Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
SCRIPPS HEALTH
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4275 CAMPUS POINT COURT
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SAN DIEGO, CA92121
D Employer identification number

95-1684089
E Telephone number

G Gross receipts $ 3,522,281,456
F Name and address of principal officer:
CHRISTOPHER VAN GORDER
4275 CAMPUS POINT COURT
SAN DIEGO,CA92121
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SCRIPPSHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1924
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.6 BILLION , PRIVATE NOT-FOR- PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. (SEE SCH O)
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 15,037
6 Total number of volunteers (estimate if necessary) ............. 6 3,406
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 5,426,611
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 99,631
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 37,062,312 26,873,287
9 Program service revenue (Part VIII, line 2g) ......... 2,478,726,147 2,395,815,994
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 107,700,580 208,770,591
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 31,293,491 38,511,975
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,654,782,530 2,669,971,847
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,739,993 781,225
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,124,361,930 1,133,685,135
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet8,711,348    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,216,952,003 1,168,441,340
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,343,053,926 2,302,907,700
19 Revenue less expenses. Subtract line 18 from line 12....... 311,728,604 367,064,147
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 3,992,344,001 4,253,258,000
21 Total liabilities (Part X, line 26)............. 1,355,940,277 1,298,760,499
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,636,403,724 2,954,497,501
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.6 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. (CONTINUED IN SCHEDULE O).
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,976,592,685 including grants of $ 1,156,448 ) (Revenue $ 2,426,984,501 )
SEE SCHEDULE O.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,976,592,685
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
Yes
 
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions).... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
1,189
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
15,037
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
Yes
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletRichard Rothberger4275 Campus Point CourtSan DiegoCA92121 (858) 678-6828
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MARY JO ANDERSON CHS........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(2) RICHARD C BIGELOW........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(3) DOUGLAS A BINGHAM ESQ........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(4) JEFF BOWMAN........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(5) JAN CALDWELL........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(6) JUDY CHURCHILL PH D........................................................................
VICE CHAIR / TRUSTEE
12.0
.......................3.0
X   X       0 0 0
(7) GORDON R CLARK........................................................................
Trustee/Vice Chair
12.0
.......................3.0
X   X       0 0 0
(8) KATHERINE A LAUER........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(9) MARTY J LEVIN........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(10) MAUREEN STAPLETON........................................................................
CHAIRMAN/TRUSTEE
12.0
.......................3.0
X   X       0 0 0
(11) ROBERT TJOSVOLD........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(12) CHRISTOPHER VAN GORDER........................................................................
PRESIDENT & CEO / TRUSTEE
57.0
.......................3.0
X   X       1,729,768 0 568,134
(13) RICHARD VORTMANN........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(14) ABBY SILVERMAN WEISS........................................................................
TRUSTEE
12.0
.......................3.0
X           0 0 0
(15) GALE D KEEL........................................................................
ASSISTANT SECRETARY
39.0
.......................1.0
    X       93,137 0 15,319
(16) VIRGINIA LEARY........................................................................
ASSISTANT SECRETARY
39.0
.......................1.0
    X       92,236 0 24,466
(17) RICHARD ROTHBERGER........................................................................
TREASURER/EXECUTIVE VP/CFO
53.0
.......................2.0
    X       1,279,910 0 260,087
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) RICHARD R SHERIDAN........................................................................
SEC/CORP SR VP, GEN COUNSEL
53.0
.......................2.0
    X       686,371 0 164,020
(19) JOHN E ARMSTRONG........................................................................
CORP SR VP, SPLY CHAIN/FACIL
50.0
.......................0.0
      X     520,046 0 82,085
(20) ROBIN BROWN........................................................................
CHIEF EXECUTIVE, SR VP
50.0
.......................0.0
      X     627,362 0 162,881
(21) VICTOR V BUZACHERO........................................................................
CORP SR VP INNOVAT/HR/PERF MGT
50.0
.......................0.0
      X     927,768 0 188,997
(22) SUSAN CAMPBELL........................................................................
Exec Dir, External Affairs
50.0
.......................0.0
      X     473,899 0 96,265
(23) ARNOLD BRENT EASTMAN MD........................................................................
CORP SR VP, CHIEF MED OFFICER
50.0
.......................0.0
      X     477,623 0 -255,042
(24) JOHN ENGLE........................................................................
CHIEF EXECUTIVE, SR VP, CHIEF
50.0
.......................0.0
      X     518,542 0 84,313
(25) CARL ETTER........................................................................
CHIEF EXECUTIVE, SR VP
50.0
.......................0.0
      X     652,821 0 97,169
(26) SHIRAZ FAGAN........................................................................
CHIEF EXECUTIVE, SR VP
50.0
.......................0.0
      X     644,662 0 100,709
(27) GARY FYBEL........................................................................
CHIEF EXECUTIVE, SR VP
50.0
.......................0.0
      X     747,792 0 139,462
(28) THOMAS GAMMIERE........................................................................
CHIEF EXECUTIVE, SR VP
50.0
.......................0.0
      X     895,067 0 130,975
(29) LARRY HARRISON........................................................................
CHIEF EXECUTIVE, SR VP
50.0
.......................0.0
      X     591,762 0 0
(30) JUNE KOMAR........................................................................
CORP EXEC VP, STRATEGY & ADMIN
50.0
.......................0.0
      X     814,897 0 141,581
(31) JAMES LA BELLE MD........................................................................
CORP SR VP, CHIEF MED OFFICER
50.0
.......................0.0
      X     710,044 0 123,360
(32) BARBARA PRICE........................................................................
CORP SRVP BUS & SERV LINE DEV
50.0
.......................0.0
      X     637,065 0 107,550
(33) MARC A REYNOLDS........................................................................
CORP SR VP, PAYER RELATIONS
35.0
.......................20.0
      X     604,020 0 94,878
(34) PATRIC THOMAS........................................................................
CORP VP, INFORMATION SVCS
50.0
.......................0.0
        X   536,536 0 72,263
(35) MARY ELLEN DOYLE........................................................................
Corp VP, Nursing Ops
50.0
.......................0.0
        X   471,965 0 76,411
(36) CATHY GUIBAL........................................................................
VP FINANCE/CFO SCRIPPS MED FDN
50.0
.......................0.0
        X   499,258 0 4,977
(37) ROBERT T HOFF........................................................................
CORP VP, CLINICAL ANC OPS
50.0
.......................0.0
        X   481,008 0 79,075
(38) EDWARD NAZARRO........................................................................
COE CLINIC
50.0
.......................0.0
        X   486,371 0 77,824
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 16,199,930 0 2,637,759
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet2,072
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
SCRIPPS CLINIC MEDICAL GROUP, 10666 N TORREY PINES RDLA JOLLACA92037 PHYSICIAN SERVICES 237,194,654
SCRIPPS COASTAL MEDICAL GROUP, 501 WASHINGTON AVE 601SAN DIEGOCA92103 PHYSICIAN SERVICES 33,330,475
MCCARTHY BUILDING COMPANIES, 20401 SW BIRCH ST 300NEWPORT BEACHCA92006 CONSTRUCTION 106,234,422
EMERGENCY ACUTE CARE MED CORP, 440 STEVENS AVE SUITE 150SAN DIEGOCA92075 PHYSICIAN SERVICES 11,240,054
WHITING-TURNER CONTRACTING, PO BOX 17596BALTIMOREMD21297 CONSTRUCTION 26,320,466
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet5
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 640,332
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
26,232,955
g Noncash contributions included in lines
1a-1f:$
1,972,264
h Total. Add lines 1a-1f.......MediumBullet 26,873,287
 Program Service RevenueAmt Business Code
2a HEALTHCARE DELIVERY REVENUE 622110 2,220,013,587 2,218,390,094 1,623,493 0
b Capitation Premium 622110 98,074,848 98,074,848 0 0
c Provider Fee Revenue 622110 21,047,432 21,047,432 0 0
d Meaningful Use Incentive 900099 14,475,560 14,475,560 0 0
e Rental Income - MOB 531120 10,803,023 10,803,023 0 0
f All other program service revenue . 31,401,544 30,653,810 747,734 0
g Total. Add lines 2a–2f........MediumBullet 2,395,815,994
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 33,574,137 504,242 42,832 33,027,063
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 1,026,393,162 0
b Less: cost or other basis and sales expenses 850,536,708 660,000
c Gain or (loss) 175,856,454 -660,000
d Net gain or (loss)..........MediumBullet 175,196,454     175,196,454
8a Gross income from fundraising events (not including
$ 640,332
of contributions reported on line 1c). See Part IV, line 18 ..
a 1,623,033
b Less: direct expenses ...b 1,112,901
c Net income or (loss) from fundraising events..MediumBullet 510,132   510,132
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a Cafeteria 722310 5,903,096 5,903,096 0 0
b Parking 812930 2,479,378 2,310,070 169,308 0
c Gift Shop 453220 1,245,488 1,245,488 0 0
d All other revenue .... 28,373,881 23,576,838 2,843,244 1,953,799
e Total. Add lines 11a–11d ...... MediumBullet 38,001,843
12 Total revenue. See Instructions......MediumBullet 2,669,971,847 2,426,984,501 5,426,611 210,687,448
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 781,225 781,225
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0 0
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0 0
4 Benefits paid to or for members 0 0
5 Compensation of current officers, directors, trustees, and key employees .... 16,879,040 0 16,879,040 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 85,110 0 85,110 0
7 Other salaries and wages 865,028,223 728,426,737 131,766,695 4,834,791
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 36,713,959 29,717,186 6,836,099 160,674
9 Other employee benefits ....... 150,553,630 125,271,631 24,727,835 554,164
10 Payroll taxes ........... 64,425,173 53,671,317 10,458,211 295,645
11 Fees for services (non-employees):        
a Management ...... 0 0 0 0
b Legal ......... 8,753,077 1,355,309 7,393,700 4,068
c Accounting ........... 1,127,916 505,670 622,246 0
d Lobbying ........... 833,962 0 833,962 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 4,463,407 0 4,463,407 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 452,359,168 412,481,630 39,331,306 546,232
12 Advertising and promotion .... 5,159,702 1,682,923 3,473,999 2,780
13 Office expenses ....... 60,043,346 41,202,191 17,827,688 1,013,467
14 Information technology ...... 38,642,376 20,505,215 18,137,161 0
15 Royalties .. 0 0 0 0
16 Occupancy ........... 75,389,690 65,001,578 10,140,080 248,032
17 Travel ............ 0 0 0 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0 0 0 0
19 Conferences, conventions, and meetings .... 0 0 0 0
20 Interest ........... 15,206,767 12,413,823 2,792,944 0
21 Payments to affiliates ....... 0 0 0 0
22 Depreciation, depletion, and amortization ..... 101,596,549 93,095,788 8,500,761 0
23 Insurance .............. 4,173,987 4,163,189 10,798 0
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 351,586,684 351,586,684 0 0
b Repairs & Maintenance 26,418,628 17,560,905 8,837,120 20,603
c Hospital Fee 14,777,628 14,777,628 0 0
d Loss on Impairment 4,518,048 32,543 4,485,505 0
e All other expenses 3,390,405 2,359,513   1,030,892
25 Total functional expenses. Add lines 1 through 24e 2,302,907,700 1,976,592,685 317,603,667 8,711,348
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720). 0      
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 0
2 Savings and temporary cash investments ......... 640,782,676 2 458,127,487
3 Pledges and grants receivable, net ........... 25,824,669 3 18,291,479
4 Accounts receivable, net ............. 364,180,990 4 307,978,390
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 16,710,695
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 ............. 114,489 7 141,217
8 Inventories for sale or use .............. 33,045,238 8 35,991,659
9 Prepaid expenses and deferred charges .......... 18,427,349 9 23,979,887
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,708,184,639
b Less: accumulated depreciation ..... 10b 1,266,511,229 1,271,846,401 10c 1,441,673,410
11 Investments—publicly traded securities .......... 1,379,258,767 11 1,454,759,554
12 Investments—other securities. See Part IV, line 11 ..... 159,953,000 12 381,816,000
13 Investments—program-related. See Part IV, line 11 ..... 9,287,762 13 18,568,036
14 Intangible assets ............... 34,674,201 14 34,674,201
15 Other assets. See Part IV, line 11 ........... 54,948,459 15 60,545,985
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 3,992,344,001 16 4,253,258,000
Liabilities 17 Accounts payable and accrued expenses ......... 363,948,917 17 333,652,890
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 14,756,262 19 14,845,504
20 Tax-exempt bond liabilities ............. 873,346,839 20 858,248,606
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 1,088,630 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 .. 10,511,180 23 10,463,011
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.................... 92,288,449 25 81,550,488
26 Total liabilities. Add lines 17 through 25......... 1,355,940,277 26 1,298,760,499
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 2,427,513,033 27 2,747,774,920
28 Temporarily restricted net assets ........... 130,729,892 28 127,888,120
29 Permanently restricted net assets ........... 78,160,799 29 78,834,461
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 2,636,403,724 33 2,954,497,501
34 Total liabilities and net assets/fund balances ........ 3,992,344,001 34 4,253,258,000
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,669,971,847
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,302,907,700
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
367,064,147
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,636,403,724
5
Net unrealized gains (losses) on investments ...............
5
-55,532,290
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
6,561,920
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,954,497,501
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
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
SCRIPPS HEALTH
 
Employer identification number

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

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (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) right arrow (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).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet 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
SCRIPPS HEALTH
 
Employer identification number

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





Form 990-PF




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

95-1684089
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


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  

Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.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
SCRIPPS HEALTH
 
Employer identification number

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

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

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

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

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


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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
0
d
Mailings to members, legislators, or the public? .........................
 
No
0
e
Publications, or published or broadcast statements? .......................
 
No
0
f
Grants to other organizations for lobbying purposes? .......................
 
No
0
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
363,275
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
40,273
i
Other activities? ..........................
Yes
 
430,414
j
Total. Add lines 1c through 1i ...............................
833,962
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
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
SCHEDULE C, PART II-B PUBLIC AFFAIRS INFORMATION AND EDUCATION SCRIPPS HEALTH ON ITS OWN BEHALF AND AS A MEMBER OF SEVERAL HOSPITAL ASSOCIATIONS AND HEALTH CARE ORGANIZATIONS PARTICIPATES REGULARLY IN PUBLIC AFFAIRS AND ADVOCACY ACTIVITIES. SOME ACTIVITY IS INDIVIDUALLY OR COLLECTIVELY CONDUCTED BY AND SPECIFICALLY ON BEHALF OF SCRIPPS HEALTH. OTHER ACTIVITY IS ORGANIZED BY THESE INVOLVED ORGANIZATIONS SUPPORTED BY SCRIPPS HEALTH PARTICIPATION. THIS ACTIVITY INCLUDES BRIEFING OF LEGISLATORS AND LEGISLATIVE STAFF MEMBERS (FEDERAL, STATE AND LOCAL) ON MATTERS AFFECTING HEALTH CARE AND HEALTH CARE OPERATIONS. MEETINGS OCCUR IN PUBLIC OFFICIAL OFFICES, AT SCRIPPS FACILITIES AND IN VARIOUS OTHER VENUES OF OPPORTUNITY. ACTIVITY IS ON FEDERAL, STATE AND LOCAL LEVELS AND LOCATIONS. SUCH MATTERS INCLUDE: ACCOUNTABLE CARE ACT (HEALTH REFORM); BUDGET AND FISCAL POLICY IMPACTS; REIMBURSEMENT MATTERS; PROVIDER FEES AND OTHER ASSESSMENTS; DATA MANAGEMENT AND REPORTING; QUALITY AND PATIENT SAFETY MATTERS, HEALTH INFORMATION TECHNOLOGY AND THE IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS, EMERGENCY DEPARTMENT OPERATIONS AND IMPACTS; UNINSURED, COST SHIFT IMPACTS AND OTHER SAFETY NET ISSUES; COMMUNITY BENEFIT PROGRAMS; GRADUATE MEDICAL EDUCATION; SITE-NEUTRAL PRICING, VALUE-BASED PURCHASING; BUNDLED PAYMENTS; ACCOUNTABLE CARE ORGANIZATIONS, MEDICARE, MEDICAID. THE ORGANIZATION STAFFS A GOVERNMENT RELATIONS DEPARTMENT THAT COORDINATES INFORMATION AND EDUCATION PROGRAMS ON PUBLIC POLICY AND ADVOCACY MATTERS. ALL WORK IS FOCUSED ON ISSUES. NO ACTIVITY ADDRESSES PARTISAN MATTERS, CANDIDATES OR POLITICAL ACTIVITIES. NO CORPORATE ACTIVITY ADDRESSED PARTISAN CAMPAIGNS. NATIONAL, STATE & LOCAL ORGANIZATIONS WITH WHICH SCRIPPS HEALTH PARTICIPATES IN PART IN LOBBY ACTIVITIES: AMERICAN HOSPITAL ASSOCIATION CALIFORNIA HOSPITAL ASSOCIATION HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES HEALTH MANAGEMENT ACADEMY PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS (PEACH) ALLIANCE FOR CATHOLIC HEALTH CARE PROTON THERAPY CONSORTIUM SAN DIEGO REGIONAL CHAMBER OF COMMERCE SAN DIEGO TAXPAYERS ASSOCIATION SAN DIEGO ECONOMIC DEVELOPMENT CORPORATION DOWNTOWN SAN DIEGO PARTNERSHIP COMMUNITY HEALTH IMPROVEMENT PARTNERS FEDERAL LEGISLATION AND ISSUES REPRESENTED: PATIENT PROTECTION AND AFFORDABLE CARE ACT PROVISIONS - 501(R) - DISPROPORTIONATE SHARE HOSPITALS (DSH) H.R.1920/S.1555 SUSTAINABLE GROWTH RATE (PHYSICIAN PAYMENT) - H.R.4015 RECOVERY AUDIT CONTRACTOR REFORM - H.R.1250/S.1012 PROTON THERAPY PAYMENT POST ACUTE CARE PAYMENT REFORM - H.R.4994/S.2553 (IMPACT ACT) READMISSIONS REDUCTIONS PROGRAM REFORM - H.R.4188 VETERANS ACCESS TO CARE ACT - H.R.4810 FLEXIBILITY IN HEALTH IT REPORTING - H.R.5481 STATE LEGISLATION AND ISSUES REPRESENTED: COVERED CALIFORNIA (STATE HEALTH INSURANCE EXCHANGE) MEDICAID (MEDI-CAL) 1115 WAIVER SB 1094 (NON-HOSPITAL TRANSACTIONS) SB 455 (PATIENT CLASSIFICATION SYSTEM) AB 2616 (WORKERS COMPENSATION PRESUMPTION FOR MRSA) SB 503 (COMMUNITY BENEFIT/CHARITY CARE) SB 906 (ELECTIVE PERCUTANEOUS CORONARY INTERVENTION) SB 1299 (WORKPLACE VIOLENCE PREVENTION PLANS) AB 1558 (CALIFORNIA HEALTH DATA SYSTEM) SB 1276 (CHARITY CARE AND DISCOUNT PAYMENT PLANS) AB 1952 (NON-PROFIT HOSPITAL CHARITY CARE PENALTY FUND)
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. 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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a 2
b Total acreage restricted by conservation easements .................. 2b 16.00
c Number of conservation easements on a certified historic structure included in (a) ..... 2c 2
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet1
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet70.00
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $ 1,742
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 112,290,000 103,819,000 94,354,000 87,057,000 81,098,000
b Contributions ........ 1,480,000 -1,051,000 745,000 2,316,000 685,000
c Net investment earnings, gains, and losses 9,068,000 14,066,000 12,924,000 657,000 7,714,000
d Grants or scholarships ..... 871,000 874,000 798,000 703,000 36,000
e Other expenditures for facilities
and programs ........
3,853,000 2,707,000 2,496,000 1,930,000 1,636,000
f Administrative expenses .... 947,000 963,000 910,000 807,000 768,000
g End of year balance ...... 117,167,000 112,290,000 103,819,000 86,590,000 87,057,000
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 22,843,333 97,001,792 119,845,125
b Buildings ................   1,108,113,429 518,117,099 589,996,330
c Leasehold improvements ............   78,196,263 49,545,814 28,650,449
d Equipment ................   915,154,880 698,848,316 216,306,564
e Other .................   486,874,942   486,874,942
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,441,673,410
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other 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) MULTI-STRATEGY HEDGE FUNDS
368,328,000 F

(B) PRIVATE EQUITY FUNDS
13,488,000 F







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 381,816,000
Part VIII
Investments—Program 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








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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.)...........Small Bullet  
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
SELF INSURED WORKER'S COMP LIAB 38,107,314
Deferred Retirement Liability 14,208,437
Self Insured Malpractice Liability 18,495,017
Asset Retirement Obligation 13,887,883
Annuity and Unitrusts 11,710,608
Deposits and Contingencies 82,822
Intercompany Liabilities -14,941,593


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 81,550,488
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

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
SCHEDULE D, PART II, LINE 3 CHANGES TO CONSERVATION EASEMENTS THERE WERE NO MODIFIED, TRANSFERRED, RELEASED, EXTINGUISHED, OR TERMINATED CONSERVATIVE EASEMENTS IN FY14.
SCHEDULE D, PART II, LINE 9 CONSERVATION EASEMENT THE HISTORICAL STRUCTURE THAT IS CONSIDERED TO BE A CONSERVATIVE EASEMENT IS REPORTED IN THE MERCY HOSPITAL ENTITY OF THE CONSOLIDATED FINANCIALS STATEMENTS. SCHEDULE D, PART
Schedule D, Part X, Line 2 INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS CONTRIBUTIONS RECEIVED FOR CAPITAL PROJECTS, INCLUDING BUILDING PROJECTS, MAJOR RENOVATIONS, AND EQUIPMENT PURCHASES $1,086,131 CONTRIBUTIONS RECEIVED TO FUND GRADUATE MEDICAL EDUCATION PROGRAMS, FELLOWS, AND LECTURE SERIES $17,550,421 CONTRIBUTIONS RECEIVED FOR USE IN SPECIFIC DEPARTMENTS OR DIVISIONS IN THE HOSPITALS AND/OR CLINICS $30,671,286 CONTRIBUTIONS RECEIVED TO COVER THE COST OF HEALTHCARE PROVIDED TO INDIVIDUALS WITHOUT INSURANCE OR THE MEANS FOR PAYING FOR THEIR CARE $13,148,710. CONTRIBUTIONS RECEIVED TO FUND RESEARCH PROJECTS IN SPECIFIC AREAS OR DIVISIONS $17,176,250
SCHEDULE D, PART V, ITEM 1A, COLUMN (C) THE BEGINNING BALANCE DOES NOT ROLL FORWARD FROM THE ENDING BALANCE OF THE PREVIOUS YEAR DUE TO THE WHITTIER INSTITUTE (TWI), $7,764,000. EFFECTIVE FY12, TWI WAS CONSOLIDATED WITH SCRIPPS HEALTH AND NEEDS TO BE REFLECTED IN THIS SCHEDULE. AS THE ROLLFORWARD DOES NOT CONTAIN AN APPROPRIATE LINE FOR THIS TRANSACTION, IT WAS DETERMINED THAT THE MOST APPROPRIATE PRESENTATION WAS TO REFLECT IT IN THE BEGINNING BALANCE.
SCHEDULE D, PART XIII UNCERTAIN TAX POSITIONS UNDER ASC 740 (AKA FIN 48) SCRIPPS HEALTH IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, SCRIPPS HEALTH IS SUBJECT TO INCOME TAXES ON ANY INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN THE FURTHERANCE OF THE PURPOSE FOR WHICH IT WAS GRANTED EXEMPTION. THE ORGANIZATION ACCOUNTS FOR INCOME TAXES RELATED TO THE OPERATIONS OF ITS FOR-PROFIT SUBSIDIARIES (SCPO) UNDER THE PROVISIONS OF FASB ASC 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. UNDER FASB ASC 740, THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS MAY BE RECOGNIZED ONLY IF IT IS MORE LIKELY THAN NOT THE TAX POSITION WILL BE SUSTAINED, BASED SOLELY ON ITS TECHNICAL MERITS, WITH THE TAXING AUTHORITY HAVING FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE ORGANIZATION RECORDS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS AS DISCRETE TAX ADJUSTMENTS IN THE FIRST INTERIM PERIOD THAT THE MORE LIKELY THAN NOT THRESHOLD IS NOT MET. THE ORGANIZATION RECOGNIZES DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF ITS ASSETS AND LIABILITIES ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS ONLY FOR TAX POSITIONS THAT MEET THE MORE LIKELY THAN NOT RECOGNITION CRITERIA. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT SEPTEMBER 30, 2014 OR 2013. SCRIPPS HEALTH CURRENTLY FILES FORM 990 (INFORMATIONAL RETURN OF ORGANIZATIONS EXEMPT FROM INCOME TAXES) AND FORM 990-T (BUSINESS INCOME TAX RETURN FOR AN EXEMPT ORGANIZATION) IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. SCRIPPS HEALTH IS NOT SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO 2007 IN MAJOR TAX JURISDICTIONS.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
North America   105 Program services Reconstructive Surgery 283,347
East Asia and the Pacific   5 Program services Med Care & Training 13,305
Central America and the Caribbean     Investments   143,686,670
Central America and the Caribbean     Investments   456,953
South America     Fundraising   24,000
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....   110 144,464,275
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)   110 144,464,275
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.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 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
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the 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).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2013
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 PROCEDURES FOR MONITORING USE OF GRANTS A SEMI-ANNUAL REPORT AND A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT TO DATE IS REQUIRED. THIS SEMI-ANNUAL REPORT SHALL INCLUDE PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN THE GRANT APPLICATION. A FINAL REPORT IS DUE WITHIN THIRTY (30) DAYS FOLLOWING THE EXPIRATION DATE OF THE GRANT. IN ADDITION TO THE PROGRESS MADE TOWARD MEETING THE OBJECTIVES OUTLINED IN THE GRANT APPLICATION, THE FINAL REPORT SHALL INCLUDE QUANTITATIVE AND QUALITATIVE RESULTS OF THE PROGRAM AGAINST ITS STATED GOALS AND OBJECTIVES. A FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT AGAINST THE BUDGET MUST BE INCLUDED AS PART OF THIS FINAL REPORT.
SCHEDULE F, PART I, LINE 3, COLUMN F ACCOUNTING METHOD THE ACCRUAL METHOD OF ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS IN COLUMN F.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

CANDLELIGHTBALL
(event type)
(b) Event #2

GOLF TOURNEY
(event type)
(c) Other events

8
(total number)
(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 667,719 551,276 1,044,370 2,263,365
2 Less: Contributions . . 127,894 50,655 461,783 640,332
3 Gross income (line 1
minus line 2) . . .
539,825 500,621 582,587 1,623,033
VerticalDirectExpenses 4 Cash prizes . . . 0 0 0 0
5 Noncash prizes . . 0 0 0 0
6 Rent/facility costs . . 111,570 92,969 379,355 583,894
7 Food and beverages . 375 0 30,976 31,351
8 Entertainment . . . 500 5,000 62,745 68,245
9 Other direct expenses . 49,226 236,834 143,351 429,411
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 1,112,901
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 510,132
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    47,964,142   47,964,142 2.130 %
b Medicaid (from Worksheet 3,
column a) ....
    211,270,948 165,587,210 45,683,738 2.030 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
    17,104,888 7,195,853 9,909,035 0.440 %
d Total Financial Assistance
and Means-Tested
Government Programs .
    276,339,978 172,783,063 103,556,915 4.600 %
Other Benefits
    5,684,124 553,827 5,130,297 0.230 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    27,575,657 6,301,189 21,274,468 0.940 %
g Subsidized health services
(from Worksheet 6) ..
    19,355,938 12,564,340 6,791,598 0.300 %
h Research (from Worksheet 7)     16,169,169 1,185,632 14,983,537 0.670 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    821,152   821,152 0.040 %
j Total. Other Benefits ..     69,606,040 20,604,988 49,001,052 2.180 %
k Total. Add lines 7d and 7j .     345,946,018 193,388,051 152,557,967 6.780 %
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     22,857   22,857  
2 Economic development     67,974   67,974  
3 Community support     222,916 40,614 182,302 0.010 %
4 Environmental improvements            
5 Leadership development and training for community members     130,704 77,122 53,582  
6 Coalition building     1,238,945 31,653 1,207,292 0.050 %
7 Community health improvement advocacy     361,848   361,848 0.020 %
8 Workforce development     3,000   3,000  
9 Other            
10 Total     2,048,244 149,389 1,898,855 0.080 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
53,701,584
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
354,191,358
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
418,780,056
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-64,588,698
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

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 %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1Scripps Encinitas
 
Ambulatory Surgery Center 55.500 %   25.000 %
2Surgery Center
 
       
3Scripps Memorial
 
Medical Office Building 15.300 %   77.200 %
4Ximed Medical
 
       
5Scripps Mercy ASC
 
Ambulatory Surgery Center 73.500 %   26.500 %
6ScrippsUSP Surgery
 
Ambulatory Surgery Center 50.000 %   27.000 %
7Centers
 
       
8
9
10
11
12
13
Schedule H (Form 990) 2013
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?4
Name, address, primary website address, and state license number
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Scripps Mercy Hospital
4077 5th Avenue
San Diego,CA92103
WWW.SCRIPPS.ORG
090000074
X X   X   X X     A
2 Scripps Memorial Hospital La Jolla
9888 Genesee Avenue
La Jolla,CA92037
WWW.SCRIPPS.ORG
080000050
X X   X   X X     A
3 Scripps Green Hospital
10666 north Torrey Pines Road
San Diego,CA92037
WWW.SCRIPPS.ORG
080000139
X X   X   X       A
4 Scripps Memorial Hospital Encinitas
354 Santa Fe Drive
La Jolla,CA92037
WWW.SCRIPPS.ORG
080000148
X X   X   X X     A
Schedule H (Form 990) 2013
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)
A
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 No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from 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 .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 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):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
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: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the 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
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible 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? ............................ 21   No
If "Yes," explain in Part VI.
22 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? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
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
SCHEDULE H, PART V, LINE 3 HEALTH EXPERT, COMMUNITY LEADER AND RESIDENT FEEDBACK THE INSTITUTE OF PUBLIC HEALTH (IPH) AND CHNA ADVISORY WORKGROUP SOUGHT FEEDBACK FROM COMMUNITY LEADERS, HEALTH EXPERTS AND RESIDENTS OF VULNERABLE COMMUNITIES. THIS WAS DONE THROUGH THREE METHODS: AN ELECTRONIC SURVEY FOR COMMUNITY LEADERS AND HEALTH EXPERTS; KEY INFORMANT INTERVIEWS; AND COMMUNITY FORUMS FOR RESIDENTS IN VULNERABLE COMMUNITIES THROUGHOUT SAN DIEGO COUNTY. - ONLINE SURVEY OF HEALTH EXPERTS AND LEADERS INITIAL EMAIL SAMPLE (N=120). TOTAL SURVEYS COMPLETED (N=89). - COMMUNITY FORUMS (106 COMMUNITY RESIDENTS) EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS, AND SAN YSIDRO CONDUCTED IN NEIGHBORHOODS WITH HIGH COMMUNITY NEED INDEX SCORES - FIVE KEY INFORMANT INTERVIEWS LEADERS CHOSEN BASED ON DISCIPLINE EXPERTISE AND KNOWLEDGE OF HEALTH ISSUES AFFECTING COMMUNITIES - COMMUNITY FORUMS (106 COMMUNITY RESIDENTS) EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS AND SAN YSIDRO CONDUCTED IN NEIGHBORHOODS WITH HIGH COMMUNITY NEED INDEX SCORES. HEALTH EXPERT AND COMMUNITY LEADER ELECTRONIC SURVEY IN ORDER TO PRIORITIZE THE HEALTH CONDITIONS AND HEALTH DRIVERS IDENTIFIED, THE IPH AND THE CHNA ADVISORY WORKGROUP DEVELOPED A LIST OF OVER 100 POSSIBLE COMMUNITY HEALTH EXPERTS AND LEADERS. A HEALTH EXPERT OR LEADER WAS DEFINED AS A PERSON WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE LIST WAS COMPILED TO ENSURE REPRESENTATION OF EXPERTS IN BOTH THE 15 HEALTH CONDITIONS AND 26 HEALTH DRIVERS THAT HAD BEEN IDENTIFIED. HEALTH EXPERTS AND LEADERS WERE IDENTIFIED FROM HOSPITAL SETTINGS, COMMUNITY-BASED ORGANIZATIONS, GOVERNMENT POLICY, LEGAL, AND HEALTH ADVOCACY ORGANIZATIONS. CONTACT INFORMATION WAS VERIFIED AND INITIAL EMAILS WERE SENT TO THE LIST OF HEALTH EXPERTS AND LEADERS IN SAN DIEGO IN ORDER TO GAUGE POTENTIAL INTEREST IN PARTICIPATING IN THE CHNA HEALTH PRIORITIZATION SURVEY. AT THE TIME OF THIS INITIAL E-MAIL, INTERESTED RESPONDENTS WERE ASKED WHICH CONDITIONS THEY HAD EXPERTISE IN, WHAT POPULATIONS THEY SERVED AND WHAT REGIONS THEY WORKED IN. THIS INITIAL FEEDBACK GAVE THE IPH AND THE CHNA ADVISORY WORKGROUP AN IDEA OF THE COVERAGE OF DATA THAT WOULD ULTIMATELY BE GATHERED ON HEALTH CONDITIONS, REGIONS AND POPULATIONS SERVED. TARGETED OUTREACH TO ADDITIONAL HEALTH EXPERTS AND LEADERS WAS THEN INITIATED TO FILL GAPS OF UNDER-REPRESENTED CONDITIONS, REGIONS, OR VULNERABLE POPULATIONS. THE CHNA SURVEY WAS EMAILED TO OVER 120 HEALTH EXPERTS AND LEADERS, WITH 89 PEOPLE COMPLETING THE SURVEY. WHEN DESIGNING THE SURVEY, IT WAS TAKEN INTO ACCOUNT THE DIVERSITY OF THE KNOWLEDGE OF THE RESPONDENTS. SOME RESPONDENTS HAD KNOWLEDGE OF SPECIFIC DISEASES OR CONDITIONS AND THE HEALTH DRIVERS AFFECTING THOSE DISEASES. OTHERS HAD A MUCH MORE GENERAL KNOWLEDGE OF HEALTH DRIVERS AND HOW THEY MIGHT AFFECT MULTIPLE HEALTH OUTCOMES. TO ACCOMMODATE THESE DIFFERENT PERSPECTIVES, THE SURVEY WAS CREATED SO THAT THE RESPONDENTS COULD ANSWER THE SURVEY FROM ONE OF THE TWO PERSPECTIVES. BOTH PERSPECTIVES ALLOWED RESPONDENTS TO COMMENT ON POOR HEALTH CONDITIONS AND HEALTH DRIVERS AS THEY COMPLETED THE SURVEY. AS PART OF THE SURVEY, PARTICIPANTS WERE PROVIDED WITH ELECTRONIC LINKS TO THE 15 CONDITION BRIEFS AND THE OPPORTUNITY TO REVIEW THOSE BRIEFS, COMPARING DATA ACROSS THE CONDITIONS PRIOR TO ANSWERING THE SURVEY. USING THE LIST OF 15 HEALTH CONDITIONS AND 26 HEALTH DRIVERS, THE IPH AND CHNA ADVISORY WORKGROUP DEVELOPED AN ELECTRONIC SURVEY THAT ASKED COMMUNITY LEADERS AND HEALTH EXPERTS TO HELP PRIORITIZE HEALTH CONDITIONS THAT MET THE FOLLOWING REQUIREMENTS: - HAVE A SIGNIFICANT PREVALENCE IN THE COMMUNITY, - CONTRIBUTE SIGNIFICANTLY TO THE MORBIDITY AND MORTALITY IN SAN DIEGO COUNTY, - DISPROPORTIONATELY IMPACT VULNERABLE COMMUNITIES, - REFLECT A NEED THAT EXISTS THROUGHOUT SAN DIEGO COUNTY, AND - CAN BE ADDRESSED THROUGH EVIDENCE-BASED PRACTICES BY HOSPITALS AND HEALTHCARE SYSTEMS. KEY INFORMANT INTERVIEWS THE IPH COMPLETED FIVE KEY INFORMANT INTERVIEWS. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH DR. WILMA WOOTEN, DR. JAMES DUNFORD, DR. CHRISTINE WOOD, DR. PHILIP HANGER, AND GREG KNOLL, ESQ. EACH INTERVIEW LASTED NO LONGER THAN ONE HOUR. THESE LEADERS WERE CHOSEN BASED ON THEIR DISCIPLINE AND KNOWLEDGE OF HEALTH ISSUES AFFECTING SAN DIEGO. KEY INFORMANTS WERE ALSO SELECTED BASED ON THEIR ABILITY TO UNDERSTAND HEALTH POLICY, AND THEIR KNOWLEDGE OF ISSUES THROUGHOUT SAN DIEGO COUNTY. THE 15 HEALTH CONDITIONS WERE SHARED WITH THE PARTICIPANTS DURING THE INTERVIEWS. THE PURPOSE OF THE KEY INFORMANT INTERVIEWS WAS TO: - GATHER MORE IN-DEPTH UNDERSTANDING OF THE HEALTH CONDITIONS MOST AFFECTING SAN DIEGO. - AID IN THE PROCESS OF PRIORITIZING HEALTH CONDITIONS. - MAKE CONNECTIONS BETWEEN THE HEALTH CONDITIONS AND ASSOCIATED HEALTH DRIVERS. - GAIN INFORMATION ABOUT THE SYSTEM OR POLICY CHANGES THAT COULD POTENTIALLY IMPACT HEALTH CONDITIONS. - GET HEALTH CONDITIONS SPECIFIC RECOMMENDATIONS AS WELL AS OVERALL RECOMMENDATIONS. COMMUNITY FORUMS THE PURPOSE OF THE COMMUNITY FORUMS WAS TO GAIN RESIDENT'S PERSPECTIVE ON THE OWN HEALTH NEEDS OF THEIR COMMUNITIES, IDENTIFY HEALTH CONDITIONS MOST AFFECTING THEIR COMMUNITIES, AND IDENTIFY COMMUNITY RECOMMENDATIONS ON HOW HOSPITALS COULD HELP TO MEET THEIR HEALTH NEEDS. IN ORDER TO ENSURE UNBIASED COMMUNITY FEEDBACK, NEITHER HEALTHCARE ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) NOR THE PARTICIPATING HOSPITALS ATTENDED. COMMUNITIES OF HIGH HEALTH NEED, BASED ON THEIR COMMUNITY NEED INDEX SCORE WERE SELECTED FOR CONDUCTING FOCUS GROUPS WITH COMMUNITY MEMBERS. THE IPH PARTNERED WITH NEIGHBORHOOD COMMUNITY COLLABORATIVE AGENCIES OR ORGANIZATIONS WITHIN EACH NEIGHBORHOOD TO RECRUIT COMMUNITY MEMBERS TO PARTICIPATE IN THE FOCUS GROUPS. RECRUITMENT INCLUDED THE STIPULATION THAT FOCUS GROUP PARTICIPANTS WERE LIVING IN THE NEIGHBORHOOD AND WERE NOT AFFILIATED WITH LOCAL HOSPITALS AND HEALTH CENTERS. FOCUS GROUPS WERE CONDUCTED IN EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS, AND SAN YSIDRO. DURING THE FOCUS GROUPS, GEOGRAPHICAL INFORMATIONAL SYSTEMS (GIS) MAPS DISPLAYING CNI SCORES BY ZIP CODE IN SAN DIEGO COUNTY AS WELL AS THE SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY (HHSA) REGION OF THE NEIGHBORHOOD WERE DISPLAYED AND HAND-OUTS IN BOTH ENGLISH AND SPANISH EXPLAINING THE CNI SCORE WERE DISTRIBUTED TO EACH PARTICIPANT. INFORMATION WAS ALSO PROVIDED TO COMMUNITY MEMBERS OF THE HEALTH RESOURCES AVAILABLE TO THEM IN THEIR NEIGHBORHOODS.
SCHEDULE H, PART V, LINE 4 SCRIPPS CONDUCTED ONE CHNA FOR THE SYSTEM. BEGINNING IN SEPTEMBER 2012 WITH COMPLETION IN APRIL 2013, THE IPH MANAGED THE DESIGN, IMPLEMENTATION AND INTERPRETATION OF THE CHNA PROCESS. PARTICIPATING HOSPITALS AND HEALTHCARE SYSTEMS WERE ALL REPRESENTED IN THE CHNA ADVISORY WORKGROUP: - KAISER FOUNDATION HOSPITAL - SAN DIEGO - PALOMAR HEALTH - RADY CHILDREN'S HOSPITAL - SAN DIEGO - SCRIPPS HEALTH - SHARP HEALTHCARE - TRI-CITY MEDICAL CENTER - UNIVERSITY OF CALIFORNIA SAN DIEGO HEALTH SYSTEM
SCHEDULE H, PART V, LINE 5 THIS COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTP://WWW.SCRIPPS.ORG/SPARKLE-ASSETS/DOCUMENTS/2013_CHNA_FINAL.PDF
SCHEDULE H, PART V, LINE 7 THE PURPOSE OF THIS CHNA WAS TO IDENTIFY AND PRIORITIZE HEALTH ISSUES AND NEEDS IN SAN DIEGO COUNTY USING MULTIPLE SOURCES OF INFORMATION. THE ANALYSIS OF SECONDARY DATA INCORPORATED THE FOLLOWING CRITERIA FOR INCLUSION AS AN IDENTIFIED COMMUNITY HEALTH NEEDS: 1. FREQUENCY OF DIAGNOSIS, FROM OSHPD HOSPITAL DISCHARGE DATA 2. HIGH MORTALITY RATE IN SAN DIEGO 3. COMMUNITY CONCERN FIFTEEN CONDITIONS WERE THEN USED AS A STARTING POINT TO SOLICIT INPUT FROM THE HEALTH EXPERTS AND LEADERS, KEY INFORMANTS, AND COMMUNITY MEMBERS. BY COMBINING THE RESULTS OF ALL OF THE METHODS EMPLOYED, I.E. SECONDARY DATA SOURCES, ELECTRONIC HEALTH EXPERT AND LEADER SURVEYS, KEY INFORMANT INTERVIEWS, AND COMMUNITY FOCUS GROUPS, THE TOP 4 HEALTH CONDITIONS THAT WERE PRIORITIZED BY THIS COMMUNITY HEALTH NEEDS ASSESSMENT WERE: 1. DIABETES (TYPE 2) 2. OBESITY 3. CARDIOVASCULAR DISEASE 4. MENTAL/BEHAVIORAL HEALTH FIVE BROAD CATEGORIES OF RECOMMENDATIONS FOR HOSPITALS TO IMPROVE COMMUNITY HEALTH INCLUDED: 1. ACCESS TO CARE OR INSURANCE 2. CARE MANAGEMENT 3. COLLABORATION 4. EDUCATION 5. SCREENING SERVICES THE OTHER ELEVEN CONDITIONS (ACUTE RESPIRATORY INFECTIONS, ASTHMA, BACK PAIN, BREAST CANCER, COLORECTAL CANCER, DEMENTIA/ALZHEIMER'S, HIGH RISK PREGNANCY, LUNG CANCER, PROSTATE CANCER, SKIN CANCER AND UNINTENTIONAL INJURY) WERE NOT ADDRESSED IN DETAIL IN THE SCRIPPS CHNA DUE TO LIMITED FINANCIAL AND STAFFING ISSUES AND THAT SOME OF THESE HEALTH CONDITIONS ARE BEING ADDRESSED BY OTHER PROVIDERS IN THE COMMUNITY.
SCHEDULE H, PART V, LINE 12I BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON FAMILY INCOME AND EXPENSES. FOR LOW-INCOME, UNINSURED PATIENTS WHO EARN LESS THAN TWICE THE FEDERAL POVERTY LEVEL (FPL), WE WILL FULLY FORGIVE THE ENTIRE BILL. FOR THOSE PATIENTS WHO EARN BETWEEN TWO AND FOUR TIMES THE FPL, WE WILL FORGIVE A PORTION OF THE BILL. WE WILL NOT CHARGE PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE MORE THAN SCRIPPS' DISCOUNTED FINANCIAL ASSISTANCE AMOUNT, WHICH REPRESENTS SCRIPPS' AGB AS CALCULATED WITH THE PROSPECTIVE METHOD. EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS. ALL UNFUNDED PATIENTS RECEIVE A MINIMUM OF A 20% DISCOUNT TAKEN AUTOMATICALLY AT BILLING. THE DETERMINATION OF WHAT PERCENTAGE OF TOTAL CHARGES A QUALIFIED FINANCIAL ASSISTANCE PATIENT MAY BE CHARGED IS BASED ON FPL AND THE PERCENTAGE OF FPL THE PATIENT IS AT. SCRIPPS FINANCIAL ASSISTANCE PROGRAM RANGES FROM NO CHARGE FOR CARE TO PATIENTS AT OR BELOW 200 PERCENT OF FPL TO 23% OF TOTAL CHARGES FROM 201% TO 400% OF FPL.
SCHEDULE H, PART V, LINE 14G METHODS OF PUBLISHING THE FINANCIAL ASSISTANCE POLICY THE FINANCIAL ASSISTANCE IS WIDELY AVAILABLE ON THE SCRIPPS HEALTH WEBSITE HTTP://WWW.SCRIPPS.ORG/PATIENT-GUIDE__FINANCIAL-ASSISTANCE THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE UPON REQUEST. PAPER COPIES OF OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY IS MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE AT ALL SCRIPPS PATIENT REGISTRATION AREAS AND BY MAIL. IN ADDITION, THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED AT ALL POINTS OF REGISTRATION AREAS (I.E. EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION AREAS AND ANCILLARY SERVICE LOCATIONS). PLAIN LANGUAGE SUMMARIES ARE STOCKED AS A PATIENT HANDOUT IN BOTH ENGLISH AND SPANISH. FOR INPATIENTS, THE INFORMATION IS INCLUDED IN THE ESSENTIAL HANDBOOK, A COMPREHENSIVE BROCHURE COVERING MANY ASPECTS OF HOSPITALIZATION. UNFUNDED PATIENTS ARE NOT ALWAYS REFERRED TO FINANCIAL COUNSELORS. SOME SITES DO NOT USE FINANCIAL COUNSELORS, BUT THE STAFF MEMBER WHO REGISTERS THE PATIENT CAN DISCUSS FINANCIAL ASSISTANCE AND THE PLAIN LANGUAGE SUMMARY PROVIDES PATIENTS WITH CONTACT INFORMATION FOR FINANCIAL COUNSELORS. SCRIPPS MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES, INCLUDING EMERGENCY AND OTHER MEDICALLY NECESSARY HOSPITAL CARE. SCRIPPS FINANCIAL ASSISTANCE IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD-PARTY COVERAGE INCLUDING MEDICARE. COMMUNITY OUTREACH AND COMMUNICATION REGARDING SCRIPPS FINANCIAL ASSISTANCE IS ACHIEVED THROUGH THE FOLLOWING MEASURES, TO INCLUDE BUT NOT LIMITED TO: - POSTERS IN CONSPICUOUS REGISTRATION AREAS I.E. EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION AREAS AND ANCILLARY SERVICE LOCATIONS. - PAPER COPIES OF SCRIPPS FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND A SUMMARY OF THE POLICY WILL BE MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE AT ALL SCRIPPS PATIENT REGISTRATION AREAS AND BY MAIL. - THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY, AND FINANCIAL ASSISTANCE APPLICATIONS WILL BE CONSPICUOUSLY POSTED ON SCRIPPS WEB SITE TO VIEW, DOWNLOAD AND PRINT FREE OF CHARGE. THE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WILL CONTAIN THE WEB SITE ADDRESS WHERE THESE DOCUMENTS ARE POSTED. - FINANCIAL ASSISTANCE INFORMATION WILL BE INCLUDED ON ALL PATIENT STATEMENTS. - A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WILL BE AVAILABLE AT COMMUNITY EVENTS AND WILL BE PROVIDED TO LOCAL AGENCIES THAT PROVIDE CONSUMER ASSISTANCE. TO THE EXTENT REQUIRED BY LAW, SCRIPPS WILL PROVIDE A COPY OF THIS POLICY AND RELATED INFORMATION TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. IN ADDITION, SCRIPPS POLICY WILL BE AVAILABLE TO THE PUBLIC FOR REVIEW UPON REQUEST MADE THROUGH PATIENT FINANCIAL SERVICES CUSTOMER SERVICE. REVIEW WILL BE FACILITATED THROUGH THE USE OF INTERPRETERS (LANGUAGE, VISION, AND HEARING) OR WRITTEN MATERIALS AS REQUESTED BY THE INDIVIDUAL.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
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?34
Name and address Type of Facility (describe)
1 Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd
La Jolla,CA92037
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
2 Scripps Clinic - Rancho Bernardo
15004 Innovation Dr
San Diego,CA92128
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
3 Scripps Medical Lab
9535 Waples St 150
San Diego,CA92121
Laboratory services
4 Scripps Clinic - Carmel Valley
3811 Valley Centre Dr
San Diego,CA92130
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
5 Scripps Clinic - Encinitas
310 Santa Fe Dr
Encinitas,CA92024
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
6 SCMC Cedar
130 Cedar Rd
Vista,CA92083
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
7 Scripps Clinic -LA JOLLA Memorial Campus
9850 Genessee Ave Ximed Bldg 600
San Diego,CA92121
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
8 Scripps Home Health Services
9619 Chespeake Dr 300
San Diego,CA92123
Home health services
9 Scripps Clinic - Mission Valley
7565 Mission Valley Rd
San Diego,CA92108
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
10 SCMC - Carlsbad
2176 Salk Ave
Carlsbad,CA92008
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
11 Scripps Clinic - Rancho San Diego
10862 Calle Verde
La Mesa,CA91941
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
12 Scripps Clinic -La Jolla Memorial CampuS
9850 Genessee Ave Ximed Bldg 600
San Diego,CA92121
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
13 Mercy ASC
550 Washington St 1st Floor
San Diego,CA92103
Primary care and specialty care services IN AN AMBULATORY ENVIRONMNET
14 Encinitas Surgery Center LLC
320 Santa Fe Dr LL1-2
Encinitas,CA92024
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
15 SCMC - Hillcrest
501 Washington St 525 600
San Diego,CA92103
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
16 Scripps Cardio & Thoracic Surgery Center
9850 Genessee Ave 560
La Jolla,CA92037
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
17 Scripps Clinic - Del Mar
12395 El Camino Real 317 112 12
Del Mar,CA92130
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
18 SCMC - Oceanside
4318 Mission Ave
Oceanside,CA92057
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
19 Scripps Hospital Medical Services
4275 Campus Point Court
San Diego,CA92121
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
20 SCMC - Eastlake
971 Lane Ave
Chula Vista,CA91914
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
21 SCMC - Encinitas
477 N El Camino Real A208 B305
Encinitas,CA92024
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
22 SCMC - Solana Beach
380 Stevens Ave 100
Del Mar,CA92075
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
23 Scripps Clinic - Santee
278 Town Center Pkwy 105
Santee,CA92071
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
24 SCMC - Vista Way OBGYN
3998 Vista Way 202C
Vista,CA92056
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
25 SCMC - Encinitas OBGYN
332 Santa Fe Dr 115
Encinitas,CA92024
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
26 Scripps Clinic - La Jolla OBGYN
9850 Genessee Ave 170
San Diego,CA92121
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
27 SCMC - Escondido
488 E Valley Pkwy 411
Escondido,CA92025
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
28 SCMC - Alvarado
6386 Alvarado Ct 310
San Diego,CA92120
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
29 Scripps Clinic - Mercy Campus
4020 Fifth Ave 401
San Diego,CA92103
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
30 Scripps Clinic - Coronado
1317 A Ynes Pl
Coronado,CA92118
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
31 SCMC - Sycamore
2120 Thibido
Vista,CA92084
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
32 Scripps Clinic - Mental Health
15004 Innovation Dr
San Diego,CA92128
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
33 Scripps Clinic - Mission Valley
7425 Mission Valley Rd
San Diego,CA92108
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
34 Scripps Clinic Rancho San Diego
3835 Avocado Blvd
La Mesa,CA91941
Primary care and specialty care services IN AN AMBULATORY ENVIRONMENT
Schedule H (Form 990) 2013
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
SCHEDULE H, PART V, LINE 3 HEALTH EXPERT, COMMUNITY LEADER AND RESIDENT FEEDBACK THE INSTITUTE OF PUBLIC HEALTH (IPH) AND CHNA ADVISORY WORKGROUP SOUGHT FEEDBACK FROM COMMUNITY LEADERS, HEALTH EXPERTS AND RESIDENTS OF VULNERABLE COMMUNITIES. THIS WAS DONE THROUGH THREE METHODS: AN ELECTRONIC SURVEY FOR COMMUNITY LEADERS AND HEALTH EXPERTS; KEY INFORMANT INTERVIEWS; AND COMMUNITY FORUMS FOR RESIDENTS IN VULNERABLE COMMUNITIES THROUGHOUT SAN DIEGO COUNTY. - ONLINE SURVEY OF HEALTH EXPERTS AND LEADERS INITIAL EMAIL SAMPLE (N=120). TOTAL SURVEYS COMPLETED (N=89). - COMMUNITY FORUMS (106 COMMUNITY RESIDENTS) EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS, AND SAN YSIDRO CONDUCTED IN NEIGHBORHOODS WITH HIGH COMMUNITY NEED INDEX SCORES - FIVE KEY INFORMANT INTERVIEWS LEADERS CHOSEN BASED ON DISCIPLINE EXPERTISE AND KNOWLEDGE OF HEALTH ISSUES AFFECTING COMMUNITIES - COMMUNITY FORUMS (106 COMMUNITY RESIDENTS) EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS AND SAN YSIDRO CONDUCTED IN NEIGHBORHOODS WITH HIGH COMMUNITY NEED INDEX SCORES. HEALTH EXPERT AND COMMUNITY LEADER ELECTRONIC SURVEY IN ORDER TO PRIORITIZE THE HEALTH CONDITIONS AND HEALTH DRIVERS IDENTIFIED, THE IPH AND THE CHNA ADVISORY WORKGROUP DEVELOPED A LIST OF OVER 100 POSSIBLE COMMUNITY HEALTH EXPERTS AND LEADERS. A HEALTH EXPERT OR LEADER WAS DEFINED AS A PERSON WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE LIST WAS COMPILED TO ENSURE REPRESENTATION OF EXPERTS IN BOTH THE 15 HEALTH CONDITIONS AND 26 HEALTH DRIVERS THAT HAD BEEN IDENTIFIED. HEALTH EXPERTS AND LEADERS WERE IDENTIFIED FROM HOSPITAL SETTINGS, COMMUNITY-BASED ORGANIZATIONS, GOVERNMENT POLICY, LEGAL, AND HEALTH ADVOCACY ORGANIZATIONS. CONTACT INFORMATION WAS VERIFIED AND INITIAL EMAILS WERE SENT TO THE LIST OF HEALTH EXPERTS AND LEADERS IN SAN DIEGO IN ORDER TO GAUGE POTENTIAL INTEREST IN PARTICIPATING IN THE CHNA HEALTH PRIORITIZATION SURVEY. AT THE TIME OF THIS INITIAL E-MAIL, INTERESTED RESPONDENTS WERE ASKED WHICH CONDITIONS THEY HAD EXPERTISE IN, WHAT POPULATIONS THEY SERVED AND WHAT REGIONS THEY WORKED IN. THIS INITIAL FEEDBACK GAVE THE IPH AND THE CHNA ADVISORY WORKGROUP AN IDEA OF THE COVERAGE OF DATA THAT WOULD ULTIMATELY BE GATHERED ON HEALTH CONDITIONS, REGIONS AND POPULATIONS SERVED. TARGETED OUTREACH TO ADDITIONAL HEALTH EXPERTS AND LEADERS WAS THEN INITIATED TO FILL GAPS OF UNDER-REPRESENTED CONDITIONS, REGIONS, OR VULNERABLE POPULATIONS. THE CHNA SURVEY WAS EMAILED TO OVER 120 HEALTH EXPERTS AND LEADERS, WITH 89 PEOPLE COMPLETING THE SURVEY. WHEN DESIGNING THE SURVEY, IT WAS TAKEN INTO ACCOUNT THE DIVERSITY OF THE KNOWLEDGE OF THE RESPONDENTS. SOME RESPONDENTS HAD KNOWLEDGE OF SPECIFIC DISEASES OR CONDITIONS AND THE HEALTH DRIVERS AFFECTING THOSE DISEASES. OTHERS HAD A MUCH MORE GENERAL KNOWLEDGE OF HEALTH DRIVERS AND HOW THEY MIGHT AFFECT MULTIPLE HEALTH OUTCOMES. TO ACCOMMODATE THESE DIFFERENT PERSPECTIVES, THE SURVEY WAS CREATED SO THAT THE RESPONDENTS COULD ANSWER THE SURVEY FROM ONE OF THE TWO PERSPECTIVES. BOTH PERSPECTIVES ALLOWED RESPONDENTS TO COMMENT ON POOR HEALTH CONDITIONS AND HEALTH DRIVERS AS THEY COMPLETED THE SURVEY. AS PART OF THE SURVEY, PARTICIPANTS WERE PROVIDED WITH ELECTRONIC LINKS TO THE 15 CONDITION BRIEFS AND THE OPPORTUNITY TO REVIEW THOSE BRIEFS, COMPARING DATA ACROSS THE CONDITIONS PRIOR TO ANSWERING THE SURVEY. USING THE LIST OF 15 HEALTH CONDITIONS AND 26 HEALTH DRIVERS, THE IPH AND CHNA ADVISORY WORKGROUP DEVELOPED AN ELECTRONIC SURVEY THAT ASKED COMMUNITY LEADERS AND HEALTH EXPERTS TO HELP PRIORITIZE HEALTH CONDITIONS THAT MET THE FOLLOWING REQUIREMENTS: - HAVE A SIGNIFICANT PREVALENCE IN THE COMMUNITY, - CONTRIBUTE SIGNIFICANTLY TO THE MORBIDITY AND MORTALITY IN SAN DIEGO COUNTY, - DISPROPORTIONATELY IMPACT VULNERABLE COMMUNITIES, - REFLECT A NEED THAT EXISTS THROUGHOUT SAN DIEGO COUNTY, AND - CAN BE ADDRESSED THROUGH EVIDENCE-BASED PRACTICES BY HOSPITALS AND HEALTHCARE SYSTEMS. KEY INFORMANT INTERVIEWS THE IPH COMPLETED FIVE KEY INFORMANT INTERVIEWS. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH DR. WILMA WOOTEN, DR. JAMES DUNFORD, DR. CHRISTINE WOOD, DR. PHILIP HANGER, AND GREG KNOLL, ESQ. EACH INTERVIEW LASTED NO LONGER THAN ONE HOUR. THESE LEADERS WERE CHOSEN BASED ON THEIR DISCIPLINE AND KNOWLEDGE OF HEALTH ISSUES AFFECTING SAN DIEGO. KEY INFORMANTS WERE ALSO SELECTED BASED ON THEIR ABILITY TO UNDERSTAND HEALTH POLICY, AND THEIR KNOWLEDGE OF ISSUES THROUGHOUT SAN DIEGO COUNTY. THE 15 HEALTH CONDITIONS WERE SHARED WITH THE PARTICIPANTS DURING THE INTERVIEWS. THE PURPOSE OF THE KEY INFORMANT INTERVIEWS WAS TO: - GATHER MORE IN-DEPTH UNDERSTANDING OF THE HEALTH CONDITIONS MOST AFFECTING SAN DIEGO. - AID IN THE PROCESS OF PRIORITIZING HEALTH CONDITIONS. - MAKE CONNECTIONS BETWEEN THE HEALTH CONDITIONS AND ASSOCIATED HEALTH DRIVERS. - GAIN INFORMATION ABOUT THE SYSTEM OR POLICY CHANGES THAT COULD POTENTIALLY IMPACT HEALTH CONDITIONS. - GET HEALTH CONDITIONS SPECIFIC RECOMMENDATIONS AS WELL AS OVERALL RECOMMENDATIONS. COMMUNITY FORUMS THE PURPOSE OF THE COMMUNITY FORUMS WAS TO GAIN RESIDENT'S PERSPECTIVE ON THE OWN HEALTH NEEDS OF THEIR COMMUNITIES, IDENTIFY HEALTH CONDITIONS MOST AFFECTING THEIR COMMUNITIES, AND IDENTIFY COMMUNITY RECOMMENDATIONS ON HOW HOSPITALS COULD HELP TO MEET THEIR HEALTH NEEDS. IN ORDER TO ENSURE UNBIASED COMMUNITY FEEDBACK, NEITHER HEALTHCARE ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) NOR THE PARTICIPATING HOSPITALS ATTENDED. COMMUNITIES OF HIGH HEALTH NEED, BASED ON THEIR COMMUNITY NEED INDEX SCORE WERE SELECTED FOR CONDUCTING FOCUS GROUPS WITH COMMUNITY MEMBERS. THE IPH PARTNERED WITH NEIGHBORHOOD COMMUNITY COLLABORATIVE AGENCIES OR ORGANIZATIONS WITHIN EACH NEIGHBORHOOD TO RECRUIT COMMUNITY MEMBERS TO PARTICIPATE IN THE FOCUS GROUPS. RECRUITMENT INCLUDED THE STIPULATION THAT FOCUS GROUP PARTICIPANTS WERE LIVING IN THE NEIGHBORHOOD AND WERE NOT AFFILIATED WITH LOCAL HOSPITALS AND HEALTH CENTERS. FOCUS GROUPS WERE CONDUCTED IN EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS, AND SAN YSIDRO. DURING THE FOCUS GROUPS, GEOGRAPHICAL INFORMATIONAL SYSTEMS (GIS) MAPS DISPLAYING CNI SCORES BY ZIP CODE IN SAN DIEGO COUNTY AS WELL AS THE SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY (HHSA) REGION OF THE NEIGHBORHOOD WERE DISPLAYED AND HAND-OUTS IN BOTH ENGLISH AND SPANISH EXPLAINING THE CNI SCORE WERE DISTRIBUTED TO EACH PARTICIPANT. INFORMATION WAS ALSO PROVIDED TO COMMUNITY MEMBERS OF THE HEALTH RESOURCES AVAILABLE TO THEM IN THEIR NEIGHBORHOODS.
SCHEDULE H, PART V, LINE 4 SCRIPPS CONDUCTED ONE CHNA FOR THE SYSTEM. BEGINNING IN SEPTEMBER 2012 WITH COMPLETION IN APRIL 2013, THE IPH MANAGED THE DESIGN, IMPLEMENTATION AND INTERPRETATION OF THE CHNA PROCESS. PARTICIPATING HOSPITALS AND HEALTHCARE SYSTEMS WERE ALL REPRESENTED IN THE CHNA ADVISORY WORKGROUP: - KAISER FOUNDATION HOSPITAL - SAN DIEGO - PALOMAR HEALTH - RADY CHILDREN'S HOSPITAL - SAN DIEGO - SCRIPPS HEALTH - SHARP HEALTHCARE - TRI-CITY MEDICAL CENTER - UNIVERSITY OF CALIFORNIA SAN DIEGO HEALTH SYSTEM
SCHEDULE H, PART V, LINE 5 THIS COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTP://WWW.SCRIPPS.ORG/SPARKLE-ASSETS/DOCUMENTS/2013_CHNA_FINAL.PDF
SCHEDULE H, PART V, LINE 7 THE PURPOSE OF THIS CHNA WAS TO IDENTIFY AND PRIORITIZE HEALTH ISSUES AND NEEDS IN SAN DIEGO COUNTY USING MULTIPLE SOURCES OF INFORMATION. THE ANALYSIS OF SECONDARY DATA INCORPORATED THE FOLLOWING CRITERIA FOR INCLUSION AS AN IDENTIFIED COMMUNITY HEALTH NEEDS: 1. FREQUENCY OF DIAGNOSIS, FROM OSHPD HOSPITAL DISCHARGE DATA 2. HIGH MORTALITY RATE IN SAN DIEGO 3. COMMUNITY CONCERN FIFTEEN CONDITIONS WERE THEN USED AS A STARTING POINT TO SOLICIT INPUT FROM THE HEALTH EXPERTS AND LEADERS, KEY INFORMANTS, AND COMMUNITY MEMBERS. BY COMBINING THE RESULTS OF ALL OF THE METHODS EMPLOYED, I.E. SECONDARY DATA SOURCES, ELECTRONIC HEALTH EXPERT AND LEADER SURVEYS, KEY INFORMANT INTERVIEWS, AND COMMUNITY FOCUS GROUPS, THE TOP 4 HEALTH CONDITIONS THAT WERE PRIORITIZED BY THIS COMMUNITY HEALTH NEEDS ASSESSMENT WERE: 1. DIABETES (TYPE 2) 2. OBESITY 3. CARDIOVASCULAR DISEASE 4. MENTAL/BEHAVIORAL HEALTH FIVE BROAD CATEGORIES OF RECOMMENDATIONS FOR HOSPITALS TO IMPROVE COMMUNITY HEALTH INCLUDED: 1. ACCESS TO CARE OR INSURANCE 2. CARE MANAGEMENT 3. COLLABORATION 4. EDUCATION 5. SCREENING SERVICES THE OTHER ELEVEN CONDITIONS (ACUTE RESPIRATORY INFECTIONS, ASTHMA, BACK PAIN, BREAST CANCER, COLORECTAL CANCER, DEMENTIA/ALZHEIMER'S, HIGH RISK PREGNANCY, LUNG CANCER, PROSTATE CANCER, SKIN CANCER AND UNINTENTIONAL INJURY) WERE NOT ADDRESSED IN DETAIL IN THE SCRIPPS CHNA DUE TO LIMITED FINANCIAL AND STAFFING ISSUES AND THAT SOME OF THESE HEALTH CONDITIONS ARE BEING ADDRESSED BY OTHER PROVIDERS IN THE COMMUNITY.
SCHEDULE H, PART V, LINE 12I BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON FAMILY INCOME AND EXPENSES. FOR LOW-INCOME, UNINSURED PATIENTS WHO EARN LESS THAN TWICE THE FEDERAL POVERTY LEVEL (FPL), WE WILL FULLY FORGIVE THE ENTIRE BILL. FOR THOSE PATIENTS WHO EARN BETWEEN TWO AND FOUR TIMES THE FPL, WE WILL FORGIVE A PORTION OF THE BILL. WE WILL NOT CHARGE PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE MORE THAN SCRIPPS' DISCOUNTED FINANCIAL ASSISTANCE AMOUNT, WHICH REPRESENTS SCRIPPS' AGB AS CALCULATED WITH THE PROSPECTIVE METHOD. EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS. ALL UNFUNDED PATIENTS RECEIVE A MINIMUM OF A 20% DISCOUNT TAKEN AUTOMATICALLY AT BILLING. THE DETERMINATION OF WHAT PERCENTAGE OF TOTAL CHARGES A QUALIFIED FINANCIAL ASSISTANCE PATIENT MAY BE CHARGED IS BASED ON FPL AND THE PERCENTAGE OF FPL THE PATIENT IS AT. SCRIPPS FINANCIAL ASSISTANCE PROGRAM RANGES FROM NO CHARGE FOR CARE TO PATIENTS AT OR BELOW 200 PERCENT OF FPL TO 23% OF TOTAL CHARGES FROM 201% TO 400% OF FPL.
SCHEDULE H, PART V, LINE 14G METHODS OF PUBLISHING THE FINANCIAL ASSISTANCE POLICY THE FINANCIAL ASSISTANCE IS WIDELY AVAILABLE ON THE SCRIPPS HEALTH WEBSITE HTTP://WWW.SCRIPPS.ORG/PATIENT-GUIDE__FINANCIAL-ASSISTANCE THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE UPON REQUEST. PAPER COPIES OF OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY IS MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE AT ALL SCRIPPS PATIENT REGISTRATION AREAS AND BY MAIL. IN ADDITION, THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED AT ALL POINTS OF REGISTRATION AREAS (I.E. EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION AREAS AND ANCILLARY SERVICE LOCATIONS). PLAIN LANGUAGE SUMMARIES ARE STOCKED AS A PATIENT HANDOUT IN BOTH ENGLISH AND SPANISH. FOR INPATIENTS, THE INFORMATION IS INCLUDED IN THE ESSENTIAL HANDBOOK, A COMPREHENSIVE BROCHURE COVERING MANY ASPECTS OF HOSPITALIZATION. UNFUNDED PATIENTS ARE NOT ALWAYS REFERRED TO FINANCIAL COUNSELORS. SOME SITES DO NOT USE FINANCIAL COUNSELORS, BUT THE STAFF MEMBER WHO REGISTERS THE PATIENT CAN DISCUSS FINANCIAL ASSISTANCE AND THE PLAIN LANGUAGE SUMMARY PROVIDES PATIENTS WITH CONTACT INFORMATION FOR FINANCIAL COUNSELORS. SCRIPPS MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES, INCLUDING EMERGENCY AND OTHER MEDICALLY NECESSARY HOSPITAL CARE. SCRIPPS FINANCIAL ASSISTANCE IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD-PARTY COVERAGE INCLUDING MEDICARE. COMMUNITY OUTREACH AND COMMUNICATION REGARDING SCRIPPS FINANCIAL ASSISTANCE IS ACHIEVED THROUGH THE FOLLOWING MEASURES, TO INCLUDE BUT NOT LIMITED TO: - POSTERS IN CONSPICUOUS REGISTRATION AREAS I.E. EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION AREAS AND ANCILLARY SERVICE LOCATIONS. - PAPER COPIES OF SCRIPPS FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND A SUMMARY OF THE POLICY WILL BE MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE AT ALL SCRIPPS PATIENT REGISTRATION AREAS AND BY MAIL. - THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY, AND FINANCIAL ASSISTANCE APPLICATIONS WILL BE CONSPICUOUSLY POSTED ON SCRIPPS WEB SITE TO VIEW, DOWNLOAD AND PRINT FREE OF CHARGE. THE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WILL CONTAIN THE WEB SITE ADDRESS WHERE THESE DOCUMENTS ARE POSTED. - FINANCIAL ASSISTANCE INFORMATION WILL BE INCLUDED ON ALL PATIENT STATEMENTS. - A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WILL BE AVAILABLE AT COMMUNITY EVENTS AND WILL BE PROVIDED TO LOCAL AGENCIES THAT PROVIDE CONSUMER ASSISTANCE. TO THE EXTENT REQUIRED BY LAW, SCRIPPS WILL PROVIDE A COPY OF THIS POLICY AND RELATED INFORMATION TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. IN ADDITION, SCRIPPS POLICY WILL BE AVAILABLE TO THE PUBLIC FOR REVIEW UPON REQUEST MADE THROUGH PATIENT FINANCIAL SERVICES CUSTOMER SERVICE. REVIEW WILL BE FACILITATED THROUGH THE USE OF INTERPRETERS (LANGUAGE, VISION, AND HEARING) OR WRITTEN MATERIALS AS REQUESTED BY THE INDIVIDUAL.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
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
SCRIPPS HEALTH
 
Employer identification number
95-1684089
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. 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) 211 San Diego
5251 Viewridge Court
San Diego,CA92123
33-1029843 501 (c) (3) 15,000       Program Support
(2) Alzheimer's Association
6632 Convoy Court
San Diego,CA92111
13-3039601 501 (c) (3) 32,000       Program Support
(3) American Cancer Society Making Strides Against Br
2655 Camino del Rio N
San Diego,CA92108
13-1788491 501 (c) (3) 15,000       Program Support
(4) American Heart Association - Sponsorship
9404 Genesee Ave
La Jolla,CA92037
13-5613797 501 (c) (3) 10,000       Program Support
(5) American Heart Association In-Kind
9404 Genesee Ave
La Jolla,CA92037
13-5613797 501 (c) (3)   25,225 FMV Supplies Program Support
(6) B'Nai B'rith International
2020 K Street NW
Washington,DC20006
53-0179971 501 (c) (3) 7,500       Program Support
(7) California Health Foundation and Trust
1215 K Street STE 800
Sacramento,CA95814
94-1498697 501 (c) (3) 387,000       CA Hospital Fee Program
(8) Catholic Charities
349 Cedar Street
San Diego,CA92101
23-7334012 501 (c) (3) 70,000       Program Support
(9) Eric Paredes Save a Life Foundation
PMB79 2514 Jamacha Rd
El Cajon,CA92019
80-0636157 501 (c) (3) 15,000       Program Support
(10) Consumer Center of Legal Aid Society of San Diego
1764 San Dieg Ave
San Diego,CA92110
98-1869806 501 (c) (3) 120,000       Program Support
(11) Susan G Komen Race for the Cure
5005 LBJ Freeway
Dallas,TX75244
75-1835298 501 (c) (3) 5,001       Program Support
(12) San Diego County Prescription Drug Abuse Task Forc
1600 Pacific Hwy
San Diego,CA92101
33-0337244 501 (c) (3) 19,500       Program Support
(13) Any Body Can Youth Foundation
3131 Market St
San Diego,CA92102
33-0659706 501 (c) (3) 20,000       Program Support
(14) Go Red for Women Luncheon
9404 Genesee Ave
San Diego,CA92037
13-5613797 501 (c) (3) 15,000       Program Support
(15) Amercian Heart Association - Teaching Garden
9404 Genesee Ave
San Diego,CA92037
13-5613797 501 (c) (3) 25,000       Program Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
19
3
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

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












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
SCHEDULE I, PART 1, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS A SEMI-ANNUAL REPORT AND A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT TO DATE IS REQUIRED. THIS SEMI-ANNUAL REPORT SHALL INCLUDE PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN THE GRANT APPLICATION. A FINAL REPORT IS DUE WITHIN THIRTY (30) DAYS FOLLOWING THE EXPIRATION DATE OF THE GRANT. IN ADDITION TO THE PROGRESS MADE TOWARD MEETING THE OBJECTIVES OUTLINED IN THE GRANT APPLICATION, THE FINAL REPORT SHALL INCLUDE QUANTITATIVE AND QUALITATIVE RESULTS OF THE PROGRAM AGAINST ITS STATED GOALS AND OBJECTIVES. A FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT AGAINST THE BUDGET MUST BE INCLUDED AS PART OF THIS FINAL REPORT.
Schedule I (Form 990) 2013


Additional Data


Software ID:  
Software Version:  


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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)JOHN E ARMSTRONGCORP SR VP, SPLY CHAIN/FACIL (i)
(ii)
326,477
0
104,780
0
88,789
0
55,111
0
26,974
0
602,131
0
63,803
0
(2)ROBIN BROWNCHIEF EXECUTIVE, SR VP (i)
(ii)
458,609
0
156,024
0
12,729
0
137,592
0
25,289
0
790,243
0
0
0
(3)VICTOR V BUZACHEROCORP SR VP INNOVAT/HR/PERF MGT (i)
(ii)
529,128
0
207,481
0
191,159
0
159,200
0
29,797
0
1,116,765
0
146,164
0
(4)SUSAN CAMPBELLExec Dir, External Affairs (i)
(ii)
384,372
0
65,523
0
24,004
0
64,308
0
31,957
0
570,164
0
0
0
(5)MARY ELLEN DOYLECorp VP, Nursing Ops (i)
(ii)
337,406
0
85,679
0
48,880
0
50,197
0
26,214
0
548,376
0
34,683
0
(6)ARNOLD BRENT EASTMAN MDCORP SR VP, CHIEF MED OFFICER (i)
(ii)
123,693
0
196,456
0
157,474
0
-256,406
0
1,364
0
222,581
0
0
0
(7)JOHN ENGLECHIEF EXECUTIVE, SR VP, CHIEF (i)
(ii)
336,110
0
116,097
0
66,335
0
55,529
0
28,784
0
602,855
0
39,155
0
(8)CARL ETTERCHIEF EXECUTIVE, SR VP (i)
(ii)
414,826
0
140,521
0
97,474
0
66,054
0
31,115
0
749,990
0
63,797
0
(9)SHIRAZ FAGANCHIEF EXECUTIVE, SR VP (i)
(ii)
481,413
0
100,976
0
62,273
0
74,442
0
26,267
0
745,371
0
50,510
0
(10)GARY FYBELCHIEF EXECUTIVE, SR VP (i)
(ii)
520,221
0
175,640
0
51,931
0
88,628
0
50,834
0
887,254
0
0
0
(11)THOMAS GAMMIERECHIEF EXECUTIVE, SR VP (i)
(ii)
530,802
0
182,252
0
182,013
0
101,123
0
29,852
0
1,026,042
0
162,904
0
(12)CATHY GUIBALVP FINANCE/CFO SCRIPPS MED FDN (i)
(ii)
317,256
0
67,219
0
114,783
0
367
0
4,610
0
504,235
0
44,347
0
(13)LARRY HARRISONCHIEF EXECUTIVE, SR VP (i)
(ii)
429,336
0
156,416
0
6,010
0
0
0
0
0
591,762
0
0
0
(14)ROBERT T HOFFCORP VP, CLINICAL ANC OPS (i)
(ii)
327,436
0
83,636
0
69,936
0
50,453
0
28,622
0
560,083
0
44,515
0
(15)JUNE KOMARCORP EXEC VP, STRATEGY & ADMIN (i)
(ii)
527,982
0
207,420
0
79,495
0
118,559
0
23,022
0
956,478
0
42,865
0
(16)JAMES LA BELLE MDCORP SR VP, CHIEF MED OFFICER (i)
(ii)
552,715
0
130,765
0
26,564
0
93,837
0
29,523
0
833,404
0
0
0
(17)EDWARD NAZARROCOE CLINIC (i)
(ii)
304,609
0
69,189
0
112,573
0
55,829
0
21,995
0
564,195
0
47,715
0
(18)BARBARA PRICECORP SRVP BUS & SERV LINE DEV (i)
(ii)
423,762
0
134,933
0
78,370
0
80,477
0
27,073
0
744,615
0
68,112
0
(19)MARC A REYNOLDSCORP SR VP, PAYER RELATIONS (i)
(ii)
342,127
0
116,524
0
145,369
0
75,908
0
18,970
0
698,898
0
128,272
0
(20)RICHARD ROTHBERGERTREASURER/EXECUTIVE VP/CFO (i)
(ii)
669,451
0
283,432
0
327,027
0
226,730
0
33,357
0
1,539,997
0
294,922
0
(21)RICHARD R SHERIDANSEC/CORP SR VP, GEN COUNSEL (i)
(ii)
466,545
0
158,910
0
60,916
0
137,535
0
26,485
0
850,391
0
31,148
0
(22)PATRIC THOMASCORP VP, INFORMATION SVCS (i)
(ii)
389,644
0
95,974
0
50,918
0
43,438
0
28,825
0
608,799
0
33,394
0
(23)CHRISTOPHER VAN GORDERPRESIDENT & CEO / TRUSTEE (i)
(ii)
1,110,658
0
581,057
0
38,053
0
524,705
0
43,429
0
2,297,902
0
0
0
Schedule J (Form 990) 2013

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
SCHEDULE J, PART I, LINE 1A SUPPLEMENTAL COMPENSATION INFORMATION SCRIPPS HEALTH INCURS THE COST OF A MEMBERSHIP FOR A BUSINESS NETWORKING CLUB IN SAN DIEGO FOR THE CHIEF EXECUTIVE OFFICER. THIS MEMBERSHIP IS USED 100% FOR BUSINESS PURPOSES AND ACCORDINGLY, NO PART OF THIS BENEFIT IS INCLUDED WITHIN THE CHIEF EXECUTIVE OFFICER'S TAXABLE COMPENSATION. THE MEMBERSHIP FEE IS $110 PER MONTH. CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR W-2S.
SCHEDULE J, PART I, LINE 4A RECEIVE A SEVERANCE PAYMENT OR CHANGE-OF-CONTROL PAYMENT THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY IN CALENDAR YEAR 2013: LARRY HARRISON $429,336 ARNOLD BRENT EASTMAN, MD $100,000 CATHY GUIBAL $251,946
SCHEDULE J, PART 1, LINE 4B SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN SCRIPPS HEALTH SUPPLEMENTAL RETIREMENT PLAN (SERP) PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN KEY EMPLOYEES. IT HAS BEEN CLOSED TO NEW PARTICIPANTS SINCE 2001. THE PLAN PROVIDES A BENEFIT DETERMINED BY A FORMULA DRIVEN BY THE EXECUTIVE'S AVERAGE OF THE FIVE HIGHEST YEARS OF PAY AND TAKES INTO CONSIDERATION TENURE AT SCRIPPS HEALTH, AGE, AND LIFE EXPECTANCY AND ASSUMES MAXIMUM PARTICIPATION IN OTHER RETIREMENT PROGRAMS. SCRIPPS HEALTH EXECUTIVE BENEFITS PROGRAM PROVIDES A 457(F) PLAN WITH A FLEXIBLE BENEFIT ALLOWANCE THAT CAN BE USED TO PURCHASE ADDITIONAL INSURANCE COVERAGE FOR CERTAIN EXECUTIVE LEVEL EMPLOYEES. ANY REMAINING BENEFIT ALLOWANCE CAN BE DEPOSITED INTO THE SUPPLEMENTAL ACCUMULATION RETIREMENT ACCOUNT (SARA) WITH A FUTURE VESTING DATE. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE SARA PLAN IN CALENDAR YEAR 2013: JOHN ARMSTRONG - $63,803 VICTOR V. BUZACHERO - $146,164 MARY ELLEN DOYLE - $34,683 JOHN ENGLE - $39,155 CARL ETTER - $63,797 SHIRAZ FAGAN - $50,510 THOMAS GAMMIERE - $162,904 CATHY GUIBAL - $44,347 ROBERT HOFF - $44,515 JUNE KOMAR - $42,865 BARBARA PRICE - $68,112 EDWARD NAZZARO - $47,715 MARC REYNOLD - $128,272 RICHARD ROTHBERGER - $294,922 RICHARD SHERIDAN - $31,148 PATRIC THOMAS - $33,394 EFFECTIVE JANUARY 1, 2014, SCRIPPS HEALTH FROZE ALL BENEFITS UNDER THE EXISTING SERP PLAN FOR FOUR PLAN PARTICIPANTS. EFFECTIVE APRIL 1, 2014, SCRIPPS HEALTH PROVIDED DEFERRED COMPENSATION ARRANGEMENTS TO THOSE FOUR EXECUTIVES IN THE FORM OF LOANS TO PURCHASE LIFE INSURANCE PRODUCTS TO FUND POST-RETIREMENT INCOME.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.

SchKMediumBulletInformation 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
SCRIPPS HEALTH
 
Employer identification number
95-1684089
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A California Statewide Communities Development AUTH
 
68-0164610 1309116Y1 03-02-2007 49,995,000 SEE PART VI   X   X X  
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033F5A4 08-14-2008 99,830,304 SEE PART VI   X   X   X
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033F5L0 08-14-2008 221,230,000 SEE PART VI   X   X   X
D California Health Facilities Financing Authority
 
52-1643828 13033FWK2 06-02-2005 40,975,000 SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LFH5 02-04-2010 119,458,924 SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LFL6 02-04-2010 100,000,000 SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LVZ7 02-01-2012 288,143,095 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 3,155,000 52,735,000 12,125,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 49,995,000 99,830,304 221,230,000 40,975,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 9,909,993 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 146,070 0 0 280,659
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 5,544 918,283
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 0 0 0
11 Other spent proceeds . . . . . . . . . . . . . . 49,848,930 89,920,897 221,224,456 39,776,058
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2005 2008 2008 2008
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    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
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      
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      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . 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      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 %      
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.        
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 . . . . . . . . . 0
 
0
 
WELLS FARGO UBOC
 
 
 
c Term of hedge . . . . . . . . . . 26.   26. 14.
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
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 . . . . . . . . . 0
 
0
 
0
 
0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
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
SCHEDULE K, PART I, COLUMN (C) - CUSIP NUMBER BOND ISSUE D (2005A/2008G): THE SERIES 2005A BONDS, CUSIP 13033FWK2, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G, CUSIP 13033F5M8 (SCRIPPS HEALTH), ON AUGUST 14, 2008. SCHEDULE K, PART I, COLUMN (E) - ISSUE PRICE BOND ISSUE A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON THE 8038 TAX FORM AS THE $49,995,000 AMOUNT REPRESENTS ONLY SCRIPPS HEALTH'S PORTION IN A POOL BOND LOAN PROGRAM. BOND ISSUE 2-A (2010A): PRIOR YEAR REPORTING REFLECTED THE PRINCIPAL AMOUNT RATHER THAN THE ISSUE PRICE. BOND ISSUE B (2008A): THE STATED PAR OF $99,020,000 DIFFERS FROM THE $99,830,304 LISTED IN FORM 8038 PART III LINE 21 (B) BECAUSE OF AN $810,304 ORIGINAL ISSUE PREMIUM. SCHEDULE K, PART I, COLUMN (F) - DESCRIPTION OF PURPOSE BOND ISSUE A (2007A): POOL BOND. PROCEEDS WERE USED TO REFUND COMMERCIAL PAPER REVENUE NOTES, SERIES 2005A, WHICH WERE USED TO PURCHASE EQUIPMENT. BOND ISSUE B (2008A): REFUNDING OF PRIOR ISSUES 07/07/2005 BOND ISSUE C (2008B-F): THE $221,230,000 (2008B - F) REFUNDED THE 2005B - F BONDS. THE ISSUE DATE FOR THE 2005 B - F WAS 6/17/2005 BOND ISSUE D (2005A/2008G): THE $40,975,000 (2008G) EXCHANGED THE 2005A BOND. THE ISSUE DATE FOR THE 2005A WAS 6/2/2005. THE PROCEEDS OF THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2005A (SCRIPPS HEALTH), WERE ISSUED FOR THE PURPOSE, TOGETHER WITH OTHER AVAILABLE FUNDS, OF ADVANCE REFUNDING THE ORGANIZATION'S SERIES 1998C BONDS. THE SERIES 2005A BONDS WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G (SCRIPPS HEALTH), ON AUGUST 14, 2008. BASED ON THE ADVICE OF BOND COUNSEL, THE ORGANIZATION IS TREATING THE SERIES 2008G BONDS AS THE SAME ISSUE AS THE SERIES 2005A BONDS FOR FEDERAL INCOME TAX PURPOSES. FURTHER INFORMATION REGARDING THE SERIES 2008G BONDS: - ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY; - ISSUER EIN: 52-1643828; - CUSIP #: 13033F5M8; - DATE EXCHANGED: 8/14/2008; - ISSUE PRICE: N/A; - DESCRIPTION OF PURPOSE: EXCHANGE FOR SERIES 2005A BONDS (SAME ISSUE). BOND ISSUE 2-A (2010A): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 2-B (2010B & C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 2-C (2012A-C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. SCHEDULE K, PART II, LINE 3 BOND ISSUE 2-C (2012A-C): THE AMOUNT SHOWN IN PART II, LINE 3 CONSISTS OF THE ISSUE PRICE OF THE BONDS ($288,143,095) PLUS INVESTMENT EARNINGS OF $17,234. SCHEDULE K, PART III -PRIVATE BUSINESS USE BOND ISSUE B (2008A): THE SERIES 2008A BONDS REFUNDED PRIOR BONDS ORIGINALLY ISSUED BEFORE 2003. ACCORDINGLY, PART III REPORTING IS NOT REQUIRED. BOND ISSUE D (2005A/2008G): THE SERIES 2005A BONDS REFUNDED PRIOR BONDS ORIGINALLY ISSUED BEFORE 2003. ACCORDINGLY, PART III REPORTING IS NOT REQUIRED. SCHEDULE K, PART III, LINE 3B THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY. SCHEDULE K, PART IV, LINE 2C BOND ISSUE B (2008A): THE 2008A REBATE COMPUTATION WAS RECENTLY PERFORMED ON AUGUST 14, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE C (2008B-F): THE 2008B-F REBATE COMPUTATION WAS RECENTLY PERFORMED ON AUGUST 14, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE D (2005A/2008G): THE 2005A/2008G REBATE COMPUTATION WAS RECENTLY PERFORMED ON JUNE 2, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-A (2010A): THE 2010A REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 4, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-B (2010B/C): THE 2010B/C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 4, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-C (2012A-C): THE 2012A-C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 1, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. SCHEDULE K, PART IV, LINE 3 BOND ISSUE 2-C (2012A-C): THE 2012A TOTALING $188,143,094.65 IS A FIXED RATE ISSUE WHEREAS THE 2010B&C TOTALING $100,000,000 IS A VARIABLE RATE ISSUE. SCHEDULE K, PART IV, LINE 4B BOND ISSUE C (2008B-F): ON SEPTEMBER 18, 2012 THE ORGANIZATION ENTERED INTO INTEREST RATE SWAP NOVATIONS WITH WELLS FARGO BANK, N.A. AND UNION BANK, N.A., AS COUNTERPARTY, REPLACING THEN-EXISTING INTEREST RATE SWAPS WITH CITIBANK, N.A. BOND ISSUE D (2005A/2008G): ON SEPTEMBER 18, 2012 THE ORGANIZATION ENTERED INTO INTEREST RATE SWAP NOVATIONS WITH WELLS FARGO BANK, N.A., AS COUNTERPARTY, REPLACING THEN-EXISTING INTEREST RATE SWAPS WITH CITIBANK, N.A. SCHEDULE K, PART IV, LINE 6 BOND ISSUE A (2007A): AN AMOUNT IN THE COSTS OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008. BOND ISSUE D (2005A/2008G): THE ISSUE DATE FOR THE 2005A WAS 6/17/2005. THE COST OF ISSUANCE WAS NOT EXPENDED UNTIL 1/4/2006. PER THE TAX CERTIFICATE IT WAS EXPECTED TO BE EXPENDED WITHIN 180 DAYS. SCHEDULE K, PART V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION THE ORGANIZATION HAS ADOPTED TAX-EXEMPT BOND COMPLIANCE PROCEDURES, INCLUDING PROCEDURES TO MONITOR PRIVATE BUSINESS USE OF FINANCED PROPERTY AND TAKING REMEDIAL ACTIONS, IF NECESSARY. THE ORGANIZATION IS AWARE OF THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS, AND HAS DISCUSSED THAT PROGRAM WITH COUNSEL. THE ORGANIZATION IS SUPPLEMENTING ITS WRITTEN PROCEDURES TO SPECIFICALLY MAKE REFERENCE TO THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.

SchKMediumBulletInformation 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
SCRIPPS HEALTH
 
Employer identification number
95-1684089
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A California Statewide Communities Development AUTH
 
68-0164610 1309116Y1 03-02-2007 49,995,000 SEE PART VI   X   X X  
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033F5A4 08-14-2008 99,830,304 SEE PART VI   X   X   X
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033F5L0 08-14-2008 221,230,000 SEE PART VI   X   X   X
D California Health Facilities Financing Authority
 
52-1643828 13033FWK2 06-02-2005 40,975,000 SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LFH5 02-04-2010 119,458,924 SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LFL6 02-04-2010 100,000,000 SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LVZ7 02-01-2012 288,143,095 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 3,155,000 52,735,000 12,125,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 49,995,000 99,830,304 221,230,000 40,975,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 9,909,993 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 146,070 0 0 280,659
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 5,544 918,283
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 0 0 0
11 Other spent proceeds . . . . . . . . . . . . . . 49,848,930 89,920,897 221,224,456 39,776,058
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2005 2008 2008 2008
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    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
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      
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      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . 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      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 %      
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.        
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 . . . . . . . . . 0
 
0
 
WELLS FARGO UBOC
 
 
 
c Term of hedge . . . . . . . . . . 26.   26. 14.
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
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 . . . . . . . . . 0
 
0
 
0
 
0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
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
SCHEDULE K, PART I, COLUMN (C) - CUSIP NUMBER BOND ISSUE D (2005A/2008G): THE SERIES 2005A BONDS, CUSIP 13033FWK2, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G, CUSIP 13033F5M8 (SCRIPPS HEALTH), ON AUGUST 14, 2008. SCHEDULE K, PART I, COLUMN (E) - ISSUE PRICE BOND ISSUE A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON THE 8038 TAX FORM AS THE $49,995,000 AMOUNT REPRESENTS ONLY SCRIPPS HEALTH'S PORTION IN A POOL BOND LOAN PROGRAM. BOND ISSUE 2-A (2010A): PRIOR YEAR REPORTING REFLECTED THE PRINCIPAL AMOUNT RATHER THAN THE ISSUE PRICE. BOND ISSUE B (2008A): THE STATED PAR OF $99,020,000 DIFFERS FROM THE $99,830,304 LISTED IN FORM 8038 PART III LINE 21 (B) BECAUSE OF AN $810,304 ORIGINAL ISSUE PREMIUM. SCHEDULE K, PART I, COLUMN (F) - DESCRIPTION OF PURPOSE BOND ISSUE A (2007A): POOL BOND. PROCEEDS WERE USED TO REFUND COMMERCIAL PAPER REVENUE NOTES, SERIES 2005A, WHICH WERE USED TO PURCHASE EQUIPMENT. BOND ISSUE B (2008A): REFUNDING OF PRIOR ISSUES 07/07/2005 BOND ISSUE C (2008B-F): THE $221,230,000 (2008B - F) REFUNDED THE 2005B - F BONDS. THE ISSUE DATE FOR THE 2005 B - F WAS 6/17/2005 BOND ISSUE D (2005A/2008G): THE $40,975,000 (2008G) EXCHANGED THE 2005A BOND. THE ISSUE DATE FOR THE 2005A WAS 6/2/2005. THE PROCEEDS OF THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2005A (SCRIPPS HEALTH), WERE ISSUED FOR THE PURPOSE, TOGETHER WITH OTHER AVAILABLE FUNDS, OF ADVANCE REFUNDING THE ORGANIZATION'S SERIES 1998C BONDS. THE SERIES 2005A BONDS WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G (SCRIPPS HEALTH), ON AUGUST 14, 2008. BASED ON THE ADVICE OF BOND COUNSEL, THE ORGANIZATION IS TREATING THE SERIES 2008G BONDS AS THE SAME ISSUE AS THE SERIES 2005A BONDS FOR FEDERAL INCOME TAX PURPOSES. FURTHER INFORMATION REGARDING THE SERIES 2008G BONDS: - ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY; - ISSUER EIN: 52-1643828; - CUSIP #: 13033F5M8; - DATE EXCHANGED: 8/14/2008; - ISSUE PRICE: N/A; - DESCRIPTION OF PURPOSE: EXCHANGE FOR SERIES 2005A BONDS (SAME ISSUE). BOND ISSUE 2-A (2010A): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 2-B (2010B & C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 2-C (2012A-C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. SCHEDULE K, PART II, LINE 3 BOND ISSUE 2-C (2012A-C): THE AMOUNT SHOWN IN PART II, LINE 3 CONSISTS OF THE ISSUE PRICE OF THE BONDS ($288,143,095) PLUS INVESTMENT EARNINGS OF $17,234. SCHEDULE K, PART III -PRIVATE BUSINESS USE BOND ISSUE B (2008A): THE SERIES 2008A BONDS REFUNDED PRIOR BONDS ORIGINALLY ISSUED BEFORE 2003. ACCORDINGLY, PART III REPORTING IS NOT REQUIRED. BOND ISSUE D (2005A/2008G): THE SERIES 2005A BONDS REFUNDED PRIOR BONDS ORIGINALLY ISSUED BEFORE 2003. ACCORDINGLY, PART III REPORTING IS NOT REQUIRED. SCHEDULE K, PART III, LINE 3B THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY. SCHEDULE K, PART IV, LINE 2C BOND ISSUE B (2008A): THE 2008A REBATE COMPUTATION WAS RECENTLY PERFORMED ON AUGUST 14, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE C (2008B-F): THE 2008B-F REBATE COMPUTATION WAS RECENTLY PERFORMED ON AUGUST 14, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE D (2005A/2008G): THE 2005A/2008G REBATE COMPUTATION WAS RECENTLY PERFORMED ON JUNE 2, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-A (2010A): THE 2010A REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 4, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-B (2010B/C): THE 2010B/C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 4, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-C (2012A-C): THE 2012A-C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 1, 2014. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. SCHEDULE K, PART IV, LINE 3 BOND ISSUE 2-C (2012A-C): THE 2012A TOTALING $188,143,094.65 IS A FIXED RATE ISSUE WHEREAS THE 2010B&C TOTALING $100,000,000 IS A VARIABLE RATE ISSUE. SCHEDULE K, PART IV, LINE 4B BOND ISSUE C (2008B-F): ON SEPTEMBER 18, 2012 THE ORGANIZATION ENTERED INTO INTEREST RATE SWAP NOVATIONS WITH WELLS FARGO BANK, N.A. AND UNION BANK, N.A., AS COUNTERPARTY, REPLACING THEN-EXISTING INTEREST RATE SWAPS WITH CITIBANK, N.A. BOND ISSUE D (2005A/2008G): ON SEPTEMBER 18, 2012 THE ORGANIZATION ENTERED INTO INTEREST RATE SWAP NOVATIONS WITH WELLS FARGO BANK, N.A., AS COUNTERPARTY, REPLACING THEN-EXISTING INTEREST RATE SWAPS WITH CITIBANK, N.A. SCHEDULE K, PART IV, LINE 6 BOND ISSUE A (2007A): AN AMOUNT IN THE COSTS OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008. BOND ISSUE D (2005A/2008G): THE ISSUE DATE FOR THE 2005A WAS 6/17/2005. THE COST OF ISSUANCE WAS NOT EXPENDED UNTIL 1/4/2006. PER THE TAX CERTIFICATE IT WAS EXPECTED TO BE EXPENDED WITHIN 180 DAYS. SCHEDULE K, PART V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION THE ORGANIZATION HAS ADOPTED TAX-EXEMPT BOND COMPLIANCE PROCEDURES, INCLUDING PROCEDURES TO MONITOR PRIVATE BUSINESS USE OF FINANCED PROPERTY AND TAKING REMEDIAL ACTIONS, IF NECESSARY. THE ORGANIZATION IS AWARE OF THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS, AND HAS DISCUSSED THAT PROGRAM WITH COUNSEL. THE ORGANIZATION IS SUPPLEMENTING ITS WRITTEN PROCEDURES TO SPECIFICALLY MAKE REFERENCE TO THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation 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
SCRIPPS HEALTH
 
Employer identification number

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





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) Christopher Van GordER Officer Deferred Compensatio   X 10,023,866 10,188,334 Yes   Yes   Yes  
(2) June Komar Executive Deferred Compensatio   X 2,769,010 2,814,443 Yes   Yes   Yes  
(3) Richard Sheridan Executive Deferred Compensatio   X 4,063,603 4,130,280 Yes   Yes   Yes  
(4) Robin Brown Executive Deferred Compensatio   X 2,668,899 2,712,689 Yes   Yes   Yes  
Total ......Small Bullet $ 19,845,746
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
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?
Yes No
(1) Matthew Balogh SEE PART V 79,678 Employee of Scripps Health   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART II LOANS TO AND FROM INTERESTED PERSONS EFFECTIVE JANUARY 1, 2014, SCRIPPS HEALTH FROZE ALL BENEFITS UNDER THE EXISTING SERP PLAN FOR FOUR PLAN PARTICIPANTS. EFFECTIVE APRIL 1, 2014, SCRIPPS HEALTH PROVIDED DEFERRED COMPENSATION ARRANGEMENTS TO THOSE FOUR EXECUTIVES IN THE FORM OF LOANS TO PURCHASE LIFE INSURANCE PRODUCTS TO FUND POST-RETIREMENT INCOME.
SCHEDULE L, PART IV BUSINESS TRANSACTIONS WITH INTERESTED PERSONS MATTHEW BALOGH, SON-IN-LAW OF BOARD MEMBER GORDON R. CLARK, IS EMPLOYED BY SCRIPPS HEALTH.
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the 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 imageInformation 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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
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 15,000 Opinion of experts
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 32 1,159,055 Cost/selling price
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential . X 3 798,209 Opinion of experts
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
...
29
2
Yes
No
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
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
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)
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
SCHEDULE M, PART I, COLUMN (B) CONTRIBUTIONS REPORTED THE NUMBER OF TRANSACTIONS, WHICH MOST CLOSELY APPROXIMATES THE NUMBER OF ITEMS CONTRIBUTED, IS BEING REPORTED IN COLUMN B. HOWEVER, CONTRIBUTIONS OF EQUIPMENT INCLUDE MULTIPLE COMPONENTS.
SCHEDULE M, PART I, ITEM 32B THIRD PARTIES ENGAGED TO SOLICIT, PROCESS, AND SELL NON-CASH CONTRIBUTIONS GIFTS. GIFTS OF REAL ESTATE ARE LIQUIDATED THROUGH LICENSED REAL ESTATE BROKERS.
Schedule M (Form 990) (2013)
Additional Data


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

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Return Reference Explanation
FORM 990, PART I AND PART III, LINE 1 MISSION STATEMENT FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.6 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,600 AFFILIATED PHYSICIANS AND 13,000 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH, GENOMIC MEDICINE, WIRELESS HEALTH AND GRADUATE MEDICAL EDUCATION. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONG STANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. TODAY, THE HEALTH SYSTEM EXTENDS FROM CHULA VISTA TO OCEANSIDE, WITH 26 PRIMARY AND SPECIALTY CARE OUTPATIENT CENTERS. A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS WAS NAMED BY TRUVEN IN 2013 AS ONE OF THE TOP 15 LARGE HEALTH SYSTEMS IN THE NATION FOR PROVIDING HIGH-QUALITY, SAFE AND EFFICIENT PATIENT CARE. ON THE FOREFRONT OF GENOMIC MEDICINE AND WIRELESS HEALTH TECHNOLOGY, THE ORGANIZATION IS DEDICATED TO IMPROVING COMMUNITY HEALTH WHILE ADVANCING MEDICINE THROUGH CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. SCRIPPS HAS ALSO EARNED A NATIONAL REPUTATION AS A PREMIER EMPLOYER, NAMED BY FORTUNE MAGAZINE AS ONE OF AMERICA'S "100 BEST COMPANIES TO WORK FOR" EVERY YEAR SINCE 2008. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY.
FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $372,630,231 TO COMMUNITY BENEFIT PROGRAMS AND SERVICES IN THE AREAS OF UNCOMPENSATED CARE, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND HEALTH RESEARCH. OUR PROGRAMS EMPHASIZE COMMUNITY-BASED PREVENTION EFFORTS AND USE INNOVATIVE APPROACHES TO REACH RESIDENTS AT GREATEST RISK FOR HEALTH PROBLEMS WE MAKE COMMITMENTS TO IMPROVE THE HEALTH OF OUR PATIENTS AND OUR SAN DIEGO COMMUNITIES. AS A LONG-STANDING MEMBER OF THESE COMMUNITIES, AND AS A NOT-FOR-PROFIT COMMUNITY RESOURCE, OUR GOAL AND RESPONSIBILITY ARE TO PROVIDE HELP AND ASSISTANCE FOR ALL WHO COME TO US FOR CARE, AND TO REACH OUT ESPECIALLY TO THOSE WHO FIND THEMSELVES VULNERABLE AND WITHOUT SUPPORT. THIS RESPONSIBILITY IS AN INTRINSIC PART OF OUR MISSION. THROUGH OUR CONTINUED ACTIONS AND COMMUNITY PARTNERSHIPS, WE STRIVE TO RAISE THE QUALITY OF LIFE IN THE COMMUNITY AS A WHOLE. ASSESSING COMMUNITY NEED CALIFORNIA SENATE BILL 697 REQUIRES THE UPDATING OF A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. IDENTIFYING SAN DIEGO COUNTY'S HEALTH PRIORITIES IS A COMPLEX PROCESS OUTLINED IN THE FOLLOWING PAGES. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, WE ARE BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ORIGINATED FROM CALIFORNIA STATEWIDE LEGISLATION IN THE EARLY 1990S. SB 697 TOOK EFFECT IN 1995, WHICH REQUIRED PRIVATE NON-PROFIT HOSPITALS TO SUBMIT DETAILED INFORMATION TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) ON THEIR COMMUNITY BENEFIT CONTRIBUTIONS. ANNUAL HOSPITAL COMMUNITY BENEFIT REPORTS ARE SUMMARIZED BY OSHPD IN A REPORT TO THE LEGISLATURE, WHICH PROVIDES VALUABLE INFORMATION FOR GOVERNMENT OFFICIALS TO ASSESS THE CARE AND SERVICES PROVIDED TO THEIR CONSTITUENTS. AS PART OF THE COMMUNITY BENEFIT REPORTS FILED, NON-PROFIT HOSPITALS ARE REQUIRED TO CONDUCT A CHNA EVERY THREE YEARS. THIS COMPREHENSIVE ACCOUNT OF HEALTH NEEDS IN THE COMMUNITY IS DESIGNED FOR HOSPITALS TO PLAN THEIR COMMUNITY BENEFIT PROGRAMS TOGETHER WITH OTHER LOCAL HEALTH CARE INSTITUTIONS, COMMUNITY BASED ORGANIZATIONS, AND CONSUMER GROUPS. IN SAN DIEGO COUNTY, THE LONG HISTORY OF COLLABORATION AMONG HOSPITALS, HEALTHCARE SYSTEMS AND COMMUNITY PARTNERS HAS RESULTED IN SUCCESSFUL PARTNERSHIP ON PAST CHNAS. WHILE PUBLIC INSTITUTIONS AND DISTRICT HOSPITALS DO NOT HAVE TO REPORT UNDER SB 697, THESE INSTITUTIONS HAVE BECOME AN INTEGRAL PART OF THE CHNA IN SAN DIEGO COUNTY. INFORMATION IS GATHERED THROUGH THE CHNA FOR THE PURPOSES OF REPORTING COMMUNITY BENEFIT, DEVELOPING STRATEGIC PLANS, CREATING ANNUAL REPORTS, PROVIDING INPUT ON LEGISLATIVE DECISIONS, AND INFORMING THE GENERAL COMMUNITY OF HEALTH ISSUES AND TRENDS. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, SCRIPPS IS BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. VIEW THE FULL SUMMARY OF THE SCRIPPS HEALTH 2014 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AT https://www.scripps.org/sparkle-assets/documents/2013_chna_final.pdf. THIS DOCUMENT ALLOWS INTERESTED PARTIES AND MEMBERS OF THE COMMUNITY, A MECHANISM TO ACCESS THE FULL SPECTRUM OF INFORMATION RELATIVE TO THE DEVELOPMENT OF THE SCRIPPS HEALTH 2013 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. BACKGROUND/REQUIRED COMPONENTS OF THE ASSESSMENT SCRIPPS HEALTH HAS A LONG HISTORY OF RESPONDING TO THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES, EXTENDING BEYOND TRADITIONAL HOSPITAL CARE TO ADDRESS THE HEALTH CARE NEEDS OF THE REGION'S MOST VULNERABLE POPULATIONS. SINCE 1994, THESE PROGRAMS HAVE BEEN CREATED BASED ON AN ASSESSMENT OF NEEDS IDENTIFIED THROUGH HOSPITAL DATA, COMMUNITY INPUT, AND MAJOR TRENDS. PREVIOUS COLLABORATIONS AMONG NON-PROFIT HOSPITALS, HEALTHCARE SYSTEMS, AND OTHER COMMUNITY PARTNERS HAVE RESULTED IN NUMEROUS WELL-REGARDED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) REPORTS. SEE http://www.sdchip.org/initiatives/charting-the-course-vi.aspx FOR PREVIOUS NEEDS ASSESSMENTS. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT ("AFFORDABLE CARE ACT" OR "ACA") OF 2010 IS BRINGING ABOUT SIGNIFICANT REGULATORY CHANGES IN THE HEALTHCARE INDUSTRY. SCRIPPS HEALTH WAS GIVEN THE TASK OF CONDUCTING AN EXPANDED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT MET THE NEW FEDERAL REQUIREMENTS. ADDITIONAL INFORMATION ON THE ACA REQUIREMENTS FOR NONPROFIT HOSPITALS CAN BE FOUND AT WWW.IRS.GOV, KEYWORD: "CHARITABLE ORGANIZATIONS". AS A NONPROFIT HOSPITAL, SCRIPPS HEALTH HAS FULFILLED THIS REQUIREMENT THROUGH THE DEVELOPMENT AND DISTRIBUTION OF THIS ASSESSMENT. WHILE THIS IS A FEDERALLY MANDATED EXERCISE, SCRIPPS HEALTH HOPES TO LEVERAGE THE INFORMATION COLLECTED FOR THIS REPORT TO BENEFIT THE COMMUNITY AT-LARGE IN OTHER FUTURE PLANNING INITIATIVES. THE IRS ALSO REQUIRED HOSPITAL ORGANIZATIONS THAT CONDUCT A CHNA TO MAKE THE REPORT WIDELY AVAILABLE BY POSTING IT ON A PUBLICLY ACCESSIBLE WEBSITE. VIEW THE FULL SUMMARY OF THE SCRIPPS HEALTH 2013 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AT https://www.scripps.org/sparkle-assets/documents/2013_chna_final.pdf. REQUIRED COMPONENTS OF THE ASSESSMENT PER IRS REQUIREMENTS THERE ARE FIVE COMPONENTS THE CHNA MUST INCLUDE: - A DESCRIPTION OF THE COMMUNITY SERVED BY THE HEALTH SYSTEM AND HOW IT WAS DETERMINED - A DESCRIPTION OF THE PROCESSES AND METHODS USED TO CONDUCT THE ASSESSMENT - A DESCRIPTION OF HOW THE HOSPITAL ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY - A PRIORITIZED DESCRIPTION OF ALL OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, AS WELL AS A DESCRIPTION OF THE PROCESS AND CRITERIA USED IN PRIORITIZING SUCH HEALTH NEEDS - A DESCRIPTION OF THE EXISTING HEALTH CARE FACILITIES AND OTHER RESOURCES WITHIN THE COMMUNITY AVAILABLE TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA EXECUTIVE SUMMARY GROUNDED IN A LONGSTANDING COMMITMENT TO ADDRESS COMMUNITY HEALTH NEEDS IN SAN DIEGO, SEVEN HOSPITALS AND HEALTHCARE SYSTEMS CAME TOGETHER UNDER THE AUSPICES OF THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) TO CONDUCT A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IDENTIFIES AND PRIORITIZES THE MOST CRITICAL HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS. PARTICIPATING HOSPITALS WILL USE THE FINDINGS TO GUIDE THEIR COMMUNITY PROGRAMS AND TO MEET IRS REGULATORY REQUIREMENTS THAT NOT FOR PROFIT (TAX EXEMPT) HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. PER GUIDANCE FROM AN ADVISORY GROUP OF HOSPITAL REPRESENTATIVES, HASD&IC CONTRACTED WITH THE INSTITUTE OF PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY TO DESIGN AND IMPLEMENT THE CHNA. THE IPH EMPLOYED A RIGOROUS METHODOLOGY USING BOTH COMMUNITY INPUT (PRIMARY DATA SOURCES) AND QUANTITATIVE ANALYSIS (SECONDARY DATA SOURCES) TO IDENTIFY AND PRIORITIZE THE TOP HEALTH CONDITIONS IN SAN DIEGO COUNTY. SAN DIEGO COUNTY IS A SOCIALLY AND ETHNICALLY DIVERSE COMMUNITY WITH A POPULATION OF 3.2 MILLION PEOPLE. ALTHOUGH THE STUDY AREA FOR THIS CHNA IS THE ENTIRE COUNTY, EACH HOSPITAL HAS THE ABILITY TO USE THE COUNTY-WIDE FINDINGS OR ADAPT THE FINDINGS TO REFLECT THE COMMUNITIES THEY SERVE, AS MUCH OF THE DATA IS AVAILABLE AT ZIP CODE LEVEL. IN ORDER TO PRIORITIZE THE COMMUNITY HEALTH NEEDS, THE IPH DEVELOPED A METHODOLOGY THAT INCLUDED BOTH QUALITATIVE AND QUANTITATIVE DATA SOURCES. QUANTITATIVE DATA INCLUDED HOSPITAL DISCHARGE DATA, STATISTICS FROM THE SAN DIEGO COUNTY HEALTH AND HUMAN SERVICES AGENCY, THE US CENSUS BUREAU, THE CENTERS FOR DISEASE CONTROL, AND OTHERS. THE IPH ALSO SOUGHT DIRECT INPUT FROM THE COMMUNITY THROUGH AN ELECTRONIC SURVEY TO HEALTH EXPERTS AND COMMUNITY LEADERS, KEY INFORMANT INTERVIEWS, AND COMMUNITY FORUMS. HEALTH EXPERT, COMMUNITY LEADER AND RESIDENT FEEDBACK THE IPH AND CHNA ADVISORY WORKGROUP SOUGHT FEEDBACK FROM COMMUNITY LEADERS, HEALTH EXPERTS AND RESIDENTS OF VULNERABLE COMMUNITIES. THIS WAS DONE THROUGH THREE METHODS: AN ELECTRONIC SURVEY FOR COMMUNITY LEADERS AND HEALTH EXPERTS; KEY INFORMANT INTERVIEWS; AND COMMUNITY FORUMS FOR RESIDENTS IN VULNERABLE COMMUNITIES THROUGHOUT SAN DIEGO COUNTY. - ONLINE SURVEY OF HEALTH EXPERTS AND LEADERS INITIAL EMAIL SAMPLE (N=120). TOTAL SURVEYS COMPLETED (N=89). - COMMUNITY FORUMS (106 COMMUNITY RESIDENTS) EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS, AND SAN YSIDRO CONDUCTED IN NEIGHBORHOODS WITH HIGH COMMUNITY NEED INDEX SCORES - FIVE KEY INFORMANT INTERVIEWS LEADERS CHOSEN BASED ON DISCIPLINE EXPERTISE AND KNOWLEDGE OF HEALTH ISSUES AFFECTING COMMUNITIES
FORM 990, PART III, LINE 4A (CONTINUED) PRIORITIZED HEALTH CONDITIONS PRIORITIZED SAN DIEGO COUNTY COMMUNITY HEALTH NEEDS: THE HEALTH NEEDS WERE PRIORITIZED BASED ON THE FOLLOWING CRITERIA: - HAVE A SIGNIFICANT PREVALENCE IN THE COMMUNITY, - CONTRIBUTE SIGNIFICANTLY TO THE MORBIDITY AND MORTALITY IN SAN DIEGO COUNTY, - DISPROPORTIONATELY IMPACT VULNERABLE COMMUNITIES, - REFLECT A NEED THAT EXISTS THROUGHOUT SAN DIEGO COUNTY, AND - CAN BE ADDRESSED THROUGH EVIDENCE-BASED PRACTICES BY HOSPITALS AND HEALTH CARE SYSTEMS. REPORT FINDINGS SAN DIEGO COUNTY COMMUNITY HEALTH NEEDS WHEN THE IPH COMBINED THE RESULTS OF ALL THE DATA AND INFORMATION GATHERED, FOUR CONDITIONS EMERGED CLEARLY AS THE TOP COMMUNITY HEALTH NEEDS IN SAN DIEGO COUNTY (IN ALPHABETICAL ORDER): - CARDIOVASCULAR DISEASE - MENTAL/BEHAVIORAL HEALTH - DIABETES (TYPE 2) - OBESITY HEALTH THEMES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT ONCE ALL THE COMMUNITY INPUT WAS INTEGRATED (SURVEY RESPONDENTS, KEY INTERVIEWEES, AND COMMUNITY FORUM PARTICIPANTS). THE FOLLOWING FIVE BROAD CATEGORIES EMERGED AS RECOMMENDATIONS FOR HOSPITALS TO ORGANIZE COMMUNITY HEALTH PROGRAMS: - ACCESS TO CARE OR INSURANCE - CARE MANAGEMENT - EDUCATION - SCREENING SERVICES - COLLABORATION SCRIPPS HEALTH IMPLEMENTATION PLAN SCRIPPS HEALTH HAS A LONG HISTORY (SINCE OCTOBER 1994) OF RESPONDING TO THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE, EXTENDING BEYOND TRADITIONAL HOSPITAL CARE TO PROVIDE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE REGION'S MOST VULNERABLE POPULATIONS. WITH THE CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED, SCRIPPS HEALTH DEVELOPED A SYSTEM-WIDE CORRESPONDING IMPLEMENTATION PLAN. THE IMPLEMENTATION PLAN TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE STRATEGIES AND OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES. SCRIPPS HEALTH CONVENED AN INTERNAL WORKGROUP COMPRISED OF SCRIPPS EXECUTIVES, COMMUNITY BENEFIT REPRESENTATIVES AND CLINICAL CARE LINE LEADERS TO LEAD THE DEVELOPMENT OF THE SCRIPPS HEALTH IMPLEMENTATION PLAN. WHILE SCRIPPS HEALTH CANNOT REALISTICALLY ADDRESS EVERY ISSUE, SCRIPPS HEALTH WILL ENDEAVOR TO RESOLVE THOSE THAT MOST HEAVILY AFFECT OUR PATIENT POPULATIONS, SERVICE AREA AND ARE CONSISTENT WITH OUR STRATEGY AND RESOURCE AVAILABILITY. IN ADDITION TO THE CHNA AND IMPLEMENTATION PLAN, SCRIPPS HEALTH WILL CONTINUE TO MEET COMMUNITY NEEDS BY PROVIDING CHARITY CARE AND UNCOMPENSATED CARE, PROFESSIONAL EDUCATION AND COMMUNITY BENEFIT PROGRAMS. SCRIPPS OFFERS COMMUNITY BENEFIT SERVICES THROUGH OUR FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH SERVICES, WELLNESS CENTERS AND CLINICS. IN SUPPORT OF THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ONGOING COMMUNITY BENEFIT INITIATIVES, A DETAILED DESCRIPTION OF SCRIPPS STRATEGIES AND CORRESPONDING MEASURES/METRICS FOR THE FOUR HEALTH ISSUES CAN BE FOUND AT SCRIPPS.ORG/COMMUNITYBENEFIT. LISTED BELOW ARE THE PROGRAMS SCRIPPS HEALTH IS ADDRESSING FOR THE HEALTH PRIORITY AREAS IDENTIFIED IN THE CHNA: CARDIOVASCULAR DISEASE THE GOAL OF THE ERIC PAREDES SAVE A LIFE FOUNDATION (SCREENINGS) ARE TO PREVENT SUDDEN CARDIAC ARREST AND DEATH IN MIDDLE HIGH SCHOOL AGED CHILDREN, INCLUDING UNDERSERVED AREAS IN SAN DIEGO COUNTY, THROUGH AWARENESS, EDUCATION AND ACTION. EACH YEAR 7,000 TEENS LOSE THEIR LIVES DUE TO SUDDEN CARDIAC ARREST (SCA). SCA IS NOT A HEART ATTACK - IT IS CAUSED BY AN ABNORMALITY IN THE HEART'S ELECTRICAL SYSTEM THAT CAN BE EASILY DETECTED WITH A SIMPLE EKG. UNFORTUNATELY, HEART SCREENINGS ARE NOT PART OF A REGULAR, WELL-CHILD EXAM OR PRE-PARTICIPATION SPORTS PHYSICAL. THE FIRST SYMPTOM OF SCA COULD BE DEATH. SAN DIEGO ALONE ANNUALLY LOSES THREE TO FIVE TEENS FROM SCA. THE SCREENINGS ARE NON-INVASIVE AND INCLUDE A HEALTH HISTORY, EKG AND IF INDICATED TO CHECK FOR AN ABNORMAL HEARTBEAT THAT COULD SIGNAL AN UNDERLYING HEART CONDITION - AN ECHOCARDIOGRAM. PARENTS ARE NOTIFIED TO THE RESULTS FOR FOLLOW UP WITH THEIR FAMILY PHYSICIANS. FOR FY14, SCRIPPS SCREENED 4,188 TEENS COUNTYWIDE, TRACKED 85 TEENS WITH HEART ABNORMALITIES, 38 TEENS WERE FOUND AT RISK AND 65 WERE UNINSURED. THIRTY- SIX PERCENT OF THE SCHOOLS REPRESENTED ARE TITLE I SCHOOLS, IN WHICH THE MAJORITY OF THE STUDENTS AT THE SCHOOLS MEET POVERTY GUIDELINES. THE SCHOOLS QUALIFY FOR GOVERNMENT FUNDING LIKE FREE OR REDUCED LUNCH PROGRAMS. DIABETES THE DIABETES COMMUNITY HEALTH EDUCATION AND OUTREACH PROGRAM IMPLEMENTS OUTREACH & EDUCATIONAL PROGRAMS THAT INCREASE KNOWLEDGE ABOUT DIABETES AND PROVIDE ACCESS FOR THE COMMUNITY AND UNDERSERVED POPULATIONS. IN FY14, SCRIPPS HEALTH FACILITATED 15 COUNTY WIDE COMMUNITY AWARENESS FAIRS AND SERVED 858 PEOPLE. 125 INDIVIDUALS AT THE HEALTH FAIRS WERE SCREENED FOR DIABETES MANAGEMENT AND THERE WERE 47 (38%) POSITIVE SCREENINGS. SCRIPPS FACILITATED 151 PEER LED HEALTH EDUCATION CLASSES AND 1,111 PEOPLE WERE TAUGHT DIABETES MANAGEMENT. RETINAL SCREENINGS ARE IMPORTANT FOR THE PREVENTION AND EARLY TREATMENT OF DIABETIC RETINOPATHY. RETINAL PHOTOGRAPHS OF PATIENTS ARE TAKEN ABOARD THE SCRIPPS MOBILE MEDICAL UNIT AND THEN THE SCREENINGS ARE INTERPRETED AND FOLLOW-UP CARE IS GIVEN IF WARRANTED. MORE THAN 100 PATIENTS, MANY SUFFERING FROM VISION COMPLICATIONS AS A RESULT OF THEIR DIABETES, RECEIVE RETINAL SCREENINGS EACH MONTH. IN FY14, SCRIPPS HEALTH FACILITATED 11 RETINAL SCREENINGS AND SERVED 282 PATIENTS. 36% (103) SCREENED POSITIVE AND 98% (276) INDIVIDUALS WERE REFERRED TO PRIMARY CARE PHYSICIANS. 12% (35) INDIVIDUALS WERE REFERRED TO A RETINAL SPECIALIST. THE PROJECT DULCE PROGRAM HAS BEEN FIGHTING THE DIABETES EPIDEMIC FOR MORE THAN 17 YEARS BY PROVIDING DIABETES CARE, SELF-MANAGEMENT EDUCATION AND CONTINUOUS SUPPORT TO LOW-INCOME AND UNINSURED POPULATIONS THROUGHOUT SAN DIEGO COUNTY. RECOGNIZED FOR ITS IMPACT, THE COMPREHENSIVE PROGRAM SERVES AS AN INTERNATIONAL MODEL OF PATIENT CARE AND ADVOCACY, HELPING INDIVIDUALS WITH THE DISEASE LEARN TO IMPROVE THEIR HEALTH. ONE OF THE PRIMARY COMPONENTS OF THE PROGRAM IS RECRUITING PEER EDUCATORS FROM THE COMMUNITY TO WORK DIRECTLY WITH PATIENTS. THESE EDUCATORS REFLECT THE DIVERSE POPULATION AFFECTED BY DIABETES AND HELP TEACH OTHERS ABOUT CHANGING EATING HABITS, ADOPTING EXERCISE ROUTINES AND OTHER WAYS TO HELP MANAGE THIS CHRONIC DISEASE. IN FY14, OFFERED A COMPREHENSIVE CULTURALLY SENSITIVE DIABETES SELF-MANAGEMENT PROGRAM FOR UNDERSERVED AND UNINSURED POPULATIONS AT VARIOUS COMMUNITY CLINICS AND SERVED 5,990 INDIVIDUALS COUNTYWIDE. MENTAL AND BEHAVIORAL HEALTH SCRIPPS PARTICIPATED IN THE NATIONAL DEPRESSION SCREENING DAY, AN ANNUAL EVENT AIMED AT HELPING PEOPLE IDENTIFY THE SIGNS OF DEPRESSION AND PROVIDING RESOURCES TO ASSIST THOSE AT RISK. SCRIPPS HAS EXPANDED THE AVAILABILITY OF FREE DEPRESSION SCREENINGS BY MAKING THEM AVAILABLE AT ALL FIVE OF OUR HOSPITAL CAMPUSES. THE SCREENINGS ARE OPEN TO ADULTS OF ALL AGES ON A WALK-IN BASIS, AND INCLUDES REFERRALS TO MENTAL HEALTH PROFESSIONALS IF SCREENING SCORES ARE HIGH, AS WELL AS LITERATURE THAT BE SHARED WITH FRIENDS AND FAMILY MEMBERS. THE SCREENINGS ARE INFORMATIONAL, NOT DIAGNOSTIC AND THE SCREENING SCORES INDICATE WHETHER RESPONSES ON THE QUESTIONNAIRE ARE CONSISTENT WITH SYMPTOMS OF DEPRESSION. IN FY14, SCRIPPS TRACKED 134 INDIVIDUALS AND 25 WERE SCREENED. CHALLENGES: THE TRACKING LOG ONLY COLLECTED METRICS THAT WERE HISTORICALLY SENT TO THE SAN DIEGO COUNTY. SINCE THEN, WE HAVE MODIFIED THE TRACKING LOG IN ORDER TO CAPTURE MORE INFORMATION ABOUT THE UNINSURED POPULATION. INFORMATION WILL BE GIVEN TO STAFF TO MAKE SURE TO DIFFERENTIATE BETWEEN THE NUMBERS OF SCREENINGS COMPLETED VS. HOW MANY INDIVIDUALS WERE TRACKED (PERSON STOPPED BY THE BOOTH AND ASKED QUESTION OR PICKED UP LITERATURE ONLY). THE LOCATION OF THE SCREENINGS TOOK PLACE AT HOSPITAL LOBBIES AND THIS IS NOT AN IDEAL LOCATION DUE TO TRAFFIC AND PRIVACY ISSUES. FOR FUTURE SCREENINGS, SCRIPPS WILL LOOK INTO PARTNERING WITH COMMUNITY CLINICS AND HOLDING THE SCREENINGS IN THOSE NEIGHBORHOODS.
FORM 990, PART III, LINE 4A (CONTINUED) OBESITY DULCE MOTHERS BEGAN AS A PILOT PROGRAM WITH THE GOAL OF DECREASING THE INCIDENCE OF TYPE 2 DIABETES BY MANAGING A MAJOR RISK FACTOR - OBESITY - IN UNDERSERVED, ETHNICALLY DIVERSE POPULATIONS BY TESTING THE EFFECTIVENESS OF A WEIGHT MANAGEMENT CURRICULUM DESIGNED FOR LATINO WOMEN WITH GESTATIONAL DIABETES (GDM). WOMEN WITH A HISTORY OF GDM AND WHO MEET THE CRITERIA FOR BEING OVERWEIGHT (BMI ABOVE 25) ARE REFERRED TO SCRIPPS DULCE MOTHERS. CHALLENGES: THERE WAS NO DATA CAPTURED IN FY14, AS DULCE MOTHERS HAD SOME CHALLENGES IN GETTING THE PILOT PROGRAM STARTED. THERE WERE PROBLEMS WITH SECURING COMMUNITY CLINIC PARTNERSHIPS THAT WOULD PROVIDE THE PARTICIPANTS FOR THE PROGRAM. THE CONTRACTS WITH THESE PARTNERSHIPS WERE NOT ABLE TO BE NEGOTIATED UNTIL LATE IN THE FISCAL YEAR AND ONCE THEY WERE SECURED, THE PARTNERS WERE UNABLE TO MEET THE REQUIREMENTS TO GENERATE THE NUMBER OF PEOPLE NEEDED TO HOLD THESE GROUPS. AS A RESULT, DULCE MOTHERS ADDED A SECOND ARM OF THE STUDY-PROGRAM NUESTRA VIDA, GEARED TOWARD MIDDLE AGED WOMEN WHO ARE AT HIGH-RISK FOR CARDIO METABOLIC CONDITIONS THAT ARE BEING ADMINISTERED IN CHULA VISTA AND THE DULCE MOTHER'S COMPONENT WILL BE ADMINISTERED IN NORTH COUNTY. IN ADDITION TO THE CHNA AND IMPLEMENTATION PLAN, SCRIPPS HEALTH WILL CONTINUE TO MEET COMMUNITY NEEDS BY PROVIDING CHARITY CARE AND UNCOMPENSATED CARE, PROFESSIONAL EDUCATION AND COMMUNITY BENEFIT PROGRAMS. SCRIPPS OFFERS COMMUNITY BENEFIT SERVICES THROUGH OUR FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH SERVICES, WELLNESS CENTERS AND CLINICS. SCRIPPS SERVES A QUARTER OF THE TOTAL COUNTY POPULATION, CONCENTRATING SERVICES IN THE NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTH REGIONS OF SAN DIEGO COUNTY WHERE SCRIPPS FACILITIES ARE LOCATED. UNCOMPENSATED HEALTH CARE SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES TO PROVIDE LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. DURING FISCAL YEAR 2014, SCRIPPS CONTRIBUTED $103,556,915 IN UNCOMPENSATED HEALTH CARE, INCLUDING $47,964,142 IN CHARITY CARE, $45,683,738 IN MEDI-CAL AND $9,909,035 IN COST FOR OTHER MEANS-TESTED GOVERNMENT PROGRAMS. SCRIPPS PROVIDES HOSPITAL SERVICES FOR ONE-QUARTER OF THE COUNTY'S UNINSURED PATIENTS. SCRIPPS MERCY HOSPITAL, SAN DIEGO AND SCRIPPS MERCY HOSPITAL, CHULA VISTA PROVIDE 68 PERCENT OF SCRIPPS' CHARITY CARE. THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO CARE FOR UNINSURED AND MEDICALLY UNDERSERVED COMMUNITIES. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE SAFETY NET IS A CRITICAL POLICY CHALLENGE. WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ABSORB THE COST OF CARING FOR UNINSURED PATIENTS IN THEIR OPERATING BUDGETS. THIS PLACES A SIGNIFICANT FINANCIAL BURDEN ON HOSPITALS AND PHYSICIANS. CALIFORNIA'S UNINSURED CALIFORNIA HAD THE GREATEST NUMBER OF UNINSURED RESIDENTS OF ANY STATE, SEVEN MILLION, AND THE SEVENTH LARGEST PERCENTAGE OF UNINSURED UNDER 65 IN THE COUNTRY. MANY OF THE STATE'S UNINSURED ARE EMPLOYED, HOWEVER THE PERCENTAGE OF RESIDENTS WHO RECEIVE COVERAGE THROUGH THEIR JOBS HAS DECLINED DRAMATICALLY, DROPPING FROM 63% IN 1988 TO 54% IN 2012. WHILE PUBLIC INSURANCE HAS MOSTLY OFFSET THIS GAP, 20% OF CALIFORNIANS REMAINS UNINSURED. WITH THE IMPLEMENTATION OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 (ACA), THE NUMBERS OF UNINSURED RESIDENTS IN CALIFORNIA WILL BE REDUCED, ALTHOUGH A SIGNIFICANT NUMBER WILL BE LEFT BEHIND. THE PERCENTAGE OF CALIFORNIANS WITH EMPLOYER-BASED COVERAGE CONTINUED TO FALL, DROPPING FROM 63 PERCENT IN 1988 TO 53.5 PERCENT IN 2012. WHILE PUBLIC INSURANCE HAS PARTIALLY FILLED THIS GAP, ALMOST 22 PERCENT OF CALIFORNIANS REMAIN UNINSURED. THIS STATISTIC SHOULD CHANGE DRAMATICALLY IN THE COMING YEARS AS THE PATIENT PROTECTION AND AFFORDABLE CARE ACT IS IMPLEMENTED. CALIFORNIANS WITH ANNUAL FAMILY INCOMES BELOW $25,000 ARE MOST LIKELY TO BE UNINSURED. THE LIKELIHOOD OF BEING UNINSURED IS GREATER IN CALIFORNIA THAN THE UNITED STATES AS A WHOLE FOR ALL INCOME LEVELS. FINANCIAL ASSISTANCE ASSISTING LOW-INCOME, UNINSURED PATIENTS ASSISTING LOW-INCOME, UNINSURED PATIENTS THE SCRIPPS FINANCIAL ASSISTANCE POLICY IS CONSISTENT WITH THE LANGUAGE OF BOTH STATE (AB774) CALIFORNIA HOSPITAL FAIR PRICING POLICY LEGISLATION AND THE INTERNAL REVENUE CODE (IRC) 501(R) REGULATIONS. THESE PRACTICES REFLECT OUR COMMITMENT TO ASSISTING LOW-INCOME AND UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE AND FLEXIBLE BILLING AND DEBT COLLECTION PRACTICES. THESE PROGRAMS ARE AVAILABLE TO EVERYONE IN NEED, REGARDLESS OF THEIR RACE, ETHNICITY, GENDER, RELIGION OR NATIONAL ORIGIN. SCRIPPS MAKES EVERY EFFORT TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON FAMILY INCOME AND EXPENSES. FOR LOW-INCOME, UNINSURED PATIENTS WHO EARN LESS THAN TWICE THE FEDERAL POVERTY LEVEL (FPL), SCRIPPS FORGIVES THE ENTIRE BILL. FOR THOSE PATIENTS WHO EARN BETWEEN TWO AND FOUR TIMES THE FPL, A PORTION OF THE BILL IS FORGIVEN. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT CHARGED MORE THAN SCRIPPS' DISCOUNTED FINANCIAL ASSISTANCE AMOUNT. FOR 2015, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES DEFINED A FAMILY OF FOUR'S 200 PERCENT FEDERAL POVERTY LEVEL AS $48,500. COMMUNITY HEALTH SERVICES COMMUNITY HEALTH SERVICES INCLUDE PREVENTION AND WELLNESS PROGRAMS SUCH AS SCREENINGS, HEALTH EDUCATION, SUPPORT GROUPS AND HEALTH FAIRS, WHICH ARE SUPPORTED BY OPERATIONAL FUNDS, GRANTS, IN-KIND DONATIONS, AND PHILANTHROPY. THESE PROGRAMS ARE DESIGNED TO RAISE PUBLIC AWARENESS, UNDERSTANDING OF AND ACCESS TO IDENTIFIED COMMUNITY HEALTH NEEDS. SCRIPPS CATEGORIZES COMMUNITY HEALTH SERVICES ACCORDING TO THE SCHEDULE H 990 CATEGORIES MANDATED BY THE IRS. IT IS CATEGORIZED INTO FIVE MAIN AREAS: - COMMUNITY HEALTH IMPROVEMENT SERVICES - COMMUNITY BENEFIT OPERATIONS - CASH AND IN-KIND CONTRIBUTIONS - SUBSIDIZED HEALTH SERVICES - COMMUNITY BUILDING ACTIVITIES DURING THIS FISCAL YEAR, SCRIPPS INVESTED $5,951,449 IN COMMUNITY HEALTH SERVICES (INCLUDES SUBSIDIZED HEALTH). THIS FIGURE REFLECTS THE COST ASSOCIATED WITH PROVIDING SUCH ACTIVITIES, INCLUDING SALARIES, MATERIALS AND SUPPLIES, MINUS REVENUE. FOLLOWING ARE HIGHLIGHTS OF JUST SOME OF THE ACTIVITIES CONDUCTED BY SCRIPPS DURING THIS FISCAL YEAR. ACCESS TO CARE TWO PRIMARY BARRIERS TO OBTAINING HEALTH CARE, ON BOTH THE LOCAL AND NATIONAL LEVEL, ARE LACK OF HEALTH INSURANCE AND ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS. REDUCED ACCESS TO BASIC HEALTH CARE SERVICES INCREASES ILLNESS, INJURY AND MORTALITY AND IS A MAJOR BURDEN ON HOSPITALS AND HEALTH PROVIDERS, WHO MUST PROVIDE UNCOMPENSATED CARE FOR THE UNINSURED. MORE PEOPLE WITHOUT INSURANCE TRANSLATES INTO HIGHER USE OF EMERGENCY DEPARTMENTS, WHICH BY LAW MUST PROVIDE STABILIZING CARE TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN AN EFFORT TO PROVIDE FOR PEOPLE IN NEED, SCRIPPS SPONSORED A NUMBER OF PROGRAMS IN FISCAL YEAR 2014. MERCY OUTREACH SURGICAL TEAM WORKING IN MEXICO, THE MERCY OUTREACH SURGICAL TEAM (MOST) PROVIDES RECONSTRUCTIVE SURGERIES FOR CHILDREN AT NO COST. MOST VOLUNTEERS PERFORMED RECONSTRUCTIVE SURGERIES ON CHILDREN SUFFERING FROM BIRTH DEFECTS OR ACCIDENTS. IN SPECIAL CIRCUMSTANCES, SURGERIES ARE ALSO PROVIDED FOR ADULTS. DURING FISCAL YEAR 2014, THE MOST TEAM PROVIDED RECONSTRUCTIVE SURGERIES FOR MORE THAN 400 CHILDREN. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO AND AFFILIATED PHYSICIANS.)
FORM 990, PART III, LINE 4A (CONTINUED) SCRIPPS RECUPERATIVE CARE PROGRAM (RCU) THE SCRIPPS RESCUE MISSION PROJECT PROVIDES A SAFE DISCHARGE FOR CHRONICALLY HOMELESS PATIENTS WITH ONGOING MEDICAL NEEDS. ALL THESE PATIENTS ARE UNFUNDED AND MANY HAVE SUBSTANCE ABUSE AND/OR MENTAL HEALTH ISSUES - ADDITIONAL PROBLEMS THAT MAKE THESE PATIENTS DIFFICULT TO PLACE POST-ACUTE. RN CASE MANAGEMENT OVERSIGHT IS PROVIDED BY SCRIPPS HEALTH WITH PHYSICIAN BACKUP TO ENSURE COMPLETION OF THEIR MEDICAL RECOVERY GOALS. THE RESCUE MISSION PROVIDES A SAFE, SECURE ENVIRONMENT WITH 24HR SUPERVISION, MEDICATION OVERSIGHT, MEALS, CLOTHING, COUNSELING, ASSISTANCE WITH MEDI-CAL AND DISABILITY APPLICATION, PLUS HELP FINDING HOUSING. SCRIPPS HEALTH PAYS A DAILY FEE TO THE RCU TO SUPPORT THE PATIENT'S COST IN THE PROGRAM. FOR FY14, TOTAL COST SAVINGS FOR SCRIPPS HAS BEEN OVER $1.7 MILLION. 100% OF PATIENTS WERE CONNECTED TO A PRIMARY CARE PROVIDER AT ONE OF THE COMMUNITY CLINICS. 74% OF THE RCU DISCHARGED PATIENTS DID NOT RETURN TO THE STREETS. THEY EITHER WENT TO A RECOVERY PROGRAM (15%), PERMANENT HOUSING (9%), HEALTHCARE, HOSPICE OR A LOWER LEVEL OF CARE (9%), FAMILY (6%), FRIEND (21%) OR TRANSITIONAL HOUSING IN THE COMMUNITY (15%). GRADUATE MEDICAL EDUCATION STAFF SUPPORT ST. VINCENT DE PAUL VILLAGE MEDICAL CENTER AND ST. LEO'S CLINIC WEEKLY COMMUNITY CLINICS WERE HELD AT THE ST. VINCENT DE PAUL AND ST. LEO'S CLINICS. STAFFED BY SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC INTERNAL MEDICINE RESIDENTS, THESE CLINICS CARED FOR APPROXIMATELY 800 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS DURING FISCAL YEAR 2014. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL). FIJI ALLIANCE PROJECT IN PARTNERSHIP WITH THE INTERNATIONAL RELIEF TEAMS OF SAN DIEGO AND THE LOLOMA FOUNDATION, SCRIPPS EMPLOYEES, SCRIPPS CLINIC PHYSICIANS AND OTHER SCRIPPS-AFFILIATED PHYSICIANS PROVIDED MEDICAL AND SURGICAL SERVICES IN FIJI. AS ONE OF THEIR ROTATIONS, RESIDENTS FROM SCRIPPS CLINIC AND SCRIPPS GREEN HOSPITAL HAVE THE OPPORTUNITY TO PARTICIPATE IN THESE MEDICAL MISSIONS. THE TEAM PERFORMS PROCEDURES TO REMEDY CLEFT LIPS AND PALATES, EYELID, FACE AND FEET DEFORMITIES, BURN SCARS, BREAST MASSES AND HERNIAS, AS WELL AS PROVIDING DIABETES MANAGEMENT. ALL SURGICAL SUPPLIES WERE DONATED BY PROFESSIONAL HOSPITAL SUPPLY CORPORATION (PHS), THE SUPPLIER FOR SCRIPPS HEALTH. THE SUPPLIES INCLUDED SURGICAL GOWNS, GLOVES, DRAPES, DRESSINGS, BANDAGES, SUTURES, ETC. CARDINAL HEALTH SYSTEMS, WHICH PROVIDES PHARMACEUTICALS AND OTHER SUPPLIES FOR SCRIPPS HEALTH, DONATED ALL MEDICATIONS. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND IN 2014, SCRIPPS AWARDED $215,000 IN COMMUNITY GRANTS TO PROGRAMS IN SAN DIEGO (SIX GRANTS RANGING FROM $10,000 TO $120,000). THE FUNDED PROJECTS ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH-PRIORITY HEALTH NEEDS, SEEKING TO IMPROVE ACCESS TO VITAL HEALTH CARE SERVICES FOR AT-RISK POPULATIONS, INCLUDING THE HOMELESS, ECONOMICALLY DISADVANTAGED, MENTALLY ILL AND OTHERS. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $2.49 MILLION. PROGRAMS FUNDED DURING FISCAL YEAR 2014 INCLUDE: CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA) FUNDING PROVIDES LOW-INCOME, UNINSURED MERCY CLINIC AND BEHAVIORAL HEALTH PATIENTS HELP OBTAINING HEALTH CARE BENEFITS, SSI AND RELATED SERVICES, WHILE REDUCING UNCOMPENSATED CARE EXPENSES AT MERCY. THE PROJECT PROVIDES ADVOCACY SERVICES FOR TIME-INTENSIVE GOVERNMENT BENEFIT CASES. (SPONSORED BY SCRIPPS MERCY HOSPITAL ADMINISTRATION) CATHOLIC CHARITIES FUNDING PROVIDES SHORT-TERM EMERGENCY SHELTER FOR MEDICALLY FRAGILE HOMELESS PATIENTS BEING DISCHARGED FROM SCRIPPS MERCY HOSPITAL, SAN DIEGO. THE PROGRAM IS BEING EXPANDED TO SCRIPPS MERCY HOSPITAL, CHULA VISTA. CASE MANAGEMENT AND SHELTER ARE PROVIDED FOR HOMELESS PATIENTS DISCHARGED FROM SCRIPPS MERCY HOSPITAL. WHILE THESE PATIENTS NO LONGER REQUIRE HOSPITAL CARE, THEY DO NEED A SHORT-TERM RECUPERATIVE ENVIRONMENT. PATIENTS WHO DEMONSTRATE A WILLINGNESS TO CHANGE RECEIVE ONE WEEK IN A HOTEL, ALONG WITH FOOD AND BUS FARE TO PURSUE A CASE PLAN. THE FOCUS OF THE CASE MANAGEMENT IS TO STABILIZE THE CLIENT BY HELPING THEM CONNECT TO MORE PERMANENT SOURCES OF INCOME, HOUSING AND OTHER SELF-RELIANCE MEASURES. THE PARTNERSHIP SEEKS TO REDUCE EMERGENCY ROOM RECIDIVISM IN THIS POPULATION AND IMPROVE THEIR QUALITY OF LIFE. 2-1-1 HEALTH CARE NAVIGATION PROGRAM LOCALLY, 2-1-1 SAN DIEGO WAS LAUNCHED IN JUNE 2005 AS A MULTILINGUAL AND CONFIDENTIAL SERVICE COMMITTED TO PROVIDING ACCESS 24/7. THERE IS AN OVERWHELMING NEED FOR A DEPENDABLE SERVICE TO HELP PEOPLE NAVIGATE TODAY'S COMPLEX HEALTH CARE SYSTEM. SINCE THE INCEPTION OF THE HEALTH CARE NAVIGATION PROGRAM, 2-1-1 HAS RESPONDED TO MORE THAN 6,000 CALLS FROM CLIENTS SEEKING HEALTH-RELATED RESOURCES. IN SEPTEMBER 2014, 2-1-1 SAN DIEGO RESPONDED TO 2,392 CALLS FROM CLIENTS SPECIALLY SEEKING HEALTH-RELATED RESOURCES. IN ADDITION, 3,483 CLIENTS HAVE BEEN SCREENED FOR BREAST HEALTH NEEDS AND 37 WERE ASSISTED BY BREAST HEALTH SPECIALISTS. 2-1-1 CLIENT SERVICE REPRESENTATIVES AND PHONE SYSTEM OUTREACHED TO 11,023 CLIENTS AND EDUCATED 575 ON COVERED CALIFORNIA. AMERICAN HEART ASSOCIATION SCRIPPS PROVIDED FUNDING FOR THE 2014 HEART WALK CORPORATE SPONSORSHIP. HEART DISEASE AND STROKE ARE THE NUMBER ONE AND THREE CAUSES OF DEATH IN THE NATION. HEART DISEASE CLAIMS MORE THAN 950,000 AMERICANS EACH YEAR. SCRIPPS PARTNERS WITH THE AMERICAN HEART ASSOCIATION ON ITS ANNUAL HEART WALK TO RAISE FUNDS FOR RESEARCH, PROFESSIONAL AND PUBLIC EDUCATION AND ADVOCACY. BACK PAIN MOST PEOPLE IN THE UNITED STATES WILL EXPERIENCE LOWER BACK PAIN AT LEAST ONCE DURING THEIR LIVES. BACK PAIN IS ONE OF THE MOST COMMON REASONS PEOPLE GO TO THE DOCTOR OR MISS WORK. SOME CAUSES OF BACK PAIN INCLUDE MUSCLE OR LIGAMENT STRAIN, BULGING OR RUPTURED DISKS, ARTHRITIS, SKELETAL IRREGULARITIES AND OSTEOPOROSIS. RISK FACTORS FOR BACK PAIN INCLUDE: - EXCESS WEIGHT OR OBESITY - LACK OF EXERCISE - IMPROPER LIFTING - THOSE WITH PSYCHOLOGICAL ISSUES, SUCH AS DEPRESSION AND ANXIETY (REASONS UNKNOWN) DISPARITIES IN THE UNITED STATES (NHIS, 2010): - ADULTS WITHOUT A HIGH SCHOOL DIPLOMA WERE MORE LIKELY TO HAVE LOWER BACK PAIN. - ADULTS IN POOR FAMILIES WERE MORE LIKELY TO EXPERIENCE LOWER BACK PAIN. - WOMEN ARE MORE LIKELY THAN MALES TO HAVE EXPERIENCED PAIN IN THE LOWER BACK (30.0% VERSUS 26.0%). HEALTHY PEOPLE 2020: - GOAL: REDUCED ACTIVITY LIMITATION DUE TO CHRONIC BACK CONDITIONS. - TARGET: 27.6 PER 1,000. - BASELINE: 30.7 IN 2008 DATA SOURCE: NATIONAL HEALTH INTERVIEW SURVEY, CDC, NCHS BURDEN: - LOWER BACK PAIN HAS BEEN REPORTED AS THE 6TH MOST COSTLY CONDITION IN THE UNITED STATES. - 29% OF ADULTS OVER THE AGE OF 18 HAVE PAIN IN THE LOWER BACK. - BACK PAIN AFFECTS 60% TO 80% OF PEOPLE IN THEIR LIFETIME. DURING FISCAL YEAR 2014, SCRIPPS ENGAGED IN THE FOLLOWING HEALTHY BACK PAIN PREVENTION AND TREATMENT ACTIVITIES. SCRIPPS MENDE WELL BEING CENTER THE SCRIPPS MENDE WELL BEING OFFERED VARIOUS LECTURES ON CHRONIC PAIN MANAGEMENT AND NEW ALTERNATIVES TO HEALING. THESE LECTURES FOCUSED ON ADVANCED PROGRAMS, TREATMENTS AND RELIEF FROM PAIN AND SUFFERING. THIS ORIENTATION INCLUDED RELATED IRRITABLE BOWEL, INSOMNIA, STRESS, BACK PAIN, DEPRESSION AND CHRONIC FATIGUE INFORMATION. THESE LECTURES WERE FREE AND OPEN TO THE COMMUNITY. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFITS). CANCER/ONCOLOGY CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE U.S., EXCEEDED ONLY BY HEART DISEASE, AND ACCOUNTS FOR ALMOST ONE-QUARTER OF ALL DEATHS IN SAN DIEGO COUNTY. ACCORDING TO NATIONAL CANCER INSTITUTE (NCI) ESTIMATES, IN 2009 THERE WERE 1,479,350 NEW CANCER CASES AND AN ESTIMATED 562,540 CANCER DEATHS. CURRENTLY, LUNG, BREAST, COLORECTAL AND PROSTATE CANCERS ACCOUNT FOR 53 PERCENT OF ALL NEW CANCER CASES AND 50 PERCENT OF ALL CANCER DEATHS. BREAST CANCER BREAST CANCER IS DEFINED AS ANY CANCEROUS GROWTH THAT INHABITS THE TISSUES IN THE BREAST. IN THIS TYPE OF CANCER, THE CELLS IN THE BREAST REGION GROW ABNORMALLY AND IN AN UNCONTROLLED WAY. THOUGH BREAST CANCER IS MOSTLY FOUND IN WOMEN, IN RARE CASES IT IS ALSO FOUND IN MEN. IN THE U.S. ALONE, ONE OUT OF EVERY EIGHT WOMEN HAS THIS DISEASE. COMMON TYPES INCLUDE: DUCTUAL CARCINOMA BREAST CANCER AND LOBULAR CARCINOMA BREAST CANCER, NAMED FOR THE LOCATION OF THE BREAST IN WHICH THEY BEGAN. NOT COUNTING SOME KINDS OF SKIN CANCER, BREAST CANCER IN THE UNITED STATES IS: - THE MOST COMMON CANCER IN WOMEN, NO MATTER YOUR RACE OR ETHNICITY. - THE MOST COMMON CAUSE OF DEATH FROM CANCER AMONG HISPANIC WOMEN. - THE SECOND MOST COMMON CAUSE OF DEATH FROM CANCER AMONG WHITE, BLACK, ASIAN/PACIFIC - ISLANDER, AND AMERICAN INDIAN/ALASKA NATIVE WOMEN. BREAST CANCER DISPARITIES IN THE UNITED STATES: ALTHOUGH THE INCIDENCE OF BREAST CANCER IN WHITE, NON-HISPANIC FEMALES IS GREATER THAN THAT OF BLACK FEMALES, THE MORTALITY RATES AMONG BLACK FEMALES IS MUCH GREATER THAN THAT OF WHITE, NON-HISPANIC FEMALES.
FORM 990, PART III, LINE 4A (CONTINUED) COLORECTAL CANCER NCI DEFINES COLORECTAL CANCER AS ANY CANCER "THAT FORMS IN THE TISSUES OF THE COLON OR RECTUM." MOST COLON CANCERS ARE ADENOCARCINOMAS (CANCERS THAT BEGIN IN CELLS THAT MAKE AND RELEASE MUCUS AND OTHER FLUIDS). OF CANCERS THAT AFFECT BOTH MEN AND WOMEN, COLORECTAL CANCER IS THE SECOND LEADING CAUSE OF CANCER-RELATED DEATHS IN THE UNITED STATES. COLORECTAL CANCER ALSO IS ONE OF THE MOST COMMONLY DIAGNOSED CANCERS IN THE UNITED STATES; AMONG ALL MEN AND WOMEN IT IS THE THIRD MOST COMMON CANCER IN THE US TODAY. CLINICAL SYMPTOMS INCLUDE BLOOD IN/ON THE STOOL, PERSISTENT CRAMPING, PAINS, AND ACHING IN THE STOMACH, AND UNEXPLAINED WEIGHT-LOSS. RISK FACTORS FOR COLORECTAL CANCER INCLUDE: - AGE: 90% OF ALL CASES DIAGNOSED ARE IN PEOPLE ABOVE THE AGE OF 50 YEARS. - INFLAMMATORY BOWEL DISEASE. - A PERSONAL OR FAMILY HISTORY OF COLORECTAL CANCER OR COLORECTAL POLYPS. - A GENETIC SYNDROME OR HEREDITARY NON-POLYPOSIS COLORECTAL CANCER (LYNCH SYNDROME). - LIFESTYLE FACTORS SUCH AS, LACK OF REGULAR PHYSICAL ACTIVITY, LOW FRUIT AND VEGETABLE INTAKE, LOW-FIBER AND HIGH-FAT DIETS, ALCOHOL CONSUMPTION, TOBACCO USE, AND BEING OVERWEIGHT OR OBESE. COLORECTAL CANCER PREVALENCE IN THE UNITED STATES: SEER ESTIMATES THAT 1,140,161 MEN AND WOMEN CURRENTLY HAVE BEEN DIAGNOSED WITH COLORECTAL CANCERS. LUNG CANCER LUNG CANCER IS THE LEADING CAUSE OF CANCER DEATH AND THE SECOND MOST DIAGNOSED CANCER IN BOTH MEN AND WOMEN IN THE UNITED STATES. IN 2008, 14% OF ALL CANCER DIAGNOSES AND 28% OF ALL CANCER DEATHS WERE DUE TO LUNG CANCER. LUNG CANCERS USUALLY ARE GROUPED INTO TWO MAIN TYPES CALLED SMALL CELL AND NON-SMALL CELL. THESE TYPES OF LUNG CANCER PROGRESS IN DIFFERENT MANNERS, AND THEREFORE REQUIRE DIFFERENT COURSES OF TREATMENT. NON-SMALL CELL LUNG CANCER IS MORE COMMON THAN SMALL CELL LUNG CANCER. CLINICAL SYMPTOMS CAN INCLUDE, CHEST PAIN, SHORTNESS OF BREATH, WHEEZING, COUGHING UP BLOOD, CONSTANT FATIGUE, UNEXPLAINED WEIGHT LOSS, AND COUGHING THAT PROGRESSIVELY WORSENS AND DOES NOT SUBSIDE. SOME FACTS ABOUT LUNG CANCER IN 2008: - 208,493 PEOPLE IN THE UNITED STATES WERE DIAGNOSED WITH LUNG CANCER, INCLUDING 111,886 MEN AND 96,607 WOMEN. - 158,592 PEOPLE IN THE UNITED STATES DIED FROM LUNG CANCER, INCLUDING 88,541 MEN AND 70,051 WOMEN. LUNG CANCER PREVALENCE IN THE UNITED STATES: ON JANUARY 1, 2009, IN THE UNITED STATES, THERE WERE APPROXIMATELY 387,762 MEN AND WOMEN ALIVE WHO HAD A HISTORY OF CANCER OF THE LUNG AND BRONCHUS -- 178,490 MEN AND 209,272 WOMEN. PROSTATE CANCER NCI DEFINES PROSTATE CANCER AS A CANCER THAT FORMS IN TISSUES OF THE PROSTATE, A GLAND IN THE MALE REPRODUCTIVE SYSTEM FOUND BELOW THE BLADDER AND IN FRONT OF THE RECTUM.1 WHILE CANCEROUS CELLS WITHIN THE PROSTATE ITSELF ARE GENERALLY NOT DEADLY ON THEIR OWN, AS A CANCEROUS TUMOR GROWS, SOME OF THE CELLS CAN BREAK OFF AND SPREAD TO OTHER PARTS OF THE BODY THROUGH THE LYMPH OR THE BLOOD, THROUGH THE PROCESS OF METASTASIS. PROSTATE CANCER USUALLY OCCURS IN OLDER MEN. CLINICAL SYMPTOMS INCLUDE: DIFFICULTY STARTING URINATION, WEAK/INTERRUPTED FLOW OF URINE, PAIN/BURNING DURING URINATION, FREQUENT URINATION, BLOOD IN URINE OR SEMEN, AND UNSPECIFIED PAIN IN THE BACK, HIPS OR PELVIS. NOT COUNTING SOME FORMS OF SKIN CANCER, PROSTATE CANCER IN THE UNITED STATES IS: - THE MOST COMMON CANCER IN MEN, NO MATTER YOUR RACE OR ETHNICITY. - THE SECOND MOST COMMON CAUSE OF DEATH FROM CANCER AMONG WHITE, AFRICAN AMERICAN, AMERICAN INDIAN/ALASKA NATIVE, AND HISPANIC MEN. - THE FOURTH MOST COMMON CAUSE OF DEATH FROM CANCER AMONG ASIAN/PACIFIC ISLANDER MEN. RISK FACTORS FOR PROSTATE CANCER INCLUDE: - AGE: THE OLDER A MAN IS, THE GREATER HIS RISK FOR GETTING PROSTATE CANCER. - FAMILY HISTORY: A MAN WITH A FATHER, BROTHER, OR SON WHO HAS HAD PROSTATE CANCER IS TWO TO THREE TIMES MORE LIKELY TO DEVELOP THE DISEASE HIMSELF. - RACE: PROSTATE CANCER IS MORE COMMON IN SOME RACIAL AND ETHNIC GROUPS THAN IN OTHERS. PROSTATE CANCER PREVALENCE IN THE UNITED STATES: SEER ESTIMATES THAT 2,496,784 MALES CURRENTLY HAVE BEEN DIAGNOSED WITH CANCER OF THE PROSTATE. SKIN CANCER SKIN CANCER IS A CANCER THAT FORMS IN THE VARIOUS TISSUES OF THE SKIN, AND IS THE MOST COMMON FORM OF CANCER IN THE UNITED STATES. THE TWO MOST PREVALENT TYPES OF SKIN CANCER-BASAL CELL (FORMS IN THE LOWER PART OF THE EPIDERMIS) AND SQUAMOUS CELL (FORMS IN THE FLAT CELLS THAT FORM THE SURFACE OF THE SKIN) CARCINOMAS-ARE HIGHLY CURABLE. HOWEVER, THE THIRD MOST COMMON SKIN CANCER, MELANOMA, FORMS IN THE CELLS THAT MAKE THE PIGMENT MELANIN AND ARE CONSIDERED MORE DANGEROUS. ABOUT 65%-90% OF MELANOMAS ARE CAUSED BY EXPOSURE TO ULTRAVIOLET (UV) LIGHT. CLINICAL SYMPTOMS INCLUDE MOLES THAT ARE ASYMMETRICAL, HAVE IRREGULAR BORDERS, UNEVEN COLORATION, EXPERIENCE INCREASES IN DIAMETER, OR HAVE EVOLVED OR CHANGED IN RECENT WEEKS OR MONTHS. RISK FACTORS FOR THE THREE MOST COMMON TYPES OF SKIN CANCER: - SUNLIGHT - SEVERE, BLISTERING SUNBURNS - LIFETIME SUN EXPOSURE - TANNING MELANOMA OF THE SKIN PREVALENCE IN THE UNITED STATES: SEER ESTIMATES THAT 876,344 PERSONS CURRENTLY HAVE BEEN DIAGNOSED WITH MELANOMA OF THE SKIN SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS TO EDUCATE PEOPLE ABOUT THE IMPORTANCE OF EARLY DETECTION AND TREATMENT FOR SOME OF THE MOST COMMON FORMS OF CANCER. HERE ARE A FEW EXAMPLES OF SCRIPPS CANCER PROGRAMS DURING FISCAL YEAR 2014. SCRIPPS GREEN HOSPITAL CANCER SUPPORT GROUPS SCRIPPS GREEN SUPPORT GROUPS OFFER CANCER PATIENTS THE OPPORTUNITY TO EXPRESS THE EMOTIONS THAT COME WITH A CANCER DIAGNOSIS AND HELP THEM COPE MORE EFFECTIVELY WITH THEIR TREATMENT REGIMENS BY THE SUPPORT GROUPS NURTURE THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL WELL-BEING. CLASSES AT SCRIPPS GREEN HOSPITAL, SUCH AS THE FREE CANCER WRITING WORKSHOP, WHEN WORDS HEAL, USE EXPRESSIVE WRITING TO HELP PATIENTS NAVIGATE THEIR JOURNEY WITH CANCER. (SPONSORED BY SCRIPPS GREEN HOSPITAL) SCRIPPS MERCY HOSPITAL, CHULA VISTA: HEALTHY WOMEN, HEALTHY LIFESTYLES: SCRIPPS MERCY BREAST HEALTH OUTREACH AND EDUCATIONAL PROGRAM A PROMOTORA-LED HEALTH AND WELLNESS PROGRAM THAT AIMS TO IMPROVE THE LIVES OF WOMEN IN SAN DIEGO'S SOUTH BAY WITH BREAST CANCER EDUCATION, PREVENTION AND TREATMENT SUPPORT. PROMOTORA'S TEACH BREAST HEALTH TO WOMEN WHO HAVE LIMITED OR NO ACCESS TO HEALTH CARE. PROMOTORA'S TEACH WOMEN IN THEIR NATIVE LANGUAGE WITH SENSITIVITY TO A WOMAN'S ETHNIC AND CULTURAL NORMS. THE PROGRAM MODEL INCLUDES A PROMOTORA, CANCER SURVIVOR AND A NURSE NAVIGATOR. THE PROMOTORA HAS KNOWLEDGE OF BREAST CANCER, OFFERS EDUCATION AND EMOTIONAL SUPPORT. SHE ALSO PROVIDES REFERRALS IN A CULTURALLY APPROPRIATE AND LANGUAGE SENSITIVE WAY. A BREAST CANCER SURVIVOR AND VOLUNTEER STRENGTHENS THE BENEFITS OF BREAST CANCER EDUCATION AND PREVENTION BY TALKING TO SOMEONE WHO HAS BEEN THERE AND CAN PROVIDE INSIGHT AND SUGGESTIONS, AND IS LIVING PROOF THAT THE DISEASE IS NOT FATAL. WORKING HAND-IN-HAND, THE PROMOTORA AND VOLUNTEER PRESENT A VERY STRONG FRONT FOR BREAST CANCER AWARENESS AND A FULL SUPPORT SYSTEM FOR THOSE ALREADY DIAGNOSED. MOREOVER, THE FACT THEY ARE BI-LINGUAL LATINAS LENDS AN AIR OF AUTOMATIC TRUST AMONG THE HISPANIC COMMUNITY AS THEY CAN CONNECT WITH THE RESIDENTS ON A CULTURAL LEVEL. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS.) SCRIPPS MERCY HOSPITAL, CHULA VISTA: BREAST HEALTH CLINICAL SERVICES A TOTAL OF 5,355 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES AT COMMUNITY AND SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY SERVICES. A TOTAL OF 2,917 SERVICES WERE PROVIDED, INCLUDING TELEPHONE REMINDERS, OUTREACH AND EDUCATION, CASE MANAGEMENT AND A VARIETY OF PRESENTATIONS. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS.) PATIENT CONTINUITY OF CARE WITH SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY A TOTAL OF 71 SERVICES WAS PROVIDED, INCLUDING ENCOURAGEMENT FOR PATIENTS TO REPEAT EXAMS, ASSISTANCE TO GET PATIENTS HEALTH INSURANCE APPROVAL TO REPEAT EXAMS, SOCIAL/EMOTIONAL SUPPORT AND EDUCATION ABOUT PREVENTING BREAST CANCER. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY, POSITIVE BREAST CANCER PATIENT SUPPORT A TOTAL OF 251 SERVICES WERE PROVIDED INCLUDING PHONE CALLS, HOME VISITS, MAILED EDUCATIONAL MATERIALS AND SUPPLIES (WIGS, BRAS AND PROSTHESIS). A RESOURCE PACKAGES WITH EDUCATIONAL MATERIALS ON NUTRITION, TREATMENT OPTIONS, COMMONLY ASKED QUESTIONS AND LOCAL RESOURCES WAS PROVIDED. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS.)
FORM 990, PART III, LINE 4A (CONTINUED) SCRIPPS POLSTER BREAST CARE CENTER, MUSIC AS MEDICINE PROGRAM PATIENTS AND THEIR SUPPORTERS PARTICIPATE IN THE MUSIC AS MEDICINE THERAPY CLASS. THE MUSIC THERAPIST ASKS QUESTIONS AND TAILORS THE THERAPY TO THE PARTICIPANTS' EMOTIONAL AND PHYSICAL NEEDS. SESSIONS INVOLVE LISTENING TO MUSIC, WRITING SONGS, DISCUSSING WHAT LYRICS MEAN TO THE PARTICIPANTS, USE OF SINGING BOWLS, VOCALIZATION AND DRUMMING. RESEARCH HAS SHOWN THAT MUSIC CAN BOOST IMMUNE FUNCTION, BLOCK INCOMING PAIN STIMULI, LOWER BLOOD PRESSURE AND INFLUENCE EMOTIONAL WELL-BEING.(SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER) SCRIPPS POLSTER BREAST CARE CENTER, SUPPORT GROUPS SCRIPPS POLSTER BREAST CARE CENTER SUPPORT GROUPS PROVIDE A VENUE FOR WOMEN TO COME TOGETHER, DISCUSS ISSUES RELATING TO DIAGNOSES AND RECEIVE SUPPORT.(SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER) CANCER AWARENESS AND EDUCATIONAL EVENTS A SERIES OF EDUCATIONAL EVENTS ARE COORDINATED WITH AMERICAN CANCER SOCIETY AWARENESS MONTHS. THE EVENTS FOCUS ON VARIOUS TYPES OF CANCER, INCLUDING BREAST, LUNG, CERVICAL, COLORECTAL, SKIN, OVARIAN/GYNECOLOGICAL AND PROSTATE. A REGISTERED NURSE CLINICIAN ANSWERS QUESTIONS AND PROVIDES EDUCATIONAL MATERIALS. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA CANCER CENTER) HEALTH EDUCATION AND SUPPORT GROUPS EDUCATION AND SUPPORT GROUPS ARE PROVIDED TO SAN DIEGO COUNTY RESIDENTS FOR A WIDE VARIETY OF HEALTH CONCERNS. TOPICS INCLUDE FAMILIES WHO HAVE EXPERIENCED THE LOSS OF A CHILD, CHILDREN WHO HAVE LOST A PARENT TO CANCER, INFERTILITY, PARENTING TWINS, IMPROVING CHILDREN'S READING ABILITIES, HUNTINGTON'S DISEASE, PARKINSON'S DISEASE, MENTAL ILLNESS, OSTOMY, POSTPARTUM ISSUES, GYNECOLOGICAL CANCER, CHRONIC PAIN AND MULTIPLE SCLEROSIS. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFITS) CARDIOVASCULAR DISEASE CORONARY HEART DISEASE AND STROKE ARE THE NUMBER ONE AND THREE CAUSES OF DEATH IN THE NATION. HEART DISEASE CLAIMS MORE THAN 950,000 AMERICANS EVERY YEAR. STROKE KILLED 137,119 PEOPLE IN 2006 AND IS A LEADING CAUSE OF SERIOUS, LONG-TERM DISABILITY. THE WORLD HEALTH ORGANIZATION DEFINES CARDIOVASCULAR DISEASE (CVD) AS A GROUP OF DISORDERS OF THE HEART AND BLOOD VESSELS THAT INCLUDE CORONARY HEART DISEASE, CEREBROVASCULAR DISEASE, PERIPHERAL ARTERIAL DISEASE, RHEUMATIC HEART DISEASE, CONGENITAL HEART DISEASE, DEEP VEIN THROMBOSIS AND PULMONARY EMBOLISM. CORONARY HEART DISEASE IS THE MOST COMMON FORM OF HEART DISEASE. HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, AND SMOKING ARE ALL RISK FACTORS THAT COULD LEAD TO CVD AND STROKE. ABOUT HALF OF AMERICANS (49%) HAVE AT LEAST ONE OF THESE THREE RISK FACTORS. HEART DISEASE IS THE LEADING CAUSE OF DEATH IN THE UNITED STATES. - HEART DISEASE IS THE LEADING CAUSE OF DEATH FOR PEOPLE OF MOST RACIAL/ETHNIC GROUPS IN THE UNITED STATES, INCLUDING AFRICAN AMERICANS, HISPANICS AND WHITES. - BETWEEN 70% AND 89% OF SUDDEN CARDIAC EVENTS OCCUR IN MEN. - ABOUT TWO-THIRDS (64%) OF WOMEN WHO DIE SUDDENLY OF CORONARY HEART DISEASE HAVE NO PREVIOUS SYMPTOMS. PREVALENCE DATA: IN 2010, 4.1% OF ADULTS LIVING IN SAN DIEGO HAD EVER HAD CORONARY HEART DISEASE. IN 2010, 3.6% OF ADULTS LIVING IN CALIFORNIA HAD EVER HAD CORONARY HEART DISEASE. DURING FISCAL YEAR 2013, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH, CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. AMERICAN HEART WALK IN ADDITION, SCRIPPS EMPLOYEES VOLUNTEERED THEIR TIME TO COORDINATE WALKER PARTICIPATION AND FUNDRAISING EFFORTS. THE SAN DIEGO HEART WALK RAISED MORE THAN $1.2 MILLION. IN 2014, MORE THAN 1,700 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES, AND FRIENDS - WALKED TO HELP RAISE MORE THAN $125,000. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT AND PROVIDED HEALTH EDUCATION MATERIALS AND GIVEAWAYS.(SPONSORED BY SCRIPPS COMMUNITY BENEFIT SERVICES) COMMUNITY HEALTH EDUCATION PROGRAMS THE COMMUNITY HEALTH EDUCATION PROGRAMS COVER A WIDE VARIETY OF TOPICS ON DISEASE MANAGEMENT, HEALTH CARE UPDATES AND PREVENTION. THE PROGRAMS COVER HYSTERECTOMY, STROKE, STRESS, VARICOSE VEINS, INFERTILITY, CARDIAC, DEPRESSION, MACULAR DEGENERATION, MEMORY, BRAIN, ORTHOPEDIC CARE, ROBOTIC SURGERY, SKIN CARE, BACK CARE, MIGRAINES, KNEE PAIN, PELVIC FLOOR INCONTINENCE, SAFETY AND FALL PREVENTION, BLADDER HEALTH, HEALTHY DINING, EXERCISE, VOICE, FLU PREVENTION, SLEEP DISORDERS, NUTRITION, HYPERTENSION, FOOT CARE, SPINE SURGERY, JOINT REPLACEMENT, BREATHING, PAIN MANAGEMENT AND MEDICATION. (SPONSORED BY SCRIPPS LA JOLLA COMMUNITY BENEFIT SERVICES) CPR CLASSES FOR PATIENTS AND FAMILIES OF THE CARDIAC TREATMENT CENTER CPR CLASSES ARE OFFERED FOUR TIMES A YEAR TO CARDIAC TREATMENT CENTER PATIENTS AND THEIR FAMILIES. THE PROGRAM IMPROVES COMMUNITY HEALTH BY INCREASING KNOWLEDGE OF CARDIOPULMONARY RESUSCITATION PRACTICES. (SPONSORED BY CARDIAC TREATMENT CENTER AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA) CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS INCLUDE TAI CHI, OFFERED TWICE WEEKLY; CLASSES TO DECREASE STRESS AND IMPROVE BALANCE, STRENGTH AND FLEXIBILITY; RESTORATIVE YOGA, OFFERED THREE TIMES A WEEK; FIT BALL, OFFERED TWICE A WEEK; CLASSES TO IMPROVE STRENGTH, POSTURE AND CORE STABILITY; YOGA FOR CANCER RECOVERY, OFFERED WEEKLY; CLASSES TO DECREASE STRESS, IMPROVE CIRCULATORY FLOW, AND EASE TENSION DURING HEALING; CLASSES CENTERING ON BALANCE, OFFERED WEEKLY; CLASSES TO BUILD BALANCE, POSTURE AND COORDINATION; POWER YOGA, OFFERED TWICE WEEKLY; CLASSES TO IMPROVE STRENGTH AND FLEXIBILITY; WEEKLY PILATES CLASSES, YOGA FOR MULTIPLE SCLEROSIS, OFFERED WEEKLY; CLASSES TO PROMOTE HEALING AND IMPROVE STRENGTH AND FLEXIBILITY; AND WEEKLY MEDITATION CLASSES. (SPONSORED BY THE CARDIAC TREATMENT CENTER, SCRIPPS MEMORIAL HOSPITAL LA JOLLA) STROKE CARE PROGRAMS SCRIPPS SPONSORED A WIDE VARIETY OF STROKE-RELATED EDUCATION AND AWARENESS PROGRAMS. (SPONSORED BY SCRIPPS MERCY HOSPITAL STROKE PROGRAM) HEART HEALTH, SCRIPPS HOME HEALTH SERVICES SCRIPPS HOME HEALTH PROVIDED COMMUNITY EDUCATION TO PROMOTE INDEPENDENT CONGESTIVE HEART FAILURE (CHF) MANAGEMENT TO PREVENT EXACERBATIONS AND HOSPITALIZATIONS. PATIENTS RECEIVED INFORMATION ON WHAT CHF IS, MEDICATIONS, DIET, WEIGHT AND EXERCISE. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES.) THE ERIC PAREDES SAVE A LIFE FOUNDATION EACH YEAR, 7,000 TEENS LOSE THEIR LIVES DUE TO SUDDEN CARDIAC ARREST (SCA). SCA IS NOT A HEART ATTACK - IT IS CAUSED BY AN ABNORMALITY IN THE HEART'S ELECTRICAL SYSTEM THAT CAN EASILY BE DETECTED WITH A SIMPLE EKG. UNFORTUNATELY, HEART SCREENINGS ARE NOT PART OF A REGULAR, WELL-CHILD EXAM OR PRE-PARTICIPATION SPORTS PHYSICAL. THE FIRST SYMPTOM OF SCA COULD BE DEATH. SAN DIEGO ALONE LOSES THREE TO FIVE TEENS FROM SCA. AS A SPONSOR FOR THE ERIC PAREDES SAVE A LIFE FOUNDATION , SCRIPPS HAS HELPED MORE THAN 10,000 FREE CARDIAC SCREENINGS TO LOCAL TEENS, INCLUDING THE HOMELESS, UNINSURED AND UNDERINSURED. IN 2014, SCRIPPS MADE A $15,000 DONATION TO HELP PAY FOR THE SCREENINGS. IN 2014, SCRIPPS SUPPORTED SCREENING EVENTS AT AREA HIGH SCHOOLS AND SCREENED 4,188 TEENS, IDENTIFYING 93 WITH ABNORMALITIES AND 30 WHO WERE AT RISK. SU VIDA, SU CORAZON/YOUR HEART, YOUR LIFE, YOUR HEART COMMUNITY INTERVENTION TO IMPROVE EDUCATION AND AWARENESS OF HEART DISEASE HEART DISEASE IS ONE OF THE MOST WIDESPREAD AND COSTLY HEALTH PROBLEMS FACING OUR NATION, EVEN THOUGH IT'S ALSO ONE OF MOST PREVENTABLE. HEART FAILURE AND STROKE ACCOUNT FOR MORE THAN $500 BILLION IN HEALTH CARE COSTS PER YEAR. HEART FAILURE IS A PROGRESSIVE DISEASE, PRIMARILY CAUSED BY HIGH BLOOD PRESSURE, HIGH CHOLESTEROL/LIPIDS AND DAMAGE TO THE HEART MUSCLE FROM CORONARY ARTERY DISEASE. SCRIPPS HEALTH ADDRESSES THIS HEALTH ISSUE THROUGH A 12- WEEK EDUCATIONAL BASED COMMUNITY INTERVENTION PROGRAM TO SUPPORT IMPROVED QUALITY OF LIFE FOR PATIENTS DIAGNOSED WITH HEART DISEASE. PROPER LIFESTYLE CHANGES TAKEN BY THOSE WITH HEART DISEASE CAN GREATLY REDUCE RISK OF FURTHER INTERMEDIATE AND FATAL OUTCOMES. TOBACCO USE, ALCOHOL ABUSE, LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, STRESS AND DEPRESSION ARE SOME OF THE MAJOR CONTRIBUTING FACTORS LEADING TO HEART DISEASE, HEART FAILURE AND READMISSION. RECENT LITERATURE SUGGESTS THAT A LACK OF POST-DISCHARGE SOCIAL SUPPORT AND EDUCATION ARE IMPORTANT TO PREVENT READMISSION. GROUP SESSIONS PROVIDE EDUCATION AND SOCIAL SUPPORT. DISCHARGE PLANNING THAT USES TRANSITIONAL COACHES HAS BEEN PROVEN TO REDUCE READMISSION RATES. THE OVERALL GOAL OF YOUR HEART, YOUR LIFE IS TO DECREASE THE READMISSION RATES FOR HEART FAILURE PATIENTS, WHICH REDUCES MEDICAL COSTS FOR THE PATIENT AND IMPROVES THEIR QUALITY OF LIFE. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS.)
FORM 990, PART III, LINE 4A (CONTINUED) DIABETES THE 2011 NATIONAL DIABETES FACT SHEET (THE MOST RECENT YEAR DATA IS AVAILABLE) ESTIMATES 25.8 MILLION CHILDREN AND ADULTS IN THE U.S., 8.3 PERCENT OF THE POPULATION, HAVE DIABETES. THESE STATISTICS INCLUDE 18.8 MILLION PEOPLE WITH DIAGNOSED DIABETES AND ANOTHER 7.0 MILLION PEOPLE WITH UNDIAGNOSED DIABETES. EACH YEAR 1.9 MILLION NEW CASES OF DIABETES ARE DIAGNOSED IN PEOPLE 20 AND OLDER. MORE THAN 90 MILLION AMERICANS (33 PERCENT) LIVE WITH A CHRONIC DISEASE. WHILE THERE ARE MANY DISABLING CHRONIC DISEASES, DIABETES HAS BEEN IDENTIFIED AS ONE OF THE PRIMARY CHRONIC CONDITIONS IN SAN DIEGO COUNTY. THE DIABETES DEATH RATE WAS 17.4 PER 100,000 IN 2009. THERE ARE THREE MAJOR TYPES OF DIABETES: TYPE 1, TYPE 2 AND GESTATIONAL. ALL THREE TYPES SHARE SIMILAR CHARACTERISTICS - THE BODY LOSES THE ABILITY TO EITHER MAKE OR TO USE INSULIN. WITHOUT ENOUGH INSULIN, GLUCOSE STAYS IN THE BLOOD, CREATING DANGEROUS BLOOD SUGAR LEVELS. OVER TIME, THIS BUILDUP DAMAGES KIDNEYS, HEART, NERVES, EYES AND OTHER ORGANS. TYPE II DIABETES, ONCE KNOWN AS ADULT-ONSET OR NONINSULIN-DEPENDENT DIABETES, IS A CHRONIC CONDITION THAT AFFECTS THE WAY YOUR BODY METABOLIZES SUGAR (GLUCOSE), WHICH IS YOUR BODY'S MAIN SOURCE OF FUEL. WITH TYPE 2 DIABETES, YOUR BODY EITHER RESISTS THE EFFECTS OF INSULIN - A HORMONE THAT REGULATES THE MOVEMENT OF SUGAR INTO YOUR CELLS - OR DOESN'T PRODUCE ENOUGH INSULIN TO MAINTAIN A NORMAL GLUCOSE level. IF LEFT UNTREATED, TYPE 2 DIABETES CAN BE LIFE-THREATENING. CLINICAL SYMPTOMS CAN INCLUDE: FREQUENT URINATION, EXCESSIVE THIRST, EXTREME HUNGER, SUDDEN VISION CHANGES, UNEXPLAINED WEIGHT LOSS, EXTREME FATIGUE, SORES THAT ARE SLOW TO HEAL, AND INCREASED NUMBER OF INFECTIONS. SOME ALARMING FACTS ABOUT TYPE 2 DIABETES: - ABOUT 1.9 MILLION PEOPLE AGED 20 YEARS OR OLDER WERE NEWLY DIAGNOSED WITH DIABETES IN 2010 IN THE U.S. - DIABETES IS THE LEADING CAUSE OF KIDNEY FAILURE, NON-TRAUMATIC LOWER-LIMB AMPUTATIONS, AND NEW CASES OF BLINDNESS AMONG ADULTS IN THE UNITED STATES. - DIABETES IS A MAJOR CAUSE OF HEART DISEASE AND STROKE, AND IS THE 7TH LEADING CAUSE OF DEATH IN THE UNITED STATES. SOME RISK FACTORS FOR DEVELOPING DIABETES INCLUDE: - BEING OVERWEIGHT OR OBESE. - HAVING A PARENT, BROTHER, OR SISTER WITH DIABETES. - HAVING HIGH BLOOD PRESSURE MEASURING 140/90 OR HIGHER. - BEING PHYSICALLY INACTIVE-EXERCISING FEWER THAN THREE TIMES A WEEK. DIABETES PREVALENCE: U.S. AGE-ADJUSTED PREVALENCE RATES FOR ADULT DIAGNOSED DIABETES FOR THE YEAR OF 2010 WERE 8.7%, AS COMPARED TO A RATE OF 3.7% RATE IN 1980. THE STATE OF CALIFORNIA REPORTED A RATE OF 8.9% FOR THE SAME YEAR. MORE THAN SEVEN MILLION AMERICANS ARE UNAWARE THEY HAVE DIABETES. THE COMPLICATIONS RELATED TO DIABETES ARE SERIOUS AND CAN BE REDUCED WITH PREVENTIVE PRACTICES. DIABETES IS A SERIOUS COMMUNITY HEALTH PROBLEM, LEADING TO SCHOOL AND WORK ABSENTEEISM, ELEVATED HOSPITALIZATION RATES, FREQUENT EMERGENCY ROOM VISITS, PERMANENT PHYSICAL DISABILITIES AND SOMETIMES DEATH. DURING FISCAL YEAR 2013, SCRIPPS SPONSORED THE FOLLOWING DIABETES MANAGEMENT INITIATIVES. PROJECT DULCE A COLLABORATION BETWEEN THE WHITTIER DIABETES INSTITUTE, THE COUNCIL OF COMMUNITY CLINICS AND COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), PROJECT DULCE IS A COMPREHENSIVE, CULTURALLY SENSITIVE DIABETES MANAGEMENT PROGRAM FOR UNDERSERVED AND UNINSURED PEOPLE IN SAN DIEGO COUNTY. THE PROGRAM IS TEAM-BASED AND INCORPORATES THE CHRONIC CARE MODEL. PROJECT DULCE HAS BEEN ACTIVE IN COMMUNITIES ACROSS SAN DIEGO FOR THE PAST 10 YEARS, PROVIDING DIABETES CARE AND SELF-MANAGEMENT EDUCATION. NURSE-LED TEAMS STRIVE FOR MEASURABLE IMPROVEMENTS IN THEIR PATIENTS' HEALTH; NURSE EDUCATORS LEAD MULTIDISCIPLINARY TEAMS THAT PROVIDE CLINICAL MANAGEMENT; AND PEER EDUCATORS FROM EACH CULTURAL GROUP, KNOWN AS PROMOTORAS, PROVIDE PUBLIC AND PATIENT EDUCATION FOR THEIR COMMUNITIES. THIS INNOVATIVE PROGRAM COMBINES STATE-OF-THE-ART CLINICAL DIABETES MANAGEMENT WITH PROVEN EDUCATIONAL AND BEHAVIORAL INTERVENTIONS. IN FISCAL YEAR 2014, PROJECT DULCE PROVIDED 7,383 DIABETES CARE AND EDUCATION VISITS FOR LOW-INCOME AND UNDERSERVED INDIVIDUALS THROUGHOUT SAN DIEGO AND ENROLLED MORE THAN 1049 NEW PATIENTS. THE PROGRAM ALSO INITIATED FOUR NEW PROJECTS: PREVENTION FOR WOMEN WITH A HISTORY OF GESTATIONAL DIABETES, REPLICATING PROJECT DULCE IN TIJUANA, DIABETES PEER CARE COORDINATION AT SCRIPPS MERCY HOSPITAL, CHULA VISTA AND THE DIABETES GENE BANK PROGRAM. THE WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION AND TRAINING THE WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION TEAMS PROVIDE STATE-OF-THE-ART EDUCATION AND TRAINING FOR PEOPLE WHO WISH TO INCREASE THEIR DIABETES MANAGEMENT KNOWLEDGE AND SKILLS. WITH THE RISE IN DIABETES, MEDICATION UPGRADES, NUTRITIONAL ADJUSTMENTS AND CHANGES IN DIABETES-RELATED DEVICES, THERE IS A GREAT NEED TO EQUIP CLINICIANS WITH THE LATEST INFORMATION AND CLINICAL SKILLS. THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION PROGRAM IS LED BY A TEAM OF EXPERTS, INCLUDING: ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS AND OTHER DIABETES SPECIALISTS. THESE INDIVIDUALS TRAIN PRACTICING PROFESSIONALS TO DELIVER THE BEST POSSIBLE CARE FOR THEIR DIABETES PATIENTS. COURSES RESPOND TO THE NEEDS OF ALLIED HEALTH PROFESSIONALS SEEKING TO UNDERSTAND NEW AND COMPLEX CLINICAL TREATMENT OPTIONS FOR TYPE 1, TYPE 2 AND GESTATIONAL DIABETES. PROFESSIONAL EDUCATION WAS PROVIDED FOR 331 PEOPLE ON INSULIN MANAGEMENT, INCRETIN THERAPY, THE DIABETES DIET AND DIABETES BASICS. PARTICIPANTS CAME FROM LOCAL HEALTH INSTITUTIONS AND THROUGHOUT THE UNITED STATES TO LEARN FROM THE WHITTIER INSTITUTE'S MOST EXPERIENCED DIABETES EXPERTS. OVER THE LAST FISCAL YEAR, THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION DEPARTMENT PROVIDED 12 SEPARATE PROGRAMS FOR PHYSICIANS, NURSES, PHARMACISTS, DIETITIANS, MIDLEVEL PROVIDERS AND SOCIAL WORKERS. HEALTH-RELATED BEHAVIORS HEALTH-RELATED BEHAVIOR IS ONE OF THE MOST IMPORTANT ELEMENTS IN PEOPLE'S HEALTH AND WELL-BEING. ITS IMPORTANCE HAS GROWN AS SANITATION HAS IMPROVED AND MEDICINE HAS ADVANCED. DISEASES THAT WERE ONCE INCURABLE CAN NOW BE PREVENTED OR SUCCESSFULLY TREATED. HEALTH-RELATED BEHAVIORS, SUCH AS IMMUNIZATION, SMOKING CESSATION, IMPROVED NUTRITION, INCREASED PHYSICAL ACTIVITY; ORAL HEALTH AND INJURY PREVENTION, HAVE BECOME IMPORTANT COMPONENTS OF LONG-TERM HEALTH. UNDERSTANDING THAT PERSONAL BEHAVIORS PLAY A SIGNIFICANT ROLE IN AN INDIVIDUAL'S OVERALL HEALTH STATUS, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS THAT HELP PEOPLE TAKE CHARGE OF THEIR OWN, AND THEIR FAMILIES', HEALTH. DURING FISCAL YEAR 2014, SCRIPPS SPONSORED A NUMBER OF HEALTH BEHAVIOR MODIFICATION EFFORTS. COMMUNITY PROGRAMS AND CLINICAL SERVICES OF THE SCRIPPS MERCY HOSPITAL CHULA VISTA COMMUNITY BENEFITS AND FAMILY MEDICINE RESIDENCY PROGRAMS HAS DELIVERED EXTENSIVE VALUE WITH SUPERIOR OUTCOMES. COMMUNITY SERVICES COMBINED REACHED 18,255 PROGRAM PATIENTS AND PARTICIPANTS. THERE WERE MORE THAN 16,700 CLINICAL VISITS PROVIDED BY SCRIPPS FAMILY MEDICINE RESIDENCY. COMMUNITY-BASED HEALTH IMPROVEMENT ACTIVITIES EACH MONTH APPROXIMATELY 250-300 COMMUNITY MEMBERS PARTICIPATE IN CLASSES, PREVENTION LECTURES AND SUPPORT GROUPS HELD AT THE WELL-BEING CENTER, NORMAN PARK, CONGREGATIONAL TOWERS AND CHULA VISTA MEDICAL PLAZA. A TOTAL OF 2,595 COMMUNITY MEMBERS HAVE PARTICIPATED IN CLASSES AND SUPPORT GROUPS. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA). YOUTH PROGRAM ACTIVITIES IMPLEMENTED A WIDE VARIETY OF YOUTH IN HEALTH CAREER ACTIVITIES INCLUDING: CAMP SCRIPPS, MENTORING PROGRAM, HOSPITAL TOURS, IN-CLASSROOM PRESENTATIONS AND SURGERY VIEWINGS. SCRIPPS FAMILY MEDICINE RESIDENTS ALSO PROVIDE FOOTBALL GAME COVERAGE, SPORTS INJURY CLINICS AND PHYSICALS. A TOTAL OF 3,261 YOUTH PARTICIPATED IN THESE PROGRAMS. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA) SENIOR PROGRAMS EACH MONTH A VARIETY OF SENIOR PROGRAMS ARE HELD WITH LOCAL SENIOR CENTERS, CHURCHES AND SENIOR HOUSING. SOME OF THESE ACTIVITIES INCLUDE: SENIOR HEALTH CHATS, MEN'S GROUP, SENIOR CAMP SCRIPPS, FLU EVENT AND HEALTH FAIRS. MORE THAN 200 SENIORS PARTICIPATED IN RESIDENCY SENIOR ACTIVITIES INCLUDING GROUP VISITS AND FLU EVENTS. A TOTAL OF 902 SENIORS PARTICIPATED IN THESE PROGRAMS. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA) PATIENT COMMUNITY SERVICES SERVICES ARE OFFERED DIRECTLY TO PATIENTS AND THEIR FAMILY POST DISCHARGE TO DECREASE THE RISKS OF READMISSION AND TO INCREASE PATIENT CONTINUITY. SUPPORT SERVICES ARE REFERRAL BASED AND PROVIDE ASSISTANCE WITH THE FOLLOWING: HOUSING/HOMELESSNESS, SENIOR ISSUES, CHRONIC DISEASE ISSUES, DRUG/ALCOHOL AND MENTAL HEALTH, CANCER AND MORE. THIS SERVICE IS CURRENTLY ONLY AVAILABLE AT THE SCRIPPS MERCY HOSPITAL CHULA VISTA CAMPUS. SINCE THE START OF THE PILOT PROJECT IN JULY 2014; 106 REFERRALS HAVE BEEN RECEIVED AND MORE THAN HALF OF PATIENTS HAVE REMAINED OUT OF THE HOSPITAL FOR MORE THAN 60 DAYS AND ARE BEING SUPPORTED THROUGH OUR STAFF, PROGRAMS AND ACTIVITIES.
FORM 990, PART III, LINE 4A (CONTINUED) COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) AND RESIDENT LEADERSHIP ACADEMY MODEL SCRIPPS IS A PARTNER WITH CHIP AND COLLABORATIVELY WORKS ON A RESIDENT LEADERSHIP MODEL THAT HAS EMPOWERED 700+ CITIZENS ACROSS THE COUNTY (AND BEYOND) TO AFFECT CHANGE IN A WIDE RANGE OF COMMUNITY HEALTH AREAS SUCH A PUBLIC SAFETY, ACCESS TO HEALTHY FOODS, AND INCREASED OPPORTUNITIES FOR PHYSICAL ACTIVITY. DEMENTIA AND ALZHEIMER'S DISEASE DEMENTIA IS A CLINICAL SYNDROME OF DECLINE IN MEMORY AND OTHER THINKING ABILITIES. IT IS CAUSED BY VARIOUS DISEASES AND CONDITIONS THAT RESULT IN DAMAGE TO BRAIN CELLS AND LEAD TO DISTINCT SYMPTOM PATTERNS AND DISTINGUISHING BRAIN ABNORMALITIES. ALZHEIMER 'S DISEASE (AD) IS A PROGRESSIVE BRAIN DISORDER THAT GRADUALLY DESTROYS A PERSON'S MEMORY AND ABILITY TO LEARN, REASON, MAKE JUDGMENTS, COMMUNICATE AND CARRY OUT DAILY ACTIVITIES SUCH AS BATHING AND EATING. ALZHEIMER'S IS THE SIXTH LEADING CAUSE OF DEATH IN THE UNITED STATES. - AD IS THE MOST COMMON FORM OF DEMENTIA ACCOUNTING FOR 70% OF ALL CAUSES OF DEMENTIA. - MOST PEOPLE WITH AD ARE DIAGNOSED AT AGE 65 OR OLDER. - WOMEN ARE MORE LIKELY THAN MEN TO HAVE AD. - PEOPLE LIVING WITH DEMENTIA ARE AT GREATER RISK FOR GENERAL DISABILITY AND EXPERIENCE FREQUENT INJURY FROM FALLS. - OLDER ADULTS WITH DEMENTIA ARE 3 TIMES MORE LIKELY TO HAVE PREVENTABLE HOSPITALIZATIONS. FINANCIAL BURDEN: - PAYMENTS FOR AD CARE ARE ESTIMATED AT $200 BILLION IN 2012 WITHIN THE UNITED STATES. PREVALENCE: - THERE ARE MORE THAN 5.2 MILLION PEOPLE IN THE UNITED STATES LIVING WITH AD. AS THE POPULATION AGES THE NUMBER IS EXPECTED TO TRIPLE BY 2050. - IN CALIFORNIA THERE ARE 588,208 PEOPLE 55 YEARS AND OLDER LIVING WITH AD. ONE TENTH OF AD PATIENTS LIVE IN CALIFORNIA. DURING FISCAL YEAR 2013, SCRIPPS ENGAGED IN THE FOLLOWING ALZHEIMER'S AND DEMENTIA PREVENTION AND TREATMENT ACTIVITIES. SENIOR HEALTH AND WELL-BEING PROGRAMS THE GOAL IS TO INCREASE HEALTH CARE, INFORMATION AND PREVENTATIVE SERVICES FOR SENIORS/OLDER ADULTS IN THE SOUTH BAY. EACH MONTH A VARIETY OF SENIOR PROGRAMS ARE HELD AT LOCAL SENIOR CENTERS, CHURCHES AND SENIOR HOUSING. SOME OF THESE ACTIVITIES INCLUDED DEMENTIA, ALZHEIMER'S AND PAIN MANAGEMENT. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) ALZHEIMER'S ASSOCIATION CAREGIVER CONFERENCE IN THIS FREE HALF-DAY CAREGIVER CONFERENCE ATTENDEES HAD AN OPPORTUNITY TO LEARN MORE ABOUT ALZHEIMER'S AND DEMENTIA FROM EXPERTS AND GET QUESTIONS ANSWERED. TOPICS INCLUDED: UNDERSTANDING THE BASICS OF ALZHEIMER'S DISEASE, HOW TO PARTNER WITH YOUR DOCTOR TO GET A DIAGNOSIS, ADDRESSING BEHAVIOR THROUGH COMPASSIONATE COMMUNICATION. OBESITY OBESITY IS A MEDICAL CONDITION IN WHICH EXCESS BODY FAT HAS ACCUMULATED TO THE EXTENT THAT IT MAY HAVE AN ADVERSE EFFECT ON HEALTH. OVERWEIGHT AND OBESITY RANGES ARE DETERMINED USING WEIGHT AND HEIGHT TO CALCULATE A NUMBER KNOWN AS "BODY MASS INDEX" (BMI). AN ADULT WITH A BMI BETWEEN 25 AND 29.9 IS CONSIDERED OVERWEIGHT, WHILE AN ADULT WHO HAS A BMI OF 30 OR HIGHER IS CONSIDERED OBESE. FOR CHILDREN AND ADOLESCENTS AGED 2-19, OVERWEIGHT IS DEFINED AS A BMI AT OR ABOVE THE 85TH PERCENTILE AND LOWER THAN THE 95TH PERCENTILE FOR CHILDREN OF THE SAME AGE AND SEX, WHILE OBESE IS DEFINED AS A BMI AT OR ABOVE THE 95TH PERCENTILE FOR CHILDREN OF THE SAME AGE AND SEX. IN SAN DIEGO COUNTY, ACCORDING TO THE 2009 CALIFORNIA HEALTH INTERVIEW SURVEY, 22.1% OF ADULTS AGED 20 YEARS AND OLDER WERE OBESE (BMI 30.0 OR HIGHER) BASED ON THEIR HEIGHT AND WEIGHT. SOME FACTS ABOUT OBESITY IN THE UNITED STATES: - IN 2009, MORE THAN ONE-THIRD OF U.S. ADULTS (35.7%) WERE OBESE AND 16.9% OF CHILDREN AND ADOLESCENTS WERE CONSIDERED OBESE. - OBESITY-RELATED CONDITIONS INCLUDE HEART DISEASE, STROKE, TYPE 2 DIABETES AND CERTAIN TYPES OF CANCER, WHICH ARE SOME OF THE LEADING CAUSES OF PREVENTABLE DEATH. HEALTH CONSEQUENCES DUE TO OVERWEIGHT AND OBESITY: RESEARCH HAS SHOWN THAT AS WEIGHT INCREASES TO REACH THE LEVELS OF "OVERWEIGHT" AND "OBESITY," THE RISKS FOR THE FOLLOWING CONDITIONS ALSO INCREASES: - CORONARY HEART DISEASE - TYPE 2 DIABETES - CANCERS (ENDOMETRIAL, BREAST, AND COLON) - HYPERTENSION (HIGH BLOOD PRESSURE) - STROKE - LIVER AND GALLBLADDER DISEASE - SLEEP APNEA AND RESPIRATORY PROBLEMS - OSTEOARTHRITIS OVERWEIGHT AND OBESITY ASSOCIATED COSTS: IN 2008, MEDICAL COSTS ASSOCIATED WITH OBESITY WERE ESTIMATED AT $147 BILLION; THE MEDICAL COSTS FOR PEOPLE WHO ARE OBESE WERE $1,429 HIGHER THAN THOSE OF NORMAL WEIGHT. DULCE MOTHERS PILOT PROGRAM IN FISCAL YEAR 2014, DULCE MOTHERS WAS PILOTED WITH THE GOAL OF DECREASING THE INCIDENCE OF TYPE 2 DIABETES BY MANAGING A MAJOR DIABETES RISK FACTOR - OBESITY - IN UNDERSERVED, ETHNICALLY DIVERSE POPULATIONS. THE PROGRAM CONTINUES TO TEST THE EFFECTIVENESS OF A WEIGHT MANAGEMENT CURRICULUM DESIGNED FOR LATINO WOMEN WITH GESTATIONAL DIABETES. . (SPONSORED BY SCRIPPS WHITTIER DIABETES INSTITUTE) COMMUNITY HEALTH IMPROVEMENT PROJECT (CHIP) AND CHILDHOOD OBESITY INITIATIVE THE SAN DIEGO COUNTY CHILDHOOD OBESITY INITIATIVE (INITIATIVE) IS A PUBLIC-PRIVATE PARTNERSHIP WITH THE MISSION OF REDUCING AND PREVENTING CHILDHOOD OBESITY THROUGH POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGE. THE INITIATIVE IS FACILITATED BY COMMUNITY HEALTH IMPROVEMENT PARTNERS. CORE FUNDING FOR THE INITIATIVE IS PROVIDED BY THE COUNTY OF SAN DIEGO, FIRST 5 COMMISSION OF SAN DIEGO COUNTY, THE CALIFORNIA ENDOWMENT, AND KAISER PERMANENTE. SCRIPPS IS A STRONG PARTNER WITH CHIP AND THE OUTCOMES OF THIS INITIATIVE HAVE SHOWN A DECREASED CHILDHOOD OBESITY FROM 4% FROM 2005-2010, THE LARGEST DROP IN SOUTHERN CALIFORNIA (MANY AREAS HAVE SEEN INCREASES). NUTRITION IN COOKING CLASSES, A LOCAL INTERVENTION AT TWO ELEMENTARY SCHOOLS (FAMILY MEDICINE AND COMMUNITY BENEFITS COLLABORATION) STUDENTS OF SOUTHWEST HIGH SCHOOL AND THEIR PARENTS ARE TAUGHT PRACTICAL SKILLS TO PLAN AND PREPARE HEALTHY, COST-EFFECTIVE, CULTURALLY-RELEVANT MEALS IN A WEEKLY THREE SESSION HEALTHY EATING AND COOKING CLASS. THE PURPOSE OF THE STUDY IS TO UNDERSTAND IF THIS INFORMATION TRANSLATES INTO BEHAVIOR CHANGE FOR STUDENTS AND THEIR PARENTS. PARTICIPANTS IN THE PROJECT LEARN FROM MEDICAL RESIDENTS ABOUT THE CONNECTION BETWEEN HEALTHY EATING AND THE PREVENTION OR MANAGEMENT OF CHRONIC DISEASES, SUCH AS HYPERTENSION AND DIABETES MELLITUS. THE SCRIPPS FAMILY MEDICINE RESIDENCY PROGRAM PROVIDES 1,300 PATIENT VISITS PER YEAR AT THE SCHOOL-BASED CLINIC LOCATED AT SOUTHWEST HIGH SCHOOL. LEVELS OF CHILDHOOD OBESITY AND DIABETES MELLITUS ARE DISPROPORTIONATELY HIGH IN THIS COMMUNITY. LOCAL SCHOOL DATA INDICATES ENROLLMENT AT SOUTHWEST OF 2,100 STUDENTS WITH 88% LATINO AND 6% FILIPINO. OUR STUDENTS HAVE BEEN DOCUMENTED THROUGH SCHOOL TESTING TO HAVE 32-34% RATES OF UNHEALTHY BODY COMPOSITIONS FOR THEIR AGE (HIGH BMI). THEIR FITNESS SCORES INDICATE THAT LESS THAN HALF CAN COMPLETE ALL 6 OF THE FITNESS GOALS SET FOR THEIR AGE, ALTHOUGH THE SCORES DO IMPROVE AS THEY PROGRESS FROM 5TH (28%) TO 9TH GRADE (48%). 66.5% OF STUDENTS ARE ENROLLED IN THE FREE/REDUCED LUNCH PROGRAM. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA COMMUNITY BENEFITS) MATERNAL CHILD HEALTH & HIGH RISK PREGNANCY MOTHERS, INFANTS AND CHILDREN MAKEUP A LARGE SEGMENT OF THE U.S. POPULATION AND THEIR WELL-BEING IS A HEALTH PREDICTOR FOR THE NEXT GENERATION. THERE IS TREMENDOUS FOCUS ON MATERNAL ILLNESS AND DEATH, AND INFANT HEALTH AND SURVIVAL, INCLUDING INFANT MORTALITY RATES, ACCESS TO PREVENTIVE CARE, AND FETAL, PERINATAL AND OTHER INFANT DEATHS. MATERNAL AND INFANT HEALTH ISSUES INCLUDE: - ALCOHOL, TOBACCO AND ILLEGAL SUBSTANCES DURING PREGNANCY, WHICH ARE MAJOR RISK FACTORS FOR LOW BIRTH WEIGHT AND OTHER POOR OUTCOMES. - VERY LOW BIRTH WEIGHT ASSOCIATED WITH PRETERM BIRTH, SPONTANEOUS ABORTION, LOW PRE-PREGNANCY WEIGHT AND SMOKING. - INFANT DEATH RATES ARE HIGHEST AMONG INFANTS BORN TO YOUNG TEENAGERS AND MOTHERS 44 AND OLDER. BEING PREGNANT, OR TRYING TO BECOME PREGNANT, IS ONLY A SMALL PORTION OF A WOMAN'S LIFE. UNINTENDED PREGNANCY, EITHER MISTIMED OR UNWANTED AT THE TIME OF CONCEPTION, ACCOUNTS FOR AN ESTIMATED 49 PERCENT OF PREGNANCIES IN THE U.S. THESE PREGNANCIES ARE ASSOCIATED WITH INCREASED MORBIDITY, AS WELL AS BEHAVIORS LINKED TO ADVERSE HEALTH. WOMEN WHO CAN PLAN THE NUMBER AND TIMING OF THEIR CHILDREN EXPERIENCE IMPROVED HEALTH, FEWER UNPLANNED PREGNANCIES AND BIRTHS, AND LOWER ABORTION RATES. HIGH RISK PREGNANCY HIGH RISK PREGNANCY CAN BE THE RESULT OF A MEDICAL CONDITION PRESENT BEFORE PREGNANCY OR A MEDICAL CONDITION THAT DEVELOPS DURING PREGNANCY FOR EITHER MOM OR BABY AND CAUSES THE PREGNANCY TO BECOME HIGH RISK. A HIGH RISK PREGNANCY CAN POSE PROBLEMS BEFORE, DURING OR AFTER DELIVERY AND MIGHT REQUIRE SPECIAL MONITORING THROUGHOUT THE PREGNANCY.
FORM 990, PART III, LINE 4A (CONTINUED) RISK FACTORS: - ADVANCED MATERNAL AGE: INCREASED RISK FOR MOTHERS 35 YEARS AND OLDER - LIFESTYLE CHOICES: SMOKING, ALCOHOL CONSUMPTION, USE OF ILLEGAL DRUGS - MEDICAL HISTORY: PRIOR HIGH RISK PREGNANCIES OR DELIVERIES, FETAL GENETIC CONDITIONS, FAMILY HISTORY OF GENETIC CONDITIONS - UNDERLYING CONDITIONS: DIABETES, HIGH BLOOD PRESSURE AND EPILEPSY - MULTIPLE PREGNANCY - OBESITY DURING PREGNANCY UNITED STATES GENERAL STATISTICS: - THE NUMBER OF BIRTHS DECLINED BY 3% FROM 2009 TO 2010 - GENERAL FERTILITY RATE ALSO DECLINED BY 3% - TEENAGE BIRTH RATE FELL 10% FROM 2009 TO 2010 - THE BIRTH RATE OF WOMEN AGED 40-44 YEARS CONTINUED TO RISE - CESAREAN DELIVERY RATE WAS DOWN FOR THE FIRST YEAR SINCE 1996, TO 32.8% - IN SAN DIEGO COUNTY, THE INFANT MORTALITY RATE WAS 4.4 DEATHS PER 1,000 LIVE BIRTHS IN 2009 SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION FOR LOW-INCOME WOMEN IN SAN DIEGO COUNTY IN FISCAL YEAR 2014. THE FOLLOWING ARE SOME EXAMPLES. SCRIPPS MEMORIAL HOSPITAL LA JOLLA COMMUNITY BENEFIT SERVICES: - OFFERED MORE THAN 1,000 MATERNAL CHILD HEALTH CLASSES THROUGHOUT SAN DIEGO COUNTY TO ENHANCE PARENTING SKILLS. LOW-INCOME WOMEN IN SAN DIEGO WHO WERE ELIGIBLE ATTEND CLASSES AT NO CHARGE OR ON A SLIDING-FEE SCHEDULE - MAINTAINED EXISTING PRENATAL EDUCATION SERVICES IN ALL REGIONS OF THE COUNTY, ENSURING THAT PROGRAMS CONTINUED TO DEMONSTRATE A SATISFACTION RATING ABOVE 90 PERCENT - PROVIDED AND SUPPORTED WEEKLY BREASTFEEDING SUPPORT GROUPS AT FIVE LOCATIONS THROUGHOUT SAN DIEGO COUNTY, INCLUDING TWO WITH BILINGUAL SERVICES - OFFERED A MATERNAL CHILD HEALTH EDUCATION SERIES IN NORTH COUNTY COVERING DOGS AND BABIES, SAFETY, GRAND PARENTING AND BABY SITTER SAFETY - OFFERED MATERNAL CHILD HEALTH CLASSES AT THE MENDE WELL BEING CENTER, SUCH AS BASIC TRAINING FOR DADS, GETTING READY FOR THE BABY, INFANT CPR AND SAFETY, PARENT CONNECTION PROGRAMS AND REDIRECTING CHILDREN'S BEHAVIOR - OFFERED THE DOGS AND BABIES PROGRAMS QUARTERLY, WITH MORE THAN 40 ATTENDEES - OFFERED WEEKLY MOMMY AND ME YOGA PROGRAMS FOR NEW PARENTS - OFFERED A PRENATAL YOGA PROGRAM FOR EXPECTANT WOMEN IN SAN DIEGO COUNTY - OFFERED A PREGNANCY NUTRITION PROGRAM QUARTERLY AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA - OFFERED CLASSES IN PELVIC FLOOR AND PREGNANCY CHANGES FOR EXPECTANT FAMILIES AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFITS) FIRST 5 AND PROMISE NEIGHBORHOODS MORE THAN 484 SERVICES WERE RECEIVED FOR FIRST TIME MOTHERS INCLUDING: HOME VISITS, REFERRALS RECEIVED, DATA ENTRY, FOLLOW UP PHONE CALLS, PARENTING CLASSES AND OTHER SUPPORT SERVICES. A TOTAL OF 325 PARENTS PARTICIPATED IN PARENTING CLASSES; 332 SESSIONS PROVIDED. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTERS THE STATE-FUNDED WIC PROGRAM. THE PROGRAM SERVES SIX LOCATIONS CONVENIENTLY SITUATED NEAR COMMUNITY CLINICS AND/OR HOSPITALS IN CENTRAL SAN DIEGO AREA. WIC TARGETS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO 5). SCRIPPS MERCY WIC SERVES APPROXIMATELY 7,500 WOMEN AND CHILDREN ANNUALLY, 44 PERCENT IN THE CITY HEIGHTS COMMUNITY. IN CITY HEIGHTS, CLIENTS ARE 91 PERCENT HISPANIC AND INCLUDE PREGNANT AND POSTPARTUM WOMEN (24 PERCENT), INFANTS (20 PERCENT) AND CHILDREN (56 PERCENT). IN FISCAL YEAR 2014, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 89,193 WOMEN AND CHILDREN IN SOUTH AND CENTRAL SAN DIEGO. THE SCRIPPS MERCY WIC PROGRAM PLAYS A KEY ROLE IN MATERNITY CARE BY REACHING LOW-INCOME WOMEN TO PROMOTE PRENATAL CARE, GOOD NUTRITION AND BREASTFEEDING. NUTRITION STAFF EDUCATE WOMEN ABOUT THE IMPORTANCE OF BREASTFEEDING DURING PREGNANCY AND OFFER LACTATION SUPPORT (ONE-ON-ONE AND GROUP), AS WELL AS SUPPLIES - PUMPS AND BREAST PADS - DURING THE POSTPARTUM PERIOD. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO) SCRIPPS FAMILY MEDICINE PROGRAM AT SCRIPPS MERCY HOSPITAL, CHULA VISTA RAISING HEALTHY FAMILIES AND CARING FOR THE NEXT GENERATION OF SAN DIEGANS - BEFORE THEY'RE EVEN BORN - HELP CREATE A HEALTHIER COMMUNITY FOR YEARS TO COME. THE SCRIPPS FAMILY MEDICINE PROGRAM AT SCRIPPS MERCY HOSPITAL, CHULA VISTA, IS PROVIDING ACCESS, EDUCATION AND CLINICAL SERVICES TO NEARLY 200 PREGNANT WOMEN IN SOUTH SAN DIEGO COUNTY. THE GOAL OF THE PROGRAM, "IMPROVING PERINATAL CARE FOR UNDERSERVED LATINA WOMEN - HEALTHY WOMEN, HEALTHY BABIES," IS TO PROVIDE ACCESS TO PERINATAL CARE FOR UNDERSERVED LATINO WOMEN IN ORDER TO IMPROVE BIRTH OUTCOMES. WITH FUNDING FROM THE MARCH OF DIMES, THE PROGRAM APPLIES THE PRINCIPLES OF THE CENTERING HEALTHCARE INSTITUTE AND FOCUSES ON CHANGING THE WAY PATIENTS EXPERIENCE THEIR CARE THROUGH ASSESSMENT, EDUCATION AND GROUP SUPPORT. CENTERING PREGNANCY IS THE INSTITUTE'S MODEL DEVOTED SPECIFICALLY TO IMPROVING MATERNAL AND CHILD HEALTH, AND HAS BEEN SHOWN TO RESULT IN INCREASED PRENATAL VISITS, GREATER LEVELS OF BREAST FEEDING AND STRONGER RELATIONSHIPS BETWEEN MOTHERS AND THEIR HEALTH CARE PROVIDERS BEFORE, DURING AND AFTER PREGNANCY. THE RESULTS ARE PROMISING. WOMEN WHO GAVE BIRTH REPORTED AN ENHANCED PRENATAL EXPERIENCE, GAINED LESS WEIGHT THROUGHOUT THEIR PREGNANCY AND SHOWED IMPROVED HEALTH CARE KNOWLEDGE. AS THE PROGRAM CONTINUES, PATIENT NAVIGATORS WILL FOLLOW-UP WITH PARTICIPANTS TO GAUGE OTHER IMPORTANT FACTORS AND HELP THEM MAINTAIN HEALTHY LIFESTYLES. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA COMMUNITY BENEFITS) UNINTENTIONAL INJURY AND VIOLENCE IN CALIFORNIA, INJURIES ARE THE NUMBER ONE KILLER AND DISABLER OF PEOPLE AGED 1 TO 44 (CDPH, 2010). UNINTENTIONAL INJURIES OCCUR AT HOME, AT WORK, WHILE PARTICIPATING IN SPORTS AND RECREATION, ON THE STREETS AND AT SCHOOL AND ARE ASSOCIATED WITH MOTOR VEHICLE ACCIDENTS, FALLS, FIREARMS, FIRE/BURNS, DROWNING, POISONING (INCLUDING DRUGS AND CAUSTIC SUBSTANCES), ALCOHOL, GAS, CLEANERS AND MANY OTHER CAUSES. THE DEATHS ASSOCIATED WITH UNINTENTIONAL INJURIES ARE SIGNIFICANT, YET REPRESENT ONLY A SMALL PART OF A MUCH LARGER PUBLIC HEALTH PROBLEM. HOSPITALIZATION DATA IS A BETTER MEASURE OF THE INJURY PROBLEM THAN DEATH DATA ALONE. IN SAN DIEGO COUNTY DURING 2009, THERE WERE MORE THAN 949 DEATHS, MORE THAN 21,149 HOSPITALIZATIONS, AND NEARLY 150,000 EMERGENCY DEPARTMENT VISITS FOR UNINTENTIONAL INJURIES. THE NUMBER OF UNINTENTIONAL INJURIES TREATED IN PHYSICIANS' OFFICES AND CLINICS, WHILE UNKNOWN, IS LIKELY MUCH HIGHER THAN THE NUMBER OF EMERGENCY DEPARTMENT VISITS. UNINTENTIONAL INJURIES ARE ONE OF THE LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY FOR RESIDENTS OF ALL AGES, REGARDLESS OF GENDER, RACE OR REGION. FALLS WERE THE MOST COMMON CAUSE OF UNINTENTIONAL INJURY IN 2009, FOLLOWED BY MOTOR-VEHICLE INJURIES. THE FOLLOWING ARE A NUMBER OF SCRIPPS HEALTH PROGRAMS THAT ADDRESSED UNINTENTIONAL INJURIES AND VIOLENCE FOR FISCAL YEAR 2014. AARP DRIVER SAFETY PROGRAM A FOUR-HOUR SUPERVISED TRAUMA VISITATION PROGRAM FOR YOUNG DRIVERS AGES 14 AND UP TO SHOW THEM THE REALISTIC CONSEQUENCES OF DRIVING UNDER THE INFLUENCE. PARTICIPANTS VISIT THE TRAUMA ROOM, ER, ICU, CAT SCAN AND OTHER HOSPITAL AREAS. (SPONSORED BY SCRIPPS MERCY HOSPITAL) EVERY 15 MINUTES ALCOHOL CAN BE ATTRIBUTED TO MORE THAN 100,000 DEATHS IN THE U.S. ANNUALLY, INCLUDING 41% OF ALL TRAFFIC FATALITIES. THE EVERY 15 MINUTES PROGRAM IS A TWO-DAY IMMERSION EXPERIENCE FOR TEENS ON THE REALISTIC CONSEQUENCES OF DRINKING AND DRIVING, WHICH INVOLVES THE SCHOOLS, LAW ENFORCEMENT, COURTS, EMERGENCY SERVICE PROVIDERS, AND THE MORTUARY. THE "INJURED" STUDENTS ARE TAKEN TO SCRIPPS MERCY TRAUMA CENTER. THIS PROGRAM IS SPONSORED JOINTLY BY LOCAL HIGH SCHOOLS, COUNTY POLICE AND SHERIFFS DEPARTMENTS, AMBULANCE SERVICES, AND EMERGENCY DEPARTMENTS (SPONSORED BY SCRIPPS MERCY HOSPITAL) HEALTH AND WELLNESS, SCRIPPS HOME HEALTH SERVICES THIS PROGRAM EDUCATES SENIORS ABOUT FALL PREVENTION (THE PRIMARY CAUSE OF FRACTURES) AND FIRE SAFETY. HOME HEALTH NURSES ALSO TEACH SENIORS AND THEIR FAMILIES ABOUT CONTINUUM-OF-CARE OPTIONS. SPORTS CONCUSSION PROGRAM, REHABILITATION CENTER AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS THERE ARE NEARLY 300,000 SPORTS-RELATED CONCUSSIONS IN THE U.S EACH YEAR - 1,000 IN FOOTBALL ALONE - AND APPROXIMATELY 130,000 HIGH SCHOOL ATHLETES SUFFER A CONCUSSION. A RECENT REPORT SHOWED THAT CLOSE TO 40 PERCENT OF HIGH SCHOOL ATHLETES WHO SUSTAIN A CONCUSSION RETURN TO PLAY TOO SOON. THE REHABILITATION CENTER AT SCRIPPS ENCINITAS HAS DEVELOPED A PUBLIC EDUCATION AND COMMUNITY OUTREACH PROGRAM TO RAISE AWARENESS ABOUT CONCUSSION SIGNS AND SYMPTOMS, AS WELL AS HOW TO AVOID, TREAT AND UNDERSTAND THEIR CONSEQUENCES. APPROXIMATELY 70 STUDENTS HAVE BEEN SERVED BY THIS PROGRAM. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL ENCINITAS)
FORM 990, PART III, LINE 4A (CONTINUED) SAN DIEGO FALL PREVENTION TASK FORCE THIS COUNTY HHSA-AGING AND INDEPENDENCE SERVICE-SUPPORTED TASK FORCE SEEKS TO REDUCE FALLS AND THEIR DEVASTATING CONSEQUENCES. THE TASK FORCE INCREASES CONNECTIONS BETWEEN PHYSICIANS AND OTHER COMMUNITY FALL PREVENTION SERVICES, AS WELL AS INCREASING AWARENESS AMONG OLDER ADULTS. SCRIPPS MERCY HOSPITAL TRAUMA CENTER PARTICIPATES IN THIS TASK FORCE. WEIGHT STATUS, NUTRITION, ACTIVITY AND FITNESS THE NUMBERS SPEAK FOR THEMSELVES - 63 PERCENT OF AMERICAN ADULTS ARE EITHER OVERWEIGHT OR OBESE. NATIONALLY, THE PREVALENCE OF OBESE ADULTS (THOSE WITH A BODY MASS INDEX (BMI) OF 30 OR MORE) HAS INCREASED BY 68 PERCENT SINCE 1995, FROM 16 PERCENT TO ALMOST 27 PERCENT. DURING THIS SAME PERIOD, THE PREVALENCE OF OVERWEIGHT ADULTS (BMI BETWEEN 25.0 AND 29.99) HAS INCREASED BY ONLY TWO PERCENT, FROM 35.5 PERCENT TO 36.2 PERCENT. SAN DIEGO COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR 2009 INDICATES THAT ALMOST 59 PERCENT OF ADULTS ARE CONSIDERED EITHER OVERWEIGHT OR OBESE. SINCE 2005, THE FIRST YEAR BRFSS DATA WAS REPORTED FOR SAN DIEGO COUNTY, THE PREVALENCE OF OBESE ADULTS HAS RANGED FROM 20 PERCENT IN 2005 TO 26.7 PERCENT IN 2006, WITH THE MOST CURRENT MEASURE AT 21.6 PERCENT. SINCE 2006, THE PREVALENCE OF OVERWEIGHT ADULTS IN SAN DIEGO COUNTY HAS INCREASED SLIGHTLY FROM 36.5 PERCENT TO 37.7 PERCENT. AT THE NATIONAL, STATE AND COUNTY LEVELS, OBESITY PREVALENCE RATES AMONG LATINOS AND AFRICAN-AMERICANS ARE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITES. OBESITY RATES BY GENDER ALSO VARIED SIGNIFICANTLY IN THE 2007 CHIS, THE MOST RECENT COUNTY DATA BY GENDER, WITH 25.4 PERCENT OF MALES AND 18.1 PERCENT OF FEMALES HAVING A BMI 30 OR HIGHER. MALES WERE SIGNIFICANTLY MORE LIKELY TO BE OVERWEIGHT THAN FEMALES, 40.5 PERCENT AND 25.8 PERCENT, RESPECTIVELY. CAUSES MANY FACTORS PLAY A ROLE IN OBESITY, MAKING IT A COMPLEX HEALTH ISSUE TO ADDRESS. FACTORS INCLUDE (DH&HS, 2010): - GENETIC PREDISPOSITION - BEHAVIOR (DIETARY PATTERNS AND PHYSICAL ACTIVITY) - ENVIRONMENTAL INFLUENCES - CULTURAL INFLUENCES - SOCIOECONOMIC STATUS TO IMPLEMENT PREVENTION STRATEGIES, IT IS IMPORTANT TO UNDERSTAND THE EFFECT EACH OF THESE FACTORS HAS ON OBESITY AND WHICH CAN BE CHANGED. THE FOLLOWING ARE SOME EXAMPLES OF SCRIPPS PROGRAMS THAT ADDRESS THESE HEALTH ISSUES. NUTRITION SERVICES AND PHYSICAL ACTIVITY ACCORDING TO THE 2009 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR SAN DIEGO COUNTY, MORE THAN 59 PERCENT OF ADULTS ARE OVERWEIGHT OR OBESE. OBESITY INCREASES THE RISK FOR HEART DISEASE, TYPE 2 DIABETES, HIGH BLOOD PRESSURE, STROKE AND SOME FORMS OF CANCER. THE NATION'S LOW-INCOME, MINORITY POPULATIONS ARE AT EVEN GREATER RISK. IN AN EFFORT TO ADDRESS THIS CRITICAL HEALTH CONCERN, STAFF MEMBERS AT THE CITY HEIGHTS WELLNESS CENTER HAVE ESTABLISHED A VARIETY OF NUTRITION EDUCATION PROGRAMS TO MEET THE NEEDS OF LOW-INCOME, MINORITY POPULATIONS. THE CENTER USES A COMBINATION OF APPROACHES TO ADDRESS A BROAD ARRAY OF COMMUNITY HEALTH PRIORITIES, INCLUDING NUTRITION, ACCESS TO SERVICES AND COMMUNITY ENGAGEMENT. THE GOAL IS TO PREVENT DISEASE BY STRENGTHENING COMMUNITY PARTNERSHIPS AND LINK EXISTING SERVICES TO PROVIDE CITY HEIGHTS' RESIDENTS WITH OPPORTUNITIES TO BECOME MORE INVOLVED IN MANAGING THEIR OWN HEALTH. THE "HUB" OF THE WELLNESS CENTER IS THEIR TEACHING KITCHEN - A HANDS-ON INTERACTIVE SETTING FOR COOKING DEMONSTRATIONS, WEIGHT MANAGEMENT, MEAL PREPARATION, NUTRITION EDUCATION AND COUNSELING. THE CENTER, WHICH SERVES MORE THAN 18,000 CULTURALLY DIVERSE FAMILIES A YEAR, IS BASED ON THE BELIEF THAT KEEPING PEOPLE HEALTHIER IS ONE OF THE MOST EFFECTIVE WAYS TO REDUCE HEALTH CARE COSTS. THE CENTER STRIVES TO BE THE HUB OF HEALTH EDUCATION ADDRESSING NUTRITION, HEALTHY LIFESTYLE BEHAVIORS AND CHILDHOOD INJURY PREVENTION THROUGH A VARIETY OF HEALTH AND WELLNESS PROGRAMS. THE CENTER HAS EARNED A REPUTATION FOR BEING (1) A SAFE PLACE TO COME AND SEEK HELP FOR A VARIETY OF HEALTH AND SOCIAL NEEDS; (2) A RESOURCE FOR OBTAINING EASY ACCESS TO INFORMATION ABOUT HEALTH AND COMMUNITY RESOURCES; (3) A FLEXIBLE MEETING PLACE THAT HAS THE CAPACITY TO BRING PEOPLE TOGETHER AROUND COMMUNITY HEALTH ISSUES, ESPECIALLY FOOD AND NUTRITION. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO COMMUNITY BENEFIT SERVICES) LET'S GET COOKING IN JANUARY 2014, THE CITY HEIGHTS WELLNESS CENTER LAUNCHED "LET'S GET COOKING", A HANDS-ON COOKING CLASS FOR MOMS, DADS, CAREGIVERS AND THEIR KIDS (AGES EIGHT AND OLDER) WHO WANT TO LEARN SIMPLE, HEALTHY RECIPES FOR THE WHOLE FAMILY. "LET'S GET COOKING" AIMS TO INSPIRE FAMILIES TO EAT FRESH, NUTRITIOUS, WHOLE FOODS AND TO MAKE HEALTHY LIFESTYLE CHOICES THROUGH COOKING, EDUCATION AND DISCUSSIONS. THE CLASSES ARE TAUGHT IN BOTH ENGLISH AND SPANISH BY BILINGUAL REGISTERED DIETITIANS. IN THE MID-CITY REGION OF SAN DIEGO, THERE ARE CURRENTLY NO OTHER HANDS-ON COOKING/NUTRITION EDUCATION/OBESITY PROGRAMS AVAILABLE. WHAT SETS THIS PROGRAM APART IS BEING ABLE TO OFFER THE HANDS-ON COOKING EXPERIENCE IN A CERTIFIED TEACHING KITCHEN. THERE ARE CURRENTLY NUTRITION EDUCATION PROGRAMS OFFERED IN THE COMMUNITY. HOWEVER, NONE OF THEM IS OFFERING NUTRITION EDUCATION THROUGH COOKING. THE TEACHING KITCHEN PROVIDES NOT ONLY A HANDS-ON LEARNING EXPERIENCE, BUT MORE IMPORTANTLY A PLACE FOR FAMILY INTERACTION AND BUILDING A SENSE OF COMMUNITY. LIVE HEALTHY FAMILY NUTRITION PROGRAM USING THE COOPERATIVE EXTENSION'S RESEARCH-BASED CURRICULUMS AND BILINGUAL STAFF, A REGISTERED DIETITIAN IMPLEMENTED WEEKLY NUTRITION EDUCATION CLASSES IN SPANISH. THE PROGRAM TARGETS LOW-INCOME PEOPLE WHO USE FOOD STAMPS AND OFFERS A SERIES OF EIGHT WEEKLY CLASSES. THE PROGRAM INCREASES RESIDENTS' KNOWLEDGE, SKILLS AND MOTIVATION TO HELP THEM PRACTICE HEALTHY EATING AND RELATED BEHAVIORS. CLASSES FOCUS ON NUTRITION, PHYSICAL FITNESS, FOOD SAFETY, MEAL PLANNING AND FOOD SHOPPING. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) COLLABORATE FOR HEALTHY WEIGHT THIS ADVISORY GROUP MEETS MONTHLY. DRS. SERPAS AND BRANDSTEIN ARE THE LEADERS OF THIS COLLABORATION. COLLABORATE FOR HEALTHY WEIGHT IS A PROGRAM OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AND THE NATIONAL INITIATIVE FOR CHILDREN'S HEALTHCARE QUALITY (NICHQ). THE SHARED VISION IS TO CREATE PARTNERSHIPS BETWEEN PRIMARY CARE, PUBLIC HEALTH, AND COMMUNITY ORGANIZATIONS TO DISCOVER SUSTAINABLE WAYS TO PROMOTE HEALTHY WEIGHT AND ELIMINATE HEALTH DISPARITIES IN COMMUNITIES ACROSS THE UNITED STATES. ALL THREE SECTORS MUST COLLABORATE, USING EVIDENCE-BASED APPROACHES, TO REVERSE THE OBESITY EPIDEMIC AND IMPROVE THE HEALTH OF OUR COMMUNITIES; 120 MEMBERS. SEVERAL MANUSCRIPTS ARE UNDER DEVELOPMENT. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFIT SERVICES) CHULA VISTA PROMISE NEIGHBORHOOD (CVPN) SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER AND SCRIPPS FAMILY MEDICINE RESIDENCY ARE PARTNERS IN THE CHULA VISTA PROMISE NEIGHBORHOOD (CVPN) EFFORTS FUNDED BY THE DEPARTMENT OF EDUCATION. CVPN BRINGS TOGETHER A COLLABORATION OF PARTNERS FOCUSED ON FAMILY, EDUCATION, HEALTH AND COMMUNITY TO PROVIDE CHILDREN AND FAMILIES IN THE CASTLE PARK NEIGHBORHOOD WITH OPPORTUNITIES THEY NEED TO EXCEL IN SCHOOL, GET INTO COLLEGE, FIND GOOD JOBS AND LEAD HEALTHY LIVES. TOGETHER, THE SCRIPPS FAMILY MEDICINE RESIDENCY AND THE SCRIPPS MERCY HOSPITAL CHULA VISTA WELL BEING CENTER ARE IMPLEMENTING HEALTH AND WELLNESS ACTIVITIES AT CASTLE PARK ELEMENTARY FOR THE STUDENTS AND THEIR PARENTS FOCUSING ON THE 5210 MESSAGE IN AN EFFORT TO PROMOTE HEALTHY LIVING IN THE CASTLE PARK AREA. THE 5210 MESSAGE EMPHASIZES TEACHING FAMILIES ON EATING MORE FRUITS AND VEGETABLES, LIMITING SCREEN TIME, INCORPORATING ONE HOUR OF PHYSICAL ACTIVITY A DAY AND PROMOTING ZERO SUGARY DRINKS. MENTAL HEALTH AND ILLNESS MENTAL HEALTH IS DEFINED AS "A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE". MENTAL ILLNESS IS DEFINED AS "COLLECTIVELY ALL DIAGNOSABLE MENTAL DISORDERS" OR "HEALTH CONDITIONS THAT ARE CHARACTERIZED BY ALTERATIONS IN THINKING, MOOD, OR BEHAVIOR (OR SOME COMBINATION THEREOF) ASSOCIATED WITH DISTRESS AND/OR IMPAIRED FUNCTIONING". DEPRESSION: - DEPRESSION IS THE MOST COMMON TYPE OF MENTAL ILLNESS, AFFECTING MORE THAN 26% OF THE U.S. ADULT POPULATION. - IT HAS BEEN ESTIMATED THAT BY THE YEAR 2020, DEPRESSION WILL BE THE SECOND LEADING CAUSE OF DISABILITY THROUGHOUT THE WORLD, TRAILING ONLY ISCHEMIC HEART DISEASE. DISPARITIES: - MALES COMMIT SUICIDE FOUR TIMES MORE THAN FEMALES. - YOUNGER AMERICAN ADULTS, AGED 18-24 YEARS, SUFFERED THE MOST MENTAL HEALTH DISTRESS. - ADULTS WITH THE LOWEST INCOME OR EDUCATION REPORT MORE UNHEALTHY DAYS THAN THOSE WITH HIGHER INCOME OR EDUCATION. - MENTAL ILLNESS IS ASSOCIATED WITH CHRONIC DISEASES SUCH AS CARDIOVASCULAR DISEASE, DIABETES, AND OBESITY.
FORM 990, PART III, LINE 4A (CONTINUED) PREVALENCE: - ABOUT 25% OF U.S. ADULTS HAVE A MENTAL ILLNESS5 (BRFSS, 2004). - NEARLY 50% OF U.S. ADULTS WILL DEVELOP AT LEAST ONE MENTAL ILLNESS DURING THEIR LIFETIME. SUICIDE AND SUICIDE ATTEMPTS SUICIDE IS A MAJOR COMPLICATION OF DEPRESSION AND A LEADING CAUSE OF NON-NATURAL DEATH FOR ALL AGES IN SAN DIEGO COUNTY, SECOND ONLY TO MOTOR VEHICLE ACCIDENTS. IN 2010, 372 SAN DIEGANS DIED BY SUICIDE, A RATE OF 11.5 PER 100,000. THIS WAS HIGHER THAN CALIFORNIA OVERALL (9.9 PER 100,000) AND SLIGHTLY LOWER THAN THE NATIONAL RATE (11.9 PER 100,000). SUICIDE DEATHS ARE ONLY PART OF THE PROBLEM; MORE PEOPLE SURVIVE SUICIDE ATTEMPTS THAN DIE. THOSE WHO ATTEMPT SUICIDE ARE OFTEN SERIOUSLY INJURED AND REQUIRE MEDICAL AND PSYCHIATRIC CARE. BETWEEN 2000 AND 2008, 2,896 SAN DIEGANS DIED FROM SUICIDE. ON AVERAGE, ONE SUICIDE AFFECTS THE LIVES OF AT LEAST SIX PEOPLE, CAUSING CONSIDERABLE GRIEF, SOCIAL STIGMA AND, IN SOME CASES, ELEVATED RISK OF ADDITIONAL SUICIDES. IN 2010, THE COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY (HHSA) LAUNCHED A SUICIDE PREVENTION PLANNING PROCESS, WHICH WAS INFORMED BY THE NATIONAL STRATEGY FOR SUICIDE PREVENTION AND THE CALIFORNIA STRATEGIC PLAN ON SUICIDE PREVENTION. SCRIPPS IS A MEMBER OF THE COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), WHICH COLLABORATES WITH THE COUNTY ON THIS INITIATIVE. SCRIPPS OFFERS BOTH INPATIENT AND OUTPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL, SAN DIEGO. THE BEHAVIORAL HEALTH PROGRAM AT SCRIPPS MERCY ALSO SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. SCRIPPS HEALTH BEHAVIORAL HEALTH INPATIENT PROGRAMS INDIVIDUALS SUFFERING FROM ACUTE PSYCHIATRIC DISORDERS ARE SOMETIMES UNABLE TO LIVE INDEPENDENTLY OR MAY EVEN POSE A DANGER TO THEMSELVES OR OTHERS. IN SUCH CASES, HOSPITALIZATION MAY BE THE MOST APPROPRIATE ALTERNATIVE. THE BEHAVIORAL HEALTH INPATIENT PROGRAM AT SCRIPPS MERCY HOSPITAL HELPS PATIENTS AND THEIR LOVED ONES WORK THROUGH SHORT-TERM CRISES, MANAGE MENTAL ILLNESS AND RESUME THEIR DAILY LIVES. CHALLENGES - LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. - IN 2014 THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM LOST $4.2 MILLION. - IN 2014, 6.9 PERCENT OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED. SCRIPPS HEALTH BEHAVIORAL HEALTH OUTPATIENT PROGRAMS SCRIPPS MERCY PROVIDES COMMUNITY-BASED ADULT PSYCHIATRIC TREATMENT AT SCRIPPS MERCY HOSPITAL, SAN DIEGO. THE INTENSIVE DAY PROGRAM HELPS PARTICIPANTS REDUCE THEIR SYMPTOMS WHILE THEY CONTINUE TO LIVE IN THE COMMUNITY. THE PROGRAM PROVIDES TWO LEVELS OF CARE: - THE OUTPATIENT PROGRAM OFFERS PATIENTS ONE TO FOUR TREATMENT DAYS PER WEEK. - THE PARTIAL HOSPITALIZATION PROGRAM PROVIDES MORE INTENSIVE TREATMENT FIVE TO SIX DAYS PER WEEK. MENTAL HEALTH OUTREACH SERVICES, A-VISION SERVICE PROGRAM BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL, IN PARTNERSHIPS WITH THE SAN DIEGO MENTAL HEALTH ASSOCIATION, ESTABLISHED THE A-VISION VOCATIONAL TRAINING PROGRAM (SOCIAL REHABILITATION AND PREVOCATIONAL SERVICES FOR PEOPLE LIVING WITH MENTAL ILLNESS) TO HELP DECREASE THE STIGMA OF MENTAL ILLNESS. THE PROGRAM PROVIDES VOCATIONAL TRAINING FOR PEOPLE RECEIVING MENTAL HEALTH TREATMENT, POTENTIALLY LEADING TO GREATER INDEPENDENCE. THIS YEAR, BEHAVIORAL HEALTH SERVICES CONTINUED PARTICIPATING IN THE A-VISION PROGRAM. TO DATE 90 CLIENTS HAVE BEEN ENROLLED IN THE PROGRAM AND 43 EMPLOYED AT SCRIPPS. CURRENTLY, 25 PEOPLE ARE VOLUNTEERING AND 23 PEOPLE ARE PARTICIPATING IN SUPPORTIVE EMPLOYMENT. THE TOTAL EXPENSE FOR THE A-VISION PROGRAM FOR FISCAL YEAR 2014 WAS $132,130. INCREASING AWARENESS OF MENTAL HEALTH AND GERIATRIC PSYCHIATRIC ISSUES IN FISCAL YEAR 2014, SCRIPPS BEHAVIORAL HEALTH SERVICES IMPROVES AWARENESS OF MENTAL HEALTH AND GERIATRIC ISSUES BY PROVIDING INFORMATION AND SUPPORTIVE SERVICES FOR MORE THAN 1,000 PEOPLE AT COMMUNITY EVENTS. DEPRESSION SCREENINGS IN OCTOBER 2014, SCRIPPS AGAIN PARTICIPATED IN NATIONAL DEPRESSION SCREENING DAY, AN ANNUAL EVENT AIMED AT HELPING PEOPLE IDENTIFY THE SIGNS OF DEPRESSION AND PROVIDING RESOURCES TO ASSIST THOSE AT RISK. IN THE PAST TWO YEARS, SCRIPPS HAS EXPANDED THE AVAILABILITY OF FREE DEPRESSION SCREENINGS BY MAILING THEM AVAILABLE AT ALL FIVE OF OUR FOUR HOSPITAL CAMPUSES. THE SCREENINGS ARE OPEN TO ADULTS OF ALL AGES ON A WALK-IN-BASIS AND INCLUDE REFERRALS TO MENTAL HEALTH PROFESSIONALS, AS WELL AS LITERATURE THAT CAN BE SHARED WITH FRIENDS AND FAMILY MEMBERS. IN 2014, SCRIPPS STAFF CARED FOR MORE THAN 151 PEOPLE AND CONDUCTED 99 DEPRESSION SCREENING SERVICES AND INFORMATION IN BOTH ENGLISH AND SPANISH. COMMUNITY HEALTH IMPROVEMENT PROJECT (CHIP) AND SUICIDE PREVENTION COUNCIL SCRIPPS IS A STRONG PARTNER OF CHIP. CHIP TRAINED APPROXIMATELY 8,000 COMMUNITY MEMBERS IN SUICIDE PREVENTION TO HELP ADDRESS RISING RATES OF SUICIDE IN THE COUNTY. MENTAL HEALTH SUPPORT SERVICES AT LOCAL SCHOOL-BASED CLINICS SCRIPPS FAMILY MEDICINE RESIDENCY AND THE SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER HAVE PARTNERED TO OFFER CLINICAL TRAINING OPPORTUNITIES FOR MASTER SOCIAL WORK STUDENTS IN TRAINING FROM SAN DIEGO STATE UNIVERSITY AT SOUTHWEST AND PALOMAR HIGH SCHOOLS. THESE STUDENTS WORK WITH LOCAL FACULTY TO ENGAGE HIGH SCHOOL STUDENTS IN COUNSELING AND REFERRALS TO PSYCHIATRISTS AND OTHER PROVIDERS THAT ADDRESS THE MENTAL HEALTH NEEDS OF VULNERABLE ADOLESCENTS. A VARIETY OF MENTAL HEALTH ISSUES ARE PRESENT FOR LOCAL HIGH SCHOOL STUDENTS. MANY OF THESE ISSUES INCLUDE DEPRESSION, ANXIETY AND SUICIDE RELATED CONCERNS. THE PROGRAM WORKS TO IMPROVE OVERALL MENTAL HEALTH CARE FOR LOCAL STUDENTS THROUGH A SCHOOL-BASED CLINIC. MORE THAN 1,400 YOUTH HAVE BEEN PROVIDED CLINICAL SERVICES IN THESE CLINICS. ACUTE RESPIRATORY INFECTIONS/PNEUMONIA RESPIRATORY DISEASES, SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), ARE A SIGNIFICANT PUBLIC HEALTH BURDEN IN THE UNITED STATES. ASTHMA AND COPD ARE AMONG THE 10 LEADING CHRONIC CONDITIONS THAT RESTRICT ACTIVITY. AFTER CHRONIC SINUSITIS, ASTHMA IS THE MOST COMMON CHRONIC ILLNESS IN CHILDREN. DEATH RATES FROM COPD HAVE DECLINED FROM 2000 TO 2009 AT THE NATIONAL, STATE, AND LOCAL LEVELS. INFLUENZA, ALSO KNOWN AS THE "FLU", IS A CONTAGIOUS RESPIRATORY ILLNESS CAUSED BY INFLUENZA VIRUSES THAT INFECT THE NOSE, THROAT, AND LUNGS. IT CAN CAUSE MILD TO SEVERE ILLNESS, AND AT TIMES CAN LEAD TO DEATH. COMPLICATIONS OF FLU CAN INCLUDE BACTERIAL PNEUMONIA (PARTICULARLY FOR OLDER AND IMMUNOCOMPROMISED INDIVIDUALS), EAR INFECTIONS, SINUS INFECTIONS, DEHYDRATION, AND WORSENING OF CHRONIC MEDICAL CONDITIONS, SUCH AS CONGESTIVE HEART FAILURE, ASTHMA, OR DIABETES. CLINICAL SYMPTOMS INCLUDE FEVER, COUGH, SORE THROAT, CHILLS, MUSCLE AND BODY ACHES, RUNNY OR STUFFY NOSE, AND CONGESTION. SOME FACTS ABOUT ACUTE RESPIRATORY INFECTIONS AND PNEUMONIA: - ACUTE RESPIRATORY INFECTIONS, INCLUDING PNEUMONIA AND INFLUENZA, ARE THE 8TH LEADING CAUSE OF DEATH IN THE UNITED STATES, ACCOUNTING FOR 56,000 DEATHS ANNUALLY. - ON AVERAGE, INFLUENZA LEADS TO MORE THAN 200,000 HOSPITALIZATIONS AND 36,000 DEATHS EACH YEAR. - THE 2009 H1N1 INFLUENZA PANDEMIC CAUSED AN ESTIMATED 270,000 HOSPITALIZATIONS AND 12,270 DEATHS (1,270 OF WHICH WERE OF PEOPLE YOUNGER THAN AGE 18) BETWEEN APRIL 2009 AND MARCH 2010. THE POPULATIONS AT HIGHER RISK FOR COMPLICATIONS DUE TO ACUTE RESPIRATORY INFECTIONS AND PNEUMONIA: - CHILDREN YOUNGER THAN 5, BUT ESPECIALLY CHILDREN YOUNGER THAN 2 YEARS OLD. - ADULTS 65 YEARS OF AGE AND OLDER. - PREGNANT WOMEN. - ALSO, AMERICAN INDIANS AND ALASKAN NATIVES SEEM TO BE AT HIGHER RISK OF FLU COMPLICATIONS. FLU/PNEUMONIA-ASSOCIATED COSTS: PNEUMONIA AND THE FLU COST $6 BILLION IN DIRECT MEDICAL CARE AND ANOTHER $34.2 BILLION IN PROJECTED LOST EARNINGS IN 2007, ACCORDING TO THE AMERICAN LUNG ASSOCIATION. THIS REPRESENTED AN INCREASE OF NEARLY 50 PERCENT FROM 2003, THE PREVIOUSLY REPORTED YEAR. HEALTH DISPARITIES IN INFLUENZA: HISPANIC CHILDREN YOUNGER THAN 18 YEARS OF AGE ACCOUNT FOR 27% OF 210 REPORTED 2009 H1N1 INFLUENZA- ASSOCIATED DEATHS IN THE UNITED STATES. THEIR REPRESENTATION IN THE US POPULATION IS 21%. ASTHMA ASTHMA IS A CHRONIC BREATHING CONDITION DUE TO INFLAMMATION OF THE AIR PASSAGES IN THE LUNGS. ASTHMA AFFECTS THE SENSITIVITY OF THE NERVE ENDINGS IN THE AIRWAYS CAUSING THEM TO BECOME EASILY IRRITATED. DURING AN ASTHMA ATTACK, THE LINING OF THESE PASSAGES SWELL CAUSING THE AIRWAYS TO NARROW THEREBY REDUCING THE FLOW OF AIR IN AND OUT OF THE LUNGS. ASTHMA ATTACKS CAN RANGE IN SEVERITY FROM MILD TO LIFE-THREATENING. CLINICAL SYMPTOMS INCLUDE COUGHING, SHORTNESS OF BREATH, WHEEZING, AND TIGHTNESS OR PAIN IN THE CHEST. IN 2009, 12.3% OF SAN DIEGO COUNTY RESIDENTS REPORTED EVER BEING DIAGNOSED WITH ASTHMA. THE COUNTY AGE-ADJUSTED ASTHMA RATES DECREASED SLIGHTLY BETWEEN 2001 AND 2004, BEFORE INCREASING AGAIN IN 2005. IT THEN DECREASED AGAIN IN 2006 AND HIT A NEW LOW IN 20
FORM 990, PART III, LINE 4A (CONTINUED) TRIGGERS OF ASTHMA ATTACKS INCLUDE: - ALLERGENS (LIKE POLLEN, MOLD, ANIMAL DANDER, AND DUST MITES) - EXERCISE - OCCUPATIONAL HAZARDS - TOBACCO SMOKE - AIR POLLUTION - AIRWAY INFECTIONS SOME RISK FACTORS FOR DEVELOPING ASTHMA INCLUDE: - DEMOGRAPHIC VARIABLES SUCH AS GENDER, AGE, RACE/ETHNICITY - EDUCATIONAL LEVEL - INCOME LEVEL - SMOKING - OBESITY ASTHMA-ASSOCIATED COSTS: IN 2009, IT WAS ESTIMATED THAT ASTHMA RELATED COSTS EXCEEDED $56 BILLION DOLLARS PER YEAR. THE AVERAGE YEARLY COST OF CARE FOR A CHILD WITH ASTHMA WAS $1,039 IN 2009. ASTHMA PREVALENCE: U.S. AGE-ADJUSTED PREVALENCE RATES FOR CURRENT DIAGNOSED ASTHMA FOR THE YEAR OF 2010 WERE 8.6%, AS COMPARED TO A RATE OF 7.3% IN 2001. THE STATE OF CALIFORNIA REPORTED A RATE OF 7.7% FOR ADULTS AND 5.9% FOR CHILDREN FOR THE YEAR OF 2010. DURING FISCAL YEAR 2014, SCRIPPS ENGAGED IN THE FOLLOWING RESPIRATORY DISEASE PREVENTION AND TREATMENT ACTIVITIES. HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 33 PARTICIPANTS INCLUDED IN THE STAY QUIT STUDY, A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. A TOTAL OF 821 PEOPLE HAVE BEEN SCREENED FOR THE STUDY. THE SMOKING CESSATION PILOT AND EXPANDED STUDY ARE RESPIRATORY DISEASE PREVENTION PROGRAMS AND RESPIRATORY THERAPISTS ARE CENTRAL TO THE PILOT, AS WELL AS TO THE LARGER NIH STUDY. MANY OF THE HOSPITALIZED SMOKERS ARE ADMITTED FOR PULMONARY AND RESPIRATORY DISEASES LINKED TO SMOKING. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA) FOSTERING VOLUNTEERISM SCRIPPS BELIEVES THAT HEALTH IMPROVEMENT BEGINS WHEN PEOPLE TAKE AN ACTIVE ROLE IN MAKING A POSITIVE IMPACT ON THEIR COMMUNITY. FOR THIS REASON, SCRIPPS SUPPORTS VOLUNTEER PROGRAMS FOR SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS WHO WANT TO MAKE AN EVEN LARGER IMPACT ON THEIR COMMUNITY. THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER CLUB IS ONE WAY SCRIPPS MATCHES THE TALENTS AND INTERESTS OF EMPLOYEES AND PHYSICIANS WITH COMMUNITY NEEDS, SUCH AS MENTORING PARTNERSHIPS WITH LOCAL SCHOOLS AND PROVIDING FREE MEDICAL AND SURGICAL CARE FOR PATIENTS IN NEED. IN ADDITION TO THE FINANCIAL COMMUNITY BENEFIT CONTRIBUTIONS MADE DURING FISCAL YEAR 2014, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS DONATED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS-SPONSORED COMMUNITY BENEFIT PROGRAMS. WITH CLOSE TO 7,529 HOURS, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $347,984.40, WHICH IS NOT INCLUDED IN THE SCRIPPS FISCAL YEAR 2014 COMMUNITY BENEFIT PROGRAMS AND SERVICES TOTALS. PROFESSIONAL EDUCATION & HEALTH RESEARCH QUALITY HEALTH CARE IS HIGHLY DEPENDENT UPON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS, OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WILL BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH BY DEVELOPING NEW AND INNOVATIVE TREATMENTS. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH, MEDICAL EDUCATION AND HEALTH PROFESSIONAL EDUCATION. DURING FISCAL YEAR 2014 (OCTOBER 2013 TO SEPTEMBER 2014), SCRIPPS INVESTED $36,258,006 IN PROFESSIONAL TRAINING PROGRAMS AND CLINICAL RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES IN SAN DIEGO COUNTY. THIS SECTION HIGHLIGHTS SOME OF OUR PROFESSIONAL EDUCATION AND HEALTH RESEARCH ACTIVITIES. HEALTH PROFESSIONS TRAINING: INTERNSHIPS SCRIPPS' COMMITMENT TO ONGOING LEARNING AND HEALTH CARE EXCELLENCE EXTENDS BEYOND OUR ORGANIZATION. OUR INTERNSHIP PROGRAMS HELP PROMOTE HEALTH CARE CAREERS TO A NEW GENERATION, SHAPE THE FUTURE WORKFORCE AND DEVELOP FUTURE LEADERS IN OUR COMMUNITY. INTERACTING WITH HEALTH CARE PROFESSIONALS IN THE FIELD EXPANDS EDUCATION OUTSIDE THE CLASSROOM. SCRIPPS STAFF PLAY AN IMPORTANT ROLE AS PRECEPTORS BY INVESTING THEIR TIME TO CREATE A VALUABLE EXPERIENCE FOR THE COMMUNITY. IN FISCAL YEAR 2014, SCRIPPS HOSTED 2,321 INTERNS WITHIN OUR SYSTEM AND PROVIDED 399,107 DEVELOPMENT HOURS SPANNING NURSING AND ANCILLARY SETTINGS. COLLEGE AND UNIVERSITY AFFILIATIONS SCRIPPS COLLABORATES WITH LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO HELP STUDENTS EXPLORE HEALTH CARE ROLES AND GAIN FIRSTHAND EXPERIENCE AS THEY WORK WITH SCRIPPS PROFESSIONALS. SCRIPPS IS AFFILIATED WITH MORE THAN 90 SCHOOLS AND PROGRAMS, INCLUDING CLINICAL AND NONCLINICAL PARTNERSHIPS. LOCAL SCHOOLS INCLUDE, BUT ARE NOT LIMITED TO, POINT LOMA NAZARENE UNIVERSITY (PLNU), UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD), CALIFORNIA STATE UNIVERSITY SAN MARCOS (CSU.S.M), SAN DIEGO STATE UNIVERSITY (SDSU), UNIVERSITY OF SAN DIEGO (U.S.D), MESA COLLEGE, SAN DIEGO CITY COLLEGE, GROSSMONT COLLEGE AND MIRA COSTA COLLEGE. SCRIPPS IS REGULARLY ACCEPTING NEW PARTNERSHIPS, BASED ON COMMUNITY AND WORKFORCE NEEDS, AND ESTABLISHED AN AFFILIATION AGREEMENT COMMITTEE TO REVIEW ALL REQUESTS AND PROVIDE A SYSTEM WIDE APPROACH TO SECURING NEW STUDENT PLACEMENTS. THIS INTERDISCIPLINARY COMMITTEE REPRESENTS EDUCATION AND DEPARTMENT LEADERSHIP ACROSS THE SCRIPPS SYSTEM, ENSURING A PROACTIVE APPROACH TO BUILDING A CAREER PIPELINE FOR TOP TALENT. RESEARCH STUDENTS SCRIPPS SUPPORTS GRADUATE RESEARCH FOR MASTERS AND DOCTORAL STUDENTS AT UNIVERSITIES WITH AFFILIATION AGREEMENTS. SCRIPPS CENTER FOR LEARNING & INNOVATION OVERSEES THE STUDENT PLACEMENT PROCESS. NON-PHYSICIAN STUDENTS WHO CONDUCT RESEARCH AT SCRIPPS REPRESENT A VARIETY OF HEALTH CARE DISCIPLINES, INCLUDING PUBLIC HEALTH, PHYSICAL THERAPY, PHARMACY AND NURSING. IN FISCAL YEAR 2014, SCRIPPS RESEARCH INCLUDED STUDENTS FROM U.S.D, WESTERN GOVERNORS, SDSU, PLNU AND POSTDOCTORAL PHARMACY RESIDENCY PROGRAMS, INCLUDING THE PGY1 PHARMACY RESIDENCY PROGRAM. COLLEGE COLLABORATIONS SCRIPPS PARTNERED WITH PLNU TO CREATE HEALTH CARE FOCUS COURSES, INCLUDING HEALTH CARE FINANCE AND HEALTH CARE OPERATIONS. PLNU STUDENTS (NON-SCRIPPS EMPLOYEES) MAY ELECT TO TAKE THESE COURSES TOWARDS THEIR MBA. HIGH SCHOOL PROGRAMS SCRIPPS IS DEDICATED TO PROMOTING HEALTH CARE AS A REWARDING CAREER, COLLABORATING WITH A NUMBER OF HIGH SCHOOLS TO OFFER STUDENTS OPPORTUNITIES TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRSTHAND EXPERIENCE WORKING WITH SCRIPPS HEALTH CARE PROFESSIONALS. HERE IS A SUMMARY OF THE HIGH SCHOOL PROGRAMS SCRIPPS MADE AVAILABLE TO THE COMMUNITY. SCRIPPS HIGH SCHOOL EXPLORATION PROGRAM AND HEALTH AND SCIENCE PIPELINE INITIATIVE (HASPI) THIS PROGRAM REACHES OUT TO SAN DIEGO HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING A CAREER IN HEALTH CARE. IN FISCAL YEAR 2014, SCRIPPS HIRED 27 STUDENTS TO PARTICIPATE IN THE PROGRAM. DURING THEIR PAID FIVE-WEEK ROTATION, THE STUDENTS WORK IN DIFFERENT DEPARTMENTS, EXPLORING CAREER OPTIONS AND LEARNING VALUABLE LIFE LESSONS ABOUT HEALTH AND HEALING.
FORM 990, PART III, LINE 4A (CONTINUED) UC HIGH SCHOOL COLLABORATION UC HIGH SCHOOL AND SCRIPPS PARTNERED TO PROVIDE A REAL-LIFE CONTEXT TO THE SCHOOL'S HEALTH CARE ESSENTIALS COURSE. FOR FISCAL YEAR 2014, TEN STUDENTS WERE SELECTED TO ROTATE THROUGH THREE DIFFERENT SCRIPPS LOCATIONS, DURING THE SPRING SEMESTER, TO INCREASE THEIR AWARENESS OF HEALTH CARE CAREERS. UC HIGH STUDENTS VISITED SCRIPPS MERCY SAN DIEGO, SCRIPPS MEMORIAL HOSPITAL LA JOLLA AND GREEN. THE STUDENTS WERE ABLE TO VIEW SURGERIES AND SHADOWING HEALTHCARE PROFESSIONALS IN THE EMERGENCY DEPARTMENT, CARDIOLOGY, FOOD SERVICES, PHYSICAL THERAPY AND TRAUMA. YOUNG LEADERS IN HEALTH CARE AN OUTREACH PROGRAM AT SCRIPPS HOSPITAL ENCINITAS, YOUNG LEADERS IN HEALTH CARE TARGETS LOCAL HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING HEALTH CARE CAREERS. STUDENT'S GRADES 9-12 PARTICIPATE IN THE PROGRAM, WHICH PROVIDES A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS CAREER OPPORTUNITIES. THIS COMBINED EXPERIENCE INCLUDES WEEKLY MEETINGS AT LOCAL SCHOOLS FACILITATED BY TEACHERS AND ADVISORS, AS WELL AS MONTHLY MEETINGS AT SCRIPPS HOSPITAL ENCINITAS. THE PROGRAM MENTORS STUDENTS ON LEADERSHIP AND PROVIDES TOOLS FOR DAILY LIFE CHALLENGES. YOUNG LEADERS IN HEALTH CARE ALSO INCLUDES A SERVICE PROJECT TO MEET HIGH SCHOOL REQUIREMENTS AND MAKE A POSITIVE IMPACT ON THE COMMUNITY. THE PROGRAM CLOSES THE YEAR WITH A PRESENTATION ALIGNED WITH THE YEARLY FOCUS. MORE THAN 100 STUDENTS, COMMUNITY MEMBERS AND HEALTH CARE SPECIALISTS ATTENDED THE YOUNG LEADER IN HEALTH CARE FINAL MEETING, CULMINATING WITH STUDENT PRESENTATIONS ON SPORTS INJURIES AND PREVENTION. WORKABILITY SCRIPPS PARTNERS WITH THE SAN DIEGUITO ACADEMY WORKABILITY PROGRAM, WHICH EDUCATES STUDENTS AND THE COMMUNITY ON HEALTH CARE CAREER OPPORTUNITIES. SCRIPPS PROVIDES FIRST HAND TOURS OF HOSPITAL FACILITIES AND EDUCATES PARTICIPANTS ABOUT THE COMPLEXITIES OF HOSPITAL OPERATIONS. THE PROGRAM IS DESIGNED TO PROVIDE PRE-EMPLOYMENT SKILLS DEVELOPMENT, WORKSITE TRAINING AND FOLLOW-UP SERVICES FOR YOUTH (AGES 12-22) WITH SPECIAL NEEDS WHO ARE MAKING THE TRANSITION FROM SCHOOL TO WORK. WHILE STUDENTS GET CLASSROOM TRAINING, SCRIPPS PARTNERS WITH THE PROGRAM TO PROVIDE ONSITE CAREER TRAINING. IN FISCAL YEAR 2014, TWO STUDENTS PARTICIPATED IN THE PROGRAM AT SCRIPPS GREEN HOSPITAL AND SCRIPPS MEMORIAL HOSPITAL ENCINITAS. NEW GRADUATE RESIDENCY PROGRAM DESIGNED FOR THE NEWLY GRADUATED REGISTERED NURSE (RN), THIS INNOVATIVE PROGRAM IMPROVES PATIENT CARE QUALITY AND SAFETY DURING THE FIRST YEAR ON THE JOB. BY TRAINING NEW NURSES AND BUILDING CONFIDENCE AT THE BEDSIDE, THE PROGRAM HELPS MAKE THE INITIAL YEAR OF A NURSE'S CAREER A LAUNCH PAD TO SUCCESS.
FORM 990, PART VI, LINE 11 990 REVIEW PROCESS WITH GOVERNING BODY THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS.
FORM 990, PART VI, LINE 12C COMPLIANCE POLICY MONITORING WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT IS REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING.
FORM 990, PART VI, LINE 15A & 15B OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN SAN DIEGO, CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: - FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. - SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. - TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. - THE BOARD SELECTS THE 65TH PERCENTILE FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). - ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON MARCH 28, 2014. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES.
FORM 990, PART VI, LINE 16 JOINT VENTURES SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS.
FORM 990, PART VI, LINE 19 AVAILABILITY OF DOCUMENTS TO THE GENERAL PUBLIC FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS CHANGE IN DEFERRED GIFTS 100,008 OTHER CHANGES IN NET ASSETS 3,891,012 JOINT VENTURE DISTRIBUTION 2,570,900 ----------- TOTAL 6,561,920
FORM 990 PART IX LINE 11G DESCRIPTION:PHYS FEES-PROVIDER SVS AGRMNT TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASE SVS - NON MED TOTAL FEES:55209834
FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:53129097
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:25638115
FORM 990 PART IX LINE 11G DESCRIPTION:ALL OTHER FEES FOR SERVICES TOTAL FEES:25192535
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:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
SCRIPPS HEALTH
 
Employer identification number

95-1684089
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (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) Scripps Cardio&Thoracic Surgery Billing
4275 Campus Point Court
San Diego,CA92121
27-0620996
HLTHCR ADMIN CA 5,648,772 0 SCRIPPS
 
(2) Scripps Hospital Billing Services LLC
4275 Campus Point Court
San Diego,CA92121
61-1677183
HLTHCR ADMIN CA 3,064,386 0 SCRIPPS
 
(3) Scripps Clinic Billing LLC
4275 Campus Point Court
San Diego,CA92121
87-0737749
HLTHCR ADMIN CA 335,190,002 0 SCRIPPS
 
(4) Scripps Mercy Billing LLC
4275 Campus Point Court
San Diego,CA92121
87-0737748
HLTHCR ADMIN CA 45,483,191 0 SCRIPPS
 




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?
Yes No
(1) Maxwell H & Muriel Gluck Child Care Ctr

10660 John J Hopkins Dr

San Diego,CA92121
35-0504809
Childcare CA 501(c)(3) 2 Scripps
 
Yes
 
(2) Mercy Hospital Foundation

4275 Campus Point Court

San Diego,CA92121
94-2958094
Fundraising CA 501(c)(3) 11, I Scripps
 
Yes
 
(3) Scripps Fdn for Medicine & Science

4275 Campus Point Court

San Diego,CA92121
33-0435949
Research CA 501(c)(3) 11, III FI Scripps
 
Yes
 
(4) Scripps Health Plan Services (SHPS)

4275 Campus Point Court

San Diego,CA92121
33-0782099
HEALTHCARE SV CA 501(c)(3) 11, I Scripps
 
Yes
 
(5) Horizon Hospice

4275 Campus Point Court

San Diego,CA92121
33-0220777
Hospice Care CA 501(c)(3) 9 Scripps
 
Yes
 




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
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


Yes No Yes No
(1) Scripps Encinitas Surgery Center LLC

15305 Dallas Pkwy Ste 1600 LB 28
Addison,TX75001
20-5942958
AMBUL SURGERY CA Scripps Health
 
Related 1,353,431 160,207   No 0   No 55.500 %
(2) ScrippsUSP Surgery Center LLC

15305 Dallas Pkwy Ste 1600 LB 28
Addison,TX75001
20-5942911
AMBUL SURGERY CA NA
 
Related 472,258 1,080,730   No 0   No 50.000 %
(3) Scripps Mercy Ambulatory Surgery Center

4275 Campus Point Court
San Diego,CA92121
45-0503246
AMBUL SURGERY CA Scripps Health
 
Related 1,151,124 3,273,680   No 0 Yes   73.500 %
(4) Scripps IDN Management LLC

4275 Campus Point Court
San Diego,CA92121
45-4557426
HEALTHCARE SV CA NA
 
Related -6,613 16,126   No 0   No 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?
Yes No
(1) SC Physicians Organization Inc

4275 Campus Point Court
San Diego,CA92121
33-0796247
Holding Company DE Scripps Health
 
C Corp -800 0 100.000 % Yes  
(2) Scripps Health & Healing Center

4275 Campus Point Court
San Diego,CA92121
20-5156965
Patient Education CA Scripps Health
 
C Corp 0 0 100.000 % Yes  
(3) ScrippsCare

4275 Campus Point Court
San Diego,CA92121
45-2870638
Healthcare Svcs CA Scripps Health
 
C Corp -15,166 5,000 100.000 % Yes  
(4) Scripps Clinical Science Center

4275 Campus Point Court
San Diego,CA92121
26-4479543
Research CA Scripps Health
 
C Corp 0 0 100.000 % Yes  
(5) Charitable Remainder Trust (60)

4275 Campus Point Court
San Diego,CA92121
Hospital Support CA NA
 
Trust          
(6) Charitable Lead Trust (2)

4275 Campus Point Court
San Diego,CA92121
45-2870638
Hospital Support CA NA
 
Trust          
(7) Scripps Health Plan Services Inc

4275 Campus Point Court
San Diego,CA92121
33-0782099
Hlthcare Svc Plan CA NA
 
C CORP -462,074 56,847,085 100.000 % Yes  
Schedule R (Form 990) 2013
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Scripps Health Plan Services (SHPS)

l 88,021,718 Accrual
(2) Scripps Health Plan Services (SHPS)

p 19,297,479 Accrual
(3) Scripps Encinitas Surgery Center LLC

a(iv) 362,123 Accrual
(4) Scripps Mercy Ambulatory Surgery Center

a(iv) 564,185 Accrual
(5) Horizon Hospice

q 13,901,015 Accrual

Schedule R (Form 990) 2013
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2013
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
RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIPS SCHEDULE R, PART III SCRIPPS MERCY AMBULATORY SURGERY CENTER, LLC EIN: 45-0503246 ADDRESS: 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121 SCRIPPS ENCINITAS SURGERY CENTER, LLC EIN: 20-5942958 ADDRESS: 15305 DALLAS PKWY, STE 1600, LB 28, ADDISON, TX 75001 SCRIPPS/USP SURGERY CENTERS, LLC EIN: 20-5942911 ADDRESS: 15305 DALLAS PKWY, STE 1600, LB 28, ADDISON, TX 75001 SCRIPPS IDN MANAGEMENT, LLC EIN: 45-4557426 ADDRESS: 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121
Schedule R (Form 990) 2013
Additional Data


Software ID:  
Software Version: