TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Tom Cantor Director	1.00	X		0	0	0
(2) Sunita V Cooke Director	3.00	X		0	0	0
(3) Jerry Fazio Director	1.00	X		0	0	0
(4) Dave Grundstrom Director	1.00	X		0	0	0
(5) Peter Hanson MD Chairman	2.00	X	X	27,000	0	0
(6) Tom Karlo Vice Chairman	2.00	X	X	0	0	0
(7) LeRoy Knutson Director	2.00	X		0	0	0
(8) Marc Kobernick MD Director	2.00	X		30,000	0	0
(9) Randolph Lenac Director	1.00	X		0	0	0
(10) Michael Long MD Director	1.00	X		0	0	0
(11) Deborah McElravy Director	.50	X		0	0	0
(12) Michael Murphy President	4.00	X	X	0	1,190,310	83,610
(13) Jim Parker Treasurer	2.00	X	X	0	0	0
(14) Philip Szold MD Secretary	2.00	X	X	0	0	0
(15) Michele Tarbet CEO - GH	55.00	X	X	0	566,221	38,420
(16) Robert Yarris Director	2.00	X		0	0	0
(17) Ann Pumpian Assistant Treasurer	2.00		X	0	660,858	35,987

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Carlisle C Lewis III Assistant Secretary	2.00	X				0	580,064	45,452
(19) Kari Cornicelli CFO - GH	55.00	X				0	226,412	27,453
(20) Maryann Cone COO - GH	55.00		X			0	312,415	35,093
(21) Suzanne K Johnson VP Hospice	42.00		X			0	214,391	15,088
(22) Janet L Hanley VP Patient Care - GH	50.00		X			0	199,294	25,141
(23) Patrick J Craychee Director of Pharmacy - GH	41.00		X			195,618	0	22,513
(24) Anthony Damico VP Clinical Services - GH	50.00		X			0	195,051	15,379
(25) Vincent J Balesteri Pharmacist	58.00			X		269,212	0	32,389
(26) Lori Hernandez Pharmacist	51.00			X		233,944	0	19,509
(27) Bruce D Schmidt Mgr Sharp Central Pharmacy	41.00			X		203,694	0	32,941
(28) Barbara Hazer Pharmacist	46.00			X		193,082	0	22,832
(29) Cornelia Del Rosario Clinical Nurse - BU	53.00			X		183,653	0	15,110
(30) Kathleen Lencioni CEO - SMV/McDonald Center	0.00				X	0	342,663	2,898

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	830,992	830,992
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,167,320	1,218,768	948,552
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	175,292	175,292
7	Other salaries and wages	207,658,812	203,889,631	3,769,181
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	9,267,375	9,064,594	202,781
9	Other employee benefits .......	26,438,349	25,790,408	647,941
10	Payroll taxes ...........	15,755,502	15,517,315	238,187
11	Fees for services (non-employees):
a	Management ......	18,892,262	17,686,047	1,206,215
b	Legal .........	503,506	25,891	477,615
c	Accounting ...........	5,458,082		5,458,082
d	Lobbying ...........	59,327		59,327
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......	101,174		101,174
g	Other ..........	37,765,656	36,981,740	783,916
12	Advertising and promotion ....	4,534,141	81,525	4,452,616
13	Office expenses .......	80,999,377	80,619,795	379,582
14	Information technology ......	18,590,769	18,033,046	557,723
15	Royalties ..
16	Occupancy ...........	8,541,359	7,602,890	938,469
17	Travel ............	560,913	542,183	18,730
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	373,764	116,773	256,991
20	Interest ...........	1,861,181	976,080	885,101
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	23,220,636	16,545,232	6,675,404
23	Insurance ..............	2,904,689	2,443,579	461,110
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	Provider Tax	31,331,512	31,331,512
b	Management Services	16,113,545	8,555,290	7,558,255
c	Repairs & Maintenance	5,533,459	5,217,799	315,660
d	Fundraising Expenses	943,326			943,326
e	UBI Taxes	193,508		193,508
f	All other expenses	1,857,871	969,381	888,490
25	Total functional expenses. Add lines 1 through 24f	522,633,699	484,215,763	37,474,610	943,326
26	Joint costs. Check here 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

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	1,728,567	1	2,012,191
2	Savings and temporary cash investments .......	31,251,749	2	37,029,263
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	43,318,011	4	46,501,940
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 .............	410,280	7	270,729
8	Inventories for sale or use ..............	9,056,292	8	9,387,834
9	Prepaid expenses and deferred charges ............	2,640,104	9	2,074,650
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	430,081,286
b	Less: accumulated depreciation. .....	10b	226,313,397	205,226,376	10c	203,767,889
11	Investments—publicly traded securities ..........	104,942,276	11	120,316,315
12	Investments—other securities. See Part IV, line 11 ......	802,256	12	1,117,412
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	18,574,168	15	13,257,967
16	Total assets. Add lines 1 through 15 (must equal line 34)...	417,950,079	16	435,736,190
	17	Accounts payable and accrued expenses .	35,897,077	17	37,137,197
18	Grants payable ..........		18
19	Deferred revenue ..........	7,459,302	19	7,624,812
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	15,500,000	23	15,500,000
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	57,965,775	25	48,277,667
26	Total liabilities. Add lines 17 through 25.....	116,822,154	26	108,539,676
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	290,817,398	27	316,920,820
28	Temporarily restricted net assets .....	8,339,996	28	9,203,292
29	Permanently restricted net assets .....	1,970,531	29	1,072,402
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	301,127,925	33	327,196,514
34	Total liabilities and net assets/fund balances .....	417,950,079	34	435,736,190

Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Name of organization Grossmont Hospital Corporation	Employer identification number 33-0449527
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	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (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 Grossmont Hospital Corporation	Employer identification number 33-0449527
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)

Identifier	Return Reference	Explanation
Explanation of Other Lobbying Activities:	Part II-B, Line 1i:	Grossmont Hospital Corporation (GHC) pays annual dues to the California Hospital Association (CHA), the Healthcare Association of San Diego and Imperial Counties (HASDIC), the California Association of Hospitals and Health Systems (CAHHS), the American Hospital Association (AHA) and the California Hospice and Palliative Care Association (CHAPCA). CHA, HASDIC, CAHHS, AHA, and CHAPCA have determined that a portion of their membership dues are used for lobbying purposes. GHC's FY 2011 portion of annual dues calculated to have been used for lobbying was $59,327.

	(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 .......


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

		Amount
c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

	(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back
1a	Beginning of year balance ....	3,421,590	2,331,612	2,245,171
b	Contributions ........	38	821,647	75,087
c	Investment earnings or losses ...	-112,858	268,716	11,354
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	31,619	385
f	Administrative expenses ....
g	End of year balance ......	3,277,151	3,421,590	2,331,612

Description of investment	(a) Cost or other basis (investment)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	581,843		581,843
b	Buildings ................	264,645,187	119,309,752	145,335,435
c	Leasehold improvements ............	4,161,047	1,151,683	3,009,364
d	Equipment ................	126,896,360	97,895,022	29,001,338
e	Other .................	33,796,849	7,956,940	25,839,909
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........	203,767,889

1.(a) Description of Liability	(b) Amount
Federal Income Taxes
Long Term Pension Liability	17,934,276
Workers' Compensation Liability	343,905
Intercompany Payable	847,372
Other Liabilities	40,134
Mark to Market Swap	843,962
Capital Leases Payable	99,096
Allocated Tax Exempt Bonds	26,810,159
Estimated Settlements Payable to Government Programs	1,358,763

Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)	48,277,667
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).

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	554,701,332
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	522,633,699
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	32,067,633
4	Net unrealized gains (losses) on investments ..........................	4	-10,649,085
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	4,650,041
9	Total adjustments (net). Add lines 4 - 8 .............................	9	-5,999,044
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	26,068,589

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	535,868,854
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	-10,649,085
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	-10,649,085
3	Subtract line 2e from line 1.....................	3	546,517,939
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	101,174
b	Other (Describe in Part XIV): ...........	4b	8,082,219
c	Add lines 4a and 4b.......................	4c	8,183,393
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......	5	554,701,332

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............	1	521,683,521
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	0
3	Subtract line 2e from line 1.....................	3	521,683,521
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	101,174
b	Other (Describe in Part XIV): ............	4b	849,004
c	Add lines 4a and 4b.......................	4c	950,178
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......	5	522,633,699

Identifier	Return Reference	Explanation
Description of Intended Use of Endowment Funds:	Part V, Line 4:	Grossmont Hospital Foundation holds 21 board designated and permanent endowments for Grossmont Hospital Corporation that are restricted for a variety of purposes, such as hospice and hospice homes, diabetes, nursing education, cancer treatement, hospital equipment and technology, and more.
Part XI, Line 8 - Other Adjustments:		Change in minimum pension liability 4,297,659. Beneficial Interest in Grossmont Hospital Foundation 497,615. Grossmont Imaging LLC (Book/Tax Difference) -145,233.
Part XII, Line 4b - Other Adjustments:		Prop G - Donations of Capital/Donations for Capital Purchases 5,426,395. Donations used to Purchase Capital Equipment 1,597,625. Medical Staff/Auxiliary Revenue 912,966. Grossmont Imaging LLC Book/Tax Difference 145,233.
Part XIII, Line 4b - Other Adjustments:		Medical Staff/Auxiliary Expenses 849,004.
		Sharp recognizes tax benefits from any uncertain tax positions only if it is more likely than not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. Sharp records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period that the more likely than not threshold is not met. Sharp recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more likely than not recognition criteria. At September 30, 2011 and 2010, no such assets or liabilities were recorded.

	(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) ..	27,861,672	211,388	27,650,285	5.290 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	115,661,161	104,853,539	10,807,622	2.070 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....	21,437,689	10,125,958	11,311,731	2.160 %
dTotal Charity Care and Means-Tested Government Programs .....	164,960,522	115,190,885	49,769,638	9.520 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	778,487		778,487	0.150 %
f Health professions education (from Worksheet 5) ..	626,561		626,561	0.120 %
g Subsidized health services (from Worksheet 6) ..	70,904,531	51,750,009	19,154,522	3.660 %
h Research (from Worksheet 7)	1,883		1,883	0 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	901,234		901,234	0.170 %
jTotal Other Benefits ...	73,212,696	51,750,009	21,462,687	4.100 %
kTotal. Add lines 7d and 7j. ..	238,173,218	166,940,894	71,232,325	13.620 %

- TIN:

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

Grossmont Hospital Corporation

Employer identification number

33-0449527

Identifier	Return Reference	Explanation
Program Service Statement	Form 990, Part III, Line 1:	To establish, maintain, conduct, and operate a hospital or hospitals related, associated and complimentary facilities and services, such as, but not limited to, skilled nursing, extended care, outpatient care, home care, and other health care programs, activities, services and facilities. To carry on any educational activities related to rendering care to the sick and injured, or to the promotion of health. To promote and carry on scientific research related to the care of the sick and injured, or to the promotion of health. To participate in any activity designed and carried on to promote the general health of the community. To operate and maintain this corporation and its assets for the benefit of the communities served by Grossmont Healthcare District, a political subdivision of the State of California, organized pursuant to Local Hospital District Law (Division 23 of the California Health & Safety Code), and which is located in San Diego County, California. Generally do anything and everything necessary, expedient or incidental to the foregoing.
	Form 990, Part IV, Line 24a:	Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, the tax exempt bond balances are reported on the Sharp HealthCare return (EIN 95-6077327). This organization's allocated portion is included in Part X, Line 25.
Form 990, Part VI, Section A, line 2		Director Dave Grundstrom had business relationships with Director Philip Szold and Director Peter Hanson. Michele Tarbet, Kari Cornicelli, and Anthony Damico were all directors on the governing board of the Grossmont Imaging Joint Venture.
Form 990, Part VI, Section A, line 6		Sharp HealthCare (FEIN 95-6077327)is the sole member of Grossmont Hospital Corporation.
Form 990, Part VI, Section A, line 7a		Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members.
Form 990, Part VI, Section A, line 7b		Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members. Sharp HealthCare also retains the approval rights afforded members for certain significant transactions (e.g. dissolution or sale or transfer of all or substantially all of the assets.)
Form 990, Part VI, Section B, line 11		The final Form 990 is placed on the organization's intranet, prior to the filing date, where it is viewable for comment from all members of the governing body. The review process includes multiple levels of review including key corporate and entity finance department personnel comprised of the Director of Accounting & Tax, Vice President of Finance, Senior Vice President and Chief Financial Officer, and entity Chief Financial Officer. Additionally, the organization contracts with Ernst & Young, an independent accounting firm, for review of the Form 990.
	Form 990, Part VI, Section B, line 12c	The Corporation is committed to preventing any Participant of the Corporation from gaining any personal benefit from information received or from any transaction of Sharp. One component of the written conflict of interest policy requires that Board Members, Corporate Officers, Senior Vice Presidents and Chief Executive Officer(s) submit a conflict of interest statement annually to Legal Services/Senior Vice President of Legal Services who will review all statements. In addition, all Vice Presidents and any employees in the Purchasing/Supply Chain, Audit and Compliance, and Case Management/Discharge Planning departments are required to complete an online conflict of interest questionnaire annually that is reviewed by the Conflict Review Committee comprised of employees from Sharp's Legal, Compliance, and Internal Audit departments. In connection with any transaction or arrangement, which may create an actual or possible conflict of interest, the person shall disclose in writing the existence and nature of his/her financial interest and all material facts. Board Members, Corporate Officers, Senior Vice Presidents, and the Chief Executive Officer(s) shall make such disclosures directly to the Chairman of the Sharp HealthCare Board, and to the members of the committee with the board designated powers considering the proposed transaction or arrangement. Upon disclosure of the financial interest and all material facts, the Board Member, Corporate Officer, Senior Vice President or the Chief Executive Officer(s) making such disclosures shall leave the board or the committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In certain instances, such as if someone takes a board seat on a competitor's board of directors or has a role with an organization whereby the information that they may obtain from Sharp would put them in a consistent conflict with their two roles, the conflict could call for the individual's removal from the board. The bylaws for the organization provide for the ability to remove directors in accordance with Section 5222 of the California Corporations Code. This can generally be done on a "for cause" or a "no cause" basis by the action of the member. Form 990, Part VI, Section B, Line 13: The Corporation is a member of a controlled group under the parent Sharp HealthCare (FEIN 95-6077327). Policies and procedures for the entire Sharp system are developed and approved under Sharp HealthCare and these policies and procedures are applied uniformly across the Sharp system. Sharp HealthCare has a written whistleblower policy which has been reviewed and approved by the Sharp HealthCare governing board, and this policy applies to all Sharp HealthCare entities. Form 990, Part VI, Section B, Line 14: The Corporation is a member of a controlled group under the parent Sharp HealthCare (FEIN 95-6077327). Policies and procedures for the entire Sharp system are developed and approved under Sharp HealthCare and these policies and procedures are applied uniformly across the Sharp system. Sharp HealthCare has a written document retention and destruction policy which has been reviewed and approved by the Sharp HealthCare Policy and Procedure Committee, and this policy applies to all Sharp HealthCare entities.
	Form 990, Part VI, Section B, line 15	The Personnel Committee of Sharp HealthCare retains an independent compensation consulting firm to review the total compensation paid to executive management (CEO/President, Executive Vice President of Hospital Operations, and Senior Vice Presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the Personnel Committee of the Board of Directors by the independent consultant. The Personnel Committee is comprised of Board members who are not physicians and who are not compensated in any way by the organization. The Personnel Committee approves the total compensation for the President/Chief Executive Officer and reviews and approves the compensation and compensation salary ranges for the remainder of the executive team. The Personnel Committee presents its decision to the Board of Directors. The Personnel Committee retains minutes of its meetings. The Compensation and Benefits department engages a third party independent consultant to conduct a compensation study covering officers and key employees. The independent third party compares base salaries to similar positions with like institutions. The information is reviewed by the Compensation and Benefits department and is presented to the President/Chief Executive Officer, the Executive Vice President of Hospital Operations and the appropriate Senior Vice President for review and approval. The compensation study was last conducted in February/March 2011. Form 990, Part VI, Section B, Line 16: The Corporation is a member of a controlled group under the parent Sharp HealthCare (FEIN 95-6077327). Policies and procedures for the entire Sharp system are developed and approved under Sharp HealthCare and these policies and procedures are applied uniformly across the Sharp system. Sharp HealthCare has a written joint venture policy which has been reviewed and approved by the Sharp HealthCare Policy and Procedure Committee, and this policy applies to all Sharp HealthCare entities.
	Form 990, Part VI, Section C, line 19	Policies are considered proprietary information, however in Sharp HealthCare's publicly available Code of Conduct, Sharp outlines its Conflict of Interest policies in a user friendly manner. The annual audited financial statements of the consolidated group are published on the dacbond.com website (www.dacbond.com), are attached to the Form 990 filed for each of the Sharp hospitals, and are available upon request. The annual audited financial statements include combining schedules which disclose the financial results (Balance Sheet, Statement of Operations, Statement of Changes in Net Assets) for each entity of the consolidated group. Quarterly financial statements of Sharp's obligated group are published on the dacbond.com website (www.dacbond.com).
	Form 990, Part VII, Section B:	Independent contractors are paid under Sharp HealthCare's tax identification number (95-6077327) and are reported on Sharp HealthCare's tax return.
Hours per week dedicated to related organizations	Form 990, Part VII, Section A:	The following officers and directors dedicated hours to the following organizations which are related to Grossmont Hospital Corporation: Michael Murphy: 60-SHC, 4-SMH, 2-SCVMC, 2-SCHHC, 4-SHP, 4-SHF Carlisle C. Lewis III: 60-SHC, 3-SMH, 1-SCVMC, 1-SCHHC Ann Pumpian: 55-SHC, 2-SMH, 2-SCVMC, 2-SCHHC, 3-SHP Kathleen Lencioni: 50-SMH Michele Tarbet: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Maryann Cone: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Kari Cornicelli: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Suzanne Johnson: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Janet Hanley: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Anthony D'Amico: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation.
	Form 990, Part X, Line 25:	Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, the tax exempt bond balances are reported on the Sharp HealthCare return (EIN 95-6077327) and this organization has reported zero on Form 990, Part X, Line 20 and has reported the allocated balance on Line 25.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 5:	Net unrealized losses on investments: -10,649,085. Change in minimum pension liability 4,297,659. Beneficial Interest in Grossmont Hospital Foundation 497,615. Grossmont Imaging LLC (Book/Tax Difference) -145,233. Total to Form 990, Part XI, Line 5: -5,999,044.
	Form 990, Part XII, Line 3a:	Sharp HealthCare, on a consolidated basis, was required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, and such an audit was performed as required.
	Form 5471	Form 5471 has been filed on behalf of by Sharp HealthCare (FEIN 95-6077327).
Community Benefits Report	Form 990, Part III, Line 4a:	An Overview of Sharp HealthCare Sharp is an integrated, regional health care delivery system based in San Diego, Calif. The Sharp system includes four acute care hospitals; three specialty hospitals; two affiliated medical groups; 20 medical clinics; five urgent care facilities; three skilled nursing facilities; two inpatient rehabilitation centers; home health, hospice, and home infusion programs; numerous outpatient facilities and programs; and a variety of other community health education programs and related services. Sharp offers a full continuum of care, including: emergency care, home care, hospice care, inpatient care, long-term care, mental health care, outpatient care, primary and specialty care, rehabilitation, and urgent care. Sharp also has a Knox-Keene-licensed health maintenance organization, Sharp Health Plan (SHP). Serving a population of approximately 3 million in San Diego County, as of September 30, 2011, Sharp is licensed to operate 2,092 beds, has approximately 2,600 Sharp-affiliated physicians and nearly 15,000 employees. Four acute-care hospitals: * Sharp Chula Vista Medical Center (343 beds) The largest provider of health care services in San Diego's rapidly expanding South Bay, Sharp Chula Vista Medical Center (SCVMC) operates the region's busiest Emergency Department (ED) and is the closest hospital to the busiest international border in the world. * Sharp Coronado Hospital and Healthcare Center (204 beds) Sharp Coronado Hospital and Healthcare Center (SCHHC), an acute-care hospital, provides services that include sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, hospice and emergency services. * Sharp Grossmont Hospital (536 beds) Sharp Grossmont Hospital (SGH) is the largest provider of health care services in San Diego's East County, and has one of the busiest EDs in San Diego County. * Sharp Memorial Hospital (656 beds) A regional tertiary care leader, Sharp Memorial Hospital (SMH) provides specialized care in trauma, oncology, orthopedics, organ transplantation, cardiology and rehabilitation. Three specialty-CARE hospitals: * Sharp Mary Birch Hospital for Women & Newborns (188 beds) A freestanding women's hospital specializing in obstetrics, gynecology, gynecologic oncology, and neonatal intensive care, Sharp Mary Birch Hospital for Women & Newborns (SMBHWN) delivers more babies than any other private hospital in California. * Sharp Mesa Vista Hospital (149 beds) The largest private freestanding psychiatric hospital in California, Sharp Mesa Vista Hospital (SMV) is a premier provider of behavioral health services. * Sharp McDonald Center (16 beds) Sharp McDonald Center (SMC) is San Diego County's only licensed chemical dependency recovery hospital. Collectively, the operations of SMH, SMBHWN, SMV and SMC are reported under the nonprofit public benefit corporation of SMH, and are referred to herein as The Sharp Metropolitan Medical Campus (SMMC). The operations of Sharp Rees-Stealy Medical Centers (SRS) are included within the nonprofit public benefit corporation of Sharp, the parent organization. The operations of Sharp Grossmont Hospital (SGH) are reported under the nonprofit public benefit corporation Grossmont Hospital Corporation. Mission Statement It is Sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patient expectations, and are provided in a caring, convenient, cost-effective and accessible manner. Vision Sharp's vision is to become the best health system in the universe. Sharp will attain this position by transforming the health care experience through a culture of caring, quality, service, innovation and excellence. Sharp will be recognized by employees, physicians, patients, volunteers and the community as the best place to work, the best place to practice medicine and the best place to receive care. Sharp will be known as an excellent community citizen, embodying an organization of people working together to do the right thing every day to improve the health and well-being of those it serves. Values Integrity - Trustworthiness, Respect, Commitment to Organizational Values, and Decision Making Caring - Service Orientation, Communication, Teamwork and Collaboration, Serving and Developing Others, and Celebration Innovation - Creativity, Continuous Improvement, Initiating Breakthroughs, and Self-Development Excellence - Quality, Safety, Operational and Service Excellence, Financial Results, and Accountability Culture: The Sharp Experience For more than 11 years, Sharp has been on a journey to transform the health care experience for patients and their families, physicians and staff. Through a sweeping organization-wide performance and experience improvement initiative called The Sharp Experience, the entire Sharp team has recommitted to purpose, worthwhile work, and creating the kind of health care people want and deserve. This work has added discipline and focus to every part of the organization, helping to make Sharp one of the nation's top-ranked health care systems. Sharp is San Diego's health care leader because it remains focused on the most important element of the health care equation: the people. Through this extraordinary initiative, Sharp is transforming the health care experience in San Diego by striving to be: The best place to work: Attracting and retaining highly skilled and passionate staff members who are focused on providing quality health care and building a culture of teamwork, recognition, celebration, and professional and personal growth. This commitment to serving patients and supporting one another will make Sharp "the best health system in the universe." The best place to practice medicine: Creating an environment in which physicians enjoy positive, collaborative relationships with nurses and other caregivers; experience unsurpassed service as valued customers; have access to state-of-the-art equipment and cutting-edge technology; and enjoy the camaraderie of the highest-caliber medical staff at San Diego's health care leader. The best place to receive care: Providing a new standard of service in the health care industry, much like that of a five-star hotel; employing service-oriented individuals who see it as their privilege to exceed the expectations of every patient - treating them with the utmost care, compassion and respect; and creating healing environments that are pleasant, soothing, safe, immaculate, and easy to access and navigate. Through all of this transformation, Sharp will continue to live its mission to care for all people, with special concern for the underserved and San Diego's diverse population. This is something Sharp has been doing for more than half a century. Pillars of Excellence In support of Sharp's organizational commitment to transform the health care experience, the six Pillars of Excellence serve as a guide for team members, providing a framework and alignment for everything that Sharp does. The six pillars listed below are a visible testament to Sharp's commitment to become the best health care system in the universe by achieving excellence in these areas: * Demonstrate and improve clinical excellence and patient safety to set community standards and exceed patient expectations * Create exceptional experiences at every touch point for customers, physicians and partners by demonstrating service excellence * Create a workforce culture that attracts, retains, and promotes the best and brightest people, who are committed to Sharp's mission, vision and values * Achieve financial results to ensure Sharp's ability to provide quality health care services, new technology and investment in the organization * Achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements and support innovative development * Be an exemplary community citizen Awards Sharp recently received the following recognition: Sharp is a recipient of the 2007 Malcolm Baldrige National Quality Award, the nation's highest Presidential honor for quality and organizational performance excellence. Sharp is the first health care system in California and eighth in the nation to receive this recognition. Sharp was named the No. 1 "best integrated health-care network" in California and No. 12 nationally by Modern Healthcare magazine in 2012. The rankings are part of the "Top 100 Most Highly Integrated Healthcare Networks (IHN)," an annual survey conducted by health care data analyst IMS. This is the 14th year running that Sharp has placed among the top in the state in the survey. Sharp was ranked 47th by Modern Healthcare in its 2008 "100 Best Places
		to Work." The awards and honors program recognizes workplaces in health care that enable employees to perform at their optimum level to provide patients and customers with the best possible care and services. SMH was named "Best Hospital" by San Diego Union-Tribune readers participating in the paper's 2011 "Best of San Diego" Readers Poll, and SGH, SMBHWN, and SCVMC were ranked fifth, sixth and seventh, respectively. This marks the fourth year in a row that Sharp received the "Best Hospital" honor. SGH and SMH have both received MAGNET Designation for Nursing Excellence by the ANCC. The Magnet Recognition Program is the highest level of honor bestowed by the ANCC and is accepted nationally as the gold standard in nursing excellence. Sharp was named one of the nation's "Most Wired" health care systems from 1998 through 2009 by Hospitals & Health Networks magazine in the annual Most Wired Survey and Benchmark Study. "Most Wired" hospitals are committed to using technology to enhance quality of care for both patients and staff. In July 2010, SMH was named the "Most Beautiful Hospital in America" by Soliant Health, one of the largest medical staffing companies in the country. With over 10,000 votes from visitors to the Soliant Health website, SMH was voted to the top of the second annual "20 Most Beautiful Hospitals in America" list. In 2010, SCHCC was re-designated as a Planetree Patient-Centered Hospital. Planetree is a coalition of more than 100 hospitals worldwide that is committed to improving medical care from the patient's perspective. Initially designated in 2007, SCHCC is the first hospital in California to receive this designation, and the only hospital in California to achieve re-designation. In 2010, Sharp received the Morehead Apex Workplace of Excellence Award. Morehead awards the health care industry's top achiever by objectively identifying the highest performer and acknowledging their contributions to health care. With this singular award, Morehead annually recognizes a client who has reached and sustained the 90th percentile on their employee engagement surveys. Sharp reached the 98th percentile in 2010 and the 99th percentile in 2011. In 2011, SCVMC and SCHHC each received the Energy Star designation from the U.S. Environmental Protection Agency (EPA) for outstanding energy efficiency. Buildings that are awarded the designation use an average of 40 percent less energy than other buildings and release 35 percent less carbon dioxide into the atmosphere. In 2011, SCVMC and SCHHC were two of only six California hospitals to receive this designation. In 2011, Sharp HealthCare was named the Crystal Winner of the 2011 Workplace Excellence Awards from the San Diego Society for Human Resource Management. This designation recognizes Sharp's Human Resources Department as an innovative and valuable asset to overall company performance. Patient Access to Care Programs Uninsured patients with no ability to pay, and insured patients with inadequate coverage receive financial assistance for medically necessary services through Sharp's Financial Assistance Program. Sharp does not refuse any patient requiring emergency medical care. Sharp provides services to help every unfunded patient received in the emergency room find coverage options. Patients use a quick, simple online questionnaire through the Foundation for Health Coverage Education to generate personalized coverage options that are filed in their account for future reference and accessibility. Sharp also continues to offer ClearBalance - a specialized loan program for patients facing high medical bills. Through this collaboration with San Diego-based CSI Financial Services, both insured and uninsured patients have the opportunity to secure small bank loans in order to pay off their medical bills in low monthly payments - as low as $25 per month - and thus prevent unpaid accounts from going to collections. Through this program, Sharp provides a more affordable alternative for patients that struggle with the ability to resolve their hospital bills. In addition, Sharp provides post-acute care facilitation for high-risk patients, including the homeless and patients lacking a safe home environment. Patients receive assistance with transportation and placement; connections to community resources; and financial support for medical equipment, medications, and even outpatient dialysis and nursing home stays. Through collaboration with the San Diego Rescue Mission, SCHHC, SGH and SMH discharge their chronically homeless patients to the Rescue Mission's Recuperative Care Unit, where patients not only receive follow-up medical care through Sharp in a safe environment, but through the organization's programs they also receive psychiatric care, substance abuse counseling and guidance to help get them off the street. Since February 2011, Sharp's acute care hospitals have partnered with Father Joe's Villages to support Project SOAR - a program designed to assist with and expedite social security and disability applications for homeless individuals with urgent health care needs. As eligible homeless patients are discharged from the hospital, hospital case managers facilitate their transition to Project SOAR workers who then continue the application process on through to completion. The program helps ensure eligible at-risk individuals are able to obtain timely access to the income and medical care benefits that they may not otherwise receive as a result of their homeless status. Also in FY 2011, Sharp collaborated with the United Way's Project 25 program to provide financial information that will help the program gauge the effectiveness of its interventions to reduce use of emergent and other front line public resources. Project 25 is a partnership between United Way of San Diego County and the City and County of San Diego with a goal to provide permanent housing (via the San Diego Housing Commission) and supportive services (via the County of San Diego) to at least 25 of San Diego County's chronically homeless, who are often the most frequent users of public resources. In FY 2011, Sharp hospitals provided services to 14 individuals enrolled in the Project 25 program. In addition, SCVMC continued its partnership with community clinics to provide timely access to primary care and behavioral health services by establishing medical homes for low-income, medically uninsured, and underserved patients in the South Bay that present in the SCVMC ED. The program seeks to: support safety net patients suffering from chronic conditions to better manage their pain, diseases and overall health care with the establishment of a medical home at a community clinic; inform safety net patients about obtaining affordable medications through generic prescription access education; increase patient access and timely referrals to primary care and behavioral health services; increase patient access to follow-up primary care services and establish a medical home at either Chula Vista Family Health Clinic or other community clinics; and offer enhanced access to transportation resources to the Chula Vista Family Health Clinic. It is this ability to schedule timely follow-up appointments for safety net patients that has contributed greatly to the success of this program, and since the program's inception SCVMC has served a total of 1,248 safety net patients, 55 percent of whom were referred to the Chula Vista Family Health Clinic. Health Professions Training Internships Students and recent health care graduates are a valuable asset to the community, and Sharp demonstrates a deep investment in these potential and newest members of the health care workforce through internships, financial aid and career pipeline programs. In FY 2011, there were 3,933 student interns within the Sharp system, providing more than 534,000 hours in disciplines that include nursing, allied health and professional educational programs. Sharp provides education and training programs for students across the continuum of nursing (e.g., critical care, medical/surgical, behavioral health, women's services and wound care) and allied health professions such as rehabilitation therapies (speech, physical, occupational and recreational therapy), pharmacy, dietetics, lab, radiology, social work, psychology and public health. Students from local community colleges such as Grossmont College (GC), San Diego Mesa College (MC), and Southwestern College (SWC); local and national university campuses such as San Diego State University (SDSU), University of California, San Diego (UCSD), University of San Diego (USD), Point Loma Nazarene University (PLNU), and University of Oklahoma (OU); and vocational schools such as Kaplan College (KC) participate in Sharp's health professions training. Table 1 presents the students and student hours at each of the Sharp entities in FY 2011.
		Table 1: Sharp HealthCare Internships - FY 2011 Sharp Chula Vista Medical Center Nursing 721 Students 63,894 Group Hours 20,440 Precepted Hours Ancillary 138 Students 24,675 Hours Total 859 Students 109,009 Hours Sharp Coronado Hospital and Healthcare Center Nursing 443 Students 82,776 Group Hours 3,600 Precepted Hours Ancillary 127 Students 22,624 Hours Total 570 Students 109,000 Hours Sharp Grossmont Hospital Nursing 566 Students 48,974 Group Hours 16,183 Precepted Hours Ancillary 222 Students 39,914 Hours Total 788 Students 105,071 Hours Sharp Mary Birch Hospital for Women & Newborns Nursing 176 Students 13,548 Group Hours 4,028 Precepted Hours Ancillary 112 Students 8,498 Hours Total 288 Students 26,074 Hours Sharp Memorial Hospital Nursing 547 Students 39,084 Group Hours 21,365 Precepted Hours Ancillary 333 Students 61,626 Hours Total 880 Students 122,075 Hours Sharp Mesa Vista Hospital Nursing 271 Students 27,548 Group Hours 1,470 Precepted Hours Ancillary 12 Students 4,148 Hours Total 283 Students 33,166 Hours Sharp HealthCare Nursing 144 Students 3,008 Group Hours 5,684 Precepted Hours Ancillary 121 Students 20,923 Hours Total 265 Students 29,615 Hours Total Nursing 2,868 Students 278,832 Group Hours 72,770 Precepted Hours Ancillary 1,065 Students 182,408 Hours Total 3,933 Students 534,010 Hours College Collaborations In FY 2011, Sharp completed its partnership with the OU College of Nursing and SWC in providing clinical, real-world experience in San Diego County for students enrolled in the OU Online Accelerated Second Degree Bachelor of Science in Nursing (BSN) Program and the OU Career Mobility Registered Nurse (RN) to BSN Program. The partnership sought to boost the number of new nurse graduates by offering programs with increased flexibility and access for students. The Accelerated Second Degree BSN Program is for individuals with a bachelor's degree or higher in a non-nursing major. The program included more than 600 hours of online coursework and nearly 900 hours of clinical experience at Sharp facilities. The Health Academy For six consecutive years, the SCVMC Health Academy program provided education to the next generation of health care professionals by introducing local elementary school students to a wide variety of health care careers. This program has provided hospital tours to hundreds of fifth graders who have benefited from interactive learning in various areas of the hospital, including the laboratory, pharmacy and billing departments. In addition, a grant from the California Endowment allowed for the expansion of the program to provide a diversity initiative to high school students. The initiative, entitled the Health Care Career Pipeline Partnership (HCCPP), represents collaboration among the hospital, Barrio Logan College Institute (BLCI), San Ysidro High School (SYHS), SWC, Harder and Associates and the San Diego chapter of the National Association of Hispanic Nurses. The program provided local high school students from diverse backgrounds, many of whom are the first in their family to attend college, a greater chance of attending college and succeeding in a career in health care. The HCCPP provided tours of SCVMC, as well as opportunities for students to volunteer or intern at the hospital. The program has had tremendous success since its inception - providing tours to nearly 650 students, paid internships to 24 students, and contributing to the 100 percent high school graduation rate of participating students. In FY 2009, SCVMC won a partnership award from the San Diego Science Alliance for its work in the HCCPP. The award recognizes a San Diego business or employer that partners with youth in the community. Health Sciences High and Middle College Sharp has teamed up as an industry partner with charter school Health Sciences High and Middle College (HSHMC) to provide students broad exposure to careers available in health care. During FY 2011, 329 HSHMC students connected to Sharp campuses for a total of more than 58,600 student hours. The collaboration between Sharp and HSHMC prepares high school students to enter health science and medical technology careers in the following five career pathways: Biotechnology Research and Development, Diagnostic Services, Health Informatics, Support Services and Therapeutic Services. During a 16-week period, supervised students rotate through instructional pods in various departments such as nursing, OB-GYN, occupational and physical therapy, behavioral health, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), imaging, rehabilitation, laboratory, pharmacy, pulmonary, cardiac services, and operations. HSHMC students not only receive hands-on experience in patient care, but also guidance from Sharp staff on professionalism, career ladder development and job/education requirements. HSHMC students earn high school diplomas, complete college entrance requirements and have opportunities to earn community college credits, degrees or vocational certificates. With the HSHMC program, Sharp links students with health care professionals through job shadowing and internships to explore real-world applications of their school-based knowledge and skills. The program began in 2007 with HSHMC students on the campuses of SGH and SMH, and expanded to include SMV and SMBHWN in 2009, SCHHC in 2010, and SCVMC in 2011. Lectures and Continuing Education Sharp contributes to the academic environment of many colleges and universities in San Diego. In FY 2011, Sharp staff committed more than 500 hours to the academic community by providing lectures, courses and presentations on numerous college/university campuses throughout San Diego. Through the delivery of a variety of guest lectures, including health information technology at San Diego Mesa College, cardiovascular technology at Grossmont College, health information lectures at San Diego Mesa College, pharmacy practice lectures at UCSD, and a variety of health administration lectures to public health graduate students at SDSU, Sharp staff remain active and engaged with San Diego's academic health care community. Sharp's Continuing Medical Education (CME) department assesses, designs, implements and evaluates educational and training initiatives for Sharp's affiliated physicians, pharmacists and other health professionals to better serve the health care needs of the San Diego community. In FY 2011 the professionals at Sharp HealthCare CME invested more than 1,800 hours in numerous CME activities open to San Diego health care providers, ranging from annual conferences on patient safety, diabetes, breast cancer, kidney-transplant, and end-of-life care, to presentations on hip preservation and hospital overcrowding. In addition, the Outcomes Research Institute (ORI) at Sharp was formed to measure long-term results of care and to promote and develop best practices for health care delivery for members of the professional health care community. With both inpatient and ambulatory locations and a diverse patient population, Sharp is well-positioned to study care processes and outcomes in a real-world setting, reflecting an authentic picture of the health care environment. Among its current and future goals, the ORI aims to: ensure patient care produces outcomes consistent with evidence-based medical literature; analyze the relationships between processes and outcomes for treatments, interventions and quality improvement initiatives; establish associations between practice, costs and outcomes for patient care; as well as to develop and disseminate effective approaches to quality care delivery in the health care community. Volunteer Service Sharp Lends a Hand In FY 2011, Sharp continued its systemwide community service program, Sharp Lends a Hand (SLAH), to further support the San Diego communities it serves. In October 2010, Sharp promoted the program both internally and in the community, requesting project ideas that: focused on improving the health and well-being of San Diego in a broad, positive way; relied on Sharp for volunteer labor only; supported nonprofit initiatives, community activities or other programs that serve the residents of San Diego County; and could be completed by September 30, 2011. Sharp employees voted on the qualified projects posted on SharpNET (Sharp's internal website). They selected six projects: Stand Down for Homeless Veterans, San Diego Food Bank, International Coastal Cleanup Day, Special Olympics, YWCA Emergency Shelter (Becky's House), and playground beautification at the Valencia Park Drama and Dance Academy. In support of these projects, more than 1,900 Sharp employees, family members and friends volunteered over 6,700 hours.
		During nine days in June and July 2011, 454 Sharp employees, family members and friends volunteered at Veterans Village of San Diego. The volunteers sorted and organized clothing donations and provided on-site support, medical services and companionship to hundreds of homeless veterans at Stand Down for Homeless Veterans, an annual event sponsored by Veterans Village of San Diego and held at San Diego High School. The San Diego Food Bank feeds people in need throughout San Diego County, and advocates and educates the public about hunger-related issues. For 10 days over January, March, May, July and September, 880 SLAH volunteers inspected and sorted donated food, assembled boxes and cleaned the San Diego Food Bank warehouse. The YWCA Emergency Shelter (Becky's House) provides emergency shelter and transitional housing to women and children who have been victimized by domestic violence. Eleven SLAH volunteers gave the shelter some much needed "tender love and care" by painting the children's patio in April 2011. The Valencia Park Drama and Dance Academy provides education, health care, food, clothing and personal hygiene for some of San Diego's estimated 2,200 homeless and at-risk children. In June 2011, a group of SLAH volunteers helped improve the outside environment for the students by repainting hopscotch and four-square lines on the playground. More than 368 SLAH volunteers provided assistance to San Diego County's Special Olympics year-round training and athletic competitions including the Fall Regional Games held in Rancho Bernardo, a Floor Hockey competition and the USA Team Training event. Special Olympics of San Diego County has more than 1,400 athletes of all ages. The program provides sports training and athletic competition for all children and adults with intellectual disabilities. The volunteers assisted with timekeeping, score-keeping and cheerleading during the Team Training for the Spring Games in Athens, Greece, which included swimming, tennis, basketball, cycling and rowing. The SLAH team partnered with I Love a Clean San Diego and San Diego Coastkeeper to put the sparkle back in the San Diego community through the International Coastal Cleanup Day on September 17. Nearly 175 volunteers of all ages helped keep San Diego's coast a beautiful place to live and play by picking up and removing trash and debris from 16 selected sites in our communities. Sharp Humanitarian Service Program In FY 2011, 32 Sharp employees were funded through Sharp's Humanitarian Service Program. This program allows employees to participate in service programs that provide health care and/or other supportive services to underserved or adversely affected populations. In FY 2011, Sharp employees devoted their time and energy to organizations that included Wheels for the World, which provides wheelchairs to people with disabilities in developing countries, including Egypt and Ghana. Sharp staff brought 250 wheelchairs, crutches and walkers and worked out of a regional hospital in rural Ghana at a seating and positioning clinic. At this clinic, patients - many who had been crawling for most of their lives - received therapy sessions and their first wheelchairs and other walking supports. In addition, Sharp staff led a team of medically-focused college students on another humanitarian program serving Ghana. Over three weeks, the team traveled to several small villages in West Africa, setting up seven temporary health clinics, and treating over 700 Ghanaians for basic medical care, such as treatment for malaria, intestinal worms, severe dehydration, scorpion stings, snake bites and wound care. The team also provided health education around nutrition, sanitation issues and women's health. Training was provided to Ghanaian health workers so that they could continue the health education after Sharp staff returned to the U.S. Sharp staff also participated in a medical mission trip to El Salvador, providing three medical clinics to the community serving hundreds of patients in poverty. Additionally, a week-long free health clinic was conducted by Sharp physical therapy staff in Punta Gorda, Belize. Patients received physical therapy screening and intervention, education on the benefits of exercise, an individualized home program, and referrals to the local clinic for follow-up services. Another medical mission trip was led in Ho Chi Minh City, Vietnam, during January 2011. Eight participants, including Sharp-affiliated physicians and nurses, served for a week at a local hospital and provided critical orthopedic therapy and treatment to 20 patients. Sharp staff performed surgery for eight of these patients, attending mostly to bone fractures and non-unions. Through the Sharp Humanitarian Service Program, in FY 2011 Sharp staff continued to provide extensive support and expertise to victims of the earthquakes that devastated Haiti in January 2010. Sharp-affiliated physicians and Sharp staff provided medical services including wound care, post-op treatment, neurological and orthopedic rehabilitation, occupational therapy and general public health, in addition to equipment and supplies to those in need. Sharp staff often delivered around-the-clock care for patients affected by the earthquakes - whose ages ranged from neonates to the elderly - at various sites throughout Haiti. Sharp staff also worked with Family Friends Community Connection (FFCC), a San Diego-based nonprofit organization, to lend vital assistance to those areas of Haiti impacted by the earthquakes. In April 2011, the FFCC team and Sharp employees set up the first mobile medical clinic in Carrefour, Haiti, and treated nearly 1,000 patients in need of critical medical care. Staff provided care, comfort, support and hope amidst a situation of complete and utter chaos, including the challenges of limited medical supplies and unsanitary living conditions. Community Walks For the past 16 years, Sharp has proudly supported the American Heart Association (AHA) annual Heart Walk. In September 2011, more than 1,000 walkers represented Sharp at the San Diego Heart Walk held in Balboa Park. Sharp was the No. 1 Heart Walk team in San Diego and the AHA Western Region Affiliates, raising more than $194,000 for the American Heart Association. Sharp Volunteers Sharp volunteers are a critical component of Sharp's dedication to the San Diego community. Sharp provides a multitude of volunteer opportunities throughout San Diego County for individuals to serve the community, meet new people, and assist programs ranging from pediatrics to Senior Resource Centers. Volunteers devote their time and compassion to patients as well as to the general public, and are an essential element to many of Sharp's programs, events and initiatives. Sharp volunteers spend their time within hospitals, in the community, and in support of the Sharp HealthCare Foundation, Grossmont Hospital Foundation, and Coronado Hospital Foundation. Sharp employees also donate time to Sharp as volunteers for the Sharp organization. In FY 2011, there were more than 2,300 total volunteers across the Sharp system, contributing 280,963 hours of their time in service to Sharp and its initiatives. More than 15,000 of these hours were provided externally to the San Diego community through activities such as delivering meals to homebound seniors and assisting with health fairs and events. Table 2 details the number of volunteers and the hours provided in service to each of Sharp's entities, as well as Sharp HospiceCare, specifically for patient and community support. Volunteers also spent additional hours supporting Sharp's three foundations for events such as Grossmont Hospital Foundation's annual Golf Tournament; the SMBHWN Stewardship Committee; galas held for SCVMC, SCHHC and SGH; and other events in support of Sharp entities and services. Table 2: Sharp Volunteers and Volunteer Hours - FY 2011 Sharp Chula Vista Medical Center 347 Volunteers (Individuals) 52,990 Volunteer Hours Sharp Coronado Hospital and Healthcare Center 165 Volunteers (Individuals) 8,181 Volunteer Hours Sharp Grossmont Hospital 950 Volunteers (Individuals) 109,487 Volunteer Hours Sharp Mary Birch Hospital for Women & Newborns 85 Volunteers (Individuals) 14,873 Volunteer Hours Sharp Memorial Hospital 617 Volunteers (Individuals) 74,961 Volunteer Hours Sharp Mesa Vista Hospital 24 Volunteers (Individuals) 2,689 Volunteer Hours Sharp HealthCare 26 Volunteers (Individuals) 4,125 Volunteer Hours TOTAL 2,214 Volunteers (Individuals) 267,306 Volunteer Hours Sharp employees also volunteer their time for the Cabrillo Credit Union Sharp Division Board, the Sharp and Children's MRI Board, the UCSD Medical Center/Sharp Bone Marrow Transplant Program Board, Grossmont Imaging LLC Board, and the SCVMC - SDI Imaging Center.
		In addition, volunteers on Sharp's auxiliary boards and the various Sharp entity Boards volunteer their time to provide program oversight, administration and decision-making regarding financial resources. In FY 2011, 129 community members contributed their time to Sharp's boards. Sharp's Greater Good In FY 2011, Sharp staff volunteered their time and passion to a number of unique initiatives, underscoring Sharp's commitment to the health and welfare of the San Diego community, and the greater good. Below are just a few examples of how Sharp employees gave of themselves to the San Diego community. At SGH, the "This Bud's for You" program brought smiles to unsuspecting patients and their loved ones with the delivery of hand-picked flowers from the medical campus's abundant gardens. The SGH landscape team grew, cut, bundled and delivered colorful bouquets each week, bringing an element of natural beauty to help ease the experience of patients and visitors of both the hospital, and the SGH Hospice Houses. The team also regularly offers single-stem roses in a small bud vase to passers-by. The program's success was made possible by support from the SGH Auxiliary and volunteers who assisted the landscape crew in navigating the hospital and supplied flower vases. Another program organized by an SGH staff member was the "Shirt Off Our Backs" program. During the 2010 holiday season, one SGH employee orchestrated and implemented a concerted effort to bring clothing, shoes, blankets and household items directly to San Diego's homeless population. The SGH Engineering Department, the SGH Auxiliary and local businesses collaborated to implement the program, and SGH's Waste Management team provided ancillary support with loaner recycle bins to use for collection. Hundreds of pounds of clothing, shoes, towels, blankets, toiletries and other items that could be put to use immediately were collected, washed, folded, boxed/bagged and prepared before delivery to the San Diego population in need. At SMMC, the Arts for Healing program was established to improve the spiritual and emotional health of patients that face significant medical challenges. The program provides services at SMH, SMH OPP, SMBHWN, SMV and SMC. Since the inception of the program in 2007, more than 5,000 patients and their families have benefitted from the time and talent provided by dedicated staff and volunteers. Trained volunteers are the primary providers of the program, which is coordinated by a clergy member of the Spiritual Care program. The Arts for Healing program utilizes the power of art and music to enhance the healing process for patients challenged by significant illness, chronic pain and long-term hospitalization. At SMH, oftentimes these are stroke patients, cancer patients, or patients facing life with newly-acquired disabilities following catastrophic events. At SMBHWN, the program is provided to high-risk mothers who are in the hospital from one to four months, awaiting childbirth and experiencing stress and loneliness over the separation from their families. The program has recently expanded to offer special interactive group art projects in the lounges of the Stephen Birch Healthcare Center, which are open to patients, families and staff. Participants paint and create cards and seasonal craft projects. Events have attracted more than 75 people who benefit from the healing power of art. In addition, Sharp sponsored the TEDxSanDiego and TEDxYouth events held in November 2010, providing support in advance of the event, including show direction, technical direction, experience design and registration. TEDxSanDiego and TEDxYouth are events for members of the San Diego community and beyond, and are designed to bring together innovators, explorers, teachers and learners in an environment that encourages collaboration, conversation and interaction. TED is a nonprofit organization devoted to "Ideas Worth Spreading," and has grown over the past 25 years to support an array of world-changing ideas with multiple initiatives. TEDxSanDiego and TEDxYouth are not-for-profit events organized entirely by local, unpaid volunteers. Between 40 to 60 Sharp staff volunteered their time on-site at each event, delivering The Sharp Experience as way finders, ushers, stage managers, speaker shadows, and in other roles. Lastly, Sharp's 2011 All-Staff Assembly drew from the spirit of giving back with its theme of "Greater Good." To inspire Sharp staff to make a difference, brown paper "bags of goodness" were mailed to all Sharp employees in September, with the simple request to fill the bag "with love and generosity" and to pass it on "to create unexpected delight." Hundreds of Sharp employees shared stories of their bags of goodness, ranging from bags of recycled eyeglasses distributed to those in need in third world countries by the La Mesa Lion's Club; to safety supplies and necessities for neighbors during a blackout; granola bars and other foods for those in need; and treats and useful items for soldiers in Iraq and Afghanistan. In addition, a group of Sharp staff organized a trip to the YWCA "C" Street Shelter, a temporary housing facility for women and children that are victims of domestic violence. They delivered over 50 bags of goodness, filled with toiletries, snacks, gift cards, books and other kind gestures. Through these and many other simple, yet powerful acts, Sharp employees demonstrated that a single good deed can ignite a spark of possibility, setting in motion a chain reaction of kindness - all for the greater good. All Ways Green Initiative As San Diego's largest private employer, Sharp recognizes that the health of its patients and employees is directly tied to the health of their environment. Sharp leadership promotes a culture of environmental responsibility by providing education and outreach to employees to improve the health of those they serve as well as their own. Sharp continues to improve its systemwide All Ways Green program, which is aimed at increasing energy efficiency, water conservation and waste minimization, as well as the promotion of other initiatives to lower Sharp's carbon footprint. Sharp created its All Ways Green logo to brand its environmental activities, and has established a Green Team at each entity to foster and communicate sustainable activities. Sharp has also instituted a systemwide environmental policy. According to the EPA, inpatient hospital facilities are now the second-most energy-intensive industry after food service and sales, with energy utilization rates 2.7 times greater than that of office buildings on a square-foot basis. Unlike other industries, hospitals must operate 24 hours a day, seven days a week, and must provide service during power outages, natural disasters and other emergencies. Given this reality, Sharp has embarked on several green initiatives to enhance energy efficiency through energy-efficient lighting, retro-commissioning, occupancy sensors, energy audits, energy-efficient plant motor replacements, equipment modernization and training of staff to conserve energy. In addition, all Sharp entities participate in the EPA Energy Star database and monitor their Energy Scores on a monthly basis. In FY 2010 and FY 2011, SCHHC earned the EPA Energy Star Award. SCHHC was also named as an "Honorable Mention" at the 2011 San Diego Gas & Electric (SDG&E) annual showcase awards. SCVMC earned the EPA Energy Star Award in FY 2009, FY 2010 and FY 2011 and was the only hospital in California to be eligible for the award during this consecutive three-year period. In an effort to conserve natural resources, Sharp has researched and implemented infrastructure changes to ensure Sharp's facilities are optimally operated while monitoring and measuring water consumption. Such changes include: installation of motion-sensing faucets; drip irrigation systems; mist eliminators; water-saving devices and equipment; water monitoring and control systems; water practice and utilization evaluations; and drought-resistant plants and other landscape redesigns. These changes have been implemented operationally with no negative impact to patient care, resulting in significant financial savings and reduced natural resource consumption. Sharp employees also donated or recycled personal cell phones and proceeds were given to the Community Health Improvement Partners (CHIP) Gift of Health program. CHIP uses the proceeds to provide medical and dental care for uninsured children in San Diego. In addition, Sharp employees were encouraged to recycle personal eyeglasses and sunglasses through the Lion's Club Recycle Sight program, which distributes recycled glasses to people in need both locally and globally. In April 2011, Sharp held its second annual systemwide Earth Week event, partnering with 11 of Sharp's vendors to elevate awareness of green initiatives.
		Sharp also held its first corporate electronic waste event at its corporate office location in Kearny Mesa. The EPA and Hospitals for a Healthy Environment have reported that each patient generates approximately 15 pounds of waste each day, while U.S. medical centers generate approximately 2 million tons of waste each year. In recognition of this dramatic environmental impact, Sharp has implemented a systemwide single-stream recycling program to divert waste from going to landfills. Facilities also began using reusable sharps containers that can be reused up to 500 times, sterile processing equipment that allows for the elimination of blue-wrapped instrument trays, and reprocessing of surgical instruments. Other efforts to reduce waste include the use of recyclable paper for printing brochures and other marketing materials, electronic patient bills and paperless payroll, recycling of exam paper at SRS, and encouragement of reduced paper use at meetings through electronic correspondence. In addition, Sharp negotiated a contract with Office Depot to allow for 30 percent recycled copy paper to be used at all entities. Items received from Office Depot are also now delivered in a small re-useable bag rather than a large single-use cardboard box. At the SMMC, volunteers continue to pick up unwanted flower vases following patient discharge to reuse them in the hospital gift shop. The impact of the waste reduction programs has been significant. In FY 2011, Sharp facilities diverted some 6.8 million pounds of paper, cardboard, plastic containers, glass containers, aluminum and metal cans from local landfills. In addition, SCHHC and SMMC diverted 39,960 pounds of waste through utilization of reusable sharps and pharmaceutical waste containers in FY 2011. Sharp recycled/reclaimed 180,669 pounds of hazardous and universal waste (e.g., batteries, solvents, fluorescent light bulbs, etc.) and diverted 27,088 pounds of waste through the reprocessing of surgical devices. Table 3 presents the quantity of waste diversion at Sharp shown as pounds (lbs.) diverted. Table 3: Sharp HealthCare Waste Diversion - FY 2011 Sharp Chula Vista Medical Center 352,954 Pounds Recycled Waste Per Year 3,229,152 Pounds Total Waste Per Year 10.9% Recycled Sharp Coronado Hospital and Healthcare Center 227,119 Pounds Recycled Waste Per Year 937,656 Pounds Total Waste Per Year 24.2% Recycled Sharp Grossmont Hospital 1,422,201 Pounds Recycled Waste Per Year 4,176,332 Pounds Total Waste Per Year 34.1% Recycled Sharp Metropolitan Medical Campus 1,960,931 Pounds Recycled Waste Per Year 6,355,666 Pounds Total Waste Per Year 30.9% Recycled Total Sharp HealthCare 7,009,641 Pounds Recycled Waste Per Year 20,097,407 Pounds Total Waste Per Year 34.9% Recycled In FY 2011, Sharp promoted various other All Ways Green initiatives to enhance environmental responsibility. Green building designs are utilized throughout the Sharp system and the new SRS Downtown medical office building is designed to be LEED (Leadership in Energy and Environmental Design) Gold certified with a co-generation system which uses natural gas to produce electricity on-site. Sharp is also implementing sustainable food practices including: removal of Styrofoam from the cafeterias; use of green-label soaps and cleaners; new dishwashing systems to reduce the use of plastics; electronic cafe menus; flatware and plates made from recycled materials; recycling of all cardboard, cans and grease from cafes; and partnering with vendors who are committed to reducing product packaging. Other sustainable food practices include organic markets at each hospital and the corporate office; purchasing of hormone-free milk; and increased purchasing of locally grown fruits and vegetables, approaching 65 percent at some entities. In addition, SMH and SCHHC are in the process of implementing composting systems in their kitchens, and close to having the first County-approved organic gardens. Ride sharing, public transit programs and other transportation efforts contribute to the reduction of Sharp's transportation emissions. Sharp ensures carpool parking spaces and designated bike racks and motorcycle spaces are available at each employee parking lot. In addition, Sharp offers discounted monthly bus passes for purchase by employees. In partnership with the San Diego Association of Governments (SANDAG), a vanpool and carpool match-up program has also been created to help employees find convenient ride share partners. In FY 2011, the Sharp system participated in the SANDAG iCommute corporate challenge, achieving first place in the large employer category. Sharp is also in the process of installing electric vehicle (EV) chargers across the Sharp system, as part of the national EV Project. Sharp is the first health care system in San Diego to offer the EV chargers and is on the forefront of helping create the national infrastructure required for the promotion of EVs. In addition, Sharp uses centralized patient scheduling to improve patient vanpools, and has replaced higher fuel-consuming cargo vans with economy Ford transit vehicles, saving approximately five miles per gallon. At SMMC, battery-operated golf carts are also used to shuttle patients between campus buildings. Table 4 highlights the All Ways Green efforts at Sharp entities. Going forward, Sharp remains committed to the All Ways Green initiative and will continue to investigate other green opportunities to reduce Sharp's carbon footprint. Green purchasing methods will be explored as a first line of defense to reduce waste volume and toxicity with less packaging, fewer toxic materials and more recyclable packaging. Sharp's All Ways Green Committee will continue to work with our employees, physicians and corporate partners to develop new and creative ways to reduce, reuse and recycle. Table 4: All Ways Green Initiatives by Sharp Entity - FY 2011 SMH/SMBHWN Energy Efficiency -Lighting retrofit -Energy Star award -Energy-efficient motors installed -Occupancy sensors Water Conservation -Drip irrigation -Hardscaping -Water-saving practices/utilization evaluations -Mist eliminators -Landscape water reduction systems -Drought-tolerant plants Waste Minimization -Reprocessing (surgical instruments, etc.) -Recycling -Reusable supplies Education and Outreach -Recycling education -Green Team -Earth Week activities -Environmental policy SMV/SMC Energy Efficiency -Lighting retrofit -Energy Star participation -Motor and pump replacements Water Conservation -Drip irrigation -Hardscaping -Water-saving practices/utilization evaluations -Landscape usage reduction -Landscape water reduction systems -Drought-tolerant plants Waste Minimization -Recycling -Waste reduction -Styrofoam elimination Education and Outreach -Green Team -Earth Week activities -Environmental policy SGH Energy Efficiency -Lighting retrofit -Energy Star participation -Retro-commissioning Water Conservation -Drip irrigation -Hardscaping -Water-saving practices/utilization evaluations -Landscape water reduction systems -Drought-tolerant plants Waste Minimization -Recycling -Sustainable supplies -Surgical instrument reprocessing Education and Outreach -Update and enforce No Smoking Policy -Green Team -Earth Week activities -Environmental policy SCVMC Energy Efficiency -Energy Star participation -Lighting retrofit -Energy-efficient chillers/motors Water Conservation -Drip irrigation -Hardscaping -Water-saving practices/utilization evaluations -Landscape water reduction systems -Drought-tolerant plants Waste Minimization -Recycling -Compactor renovation -Surgical instrument reprocessing Education and Outreach -Recycling/ride sharing promotion -Green Team -Earth Week activities -Environmental policy SCHHC Energy Efficiency -Lighting retrofit -Energy Star award -Elevator/chiller modernizations -A/C replacement -Energy efficient chillers/motors -SDG&E "honorable mention" award Water Conservation -Drip irrigation -Hardscaping -Water-saving practices/utilization evaluations -Landscape usage/water reduction -Drought-tolerant plants Waste Minimization -Recycling -Reusable supplies -Reprocessing -Surgical instrument reprocessing Education and Outreach -Recycling education -Green Team -Earth Week activities -Environmental policy -Farmer's Market SRS Energy Efficiency -Lighting retrofit -Energy Star participation -Energy audits Water Conservation -Drip irrigation -Hardscaping -Water-saving practices/utilization evaluations -Landscape usage/water reduction -Drought-tolerant plants -Low-flow systems Waste Minimization -Recycling Education and Outreach -Contractor education -Green Team -Earth Week activities -Environmental policy
		SHP Energy Efficiency -Lighting retrofit -Energy Star participation -Occupancy sensors Water Conservation -Drip irrigation -Hardscaping -Water-savings practices/utilization evaluations -Landscape water reduction systems -Drought-tolerant plants -Water-saving devices Waste Minimization -Recycling -Spring Cleaning events Education and Outreach -Mass transit education -Green Team -Earth Week activities -Environmental policy Sharp System Services Energy Efficiency -Energy Star participation -Energy efficient chillers/motors -Thermostat control software -Occupancy sensors Water Conservation -Drip irrigation -Hardscaping -Water-saving practices and utilization evaluations -Landscape usage/water reduction -Drought-tolerant plants Waste Minimization -Green Grocer's market -Recycling -e-Waste event Education and Outreach -Sharp-sponsored mass transit and carpooling program -Green Team -Earth Week activities -Environmental policy Executive Summary This Executive Summary provides an overview of community benefits planning at Sharp, a listing of community needs addressed in this Community Benefits Report, and a summary of community benefits programs and services provided by Sharp in Fiscal Year (FY) 2011 (October 1, 2010, through September 30, 2011). In addition, the summary reports the economic value of community benefits provided by Sharp, according to the framework specifically identified in SB 697, for the following: Sharp Chula Vista Medical Center Sharp Coronado Hospital and Healthcare Center Sharp Grossmont Hospital Sharp Mary Birch Hospital for Women & Newborns Sharp Memorial Hospital Sharp Mesa Vista Hospital and Sharp McDonald Center Sharp Health Plan Community Benefits Planning at Sharp HealthCare Sharp bases its community benefits planning on the triennial community health needs assessment (CHNA) conducted by San Diego Community Health Improvement Partners (CHIP) combined with the expertise in programs and services of each Sharp hospital. Listing of Community Needs Addressed in This Community Benefits Report The following community needs are addressed by one or more Sharp hospitals in this Community Benefits Report: Access to care for individuals without a medical provider Focused education and screening programs on health conditions such as heart and vascular disease, stroke, cancer, diabetes, preterm delivery, unintentional injuries and behavioral health Health education and screening activities for seniors Outreach for flu vaccinations Special support services for hospice patients and their loved ones, and for the community Support of community nonprofit health organizations Education and training of health care professionals Collaboration with local schools to promote interest in health care careers Welfare of seniors and disabled people Cancer education, patient navigator services, and participation in clinical trials Women's and prenatal health services and education Meeting the needs of new mothers and their loved ones Mental health and substance abuse education for the community Highlights of Community Benefits Provided by Sharp in FY 2011 The following are examples of community benefits programs and services provided by Sharp hospitals and entities in FY 2011. Unreimbursed Medical Care Services included uncompensated care for patients who are unable to pay for services, and the unreimbursed costs of public programs such as Medi-Cal, Medicare, San Diego County Indigent Medical Services, Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), and TRICARE - the regionally managed health care program for active-duty and retired members of the uniformed services, their loved ones and survivors; and unreimbursed costs of workers' compensation programs. This also included financial support for on-site workers to process Medi-Cal eligibility forms. Other Benefits for Vulnerable Populations included van transportation for patients to and from medical appointments; financial and other support to community clinics to assist in providing health services, and improving access to health services; Project HELP; Project CARE; contribution of time to the YWCA Emergency Shelter (Becky's House), Stand Down for Homeless Veterans, and the San Diego Food Bank; financial and other support to the Sharp Humanitarian Service Program; and other assistance for the needy. Other Benefits for the Broader Community included health education and information, and participation in community health fairs and events addressing the unique needs of the community, plus providing flu vaccinations and health screenings. Sharp collaborated with local schools to promote interest in health care careers; made Sharp facilities available for use by community groups at no charge; and executive leadership and staff actively participated in numerous community organizations, committees and coalitions to improve the health of the community. See Appendix A for a listing of Sharp's involvement in community organizations. Health Research, Education and Training Programs included education and training programs for medical, nursing and other health care professionals, as well as student/intern supervision. Sharp also completed its partnership with Southwestern College (SWC) and University of Oklahoma (OU) College of Nursing to provide clinical experience in SDC for students enrolled in the OU Online Accelerated Second Degree BSN Program. Economic Value of Community Benefits Provided in FY 2011 In FY 2011, Sharp provided a total of $297,942,782 in community benefits programs and services that were unreimbursed. Table 1 displays a summary of unreimbursed costs based on the categories specifically identified in SB 697. In FY 2011, the State of California and the Centers for Medicare and Medicaid Services approved a Medi-Cal Hospital Fee Program for the period April 1, 2009 through December 31, 2010, resulting in increased reimbursement of $120.7 million and an assessment of a quality assurance fee totaling $82.7 million. The net impact of the program totaling $38.1 million reduced the amount of unreimbursed medical care service for the Medi-Cal population. This reimbursement helped offset prior years' unreimbursed medical care services, but was fully recorded in FY 2011, thereby understating the true unreimbursed medical care services performed for FY 2011. Table 1: Total Economic Value of Community Benefits Provided Sharp HealthCare Overall - FY 2011 Senate Bill 697 Category Programs and Services Included in Senate Bill 697 Category Estimated FY 2011 Unreimbursed Costs Medical Care Services Shortfall in Medi-Cal $29,099,719 Shortfall in Medicare $159,888,631 Shortfall in San Diego County Indigent Medical Services $26,653,890 Shortfall in CHAMPVA/TRICARE $2,608,868 Shortfall in Workers' Compensation $124,996 Charity Care and Bad Debt $68,569,532 Other Benefits for Vulnerable Populations Patient transportation and other assistance for the needy $3,092,761 Other Benefits for the Broader Community Health education and information, support groups, health fairs, meeting room space, donations of time to community organizations and cost of fundraising for community events $3,125,051 Health Research, Education, and Training Programs Education and training programs for students, interns, and health care professionals $4,779,334 TOTAL $297,942,782 Table 2 shows a listing of these unreimbursed costs provided by each Sharp entity. Table 2: Total Economic Value of Community Benefits Provided Sharp HealthCare Entities - FY 2011 Sharp HealthCare Entity Estimated FY 2011 Unreimbursed Costs Sharp Chula Vista Medical Center $53,843,127 Sharp Coronado Hospital and Healthcare Center $9,922,973
		Sharp Grossmont Hospital $103,258,405 Sharp Mary Birch Hospital for Women & Newborns $3,530,274 Sharp Memorial Hospital $119,458,481 Sharp Mesa Vista Hospital and Sharp McDonald Center $7,753,855 Sharp Health Plan $175,667 ALL ENTITIES $297,942,782 Table 3 includes a summary of unreimbursed costs for each Sharp entity based on the categories specifically identified in SB 697. Sharp leads the community in unreimbursed medical care services among San Diego County's SB 697 hospitals and health care systems. Table 3: FY 2011 Detailed Economic Value of Community Benefits at Sharp HealthCare Entities Based on Senate Bill 697 Categories Sharp HealthCare Entity SENATE BILL 697 CATEGORY Medical Care Services Other Benefits for Vulnerable Populations Other Benefits for the Broader Community Health Research, Education and Training Programs Estimated FY 2011 Unreimbursed Costs Sharp Chula Vista Medical Center $52,084,235 $489,363 $450,848 $818,681 $53,843,127 Sharp Coronado Hospital and Healthcare Center $9,305,632 $26,881 $194,701 $395,759 $9,922,973 Sharp Grossmont Hospital $100,479,517 $633,152 $1,109,244 $1,036,492 $103,258,405 Sharp Mary Birch Hospital for Women & Newborns $2,665,218 $42,169 $233,139 $589,748 $3,530,274 Sharp Memorial Hospital $116,152,668 $906,896 $804,684 $1,594,233 $119,458,481 Sharp Mesa Vista Hospital and Sharp McDonald Center $6,258,366 $984,422 $171,845 $339,222 $7,753,855 Sharp Health Plan $9,878 $160,590 $5,199 $175,667 ALL ENTITIES $286,945,636 $3,092,761 $3,125,051 $4,779,334 $297,942,782 Community Benefits Planning Process For the past 15 years, Sharp has based its community benefits planning on findings from the triennial Community Health Needs Assessment (CHNA) conducted by San Diego Community Health Improvement Partners (CHIP), as well as the combination of expertise in programs and services of each Sharp hospital and knowledge of the populations and communities served by those hospitals. Methodology to Conduct the 2010 Community Health Needs Assessment Since 1995, Sharp has participated in a countywide collaborative - including a broad range of hospitals, health care organizations, and community agencies - to conduct a triennial CHNA. The 2010 CHNA is publicly available at: http://www.sdchip.org/initiatives/charting-the-course-vi.aspx. In 2010, the CHIP Needs Assessment Advisory Council, under the direction of the CHIP Steering Committee, determined a methodology and approach to the sixth edition of the triennial needs assessment, which included a community priority-setting process composed of the following steps: * Review of the 38 Healthy People 2020 focus areas by the Needs Assessment Advisory Council, comprising more than 30 community stakeholders. Seventeen health issues emerged as a result of the combining and streamlining of these areas by the Council. * Division of the 17 health issues into the following three categories: Overarching Issues, Health-Related Behaviors and Health Outcomes. Health issue briefs were developed to provide detailed information on each of the 17 identified health issues. * Invitation to community leaders throughout San Diego County (72 out of 379 invitees participated) to prioritize each health issue with information from the health issue briefs and based on the following criteria: - Size of the health issues - Seriousness of the health issue - Community resources available to address the health issue - Availability of data/information to evaluate the health issue's outcomes - Each of the health issues was scored separately within the three categories noted above (Overarching Issues, Health-Related Behaviors and Health Outcomes) * Utilization of the Spectrum of Prevention Framework to determine which issues prioritized by the community were most impacted by prevention activities (as opposed to treatment): - Health access and delivery - Social determinants of health - A combination of nutrition, weight status, physical activity and fitness - Injury and violence - Mental health and mental disorders * Discussion of the above identified issues in community forums held in the six regions of San Diego County in order to: - Allow community stakeholders to identify root causes related to each health issue - Begin the process of understanding each issue from a regional perspective - Foster community relationships and promote the voice(s) of San Diego's various regional and sub-regional communities in the needs assessment process * In-depth analysis of each of the five health issues selected for the 2010 CHNA, which were the same issues identified through the Spectrum of Prevention Framework. Depending on the level of available data, these analyses included an overview of the health issue and its importance; seriousness of the health issue in terms of economic costs, use of resources and/or loss of functional status; incidence data; prevalence of morbidity and mortality in the populations most impacted by the health issue; and the local impact of the health issue. In addition to a review of the results from the priority-setting process, the 2010 CHNA utilized information from the following: * Analysis of health-related statistics gathered and analyzed by the County of San Diego Health and Human Services Agency (HHSA), supplemented by data from the California Health Interview Survey (CHIS), California Office of Statewide Planning and Development (OSHPD), the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System and census data from the San Diego Association of Governments (SANDAG). * Review of health-related scientific literature * Review of the results from facilitated discussions of six community regional forums held with a cross-section of stakeholders from the San Diego County community Determination of Priority Community Needs: Sharp HealthCare Each Sharp hospital reviewed the 2010 CHNA and used it to determine priority needs for their hospital's communities. In identifying these priorities, each entity considered the expertise and mission of the hospital in providing programs and services, in addition to the needs of the unique, ever-changing demographics and/or health topics that comprise the entity's service area and region. For example, the specialty hospitals - SMBHWN, SMV, and SMC - reviewed the needs assessment priorities, specifically focusing on issues relevant to women and infants, behavioral health, and substance abuse, respectively. Sharp's general acute-care hospitals reviewed the needs assessment with a focus on the region and/or sub-regional areas, with the goal of matching community benefit programs and services to the unique needs of the region. Steps Completed to Prepare an Annual Community Benefits Report
		On an annual basis, each Sharp hospital performs the following steps in the preparation of its Community Benefits Report: * Establishes and/or reviews hospital-specific measurable objectives * Verifies the need for an ongoing focus on identified community needs and/or adds new identified community needs * Reports on activities conducted in the prior fiscal year - FY 2011 Report of Activities * Develops a plan for the upcoming fiscal year, including specific steps to be undertaken - FY 2012 Plan * Reports and categorizes the economic value of community benefits provided in FY 2011, according to the framework specifically identified in SB 697 * Reviews and approves a Community Benefits Plan * Distributes the Community Benefits Plan and Report to members of the Sharp Board of Directors and Sharp hospital boards of directors, highlighting activities provided in the prior fiscal year as well as specific action steps to be undertaken in the upcoming fiscal year Ongoing Commitment to Collaboration In support of its ongoing commitment to working with others on addressing community health priorities to improve the health status of San Diego County residents, Sharp executive leadership, operational experts and other staff are actively engaged in the national American Hospital Association, statewide California Hospital Association, Hospital Association of San Diego & Imperial Counties and other local collaboratives such as the CHIP Access to Health Literacy Initiative and the CHIP Behavioral Health Work Team. Sharp Grossmont Hospital * SGH is located at 5555 Grossmont Center Drive, in La Mesa, ZIP code 91942. * Sharp HospiceCare is located at 8881 Fletcher Parkway, in La Mesa, ZIP code 91942. FY 2011 Community Benefits Program Highlights SGH provided a total of $103,258,405 in community benefits in FY 2011. See Table 1 for a summary of unreimbursed costs based on the categories identified in SB 697. Table 1: Economic Value of Community Benefits Provided Sharp Grossmont Hospital - FY 2011 Senate Bill 697 Category Programs and Services Included in Senate Bill 697 Category Estimated FY 2011 Unreimbursed Costs Medical Care Services Shortfall in Medi-Cal, financial support for onsite workers to process Medi-Cal eligibility forms $11,494,217 Shortfall in Medicare $48,139,056 Shortfall in San Diego County Indigent Medical Services $12,019,736 Shortfall in CHAMPVA/TRICARE $972,245 Charity Care and Bad Debt $27,854,263 Other Benefits for Vulnerable Populations Patient transportation, Project HELP and other assistance for the needy $633,152 Other Benefits for the Broader Community Health education and information, health screenings, health fairs, support groups, meeting room space, donations of time to community organizations, and cost of fundraising for community events $1,109,244 Health Research, Education, and Training Programs Education and training programs for students, interns, and health care professionals $1,036,942 TOTAL $103,258,405 Key highlights: * Unreimbursed Medical Care Services included uncompensated care for patients who were unable to pay for services; the unreimbursed costs of public programs such as Medi-Cal, Medicare, and San Diego County Indigent Medical Services; and financial support for onsite workers to process Medi-Cal eligibility forms. In FY 2011, the State of California and the Centers for Medicare and Medicaid Services approved a Medi-Cal Hospital Fee Program for the period April 1, 2009 through December 31, 2010 resulting in increased reimbursement of $40.8 million to SGH and an assessment of a quality assurance fee totaling $32.0 million from SGH. The net impact of the program on SGH (totaling $8.8 million) reduced the amount of unreimbursed medical care service for the Medi-Cal population. This reimbursement helped offset prior years' unreimbursed medical care services, but was fully recorded in FY 2011 thereby understating the true unreimbursed medical care services performed for FY 2011. * Other Benefits for Vulnerable Populations included van transportation for patients to and from medical appointments; comprehensive prenatal clinical and social services to low-income, low-literacy women with Medi-Cal benefits; financial and other support to Neighborhood Healthcare; Project HELP; Project CARE; contribution of time to Habitat for Humanity, Stand Down for Homeless Veterans, and the San Diego Food Bank; the Sharp Humanitarian Service Program; Meals-on-Wheels Greater San Diego; and other assistance for the needy. * Other Benefits for the Broader Community included health education and information on a variety of topics; support groups; participation in community health fairs and events and health screenings for stroke, blood pressure, glucose, balance/fall prevention, hand, depression, lung function, peripheral artery disease, vascular disease and carotid artery disease; flu vaccination clinics for heart disease patients and high-risk adults; and the Breast Cancer Patient Navigator Program. The hospital's Senior Resource Center offered flu vaccinations and specialized education and information. SGH staff collaborated with local schools to promote interest in health care careers. SGH also offered meeting room space at no charge to community groups. In addition, staff at the hospital actively participated in community boards, committees, and civic organizations, such as Aging and Independent Services (AIS), La Mesa Park and Recreation Foundation, Communities Against Substance Abuse, East County Chamber of Commerce, Neighborhood Healthcare Community Clinics, Santee Chamber of Commerce, Salvation Army Kroc Center Board, Meals-on-Wheels Greater San Diego Advisory Board, San Diego Nutrition Council, San Diego County Social Services Advisory Board, YMCA, San Diego Caregiver Coalition, East County Senior Service Providers and the Caregiver Education Committee. See Appendix A for a listing of Sharp community involvement. * Health Research, Education and Training Programs included education and training of health care professionals, and student and intern supervision. Definition of Community The community served by SGH includes the entire East Region of San Diego County (SDC), including the sub-regional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley and Mountain Empire. Approximately five percent of the population lives in remote or rural areas of this region. Description of Community Health In the County's East Region in 2009, 96 percent of children ages 0 to 11, 96.2 percent of children ages 12 to 17 and 86.6 percent of adults ages 18 and older had health insurance, while 97.7 percent of children ages 0 to 11 and 93.7 percent of children ages 12 to 17 had a regular source of medical care - failing to meet the Healthy People (HP) 2020 national targets for health insurance coverage and regular source of medical care. Among adults ages 18 to 64 years in SDC's East Region, 15.7 percent were not currently insured in 2009. See Table 2 for a summary of key indicators of access to care, and Table 3 for data regarding eligibility for Medi-Cal Healthy Families. Table 2: Health Care Access in San Diego County's East Region, 2009 Description Rate Year 2020 Target Health Insurance Coverage Children 0 to 11 Years 96.0% 100% Children 12 to 17 Years 96.2% 100% Adults 18 + Years 86.6% 100% Regular Source of Medical Care Children 0 to 11 Years 97.7% 100% Children 12 to 17 Years 93.7% 100% Adults 18 + Years 89.7% 89.4% Not Currently Insured Adults 18 to 64 Years 15.7% Source: 2009 CHIS Table 3: Medi-Cal (Medicaid)/Healthy Families Eligibility, Among Uninsured in San Diego County (Adults ages 18-64 yrs), 2009 Description Rate Medi-Cal Eligible 8.3% Healthy Families Eligible 0.8% Not Eligible 90.9% Source: 2009 CHIS Heart Disease and cancer were the top two leading causes of death in the County's East Region. See Table 4 for a summary of leading causes of death in the East Region. Table 4: Leading Causes of Death in San Diego County's East Region 2009 Cause of Death Number of Deaths Percent of Total Deaths Diseases of heart 889 24.6% Malignant neoplasms 831 23.0% Alzheimer's disease 238 6.6% Chronic lower respiratory diseases 199 5.5% Cerebrovascular diseases 191 5.3% Accidents (unintentional injuries) 179 5.0% Diabetes mellitus 109 3.0% Intentional self-harm (suicide) 70 1.9% Essential (primary) hypertension and hypertensive renal disease 64 1.8% Chronic liver disease and cirrhosis 59 1.6% Influenza and pneumonia 59 1.6% Parkinson's disease 35 1.0% Nephritis, nephritic syndrome and nephrosis 30 0.8%
		Viral hepatitis 30 0.8% Septicemia 27 0.7% All other deaths 600 16.6% Total Deaths 3,610 100.0% Notes: Ranking of leading causes of death based on the countywide rank among San Diego residents in 2009. Source: County of San Diego, HHSA, Public Health Services, Community Epidemiology Branch Community Benefits Planning Process In addition to the steps outlined in Section 3 regarding community benefits planning, SGH: * Incorporates community priorities and community input into its strategic plan and develops service line-specific goals * Estimates an annual budget for community programs and services based on community needs, the prior years experience and current funding levels * Prepares and distributes a monthly report of community activities to its board of directors, describing community benefits provided such as education, screenings and flu vaccinations * Prepares and distributes information on community benefits programs and services through its foundation and community newsletters * Consults with representatives from a variety of departments to discuss, plan and implement community activities Priority Community Needs Addressed in Community Benefits Report SGH's Community Benefits Report addresses the following identified community needs: * Stroke education and screening * Heart and vascular disease education and screening * Cancer education and participation in clinical trials * Diabetes education and testing * Outreach for flu vaccinations * Health education and screening for seniors * Prevention of unintentional injuries * Special support services for hospice patients, their loved ones and the community * Collaboration with local schools to promote interest in health care careers * Women's and prenatal health services and education * Orthopedic and osteoporosis education and screening For each priority community need identified above, subsequent pages include a summary of the rationale and importance of the need, measurable objective(s), FY 2011 Report of Activities conducted in support of the objective(s), and FY 2012 Plan of Activities. Identified Community Need: Stroke Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified heart disease and stroke as the second-most important health outcomes overall (when considering a total of seven health outcomes). * According to the 3-4-50 Chronic Disease in San Diego County 2010 report from the County's Health and Human Services Agency (HHSA), in 2007, stroke was the third-leading cause of death in SDC. * In 2009, there were 191 deaths due to cerebrovascular diseases in SDC's East Region. The region's age-adjusted death rate due to cerebrovascular diseases was 37.1 deaths per 100,000 population. The region's age-adjusted death rate was the second highest of all regions and higher than the SDC age-adjusted rate of 32.6 deaths per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, if no changes are made in risk behavior, based on current disease rates, it is projected that by the year 2020, the total number of deaths from heart disease and stroke will both increase by 38 percent. * In 2008 there were 1,133 hospitalizations due to stroke in SDC's East Region. The rate of hospitalizations for stroke was 244 per 100,000 population. The stroke hospitalization rate in the region was among the highest in SDC's regions and higher than the County average of 206.2 stroke hospitalizations per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, in 2007, nearly 63 percent of hospitalizations were due to heart disease and stroke. If no changes are made in risk behavior, based on current rates, it is projected that by the year 2020 the total number of hospitalizations is projected to increase by 31 percent for stroke. * In 2008, there were 213 stroke-related ED visits in the County's East Region. The rate of visits was 45.9 per 100,000 population. The stroke-related ED visit rate in the region was comparable to the County average of 42.0 per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, the most common risk factors associated with stroke include physical inactivity, obesity, hypertension, cigarette smoking, high cholesterol and diabetes. * Although the east suburban area has the same percentage of seniors age 65 and over as the county of San Diego (11 percent), a higher percentage (15.2 percent) of the east rural area population are seniors. Measurable Objective * Provide stroke education and screening services for the community, with an emphasis on seniors. FY 2011 Report of Activities Note: SGH is certified by The Joint Commission as a Primary Stroke Center. The program is nationally recognized for its outreach, education and thorough screening procedures, as well as documentation of its success rate. Sharp Grossmont Hospital is a recipient of the American Heart Association's Get With the Guidelines (GWTG) Gold Plus Achievement Awards for Stroke. The American Heart Association's GWTG is a national effort focused on ensuring that evidence-based therapies are used with stroke patients. SGH's Stroke Center conducted stroke screening and educational events to educate the public on stroke risk factors, warning signs and appropriate interventions, including arrival at hospitals within early onset of symptoms. In FY 2011, the hospital conducted seven community screenings and two community stroke education presentations in East SDC. A total of 270 patients participated in stroke screenings and education was provided to an additional 22 people at educational programs and health fairs. The events were held at the Sharp Grossmont Senior Resource Center; Super Saturday Health Fair at Grossmont Center; Celebrando Event at Sheraton Hotel and Marina; East County Senior Health Fair at Santee Trolley Center; Speaking of Women's Health Conference at Sheraton Hotel and Marina; and the Women's Health Fair at St. Peter's Chaldean Church. SGH provided education and advised behavior modification, including smoking cessation, weight reduction and stress reduction for community members with health risk factors identified during the stroke screenings. A Stroke Unit nurse provided education on stroke signs and symptoms and risk factor modification on the Hispanic TV stations 17 and 33. In addition, SGH's Stroke Center, presented two Meet the Physician lectures entitled Stroke Is a Brain Attack organized through the Senior Resource Center. In FY 2011, the SGH Outpatient Rehabilitation Department offered a stroke support group at no charge to participants. In addition, SGH actively participated in the quarterly San Diego County Stroke Consortium, a collaborative effort to improve SDC stroke care and discuss issues impacting stroke care in SDC. In November 2010, SGH provided expert speakers on stroke and interventional radiology procedures to 220 attendees at the Vascular Symposium designed for local physicians and health care workers. Speakers also presented related topics to 120 attendees at the annual Heart and Vascular Nursing Symposium held in February. Also in February 2011, stroke leadership presented a poster outlining the In-House Stroke Code project designed to improve patient stroke care and use of the Tissue Plasminogen Activator (tPA) window at the International Stroke Conference in Los Angeles. SGH also collaborated with SDC to provide data for the County's stroke registry. FY 2012 Plan SGH Stroke Center will conduct the following: * Participate in stroke screening and education events in East SDC * Provide education for individuals with identified risk factors * Offer a stroke support group, in conjunction with the hospital's Outpatient Rehabilitation Department * Participate with other SDC hospitals in the Stroke Consortium * Continue to provide data to the SDC stroke registry * Continue to collaborate with the state of California to develop a stroke registry * Provide at least two physician speaking events around stroke care and prevention * Participate in SGH Vascular Conference for community physicians * Collaborate with the Vascular Department to provide carotid artery screenings for community members Identified Community Need: Heart and Vascular Disease Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified heart disease and stroke as the second-most important health outcomes overall (when considering a total of seven health outcomes).
		* Vascular disease affects approximately 12 percent of the population in the U.S., but most people do not have symptoms. Among persons over age 55 years, 10 to 25 percent are affected. Those with vascular disease have a six-fold higher death rate due to cardiovascular disease than those without vascular disease. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report from the County's HHSA, in 2007 heart disease was the second-leading cause of death in SDC. * In 2009, there were 889 deaths due to heart disease in SDC's East Region. The region's age-adjusted death rate due to diseases of the heart was 168.2 per 100,000 population. The region's age-adjusted death rate was the second highest of all regions, higher than the SDC age-adjusted rate of 139.7 deaths per 100,000 population, and higher than the Healthy People (HP) 2020 target of 100.8 deaths per 100,000. * According to the 3-4-50 Chronic Disease in San Diego County 2010, if no changes are made in risk behavior, based on current disease rates, it is projected that by the year 2020, the total number of deaths from heart disease and stroke will both increase by 38 percent. * In 2008, there were 1,914 hospitalizations due to coronary heart disease in the County's East Region. The rate of hospitalizations for coronary heart disease was 412.3 per 100,000 population. The hospitalization rate in the region was among the highest in SDC and higher than the County average of 317.0 coronary heart disease hospitalizations per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, in 2007, almost 63 percent of hospitalizations were due to heart disease and stroke. If no changes are made in risk behavior, based on current rates, it is projected that by the year 2020 the total number of hospitalizations is projected to increase by 28 percent for heart disease. * In 2008, there were 172 coronary heart disease-related ED visits in SDC's East Region. The rate of visits was 37.0 per 100,000 population. The coronary heart disease-related ED visit rate in the region was the highest of the regions with a County average of 26.3 per 100,000 population. * In 2009, 5.2 percent of adults in the County's East Region participating in the 2009 CHIS indicated that they were ever diagnosed with heart disease, lower than the County statistic of 6.4 percent. * The 2010 CHNA recognized smoking cessation, increasing physical activity, achieving healthy weight status and improving nutrition as health-related behaviors that are important components in long-term health. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, the most common risk factors associated with heart disease include physical inactivity, obesity, hypertension, cigarette smoking, high cholesterol and diabetes. Measurable Objectives * Provide heart and vascular education and screening services for the community, with an emphasis on adults, women and seniors. * Participate in programs to improve the care and outcomes of individuals with heart and vascular disease. FY 2011 Report of Activities SGH is recognized as a Blue Distinction Center for Cardiac Care by Blue Cross/Blue Shield (BCBS) for demonstrated expertise in delivering quality cardiac health care. SGH is also a recipient of the American Heart Association's GWTG Gold Performance Achievement Award for heart failure care. The American Heart Association's GWTG is a national effort focused on ensuring that evidence-based therapies are used with congestive heart failure patients. SGH offered two community education lectures in September 2011 on Management of Risk Factors, provided by the hospital's nurse practitioner for cardiology and serving 110 people. SGH also provided three congestive heart failure (CHF) classes held in FY 2011, serving 15 people. Topics of the CHF classes included exercise, nutrition, treatment plans and symptoms. In addition, SGH's Cardiac Rehabilitation Department served approximately 350 community members through bimonthly cardiac education classes. In FY 2011, SGH's Cardiac Rehabilitation Program participated in the Super Saturday Health Fair at Grossmont Center, as well as the Santee Senior Health Fair, serving a total of 110 community members. In addition, SGH offered cardiovascular disease preventative screenings from March through September, serving 220 people. SGH's Cardiac Rehabilitation Department also conducted five flu vaccination clinics for heart disease patients and high-risk adults, serving 80 people. Throughout the year, SGH provided expert speakers on heart disease and heart failure for various professional events, including SGH's Cardiac Symposium and SGH's Vascular Symposium. SGH also participated in several programs to improve the care and outcomes of individuals with heart and vascular disease. To assist in improving care for acutely ill patients in the County, SGH provided data on STEMI (ST elevation myocardial infarction or acute heart attack) to San Diego County Emergency Medical Services (EMS). In addition, the hospital completed the third and final year of a study sponsored by National Institutes of Health (NIH) research, which studied heart attacks and heart disease in women age 55 and younger, known as VIRGO (Variation in Recovery: Role of Gender on Outcomes in Young AMI Patients). In FY 2011, SGH successfully screened 10 patients and enrolled two patients in the study before enrollment closed in the fall. SGH's Cardiac Department is committed to supporting future health care leaders through active participation in student training and internship programs. The Sharp Grossmont Cardiac Catheterization Lab hosted a Grossmont College cardiovascular technologist student three days per week, eight hours per day for eight months for a total of 768 hours. The Cath lab RN and staff also worked with a nursing student every Tuesday during the school year. The Noninvasive Cardiology Department also hosted students in echocardiography, electrocardiography and vascular laboratory two days per week during the school year. FY 2012 Plan SGH will conduct the following: * Provide free bimonthly cardiac education classes by the Cardiac Rehabilitation Department * Provide three free CHF education classes * Provide cardiac and/or vascular risk factor education and/or screening through participation in one to two community events, such as health fairs and lectures * Provide weekly preventive heart and vascular screenings * Provide a complimentary flu vaccination clinic to cardiac rehabilitation patients and other senior community members * Offer educational speakers to the professional community on topics such as performance improvements in CHF and acute myocardial infarction, as invited * Maintain BCBS Center of Excellence status * Provide data on STEMI patients to San Diego County Emergency Medical Services * Pursue research opportunities to benefit patients * Provide a continuing medical education conference on vascular disease for community physicians in fall 2012 * Provide student learning opportunities from technologist training campuses Identified Community Need: Cancer Education and Participation in Clinical Trials Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified cancer as the fourth-most important health outcome overall (when considering a total of seven health outcomes). * In 2009, cancer was the second-leading cause of death in the County's East Region, responsible for 23.0 percent of deaths. * In 2009, there were 831 deaths due to cancer (all sites) in the County's East Region. The region's age-adjusted death rate due to cancer was 169.3 deaths per 100,000 population, higher than the SDC age-adjusted rate of 150.1 deaths per 100,000 population, and higher than the HP 2020 target of 160.6 deaths per 100,000. * In 2007, 23 percent of all cancer deaths in the County's East Region were due to lung cancer, 10 percent to colorectal cancer, 7 percent to female breast cancer, 6 percent to prostate cancer, and less than 1 percent to cervical cancer. * Research for the 2010 CHNA recognized the importance of various types of preventative health screenings, including cancer, in preventing disease. * According to a 2012 report from the California Cancer Registry, breast cancer is the most common cancer among women in California, with an estimated 292,400 existing cases (42 percent of all cancers). * According to the 2009 Susan G. Komen for the Cure San Diego Affiliate Community Profile Report, San Diego had the highest incidence rate for breast cancer (163.95 per 100,000) compared to the neighboring counties of Imperial, Los Angeles, Orange and Riverside. San Diego's incidence
		rate for breast cancer is also above that of the State (151.82 per 100,000). * Cancer survivors face many physical, psychological, social, spiritual and financial issues at diagnosis, during treatment and for the remainder of their lives. According to findings presented in the 2007 CHNA, cancer survivors identified several significant burdens, including poorer health, spending more days in bed, increased need for help with activities of daily living and decreased likelihood of employment. * Behavioral and social risk factors associated with cancer deaths include overweight/obesity, poor nutrition, lack of physical activity, and lack of appropriate medical care often due to health disparities, according to research for the 2010 CHNA. * According to the Susan G. Komen for the Cure San Diego Affiliate Community Profile Report, the most common barriers to receiving effective breast health care included lack of awareness and knowledge, financial barriers, cultural barriers and emotional factors. The most common challenges in the current breast health care system included cost of care, quality of providers, lack of communication, and education and language barriers. Increased advocacy, education, funding and partnerships were among the suggestions for improving programs, services and the breast health care system overall. * Breast Cancer Patient Navigator Programs are interventions that address barriers to quality standard care by providing individualized assistance to patients, cancer survivors and their families. Measurable Objectives * Provide cancer education and support services to the community. * Participate in cancer clinical trials, including screening and enrolling patients. FY 2011 Report of Activities Note: The SGH Cancer Center is accredited by the National Accreditation Program for Breast Centers (NAPBC). The NAPBC grants accreditation to only those centers that voluntarily commit to providing the best possible care to patients with diseases of the breast. In FY 2011, SGH Cancer Center participated in a variety of community cancer educational sessions. These events served more than 1,000 community members, and included the East County Senior Service Provider Health Event; the It's How We Live Festival; the Power Shop for the Cure at Grossmont Center; the East County Health Fair at Santee Trolley Station; Learn and Live Events for Breast, Colon and Prostate Cancer; the Philanthropic Educational Organization (PEO) Women's Group Breast Cancer Talk; the Senior Citizen Health Fair at Waterford Terrace; the Super Saturday Health Fair at Grossmont Center; Hospice Resource and Education Expo; Sharp's Speaking of Women's Health Conference; the CMF Women's Association Run for Cancer; and the Ladies of Hope Health Fair at St. Peter's Chaldean Catholic Cathedral. SGH Cancer Center staff also supported the American Cancer Society (ACS) Making Strides Against Breast Cancer Walk and the Susan G. Komen Race for the Cure in Balboa Park. In addition, staff served as health and science project judges for 15 student projects at the San Diego Science Fair. The SGH Cancer Center continued to offer support programs for cancer patients, including breast cancer support group meetings. These meetings were held twice per month at no cost to participants, with an average attendance of 12 to 15 community members. In addition, the Look Good...Feel Better program - offered through the ACS - provided quarterly classes to approximately 21 participants. The program boosts women's self-confidence by teaching them how to cope with skin changes and hair loss using cosmetic and skin care products, wigs, scarves and other accessories. In addition, the SGH Cancer Center provided its Children's Lives Include Moments of Bravery (CLIMB) support group. The program provided two six-to-eight week courses in FY 2011, offering support to children ages 6 and older whose parents or grandparents are battling cancer. In FY 2011, SGH continued its Breast Health Navigator Program, where an RN certified in breast health personally assists breast cancer patients in their navigation of the health care system, offering support, guidance, financial assistance, and connection to community resources. The Breast Health Navigator also played an active role in community education, providing presentations and educational resources about breast cancer, mammography guidelines, and early detection, at no charge to the San Diego community. During pre-lecture educational booths at free physician lectures such as Breast Cancer Awareness, the Navigator provided breast lump models, demonstrated breast self-exam techniques and answered questions regarding breast health among community attendees. In addition, the Breast Health Navigator facilitated access to care for breast cancer patients in need through the provision of gas money and gas cards, as well as financial assistance to approximately 180 individuals. In FY 2011, SGH Cancer Center screened approximately 120 patients for participation in cancer clinical trials, and enrolled 59 patients in cancer research studies. In addition, the SGH Cancer Center trained two California State University, Long Beach Bachelor of Science in Health Science students specializing in Radiation Therapy for 32 hours weekly for one semester each. FY 2012 Plan SGH Cancer Center will conduct the following: * Provide biweekly breast cancer support groups to participants at no charge * Provide free six- to eight-week CLIMB course * Provide quarterly Look Good...Feel Better classes * Continue to provide education and resources to the community with the Breast Health Navigator; also provide ongoing personalized education and information, support and guidance to breast cancer patients and their loved ones as they move through the continuum of care * Screen and enroll oncology patients in clinical trials for research studies * Provide educational lectures to the community on leading forms of cancer and radiation oncology treatment options * Provide educational information on cancers and available treatments through community physician lectures and participation in health fairs and events with demonstrations on breast self-exams Identified Community Need: Diabetes Education and Testing Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified diabetes as the most important health outcome overall (when considering a total of seven health outcomes) in the 2010 CHNA. * In 2009, there were 109 deaths due to diabetes in SDC's East Region. The region's age-adjusted death rate due to diabetes was 21.9 per 100,000 population, the second highest of all regions and higher than the SDC age-adjusted rate of 17.5 deaths per 100,000 population. (Note: Diabetes is also a contributing cause of death.) * In 2008, there were 870 hospitalizations due to diabetes in the County's East Region. The rate of hospitalizations for diabetes was 187.4 per 100,000 population. The hospitalization rate in the region was the highest in SDC's regions and higher than the County average of 126.2 diabetes hospitalizations per 100,000 population. * In FY 2008, there were 680 diabetes-related ED visits in the County's East Region. The rate of visits was 146.5 per 100,000 population. The diabetes-related ED visit rate in the region was among the highest in SDC and higher than the County average of 136.7 per 100,000 population. * 4.5 percent of adults in the County's East Region participating in the 2009 CHIS indicated that they were ever diagnosed with diabetes. The rate was one of the lowest among SDC's regions and lower than the County rate of 7.8 percent of adults. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report from the County's HHSA, the most common risk factors associated with Type II diabetes include overweight and obesity, physical inactivity, smoking, hypertension and abnormal cholesterol. (Note: Two out of three Americans are now overweight or obese.) Measurable Objective * Provide diabetes education and testing in SDC's East Region. FY 2011 Report of Activities SGH Diabetes Education Program is recognized by the ADA (American Diabetes Association) and meets national standards for excellence and quality in diabetes education. In FY 2011, the SGH Diabetes Education Program conducted three community educational lectures and four blood glucose screening events at hospital and off-site locations, testing 163 people. As a result of these screenings, 37 people were identified with elevated blood glucose levels. Screening events were located throughout San Diego's East County, including the Grossmont Healthcare District Library, Waterford Terrace in La Mesa, the 12th Annual Senior Health Fair at the Santee Trolley Square and the Ladies of Hope
		Fair at St. Peter's Chaldean Catholic Cathedral. SGH's Diabetes Education Program conducted community lectures on diabetes at libraries, community centers, educational institutions, national conferences and other hospitals. In addition, the SRS Diabetes Education Program conducted a screening event at the Vista Promotoras at Cuyamaca College, and a Meet the Pharmacist event at the YMCA in Santee, screening a total of 104 community members at these two events. As a result of these screenings, 13 people were identified with elevated blood glucose levels. SGH's Diabetes Education Program conducted educational seminars for health care professionals on management of diabetes in hospitalized patients and outpatients and on other topics, including prevention of diabetic heart disease, diabetes and renal failure. In FY 2011, the SGH Diabetes Education Program continued to provide targeted outreach to the newly immigrated Iraqi Chaldean population in San Diego. The program facilitated translation, as well as provided materials and resources to better understand the cultural needs of this newly immigrated population. The resources provided included an information binder on topics such as: How to Live Healthy With Diabetes; What You Need to Know About Diabetes; All About Blood Glucose for People With Type II Diabetes; All About Carbohydrate Counting; Getting the Very Best Care for Your Diabetes; All About Insulin Resistance; and All About Physical Activity With Diabetes. Handouts were provided in Arabic as well as Somali, Tagalog and Vietnamese for additional populations. Education was also provided to staff members regarding the different cultural needs of these communities. FY 2012 Plan The SGH Diabetes Education Program will conduct the following: * Coordinate and implement blood glucose screenings at community and hospital sites in the County's East Region * Conduct educational lectures at various community venues * Support the American Diabetes Association's Step Out for Diabetes Walk * Continue to collaborate with the Diabetes Behavioral Institute to host community lectures that will assist diabetes patients and their loved ones * Conduct educational symposiums for health care professionals * Explore additional opportunities for culturally competent diabetes education and/or outreach to newly immigrated populations * Continue to provide lectures to multicultural elementary students that focus on healthy diets and weight management * Keep current on resources to give to the community for support Identified Community Need: Outreach for Flu Vaccinations Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified keeping immunizations current as the seventh-most important health-related behavior overall in the 2010 CHNA. * Pneumonia and influenza ranked as the ninth-leading cause of death in SDC. * In 2009, there were 59 deaths due to pneumonia and influenza in the County's East Region. The region's age-adjusted death rate due to pneumonia and influenza was 11.5 per 100,000 population, the second highest of all regions, and higher than the SDC age-adjusted rate of 9.6 deaths per 100,000 population. * In SDC, an estimated 72 percent of seniors 65 years and older were vaccinated for influenza in 2007, failing to meet the HP 2020 target of at least 90 percent of adults 65 years and older vaccinated annually for influenza. * The CDC recommends annual vaccination against influenza for the following: people aged 50 years and older; adults and children with a chronic health condition; children aged 6 months up to their 19th birthday; pregnant women; people who live in nursing homes and other long-term care facilities; and people who live with or care for those at high risk for complications from flu, including health care workers, household contacts of persons at high risk for complications from the flu, and household contacts and caregivers of children younger than 5 years of age. * Flu clinics offered in community settings at no or low cost improve access for those who may experience transportation, cost or other barriers. Measurable Objectives * In collaboration with community partners, offer seasonal flu vaccination clinics at convenient locations for seniors and high-risk adults in the community. * Provide information at the seasonal flu clinics about other Senior Resource Center programs and other health education materials. FY 2011 Report of Activities In FY 2011, SGH's Senior Resource Center participated in the San Diego Immunization Coalition to educate high-risk adults about the importance of seasonal flu immunizations and to organize seasonal flu clinics at convenient locations for seniors and high-risk adults. SGH's Senior Resource Center coordinated notification of availability and provision of seasonal flu vaccines in selected community settings through activity reminders and newspaper notices. The SGH Senior Resource Center provided 1,035 seasonal flu vaccinations at 16 community sites to high-risk adults with limited access to health care resources, including seniors with limited resources for transportation and those with chronic illnesses. Sites included senior centers, mobile home parks, senior housing complexes, food banks and various hospital departments. At these community sites, SGH provided activity calendars for the Senior Resource Center detailing upcoming community events, including blood pressure clinics, community senior programs and Project CARE. FY 2012 Plan The SGH Senior Resource Center will conduct the following: * Provide seasonal flu vaccinations at 16 community sites for seniors with limited mobility and access to transportation, as well as high-risk adults, including low-income, minority and refugee populations * Coordinate the notification of seniors regarding the availability of seasonal flu vaccines and the provision of seasonal flu vaccines to high-risk individuals in select community settings * Direct seniors and other chronically ill adults to available seasonal flu clinics, including physicians' offices, pharmacies and public health centers * Work with community agencies to ensure seasonal flu immunizations are offered at sites convenient to seniors and chronically ill adults * Expand outreach for provision of seasonal flu immunizations to include food bank sites across SDC * Publicize flu clinics through media and community partners Identified Community Need: Health Education and Screening for Seniors Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified heart disease and stroke, cancer, diabetes, arthritis, overweight and obesity, and chronic respiratory disease as the top six health issues facing seniors age 65 years and older in the 2010 CHNA. * In 2008, the top 10 leading causes of death among senior adults age 65 years and older in SDC were heart disease; cancer; Alzheimer's disease; stroke; chronic lower respiratory diseases; diabetes; influenza and pneumonia; unintentional injuries; hypertension and hypertensive renal disease; and Parkinson's disease. * In 2007, there were 83,906 visits by seniors aged 65 years and older that were treated and discharged from a SDC ED (23,883 per 100,000), or one out of every four senior residents of SDC. The rate of ED discharge increased with age and was higher among females than males. Black and Hispanic seniors had the highest rates of ED discharge, and rates were highest among residents of the County's Central and East Regions. * In 2008, rates of hospitalization among senior adults age 65 years and older in SDC were higher than the general population due to: coronary heart disease, cancer, stroke, diabetes, chronic lower respiratory diseases, non-fatal unintentional injuries (including falls), arthritis, and dorsopathy (diseases of the spine). * In 2008, the top causes of ED utilization among persons age 65 years and older were falls, arthritis, chronic lower respiratory diseases, diabetes and stroke. Older adults utilize more ambulatory care, hospital services, nursing home services and home health services than young people. * Seniors in SDC use the 9-1-1 system at higher rates than any other age group. In 2007, 58,060 calls were made to 9-1-1 for seniors aged 65 years and older in need of pre-hospital (ambulance) care in SDC, at a rate of 16,526 per 100,000 population, or one out of every six seniors. The rate increased with age to one out of three seniors aged 85 years and older, and was higher for females than for males. * There are an estimated 4 million family caregivers in California
		today, according to the California Caregiver Resource Center (CRC). Whether aging Californians live in their own homes, with a relative, in an assisted-living residential facility, or in a nursing home, one of the keys to their care is family caregiving - defined as those family members and informal care providers who assist with the care of disabled elderly relatives. Reaching out to families and community members who care for older adults helps to maintain the health of older adults as well as their caregivers. * Project CARE is a cooperative safety net designed to ensure the well-being and independence of older persons and persons with disabilities in the community. Through its component services, Project CARE helps people live independently in their homes. The County's East Region autonomously administers a local Project CARE site, located at SGH's Senior Resource Center, to meet the unique needs of the community's seniors. Measurable Objectives * Host a variety of senior health education and screening programs. * Produce activity calendars four times a year. * Act as lead agency for East County Project CARE. FY 2011 Report of Activities In FY 2011, the SGH Senior Resource Center provided free health education programs (1,067 people attended) and health screenings (739 people screened). Health education topics included: hearing, stroke, heart health, vascular disease, osteoporosis, weight loss, diabetes, senior services, Vials of Life, Advance Directives for Health Care, financial issues, memory loss, caregiver resources, end-of-life issues, Medicare, depression, stress management and sleep disturbances. Educational programs were offered at the hospital campus, the Grossmont Healthcare District Conference Center, and in various communities in East County. The hospital offered free monthly blood pressure screenings at community sites, along with four balance/fall prevention screenings, and five hand screenings. The hospital also offered health screenings for depression, lung function, peripheral artery disease, vascular disease, carotid artery disease and stroke. From these screenings, 26 attendees with abnormal results were referred to physicians for follow-up. The SGH Senior Resource Center also provided a series of physician lectures in FY 2011, covering topics such as foot care, stroke and hearing loss. In total, 152 community members attended these lectures. In addition, the hospital provided education for seniors on how to communicate with their providers, as well as education for caregivers. Calendars highlighting SGH's Senior Resource Center activities were mailed four times a year to approximately 7,600 households. The SGH Senior Resource Center distributed 250 Advance Directives for Health Care, as well as 2,150 Vials of Life, which provide important medical information to emergency personnel for seniors and disabled people living in their homes. Project CARE is a community program that includes the County's AIS, Jewish Family Services, SDG&E, local senior centers, sheriff and police, and many others. The Senior Resource Center provided daily computerized phone calls - at regularly scheduled times selected by participants - to an average of 40 East County seniors who live alone each day. A total of 10,235 phone calls were placed to seniors or disabled individuals in FY 2011. Staff completed 108 follow-up phone calls with friends or neighbors to ensure the participants' safety if staff were unable to reach them at home. In collaboration with the San Diego Caregiver Coalition, the Senior Resource Center provided a Caregiver Conference at the United Methodist Church of Mission Valley for 100 family caregivers, focusing on emotional issues, physical aspects of care giving, and community resources. The Senior Resource Center also coordinated an end-of-life conference entitled Aging, Planning and Coping with Sharp HospiceCare - serving 84 individuals - and provided information on advance directives, end-of-life issues, and conversations with loved ones. The Senior Resource Center also participated in health fairs in Campo, El Cajon, Lakeside, Santee, La Mesa, the College Area, and San Diego. In addition, the Senior Resource Center assisted in the planning and coordination of a Meet the Pharmacist event at the Santee YMCA, serving 50 community members and also participated in another Caregiver Conference held at the La Mesa Community Center, providing resources to more than 95 attendees from the community. In FY 2011, the Senior Resource Center maintained active relationships with organizations serving seniors, enhancing networking among East County professionals and providing quality programming for seniors. These organizations included AIS (Project CARE and the Caregiver Coalition), East County Senior Service Providers, Meals-on-Wheels Greater San Diego, and the Caregiver Education Committee. The SGH Senior Resource Center also enhanced its educational resources on the Sharp.com website with the addition of monthly Healthy Aging podcast segments. Audio and video presentations offered important public information on fall prevention, maintaining brain health, advance directives, caregiving for older adults, and exercises to help seniors live a healthy and independent life. These podcasts were made possible by a grant from the PacifiCare/United Healthcare Charitable Commitment Program. FY 2012 Plan SGH's Senior Resource Center will conduct the following activities: * Provide resources at the Senior Resource Center to address relevant concerns of seniors, including health information and community resources through educational programs, monthly blood pressure clinics, and four to eight health screenings annually * Utilize Sharp experts in the field for 12 seminars per year that focus on issues of concern to seniors * Maintain daily contact through phone calls with individuals (many are home bound) in rural and suburban settings who are at risk for injury or illness, and continue supporting Project CARE services for the East County community * Participate in six community health fairs and special events targeting seniors * Coordinate two conferences - one dedicated to family caregiver issues in collaboration with San Diego Caregiver Coalition and one focused on end-of-life issues in collaboration with Sharp HospiceCare * Produce and distribute quarterly calendars highlighting events of interest to seniors and family caregivers * Provide 2,000 Vials of Life to seniors * Present an Advanced Directives and Health Care Decisions program to inform seniors about advance directives and other necessary documents available to communicate their end-of-life wishes Identified Community Need: Prevention of Unintentional Injuries Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified injury and violence as the fourth-most important health-related behaviors overall (when considering a total of seven health-related behaviors) in the 2010 CHNA. * Injury, including both intentional and unintentional, is the number one killer and disabler of persons aged 1 to 44 in California. * Unintentional injuries - motor vehicle accidents, falls, firearms, fire/burns, drowning, poisoning (including drugs and alcohol, gas, cleaners and caustic substances) and injuries at work - are one of the leading causes of death for SDC residents of all ages, regardless of gender, race or region. * During 2008, unintentional injury was the leading cause of death for persons ages 1 to 4 years and 15 to 34 years, and the sixth-leading cause of death overall in SDC.
		* Between 2000 and 2008, 6,725 San Diegans died as a result of unintentional injuries, and since 2000, the rate of death has increased by 9.8 percent. * In 2009, there were 179 deaths due to unintentional injury in the County's East Region. The region's age-adjusted death rate due to unintentional injuries was 36.3 deaths per 100,000 population, the highest of all regions and higher than the SDC age-adjusted rate of 28.9 deaths per 100,000 population. * In FY 2008, there were 3,947 hospitalizations related to unintentional injury in the County's East Region. The rate of hospitalizations was 850. per 100,000 population, the highest of all regions and higher than the County average of 661 per 100,000 population * In FY 2008, there were 25,466 ED visits related to unintentional injury in the County's East Region. The rate of visits was 5,485 per 100,000 population, the highest of all regions and higher than the County average of 4,764 per 100,000 population. * According to HP 2020, most events resulting in injury, disability or death are predictable and preventable. There are many risk factors for unintentional injury and violence, including individual behaviors and choices, such as alcohol use or risk-taking; the physical environment both at home and in the community; access to health services and systems created for injury-related care; and the social environment, including individual social experiences (social norms, education, victimization history), social relationships (parental monitoring and supervision of youth, peer group associations, family interactions), the community environment (cohesion in schools, neighborhoods and communities) and societal-level factors (cultural beliefs, attitudes, incentives and disincentives, laws and regulations). Measurable Objective * To offer an injury and violence prevention program for children, adolescents, and young adults throughout SDC. FY 2011 Report of Activities In FY 2011, ThinkFirst/Sharp on Survival participated in 31 programs at elementary, middle and high schools in East County, serving 2,630 students. During these one-to-two hour classes, students learned about modes of injury, the anatomy and physiology of the brain and spinal cord, and disability awareness. They also heard personal testimonies from individuals, known as Voices for Injury Prevention (VIPs), with traumatic brain or spinal cord injuries. In addition, due to funding changes, ThinkFirst/Sharp on Survival offered schools multiple opportunities for learning. Schools were provided with a variety of lesson plans to choose from, including information on physical rehabilitation, careers in health care, and disability awareness panels to meet the needs of specific class curricula. In addition, ThinkFirst/Sharp on Survival spoke to at-risk youth about the consequences of violence, gangs, reckless driving and making poor choices. ThinkFirst/Sharp on Survival participated in a variety of community events throughout FY 2011, including presentations for youth and their parents, as well as health- and safety-related fairs and community groups. These community-based events and presentations served more than 1,520 participants throughout the year. Events included the annual Kids Care Fest event in La Mesa sponsored by the Grossmont Healthcare District, where ThinkFirst/Sharp on Survival provided helmet-fitting information as well as education on booster and car seats to approximately 500 community members. In October, ThinkFirst/Sharp on Survival also provided information on proper helmet fitting and booster seat education for the El Cajon Fire Department Safety Fair and Open House, serving 800 people. Also in FY 2011, through a partnership between SDSU and the Health and Science Pipeline Initiative (HASPI), 35 high school students were educated by ThinkFirst/Sharp on Survival staff about careers in physical rehabilitation. This teen day-camp was offered to students to help them connect with health professionals, practice career skills and explore new options for their future careers. A VIP also helped students learn more about disability awareness and how to interact with the disabled population. Through HASPI's Gateway to Allied Health and Nursing Program, a dozen Cuyamaca College students received a presentation from ThinkFirst/Sharp on Survival focusing on the different elements and careers within the physical rehabilitation field. As a conclusion to the careers talk, a VIP shared details on how therapists and nurses in physical rehabilitation helped him to become as independent as possible after his spinal cord injury and what the rehab experience has meant personally to him. In addition, more than 200 college students enrolled in SDSU's Disability in Society course benefited from receiving injury prevention education and learning about brain injury, spinal cord injury and disability awareness. FY 2012 Plan ThinkFirst/Sharp on Survival will do the following: * With funding support from grants, provide educational programming and presentations for local schools and organizations * Increase community awareness of the program through attendance and participation at community events and health fairs using grant funding * Continue to evolve program curricula to meet the needs of health career pathway classes as part of the HASPI partnership Identified Community Need: Special Support Services for Hospice Patients and Their Loved Ones and the Community Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * As patients and their loved ones deal with death and dying, many experience intense grief over the loss of life, yet have the opportunity to experience a profound transformation. A hospice model - combining medical, spiritual, emotional and other support services - can offer many patients and their families assistance, information and strategies related to bereavement, grief and healing. * A 2004 Journal of the American Medical Association (JAMA) study (Source: JAMA January 7, 2004) titled, "Quality of End-of-Life Care and Last Place of Care," examined 1,578 family members of people who died in the year 2000 of non-traumatic causes. Families were asked about the quality of patients' experiences at the last place where they spent more than 48 hours. Significant findings of the study include more than one-third of those cared for by nursing homes, hospitals and home health agencies reported either insufficient or problematic emotional support for the patient and/or family, compared to one-fifth of those in hospice. * As presented in the 2010 CHNA, the Agency for Healthcare Research and Quality has identified coping with the end of life as a component of its National Health Care Quality Report, a conceptual framework for measuring the performance improvement of the U.S. health system in its provision of high-quality care. * A study by the National Hospice and Palliative Care Organization (NHPCO) suggests that hospice may have a positive impact on patients' longevity. The study found that for certain well-defined terminally ill populations, patients who choose hospice care live an average of 29 days longer than similar patients who do not choose hospice, allowing patients and their families extra time for resolution and closure at the end of life (Conner, et al., 2007). * According to a 2011 article in the American Family Physician journal (AFP), in the next few decades, the demand for family caregivers is expected to rise by 85 percent. Furthermore, family caregiving has been affected in several important ways over the past five years: caregivers and care recipients are older and have higher levels of disability than in years past; the duration, intensity and burden of care has increased; the financial cost associated with informal caregiving has risen; and the use of paid formal care has declined significantly. * According to a 2010 article in the Journal of the American Medical Association (JAMA), when compared with nursing homes or home health nursing services, bereaved family members report fewer unmet needs for pain and emotional support when the last place of care was hospice. In addition, lower spousal mortality at 18 months was found among bereaved wives of decedents who used hospice care versus those who did not.
		Measurable Objectives * Provide counseling and support, education, and referral services to hospice patients and their loved ones, and to the community in SDC. * Provide professional education to community physicians and other health care professionals. * Collaborate with community, state and national organizations to provide appropriate services to hospice patients and their loved ones and to the community in San Diego. FY 2011 Report of Activities Sharp HospiceCare serves patients and their loved ones through a hospice model of care. In FY 2011, key services included individual and family bereavement counseling and support; volunteer training programs; the Memory Bear Program; community and professional education; advance care planning; and referral services to hospice and palliative care. Using a flexible approach, Sharp HospiceCare offered a variety of bereavement service options - offered in Spanish and English - including professional bereavement counseling through individual/family and group therapy, education, support groups, and monthly newsletter mailings. In FY 2011, Sharp HospiceCare devoted more than 1,700 hours to home, office and phone contacts made to patients and their loved ones, providing them with pre-bereavement and bereavement counseling services by professionals with specific training in grief and loss. In FY 2011, 12 bereavement support groups, including two Spanish-speaking groups, were provided free of charge, serving 202 participants. The various groups were facilitated by skilled mental health care professionals who specialize in the needs of the bereaved. A unique event entitled Healing Through the Holidays served 104 adults at four locations with presentations on coping with grief during the holiday season, spirituality during the holidays, and a family's grief journey through the holidays. In further support of bereavement counseling, 1,427 people received 13 monthly issues of the bereavement support newsletter, Healing Through Grief (for adults), and Journey to My Heart (for children under 12 years). In addition, Sharp HospiceCare bereavement counselors provided referrals to needed community services including ongoing mental health services, financial assistance, child protective services, drug and alcohol counseling, parent education courses and anger management. Sharp HospiceCare provided extensive training for 68 new volunteers in FY 2011. Potential volunteers undergo a rigorous 32-hour training program to confirm their understanding of and commitment to hospice care. Including both new and returning volunteers, over 185 individuals served as Sharp HospiceCare volunteers during the past fiscal year. As part of the hospice interdisciplinary team, volunteers provided 6,120 hours of service through direct patient care as well as 6,150 hours of clerical and administrative support, devoting 12,270 hours in total to this project. In addition, Sharp HospiceCare coordinated a volunteer-run wig donation program that is open to community members who have suffered hair loss. During FY 2011, Sharp HospiceCare met with 32 individuals and provided 64 wigs. The Sharp HospiceCare program supported volunteers with a monthly volunteer support group and recognition during National Volunteer Month and National Hospice Month. In addition, Sharp HospiceCare provided training and supervision to 15 premedical students through the Pre-Professional Program at SDSU during FY 2011. The Sharp HospiceCare Teen Volunteer Program trained 11 high-school-age teens (14 to 18 years old) during FY 2011. The teen program specializes in helping to create family videos; however, teens are also assigned special projects in the office or patient assignments at LakeView and ParkView homes. Sharp HospiceCare also hosted an intern from San Diego Metropolitan Regional & Technical High School during FY 2011. The student spent one six-hour shift per week in Sharp HospiceCare's administrative office, and another six-hour shift in a Sharp HospiceCare home. The student experienced hospice care through case conferences, interdisciplinary team (IDT) meetings, and a variety of other tasks. The Memory Bear Program, a component of the Volunteer Program, provides a unique keepsake for family members by making teddy bears from garments of the loved one who has passed on. For surviving family members, these bears become permanent reminders of their loved ones. Sharp HospiceCare volunteers, who handcraft all bears stitch by stitch, devoted more than 5,800 hours to craft 968 bears for 241 families during FY 2011. In FY 2011, Sharp HospiceCare provided community education for more than 1,000 people. Topics included end-of-life care and symptom management; information about hospice; home-based palliative care programs; advance care planning; the grieving process; hospice and dementia; hospice and depression; the importance of humor in hospice and end-of-life care; stress management and integrative therapies; pain management; death and dying; and hospice volunteer opportunities. In addition, Sharp HospiceCare promoted Transitions - an innovative disease management program that focuses on aggressive in-home disease management and aligns patient goals of care with medical, psychological and spiritual interventions throughout the community. In FY 2011, Sharp HospiceCare participated in multiple events and community forums at various sites throughout San Diego, including service clubs, senior centers, retirement communities, home health agencies, community planning groups, community centers, churches, libraries, colleges and universities. In addition, Sharp HospiceCare - in collaboration with the SGH Senior Resource Center
		and often on their own - provided a variety of caregiver conferences throughout SDC. The conferences provided information on communicating end-of-life wishes, wills and trusts, spiritual planning, and advance care planning. Also in conjunction with the SGH Senior Resource Center and the Caregiver Coalition, Sharp HospiceCare coordinated end-of-life conferences and offered resources on hospice care, financial planning, funeral planning, and advance care planning. Sharp HospiceCare has also been involved in a variety of local networking groups that provide caregiver classes, end-of-life programs, and advance care planning seminars and web presentations. In November 2010, Sharp HospiceCare hosted its fifth annual conference for San Diego end-of-life professionals entitled Integrating the Medical, Ethical and Philosophical Aspects of End-of-Life Care. The conference featured a nationally renowned expert in hospice and palliative care, and provided over 150 members of the health care community with an in-depth perspective on what matters most for patients with advanced chronic illness as they are nearing the end of their lives. In addition, Sharp HospiceCare provided a Continuing Medical Education (CME) Geriatric Frailty course at Grossmont Hospital to 160 community physicians and other health care professionals. Sharp HospiceCare leadership presented at several state and national conferences, including the National Hospice and Palliative Care Association, California Association of Physician Groups (CAPG), and the California Coalition of Caring. Topics included management and leadership, the continuum of care and advance care planning. In FY 2011, Sharp HospiceCare also maintained active relationships with organizations including SDC Council on Aging (SDCCOA), Regional Home Care Council, California Hospice and Palliative Care Association (CHAPCA), Hospice and Palliative Nurses Association (HPNA), and San Diego Coalition for End of Life Care. Sharp HospiceCare served as a training site for approximately 25 nursing students from the University of Oklahoma (OU) and Point Loma Nazarene University (PLNU) in FY 2011. Students partnered with Sharp HospiceCare case managers and staff during home visits and skilled nursing facility site visits. Offering a unique end-of-life care experience at LakeView and ParkView Homes, Sharp HospiceCare served as a training site for SDSU Nursing students for 32 hours per week throughout the 2011 spring semester. In addition, several Sharp HospiceCare staff provided guest lectures for programs at San Diego State University (SDSU), Kaplan College, and Southwestern College (SWC). At SDSU, Sharp HospiceCare provided a lecture on music therapy for hospice patients for the university's music department. Nursing students at SWC received a presentation on hospice with an emphasis on bioethics and advance care planning, and Kaplan College students were provided a lecture entitled An Introduction to Hospice Nursing. FY 2012 Plan Sharp HospiceCare will do the following: * Offer individual and family bereavement counseling and support groups * Provide 13 bereavement mailings * Provide volunteer training programs for at least 75 adults and teens * Offer a Memory Bear program to serve 250 families * Conduct community education and referral services * Conduct monthly outreach activities to community groups, health care facilities, colleges and universities * Provide a National Hospice Month End-of-Life Conference in November * Continue to provide professional education on hospice-related topics to community members, students and other health care professionals * Continue to provide training opportunities for nursing students and interns Identified Community Need: Collaboration With Local Schools to Promote Interest in Health Care Careers Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * The demand for registered nurses and other health care personnel in the United States will continue to rise with the growing health care needs of the 78 million baby boomers that began to retire in 2010. The DHHS estimates that by 2020, there will be a need for 2.8 million nurses, 1 million more than the projected supply. In 2008, the U.S. Department of Labor (DOL) ranked RN as the occupation with the highest demand rate. * According to the 2010 Healthcare Shortage Areas Atlas from the County of San Diego HHSA, SDC is one of 27 counties in California listed as a Registered Nurse Shortage Area. * The DOL reports that allied health professions represent about 60 percent of the American health care work force and projects severe shortages of many allied health care professionals (DOL, 2010). * According to the San Diego Workforce Partnership 2011 report titled, Healthcare Workforce Development in SDC: Recommendations for Changing Times, health care occupations that will be in highest demand in the next three to five years include physical therapists, medical assistants, occupational therapists, registered nurses, medical record and health information technicians, radiologic technologists and technicians, pharmacists and medical and clinical laboratory technologists. * According to the San Diego Workforce Partnership, despite the growing demand for health care workers, employers express an "experience gap" among recent graduates as a challenge to filling open positions. While new graduates often possess the requisite academic knowledge to be hired, they lack necessary real world experience. * The San Diego Workforce Partnership recommends programs that provide volunteer experiences to high school and post-secondary students, as on-the-job training could provide real world experience for workers. Programs that target underrepresented groups and disadvantaged students could help increase the number of culturally competent health care workers. Measurable Objective * In collaboration with local schools, offer opportunities for students to explore a vast array of health care professions. FY 2011 Report of Activities In collaboration with Grossmont Union High School District (GUHSD), SGH participated in the Health-careers Exploration Summer Institute (HESI), providing 12 students with opportunities for classroom instruction, job shadowing observations and limited hands-on experiences in hospital departments. At the conclusion of the program, students presented their experiences as case studies to family members, educators and hospital staff.
		Those completing the program received high school credits equal to two summer school sessions. In FY 2011, HESI students spent more than 1,150 hours on the SGH campus. SGH also continued its participation in the Health Sciences High and Middle College (HSHMC) program in FY 2011, providing early professional development for 173 students from a broad array of backgrounds in grades nine through 12. Students spent a total of approximately 46,000 hours with an estimated 50 health professionals in 33 different departments and nursing areas, and were in direct contact with health care professionals throughout the hospital. During each semester, students were supervised in different levels of the HSHMC program as they rotated through instructional pods in areas such as nursing, obstetrics, occupational and physical therapy, behavioral health, SICU, MICU, imaging, rehabilitation, laboratory, pharmacy, pulmonary, cardiac services and food services. In May 2011, the HSHMC program achieved its first full graduating class of students. Level I of the HSHMC program is the entry level for all students and is conducted over a 16-week period. For FY 2011, 66 ninth-graders shadow primarily in non-nursing areas of the hospital, including physical therapy, food services, laboratory, cardiac services, imaging, physician offices, pulmonary, pharmacy and radiation therapy. In FY 2011, ninth-graders spent a greater length of time within each department in order to more fully experience different clinical areas of the hospital, and in total devoted 7,128 hours to the program. Level II of the HSHMC program offers patient interaction, where students are trained in Tender Loving Care (TLC) functions and then paired with a Certified Nursing Assistant (CNA) on nursing floors. Students assisted the CNA with patient ambulation, personal hygiene, etc. In FY 2011, sixty-four 10th graders, thirty-three 11th graders and ten 12th graders participated in the Level II TLC program, experiencing college-level clinical rotations, hands-on experience, TLC function patient care and mentoring. Students were placed in a new assignment every four to six weeks for a variety of patient care experiences, and also took additional health-related coursework at San Diego Mesa College, including Anatomy, Physiology, and Human Behavior courses. New in FY 2011, 12th graders were also trained in First Touch - the patient-centered model of care provided by SGH to help ease patient anxiety and increase trust in their caregiver. In addition, SGH staff provided HSHMC students instruction on educational requirements, career ladder development and job requirements. At the end of the academic year, SGH staff provided HSHMC students, their loved ones, community leaders and hospital mentors a symposium that showcased the lessons learned throughout the program. FY 2012 Plan SGH will do the following: * In collaboration with GUHSD, participate in the HESI * Expand integration of First Touch program into 10th and 11th grades * Continue to track and report outcomes of HSHMC students and graduates * Create a long-term plan for program sustainability Identified Community Need: Women's and Prenatal Health Services and Education Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified maternal, infant and child health/family planning as the fifth-most important health outcome overall (when considering a total of seven health outcomes) in the 2010 CHNA. According to a 2006 report by the CDC, progress in the United States to improve pregnancy outcomes - including low birth weight, premature birth, and infant mortality - has slowed, in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat, and help women modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes. Between 2005 and 2008, mothers in San Diego County beginning their prenatal care during their first trimester decreased from 87.2 percent to 81.3 percent, a 5.9 percent decrease. * According to HP 2020, the risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception and interconception care. Healthy birth outcomes and early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential. * Women who deliver prematurely, experience repeated miscarriages, or develop gestational diabetes are at increased risk of complications with subsequent pregnancies, according to the CDC (2006). * According to the CDC, only 30 percent of women ages 18 years and older engage in regular leisure-time physical activity (CDC, 2008). * Nationally, 35 percent of women ages 20 and older are obese, and 30 percent of these women have hypertension (CDC, 2003 to 2006). * Data from the 2005 CHIS indicate that only 38.6 percent of SDC women ages 18 to 65 consume the recommended five or more servings of fruits and vegetables daily. * According to the 2007 CHIS, only 18.1 percent of adult women (aged 18 to 65 years) in SDC indicated that they engage in moderate physical activity. * In the County's East Region, only 13.8 percent of adult women (aged 18 to 65 years) indicated that they engage in vigorous physical activity. The rate of self-reported vigorous physical activity was lower than all SDC regions and lower than the county average of 20.1 percent (CHIS, 2007). Measurable Objectives * Conduct outreach and education activities for women on a variety of health topics as well as prenatal care and parenting skills. * Collaborate with community organizations to help raise awareness of women's health issues and services, as well as to provide low-income and underserved women in the San Diego community with critical prenatal services. * Participate in professional associations related to women's services and prenatal health and disseminate research. FY 2011 Report of Activities In FY 2011, SGH offered four wellness and prevention-related community classes that addressed women's health topics. These classes - led by physicians and topic-experts - reached a total of 352 women. The range of topics for these classes included information on heart health, prevention of osteoporosis and arthritis, managing menopause symptoms and the ever-popular cooking demonstrations that offer tips on nutrition, cooking and how to select local seasonal ingredients. SGH provided free breastfeeding support groups to the community twice per week, reaching approximately 20 to 25 participants per session. SGH also offered weekly post-partum depression support groups for women and families struggling with the challenges and adaptations of having a newborn. Also in FY 2011, SGH provided resources for and education on women's health issues and treatment services at various community events including the Speaking of Women's Health Conference and the Ladies of Hope Health Fair at St. Peter's Chaldean Catholic Cathedral. SGH participated in and partnered with a number of community organizations and advisory boards for maternal and child health in FY 2011, including the local Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) chapter, WIC, the California Teratogen Information Service (CTIS), Partnership for Smoke-Free Families, the Breast Feeding Coalition Advisory Board, Association of California Nurse Leaders (ACNL), the regional Perinatal Care Network (PCN), and the Public Health Nurse Advisory Board. In FY 2011, SGH published an article on infant security entitled "How Safe Are Our Babies? A Community Hospital's Innovative Approach to Hardwiring Infant Security" in the Journal of Perinatal and Neonatal Nursing. In addition, SGH participated in the Regional Perinatal Care Network Quality Initiative, reducing the number of elective deliveries between 37 and 39 weeks. In August 2011, SGH submitted an abstract of this work to the American Nurses Credentialing Center. In May 2011, SGH delivered a podium presentation to the Perinatal Safety Collaborative on the identification of maternal morbidities associated with induction of labor. SGH's Women's Health Center's Prenatal Clinic midwives provided in-kind help at Neighborhood Health Centers in El Cajon, Family Health Centers of San Diego (FHCSD), and Lakeside community health clinics. The SGH Prenatal Clinic participated in the California Department of Public Health (CDPH) Comprehensive Perinatal Services Program (CPSP) to offer comprehensive prenatal clinical and social services to low-income, low-literacy women with Medi-Cal benefits. Services provided included health education, nutritional
		guidance and psychological/social issue support, as well as translation services for non-English speaking women. As part of this effort, women with nutrition issues were also referred to an SGH registered dietician and the SGH Diabetes Program as needed. Free education on gestational diabetes was also provided to pregnant members of the community. In addition, the SGH Women's Health Center partnered with Vista Hill ParentCare to assist drug-addicted patients with psychological and social issues during pregnancy. These approaches have been shown to reduce both low birth weight rates and health care costs in women and infants. FY 2012 Plan * Provide wellness and prevention classes * Provide cooking and nutrition classes on eating and staying healthy * Provide free breastfeeding support groups * Provide parenting education classes * Participate in community events such as Learn and Live events for breast and colon cancer and the Sharp Speaking of Women's Health Conference * Provide medical services to low-income patients through the prenatal clinic Identified Community Need: Orthopedic / Osteoporosis Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * According to the CDC, arthritis is the nation's most common cause of disability. An estimated 50 million U.S. adults (about one in five) report doctor-diagnosed arthritis. As the U.S. population ages, these numbers are expected to increase sharply to 67 million by 2030, and more than one-third of these adults will have limited activity as a result. In addition, a recent study indicated that some form of arthritis or other rheumatic condition affects 1 in every 250 children (CDC, 2011). * According to the NIH (2006), osteoporosis is responsible for more than 1.5 million fractures each year, including 250,000 wrist fractures, 300,000 hip fractures, 700,000 vertebral fractures, and 300,000 fractures at other sites. * According to an HP 2010 Progress Review released in 2006, osteoporosis is responsible for more than $14 billion in health care costs annually. * According to data presented in the 2007 CHNA, in the U.S., the age-adjusted prevalence of doctor-diagnosed arthritis is estimated to be 21.3 percent among adults ages 18 and over. * According to HP 2020, approximately 80 percent of Americans experience low back pain (LBP) in their lifetime. Each year, it is estimated that 15 to 20 percent of the population develops protracted back pain, 2 to 8 percent have chronic back pain (pain that lasts more than 3 months), 3 to 4 percent of the population is temporarily disabled due to back pain, and 1 percent of the working-age population is disabled completely and permanently due to LBP. * In addition, research for HP 2020 reveals that Americans spend $50 billion each year for LBP, which is the third-most common reason to undergo a surgical procedure and the fifth-most frequent cause of hospitalization (2009). * In the County's East Region from 2006 to 2008, the number of arthritis-related hospitalizations increased from 1,494 to 1,600, while the rate of arthritis-related hospitalizations increased from 329 to 345 per 100,000 population. The region's 2008 arthritis-related hospitalization rate of 345 per 100,000 population was higher than the 2008 age-adjusted County average of 291 arthritis hospitalizations per 100,000 population, as well as higher than all other SDC regions. * In the County's East Region from 2006 to 2008, the number of arthritis-related ED discharges increased from 2,022 to 2,088, while the rate of arthritis-related ED discharges increased from 445 to 450 per 100,000 population. The region's 2008 arthritis-related ED discharge rate of 450 per 100,000 population was higher than the 2008 age-adjusted County average of 400 per 100,000 population. * In the County's East Region in 2008, females had a higher ED discharge rate for arthritis-related diagnosis than males (488 and 410 per 100,000 population, respectively). Blacks had a higher ED discharge rate for arthritis-related diagnosis than persons of other racial or ethnic groups, and persons ages 65 and over had higher ED discharge rates for arthritis-related diagnosis than younger persons. Measurable Objective * Provide education on orthopedics and osteoporosis to the community, with an emphasis on seniors. FY 2011 Report of Activities In FY 2011, SGH offered six educational sessions on arthritis and hip and knee problems to more than 350 community members. Topics included management of arthritis and hip/knee repair and treatment. Sessions were held at the Grossmont Healthcare District Conference Center. Attendance ranged from 28 to 80 individuals at each event. SGH offered specialized education on osteoporosis prevention and treatment to the community. As part of its Women's Healthy Hour series of talks on women's health issues, SGH offered a free community seminar in May entitled, Better Bone Health: Reduce Your Risk of Osteoporosis and Arthritis. The session was attended by 60 community members. The talk provided education on the risks of osteoporosis, treatment options and tips for maintaining good bone health. A Sharp-affiliated physician provided education on the pathology of osteoporosis and its impact on daily activities, as well as how exercise, nutrition, and proper posture and body mechanics contribute to reduced risk of the bone disease. FY 2012 Plan * Continue to offer orthopedic, arthritis and osteoporosis educational presentations to the community SGH Program and Service Highlights * 24-hour emergency services with heliport and paramedic base station - designated STEMI Center * Acute care * Ambulatory care services, including infusion therapy * Behavioral Health Unit * Breast Health Center, including mammography * Cardiac services, recognized by the American Heart Association - GWTG * Cardiac Training Center * CT scan * David and Donna Long Center for Cancer Treatment * EEG and EKG * Endoscopy unit * Grossmont Plaza Outpatient Surgery Center * Group and art therapies * Home health * Home infusion therapy * Hospice * Hyperbaric treatment * ICU * LakeView Home * NICU * Orthopedics * Outpatient diabetes services, recognized by the American Diabetes Association * Outpatient Imaging Centers * Laboratory services (inpatient and outpatient) * ParkView Home * Pathology services * Pediatric services * Pulmonary services * Radiology services * Rehabilitation Center * Robotic surgery * Senior Resource Center * Sleep Disorders Center * Spiritual care services * Stroke Center * Surgical services * Transitional Care Unit * Van services * Vascular services * Women's Health Center * Wound Care Center Appendix A - Sharp HealthCare Involvement in Community Organizations The list below shows the involvement Sharp executive leadership and other staff in community organizations and coalitions in Fiscal Year 2011. Community organizations are listed alphabetically. * 211 San Diego Board * Academy of Medical-Surgical Nurses * ACS * AF * AIS * ALA * Alzheimer's Association * American Association of Critical Care Nurses San Diego Chapter * American College of Healthcare Executives * American Diabetes Association * American Health Information Management Association * American Heart Association * American Hospital Association * American Psychiatric Nurses Association * American Red Cross of San Diego * Arthritis Foundation * Association for Ambulatory Behavioral Health Care (National) * Association for Ambulatory Behavioral Health Care of Southern California * Association for Clinical Pastoral Education * Association of California Nurse Leaders * Association of Rehabilitation Nurses * AWHONN * BLCI * Boys and Girls Club of San Diego * Breast Feeding Coalition Advisory Board * Breast Health Coordinators * California Association of Health Plans * California Association of Medical Staff Services * California Association of Physician Groups * California Council for Excellence * California Dietetic Association, Member Council * California HealthCare Foundation * California Health Information Association * California Hospice and Palliative Care Association * CHA * California Perinatal Quality Care Collaborative * California Physical Therapy Association * California Society of Health System Pharmacists * California State Bar, Health Subcommittee * California Teratogen Information Service * California Women Lead * CHIP Access to Care Committee
		* CHIP Access to Care Committee Health Literacy * CHIP Access to Care Gift of Health * CHIP Behavioral Health Work Team * CHIP Board * CHIP Executive Partners Committee * CHIP Health Literacy Task Force * CHIP Needs Assessment Committee * CHIP Public Policy Committee * CHIP Steering Committee * Chula Vista Chamber of Commerce * Chula Vista Community Collaborative * City of Chula Vista Wellness Program * City of Poway - Housing Commission * College Area Pregnancy Services * Community Emergency Response Team * Consortium for Nursing Excellence, San Diego * Coronado Chapter of Rotary International * Coronado Christmas Parade * Coronado Flower Show * Creative Arts Consortium * CWISH * Cycle Eastlake * Diabetes Behavioral Institute * Disabled Services Advisory Board * DOVIA * East County Chamber Health Committee * East County Pregnancy Care Center * East County Refugee Center * East County Senior Service Providers * ECOLIFE Foundation * El Cajon Rotary * Emergency Nurses Association, San Diego Chapter * Employee Assistance Program Association * Family Health Centers of San Diego * First Five Commission * Gay Men's Spiritual Retreat Board * Grossmont College * Grossmont Healthcare District * Grossmont Union High School District * Health Care Communicators Board * Healthcare Financial Management Association San Diego/Imperial Chapter * Hospital Association of San Diego and Imperial Counties * HSHMC Board * Huntington's Disease Society of America * Immunize San Diego Coalition * Institute of Internal Auditors San Diego Chapter Board * International Lactation Consultants Association * Kiwanis Club of Bonita * Komen Board * Komen Breast Cancer Coalition Committee * Komen Race for the Cure Committee * La Mesa Lion's Club * La Mesa Park and Recreation Finance Committee * La Mesa Park and Recreation Foundation Board * Las Hermanas * LEAD, San Diego, Inc. * Leukemia & Lymphoma Society * March of Dimes * Meals-on-Wheels East County * Medical Library Group of Southern California and Arizona * Mended Hearts * Mental Health America Board * Mental Health Coalition * Mesa College * Miracle Babies * Mountain Health and Community Services, Inc. Board * NAMI * NAMI Schizophrenics in Transition Board of Directors * NANN * National Association of Hispanic Nurses, San Diego Chapter * National Association of Psychiatric Healthcare Systems * National Foundation for Trauma Care * National Hospice and Palliative Care Association * National Kidney Foundation * National Ovarian Cancer Coalition * National Perinatal Information Center * National Trauma Foundation Board * Neighborhood Healthcare Community Clinic - Board of Directors * NurseWeek * Parents for Addiction, Treatment, and Healing * Partnership for Philanthropic Planning of San Diego (formerly San Diego Planned Giving Roundtable) * Partnership for Smoke-Free Families * Peninsula Shepherd Senior Center * Perinatal Social Work Cluster * Planetree Board of Directors * Planned Parenthood of San Diego and Imperial Counties * Potiker Family Senior Residence * Port of San Diego Marketing Committee * Premier, Inc. HIT Collaborative * Premier, Inc. Medication Use Committee * Professional Oncology Network * Project CARE Council * Public Health Nurse Advisory Board * Recovery Innovations of California * Regional Home Care Council * Regional Perinatal System * Residential Care Council * SAFE Foundation * Safety Net Connect * SanDi-Can * San Diegans for Healthcare Coverage * San Diego Healthcare Disaster Council * San Diego Asian Film Festival Foundation * San Diego Association for Diabetes Educators * San Diego Association of Directors of Volunteer Services * San Diego Association for Healthcare Recruitment * San Diego Blood Bank * San Diego Brain Injury Foundation * San Diego Breastfeeding Coalition * San Diego Caregiver Coalition * San Diego Center for Patient Safety Task Force * San Diego Chapter of Rotary International * San Diego City Parks and Recreation * San Diego Committee on Employment of People with Disabilities * San Diego Council of Hospital Volunteers * San Diego County Perinatal Care Network * San Diego County Pharmacists Association * San Diego County Safety Net Workgroup * San Diego County Social Services Advisory Board * San Diego County Taxpayer Association * San Diego Delta Leadership Academy * San Diego Diabetes Coalition * San Diego Dietetic Association Board * San Diego East County Chamber of Commerce Board * San Diego Emergency Medical Care Committee * San Diego Eye Bank * San Diego Foundation * San Diego Health Information Association * San Diego Healthcare Disaster Council * San Diego Immigrants' Rights Consortium * San Diego Interreligious Committee * San Diego Mental Health Coalition * San Diego North Chamber of Commerce * San Diego Nutrition Council * San Diego Organization of Healthcare Leaders, a local ACHE Chapter * San Diego Patient Safety Consortium * San Diego Regional Energy Office * San Diego Regional Homecare Council * San Diego Restorative Justice Mediation Program * San Diego Society for Human Resource Management * San Diego Society of Hospital Pharmacists, California Society of Health System Pharmacists Chapter * San Diego Urban League * San Diego-Imperial Council of Hospital Volunteers * San Diego Regional Chamber of Commerce * Santee Chamber of Commerce * Santee-Lakeside Rotary * Schizophrenics in Transition * Scoliosis Research Society * SDCOI * SDSU * SDSU Nursing Evidence-Based Practice Institute * Senior Community Centers of San Diego * Serra Foundation * Sidney Kimmel Cancer Center * Sigma Theta Tau International Honor Society of Nursing * Society of Trauma Nurses * South Bay Community Services * South Bay Community Services, Baby First Program * South County Economic Development Council * South County Education Board and Policy Committee * Southern California Association of Neonatal Nurses * Southern California Society of Gastroenterology Nurses and Associates * Southwestern College * Susan G. Komen Breast Cancer Foundation * Sustainable San Diego * SYHS * The Meeting Place Clubhouse * The Polinsky Center * Trauma Intervention Programs of San Diego County, Inc. * Trauma Managers Association of California * Union of Pan Asian Communities * United Behavioral Health Medical Credentials Committee * United Way of San Diego County * UCSD * VA San Diego Healthcare System * Vista Hill ParentCare * Wellpoint/US Behavioral Health Clinical Advisory Board * WIC * YMCA * YWCA Becky's House * YWCA Board of Directors * YWCA Executive Committee * YWCA In the Company of Women Luncheon * YWCA TWIN Event

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:

1	Briefly describe the organization’s mission or most significant activities: Grossmont Hospital provides inpatient and outpatient medical services to the community.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	10
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	3,281
6	Total number of volunteers (estimate if necessary) ....	6	950
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	745,542
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	294,758

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	12,469,119	8,212,893
9	Program service revenue (Part VIII, line 2g) .........	492,267,761	536,862,808
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,076,034	7,690,658
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	963,940	1,934,973
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	508,776,854	554,701,332
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	196,412	830,992
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)	248,174,477	261,462,650
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 943,326
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	244,014,951	260,340,057
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	492,385,840	522,633,699
19	Revenue less expenses. Subtract line 18 from line 12......	16,391,014	32,067,633
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	417,950,079	435,736,190
21	Total liabilities (Part X, line 26)............	116,822,154	108,539,676
22	Net assets or fund balances. Subtract line 21 from line 20 .....	301,127,925	327,196,514

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 484,215,763 including grants of $ 830,992 ) (Revenue $ 536,862,808 )
	Grossmont Hospital provides inpatient and outpatient services to the community. Patient days were 119,234 and outpatient visits were 238,256 for the twelve months ended 9/30/11.See Community Benefits Report on Schedule O.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 484,215,763

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,336,203	4,487,679	469,815

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		2,786,498
e	Government grants (contributions)1e		5,426,395

f	All other contributions, gifts, grants, and similar amounts not included above1f
g	Noncash contributions included in lines 1a-1f:$ 5,027,623
h	Total. Add lines 1a-1f.......			8,212,893
			Business Code
2a	Medicare/Medicaid		900,099	297,862,878	297,862,878
b	Patient Services		900,099	232,928,086	232,928,086
c	Medical Office Lease		531,120	3,574,685	3,574,685
d	Reference Lab		621,500	745,542		745,542
e	Grossmont Imaging LLC		621,400	510,389	510,389
f	All other program service revenue .			1,241,228	1,241,228
g	Total. Add lines 2a–2f........			536,862,808
3	Investment income (including dividends, interest
	and other similar amounts).....			2,215,397			2,215,397
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	44,645,384	128,787
b	Less: cost or other basis and sales expenses	39,249,007	49,903
c	Gain or (loss)	5,396,377	78,884
d	Net gain or (loss)..........			5,475,261			5,475,261
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..
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...
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..
Miscellaneous Revenue			Business Code
11a	Parking		812,930	1,024,174			1,024,174
b	Auxiliary		453,220	758,316			758,316
c	Cash Discounts		900,099	82,767			82,767
d	All other revenue ....			69,716			69,716
e	Total. Add lines 11a–11d ......			1,934,973
12	Total revenue. See Instructions....			554,701,332	536,117,266	745,542	9,625,631


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			1,728,567	1	2,012,191
2	Savings and temporary cash investments .......			31,251,749	2	37,029,263
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			43,318,011	4	46,501,940
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 .............			410,280	7	270,729
8	Inventories for sale or use ..............			9,056,292	8	9,387,834
9	Prepaid expenses and deferred charges ............			2,640,104	9	2,074,650
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	430,081,286
b	Less: accumulated depreciation. .....	10b	226,313,397	205,226,376	10c	203,767,889
11	Investments—publicly traded securities ..........			104,942,276	11	120,316,315
12	Investments—other securities. See Part IV, line 11 ......			802,256	12	1,117,412
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			18,574,168	15	13,257,967
16	Total assets. Add lines 1 through 15 (must equal line 34)...			417,950,079	16	435,736,190
17	Accounts payable and accrued expenses .			35,897,077	17	37,137,197
18	Grants payable ..........				18
19	Deferred revenue ..........			7,459,302	19	7,624,812
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			15,500,000	23	15,500,000
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			57,965,775	25	48,277,667
26	Total liabilities. Add lines 17 through 25.....			116,822,154	26	108,539,676
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			290,817,398	27	316,920,820
28	Temporarily restricted net assets .....			8,339,996	28	9,203,292
29	Permanently restricted net assets .....			1,970,531	29	1,072,402
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			301,127,925	33	327,196,514
34	Total liabilities and net assets/fund balances .....			417,950,079	34	435,736,190

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

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.

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).

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.)

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.).

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	10,335	10,335	0 %
2	Economic development
3	Community support	27,385	27,385	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	37,720	37,720	0.010 %

(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 %
11 Grossmont Imaging LLC	Joint Venture-Diagnostic Imaging	50.000 %	0 %	50.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	Grossmont Hospital Corporation 5555 Grossmont Center Drive La Mesa,CA91942	X	X	X

				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: %

				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)

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.

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?9
Name and address		Type of Facility (Describe)
1	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
2	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
3	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
4	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
5	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
6	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
7	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
8	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
9	Sharp Hospice Care 8881 Fletcher Parkway Suite 336 LL La Mesa,CA91942	Hospice
10

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 6a: Grossmont Hospital Corporation's community benefit report is prepared by Sharp HealthCare.
		Part I, Line 7: Historical charity care percentages are applied to current revenues to estimate charity on a monthly basis. Actual charity transactions are applied against the estimate and any increase or decrease over estimated amounts is accounted for. Other Cost includes State/County programs included in the S-10 for Medicare Cost Reporting primarily for prison/in custody patient care. Ratio of Cost to Charges (RCC) were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger with no exclusions, representing direct revenue and expense plus stepdown from Overhead departments. The RCC by CMS line was then applied to the applicable revenue departments broken down by payer to obtain the fully weighted cost by payer.
		Part I, L7 Col(f): Bad debt expense is a deduction from revenue and is separately identified in the audited statement of operations. As such, $0.00 was backed out of total expenses for column (f) calculation.
		Part II: Grossmont Hospital Corporation at times provides a provision for housing for vulnerable patients upon discharge from the hospital.Grossmont Hospital Corporation incurred expenses for disaster preparedness training and capital expenditures.
		Part III, Line 4: Bad Debt represents amounts that go unpaid where the patient was determined to have the ability to pay. If an inability to pay is demonstrated, then full or partial Charity is granted and not considered Bad Debt. Bad Debt at Cost should be included as a Community Benefit because, like other shortfall programs, Grossmont Hospital Corporation is required to accept these patients through the Emergency Room or as a referral with "good faith" in collecting.Grossmont Hospital Corporation consolidates into Sharp HealthCare's audited financial statements. The audited financial statements of Sharp HealthCare include a footnote discussing accounts receivable and allowance for doubtful accounts which is included below. * Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, Sharp analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, Sharp analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For services associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), Sharp records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.Sharp HealthCare's audited financial statements include a deduction from revenue line on the Combined Statement of Operations titled Provision for Doubtful Accounts. Additionally, the accounts receivable line on the Combined Balance Sheet details the amount of allowance for doubtful accounts that is netted against the receivable balance.
		Part III, Line 8: Medicare shortfall should be included as a community benefit because participation in the Medicare program requires all patients be accepted whether through the Emergency Room or as a referral and Grossmont Hospital Corporation must accept the Medicare established rates whether they cover the cost or not. Ratio of Cost to Charges (RCC) were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger with no exclusions, representing direct revenue and expense plus stepdown from Overhead departments. The RCC by CMS line was then applied to the applicable revenue departments broken down by payer to obtain the fully weighted cost by payer.
		Part III, Line 9b: It is Sharp's policy to recall/cancel accounts assigned to a collection agency if it is determined, at any time, a patient is eligible for Financial Assistance or Charity care.
		Part VI, Line 2: Since 1995, Sharp has participated in a countywide collaborative - including a broad range of hospitals and health care organizations - to conduct a triennial community needs assessment. Findings from the community health needs assessments conducted by the Community Health Improvement Partners (CHIP) and the expertise in programs and services of each Sharp hospital form the basis for community benefits planning at Sharp.In 2010, the CHIP Needs Assessment Advisory Council, under the direction of the CHIP Steering Committee, determined a methodology and approach to the sixth edition of the triennial community health needs assessment (CHNA), which included a community priority-setting process composed of the following steps:* Review of the 38 Healthy People 2020 focus areas by the Needs Assessment Advisory Council, comprised of more than 30 community stakeholders. Seventeen health issues emerged as a result of the combining and streamlining of these areas by the Council.* Division of the 17 health issues into the following three categories: Overarching Issues, Health-Related Behaviors and Health Outcomes. Health issue briefs were developed to provide detailed information on each of the 17 identified health issues.* Invitation to community leaders throughout San Diego County (72 out of 379 invitees participated) to prioritize each health issue with information from the health issue briefs and based on the following criteria:o Size of the health issueso Seriousness of the health issueo Community resources available to address the health issueo Availability of data/information to evaluate the health issue's outcomeso Each of the health issues were scored separately within the three categories noted above (Overarching Issues, Health-Related Behaviors and Health Outcomes)* Utilization of the Spectrum of Prevention Framework to determine which issues prioritized by the community were most impacted by prevention activities (as opposed to treatment):o Health access and deliveryo Social determinants of healtho A combination of nutrition, weight status, physical activity and fitnesso Injury and violenceo Mental health and mental disorders* Discussion of the above identified issues in community forums held in the six regions of San Diego County in order to:o Allow community stakeholders to identify root causes related to each health issueo Begin the process of understanding each issue from a regional perspectiveo Foster community relationships and promote the voice(s) of San Diego's various regional and sub-regional communities in the needs assessment process* In-depth analysis of each of the five health issues selected for the 2010 CHNA, identified as:o Health access and deliveryo Social determinants of healtho Combination of nutrition, weight status, physical activity and fitnesso Injury and violenceo Mental health and mental disordersDepending on the level of available data, these analyses included an overview of the health issue and its importance; seriousness of the health issue in terms of economic costs, use of resources and/or loss of functional status; incidence data; prevalence of morbidity and mortality in the populations most impacted by the health issue; and the local impact of the health issue. In addition to a review of the results from the priority-setting process, the 2010 CHNA utilized information from the following:* Analysis of health-related statistics gathered and analyzed by the County of San Diego Health and Human Services Agency (HHSA), supplemented by data from the California Health Interview Survey (CHIS), California Office of Statewide Planning and Development (OSHPD), the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System and census data from the San Diego Association of Governments (SANDAG).* Review of health-related scientific literatureReview of the results from facilitated discussions of six community regional forums held with a cross-section of stakeholders from the San Diego County communityIn order to determine the priority needs of the community, the 2010 Community Health Needs Assessment conducted by CHIP was reviewed by each Sharp hospital and used to determine priority needs for their communities. In identifying these priorities, each entity considered the expertise and mission of the hospital in providing services, in addition to the unique regional, age group and/or health topics.Specifically, Sharp Grossmont Hospital reviewed the needs assessment priorities, specifically focusing on issues relevant to their region and subregional areas with the goal of matching community benefits programs and services to the unique needs of the region with special attention to:* Stroke education and screening* Heart and vascular disease education and screening* Cancer education and participation in clinical trials* Diabetes education and testing* Outreach for flu vaccinations* Health education and screening for seniors* Prevention of unintentional injuries* Special support services for hospice patients and their loved ones, and the community* Collaboration with local schools to promote interest in health care careers* Women's and prenatal health services and education* Orthopedic / osteoporosis education and screeningIn addition, Sharp Grossmont Hospital:* Incorporates community priorities and community input into its strategic plan and develops service line specific goals* Estimates an annual budget for community programs and services based on community needs, the prior year's experience and current funding levels* Prepares and distributes a monthly report of community activities to its board of directors, describing community benefits provided, such as education, screenings and flu shots * Prepares and distributes information on community benefits programs and services through its foundation and community newsletters* Consults with representatives from a variety of departments, to discuss, plan and implement community activities
		Part VI, Line 3: Sharp HealthCare's financial assistance policy is in furtherance of its charitable mission. The policy identifies eligibility for, and circumstances under which, financial assistance will be extended to Sharp HealthCare's hospital patients for medically necessary services. Information regarding the availability of charity care and financial assistance is posted at all emergent/urgent access points of the hospital. "Charity Care" is that portion of Sharp HealthCare's charges for medically necessary patient care services provided by a hospital that a patient (either individually or through a third party payer) is unable to pay. Charity Care does not include bad debt, contractual adjustments, or un-reimbursed costs of providing care to patients eligible under government programs for health care services to low-income and medically indigent patients. "Financial Assistance" means any reduction of charges for medically necessary services as defined herein that may be made by Sharp HealthCare either for, or on behalf of, a patient who applies to Sharp HealthCare for Financial Assistance and meets Sharp HealthCare's financial eligibility requirements or criteria as described in this policy. For purposes of the policy Financial Assistance includes "charity care" which means a 100% reduction in charges for medically necessary services and "partial charity care" which means a reduction in a portion of charges for such services.All patients are screened at the time of admission or at registration for ability to pay for services, including whether or not they are candidates for Financial Assistance. Care for patients presenting with a known or possible emergency medical condition or in active labor are not delayed in order to assess financial status. For those patients arriving via the emergency room, once stabilization has occurred, an unfunded patient is provided with information regarding public funding options and information on Sharp HealthCare's financial assistance policy. Every unfunded urgent/emergent patient is provided with information on qualifications, in addition to an application for financial assistance/charity care.All self-pay patients are informed again regarding the availability of financial assistance on each patient statement. The availability of financial assistance and the application to apply are readily accessible on the Sharp.com website.In order to both inform patients of the various programs they may be entitled to, and assist them in the application process, Uncompensated Care Specialists provide patient(s) with a Financial Assistance Form. The Uncompensated Care Specialists direct the patient (or their guarantor) to complete a Patient Financial Statement, include specified financial items for both the patient and spouse (if any), direct the patient to return all information within ten days and document in patient's account history notes the substance of any patient discussions and that the Patient Financial Statement was provided.Following internal processing of the Financial Assistance Form, Sharp Uncompensated Care Specialists and/or Private Pay Representatives notify patient of Financial Assistance Application results, document the decision in all approved and denied Financial Assistance Accounts and secure payment arrangements for remaining balance of partial Financial Assistance or denied Financial Assistance accounts. All follow-up and patient interaction is documented in the patient's account history notes.
		Part VI, Line 4: The community served by Sharp Grossmont Hospital includes the entire East Region of San Diego County, including the sub-regional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley and Mountain Empire. Approximately five percent of the population lives in remote or rural areas of this region. The race/ethnicity breakdown of the community served by Grossmont Hospital is: 50.2% White; 28.4% Hispanic; 7.9% Black; 8.7% Asian/Pacific Islander; and 0.6% Native American. In the County's East Region in 2009, 96 percent of children ages 0 to 11, 96.2 percent of children ages 12 to 17 and 86.6 percent of adults ages 18 and older had health insurance, while 97.7 percent of children ages 0 to 11 and 93.7 percent of children ages 12 to 17 had a regular source of medical care - failing to meet the Healthy People (HP) 2020 national targets for health insurance coverage and regular source of medical care. Among uninsured adults ages 18 to 64 years in SDC's East Region, 15.7 percent were not currently insured in 2009.
		Part VI, Line 6: Grossmont Hospital Corporation has an open medical staff and a community board. Surplus funds generated by hospital operations are re-invested by the organization to fund capital improvements and acquire state of the art medical equipment with the intent of continually improving patient care.
		Part VI, Line 7: Sharp HealthCare is an integrated, regional health care delivery system based in San Diego, Calif. The Sharp system includes four acute care hospitals, three specialty hospitals, two affiliated medical groups, 22 medical clinics, five urgent care facilities, four skilled nursing facilities, two inpatient rehabilitation programs, home health, hospice and home infusion programs, numerous outpatient facilities and programs, and a variety of other community health education programs and related services. Sharp also has a Knox-Keene-licensed health maintenance organization, Sharp Health Plan. Serving a population of approximately three million in San Diego County, Sharp is licensed to operate 2,092 beds, has approximately 2,600 Sharp-affiliated physicians and more than 15,000 employees.It is Sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patient expectations and are provided in a caring, convenient, cost-effective and accessible manner. Sharp will be recognized by employees, physicians, patients, volunteers and the community as the best place to work, the best place to practice medicine and the best place to receive care. Sharp is known as an excellent community citizen embodying an organization of people working together to do the right thing every day to improve the health and well being of those it serves. Sharp Grossmont Hospital is the largest provider of health care services in San Diego's East County, and operates one of the busiest emergency rooms in San Diego County. Sharp Grossmont Hospital received Magnet Designation for Nursing Excellence by the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program is the highest level of honor awarded by the ANCC and is accepted nationally as the gold standard in nursing excellence.
Reports Filed With States	Part VI, Line 7	CA
		Sharp HealthCare prepares an annual Community Benefits Report in accordance with the requirements of California Senate Bill (SB) 697, community benefits legislation. According to SB 697, hospitals under the common control of a single corporation or another entity may file a consolidated report with the Calif. Office of Statewide Health Planning and Development (OSHPD). Sharp HealthCare submits an annual Community Benefits Report to the Calif. OSHPD.The Sharp HealthCare Community Benefits Plan and Report, Fiscal Year 2011 is available online at www.sharp.com/community .No figure is reported on Part III, line 3 (estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's charity care policy) due to all amounts attributable to patients eligible under the charity care policy being reported as charity.The organization incurred additional Medicare shortfall that is not allowed to be reported on Parts I and III, due to the definition of Medicare shortfall as prescribed by the IRS. This additional shortfall arises from the use of the Medicare cost report data which excludes fee based services, non-billable services, and disallowed operating expenses which the organization has determined to be revenues and expenses of the Medicare program and should be included in the total shortfall. A reconciliation of what the organization classifies as Medicare shortfall is as follows:Medicare revenue received reported on Parts I and III - $141,052,705Medicare allowable costs reported on Parts I and III - $168,865,710Shortfall included on Parts I and III - $(27,813,005)Actual Medicare revenue received - $141,253,978Actual Medicare cost - $185,302,235Actual Medicare shortfall - $(44,048,257)Additional Medicare shortfall not on Parts I and III - $(16,235,252)

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Boys & Girls Clubs of East County8820 Tamberly Way Santee,CA92071	95-2088013	501(c)(3)	10,200	Sponsorship - East County Children's Ball, Golf Day
(2) San Diego East County Chamber of Commerce201 S Magnolia Ave El Cajon,CA92020	95-1494069	501(c)(6)	10,000	Sponsorship - Women in Leadership Luncheon
(3) California Health Foundation & Trust1215 K Street Suite 800 Sacramento,CA95814	94-1498697	501(c)(3)	660,316	Medi-Cal Program

(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
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) Peter Hanson MD	(i) (ii)	27,000 0	0 0	0 0	0 0	0 0	27,000 0	0 0
(2) Marc Kobernick MD	(i) (ii)	30,000 0	0 0	0 0	0 0	0 0	30,000 0	0 0
(3) Michael Murphy	(i) (ii)	0 950,995	0 188,310	0 51,005	0 69,124	0 14,486	0 1,273,920	0 0
(4) Michele Tarbet	(i) (ii)	0 454,069	0 95,652	0 16,500	0 23,934	0 14,486	0 604,641	0 0
(5) Ann Pumpian	(i) (ii)	0 534,881	0 109,477	0 16,500	0 25,427	0 10,560	0 696,845	0 0
(6) Carlisle C Lewis III	(i) (ii)	0 464,958	0 98,606	0 16,500	0 31,533	0 13,919	0 625,516	0 0
(7) Kari Cornicelli	(i) (ii)	0 189,017	0 36,786	0 609	0 12,511	0 14,942	0 253,865	0 0
(8) Maryann Cone	(i) (ii)	0 242,782	0 48,210	0 21,423	0 23,708	0 11,385	0 347,508	0 0
(9) Suzanne K Johnson	(i) (ii)	0 174,307	0 30,183	0 9,901	0 252	0 14,836	0 229,479	0 0
(10) Janet L Hanley	(i) (ii)	0 171,601	0 27,156	0 537	0 10,311	0 14,830	0 224,435	0 0
(11) Patrick J Craychee	(i) (ii)	166,266 0	23,428 0	5,924 0	7,806 0	14,707 0	218,131 0	0 0
(12) Anthony Damico	(i) (ii)	0 177,857	0 89	0 17,105	0 8,865	0 6,514	0 210,430	0 0
(13) Vincent J Balesteri	(i) (ii)	256,294 0	5,916 0	7,002 0	26,257 0	6,132 0	301,601 0	0 0
(14) Lori Hernandez	(i) (ii)	220,430 0	7,393 0	6,121 0	9,367 0	10,142 0	253,453 0	0 0
(15) Bruce D Schmidt	(i) (ii)	181,532 0	17,374 0	4,788 0	18,169 0	14,772 0	236,635 0	0 0
(16) Barbara Hazer	(i) (ii)	186,349 0	416 0	6,317 0	16,712 0	6,120 0	215,914 0	0 0
(17) Cornelia Del Rosario	(i) (ii)	183,075 0	316 0	262 0	9,236 0	5,874 0	198,763 0	0 0
(18) Kathleen Lencioni	(i) (ii)	0 275,245	0 50,918	0 16,500	0 1,898	0 1,000	0 345,561	0 0

Identifier	Return Reference	Explanation
	Part I, Line 1a	Non-management staff were paid superior performance bonuses which were grossed up so the net payment would be a specified amount based on each staff member's productive hours worked during the year. The net payments per staff member ranged from $100 to $300.
	Part I, Line 4b	Sharp HealthCare ("Company") sponsors an Executive Flexible Benefit Plan ("Plan") to provide designated executives with a reasonable level of benefits in return for their continued employment with the Company. The Plan is administered on a Plan Year basis of January 1 to December 31. Changes in Flexible Benefit Options are permitted annually, effective January 1 of the new Plan Year. The provisions of the Plan, which were restated effective as of December 31, 2008, are described below as restated. The Plan is available to the Chief Executive Officer, Executive Vice President of Hospital Operations, and Senior Vice Presidents. The Flexible Benefit Allowance available to each participant each plan year shall equal the sum of the following: - A company provided base allowance equal to 18% of the participant's base salary - A participant deferral up to 6% of the participant's pre-tax base salary for such plan year as elected by the participant - A company match should the participant make an elective deferral for a plan year. The company match begins at 2% for the first 1% elective deferral and increases 0.5% for each additional 1% elective deferral, to a maximum match of 4.5% on a 6% elective deferral. The Plan allows participants to use the Flexible Benefit Allowance to purchase additional long-term disability coverage, long-term care coverage, and flexible survivor coverage/accumulation benefits (life insurance). Participants in the flexible survivor coverage/accumulation benefits plan previously could elect to apply Flexible Benefit Allowance to acquire additional survivor coverage, or toward deposits to the Supplemental Survivor Accumulation Benefit Plan ("SSAB") to fund post-retirement survivor benefits, subject to the ERISA limit provided their policies were issued prior to September 18, 2003. The Company shall automatically continue whatever elective coverage and additional deposit elections that were in place for the SSAB during the 2008 plan year. No elective coverage or additional deposits were available to participants whose policies were issued on or after September 18, 2003. Any Flexible Benefit Allowance that remains after purchasing these additional coverages shall be paid to the participant in cash in equal installments throughout the Plan Year, not less frequently than quarterly. If the participant separates from service during the Plan Year, the participant forfeits any unpaid Allowance.
Supplemental Information	Part III	Compensation was paid to Dr. Peter Hanson through Peter B Hanson MD Inc., for medical director services, by Grossmont Hospital Corporation. He was compensated directly by Peter B Hanson MD Inc.
Supplemental Information	Part III	Compensation was paid to Dr. Marc Kobernick through his professional corporation, for medical director and chief of staff services, by Grossmont Hospital Corporation. He was compensated directly by the professional corporation.
Supplemental Information	Part III	Part I, Line 3: The Compensation Committee of Sharp HealthCare, the parent organization, establishes the compensation of the Chief Executive Officer. The Compensation Committee engages independent compensation consultants and the amount is approved by both the Compensation Committee and Board of Directors.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

(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?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

(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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Cynthia Szold	See Part V	116,517	Employment		No
(2) Stephen Hanley	See Part V	36,458	Employment		No
(3) Katelyn Cone	See Part V	22,317	Employment		No
(4) Grossmont Imaging LLC	See Part V	510,389	See Part V		No

	(a) Check if applicable	(b) Number of Contributions or items contributed	(c) Contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( ED/CCU Building )	X	8	92,404	Cost
26 Other ( Heart and Vascular Center )	X	12	2,306,619	Cost
27 Other ( Central Power Plant )	X	12	585,947	Cost
28 Other ( East Tower )	X	12	2,031,971	Cost
Other ( Equipment, Supplies )	X	6	10,682	Cost

(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
(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	Yes	No
(1) Sharp HealthCare (SHC) 8695 Spectrum Center Blvd San Diego,CA921231489 95-6077327	Healthcare Organization	CA	501 (c)(3)	3	SharpCare		No
(2) Sharp Memorial Hospital (SMH) 8695 Spectrum Center Blvd San Diego,CA921231489 95-3782169	Hospital	CA	501 (c)(3)	3	Sharp HealthCare	Yes
(3) Sharp Chula Vista Medical Center (SCVMC) 8695 Spectrum Center Blvd San Diego,CA921231489 95-2367304	Hospital	CA	501 (c)(3)	3	Sharp HealthCare	Yes
(4) Sharp HealthCare Foundation (SHF) 8695 Spectrum Center Blvd San Diego,CA921231489 95-3492461	Healthcare Foundation	CA	501 (c)(3)	7	Sharp HealthCare	Yes
(5) Grossmont Hospital Foundation 8695 Spectrum Center Blvd San Diego,CA921231489 33-0124488	Hospital Foundation	CA	501 (c)(3)	7	N/A	Yes
(6) Sharp Health Plan (SHP) 8695 Spectrum Center Blvd San Diego,CA921231489 33-0519730	Health Plan	CA	501 (c)(4)	N/A	Sharp HealthCare	Yes
(7) Sharp Coronado Hospital and Healthcare Center 8695 Spectrum Center Blvd San Diego,CA921231489 95-0651579	Hospital	CA	501 (c)(3)	3	Sharp HealthCare	Yes
(8) Sharp Care 8695 Spectrum Center Blvd San Diego,CA921231489 61-1637133	Healthcare Organization	CA	501 (c)(3) (pending)	3	N/A		No

(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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Grossmont Imaging LLC 7777 Alvarado Road Suite 108 La Mesa,CA91941 20-2655131	Diagnostic Imaging	CA	N/A	Related	364,138	1,649,631		No		Yes		50.000 %