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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 10-01-2012 , 2012, and ending 09-30-2013
BCheck if applicable:
CName of organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
One Hoag Drive box 6100
Suite
Room/suite
City or town, state or country, and ZIP + 4
Newport Beach, CA926586100
D Employer identification number

95-1643327
E Telephone number

G Gross receipts $ 1,443,428,949
F Name and address of principal officer:
Robert Braithwaite
ONE HOAG DRIVE
NEWPORT BEACH,CA926586100
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HOAG.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1944
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Our mission as a not-for-profit, faith-based hospital is to provide the highest quality health care services to the communities we serve.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 13
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 5,559
6 Total number of volunteers (estimate if necessary) ............. 6 1,600
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 4,071,844
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 43,891,293 27,150,246
9 Program service revenue (Part VIII, line 2g) ......... 791,587,501 819,803,004
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 15,561,345 29,170,024
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 20,224,648 36,594,478
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 871,264,787 912,717,752
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 5,695,206 7,373,264
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) 356,147,500 375,338,238
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 429,717,266 441,947,125
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 791,559,972 824,658,627
19 Revenue less expenses. Subtract line 18 from line 12....... 79,704,815 88,059,125
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,270,288,695 2,392,484,752
21 Total liabilities (Part X, line 26)............. 824,008,683 749,125,003
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,446,280,012 1,643,359,749
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: Our mission as a not-for-profit, faith-based hospital is to provide the highest quality health care services to the communities we serve.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 517,929,623 including grants of $ 7,373,264 ) (Revenue $ 850,638,703 )
Executive Summary The Community Health department at Hoag Memorial Hospital Presbyterian was established in 1995. Since its beginning the program has focused on two principal strategies: - Provide necessary healthcare-related services which are unduplicated in the community. - Provide financial support to existing community based not-for-profit organizations which already provide effective healthcare and related social services to meet community health needs. The Department of Community Health, led by its Director, Gwyn Parry, MD, is responsible for the coordination of Hoag's Community Benefit reporting, and provides free programs to assist the underserved in the community. These include Mental Health Services, Community Case Management and Health Ministries Coordination. In addition to these services, many other Hoag departments provide community health services including education and support groups which are free to the community. Hoag also has substantial relationships with local colleges and universities to invest in the education of various health professions. Community Benefit grants support Hoag Health Associates- organizations that provide a broad range of services, including the following: - Free medical and dental care - Adult day care and education for persons who suffer from Alzheimer's disease or mild dementia, with support and education for their caregivers and families - Transportation services for local senior centers Introduction The Hoag Memorial Hospital Presbyterian Community Benefit Program was formalized in 1995 and has grown significantly since that time. We have served over eighty not-for-profit community organizations in a variety of health and social service categories. We continue to emphasize the development of sustained collaborative relationships and the provision of unduplicated services to disadvantaged residents in our community as core elements of the program. Hoag's nonprofit regional healthcare delivery network consists of two acute-care hospitals, five urgent care centers and seven health centers, and has delivered a level of personalized care that is unsurpassed among Orange County's healthcare providers. Renowned for its excellence, specialized health care services and exceptional physicians and staff, Hoag is admired as one of California's leading hospitals. It is one of the county's largest employers with approximately 5,000 employees and 1,600 volunteers. Hoag's network of more than 1,500 physicians represents 52 different specialties. Hoag Hospital Newport Beach, which has served Orange County since 1952, and Hoag Hospital Irvine, which opened in 2010, are designated Magnet hospitals by the American Nurses Credentialing Center (ANCC) and are fully accredited by DNV. In 2013, Hoag entered into an affiliation with St. Joseph Health to further expand health care services in the Orange County Community. Hoag offers a variety of health care services to treat virtually any routine or complex medical condition. Through its medical staff, state-of-the-art equipment and modern facilities, Hoag provides a full spectrum of health care services including five institutes that provide specialized services in the following areas: cancer, heart and vascular, neurosciences, women's health, and orthopedics through Hoag's affiliate, Hoag Orthopedic Institute. To further Hoag's commitment to provide comprehensive care to the communities we serve, Hoag Medical Group was established in 2012 with the core values of excellence, innovation, and compassion. The physician group comprises specialties and sub-specialties in internal medicine, family medicine, pediatrics, geriatrics, sports medicine, vascular medicine, genetics, diabetes, HIV and addiction medicine. Hoag has been named one of the Best Regional Hospitals in the U.S. News & World Report Metro Edition. The organization was ranked nationally for Orthopedics and placed high-ranking in Cancer, Geriatrics, Nephrology, Pulmonary, Gastroenterology, Gynecology, Neurology & Neurosurgery, and Urology. National Research Corporation has endorsed Hoag as Orange County's most preferred hospital for the past 18 consecutive years, and for an unprecedented 18 years, residents of Orange County have chosen Hoag as the county's best hospital in a newspaper survey by the Orange County Register. History Hoag opened in 1952 as a community partnership between the Association of Presbyterian Members and the George Hoag Family Foundation, a private charitable foundation. The George Hoag Family Foundation and the Association of Presbyterian Members represent the two founding organizations of the hospital and continue to provide leadership as corporate members of the Hoag Corporation. These members annually elect the Board of Directors, which consists of 18 members with representatives from the Hoag community and medical staff. The hospitals' Chief Executive Officer is also seated on the board as a voting member. An annual meeting at the end of the fiscal year provides the corporate members the opportunity for the election/re-election of directors for the ensuing year. Since its founding the hospital has welded a strong commitment to the community that it serves, including the provision of services for those who constitute a more vulnerable, at-risk population. Such care, for both inpatients and outpatients, is often only partially compensated. With excellence of management and the diligent stewardship of funds, Hoag has been able to sustain its financial strength. As a result, Hoag has been able to maintain a continuing commitment to quality of care while developing and expanding community programs and partnerships. Most of the funds expended upon Hoag's Community Benefit Program are from operating income.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4d Other program services (Describe in Schedule O.)
(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e Total program service expensesMediumBullet517,929,623
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
747
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
5,559
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
18
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletJennifer MitznerONE HOAG DRIVE BOX 6100Newport BeachCA926586100 (949) 764-4411
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Gary S McKitterick........................................................................
Chair
 3.0
.......................1.0 		X   X       0 0 0
(2) Robert W Evans........................................................................
VICE CHAIR
 3.0
.......................0.0 		X   X       0 0 0
(3) John L Benner........................................................................
Secretary
 3.0
.......................0.0 		X   X       0 0 0
(4) Dennis J Gilmore........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(5) Dick P Allen........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(6) Raymond Ricci MD........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(7) Weston G Chandler MD........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(8) Jake Easton III........................................................................
Board Member
 3.0
.......................0.0 		X           17,460 0 0
(9) Max W Hampton........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(10) Jeffrey H Margolis........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(11) Michael D Stephens........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(12) Karen Linden........................................................................
CHAIR ELECT
 3.0
.......................0.0 		X   X       0 0 0
(13) Virginia Ueberroth........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(14) Yulun Wang PhD........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(15) Leslie A Margolin........................................................................
Board Member
 3.0
.......................0.0 		X           10,039 0 0
(16) Cindy Stokke........................................................................
Board Member
 3.0
.......................2.0 		X           0 0 0
(17) George H Wood........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Douglas Zusman MD........................................................................
Board Member
 3.0
.......................0.0 		X           0 0 0
(19) Richard Afable end 022813........................................................................
Pres/CEO & Board Member
 50.0
.......................9.0 		X   X       978,250 0 228,392
(20) richard A norling........................................................................
board member (END 03/01/13)
 3.0
.......................0.0 		X                
(21) stephen jones........................................................................
board member (END 03/01/13)
 3.0
.......................0.0 		X                
(22) Robert Braithwaite........................................................................
President/CEO
 50.0
.......................3.0 		    X       937,145 0 54,965
(23) Jennifer Mitzner........................................................................
SVP Corporate Services & CFO
 50.0
.......................3.0 		    X       1,071,872 0 54,835
(24) Jack Cox MD........................................................................
SVP & Chief Quality Officer
 50.0
.......................0.0 		      X     686,465 0 147,457
(25) Richard Martin........................................................................
SVP & Chief Nursing Officer
 50.0
.......................0.0 		      X     735,138 0 44,618
(26) Sanford Smith........................................................................
SVP Real Estate & Facilities
 50.0
.......................0.0 		      X     602,641 0 80,468
(27) Timothy C L Moore........................................................................
SVP & Chief Info OfficeR
 50.0
.......................0.0 		      X     723,907 0 39,785
(28) Cynthia Perazzo........................................................................
SVP Strat. & Business Devel.
 50.0
.......................0.0 		      X     673,958 0 40,812
(29) Flynn Andrizzi........................................................................
SVP
 3.0
.......................51.0 		      X     512,441 0 49,985
(30) Jan Blue........................................................................
SVP Human Resources
 50.0
.......................0.0 		      X     569,225 0 28,303
(31) Robert Dillman MD........................................................................
Executive Medical Director
 50.0
.......................0.0 		        X   433,462 0 34,742
(32) Michael Brant-Zawadzki MD........................................................................
Executive Medical Director COE
 50.0
.......................0.0 		        X   484,148 0 28,335
(33) Terri Cammarano........................................................................
VP Legal
 50.0
.......................0.0 		        X   568,467 0 32,120
(34) James Rice........................................................................
VP Facilities & Operations
 50.0
.......................0.0 		        X   382,949 0 19,435
(35) Stephen Mayfield........................................................................
VP Performance Improvement
 50.0
.......................0.0 		        X   345,026 0 43,074
(36) Kris Iyer MD........................................................................
FORMER BOARD MEMBER
 50.0
.......................0.0 		          X 329,690 0 15,782
(37) ALLYSON M BROOKS........................................................................
FORMER BOARD MEMBER
 0.0
.......................0.0 		          X 276,607 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 10,338,890 0 943,108
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet616
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Pacific Hospitalist ASSOCIATES, 510 Superior Avenue Suite 290Newport BeachCA92663 Medical 6,146,006
ALLSCRIPTS, 8529 SIX FORKS ROADRALEIGHNC27615 SOFTWARE SYSTEMS 2,634,090
HOWE BONNEY ASSOCIATES LLC, 1411 W 190TH STREET SUITE 355GARDENACA90248 project mgmt 1,628,267
TAYLOR AND ASSOCIATES, 2220 UNIVERSITY DRIVE SUITE 200NEWPORT BEACHCA92660 ARCHITECTURE 3,070,595
NEWPORT CRITICAL CARE, 17 EMERALD TRACEALISO VIEJOCA92656 MEDICAL 2,963,254
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet109
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 0
d Related organizations...1d 13,776,518
e Government grants (contributions)1e 13,191,644
f All other contributions, gifts, grants, and
similar amounts not included above1f 		182,084
g Noncash contributions included in lines
1a-1f:$ 		0
h Total. Add lines 1a-1f.......MediumBullet 27,150,246
Program Service Revenue Business Code
2a PATIENT SERVICES 622110 689,496,183 689,496,183 0 0
b HMO Capitated Payment 622110 98,103,874 98,103,874 0 0
c MOB Rental Income 531190 20,191,573 20,191,573 0 0
d Cafeteria Sales 722514 3,956,474 3,956,474 0 0
e Refunds & Rebates 532299 3,031,265 3,031,265 0 0
f All other program service revenue . 5,023,635 5,023,635 0 0
g Total. Add lines 2a–2f........MediumBullet 819,803,004
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 17,843,629     17,843,629
4 Income from investment of tax-exempt bond proceeds..MediumBullet 218     218
5 Royalties...........MediumBullet 54,418     54,418
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 541,768,123 269,251
b Less: cost or other basis and sales expenses 530,023,671 687,526
c Gain or (loss) 11,744,452 -418,275
d Net gain or (loss)..........MediumBullet 11,326,177     11,326,177
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a INCOME FROM PARTNERSHIPS 525990 12,606,846 12,156,430 450,416 0
b MISC-HOI SERVICES 561000 9,572,753 6,563,739 3,009,014 0
c CHILD CARE PROGRAM 624410 1,632,517 0 0 1,632,517
d All other revenue .... 12,727,944 12,115,530 612,414  
e Total. Add lines 11a–11d ...... MediumBullet 36,540,060
12 Total revenue. See Instructions......MediumBullet 912,717,752 850,638,703 4,071,844 30,856,959
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
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 7,351,962 7,351,962
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 21,302 21,302
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0 0
4 Benefits paid to or for members 0 0
5 Compensation of current officers, directors, trustees, and key employees .... 10,505,574 671,116 9,834,458 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 734,117 0 734,117 0
7 Other salaries and wages 285,662,204 199,137,044 86,525,160 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 14,560,374 3,338,897 11,221,477 0
9 Other employee benefits ....... 42,927,714 21,685,224 21,242,490 0
10 Payroll taxes ........... 20,948,255 14,398,841 6,549,414 0
11 Fees for services (non-employees):        
a Management ...... 0 0 0 0
b Legal ......... 3,184,927 0 3,184,927 0
c Accounting ........... 668,367 2,225 666,142 0
d Lobbying ........... 33,680 0 33,680 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 4,153,709 0 4,153,709 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 112,647,355 70,966,281 41,681,074 0
12 Advertising and promotion .... 1,187,175 18,832 1,168,343 0
13 Office expenses ....... 12,038,978 1,821,277 10,217,701 0
14 Information technology ...... 8,960,512 111,503 8,849,009 0
15 Royalties .. 0 0 0 0
16 Occupancy ........... 40,693,274 16,173,810 24,519,464 0
17 Travel ............ 223,240 75,100 148,140 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0 0 0 0
19 Conferences, conventions, and meetings .... 707,596 143,443 564,153 0
20 Interest ........... 19,411,770 19,217,652 194,118 0
21 Payments to affiliates ....... 0 0 0 0
22 Depreciation, depletion, and amortization ..... 78,304,947 24,440,991 53,863,956 0
23 Insurance .............. 2,378,101 1,238,078 1,140,023 0
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 107,411,069 106,440,540 970,529 0
b QA CA Hospital Fee 25,248,867 25,248,867 0 0
c ALL OTHER EXPENSES 24,693,558 5,426,638 19,266,920 0
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 824,658,627 517,929,623 306,729,004 0
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 MediumBullet if following SOP 98-2 (ASC 958-720). 0      
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 119,594,584 1 93,536,365
2 Savings and temporary cash investments ......... 63,585,347 2 133,926,782
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 75,951,414 4 76,040,407
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
2,500,000 5 1,500,000
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 2,704,536 7 337,854
8 Inventories for sale or use .............. 6,408,505 8 6,110,396
9 Prepaid expenses and deferred charges .......... 10,940,354 9 22,745,236
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,486,169,238
b Less: accumulated depreciation ..... 10b 615,284,201 891,989,376 10c 870,885,037
11 Investments—publicly traded securities .......... 646,542,056 11 1,064,476,173
12 Investments—other securities. See Part IV, line 11 ..... 343,872,874 12 0
13 Investments—program-related. See Part IV, line 11 ..... 49,947,698 13 54,944,295
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 56,251,951 15 67,982,207
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 2,270,288,695 16 2,392,484,752
Liabilities 17 Accounts payable and accrued expenses ......... 153,334,453 17 137,439,045
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 7,839,880
20 Tax-exempt bond liabilities ............. 564,052,132 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other 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.................... 106,622,098 25 603,846,078
26 Total liabilities. Add lines 17 through 25......... 824,008,683 26 749,125,003
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 1,446,280,012 27 1,643,207,104
28 Temporarily restricted net assets ........... 0 28 152,645
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 1,446,280,012 33 1,643,359,749
34 Total liabilities and net assets/fund balances ........ 2,270,288,695 34 2,392,484,752
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
912,717,752
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
824,658,627
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
88,059,125
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,446,280,012
5
Net unrealized gains (losses) on investments ...............
5
75,223,053
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
33,797,559
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,643,359,749
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
  		Employer identification number

95-1643327
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


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
  		Employer identification number

95-1643327
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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
  		Employer identification number

95-1643327
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 (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable 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) 2012


Schedule C (Form 990 or 990-EZ) 2012
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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
0
d
Mailings to members, legislators, or the public? .........................
 
No
0
e
Publications, or published or broadcast statements? .......................
 
No
0
f
Grants to other organizations for lobbying purposes? .......................
 
No
0
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
0
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
0
i
Other activities? ..........................
Yes
 
33,680
j
Total. Add lines 1c through 1i ...............................
33,680
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) 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."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Lobbying efforts Schedule C, Part II-B, Line 1I Hoag Memorial Hospital Presbyterian (HMHP) pays dues to the Hospital Association of Southern California. A portion of the dues paid by HMHP are spent on lobbying efforts by the Hospital Association. In FY 2013, $33,680 was spent on lobbying.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a 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.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (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 XIII, the text of the footnote to its financial statements that describes these items.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII 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 ................. 0 77,330,825 77,330,825
b Buildings ................   849,184,879 280,907,417 568,277,462
c Leasehold improvements ............   103,555,814 27,881,897 75,673,917
d Equipment ................   443,187,467 306,494,887 136,692,580
e Other .................   12,910,253   12,910,253
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 870,885,037
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








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








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








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
TAX-EXEMPT BOND LIABILITIES 540,711,816
Medical Cost Reports 210,495
Lease Incentive Obligation-Irvine 13,096,818
ARO Liability 1,804,181
Accrued Income Guarantees 8,804,174
Accrued Malpractice Liability 10,922,000
Accrued Capitation Liability 25,828,092
DUE TO ST JOSEPH HEALTH SYSTEM 2,468,502

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 603,846,078
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI 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 XIII.) ............ 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 XIII.) ........... 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 XII 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 XIII.) ............ 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 XIII.) ............ 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 XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, 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 The following footnote comes from the consolidated St. Joseph Health System audited financial statements for the year ending 6/30/13: 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 STATMENTS. 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 OR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2013 OR 2012.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I
General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (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 and investments
in region
Central America and the Caribbean     Investments   181,465,106
East Asia and the Pacific     Investments   1,654,591
Europe (Including Iceland and Greenland)     Investments   24,160,845
North America     Investments   3,434,349
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     210,714,891
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     210,714,891
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
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. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012Page 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.
Part III can be duplicated 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) 2012
Schedule F (Form 990) 2012
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
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 AMOUNTS REPORTED IN PART I, LINE 3, COLUMN F REPRESENT THE MARKET VALUES OF THE INVESTMENTS IN THE IDENTIFIED REGIONS AS OF THE ORGANIZATION'S FISCAL YEAR ENDED SEPTEMBER 30, 2013.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2012
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining 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, as a factor in determining eligibility for free or discounted care.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    7,730,839   7,730,839 0.900 %
b Medicaid (from Worksheet 3,
column a) .... 		    55,201,337 41,106,487 14,094,850 1.710 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    20,804,000 6,486,000 14,318,000 1.740 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		    83,736,176 47,592,487 36,143,689 4.350 %
Other Benefits
     7,404,008   7,404,008 0.900 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    382,530   382,530 0.050 %
g Subsidized health services
(from Worksheet 6) .. 		    1,207,240   1,207,240 0.150 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    2,027,738   2,027,738 0.250 %
j Total. Other Benefits ..     11,021,516   11,021,516 1.350 %
k Total. Add lines 7d and 7j .     94,757,692 47,592,487 47,165,205 5.450 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     35,103   35,103 0 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy     10,224   10,224 0 %
8 Workforce development     7,414   7,414 0 %
9 Other            
10 Total     52,741   52,741 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
22,754,084
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
135,051,705
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
201,379,837
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-66,328,132
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
 
No
b
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.......................

9b

 

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—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 %
1HOAG OTHRO INST
  		SPECIALTY HOSPITAL 51.000 %   49.000 %
2MAIN ST SPEC SURGERY
  		OUTPATIENT SURGERY CTR 42.360 %   14.660 %
3hoag outpatient ctr
  		endoscopy center 45.250 %   49.750 %
4nwpt bch radiosrgry
  		surgery center 50.000 %   50.000 %
5nwpt surgical prtns
  		surgery center 15.000 %   60.000 %
6nwpt bch endoscopy
  		endoscopy center 5.000 %   55.500 %
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?2
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN
ONE HOAG DRIVE BOX 6100
NEWPORT BEACH,CA926586100 		X X     X   X      
2 HOAG ORTHOPEDIC INSTITUTE
1250 SAND CANYON
IRVINE,CA92614 		X               ORTHOPEDIC HOSPITAL  
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 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.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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?....... 15 Yes  
16 Check all of the following 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
b
c
d
e
17 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?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
HOAG ORTHOPEDIC INSTITUTE
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 2
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1   No
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20  
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 CHNA 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 CHNA report widely available to the public? ............. 5    
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7    
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a    
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 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.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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?....... 15 Yes  
16 Check all of the following 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
b
c
d
e
17 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?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19   No
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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?11
Name and address Type of Facility (describe)
1 hoag op imaging center
510 superior avenue
newport beach,CA92663 		imaging center
2 hoag health center - huntington beach
19582 beach boulevard
huntington beach,CA92648 		health center
3 hoag newport surgicare
1441 avocado suite 100
newport beach,CA92663 		outpatient surgery center
4 hoag diabetesptrehab center
520 superior avenue
newport beach,CA92663 		outpatient diabetes education center
5 irvine imaging center
4870 barranca parkway
irvine,CA92614 		imaging center
6 hoag health center - aliso viejo
26671 aliso creek road
aliso viejo,CA92656 		health center
7 health care center - costa mesa
1190 baker
costa mesa,CA92626 		health center
8 hic woodbury
6352 irvine boulevard
irvine,CA62614 		health center
9 newport imaging center
360 san miguel
newport beach,CA92660 		imaging center
10 main st specialty surgery center
280 main st 100
orange,CA92868 		outpatient surgery center
11 orthopedic surgery center of orange co
22 corporate plaza dr suite 150
newport beach,CA92660 		outpatient orthopedic surgery center
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
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.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
SCHEDULE H, PART VI, LINE 1   THE ORGANIZATION'S REQUIRED SCHEDULE H SPECIFIC LINE ITEM DESCRIPTIONS ARE AS FOLLOWS: Part I, Line 6a Hoag Hospital completed the FY2013 Community Benefit report and submitted it to OSHPD in February 2013. The report is available to the public through the Hoag Hospital website http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx PART I, LINE 7a-i COST ACCOUNTING SYSTEM WAS USED TO DERIVE THE COST-TO-CHARGE RATIO. OUR TOTAL COSTS (DIRECT AND INDIRECT) AND TOTAL CHARGES WERE $644,163,000 AND $2,088,657,000, RESPECTIVELY. THIS RESULTED IN A COST-TO-CHARGE RATIO OF APPROXIMATELY 32% WHICH WAS USED TO CALCULATE CHARITY CARE AT COST (GROSS PATIENT CHARGES WRITTEN OFF ON THE P&L TIMES COST-TO-CHARGE RATIO). THE COST ACCOUNTING SYSTEM ADDRESSES INPATIENT, OUTPATIENT AND VARIOUS PAYOR TYPES. FOR THE SECTIONS OF LINE 7 AS APPLICABLE, WORKSHEET 2 WAS NOT USED WHILE THE COST TO CHARGE RATIO WAS USED. PART II - COMMUNITY BUILDING ACTIVITIES The primary purpose of Hoag's Community Building activities is to improve local health in Orange County through a collaborative process with other non-profit organizations and health care delivery systems in providing funding opportunities for health related community initiatives. Hoag participates in a variety of community building such as supporting the Health Funders Partnership of Orange County ($10,224). The goal of the Partnership is to improve local health by enhancing the impact and efficiency of health philanthropy and health service delivery in Orange County. The Partnership addresses this goal by identifying strategic issues for collaborative funding and the potential to leverage community resources. Hoag also assists with community disaster preparedness planning ($35,104). In addition, Hoag partnered with Project SEARCH, a one year, high school transition program which provides skills training and work experience for young adults with disabilities ages 18 to 21. fORM 990, SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE The following footnote comes from the consolidated St. Joseph Health System audited financial statements for the year ending 6/30/13: PAGE 11 OF THE FINANCIAL STATEMENTS - 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. Form 990, Schedule H, Part III, Line 8 MEDICARE COSTING METHODOLOGY Medicare allowable costs were calculated using a cost to charge ratio. The organization does not treat the shortfall from Medicare as a community benefit. FORM 990, SCHEDULE H, PART V, LINE 1 HOAG ORTHOPEDIC INSTITUTE HOAG ORTHOPEDIC INSTITUTE IS ON A CALENDAR TAX YEAR AND THEREFORE 2013 IS THE FIRST YEAR THAT THEY ARE REQUIRED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).
FORM 990, SCHEDULE H, PART V, LINE 3 INPUT FROM COMMUNITY REPRESENTATIVES HOAG MEMORIAL HOSPITAL PRESBYTERIAN As part of this Community Health Needs Assessment, two focus groups were held on June 13, 2013. Participants included: physicians, a public health representative, other health professionals, social service providers, business leaders and other community leaders. Hoag recruited the participants for the focus groups. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Final participation included representatives of 20 local organizations. Through this process, input was gathered from a representative of public health, as well as several individuals whose organizations work with low-income, minority (including Hispanic, Asian Americans, and undocumented residents), refugees from Africa and the Middle East, and other medically underserved populations (specifically, children and college age adolescents, elderly, disabled, the uninsured/underinsured, and Medi-Cal recipients).
FORM 990, SCHEDULE H, PART V, LINE 5C AVAILABILITY OF CHNA REPORT HOAG MEMORIAL HOSPITAL PRESBYTERIAN This Community Health Needs Assessment is also available to the public using the following URL: http://hoag.healthforecast.net. HealthForecast.net is an interactive, dynamic tool designed to share CHNA data with community partners and the public at large. This site: * INFORMS READERS THAT THE CHNA REPORT IS AVAILABLE AND PROVIDES instructions for downloading it; * OFFERS THE CHNA REPORT DOCUMENT IN A FORMAT THAT, WHEN ACCESSED, downloaded, viewed, and printed in hard copy, exactly reproduces the image of the report; * GRANTS ACCESS TO DOWNLOAD, VIEW, AND PRINT THE DOCUMENT WITHOUT special computer hardware or software required for that format (other than software that is readily available to members of the public without payment of any fee) and without payment of a fee to the hospital organization or facility or to another entity maintaining the website. The 2013 CHNA and Implementation Strategy is posted on the Hoag website: http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx
FORM 990, SCHEDULE H, PART V, LINE 7 NEEDS NOT ADDRESSED HOAG MEMORIAL HOSPITAL PRESBYTERIAN In acknowledging the wide range of priority health issues that emerged from the CHNA process, Hoag determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence. Priority Health Issues Not Chosen for Action: * SUBSTANCE ABUSE: SUBSTANCE ABUSE TREATMENT FOR THE VULNERABLE population is currently being addressed on a limited scale by the Chemical Dependency Program at Hoag. Hoag will look for opportunities to collaborate with local community organizations that have the infrastructure and resources to better meet this need. Substance abuse prevention will be addressed through community education and outreach opportunities. * TOBACCO USE: HOAG OFFERS AN EIGHT SESSION SMOKING CESSATION PROGRAM that is free and open to the community. Other community organizations have the infrastructure and programs in place to better meet this need. Limited resources and lower priority excluded this as an area chosen for action. The 2013 CHNA and Implementation Strategy is posted on the Hoag website: http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 12H Other basis for calculating amount charged to patient HOAG MEMORIAL HOSPITAL PRESBYTERIAN HOAG PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE FAMILY INCOME LEVELS OF UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES. HOAG GIVES CONSIDERATION TO ELIGIBLE PATIENTS WITH INSURANCE IF THEY INCUR HIGH MEDICAL COSTS AS DEFINED BY CALIFORNIA LAW, AND ALSO HAVE FAMILY INCOMES UP TO 400% OF THE FPL. HOAG'S POLICY ALSO PROVIDES FOR DISCRETIONARY DETERMINATION OF CHARITY CARE TAKING INTO CONSIDERATION INDIVIDUAL FACTS AND CIRCUMSTANCES. HOAG ORTHOPEDIC INSTITUTE HOAG ORTHOPEDIC INSTITUTE PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE FAMILY INCOME LEVELS OF UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES. HOAG GIVES CONSIDERATION TO ELIGIBLE PATIENTS WITH INSURANCE IF THEY INCUR HIGH MEDICAL COSTS AS DEFINED BY CALIFORNIA LAW, AND ALSO HAVE FAMILY INCOMES UP TO 400% OF THE FPL. HOAG ORTHOPEDIC INSTITUTE'S POLICY ALSO PROVIDES FOR DISCRETIONARY DETERMINATION OF CHARITY CARE TAKING INTO CONSIDERATION INDIVIDUAL FACTS AND CIRCUMSTANCES. FORM 990, SCHEDULE H, SECTION B, LINE 14g HOAG MEMORIAL HOSPITAL PRESBYTERIAN and hoag orthopedic institute The Policy is communicated via our website and is communicated via our Financial Counselors at each location. Further, it is communicated in our self pay customer service area along with any external collection vendors as well. Any written letters also offer the assistance program and to contact customer service for an application.
FORM 990, SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT In the Spring of 2013, Hoag embarked on a comprehensive Community Health Needs Assessment (CHNA) process to identify and address the key health issues of our community. This assessment was conducted by Professional Research Consultants, Inc. (PRC). PRC is a nationally-recognized healthcare consulting firm with extensive experience conducting Community Health Needs Assessments in communities across the United States since 1994. To access the 2013 CHNA report in its entirety, please visit: http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx The Community Health Needs Assessment (CHNA) is a systematic, data-driven approach to determining the health status, behaviors and needs of residents in the service area of Hoag. Subsequently, this information may be used to inform decisions and guide efforts to improve community health and wellness. A CHNA provides information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. This CHNA will serve as a tool toward reaching three basic goals: - To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life. - To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health. - To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care. This assessment incorporates data from both quantitative and qualitative sources. Quantitative data input includes primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for trending and comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through two Key Informant Focus Groups. The survey instrument used for this study is based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. The final survey instrument was developed by Hoag and PRC. A precise and carefully executed methodology is critical in asserting the validity of the results gathered in the PRC Community Health Survey. Thus, to ensure the best representation of the population surveyed, a telephone interview methodology - one that incorporates both landline and cell phone interviews - was employed. The primary advantages of telephone interviewing are timeliness, efficiency and random selection capabilities. The sample design used for this effort consisted of a random sample of 751 individuals age 18 and older in Hoag's Service Area. All administration of the surveys, data collection and data analysis was conducted by Professional Research Consultants, Inc. (PRC). The sample design and the quality control procedures used in the data collection ensure that the sample is representative. Thus, the findings may be generalized to the total population of community members in the defined area with a high degree of confidence. A variety of existing (secondary) data sources was consulted to complement the research quality of this Community Health Needs Assessment. Data for the service area were obtained from the following sources - California Department of Public Health - Centers for Disease Control & Prevention - National Center for Health Statistics - State of California Department of Justice - US Census Bureau - US Department of Health and Human Services - US Department of Justice, Federal Bureau of Investigation As part of this Community Health Needs Assessment, two focus groups were held on June 13, 2013. Participants included: physicians, a public health representative, other health professionals, social service providers, business leaders and other community leaders. Hoag recruited the participants for the focus groups. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Final participation included representatives of 20 local organizations. Through this process, input was gathered from a representative of public health, as well as several individuals whose organizations work with low-income, minority (including Hispanic, Asian Americans, and undocumented residents), refugees from Africa and the Middle East, and other medically underserved populations (specifically, children and college-age adolescents, elderly, disabled, the uninsured/underinsured, and MediCal recipients).
FORM 990, SCHEDULE H, PART VI, LINE 3 Patient education of eligibility for assistance IN ADDITION TO THE VISUAL NOTICES OF ASSISTANCE AVAILABLE, SELF PAY PATIENTS MEET WITH THE FINANCIAL COUNSELOR TO EVALUATE THEIR STATUS. FOR ALL OTHER PATIENTS, THEY WOULD BE EDUCATED AT TIME OF NEED OR UPON PATIENT'S INQUIRY ABOUT THEIR BALANCE.
FORM 990, SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION Hoag's community, as defined for the purpose of the Community Health Needs Assessment, included each of the 56 residential ZIP Codes comprising the hospital's service area. This community definition was determined because a majority of Hoag's patients originate from this area. Please refer to Hoag 2013 Community Benefit report at http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx for more detailed information on Hoag's community. The population of the hospital's service area is estimated at 1,874,329 people. The age distribution of our population is similar to that of that nation as a whole, but our area is racially and ethnically much more diverse, with non-Hispanic White residents comprising only a narrow majority of residents. Please refer to Hoag 2013 Community Benefit report at http://www.hoag.org/Why-HOAG/Pages/Community-Benefit/Reports.aspx for more details on this information. Other Hospitals in the area include, but are not limited to: - Ahmc Anaheim Regional Medical Center - Anaheim - Anaheim General Hospital (Anaheim, Buena Park) - Chapman Medical Center - Orange - Children's Hospital At Mission - Mission Viejo - Children's Hospital of Orange County - Orange - Fountain Valley Rgnl Hosp and Med Ctr -Fountain Valley - Garden Grove Hospital and Medical Center - Garden Grove - Huntington Beach Hospital - Huntington Beach - Kaiser Permanente (Irvine, Anaheim) - Kindred Hospital (Santa Ana, Westminster) - La Palma intercommunity Hospital - La Palma - Mission Hospital Laguna Beach - Laguna Beach - Mission Hospital Regional Medical Center - Mission Viejo - Orange Coast Memorial Medical Center - Fountain Valley - Saddleback Memorial Medical Center (Laguna Hills/San Clemente) - St. Joseph Hospital - Orange - Orange - St. Jude Medical Center - Fullerton - University of California Irvine Medical Center - Orange - Western Medical Center - Santa Ana FORM 990, SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH - Community Benefit staff continuously assess the health needs of the community by serving on Board of Directors and committees of non profit organizations which allows them to be actively engaged with the community and provide support and strategic direction. - Hoag continues to collaborate with the Department of Education in support of a full-time School-Based County physician to serve the public school system in Orange County. Hoag provides the majority funding for this position. - Hoag Hospital has a relationship with local colleges and universities to invest in the education of various health professions especially with the growing need of bilingual and bicultural health professionals in Orange County. - Hoag Hospital and Share Our Selves (SOS) Clinic have nurtured a unique partnership since 1984 to provide health care to the low income, uninsured, and underinsured individuals residing in the community. The SOS and Hoag collaboration includes more than 150 volunteer healthcare specialists available to provide care to SOS patients by providing diagnostic tests, procedures, hospitalizations and ER visits for SOS patients. In addition, SOS is acquiring a pediatric clinic from the Children's Hospital of Orange County (CHOC). Hoag will be building a physical site for this clinic which will serve primarily low income families from the Costa Mesa and Newport Beach communities. - Hoag Hospital also maintains a unique relationship with the Alzheimer's Family Resource Center (AFSC) which is committed to the mission of improving the quality of life for families challenged by Alzheimer's disease or another dementia through services tailored to meet individual needs. Hoag Hospital owns the AFSC facility and provides it at no charge, including maintenance services as specified in the lease, to the agency. Additionally, the hospital provides annual operating and transportation grants, and in-kind services such as consultation in nursing and compliance-related issues to the center. - HOAG'S MENTAL HEALTH CENTER (MHC) PROVIDES BILINGUAL BICULTURAL SERVICES ON A SLIDING SCALE TO PEOPLE WHO OTHERWISE COULD NOT OBTAIN MENTAL HEALTH SERVICES. During FY 2013, the MHC PROVIDED SERVICES TO 817 CLIENTS IN THE FORM OF PSYCHOTHERAPY, RESOURCE BROKERING, AND/OR CASE MANAGEMENT. - Through the Hoag Health Ministries Program, the Faith Community Nurse's (FCN's) administered 6,540 flu vaccine doses to faith members and other community members. - In collaboration with Hoag's Neurosciences Institute and the Alzheimer's Family Services Center, Hoag Community Benefit sponsored the 2013 Spirituality Conference - Keeping the Care in Caregiving. The conference was attended by 150 community clergy, health care professionals and caregivers. - HOAG HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY THOUGH A CREDENTIALING PROCESS. MEMBERSHIP AND PRIVILEGES ARE GRANTED TO QUALIFIED MD'S, DO'S, AND OTHER ALLIED HEALTH PROFESSIONALS BY THE MEDICAL STAFF AND HOAG HOSPITAL BOARD OF DIRECTORS. - AS A NOT-FOR-PROFIT INSTITUTION, GOVERNANCE IS PROVIDED BY A VOLUNTEER BOARD OF DIRECTORS COMPRISED OF 18 VOTING MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. - THE BOARD OF DIRECTORS ALLOCATE A SIGNIFICANT PORTION OF THE NET OPERATING INCOME TO PROMOTING THE HEALTH OF THE COMMUNITY, SPECIFICALLY SERVING THE NEEDS OF THE UNINSURED AND LOW INCOME COMMUNITIES THROUGH CHARITY CARE AND A VARIETY OF FREE OR LOW COST SERVICES AND PROGRAMS PROVIDED BY THE DEPARTMENT OF COMMUNITY HEALTH. - IN AN EFFORT TO INCREASE THE COMMUNITY POOL OF AVAILABLE TRAINED AND EDUCATED HEALTH PROFESSIONALS, HOAG INVESTS ANNUALLY IN HEALTH PROFESSIONAL TRAINING AND DEVELOPMENT. THE HOSPITAL CURRENTLY WORKS WITH A NUMBER OF PROFESSIONAL GROUPS IN THIS ENDEAVOR, INCLUDING NURSES, PHYSICAL THERAPISTS, PHARMACISTS, LABORATORY PROFESSIONALS, SOCIAL WORKERS, AND CLINICAL CARE EXTENDERS. - Hoag provides uncompensated care (charity) to patients who are unable to pay for the full cost of their care. These expenditures amounted to over $37 million in Fiscal Year 2013 (October 1, 2012 through September 30, 2013.) Hoag's charity care and self pay discount policy states that self-pay and uninsured patients who are unable to pay for the full cost of their care may qualify for charity or discounts on a sliding scale for incomes up to 400% of the federal poverty level. Total quantifiable Community Benefit expenditures (excluding Medicare Cost of Unreimbursed Care) for FY2013 amounted to over $49 million.
FORM 990, SCHEDULE H, PART VI, LINE 6 Affiliated health care system Hoag Hospital is a nonprofit regional healthcare delivery network consisting of two acute-care hospitals, five urgent care centers and seven health centers. In 2013, Hoag Hospital became affiliated with St. Joseph Health, an integrated healthcare delivery system sponsored by the St. Joseph Health ministry. St. Joseph Health 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.
FORM 990, SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CA
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number
95-1643327
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(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) Share Our Selves Clinic
1550 superior ave
costa mesa,CA92627 		95-3222316 501(c)(3) 2,096,082       Free Medical and Dental clinic
(2) Alzheimer's Family Services Center
9451 indianapolis ave
huntington beach,CA92646 		95-3463978 501(c)(3) 1,783,569       Operations, Matching Grts, misc grants
(3) Childrens Hospital Orange County (CHOC)
455 s main street
orange,CA92868 		95-2321786 501(c)(3) 960,000       Pediatric Diabetes Services
(4) Newport -Mesa Unified School District
2985 a bear street
costa mesa,CA92628 		95-2417783 government 250,000       Expansion of 13 programs for the HOPE Clinic
(5) CHOC Foundation
455 s main street
orange,CA92868 		95-6097416 501(c)(3) 225,000       IUSD/CHOC Athletic Program, Pledge CVICU/NICU
(6) Orange County Dept of Education
200 kalmus drive
costa mesa,CA92628 		95-6000943 government 200,000       Grant: Support full time physician to OC students
(7) Keck School of Medicine of USC
1520 san pablo
los angeles,CA90033 		95-1642394 501(c)(3) 180,000       Grant: Resident Education and Research Activites .
(8) Costa Mesa Senior Center
695 west 19th st
costa mesa,CA92627 		33-8265009 501(c)(3) 173,237       Senior Transportation and program development
(9) City of Huntington Beach Council on Aging
1706 orange ave
huntington beach,CA92648 		51-0179431 government 155,000       Senior Transportation/Care Managers (2) Home visit ation
(10) Age Well Senior Services (S County Sr Svc)
24300 el toro
laguna woods,CA92637 		93-1163563 501(c)(3) 147,827       Grant: Senior Transportation, Operations of progra ms, Mobile Meals
(11) City of Newport Beach
po box 1768
newport beach,CA92658 		95-6000751 government 121,000       Oasis Senior Center transportation, Police Explore rs, Bike Safety Program
(12) Providence Speech & Hearing Center
1301 providence ave
Orange,CA92868 		95-6154473 501(c)(3) 115,000       Grant: Low income subsidy program and El Sol Clin ic Collaborative
(13) Pediatric Adolescent Diabetes Research Edu
455 S Main St
Orange,CA92868 		33-0099451 501(c)(3) 92,918       Grant: Diabetes Education GRANT AT ALLEN CENTER
(14) ONE OC
1901 e 4th st
santa ana,CA92705 		95-2021700 501(c)(3) 89,000       Grants and Contributions to other Non-profit servi ce organizations
(15) Orange County United Way
18012 mitchell ave
irvine,CA92614 		33-0047994 501(c)(3) 64,522       Hoag employees match contribution, Executive Progr am
(16) 2 1 1 Orange County
po box 14277
irvine,CA92623 		33-0063532 501(c)(3) 50,000       211 Information/Referral Call Center operating sup port
(17) Irvine Adult Day Health Services
20 lake road
irvine,CA92604 		33-0599371 501(c)(3) 45,750       Expansion of Educational programs and Senior Trans portation
(18) Access California Services
2180 w crescent ave
anaheim,CA92801 		33-0826205 501(c)(3) 45,000       Expansion of Mental Health Program and other progr ams
(19) Irvine Public Schools Foundation
18552 macarthur blvd
irvine,CA92612 		33-0733191 501(c)(3) 41,158       Pledge for matching funds Generation Wall Hoag Irv ine
(20) Healthy Smiles
10602 chapman ave
garden grove,CA92840 		38-3675065 501(c)(3) 38,000       Provide children's dental services at Oakview Dist rict in Huntington Bch
(21) Juvenile Diabetes Research Foundation
17992 mitchell south
irvine,CA92614 		23-1907729 501(c)(3) 35,000       Sponsoship Walks,Gala, program support
(22) Orange County Human Relations
1300 s grand ave
santa ana,CA92705 		33-0438086 501(c)(3) 35,000       Bridges School Inter Group Relations & Violence Pr evention programs
(23) Someone Care Soup Kitchen
720 w 19th st
costa mesa,CA92627 		33-0279080 501(c)(3) 31,475       Support towards programs to feed the poor COMMUNITY EDUCATION
(24) MOMS
1128 w santa ana
santa ana,CA92703 		33-0518078 501(c)(3) 26,000       Grant: Support educational programs Clinics
(25) City of Irvine
po box 19575
irvine,CA92623 		95-2759391 government 25,000       Grant: I-CHP - support Childrens Health programs
(26) Latino Health Access
1701 n main street
Santa Ana,CA92706 		33-0562943 501(c)(3) 25,000       Grants for Latino Health probems, Diabetes, etc.. EDUCATION & ADVOCACY
(27) Save Our Youth
661 hamilton
costa mesa,CA92627 		33-0585600 501(c)(3) 25,000       Grant: Operating support DISTRICT IN HUNTINGTON BCH
(28) Sweet Success Express Program
po box 9705
fountain valley,CA92728 		34-2044369 501(c)(3) 22,000       Grant: Diabetes Education
(29) Hurrt Family Health Clinic
One Hope Drive
Tustin,CA92782 		33-0906866 501(c)(3) 21,275       Mobile Clinic visits to Oak View Community Center in Huntington Beach
(30) Friends of Oasis
801 narcissus rd
corona del mar,CA92625 		95-3196296 501(c)(3) 20,000       Program Grant for database resources and outreach needs
(31) Irvine Childrens Fund
14301 Yale Ave
Irvine,CA92604 		33-0177921 501(c)(3) 20,000       Provides Before and After School Child Care Schola rships
(32) Youth Employment Services
114 east 19th street
costa mesa,CA92627 		95-2704522 501(c)(3) 15,549       Provide pre-employemnt training, job counseling to young people
(33) American Lung Assoc
1570 e 17th st
santa ana,CA92705 		95-0362650 501(c)(3) 15,000       Scamp Camp, Sponsor Oc Respiratory Rally Irvine
(34) Crohn's & Colitis
10350 santa monica
Los Angeles,CA90025 		13-6193105 501(c)(3) 15,000       Sponsorship: 'Inaugural CCFS Golf Classic Activites.
(35) Girls Incorporated of Orange County
1815 anaheim
Costa Mesa,CA92627 		95-1810150 501(c)(3) 12,000       Community programs - Fit Girls and Families school supplies
(36) Academy of International Dance
220 E FOURTH ST
COSTA MESA,CA92627 		26-2657759 501(c)(3) 10,000       Grant: Expansion of after school activiities, Lite racy, tutoring
(37) Alzheimer's Association
17771 COWAN AVE
IRVINE,CA92614 		95-3702013 501(c)(3) 10,000       Program Grant
(38) American Heart Assoc
4600 CAMPUS DRIVE
IRVINE,CA32614 		13-5613797 501(c)(3) 10,000       Grant: Support Orange County Community programs
(39) California Assoc Hospitals & Health Systems
1215 K STREET
SACRAMENTO,CA95814 		94-1205308 501(c)(6) 10,000       Grant: Educational Conference - Medical advancemen t/Reglatory req.
(40) COUNCIL ON AGING OC
1971 EAST 4TH ST
SANTA ANA,CA92705 		95-2874089 501(c)(3) 10,000       Sponsorship: Just Imagin Luncheon
(41) Human Options
PO Box 53745
IRVINE,CA92619 		95-3667817 501(c)(3) 10,000       Grant Support for programs
(42) MADD
17772 IRVINE BLVD
TUSTIN,CA92780 		94-2707273 501(c)(3) 10,000       Grant: Community Education
(43) Merage Jewish Community Center
1 FEDERATION WAY
IRVINE,CA92603 		95-2407026 501(c)(3) 10,000       Sponsorship: JCC Celebration Ball 'Spirit of Macca bi
(44) Newport Beach Sunrise Rotary Foundation
PO BOX 8113
NEWPORT BEACH,CA92856 		33-0222352 501(c)(3) 10,000       Grant: Support Families of wounded warriors SERVICE ORGANIZATIONS
(45) Newport Community Counseling Center
2200 SAN JOAQUIN
NEWPORT BEACH,CA92660 		20-2108327 501(c)(3) 10,000       Grant: Scholarship/ Mental Health Counseling progr am
(46) Orange Coast Interfaith Shelter
1963 WALLACE AVE
COSTA MESA,CA92627 		95-3613254 501(c)(3) 10,000       Grant: Program support PREVENTION PROGRAMS
(47) Susan G Komen Orange County
3191 A AIRPORT LOOP
COSTA MESA,CA92626 		33-0487943 501(c)(3) 10,000       Sponsorship: Orange County Race for the Cue
(48) UCI Foundation
DEV OFFICE MPAA210
IRVINE,CA92697 		95-2540117 501(c)(3) 10,000       Pledge support to Paul Merage School of Business H ealthcare Mngmt
(49) Huntington Beach Union High School District
5832 BOLSA AVE
HUNTINGTON BEACH,CA92649 		95-6001644 government 5,600       Oak View Mobil Health Programs
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
48
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
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.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) EMS SAFETY SERVICES 1 21,302      












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
Description of Organization's Procedures for Monitoring the Use of Grants Form 990, Schedule I In order to be eligible for a Community Benefit grant, an applicant organization (or fiscal agent) must be designated by the IRS as a tax exempt non-profit and submit a copy of their EXEMPT status for verification. The organization must have an Executive Director and an established Board of Directors that meets regularly. Prior to funding, research is conducted regarding the reputation and performance of the organization. Grant requests must include previous and current year budgets, program goals and objectives, and measurable outcomes for the specified program that is being funded. An interview with the Executive director and one or more board members may be conducted as well as a site visit in order to familiarize ourselves with the organization and the programs offered. Department staff may actively participate with the organization by providing in-kind services and board participation. Once a grant request has been approved and funded, we require progress reports/and or a final report on the implementation strategy and measurable outcomes. Throughout the funding period of a specified program, there may be occasional meetings with the director and program personnel to receive reports on progress and updates of the activities conducted as well as the number of individuals served. This process allows us to monitor that the donated funds are being used for the intended purpose. Those that request grant funding on a continuous basis provide a detailed year end annual report describing implementation and outcomes for the programs.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
Yes
 
3
Indicate which, if any, of the following the filing organization used 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.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
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 (E) amounts for that individual.
(A) Name and Title (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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Richard Afable end 022813Pres/CEO & Board Member (i)
(ii)		 659,815
0 		231,695
0 		86,740
0 		208,521
0 		19,871
0 		1,206,642
0 		0
0
(2)Robert BraithwaitePresident/CEO (i)
(ii)		 524,022
0 		411,802
0 		1,321
0 		33,415
0 		21,550
0 		992,110
0 		0
0
(3)Jack Cox MDSVP & Chief Quality Officer (i)
(ii)		 474,004
0 		209,192
0 		3,269
0 		127,108
0 		20,349
0 		833,922
0 		0
0
(4)Richard MartinSVP & Chief Nursing Officer (i)
(ii)		 407,761
0 		325,528
0 		1,849
0 		35,972
0 		8,646
0 		779,756
0 		0
0
(5)Jennifer MitznerSVP Corporate Services & CFO (i)
(ii)		 464,066
0 		606,715
0 		1,091
0 		35,284
0 		19,551
0 		1,126,707
0 		0
0
(6)Sanford SmithSVP Real Estate & Facilities (i)
(ii)		 372,276
0 		226,996
0 		3,369
0 		55,711
0 		24,757
0 		683,109
0 		0
0
(7)Timothy C L MooreSVP & Chief Info OfficeR (i)
(ii)		 399,527
0 		322,331
0 		2,049
0 		23,146
0 		16,639
0 		763,692
0 		0
0
(8)Cynthia PerazzoSVP Strat. & Business Devel. (i)
(ii)		 373,876
0 		298,991
0 		1,091
0 		21,623
0 		19,189
0 		714,770
0 		0
0
(9)Flynn AndrizziSVP (i)
(ii)		 352,241
0 		147,970
0 		12,230
0 		20,476
0 		29,509
0 		562,426
0 		0
0
(10)Jan BlueSVP Human Resources (i)
(ii)		 322,046
0 		244,313
0 		2,866
0 		18,447
0 		9,856
0 		597,528
0 		0
0
(11)Robert Dillman MDExecutive Medical Director (i)
(ii)		 376,102
0 		48,678
0 		8,682
0 		12,500
0 		22,242
0 		468,204
0 		0
0
(12)Michael Brant-Zawadzki MDExecutive Medical Director COE (i)
(ii)		 417,790
0 		45,791
0 		20,567
0 		12,500
0 		15,835
0 		512,483
0 		0
0
(13)Terri CammaranoVP Legal (i)
(ii)		 339,719
0 		227,658
0 		1,090
0 		12,500
0 		19,620
0 		600,587
0 		0
0
(14)James RiceVP Facilities & Operations (i)
(ii)		 226,366
0 		155,558
0 		1,025
0 		0
0 		19,435
0 		402,384
0 		0
0
(15)Stephen MayfieldVP Performance Improvement (i)
(ii)		 209,997
0 		131,899
0 		3,130
0 		26,044
0 		17,030
0 		388,100
0 		0
0
(16)Kris Iyer MDFORMER BOARD MEMBER (i)
(ii)		 320,008
0 		0
0 		9,682
0 		12,500
0 		3,282
0 		345,472
0 		0
0
(17)ALLYSON M BROOKSFORMER BOARD MEMBER (i)
(ii)		 0
0 		0
0 		276,607
0 		0
0 		0
0 		276,607
0 		0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
SCHEDULE J, PART I, LINE 1(A) Supplemental Compensation Information THE PREVIOUS CEO (RICK AFABLE) AND CHIEF QUALITY OFFICER ARE PROVIDED WITH A RELOCATION LOAN IN ACCORDANCE WITH THEIR EMPLOYMENT CONTRACTS. EACH YEAR, THERE IS IMPUTED INCOME THAT IS GROSSED UP FOR TAX PURPOSES WHICH IS REPORTED AS TAXABLE INCOME TO THE EXECUTIVE AND INCLUDED IN COLUMN B(III) OF PART II. THE RELOCATION LOAN OF THE PREVIOUS CEO WAS SUBSEQUENTLY PAID IN FULL AND THERE WAS NO OUTSTANDING BALANCE AT THE END OF TAX YEAR 2012. THE CEO ALSO RECEIVES A REIMBURSEMENT FOR A PORTION OF HIS CLUB DUES THAT ARE ESSENTIAL TO FUNDRAISING EFFORTS. THIS REIMBURSEMENT WAS EXCLUDED FROM TAXABLE INCOME.
SCHEDULE J, PART I, LINE 4(B) Supplemental Compensation Information THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A SERP PLAN ON BEHALF OF CERTAIN MEMBERS OF SENIOR MANAGEMENT IN ACCORDANCE WITH THEIR EMPLOYMENT CONTRACTS. CONTRIBUTIONS TO THE SERP IN THE AMOUNT OF $443,639 ARE INCLUDED IN COLUMN C OF PART II. THE ORGANIZATION MAINTAINS A LEGACY DEFERRED COMPENSATION PLAN THAT IS FROZEN (NO NEW CONTRIBUTION CAN BE MADE). THERE WERE 4,003.065 SHARES EXERCISED DURING CALENDAR YEAR 2012.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) Jack Cox senior vp Recruitment   X 1,500,000 1,500,000   No Yes   Yes  
Total ......Small Bullet $ 1,500,000
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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) RANEY ZUSMAN Board Member 780,081 medical services   No
(2) alexander easton Board Member 31,181 compensation   No
(3) HOAG ORTHOPEDIC INSTITUTE HOAG OFF. & HOI DIR. 19,510,019 ADMINISTRATIVE SERVICES   No
(4) melissa dickerson Key Employee 69,910 compensation   No
(5) PACIFIC HOSPITALIST ASSOCIATES Board Member 5,774,280 CONTRACTED SERVICES   No
(6) INTOUCH HEALTH Board Member 149,017 PRODUCT PURCHASES   No
(7) MARGOLIN GROUP BOARD MEMBER 13,836 CONSULTING SERVICES   No
(8) PROVIDENCE SPEECH AND HEARING KEY EMPLOYEE 131,000 PATIENT SERVICES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS RELATIONSHIPS FORM 990, SCHEDULE L, PART IV - DOUGLAS ZUSMAN, BOARD MEMBER OF HMHP, HAS 50% OWNERSHIP INTEREST IN RANEY & ZUSMAN WHICH PROVIDES MEDICAL SERVICES TO HMHP. - JAKE EASTON III IS A BOARD MEMBER OF HOAG MEMORIAL HOSPITAL PRESBYTERIAN ("HMHP"). HIS SON, ALEXANDER EASTON, IS AN EMPLOYEE OF HMHP. - JENNIFER MITZNER AND ROBERT BRAITHWAITE ARE OFFICERS OF HMHP AND ALSO SERVE AS BOARD MEMBERS OF HOAG ORTHOPEDIC INSTITUTE (HOI). HMHP PROVIDES ADMINISTRATIVE AND OPERATIONAL SERVICES TO HOI. - TIMOTHY MOORE IS A KEY EMPLOYEE OF HMHP. HIS DAUGHTER-IN-LAW, MELISSA DICKERSON, IS AN EMPLOYEE OF HMHP. - WESTON CHANDLER, BOARD MEMBER OF HMHP, SERVES AS PRESIDENT & CEO OF PACIFIC HOSPITALIST ASSOCIATES WHICH PROVIDES MEDICAL SERVICES TO HMHP. - YULUN WANG, BOARD MEMBER OF HMHP, SERVES AS AN OFFICER / DIRECTOR AT INTOUCH HEALTH WHICH SELLS PRODUCTS TO HMHP. - LESLIE A. MARGOLIN IS A BOARD MEMBER OF HMHP. She is ALSO the owner of The Margolin Group, which provides consulting services to HMHP. -SANFORD SMITH IS A KEY EMPLOYEE OF HMHP. His wife, Linda Smith, is the CEO of Providence Speech and Hearings, which provided in-patient speech services to HMHP.
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Identifier Return Reference Explanation
Form 990, Part VI, Line 2 Family or business relationships OFFICERS ROBERT BRAITHWAITE AND JENNIFER MITZNER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, LINE 4 CHANGES TO GOVERNING DOCUMENTS Hoag Hospital's affiliation with St. Joseph Health System became effective on March 1, 2013. The affiliation was accomplished through the creation of a new entity, St. Joseph Hoag Health, formerly known as Covenant Health Network, a California nonprofit public benefit corporation. St. Joseph Hoag Health became the third member of Hoag along with the then current members comprising of the George Hoag Family Foundation and the constituent churches of the Los Ranchos Presbytery of the Presbyterian Church (USA), as represented by the Association of Presbyterian (APM). St. Joseph Hoag health also became a member, joining the St. Joseph Health System, of the four Southern California hospital ministries; St. Joseph Hospital of Orange, St. Jude Medical Center, Mission Hospital, and St. Mary Medical Center. A majority of St. Joseph Hoag Health's board of directors is designated by St. Joseph Health System and the balance of directors is appointed by the Hoag Family Foundation and the APM.
Form 990, Part VI, Line 6 Members or stockholders THE MEMBERS OF THE CORPORATION CONSISTS OF THE FOLLOWING: (I) ST. JOSEPH HOAG HEALTH (FORMERLY COVENANT HEALTH NETWORK INC), (II) THE GEORGE HOAG FAMILY FOUNDATION ("GHF FOUNDATION"), (III) THE CONSTITUENT CHURCHES OF THE LOS RANCHOS PRESBYTERY OF THE PRESBYTERIAN CHURCH (USA) (THE "APM"), AND (IV) SUCH INDIVIDUAL MEMBERS AS MAY BE APPOINTED BY THE GHF FOUNDATION OR THE APM UP TO A MAXIMUM OF FORTY-EIGHT (48) INDIVIDUAL MEMBERS TO BE DIVIDED EQUALLY BETWEEN THE GHF FOUNDATION AND THE APM.
Form 990, Part VI, Line 7a Power to elect or appoint members THE MEMBERS OF THE CORPORATION HAVE THE POWER TO ELECT OR REMOVE DIRECTORS FROM THE BOARD OF DIRECTORS OF THE CORPORATION.
Form 990, Part VI, Line 7b Decisions reserved to members or stockholders THE POWERS AND RESPONSIBILITIES OF THE MEMBERS OF THE CORPORATION INCLUDE, BUT ARE NOT LIMITED TO: (A) TO ASSURE THE BOARD OF DIRECTORS CARRIES OUT THE CORPORATION'S MISSION; (B) TO CONSIDER THE QUALIFICATIONS OF DIRECTORS TO BE ELECTED TO THE BOARD OF DIRECTORS; (C) TO APPROVE ANY AMENDMENT, MODIFICATION OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (D) TO APPROVE THE ELECTION, APPOINTMENT OR REMOVAL OF ANY DIRECTOR OF THE CORPORATION; AND (E) TO APPROVE ANY SALE, TRANSFER CONVEYANCE OR OTHER DISPOSITION OF ALL, SUBSTANTIALLY ALL OR A MATERIAL PORTION OF THE ASSETS OF THE CORPORATION, OR ANY MERGER, CONSOLIDATION, AFFILIATION OR DISSOLUTION OF THE CORPORATION.
Form 990, Part VI, Line 11b Process used to review the Form 990 THE ORGANIZATION'S BOARD OF DIRECTORS HAS DELEGATED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD THE REVIEW OF THE FORM 990 PRIOR TO ISSUANCE. MANAGEMENT, INCLUDING AN OFFICER OF THE ORGANIZATION, PREPARES AND REVIEWS THE FORM 990. THE AUDIT AND COMPLIANCE COMMITTEE IS PROVIDED WITH A DRAFT FORM 990 AND IS PROVIDED AMPLE TIME TO READ THE DOCUMENT AND DEVELOP QUESTIONS. THE AUDIT AND COMPLIANCE COMMITTEE THEN CONVENES PRIOR TO ISSUANCE OF THE FORM 990 TO REVIEW AND DISCUSS THE DRAFT FORM 990 WITH MANAGEMENT AND EXTERNAL EXPERTS HIRED BY MANAGEMENT. AN ELECTRONIC VERSION OF THE FORM 990 IS POSTED TO A SECURE WEBSITE AVAILABLE TO ALL OF THE BOARD OF DIRECTORS PRIOR TO FILING.
Form 990, Part VI, Line 12c Monitoring and enforcement of compliance with conflict of interest policy THE ORGANIZATION HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. OFFICERS, DIRECTORS, NON-DIRECTOR MEMBERS OF BOARD COMMITTEES, AND SENIOR EXECUTIVES ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. RESPONSES TO THE QUESTIONNAIRE ARE REVIEWED BY THE CHAIR AND CEO AND MATTERS ARE DISCUSSED AT THE APPROPRIATE LEVEL AS APPLICABLE GIVEN THE SITUATION. INDIVIDUAL TRANSACTIONS THAT OCCUR BETWEEN THE ANNUAL QUESTIONNAIRE ARE REVIEWED BY THE CORPORATION'S LEGAL AND COMPLIANCE OFFICERS FOR POTENTIAL CONFLICTS OF INTEREST. ANY DIRECTOR WHO HAS A CONFLICT OF INTEREST WITH RESPECT TO A PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT SHALL REFRAIN FROM VOTING ON ANY MATTER RELATING TO THE CONTRACT, TRANSACTION OR ARRANGEMENT, OR BE EXCUSED FROM ANY MEETING WHERE THE PROPOSED CONTRACT IS DISCUSSED.
Form 990, Part VI, Line 15a & 15b Process for determining compensation THE COMPENSATION OF THE CEO, CFO AND ALL SENIOR VICE PRESIDENTS (KEY EMPLOYEES) IS REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, COMPRISED SOLELY OF INDEPENDENT DIRECTORS PLUS ONE OUTSIDE NON-VOTING MEMBER. THE COMPENSATION COMMITTEE RECEIVES A STUDY PERFORMED BY AN INDEPENDENT CONSULTING FIRM THAT REVIEWS LEVELS OF COMPENSATION AT COMPARABLE ORGANIZATIONS FOR COMPARABLE POSITIONS WHEN SETTING COMPENSATION OF THE KEY EXECUTIVES. THE COMPENSATION COMMITTEE'S RECOMMENDATIONS RELATIVE TO EXECUTIVE COMPENSATION ARE REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS, MEETING IN EXECUTIVE SESSION, WHOSE MINUTES DOCUMENT THAT THE APPROVED COMPENSATION IS DEEMED REASONABLE. THIS PROCESS OF USING COMPARABLE DATA TO ESTABLISH LEVELS OF COMPENSATION HAS BEEN IN PLACE FOR IN EXCESS OF 37 YEARS. THIS PROCESS WAS LAST COMPLETED IN 2013. IN ADDITION, THE INDEPENDENT CONSULTING FIRM PROVIDES THE BOARD WITH AN OPINION LETTER EACH YEAR CERTIFYING THAT THE COMPENSATION PROGRAM AND ALL PAY ELEMENTS (TOTAL REMUNERATION) APPROVED BY THE BOARD ARE DEEMED REASONABLE IN COMPLIANCE WITH IRC SECTION 4958.
Form 990, Part VI, Line 19 Process for making documents available to the public The Corporation's financial statements are made available to the public in summary by inclusion in an Annual Report that is available on its web site - http://www.hoag.org/About-Hoag/Pages/Corporate-Info/Corporate-Information. aspx Hoag's Code of Conduct is posted on its public Web site as well. The Code of Conduct provides readers with an understandable review of the code of conduct that must be adhered to by all employees, directors and vendors. The Corporation makes its governing documents available upon request. Form 990, Part IX, Line 11g Other Expenses Hospital Based Physician Fees $20,133,388 Purchased Services $40,949,364 HMO Purchased Services $51,829,765 ------------- $112,912,517
form 990, part xi, line 9 changes in net assets or fund balance EQUITY TRANSFERS RELATED TO SWAP 34,187,926 OTHER REVENUE RELATED TO EXCLUDED SERVICES 152,645 PARTNERSHIP INVESTMENT INCOME (450,416) OTHER (92,596) ------------- 33,797,559 FORM 990, PART XII, LINE 2C CHANGES TO THE FINANCIAL STATEMENT OVERSIGHT PROCESS As result of affiliation with St. Joseph Health System, Hoag is included within the St. Joseph Health System consolidated financial statements. The oversight of the St. Joseph Health System consolidated financial statement audit and selection of the independent accounting firm is performed by the St. Joseph Health System audit committee.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


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

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
 
Employer identification number

95-1643327
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) NEWPORT HEALTHCARE CENTER LLC
ONE HOAG DRIVE BOX 6100
NEWPORT BEACH,CA92663
33-1127904 		MEDICAL BLDG CA 11,128,304 153,036,157 HMHP
 
(2) HOAG OUTPATIENT CENTERS LLC
ONE HOAG DRIVE BOX 6100
NEWPORT BEACH,CA92663
45-3587572 		PATIENT SVCS CA 3,020,977 0 HMHP
 








Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
Yes No
(1) COVENANT HEALTH NETWORK INC

3345 MICHELSON DR STE 100

IRVINE,CA92612
46-1259908 		HEALTHCARE CA 501(C)(3) 11, III SJHS
 
Yes
 
(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

3623 22ND PLACE

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) HOAG CHARITY SPORTS

3920 BIRCH ST STE 105

NEWPORT BEACH,CA92660
45-2982422 		SUPPORT CA 501(C)(3) 7 HHF
 
Yes
 
(7) HOAG HOSPITAL FOUNDATION

1 HOAG DR BOX 6100

NEWPORT BEACH,CA92663
95-3222343 		FUNDRAISING CA 501(C)(3) 7 HMHP
 
Yes
 
(8) HOME CARE PARTNERS

1165 MONTGOMERY DR

SANTA ROSA,CA95405
68-0318656 		INACTIVE CA 501(C)(3) 3 SRMH
 
Yes
 
(9) HOSPICE OF LUBBOCK

1102 SLIDE ROAD

LUBBOCK,TX79414
75-2133781 		HEALTHCARE TX 501(C)(3) 9 CHS
 
Yes
 
(10) LUBBOCK METHODIST HOSPITAL FOUNDATION

3615 19TH STREET

LUBBOCK,TX79410
75-2220963 		HEALTHCARE TX 501(C)(3) 7 CHS
 
Yes
 
(11) METHODIST CHILDREN'S HOSPITAL

3610 21ST STREET

LUBBOCK,TX79410
75-2428911 		HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(12) METHODIST HOSPITAL LEVELLAND

1900 COLLEGE AVENUE

LEVELLAND,TX79336
75-2246348 		HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(13) METHODIST HOSPITAL PLAINVIEW

2601 DIMMITT ROAD

PLAINVIEW,TX79072
75-2426010 		HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(14) MISSION HOSPITAL REGIONAL MEDICAL CENTER

27700 MEDICAL CENTER ROAD

MISSION VIEJO,CA92691
95-1643360 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(15) QUEEN OF THE VALLEY MEDICAL CENTER

1000 TRANCAS STREET

NAPA,CA94558
94-1243669 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(16) REDWOOD MEMORIAL FOUNDATION

3300 RENNER DRIVE

FORTUNA,CA95540
94-2779313 		FOUNDATION CA 501(C)(3) 7 RMH
 
Yes
 
(17) SANTA ROSA MEMORIAL HOSPITAL

1165 MONTGOMERY DRIVE

SANTA ROSA,CA95405
94-1231005 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(18) SISTERS OF ST JOSEPH OF ORANGE

480 S BATAVIA

ORANGE,CA92868
95-1643383 		RELIGIOUS ORG CA 501(C)(3) 1 NA
 
 
No
(19) SRM ALLIANCE HOSPITAL SERVICES

400 NORTH MCDOWELL BLVD

PETALUMA,CA94954
68-0395200 		HEALTHCARE CA 501(C)(3) 3 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 		FOUNDATION 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

500 S MAIN STREET STE 1000

ORANGE,CA92868
33-0185031 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(27) ST JUDE HOSPITAL INC

101 EAST VALENCIA MESA DRIVE

FULLERTON,CA92635
95-1643325 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(28) ST MARY MEDICAL CENTER

18300 HIGHWAY 18

APPLE VALLEY,CA92307
95-1914489 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(29) ST MARY OF THE PLAINS HOSPITAL FDN

4000 24TH STREET

LUBBOCK,TX79410
75-1653181 		HEALTHCARE TX 501(C)(3) 7 CHS
 
Yes
 
(30) TALLER SAN JOSE

801 NORTH BROADWAY

SANTA ANA,CA92701
59-3816355 		WORKFORCE DEV CA 501(C)(3) 2 SSJO
 
Yes
 
(31) redwood memorial hospital

3300 renner drive

fortuna,CA95540
94-1384665 		healthcare CA 501(c)(3) 3 sjhs
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) ST JOSEPH HLTH SYS HOME HLTH

 
 
HOME HEALTH CA NA
  		N/A                
(2) ST JOSEPH HLTH SYS HOME CARE

 
 
HOME HEALTH CA na
  		n/a                
(3) METHODIST DIAGNOSTIC IMAGING

 
 
HEALTHCARE SVCS TX NA
  		N/A                
(4) SHA LLC

 
 
HEALTHCARE SVCS TX NA
  		N/A                
(5) LUBBOCK SURGERY CENTER LTD

 
 
HEALTHCARE SVCS TX NA
  		N/A                
(6) COVENANT LONG-TERM CARE LP

 
 
healthcare svcs TX NA
  		N/A                
(7) HERITAGE INVESTMENT GROUP

 
 
investment CA NA
  		N/A                
(8) MISSION AMBULATORY SURGICENTER

 
 
healthcare svcs CA na
  		n/a                
(9) COMPREHENSIVE IMAGING PARTNERS

 
 
healthcare svcs CA na
  		n/a                
(10) ST JOSEPH PHYSICIAN VENTURES

 
 
real estate CA na
  		n/a                
(11) NEWPORT IMAGING CENTER

 
 
healthcare svcs CA hmhp
  		related -2,068,073 3,323,403   No 0 Yes   99.877 %
(12) HOAG ORTHOPEDIC INSTITUTE

 
 
healthcare CA hmhp
  		related 13,936,174 46,266,481   No 0 Yes   51.000 %
(13) MAIN ST SPECIALTY SURGERY CNTR

 
 
healthcare svcs CA na
  		n/a                
(14) ORTHOPEDIC SURGERY CNTR OF OC

 
 
healthcare svcs CA na
  		n/a                
(15) ADVANCED SURGERY INST LLC

 
 
HEALTHCARE SVCS CA na
  		n/a                
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) ST JOSEPH PROF SVCS ENTERPRISES INC

3345 MICHELSON DR STE 100
IRVINE,CA92612
33-0155323 		HEALTHCARE SVCS CA NA
  		C CORP          
(2) AMERICAN UNITY GROUP LTD

58 par-la-ville road
hamilton hm, hx   bd
BD
CAPTIVE INSURANCE BD NA
  		C CORP          
(3) ALLIANCE PHYSICIAN SERVICES

 
 
INACTIVE CA NA
  		C CORP          
(4) MISSION VIEJO MEDICAL VENTURES

27800 MEDICAL CENTER RD 354
MISSION VIEJO,CA92691
33-0212905 		HEALTHCARE SVCS CA NA
  		C CORP          
(5) MISSION MEDICAL CENTER ASSOCIATION

27800 MEDICAL CENTER RD 354
MISSION VIEJO,CA92691
33-0201044 		HEALTHCARE SVCS CA NA
  		C CORP          
(6) ST JOSEPH YORBA PARK

 
 
INACTIVE CA NA
  		C CORP          
(7) LUBBOCK METHODIST HOSP SVCS

PO BOX 1201
LUBBOCK,TX79410
75-2118585 		HEALTHCARE SVCS TX CHS
  		C CORP          
(8) LUBBOCK METHODIST HOSP PRACTICE MGMT

2107 OXFORD STREET SUITE 300
LUBBOCK,TX79410
75-2578995 		INACTIVE TX na
  		C CORP          
(9) ST JOSEPH HEALTH SOURCE INC

3345 MICHELSON DR STE 100
IRVINE,CA92612
46-1900168 		HEALTHCARE SVCS CA NA
  		C CORP          
(10) HOAG MANAGEMENT SERVICES INC

1 HOAG DR BOX 6100
NEWPORT BEACH,CA92658
33-0731587 		HEALTHCARE SVCS CA hmhp
  		C CORP 565,670 52,550,144 100.000 % Yes  
(11) COASTAL MANAGEMENT SERVICES ORG

1 HOAG DR BOX 6100
NEWPORT BEACH,CA92658
33-0676831 		HEALTHCARE SVCS CA hmhp
  		C CORP 326,823 643,126 100.000 % Yes  
(12) DATU HEALTH INC

16150 MAIN CIRCLE DR STE 250
CHESTERFIELD,MO63017
46-3070062 		IT SVCS MO NA
  		C CORP          
(13) HOAG MEDICAL FOUNDATION

1 HOAG DR BOX 6100
NEWPORT BEACH,CA92663
45-3583707 		HEALTHCARE SVCS CA hmhp
  		C CORP 0 0 100.000 % Yes  
(14) CHARITABLE REMAINDER TRUST (1)

 
 
SUPPORT CA NA
  		TRUST          
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HOAG HOSPITAL FOUNDATION

 a 218,432 ACCRUAL
(2) HOAG ORTHOPEDIC INSTITUTE

 c 14,518,183 ACCRUAL
(3) HOAG HOSPITAL FOUNDATION

 c 13,876,146 ACCRUAL
(4) HOAG HOSPITAL FOUNDATION

 l 90,000 ACCRUAL
(5) COASTAL MANAGEMENT SERVICES ORGANIZATION

 l 100,220 ACCRUAL
(6) NEWPORT IMAGING CENTER

 l 64,175 ACCRUAL
(7) HOAG OUTPATIENT CENTERS LLC

 l 12,307 ACCRUAL
(8) HOAG MANAGEMENT SERVICES INC

 m 2,841,643 ACCRUAL
(9) HOAG HOSPITAL FOUNDATION

 Q 6,265,275 ACCRUAL
(10) HOAG CHARITY SPORTS

 Q 611,090 ACCRUAL
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(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 V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
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: 2301 QUAKER, 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 DRIVE, 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 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 MAIN ST SPECIALTY SURGERY CENTER EIN: 95-4813223 ADDRESS: 280 MAIN STREET, ST 100, ORANGE, CA 92868 ORTHOPEDIC SURGERY CENTER OF OC, LLC EIN: 33-0841806 ADDRESS: 22 CORPORATE PLAZA, NEWPORT BEACH, CA 92660 advanced surgery institute, llc EIN: 26-2299255 Address: 1739 4th street, santa rosa, ca 95404

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