TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) SISTER CECILIA MAGLADRY BOARD MEMBER	2.0	X		0	0	0
(2) OSCAR FLORES BOARD CHAIR	4.0	X		0	0	0
(3) WILLIAM MURIN BOARD MEMBER	2.0	X		0	929,193	20,134
(4) MICHELE STAUNTON MD BOARD MEMBER	2.0	X		0	0	0
(5) R CLIFFORD CARPER BOARD MEMBER	2.0	X		0	0	0
(6) SISTER MARYANNE HUEPPER BOARD MEMBER	2.0	X		0	0	0
(7) ELLEN LEWIS MSN FAAN BOARD MEMBER	2.0	X		0	0	0
(8) FARZAD MASSOUDI MD BOARD MEMBER	2.0	X		33,130	0	0
(9) SISTER EILEEN MCNERNEY BOARD MEMBER	2.0	X		0	0	0
(10) BETH SCHIMMEL BOARD MEMBER	2.0	X		0	0	0
(11) ROBERT WINOKUR MD BOARD VICE CHAIR	2.0	X		0	0	0
(12) KENNETH MCFARLAND BOARD MEMBER, CEO & PRESIDENT	50.0	X	X	621,561	0	46,507
(13) SISTER CHRISTINE RAY BOARD MEMBER	2.0	X		0	0	0
(14) RUDY MARQUEZ MD BOARD MEMBER	2.0	X		0	0	0
(15) JOE ROBBEN BOARD MEMBER	2.0	X		0	0	0
(16) WILLIAM ELDIEN BOARD MEMBER (OUTGOING)	2.0	X		0	0	0
(17) PAT KELLY BOARD MEMBER (OUTGOING)	2.0	X		0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
MARLA FENNELL INC 2542 CALLE JADE SAN CLEMENTE,CA92673	TRANSCRIPTION SVC	2,017,385
TRIAGE CONSULTING GROUP 221 MAIN ST SUITE 1100 SAN FRANCISCO,CA94105	COLLECTION SERVICE	1,375,361
EMERGENCY AND ACUTE CARE MED CORP 440 STEVENS AVE SUITE 150 SOLANA BEACH,CA920752058	MEDICAL SERVICE	1,355,382
PACIFIC HOSPITALIST 510 SUPERIOR AVE SUITE 290 NEWPORT BEACH,CA92663	MEDICAL SERVICE	1,330,948
CALIFORNIA PHYSICIAN CONSULTANTS 170 SOUTHPORT DRIVE MORRISVILLE,CA27560	MEDICAL SERVICE	914,406
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 23

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 United States. See Part IV, line 21	7,143,971	7,143,971
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	47,653	47,653
3	Grants and other assistance to governments, organizations, and individuals outside the United States. 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 ....	2,699,982	1,844,838	855,144
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	84,000	84,000
7	Other salaries and wages	144,679,482	134,001,347	8,494,226	2,183,909
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,019,359	8,058,246	827,325	133,788
9	Other employee benefits .......	46,935,270	44,242,842	2,207,743	484,685
10	Payroll taxes ...........	12,304,309	11,474,584	684,065	145,660
11	Fees for services (non-employees):
a	Management ......	17,412,412	13,755,805	3,656,607
b	Legal .........	1,237,584	397,338	800,167	40,079
c	Accounting ...........	493,262		484,436	8,826
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	119,375			119,375
f	Investment management fees ......	0
g	Other ..........	48,806,667	38,839,806	9,575,387	391,474
12	Advertising and promotion ....	1,569,543		1,527,566	41,977
13	Office expenses .......	14,167,536	13,104,017	943,688	119,831
14	Information technology ......	3,859,748	3,859,748
15	Royalties ..	0
16	Occupancy ...........	31,509,416	28,797,642	2,295,843	415,931
17	Travel ............	213,700	117,227	68,395	28,078
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	89,863	69,687	7,037	13,139
20	Interest ...........	9,788,739	8,860,707	928,032
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	21,391,498	20,353,566	1,037,515	417
23	Insurance ..............	2,872,036		2,872,036
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	MEDICAL SUPPLIES	64,320,698	64,320,698
b	HOSPITAL FEE PROGRAM	17,816,841	17,816,841
c	LICENSES/TAXES/DUES	1,122,830	239,812	874,452	8,566
d	ALL OTHER EXPENSES	2,753,282	1,184,768	1,250,109	318,405
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	462,459,056	418,615,143	39,389,773	4,454,140
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	6,423,372	1	17,526,564
2	Savings and temporary cash investments .......	93,093,095	2	101,613,600
3	Pledges and grants receivable, net .........	3,131,568	3	4,313,515
4	Accounts receivable, net .........	63,396,356	4	73,475,509
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
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 ..........	0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	5,043,978	8	5,617,584
9	Prepaid expenses and deferred charges ............	2,484,057	9	1,314,875
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	479,630,386
b	Less: accumulated depreciation. .....	10b	158,337,564	321,262,752	10c	321,292,822
11	Investments—publicly traded securities ..........	56,127,284	11	68,497,533
12	Investments—other securities. See Part IV, line 11 ......	23,373,344	12	22,091,184
13	Investments—program-related. See Part IV, line 11 ..	0	13	0
14	Intangible assets .........	13,717,072	14	13,717,072
15	Other assets. See Part IV, line 11 ...........	8,686,816	15	14,528,501
16	Total assets. Add lines 1 through 15 (must equal line 34)...	596,739,694	16	643,988,759
	17	Accounts payable and accrued expenses .	50,160,446	17	56,172,717
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	0	19	0
20	Tax-exempt bond liabilities ..........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	228,259,359	25	232,310,583
26	Total liabilities. Add lines 17 through 25.....	278,419,805	26	288,483,300
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	268,304,392	27	305,253,682
28	Temporarily restricted net assets .....	50,015,497	28	50,172,777
29	Permanently restricted net assets .....	0	29	79,000
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	318,319,889	33	355,505,459
34	Total liabilities and net assets/fund balances .....	596,739,694	34	643,988,759

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... 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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2

Name of organization MISSION HOSPITAL REGIONAL MEDICAL CENTER
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization MISSION HOSPITAL REGIONAL MEDICAL CENTER
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose 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

(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

(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

(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) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

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, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2011

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 if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

55,275

Total. Add lines 1c through 1i ...............................

55,275

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
OTHER ACTIVITIES	SCHEDULE C, PART II-B, LINE 1I	THE AMOUNT ON LINE 1I IS THE PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. DURING THE PAST YEAR, THE ST. JOSEPH HEALTH SYSTEM HAS CONDUCTED AN ADVOCACY EFFORT WHICH INCLUDED SOME LOBBYING ACTIVITY. THESE INCLUDED MEETING WITH LOCAL, STATE, AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS; AND COMMUNICATIONS TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION.

Schedule C (Form 990 or 990EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

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 .......

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? ....................................

Yes No

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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


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

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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
1a	Beginning of year balance ....	1,257,495	0
b	Contributions ........	514,556	1,207,312
c	Net investment earnings, gains, and losses ...	10,588	57,912
d	Grants or scholarships .....	0	0
e	Other expenditures for facilities and programs ........	0	0
f	Administrative expenses ....	16,084	7,729
g	End of year balance ......	1,766,555	1,257,495

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

95.500 %

Permanent endowment SchDMd Bullet

4.500 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,300,000	35,735,120		37,035,120
b	Buildings ................		277,809,633	63,138,510	214,671,123
c	Leasehold improvements ............		17,341,952	8,868,852	8,473,100
d	Equipment ................		125,310,277	86,304,953	39,005,324
e	Other .................		22,133,404	25,249	22,108,155
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					321,292,822

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

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








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

Part VIII

InvestmentsProgram 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) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
INTERCO. WITH HEALTH SYSTEM-BONDS		187,066,284
INTERCOMPANY PAYABLE		31,513,149
THIRD PARTY PAYABLES		10,093,112
OTHER LIABILITIES		3,638,038





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		232,310,583
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) 2011

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 through 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 must 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 must 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
CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740)	SCHEDULE D, PART X, LINE 2	ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2012 OR 2011.

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

2011

Open to Public Inspection

Name of the organization
MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I

General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants

and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? ..............................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.

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
	Central America and the Caribbean	0	0	Program Services	CAPTIVE INSURANCE	1,917,229
















3a	Sub-total .....	0	0			1,917,229
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0			1,917,229

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011

Schedule F (Form 990) 2011

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)

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

Enter total number of other organizations or entities ........................ MediumBullet

Schedule F (Form 990) 2011

Schedule F (Form 990) 2011Page 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) 2011

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2011

Page 5

Part V

Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	ReturnReference	Explanation
ACCOUNTING METHOD	SCHEDULE F, PART I, LINE 3, COLUMN (F)	THE ACCRUAL METHOD OF ACCOUNTING WAS USED TO DETERMINE THE AMOUNT IN COLUMN (F).

Schedule F (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public Inspection

Name of the organization
MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

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?

Yes

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
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
HARRIS CONNECT	TELEPHONE OUTREACH		No	94,496	119,375	-24,879
Total .................				94,496	119,375	-24,879

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) 2011

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 GOLF (event type)	(b) Event #2 GALA (event type)	(c) Other Events 4 (total number)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	350,113	1,293,827	617,956	2,261,896
2	Less: Charitable contributions . . .	261,982	964,386	442,904	1,669,272
3	Gross income (line 1 minus line 2) . . .	88,131	329,441	175,052	592,624
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .	55,617	29,807		85,424
7	Food and beverages . .	25,131	114,445	88,134	227,710
8	Entertainment . . .		30,000		30,000
9	Other direct expenses .	95,020	62,326	114,361	271,707
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				614,841
11	Net income summary. Combine lines 3 and 10 in column (d)............				-22,217

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.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

184,106

Cash prizes . . . .

3,750

Non-cash prizes . . .

38,000

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes 100.000 %
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

41,750

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

142,356

Enter the state(s) in which the organization operates gaming activities: CA

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

AS A TAX-EXEMPT HOSPITAL, MISSION HOSPITAL REGIONAL MEDICAL CENTER IS EXEMPT FROM THE CALIFORNIA ATTORNEY GENERAL REGISTRATION AND REPORTING REQUIREMENTS FOR THE RAFFLES.

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

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? ..........................

YesNo

Schedule G (Form 990 or 990-EZ) 2011

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

0 %

An outside facility ........................

13b

100.000 %

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

WINIFRED JOHNSON

Address

27700 MEDICAL CENTER ROAD
MISSION VIEJO,CA92691

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

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

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

WINIFRED JOHNSON

Gaming manager compensation right arrow

$ 15,567

Description of services provided right arrow

VP FOUNDATION/FUNDRAISING

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

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

$ 165,695

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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2011

Open to Public Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other 500 %

If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..	7,919,091	0	7,919,091	1.700 %
b Medicaid (from Worksheet 3, column a) .....	53,254,085	26,133,006	27,121,079	5.820 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .	9,483,206	4,143,682	5,339,524	1.150 %
dTotal Financial Assistance and Means-Tested Government Programs .....	70,656,382	30,276,688	40,379,694	8.670 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	3,015,055	28,489	2,986,566	0.640 %
f Health professions education (from Worksheet 5) ..	30,000		30,000	0.010 %
g Subsidized health services (from Worksheet 6) ..	1,500,608		1,500,608	0.320 %
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	1,835,765		1,835,765	0.390 %
jTotal Other Benefits ...	6,381,428	28,489	6,352,939	1.360 %
kTotal. Add lines 7d and 7j. ..	77,037,810	30,305,177	46,732,633	10.030 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	111,968	0	111,968	0.020 %
2	Economic development
3	Community support	144,086	0	144,086	0.030 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	2,979	0	2,979	0 %
8	Workforce development
9	Other	121,347	0	121,347	0.030 %
10	Total	380,380	0	380,380	0.080 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense........

25,966,239

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

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

Enter total revenue received from Medicare (including DSH and IME).....

91,792,080

Enter Medicare allowable costs of care relating to payments on line 5.....

117,397,804

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-25,605,724

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(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 %
1MECC - SEE PART VI	PHYSICIAN OFFICE&CONF ED CTR	50.000 %	0 %	50.000 %
2MAS - SEE PART VI	OUTPATIENT SURGERY CENTER	43.750 %	0 %	56.250 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	MISSION HOSPITAL REGIONAL MEDICAL CENTER 27700 MEDICAL CENTER ROAD MISSION VIEJO,CA92691	X	X	X

Schedule H (Form 990) 2011

Page

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)

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Name of Hospital Facility:

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 2011)
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 the community health 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 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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and 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	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 500.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	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	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address		Type of Facility (describe)
1	MISSION MEDICAL TOWER 26732 CROWN VALLEY PARKWAY MISSION VIEJO,CA92691	WELLNESS CENTER, OUTPATIENT IMAGING CENTER, CARDIAC REHAB, PHYSICAL THERAPY
2	MISSION AMBULATORY SURGICENTER 27800 MEDICAL CENTER ROAD STE 362 MISSION VIEJO,CA92691	OUTPATIENT SURGERY CENTER
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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 7		A COST-TO-CHARGE RATIO FROM THE COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COST OF ALL REPORTED CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. IT INCLUDED ALL PATIENT TYPES (I.E. INPATIENT OUTPATIENT, EMERGENCY ROOM), AND WOULD ONLY INCLUDE CHARGES OR RELATED COSTS THAT PERTAIN TO EACH RESPECTIVE AREA (I.E. CHARITY, MEDICAID, MANAGED CARE, PRIVATE INSURANCE, SELF PAY, UNINSURED, ETC.). FOR UNREIMBURSED COSTS, THAT WOULD BE THE DIFFERENCE BETWEEN THE DETERMINED COSTS UTILIZING THE COST-TO-CHARGE RATIO LESS ANY PAYMENTS RECEIVED FOR THAT PARTIAL PAYOR GROUP. THE COST-TO-CHARGE RATIO USED WAS NOT DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
SCHEDULE H, PART I, LINE 7G		NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.
COMMUNITY BUILDING ACTIVITIES	SCHEDULE H, PART II	OUR MISSION CALLS US TO IMPROVE HEALTH AND QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. A KEY EMPHASIS IS PUT ON DEVELOPING PROGRAMS THAT ADDRESS ROOT CAUSES OF HEALTH PROBLEMS. KEY ISSUES FOR FISCAL YEAR 2012 CONTINUE TO BE ACCESS TO AFFORDABLE HOMES AND SERVING THE HOMELESS. MISSION HOSPITAL HAS PARTNERED WITH KEY COMMUNITY STAKEHOLDERS TO HELP ADDRESS THESE LONG-TERM ISSUES. ACCESS TO AFFORDABLE HOMES: THE AFFORDABLE HOMES OUTCOME GOAL IS TO INCREASE AFFORDABLE HOMES IN SOUTH ORANGE COUNTY, WITH A SPECIAL FOCUS ON THE CITIES OF SAN CLEMENTE, SAN JUAN CAPISTRANO, LAKE FOREST, AND MISSION VIEJO. IN 2008, MISSION HOSPITAL INITIATED A PARTNERSHIP WITH OVER A DOZEN AGENCIES TO CREATE THE SOUTH ORANGE COUNTY ALLIANCE FOR HOUSING OUR COMMUNITIES (SOCAHOC). TOGETHER, THE ALLIANCE WORKS TO INCREASING THE NUMBER OF PUBLIC OR PRIVATE POLICIES THAT SUPPORT AFFORDABLE HOMES, INCREASING BROAD-BASED COMMUNITY ADVOCACY ORGANIZATIONS THAT IDENTIFY AND ACT ON AFFORDABLE HOMES AS A PRIORITY, AND COLLABORATING TO CREATE NEW AFFORDABLE HOMES. HOMELESS OUTREACH: AFTER PURCHASING THE LAGUNA BEACH CAMPUS, THE LOCAL HEALTH NEEDS ASSESSMENT IDENTIFIED HOMELESS OUTREACH AS A PRIMARY NEED FOR THE COMMUNITY. BEGINNING IN 2009, WE BEGAN COLLABORATING WITH LOCAL RESIDENTS AND AGENCIES WHO SERVE THE HOMELESS TO MEET THEIR NEEDS. MISSION HOSPITAL PROVIDES A NUTRITIONALLY BALANCED LUNCH FOR UP TO 50 HOMELESS PEOPLE STAYING AT THE CITY'S ALTERNATIVE SLEEPING LOCATION 5 DAYS EACH WEEK (REPRESENTING $42,000 ANNUALLY). IN ADDITION, WE PROVIDE $5,000 TO A LOCAL SOUP KITCHEN IN CAPISTRANO BEACH. SAFE RIDES TO TEENS: TO AVOID TRAGEDY DUE TO DRUNK DRIVING, MISSION HOSPITAL SPONSORS AND COORDINATES THE SAFE RIDES PROGRAM, A FREE, ANONYMOUS SERVICE THAT PROVIDES TEENS A SAFE RIDE HOME SHOULD THEY NEED A RIDE ON FRIDAY OR SATURDAY EVENINGS. THIS PROGRAM HAS AN ANNUAL COST OF APPROXIMATELY $35,000.
SCHEDULE H, PART III, LINE 4		THE ORGANIZATION RECOGNIZED THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY ARE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT: THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED AND OTHERS ARE FROM VARIOUS PAYORS WHO ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS, AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. DISCOUNTS ON PATIENT ACCOUNTS IN BAD DEBT: ANY ACCOUNT RETURNED TO THE HOSPITAL FROM A COLLECTION AGENCY THAT HAS DETERMINED THE PATIENT DOES NOT HAVE THE RESOURCES TO PAY HIS OR HER BILL, MAY BE DEEMED ELIGIBLE FOR CHARITY CARE WITHOUT ABSOLUTE REQUIREMENT FOR SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION. ALL OUTSIDE COLLECTION AGENCIES CONTRACTED WITH SJHS TO PERFORM ACCOUNT FOLLOW-UP AND/OR BAD DEBT COLLECTION WILL UTILIZE THE FOLLOWING CRITERIA TO IDENTIFY A STATUS CHANGE FROM BAD DEBT TO CHARITY CARE: - PATIENT ACCOUNTS MUST HAVE NO APPLICABLE INSURANCE (INCLUDING GOVERNMENTAL COVERAGE PROGRAMS OR OTHER THIRD PARTY PAYERS); AND - THE PATIENT MUST HAVE A CREDIT SCORE AND BEHAVIOR RATING WITHIN THE LOWEST 25TH PERCENTILE OF CREDIT SCORES FOR ANY CREDIT EVALUATION METHOD USED; AND - THE PATIENT HAS NOT MADE A PAYMENT WITHIN 150 DAYS OF ASSIGNMENT TO THE COLLECTION AGENCY; AND - THE COLLECTION AGENCY HAS DETERMINED THAT THE PATIENT IS UNABLE TO PAY; AND/OR - THE PATIENT DOES NOT HAVE A VALID SOCIAL SECURITY NUMBER AND/OR AN ACCURATELY STATED RESIDENCE ADDRESS IN ORDER TO DETERMINE A CREDIT SCORE. ALL ACCOUNTS RETURNED FROM A COLLECTION AGENCY FOR RE-ASSIGNMENT FROM BAD DEBT TO CHARITY CARE WILL BE EVALUATED BY HOSPITAL PERSONNEL TO DETERMINE ELIGIBILITY FOR CHARITY CARE OR DISCOUNTED CARE PRIOR TO ANY RE-CLASSIFICATION WITHIN THE HOSPITAL ACCOUNTING SYSTEM AND RECORDS. DOCUMENTATION OF THE PATIENT'S INABILITY TO PAY FOR SERVICES WILL BE MAINTAINED BY THE HOSPITAL.
SCHEDULE H, PART III, LINE 8		THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES (EXCEPT FOR AMOUNTS REPORTED IN PART I, LINE 7) AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED USING THE MEDICARE COST REPORT.
SCHEDULE H, PART III, LINE 9B		SJHS PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE (100 PERCENT FINANCIAL ASSISTANCE) WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED.
NAME OF ENTITY	SCHEDULE H, PART IV, COLUMN (A)	1. MISSION EDUCATION CONFERENCE CENTER, LLC 2. MISSION AMBULATORY SURGICENTER, LTD, DBA MISSION SURGERY CENTER
MISSION HOSPITAL REGIONAL MEDICAL CENTER (1)	SCHEDULE H, PART V, SECTION B, LINE 11H	THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.
MISSION HOSPITAL REGIONAL MEDICAL CENTER (1)	SCHEDULE H, PART V, SECTION B, LINE 13G	THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S PATIENT POPULATION.
MISSION HOSPITAL REGIONAL MEDICAL CENTER (1)	SCHEDULE H, PART V, SECTION B, LINE 19D	FOR PATIENTS WITH A FAMILY INCOME BETWEEN 201% AND 350% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USES MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR PATIENTS WITH A FAMILY INCOME BETWEEN 351% AND 500% OF FPG, THE AVERAGE OF NEGOTIATED COMMERCIAL INSURANCE RATES IS USED TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED.
NEEDS ASSESSMENT	SCHEDULE H, PART VI, LINE 2	FROM JANUARY - MAY 2011, MISSION HOSPITAL CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN THE CITIES OF SAN CLEMENTE, SAN JUAN CAPISTRANO AND LAKE FOREST (LAGUNA BEACH NEEDS ASSESSMENT WAS CONDUCTED IN 2010 JUST AFTER PURCHASING SOUTH COAST MEDICAL CENTER IN JULY 2009). IN ORDER TO OBTAIN FEEDBACK FROM RESIDENTS IN THE COMMUNITY, MISSION HOSPITAL COLLECTS DATA IN THREE WAYS: TELEPHONE SURVEY: CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC), A TELEPHONE SURVEY OF 146 QUESTIONS FOCUSED ON ISSUES SUCH AS GENERAL HEALTH, CHRONIC DISEASE, INJURY AND VIOLENCE, HEALTH RISKS, PREVENTIVE CARE, ACCESS TO HEALTHCARE SERVICES AND BROAD COMMUNITY ISSUES. THE SURVEY IS MODELED AFTER THE CENTERS FOR DISEASE CONTROL'S (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, WHICH ENABLES US TO BENCHMARK OUR RESULTS TO STATEWIDE AND NATIONAL RESULTS. 919 SURVEYS WERE CONDUCTED IN EACH OF THE THREE TARGETED CITIES AND WERE DEMOGRAPHICALLY REPRESENTATIVE OF EACH OF THE COMMUNITIES. VALIDITY OF RESULTS IS AT A 95% CONFIDENCE LEVEL (AND 95% WHEN LOOKING AT CITY-SPECIFIC DATA). KEY STAKEHOLDER PANELS: TWO PANELS OF KEY STAKEHOLDERS WERE HELD IN SAN CLEMENTE AND SAN JUAN CAPISTRANO TO OBTAIN INPUT FROM LOCAL SERVICE PROVIDERS FROM A CROSS-SECTION OF DISCIPLINES WHO PROVIDE SERVICES TO LOCAL RESIDENTS. 40 PEOPLE PARTICIPATED IN THESE TWO PANELS AND REPRESENTATION INCLUDED THE MEDICAL FIELD, EDUCATION, FAITHBASED GROUPS, LOCAL RESIDENT LEADERS, NON-PROFIT AGENCIES AND COUNTY-FUNDED PROGRAMS. RESIDENT FORUMS: ONCE THE PRC SURVEYS WERE COMPLETE, SIX COMMUNITY FORUMS WERE CONDUCTED WITH RESIDENTS IN THE CITIES OF SAN JUAN CAPISTRANO, SAN CLEMENTE, AND LAKE FOREST. THERE WERE A TOTAL OF 63 PARTICIPANTS ACROSS ALL FORUMS, WITH EACH FORUM RANGING IN SIZE FROM 2 TO 21 AND AVERAGING 10 PARTICIPANTS. THE MAJORITY OF PARTICIPANTS WERE WOMEN (N = 54). PARTICIPANTS WERE ALL ADULTS, MAINLY RESIDENTS AND A FEW STAKEHOLDERS (E.G., SERVICE PROVIDERS, CITY EMPLOYEES, AND HOSPITAL EMPLOYEES). THE ENGLISH LANGUAGE FORUMS INCLUDED MOSTLY STAKEHOLDERS AND TO A LESSER EXTENT INCLUDED RESIDENTS, WHILE THE SPANISH LANGUAGE FORUMS INCLUDED MOSTLY RESIDENTS. EACH FORUM LASTED ABOUT ONE AND A HALF HOURS. PARTICIPANTS IDENTIFIED 25 PRIORITY ISSUES. THE RESULTS AGGREGATED ACROSS THE FORUMS INDICATE THAT THE FOUR PRIORITY HEALTH AND QUALITY OF LIFE ISSUES PERCEIVED BY THE PARTICIPANTS ARE AS FOLLOWS: 1. OBESITY 2. LACK OF HEALTH INSURANCE 3. STRESS AND ANXIETY 4. ACCESS TO AFFORDABLE HOMES THERE WAS A NOTABLE DIFFERENCE BETWEEN THE ENGLISH LANGUAGE AND SPANISH LANGUAGE FORUMS, HOWEVER, IN THAT THE SPANISH LANGUAGE FORUM PARTICIPANTS BELIEVED UNAUTHORIZED IMMIGRATION STATUS IS A DETERMINANT TO HEALTH DISPARITY AND QUALITY OF LIFE. FOR THE FULL REPORT, PLEASE VISIT OUR WEBSITE AT WWW.MISSION4HEALTH.COM THE NEEDS ASSESSMENT WAS MADE AVAILABLE ON THE WEBSITE AND BY REQUEST. IN ADDITION, MISSION HOSPITAL STAFF PRESENTED TO CITY OFFICIALS AND SELECTED CITY COMMISSIONS IN ALL TARGETED CITIES AS WELL AS LOCAL COMMUNITY COALITIONS, MISSION HOSPITAL'S BOARD OF TRUSTEES AND COMMUNITY BENEFIT COMMITTEE, AND THE SAN CLEMENTE COMMUNITY RESOURCE CENTER AND SAN CLEMENTE COLLABORATIVE. THE NEEDS ASSESSMENT AND RESIDENT FORUMS BROUGHT FORWARD OVER 25 ADDITIONAL HEALTH AND QUALITY OF LIFE ISSUES, INCLUDING CARDIOVASCULAR RISK, DENTAL SERVICES, ALCOHOL AND SUBSTANCE ABUSE, AND JOB TRAINING FOR YOUTH. HOWEVER, BASED UPON HOSPITAL RESOURCES AND THE DESIRE TO FOCUS DEEPLY ON A FEW PRIORITIES VERSUS SPREADING RESOURCES TOO THINLY, MISSION HOSPITAL SELECTED FOUR PRIORITIES FOR ITS COMING FISCAL YEAR 2012-2014 COMMUNITY BENEFIT PLAN, TO INCLUDE: CHILDHOOD OBESITY, MENTAL HEALTH, YOUTH ALCOHOL & SUBSTANCE USE, AND AFFORDABLE HOMES.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI, LINE 3	THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE.
COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINE 4	MISSION HOSPITAL PROVIDES SOUTH ORANGE COUNTY COMMUNITIES WITH HEALTH ACCESS THROUGH TWO CONVENIENT LOCATIONS, MISSION VIEJO AND LAGUNA BEACH. THE HOSPITAL'S SERVICE AREA EXTENDS FROM THE JUNCTION OF THE 405 AND 5 FREEWAYS IN THE NORTH TO CAMP PENDLETON IN THE SOUTH. GEOGRAPHICALLY, SOUTH COUNTY IS BORDERED BY THE PACIFIC OCEAN TO THE WEST, THE SANTA ANA MOUNTAINS TO THE NORTH AND EAST, AND THE MARINE BASE CAMP PENDLETON TO THE SOUTH. OUR PRIMARY SERVICE AREA INCLUDES THE CITIES OF MISSION VIEJO, LAGUNA BEACH, LAGUNA NIGUEL, SAN JUAN CAPISTRANO, SAN CLEMENTE, RANCHO SANTA MARGARITA, LAKE FOREST, LAGUNA HILLS, DANA POINT, LADERA RANCH TRABUCO CANYON, CAPISTRANO BEACH AND ALISO VIEJO. THIS INCLUDES A POPULATION OF APPROXIMATELY 623,000 PEOPLE, AN INCREASE OF 4% FROM THE PRIOR ASSESSMENT. MISSION HOSPITAL'S SECONDARY SERVICE AREA INCLUDES LAGUNA WOODS, IRVINE, FOOTHILL RANCH AND SILVERADO. SOUTH ORANGE COUNTY IS A RELATIVELY AFFLUENT COMMUNITY WITH A MEDIAN HOUSEHOLD INCOME OF $95,506 COMPARED TO THE ORANGE COUNTY MEDIAN HOUSEHOLD INCOME OF $79,132 (2000 US CENSUS QUICK FACTS). THE AVERAGE HOUSEHOLD SIZE IS 2.70 COMPARED TO THE ORANGE COUNTY WIDE HOUSEHOLD SIZE OF 3.06. DEMOGRAPHICALLY, THE AREA IS PRIMARILY CAUCASIAN (69.7%), WITH THE HISPANIC POPULATION REPRESENTING 17.9%. IN GENERAL, MISSION'S SERVICE AREA REFLECTS A HIGH DEGREE OF HEALTH AND QUALITY OF LIFE. MISSION PROVIDES BROAD COMMUNITY BENEFIT SERVICES TO ITS PRIMARY AND SECONDARY SERVICE AREA. HOWEVER, ISOLATED AREAS OF HIGH NEED HAVE BEEN IDENTIFIED IN THE CITIES OF SAN CLEMENTE, DANA POINT, SAN JUAN CAPISTRANO, LAGUNA NIGUEL, MISSION VIEJO, LAKE FOREST AND RANCHO SANTA MARGARITA. THESE AREAS WERE DETERMINED BASED ON KEY DRIVERS FOR COMMUNITY VULNERABILITY, WHICH INCLUDE MEDIAN HOUSEHOLD INCOME, NUMBER OF PEOPLE LIVING IN A HOME, HEALTH INSURANCE COVERAGE, HIGHEST EDUCATIONAL LEVEL, ETC. ALTHOUGH HIGH NEEDS WERE IDENTIFIED IN THESE 7 AREAS, BASED ON HOSPITAL RESOURCES AND PARTNERSHIPS AND IN AN EFFORT TO SHOW SIGNIFICANT OUTCOMES AT THE END OF THE THREE-YEAR PLAN, A DECISION WAS MADE TO PRIMARILY FOCUS ON THE CITIES OF SAN CLEMENTE, DANA POINT, SAN JUAN CAPISTRANO, LAGUNA BEACH AND LAKE FOREST. THIS DECISION WAS MADE IN PARTNERSHIP WITH COMMUNITY BENEFIT DEPARTMENT STAFF, THE HOSPITAL EXECUTIVE TEAM AND THE COMMUNITY BENEFIT COMMITTEE.
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI, LINE 5	THE GOVERNING BODY IS COMPRISED OF A MAJORITY OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NOT EMPLOYEES, CONTRACTORS, OR FAMILY MEMBERS. THE SUB-COMMITTEE OF THE BOARD OF TRUSTEES, KNOWN AS THE COMMUNITY BENEFIT COMMITTEE, OVERSAW THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN EVERY THREE YEARS, AS WELL AS AN ANNUAL COMMUNITY BENEFIT REPORT. THE COMMITTEE ALSO PROVIDES GENERAL DIRECTION TO MISSION HOSPITAL REGARDING: 1) BUDGETING DECISIONS, 2) COMMUNITY BENEFIT PROGRAM CONTENT, 3) COMMUNITY BENEFIT PROGRAM DESIGN, 4) TARGET GEOGRAPHIC/POPULATION, 5) PROGRAM CONTINUATION OR DISCONTINUATION, 6) FUND DEVELOPMENT SUPPORT, AND 7) COMMUNITY-WIDE ENGAGEMENT. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. GIVING BACK TO THE COMMUNITY IS INTEGRATED INTO EVERY ASPECT OF OUR ORGANIZATION. AS A MEMBER OF THE FAITH-BASED HEALTH MINISTRY OF ST. JOSEPH HEALTH SYSTEM, WE PROVIDE FREE AND DISCOUNTED CARE VIA OUR FINANCIAL ASSISTANCE PROGRAM AND HAVE A FUNDING STREAM TO ADDRESS THE NEEDS OF THE ECONOMICALLY POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE. THIS PAST FISCAL YEAR OUR HOSPITAL PROMOTED HEALTH AND ACCESS TO CARE BY SUPPORTING CAMINO HEALTH CENTER, SOUTH ORANGE COUNTY'S ONLY COMMUNITY CLINIC, PROVIDING SUPPORT TO THE HOMELESS THROUGH A DAILY LUNCH PROGRAM, COLLABORATING WITH A LOCAL AGENCY TO COORDINATE MEALS FOR ISOLATED SENIORS IN LAGUNA BEACH AS WELL AS PROVIDING FREE TRANSPORTATION. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. WE BELIEVE THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY MISSION HOSPITAL, AS A MINISTRY OF ST. JOSEPH HEALTH SYSTEM, HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. ON AN ANNUAL BASIS, TEN PERCENT OF OUR NET INCOME IS DEVOTED TO FUND COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR (CARE FOR THE POOR FUNDS). SPECIFICALLY, FUNDS ARE USED FOR OUTREACH PROGRAMS, DEFINED AS THOSE SERVICES THAT ADDRESS A SPECIFIC UNMET HEALTH NEED AND ARE SEPARATE FROM TRADITIONAL ACUTE CARE SERVICES. IN ADDITION TO DEVOTING A PERCENTAGE OF OUR NET INCOME TO COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR VIA CARE FOR THE POOR FUNDS, WE STRIVE TO ANNUALLY BUDGET A PORTION OF OUR TOTAL OPERATING EXPENSES FOR HEALTHY COMMUNITIES AND COMMUNITY HEALTH EFFORTS. DURING THE PAST YEAR, MISSION HOSPITAL DEDICATED $1.7 MILLION IN CARE FOR THE POOR FUNDS AND $5.1 MILLION TO HEALTHY COMMUNITIES AND COMMUNITY HEALTH INITIATIVES. THIS FUNDING MADE THE FOLLOWING PROGRAMS THAT PROMOTE HEALTH AND ACCESS TO CARE TO THE LOW-INCOME POSSIBLE: REDUCING THE PREVALENCE OF CHILDHOOD OBESITY, INCREASING AFFORDABLE HOMES, IMPROVING OUTCOMES FOR PERSONS WITH DEPRESSION AS WELL AS PROVIDING FREE NURSE HOURS AT LOCAL CHURCHES AND OPERATING TWO INDEPENDENT FAMILY RESOURCE CENTERS.
AFFILIATED HEALTH CARE SYSTEM	SCHEDULE H, PART VI, LINE 6	MISSION HOSPITAL IS A HEALING MINISTRY OF ST. JOSEPH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITIES IT SERVES. IN 1986, ST. JOSEPH HEALTH SYSTEM CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH SYSTEM FOUNDATION TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. OUR FOUNDATIONAL DOCUMENT, A VISION OF VALUES, FORMALIZES A POLICY THROUGH WHICH THE HOSPITAL MINISTRIES RETURN TEN PERCENT OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION TO SUPPORT OUTREACH EFFORTS FOR THE MATERIALLY POOR. THE FOUNDATION THEN FUNDS PROGRAMS IN COMMUNITIES SERVED BY ST. JOSEPH HEALTH HOSPITALS THAT EXEMPLIFY THE FOUR CORE VALUES OF ST. JOSEPH HEALTH SYSTEM: SERVICE, EXCELLENCE, DIGNITY, AND JUSTICE.
STATE FILING OF COMMUNITY BENEFIT REPORT	SCHEDULE H, PART VI, LINE 7	CALIFORNIA MINISTRIES REPORT TO CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT IN ACCORDANCE WITH CALIFORNIA SENATE BILL 697.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public
Inspection

Name of the organization
MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number
95-1643360

Part I

General Information on Grants and Assistance

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? ....................................

Yes No

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) ST JOSEPH HEALTH SYSTEM FOUNDATION3345 MICHELSON DR IRVINE,CA92612	33-0143024	501(C)(3)	4,678,395				CARE FOR THE POOR
(2) CAMINO HEALTH CENTER30300 CAMINO CAPISTRANO SJC,CA92675	33-0574214	501(C)(3)	1,600,000				PROGRAM SUPPORT
(3) CAMINO HEALTH CENTER30300 CAMINO CAPISTRANO SJC,CA92675	33-0574214	501(C)(3)	623,490				COMMUNITY OUTREACH
(4) DANA POINT CHAMBER OF COMMERCE24681 LA PLAZA DANA POINT,CA92629	51-0181182	501(C)(6)	10,000				PROGRAM SUPPORT
(5) LIGA INTERNATIONAL & OPERATION RAINBOW19671 LUCAYA CT APPLE VALLEY,CA92308	95-6111639	501(C)(3)		10,000	COST	MEDICAL SUPPLIES	MEDICAL SUPPLIES
(6) TALLER SAN JOSE801 NORTH BROADWAY SANTA ANA,CA92701	59-3816355	501(C)(3)	10,000				PROGRAM SUPPORT
(7) GIVING CHILDREN HOPE8332 COMMONWEATH AVE BUENA PARK,CA90621	95-3464287	501(C)(3)		14,538	COST	ULTRASOUND DIAG/BEDS	ULTRASOUND DIAG/BEDS
(8) ST TIMOTHY'S CATHOLIC CHURCH29102 CROWN VALLEY LAGUNA NIGUEL,CA92677	95-3656905	501(C)(3)		76,755	COST	FOOD DONATIONS	FOOD DONATIONS
(9) NATIONAL HEALTH FOUNDATION515 S FIGUEROA ST LOS ANGELES,CA90071	23-7314808	501(C)(3)	63,000				PROGRAM SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

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
(1) PAYMENT FOR MEDICAL SERVICES	18	7,779
(2) RECUPERATION-HELPING HANDS-ON BEHALF OF PATIENTS	237	28,889
(3) INDIVIDUAL FUNERALS	7	10,985

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	SCHEDULE I, PART I, LINE 2	MISSION HOSPITAL HAS AN AFFILIATION AGREEMENT WITH CAMINO HEALTH CENTER THAT CALLS FOR THE STEERING COMMITTEE, WHICH INCLUDES AN OFFICER FROM THE HOSPITAL, TO PROVIDE OVERSIGHT OF FUNDS GRANTED TO CAMINO BY THE HOSPITAL FOR PROGRAM SUPPORT. THE CARE FOR THE POOR FUNDS GIVEN TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION IS GOVERNED BY THE HEALTH SYSTEM FOUNDATION. THE DISBURSEMENT OF THE FUNDS FOLLOWS SPECIFICS SET FORTH BY THE HEALTH SYSTEM POLICY "CARE FOR THE POOR PROGRAM ACCOUNTING." THERE IS NO MONITORING DONE ON THE OTHER GRANTS.

Schedule I (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

Yes

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? ....

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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) WILLIAM MURIN	(i) (ii)	0 547,394	0 245,426	0 136,373	0 7,350	0 12,784	0 949,327	0 0
(2) KENNETH MCFARLAND	(i) (ii)	379,856 0	101,335 0	140,370 0	16,825 0	29,682 0	668,068 0	24,452 0
(3) PETER BASTONE	(i) (ii)	0 224,269	0 197,965	0 1,122,833	0 18,519	0 19,867	0 1,583,453	0 746,135
(4) MARGARITA COWLEY	(i) (ii)	288,578 0	101,610 0	92,135 0	22,009 0	22,930 0	527,262 0	0 0
(5) EILEEN HAUBL	(i) (ii)	169,873 0	57,194 0	54,584 0	20,470 0	20,357 0	322,478 0	0 0
(6) CYNTHIA MUELLER	(i) (ii)	153,958 0	51,980 0	35,618 0	22,803 0	20,348 0	284,707 0	0 0
(7) DENNIS HAGHIGHAT	(i) (ii)	253,448 0	83,409 0	55,022 0	9,592 0	9,682 0	411,153 0	0 0
(8) LINDA JOHNSON	(i) (ii)	215,841 0	72,782 0	121,586 0	17,096 0	29,811 0	457,116 0	61,155 0
(9) PAULA SERIOS	(i) (ii)	132,622 0	61,928 0	207,399 0	6,482 0	10,098 0	418,529 0	86,666 0
(10) SHIRLEY BARNES	(i) (ii)	233,656 0	88,686 0	68,575 0	19,412 0	10,626 0	420,955 0	0 0
(11) WINIFRED JOHNSON	(i) (ii)	186,073 0	63,991 0	61,281 0	19,356 0	25,331 0	356,032 0	0 0
(12) MICHAEL BECK	(i) (ii)	157,352 0	56,074 0	49,072 0	18,176 0	37,237 0	317,911 0	0 0
(13) DAVID HALTERMAN	(i) (ii)	186,726 0	20,323 0	1,813 0	0 0	29,699 0	238,561 0	0 0

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 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 1A	EXECUTIVES RECEIVE A PERCENTAGE OF BASE COMPENSATION FOR DISCRETIONARY SPENDING. THESE AMOUNTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION.
SCHEDULE J, PART I, LINE 3		THE ORGANIZATION'S CEO WAS SELECTED IN NOVEMBER OF 2011 AND IS BEING COMPENSATED BY THE ORGANIZATION'S TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, IN 2012. THE AMOUNTS CURRENTLY BEING REPORTED ON SCHEDULE J, PART II INCLUDE HIS 2011 COMPENSATION AS CFO AND INTERIM CEO. SEE SCHEDULE O, FORM 990, PART VI, LINE 15A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM IN DETERMINING COMPENSATION.
SCHEDULE J, PART I, LINE 4A		THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FOR EITHER PART OR ALL OF THE YEAR: PETER BASTONE - $217,668 PAULA SERIOS - $57,619
SCHEDULE J, PART I, LINE 4B		EXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE DECEMBER 31, 2007 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (SERP): PETER BASTONE - $746,135 KENNETH MCFARLAND - $24,452 LINDA JOHNSON - $61,155 PAULA SERIOS - $86,666
SCHEDULE J, PART I, LINE 7		A PORTION OF EXECUTIVES SALARIES ARE PLACED "AT-RISK" AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

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

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

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






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

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) 2011

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JOHN SHAVER MD	SPOUSE OF M. STAUNTON, MD	84,000	TRAUMA MEDICAL DIRECTORSHIP		No
(2) MISSION VIEJO EMERGENCY MEDICAL ASS	SEE PART V	109,200	PROF FEES PAID TO MVEMA		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
RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION	SCHEDULE L, PART IV, LINE (2), COLUMN (B)	ROBERT WINOKUR, M.D. SERVES ON THE BOARD OF MISSION HOSPITAL REGIONAL MEDICAL CENTER AND ALSO HAS A GREATER THAN 5% OWNERSHIP IN MISSION VIEJO EMERGENCY MEDICAL ASSOCIATION (MVEMA), MAKING MVEMA AN INTERESTED PERSON FOR SCHEDULE L REPORTING PURPOSES.

Schedule L (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

NonCash Contributions

Complete 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

2011

Open to Public Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I

Types of Property

	(a) Check if applicable	(b) Number of Contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		0
6 Cars and other vehicles ..	X	1	26,710	COST/SELLING PRICE
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	10	144,406	COST/SELLING PRICE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....	X	1	73,300	COST/SELLING PRICE
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( GIFTS IN KIND )	X	682	0	0
26 Other ( LIFE POLICY )	X	1	112,515	OTHER
27 Other ( )
28 Other ( )

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 ...

Yes

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

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ............................

32a

If "Yes," describe in Part II.

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) 2011

Page 2

Part II

Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
CLOTHING AND HOUSEHOLD GOODS	SCHEDULE M, PART I, LINE 5	CLOTHING AND HOUSEHOLD GOODS WERE DONATED TO THE HOSPITAL THRIFT N' GIFT PROGRAM. $471,565 WAS RECOGNIZED FROM THE SALE OF SUCH ITEMS IN FY12, THE AMOUNT BEING DETERMINED BY THE SELLING PRICE. REVENUE FROM THE SALE OF THE DONATED ITEMS IS REPORTED ON FORM 990, PART VIII, LINE 10A.
OTHER - GIFTS IN KIND	SCHEDULE M, PART I, LINE 25	GIFTS IN KIND WITH AN ESTIMATED VALUE OF $494,300 WERE RECEIVED DURING THE YEAR AND WERE NOT INCLUDED ON THE BOOKS. VALUE WAS ESTIMATED FROM DONOR'S APPROXIMATION OF VALUE. REVENUE FROM THE SALE OF THESE ITEMS IS INCLUDED IN FUNDRAISING REVENUE ON FORM 990, PART VIII, LINE 8A.

Schedule M (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1	AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), MISSION HOSPITAL IS COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE.
PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PART III, LINE 4A	MISSION HOSPITAL HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 40 YEARS. MISSION HOSPITAL IN MISSION VIEJO IS AN ACUTE CARE, FULL-SERVICE FACILITY THAT HOUSES THE REGION'S DESIGNATED TRAUMA CENTER, ONE OF ONLY THREE IN THE COUNTY. A COMPLETE ARRAY OF TOP-QUALITY HEALTHCARE SERVICES ARE OFFERED INCLUDING 24-HOUR EMERGENCY CARE; IMAGING, CARDIAC REHABILITATION AND CHEST PAIN CENTER; STROKE CENTER, MATERNITY CENTER. MISSION HOSPITAL ALSO OFFERS ORTHOPEDICS, REHABILITATION, CANCER, SPINE AND VASCULAR SERVICES. OUR LAGUNA BEACH HEALTHCARE SERVICES INCLUDE 24-HOUR EMERGENCY, MEDICAL-SURGICAL CARE AS WELL AS BEHAVIORAL HEALTH AND CHEMICAL AND PAIN MEDICATION DEPENDENCY TREATMENT. WITH OVER 2,700 EMPLOYEES COMMITTED TO REALIZING THE MISSION, MISSION HOSPITAL IS ONE OF THE LARGEST EMPLOYERS IN THE SOUTH ORANGE COUNTY REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, MISSION HOSPITAL IS COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORS" AND MINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. THREE MISSION OUTCOMES STRATEGICALLY GUIDE OUR MINISTRY WORK MISSION HOSPITAL IS COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: 1) SACRED ENCOUNTERS, 2) PERFECT CARE AND 3) HEALTHIEST COMMUNITIES. EVERY INTERACTION WILL BE EXPERIENCED AS A SACRED ENCOUNTER. THE GOAL OF SACRED ENCOUNTER HAS A DIRECT CONNECTION TO THE OVERALL MISSION. OUR VALUE OF DIGNITY CALLS FOR US TO RESPECT EACH PERSON AS AN INHERENTLY VALUABLE MEMBER OF THE HUMAN COMMUNITY AND AS A UNIQUE EXPRESSION OF LIFE. WE STRIVE TO DO THIS BY KEEPING AT THE FOREFRONT OF OUR MINDS THE UNDERSTANDING OF THE IMPACT WE CAN HAVE ON ONE ANOTHER WITH EVERY ACTION WE TAKE. SACRED MOMENTS SUPPORTS OUR MISSION OUTCOME OF SACRED ENCOUNTERS BY FOSTERING SACRED ENCOUNTERS THROUGHOUT THE PATIENT JOURNEY. OUR SACRED MOMENTS PROGRAM IS A PROACTIVE APPROACH TO 'HEALING BEYOND SCIENCE'. IT ATTEMPTS TO BRING THE SACRED INTO EVERYDAY INTERACTIONS BY PROVIDING A PRACTICAL STRUCTURE FOR FRONTLINE CAREGIVERS TO FOSTER SACRED ENCOUNTERS WITH THEIR PATIENTS, VISITORS, PHYSICIANS AND COLLEAGUES. EMPLOYEES HAVE PARTICIPATED IN 12-HOURS OF SACRED MOMENTS DESIGNS IN THEIR UNIT, AND HAVE ATTENDED A 90-MINUTE SACRED MOMENTS DEVELOPMENT SESSION. ALL PATIENTS WILL RECEIVE PERFECT CARE. IT IS OUR ATTENTION TO DETAIL AND THE SMALLEST IMPERFECTIONS OF EACH PATIENT'S EXPERIENCE THAT DRIVES A DEEPER UNDERSTANDING AND ULTIMATELY A SUSTAINABLE APPROACH TO THE ACHIEVEMENT OF PERFECT CARE. THE COMMUNITIES WE SERVE WILL BE AMONG THE HEALTHIEST IN OUR NATION. WE SEEK TO DEVELOP COMMUNITY HEALTH INITIATIVES THAT IMPACT LONG-TERM HEALTH ACROSS THE ENTIRE COMMUNITY. FOR THE PAST SEVERAL YEARS, WE HAVE FOCUSED ON CHILDHOOD OBESITY TO CREATE HEALTHIEST COMMUNITIES. THIS INITIATIVE HAS THREE STRATEGIES: WORKING WITH FAMILIES, IMPROVING POLICIES AT LOCAL SCHOOLS, AND INCREASING ENVIRONMENTAL OPTIONS. WE HAVE WORKED WITH FAMILIES TO INCREASE THEIR OWN EDUCATION AND SKILLS IN CREATING HEALTHY FAMILY MEALS AND INCORPORATING PHYSICAL ACTIVITY INTO THEIR DAILY LIVES. OUR GRASSROOTS SOCIAL MARKETING CAMPAIGN SERVED OVER 2,600 RESIDENTS VIA BLOCK PARTIES, BMI IN A BOX EVENTS AND CHAMPIONS PROGRAM. FOR OUR STRATEGY FOCUSED ON SCHOOL PROGRAMS AND POLICIES, IN 2012 OUR FOCUS WAS ON INCREASING THE NUMBER OF SCHOOLS WHO MEET AN ENVIRONMENTAL NUTRITION AND ACTIVITY ASSESSMENT MINIMUM SCORE OF 3.5 BY 2014. 2012 FOCUSED ON THREE HIGH-NEED SCHOOLS IN OUR COMMUNITY BENEFIT AREA AND EACH SHOWED AN IMPROVEMENT FROM THEIR BASELINE SCORES BY AN AVERAGE .5 POINTS IN 6 MONTHS. IN ADDITION, HEALTHY FOR LIFE, A SJHS-WIDE PROJECT SERVED 751 STUDENTS IN SOUTH ORANGE COUNTY IN 44 CLASSES COVERING 34 SOUTH COUNTY ELEMENTARY SCHOOLS. AND FOR ENVIRONMENTAL OPTIONS, SINCE SAFE PLACES TO PLAY WAS IDENTIFIED AS A COMMUNITY BARRIER, THIS WAS A PRIMARY FOCUS FOR OUR ENVIRONMENTAL EFFORTS. AS A RESULT, WE DEVELOPED A RELATIONSHIP WITH LOCAL POLICE DEPARTMENTS TO IMPROVE COMMUNITY RELATIONSHIPS AND ASSISTED SAN JUAN CAPISTRANO AND SAN CLEMENTE WITH THEIR FIRST NEIGHBORHOOD SAFETY EVENTS IN SPECIFIC AREAS. WE ALSO ASSISTED WITH THE DEVELOPMENT OF A COMMUNITY GARDEN IN SAN CLEMENTE AND PROVIDED $6,000 FOR THE CREATION OF STAIRWAY ACCESS FOR THE COMMUNITY TO THE GARDEN. PROGRAM SERVICE ACCOMPLISHMENTS NAME: UNREIMBURSED MEDICAID MEDICAID, ALSO KNOWN AS MEDI-CAL IN CALIFORNIA, IS THE US HEALTH PROGRAM FOR PEOPLE WITH LOW INCOME. IT IS JOINTLY FUNDED BY THE STATE AND FEDERAL GOVERNMENTS, AND IS MANAGED BY THE STATES. ACCOMPLISHMENTS: 12,131 PERSONS SERVED NAME: UNREIMBURSED OTHER-MEANS GOVERNMENT PROGRAM MEDICAL SERVICES INITIATIVE (MSI) IS A FEDERAL, STATE AND COUNTY FUNDED HEALTHCARE PROGRAM THAT PROVIDES A FULL RANGE OF MEDICAL SERVICES FOR COUNTY RESIDENTS 21 - 64 YEARS OF AGE. FINANCIAL ELIGIBILITY IS DETERMINED ON A CASE-BY-CASE BASIS HOWEVER, ONLY PERSONS WITH ANNUAL INCOMES BELOW 200% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE. IN APPLYING FOR THE PROGRAM, PROOF OF ORANGE COUNTY RESIDENCY AND U.S. CITIZENSHIP OR LEGAL RESIDENCY IS REQUIRED. ACCOMPLISHMENTS: 3,738 PERSONS SERVED NAME: FINANCIAL ASSISTANCE PROGRAM GOAL: WE BELIEVE THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. OUR PATIENT FINANCIAL ASSISTANCE PROGRAM PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. FACTORS USED IN DETERMINING ELIGIBILITY FOR PATIENT FINANCIAL ASSISTANCE INCLUDE INCOME LEVEL, ASSET LEVEL, AND MEDICAL INDIGENCE. KEY PARTNERS: MINISTRY BUSINESS OFFICE ACCOMPLISHMENTS: 7,357 PERSONS SERVED NAME: CARE FOR THE POOR PROGRAMS GOAL: WE BELIEVE THAT ALL RESIDENTS IN THE COMMUNITY DESERVE ACCESS TO MEDICAL CARE. THAT IS WHY MISSION HOSPITAL, AS A MINISTRY OF ST. JOSEPH HEALTH SYSTEM, DEDICATES 10% OF ITS NET INCOME TOWARD CARE FOR THE POOR TO SUPPORT LOCAL PROGRAMS SUCH AS CAMINO HEALTH CENTER, THE LOCAL COMMUNITY CLINIC WHO SERVES SOUTH COUNTY RESIDENTS WHO ARE UNINSURED OR UNDERINSURED; CALIFORNIA KIDS, A LOW-COST HEALTH INSURANCE PROGRAM FOR CHILDREN INELIGIBLE FOR OTHER GOVERNMENT FUNDED PROGRAMS, AND SERVICES FOR THE HOMELESS WHO ARE RECENTLY DISCHARGED FROM THE HOSPITAL TO ENSURE THEY HAVE THE NEEDED MEDICAL SUPPORT TO RETURN THEIR HEALTH TO THE OPTIMAL LEVEL. KEY PARTNERS: BUSINESS OFFICE, MISSION INTEGRATION, CASE MANAGEMENT OFFICE, MEDICAL RECORDS ACCOMPLISHMENTS: 116,419 PERSONS SERVED NAME: FAMILY RESOURCE CENTERS GOAL: OUR TWO FAMILY RESOURCE CENTERS ARE CREATED TO PROVIDE EDUCATION, SUPPORT, AND RESOURCES TO ENHANCE THE PROCESS OF FAMILY GROWTH THROUGH THE DEVELOPMENT OF SKILLS THAT PROMOTE THE HEALTH, SELF-SUFFICIENCY, AND QUALITY OF LIFE FOR THE COMMUNITY KEY PARTNERS: RAISE FOUNDATION, CHILDRENS BUREAU, HUMAN OPTION OUR FAMILY RESOURCE CENTERS PROVIDE SERVICES FOR THE COMMUNITY SUCH AS LOW/NO COST MENTAL HEALTH COUNSELING AND SUPPORT GROUPS, ACCESS TO HEALTHCARE THROUGH MEDI-CAL APPLICATION ASSISTANCE, PARENTING CLASSES, CHILD DEVELOPMENT CLASSES, FINANCIAL ASSISTANCE PROGRAMS INCLUDING SERVICES FROM THE CONSUMER CREDIT COUNSELING OF ORANGE COUNTY. PARTNERS IN OUR FAMILY RESOURCE CENTERS INCLUDE THE RAISE FOUNDATION, CHILDREN'S BUREAU, AND HUMAN OPTIONS. WE JOIN EFFORTS WITH THE LAKE FOREST WOMEN, INFANT & CHILDREN'S CLINIC TO PROVIDE WRAP-AROUND SERVICES FOR THOSE IN NEED. IN SAN JUAN CAPISTRANO, WE COLLABORATE WITH THE MISSION BASILICA TO PROVIDE OUTREACH SERVICES TO THE MOST VULNERABLE AND WORK WITH LOCAL SCHOOL DISTRICTS AND PARENTS TO ENSURE CHILDREN HAVE APPROPRIATE ACCESS TO EDUCATION AND OTHER SUPPORT SERVICES. FOR MORE INFORMATION ABOUT MISSION HOSPITAL, PLEASE VISIT WWW.MISSION4HEALTH.COM. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH SYSTEM, PLEASE VISIT WWW.STJOE.ORG.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PART VI, QUESTION 6	ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF MISSION HOSPITAL.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS	FORM 990, PART VI, QUESTION 7A	MISSION HOSPITAL HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE MISSION HOSPITAL BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE MISSION HOSPITAL BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS	FORM 990, PART VI, QUESTION 7B	THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990	FORM 990, PART VI, QUESTION 11B	THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 WAS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2013 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST	FORM 990, PART VI, QUESTION 12C	OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ON THE CONFLICT OF INTEREST DISCLOSURE FORM THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE. ADDITIONALLY, DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION, OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, SUCH CONFLICT IS DISCLOSED TO THE MISSION HOSPITAL COMPLIANCE COMMITTEE. IF THE CONFLICT INVOLVES A MEMBER OF THAT COMMITTEE, THE REMAINING COMMITTEE MEMBERS REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE OFFICER, TRUSTEE, OR KEY EMPLOYEE MAY NOT BE PRESENT DURING ANY MEETING IN WHICH THE COMMITTEE CONDUCTS ITS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED & YEAR PROCESS WAS BEGUN	FORM 990, PART VI, QUESTION 15A AND 15B	THE ORGANIZATION'S CEO WAS SELECTED IN NOVEMBER OF 2011 AND WAS PAID THROUGH THE END OF 2011 BY THE ORGANIZATION FOR HIS SERVICES AS CFO AND INTERIM CEO. THE CEO IS BEING COMPENSATED BY THE ORGANIZATION'S TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, IN 2012. THE EXECUTIVE COMPENSATION PROCESS AT ST. JOSEPH HEALTH SYSTEM IS ADMINISTERED BY A COMMITTEE OF INDEPENDENT TRUSTEES. THEY FOLLOW A BOARD-APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER EMPOWERS THE SJHS BOARD WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND PROCESS ON BEHALF OF THE FULL BOARD OF TRUSTEES OF SJHS. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS THE RETENTION OF KEY MANAGEMENT TALENT. THE SJHS EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. SJHS PROVIDES COMPENSATION TO ITS SENIOR EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO FULFILL THEIR RESPONSIBILITY, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA. THEY USE THIS INFORMATION TO SUPPORT THEIR DECISIONS REGARDING ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE WORKLIFE COMMITTEE IS COMPRISED OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD. THEY MEET AT LEAST 3 TIMES A YEAR AND MAKE ALL CRITICAL DECISIONS IN EXECUTIVE SESSION. THESE DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. THE COMMITTEE IS EMPOWERED TO ENGAGE OUTSIDE COUNSEL AND CONSULTING SUPPORT AS NEEDED. THE WORKLIFE COMMITTEE PERFORMED ITS LAST COMPENSATION REVIEW FOR ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN JUNE 2012.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC	FORM 990, PART VI, QUESTION 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990.
HOURS DEVOTED TO RELATED ORGANIZATION	FORM 990, PART VII	CERTAIN EXECUTIVES AND BOARD MEMBERS OF THIS ORGANIZATION ALSO DEVOTED TIME TO OTHER ENTITIES RELATED TO THE FILING ORGANIZATION. THE HOURS DEVOTED TO THE RELATED ORGANIZATIONS ARE NOT GENERALLY TRACKED BY ENTITY.
OTHER CHANGES IN NET ASSETS OR FUND BALANCE	FORM 990, PART XI, LINE 5	INVESTMENT UNREALIZED GAIN/LOSS $(1,742,935) ST. JOSEPH HEALTH SYSTEM EQUITY ADJUSTMENT 1,570,173 CAPITAL CONTRIBUTION TO HERITAGE FOUNDATION (3,708,084) INCOME FROM SUBSIDIARIES 1,894,704 REVENUE ON AFS BUT REPORTED ON PRIOR YEAR FORM 990 121,357 FOUNDATION OTHER ADJUSTMENTS (109,248) ----------- TOTAL $(1,974,033) ===========
OVERSIGHT OF SELECTION PROCESS	FORM 990, PART XII, LINE 2C	THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVED THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MISSION HOSPITAL REGIONAL MEDICAL CENTER

Employer identification number

95-1643360

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) AUXILIARY OF MISSION HOSP LAGUNA BEACH 31872 COAST HWY LAGUNA BEACH,CA92651 95-6050019	SUPPORT	CA	501(C)(3)	11, III-O	NA		No
(2) COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK,TX79410 61-1573313	HEALTHCARE	TX	501(C)(3)	11, I	CHS	Yes
(3) COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK,TX79410 75-2765566	HEALTHCARE	TX	501(C)(3)	3	SJHS	Yes
(4) COVENANT HEALTH SYSTEM FOUNDATION 4000 24TH STREET LUBBOCK,TX79410 75-2897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(5) COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK,TX79410 75-2743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(6) HOME CARE PARTNERS 1165 MONTGOMERY DR SANTA ROSA,CA95405 68-0318656	INACTIVE	CA	501(C)(3)	3	SRMH	Yes
(7) HOSPICE OF LUBBOCK 1102 SLIDE ROAD LUBBOCK,TX79414 75-2133781	HEALTHCARE	TX	501(C)(3)	9	CHS	Yes
(8) LUBBOCK METHODIST HOSPITAL FOUNDATION 3615 19TH STREET LUBBOCK,TX79410 75-2220963	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(9) METHODIST CHILDREN'S HOSPITAL 3610 21ST STREET LUBBOCK,TX79410 75-2428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(10) METHODIST HOSPITAL LEVELLAND 1900 COLLEGE AVENUE LEVELLAND,TX79336 75-2246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(11) METHODIST HOSPITAL PLAINVIEW 2601 DIMMITT ROAD PLAINVIEW,TX79072 75-2426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(12) MISSION HOSPITAL REG MED CTR FDN 27700 MEDICAL CENTER ROAD MISSION VIEJO,CA92691 33-0406118	HEALTHCARE	CA	501(C)(3)	7	MHRMC	Yes
(13) QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA,CA94558 94-1243669	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(14) REDWOOD MEMORIAL FOUNDATION 3300 RENNER DRIVE FORTUNA,CA95540 94-2779313	FOUNDATION	CA	501(C)(3)	7	RMH	Yes
(15) REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA,CA95540 94-1384665	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(16) SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DRIVE SANTA ROSA,CA95405 94-1231005	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(17) SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE,CA92868 95-1643383	RELIGIOUS ORG	CA	501(C)(3)	1	NA		No
(18) SRM ALLIANCE HOSPITAL SERVICES 400 NORTH MCDOWELL BLVD PETALUMA,CA94954 68-0395200	HEALTHCARE	CA	501(C)(3)	3	SRMH	Yes
(19) ST JOSEPH HEALTH FDN OF N CALIFORNIA PO BOX 552 SANTA ROSA,CA95405 68-0338070	INACTIVE	CA	501(C)(3)	11, I	SRMH	Yes
(20) ST JOSEPH HEALTH MINISTRY 3345 MICHELSON DR STE 100 IRVINE,CA92612 27-1666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO		No
(21) ST JOSEPH HEALTH SYSTEM 3345 MICHELSON DR STE 100 IRVINE,CA92612 95-3589356	HEALTHCARE	CA	501(C)(3)	11, I	SJHM		No
(22) ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DR STE 100 IRVINE,CA92612 33-0143024	HEALTHCARE	CA	501(C)(3)	7	SJHS	Yes
(23) ST JOSEPH HOME CARE NETWORK 170 PROFESSIONAL CENTER DR B ROHNERT PARK,CA94928 68-0331084	HEALTHCARE	CA	501(C)(3)	9	SJHS	Yes
(24) ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA,CA95501 94-1156596	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(25) ST JOSEPH HOSPITAL OF ORANGE 1100 WEST STEWART DRIVE ORANGE,CA92868 95-1643359	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(26) ST JUDE HOSPITAL YORBA LINDA 279 E IMPERIAL HWY 750 FULLERTON,CA92835 33-0185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(27) ST JUDE HOSPITAL INC 101 EAST VALENCIA MESA DRIVE FULLERTON,CA92835 95-1643325	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(28) ST JUDE MEMORIAL FOUNDATION 1440 N HARBOR BLVD 200 FULLERTON,CA92835 95-3607229	HEALTHCARE	CA	501(C)(3)	11, I	SJMC	Yes
(29) ST MARY MEDICAL CENTER 18300 HIGHWAY 18 APPLE VALLEY,CA92307 95-1914489	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(30) ST MARY OF THE PLAINS HOSPITAL FDN 4000 24TH STREET LUBBOCK,TX79410 75-1653181	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(31) TALLER SAN JOSE 801 NORTH BROADWAY SANTA ANA,CA92701 59-3816355	WORKFORCE DEV	CA	501(C)(3)	2	SSJO	Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ST JOSEPH HLTH SYS HOME HLTH AGENCY 1845 W ORANGEWOOD AVENUE STE 200 ORANGE,CA928682012 33-0282945	HOME HEALTH	CA	NA	N/A	0	0		No	0		No	0 %
(2) ST JOSEPH HLTH SYS HOME CARE SVCS 1845 W ORANGEWOOD AVE STE 100 ORANGE,CA928682012 33-0307672	HOME HEALTH	CA	NA	N/A	0	0		No	0		No	0 %
(3) METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK,TX79410 75-2343261	HEALTHCARE SVCS	TX	NA	N/A	0	0		No	0		No	0 %
(4) SHA LLC 12940 NORTH HIGHWAY 183 AUSTIN,TX78750 75-2569094	HEALTHCARE SVCS	TX	NA	N/A	0	0		No	0		No	0 %
(5) LUBBOCK SURGERY CENTER LTD 4000 24TH STREET LUBBOCK,TX79410 75-2177401	HEALTHCARE SVCS	TX	NA	N/A	0	0		No	0		No	0 %
(6) COVENANT LONG-TERM CARE LP 4000 24TH STREET LUBBOCK,TX79410 20-5033419	HEALTHCARE SVCS	TX	NA	N/A	0	0		No	0		No	0 %
(7) HERITAGE INVESTMENT GROUP 3345 MICHELSON DR STE 100 IRVINE,CA92612 27-1000061	INVESTMENT	CA	NA	N/A	0	0		No	0		No	0 %
(8) MISSION AMBULATORY SURGICENTER LTD 26730 CROWN VALLEY PKWY 1 ST FL MISSION VIEJO,CA92691 33-0355575	HEALTHCARE SVCS	CA	MVMV	RELATED	1,535,662	3,702,886		No	0		No	43.429 %
(9) COMPREHENSIVE IMAGING PARTNERS OF OCLLC 1 CITY BOULEVARD WEST 1110 ORANGE,CA92868 26-4591502	HEALTHCARE SVCS	CA	NA	N/A	0	0		No	0		No	0 %
(10) ST JOSEPH PHYSICIAN VENTURES I LLC 1100 WEST STEWART DRIVE ORANGE,CA92868 45-4521884	REAL ESTATE	CA	NA	N/A	0	0		No	0		No	0 %

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) ST JOSEPH PROF SVCS ENTERPRISES INC 3345 MICHELSON DR STE 100 IRVINE,CA92612 33-0155323	HEALTHCARE SVCS	CA	NA	C CORP	0	0	0 %
(2) AMERICAN UNITY GROUP LTD 58 PAR-LA-VILLE ROAD HAMILTON HM HX BD	CAPTIVE INSURANCE	BD	NA	C CORP	0	0	0 %
(3) ALLIANCE PHYSICIAN SERVICES	INACTIVE	CA	NA	C CORP	0	0	0 %
(4) MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD 354 MISSION VIEJO,CA92691 33-0212905	HEALTHCARE SVCS	CA	MHRMC	C CORP	37,399	299,680	100.000 %
(5) MISSION MEDICAL CENTER ASSOCIATION 27800 MEDICAL CENTER RD 354 MISSION VIEJO,CA92691 33-0201044	HEALTHCARE SVCS	CA	MHRMC	C CORP	0	0	100.000 %
(6) ST JOSEPH YORBA PARK	INACTIVE	CA	NA	C CORP	0	0	0 %
(7) LUBBOCK METHODIST HOSP SVCS PO BOX 1201 LUBBOCK,TX79410 75-2118585	HEALTHCARE SVCS	TX	NA	C CORP	0	0	0 %
(8) LUBBOCK METHODIST HOSP PRACTICE MGMT 2107 OXFORD STREET SUITE 300 LUBBOCK,TX79410 75-2578995	INACTIVE	TX	NA	C CORP	0	0	0 %
(9) CHARITABLE REMAINDER UNITRUSTS (2)	HOSPITAL SUPPORT	CA	NA	TRUST	0	0	0 %

Schedule R (Form 990) 2011

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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) AMERICAN UNITY GROUP LTD	Q	1,917,229	ACCRUAL
(2) ST JOSEPH HEALTH SYSTEM FOUNDATION	B	4,678,395	ACCRUAL
(3) ST JOSEPH HEALTH SYSTEM FOUNDATION	C	1,773,848	ACCRUAL
(4) ST JUDE HOSPITAL YORBA LINDA	B	3,708,085	ACCRUAL
(5) ST JUDE HOSPITAL YORBA LINDA	I	384,972	ACCRUAL
(6)

Schedule R (Form 990) 2011

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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

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
IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP	SCHEDULE R, PART III	ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 200 ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 100 ORANGE, CA 92868-2012 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET LUBBOCK, TX 79410 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183 AUSTIN, TX 78750 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET LUBBOCK, TX 79410 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 3345 MICHELSON DR, STE 100 IRVINE, CA 92612 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE. 362 MISSION VIEJO, CA 92691 COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY, LLC EIN: 26-4591502 ADDRESS: ONE CITY BOULEVARD WEST, SUITE 1100 ORANGE, CA 92868 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE ORANGE, CA 92868

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: WE ARE COMMITTED TO EXTENDING THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	10
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,832
6	Total number of volunteers (estimate if necessary) ....	6	682
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	999,721
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	94,914

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	9,441,550	10,659,988
9	Program service revenue (Part VIII, line 2g) .........	482,113,797	485,724,810
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,134,977	4,642,157
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	460,468	591,704
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	500,150,792	501,618,659
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,104,532	7,191,624
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)	211,360,544	215,722,402
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	119,375
b	Total fundraising expenses (Part IX, column (D), line 25) 4,454,140
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	246,853,007	239,425,655
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	463,318,083	462,459,056
19	Revenue less expenses. Subtract line 18 from line 12.......	36,832,709	39,159,603
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	596,739,694	643,988,759
21	Total liabilities (Part X, line 26).............	278,419,805	288,483,300
22	Net assets or fund balances. Subtract line 21 from line 20.....	318,319,889	355,505,459

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 418,615,143 including grants of $ 7,191,624 ) (Revenue $ 485,724,810 )
	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 expenses$ 418,615,143

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)					(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
(A) Name and Title
(18) MARGARITA COWLEY EVP, COO (RESIGNED 3/2/2012)	50.0	X				482,323	0	44,939
(19) EILEEN HAUBL VP & CHIEF FINANCIAL OFFICER	50.0	X				281,651	0	40,827
(20) CYNTHIA MUELLER VP MISSION INTEGRATION/SEC.	50.0	X				241,556	0	43,151
(21) DENNIS HAGHIGHAT VP MEDICAL AFFAIRS	50.0		X			391,879	0	19,274
(22) LINDA JOHNSON VP PATIENT CARE SERVICES	50.0		X			410,209	0	46,907
(23) PAULA SERIOS VP MARKETING/COMMUNICATIONS	50.0			X		401,949	0	16,580
(24) SHIRLEY BARNES SR VP HUMAN RESOURCES	50.0			X		390,917	0	30,038
(25) WINIFRED JOHNSON CHIEF DEVELOPMENT OFFICER	50.0			X		311,345	0	44,687
(26) MICHAEL BECK VP OPERATIONS - LAGUNA BEACH	50.0			X		262,498	0	55,413
(27) DAVID HALTERMAN DIRECTOR OF PHARMACY	50.0			X		208,862	0	29,699
(28) PETER BASTONE FORMER CEO & PRESIDENT	0.0				X	0	1,545,067	38,386

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	4,037,880	2,474,260	476,542

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a		10,000
b	Membership dues....1b
c	Fundraising events....1c		1,669,272
d	Related organizations...1d		1,965,833
e	Government grants (contributions)1e		163,995

f	All other contributions, gifts, grants, and similar amounts not included above1f		6,850,888
g	Noncash contributions included in lines 1a-1f:$ 356,931
h	Total. Add lines 1a-1f.......			10,659,988
			Business Code
2a	NET PATIENT REVENUE		621,110	455,341,531	455,341,531
b	MOB RENTAL		531,120	14,732,831	14,732,831
c	CHILDREN HOSPITAL AT MISSION		622,110	5,992,543	5,992,543
d	NUTRITIONAL SERVICES		722,310	2,162,479	2,162,479
e	PATHOLOGY REVENUE		621,511	834,321		834,321
f	All other program service revenue .			6,661,105	6,495,705	165,400
g	Total. Add lines 2a–2f........			485,724,810
3	Investment income (including dividends, interest
	and other similar amounts).....			4,645,125			4,645,125
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	144,406
b	Less: cost or other basis and sales expenses	147,374
c	Gain or (loss)	-2,968
d	Net gain or (loss)..........			-2,968			-2,968
8a	Gross income from fundraising events (not including $ 1,669,272 of contributions reported on line 1c). See Part IV, line 18 ...
	a		592,624
b	Less: direct expenses ...b		614,841
c	Net income or (loss) from fundraising events..			-22,217			-22,217
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		184,106
b	Less: direct expenses ...b		41,750
c	Net income or (loss) from gaming activities...			142,356			142,356
10a	Gross sales of inventory, less returns and allowances .
	a		471,565
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			471,565			471,565
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions....			501,618,659	484,725,089	999,721	5,233,861


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			6,423,372	1	17,526,564
2	Savings and temporary cash investments .......			93,093,095	2	101,613,600
3	Pledges and grants receivable, net .........			3,131,568	3	4,313,515
4	Accounts receivable, net .........			63,396,356	4	73,475,509
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
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 ..........			0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			5,043,978	8	5,617,584
9	Prepaid expenses and deferred charges ............			2,484,057	9	1,314,875
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	479,630,386
b	Less: accumulated depreciation. .....	10b	158,337,564	321,262,752	10c	321,292,822
11	Investments—publicly traded securities ..........			56,127,284	11	68,497,533
12	Investments—other securities. See Part IV, line 11 ......			23,373,344	12	22,091,184
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets .........			13,717,072	14	13,717,072
15	Other assets. See Part IV, line 11 ...........			8,686,816	15	14,528,501
16	Total assets. Add lines 1 through 15 (must equal line 34)...			596,739,694	16	643,988,759
17	Accounts payable and accrued expenses .			50,160,446	17	56,172,717
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			0	19	0
20	Tax-exempt bond liabilities ..........			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			228,259,359	25	232,310,583
26	Total liabilities. Add lines 17 through 25.....			278,419,805	26	288,483,300
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			268,304,392	27	305,253,682
28	Temporarily restricted net assets .....			50,015,497	28	50,172,777
29	Permanently restricted net assets .....			0	29	79,000
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			318,319,889	33	355,505,459
34	Total liabilities and net assets/fund balances .....			596,739,694	34	643,988,759

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).................	Yes	No
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)..........	Yes	No
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)..............................	Yes	No
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)	Yes	No
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)....................................	Yes	No
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)................................................	Yes	No