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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
SCRIPPS HEALTH
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4275 CAMPUS POINT COURT
 
Room/suite
City or town, state or country, and ZIP + 4
SAN DIEGO, CA92121
D Employer identification number

95-1684089
E Telephone number

G Gross receipts $ 2,972,936,548
F Name and address of principal officer:
CHRISTOPHER VAN GORDER
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SCRIPPSHEALTH.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1924
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. (CONTINUED IN SCHEDULE O)
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
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 14,503
6 Total number of volunteers (estimate if necessary) .... 6 2,017
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,570,062
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 116,296
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 32,675,457 29,783,755
9 Program service revenue (Part VIII, line 2g) ......... 2,168,904,416 2,330,470,088
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 43,151,540 52,825,764
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 21,717,638 23,264,824
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,266,449,051 2,436,344,431
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 248,745 1,807,000
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) 1,007,336,617 1,055,666,424
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet9,260,455    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,069,409,188 1,100,823,614
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,076,994,550 2,158,297,038
19 Revenue less expenses. Subtract line 18 from line 12...... 189,454,501 278,047,393
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 2,593,861,709 2,852,085,000
21 Total liabilities (Part X, line 26)............ 1,028,635,427 1,067,338,141
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 1,565,226,282 1,784,746,859
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. (CONTINUED IN SCHEDULE O)
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,946,297,403 including grants of $ 1,807,000 ) (Revenue $ 2,351,857,161 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 1,946,297,403
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
1,333
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
14,503
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
No
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
RICHARD ROTHBERGER
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
(858) 678-6828
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) MARY JO ANDERSON CHS
TRUSTEE
 5.0 X           0 0 0
(2) RICHARD BIGELOW
TRUSTEE
 5.0 X           0 0 0
(3) DOUGLAS A BINGHAM ESQ
TRUSTEE
 5.0 X           0 0 0
(4) JEFF BOWMAN
TRUSTEE (PART-YEAR)
 5.0 X           0 0 0
(5) JUDY CHURCHILL PHD
TRUSTEE
 5.0 X           0 0 0
(6) GORDON R CLARK
TRUSTEE
 5.0 X           0 0 0
(7) MARTIN C DICKINSON
TRUSTEE
 5.0 X           0 0 0
(8) VIRGINIA GILLIS RSM EDD
TRUSTEE
 5.0 X           0 0 0
(9) RICHARD L HALL MD
TRUSTEE (PART-YEAR)
 5.0 X           0 0 0
(10) KATHERINE A LAUER
TRUSTEE
 5.0 X           0 0 0
(11) MARTY J LEVIN
TRUSTEE
 5.0 X           0 0 0
(12) ERNEST S RADY
TRUSTEE (PART-YEAR)
 5.0 X           0 0 0
(13) MAUREEN STAPLETON
TRUSTEE
 5.0 X           0 0 0
(14) ROBERT TJOSVOLD
TRUSTEE
 5.0 X           0 0 0
(15) CHRISTOPHER VAN GORDER
PRESIDENT AND CEO
 40.0 X   X       1,453,121 0 1,213,781
(16) RICHARD VORTMANN
TRUSTEE (PART-YEAR)
 5.0 X           0 0 0
(17) ABBY SILVERMAN WEISS
TRUSTEE
 5.0 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) RICHARD ROTHBERGER
EXEC VP/CFO
 40.0     X       883,519 0 143,644
(19) RICHARD SHERIDAN
CORP SR VP, GENERAL COUNSEL
 40.0     X       574,758 0 609,240
(20) GALE KEEL
ASST SEC TO SCRIPPS BOARD
 40.0     X       87,477 0 12,840
(21) VIRGINIA LEARY
EXEC SECRETARY TO CEO
 40.0     X       92,733 0 21,097
(22) ARNOLD BRENT EASTMAN MD
CORP SR VP, CHIEF MED OFFICER
 40.0       X     728,589 0 528,983
(23) VICTOR V BUZACHERO
CORP SR VP INNOVAT/HR/PERF MGT
 40.0       X     642,395 0 156,738
(24) JUNE KOMAR
CORP EXEC VP, STRATEGY & ADMIN
 40.0       X     626,504 0 605,371
(25) LARRY HARRISON
CHIEF EXECUTIVE, SR VP
 40.0       X     658,470 0 109,493
(26) THOMAS GAMMIERE
CHIEF EXECUTIVE, SR VP
 40.0       X     615,525 0 117,086
(27) GARY FYBEL
CHIEF EXECUTIVE, SR VP
 40.0       X     678,579 0 101,184
(28) ROBIN BROWN
CHIEF EXECUTIVE, SR VP
 40.0       X     550,038 0 287,858
(29) CARL ETTER
CHIEF EXECUTIVE, SR VP
 40.0       X     538,731 0 84,454
(30) JOHN ENGLE
CHIEF EXECUTIVE, SR VP
 40.0       X     485,831 0 83,220
(31) MARY L CARRAHER
CHIEF EXECUTIVE, SR VP
 40.0       X     319,325 0 32,808
(32) BARBARA PRICE
CORP SR VP BUS & SERV LINE DEV
 40.0       X     527,886 0 90,853
(33) DAVID M COHN
CORP VP, REVENUE CYCLE
 40.0       X     406,208 0 71,465
(34) MARC A REYNOLDS
CORP SR VP, PAYER RELATIONS
 40.0       X     410,780 0 78,073
(35) JOHN E ARMSTRONG
CORP SR VP, SPLY CHAIN/FACIL
 40.0       X     374,876 0 78,002
(36) PATRIC THOMAS
CORP VP, INFORMATION SVCS
 40.0       X     407,156 0 32,287
(37) GLEN MUELLER
CORP VP, AUDIT AND COMPLIANCE
 40.0       X     382,260 0 68,436
(38) BRIAN ISSELL MD
CORP VP, CLINICAL RESEARCH
 40.0         X   727,876 0 100,981
(39) CATHY GUIBAL
VP FINANCE/CFO SCRIPPS MED FDN
 40.0         X   324,067 0 63,099
(40) EDWARD NAZARRO
COE CLINIC
 40.0         X   325,751 0 81,600
(41) ROBERT T HOFF
CORP VP, CLINICAL ANC OPS
 40.0         X   424,450 0 58,564
(42) DANA LAUNER
DIRECTOR OF MEDICAL AFFAIRS
 40.0         X   431,182 0 30,313
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 13,678,087 0 4,861,470
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet1,560
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SCRIPPS CLINIC MEDICAL GROUP
10666 N TORREY PINES RD MS129
LA JOLLA,CA92037 		PHYSICIAN SERVICES 138,859,184
SCRIPPS COASTAL MEDICAL GROUP
501 WASHINGTON AVE 601
SAN DIEGO,CA92103 		PHYSICIAN SERVICES 50,782,851
MCCARTHY BUILDING COMPANIES
20401 SW BIRCH ST STE 300
NEWPORT BEACH,CA92006 		CONSTRUCTION 37,446,929
KILROY REALTY LP
12200 W OLYMPIC BLVD 200
LOS ANGELES,CA90064 		LEASE SERVICES 12,805,269
EMERGENCY ACUTE CARE MED CORP
440 STEVENS AVE STE 150
SOLANA BEACH,CA92075 		PHYSICIAN SERVICES 11,656,980
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet149
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 507,593
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		29,276,162
g Noncash contributions included in lines 1a-1f:$ 7,487,759
h Total. Add lines 1a-1f.......MediumBullet 29,783,755
Program Service Revenue Business Code
2a HEALTHCARE DELIVERY REVENUE 622,110 2,218,890,952 2,217,846,874 1,044,078  
b CAPITATION PREMIUM 622,110 71,502,171 71,502,171    
c RESEARCH REVENUE 541,700 7,266,993 6,919,286 347,707  
d JOINT VENTURE - CHILDRENS HOSPITAL 622,110 5,819,085 5,819,085    
e RENTAL INCOME - MEDICAL OFFICE BUILDING 531,120 10,653,195 10,653,195    
f All other program service revenue . 16,337,692 16,337,692    
g Total. Add lines 2a–2f........MediumBullet 2,330,470,088
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 21,788,066 0 44,970 21,743,096
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 566,987,787  
b Less: cost or other basis and sales expenses 535,950,089  
c Gain or (loss) 31,037,698  
d Net gain or (loss)..........MediumBullet 31,037,698     31,037,698
8a Gross income from fundraising events (not including
$ 507,593
of contributions reported on line 1c). See Part IV, line 18 ...
a 1,069,898
b Less: direct expenses ...b 642,028
c Net income or (loss) from fundraising events..MediumBullet 427,870   427,870
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA 722,310 5,802,643 5,802,643    
b PARKING 812,930 2,677,282 2,543,975 133,307  
c GIFT SHOP 453,220 1,544,447 1,544,447    
d All other revenue .... 12,812,582 11,496,008   1,316,574
e Total. Add lines 11a–11d ......MediumBullet 22,836,954
12 Total revenue. See Instructions....MediumBullet 2,436,344,431 2,350,465,376 1,570,062 54,525,238
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 1,807,000 1,807,000
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 18,257,609   18,257,609  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 815,322,824 731,334,533 78,759,831 5,228,460
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 30,164,000 26,533,049 3,500,861 130,090
9 Other employee benefits ....... 132,913,091 118,253,363 14,009,177 650,551
10 Payroll taxes ........... 59,008,900 52,445,552 6,274,277 289,071
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 6,036,853 646,231 5,367,652 22,970
c Accounting ........... 527,996 13,652 514,344  
d Lobbying ........... 489,897 0 489,897  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 3,139,800   3,139,800  
g Other .......... 372,627,186 347,864,478 24,166,184 596,524
12 Advertising and promotion .... 3,556,981 324,183 3,220,948 11,850
13 Office expenses ....... 398,548,889 388,733,946 8,888,875 926,068
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 71,152,319 63,297,462 7,655,179 199,678
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 13,538,240 11,938,676 1,599,564  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 91,970,689 88,295,970 3,674,719  
23 Insurance .............. 6,523,167 6,509,772 13,395  
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 HOSPITAL FEE PROGRAM 79,451,766 79,451,766    
b REPAIRS & MAINTENANCE 44,600,184 23,493,268 21,060,689 46,227
c LOSS ON IMPAIRMENT 1,961,780 1,961,780    
d PROFESSIONAL CLAIMS EXPENSES 906,250 906,250    
e BAD DEBT 89,492 89,492    
f All other expenses 5,702,125 2,396,980 2,146,179 1,158,966
25 Total functional expenses. Add lines 1 through 24f 2,158,297,038 1,946,297,403 202,739,180 9,260,455
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 506,688,259 2 624,787,001
3 Pledges and grants receivable, net ......... 26,952,656 3 25,264,516
4 Accounts receivable, net ......... 250,792,672 4 250,516,944
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 ............. 515,667 7 687,129
8 Inventories for sale or use .............. 30,659,540 8 29,961,850
9 Prepaid expenses and deferred charges ............ 13,822,671 9 41,364,501
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,836,549,514
b Less: accumulated depreciation. ..... 10b 987,553,299 781,990,459 10c 848,996,215
11 Investments—publicly traded securities .......... 525,186,264 11 440,203,894
12 Investments—other securities. See Part IV, line 11 ...... 343,111,000 12 485,217,000
13 Investments—program-related. See Part IV, line 11 .. 9,233,008 13 9,314,963
14 Intangible assets ......... 33,914,773 14 33,953,343
15 Other assets. See Part IV, line 11 ........... 70,994,740 15 61,817,644
16 Total assets. Add lines 1 through 15 (must equal line 34)... 2,593,861,709 16 2,852,085,000
Liabilities 17 Accounts payable and accrued expenses . 303,777,923 17 337,402,887
18 Grants payable ..........   18  
19 Deferred revenue .......... 11,302,644 19 13,078,381
20 Tax-exempt bond liabilities .......... 619,641,282 20 608,828,692
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 .. 8,446,438 23 5,460,073
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 85,467,140 25 102,568,108
26 Total liabilities. Add lines 17 through 25..... 1,028,635,427 26 1,067,338,141
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 1,376,703,739 27 1,605,255,443
28 Temporarily restricted net assets ..... 119,066,984 28 107,716,333
29 Permanently restricted net assets ..... 69,455,559 29 71,775,083
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 1,565,226,282 33 1,784,746,859
34 Total liabilities and net assets/fund balances ..... 2,593,861,709 34 2,852,085,000
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
2,436,344,431
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
2,158,297,038
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
278,047,393
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
1,565,226,282
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-58,526,816
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
1,784,746,859
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


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

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

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

95-1684089
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

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

Additional Data


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

95-1684089
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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

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

95-1684089
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

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

95-1684089
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

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

95-1684089
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


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

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

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

95-1684089
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










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

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

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


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
287,345
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
37,312
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
165,240
j
Total. lines 1c through 1i ...................................
489,897
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
PUBLIC AFFAIRS EDUCATION AND INFORMATION SCHEDULE C, PART II-B, LINE 1I SCRIPPS HEALTH IS AS MEMBER OF SEVERAL HOSPITAL ASSOCIATIONS AND HEALTH CARE ORGANIZATIONS AND HAS PARTICIPATED IN PUBLIC AFFAIRS AND ADVOCACY ACTIVITIES ORGANIZED BY THESE ORGANIZATIONS. THIS ACTIVITY HAS INCLUDED BRIEFING OF LEGISLATORS AND LEGISLATIVE STAFF MEMBERS (FEDERAL, STATE AND LOCAL) ON MATTERS AFFECTING HEALTH CARE AND HEALTH CARE OPERATIONS. ACTIVITY IS ON FEDERAL, STATE AND LOCAL LEVELS AND LOCATIONS. SUCH MATTERS INCLUDE: ACCOUNTABLE CARE ACT (HEALTH REFORM); BUDGET IMPACTS; REIMBURSEMENT; PROVIDER FEES; DATA MANAGEMENT AND REPORTING; QUALITY AND PATIENT SAFETY, HEALTH INFORMATION TECHNOLOGY, EMERGENCY DEPARTMENT OPERATIONS AND IMPACTS; UNINSURED, COST SHIFT IMPACTS AND OTHER SAFETY NET ISSUES; COMMUNITY BENEFIT PROGRAMS; GRADUATE MEDICAL EDUCATION; VALUE-BASED PURCHASING; BUNDLED PAYMENTS; ACCOUNTABLE CARE ORGANIZATIONS. THE ORGANIZATION STAFFS A GOVERNMENT RELATIONS DEPARTMENT THAT COORDINATES INFORMATION AND EDUCATION PROGRAMS ON PUBLIC POLICY AND ADVOCACY MATTERS. ALL WORK IS FOCUSED ON ISSUES AND NOT ON PARTISAN MATTERS, CANDIDATES OR POLITICAL ACTIVITIES. NO CORPORATE ACTIVITY ADDRESSED PARTISAN CAMPAIGNS. A PORTION OF ANNUAL MEMBERSHIP DUES SCRIPPS HEALTH PAYS TO CALIFORNIA HOSPITAL ASSOCIATION (CHA) AND ITS SUBSIDIARY THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD & IC), AMERICAN HOSPITAL ASSOCIATION (AHA), THE ALLIANCE OF CATHOLIC HEALTH CARE AND PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS (PEACH) IS DIRECTED BY THESE ORGANIZATIONS TO DIRECT LOBBYING SERVICES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

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

95-1684089
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 87,057,000 81,098,000 69,740,000
b Contributions ........ 2,316,000 685,000 7,288,000
c Investment earnings or losses ... 657,000 7,714,000 5,902,000
d Grants or scholarships ..... 703,000 36,000 0
e Other expenditures for facilities
and programs ........ 		1,930,000 1,636,000 1,372,000
f Administrative expenses .... 807,000 768,000 460,000
g End of year balance ...... 86,590,000 87,057,000 81,098,000
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet0 %
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet0 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 26,592,333 65,153,697 91,746,030
b Buildings ................   799,283,316 409,684,769 389,598,547
c Leasehold improvements ............   75,183,248 34,429,643 40,753,605
d Equipment ................   699,998,315 543,438,887 156,559,428
e Other .................   170,338,605   170,338,605
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 848,996,215
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) PRIVATE EQUITY INVESTMENTS 		7,760,107 F

(B) HEDGE FUND INVESTMENTS 		121,189,431 F

(C) FGN EQUITY COMMINGLED FUNDS 		43,088,739 F

(D) DOM FXD INC COMMINGLED FUNDS 		216,677,968 F

(E) FGN FXD INC COMMINGLED FUNDS 		96,500,755 F




Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 485,217,000
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








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








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
ANNUITY AND UNITRUSTS 9,716,854
DEFERRED RETIREMENT LIABILITY 16,804,341
DEPOSITS & CONTINGENCIES 83,957
SELF INSURED MALPRACTICE LIABILITY 17,064,900
SELF INSURED WORKERS COMP LIABILITY 45,055,660
ASSET RETIREMENT OBLIGATION 13,813,293
AGENCY ENDOWMENT LIABILITY 830,244
ARBITRAGE REBATE LIABILITY 419,180
INTERCOMPANY LIABILITIES -1,220,321
Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 102,568,108
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
INTENDED USES OF ORGANIZATIONS ENDOWMENT FUNDS SCHEDULE D, PART V, QUESTION 4 CONTRIBUTIONS RECEIVED FOR CAPITAL PROJECTS USE INCLUDING BUILDING PROJECTS, MAJOR RENOVATIONS, AND EQUIPMENT PURCHASES. $1,086,131 CONTRIBUTIONS RECEIVED TO FUND GRADUATE MEDICAL EDUCATION PROGRAMS, FELLOWS, AND LECTURE SERIES. $14,782,529 CONTRIBUTIONS RECEIVED FOR USE IN SPECIFIC DEPARTMENTS OR DIVISIONS IN THE HOSPITALS AND/OR CLINICS. $24,979,944 CONTRIBUTIONS RECEIVED TO COVER COSTS OF HEALTHCARE PROVIDED TO INDIVIDUALS WITHOUT INSURANCE OR THE MEANS FOR PAYING FOR THEIR CARE. $12,820,850 CONTRIBUTIONS RECEIVED TO FUND RESEARCH PROJECTS IN SPECIFIC AREAS OR DIVISIONS. $14,683,156 TOTAL - $68,352,610
UNCERTAIN TAX POSITIONS UNDER ASC 740 (FKA FIN 48) SCHEDULE D, PART X, LINE 2 SCRIPPS HEALTH IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, SCRIPPS HEALTH IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSE FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS TAKEN AS A WHOLE. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT SEPTEMBER 30, 2011 OR 2010.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
North America 0 25 Program Services Reconstructive Surgery 173,358
East Asia and the Pacific 0 14 Program Services Medical Care & Trainin 43,537
Central America and the Caribbean 0 0 Investments   95,876,806
East Asia and the Pacific 0 0 Fundraising   0
Central America and the Caribbean 0 0 Fundraising   0
North America 0 0 Fundraising   0
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 39 96,093,701
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 39 96,093,701
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
ACCOUNTING METHOD SCHEDULE F, PART I, LINE 3, COLUMN F THE ACCRUAL METHOD OF ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS IN COLUMN F.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

SPINOFF 2011
(event type) 		(b) Event #2

MERCY BALL '11
(event type) 		(c) Other Events

4
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 485,484 310,890 781,117 1,577,491
2 Less: Charitable
contributions . . . 		150,855 90,930 265,808 507,593
3 Gross income (line 1
minus line 2) . . . 		334,629 219,960 515,309 1,069,898
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . . 77,069 57,830 222,980 357,879
7 Food and beverages . . 60 3,537   3,597
8 Entertainment . . . 200 15,700 46,499 62,399
9 Other direct expenses . 33,943 34,814 149,396 218,153
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 642,028
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 427,870
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


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

95-1684089
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    41,216,024 0 41,216,024 1.910 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    141,543,730 124,971,888 16,571,842 0.770 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     39,022,213 17,405,159 21,617,054 1.000 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    221,781,967 142,377,047 79,404,920 3.680 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    6,292,954 1,024,381 5,268,573 0.240 %
f Health professions education
(from Worksheet 5) .. 		    23,535,692 5,591,590 17,944,102 0.830 %
g Subsidized health services
(from Worksheet 6) .. 		    21,831,463 12,712,847 9,118,616 0.420 %
h Research (from Worksheet 7)     22,943,384 6,383,325 16,560,059 0.770 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    2,025,702 11,278 2,014,424 0.090 %
jTotal Other Benefits ...     76,629,195 25,723,421 50,905,774 2.360 %
kTotal. Add lines 7d and 7j. ..     298,411,162 168,100,468 130,310,694 6.040 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 1 0 51,676 0 51,676 0 %
3 Community support 5 4,616 346,063 11,345 334,718 0 %
4 Environmental improvements            
5 Leadership development and training for community members 4 2,734 110,999 49,133 61,866 0 %
6 Coalition building 3 2,212 163,483 72,935 90,548 0 %
7 Community health improvement advocacy 5 20 332,307 0 332,207 0 %
8 Workforce development            
9 Other            
10 Total 18 9,582 1,004,528 133,413 871,015 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
16,602,587
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
343,069,577
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
405,590,777
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-62,521,200
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1SCRIPPS ENCINITAS
  		AMBULATORY SURGERY CENTER 55.500 % 0 % 25.000 %
2Surgery Center
  		       
3SCRIPPS MEMORIAL
  		MEDICAL OFFICE BUILDING 15.300 % 0 % 77.200 %
4XIMED MEDICAL
  		       
5SCRIPPS MERCY ASC
  		AMBULATORY SURGERY CENTER 73.500 % 0 % 26.500 %
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?5
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Scripps Memorial Hospital La Jolla
9888 Genesee Avenue
La Jolla,CA92037 		X X   X X X X X  
2 Scripps Mercy Hospital
4077 5th Avenue
San Diego,CA92103 		X X   X X X X X  
3 Scripps Green Hospital
10666 N Torrey Pines Road
La Jolla,CA92037 		X X   X X X      
4 Scripps Memorial Hospital Encinitas
354 Santa Fe Drive
Encinitas,CA92024 		X X   X X X X X  
5 Scripps Mercy Hospital Chula Vista
435 H Streeet
Chula Vista,CA91910 		X X   X X X X X  
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

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

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

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Scripps Mercy Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

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

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

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Scripps Green Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

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

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

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Scripps Memorial Hospital Encinitas
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

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

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

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Scripps Mercy Hospital Chula Vista
Line Number of Hospital Facility (from Schedule H, Part V, Section A):5

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

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

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

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?29
Name and address Type of Facility (Describe)
1 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
2 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
3 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
4 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
5 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
6 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
7 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
8 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
9 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
10 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
11 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
12 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
13 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
14 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
15 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
16 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
17 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
18 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
19 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
20 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
21 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
22 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
23 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
24 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
25 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
26 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
27 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
28 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
29 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037 		PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
SCHEDULE H, PART I, LINE 3C   FPG ARE USED TO DETERMINE CHARITY CARE ELIGIBILITY.
SCHEDULE H, PART I, LINE 6A   SCRIPPS HEALTH COMMUNITY BENEFIT REPORT IS PREPARED FOR THE HEALTH SYSTEM AS A WHOLE AND CAN BE FOUND AT WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE- COMMUNITY.
SCHEDULE H, PART I, LINE 7G   SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN EVEN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDI-CAL SHORTFALLS. SCRIPPS PROVIDES SUCH SERVICES BECAUSE THEY MEET AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, THEY WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION TO PROVIDE. SUBSIDIZED SERVICES DO NOT INCLUDE SUCH ANCILLARY SERVICES AS LAB WORK AND RADIOLOGY. IF THESE SERVICES ARE PROVIDED TO LOW-INCOME PERSONS, THEY ARE REPORTED AS CHARITY CARE/FINANCIAL ASSISTANCE. SCRIPPS' TOTAL NET COST FOR SUBSIDIZED HEALTH SERVICES FOR FY11 WAS $9,118,616. THIS INCLUDES SCRIPPS INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES, MERCY CLINIC AND SCRIPPS IN-LIEU OF FUNDS, WHICH ARE USED FOR UNFUNDED OR UNDERFUNDED PATIENTS AND THEIR POST-DISCHARGE NEEDS INCLUDING BOARD AND CARE, SKILLED NURSING FACILITIES, LONG-TERM ACUTE CARE AND HOME HEALTH. IN ADDITION, THE FUNDS MAY BE USED FOR MEDICATIONS, EQUIPMENT AND TRANSPORTATION SERVICES. MERCY CLINIC OF SCRIPPS MERCY HOSPITAL SAN DIEGO FOUNDED IN 1930 AND ADOPTED BY THE SISTERS OF MERCY IN 1961, MERCY CLINIC OF SCRIPPS MERCY HOSPITAL IS A PRIMARY CARE CLINIC THAT TREATS MORE THAN 1,000 PATIENTS EACH MONTH. TOTAL PATIENT VISITS FOR PRIMARY AND SUBSPECIALTY CARE AT THE CLINIC IN FY11 WERE 12,715. A FULL TIME CLINIC STAFF OF NURSES AND OTHER PERSONNEL WORK HAND-IN-HAND WITH PHYSICIANS FROM SCRIPPS MERCY HOSPITAL. AS AN INTEGRAL PART OF TREATING ITS PATIENTS, MERCY CLINIC SERVES AS A TRAINING GROUND FOR MORE THAN 50 RESIDENTS EACH YEAR FROM THE SCRIPPS MERCY HOSPITAL GRADUATE MEDICAL EDUCATION PROGRAM. ESTABLISHED WITH THE INTENT OF CARING FOR THE POOR, MERCY CLINIC HAS BECOME A CRITICAL SOURCE OF MEDICAL CARE FOR SAN DIEGO'S "WORKING AND DISABLED POOR". EACH YEAR, 90 PERCENT OF PATIENT VISITS ARE PAID THROUGH MEDI-CAL, MEDICARE OR SOME OTHER INSURANCE PLAN. THE REMAINING 10 PERCENT PAY WHAT, AND IF, THEY CAN. THOUSANDS OF PEOPLE IN THE REGION RELY ON MERCY CLINIC; MOST ARE LOW-INCOME, MEDICALLY UNDERSERVED ADULTS AND SENIORS WHO OTHERWISE WOULD HAVE NO ACCESS TO HEALTH CARE. THE TOTAL SUBSIDIZED NET COST FOR MERCY CLINIC FOR FY11 WAS $2.3 MILLION (EXCLUDES MEDI-CAL, BAD DEBT AND CHARITY CARE).
SCHEDULE H, PART I, LINE 7, COLUMN F   $89,492 IS THE AMOUNT OF BAD DEBT INCLUDED IN PART IX, LINE 25 BUT ADDED BACK FOR THE PURPOSE OF CALCULATING THE PERCENTAGES IN SCHEDULE H, PART I, LINE 7, COLUMN (F).
SCHEDULE H, PART I, LINE 7   FINANCIAL SUPPORT REFLECTS THE COST (LABOR, SUPPLIES, OVERHEAD, ETC) ASSOCIATED WITH THE PROGRAMS/SERVICE LESS DIRECT REVENUE. THE FIGURE DOES NOT INCLUDE A CALCULATION FOR PHYSICIAN AND STAFF VOLUNTEER LABOR HOURS. IN SOME INSTANCES, AN ENTIRE COMMUNITY BENEFIT PROGRAM COST CENTER HAS BEEN DIVIDED BETWEEN SEVERAL INITIATIVES. SCRIPPS EMPLOYEES TRACK COMMUNITY BENEFIT PROGRAMS/ACTIVITIES VIA AN ACCESS COMMUNITY BENEFIT DATABASE. THE ACCESS COMMUNITY BENEFIT DATABASE HAS BEEN ALIGNED TO THE SCHEDULE H 990 CATEGORIES AND REPORTING CRITERIA. THE DATABASE IS USED TO RECORD INFORMATION FOR EACH ACTIVITY (SERVICE OR PROGRAM) WHICH PROVIDES COMMUNITY BENEFIT. THIS DATABASE IS USED TO RECORD ACTUAL EXPENSES AND FUNDING/OFFSETTING REVENUE FOR SINGLE OR MULTIPLE OCCURRENCES OF AN "ACTIVITY". ALL COMMUNITY BENEFIT PROGRAMS/ACTIVITIES ARE THEN ENTERED INTO THE "COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY" (CBISA) DATABASE. CBISA SERVES AS THE ROLL UP AND OR END PRODUCT OF COMMUNITY BENEFIT TRACKING. IT IS ALIGNED WITH THE NEW SCHEDULE H REQUIREMENTS AND HOUSES THE SCHEDULE H WORKSHEETS THAT CAN BE USED FOR AUDIT PURPOSES. FINANCE WORKS TO RECONCILE UNCOMPENSATED CARE NUMBERS ACCORDING TO THE SCHEDULE H METHODOLOGY. FINANCIAL PLANNING EXCEL WORKSHEETS ARE USED TO RECONCILE COMMUNITY BENEFIT NUMBERS INCLUDING UNCOMPENSATED CARE NUMBERS. SCRIPPS UNCOMPENSATED CARE FY2011 METHODOLOGY SCRIPPS CONTINUES TO CONTRIBUTE RESOURCES TO PROVIDE LOW- AND NO-COST HEALTH CARE SERVICES TO POPULATIONS IN NEED. CALCULATIONS FOR BAD DEBT AND CHARITY CARE IS ESTIMATED BY EXTRACTING THE GROSS WRITE-OFFS OF BAD DEBT AND CHARITY CARE CHARGES AND APPLYING THE HOSPITAL RATIO OF COST TO CHARGES (RCC) TO ESTIMATE THE COST OF CARE. CALCULATIONS FOR MEDI-CAL AND OTHER MEANS- TESTED GOVERNMENT PROGRAMS AND MEDICARE SHORTFALL ARE DERIVED USING THE PAYOR-BASED COST ALLOCATION METHODOLOGY. PROVIDER TAX PROGRAM (REFLECTED IN PART I, LINE 7B) IN JANUARY 2010, THE STATE OF CALIFORNIA ENACTED LEGISLATION THAT PROVIDED FOR SUPPLEMENTAL MEDI-CAL PAYMENTS TO CERTAIN HOSPITALS FUNDED BY A QUALITY ASSURANCE FEE PAID BY PARTICIPATING HOSPITALS AND MATCHING FEDERAL FUNDS ("THE 2010 HOSPITAL FEE PROGRAM"). THE LEGISLATION COVERED THE PERIOD OF APRIL 1, 2009 THROUGH DECEMBER 31, 2010 (21 MONTHS). THE CENTERS FOR MEDICARE & MEDICAID SERVICES ("CMS") APPROVED THE 2010 HOSPITAL FEE PROGRAM IN ITS ENTIRETY IN DECEMBER 2010, AND, THEREFORE, ALL ACTIVITY OF THE PROGRAM WAS RECOGNIZED DURING THE YEAR ENDED SEPTEMBER 30, 2011, RESULTING IN NET ADDITIONAL INCOME OF $22,620,000. THE SUPPLEMENTAL PAYMENTS RECEIVED DURING THE YEAR ENDED SEPTEMBER 30, 2011 ENCOMPASSED FEE-FOR-SERVICE PAYMENTS TO THE ORGANIZATION DIRECTLY FROM THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES AS WELL AS PAYMENTS ROUTED THROUGH MANAGED CARE PLANS, AMOUNTING IN TOTAL TO APPROXIMATELY $102,072,000. THESE PAYMENTS WERE RECORDED IN NET PATIENT REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. QUALITY ASSURANCE FEES ASSESSED TO AND PAID BY THE ORGANIZATION RELATED TO THE 2010 HOSPITAL FEE PROGRAM DURING THE YEAR ENDED SEPTEMBER 30, 2011, WERE $77,850,000 AND WERE RECORDED AS PROVIDER TAX FEES IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE CALIFORNIA HOSPITAL ASSOCIATION CREATED A PRIVATE PROGRAM, THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT), ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA (TOGETHER WITH THE SUPPLEMENTAL PAYMENTS AND THE QUALITY ASSURANCE FEE DISCUSSED ABOVE, THE 2010 PROVIDER FEE PROGRAM). DURING THE YEAR ENDED SEPTEMBER 30, 2011, THE ORGANIZATION MADE CHARITABLE CONTRIBUTIONS OF $1,602,000 RELATED TO THE 2010 PROVIDER FEE PROGRAM TO CHFT, WHICH WERE RECORDED AS PROVIDER TAX FEES IN THE CONSOLIDATED STATEMENTS OF OPERATIONS.
SCHEDULE H, PART II   COMMUNITY BUILDING ACTIVITIES. ECONOMIC DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 2 EXECUTIVE LEADERSHIP, SPONSORED BY THE OFFICE OF THE PRESIDENT, DONATES TIME ON NOT-FOR PROFIT BOARDS REPRESENTING SCRIPPS HEALTH, INCLUDING THE FOLLOWING ORGANIZATIONS AND BOARDS: SAN DIEGO REGIONAL CHAMBER OF COMMERCE (CHAMBER BOARD, CHAMBER CEO ROUNDTABLE AND POLICY COMMITTEE ASSIGNMENTS); SAN DIEGO COUNTY TAXPAYERS ASSOCIATION (SDCTA BOARD, EXECUTIVE COMMITTEE AND HEALTH COMMITTEE WORK ASSIGNMENTS); SAN DIEGO REGIONAL ECONOMIC DEVELOPMENT CORPORATION (EDC BOARD AND POLICY COMMITTEE ASSIGNMENTS); AND THE DOWNTOWN SAN DIEGO PARTNERSHIP (DSDP BOARD AND WORKING COMMITTEE ASSIGNMENTS). COMMUNITY SUPPORT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 3. THE CITY HEIGHTS WELLNESS CENTER (CHWC) IS A UNIQUE RESOURCE, AS THERE IS NO OTHER COMMUNITY-BASED FACILITY PROMOTING HEALTH AND WELLNESS IN CENTRAL SAN DIEGO. THE OVERALL GOAL OF CHWC IS TO PREVENT DISEASE AND PROMOTE HEALTH, STRENGTHEN COMMUNITY PARTNERSHIPS AND PROVIDE OPPORTUNITIES TO RESIDENTS TO BECOME SELF-EMPOWERED AND BECOME MORE INVOLVED IN MANAGING THEIR OWN HEALTH. IN FY11, THE CENTER PROVIDED COMMUNITY MEETINGS FOCUSED ON ACCESS TO HEALTH CARE SERVICES, CREATING A SAFER COMMUNITY ENVIRONMENT AND COMMUNITY-WIDE COMMUNICATION AND COMMUNITY BUILDING STRATEGIES. THE CENTER IS OPERATED JOINTLY BY SCRIPPS MERCY HOSPITAL AND CHILDREN'S HOSPITAL. HOLIDAY CARDS TO OVERSEAS MILITARY HOLIDAYS CARDS SEND ENCOURAGEMENT TO OVERSEE MILITARY PERSONNEL. THE CARDS WERE SIGNED AND THE ENVELOPES WERE LEFT OPEN FOR FINAL INSPECTION BY PITNEY BOWES. SCRIPPS GATHERED THE CARDS AND MAILED TO PITNEY BOWES SO THEY WOULD RECEIVE THE CARDS ON TIME. IN ADDITION, SCRIPPS COLLECTED DONATED GIFTS MAILED TO A NAVY SHIP AT SEA ON ACTIVE DUTY FOR ONE YEAR. EAT LIKE A MARINE FUNDRAISER SCRIPPS HEALTH AND MEDASSETS WORKED TOGETHER WITH THEIR VENDORS TO RAISE MORE THAN $155,000 TO SPONSOR A MAKE-UP HOMECOMING BALL FOR THE MARINES FROM THE DARK HORSE BATTALION. MARINES AND THEIR FAMILY MEMBERS TRAVELED FROM AROUND THE COUNTRY TO LAS VEGAS TO ATTEND THEIR SPECIAL HOMECOMING BALL. SCRIPPS HEALTH AND MEDASSETS THANKED THOSE VENDORS WHO HELPED FUND THE ENTIRE HOMECOMING BALL BY INVITING THEM TO "EAT LIKE A MARINE". THIS THANK YOU RECEPTION PROVIDED A CHANCE FOR ALL WHO CONTRIBUTED TO MEET SOME OF OUR COUNTRY'S BRAVEST MARINES FROM THE DARK HORSE BATTALION. THEY WERE ON HAND TO SHARE THEIR STORIES AND TEACH GUESTS HOW TO PREPARE MEALS READY TO EAT (MRE'S). DISASTER PREPAREDNESS - COMMUNITY OUTREACH AND EDUCATION HAVING THE ABILITY TO PROVIDE EMERGENCY SERVICES TO THOSE INJURED IN A LOCAL DISASTER WHILE CONTINUING TO CARE FOR HOSPITALIZED PATIENTS IS A CRITICAL COMMUNITY NEED. SCRIPPS DELEGATES PARTICIPATION IN SD COUNTY AND STATE OF CA ADVISORY GROUPS TO PLAN, IMPLEMENT AND EVALUATE KEY DISASTER PREPAREDNESS RESPONSE PLANS AND FUNDING. EFFORTS LED BY THE DISASTER PREPAREDNESS PROGRAM UNDER THE DIRECTION OF THE CHIEF MEDICAL OFFICER. AMERICAN HEART ASSOCIATION HEART WALK AMERICAN HEART WALK -SCRIPPS ALLOCATED $29,010 IN OPERATIONAL FUNDS TO SUPPORT THE AMERICAN HEART ASSOCIATION'S EFFORTS TO FIGHT HEART DISEASE AND STROKE. IN ADDITION, THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER PROGRAM COORDINATED WALKER PARTICIPATION AND FUND RAISING EFFORTS. THE SAN DIEGO HEART WALK RAISED MORE THAN $1.2 MILLION. IN 2011, MORE THAN 2,000 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES AND FRIENDS - WALKED TO HELP RAISE MORE THAN $138,000. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT BY PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION MATERIALS, AND MORE. FOOD STAMP ASSISTANCE THE CITY HEIGHTS WELLNESS CENTER (CHWC) HOSTS ELIGIBILITY WORKERS FROM THE SAN DIEGO HUNGER COALITION WHO ARE AVAILABLE TO COUNSEL PEOPLE AND HELP FILL OUT APPLICATIONS FOR FOOD STAMP ASSISTANCE. CHWC NOT ONLY PROVIDES THE NEEDED SPACE FOR THIS ACTIVITY, BUT ALSO ACTIVELY PARTICIPATES BY DEVELOPING OUTREACH FLYERS, SCHEDULING COMMUNITY RESIDENTS, AND OVERALL COORDINATION FOR THE CLASS. MID-CITY CAN, SAN DIEGO CITY HEIGHTS WELLNESS CENTER HOSTS AND PARTICIPATES IN MONTHLY NETWORKING MEETINGS FOR MID-CITY CAN (COMMUNITY ADVOCACY NETWORK). THESE MEETINGS PROVIDE AN OPPORTUNITY FOR COMMUNITY RESIDENTS AND REPRESENTATIVES FROM PRIVATE AND PUBLIC ORGANIZATIONS, FAITH COMMUNITIES, SCHOOLS AND BUSINESSES TO COME TOGETHER FOR ACTION ON AREAS OF COMMON INTEREST. IN ASSOCIATION WITH THESE MEETINGS, SELF-DIRECTED MOMENTUM TEAMS HAVE BEEN DEVELOPED TO PROVIDE DIRECTION AND LEADERSHIP AS NEEDS AND ISSUES ARISE WITHIN THE COMMUNITY. SAN DIEGO CAREGIVER ACTION NETWORK (SANDI-CAN) THE CITY HEIGHTS WELLNESS CENTER HOSTS MONTHLY MEETINGS FOR SANDI-CAN, A COMMUNITY PARTNERSHIP OF 200 CONSUMERS, VOLUNTEERS, CAREGIVERS, AND SERVICE PROVIDERS DEDICATED TO WORKING TOGETHER ON PROJECTS THAT ENHANCE THE LIVES OF OLDER ADULTS AND ADULTS WITH DISABILITIES LIVING IN THE CITY OF SAN DIEGO. LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS -- THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 5. CITY HEIGHTS WELLNESS CENTER - HEALTH ADVOCACY PROJECT THE CITY HEIGHTS WELLNESS CENTER HEALTH ADVOCACY PROJECT IS SUPPORTED BY A GRANT FROM THE CALIFORNIA ENDOWMENT FOUNDATION AND IS DESIGNED TO STRENGTHEN THE CAPACITY TO DELIVER CULTURALLY AND RELIGIOUSLY COMPETENT HEALTH PROMOTION SERVICES TO SOMALI AND EAST AFRICAN WOMEN AND THEIR FAMILIES. THIS PROGRAM ADDRESSES UNMET NEEDS LIKE PRENATAL OUTREACH AND EDUCATION, CULTURALLY ADAPTED NUTRITION AND FITNESS EDUCATION, BREASTFEEDING EDUCATION, EARLY CHILDHOOD HEALTH, AND NUTRITION AND SAFETY CLASSES. THE PROJECT IS SPONSORED BY SCRIPPS MERCY SAN DIEGO COMMUNITY BENEFIT SERVICES. LEAD SAN DIEGO VISIONARY AWARDS THROUGH THE OFFICE OF THE PRESIDENT, SCRIPPS SPONSORED THE LEAD SAN DIEGO VISIONARY AWARD. LEAD SAN DIEGO MEMBERS AND INVESTORS PLAY A VITAL ROLE IN DEVELOPING DIVERSE LEADERS. THE VISIONARY AWARDS STRIVE TO INSPIRE INNOVATIONS AND SHARE SUCCESSES IN COMMUNITY LEADERSHIP. LEARNING FOR LIFE SAN DIEGO - IMPERIAL COUNCIL BOY SCOUTS OF AMERICA SCRIPPS SPONSORSHIP, PROVIDED BY SCRIPPS OFFICE OF THE PRESIDENT, SUPPORTED THE DISTINGUISHED CITIZEN'S DINNER. THE EVENT RAISED FUNDS FOR OUTREACH PROGRAMS DELIVERED BOTH IN SCHOOL AND AFTER SCHOOL TO SUPPORT YOUTH IN HIGH-RISK AREAS OF SAN DIEGO COUNTY, AFFORDING THEM THE OPPORTUNITY TO BUILD LEADERSHIP SKILLS, DEVELOP CHARACTER AND LEARN JOB SKILLS. FOUNDATION OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES DONATION MADE TO THE FOUNDATION OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES, FUND FOR INNOVATION IN HEALTHCARE LEADERSHIP. THIS DONATION WILL HELP FUND THE IMPLEMENTATION AND APPLICATION OF HEALTH SERVICES RESEARCH AND TO HELP DEVELOP FUTURE LEADERSHIP. SPONSORED BY SCRIPPS OFFICE OF THE PRESIDENT. COALITION BUILDING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 6. CALIFORNIA ENDOWMENT MEETING THE CITY HEIGHTS WELLNESS CENTER (CHWC) HOSTS MEETINGS OF THE CALIFORNIA ENDOWMENT (A PRIVATE, STATEWIDE HEALTH FOUNDATION) FOR ITS 10-YEAR BUILDING HEALTHY COMMUNITIES INITIATIVE, WHICH AIMS TO SUPPORT THE DEVELOPMENT OF COMMUNITIES WHERE YOUTH ARE HEALTHY, SAFE AND READY TO LEARN. THE CHWC HAS BEEN INVOLVED, PARTICIPATORY AND SUPPORTIVE OF THE ENDOWMENT AND THEIR EFFORTS IN THIS INITIATIVE. CALIFORNIA PARTNERSHIP LATINOS Y LATINAS EN ACCIN (LLEA), A PROJECT OF MID-CITY CAN (COMMUNITY ADVOCACY NETWORK), SUPPORTS LATINOS IN USING THEIR COLLECTIVE VOICE EFFECTIVELY AND INCREASING LATINO INVOLVEMENT IN ALL LEVELS OF COMMUNITY DECISION MAKING AND CIVIC PARTICIPATION. LLEA HAS BEEN IN EXISTENCE SINCE 2002, AS A GRASSROOTS EFFORT LEAD BY CONCERNED PARENTS, RESIDENTS AND TEACHERS OF THE CITY HEIGHTS COMMUNITY. MOVILIZANDO EL VOTO INMIGRANTE IS A CAMPAIGN IN WHICH LLEA COLLABORATED WITH CALIFORNIA PARTNERSHIP, A COALITION OF COMMUNITY GRASSROOTS ORGANIZATIONS THROUGHOUT THE STATE OF CALIFORNIA. OVER THE LAST THREE YEARS LLEA MEMBERS HAVE WALKED PRECINCTS IN CITY HEIGHTS BEFORE, DURING AND AFTER ELECTORAL CAMPAIGNS WITH THE GOAL OF IDENTIFYING POTENTIAL IMMIGRANT VOTERS AND ENGAGING THEM IN DIALOGUE ABOUT ISSUES FACING THE LATINO COMMUNITY IN CITY HEIGHTS. DURING THE NOVEMBER PRESIDENTIAL ELECTIONS RETURNED OUT MORE THAN 2,500 CITY HEIGHTS VOTERS WHO WERE KEY IN A HISTORIC SUCCESS FOR PEOPLE OF COLOR IN THIS COUNTRY. SPONSORED BY SCRIPPS CITY HEIGHTS WELLNESS CENTER. FOOD JUSTICE MOMENTUM TEAM THE CITY HEIGHTS WELLNESS CENTER HOSTS AND CO-CHAIRS MONTHLY MEETINGS OF THE FOOD JUSTICE MOMENTUM TEAM. THE MISSION OF THIS TEAM IS TO GATHER A DIVERSE COMMUNITY WORKING TOGETHER TOWARDS CREATING AN ECOLOGICALLY SOUND, ECONOMICALLY VIABLE AND SOCIALLY JUST FOOD SYSTEM FOR ALL. ACCESS TO HEALTH CARE THE CITY HEIGHTS WELLNESS CENTER HOSTS AND PARTICIPATES IN MONTHLY MEETINGS OF THE ACCESS TO HEALTH CARE MOMENTUM TEAM.
SCHEDULE H, PART III, LINE 4   FOOTNOTE FOR PART III, LINE 4 - BAD DEBT FOOTNOTE: The Organization adopted the accounting standard addressing the presentation of the provision for bad debts as of the current reporting period and as such, net patient service revenues are reported net of the provision for bad debts on the statements of operations. The Organization records its provision for doubtful accounts based upon historical experience, as well as collection trends for major payor types. The provision for bad debts for fiscal year 2010 was reclassified as a reduction of net patient service revenues. BAD DEBT METHODOLOGY UNCOMPENSATED COST IS ESTIMATED BY APPLYING RATIO-COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS BAD-DEBT ADJUSTMENTS, LESS RECOVERIES. THE FOLLOWING COSTS ARE EXCLUDED: BAD DEBT ADJUSTMENTS AT COST FOR MEDI-CAL AND CMS PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. THE AMOUNT ON PART III, LINE 2 REPRESENTS PATIENT CARE CHARGES WRITTEN OFF TO BAD DEBT WHERE THE PATIENT HAD THE ABILITY TO PAY. WHERE A PATIENT QUALIFIED FOR PARTIAL OR FULL CHARITY CARE, THE UNPAID AMOUNT IS NOT CONSIDERED BAD DEBT. WE BELIEVE THAT BAD DEBT PERTAINING TO PATIENT CARE CHARGES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THESE PATIENTS RECEIVE TREATMENT REGARDLESS OF WHETHER WE COLLECT PAYMENT FOR THE SERVICES PERFORMED. DESCRIBE HOW THE ORGANIZATION HAS ACCOUNTED FOR DISCOUNTS IN DETERMINING BAD DEBT EXPENSE (E.G. SELF-PAY DISCOUNTS): A PROMPT-PAY DISCOUNT OF 50 PERCENT IS AVAILABLE. BAD DEBT DOES NOT INCLUDE ANY AMOUNTS RELATED TO DISCOUNTS.
SCHEDULE H, PART III, LINE 8   MEDICARE AND MEDICARE HMO: HOSPITALS MEDICARE ALLOWABLE COSTS ARE DETERMINED USING A COST TO CHARGE RATIO. THE FOLLOWING COSTS ARE EXCLUDED: CHARITY AND BAD DEBT ADJUSTMENTS AT COST FOR MEDICARE AND MEDICARE SENIOR PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, SUBSIDIZED HEALTH SERVICES PROVIDED TO MEDICARE PATIENTS AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. DESCRIBE THE ORGANIZATION'S RATIONALE FOR THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS A NOT-FOR-PROFIT, COMMUNITY BENEFIT 501(C)(3) ORGANIZATION, SCRIPPS HEALTH'S PURPOSE IS TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES SERVED. MEDICARE COVERS A SIGNIFICANT PROPORTION OF THE SAN DIEGO COMMUNITY PATIENT POPULATION, INPATIENT AND OUTPATIENT. THE LEVEL OF QUALITY AND ACCESS TO CARE IS THE SAME, REGARDLESS OF PAYER. HOSPITALS DO NOT DETERMINE THE LEVEL OF PAYMENT FOR MEDICARE; RATHER, IT IS SUBJECT TO GOVERNMENT REIMBURSEMENT POLICY. THERE IS A WELL-DOCUMENTED MEDICARE REIMBURSEMENT SHORTFALL OF PAYMENT FOR CARE NOT MEETING THE COST OF DELIVERING CARE. THAT SHORTFALL IS AN UNREIMBURSED AMOUNT THAT MUST BE ACCOUNTED FOR IN THE HOSPITAL'S FINANCIAL STATEMENTS. IT IS REAL AND SUBSTANTIAL. IT SHOULD BE ACCEPTED AS A SHORTFALL IN IRS REPORTING STANDARDS. SCRIPPS MUST ACCEPT THE PATIENTS REGARDLESS OF REIMBURSEMENT RATES FROM MEDICARE AND IF PATIENTS ARE NOT CARED FOR BY SCRIPPS IT IS LIKELY THAT ANOTHER COMMUNITY OR GOVERNMENT AGENCY WOULD HAVE TO COVER THE CARE OF THE PATIENT.
SCHEDULE H, PART III, LINE 9B   COLLECTION POLICY ALL PATIENT FINANCIAL RESOURCES ARE EXPLORED PRIOR TO USING A COLLECTION AGENCY OR OTHER MEANS TO COLLECT ON ACCOUNTS. THE ORGANIZATION ALSO SCREENS PATIENTS WHO CANNOT AFFORD TO PAY CO-INSURANCE AND DEDUCTIBLES TO SEE WHETHER THEY QUALIFY FOR FINANCIAL ASSISTANCE OR CHARITY CARE PROGRAM. IF THE PATIENT DOES NOT QUALIFY, OR IF THERE IS A LACK OF INFORMATION AVAILABLE TO MAKE A DETERMINATION AND NO CONTACT IS ESTABLISHED WITH THE PATIENT, THEN THE ORGANIZATION MAY USE A COLLECTION AGENCY OR INTERNAL STAFF TO COLLECT THE ACCOUNT. WHEN A COLLECTION AGENCY OR THE ORGANIZATION STAFF DETERMINES THAT A PATIENT CANNOT PAY ON THE ACCOUNT, THE ORGANIZATION WRITES THE ACCOUNT OFF AS CHARITY. SHOULD A PATIENT MAKE A PAYMENT ON AN ACCOUNT THAT HAS BEEN WRITTEN OFF TO BAD-DEBT EXPENSE, BAD-DEBT EXPENSE IS REDUCED TO THE EXTENT OF THE PAYMENT.
NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. CALIFORNIA SENATE BILL 697 (CHAPTERED IN 1994) REQUIRES AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. IDENTIFYING SAN DIEGO COUNTY'S HEALTH PRIORITIES IS A COMPLEX PROCESS. THE WORKING GROUP KNOWN AS THE SAN DIEGO COUNTY SB697 COALITION WAS INITIALLY ATTENDED BY REPRESENTATIVES FROM OVER 25 HEALTH CARE-RELATED ORGANIZATIONS WITH THE GOAL OF PRODUCING ONE NEEDS ASSESSMENT TO MAXIMIZE RESOURCES AND DEVELOP A MORE COMPREHENSIVE REPORT FOR THE COUNTY OF SAN DIEGO. THE COALITION, RENAMED COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) SHORTLY AFTER THE COMPLETION OF THE FIRST ASSESSMENT, FORMALIZED ITS ROLE TO PROVIDE OVERSIGHT AND DIRECTION TO THE PERIODIC NEEDS-ASSESSMENT PROCESS. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, THE ORGANIZATION IS BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. COMMUNITY HEALTH IMPROVEMENT PARTNERS SCRIPPS IS AN OFFICIAL PARTNER AND AN ACTIVE PARTICIPANT IN COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP). THROUGH CHIP, MORE THAN 25 COMMUNITY HEALTH-RELATED ORGANIZATIONS COME TOGETHER TO JOINTLY ADDRESS THE COUNTY'S HEALTH NEEDS. SCRIPPS WORKS WITH CHIP AND OTHER HEALTH CARE SYSTEMS AND PARTNERS TO DEVELOP A COMPREHENSIVE COUNTY HEALTH NEEDS ASSESSMENT, UPDATED EVERY THREE YEARS, INCLUDING COUNTY, STATE AND NATIONAL HEALTH STATISTIC COMPARISONS. THE COLLABORATIVE ASSESSMENT PROCESS IS ONE OF THE MOST RESPECTED IN CALIFORNIA. CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY "CHARTING THE COURSE VI," CHIP'S 2010 HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY, BUILDS ON THE WORK DONE IN THE FIVE PREVIOUS ASSESSMENTS IN 1995, 1998, 2001, 2004 AND 2007. THE CHIP HEALTH NEEDS ASSESSMENTS MONITOR CHANGES AND TRENDS IN HEALTH STATUS AMONG SAN DIEGO COUNTY RESIDENTS. THIS INFORMATION PROVIDES THE BASIS UPON WHICH PROGRAMS AND INTERVENTIONS CAN BE TARGETED, DEVELOPED AND EVALUATED, WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY AND ITS MEMBERS. IN ADDITION TO FULFILLING LEGISLATIVE REQUIREMENTS, "CHARTING THE COURSE VI" PROVIDES A RESOURCE FOR INDIVIDUALS, AGENCIES AND INSTITUTIONS TO IDENTIFY COMMUNITY HEALTH NEEDS AND CONCERNS. IT IS AVAILABLE VIA THE CHIP WEBSITE (WWW.SDCHIP.ORG).
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI LINE 3 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 CHARITY CARE POLICY. HOSPITAL CARE CAN BE EXPENSIVE AND IS OFTEN UNEXPECTED. TO HELP MEET THE NEEDS OF LOW-INCOME UNINSURED AND UNDERINSURED PATIENTS WHO USE SCRIPPS HOSPITALS, SCRIPPS HAS A PATIENT FINANCIAL ASSISTANCE POLICY CONSISTENT WITH CALIFORNIA AB774 "FAIR PRICING POLICY" LEGISLATION, CHAPTERED IN 2006. FOLLOWING PRINCIPLES AND GUIDELINES SET BY THE AMERICAN HOSPITAL ASSOCIATION AND THE CALIFORNIA HOSPITAL ASSOCIATION, THE POLICY ESTABLISHES STANDARDS FOR CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES AND LOW-INCOME PATIENT ASSISTANCE THROUGH DISCOUNTED HOSPITAL CHARGES. SCRIPPS ACTIVELY SCREENS, MONITORS AND IDENTIFIES PATIENT ACCOUNTS THAT MAY BENEFIT FROM FINANCIAL ASSISTANCE, PROVIDES COUNSELING, INFORMATION AND LANGUAGE INTERPRETATION AND MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING FINANCIAL OBLIGATIONS. WHEN NECESSARY, SCRIPPS ALSO HELPS PATIENTS UNDERSTAND AND PARTICIPATE IN FINANCIAL ASSISTANCE OPTIONS. THIS INCLUDES BILLING STATEMENTS THAT ALERT PATIENTS TO THE AVAILABILITY OF ASSISTANCE AS WELL AS LIMITS ON ACCOUNT COLLECTION ACTIVITIES. (SCRIPPS DOES NOT, FOR EXAMPLE, APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS.) ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON AN EVALUATION OF INCOME AND EXPENSE INFORMATION. FOR LOW-INCOME, UNINSURED PATIENTS EARNING LESS THAN 200 PERCENT OF THE FEDERAL POVERTY GUIDELINES (FPG), SCRIPPS FULLY FORGIVES THE ENTIRE BILL. FOR INDIVIDUALS WHO EARN BETWEEN 201-400 PERCENT OF THE FPG, FINANCIAL ASSISTANCE IS BASED ON A SCHEDULE WITH SHARE-OF-COST DISCOUNTS. SCRIPPS POSTS A SUMMARY OF ITS CHARITY CARE POLICY ON THE SCRIPPS WEB SITE AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE FINANCIAL ASSISTANCE POLICY IS IN WRITTEN FORM TO GUIDE AND DIRECT STAFF AND EFFECTIVELY COMMUNICATES HOW OUR COMMITMENT WILL BE APPLIED CONSISTENTLY TO ALL PATIENTS. THE POLICY INITIALLY ESTABLISHED IN 2001 WAS REVISED TO BE CONSISTENT WITH AB774 "FAIR PRICING POLICY" LEGISLATION. THE PRACTICES ESTABLISHED IN THE POLICY REFLECT SCRIPPS' CONTINUING COMMITMENT TO ASSISTING LOW-INCOME UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES. POLICY HIGHLIGHTS INCLUDE: - SCRIPPS HEALTH WILL RESPECT THE DIGNITY OF EACH PATIENT, ACT ETHICALLY IN ALL PATIENT FINANCIAL MATTERS AND COMMUNICATE EFFECTIVELY TO ASSIST PATIENTS IN RESOLVING THEIR FINANCIAL OBLIGATIONS. EVERY REASONABLE EFFORT IS MADE TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES. SCRIPPS FINANCIAL ASSISTANCE IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD PARTY COVERAGE INCLUDING MEDICARE. - FINANCIAL ASSISTANCE INFORMATION IS POSTED IN CONSPICUOUS REGISTRATION AREAS INCLUDING THE EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION, AND ANCILLARY SERVICE LOCATIONS. PATIENT ACCOUNTS THAT MAY BENEFIT FROM FINANCIAL ASSISTANCE ARE ACTIVELY SCREENED, MONITORED AND IDENTIFIED AS SOON AS POSSIBLE. EVALUATION FOR FINANCIAL ASSISTANCE ELIGIBILITY IS BASED ON THE EVALUATION OF INCOME AND EXPENSE INFORMATION PROVIDED BY THE PATIENT. - SCRIPPS HEALTH WILL WORK TO ASSIST ANY PATIENT UNABLE TO PAY FOR SERVICES, WHO COOPERATIVELY PROVIDES INFORMATION ABOUT HIS/HER ABILITY TO PAY. FAILURE BY THE PATIENT TO COOPERATE MAY RESULT IN THE INABILITY OF THE HOSPITAL TO PROVIDE FINANCIAL ASSISTANCE DETERMINATION. - PATIENTS ARE PROVIDED WITH COUNSELING AND WRITTEN INFORMATION REGARDING FINANCIAL ASSISTANCE. LANGUAGE INTERPRETIVE SERVICES ARE UTILIZED FREE OF CHARGE WHENEVER NECESSARY TO FACILITATE THE PATIENTS UNDERSTANDING AND PARTICIPATION IN FINANCIAL ASSISTANCE OPTIONS. - FINANCIAL ASSISTANCE APPLIES TO INDIVIDUALS WHOSE FAMILY INCOME LEVEL IS 400 PERCENT OF THE FEDERAL POVERTY GUIDELINES OR BELOW. DETERMINATION IS MADE ON AN ALL OR PARTIAL BASIS USING THE APPROVED DISCOUNT SCHEDULE.
COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES. (E.G., URBAN, SUBURBAN, RURAL), THE COMMUNITY OR COMMUNITIES (E.G., POPULATION, AVERAGE INCOME, PERCENTAGES OF COMMUNITY RESIDENTS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE, PERCENTAGE OF THE HOSPITAL'S AND COMMUNITY'S PATIENTS WHO ARE UNINSURED OR MEDICAID RECIPIENTS), THE NUMBER OF OTHER HOSPITALS SERVING THE COMMUNITY OR COMMUNITIES, AND WHETHER ONE OR MORE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE COMMUNITY. MEETING THE CHALLENGES OF A DIVERSE BORDER COMMUNITY SAN DIEGO COUNTY IS AN INTERNATIONAL BORDER COMMUNITY COMPRISED OF 3.2 MILLION PEOPLE. GEOGRAPHICALLY DISPERSED OVER 4,300 SQUARE MILES, THE POPULATION REPRESENTS MULTIPLE ETHNIC GROUPS. THE SAN DIEGO ASSOCIATION OF GOVERNMENT'S (SANDAG) POPULATION GROWTH PROJECTIONS ARE JUST OVER 1 PERCENT PER YEAR, EXTENDING OUT 25 YEARS TO THE YEAR 2030. THE SANDAG 2050 SUB-REGIONAL GROWTH FORECAST PROJECTS POPULATION GROWTH TO 4.4 MILLION BY 2050. THIS IS A 40.0% INCREASE IN POPULATION GROWTH. DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE BASED ON SANDAG 2010 ESTIMATES AND ARE AVAILABLE AT THE ZIP CODE LEVEL AT HTTP://DATAWAREHOUSE.SANDAG.ORG. A BREAKDOWN OF THE REGIONAL DEMOGRAPHICS CAN BE FOUND IN THE REGIONAL FORUM SECTIONS OF THE CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY (APPENDIX SECTION) HTTP://WWW.SDCHIP.ORG. SCRIPPS SERVES A QUARTER OF THE TOTAL COUNTY POPULATION, CONCENTRATING SERVICES IN THE NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTH REGIONS OF SAN DIEGO COUNTY WHERE SCRIPPS FACILITIES ARE LOCATED. SCRIPPS MERCY HOSPITAL (INCLUDING SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 67 PERCENT OF THE CHARITY CARE WITHIN THE SCRIPPS SYSTEM. SCRIPPS MERCY'S SERVICE AREA HAS A MORE ECONOMICALLY DISADVANTAGED POPULATION COMPARED TO THE COUNTY AS A WHOLE, WITH THE LOWEST NUMBERS OF INSURED ADULTS IN THE COUNTY AND A MUCH HIGHER PERCENTAGE OF ETHNIC MINORITIES, PRIMARILY HISPANIC AND ASIAN. AS A DISPROPORTIONATE-SHARE HOSPITAL, SCRIPPS MERCY SAN DIEGO AND CHULA VISTA CAMPUSES PLAY IMPORTANT HEALTH CARE SERVICE ROLES IN THE CENTRAL/SOUTHERN SAN DIEGO COUNTY SERVICE AREA (RANGING FROM INTERSTATE 8 TO THE UNITED STATES-MEXICO BORDER). MORE THAN HALF OF SCRIPPS MERCY SAN DIEGO AND CHULA VISTA PATIENTS ARE GOVERNMENT INSURED-MEDICARE AND MEDI-CAL. SCRIPPS HOSPITALS HOUSE 26.0 PERCENT OF THE COUNTY'S GENERAL ACUTE-CARE LICENSED BEDS. SCRIPPS PROVIDES SIGNIFICANT AND GROWING VOLUMES OF EMERGENCY, OUTPATIENT AND PRIMARY CARE. IN FY11, SCRIPPS PROVIDED 2.1 MILLION OUTPATIENT VISITS. ALMOST HALF (43.7 PERCENT) OF SAN DIEGO SAFETY NET DISCHARGES ARE FROM CENTRAL AND SOUTH SUBURBAN REGIONS. SAFETY NET DISCHARGES INCLUDE COUNTY INDIGENT PROGRAMS, MEDI-CAL AND SELF PAY. COUNTY SAFETY NET DISCHARGES CY10: - CENTRAL DISCHARGES - 17,493 - SOUTH SUBURBAN DISCHARGES - 13,404 SCRIPPS OSHPD SAFETY NET DISCHARGES CY10: - SCRIPPS CENTRAL DISCHARGES - 5,359 - SCRIPPS SOUTH SUBURBAN DISCHARGES - 4,252 COUNTY OVERVIEW ACCESS TO MEDICAL CARE IS CRUCIAL TO THE WELL-BEING OF INDIVIDUALS AND THE SAN DIEGO COMMUNITY AS A WHOLE. THERE ARE MANY BARRIERS TO CARE FOR THE SAFETY NET POPULATION THAT PREVENT THEM FROM OBTAINING MUCH NEEDED MEDICAL SERVICES. LACK OF INSURANCE IS A PRIMARY BARRIER, AS EVIDENCED BY THE 17.2 PERCENT OF ADULTS AGE 19-64 (EXCLUDING MEDICARE AND MILITARY) WHO LACK HEALTH INSURANCE IN SAN DIEGO COUNTY. THE CALIFORNIA HEALTHCARE FOUNDATION (CHCF) REPORTED ESTIMATES THAT 21% OF STATE RESIDENTS HAD NO INSURANCE IN 2010, THE SAME PERCENTAGES OF 2009 BUT UP FROM 19.3% IN 2000. CALIFORNIA HAD THE HIGHEST NUMBER OF UNINSURED RESIDENTS IN THE NATION AT 6.9 MILLION - A FUNCTION OF IT BEING THE MOST POPULOUS STATE IN THE U.S.- AND THE EIGHTH HIGHEST PERCENTAGE AMONG STATES. CALIFORNIA'S HIGH RATE OF UNINSURED RESIDENTS IS ATTRIBUTABLE TO SEVERAL FACTORS, INCLUDING A STEADY DECLINE IN EMPLOYER-BASED HEALTH COVERAGE. THE CHCF REPORT NOTED THAT "THE PERCENTAGE OF CALIFORNIANS WHO OBTAIN THEIR INSURANCE THROUGH THEIR JOB HAS CONTINUED TO FALL," DECLINING FROM 61.9% IN 2000 TO 53% IN 2010. DURING THE SAME TIME PERIOD, THE PERCENTAGE OF STATE RESIDENTS COVERED BY MEDI-CAL INCREASED FROM 13.3% IN 2000 TO 19.3% IN 2010. INCOME WAS ALSO A FACTOR, WITH 35.1% OF STATE RESIDENTS WITH ANNUAL INCOMES UNDER $25,000 LACKING INSURANCE. BUT EVEN MORE AFFLUENT RESIDENTS WERE NOT IMMUNE, WITH 18.3% OF RESIDENTS WITH HOUSEHOLD INCOMES BETWEEN $50,000 AND $75,000 GOING WITHOUT HEALTH INSURANCE IN 2010. THE RATES OF UNINSURED RESIDENTS IN THE STATE COULD DECLINE IN 2011 AS MORE ADULTS WITHOUT INSURANCE FIND COVERAGE THROUGH THE STATE'S BRIDGE TO REFORM PROGRAM. SINCE THE START OF 2011, A DOZEN COUNTIES HAVE LAUNCHED LOW-INCOME HEALTH PLANS TO COVER UNINSURED ADULTS WHO DO NOT QUALIFY FOR MEDI-CAL, PROVIDING COVERAGE FOR MORE THAN 200,000 RESIDENTS (CALIFORNIA HEALTHCARE FOUNDATION. CALIFORNIA HEALTH CARE ALMANAC, DECEMBER 2011). ACCORDING TO A 2006 SAN DIEGO COUNTY HEALTH CARE SAFETY NET STUDY, NEARLY ONE-THIRD OF SAN DIEGO COUNTY'S POPULATION (909,661) IS UNINSURED OR UNDERINSURED, WITH THE HIGHEST CONCENTRATION - HALF OF THE TOTAL - SOUTH OF INTERSTATE 8. THE HOSPITALS AND COMMUNITY CLINICS THAT PROVIDE HEALTH CARE TO THIS POPULATION COMPRISE THE SAFETY NET. SINCE SAN DIEGO COUNTY DOES NOT OPERATE A PUBLIC HOSPITAL, THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO PROVIDE CARE TO UNINSURED AND MEDICALLY UNDERSERVED POPULATIONS. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE CURRENT SAFETY NET IS A CRITICAL POLICY CHALLENGE. THE SAN DIEGO COUNTY HEALTH CARE SAFETY NET STUDY FOUND THAT THE CENTRAL AND SOUTH REGIONS HAVE THE LARGEST PROPORTION OF UNINSURED. NORTH CENTRAL HAS THE LEAST NUMBER OF UNINSURED. THE COUNTY HAS 14.3 PERCENT OF ITS POPULATION ON MEDI-CAL (434,936). CENTRAL AND SOUTH REGIONS HAVE THE LARGEST NUMBER OF MEDI-CAL BENEFICIARIES (22.3 AND 19.4 PERCENT, RESPECTIVELY). COMBINED, THE SAFETY NET CONSUMER COMPRISES 29.5 PERCENT OF THE POPULATION (907,661). WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ARE LEFT TO ABSORB THE COST INVOLVED IN CARING FOR UNINSURED PATIENTS INTO THEIR OPERATING BUDGETS. THE FINANCIAL BURDEN PLACED ON HOSPITALS AND PHYSICIANS CARING FOR UNINSURED PATIENTS IS SIGNIFICANT. SAN DIEGO MEDI-CAL REIMBURSEMENT IS AMONG THE LOWEST IN CALIFORNIA, ALREADY THE STATE WITH THE NATION'S LOWEST MEDICAID REIMBURSEMENT RATE.
PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 PROVIDE ANY OTHER IMPORTANT INFORMATION TO DESCRIBING HOW THE ORGANIZATION'S HOSPITALS OR 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). FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE, NOT-FOR-PROFIT COMMUNITY HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS A HALF-MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF MORE THAN 2,563 AFFILIATED PHYSICIANS AND 13,323 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIAN OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. SCRIPPS IS A RECOGNIZED LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE AND IS AT THE FOREFRONT OF CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. AS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, SCRIPPS TAKES PRIDE IN ITS SERVICE TO THE COMMUNITY. THE SCRIPPS SYSTEM IS GOVERNED BY A 14-MEMBER VOLUNTEER BOARD OF TRUSTEES. THIS SINGLE POINT OF AUTHORITY FOR ORGANIZATIONAL POLICY ENSURES A UNIFIED APPROACH TO SERVING PATIENTS ACROSS THE REGION. THE BOARD IS RESPONSIBLE FOR PROMOTING CORPORATE PURSUIT OF ITS MISSION, APPROVAL OF THE BUDGET AND ASSURING THROUGH OVERSIGHT THE EFFECTIVE FUNCTIONING OF THE CORPORATION. ITS PURPOSE IS TO ESTABLISH AND MAINTAIN A NONPROFIT PUBLIC BENEFIT CORPORATION ORGANIZED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES, WHOSE ACTIVITIES ARE CONDUCTED IN SUCH A MANNER THAT NO PART OF ITS NET EARNINGS WILL BENEFIT OF ANY TRUSTEE, OFFICER OR OTHER INDIVIDUAL. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL SYSTEM IN THEIR OVERSIGHT ROLE, PARTICIPATION IN VARIOUS BOARD COMMITTEES AND GENERAL STEWARDSHIP. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES HAVE AN OPEN MEDICAL STAFF FOR ALL QUALIFIED PHYSICIANS. THE BOARD OF TRUSTEES HAS AUTHORITY TO APPROVE BYLAWS, RULES AND REGULATIONS FOR THE MEDICAL STAFF OF EACH HOSPITAL, SURGERY CENTER OR SIMILAR FACILITY, AND TO APPOINT, SUSPEND OR REMOVE ANY PHYSICIAN FROM THE MEDICAL STAFF. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES PARTICIPATE IN MEDI-CAL AND MEDICARE CONTRACTS. SCRIPPS SURPLUS FUNDS ARE REINVESTED BACK INTO THE SAN DIEGO COMMUNITY. SURPLUS FUNDS ARE UTILIZED FOR NEW FACILITIES, EQUIPMENT, SEISMIC RETROFITTING, PROFESSIONAL EDUCATION AND HEALTH RESEARCH, ACCESS TO PATIENT CARE AND COMMUNITY BENEFIT PROGRAMS. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH AND MEDICAL EDUCATION PROGRAMS. DURING FY11 (OCTOBER 2010 TO SEPTEMBER 2011), SCRIPPS INVESTED $35,486,538 IN PROFESSIONAL TRAINING PROGRAMS AND HEALTH RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES FOR SAN DIEGO COUNTY. QUALITY HEALTH CARE DEPENDS ON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WOULD BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH THROUGH THE DEVELOPMENT OF NEW AND INNOVATIVE TREATMENT OPTIONS. PROFESSIONAL EDUCATION AND HEALTH RESEARCH REFLECTS CLINICAL RESEARCH, AS WELL AS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. RESEARCH TAKES PLACE PRIMARILY AT SCRIPPS CLINICAL RESEARCH SERVICES, SCRIPPS WHITTIER DIABETES INSTITUTE, SCRIPPS GENOMIC MEDICINE AND SCRIPPS TRANSLATIONAL SCIENCE INSTITUTE. CALCULATIONS ARE BASED ON TOTAL PROGRAM EXPENSES LESS APPLICABLE DIRECT-OFFSETTING REVENUE. EXPENSES ARE NOT OFFSET BY GRANT REVENUE OR RESTRICTED FUNDS ACCORDING TO THE SCHEDULE H 990 IRS GUIDELINES. A LACK OF HEALTH INSURANCE AND ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS ARE TWO OF THE PRIMARY BARRIERS TO HEALTH CARE ON BOTH A LOCAL AND NATIONAL LEVEL. WITHOUT ACCESS TO BASIC HEALTH CARE SERVICES, INDIVIDUALS SUFFER FROM MORE ACUTE EPISODES OF ILLNESS, INJURY AND MORTALITY. LACK OF INSURANCE ALSO INCREASES THE BURDEN ON HOSPITALS AND HEALTH PROVIDERS. IN AN EFFORT TO PROVIDE FOR POPULATIONS IN NEED, SCRIPPS ASSISTED IN FY11 WITH THE FOLLOWING HEALTH CARE PROGRAMS AND PROJECTS. MERCY OUTREACH SURGICAL TEAM (MOST) REACHING OUT TO THOSE WHO HAVE LIMITED ACCESS TO HEALTH CARE, THE MERCY OUTREACH SURGICAL TEAM (MOST) PROVIDES MEDICAL AND SURGICAL CARE TO UNDERPRIVILEGED CHILDREN AND ADULTS FROM OTHER COUNTRIES. THE VOLUNTEER GROUP OF PHYSICIANS, NURSES, TECHNICIANS AND OTHERS PERFORM LIFE-CHANGING SURGERIES TO CORRECT CLEFT LIPS, CLEFT PALATES, BURN SCARS, CROSSED EYES, HERNIAS AND A VARIETY OF OTHER CONDITIONS. DURING FY11, THE MOST TEAM SERVED 233 INDIVIDUALS. GRADUATE MEDICAL EDUCATION STAFF SUPPORT TO ST. VINCENT DE PAUL VILLAGE MEDICAL CENTER AND MID-CITY COMMUNITY CLINICS THE GRADUATE MEDICAL EDUCATION (GME) PROGRAM AT SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC FOCUSES ON PHYSICIAN TRAINING AND CLINICAL RESEARCH, WITH 28 RESIDENTS AND 37 FELLOWS. THE PROGRAM ALSO GIVES BACK TO THE COMMUNITY BY STAFFING EVENING CLINICS AT ST. VINCENT DE PAUL VILLAGE AND THE MID-CITY COMMUNITY CLINIC, WHERE SCRIPPS RESIDENTS AND STAFF PROVIDED MEDICAL CARE TO APPROXIMATELY 295 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS DURING FY11. SCRIPPS HEALTH COMMUNITY BENEFIT GRANTING IN 2011, SCRIPPS AWARDED A TOTAL OF $215,000 IN SEVEN COMMUNITY GRANTS TO PROGRAMS BASED THROUGHOUT SAN DIEGO, RANGING FROM $10,000 TO $120,000 EACH. THE PROJECTS THAT RECEIVED FUNDING ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH-PRIORITY HEALTH NEEDS WITH THE GOAL OF IMPROVING ACCESS TO VITAL HEALTH CARE SERVICES FOR A VARIETY OF AT-RISK POPULATIONS, INCLUDING PEOPLE WHO ARE HOMELESS, ECONOMICALLY DISADVANTAGED, AND MENTALLY ILL. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $2.2 MILLION DOLLARS.
AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 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. SCRIPPS HEALTH IS AN INTEGRATED HEALTH SYSTEM, OPERATING FIVE ACUTE CARE HOSPITALS AND TWENTY-TWO OUT PATIENT CLINICS IN SAN DIEGO COUNTY. IN ADDITION, SCRIPPS HEALTH IS THE PARENT ORGANIZATION OF THE WHITTIER INSTITUTE OF DIABETES WHICH OFFERS IMPROVED QUALITY OF LIFE FOR INDIVIDUALS WITH DIABETES THROUGH INNOVATIVE EDUCATION PROGRAMS, CLINICAL CARE, RESEARCH AND COLLABORATION THAT PURSUES PREVENTION AND A CURE.
STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 California. Scripps Health Community Benefit Report can be found at: http://www.scripps.org/about-us__scripps-in-the-community
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
SCRIPPS HEALTH
 
Employer identification number
95-1684089
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) Infoline of San Diego CountyPO Box 881307
SAN DIEGO,CA92018 		33-1029843 501(c)(3) 15,000       PROGRAM SUPPORT
(2) Partnership for Smoke Free Families3020 Childrens Way
SAN DIEGO,CA92123 		95-3545901 501(c)(3) 15,000       PROGRAM SUPPORT
(3) Legal Aid Society of San Diego1764 SD Ave Ste 200
SAN DIEGO,CA92110 		98-1869806 501(c)(3) 120,000       PROGRAM SUPPORT
(4) Catholic Charities349 Cedar Street
SAN DIEGO,CA92101 		23-7334012 501(c)(3) 55,000       PROGRAM SUPPORT
(5) California Health Foundation & Trust (CHFT)1215 K ST STE 800
SACRAMENTO,CA95814 		94-1498697 501(c)(3) 1,602,000       CA HOSP FEE PROGRAM














2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
5
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

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













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Description of Organization's Procedures for Monitoring the Use of Grants FORM 990, SCHEDULE I, LINE 2 A SEMI-ANNUAL REPORT AND A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT TO DATE IS REQUIRED. THIS SEMI-ANNUAL REPORT SHALL INCLUDE PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN THE GRANT APPLICATION. A FINAL REPORT IS DUE WITHIN THIRTY (30) DAYS FOLLOWING THE EXPIRATION DATE OF THE GRANT. IN ADDITION TO THE PROGRESS MADE TOWARD MEETING THE OBJECTIVES OUTLINED IN THE GRANT APPLICATION, THE FINAL REPORT SHALL INCLUDE QUANTITATIVE AND QUALITATIVE RESULTS OF THE PROGRAM AGAINST ITS STATED GOALS AND OBJECTIVES. A FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT AGAINST THE BUDGET MUST BE INCLUDED AS PART OF THIS FINAL REPORT.
Schedule I (Form 990) 2010


Additional Data


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

95-1684089
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

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

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) CHRISTOPHER VAN GORDER (i)
(ii)		 1,001,043
0 		420,899
0 		31,179
0 		1,170,401
0 		43,380
0 		2,666,902
0 		0
0
(2) RICHARD ROTHBERGER (i)
(ii)		 612,723
0 		220,562
0 		50,234
0 		114,532
0 		29,112
0 		1,027,163
0 		0
0
(3) RICHARD SHERIDAN (i)
(ii)		 425,277
0 		123,229
0 		26,252
0 		585,282
0 		23,958
0 		1,183,998
0 		0
0
(4) ARNOLD BRENT EASTMAN MD (i)
(ii)		 523,762
0 		160,174
0 		44,653
0 		475,886
0 		53,097
0 		1,257,572
0 		0
0
(5) VICTOR V BUZACHERO (i)
(ii)		 468,464
0 		154,349
0 		19,582
0 		125,674
0 		31,064
0 		799,133
0 		0
0
(6) JUNE KOMAR (i)
(ii)		 464,064
0 		133,286
0 		29,154
0 		583,479
0 		21,892
0 		1,231,875
0 		0
0
(7) LARRY HARRISON (i)
(ii)		 446,327
0 		120,512
0 		91,631
0 		68,144
0 		41,349
0 		767,963
0 		57,497
0
(8) THOMAS GAMMIERE (i)
(ii)		 487,924
0 		114,285
0 		13,316
0 		88,684
0 		28,402
0 		732,611
0 		0
0
(9) GARY FYBEL (i)
(ii)		 471,874
0 		109,081
0 		97,624
0 		66,319
0 		34,865
0 		779,763
0 		58,483
0
(10) ROBIN BROWN (i)
(ii)		 415,853
0 		106,654
0 		27,531
0 		254,642
0 		33,216
0 		837,896
0 		0
0
(11) CARL ETTER (i)
(ii)		 379,595
0 		88,312
0 		70,824
0 		55,687
0 		28,767
0 		623,185
0 		41,489
0
(12) JOHN ENGLE (i)
(ii)		 314,744
0 		97,635
0 		73,452
0 		60,284
0 		22,936
0 		569,051
0 		48,189
0
(13) MARY L CARRAHER (i)
(ii)		 224,256
0 		55,609
0 		39,460
0 		17,937
0 		14,871
0 		352,133
0 		8,137
0
(14) BRIAN ISSELL MD (i)
(ii)		 427,224
0 		77,530
0 		223,122
0 		84,111
0 		16,870
0 		828,857
0 		180,838
0
(15) BARBARA PRICE (i)
(ii)		 371,756
0 		86,540
0 		69,590
0 		62,218
0 		28,635
0 		618,739
0 		45,811
0
(16) CATHY GUIBAL (i)
(ii)		 299,034
0 		14,750
0 		10,283
0 		43,950
0 		19,149
0 		387,166
0 		0
0
(17) DAVID M COHN (i)
(ii)		 282,078
0 		67,479
0 		56,651
0 		47,037
0 		24,428
0 		477,673
0 		35,555
0
(18) MARC A REYNOLDS (i)
(ii)		 307,634
0 		91,627
0 		11,519
0 		62,669
0 		15,404
0 		488,853
0 		0
0
(19) EDWARD NAZARRO (i)
(ii)		 299,845
0 		15,613
0 		10,293
0 		51,358
0 		30,242
0 		407,351
0 		0
0
(20) JOHN E ARMSTRONG (i)
(ii)		 290,347
0 		65,988
0 		18,541
0 		39,952
0 		38,050
0 		452,878
0 		0
0
(21) PATRIC THOMAS (i)
(ii)		 315,605
0 		68,191
0 		23,360
0 		23,068
0 		9,219
0 		439,443
0 		13,141
0
(22) ROBERT T HOFF (i)
(ii)		 310,469
0 		73,553
0 		40,428
0 		33,736
0 		24,828
0 		483,014
0 		18,361
0
(23) GLEN MUELLER (i)
(ii)		 285,523
0 		68,196
0 		28,541
0 		5,399
0 		63,037
0 		450,696
0 		0
0
(24) DANA LAUNER (i)
(ii)		 377,319
0 		51,417
0 		2,446
0 		7,350
0 		22,963
0 		461,495
0 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Supplemental Compensation Information Schedule J, Part I, Line 1 Scripps Health incurs the cost of a membership for a business networking club in San Diego for the Chief Executive Officer. This membership is used 100% for business purposes and accordingly, no part of this benefit is included within the Chief Executive Officer's taxable compensation. The membership fee is $94 per month. CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR W-2.
SEVERANCE PAYMENT Schedule J, Part I, Line 4A THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAY IN CALENDAR YEAR 2010: BRIAN ISSELL, MD - $35,807
SERP Schedule J, Part I, Line 4B SCRIPPS HEALTH SUPPLEMENTAL RETIREMENT PLAN (SERP) PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN KEY EMPLOYEES. IT HAS BEEN CLOSED TO NEW PARTICPANTS SINCE 2001. THE PLAN PROVIDES A BENEFIT DETERMINED BY A FORMULA DRIVEN BY THE EXECUTIVE'S AVERAGE OF THE FIVE HIGHEST YEARS OF PAY AND TAKES INTO CONSIDERATION TENURE AT SCRIPPS HEALTH, AGE AND LIFE EXPECTANCY AND ASSUMES MAXIMUM PARTICIPATION IN OTHER RETIREMENT PROGRAMS. SCRIPPS HEALTH EXECUTIVE BENEFITS PROGRAM PROVIDES A 457F PLAN WITH A FLEXIBLE BENEFIT ALLOWANCE THAT CAN BE USED TO PURCHASE ADDITIONAL INSURANCE COVERAGE FOR CERTAIN EXECUTIVE LEVEL EMPLOYEES. ANY REMAINING BENEFIT ALLOWANCE CAN BE DEPOSITED INTO THE SUPPLEMENTAL ACCUMULATION RETIREMENT ACCOUNT (SARA) WITH A FUTURE VESTING DATE. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE SARA PLAN IN CALENDAR YEAR 2010: MARY L. CARRAHER - $ 8,137 DAVID M. COHN - $ 35,555 JOHN ENGLE - $ 48,189 CARL ETTER - $ 41,489 GARY FYBEL - $ 58,483 LARRY HARRISON - $ 57,497 ROBERT T. HOFF - $ 18,361 BRIAN ISSELL, MD - $180,838 BARBARA PRICE - $ 45,811 PATRIC THOMAS - $ 13,141
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
SCRIPPS HEALTH
 
Employer identification number
95-1684089
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CA STATEWIDE COMMUNITIES DEVELOPMENT AGENCY
  		68-0164610 1309116Y1 03-02-2007 49,995,000 SEE PART V   X   X X  
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033F5A4 08-14-2008 99,830,304 SEE PART V   X   X   X
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033F5L0 08-14-2008 221,230,000 SEE PART V   X   X   X
D CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033FWK2 06-02-2005 40,975,000 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 0 2,010,000 32,160,000 0
2 Amount of bonds defeased . . . . 0 0 0 0
3 Total proceeds of issue . . . . 49,995,000 99,830,304 221,230,000 40,975,000
4 Gross proceeds in reserve funds . . 0 9,904,407 0 0
5 Capitalized interest from proceeds. 0 0 0 0
6 Proceeds in refunding escrow. . . . . 0 0 0 0
7 Issuance costs from proceeds . . . 146,070 0 0 280,659
8 Credit enhancement from proceeds. 0 0 5,544 918,283
9 Working capital expenditures from proceeds . . 0 0 0 0
10 Capital expenditures from proceeds . . 0 0 0 0
11 Other spent proceeds . . 49,848,930 89,925,897 221,224,456 39,776,058
12 Other unspent proceeds. . . 0 0 0 0
13 Year of substantial completion . . . 2005
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X       X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X X  
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X     X X   X  
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X X   X  
b Name of provider . CITIBANK NA
  		 
  		CITIBANK NA
  		 
 
c Term of hedge . . 23.1   23.1 14.3
d Was the hedge superintegrated? .   X       X   X
e Was a hedge terminated? .   X       X   X
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? . X     X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SEE SCHEDULE O    
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

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

95-1684089
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) HG FENTON COMPANY INC SEE PART V 2,435,550 SEE PART V   No
(2) MATTHEW BALOGH SEE PART V 50,289 SEE PART V   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV MARTIN DICKINSON IS ON THE BOARD OF H.G. FENTON COMPANY, INC., A REAL ESTATE COMPANY, FROM WHICH THE ORGANIZATION LEASES LAND AND BUILDINGS AND HAS ENTERED INTO A DEVELOPMENT AGREEMENT. MATTHEW BALOGH, SON-IN-LAW OF BOARD MEMBER GORDON R. CLARK, IS EMPLOYED BY SCRIPPS HEALTH.
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Types of Property
(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 .... X 4 149,840 OPINIONS OF EXPERTS
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles .. X 1 14,560 COST/SELLING PRICE
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 42 6,738,322 COST/SELLING PRICE
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 . X 7 574,037 COST/SELLING PRICE
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 3 11,000 OPINIONS OF EXPERTS
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( EVENT INVENTORY ) X 651 0 0
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
CONTRIBUTIONS REPORTED SCHEDULE M, PART I, COLUMN B THE NUMBER OF TRANSACTIONS, WHICH MOST CLOSELY APPROXIMATES THE NUMBER OF ITEMS CONTRIBUTED IS BEING REPORTED IN COLUMN B. HOWEVER, CONTRIBUTIONS OF EQUIPMENT AND EVENT GIFTS IN KIND INCLUDE MULTIPLE COMPONENTS.
THIRD PARTIES ENGAGED TO SOLICIT, PROCESS AND SELL NON-CASH CONTRIBUTIONS SCHEDULE M, PART I, ITEM 32B SCRIPPS HEALTH USES A NUMBER OF BROKERS AND VENDORS IN THE COURSE OF SOLICITING, PROCESSING AND LIQUIDATING DONATED NON-CASH ASSETS: REAL ESTATE BROKERS: LOCATE BUYER AND NEGOTIATE/CLOSE SALE THROUGH ESCROW; SECURITIES BROKER: RECEIVE DONATED SECURITIES INTO SCRIPPS ACCOUNTS, SELL ASSETS ON SECURITIES MARKET, AND REMIT NET PROCEEDS TO SCRIPPS; TRANSACTION SERVICES PROVIDER: PROVIDE HOSTED WEB SITE SUPPORTING EVENT REGISTRATION, ON-LINE AUCTIONS, AND/OR EVENT ON-SITE AUTOMATED PROCESSING SYSTEM FOR SPECIAL EVENTS; CONSIGNMENT AUCTION HOUSE: ACCEPT GOODS FOR SALE THROUGH AUCTIONS, LOCATE BUYERS, SETTLE PAYMENT WITH BUYERS, AND REMIT NET PROCEEDS TO SCRIPPS HEALTH; DIRECT MAIL SERVICES PROVIDER: PLAN AND SCHEDULE MAILINGS, DESIGN AND PRODUCE COLLATERAL MATERIALS, DELIVER MAIL LIST WITH MATERIALS TO COMMERCIAL MAIL HOUSE, ANALYZE RESULTS, AND PROVIDE GUIDANCE ON FUTURE STRATEGIES.
NON-CASH GIFTS - REVENUE RECOGNITION SCHEDULE M, PART I, ITEM 33 IT IS SCRIPPS HEALTH'S POLICY TO ONLY RECORD CONTRIBUTION REVENUE FOR NON-CASH ITEMS IF THE FAIR MARKET VALUE IS OVER $10,000. GIFTS OF SECURITIES ARE AN EXCEPTION TO THIS POLICY AND ARE RECORDED AS CONTRIBUTION REVENUE ONCE THE SECURITY IS SOLD.
Schedule M (Form 990) 2010
Additional Data


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

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

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

95-1684089
Identifier Return Reference Explanation
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES FORM 990, PART I AND PART III, LINE 1 FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,563 AFFILIATED PHYSICIANS AND 13,323 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY.
FY11 PROGRAM SERVICES ACCOMPLISHMENTS FORM 990, PART III, LINE 4A FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $320,673,826 TO COMMUNITY BENEFIT PROGRAMS AND SERVICES IN THE AREAS OF UNCOMPENSATED CARE, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND HEALTH RESEARCH. OUR PROGRAMS EMPHASIZE COMMUNITY-BASED PREVENTION EFFORTS AND USE INNOVATIVE APPROACHES TO REACH RESIDENTS AT GREATEST RISK FOR HEALTH PROBLEMS. WE MAKE COMMITMENTS TO IMPROVE THE HEALTH OF OUR PATIENTS AND OUR SAN DIEGO COMMUNITIES. AS A LONG-STANDING MEMBER OF THESE COMMUNITIES, AND AS A NOT-FOR-PROFIT COMMUNITY RESOURCE, OUR GOAL AND RESPONSIBILITY ARE TO PROVIDE HELP AND ASSISTANCE FOR ALL WHO COME TO US FOR CARE, AND TO REACH OUT ESPECIALLY TO THOSE WHO FIND THEMSELVES VULNERABLE AND WITHOUT SUPPORT. THIS RESPONSIBILITY IS AN INTRINSIC PART OF OUR MISSION. THROUGH OUR CONTINUED ACTIONS AND COMMUNITY PARTNERSHIPS, WE STRIVE TO RAISE THE QUALITY OF LIFE IN THE COMMUNITY AS A WHOLE. ASSESSING COMMUNITY NEED CALIFORNIA SENATE BILL 697 REQUIRES THE UPDATING OF A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. IDENTIFYING SAN DIEGO COUNTY'S HEALTH PRIORITIES IS A COMPLEX PROCESS OUTLINED IN THE FOLLOWING PAGES. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, WE ARE BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. THE REPORT IS THE SIXTH EDITION OF THE TRIENNIAL NEEDS ASSESSMENT. THE PROJECT WAS INITIALLY UNDERTAKEN BY THE HOSPITAL COUNCIL OF SAN DIEGO AND IMPERIAL COUNTIES IN 1995 TO ASSIST PRIVATE NOT-FOR-PROFIT HOSPITALS TO COMPLY WITH STATE COMMUNITY BENEFIT LEGISLATION SENATE BILL 697 (SB697), WHICH REQUIRED THEM TO CONDUCT A PERIODIC ASSESSMENT OF THE HEALTH NEEDS OF THOSE LIVING IN THEIR SERVICE AREA IN ORDER TO BETTER RESPOND TO THE COMMUNITY'S HEALTH NEEDS. THE GROUP WAS INITIALLY KNOWN AS THE SAN DIEGO COUNTY SB697 COALITION AND ATTENDED BY REPRESENTATIVES FROM OVER 25 HEALTH CARE-RELATED ORGANIZATIONS. THE GOAL OF THE COALITION WAS TO COLLABORATE AND PRODUCE ONE NEEDS ASSESSMENT IN ORDER TO MAXIMIZE RESOURCES AND DEVELOP A MORE COMPREHENSIVE REPORT FOR THE COUNTY OF SAN DIEGO. DURING THE FIVE SUBSEQUENT NEEDS ASSESSMENTS, THE COALITION, RENAMED COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), SHORTLY AFTER THE COMPLETION OF THE FIRST ASSESSMENT, FORMALIZED ITS ROLE TO PROVIDE OVERSIGHT AND DIRECTION TO THE PERIODIC NEEDS ASSESSMENT PROCESS. COMMUNITY HEALTH IMPROVEMENT PARTNERS SCRIPPS IS AN OFFICIAL PARTNER AND AN ACTIVE PARTICIPANT IN COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP). THROUGH CHIP, MORE THAN 25 COMMUNITY HEALTH-RELATED ORGANIZATIONS COME TOGETHER TO JOINTLY ADDRESS THE COUNTY'S HEALTH NEEDS. SCRIPPS WORKS WITH CHIP AND OTHER HEALTH CARE SYSTEMS AND PARTNERS TO DEVELOP A COMPREHENSIVE COUNTY HEALTH NEEDS ASSESSMENT WHICH IS UPDATED EVERY THREE YEARS, INCLUDING COUNTY, STATE AND NATIONAL HEALTH STATISTIC COMPARISONS. THE COLLABORATIVE ASSESSMENT PROCESS IS ONE OF THE MOST RESPECTED IN CALIFORNIA. CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY CHARTING THE COURSE VI IS INTENDED TO HELP FULFILL LEGISLATIVE REQUIREMENTS OF SB 697 AND TO PROVIDE A RESOURCE FOR INDIVIDUALS, AGENCIES AND INSTITUTIONS TO IDENTIFY COMMUNITY HEALTH NEEDS AND CONCERNS. READERS ARE ENCOURAGED TO EXPLORE CHARTING THE COURSE VI TO LEARN MORE ABOUT THE CRITICAL HEALTH ISSUES IMPACTING SAN DIEGO COUNTY RESIDENTS. THIS DOCUMENT PRESENTS A WEALTH OF INFORMATION RELATING THE HEALTH ISSUES TO RACE/ETHNICITY, GENDER, AGE CATEGORY AND GEOGRAPHIC REGION. THE REPORT ALSO MONITORS CHANGES AND TRENDS IN HEALTH STATUS AMONG SAN DIEGO COUNTY RESIDENTS. THIS INFORMATION PROVIDES THE BASIS UPON WHICH COMMUNITY HEALTH PROGRAMS AND INTERVENTIONS CAN BE TARGETED, DEVELOPED AND EVALUATED, WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY AND ITS MEMBERS. TO GAIN A FULL UNDERSTANDING OF SCRIPPS' HEALTH ASSESSMENT AND ANALYSIS OF COMMUNITY NEED IN SAN DIEGO, WE RECOMMEND REVIEWING THE CHIP 2010 "CHARTING THE COURSE VI" SAN DIEGO COUNTY HEALTH NEEDS ASSESSMENT AT HTTP://WWW.SDCHIP.ORG. 2010 PRIORITY SETTING PROCESS ONE OF THE MAJOR FEATURES OF EACH NEEDS ASSESSMENT IS THE REVIEW OF HEALTH ISSUES FELT TO BE IMPACTING THE SAN DIEGO REGION. THESE HEALTH ISSUES ARE EXAMINED FROM A LOCAL (SAN DIEGO COUNTY), STATE AND NATIONAL PERSPECTIVE. THE STARTING POINT FOR THIS PROCESS WAS A REVIEW OF THE 38 HEALTHY PEOPLE 2020 FOCUS AREAS. BECAUSE OF THE LARGE NUMBER AND THE DIVERSITY OF HEALTH ISSUES, THE NEEDS ASSESSMENT COMMITTEE SELECTED 17 OF THESE HEALTH ISSUES FOR ADDITIONAL STUDY AND POSSIBLE INCLUSION IN THIS YEAR'S NEEDS ASSESSMENT. THESE ISSUES WERE SELECTED BASED ON AN EXTENSIVE REVIEW OF THE ISSUES AND A RANKING OF THEIR PERCEIVED IMPORTANCE BY THE NEEDS ASSESSMENT COMMITTEE. THE GOAL OF THE PRIORITY-SETTING PROCESS FOR CHARTING THE COURSE VI WAS TO PROVIDE AN ORGANIZED, OBJECTIVE METHOD OF REVIEWING AND PRIORITIZING THE HEALTH ISSUES FACING SAN DIEGO COUNTY. BECAUSE OF THE LARGE NUMBER AND THE DIVERSITY OF HEALTH ISSUES, THE NEEDS ASSESSMENT COMMITTEE SELECTED 17 OF THESE HEALTH ISSUES FOR ADDITIONAL STUDY AND POSSIBLE INCLUSION IN THIS YEAR'S NEEDS ASSESSMENT. THESE ISSUES WERE DIVIDED INTO THREE CATEGORIES: - OVERARCHING ISSUES (4 ISSUES) - CONSIDERED OVERARCHING BECAUSE THEY POTENTIALLY IMPACT ALL OF THE OTHER ISSUES IN THIS REPORT. THESE INCLUDED: O ACCESS TO HEALTH SERVICES O HEALTH COMMUNICATIONS AND HEALTH INFORMATION TECHNOLOGY O PUBLIC HEALTH INFRASTRUCTURE O SOCIAL DETERMINANTS OF HEALTH - HEALTH-RELATED BEHAVIORS (7 ISSUES) - BEHAVIORS THAT ARE IMPORTANT COMPONENTS IN LONG-TERM HEALTH, SUCH AS: O IMMUNIZATION O SMOKING CESSATION O IMPROVING NUTRITION O INCREASING PHYSICAL ACTIVITY O ACHIEVING A HEALTHY WEIGHT STATUS O ORAL HEALTH O VIOLENCE AND INJURY PREVENTION - HEALTH OUTCOMES (7 ISSUES) - LOOKS AT THE CHANGE IN THE HEALTH STATUS OF THE POPULATION AND VARIOUS DEMOGRAPHIC GROUPS OVER TIME RELATED TO: O CANCER O DIABETES O HEART DISEASE AND STROKE O INFECTIOUS DISEASES O MATERNAL, INFANT AND CHILD HEALTH O MENTAL HEALTH O RESPIRATORY DISEASES TO HELP NARROW THE NUMBER OF HEALTH ISSUES, 379 COMMUNITY LEADERS FROM THROUGHOUT SAN DIEGO COUNTY WERE INVITED TO PRIORITIZE EACH ISSUE BASED ON THE FOLLOWING FOUR CRITERIA: 1. WHAT IS THE SIZE OF THE HEALTH ISSUE IN SAN DIEGO COUNTY? 2. WHAT IS THE SERIOUSNESS OF THE HEALTH ISSUE IN SAN DIEGO COUNTY? 3. WHAT COMMUNITY RESOURCES ARE CURRENTLY AVAILABLE TO ADDRESS THE HEALTH ISSUE? 4. HOW MUCH DATA OR INFORMATION DO WE HAVE TO EVALUATE THE HEALTH ISSUE'S OUTCOME? PARTICIPANTS IN THIS PRIORITY-SETTING PROCESS WERE ASKED TO REVIEW THE INFORMATION FOR EACH HEALTH ISSUE COVERED IN A BRIEFING DOCUMENT, PROVIDE THEIR RATINGS FROM THEIR PERSPECTIVE AND WEIGH EACH ISSUE USING THE INFORMATION PROVIDED ALONG WITH THEIR KNOWLEDGE OF THE HEALTH ISSUE. OVERALL, 72 COMMUNITY LEADERS PARTICIPATED IN THE PRIORITY SETTING PROCESS. BASED ON INPUT FROM THIS PRIORITY-SETTING PROCESS, THE NEEDS ASSESSMENT COMMITTEE SELECTED FIVE HEALTH ISSUES FOR THE FOCUS OF CHARTING THE COURSE IV. - ACCESS TO HEALTH SERVICES - SOCIAL DETERMINANTS OF HEALTH - WEIGHT STATUS AND PHYSICAL ACTIVITY - INJURY AND VIOLENCE - MENTAL HEALTH CHARTING THE COURSE VI CONTAINS AN IN-DEPTH REVIEW OF THESE FIVE HEALTH ISSUES ABOVE ALONG WITH THE PRIORITY-SETTING PROCESS USED TO SELECT THESE ISSUES AND THE BACKGROUND INFORMATION RELATED TO 17 ADDITIONAL ISSUES REVIEWED AS PART OF THE PRIORITY-SETTING PROCESS. IN ADDITION, INFORMATION IS PRESENTED RELATED TO THE COMMUNITY FORUMS HELD IN EACH OF THE SIX REGIONS OF SAN DIEGO COUNTY TO GAIN INSIGHTS INTO THE HEALTH ISSUES OF WEIGHT STATUS, MENTAL HEALTH, AND INJURY AND VIOLENCE, AND TO BEGIN THE PROCESS OF IDENTIFYING SOME OF THE ROOT CAUSES RELATED TO THESE ISSUES.
MEETING THE CHALLENGES OF A DIVERSE BORDER COMMUNITY   SAN DIEGO COUNTY IS AN INTERNATIONAL BORDER COMMUNITY COMPRISED OF 3.2 MILLION PEOPLE. GEOGRAPHICALLY DISPERSED OVER 4,300 SQUARE MILES, THE POPULATION REPRESENTS MULTIPLE ETHNIC GROUPS. THE SAN DIEGO ASSOCIATION OF GOVERNMENT'S (SANDAG) POPULATION GROWTH PROJECTIONS ARE JUST OVER 1 PERCENT PER YEAR, EXTENDING OUT 25 YEARS TO THE YEAR 2030. THE SANDAG 2050 SUB-REGIONAL GROWTH FORECAST PROJECTS POPULATION GROWTH TO 4.4 MILLION BY 2050. THIS IS A 40.0% INCREASE IN POPULATION GROWTH. DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE BASED ON SANDAG 2010 ESTIMATES AND ARE AVAILABLE AT THE ZIP CODE LEVEL AT HTTP://DATAWAREHOUSE.SANDAG.ORG. A BREAKDOWN OF THE REGIONAL DEMOGRAPHICS CAN BE FOUND IN THE REGIONAL FORUM SECTIONS OF THE CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY (APPENDIX SECTION) HTTP://WWW.SDCHIP.ORG. SCRIPPS SERVES A QUARTER OF THE TOTAL COUNTY POPULATION, CONCENTRATING SERVICES IN THE NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTH REGIONS OF SAN DIEGO COUNTY WHERE SCRIPPS FACILITIES ARE LOCATED. COUNTY OVERVIEW ACCORDING TO A 2006 SAN DIEGO COUNTY HEALTHCARE SAFETY NET STUDY, NEARLY ONE-THIRD OF SAN DIEGO COUNTY'S POPULATION (909,661) IS UNINSURED OR UNDERINSURED, WITH THE HIGHEST CONCENTRATION - HALF OF THE TOTAL - SOUTH OF INTERSTATE 8. THE HOSPITALS AND COMMUNITY CLINICS THAT PROVIDE HEALTH CARE TO THIS POPULATION ARE THE SAFETY NET. THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO PROVIDE CARE TO UNINSURED AND MEDICALLY UNDERSERVED POPULATIONS. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE CURRENT SAFETY NET IS A CRITICAL POLICY CHALLENGE. WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ARE LEFT TO ABSORB THE COST INVOLVED IN CARING FOR THE UNINSURED IN THEIR OPERATING BUDGETS. THE FINANCIAL BURDEN PLACED ON HOSPITALS AND PHYSICIANS TO CARE FOR UNINSURED PATIENTS IS SIGNIFICANT. SAN DIEGO HAS EXPERIENCED A BRIEF IMPROVEMENT IN THE NUMBER OF INSURED RESIDENTS FROM 2003 TO 2009. AT THAT TIME, 17.2 PERCENT OF THE ADULT (19 TO 64 & NON-MILITARY) POPULATION IN SAN DIEGO COUNTY LACKS HEALTH INSURANCE COVERAGE. THE CALIFORNIA HEALTHCARE FOUNDATION (CHCF) REPORTED ESTIMATES OF 21% OF STATE RESIDENTS HAD NO INSURANCE IN 2010, THE SAME PERCENTAGES OF 2009 BUT UP FROM 19.3% IN 2000. CALIFORNIA HAD THE HIGHEST NUMBER OF UNINSURED RESIDENTS IN THE NATION AT 6.9 MILLION - A FUNCTION OF IT BEING THE MOST POPULOUS STATE IN THE U.S.- AND THE EIGHTH HIGHEST PERCENTAGE AMONG STATES. CALIFORNIA'S HIGH RATE OF UNINSURED RESIDENTS IS ATTRIBUTABLE TO SEVERAL FACTORS, INCLUDING A STEADY DECLINE IN EMPLOYER-BASED HEALTH COVERAGE. THE CHCF REPORT NOTED THAT "THE PERCENTAGE OF CALIFORNIANS WHO OBTAIN THEIR INSURANCE THROUGH THEIR JOB HAS CONTINUED TO FALL," DECLINING FROM 61.9% IN 2000 TO 53% IN 2010. DURING THE SAME TIME PERIOD, THE PERCENTAGE OF STATE RESIDENTS COVERED BY MEDI-CAL INCREASED FROM 13.3% IN 2000 TO 19.3% IN 2010. INCOME WAS ALSO A FACTOR, WITH 35.1% OF STATE RESIDENTS WITH ANNUAL INCOMES UNDER $25,000 LACKING INSURANCE. BUT EVEN MORE AFFLUENT RESIDENTS WERE NOT IMMUNE, WITH 18.3% OF RESIDENTS WITH HOUSEHOLD INCOMES BETWEEN $50,000 AND $75,000 GOING WITHOUT HEALTH INSURANCE IN 2010. THE RATES OF UNINSURED RESIDENTS IN THE STATE COULD DECLINE IN 2011 AS MORE ADULTS WITHOUT INSURANCE FIND COVERAGE THROUGH THE STATE'S BRIDGE TO REFORM PROGRAM. SINCE THE START OF 2011, A DOZEN COUNTIES HAVE LAUNCHED LOW-INCOME HEALTH PLANS TO COVER UNINSURED ADULTS WHO DON'T QUALIFY FOR MEDI-CAL, PROVIDING COVERAGE FOR MORE THAN 200,000 RESIDENTS. LAST YEAR CALIFORNIA HOSPITALS PROVIDED MORE THAN $12.5 BILLION IN UNCOMPENSATED CARE IN 2010 ACCORDING TO THE CALIFORNIA HOSPITAL ASSOCIATION. OF THAT AMOUNT, MEDICARE AND MEDI-CAL PAYMENTS WERE $8.3 BILLION LESS THAN THE ACTUAL COST OF PROVIDING NECESSARY HEALTH CARE SERVICES, WHILE CHARITY CARE AND BAD DEBTS TOTALED MORE THAN $4 BILLION. THE AVERAGE CALIFORNIA HOSPITAL RECEIVES 68 PERCENT OF ITS REVENUE FROM MEDICARE AND MEDI-CAL; FOR CERTAIN HOSPITALS, THAT NUMBER EXCEEDS 95 PERCENT. FINANCIAL ASSISTANCE ASSISTING LOW-INCOME, UNINSURED PATIENTS THE SCRIPPS FINANCIAL ASSISTANCE POLICY IS CONSISTENT WITH THE AB774 "FAIR PRICING POLICY" LEGISLATION. THE PRACTICES ESTABLISHED REFLECT OUR COMMITMENT WITH RESPECT TO ASSISTING LOW-INCOME, UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES. OUR PROGRAM IS PROVIDED WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION OR NATIONAL ORIGIN. SCRIPPS PROVIDES FULL FINANCIAL ASSISTANCE TO LOW-INCOME AND UNINSURED PATIENTS EARNING LESS THAN 200 PERCENT OF THE FEDERAL POVERTY LEVEL GUIDELINES. FOR INDIVIDUALS WHO QUALIFY BETWEEN 201-400 PERCENT OF THE POVERTY LEVEL, FINANCIAL ASSISTANCE IS BASED ON A DISCOUNT SCHEDULE. FOR 2011, HEALTH AND HUMAN SERVICES DEFINED THE 200 PERCENT FEDERAL POVERTY LEVEL OF A FAMILY OF FOUR AS $44,700. COMMUNITY HEALTH SERVICES COMMUNITY HEALTH SERVICES INCLUDE PREVENTION AND WELLNESS PROGRAMS SUCH AS SCREENINGS, HEALTH EDUCATION, SUPPORT GROUPS AND HEALTH FAIRS, WHICH ARE SUPPORTED BY OPERATIONAL FUNDS, GRANTS, IN-KIND DONATIONS, AND PHILANTHROPY. THESE PROGRAMS ARE DESIGNED TO RAISE PUBLIC AWARENESS, UNDERSTANDING OF AND ACCESS TO IDENTIFIED COMMUNITY HEALTH NEEDS. SCRIPPS CATEGORIZES COMMUNITY HEALTH SERVICES ACCORDING TO THE SCHEDULE H 990 CATEGORIES MANDATED BY THE IRS. IT IS CATEGORIZED INTO FIVE MAIN AREAS: o COMMUNITY HEALTH IMPROVEMENT SERVICES o COMMUNITY BENEFIT OPERATIONS o CASH AND IN-KIND CONTRIBUTIONS o SUBSIDIZED HEALTH SERVICES o COMMUNITY BUILDING ACTIVITIES DURING THIS FISCAL YEAR, SCRIPPS INVESTED $17,272,628 IN COMMUNITY HEALTH SERVICES (INCLUDES SUBSIDIZED HEALTH). THIS FIGURE REFLECTS THE COST ASSOCIATED WITH PROVIDING SUCH ACTIVITIES, INCLUDING SALARIES, MATERIALS AND SUPPLIES, MINUS REVENUE. FOLLOWING ARE HIGHLIGHTS OF JUST SOME OF THE ACTIVITIES CONDUCTED BY SCRIPPS DURING THIS FISCAL YEAR.
ACCESS TO CARE   A LACK OF HEALTH INSURANCE AND ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS ARE TWO OF THE PRIMARY BARRIERS TO HEALTH CARE ON BOTH A LOCAL AND NATIONAL LEVEL. WITHOUT ACCESS TO BASIC HEALTH CARE SERVICES, INDIVIDUALS SUFFER FROM MORE ACUTE EPISODES OF ILLNESS, INJURY AND MORTALITY. IT IS ALSO AN INCREASED BURDEN ON HOSPITALS AND HEALTH PROVIDERS RESULTING FROM PROVIDING UNCOMPENSATED CARE TO THE UNINSURED. RISING RATES OF UNINSURED MAY BE REFLECTED IN HIGHER USE OF EMERGENCY DEPARTMENTS, WHICH BY LAW MUST PROVIDE AT LEAST STABILIZING CARE TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. REVIEW OF THE SAN DIEGO COUNTY ED DISCHARGES BY SOURCE OF PAYMENT BETWEEN 2006 AND 2008 FOUND THE DEMAND OF ED SERVICES INCREASED BY 11.9%, 582,129 AND 651,595 RESPECTIVELY. IN ADDITION, SEVERAL SHIFTS IN PAYOR SOURCES WERE NOTED INCLUDING A DECLINE IN PRIVATE HMO AND WORKER COMPENSATION ED DISCHARGES AND INCREASES IN BOTH SELF PAY AND MEDI-CAL ED DISCHARGES. THE DECLINE IN PRIVATE HMP COVERAGE WAS OFFSET BY A SLIGHT INCREASE IN OTHER PRIVATE INSURANCE. THE INCREASE IN SELF-PAY AND MEDI-CAL DISCHARGES SUGGESTS MORE PATIENTS ARE RELYING ON ED CARE DUE TO LACK OF INSURANCE COVERAGE. IN AN EFFORT TO PROVIDE FOR POPULATIONS IN NEED, SCRIPPS ASSISTED IN FY11 WITH THE FOLLOWING EXAMPLES OF HEALTH CARE PROGRAMS AND PROJECTS. MERCY OUTREACH SURGICAL TEAM (MOST) - THE MERCY OUTREACH SURGICAL TEAM (MOST) WORKS TO MITIGATE THE EFFECTS PHYSICAL DEFORMITIES HAVE ON CHILDREN BY PROVIDING RECONSTRUCTIVE SURGERIES AT NO COST TO CHILDREN IN NEED. THROUGH VOLUNTEERISM, MOST PROVIDES RECONSTRUCTIVE SURGERIES TO MORE THAN 400 CHILDREN (UNDER 18 YEARS OF AGE) WITH PHYSICAL DEFORMITIES CAUSED BY BIRTH DEFECTS OR ACCIDENTS IN MEXICO. IN SPECIAL CIRCUMSTANCES, SURGERIES ALSO ARE PROVIDED FOR ADULTS. DURING FY11, THE MOST TEAM PROVIDED RECONSTRUCTIVE SURGERIES FOR MORE THAN 353 CHILDREN. (SPONSORED BY SCRIPPS MERCY HOSPITAL SAN DIEGO AND AFFILIATED PHYSICIANS). GRADUATE MEDICAL EDUCATION STAFF SUPPORT TO ST. VINCENT DE PAUL VILLAGE MEDICAL CENTER AND MID-CITY COMMUNITY CLINICS - WEEKLY COMMUNITY CLINICS WERE HELD AT THE ST. VINCENT DE PAUL AND MID-CITY COMMUNITY CLINICS. STAFFED BY THE SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC INTERNAL MEDICINE RESIDENTS, THESE CLINICS PROVIDED MEDICAL CARE TO APPROXIMATELY 294 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS DURING FY11. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) FIJI ALLIANCE PROJECT - IN PARTNERSHIP WITH THE INTERNATIONAL RELIEF TEAMS OF SAN DIEGO, THE LOLOMA FOUNDATION, SCRIPPS EMPLOYEES, SCRIPPS CLINIC PHYSICIANS AND OTHER SCRIPPS AFFILIATED PHYSICIANS PROVIDED MEDICAL AND SURGICAL SERVICES IN FIJI TO PERSONS IN NEED. RESIDENTS FROM SCRIPPS CLINIC AND SCRIPPS GREEN HOSPITAL HAVE AN OPPORTUNITY TO PARTICIPATE IN THE MEDICAL MISSIONS AS ONE OF THEIR ROTATIONS. EXAMPLES OF PROCEDURES INCLUDE CLEFT LIP AND PALATE REPAIRS, REPAIRS OF DEFORMITIES OF EYELIDS, FACE AND FEET, BURN SCAR REVISION, BREAST MASSES, DIABETES MANAGEMENT AND HERNIA REPAIRS. ALL SURGICAL SUPPLIES WERE DONATED BY PROFESSIONAL HOSPITAL SUPPLY CORP. (PHS), THE SUPPLIER FOR SCRIPPS HEALTH SYSTEM. THE SUPPLIES INCLUDED SURGICAL GOWNS, GLOVES, DRAPES, DRESSINGS, BANDAGES, SUTURES, ETC. CARDINAL HEALTH SYSTEMS, WHICH PROVIDES PHARMACEUTICALS AND OTHER SUPPLIES TO SCRIPPS HEALTH, DONATED ALL THE MEDICATIONS NECESSARY. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND - IN 2011, SCRIPPS AWARDED A TOTAL OF $215,000 IN COMMUNITY GRANTS TO PROGRAMS BASED THROUGHOUT SAN DIEGO. SCRIPPS AWARDED SIX GRANTS RANGING FROM $10,000 TO $120,000 EACH. THE PROJECTS THAT RECEIVED FUNDING ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH-PRIORITY HEALTH NEEDS WITH THE GOAL OF IMPROVING ACCESS TO VITAL HEALTH CARE SERVICES FOR A VARIETY OF AT-RISK POPULATIONS, INCLUDING THE HOMELESS, ECONOMICALLY DISADVANTAGED, MENTALLY ILL AND OTHERS. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $2.2 MILLION DOLLARS. PROGRAMS FUNDED DURING FY11 INCLUDE: O CB FUND - CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA). FUNDING PROVIDES LOW INCOME UNINSURED MERCY CLINIC PATIENTS' AND BEHAVIORAL HEALTH PATIENTS WHO NEED ASSISTANCE IN OBTAINING HEALTHCARE BENEFITS, SSI AND RELATED SERVICES, WHILE SIMULTANEOUSLY REDUCING UNCOMPENSATED CARE EXPENSES FOR MERCY. THIS PROJECT PROVIDES ADVOCACY SERVICES FOR THE TIME-INTENSIVE GOVERNMENT BENEFIT CASES. (SPONSORED BY SCRIPPS MERCY HOSPITAL ADMINISTRATION). O CB FUND - CATHOLIC CHARITIES - FUNDING AWARDED TO PROVIDE SHORT-TERM EMERGENCY SHELTER TO MEDICALLY FRAGILE HOMELESS PATIENTS BEING DISCHARGED FROM SCRIPPS MERCY HOSPITAL SAN DIEGO AND TO EXPAND TO SCRIPPS MERCY CHULA VISTA. CASE MANAGEMENT AND SHELTER IS PROVIDED FOR PREVIOUSLY HOMELESS PATIENTS DISCHARGED FROM SCRIPPS MERCY HOSPITAL WHO NO LONGER REQUIRE HOSPITAL CARE BUT DO NEED A SHORT-TERM SUPPORTIVE RECUPERATIVE ENVIRONMENT. PATIENTS DEMONSTRATING A READINESS FOR CHANGE ARE ASSISTED WITH ONE WEEK IN A HOTEL ALONG WITH FOOD AND BUS FARE TO PURSUE CASE PLAN. THE FOCUS OF THE CASE MANAGEMENT IS TO STABILIZE THE CLIENT BY HELPING THEM CONNECT TO MORE PERMANENT SOURCES OF INCOME, HOUSING AND ONGOING SUPPORTS FOR EFFORTS TOWARD SELF-RELIANCE. THE GOAL OF THIS PARTNERSHIP IS TO REDUCE THE INCIDENCE OF ER RECIDIVISM IN THIS POPULATION AND IMPROVE THE QUALITY OF LIFE FOR THE PATIENT. O CB FUND - 2-1-1 NEW ACCESS SYSTEM - FUNDING WAS AWARDED FOR 2-1-1 HEALTHCARE NAVIGATION PROGRAM. THERE IS AN OVERWHELMING NEED FOR A DEPENDABLE SERVICE TO ASSIST PEOPLE IN NAVIGATING TODAY'S COMPLEX HEALTHCARE SYSTEM. SINCE THE INCEPTION OF THE HEALTHCARE NAVIGATION PROGRAM, 2-1-1 HAS RESPONDED TO OVER 6,000 CALLS FROM CLIENTS SPECIFICALLY SEEKING HEALTH-RELATED RESOURCES AND 5,726 SELF SELECTED "HEALTH" AS THEIR NEED. 2-1-1 SAN DIEGO IS THE DIALING CODE FOR INFORMATION ABOUT COMMUNITY, HEALTH AND DISASTER SERVICES. IT CONNECTS PEOPLE WITH RESOURCES OVER THE PHONE, ONLINE AND IN PRINT. LOCALLY, 2-1-1 SAN DIEGO WAS LAUNCHED IN JUNE 2005 AS A MULTILINGUAL AND CONFIDENTIAL SERVICE COMMITTED TO PROVIDING ACCESS 24/7. O CB FUND - AMERICAN HEART ASSOCIATION - FUNDING AWARDED FOR THE 2011 HEART WALK CORPORATE SPONSORSHIP. HEART DISEASE AND STROKE ARE THE NUMBER ONE AND NUMBER THREE CAUSES OF DEATH IN THE NATION FOR MEN AND WOMEN. HEART DISEASE IS THE NATION'S LEADING CAUSE OF DEATH, CLAIMING MORE THAN 950,000 AMERICAN LIVES EACH YEAR. SCRIPPS PARTNERS WITH THE AMERICAN HEART ASSOCIATION ON THEIR ANNUAL HEART WALK, TO RAISE FUNDS FOR RESEARCH, PROFESSIONAL AND PUBLIC EDUCATION AND ADVOCACY. O CB FUND - PARTNERSHIP FOR SMOKE-FREE FAMILIES - THE PARTNERSHIP FOR SMOKE-FREE FAMILIES PROGRAM (PSF) IS A COMPREHENSIVE TOBACCO CONTROL PROGRAM TO REDUCE TOBACCO SMOKE EXPOSURE AMONG PREGNANT WOMEN AND SMALL CHILDREN BY SYSTEMATICALLY SCREENING PREGNANT WOMEN AND NEW PARENTS FOR TOBACCO USE IN THEIR OBSTETRICIAN'S AND PEDIATRICIAN'S OFFICE AND LINKING THEM WITH TAILORED INTERVENTIONS. PSF HAS BECOME A STANDARD OF CARE IN SAN DIEGO COUNTY AND A NATIONALLY RECOGNIZED MODEL. PSF PROVIDES A VALUABLE RESOURCE FOR PHYSICIANS AND SMOKING CESSATION SERVICES SPECIFICALLY FOR PREGNANT WOMEN AND NEW PARENTS THAT WAS PREVIOUSLY NON-EXISTENT IN SAN DIEGO. CANCER/ONCOLOGY CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE U.S. EXCEEDED ONLY BY HEART DISEASE AND ACCOUNTS FOR ALMOST ONE QUARTER OF ALL DEATHS IN SAN DIEGO COUNTY. ACCORDING TO NATIONAL CANCER INSTITUTE (NCI) ESTIMATES, IN 2009 THERE WILL BE 1,479,350 NEW CASES OF CANCER DIAGNOSED AND AN ESTIMATED 562,540 DEATHS RELATED TO CANCER. CURRENTLY LUNG, BREAST, COLORECTAL AND PROSTATE CANCERS ACCOUNTED FOR 53% OF ALL NEW CASES OF CANCER AND 50% OF ALL CANCER DEATHS. IN SAN DIEGO COUNTY DURING 2007, PERSONS AGE 55 AND OVER ACCOUNTED FOR ALMOST 88% OF CANCER DEATHS WITH MORTALITY RATES PER 100,000 POPULATION RANGING FROM 267.7 AMONG THOSE IN THE 55 - 64 AGE CATEGORY TO 1,533.5 AMONG THOSE AGE 85 AND OVER. TRENDS BETWEEN 2000 AND 2007, SAN DIEGO COUNTY'S AGE-ADJUSTED MORTALITY RATE FOR CANCER HAS DECLINED FROM 189.1 TO 162.6 PER 100,000 POPULATION. IN RESPONSE TO THIS SERIOUS HEALTH CONCERN, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS DESIGNED TO EDUCATE PEOPLE ON THE IMPORTANCE OF EARLY DETECTION AND TREATMENT FOR SOME OF THE MOST COMMON FORMS OF CANCER. THE FOLLOWING ARE SOME EXAMPLES OF CANCER PROGRAMS AND ACTIVITIES IN WHICH SCRIPPS ENGAGED IN DURING FY11.
SCRIPPS GREEN CANCER CENTER SUPPORT GROUPS   SCRIPPS GREEN CANCER CENTER SUPPORT GROUPS OFFER CANCER PATIENTS THE OPPORTUNITY TO EXPRESS THE EMOTIONS THAT COME WITH A CANCER DIAGNOSIS AND HELP THEM COPE MORE EFFECTIVELY WITH THEIR TREATMENT REGIMEN BY NURTURING THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL WELL BEING. CLASSES AT SCRIPPS GREEN HOSPITAL SUCH AS THE FREE CANCER WRITING WORKSHOP, WHEN WORDS HEAL, ARE DESIGNED TO USE EXPRESSIVE WRITING TO HELP PATIENTS NAVIGATE THEIR JOURNEY WITH CANCER. IN 2011, 16 CANCER PATIENTS ATTENDED A SUPPORT GROUP AT SCRIPPS GREEN AT A COST OF $1,818 TO PROVIDE THESE FREE SERVICES TO THE COMMUNITY. (SPONSORED BY SCRIPPS GREEN HOSPITAL) SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFIT SERVICES BREAST HEALTH CLINICAL SERVICES A TOTAL OF 4,968 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES IN THE COMMUNITY AND SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY SERVICES. A TOTAL OF 6,859 SERVICES WERE PROVIDED INCLUDING TELEPHONE REMINDERS, OUTREACH AND EDUCATION, CASE MANAGEMENT AND A VARIETY OF PRESENTATIONS. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS). SCRIPPS MERCY HOSPITAL CHULA VISTA, RADIOLOGY LOSS TO FOLLOW-UP SERVICES A TOTAL OF 36 PATIENTS HAVE BEEN PROVIDED SUPPORT. OF THESE PATIENTS, A TOTAL OF 77 SERVICES WERE PROVIDED. SERVICES INCLUDE ENCOURAGEMENT FOR PATIENTS TO REPEAT EXAM, ASSIST PATIENTS TO GET HEALTH INSURANCE APPROVAL TO REPEAT EXAM, SOCIAL/ EMOTIONAL SUPPORT, AND EDUCATION ABOUT HOW TO PREVENT BREAST CANCER. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS). SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY POSITIVE BREAST CANCER PATIENT SUPPORT A TOTAL OF 14 PATIENTS WERE SUPPORT. A TOTAL OF 61 SERVICES WERE PROVIDED THAT INCLUDE PHONE CALLS, HOME VISITS, GIVE A PACKAGE WITH A CALENDAR, A PEN AND EDUCATIONAL MATERIALS, SOCIAL AND EMOTIONAL SUPPORT. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS). SCRIPPS POLSTER BREAST CARE CENTER MUSIC AS MEDICINE PROGRAM PATIENTS AND THEIR SUPPORT PERSON PARTICIPATE IN THE MUSIC AS MEDICINE THERAPY CLASS FACILITATED BY A MUSIC THERAPIST. THE MUSIC THERAPIST ASKS QUESTIONS AND TAILORS THE THERAPY TO THE PARTICIPANTS' EMOTIONAL AND PHYSICAL NEEDS. SESSIONS INVOLVE LISTENING TO MUSIC, WRITING SONGS, DISCUSSING WHAT LYRICS MEAN TO THE PARTICIPANTS, USE OF SINGING BOWLS, VOCALIZATION, AND DRUMMING. RESEARCH HAS SHOWN MUSIC'S ABILITY TO BOOST THE IMMUNE FUNCTION, TO BLOCK INCOMING PAIN STIMULI, LOWER BLOOD PRESSURE AND INFLUENCE EMOTIONAL WELL BEING. (SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER). SCRIPPS POLSTER BREAST CARE CENTER SUPPORT GROUPS SCRIPPS POLSTER BREAST CARE CENTER SUPPORT GROUPS PROVIDE A VENUE FOR WOMEN TO COME TOGETHER, DISCUSS ISSUES RELATING TO DIAGNOSES, AND RECEIVE SUPPORT. THE SUPPORT GROUPS ARE OFFERED TO WOMEN IN THE SAN DIEGO COMMUNITY. (SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER). CANCER CENTER AWARENESS AND EDUCATIONAL EVENTS A SERIES OF EDUCATIONAL EVENTS, COORDINATED WITH AMERICAN CANCER SOCIETY AWARENESS MONTHS, ON VARIOUS TYPES OF CANCER, SUCH AS BREAST CANCER, LUNG CANCER, CERVICAL CANCER, COLORECTAL CANCER, SKIN CANCER, OVARIAN/GYNECOLOGICAL CANCER, AND PROSTATE CANCER. AN RN CLINICIAN ANSWERS QUESTIONS AND PROVIDES WRITTEN EDUCATIONAL MATERIAL. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA CANCER CENTER). HEALTH EDUCATION AND SUPPORT GROUPS EDUCATION AND SUPPORT GROUPS PROVIDED TO SAN DIEGO COUNTY RESIDENTS REGARDING A WIDE VARIETY OF HEALTH CONCERNS AND DISEASES. EDUCATION AND SUPPORT GROUP TOPICS INCLUDE: FAMILIES WHO HAVE EXPERIENCED THE LOSS OF A CHILD, CHILDREN WHO HAVE LOST A PARENT TO CANCER, INFERTILITY, PARENTING TWINS, IMPROVING CHILDREN'S READING ABILITIES, HUNTINGTON'S DISEASE, PARKINSON'S DISEASE, MENTAL ILLNESS, OSTOMY, POSTPARTUM, GYNECOLOGICAL CANCER, CHRONIC PAIN, AND MULTIPLE SCLEROSIS. (SPONSORED BY SCRIPPS LA JOLLA COMMUNITY BENEFIT SERVICES.) CARDIOVASCULAR DISEASE CORONARY HEART DISEASE AND STROKE ARE THE NUMBER ONE AND NUMBER THREE CAUSES OF DEATH IN THE NATION FOR BOTH MEN AND WOMEN. HEART DISEASE IS OUR NATION'S LEADING CAUSE OF DEATH, CLAIMING MORE THAN 950,000 AMERICAN LIVES EVERY YEAR. STROKE IS AMERICA'S THIRD KILLER AND IS A LEADING CAUSE OF SERIOUS, LONG-TERM DISABILITY. ACCORDING TO THE AMERICAN HEART ASSOCIATION, AN ESTIMATED 80,000,000 AMERICAN ADULTS HAVE ONE OR MORE TYPES OF CARDIOVASCULAR DISEASE (CVD). IT IS ESTIMATED THAT FEWER THAN HALF OF THESE, 38,100,000, ARE AGE 60 OR OLDER. HIGH BLOOD PRESSURE, CORONARY HEART DISEASE (CHD) AND STROKE ARE THE MOST COMMON FORMS OF CVD. CHD WAS THE LARGEST SINGLE KILLER OF AMERICANS IN 2006, RESULTING IN 445,687 DEATHS. THE PREVALENCE OF CHD AMONG U.S. ADULTS AGE 20 AND OLDER WAS 16,800,000 AND AN ESTIMATED 785,000 PERSONS IN THE U.S. HAD A NEW CORONARY ATTACK AND ANOTHER 470,000 HAD A RECURRENT ATTACK DURING 2006. AN ESTIMATED ADDITIONAL 195,000 PERSONS HAD A SILENT ATTACK DURING THIS SAME PERIOD. STROKE KILLED 137,119 PEOPLE IN 2006. IT'S THE THIRD LARGEST CAUSE OF DEATH, RANKING BEHIND "DISEASES OF THE HEART" AND ALL FORMS OF CANCER. STROKE IS A LEADING CAUSE OF SERIOUS, LONG-TERM DISABILITY IN THE UNITED STATES. THERE ARE NINE POTENTIALLY MODIFIABLE RISK FACTORS FOR CVD THAT HAVE BEEN IDENTIFIED AS CONSISTENT IN MEN AND WOMEN ACROSS ETHNIC GROUPS AND REGIONS. THEY INCLUDE CIGARETTE SMOKING, ABNORMAL BLOOD LIPID LEVELS, HYPERTENSION, DIABETES, ABDOMINAL OBESITY, A LACK OF PHYSICAL ACTIVITY, LOW DAILY FRUIT AND VEGETABLE CONSUMPTION, ALCOHOL OVERCONSUMPTION, AND PSYCHOSOCIAL INDEX. DURING 2007, DISEASES OF THE HEART WERE THE SECOND LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 4,743 DEATHS DURING THIS PERIOD. BETWEEN 2003 AND 2007, THE NUMBER OF HEART DISEASE DEATHS DROPPED 12 PERCENT FROM 5,404 IN 2003. THE AGE-ADJUSTED RATE OF DEATH RELATED TO HEART DISEASE DURING 2007 WAS 151 PER 100,000 POPULATION. DURING 2007, THE SAN DIEGO COUNTY DEATH RATE PER 100,000 ATTRIBUTED TO CHD WAS 112.5. THOSE MOST IMPACTED WERE MALES 148.3, WHITES 118.8, AFRICAN AMERICANS 179.0 AND PERSONS AGES 65 AND OLDER, ACCOUNTING FOR 82% OF CHD DEATHS. THE SAN DIEGO DEATH RATE FOR STROKE WAS 36.1 PER 100,000 POPULATION. HISPANICS AND AFRICAN AMERICANS HAVE THE HIGHEST RATE OF STROKE, 43.1 AND 41.0, RESPECTIVELY. WOMEN, WITH A RATE OF 36.1 ACCOUNTED FOR 59.1% OF SAN DIEGO COUNTY STROKE DEATHS. DURING FY11, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. AMERICAN HEART WALK SCRIPPS ALLOCATED $10,000 IN OPERATIONAL FUNDS AND $30,000 IN IN-KIND DONATIONS TO SUPPORT THE AMERICAN HEART ASSOCIATION'S EFFORTS TO FIGHT HEART DISEASE AND STROKE. IN ADDITION, THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER PROGRAM COORDINATED WALKER PARTICIPATION AND FUND RAISING EFFORTS. THE SAN DIEGO HEART WALK EXCEEDED ITS GOAL BY RAISING MORE THAN $1 MILLION. IN 2011, MORE THAN 2,000 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES AND FRIENDS - WALKED TO HELP RAISE MORE THAN $138,000. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT BY PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION MATERIALS AND MORE. (SPONSORED BY SCRIPPS COMMUNITY BENEFIT SERVICES) COMMUNITY HEALTH EDUCATION PROGRAMS THE COMMUNITY HEALTH EDUCATION PROGRAMS COVER A WIDE VARIETY OF HEALTH RELATED TOPICS ON DISEASE MANAGEMENT, HEALTH CARE UPDATES, AND PREVENTION. THE TOPICS INCLUDE: ALTERNATIVES TO HYSTERECTOMY, STROKE, STRESS, VARICOSE VEINS, INFERTILITY, CARDIAC, DEPRESSION, MACULAR DEGENERATION, MEMORY, BRAIN, ORTHOPEDIC CARE, ROBOTIC SURGERY, SKIN CARE, BACK CARE, MIGRAINES, KNEE PAIN, PELVIC FLOOR INCONTINENCE, SAFETY AND FALL PREVENTION, BLADDER HEALTH, HEALTHY DINING, EXERCISE, VOICE, FLU PREVENTION, SLEEP DISORDERS, NUTRITION, HYPERTENSION, FOOT CARE, SPINE SURGERY, JOINT REPLACEMENT, BREATHING, PAIN MANAGEMENT, AND MEDICATION MATTERS. (SPONSORED BY SCRIPPS LA JOLLA COMMUNITY BENEFIT SERVICES) CPR CLASSES FOR PATIENTS AND FAMILIES OF THE CARDIAC TREATMENT CENTER CPR CLASSES OFFERED TO CARDIAC TREATMENT CENTER PATIENTS AND THEIR FAMILIES. CPR CERTIFICATION CLASSES (FRIENDS AND FAMILIES) OFFERED 4 TIMES YEAR TO PATIENTS AND FAMILY MEMBERS. DESIGNED TO IMPROVE COMMUNITY HEALTH THROUGH INCREASED KNOWLEDGE OF CARDIOPULMONARY RESUSCITATION PRACTICES. (SPONSORED BY CARDIAC TREATMENT CENTER AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA)
CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS   CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS INCLUDE: TAI CHI- TWICE WEEKLY. DESIGNED TO DECREASE STRESS & IMPROVE BALANCE; RESTORATIVE YOGA- THREE TIMES A WEEK. DESIGNED TO DECREASE STRESS, IMPROVE STRENGTH & FLEXIBILITY; FITBALL- TWICE WEEKLY. DESIGNED TO IMPROVE STRENGTH, POSTURE, CORE STABILITY & BALANCE; YOGA FOR CANCER RECOVERY- WEEKLY. DESIGNED TO DECREASE STRESS, IMPROVE CIRCULATORY FLOW, EASE TENSION DURING HEALING; BALANCE- WEEKLY. DESIGNED TO BUILD BALANCE, POSTURE & COORDINATION; POWER YOGA- TWICE WEEKLY. DESIGNED TO IMPROVE STRENGTH & FLEXIBILITY; PILATES-WEEKLY. DESIGNED TO IMPROVE STRENGTH, BALANCE & FLEXIBILITY. YOGA FOR MS-WEEKLY. DESIGNED TO PROMOTE HEALING & IMPROVE STRENGTH & FLEXIBILITY. MEDITATION-WEEKLY. (SPONSORED BY THE CARDIAC TREATMENT CENTER, SCRIPPS MEMORIAL HOSPITAL LA JOLLA) STROKE CARE PROGRAMS A WIDE VARIETY OF COMMUNITY EDUCATION AND AWARENESS WAS PROVIDED ON STROKE RELATED ISSUES. (SPONSORED BY SCRIPPS MERCY SAN DIEGO AND CHULA VISTA STROKE PROGRAM) HEART HEALTH - SCRIPPS HOME HEALTH SERVICES SCRIPPS HOME HEALTH PROVIDED COMMUNITY EDUCATION TO PROMOTE INDEPENDENT MANAGEMENT OF CONGESTIVE HEART FAILURE (CHF) IN ORDER TO PREVENT EXACERBATIONS AND HOSPITALIZATIONS. EDUCATION INCLUDES WHAT IS CHF, MEDICATIONS, DIET, WEIGHT AND EXERCISE. IN FY11, 20 SAN DIEGO COUNTY RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) PREVENTION OF CARDIOVASCULAR DISEASE - SCRIPPS HOME HEALTH SERVICES COMMUNITY EDUCATION TO PROMOTE A HEART HEALTHY DIET AND HEALTHY EATING. IN FY11, 40 SAN DIEGO COUNTY RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES). THE ERIC PAREDES SAVE A LIFE FOUNDATION. THE ERIC PAREDES SAVE A LIFE FOUNDATION IS COMMITTED TO PREVENTING SUDDEN CARDIAC ARREST/DEATH IN MIDDLE AND HIGH SCHOOL AGED CHILDREN THROUGH AWARENESS, EDUCATION AND ACTION. A $15,000 DONATION WAS MADE TO PURCHASE SCREENING EQUIPMENT (EKG MACHINES). THE DONATION GIVEN, HELPED THE FOUNDATION TO PROVIDE HEALTH SCREENINGS, INVOLVING ELECTROCARDIOGRAMS (ECGS) AND ECHOCARDIOGRAMS TO CHILDREN BEFORE THEY CAN PARTICIPATE IN ORGANIZED SPORTS AND ACTIVITIES, ALONG WITH EQUIPPING SCHOOLS WITH AUTOMATED EXTERNAL DEFIBRILLATORS (AEDS). DIABETES DATA FROM THE 2007 NATIONAL DIABETES FACT SHEET (THE MOST RECENT YEAR FOR WHICH DATA IS AVAILABLE) ESTIMATED A TOTAL OF 23.6 MILLION CHILDREN AND ADULTS IN THE US, 7.8% OF THE POPULATION, HAVE DIABETES. THESE INCLUDED 17.9 MILLION PEOPLE WHO HAVE BEEN DIAGNOSED WITH DIABETES AND ANOTHER 5.7 MILLION PEOPLE WITH UNDIAGNOSED DIABETES. ADDITIONALLY, THERE WERE 57 MILLION PEOPLE WITH PRE-DIABETES. EACH YEAR 1.6 MILLION NEW CASES OF DIABETES ARE DIAGNOSED IN PEOPLE AGED 20 YEARS AND OLDER. THERE ARE THREE MAJOR TYPES OF DIABETES: TYPE 1 DIABETES, TYPE 2 DIABETES, AND GESTATIONAL DIABETES. ALL THREE TYPES OF DIABETES SHARE THE SAME BASIC CHARACTERISTIC -- THE BODY'S INABILITY EITHER TO MAKE OR TO USE INSULIN. WITHOUT ENOUGH INSULIN, GLUCOSE STAYS IN THE BLOOD, CREATING HIGH LEVELS OF BLOOD SUGAR. OVER TIME, THIS BUILDUP CAUSES DAMAGE TO KIDNEYS, HEART, NERVES, EYES, AND OTHER ORGANS. TYPE 1 DIABETES MOST OFTEN OCCURS DURING CHILDHOOD OR ADOLESCENCE, ACCOUNTING FOR 5% TO 10% OF ALL DIAGNOSED CASES OF DIABETES. TYPE 2 DIABETES TYPICALLY OCCURS LATER IN LIFE, FREQUENTLY AS THE RESULT OF OBESITY, PHYSICAL INACTIVITY AND OTHER RISK FACTORS. TYPE 2 DIABETES ACCOUNTS FOR 90% TO 95% OF DIABETES CASES. HOWEVER, DUE TO THE CURRENT OBESITY EPIDEMIC, IT IS ESTIMATED THAT 39% OF THE GIRLS AND 33% OF THE BOYS WHO ARE NOW HEALTHY 2 TO 3 YEAR OLDS ARE LIKELY TO DEVELOP DIABETES. MORE THAN 90 MILLION AMERICANS (33 PERCENT) LIVE WITH A CHRONIC DISEASE. WHILE THERE ARE MANY DISABLING CHRONIC DISEASES, DIABETES HAS BEEN IDENTIFIED AS ONE OF THE PRIMARY CHRONIC CONDITIONS IN SAN DIEGO COUNTY. AS THE SEVENTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY DURING 2007, DIABETES WAS RESPONSIBLE FOR 2.7% (520) OF DEATHS DURING THIS PERIOD. IN SAN DIEGO COUNTY, THE AGE-ADJUSTED ESTIMATE OF ADULTS DIAGNOSED WITH DIABETES IN 2007 WAS 6.7%. NATIONALLY, DIABETES WAS THE SIXTH LEADING CAUSE OF DEATH DURING 2006, ACCOUNTING FOR 72,449 DEATHS DURING THIS PERIOD. HEALTH CONSEQUENCES THE COMPLICATIONS ASSOCIATED WITH DIABETES ARE SIGNIFICANT AND WELL ESTABLISHED. THE CDC REPORTS COMPLICATIONS INCLUDING HEART DISEASE, STROKE, HYPERTENSION, BLINDNESS, KIDNEY DISEASE, PREGNANCY COMPLICATIONS, LOWER-LIMB AMPUTATIONS, PERIODONTAL DISEASE AND NERVOUS SYSTEM DISEASE. - THE AGE-ADJUSTED RATE OF HOSPITALIZATION FOR PERSONS WITH DIABETES AMONG SAN DIEGO COUNTY RESIDENTS IN 2008 WAS 128.5 PER 100,000 POPULATION, AN 18.9% INCREASE SINCE 2001. - IN 2008, HISPANICS AND AFRICAN AMERICANS LIVING IN SAN DIEGO COUNTY HAD DIABETES-RELATED HOSPITALIZATION RATES 1.8 AND 2.6 TIMES HIGHER THAN THAT OF THE OVERALL POPULATION. - IN SAN DIEGO COUNTY, THE AGE-ADJUSTED DIABETES-RELATED MORTALITY RATES DECREASED FROM 21.4 PER 100,000 POPULATION IN 2005 TO 17.5 IN 2007, AN 18.2% DECREASE. - IN 2007, DIABETES WAS THE SEVENTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 520 DEATHS. - IN 2007, DIABETES WAS THE SEVENTH LEADING CAUSE OF DEATH IN THE U.S. WITH AN AGE-ADJUSTED DEATH RATE FOR DIABETES AT 23.5 PER 100,000 POPULATION. AMONG THOSE 65 AND OVER, DIABETES WAS THE SIXTH LEADING CAUSE OF DEATH WITH A DEATH RATE OF 135.6 PER 100,000 POPULATION. OVER SIX MILLION AMERICANS ARE UNAWARE THEY HAVE DIABETES. THE COMPLICATIONS RELATED TO DIABETES ARE SERIOUS AND CAN BE REDUCED WITH PREVENTIVE PRACTICES. LEADING TO SCHOOL AND WORK ABSENTEEISM, AN ELEVATED RATE OF HOSPITALIZATION, FREQUENT EMERGENCY ROOM VISITS, PERMANENT PHYSICAL DISABILITIES AND SOMETIMES DEATH, DIABETES IS A SERIOUS COMMUNITY HEALTH PROBLEM. DURING FY11, SCRIPPS ENGAGED IN THE FOLLOWING DIABETES MANAGEMENT INITIATIVES. PROJECT DULCE - FORMED THROUGH COLLABORATION BETWEEN THE SCRIPPS WHITTIER DIABETES INSTITUTE, THE COUNCIL OF COMMUNITY CLINICS, AND COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) PROJECT DULCE IS A COMPREHENSIVE, CULTURALLY COMPETENT DIABETES MANAGEMENT PROGRAM FOR UNDERSERVED AND UNINSURED POPULATIONS IN SAN DIEGO COUNTY. PROJECT DULCE INCORPORATES THE CHRONIC CARE MODEL IN ITS TEAM-BASED APPROACH TO CARE. PROJECT DULCE HAS BEEN WORKING IN COMMUNITIES ACROSS SAN DIEGO FOR THE PAST 10 YEARS BY PROVIDING DIABETES CARE AND SELF MANAGEMENT EDUCATION. NURSE-LED TEAMS FOCUS ON ACHIEVING MEASURABLE IMPROVEMENTS IN THE HEALTH OF THEIR PATIENTS; NURSE EDUCATORS LEAD MULTIDISCIPLINARY TEAMS THAT PROVIDE CLINICAL MANAGEMENT; AND PEER EDUCATORS FROM EACH CULTURAL GROUP, KNOWN AS PROMOTORAS, PROVIDE PUBLIC AND PATIENT EDUCATION TO THEIR PERSPECTIVE COMMUNITIES. THIS INNOVATIVE PROGRAM COMBINES THE STATE-OF-THE-ART IN CLINICAL DIABETES MANAGEMENT WITH PROVEN EDUCATIONAL AND BEHAVIORAL INTERVENTIONS. PROJECT DULCE PROVIDED 6,036 DIABETES CARE AND EDUCATION VISITS FOR LOW-INCOME AND UNDERSERVED INDIVIDUALS THROUGHOUT SAN DIEGO IN FY11 AND ENROLLED MORE THAN 812 NEW PATIENTS IN PROJECT DULCE. THE PROGRAM ALSO INITIATED FOUR NEW PROGRAMS: 1) DIABETES PREVENTION FOR WOMEN WITH A HISTORY OF GESTATIONAL DIABETES; 2) REPLICATING PROJECT DULCE IN TIJUANA; 3) DIABETES PEER CARE COORDINATION PROJECT AT SCRIPPS MERCY CHULA VISTA HOSPITAL AND 4) DIABETES GENEBANK PROGRAM. SCRIPPS WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION AND TRAINING THE SCRIPPS WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION TEAMS PROVIDE STATE-OF-THE-ART EDUCATION AND TRAINING FOR PEOPLE WHO WISH TO INCREASE THEIR DIABETES MANAGEMENT KNOWLEDGE AND SKILLS. WITH THE RISE IN THE NUMBER OF PEOPLE WITH DIABETES, MEDICATION UPGRADES, NUTRITION CHANGES AND CHANGES IN DIABETES RELATED DEVICES, THERE IS A GREAT NEED TO EQUIP HEALTH CARE PROFESSIONALS WITH THE LATEST INFORMATION AND CLINICAL PRACTICE SKILLS. THE WHITTIER'S PROFESSIONAL EDUCATION PROGRAM IS LED BY A TEAM OF EXPERTS THAT INCLUDE ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS, AND OTHER DIABETES SPECIALISTS, THESE INDIVIDUALS TRAIN PRACTICING PROFESSIONALS TO DELIVER THE BEST CARE POSSIBLE FOR THEIR PATIENTS WITH DIABETES. COURSES ARE DESIGNED TO RESPOND TO THE NEEDS OF ALLIED HEALTH PROFESSIONALS SEEKING AN UNDERSTANDING OF THE NEW AND COMPLEX CLINICAL TREATMENT OPTIONS FOR TYPE 1, TYPE 2 AND GESTATIONAL DIABETES. PROVIDED PROFESSIONAL EDUCATION TO 2,126 INDIVIDUALS ON DIABETES TOPICS, INCLUDING INSULIN MANAGEMENT, INCRETIN THERAPY, THE DIABETES DIET, THE BASICS OF DIABETES, HOME HEALTH EDUCATION AND 5-DAY COMPREHENSIVE TRAINING FOR DIABETES CARE PROFESSIONALS. INDIVIDUALS CAME FROM THROUGHOUT THE UNITED STATES, AS WELL AS FROM LOCAL HEALTH INSTITUTIONS, TO LEARN FROM THE WHITTIER INSTITUTE'S MOST EXPERIENCED DIABETES EXPERTS, INCLUDING ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS AND COMMUNITY EDUCATORS. OVER THE LAST YEAR, THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION DEPARTMENT PROVIDED 23 SEPARATE PROGRAMS TO PHYSICIANS, NURSES, PHARMACISTS, SOCIAL WORKERS, DIETITIANS, MID-LEVEL PROVIDERS AND SOCIAL WORKERS.
HEALTH RELATED BEHAVIORS   HEALTH-RELATED BEHAVIOR IS ONE OF THE MOST IMPORTANT ELEMENTS IN PEOPLE'S HEALTH AND WELL-BEING. ITS IMPORTANCE HAS GROWN AS SANITATION HAS IMPROVED AND MEDICINE HAS ADVANCED. DISEASES THAT WERE ONCE INCURABLE OR FATAL CAN NOW BE PREVENTED OR SUCCESSFULLY TREATED. HEALTH-RELATED BEHAVIORS SUCH AS IMMUNIZATION, SMOKING CESSATION, IMPROVED NUTRITION, INCREASED PHYSICAL ACTIVITY, ORAL HEALTH, AND INJURY PREVENTION HAVE BECOME IMPORTANT COMPONENTS OF LONG-TERM HEALTH. UNDERSTANDING THAT PERSONAL BEHAVIORS PLAY A SIGNIFICANT ROLE IN AN INDIVIDUAL'S OVERALL HEALTH STATUS, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS THAT HELP PEOPLE TAKE CHARGE OF THEIR OWN HEALTH AND THAT OF THEIR FAMILIES. DURING FY11, SCRIPPS PARTICIPATED IN A NUMBER OF HEALTH BEHAVIOR MODIFICATION EFFORTS. FLU VACCINATION CAMPAIGN ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), AN AVERAGE OF 50,000 ADULTS DIE ANNUALLY IN THE UNITED STATES FROM DISEASES THAT ARE PREVENTABLE THROUGH VACCINATION. APPROXIMATELY 36,000 ADULTS DIE FROM INFLUENZA, OVER 6,000 FROM INVASIVE PNEUMOCOCCAL DISEASE, AND 5,000 FROM HEPATITIS B. IN SAN DIEGO COUNTY, INFLUENZA AND PNEUMONIA WERE THE TENTH LEADING CAUSE OF DEATH IN 2007, WITH 1,111 DEATHS RECORDED BETWEEN 2005 AND 2007. BASED ON 2007 CHIS DATA, ONLY 34.6% OF SAN DIEGO COUNTY RESIDENTS REPORTED RECEIVING AN INFLUENZA VACCINATION DURING THE PAST 12 MONTHS. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR 2008 REPORTED ONLY 26.5% OF ADULTS AGED 65 AND OVER HAD BEEN VACCINATED FOR INFLUENZA DURING THE PAST 12 MONTHS. VACCINATIONS MAY NOT BE RECEIVED DUE TO COST AND LOCAL AVAILABILITY ISSUES OR A LACK OF EDUCATION ABOUT TIMING AND EFFECTIVENESS. MISUNDERSTANDING, MISINFORMATION, OR SKEPTICISM RELATED TO THE BENEFITS AND POSSIBLE RISKS ASSOCIATED WITH VACCINES MAY ALSO REDUCE VACCINATION RATES. MATERNAL CHILD HEALTH THE HEALTH OF MOTHERS, INFANTS, AND CHILDREN IS A REFLECTION OF THE CURRENT HEALTH STATUS OF A LARGE SEGMENT OF THE US POPULATION AND A HEALTH PREDICTOR FOR THE NEXT GENERATION. THE FOCUS OF THE INFORMATION IN THIS TOPIC INCLUDES INDICATORS OF MATERNAL ILLNESS AND DEATH AND THOSE THAT AFFECT INFANT HEALTH AND SURVIVAL. AMONG THESE ARE INFORMATION RELATED TO INFANT MORTALITY RATES, ACCESS TO PREVENTIVE CARE, AND FETAL, PERINATAL, AND OTHER INFANT DEATHS. THERE ARE NUMEROUS RISK FACTORS ASSOCIATED WITH MATERNAL AND INFANT HEALTH INCLUDING: - ALCOHOL, TOBACCO, AND ILLEGAL SUBSTANCES DURING PREGNANCY - A MAJOR RISK FACTOR FOR LOW BIRTH WEIGHT AND OTHER POOR INFANT OUTCOMES - VERY LOW BIRTH WEIGHT - ASSOCIATED WITH PRETERM BIRTH, SPONTANEOUS ABORTION, LOW PRE-PREGNANCY WEIGHT, AND CIGARETTE SMOKING - INFANT DEATH - RATES ARE HIGHEST AMONG INFANTS BORN TO YOUNG TEENAGERS AND MOTHERS AGED 44 YEARS AND OLDER BEING PREGNANT OR TRYING TO BECOME PREGNANT ACCOUNTS FOR A SMALL PORTION OF A WOMAN'S LIFE. AN UNINTENDED PREGNANCY IS A PREGNANCY THAT IS EITHER MISTIMED OR UNWANTED AT THE TIME OF CONCEPTION. UNINTENDED PREGNANCY ACCOUNTS FOR AN ESTIMATED 49% OF ALL PREGNANCIES IN THE U.S. AND IS ASSOCIATED WITH INCREASED MORBIDITY AND WITH BEHAVIORS DURING PREGNANCY THAT ARE LINKED WITH ADVERSE HEALTH EFFECTS. WOMEN WHO CAN PLAN THE NUMBER AND TIMING OF THE BIRTHS OF THEIR CHILDREN ENJOY IMPROVED HEALTH, EXPERIENCE FEWER UNPLANNED PREGNANCIES AND BIRTHS, AND HAVE LOWER RATES OF ABORTION. WHO IS MOST IMPACTED DURING 2008, SAN DIEGO COUNTY'S CRUDE BIRTH RATE PER 1,000 POPULATION WAS 14.9, ACCOUNTING FOR 46,742 LIVE BIRTHS. CRUDE BIRTH RATES RANGED FROM 9.2 AMONG WHITE WOMEN TO 22.3 AMONG HISPANIC WOMEN. DURING 2008, HISPANICS ACCOUNTED FOR 44.7% OF ALL LIVE BIRTHS FOLLOWED BY 30.9% FOR WHITES. WOMEN BETWEEN THE AGES OF 20 AND 34 ACCOUNTED FOR 74.2% OF BIRTHS. SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION OFFERINGS FOR LOW-INCOME WOMEN IN SAN DIEGO COUNTY IN FY11. THE FOLLOWING ARE EXAMPLES OF PROGRAMS: SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFIT SERVICES o OFFERED A TOTAL OF OVER 700 MATERNAL CHILD HEALTH CLASSES THROUGHOUT SAN DIEGO COUNTY DESIGNED TO ENHANCE THE PARENTING SKILLS. LOW-INCOME WOMEN IN THE COUNTY OF SAN DIEGO WERE ELIGIBLE TO ALL ATTEND CLASSES AT NO CHARGE OR ON A SLIDING FEE SCHEDULE. o MAINTAINED THE EXISTING PRENATAL EDUCATION SERVICES IN ALL REGIONS OF THE COUNTY ENSURING THAT PROGRAMS CONTINUED TO DEMONSTRATE A MORE THAN 90 PERCENT SATISFACTION RATING o PROVIDED AND SUPPORTED WEEKLY BREASTFEEDING SUPPORT GROUPS THROUGHOUT SAN DIEGO COUNTY. THIS INCLUDES TWO WITH BILINGUAL SERVICES. o OFFERED A MATERNAL CHILD HEALTH EDUCATION SERIES COVERING ISSUES SUCH AS DOGS AND BABIES: SAFETY, GRANDPARENTING AND BABY SITTER SAFETY IN THE NORTH COUNTY. o OFFERED THE FOLLOWING MATERNAL CHILD HEALTH CLASSES AT THE MENDE WELL BEING CENTER: BASIC TRAINING FOR DADS, GETTING READY FOR THE BABY, THE INFANT CPR AND SAFETY PROGRAM, PARENT CONNECTION PROGRAMS, AND REDIRECTING CHILDREN'S BEHAVIOR. o OFFERED DOGS & BABIES PROGRAM QUARTERLY WITH MORE THAN 40 ATTENDEES. o OFFERED WEEKLY MOMMY & ME YOGA PROGRAMS TO NEW PARENTS. o OFFERED A PRENATAL YOGA PROGRAM FOR EXPECTANT WOMEN IN SAN DIEGO COUNTY. o OFFERED A PREGNANCY NUTRITION PROGRAM QUARTERLY AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. o OFFERED "PELVIC FLOOR AND PREGNANCY CHANGES" FOR EXPECTANT FAMILIES AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFIT SERVICES) FIRST 5 MORE THAN 1,285 SERVICES WERE RECEIVED FOR FIRST TIME MOTHERS INCLUDING: HOME VISITS, REFERRALS RECEIVED, DATA ENTRY, FOLLOW UP PHONE CALLS, PARENTING CLASSES AND OTHER SUPPORT SERVICES. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE-FUNDED WIC PROGRAM, SERVING 6 LOCATIONS THAT ARE CONVENIENTLY SITUATED EITHER IN OR NEXT TO COMMUNITY CLINICS AND/OR HOSPITALS IN THE CENTRAL SAN DIEGO AREA OF SAN DIEGO COUNTY. WIC'S TARGET POPULATION IS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO FIVE). ON AN ANNUAL BASIS, SCRIPPS MERCY WIC SERVES APPROXIMATELY 9,000 WOMEN AND CHILDREN WITH 44% IN THE CITY HEIGHTS COMMUNITY. THE CLIENT BASE IN CITY HEIGHTS IS 91% HISPANIC AND MADE UP OF PREGNANT AND POSTPARTUM WOMEN (24%), INFANTS (20%) AND CHILDREN (56%). IN FY11, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS TO 119,003 WOMEN AND CHILDREN IN THE SOUTH AND CENTRAL REGIONS OF SAN DIEGO. SCRIPPS MERCY WIC PROGRAM PLAYS A KEY ROLE IN MATERNITY CARE BY REACHING LOW-INCOME WOMEN DURING PREGNANCY TO PROMOTE PRENATAL CARE, GOOD NUTRITION AND BREASTFEEDING. NUTRITION-TRAINED STAFF BEGIN EDUCATING WOMEN ABOUT THE IMPORTANCE OF BREASTFEEDING DURING PREGNANCY; OFFER LACTATION SUPPORT (ONE ON ONE AND GROUP) AS WELL AS SUPPLIES - PUMPS, BREAST PADS - DURING THE POSTPARTUM PERIOD. (SPONSORED BY SCRIPPS MERCY SAN DIEGO) SUBSTANCE ABUSE AND TOBACCO USE SUBSTANCE ABUSE HAS A MAJOR IMPACT ON INDIVIDUALS, THEIR FAMILIES, AND THEIR COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL AND PUBLIC HEALTH PROBLEMS. THESE PROBLEMS INCLUDE TEENAGE PREGNANCY, HIV/AIDS, OTHER SEXUALLY TRANSMITTED DISEASES (STDS), DOMESTIC VIOLENCE, CHILD ABUSE, MOTOR VEHICLE CRASHES, PHYSICAL FIGHTS, CRIME, HOMICIDE AND SUICIDE. ACCORDING TO THE NATIONAL INSTITUTE ON DRUG ABUSE, THE TOTAL ESTIMATED ANNUAL COSTS ASSOCIATED WITH SUBSTANCE ABUSE EXCEED HALF A TRILLION DOLLARS. THIS INCLUDES APPROXIMATELY $181 BILLION FOR ILLICIT DRUGS, $168 BILLION FOR TOBACCO AND $185 BILLION FOR ALCOHOL. DURING 2009, CALIFORNIA'S ESTIMATED HEALTHCARE COSTS DIRECTLY CAUSED BY SMOKING WERE $9.14 BILLION. TOBACCO USE - DURING 2007, BASED ON THE YOUTH RISK BEHAVIOR SURVEILLANCE SURVEY (YRBSS), 43.6% OF STUDENTS IN GRADES 9-12 WITHIN THE SAN DIEGO UNIFIED SCHOOL DISTRICT REPORTED THEY HAD EVER TRIED CIGARETTE SMOKING. - DURING THIS SAME TIME PERIOD, 11.0% OF STUDENTS IN GRADES 9-12 REPORTED CURRENT CIGARETTE USE AND 7.0% REPORTED THEY SMOKED MORE THAN 10 CIGARETTES PER DAY. - OF THOSE STUDENTS WHO REPORTED THEY CURRENTLY SMOKE, 41.4% REPORTED THEY HAVE TRIED TO QUIT SMOKING AT LEAST ONCE DURING THE PAST 12 MONTHS. - DURING 2008, BASED ON BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA FOR SAN DIEGO COUNTY, 14.5% OF ADULTS, AGED 18 OR OLDER, CURRENTLY SMOKE. MOREOVER, 23% ARE FORMER SMOKERS AND 62.5 HAVE NEVER SMOKED.
ALCOHOL USE   - DURING 2007, BASED ON THE YRBSS, 72.0% OF STUDENTS IN GRADES 9-12 WITHIN THE SAN DIEGO UNIFIED SCHOOL DISTRICT REPORTED THEY HAD AT LEAST ONE DRINK OF ALCOHOL ON AT LEAST 1 DAY DURING THEIR LIFE. - DURING THIS SAME TIME PERIOD, 36.7% OF STUDENTS IN GRADES 9-12 REPORTED THEY HAD AT LEAST ONE DRINK OF ALCOHOL ON AT LEAST 1 DAY DURING THE 30 DAYS PRIOR TO THE SURVEY. - EPISODIC HEAVY DRINKING, HAVING FIVE OR MORE DRINKS OF ALCOHOLIC IN A ROW WITHIN A COUPLE OF HOURS ON AT LEAST ONE DAY DURING THE 30 DAYS PRIOR TO THE SURVEY, WAS REPORTED BY 21.8% OF STUDENTS. - DURING 2008, BASED ON BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA FOR SAN DIEGO COUNTY, 55.1% OF ADULTS, AGED 18 OR OLDER, HAVE HAD AT LEAST ONE DRINK DURING THE PAST 30 DAYS. IN AN EFFORT TO ENCOURAGE MORE PEOPLE TO TAKE STEPS TO PREVENT SUBSTANCE ABUSE, SCRIPPS ENGAGED IN THE FOLLOWING ACTIVITIES: INTERVENTION WORKSHOPS AIM TO IMPROVE COMMUNITY HEALTH THE INTERVENTION PROGRAM AT SCRIPPS DRUG AND ALCOHOL TREATMENT PROGRAM OFFERS FREE WORKSHOPS FOR PARENTS TO HELP THEM BETTER UNDERSTAND ADOLESCENT ALCOHOL AND SUBSTANCE ABUSE AND THE WIDESPREAD PROBLEM OF TEEN ADDICTION. OTHER INTERVENTION WORKSHOPS ADDRESS THE WARNING SIGNS OF ADULT ADDICTION FOR FAMILIES AND EMPLOYERS, PROVIDING AGE-SPECIFIC INFORMATION ON HOW TO HELP LOVED-ONES RECOGNIZE THE SIGNS OF ADDICTION AND HOW TO GET AN ADDICTED INDIVIDUAL TO SEEK TREATMENT. MORE THAN 11,000 PEOPLE ATTENDED THE WORKSHOPS ON THE SCRIPPS MEMORIAL HOSPITAL LA JOLLA CAMPUS IN 2011. EVERY 15 MINUTES THE EVERY 15 MINUTES PROGRAM IS A TWO-DAY EVENT THAT EXPOSES HIGH SCHOOL STUDENTS TO THE CONSEQUENCES OF DRINKING AND DRIVING THROUGH A DRAMATIC REENACTMENT OF AN ALCOHOL-RELATED TRAFFIC ACCIDENT. THE "INJURED" STUDENTS ARE TAKEN TO SCRIPPS MERCY TRAUMA CENTER. THIS PROGRAM IS SPONSORED JOINTLY BY LOCAL HIGH SCHOOLS, COUNTY POLICE, SHERIFFS, CHP, EMERGENCY DEPARTMENTS AND AMBULANCE SERVICES. DURING FY11, SCRIPPS MERCY HOSPITAL PARTICIPATED IN FOUR (4) EVERY 15 MINUTES PROGRAMS, REACHING OVER 3,000 HIGH SCHOOL STUDENTS THROUGHOUT SAN DIEGO COUNTY. SCRIPPS MEMORIAL HOSPITAL LA JOLLA PARTICIPATED IN ONE EVERY 15 MINUTES PROGRAM, REACHING 250 HIGH SCHOOL STUDENTS IN LA JOLLA. (SPONSORED BY SCRIPPS MERCY TRAUMA AND ED; SCRIPPS LA JOLLA TRAUMA DEPARTMENT) PARTNERSHIP FOR SMOKE-FREE FAMILIES PROGRAM CIGARETTE SMOKING HAS BEEN IDENTIFIED AS THE MOST IMPORTANT SOURCE OF PREVENTABLE MORBIDITY AND PREMATURE MORTALITY WORLDWIDE. CIGARETTE SMOKING CAUSES HEART DISEASE, SEVERAL KINDS OF CANCER (LUNG, LARYNX, ESOPHAGUS, PHARYNX, MOUTH AND BLADDER AND CHRONIC LUNG DISEASE. APPROXIMATELY 11% OF PREGNANT WOMEN SMOKE. AN ESTIMATED 25-60% OF ALL FEMALE SMOKERS QUIT SHORTLY AFTER LEARNING THEY ARE PREGNANT (RECENT QUITTERS). AMONG THOSE WHO QUIT ON THEIR OWN, 20% TO 40% WILL GO BACK TO SMOKING DURING PREGNANCY. IN THE US, 25% OF CHILDREN UNDER THE AGE OF SIX YEARS LIVE IN A HOUSE WHERE SOMEONE SMOKES INSIDE AT LEAST FOUR DAYS PER WEEK. PRENATAL RISKS SMOKING DURING PREGNANCY HAS BEEN SHOWN TO CAUSE ADVERSE OUTCOMES INCLUDING MISCARRIAGE, PLACENTAL ABRUPTION AND SEPARATION AND INCREASED PERINATAL MORTALITY. IT ACCOUNTS FOR 20% OF LOW BIRTH WEIGHT DELIVERIES, EIGHT PERCENT OF PRETERM BIRTHS, AND 5 PERCENT OF ALL PRENATAL DEATHS. INFANT/CHILD RISKS THE EFFECTS OF MATERNAL SMOKING ARE NOT LIMITED TO THE PRENATAL PERIOD. MORE INFANTS DIE OF SUDDEN INFANT DEATH SYNDROME WHETHER THE MOTHER SMOKED DURING PREGNANCY OR AFTER THE BIRTH. CHILDREN OF SMOKERS HAVE MORE RESPIRATORY PROBLEMS, EAR INFECTIONS, ASTHMA, AND DOCTOR VISITS. CHILDREN WHOSE PARENTS SMOKE ARE MORE LIKELY TO HAVE BEHAVIOR PROBLEMS AND TROUBLE WITH SCHOOLWORK. LAUNCHED IN 1998 BY THE CEOS OF RADY CHILDREN'S HOSPITAL, SCRIPPS AND SHARP HEALTHCARE, PSF HAS THE GOAL OF REDUCING TOBACCO SMOKE EXPOSURE AMONG PREGNANT WOMEN AND YOUNG CHILDREN. THE PROGRAM WORKS DIRECTLY WITH OBSTETRICIANS AND PEDIATRICIANS ACROSS SAN DIEGO COUNTY TO IMPLEMENT "BEST PRACTICES" AS OUTLINED IN THE USDHHS TREATING TOBACCO USE AND DEPENDENCE CLINICAL PRACTICE GUIDELINE. PSF HAS BECOME A STANDARD OF CARE IN SAN DIEGO COUNTY, AND IS RECOGNIZED NATIONALLY. AS OF NOVEMBER 30, 2010 NEARLY 300,000 PREGNANT WOMEN AND PARENTS OF SMALL CHILDREN HAVE BEEN SCREENED FOR TOBACCO USE/EXPOSURE AND MORE THAN 55,000 PROACTIVELY LINKED WITH TARGETED INTERVENTIONS. (SPONSORED BY SCRIPPS HEALTH SYSTEM, COMMUNITY BENEFIT SERVICES) HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 84 PARTICIPANTS WERE INCLUDED IN THE STAY QUIT STUDY. THIS STUDY IS A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. A TOTAL OF 507 PEOPLE HAVE BEEN SCREENED. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA) YOUTHFUL DRINKING AND DRIVING PROGRAM CONSIDERING THAT AT LEAST 74.3 PERCENT OF HIGH SCHOOL STUDENTS IN THE U.S. REPORT DRINKING ALCOHOL, IT IS IMPERATIVE THAT STUDENTS UNDERSTAND THE RISKS ASSOCIATED WITH ALCOHOL ABUSE. IN AN EFFORT TO EDUCATE AT-RISK STUDENTS ABOUT THE DANGERS ASSOCIATED WITH DRINKING AND DRIVING, SCRIPPS MERCY HOSPITAL'S EMERGENCY DEPARTMENT AND TRAUMA CENTER PARTICIPATED IN THE CORRECTIVE BEHAVIOR INSTITUTE'S YOUTHFUL DRINKING AND DRIVING PROGRAM, PROVIDING TEENS WITH A TRAUMA CENTER VISITATION EXPERIENCE. THIS FOUR-HOUR SUPERVISED TRAUMA VISITATION PROGRAM FOR YOUNG DRIVERS AGES 14 AND OVER TO SHOW THEM THE REALISTIC CONSEQUENCES OF DRIVING UNDER THE INFLUENCE. OVER 44 HIGH SCHOOL STUDENTS WERE SERVES WITH THIS PROGRAM. PARTICIPANTS VISIT THE TRAUMA ROOM, ER, ICU, CAT SCAN AND OTHER HOSPITAL AREAS. (SPONSORED BY SCRIPPS MERCY HOSPITAL'S EMERGENCY DEPARTMENT AND TRAUMA CENTER) SAN DIEGO COUNTY POLICY PANEL ON YOUTH ACCESS TO ALCOHOL SCRIPPS PARTICIPATES ON A PANEL WHICH WORKS TO SHAPE LOCAL, STATE AND NATIONAL POLICIES THAT AFFECT UNDERAGE DRINKING. IT IS THE LEAD ORGANIZATION FOR THE REGION'S COMBATING UNDERAGE DRINKING INITIATIVE, AND PROVIDES STRUCTURE TO SUPPORT THE PROJECT'S STRATEGIES THROUGH MEDIA ADVOCACY, DATA COLLECTION, AND RESPONSIBLE BEVERAGE SERVICE TRAINING AND YOUTH PARTICIPATION. (SPONSORED BY SCRIPPS MERCY HOSPITAL, TRAUMA SERVICES) SAN DIEGO COUNTY METHAMPHETAMINE STRIKE FORCE (MSF) CONVENED IN 1996 BY THE COUNTY BOARD OF SUPERVISORS, THIS MULTIAGENCY GROUP IS TASKED WITH THE DEVELOPMENT OF A REGIONAL PREVENTION AND TREATMENT STRATEGY TO ADDRESS METHAMPHETAMINE ABUSE. SCRIPPS MERCY HOSPITAL TRAUMA SERVICES IS ON THE COORDINATING COMMITTEE. THE STRIKE FORCE TRACKS ITS PROGRESS WITH AN ANNUAL REPORT CARD OF TEN INDICATORS. THE STRIKE FORCE PROGRAMS HAVE BEEN DUPLICATED IN SEVERAL OTHER PARTS OF THE UNITED STATES. (SPONSORED BY SCRIPPS MERCY HOSPITAL, TRAUMA SERVICES) UNINTENTIONAL INJURY AND VIOLENCE IN CALIFORNIA, INJURY, INCLUDING BOTH UNINTENTIONAL AND INTENTIONAL, IS THE NUMBER ONE KILLER AND DISABLER OF PERSONS AGED 1 TO 44 (CDPH, 2010). THE NUMBERS OF DEATHS ASSOCIATED WITH UNINTENTIONAL INJURY ARE SIGNIFICANT, YET PRESENT ONLY A SMALL PART OF A MUCH LARGER AND SERIOUS PUBLIC HEALTH PROBLEM. HOSPITALIZATION DATA IS MORE INDICATIVE OF THE EXTENT OF THE INJURY PROBLEM THAN DEATH DATA ALONE. IN SAN DIEGO COUNTY DURING 2008 THERE WERE OVER 930 DEATHS, MORE THAN 20,800 SAN DIEGANS WERE HOSPITALIZED AND NEARLY 150,000 WERE TREATED ANNUALLY IN EMERGENCY DEPARTMENTS FOR UNINTENTIONAL INJURIES. THE NUMBER OF UNINTENTIONAL INJURIES TREATED IN PHYSICIANS' OFFICES AND CLINICS RELATED TO UNINTENTIONAL INJURY, WHILE UNKNOWN, IS LIKELY MUCH HIGHER THAN THE NUMBER OF EMERGENCY DEPARTMENT VISITS. UNINTENTIONAL INJURIES ARE ONE OF THE LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY 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. OVER 930 SAN DIEGANS DIED IN 2008 AS A RESULT OF UNINTENTIONAL INJURIES. DURING 2008, THERE WERE 149,900 UNINTENTIONAL INJURY DISCHARGES FROM SAN DIEGO COUNTY EDS, ACCOUNTING FOR ALMOST ONE IN FOUR (24.2%) OF ALL ED DISCHARGES DURING THIS PERIOD. THE RATE OF ED DISCHARGES RELATED TO UNINTENTIONAL INJURY WAS 4,735 PER 100,000 AND REPRESENTED THE LOWEST RATE DURING THE PAST THREE YEARS. UNINTENTIONAL INJURIES CAN OCCUR AT HOME, AT WORK, WHILE PARTICIPATING IN SPORTS AND RECREATION, ON THE STREETS, AND AT SCHOOL. CAUSES OF UNINTENTIONAL INJURIES INCLUDE MOTOR VEHICLE ACCIDENTS, FALLS, FIREARMS, FIRE/BURNS, DROWNING, POISONING (INCLUDING DRUGS AND CAUSTIC SUBSTANCES) AND ALCOHOL, GAS, CLEANERS AND INJURIES AT WORK. THE FOLLOWING ARE SOME OF SCRIPPS HEALTH PROGRAMS THAT ADDRESS UNINTENTIONAL INJURIES AND VIOLENCE FOR FY11.
HEALTH AND SAFETY FAIR - SCRIPPS HOME HEALTH SERVICES   PROVIDED EDUCATION FOR SENIORS ON FALL PREVENTION (PRIMARY CAUSES OF FALLS AND FRACTURES) AND FIRE SAFETY. HOME HEALTH NURSES PROVIDE INFORMATION TO SENIORS AND THEIR FAMILIES ON CONTINUUM OF CARE OPTIONS. IN FY11, 735 SAN DIEGO RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) FALL PREVENTION - SCRIPPS MEMORIAL HOSPITAL LA JOLLA AND THE LAWRENCE FAMILY JEWISH COMMUNITY CENTER PARTNERED TO OFFER A CLASS TAUGHT BY TRAUMA CARE EXPERTS TO LEARN WAYS TO REDUCE FALL RISK, IMPROVE SAFETY AWARENESS AND UTILIZE AVAILABLE RESOURCES TO PROMOTE INDEPENDENCE AND OVERALL SAFETY. 3,500 PARTICIPANTS FROM THE COMMUNITY ATTENDED THIS CLASS. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, TRAUMA SERVICES) SPORTS CONCUSSION PROGRAM - REHABILITATION CENTER AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS EVERY YEAR IN THE U.S., ALMOST 300,000 SPORTS-RELATED CONCUSSIONS OCCUR PER YEAR - 100,000 IN FOOTBALL ALONE, AND APPROXIMATELY 130,000 HIGH SCHOOL ATHLETES SUFFER A CONCUSSION. A RECENT REPORT SHOWED THAT CLOSE TO 40 PERCENT OF HIGH SCHOOL ATHLETES WHO SUSTAIN A CONCUSSION RETURN TO PLAY TOO SOON. THE REHABILITATION CENTER AT SCRIPPS ENCINITAS HAS DEVELOPED A PUBLIC EDUCATION AND COMMUNITY OUTREACH PROGRAM DESIGNED TO BRING AWARENESS TO CONCUSSION, SIGNS AND SYMPTOMS OF CONCUSSION, HOW TO AVOID THEM, TREAT THEM AND UNDERSTAND THEIR CONSEQUENCES. 194 STUDENTS HAVE BEEN SERVED BY THIS PROGRAM. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL ENCINITAS) SAN DIEGO FALL PREVENTION TASK FORCE THIS COUNTY HHSA- AGING AND INDEPENDENCE SERVICE-SUPPORTED TASK FORCE SEEKS TO REDUCE FALLS AND THEIR DEVASTATING CONSEQUENCES IN SAN DIEGO COUNTY. GOALS AND STRATEGIES INCLUDE: (1) INCREASE CONNECTIONS BETWEEN PHYSICIANS AND OTHER COMMUNITY SERVICE PROVIDERS THAT PROVIDE FALL PREVENTION SERVICES; (2) INCREASE AWARENESS AMONG OLDER ADULTS AND SERVICE. SCRIPPS MERCY HOSPITAL TRAUMA DEPARTMENT PARTICIPATES IN THIS TASK FORCE. WEIGHT STATUS, NUTRITION, ACTIVITY AND FITNESS THE NUMBERS SPEAK FOR THEMSELVES - 63% OF AMERICAN ADULTS ARE EITHER OVERWEIGHT OR OBESE. NATIONALLY, THE PREVALENCE OF OBESE ADULTS (THOSE WITH A BODY MASS INDEX [BMI] OF 30 OR MORE) HAS INCREASED BY 68% SINCE 1995, FROM 16% TO ALMOST 27%. DURING THIS SAME PERIOD, THE PREVALENCE OF OVERWEIGHT ADULTS HAS INCREASED BY ONLY TWO PERCENT, 35.5% TO 36.2%. 2009 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR SAN DIEGO COUNTY INDICATES THAT ALMOST 59% OF THE ADULT POPULATION IS CONSIDERED EITHER OVERWEIGHT OR OBESE. SINCE 2005, THE FIRST YEAR BRFSS DATA WAS REPORTED FOR SAN DIEGO COUNTY, THE PREVALENCE OF OBESE ADULTS HAS RANGED FROM 20% IN 2005 TO 26.7% IN 2006, WITH THE MOST CURRENT MEASURE AT 21.6% SINCE 2006. THE PREVALENCE OF OVERWEIGHT ADULTS IN SAN DIEGO COUNTY HAS INCREASED SLIGHTLY FROM 36.5% TO 37.7%. REVIEW OF ADULT OVERWEIGHT AND OBESITY PREVALENCE DATA BY ETHNICITY, RACE AND GENDER INDICATES THE PREVALENCE RATES OF OBESITY AMONG LATINOS AND AFRICAN AMERICANS ARE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITES AT THE NATIONAL, STATE AND COUNTY LEVELS. OBESITY RATES BY GENDER ALSO VARIED SIGNIFICANTLY IN THE 2007 CHIS, THE MOST RECENT COUNTY LEVEL DATA AVAILABLE BY GENDER, WITH 25.4% OF MALES AND 18.1% OF FEMALES HAVING A BMI OF 30.0 OR HIGHER. MOREOVER, MALES WERE SIGNIFICANTLY MORE LIKELY TO BE OVERWEIGHT (BMI BETWEEN 25.0 AND 29.99) THAN FEMALES, 40.5% AND 25.8%, RESPECTIVELY. CAUSES OF OBESITY MANY FACTORS PLAY A ROLE IN OVERWEIGHT AND OBESITY, MAKING IT A COMPLEX HEALTH ISSUE TO ADDRESS. SOME OF THE FACTORS THAT ARE MAJOR CONTRIBUTORS TO THE OBESITY EPIDEMIC INCLUDE (DH&HS, 2010): - GENETIC PREDISPOSITION - ENVIRONMENTAL INFLUENCES - BEHAVIOR (DIETARY PATTERNS AND PHYSICAL ACTIVITY) - CULTURAL INFLUENCES - SOCIOECONOMIC STATUS IN THE CONTEXT OF PREVENTION, IT IS IMPORTANT TO UNDERSTAND THE AFFECT EACH OF THESE FACTORS HAS ON OBESITY AND WHICH CAN BE CHANGED AS A MEANS OF REDUCING THE PREVALENCE OF OBESITY. THE FOLLOWING ARE SOME EXAMPLES OF SCRIPPS PROGRAMS THAT ADDRESS THE HEALTH ISSUES DESCRIBED ABOVE. NUTRITION SERVICES AND PHYSICAL ACTIVITY ACCORDING TO THE 2009 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR SAN DIEGO COUNTY, MORE THAN 59 PERCENT OF THE ADULT POPULATION IS CONSIDERED EITHER OVERWEIGHT OR OBESE. OBESITY INCREASES THE HEALTH RISK FOR CHRONIC DISEASES, SUCH AS HEART DISEASE, TYPE 2 DIABETES, HIGH BLOOD PRESSURE, STROKE AND SOME FORMS OF CANCER. AT EVEN GREATER RISK ARE THE NATION'S LOW-INCOME MINORITY POPULATIONS. IN AN EFFORT TO ADDRESS THIS CRITICAL HEALTH CONCERN, STAFF MEMBERS BASED AT THE CITY HEIGHTS WELLNESS CENTER HAVE ESTABLISHED A VARIETY OF NUTRITION EDUCATION AND SERVICES, DESIGNED SPECIFICALLY TO MEET THE NEEDS OF LOW-INCOME MINORITY POPULATIONS. THE CENTER USES A COMBINATION OF APPROACHES TO ADDRESS A BROAD ARRAY OF COMMUNITY HEALTH PRIORITIES, INCLUDING NUTRITION, ACCESS TO SERVICES AND COMMUNITY ENGAGEMENT. THE "HUB" OF THE WELLNESS CENTER IS A TEACHING KITCHEN; A HANDS-ON INTERACTIVE SETTING FOR COOKING DEMONSTRATIONS, WEIGHT MANAGEMENT AND MEAL PREPARATION CLASSES, NUTRITION EDUCATION AND COUNSELING. DURING FY11, MORE THAN 6,000 VISITS ACCESSED NUTRITION EDUCATION AND COUNSELING SERVICES AT THE CITY HEIGHTS WELLNESS CENTER. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE-FUNDED WIC PROGRAM, SERVING 6 LOCATIONS THAT ARE CONVENIENTLY SITUATED EITHER IN OR NEXT TO COMMUNITY CLINICS AND/OR HOSPITALS IN THE CENTRAL SAN DIEGO AREA OF SAN DIEGO COUNTY. WIC'S TARGET POPULATION IS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO FIVE). ON AN ANNUAL BASIS, SCRIPPS MERCY WIC SERVES APPROXIMATELY 9,000 WOMEN AND CHILDREN WITH 44% IN THE CITY HEIGHTS COMMUNITY. THE CLIENT BASE IN CITY HEIGHTS IS 91% HISPANIC AND MADE UP OF PREGNANT AND POSTPARTUM WOMEN (24%), INFANTS (20%) AND CHILDREN (56%). IN FY11, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS TO 119,003 WOMEN AND CHILDREN IN THE SOUTH AND CENTRAL REGIONS OF SAN DIEGO. (SPONSORED BY SCRIPPS MERCY SAN DIEGO) HEALTHY LIVE HEALTHY - FAMILY NUTRITION PROGRAM USING THE COOPERATIVE EXTENSION'S RESEARCH-BASED CURRICULUMS AND BILINGUAL STAFF, A REGISTERED DIETITIAN SUPERVISED THE IMPLEMENTATION OF WEEKLY NUTRITION EDUCATION CLASSES IN SPANISH. PROGRAM TARGETS THE LOW-INCOME, FOOD STAMP POPULATION. IT CONSISTS OF A SERIES OF EIGHT WEEKLY CLASSES AND THE PRIMARY GOAL IS TO INCREASE KNOWLEDGE, SKILLS AND MOTIVATIONAL LEVEL OF AREA RESIDENTS TO PRACTICE HEALTHY EATING AND RELATED BEHAVIORS. CLASS TOPICS FOCUS ON NUTRITION, PHYSICAL FITNESS, FOOD SAFETY, MEAL PLANNING AND FOOD SHOPPING. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) COLLABORATE FOR HEALTHY WEIGHT. THIS ADVISORY GROUP MEETS MONTHLY. COLLABORATE FOR HEALTHY WEIGHT IS A PROGRAM OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AND THE NATIONAL INITIATIVE FOR CHILDREN'S HEALTHCARE QUALITY (NICHQ). THE SHARED VISION IS TO CREATE PARTNERSHIPS BETWEEN PRIMARY CARE, PUBLIC HEALTH, AND COMMUNITY ORGANIZATIONS TO DISCOVER SUSTAINABLE WAYS TO PROMOTE HEALTHY WEIGHT AND ELIMINATE HEALTH DISPARITIES IN COMMUNITIES ACROSS THE UNITED STATES. ALL THREE SECTORS MUST COLLABORATE, USING EVIDENCE-BASED APPROACHES, TO REVERSE THE OBESITY EPIDEMIC AND IMPROVE THE HEALTH OF OUR COMMUNITIES. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA, VISTA, COMMUNITY BENEFIT SERVICES) MENTAL HEALTH AND MENTAL DISORDERS ACCORDING TO THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH), ANNUALLY, AN ESTIMATED 13 MILLION AMERICAN ADULTS (APPROXIMATELY 1 IN 17) HAVE A SERIOUSLY DEBILITATING MENTAL ILLNESS (NIMH, 2008). FURTHERMORE, MENTAL HEALTH DISORDERS ARE THE LEADING CAUSE OF DISABILITY IN THE U.S., ACCOUNTING FOR 25% OF ALL YEARS OF LIFE LOST TO DISABILITY AND PREMATURE MORTALITY (WHO, 2004). MOREOVER, IN 2007, SUICIDE WAS THE 11TH LEADING CAUSE OF DEATH IN THE U.S., ACCOUNTING FOR OVER 34,500 DEATHS (NVSS, 2010). SAN DIEGO COUNTY - PREVALENCE OF SERIOUS MENTAL ILLNESS THERE ARE 141,420 PERSONS IN SAN DIEGO COUNTY WITH SERIOUS MENTAL ILLNESS, REPRESENTING 4.9% OF THE HOUSEHOLD POPULATION IN SAN DIEGO COUNTY (DMH, 2007). THE MOST IMPACTED BY SERIOUS MENTAL ILLNESS IN SAN DIEGO ARE PERSONS UNDER AGE 18 AND THOSE LIVING IN HOUSEHOLDS UNDER 200% OF THE FEDERAL POVERTY LEVEL, 7.4% AND 8.8% RESPECTIVELY. EMERGENCY DEPARTMENT DISCHARGES DURING 2008, THERE WERE 25,468 DISCHARGES FROM SAN DIEGO COUNTY HOSPITAL EMERGENCY DEPARTMENTS WITH A PRIMARY DIAGNOSIS OF MENTAL DISORDER, ACCOUNTING FOR 4.1% OF ALL ED DISCHARGES. (NOTE, THE PRIMARY DIAGNOSIS OF MENTAL DISORDER INCLUDES A WIDE RANGE OF DIAGNOSES INCLUDING ALCOHOLIC AND DRUG PSYCHOSES, DEPENDENCE AND ABUSE.) THE OVERALL RATE OF ED DISCHARGES WITH A DIAGNOSIS OF MENTAL DISORDER WAS 809.5 PER 100,000 POPULATION.
HOSPITALIZATIONS   DURING 2008, THERE WERE 22,971 HOSPITALIZATIONS IN SAN DIEGO COUNTY HOSPITALS WITH A PRINCIPAL DIAGNOSIS CODE OF MENTAL DISORDERS (ICD-9-CD CODE 290 - 319), ACCOUNTING FOR 7.4% OF ALL HOSPITALIZATIONS. THESE HOSPITALIZATIONS INCLUDED 17,556 WITH A PRINCIPAL DIAGNOSIS OF PSYCHOSES, ACCOUNTING FOR 59% OF ALL MENTAL HEALTH HOSPITALIZATIONS. THERE WERE 6,210 WITH A PRINCIPAL DIAGNOSIS OF SCHIZOPHRENIC DISORDERS AND 4,583 WITH A PRINCIPAL DIAGNOSIS OF MAJOR DEPRESSIVE DISORDER, ACCOUNT FOR 27% AND 20% OF ALL MENTAL HEALTH HOSPITALIZATIONS, RESPECTIVELY (COSDEPI, 20010). SUICIDE AND SUICIDE ATTEMPTS (SELF-INFLECTED INJURY) SUICIDE OCCURS WHEN A PERSON ENDS HIS OR HER LIFE AND IS A MAJOR COMPLICATION OF DEPRESSION. IN 2008, IT WAS THE EIGHTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 369 DEATHS WITH AN OVERALL RATE OF 11.3 SUICIDE DEATHS PER 100,000 PEOPLE (SDEPI, 2010). SUICIDE DEATHS ARE ONLY PART OF THE PROBLEM, MORE PEOPLE SURVIVE SUICIDE ATTEMPTS THAN ACTUALLY DIE. THOSE WHO ATTEMPT SUICIDE ARE OFTEN SERIOUSLY INJURED AND REQUIRE MEDICAL AND PSYCHIATRIC CARE. BETWEEN 2000 AND 2008, 2,896 SAN DIEGANS HAVE DIED AS A RESULT OF SUICIDE. SCRIPPS OFFERS BOTH INPATIENT AND OUTPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT THE SCRIPPS MERCY HOSPITAL SAN DIEGO CAMPUS. SCRIPPS MERCY'S BEHAVIORAL HEALTH PROGRAM ALSO ACTIVELY SUPPORTS COMMUNITY PROGRAMS DESIGNED TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. SCRIPPS HEALTH BEHAVIORAL HEALTH INPATIENT PROGRAMS INDIVIDUALS SUFFERING FROM ACUTE PSYCHIATRIC DISORDERS ARE SOMETIMES UNABLE TO LIVE INDEPENDENTLY OR MAY EVEN POSE A DANGER TO THEMSELVES OR OTHERS. IN SUCH CASES, HOSPITALIZATION MAY BE THE MOST APPROPRIATE ALTERNATIVE. SCRIPPS MERCY HOSPITAL'S BEHAVIORAL HEALTH INPATIENT PROGRAM HELPS PATIENTS AND THEIR LOVED ONES WORK THROUGH SHORT-TERM CRISES, MANAGE MENTAL ILLNESS AND RESUME THEIR DAILY LIVES. CHALLENGES * LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. * IN 2011, SCRIPPS MERCY'S BEHAVIORAL HEALTH PROGRAM LOST $5.2 MILLION. * IN 2011, 25 PERCENT OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED. SCRIPPS HEALTH BEHAVIORAL HEALTH OUTPATIENT PROGRAMS SCRIPPS MERCY PROVIDES COMMUNITY-BASED ADULT PSYCHIATRIC TREATMENT AT SCRIPPS MERCY SAN DIEGO. THE OUTPATIENT PROGRAM IS AN INTENSIVE DAY PROGRAM DESIGNED TO HELP INDIVIDUALS REDUCE THEIR SYMPTOMS WHILE THEY CONTINUE TO LIVE IN THE COMMUNITY. THE PROGRAM PROVIDES TWO LEVELS OF CARE: * THE OUTPATIENT PROGRAM OFFERS PATIENTS ONE TO FOUR TREATMENT DAYS PER WEEK * THE PARTIAL HOSPITALIZATION PROGRAM PROVIDES MORE INTENSIVE TREATMENT FIVE TO SIX DAYS PER WEEK. MENTAL HEALTH OUTREACH SERVICES A-VISIONS SERVICE PROGRAM BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL ESTABLISHED THE A-VISIONS VOCATIONAL TRAINING PROGRAM, IN PARTNERSHIP WITH THE SAN DIEGO MENTAL HEALTH ASSOCIATION TO HELP DECREASE THE STIGMA OF MENTAL ILLNESS. THE PROGRAM HELPS PEOPLE RECEIVING MENTAL HEALTH TREATMENT BY PROVIDING VOCATIONAL TRAINING, POTENTIALLY LEADING TO A GREATER LEVEL OF INDEPENDENCE. THIS YEAR, BEHAVIORAL HEALTH CONTINUED PARTICIPATION IN THE A-VISIONS PROGRAM (SOCIAL REHABILITATION AND PREVOCATIONAL SERVICES FOR PEOPLE LIVING WITH MENTAL ILLNESS). IN FY11, 32 CLIENTS WERE SERVED. CURRENTLY 21 PEOPLE ARE VOLUNTEERING AND 20 PEOPLE ARE PARTICIPATING IN SUPPORTIVE EMPLOYMENT. THE TOTAL EXPENSE FOR THE A-VISIONS PROGRAM FOR FY11 WAS $174,037. INCREASE AWARENESS OF MENTAL HEALTH AND GERIATRIC PSYCHIATRIC ISSUES IN FY11, SCRIPPS BEHAVIORAL HEALTH DEPARTMENT IMPROVED AWARENESS OF MENTAL HEALTH AND GERIATRIC ISSUES BY PROVIDING INFORMATION AND SUPPORTIVE SERVICES TO MORE THAN 1,000 PEOPLE AT COMMUNITY EVENTS. MENTAL HEALTH EMERGING ISSUES HEALTHY PEOPLE 2020 HAS IDENTIFIED SEVERAL MENTAL HEALTH ISSUES THAT HAVE EMERGED AMONG SOME SPECIAL POPULATIONS; THESE INCLUDE: POST-TRAUMATIC STRESS DISORDER (PTSD) AMONG VETERANS AND OTHERS WHO HAVE EXPERIENCED SOME TYPE OF TRAUMATIC EVENT. THESE TRAUMATIC EVENTS MAY INCLUDE: WAR, RAPE, NATURAL DISASTERS, A CAR OR PLANE CRASH, KIDNAPPING, VIOLENT ASSAULT, SEXUAL OR PHYSICAL ABUSE AND MEDICAL PROCEDURES (ESPECIALLY IN KIDS). SCRIPPS MEMORIAL HOSPITAL AT ENCINITAS OFFERS A TWO DAY COURSE CALLED "BRAIN INJURY REHABILITATION CONFERENCE: BEYOND THE HOSPITAL, INTO THE COMMUNITY". THIS TWO DAY COURSE ON PTSD AND STRESS DISORDER IS DESIGNED TO PROVIDE STRATEGIES AND A FRAMEWORK FOR THE MANAGEMENT OF BRAIN INJURED PATIENTS BOTH WITHIN AND OUTSIDE THE CLINICAL SETTING. TREATMENTS ARE FOCUSED ON THE TOTAL CARE CONTINUUM-PHYSICAL, COGNITIVE, PERCEPTUAL, EMOTIONAL AND SOCIAL-IN A MULTIDISCIPLINARY FORMAT. THIS CONFERENCE ALSO PROVIDES THE PARTICIPANT WITH THEORETICAL, PRACTICAL, AND ADVANCED APPLICATIONS IN BRAIN INJURY REHABILITATION. THE COURSE IS TAUGHT BY AN INTERDISCIPLINARY TEAM OF SPECIALISTS IN BRAIN INJURY REHABILITATION AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS. INFECTIOUS DISEASE SEXUALLY TRANSMITTED DISEASES AND HIV/AIDS SEXUALLY TRANSMITTED DISEASES (STDS) HAVE BEEN REFERRED TO BY THE INSTITUTE OF MEDICINE AS A "HIDDEN EPIDEMIC OF ENORMOUS HEALTH AND ECONOMIC CONSEQUENCE IN THE U.S. THEY ARE HIDDEN BECAUSE MANY AMERICANS ARE RELUCTANT TO ADDRESS SEXUAL HEALTH ISSUES IN AN OPEN WAY AND BECAUSE OF THE BIOLOGICAL AND SOCIAL CHARACTERISTICS OF THESE DISEASES". STDS ENCOMPASS MORE THAN 25 INFECTIOUS ORGANISMS TRANSMITTED PRIMARILY THROUGH SEXUAL ACTIVITY. LOCAL, STATE AND NATIONAL HEALTH AGENCIES ARE RESPONSIBLE FOR SURVEILLANCE AND MONITORING OF STDS. TUBERCULOSIS TUBERCULOSIS (TB) IS AN AIRBORNE INFECTIOUS DISEASE CAUSED BY THE BACTERIUM MYCOBACTERIUM TUBERCULOSIS THAT USUALLY AFFECTS THE LUNGS, ALTHOUGH OTHER ORGANS AND TISSUES SUCH AS THE KIDNEY, SPINE, AND BRAIN CAN BE AFFECTED AS WELL. TB CAN BE SPREAD BY COUGHING, SNEEZING, LAUGHING OR SINGING. AS OF DECEMBER 31, 2008, 13,820 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) CASES HAVE BEEN REPORTED IN SAN DIEGO COUNTY SINCE 1981. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH AIDS IN SAN DIEGO COUNTY ARE WHITE, MALE, AGED 30 TO 39 YEARS AND HAVE MALE SEX PARTNERS. DURING THIS PERIOD, 3,847 HUMAN IMMUNODEFICIENCY VIRUS (HIV) CASES HAVE BEEN REPORTED. BECAUSE OF A CHANGE IN THE HIV REPORTING SYSTEM, ALL HIV REPORTING DATA CURRENTLY AVAILABLE COVERS THE PERIOD APRIL 17, 2006 THROUGH DECEMBER 2008. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH HIV ARE WHITE, MALE AND AGED 30 TO 39. DURING 2009, THERE WERE 264 TUBERCULOSIS CASES. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH TB ARE HISPANIC (52.3%) OR ASIAN/PACIFIC ISLANDER (31.1%), MALE (62.5%) AND BETWEEN THE AGES OF 25 AND 64 YEARS . SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER SENIOR PREVENTION AND WELLNESS SENIOR HEALTH CHATS WERE IMPLEMENTED TO PROVIDE HEALTH EDUCATION TO THE OLDER ADULT COMMUNITY IN SOUTH BAY. APPROXIMATELY 25-20 SENIORS ATTENDED THESE MONTHLY THROUGHOUT THE YEAR. THESE PRESENTATIONS INCLUDED A VARIETY OF HEALTH AND AGE RELATED PREVENTION AND WELLNESS. ONE OF THE TOPICS WAS ABOUT TUBERCULOSIS AND HOW TO PREVENT AND TREAT. IN ADDITION, INFORMATION WAS PRESENTED ABOUT SIGNS AND SYMPTOMS. THE PRESENTATIONS ARE FACILITATED BY VARIOUS SCRIPPS MERCY HEALTH CARE PROFESSIONALS, PHYSICIANS AND FAMILY MEDICINE RESIDENTS. TOPICS ARE ALL CHOSEN BY THE SENIORS THEMSELVES SO AS TO MEET THEIR LOCAL NEEDS. ALSO, THE HEALTH CHATS PROVIDE AN INTERCHANGE BETWEEN THE COMMUNITY MEMBERS AND MEDICAL RESIDENTS AND OTHER HEALTH CARE PROFESSIONALS TO FOSTER HEALTHY LIFESTYLES AND HEALTH PREVENTION. SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER STAFF PREPARE AND CONDUCT THESE SESSIONS WITH THE SENIORS TO FOSTER HEALTH PREVENTION, AWARENESS AND DIALOGUE BETWEEN THE SENIORS. MANY QUESTIONS ARE ASKED ABOUT CHRONIC HEALTH ISSUES AND OTHER GERIATRIC RELATED HEALTH CONCERNS.
SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER   YOUTH PREVENTION AND WELLNESS SCRIPPS MERCY HOSPITAL HEALTH CARE PROFESSIONALS, FAMILY MEDICAL RESIDENTS, DIETICIANS, NURSES AND DOCTORS, ENLIGHTEN STUDENTS IN THE CLASSROOM OF TEN LOCAL SOUTH BAY HIGH SCHOOLS ON HEALTH RELATED TOPICS. SOME OF THE TOPICS INCLUDED SEXUALLY TRANSMITTED ILLNESSES AND TUBERCULOSIS 101. STUDENTS RECEIVED HEALTH CAREER TOOLS/BROCHURES THAT INCLUDED INFORMATION ON PREVENTION AND DETECTION AS WELL AS TREATMENT, SIGNS AND SYMPTOMS. 2,527 PEOPLE WERE SERVED. SCRIPPS MERCY HOSPITAL FAMILY MEDICINE RESIDENCY RUN TWO HEALTH CLINICS ESTABLISHED AT PALOMAR AND SOUTHWEST HIGH SCHOOL FOR FAMILY MEDICINE RESIDENTS TO GAIN ADDITIONAL SKILLS IN ADOLESCENT MEDICINE AND FOR YOUTH TO GAIN THE KNOWLEDGE, ATTITUDES, AND SKILLS NECESSARY TO PURSUE HEALTH CAREERS. FAMILY MEDICINE RESIDENTS AND FACULTY INTERACT TWICE PER WEEK AT THE CLINIC PROVIDING ADOLESCENT MEDICINE. SOME TEACHING AND EDUCATION TAKES PLACE ONE-ON-ONE WITH STUDENTS REGARDING SEXUALLY TRANSMITTED ILLNESSES PREVENTION, SIGNS, SYMPTOMS AND TREATMENT. ALSO, INFORMATION IS PRESENTED ON TUBERCULOSIS PREVENTION, SIGNS, SYMPTOMS AND TREATMENT. RESPIRATORY DISEASE RESPIRATORY DISEASES SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE A SIGNIFICANT PUBLIC HEALTH BURDEN IN THE UNITED STATES. ASTHMA AND COPD ARE AMONG THE 10 LEADING CHRONIC CONDITIONS CAUSING RESTRICTED ACTIVITY. AFTER CHRONIC SINUSITIS, ASTHMA IS THE MOST COMMON CAUSE OF CHRONIC ILLNESS IN CHILDREN. COPD, WHICH INVOLVES EMPHYSEMA AND CHRONIC BRONCHITIS, IS THE FOURTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY AND THE US. IN 2007, COPD ACCOUNTED FOR 1,023 DEATHS IN SAN DIEGO COUNTY AND 123,311 DEATHS NATIONALLY FOR AN AGE-ADJUSTED MORTALITY RATE PER 100,000 POPULATION OF 34.1 AND 40.5, RESPECTIVELY. HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 507 PARTICIPANTS WERE INCLUDED IN THE PILOT RANDOMIZED CONTROL TRIAL TO ASSESS HOW BEST TO ASSIST HOSPITALIZED SMOKERS QUIT SMOKING. THIS STUDY IS A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. THE SMOKING CESSATION PILOT AND EXPANDED STUDY ARE PREVENTION PROGRAMS RELATED TO RESPIRATORY DISEASE CONSIDERING THE RESPIRATORY THERAPISTS ARE CORE TO THE PILOT AS WELL AS THE LARGER NIH STUDY. MANY OF THE HOSPITALIZED SMOKERS ARE ADMITTED FOR PULMONARY AND RESPIRATORY DISEASE THAT IS OF COURSE LINKED TO SMOKING. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA). PARTNERSHIP FOR SMOKE-FREE FAMILIES PROGRAM SECOND-HAND SMOKE IS CLEARLY A COMMUNITY HEALTH RISK ATTRIBUTING TO LOW BIRTH WEIGHT IN NEWBORNS, SUDDEN INFANT DEATH SYNDROME (SIDS), RESPIRATORY INFECTIONS, ASTHMA AND MIDDLE-EAR DISEASE IN INFANTS AND CHILDREN. THE PARTNERSHIP FOR SMOKE-FREE FAMILIES (PSF) IS A COLLABORATIVE EFFORT SUPPORTED BY SCRIPPS, SHARP HEALTHCARE AND CHILDREN'S HOSPITAL FOCUSED ON IMPROVING THE HEALTH AND WELL BEING OF CHILDREN BY REDUCING THEIR EXPOSURE TO SECOND-HAND SMOKE. (SPONSORED BY SCRIPPS HEALTH COMMUNITY BENEFITS) CITY HEIGHTS WELLNESS CENTER, "HEALTHY HOMES AND ASTHMA TRIGGER NIGHT FORUM" THE CITY HEIGHTS WELLNESS CENTER PARTNERED WITH THE COMMUNITY ASTHMA TASK FORCE (CAT FORCE). FAMILIES WITH ASTHMATIC CHILDREN OFTEN FACE A NUMBER OF CHALLENGES THAT CAN LEAD TO ANXIETY, FEAR OR CONFLICT. THE FORUM PRESENTED WAYS FOR PARENTS TO LEARN TO OVERCOME OBSTACLES AND CHALLENGES PRESENTED BY THEIR CHILD'S CONDITION AND FIND WAYS TO WORK WITH THEM TO MAINTAIN A HEALTHY AND POSITIVE LIVING ENVIRONMENT. SOME OF THE TOPICS THAT WERE PRESENTED INCLUDED: LEARNING HOW TO GET AN ASTHMA ACTION PLAN COMPLETED BY A DOCTOR; LEARNING HOW TO HAVE A SCHOOL NURSE AND THE CLASSROOM TEACHER FOLLOW THE ASTHMA ACTION PLAN; LEARNING HOW TO RID HOMES OF MOLD, ALLERGENS AND OTHER ASTHMA TRIGGERS; AND LEARNING WHAT CAN BE DONE IN HOMES TO HELP CHILDREN FROM HAVING ASTHMA ATTACKS AND LEARNING ABOUT QUALIFYING TO HAVE HOMES OR APARTMENTS RENOVATED AT NO COST. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) ORAL HEALTH ORAL HEALTH IN AMERICA: A REPORT OF THE SURGEON GENERAL, DECLARES THAT "ORAL HEALTH IS ESSENTIAL TO THE GENERAL HEALTH AND WELL-BEING OF ALL AMERICANS." THE REPORT IDENTIFIES HUGE DISPARITIES IN THE ORAL HEALTH STATUS OF CERTAIN POPULATIONS IN THE UNITED STATES, INCLUDING LOW-INCOME FAMILIES, THOSE LIVING IN RURAL COMMUNITIES, RACIAL OR ETHNIC MINORITIES, CHILDREN, THE ELDERLY AND THE DEVELOPMENTALLY DISABLED. THE 2005 CALIFORNIA ORAL HEALTH NEEDS ASSESSMENT REPORTED 54% OF KINDERGARTENERS AND 71% OF THIRD GRADERS HAVE A HISTORY OF TOOTH DECAY AND MORE THAN 25% OF ELEMENTARY SCHOOL CHILDREN HAVE UNTREATED DECAY. A REPORT CARD ISSUED IN 2010 BY CHILDREN NOW GAVE CALIFORNIA A D+ FOR HEALTH COVERAGE AND A D+ FOR ORAL HEALTH. THOSE WHO SUFFER THE WORST ORAL HEALTH ARE FOUND AMONG THE POOR OF ALL AGES, WITH POOR CHILDREN AND POOR OLDER AMERICANS PARTICULARLY VULNERABLE. IDENTIFIED BARRIERS TO CARE INCLUDE: NO PERCEIVED NEED FOR ORAL CARE AND/OR THE PUBLIC AND POLICYMAKERS PLACING A LOW PRIORITY ON ORAL HEALTH AND PREVENTION STRATEGIES; LACK OF ACCESS TO DENTISTS; LOW SOCIO-ECONOMIC STATUS AND/OR LACK OF FINANCIAL RESOURCES TO PAY FOR CARE; INADEQUATE REIMBURSEMENT BY GOVERNMENT INSURANCE PROGRAMS AND EXCESSIVE PAPERWORK REQUIRED FOR REIMBURSEMENT; LACK OF PROVIDERS TRAINED TO CARE FOR DIVERSE POPULATIONS, VERY YOUNG CHILDREN AND PEOPLE WITH SPECIAL NEEDS; AND MEDI-CAL BENEFICIARIES BEING UNAWARE THAT DENTAL BENEFITS ARE INCLUDED AS PART OF THEIR INSURANCE PLAN. PROJECT DULCE PROJECT DULCE ADDRESSES ORAL HEALTH ISSUES WITH PATIENTS DURING COUNSELING VISITS. FOSTERING VOLUNTEERISM SCRIPPS BELIEVES THAT HEALTH IMPROVEMENT BEGINS WHEN COMMUNITY MEMBERS TAKE AN ACTIVE ROLE IN MAKING A POSITIVE IMPACT ON THEIR COMMUNITY. FOR THIS REASON, SCRIPPS SUPPORTS VOLUNTEER PROGRAMS FOR SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS WHO WANT TO HELP MAKE EVEN MORE OF A DIFFERENCE IN THE HEALTH OF THEIR COMMUNITY. THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER CLUB IS ONE AVENUE THROUGH WHICH SCRIPPS MATCHES THE TALENTS AND INTERESTS OF EMPLOYEES AND PHYSICIANS WITH COMMUNITY NEEDS. THIS INCLUDES, BUT IS NOT LIMITED TO, MENTORING PARTNERSHIPS WITH LOCAL SCHOOLS AND EFFORTS TO PROVIDE FREE MEDICAL AND SURGICAL CARE TO PATIENTS IN NEED. IN ADDITION TO THE FINANCIAL COMMUNITY BENEFIT CONTRIBUTIONS MADE DURING FY11, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS CONTRIBUTED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS-SPONSORED COMMUNITY BENEFIT PROGRAMS AND SERVICES. WITH CLOSE TO 21,302 HOURS OF VOLUNTEER TIME, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $906,229.90. PROFESSIONAL EDUCATION & HEALTH RESEARCH QUALITY HEALTH CARE IS HIGHLY DEPENDENT UPON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WOULD BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH THROUGH THE DEVELOPMENT OF NEW AND INNOVATIVE TREATMENT OPTIONS. REFLECTS CLINICAL RESEARCH AS WELL AS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES, INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. RESEARCH TAKES PLACE PRIMARILY AT SCRIPPS CLINICAL RESEARCH SERVICES, SCRIPPS WHITTIER DIABETES INSTITUTE, SCRIPPS GENOMIC MEDICINE AND SCRIPPS TRANSLATIONAL SCIENCE INSTITUTE. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO THE ADVANCEMENT OF HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH AND MEDICAL EDUCATION PROGRAMS. DURING THIS FISCAL YEAR, SCRIPPS INVESTED $34,504,162 IN PROFESSIONAL TRAINING PROGRAMS AND CLINICAL RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES FOR SAN DIEGO COUNTY. HEALTH PROFESSIONS TRAINING INTERNSHIPS SCRIPPS' COMMITMENT TO ONGOING LEARNING AND HEALTH CARE EXCELLENCE EXTENDS BEYOND OUR ORGANIZATION. OUR INTERNSHIP PROGRAMS HELP PROMOTE HEALTH CARE CAREERS TO A NEW GENERATION, SHAPE THE FUTURE WORKFORCE, AND DEVELOP FUTURE LEADERS IN OUR COMMUNITY. INTERACTING WITH HEALTH CARE PROFESSIONALS IN THE FIELD PROVIDES A LEARNING EXPERIENCE THAT EXPANDS EDUCATION OUTSIDE OF THE CLASSROOM. SCRIPPS STAFF PLAYS AN IMPORTANT ROLE AS PRECEPTORS BY INVESTING THEIR TIME TO CREATE A VALUABLE EXPERIENCE FOR THE COMMUNITY. IN FISCAL YEAR 2011 SCRIPPS HOSTED 1,903 INTERNS WITHIN OUR SYSTEM AND PROVIDED A COMBINED TOTAL OF 192,609 DEVELOPMENT HOURS SPANNING ACROSS NURSING AND ANCILLARY SETTINGS. TABLE 1 PROVIDES A BREAKDOWN OF INTERNS BY SCRIPPS FACILITY.
COLLEGE AND UNIVERSITY AFFILIATIONS   SCRIPPS COLLABORATES WITH LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO ENABLE STUDENTS TO EXPLORE ROLES IN HEALTH CARE AND GAIN FIRST-HAND EXPERIENCE AS THEY WORK WITH SCRIPPS PROFESSIONALS. SCRIPPS IS AFFILIATED WITH OVER 90 DIFFERENT SCHOOLS AND PROGRAMS RANGING FROM CLINICAL TO NON-CLINICAL PARTNERSHIPS. LOCAL SCHOOLS INCLUDE, BUT ARE NOT LIMITED TO, POINT LOMA NAZARENE UNIVERSITY (PLNU), UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD), CAL STATE UNIVERSITY SAN MARCOS (CSUSM), SAN DIEGO STATE UNIVERSITY (SDSU), UNIVERSITY OF SAN DIEGO (USD), MESA COLLEGE, SAN DIEGO CITY COLLEGE, GROSSMONT COLLEGE AND MIRA COSTA COLLEGE. SCRIPPS IS REGULARLY ACCEPTING NEW PARTNERSHIPS BASED ON COMMUNITY AND WORKFORCE NEEDS. SCRIPPS ESTABLISHED AN AFFILIATION AGREEMENT COMMITTEE TO REVIEW ALL REQUESTS AND PROVIDE A SYSTEMWIDE APPROACH TO SECURING NEW STUDENT PLACEMENTS. THIS COMMITTEE IS INTERDISCIPLINARY AND REPRESENTS LEARNING AND DEPARTMENT LEADERSHIP ACROSS THE SCRIPPS SYSTEM, ENSURING A PROACTIVE APPROACH TO BUILDING A CAREER PIPELINE FOR TOP TALENT. RESEARCH STUDENTS SCRIPPS SUPPORTS GRADUATE LEVEL RESEARCH AT ITS FACILITIES FOR MASTER AND DOCTORAL LEVEL STUDENTS STUDYING AT A UNIVERSITY WHICH HAS AN AFFILIATION AGREEMENT WITH SCRIPPS. SCRIPPS CENTER FOR LEARNING & INNOVATION OVERSEES THE STUDENT PLACEMENT PROCESS. NON-PHYSICIAN STUDENTS WHO HAVE PARTICIPATED IN RESEARCH AT SCRIPPS REPRESENT A VARIETY OF HEALTHCARE DISCIPLINES INCLUDING PUBLIC HEALTH, PHYSICAL THERAPY, PHARMACY AND NURSING. IN FY11, STUDENT RESEARCH CONDUCTED AT SCRIPPS REPRESENTED STUDENTS FROM THE USD, SDSU, PLNU, POST-DOCTORAL PHARMACY RESIDENCY PROGRAMS AND PGY1 PHARMACY RESIDENCY PROGRAM. COLLEGE COLLABORATIONS SCRIPPS PARTNERED WITH POINT LOMA NAZARENE UNIVERSITY TO CREATE HEALTHCARE FOCUS COURSES INCLUDING HEALTHCARE FINANCE AND HEALTHCARE OPERATIONS. PLNU STUDENTS (NON-SCRIPPS EMPLOYEES) MAY ELECT TO TAKE THESE COURSES TOWARDS MBA COMPLETION. HIGH SCHOOL PROGRAMS SCRIPPS IS DEDICATED TO PROMOTING HEALTH CARE AS A REWARDING CAREER TO TOMORROW'S WORKFORCE. SCRIPPS COLLABORATES WITH PARTICIPATING HIGH SCHOOLS TO OFFER STUDENTS AN OPPORTUNITY TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRST-HAND EXPERIENCE AS THEY WORK WITH SCRIPPS HEALTH CARE PROFESSIONALS. FOLLOWING IS A SUMMARY OF THE HIGH SCHOOL PROGRAMS MADE AVAILABLE TO THE COMMUNITY THIS PAST YEAR: SCRIPPS HIGH SCHOOL EXPLORATION PROGRAM AND REGIONAL ALLIED HEALTH AND SCIENCE INITIATIVE (RASHI) THIS PROGRAM IS DESIGNED TO REACH OUT TO SAN DIEGO HIGH SCHOOL YOUTH INTERESTED IN EXPLORING A CAREER IN HEALTH CARE. IN FY11 SCRIPPS HIRED 35 STUDENTS TO PARTICIPATE IN THE PROGRAM. DURING THEIR PAID FIVE WEEK ROTATION, THE STUDENTS ROTATE THROUGH DEPARTMENTS, EXPLORING CAREER OPTIONS AND LEARNING VALUABLE LIFE LESSONS ABOUT HEALTH AND HEALING. UC HIGH SCHOOL COLLABORATION UC HIGH SCHOOL AND SCRIPPS PARTNERED THIS YEAR TO PROVIDE A REAL-LIFE CONTEXT TO HEALTHCARE ESSENTIALS COURSE TAUGHT AT UC HIGH SCHOOL. FOR FY11, 10 STUDENTS WERE INTERVIEWED AND SELECTED TO ROTATE THROUGH THREE DIFFERENT SCRIPPS CLINIC LOCATIONS DURING THE FALL AND SPRING SEMESTER TO INCREASE THEIR AWARENESS OF HEALTHCARE CAREERS. UC HIGH STUDENTS VISITED SCRIPPS CLINIC TORREY PINES, DEL MAR, AND CARMEL VALLEY SHADOWING HEALTHCARE PROFESSIONALS IN VARIOUS DEPARTMENTS INCLUDING INTERNAL MEDICINE, RADIOLOGY, ASC, INTEGRATIVE MEDICINE, URGENT CARE, CARDIOLOGY, AND PEDIATRICS. YOUNG LEADERS IN HEALTH CARE AN OUTREACH PROGRAM AT SCRIPPS HOSPITAL ENCINITAS, YOUNG LEADERS IN HEALTH CARE TARGETS LOCAL HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING CAREERS IN HEALTH CARE. STUDENTS FROM GRADES 9-12 PARTICIPATE IN THE PROGRAM. THIS PROGRAM IS DESIGNED TO PROVIDE A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS BREADTH OF CAREER OPPORTUNITIES. IT IS A COMBINED EXPERIENCE INCLUDING WEEKLY MEETINGS AT LOCAL SCHOOLS FACILITATED BY TEACHERS AND ADVISORS, AS WELL AS MONTHLY MEETINGS AT SCRIPPS HOSPITAL ENCINITAS. THE PROGRAM MENTORS STUDENTS ABOUT LEADERSHIP AND PROVIDES TOOLS DAILY LIFE CHALLENGES. YOUNG LEADERS IN HEALTH CARE ALSO INCLUDES A SERVICE PROJECT TO MEET HIGH SCHOOL REQUIREMENTS AND ALSO MAKE A POSITIVE IMPACT ON THE COMMUNITY. THE PROGRAM CLOSES THE YEAR WITH A PRESENTATION THAT IS ALIGNED WITH THE YEARLY FOCUS. MORE THAN 60 STUDENTS, COMMUNITY MEMBERS AND HEALTH CARE SPECIALISTS ATTENDED THE YOUNG LEADER IN HEALTH CARE FINAL MEETING OF THE SCHOOL YEAR CULMINATING IN STUDENT PRESENTATIONS ON SPORTS INJURIES AND PREVENTION. WORKABILITY SCRIPPS PARTNERS WITH THE SAN DIEGUITO ACADEMY WORKABILITY PROGRAM WHICH EDUCATES STUDENTS AND THE COMMUNITY REGARDING HEALTH CARE CAREER OPPORTUNITIES. SCRIPPS PROVIDES FIRST-HAND TOURS OF HOSPITAL FACILITIES AND EDUCATES PARTICIPANTS ABOUT THE COMPLEXITIES OF HOSPITAL OPERATIONS. THE PROGRAM IS DESIGNED TO PROVIDE PRE-EMPLOYMENT SKILLS DEVELOPMENT, WORKSITE TRAINING AND FOLLOW-UP SERVICES FOR YOUTH (AGES 12-22) WITH SPECIAL NEEDS WHO ARE MAKING THE TRANSITION FROM SCHOOL TO WORK. WHILE STUDENTS GET CLASSROOM TRAINING, SCRIPPS HAS PARTNERED WITH THE PROGRAM TO PROVIDE ONSITE CAREER TRAINING FOR THE STUDENTS. IN FY11, 5 STUDENTS PARTICIPATED IN THE PROGRAM AT GREEN AND ENCINITAS. NEW GRAD RESIDENCY PROGRAM DESIGNED FOR THE NEWLY GRADUATED REGISTERED NURSE (RN), THIS INNOVATIVE PROGRAM AIMS TO IMPROVE PATIENT CARE QUALITY AND SAFETY DURING THE FIRST YEAR ON THE JOB. BY TRAINING NEW NURSES AND BUILDING CONFIDENCE AT THE BEDSIDE, THE PROGRAM HELPS MAKE THE INITIAL YEAR OF A NURSE'S CAREER A LAUNCH PAD TO SUCCESS. 990 PART V, LINE 7H THE DONATED VEHICLE WAS PLACED IN SERVICE FOR THE ORGANIZATION, THEREFORE, FORM 1098-C IS NOT APPLICABLE.
990 REVIEW PROCESS WITH GOVERNING BODY FORM 990, PART VI, LINE 11B THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS.
COMPLIANCE POLICY MONITORING FORM 990, PART VI, LINE 12C WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT ARE REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINE 15A & 15B PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN SAN DIEGO, CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: -FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. -SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. -TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. -BENEFITS ARE POSITIONED AT THE 65TH PERCENTILE OF THE PEER GROUP. -ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 14, 2011. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES.
JOINT VENTURES FORM 990, PART VI, LINE 16 SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS.
AVAILABILITY OF DOCUMENTS TO THE GENERAL PUBLIC FORM 990, PART VI, LINE 19 FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII THE TRUSTEES OF SCRIPPS HEALTH ALSO SERVE AS TRUSTEES OF THE WHITTIER INSTITUTE WHERE THEY DEVOTE 5 HOURS PER WEEK. CHRISTOPHER VAN GORDER IS ALSO THE PRESIDENT AND CEO OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK. RICHARD ROTHBERGER IS ALSO THE CFO AND CORPORATE EXECUTIVE VP OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK. RICHARD SHERIDAN IS ALSO THE CORPORATE SENIOR VP AND GENERAL COUNSEL OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK. GALE KEEL IS ALSO THE ASSISTANT SECRETARY TO THE BOARD OF DIRECTORS OF THE WHITTIER INSTITUTE WHERE SHE DEVOTES 5 HOURS PER WEEK. VIRGINIA LEARY IS ALSO THE EXECUTIVE SECRETARY TO THE CEO OF THE WHITTIER INSTITUTE WHERE SHE DEVOTES 5 HOURS PER WEEK. ARNOLD BRENT EASTMAN IS ALSO THE CORPORATE SENIOR VP AND CHIEF MEDICAL OFFICER OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK.
OTHER CHANGES TO NET ASSETS/FUND BALANCES FORM 990, PART XI, LINE 5 UNREALIZED GAIN/LOSS ON INVESTMENTS $(62,209,559) CHANGE IN VALUE OF DEFERRED GIFTS $ (852,534) OTHER CHANGES IN NET ASSETS $ 1,322,181 JOINT VENTURES-NONCONTROLLING INTERESTS $ 3,212,000 OTHER CHANGES $ 1,096 --------------- TOTAL $(58,526,816)
TAX EXEMPT BONDS SCHEDULE K, PART I, ISSUE PRICE BOND ISSUE A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON THE 8038 TAX FORM AS THE $49,995,000 AMOUNT REPRESENTS ONLY SCRIPPS HEALTH'S PORTION IN A POOL BOND LOAN PROGRAM.
SCHEDULE K, PART I, CUSIP NUMBER BOND ISSUE D (2005A/2008G): THE SERIES 2005A BONDS, CUSIP 13033FWK2, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G, CUSIP 13033F5M8 (SCRIPPS HEALTH), ON AUGUST 14, 2008.
SCHEDULE K, PART I, DESCRIPTION OF PURPOSE BOND ISSUE A (2007A): POOL BOND. PROCEEDS USED FOR EQUIPMENT PURPOSES. BOND ISSUE B (2008A): REFUNDING OF PRIOR ISSUES 07/07/2005 BOND ISSUE C (2008B-F): THE $221,230,000 (2008B - F) REFUNDED THE 2005B - F BONDS. THE ISSUE DATE FOR THE 2005 B - F WAS 6/17/2005. BOND ISSUE D (2005A/2008G): THE $40,975,000 (2008G) EXCHANGED THE 2005A BOND. THE ISSUE DATE FOR THE 2005A WAS 6/2/2005. THE PROCEEDS OF THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2005A (SCRIPPS HEALTH), WERE ISSUED FOR THE PURPOSE, TOGETHER WITH OTHER AVAILABLE FUNDS, OF ADVANCE REFUNDING THE ORGANIZATION'S SERIES 1998C BONDS. THE SERIES 2005A BONDS, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G (SCRIPPS HEALTH), ON AUGUST 14, 2008. BASED ON THE ADVICE OF BOND COUNSEL, THE ORGANIZATION IS TREATING THE SERIES 2008G BONDS AS THE SAME ISSUE AS THE SERIES 2005A BONDS FOR FEDERAL INCOME TAX PURPOSES. FURTHER INFORMATION REGARDING THE SERIES 2008G BONDS: ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY; ISSUER EIN: 52-1643828; CUSIP #: 13033F5M8; DATE EXCHANGED: 8/14/2008; ISSUE PRICE: N/A; DESCRIPTION OF PURPOSE: EXCHANGE FOR SERIES 2005A BONDS (SAME ISSUE). BOND ISSUE A-2 (2010A): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE B-2 (2010B & C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT.
SCHEDULE K, PART II, QUESTION 8 BOND ISSUE B (2008B-F): SUBSTANTIALLY COMPLETE PRIOR TO ISSUANCE BOND ISSUE D (2005A/2008G): SUBSTANTIALLY COMPLETE PRIOR TO ISSUANCE
SCHEDULE K, PART III, QUESTION 3C   THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY.
SCHEDULE K, PART IV, ARBITRAGE, QUESTION 5 BOND ISSUE A (2007A): AN AMOUNT IN THE COSTS OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008. BOND ISSUE D (2005A/2008G): THE COST OF ISSUANCE WAS NOT EXPENDED UNTIL 1/4/2006. PER THE TAX CERTIFICATE IT WAS EXPECTED TO BE EXPENDED WITHIN 180 DAYS.
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:  
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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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


 		(f)
Direct controlling
entity







(1) SCRIPPS CARDIO&THORACIC SURGERY BILLING
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
27-0602996 		HLTHCR ADMIN CA 4,764,135 0 NA
 
(2) SCRIPPS CLINIC BILLING LLC
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
87-0737749 		HLTHCR ADMIN CA 360,005,626 0 NA
 
(3) SCRIPPS MERCY BILLING LLC
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
87-0737748 		HLTHCR ADMIN CA 55,032,815 0 NA
 






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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) THE WHITTIER INSTITUTE

9894 GENESEE AVENUE

LA JOLLA,CA92037
95-3621314 		RSRCH & EDU CA 501(C)(3) 4 SCRIPPS
 
 
 
(2) SCRIPPS CLINICAL SCIENCE CENTER

4275 CAMPUS POINT COURT

SAN DIEGO,CA92121
26-4479543 		RESEARCH CA 501(C)(3) 4 SCRIPPS
 
 
 
(3) MERCY HOSPITAL FOUNDATION

4275 CAMPUS POINT COURT

SAN DIEGO,CA92121
94-2958094 		FUNDRAISING CA 501(C)(3) 11, I SCRIPPS
 
 
 








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



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) SCRIPPS MERCY AMBULATORY SURGERY CENTER

4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
45-0503246 		AMBUL SURGERY CTR CA NA
  		RELATED 2,568,078 3,845,311   No 0 Yes   73.500 %
(2) SCRIPPS ENCINITAS SURGERY CENTER LLC

4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
20-5942958 		HOSPITAL CA NA
  		RELATED 1,467,685 95,939   No 0   No 55.500 %
(3) SCRIPPS IDN MGMT LLC

4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
45-4557426 		HEALTHCARE SVCS CA NA
  		RELATED 0 0   No 0 Yes   50.000 %








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



 		(b)
Primary activity



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


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

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) SC PHYSICIANS ORGANIZATION INC
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
33-0796247 		HOLDING COMPANY CA NA
  		C CORP 0 420,432 100.000 %
(2) SCRIPPS HEALTH & HEALING
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
20-5156965 		PATIENT EDUCATION CA NA
  		C CORP 0 0 100.000 %
(3) SCRIPPS HEALTH PLAN SERVICES (SHPS)
4275 CAMPUS POINT COURT
SAN DIEGO,CA92191
33-0782099 		HLTHCARE SVC PLAN CA NA
  		C CORP 236,291,742 39,250,328 100.000 %
(4) CHARITABLE REMAINDER TRUSTS (66)
 
 
HOSPITAL SUPPORT CA NA
  		TRUST      
(5) CHARITABLE LEAD TRUSTS (2)
 
 
HOSPITAL SUPPORT CA NA
  		TRUST      
(6) SCRIPPSCARE
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
45-2870638 		HEALTHCARE SVCS CA NA
  		C CORP 0 0 100.000 %


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

 K 78,139,020  
(2) Scripps Health Plan Services (SHPS)

 L 9,715,236  
(3) Whittier Institute for Diabetes

 P 2,961,475  
(4) Scripps Mercy Ambulatory Surgery Center

 A(IV) 741,913  
(5) Scripps Encinitas Surgery Center LLC

 A(IV) 339,169  
(6) Scripps Clinical Science Center

   0  
(7) Mercy Hospital Foundation

   0  
(8) Scripps IDN Management LLC

   0  
(9) SC Physicians Organizations INC

   0  
(10) Scripps Health & Healing

   0  
(11) Charitable Remainder Trusts (66)

   0  
(12) Charitable Lead Trusts (2)

   0  
(13) ScrippsCare

   0  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIPS SCHEDULE R, PART III SCRIPPS MERCY AMBULATORY SURGERY CENTER EIN: 45-0503246 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121 SCRIPPS ENCINITAS SURGERY CENTER EIN: 20-5942958 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121 SCRIPPS IDN MANAGEMENT LLC EIN: 45-4557426 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121
Additional Data


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