TY 2013 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Andrew C Agwunobi MD........................................................................ Board Member	3.0 .......................0.0	X			29,250		0
(2) Mark DeMichele........................................................................ Board Member	3.0 .......................0.0	X			31,500		0
(3) Peter G Hanelt CPA........................................................................ Board Member	3.0 .......................0.0	X			30,000	0	0
(4) Julie Hyer OP........................................................................ Board Member	3.0 .......................0.0	X			0		0
(5) Todd Pierce........................................................................ Board Member	3.0 .......................0.0	X			28,500		0
(6) Patrick Steele........................................................................ Board Member	3.0 .......................0.0	X			27,000		0
(7) Judy Carle RSM........................................................................ Board Vice Chair	3.0 .......................0.0	X	X		0		0
(8) Caretha Coleman........................................................................ Board Chairperson	5.0 .......................0.0	X	X		38,813		0
(9) Tessie Guillermo........................................................................ Board Secretary	3.0 .......................0.0	X	X		30,750		0
(10) Lloyd H Dean........................................................................ BOARD MEMBER/PRESIDENT/CEO	40.0 .......................0.0	X	X		6,917,391	0	1,139,989
(11) Michael D Blaszyk........................................................................ SEVP, Chief Financial Officer	40.0 .......................0.0		X		3,528,848	0	586,339
(12) Rick Grossman........................................................................ EVP General Counsel	40.0 .......................0.0		X		837,521	0	196,925
(13) Diane Lee........................................................................ VP & Associate General Counsel	40.0 .......................0.0		X		533,213	0	65,861
(14) Marvin O'Quinn........................................................................ SEVP, Chief Operating Officer	40.0 .......................0.0		X		2,899,983	0	1,122,219
(15) Elizabeth Shih........................................................................ EVP, Chief Admin Officer	40.0 .......................0.0		X		2,632,490	0	229,389
(16) Steven Barron........................................................................ SVP, Operations So Cal East	40.0 .......................0.0			X	935,069	0	103,200
(17) Keith Callahan........................................................................ SVP, Supp & Srvcs Resrcs Mgmt	40.0 .......................0.0			X	755,923	0	84,090

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Mary Connick........................................................................ SVP Finance, Corporate Control	40.0 .......................0.0	X			779,679	91,123
(19) Charles P Francis........................................................................ SEVP, CHIEF STRATEGY OFFICER	40.0 .......................0.0	X			1,794,105	262,065
(20) Lisa Gamshad Zuckerman........................................................................ VP, Treasury Services	40.0 .......................0.0	X			636,645	92,593
(21) Linda Hunt........................................................................ SVP Operations - Arizona	40.0 .......................0.0	X			1,931,180	125,214
(22) Jeffrey W Land........................................................................ VP Corporate Real Estate	40.0 .......................0.0	X			613,640	88,105
(23) Bernita McTernan........................................................................ EVP/SPONSORSHIP/MISSION INTEGR	40.0 .......................0.0	X			1,541,205	159,506
(24) Timothy Panks........................................................................ SVP Finance & Rev Cycle Mgmt	40.0 .......................0.0	X			563,455	68,475
(25) Darryl Robinson........................................................................ EVP/ Chief HR Officer	40.0 .......................0.0	X			967,972	122,582
(26) Karl Silberstein........................................................................ SVP Financial Operations	40.0 .......................0.0	X			1,159,514	119,206
(27) Michael Taylor........................................................................ SVP OPERATIONS-SAC/SAN JOAQUIN	40.0 .......................0.0	X			1,670,779	131,083
(28) LeAnne Trachok........................................................................ SVP, Revenue Services	40.0 .......................0.0	X			792,425	76,553
(29) Karl Ulrich MD........................................................................ Interim SVP Ops Sac-San Joaqui	40.0 .......................0.0	X			725,333	75,419
(30) Glenna L Vaskelis........................................................................ SVP Operations- Bay Area	40.0 .......................0.0	X			894,332	111,109
(31) Robert Wiebe MD........................................................................ EVP CHIEF MEDICAL OFFICER	40.0 .......................0.0	X			1,778,173	906,091
(32) Tammara Wilcox........................................................................ SVP, Managed Care	40.0 .......................0.0	X			829,171	93,071
(33) Deanna Wise........................................................................ EVP, Chief Information Officer	40.0 .......................0.0	X			1,420,873	260,880
(34) Charles Cova........................................................................ SVP Operations- Central Coast	40.0 .......................0.0		X		892,541	88,072
(35) Laurie Harting........................................................................ SVP Operations- So Cal West	40.0 .......................0.0		X		962,085	90,546
(36) Daniel Roach........................................................................ VP Compliance and Audit	40.0 .......................0.0		X		840,252	101,295
(37) Hillery Trippe........................................................................ VP, Risk Services	40.0 .......................0.0		X		906,598	33,005
(38) Jon VanBoening........................................................................ SVP Operations- Central Valley	40.0 .......................0.0		X		921,019	110,718
(39) Derek F Covert........................................................................ Former Officer	0.0 .......................0.0			X	2,175,920	13,598
(40) Rodney A Davis........................................................................ Former Key Employee	40.0 .......................0.0			X	1,121,662	101,881
(41) Saliba Salo........................................................................ Former Key Employee	40.0 .......................0.0			X	555,407	85,933
(42) Herbert Vallier........................................................................ Former EVP-Chief HR Officer	0.0 .......................0.0			X	141,354	9,555

(A) Name and business address	(B) Description of services	(C) Compensation
CLARK CONSTRUCTION GROUP, 7500 OLD GEORGETOWN RDBETHESDAMD208146133	CONTRACTORS	20,664,584
ERNST YOUNG LLP, 200 PLAZA DRIVESECAUCUSNJ07094	Consulting Services	19,906,636
OPTUM360 LLC, 13625 TECHNOLOGY DREDEN PRAIRIEMN55344	Revenue Cycle Svcs	10,245,150
MANATT PHELPS AND PHILLIPS LLP, 11355 W OLYMPIC BLVDLOS ANGELESCA900641614	Consulting Services	7,244,849
DELOITTE TOUCHE LLP, PO BOX 844708DALLASTX752844708	Consulting Services	7,053,771
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 680

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	186,312,767	186,312,767
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	956,749	956,749
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	40,000	40,000
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	43,758,982	23,395,267	20,363,715
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	249,670		249,670
7	Other salaries and wages	3,550,039,064	3,209,972,116	340,066,948
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	219,456,887	198,850,583	20,606,304
9	Other employee benefits .......	528,223,773	486,940,658	41,283,115
10	Payroll taxes ...........	250,629,260	230,220,244	20,409,016
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	27,291,529	407,297	26,884,232
c	Accounting ...........	8,119,925		8,119,925
d	Lobbying ...........	8,059,430	7,039,887	1,019,543
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	21,755,838		21,755,838
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	936,624,291	627,514,153	309,110,138	0
12	Advertising and promotion ....	50,725,747	3,145,176	47,580,571
13	Office expenses .......	165,009,867	122,428,862	42,581,005
14	Information technology ......	141,249,262	86,277,603	54,971,659
15	Royalties ..	0
16	Occupancy ...........	111,929,232	94,577,974	17,351,258
17	Travel ............	19,321,048	11,278,664	8,042,384
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	11,563,766	6,336,491	5,227,275
20	Interest ...........	190,907,796	190,907,796
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	393,411,391	331,065,822	62,345,569
23	Insurance ..............	94,153,071	56,660,509	37,492,562
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	1,095,374,539	1,095,374,539	0	0
b	MEDI-CAL PROVIDER FEE	156,638,072	156,638,072	0	0
c	MEDICAL PRVDR/OUT-OF NTWRK CST	87,231,053	87,231,053	0	0
d	UNRELATED BUSINESS INC TAXES	72,493	72,493	0	0
e	All other expenses	79,358,759	50,347,400	29,011,359
25	Total functional expenses. Add lines 1 through 24e	8,378,464,261	7,263,992,175	1,114,472,086	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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	206,418	1	173,627
2	Savings and temporary cash investments .........	1,503,921,577	2	1,376,748,933
3	Pledges and grants receivable, net ...........	15,388,298	3	26,966,126
4	Accounts receivable, net .............	1,196,698,641	4	1,397,726,348
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		200,000	5	550,000
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 .............	62,832,410	7	59,425,049
8	Inventories for sale or use ..............	148,418,929	8	153,255,364
9	Prepaid expenses and deferred charges ..........	556,300,566	9	381,196,061
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	8,758,793,352
b	Less: accumulated depreciation .....	10b	4,708,674,851	3,843,859,411	10c	4,050,118,501
11	Investments—publicly traded securities ..........	2,849,870,482	11	2,768,684,401
12	Investments—other securities. See Part IV, line 11 .....	862,113,445	12	1,268,139,458
13	Investments—program-related. See Part IV, line 11 .....	1,441,654,432	13	1,376,607,252
14	Intangible assets ...............	19,622,748	14	15,584,695
15	Other assets. See Part IV, line 11 ...........	68,249,504	15	105,790,398
16	Total assets. Add lines 1 through 15 (must equal line 34)......	12,569,336,861	16	12,980,966,213
	17	Accounts payable and accrued expenses .........	1,743,550,930	17	1,696,996,132
18	Grants payable .................	0	18	0
19	Deferred revenue ................	26,593,350	19	29,302,261
20	Tax-exempt bond liabilities .............	3,658,976,075	20	3,427,625,299
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 ..	1,202,145,963	23	1,437,005,954
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....................	1,262,007,110	25	1,008,370,795
26	Total liabilities. Add lines 17 through 25.........	7,893,273,428	26	7,599,300,441
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	4,513,062,761	27	5,214,735,965
28	Temporarily restricted net assets ...........	129,793,292	28	131,586,303
29	Permanently restricted net assets ...........	33,207,380	29	35,343,504
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	4,676,063,433	33	5,381,665,772
34	Total liabilities and net assets/fund balances ........	12,569,336,861	34	12,980,966,213

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.

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

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

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

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

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

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

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

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

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

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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

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

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

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

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

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)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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).

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2013

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)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

Supplemental Information. 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) 2013

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization DIGNITY HEALTH

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, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization DIGNITY HEALTH

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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
DIGNITY HEALTH

Employer identification number

94-1196203

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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

DIGNITY HEALTH

Employer identification number

94-1196203

Part I-A

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

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

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

$ 25

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

Part I-B

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

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

$ 3

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

$ 0

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(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) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

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

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

Yes

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

Yes

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

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

Yes

19,867

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

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

Yes

6,813,760

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

Yes

267,833

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

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

Yes

957,970

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

8,059,430

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

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

Part IV

Supplemental Information

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.

Return Reference	Explanation
PART I-B, LINE 4B	During the year, Dignity Health paid membership dues to Greater Bakersfield Chamber of Commerce ("the Chamber"). The invoice provided for voluntary contributions to the Chamber's Political Action Committee (PAC). The check request for annual dues inadvertently included an amount for voluntary contributions to the PAC. Dignity Health has policies and procedures in place to avoid such transactions, and once the organization became aware of this situation, immediate action was taken to obtain a refund from the Chamber for the amounts designated for the PAC. A copy of the refund check, dated 5/22/2014, evidencing that $25.00 has been recovered has been attached to Form 4720. This represents the full amount of inadvertent payment made related to voluntary contributions to The Chamber's PAC.
PART II-B	THE ORGANIZATION PAID FEES TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES, AND PAID COMPENSATION TO STAFF AND MANAGEMENT IN THE PERFORMANCE OF THEIR DUTIES IN ATTEMPTING TO INFLUENCE LEGISLATION, WHICH INCLUDED MEETING WITH AND CALLING GOVERNMENT OFFICIALS, AND DEVELOPED AND SENT LETTERS. IN ADDITION, THIS ORGANIZATION IS A MEMBER OF HEALTHCARE ASSOCIATIONS WHOSE PURPOSES INCLUDE DIRECTING, DEVELOPING, AND AFFECTING PUBLIC POLICY AND LEGISLATION WITH REGARD TO ISSUES AFFECTING HEALTHCARE. THE ORGANIZATION PAID ANNUAL DUES TO THESE ASSOCIATIONS, WHICH MAY BE USED FOR LOBBYING PURPOSES AS REFLECTED ON PART II-B, LINE 1I, OTHER ACTIVITIES.

Return Reference

Explanation

PART I-B, LINE 4B

During the year, Dignity Health paid membership dues to Greater Bakersfield Chamber of Commerce ("the Chamber"). The invoice provided for voluntary contributions to the Chamber's Political Action Committee (PAC). The check request for annual dues inadvertently included an amount for voluntary contributions to the PAC. Dignity Health has policies and procedures in place to avoid such transactions, and once the organization became aware of this situation, immediate action was taken to obtain a refund from the Chamber for the amounts designated for the PAC. A copy of the refund check, dated 5/22/2014, evidencing that $25.00 has been recovered has been attached to Form 4720. This represents the full amount of inadvertent payment made related to voluntary contributions to The Chamber's PAC.

PART II-B

THE ORGANIZATION PAID FEES TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES, AND PAID COMPENSATION TO STAFF AND MANAGEMENT IN THE PERFORMANCE OF THEIR DUTIES IN ATTEMPTING TO INFLUENCE LEGISLATION, WHICH INCLUDED MEETING WITH AND CALLING GOVERNMENT OFFICIALS, AND DEVELOPED AND SENT LETTERS. IN ADDITION, THIS ORGANIZATION IS A MEMBER OF HEALTHCARE ASSOCIATIONS WHOSE PURPOSES INCLUDE DIRECTING, DEVELOPING, AND AFFECTING PUBLIC POLICY AND LEGISLATION WITH REGARD TO ISSUES AFFECTING HEALTHCARE. THE ORGANIZATION PAID ANNUAL DUES TO THESE ASSOCIATIONS, WHICH MAY BE USED FOR LOBBYING PURPOSES AS REFLECTED ON PART II-B, LINE 1I, OTHER ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

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.

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.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

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

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No

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


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

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

Yes No

If "Yes," explain the arrangement in Part 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 ....	119,411,098	112,677,658	114,824,736	92,617,477	78,739,233
b	Contributions ........	2,115,261	3,857,469	5,904,333	9,388,271	12,468,055
c	Net investment earnings, gains, and losses	12,008,691	9,375,208	-1,307,763	14,666,246	7,851,317
d	Grants or scholarships .....	184,339	211,353	216,638	304,610	87,952
e	Other expenditures for facilities and programs ........	1,121,080	6,287,884	6,527,010	1,542,648	6,353,176
f	Administrative expenses ....	1,050,168	0	0	0	0
g	End of year balance ......	131,179,463	119,411,098	112,677,658	114,824,736	92,617,477

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

Board designated or quasi-endowment SchDMd Bullet

14.000 %

Permanent endowment SchDMd Bullet

86.000 %

Temporarily restricted endowment SchDMd Bullet

0 %

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

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

Yes

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

3a(i)

Yes

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

3a(ii)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	195,518,852		195,518,852
b	Buildings ................	4,014,655,420	2,017,372,328	1,997,283,092
c	Leasehold improvements ............	61,400,035	40,787,693	20,612,342
d	Equipment ................	3,616,106,779	2,573,352,476	1,042,754,303
e	Other .................	871,112,266	77,162,354	793,949,912
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				4,050,118,501

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) POOLED INVESTMENTS	1,268,139,458	F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	1,268,139,458

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) INVESTMENT IN UNCONSOLIDATED	158,080,267	F
(2) INVESTMENTS IN HEALTH RELATED	1,197,762,801	F
(3) INVESTMENTS IN HEALTH RELATED	20,764,184	C






Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	1,376,607,252

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









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

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
PENSION PAYABLE		688,650,936
DUE TO RELATED PARTIES		253,458,332
ASSET RETIREMENT OBLIGATIONS		31,401,067
OTHER NON-CURRENT LIABILITIES		16,012,992
DEFERRED COMPENSATION		18,847,468




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		1,008,370,795
2. Liability for uncertain tax positions 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) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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

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.

Return Reference	Explanation
SCH D, Part V, Line 4	DIGNITY HEALTH HAS VARIOUS SUPPORTING 501(C)(3) FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THEY OPERATE TO RAISE FUNDS FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH'S HOSPITALS. DIGNITY HEALTH'S INTENDED USE FOR THE FUNDS IS TO INVEST IN EXPANDING ACCESS TO CARE, PURCHASE OR CONSTRUCT STATE-OF-THE-ART EQUIPMENT AND BUILDINGS, AND PROVIDE ADVANCED TRAINING AND EDUCATION TO CAREGIVERS AND PATIENTS.
SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE	DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Return Reference

Explanation

SCH D, Part V, Line 4

DIGNITY HEALTH HAS VARIOUS SUPPORTING 501(C)(3) FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THEY OPERATE TO RAISE FUNDS FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH'S HOSPITALS. DIGNITY HEALTH'S INTENDED USE FOR THE FUNDS IS TO INVEST IN EXPANDING ACCESS TO CARE, PURCHASE OR CONSTRUCT STATE-OF-THE-ART EQUIPMENT AND BUILDINGS, AND PROVIDE ADVANCED TRAINING AND EDUCATION TO CAREGIVERS AND PATIENTS.

SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE

DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions. Right pointing arrow large image

Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number

94-1196203

Part I

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

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

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

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

Yes

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

Activites per Region. (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	0	0	Investments	N/A	312,170
	Central America and the Caribbean	0	0	Investments	N/A	1,915,951,821
	Europe (Including Iceland and Greenland)	0	0	Investments	N/A	194,732,641
	Europe (Including Iceland and Greenland)	0	0	Grantmaking	N/A	40,000













3a	Sub-total .....	0	0			2,111,036,632
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0			2,111,036,632

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013

Schedule F (Form 990) 2013

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.

(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)
Europe (Including Iceland and Greenland)	GENERAL	40,000	CHECK	0	N/A	N/A

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

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

Schedule F (Form 990) 2013

Schedule F (Form 990) 2013Page 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) 2013

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2013

Page 5

Part V

Supplemental Information
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).

ReturnReference	Explanation
SCHEDULE F, PART I, LINE 2	THE GRANTS ARE APPROVED BY THE HOSPITAL'S ADMINISTRATION DEPARTMENT OR A DESIGNATED COMMITTEE REVIEWS AND APPROVES GRANTS TO BE AWARDED. THE INTERNATIONAL ORGANIZATIONS MUST BE ALIGNED WITH THE DIGNITY HEALTH MISSION.
SCHEDULE F, PART I, LINE 3	CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL EUROPE (INCLUDING ICELAND AND GREENLAND): ACCRUAL GRANTS: ACCRUAL

Schedule F (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

Did the organization use Federal Poverty Guidelines (FPG) 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:

Yes

100% 150% 200% Other %

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: .........

Yes

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

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.

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

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) ..		97,332	156,854,678	147,586	156,707,092	1.870 %
b	Medicaid (from Worksheet 3, column a) ....		938,282	2,014,893,573	1,288,088,735	726,804,838	8.680 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .		259,303	60,925,790	20,730,421	40,195,369	0.480 %
d	Total Financial Assistance and Means-Tested Government Programs .		1,294,917	2,232,674,041	1,308,966,742	923,707,299	11.030 %
Other Benefits		636	660,165	63,382,812	7,230,151	56,152,661	0.670 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	636	660,165	63,382,812	7,230,151	56,152,661	0.670 %
f	Health professions education (from Worksheet 5) ..	105	37,062	72,491,171	9,057,686	63,433,485	0.760 %
g	Subsidized health services (from Worksheet 6) ..	45	111,332	31,599,888	3,881,644	27,718,244	0.330 %
h	Research (from Worksheet 7)	10	408	33,538,270	10,379,685	23,158,585	0.280 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	231	126,566	25,854,773	783,827	25,070,946	0.300 %
j	Total. Other Benefits ..	1,027	935,533	226,866,914	31,332,993	195,533,921	2.340 %
k	Total. Add lines 7d and 7j .	1,027	2,230,450	2,459,540,955	1,340,299,735	1,119,241,220	13.370 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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	4	53	2,059,307	1,195,163	864,144	0.010 %
2	Economic development	4	49	232,669	0	232,669
3	Community support	23	2,058	1,533,448	331,113	1,202,335	0.010 %
4	Environmental improvements	5	4	39,795	1,344	38,451
5	Leadership development and training for community members	12	1,135	285,966	16,600	269,366
6	Coalition building	31	3,563	111,814	0	111,814
7	Community health improvement advocacy	26	1,251	560,832	42,095	518,737	0.010 %
8	Workforce development	5	325	1,681,515	0	1,681,515	0.020 %
9	Other
10	Total	110	8,438	6,505,346	1,586,315	4,919,031	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

183,198,410

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. ......

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

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

1,807,946,536

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

2,166,332,224

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

-358,385,688

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

Management Companies and Joint Ventures(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 %	(e) Physicians' profit % or stock ownership %
1St Joseph's Outpatie	Surgery	26.030 %	39.960 %
2Desert Ridge Outpati	Surgery	31.320 %	12.000 %
3Southwest Orthopedic	Surgery	5.960 %	88.100 %
4Surgery Center of Pe	Surgery	25.360 %	21.520 %
5Chandler Endoscopy A	Surgery	25.550 %	49.000 %
6Southwest Lithotrips	Litho/Kidney	9.000 %	79.000 %
7BNI Management LLC	Mgmt services	25.000 %	75.000 %
8St Joseph's Cardiolo	Mgmt services	50.000 %	50.000 %
9Excelsius Surgical L	Medical Technology Developmen	3.110 %	48.840 %
10San Martin Surgery C	Surgery	43.490 %	10.230 %
11Parkway Surgery Cent	Surgery	27.140 %	41.810 %
12San Martin Investors	Real Estate (RENT/LEASE)	4.700 %	33.150 %
13North State Surgery	Surgery	31.650 %	33.198 %
14Sacramento Midtown E	Surgery	20.000 %	80.000 %
15Folsom Sierra Endosc	Surgery	51.000 %	38.972 %
16Folsom Outpatient Su	Surgery	30.080 %	39.970 %
17Roseville Surgery Ce	Surgery	28.320 %	18.310 %
18Grass Valley Outpati	Surgery	22.850 %	31.594 %
19St Joseph's Surgery	Surgery	79.762 %	15.238 %
20Stockton Outpatient	Surgery	25.550 %	49.000 %
21CBCC Outsmarting Can	Cancer	51.000 %	49.000 %
22Santa Cruz Surgery C	Surgery	50.000 %	50.000 %
23Santa Cruz Comprehen	Imaging	50.000 %	50.000 %
24Dominican Breast Cen	Imaging	50.000 %	50.000 %
25Dominican Magnetic R	Imaging	80.000 %	20.000 %
26San Francisco Cyberk	Cancer	39.000 %	18.000 %
27Coastal Surgical Spe	Surgery	51.000 %	49.000 %
28Templeton Surgery Ce	Surgery	70.450 %	29.470 %
29Plaza Surgery Center	Surgery	50.800 %	49.200 %
30Renaissance Imaging	Imaging	49.000 %	32.350 %
31Inland Endoscopy Cen	Surgery	25.000 %	39.000 %
32Medical Pavilion at	Real Estate (RENT/LEASE)	25.000 %	45.250 %
33Radiation Oncology C	Cancer	50.000 %	50.000 %
34NSC Channel Islands	Surgery Center	51.000 %	48.600 %

Schedule H (Form 990) 2013

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?34 Name, address, primary website address, and state license number								Other (Describe)
1	St Joseph's Hospital and Medical Ctr 350 W Thomas Road Phoenix,AZ85013 www.dignityhealth.org/stjosephs H-3003	X	X	X		X	X
2	Mercy San Juan Medical Center 6501 Coyle Avenue Carmichael,CA95608 www.dignityhealth.org/mercysanjuan 30000063	X	X	X			X
3	Mercy General Hospital 4001 J Street Sacramento,CA95819 www.dignityhealth.org/mercygeneral 30000062	X	X	X			X
4	Mercy Medical Center Redding 2175 Rosaline Avenue Redding,CA96001 redding.mercy.org/ 230000024	X	X	X			X
5	Chandler Regional Hospital 475 South Dobson Road Chandler,AZ85224 www.dignityhealth.org/chandlerregional H-3002	X	X				X
6	St Joseph's Medical Center of Stockto 1800 N California Street Stockton,CA95204 www.stjosephscares.org/ 30000284	X	X	X			X
7	St Rose Dominican Hospital - Siena 3001 St Rose Parkway Henderson,NV89052 www.dignityhealth.org/las-vegas 2969HOS-21	X	X	X			X
8	Northridge Hospital Medical Center 1830 Roscoe Boulevard Northridge,CA91328 www.dignityhealth.org/northridgehospital 930000114	X	X	X			X
9	Dominican Hospital 1555 Soquel Drive Santa Cruz,CA95065 www.dominicanhospital.org 70000030	X	X				X
10	Marian Regional Medical Center 1400 E Church Street Santa Maria,CA93454 www.marianmedicalcenter.org/ 50000040	X	X				X
11	California Hospital Medical Center 1401 South Grand Avenue Los Angeles,CA90015 www.dignityhealth.org/californiahospital 930000024	X	X	X			X
12	St Bernardine Medical Center 2101 N Waterman Avenue San Bernardino,CA92404 www.dignityhealth.org/stbernardinemedica 240000206	X	X				X
13	Mercy Hospital (Bakersfield) 2215 Truxtun Avenue Bakersfield,CA93301 www.mercybakersfield.org/ 120000184	X	X				X
14	Mercy Gilbert Medical Center 3555 S Val Vista Drive Gilbert,AZ85297 www.dignityhealth.org/mercygilbert H-3972	X	X				X
15	Methodist Hospital of Sacramento 7500 Hospital Drive Sacramento,CA95823 www.dignityhealth.org/methodistsacrament 30000064	X	X	X			X
16	Sequoia Hospital 170 Alameda de las Pulgas Redwood City,CA94062 www.sequoiahospital.org/ 220000045	X	X				X
17	Mercy Medical Center Merced 333 Mercy Avenue Merced,CA95340 www.mercymercedcares.org/ 40000178	X	X	X			X
18	St John's Regional Medical Center 1600 North Rose Avenue Oxnard,CA93030 www.stjohnshealth.org/ 50000064	X	X				X
19	St Mary Medical Center - Long Beach 1050 Linden Avenue Long Beach,CA90813 www.dignityhealth.org/stmarymedical 930000012	X	X	X			X
20	St Mary's Medical Center 450 Stanyan Street San Francisco,CA94117 www.stmarysmedicalcenter.org/ 220000071	X	X	X			X
21	Mercy Hospital of Folsom 1650 Creekside Drive Folsom,CA95630 www.dignityhealth.org/mercyfolsom 30000372	X	X				X
22	Glendale Memorial Hospital and Health 1420 South Central Avenue Glendale,CA91204 www.dignityhealth.org/glendalememorial 930000099	X	X				X
23	St Rose Dominican Hospital - San Mart 8280 West Warm Springs Road Las Vegas,NV89113 www.dignityhealth.org/las-vegas 4576HOS-6	X	X				X
24	Woodland Memorial Hospital 1325 Cottonwood Street Woodland,CA95695 www.dignityhealth.org/woodland 30000115	X	X				X
25	St Rose Dominican Hospital - Rose de 102 E Lake Mead Drive Henderson,NV89015 www.dignityhealth.org/las-vegas 659HOS-20	X	X				X
26	French Hospital Medical Center 1911 Johnson Avenue San Luis Obispo,CA93401 www.frenchmedicalcenter.org 50000031	X	X				X
27	St John's Pleasant Valley Hospital 2309 Antonio Avenue Camarillo,CA93010 www.stjohnshealth.org/ 50000048	X	X				X
28	St Elizabeth Community Hospital 2550 Sister Mary Columba Drive Red Bluff,CA96080 redbluff.mercy.org/ 230000036	X	X				X
29	Arroyo Grande Community Hospital 345 S Halcyon Road Arroyo Grande,CA93420 www.arroyograndehospital.org/ 50000021	X	X				X
30	Mercy Medical Center Mt Shasta 914 Pine Street Mt Shasta,CA96067 www.mercymtshasta.org/ 230000015	X	X		X		X
31	Southwest Orthopedic & Spine Hospital 750 North 40th Street Phoenix,AZ85008 OASISHOSPITAL.COM SH5128	X						Orthopedic/Spine HOSPITAL
32	St Joseph's Behavioral Health Center 2510 N California Street Stockton,CA95204 www.stjosephscanhelp.org/ 30000367	X
33	Arizona Orthopedic Specialty Hospital 2905 West Warner Road Chandler,AZ85224 AZOSH.COM SH3571	X						Orthopedic Hospital
34	St Joseph's Westgate Medical Center 7300 N 99th Avenue Glendale,AZ85305 www.dignityhealth.org/westgate H6522	X	X				X

Schedule H (Form 990) 2013

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)

	St Joseph's Hospital and Medical Ctr
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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 ........

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy San Juan Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy General Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy Medical Center Redding
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 11

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Chandler Regional Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Joseph's Medical Center of Stockto
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Rose Dominican Hospital - Siena
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Northridge Hospital Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Dominican Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Marian Regional Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	California Hospital Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Bernardine Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy Hospital (Bakersfield)
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy Gilbert Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Methodist Hospital of Sacramento
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Sequoia Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy Medical Center Merced
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St John's Regional Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Mary Medical Center - Long Beach
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Mary's Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy Hospital of Folsom
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Glendale Memorial Hospital and Health
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Rose Dominican Hospital - San Mart
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Woodland Memorial Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Rose Dominican Hospital - Rose de
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	French Hospital Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St John's Pleasant Valley Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Elizabeth Community Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 11

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Arroyo Grande Community Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Mercy Medical Center Mt Shasta
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 11

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Southwest Orthopedic & Spine Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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		No
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: % 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Joseph's Behavioral Health Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url): SEE SECTION C

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Arizona Orthopedic Specialty Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	St Joseph's Westgate Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

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

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url):

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

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

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

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) 2013

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: 500.% 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	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
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	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
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 individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
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 individual’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	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
SECTION B, LINE 1 - CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT	St Joseph's Westgate Medical Center THE HOSPITAL BEGAN OPERATING EFFECTIVE 5/12/14. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS CURRENTLY BEING CONDUCTED IN CONJUNCTION WITH ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER AS THE TWO HOSPITALS SERVE THE SAME SERVICE AREA.
SECTION B, LINE 3- COMMUNITY SERVED BY NEEDS ASSESSMENT	St Joseph's Hospital and Medical Center IN JUNE 2012, THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES COMPLETED A COMPREHENSIVE CHNA FOR MARICOPA COUNTY. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. MERCY SAN JUAN MEDICAL CENTER MERCY SAN JUAN MEDICAL CENTER COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 25 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). FIVE FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY GENERAL HOSPITAL MERCY GENERAL HOSPITAL COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 37 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). TEN FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY MEDICAL CENTER REDDING (MMCR) MMCR CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA) RELATING TO A WIDE ARRAY OF COMMUNITY HEALTH INDICATORS. PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MMCR AND THE PUBLIC HEALTH DEPARTMENT AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. THE SURVEYS WERE EMAILED TO APPROXIMATELY 1,000 EMAILS THROUGH A DISTRIBUTION LIST THAT THE HOSPITAL USES TO DISSEMINATE HEALTH EDUCATION MATERIALS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THERE WERE 168 SURVEYS COMPLETED FOR A RETURN RATE OF APPROXIMATELY 16.8%. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MMCR ADVISORY COUNCIL, COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA, AND SHASTA COUNTY PUBLIC HEALTH. IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN, PUBLIC HEALTH REPRESENTATIVES DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. CHANDLER REGIONAL MEDICAL CENTER (CRMC) THROUGH THE 2012 NEEDS ASSESSMENT, CRMC AND MERCY GILBERT MEDICAL CENTER CONSULTED WITH ARIZONA STATE UNIVERSITY COMMUNITY HEALTH INFORMATION RESEARCH. THE PRIMARY DATA COLLECTION INCLUDED INTERVIEWS WITH STAFF AND LEADERS OF MORE THAN 20 COMMUNITY SERVICES AGENCIES IN FIVE MUNICIPALITIES, AND TWO FOCUS GROUPS IN COMMUNITY AGENCY LOCATIONS. CRMC PARTNERED WITH ARIZONA STATE UNIVERSITY DOCTORAL STUDENTS AND CHANDLER GILBERT COMMUNITY COLLEGE NURSING STUDENTS TO CONDUCT THE AGENCY INTERVIEWS AND FOCUS GROUPS. GOVERNMENT AGENCY RESOURCES INCLUDED ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, ARIZONA DEPARTMENT OF HEALTH SERVICES, PUBLIC DATA SOURCES, ARIZONA CANCER REGISTRY, ARIZONA HEALTH STATUS AND VITAL STATISTICS, ARIZONA HEALTH SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, AND US CENSUS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS, RETAINED VALLEY VISION, INC., TO CONDUCT THE 2012 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM, HELD IN NOVEMBER 2012. ST. ROSE DOMINICAN HOSPITALS - ROSE DE LIMA, SAN MARTIN AND SIENA THE HEALTHY COMMUNITIES INSTITUTE (HCI) OF BERKELEY, CALIFORNIA, IN PARTNERSHIP WITH ST. ROSE DOMINICAN HOSPITALS, CONDUCTED A CHNA OF CLARK COUNTY, NEVADA IN 2013. BOTH QUANTITATIVE AND QUALITATIVE RESEARCH METHODOLOGIES WERE USED TO ENSURE AN ACCURATE PROFILE OF THE ST. ROSE SERVICE AREAS. PRIMARY AND SECONDARY DATA FROM A VARIETY OF SOURCES INCLUDES: PAPER AND ELECTRONIC SURVEYS; DATA FROM EXISTING LITERATURE AND DATABASES; AND INFORMATION FROM COMMUNITY STAKEHOLDERS. SEVERAL TOOLS WERE CREATED FOR PRIMARY DATA COLLECTION, AND MANY METHODOLOGIES WERE UTILIZED, INCLUDING: 1) 221 INDIVIDUALS COMPLETED A SURVEY RANKING THE TOP HEALTH ISSUES FOR THEIR FAMILY AND THE COMMUNITY. THE SURVEY PROVIDED THE LIST OF 15 HEALTH ISSUES THAT WERE SELECTED AFTER AN ANALYSIS OF HCI AND PREVENTION QUALITY INDICATOR DATA. A CONVENIENCE SAMPLE OF THOSE UTILIZING ST. ROSE COMMUNITY OUTREACH PROGRAMS COMPLETED THE SURVEYS; 2) MORE THAN 50 KEY COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES OF THE UNIVERSITY OF NEVADA AT LAS VEGAS DEPARTMENT OF PUBLIC HEALTH, WERE INVITED TO COMPLETE A SURVEY RANKING PRIORITY HEALTH NEEDS IDENTIFYING WAYS ST. ROSE CAN ADDRESS THESE HEALTH ISSUES, AND PROVIDING SUGGESTIONS FOR ENHANCED COLLABORATION WITH PARTNER ORGANIZATIONS. NORTHRIDGE HOSPITAL (NHMC) NHMC, IN COLLABORATION WITH THE VALLEY CARE COMMUNITY CONSORTIUM (VCCC), DEVELOPED NHMC'S 2013 CHNA IN COMPLIANCE WITH FEDERAL REQUIREMENTS. VCCC IS THE HEALTH PLANNING COLLABORATIVE FOR THE SAN FERNANDO AND SANTA CLARITA VALLEYS IN LOS ANGELES COUNTY. DATA WERE SUMMARIZED FROM SECONDARY DATA SOURCES TO DESCRIBE 17 HEALTH ISSUES. TABLES OF DISEASES BY ZIP CODE FOCUSING ON THE HOSPITAL'S PRIMARY SERVICE AREA, USING THE 2012 THOMSON REUTERS DATABOOK, WERE COMPARED WITH AVAILABLE COUNTY, STATE AND NATIONAL DATA (CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, LOS ANGELES DEPARTMENT OF PUBLIC HEALTH, THE CENTERS FOR DISEASE CONTROL, AND HEALTHY PEOPLE 2020) AND ANALYZED. BASED ON THIS ANALYSIS, DISCUSSION TOPICS WERE DEVELOPED TO GATHER PRIMARY DATA THROUGH LOCAL FOCUS GROUPS, COMMUNITY FORUMS, PAPER SURVEYS, AN ONLINE SURVEY AND INTERVIEWS WITH KEY INFORMANTS, INCLUDING PUBLIC HEALTH REPRESENTATIVES. THIS COMMUNITY INPUT WAS OBTAINED FROM ACROSS THE HOSPITAL'S COMMUNITY, WITH A FOCUS ON PERSONS AND AREAS IMPACTED BY HEALTH DISPARITIES. DOMINICAN HOSPITAL THE COMMUNITY ASSESSMENT PROJECT I
MERCY MEDICAL CENTER MT. SHASTA	MERCY MEDICAL CENTER MT. SHASTA CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. MERCY MEDICAL CENTER MT. SHASTA TOOK INTO CONSIDERATION AVAILABLE INTERNAL AND EXTERNAL RESOURCES, AND PARTNERED WITH OUTSIDE INDIVIDUALS AND ORGANIZATIONS AS APPROPRIATE THROUGHOUT THE CHNA PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MERCY MEDICAL CENTER MT. SHASTA AND THE PUBLIC HEALTH DEPARTMENT, AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN, PUBLIC HEALTH AGENCY REPRESENTATIVES DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MERCY MEDICAL CENTER MT.SHASTA COMMUNITY ADVISORY COUNCIL COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA; SISKIYOU COUNTY RURAL HEALTH CLINICS; AND SISKIYOU COUNTY COMMUNITY RESOURCE CENTERS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL THE HOSPITAL UTILIZED INFORMATION COMPILED IN A 2012 COUNTYWIDE CHNA BY THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. ST. JOSEPH'S BEHAVIORAL HEALTH CENTER THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS RETAINED VALLEY VISION, INC. TO CONDUCT THE 2012 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM HELD IN NOVEMBER 2012. ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL THE HOSPITAL UTILIZED INFORMATION COMPILED IN A 2012 COUNTYWIDE CHNA BY THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF.
SECTION B, LINE 4- OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSSESSMENT	ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER BANNER HEALTH, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER MERCY GENERAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPH'S BEHAVIORAL HEALTH, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER STOCKTON AND LODI HEALTH ST. ROSE DOMINICAN HOSPITAL - SIENA CAMPUS ST. ROSE DOMINICAN HOSPITAL SAN MARTIN AND ST. ROSE DOMINICAN HOSPITAL DE LIMA NORTHRIDGE HOSPITAL MEDICAL CENTER ADVANCE HEALTH MEDICAL CENTER, DEL CARMEN MEDICAL CENTER, GLENDALE ADVENTIST MEDICAL CENTER, HENRY MAYO NEWHALL MEMORIAL HOSPITAL, HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS, KAISER PERMANENTE WOODLAND HILLS, KAISER PERMANENTE PANORAMA CITY, MISSION COMMUNITY HOSPITAL, PROVIDENCE HEALTH CENTER, SHERMAN OAKS HOSPITAL, AND VALLEY PRESBYTERIAN HOSPITAL DOMINICAN HOSPITAL SUTTER MATERNITY AND SURGERY CENTER, WATSONVILLE COMMUNITY HOSPITAL MARIAN REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND FRENCH HOSPITAL MEDICAL CENTER CALIFORNIA HOSPITAL MEDICAL CENTER GOOD SAMARITAN HOSPITAL AND ST. VINCENT MEDICAL CENTER ST. BERNARDINE MEDICAL CENTER COMMUNITY HOSPITAL SAN BERNARDINO MERCY HOSPITAL BAKERSFIELD DELANO REGIONAL MEDICAL CENTER, BAKERSFIELD MEMORIAL HOSPITAL, KAISER PERMANENTE AND SAN JOAQUIN COMMUNITY HOSPITAL MERCY GILBERT MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER SEQUOIA HOSPITAL STANFORD HOSPITAL & CLINICS, SETON MEDICAL CENTER, MILLS-PENINSULA HEALTH SERVICES, SAN MATEO MEDICAL CENTER, LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, KAISER PERMANENTE SAN MATEO AREA ST. JOHN'S REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. MARY MEDICAL CENTER - LONG BEACH LONG BEACH MEMORIAL, MILLER'S CHILDREN'S HOSPITAL, COMMUNITY HOSPITAL OF LONG BEACH, AND LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COLLABORATION WITH KAISER PERMANENTE ST. MARY'S MEDICAL CENTER CALIFORNIA PACIFIC MEDICAL CENTER, CHINESE HOSPITAL, KAISER PERMANENTE HOSPITAL, SAINT FRANCIS MEMORIAL HOSPITAL, UCSF MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER GLENDALE ADVENTIST MEDICAL CENTER AND USC VERDUGO HILLS HOSPITAL ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL DE LIMA WOODLAND MEMORIAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL SAN MARTIN FRENCH HOSPITAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND MARIAN REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. JOHN'S REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL FRENCH HOSPITAL MEDICAL CENTER AND MARIAN REGIONAL MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S BEHAVIORAL HEALTH CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER STOCKTON AND LODI HEALTH ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL
SECTION B, LINE 5A- AVAILABILITY OF NEEDS ASSESSMENT	INDIVIDUAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLAN SUMMARIES MAY BE ACCESSED AT HTTP://WWW.DIGNITYHEALTH.ORG/CM/CONTENT/PAGES/COMMUNITY-BENEFIT.ASP INDIVIDUAL WEB SITES FOR EACH FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/about-us/community-benefit/communit y-benefit-resources MERCY SAN JUAN MEDICAL CENTER http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community MERCY GENERAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community MERCY MEDICAL CENTER REDDING http://redding.mercy.org/Who_We_Are/Serving_the_Community/index.htm CHANDLER REGIONAL HOSPITAL http://www.dignityhealth.org/chandlerregional/about-us/community-benefit-a nd-outreach ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.stjosephscares.org/Who_We_Are/Serving_the_Community/index.htm ST. ROSE DOMINICAN HOSPITALS - SIENA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/who-we-are/serving-the-com munity DOMINICAN HOSPITAL http://www.dominicanhospital.org/Who_We_Are/Serving_the_Community/index.ht m MARIAN REGIONAL MEDICAL CENTER http://www.marianmedicalcenter.org/Who_We_Are/Serving_the_Community/index. htm CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/who-we-are/community-benef its ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/who-we-are/serving-the-co mmunity MERCY HOSPITAL BAKERSFIELD http://www.mercybakersfield.org/Who_We_Are/Serving_the_Community/index.htm MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/about-us/community-benefit-outre ach METHODIST HOSPITAL OF SACRAMENTO http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community SEQUOIA HOSPITAL http://www.sequoiahospital.org/Who_We_Are/Serving_the_Community/index.htm MERCY MEDICAL CENTER MERCED http://www.mercymercedcares.org/Who_We_Are/Serving_the_Community/index.htm ST. JOHN'S REGIONAL MEDICAL CENTER http://www.stjohnshealth.org/Who_We_Are/Serving_the_Community/index.htm ST. MARY MEDICAL CENTER - Long Beach http://www.dignityhealth.org/stmarymedical/community-benefits ST. MARY'S MEDICAL CENTER http://www.stmarysmedicalcenter.org/Who_We_Are/Serving_the_Community/index .htm MERCY HOSPITAL OF FOLSOM http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/who-we-are/serving-the-commu nity/community-health-needs-assessment-and-plan ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment WOODLAND MEMORIAL HOSPITAL http://www.dignityhealth.org/woodland/Community-Benefit ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment FRENCH HOSPITAL MEDICAL CENTER http://www.frenchmedicalcenter.org/Who_We_Are/Serving_the_Community/index. htm ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.stjohnshealth.org/Who_We_Are/Serving_the_Community/index.htm ST. ELIZABETH COMMUNITY HOSPITAL http://redbluff.mercy.org/Who_We_Are/Serving_the_Community/DEVCV120839 ARROYO GRANDE COMMUNITY HOSPITAL http://www.arroyograndehospital.org/Who_We_Are/Serving_the_Community/index .htm MERCY MEDICAL CENTER MT. SHASTA http://www.mercymtshasta.org/Who_We_Are/Serving_the_Community/index.htm SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL HTTP://WWW.OASISHOSPITAL.COM/ ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.stjosephscanhelp.org/Who_We_Are/Serving_the_Community/index.htm ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL HTTP://AZOSH.COM/
SECTION B, LINE 5B - OTHER WEBSITES	MERCY HOSPITAL SAN JUAN HTTP://WWW.HEALTHYLIVINGMAP.COM MERCY GENERAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S MEDICAL CENTER OF STOCKTON WWW.HEALTHIERSANJOAQUIN.ORG. DOMINICAN HOSPITAL HTTP://WWW.APPLIEDSURVEYRESEARCH.ORG/PROJECTS_DATABASE/QUALITY-OF-LIFE/SAN TA-CRUZ-COUNTY-COMMUNITY-ASSESSMENT-PROJECT-CAP.HTML MERCY HOSPITAL BAKERSFIELD HTTP://WWW.HEALTHYKERN.ORG/ METHODIST HOSPITAL OF SACRAMENTO HTTP://WWW.HEALTHYLIVINGMAP.COM SEQUOIA HOSPITAL WWW.HOSPITALCONSORT.ORG HTTP://WWW.PLSINFO.ORG/HEALTHYSMC/PDF/2013_EXECUTIVE_SUMMARY_FINAL.PDF ST. MARY'S MEDICAL CENTER HTTP://WWW.SFHIP.ORG/ MERCY HOSPITAL FOLSOM HTTP://WWW.HEALTHYLIVINGMAP.COM WOODLAND MEMORIAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S BEHAVIORAL HEALTH CENTER WWW.HEALTHIERSANJOAQUIN.ORG.
SECTION B, LINE 7 - NEEDS NOT ADDRESSED IN NEEDS ASSESSMENT	ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER WITHIN THE SCOPE OF THE HOSPITAL'S SERVICES, THE PRIORITY NEEDS NOT BEING ADDRESSED ARE THOSE OF CHILDREN'S HEALTH FROM 1 TO 15 YEARS OF AGE. THESE HEALTH ISSUES ARE BEING ADDRESSED IN VARIOUS WAYS BY SEVERAL OTHER HEALTH PROVIDERS IN THE COMMUNITY. IN 2012 THE HOSPITAL JOINED PHOENIX CHILDREN'S HOSPITAL IN HELPING TO ADDRESS THESE NEEDS. MERCY SAN JUAN MEDICAL CENTER THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED BY ANOTHER HOSPITAL IN THE AREA. MERCY GENERAL HOSPITAL THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED AT ANOTHER HOSPITAL IN THE AREA. MERCY MEDICAL CENTER REDDING WHILE THE HEALTH NEEDS AND RISKS OF DOMESTIC VIOLENCE AND CHILD ABUSE/NEGLECT WERE ALSO IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT, THE HOSPITAL HAS LIMITED RESOURCES AND ABILITY TO EFFECT SUSTAINABLE CHANGE. MERCY MEDICAL CENTER REDDING WILL SUPPORT LOCAL NON-PROFIT ORGANIZATIONS THAT ADDRESS THOSE NEEDS THROUGH DONATIONS, SPONSORSHIPS, AND THE COMMUNITY GRANTS PROGRAM, AS APPROPRIATE. CHANDLER REGIONAL MEDICAL CENTER TO ADDRESS NEEDS NOT SPECIFICALLY MET BY CHANDLER REGIONAL MEDICAL CENTER, STRONG AND EFFECTIVE PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL ARE MET BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA. SERVICES NOT PROVIDED BY CRMC INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BEHAVIORAL HEALTH, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON IDENTIFIED HEALTH NEEDS NOT BEING ADDRESSED DIRECTLY BY THE HOSPITAL INCLUDE: LACK OF OR LIMITED ACCESS TO DENTAL CARE, LIMITED OR NO NUTRITION LITERACY/ACCESS TO HEALTHY, NUTRITIOUS FOODS, FOOD SECURITY, LIMITED TRANSPORTATION OPTIONS, AND A LACK OF SAFE AND AFFORDABLE PLACES TO BE ACTIVE. ALTHOUGH NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION PLAN, THESE NEEDS WILL RECEIVE SECONDARY SUPPORT BY THE HOSPITAL, AS ABLE. THIS MAY INCLUDE SUPPORTING PARTNERS BETTER SUITED TO ADDRESS THESE NEEDS THROUGH THE GRANTS PROGRAM. ST. ROSE HOSPITAL SIENA CAMPUS HEALTH NEEDS NOT BEING ADDRESSED INCLUDE: TOBACCO USAGE, BABIES WITH LOW BIRTHWEIGHT, CERVICAL CANCER SCREENING AND PREVENTION, COLORECTAL CANCER SCREENING AND PREVENTION, COPD MANAGEMENT, FLU AND PNEUMONIA IMMUNIZATIONS, HEALTHY ENVIRONMENTS INCLUDING ACCESS TO FITNESS AND NUTRITION, LACK OF SOCIAL SUPPORT, AND OBESITY. ST. ROSE DOMINICAN HOSPITALS' PROGRAMS MAY TOUCH UPON ASPECTS OF THESE HEALTH ISSUES, ALTHOUGH NOT AS A PRIMARY FOCUS, THROUGH EXISTING PROGRAMS OR PARTNERSHIPS WITH OTHERS IN THE COMMUNITY. NORTHRIDGE HOSPITAL MEDICAL CENTER ONE OF THE NEEDS IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT NOT BEING ADDRESSED BY NORTHRIDGE HOSPITAL MEDICAL CENTER IS ACCESS TO AFFORDABLE DENTAL HEALTH SERVICES. THE HOSPITAL DOES NOT HAVE THE RESOURCES TO ADDRESS THIS HEALTH ISSUE, BUT THE HOSPITAL DOES MAKE REFERRALS TO APPROPRIATE CARE PROVIDERS. DOMINICAN HOSPITAL DOMINICAN HOSPITAL WILL NOT FOCUS ON ISSUES RELATED TO CATEGORIES THAT INCLUDE SELECT WOMEN'S SERVICES, SUBSTANCE ABUSE AND CHEMICAL DEPENDENCY ISSUES, ORAL/DENTAL CARE,AND END OF LIFE ISSUES. THESE ISSUES ARE EITHER BEYOND THE SCOPE OF HOSPITAL RESOURCES OR ARE ALREADY BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MARIAN REGIONAL MEDICAL CENTER ORAL HEALTH, CULTURAL AWARENESS AND TRANSPORTATION ARE THREE AREAS IDENTIFIED IN THE NEEDS ASSESSMENT THAT WILL NOT BE DIRECTLY ADDRESSED BY THE HOSPITAL. THE HOSPITAL OFFERS SPACE WITHIN THE FACILITY AND SUPPORT SERVICES FOR SOME ORAL HEALTH NEEDS, BUT THE HEALTH ISSUE IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THOUGH THE HOSPITAL DOES NOT HAVE A SPECIFIC FOCUS ON CULTURAL AWARENESS OR TRANSPORTATION, BOTH WILL BE GIVEN CONSIDERATION AS THE OTHER HEALTH PRIORITIES ARE ADDRESSED. CALIFORNIA HOSPITAL MEDICAL CENTER NEEDS IDENTIFIED IN THE CHNA NOT BEING ADDRESSED BY CALIFORNIA HOSPITAL MEDICAL CENTER INCLUDE ALZHEIMER'S DISEASE (LOW INCIDENCE RATE), ALLERGIES (OTHER FACILITIES ASSIST ADOLESCENTS), CANCER (ASSIST INDIVIDUALS TO FIND A MEDICAL HOME FOR PREVENTIVE SERVICES), HIV/AIDS (ADDRESSED BY OTHER RESOURCES IN THE COMMUNITY), AND SEXUALLY TRANSMITTED DISEASES (LA COUNTY DEPT OF PUBLIC HEALTH AND LOCAL PUBLIC HEALTH CLINICS ARE ADDRESSING THIS ISSUE). ST. BERNARDINE MEDICAL CENTER NEEDS IDENTIFIED IN THE CHNA WITH UNFAVORABLE COMPARISONS TO THE GOALS ESTABLISHED BY HEALTHY PEOPLE 2020 THAT ARE NOT ADDRESSED IN THE ESTABLISHED HEALTH PRIORITIES INCLUDE: HIV/AIDS, CANCER SCREENINGS AND PREVENTION PRACTICES (SENIOR PNEUMONIA SHOT, COLORECTAL CANCER SCREENING, PAP SMEAR, AND MAMMOGRAM). WHILE RECOGNIZING THAT THESE ARE VALID HEALTH CONCERNS, WITH LIMITED RESOURCES THE COMMITTEE PRIORITIZED HEALTH ISSUES THAT IMPACT HOSPITAL ADMISSIONS, RECOGNIZING THAT THERE ARE EXISTING COMMUNITY RESOURCES IN PLACE THAT HAVE THE COMPETENCIES AND CAPACITY TO ADDRESS THESE OTHER ISSUES. MERCY HOSPITAL BAKERSFIELD LOW BIRTHWEIGHT AND INFANT MORTALITY ARE NOT BEING ADDRESSED BY THE HOSPITAL. THESE ISSUES ARE BEING ADDRESSED BY OTHER ENTITIES AND ORGANIZATIONS IN THE COMMUNITY. MERCY GILBERT MEDICAL CENTER TO ADDRESS NEEDS NOT SPECIFICALLY MET BY MERCY GILBERT MEDICAL CENTER, STRONG AND EFFECTIVE PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL ARE MET BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA. SERVICES NOT PROVIDED BY MERCY GILBERT MEDICAL CENTER INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BEHAVIORAL HEALTH, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. METHODIST HOSPITAL OF SACRAMENTO THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESS BY ANOTHER FACILITY IN THE AREA. SEQUOIA HOSPITAL SEQUOIA HOSPITAL WILL NOT BE DIRECTLY FOCUSING ON MENTAL HEALTH, ORAL HEALTH, VIOLENCE OR STDS/HIV-AIDS ISSUES BECAUSE THEY ARE BEYOND THE SCOPE OF THE HOSPITAL FACILITY AND ARE BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY MEDICAL CENTER MERCED MERCY MEDICAL CENTER MERCED HAS PROGRAMS AND HEALTH SERVICES TO ADDRESS ALL OF THE TOP ELEVEN IDENTIFIED HEALTH PRIORITIES, EXCEPT FOR THE FOLLOWING FOUR: FAMILY PLANNING, ORAL HEALTH, INJURY AND VIOLENCE PREVENTION, AND VISION. SERVICES ARE BEING PROVIDED IN THE COMMUNITY BY OTHER ENTITIES OR THE HOSPITAL DOES NOT HAVE EXPERTISE IN THESE AREAS. ST. JOHN'S REGIONAL MEDICAL CENTER THE HOSPITAL HAS LIMITED ABILITY TO ADDRESS THE DIFFERENCES IN PROSPERITY/POVERTY AT A PUBLIC POLICY LEVEL, DUE TO A LACK OF A MEANINGFUL AVENUE TO APPROACH THIS ISSUE. NONETHELESS, THE HOSPITAL DOES HAVE REPRESENTATION ON THE GOLD COAST BOARD AND A MONTHLY NETWORKING MEETING IN AN ATTEMPT TO BUILD COHESION AT A HUMAN SERVICES PROVIDER LEVEL. THE CHNA NEED REGARDING "CONTINUING ENVIRONMENTAL DEGRADATION" IS NOT ADDRESSED DUE TO A LACK OF STAFF AND FUNDING; HOWEVER ST. JOHN'S HOSPITAL HAS AN EFFECTIVE IN-HOUSE ECOLOGY PROGRAM WHICH IS INTENDED TO REDUCE THE FACILITY'S OWN ECOLOGICAL FOOTPRINT. ST. MARY MEDICAL CENTER THE HOSPITAL IS NOT DIRECTLY ADDRESSING THE FOLLOWING PRIORITIES: ARTHRITIS, EXERCISE CLASSES, DRUG AND ALCOHOL PROGRAMS, BEFORE AND AFTER SCHOOL PROGRAMS, COUNSELING AND ASSISTED LIVING. THESE ARE EITHER BEYOND THE EXPERTISE OF THE HOSPITAL OR ARE BEING ADDRESSED BY OTHER COMMUNITY ORGANIZATIONS. ST. MARY'S MEDICAL CENTER THE IDENTIFIED NEED TO "ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS" IS BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES AND RESOURCES, AND IT IS ALREADY BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY HOSPITAL FOLSOM THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESS BY ANOTHER FACILITY IN THE AREA. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER WILL NOT BE ADDRESSING DISABILITY AND ORAL HEALTH DUE TO LIMITED RESOURCES. FURTHERMORE, GLENDALE HEALTHY KIDS WORKS WITH CHILDREN IN THE COMMUNITY TO PROVIDE ORAL HEALTH EDUCATION AND SERVICES FOR CHILDREN. ST. ROSE HOSPITAL SAN MARTIN CAMPUS HEALTH NEEDS NOT BEING ADDRESSED INCLUDE: TOBACCO USAGE, BABIES WITH LOW BIRTHWEIGHT, CERVICAL CANCER SCREENING AND PREVENTION, COLORECTAL CANCER SCREENING AND PREVENTION, COPD MANAGEMENT, FLU AND PNEUMONIA IMMUNIZATIONS, HEALTHY ENVIRONMENTS INCLUDING ACCESS TO FITNESS AND NUTRITIO
SECTION B, LINE 11 - ELIGIBILITY FOR PROVIDING DISCOUNTED CARE CRITERIA	DIGNITY HEALTH OPERATES TWO FOR-PROFIT HOSPITALS THROUGH JOINT VENTURE ARRANGEMENTS. THESE HOSPITALS ARE SPECIALTY HOSPITALS THAT PRIMARILY PROVIDE ELECTIVE SURGERY TO PATIENTS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL PROVIDES A 35% DISCOUNT TO ALL SELF-PAY PATIENTS.
SECTION B, LINE 14G - OTHER WAYS HOSPITAL PUBLICIZED FINANCIAL ASSISTANCE	ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS, A COPY OF THE CHARITY CARE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION, AND THE FACILITY'S WEBPAGE ADDRESS WHERE ADDITIONAL INFORMATION AND APPLICATIONS CAN BE ACCESSED.
SECTION B, LINE 20D - MEANS USED TO DETERMINE AMOUNTS BILLED	FOR ALL HOSPITALS THAT MARKED BOX 20D PATIENTS WHO ARE APPLYING FOR DISCOUNTS UNDER THE DISCOUNT PROVISION POLICY WHOSE HOUSEHOLD INCOME IS AT OR BELOW 350% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES FROM MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT SPONSORED HEALTH PROGRAM OR HEALTH BENEFIT IN WHICH THE HOSPITAL PARTICIPATES. PATIENTS WHOSE INCOME IS ABOVE 350% BUT NOT MORE THAN 500% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT 135% OF THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES TO PATIENTS COVERED BY MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT-SPONSORED HEALTH ROGRAM OF HEALTH BENEFITS IN WHICH THE HOSPITAL PARTICIPATES.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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?89
Name and address		Type of Facility (describe)
1	Folsom Outpatient Surgery Center (USPI) 1651 Creekside Drive Folsom,CA95630	Surgery Center
2	NICU Operating CO of Santa Cruz LLC 1555 Soquel Drive Santa Cruz,CA95065	Neonatal Healthcare
3	USP Surgery Center - Parkway 100 N Green Valley Pkwy 125 Henderson,NV89074	Surgery Center
4	St Joseph's Outpatient Surgery Center 240 West thomas Road Phoenix,AZ85013	Surgery Center
5	St Joseph's Surgery Center LP (USPI) 1800 N California Street Ste 1 Stockton,CA95204	Surgery Center
6	DH Nevada Imaging Center Siena 861 Coronada Center Drive 101 Henderson,NV89052	Imaging Center
7	USP Surgery Center - Durango 8530 W Sunset Road Las Vegas,NV89113	Surgery Center
8	Folsom Sierra Endoscopy Center 1600 Creekside Drive Folsom,CA95630	Endoscopy Center
9	Simon Med - Greenfield 1425 S Greenfield Suite 114 Mesa,AZ85206	Imaging Center
10	Court Street Surgery Center 2184 Court Street Redding,CA96001	Surgery Center
11	CBCC Outsmarting Cancer LLC 6501 Truxtun Avenue Bakersfield,CA93309	Radiation / Oncology incl Cyberknife
12	Coastal Surgical Specialist Inc 921 Oak Park Boulevard 100B Pismo Beach,CA93449	Surgery Center
13	Mercy Surgery Center 2175 Rosaline Avenue Suite A Redding,CA96001	Surgery Center
14	Simon Med - Thunderbird III & III 5410 W Thunderbird Road 100/105/21 Glendale,AZ85306	Imaging Center
15	DH Nevada Imaging Center Spring Valley 5495 S Rainbow Boulevard 101 103 Las Vegas,NV89118	Imaging Center
16	Simon Med - Dobson III 235 S Dobson Suites 1 and 1870 W Fr Chandler,AZ85224	Imaging Center
17	Simon Med - Mountain View 9201 E Mountain View Road Suite 150 Scottsdale,AZ85258	Imaging Center
18	Simon Med - OPEN MRI & Imaging Phoenix 1331 N 7th Street Suite 150 Phoenix,AZ85006	Imaging Center
19	St John's Regional Imaging Center LLC 1700 N Rose Avenue 110 Oxnard,CA93030	Imaging center
20	Surgery Center of Peoria 13260 North 94th Drive Suite 200 Peoria,AZ85381	Surgery Center
21	Crockett School Family Practice Clinic 4825 E Roosevelt Street Phoenix,AZ85008	Surgery Center
22	Surgery Center of Scottsdale 8962 East Desert Cove Drive Scottsdale,AZ85260	Surgery Center
23	Simon Med - Spectrum 2680 S Val Vista Drive Bldg 7 Suite Gilbert,AZ85295	Imaging Center
24	Warner Park Ambulatory Surgical 604 West Warner Road Bldg A Chandler,AZ85225	Surgery Center
25	Desert Ridge Outpatient Surgery Center 20940 North Tatum Boulevard Suite 1 Phoenix,AZ85050	Surgery Center
26	Simon Med - Avondale 10815 W McDowell Road Suite 102 Avondale,AZ85323	Imaging Center
27	Renaissance Imaging Center at Northridge 18436 Roscoe Boulevard Northridge,CA91328	Imaging Center
28	Roseville USP Surgery Center 1420 E Roseville Parkway No 100 Roseville,CA95661	Surgery Center
29	Huger Mercy Living Center 2345 W Orangewood Phoenix,AZ85021	Assisted Living Facility
30	Plaza Surgery Center 525 E Plaza 100 Santa Maria,CA93454	Surgery Center
31	21st Century Oncology (Redding) 963 Butte Street Redding,CA96001	Oncology
32	Radiation Oncology Center of Ventura Cou 1700 N Rose Ave 120 OxnardCamarillo,CA93030	Imaging Center
33	Santa Cruz Surgery Center 3003 Paul Sweet Road Santa Cruz,CA95065	Surgery Center
34	NSC Channel Islands LLC 2030 Wankel Way Oxnard,CA93030	Surgery Center
35	St Joseph's Medical Group Maternal Fetal 1727 W Frye Ste 210 Chandler,AZ85224	Multi-specialty clinics
36	Simon Med - Sun City - Peoria 9403 W Thunderbird Road Peoria,AZ95381	Imaging Center
37	Simon Med - Desert Ridge 20830 N Tatum Blvd Suite 190 Phoenix,AZ85050	Imaging Center
38	Simon Med - Baywood 130 S 63rd St Bldg 4 Mesa,AZ85206	Imaging Center
39	Simon Med - Dobson Imaging (PDI) 1111 S Dobson Road Mesa,AZ85202	Imaging Center
40	Simon Med - Daly City 455 Hickey Blvd Suite 200 Daly City,CA94015	Imaging Center
41	Simon Med - Fashion Square 6740 E Camelback Road Suites 100 Scottsdale,AZ85251	Imaging Center
42	Chandler Endoscopy Center 2095 W Pecos Road Suite 1 Chandler,AZ85224	Surgery Center
43	Templeton Surgery Center 1310 Las Tables Rd Suite 104 Templeton,CA93465	Surgery Center
44	Simon Med - Deer Valley 20414 N 27th Avenue Phoenix,AZ85027	Imaging Center
45	Simon Med - Sun City West 13624 W Camino Del Sol Suite 300 Sun City West,AZ85375	Imaging Center
46	Dominican Magnetic Resonance Imaging Cen 1545 Soquel Drive Santa Cruz,CA95065	Imaging Center
47	Simon Med - Queen Creek 36297 N Gantzel Road Suite 101 Queen Creek,AZ85140	Imaging Center
48	Simon Med - Surprise Stadium Village 14823 W Bell Road Suite 110 Surprise,AZ85374	Imaging Center
49	Simon Med - Ahwatukee 15810 S 45th St Suite 110 Phoenix,AZ85048	Imaging Center
50	Simon Med - Palm Valley III (aka Goodye 13657 W McDowell Rd Suites 207 21 Goodyear,AZ85338	Imaging Center
51	Simon Med - San Francisco 325 Sacramento Street San Francisco,CA94104	Imaging Center
52	Simon Med - Prescott Valley 3033 N Windsong Drive Suite 102 Prescott Valley,AZ86314	Imaging Center
53	Woodland Adult Day Health 20 N Cottonwood Street Woodland,CA95695	Health Center
54	Stockton Outpatient Surgery Center LLC 2388 N California Street Stockton,CA95204	Surgery Center
55	Sacramento Midtown Endoscopy 3941 J Street Sacramento,CA95819	Surgery Center
56	21st Century Oncology (Mt Shasta) 902 Pine Street Mt Shasta,CA96067	Oncology
57	Simon Med - Redwood City 345 Convention Way Suite D1 Redwood City,CA94063	Imaging Center
58	Simon Med - 19th Avenue 6707 N 19th Ave Suite 108 Phoenix,AZ85015	Imaging Center
59	St Joseph's Medical Group Peoria North C 7727 W Deer Valley Road Peoria,AZ85382	Multi-specialty clinics
60	Simon Med - Chandler Imaging (PDI) 725 S Dobson Road Suite 105 Chandler,AZ85224	Imaging Center
61	Dominican Breast Center 1661 Soquel Drive Bldg G Santa Cruz,CA95065	Imaging Center
62	Trinity Care Infusion Services 18440 Roscoe Boulevard Northridge,CA91325	Infusion Center
63	St Joseph's Medical Group Adult Cardiova 1727 W Frye Suite 210 Chandler,AZ85224	Multi-specialty clinics
64	Simon Med - Burlingame 1860 El Camino Real Suite 101 Burlingame,CA94010	Imaging Center
65	Simon Med - Monterey 665 Munras Avenue 109 Monterey,CA93940	Imaging Center
66	Simon Med - Stand Up MRI of Beverly Hill 8370 Wilshire Blvd Suite 110 Beverly Hills,CA90211	Imaging Center
67	Simon Med - Superstition Imaging (PDI) 875 N Greenfield Road Suite 107 Gilbert,AZ85234	Imaging Center
68	Metro Surgery Center LP 3131 W Peoria Avenue Phoenix,AZ95381	Surgery Center
69	Simon Med - San Francisco - MRI 50 Francisco Street Suite 105 San Francisco,CA94133	Imaging Center
70	Simon Med - San Rafael 4144 Redwood Highway Suite B San Rafael,CA94903	Imaging Center
71	Simon Med - Los Gatos 14651 S Bascom Los Gatos,CA95032	Imaging Center
72	Santa Cruz Comprehensive Imaging LLC 1685 Commercial Way Santa Cruz,CA95065	Imaging Center
73	Southwest Lithotripsy 100 W Third Ave Suite 350 Columbus,OH43201	Lithotripsy
74	Simon Med - Mesa Drive 456 N Mesa Drive Mesa,AZ85201	Imaging Center
75	Simon Med - Orange Grove LLC 1845 W Orange Grove Rd Bldg 5 Suite Tucson,AZ85704	Imaging Center
76	Dignity Health Medical Group Nevada LLC 10001 S Eastern Ave Suite 203 Henderson,NV89052	Multi-specialty clinics
77	The Barbara Greenspun Women's Care Cente 100 N Green Valley Pkwy Suite 330 Henderson,NV89074	Health Center
78	Simon Med - Academy (LLC) 310 N Wilmot Rd - 302 303 304 Tucson,AZ85711	Imaging Center
79	Dignity Health Medical Group Nevada LLC 7190 S Cimarron Road Las Vegas,NV89052	Multi-specialty clinics
80	Dignity Health Medical Group Nevada LLC 8689 W Charleston Blvd Suite 105 Las Vegas,NV89117	Multi-specialty clinics
81	Simon Med - Mountain View 105 South Drive Ste 100/110 Mountain View,CA94040	Imaging Center
82	Simon Med - Thompson Peak 7304 E Deer Valley Road Bldg E Scottsdale,AZ85255	Imaging Center
83	Dignity Health Medical Group Nevada LLC 10001 S Eastern Avenue Suite 209 Henderson,NV89052	Multi-specialty clinics
84	Simon Med - McCormick Ranch 8630 E Via De Ventura St 208 Scottsdale,AZ85258	Imaging Center
85	Northern Arizona Congenital Heart Center 1330 Rim Drive Ste A Flagstaff,AZ86001	Congenital Heart Center
86	Redding Surgery Center 2439 Sonoma Redding,CA96001	Surgery Center
87	CHWUSP Oxnard Surgery Centers LLC 1700 N ROSE AVENUE STE 100 Oxnard,CA93030	Surgery Center
88	Radiation Oncology Center of Ventura Cou 5301 Mission Oaks Boulevard Suite A Camarillo,CA93012	Surgery Center
89	Simon Med - Fiesta 1457 W Southern Ave Suite 26 Mesa,AZ85202	Imaging Center

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
SECTION B, LINE 1 - CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT	St Joseph's Westgate Medical Center THE HOSPITAL BEGAN OPERATING EFFECTIVE 5/12/14. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS CURRENTLY BEING CONDUCTED IN CONJUNCTION WITH ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER AS THE TWO HOSPITALS SERVE THE SAME SERVICE AREA.
SECTION B, LINE 3- COMMUNITY SERVED BY NEEDS ASSESSMENT	St Joseph's Hospital and Medical Center IN JUNE 2012, THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES COMPLETED A COMPREHENSIVE CHNA FOR MARICOPA COUNTY. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. MERCY SAN JUAN MEDICAL CENTER MERCY SAN JUAN MEDICAL CENTER COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 25 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). FIVE FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY GENERAL HOSPITAL MERCY GENERAL HOSPITAL COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 37 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). TEN FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY MEDICAL CENTER REDDING (MMCR) MMCR CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA) RELATING TO A WIDE ARRAY OF COMMUNITY HEALTH INDICATORS. PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MMCR AND THE PUBLIC HEALTH DEPARTMENT AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. THE SURVEYS WERE EMAILED TO APPROXIMATELY 1,000 EMAILS THROUGH A DISTRIBUTION LIST THAT THE HOSPITAL USES TO DISSEMINATE HEALTH EDUCATION MATERIALS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THERE WERE 168 SURVEYS COMPLETED FOR A RETURN RATE OF APPROXIMATELY 16.8%. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MMCR ADVISORY COUNCIL, COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA, AND SHASTA COUNTY PUBLIC HEALTH. IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN, PUBLIC HEALTH REPRESENTATIVES DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. CHANDLER REGIONAL MEDICAL CENTER (CRMC) THROUGH THE 2012 NEEDS ASSESSMENT, CRMC AND MERCY GILBERT MEDICAL CENTER CONSULTED WITH ARIZONA STATE UNIVERSITY COMMUNITY HEALTH INFORMATION RESEARCH. THE PRIMARY DATA COLLECTION INCLUDED INTERVIEWS WITH STAFF AND LEADERS OF MORE THAN 20 COMMUNITY SERVICES AGENCIES IN FIVE MUNICIPALITIES, AND TWO FOCUS GROUPS IN COMMUNITY AGENCY LOCATIONS. CRMC PARTNERED WITH ARIZONA STATE UNIVERSITY DOCTORAL STUDENTS AND CHANDLER GILBERT COMMUNITY COLLEGE NURSING STUDENTS TO CONDUCT THE AGENCY INTERVIEWS AND FOCUS GROUPS. GOVERNMENT AGENCY RESOURCES INCLUDED ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, ARIZONA DEPARTMENT OF HEALTH SERVICES, PUBLIC DATA SOURCES, ARIZONA CANCER REGISTRY, ARIZONA HEALTH STATUS AND VITAL STATISTICS, ARIZONA HEALTH SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, AND US CENSUS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS, RETAINED VALLEY VISION, INC., TO CONDUCT THE 2012 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM, HELD IN NOVEMBER 2012. ST. ROSE DOMINICAN HOSPITALS - ROSE DE LIMA, SAN MARTIN AND SIENA THE HEALTHY COMMUNITIES INSTITUTE (HCI) OF BERKELEY, CALIFORNIA, IN PARTNERSHIP WITH ST. ROSE DOMINICAN HOSPITALS, CONDUCTED A CHNA OF CLARK COUNTY, NEVADA IN 2013. BOTH QUANTITATIVE AND QUALITATIVE RESEARCH METHODOLOGIES WERE USED TO ENSURE AN ACCURATE PROFILE OF THE ST. ROSE SERVICE AREAS. PRIMARY AND SECONDARY DATA FROM A VARIETY OF SOURCES INCLUDES: PAPER AND ELECTRONIC SURVEYS; DATA FROM EXISTING LITERATURE AND DATABASES; AND INFORMATION FROM COMMUNITY STAKEHOLDERS. SEVERAL TOOLS WERE CREATED FOR PRIMARY DATA COLLECTION, AND MANY METHODOLOGIES WERE UTILIZED, INCLUDING: 1) 221 INDIVIDUALS COMPLETED A SURVEY RANKING THE TOP HEALTH ISSUES FOR THEIR FAMILY AND THE COMMUNITY. THE SURVEY PROVIDED THE LIST OF 15 HEALTH ISSUES THAT WERE SELECTED AFTER AN ANALYSIS OF HCI AND PREVENTION QUALITY INDICATOR DATA. A CONVENIENCE SAMPLE OF THOSE UTILIZING ST. ROSE COMMUNITY OUTREACH PROGRAMS COMPLETED THE SURVEYS; 2) MORE THAN 50 KEY COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES OF THE UNIVERSITY OF NEVADA AT LAS VEGAS DEPARTMENT OF PUBLIC HEALTH, WERE INVITED TO COMPLETE A SURVEY RANKING PRIORITY HEALTH NEEDS IDENTIFYING WAYS ST. ROSE CAN ADDRESS THESE HEALTH ISSUES, AND PROVIDING SUGGESTIONS FOR ENHANCED COLLABORATION WITH PARTNER ORGANIZATIONS. NORTHRIDGE HOSPITAL (NHMC) NHMC, IN COLLABORATION WITH THE VALLEY CARE COMMUNITY CONSORTIUM (VCCC), DEVELOPED NHMC'S 2013 CHNA IN COMPLIANCE WITH FEDERAL REQUIREMENTS. VCCC IS THE HEALTH PLANNING COLLABORATIVE FOR THE SAN FERNANDO AND SANTA CLARITA VALLEYS IN LOS ANGELES COUNTY. DATA WERE SUMMARIZED FROM SECONDARY DATA SOURCES TO DESCRIBE 17 HEALTH ISSUES. TABLES OF DISEASES BY ZIP CODE FOCUSING ON THE HOSPITAL'S PRIMARY SERVICE AREA, USING THE 2012 THOMSON REUTERS DATABOOK, WERE COMPARED WITH AVAILABLE COUNTY, STATE AND NATIONAL DATA (CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, LOS ANGELES DEPARTMENT OF PUBLIC HEALTH, THE CENTERS FOR DISEASE CONTROL, AND HEALTHY PEOPLE 2020) AND ANALYZED. BASED ON THIS ANALYSIS, DISCUSSION TOPICS WERE DEVELOPED TO GATHER PRIMARY DATA THROUGH LOCAL FOCUS GROUPS, COMMUNITY FORUMS, PAPER SURVEYS, AN ONLINE SURVEY AND INTERVIEWS WITH KEY INFORMANTS, INCLUDING PUBLIC HEALTH REPRESENTATIVES. THIS COMMUNITY INPUT WAS OBTAINED FROM ACROSS THE HOSPITAL'S COMMUNITY, WITH A FOCUS ON PERSONS AND AREAS IMPACTED BY HEALTH DISPARITIES. DOMINICAN HOSPITAL THE COMMUNITY ASSESSMENT PROJECT I
MERCY MEDICAL CENTER MT. SHASTA	MERCY MEDICAL CENTER MT. SHASTA CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. MERCY MEDICAL CENTER MT. SHASTA TOOK INTO CONSIDERATION AVAILABLE INTERNAL AND EXTERNAL RESOURCES, AND PARTNERED WITH OUTSIDE INDIVIDUALS AND ORGANIZATIONS AS APPROPRIATE THROUGHOUT THE CHNA PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MERCY MEDICAL CENTER MT. SHASTA AND THE PUBLIC HEALTH DEPARTMENT, AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN, PUBLIC HEALTH AGENCY REPRESENTATIVES DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MERCY MEDICAL CENTER MT.SHASTA COMMUNITY ADVISORY COUNCIL COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA; SISKIYOU COUNTY RURAL HEALTH CLINICS; AND SISKIYOU COUNTY COMMUNITY RESOURCE CENTERS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL THE HOSPITAL UTILIZED INFORMATION COMPILED IN A 2012 COUNTYWIDE CHNA BY THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. ST. JOSEPH'S BEHAVIORAL HEALTH CENTER THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS RETAINED VALLEY VISION, INC. TO CONDUCT THE 2012 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM HELD IN NOVEMBER 2012. ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL THE HOSPITAL UTILIZED INFORMATION COMPILED IN A 2012 COUNTYWIDE CHNA BY THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF.
SECTION B, LINE 4- OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSSESSMENT	ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER BANNER HEALTH, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER MERCY GENERAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPH'S BEHAVIORAL HEALTH, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER STOCKTON AND LODI HEALTH ST. ROSE DOMINICAN HOSPITAL - SIENA CAMPUS ST. ROSE DOMINICAN HOSPITAL SAN MARTIN AND ST. ROSE DOMINICAN HOSPITAL DE LIMA NORTHRIDGE HOSPITAL MEDICAL CENTER ADVANCE HEALTH MEDICAL CENTER, DEL CARMEN MEDICAL CENTER, GLENDALE ADVENTIST MEDICAL CENTER, HENRY MAYO NEWHALL MEMORIAL HOSPITAL, HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS, KAISER PERMANENTE WOODLAND HILLS, KAISER PERMANENTE PANORAMA CITY, MISSION COMMUNITY HOSPITAL, PROVIDENCE HEALTH CENTER, SHERMAN OAKS HOSPITAL, AND VALLEY PRESBYTERIAN HOSPITAL DOMINICAN HOSPITAL SUTTER MATERNITY AND SURGERY CENTER, WATSONVILLE COMMUNITY HOSPITAL MARIAN REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND FRENCH HOSPITAL MEDICAL CENTER CALIFORNIA HOSPITAL MEDICAL CENTER GOOD SAMARITAN HOSPITAL AND ST. VINCENT MEDICAL CENTER ST. BERNARDINE MEDICAL CENTER COMMUNITY HOSPITAL SAN BERNARDINO MERCY HOSPITAL BAKERSFIELD DELANO REGIONAL MEDICAL CENTER, BAKERSFIELD MEMORIAL HOSPITAL, KAISER PERMANENTE AND SAN JOAQUIN COMMUNITY HOSPITAL MERCY GILBERT MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER SEQUOIA HOSPITAL STANFORD HOSPITAL & CLINICS, SETON MEDICAL CENTER, MILLS-PENINSULA HEALTH SERVICES, SAN MATEO MEDICAL CENTER, LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, KAISER PERMANENTE SAN MATEO AREA ST. JOHN'S REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. MARY MEDICAL CENTER - LONG BEACH LONG BEACH MEMORIAL, MILLER'S CHILDREN'S HOSPITAL, COMMUNITY HOSPITAL OF LONG BEACH, AND LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COLLABORATION WITH KAISER PERMANENTE ST. MARY'S MEDICAL CENTER CALIFORNIA PACIFIC MEDICAL CENTER, CHINESE HOSPITAL, KAISER PERMANENTE HOSPITAL, SAINT FRANCIS MEMORIAL HOSPITAL, UCSF MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER GLENDALE ADVENTIST MEDICAL CENTER AND USC VERDUGO HILLS HOSPITAL ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL DE LIMA WOODLAND MEMORIAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL SAN MARTIN FRENCH HOSPITAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND MARIAN REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. JOHN'S REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL FRENCH HOSPITAL MEDICAL CENTER AND MARIAN REGIONAL MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S BEHAVIORAL HEALTH CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER STOCKTON AND LODI HEALTH ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL
SECTION B, LINE 5A- AVAILABILITY OF NEEDS ASSESSMENT	INDIVIDUAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLAN SUMMARIES MAY BE ACCESSED AT HTTP://WWW.DIGNITYHEALTH.ORG/CM/CONTENT/PAGES/COMMUNITY-BENEFIT.ASP INDIVIDUAL WEB SITES FOR EACH FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/about-us/community-benefit/communit y-benefit-resources MERCY SAN JUAN MEDICAL CENTER http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community MERCY GENERAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community MERCY MEDICAL CENTER REDDING http://redding.mercy.org/Who_We_Are/Serving_the_Community/index.htm CHANDLER REGIONAL HOSPITAL http://www.dignityhealth.org/chandlerregional/about-us/community-benefit-a nd-outreach ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.stjosephscares.org/Who_We_Are/Serving_the_Community/index.htm ST. ROSE DOMINICAN HOSPITALS - SIENA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/who-we-are/serving-the-com munity DOMINICAN HOSPITAL http://www.dominicanhospital.org/Who_We_Are/Serving_the_Community/index.ht m MARIAN REGIONAL MEDICAL CENTER http://www.marianmedicalcenter.org/Who_We_Are/Serving_the_Community/index. htm CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/who-we-are/community-benef its ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/who-we-are/serving-the-co mmunity MERCY HOSPITAL BAKERSFIELD http://www.mercybakersfield.org/Who_We_Are/Serving_the_Community/index.htm MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/about-us/community-benefit-outre ach METHODIST HOSPITAL OF SACRAMENTO http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community SEQUOIA HOSPITAL http://www.sequoiahospital.org/Who_We_Are/Serving_the_Community/index.htm MERCY MEDICAL CENTER MERCED http://www.mercymercedcares.org/Who_We_Are/Serving_the_Community/index.htm ST. JOHN'S REGIONAL MEDICAL CENTER http://www.stjohnshealth.org/Who_We_Are/Serving_the_Community/index.htm ST. MARY MEDICAL CENTER - Long Beach http://www.dignityhealth.org/stmarymedical/community-benefits ST. MARY'S MEDICAL CENTER http://www.stmarysmedicalcenter.org/Who_We_Are/Serving_the_Community/index .htm MERCY HOSPITAL OF FOLSOM http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/who-we-are/serving-the-commu nity/community-health-needs-assessment-and-plan ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment WOODLAND MEMORIAL HOSPITAL http://www.dignityhealth.org/woodland/Community-Benefit ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment FRENCH HOSPITAL MEDICAL CENTER http://www.frenchmedicalcenter.org/Who_We_Are/Serving_the_Community/index. htm ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.stjohnshealth.org/Who_We_Are/Serving_the_Community/index.htm ST. ELIZABETH COMMUNITY HOSPITAL http://redbluff.mercy.org/Who_We_Are/Serving_the_Community/DEVCV120839 ARROYO GRANDE COMMUNITY HOSPITAL http://www.arroyograndehospital.org/Who_We_Are/Serving_the_Community/index .htm MERCY MEDICAL CENTER MT. SHASTA http://www.mercymtshasta.org/Who_We_Are/Serving_the_Community/index.htm SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL HTTP://WWW.OASISHOSPITAL.COM/ ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.stjosephscanhelp.org/Who_We_Are/Serving_the_Community/index.htm ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL HTTP://AZOSH.COM/
SECTION B, LINE 5B - OTHER WEBSITES	MERCY HOSPITAL SAN JUAN HTTP://WWW.HEALTHYLIVINGMAP.COM MERCY GENERAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S MEDICAL CENTER OF STOCKTON WWW.HEALTHIERSANJOAQUIN.ORG. DOMINICAN HOSPITAL HTTP://WWW.APPLIEDSURVEYRESEARCH.ORG/PROJECTS_DATABASE/QUALITY-OF-LIFE/SAN TA-CRUZ-COUNTY-COMMUNITY-ASSESSMENT-PROJECT-CAP.HTML MERCY HOSPITAL BAKERSFIELD HTTP://WWW.HEALTHYKERN.ORG/ METHODIST HOSPITAL OF SACRAMENTO HTTP://WWW.HEALTHYLIVINGMAP.COM SEQUOIA HOSPITAL WWW.HOSPITALCONSORT.ORG HTTP://WWW.PLSINFO.ORG/HEALTHYSMC/PDF/2013_EXECUTIVE_SUMMARY_FINAL.PDF ST. MARY'S MEDICAL CENTER HTTP://WWW.SFHIP.ORG/ MERCY HOSPITAL FOLSOM HTTP://WWW.HEALTHYLIVINGMAP.COM WOODLAND MEMORIAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S BEHAVIORAL HEALTH CENTER WWW.HEALTHIERSANJOAQUIN.ORG.
SECTION B, LINE 7 - NEEDS NOT ADDRESSED IN NEEDS ASSESSMENT	ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER WITHIN THE SCOPE OF THE HOSPITAL'S SERVICES, THE PRIORITY NEEDS NOT BEING ADDRESSED ARE THOSE OF CHILDREN'S HEALTH FROM 1 TO 15 YEARS OF AGE. THESE HEALTH ISSUES ARE BEING ADDRESSED IN VARIOUS WAYS BY SEVERAL OTHER HEALTH PROVIDERS IN THE COMMUNITY. IN 2012 THE HOSPITAL JOINED PHOENIX CHILDREN'S HOSPITAL IN HELPING TO ADDRESS THESE NEEDS. MERCY SAN JUAN MEDICAL CENTER THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED BY ANOTHER HOSPITAL IN THE AREA. MERCY GENERAL HOSPITAL THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED AT ANOTHER HOSPITAL IN THE AREA. MERCY MEDICAL CENTER REDDING WHILE THE HEALTH NEEDS AND RISKS OF DOMESTIC VIOLENCE AND CHILD ABUSE/NEGLECT WERE ALSO IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT, THE HOSPITAL HAS LIMITED RESOURCES AND ABILITY TO EFFECT SUSTAINABLE CHANGE. MERCY MEDICAL CENTER REDDING WILL SUPPORT LOCAL NON-PROFIT ORGANIZATIONS THAT ADDRESS THOSE NEEDS THROUGH DONATIONS, SPONSORSHIPS, AND THE COMMUNITY GRANTS PROGRAM, AS APPROPRIATE. CHANDLER REGIONAL MEDICAL CENTER TO ADDRESS NEEDS NOT SPECIFICALLY MET BY CHANDLER REGIONAL MEDICAL CENTER, STRONG AND EFFECTIVE PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL ARE MET BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA. SERVICES NOT PROVIDED BY CRMC INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BEHAVIORAL HEALTH, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON IDENTIFIED HEALTH NEEDS NOT BEING ADDRESSED DIRECTLY BY THE HOSPITAL INCLUDE: LACK OF OR LIMITED ACCESS TO DENTAL CARE, LIMITED OR NO NUTRITION LITERACY/ACCESS TO HEALTHY, NUTRITIOUS FOODS, FOOD SECURITY, LIMITED TRANSPORTATION OPTIONS, AND A LACK OF SAFE AND AFFORDABLE PLACES TO BE ACTIVE. ALTHOUGH NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION PLAN, THESE NEEDS WILL RECEIVE SECONDARY SUPPORT BY THE HOSPITAL, AS ABLE. THIS MAY INCLUDE SUPPORTING PARTNERS BETTER SUITED TO ADDRESS THESE NEEDS THROUGH THE GRANTS PROGRAM. ST. ROSE HOSPITAL SIENA CAMPUS HEALTH NEEDS NOT BEING ADDRESSED INCLUDE: TOBACCO USAGE, BABIES WITH LOW BIRTHWEIGHT, CERVICAL CANCER SCREENING AND PREVENTION, COLORECTAL CANCER SCREENING AND PREVENTION, COPD MANAGEMENT, FLU AND PNEUMONIA IMMUNIZATIONS, HEALTHY ENVIRONMENTS INCLUDING ACCESS TO FITNESS AND NUTRITION, LACK OF SOCIAL SUPPORT, AND OBESITY. ST. ROSE DOMINICAN HOSPITALS' PROGRAMS MAY TOUCH UPON ASPECTS OF THESE HEALTH ISSUES, ALTHOUGH NOT AS A PRIMARY FOCUS, THROUGH EXISTING PROGRAMS OR PARTNERSHIPS WITH OTHERS IN THE COMMUNITY. NORTHRIDGE HOSPITAL MEDICAL CENTER ONE OF THE NEEDS IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT NOT BEING ADDRESSED BY NORTHRIDGE HOSPITAL MEDICAL CENTER IS ACCESS TO AFFORDABLE DENTAL HEALTH SERVICES. THE HOSPITAL DOES NOT HAVE THE RESOURCES TO ADDRESS THIS HEALTH ISSUE, BUT THE HOSPITAL DOES MAKE REFERRALS TO APPROPRIATE CARE PROVIDERS. DOMINICAN HOSPITAL DOMINICAN HOSPITAL WILL NOT FOCUS ON ISSUES RELATED TO CATEGORIES THAT INCLUDE SELECT WOMEN'S SERVICES, SUBSTANCE ABUSE AND CHEMICAL DEPENDENCY ISSUES, ORAL/DENTAL CARE,AND END OF LIFE ISSUES. THESE ISSUES ARE EITHER BEYOND THE SCOPE OF HOSPITAL RESOURCES OR ARE ALREADY BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MARIAN REGIONAL MEDICAL CENTER ORAL HEALTH, CULTURAL AWARENESS AND TRANSPORTATION ARE THREE AREAS IDENTIFIED IN THE NEEDS ASSESSMENT THAT WILL NOT BE DIRECTLY ADDRESSED BY THE HOSPITAL. THE HOSPITAL OFFERS SPACE WITHIN THE FACILITY AND SUPPORT SERVICES FOR SOME ORAL HEALTH NEEDS, BUT THE HEALTH ISSUE IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THOUGH THE HOSPITAL DOES NOT HAVE A SPECIFIC FOCUS ON CULTURAL AWARENESS OR TRANSPORTATION, BOTH WILL BE GIVEN CONSIDERATION AS THE OTHER HEALTH PRIORITIES ARE ADDRESSED. CALIFORNIA HOSPITAL MEDICAL CENTER NEEDS IDENTIFIED IN THE CHNA NOT BEING ADDRESSED BY CALIFORNIA HOSPITAL MEDICAL CENTER INCLUDE ALZHEIMER'S DISEASE (LOW INCIDENCE RATE), ALLERGIES (OTHER FACILITIES ASSIST ADOLESCENTS), CANCER (ASSIST INDIVIDUALS TO FIND A MEDICAL HOME FOR PREVENTIVE SERVICES), HIV/AIDS (ADDRESSED BY OTHER RESOURCES IN THE COMMUNITY), AND SEXUALLY TRANSMITTED DISEASES (LA COUNTY DEPT OF PUBLIC HEALTH AND LOCAL PUBLIC HEALTH CLINICS ARE ADDRESSING THIS ISSUE). ST. BERNARDINE MEDICAL CENTER NEEDS IDENTIFIED IN THE CHNA WITH UNFAVORABLE COMPARISONS TO THE GOALS ESTABLISHED BY HEALTHY PEOPLE 2020 THAT ARE NOT ADDRESSED IN THE ESTABLISHED HEALTH PRIORITIES INCLUDE: HIV/AIDS, CANCER SCREENINGS AND PREVENTION PRACTICES (SENIOR PNEUMONIA SHOT, COLORECTAL CANCER SCREENING, PAP SMEAR, AND MAMMOGRAM). WHILE RECOGNIZING THAT THESE ARE VALID HEALTH CONCERNS, WITH LIMITED RESOURCES THE COMMITTEE PRIORITIZED HEALTH ISSUES THAT IMPACT HOSPITAL ADMISSIONS, RECOGNIZING THAT THERE ARE EXISTING COMMUNITY RESOURCES IN PLACE THAT HAVE THE COMPETENCIES AND CAPACITY TO ADDRESS THESE OTHER ISSUES. MERCY HOSPITAL BAKERSFIELD LOW BIRTHWEIGHT AND INFANT MORTALITY ARE NOT BEING ADDRESSED BY THE HOSPITAL. THESE ISSUES ARE BEING ADDRESSED BY OTHER ENTITIES AND ORGANIZATIONS IN THE COMMUNITY. MERCY GILBERT MEDICAL CENTER TO ADDRESS NEEDS NOT SPECIFICALLY MET BY MERCY GILBERT MEDICAL CENTER, STRONG AND EFFECTIVE PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL ARE MET BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA. SERVICES NOT PROVIDED BY MERCY GILBERT MEDICAL CENTER INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BEHAVIORAL HEALTH, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. METHODIST HOSPITAL OF SACRAMENTO THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESS BY ANOTHER FACILITY IN THE AREA. SEQUOIA HOSPITAL SEQUOIA HOSPITAL WILL NOT BE DIRECTLY FOCUSING ON MENTAL HEALTH, ORAL HEALTH, VIOLENCE OR STDS/HIV-AIDS ISSUES BECAUSE THEY ARE BEYOND THE SCOPE OF THE HOSPITAL FACILITY AND ARE BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY MEDICAL CENTER MERCED MERCY MEDICAL CENTER MERCED HAS PROGRAMS AND HEALTH SERVICES TO ADDRESS ALL OF THE TOP ELEVEN IDENTIFIED HEALTH PRIORITIES, EXCEPT FOR THE FOLLOWING FOUR: FAMILY PLANNING, ORAL HEALTH, INJURY AND VIOLENCE PREVENTION, AND VISION. SERVICES ARE BEING PROVIDED IN THE COMMUNITY BY OTHER ENTITIES OR THE HOSPITAL DOES NOT HAVE EXPERTISE IN THESE AREAS. ST. JOHN'S REGIONAL MEDICAL CENTER THE HOSPITAL HAS LIMITED ABILITY TO ADDRESS THE DIFFERENCES IN PROSPERITY/POVERTY AT A PUBLIC POLICY LEVEL, DUE TO A LACK OF A MEANINGFUL AVENUE TO APPROACH THIS ISSUE. NONETHELESS, THE HOSPITAL DOES HAVE REPRESENTATION ON THE GOLD COAST BOARD AND A MONTHLY NETWORKING MEETING IN AN ATTEMPT TO BUILD COHESION AT A HUMAN SERVICES PROVIDER LEVEL. THE CHNA NEED REGARDING "CONTINUING ENVIRONMENTAL DEGRADATION" IS NOT ADDRESSED DUE TO A LACK OF STAFF AND FUNDING; HOWEVER ST. JOHN'S HOSPITAL HAS AN EFFECTIVE IN-HOUSE ECOLOGY PROGRAM WHICH IS INTENDED TO REDUCE THE FACILITY'S OWN ECOLOGICAL FOOTPRINT. ST. MARY MEDICAL CENTER THE HOSPITAL IS NOT DIRECTLY ADDRESSING THE FOLLOWING PRIORITIES: ARTHRITIS, EXERCISE CLASSES, DRUG AND ALCOHOL PROGRAMS, BEFORE AND AFTER SCHOOL PROGRAMS, COUNSELING AND ASSISTED LIVING. THESE ARE EITHER BEYOND THE EXPERTISE OF THE HOSPITAL OR ARE BEING ADDRESSED BY OTHER COMMUNITY ORGANIZATIONS. ST. MARY'S MEDICAL CENTER THE IDENTIFIED NEED TO "ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS" IS BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES AND RESOURCES, AND IT IS ALREADY BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY HOSPITAL FOLSOM THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESS BY ANOTHER FACILITY IN THE AREA. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER WILL NOT BE ADDRESSING DISABILITY AND ORAL HEALTH DUE TO LIMITED RESOURCES. FURTHERMORE, GLENDALE HEALTHY KIDS WORKS WITH CHILDREN IN THE COMMUNITY TO PROVIDE ORAL HEALTH EDUCATION AND SERVICES FOR CHILDREN. ST. ROSE HOSPITAL SAN MARTIN CAMPUS HEALTH NEEDS NOT BEING ADDRESSED INCLUDE: TOBACCO USAGE, BABIES WITH LOW BIRTHWEIGHT, CERVICAL CANCER SCREENING AND PREVENTION, COLORECTAL CANCER SCREENING AND PREVENTION, COPD MANAGEMENT, FLU AND PNEUMONIA IMMUNIZATIONS, HEALTHY ENVIRONMENTS INCLUDING ACCESS TO FITNESS AND NUTRITIO
SECTION B, LINE 11 - ELIGIBILITY FOR PROVIDING DISCOUNTED CARE CRITERIA	DIGNITY HEALTH OPERATES TWO FOR-PROFIT HOSPITALS THROUGH JOINT VENTURE ARRANGEMENTS. THESE HOSPITALS ARE SPECIALTY HOSPITALS THAT PRIMARILY PROVIDE ELECTIVE SURGERY TO PATIENTS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL PROVIDES A 35% DISCOUNT TO ALL SELF-PAY PATIENTS.
SECTION B, LINE 14G - OTHER WAYS HOSPITAL PUBLICIZED FINANCIAL ASSISTANCE	ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS, A COPY OF THE CHARITY CARE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION, AND THE FACILITY'S WEBPAGE ADDRESS WHERE ADDITIONAL INFORMATION AND APPLICATIONS CAN BE ACCESSED.
SECTION B, LINE 20D - MEANS USED TO DETERMINE AMOUNTS BILLED	FOR ALL HOSPITALS THAT MARKED BOX 20D PATIENTS WHO ARE APPLYING FOR DISCOUNTS UNDER THE DISCOUNT PROVISION POLICY WHOSE HOUSEHOLD INCOME IS AT OR BELOW 350% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES FROM MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT SPONSORED HEALTH PROGRAM OR HEALTH BENEFIT IN WHICH THE HOSPITAL PARTICIPATES. PATIENTS WHOSE INCOME IS ABOVE 350% BUT NOT MORE THAN 500% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT 135% OF THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES TO PATIENTS COVERED BY MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT-SPONSORED HEALTH ROGRAM OF HEALTH BENEFITS IN WHICH THE HOSPITAL PARTICIPATES.

Schedule H (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. 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) 5 Cities Homeless Coalition PO Box 558 GROVER BEACH,CA93483	27-0413593	501(c)(3)	12,000	0	N/A	N/A	Community Health
(2) About Care Inc PO Box 3278 CHANDLER,AZ852443278	34-2047687	501(c)(3)	25,234	0	N/A	N/A	Community Health
(3) Allan Hancock College 800 S COLLEGE DRIVE SANTA MARIA,CA934546399	52-1692042	Govt	210,000	0	N/A	N/A	Education support Friends Fore Golf
(4) Alliance For Housing & Healing 825 Colorado Boulevard Suite 100 LOS ANGELES,CA90041	95-4147364	501(c)(3)	15,000	0	N/A	N/A	Community Health
(5) Alliance For Pharmaceutical Access Incorporated 237 Town Center West Suite 122 SANTA MARIA,CA93458	20-3117940	501(c)(3)	82,500	0	N/A	N/A	Community Health
(6) Alpha House A Place For New Beginnings PO BOX 712 TAFT,CA93268	77-0366593	501(c)(3)	7,942	0	N/A	N/A	community Health
(7) Al-Shifa Clinic Inc 2034-B Mallory Street SAN BERNARDINO,CA92407	33-0855769	501(c)(3)	25,000	0	N/A	N/A	Community Health
(8) Alzheimer's Disease And Related Disorders Associat 1777-A Capitola Road SANTA CRUZ,CA95062	94-2897949	501(c)(3)	53,500	0	N/A	N/A	Community Health
(9) Alzheimer's Disease And Related Disorders Associat 4221 Wilshire Boulevard Suite 400 LOS ANGELES,CA90010	95-3718119	501(c)(3)	5,254	0	N/A	N/A	Community Health
(10) Alzheimer's Disease Association Of Kern County Inc 5500 Olive Drive Building 1 BAKERSFIELD,CA93308	77-0017561	501(c)(3)	36,560	2,200	Book	cabinets	Community Health
(11) American Cancer Society California Division Inc 1165 EAST AVEnue SuiTE 100 CHICO,CA95926	94-1170350	501(c)(3)	32,500	0	N/A	N/A	Community Health
(12) American Cancer Society Great West Division Inc 4550 East Bell Road Suite 126 Phoenix,AZ85032	13-1788491	501(c)(3)	17,750	0	N/A	N/A	Community Health
(13) American Heart Association Inc 100 Montgomery Street Suite 1650 SAN FRANCISCO,CA94104	13-5613797	501(c)(3)	343,339	0	N/A	N/A	Community Health
(14) American Lung Association In California 575 Market Street Suite 2125 SAN FRANCISCO,CA941052870	94-0362650	501(c)(3)	5,254	0	N/A	N/A	Community Health
(15) American Lung Association Of The Southwest Inc 102 W MCDowell Road Phoenix,AZ85003	86-0111676	501(c)(3)	6,040	0	N/A	N/A	Community Health
(16) American National Red Cross PO Box 100805 PASADENA,CA911890805	53-0196605	501(c)(3)	56,085	0	N/A	N/A	Community Health
(17) Archdiocese Of Los Angeles 3424 Wilshire Boulevard LOS ANGELES,CA900102241	95-1642382	501(c)(3)	23,200	0	N/A	N/A	Community Health
(18) Architects Of Peace Foundation 1589 Welford Circle HAYWARD,CA94544	26-2241256	501(c)(3)	45,000	0	N/A	N/A	Community Health
(19) Arizona Bridge To Independent Living 15218 S 45Th Place PHOENIX,AZ85044	86-0486447	501(c)(3)	40,000	0	N/A	N/A	Community Health
(20) Arroyo Grande Community Hospital Foundation 345 S Halcyon Road Arroyo Grande,CA93406	20-3256066	501(c)(3)	436,617	0	N/A	N/A	Foundation Support
(21) Arthritis Foundation Southern California Chapter 4060 CHESTNUT Street RIVERSIDE,CA92501	95-1885447	501(c)(3)	16,000	0	N/A	N/A	Community Health
(22) Ascencia 437 Fernando Court GLENDALE,CA91104	20-4233822	501(c)(3)	20,000	0	N/A	N/A	Community Health
(23) Asian Community Nursing Home 7801 Rush River Drive SACRAMENTO,CA95831	94-2271380	501(c)(3)	25,000	0	N/A	N/A	Community Health
(24) Asian Week Foundation 564 Market Street Suite 320 SAN FRANCISCO,CA94104	20-1719535	501(c)(3)	9,500	0	N/A	N/A	Community Health
(25) Assistance League Of San Bernardino 580 W 6Th Street SAN BERNARDINO,CA92410	95-6065105	501(c)(3)	18,750	0	N/A	N/A	Community Health
(26) Assistance League Of Ventura County 913 E Santa Clara Street VENTURA,CA93001	95-2100846	501(c)(3)	8,000	0	N/A	N/A	Community Health
(27) Association Of California Nurse Leader 2520 Venture Oaks Way Suite 210 SACRAMENTO,CA95833	94-2910850	501(c)(3)	10,000	0	N/A	N/A	Community Health Training Kits
(28) Atwater Police Cadets 750 Bellevue Road ATWATER,CA95301	77-0451403	501(c)(3)	14,284	0	N/A	N/A	Community Health
(29) Az Diamondbacks Foundation Inc 401 E Jefferson Street Phoenix,AZ85004	86-0901615	501(c)(3)	13,500	0	N/A	N/A	Community Health
(30) Az Spinal Cord Injury Association 5025 E Washington Street Suite 200 PHOENIX,AZ85034	86-0953423	501(c)(3)	27,500	0	N/A	N/A	Community Health
(31) Bakersfield Association For The Retarded Citizens 2240 S Union Avenue BAKERSFIELD,CA93307	95-1805520	501(c)(3)	25,000	0	N/A	N/A	Community Health
(32) Bakersfield College 1801 Panorama Drive BAKERSFIELD,CA93307	95-6006644	Govt	32,087	0	N/A	N/A	Education Support
(33) Bakersfield Pregnancy Center 1801 21Street Suite 1 BAKERSFIELD,CA93301	77-0024688	501(c)(3)	15,000	0	N/A	N/A	Community Health
(34) Barrow Foundation UK 350 W Thomas Road Phoenix,AZ85013	31-1724184	501(c)(3)	246,476	0	N/A	N/A	Foundation Support
(35) Barrow Neurological Foundation 350 West Thomas Road Phoenix,AZ85013	86-0174371	501(c)(3)	2,774,662	0	N/A	N/A	Foundation Support
(36) Bay Area Council 201 California Street Suite 1450 SAN FRANCISCO,CA94111	23-7325853	501(c)(4)	24,575	0	N/A	N/A	Community Health
(37) Bay Area Council Foundation 201 California Street Suite 1450 SAN FRANCISCO,CA94111	20-1826827	501(c)(3)	100,000	0	N/A	N/A	Community Health
(38) Beacon House Association Of San Pedro 1003 S Beacon Street SAN PEDRO,CA90731	23-7376148	501(c)(3)	25,660	0	N/A	N/A	Community Health
(39) B'Nai B'Rith Region 17 Department 224 WASHINGTON,DC200550224	53-0179971	501(c)(3)	6,000	0	N/A	N/A	Community Health
(40) Board Of Regents Of The Nevada System Of Higher Ed 1664 N Virginia Street Suite 0243 RENO,NV89557	88-6000024	501(c)(3)	115,000	0	N/A	N/A	Community Health
(41) Boys & Girls Clubs Of Oxnard & Port Hueneme 1900 W 5Th Street OXNARD,CA93030	95-1785162	501(c)(3)	52,300	0	N/A	N/A	Community Health
(42) Boys & Girls Clubs Of Merced 615 W 15Th Street MERCED,CA95340	77-0357487	501(c)(3)	35,000	0	N/A	N/A	Community Health
(43) Boys & Girls Clubs Of Redlands Inc 1251 Clay Street REDLANDS,CA92374	95-6187083	501(c)(3)	13,750	0	N/A	N/A	Community Health
(44) Boys And Girls Club Of Santa Maria Valley 901 N RAILROAD AVEnue Santa Maria,CA93458	95-2468116	501(c)(3)	15,175	0	N/A	N/A	Community Health
(45) Brain Injury Alliance Of Az 5025 E Washington Street Suite 200 PHOENIX,AZ85034	94-2937165	501(c)(3)	20,500	0	N/A	N/A	Community Health
(46) Brain Injury Center Of Ventura PO Box 1477 CAMARILLO,CA93011	77-0491413	501(c)(3)	9,625	0	N/A	N/A	Community Health
(47) Cabrillo College Foundation 6500 Soquel Drive Aptos,CA95003	94-6121953	501(c)(3)	38,440	0	N/A	N/A	Education Support
(48) California Health Foundation And Trust 1215 K Street Suite 800 Sacramento,CA95814	94-1498697	501(c)(3)	6,576,221	0	N/A	N/A	Community Health
(49) California Hospital Medical Center Foundation 1401 South Grand Avenue Los Angeles,CA90015	95-4000909	501(c)(3)	1,650,918	0	N/A	N/A	Foundation Support
(50) California Pan-Ethnic Health Network 654 13Th Street OAKLAND,CA94612	94-3306223	501(c)(3)	15,000	0	N/A	N/A	Community Health
(51) California State University-Northridge Foundation 18111 Nordhoff Street NORTHRIDGE,CA91330	95-6196006	501(c)(3)	30,000	0	N/A	N/A	Community Health
(52) California Veterans Assistance Foundation Inc 729 Decatur Street BAKERSFIELD,CA93308	30-0186044	501(c)(3)	25,000	0	N/A	N/A	Community Health
(53) Camarillo Health Care District 3639 E Las Posses Road Suite 117 CAMARILLO,CA93010	95-2834854	Govt	35,000	0	N/A	N/A	Community Health
(54) Camarillo Hospice Corp 400 Rosewood Avenue Suite 102 CAMARILLO,CA93010	95-3347061	501(c)(3)	10,000	0	N/A	N/A	Community Health
(55) Capitol Community Health Network 555 University Avenue Suite 114 SACRAMENTO,CA95825	68-0400624	501(c)(3)	15,000	0	N/A	N/A	Community Health
(56) Care Harbor 5855 Green Valley Circle Suite 204 CULVER CITY,CA90230	27-2984870	501(c)(3)	100,000	0	N/A	N/A	Community Health
(57) Catholic Charities Community Services Inc 4747 N 7Th Avenue PHOENIX,AZ85013	86-0223999	501(c)(3)	10,000	0	N/A	N/A	Community Health
(58) Catholic Charities Cyo Of The Archdiocese Of SF 2255 Hayes Street SAN FRANSISCO,CA94117	94-1498472	501(c)(3)	10,000	0	N/A	N/A	Community Health
(59) Catholic Charities Diocese Of Monterey 922 HILBY AVEnue SuiTE C SEASIDE,CA93955	77-0042961	501(c)(3)	25,000	0	N/A	N/A	Community Health
(60) Catholic Charities Of Los Angeles 607 West Main Street SANTA MARIA,CA93458	95-1690973	501(c)(3)	20,000	0	N/A	N/A	Community Health
(61) Catholic Charities Of Stockton 1106 N EL DORADO Street STOCKTON,CA95202	94-1629114	501(c)(3)	20,050	0	N/A	N/A	Community Health
(62) Catholic Charities Of The Diocese Of Fresno 825 CHESTER AVEnue BAKERSFIELD,CA93301	94-1678938	501(c)(3)	5,025	0	N/A	N/A	Community Health
(63) Catholic Charities San Bernardino Riverside 1450 North D Street SAN BERNARDINO,CA92405	95-3516461	501(c)(3)	18,750	0	N/A	N/A	Community Health
(64) Catholic Charities Usa 2050 Ballenger Avenue Suite 400 ALEXANDRIA,VA22314	53-0196620	501(c)(3)	10,000	0	N/A	N/A	Community Health
(65) Catholic Outreach Center Foundation For Senior Liv 1201 E Thomas Road PHOENIX,AZ85014	86-0411904	501(c)(3)	70,000	0	N/A	N/A	Community Health
(66) Celebrity Fight Night Foundation 2425 E Camelback Road Suite 150 PHOENIX,AZ85016	86-0903119	501(c)(3)	166,000	0	N/A	N/A	Community Health
(67) Center For Aids Research Education And Services-Sa 1500 21St Street SACRAMENTO,CA95814	68-0162903	501(c)(3)	51,855	0	N/A	N/A	Community Health
(68) Center For Community Health & Well-Being Inc 1900 T Street SACRAMENTO,CA95811	68-0248303	501(c)(3)	25,000	0	N/A	N/A	Community Health
(69) Center For Environmental Health 2201 Broadway Suite 302 OAKLAND,CA94612	94-3251981	501(c)(3)	12,500	0	N/A	N/A	Community Health
(70) Center For Healthcare Decisions Inc 3400 DATA Drive RANCHO CORDOVA,CA95670	68-0441958	501(c)(3)	25,000	0	N/A	N/A	Community Health
(71) Center For The Blind And Visually Impaired 1721 Westwind Drive Suite B BAKERSFIELD,CA93301	23-7259272	501(c)(3)	5,225	0	N/A	N/A	Community Health
(72) Central City Lutheran Mission 1354 North G Street SAN BERNARDINO,CA92405	33-0634580	501(c)(3)	11,250	0	N/A	N/A	Community Health
(73) Central Coast Senior Citizens Foundation 528 S Broadway SANTA MARIA,CA93454	25-1911411	501(c)(3)	10,000	0	N/A	N/A	Community Health
(74) Chandler Chamber Community Foundation Inc 25 S Arizona place suite 201 Chandler,AZ85225	20-1338578	501(c)(3)	5,140	0	N/A	N/A	Community Health
(75) Chandler Christian Community Center 345 S California Street CHANDLER,AZ85225	86-0428780	501(c)(3)	33,333	0	N/A	N/A	Community Health
(76) Chandler Education Foundation Inc 1525 W Frye Road CHANDLER,AZ85224	86-0589677	501(c)(3)	23,000	0	N/A	N/A	EDUCATION SUPPORT
(77) Chandler Unified School District 1525 W Frye Road Chandler,AZ85225	86-6000515	Govt	50,170	0	N/A	N/A	Community Health
(78) Chicks In Crisis 8359 ELK GROVE FLORIN RoaD SuiTE 10 SACRAMENTO,CA95829	94-3371317	501(c)(3)	9,500	0	N/A	N/A	Community Health
(79) Children Of Grace PO Box 2394 DANVILLE,CA94526	68-0474040	501(c)(3)	150,000	0	N/A	N/A	Community Health
(80) Circle The City 333 W Indian School Road PHOENIX,AZ85203	26-2420730	501(c)(3)	30,000	0	N/A	N/A	Community Health
(81) Citizens Who Care Inc 1017 Main Street WOODLAND,CA95695	68-0154969	501(c)(3)	17,500	0	N/A	N/A	Community Health
(82) Citrus Heights Rotary Foundation PO BOX 221 CITRUS HEIGHTS,CA95611	03-0566682	501(c)(3)	20,000	0	N/A	N/A	community Health
(83) City Of Chandler 175 S Arizona place Chandler,AZ85225	86-6000238	Govt	22,500	0	N/A	N/A	Community Health
(84) City Of Glendale 613 E Broadway Suite 200 GLENDALE,CA91206	95-6000714	Govt	10,410	0	N/A	N/A	Community Health
(85) Clark County Public Education Foundation Inc 3360 West Sahara Avenue Suite 160 Las Vegas,NV89102	88-0275767	501(c)(3)	5,250	0	N/A	N/A	EDUCATION SUPPORT
(86) Collective Impact PO Box 156853 SAN FRANCISCO,CA94115	20-8964069	501(c)(3)	10,000	0	N/A	N/A	Community Health
(87) Colon Cancer Alliance 1025 Vermont Avenue NW Suite 1066 Washington,DC20005	86-0947831	501(c)(3)	10,000	0	N/A	N/A	Community Health
(88) Communicare Health Centers PO BOX 1260 DAVIS,CA95617	94-2188574	501(c)(3)	20,000	0	N/A	N/A	Community Health
(89) Community Bridges 236 Santa Cruz Avenue APTOS,CA95003	94-2460211	501(c)(3)	55,000	0	N/A	N/A	Community Health
(90) Community Center For The Blind 130 W Flora Street STOCKTON,CA952021636	94-1337611	501(c)(3)	10,000	0	N/A	N/A	Community Health
(91) Community Counseling Center Of San Luis Obispo Cou 129 Marsh Street SAN LUIS OBISPO,CA93401	95-2906369	501(c)(3)	5,495	0	N/A	N/A	Community Health
(92) Community Link Capital Region 909 12Th Street Suite 200 SACRAMENTO,CA95814	94-1201196	501(c)(3)	45,000	0	N/A	N/A	Community Health
(93) Community Recovery Resources 1805 Sierra College Drive GRASS VALLEY,CA95945	94-2275091	501(c)(3)	13,333	0	N/A	N/A	Community Health
(94) Corporation For Supportive Housing 800 S Figueroa Suite 810 LOS ANGELES,CA90017	13-3600232	501(c)(3)	51,331	0	N/A	N/A	Community Health
(95) Cottage Rehabilitation Hospital Foundation 1528 Chapala Street Suite 302 SANTA BARBARA,CA93101	26-0433816	501(c)(3)	7,000	0	N/A	N/A	Community Health
(96) County Of Sacramento 827 7TH Street SACRAMENTO,CA95814	94-6000529	Govt	10,000	0	N/A	N/A	Community Health
(97) County Of Santa Barbara 300 North San Antonio Road Bldg 3 Santa Barbara,CA93110	95-6002833	Govt	36,750	0	N/A	N/A	Community Health
(98) Court Appointed Special Advocates Of Kern County 2000 24Th Street Suite 130 BAKERSFIELD,CA93301	77-0344298	501(c)(3)	38,500	0	N/A	N/A	Community Health
(99) Creighton University PO Box 30282 Omaha,NE68103	47-0376583	501(c)(3)	167,000	0	N/A	N/A	Education Support
(100) Crime Victims Assistance Network 1809 S Street Suite 101316 SACRAMENTO,CA95811	68-0350825	501(c)(3)	40,000	0	N/A	N/A	Community Health
(101) Csulb 49Er Foundation 6300 E State Universary Drive Suite Long Beach,CA90815	45-2163910	501(c)(3)	10,000	0	N/A	N/A	Community Health
(102) Cuesta College Foundation PO Box 8016 San Luis Obispo,CA93403	23-7225601	501(c)(3)	15,000	0	N/A	N/A	Education support
(103) Delta Health Care And Management Services Corporat 4662 Precissi Lane Suite 200 STOCKTON,CA95207	94-2529117	501(c)(3)	33,207	0	N/A	N/A	Community Health
(104) Dientes Community Dental Clinic 1830 Commercial Way SANTA CRUZ,CA95065	77-0311752	501(c)(3)	7,500	0	N/A	N/A	Community Health
(105) Dignity Health Foundation East Valley 1727 W Frye Road Suite 230 CHANDLER,AZ85224	74-2418514	501(c)(3)	1,841,962	0	N/A	N/A	Foundation Support
(106) Dignity Health Medical Foundation 3400 Data Drive Rancho Cordova,CA95670	68-0220314	501(c)(3)	116,637,542	0	N/A	N/A	Medical Fnd Support
(107) Diocese Of Las Vegas Diocese Conference PO Box 18316 LAS VEGAS,NV89114	88-0059349	501(c)(3)	17,394	0	N/A	N/A	Community Health
(108) Diocese Of San Bernadino 1201 East Highland Avenue San Bernadino,CA92404	95-3293901	501(c)(3)	7,120	0	N/A	N/A	Community Health
(109) Domestic Violence & Sexual Assault Coalition PO Box 484 GRASS VALLEY,CA95945	94-2688893	501(c)(3)	15,000	0	N/A	N/A	Community Health
(110) Dominican Hospital Foundation 1555 Soquel Drive Santa Cruz,CA95065	94-2450442	501(c)(3)	1,185,597	0	N/A	N/A	Foundation Support
(111) Downtown Sacramento Foundation 980 9Th Street Suite 400 SACRAMENTO,CA95814	45-2853432	501(c)(3)	40,000	0	N/A	N/A	Community Health
(112) Duet Partners In Health & Aging Inc 555 W Glendale Avenue PHOENIX,AZ85021	74-2370522	501(c)(3)	10,000	0	N/A	N/A	Community Health
(113) East Valley Hispanic Chamber Of Commerce 215 N Robson Street Mesa,AZ85201	27-5501336	501(c)(6)	7,278	0	N/A	N/A	Community Health related
(114) Economic Development Corp Of Shasta County 410 Hemsted Drive Ste 100 Redding,CA96002	94-1417261	501(c)(3)	10,833	0	N/A	N/A	Community Health
(115) El Dorado Hills Community Vision PO BOX 1342 FOLSOM,CA95763	91-1764812	501(c)(3)	10,000	0	N/A	N/A	Community Health
(116) El Hogar Community Services 3780 Rosin Court Suite 110 SACRAMENTO,CA95834	68-0032730	501(c)(3)	96,015	0	N/A	N/A	Community Health
(117) El Sol Neighborhood Educational Center PO Box 449 SAN BERNARDINO,CA92402	33-0552297	501(c)(3)	13,483	0	N/A	N/A	Community Health
(118) Elica Health Center 1860 Howe Street Suite 440 SACRAMENTO,CA95825	37-1424390	501(c)(3)	70,000	0	N/A	N/A	Community Health
(119) Empire Hotel Alcoholic Rehabilitation Center 1237 California Street REDDING,CA960010618	94-2326975	501(c)(3)	25,000	0	N/A	N/A	Community Health
(120) Encompass Community Services 195 Harvey West Boulevard SANTA CRUZ,CA95060	23-7275290	501(c)(3)	8,500	0	N/A	N/A	Community Health
(121) Enrichment Works 5605 Woodman Avenue Suite 207 VALLEY GLEN,CA914014703	95-4754624	501(c)(3)	18,000	0	N/A	N/A	Community Health
(122) Enroll America 1201 New York Avenue NW Suite 1100 WASHINGTON,DC20005	27-1661221	501(c)(3)	100,000	0	N/A	N/A	Community Health
(123) Episcopal Community Services 165 Eighth Street SAN FRANCISCO,CA94103	94-3096716	501(c)(3)	50,000	0	N/A	N/A	Community Health
(124) Eric Okerblom Foundation 1014 Fairway Vista Drive SANTA MARIA,CA93455	27-3435365	501(c)(3)	10,000	0	N/A	N/A	Community Health
(125) Eskaton Foundation 5105 MANZANITA AVEnue CARMICHAEL,CA95608	68-0227233	501(c)(3)	12,500	0	N/A	N/A	community Health
(126) Facing History & Ourselves National Foundation Inc 24301 Southland Drive Suite 207 HAYWARD,CA94545	04-2761636	501(c)(3)	8,700	0	N/A	N/A	Community Health
(127) Family Resource & Referral Center 509 W Weber Avenue Suite 101 STOCKTON,CA952033167	94-1691503	501(c)(3)	21,000	0	N/A	N/A	Community Health
(128) Feeding Matters 8711 E Pinnacle Peak Road Suite 290 SCOTTSDALE,AZ85255	20-8095826	501(c)(3)	12,370	0	N/A	N/A	Community Health
(129) Fellowship Of Christian Athletes 9530 HAGEMAN Road BAKERSFIELD,CA93312	44-0610626	501(c)(3)	14,500	0	N/A	N/A	Community Health
(130) Firstmed Health & Wellness Center 3343 S Eastern Avenue LAS VEGAS,NV89160	27-0759056	501(c)(3)	20,000	0	N/A	N/A	Community Health
(131) Folsom Chamber Of Commerce 200 WOOL Street FOLSOM,CA95630	94-1573092	501(c)(6)	7,500	0	N/A	N/A	Community Health
(132) Food Bank Of Santa Barbara 490 W Foster Road SANTA MARIA,CA93455	77-0169214	501(c)(3)	20,600	0	N/A	N/A	Community Health
(133) Freed Center For Independent Living 117 New Mohawk Road Suite A NEVADA CITY,CA95959	68-0085639	501(c)(3)	13,333	0	N/A	N/A	Community Health Barrow Neurological Institute
(134) French Hospital Medical Center Foundation 1911 Johnson Avenue San Luis Obispo,CA93401	20-3256125	501(c)(3)	966,054	0	N/A	N/A	Foundation Support
(135) Fuse Corps 925 Mission Street Suite 109 SAN FRANCISCO,CA94103	27-5469219	501(c)(3)	25,000	0	N/A	N/A	Community Health
(136) Garden Pathways Inc 3509 UNION AVEnue BAKERSFIELD,CA933052937	77-0442212	501(c)(3)	21,885	0	N/A	N/A	Community Health
(137) Gilbert Chamber Of Commerce Inc PO Box 527 Gilbert,AZ85299	86-0453767	501(c)(6)	10,500	0	N/A	N/A	Community Health
(138) Glendale Association For The Retarded 6512 San Fernando Road GLENDALE,CA91201	95-1976088	501(c)(3)	15,000	0	N/A	N/A	Community Health
(139) Glendale Community Free Health 134 N Kenwood Street Rm 330 GLENDALE,CA91206	87-0732681	501(c)(3)	20,000	0	N/A	N/A	Community Health
(140) Glendale Healthy Kids 223 N Jackson Street B-17 GLENDALE,CA91206	95-4487466	501(c)(3)	19,000	0	N/A	N/A	Community Health
(141) Glendale Memorial Health Foundation 1420 S Central Avenue Glendale,CA91204	95-3625651	501(c)(3)	915,254	0	N/A	N/A	Foundation Support communities.
(142) Glide Health Services 330 Ellis Street SAN FRANCISCO,CA94102	94-1156481	501(c)(3)	98,800	0	N/A	N/A	Community Health
(143) Golden Umbrella 200 Mercy Oaks Drive Redding,CA96003	23-7115371	501(c)(3)	347,802	0	N/A	N/A	Community Health
(144) Good News Rescue Mission 3100 S Market Street REDDING,CA96001	94-1652602	501(c)(3)	66,712	0	N/A	N/A	Community Health
(145) Good Samaritan Shelter Inc 731 S Lincoln Street SANTA MARIA,CA93454	77-0133375	501(c)(3)	15,000	0	N/A	N/A	Community Health
(146) Great Northern Corp PO Box 20 WEED,CA96064	94-2562423	501(c)(3)	8,265	0	N/A	N/A	Community Health
(147) H Street Clinic 1329 NORTH H Street SAN BERNARDINO,CA92405	20-8191393	501(c)(3)	256,000	0	N/A	N/A	Community Health
(148) Harold Pump Foundation 13636 VENTURA Boulevard Suite 416 SHERMAN OAKS,CA91432	95-4807001	501(c)(3)	26,400	0	N/A	N/A	Community Health
(149) Health & Life Org Inc 7275 E Southgate Drive Suite 204-20 SACRAMENTO,CA95823	02-0714551	501(c)(3)	30,000	0	N/A	N/A	Community Health
(150) Health Alliance Of Northern California 2280 BENTON DRive Building C SuiTE REDDING,CA96003	31-1580642	501(c)(3)	6,000	0	N/A	N/A	Community Health
(151) Health For All Inc 4201 I St Suite 7 SACRAMENTO,CA95814	94-2747710	501(c)(3)	20,000	0	N/A	N/A	Community Health
(152) Health Improvement Partnership Of Santa Cruz Cnty PO Box 962 SANTA CRUZ,CA95062	01-0826156	501(c)(3)	40,500	0	N/A	N/A	Community Health
(153) Healthcare Without Harm 12355 Sunrise Valley Drive Suite 68 RESTON,VA20191	52-2358837	501(c)(3)	42,500	0	N/A	N/A	Community Health
(154) Healthy Community Forum For The Greater Sacramento 8928 VOLUNTEER LaNe SuiTE 220 SACRAMENTO,CA95828	68-0377256	501(c)(3)	46,000	0	N/A	N/A	Community Health
(155) Helping Kids Health Accesss Without Walls 968 E Sahara Avenue LAS VEGAS,NV89104	20-5552699	501(c)(3)	50,000	0	N/A	N/A	Community Health
(156) Henderson Chamber Of Commerce Foundation Inc 590 S Boulder Highway Henderson,NV89015	88-0358312	501(c)(3)	15,000	0	N/A	N/A	Community Health
(157) Hmong Women'S Heritage Association 7275 S Southgate Drive Suite 306 SACRAMENTO,CA95823	68-0350323	501(c)(3)	40,000	0	N/A	N/A	Community Health
(158) Homeless Services Center 115-B Coral Street SANTA CRUZ,CA95060	77-0126783	501(c)(3)	48,850	7,000	cost	Food	Community Health
(159) Hope Community Health Center PO Box 7188 TEMPE,AZ852810007	20-1526381	501(c)(3)	43,500	0	N/A	N/A	Community Health
(160) Hope Of The Valley Rescue Mission 8165 San Fernando Road SUN VALLEY,CA91352	27-2053273	501(c)(3)	10,835	0	N/A	N/A	Community Health
(161) Hospice Of Santa Cruz County 940 Disc Drive SCOTTS VALLEY,CA95066	94-2497618	501(c)(3)	8,000	0	N/A	N/A	Community Health
(162) Hospice Of The Valley 1510 E Flower Street Phoenix,AZ85014	86-0338886	501(c)(3)	6,500	0	N/A	N/A	Community Health
(163) Hospital Consortium Of San Mateo County 222 W 39TH AVEnue 3RD FLoor SAN MATEO,CA94403	94-2637032	501(c)(3)	46,000	0	N/A	N/A	Community Health
(164) Human Services Campus Llc 204 S 12Th Avenue PHOENIX,AZ85007	86-1050572	501(c)(3)	20,000	0	N/A	N/A	Community Health
(165) ICAN 650 E Morelos Street Chandler,AZ85225	86-0761030	501(c)(3)	9,300	0	N/A	N/A	Community Health
(166) Immanuel Presbyterian Church 3300 Wilshire Boulevard LOS ANGELES,CA90010	95-1643330	501(c)(3)	18,000	0	N/A	N/A	Community Health
(167) Inland Caregiver Resource Center 1430 E Cooley Drive Suite 124 COLTON,CA92324	33-0460833	501(c)(3)	13,750	0	N/A	N/A	Community Health grant)
(168) Innvision Shelter Network 181 Constitution Drive Menlo Park,CA94025	77-0160469	501(c)(3)	200	66,519	cost	Food	Community Health
(169) Interface Children Family Service 1305 Del Norte Road Suite 200 CAMARILLO,CA93010	95-2944459	501(c)(3)	10,000	0	N/A	N/A	Community Health
(170) International Society For Cardiovascular Translati 3951 E Paradise View Drive Paradise Valley,AZ85253	77-0682420	501(c)(3)	49,650	0	N/A	N/A	Community Health
(171) Jefferson Awards For Public Service 100 W 10Th Street Suite 215 WILMINGTON,DE19801	52-0959336	501(c)(3)	13,250	0	N/A	N/A	Community Health
(172) Jewish Family & Children'S Services 3801 E Willow Street LONG BEACH,CA90815	95-2273033	501(c)(3)	25,000	0	N/A	N/A	Community Health
(173) Jewish Federation Of Las Vegas 2317 Renaissance Drive LAS VEGAS,NV89119	88-0098500	501(c)(3)	50,000	0	N/A	N/A	Community Health
(174) JMJ Maternity Homes 435 W 21St Street MERCED,CA95340	20-5611546	501(c)(3)	10,000	0	N/A	N/A	Community Health
(175) Keogh Health Connection 2375 E Camelback Rd Suite 250 PHOENIX,AZ85016	20-0251176	501(c)(3)	37,130	0	N/A	N/A	Community Health
(176) Kids For Peace Inc 3303 James Drive CARLSBAD,CA92008	26-1564351	501(c)(3)	125,000	0	N/A	N/A	Community Health
(177) Kiwanis Club Of Glendale PO Box 10545 Glendale,CA91209	95-6225168	501(c)(3)	10,000	0	N/A	N/A	Community Health
(178) La Familia Counseling Center Inc 5523 34th Street SACRAMENTO,CA95820	94-2270786	501(c)(3)	40,000	0	N/A	N/A	Community Health
(179) Laughing At My Nightmare Inc 2732 Lafayette Avenue BETHLEHEM,PA18017	45-4553464	501(c)(3)	50,000	0	N/A	N/A	Community Health
(180) Legal Aid Society Of San Bernardino 588 W Sixth Street SAN BERNARDINO,CA92410	95-1997024	501(c)(3)	25,000	0	N/A	N/A	Community Health support
(181) Links For Life 1706 Chester Avenue Suite 200 BAKERSFIELD,CA93301	93-1088003	501(c)(3)	45,800	0	N/A	N/A	Community Health opening
(182) Livingston Memorial Living Visiting Nurse Associat 1996 Eastman Avenue Suite 101 VENTURA,CA93003	95-1693538	501(c)(3)	20,000	0	N/A	N/A	Community Health support
(183) Local 39 Scholarship Fund 337 VALENCIA Street SAN FRANCISCO,CA941033504	25-1918535	501(c)(3)	5,700	0	N/A	N/A	Education Support
(184) Lodestar Day Resource Center 1125 W Jackson Street PHOENIX,AZ85007	26-0235106	501(c)(3)	50,000	0	N/A	N/A	Community Health
(185) Los Rios Foundation 1919 Spanos Court Sacramento,CA95825	94-2506591	501(c)(3)	10,000	0	N/A	N/A	Education Support
(186) Luis Miramontes Memorial Foundation Inc 2300 HILLTOP Drive REDDING,CA96002	45-2964648	501(c)(3)	10,000	0	N/A	N/A	Community Health
(187) Lutheran Social Service Of Southern California 1611 Pine Avenue LONG BEACH,CA90813	95-2225798	501(c)(3)	20,000	0	N/A	N/A	Community Health
(188) Lutheran Social Services Of The Southwest 1525 N Power Road MESA,AZ85205	86-0252302	501(c)(3)	33,333	0	N/A	N/A	Community Health
(189) Maggie's Place Po Box 1102 Phoenix,AZ85001	27-2545687	501(c)(3)	6,000	0	N/A	N/A	Community Health
(190) March Of Dimes Foundation 3550 N Central Avenue Suite 610 Phoenix,AZ85012	13-1846366	501(c)(3)	31,525	0	N/A	N/A	Community Health
(191) Marian Regional Medical Center Foundation 1400 E Church Street Santa Maria,CA93454	95-3818027	501(c)(3)	918,702	0	N/A	N/A	Foundation Support
(192) Mary Magdalene Project Inc 7136 Haskell Avenue Suite 125 VAN NUYS,CA91406	95-3817864	501(c)(3)	30,000	0	N/A	N/A	Community Health
(193) Mary'S Mercy Center PO Box 7563 SAN BERNARDINO,CA92411	33-0632426	501(c)(3)	25,000	0	N/A	N/A	Community Health
(194) Mccloud Healthcare Clinic 116 W Minnesota Avenue MCCLOUD,CA96057	68-0427383	501(c)(3)	14,489	0	N/A	N/A	Community Health
(195) Medshare International 2937 Alvarado Street San Leandro,CA94577	58-2433968	501(c)(3)	10,400	38,368	Book	Medical supplies/equ	Community Health
(196) Mental Health Client Action Network 1051 Cayuga Street SANTA CRUZ,CA95062	93-1177400	501(c)(3)	15,000	0	N/A	N/A	Community Health
(197) Merced Community College District 3600 M Street MERCED,CA95348	77-0362218	Govt	110,250	0	N/A	N/A	Education Support
(198) Mercy Beyond Borders 1885 De La Cruz Boulevard Suite 101 SANTA CLARA,CA950503000	26-0323282	501(c)(3)	25,000	0	N/A	N/A	Community Health
(199) Mercy Foundation 3400 Data Drive Rancho Cordova,CA94577	23-7072762	501(c)(3)	2,327,328	0	N/A	N/A	Foundation Support
(200) Mercy Foundation Bakersfield DBA FRIENDS OF MERCY PO Box 119 Bakersfield,CA93302	77-0201321	501(c)(3)	862,123	0	N/A	N/A	Foundation Support
(201) Mercy Foundation North 2400 Washington Street Suite 410 Redding,CA96001	94-3136799	501(c)(3)	901,386	0	N/A	N/A	Foundation Support
(202) Mercy Housing California 1100 Duchow Way FOLSOM,CA95630	94-3081666	501(c)(3)	317,850	0	N/A	N/A	Community Health
(203) Mercy Housing Southwest 4802 E Ray Road Suite 23 Pmb256 PHOENIX,AZ85044	47-0646706	501(c)(3)	200,000	0	N/A	N/A	Community Health
(204) Mercy Medical Center Merced Foundation 301 East 13th Street Merced,CA95340	77-0035928	501(c)(3)	582,699	0	N/A	N/A	Foundation Support
(205) Mercy Retirement Care Center 3431 Foothill Boulevard OAKLAND,CA94601	94-1156579	501(c)(3)	15,000	0	N/A	N/A	Community Health
(206) Mission Dolores Academy 3371 16Th Street SAN FRANCISCO,CA84114	20-2849575	501(c)(3)	10,000	0	N/A	N/A	Community Health
(207) Mountain Communities Healthcare Foundation PO Box 3051 WEAVERVILLE,CA96093	27-0460666	501(c)(3)	12,867	0	N/A	N/A	Community Health
(208) Museum Of African Diaspora 685 Mission Street 3Rd Floor SAN FRANCISCO,CA94105	94-3338239	501(c)(3)	319,400	0	N/A	N/A	Community Health
(209) Nami Merced County 827 W 20Th Street MERCED,CA95340	41-2198536	501(c)(3)	10,000	0	N/A	N/A	Community Health
(210) Nami Of San Joaquin County PO Box 448 STOCKTON,CA95201	68-0050622	501(c)(3)	8,000	0	N/A	N/A	Community Health
(211) National Association For The Advancement Of Colore 1215 K Street Suite 1609 SACRAMENTO,CA95814	95-4617376	501(c)(3)	24,000	0	N/A	N/A	Community Health
(212) National Multiple Sclerosis Society 1700 OWENS STreet SuiTE 190 SAN FRANCISCO,CA94158	94-1294935	501(c)(3)	5,936	0	N/A	N/A	community Health
(213) Native American Community Health Center Inc 4520 N Central Avenue Suite 350 PHOENIX,AZ85012	94-2540194	501(c)(3)	30,000	0	N/A	N/A	Community Health assistant
(214) Native American Connections 4520 N Central Avenue Suite 600 PHOENIX,AZ85012	86-0293585	501(c)(3)	40,000	0	N/A	N/A	Community Health
(215) Necessities Bag Sacramento 826 Mission Way Sacramento,CA95819	20-8852114	501(c)(3)	8,500	0	N/A	N/A	Community Health
(216) Needs Center PO Box 933 TAFT,CA93268	65-1305502	501(c)(3)	25,000	0	N/A	N/A	Community Health
(217) Neighbors Who Care Inc 10450 E Riggs Road Suite 113 SUN LAKES,AZ85248	86-0966061	501(c)(3)	42,276	0	N/A	N/A	Community Health
(218) Nichi Bei Foundation PO Box 15693 SAN FRANCISCO,CA94115	94-3255070	501(c)(3)	20,000	0	N/A	N/A	Community Health
(219) Northern California Center For Family Awareness In PO Box 991473 REDDING,CA96003	68-0363217	501(c)(3)	30,000	0	N/A	N/A	Community Health
(220) Northern California Child Development 220 Sycamore Street Suite 200 RED BLUFF,CA96080	94-1642028	501(c)(3)	22,402	0	N/A	N/A	Community Health
(221) Northern Valley Catholic Social Service Inc 2400 Washington Avenue REDDING,CA96001	20-0984601	501(c)(3)	18,220	0	N/A	N/A	Community Health
(222) Northridge Hospital Foundation 18300 Roscoe Boulevard Northridge,CA91328	23-7444901	501(c)(3)	1,071,852	0	N/A	N/A	Foundation Support
(223) NV Diabetes Association For Children And Adults 1005 Terminal Way Suite 104 RENO,NV88502	88-0386000	501(c)(3)	15,000	0	N/A	N/A	Community Health
(224) One In Long Beach Inc 2017 E Fourth Street Long Beach,CA90814	95-3523149	501(c)(3)	10,000	0	N/A	N/A	Community Health
(225) Opportunity Village Assoc For Retarded Citizens 6300 West Oakey Boulevard Las Vegas,NV89146	88-6003567	501(c)(3)	9,180	0	N/A	N/A	Community Health
(226) Pacific Trauma Specialists Of Folsom 706 Natoma Street FOLSOM,CA95630	45-5267300	501(c)(3)	53,000	0	N/A	N/A	Community Health
(227) Panetta Institute For Public POLICY 100 Campus Center Bldg 86E Csumb SEASIDE,CA93955	77-0495799	501(c)(3)	11,000	0	N/A	N/A	Community Health
(228) Partners In Care Foundation Inc 15030 Ventura Boulevard Suite 19-81 SHERMAN OAKS,CA91403	95-3954057	501(c)(3)	9,800	0	N/A	N/A	Community Health
(229) Partners In Care Of El Dorado County Inc PO Box 845 PLACERVILLE,CA95667	20-5016935	501(c)(3)	50,000	0	N/A	N/A	Community Health
(230) Pathways Home Health And Hospice 585 N MARY AVEnue SUNNYVALE,CA94085	94-2823240	501(c)(3)	26,000	0	N/A	N/A	Community Health
(231) Pathways LA 3500 W 6Th Street Suite 500 LOS ANGELES,CA90020	95-3258661	501(c)(3)	18,000	0	N/A	N/A	Community Health
(232) Peninsula Family Service 24 Second Avenue SAN MATEO,CA94401	94-1186169	501(c)(3)	75,000	0	N/A	N/A	Community Health
(233) Peninsula Volunteers Inc 800 Middle Avenue MENLO PARK,CA94025	94-1294939	501(c)(3)	35,000	0	N/A	N/A	Community Health
(234) Phoenix Children'S Hospital Foundation 2929 E Camelback Road Suite 122 Phoenix,AZ85016	74-2421549	501(c)(3)	5,850	0	N/A	N/A	Community Health
(235) Phoenix Indian Center 4520 Central Avenue Suite 250 PHOENIX,AZ85012	86-6006566	501(c)(3)	30,000	0	N/A	N/A	Community Health Children
(236) Phoenix Symphony Association One North First street Suite 200 Phoenix,AZ85004	86-6000134	501(c)(3)	31,000	0	N/A	N/A	Community Health
(237) Points Of Light Foundation 465 California Street Suite 425 SAN FRANCISCO,CA94104	65-0206641	501(c)(3)	25,000	0	N/A	N/A	Community Health
(238) President-Board Of Trustees Santa Clara College 500 El Camino Real SANTA CLARA,CA950531400	94-1156617	501(c)(3)	35,000	0	N/A	N/A	Community Health
(239) Project Fit America PO BOX 308 BOYES HOT SPRINGS,CA95416	36-3730823	501(c)(3)	8,900	0	N/A	N/A	Community Health
(240) Puentes 4719 Quail Lakes Drive Suite G STOCKTON,CA95207	27-0715942	501(c)(3)	48,000	0	N/A	N/A	Community Health
(241) Raising Special Kids 5025 E Washington Street Suite 204 PHOENIX,AZ85034	86-0517082	501(c)(3)	13,000	0	N/A	N/A	Community Health
(242) Red Bluff Roundup Rodeo Museum And Historical Soci PO Box 1028 RED BLUFF,CA96080	68-0333674	501(c)(3)	10,750	0	N/A	N/A	Community Health
(243) Redwood City San Mateo County Chamber Of Commerce 1450 Veterans Boulevard Suite 125 Redwood City,CA94063	94-0337914	501(c)(6)	6,325	0	N/A	N/A	Community Health
(244) Rescue Mission Alliance 104 N Hayes Avenue OXNARD,CA93030	23-7278002	501(c)(3)	12,000	0	N/A	N/A	Community Health
(245) Retreat & Refresh Stroke Camp 425 W Giles Lane Peoria,AZ61614	64-0954851	501(c)(3)	23,800	0	N/A	N/A	Community Health
(246) Right Road Recovery Programs 2110 Ferry Street ANDERSON,CA96007	94-2588754	501(c)(3)	15,840	0	N/A	N/A	Community Health
(247) Riverside County Physicians Memorial Foundation 3993 Jurupa Avenue RIVERSIDE,CA92506	95-6080778	501(c)(3)	13,750	0	N/A	N/A	Community Health
(248) Roman Catholic Archbishop Of San Francisco 1 Peter Yorke Way SAN FRANCISCO,CA94109	94-1156707	501(c)(3)	75,000	0	N/A	N/A	Community Health
(249) Roseman University Of Health Sciences 11 Sunset Way Henderson,NV89014	88-0435559	501(c)(3)	5,894	0	N/A	N/A	Education Support
(250) Rotacare Bay Area Inc PO Box 18430 SAN JOSE,CA951588430	77-0328723	501(c)(3)	21,000	0	N/A	N/A	Community Health
(251) Rural Innovations In Social Economics Inc 17313 Fremont Avenue ESPARTO,CA95627	68-0121168	501(c)(3)	17,500	0	N/A	N/A	Community Health
(252) Sacramento Loaves & Fishes 1351 North C Street SACRAMENTO,CA95811	68-0189897	501(c)(3)	30,000	0	N/A	N/A	Community Health
(253) Sacramento Running Association 120 PONDEROSA Court FOLSOM,CA95630	94-3300121	501(c)(3)	10,000	0	N/A	N/A	Community Health
(254) Saint Vincent De Paul Center 300 Baker Street BAKERSFIELD,CA93305	95-1853364	501(c)(3)	30,200	0	N/A	N/A	Community Health
(255) San Bernardino Sexual Assault Services Inc 444 N Arrowhead Avenue Suite 101 SAN BERNARDINO,CA92401	95-3543081	501(c)(3)	25,000	0	N/A	N/A	Community Health
(256) San Carlos Chamber Of Commerce 1500 LAUREL STreet SuiTE B SAN CARLOS,CA940705103	94-1074734	501(c)(6)	7,500	0	N/A	N/A	Community Health
(257) San Francisco African American Historical & Cultur 680 McAllister Street SAN FRANCISCO,CA94102	94-1721596	501(c)(3)	10,000	0	N/A	N/A	Community Health
(258) San Francisco Chamber Of Commerce 235 Montgomery Street 12Th Floor SAN FRANCISCO,CA94104	94-0834950	501(c)(6)	11,582	0	N/A	N/A	Community Health
(259) San Francisco Retina Foundation 1445 BUSH Street SAN FRANCISCO,CA94109	20-5175062	501(c)(3)	11,000	0	N/A	N/A	Community Health
(260) San Francisco Senior Center 890 Beach Street SAN FRANCISCO,CA94109	94-1212136	501(c)(3)	25,000	0	N/A	N/A	Community Health
(261) San Joaquin County Office Of Education Educat Fntd PO Box 213030 STOCKTON,CA952139030	68-0342748	501(c)(3)	52,000	0	N/A	N/A	Community Health
(262) San Joaquin Delta Community College District 5151 PACIFIC AVEnue STOCKTON,CA95207	94-1044400	Govt	6,500	0	N/A	N/A	Education Support
(263) San Luis Obispo County Child Abuse Prevention Coun PO Box 16036 SAN LUIS OBISPO,CA93406	77-0206822	501(c)(3)	10,819	0	N/A	N/A	Community Health
(264) San Luis Obispo Marathon 205 Suburban Road Suite 6 San Luis Obispo,CA93401	27-2625758	Govt	6,300	0	N/A	N/A	Community Health
(265) Santa Barbara County Schools 402 FARNEL RoaD SUITE M Santa Maria,CA93458	95-6000940	Govt	5,400	0	N/A	N/A	EDUCATION SUPPORT
(266) Santa Cruz Women'S Health Center 250 LOCUST Street SANTA CRUZ,CA95060	23-7428303	501(c)(3)	1,500,000	0	N/A	N/A	Community Health
(267) Santa Maria Valley Fish Meals On Wheels PO Box 6526 SANTA MARIA,CA93454	95-2757731	501(c)(3)	9,992	0	N/A	N/A	Community Health
(268) Second Harvest Food Bank 800 Ohlone Parkway WATSONVILLE,CA95076	77-0326685	501(c)(3)	22,500	0	N/A	N/A	Community Health
(269) Self Help For The Elderly 407 Sansome Street SAN FRANCISCO,CA941113123	94-1750717	501(c)(3)	40,000	0	N/A	N/A	Community Health
(270) Senior Citizens Legal Services 501 SOQUEL AVEnue SuiTE F SANTA CRUZ,CA95062	94-2280258	501(c)(3)	27,750	0	N/A	N/A	Community Health
(271) Senior Services For Northern California 1525 Post Street SAN FRANCISCO,CA941096567	94-6615829	501(c)(3)	25,000	0	N/A	N/A	Community Health
(272) Senoras Of Excellence Senores Of Distinction 1709 Shadow Mountain Place Las Vegas,NV89108	26-4252853	501(c)(3)	6,750	0	N/A	N/A	Community Health
(273) Sequoia Hospital Foundation 170 Alameda de Las Pulgas Redwood City,CA94062	94-2909990	501(c)(3)	1,681,913	0	N/A	N/A	Foundation Support
(274) Serotonin Surge Charities 1955 COWELL Boulevard DAVIS,CA95616	68-0411254	501(c)(3)	35,000	0	N/A	N/A	Community Health
(275) Servants Of Mary Ministers To The Sick 140 North G Street OXNARD,CA93030	95-6054374	501(c)(3)	12,000	0	N/A	N/A	Community Health
(276) Service First Of Northern Ca 102 W Bianchi Road STOCKTON,CA95207	68-0367046	501(c)(3)	15,000	0	N/A	N/A	Community Health
(277) SF General Hospital Foundation 2789 25th Street SAN FRANCISCO,CA94110	94-3189424	501(c)(3)	2,500,000	0	N/A	N/A	Community Health
(278) SF SB Committee Inc 555 Mission Street Suite 3000 SAN FRANCISCO,CA94105	46-1177365	501(c)(6)	37,500	0	N/A	N/A	Community Health
(279) Shanti Project Inc 730 Polk Street SAN FRANCISCO,CA941097813	94-2297147	501(c)(3)	25,000	0	N/A	N/A	Community Health
(280) Shasta Community Health Center 1035 Placer Street REDDING,CA96001	68-0165855	501(c)(3)	50,000	0	N/A	N/A	Community Health
(281) Shasta County Health And Human Services Agency 1855 PLACER STreet SUITE 201 REDDING,CA96001	94-6000535	Govt	20,000	0	N/A	N/A	Community Health
(282) Shasta County Young Mens Christian Association 1155 COURT Street REDDING,CA96001	94-1212141	501(c)(3)	10,000	0	N/A	N/A	Community Health
(283) Shasta Senior Nutrition Program 100 Mercy Oaks Drive Redding,CA96003	94-2650429	501(c)(3)	331,760	0	N/A	N/A	Community Health
(284) Shasta Women'S Refuge 2880-A Benton Drive REDDING,CA96003	94-2663045	501(c)(3)	35,000	0	N/A	N/A	Community Health
(285) Sierra Foothills Aids Foundation 12183 Locksley Lane Suite 208 AUBURN,CA95602	68-0179770	501(c)(3)	20,000	0	N/A	N/A	Community Health related
(286) Sisters Of Mercy Of The Americas West Midwest Comm 360 Hamilton Suite 2 SAN FRANCISCO,CA94134	26-2400800	501(c)(3)	40,000	0	N/A	N/A	Community Health
(287) Sisters Of St Dominic Congregation Of The Most Hol 1520 Grand Avenue SAN RAFAEL,CA949012236	94-6080138	501(c)(3)	25,000	0	N/A	N/A	Community Health
(288) Sisters Of St Francis - Mt Alvernomarian Residence 124 S College Drive SANTA MARIA,CA94064	20-4019358	501(c)(3)	25,000	0	N/A	N/A	Community Health
(289) SLO Noor Foundation 1428 Phillips Lane Suite B4 SAN LUIS OBISPO,CA93401	27-1412176	501(c)(3)	22,000	0	N/A	N/A	Community Health
(290) Social Advocates For Youth Santa Maria Valley Yout 105 N Lincoln SANTA MARIA,CA93458	95-3144808	501(c)(3)	15,000	0	N/A	N/A	Community Health
(291) South Central Family Health Center 1111 E Vernon Avenue LOS ANGELES,CA90011	95-3877793	501(c)(3)	18,400	0	N/A	N/A	Community Health
(292) Southeast Asian Assistance Center 5625 24Th Street SACRAMENTO,CA95822	68-0227882	501(c)(3)	40,000	0	N/A	N/A	Community Health
(293) Southwest Behavioral Health Services Inc 3450 N 3Rd Street PHOENIX,AZ85012	86-0290033	501(c)(3)	39,000	0	N/A	N/A	Community Health
(294) Southwest Human Development 2850 N 24Th Street PHOENIX,AZ85008	86-0407179	501(c)(3)	43,731	0	N/A	N/A	Community Health
(295) Special Olympics Southern California Inc 615 S McClelland SANTA MARIA,CA93454	95-4538450	501(c)(3)	16,650	0	N/A	N/A	Community Health
(296) Spelman College 350 Spelman Lane SW Box 616 ATLANTA,GA303144399	58-0566243	501(c)(3)	173,836	0	N/A	N/A	Education Support
(297) St Anthony Foundation 150 Gold Gate Avenue SAN FRANCISCO,CA94102	94-1513140	501(c)(3)	201,000	0	N/A	N/A	Community Health
(298) St Barnabas Senior Services Of Los Angeles 675 S Carondelet Street LOS ANGELES,CA90057	95-1641435	501(c)(3)	18,000	0	N/A	N/A	Community Health
(299) St Bernardine Medical Center Foundation 2101 N Waterman Avenue San Bernadino,CA92404	23-7440086	501(c)(3)	883,990	0	N/A	N/A	Foundation Support
(300) St Jeanne De Lestonnac Free Clinic 1215 E Chapman Avenue ORANGE,CA92866	95-3499011	501(c)(3)	13,750	0	N/A	N/A	Community Health
(301) St John's Healthcare Foundation 1600 NORTH ROSE AVEnue OXNARD,CA93030	20-2865781	501(c)(3)	1,246,328	0	N/A	N/A	Foundation Support
(302) St Joseph High School 4120 S BRADLEY ROAD Santa Maria,CA93455	95-2315939	501(c)(3)	7,402	0	N/A	N/A	EDUCATION SUPPORT
(303) St Joseph Parish School 2460 GOLD STREET REDDING,CA96001	94-1337645	501(c)(3)	5,500	0	N/A	N/A	Education Support
(304) St Joseph's Foundation 350 West Thomas Road Phoenix,AZ85013	94-2941245	501(c)(3)	1,696,480	0	N/A	N/A	Foundation Support
(305) St Joseph's Foundation Of San Joaquin 1800 N California Street Stockton,CA95204	51-0432777	501(c)(3)	892,076	0	N/A	N/A	Foundation Support
(306) St Mary Medical Center Foundation 1050 Linden Avenue Long Beach,CA90801	23-7153876	501(c)(3)	2,127,108	0	N/A	N/A	Foundation Support
(307) St Mary's Dining Room 545 W SONORA Street STOCKTON,CA95203	94-2687280	501(c)(3)	67,379	0	N/A	N/A	Community Health
(308) St Mary's Medical Center Foundation 450 Stanyan Street San Francisco,CA94117	94-3336143	501(c)(3)	1,109,077	0	N/A	N/A	Foundation Support
(309) St Rose Dominican Health Foundation 102 East Lake Mead Parkway Henderson,NV89015	88-0349432	501(c)(3)	2,606,318	0	N/A	N/A	Foundation Support small equipment
(310) Stockton Shelter For The Homeless PO Box 4803 STOCKTON,CA95204	68-0095693	501(c)(3)	13,000	0	N/A	N/A	Community Health hygiene items/ pamphlet rack
(311) Suicide Prevention Of Yolo County Inc PO Box 622 DAVIS,CA95617	94-2619492	501(c)(3)	15,000	0	N/A	N/A	Community Health
(312) Sustainable Economic Enterprise Of Los Angeles 6255 Sunset Boulevard Suite 714 LOS ANGELES,CA90028	95-4597000	501(c)(3)	20,000	0	N/A	N/A	Community Health
(313) Tarzana Treatment Centers 18646 Oxnard Street TARZANA,CA91356	94-2219349	501(c)(3)	50,000	0	N/A	N/A	Community Health
(314) Tempe Community Action Agency 2150 E Orange Street TEMPE,AZ85281	86-0254820	501(c)(3)	33,333	0	N/A	N/A	Community Health
(315) The Arc Of Amador & Calaveras 75 Academy Drive SUTTER CREEK,CA95685	23-7312930	501(c)(3)	6,000	0	N/A	N/A	Community Health
(316) The Board Of Trustees Of The Leland Stanford Junio 1265 Welch Road MC 5415 STANFORD,CA94305	94-1156365	501(c)(3)	650,100	0	N/A	N/A	Community Health
(317) The Community Service Education And Research Fund 5380 ELVAS AVEnue SACRAMENTO,CA95819	23-7003581	501(c)(3)	15,000	0	N/A	N/A	Community Health
(318) The Friendship Club 138 New Mohawk Road Suite 275 NEVADA CITY,CA95959	68-0262000	501(c)(3)	10,000	0	N/A	N/A	Community Health
(319) The Public Good Projects Inc 105 Madison Ave 11Th Floor NEW YORK,NY10016	46-2717584	501(c)(3)	1,000,000	0	N/A	N/A	Community Health
(320) The Salvation Army 900 W James M Wood Boulevard LOS ANGELES,CA90015	94-1156347	501(c)(3)	53,000	0	N/A	N/A	Community Health
(321) The Shade Tree Inc PO Box 669 LAS VEGAS,NV89125	88-0253276	501(c)(3)	20,000	0	N/A	N/A	Community Health
(322) The UC Davis Foundation 4610 X Street Suite 4202 SACRAMENTO,CA95817	94-6081352	501(c)(3)	28,702	0	N/A	N/A	Community Health
(323) University Of Arizona 100 West Washington 13th floor Phoenix,AZ85003	74-2652689	Govt	13,920,000	0	N/A	N/A	Education Support
(324) The Valley Economic Alliance 5121 VAN NUYS Boulevard SuiTE 200 Sherman Oaks,CA914031497	95-4524503	501(c)(3)	14,800	0	N/A	N/A	Community Health
(325) Town Of Gilbert -Gilbert Fire Department 85 E Civic Center Drive Gilbert,AZ85296	86-6000246	GOVT	14,500	0	N/A	N/A	Community Health
(326) Transitional Living & Community Support 2777 Fair Oaks Boulevard Suite 4440 SACRAMENTO,CA95825	94-2777955	501(c)(3)	50,000	0	N/A	N/A	Community Health
(327) Iu-Mien Community Services PO Box 245693 SACRAMENTO,CA95824	68-0364879	501(c)(3)	20,000	0	N/A	N/A	Community Health
(328) United States Veterans Initiative 800 W 6Th Street Suite 1505 LOS ANGELES,CA90017	95-4382752	501(c)(3)	15,000	0	N/A	N/A	Community Health
(329) United Way 5405 Stockdale Highway Suite 200 BAKERSFIELD,CA933092560	95-2274560	501(c)(3)	44,000	0	N/A	N/A	Community Health
(330) United Way Of Merced County 658 W Main Street MERCED,CA95348	94-2633265	501(c)(3)	50,000	0	N/A	N/A	Community Health
(331) United Way Of Santa Cruz County 4450 Capitola Road Suite 106 CAPITOLA,CA95010	94-1422471	501(c)(3)	56,771	0	N/A	N/A	Community Health
(332) University Foundation At Sacramento State 6000 J Street SACRAMENTO,CA958196026	94-3001359	501(c)(3)	100,000	0	N/A	N/A	Education Support
(333) University Of The Pacific 3601 Pacific Avenue STOCKTON,CA95211	94-1156266	501(c)(3)	24,250	0	N/A	N/A	Education Support
(334) Unlv Foundation 4505 S Maryland Parkway Box 451006 Las Vegas,NV891541006	94-2790134	501(c)(3)	48,715	0	N/A	N/A	Education Support
(335) Valley Of The Sun Young Mens Christian Association 1655 W Frye Road CHANDLER,AZ85224	86-0096799	501(c)(3)	22,500	0	N/A	N/A	Community Health
(336) Valley Vision Inc 1900 S Street SACRAMENTO,CA95814	94-3214572	501(c)(3)	10,000	0	N/A	N/A	Community Health
(337) Vision Y Compromiso 1000 N Alameda Street Suite 350 LOS ANGELES,CA90012	32-0071651	501(c)(3)	5,900	0	N/A	N/A	Community Health
(338) Volunteers In Medicine Of Southern Nevada Inc 4770 Harrison Drive Suite 200 LAS VEGAS,NV89121	39-2072453	501(c)(3)	81,593	0	N/A	N/A	Community Health
(339) Volunteers In Victims Assistance 2020 Hurley Way Suite 205 SACRAMENTO,CA95814	68-0000542	501(c)(3)	40,000	0	N/A	N/A	Community Health
(340) Weave Incorporated 1900 K Street SACRAMENTO,CA95814	94-2493158	501(c)(3)	50,000	0	N/A	N/A	Community Health
(341) Wellspace Health Family Service Agency 8912 VOLUNTEER Lane Suite 100 SACRAMENTO,CA95826	94-1713704	501(c)(3)	1,213,232	0	N/A	N/A	Community Health
(342) Westcare Nevada Inc PO Box 94738 Las Vegas,NV89123	94-2778981	501(c)(3)	52,429	0	N/A	N/A	Community Health
(343) Western Sierra Medical Clinic Inc 1345 Whispering Pines GRASS VALLEY,CA95945	94-2279011	501(c)(3)	13,333	0	N/A	N/A	Community Health
(344) Westside Neighborhood Clinic 2125 Santa Fe Avenue LONG BEACH,CA90810	95-2973364	501(c)(3)	20,000	0	N/A	N/A	Community Health
(345) Willie L Brown Jr Center On Politics And Public Se 100 Embarcadero Penthouse SAN FRANCISCO,CA94105	42-1572763	501(c)(3)	10,000	0	N/A	N/A	Community Health
(346) Women's Shelter Program Of San Luis Obispo County PO Box 125 SAN LUIS OBISPO,CA93406	95-3370729	501(c)(3)	7,745	0	N/A	N/A	Community Health
(347) Woodland Memorial Hospital Foundation 1321 Cottonwood Street Woodland,CA95695	94-6167964	501(c)(3)	463,900	0	N/A	N/A	Foundation Support
(348) Yolo Community Care Continuum PO Box 1101 DAVIS,CA95617	94-2623205	501(c)(3)	20,000	0	N/A	N/A	Community Health
(349) Yolo County Children's Alliance 600 A STreet SuiTE Y DAVIS,CA95616	68-0526185	501(c)(3)	15,000	0	N/A	N/A	Community Health
(350) Yolo Family Resource Center 828 COURT Street WOODLAND,CA95695	47-0871252	501(c)(3)	20,000	0	N/A	N/A	Community Health
(351) Young Mens Christian Association Of San Joaquin Co 6135 Tam OShanter Drive STOCKTON,CA95210	94-1156319	501(c)(3)	65,000	0	N/A	N/A	Community Health
(352) Ywca Of Glendale California 735 E Lexington Drive GLENDALE,CA91206	95-1644057	501(c)(3)	20,000	0	N/A	N/A	Community Health
(353) Dignity Health Foundation 185 Berry Street San Francisco,CA94107	46-2037641	501(C)(3)	809,464	0	N/A	N/A	Foundation Support

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

345

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

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

Cat. No. 50055P

Schedule I (Form 990) 2013

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) DIRECT CASH ASSISTANCE	2534	12,462	0	N/A	N/A
(2) FINANCIAL ASSISTANCE TO PATIENTS/NEEDY	7262	401,605	0	N/A	N/A
(3) SCHOLARSHIP	128	57,650	0	N/A	N/A
(4) SPONSORSHIP OF MEDICAL CONFERENCE	1	10,000	0	N/A	N/A
(5) DONATION OF CLOTHING/OTHER TO PATIENTS/NEEDY	6738	0	60,354	COST	CLOTHING, CAR SEATS
(6) MEDICAL SUPPLIES/EQUIPMENT TO INDIGENTS	115	0	57,970	BOOK	MEDICAL SUPPLIES
(7) PHARMACY CHARITY PRESCRIPTION	532	0	24,960	COST	PHARMACEUTICALS
(8) PROVISION OF FOOD/MEALS	87590	0	331,748	COST	FOOD/MEALS

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

Part I, line 1

INCLUDED IN PART II ABOVE IS $4,723,108 RELATED TO The Dignity Health Community Grants program. THIS PROGRAM IS one way in which Dignity Health supports and enhances the advocacy, social justice and healthier communities efforts of its hospitals and the religious sponsors of our Catholic hospitals. Begun in 1990, the program's initial objectives were: (1) to strengthen the bonds among our member hospitals; and (2) to partner with other nonprofit organizations that share our values and also work to improve the health status and quality of life of the communities we serve. Each of the grant recipients are required to submit an annual accountability report to Dignity Health. The reports reflect activities performed, objectives, and outcomes reached by the grant recipientS. All organizations that apply for these grants are required to be a 501(c)(3) organization. OTHER GRANTS ARE PROVIDED BY Dignity Health (AND ITS MEMBER HOSPITALS) TO NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER Dignity Health'S EXEMPT PURPOSE. GRANTS ARE ALSO PROVIDED TO THE FUNDRAISING FOUNDATIONS THAT SUPPORT Dignity Health AND ITS MEMBER HOSPITALS TO FUND THE OPERATIONS OF THOSE FOUNDATIONS. Several grants are provided to other organizations in which Dignity Health supports community efforts. In addition, grants are provided to individuals, primarily patients, due to financial need or urgent, unforeseen occurrences requiring immediate action. Examples of assistance include transportation costs to a hospital for treatment, pharmacy costs for indigent patients, and sheltered meals. The grants are approved by the hospital's Administration department or a designated committee reviews and approves grants to be awarded.

Part II

$6,576,221 IN GRANT PAYMENTS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST, A 501(C)(3) PUBLIC BENEFIT CHARITY ESTABLISHED TO SPONSOR AND SUPPORT HEALTH CARE, WERE RECOGNIZED IN CONNECTION WITH THE CALIFORNIA PROVIDER FEE PROGRAMS IN FISCAL YEAR 2014. IN ADDITION, $13,920,000 IN GRANT PAYMENTS WERE ALSO PROVIDED TO UNIVERSITY OF ARIZONA, A GOVERNMENT INSTITUTION, TO SUPPORT THE DEVELOPMENT OF EDUCATION, TRAINING AND CLINICAL RESEARCH PROGRAMS.

Schedule I (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

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

Yes

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

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

Yes

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

Yes

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

Cat. No. 50053T

Schedule J (Form 990) 2013

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)Lloyd H DeanBOARD MEMBER/PRESIDENT/CEO	(i) (ii)	1,581,557 0	5,076,340 0	259,494 0	1,045,513 0	94,476 0	8,057,380 0	231,775 0
(2)Michael D BlaszykSEVP, Chief Financial Officer	(i) (ii)	883,634 0	2,227,020 0	418,194 0	521,207 0	65,132 0	4,115,187 0	394,020 0
(3)Rick GrossmanEVP General Counsel	(i) (ii)	410,854 0	337,117 0	89,550 0	141,422 0	55,503 0	1,034,446 0	0 0
(4)Diane LeeVP & Associate General Counsel	(i) (ii)	268,520 0	250,388 0	14,305 0	38,445 0	27,416 0	599,074 0	0 0
(5)Marvin O'QuinnSEVP, Chief Operating Officer	(i) (ii)	918,044 0	1,908,776 0	73,163 0	1,056,836 0	65,383 0	4,022,202 0	0 0
(6)Elizabeth ShihEVP, Chief Admin Officer	(i) (ii)	755,075 0	1,815,344 0	62,071 0	159,880 0	69,509 0	2,861,879 0	0 0
(7)Steven BarronSVP, Operations So Cal East	(i) (ii)	387,195 0	511,976 0	35,898 0	53,943 0	49,257 0	1,038,269 0	0 0
(8)Keith CallahanSVP, Supp & Srvcs Resrcs Mgmt	(i) (ii)	354,084 0	367,404 0	34,435 0	51,105 0	32,985 0	840,013 0	0 0
(9)Mary ConnickSVP Finance, Corporate Control	(i) (ii)	369,318 0	398,668 0	11,693 0	53,424 0	37,699 0	870,802 0	0 0
(10)Charles P FrancisSEVP, CHIEF STRATEGY OFFICER	(i) (ii)	630,480 0	1,014,102 0	149,523 0	201,148 0	60,917 0	2,056,170 0	135,296 0
(11)Lisa Gamshad ZuckermanVP, Treasury Services	(i) (ii)	323,343 0	309,809 0	3,493 0	45,782 0	46,811 0	729,238 0	0 0
(12)Linda HuntSVP Operations - Arizona	(i) (ii)	564,849 0	699,467 0	666,864 0	82,535 0	42,679 0	2,056,394 0	643,684 0
(13)Jeffrey W LandVP Corporate Real Estate	(i) (ii)	318,906 0	290,570 0	4,164 0	43,783 0	44,322 0	701,745 0	0 0
(14)Bernita McTernanEVP/SPONSORSHIP/MISSION INTEGR	(i) (ii)	512,902 0	984,730 0	43,573 0	96,944 0	62,562 0	1,700,711 0	0 0
(15)Timothy PanksSVP Finance & Rev Cycle Mgmt	(i) (ii)	291,661 0	161,788 0	110,006 0	34,471 0	34,004 0	631,930 0	0 0
(16)Darryl RobinsonEVP/ Chief HR Officer	(i) (ii)	195,512 0	771,000 0	1,460 0	114,562 0	8,020 0	1,090,554 0	0 0
(17)Karl SilbersteinSVP Financial Operations	(i) (ii)	550,768 0	588,754 0	19,992 0	75,024 0	44,182 0	1,278,720 0	0 0
(18)Michael TaylorSVP OPERATIONS-SAC/SAN JOAQUIN	(i) (ii)	556,342 0	841,793 0	272,644 0	90,220 0	40,863 0	1,801,862 0	0 0
(19)LeAnne TrachokSVP, Revenue Services	(i) (ii)	324,928 0	448,957 0	18,540 0	53,813 0	22,740 0	868,978 0	0 0
(20)Karl Ulrich MDInterim SVP Ops Sac-San Joaqui	(i) (ii)	530,669 0	146,559 0	48,105 0	41,168 0	34,251 0	800,752 0	0 0
(21)Glenna L VaskelisSVP Operations- Bay Area	(i) (ii)	425,579 0	447,647 0	21,106 0	59,281 0	51,828 0	1,005,441 0	0 0
(22)Robert Wiebe MDEVP CHIEF MEDICAL OFFICER	(i) (ii)	679,154 0	1,083,023 0	15,996 0	878,646 0	27,445 0	2,684,264 0	0 0
(23)Tammara WilcoxSVP, Managed Care	(i) (ii)	406,391 0	418,835 0	3,945 0	56,691 0	36,380 0	922,242 0	0 0
(24)Deanna WiseEVP, Chief Information Officer	(i) (ii)	560,543 0	858,452 0	1,878 0	232,165 0	28,715 0	1,681,753 0	0 0
(25)Charles CovaSVP Operations- Central Coast	(i) (ii)	390,630 0	474,385 0	27,526 0	58,884 0	29,188 0	980,613 0	0 0
(26)Laurie HartingSVP Operations- So Cal West	(i) (ii)	393,853 0	536,888 0	31,344 0	63,063 0	27,483 0	1,052,631 0	0 0
(27)Daniel RoachVP Compliance and Audit	(i) (ii)	374,953 0	458,873 0	6,426 0	57,032 0	44,263 0	941,547 0	0 0
(28)Hillery TrippeVP, Risk Services	(i) (ii)	163,036 0	26,799 0	716,763 0	19,225 0	13,780 0	939,603 0	0 0
(29)Jon VanBoeningSVP Operations- Central Valley	(i) (ii)	426,681 0	466,938 0	27,400 0	60,419 0	50,299 0	1,031,737 0	0 0
(30)Derek F CovertFormer Officer	(i) (ii)	61,922 0	0 0	2,113,998 0	7,788 0	5,810 0	2,189,518 0	2,013,000 0
(31)Rodney A DavisFormer Key Employee	(i) (ii)	464,803 0	502,216 0	154,643 0	65,349 0	36,532 0	1,223,543 0	119,689 0
(32)Saliba SaloFormer Key Employee	(i) (ii)	376,312 0	154,225 0	24,870 0	39,595 0	46,338 0	641,340 0	0 0
(33)Herbert VallierFormer EVP-Chief HR Officer	(i) (ii)	62,337 0	0 0	79,017 0	3,784 0	5,771 0	150,909 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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.

Return Reference

Explanation

Sch J, PART I, LINES 1A, 4A, & 4B

PART I, 1A First class travel and upgrades to such are treated on an exception basis according to Dignity Health policy. Such travel totaling $40,868 was provided to five officers, directors and key employees. No amounts have been included as reportable compensation as these travel expenses were incurred for business purposes. There was no charter travel in 2013. Tax gross-up payments were provided to one officer and one key employee related to relocation expenses and/or forgiveness of relocation loans based on service requirements met. These gross up payments were included as taxable compensation to the listed persons. Club dues have been paid by Dignity Health for business use by four key and highest compensated employees. No amounts have been included as reportable income as expenses related to personal usage, if any, are paid by these employees. No amount has been paid for club dues for officers. Dignity Health does not pay or reimburse for any health club memberships. PART I, 4A Dignity Health's key employees and officers and certain highly compensated employees participate in a severance plan that provides market-standard compensation, ranging from payments of 6 months to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. Payments pursuant to the plan arrangement for one highest compensated employee occurred during 2013 related to such terminations: H. Trippe, $626,777. PART I, 4B Certain officers and key employees participate in the Dignity Health Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the Dignity Health Retirement Plan whose benefits are affected by the limitations imposed by sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. Payments pursuant to the plan arrangement for one former officer occurred during 2013: D. Covert, $2,013,000. Dignity Health's key employees and certain officers and highly compensated employees are eligible to participate in one of two non-qualified 457(f) plans that are subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is for executives hired prior to June 30, 2006. The benefit is intended to bridge the difference, if any, between the benefit provided under the Dignity Health Excess Benefit Plan had benefit service not been frozen at January 1, 2008, and the benefits provided from all other qualified and non-qualified plans. No benefit will vest under this 457(f) plan before the attainment of age 62 or the completion of 15 years of service. The 2010 Executive Deferred Compensation Plan is for certain officers and key employees, primarily those who are not eligible to participate in the Dignity Health Excess Benefit Plan or the 2007 Executive Deferred Compensation Plan described above. This benefit provides an annual accrual of 10% of total compensation and is payable annually on July 1 once vested, which is age 62 with 5 years of service. Payments pursuant to the plan arrangements for one board member/officer and two key employees occurred during 2013 L. Dean, $231,775; R. Davis, $119,689; and L. Hunt, $643,684. Certain listed persons participate in the Dignity Health Key Employee Share Option Plan (KeySOP), which was frozen in May 2002. The KeySOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. There were no payments related to this plan in 2013. Certain officers and key employees participate in the Dignity Health Supplemental Executive Retention/Retirement Plan, a nonqualified supplemental benefit plan which in 2002 was offered to members of the executive management team by the Dignity Health Board of Directors and would be paid only if the executives stayed with the organization for a specified number of years as the primary purpose of this plan is to provide for the retention and retirement of the participants. The executive management team was recruited from stable careers in organizations from across the country and from various industries to engineer and lead a financial and operational turnaround after the organization had lost nearly $1 billion in net operating performance. The calculation for the payments to each executive is based on the value of a final average pay annuity benefit based on retirement age and service years to the organization. Distribution occurs each July 1 if the plan formula warrants a payment. Payments made during 2013 pursuant to this plan include $394,020 to M. Blaszyk and $135,296 to C. Francis. Vested amounts are reported as deferred compensation in the year vesting occurs (Schedule J, Part II, column C) and are reflected again as reportable compensation in the year paid (Schedule J, Part II, column B(iii)). PART I, 8 Dignity Health entered into an employment contract with a key employee in 2013 that is subject to the initial contract exception described in Regulations section 53.4958-4(a)(3). The employment contract represents an initial contract under which the key employee receives fixed payments, and as such, is not subject to section 4958.

Sch J - PART II

Dignity Health's executive compensation philosophy is designed to assist Dignity Health in attracting and retaining the caliber of executives required to enable Dignity Health to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities Dignity Health serves, promoting patient and employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Human Resources and Compensation Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and Dignity Health's commitment to serving the poor and disenfranchised in the communities it serves. Total compensation, which includes base salary, annual and long-term incentive compensation, is established to approximate the prevailing market conditions for executives of companies of similar size and revenue.

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FRT9	04-28-2004	470,300,483	BOND A: CUSIP 13033FRT9-SEE PRT VI	X			X		X
B	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816GY4	04-28-2004	259,114,410	BOND B: CUSIP 566816GY4-SEE PRT VI	X			X		X
C	CITY OF HENDERSON NEVADA	88-6000720	425203BM7	04-28-2004	166,163,811	BOND C: CUSIP 425203BM7-SEE PRT VI	X			X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FTN0	05-19-2004	150,000,000	BOND D: CUSIP 13033FTN0-SEE PRT VI		X		X	X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FG46	11-10-2005	351,135,742	BOND E: CUSIP 13033FG46-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FYE4	11-10-2005	200,000,000	BOND F: CUSIP 13033FYE4-SEE PRT VI		X		X	X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507GL3	11-10-2005	224,000,000	BOND G: CUSIP 040507GL3-SEE PRT VI		X		X	X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DH7	04-26-2007	400,000,000	BOND H: CUSIP 130795DH7-SEE PRT VI	X			X		X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DR5	04-26-2007	276,250,000	BOND I: CUSIP 130795DR5-SEE PRT VI		X		X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816HP2	04-26-2007	178,702,052	BOND J: CUSIP 566816HP2-SEE PRT VI	X			X		X
	CITY OF RENO NEVADA	88-6000201	759835AA9	04-26-2007	98,635,589	BOND K: CUSIP 759835AA9-SEE PRT VI	X			X		X
	CITY OF HENDERSON NEVADA	88-6000720	425203CF1	04-26-2007	200,626,751	BOND L: CUSIP 425203CF1-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LAZ0	05-14-2009	457,778,078	BOND M: CUSIP 13033LAZ0-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816JJ4	05-14-2009	127,153,706	BOND N: CUSIP 566816JJ4-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LEQ6	11-12-2009	235,106,175	BOND O: CUSIP 13033LEQ6-SEE PRT VI	X			X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MJ1	11-12-2009	75,689,293	BOND P: CUSIP 040507MJ1-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	88-0445263	566816JL9	07-14-2011	115,008,059	BOND Q: CUSIP 566816JL9-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LSZ1	11-09-2011	515,217,012	BOND R: CUSIP 13033LSZ1-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MU6	11-09-2011	125,000,601	BOND S: CUSIP 040507MU6-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LUD7	06-27-2012	140,000,000	BOND T: CUSIP 13033LUD7-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MV4	06-27-2012	75,000,000	BOND U: CUSIP 040507MV4-SEE PRT VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	395,000		235,000		720,000		0
2 Amount of bonds legally defeased . . . . . . . . . . .	362,375,000		175,000,000		125,000,000		0
3 Total proceeds of issue . . . . . . . . . . . . . .	473,075,038		268,026,055		171,864,069		143,115,163
4 Gross proceeds in reserve funds . . . . . . . . . . . .	7,910,480		8,557,517		4,164,721		0
5 Capitalized interest from proceeds . . . . . . . . . . .	6,640,000		0		5,184,771		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	4,074,727		2,542,136		1,638,159		0
8 Credit enhancement from proceeds . . . . . . . . . . .	25,069,705		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	7,774,075		6,949,390		2,791,982		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		158,912,634		109,338,989		121,926,573
11 Other spent proceeds . . . . . . . . . . . . . .	421,606,051		74,718,546		48,745,447		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		16,345,832		0		21,188,590
13 Year of substantial completion . . . . . . . . . . . .	2004		2006		2007		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X			X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0.400 %		0.100 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0.700 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0.400 %		0.100 %		1.500 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %		0 %		0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X		X			X
b Name of provider . . . . . . . . .	CITIGROUP & JPMORGAN		JP MORGAN		CITIGROUP
c Term of hedge . . . . . . . . . .	21.2		5.		5.		34.2
d Was the hedge superintegrated? . . . .		X		X		X		X
e Was the hedge terminated? . . . . . .	X		X		X		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X		X		X			X
b Name of provider . . . . . . . . .	LEHMAN BROTHERS		LEHMAN BROTHERS		LEHMAN BROTHERS		0
c Term of GIC . . . . . . . . . .	22.2		22.2		23.2
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A: CUSIP 13033FRT9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund prior bond issues - California Health Facilities Financing Authority ("CHFFA") 1988 AB (issued June 23, 1988) CHFFA 1992 A (issued September 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (issued January 4, 1994); California Statewide Communities Development Authorities ("CSCDA") 1993 A Certificates of Participation ("COPs") (issued August 12, 1993); CHFFA 1994 AB (issued January 27, 1994); CHFFA 1996 B (issued May 30, 1996); CHFFA 1996 CD (issued May 30, 1996); CHFFA 1996 F (issued December 12, 1996); CHFFA 1997 ABC (issued October 15, 1997); CHFFA 1998 A (issued December 3, 1998). Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND B: CUSIP 566816GY4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1993 A (issued August 12, 1993); AZ 1994 A (issued January 27, 1994); and to finance capital expenditures for construction of Mercy Gilbert and add a new tower at St. Joseph's Hospital and Medical Center. Part II, Line 13 The Industrial Development Authority of Maricopa County (IDAMC) 2004 SERIES AB construction fund proceeds were spent by 2006 on projects that were substantially completed by that date. In March 2009, the IDAMC 2004 Series B bonds were refinanced with a draw on a taxable line of credit, and in May 2009, a portion of the draw on the line was refinanced with tax-exempt debt. In March 2009, approximately $17 million was released from debt service reserve funds, a portion of which is allocable to the un-refinanced portion of the taxable line of credit and a portion of which is allocable to the May 2009 tax-exempt bonds. Such funds are currently unspent and will be used either for capital projects or to redeem or defease May 2009 bonds. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND C: CUSIP 425203BM7	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues NV 1994 A (issued January 27, 1994) and NV 1998 A (issued December 3, 1998) to finance capital expenditures for the construction of a new hospital, St. Rose Dominican Hospital - San Martin Campus. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5a Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND D: CUSIP 13033FTN0	Part I, column (c) The CHFFA 2004 Series J bonds were exchanged in November 2009 for the CHFFA 2009 Series H bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In May 2013, all of the loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $143,112,407 to finance the construction/renovation of facilities and the acquisition of medical equipment at various hospitals. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND E: CUSIP 13033FG46	Part I, Column (c) The CHFFA 2005 Series ABCDEF bonds were exchanged in May 2008 for the CHFFA 2008 Series FHIJKL bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CHFFA 1988 Series A (issued December 3, 1998); CHFFA 1995 Series H (issued May 25, 1995); CHFFA 1997 Series A (issued October 15, 1997); CHFFA 1998 Series A (issued December 3, 1998); CSCDA 1999 (issued December 9, 1999) and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 11/2/2010. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND F: CUSIP 13033FYE4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In October 2012, certain loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $147,665,635 to finance the construction/renovation of the facilities and the acquisition of medical equipment at various hospitals. $15,000,000 of the loan pool remained the same and was not required to repurpose the assets. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated.
BOND G: CUSIP 040507GL3	Part I, Column (c) The Arizona Health Facility Authority (AHFA) 2005 Series CDE bonds were exchanged in May 2008 for the AHFA 2008 Series ABC Bonds and November 2009 the AHFA 2008 Series ABC bonds and November 2009 the AHFA 2008 Series C bonds were exchanged in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. AHFA 2005 Series BCDE, of which AHFA 2005 Series CDE were exchanged for AHFA 2008 Series ABC, of which AHFA 2008 Series C was exchanged for AHFA 2009 Series F. The CUSIP number noted on Schedule K '040507GL3' is the CUSIP from the original Form 8038 filed for the 2005 Series BCDE Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the AHFA 2005 CDE Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for AHFA 2008 Series ABC. The AHFA 2008 Series C Bonds were later exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for the AHFA 2009 Series F Bonds on November 12, 2009. All the series noted above have the same maturity of July 1, 2035. The CUSIPs of the outstanding bonds are AHFA 2005 Series B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' and AHFA 2009 Series F '040507MK8.' Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of the loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 1/28/2014. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND H: CUSIP 130795DH7	Part I, column (c) The CSCDA 2007 Series ABC bonds were exchanged in May 2008 for the CSCDA 2008 Series CFG bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CA 1995 A (issued May 25, 1995); CA 1996 A (issued May 30, 1996); and CA 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to CSCDA 2007 Series ABC, such hedges were deemed terminated May 16, 2008 (CSCDA 2007 Series A were later exchanged for CSCDA 2008 Series C fixed rate bonds), May 14, 2009 (CSCDA 2007 Series C were exchanged without a reissuance for CSCDA 2008 Series G and later refinanced to CHFFA 2009 Series A fixed rate bonds) and November 12, 2009 (CSCDA 2007 Series B were exchanged without a reissuance for CSCDA 2008 Series F and later refinanced with CHFFA 2009 Series G put bonds) as a result of either the refinancing of these bonds or the exchange (without a reissuance) and conversion of these bonds into long-term fixed-rate bonds. The CSCDA DEF bonds are still outstanding and continue to have hedges associated with them. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND I: CUSIP 130795DR5	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (c) California Statewide Community Development Authority (CSCDA) 2007 Series G-L, of which CSCDA 2007 Series G-J were exchanged for CSCDA 2008 Series ABDE. The CUSIP number noted on Schedule K '130795DR5' is the CUSIP from the original Form 8038 filed for the 2007 Series G-L Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the CSCDA 2007 Series GHIJ Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for CSCDA 2008 Series ABDE, and there was an interest rate conversion on the CSCDA 2007 Series KL Bonds. The latest maturities on the currently outstanding exchanged bonds are the CSCDA 2007 Series KL Bonds, both of which have a final maturity date of July 1, 2041. The CUSIPs are '130795TV9' for the CSCDA 2007 Series K Bonds and '130795TW7' for the CSCDA Series 2007 L Bonds. The CSCDA 2007 Series GHIJ bonds were exchanged in May 2008 for the CSCDA 2008 Series ABDE bonds in an exchange pursuant to Notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (f) To finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2013.
BOND J: CUSIP 566816HP2	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND K: CUSIP 759835AA9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) To finance acquisition and renovation of hospital facility (including Emergency Room) and acquisition of medical equipment. Part III, Line 8A Although the City of Reno, Nevada, health facility revenue bonds, 2007 Series A (the "2007 Reno bonds"), are shown on line 1 of Part I of this Schedule K, Dignity Health and the City of Reno, Nevada (the "City"), took appropriate remedial action with respect to all of the 2007 Reno bonds, under section 1.141-12(d) of the treasury regulations, on September 24, 2012, by defeasing a pro rata portion of the 2007 Reno bonds, in the principal amount of $42,085,000, within 90 days of the sale by Dignity Health of Saint Mary's Regional Medical Center ("SMRMC"), in Reno, Nevada. Such defeasance will cause such portion of the 2007 Reno bonds to be redeemed on their first optional redemption date of July 1, 2017. Because the consideration for the sale of SMRMC was exclusively cash, pursuant to section 1.141-12(d)(2) of the treasury regulations, Dignity Health and the City were permitted to meet, and met, the requirements of section 1.141-12(d) of the treasury regulations with respect to all of the 2007 Reno bonds by applying the "disposition proceeds" received from the sale of SMRMC to the defeasance of a pro rata portion of the 2007 Reno bonds through their first optional redemption date of July 1, 2017. Such pro rata portion of the 2007 Reno bonds was determined to have a principal amount of $42,085.000. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND L: CUSIP 425203CF1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - NV 1998 A (issued December 3, 1998); NV 1999 series A (issued December 9, 1999); NV 2004 Series B (issued April 28, 2004); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND M: CUSIP 13033LAZ0	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series CDE (issued May 16, 2008); and California Statewide Communities Development Authority 2008 Series G (issued May 16, 2008); and to finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND N: CUSIP 566816JJ4	Part I, Column (f) Refinance taxable line of credit used to refinance Industrial Development Authority of Maricopa County Arizona 2004 Series B bonds issued on April 28, 2004. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND O: CUSIP 13033LEQ6	Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series ABF; and California Statewide Communities Development Authority 2008 Series F bonds issued on May 16, 2008. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2011.
BOND P: CUSIP 040507MJ1	Part I, Column (f) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND Q: CUSIP 566816JL9	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 1992 Series A bonds issued on September 1, 1992 and Industrial Development Authority of Maricopa County Arizona 1998 Series A bonds issued on December 3, 1998.
BOND R: CUSIP 13033LSZ1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund CHFFA 1993 Series A bonds issued on March 17, 1993, CHFFA 1996 Series E bonds issued on December 12, 1996, CHFFA 1997 Series A bonds issued on October 15, 1997 and CHFFA 1998 Series A bonds Issued On December 3, 1998. Repay line of credit used to retire CHFFA 2004 Series H bonds issued on April 28, 2004. Finance capital projects at various hospital facilities. Part II, Line 11 Bond proceeds were used to pay off the CHFFA 2004 Series H put bond that came due on 7/1/2011 that was financed with a draw on the working line of credit. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND S: CUSIP 040507MU6	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f)Finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND T: CUSIP 13033LUD7	Part I, Column (f) Refund CHFFA 2009 Series BC bonds issued on May 14, 2009 and CHFFA 2009 Series G bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND U: CUSIP 040507MV4	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 2009 Series B bonds issued on May 14, 2009 and Arizona Health Facilities Financing Authority 2009 Series E bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FRT9	04-28-2004	470,300,483	BOND A: CUSIP 13033FRT9-SEE PRT VI	X			X		X
B	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816GY4	04-28-2004	259,114,410	BOND B: CUSIP 566816GY4-SEE PRT VI	X			X		X
C	CITY OF HENDERSON NEVADA	88-6000720	425203BM7	04-28-2004	166,163,811	BOND C: CUSIP 425203BM7-SEE PRT VI	X			X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FTN0	05-19-2004	150,000,000	BOND D: CUSIP 13033FTN0-SEE PRT VI		X		X	X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FG46	11-10-2005	351,135,742	BOND E: CUSIP 13033FG46-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FYE4	11-10-2005	200,000,000	BOND F: CUSIP 13033FYE4-SEE PRT VI		X		X	X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507GL3	11-10-2005	224,000,000	BOND G: CUSIP 040507GL3-SEE PRT VI		X		X	X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DH7	04-26-2007	400,000,000	BOND H: CUSIP 130795DH7-SEE PRT VI	X			X		X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DR5	04-26-2007	276,250,000	BOND I: CUSIP 130795DR5-SEE PRT VI		X		X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816HP2	04-26-2007	178,702,052	BOND J: CUSIP 566816HP2-SEE PRT VI	X			X		X
	CITY OF RENO NEVADA	88-6000201	759835AA9	04-26-2007	98,635,589	BOND K: CUSIP 759835AA9-SEE PRT VI	X			X		X
	CITY OF HENDERSON NEVADA	88-6000720	425203CF1	04-26-2007	200,626,751	BOND L: CUSIP 425203CF1-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LAZ0	05-14-2009	457,778,078	BOND M: CUSIP 13033LAZ0-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816JJ4	05-14-2009	127,153,706	BOND N: CUSIP 566816JJ4-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LEQ6	11-12-2009	235,106,175	BOND O: CUSIP 13033LEQ6-SEE PRT VI	X			X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MJ1	11-12-2009	75,689,293	BOND P: CUSIP 040507MJ1-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	88-0445263	566816JL9	07-14-2011	115,008,059	BOND Q: CUSIP 566816JL9-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LSZ1	11-09-2011	515,217,012	BOND R: CUSIP 13033LSZ1-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MU6	11-09-2011	125,000,601	BOND S: CUSIP 040507MU6-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LUD7	06-27-2012	140,000,000	BOND T: CUSIP 13033LUD7-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MV4	06-27-2012	75,000,000	BOND U: CUSIP 040507MV4-SEE PRT VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	395,000		235,000		720,000		0
2 Amount of bonds legally defeased . . . . . . . . . . .	362,375,000		175,000,000		125,000,000		0
3 Total proceeds of issue . . . . . . . . . . . . . .	473,075,038		268,026,055		171,864,069		143,115,163
4 Gross proceeds in reserve funds . . . . . . . . . . . .	7,910,480		8,557,517		4,164,721		0
5 Capitalized interest from proceeds . . . . . . . . . . .	6,640,000		0		5,184,771		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	4,074,727		2,542,136		1,638,159		0
8 Credit enhancement from proceeds . . . . . . . . . . .	25,069,705		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	7,774,075		6,949,390		2,791,982		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		158,912,634		109,338,989		121,926,573
11 Other spent proceeds . . . . . . . . . . . . . .	421,606,051		74,718,546		48,745,447		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		16,345,832		0		21,188,590
13 Year of substantial completion . . . . . . . . . . . .	2004		2006		2007		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X			X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0.400 %		0.100 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0.700 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0.400 %		0.100 %		1.500 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %		0 %		0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X		X			X
b Name of provider . . . . . . . . .	CITIGROUP & JPMORGAN		JP MORGAN		CITIGROUP
c Term of hedge . . . . . . . . . .	21.2		5.		5.		34.2
d Was the hedge superintegrated? . . . .		X		X		X		X
e Was the hedge terminated? . . . . . .	X		X		X		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X		X		X			X
b Name of provider . . . . . . . . .	LEHMAN BROTHERS		LEHMAN BROTHERS		LEHMAN BROTHERS		0
c Term of GIC . . . . . . . . . .	22.2		22.2		23.2
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A: CUSIP 13033FRT9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund prior bond issues - California Health Facilities Financing Authority ("CHFFA") 1988 AB (issued June 23, 1988) CHFFA 1992 A (issued September 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (issued January 4, 1994); California Statewide Communities Development Authorities ("CSCDA") 1993 A Certificates of Participation ("COPs") (issued August 12, 1993); CHFFA 1994 AB (issued January 27, 1994); CHFFA 1996 B (issued May 30, 1996); CHFFA 1996 CD (issued May 30, 1996); CHFFA 1996 F (issued December 12, 1996); CHFFA 1997 ABC (issued October 15, 1997); CHFFA 1998 A (issued December 3, 1998). Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND B: CUSIP 566816GY4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1993 A (issued August 12, 1993); AZ 1994 A (issued January 27, 1994); and to finance capital expenditures for construction of Mercy Gilbert and add a new tower at St. Joseph's Hospital and Medical Center. Part II, Line 13 The Industrial Development Authority of Maricopa County (IDAMC) 2004 SERIES AB construction fund proceeds were spent by 2006 on projects that were substantially completed by that date. In March 2009, the IDAMC 2004 Series B bonds were refinanced with a draw on a taxable line of credit, and in May 2009, a portion of the draw on the line was refinanced with tax-exempt debt. In March 2009, approximately $17 million was released from debt service reserve funds, a portion of which is allocable to the un-refinanced portion of the taxable line of credit and a portion of which is allocable to the May 2009 tax-exempt bonds. Such funds are currently unspent and will be used either for capital projects or to redeem or defease May 2009 bonds. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND C: CUSIP 425203BM7	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues NV 1994 A (issued January 27, 1994) and NV 1998 A (issued December 3, 1998) to finance capital expenditures for the construction of a new hospital, St. Rose Dominican Hospital - San Martin Campus. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5a Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND D: CUSIP 13033FTN0	Part I, column (c) The CHFFA 2004 Series J bonds were exchanged in November 2009 for the CHFFA 2009 Series H bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In May 2013, all of the loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $143,112,407 to finance the construction/renovation of facilities and the acquisition of medical equipment at various hospitals. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND E: CUSIP 13033FG46	Part I, Column (c) The CHFFA 2005 Series ABCDEF bonds were exchanged in May 2008 for the CHFFA 2008 Series FHIJKL bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CHFFA 1988 Series A (issued December 3, 1998); CHFFA 1995 Series H (issued May 25, 1995); CHFFA 1997 Series A (issued October 15, 1997); CHFFA 1998 Series A (issued December 3, 1998); CSCDA 1999 (issued December 9, 1999) and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 11/2/2010. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND F: CUSIP 13033FYE4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In October 2012, certain loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $147,665,635 to finance the construction/renovation of the facilities and the acquisition of medical equipment at various hospitals. $15,000,000 of the loan pool remained the same and was not required to repurpose the assets. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated.
BOND G: CUSIP 040507GL3	Part I, Column (c) The Arizona Health Facility Authority (AHFA) 2005 Series CDE bonds were exchanged in May 2008 for the AHFA 2008 Series ABC Bonds and November 2009 the AHFA 2008 Series ABC bonds and November 2009 the AHFA 2008 Series C bonds were exchanged in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. AHFA 2005 Series BCDE, of which AHFA 2005 Series CDE were exchanged for AHFA 2008 Series ABC, of which AHFA 2008 Series C was exchanged for AHFA 2009 Series F. The CUSIP number noted on Schedule K '040507GL3' is the CUSIP from the original Form 8038 filed for the 2005 Series BCDE Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the AHFA 2005 CDE Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for AHFA 2008 Series ABC. The AHFA 2008 Series C Bonds were later exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for the AHFA 2009 Series F Bonds on November 12, 2009. All the series noted above have the same maturity of July 1, 2035. The CUSIPs of the outstanding bonds are AHFA 2005 Series B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' and AHFA 2009 Series F '040507MK8.' Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of the loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 1/28/2014. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND H: CUSIP 130795DH7	Part I, column (c) The CSCDA 2007 Series ABC bonds were exchanged in May 2008 for the CSCDA 2008 Series CFG bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CA 1995 A (issued May 25, 1995); CA 1996 A (issued May 30, 1996); and CA 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to CSCDA 2007 Series ABC, such hedges were deemed terminated May 16, 2008 (CSCDA 2007 Series A were later exchanged for CSCDA 2008 Series C fixed rate bonds), May 14, 2009 (CSCDA 2007 Series C were exchanged without a reissuance for CSCDA 2008 Series G and later refinanced to CHFFA 2009 Series A fixed rate bonds) and November 12, 2009 (CSCDA 2007 Series B were exchanged without a reissuance for CSCDA 2008 Series F and later refinanced with CHFFA 2009 Series G put bonds) as a result of either the refinancing of these bonds or the exchange (without a reissuance) and conversion of these bonds into long-term fixed-rate bonds. The CSCDA DEF bonds are still outstanding and continue to have hedges associated with them. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND I: CUSIP 130795DR5	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (c) California Statewide Community Development Authority (CSCDA) 2007 Series G-L, of which CSCDA 2007 Series G-J were exchanged for CSCDA 2008 Series ABDE. The CUSIP number noted on Schedule K '130795DR5' is the CUSIP from the original Form 8038 filed for the 2007 Series G-L Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the CSCDA 2007 Series GHIJ Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for CSCDA 2008 Series ABDE, and there was an interest rate conversion on the CSCDA 2007 Series KL Bonds. The latest maturities on the currently outstanding exchanged bonds are the CSCDA 2007 Series KL Bonds, both of which have a final maturity date of July 1, 2041. The CUSIPs are '130795TV9' for the CSCDA 2007 Series K Bonds and '130795TW7' for the CSCDA Series 2007 L Bonds. The CSCDA 2007 Series GHIJ bonds were exchanged in May 2008 for the CSCDA 2008 Series ABDE bonds in an exchange pursuant to Notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (f) To finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2013.
BOND J: CUSIP 566816HP2	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND K: CUSIP 759835AA9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) To finance acquisition and renovation of hospital facility (including Emergency Room) and acquisition of medical equipment. Part III, Line 8A Although the City of Reno, Nevada, health facility revenue bonds, 2007 Series A (the "2007 Reno bonds"), are shown on line 1 of Part I of this Schedule K, Dignity Health and the City of Reno, Nevada (the "City"), took appropriate remedial action with respect to all of the 2007 Reno bonds, under section 1.141-12(d) of the treasury regulations, on September 24, 2012, by defeasing a pro rata portion of the 2007 Reno bonds, in the principal amount of $42,085,000, within 90 days of the sale by Dignity Health of Saint Mary's Regional Medical Center ("SMRMC"), in Reno, Nevada. Such defeasance will cause such portion of the 2007 Reno bonds to be redeemed on their first optional redemption date of July 1, 2017. Because the consideration for the sale of SMRMC was exclusively cash, pursuant to section 1.141-12(d)(2) of the treasury regulations, Dignity Health and the City were permitted to meet, and met, the requirements of section 1.141-12(d) of the treasury regulations with respect to all of the 2007 Reno bonds by applying the "disposition proceeds" received from the sale of SMRMC to the defeasance of a pro rata portion of the 2007 Reno bonds through their first optional redemption date of July 1, 2017. Such pro rata portion of the 2007 Reno bonds was determined to have a principal amount of $42,085.000. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND L: CUSIP 425203CF1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - NV 1998 A (issued December 3, 1998); NV 1999 series A (issued December 9, 1999); NV 2004 Series B (issued April 28, 2004); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND M: CUSIP 13033LAZ0	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series CDE (issued May 16, 2008); and California Statewide Communities Development Authority 2008 Series G (issued May 16, 2008); and to finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND N: CUSIP 566816JJ4	Part I, Column (f) Refinance taxable line of credit used to refinance Industrial Development Authority of Maricopa County Arizona 2004 Series B bonds issued on April 28, 2004. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND O: CUSIP 13033LEQ6	Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series ABF; and California Statewide Communities Development Authority 2008 Series F bonds issued on May 16, 2008. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2011.
BOND P: CUSIP 040507MJ1	Part I, Column (f) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND Q: CUSIP 566816JL9	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 1992 Series A bonds issued on September 1, 1992 and Industrial Development Authority of Maricopa County Arizona 1998 Series A bonds issued on December 3, 1998.
BOND R: CUSIP 13033LSZ1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund CHFFA 1993 Series A bonds issued on March 17, 1993, CHFFA 1996 Series E bonds issued on December 12, 1996, CHFFA 1997 Series A bonds issued on October 15, 1997 and CHFFA 1998 Series A bonds Issued On December 3, 1998. Repay line of credit used to retire CHFFA 2004 Series H bonds issued on April 28, 2004. Finance capital projects at various hospital facilities. Part II, Line 11 Bond proceeds were used to pay off the CHFFA 2004 Series H put bond that came due on 7/1/2011 that was financed with a draw on the working line of credit. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND S: CUSIP 040507MU6	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f)Finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND T: CUSIP 13033LUD7	Part I, Column (f) Refund CHFFA 2009 Series BC bonds issued on May 14, 2009 and CHFFA 2009 Series G bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND U: CUSIP 040507MV4	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 2009 Series B bonds issued on May 14, 2009 and Arizona Health Facilities Financing Authority 2009 Series E bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FRT9	04-28-2004	470,300,483	BOND A: CUSIP 13033FRT9-SEE PRT VI	X			X		X
B	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816GY4	04-28-2004	259,114,410	BOND B: CUSIP 566816GY4-SEE PRT VI	X			X		X
C	CITY OF HENDERSON NEVADA	88-6000720	425203BM7	04-28-2004	166,163,811	BOND C: CUSIP 425203BM7-SEE PRT VI	X			X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FTN0	05-19-2004	150,000,000	BOND D: CUSIP 13033FTN0-SEE PRT VI		X		X	X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FG46	11-10-2005	351,135,742	BOND E: CUSIP 13033FG46-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FYE4	11-10-2005	200,000,000	BOND F: CUSIP 13033FYE4-SEE PRT VI		X		X	X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507GL3	11-10-2005	224,000,000	BOND G: CUSIP 040507GL3-SEE PRT VI		X		X	X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DH7	04-26-2007	400,000,000	BOND H: CUSIP 130795DH7-SEE PRT VI	X			X		X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DR5	04-26-2007	276,250,000	BOND I: CUSIP 130795DR5-SEE PRT VI		X		X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816HP2	04-26-2007	178,702,052	BOND J: CUSIP 566816HP2-SEE PRT VI	X			X		X
	CITY OF RENO NEVADA	88-6000201	759835AA9	04-26-2007	98,635,589	BOND K: CUSIP 759835AA9-SEE PRT VI	X			X		X
	CITY OF HENDERSON NEVADA	88-6000720	425203CF1	04-26-2007	200,626,751	BOND L: CUSIP 425203CF1-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LAZ0	05-14-2009	457,778,078	BOND M: CUSIP 13033LAZ0-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816JJ4	05-14-2009	127,153,706	BOND N: CUSIP 566816JJ4-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LEQ6	11-12-2009	235,106,175	BOND O: CUSIP 13033LEQ6-SEE PRT VI	X			X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MJ1	11-12-2009	75,689,293	BOND P: CUSIP 040507MJ1-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	88-0445263	566816JL9	07-14-2011	115,008,059	BOND Q: CUSIP 566816JL9-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LSZ1	11-09-2011	515,217,012	BOND R: CUSIP 13033LSZ1-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MU6	11-09-2011	125,000,601	BOND S: CUSIP 040507MU6-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LUD7	06-27-2012	140,000,000	BOND T: CUSIP 13033LUD7-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MV4	06-27-2012	75,000,000	BOND U: CUSIP 040507MV4-SEE PRT VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	395,000		235,000		720,000		0
2 Amount of bonds legally defeased . . . . . . . . . . .	362,375,000		175,000,000		125,000,000		0
3 Total proceeds of issue . . . . . . . . . . . . . .	473,075,038		268,026,055		171,864,069		143,115,163
4 Gross proceeds in reserve funds . . . . . . . . . . . .	7,910,480		8,557,517		4,164,721		0
5 Capitalized interest from proceeds . . . . . . . . . . .	6,640,000		0		5,184,771		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	4,074,727		2,542,136		1,638,159		0
8 Credit enhancement from proceeds . . . . . . . . . . .	25,069,705		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	7,774,075		6,949,390		2,791,982		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		158,912,634		109,338,989		121,926,573
11 Other spent proceeds . . . . . . . . . . . . . .	421,606,051		74,718,546		48,745,447		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		16,345,832		0		21,188,590
13 Year of substantial completion . . . . . . . . . . . .	2004		2006		2007		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X			X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0.400 %		0.100 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0.700 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0.400 %		0.100 %		1.500 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %		0 %		0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X		X			X
b Name of provider . . . . . . . . .	CITIGROUP & JPMORGAN		JP MORGAN		CITIGROUP
c Term of hedge . . . . . . . . . .	21.2		5.		5.		34.2
d Was the hedge superintegrated? . . . .		X		X		X		X
e Was the hedge terminated? . . . . . .	X		X		X		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X		X		X			X
b Name of provider . . . . . . . . .	LEHMAN BROTHERS		LEHMAN BROTHERS		LEHMAN BROTHERS		0
c Term of GIC . . . . . . . . . .	22.2		22.2		23.2
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A: CUSIP 13033FRT9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund prior bond issues - California Health Facilities Financing Authority ("CHFFA") 1988 AB (issued June 23, 1988) CHFFA 1992 A (issued September 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (issued January 4, 1994); California Statewide Communities Development Authorities ("CSCDA") 1993 A Certificates of Participation ("COPs") (issued August 12, 1993); CHFFA 1994 AB (issued January 27, 1994); CHFFA 1996 B (issued May 30, 1996); CHFFA 1996 CD (issued May 30, 1996); CHFFA 1996 F (issued December 12, 1996); CHFFA 1997 ABC (issued October 15, 1997); CHFFA 1998 A (issued December 3, 1998). Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND B: CUSIP 566816GY4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1993 A (issued August 12, 1993); AZ 1994 A (issued January 27, 1994); and to finance capital expenditures for construction of Mercy Gilbert and add a new tower at St. Joseph's Hospital and Medical Center. Part II, Line 13 The Industrial Development Authority of Maricopa County (IDAMC) 2004 SERIES AB construction fund proceeds were spent by 2006 on projects that were substantially completed by that date. In March 2009, the IDAMC 2004 Series B bonds were refinanced with a draw on a taxable line of credit, and in May 2009, a portion of the draw on the line was refinanced with tax-exempt debt. In March 2009, approximately $17 million was released from debt service reserve funds, a portion of which is allocable to the un-refinanced portion of the taxable line of credit and a portion of which is allocable to the May 2009 tax-exempt bonds. Such funds are currently unspent and will be used either for capital projects or to redeem or defease May 2009 bonds. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND C: CUSIP 425203BM7	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues NV 1994 A (issued January 27, 1994) and NV 1998 A (issued December 3, 1998) to finance capital expenditures for the construction of a new hospital, St. Rose Dominican Hospital - San Martin Campus. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5a Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND D: CUSIP 13033FTN0	Part I, column (c) The CHFFA 2004 Series J bonds were exchanged in November 2009 for the CHFFA 2009 Series H bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In May 2013, all of the loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $143,112,407 to finance the construction/renovation of facilities and the acquisition of medical equipment at various hospitals. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND E: CUSIP 13033FG46	Part I, Column (c) The CHFFA 2005 Series ABCDEF bonds were exchanged in May 2008 for the CHFFA 2008 Series FHIJKL bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CHFFA 1988 Series A (issued December 3, 1998); CHFFA 1995 Series H (issued May 25, 1995); CHFFA 1997 Series A (issued October 15, 1997); CHFFA 1998 Series A (issued December 3, 1998); CSCDA 1999 (issued December 9, 1999) and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 11/2/2010. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND F: CUSIP 13033FYE4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In October 2012, certain loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $147,665,635 to finance the construction/renovation of the facilities and the acquisition of medical equipment at various hospitals. $15,000,000 of the loan pool remained the same and was not required to repurpose the assets. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated.
BOND G: CUSIP 040507GL3	Part I, Column (c) The Arizona Health Facility Authority (AHFA) 2005 Series CDE bonds were exchanged in May 2008 for the AHFA 2008 Series ABC Bonds and November 2009 the AHFA 2008 Series ABC bonds and November 2009 the AHFA 2008 Series C bonds were exchanged in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. AHFA 2005 Series BCDE, of which AHFA 2005 Series CDE were exchanged for AHFA 2008 Series ABC, of which AHFA 2008 Series C was exchanged for AHFA 2009 Series F. The CUSIP number noted on Schedule K '040507GL3' is the CUSIP from the original Form 8038 filed for the 2005 Series BCDE Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the AHFA 2005 CDE Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for AHFA 2008 Series ABC. The AHFA 2008 Series C Bonds were later exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for the AHFA 2009 Series F Bonds on November 12, 2009. All the series noted above have the same maturity of July 1, 2035. The CUSIPs of the outstanding bonds are AHFA 2005 Series B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' and AHFA 2009 Series F '040507MK8.' Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of the loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 1/28/2014. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND H: CUSIP 130795DH7	Part I, column (c) The CSCDA 2007 Series ABC bonds were exchanged in May 2008 for the CSCDA 2008 Series CFG bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CA 1995 A (issued May 25, 1995); CA 1996 A (issued May 30, 1996); and CA 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to CSCDA 2007 Series ABC, such hedges were deemed terminated May 16, 2008 (CSCDA 2007 Series A were later exchanged for CSCDA 2008 Series C fixed rate bonds), May 14, 2009 (CSCDA 2007 Series C were exchanged without a reissuance for CSCDA 2008 Series G and later refinanced to CHFFA 2009 Series A fixed rate bonds) and November 12, 2009 (CSCDA 2007 Series B were exchanged without a reissuance for CSCDA 2008 Series F and later refinanced with CHFFA 2009 Series G put bonds) as a result of either the refinancing of these bonds or the exchange (without a reissuance) and conversion of these bonds into long-term fixed-rate bonds. The CSCDA DEF bonds are still outstanding and continue to have hedges associated with them. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND I: CUSIP 130795DR5	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (c) California Statewide Community Development Authority (CSCDA) 2007 Series G-L, of which CSCDA 2007 Series G-J were exchanged for CSCDA 2008 Series ABDE. The CUSIP number noted on Schedule K '130795DR5' is the CUSIP from the original Form 8038 filed for the 2007 Series G-L Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the CSCDA 2007 Series GHIJ Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for CSCDA 2008 Series ABDE, and there was an interest rate conversion on the CSCDA 2007 Series KL Bonds. The latest maturities on the currently outstanding exchanged bonds are the CSCDA 2007 Series KL Bonds, both of which have a final maturity date of July 1, 2041. The CUSIPs are '130795TV9' for the CSCDA 2007 Series K Bonds and '130795TW7' for the CSCDA Series 2007 L Bonds. The CSCDA 2007 Series GHIJ bonds were exchanged in May 2008 for the CSCDA 2008 Series ABDE bonds in an exchange pursuant to Notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (f) To finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2013.
BOND J: CUSIP 566816HP2	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND K: CUSIP 759835AA9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) To finance acquisition and renovation of hospital facility (including Emergency Room) and acquisition of medical equipment. Part III, Line 8A Although the City of Reno, Nevada, health facility revenue bonds, 2007 Series A (the "2007 Reno bonds"), are shown on line 1 of Part I of this Schedule K, Dignity Health and the City of Reno, Nevada (the "City"), took appropriate remedial action with respect to all of the 2007 Reno bonds, under section 1.141-12(d) of the treasury regulations, on September 24, 2012, by defeasing a pro rata portion of the 2007 Reno bonds, in the principal amount of $42,085,000, within 90 days of the sale by Dignity Health of Saint Mary's Regional Medical Center ("SMRMC"), in Reno, Nevada. Such defeasance will cause such portion of the 2007 Reno bonds to be redeemed on their first optional redemption date of July 1, 2017. Because the consideration for the sale of SMRMC was exclusively cash, pursuant to section 1.141-12(d)(2) of the treasury regulations, Dignity Health and the City were permitted to meet, and met, the requirements of section 1.141-12(d) of the treasury regulations with respect to all of the 2007 Reno bonds by applying the "disposition proceeds" received from the sale of SMRMC to the defeasance of a pro rata portion of the 2007 Reno bonds through their first optional redemption date of July 1, 2017. Such pro rata portion of the 2007 Reno bonds was determined to have a principal amount of $42,085.000. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND L: CUSIP 425203CF1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - NV 1998 A (issued December 3, 1998); NV 1999 series A (issued December 9, 1999); NV 2004 Series B (issued April 28, 2004); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND M: CUSIP 13033LAZ0	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series CDE (issued May 16, 2008); and California Statewide Communities Development Authority 2008 Series G (issued May 16, 2008); and to finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND N: CUSIP 566816JJ4	Part I, Column (f) Refinance taxable line of credit used to refinance Industrial Development Authority of Maricopa County Arizona 2004 Series B bonds issued on April 28, 2004. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND O: CUSIP 13033LEQ6	Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series ABF; and California Statewide Communities Development Authority 2008 Series F bonds issued on May 16, 2008. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2011.
BOND P: CUSIP 040507MJ1	Part I, Column (f) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND Q: CUSIP 566816JL9	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 1992 Series A bonds issued on September 1, 1992 and Industrial Development Authority of Maricopa County Arizona 1998 Series A bonds issued on December 3, 1998.
BOND R: CUSIP 13033LSZ1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund CHFFA 1993 Series A bonds issued on March 17, 1993, CHFFA 1996 Series E bonds issued on December 12, 1996, CHFFA 1997 Series A bonds issued on October 15, 1997 and CHFFA 1998 Series A bonds Issued On December 3, 1998. Repay line of credit used to retire CHFFA 2004 Series H bonds issued on April 28, 2004. Finance capital projects at various hospital facilities. Part II, Line 11 Bond proceeds were used to pay off the CHFFA 2004 Series H put bond that came due on 7/1/2011 that was financed with a draw on the working line of credit. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND S: CUSIP 040507MU6	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f)Finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND T: CUSIP 13033LUD7	Part I, Column (f) Refund CHFFA 2009 Series BC bonds issued on May 14, 2009 and CHFFA 2009 Series G bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND U: CUSIP 040507MV4	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 2009 Series B bonds issued on May 14, 2009 and Arizona Health Facilities Financing Authority 2009 Series E bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FRT9	04-28-2004	470,300,483	BOND A: CUSIP 13033FRT9-SEE PRT VI	X			X		X
B	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816GY4	04-28-2004	259,114,410	BOND B: CUSIP 566816GY4-SEE PRT VI	X			X		X
C	CITY OF HENDERSON NEVADA	88-6000720	425203BM7	04-28-2004	166,163,811	BOND C: CUSIP 425203BM7-SEE PRT VI	X			X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FTN0	05-19-2004	150,000,000	BOND D: CUSIP 13033FTN0-SEE PRT VI		X		X	X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FG46	11-10-2005	351,135,742	BOND E: CUSIP 13033FG46-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FYE4	11-10-2005	200,000,000	BOND F: CUSIP 13033FYE4-SEE PRT VI		X		X	X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507GL3	11-10-2005	224,000,000	BOND G: CUSIP 040507GL3-SEE PRT VI		X		X	X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DH7	04-26-2007	400,000,000	BOND H: CUSIP 130795DH7-SEE PRT VI	X			X		X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DR5	04-26-2007	276,250,000	BOND I: CUSIP 130795DR5-SEE PRT VI		X		X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816HP2	04-26-2007	178,702,052	BOND J: CUSIP 566816HP2-SEE PRT VI	X			X		X
	CITY OF RENO NEVADA	88-6000201	759835AA9	04-26-2007	98,635,589	BOND K: CUSIP 759835AA9-SEE PRT VI	X			X		X
	CITY OF HENDERSON NEVADA	88-6000720	425203CF1	04-26-2007	200,626,751	BOND L: CUSIP 425203CF1-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LAZ0	05-14-2009	457,778,078	BOND M: CUSIP 13033LAZ0-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816JJ4	05-14-2009	127,153,706	BOND N: CUSIP 566816JJ4-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LEQ6	11-12-2009	235,106,175	BOND O: CUSIP 13033LEQ6-SEE PRT VI	X			X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MJ1	11-12-2009	75,689,293	BOND P: CUSIP 040507MJ1-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	88-0445263	566816JL9	07-14-2011	115,008,059	BOND Q: CUSIP 566816JL9-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LSZ1	11-09-2011	515,217,012	BOND R: CUSIP 13033LSZ1-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MU6	11-09-2011	125,000,601	BOND S: CUSIP 040507MU6-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LUD7	06-27-2012	140,000,000	BOND T: CUSIP 13033LUD7-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MV4	06-27-2012	75,000,000	BOND U: CUSIP 040507MV4-SEE PRT VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	395,000		235,000		720,000		0
2 Amount of bonds legally defeased . . . . . . . . . . .	362,375,000		175,000,000		125,000,000		0
3 Total proceeds of issue . . . . . . . . . . . . . .	473,075,038		268,026,055		171,864,069		143,115,163
4 Gross proceeds in reserve funds . . . . . . . . . . . .	7,910,480		8,557,517		4,164,721		0
5 Capitalized interest from proceeds . . . . . . . . . . .	6,640,000		0		5,184,771		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	4,074,727		2,542,136		1,638,159		0
8 Credit enhancement from proceeds . . . . . . . . . . .	25,069,705		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	7,774,075		6,949,390		2,791,982		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		158,912,634		109,338,989		121,926,573
11 Other spent proceeds . . . . . . . . . . . . . .	421,606,051		74,718,546		48,745,447		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		16,345,832		0		21,188,590
13 Year of substantial completion . . . . . . . . . . . .	2004		2006		2007		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X			X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0.400 %		0.100 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0.700 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0.400 %		0.100 %		1.500 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %		0 %		0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X		X			X
b Name of provider . . . . . . . . .	CITIGROUP & JPMORGAN		JP MORGAN		CITIGROUP
c Term of hedge . . . . . . . . . .	21.2		5.		5.		34.2
d Was the hedge superintegrated? . . . .		X		X		X		X
e Was the hedge terminated? . . . . . .	X		X		X		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X		X		X			X
b Name of provider . . . . . . . . .	LEHMAN BROTHERS		LEHMAN BROTHERS		LEHMAN BROTHERS		0
c Term of GIC . . . . . . . . . .	22.2		22.2		23.2
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A: CUSIP 13033FRT9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund prior bond issues - California Health Facilities Financing Authority ("CHFFA") 1988 AB (issued June 23, 1988) CHFFA 1992 A (issued September 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (issued January 4, 1994); California Statewide Communities Development Authorities ("CSCDA") 1993 A Certificates of Participation ("COPs") (issued August 12, 1993); CHFFA 1994 AB (issued January 27, 1994); CHFFA 1996 B (issued May 30, 1996); CHFFA 1996 CD (issued May 30, 1996); CHFFA 1996 F (issued December 12, 1996); CHFFA 1997 ABC (issued October 15, 1997); CHFFA 1998 A (issued December 3, 1998). Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND B: CUSIP 566816GY4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1993 A (issued August 12, 1993); AZ 1994 A (issued January 27, 1994); and to finance capital expenditures for construction of Mercy Gilbert and add a new tower at St. Joseph's Hospital and Medical Center. Part II, Line 13 The Industrial Development Authority of Maricopa County (IDAMC) 2004 SERIES AB construction fund proceeds were spent by 2006 on projects that were substantially completed by that date. In March 2009, the IDAMC 2004 Series B bonds were refinanced with a draw on a taxable line of credit, and in May 2009, a portion of the draw on the line was refinanced with tax-exempt debt. In March 2009, approximately $17 million was released from debt service reserve funds, a portion of which is allocable to the un-refinanced portion of the taxable line of credit and a portion of which is allocable to the May 2009 tax-exempt bonds. Such funds are currently unspent and will be used either for capital projects or to redeem or defease May 2009 bonds. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND C: CUSIP 425203BM7	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues NV 1994 A (issued January 27, 1994) and NV 1998 A (issued December 3, 1998) to finance capital expenditures for the construction of a new hospital, St. Rose Dominican Hospital - San Martin Campus. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5a Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND D: CUSIP 13033FTN0	Part I, column (c) The CHFFA 2004 Series J bonds were exchanged in November 2009 for the CHFFA 2009 Series H bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In May 2013, all of the loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $143,112,407 to finance the construction/renovation of facilities and the acquisition of medical equipment at various hospitals. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND E: CUSIP 13033FG46	Part I, Column (c) The CHFFA 2005 Series ABCDEF bonds were exchanged in May 2008 for the CHFFA 2008 Series FHIJKL bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CHFFA 1988 Series A (issued December 3, 1998); CHFFA 1995 Series H (issued May 25, 1995); CHFFA 1997 Series A (issued October 15, 1997); CHFFA 1998 Series A (issued December 3, 1998); CSCDA 1999 (issued December 9, 1999) and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 11/2/2010. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND F: CUSIP 13033FYE4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In October 2012, certain loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $147,665,635 to finance the construction/renovation of the facilities and the acquisition of medical equipment at various hospitals. $15,000,000 of the loan pool remained the same and was not required to repurpose the assets. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated.
BOND G: CUSIP 040507GL3	Part I, Column (c) The Arizona Health Facility Authority (AHFA) 2005 Series CDE bonds were exchanged in May 2008 for the AHFA 2008 Series ABC Bonds and November 2009 the AHFA 2008 Series ABC bonds and November 2009 the AHFA 2008 Series C bonds were exchanged in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. AHFA 2005 Series BCDE, of which AHFA 2005 Series CDE were exchanged for AHFA 2008 Series ABC, of which AHFA 2008 Series C was exchanged for AHFA 2009 Series F. The CUSIP number noted on Schedule K '040507GL3' is the CUSIP from the original Form 8038 filed for the 2005 Series BCDE Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the AHFA 2005 CDE Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for AHFA 2008 Series ABC. The AHFA 2008 Series C Bonds were later exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for the AHFA 2009 Series F Bonds on November 12, 2009. All the series noted above have the same maturity of July 1, 2035. The CUSIPs of the outstanding bonds are AHFA 2005 Series B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' and AHFA 2009 Series F '040507MK8.' Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of the loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 1/28/2014. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND H: CUSIP 130795DH7	Part I, column (c) The CSCDA 2007 Series ABC bonds were exchanged in May 2008 for the CSCDA 2008 Series CFG bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CA 1995 A (issued May 25, 1995); CA 1996 A (issued May 30, 1996); and CA 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to CSCDA 2007 Series ABC, such hedges were deemed terminated May 16, 2008 (CSCDA 2007 Series A were later exchanged for CSCDA 2008 Series C fixed rate bonds), May 14, 2009 (CSCDA 2007 Series C were exchanged without a reissuance for CSCDA 2008 Series G and later refinanced to CHFFA 2009 Series A fixed rate bonds) and November 12, 2009 (CSCDA 2007 Series B were exchanged without a reissuance for CSCDA 2008 Series F and later refinanced with CHFFA 2009 Series G put bonds) as a result of either the refinancing of these bonds or the exchange (without a reissuance) and conversion of these bonds into long-term fixed-rate bonds. The CSCDA DEF bonds are still outstanding and continue to have hedges associated with them. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND I: CUSIP 130795DR5	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (c) California Statewide Community Development Authority (CSCDA) 2007 Series G-L, of which CSCDA 2007 Series G-J were exchanged for CSCDA 2008 Series ABDE. The CUSIP number noted on Schedule K '130795DR5' is the CUSIP from the original Form 8038 filed for the 2007 Series G-L Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the CSCDA 2007 Series GHIJ Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for CSCDA 2008 Series ABDE, and there was an interest rate conversion on the CSCDA 2007 Series KL Bonds. The latest maturities on the currently outstanding exchanged bonds are the CSCDA 2007 Series KL Bonds, both of which have a final maturity date of July 1, 2041. The CUSIPs are '130795TV9' for the CSCDA 2007 Series K Bonds and '130795TW7' for the CSCDA Series 2007 L Bonds. The CSCDA 2007 Series GHIJ bonds were exchanged in May 2008 for the CSCDA 2008 Series ABDE bonds in an exchange pursuant to Notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (f) To finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2013.
BOND J: CUSIP 566816HP2	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND K: CUSIP 759835AA9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) To finance acquisition and renovation of hospital facility (including Emergency Room) and acquisition of medical equipment. Part III, Line 8A Although the City of Reno, Nevada, health facility revenue bonds, 2007 Series A (the "2007 Reno bonds"), are shown on line 1 of Part I of this Schedule K, Dignity Health and the City of Reno, Nevada (the "City"), took appropriate remedial action with respect to all of the 2007 Reno bonds, under section 1.141-12(d) of the treasury regulations, on September 24, 2012, by defeasing a pro rata portion of the 2007 Reno bonds, in the principal amount of $42,085,000, within 90 days of the sale by Dignity Health of Saint Mary's Regional Medical Center ("SMRMC"), in Reno, Nevada. Such defeasance will cause such portion of the 2007 Reno bonds to be redeemed on their first optional redemption date of July 1, 2017. Because the consideration for the sale of SMRMC was exclusively cash, pursuant to section 1.141-12(d)(2) of the treasury regulations, Dignity Health and the City were permitted to meet, and met, the requirements of section 1.141-12(d) of the treasury regulations with respect to all of the 2007 Reno bonds by applying the "disposition proceeds" received from the sale of SMRMC to the defeasance of a pro rata portion of the 2007 Reno bonds through their first optional redemption date of July 1, 2017. Such pro rata portion of the 2007 Reno bonds was determined to have a principal amount of $42,085.000. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND L: CUSIP 425203CF1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - NV 1998 A (issued December 3, 1998); NV 1999 series A (issued December 9, 1999); NV 2004 Series B (issued April 28, 2004); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND M: CUSIP 13033LAZ0	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series CDE (issued May 16, 2008); and California Statewide Communities Development Authority 2008 Series G (issued May 16, 2008); and to finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND N: CUSIP 566816JJ4	Part I, Column (f) Refinance taxable line of credit used to refinance Industrial Development Authority of Maricopa County Arizona 2004 Series B bonds issued on April 28, 2004. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND O: CUSIP 13033LEQ6	Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series ABF; and California Statewide Communities Development Authority 2008 Series F bonds issued on May 16, 2008. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2011.
BOND P: CUSIP 040507MJ1	Part I, Column (f) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND Q: CUSIP 566816JL9	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 1992 Series A bonds issued on September 1, 1992 and Industrial Development Authority of Maricopa County Arizona 1998 Series A bonds issued on December 3, 1998.
BOND R: CUSIP 13033LSZ1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund CHFFA 1993 Series A bonds issued on March 17, 1993, CHFFA 1996 Series E bonds issued on December 12, 1996, CHFFA 1997 Series A bonds issued on October 15, 1997 and CHFFA 1998 Series A bonds Issued On December 3, 1998. Repay line of credit used to retire CHFFA 2004 Series H bonds issued on April 28, 2004. Finance capital projects at various hospital facilities. Part II, Line 11 Bond proceeds were used to pay off the CHFFA 2004 Series H put bond that came due on 7/1/2011 that was financed with a draw on the working line of credit. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND S: CUSIP 040507MU6	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f)Finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND T: CUSIP 13033LUD7	Part I, Column (f) Refund CHFFA 2009 Series BC bonds issued on May 14, 2009 and CHFFA 2009 Series G bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND U: CUSIP 040507MV4	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 2009 Series B bonds issued on May 14, 2009 and Arizona Health Facilities Financing Authority 2009 Series E bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FRT9	04-28-2004	470,300,483	BOND A: CUSIP 13033FRT9-SEE PRT VI	X			X		X
B	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816GY4	04-28-2004	259,114,410	BOND B: CUSIP 566816GY4-SEE PRT VI	X			X		X
C	CITY OF HENDERSON NEVADA	88-6000720	425203BM7	04-28-2004	166,163,811	BOND C: CUSIP 425203BM7-SEE PRT VI	X			X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FTN0	05-19-2004	150,000,000	BOND D: CUSIP 13033FTN0-SEE PRT VI		X		X	X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FG46	11-10-2005	351,135,742	BOND E: CUSIP 13033FG46-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FYE4	11-10-2005	200,000,000	BOND F: CUSIP 13033FYE4-SEE PRT VI		X		X	X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507GL3	11-10-2005	224,000,000	BOND G: CUSIP 040507GL3-SEE PRT VI		X		X	X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DH7	04-26-2007	400,000,000	BOND H: CUSIP 130795DH7-SEE PRT VI	X			X		X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DR5	04-26-2007	276,250,000	BOND I: CUSIP 130795DR5-SEE PRT VI		X		X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816HP2	04-26-2007	178,702,052	BOND J: CUSIP 566816HP2-SEE PRT VI	X			X		X
	CITY OF RENO NEVADA	88-6000201	759835AA9	04-26-2007	98,635,589	BOND K: CUSIP 759835AA9-SEE PRT VI	X			X		X
	CITY OF HENDERSON NEVADA	88-6000720	425203CF1	04-26-2007	200,626,751	BOND L: CUSIP 425203CF1-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LAZ0	05-14-2009	457,778,078	BOND M: CUSIP 13033LAZ0-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816JJ4	05-14-2009	127,153,706	BOND N: CUSIP 566816JJ4-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LEQ6	11-12-2009	235,106,175	BOND O: CUSIP 13033LEQ6-SEE PRT VI	X			X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MJ1	11-12-2009	75,689,293	BOND P: CUSIP 040507MJ1-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	88-0445263	566816JL9	07-14-2011	115,008,059	BOND Q: CUSIP 566816JL9-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LSZ1	11-09-2011	515,217,012	BOND R: CUSIP 13033LSZ1-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MU6	11-09-2011	125,000,601	BOND S: CUSIP 040507MU6-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LUD7	06-27-2012	140,000,000	BOND T: CUSIP 13033LUD7-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MV4	06-27-2012	75,000,000	BOND U: CUSIP 040507MV4-SEE PRT VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	395,000		235,000		720,000		0
2 Amount of bonds legally defeased . . . . . . . . . . .	362,375,000		175,000,000		125,000,000		0
3 Total proceeds of issue . . . . . . . . . . . . . .	473,075,038		268,026,055		171,864,069		143,115,163
4 Gross proceeds in reserve funds . . . . . . . . . . . .	7,910,480		8,557,517		4,164,721		0
5 Capitalized interest from proceeds . . . . . . . . . . .	6,640,000		0		5,184,771		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	4,074,727		2,542,136		1,638,159		0
8 Credit enhancement from proceeds . . . . . . . . . . .	25,069,705		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	7,774,075		6,949,390		2,791,982		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		158,912,634		109,338,989		121,926,573
11 Other spent proceeds . . . . . . . . . . . . . .	421,606,051		74,718,546		48,745,447		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		16,345,832		0		21,188,590
13 Year of substantial completion . . . . . . . . . . . .	2004		2006		2007		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X			X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0.400 %		0.100 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0.700 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0.400 %		0.100 %		1.500 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %		0 %		0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X		X			X
b Name of provider . . . . . . . . .	CITIGROUP & JPMORGAN		JP MORGAN		CITIGROUP
c Term of hedge . . . . . . . . . .	21.2		5.		5.		34.2
d Was the hedge superintegrated? . . . .		X		X		X		X
e Was the hedge terminated? . . . . . .	X		X		X		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X		X		X			X
b Name of provider . . . . . . . . .	LEHMAN BROTHERS		LEHMAN BROTHERS		LEHMAN BROTHERS		0
c Term of GIC . . . . . . . . . .	22.2		22.2		23.2
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A: CUSIP 13033FRT9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund prior bond issues - California Health Facilities Financing Authority ("CHFFA") 1988 AB (issued June 23, 1988) CHFFA 1992 A (issued September 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (issued January 4, 1994); California Statewide Communities Development Authorities ("CSCDA") 1993 A Certificates of Participation ("COPs") (issued August 12, 1993); CHFFA 1994 AB (issued January 27, 1994); CHFFA 1996 B (issued May 30, 1996); CHFFA 1996 CD (issued May 30, 1996); CHFFA 1996 F (issued December 12, 1996); CHFFA 1997 ABC (issued October 15, 1997); CHFFA 1998 A (issued December 3, 1998). Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND B: CUSIP 566816GY4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1993 A (issued August 12, 1993); AZ 1994 A (issued January 27, 1994); and to finance capital expenditures for construction of Mercy Gilbert and add a new tower at St. Joseph's Hospital and Medical Center. Part II, Line 13 The Industrial Development Authority of Maricopa County (IDAMC) 2004 SERIES AB construction fund proceeds were spent by 2006 on projects that were substantially completed by that date. In March 2009, the IDAMC 2004 Series B bonds were refinanced with a draw on a taxable line of credit, and in May 2009, a portion of the draw on the line was refinanced with tax-exempt debt. In March 2009, approximately $17 million was released from debt service reserve funds, a portion of which is allocable to the un-refinanced portion of the taxable line of credit and a portion of which is allocable to the May 2009 tax-exempt bonds. Such funds are currently unspent and will be used either for capital projects or to redeem or defease May 2009 bonds. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND C: CUSIP 425203BM7	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues NV 1994 A (issued January 27, 1994) and NV 1998 A (issued December 3, 1998) to finance capital expenditures for the construction of a new hospital, St. Rose Dominican Hospital - San Martin Campus. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5a Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND D: CUSIP 13033FTN0	Part I, column (c) The CHFFA 2004 Series J bonds were exchanged in November 2009 for the CHFFA 2009 Series H bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In May 2013, all of the loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $143,112,407 to finance the construction/renovation of facilities and the acquisition of medical equipment at various hospitals. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND E: CUSIP 13033FG46	Part I, Column (c) The CHFFA 2005 Series ABCDEF bonds were exchanged in May 2008 for the CHFFA 2008 Series FHIJKL bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CHFFA 1988 Series A (issued December 3, 1998); CHFFA 1995 Series H (issued May 25, 1995); CHFFA 1997 Series A (issued October 15, 1997); CHFFA 1998 Series A (issued December 3, 1998); CSCDA 1999 (issued December 9, 1999) and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 11/2/2010. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND F: CUSIP 13033FYE4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In October 2012, certain loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $147,665,635 to finance the construction/renovation of the facilities and the acquisition of medical equipment at various hospitals. $15,000,000 of the loan pool remained the same and was not required to repurpose the assets. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated.
BOND G: CUSIP 040507GL3	Part I, Column (c) The Arizona Health Facility Authority (AHFA) 2005 Series CDE bonds were exchanged in May 2008 for the AHFA 2008 Series ABC Bonds and November 2009 the AHFA 2008 Series ABC bonds and November 2009 the AHFA 2008 Series C bonds were exchanged in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. AHFA 2005 Series BCDE, of which AHFA 2005 Series CDE were exchanged for AHFA 2008 Series ABC, of which AHFA 2008 Series C was exchanged for AHFA 2009 Series F. The CUSIP number noted on Schedule K '040507GL3' is the CUSIP from the original Form 8038 filed for the 2005 Series BCDE Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the AHFA 2005 CDE Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for AHFA 2008 Series ABC. The AHFA 2008 Series C Bonds were later exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for the AHFA 2009 Series F Bonds on November 12, 2009. All the series noted above have the same maturity of July 1, 2035. The CUSIPs of the outstanding bonds are AHFA 2005 Series B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' and AHFA 2009 Series F '040507MK8.' Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of the loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 1/28/2014. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND H: CUSIP 130795DH7	Part I, column (c) The CSCDA 2007 Series ABC bonds were exchanged in May 2008 for the CSCDA 2008 Series CFG bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CA 1995 A (issued May 25, 1995); CA 1996 A (issued May 30, 1996); and CA 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to CSCDA 2007 Series ABC, such hedges were deemed terminated May 16, 2008 (CSCDA 2007 Series A were later exchanged for CSCDA 2008 Series C fixed rate bonds), May 14, 2009 (CSCDA 2007 Series C were exchanged without a reissuance for CSCDA 2008 Series G and later refinanced to CHFFA 2009 Series A fixed rate bonds) and November 12, 2009 (CSCDA 2007 Series B were exchanged without a reissuance for CSCDA 2008 Series F and later refinanced with CHFFA 2009 Series G put bonds) as a result of either the refinancing of these bonds or the exchange (without a reissuance) and conversion of these bonds into long-term fixed-rate bonds. The CSCDA DEF bonds are still outstanding and continue to have hedges associated with them. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND I: CUSIP 130795DR5	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (c) California Statewide Community Development Authority (CSCDA) 2007 Series G-L, of which CSCDA 2007 Series G-J were exchanged for CSCDA 2008 Series ABDE. The CUSIP number noted on Schedule K '130795DR5' is the CUSIP from the original Form 8038 filed for the 2007 Series G-L Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the CSCDA 2007 Series GHIJ Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for CSCDA 2008 Series ABDE, and there was an interest rate conversion on the CSCDA 2007 Series KL Bonds. The latest maturities on the currently outstanding exchanged bonds are the CSCDA 2007 Series KL Bonds, both of which have a final maturity date of July 1, 2041. The CUSIPs are '130795TV9' for the CSCDA 2007 Series K Bonds and '130795TW7' for the CSCDA Series 2007 L Bonds. The CSCDA 2007 Series GHIJ bonds were exchanged in May 2008 for the CSCDA 2008 Series ABDE bonds in an exchange pursuant to Notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (f) To finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2013.
BOND J: CUSIP 566816HP2	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND K: CUSIP 759835AA9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) To finance acquisition and renovation of hospital facility (including Emergency Room) and acquisition of medical equipment. Part III, Line 8A Although the City of Reno, Nevada, health facility revenue bonds, 2007 Series A (the "2007 Reno bonds"), are shown on line 1 of Part I of this Schedule K, Dignity Health and the City of Reno, Nevada (the "City"), took appropriate remedial action with respect to all of the 2007 Reno bonds, under section 1.141-12(d) of the treasury regulations, on September 24, 2012, by defeasing a pro rata portion of the 2007 Reno bonds, in the principal amount of $42,085,000, within 90 days of the sale by Dignity Health of Saint Mary's Regional Medical Center ("SMRMC"), in Reno, Nevada. Such defeasance will cause such portion of the 2007 Reno bonds to be redeemed on their first optional redemption date of July 1, 2017. Because the consideration for the sale of SMRMC was exclusively cash, pursuant to section 1.141-12(d)(2) of the treasury regulations, Dignity Health and the City were permitted to meet, and met, the requirements of section 1.141-12(d) of the treasury regulations with respect to all of the 2007 Reno bonds by applying the "disposition proceeds" received from the sale of SMRMC to the defeasance of a pro rata portion of the 2007 Reno bonds through their first optional redemption date of July 1, 2017. Such pro rata portion of the 2007 Reno bonds was determined to have a principal amount of $42,085.000. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND L: CUSIP 425203CF1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - NV 1998 A (issued December 3, 1998); NV 1999 series A (issued December 9, 1999); NV 2004 Series B (issued April 28, 2004); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND M: CUSIP 13033LAZ0	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series CDE (issued May 16, 2008); and California Statewide Communities Development Authority 2008 Series G (issued May 16, 2008); and to finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND N: CUSIP 566816JJ4	Part I, Column (f) Refinance taxable line of credit used to refinance Industrial Development Authority of Maricopa County Arizona 2004 Series B bonds issued on April 28, 2004. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND O: CUSIP 13033LEQ6	Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series ABF; and California Statewide Communities Development Authority 2008 Series F bonds issued on May 16, 2008. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2011.
BOND P: CUSIP 040507MJ1	Part I, Column (f) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND Q: CUSIP 566816JL9	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 1992 Series A bonds issued on September 1, 1992 and Industrial Development Authority of Maricopa County Arizona 1998 Series A bonds issued on December 3, 1998.
BOND R: CUSIP 13033LSZ1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund CHFFA 1993 Series A bonds issued on March 17, 1993, CHFFA 1996 Series E bonds issued on December 12, 1996, CHFFA 1997 Series A bonds issued on October 15, 1997 and CHFFA 1998 Series A bonds Issued On December 3, 1998. Repay line of credit used to retire CHFFA 2004 Series H bonds issued on April 28, 2004. Finance capital projects at various hospital facilities. Part II, Line 11 Bond proceeds were used to pay off the CHFFA 2004 Series H put bond that came due on 7/1/2011 that was financed with a draw on the working line of credit. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND S: CUSIP 040507MU6	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f)Finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND T: CUSIP 13033LUD7	Part I, Column (f) Refund CHFFA 2009 Series BC bonds issued on May 14, 2009 and CHFFA 2009 Series G bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND U: CUSIP 040507MV4	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 2009 Series B bonds issued on May 14, 2009 and Arizona Health Facilities Financing Authority 2009 Series E bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
DIGNITY HEALTH

Employer identification number
94-1196203

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FRT9	04-28-2004	470,300,483	BOND A: CUSIP 13033FRT9-SEE PRT VI	X			X		X
B	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816GY4	04-28-2004	259,114,410	BOND B: CUSIP 566816GY4-SEE PRT VI	X			X		X
C	CITY OF HENDERSON NEVADA	88-6000720	425203BM7	04-28-2004	166,163,811	BOND C: CUSIP 425203BM7-SEE PRT VI	X			X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1598225	13033FTN0	05-19-2004	150,000,000	BOND D: CUSIP 13033FTN0-SEE PRT VI		X		X	X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FG46	11-10-2005	351,135,742	BOND E: CUSIP 13033FG46-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FYE4	11-10-2005	200,000,000	BOND F: CUSIP 13033FYE4-SEE PRT VI		X		X	X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507GL3	11-10-2005	224,000,000	BOND G: CUSIP 040507GL3-SEE PRT VI		X		X	X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DH7	04-26-2007	400,000,000	BOND H: CUSIP 130795DH7-SEE PRT VI	X			X		X
	CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES	68-0164610	130795DR5	04-26-2007	276,250,000	BOND I: CUSIP 130795DR5-SEE PRT VI		X		X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816HP2	04-26-2007	178,702,052	BOND J: CUSIP 566816HP2-SEE PRT VI	X			X		X
	CITY OF RENO NEVADA	88-6000201	759835AA9	04-26-2007	98,635,589	BOND K: CUSIP 759835AA9-SEE PRT VI	X			X		X
	CITY OF HENDERSON NEVADA	88-6000720	425203CF1	04-26-2007	200,626,751	BOND L: CUSIP 425203CF1-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LAZ0	05-14-2009	457,778,078	BOND M: CUSIP 13033LAZ0-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	86-0445263	566816JJ4	05-14-2009	127,153,706	BOND N: CUSIP 566816JJ4-SEE PRT VI	X			X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LEQ6	11-12-2009	235,106,175	BOND O: CUSIP 13033LEQ6-SEE PRT VI	X			X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MJ1	11-12-2009	75,689,293	BOND P: CUSIP 040507MJ1-SEE PRT VI	X			X		X
	THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ	88-0445263	566816JL9	07-14-2011	115,008,059	BOND Q: CUSIP 566816JL9-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LSZ1	11-09-2011	515,217,012	BOND R: CUSIP 13033LSZ1-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MU6	11-09-2011	125,000,601	BOND S: CUSIP 040507MU6-SEE PRT VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LUD7	06-27-2012	140,000,000	BOND T: CUSIP 13033LUD7-SEE PRT VI		X		X		X
	ARIZONA HEALTH FACILITIES AUTHORITY	86-0453292	040507MV4	06-27-2012	75,000,000	BOND U: CUSIP 040507MV4-SEE PRT VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	395,000		235,000		720,000		0
2 Amount of bonds legally defeased . . . . . . . . . . .	362,375,000		175,000,000		125,000,000		0
3 Total proceeds of issue . . . . . . . . . . . . . .	473,075,038		268,026,055		171,864,069		143,115,163
4 Gross proceeds in reserve funds . . . . . . . . . . . .	7,910,480		8,557,517		4,164,721		0
5 Capitalized interest from proceeds . . . . . . . . . . .	6,640,000		0		5,184,771		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	4,074,727		2,542,136		1,638,159		0
8 Credit enhancement from proceeds . . . . . . . . . . .	25,069,705		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	7,774,075		6,949,390		2,791,982		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		158,912,634		109,338,989		121,926,573
11 Other spent proceeds . . . . . . . . . . . . . .	421,606,051		74,718,546		48,745,447		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		16,345,832		0		21,188,590
13 Year of substantial completion . . . . . . . . . . . .	2004		2006		2007		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X			X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0.400 %		0.100 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0.700 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0.400 %		0.100 %		1.500 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.	0 %		0 %		0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X		X			X
b Name of provider . . . . . . . . .	CITIGROUP & JPMORGAN		JP MORGAN		CITIGROUP
c Term of hedge . . . . . . . . . .	21.2		5.		5.		34.2
d Was the hedge superintegrated? . . . .		X		X		X		X
e Was the hedge terminated? . . . . . .	X		X		X		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X		X		X			X
b Name of provider . . . . . . . . .	LEHMAN BROTHERS		LEHMAN BROTHERS		LEHMAN BROTHERS		0
c Term of GIC . . . . . . . . . .	22.2		22.2		23.2
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A: CUSIP 13033FRT9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund prior bond issues - California Health Facilities Financing Authority ("CHFFA") 1988 AB (issued June 23, 1988) CHFFA 1992 A (issued September 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (issued January 4, 1994); California Statewide Communities Development Authorities ("CSCDA") 1993 A Certificates of Participation ("COPs") (issued August 12, 1993); CHFFA 1994 AB (issued January 27, 1994); CHFFA 1996 B (issued May 30, 1996); CHFFA 1996 CD (issued May 30, 1996); CHFFA 1996 F (issued December 12, 1996); CHFFA 1997 ABC (issued October 15, 1997); CHFFA 1998 A (issued December 3, 1998). Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND B: CUSIP 566816GY4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1993 A (issued August 12, 1993); AZ 1994 A (issued January 27, 1994); and to finance capital expenditures for construction of Mercy Gilbert and add a new tower at St. Joseph's Hospital and Medical Center. Part II, Line 13 The Industrial Development Authority of Maricopa County (IDAMC) 2004 SERIES AB construction fund proceeds were spent by 2006 on projects that were substantially completed by that date. In March 2009, the IDAMC 2004 Series B bonds were refinanced with a draw on a taxable line of credit, and in May 2009, a portion of the draw on the line was refinanced with tax-exempt debt. In March 2009, approximately $17 million was released from debt service reserve funds, a portion of which is allocable to the un-refinanced portion of the taxable line of credit and a portion of which is allocable to the May 2009 tax-exempt bonds. Such funds are currently unspent and will be used either for capital projects or to redeem or defease May 2009 bonds. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5c Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND C: CUSIP 425203BM7	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues NV 1994 A (issued January 27, 1994) and NV 1998 A (issued December 3, 1998) to finance capital expenditures for the construction of a new hospital, St. Rose Dominican Hospital - San Martin Campus. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated. Part IV, Line 5a Although the debt service reserve funds for the above series were invested in GICs with Lehman Brothers as provider, the GICs with Lehman Brothers were subsequently terminated. As a result, the debt service reserve funds are no longer invested in GICs.
BOND D: CUSIP 13033FTN0	Part I, column (c) The CHFFA 2004 Series J bonds were exchanged in November 2009 for the CHFFA 2009 Series H bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In May 2013, all of the loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $143,112,407 to finance the construction/renovation of facilities and the acquisition of medical equipment at various hospitals. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND E: CUSIP 13033FG46	Part I, Column (c) The CHFFA 2005 Series ABCDEF bonds were exchanged in May 2008 for the CHFFA 2008 Series FHIJKL bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CHFFA 1988 Series A (issued December 3, 1998); CHFFA 1995 Series H (issued May 25, 1995); CHFFA 1997 Series A (issued October 15, 1997); CHFFA 1998 Series A (issued December 3, 1998); CSCDA 1999 (issued December 9, 1999) and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 11/2/2010. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to each such series, such hedges were deemed terminated April 25, 2008 (NV 2005 Series A bonds were retired with a draw on a taxable line of credit), May 16, 2008 (CHFFA 2004 Series B bonds and CHFFA 2005 Series ABCEF bonds were exchanged without a reissuance with fixed rate bonds) and November 12, 2009 (upon refinancing of the CHFFA 2005 Series D which were later exchanged for CHFFA 2008 Series F and AHFA 2005 Series A which were exchanged for AHFA 2008 Series D) as a result of either the refinancing of one or more of these series or the exchange (without a reissuance) and conversion of one or more of these series into long-term fixed-rate bonds. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND F: CUSIP 13033FYE4	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 In October 2012, certain loans originated with proceeds of the bonds matured and were repaid to the issuer. Of such repayments, Dignity Health borrowed the sum of $147,665,635 to finance the construction/renovation of the facilities and the acquisition of medical equipment at various hospitals. $15,000,000 of the loan pool remained the same and was not required to repurpose the assets. Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of a loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated.
BOND G: CUSIP 040507GL3	Part I, Column (c) The Arizona Health Facility Authority (AHFA) 2005 Series CDE bonds were exchanged in May 2008 for the AHFA 2008 Series ABC Bonds and November 2009 the AHFA 2008 Series ABC bonds and November 2009 the AHFA 2008 Series C bonds were exchanged in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. AHFA 2005 Series BCDE, of which AHFA 2005 Series CDE were exchanged for AHFA 2008 Series ABC, of which AHFA 2008 Series C was exchanged for AHFA 2009 Series F. The CUSIP number noted on Schedule K '040507GL3' is the CUSIP from the original Form 8038 filed for the 2005 Series BCDE Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the AHFA 2005 CDE Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for AHFA 2008 Series ABC. The AHFA 2008 Series C Bonds were later exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for the AHFA 2009 Series F Bonds on November 12, 2009. All the series noted above have the same maturity of July 1, 2035. The CUSIPs of the outstanding bonds are AHFA 2005 Series B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' and AHFA 2009 Series F '040507MK8.' Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is primarily a result of the fact that the composite bond issue was a pooled financing issue, the full issue price of which is shown in Part I, column (e). In comparison, the amount of proceeds shown on Part II, Line 3 reflects only the portion of the bond issue borrowed by Dignity Health and currently outstanding. A small part of the difference between the issue price and proceeds is due to investment earnings. Part I, Column (f) To finance acquisition of medical equipment and construction and renovation of hospital facilities. Part II, Line 3 Although the facilities originally financed with proceeds of the bonds were substantially completed in the year indicated, repayments of the loans originated with proceeds of the bonds were and/or will be recycled into newly originated loans contingent on demand by particular borrowers at the time of the loan repayment. Completion dates of projects financed or to be financed with such recycled amounts are not indicated. Part IV, Line 2c The calculation for computing no rebate due was performed on 1/28/2014. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND H: CUSIP 130795DH7	Part I, column (c) The CSCDA 2007 Series ABC bonds were exchanged in May 2008 for the CSCDA 2008 Series CFG bonds in an exchange pursuant to notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - CA 1995 A (issued May 25, 1995); CA 1996 A (issued May 30, 1996); and CA 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014. Part IV, Line 4a Although at the time of sale of the above series of bonds, hedges were properly identified with respect to CSCDA 2007 Series ABC, such hedges were deemed terminated May 16, 2008 (CSCDA 2007 Series A were later exchanged for CSCDA 2008 Series C fixed rate bonds), May 14, 2009 (CSCDA 2007 Series C were exchanged without a reissuance for CSCDA 2008 Series G and later refinanced to CHFFA 2009 Series A fixed rate bonds) and November 12, 2009 (CSCDA 2007 Series B were exchanged without a reissuance for CSCDA 2008 Series F and later refinanced with CHFFA 2009 Series G put bonds) as a result of either the refinancing of these bonds or the exchange (without a reissuance) and conversion of these bonds into long-term fixed-rate bonds. The CSCDA DEF bonds are still outstanding and continue to have hedges associated with them. Part IV, Line 4e Although none of the interest rate swaps (each a "swap" and collectively the "swaps") entered into with respect to certain of the bond issues set forth in Schedule K were actually terminated by either Dignity Health, which was the party to the swap, or by the counterparty to the particular swap, each swap was deemed terminated pursuant to section 1.148-4(h)(3)(iv)(a) of the treasury regulations at the time such swap ceased to be a "qualified hedge" with respect to the bonds with which it was associated.
BOND I: CUSIP 130795DR5	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (c) California Statewide Community Development Authority (CSCDA) 2007 Series G-L, of which CSCDA 2007 Series G-J were exchanged for CSCDA 2008 Series ABDE. The CUSIP number noted on Schedule K '130795DR5' is the CUSIP from the original Form 8038 filed for the 2007 Series G-L Bonds, all of which were issued on November 10, 2005. On May 16, 2008, the CSCDA 2007 Series GHIJ Bonds were exchanged, pursuant to IRS Notice 2008-41, without causing a reissuance, for CSCDA 2008 Series ABDE, and there was an interest rate conversion on the CSCDA 2007 Series KL Bonds. The latest maturities on the currently outstanding exchanged bonds are the CSCDA 2007 Series KL Bonds, both of which have a final maturity date of July 1, 2041. The CUSIPs are '130795TV9' for the CSCDA 2007 Series K Bonds and '130795TW7' for the CSCDA Series 2007 L Bonds. The CSCDA 2007 Series GHIJ bonds were exchanged in May 2008 for the CSCDA 2008 Series ABDE bonds in an exchange pursuant to Notice 2008-41 that was not treated as a new issuance for purposes of sections 103 and 141-150 of the Internal Revenue Code. Part I, Column (f) To finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2013.
BOND J: CUSIP 566816HP2	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - AZ 1999 A (issued December 9, 1999); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND K: CUSIP 759835AA9	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) To finance acquisition and renovation of hospital facility (including Emergency Room) and acquisition of medical equipment. Part III, Line 8A Although the City of Reno, Nevada, health facility revenue bonds, 2007 Series A (the "2007 Reno bonds"), are shown on line 1 of Part I of this Schedule K, Dignity Health and the City of Reno, Nevada (the "City"), took appropriate remedial action with respect to all of the 2007 Reno bonds, under section 1.141-12(d) of the treasury regulations, on September 24, 2012, by defeasing a pro rata portion of the 2007 Reno bonds, in the principal amount of $42,085,000, within 90 days of the sale by Dignity Health of Saint Mary's Regional Medical Center ("SMRMC"), in Reno, Nevada. Such defeasance will cause such portion of the 2007 Reno bonds to be redeemed on their first optional redemption date of July 1, 2017. Because the consideration for the sale of SMRMC was exclusively cash, pursuant to section 1.141-12(d)(2) of the treasury regulations, Dignity Health and the City were permitted to meet, and met, the requirements of section 1.141-12(d) of the treasury regulations with respect to all of the 2007 Reno bonds by applying the "disposition proceeds" received from the sale of SMRMC to the defeasance of a pro rata portion of the 2007 Reno bonds through their first optional redemption date of July 1, 2017. Such pro rata portion of the 2007 Reno bonds was determined to have a principal amount of $42,085.000. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND L: CUSIP 425203CF1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refunding of prior bond issues - NV 1998 A (issued December 3, 1998); NV 1999 series A (issued December 9, 1999); NV 2004 Series B (issued April 28, 2004); and to finance capital expenditures at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND M: CUSIP 13033LAZ0	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series CDE (issued May 16, 2008); and California Statewide Communities Development Authority 2008 Series G (issued May 16, 2008); and to finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND N: CUSIP 566816JJ4	Part I, Column (f) Refinance taxable line of credit used to refinance Industrial Development Authority of Maricopa County Arizona 2004 Series B bonds issued on April 28, 2004. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND O: CUSIP 13033LEQ6	Part I, Column (f) Refund California Health Facilities Financing Authority 2008 Series ABF; and California Statewide Communities Development Authority 2008 Series F bonds issued on May 16, 2008. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2011.
BOND P: CUSIP 040507MJ1	Part I, Column (f) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND Q: CUSIP 566816JL9	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 1992 Series A bonds issued on September 1, 1992 and Industrial Development Authority of Maricopa County Arizona 1998 Series A bonds issued on December 3, 1998.
BOND R: CUSIP 13033LSZ1	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f) Refund CHFFA 1993 Series A bonds issued on March 17, 1993, CHFFA 1996 Series E bonds issued on December 12, 1996, CHFFA 1997 Series A bonds issued on October 15, 1997 and CHFFA 1998 Series A bonds Issued On December 3, 1998. Repay line of credit used to retire CHFFA 2004 Series H bonds issued on April 28, 2004. Finance capital projects at various hospital facilities. Part II, Line 11 Bond proceeds were used to pay off the CHFFA 2004 Series H put bond that came due on 7/1/2011 that was financed with a draw on the working line of credit. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND S: CUSIP 040507MU6	Part I, Column (e) The difference between the issue price in Part I, column (e) and Part II, Line 3 is due to investment earnings. Part I, Column (f)Finance capital projects at various hospital facilities. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND T: CUSIP 13033LUD7	Part I, Column (f) Refund CHFFA 2009 Series BC bonds issued on May 14, 2009 and CHFFA 2009 Series G bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.
BOND U: CUSIP 040507MV4	Part I, Column (f) Refund Industrial Development Authority of Maricopa County Arizona 2009 Series B bonds issued on May 14, 2009 and Arizona Health Facilities Financing Authority 2009 Series E bonds issued on November 12, 2009. Part IV, Line 2c The calculation for computing no rebate due was performed on 6/30/2014.

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

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

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) Rick Grossman	OFFICER	relocation		X	550,000	550,000		No		No	Yes





Total ...... $						550,000

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) 2013

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Wade Dean	Family member of L Dean	56,966	Employment		No
(2) Paige Gemuenden	Famly membr of K Callahan	45,472	Employment		No
(3) Caitlin E Barron	Family member of S Barron	18,081	Employment		No
(4) Allison Cova	Family member of C Cova	129,151	Employment		No
(5) E-lead Resources Inc	Family member of L Dean	2,190,559	Marketing products & services		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....	X	1	24,000	COMPARABLE SALE
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		534	RESALE VALUE
5 Clothing and household goods .......	X		283,615	RESALE VALUE
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....	X	13	1,160	COMPARABLE SALE
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( MEDICAL EQUIPMENT )	X	7	80,525	COMPARABLE SALE
26 Other ( TOYS )	X	15	13,715	COMPARABLE SALE
27 Other ( TICKETS/GIFT CERTIFICATES )	X	3	9,548	COMPARABLE SALE
28 Other ( OFFICE EQUIPMENT )	X	1	2,700	COMPARABLE SALE
Other ( ELECTRONICS )	X	2	945	COMPARABLE SALE
Other ( FLOWER SUPPLIES )	X	1	489	COMPARABLE SALE
Other ( SPORTING GOODS )	X	2	9,502	COMPARABLE SALE
Other ( FOOD & WINE )	X	4	142	COMPARABLE SALE

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

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

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

Yes

32a

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

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

32a

Yes

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2013)

Page 2

Part II

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

Return Reference

Explanation

SCH M, PART I-EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS

ART - WORKS OF ART: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. COLLECTIBLES: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. MEDICAL EQUIPMENT: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. TOYS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. TICKETS/GIFT CERTIFICATES: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OFFICE EQUIPMENT: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. ELECTRONICS: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FLOWER SUPPLIES: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. SPORTING GOODS: THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. FOOD & WINE: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED.

Sch M, Part 1, Line 32b

DIGNITY HEALTH IS SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS SOLICIT AND PROCESS NON-CASH CONTRIBUTIONS ON BEHALF OF DIGNITY HEALTH'S HOSPITALS.

Schedule M (Form 990) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Return Reference	Explanation
FORM 990, PART V, LINE 4B - NAME OF FOREIGN COUNTRY (CONT'D)	TURKEY
FORM 990, PART VI, GOVERNANCE AND MANAGEMENT DISCLOSURES	FORM 990, PART VI, SECTION A, LINE 2 M. Blaszyk and P. Hanelt- business relationship FORM 990, PART VI, SECTION A, LINE 7b In its governance restructuring in 2012, the corporation committed in its bylaws to continue a healing ministry based on the life and works of Jesus in the provision of healthcare services in the communities it serves ("the healing ministry.") To further the healing ministry, the rights formerly reserved to the religious founding co-sponsors of dignity health in this regard were preserved post-restructuring as follows: a sponsorship council was formed pursuant to the bylaws, composed of members of the co-sponsoring organizations, and responsible for overseeing and acting upon issues of catholic identity for catholic-sponsored facilities, and informing the healing ministry of the corporation, including both catholic-sponsored and non-Catholic sponsored facilities, through the right to appoint three of seven members of the mission integrity committee of the board and to approve any changes in the statement of common values. The mission integrity committee is responsible for evaluation and resolution of management, operational, and patient care issues that impact conformance with the mission and values of the healing ministry in the operations of the corporation; approving policies and procedures with respect to implementation and conformance to the mission and values of the healing ministry; establishing and maintaining systems for monitoring compliance with the mission and values of the healing ministry, the operational integrity of the statement of common values and the ethical and religious directives; the operational integrity of mission integration standards; pastoral care and education programs; and ministry leadership formation programs. In addition, the mission integrity committee shall have the power and responsibility to review and monitor the system's labor practices and pension administration. The mission committee may propose changes to the statement of common values, provided the proposal is first reviewed with the sponsorship council, which has the sole power to veto any such changes before they are presented to the corporation's board for final approval. In addition to working through the sponsorship council, at least two members of the dignity health board continue to be women religious, serving as individuals, not as representatives of their congregations. Also, each individual sponsoring congregation continues to have the right to approve the sale or closure of its sponsored catholic hospitals or disposition of its other stable patrimony, or the change of name of such Catholic hospital. FORM 990, PART VI, SECTION B, LINE 11B The Board of Directors delegated the review of the Form 990 to the Audit and Compliance Committee. The organization's VP/Financial Services and Reporting, and the outside accounting firm it engaged to review the return, presented each section of the final draft of this Form 990 to the Audit and Compliance Committee. Compensation schedules and disclosures were presented to the Human Resources and Compensation Committee of the Dignity Health Board of Directors by executive management. The Audit and Compliance Committee also met with various personnel involved in the preparation process of the return, including, but not limited to, the SVP/Finance and Corporate Controller, the VP/Compliance and Internal Audit, and the Tax Manager. The review included an explanation of each schedule of the Form 990 and the pertinent information contained on each schedule. Subsequent to its review, the Audit and Compliance Committee reported back to the Board regarding its oversight of the Form 990 and a complete copy of the Form 990 was provided to the entire Board before the return was filed. FORM 990, PART VI, SECTION B, LINE 12C The Board of Directors has promulgated policies for disclosure and management of conflicts of interest. Under such policies, the EVP/General Counsel is responsible for collecting, reviewing and validating annual disclosures of all covered persons (i.e., Board and Board Committee members, officers and executive leadership, key employees, management personnel at the Vice President level and above, and any other personnel at his or her discretion). All covered persons are required to disclose real or potential conflicts arising from business, financial and personal interests held by such covered persons or their family members. Covered persons are required to disclose to their superiors and to relevant decision makers any interest that may present a conflict or the appearance of a conflict of interest. Such disclosure is required on a transactional basis at the time such conflicts arise, when an individual becomes a covered person, and annually thereafter. Each covered person is required to certify at least annually that he/she: (1) has received a copy of the policy applicable to his/her position; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflicts of interest disclosure statement as required by the policy. The President/CEO and EVP/General Counsel prepare annual reports of reported conflicts of interest which are provided to the Board of Directors, Committee Chairs, and key leaders of the organization to enable responsible individuals to monitor and manage disclosed conflicts of interest and assure decisions are made in the organization's best interests. The procedures for addressing any conflict of interest related to a proposed transaction include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the Board; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the person with the conflict of interest is excluded from the discussion and approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) the transaction or action is approved by a majority of disinterested persons, consistent with any requirements of bylaws or policies; and (6) any conflicting issues arising during the course of a board meeting which cannot be resolved may be referred to an independent committee of the Board of Directors. There are also conflicts of interest provisions under the standards of conduct applicable to all employees, which are administered by the chief compliance officer who has reporting responsibility to the Audit and Compliance Committee. FORM 990, PART VI, SECTION B, LINE 15A & 15B The Board of Directors appoints a Human Resources and Compensation Committee, comprised of independent directors, who are accountable for setting reasonable compensation packages for each officer and certain key employees (including the President/CEO). The Human Resources and Compensation Committee approves, consistent with the organization's philosophy and principles, the annual performance goals and criteria to be used in determining merit increases and variable compensation criteria for officers and key employees. The Human Resources and Compensation Committee also engages outside legal counsel as necessary and qualified independent compensation and benefits specialists (independent experts) to review, analyze and provide benchmarking data for the total compensation and benefits packages of officers and key executives. Appropriate comparable data is obtained from the independent experts, (e.g., total economic benefits paid by similarly situated organizations, both taxable and tax-exempt, for similar job responsibilities). Key deliberations of the Committee are documented in meeting minutes which are approved at the next Committee meeting and provided to the Board of Directors. The documentation of the deliberations includes (a) the terms of the transaction approved and the date approved, (b) the members of the Committee who were present during discussion of the approved transaction and those who voted on it, and (c) the comparability data obtained and relied upon by the Committee and how the data was obtained. FORM 990, PART VI, SECTION C, LINE 19 Federal tax laws do not require that the organization's governing documents and policies related to conflicts of interest be made available for public inspection. The organization makes its consolidated audited financial statements available on its website and upon request. The financial statements are also attached to this Form 990. FORM 990, PART VI, SECTION C, LINE 19 Federal tax laws do not require that the organization's governing documents and policies related to conflicts of interest be made available for public inspection. The organization makes its consolidated audited financial statements available on its website and upon request. The financial statements are also attached
FORM 990, PART XI, Line 9 - Reconciliation of Net Assets	CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY; 99,640,000 REVENUE FROM HEALTH-RELATED ACTIVITIES ORGANIZED AS CORPORATIONS/EXEMPT ORGANIZATIONS; 107,367,127 MARK-TO-MARKET ON INTEREST RATE SWAPS; 2,682,936 CHANGE IN INTEREST IN NET ASSETS OF UNCONSOLIDATED FOUNDATIONS; 12,201,537 CHANGE IN OWNERSHIP INTERESTS HELD BY CONTROLLED SUBSIDIARIES AND OTHER FUND BALANCE TRANSFERS; 202,919
FORM 990, PART XII, Line 3a - Financial Statements AND Reporting	The organization's federal awards were included in dignity health and subordinate corporations' consolidated OMB Circular A-133 audited schedule of federal expenditures.
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL FEES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES/CONSULTING TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIRS AND MAINTENANCE TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:84515430
FORM 990 PART IX LINE 11G	DESCRIPTION:LAUNDRY/LINEN SERVICES TOTAL FEES:27047007
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:XXX-XX-XXXX

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

DIGNITY HEALTH

Employer identification number

94-1196203

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on 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) Arizona Care Network LLC 350 W Thomas Rd Phoenix,AZ85013 45-4494682	Care Network	AZ	643	0	DIGNITY HLTH
(2) CHMC Hope Street Family Center Property 1401 South Grand Avenue Los Angeles,CA90015 27-0967098	Real Property	CA	105,729	77,354	DIGNITY HLTH
(3) Dignity Health Nevada Imaging Company LL 5495 South Rainbow Blvd Suite 203 Las Vegas,NV89118 26-3322792	Imaging SVC	NV	4,927,857	6,173,768	DIGNITY HLTH
(4) Dignity Health USP Oxnard Surgery Center 1700 N ROSE AVENUE STE 100 OXNARD,CA93030 20-0707388	OP Surgery	CA	0	0	DIGNITY HLTH
(5) Dignity Health Medical Group Nevada LLC 3001 St Rose Parkway Henderson,NV89052 46-2574491	clinics	NV	909,903	1,958,194	DIGNITY HLTH
(6) Dignity Health Purchasing Network LLC 3033 North Third Avenue Phoenix,AZ85013 45-5555133	Group Purchas	AZ	2,181,791	1,937,829	DIGNITY HLTH
(7) Southern California Integrated Care Netw 2101 NORTH WATERMAN AVENUE San Bernardino,CA92404 45-5566171	Care Network	CA	0	1,098,807	DIGNITY HLTH
(8) St John's Regional Imaging Center LLC 1700 N ROSE AVENUE STE 110 Oxnard,CA93030 77-0483564	OP Radiology	CA	3,249,805	2,524,272	DIGNITY HLTH
(9) St Francis Foundation LLC 112 E Victoria Street Santa Barbara,CA93101 42-1691710	Leasing	CA	0	1,520,494	DIGNITY HLTH
(10) St Rose Quality Care Network LLC 102 E Lake Mead Drive Henderson,NV89015 46-2147857	Care Network	NV	29,863	93,758	DIGNITY HLTH
(11) Trinity Care LLC 901 Corporate Center Drive Suite 40 Monterey Park,CA91754 33-0805338	Health care	CA	14,066,624	1,594,236	DIGNITY HLTH

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Bakersfield Memorial Hospital 420 34TH Street Bakersfield,CA93301 95-1802779	Hospital	CA	501(c)(3)	3	DIGNITY HLTH	Yes
(2) Community Hospital of San Bernardino 1805 Medical Center Drive San Bernardino,CA92411 95-1643373	Hospital	CA	501(c)(3)	3	DIGNITY HLTH	Yes
(3) Dignity Health HPL Self-Insurance Trust 185 Berry Street San Francisco,CA94107 94-3006034	Administratio	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(4) DIGNITY HEALTH Medical Foundation 3400 Data Drive Rancho Cordova,CA95670 68-0220314	Multi-sp clin	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(5) DIGNITY HEALTH Workers' Comp SELF-INS 185 Berry Street San Francisco,CA94107 94-6612446	Administratio	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(6) Dominican Health Services 1555 Soquel Drive Santa Cruz,CA95065 77-0056778	Community Hea	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(7) Dominican Oaks Corporation 1555 Soquel Drive Santa Cruz,CA95065 77-0127719	Sr Housing	CA	501(c)(3)	9	DHS	Yes
(8) Golden Umbrella 200 Mercy Oaks Drive Redding,CA96003 23-7115371	Senior ctr	CA	501(c)(3)	7	DIGNITY HLTH	Yes
(9) Mark Twain Medical Center 768 Mountain Ranch Road San Andreas,CA95249 68-0127677	Hospital	CA	501(c)(3)	3	NA		No
(10) Mercy McMahon Terrace 3865 J Street Sacramento,CA95816 68-0117340	SR HOUSING	CA	501(c)(3)	9	DIGNITY HLTH	Yes
(11) Pacific Central Coast Health Centers 1400 E Church Street Santa Maria,CA93454 77-0447575	Clinics	CA	501(c)(3)	3	DIGNITY HLTH	Yes
(12) Saint Francis Memorial Hospital 900 Hyde Street San Francisco,CA94109 94-1156295	Hospital	CA	501(c)(3)	3	DIGNITY HLTH	Yes
(13) Shasta Senior Nutrition Program 100 Mercy Oaks Drive Redding,CA96003 94-2650429	Sr Meal	CA	501(c)(3)	7	DIGNITY HLTH	Yes
(14) Sierra Nevada Memorial-Miners Hospital 155 Glasson Way Grass Valley,CA95945 94-1439787	Hospital	CA	501(c)(3)	3	DIGNITY HLTH	Yes
(15) St Francis Hospital Support Corporation 601 E Micheltorena Street Santa Barbara,CA93103 77-0022302	INACTIVE	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(16) St Mary Catholic Housing Corporation 1050 Linden Avenue Long Beach,CA90813 33-0007728	Sr HOusing	CA	501(c)(3)	1	DIGNITY HLTH	Yes
(17) St Mary Professional Building Inc 1050 Linden Avenue Long Beach,CA90813 23-7373088	office space	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(18) Arroyo Grande Community Hospital Foundat 345 S Halcyon Rd Arroyo Grande,CA93420 20-3256066	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(19) Barrow Foundation UK 350 West Thomas Road Phoenix,AZ85013 31-1724184	FNDRSING FND	AZ	501(c)(3)	11C-III-FI	NA		No
(20) Barrow Neurological Foundation 350 West Thomas Road Phoenix,AZ85013 86-0174371	FNDRSING FND	AZ	501(c)(3)	11C-III-FI	DIGNITY HLTH		No
(21) California Hospital Medical Center Found 1401 South Grand Avenue Los Angeles,CA90015 95-4000909	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(22) Community Hospital Foundation of San Ber 1805 Medical Center Drive San Bernardino,CA92411 95-3051931	FNDRSING FND	CA	501(c)(3)	11A-I	CHSB	Yes
(23) DIGNITY HEALTH Foundation 185 Berry Street San Francisco,CA94107 46-2037641	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(24) DIGNITY HEALTH Foundation East Valley 475 South Dobson Road Chandler,AZ85224 74-2418514	FNDRSING FND	AZ	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(25) Dominican Hospital Foundation 1555 Soquel Drive Santa Cruz,CA95065 94-2450442	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(26) French Hospital Medical Center Foundatio 1911 Johnson Avenue San Luis Obispo,CA93401 20-3256125	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(27) Glendale Memorial Health Foundation 1420 South Central Avenue Glendale,CA91204 95-3625651	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(28) Marian Regional Medical Center Foundatio 1400 E Church Street Santa Maria,CA93454 95-3818027	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(29) Mercy Foundation Bakersfield PO Box 119 Bakersfield,CA93302 77-0201321	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(30) Mercy Foundation Sacramento 3400 Data Drive 3rd Flr Rancho Cordova,CA95670 23-7072762	FNDRSING FND	CA	501(c)(3)	11A-I	NA		No
(31) MERCY MEDICAL CENTER MERCED FOUNDATION 301 E 13th Street Merced,CA95340 77-0035928	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(32) Northridge Hospital Foundation 18300 Roscoe Blvd Northridge,CA91328 23-7444901	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(33) San Gabriel Valley Medical Center Founda 438 West Las Tunas Drive San Gabriel,CA91776 95-3430341	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(34) Sequoia Hospital Foundation 170 Alameda de las Pulgas Redwood City,CA94062 94-2909990	FNDRSING FND	CA	501(c)(3)	11C-III-FI	NA		No
(35) St Bernardine Medical Center Foundation 2101 N Waterman Avenue San Bernardino,CA92404 23-7440086	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(36) St Francis Foundation of Santa Barbara 2323 De La Vina St Suite 104 Santa Barbara,CA93105 23-7137119	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(37) St John's Healthcare Foundation 1600 North Rose Avenue Oxnard,CA93030 20-2865781	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(38) St Joseph's Foundation 350 West Thomas Road Phoenix,AZ85013 94-2941245	FNDRSING FND	AZ	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(39) St Joseph's Foundation of San Joaquin 1800 N California Street Stockton,CA95204 51-0432777	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(40) St Mary Medical Center Foundation 1050 Linden Avenue Long Beach,CA90813 23-7153876	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(41) St Mary's Medical Center Foundation 450 Stanyan Street San Francisco,CA94117 94-3336143	FNDRSING FND	CA	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(42) St Rose Dominican Health Foundation 3001 St Rose Parkway Henderson,CA89052 88-0349432	FNDRSING FND	NV	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(43) The Congenital Heart Foundation 350 W Thomas Road Phoenix,AZ85013 26-3342554	FNDRSING FND	AZ	501(c)(3)	11A-I	DIGNITY HLTH	Yes
(44) Woodland Memorial Hospital Foundation 1321 Cottonwood Street 305 Woodland,CA95695 94-6167964	FNDRSING FND	CA	501(c)(3)	7	NA		No
(45) Southwest Catholic Health Network Corpor 4350 E Cotton Center Blvd Bldg D Phoenix,AZ85040 86-0527381	Health PLAN	AZ	501(c)(3)	11A-I	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) CBCC Outsmarting Cancer LLC 6501 Truxtun Avenue Bakersfield,CA93309 46-1602286	Radiation/Oncolog	CA	Dignity Health	Related	649,892	20,702,236		No	0	Yes		51.000 %
(2) DHRT Holdings LLC 185 Berry Street Suite 300 San Francisco,CA94107 35-2484591	Holding Company	DE	Dignity Health	Related	-687,627	78,161,216		No	0	Yes		33.870 %
(3) DignityAbrazo Health Network LLC dba AC 3030 N Central Avenue Suite 1402 Phoenix,AZ85012 46-5477985	Management Srvcs	AZ	Dignity Health	Related	0	0		No	0		No	50.000 %
(4) DIGNITYUSP LAS VEGAS SURGERY CENTERS LL 15305 Dallas Parkway Suite 1600 LB Addison,TX75001 20-2999237	Surgery	TX	Dignity Health	Related	709,240	6,880,810		No	0		No	50.100 %
(5) DIGNITYUSP NORCAL SURGERY CENTERS LLC 15305 Dallas Parkway Suite 1600 LB Addison,TX75001 20-2468509	Surgery	TX	Dignity Health	Related	3,190,325	23,775,561		No	0		No	50.100 %
(6) DIGNITYUSP PHOENIX SURGERY CENTERS LLC 15305 Dallas Parkway Suite 1600 LB Addison,TX75001 13-4248908	Surgery	TX	Dignity Health	Related	1,694,351	35,583,381		No	0		No	50.100 %
(7) Dominican Breast Center LLC 1661 SOQUEL DRIVE SUITE G SANTA CRUZ,CA95065 77-0419106	IMAGING Center	CA	Dignity Health	Related	77,032	339,399		No	0	Yes		50.000 %
(8) Dominican Magnetic Resonance Imaging Cen 1545 Soquel Drive Santa Cruz,CA94065 77-0095477	Imaging Center	CA	Dignity Health	Related	-119,928	448,945		No	0	Yes		80.000 %
(9) Folsom Sierra Endoscopy Center LP 1650 Creekside Drive 1600 Folsom,CA95630 68-0482416	Endoscopy	CA	Dignity Health	Related	1,593,092	776,817		No	0	Yes		51.000 %
(10) Mercy Davis Cancer Center Management Co 2740 M Street Merced,CA95340 94-3358445	Mgmt of Cancer ct	CA	Dignity Health	Related	1,283,774	5,906,899		No	0	Yes		50.000 %
(11) NICU Operating CO of Santa Cruz LLC 1555 Soquel Drive Santa Cruz,CA95065 46-0502935	Neonatal Healthca	CA	Dignity Health	Related	5,936,129	12,564,609		No	0		No	51.000 %
(12) NSC Channel Islands LLC 3000 Riverchase Galleria Suite 500 Birmingham,AL35244 77-0418197	Ambulatory surgic	CA	Dignity Health	Related	55,873	2,839,683		No	0	Yes		51.000 %
(13) Plaza Surgery Center LP 525 E Plaza Drive Suite 100 Santa Maria,CA93454 77-0573567	Surgery	CA	Marian Health S	Related	0	0		No	0	Yes		50.800 %
(14) Radiation Oncology Centers of Ventura Co 1700 N ROSE AVENUE SUITE 120 OXNARD,CA93030 77-0191706	IMAGING center	CA	Dignity Health	Related	432,836	562,536		No	0	Yes		50.000 %
(15) RBR Management LLC 91 Corporate Park Drive Suite 120 Henderson,NV89074 27-1466450	Ambulance	NV	Dignity Health	Related	287,530	956,010		No	0		No	50.100 %
(16) Santa Cruz Land & Building LP 1555 Soquel Drive Santa Cruz,CA95065 77-0285236	real estate	CA	Dominican Healt	Related	0	0		No	0	Yes		86.210 %
(17) SMI Imaging LLC 6740 E Camelback Road Suite 101 Scottsdale,AZ85251 26-4000683	Imaging Center	CA	Dignity Health	Related	-893,320	44,925,782		No	0		No	59.730 %
(18) St Joseph's Surgery Center LP 15305 Dallas Parkway Suite 1600 LB Addison,TX75001 20-1019390	Surgery	TX	Dignity Health	Related	952,630	3,091,541		No	0	Yes		79.760 %
(19) Templeton Surgery Center LLC 1310 Las Tablas Road Suite 104 Templeton,CA94365 20-2246616	Surgery	CA	Dignity Health	Related	-49,049	960,716		No	0	Yes		70.450 %
(20) The Medical Pavilion at St John's 1700 Rose Avenue Oxnard,CA93030 77-0332349	Real Estate	CA	Dignity Health	Related	35,923	2,213,308		No	0	Yes		25.000 %
(21) Arizona Care Network LLC 350 W Thomas Rd PHOENIX,AZ85013 45-4494682	CARE NETWORK		Dignity Health	RELATED	0	0		No	0	Yes		50.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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		Yes	No
(1) CDS of Nevada Inc 1510 Meadowland Lane Reno,NV89502 88-0202496	3rd Party Adminis	NV	Saint Mary's He	C Corp	4,343,060	1,356,557	100.000 %	Yes
(2) Coastal Surgical Specialists Inc 921 Oak Park Blvd Suite 101 Pismo Beach,CA93449 74-3000596	Ambulatory Surger	CA	DIGNITY HEALTH	S Corp	1,575,146	4,145,533	51.000 %	Yes
(3) Dignity Health Insurance Ltd PO Box 1051 KY1-1102 Grand Cayman Islands CJ 98-1065338	Self Ins Fund	CJ	Dignity Health	C Corp	116,315	40,950,446	100.000 %	Yes
(4) Glendale Memorial Services Corporation 1420 South Central Avenue Glendale,CA91204 95-4051021	Inactive	CA	DIGNITY HEALTH	C Corp	0	0	100.000 %	Yes
(5) Inland Health Organization of Southern C 1980 Orange Tree Lane Ste 200 Redlands,CA92374 33-0578944	HLTH CARE MGT	CA	DIGNITY HEALTH	C Corp	3,811,901	3,181,982	100.000 %	Yes
(6) Management Services Organization of Sant 1400 E Church Street Santa Maria,CA93454 77-0318135	Inactive	CA	DIGNITY HEALTH	C Corp	0	0	100.000 %	Yes
(7) Marian Health Services Inc 1400 E Church Street Santa Maria,CA93454 77-0074057	Health Services	CA	DIGNITY HEALTH	C Corp	621,664	1,491,343	100.000 %	Yes
(8) Millenium Surgery Center Inc 9300 Stockdale Hwy 200 Bakersfield,CA93311 77-0513445	OP SURGERY SVC	CA	Bakersfield Mem	S Corp	1,790,456	7,742,475	57.980 %	Yes
(9) Saint Mary's Multi Specialty Clinic Inc 1625 Prater Way Suite 102 Sparks,NV89434 11-3763590	Urgent care clini	NV	Saint Mary's He	C Corp	-1,098,979	121,289	100.000 %	Yes
(10) Saint Mary's Healthfirst 1510 Meadowland Lane Reno,NV89502 88-0293082	Insurance Provide	NV	DH Holding Corp	C Corp	85,645,734	43,514,949	100.000 %	Yes
(11) Saint Mary's Preferred Health Insurance 1510 Meadowland Lane Reno,NV89502 88-0193357	Insurance Provide	NV	Saint Mary's He	C Corp	69,277,358	26,551,852	100.000 %	Yes
(12) St Mary Health Ventures Inc 1050 Linden Avenue Long Beach,CA90813 95-1912528	Retail Pharmacy	CA	DIGNITY HEALTH	C Corp	2,016,209	5,267,900	100.000 %	Yes
(13) Trinity Care Infusion Services 18440 Roscoe Boulevard Northridge,CA91325 33-0828794	HOME CARE MED SVC	CA	DIGNITY HEALTH	C Corp	895,477	209,429	100.000 %	Yes
(14) Dignity Health Holding Corporation 185 Berry Street Suite 300 San Francisco,CA94107 46-0675371	HOLDING COMPANY	NV	DIGNITY HEALTH	C Corp	7,477,250	756,509,964	100.000 %	Yes
(15) USHW Holding Corporation 25124 Springfield Court Suite 200 Valencia,CA91355 20-8050895	Occupatnl Med Svc	DE	DH Holding Corp	C Corp	0	0	100.000 %	Yes
(16) US HealthWorks Holding Company Inc 25124 Springfield Court Suite 200 Valencia,CA91355 58-2420844	Occupatnl Med Svc	CA	USHW Holding Co	C Corp	0	0	100.000 %	Yes
(17) US HealthWorks Inc 25124 Springfield Court Suite 200 Valencia,CA91355 04-3289947	Occupatnl Med Svc	CA	USHW Holding Co	C Corp	1,625,298	557,489,075	100.000 %	Yes
(18) US HealthWorks Medical Group of Alaska L 25124 Springfield Court Suite 200 Valencia,CA91355 63-1219117	Occupatnl Med Svc	AK	USHW Holding Co	C Corp	19,133,603	3,484,984	100.000 %	Yes
(19) US HealthWorks of Arizona Inc 25124 Springfield Court Suite 200 Valencia,CA91355 58-2660957	Occupatnl Med Svc	AZ	USHW Holding Co	C Corp	6,562,597	1,794,088	100.000 %	Yes
(20) USHW of California Inc 25124 Springfield Court Suite 200 Valencia,CA91355 95-4585828	Occupatnl Med Svc	CA	USHW Holding Co	C Corp	211,676,305	48,330,042	100.000 %	Yes
(21) US HealthWorks Medical Group of Florida 25124 Springfield Court Suite 200 Valencia,CA91355 58-2654983	Occupatnl Med Svc	FL	USHW Holding Co	C Corp	20,268,475	6,163,817	100.000 %	Yes
(22) US HealthWorks of Georgia Inc 25124 Springfield Court Suite 200 Valencia,CA91355 58-2660956	Occupatnl Med Svc	GA	USHW Holding Co	C Corp	989,297	393,568	100.000 %	Yes
(23) US HealthWorks of Indiana Inc 25124 Springfield Court Suite 200 Valencia,CA91355 35-1991196	Occupatnl Med Svc	IN	USHW Holding Co	C Corp	10,947,446	17,741,161	100.000 %	Yes
(24) US HealthWorks Medical Group of Maine In 25124 Springfield Court Suite 200 Valencia,CA91355 58-2654976	Occupatnl Med Svc	ME	USHW Holding Co	C Corp	2,549,319	371,600	100.000 %	Yes
(25) US HealthWorks of New Jersey Inc 25124 Springfield Court Suite 200 Valencia,CA91355 04-3323869	Occupatnl Med Svc	NJ	USHW Holding Co	C Corp	12,752,625	4,497,091	100.000 %	Yes
(26) US HealthWorks of North Carolina Inc 25124 Springfield Court Suite 200 Valencia,CA91355 56-2029468	Occupatnl Med Svc	NC	USHW Holding Co	C Corp	2,989,168	737,805	100.000 %	Yes
(27) US HealthWorks of Ohio Inc 25124 Springfield Court Suite 200 Valencia,CA91355 31-1249564	Occupatnl Med Svc	OH	USHW Holding Co	C Corp	8,533,731	2,197,440	100.000 %	Yes
(28) US HealthWorks of Pennsylvania Inc 25124 Springfield Court Suite 200 Valencia,CA91355 58-2660955	Occupatnl Med Svc	PA	USHW Holding Co	C Corp	4,941,995	2,770,847	100.000 %	Yes
(29) USHW of Texas Inc 25124 Springfield Court Suite 200 Valencia,CA91355 74-2785392	Occupatnl Med Svc	TX	USHW Holding Co	C Corp	21,403,121	4,419,569	100.000 %	Yes
(30) US HealthWorks of Washington Inc 25124 Springfield Court Suite 200 Valencia,CA91355 91-1173613	Occupatnl Med Svc	WA	USHW Holding Co	C Corp	44,019,958	10,289,253	100.000 %	Yes
(31) RUSHWINC Properties Inc 25124 Springfield Court Suite 200 Valencia,CA91355 75-3160650	Lease negotiation	GA	USHW Holding Co	C Corp	0	0	100.000 %	Yes
(32) US HealthWorks of Minnesota Inc 25124 Springfield Court Suite 200 Valencia,CA91355 45-2494357	Occupatnl Med Svc	MN	USHW Holding Co	C Corp	4,037,869	1,166,771	100.000 %	Yes
(33) US HealthWorks of Tennessee Inc 25124 Springfield Court Suite 200 Valencia,CA91355 45-2697510	Occupatnl Med Svc	TN	USHW Holding Co	C Corp	6,084,941	1,584,071	100.000 %	Yes
(34) US HealthWorks of Illinois Inc 25124 Springfield Court Suite 200 Valencia,CA91355 46-1384805	Occupatnl Med Svc	IL	USHW Holding Co	C Corp	8,569,341	8,594,980	100.000 %	Yes
(35) US HealthWorks of Wisconsin Inc 25124 Springfield Court Suite 200 Valencia,CA91355 46-1384564	Occupatnl Med Svc	WI	USHW Holding Co	C Corp	6,965,018	9,533,931	100.000 %	Yes
(36) US HealthWorks of Kansas City Inc 25124 Springfield Court Suite 200 Valencia,CA91355 46-2754415	Occupatnl Med Svc	KS	USHW Holding Co	C Corp	5,663,224	16,004,394	100.000 %	Yes

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on 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

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

Yes

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

Yes

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

Yes

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

Yes

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

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

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Community Hospital San Bernardino	a	5,873,450	SEE PART VII
(2) Dignity Health Medical Foundation	a	3,303,723	SEE PART VII
(3) DignityUSP NorCal Surgery Centers LLC	a	408,408	SEE PART VII
(4) Dominican Magnetic Resonance Imaging Center	a	138,558	SEE PART VII
(5) Golden Umbrella	a	145,757	SEE PART VII
(6) Shasta Senior Nutrition Program	a	272,484	SEE PART VII
(7) SMI Imaging LLC	a	118,551	SEE PART VII
(8) St Joseph's Foundation of San Joaquin	a	30,000	SEE PART VII
(9) St Joseph's Surgery Center LP	a	387,825	SEE PART VII
(10) St Mary Health Venture	a	35,109	SEE PART VII
(11) St Mary Professional Building	a	177,000	SEE PART VII
(12) Arizona Care Network LLC	B	1,300,000	SEE PART VII
(13) Arroyo Grande Community Hospital Foundation	b	436,617	SEE PART VII
(14) California Hospital Medical Center Foundation	b	1,650,918	SEE PART VII
(15) DHRT Holdings LLC	B	1,134,415	SEE PART VII
(16) DignityAbrazo Health Network LLC	B	1,425,000	SEE PART VII
(17) Dignity Health Foundation East Valley	b	1,815,462	SEE PART VII
(18) Dignity Health Holding Corporation	b	22,215,198	SEE PART VII
(19) Dignity Health Medical Foundation	b	116,637,542	SEE PART VII
(20) Dominican Breast Center LLC	b	90,000	SEE PART VII
(21) Dominican Hospital Foundation	b	1,185,597	SEE PART VII
(22) Dominican Magnetic Resonance Imaging Center	b	282,000	SEE PART VII
(23) French Hospital Medical Center Foundation	b	966,054	SEE PART VII
(24) Glendale Memorial Health Foundation	b	915,254	SEE PART VII
(25) Golden Umbrella	b	324,693	SEE PART VII
(26) Inland Health Organization of Southern Califo	b	3,300,909	SEE PART VII
(27) Marian Regional Medical Center Foundation	b	918,702	SEE PART VII
(28) Mercy Foundation Bakersfield	b	862,123	SEE PART VII
(29) Mercy Medical Center Merced Foundation	b	582,699	SEE PART VII
(30) Northridge Hospital Foundation	b	1,071,852	SEE PART VII
(31) Shasta Senior Nutrition Program	b	320,341	SEE PART VII
(32) St Bernardine Medical Center Foundation	b	883,990	SEE PART VII
(33) St John's Healthcare Foundation	b	1,243,628	SEE PART VII
(34) St Joseph's Foundation	b	1,696,230	SEE PART VII
(35) St Joseph's Foundation of San Joaquin	b	892,076	SEE PART VII
(36) St Mary Medical Center Foundation	b	2,125,608	SEE PART VII
(37) St Mary's Medical Center Foundation	b	1,109,077	SEE PART VII
(38) St Rose Dominican Health Foundation	b	2,601,318	SEE PART VII
(39) California Hospital Medical Center Foundation	c	4,028,265	SEE PART VII
(40) Dignity Health Foundation East Valley	c	2,678,196	SEE PART VII
(41) Dominican Hospital Foundation	c	2,304,324	SEE PART VII
(42) French Hospital Medical Center Foundation	c	2,109,989	SEE PART VII
(43) Glendale Memorial Health Foundation	c	348,743	SEE PART VII
(44) Marian Regional Medical Center Foundation	c	2,810,945	SEE PART VII
(45) Mercy Foundation Bakersfield	c	2,049,680	SEE PART VII
(46) Mercy Medical Center Merced Foundation	c	650,843	SEE PART VII
(47) Northridge Hospital Foundation	c	2,934,551	SEE PART VII
(48) St Bernardine Medical Center Foundation	c	2,141,672	SEE PART VII
(49) St John's Healthcare Foundation	c	551,292	SEE PART VII
(50) St Joseph's Foundation	c	5,257,117	SEE PART VII
(51) St Joseph's Foundation of San Joaquin	c	3,212,700	SEE PART VII
(52) St Mary Medical Center Foundation	c	4,685,682	SEE PART VII
(53) St Mary's Medical Center Foundation	c	2,441,835	SEE PART VII
(54) St Rose Dominican Health Foundation	c	5,821,732	SEE PART VII
(55) Dignity Health Holding Corporation	d	125,000	SEE PART VII
(56) SMI Imaging LLC	D	1,487,048	SEE PART VII
(57) Dignity Health Holding Corporation	f	200,000,000	SEE PART VII
(58) Bakersfield Memorial Hospital	l	26,878,997	SEE PART VII
(59) CDS of Nevada Inc	l	215,275	SEE PART VII
(60) Community Hospital San Bernardino	l	15,115,508	SEE PART VII
(61) Community Hospital San Bernardino Foundation	l	49,788	SEE PART VII
(62) Dignity Health Foundation East Valley	l	86,260	SEE PART VII
(63) Dignity Health Hospital Prof Liab Self-Insura	l	8,644,118	SEE PART VII
(64) Dignity Health Medical Foundation	l	19,154,179	SEE PART VII
(65) Dignity Health Workers' Comp Self-Insurance T	l	1,061,319	SEE PART VII
(66) DignityUSP NorCal Surgery Centers LLC	l	3,338,342	SEE PART VII
(67) Dominican Oaks Corporation	l	221,133	SEE PART VII
(68) Folsom Sierra Endoscopy Center	l	2,052,441	SEE PART VII
(69) French Hospital Medical Center Foundation	l	58,140	SEE PART VII
(70) Glendale Memorial Health Foundation	l	60,780	SEE PART VII
(71) Inland Health Organization of Southern Califo	l	256,530	SEE PART VII
(72) Marian Regional Medical Center Foundation	l	52,560	SEE PART VII
(73) Mercy Davis Cancer Center Management Co LLC	l	2,869,973	SEE PART VII
(74) Mercy Foundation Bakersfield	l	62,915	SEE PART VII
(75) Mercy McMahon Terrace	l	92,738	SEE PART VII
(76) NICU OPERATING CO SANTA CRUZ LLC	l	3,967,725	SEE PART VII
(77) Northridge Hospital Foundation	l	95,220	SEE PART VII
(78) PACIFIC CENTRAL COAST HEALTH CENTERS	L	595,704	SEE PART VII
(79) Saint Francis Memorial Hospital	l	19,086,895	SEE PART VII
(80) Saint Mary's Preferred Health Insurance Compa	l	439,752	SEE PART VII
(81) Saint Mary's HealthFirst	l	6,671,725	SEE PART VII
(82) Sierra Nevada Memorial-Miners Hospital	l	7,109,680	SEE PART VII
(83) St Bernardine Medical Center Foundation	l	70,548	SEE PART VII
(84) St John's Healthcare Foundation	l	220,720	SEE PART VII
(85) St Joseph's Foundation of San Joaquin	l	118,697	SEE PART VII
(86) St Joseph's Surgery Center LP	l	4,643,864	SEE PART VII
(87) St Mary Health Venture	l	2,918,346	SEE PART VII
(88) St Mary Medical Center Foundation	l	148,046	SEE PART VII
(89) St Mary Professional Building	l	262,633	SEE PART VII
(90) St Rose Dominican Health Foundation	l	175,320	SEE PART VII
(91) Trinity Care Infusion Services	l	111,158	SEE PART VII
(92) Bakersfield Memorial Hospital	m	309,048	SEE PART VII
(93) CBCC Outsmarting Cancer LLC	m	150,351	SEE PART VII
(94) DignityAbrazo Health Network LLC	M	1,746,558	SEE PART VII
(95) Dignity Health Hospital Prof Liab Self-Insura	m	91,662,816	SEE PART VII
(96) Dignity Health Workers' Comp Self-Insurance T	m	20,878,960	SEE PART VII
(97) Dignity Health Medical Foundation	m	17,977,857	SEE PART VII
(98) Folsom Sierra Endoscopy Center	m	5,470,101	SEE PART VII
(99) Saint Francis Memorial Hospital	m	58,619	SEE PART VII
(100) Saint Mary's HealthFirst	m	8,027,872	SEE PART VII
(101) DignityUSP NorCal Surgery Centers LLC	s	8,016,000	SEE PART VII
(102) Dominican Health Services	s	75,000	SEE PART VII
(103) Folsom Sierra Endoscopy Center	s	1,403,520	SEE PART VII
(104) NICU Operating CO of Santa Cruz LLC	s	3,583,711	SEE PART VII
(105) NSC CHANNEL ISLANDS LLC	s	203,668	SEE PART VII
(106) RBR MANAGEMENT LLC	S	165,660	SEE PART VII
(107) St Joseph's Surgery Center LP	s	1,265,822	SEE PART VII

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference

Explanation

Schedule R, Part V, Line 2 column (c)

PART V, LINE 1A - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT TO CERTAIN RELATED ORGANIZATIONS (FUNDRAISING FOUNDATIONS, JOINT VENTURES AND MEDICAL FOUNDATION). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE AMOUNTS CHARGED FOR SUCH AGREEMENTS. SUCH CHARGES REPRESENT FAIR MARKET VALUE OF THE AMOUNTS CHARGED UNDER THESE AGREEMENTS. DIGNITY HEALTH PROVIDES LOANS TO RELATED ORGANIZATIONS (HOSPITALS, FUNDRAISING FOUNDATIONS AND WHOLLY OWNED ORGANIZATIONS). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE INTEREST PAYMENTS CHARGED FOR THESE LOANS. PART V, LINE 1B, AND 1C - DIGNITY HEALTH AND ITS HOSPITAL FACILITIES ARE SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS OPERATE FOR THE BENEFIT OF, TO RAISE FUNDS FOR, OR TO CARRY OUT THE PURPOSES OF DIGNITY HEALTH AND ITS HOSPITALS. AS A RESULT, PAYMENTS ARE MADE DIRECTLY TO DIGNITY HEALTH FROM THE FOUNDATIONS OR DIRECTLY TO THE FOUNDATIONS FROM DIGNITY HEALTH. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" INCLUDE FUNDS EXPENDED BY DIGNITY HEALTH ON BEHALF OF THE FOUNDATIONS FOR OPERATIONAL EXPENSES. AMOUNTS REPORTED AS TRANSACTION TYPE "C" REPRESENT FUNDS RECEIVED AS GRANTS BY DIGNITY HEALTH HOSPITALS FROM THE FOUNDATIONS. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" ALSO INCLUDE FUNDING SUPPORT OF DIGNITY HEALTH MEDICAL FOUNDATION (DHMF), WHICH OPERATES CLINICS IN THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS THROUGHOUT CALIFORNIA. DIGNITY HEALTH ALSO PROVIDES FUNDING SUPPORT OF OTHER EXEMPT ORGANIZATIONS THAT PROVIDE SERVICES TO COMMUNITIES SERVED BY DIGNITY HEALTH FACILITIES WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". DIGNITY HEALTH ALSO PROVIDES CAPITAL FUNDING TO CERTAIN RELATED ORGANIZATIONS, WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". PART V, LINE 1D - DIGNITY HEALTH MADE LOANS TO AND LOAN GUARANTEES ON BEHALF OF VARIOUS RELATED ORGANIZATIONS. AMOUNTS REPORTED AS TRANSACTION TYPE "D" REPRESENT THE FAIR MARKET VALUE OF THE LOANS AND GUARANTEES. PART V, LINE 1F - DIGNITY HEALTH RECEIVED A RETURN ON CAPITAL CONTRIBUTION FROM DIGNITY HEALTH HOLDING CORPORATION WHICH IS REFLECTED AS A DIVIDEND. PART V, LINE 1L - DIGNITY HEALTH FACILITIES PERFORM VARIOUS SERVICES FOR OTHER RELATED ORGANIZATIONS. BELOW IS A SUMMARY OF THE TRANSACTIONS AMONG RELATED ORGANIZATIONS FOR SUCH ACTIVITIES. DIGNITY HEALTH'S CONTROLLED ENTITIES ARE ASSESSED AN AMOUNT TO COVER THE SYSTEM OFFICE OPERATIONS. IN ADDITION, AN EXPENSE IS ALSO ASSESSED TO COVER CENTRALIZED INFORMATION TECHNOLOGY COSTS OF THE ORGANIZATION, CENTRALIZED ACCOUNTS PAYABLE, PAYROLL, ACCOUNTING, DECISION SUPPORT, AND CERTAIN OTHER MANAGEMENT SERVICES. DIGNITY HEALTH HOSPITALS PROVIDE CARE TO INDIVIDUALS INSURED BY SAINT MARY'S HEALTHFIRST. AMOUNTS REPORTED UNDER TRANSACTION TYPE "L" INCLUDE NET PATIENT REVENUE RELATED TO THESE SERVICES. IN FY14, DIGNITY HEALTH HOSPITALS ALSO PERFORMED SERVICES FOR OTHER RELATED ORGANIZATIONS. SERVICES INCLUDED PLANT MAINTENANCE, LAUNDRY SERVICES, PATIENT FINANCIAL SERVICES MANAGEMENT, CENTRAL STERILIZATION SERVICES, CATERING SERVICES FOR PATIENT NOURISHMENT, AND OTHER SERVICES AS DEEMED NECESSARY. THE SERVICES PERFORMED ARE REIMBURSED AT COST. PART V, LINE 1M - PHYSICIAN CLINIC SUPPORT SERVICES ARE PROVIDED TO DIGNITY HEALTH HOSPITALS BY DHMF. DHMF OPERATES CLINICS WITH LOCATIONS THROUGHOUT NORTHERN CALIFORNIA AND NEVADA. AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE PAYMENTS MADE TO DHMF FOR THE HOSPITALISTS AND RISK POOL PROGRAMS. DIGNITY HEALTH IS SELF-INSURED FOR WORKERS' COMPENSATION BENEFITS AND FOR HOSPITAL PROFESSIONAL AND GENERAL LIABILITY RISKS. DIGNITY HEALTH MAINTAINS SEPARATE TRUSTS FOR THESE PROGRAMS FROM WHICH CLAIMS AND RELATED EXPENSES AND COSTS OF ADMINISTERING THE PLANS ARE PAID. DIGNITY HEALTH HOSPITALS FUND THE TRUSTS, SUCH THAT OVER TIME, ASSETS HELD EQUAL LIABILITIES FOR CLAIMS INCURRED. THE AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE CASH TRANSFERRED FROM DIGNITY HEALTH TO THE TRUSTS FOR THE FY14 FUNDING OF THE SELF-INSURANCE PROGRAMS. CERTAIN DIGNITY HEALTH HOSPITALS PURCHASED HEALTH INSURANCE FOR THEIR EMPLOYEES FROM SAINT MARY'S HEALTHFIRST. AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE PAYMENTS MADE FOR INSURANCE PREMIUMS. PART V, LINE 1S - AMOUNTS REPORTED UNDER TRANSACTION TYPE "S" REPRESENT FUNDING FROM PARTNERSHIPS VIA K-1 DISTRIBUTIONS.

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Dignity Health is committed to furthering the healing ministry of Jesus through the delivery of affordable health care, advocacy for the poor and community partnerships.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	49,928
6	Total number of volunteers (estimate if necessary) .............	6	7,775
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	23,479,257
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	990	98,811,080
9	Program service revenue (Part VIII, line 2g) .........	8,205,245,150	8,053,649,140
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	359,557,441	443,310,156
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	58,222,772	59,358,653
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	8,623,026,353	8,655,129,029
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	162,756,927	187,309,516
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)	4,577,305,554	4,592,357,636
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	3,577,679,180	3,598,797,109
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	8,317,741,661	8,378,464,261
19	Revenue less expenses. Subtract line 18 from line 12.......	305,284,692	276,664,768
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	12,569,336,861	12,980,966,213
21	Total liabilities (Part X, line 26).............	7,893,273,428	7,599,300,441
22	Net assets or fund balances. Subtract line 21 from line 20.....	4,676,063,433	5,381,665,772

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 7,263,992,175 including grants of $ 187,309,516 ) (Revenue $ 8,042,137,336 )
	Dignity Health is a California nonprofit public benefit corporation headquartered in San Francisco, California. Dignity Health, together with its subsidiary corporations, is one of the largest not-for-profit acute health care delivery systems in the United States as measured by annual revenue. Dignity Health operated 39 hospitals throughout major California markets and in the Phoenix, Arizona and Las Vegas, Nevada metropolitan markets during the year ended June 30, 2014. Dignity health and its subordinate corporations' facilities included approximately 8,500 licensed acute care beds and approximately 700 licensed skilled nursing beds as of June 30, 2014. Dignity health maintains a prominent market share in many of its service areas, and many of its hospitals rank among the finest in the nation. With a significant presence in Greater Sacramento, San Francisco Bay Area, Southern California, Central Coast, Central California, and Northern California, Dignity Health's California operations are well dispersed throughout the state. Dignity Health's hospitals operate emergency rooms that are open to all persons regardless of ability to pay; have governing bodies in which primarily independent persons representative of the community comprise a majority; engage in the training and education of healthcare professionals; and participate in Medicaid, Medicare, Tricare and/or other government-sponsored health care programs. This organization is a public benefit corporation exempt from taxation under Section 501(c)(3) of the internal revenue code.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses7,263,992,175

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	45,871,570	0	6,945,690

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		67,555,858
e	Government grants (contributions)1e		22,030,945

f	All other contributions, gifts, grants, and similar amounts not included above1f		9,224,277

g	Noncash contributions included in lines 1a-1f:$		426,875
h	Total. Add lines 1a-1f.......			98,811,080
			Business Code
2a	PATIENT NET OF CHARITY/BAD DEBT		900099	4,823,816,343	4,823,816,343
b	MEDICARE/MEDICAID PAYMENTS		900099	3,032,786,663	3,032,786,663
c	MANAGEMENT SERVICES		541610	88,711,595	88,711,595
d	MEANINGFUL USE INCENTIVES (EHR)		900099	40,125,716	40,125,716
e	MED OFFICE BLDG		621300	11,556,740	11,556,740
f	All other program service revenue .			56,652,083	45,140,279	11,511,804
g	Total. Add lines 2a–2f........			8,053,649,140
3	Investment income (including dividends, interest, and other similar amounts).......			131,959,156	0	11,463,667	120,495,489
4	Income from investment of tax-exempt bond proceeds..			283,253			283,253
5	Royalties...........			209,942			209,942
		(i) Real	(ii) Personal
6a	Gross rents	3,748,634
b	Less: rental expenses	587,205
c	Rental income or (loss)	3,161,429	0
d	Net rental income or (loss).......			3,161,429		34,873	3,126,556
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	2,232,761,482	24,151,357
b	Less: cost or other basis and sales expenses	1,937,498,386	8,346,706
c	Gain or (loss)	295,263,096	15,804,651
d	Net gain or (loss)..........			311,067,747			311,067,747
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			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...			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..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA		900099	21,547,857		0	21,547,857
b	GIFT SHOP		453220	4,759,870		0	4,759,870
c	PARKING LOT		812930	3,527,946		190,404	3,337,542
d	All other revenue ....			26,151,609		278,509	25,873,100
e	Total. Add lines 11a–11d ......			55,987,282
12	Total revenue. See Instructions......			8,655,129,029	8,042,137,336	23,479,257	490,701,356


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			206,418	1	173,627
2	Savings and temporary cash investments .........			1,503,921,577	2	1,376,748,933
3	Pledges and grants receivable, net ...........			15,388,298	3	26,966,126
4	Accounts receivable, net .............			1,196,698,641	4	1,397,726,348
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				200,000	5	550,000
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 .............			62,832,410	7	59,425,049
8	Inventories for sale or use ..............			148,418,929	8	153,255,364
9	Prepaid expenses and deferred charges ..........			556,300,566	9	381,196,061
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	8,758,793,352
b	Less: accumulated depreciation .....	10b	4,708,674,851	3,843,859,411	10c	4,050,118,501
11	Investments—publicly traded securities ..........			2,849,870,482	11	2,768,684,401
12	Investments—other securities. See Part IV, line 11 .....			862,113,445	12	1,268,139,458
13	Investments—program-related. See Part IV, line 11 .....			1,441,654,432	13	1,376,607,252
14	Intangible assets ...............			19,622,748	14	15,584,695
15	Other assets. See Part IV, line 11 ...........			68,249,504	15	105,790,398
16	Total assets. Add lines 1 through 15 (must equal line 34)......			12,569,336,861	16	12,980,966,213
17	Accounts payable and accrued expenses .........			1,743,550,930	17	1,696,996,132
18	Grants payable .................			0	18	0
19	Deferred revenue ................			26,593,350	19	29,302,261
20	Tax-exempt bond liabilities .............			3,658,976,075	20	3,427,625,299
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 ..			1,202,145,963	23	1,437,005,954
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....................			1,262,007,110	25	1,008,370,795
26	Total liabilities. Add lines 17 through 25.........			7,893,273,428	26	7,599,300,441
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			4,513,062,761	27	5,214,735,965
28	Temporarily restricted net assets ...........			129,793,292	28	131,586,303
29	Permanently restricted net assets ...........			33,207,380	29	35,343,504
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			4,676,063,433	33	5,381,665,772
34	Total liabilities and net assets/fund balances ........			12,569,336,861	34	12,980,966,213

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)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, 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).......................................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................	Yes	No