education and Health Navig
(448) Jewish Family and Children's Services600 Fifth Ave
San Rafael,CA949013348 		94-1156528 501(c)(3) 10,000       Care Management for Medically Ill and Disabled Adu
(449) Jewish Family Service of Silicon Valley14855 Oka Rd 202
Los Gatos,CA950321956 		94-2536452 501(c)(3) 15,000       TO LIFE! Healthy Living Program
(450) JWCH Institute Inc1910 West Sunset Blvd 650
Los Angeles,CA90026 		95-2289916 501(c)(3) 177,550       Eligibility Services Program
(451) KFHP CO10350 East Dakota Ave
Denver,CO80231 		84-0591617 501(c)(3) 8,685,089       Reimbursement for various projects
(452) KFHP GA3495 Piedmont Rd NE
Atlanta,GA30305 		58-1592076 501(c)(3) 1,615,658       Reimbursement for various projects
(453) KFHP MAS1 KAISER PLAZA 15L
Oakland,CA946123610 		52-0954463 501(c)(3) 18,900       Reimbursement for various projects
(454) KFHP OH1001 LAKESIDE AVE E 1200
Cleveland,OH441141172 		34-0922268 501(c)(3) 235,047       Reimbursement for various projects
(455) KFHP SCAL393 E Walnut St
Pasadena,CA91188 		94-1340523 501(c)(3) 8,839,512       Reimbursement for various projects
(456) Kern County Children and Families Commission2724 L St
Bakersfield,CA93301 		77-0529128 GOVT ENTITY 20,000       Medically Vulnerable Care Coordination Project
(457) Kidango44000 Old Warm Springs Blvd
Fremont,CA94538 		94-2581686 501(c)(3) 6,500       Healthy Children and Healthy Families Program
(458) Kids Breakfast Club TKBC22542 Second St
Hayward,CA94541 		94-3273619 501(c)(3) 17,000       Healthy Kids, Healthy Future - Newark Program
(459) Kids Come First Community Clinic1501A South Bon View Ave
Ontario,CA91761 		33-0969025 501(c)(3) 65,000       capacity building
(460) Kids Community Clinic of Burbank400 W Elmwood Ave
Burbank,CA91506 		95-4791296 501(c)(3) 12,000       20 Healthy Smiles
(461) KidsFirst7311 Galilee Rd 105
Roseville,CA956787207 		68-0195225 501(c)(3) 26,950       Differential Response: Keeping Kids Safe
(462) Korean American Family Service Center3727 West 6th St 320
Los Angeles,CA90020 		95-3899329 501(c)(3) 6,500       Korean American Family Violence Intervention Progr
(463) KVIE 62030 West El Camino Ave
Sacramento,CA95833 		94-1421463 501(c)(3) 10,000       Collision Course- Teenage Addiction Epidemic
(464) LAS Best200 North Spring St M-120
Los Angeles,CA90012 		95-4311058 501(c)(3) 9,720       15th Annual Family Brunch
(465) La Casa Community Center203 E Mission Rd
San Gabriel,CA91776 		95-1660846 501(c)(3) 14,700       Teen Violence Prevention Project
(466) La Casa De Las Madres1663 Mission St 225
San Francisco,CA941032474 		94-2330864 501(c)(3) 15,000       2010 Grant - Teen Program
(467) La Clinica De La Raza1450 Fruitvale Ave
Oakland,CA94601 		94-1744108 501(c)(3) 161,000       Oakley Satellite Clinic; 6th Annual Pittsburg Bina
(468) La Maestra Family Clinic Inc4185 Fairmount Ave
San Diego,CA92105 		33-0473171 501(c)(3) 40,859       Increase access to medical care to uninsured and l
(469) LA Voice760 S Westmoreland Ave 336
Los Angeles,CA90005 		95-4781974 501(c)(3) 30,000       Local Partnership Grant: Food Access & Safety Proj
(470) Labor's Training and Community Development Allianc4265 Fairmont Ave 210
San Diego,CA92105 		95-6136389 501(c)(3) 25,000       webcam project
(471) LACER Afterschool Programs1718 North Cherokee Ave A
Hollywood,CA90028 		95-3890819 501(c)(3) 12,000       LACER Afterschool Programs
(472) Laguna Honda Hospital Volunteers Inc90 New Montgomery St Fl 11
San Francisco,CA941054514 		94-6065339 501(c)(3) 14,000       Hospital and Rehabilitation Center Gala
(473) LAMP Inc526 San Pedro St
Los Angeles,CA90013 		95-3993742 501(c)(3) 50,000       New Lease on Life Supportive Housing Program
(474) Larkin Street Youth Services701 Sutter St 2
San Francisco,CA941096434 		94-2917999 501(c)(3) 9,250       2010 Paving the Way Gala, March 4, 2010
(475) Latinas Contra Cancer255 North Market St 175
San Jose,CA95112 		56-2412069 501(c)(3) 16,667       National Latino Cancer Summit (Statewide)
(476) Latino Community Foundation225 Bush St 500
San Francisco,CA94104 		81-0564400 501(c)(3) 54,450       Children and Youth Initiative
(477) Latino Health Access1701 N Main St 200
Santa Ana,CA92706 		33-0562943 501(c)(3) 21,500       Core Support for Prevention & Management of Diabet
(478) Latino Health Collaborative1800 Western Ave 402
San Bernardino,CA92411 		02-0778114 501(c)(3) 30,000       Local Partnership Grant: Healthy City Coalition
(479) Latino Leadership Council2945 Bell Rd
Auburn,CA956032540 		27-0970476 501(c)(3) 27,168       CREER en tu Salud Promotora program
(480) Lavender Youth Recreation and Info Center127 Collingwood St
San Francisco,CA941142414 		94-3227296 501(c)(3) 10,000       2010 Grant - 'Let's Talk About Sex': HIV & STI Pre
(481) League of California Cities1400 K St
Sacramento,CA95814 		94-6000835 GOVT ENTITY 8,500       2010 GLBTLO Caucus membership and participation (S
(482) League of Volunteers36120 Ruschin Dr
Newark,CA94560 		94-2638329 501(c)(3) 8,000       Summer Recreation in the Park
(483) Learning and Loving Education Center16890 Church St 16
Morgan Hill,CA95037 		20-3270605 501(c)(3) 10,000       Project Our Future
(484) Legal Aid Society of San Mateo County521 E 5th Ave
San Mateo,CA94402 		94-1451894 501(c)(3) 25,000       Domestic Violence and Abuse Prevention Project
(485) Leukemia & Lymphoma Society Inc The221 Main St 1650
San Francisco,CA94105 		13-5644916 501(c)(3) 25,500       Nike Women's Marathon Contribution; Embracing Surv
(486) Life Foundation677 Ala Moana Blvd 226
Honolulu,HI96813 		99-0230542 501(c)(3) 7,500       Native Hawaiian HIV Prevention and Care Services
(487) LifeLong Medical Care2344 Sixth St
Berkeley,CA947102412 		94-2502308 501(c)(3) 250,000       West Berkeley Family Practice - Renovation & Expan
(488) LIFT3 Support GroupPO BOX 5251 Shelter
Vallejo,CA94590 		87-0723514 501(c)(3) 20,000       Lifestyle Improvements Through Financial Incentive
(489) Lighthouse Counseling & Family Resource Ctr427 A St 400
Lincoln,CA95648 		35-2252834 501(c)(3) 22,500       Safety Net Services Program: Differential Response
(490) Lincoln Child Center4368 Lincoln Ave
Oakland,CA946022529 		94-1156501 501(c)(3) 15,000       Student Resource Center at Barack Obama Academy
(491) Live Oak Adult Day Services1147 Minnesota Ave
San Jose,CA95125 		77-0069106 501(c)(3) 10,000       Adult Day Care
(492) Livermore Valley Joint Unified School Distr685 East Jack London Blvd
Livermore,CA945511855 		94-2175582 GOVT ENTITY 6,000       Healthy Futures: Nosotras en Control/ We are in Ch
(493) Loaves and Fishes of Contra Costa1985 Bonifacio St 100
Concord,CA94520 		68-0018077 501(c)(3) 15,000       Food and supplies to feed the hungry of Contra Cos
(494) Loma Linda UniversityNichol Hall 24951 North Circle Dr
Loma Linda,CA92350 		95-1816009 501(c)(3) 9,050       Healthy People 2011
(495) Los Amigos Research and Education Institute Inc4601 E Imperial Hwy Building 900 A
Downey,CA90242 		95-1911180 501(c)(3) 75,000       2009 KP QI Initiative
(496) Los Angeles Alliance for a New Economy464 Lucas Ave 202
Los Angeles,CA90017 		95-4459427 501(c)(3) 8,875       2010 Annual City of Justice Awards Dinner
(497) Los Angeles Brotherhood Crusade Inc200 E Slauson Ave
Los Angeles,CA90011 		95-2543819 501(c)(3) 10,000       2010 Bremond / Bakewell Pioneer of African America
(498) Los Angeles Conservation Corps605 West Olympic Blvd 450
Los Angeles,CA90015 		95-4002138 501(c)(3) 8,000       EcoAcademy Health Enrichment Team
(499) Los Angeles Free Clinic dba The Saban Free Clinic8405 Beverly Blvd
Los Angeles,CA90048 		95-2539105 501(c)(3) 12,000       Integrated medical, dental, behavioral health, hea
(500) Los Angeles Jewish Aids ServicesPO Box 480241
Los Angeles,CA90048 		95-4232540 501(c)(3) 6,000       Project Chicken Soup
(501) Los Angeles Regional Foodbank1734 E 41st St
Los Angeles,CA900581502 		95-3135649 501(c)(3) 82,200       Healthy Eating In Hard Times: Bolstering Nutrition
(502) Los Angeles Retarded Citizens Foundation29890 N Bouquet Canyon Rd
Santa Clarita,CA91390 		95-2134243 501(c)(3) 7,680       Activities Program
(503) Los Angeles Youth Network1754 Taft St
Los Angeles,CA90028 		95-3953979 501(c)(3) 7,000       Emergency Youth Shelter
(504) LOVELACE CLINIC FOUNDATION2309 Renard Place SE
Albuquerque,NM87106 		85-0392796 501(c)(3) 78,777       Pass Through from Northern California region for v
(505) Lowell Joint School District11019 Valley Home Ave
Whittier,CA90603 		95-6001974 GOVT ENTITY 6,000       Healthy Lifestyle Challenge
(506) Low-Income Families Empowerment Through Ed1880 Fairway Dr
San Leandro,CA94577 		94-3348126 501(c)(3) 15,000       Healthy Mama's, Healthy Families
(507) Loyola Marymount University1 LMU Dr University Hall 4119
Los Angeles,CA90045 		95-1643334 501(c)(3) 50,000       Leadership Initiative
(508) Lutheran Social Service of Northern CA3734 Broadway
Sacramento,CA95817 		94-1659687 501(c)(3) 7,000       Faith and Homeless Families
(509) Making Waves Education Program200-24th St
Richmond,CA948041804 		94-3267851 501(c)(3) 20,000       Mental Health Services for Wave-Makers
(510) Mama's Kitchen1875 Second Ave
San Diego,CA92101 		33-0434246 501(c)(3) 12,000       AIDS Nutrition Program
(511) March of Dimes Foundation1050 Sansome St 4th Fl
San Francisco,CA94111 		13-1846366 501(c)(3) 8,500       Signature Chefs Auction
(512) Marin AIDS Project910 Irwin St
San Rafael,CA949013318 		68-0072470 501(c)(3) 20,000       HIV Harm Reduction
(513) Marin Community Food Bank75 Digital Dr
Novato,CA94949 		68-0044262 501(c)(3) 10,000       Brown Bag Supplemental Food Program for Marin?s Lo
(514) Marin Community Foundation5 Hamilton Landing 200
Novato,CA94949 		94-3007979 501(c)(3) 12,500       Support for Healthy Marin Partnership
(515) Marjaree Mason Center IncCommunity Service Center 1600 M St
Fresno,CA937211122 		94-1156639 501(c)(3) 40,000       Children's Healthy Relationships Program
(516) MARSHFIELD CLINIC RESEARCH1000 North Oak Ave 1R3
Marshfield,WI54449 		39-0452970 501(c)(3) 77,114       Pass Through from Northern California region for v
(517) Marthas Village and Kitchen Inc83791 Date Ave
Indio,CA922014737 		33-0777892 501(c)(3) 20,000       Martha's Medical Clinic
(518) Martin Luther King Jr Freedom Center333 East 8th St
Oakland,CA946062844 		94-3390034 501(c)(3) 50,000       All of Us Around the Table...Together
(519) Mary's Mercy Center IncPO Box 7563
San Bernardino,CA92411 		33-0632426 501(c)(3) 10,000       Installation of a Children's Fitness Zone for Phys
(520) MASSACHUSETTS GENERAL HOSPITAL50 Staniford St
Boston,MA021142696 		04-2697983 501(c)(3) 309,989       Pass Through from Northern California region for v
(521) Mayview Community Health Center270 Grant Ave
Palo Alto,CA943061911 		94-2239648 501(c)(3) 15,000       Services for a Better Life for At Risk Youth
(522) Meals on Wheels Family&Comm Svcs Contra Co1300 Civic Dr
Walnut Creek,CA94596 		68-0044205 501(c)(3) 8,920       Bay Point Exercise Program
(523) Meals on Wheels of San Francisco Inc1375 Fairfax Ave
San Francisco,CA94124 		94-1741155 501(c)(3) 24,500       23th Annual Star Chefs and Vintners, Gala, May 16,
(524) Meals On Wheels of Solano County Inc95 Marina Center
Suisun,CA945852522 		94-2453452 501(c)(3) 20,000       Elder Nutrition Meal Program - Home Delivered Meal
(525) Medshare International2937 Alvarado St
San Leandro,CA94577 		58-2433968 501(c)(3) 50,000       general operating support
(526) MEND10641 N San Fernando Rd
Pacoima,CA91331 		23-7306337 501(c)(3) 25,000       Health Services (Primary Care) Program
(527) Mental Health America of Los Angeles506 W Jackson St
Lancaster,CA93534 		95-1881491 501(c)(3) 6,500       Operation Healthy Homecoming - mental health educa
(528) Mercy Foundation-BakersfieldPO Box 119
Bakersfield,CA93302 		77-0201321 501(c)(3) 10,000       The Children's Health Initiative coordinates activ
(529) Metro600 NE Grand Ave
Portland,OR97232 		93-0636311 501(c)(3) 75,000       Vamanos! Let's explore Cornelius, Forest Grove and
(530) Mexican American Legal Defense and Educational Fun634 S Spring St 11th Fl
Los Angeles,CA90014 		74-1563270 501(c)(3) 9,130       2010 Los Angeles Awards Gala
(531) Midnight Mission601 South San Pedro St
Los Angeles,CA90014 		95-1691293 501(c)(3) 5,500       Mental Health Services with Case Management
(532) Mid-Peninsula Boys & Girls Club Inc200 North Quebec St
San Mateo,CA944010860 		94-1431583 501(c)(3) 20,000       Nutrition and Physical Fitness Program
(533) Mission City Community Network Inc15206 Parthenia St
North Hills,CA91343 		95-4226189 501(c)(3) 10,500       Reducing Health Disparities for Medically Underser
(534) Mission Neighborhood Centers Inc362 Capp St
San Francisco,CA94110 		94-1408150 501(c)(3) 38,500       Anniversary
(535) Mixteco Indigena Community Organizing Project520 West 5th St G
Oxnard,CA93030 		30-0045901 501(c)(3) 15,000       Mixteco Health Care Interpreter Program
(536) Momentum for Mental Health438 N White Rd
San Jose,CA95127 		94-1496052 501(c)(3) 15,000       Southeast Families United Child Development Center
(537) MOMS Orange County1128 W Santa Ana Blvd
Santa Ana,CA92703 		33-0518078 501(c)(3) 24,500       Healthy Beginnings, Bright Futures Luncheon and Aw
(538) Montebello Unified School District123 South Montebello Blvd
Montebello,CA90640 		95-6002104 501(c)(3) 10,000       USC Mobile Dental Free Clinic
(539) Monument Community Partnership1760 Clayton Rd
Concord,CA945202700 		68-0476982 501(c)(3) 41,000       The Neighborhood Action Teams Community Health Le
(540) Monument Crisis Center2350 Monument Blvd B
Concord,CA945206910 		41-2111171 501(c)(3) 31,400       MOCCHA Challenge:Monument-Obesity/Weight, Cancer P
(541) Morrison Center1500 NE Irving St 250
Portland,OR97232 		93-0354176 501(c)(3) 15,000       Trauma-Focused Cognitive Behavioral Therapy
(542) Mountain Health & Community Services IncPO Box 37
Campo,CA91906 		33-0164420 501(c)(3) 37,037       Direct service to fund uninsured and underinsured
(543) Mountain View Whisman School District750-A San Pierre Way
Mountain View,CA94043 		93-0991812 GOVT ENTITY 7,000       Kick Lead Dream Youth Soccer Camp
(544) MOVE International1300 17th St
Bakersfield,CA93301 		94-3227458 501(c)(3) 10,000       MOVE Toiletting Program
(545) Museum of the African Diaspora685 Mission St
San Francisco,CA94105 		94-3338239 501(c)(3) 24,000       Nutrition Education 'Garden Club'
(546) Music in Schools Today582 Market St 213
San Francisco,CA94104 		94-2920480 501(c)(3) 12,000       Gala Soiree
(547) My Sister's House3053 Freeport Blvd 120
Sacramento,CA958184346 		68-0464114 501(c)(3) 15,000       Achieving Through Music
(548) Napa Valley Hospice & Adult Day Services414 South Jefferson St
napa,CA94559 		68-0393144 501(c)(3) 18,000       Latino Specialty Services
(549) NapaSolano SANESART1141 Pear Tree Lane 200
Napa,CA935586486 		68-0285816 501(c)(3) 20,000       Outreach Awareness and Prevention -
(550) National Association of Community Health Centers7200 Wisconsin Ave 210
Bethesda,MD20814 		52-0939952 501(c)(3) 10,000       2010 National Farmworker Health Conference
(551) National Association of Latino Elected Officials N1122 W Washington Blvd 3rd Flr
Los Angeles,CA90015 		52-1212849 501(c)(3) 10,000       2010 National Policy Institute on Healthy Communit
(552) National Coalition Against Domestic Violence1120 Lincoln St 1603
Denver,CO80203 		91-1081344 501(c)(3) 16,083       2010 Conference
(553) NATIONAL COMMITTEE FOR QUALITY ASSURANCE - NCQA1100 13th St NW
Washington,DC20005 		52-1191985 501(c)(3) 12,468       Pass Through from Northern California region for v
(554) National Fragile X Foundation1615 Bonanza St 202
Walnut Creek,CA94596 		84-0960471 501(c)(3) 10,000       Continuing Garden Education for Where Food Comes F
(555) National Governor's Assn Center for Best Practices444 N Capitol St 267
Washington,DC20001 		23-7391796 501(c)(3) 75,000       Charitable donations
(556) National Health Services Inc659 South Central Valley Highway
Shafter,CA93263 		95-3218000 501(c)(3) 10,000       Mobile Medical Services
(557) National Kidney Foundation of No CA Inc131 Steuart St 520
San Francisco,CA941051240 		94-6130713 501(c)(3) 15,050       Champions of Hope Awards Sacramento; Authors Lunch
(558) National League of Cities Institute1301 Pennsylvania Ave NW 550
Washington,DC200041763 		52-6055762 501(c)(3) 24,500       Strengthening Violence Prevention in California Ci
(559) Native American Rehabilitation Association1776 SW Madison
Portland,OR97205 		23-7098400 501(c)(3) 50,000       Improving Health Outcomes in American Indians/Alas
(560) Natomas Crossroads Church1101 National Dr A
Sacramento,CA95834 		26-3625632 501(c)(3) 30,000       Natomas Crossroads Clinic
(561) Neighborhood Healthcare425 North Date St
Escondido,CA92025 		95-2796316 501(c)(3) 72,000       Providing Healthcare for uninsured patients in Nor
(562) Neighborhood House Inc7780 SW Capitol Hwy
Portland,OR97219 		93-0386875 501(c)(3) 20,000       Emergency Food Box and Senior Food Programs
(563) Neighborhood Legal Services of Los Angeles County1102 East Chevy Chase Dr
Glendale,CA91205 		95-2408642 501(c)(3) 52,390       Medical Legal Community Partnership with Northeast
(564) New Directions for Youth7315 North Lankershim Blvd
North Hollywood,CA91605 		95-2973008 501(c)(3) 12,300       Health Watch Program
(565) Next Door Solutions to Domestic Violence234 East Gish Rd 200
San Jose,CA951124724 		94-2420708 501(c)(3) 40,000       Teen Club/Youth Leadership Forum
(566) North by Northeast Community Health Center4725 N Williams Ave
Portland,OR97212 		72-1618287 501(c)(3) 27,500       Free Clinic
(567) North County Health Project Inc150 Valpreda Rd
San Marcos,CA92069 		95-2847102 501(c)(3) 72,000       Primary care and preventative health care services
(568) Northeast Community Clinic2550 West Main St 301
Alhambra,CA91801 		95-2687213 501(c)(3) 49,500       core operating support
(569) Northeast Valley Health Corporation1172 North Maclay Ave
San Fernando,CA91340 		23-7120632 501(c)(3) 23,266       Santa Clarita Health Center Program
(570) Northern California Center for Well-Being365 B Tesconi Circle
Santa Rosa,CA954014617 		93-1144835 501(c)(3) 12,500       Project TRUE: Teens R U Educated?
(571) Northern California Community Development907 W Tennyson Rd
Hayward,CA945445205 		68-0276554 501(c)(3) 15,000       Project S.E.E.K. (Sisters Embracing & Educating Ki
(572) Norwalk La Mirada Unified School District12820 Pioneer Blvd
Norwalk,CA90650 		95-6002228 GOVT ENTITY 15,347       Health on Wheels
(573) Novato Youth Center680 Wilson Ave
Novato,CA94947 		94-1735064 501(c)(3) 10,000       Transitional Aged Youth Substance Abuse Prevention
(574) Oak View Renewal Partnership17241 Oak Lane
Huntington Beach,CA92647 		61-1495237 501(c)(3) 25,000       Oak View Community Health Initiative
(575) Oakland Based Urban Gardens (OBUGS)1724 Mandela Parkway 5
Oakland,CA946072050 		94-3345794 501(c)(3) 15,000       OBUGS In-School and After-School in the Garden
(576) Oakland Metropolitan Chamber of Commerce475 14th St
Oakland,CA94612 		95-3217684 501(c)(3) 50,000       Remember Them Launch
(577) Oakland School for the Arts1800 San Pablo Ave
Oakland,CA94612 		68-0463892 501(c)(3) 29,500       Gala supporting Programs
(578) Occidental College1600 Campus Rd
Los Angeles,CA90041 		95-1667177 501(c)(3) 52,500       Project of Occidental College: Access to Healthy S
(579) Ocean Park Community Center1453 16th St
Santa Monica,CA90404 		95-6143865 501(c)(3) 6,500       Campion Mental Health Services
(580) Odd Fellow- Rebekah Children's Home of CA290 IOOF Ave
Gilroy,CA95020 		94-1167402 501(c)(3) 15,000       School-Based LifeSkills Training
(581) OK Program of Oakland1714 Franklin St 100-142
Oakland,CA94612 		26-4130155 501(c)(3) 30,000       O.K. Program of Oakland
(582) Okizu Foundation16 Digital Dr 130
Novato,CA949495755 		68-0291178 501(c)(3) 38,000       Annual Celebration for Camp Okizu; Camp Okizu Volu
(583) Olive Crest Treatment Center2130 E 4th St 200
Santa Ana,CA92705 		95-2877102 501(c)(3) 21,000       Bellflower Family Resource Center
(584) Olive View UCLA Education and Research Institute I14445 Olive View Dr
Sylmar,CA91342 		95-2249539 501(c)(3) 115,000       Healthcare Access
(585) Omega Boys Club of San Francisco1060 Tennessee St
San Francisco,CA941073016 		94-3171846 501(c)(3) 15,000       2010 Grant - Alive & Free San Francisco
(586) On Lok Day Services1333 Bush St
San Francisco,CA941095611 		94-3101292 501(c)(3) 10,040       On Lok 30th Street Senior Center - Autumn Magic Ce
(587) On The Move1801 Oak St
Napa,CA94559 		75-3149095 501(c)(3) 25,000       McPherson Community Gardens Program
(588) Ontario-Montclair School District950 West D St
Ontario,CA91762 		95-6002267 GOVT ENTITY 15,000       Mental Health Access Point (MHAP)
(589) Open Heart Kitchen of Livermore Inc1141 Catalina Dr 137
Livermore,CA94550 		94-3396038 501(c)(3) 10,000       Childrens Weekend Box lunch Program and Hot Meal P
(590) Open PATHS Counseling Center12655 West Washington Blvd 101
Los Angeles,CA90066 		95-3221061 501(c)(3) 9,000       Spanish Counseling Services
(591) Operation Samahan Inc2835 Highland Ave B
National City,CA91950 		95-3008798 501(c)(3) 35,123       Patient navigation and financial support for safet
(592) Opportunity West598 Nevin Ave
Richmond,CA948013026 		31-1685366 501(c)(3) 10,600       Turn Off your TV and a healthy Richmond campaign
(593) Orange County Rescue Mission Health Care ServicesOne Hope Dr
Tustin,CA92782 		33-0906866 501(c)(3) 10,000       Prescription Assistance Program
(594) Orange County Sheriffs Advisory Council500 North Flower St
Santa Ana,CA92703 		95-3498487 501(c)(3) 10,000       Drug Use is Life Abuse
(595) Orangewood Children's Foundation1575 E 17th St
Santa Ana,CA92705 		95-3616628 501(c)(3) 20,000       Independent Living Program-Health and Wellness Wor
(596) Oregon Health Career Center25195 SW Parkway 204
Wilsonville,OR97070 		93-1166189 501(c)(3) 309,139       Healthcare Career Scholarship Program
(597) Oregon Primary Care Association110 SW Yamhill St 300
Portland,OR97204 		93-0877986 501(c)(3) 12,000       Instigating Health in the "Hood"
(598) Our Saviour Center4368 Santa Anita Ave
El Monte,CA91731 		95-1765149 501(c)(3) 15,000       Healthy Lifestyle for Kids
(599) Outside In1132 SW 13th Ave
Portland,OR97205 		93-0576549 501(c)(3) 7,500       Tattoo Removal- MLK Day
(600) Pacific Asian Counseling Services8616 La Tijera Blvd 200
Los Angeles,CA90045 		95-4564739 501(c)(3) 10,500       Continuity of Care for Vulnerable Asian Pacific Is
(601) Pacifica's Environmental Family830 Rosita Rd
Pacifica,CA940443412 		94-3229680 501(c)(3) 5,967       Garden Project in Pacifica; Donation to purchase p
(602) Pacoima Beautiful11243 Glenoaks Blvd 1
Pacoima,CA91331 		95-4770745 501(c)(3) 30,000       Local Partnership Grant: Youth United Toward Envir
(603) Para Los Ninos500 Lucas Ave
Los Angeles,CA90017 		95-3443276 501(c)(3) 15,000       Mental Health Program
(604) Partners for a Hunger Free Oregon712 SE Hawthorne Blvd 202
Portland,OR97214 		20-4970868 501(c)(3) 75,000       Healthy Kids, Healthy Minds Project
(605) Partners In Care Foundation Inc732 Mott St 150
San Fernando,CA91340 		95-3954057 501(c)(3) 72,400       2010 Vision & Excellence in Health Care Leadership
(606) Partnership for Quality Care555 West 57th Street 15th Fl
New York,NY10019 		26-0355572 501(c)(3) 1,000,000       Charitable donations
(607) Pasadena - Foothill Valley YWCA1200 North Fair Oaks Ave
Pasadena,CA91103 		95-1644059 501(c)(3) 36,000       Just For Girls
(608) Pasadena Educational Foundation351 South Hudson
Pasadena,CA91109 		23-7149451 501(c)(3) 25,000       Student Health Services Project
(609) Pasadena Senior Center85 East Holly St
Pasadena,CA91103 		95-2085393 501(c)(3) 30,000       50th Anniversary Gala
(610) PATH Achieve Glendale437 Fernando Court
Glendale,CA91204 		20-4233822 501(c)(3) 6,000       PAG Access Center - Mental Health Services
(611) Path of Life Ministries4495 Magnolia Ave
Riverside,CA92501 		33-0724945 501(c)(3) 20,000       Health In Motion
(612) Pathways Volunteer Hospice3701 Michaelson St
Lakewood,CA90712 		33-0241726 501(c)(3) 15,000       Improving Health Care and Access for Seniors
(613) PDAP of Ventura County Inc450 Rosewood Ave 215
Camarillo,CA93010 		77-0209843 501(c)(3) 15,000       Substance Abuse Treatment for High-Risk Underserve
(614) Peace Over Violence1015 Wilshire Blvd 200
Los Angeles,CA90017 		51-0179305 501(c)(3) 9,250       39th Annual Humanitarian Awards Fundraising Dinner
(615) Pediatric Adolescent Diabetes Research & Education455 South Main St
Orange,CA92868 		33-0099451 501(c)(3) 14,000       Diabetes Education Program
(616) Pediatric Dental Initiative of No Coast1380 19th Hole Dr
Windsor,CA954927713 		34-2012430 501(c)(3) 10,760       Hospital Dentistry and Early Childhood Cavities Pr
(617) Peninsula Family Service24 Second Ave
San Mateo,CA944013828 		94-1186169 501(c)(3) 26,200       Donation to support 26 addtl weekly Tai Chi Classe
(618) PENNINGTON BIOMEDICAL RESEARCH6400 Perkins Rd
Baton Rouge,LA708084124 		72-1304948 501(c)(3) 68,416       Pass Through from Northern California region for v
(619) People Assisting the Homeless340 North Madison Ave
Los Angeles,CA90004 		95-3950196 501(c)(3) 45,000       PATHMall Health Collaborative - Partnership Grant
(620) People Reaching Out5299 Auburn Blvd
Sacramento,CA95814 		94-2795430 501(c)(3) 26,000       Youth in Action Summer Program
(621) People United for a Better Life in Oakland3528 Foothill Blvd
Oakland,CA94601 		26-0877633 501(c)(3) 15,000       Urban Youth Harvest
(622) People's Grocery Inc909 7th St
Oakland,CA94607 		75-3055917 501(c)(3) 17,500       Community HANDS (Health and Nutrition Demonstrator
(623) Petaluma Health Center1304 Southpoint Blvd 110
Petaluma,CA949547464 		68-0437840 501(c)(3) 20,000       Support for Additional Application Assisters and E
(624) Physicians for Social Responsibility Inc812 SW Morrison St 1050
Portland,OR97205 		93-0774594 501(c)(3) 41,994       Healthy Food in Health Care Project
(625) Planned Parenthood Los Angeles400 West 30th
Los Angeles,CA90007 		95-2408623 501(c)(3) 25,000       ELA Youth Development - Partnership Grant
(626) Planned Parenthood Shasta Diablo Inc2185 Pacheco St
Concord,CA945202309 		94-1575233 501(c)(3) 60,000       Chlamydia Awareness Prog; El Cerrito Youth Peer Ed
(627) Play and Learning in Adaptable Environments800 Hearst Ave
Berkeley,CA94710 		94-2825563 501(c)(3) 20,000       Blueprint for Healthy Living
(628) Playworks Education Energized477 Valley Way
Milpitas,CA95032 		94-3251867 501(c)(3) 47,500       2nd Annual corporate Kickball Event; Playworks Sil
(629) Pomona Community Health Center750 S Park Ave 101
Pomona,CA91766 		22-3914738 501(c)(3) 10,000       Clinic Primary Care
(630) Positive Resource Center785 Market St 10th Fl
San Francisco,CA941032017 		94-3078431 501(c)(3) 20,000       2010 Grant - Employment Services for HIV+ Individu
(631) Pretend City The Children's Museum of Orange Count29 Hubble
Irvine,CA92618 		33-0761254 501(c)(3) 37,500       The Campaign to Create Pretend City
(632) Prevention Institute221 Oak St
Oakland,CA946074595 		94-3282858 501(c)(3) 95,000       Prevention Institute Core Support and Advancement
(633) Professional Business Women of California PBWC180 Sutter St 2nd Fl
San Francisco,CA94104 		94-3093360 501(c)(3) 20,000       2010 Sponsorship Partnership
(634) Project Access NOWPO Box 10953
Portland,OR972960953 		20-8928388 501(c)(3) 97,000       Project Access NOW
(635) Project Angel Food922 Vine St
Los Angeles,CA90038 		95-4115863 501(c)(3) 33,500       Home Delivered Meals
(636) Project Homeless Connect Inc1380 Howard St 2nd Fl
San Francisco,CA941032649 		20-4331462 501(c)(3) 30,000       Project Homeless Connect 37, December 8, 2010
(637) Project Re-connect3350 MacArthur Blvd
Oakland,CA94602 		94-3140784 501(c)(3) 15,000       Project Re-Connect (PRC)
(638) Project Sister Family Services363 South Park Ave 303
Pomona,CA91769 		23-7116161 501(c)(3) 10,000       Sexual Assault/Child Abuse Prevention and Educatio
(639) Promotoras y Promotores Foundation1500 Camino del Sol Room 18
Oxnard,CA93030 		42-1618670 501(c)(3) 15,000       Evaluacion de Su Salud
(640) PROTOTYPES Centers for Innovation in Health Mental1000 North Alameda St 390
Los Angeles,CA90012 		95-4092046 501(c)(3) 10,000       Responsibility, Empowerment, Achievement, Commitme
(641) Public Health Foundation Enterprises INC12801 CrossRds Parkway South 200
City of Industry,CA91746 		95-2557063 501(c)(3) 13,000       Aztecs Rising Gang Awareness Course
(642) Public Health Institute1825 Bell St 203
Sacramento,CA95825 		94-1646278 501(c)(3) 372,857       California Task Force on Youth and Workplace Welln
(643) Public Health Policy & Law2201 Broadway 502
Oakland,CA946123063 		26-3710746 501(c)(3) 120,000       California Convergence Healthy Food Policy
(644) Puente de la Costa Sur620 North St
Pescadero,CA94060 		37-1484262 501(c)(3) 20,000       Community-Based Outreach, Enrollment, Retention, a
(645) Purpose Center International75 W Nuevo Rd 133
Perris,CA92571 		84-1693330 501(c)(3) 9,000       Healthy Heritage Cultural and Wellness Center
(646) Quadriplegics United Against Dependency Inc5125 Sw Macadam Ave 205
Portland,OR97239 		93-0639118 501(c)(3) 15,000       Independence and Self-Reliance for People with Sev
(647) Queen of the Valley Medical Center3448 Villa Lane 102
Napa,CA94558 		94-1243669 501(c)(3) 20,000       Healthy For Life
(648) Quinn Community Outreach Corporation25400 Alessandro Blvd 101
Moreno Valley,CA92553 		33-0637525 501(c)(3) 15,000       Southern California Esperanza y Vida Project
(649) Rainbow Community Center3024 Willow Pass Rd
Concord,CA945195277 		68-0375857 501(c)(3) 7,000       Kind Hearts Program Nutrition Services
(650) Rancho Los Amigos Foundation Inc7601 E Imperial Hwy
Downey,CA90242 		95-3849600 501(c)(3) 29,000       24th Annual Amistad Gala
(651) Rape Trauma Services1860 El Camino Real 406
Burlingame,CA940103117 		94-3215045 501(c)(3) 10,000       Rape and Sexual Abuse Prevention Program
(652) Reading and Beyond4819 N Butler Ave
Fresno,CA93727 		77-0508471 501(c)(3) 27,206       Get Healthy! Program
(653) Rebuilding Together AlbanyBerkeleyEmeryville3318 Adeline St
Berkeley,CA94703 		94-3238591 501(c)(3) 15,000       MLK Day of Service 2010 - East Bay
(654) Rebuilding Together Diablo Valley1647 Willow Pass Rd PMB 435
Concord,CA94520 		68-0364884 501(c)(3) 15,000       MLK Day of Service 2010- Diablo
(655) Rebuilding Together Oakland1111 Pine St A
Oakland,CA94607 		94-3213325 501(c)(3) 30,000       MLK Jr Day of Service 2010 - GSAA
(656) Rebuilding Together Peninsula841 Kaynyne St
Redwood City,CA94063 		94-3106209 501(c)(3) 7,500       MLK Jr Day of Service 2010 (NCAL Region)
(657) Rebuilding Together Petaluma402 Petaluma Blvd North
Petaluma,CA94952 		91-1762902 501(c)(3) 15,000       Redwood City - MLK Day 2010 Day of Service
(658) Rebuilding Together San FranciscoPier 28
San Francisco,CA94105 		94-3107808 501(c)(3) 15,000       MLK Jr Day of Service - 2010 (Napa/Solano)
(659) Rebuilding Together Silicon Valley2827 Aiello Dr
San Jose,CA95111 		77-0289381 501(c)(3) 30,000       MLK Day of Service 2010 Santa Clara/San Jose
(660) Redwood Empire Food Bank3320 Industrial Dr
Santa Rosa,CA954032056 		68-0121855 501(c)(3) 42,500       Megan Furth Harvest Pantry at Link Lane; Expansion
(661) Regents of the University of California3333 California St 315
San Francisco,CA941430962 		94-3067788 501(c)(3) 96,000       Rural Doctors Academy
(662) REGENTS OF THE UNIVERSITY OF MINNESOTA200 Oak St SE
Minneapolis,MN554552070 		41-6007513 501(c)(3) 7,282       Pass Through from Northern California region for v
(663) Regional Access Project75105 Merle Dr 800
Palm Desert,CA92211 		33-0547453 501(c)(3) 10,000       Coachella Valley Health Initiative Healthcare Summ
(664) Regional Parks Foundation2950 Peralta Oaks Court
Oakland,CA946055320 		23-7011877 501(c)(3) 55,000       Embrace Life to Thrive and Campership 2010
(665) Richmond Children's Foundation125 Park Pl 230
Richmond,CA948013980 		94-3337754 501(c)(3) 24,265       Safety Net Initiative; Northern California Childre
(666) River City Food BankPO Box 160204
Sacramento,CA95816 		91-1851398 501(c)(3) 41,000       Food Stamp Outreach Prog for Sacramento County; Em
(667) Riverside Area Rape Crisis Center1845 Chicago Ave A
Riverside,CA92507 		95-3245057 501(c)(3) 15,000       Child Abuse Prevention Programs
(668) Riverside Community College Foundation4800 Magnolia Ave
Riverside,CA925069982 		95-2993847 501(c)(3) 20,000       Dental Hygiene Program
(669) Riverside Community Health Foundation4445-A Magnolia Ave
Riverside,CA92501 		23-7276444 501(c)(3) 13,000       Riverside Community Diabetes Collaborative Communi
(670) Riverside County Department of Public Health4065 County Circle Dr 403
Riverside,CA92503 		95-6000930 GOVT ENTITY 30,000       Local Partnership Grant: Riverside County Joint He
(671) Riverside-San Bernardino County Indian Health Inc11555 1/2 Potrero Rd
Banning,CA92220 		95-2846605 501(c)(3) 50,000       planning and quality improvement project
(672) Road Runners Club of America120 Ponderosa Court
Folsom,CA95630 		94-3300121 501(c)(3) 30,000       Kaiser Youth Fitness Program
(673) Robert F Kennedy Institute of Community and Family544 N Avalon 309
Wilmington,CA90744 		33-0531975 501(c)(3) 6,250       Navigating Health Care Reform for Families Project
(674) Roberts Family Development Center770 Darina Ave
Sacramento,CA958153120 		68-0470557 501(c)(3) 23,400       Thursday Fitness, Junior Olympics and Dance Progra
(675) Ronald McDonald House Charities of Southern Califo4560 Fountain Ave
Los Angeles,CA90029 		95-3167869 501(c)(3) 20,000       Family Support at Ronald McDonald House
(676) Rose Bowl Aquatics Center360 N Arroyo Blvd
Pasadena,CA91103 		95-3994788 501(c)(3) 7,000       Fit for Life 2010 Conference
(677) RotaCare Bay Area Inc815 Pollard Rd T1230
Los Gatos,CA950321438 		77-0328723 501(c)(3) 50,000       RotaCare Concord Free Health Clinic; Coastside Cli
(678) Ryse Inc205 41st St
Richmond,CA948042321 		26-0692904 501(c)(3) 15,000       Education & Career Advancement Program
(679) SAC Health System1454 E Second St
San Bernardino,CA92408 		33-0664371 501(c)(3) 125,000       capacity building
(680) Sacramento Area Congregations Together2510 J St 200
Sacramento,CA958164858 		94-3146791 501(c)(3) 14,750       Stand Together Luncheon 2010: Acting in Hope
(681) Sacramento Children's Home2750 Sutterville Rd
Sacramento,CA958201024 		94-1156588 501(c)(3) 15,000       Sacramento Crisis Nursery North
(682) Sacramento City Unified School District5735 47th Ave
Sacramento,CA958244528 		94-6002491 GOVT ENTITY 50,000       SCUSD Central Youth and Family Resource Center
(683) Sacramento Loaves and Fishes1321 North C St
Sacramento,CA958110607 		68-0189897 501(c)(3) 9,000       Guest Health Outreach Program
(684) Sacramento Native American Health Ctr Inc2020 J St
Sacramento,CA958113120 		20-4287737 501(c)(3) 97,137       Full Circle Chronic Disease Management Program
(685) Sacramento Neighborhood Housing Services2400 Alhambra Blvd
Sacramento,CA95817 		68-0118032 501(c)(3) 20,000       Oak Park Farmers Market
(686) Sacramento Public Policy Foundation1717 I St
Sacramento,CA95811 		61-1614386 501(c)(3) 20,000       Sacramento Steps Forward
(687) Sacramento Region Community Foundation740 University Ave 110
Sacramento,CA95825 		94-2891517 501(c)(3) 25,000       The Greater Sacramento Generosity Project
(688) Sacred Heart Community Service1381 South First St
San Jose,CA951103431 		23-7179787 501(c)(3) 15,000       Healthy Families
(689) Safe Alternatives for Everyone Inc28910 Pujol St
Temecula,CA92590 		91-1962947 501(c)(3) 15,000       Family Support Program
(690) Salem Keizer School District2450 Lancaster Dr NE130
Salem,OR97309 		93-6000763 GOVT ENTITY 60,000       Capacity Building Project
(691) Salvation Army625 I St
Modesto,CA95354 		94-1156347 501(c)(3) 89,500       Medical Clinic Supplies; 2010 Essential Services P
(692) Samaritan House4031 Pacific Blvd
San Mateo,CA94403 		23-7416272 501(c)(3) 30,500       Safe Harbor for Health
(693) Samuel Dixon Family Health Center Inc25115 W Ave Stanford A-104
Valencia,CA91355 		95-4278726 501(c)(3) 15,000       Implementation of Dental Treatment Services for Lo
(694) San Diego American Indian Health Center2602 First Ave 105
San Diego,CA92103 		95-3397369 501(c)(3) 15,000       Access to Healthcare for American Indians & Alaska
(695) San Diego Council on Literacy2515 Camino Del Rio South 125
San Diego,CA92108 		33-0390376 501(c)(3) 15,000       Health Literacy San Diego
(696) San Diego County Medical Society Foundation5575 Ruffin Rd 250
San Diego,CA92123 		95-2568714 501(c)(3) 45,503       Surgery Day Program Manager
(697) San Diego Family Care6973 Linda Vista Rd
San Diego,CA92111 		95-2700856 501(c)(3) 34,206       provide medical care for unfunded, uninsured or un
(698) San Diego Food Bank Corporation9850 Distribution Ave
San Diego,CA921041313 		20-4374795 501(c)(3) 45,000       Healthy Eating In Hard Times: Primarius Food Bank
(699) San Diego Organizing Project4305 University Ave 530
San Diego,CA92105 		95-3284521 501(c)(3) 17,000       A Zone of Hope and Opportunity
(700) San Diego Rescue Mission Inc120 Elm St
San Diego,CA92101 		95-1874073 501(c)(3) 75,000       Recuperative Care Unit
(701) San Diego Youth Services3255 Wing St
San Diego,CA92110 		95-2648050 501(c)(3) 12,000       Peer Education Empowerment Program (PEEP)
(702) San Francisco AIDS Foundation995 Market St 200
San Francisco,CA94103 		94-2927405 501(c)(3) 10,000       AIDS Walk San Francisco
(703) San Francisco AIDS Fund12 Grace St 300
San Francisco,CA940132679 		94-2922039 501(c)(3) 22,260       2010 Grant - Eviction Prevention and Housing Stabi
(704) San Francisco Community Clinic Consortium1550 Bryant St 450
San Francisco,CA941034869 		94-2897258 501(c)(3) 8,500       2010 SFCCC Gala Honoring Congresswoman Jackie Spei
(705) San Francisco General Hospital Foundation2789 25th St 2028
San Francisco,CA941103582 		94-3189424 501(c)(3) 44,400       2010 Grant - Continue year 3 of the three year LEA
(706) San Francisco School Alliance Foundation114 Sansome St 800
San Francisco,CA941043818 		94-3222869 501(c)(3) 50,000       Gateway to Fitness Project First Half Funding, Sep
(707) San Francisco Study Center1095 Market St Room 601
San Francisco,CA94103 		94-2168838 501(c)(3) 36,222       2010 Grant - Gateway to Fitness - Spring and Summe
(708) San Gabriel Unified School District408 Junipero Serra Dr
San Gabriel,CA91776 		95-6000777 GOVT ENTITY 15,000       All Aboard!
(709) San Joaquin AIDS Foundation4330 N Pershing AveB-3
Stockton,CA952076965 		94-3018864 501(c)(3) 68,000       HIV Education, Intervention and Testing Program
(710) San Joaquin County Human Services Agency102 S San Joaquin St
Stockton,CA952013213 		94-6000531 GOVT ENTITY 93,038       2009 211 Information and Referral
(711) San Joaquin County Office of Education2901Arch-Airport Rd
Stockton,CA952139030 		68-0006282 GOVT ENTITY 67,456       Exercise Across California
(712) San Jose Children's Discovery Museum180 Woz Way
San Jose,CA951102722 		94-2870828 501(c)(3) 23,800       Kick Start Eat Smart
(713) San Jose State UniversityMH 407 SJSU One Washington Square
San Jose,CA951920052 		05-0520840 GOVT ENTITY 15,000       Campeonas 2
(714) San Jose Unified School District855 Lenzen Ave
San Jose,CA95126 		94-6002606 GOVT ENTITY 11,500       Pre-K Healthy Steps; Trace Elementary School Fire
(715) San Juan Bautista Child Development Center1400 Parkmoor Ave 220
San Jose,CA951263798 		94-1747079 501(c)(3) 15,000       Health Initiative
(716) San Leandro Boys and Girls Club401 Marina Blvd
San Leandro,CA94577 		94-6003779 501(c)(3) 52,000       Thrive for Healthy Habits; Gala Auction for May 8,
(717) San Leandro Public Library Foundation300 Estudillo Ave
San Leandro,CA94577 		94-3180326 501(c)(3) 15,000       Literacy,Food and Fitness
(718) Santa Clara City Library Foundation & Friends2635 Homestead Rd
Santa Clara,CA950515322 		91-2125234 501(c)(3) 12,500       Kaiser Permanente Health & Wellness Collection
(719) Santa Clara Unified School District1250 Pomeroy Ave
Santa Clara,CA95051 		77-0219105 GOVT ENTITY 10,000       Pomeroy Healthy Behaviors Collaborative
(720) Santa Clarita Valley Boys and Girls Club24909 Newhall Ave
Newhall,CA91321 		95-2572622 501(c)(3) 9,000       Triple Play Expansion Project Program
(721) Santa Rosa Memorial Hospital1165 Montgomery Dr
Santa Rosa,CA954054801 		94-1231005 501(c)(3) 45,000       Sonoma Health Alliance - annual partnership fundin
(722) School Health Clinics of Santa Clara County5671 Santa Teresa Blvd 105
San Jose,CA951236512 		77-0031679 501(c)(3) 20,000       Continuing Nutritional Healthy Lifestyle Education
(723) SCOTT AND WHITE MEMORIAL5701 Airport Rd
Temple,TX76502 		74-1166904 501(c)(3) 120,745       Pass Through from Northern California region for v
(724) Second Harvest Fd Bank SantaClara&San Mateo750 Curtner Ave
San Jose,CA951252118 		94-2614101 501(c)(3) 117,500       Produce Mobile Program
(725) Second Harvest Food Bank SanJoaquin&Stanisl704 E Industrial Park Dr
Manteca,CA953376116 		68-0376587 501(c)(3) 8,000       Food 4 Thought
(726) Second Harvest Food Bank Serving Riverside & San B2950-B Jefferson St
Riverside,CA92504 		33-0072922 501(c)(3) 15,000       Fresh Produce Distribution Program
(727) Senior Advocacy Services3262 Airway Dr C
Santa Rosa,CA954032004 		94-2684774 501(c)(3) 5,560       Pick of the Vine; Web design support
(728) Senior Community Centers of San Diego525 14th St 200
San Diego,CA92101 		95-2850121 501(c)(3) 25,000       Senior Health and Wellness Program
(729) Senior Support of the Tri-Valley5353 Sunol Blvd
Pleasanton,CA945967607 		20-3225569 501(c)(3) 15,000       Weight Control for Heart Health and Diabetes and W sepsis mortality rate through improved early identification and treatment over the 2006-2007 baseline at 12 KP hospitals by the end of 2013
(730) Seniors First11566 D Ave
Auburn,CA95603 		68-0430154 501(c)(3) 60,000       Home Safety Modification and Home Safety Repair Pr
(731) Serotonin Surge Charities1955 Cowell Blvd
Davis,CA956186325 		68-0411254 501(c)(3) 50,000       Spring Break 2010
(732) SERRA ANCILLARY CARE CORPORATION825 Colorado Blvd 100
Los Angeles,CA90041 		95-4147364 501(c)(3) 18,609       Community Housing Options at Independent Supported
(733) Shane's Inspiration15213 Burbank Blvd
Van Nuys,CA91411 		95-4760497 501(c)(3) 10,000       Together We Are Able
(734) Shanti Orange County23001 Del Lago Dr B-1
Laguna Hills,CA92653 		33-0236592 501(c)(3) 15,000       PRISM: Integrated Services Management Program
(735) Shelter from the Storm73-555 Alessandro Dr D
Palm Desert,CA92260 		33-0293124 501(c)(3) 20,000       Mental Health Services for Families Affected by Do
(736) Shelter Inc of Contra Costa County1815 Arnold Dr
Martinez,CA945534110 		68-0117241 501(c)(3) 20,000       Food Smarts: Nutrition Workshops for Homeless Fam
(737) Shelter Network of San Mateo County1450 Chapin Ave 2nd Fl
Burlingame,CA940104062 		77-0160469 501(c)(3) 15,000       Child Development Center - First Step Families Cen
(738) Shoulder to Shoulder3051 Fairfield St
Sacramento,CA95815 		94-3343868 501(c)(3) 15,000       Healthy Youth Healthy Future
(739) Sierra Vista Children's Center100 Poplar Ave
Modesto,CA95354 		94-2158023 501(c)(3) 50,000       Mental Health Services for School Age Youth and Fa
(740) Silicon Valley Christian Health Alliance2360 McLaughlin Ave
San Jose,CA951223560 		33-1070182 501(c)(3) 20,000       Project Brightening Smiles
(741) Silicon Valley Community Foundation2440 West El Camino Real 300
Mountain View,CA94040 		20-5205488 501(c)(3) 150,000       Emergency Grant for San Bruno Fire
(742) Slavic Assistance Center Inc2117 Cottage Way
Sacramento,CA958251064 		01-0620969 501(c)(3) 10,000       Access to Essential Services for the Slavic Commun
(743) Socrates Opportunity Scholarship Foundation24241 Park Granada
Calabasas,CA91302 		95-4722980 501(c)(3) 44,000       Shape Up
(744) Soil Born Farms Urban Agriculture Educ Proj3000 Hurley Way
Sacramento,CA958643732 		20-0774693 501(c)(3) 30,000       Youth Corps 2010
(745) Solano Coalition for Better Health360 Campus Lane 200
Fairfield,CA94534 		94-3189914 501(c)(3) 62,000       Strategic Planning Support
(746) Solano Community Foundation1261 Travis Blvd 320
Fairfield,CA945334897 		68-0354961 501(c)(3) 21,000       Education Plus! Mini-Grant Program
(747) Solano County Health and Social Services Departmen2201 Courage Dr MS 9-100
Fairfield,CA94533 		94-6000538 GOVT ENTITY 68,000       Teen Pregnancy Prevention Proj; Rapid HIV Testing
(748) Solano Midnight Sun Foundation198 Dobbins St D
Vacaville,CA95688 		20-8124921 501(c)(3) 15,000       Breast Health Project
(749) SONOMA COUNTY ADULT & YOUTH DEVELOPMENT7345 Burton Ave
Rohnert Park,CA949283300 		94-2812489 501(c)(3) 18,300       The Rohnert Park-Cotati Healthy Family Outreach, E
(750) Sonoma County Task Force for the Homeless3315 Airway Dr
Santa Rosa,CA954032005 		68-0197522 501(c)(3) 16,000       Health Care for the Homeless Access & Care
(751) South Bay Community Services1124 Bay Blvd D
Chula Vista,CA91910 		95-2693142 501(c)(3) 17,000       Domestic Violence Support Services Program
(752) South Bay Family Healthcare Center23430 Hawthorne Blvd 210
Torrance,CA90505 		23-7049937 501(c)(3) 115,892       HIV/AIDS Risk Reduction Program
(753) South Central Family Health Center4425 South Central Ave
Los Angeles,CA90011 		95-3877793 501(c)(3) 24,500       Disease Management for Diabetics
(754) South County Community Health Center Inc1798A Bay Rd
East Palo Alto,CA94303 		94-3372130 501(c)(3) 43,000       Ravenswood Family Dentistry Grand Opening - April
(755) South San Francisco Friends of The Library840 West Orange Ave
South San Francisco,CA940803125 		74-3116201 501(c)(3) 27,000       Learning Wheels/Hike with your Tyke-Family Fitness
(756) South West Community Health Center7688 SW Capital Hwy
Portland,OR97219 		74-3050497 501(c)(3) 20,000       Expanded Access and Quality Assurance Project
(757) Southern Alameda Co Sponsoring Committee22634 Second St 209
Hayward,CA94541 		94-3282881 501(c)(3) 25,000       STRATEGIC GRANT: School and Neighbor hood Based Vi
(758) Southern California Grantmakers1000 North Alameda St 230
Los Angeles,CA90012 		95-2831058 501(c)(3) 10,000       Signature Publication on health philanthropy
(759) Southside Coalition of Community Health Centers555 West 5th St 19th Fl
Los Angeles,CA90013 		20-8892311 501(c)(3) 300,000       Specialty Care Initiative Phase II: South Los Ange
(760) Southwest Community Health Center751 Lombardi Court B
Santa Rosa,CA954076793 		68-0365296 501(c)(3) 35,000       Capital Campaign
(761) Spanish Speaking Citizens' Foundation1470 Fruitvale Ave
Oakland,CA946012324 		94-1628221 501(c)(3) 20,000       LIBRE - Leading Independence of our Barrios for Ra
(762) Special Olympics - Southern California10977 San Diego Mission Rd
San Diego,CA92108 		95-4538450 501(c)(3) 10,000       Special Olympics
(763) Special Olympics Northern California Inc3480 Buskirk Ave
Pleasant Hill,CA94523 		68-0363121 501(c)(3) 25,000       Summer Games
(764) Special Service for Groups Inc605 West Olympic Blvd 600
Los Angeles,CA90015 		95-1716914 501(c)(3) 10,000       Childrens Dental and Outreach Project
(765) Spectrum Community Services1435 Grove Way
Hayward,CA94546 		94-1748275 501(c)(3) 15,000       Multiple Program Approach
(766) St Joseph Center204 Hampton Dr
Venice,CA90291 		95-3874381 501(c)(3) 9,438       Senior Services Mental Health Intervention Program
(767) St Anne's Maternity Home155 North Occidental Blvd
Los Angeles,CA90026 		95-1691306 501(c)(3) 10,000       Help To Boost Health
(768) St Anthony Foundation150 Golden Gate Ave
San Francisco,CA941023809 		94-1513140 501(c)(3) 15,000       2010 Grant - Obesity Treatment and Prevention Prog
(769) St James Infirmary1372 Mission St
San Francisco,CA941032609 		94-3330568 501(c)(3) 10,000       2010 Grant - Health access for uninsured, low inco
(770) St Jeanne De Lestonnac Free Clinic1215 E Chapman Ave
Orange,CA92866 		95-3499011 501(c)(3) 70,000       Bridge to Care
(771) St John's Shelter for Women and Children4410 Power Inn Rd
Sacramento,CA95826 		68-0132934 501(c)(3) 25,000       Celebrating Mothers 2010 Tea
(772) St Johns Well Child and Family Center Inc5701 South Hoover St
Los Angeles,CA90037 		95-4067758 501(c)(3) 16,940       2nd Annual South Los Angeles Health and Human Righ
(773) St Mary Medical Center Foundation411 East 10th St
Long Beach,CA90813 		94-1196203 501(c)(3) 5,937       HIV Counseling and Testing Services at St. Mary Me
(774) St Rose Hospital Foundation27200 Calaroga Ave
Hayward,CA94545 		94-2428886 501(c)(3) 10,000       Preventing Obesity
(775) St Vincent de Paul Village Inc3350 E St
San Diego,CA92102 		33-0492302 501(c)(3) 30,000       Access to care for homeless and impoverished men,
(776) Stand Against Domestic Violence1410 Danzig Plaza 200
Concord,CA945207972 		94-2476576 501(c)(3) 22,500       Promoting Gender Respect
(777) STANFORD UNIVERSITY1215 Welch Rd Building
Stanford,CA943055402 		94-1156365 501(c)(3) 69,155       Pass Through from Northern California region for v
(778) Stanford University Pacific Free Clinic301 Ravenswood Ave
Menlo Park,CA940253434 		94-1156365 501(c)(3) 20,000       Pacific Free Clinic Screening for Underserved
(779) Stanislaus MultiCultural Health Coalition601 S Martin Luther King Dr
Modesto,CA95351 		31-1751288 501(c)(3) 49,952       Vine and Branches Food Co-Op / Project Coordinator
(780) Steelworkers Oldtimers Foundation8572 Sierra Ave
Fontana,CA92335 		95-6126109 501(c)(3) 10,000       Aquatics and Tai Chi Classes for Low-Income Senior
(781) Stepping Stones Growth Center Children Ret311 Mac Arthur Blvd
San Leandro,CA94577 		94-6069868 501(c)(3) 10,000       Stepping Up For a Challenge
(782) Stiles Hall2400 Bancroft Way
Berkeley,CA94704 		94-1156636 501(c)(3) 50,000       Experience Berkeley
(783) Stop the Violence Movement Inc1016 S Owens St
Bakersfield,CA93307 		74-3172044 501(c)(3) 10,000       Project YES
(784) Street Level Health Project2501 International Blvd
Oakland,CA946011509 		56-2324355 501(c)(3) 15,000       Familia Saludable (Healthy Family)
(785) Students Run America6505 Zelzah Ave
Reseda,CA91335 		95-4430502 501(c)(3) 22,000       Training for Marathon: Training for Life
(786) Sunnyhills Neighborhood Improvement Assoc918 Boar Circle
Fremont,CA94539 		77-0493926 501(c)(3) 15,000       Diabetes and Obesity
(787) Sunnyvale Community Services725 Kifer Rd
Sunnyvale,CA94086 		94-1713897 501(c)(3) 10,000       Kids's Summer Food Program (Food Provision to Unde
(788) Sunset District Community Development dba Sunset Y3918 Judah St
San Francisco,CA941221121 		93-1004117 501(c)(3) 15,000       2010 Grant - Juvenile Violence Prevention
(789) Susan G Komen Breast Cancer Foundation3191-A Airport Loop Dr
Costa Mesa,CA92626 		33-0487943 501(c)(3) 39,500       Komen Fund for Breast Health Care (KFBHC)
(790) Sustainable Community Gardens1055 Dunford Way
Sunnyvale,CA940871602 		55-0886675 501(c)(3) 25,000       Full Circle Farm
(791) Sustainable Economic Enterprises Of Los Angeles6605 Hollywood Blvd 220
Hollywood,CA90028 		95-4597000 501(c)(3) 85,000       Watts Healthy Farmers Market
(792) THE Clinic Inc3834 S Western Ave
Los Angeles,CA90062 		23-7351622 501(c)(3) 25,000       36th Anniversary Celebration
(793) Taiwan Buddhist Tzu Chi Medical Foundation7421 N Maple Ave
Fresno,CA937200115 		95-4457939 501(c)(3) 95,000       Tzu Chi Outreach and Mobile Clinic
(794) Tapfound Inc dba Taproot Foundation466 Geary St 200
San Francisco,CA94102 		91-2162645 501(c)(3) 75,000       Oakland Unified School District Program Developmen
(795) Tarzana Treatment Center Inc18646 Oxnard St
Tarzana,CA91356 		94-2219349 501(c)(3) 10,000       Increasing Access to Medical Care for Antelope Val
(796) Team-Up for Youth310 Eighth St 300
Oakland,CA94607 		94-3310845 501(c)(3) 60,000       Team-Up for Youth Core Operating Support
(797) Teen Pregnancy Coalition of San Mateo Co120 James Ave
Redwood City,CA94062 		94-3227947 501(c)(3) 15,000       Greater Contraceptive Access for Youth in San Mate
(798) TERI Inc251 Airport Rd
Oceanside,CA92058 		95-3532129 501(c)(3) 15,000       Fit for Life
(799) Terrance TK Kelly Youth FoundationP O Box 1006
Richmond,CA94802 		20-1772303 501(c)(3) 20,000       E. A. G. L. E. S. ( Education Allow Growth Leaders
(800) The Alameda Co Comm Food Bank Inc7900 Edgewater Dr
Oakland,CA946212004 		94-2960297 501(c)(3) 50,260       Lose a Pound, Lend a Hand; Nutrition Support for C
(801) The Alliance for Children's Rights3333 Wilshire Blvd 550
Los Angeles,CA90010 		95-4358213 501(c)(3) 75,000       NextSTEP Program
(802) The California Conference for Equality and Justice444 West Ocean Blvd 940
Long Beach,CA90802 		54-2178438 501(c)(3) 10,000       Talking in Class
(803) The California Health Care Safety-Net Inst70 Washington St 215
Oakland,CA946073705 		94-2970752 501(c)(3) 225,000       2010 CAPH/SNI Annual Conference
(804) The Carolyn E Wylie Center for Children Youth & Fa4164 Brockton Ave
Riverside,CA92501 		93-0670286 501(c)(3) 8,000       Adolescent Mental Health Services
(805) The Center to Promote Healthcare Access Inc1333 Broadway 1020
Oakland,CA94612 		59-3831966 501(c)(3) 611,893       One-e-App in Los Angeles
(806) The Cerritos College Foundation11110 Alondra Blvd
Norwalk,CA90650 		95-3387108 501(c)(3) 14,900       Pound by Pound
(807) The Children's Center of the Antelope Valley45111 N Fern Ave
Lancaster,CA93534 		95-4212759 501(c)(3) 22,300       Fit Families' - Obesity Prevention Program
(808) The Childrens Clinic Serving Children and Their Fa2790 Atlantic Ave
Long Beach,CA90806 		95-1643332 501(c)(3) 309,500       Healthcare Delivery to the Uninsured
(809) The Community Foundation4280 Latham C
Riverside,CA92501 		33-0748536 501(c)(3) 50,000       San Bernardino County Children's Health Initiative
(810) The Davis Street Community Center Inc3081 Teagarden St
San Leandro,CA94577 		94-3121699 501(c)(3) 74,800       Healthy Hearts and Bodies; 2010 Essential Services
(811) The Effort Inc1820 J St
Sacramento,CA958113010 		94-1713704 501(c)(3) 374,933       Creating Access to Mental Health Care; Sacramento
(812) The Eli Home Inc1175 N East St
Anaheim,CA92805 		33-0189254 501(c)(3) 10,000       The Mental Health Counseling and We Fit Program
(813) The Family Giving Tree312 South Abbott Ave
Milpitas,CA95035 		77-0284682 501(c)(3) 10,000       Back to school
(814) The Gardens A Family Care Community Center2251 Florin Rd 129
Sacramento,CA95822 		68-0463156 501(c)(3) 15,000       PEOPLE Project - Providing Education, Outreach, P
(815) The Gathering Inn201 Berkley Ave
Roseville,CA95678 		84-1657746 501(c)(3) 45,288       Splendor of the Trees 2010; Gathering Inn and St.
(816) The Girl Scout Council of Orange County9500 Toledo Way
Irvine,CA92628 		95-2023244 501(c)(3) 10,000       Camp Scherman Resident Camp
(817) The Health Trust2105 S Bascom Ave 220
Campbell,CA950083292 		94-6050231 501(c)(3) 20,000       Healthy Steps in Silicon Valley; The Health Trust
(818) The Leaven2397 Heath Dr
Fairfield,CA945337612 		26-3653717 501(c)(3) 26,600       Digital Video Diary Project- Leaven & Farm to Fami
(819) The Link to Children5236 Claremont Ave 2nd Fl
Oakland,CA94618 		94-2224033 501(c)(3) 17,100       1st Annual Benefit Concert and Silent Auction
(820) The Mar Vista Family Center5075 South Slauson Ave
Culver City,CA90230 		95-2647443 501(c)(3) 5,500       Preschool Parent Peer Coaching Program
(821) The Oregon Food BankPO Box 55370 97238
Portland,OR97211 		93-0785786 501(c)(3) 200,000       OFB West Nutrition education, advocacy & hunger aw
(822) The Raise Foundation1920 East Warner Ave A
Santa Ana,CA92705 		33-0240178 501(c)(3) 45,000       Resources in Motion
(823) The Salvation ArmyDel Oro Division 3755 No Freeway Bl
Sacramento,CA95834 		94-1156347 501(c)(3) 50,000       2010 Essential Services Program - Community in Cri
(824) The Tides CenterThe Presidio Bldg 1014 Torney Ave
San Francisco,CA94129 		94-3213100 501(c)(3) 9,995       The Leadership Institute
(825) The Tomas Rivera Policy Institute650 Childs Way Lewis Hall 201A
Los Angeles,CA90089 		95-4019627 501(c)(3) 15,000       Core operating support
(826) The Tri-Valley Community Foundation5674 Stoneridge Dr 206
Pleasanton,CA945888532 		91-2078642 501(c)(3) 45,000       Project Roadrunner - Community Outreach
(827) The Trust For Public Land101 Montgomery St 1100
San Francisco,CA94104 		23-7222333 501(c)(3) 100,000       Los Angeles open space projects
(828) The Tucker Maxon Oral School2860 SE Holgate Blvd
Portland,OR97202 		93-0391592 501(c)(3) 15,000       Educational Programs
(829) The Vacaville Neighborhood Boys&GirlsClub1625 Alamo Dr
Vacaville,CA956876003 		13-4223488 501(c)(3) 15,000       Triple Play
(830) The Wall-Las Memorias Project111 N Ave 56
Los Angeles,CA90042 		95-4468225 501(c)(3) 10,000       4th Annual Conference on Latinos, Faith, Culture,
(831) The Wellness Community - San Franc East Bay3276 McNutt Ave
Walnut Creek,CA945971833 		68-0157858 501(c)(3) 21,200       Wellness Gala 2010
(832) The Wellness Community Valley Ventura Inc530 Hampshire Rd
Westlake Village,CA91361 		77-0205691 501(c)(3) 15,000       Latino Outreach Cancer Program
(833) The Women's Center of San Joaquin Co620 North San Joaquin St
Stockton,CA952022030 		94-2341360 501(c)(3) 47,000       Wellness Ways
(834) Tiburcio Vasquez Health Center (TVHC)33255 Ninth St
Union City,CA94587 		23-7118361 501(c)(3) 80,000       Photovoice 2010; BiNational Health Fair Oct. 16, 2
(835) Tides Center1014 Torney Ave
San Francisco,CA941291755 		94-3213100 501(c)(3) 454,550       Innovations Incubator Tools Project
(836) To Celebrate Life Breast Cancer FoundationPO Box 367
Kentfield,CA949140367 		94-3323358 501(c)(3) 7,700       Stepping Out to Celebrate Life annual gala
(837) Toberman Neighborhood Center Inc131 N Grand
San Pedro,CA90731 		95-1643387 501(c)(3) 15,000       Request support for Toberman's Gang Intervention U
(838) TransFormCA436 14th St 600
Oakland,CA94612 		72-1521579 501(c)(3) 60,000       Creating a Healthier Bay Area through Improved Wal
(839) Transportation Options Group of OregonPO Box 12242
Portland,OR97212 		20-3860524 501(c)(3) 25,000       Westside Transportation Alliance Carfree Commuter
(840) Trauma Intervention Programs Inc6 Marble Creek Lane
Coto de Caza,CA92679 		33-0317893 501(c)(3) 10,000       Hospital Response Program
(841) Travelers Aid Society of Los Angeles Calif1507 Winona Blvd
Los Angeles,CA90027 		95-1691323 501(c)(3) 12,000       Crisis Management and Family Reunification
(842) Tri-City Health Center39500 Liberty St 2100
Fremont,CA94538 		23-7255435 501(c)(3) 80,000       Project LOUD (Live Outreach Uniquely Delivered; Te
(843) Ujima Family Recovery Services1901 Church Lane
San Pablo,CA948063707 		68-0127450 501(c)(3) 15,000       Children?s Recovery and Education Program
(844) Unforgettable Foundation7197 Brockton Ave 5
Riverside,CA92506 		33-0885478 501(c)(3) 10,000       CPR Training to Save the Lives of Children
(845) United Against Sexual Assault of Sonoma Co835 Piner Rd D
Santa Rosa,CA954032063 		94-2437947 501(c)(3) 14,000       Unity in Action -- Unidad con Accin
(846) United Health Centers of San Joaquin Valley650 Zediker Ave
Parlier,CA936482639 		94-1732538 501(c)(3) 39,761       Childhood Obesity Prevention & Diabetes Self-Manag
(847) United Negro College Fund220 Montgomery St 1120
San Francisco,CA94104 		13-1624241 501(c)(3) 15,000       Walk for Education, Health and Education Fair
(848) United Seniors of Oakland & Alameda County7200 Bancroft Ave 178
Oakland,CA94605 		94-3092404 501(c)(3) 29,360       7th Annual Healthy Living Festival July 9, 2010; I
(849) United Way of Fresno County4949 E Kings Canyon Rd
Fresno,CA93727 		94-1156514 501(c)(3) 80,000       Fresno First Steps Home Proj; 2010 211 Fresno Coun
(850) United Way of San Diego County4699 Murphy Canyon Rd
San Diego,CA92123 		95-2213995 501(c)(3) 25,000       Support United Way's Community Impact work which a
(851) United Way of San Joaquin County401 E Main St
Stockton,CA952023032 		94-1279805 501(c)(3) 15,000       Neighbors in Health
(852) United Way of Stanislaus County422 McHenry Ave
Modesto,CA95354 		94-1212129 501(c)(3) 106,760       2010 211 Stanislaus County; Stanislaus County 2-1-
(853) United Way of the Bay Area221 Main St 300
San Francisco,CA94105 		94-1312348 501(c)(3) 75,000       2010 211 Help Link
(854) United Way of the Wine Country418 B St 400
Santa Rosa,CA95401 		94-1669646 501(c)(3) 71,000       Day of Caring 2010; Neighbors in Health 2010
(855) United Way Silicon Valley750 Anderson St
San Jose,CA95126 		94-1450153 501(c)(3) 6,250       Charitable Donation
(856) United Way Silicon Valley1400 Parkmoor Ave 250
San Jose,CA95126 		94-1450153 501(c)(3) 50,000       2010 211 Santa Clara County
(857) UNIV OF MASS MED SCHOOL333 South St
Shrewsbury,MA01545 		04-3167352 501(c)(3) 240,474       Pass Through from Northern California region for v
(858) UNIVERSITY OF CALIFORNIA - DAVISPO Box 989062
West Sacramento,CA957989062 		94-6036494 501(c)(3) 79,206       Pass Through from Northern California region for v
(859) University Muslim Medical Association Inc1704 West Manchester Ave
Los Angeles,CA90047 		95-4666712 501(c)(3) 17,000       Promoting a Healthy Los Angeles through Primary &
(860) UNIVERSITY OF ALABAMA BIRMINGHAMAB 990 1530 3rd Ave S
Birmingham,AL352940109 		63-0649108 501(c)(3) 17,286       Pass Through from Northern California region for v
(861) UNIVERSITY OF CALIFORNIA - SAN FRANCISCOAccounting Office EMF Box 0897
San Francisco,CA94143 		94-6036493 501(c)(3) 4,643,965       Pass Through from Northern California region for v
(862) UNIVERSITY OF CALIFORNIA - SANTA CRUZ1156 High St
Santa Cruz,CA95064 		94-1539563 501(c)(3) 13,859       Pass Through from Northern California region for v
(863) UNIVERSITY OF CHICAGO6045 South Drexel Ave
Chicago,IL60637 		36-2177139 501(c)(3) 164,997       Pass Through from Northern California region for v
(864) UNIVERSITY OF HAWAII2530 Dole St Sakamarki D-200
Honolulu,HI96822 		99-6000354 501(c)(3) 25,318       Pass Through from Northern California region for v
(865) UNIVERSITY OF MICHIGAN3003 S State St
Ann Arbor,MI481091287 		38-6006309 501(c)(3) 36,421       Pass Through from Northern California region for v
(866) UNIVERSITY OF NORTH CAROLINACB 1350 104 Airport Dr
Chapel Hills,NC275991350 		56-6001393 501(c)(3) 14,076       Pass Through from Northern California region for v
(867) University of Southern California837 Downey Way STO 335
Los Angeles,CA900891147 		95-1642394 501(c)(3) 70,000       Improving Healthcare Access for the Underserved--T
(868) UNIVERSITY OF TEXASPO Box 203382
Houston,TX772163382 		74-1769336 501(c)(3) 24,607       Pass Through from Northern California region for v
(869) University of the Pacific3601 Pacific Ave
Stockton,CA95211 		94-1156266 501(c)(3) 6,000       HEALTHY CHILDREN 2010: REDUCING THE IMPACT OF CHIL
(870) UNIVERSITY OF UTAH75 South 2000 East
Salt Lake City,UT84112 		23-7112869 501(c)(3) 81,080       Pass Through from Northern California region for v
(871) Vacaville Public Education Foundation3442 Browns Valley Rd 400
Vacaville,CA956884246 		61-1568727 501(c)(3) 22,500       7th Annual Vacaville Public Education Foundation L
(872) Vacaville Social Services CorporationPO Box 6593 Shelter
Vacaville,CA95696 		68-0364021 501(c)(3) 20,000       Expanded Transitional Housing Access (ETHA)
(873) Vallejo Senior Citizens Council333 Amador St
Vallejo,CA94590 		23-7367329 501(c)(3) 7,500       Florence Douglas Senior Center (FDSC) Health Serv
(874) Valley Care Community Consortium Inc7515 Van Nuys Blvd Fifth Fl
Van Nuys,CA91405 		20-5569606 501(c)(3) 306,083       Specialty Care Initiative Phase II: C-SNAP
(875) Valley Community Clinic6801 Coldwater Canyon Ave 1B
North Hollywood,CA91605 		23-7050082 501(c)(3) 111,500       2009 KP QI Initiative
(876) Valley Village20830 Sherman Way
Winnetka,CA91306 		23-7314159 501(c)(3) 10,000       Adult Day Health Care Programs
(877) Valley Vision2320 Broadway
Sacramento,CA95818 		68-0153162 501(c)(3) 48,667       RUCS 2011 Forum; Community Access Pilot
(878) Venice Family Clinic604 Rose Ave
Venice,CA90291 		95-2769432 501(c)(3) 372,000       Specialty Care Initiative Phase II: Increase Speci
(879) Ventura Unified School District - Sheridan Way Fam255 West Stanley Ave 100
Ventura,CA93001 		95-2397308 GOVT ENTITY 7,500       Andale - Get Moving
(880) VIP Community Mental Health Center Inc1721 Griffin Ave
Los Angeles,CA90031 		30-0017808 501(c)(3) 6,000       Santana House Youth Action Center Youth Leadership
(881) Vision y Compromiso2536 Edwards Ave
El Cerrito,CA94530 		32-0071651 501(c)(3) 24,000       Familia Saludable: The Healthy Family Diabetes Pre
(882) Visiting Nurse Association of the Inland Counties6235 River Crest Dr L
Riverside,CA92507 		95-1641973 501(c)(3) 10,000       Riverside Mourning Star Center
(883) Vista Community Clinic1000 Vale Terrace
Vista,CA92084 		95-2815615 501(c)(3) 72,919       Counseling for Positives
(884) Vista Del Mar Child and Family Services Jewish Orp3200 Motor Ave
Los Angeles,CA90034 		95-1647832 501(c)(3) 6,500       Agency Based Mental Health Services
(885) VMC Foundation2400 Moorpark 207
San Jose,CA951282625 		77-0187890 501(c)(3) 28,500       Grand Opening of Valley Health Center Milpitas; Tu
(886) Volunteer Center of Greater Orange County1901 East Fourth St 100
Santa Ana,CA92705 		95-2021700 501(c)(3) 258,000       eConsult program
(887) Walk San Diego740 13th St 502
San Diego,CA92101 		46-0505205 501(c)(3) 75,000       Next Steps VI
(888) Wallace Medical Concern254 NW Burnside
Gresham,OR97030 		93-0853709 501(c)(3) 27,500       Growing WMC Capacity to Expand to Primary Care
(889) Washington State University FoundationPO Box 641927
Pullman,WA99164 		91-1075542 501(c)(3) 15,000       Charitable Donation
(890) Watts Willowbrook Boys & Girls Club1339 East 120th St
Los Angeles,CA90059 		95-1945829 501(c)(3) 25,500       general operating support
(891) WEAVE Inc1900 K St
Sacramento,CA958144187 		94-2493158 501(c)(3) 44,000       Crisis Advocacy and Therapeutic Counseling Service
(892) Weingart Center Association566 S San Pedro St
Los Angeles,CA90013 		95-6054617 501(c)(3) 12,000       Clinical Services
(893) Wellness Community - Foothills Inc200 East Del Mar Blvd 118
Pasadena,CA91105 		95-4201985 501(c)(3) 7,500       10th Annual Women's Educational Health Conference
(894) West Coast Sports Medicine Foundation1200 Rosecrans Ave 206
Manhattan Beach,CA90266 		95-4497009 501(c)(3) 25,000       Sports medicine injury clinic
(895) West County Health Centers Inc14045 Mill St
Guerneville,CA95446 		23-7310613 501(c)(3) 8,000       West County Homeless Outreach and Medical Engageme
(896) West Marin Senior Services11435 State Highway One
Point Reyes Station,CA949560791 		51-0192320 501(c)(3) 14,000       Holstein Hundred; Case Management for Frail and Ru
(897) West Side Food Bank1710 22nd St
Santa Monica,CA90404 		95-3685875 501(c)(3) 30,000       Healthy Eating In Hard Times: Westside Food Bank's
(898) West Valley Community Services10104 Vista Dr
Cupertino,CA95014 		94-2211685 501(c)(3) 8,635       Community Access Resources Education (CARE)
(899) Western Clinicians NetworkPO Box 191
Zamora,CA95698 		94-3138160 501(c)(3) 40,000       core supporting support
(900) Western Justice Center Foundation55 South Grand Ave
Pasadena,CA91105 		95-4176583 501(c)(3) 35,000       Core support
(901) Westminster Free Clinic5560 Napoleon Ave
Oak Park,CA91377 		77-0563241 501(c)(3) 15,000       Volunteer-based Health Clinic Services
(902) Westside Community Mental Health Center1153 Oak St
San Francisco,CA941172216 		94-1164909 501(c)(3) 10,000       2010 Grant - Crisis Clinic Wellness & Resiliency G
(903) Westside Family Health Center1711 Ocean Park Blvd
Santa Monica,CA90405 		95-2931931 501(c)(3) 17,000       VYBE (Visions for Youth Becoming Empowered)
(904) Westside Neighborhood Clinic2125 Santa Fe Ave
Long Beach,CA90810 		95-2973364 501(c)(3) 12,500       Clinical Services Expansion
(905) Whittier Rio Hondo AIDS Project9200 Colima Rd 104
Whittier,CA90605 		95-4438637 501(c)(3) 15,000       HIV Case Management and Mental Health Program
(906) William James Association647 S King Rd
San Jose,CA95116 		23-7320163 501(c)(3) 25,000       Veggie Youth Leadership and Outreach Project
(907) Wilmington Community Free Clinic1009 N Avalon Blvd
Wilmington,CA90744 		95-3137803 501(c)(3) 10,000       Expanded Access to Breast Cancer Screening
(908) WIND Youth Services701 Dixieanne Ave
Sacramento,CA958153121 		55-0844444 501(c)(3) 35,000       HealthShack Outreach and Clinical Care Coordinatio
(909) WISE Senior Services Inc1527 Fourth St 2nd Fl
Santa Monica,CA90401 		95-2788014 501(c)(3) 12,000       Wise & Healthy Aging Elder Health Education Projec
(910) Women At Work3871 E Colorado Blvd
Pasadena,CA91107 		95-3411403 501(c)(3) 15,000       Women at Work, Women at Play: An Evening of Comedy
(911) Womens Breast Cancer Resource Center41785 Elm St 305
Murrieta,CA92562 		33-0951216 501(c)(3) 10,000       Survivor Support Program
(912) Women's Initiative for Self Employment1398 Valencia St
San Francisco,CA941103715 		94-3081525 501(c)(3) 73,750       Providing Economic Opportunity to Low-Income Entre
(913) Worker Education and Resource Center Inc500 South Virgil Ave 200
Los Angeles,CA90020 		95-4888539 501(c)(3) 40,000       Los Angeles Healthcare Workforce Development Progr
(914) Workforce Development Corporation Southeast Los An10900 East 183rd St 350
Cerritos,CA90703 		33-0287492 501(c)(3) 85,000       Healthcare Occupations Training (HOT) Project
(915) Working Wonders35-325 Date Palm Dr 145
Cathedral City,CA92234 		33-0944802 501(c)(3) 7,000       From High Risk to Mainstream
(916) Worksite Wellness LA5955 South Western Ave
Los Angeles,CA90047 		55-0802354 501(c)(3) 6,000       Project Access
(917) YMCA of East Bay263 So 20th St
Richmond,CA948042709 		94-1156317 501(c)(3) 24,000       Prevention and Early Intervention of Mental Illnes
(918) YMCA of Silicon Valley1922 The Alameda 3rd Fl
San Jose,CA95126 		94-1156318 501(c)(3) 120,500       Asset Champions Awards Breakfast March 25; Buildin
(919) YMCA of the East Bay263 South 20th St
Richmond,CA94804 		94-1156317 501(c)(3) 90,000       Mental Health/Substance Abuse Prevention and Early
(920) Yolo County Childrens Alliance600 A St Y
Davis,CA946163648 		68-0526185 501(c)(3) 52,420       2010 Essential Services Program - Essential Servic
(921) Yolo Family Resource Center828 Court St
Woodland,CA95695 		47-0871252 501(c)(3) 10,000       Access to Health Project
(922) Young & Healthy37 North Holliston Ave
Pasadena,CA91106 		95-4527969 501(c)(3) 25,000       core programmatic and operational support
(923) YMCA of Metropolitan Los Angeles6901 Lennox Ave
Van Nuys,CA91405 		95-1644052 501(c)(3) 104,500       Mid Valley Family YMCA's Healthy Communities Outre
(924) YWCA Sonoma Co1421 Guerneville Rd 200
Santa Rosa,CA954037238 		94-2347428 501(c)(3) 15,000       YWCA Domestic Violence Counseling for Women and Ch
(925) YWCA of Glendale735 E Lexington Dr
Glendale,CA91206 		95-1644057 501(c)(3) 12,000       ENCOREplus
(926) YWCA of San Pedro437 W 9th St
San Pedro,CA90731 		95-1691337 501(c)(3) 10,000       Breast Cancer Early Detection Program
(927) Youth ALIVE3300 Elm St
Oakland,CA946093012 		94-3143254 501(c)(3) 75,000       Hospital-based Youth Violence Technical Assistance
(928) Youth and Family Enrichment Services610 Elm St 212
San Carlos,CA940703070 		94-3094966 501(c)(3) 15,750       The Children's Place; 18th Annual 'Starting Line B
(929) Youth and Family Services Inc1017 Tennessee St
Vallejo,CA945904547 		94-2793548 501(c)(3) 20,000       Parents and Children Recovering Together
(930) Youth Enrichment Strategies2811 Macdonald Ave
Richmond,CA948043008 		03-0458294 501(c)(3) 15,000       PeaceTalk: Non-Defensive Communication for Positiv
(931) Youth for Christ USA Inc1102 N School St
Stockton,CA952053721 		94-1708137 501(c)(3) 47,170       Reducing School Violence Partnership
(932) Youth Leadership Institute2440 Tulare St 200
Fresno,CA93721 		68-0184712 501(c)(3) 19,750       Snack Shack Makeover
(933) Youth Speak Collective11243 Glenoaks Blvd 11
Pacoima,CA91331 		27-0126980 501(c)(3) 18,000       Project Youth Green Program
(934) Youth Together449 15th St 302
Oakland,CA946122821 		35-2201239 501(c)(3) 15,000       Richmond Youth Leadership Initiative
(935) Yu-Ai Kai Japanese Americ Sr Svcs San Jose588 N 4th St
San Jose,CA951125311 		94-2427398 501(c)(3) 15,000       Seniors-at-Home Outreach Program
(936) Zero Breast Cancer4340 Redwood Hwy C400
San Rafael,CA949032121 		68-0386016 501(c)(3) 11,694       Honor thy Healer i
(937) JK GroupPO Box 24619
Oakland,CA94623 		501(c)(3) 26,038       matching gift
(938) tabernacle community development corporation1601 McKinnon St
SAN FRANCISCO,CA94124 		94-3402767 501(c)(3)   10,955,342 book low income bldg proj demolish the 21-unit residential apartment building and have the site reclassified for medical use zoning
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
938
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













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
SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANTS Grantees are required to submit a final report that describes progress toward goals, impact to date, as well as financial accounting for how funds were used.
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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
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) Gregory A Adams (i)
(ii)		 0
604,032 		0
604,028 		0
24,458 		0
256,054 		0
13,068 		0
1,501,640 		0
0
(2) Peter Andruszkiewicz (i)
(ii)		 0
396,169 		0
227,750 		0
21,290 		0
141,947 		0
15,982 		0
803,138 		0
0
(3) Terry L Austen (i)
(ii)		 0
272,592 		0
113,453 		0
100,683 		0
157,172 		0
13,068 		0
656,968 		0
81,042
(4) Mary Ann Barnes (i)
(ii)		 0
332,077 		0
156,576 		0
23,426 		0
112,671 		0
11,306 		0
636,056 		0
0
(5) Anne D Barr (i)
(ii)		 0
151,827 		0
220,670 		0
143,041 		0
28,633 		0
23,068 		0
567,239 		0
0
(6) Anthony A Barrueta (i)
(ii)		 0
354,645 		0
196,875 		0
19,936 		0
103,343 		0
13,068 		0
687,867 		0
0
(7) Raymond J Baxter (i)
(ii)		 0
521,756 		0
575,493 		0
239,532 		0
62,481 		0
13,068 		0
1,412,330 		0
197,173
(8) Michael O Brady (i)
(ii)		 0
339,433 		0
219,476 		0
34,030 		0
74,725 		0
24,892 		0
692,556 		0
0
(9) Virginia C Campbell (i)
(ii)		 0
348,178 		0
74,487 		0
37,192 		0
84,326 		0
13,611 		0
557,794 		0
0
(10) Christine K Cassel (i)
(ii)		 0
172,625 		0
0 		0
0 		0
0 		0
0 		0
172,625 		0
0
(11) William B Caswell (i)
(ii)		 0
367,772 		0
238,537 		0
35,867 		0
98,691 		0
11,306 		0
752,173 		0
0
(12) Thomas W Chapman Edd (i)
(ii)		 0
185,427 		0
0 		0
0 		0
59,810 		0
0 		0
245,237 		0
0
(13) Benjamin K Chu (i)
(ii)		 0
604,656 		0
743,048 		0
24,458 		0
260,985 		0
11,306 		0
1,644,453 		0
0
(14) Judith L Coffey (i)
(ii)		 0
282,503 		0
126,138 		0
128,623 		0
199,650 		0
13,068 		0
749,982 		0
108,343
(15) Charles E Columbus (i)
(ii)		 0
356,817 		0
310,248 		0
130,789 		0
97,687 		0
13,068 		0
908,609 		0
0
(16) Diane Comer (i)
(ii)		 0
318,214 		0
197,712 		0
33,458 		0
82,522 		0
13,068 		0
644,974 		0
0
(17) Mark E Costa (i)
(ii)		 0
283,109 		0
131,935 		0
16,452 		0
74,531 		0
11,306 		0
517,333 		0
0
(18) Richard D Daniels (i)
(ii)		 0
435,258 		0
346,897 		0
28,658 		0
115,802 		0
13,611 		0
940,226 		0
0
(19) Steven Doshay (i)
(ii)		 0
180,446 		0
73,941 		0
5,600 		0
43,366 		0
11,306 		0
314,659 		0
0
(20) Philip Fasano (i)
(ii)		 0
659,255 		0
1,005,000 		0
97,929 		0
294,051 		0
12,436 		0
2,068,671 		0
0
(21) Elizabeth Jane Finley (i)
(ii)		 0
285,266 		0
160,264 		0
39,117 		0
95,011 		0
11,306 		0
590,964 		0
0
(22) Jerry C Fleming (i)
(ii)		 0
417,965 		0
457,586 		0
145,571 		0
170,037 		0
13,611 		0
1,204,770 		0
86,983
(23) Diane E Gage Lofgren (i)
(ii)		 0
368,334 		0
411,793 		0
22,560 		0
138,120 		0
13,611 		0
954,418 		0
0
(24) Lazaro M Garcia (i)
(ii)		 0
289,344 		0
202,950 		0
89,840 		0
137,917 		0
13,068 		0
733,119 		0
0
(25) Daniel P Garcia (i)
(ii)		 0
517,930 		0
585,000 		0
177,308 		0
62,481 		0
11,306 		0
1,354,025 		0
151,518
(26) Jennifer M Gardner (i)
(ii)		 0
95,718 		0
6,040 		0
1,489 		0
41,870 		0
13,068 		0
158,185 		0
0
(27) Edward S Glavis (i)
(ii)		 0
314,973 		0
183,532 		0
76,627 		0
108,721 		0
13,068 		0
696,921 		0
39,382
(28) Sandra A Golze (i)
(ii)		 0
242,163 		0
132,711 		0
16,960 		0
85,624 		0
13,068 		0
490,526 		0
0
(29) Mitchell J Goodstein (i)
(ii)		 0
420,962 		0
452,848 		0
25,254 		0
146,821 		0
13,068 		0
1,058,953 		0
0
(30) William R Graber (i)
(ii)		 0
232,123 		0
0 		0
0 		0
0 		0
0 		0
232,123 		0
0
(31) J Eugene Grigsby III PhD (i)
(ii)		 0
193,743 		0
0 		0
0 		0
0 		0
0 		0
193,743 		0
0
(32) George C Halvorson (i)
(ii)		 0
1,177,487 		0
5,155,125 		0
1,334,723 		0
62,481 		0
13,611 		0
7,743,427 		0
0
(33) Corwin Nathaniel Harper (i)
(ii)		 0
269,943 		0
128,366 		0
16,080 		0
72,945 		0
13,611 		0
500,945 		0
0
(34) Garry L Hurlbut (i)
(ii)		 0
174,074 		0
396,445 		0
83,998 		0
65,219 		0
6,784 		0
726,520 		0
46,026
(35) Linda J Jensen (i)
(ii)		 0
282,103 		0
144,033 		0
18,433 		0
105,772 		0
13,068 		0
563,409 		0
0
(36) Judith Johansen (i)
(ii)		 0
184,560 		0
0 		0
0 		0
0 		0
0 		0
184,560 		0
0
(37) Marilyn Kawamura (i)
(ii)		 0
390,260 		0
438,827 		0
132,118 		0
194,439 		0
12,893 		0
1,168,537 		0
90,440
(38) Patricia Kennedy-Scott (i)
(ii)		 0
362,953 		0
312,689 		0
39,013 		0
150,579 		0
16,231 		0
881,465 		0
0
(39) Kathryn Lancaster (i)
(ii)		 0
615,090 		0
919,900 		0
23,086 		0
283,406 		0
13,068 		0
1,854,550 		0
0
(40) Janet A Liang (i)
(ii)		 0
361,133 		0
292,123 		0
24,529 		0
130,917 		0
9,873 		0
818,575 		0
0
(41) Donna Lynne (i)
(ii)		 0
393,534 		0
404,384 		0
22,740 		0
169,239 		0
13,511 		0
1,003,408 		0
0
(42) Christine L Malcolm (i)
(ii)		 0
0 		0
0 		0
568,721 		0
0 		0
12,021 		0
580,742 		0
0
(43) Philip Marineau (i)
(ii)		 0
193,623 		0
0 		0
0 		0
0 		0
0 		0
193,623 		0
0
(44) Gerald A McCall (i)
(ii)		 0
383,512 		0
246,037 		0
72,489 		0
125,415 		0
11,306 		0
838,759 		0
51,102
(45) Andrew R McCulloch (i)
(ii)		 0
392,037 		0
353,325 		0
67,791 		0
194,628 		0
12,994 		0
1,020,775 		0
0
(46) Colleen M McKeown (i)
(ii)		 0
308,591 		0
163,158 		0
17,032 		0
96,588 		0
13,068 		0
598,437 		0
0
(47) Judith M Mears (i)
(ii)		 0
233,623 		0
144,237 		0
28,109 		0
84,337 		0
13,611 		0
503,917 		0
0
(48) Thomas R Meier (i)
(ii)		 0
316,076 		0
297,094 		0
34,615 		0
94,371 		0
13,068 		0
755,224 		0
0
(49) Julie Miller-Phipps (i)
(ii)		 0
311,375 		0
189,079 		0
16,790 		0
98,706 		0
11,306 		0
627,256 		0
0
(50) Jenny J Ming (i)
(ii)		 0
182,748 		0
0 		0
0 		0
0 		0
0 		0
182,748 		0
0
(51) Henry Neidermeier (i)
(ii)		 0
259,197 		0
195,704 		0
287,352 		0
95,353 		0
13,611 		0
851,217 		0
0
(52) Indrajit Obeysekere (i)
(ii)		 0
201,691 		0
94,972 		0
16,292 		0
40,976 		0
13,611 		0
367,542 		0
0
(53) Donald H Orndoff (i)
(ii)		 0
333,479 		0
0 		0
174,579 		0
57,212 		0
13,720 		0
578,990 		0
0
(54) Nathaniel L Oubre (i)
(ii)		 0
354,886 		0
153,469 		0
56,948 		0
92,317 		0
11,560 		0
669,180 		0
0
(55) Edward Pei (i)
(ii)		 0
168,250 		0
0 		0
0 		0
16,500 		0
0 		0
184,750 		0
0
(56) J Neal Purcell (i)
(ii)		 0
219,738 		0
0 		0
0 		0
0 		0
0 		0
219,738 		0
0
(57) Paul B Records (i)
(ii)		 0
345,387 		0
483,350 		0
1,412,799 		0
35,147 		0
48,611 		0
2,325,294 		0
133,545
(58) Frank P Richardson (i)
(ii)		 0
193,345 		0
54,193 		0
4,194 		0
32,219 		0
9,873 		0
293,824 		0
0
(59) Thomas J Risse (i)
(ii)		 0
271,531 		0
93,733 		0
144,045 		0
43,354 		0
9,873 		0
562,536 		0
0
(60) Christine Robisch (i)
(ii)		 0
277,998 		0
123,699 		0
16,803 		0
75,648 		0
13,611 		0
507,759 		0
0
(61) Rochelle M Roth (i)
(ii)		 0
156,416 		0
23,838 		0
2,385 		0
38,895 		0
12,680 		0
234,214 		0
0
(62) Jacqueline Sellers (i)
(ii)		 0
173,781 		0
71,202 		0
14,493 		0
55,491 		0
13,611 		0
328,578 		0
0
(63) Arthur M Southam (i)
(ii)		 0
735,252 		0
1,241,861 		0
43,186 		0
342,622 		0
11,306 		0
2,374,227 		0
0
(64) Deborah Stokes (i)
(ii)		 0
313,713 		0
249,552 		0
59,377 		0
110,792 		0
13,068 		0
746,502 		0
40,338
(65) Cynthia Telles PHD (i)
(ii)		 0
182,647 		0
0 		0
0 		0
0 		0
0 		0
182,647 		0
0
(66) Sandra Thompkins (i)
(ii)		 0
166,951 		0
0 		0
0 		0
0 		0
0 		0
166,951 		0
0
(67) Bernard J Tyson (i)
(ii)		 0
737,887 		0
1,180,500 		0
24,127 		0
346,893 		0
13,068 		0
2,302,475 		0
0
(68) Max Villalobos (i)
(ii)		 0
285,500 		0
203,851 		0
68,307 		0
82,980 		0
13,611 		0
654,249 		0
0
(69) Herman M Weil (i)
(ii)		 0
325,892 		0
280,379 		0
144,075 		0
240,582 		0
15,563 		0
1,006,491 		0
103,458
(70) Jed Weissberg (i)
(ii)		 0
454,021 		0
246,469 		0
23,241 		0
207,651 		0
13,068 		0
944,450 		0
0
(71) Vita M Willett (i)
(ii)		 0
270,405 		0
109,719 		0
17,318 		0
89,992 		0
11,306 		0
498,740 		0
0
(72) Carlos Zaragoza (i)
(ii)		 0
253,758 		0
150,787 		0
20,140 		0
126,165 		0
11,306 		0
562,156 		0
0
(73) Steven R Zatkin (i)
(ii)		 0
283,028 		0
932,500 		0
31,725 		0
86,239 		0
11,477 		0
1,344,969 		0
0
(74) Victoria B Zatkin (i)
(ii)		 0
196,570 		0
80,174 		0
34,625 		0
81,763 		0
1,884 		0
395,016 		0
0
(75) Mark S Zemelman (i)
(ii)		 0
342,852 		0
224,105 		0
239,242 		0
137,956 		0
12,680 		0
956,835 		0
57,187
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
Schedule J, Part I, Line 3 Top Management Officials' Compensation Kaiser Foundation Hospitals relied on Kaiser Foundation Health Plan, Inc that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study, and - Approval by the board or compensation committee
SCHEDULE J, PART I, LINE 4-A SEVERANCE PAYMENTS Paul Records $ 880,595 Christine Malcolm 568,515 Anne Barr 134,823 Total $ 1,583,933 Listed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments.
SCHEDULE J, PART I, LINE 4-B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS George Halvorson $ 1,237,500 Paul Records 451,325 Henry Neidermeier 251,356 Mark Zemelman 218,741 Raymond Baxter 197,173 Daniel Garcia 151,518 Judith Coffey 108,343 Herman Weil 103,458 Marilyn Kawamura 92,729 Jerry Fleming 90,843 Terry Austen 81,042 Gerald McCall 53,088 Garry Hurlbut 49,898 Edward Glavis 41,219 Steven Zatkin 5,463 Judith Mears 2,643 Mitchell Goodstein 921 Nathaniel Oubre 815 Thomas Meier 609 Kathryn Lancaster 368 Total $ 3,139,051 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture.
Schedule J, Line 7   The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HOSPITALS
 
Employer identification number
94-1105628
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA STATEWIDE CMNTYS DEV AUTH
  		52-1598225 130911RW2 08-06-2003 213,060,000 FINANCE HEALTH CARE FACILITY   X   X   X
B CALIFORNIA STATEWIDE CMNTYS DEV AUTH
  		68-0164610 130911WF3 03-30-2004 1,600,000,000 FINANCE HEALTH CARE FACILITY   X   X   X
C CALIFORNIA STATEWIDE CMNTYS DEV AUTH
  		68-0164610 1309112G4 06-08-2006 916,299,000 FINANCE HEALTH CARE FACILITY   X   X   X
D CALIFORNIA HEALTH FACILITIES FINANCING AUTH
  		52-1643828 13033FK74 06-08-2006 600,000,000 FINANCE HEALTH CARE FACILITY   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 0 0 0 0
2 Amount of bonds defeased . . . . 0 0 0 0
3 Total proceeds of issue . . . . 213,060,000 1,639,844,037 954,024,896 602,245,616
4 Gross proceeds in reserve funds . . 0 0 0 0
5 Capitalized interest from proceeds. 0 0 0 0
6 Proceeds in refunding escrow. . . . . 0 0 0 0
7 Issuance costs from proceeds . . . 0 6,375,000 0 0
8 Credit enhancement from proceeds. 0 0 0 0
9 Working capital expenditures from proceeds . . 0 0 0 0
10 Capital expenditures from proceeds . . 0 1,633,469,037 954,024,896 602,245,616
11 Other spent proceeds . . 0 0 0 0
12 Other unspent proceeds. . . 0 0 0 0
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X     X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X     X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . . X   X   X   X  
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .   X   X   X   X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X X  
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X X     X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X X   X  
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
2003 CSCDA   2003 CSCDA Bond Part III, Private Use, questions 1 and 2 have not been answered due to the instructions stating "Complete for Bond Issues listed in rows A - D of Part I, other than listed bond issues that are post-December 31, 2002 refunding issues which refund pre-January 1, 2003 bond issues directly or through a series of refundings. The 2003 bonds refunded were bonds issued from October 1983, November 1985, and May 1993
2006 CSCDA / CHFFA   2006 CSCDA / CHFFA Variable and 2006 CSCDA / CHFFA Fixed have multiple Issuers and therefore multiple EIN numbers. The EIN number reported matched the reported cusip
Part II Line 3   Difference between total proceeds (Part II line 3) and issue price (Part I) is due to interest earned on the construction fund.
Schedule K (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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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) MARK MALCOLM KFHP INC EMPLOYEE 96,476 COMPENSATION   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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
Identifier Return Reference Explanation
PART I, LINE 10 (PRIOR YEAR)   2009 Form 990, Part VIII, line 7c In 2009, we reported $974,611,656 loss from sales of securities. We have received final tax basis numbers showing $507,797,695 loss from sales of securities. We have updated page 1 of the 2010 Form 990 prior year column to reflect this correction. If we had presented this information at the time of filing the 2009 Form 990 the presentation in Part VIII would have been: 7a gross proceeds 4,641,612,303 7b less: cost (5,149,409,998) 7c gain (loss) (507,797,695)
PART I, LINE 19   CURRENT YEAR REVENUE LESS EXPENSES $ 1,371,690,345 OTTI (NOTE 1) (190,424,614) BOOK GAIN ON SALE OF INVESTMENTS 704,114,095 TAX GAIN ON SALE OF INVESTMENTS (288,920,405) HEALTH CARE MANAGEMENT SOLUTIONS, LLC 3,388,821 OTHER PASSTHROUGH INCOME (39,388,267) KP ONCALL, LLC 2,359,386 KPV, LLC - SERIES A (215,204) KFHP - CO RESTRICTED GRANT (20,299,319) INTERCOMPANY ELIMINATIONS (11,859,472) UNAUDITED STANDALONE GAAP REVENUE LESS EXPENSES $ 1,530,445,365 NOTE 1: OTHER THAN TEMPORARY IMPAIRMENT OF INVESTMENT RECOGNIZED FOR FINANCIAL STATEMENT PURPOSES, WHICH WILL BE TAX REPORTED WHEN REALIZED
PART III, LINE 4A-D   Kaiser Foundation Hospitals (KFH) and Kaiser Foundation Health Plan, Inc. (KFHP), with its five principal operating tax-exempt subsidiary health plans-Kaiser Foundation Health Plan of Colorado; Kaiser Foundation Health Plan of Georgia, Inc.; Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Kaiser Foundation Health Plan of the Northwest; and Kaiser Foundation Health Plan of Ohio, are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." Kaiser Permanente is an integrated health care delivery system that combines the provision and financing of health care services. People who elect to enroll in a Kaiser Permanente health plan receive a full range of prepaid health care services, including hospital care, professional care in hospitals and physicians' offices, x-ray and laboratory services, physical therapy, emergency, ambulance transportation, preventive services, health education and certain prescribed drugs. More comprehensive drug coverage is also provided through a separate coverage rider. KFHP and KFH are separate corporations governed by identical boards of directors. KFH accepts responsibility to provide or arrange necessary hospital services and facilities for Health Plan members. KFH owns and operates 38 licensed hospitals, including several licensed hospitals with multiple campuses in California, Hawaii and Oregon, which provide emergency and in-patient services to all persons in the community regardless of membership or ability to pay. Staff privileges are available on a nondiscriminatory basis to physicians in the communities served. KFH also contracts with other community hospitals to provide hospital services to members for specialized care and other services. In California, KFH medical centers are located in the cities of Anaheim, Antioch, Baldwin Park, Downey, Fontana, Fremont, Fresno, Harbor City, Hayward, Irvine, Los Angeles, Manteca, Modesto, Moreno Valley, Oakland, Panorama City, Redwood City, Richmond, Riverside, Roseville, Sacramento, San Diego, San Francisco, San Jose, San Rafael, Santa Clara, Santa Rosa, South Sacramento, South San Francisco, Vacaville, Vallejo, Walnut Creek, West Los Angeles, and Woodland Hills. In Hawaii, the Moanalua Medical Center is located in the City of Honolulu on the island of Oahu. In Oregon, the Sunnyside Medical Center is located in the City of Clackamas. Services provided by KFH and membership in Health Plan are available without regard to sex, race, religion, ethnic background, sexual orientation, occupational status or income level. Health Plan members are broadly representative of the various ages, social, and income groups within the areas served. Once enrolled, a member is free to maintain membership regardless of age, health status, or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre Programs, Safety Net Partnerships, Community Health Initiatives and Charitable Health Coverage Programs. In 2007, the KFHP/H Board of Directors refined the focus of the organization's Community Benefit Program and established the following four priority areas which have come to be known as "streams of work": - Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for the under- and uninsured. - Community Health Initiatives - Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improves health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four priority areas. COMMUNITY BENEFIT PROVIDED BY KAISER FOUNDATION HOSPITALS KFH's principal purpose is to provide hospital, medical, and surgical care, including emergency services, extended care, and home health care to members of the public without regard to age, sex, race, religion, or national origin, or to the individual's ability to pay. KFH's general community benefits are: Emergency Departments - KFH operates full-time emergency departments in each of its 38 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon. Emergency medical services are available to all individuals regardless of their ability to pay. Care Provided to All Patients - Hospital care is provided to individuals with health care coverage from any private or government-sponsored health plan, insured and uninsured referrals from safety net and other public health partnerships, and uninsured patients admitted through the emergency department. Open Medical Staff Privileges - Staff privileges in the hospitals are available to community practitioners who are not affiliated with a Permanente Medical Group.
.   THE COMMUNITY BENEFIT PROGRAMS IN CALIFORNIA, HAWAII, OREGON AND WASHINGTON In 2010, KFH spent approximately $879 million to support the Community Benefit Program. Breakdowns of the 2010 Community Benefit dollars attributable to KFH for its hospital-based regions (California, Hawaii, Oregon and Washington) are described in Attachment A. The following identifies many of the signature community benefit programs and services, grouped according to the national streams of work, funded by KFH. CARE AND COVERAGE FOR LOW-INCOME PEOPLE There are roughly 46 million Americans without access to health care or coverage. Uninsured, low-income individuals and families who are not eligible for public programs often have to rely on traditional charity care. Frequently, individuals in this situation may wait to seek medical care until their conditions become critical, and end up in hospital emergency rooms for treatment of conditions that are preventable or easily treated in earlier stages. In 2010, KFH invested approximately $593 million to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age, or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or by a Permanente provider. Following are highlights of the programs and services provided to vulnerable populations in California, Hawaii, Oregon and Washington: Charitable Care (Medical Financial Assistance and Charitable Health Coverage) KFH provides charity care to low-income vulnerable populations through the Medical Financial Assistance and Charitable Health Coverage programs. - Medical Financial Assistance (MFA) KFH contributed approximately $162 million to assist patients with limited or no resources to pay for care provided in Kaiser Permanente facilities. Each hospital-based region offers financial assistance to help families and individuals who are unable to meet all or part of the cost of medical care on an immediate and nonrecurring basis. Kaiser Permanente expanded its charity care program to include discounted charges for uninsured patients below 400% of the federal poverty guidelines and aligned contracted collection agency practices with Kaiser Permanente social values. The amount reported under this category is only part of the funds spent by KFH for the poor and uninsured. The organization's commitment to charitable care is also reflected in a variety of other programs and initiatives such as the Charitable Health Coverage Program and grants and donations to community clinics and other safety net providers. The MFA programs in California and Hawaii strive to assist families and individuals who are unable to meet all or part of the cost of medical care on an immediate and nonrecurring basis. The program is designed to assist as many patients as reasonably possible and is generally available to people in greatest financial need, including those experiencing unusual or unfortunate circumstances. The MFA program's eligibility criteria allows most patients below 350% of the federal poverty guidelines (FPG) to receive full write off, that uninsured patients who do not qualify for MFA but make less the 400% FPG will receive up to a 70% discount on charges and that any patient experiencing financial hardship due to unreasonable medical expenses relative to their income may qualify for the program under "special circumstances". In 2010, the programs provided 102,067 MFA awards, which included approximately 604,312 prescriptions and more than 120 thousand subsidized in-patient days of care. In Oregon and Washington, the MFA program supports patients with limited resources by forgiving full or partial expenses for medical and /or dental expenses if they meet the qualifying guidelines. In 2010, the program provided more than 7,726 MFA awards, which included approximately 107,428 prescriptions and more than 15 thousand subsidized I/P days of care. - Charitable Health Coverage Program Charitable Health Coverage (CHC) is a unique approach to caring for low-income uninsured people in the community. Participants receive a regular Kaiser Permanente membership card and access to the full range of our services and providers-a much better alternative to a brief and costly emergency room visits or hospitalization. This allows us to invest in the longer term health of patients and the community. Since the early 1980s, CHC programs have made a real difference in the lives of low-income people who were not eligible for other public or privately sponsored coverage. In 2010, approximately 93,928 low-income adults and children who were not eligible for other public or privately sponsored coverage received health care coverage through one of Kaiser Permanente's Charitable Health Coverage Programs in California, Hawaii, Oregon and Washington. KFH contributed $67 million to provide subsidized care for these underserved populations in 2010. The Steps Plan and Kaiser Permanente Child Health Plan are the specific products that form the Charitable Health Coverage Programs in California. Kaiser Permanente Steps Plan - The Steps Plan provided 7,686 individuals the opportunity to continue their health care coverage at reduced cost when experiencing financial difficulty due to job loss, involuntary reduction in work hours, legal separation, divorce or death of a spouse. Typically, participants are not eligible for any public or private group health insurance plan, and have family income between 100% and 300% of the federal poverty guidelines. The plan is available to parents of children enrolled in AIM, Healthy Families or Kaiser Permanente Child Health Plan as well as to individuals participating in vocational training programs offered through government, private industry councils and social agencies. The Steps Plan premium is subsidized at four levels or steps: 20%, 40%, 60%, and 80%. Participants are placed in an initial premium step based on their current family income. They remain at the initial step for one year and are then moved to the next higher step. Kaiser Permanente Child Health Plan (KPCHP) - The Child Health Plan provides medical and dental coverage to eligible children (birth through 18) in families with income up to 300% of the federal poverty guidelines who do not have access to employer-subsidized coverage and do not qualify for public programs because of family income or immigration status. Child Health Plan provides comprehensive benefits including preventive care, inpatient and outpatient services, prescription drugs, and vision and dental care. Premiums are $8 or $15 per child per month, depending on family income, for a maximum of three children (additional children are covered free of charge). In 2010, approximately 79,532 children received care and coverage through this program.
.   KFH in the Northwest subsidized coverage to 5,428 low-income adults and children who are not eligible for standard Medicaid or privately funded coverage. The Charitable Health Coverage Program consists of Transitions, Child Health Program, and Washington Basic Health. - Transitions - This program is a fully subsidized health insurance program for eligible low-income families. Eight college campuses currently participate within the Portland Metropolitan area. Students must be enrolled in a participating school, meet the financial criterion, and can not be enrolled in another private or pubic health care plan. Graduates are eligible for an additional six months coverage or until the employer-paid coverage is activated. - Child Health Program - Northwest Health Plan offers full subsidy health insurance for eligible low-income students. Currently, 180 schools within the Multnomah Education Service District, Salem-Keizer School District, and Hillsboro School District participate in this program. Students must be enrolled in a participating school, meet the financial criterion, and can not be enrolled in another private or pubic health care plan. The participating school districts act as the administrator for the program and are responsible for outreach, and enrollment. - Washington Basic Health Plan - This program offers quality, low-cost health coverage to eligible people who live in Washington State and is managed by Washington State Health Care Authority (HCA). The Northwest Health Plan provides service to eligible participants who reside in Clark or Cowlitz counties. Participation in Medicaid and Other Government-Sponsored Programs KFH has a long history of participating in publicly financed health programs. In 2010, $361 million was expended (in excess of reimbursement) on government- sponsored programs for low-income people in California, Hawaii, Oregon and Washington. Highlights of the government-sponsored health care coverage programs in California supported by KFH include: Medi-Cal - KFHP enrolled, and KFH provided access to inpatient care for 174,641 Medi-Cal (Medicaid) managed care members in California. - Medi-Cal Fee-for-Service - KFH in California provided subsidized care to 69,691 Medi-Cal Fee-for-Service patients. Of this amount, approximately $107 million is attributed to services provided by KFH. - Healthy Families - KFHP enrolled, and KFH provided access to inpatient care for 177,344 California children in this federal- and state-funded insurance program that provides low- and moderate-income families with health insurance for their children under 19 years of age. The program provides comprehensive health benefits, including dental and vision care. To qualify, families must have a total income between 100% and 250% of the federal poverty guidelines and the children must be ineligible for Medi-Cal coverage. Highlights of the government-sponsored health care coverage programs in Hawaii supported by KFH include: - Quest & Medicaid Fee-for-Service - QUEST is a Medicaid managed care program run by the Hawaii's Department of Human Services. KFH participates in the QUEST programs on the islands of Oahu and Maui. KFH provided access to care for 21,892 individuals enrolled in Quest and expended approximately $6.2 million on subsidized medical care services. The Hawaii Region also contributed an additional $1.1 million on subsidized care for Medicaid Fee-for-Service patients. - SCHIP - This government program provides children with family incomes up to twice the federal poverty guidelines for Hawaii, health care coverage under Title XXI of the Social Security Act. SCHIP is one of several aid categories under the QUEST program. Highlights of the government-sponsored health care coverage programs in Oregon and Washington supported by KFH include: - Washington Basic Health Plus (BH-Plus) - This is Washington's Medicaid program for children under age 19 who live in households that meet the eligibility guidelines for Medicaid. The Maternity Benefits Program is a Medicaid program for pregnant women. The Department of Social and Health Services (DSHS) determines eligibility for BH Plus. KFH provides services to eligible participants who reside in Clark and Cowlitz counties. - Medicaid Fee-for-Service - KFH in Northwest provided $5.4 million in subsidized care to Medicaid Fee-for-Service patients. Grants and Donations for Care and Coverage In 2010, KFH donated $2.7 million to more than 130 nonprofit and community-based organizations in California to help low-income families and uninsured children navigate the enrollment and recertification processes for public and private programs and improve their ability to access needed medical care. COMMUNITY HEALTH INITIATIVES As an innovator in health, Kaiser Permanente designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods, workplaces, and schools to support good health. Our community Health Initiatives (CHI) started with a focus on nutrition and physical activity. Our work has since expanded to address community economic development, environmental sustainability, and neighborhood safety - additional factors that are key to promoting health communities. In 2010, KFH expended approximately $11 million to support CHI work. The following are examples of programs and services funded in 2010: Health Eating Active Living (HEAL) Programs The HEAL program combats obesity by promoting place-based healthy eating and active living programs and interventions in the community. The program supports community health initiatives and coalitions that bring community-level medical, environmental, and social changes such as empowering community residents to eat healthy foods, changing physical and social environments to promote physical activity, and supporting policy changes to reduce racial and ethnic health disparities, particularly those related to poor nutrition and inactivity. Community Health Education and Prevention Programs KFH in California, Hawaii, Oregon, and Washington provided a variety of activities and programs to assist health care consumers in managing their health and well-being. The hospitals serve as the primary site for the dissemination of health education information to both Health Plan and community members who access these resources through the health education centers. Expenditures in this category exclude program costs for health education programs targeting or restricted to Health Plan members. Other programs and services are offered in various community locations.
.   Grants and Donations for Community Health Initiatives KFH contributed approximately $9.2 million to nonprofit community organizations in California, Hawaii, Oregon and Washington to support a variety of community health initiatives. The following are examples of programs and services funded in 2010: - Kaiser Permanente Southern California's Healthy Eating in Hard Times (HEHT) initiative helps to ensure that low-income families who are eligible are participating in federal nutrition programs, such as food stamps and free school meals, and that food bank/pantry patrons can obtain healthy foods such as fruits and vegetables from emergency food sources. Nine food banks across the region were supported by grants totaling $365,000, - California Food Policy Advocates (CFPA) received a $225,000 HEAL School Wellness grant from Kaiser Permanente Southern California Region to provide healthier foods and increase access to eligible participants in nutrition programs. CFPA is working on improving nutritional quality of meal programs in more schools, increasing participation in classroom breakfast programs, expanding nutrition standards into other child care environments, and providing technical assistance to streamline the application process for food stamps. - Public Health Institute (as fiscal agent for Safe Community Partnership) received $200,000 to support the ongoing implementation, expansion and evaluation of the Safe Community Partnership (SCP), which is a city-based, data-driven, approach to reducing street violence. SAFETY NET PARTNERSHIPS Through funding, technical assistance, public policy advocacy, training and volunteering, dissemination of care-management and quality improvement technologies, Kaiser Permanente helps these vital health care providers improve care and expand treatment capacity for the communities and vulnerable people they serve. In 2010, KFH contributed $26million to support these programs. Through contractual arrangements with safety net partners, specific populations of nonmembers received specialty and dental care in Northwest KFH and Health Plan facilities. The following describes two of these special community partnerships: - Northwest Permanente perinatalogists provide prenatal care in Health Plan facilities to high-risk obstetric patients (nonmembers) referred by Virginia Garcia Memorial Health Center. This community collaboration serves women in Washington and Yamhill counties. - The Northwest Dental Program provides charitable dental care and treatment to uninsured resident in Oregon and Washington. These services are provided in collaboration with University of Washington, Community Health Partners, Salem-Keiser School District and the County of Multnomah. Approximately 1,500 children and adults were served by the dental program in 2010. Grants and Donations for Safety Net Partnerships During 2010, KFH spent $26 million to support more than 300 organizations that deliver medical and/or dental care services to uninsured people in community setting, primarily safety net clinics in California, Oregon and Washington. Below are examples of the community organizations supported by these grants: - The Coalition of Orange County Community Clinics in Southern California received a $90,000 grant for core operating support to help member clinics keep serving over 200,000 low-income, uninsured, and underserved individuals in Orange County annually. Supporting the coalition to create and develop new strategies, improve the financial infrastructure, and maintain core operations is vital to the success and sustainability of the safety-net system in the county. - The Council of Community Clinics in Southern California received a $90,000 grant for core operating support. The council represents 16 community clinics and community health centers, operating more than 95 sites across the county, which provides health care services to thousands of uninsured and low-income residents in the county. The funding will enable the council to continue its advocacy efforts, improve the financial stability of its member clinics, and increase the capacity of providers. - In 2007, Kaiser Permanente Southern California Region initiated funding for a Specialty Care Initiative (SCI) to address the problem of specialty care for the uninsured and underinsured through a number of community-based coalitions in Southern California. The SCI is a statewide effort that provides the means for a community to examine, coordinate, spread, and deepen community-based solutions to the challenges of specialty care access and demand. In 2010, a grant for $300,000 was awarded to Community Partners to continue providing technical assistance to grantees As the SCI Technical Assistance Provider, Community Partner will continue to provide centralized coordination and technical assistance, support opportunities for shared learnings, and mobilize resources that support the SCI coalitions' implementation efforts to improve access to and delivery of services. To support continued evaluation of SCI, a grant for $150,000 was awarded to Group Health Cooperative to implement the evaluation plan: collect and analyze data, provide technical assistance to the grantees, and provide feedback to grantees and funders about the initiative's progress and lessons learned. - Alameda County Health Care Foundation received $75,000 to support the building and equipping of a new cardiac catheterization/angiography suite to be located on the campus of the Alameda County Medical Center. DEVELOPING AND DISSEMINATING KNOWLEDGE Kaiser Permanente aims to improve health care by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. KFH spent $222 million to support programs and services for the development and dissemination of knowledge and provided grants and donations to nonprofit organizations. Since 1946, Kaiser Permanente researchers have made thousands of medical discoveries. In 2010, investigators at our research centers in California, Oregon and Washington conducted more than 2,900 research and evaluation studies and published almost 700 journal articles Kaiser Permanente investigators participated in research and evaluation studies, collaborating with several prominent academic research institutions, including Harvard University, Oregon Health & Sciences University, Stanford University, University of California (Los Angeles, Berkeley, and San Francisco), University of Southern California, University of Washington, National Institutes of Health, Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention. In California, KFH funds three research departments: the Division of Research (DOR) in Northern California, established in 1961; Department of Research & Evaluation (R&E) in Southern California, established in the early 1980s: and Kaiser Foundation Research Institute (KFRI). Two nursing research units for KFH in California also engage in studies on nursing practices, patient care, and patient outcomes to improve clinical practices. The Center for Health Research (CHR) is the primary research department for KFH in Oregon and Washington and the Center for Health Research Hawaii (CHRH) is a formal subdivision of CHR in the Northwest.
.   CHR, CHRH, DOR, KFRI, and R&E-together with the Northern and Southern California Nursing Research Departments-spent approximately $100 million to support research and evaluation studies. Their studies appeared in The New England Journal of Medicine, The Journal of the American Medical Association, American Journal of Public Health, Annals of Internal Medicine and many other leading general and specialized journals. Following is a sampling of the evidence-based studies conducted in 2010: - A study published in the journal Pediatrics investigated whether exposure to thimerosal, a mercury-containing preservative that is used in vaccines and immunoglobulin preparations, is associated with increased risk of autism spectrum disorder (ASD). This study was designed to examine relationships between prenatal and infant ethylmercury exposure from thimerosal-containing vaccines and/or immunoglobulin preparations and ASD and 2 ASD subcategories: autistic disorder (AD) and ASD with regression. The study concluded that prenatal and early-life exposure to ethylmercury from thimerosal-containing vaccines and immunoglobulin preparations was not related to increased risk of ASDs. - A study that appeared in the Annals of Neurology found that compared to women never on hormone therapy, those taking hormone therapy only at midlife had a 26 percent decreased risk of dementia; while women taking hormone therapy only in late life had a 48 percent increased risk of dementia. Although previous research has shown that initiation of postmenopausal estrogen hormone therapy in late life increases the risk of dementia, animal studies and some observational studies have suggested that midlife use of hormone therapy may be beneficial. This is the first observational, long-term study to directly compare the effect of hormone therapy status in both midlife and late life on risk of dementia. - A study published in the journal Fertility and Sterility showed that increasing urine BPA (Bisphenol-A) level was significantly associated with decreased sperm concentration, decreased total sperm count, decreased sperm vitality and decreased sperm motility. This is among the first human studies to report an adverse association between BPA and semen quality. Previous animal studies found a detrimental association between BPA and male reproductive systems in mice and rats. This study adds to emerging human evidence questioning the safety of BPA, a chemical created in the production of polycarbonated plastics and epoxy resins found in baby bottles, plastic containers, the linings of cans used for food and beverages, and in dental sealants. - The Journal of Pediatrics published a study that showed extreme obesity is affecting more children at younger ages, with 12 percent of black teenage girls, 11.2 percent of Hispanic teenage boys, 7.3 percent of boys and 5.5 percent of girls now classified as extremely obese. This is the first study to provide a snapshot of the prevalence of extreme obesity in a contemporary cohort of children ages 2 - 19 years from a large racially and ethnically diverse population using the recent 2009 U.S. CDC extreme obesity definition. Children who are extremely obese may continue to be extremely obese as adults, and all the health problems associated with obesity may be in these children's futures. - A study published in the journal Diabetes Care showed that the sooner people with diabetes start taking metformin, the longer the drug remains effective. Metformin is an inexpensive, generic drug that helps patients prevent dangerously high blood sugar levels. The study found that it worked nearly twice as long for people who began taking it within three months of their diabetes diagnosis. This is the first study to compare metformin failure rates in a real-world, clinical practice setting. Other studies compared failure rates of metformin only in clinical trials. Metformin is recommended as a first-line agent in the treatment of type 2 diabetes, but in most patients it eventually stops working, forcing them to take additional medications to control their blood sugar. Each additional drug adds extra costs and the possibility of more side effects including weight gain, so this study is welcome news for newly diagnosed patients. In 2010, in response to significant new federal interest and support for comparative effectiveness research, KFH established the Center for Effectiveness and Safety Research (CESR) to better coordinate and focus our long standing comparative effectiveness research studies across the program. The center will enable us to more rapidly address high-priority research needs, quickly translate findings into practice, evaluate the impact and share the results with the community at large. The ultimate goal is to improve clinical outcomes, advance public health, maximize patient safety, and ensure that health care dollars are well spent. Health Sciences and Medical Libraries KFH spent approximately $382,000 to support its medical libraries, and other health resource and information dissemination services. These programs give medical staff and the greater professional community access to health-related research conducted within and outside of Kaiser Permanente. Medical libraries participated in an inter-loan system with other community hospitals, supported students in training and education programs to conduct literature searches, and conducted searches for community clinics and other community-based organizations on advances in medical treatment, clinical protocols and new development on specific health issues. During 2010, health sciences and medical libraries in California, Hawaii, Oregon and Washington completed thousands of requests for general knowledge and literature searches for research purposes. Tumor Board and Cancer Registry KFH spent $1.5 million to support the Tumor Board and Cancer Registry in the Northwest and Hawaii Regions. Besides being a statistical database utilized by clinicians and researchers within the regions, the registry submits statistics to the National Cancer Data Base annually. Educational Theatre Programs (ETP) For 20 years, Educational Theatre Programs has used live theatre, music, comedy, and drama to inspire children, teens, and adults to make healthier choices and better decisions about their well-being. These educational programs were developed with the advice of teachers, parents, students, health educators, medical professionals, and professional theatre artists. All performances are delivered by professional actors who are also trained as peer health educators, and performed free of charge for the community. ETP also provides schools and organizations with supplementary educational materials, such as workbooks, parent and teacher guides, and student wallet cards to reinforce the messages presented on stage. KFH in California spent $9.3 million to provide more than 609 thousand children and adults the opportunity to view one of ETP's 2,972 performances during 2010. Continuing Medical Education KFH spent approximately $1 million to provide continuing medical education to community physicians and providers, and physicians affiliated with the Permanente Medical Groups and other health care providers. A variety of continuing education programs were offered during 2010, attracting approximately 108 thousand participants in California, Hawaii, Oregon and Washington.
.   Graduate Medical Education Kaiser Permanente's first KFH Graduate Medical Education (GME) program began nearly 60 years ago in Oakland, California. Today, all hospital-based regions provide training and education for medical residents and interns. The nationally acclaimed program attracts some of the top medical school graduates in the United States and serves as a national model by educating the next generation of physicians in an integrated health care delivery system. Residents are offered the opportunity to serve a large, culturally diverse patient base in a setting with sophisticated technology and information systems, established clinical guidelines and an emphasis on preventive and primary care. KFH contributed $48.5 million to educate 606 independent and 1,624 affiliated interns and residents in California, Hawaii, Oregon, and Washington. The majority of medical residents are studying within the primary care medicine areas of Family Practice, Internal Medicine, Ob/Gyn, Pediatrics, Preventive Medicine, and Psychiatry. Residents and fellows in Oregon and Washington received training in Dermatology, Endocrinology, Family Practice, Internal Medicine, Geriatrics, Genetics, Obstetrics & Gynecology, Otolaryngology, Pathology, Pediatrics, Palliative Medicine, Plastic Surgery, and Rheumatology. Nurse Practitioner and Other Non-Physician Training Programs During 2010, KFH supported nearly 5,695 students pursuing a career in the allied health care field and spent $9 million on training and education programs for nurse practitioners, nurses, radiology and sonography technicians, physical therapists, post-graduate psychology and social work students, pharmacists, and other non-physician health professionals. - In the Northwest, KFH and Health Plan provide uncompensated on-site clinical training for students from various community institutions that are pursuing careers in the health care field. The Graduate Medical Education Department provides administrative support for the nurse practitioner, physician assistant, allopathic medicine, midwifery, optometry, podiatry, nurse anesthetist and behavioral health programs. - The Kaiser Permanente School of Allied Health Sciences (KPSAHS), located Richmond, California, was originally established in 1989 as a radiology program in response to the severe shortage of radiology technologists. Due to the continued national shortage of medical imaging and therapy workforce, KPSAHS expanded the school to include 18-month programs in sonography, nuclear medicine and radiation therapy. In addition, the school provides courses in anatomy and physiology and advanced/basic phlebotomy. - Through Kaiser Permanente's pharmacist residency programs in California, licensed pharmacists gain additional experience and training in the provision of pharmaceutical care and administrative pharmacy services in an integrated managed care organization during a one- or two-year postgraduate education and training program. These programs enable residents to improve their clinical knowledge and skills while enhancing continuity of patient care in a wide range of ambulatory, intermediate and hospital settings. - The Kaiser Permanente Deloras Jones Nursing Scholarship program provides financial assistance for students enrolled in any California nursing program to encourage and support them to become registered nurses or to pursue advanced nursing degrees. Scholarships are awarded in the categories of underrepresented minorities, academic excellence, nursing as a second career and pursuit of graduate nursing degree. Grants and Donations for Knowledge Dissemination KFH donated approximately $3.6 million in charitable contributions to nonprofit organizations in California, Hawaii, Oregon, and Washington for the dissemination of evidence-based studies, which informed the community on health care public policy and educational opportunities for individuals seeking a career as a health care provider or professional. Below are examples of the community organizations supported by these grants: - The Worker Education and Resource Center, Inc. received a $40,000 grant for the Health Care Workforce Development Program (HCWDP) to expand its services to include unemployed and underemployed adults and older youth with high poverty, unemployment, and school dropout rates in East and South Los Angeles. The HCWDP provides education, training, and job placement for workers who seek to advance into critically needed health care careers serving underserved patient populations in Los Angeles County. - The Grossmont-Cuyamaca Community College District Auxiliary Organization received a $50,000 grant for San Diego Welcome Back Center to provide counseling and case management services for health care professionals in San Diego. - Tiburcio Vasquez Health Center (TVHC) received $50,000 to create and develop a Promotoras Institute to facilitate the dissemination of culturally appropriate health information in underserved Southern Alameda communities OTHER COMMUNITY BENEFITS In 2010, KFH in California, Hawaii, Oregon and Washington spent approximately $27 million on other community benefit activities and programs beyond the national streams of work. Self Sufficiency Programs KFH provided community-based programs and services to low-income residents and students through the Learning Centers and Youth Employment Programs. In 2010, KFH spent $5.6 million to support the following programs. - Learning Centers - Through the Watts Counseling and Learning Center (WCLC) and Educational Outreach Program (EOP), disadvantaged children and their families in Southern California are provided a variety of counseling, education, and social services. WCLC provides mental health and counseling services, assistance to children with learning disabilities, and pre-employment training to high school youth. It also operates a state-licensed preschool program, a summer day camp, and "Kids Can Cope" support groups for children dealing with siblings or parents fighting cancer. EOP provides education and support services to primarily Latino youth, ages 10 to 14, in the San Gabriel Valley, east of downtown Los Angeles. The focus of EOP is to provide dropout prevention programs in a community setting. Currently, EOP provides nine different programs both in English and Spanish to children and parents during after-school hours and on Saturdays.
.   Community Giving Campaigns In 2010, KFH contributed $367 thousand to support Community Giving Campaigns, a program-wide effort that has a direct impact on local communities. While a number of federations, including America's Charities, Black United Fund, Earth Share and United Way, and the many charities they represent, are listed in Campaign materials, the Campaign also supports a write-in option, which allows participants to donate to the non-profit 501(c) of their choice. Participants can make a donation using payroll deduction or make a one-time contribution via cash, check, or credit card. Kaiser Permanente underwrites all of the associated processing costs for the Campaign, so 100% of all pledges go directly to the organizations our employees and physicians choose to support. Other Grants and Donations KFH donated approximately $6.4 million to support community benefit activities and programs in California, Hawaii, Oregon, and Washington beyond the national streams of work. The following chart summarizes 2010 Community Benefit investments by KFH for California, Hawaii, Oregon, and Washington. The investments in the community reflected in the chart are unaudited. CARE AND COVERAGE Charitable Care and Coverage Programs $ 228,377,242 Government Sponsored Programs 360,901,486 Grants & Donations for Care and Coverage 2,678,938 CB Operations for Care and Coverage 804,545 Subtotal: $ 592,762,211 COMMUNITY HEALTH INITIATIVES Community Health Initiatives Programs and Services $ 1,666,660 Grants & Donations for Community Health Initiatives 9,198,700 CB Operations for Community Health Initiatives 274,539 Subtotal: $ 11,139,899 SAFETY NET PARTNERSHIPS Grants & Donations for Safety Net Partnerships $ 26,144,433 CB Operations for Safety Net 201,199 Subtotal: $ 26,345,632 KNOWLEDGE DISSEMINATION Medical Research $ 140,265,711 Educational Theatre Programs 9,251,227 Health Care Training and Education Programs 68,487,273 Grants & Donations for Knowledge Dissemination 3,631,246 CB Operations for Knowledge Dissemination 117,740 Subtotal: $ 221,753,197 OTHER COMMUNITY BENEFITS Self-Sufficiency Programs $ 5,602,570 Other CB Grants & Donations 6,391,192 CB Operations 14,816,116 Subtotal: $ 26,809,878 TOTAL $ 878,810,817
PART V, LINE 4B   Kaiser Foundation Hospitals' foreign investments are held in a US third party custodian bank. Kaiser Foundation Hospitals personnel cannot directly access the foreign investments.
PART VI, LINE 2   NAME: steven r zatkin FAMILY MEMBER AFFILIATION: Spouse: officer of kfhp inc., kfh and subsidiaries NAME: victoria zatkin FAMILY MEMBER AFFILIATION: SPOUSE: senior vp, general counsel and officer of kfh, kfhp inc. and regional health plans
PART VI, LINE 4   THE FOLLOWING WERE THE AMENDMENTS TO THE BYLAWS IN 2010 AND 2011: 6/24/10 Article D., Officers, of the Bylaws of the Corporation was amended to (a) add the titles of Ambulatory Surgery Center Administrator, Psychiatric Health Facility ("PHF") Administrator and Clinical Director (Section D-1); (b) add new Section D-12 to provide for the appointment of an Ambulatory Surgery Center ("ASC") Administrator at each ASC operated by the Corporation and to set forth the authority and responsibilities of an ASC Administrator; and (c) add new Section D-13 to provide for the appointment of a PHF Administrator and Clinical Director for each psychiatric health facility operated by the Corporation and to set forth the education and experience requirements and responsibilities of the PHF Administrator and Clinical Director; and 9/24/10 Article E., Committees and Professional Staff, Section E-10, Quality and Health Improvement Committee ("QHIC"), of the Bylaws of the Corporation was amended to reflect amendments approved to the QHIC charter for the Corporation relating to organizational accreditation and credentialing to add references to clinical staff or medical staff; and to add new subsections B-3(g) and (h) relating to the appointment of psychiatric health facility clinical directors, ambulatory surgery center medical directors and hospital administrators and other administrators; and 3/3/11 Article D., Officers, of the Bylaws of the Corporation was amended to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section D-1, Officers); (b) add a new Section D-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section D-7, President); (d) provide clarification regarding leadership in the event of the absence or disability of the President (Section D-9, Executive Vice President or National Senior Vice President); and (e) change the reference to "the President" in Sections D-3, D-4 and D-11 to "any President"
PART VI, LINE 11B   1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefits details are presented to the community benefit committee of the board for review. 3. Executive compensation details are presented to the compensation committee of the board for review. 4. The complete tax return is reviewed and signed by a KPMG tax advisor. 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 6. The tax return is discussed with the full board of directors. A copy of the return is provided to each board member in electronic format prior to filing.
PART VI, LINE 12C   Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente informs employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem - Written notice, with or without final warning - Paid or unpaid suspension, with or without final warning - Termination of employment
PART VI, LINE 15   The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves prior to payment all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization.
PART VI, LINE 19   Governing documents - are available as provided to the California Secretary of State on state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with the state regulatory agency. Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG. To request copies contact: VP - NATIONAL tax compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 15L Oakland, CA 94612
PART VII, SECTION A, COLUMN B   Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.
PART XI, LINE 5   Change in donated capital $ (1,520,895) grants to regions (10,265,080) change in unrealized holding gain 318,801,409 change in other comprehensive income (705,860,017) KP OnCall book income (2,269,856) KP OnCall tax income 2,359,386 Passthrough income from HCMS 3,388,821 Other Passthrough income (39,388,267) Book gain on sale of securities 704,114,095 Tax gain on sale of securities (288,920,405) OTTI (190,424,614) TOTAL $ (209,985,423)
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Christine K Cassel TITLE:Director HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas W Chapman, Edd TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel P Garcia TITLE:SVP, Chief Compliance Officer HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:William R Graber TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J Eugene Grigsby, III, PhD TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:George C Halvorson TITLE:Chairman and CEO HOURS:37
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith Johansen TITLE:Director HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kim J Kaiser TITLE:Director HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Philip Marineau TITLE:Director HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jenny J Ming TITLE:Director HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edward Pei TITLE:Director HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J Neal Purcell TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Cynthia Telles, PHD TITLE:Director HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Sandra Thompkins TITLE:Director HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gregory A Adams TITLE:Region President - NCAL HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Peter Andruszkiewicz TITLE:Regional President, Georgia HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Anthony A Barrueta TITLE:SVP, Government Relations HOURS:28
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Raymond J Baxter TITLE:SVP, Comm Benefit, Research & HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Benjamin K Chu TITLE:Region President - SCAL HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Charles E Columbus TITLE:SVP, Chief Human Resources Off HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Steven Doshay TITLE:Senior Counsel HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Philip Fasano TITLE:EVP & CIO HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jerry C Fleming TITLE:SVP, Health Plan Manager HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Diane E Gage Lofgren TITLE:SVP, Brand Mgmt & Communicatio HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jennifer M Gardner TITLE:Special Asst to BOD HOURS:33
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Sandra A Golze TITLE:VP, Regional Counsel - NCAL HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mitchell J Goodstein TITLE:SVP, Actuarial, U/W & Pricing HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Marilyn Kawamura TITLE:Region President - Mid-Atlanti HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Patricia Kennedy-Scott TITLE:Region President - Ohio HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:38
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Janet A Liang TITLE:Region President - Hawaii HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donna Lynne TITLE:Region President - Colorado HOURS:26
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Andrew R McCulloch TITLE:Region President - Northwest HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith M Mears TITLE:VP & Asst Gen Counsel HOURS:47
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas R Meier TITLE:SVP, Corporate Treasurer HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Indrajit Obeysekere TITLE:Section Head HOURS:29
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donald H Orndoff TITLE:SVP, NFS HOURS:37
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Paul B Records TITLE:SVP, Human Resources HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Frank P Richardson TITLE:VP, Regional Counsel - HI HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Rochelle M Roth TITLE:Senior Director, QRM HOURS:32
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jacqueline Sellers TITLE:Senior Counsel HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur M Southam TITLE:EVP, Health Plan Operations HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Deborah Stokes TITLE:SVP, Corp Controller, CAO HOURS:38
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Bernard J Tyson TITLE:President & COO HOURS:38
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Herman M Weil TITLE:SVP, Federal & State Programs HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jed Weissberg TITLE:SVP, Quality & Care Delivery E HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carlos Zaragoza TITLE:VP, Practice Leader - Labor & HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Steven R Zatkin TITLE:SVP, General Counsel & Secreta HOURS:38
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Victoria B Zatkin TITLE:VP, Off of Brd & Corp Gov Svcs HOURS:36
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark S. Zemelman TITLE:SVP, General Counsel & Secreta HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Terry L Austen TITLE:SVP & Area Mgr - San Jose HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mary Ann Barnes TITLE:SVP, Exec Dir - San Diego HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael O Brady TITLE:SVP, Infrastructure Mgmt Group HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Virginia C Campbell TITLE:SVP & Area Mgr - Diablo HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:William B Caswell TITLE:SVP, Operations HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith L Coffey TITLE:SVP & Area Mgr - Marin/Sonoma HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark E Costa TITLE:Exec Dir - Los Angeles HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard D Daniels TITLE:SVP, Business Info Officer - H HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Elizabeth Jane Finley TITLE:SVP & Exec Dir - Bellflower HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edward S. Glavis TITLE:SVP & Area Mgr - North Valley HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Corwin Nathaniel Harper TITLE:SVP & Area Mgr - Central Valle HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Linda J Jensen TITLE:SVP & Area Mgr - San Mateo HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gerald A McCall TITLE:SVP Operations HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Colleen M McKeown TITLE:SVP & Area Mgr - Greater So. A HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Julie Miller-Phipps TITLE:SVP & Exec Dir - Orange HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Nathaniel L Oubre TITLE:SVP & Area Mgr - East Bay HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas J Risse TITLE:VP, CFO - Hawaii HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Christine Robisch TITLE:SVP & Area Manager - San Franc HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Max Villalobos TITLE:SVP & Area Manager - Napa/Sola HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Vita M Willett TITLE:Exec Dir - Riverside HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Anne D Barr TITLE:VP Integrated Planng & Delvry HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Diane Comer TITLE:SVP, Business Info Officer - H HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lazaro M Garcia TITLE:VP, Data Center Svcs HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Garry L Hurlbut TITLE:VP, COO-KPIT HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Henry Neidermeier TITLE:VP, Technology SOX & Complianc HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Christine L Malcolm TITLE:FORMER SVP HOURS:
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


Software ID:  
Software Version:  
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
KAISER FOUNDATION HOSPITALS
 
Employer identification number

94-1105628
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







(1) KP ONCALL LLC
ONE KAISER PLAZA 15L
OAKLAND,CA94612
91-2166347 		CALL CENTER CA 34,074,062 10,210,994 NA
 
(2) KAISER PERMANENTE VENTURES LLC SERIES A
ONE KAISER PLAZA 15L
OAKLAND,CA94612
27-2252521 		INVESTMENTS CA 268,420 12,656,339 NA
 








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) KAISER FDN HEALTH PLAN OF COLORADO

ONE KAISER PLAZA 15L

OAKLAND,CA94612
84-0591617 		HEALTH CARE CO 501(C)(3) 9 KFHP INC
 
 
 
(2) KAISER FDN HEALTH PLAN OF GEORGIA INC

ONE KAISER PLAZA 15L

OAKLAND,CA94612
58-1592076 		HEALTH CARE GA 501(C)(3) 9 KFHP INC
 
 
 
(3) KFHP OF THE MID-ATLANTIC STATES INC

ONE KAISER PLAZA 15L

OAKLAND,CA94612
52-0954463 		HEALTH CARE MD 501(C)(3) 9 KFHP INC
 
 
 
(4) KAISER FDN HEALTH PLAN OF THE NORTHWEST

ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0798039 		HEALTH CARE OR 501(C)(3) 9 KFHP INC
 
 
 
(5) KAISER FDN HEALTH PLAN OF OHIO

ONE KAISER PLAZA 15L

OAKLAND,CA94612
34-0922268 		HEALTH CARE OH 501(C)(3) 9 KFHP INC
 
 
 
(6) KAISER FOUNDATION HEALTH PLAN INC

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-1340523 		HEALTH CARE CA 501(C)(3) 9 NA
 
 
 
(7) CAMP BOWIE SERVICE CENTER

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299123 		ADMIN CA 501(C)(3) 11 KFHP INC
 
 
 
(8) KAISER HOSPITAL ASSET MANAGEMENT INC

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299125 		ASSET MGT CA 501(C)(3) 11 KFH
 
 
 
(9) KAISER HEALTH PLAN ASSET MANAGEMENT INC

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299124 		ASSET MGT CA 501(C)(3) 11 KFHP INC
 
 
 
(10) LOKAHI ASSURANCE LTD

ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-2171891 		RISK MGMT HI 501(C)(3) 11 KFHP INC
 
 
 
(11) KAISER HEALTH ALTERNATIVES

ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0954562 		HEALTH CARE OR 501(C)(3) 9 KFHP INC
 
 
 
(12) OHP

ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0480268 		LEASING WA 501(C)(3) 11 KFHP INC
 
 
 
(13) 1800 HARRISON FOUNDATION

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3317484 		FINANCING CA 501(C)(3) 11 KFHP INC
 
 
 
(14) KAISER HOSPITAL ASSISTANCE CORPORATION

ONE KAISER PLAZA 15L

OAKLAND,CA94612
31-1779500 		FINANCING CA 501(C)(3) 11 KFH
 
 
 
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
(1) HCMS LLC

ONE KAISER PLAZA 15L
OAKLAND,CA94612
20-3924985 		CARE MANAGEMENT CA NA
  		RELATED -3,388,821 5,884,882   No -3,396,695   No 81.000 %












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) ARCHIMEDES INC
ONE KAISER PLAZA 15L
OAKLAND,CA94612
20-3774729 		CONSULTING CA NA
  		C CORP -7,007,751 7,560,337 100.000 %
(2) KAISER PERMANENTE INTERNATIONAL
ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3245176 		CONSULTING CA NA
  		C CORP 492,079 706,708 100.000 %
(3) KAISER PERMANENTE INSURANCE COMPANY
ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3203402 		INSURANCE CA NA
  		C CORP 0 0 0 %
(4) KAISER PROPERTIES SERVICES INC
ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3259432 		REAL ESTATE CA NA
  		C CORP 0 0 0 %
(5) OAK TREE ASSURANCE LTD
ONE KAISER PLAZA 15L
OAKLAND,CA94612
03-0329760 		INSURANCE VT NA
  		C CORP 0 0 0 %




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
Yes
 
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
 
No
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
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
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) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 A 204,000  
(2) KAISER FOUNDATION HEALTH PLAN OF OHIO

 A 419,178  
(3) LOKAHI ASSURANCE LTD

 A 26,974,391  
(4) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 B 54,620  
(5) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 B 1,411,679  
(6) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 C 56,679  
(7) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 D 102,694,700  
(8) KAISER FOUNDATION HEALTH PLAN OF THE NW

 D 1,309,297,671  
(9) KAISER FOUNDATION HEALTH PLAN OF OHIO

 D 46,429,932  
(10) LOKAHI ASSURANCE LTD

 D 13,155,889  
(11) KAISER FOUNDATION HEALTH PLAN of COLORADO

 E 416,934,183  
(12) KAISER FOUNDATION HEALTH PLAN of GEORGIA

 E 40,738,300  
(13) KAISER FOUNDATION HEALTH PLAN of THE NW

 E 2,212,212,095  
(14) KAISER FOUNDATION HEALTH PLAN of OHIO

 E 429,658  
(15) LOKAHI ASSURANCE LTD

 E 483,347,471  
(16) KAISER HOSPITAL ASSET MANAGEMENT

 G 8,110,991  
(17) KAISER FOUNDATION HEALTH PLAN of THE NW

 H 4,107,224  
(18) KAISER HOSPITAL ASSET MANAGEMENT

 J 181,826,359  
(19) KAISER FOUNDATION HEALTH PLAN INC

 K 23,739,629,793  
(20) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 K 688,198,120  
(21) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 K 253,969,563  
(22) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 K 947,175,998  
(23) KAISER FOUNDATION HEALTH PLAN OF THE NW

 K 759,300,960  
(24) KAISER FOUNDATION HEALTH PLAN OF OHIO

 K 42,253,884  
(25) OAK TREE ASSURANCE LTD

 K 2,114  
(26) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 L 1,823,671  
(27) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 L 13,656,462  
(28) KAISER FOUNDATION HEALTH PLAN OF THE NW

 L 9,298,555  
(29) KAISER FOUNDATION HEALTH PLAN OF OHIO

 L 35,665,931  
(30) LOKAHI ASSURANCE LTD

 L 6,649,313,862  
(31) OAK TREE ASSURANCE LTD

 L 8,375  
(32) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 N 998  
(33) KAISER FOUNDATION HEALTH PLAN OF THE NW

 N 2,238  
(34) KAISER FOUNDATION HEALTH PLAN OF OHIO

 N 225  
(35) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 O 3,974,815  
(36) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 O 2,641,835  
(37) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 O 721,817,519  
(38) KAISER FOUNDATION HEALTH PLAN OF THE NW

 O 573,781,528  
(39) KAISER FOUNDATION HEALTH PLAN OF OHIO

 O 89,551,212  
(40) CAMP BOWIE SERVICE CENTER

 O 253,103  
(41) KAISER HOSPITAL ASSET MANAGEMENT

 O 121,472  
(42) KAISER HEALTH PLAN ASSET MANAGEMENT

 O 74,467  
(43) KAISER PERMANENTE INSURANCE COMPANY

 O 8,027,777  
(44) OAK TREE ASSURANCE LTD

 O 60,993  
(45) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 P 247,727  
(46) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 P 50,189,174  
(47) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 P 33,747,810  
(48) KAISER FOUNDATION HEALTH PLAN OF THE NW

 P 490,510,355  
(49) KAISER FOUNDATION HEALTH PLAN OF OHIO

 P 31,418,894  
(50) ARCHIMEDES INC

 P 51,248  
(51) CAMP BOWIE SERVICE CENTER

 P 274,375  
(52) KAISER HOSPITAL ASSET MANAGEMENT

 P 310  
(53) KAISER HEALTH PLAN ASSET MANAGEMENT

 P 42,037  
(54) KAISER PERMANENTE INTERNATIONAL

 P 401,610  
(55) LOKAHI ASSURANCE LTD

 P 83,028,123  
(56) OAK TREE ASSURANCE LTD

 P 550  
(57) KAISER FOUNDATION HEALTH PLAN OF THE NW

 Q 369,698,458  
(58) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 R 23,634,492  
(59) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 R 134,760,765  
(60) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 R 1,874,079,289  
(61) KAISER FOUNDATION HEALTH PLAN OF THE NW

 R 605,215,476  
(62) KAISER FOUNDATION HEALTH PLAN OF OHIO

 R 34,521,138  
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


Software ID:  
Software Version: